[Purpose] The objective of this study was to provide cerebral stroke patients with virtual reality videos of gait occurring at a faster speed than their actual measured gait speed and ascertain the effect on generating errors of gait. [Participants and Methods] The participants were 12 stroke patients. They were given a 2-minute virtual reality presentation of gait occurring at a speed faster than their actual measured comfortable walking speed. Immediately following the presentation, their 10-m walking speed was measured again to observe the immediate effect of the intervention, after which the time required to walk at maximum gait speed was measured. Stride length, cadence, and walking speed before and after the intervention were compared. In addition, heard an immersive feeling. [Results] At a comfortable walking speed, the cadence improved significantly post-intervention. Walking speed and stride length also tended to increase. At the maximum walking speed, there were no significant differences in any parameter. There was no problem with the immersive feeling. [Conclusion] After watching virtual reality videos of gait at a speed faster than the patients’ actual gait speed, their walking speed tended to increase in comfortable walking. It was speculated that this technique could be applied to walking training, depending on the device.

[Purpose] The purpose of this study was to investigate the effect of speed misperception on brain activity, created by a speed difference between actual walking and virtual reality walking videos. [Participants and Methods] The participants were 20 healthy young people. The walking speed in the video was set to 3 km/h to induce an error, while the actual walking speed was 1 km/h. Cerebral blood flow was measured using an optical imaging brain function measurement device. Left and right prefrontal cortices were analyzed using two channels and oxyhemoglobin level change from rest was used as a cerebral blood flow index. A t-test compared the cerebral blood flow dynamics before, during, and after the virtual reality video viewing under forward and backward walking conditions. [Results] Regarding changes in oxyhemoglobin levels during walking after watching the virtual reality video, cerebral blood flow increased especially in the backward walking state, where the difference was large in the right prefrontal cortex. [Conclusion] The backward walking that caused misperception by virtual reality is an extraordinary movement compared to forward walking. Thus, it is necessary to voluntarily adjust the movement by the cerebral cortex, and it is thought that activation of the prefrontal cortex occurs.

[Purpose] The thoracolumbar supraspinous intersegmental tenderness test (ITT) in the segment above was performed to compare spinal alignment and autonomic activity in the presence or absence of pain. [Participants and Methods] Thirty young males were grouped into Th1–4 (Cardiopulmonary visceral nerves), Th5–9 (Large visceral nerve), and Th10–12 (Small visceral nerve) by ITT for the presence of pain. Measurements of the spinal alignment and autonomic function were performed. [Results] Those with ITT pain had a significantly lower range of motion in the sagittal plane at Th12, Th12–L1, and L2–3 and in the frontal plane at Th1–2, Th4–5, Th6–7, and L3–4 than those in the no pain group. On autonomic function tests, the pain group had significantly lower Total Power, LF (Low Frequency), and CVRR (Coefficient of variation of R-R interval). [Conclusion] In ITT, patients with pain at Th5–9 have a mixture of reduced sagittal tilt angle and autonomic hypofunction of the adjacent upper and lower thoracic to lumbar vertebrae.

[Purpose] This study investigated the relationship between the single-leg stance test with light touch and hip rotator muscle strength. [Participants and Methods] Thirty-one healthy young adults participated in the study. A single leg stance test with light touch was performed to evaluate the participants’ static balance ability. The duration that an individual could successfully perform the single leg stance test with light touch in the eyes open was measured. The participants were instructed to slightly touch their right index fingertip on the digital scale. The hip muscle strength of the internal rotators and external rotators were measured by the isometric peak torque. The internal/external rotator strength ratio was calculated by dividing the strength of the internal rotator by that of the external rotator. [Results] The hip external rotator muscle strength was higher in males than in females. Moreover, there was a significant correlation between the single-leg stance test with light touch and hip external rotator muscle strength in males and between the single leg stance test with light touch and hip internal rotator muscle strength in females. Furthermore, a significant positive correlation was found between the single leg stance test with light touch and hip internal rotator/external rotator ratio in males. [Conclusion] We concluded that the single leg stance test with light touch is a useful tool to evaluate static hip muscle strength.

