[Purpose] We evaluated brain organization during passive touch and tactile discrimination using functional magnetic resonance imaging and examined the influence of learning. [Methods] The subjects were 7 persons who were experienced Mahjong player and were able to distinguish a Mahjong tile pattern by thumb touch without visual clues and 10 persons who were novices with no Mahjong experience. During magnetic resonance imaging, all subjects lay resting in the supine position, with their eyes closed. They were given touch and tactile discrimination tasks using the dominant thumb. [Results] In both groups, contralateral (thumb) sensorimotor cortex activation occurred during touch and bilateral sensorimotor cortex activation occurred during tactile discrimination. In both groups, there was a significant difference between the touch and tactile discrimination tasks. Compared to touch, the activation area was significantly increased during tactile discrimination. No significant between group difference was observed in either the touch or tactile discrimination task, but during tactile discrimination, the activation area tended to be larger in the experienced group. [Conclusion] Brain organization clearly differed between passive touch and passive tactile discrimination. Our findings suggest that with passive tactile discrimination, brain area activation may increase with learning.
[Purpose] Little is known about the rubro-olivary tract (ROT) in the human brain. We attempted to identify the ROT using diffusion tensor tractography (DTT). [Subjects and Methods] We obtained ROT data from 11 healthy subjects with no history of neurological disorder. For tracking of the ROT, a seed region of interest (ROI) was selected in the red nucleus, and a target ROI was found in the inferior olive of each subject. [Results] The ROT, originated in the red nucleus, and passed laterally to the decussation of the superior cerebellar peduncle in the lower midbrain. In the pons, it descended through the area adjacent to the medial lemnicus in the posterior direction. Within the medulla, the ROT ended in the inferior olive, which was located lateral to the medial lemnicus and posterior to the pyramid. [Conclusion] We identified the ROT in the human brain using DTT. These results will be informative for research into the ROT in the human brain.
[Purpose] In general, people with bilateral osteoarthritis descend stairs sideways or backwards as compensatory movements. However, to the best of our knowledge, no studies have investigated these movements. The objective of the present study was to ascertain the effects of descending forwards and descending backwards on kinetic changes in the knee joint, to ascertain the optimal stair descending method for minimizing stress on the knee joint. [Subjects] Subjects were 30 adult women with no orthopedic or neurological disorders. [Methods] With step heights (riser heights) of 10, 15, 20 and 25 cm, changes in knee flexion angle, extension moment and joint force were measured when descending forwards and descending backwards using a three dimensional motion analysis system. [Results] Peak knee flexion angle, peak knee extension moment and peak knee joint forces observed in descending stairs backwards were smaller than those in the descending forwards action. [Conclusion] The present results suggest that descending stairs backwards for osteoarthritis patients is effective in protecting the knees, alleviating pain and acquiring compensatory movements.
[Purpose] This study was performed to investigate the inhibitory effect of a short-term thermal load in combination with treadmill running or neuromuscular electrical stimulation on the progression of disuse muscle atrophy and its causative mechanism. [Subjects and Methods] The ankle joints of Wistar rats were fixed at maximum plantar flexion, and the fixation was removed for intervention once a day. The rats were divided into 6 groups for intervention: control, fixation, treadmill running, thermal treadmill running, neuromuscular electrical stimulation, and thermal neuromuscular electrical stimulation groups. [Results] The progression of disuse muscle atrophy was inhibited only in the group given a thermal load before treadmill running. Regarding the atrophy mechanism, the expression of heat shock protein 72, which promotes protein synthesis and repair, was enhanced, while the expression of protein ligase E3, which promotes protein degradation, was inhibited. [Conclusion] These findings suggest that thermotherapy prior to exercise therapy promotes the effect of exercise therapy in patients with disuse muscle atrophy and elderly persons.
