[Purpose] The purpose of this study was to determine the effects of motorized spinal decompression using the DRX3000 system (Axiom Worldwide, Tampa, FL, USA) combined with spinal mobilization as well as lumbar stabilization exercises on patients with discogenic low back pain (LBP). [Subjects] A total of 30 adults with discogenic LBP (mean age, 34.06 ± 6.41 years; age range, 28-48 years; 14 males, 16 females) volunteered to participate in this study. [Methods] A 4-week course of spinal decompression treatment combined with motorized flexion-distraction mobilization and lumbar stabilization exercises were administered to the participants for 6 days per week for the first two weeks, and four times per week for two additional weeks. The entire treatment consisted of 20 visits over a 4-week period. Comparisons of changes in the Oswestry Disability Index (ODI) and straight leg raise (SLR) test at pre-intervention, after 10 treatment sessions, and at discharge (after 20 treatment sessions) were analyzed. [Results] There were significant improvements in the outcome measures of ODI score and SLR test after 10 and 20 sessions of spinal decompression treatment combined with spinal mobilization and lumbar stabilization exercises as compared with the pre-intervention. [Conclusion] Spinal decompression treatment combined with spinal mobilization and lumbar stabilization exercises significantly improved the clinical outcome measures of ODI score and SLR test in patients with LBP secondary to intervertebral disc herniation.
[Purpose] The purpose of this study was to evaluate the effects of push-up plus exercise with visual biofeedback on the activity of the shoulder stabilizer muscles in individuals with winged scapula. [Subjects] This study was conducted with two groups: a visual biofeedback push-up plus exercise group (n=6) and a control push-up plus exercise group (n=6). [Methods] Muscular activity of the shoulder stabilizer muscles of both groups were measured by electromyogram (EMG), both before and after the exercise. [Results] The control group showed a significant difference pre-and post-exercise in the activity of the serratus anterior muscle during elbow extension, but differences in other muscles were insignificant. The visual feedback group showed significant differences pre-and post-exercise in activity of the upper and lower trapezius during elbow extension, in the serratus anterior muscle during elbow flexion and extension and scapula protraction, and in the pectoralis major muscle during elbow flexion. [Conclusion] Providing visual biofeedback during push-up plus exercise made the exercise more effective for winged scapula.
[Purpose] The purpose of this research was to study the test-retest reliability of isometric knee extension muscle strength measurement using a hand-held dynamometer (HHD) with a belt, with healthy elderly people living in the community as subjects. [Subjects] The subjects were healthy elderly people living in the community, with an average age of 70.5 years, and measurements were made of the leg on the side that was used to kick a ball. [Method] The subjects sat on a mat table, and isometric knee extension muscle strength measurements using a HHD with a belt were conducted twice, at an interval of 30 seconds, with a knee flexion angle of 90 degrees. The measurement values were classified according to the gender of the subjects, and by age group 65-69 years, 70-74 years, and 75 years and above, and studied. Test-retest reliability was studied using the intraclass correlation coefficient (ICC) and checks of the differentials. [Results] The ICC(1,1) between the first and second measurements ranged from 0.85 to 0.92. Apart from the group of men aged 75 years and above, the second measurement values were higher than those of the first. [Conclusion] Test-retest reliability of isometric knee extension muscle strength measurement using a HHD with a belt was high in healthy elderly persons. However, measuring only once, or measuring twice and taking the average was considered inappropriate, since there is the possibility that the values in such cases would be lower than the actual muscle strength.
[Purpose] We investigated the effects of compression on the posterior surface of the thorax caused by a pillow used for postural changes on the respiratory function. [Subjects] The subjects were 22 healthy males with no history of ailments of the respiratory and circulatory organs. [Methods] With the subjects placed in the supine position, a half-lateral position with a pillow supporting the posterior surface of the thorax (pillow-supported position (1)), and a half-lateral position with pillows supporting the shoulder girdle and the pelvic band (pillow- supported position (2)), the ventilatory volume per breath (hereinafter TV) and expiratory reserve volume (hereinafter ERV) were measured based on the respiratory function, and at the same time, the distanced moved by the diaphragm was measured using an ultrasonic imaging device. [Results] Significantly lower values for TV were observed in the pillow-supported position (1) in comparison to the other postures. Significantly higher values for ERV were observed in the pillow-supported position (1) in comparison to the other postures. Significantly lower values for the distance moved by the diaphragm were observed in the pillow-supported position (1) in comparison to the other postures. [Conclusion] Ventilation decreased in pillow-supported position (1). We therefore consider that the movement of the diaphragm was reduced due to an expanded state caused by increase in residual air in the lungs.
