Purpose: Motor-level transcutaneous electrical nerve stimulation (TENS) provides greater analgesic effects than sensory-level TENS. However, it may also cause muscle fatigue and psychological discomfort. To mitigate these issues, the concept of intermittent duty cycle (ON/OFF time) in motor-level TENS was proposed. This study investigated the relationship between different ON/OFF time ratios in motor-level TENS and its analgesic effects.

Methods: Twenty healthy volunteers participated in five experimental conditions over 5 days: 1) conventional motor-level TENS without ON/OFF time, (2–4) motor-level TENS with ON/OFF time ratios of 1:1, 1:2, or 2:1, and (5) a control condition without motor-level TENS. All motor-level TENS interventions were applied to the left tibialis anterior muscle for 30 min, with intensity adjustments made at 10 and 20 min to counteract muscle contraction weakening due to fatigue. Pain thresholds were measured at baseline and at 3, 10, 20, and 30 min after the of motor-level TENS onset. Psychological anxiety was assessed using the state-trait anxiety inventory (STAI), while muscle fatigue was evaluated by changes in the current intensity required to maintain muscle contraction during motor-level TENS.

Results: Significant increases in pain threshold were observed with both conventional motor-level TENS and all motor-level TENS with ON/OFF time ratios compared to the control. No significant differences were found in STAI scores across conditions. Notably, all motor-level TENS interventions with ON/OFF time ratios required significantly lower current intensity compared to conventional motor-level TENS.

Conclusion: This study suggests that motor-level TENS maintains its analgesic effects even with the inclusion of ON/OFF time. Additionally, motor-level TENS with ON/OFF time may be recommended over conventional motor-level TENS.

Objective: This study aimed to examine the association between length of stay (LOS) and pain in patients with osteoporosis-related fractures (ORF) admitted to a convalescent rehabilitation ward using structural equation modeling (SEM).

Methods: This retrospective observational study included 114 patients with ORF admitted to our convalescent rehabilitation ward between April 2020 and March 2023. We evaluated basic information, physical function, activity levels, pain intensity, number of pain sites, pain catastrophizing, and central sensitization-related symptoms. The associations with LOS were analyzed using SEM.

Results: SEM analysis revealed that discharge pain showed a significant direct association with LOS (standardized coefficient = 0.56), while pain-related factors demonstrated an indirect association through pain (standardized coefficient = 0.64). Basic information showed a significant direct association with LOS (standardized coefficient = 0.61), but physical function/activity did not show a significant direct association (standardized coefficient = 0.11).

Conclusion: In ORF patients admitted to convalescent rehabilitation wards, a significant association was observed between LOS and discharge pain, while psychosocial factors such as pain catastrophizing and central sensitization were indirectly associated with LOS through pain. The findings suggest the importance of comprehensive pain management for optimizing LOS.

Objective: To identify factors associated with walking ability within six months after stroke in subacute patients undergoing gait training with Knee-Ankle-Foot Orthoses (KAFO).

Methods: This retrospective study included 103 stroke patients. Data collected at the time of admission to the rehabilitation ward included age, sex, BMI, stroke type, affected hemisphere, days from onset, Japan Coma Scale (JCS) score, 12-level hemiplegia recovery grade, severity of sensory impairment, Range Of Motion (ROM) of the affected ankle joint, Manual Muscle Testing (MMT) for knee extension on the unaffected side, Functional Independence Measure (FIM) motor and cognitive scores, Unilateral Spatial Neglect (USN), aphasia and the average daily physical therapy dose (PT dose). Patients were categorized into two groups: the ambulatory group and the assisted ambulatory group. Comparisons between the two groups were conducted, and multiple logistic regression analysis was performed with walking ability within 6 months after onset as the dependent variable. Significant factors and their cutoff values were determined.

Results: The ambulatory group consisted of 50 patients, and the assisted ambulatory group consisted of 53 patients. Significant differences were observed in age, days from onset, JCS, 12-level hemiplegia recovery grade, MMT, FIM, USN and PT dose between the two groups. Furthermore, age, FIM motor score, and days from onset were identified as significant predictors of walking prognosis. The cutoff values were 70 years for age, 24 points for the FIM motor score, and 27 days for time since onset.