[Purpose] We aimed to obtain the mean values for physical function tests in healthy community-dwelling people aged 50-79 years and to compare these values between age decades. [Subjects and Methods] We recruited 172 healthy community-dwelling people, who provided their written consent. Grip strength (GS), isometric knee extension torque (IKET), and the times for performing the sit-to-stand test (STS) and timed up-and-go test (TUG) were used as indicators of physical function. Maximum force (Fmax) and maximum power (Pmax) were measured by asking the subjects to perform the counter-movement jump on a force platform system. The mean values were calculated and compared between different age decades by one-way analysis of variance. [Results] In men, all the measurements showed significant differences among different age decades; moreover, GS, IKET, Fmax, and Pmax decreased, while the time required for performing the STS and TUG increased with age. In women, GS, IKET, Fmax, and Pmax decreased, while the time required for performing the TUG increased with age. However, the time required for performing the STS did not differ across age groups in women. [Conclusion] The target values for physical function tests in people aged 50-79 years were established, and they were found to change with age.
[Purpose] The purpose of this study was to investigate the association of ability to rise from bed with improvement in functional limitations and activities of daily living (ADL) in hemiplegic inpatients with stroke. [Subjects] Participants were 38 hemiplegic inpatients with stroke in a convalescence rehabilitation unit. [Methods] On admission, a newly developed assessment, rising from bed independence score (RIS) and rise from bed time (RBT) were measured. On discharge, the Berg Balance Scale, Functional Movement Scale, and Functional Independence Measure were measured. We calculated correlation coefficients between ability to rise from bed on admission and these traditional measures on discharge. The proportion of subjects who regained independent gait was calculated among subjects whose RIS was 7 on admission. [Results] RIS and RBT were significantly correlated with most of the traditional measures on discharge. Only RIS was significantly correlated with relative gain. Of those with RIS=7 on admission, 76.9% regained independent gait. [Conclusion] We found that ability to rise from bed of inpatients with stroke was associated with improvement of functional limitation and ADL in a convalescence rehabilitation unit. Ability to rise from bed on admission was a useful predictor of independent gait on discharge.
[Purpose] This study investigated the effects of position and force of calf compression with graded ankle plantar flexion on central aponeurosis displacement. [Subjects] Ten healthy adult men participated in this study. [Methods] The subjects were placed in the prone position with knee and ankle joint angles of 0° and asked to perform graded isometric plantar flexion at 0, 5, 10 or 15 kg. The position of compression was either proximal or distal to the maximum circumference of the calf. Force of compression was set at 0, 50, 100 or 150 mmHg. Under these conditions, displacement of the central aponeurosis of the gastrocnemius lateralis, soleus and triceps surae-Achilles tendon junction was measured by ultrasonography. [Results] With isometric contraction, central aponeurosis displacement of the gastrocnemius lateralis and soleus with 100 or 150 mmHg of distal compression was significantly lower than at 0 mmHg of distal compression. However, with proximal compression, central aponeurosis displacement with isometric contraction did not change in relation to the compression force. [Conclusion] This study showed that even when the level of compression remains unchanged, compression achieves different effects depending on the position of compression.
[Purpose] Sustained isometric muscle actions induce fatigue which manifests as a decline in force. This decline has well known physiological correlates that are often assessed using EMG signal frequency changes, changes in blood flow and muscle temperature. The purpose of this study was to investigate how cooling influences recovery following isometric muscle fatigue. [Methods] Eight healthy volunteers performed isometric elbow flexion to fatigue on two occasions, with 10 minutes of rest with no cooling, 2 minutes and 10 minutes cooling. The surface EMG (median frequency), deep muscle temperature and circulating blood flow were assessed during and after each endurance task. [Results] The 10-minute cooling condition extended endurance in the isometric contraction task. No changes to median frequency EMG signals were detected and the deep temperature and blood flow was most profoundly affected with the extended period of cooling compared to rest and 2 minutes. [Conclusion] This exercise task was enough to induce fatigue in this study. It was shown that 10 minutes cooling for fatigued muscles will extend the duration of subsequent exercise. Indeed, the results of this study suggest the effects of muscle fatigue recovery by cooling are instantaneous.
