[Purpose] We aimed to evaluate the validity and reproducibility of the incremental sit-to-stand exercise test for aerobic fitness evaluation in healthy middle-aged individuals. [Participants and Methods] Thirteen healthy middle-aged individuals randomly underwent the incremental sit-to-stand exercise and cycle ergometer tests, and the peak oxygen uptake was measured during both tests. Pearson’s correlation coefficients were used to assess the strength of the association between the peak oxygen uptake measured during the aforementioned tests. Intraclass correlation coefficients with 95% confidence intervals for peak oxygen uptake obtained during the first, second, and third incremental sit-to-stand exercise tests were used to determine the reproducibility of this test. [Results] The peak oxygen uptake measured during the incremental sit-to-stand exercise test was strongly associated with that measured during the cycle ergometer test (r=0.86). The intraclass correlation coefficients (95% confidence intervals) used to verify the association of the peak oxygen uptake between the first and the second incremental sit-to-stand exercise tests and between the second and third incremental sit-to-stand exercise tests were 0.92 (0.66–0.99) and 0.96 (0.82–0.99), respectively. [Conclusion] The incremental sit-to-stand exercise test is a valid and reproducible tool to evaluate aerobic fitness in healthy middle-aged individuals.

[Purpose] To determine the motor Functional Independence Measure item and level that contribute to improvement in Functional Independence Measure gain in the recovery rehabilitation ward. [Participants and Methods] This study analyzed the data of 1,866 participants who were selected based on four criteria: age, number of days from onset to admission, length of hospital stay, and motor Functional Independence Measure upon admission. Moreover, all items examined were recorded. The participants were divided into two groups, the non-improving and improving group, based on a motor Functional Independence Measure gain of 22 points. The degree of contribution of each item was analyzed based on the median motor Functional Independence Measure. Logistic regression analysis was performed, with the two groups as dependent variables and the item with high contribution as independent variable; receiver operating characteristic analysis was performed. [Results] The items that highly contributed to motor Functional Independence Measure gain were bathing (level 3), dressing (lower body) (level 4), bladder management (level 5), and stair climbing (level 3). [Conclusion] The results of this study were suggested that the items that contribute to the improvement in motor Functional Independence Measure gain in stroke patients with a motor Functional Independence Measure of less than 50 were related to self-care and at least over moderate assistance.

[Purpose] A sense of agency and feedback control may be related when the sensory feedback is attributed to the self; however, the relationship between sense of agency and movement disorders remains unclear. Although a feedback-control task might enable the examination of this relationship, it may be difficult for patients with movement disorders to complete this task. The present study modified the feedback-control task for future clinical research. [Participants and Methods] Twenty-four healthy adults participated in the study. The basic procedure followed that of a previous study in which participants traced a target line while receiving visual feedback of their actual or fake movement. The task was modified to reduce the width of the movement area, change the shape of the line from sinusoidal to horizontal, and reduce the number of trials from 45 to 15. [Results] When participants received the visual feedback of their actual movement, the movement error significantly decreased, whereas when participants received the fake movement that represented pre-recordings of their previous own movements, the movement error significantly increased. [Conclusion] The results partially agreed with those of the previous study. This modified task might help in examining the relationship between sense of agency and movement disorders in terms of motor control.

[Purpose] To investigate how well rehabilitation is described in Japanese clinical practice guidelines of various diseases or disorders requiring rehabilitation. [Participants and Methods] Clinical practice guidelines were extracted from the MINDS database (Japan Council for Quality Health Care). Japanese clinical practice guidelines of specific diseases or disorders requiring rehabilitation were included. The exclusion criteria were clinical practice guidelines on the procedure, symptoms, and/or medical examination. To select the clinical practice guidelines of diseases or disorders requiring rehabilitation, eight participants evaluated the need for rehabilitation for the disease or disorder through the modified Delphi method. They graded the necessity of rehabilitation from 1 to 9 (1, completely disagree; 9, completely agree). The clinical practice guidelines that had grades 7 or higher as the median were included in the analyses. Systematic reviews were compiled as an indicator of the extent to which rehabilitation is described in clinical practice guidelines. [Results] Forty-four clinical practice guidelines were selected, and 26 (59.1%) included descriptions of rehabilitation. There were 443 existing systematic reviews related to rehabilitation for each disease or disorder enrolled in the present study and 67 (15.1%) systematic reviews quoted in those guidelines. [Conclusion] Rehabilitation was not well described in the clinical practice guidelines of the diseases or disorders that require rehabilitation.

[Purpose] Although gum chewing while walking has been reported to increase walking speed and heart rate, its effect on energy expenditure remains unclear. The purpose of the present study was to investigate the effects of gum chewing while walking on fat oxidation, energy expenditure, and different walking parameters. [Participants and Methods] This randomized crossover study included 10 males and 5 females who walked for 15 min at their own pace while chewing 2 pieces of gum in the gum trial or while eating 2 tablets in the control trial. A wearable metabolic system, heart rate monitor, and pedometer measured fat oxidation, energy expenditure, heart rate, step count, and walking distance. Walking speed and stride length were also calculated. [Results] The energy expenditure, fat oxidation and heart rate were significantly higher during the gum trial than during the control trial. Significant increases were observed in the step count, walking distance, and walking speed but not in the stride length. [Conclusion] Our results suggest that gum chewing affects sympathetic nervous system activity and walking rhythm with a consequent improvement in the health-related effects of walking, which in turn helps to maintain weight. These findings may play a role in preventing the gradual age-related weight gain that predisposes to obesity.