[Purpose] This study aimed to investigate the reliability of an infrared motion-time acquisition system by measuring the time taken for five motion segments (sit-to-stand, forward gait, mid-turn, return gait, and turn-stand-to-sit) in the timed up-and-go test. [Participants and Methods] In total, 30 healthy adults (25.1 ± 4.6 years, 19 males and 11 females) were included in this study. Tester A and Tester B measured the time taken in the timed up-and-go test and its five motion segments with an infrared motion-time acquisition system, and two measurements were made by Tester A and one by Tester B. [Results] Intraclass correlation coefficients of the time taken for the five motion segments in the timed up-and-go test and the intra- and inter-rater intraclass correlation coefficients were greater than 0.9. [Conclusion] Infrared motion-time acquisition systems and its five motion segments are reliable and provide accurate measurements during the timed up-and-go test.

[Purpose] To characterize depression related to nutritional status in older adults requiring long-term care. [Participants and Methods] One hundred and six individuals (66 males and 40 females) over the age of 65 who required support level 1/2 or care level 1 and were receiving day care through the long-term care insurance (LTCI) system, were enrolled. The survey items included basic attributes, comorbidities, previous medical history, requiring support/care under Japan’s LTCI system, the Mini Nutritional Assessment–Short Form, the Geriatric Depression Scale 15 (GDS-15), and body mass index (BMI). The factors associated with malnutrition/risk of malnutrition were evaluated. In addition, the relationship between nutritional status and the GDS-15 items was evaluated. [Results] Depression, LTCI, BMI, and gender were identified as related factors for malnutrition/risk of malnutrition. Compared with the favorable nutritional status group, the malnutrition/risk of malnutrition group reported GDS-15 items such as “Dropped activities and interests”, “Feel that life is empty”, “In good spirits most of the time (reversed)”, “Afraid of something bad”, “Prefer to stay at home”, and “Feel full of energy (reversed)”. [Conclusion] The results show certain parameters characteristic of depression in Japanese older adults with malnutrition requiring long-term care/support. These data will help guide future research and interventions.

[Purpose] To clarify the inter-rater reliability of the evaluation criteria for paraspinal muscle fat infiltration on magnetic resonance images between two examiners with different professional roles in interdisciplinary physical therapy teams. [Participants and Methods] In this retrospective study, we reviewed the clinical data of 225 patients with degenerative lumbar diseases who underwent posterior lumbar surgery at our hospital. A physical therapist and a spinal surgeon visually quantified fat infiltration of the multifidus muscles at the level of L4/5 on the preoperative magnetic resonance images of the patients using Kjaer’s criteria (Grade 0: 0–10%, Grade 1: 10–50%, and Grade 2: >50%). We used the kappa coefficient to assess inter-rater reliability. [Results] The participants included 142 males and 83 females (mean age, 64.7 years; range, 21–89 years). The number of patients with grades 0/1/2 were 50/160/15, respectively, for examiner 1; and 59/155/11, respectively, for examiner 2. The kappa coefficient was 0.69, indicating a substantial agreement. [Conclusion] Our study, which is the first to assess the inter-rater reliability of Kjaer’s criteria between examiners with different medical occupations, revealed that these criteria could be a reliable tool for evaluating fat infiltration in the multifidus muscles and sharing information between interdisciplinary physical therapy teams.

[Purpose] The March Test (MT), evaluating hypomobility of the sacroiliac joint (SIJ), is often used in clinical practice to evaluate low back pain but has limited reported validity and reliability. Capturing the innominate movement at SIJ associated with the results of MT has not been examined. The purpose of this study was to determine if there was a significant difference in the motion of the innominate between a positive and a negative MT. [Participants and Methods] Sixteen healthy volunteers were assigned into two groups: positive or negative results of the MT. All participants were asked to perform three different tasks: standing on both limbs, static standing on one-limb and flexing the hip to 90 and 100 degrees, and active flexing the hip past 90 degrees. In a 3D motion analysis system, virtual vectors created by landmarks over the ilium defined innominate movement of the ilium related to the sacrum, which were compared between the groups. [Results] There was significantly limited innominate movement in the March Test positive group compared to the March Test negative group. [Conclusion] This study showed hypomobility at SIJ in the March test positive groups. Further investigation is needed for clinical applications.