[Purpose] This study investigated the effect of physical training with visual feedback and mental training with motor imagery on balance control ability. [Subjects] Twenty-one healthy adults (male/female: 7/14, mean age: 19.8 ± 0.1 years) with no history of neurological or orthopedic problems were enrolled in this study. The subjects were randomly divided into a physical training group (PTG), a mental training group (MTG), and a control group (CG). [Methods] PTG and MTG performed a dynamic balance task with physical and mental training, respectively, in a 30-minute training session, 5 days a week for 3 weeks. The CG did not receive any training. The outcomes of postural balance were evaluated in terms of the performance time and sway length measured by a force platform. [Results] In the baseline test, the three groups showed similar demographic data, performance time, and sway length. The PTG and MTG showed a significant decrease in performance time, but neither group showed any significant change in sway length. There was no significant difference in the CG. [Conclusion] Our findings indicate that physical balance training with visual feedback as well as mental balance training with motor imagery is effective. Therefore, mental training could contribute to improving dynamic balance ability in a cost-effective home-based training program.
[Purpose] The purpose of the present study was to investigate the reliability of Japanese manuals for the Aberrant Behavior Checklist (ABC-J) in daycare centers for handicapped children. [Subjects] Nine handicapped children with mental retardation, cerebral paralysis, etc were the subjects. [Methods] Four raters (one physical therapist: PT, one occupational therapist: OT, and two nursery teachers) individually used the ABC-J in an inter-rater reliability to determine the reliability of the result between different raters. Intra-rater and inter-rater reliability were examined using the Intraclass Correlation Coefficient (ICC). [Results] Inter-rater reliability ICC (2.1) were 0.582, 0.144, 0, 0.494 and 0.467 for "Irritability", "Lethargy", "Stereotypy", "Hyperactivity", and "Inappropriate speech" respectively. In intra-rater reliability ICC (1.1), the ICCs of the PT were 0.720, 0.991, 0.996, 0.902, and 0.261 for each item, and those of the OT were 0.578, 0, 0.636, 0.288, and 1. [Conclusion] Some items had inter-rater reliability. In the intra-rater reliability, the score was 0.7 or more, excluding the item of Inappropriate speech for the PT and were 0.57 or more, excluding the items of Lethargy and Hyperactivity for the OT.
[Purpose] As demands for physical therapy increase, the numbers of patients in physical therapy rooms are rapidly increasing. However, studies on the state of microorganism infections of physical therapy equipment and their effects on hospital-acquired infections are currently lacking. The purpose of this study was to examine the rate of infections of physical therapy rooms by pathogenic microorganisms. [Methods] Facilities in physical therapy rooms were divided into three groups, therapeutic environments, wet therapeutic equipment, and dry therapeutic equipment, to check the degree of microbial infection and to conduct antimicrobial susceptibility tests on microorganisms that could be isolated. [Results] The main microorganisms isolated from the therapeutic environments were Staphylococcus spp., including Staphylococcus aureus (S. aureus), and 20% of these isolates were methicillin-resistant S. aureus (MRSA). From the wet therapeutic equipment, Acinetobacter spp., including Acinetobacter baumannii (A. baumannii) and A. lowffii, were the primary isolates and 25% of these isolated bacteria were also identified as multi-drug resistant forms. No microorganism was detected from moist hot packs or hot pack units. Diverse bacterial strains were isolated from dry therapeutic equipment, but the isolation rate of Staphylococcus spp. was a little higher than that of other strains. [Conclusion] Our result suggests the possibility of hospital-acquired infection in physical therapy rooms could be very high. Strict hygiene management systems should be established in order to reduce hospital infection during physical therapy.
