Objective: To investigate the effects of knee flexion range of motion and knee flexion range of motion in hip extension (knee flexion E value) on the maximum knee flexion angle during the swing phase (Sw angle) after total knee arthroplasty (TKA).

Methods: Knee flexion range of motion and knee flexion E value were measured preoperatively and at hospital discharge, and the Sw angle was measured at hospital discharge. The factors affecting the Sw angle were studied, taking the Sw angle as the dependent variable, and the knee flexion range of motion and knee flexion E value at hospital discharge as the independent variables. The differences of knee flexion range of motion and knee flexion E value between the preoperatively stage and at hospital discharge were also examined.

Results: The knee flexion E value was extracted as a factor affecting the Sw angle. The knee flexion E value showed a significant decrease from the preoperative stage to hospital discharge.

Conclusion: We speculated that the knee flexion E value may affect the Sw angle, and it was suggested that in order to improve gait after TKA, there is a need to assess and intervene with regard to not only knee flexion range of motion, but also knee flexion E value.

Objective: Patients who underwent autologous chondrocyte implantation (ACI) can resume moderate-intensity daily living activities 6 months after the procedure. However, the relationship between postoperative patient-oriented assessments and physical function is unclear. Thus, this study aimed to conduct patient-oriented assessments of physical functions 6 months after ACI.

Methods: A total of 29 patients who underwent ACI 6 months prior were enrolled in the study. Patient-oriented assessments were evaluated using the Lysholm Knee Score (LKS). Measured outcomes included range of motion, isometric muscle strength (including knee extension, hip abduction, and toe grip), as well as normal and maximum walking speed. The results of the isometric muscle strength tests were expressed using body weight ratios and limb symmetry index (patients affected/non-affected×100%). Patients were divided into two groups according to their LKS score; the LKS-good group (those who scored ≥65 points) and the LKS-poor group (those who scored below 65 points). Background factors and measured outcomes of each group were then compared using the Mann-Whitney U and chi-squared tests.

Results: Hip-abduction strength and maximum walking speed in the LKS-good group were significantly higher than that in the poor group (p < 0.05).

Conclusion: Hip abduction muscle strength and maximum walking speed may be related to LKS score, and thereby patient-oriented assessments of knee function 6 months after ACI.

Objective: This study aimed to examine the existence of gender differences in posture and mechanical energy transfer during stop jump (SJ) in healthy adults.

Methods: This study involved 15 healthy adult males and fourteen healthy adult females. Vicon was used to assess the leg joint angle, ground response force, segmental moment power, mechanical works (Positive Mechanical works: PMW, Negative mechanical works: NMW), and running speed during SJ. Biodex was used to quantify the muscle torque during maximal isometric contraction. We investigated the gender difference of each parameter and examined the correlation.

Results: As for the posture at the time of landing, females demonstrated considerably larger hip flexion angles, lower knee and ankle extension angles, and higher maximum posterior ground reaction force than males. In males and females, mechanical energy is transferred from the thigh to the pelvis, from the shanks to the foot segment, and at the knee joint, from each segment to the knee extensor muscles. NMW was substantially lower in the distal shanks in females than in males.

Conclusion: It was proposed that the shock absorption of the knee joint was reduced due to low knee extension muscle strength and large knee joint laxity in females and that the effect of landing could not be completely prevented.

Objectives: This study aimed to establish the relationship between low back pain and spinal mobility in patients with hip osteoarthritis.

Methods: Seventy patients with advanced to end-stage hip osteoarthritis were divided into low back pain and no low back pain groups. Spinal mobility was evaluated using Spinal Mouse, spinal alignment was evaluated from lateral images of the entire spine imaging simple X-rays, and hip range of motion was measured.

Result: Multivariate analysis showed that the most significant factor in the development of low back pain in patients with hip osteoarthritis was decreased thoracic spine mobility (p < 0.05).

Conclusion: Decreased thoracic spine mobility may be a significant factor in low back pain secondary to hip osteoarthritis.

