[Purpose] The purpose of this preliminary study was to investigate whether young players with no history of injury, have developed early asymmetries in dynamic balance ability tested via the recommended for screening in sports, Modified Star Excursion Balance Test (MSEBT). [Participants and Methods] Twenty-four young healthy male soccer players participated in the study having at least 4 years of systematic soccer training. The Waterloo Footedness Questionnaire was used to discriminate the stability dominant leg (STAB) from the non-stability dominant leg (NSTAB). Dynamic balance was assessed via the MSEBT. Participants, after familiarization, made 3 attempts in each direction for both legs: a) Anterior (AN), b) Posterolateral (PL) and c) Posteromedial (PM). [Results] The sole statistically significant performance asymmetry was in the PL direction, in favor of the STAB (94.5 ± 13.3 cm vs. 98.1 ± 10.4 cm). [Conclusion] The results of this pilot study showed a potential for developing dynamic balance asymmetries, in soccer players at the age of 13–14 years. Since asymmetry was significant in only one direction, further long term monitoring would be helpful to evaluate whether this is a growing functional deficit, potentially involving any of the other two directions of testing or if it is alleviated with increasing training age. These asymmetries could comprise an injury risk factor.

[Purpose] This study aimed to evaluate the effect of radial extracorporeal shock wave therapy (rESWT) on patients with chronic pelvic pain syndrome (CPPS). [Participants and Methods] Forty male CPPS patients were randomly assigned into either an rESWT group or a control group. The first group was treated with rESWT two times per week for four weeks with a protocol 3,000 pulse, 12 Hz at 3 to 5 bar. The control group was treated with the same protocol, but the device’s probe had been turned off. The follow-up assessment was done using the National Institutes of Health-developed Chronic Prostatitis Symptom Index (NIH-CPSI) before treatment, as well as one week, four weeks, and 8 weeks after treatment. [Results] No significant difference was found in terms of age, sub-domain, or the total score of the NIH-CPSI between the rESWT group and the control group at the baseline. A statistically significant decrease was determined in the pain domain, urine score, quality of life, and the total NIH-CPSI score of the rESWT group at all post-treatment time points. All domains and the total score of the NIH-CPSI at all three follow-up time points decreased more significantly in the rESWT group as compared to the control group. [Conclusion] The findings of this study confirmed that rESWT is an effective method for treating CPPS.

[Purpose] This study aimed to induce disuse muscle atrophy in Goto-Kakizaki rats, a type 2 diabetes model, to investigate the effects of reloading on the soleus and plantaris muscles. [Materials and Methods] Wistar and Goto-Kakizaki (GK) rats were divided into 6 groups: Wistar Control (WC), GK Control (GC), Wistar Tail suspension (WS), GK Tail suspension (GS), and Wistar Reload (WR), GK Reload (GR). [Results] Investigation of myofiber cross-sectional area in Goto-Kakizaki rat soleus muscles indicated that the GS group showed significantly lower values than the GC and GR groups. No significant differences were observed between the GC and GR groups. However, investigation of plantaris muscles in Goto-Kakizaki rats indicated that the GS and GR groups showed a significant decrease compared to the GC group. No significant differences were found between the GS and GR groups. [Conclusion] Investigation of muscle weight/body weight ratios and myofiber cross-sectional area in tail suspension groups confirmed the induction of muscular atrophy. The differences in the degree of atrophy and recovery in terms of myofiber cross-sectional area observed in Goto-Kakizaki rat plantaris muscles may be influenced by the myofiber type and diabetes.

