Muscle function and functional performance are affected in patients with osteoarthritis (OA). The aim of the study was to investigate and compare the concentric torque of knee muscles (quadriceps and hamstring) and functional status in two matched groups: one group of patients with low grade of tibiofemoral OA, and one group of matched healthy subjects. Concentric peak torques of quadriceps and hamstring were measured in both groups at an angular velocity of 90 and 150 degree/second. In addition, selected functional tests, selected lower extremity range of motion (ROM) and thigh girth were assessed in both groups. The independent t-test revealed statistically significant differences between the two groups with regard to isokinetic concentric peak torque at different angular velocities and for the timed walking test, as a measure of functional status. However, no significant difference in lower extremity joints' ROM and thigh girth were seen. In conclusion, patients with knee OA, even in low grades and with minimum symptoms and signs, had muscle weakness and functional limitation in comparison with the matched healthy subjects. This weakness may result from a variety of factors, leading to muscle strength loss and functional limitation.
The relationship between muscle fiber conduction velocity (MFCV) of the vastus medialis and muscle strength of knee extensors was observed in patients with joint disorder of the lower limb, and the feasibility of MFCV as an index for evaluating the condition of muscular disuse was examined. MFCV was significantly slower in patients with joint disorder (2.91 ± 0.27 m·s-1) than in healthy subjects (3.22 ± 0.22 m·s-1; p<0.01). Muscle strength of knee extensors was significantly lower in patients (198.1 ± 72.2 N) than in healthy subjects (311.2 ± 79.6 N; p<0.01). Muscle strength displayed a significant positive correlation with MFCV in patients with joint disorder (r=0.63, p<0.01). In patients after joint surgery of the lower limb, MFCV increased with muscle strength recovery. Reduced MFCV in patients with joint disorder appears to primarily reflect muscle atrophy of type II fibers. MFCV of patients with joint disorder of the lower limb may thus reflect changes in muscle fiber type and diameter.
The behavioral and psychological symptoms of dementia (BPSD) change the lifestyles of demented people and their caregivers. While various interventions in dementia have been reported, the relationship between family visits and suppression of BPSD in a nursing home has rarely been addressed. This study investigated whether the frequency of family visits was associated with a reduction in BPSD in aging people in a nursing home. Sixty-seven aged people (average age: 87.3 years), who were diagnosed as having dementia according to the Hasegawa Dementia Scale-Revised (HDS-R) score, in a nursing home were selected. They were divided into 3 groups as follows: HDS-R score of 0-9 (group A), 10-14 (group B), 15-19 (group C). The subjects were further divided into 2 groups by their average monthly frequency of family visits: 0-10 (group X) and >10 (group Y). The rates of change in the HDS-R and dementia behavior disturbance (DBD) Scale scores were calculated. The rate of change in the DBD Scale score was influenced by the frequency of family visits, and the effect was significantly greater in group X than in group Y. Among the groups, only group B showed significant differences in the rates of change in the HDS-R and DBD Scale scores, and both of these were lower in group Y than in group X. This investigation demonstrated that the frequency of family visits was associated with suppression of BPSD, and was particularly effective for subjects with moderate dementia.
This study analysed the responses of 183 clinicians in Ishikawa Prefecture to a Japanese version of the Speakman's scale on job satisfaction in the form of a self-administered questionnaire. Specifically, the questionnaire sought the clinicians' responses to 10-item statements related to their jobs concerning paperwork, challenge, physical demand, professional autonomy, fulfillment, and stress. The degree of agreement with the scale was moderate, though the respondents considered themselves to be engaged in rewarding work. The causes of their job dissatisfaction were excessive paperwork and physical/mental stress. Despite these negative feelings, the clinicians were able to find the positive aspects of their job. The degree of importance for the scale as a measure of job satisfaction was also moderate, as opposed to that of their American colleagues who rated it high when Speakman et al. conducted their study in 1996. This finding suggests that clinicians from Ishikawa Prefecture may find the `hygiene' factors (ie. salary and fringe benefits) to be of more importance for their daily job satisfaction. The results should be interpreted in terms of culture and mores, differences in healthcare systems and the time period in which the studies were carried out.