[Purpose] It is not clear whether changes in the neural networks within the primary motor area contralateral to the infarct hemisphere influence the recovery of neurological functions after strokes. Thus, we investigated whether the number of synapses increased within the contralateral primary motor area after brain infarction. [Subjects] Twenty-four Wistar rats (8 weeks old) were randomly allocated to ischemic or control groups. [Methods] Rats underwent middle cerebral artery occlusion surgery (ischemic group) or sham surgery (control group). All rats underwent two kinds of neurological examination on day 1 after surgery and again 2 and 4 weeks after surgery. The expression of synaptophysin and PSD-95 within the contralateral primary motor area was investigated by western blot analysis. [Results] In the ischemic group, the neurological scores at 4 weeks after surgery were significantly better than those on day 1. There were no significant differences between the two groups in the expression of synaptophysin and PSD-95. [Conclusion] Neurological functions significantly improved after brain infarction, but the number of synapses did not change within the contralateral primary motor area. These findings suggest that changes in synapse number within the contralateral primary motor area are not related to functional improvement after brain infarction.
[Purpose] The purpose of this study was to evaluate the influence of a dual-task condition on toe clearance of young and elderly subjects while stepping over an obstacle. [Subjects] The subjects were 30 young women and 30 community-dwelling elderly women. [Methods] The subjects were asked to perform two types of tasks. One was a dual-task consisting of a motor task with a concurrent cognitive task. The other was a solitary motor task. The motor task was stepping over an obstacle during comfortable gait. The cognitive task was a 7-series task. We measured toe clearance in performance of both the single and dual tasks. [Results] Although a two-way ANOVA showed that toe clearance was not influenced by the dual-task, heel obstacle distance decreased. [Conclusion] These results clarified that during the dual-task the movement of stepping over the obstacle was different from stepping over the obstacle during comfortable gait.
[Purpose] The purpose of this study was to elucidate what influences PBL (Problem Based Learning) tutorials have on the evaluation items in evaluation practice. We also examined the relationship between the degree of self-learning achievement in PBL tutorial and the inferred items in practical training. [Subjects] A total of 35 students, comprising 25 male and 10 female 3rd-year students with an average age of 23.7 ± 6.2 in the department of physical therapy at a 4-year vocational college were included in this study as study subjects. [Methods] A PBL tutorial was implemented based on the cerebrovascular hemiplegia scenario, comprising Parts 1 to 3. Evaluation practice was then held to calculate the correlation between the degree of influence and the degree of self-learning achievement from PBL for each of the evaluation practice items including "active learning attitude", "information gathering and test/measurement", "pursuit of the problem", "goal setting and treatment program development" and "report preparation and presentation". [Results] The degree of PBL influence was relatively high for "active learning attitude", "information gathering and test/measurement" and "pursuit of the problem". In addition, there was significant correlation between the degree of self-learning achievement from PBL and the degree of influence for "information gathering and test/measurement", "goal setting and treatment program development" and "overall evaluation". [Conclusion] While PBL may show a high degree of influence on evaluation practice for some items, this study indicated the possibility that the results may be improved with a better degree of self-learning achievement from PBL, even for items with relatively low degree of influence.
[Purpose] The purpose of this study was to investigate whether a cranio-cervical flexor exercise and thoracic mobilization are effective for muscular endurance (Endurance), visual analog scale (VAS) pain, and neck disability index (NDI) of patients with chronic neck pain. [Subjects] The subjects in this study were 53 patients who had chronic neck pain. [Methods] The experimental group (n=27) did both cranio-cervical flexor exercises and thoracic mobilizations and the control group (n=26) did cranio-cervical flexor exercises. [Results] A paired t-test analysis revealed significant pre-post score changes within both groups. The 2-way group time interaction for the repeated measures ANOVA was statistically significant for Endurance, VAS and NDI. The experimental group showed greater improvement in Endurance, with a between-group difference of 14.26 seconds, VAS pain, with a between-group difference of 2.02 points, and NDI, with a between-group difference of 2.07 points. [Conclusion] These results suggest that the combination of thoracic mobilization with cranio-cervical flexor exercise was more effective at increasing Endurance and reducing VAS pain and NDI.