[Purpose] This study compared the effects of a short-term conservative physiotherapy program versus those of occlusive splinting on pain and range of motion in cases of Temporomandibular Joint Dysfunction. [Participants and Methods] This study included 112 male and female participants with ages ranging from 15–27 years. Outcome measures were pain assessed by the visual analogue scale and Temporomandibular Joint Range of Motion measured with the Temporomandibular joint opening index. Patients were randomly assigned to one of two groups. Conservative physiotherapy was provided to one group 3 days weekly while the other group received standard occlusive splinting. Splinting was used daily for the total period of treatment. Any adjustments for splints were done by the treating dentist. Both groups were treated for a total period of 6 weeks. [Results] Between group statistical analysis revealed a significant reduction in pain intensity and Temporomandibular joint opening index in favor of the conservative physiotherapy group. [Conclusion] Over a treatment period of 6 consecutive weeks, conservative physiotherapy could be a better initial treatment than occlusive splint in relieving pain and improving range of motion in cases of myogenic temporomandibular dysfunction.

[Purpose] The purpose of this study was to investigate the effects of a newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Participants and Methods] This study was investigated 10 participants who were diagnosed with stroke. Patients were evaluated based on a 10-meter walk test, timed up and go test and Berg balance scale after each participant wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis (AFO) that consisted of orthosis joints (having poster-stop joint and Klenzak joint functions). [Results] The 10-meter walk test, timed up and go test and Berg balance scale showed significant differences in the orthosis with the Klenzak joint function. [Conclusion] The appropriate use of Klenzak AFO of the newly designed multi joint AFO is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

[Purpose] The initial cardiopulmonary response to exercise is hypothesized to be a useful predictor of aerobic threshold in patients with heart failure. This study aimed to evaluate the correlation between aerobic threshold and cardiopulmonary responses to exercise onset by comparing patients with heart failure using preserved (≥50%) and reduced (<50%) left ventricular ejection fractions. [Participants and Methods] Twenty-eight males (age, 36–82 years; 12 with preserved and 16 with reduced left ventricular ejection fractions) underwent a progressive submaximal cardiopulmonary exercise test using a cycle ergometer. The aerobic threshold, time constant, and area under the oxygen uptake curve for the first 4 min (V̇O₂AUC) were determined. [Results] A significant association was observed between aerobic threshold and V̇O₂AUC in the reduced group but not in the preserved group. No significant correlations were found between time constant and V̇O₂AUC or between aerobic threshold and time constant in either group. [Conclusion] The results suggest that V̇O₂AUC measured from exercise onset to an initial 4-min period could provide an easily and safely obtained predictor to assess aerobic capacity in people with reduced left ventricular ejection fractions.

[Purpose] Angle measurement using images of bony prominences (AMI) determines frontal plane knee alignment from the skin surface without using radiation. The purpose of this study was to assess the validity and reliability of images obtained with the AMI method. [Participants and Methods] The study included 21 patients with osteoarthritis. We measured the functional axis of the lower limb, obtained via full-leg radiography and correlated the findings with the angle of dissection and the angle measured with the AMI method. Additionally, we assessed the reliability of the AMI method. [Results] The angle obtained using the AMI method and the radiographic anatomic axis (the full-leg radiograph)/the mechanical axis were well correlated. The AMI method also showed high reliability. [Conclusion] The AMI method is a valid and reliable alternative to full-leg radiography for imaging of functional and anatomical knee axes. As AMI does not use special equipment or involve radiation exposure, the method can be used in outside medical facilities and can be repeated over time without increased risk to patients.

[Purpose] The aim of the present study is to examine effects of diaphragm breathing exercise and feedback breathing exercise on maximal oxygen uptake and resting metabolic rate. [Participants and Methods] Thirty-eight healthy participants were randomly assigned to two groups; the diaphragm breathing exercise group and the feedback breathing exercise group. The diaphragm breathing exercise group was asked to perform diaphragm respiration, and the feedback breathing exercise group was asked to breathe with feedback breathing device. Maximal oxygen uptake and resting metabolic rate were measured before and after two breathing exercises. [Results] Significant difference was found in maximal oxygen uptake before and after two breathing exercises. There was also significant difference in resting metabolic rate before and after diaphragm breathing exercise. However, significant difference was not found in resting metabolic rate before and after feedback breathing exercise. There were not significant between-group differences in both maximal oxygen uptake and resting metabolic rate. [Conclusion] Diaphragm breathing exercise and feedback breathing exercise could influence maximal oxygen uptake. Diaphragm breathing exercise could influence resting metabolic rate, but feedback breathing exercise could not.

