[Purpose] This study aimed to examine the immediate effects of a pelvic neuromuscular joint-facilitation intervention on the walking and balance ability of patients with hemiplegia caused by cerebrovascular accidents. [Participants and Methods] A total of 15 patients with hemiplegia caused by cerebrovascular accidents underwent a neuromuscular joint-facilitation lumbar-pattern intervention (intervention group), a bridge exercise (bridge intervention group), or a neuromuscular joint-facilitation bridge intervention (neuromuscular joint-facilitation bridge group). Each intervention was randomly administered at 7-day intervals. Measurement items included the timed up-and-go test, functional reach test, 10-m maximum walking speed test, and load in the standing position. Measurements were taken before and after the intervention in each group. [Results] The timed up-and-go test result was significantly shorter in the neuromuscular joint-facilitation intervention group. Timed up-and-go test results, functional reach, 10-m walking time, and standing load (non-paralyzed side) significantly improved in the neuromuscular joint-facilitation bridge group. [Conclusion] The neuromuscular joint-facilitation bridge intervention was immediately effective in patients with hemiplegia caused by cerebrovascular accidents and improved their walking and balance ability.

[Purpose] This study aimed to investigate the effect of cognitive tasks on the center-of-foot pressure (COP) displacements and brain activity during single leg stance (SLS) in older people. [Participants and Methods] This study included 25 healthy older (age, 68.8 ± 4.9 years) and 25 young (age, 21.0 ± 0.9 years) participants. Participants performed SLS for 35 s under a single-task (ST) and three dual-tasks (DTs), namely verbal, subtraction, and recall tasks. We measured the total length of COP (COP__TL) and change in oxygenated hemoglobin (HbO₂) levels during SLS under four tasks. [Results] There were no differences in COP__TL and HbO₂ levels in the young group, whereas COP__TL in the recall task was significantly longer than in ST in the older group. In the comparisons of the DTc (the relative change of DT to ST), no differences were found among three DTs in the young group, whereas the DTc of COP__TL in the recall task was significantly higher than that in the verbal task in the older group. Regarding HbO₂, no differences were observed among the four tasks in both groups. [Conclusion] These results suggest that SLS combined with a recall task may be useful for fall risk screening in healthy older individuals.

[Purpose] This study aimed to examine the changes in the balance ability of community-residing elderly females between 2017 and 2020. [Participants and Methods] The participants included 202 females with ≥65 years of age (average age, 78.3 ± 5.88 years), living independently in the community and attending the salon. The balance ability was measured through a one-legged standing test by keeping the participants’ eyes open. The measurement duration was a maximum of 120 s while standing still. Each participant underwent the measurement twice, and the best attempt was recorded. The survey period was from 2017 to 2020, and the measurements were conducted once a year. [Results] The 2020 records showed a statistically significant difference compared to those of the other 3 years. The degree of decline was higher in the old-old than that in the young-old. [Conclusion] The balance ability of the elderly females was found to reduce significantly during the COVID-19 pandemic. Specifically, supporting physical activities in the old-old females is necessary to improve their balance ability.

[Purpose] This study aimed to examine the effective time allocation for physical therapy activities in patients with stroke. The primary outcome measure was the improvement in the time required to transition from the supine to the sitting position. [Participants and Methods] This study enrolled 19 inpatients with stroke. The activities performed during physical therapy were classified as nontherapeutic activities, minimal therapeutic activities, moderate therapeutic activities, high therapeutic activities, and other activities. We determined the relationship between the activities and the relative shortening ratio of the time required to sit up from the supine position for up to 13 weeks of physical therapy. We also considered the following background factors: patient information, functional independence measure, and Brunnstrom recovery stage. [Results] The Brunnstrom recovery stage for the lower extremity was identified as the confounding factor, and the participants were stratified into the Brunnstrom recovery stage 6 group, in which moderate therapeutic activities and other activities were significantly related to the relative shortening ratio. [Conclusion] The results suggested that other activities exerted a similar effect as moderate therapeutic activities in the Brunnstrom recovery stage 6 group and were more effective than high therapeutic activities in reducing the time required to sit up from the supine position.

