Early intervention planning for infants with disabilities has conventionally been centered on the infants' disabilities, rather than the family's adjustment. This study investigates the effectiveness of an Neonatal Behavioral Assessment Scale (NBAS)-based intervention for infants with disabilities, in enhancing infant neurobehavioral organization, maternal self-efficacy, and mother-infant interaction. A time series design was used, with the intervention trial consisting of a two-week observation at baseline and intervention periods. Subjects were 15 infants with disabilities and their mothers. The NBAS, Lack of Confidence in Caregiving (LCC) items of the Mother and Baby Scale, and the Nursing Child Assessment Teaching Scale (NCATS), were used to assess neonatal neurobehaviors, maternal self-efficacy, and the quality of mother-infant interaction respectively, at 3 time points: at intake, pre-intervention, and post-intervention. Intervention sessions were performed 6-8 times, 30 minutes per session, during the intervention period. The NBAS, LCC, and NCAST scores were significantly improved post-intervention. The NBAS-based intervention has beneficial effects on neonatal neurobehavioral organization and the quality of mother-infant interaction skills and maternal self-efficacy, in infants with developmental disabilities. Attunement of mothers to their infants' behaviors early on in life may promote a positive cycle of interaction between parents and infants.
The purpose of this study was to assess the validity of the measurement values obtained from "Power Measure", a simple muscular strength measuring instrument that we have developed. This instrument consists of two acrylic outer and inner cylinders with internal diameters of 9.5 cm and 8.5 cm, respectively, and one of three kinds of compression coil spring. To assess the validity of the measurement values, a weight was loaded on the instrument perpendicularly, and the compression distance of the spring corresponding to the load of the weight was defined as the actual measurement value, while the value obtained by dividing the loaded weight by the spring constant was defined as the reference value for the measurement. Although there were some issues regarding the measurement values, the relationship between the weight load and compression distance was strongly correlated with the reference values whichever spring was used. This indicates that the principle of this measuring instrument, estimation of muscular strength from the distance of spring compression in relation to the spring constant, is consistent with physical principles, and that the measurement values obtained from this instrument are highly valid.
The purpose of this study is to clarify the effects of exercise on the improvement of the physical functions of the elderly. Ten males and thirty-four females, 44 in total, living in or visiting health care facilities and special nursing homes for the elderly who were able to either walk independently or with walking aids were randomly divided into a treatment intervention group (TIG) and a control group (CG). The average age of the TIG was 84.4 ± 5.6 years old, and that of the CG was 85.6 ± 4.8 years old respectively. The training exercises of the TIG were standing up from a chair grasping parallel bars and raising arms with pet bottles 2 or 3 times a week for 6 months. In the TIG, increased mean values of each estimation parameter were recognized: muscle strength of upper and lower limbs, grip strength, thigh circumference, standing up, the movement of raising arms, walking time and number of steps for 10 m, Functional Reach Test and Timed up & Go Test. Moreover, significant differences between the TIG and the CG were found in each evaluation item (p<0.05). This study suggests that the continuation of light-load exercise is effective and imperative for the elderly to keep and improve their physical functions.
This paper describes the results of a study that examined the reliability and validity of a Japanese version of Kogan's Scale of Attitudes Towards the Elderly (ATE). The ATE scale measures the affective attitude component towards the elderly and contains 17 paired positive and negative statements to be responded to in a six-point range, from strongly agree to strongly disagree. A convenience sample of 314 practising physiotherapists in Ishikawa Prefecture, Japan, participated in this study, and data were collected by means of a mailed ATE questionnaire. The reliability of the scale was assessed as homogeneity, and its validity as construct validity. The rate of return was 57.3%, of which the number of men was 79 (43.9%) and women 101 (56.1%). The mean (SD) number of years of the respondents' clinical experience was 8.9 (7.3) ranging from 0.5 to 37.9. All of the 34 items were found to have significant item-to-total correlations (p<0.01). The Cronbach's alpha reliability estimates for the total scale, positive items and negative items were 0.87, 0.86 and 0.85, respectively. Some evidence for construct validity was found in the three-factor solution, which explained 30.7% of the variances. The factors derived from Spearman's rank correlation and factor analysis were `prejudice,' `appreciation,' and `expectation,' with the rate of contribution (Cronbach's alpha) being 14.0% (0.84), 8.7% (0.77), and 8.0% (0.74), respectively. The result of a multiple regression analysis indicated that neither the amount of clinical practice, the gender nor cohabitation with the elderly had any influence on the ATE of the respondents. This precluded the verification of convergent validity. From the results of this current study group, the Japanese version of the ATE scale can be considered a reliable and valid measure of documenting trends of importance for the care of the elderly.