[Purpose] This study aimed to identify a simple and useful muscle parameter for use with the Gait Deviation Index in assessment of ambulatory children with unilateral and bilateral spastic cerebral palsy. [Participants and Methods] Twenty-eight patients (aged 6 to 18 years; 16 females and 12 males) participated in this cross-sectional study. Outcome measurements included the Gait Deviation Index, grip strength, 5-repetition chair stand test, upper limb skeletal muscle mass index, and lower limb skeletal muscle mass index. [Results] By multiple regression analysis, significant independent correlations were observed between the Gait Deviation Index and 5-repetition chair stand test and the Gait Deviation Index and lower limb skeletal muscle mass index, but not between the Gait Deviation Index and grip strength or upper limb skeletal muscle mass index. [Conclusion] The Gait Deviation Index was correlated with lower limb muscle mass in children with spastic cerebral palsy. Determination of lower limb muscle mass may be useful gait evaluation.

[Purpose] This study aimed to identify the efficacy of a progressive walking program on the risk of developing locomotive syndrome among untrained elderly Japanese people. [Participants and Methods] Twenty-four untrained elderly individuals (68 ± 4 years) completed a 17-week progressive walking program. The stand-up, two-step tests and the 25-question geriatric locomotive function scale were used to assess the risk of locomotive syndrome at baseline, the 8-week midpoint (2 months), and the 17-week endpoint (4 months). Maximal isometric muscle strength of the knee extensors and flexors were measured using a dynamometer with the hip joint angle at 90° of flexion and physical function (the 30-s sit-to-stand, sit-up, 10-meter walk, and grip strength) were evaluated. [Results] The 4-month walking program significantly improved the two-step test and geriatric locomotive function scale scores. This may be attributable to the improvement in knee flexor strength and physical function. [Conclusion] A 4-month program of progressive walking effectively lowered the risk of developing locomotive syndrome in elderly Japanese people by improving knee flexor muscle strength and physical function.

[Purpose] We examined the effects of Hatha yoga on EEG and ERP in patients with physical disability-related stress. [Participants and Methods] Eighteen male and female injured workers with high stress levels, aged between 18 to 55 years, were evenly divided into two groups: untrained (CG) and trained (TG) modified hatha yoga groups. A modified Hatha yoga protocol was designed for this population by two certified yoga instructors, approved by a physical therapist, and conducted for one hour, three times weekly for 8 weeks. [Results] The results indicated a significant increase in alpha EEG activity over the frontal, central, and parietal electrodes and the delta EEG activity over the centroparietal electrode from pre- to post-training in TG. In addition, significantly faster auditory reaction time for target stimuli, as well as lower P300 peak latency of ERP in auditory oddball paradigm were obtained in TG after 8 weeks of yoga training compare to CG. [Conclusion] Changes in brain activity and ERP components following yoga training would support the psychophysiological effects of hatha yoga as an adjunct to routine rehabilitation.

[Purpose] To review the literature that examines rehabilitation and early mobilization and that involves different practices (effects of interventions) for the critically ill patient. [Materials and Methods] A PRISMA-Systematic review has been conducted based on different data sources: Biblioteca Virtual en Salud, CINHAL, Pubmed, Scopus, and Web of Science were used to identify randomized controlled trials, crossover trials, and case-control studies. [Results] Eleven studies were included. Early rehabilitation had no significant effect on the length of stay and number of cases of Intensive Care Unit Acquired Weaknesses. However, early rehabilitation had a significant effect on the functional status, muscle strength, mechanical ventilation duration, walking ability at discharge, and health quality of life. [Conclusion] Rehabilitation and early mobilization are associated with an increased probability of walking more distance at discharge. Early rehabilitation is associated with an increase in functional capacity and muscle strength, an improvement in walking distance and better perception of the health-related quality of life. Cycloergometer and electrical stimulation can be used to maintain muscle strength. Further research is needed to establish stronger evidences.

