[Purpose] A purpose of this study is investigation of risk management organization of a physical therapy section of an acute care hospital. [Subjects] One hundred sixty-nine facilities were selected from among those hospitals registered with the welfare health medical information network (9,019 facilities). [Methods] The study method was a questionnaire survey by mail. The numbers of returned questionnaires was 112, a response rate of 66.3%. [Results] Hospitals sizes ranged from 200~1,500 beds, and the average number of physical therapists was 10.5. The main equipment provided in the physical therapy departments were electrocardiogram monitors, transdermal oxygen saturation level measuring instruments, oxygen tanks, and suction units. In 37.5% of hospitals, nurses did not work in the physical therapy department. [Conclusion] In the near future, physical therapists should be allowed to perform suction technique. Safety in physical therapy was provision of the equipment and the tool of the risk management. The complete procedures are necessary in the case of emergencies.
[Purpose] Postural control has been shown to decline with age. The purpose of this study was to clarify the muscular activities of the trunk and hip joint while moving from two-leg standing to one-leg standing in healthy elderly adults and compare them with healthy young subjects. [Subjects and Methods] For 5 elderly and 8 young men subjects, electromyography activities of the left obliquus internus abdominis, left multifidus, left gluteus medius, and right ilio-psoas muscles were recorded using a surface electromyograph. EMG data were analyzed from 500 ms before lift-off to lift-off (0 ms). [Results] In the results, the muscular activities were not statistically significant between elderly and young people. [Conclusion] The presence of a qualitative change in muscle activities of elderly people was not demonstrated.
[Purpose] In this study, the effects of muscle fatigue involving only the quadriceps femoris on low back load during lifting were dynamically and mechanically investigated in relation to the degree of muscle fatigue and distance from a heavy object. [Methods] We measured the joint angle, electromyography and ground reaction force of 18 healthy male students during lifting at 3 fatigue levels of loads placed at 3 distances from the toes. [Results] At 25% fatigue of the quadriceps femoris, at the intermediate point of lifting, the knees were mostly extended and the body trunk was leaning forward, thus altering the mode of lifting. Myoelectrical activity of the quadriceps femoris was also decreased, and myoelectrical activity of the lumbar muscle decreased during the phase from the start of muscle activity to when the object was lifted off the floor. At 50% fatigue of the quadriceps femoris, no change in joint angles was seen during lifting, and as myoelectrical activity of the quadriceps femoris decreased, myoelectrical activity of the lumbar muscle increased during the phase from the start of muscle activity to when the object was lifted off the floor. In terms of ground reaction force, greater distance was associated with greater anterior load. [Conclusion] These results suggest that when the level of quadriceps femoris fatigue is relatively low, altering the mode of lifting somewhat lessens low back load, but when the level of quadriceps femoris fatigue is relatively high, compensatory changes cannot be made and an increase in low back load can increase the risk of lumbar injury.
[Purpose] This study examined the reliability of measurement of the probe reaction time (P-RT) in different types of repetitive movement. Also the study tried to determine the optimal number of times P-RT should be taken to yield reliable measurements. [Subjects] Ten subjects (7 males, 3 females) measured on two consecutive days. [Methods] Six different types of movements were tested including rest sitting position, marking time on sitting, marking time on standing, walking, tapping with the non-dominant hand at 1 Hz and 4 Hz. Simple reaction time (SRT) and P-RT movements were measured 10 times. [Results] The results show that the P-RT of marking time on sitting position, marking time on standing, walking, tapping with the non-dominant hand at 1 Hz and tapping 4 Hz had high interclass correlation coefficients. Further analysis showed that there were significant correlations among the six different kinds of movements, and that the 3rd time measurement could yield the optimal results. [Conclusion] In the clinical field, especially for the patients who are not able to walk or stand and weak people, the number of times of testing for P-RT could be reduced for each the six movements.
[Purpose] The purpose of this study was to better clarify the influence of wearing a lumbo-sacral orthosis (LSO) on the respiratory and circulatory responses during ergometry exercise, especially on work capacity and energy consumption. [Subjects] Work capacity (WC), peak oxygen uptake (VO2peak) and values of gas exchange threshold (VO2GET) in ten healthy male subjects (age 19.9 ± 0.6 yr, height 1.71 ± 0.06 m, weight 61.2 ± 5.0 kg; mean ± SD) were examined. [Methods] Experimental conditions were as follows: a non-elastic lumbo-sacral orthosis (NLSO) or an elastic lumbo-sacral orthosis (ELSO) were worn and no orthosis was used for the control. For statistic analyses, one-way ANOVA was performed. A P value less than 0.05 was considered statistically significant. [Results] In this study, we found no significant differences among the three conditions. Mean values of WC were 237 ± 32.6 W in controls, 220 ± 35.2 W with the NLSO and 227 ± 32.3 W with the ELSO, except for one subject who was instructed to stop exercising. Values of VO2peak were, on the average, 2.59 ± 0.34 ml/min in controls, 2.30 ± 0.40 ml/min in the NLSO and 2.41 ± 0.45 ml/min in the ELSO, excluding the subject who failed to exercising. Mean values of VO2GET were 1.21 ± 0.30 ml/min in controls, 1.02 ± 0.24 ml/min with the NLSO and 1.14 ± 0.32 ml/min with the ELSO, for all of the 10 subjects. [Conclusion] It was concluded that both types of LSO had no effect on cardio-pulmonary responses during ergometry exercise.