[Purpose] We examined the histopathological changes in the joint capsule that occurred due to long-term immobilization of the joint, and compared them with those seen in aged rats. [Subjects] A total of 26 male Wistar rats were used in this study. [Methods] The right knee joints of the experimental group rats were immobilized for periods of 2, 4, 8, 16, or 32 weeks, and three 13-week-old "adult" rats and three 70-week-old "aged" rats were used as control groups. At the end of each immobilization period, the right knee joints of the rats were used as samples for histological examination. [Results] We observed histopathological changes in the joint capsules occurring due to joint immobilization. Increase in the thickness of the joint capsule had occurred by 4 weeks of immobilization and developed with prolongation of the immobilization period. An increase in the thickness was also observed in the joint capsule of aged rats. Further, the areas of elastic fibers in aged rats and those immobilized for 32 weeks were decreased compared to adult rats. [Conclusion] The joint capsules after immobility and aging showed similar changes, suggesting that some kind of identical mechanism causes the two conditions.
[Purpose] The purpose of the present study was to determine whether transient upper chest wall restriction would enhance diaphragmatic contribution to tidal volume in healthy subjects. [Methods] Changes of diaphragm thickness (ΔTdi) were studied by ultrasound in 24 healthy male subjects in the supine position. Tidal volume (Vt) and respiratory rate were measured by spirometer. ΔTdi with each breath was expressed as percentage of the thickness at the end of expiration (ΔTdi%) and the ratio of ΔTdi% to tidal volume was calculated (ΔTdi%/Vt). The upper rib cage was compressed with a sphygmomanometer cuff to restrict its motion. All parameters were measured in three conditions: during rib cage compression, prior to the compression, and subsequent to the compression. [Results] When upper rib cage compression was applied, ΔTdi% significantly increased, whereas it returned to baseline levels upon release of the compression. ΔTdi%/Vt tended to increase, however there was no significant difference. Subjects were divided into those who showed an increase in ΔTdi%/Vt (group 1: n=16) and those who showed a decrease (group 2: n=8). Prior to the compression, ΔTdi% and ΔTdi%/Vt of group 1 were higher than those of group 2. [Conclusion] These results suggest that in healthy male subjects transient upper rib cage ristriction may enhance diaphragmatic contribution to tidal volume, particularly in those subjects with low initial diaphragm recruitment.
[Purpose] The purpose of this study was to investigate the physical, psychological and social factors associated with the locomotor skills of housebound community-dwelling stroke patients. [Methods] The subjects were 78 stroke patients who had been discharged for more than six months. We classified subjects as 31 patients who had difficulty with going out by themselves and, 47 patients who could go out by themselves. We investigated psychological and social factors by questionnaire and physical factors from medical records. [Results] The number of "type 1" housebound patients were 25, and the main factor associated with "type 1" housebound was instrumental self-maintenance of the TMIG index of competence. The number of "type 2" housebound patients were 18, and the main factors associated with "type 2" housebound were the Barthel Index, expectations for rehabilitation, and presence or absence of a role in the community. [Conclusions] The factors associated with housebound were different according to type. Therefore it is necessary to tailor physical therapy to prevent a housebound condition according to locomotor skills.