We evaluated the efficacy of an 1-hour Taijiquan daily exercise for maintaining and improving the physical fitness of elderly Chinese people in an urban area of China. They had practiced Taijiquan in the park every morning for many years. Thirty subjects (male: n=10, average age 74.4 ± 3.2 years; female: n=20, average age 73.4 ± 4.4 years) participated in the study. Measures of physical fitness were taken immediately before and after the Taijiquan exercise. In both male and female groups, the results for tests consisting of standing on one leg with eyes open, grip strength, functional reach, 10-m walking speed, finger-floor distance, and standing on one leg while swinging the other leg were significantly improved. Results for standing on one leg with eyes closed, did not show a significant change. These results suggest that a 1-hour Taijiquan session can improve physical fitness in terms of static and dynamic balance, muscular strength, coordination, walking ability and flexibility in elderly individuals who have practiced Taijiquan over a long period of time. Thus, Taijiquan could help elderly individuals to maintain and improve their health and their ability to perform daily activities.
In this report we examined the factors regarding falling related to physical strength awareness in the elderly using the functional reach test. The objective was to construct a tool of high accuracy for estimating falling. We used 88 healthy elderly people who could continue the trial and had no impediments in daily life. After estimating values in the functional reach test actual measurements were conducted. Errors in individual physical strength awareness were differences between predicted and measured values. Three months later, subjects were surveyed as to whether a fall had taken place and were examined on physical strength awareness in falling. From multiple logistic regression analysis, the usual functional reach test result (p<0.05) and physical strength awareness error (p<0.01) were both chosen as influences and factors in falling within the 3-month period. The recurrence adoption when the two factors were included was the best. Furthermore, discriminant characteristic analysis indicated the possibility of distinguishing falls concerning errors in physical strength awareness which were 8.5 cm for the over-estimate group (discriminant rate 84.4% sensitivity 88.4%) and 9.5 cm for the under-estimate group (discriminant rate 95.7% · sensitivity 95.7%). It is thought that this test is useful information for physical strength awareness to predict falling.
Muscle strengthening exercise in Open Kinetic Chain (OKC) and muscle strengthening exercise in Closed Kinetic Chain (CKC) with a Toe-Heel Pedal Exercise Machine were performed, and were compared the results of knee proprioception tests (threshold test / position sense test). The subjects were 17 patients who had received total knee arthroplasty. They were assigned to either group A (OKC exercise group, n = 9) or group B (CKC exercise group, n = 8). The effect of 3-week exercise therapy was evaluated as the outcome of the knee proprioception tests. In group A, improvement rates were 3.8 ± 6.9% in the threshold test and 7.6 ± 10.7% in the position sense test. In group B, improvement rates were 25.2 ± 4.9% in the threshold test and 27.6 ± 8.2% in the position sense test. Thus, the group of muscle strengthening exercises in CKC with the Toe-Heel Pedal Exercise Machine showed higher improvement rates both in the threshold test and the position sense test.
The purpose of the present study was to examine the relationship between balance performance during one-leg and two-leg standing and leg muscular strength in junior speed skaters, and to formulate one indicator for on-land training. There were a total of 48 subjects comprising 22 junior elite and 26 junior non-elite speed skaters. The method involved analyzing the unit trajectory length (LNG/TIME), the peak value for center of gravity fluctuations (RMS) and the area where fluctuations in the center of gravity are concentrated (SD-A) in keeping one-leg and two-leg standing; and measuring the maximum isometric muscular strength for knee extension with a leg muscular strength measurement device, and thereby calculating a weight-bearing index (WBI). As far as the characteristics for the center of gravity were concerned, significantly lower values in the elite group compared with the non-elite group were exhibited for the peak center of gravity fluctuations (RMS) and the area in which fluctuations in the center of gravity were concentrated (SD-A). However, no significant differences were observed in the unit trajectory length (LNG/TIME). In addition, no significant differences between the groups were observed when the right leg was kept standing. The elite group exhibited significantly higher values in the weight-bearing index (WBI) compared with the non-elite group for both legs. With regards to the differences between the left and right leg WBI, the elite group exhibited significantly higher values for the left leg than the right leg, but no significant difference was observed between left and right in the non-elite group. Based on this, it is suggested that there is a need to carry out qualitative training for improving the ability to keep the left leg standing in a posture simulating skating, and to carry out quantitative training for increasing the muscle strength of knee extensors, in order to improve the competitiveness of junior speed skaters.
