The Therapeutic Alliance in Physiotherapy Questionnaire-Patients (CAF-P) assesses the therapeutic alliance between a patient and a therapist by specifically examining the extent to which a patient agrees with a treatment. It is highly related to the effectiveness of the treatment and patient satisfaction. In this study, a Japanese version of the CAF-P comprising 14 questions was developed in accordance with the international guidelines for the cross-cultural adaptation of questionnaires. As per the guidelines, the process involved five stages: forward translation, creation of an integrated version of the forward translation, backward translation, creation of a provisional Japanese version, and pilot testing. In the pilot test with 30 first-language Japanese speakers receiving treatment for musculoskeletal diseases, we assessed whether the meaning of the questionnaire was comprehensible in Japanese, using a 5-point Likert scale (1: not understandable at all in Japanese, 5: fully understandable in Japanese). The respondents’ comments were obtained on items that they rated from 1 to 3; we noted that 3 responses out of the total 420 (30 respondents × 14 questions) had a score of 3. Based on the comments, the Japanese version of the CAF-P was revised for comprehensibility. The Japanese version of the CAF-P is expected to be used in future research and as a checklist for therapists in clinical settings.

The purpose of this pilot study was to investigate the minimum sample size required to determine whether the muscle activity patterns of the superficial trunk extensor muscles differ among individuals when distinct active straight leg raise (ASLR) test scores are measured using a functional movement screening (FMS) system. Eighteen and nine individuals with FMS–ASLR test scores of 1 (with dysfunction) and 3 (without dysfunction), respectively, were included in the analysis. None of the participants had back or leg pain. For the right ASLR test, we calculated the differences in muscle activity delay among the right and left longissimus thoracis, right and left iliocostalis lumborum, and right and left multifidus muscles in relation to the onset of muscle activity in the right rectus femoris muscle. We also calculated the effect size (Hedges’ g) and the required sample size at α = 0.05 and β = 0.2. Our results demonstrate that the group with an FMS-ASLR test score of 1 had a shorter delay in the muscle activities of the right and left longissimus thoracis, right and left iliocostalis lumborum, and right and left multifidus muscles relative to the right rectus femoris muscle than the group with an FMS–ASLR test score of 3. Analysis revealed that the study required a sample size of at least 28 participants (14 with an FMS–ASLR test score of 1 and 14 with an FMS–ASLR test score of 3).

The purpose of this study was to adapt the Self-Efficacy for Home Exercise Programs Scale (SEHEPS) for use in Japan. SEHEPS examines the degree of confidence in performing home exercises. The adaptation involved five steps (forward translation, creation of a forward-translated integrated version of the assessment, backward translation, creation of a provisional Japanese version, and pilot testing) and followed an international guideline for the cross-cultural adaptation of patient-reported outcome measures. The provisional Japanese version was pilot-tested by 16 men and 14 women, aged 52.6 ± 17.1 years, with musculoskeletal disorders who were prescribed a home exercise program. The participants rated their comprehension of the provisional Japanese version of SEHEPS using a 5-point scale (from 1: I don't understand the meaning at all, to 5: I can sufficiently understand the sentence). In the case of scores of 1-3, feedback concerning the difficulty of the expressions was obtained. The percentage of those who selected a score of 4 or higher ranged from 66.7% to 100%, and none of the participants selected a score of 1. Furthermore, based on the comments from the pilot test, the final Japanese version of the SEHEPS was developed through discussion among all five members of the team of translators and authors.

[Purpose] We report the case of a patient with spinal cord injury, caused by thoracolumbar compression fracture, who was able to return home after manual therapy, and stabilization and balance exercises after surgery. [Case Description] A male patient was diagnosed with myelopathy, thoracolumbar compression fracture, and spinal canal stenosis. His chief complaints were weakness, pain, and bilateral numbness in the lower limbs, and low back pain. The patient underwent spinal fusion and decompression. Physical therapy was started on the sixth postoperative day. [Clinical Reasoning] Based on the assessments of muscle strength and pain, and the results of neurodynamic testing, it was determined that the patient had motor paralysis and neurological symptoms of pain and numbness in the L1-S2 region. [Results] The numbness in both lower limbs and low back pain were relieved, and the patient was able to walk using a cane and was discharged to home. [Conclusion] The treatment program for this patient may be proposed as a treatment method for patients with neurological symptoms due to paralysis and pain in both lower limbs, and who have difficulty in movement.

Recently, the central nervous system analgesic mechanisms have been reported for the analgesic effects of manual physical therapy, rather than the traditional mechanisms resulting from changes in peripheral tissues. A comprehensive model that includes the central nervous system and the analgesic mechanisms of manual physical therapy has been proposed. This article outlines the analgesic mechanisms of manual physical therapy based on the physiology of pain, classifying them into analgesic effects derived from manual stimulation and placebo analgesic effects. In addition, this article outlines the evidence for manual physical therapy.