Conclusion: In subacute patients undergoing gait training with KAFO, age, FIM motor score, and the number of days from stroke onset to rehabilitation ward admission were associated with walking ability within six months after stroke.

Objective: Bendopnea is a symptom characterized by dyspnea during forward bending and is considered a typical sign of congestion. However, the relationship between Bendopnea and physical function remains unclear. The aim of this study was to clarify the association between Bendopnea on discharge and physical function in patients hospitalized for heart failure.

Methods: The study included 193 patients (mean age 82.8 ± 9.0 years; 41.5% male) hospitalized with heart failure. Bendopnea was assessed at discharge. Physical function was evaluated using the Short Physical Performance Battery (SPPB) and comfortable gait speed. Multiple regression analysis was performed to examine the association between Bendopnea and physical function.

Results: Multiple regression analysis showed that Bendopnea at discharge was significantly associated with SPPB scores (B = –1.50, 95% CI: –2.62 to –0.38, p < 0.01) and comfortable gait speed (B = –0.16, 95% CI: –0.26 to –0.06, p < 0.01).

Conclusion: Bendopnea at discharge was independently associated with impaired physical function in older patients with heart failure. These findings suggest a close association between Bendopnea and the pathophysiology of heart failure, indicating that it may be a useful clinical indicator in physical function assessment.

Purpose: This study aimed to investigate the effects of adding visual or auditory sensory information to motor imagery on spinal motor neuron excitability and finger dexterity.

Methods: Fifteen healthy adults (8 males, 7 females; mean age: 21 years) participated. F-waves were first recorded at rest. Subsequently, a pinch task requiring participants to adjust their exerted force to 50% of maximal voluntary contraction (MVC) as accurately and rapidly as possible was administered to evaluate finger dexterity, with adjustment time used as the primary index. Participants then performed motor imagery with either visual or auditory cues, during which F-waves were again measured. Following imagery, the pinch task was repeated for post-intervention assessment.

Results: Both conditions showed increased F-wave persistence and improved task completion times, though no significant differences were found between visual and auditory conditions. No significant differences were observed in imagery vividness scores or F/M amplitude ratios across conditions.

Conclusion: Motor imagery with sensory augmentation may enhance spinal motor neuron excitability and finger dexterity. Although no superiority was observed between visual and auditory input, the findings suggest that both modalities can facilitate neuromotor function. Notably, in clinical settings where visual information is difficult to implement due to environmental or attentional limitations, auditory cues may serve as a viable and practical alternative.

Purpose: This exploratory study aimed to investigate the relationship between trunk lateral flexion during batting in baseball players, which has been implicated in lumbar injuries, and vertical jump performance as a global motor function indicator, in order to contribute to the prevention of lumbar injuries in baseball players.

Methods: Twenty-eight healthy male junior high school baseball players were included. Vertical jump height was measured using a digital device, and trials not meeting measurement conditions were considered unsuccessful. Trunk lateral flexion angles during batting were measured using motion analysis software. Correlations between jump height and trunk lateral flexion angle during batting were examined. In addition, comparisons of trunk lateral flexion angle and jump height were made between successful jump group and unsuccessful jump group, as well as between players with and without a history of low back pain.

Results: Lumbar and thoracic spine lateral flexion angle showed a significant negative correlation with jump height (p < 0.01). The successful jump group exhibited significantly smaller lumbar and thoracic spine lateral flexion angles and greater jump heights than the unsuccessful jump group (p < 0.05). Players with a history of low back pain demonstrated significantly greater lumbar lateral flexion angles and lower jump heights compared with those without such a history (p < 0.05).

Conclusion: The findings of this exploratory study suggest a possible partial association between trunk lateral flexion during batting and vertical jump performance. However, further research is required to clarify the causal relationship between the two movements and to determine their potential utility in sports settings.

Purpose: Falls are a common complication in patients with Parkinson’s disease (PD), frequently resulting in injury, fracture, and reduced quality of life. This study aimed to identify factors associated with a high frequency of falls and to inform clinical decision-making in PD rehabilitation.

