[Purpose] The aim of the study is to evaluate the efficacy of dry needling (DN) in the treatment of spasticity in patients with multiple sclerosis (MS). [Participants and Methods] Twelve participants (3 males and 9 females) with MS, with no evidence of a relapse in the last four weeks and with an EDSS (Expanded Disability Status Scale) greater than 2.5 points (related with pyramidal score) were recruited. DN was performed in lower limbs for 12 consecutive sessions and evaluated with: PSFS (Penn Spasm Frequency Scale), VAS (visual analogical scale) of spasticity, EDSS (Pyramidal item), Time up and go (TUG), 25 foot, 9hold peg test (9HPT) and the improvement or not in the quality of life (MSQol54) was verified before and after treatment. A follow up visit was carried out to assess improvement. [Results] All patients improved in: VAS scale, EDSS score, quality of life, 9HPT, 25 foot test and TUG and 90% of them showed a decrease in the number of spasms/hour (PSFS). [Conclusion] Dry needling produces positive changes in spasticity in patients with MS and their quality of life, as well as walking capacity and manual dexterity. Therefore, DN should be considered in the treatment of spasticity in patients with MS.

[Purpose] Patellofemoral pain (PFP) is a common musculoskeletal complaint. It has been suggested that hip adduction creates a load on the iliotibial band and causes lateral displacement of the patella (patella tilt). However, data gathered in a previous study were derived from a small sample of males, while the condition predominantly affects females. We assessed the relationship between hip adduction and patellar position with a larger sample size, including males and females. [Participants and Methods] Forty healthy, asymptomatic females and males (age 21.5 ± 1.3 years) were recruited. Their knees were passively flexed by 20°. Using ultrasound, the distance between the lateral edge of the patella and the lateral condyle of the femur was measured in the neutral position and at 20° adduction. [Results] Hip adduction produced a smaller patella-lateral femoral condyle measurement than in the neutral position. The mean difference in the patella-condyle distance between the neutral position and 20° hip adduction was 0.18 cm. No statistically significant difference was found between the right and left limbs, genders, Tegner scores, or BMI of the study participants. [Conclusion] The results of the study showed that hip adduction causes lateral displacement of the patella. Ultrasound is an effective means of assessing patella tilt.

[Purpose] The purpose of this study was to elucidate whether insoles alter postural sway on a sideward slope rather than on level ground. [Participants and Methods] This study involved 20 flat-footed individuals and 20 normal-footed individuals. The postural sway was determined based on the total length of the locus and the body sway area, which were measured using the Zebris system. The participants were divided into three groups: the BMZ insoles, Superfeet insoles, and no insole groups. These insoles were worn by the participants with their normal shoes worn daily. [Results] The total length of the locus of the BMZ group was significantly lower than those of the Superfeet and no-insole groups. The body sway area did not significantly differ based on the insole condition. [Conclusion] BMZ insoles improve postural sway in both normal-footed and flat-footed individuals on a sideward slope.

[Purpose] Information about clinical trials related to physical therapy (CTPT) in Japan, which has the highest aging rate in the world, is essential for physical therapy education, research, and policymaking to change and strengthen the education system and promote research grants. This survey aimed to clarify the proportion of CTPT in the clinical registry and compare the proportion of CTPT in Japan with that in North America. [Participants and Methods] The ClinicalTrials.gov (CTG) and National Institute of Public Health (NIPH) Clinical Trials were used. The number and proportion of CTPT were compared each year. The analyzed data spanned 10 years from 2010 to 2019. [Results] A total of 222,821 trials were registered in CTG during the 10 years. In search of “physical therapy”, 3,001 trials searched. The proportion of CTPT increased from 0.8% to 1.7%. In total 42,194 trials were registered in the NIPH Clinical Trials Search. From the CTPT, 141 trials were obtained. The proportion of CTPT increased from 0.05% to 0.5%. The proportion of CTPT in the NIPH Clinical Trials Search was one-third or less than that in the CTG. The proportion of CTPT in CTG increased yearly, but the proportion of CTPT in NIPH Clinical Trials Search has not increased since 2016. [Conclusion] The proportion of CTPT is relatively low in Japan, compared with that in North America, and it showed no increasing trend. It is important to provide education and support for clinical trials in an aging country such as Japan.

[Purpose] The purpose of this study was to identify the differences in the incidence of sleep disorders and depression in postmenopausal middle-aged females in South Korea. [Participants and Methods] This study was a cross-sectional study. A total of 87 middle-aged females between the ages of 40 and 60 years were selected through convenience sampling. The data were collected with a self-reported questionnaire from May 1 to May 29, 2017. [Results] The mean menopause score of the study was 5.37. The menopause symptoms indicated significant differences in sexual life. The association between the incidence of menopausal symptoms and sleep disorders and depression scores based on a scale of 1 to 10 was analyzed. Menopausal symptoms strongly affected sleep and depression in middle-aged females. [Conclusion] The findings of this study may be useful in understanding depression and sleep disorders in middle-aged females and for developing more specific programs for depression and sleep disorders. Management strategies are also needed.

[Purpose] Muscle fatigue can affect the inherent properties of muscles. It is important to know how muscle stiffness changes with muscle fatigue and the different effects of the initial and terminal stages of exercise. Therefore, we aimed to examine the effects of bicep and tricep contraction tasks that lead to fatigue on joint-driven resistance of the elbow joint. [Participants and Methods] Twenty-five healthy men were included. Joint-driven resistance of the elbow joint was measured before and after the muscle contraction task. The slope of the regression line of the angle torque at the time of passive movement was calculated as an elastic coefficient and the entire movable range, proximal range, and distal range were compared. [Results] Owing to the muscular contraction of the biceps and triceps, the elastic coefficient increased in the elbow joint during both flexion and extension. The rate of change in the elastic coefficient was lower during the tricep contraction task than during the bicep contraction task. For both tasks, the change in the elastic coefficient varied depending on the range of exercise. [Conclusion] Resistance exercise increased the driven resistance of the joint during passive movement, and this effect was greater during terminal exercises.