[Purpose] This study compared the relative efficacy of Posterior-Anterior Unilateral Pressure (PAUP), Anterior-Posterior Unilateral Pressure (APUP), Cervical Oscillatory Rotation (COR) and Transverse Oscillatory Pressure (TOP) techniques of manual therapy in the management of unilateral cervical spondylosis. [Subjects and Methods] Twenty-four male subjects in each of four groups (96 patients; age range 40-50 years, mean 44 ± 5.3 years) received treatment 3 times per week for four weeks. Mean treatment time, pain recovery pattern (pain-free, residual pain, fair improvement, no change or worse) and relapse after 3 months were outcome measures. [Results] Significantly (P<0.001) less time was spent applying APUP (130 min) and PAUP (156 min) than COR (192 min) and TOP (219 min) with significantly (P<0.001) more pain-free patients in APUP (63%) and PAUP (46%) groups than in COR (17%) and TOP (25%) groups. Relapse rates after 3 months were 8% (TOP) and 12% (COR) and these treatments had no effect on symptoms of 4% and 8% of patients, respectively. [Conclusion] APUP and PAUP achieve faster pain relief in more patients with unilateral cervical spondylosis than rotation and transverse pressure. Unilateral pressures should be preferred techniques of manual therapy for patients with unilateral neck pain and APUP promise a better outcome.
[Purpose] The purpose of this study was to investigate adaptations to slip perturbations using a customized separated-belt treadmill in older adults. [Subjects] Forty-five healthy older subjects participated in this study. [Methods] Participants were requested to continue to walk against 20 slip perturbations during a 5-minute period. The magnitudes of the reactive responses were evaluated with the use of a tri-axial accelerometer attached to the subject's pelvis. Also, the latency to the onset of EMG activity and the magnitude of EMG activity were measured using surface electrodes placed on both sides of the erector spinae, rectus abdominis, biceps femoris, vastus medialis (VM), gastrocnemius medialis (GM), and tibialis anterior muscles. [Results] The magnitude of the reactive response in the second half of the perturbed walk was significantly more decreased than during the first half (p < 0.01). Decreases in the magnitude of EMG were also observed from VM and GM muscles (p < 0.01, p < 0.05, respectively), but the latency of each of the muscles was unchanged. [Conclusion] In conclusion, adaptations that may have contributed to the prevention of falls occurred in older adults. These adaptations might have been accomplished by a change in magnitude of muscle activity rather than by a change in timing.
[Purpose] We aimed to examine the uptake and retention behavior of the radioisotope thallium-201(201Tl) in 5 hindlimb muscles, the soleus (Sol), plantaris (Pla), gastrocnemius (Gast), extensor digitorum longus (EDL), and tibialis anterior (TA). [Subjects] Male Wistar rats. [Methods] Three experiments were perfomed: 201Tl uptake and retention as a function of time after intravenous injection; uptake and retention under general anesthesia and in the conscious state; Analysis in hindlimb suspension model rats. [Results] There were significant differences between the uptake rates of Sol and other muscles. The uptake rates of the conscious group muscles were significantly higher than those of the unconscious group; the ratio of Sol/EDL uptake was approximately 2.5 for the conscious animals, although that for unconscious animals was 1.3. In hindlimb-suspended rats, no significant differences between Sol and EDL uptake rates were seem throughout the course of the experiment. [Conclusion] In summary, rat skeletal muscles are very sensitive to uptake and retention of 201Tl and are markedly dependent on time from injection, state of consciousness and on the muscular trophicity. The results of the present study suggest that 201Tl may contribute to physiological evaluation of muscle in rehabilitation science.