[Purpose] This study aimed to clarify the characteristics of joint moment and force for postural control performance after stopping walking under two conditions. [Participants and Methods] A total of 18 healthy males participated in this study. The joint moment and power were compared between the normal and kyphosis postures after stopping walking based on the critical time interval as calculated by stabilogram diffusion analysis. [Results] The polarity of the joint moment in both postures was different in the knee and hip extension–flexion directions, the absolute value being higher in the kyphosis posture than in the normal one. The hip and knee joint powers were negative in the normal posture but positive in the kyphosis posture; these values were higher in the kyphosis posture than the normal one. [Conclusion] The polarity of the joint moment of the hip and knee joints in the direction of flexion and extension differed from the normal one due to the postural changes caused by the kyphosis posture. The postural controls between the two conditions were considered different. The leading limb was thought to be an important braking action in stopping walking.

[Purpose] Intensity for resistance exercise is estimated based on the maximum muscle strength. Exercise prescription without evaluating the biological response has a challenge. This study aimed to confirm whether anaerobic threshold measured using cardiopulmonary exercise test in resistance exercise is appropriate or not. [Participants and Methods] Resistance exercise adopted for the study was right-leg knee extension. The participants were 10 healthy young males. We investigated whether the oxygen uptake kinetics achieved a steady state within 3 min during the constant-load test with knee extension at 80% anaerobic threshold using cardiopulmonary exercise test with knee extension. If oxygen uptake kinetics achieved a steady state within 3 min, the exercise intensity measured using cardiopulmonary exercise test was considered appropriate. [Results] Anaerobic threshold was measured using the conventional approach in all participants. The steady state of oxygen uptake kinetics could be achieved within 3 min. In the constant-load test with knee extension at 80% anaerobic threshold, the oxygen uptake kinetics achieved a steady state within 3 min. [Conclusion] Based on the findings, the anaerobic threshold obtained using cardiopulmonary exercise test with resistance exercise was judged as appropriate. The results of this study contribute to the accurate setting of exercise load for resistance exercise and condition setting for the evaluation of skeletal muscle function.

[Purpose] Cancer survivors have functional impairments that adversely affect patients’ quality of life (QoL). Acute rehabilitation helps to reduce disability and improves QoL in cancer survivors. This study investigated the potential improvement in mobility levels and QoL of cancer patients during acute inpatient physical therapy (PT) from admission to discharge. [Participants and Methods] This was a cross-sectional study conducted at King Fahad Medical City, Riyadh. Acute inpatient cancer survivors (n=99) were assessed at their admission and discharge. The primary outcome measure was the AM-PAC “6-Clicks” Basic Mobility, Functional Assessment of Cancer Therapy-General (FACT-G7) and the Karnofsky Performance Scale (KPS). [Results] Overall, 82.8% of cancer patients were discharged home. There were significant improvements in all the three outcome measures for all the patients from admission to discharge. Patients who were discharged home exhibited significantly better improvement in all the scales. Factors that predicted discharge mobility and quality of life were discharge destination, number of PT sessions, and baseline admission scores. [Conclusion] The study found that acute inpatient cancer rehabilitation helps to improve mobility and QoL. Rehabilitation programs available in Saudi Arabia are limited, and it is important to integrate the cancer rehabilitation model into the oncology services.

[Purpose] The purpose of this study was to investigate the differences in respiratory function, physical function, and Activities of Daily Living (ADL) between respiratory and non-respiratory patients using community-based home rehabilitation. [Participations and Methods] Maximum Phonation Time (MPT), upper and lower limb muscle strength, and ADL were compared in two groups: a respiratory disease group including respiratory patients and those with respiratory comorbidities, and a non-respiratory disease group. Cutoff values were determined for items that showed significant differences between groups. [Results] There were no significant differences between the two groups in assessments other than MPT. MPT was significantly lower in the respiratory disease group, with an MPT cutoff value of 10.1 sec and an area under the curve of 0.74. [Conclusion] Use of the MPT cutoff value may help to determine whether respiratory function is impaired in patients with respiratory disease.

[Purpose] This study aimed to clarify whether the distribution range of the forward reach distance and the relationship between the forward reach distance and the movement distance of the center of pressure differed depending on whether the controlled starting standing position during the functional reach test with an ankle joint strategy. [Participants and Methods] Sixteen healthy male volunteers participated in the study. The distribution range of the forward reach distance and the relationship between the forward reach distance and movement distance of the center of pressure in the controlled starting standing position and non-controlled starting standing position conditions were analyzed. [Results] The distribution range of the forward reach distance was significantly smaller in the controlled starting standing position than in the non-controlled starting standing position. In both groups, the forward reach distance was associated with the movement distance of the center of pressure. [Conclusion] The findings suggested that the use of an ankle joint strategy with a controlled starting standing position in the functional reach test may be a more accurate method to evaluate standing balance ability.