[Purpose] To investigate the effects of a flexible brace, by analyzing whether its usage; the difference in wearing pressure could change the joint position sensation in healthy participants; and develop a flexible knee brace for patients with knee osteoarthritis. [Participants and Methods] The study included eight healthy males with 14 knee joints (mean age, 22.0 ± 3.1 years). To measure joint position sense, an “angle reproduction test” was performed in three experimental conditions: 1) participants not wearing the brace, 2) the brace was secured with an appropriate force, and 3) the brace was fully secured using hook-and-loop fasteners. [Results] No significant difference was observed among groups comprising of those not wearing, those wearing with the standard force, and those wearing with the tight force. When the maximum hook-and-loop fastener was squeezed, the sensory error in joint position was maximized at both 30° and 60° flexion. [Conclusion] Joint position sense improvement was confirmed to be poor by orthosis, and an error occurred in the joint position sense by increasing the wearing pressure in orthosis. In future, measurements should be performed on patients with knee osteoarthritis who have decreased joint position sense and verify the effect of different wearing pressures verified.

[Purpose] This study aimed to examine the importance of the level of satisfaction with initiatives toward the national examination of the physical therapy department based on the relationship between the levels of satisfaction with initiatives toward the national examination of the physical therapy and satisfaction with experiences such as activities for job hunting, graduation research, mock test scores of the national examination, and own effort for computer-based testing according to gender in a four-year cross-sectional study. [Participants and Methods] The participants were 202 males and 158 females who graduated from the International University of Health and Welfare, in March from 2017 to 2020. The levels of satisfaction with initiatives toward the national examination of the physical therapy and satisfaction with experiences were assessed using a visual analog scale. The participants were ranked into four 25th percentile groups based on the visual analog scale score of satisfaction with initiatives toward the national examination of the physical therapy. [Results] There was a significant difference in the level of satisfaction with activities for job hunting and mock test scores of the national examination in both males and females, graduation research in males, and own effort for computer-based testing in females. [Conclusion] It is suggested that the degree of satisfaction with initiatives toward the national examination of the physical therapy is related to the level of satisfaction with student life activities and that there are gender differences in this relationship.

[Purpose] Adults with cerebral palsy often use a cane as a walking aid because of their decreased gait ability. However, it is unclear whether this affects lower limb muscle activity during walking. The purpose of this study was to clarify the influence of using a cane during walking on the spatio-temporal parameters of walking, lower limb muscle activity, and lower limb muscle coactivation in adults with spastic cerebral palsy. [Participants and Methods] Eleven participants with cerebral palsy were included. The spatio-temporal parameters of walking, lower limb muscle activity, and coactivation of lower limb muscle were measured during a 10 m trial with no cane, one cane, and two canes. [Results] Walking speed was lower and the stride time longer when using two canes than when using no cane. All muscle activities significantly reduced when using two canes. No significant difference was observed between using no cane and one cane, except for walking speed. In addition, there was no significant difference in coactivation between the conditions. [Conclusion] This study revealed that when two canes were used, the walking speed was reduced, and lower limb muscle activity was reduced, reducing the burden. In contrast, the movement pattern was not suggested to have changed.

[Purpose] To investigate the efficacy of the multi-wave locked system laser therapy on the regeneration of peripheral nerve injuries by evaluating the functional, electrophysiological, and morphological changes of the crushed sciatic nerve in Wistar rats. [Materials and Methods] Sixty male Wistar rats (200–250 g) were randomly assigned to control negative, control positive, or laser groups and subjected to no laser therapy or crushing, to crushing without laser therapy, or crushing followed by multi-wave locked system laser therapy five times/week for four weeks (power=1 W, energy density=10 J/cm², total energy=100 J), respectively. Functional, electrophysiological, and morphometric analyses were performed before and 7, 15, 21, and 28 days after crushing. The sciatic functional index, compound motor action potential amplitude, motor nerve conduction velocity, and nerve and myelin sheath diameters were measured. [Results] The sciatic functional index value decreased significantly, while the compound motor action potential amplitude, motor nerve conduction velocity, nerve diameter, and myelin sheath diameter increased significantly in the laser group post-treatment compared to the values in the control groups. [Conclusion] Multi-wave locked system laser therapy was effective in accelerating the regeneration of crushed sciatic nerves in Wistar rats.

[Purpose] The sagittal shape of the spine is associated with back-pain, balance and quality of life. We developed, evaluated and report the responses of a graphical tool to assess sagittal spine shape knowledge (literacy). [Participants and Methods] Two hundred and fifty adults were randomly assigned, in a cross-sectional crossover study, to free-hand draw and select the “ideal” sagittal spine shape. We evaluated the inter and intra-rater reliability and agreement between tests and the sagittal and lordotic spine literacy between the drawing and selection test versions. [Results] Drawing test inter- and intra-rater agreement was 79% and 80% respectively. Drawing vs. selection agreement was 43%. More participants drew than selected the correct spine (30% vs. 21%) (p<0.001) and lumbar lordosis shape (56% vs. 42%) (p<0.001). Test order did not affect spine shape literacy scores. A significantly poorer literacy trend was observed with spine pain presence (p=0.02). [Conclusion] We developed a reliable method to evaluate spine shape literacy and established that only 21% and 42% of our sample demonstrated correct sagittal spine and lordotic spine shape literacy, respectively. The low literacy scores suggests that consideration of including spine shape literacy in health literacy and self-management programs may be warranted, especially in ageing populations.