[Purpose] This study was performed to investigate the changes of thickness and reliability of the measurements of lateral abdominal muscles during respiratory maneuvers using ultrasonography. [Subjects and Methods] Participants were 10 healthy male volunteers (26.4±2.7 years old). Ultrasound B-mode scanning was performed with the subjects lying supine and the probe was placed transversely midway between the costal inferior border and the crista iliaca. The muscle thickness of the external oblique (EO), internal oblique (IO), and transverses abdominal (TA) were measured under two conditions: resting expiration (Rex) and maximum expiratory effort (MEE). Percent thickness change was calculated as thickness MME — thickness Rex / thickness Rex×100%. Interclass correlation coefficients (ICC 1, 2) were used to estimate reliability. [Results] Muscle thickness during MME were significantly increased compared with that during Rex and the EO thickness was significantly decreased. Intraexaminer reliability estimates ranged from 0.97 to 0.82 for EO, 0.94 to 0.81 for IO and 0.67 to 0.86 for TA. [Conclusions] We conclude that the thickness of the lateral abdominal muscles is influenced by voluntary respiration, and the assessment of the thickness by means of ultrasonography is adequately reliable. This information may be useful for deciding exercise prescription.
[Purpose] The aim of this study was to monitor the motor recovery process of stroke patients using a laterality index between the paretic and non-paretic upper limb actigraphic activities. [Subjects and Methods] Sixteen stroke patients wore an Actiwatch® accelerometer on both wrists for 24 hours. The motor activity was recorded at four different time points: approximately 15 days, 33 days, 61 days and 91 days after the onset of stroke. [Results] An increase in motor activity was found on both sides during the course of the recovery process. The laterality index also increased, suggesting an improvement in the paretic side. In patients who showed little improvement on the paretic side, the activity increased on both sides, but the laterality index remained almost constant. Moreover, a significant positive correlation was found between the laterality index and the Brunnstrom stage (arm; rs=0.83, hand; rs =0.82). [Conclusions] Our results suggest that the laterality index of actigraphic activity is useful for assessing real improvement of the paretic side.
[Purpose] This study compared the activations of the shoulder and trunk muscles during dominant-leg-extended knee push-up-plus (KPP) exercises on a mat, on an unstable surface, and with loading. [Subjects] Fourteen healthy subjects, all right-side dominant and with no history of injury or surgery to the shoulder or neck were the subjects. [Methods] The subjects performed dominant-leg-extended knee push-up-plus using three variations. Electromyography activities of the serratus anterior (SA), upper trapezius (UT), external oblique (EO), and internal oblique (IO) muscles were recorded. [Results] We observed significant differences in SA activity among the exercise conditions. Dominant-leg-extended KPP on a stable surface produced the highest SA muscle activity. Dominant-leg-extended KPP using a wobble board produced the highest EO and IO muscle activity. [Conclusion] To apply the proper resistance to enhance selective SA muscle activity in KPP, the best technique is to raise the ipsilateral leg. Furthermore, KPP on an unstable surface can facilitate lumbar stabilization.
[Purpose] The purpose of this study was to investigate the influence of a dual-task on movements of stepping over an obstacle by elderly people who had a fall experience in the past year. [Subjects] Subjects were 7 people who had a history of falls and 22 people who had no history of falls in the past year. [Methods] Subjects were divided into fallers group while subjects performed and non-fallers group by based on interview results. We measured toe clearance the single and dual tasks. The single task was a solitary motor task. The dual task consisted of a motor task and a concurrent cognitive task. The motor task was stepping over an obstacle during comfortable gait, and the cognitive task was the serial subtraction of seven from 100. [Results] Two-way ANOVA showed that toe-obstacle distance had a significant interaction effect. [Conclusion] These results suggest that fallers and non-fallers may have different strategies for stepping over an obstacle.
[Purpose] The present study compared the ground reaction forces and temporospatial characteristics of the initial foot movement following anteroposterior platform perturbation between elderly fallers and non-fallers. [Subjects] Eighty-one elderly female subjects aged between 60 to 70 years were divided into faller (N=36) and non-faller (N=45) groups. [Methods] A motorized platform translation was applied as a perturbation. The response characteristics were recorded using a forceplate and a six-video camera 3D ViconTM motion analysis system. [Results] Both faller and non-faller groups showed a forward single step pattern greater than a backward single step pattern. The swing duration time of the non-faller group was significantly longer than that of the fallers, whereas step velocity of the fallers showed higher values than that of the non-fallers during forward single step. [Conclusion] The step ability in the faller group was decreased compared to the non-faller group during the forward single step. The findings suggest that the muscle performance of the primary muscles for balance recovery should be promoted in the elderly. Moreover, stability and ability to stand on one leg should be a measurement and training concern for the elderly to reduce the likelihood of falls.
