[Purpose] In the photography of new-borns, there is an epidemic trend in the posing of 0–14-day-old neonates that induces ethical and competence issues. The aim of this study is to map the key concepts underpinning the contraindications of this type of passive positioning of the new-borns. [Methods] During the search for literature, the following keywords were used in the PubMed database: neonates; new-born; neck position; hyperextension; rotation; atlanto-occipital joint; sudden infant death; prone sleeping position; white noise; and pain perception. [Results] The white noise applied has been described as a pain perception modulator and an alternative pain reducing method in new-born care. There is evidence warning of the potential danger of passively produced cervical spine positions, considering the primary unstable atlanto-occipital joint during early infancy, the possible compression on vertebral arteries, and the intradural diameter decreasing the effect of extension. These factors may have an impact on healthy motor and cognitive development. [Conclusion] This perspective suggests that a wider debate should be called for concerning the role of medical professions to control this very dangerous practice, and that future cohort studies are necessary to monitor and follow up on the potential negative effects of this current trend.

[Purpose] The incidence of chronic obstructive pulmonary disease is rapidly increasing worldwide. In Nepal, it has the highest mortality rate among all noninfectious diseases. Since 2015, we have been involved in a project that aims to facilitate chest rehabilitation for patients with chronic obstructive pulmonary disease in Nepal. We compared the Nepali version of the St. George’s Respiratory Questionnaire with the Chronic Obstructive Pulmonary Disease Assessment Test, the latter of which was translated into Nepali for this project. We also evaluated the extent to which patient quality of life improved after the rehabilitation program. [Participants and Methods] The Nepali St. George’s Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test were used to assess the health status of patients both before the intervention’s initiation and one year after it. Between May and September of 2016, 122 patients with chronic obstructive pulmonary disease participated in this program. [Results] We collected valid responses from 57 patients both before and after the intervention. The scores of both screening tools were significantly lower after the intervention than before and showed a significant correlation with one another. [Conclusion] These results suggest that the Nepali version of the Chronic Obstructive Pulmonary Disease Assessment Test is a reliable tool for the evaluation of chronic obstructive pulmonary disease and that the intervention used in the project might be effective for patients afflicted with the disease. However, there are limitations to the research design, such as the limited number of participants used in the study.

[Purpose] This study aimed to clarify the contribution of the morphology of the facet joint in spondylolysis. [Participants and Methods] A total of 68 junior athletes with lower back pain were evaluated. They were classified into groups B (bilateral spondylolysis), U (unilateral spondylolysis), and C (without spondylolysis). The same observer measured the sagittal orientation of the L4/L5 and L5/S1 facet joint angles from the axial sections, using computed tomography. Facet joint angles were statistically compared for differences among groups B, UL (the spondylolysis side in group U), UN (the normal side in group U), and C. [Results] The L4/L5 facet joint angles were significantly more coronally oriented in groups B and UL than in group C, while the L5/S1 facet joint angles showed no significant differences among the four groups. [Conclusion] The results of this study suggest that a more coronal orientation of the L4/L5 facet joint may increase the point loading through the L5 pars interarticularis in extension and rotation. Therefore, if the L4/L5 facet joint is more coronally orientated, the patient may be at the risk of spondylolysis. This observation may aid in predicting patients with increased possibility of developing spondylolysis.

[Purpose] The effect of physical activity on systemic inflammation remains unclear and might be negative in patients with chronic obstructive pulmonary disease (COPD) and lower weight. We investigated the amount of physical activity as the time spent in posture and movement and its association with systemic inflammation. [Participants and Methods] In this retrospective cross-sectional pilot study, we evaluated 11 patients with COPD (age, 73 ± 7 years; body mass index, 18.9 ± 2.9 kg/m²). A recently developed triaxial accelerometer was used to measure the time spent in posture and movement. We also evaluated body composition, physiological indexes, and serum levels of inflammatory cytokines. Single correlation coefficients were calculated as the association between physical activity and other outcomes. [Results] The walking time was 36 ± 32 min/d, and the standing time was 151 ± 118 min/d. The time spent walking significantly correlated with the fat-free mass index (r=0.73) and interleukin (IL)-8 level (r=0.76). The time spent standing significantly correlated with the C-reactive protein (r=0.80) and IL-6 levels (r=0.74). [Conclusion] These data indicate that increased physical activity is associated with higher systematic inflammation. We should consider that the systemic inflammation may have been affected by the increased physical activity of the patients with COPD and lower weight in this study.

[Purpose] This study aimed to investigate a cross-cultural adaptation of the 40-item Healthcare Provider-Patient Activation Scale (HP-PAS). [Participants and Methods] We followed a guideline for cross-cultural adaptation that recommended using two forward and backward translations. In pilot testing, participants were Japanese physical therapists who provided comments about expression readability. Two authors independently categorized each comment as either “unable to understand” or “suggestion to enhance clarity”, after which Cohen κ and % agreement were used to assess agreement. We then assessed the flooring and ceiling effects, internal consistency, and Spearman ρ between the factor scores of the patient-activation-approach and non-patient-activation-approach. [Results] A total of 58 Japanese physical therapists participated in the pilot test. The agreement on comments was κ=0.44 and 86.5%. We identified the flooring and ceiling effects for most items. In addition, the internal consistency was acceptable for each factor; however, the Spearman ρ between the patient-activation-approach and non-patient-activation-approach factor scores was positive when it should have been negative. [Conclusion] We developed a Japanese version of the HP-PAS which will serve as a foundation for future studies to establish a measurement method for the magnitude of patient activation in the physical therapist population.

