To examine the validity and reliability of values measured with a stopwatch (SW) and a three-dimensional motion analyzer (3D), walking speed and gait cycle variables were measured for ten healthy young individuals. Participants were given two assignments as subjects of the experiment. Their first role was to walk on a 16 m track from end to end at a comfortable speed, and as data measurers their second role was to use the stopwatch method to measure the time and number of steps taken for other subjects to pass through the measurement section of the track. The measurement section was set up in the middle of the track, with 4 m distance for the 3D and 10 m distance for the SW method. While subjects were walking from one end of the track to the other, their gait was measured by both the 3D and the SW methods. Each subject performed the gait trial 10 times. Results: Strong correlations were obtained among the measured values, both with the SW method and the 3D method, and high reliability was confirmed. Variables of time and space such as walking speed, cadence, and stride length can be measured by a stopwatch within the range of ± 0.1 s. The validity of the stopwatch method is strong: it showed tight correlation with the 3D method, but gave slightly shorter temporal and spatial parameters than the 3D method. The conclusion is that the stopwatch method is sufficient for the measurement of walking speed in the clinical field.
The purpose of this study was to investigate the relationships between dyspnea, respiratory muscle strength, and ventilatory failure in patients with amyotrophic lateral sclerosis (ALS). A cross-sectional study, based on patients' medical records, was performed at a primary care hospital in Japan. Twenty-five patients diagnosed with ALS who received care as outpatients or inpatients were included in this study, and patients' characteristics, dyspnea on the subscale of the revised ALS Functional Rating Scale, sniff nasal inspiratory pressure (SNIP), an indicator of respiratory muscle strength, and arterial carbon dioxide pressure (PaCO2) were selected as main outcome measures. All data were collected from patients' medical records. For patients with dyspnea, SNIP was significantly lower and PaCO2 tended to be higher than in patients without dyspnea. There were no significant differences in both bulbar symptoms and types of disease onset between the patients with and without dyspnea. In patients with ALS, it is suggested that dyspnea reflects respiratory muscle weakness and ventilatory failure. For the assessment of respiratory function in patients with ALS, it may be important to evaluate dyspnea in addition to SNIP and PaCO2.
A preliminary study was carried out by means of a three-part questionnaire to determine attitudes of 146 physiotherapy clinicians in Yamaguchi Prefecture, Japan, towards death and terminal illness. This self-administered postal survey was cross-sectional. Results indicated that there was little discernible difference in the response to the questions among the subgroups vis-á-vis gender and years of professional practice. Topics of death and terminal illness were found to have been subjects that were relatively openly discussed in the respondents' families. The majority of the respondents desired "dignified death" for themselves and to be informed of their condition if they became terminally ill. Although they were willing to treat persons with terminal illness, the respondents were psychologically uncomfortable in the situation, and the majority of them seemed to lack sufficient knowledge and, therefore, necessary execution skills to provide the necessary psychological support when subjected to such a situation. Therefore, education and training of physiotherapists enabling them to professionally confront persons with terminal illness would be of significant value if introduced into the physiotherapy curricula.
The purpose of this study was to test the efficacy of a health promotion program consisting of simple exercises among healthy elderly people in a community. The participants were healthy and elderly people, who were picked out from the users of a sports recreation facility. We carried out physical fitness measurements and instructed on exercises to participants. The evaluations were grip strength, knee extensor strength, sitting trunk flexion, falling-stick reaction time, one leg stance, Functional Reach Test, Timed "Up and Go" Test (TUG), 10-m walking time, 6 minutes distance (6MD), Tokyo Metropolitan Institute of Gerontology Index of Competence, Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), and Profile of Mood States (POMS). All the exercises we instructed were those which can be easily performed at home. As resistance exercise, rubber tube and subject's body weight were used. In the intervention group, the improvements of leg strength, TUG, 6MD, physical function item of SF-36 and vigor item of POMS were significant. Exercise instruction with simple exercise programs in this study improved not only physical abilities but also the social and psychological attitudes of the participants.
In this study, both a questionnaire survey and a functional assessment were performed. The results were examined to clarify factors which might influence clinical symptoms in patients with surgical repairs following complete rotator cuff tear. In addition, evidence on which to base postoperative activities of daily living and rehabilitation was elucidated. The percentage of patients with satisfactory postoperative outcomes was 82.3%, and that of those with unsatisfactory outcomes was 17.7%, which shows that the function of, and pain in the shoulder improved in most cases after the surgical repairs. There were significant differences in activities of daily living and mobility depending on time from the surgery, presence of pain, and presence of activity limitation. The majority of the satisfactory group had returned to their original jobs, but many males in the unsatisfactory group could not do any work due to activity limitation, and many females in the unsatisfactory group were doing household work complaining of pain and activity limitation. In addition, muscular weakness and persistence of mild limitation in the range of motion were seen on the operated side. These results indicate that a long-term approach to improve the muscle strength and the range of motion as well as pain management and improvement of activity levels, especially for women doing housework, are necessary to improve the lifestyles of patients who have undergone the surgical repair of rotator cuff tear.