[Purpose] This study aimed to examine problematic behaviors of mentally handicapped children receiving pediatric physical therapy, through applying the Japanese version of the Aberrant Behavior Checklist(ABC-J) to persons receiving pediatric physical therapy. [Subjects] Subjects were 26 handicapped children who had received pediatric physical therapy (18 males and 8 females, aged from 1 year and 4 months to 19 years and 10 months). The raters were 5 physical therapists and 1 occupational therapist. [Methods] The subjects were rated using ABC-J. [Results] Twenty-four of 26 subjects showed "Irritability", 23 subjects showed "Lethargy", 13 subjects showed "Stereotypy", 23 subjects showed "Hyperactivity", 12 subjects showed "Inappropriate speech". [Conclusion] "Irritability" "Lethargy" and "Hyperactivity" showed comparatively a stronger tendencies. However, all items were graded high in comparison with reports for Down syndrome. The results of this study suggest that the subjects of pediatric physical therapy show problem in problematic behaviors.
[Purpose] This study was conducted to examine the degree of lumbar lordosis, L4-5 disc angle, L4-5 disc height and the lumbosacral angle in L4-5 herniated nucleus pulposus (HNP) patients and analyze the correlations between these variables to examine the relationship between HNP and abnormal sagittal spinal alignment. [Subjects] The study subjects were 15 lumbar spine 4-5 (L4-5) HNP patients; the control group comprised 15 normal adults. [Methods] Both groups' magnetic resonance imaging scans were compared and analyzed. [Results] The HNP group showed a significantly smaller degree of lumbar lordosis, L4-5 disc angle, L4-5 disc height, and lumbosacral angle (p<0.05). I was also shown that as the degree of lumbar lordosis decreased, the disc angle, disc height, and lumbosacral angle decreased. [Conclusion] We found that L4-5 HNP patients have abnormal sagittal spinal alignments.
[Purpose] The purpose of the present study was to investigate the effect of magnetic infrared laser (MIL) irradiation on formalin-induced chronic inflammation. [Subjects] Male ICR mice. [Methods] Mice were subaponeurotically injected in the left hind paw with 0.02 ml of 3.75% formalin, then subjected to 1.33, 2.66 and 6.65 J/cm2 of MIL irradiation, once a day for 10 days during which then the hind-paw thickness and volume were measured daily. The paw wet-weight, histological profiles, histomorphometrical analyses and paw tumor necrosis factor (TNF)-α contents were conducted at termination and compared with those of dexamethasone, 15 mg/kg, intraperitoneally injected mice. [Results] After two formalin treatments, a marked increase in the paw thickness and volume was detected in the formalin-injected control as compared with the vehicle control. Also at the time of sacrifice the paw wet-weights, and paw TNF-α contents were also dramatically increased and confirmed by histopathological observations. However, these formalin-induced chronic inflammatory changes were significantly and dose-dependently decreased by MIL irradiation. [Conclusion] MIL radiation has favorable effects on formalin-induced chronic inflammation mediated by TNF-α suppression, and MIL therapy may represent an alternative approach for the treatment of chronic inflammatory diseases.
[Purpose] In this study, we examined the physical predictors of the decline of functional capacity among community-dwelling older Japanese individuals. [Methods] A total of 265 Japanese individuals aged 68-96 years participated in a baseline survey and a follow-up 4 years later. In this survey, participants performed tests for grip strength, one-legged standing, and 5-m walking. At baseline and the follow-up survey, we measured functional capacity using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), which consists of the instrumental self-maintenance scale, the intellectual activity scale, and the social role scale. [Results] There was only a weak association between physical performance and the decline of functional status in men. The 5-m walking time was most sensitive at predicting the future decline of the instrumental self-maintenance scale in women. Even after controlling for age, body mass index, grip strength, and one-legged standing, a slower 5-m walking time (greater than 4.6 sec) indicated an increased risk of future decline in instrumental self-maintenance in women (odds ratio = 5.31, p<0.01). [Conclusions] The usual walking speed is the best performance measure for predicting the decline of instrumental self-maintenance among Japanese older women.
