[Purpose] We investigated morphological and histopathological changes in the joint capsule of rats with aging. [Materials and Methods] A total of 18 male Wistar rats were categorized into two groups: the control group (n=8), and the aged group (n=10). The aged group was reared until 75 weeks of age, while the control group was maintained until 11 weeks of age. At the end of the experiment period, the knee joints were sampled, joint capsules were subjected to histopathological analysis, and their thickness was measured. [Results] The joint capsule in the aging group exhibited significantly greater thickness compared to the control group. Histopathological examination revealed distinct differences between the two groups. The control group displayed gaps between the collagen fibers in the posterior joint capsule, along with loosely overlapping connective tissue and the presence of fat cells. Conversely, in the aged group’s joint capsule, these gaps between the collagen fibers almost disappeared and fibers became densely packed and thickened. [Conclusion] These results were similar to our previous study in rats with immobilized hindlimb knee joints. Similar findings, including collagen fiber thickening, densification in the joint capsule, and reduced hindlimb knee joint range of motion, were consistent with those observed in the present investigation.

[Purpose] Non-invasive and drug-free interventions for pain are being developed. One of them is ANF (which stands for “Amino Neuro Frequency”) Therapy^®, which consists in the application of carbonized metal devices on a patient’s skin. We aimed to: 1) test perceived changes in pain intensity after ANF application, 2) record frequency and severity of side effects, 3) assess clinician and patient satisfaction, 4) explore effects on swelling and range of motion (ROM). [Participants and Methods] In this real-world multisite observational study, N=113 physical therapists in 45 countries, applied ANF to N=1,054 patients (Mage=45.2, 56.2% female) with pain complaints. Demographic data, pain intensity (NRS-11), effects of ANF on swelling and ROM, clinician and patient satisfaction and side effects were collected. [Results] Main pain locations were: low back (14.9%), knee (12.4%), neck (10%), and shoulder (9.6%). Pre-treatment pain intensity was high (Mean=7.6, SD=1.9). It significantly decreased post-treatment (Mean=3.1, SD=2.0), t(1053)=7.25, with a large effect size (Cohen’s d=2.2). Swelling decreased and ROM increased. Average satisfaction with ANF was 92/100. Patients often experienced mild side effects (42.3%): dry mouth, headache and fatigue. [Conclusion] Results show large effect sizes, high satisfaction, and mild and short-term side effects. This is very promising but should be interpreted with caution considering the study limitations.

[Purpose] Ankle foot orthosis (AFO) is widely used to regain gait function after injuries and/or stroke; however, limited information is currently available on their effects. We herein examined the effects of three-hour immobilization with AFO on corticospinal excitability and ankle joint movement during gait in healthy volunteers. [Participants and Methods] The participants comprised of seven healthy volunteers. Corticospinal excitability and ankle joint excursions were evaluated before and after three hours of immobilization with left limb AFO. We measured motor evoked potentials in the tibialis anterior (TA) and gastrocnemius (Ga) muscles induced by transcranial magnetic stimulation. In a kinematic analysis, we focused on transition points, such as the timing from dorsiflexion to plantarflexion of the ankle joint and/or vice versa, during gait. [Results] Corticospinal excitability in TA and Ga both significantly decreased. During the normalized gait cycle (GC), ankle angles showed less dorsiflexion at 0% GC and 100% GC, and during loading response and mid-swing and terminal swing phases. Furthermore, less plantarflexion was observed during the initial swing phase. [Conclusion] This study showed that short-term ankle joint immobilization with AFO induces a significant decrease in corticospinal excitability and has an effect on ankle joint excursion during gait. Further studies are needed on the effects of long-term immobilization by AFO.