The purpose of this study was to evaluate the repeated one-leg heel-rise test method of ankle plantar flexors in MMT with kinetic measuring devices and electromyograms (EMG). Seven healthy young males (age, 23 ± 2 y) with no prior history of fractures or surgery involving the lower limbs participated in this study. The ankle and knee motions from flexible electrogoniometers (EGM), ground reaction forces (GRF) and center of pressure (COP) from one force plate and the root-mean-square (RMS) and mean-power-frequency (MPF) from EMG in the medial head of the gastrocnemius and soleus muscles during the repeated one-leg heel-rise test. Kinetic and kinematic data from EGM, GRF and COP were unchanged during the tests. Although the RMS in both muscles and the MPF in the soleus muscles were unchanged during this test, the MPF in the gastrocnemius muscles decreased with the number of iterations (r=-0.79, p<0.001). The MPF of the gastrocnemius muscles in the late phase was significantly lower that in the early and middle phases (respectively, p<0.05, p<0.05). Our results show that this repeated motion method estimates muscle endurance rather than the muscle power.
The purpose of this research was to investigate the relationship between the probe reaction time of physical therapists and their record of patient accidents involving falling. The measurement items were the simple reaction time, the probe reaction time, and the Trail Marking Test Part-A. The probe reaction time was measured while the subjects were walking at a self-determined velocity. The subjects were divided into two groups: 11 physical therapists who had experienced patient fall accidents at least once in the previous 12 months (Fall group: 9 males, 2 females); and 26 physical therapists with no history of patient fall accidents (No-fall group: 14 males, 12 females). Using a digital audio player (for sonic stimulation) and sound recording equipment, the probe reaction time was measured. The results show that the probe reaction time of the Fall group was slower than that of the No-fall group. The simple reaction time and Trail Marking Test Part-A were not significant different between the Fall and No-fall groups. In logistic regression analysis with fall accident as the dependent variable, only the probe reaction time was significant. The cut-off value of the probe reaction time was 328 ms by evaluation of receiver-operating-characteristic curve. It was found that the probe reaction time of physical therapists is reliable and useful for predicting the falling accident risk.
Few methods are available for measurement of muscle strength during physical activities. This study addresses the validity of estimating the force of the quadriceps femoris during the forward lunge and squat carried out by 18 healthy men. Data were collected by the utilization of a musculoskeletal model through computer simulation. From the electromyographic (EMG) recordings of the vasti medialis (VM) and lateralis (VL) and rectus femoris (RF) muscles a correlation coefficient (r) was calculated between the estimated value for the muscle force and the root mean square (RMS) value. The median r for VM and VL was found to exceed 0.65 during the flexion and extension phases of forward lunge and below 0.44 for VM and VL during squat for the same phases. For RF, the median r for both tasks was below 0.39 except during the flexion phase of squat. The coefficient of the similarity in the EMG patterns exceeded 0.93 between the estimated muscle force and EMG RMS for both the forward lunge and squat. The value of the estimated muscle force for RF in these 2 tasks was found to be very small. The results show that the musculoskeletal model can be considered a valid measure for estimating muscle force.
It is important to clarify the normal biomechanical characteristics of the sit-to-walk (STW) series of motions clear for healthy elderly people. Clarifying the biomechanical characteristics of normal motions is necessary to be able to develop an appropriate intervention to improve physical functions. Eight healthy elderly people performed STW motion at the two patterns of speeds: a fast condition and a slow condition. Kinematic and kinetic data were obtained. Maximal anterior ground reaction force was significantly larger in the fast speed condition. In the fast speed condition, the subjects initiated gait with the hip and knee more flexed. And the center of pressure (COP) moved forward gradually constraining the forward movement of the center of the gravity (COG). In the slow speed condition, the COG movement was slower, so the COP moved backward in order to induce a forward COG movement. In the fast motion it is important to accelerate and control the forward movement of the body.