[Purpose] The purpose of this study was to investigate whether healthy young and older people differ in self-reported movement time and brain activity pattern as indicated by electroencephalography during physical and imagined sit-to-stand movements. [Participants and Methods] Twenty healthy young (aged 20–29 years) and 19 older (aged 60–69) participants performed physical and imagined sit-to-stand movements while their self-reported movement times and electroencephalography were recorded. [Results] No age-related differences were found in self-reported movement time for physical or imagined sit-to-stand. In the frontal and temporal regions, electroencephalography showed a beta wave (14–17 Hz) for all conditions in both young and older adults. In the parietal and occipital regions, during physical sit-to-stand trials, both groups showed a beta wave in both regions. During imagined sit-to-stand trials, however, young participants showed a high alpha wave (10.6–13 Hz) in the parietal and a low alpha wave (8–10.5 Hz) in the occipital region, whereas older participants showed all three (alpha and beta) waves in the parietal and occipital regions. [Conclusion] Although no age-related differences were found in the ability to generate motor imagery, brain activity pattern as indicated by electroencephalography was dissimilar between young and older participants during motor imagery.

[Purpose] Flat feet frequently present in children with Down syndrome, necessitating a clinical evaluation and diagnosis. Therefore, a simple, low cost diagnostic method that can avoid radiation exposure is needed. This study was performed to investigate the intra-rater reliability of arch height ratio measurement using bone markers of the foot on the surface of the body in children with Down syndrome. [Participants and Methods] In total, 27 feet of 27 children with Down syndrome (16 male, 11 female) were included. We measured the length of each foot and the height of the navicular tuberosity on the surface of the body. The arch height ratio was calculated using the length and height. The same examiner performed three consecutive measurements of each of the two parameters. We calculated the arch height ratio using each of these measurements. The intraclass correlation coefficient [ICC(1,3)] of the length of the foot, height of the navicular tuberosity, and arch height ratio among the three measurements was obtained. [Results] The ICC of the height of the navicular tuberosity, length of the foot, and arch height ratio were quite high at 0.998, 0.999, and 0.997, respectively. [Conclusion] This study showed high intra-rater reliability of arch height ratio measurement using the length of the foot and height of the navicular tuberosity on the surface of the body in children with Down syndrome.

[Purpose] Limited data are available regarding the outcomes of non-operative treatment for hip fractures. We investigated the factors associated with functional rehabilitation outcomes in patients undergoing non-operative treatment for hip fractures. [Participants and Methods] We investigated 57 patients with hip fractures who underwent non-operative treatment. We retrospectively analyzed medical or rehabilitation outcomes and functional outcomes (assessed using the Functional Independence Measure tool). We examined the association between functional outcomes and other factors and compared the medical and rehabilitation outcomes between mobile and immobile patients at the time of discharge. [Results] Of the 57 patients investigated, 15 (26.3%) were mobile at discharge. We observed a significant association between the Functional Independence Measure subscores (Motor and Cognitive) and serum albumin levels. Serum albumin levels and the Functional Independence Measure subscores (Motor and Cognitive) were significantly higher in mobile than in immobile patients. [Conclusion] We observed that functional outcomes at discharge in patients undergoing non-operative treatment for hip fractures were associated with serum albumin ratios and the Functional Independence Measure-Cognitive score.

[Purpose] The purpose was to clarify the relationship between foot morphology and toe muscle strength in female university students. [Participants and Methods] Data from 103 female university students (age, 20.4 ± 1.6 years) on height, body weight, pain in the foot and toes, heel height (cm) of shoes worn in everyday life, and the number of times (per week) shoes with heels ≥3 cm were worn were collected. The hallux valgus angle and medial longitudinal arch height ratio of the foot were measured, and toe muscle strength was evaluated according to the strength of the toe flexor and abductor hallucis muscles. [Results] Arch height ratio was significantly lower with hallux valgus angle ≥16°. In the 206 feet, a very weak negative correlation was found between hallux valgus angle and arch height ratio. In 150 feet with hallux valgus angle <16°, a very weak correlation was found between toe flexor strength and arch height ratio. [Conclusion] Body mass index was within the normal range, and the period of wearing high-heeled shoes was short; these factors have no effect on hallux valgus angle. Hallux valgus may be prevented by increasing toe flexor strength to prevent downward movement of the navicular and first cuneiform bones.

[Purpose] We investigated whether an increase or decrease in subcutaneous fat mass secondary to cardiac cachexia can be evaluated using diagnostic ultrasonography in patients with heart failure. [Participant and Methods] We report a case of cardiac cachexia in a patient in whom cachexia was confirmed by weight loss, decreased dietary intake, and biochemical indicators measured by blood tests. We measured the subcutaneous fat mass in the patient’s thigh using ultrasonic diagnostic equipment during the cachectic state, as well as 1 and 2 months later. [Results] An increase in weight and ultrasonographically documented femoral subcutaneous fat mass was confirmed by improvement in heart failure-induced cachexia. [Conclusion] Clinically convenient ultrasonic diagnostic equipment is useful to assess subcutaneous fat mass, which serves as an indicator of the degree of cachexia.