[Purpose] The purpose of this study was to determine the relationship between pitching weight and pitching mechanics, including ball reaction force (BRF) and temporal parameters, for the prevention of throwing injury in adult amateur pitchers. [Participants and Methods] Twenty adult male amateur pitchers (mean age, height, and body mass: 26 ± 3.4 years, 1.7 ± 0.03 m, and 71.6 ± 9.5 kg, respectively) randomly pitched light (110 g) and heavy (145 g) baseballs at maximum velocity. Kinematic, kinetic, and temporal parameters were compared between the light and heavy balls. [Results] Pitching heavy balls significantly increased the BRF to 9.2 N and maximum trunk rotation angular velocity to 26.2°/sec, and decreased the ball speed to 1.4 m/sec and upper limb joint torque efficiency and shoulder internal rotation angular velocity at the moment of ball release at 250.8°/sec. Furthermore, the peak temporal kinetic parameters until ball release appeared early in the throwing of the heavy ball. [Conclusion] Adult amateur pitchers who pitched heavy balls had greater BRF; had decreased upper limb joint torque efficiency, ball speed, and arm angular velocity; and reached maximum kinetics early. Adult amateur pitchers may be at risk of throwing injuries due to throwing of heavy balls.

[Purpose] Heat can prevent cartilage degeneration when applied to articular cartilage, but the size of the human knee joint makes it difficult to target cartilage during heat treatment. In this study, we aimed to establish a heat therapy method capable of safely applying heat to deep intra-articular tissues utilizing a resonant cavity applicator and to confirm the extent of cartilage heating in the human knee when using this system. [Participants and Methods] Heating experiments were carried out on the knees of healthy three volunteers using a resonant cavity applicator and a microwave diathermy system. After heat application, temperature distributions inside the knee were measured noninvasively using our measurement method based on ultrasound imaging techniques. [Results] We observed an increase in the temperature around the cartilage tissue in the knees of the volunteers using an ultrasonic thermometer; there was no increase in temperature in the overlying layers. During heating with up to 20 W of power, none of the volunteers experienced adverse reactions. [Conclusion] This study indicates the potential safety and effectiveness of the resonant cavity heat therapy system for knee osteoarthritis in a clinical setting.

[Purpose] To compare the changes in the muscle cross-sectional area (MCSA) along the long axis of the lower leg muscles at rest and during ankle plantar flexors isometric contraction and to obtain basic information regarding the movement of lower leg muscles during ankle plantar flexors contraction. [Participants and Methods] Sixteen healthy young female participants (20.9 ± 1.2 years) were asked to sit with their ankles in a neutral ankle position. Images were obtained at rest and during isometric contraction of the ankle plantar flexors using gravity magnetic resonance imaging. The MCSAs of the triceps surae and tibialis anterior were measured. [Results] The middle region of the soleus muscle had a lower MCSA on contraction than at rest. In addition, the medial head of the gastrocnemius had a lower MCSA on contraction than at rest in the distal quarter. Moreover, the tibialis anterior had a lower MCSA at rest than on contraction in the middle region. [Conclusion] The area to be used as an indicator and the movement to be induced differ depending on the muscle during isometric contraction of the triceps surae.

[Purpose] The purpose of this study was to investigate the relationship among aging factors using the new Japanese elderly standard, early postoperative physical function, and health-related quality of life (HRQOL) in patients with gastrointestinal cancer. [Participants and Methods] We studied 94 patients scheduled for elective surgery of gastrointestinal cancer: 53 males and 41 females aged 62.0 ± 12.1 years (mean ± SD). Patients were divided into three groups based on age at baseline: young (<65 years), pre-old (65–74 years), and old (≥75 years) groups. We measured body mass index, isometric knee extension force (IKEF), 6-minute walk test (6MWT), and Short-Form 36-Item Health Survey version 2 (SF-36) at baseline and 4 weeks after surgery. [Results] Patients 75 years or older had significantly lower IKEF and 6MWT compared to the other groups. Patients younger than 65 years had significantly greater scores on the mental health SF36 subscale 4 weeks after surgery compared to baseline. Comparatively, patients older than 75 years had significantly decreased mental health scores 4 weeks after surgery. [Conclusion] Based on the new Japanese elderly standard, advanced age appears to worsen the postoperative change of HRQOL in patients with gastrointestinal cancer.

