[Purpose] Reports on the amount of unloading maximizing walking ability in patients with stroke are limited. The effect of body weight-supported treadmill training (BWSTT) in patients with stroke has not been clarified. We aimed to investigate the effects of unloading rate during BWSTT on the gait of patients with stroke and the relationship between BWSTT and walking ability on flat ground. [Participants and Methods] We performed BWSTT in 17 patients at three unloading rates: 0%, 20%, and 40%. Then, we examined the walking speed and rate, number of steps, single-leg support time ratio, and root mean square before and after unloading. Furthermore, we examined the relationship between walking ability on flat ground and immediate effects of BWSTT at each unloading rate. [Results] We observed no significant improvement under all conditions. However, walking ability improved at unloading rates of 20% and 40%, with poor temporal symmetry while walking on flat ground. [Conclusion] Our results revealed that BWSTT has diverse effects depending on the unloading rate and the ability to walk on flat ground. In particular, it tends to be highly effective for those who have poor sway and symmetry, which may serve as an index for prescribing BWSTT.
[Purpose] To evaluate the severity of symptoms before and after cervical myelopathy surgery using the Simple Test for Evaluating hand Function. Because a test ceiling effect was observed in patients with less severe forms of myelopathy, we investigated the correlation between and accuracy of several different tests in order to clarify the usefulness of the Purdue Pegboard Test for evaluation of one or both hands. [Participants and Methods] Thirty-four patients (6 females and 28 males; mean age, 64.5 years) were examined, and scores were determined for each of the following tests: Purdue Pegboard Test; Simple Test for Evaluating hand Function; Japanese Orthopedic Association assessment; and Disabilities of the Arm, Shoulder, and Hand assessment. Correlations between scores of different tests were then determined. The cut-off values used for the Purdue Pegboard Test and the Simple Test for Evaluating hand Function were determined using the area under the receiver operating characteristic curve to assess the use of chopsticks. [Results] The Purdue Pegboard Test assembly task correlated moderately with the Japanese Orthopedic Association and Disabilities of the Arm, Shoulder, and Hand scores. In the receiver operating characteristic curve analyses, the Purdue Pegboard Test cut-off value was 11 and the Simple Test for Evaluating hand Function cut-off value was 90. [Conclusion] The Purdue Pegboard Test is useful for evaluating manual dexterity and coordination in both hands in patients with cervical myelopathy.
[Purpose] The purpose of this study was to examine the effectiveness of unsupervised low-intensity home exercises in improving physical activity and physical capacity for daily activities among the community-dwelling elderly. [Participants and Methods] We included 24 female older participants and divided them into two groups: 14 in the resistance training group and 10 in the fast walking group. The resistance training group performed shoulder joint flexion and abduction exercises using a resistance tube twice daily (in the morning and afternoon). Participants in the fast walking group walked fast for 3,000 steps once daily. Both groups continued the exercise intervention for 6 months. We measured the forced vital capacity, respiratory muscle strength, physical activity, walking distance in the 6-min walk test, grip strength, and knee extension strength before and after the intervention. [Results] The forced vital capacity significantly increased in the resistance training group, whereas the moderate-intensity physical activity time significantly increased in both groups and the vigorous-intensity physical activity time increased in the fast walking group only. We observed no intergroup differences in respiratory muscle strength, 6-min walking distance, grip strength, or knee extension strength. [Conclusion] The results of this study suggest that low-intensity home exercises can improve pulmonary function and physical activity and should be recommended for promoting health in the community-dwelling elderly.
[Purpose] The purpose of this study was to investigate the changes of muscle activity during squat motion after stretching the tensor fasciae latae muscle. [Participants and Methods] The participants comprised 19 healthy males. The test muscles were the vastus medialis obliquus and vastus lateralis. The participants performed the squat motion before and after stretching the tensor fasciae latae. We measured the muscle activities and the onset timing of the vastus medialis obliquus relative to that of the vastus lateralis during squat motions. [Results] The onset timing of the vastus medialis obliquus relative to that of the vastus lateralis was decreased, and the vastus medialis obliquus activity and vastus medialis obliquus/vastus lateralis activity ratio were increased after stretching the tensor fasciae latae. [Conclusion] This study revealed that stretching of the tensor fasciae latae increases the relative vastus medialis obliquus muscle activity.
[Purpose] The aim of this study was to investigate whether the coexistence of locomotive syndrome and sarcopenia is associated with the risk of fall or performance of activities of daily living in elderly females. [Participants and Methods] We categorized 112 Japanese elderly female participants under three groups: control, locomotive syndrome, and locomotive syndrome and co-existing sarcopenia. We compared the groups based on the mean scores of anthropometric and physical function measurements, the Timed Up and Go test, and the Tokyo Metropolitan Institute of Gerontology Index of Competence to evaluate activities of daily living. [Results] The Timed Up and Go test score significantly differed among the groups. The score of the Timed Up and Go test significantly correlated with scores of the skeletal muscle mass index, skeletal muscle strength grading, and usual gait speed. The total score of the Tokyo Metropolitan Institute of Gerontology Index of Competence significantly decreased in all the groups. [Conclusion] The coexistence of locomotive syndrome and sarcopenia is associated with an increased risk of fall and worsened performance of activities of daily living. Further, the risk of fall is associated with the skeletal muscle mass, skeletal muscle strength, and gait speed. It seems likely that, compared to sarcopenia, locomotive syndrome is more sensitive to lower limb dysfunctions.