[Purpose] We attempted to locate the motor points (MPs) of the tibialis anterior muscle (TA) for more effective neuromuscular electrical stimulation (NMES). [Subjects] We dissected 16 legs from 12 cadavers. [Methods] Branches of the deep peroneal nerve were traced to their entry into TA (MPs). We defined the FH-LM line connecting the fibular head to the lateral malleolus and the pFH-LM perpendicular to the FH-LM lines that ran through each MP. The distance from the fibular head to MPs projected on the FH-LM line was measured. On the pFH-LM line, the width of TA and the distance from the lateral edge of TA to each MP were measured. The location of each MP was expressed as a percentage of total length of the FH-LM line and of TA width, respectively. [Results] The median number of MPs was 8 per cadaver. About 68% of all MPs were located within the proximal one-third of the FH-LM line. The average location of the thickest motor branch MP was 4.2 cm (13.9 %) on the FH-LM line and 0.9 cm (33.5 %) medial from the lateral edge of TA. [Conclusion] This data should enable more effective NMES.
[Purpose] This study examined the effects of walking exercise and weight-bearing exercise on the prevention of disuse muscle atrophy. [Subjects and Method] Male Wistar rats aged 7 weeks were used. They were randomly divided into control groups and experimental groups (n=8). After hindlimb-suspension for 7 days, the experimental groups were 1) hindlimb-suspended (HS), 2) exercised by treadmill walking (EX), 3) body weight-loaded (WB) and 4) re-loaded (RL) for 1 (day-8) or 7 (day-14) more days. The right soleus muscle was used for histology and stained with hematoxylin eosin and the left soleus muscle was used to measure the MyoD and mechano growth factor mRNA expressions. [Result] Soleus muscle wet weights and cross-sectional areas of RL-14 and WB-14 were significantly greater than those of HS-14, although those of EX-14 were not. Mechano growth factor mRNA expression of RL-8 was significantly higher than those of HS-8 and WB-8, but there were no significant differences between the values for RL-8 and EX-8. MyoD mRNA expression of RL-8 was significantly higher than those of the other groups.[Conclusion] Walking exercise couldn't prevent disuse muscle atrophy any more than weight-bearing exercise, even though the mechanical stress of walking exercise was greater than that of the weight-bearing exercise.
[Purpose] The purpose of this study was to verify the effects of Gong's Mobilization on shoulder abduction range of motion (ROM). [Subjects] In this study, 57 male and female adults whose shoulder abduction ROM was limited to 120 degree or less were selected and separated into a Gong's Mobilization group (n=28) and anterior to posterior gliding group (n=29). [Methods] Gong's Mobilization and an anterior to posterior gliding were repeated 10-15 times. A goniometer was used to measure the shoulder abduction ROM. [Results] Both Gong's Mobilization and anterior to posterior gliding were effective in increasing shoulder abduction ROM, but the effect of Gong's Mobilization was greater. [Conclusion] Gong's Mobilization is a useful treatment alternative in the clinical setting because it has an immediate effect and it can be done in the sitting position.
[Purpose] The aim of this study was to investigate and compare changes in muscle fascicle and tendon tissue behavior during stretching between a weight-bearing position and non-weight-bearing position. [Subjects] The study subjects were fifteen healthy individuals. [Method] Changes in the calf muscle after stretching in a weight-bearing and a non-weight-bearing position were compared using ultrasonography. Weight-bearing and non-weight-bearing stretching were performed for 30 seconds, and the medial gastrocnemius (MG) muscle fascicle length, pennation angle, and Achilles tendon length were measured before and after stretching. [Results] The post-stretching results in both positions showed increased fascicle length, decreased pennation angle, and increased Achilles tendon length compared with the pre-stretching results. Significant interactions were found between weight-bearing and stretching as evidenced by MG fascicle length and Achilles tendon length; specifically, the non-weight-bearing position increased the length more than the weight-bearing position. [Conclusion] This study revealed that while both weight-bearing and non-weight-bearing stretching were able to stretch the MG muscle and the Achilles tendon, non-weight-bearing stretching was more effective with regard to extending the MG muscle and Achilles tendon.