[Purpose] To present the case of a total reduction of pseudoscoliosis spinal deformity in an adult female suffering from recurrent back pains. [Participant and Methods] A 29 year old female suffering from recurrent back pains was diagnosed with lateral thoracic translation posture; aka pseudoscoliosis. The patient was initially given 12 treatments of relief care including spinal manipulative therapy, then another 24 treatments receiving the same plus mirror image^® translation traction and exercises. [Results] The patient achieved a complete reduction of the lateral thoracic translation posture (pseudoscoliosis) as indicated on a post-treatment radiograph after 36 total treatments. Most orthopedic tests became normalized and the patients back pains were significantly improved after the correction of posture, but only slight improvements after the initial 12 sessions of manipulative therapy only. [Conclusion] Pseudoscoliosis is structurally reducible by use of CBP^® mirror image^® lateral translation traction methods and exercises and led to the resolution of back pains in this case. The diagnosis of pseudoscoliosis as opposed to true scoliosis is very important and likely underdiagnosed in common practice. Upright radiographic imaging is essential to differentiate these two spinal disorders and offers no harm to the patient. Comprehensive assessment including routine use of x-ray is recommended to differentiate between spinal disorders.

[Purpose] The hybrid assistive limb was developed to improve the kinematics and muscle activity in patients with neurological and orthopedic conditions. The purpose of the present study was to examine the long-term sustained effect of gait training using a hybrid assistive limb on gait stability, kinematics, and muscle activity by preventing knee collapse in a patient with cerebral palsy. [Participant and Methods] A 17 year-old male with cerebral palsy performed gait training with a hybrid assistive limb 12 times in 4 weeks. After completion of 12 sessions of hybrid assistive limb training, monthly follow-up was conducted for 8 months. The improvement was assessed on the basis of joint angle and muscle activity during gait. [Results] The degree of knee collapse observed at baseline was improved at 8-month follow-up. Regarding muscle activity, electromyography revealed increased activation of the vastus lateralis at 8-month follow-up. Moreover, the hip and knee angles were expanded during gait. In particular, the knee extension angle at heel contact was increased at 8 months after follow-up. [Conclusion] Gait training with a hybrid assistive limb provided improvement of gait stability such as kinematics and muscle activity in a patient with cerebral palsy. The improved gait stability through prevention of knee collapse achieved with hybrid assistive limb training sustained for 8 months.

[Purpose] Motor function evaluation by physical therapists is considered a valuable tool to assess the progression of muscular dystrophies. Few reports have described long-term motor function assessment during the administration of corticosteroids such as prednisolone (PSL) in these patients. This study examined the importance of long-term non-invasive motor function evaluation in a series of 3 cases. [Participants and Methods] Three boys with Duchenne muscular dystrophy who were administered an identical PSL dosage regimen were retrospectively evaluated, and motor function tests were compared in them before and after an increase in PSL dosage. Regular feedback was obtained from the patients’ mothers regarding their impressions of their child’s motor function after the introduction of PSL. [Results] Motor function was conserved or significantly improved after an increase in dosage in all cases. Interestingly, subjective assessment by mothers revealed a perceived improvement only in case 1 without any changes reported in cases 2 or 3. [Conclusion] PSL was demonstrably effective for 2.5–5 years after initiating PSL treatment, although parental impressions varied. Thus, long-term non-invasive evaluation by physical therapists may provide important objective data regarding medication efficacy and disease progression. Future studies should include long-term testing results as an essential component of the discontinuation criteria for PSL.