Background: The purpose of this study was to investigate the relationship between isometric leg press (LP) and knee extension (KE) muscle strength and the degree of walking independence in stroke patients, and to obtain assistance in the evaluation of lower limb muscle strength in patients with severe hemiplegia.

Methods: Fifty-one patients with first-episode stroke patients admitted to our hospital who were able to perform LP and KE measurements, excluding those with higher brain dysfunction such as hemi spatial neglect and aphasia, and those who had difficulty understanding the content of the test measurements. The muscle strength was measured using a traction manual muscle tester, and the leg extension muscle strength was measured in a sitting position with the patient sitting deeply in a chair with a backrest. At the time of measurement, the lower limb was raised on the seat of the chair placed in front of the patient, and with the knee joint flexed at 30 degrees. KE was measured using the belt fixation method. Gait independence was assessed using the Functional Ambulation Category (FAC). An examination of the relationship between LP and KE and a partial correlation analysis between FAC and each muscle strength value with paralysis severity as a control variable were also performed.

Results: We found a high positive correlation between LP and KE and a moderate positive correlation between LP and KE on the paralyzed side and FAC. The partial correlation analysis also showed significant positive correlations.

Conclusion: LP in stroke patients was found to reflect walking independence as much as KE.

Purpose: To retrospectively investigate the prevalence of frailty in older patients admitted to an emergency and critical care center and treated with physical therapy interventions and mobilization and outcome status of older patients with frailty.

Method: The participants were patients aged 65 years or older who entered the emergency and critical care center of our hospital from April, 2016 to January, 2019 and underwent physical therapy. Institutionalized and deceased patients were excluded. Subsequently, we defined frailty as the condition with Clinical Frailty Scale score of 5 or higher, classified patients into the frailty and non-frailty groups, and compared their clinical characteristics.

Result: The frailty and non-frailty groups consisted of 36 (23%) and 123 patients, respectively. The frailty group was significantly older and had a higher rate of ventilator use than the non-frailty group. In addition, the proportion of patients who were able to start walking during hospitalization, ICU Mobility Scale at discharge, and rate of patients discharged were significantly lower in the frailty group. However, the results adjusted for sex and age showed no significant association with discharge rates.

Conclusion: Older patients who presented with frailty before admission were unable to begin gait practice during hospitalization, suggesting that they may have decreased mobility at discharge, but this was not associated with the outcome.

Purpose: Factors influencing the improvement of nocturnal pain in patients undergoing conservative treatment for rotator cuff tears of the shoulder were investigated.

Methods: Fifty patients with conservatively treated rotator cuff tears were included in the study. Patient information at the initial visit, plain radiographs, and shoulder range of motion at the start of physical therapy and 3 months after the start of physical therapy were examined. The dependent variable was the presence of nocturnal pain 3 months after the start of physical therapy; covariates were age, sex, disease duration, tear size, and presence of subacromial bursitis; and independent variables were plain radiographs at the initial visit and shoulder range of motion at the start of physical therapy and 3 months later. Factors associated with improvement in nocturnal pain were examined using multiple logistic regression analysis.

Results: External rotation range of motion of the shoulder was selected as a factor associated with improvement in nocturnal pain three months after starting physical therapy.

Conclusion: In patients receiving conservative treatment for rotator cuff tears, improvement in nocturnal pain three months after starting physical therapy was associated with shoulder external rotation range of motion.

Purpose: This study aimed to conduct a survey on postoperative return-to-work (RTW) status and problems related among patients undergoing orthopedic surgery.

Methods: A total of 105 workers who underwent orthopedic surgeries underwent a self-administered survey questionnaire at 6 months after surgery. The questionnaire included questions about patient attributes, RTW status, period for RTW, and problems related to RTW (symptoms or difficulty performing work-related movements when returning to work and reasons for not RTW).

Results: The questionnaire response rate was 63% (66 patients). The rate of RTW was 89% (59 patients). Regarding problems related to RTW, 63% of those who returned to work had symptoms or difficulty performing work-related movements. The most common symptom observed upon RTW was pain (10 patients, 17% of those returning to work). The most common difficulty performing work-related movements was squatting (9 patients, 15% of those returning to work). Five out of 7 respondents indicated that the reasons for not RTW were due to physical problems.

Conclusion: Among the postoperative orthopedic patients, 89% returned to work. However, 63% of those who returned to work had symptoms or difficulty performing work-related movements. More than half of the patients who could not return to work responded that physical problems was the reason behind not returning to work, suggesting the need for considering more effective exercise therapy and guidance focusing on returning to work.

Purpose: The Stroke Treatment Guidelines 2021, Physical Therapy Guidelines (2nd Edition), and existing clinical studies have not adequately elucidated the efficacy of Knee-Ankle-Foot Orthosis (KAFO). This study aims to conduct a Scoping Review to assess the clinical utility of KAFO for patients with stroke.