[Purpose] This study examined whether motor imagery leads to a decrease in the temporal process in terms of the onset of muscle activation and reaction time according to acquisition of motor skills in a serial reaction time (SRT) task. [Subjects] Forty one healthy, right-handed subjects with no history of neurological, orthopedic, or psychiatric disorders were enrolled in this study. The subjects were assigned randomly to the motor training group (n=13), motor imagery group (n=14), and control group (n=11). [Methods] After six visual stimuli, the subjects were instructed to move or press a moveable arm/button according to the corresponding stimuli. However, the motor imagery group performed the task without actual movement in the same task paradigm. The kinetic parameters (i.e. muscle activation and movement initiation) were analyzed before and after the training/controlled session over three consecutive days with two repetitions per day for each group. [Results] After motor skill acquisition, the motor training group and motor imagery group showed a significant decrease in processing times between the visual stimuli and two predetermined onsets, which consisted of the onset of muscular activation and reaction time. However, there were no significant changes in the control group. [Conclusion] The decrease in processing time through motor imagery can be attributed to the rapid onset of muscle activation and movement initiation, which might be induced by neuromuscular adaptation in the motor performance phase. Furthermore, we assumed that imagining the performance of a motor task could contributes to improving the motor performance in motor sequential learning.
[Purpose] The aim of this study was to identify the age-associated changes in gait speed, stride length, cadence and step width, and to examine the relationship between these gait variables with a history of falls and life-space experience among elderly people. [Subjects] The participants were 848 healthy elderly adults (mean age 80 years, range 73-91, 76.8% women) living independently at home. [Methods] Gait speed, stride length, cadence and step width were measured at a normal pace using WalkWay, a device for measuring the distribution of foot pressure during walking. Any history of falls in the previous year was investigated by self-report and a life-space assessment was used to investigate the activity status of the subjects. [Results] Gait speed and stride length decreased markedly from age 85 years in women, and from age 90 years in men. Cadence and step width did not change consistently with aging. Gait speed was associated significantly with a history of falls and with life-space restriction, although these relationships were weak. [Conclusion] Gait speed reduces with age and might reflect a functional decline in elderly people.
[Purpose] We investigated how two types of exercise affect walking and single-leg standing in people with hip osteoarthritis (OA) using surface electromyogram (EMG) and three-dimensional (3D) motion analysis system. [Subjects and Methods] Participants were 18 female diagnosed as having hip OA. We defined hip abduction movement with a tube band wrapped around the thigh as monoarticular- (Mono-) group and the group using resisted joint extension with rotation movement as multiarticular- (Multi-) group. EMG measured the activity of the gluteus maximus (GMax) and gluteus medius (GMed) of affected side during 10 meters gait and single-leg standing on affected side. 3D motion analysis calculated the total locus length (TL) of anterior superior iliac spine (ASIS) of affected side during single-leg standing. These results were analyzed by t-test. [Results] After each exercise, %IEMG of GMax in Mono-group showed a significant decrease during the stance phase. In Multi group, GMax and GMed were significantly increased during the stance phase, whereas GMax was significantly decreased during the swing phase. TL during single-leg standing in Multi group decreased significantly. [Conclusion] These results indicate that exercise focusing on multiarticular movement improves muscle activity and stability in relation to daily activities.
[Purpose] The purpose of the present study was to determine the effect of a 4-week course of motorized spinal decompression delivered via SpineMED combined with physical therapy modalities on the treatment of patients with cervical radiculopathy (CRP). [Subjects] A total of 10 patients with CRP (mean age, 34.70 years; age range, 23-48 years) participated in the study. [Methods] A 4-week course of spinal decompression delivered via SpineMED combined with physical therapy modalities was delivered to the patients for 6 days per week for the first two weeks, and four times per week for two additional weeks. The entire treatment consisted of 20 visits over 4-week period. Comparisons of changes in the visual analogue scale (VAS) and neck disability index (NDI) at pre-intervention and at discharge were analyzed using the paired t-test. [Results] There was a significant improvement in the outcome measures of VAS and NDI after 20 sessions of spinal decompression combined with physical therapy modalities. The mean values of discharge for VAS and NDI were reduced by 21% and 14% respectively, as compared with their mean values at pre-intervention. [Conclusion] The results from the present study suggest that the use of motorized spinal decompression delivered via SpineMED combined with physical therapy modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with CRP.