Methods: The study included 98 ambulatory inpatients with PD. They were divided into two groups according to whether they had experienced two or more falls in the month before admission. Demographics, clinical characteristics, and motor function during the on state were compared between groups. Factors associated with frequent falls were examined using multivariate logistic regression analysis, and cut-off values for significant predictors were determined from receiver operating characteristic curves.

Results: Independent predictors of frequent falls were disease duration (odds ratio 1.16, p < 0.01) and Berg Balance Scale (BBS) score (odds ratio 0.92, p < 0.05). The cut-off values were 15 years for disease duration (sensitivity 45.0%, specificity 93.6%) and 53 points for BBS (sensitivity 90.0%, specificity 43.6%), both showing adequate ability to discriminate patients at high risk of frequent falls.

Conclusion: Disease duration and BBS are useful screening indicators for frequent falls in patients with PD. BBS should be emphasized as a key clinical evaluation index from the early stages of PD. Early interventions to maintain or improve balance function are essential to reduce fall risk.

Objective: We investigated whether there was a difference in improvements in physical function and activities of daily living between a group that received custom made Knee-ankle-foot orthosis for acute-phase stroke patients with severe hemiplegia and a group that received intervention using standard Knee-ankle-foot orthosis.

Subjects and Methods: Thirty-seven patients were admitted to the hospital, 16 patients (10 males, 6 females, age: 66.5 ± 10.27 years old) in the orthotic group and 21 patients (12 males, 9 females, age: 72.90 ± 10.59 years old) in the non orthotic group, who used the long leg orthosis provided by the hospital. The group was defined as follows. Br. stage, BBS, FMS, FAC, and FIM were evaluated at admission and at discharge and compared. ANCOVA was performed for discharge FIM, adjusting for admission FIM, age, and stroke subtype. Immobility-related complications during hospitalization were also investigated.

Results: The orthotic group had significantly higher BBS, total FIM, FIM cognitive, FIM eating, and FIM transfer scores. However, ANCOVA showed no significant difference in total FIM at discharge. There was also no difference in immobility-related complications.

Conclusion: Although the orthotic group showed better outcomes in unadjusted analyses, these differences were not significant after adjustment for background factors.

Purpose: The joint movements during stance leg and the displacement of the center of pressure (COP) in the gait initiation and stepping were compared.

Methods: Thirteen healthy men were asked to perform gait initiation and stepping with defined stride length and cadence, and the joint movements during stance leg were calculated using three-dimensional motion analysis. Additionally, a force platform was used to measure COP displacement.

Results: Hip adduction and lateral tilt of shank during stance leg were significantly greater in the stepping. Ankle dorsiflexion was significantly smaller in the stepping. The backward, forward, and lateral displacement during COP movement was significantly smaller in the stepping.

Conclusion: The stepping is a movement strategy that induces a change in alignment, specifically a lateral tilt of shank during stance leg. On the other hand, during the gait initiation that requires forward propulsion, the movement strategy may involve significantly shifting COP toward the swing side to prevent excessive lateral tilt of shank during stance leg. Since braking is required in the stepping, it is possible that the COP may have been prevented from moving too far forword by the right knee joint extension and backward tilt of the trunk instead of forward tilt of shank with ankle dorsiflexion.

Objective: Delayed return to sports is sometimes observed after meniscal repair; however, the factors contributing to this delay remain unclear. This study aimed to identify factors associated with delayed return to sports after lateral meniscus (LM) repair.

Methods: This study included 33 patients (33 knees) who underwent LM repair using the inside-out technique and were followed for at least 6 months postoperatively. Patients were divided into two groups: those who returned to sports within 6 months (Group G) and those who returned after 7 months (Group P). Patient characteristics and postoperative functional outcomes were compared between the groups. An unpaired t-test was used for group comparisons.

Results: Compared with Group G, Group P demonstrated significantly reduced knee extension range of motion at 1 and 2 months postoperatively, as well as lower knee extension muscle strength at 3 months postoperatively.

Discussion: Early recovery of knee extension range of motion and knee extensor muscle strength may be important factors influencing the timing of return to sports after LM repair.