[Purpose] This study aimed to verify muscle activity patterns during posterior gait assistance with a knee-ankle-foot orthosis (KAFO) in patients with severe acute stroke hemiplegia and clarify its relationships with physical therapy parameters. [Participants and Methods] We measured activity in the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius muscles in 30 patients with acute stroke during KAFO posterior gait assistance and examined their muscle activity patterns using the Japan Coma Scale (JCS), Brunnstrom Recovery Stage (BRS), Berg Balance Scale (BBS), Functional Movement Screen (FMS), and Functional Independence Measure (FIM). We divided lower extremity muscle activity into first and second half of the stance phase, compared muscle activity during the first half of the stance phase and the second half of the stance phase. In addition, the relationship between muscle activity during gaiting and each parameter was analyzed. [Results] All four muscles showed significantly higher values in the first half of the stance phase than in the second half of the stance phase. Rectus femoris first half of the stance phase muscle activity showed a moderate correlation with the BRS, BBS, and FMS scores. [Conclusion] The amount of gastrocnemius muscle activity when KAFO assists walking from behind increases in the latter half of stance in healthy individuals. However, in patients with stroke, the activity was lower and deviated from the gastrocnemius muscle activity during walking in healthy individuals.

[Purpose] This study aimed to investigate the contribution of hip muscle torque to figure-of-eight walk (F8W) test in healthy young males. [Participants and Methods] Twenty healthy young males (40 limbs; mean age, 21.7 ± 0.6 years) participated. We measured the maximum F8W speed and steps. The hip muscle strengths (MS) of the flexor, extensor, abductor, and adductor muscles as well as the internal and external rotators (ER) were measured using a handheld belt-stabilized dynamometer. The hip muscle torque to weight-bearing index (WBI) is expressed as the measured MS divided by the lower thigh or shin length and body weight. [Results] F8W-time and F8W-rate were relevant to the ER-WBI (F8W time: β=−0.330; F8W rate: β=0.369). [Conclusion] This study’s findings suggest that hip ER strength contributes to F8W in healthy young males.

[Purpose] Oxidative stress is regulated by antioxidant capacity in vivo. However, its impact on aging characteristics remains debatable. This study is first to report oxidative stress, antioxidant capacity, and their ratio in five age groups of rats, and aimed to provide basic data useful for disease prevention. [Materials and Methods] Sixty male Wistar rats of different ages were used as experimental animals, grouped as follows: weaned (three weeks), growth (eight weeks), adulthood (six months), middle-age (12 months), and old-age (24 months). To assess oxidative stress and antioxidant capacity, derivatives of reactive oxygen metabolites and biological antioxidant potential were measured. [Results] The lowest level of oxidative stress and the highest level of antioxidant capacity were observed during the weaning stage, and remarkable dynamic changes were observed until adulthood. The highest oxidative stress and lowest antioxidant capacity were observed in the old-age group. [Conclusion] In vivo oxidative stress and antioxidant capacity are largely reflected in the characteristics of aging, and this ratio is greatly influenced by the dynamics of oxidative stress and antioxidant capacity with age.

[Purpose] This study aimed to investigate the usefulness of a quality index in gait for proximal femur fractures. [Participants and Methods] In this study, 20 females with postoperative proximal femur fracture in the preparation phase for discharge (femur fracture group) aged ≥60 years (63.0 ± 3.0 years) and 20 healthy older females (healthy group) participated (75.7 ± 7.7 years) (n=40). Measurements were conducted at comfortable and maximal gait speeds. Power spectrum entropy (PSE), harmonic ratio (HR), and modified HR (mHR), which are smoothness indices, were calculated from the measured data in each of the three axial directions and compared. [Results] The healthy and femur fracture groups showed significant differences in the PSE, HR, and mHR for comfortable and maximal gait speed in the lateral and vertical directions. Furthermore, all directions between the HR and mHR in the femur fracture group had significant differences. [Conclusion] The usefulness of the PSE, HR, and mHR as quality evaluation indices of gait was demonstrated in patients with postoperative femur fractures after unilateral disability.