The purpose of this study was to examine the effect on oxidative stress (OS) of muscle stress caused by different training sets. Twenty-five healthy volunteers (22.0 ± 2.6 years old) with no past history of medication were recruited for this study. A free radical analytical system was used to measure OS (hydroperoxide consistency), and blood specimens were collected from volunteers' finger tips on three occasions: 1) at rest, 2) immediately after test completion, and 3) thirty minutes after test completion. Muscle Stress was assessed by an isokinetic testing and training system, and eccentric contraction was carried out in different training sets (10 times × 5 sets, 5R; and 10 times × 10 sets, 10R) for right knee extension. OS showed a significant increase under 10R (p<0.05), but OS values were changes within the normal range when averaged for the analysis. However, OS did not show an increase in 5R. Blood pressure (BP) and heart rate (HR) showed significant increases immediately after both 5R and 10R,compared to the rest period (p<0.001 for both). OS in muscle stress was affected by the training sets, but it was not the significantly related to BP or HR.
Our objective was to examine the influence of leg muscle weakness and body mass index (BMI) on ultrasonography (US) of the knee joint in middle-aged women. US and measurements of leg muscle strength and BMI were performed at the beginning of the study and after 6 months. Subjects with US abnormalities at the first examination were excluded from the study. Muscle strength and BMI were compared between subjects with normal US findings at the beginning of the study and after 6 months (N) and those in whom initially normal US findings became abnormal after 6 months (A). Analysis was performed for 20 knees with a mean age of 52.9 years old. In Group N, there were no significant changes in muscle strength and BMI between the initial results and those after 6 months. Significant changes in muscle strength occurred in Group A, but there was no significant change in BMI. There were significant differences between Groups N and A in the changes after 6 months; however, there was no significant difference in the change in BMI between the two groups. We conclude that abnormal knee-joint findings in US of the knee are associated with leg muscle weakness in middle-aged women.
In order to identify the group of muscles related to deterioration of balance function in the elderly, an exploratory experiment was conducted to analyze and study the influence of lower limb muscular fatigue on balance disturbance in the stable upright position. A stabilometer and a multipurpose muscle function testing and training system were used to assess 12 normal healthy subjects. Evaluations were made using the total trajectory length and the trajectory length per unit area with the eyes-open for 30 seconds. All statistical analyses were performed using SPSS Ver. 13.0 with analysis of variance (repeated measures) at a significance level of below 5%. In the gluteus maximus muscles, the total trajectory length showed a significant downward trend while the trajectory length per unit area showed a significant upward trend.
This study was carried out for the purpose of quantifying resistance demonstrated by Thera-Band® exercise bands in knee joint extension. The subjects were 35 healthy adults (19 male, 16 female), and their average age was 21.0 ± 2.3 years old. The exercise bands had 6 colors. From the lower leg nutation position in sitting on the edge of a bed, knee joints were extended to 30° and 45°, and the value of the muscle strength used in retaining those angles with the different colored exercise bands was measured with a dynamometer. In this study, the resistance demonstrated in knee extension with the exercise bands was quantified using a dynamometer, and the resistance quantity of the six colored exercise bands used in this study was clarified, enabling the construction of an index for their selection.
The purpose of this study was to examine the effect of circulatory response changes on DPBP evaliation. Seventeen healthy males and females who did not perform exercises daily participated in this study. All subjects performed a graded ergometric test that is generally performed on a cycle ergometer. The SBP and HR were measured at 1-min intervals. In healthy subjects who don't exercise daily, the relationship between HR and SBP, was described by a third order regression curve during exercise in males, and a continuously increasing linear equation in females. The relationship between work rate and DP was described by a third order regression curve during exercise in males, while there was no increase in suppression for females, for whom the relationship could be described by a linear equation. At DPBP, HR was 64.4 ± 4% for males and 60.4 ± 5% for females of maximum heart rate. It is possible to detect with DPBP, the increasing pattern of SBP or HR that was expressed as linear or third regression curve against the work load. It was suggested that DP can be compensated even when the increase of SBP (or HR) was low, because DP is the integral number of SBP and HR.
Quantitative evaluation parameters for care-giving motions were investigated by analyzing three-dimensional motion data of skilled and unskilled caregivers. Subjects were three skilled caregivers, each of whom had over 12 yrs of clinical experience, and four physical therapy students. We recorded a typical care-giving motion between a caregiver and a care-receiver three times for each caregiver/receiver pair with a 3-D motion analysis system (VICON system, Oxford Metrics, UK). We did time-series analyses to extract performance evaluation parameters from observed indexes such as trajectories, velocities, accelerations of the body's center of gravity (COG), jerk-cost, and impulse. The analyzed motion was lifting a patient lying on a bed into the sitting position. The skilled caregivers' operation times were shorter than those of the unskilled caregivers. The COG trajectories of skilled caregivers showed smoother and better reproducibility over the three trials, and the COG velocity curves showed a high single peak at start up. The jerk-cost and impulse of skilled caregivers were lower than those of unskilled caregivers. We found reproducibility and smoothness of movement to be good evaluation parameters for care-giving motions. The measurement indexes observed in this study should be introduced to improve evaluation of the education of unskilled caregivers.