[Purpose] In order to succeed and achieve in sports, athletes need to enhance their specific athletic performance in competitions. Therefore, athletes seek to find the best training method for improvement. Stretch is a major part of athletic training preparation during in and off season. However, performing static stretch during warm-up session is controversial. Thus, the purpose of this study was to examine the effects of different stretches prior to a 40 m sprint and the Margaria-Kalamen Power Test on lower extremity power. [Subjects] Twenty-eight high school sprinters participated in this study. [Methods] They performed three 40 m sprints and the Margaria-Kalamen Power Test following the 12 weeks of different stretches. Repeated measures ANOVA was used for statistical analysis. [Results] The results show that after 12 weeks of intervention, 40 m sprint times and the Margaria-Kalamen Power test performance were significantly enhanced in dynamic stretch compared to static stretch. [Conclusion] We concluded that 12 weeks of dynamic stretch improved 40 m sprint times and leg power compared to static and mixed types of stretch programs. It should be noted that a dynamic stretch program enhanced lower extremity power in high school sprinters.
[Purpose] We investigated the effect of lower extremity muscle strengthening exercise and treadmill walking exercise on the gait and balance of stroke patients. [Subjects] The subjects were 44 stroke patients and they were randomly assigned to the lower extremity muscle strengthening group (MSG, n=24) and the treadmill walking group (TWG, n=20). [Methods] Both groups performed the exercises 3 times a week for 6 weeks in addition to general physical therapy. Walking ability was evaluated using the 10 m walking test and the timed up-and-go test (TUG), and balance ability was evaluated using the Berg Balance Scale (BBS) and a balance performance monitor (BPM). [Results] There was no difference between the groups in the 10 m walking test and TUG with respect to walking ability, but walking ability was significantly improved after the exercise in each group when compared to before the exercise. [Conclusion] It was found that both the lower extremity muscle strengthening exercise and the treadmill walking exercise helped the stroke patients to improve their walking ability, but it is hard to decide which exercise is more effective.
[Purpose] The purpose of this study was to demonstrate the preventative effect of thermal preconditioning on exercise-induced muscle injury. [Subjects and Methods] Eight-week old male ICR mice were divided into a control group (Cont) and heat stress group (Heat). Mice in the Heat group were immersed in water at 41.5 ± 0.5°C for 20 minutes, 24 h before exercise. Mice performed downhill running at 22 m/min on a —14 degree incline, for 150 minutes. Before and 24, 48, and 72 h after exercise, the quadriceps femoris muscles were removed to analyze heat shock protein 25 (HSP25) levels before exercise and glucose-6-phosphate dehydrogenase (G6PD) activity at all time points. [Result] HSP25 level before exercise was significantly greater in the Heat group than in the Cont group. G6PD activity was significantly increased at 24, 48, and 72 h in the Cont group, and at 48 h in the Heat group compared with before exercise. Increases in G6PD activity in the Heat group were significantly lower than in the Cont group at 24, 48, and 72 h. [Conclusion] These results suggest that thermal preconditioning induces an increase in HSP25 protein and attenuates exercise-induced muscle injury.
[Purpose] The purpose of the present study was to investigate the effect of a magnetic infrared laser (MIL) on the 2, 4-dinitrofluorobenzene (DNFB)-induced contact dermatitis, type I allergic mouse model. [Subjects] Male ICR mice. [Methods] Contact dermatitis was induced by sensitization with dinitrophenyl-derivatized ovalbumin (DNP-OVA) and DNFB challenge as antigen. MIL radiation doses of 1.33, 2.66 and 6.65 J/cm2 were given, once a day for 7 continuous days, to DNP-OVA sensitized mice and compared with 15 mg/kg dexamethasone (intraperitoneal treatment). The edematous changes and scratching behavior were measured together with ear histopathological observations. [Results] Immediately after DNFB challenge to the ear or paw of DNP-OVA sensitized mice, increases of ear and paw thicknesses and weights were detected as well as anterior ear skin (dermis to epidermis) thickness and paw scratching behavior increases. However, these DNFB-induced increases of edematous changes and scratching behavior were significantly and dose-dependently decreased by MIL irradiation. [Conclusion] The results obtained in this study suggest that MIL radiation has relatively favorable effects on allergic dermatitis, and MIL therapy may represent an alternative approach for the treatment of allergic cutaneous diseases.