[Purpose] To investigate the incidence of spinal instability among patients with discogenic low back pain and its various effects with respect to the patients’ age, gender, sports activity, and occupation. [Participants and Methods] We assessed 65 patients diagnosed with discogenic low back pain at our clinic between May 2016 and May 2020. After measuring segmental angulation using plain radiographs, we divided these patients into two groups: (1) instability group with >10° of segmental angulation or >3 mm of sagittal translation and (2) stability group with <10° of segmental angulation and <3 mm of sagittal translation. Patient data such as age, gender, sports activity, and occupation were collected using their medical records. [Results] The incidence of spinal instability was 57% (37 patients) among the patients with discogenic low back pain. No significant differences in age, gender, sports activity, and occupation were identified between the groups. [Conclusion] The incidence of spinal instability accounted for more than half of the total number of patients. Additionally, age, gender, sports activity, and occupation did not affect the incidence of spinal instability. Our results support the importance of rehabilitation, such as stability training for spinal instability, for patients with discogenic low back pain.

[Purpose] This study aimed to examine whether pulmonary oxygen uptake on-kinetics at the onset of moderate-intensity exercise can predict acute cardiovascular responses to resistance exercise. [Participants and Methods] The association between pulmonary oxygen uptake on-kinetics and acute cardiovascular responses to a single resistance exercise session was investigated in seven patients with low-risk coronary artery disease who underwent revascularization through percutaneous coronary intervention. The participants performed a cardiopulmonary exercise test on a cycle ergometer and a single resistance exercise session at 30% of maximum voluntary contraction on a bilateral leg-extension machine 1 week after surgery. We measured the ventilatory anaerobic threshold and pulmonary oxygen uptake on-kinetics during the cardiopulmonary exercise test; left ventricular ejection fraction at rest; and heart rate, systolic blood pressure, and rate pressure product during the single resistance exercise session. [Results] Pulmonary oxygen uptake on-kinetics showed a positive association with the amount of increase in systolic blood pressure and rate pressure product during the single resistance exercise session, but had no association with the amount of increase in heart rate. Ventilatory anaerobic threshold and left ventricular ejection fraction were not associated with these parameters. [Conclusion] These data suggested that pulmonary oxygen uptake on-kinetics can be a useful evaluation index for predicting acute systolic blood pressure and rate pressure product responses to low-intensity resistance exercise 1 week after percutaneous coronary intervention in patients with low-risk coronary artery disease.

[Purpose] We investigated whether blood flow-restricted training known as KAATSU training, was effective for rehabilitation of a pianist with residual neurological symptoms in the upper limbs. [Participant and Methods] A pianist with residual neurological symptoms in the upper body played “Revolutionary Etude” under two conditions: piano performance with (Piano-blood flow-restricted) and without (Piano-control) the restriction of blood flow to the upper limbs. In the Piano-blood flow-restricted exercise, a pressure of 130–170 mmHg was applied around the most proximal portion of both arms. The changes in upper limb circumference and muscle strength were measured before, immediately after, and 15 min after the performance. The impression of the piano performance was recorded after the Piano-blood flow-restricted exercise. [Results] Immediately after the piano performance, the forearm and upper arm circumferences had increased significantly in both arms, and the change was greater in the Piano-blood flow-restricted than in the Piano-control condition. The handgrip strength for the right arm also showed greater changes in the former than the latter. However, there were no significant differences between the two conditions regarding the handgrip strength of the left arm. [Conclusion] There is a high possibility that blood flow-restricted training is effective for rehabilitation of the pianist with residual neurological symptoms in the upper limbs.

[Purpose] Describe the measurement, reliability and validity of finger tapping repetitions recorded using a commercially available smartphone application (app). [Participants and Methods] We tested a convenience sample of 12 young right-handed participants who completed unilateral index finger tapping and peg board completion tasks with each hand. [Results] Measurement of finger tapping performance was practicable and was shown to be acceptably reliable and able to distinguish between performance of the dominant versus nondominant hand. Finger tapping was not correlated with pegboard performance. [Conclusion] A small sample of young adults showed that measures of finger tapping were easily obtained using a smartphone app. The measures demonstrated acceptable reliability and known groups validity. They, however, may not reflect performance at other measures of voluntary movement functions.