This study focuses on the reliability and validity of a Japanese version of the "attitudes towards the physically challenged" (ATPC) Form O. Form O measures the affective attitude component of the views towards the physically challenged and contains 20 statements to be responded to in a six-point range. A convenience sample of 154 physiotherapists in Fukui Prefecture participated in this mailed survey. The reliability of Form O was assessed as homogeneity, and its validity as construct validity. The rate of return was 47.5%. All but 1 of the 20 items were found to have significant item-total correlations. Cronbach's alpha coefficient for Form O was 0.76 with some evidence for construct validity, which explained 30.9% of the variance. The obtained factors were labelled as "prejudice", "differing view" and "self-concept" with the rate of contribution (Cronbach's alpha) being 20.27% (0.73), 6.41% (0.66), and 4.25% (0.69), respectively. Evidence for construct validity was demonstrated in Form O's ability to differentiate between genders and also between physiotherapists who preferred treating clients with conditions or diseases that would lead to permanent disability and those who preferred treating clients with conditions or diseases that would lead to a full recovery. Convergent validity, as a form of construct validity, was also supported for Form O. The results show that Form O can be considered a reliable and valid measure of documenting trends of importance in regards to the physically challenged.
This study investigated the accessory movement of the lunate in the volar-dorsal direction during active flexion-extension motion of the wrist. The right wrist of a healthy 50-year-old (right-handed) male was studied using an ultrasound diagnostic instrument to measure the wrist's continuous motion from (neutral to) flexion to extension (back to neutral). An ultrasound system was applied on the dorsal aspect of the subject's wrist over the radiocarpal joint. The distance between the dorsal plane of the radius and that of the lunate was measured in each image. The distance data were depicted on a graph using the method of least squares. The lunate moved 0.5 mm dorsally during flexion, and it moved 1.5 mm in the palmar direction during extension. The variance value of the 5th degree polynomial expression of the curve was 0.147. It is hoped that our polynomial expression in this study will serve as a frame of reference in the evaluation of a given mode of physical therapy prescribed for subjects with joint dysfunction.
The aim of this study was to investigate the kinematical movements and electromyographic activities of the trunk and hip during trunk flexion and extension at different velocities. Thirteen male subjects performed trunk flexion and extension movements for 5 times at three different velocities of 1 s, 3 s, and 5 s in the standing position. Sagittal angular displacements of the lumbar spine, pelvis, and hip as well as the surface electromyogram of the trunk and hip muscles were recorded. The kinematic characteristic was normalized, and the electromyogram was integrated and normalized separately in cycles of flexion and extension. During flexion, the lumbar spine range was significantly larger during 5 s than during 3 s and 1 s, whereas the hip range was significantly larger during 1 s than during 5 s (p<0.01). During extension, the normalized electromyogram values of the iliocostalis and longissimus were significantly greater during 1 s than during 5 s (p<0.05). Increase in the movement velocity during extension produced greater activity in the trunk extensors, while the activities of the flexors showed minimal change. The results suggest that there is a kinematic and kinetic strategy among the lumbar, pelvis and hips in order to accomplish task-oriented movements.
The purpose of this study was to verify the utility of a simple motion analysis system which we made by partially observing actual movement in a clinical setting and demonstrating the objectivity of the data thus obtained. In this system, angular velocity sensors were put on the right and left acromion of the subjects to measure the movement of each during free walking. The gait cycle was determined using plantar pressure sensors. The subjects of the measurement were healthy persons and hemiplegic cases, and the characteristics of their gait were comparatively analyzed. As a result, we could objectively obtain gait data from healthy subjects which showed few differences between the right and left sides and from hemiplegic cases which showed individual characteristic acromial movements. Consequently, this gait analysis method was considered to be clinically applicable as an objective gait analysis method.
This paper discusses the relationship of the probe reaction time (P-RT), the number of steps, and the step rhythm to the risk of falls. These three factors were measured while subjects marked time at a self-determined rate. The subjects were divided into three groups including 18 young subjects (Young group; 15 males, 3 females), 11 elderly subjects who had not experienced falls (Old no-fall group; 1 male, 10 females) and 8 elderly subjects who had experienced falls (Old fall group; 3 males, 5 females). Using a digital audio player (for sonic stimulation) and sound recording equipment, the probe reaction time and the sound of the foot touching the ground was measured. One-way analysis of the variance of the probe reaction time showed a significant effect in all groups, and post-hoc comparison of the means confirmed that the probe reaction time scores were significantly longer in the Old fall group than in the Young group or the Old no-fall group. The coefficient of variation (CV) of the time for a single step was calculated once for the right foot and once for the left foot, and revealed that the effect was significant for all groups. Two-way analysis of the variance was significant, and a post-hoc comparison of the means confirmed the differences between the groups. It was thus found that the probe reaction time and the coefficient of variation of the time for a single step are reliable and useful for evaluation of the risk of falls.
