This article sets out the classification of stretching techniques as the basic physical therapy approach for the limitation of joint motion. To achieve adequate stretching for muscle shortening, it is necessary to evaluate joint instability, laxity and alignment, and muscle conditions, such as the limit to joint movement imposed by muscle contraction. And in this article, the concept of muscle stretching for lateral hamstring muscles and triceps surae muscles is introduced.

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The technique of joint mobilization is often used clinically, in order to improve the range of mobility. Joint mobilization is a safety technique because it is carried out slowly and power is supplied by controlling body weight. I mention the introduction of the technique of joint mobilization and refer to my experiment.

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Consideration of the way in which body weight is applied is required in almost all movements. For example, when changing body position from the prostrate to the lying on the side position, the weight is shifted as when turning over in bed. And we are not conscious of muscle activity, for example, in physical therapy. And with regard to the application of body weight, we wish to know how body weight is applied, and if it can be maintained.

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Many diseases present extraordinary muscle tonus and the therapeutic approach for spasticity which is seen in disorders of the upper motor neurons is difficult to treat. This study describes muscle tonus from the viewpoint of neurophysiology, and control of muscle tonus of the hemiparesis due to cerebrovascular disease demonstrated in the field of physical therapy.

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We reported the important points and methods of motion observation and motion analysis, which are evaluations in physical therapy. Motion observation involves watching and thinking in detail, and the problems were differentiated between those with impairment and disability. Motion observation and motion analysis by therapists are a very important techniques in physical therapy. To observe and analyze a patient's motion in detail is the first step in solving their problems in physical therapy.

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It is said that postural stability means almost the same as balance, but the meaning of the word balance has changed. Previously it was the capacity to maintain a quiet position such as standing and sitting. At present, it involves the capacity to excute movement in a task in the environment. This paper asks "What kind of features does a construction of balance have?" and "What is the nature of balance testing?" In physical therapy, it is useful to perform balance testing because it is related to active daily living (ADL) in patients.

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In competitive sports, complex movements by athletes can be observed.These movements are highly rationalized and sophisticated, compared to movements in the activity of daily life. They are practised and perfected in order to win. This all too often leads to injury. Stability is defined in various ways, but in this paper, stability and stable movements are defined as movements with the minimum of sports injuries but the maximum of sports performance. Movements that are likely to cause injuries and have a bad effect on performance are defined as unstable movements. The movements seen in running, throwing and tackling are focussed on mechanical factors related to injuries. Points of importance are made with regard to stability.

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This article describes the factors in posture and motion from the standpoint of dynamics and kinematics. Factors in stability include the following: base of support, gravity, link segment, mass and friction. And also, angular momentum introduces us to an understanding of the stability of motion during a jump. Understanding stability is important in analyzing posture and motion in the field of physical therapy.

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We introduced the evaluation and acupuncture therapy for imbalance of qi that is an important method for in acupuncture medicine. To push acupoints with imbalance of qi with the therapist's finger, we get the same effect in the same as in acupuncture therapy. To combine physical therapy with this acupuncture therapy is a new effective therapy applying acupuncture in the field of physical therapy.

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The first edition of this book was published in 1946 and it has now reached the seventh edition. The principal change made in the sixth edition was the information on the testing of infants and young children. And also the hip extension test in the supine position has been added. If for any reason a patient cannot lie prone, the new method is used.

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This article describes the relationship between the muscle strengthening exercises for the lower extremities and the traction load on the cruciate ligament of the knee. In particular, the traction load calculated by means of the mathematical model of the knee joint is introduced in this article. It is considered that understanding of the kinetic information on the knee joint during muscle strengthening is helpful for therapist in guiding rehabilitation after cruciate ligament reconstructive surgery.

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During 45°-flexion of the hip joint, actions on the pelvis and integral values of abdominal muscle groups were measured by maintaining SLR at 3 different angles of hip joint abduction (0°, 15°, and 30°) to evaluate the relationship between the two. The results of this study suggest that rotating and anteverting actions occur on the pelvic side ipsilateral of SLR when the SLR is held at 30°-abduction of the hip joint in healthy volunteers. In addition, integral values of the abdominal scalenus ipsi- and contralateral of SLR and those of the rectus muscle of the abdomen ipsilateral of SLR obtained by maintaining SLR at 30°-abduction of the hip joint were significantly larger than those obtained at 0°-abduction of the hip joint (p<0.05). Integral values of the rectus muscle of the abdomen contralateral of SLR increase with the angle of hip joint abduction. These results suggest that attention should be focused on hip joint abduction angles during SLR exercise to increase the activity of the entire abdominal muscle groups.

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The purpose of this study was to investigate the muscular activity characteristics of the trunk muscles during stepping forward often used in the treatment in patients with cerebrovascular disease. We measured the sway path of the center of pressure (COP) and the muscular activity of the trunk muscles of 11 healthy subjects during stepping forward with a force-measuring platform and a surface electromyogram. The activity of the lumber back muscles on either right and left or both sides decreases once in 8 subjects and the COP moves to the rear outside the swing side in all subjects when beginning to step forward. The activity increased immediately on the stance side before heel off, and increased on the other side after toe off in all subjects except 1 man. It tended to maintain the rise on the swing side during the swing phase in 8 subjects. It becomes eminent on either or both sideswhen the is flat in all subjects. The relationship between lumbar back muscles and the direction and the velocity of the movement of COP was analyzed, and it was considered that lumbar back muscles worked to control the rotational moment to the trunk when the direction and the velocity of the COP movement was changed greatly.