[Purpose] The purpose of the present study was to investigate somatosensory cortical reorganization in terms of source locations of somatosensory evoked magnetic fields (SEFs) in hemiplegic patients after thalamic hemorrhage. [Subjects] Nine hemiplegic patients after thalamic hemorrhage participated in this study. [Methods] SEFs in the affected and healthy hemispheres were obtained with alternative current stimulation of the left and right median nerves at the wrist within 72 hours (acute stage) and at three months (chronic stage) after the onset of thalamic hemorrhage. After source estimation using a single equivalent current dipole model was performed to two median nerve SEF components, the source location changes of corresponding components between the acute and chronic stages were investigated. [Results] In the affected hemisphere, no patients showed significant SEF source location changes between the acute and chronic stages. In the healthy hemisphere, three patients showed significant SEF source location changes between the acute and chronic stages. [Conclusion] The significant SEF source location changes in the healthy hemisphere between the acute and chronic stages might reflect somatosensory cortical reorganization based on dependence on the non-affected upper extremity (UE) due to affected UE dysfunction in activities of daily living (i.e. use-dependent plasticity).
[Purpose] An experiment was carried out to investigate possible age-associated changes in the cross-sectional area of the type II fibers of the extensor digitorum longus (EDL) of male rats during hindlimb unweighting. [Subjects] Nine 3-month-old and seven 8-month-old rats were divided into three groups each. [Methods] One group was reared under hindlimb suspension for one week, another group for two weeks and a control group under normal rearing conditions for three weeks. The cross-sectional area of 200 to 230 muscle fibers of the right EDL from each rat was measured, followed by random sampling of 15 type II fibers from each of the six groups that were used for a comparison of their mean values. In addition, 50 type II fibers were selected for a comparison of their frequency distribution patterns. [Results] Significant atrophic changes were demonstrated in EDL of the 3-month-old rats in hindlimb suspension for one week in comparison to the control group, but the 8-month-old rats showed no significant atrophic changes in any of the groups. [Conclusion] The atrophying process of the rat EDL may differ depending on its age, and this process in aged skeletal muscle fibers may be delayed for a short period of time during unweighting.
[Purpose] The aim of this study was to verify frontal lobe activity in healthy individuals during the performance of spatial tasks as part of a cognitive therapeutic exercise. [Subjects] Twelve healthy young adults participated in the experiment. [Methods] The spatial tasks were to differentiate the sizes of circles with different diameters. In actual practice, a therapist held the upper limbs of an experiment participant and passively traced 5 randomly appearing circles of differing sizes by moving only the participant's shoulder joint and then had the participant determine the order of the circles. Under control conditions, the participant was not asked to make this determination. Under both experimental and control conditions, the experiment participant was asked to close his or her eyes during the tasks. Functional near-infrared spectroscopy (fNIRS) was used for measurement, and relative changes in blood flow in the frontal lobe were measured. [Results] Blood flow in the premotor cortex and dorsolateral prefrontal cortex increased significantly (p<0.05) under spatial task conditions in comparison to control conditions. [Conclusion] This result suggests that the premotor cortex, which is responsible for motor learning, and the dorsolateral prefrontal cortex, which is responsible for working memory function, are activated during the performance of spatial tasks as part of cognitive therapeutic exercise.
Clinical studies have shown that functional motor recovery after stroke may be facilitated by mirror therapy (MT). However, its underlying mechanism is uncertain. In this study, we examined brain activation during unilateral hand movement in 5 right-handed healthy subjects (1 male and 4 females) with or without viewing a mirror reflection of the moving hand (MT). We measured the changes in the concentration of oxygenated hemoglobin in the primary sensorimotor cortex (SMC) using near-infrared spectroscopy. We calculated the laterality index (LI) using the extent of activation in the right and left SMCs. The LIs (± standard error of mean) during right hand grasping without and with MT were 0.17 ± 0.11 (left SMC predominance) and -0.42 ± 0.24 (right SMC predominance), respectively (p < 0.05). However, there was no significant difference in LIs during left hand grasping without and with MT (0.02 ± 0.05 and 0.08 ± 0.05, respectively). The findings suggest that MT is more effective when it is used for dominant right hand movement, and this phenomenon may be the related to the different manipulability between the dominant and non-dominant hands.
[Purpose] The purpose of this study was to investigate the relationship between the expiratory activity of the lateral abdominal muscle during quiet breathing and exercise tolerance in COPD patients. [Subjects] The participants were 15 moderate and severe male COPD patients (FEV1 = 42.5 ± 15.9% predicted) and 15 sex- and age-matched healthy subjects. [Methods] The expiratory activity of the lateral abdominal muscle and exercise tolerance were measured. The expiratory activity was estimated from the thickness difference (Tdif) of the lateral abdominal muscle during quiet breathing using ultrasonography. Exercise tolerance was assessed by the incremental shuttle walking test (ISWT). Pearson's correlation coefficient was used to study the correlation between Tdif and the distance walked in ISWT, and FEV1. [Results] Tdif was higher in COPD patients than in healthy subjects, and a moderate significant negative correlation was found between Tdif and the distance walked. However, there was no significant correlation between Tdif and FEV1. [Conclusion] The results indicate that exercise intolerance may be more important factors than airflow limitation in expiratory muscle activity during quiet breathing in advanced COPD patients.