We have examined whether the lateral abdominal muscle activity during expiratory loading can be noninvasively evaluated using ultrasonography. This study included 12 healthy adult men, and measured the thicknesses of their lateral abdominal muscles at the end of inspiration and the end of expiration, and the thickness differences when 5%, 10%, and 15% of the maximal expiratory pressure were loaded as expiratory threshold loads. Tidal volume, inspiratory reserve volume and expiratory reserve volume were also measured at the same time. Obtained data were compared by expiratory threshold load, and correlation between muscle thickness and the thickness difference was assessed. Muscle thickness at the end of expiration and thickness difference significantly increased in proportion to the expiratory threshold load, and were accompanied by increase of tidal volume. Additionally, a significant positive correlation was found between muscle thickness and the thickness difference. The results of this study indicate that expiration activities of the lateral abdominal muscles can be evaluated by ultrasonography, and that the thickness difference reflects expiration activities.
The purpose of this study was to visualize the changes of muscle architecture by measuring pennation angle on ultrasound (US) images, and to examine the influence of thermotherapy on the elasticity of muscles which were stretched passively. Ten healthy male subjects positioned with the ankle joint planterflexed or dorsiflexed were continuously stretched in the dorsiflexion direction for 3 minutes in both positions, and the pennation angle and muscle extensibility were measured. Each subject received the following thermotherapy interventions randomly: Group 1 received continuous US wave (1 MHz, 1.5 W/cm2, 5 minutes); Group 2 underwent the same intervention as Group 1 but with no ultrasound output. Subjects of Group 3 were given 20 minutes of moist hot pack; Group 4 stayed still for 20 minutes. All interventions were practiced on the medial gastrocnemius muscle belly. Stretching was given after each intervention. Our study results showed that muscle extensibility did not differ significantly in any group, except for neutral positioning in groups 1 and 4. However, while groups 2 and 4 showed reduction in the pennation angle, it did not change in groups 1 and 3. These results support the hypothesis that thermotherapy is one of the factors which contributes to muscle relaxation. In other words, the measurements of pennation angle enables us to see in vivo effects of thermotherapy on muscle elasticity.
There are few papers about the biomechanical characteristics of sit-to-walk motion, although many researchers have written about the biomechanical analyses of sit-to-stand motion or gait initiation. The purpose of this study was to compare the biomechanics of sit-to-walk motion with sit-to-stand motion or gait initiation. The subjects were 9 healthy young men, who were instructed to perform sit-to-walk motion, sit-to-stand motion, and gait initiation. Kinematics and kinetics data were obtained using a 3D motion capture system and two force plates. The coordinates of reflective markers (RM)s, the coordinates and velocity of the center of gravity of the whole body (COG), the coordinates and velocity of the center of gravity of the head, arm and trunk (COG of HAT), each joint angle, and the ground reaction forces (GRFs) were calculated from the data. We found that the maximal horizontal velocity of HAT occurred later in a sit-to-walk motion than in sit-to-stand (p<0.05). On the other hand, there was no significant difference of timing between sit-to-walk motion and gait initiation. At the highest point of COG, it moved forward farther in sit-to-walk and moved upward higher in sit-to-stand. Maximal horizontal velocity of COG of HAT before seat-off was significantly higher in the sit-to-walk motion than in the sit-to-stand motion. The peak value of anterior-posterior GRF (Fy) at the heel strike was significantly greater in the sit-to-walk motion than in gait initiation (p<0.05). The COG moved forward over the base of support in the sit-to-walk motion, and then the COG moved forward with one-leg support. These results suggest that sit-to-walk motion is an unstable motion, and requires balance ability to perform. To create an impulsive force, it is important that horizontal velocity of COG of HAT is higher at seat-off in the sit-to-walk motion. Horizontal impulsive force created by HAT movement is suppressed at the first heel strike.