[Purpose] This study investigated the relationship between physical activity and job stress among public office workers. [Participants and Methods] We examined the levels of physical activity and job stress of 488 male public officers in Seoul-city, Republic of Korea through self-reported questionnaires. The International Physical Activity Questionnaires and the Korean Occupational Stress Scale were used to evaluate physical activity and job stress, respectively. The level of physical activity was divided into three quantiles (low, moderate, high). [Results] We found no significant difference in job stress by physical activity level. Although a positive correlation between physical activity and job stress was found in the organizational system category, no significant difference was found in the categories of the physical environment, job demand, insufficient job control, interpersonal conflict, job insecurity, lack of reward, and occupational climate. [Conclusion] There was no apparent correlation between physical activity and job stress among public office workers.

[Purpose] To elucidate factors that affect walking before and after direction changes and their effects on reaction time by investigating different angles of direction changes. [Participants and Methods] A total of 29 healthy young males and females participated in this study. The task was to walk along a 20-m path and perform three direction changes while walking: straight walking, 45° direction change, and 90° direction change. Step length and probe reaction time (P-RT) were measured before and after the point of direction change. A two-factor repeated measures analysis of variance was applied to measure P-RT and step length before and after direction changes. [Results] A significant effect was observed for step length and P-RT immediately before and after direction changes. An interaction was also observed between the angle of direction change and the step length before and after the direction change. When compared with the straight walk, a significant effect was observed at 45° and 90° direction changes. [Conclusion] While walking, 90° direction changes are suggested to be more difficult than 45° direction changes, and 45° direction changes are more difficult than walking in a straight line.

[Purpose] This study aimed to assess the reliability of the Functional Movement Screen and explore whether this evaluation tool can predict the risks of personal injuries in Japanese soccer players. [Participants and Methods] Seventy-five Japanese college soccer players who participated in our 1 year prospective cohort study underwent a Functional Movement Screen assessment. Demographic data, athletic characteristics, and types and frequency of injuries sustained, were analyzed with the assessment results. [Results] There was no significant difference in the mean Functional Movement Screen composite scores between genders. Although the Functional Movement Screen showed excellent inter-rater reliability (0.92), low overall internal consistency (0.35) was observed. A maximum score of 3 in straight leg raise occurred in 94% of the females and was considered a ceiling effect. None of the cut-off point scores of the Functional Movement Screen were associated with the number of overall injuries, lower limb injuries, and traumatic injuries, or time to return to play. The Functional Movement Screen composite score of ≤15 represented the maximum sensitivity of 76.92% and specificity of 34.78% with 0.56 in the area under the curve. [Conclusion] Functional Movement Screen composite scores do not have sufficient sensitivity and specificity for predicting injuries in Japanese college soccer players.

[Purpose] We aimed to investigate the difficulties perceived by physical therapy students during clinical practice, and to identify the associated factors based on the results of our previous interview survey. We collected opinions from these students through a questionnaire survey. Furthermore, we analyzed the relationships between the difficulties perceived by physical therapy students during clinical practice and the students’ level of achievement at the end of their clinical practice. [Participants and Methods] The study included 176 students, who had completed comprehensive clinical practice during their fourth year, to rate the difficulties perceived by them on an 11-point scale from 0 to 10. [Results] There were 127 responses. Through exploratory factor analysis, 43 items representing 5 factors were selected: Factor 1, difficulties related to communication of behavioral improvement/relationship building; Factor 2, difficulty obtaining supportive guidance/having appropriate learning environments coordinated; Factor 3, difficulty organizing/expressing clinical reasoning for physical therapy; Factor 4, difficulty learning in the clinical practice environment; and Factor 5, difficulty managing patients/adapting to the environment. [Conclusion] Regardless of the level of achievement at the end of clinical practice, the students strongly perceived “Factor 2: difficulty obtaining supportive guidance/having appropriate learning environments coordinated”. The results identified the factors associated with the difficulties perceived by physical therapy students during clinical practice, thereby providing a basis for resolving such difficulties.

[Purpose] To present the case of the relief of idiopathic dizziness and the reduction of neck pains and headache by the improvement in cervical alignment using Chiropractic BioPhysics^® technique. [Participant and Methods] A 57 year old female presented with 30 years of chronic dizziness, neck pains and headache. Multiple testing ruled out known causes of vertigo. The patient was diagnosed with idiopathic dizziness. The patient scored 56 points on the dizziness handicap inventory. The patient showed a cervical hypolordosis of −13.7° and anterior head translation of 27 mm. The patient underwent a multimodal treatment of spinal manipulation, cervical extension traction, neck exercises as well as initial electrical stimulation. Traction procedures were slowly progressive due to the severity of the dizziness symptoms. [Results] Over a period of 12-months and 115 treatments there was a 20° increase in cervical lordosis. The patient reported significant reduction in neck pains, headache and dizziness frequency and severity. The patient had a 44-point drop on the dizziness handicap inventory; dizziness symptoms were reported to be very rare. A 1.5 year follow-up showed stability of the symptom relief and a negligible score on the dizziness handicap inventory. [Conclusion] Cervical hypolordosis may be an under-diagnosed cause of idiopathic dizziness in some patients.