Objective: This study aimed to investigate the effect of different shoulder horizontal adduction angles on the muscle activity of the shoulder external rotators during Prone Shoulder External Rotation (PSER).

Methods: Twelve healthy males participated in this study. The exercise involved maintaining an isometric contraction of the shoulder at 90° external rotation in 90° abduction. Muscle activity during PSER was measured in the infraspinatus, teres minor, and posterior deltoid muscles. PSER was performed at three different shoulder horizontal adduction angles: 0°, 15°, and 30°. The muscle activities of three muscles were compared among the three conditions in PSER.

Results: There was no significant difference in muscle activity of the infraspinatus and teres minor muscles among the three conditions. However, muscle activity of the posterior deltoid muscle was significantly decreased at PSER with horizontal adduction angles 30° compared to 0° (p = 0.003, d = 0.95).

Conclusion: This study indicated that PSER with horizontal adduction angle 30° suppressed muscle activity of the posterior deltoid muscle, while no decrease was observed in the muscle activity of the infraspinatus and teres minor muscles.

Objective: We report the results of exercise therapy in a patient with habitual shoulder dislocation and posterior instability.

Case: The patient was a woman in her 10s diagnosed with habitual shoulder dislocation, who complained of shoulder pain and dislocation sensation during daily life and kendo activities. We performed exercise therapy and activities of daily living guidance for 8 weeks. Treatment outcomes were evaluated using shoulder pain, dislocation sensation, shoulder 36, Rowe score, and Pain Catastrophizing scale. The temporal changes in shoulder joint dynamics were assessed by confirming the posterior translation of the humeral head using ultrasonography. After 8 weeks of intervention, the patient's daily shoulder pain and dislocation sensation disappeared. Analysis of the temporal changes in shoulder joint dynamics revealed a reduction in posterior humeral head translation 8 weeks after intervention compared with the initial assessment findings. In addition, the patient was able to return to kendo with improvement in shoulder function.

Conclusion: The findings of this case report demonstrated the effectiveness of exercise therapy in habitual shoulder dislocation.

Objective: Herein, we report the case of a patient with a proximal humerus fracture whose symptoms improved postoperatively after physical therapy combined with assessment and intervention for psychosocial factors.

Case: The patient underwent plate fixation 3 d after the injury. The patient returned to work at 6 weeks postoperatively and was doing well until 11 weeks postoperatively. However, the patient had difficulty requesting wheelchair assistance on the road due to fear of a feeling on the left shoulder. We included an evaluation of psychosocial factors because we believe that the factors limiting wheelchair assistance are different from those that cause shoulder dysfunction. Assessment results focused on the patient's fear of movement because TSK was high, and the patient was fearful of wheelchair assistance. As a result of GMI focusing on the fear of movement, the fear of wheelchair assistance was reduced and wheelchair assistance became possible.

Conclusion: The assessment of and intervention for psychosocial factors may be useful in postoperative cases of proximal humerus fractures.

Objective: To investigate physical therapists' implementation of Physical Therapy Guidelines 2nd Edition (hereafter referred to as “the Guidelines”) for the management of upper body disorders, including the neck, shoulder, elbow, as well as wrist and hand.

Methods: A questionnaire survey was conducted to analyze responses regarding clinician's use of the guidelines, their contribution to improving patient outcomes, and the clinician's satisfaction with their use.

Results: 92.9% of the respondents found the guidelines useful. The most common situations in which they were reported as useful were “when researching evidence for physical therapy practice” (80.8%) and “when selecting physical therapy treatments in clinical practice” (61.5%). Regarding satisfaction with respect to each body area, 55.1±4.7% reported satisfaction for the neck, 69.4±7.6% for the shoulder, 57.1±10.3% for lateral epicondylitis, 42.5±8.3% for elbow tunnel syndrome, 64.3±16.0% with distal radius fracture, 57.1% with hand flexor tendon injury, 64.3±7.1% with rheumatoid arthritis, and 57.1±20.0% with carpal tunnel syndrome 57.1±20.2%.

Conclusion: A high level of usefulness was shown for the guidelines, but satisfaction with their use was only moderate.