[Purpose] The present study was performed to clarify the influence of the vestibulorespiratory and peripheral reflexes on ventilation when standing on one leg. Ventilatory responses and metabolic responses under various vision and platform conditions were investigated and the responses in phases I and II were compared. [Subjects] Twenty healthy subjects were instructed to stand on one leg with eyes open or closed under three platform conditions for 1 min. [Methods] The platform conditions were flat, upward sloping, and unstable platform. Ventilatory and metabolic parameters were measured during one leg standing under each of the six conditions. The experimental results for 1 min were divided into between Phases I and II and analyzed. [Results] In Phase I, there were no significant differences between ventilatory parameters among any of the 6 conditions. In Phase II, the respiratory rate and minute ventilation were significantly different between the vision conditions, and between the flat and unstable platforms. These ventilatory responses to changes in condition were strongly correlated with oxygen uptake when standing on one leg under each condition. [Conclusions] These results suggest ventilatory responses to balancing the whole body on one leg were influenced by exercise intensity rather than by the vestibulorespiratory reflex or the peripheral reflex.
[Purpose] The purpose of this study was to determine whether a subjective risk rating for falls is more valuable than other screening tools in relating falls in frail elderly people. [Subjects] The study included 232 elderly subjects (48 men, 184 women, mean age 82.8 ± 6.3 years) who had been using day care services. [Methods] Data included history of falls during the previous year, the subjective risk rating of specific tasks (SRRST), which is composed of seven questions, and potential confounding factors including demographic variables, primary diseases or general health status, physical performance, and behavioral variables. To determine the independent factors related to falls, a multiple logistic regression analysis was used to measure odds ratios adjusted for all measurement variables. [Results] Eighty-one subjects (34.9%) had fallen during the previous year. In the multiple logistic regression analysis, a significant relationship was found only with the SRRST score (odds ratio; 1.22). [Conclusion] The SRRST is related independently with falls, and may be useful for determining interventions for preventing falls, such as the supervision approach in the frail elderly people.
[Purpose] Recently, a digital inclination meter was developed to evaluate severe defective posture. However, the validity and reliability of this instrument for slightly defective posture have not been tested. The purpose of this study was to test the intra-rater reliability, inter-rater validity and reliability of the instrument with healthy adults. [Methods] Ten subjects volunteered to participate in this study. Trunk and pelvis inclination angles were measured using the digital inclination meter. To test intra-rater reliability, a rater evaluated 5 standing postures 3 times for each of the 10 subjects using the digital inclination meter. To test inter-rater reliability, the postures of 5 subjects were measured 3 times by 3 raters. In order to test validity, each posture was also captured using a digital camera and image analysis software. [Results] All tests of intra-rater reliability and inter-rater reliability were at either the substantial or almost perfect level (intra-class correlation coefficients were from 0.61 to 1.00). Pearson's correlation coefficients for the results of digital inclination meter and image analysis were over 0.85 for all measurement items. [Conclusion] This evaluation method using the digital inclination meter was shown to be a reliable, valid and easy way to assess defective posture in a clinical setting as compared to image analysis using a digital camera and software.
[Purpose] The aim of this cross-sectional study was to test whether the body mass index (BMI), airway obstruction, dyspnea, and exercise capacity (BODE) index is superior to the global initiative for chronic obstructive lung disease (GOLD) classification for physical ability, and to ascertain the usefulness of the BODE index in chronic obstructive pulmonary disease (COPD) patients. [Methods] We studied 48 patients with stable COPD (mean [±SD] age: 76.2±7.0 years). We measured BMI, modified medical research council (mMRC) dyspnea score, pulmonary function, muscle strength, timed up-and-go test (TUG), 6 minute walk distance (6MWD), and St. George's respiratory questionnaire (SGRQ). Comparisons of each measurement item in the BODE index quartile groups 1-2 and 3-4 were conducted for patients in GOLD Stages II and III. [Results] The mean total score for the BODE index was 3.9±2.9. The characteristics that showed a significant difference between the two groups were mMRC, %FVC, muscle strength, TUG and 6MWD. [Conclusions] This study showed that the GOLD classification assesses milder symptoms than the BODE index. The BODE index is as useful as the GOLD classification for physical ability, and also indicates comprehensive measures for COPD patients.