It is still unclear how rehabilitative intervention assists recovery from strokes. In order to address this question, we made an animal model to examine the recovery process after experimental strokes. The forelimb movements in 2 monkeys retrieving food from a well were analyzed with a videotape recording. A small infarction by coagulation of blood vessels was made in the forelimb areas after mapping of the primary motor areas. The recovery process was evaluated by measuring the time required for taking food. We used the modified Klüver board with the small diameter in order to restrict the monkeys' compensatory movements such as pronation or supination. After the infarction, the monkeys could not use their impaired hands for the first 2 days. Failure to retrieve food and compensatory movements such as involvement of other joints were often observed during the first week. However, the forelimb function of both monkeys showed no significant impairments on the 6th week, compared to the results before the infarction. Throughout the experiments, the monkeys showed no supination or pronation of the forearm. These results suggest that this animal model with the modified Klüver board may be useful for the evaluation of motor deficit.
To evaluate the strength of research evidence for selected interventions in the management of plantar fasciitis and compare the evidence with current clinical guidelines. A literature search of PubMed and CINAHL from 1995 to 2005 was conducted using articles that involve interventions that physical therapists would administer directly, are English-only, peer reviewed, prospective and retrospective studies, and whose interventions are supported at least two randomized controlled trials. Grouped by treatment category, these articles were evaluated using the American Academy of Cerebral Palsy and Development Medicine classification system. Each category was assessed using the Modified Canadian Task Force grading format, and compared with current clinical guidelines. Twenty-seven articles were reviewed: 6 for night splints, 9 for orthotics/inserts, 9 for extracorporeal shock wave therapy (ESWT), and 3 for stretching. Night splints and stretching received a C; orthotics/inserts received a B, and ESWY received an A. Comparisons between the results and the Brigham and Women's Clinical Guideline for Lower Extremity Musculoskeletal Disorders revealed similar recommendations, except for ESWT. Evidence exists for night splints, orthoses, extracorporeal shock wave, and stretching as interventions for plantar fasciitis. ESWT received the highest grade, although existing guidelines have not mentioned this as an intervention.
The purpose of this study was to determine and verify a measuring and modeling technique for the center of gravity during manual wheelchair propulsion. Eight non-wheelchair users propelled themselves on linear flat floor and a slope (1/12) in four axle conditions. A three dimensional motion capture system and the force plates recorded static and dynamic trials of propulsion performance. Positions of the combined center of gravity of a wheelchair and the human body were calculated using a kinematic model. The positions of the center of gravity had a highly significant correlation with the positions of the center of pressure obtained from the force plate data in the anterior-posterior direction in static trials (r=0.99, p<.05), giving an average error (RMSE approximately 1.0). The minimal distance between the center of gravity and axle positions significantly decreased with axle position forwarded in propulsion on the floor (p<.05). Propulsion on the slope, however, demonstrated less significant differences of the distance between the center of gravity and axle positions. It implies that more dynamic activities lead to a variety of changes in the center of gravity. This method for determination of the center of gravity can be considered valid in static trials for wheelchair sitting and in dynamic trials on level ground during manual wheelchair propulsion.
The objectives of this study were to identify the position where optimal leg muscle force occurs and to analyze the lower extremity muscle activity by comparing different hip and knee joint angle positions using a newly developed closed kinetic chain (CKC) leg press exercise device. Muscle force and electromyogram (EMG) measurements during maximum voluntary isometric leg presses (MVC-CKC) were performed on 6 healthy women in 6 different knee flexion angles (15°, 30°, 45°, 60°, 75°, 90°) and 2 different postures (supine and trunk upright posture). Results showed that the muscle force of MVC-CKC reached its peak at 60° knee flexion angle in both postures. Significant knee angle-dependent differences in EMG activity for both rectus femoris and gastrocnemius muscles were observed, while posture-dependent differences in EMG were found in biceps femoris. These particular joint-dependent EMG activities may be explained by the architectural characteristics of bi-articular muscles and muscle length-tension relationship theory. Co-activation of an antagonist muscle may appear with activation of the gastrocnemius muscle when the knee approaches full extension. Consequently, measurement of isometric CKC leg extension muscle force at 60° knee flexion angle in the trunk upright posture seems to be the optimal position.