[Purpose] To clarify the influence of flexibilities of the hip and lumbar spine joints on bending the trunk forward. [Participants and Methods] We assessed the joint flexibility of 47 healthy university students using the Beighton hypermobility score and assigned them to the group of normal or poor flexibility. We performed electromyography to acquire kinematic data and analyzed the three-dimensional motion while the students bent their trunks forward. Further, we compared the groups based on angular displacements of the hip joint and lumbar spine in each phase of the movement. Offset of the erector spinae and hip extensor muscle activity was calculated as a percentage (%) of the maximum range of motion. [Results] The lumbo-pelvic rhythm differed between participants with and without poor flexibility of the hip joint in the second half of the forward bending task. Participants with poor flexibility of the hip joint showed activation of the erector spinae and biceps femoris for a longer period compared to those with normal flexibility. Notably, flexion–relaxation responses were not found in the biceps femoris of 30% of the participants. [Conclusion] Poor hip joint flexibility may cause low back pain. Measuring the lumbo-pelvic rhythm might help identify individuals at a high risk of low back pain while they are still healthy.
[Purpose] The purpose of this study was to investigate a correlation between the morphology of the intrinsic musculature of the foot and foot kinematics during gait using a foot type classification based on the windlass function. [Participants and Methods] We examined 67 feet of 35 healthy participants in this study. We collected three-dimensional foot kinematic data during gait from the Oxford Foot Model and assessed the morphology of the flexor digitorum brevis, abductor hallucis, adductor halluces (oblique head), and abductor digiti minimi muscles using B-mode ultrasound. Using the Foot Posture Index (six-item version), we divided static foot postures into two groups: normal arch and flatfoot. Subsequently, we compared foot kinematics and the morphology of the intrinsic musculature among the four groups using the analysis of variance with the Bonferroni test. [Results] Foot kinematics of the flatfoot-adduction type during gait significantly differed from that of the normal arch-abduction type. The abductor digiti minimi of the flatfoot-adduction type was significantly thinner than that of the normal arch-abduction type. [Conclusion] There may be some variations in flatfoot, and the flatfoot-abduction type might not be a risk factor for overuse injuries.
[Purpose] To provide data on the applicability of pedometers in the evaluation of the results of rehabilitative treatment on total daily walking activity after total knee arthroplasty (TKA) and total hip arthroplasty (THA). [Participants and Methods] One hundred fifty six hospitalized patients (age 63.9 ± 12.2 years) involved. On the day of hospitalization and at the end of the rehabilitation treatment the following were performed: clinical examination, X-ray examination and weight. On the same day the pedometer was applied and removed after 48 hours. Only on 30 participants, the same evaluation was carried out 5 days before the hospitalization to measure reliability and responsiveness. Compliance was measured by a face-to-face interview. Visual analogic scale (VAS), Barthel Index (BI) and Ambulation Index (AI) were used to better describe the analyzed sample. [Results] VAS, BI and AI improved by 29.8%, 19.4 and 60.6% respectively. The data obtained on testing-retesting showed a good reliability and a mean Total Error of 7.3% for steps and 15.8% for distance. A good response in the test-retest was detected. The deambulatory autonomy of patients passed from 2,070 ± 740 m to 3,100 ± 810 m. Average improvement in the number of daily steps is 25%. [Conclusion] The data showed a good applicability of pedometer. The results on responsiveness can be used to better interpret the results of rehabilitative treatment on total daily walking activity after THA and TKA.
[Purpose] Leg length discrepancy is common among patients with scoliosis. Some studies reported reduced functional scoliosis curves with correction of leg length discrepancy. Others, however, have shown that induced leg length discrepancy has little effects on spinal deformities. Also, small number of studies assessed the use of foot orthoses in patients with faulty foot biomechanics and their impact on idiopathic scoliosis. In this context, a review of the literature is needed to determine the current evidence for the appropriate use of sole lift and foot orthoses in a context of scoliosis. [Methods] A literature review was performed. [Results] It appeared that sole lifts are indicated for functional lumbar scoliosis when the level of the sacrum is parallel to that of the hips. Sole lifts may not be indicated for patients with structural scoliosis, seemingly inducing a compensatory curve. Custom foot orthoses were found to reduce spinal curves in juvenile patients with mild idiopathic scoliosis and concomitant abnormal foot biomechanics. [Conclusion] Sole lift appeared to be indicated in the presence of certain types of functional scoliosis. Custom foot orthoses can be considered in the management of mild idiopathic scoliosis in juvenile patients. Evidence, however, is low and quality studies are needed to validate these findings.
[Purpose] The primary purpose of this study was to evaluate the usefulness of the intraclass correlation coefficient for evaluating the reliability of the measurement of the supraspinatus thickness on shoulder ultrasonography at different angles in a resting position in patients with stroke. [Participants and Methods] The study included 20 patients with stroke. The supraspinatus thickness was measured on both sides on ultrasonography, with the participants’ shoulders in abduction at 3 testing angles (0°, 30°, and 60° abduction). Each measurement was performed three times, and the average of the three measurements was recorded. The intraclass correlation coefficient was calculated, with the supraspinatus thickness measured twice at an interval of 24 hours as the factor. [Results] All intraclass correlation coefficients for the hemiplegic and normal sides were greater than 0.93 when the shoulders were at the three testing angles. [Conclusion] In this investigation, the reliability of measuring the supraspinatus thickness on shoulder ultrasonography at each angle for 3 times was evaluated and was found to be excellent.