[Purpose] The purpose of the present study was to evaluate the relationship between pulmonary function and the physical function and mobility of community-dwelling elderly women aged ≥75 years. [Methods] The subjects were 1,022 women aged ≥75 years who were living in an urban environment. We measured their vital capacity (VC) and forced expiratory volume in 1 s (FEV1.0) by spirometry, and assessed their physical function and mobility. [Results] Older women exhibited inferior pulmonary function as well as reduced physical function and mobility. These findings highlight the impact of diminished pulmonary function on physical function in old age. [Conclusions] Women of advanced age have diminished pulmonary function, physical function, and mobility, and diminished pulmonary function is associated with declining physical function. When an examination is required, spirometry should be included as an examination modality for its diagnostic value.
[Purpose] The purpose of this study was to investigate changes in plantar pressure distribution on the affected side related to arm length ratio to height of adult hemiplegia patients during gait. [Subjects] Twenty-four individuals with stroke were included in this study. [Methods] Subjects were divided into two groups according to the ratio of arm length to total height of each individual: group 1 had a ratio of less than 50% and group 2 had a ratio equal to or greater than 50%. The F-scan system was used to investigate the foot pressures of both feet with data captured during three strides. [Results] Group 1 showed greater increase in contact width, contact pressure, and peak contact pressure of the hind foot of the affected side. [Conclusion] With the use of a cane height standardized to the greater trochanter, group 1 was more effective than group 2 at increasing foot pressures of the hind foot on the affected side of stroke patients. The adjustment of cane length according to the individual's ratio of arm length to height, because of unique physical characteristics of individuals should be considered for patients with stroke who use a cane daily.
[Purpose] The towel gathering exercise is commonly chosen in the treatment of painful accessory navicular. However, the effect has not been well documented in clinical settings. So we compared the reduction in pain effect of towel gathering exercise with those of three toe flexor exercises we developed. [Subjects and Methods] Fifteen accessory navicular cases (4 males, 11 females) were chosen as subjects. Their mean age was 20.3±10.7 years old. The three exercises were almost maximal isometric contraction of first toe flexor, 2nd-to-5th toe flexors and 3rd-to-5th toe flexors. All subjects randomly performed the three toe exercises and the towel gathering exercise. Before and after each exercise we assessed the pain by provocative tests such as stepping and others using a visual analog scale (100 mm). [Results] The exercises of 2nd-to-5th toe flexors and 3rd-to-5th toe flexors showed overtly significant improvement of pain. On the other hand, the effects of both the towel gathering and first toe exercises were less significant. Especially, the towel gathering exercise showed the poorest effect of pain relief.
[Purpose] The purpose of this study was to understand the relationship between hand power and muscle activation during power grip and pinch grip. [Subjects] Fifty healthy adults were randomly arranged into two groups. [Methods] Hand power was measured using a hand dynamometer and pinch grip was measured with a pinch gauge. Muscle activation was measured using electromyography. [Results] The results were as follows: the power grip group and pinch grip group showed a significant difference in hand strength, but there was no significant difference in muscle activation. [Conclusion] In conclusion, the power grip showed greater hand strength than the pinch grip. However, no significant difference was found between the activation of the forearm and hand muscles. In other words, increased strength did not necessarily mean increased muscle activation. Therefore, the pinch grip is a more effective method of exercise.
[Purpose] The aim of this study was to quantitatively investigate gender differences in trunk muscle strength and activity and to verify the two proposed field tests for screening the muscle strength of trunk flexors by use of surface EMG (sEMG). [Subjects and Methods] Fifty-four healthy young volunteers participated in this study and RA strength was evaluated using the curl-up (CU) and double-leg-lower (DLL) tests. All muscle activity that occurred in the upper and lower RA sites during the two tests was recorded using sEMG. The sEMG data were then normalized using the maximum voluntary contraction. To investigate the validity of the two tests, the ratio of muscle activity between the upper and lower RA sites was calculated. [Results] The reliability of the CU and the DLL tests were estimated using the intraclass correlation coefficient and the values ranged from 0.84?0.96 and 0.93?0.98, respectively. Muscle activity was significantly higher in females than in males in all tests except one of the DLL tests. The activity ratio with respect to each muscle grade was constant between the CU and the DLL tests. [Conclusion] Our results indicate that trunk muscle activity is affected by gender, and the tests should be selected according to purpose.