[Purpose] The purpose of this study was to evaluate the effects of wheel chair tilt systems on lower limb hemodynamic states and their relationship to mechanical factors using near-infrared spectroscopy and a pressure distribution measuring system. [Subjects] Twelve healthy adult volunteers participated in this study. [Methods] We measured the lower limb hemodynamic states and pressure distribution experienced in a wheelchair in four tilt-conditions: reclining by five degrees, ten degrees, twenty degrees and full tilt-reclining. [Results] The results show a significant decrease in Deoxy-Hb was induced in the full-tilt reclining position. Furthermore, in comparison with the other sitting positions, full-tilt reclining produced a decrease in contact area, especially in the posterior femoral region. [Conclusion] These results suggest wheelchairs that combine tilt and reclining capabilities can, by altering the sitting position and thus improving lower limb hemodynamic states, prevent venous edema in wheelchair users who cannot perform active muscular pumping.
[Purpose] This study examined the influence of the probe reaction time on sitting stability during rhythmic stabilization. [Subjects] The subjects were divided into two groups of thirty-three elderly subjects (70.0 ± 6.0 years), and ten younger subjects (22.4 ± 2.8 years). [Methods] We evaluated the simple reaction time, the probe reaction time during rhythmic stabilization, and the resistance force of rhythmic stabilization. [Results] The probe reaction time was significantly longer than the simple reaction time in both groups. The resistance force of rhythmic stabilization decreased in the Elderly group compared with the Younger group. Partial correlation analysis gave correlations of r = 0.87 for the probe reaction time, r = 0.87 for the simple reaction time, r = -0.34 for the probe reaction time and the resistance force, and r = 0.80 for the probe reaction time and the ΔRT (ΔRT= probe reaction time - simple reaction time). [Conclusion] The results suggest that not only the trunk muscle force but also the attention are factors influencing the sitting stability.
[Purpose] We attempted to examine the range of motion (rotation, flexion and extension) of the neck and forward head posture in patients with a cervical herniated nucleus pulposus (C-HNP) and in normal persons through radiometry; and examined the correlations between the ranges of these motions and C-HNP. [Subjects] The study subjects were 15 patients with C-HNP at level 5 or 6 (C5-6, (males=5, females=10) and 15 normal persons (males=5, females=10). [Methods] We analyzed the degree of cervical lordosis of patients with C-HNP at C5-6 and normal adults and compared them using radiographs of their lateral views. We observed the absolute rotation angles (ARA), anterior weight bearings (AWB) and ranges of flexion and extension motion (RFEM). [Results] The results indicated that as ARA increased, AWB decreased and RFEM increased. In particular, we confirmed that as AWB increased, RFEM decreased. [Conclusion] This study identified a remarkably decreased range of cervical motion in patients with C-HNP compared to normal persons, along with misalignments of the cervical spine due to from increased forward head posture.
This study examined the measurement reliability and the kinetic chain of the thickness of the transverse abdominal muscle (TA) and the action potential of the levator ani muscle (LA). In other words, the change in the muscle output was examined during simultaneous contraction of both TA and LA. [Subjects] The subjects were seven healthy adult women (40.1 ± 12.8 years). [Method] Thicknesses of TA and integration electromyograms (iEMG) of LA were measured in five tasks in the supine position. The tasks were: 1) Resting state, 2) Maximal contraction of TA, 3) Maximal contraction of LA, 4) Maximal simultaneous contraction of both TA and LA, and 5) Maximal simultaneous contraction of both TA and LA with resistance added to both knees. To examine the measurement reliability, the tasks were tested twice. [Results] The interclass correlation coefficient (ICC) of the thickness of TA and the iEMG of LA showed high reproducibility during maximal simultaneous contraction. The thicknesses of TA during maximal simultaneous contraction and maximal simultaneous contraction with resistance were greater than during the resting state and maximal contraction of TA. The iEMG of LA during maximal simultaneous contraction was greater than during the resting state, maximal contraction of TA and maximal contraction of LA. In regression analysis, a significant relationship was found between the thickness of TA and iEMG of LA. [Conclusion] The muscle output during simultaneous contraction was larger than that of each individual muscle, suggesting that it is easier to contract LA when TA is contracted from the aspect of the kinetic chain.