"Mirror Agnosia" is characterized by searching for the mirror image and showing difficulty of modifying behavior even after the object is presented in real space (Ramachandran, 1997). The possibility of therapeutic intervention of using a mirror for unilateral spatial neglect (USN) with mirror agnosia was suggested, but few researches on mirror agnosia and mirror approach for USN have been reported. The purpose of this study was to confirm the influence of the use of a mirror for USN with mirror agnosia. Two patients with left hemiparesis with USN were evaluated. We propped a mirror on the right side of the patient parallel to the sagittal plane and presented a ball apart from it. We asked the patient to grasp it with looking into the mirror. If they could not reach the actual ball, we shifted the ball closer to the mirror and tried again. When two patients grasped the ball, we asked them to reach it repeatedly. Albert test was executed before and after the session. Both patients could not reach the ball initially, but were able to grasp it when it was closer to the mirror. They showed an improvement in the Albert test after this approach. This method might be useful therapeutic intervention for USN with mirror agnosia.
The purpose of this study was to investigate the function of Japanese Geta clogs. We measured the foot pressure and the distance between the Geta and the heel. An F-scan and three-dimensional motion analyses were done. Toe pressure increased in the stance phase at toe-off, and we confirmed that heel-Geta contact is present at the beginning of swing phase. The distance between the Geta and the heel increased from heel-off to toe-off and decreased from toe-off to mid-swing. The results suggest that active toe movement occurs during Geta gait, and the use of Geta clogs may contribute to preventing foot disorders and falls. Geta may be useful for foot and toe strengthening.
The purpose of this study was to investigate the influence of repetition on anticipatory postural adjustments between two tiptoe movement tasks. Ten healthy young male (22.5 ± 2.6 years old) participated in this study. They stood on tiptoe from standing position as quickly as possible after an auditory stimulus. Single and repetitive tasks as the tiptoe movement task were performed. Electromyogram during the tiptoe movement was measured in the gastrocnemius (Gas), tibialis anterior (TA), biceps femoris (BF), rectus femoris (RF), erector spinae (ES) and rectus abdominus (RA). The characteristics of the initial tiptoe movement during each task were established by analysis of kinematics data. Onsets of each muscle activity, integrated electromyography (EMG) and center of pressure (COP) displacement prior to the onset of Gas were compared between the single and repetitive tasks. The onset of TA and RF in the repetitive task was earlier than that of the single task, and integrated EMG per unit time and COP displacement also changed. These results suggest that the central nervous system may transmit different motor commands to postural muscles during single and repetitive tasks, and anticipatory postural adjustment might be modulated by the repetition of task.
The effects on expiratory muscle strength and exhalation capacity of increased pelvis elevator muscles strength caused by strength training are not known. Twenty-six male students were randomized to either a training group or a control group. The training group had pelvis elevator muscles strength training twice daily for 4 weeks. At the beginning and end of the study, pelvis elevator muscle strength, maximum expiratory muscle strength (PEmax), and peak cough flow (PCF) were measured, and pulmonary function testing (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), peak expiratory flow rate (PFR)) was performed. In the training group, significant increases were seen in pelvis elevator muscles strength, PEmax, and FEV1.0; no changes were seen in FVC, PFR, or PCF. No significant correlation was seen between change in pelvis elevator muscles strength and changes in exhalation capacity parameters in the training group. Strength training of the pelvis elevator muscles increases respiratory muscle strength, which would suggest that such training could increase exhalation capacity. However, the increase in pelvis elevator muscles strength that occurred as a result of training could not fully account for the changes in expiratory muscle strength or other parameters of exhalation capacity noted after training.
The purpose of this study was to re-examine the influence of prolonged stretching on joint contractures by using a specific force for joint correction and ROM measurement. Twenty-five 8-week-old female Wistar rats were divided into five groups. One group was used as a control (G1), and the rats in the four experimental groups were immobilized to cause ankle contractures. The first group was immobilized continuously (G2). In the second, third and fourth groups, the casts were removed daily, and the foot was held in dorsiflexion for periods of 30 minutes (G3), 60 minutes (G4), and 120 minutes (G5), respectively. After a week, restriction in ROM in G4 and G5 significantly increased, as compared to G2 and G3, and contraction bands were observed in G4 and G5. These results suggest that aggravation of ROM restriction increased with the amount of stretching, and the cause may be a decrease in muscle circulation.