[Purpose] The present study investigated the center of pressure (COP) and center of mass needed for gait initiation in children with typical development (TD), children with diplegia who independently walk (CP-GI), and children with diplegia who walk with a walker (CP-depGI). [Subjects] Three groups of 10 children (TD, CP-GI, & CP-DepGI), aged 7-10 years, were matched by age, weight, and height. [Methods] Each group was asked to independently initiate gait 3 times at a self-selected pace. The data were collected by a 3D motion analysis system (Vicon 612) and a force plate (AMTI-Advanced Mechanical Technology). The best trial of each participant was analyzed. The displacements and velocities of the COP and the COM were compared among the three groups. These parameters were analyzed using one-way ANOVA or the Kruskal-Wallis test. [Results] The COP-AP, COP-ML, COM-ML displacements and the COP-ML velocity before lift-off of the swing limb (phase 2) were similar among the three groups whereas they were somewhat different prior to movement (phase 1). Additionally, the COM-AP velocities in phase 2 were significantly different among the three groups. [Conclusion] This study provides basic data regarding the COP and the COM parameters that influence the achievement and efficiency of gait initiation in children. The data indicate the essential parameters for gait initiation and efficiency that should help physical therapists to appropriately treat children with spastic diplegia who cannot initiate gait or perform the task with a difficulty.
[Purpose] The aim of this preliminary study was to determine the influence of compression types on hand function in asymptomatic subjects and to collect baseline data for the comparison of hand function in patients with chronic arm lymphedema. [Methods] The subjects of this study were 32 healthy female volunteers with a mean age of 44.97 years. Hand function and grip strength were tested under the three conditions (no compression, garment, and bandage condition) using the Jebsen-Taylor Hand Function Test (JTHFT) and a hand-held Jamar dynamometer. The experimental order was randomized to minimize order effects on the results. [Results] The time needed to complete all of the subtests increased as the thickness of the compression materials increased, and grip strength in the bandage condition was the smallest under each condition. Pearson's correlation coefficient indicated moderate to high correlations ranging from —0.357 to —0.779. [Conclusion] The results of this study suggest that the grip strength and hand function scores are influenced by the characteristics of the compression type. A future study is needed to determine the level of hand function between patients with chronic arm lymphedema and healthy individuals.
[Purpose] This study used radiography measurements and brain wave analysis to examine the correlations between the forward head posture (FHP) of the neck, the range of motion of cervicospinal area, and neurological measures of mental rest, and concentration of college students in their 20s. [Subjects] The subjects of this study were 22 college students (10 males, 12 females) in their 20s. [Methods] The cervical lordosis angle, FHP, and the flexion and extension angles of the cervicospinal area were analyzed from lateral view radiographs, and mental rest and concentration of the brain were measured with a neuro-feedback device. [Results] A higher absolute rotation angle (ARA) was associated with lower anterior weight bearing (AWB) and greater range of flexion and extension motions (RFEM). A higher AWB was associated with a lower RFEM and mental resting state score. Positive correlations were found between increased range of motion of the cervicospinal area and the mental resting state score and between increased RFEM and mental concentration score. [Conclusion] The FHP decreases the range of motion of the cervicospinal area, and this biomechanical problem negatively influences the mental resting state and concentration.
[Purpose] This study aimed to assess the relationship between exercise therapy and diet therapy in Type 2 diabetes mellitus management, and to analyze trends in the effects of exercise and diet therapies in order to identify the optimal approach to treatment. [Methods] This study included 101 patients with Type 2 diabetes mellitus admitted to Hachinohe City Hospital to receive diabetic education and individual exercise counseling. All had been discharged at least 1 year prior to this study. All agreed to participate in this study. We conducted telephone interviews regarding the continuation of exercise therapy and diet therapy after discharge. [Results] One-year post-discharge results were as follows. The exercise continuation rate was 88% and the relationship between continuation of exercise and HbA1c changes was significant, as was the relationship between exercise therapy and diet therapy. [Conclusions] Our results suggest that diabetic patients with unstable treatment courses are unlikely to continue exercise and diet therapies. Therefore, diabetes education should be performed as a collaborative effort between physical therapists and nurses in charge of exercise therapy and registered dietitians in charge of diet therapy. An education system to promote continuation of these therapies after discharge from the hospital should be established.