[Purpose] In April 2014, an additional health insurance system aiming to maintain or improve activities of daily living levels was newly established by the Japanese government. The purpose of this study was to determine the influence of this new medical system for rehabilitation on patient management (e.g., activities of daily living level and length of hospital stay) in an acute-phase stroke patient ward. [Participants and Methods] All patients were admitted to the stroke patient ward in our hospital and were registered between January 2012 and December 2019. We assessed the differences in the time to initiation of rehabilitation, length of hospitalization, implementation rate of rehabilitation, and Barthel Index between the period before the start of the new medical system (Prior period) and after this system was started (Post period). [Results] Significant improvements were observed in the initiation of rehabilitation and the difference in the Barthel Index scores after the start of the new medical system. Although the length of hospitalization and implementation rate of rehabilitation did not differ significantly, both indicators gradually improved after the start of the new system. [Conclusion] Our results suggest that the new medical system for rehabilitation is beneficial for patient management in the acute-phase stroke patient ward.

[Purpose] To investigate the effects of incorporating elliptical trainer exercise in early rehabilitation after total hip arthroplasty on physical function and self-reported outcomes. [Participants and Methods] Participants with independent gait prior to total hip arthroplasty underwent conventional postoperative physiotherapy and were divided into two groups. The intervention group additionally underwent elliptical trainer exercise, while the control group underwent a walking program. The main outcomes were low back and hip region pain, lower limb muscle strength, single-leg stance time, Timed Up & Go Test results, 10 m walking test results, hip disability and osteoarthritis outcome score, and modified fall efficacy scale score. These outcomes were evaluated preoperatively, at discharge, and at 1 and 3 months postoperatively. [Results] Fifty participants (including 40 females; age, 68.3 ± 10.8 years) participated in this study. Physical function evaluations showed a significant improvement in hip region pain during walking at discharge. Knee extensor strength, single-leg stance time, stride length, and walking speed were significantly greater in the intervention group at discharge and at 1 and 3 months postoperatively. The modified fall efficacy scale score significantly improved in the intervention group 1 month postoperatively. [Conclusion] Elliptical trainer exercise and conventional physiotherapy in the early postoperative period contribute to improved physical function and walking ability and improvement in the fear of falling.

[Purpose] This study aimed to clarify the optimal method of attention focus in which temporal changes in the seating pressure can induce effective sitting motion in order to prevent osteoporotic vertebral fractures in the elderly. [Participants and Methods] This study included 101 community-dwelling elderly people. The participants were seated in a chair with a force plate under two conditions: external focus of attention with metaphor and internal focus of attention. We evaluated and analyzed the seating pressure by using the force plate and the sitting motion with a three-dimensional motion capture system. The unit time sitting pressure value and the trunk forward tilt angle were calculated and compared between the two conditions. [Results] The unit time sitting pressure value was significantly smaller in the external condition than the internal condition. The trunk forward tilt angle was significantly greater in the internal condition than the external condition. [Conclusion] This study demonstrated that external focus of attention with metaphor can induce a sitting motion with a slower temporal change in sitting pressure than the internal focus of attention. We concluded that external focus of attention with metaphor may be an effective instruction to prevent osteoporotic vertebral fractures in the elderly.

[Purpose] This study aimed to compare the muscle activity around the foot and ankle joints, notably of the abductor digiti minimi, between affected and unaffected sides of individuals with chronic ankle instability. [Participants and Methods] Twelve adult males with chronic ankle instability in one ankle (age, 27.7 ± 5.4 years; height, 172.5 ± 8.1 cm; weight, 67.5 ± 8.1 kg) were included and underwent surface electromyography assessments in multiple positions on both affected and unaffected sides. Measurements were obtained for eight muscles including the abductor digiti minimi. Each measurement included a 5-s segment of the stable waveform, with the root mean square-processed and normalized to the resting position set to 1. [Results] Abductor digiti minimi activity on the affected side was significantly reduced during maximal toe extension/abduction with both ankle dorsiflexion and plantarflexion. Peroneus longus activity on the affected side was significantly greater during maximal toe extension/abduction with ankle plantarflexion; peroneus longus and tibialis anterior muscle activities were significantly greater on the affected side during maximal toe extension/abduction with ankle dorsiflexion. [Conclusion] In the absence of load, muscle imbalance in the intrinsic and extrinsic muscles of the foot was suggested. However, no significant differences were observed under loading conditions.