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A shoulder-wheel is used in one of the therapeutic exercises for shoulder joint disease, but there are few practical studies about the actual method and the time that is clinically important in using a shoulder-wheel. Therefore, the subject of exercise with the shoulder-wheel is difficult to decide on and to prescribe. The purpose of this study is to analyze the characteristic activity of the shoulder muscles (Trapezius-upper, Deltoid-anterior and middle, Infra spinatus), and trunk muscles (Internus-Externus obliques abdominis, Multifidus), so that healthy subjects and the patient with a scapula fracture use the shoulder-wheel for exercising in different directions. The shoulder muscle activity in the abducted direction in the healthy subjects gradually increases to the peak activity on the elevation phase. The activity of the trunk muscle of exercise side increases on the depression phase. After that, the activity of trunk muscle displaces to opposite side smoothly. On the other hand, the activity of the shoulder muscle on the elevation phase in the adducted direction rapidly increased compared with another direction. And the trunk muscles act on markedly on the elevation phase. In the patient, a pattern of muscle activity was similar to a healthy subject, except for deltoid, infra spinatus and multifidus on the elevation phase in the abducted direction. A shoulder-wheel is often used in individual training, but it causes a secondary trouble when going on the exercise of a different muscle active pattern.

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In this thesis, the problem of a patient with dystonia of the trunk who was admitted with excessive rotation to the other side and lateral bending to the same side of the upper trunk in both stance phases was examined. It was clarified that lower muscle activity of the both oblique abdominus was the primary disturbance and excessive muscle activity of the back-muscles of the swing phase was a secondary one. The effect before and after one treatment was examined by electromyography evaluation. As a result, a therapautic approach for not only the primary disturbance but also the secondary one was important. Furthermore, it was suggested that the specific of a secondary disturbance based on a detailed motion analysis and a grasp of the relation between primary and secondary disturbances were effective in patients with dystonia of the trunk.

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The purpose of this study is to evaluate the effect of acupuncture for 2 patients with the writer's cramp in the outpatient-clinic of Kansai College of Oriental Medicine. We evaluated the patients by a writing test and subjective analogue score. The first case was a 67-year-old male, dextrality, a former junior high school teacher. Difficulty in writing appeared in 1997. The second case was a 67-year-old female, dextrality, a former calligrapher. Difficulty in writing was appeared in 1998. We started acupuncture treatment once a week at our clinic. Retained needles on scalp acupuncture of the upper limb area, ST11 and GB20 were used for relief of dysgraphia. A multiple epidermis penetrating needle on the palm was added in the first case. Both a writing test and subjective analogue score significantly improved after three weeks of acupuncture treatment in the first case, and after five weeks in the second case. These findings suggested that acupuncture therapy with the retained needles was beneficial for writer's cramp.

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We saw that in a patient with Symptomatic Parkinsonism, standing-up of the patient was improved by inputting a sensor into the base of support (BOS). The purpose of our examination was to investigate the reason why the patient has improved the motion of standing up. The patient was not fully able to stand-up, because the forward flexion of the trunk from the sitting position decreased on standing-up. The physical therapy for the patient involved two kinds of exercise. First, the range of motion(ROM) of the hip joint was exercised, second, the perception and change of the pressure on the BOS accompanying forward flexion of the trunk was input. We compared the pressure on the posterior femur in the two kinds of exercises, involving forward flexion of trunk from the sitting position. There was no change in performance after exercising the ROM of the hip joint, and there was no change in the pressure on the posterior femur also. Standing up has improved after inputting the perception and changing the pressure on the BOS accompanying forward flexion of the trunk, and the pressure on the posterior femur was increased. In order to change the BOS continuously, it is important to perceive the change in pressure accompanying body movement. Through this case, we found that it was important to make a patient perceive the pressure accompanying motion.

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Lateral shift of the center of gravity for the treatment of cerebral angiopathic paralysis was investigated. These patients show increased tension in the dorsolumbar muscles on the paralyzed side, and have difficulty in shifting their weight toward the paralyzed side. Prior to the restoration of standing and walking motions, it is necessary to improve the sitting posture. In this study, we treated cerebral angiopathic paralysis by 2 lateral methods of shifting the center of gravity by inducing movement of the trunk alone and simultaneous movements of the trunk, pelvis and lower limbs. The effects of the treatment by these methods were evaluated with muscle integration values and observation of the posture of the patients. The muscular activity pattern of the muscles in the trunk became closer to normal, and posture and motion were improved when movements of the trunk, pelvis and lower limbs were simultaneously induced. It was suggested that simultaneous induction of the trunk, pelvis and lower limbs was important for treatment based on lateral shift of the center of gravity.

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We report the effect of Hinaishin (intracutaneous acupuncture) therapy for pain in the anterior part of the ankle joint and limitation of dorsiflexion of the ankle joint during weight bearing. The patient injured the lateral ligament of the ankle joint and cast fixation of the ankle was performed for one week. Pain in the anterior part of the ankle joint occurred after removing the cast fixing the ankle joint. We considered the cause of pain to be limitation of the dorsiflexion of the ankle joint due to displacement of the pivot of dorsiflexion motion by hyper activity of the tibialis anterior (TA) muscle. In order to reduce the hyper activity of the TA, Hinaishin therapy was performed to ST43(Kankoku). ST43 was the reaction point on the Stomach Meridian through the TA. As a result of Hinaishin therapy, the ankle pain was reduced and the range of dorsiflexion of the ankle joint was improved because of the hyper activity of the TA. In conclusion, it was considered that we were able to perform therapy with immediate and continuous effect by performing Hinaishin on the remote part corresponding to the problem muscle.

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