[Purpose] The measurement of foot pressure (FP) is widely used for the evaluation of gait. The fluctuating changes of FP parameters according to various types of crutch gait, however, are not fully understood. This study examined the changes of FP during normal, two-point, and four-point crutch gait of healthy volunteers. [Subjects] The subjects were thirty-three adults who were 26.5 ± 1.4 years old, weighed 64.2 ± 10.3 kg, and were 168.8 ± 8.7 cm in height. [Methods] FP parameters were collected by a force plate with 2,304 resistive sensors. Regional plantar FP, trajectories of center of pressure (COP) in the anterior-posterior (AP) and the medio-lateral (ML) directions, contact time of foot on the ground, and the relative durations of sub-stages of the stance phase were measured during gait with or without a crutch. [Results] The regional plantar FP significantly decreased during two-point and four-point crutch gait compared with that during normal gait in the AP direction and overall. Analyzed by its trajectory, displacement of COP in the AP direction was significantly smaller during four-point gait than during normal gait. Contact time during two-point and four-point gait was significantly longer than during normal gait. Also, the relative duration of heel contact stage during four-point gait was significantly smaller than during normal gait. The relative durations of the midstance stage during two-point and four-point gait, however, were longer than that of normal gait. [Conclusion] These results suggest that types of gait with or without a crutch affect the fluctuation of FP and that may lead to a change of body position and gait pattern. The present data therefore may be useful for understanding the variations of crutch gait.
[Purpose] The objective of this study was to investigate the effect of the duration of muscle relaxation during intermittent isometric exercises (IIEs). [Subjects] Subjects were twelve healthy males.[Methods] The subjects performed 10 cycles of intermittent isometric knee extension at 60% maximum voluntary contraction for 8 seconds. One cycle of IIE consisted of a muscle contraction phase and subsequent muscle relaxation phase. To determine the durations of the muscle relaxation phase, two recovery periods (TR1.0 and TR0.5) of oxygenation level in the vastus lateralis muscle (VL) were measured with near-infrared spectroscopy immediately after the isometric knee extension. TR1.0 and TR0.5 were 30.6 ± 6.8 seconds and 15.4 ± 4.8 seconds, respectively. Therefore, IIEs were performed as two different types (IIE-TR1.0 and IIE-TR0.5). [Results] Deoxygenation during muscle contraction and relaxation phases in VL were significantly stronger in IIE-TR0.5 than in IIE-TR1.0. The reduction in median power frequency, an indirect measure of lactate accumulation in VL, was also significantly greater in IIE-TR0.5 than in IIE-TR1.0. [Conclusion] The results of this study suggest that the duration of muscle relaxation determines both deoxygenation and lactate accumulation in active muscles during IIE.
[Purpose] This study examined the relationship between the subjective quality of life of clinical physical therapists and the factors affecting their work satisfaction. [Subjects and Methods] A questionnaire was given to 101 clinical physical therapists who worked in medical institutions in A region from October to November 2009. [Results] Personal environment factors, such as marital status, education, work experience, etc, were found to affect the subjective quality of life. Hierarchical regression revealed job stress, self-esteem, job satisfaction and support of superiors or co-workers to be associated with the subjective quality of life of clinical physical therapists. [Conclusion] Several factors were found to affect the level of work satisfaction, which affected the subjective quality of life. These results can be used as base data for the development of programs for improving the subjective quality of life of clinical physical therapists.
[Purpose] The present study aimed to quantitatively evaluate and characterize the physical activities of people with ParkinsonÅfs disease (PD) receiving nursing care at home, as well as to clarify the factors that affect the amount of physical activity and the ability of people with PD to perform activities. [Subjects] Nine PD patients participated in this study. [Methods] The physical activities of subjects were measured over a 24-h period using an accelerometer and an activity meter simultaneously. [Results] The average total impulse value of PD patients was approximately equal to that of elderly people, and was lower than that of young adults reported in other studies. Over the 24-h study period, PD patients spent 43.6% of the time in a sitting position. Patients with milder PD were more physically active, had higher activities of daily living, had better balance ability in a standing position, were able to stand for longer periods, and showed more frequent posture changes; however, their frequency of falls tended to increase. [Conclusion] To increase physical activities and prevent falls among home-bound PD patients, it is important to practice standing balance and walking exercises.
[Purpose] This study was performed to investigate the effect of microcurrent electrical stimulation on the foot blood circulation and the degree of pain experienced by diabetes patients. [Subjects] Twenty nine patients with diabetic neuropathy over the age of 60 were randomly divided into an experimental(16 patients, 67.9 ± 8.0 years) and a control group(13 patients, 70.4 ± 4.4 years). [Methods] Both groups walked on a treadmill at a comfortable pace for 50 min/day, 5 days/week for 4 weeks, and each participant's body weight, body composition, and blood lipid were examined at the baseline and 4 weeks later. [Results] The results show that the foot blood flow rate increment after the intervention was significantly different between the experimental group and the control group, and the VAS was also significantly different. [Conclusion] Based on the results of this study, we consider that microcurrent electric stimulation of the foot may be helpful for preventing the pain and diabetic ulcers by increasing the foot blood circulation in diabetes patients.