Methods: Six distinct databases were meticulously harnessed for the purpose of retrieving study reports, spanning until the terminus of March 2022. We included studies that included a description of KAFO for patients with stroke. Furthermore, interventional studies, inclusive of randomized controlled trials, non-randomized controlled trials, and observational inquiries, notably cohort studies and cross-sectional investigations, were subjected to consideration for incorporation.

Results: The obtained findings revealed an assemblage of 873 subjects who availed themselves of KAFO, culminating in the amalgamation of 20 articles. Predominantly, these reports featured data pertaining to the early subacute phase, with a preponderance emphasizing the utilization of KAFO in cases characterized by severe or moderate motor paralysis. Although prospective cohort studies and randomized controlled trials remained conspicuous by their absence, a compendium of five reports substantiated the efficaciousness of KAFO.

Conclusion: Presently, determining the appropriate stage of disease, severity of paralysis, and optimal utilization of KAFO remains challenging. The existing literature lacks conclusive evidence to address these factors.

Objective: This study aimed to investigate the characteristics of shoulder function in patients with non-traumatic rotator cuff tears complicated by superior labrum anterior to posterior (SLAP) lesions.

Methods: The participants were 55 patients with non-traumatic rotator cuff tears who underwent arthroscopic rotator cuff repair and were divided into two groups; with and without SLAP lesions. Patient background, pain, shoulder joint range of motion, Japanese Orthopaedic Association shoulder score, and Shoulder 36 were compared between the two groups based on preoperative assessment.

Results: There were 31 shoulders in the with SLAP lesions group and 24 shoulders in the without SLAP lesions group. The frequency of SLAP lesions was 56%. The with SLAP lesions group had flattened biceps long head tendon, flexion and external rotation angles were significantly higher. There were no significant differences in other shoulder functions between the two groups.

Conclusion: Patients with non-traumatic rotator cuff tears complicated by SLAP lesions are characterized by high flexion and external rotation angles, which may be associated to degeneration of the long head tendon of the biceps brachii.

Objective: To predict upper extremity function at the outcome in cases with intervening Constraint-Induced movement therapy.

Methods: The subjects were 20 patients in the home group and 44 patients in the recovery group who received CI therapy. These Fugl Mayer Assessment upper extremity (FMA) and functional independence measure (FIM) were investigated at the beginning of rehabilitation, at the beginning of CI therapy, and at discharge.

Results: The FMA cut-off value was 47.0 points. Analysis of variance on FMA and FIM showed significant differences, and there was an interaction between outcome and FIM. Multiple regression analysis showed significant differences in outcome and FIM, and an interaction effect.

Conclusion: The FMA score of 47 was extracted as a guideline for discharge home. However, it is necessary to consider ADL as well.

Purpose: The purpose of this study was to identify factors that influence the ability to walk independently at discharge in postoperative patients with femoral proximal fractures admitted to a community comprehensive care unit.

Methods: In order to examine the factors affecting the patients’ ability to walk independently at the time of discharge from the Community Care Unit, multiple logistic regression analysis was used, with the objective variable being the ability to walk independently at the time of discharge and the explanatory variables being the patient’s background information and assessment results obtained at the time of admission. The cut-off value for determining whether the patient could walk independently was calculated using the receiver operating characteristic curve.

Results: The total score of the Mini Mental State Examination (Below, MMSE) and Functional Independence Measure (Below, FIM) motor items at admission was identified as a factor influencing the ability to walk independently at discharge from the community care unit. The cut-off scores for determining whether the patient was able to walk independently at discharge were 21.5 for the MMSE and 49.5 for the FIM motor score.

Conclusion: It was suggested that MMSE and FIM motor scores at admission may be useful in determining whether patients are able to walk independently when they are discharged from the community care unit.

Objective: Extracorporeal shock wave therapy (ESWT) has been shown to be an effective treatment for shoulder joint pain, but its effectiveness may depend on the type of ESWT. However, the effects of different types of ESWT have not been studied. This study was designed to provide a comprehensive overview of the effects of radial ESWT (radial pressure wave therapy: RPT) on pain and joint range of motion (ROM) in patients with shoulder joint pain.

Method: A systematic search of PubMed, The Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar was conducted in June 2023. We systematically searched Google Scholar using the keywords “extracorporeal shockwave therapies” and “Shoulder Pain”. Those included in this study were those comparing RPT with other treatment modalities for shoulder pain.

Result: The study included 23 reports, of which 19 of 23 reported reduced pain in the shoulder joint and 12 of 13 reported increased shoulder joint ROM.

Conclusion: RPT is a non-invasive tool that can improve shoulder joint ROM, shoulder pain, and some studies have shown similar effects to focused ESWT and steroid injections.