[Purpose] The purpose of this study was to examine the reliability and clinical usefulness of a subjective risk rating of specific tasks (SRRST) for assessing risks of falls in frail elderly people. The participants were 30 elderly individuals who utilized day-care services. [Subjects and Methods] Participants were investigated the SRRST, grip strength, one repetition maximum of leg-press machine (1RM), one-leg standing time (OLS), functional reach, timed up and go test (TUG), and 10 m-walking speed, Barthel index, Tokyo Metropolitan Institute of Gerontology index, and history of falls in the previous year. The SRRST is comprised of 7 dichotomous questions screening of fall risk during activities of daily living such as walking, transferring, and wandering, and was scored twice a week by four raters. [Results] Intra-rater reliabilities of the SRRST were high (ICC (1,1) = 0.727 to 0.914, ICC (1,2) = 0.842 to 0.955), and inter-rater reliabilities of the SRRST were moderate to high (ICC (2,1) = 0.513, ICC (2,4) = 0.808). In comparison to the non-faller group, the faller group showed significantly lower 1RM and higher the SRRST. The SRRST showed moderate correlations with the OLS and TUG. [Conclusion] The SRRST showed moderate to high reliability and concurrent validity for assessing the fall risks in frail elderly people.
[Purpose] The purpose of this study was to examine foot pressure and trunk muscle activity during reaching tasks performed by patients with hemiplegia, and compare them with healthy subjects. [Subjects] Ten left-side hemiplegia patients and ten healthy subjects were recruited for this study. [Methods] The foot pressure and trunk muscle activity were measured while performing four reaching tasks in the diagonal and horizontal directions in a sitting position. [Results] In patients with hemiplegia, the foot pressure on the non-paretic side increased when performing the tasks on the paretic side, while the muscle activities of the erector spinae on the paretic side were lower than those of healthy subjects. [Conclusion] We found that the proper selection of the starting point for a task is more important than the direction of the task for the rehabilitation of patients with hemiplegia. We consider that performing the task on the non-paretic side to encourage symmetric weight distribution on the feet and trunk stability may be effective.
[Purpose] In this study, the effectiveness of Gong's Mobilization and sustained natural apophyseal glides (SNAGS) were compared in college students who had problems with cervical posture and range of motion (ROM) in order to examine the effects of Gong's Mobilization on cervical lordosis, forward head posture (FHP), and cervical ROM. [Subjects] Forty college students in their twenties with problems of cervical posture and ROM were divided into a Gong's Mobilization group (n=20) and a SNAGS group (n=20). [Methods] Gong's Mobilization and SNAGS were administered three times a week for four weeks to each respective group and then changes in cervical lordosis, FHP, and cervical ROM were evaluated. [Results] Gong's Mobilization was effective at increasing cervical lordosis, cervical extension ROM (CER), and ranges of flexion and extension motion (RFEM), as well as decreasing FHP. In contrast, SNAGS was effective at increasing CER and decreasing FHP. [Conclusion] Although both Gong's Mobilization and SNAGS affected cervical posture and ROM, Gong's Mobilization was more effective at increasing cervical lordosis, CER, and RFEM.
[Purpose] This study examined pain in patients with hip disease before and after arthroplasty and whether the pain was induced in the hip joint itself. [Subjects and Methods] Fifty-two patients presenting with hip disease who did not exhibit dementia, disease of the lower limbs or lumbar disease were included in this investigation. Regional pain, the site of maximum pain and Visual Analogue Scale (VAS) of the site of maximum pain before and after arthroplasty were evaluated. [Results] Groin displayed the highest incidence of pre-operative pain (28 cases, 53.8%); that number decreased post-operatively. Post-operative VAS was significantly smaller than pre-operative VAS. Six patients (11.5%) demonstrated pain below the knee pre- and post-operatively. [Conclusions] The present results suggest that hip arthroplasty is effective in terms of reduction of pain in the hip joint itself. However, instances in which pain persists in remote areas of the hip joint following arthroplasty occur, and the reason for this is uncertain. Clinicians must consider an appropriate rehabilitation program to address this pain.