[Purpose] Trust among patients and clinical suppliers is the foundation for achieving appropriate treatment. This double-blind randomized control trial aimed to determine whether providing patients a pre-treatment physical therapists’ introductions and positive appraisal can enhance the trust of patients in therapists. [Participants and Methods] This study included patients diagnosed with lumbar spine spondylosis or non-acute lower back muscle strain who were divided into intervention and control groups. The previously recorded video informed the intervention group patients that they were assigned to our best therapist because of their participation. The primary outcome was evaluated twice, once before and once after the treatment, and the secondary outcome was measured using the second time pain inventory evaluation. [Results] A total of 32 patients participated in this study. No significant difference was found in patients’ trust in therapists between the two groups, and a lower successful treatment rate with a higher pain influence level to daily life was noted in the intervention group. [Conclusion] Doctors who offer introductions with a positive assessment of physical therapists cannot change the trust of patients on therapists. Furthermore, this action may risk worse treatment outcomes.

[Purpose] The present study aimed to determine the effectiveness of locomotion training on physical function and quality of life in patients with rheumatoid arthritis (RA) and identify factors associated with its effectiveness. [Participants and Methods] Data were obtained from 103 patients with rheumatoid arthritis who underwent locomotion training for 6 months using the Health Assessment Questionnaire Disability Index, pain visual analog scale, 10-meter walking speed, timed up-and-go test, single-leg standing time, grip strength, 25-question Geriatric Locomotive Function Scale, Short Form-8, fat-free mass index, and fat mass index. [Results] A significant improvement in the Health Assessment Questionnaire Disability Index, pain visual analog scale score, maximum 10-meter walking speed, timed up-and-go test, single-leg standing time, grip strength, and physical component summary in Short Form-8 was observed at six months. [Conclusion] The current study demonstrated that locomotion training for 6 months improved physical function, certain aspects of quality of life, and sarcopenia in patients with RA. We believe that locomotion training should be recommended as a non-pharmacological therapeutic option for improving physical function in patients with RA.

[Purpose] The purpose of this study was to investigate the interrelationship between different baseline functional capacity items, and their relationship with postoperative course in colorectal cancer patients. [Participants and Methods] This was a three-institution cohort study that included 127 patients scheduled for elective colorectal cancer surgery. Baseline functional capacity was evaluated using skeletal muscle index (SMI), six-minute walk test (6MWT), serum-albumin (Alb), vitality, and mental health before surgery. Postoperative findings, including C-reactive protein (CRP) levels 3 days post-operation, frequency of postoperative complications, and length of hospital stay (LOS), were evaluated based on the medical records. [Results] CRP was positively related to SMI, but negatively related to Alb level. LOS was negatively related to vitality. The 6MWT results and mental health-related findings were not significantly related to the postoperative course, but were directly and indirectly related to vitality, respectively. Alb level was also indirectly related to vitality through the 6MWT and mental health-related findings. The final constructed model demonstrated an acceptable fit to the data (goodness-of-fit index=0.958, adjusted goodness-of-fit index=0.930, comparative fit index=1.000, root mean square error of approximation=0.000). [Conclusion] Nutrition status, as measured by Alb level before surgery, may positively affect both the postoperative course and other functional capacity parameters.

[Purpose] To present the case of a significant reduction in thoraco-lumbar deformity and alleviation of chronic low back pain in an otherwise healthy and active adolescent male basketball player. [Participant and Methods] A 17 year old was assessed with chronic low back pain persisting for 4 years. Radiographic assessment revealed a prominent thoraco-lumbar kyphosis. Chiropractic Biophysics^® structural rehabilitation including mirror image^® exercise and traction methods as well as spinal manipulative therapy was performed 2–3 times per week. [Results] There was a 12° improvement in the thoraco-lumbar deformity corresponding with the alleviation of chronic low back pains and near complete reduction in disability after 36 treatments over a 4-month period. [Conclusion] This case adds to the growing literature showing the efficacy of the non-surgical spinal rehabilitative methods of Chiropractic Biophysics in improving spine alignment and relieving spinal pain syndromes. This case also demonstrates the importance of the routine screening for spine alignment via radiography in leading to proper biomechanical diagnosis and treatment.

[Purpose] To present the dramatic improvement in posture, radiographic parameters and the alleviation of neck and severe shoulder pain related to shoulder injury associated with vaccine administration (SIRVA) after a COVID-19 injection with a shoulder mobility and posture rehabilitation program. [Participant and Methods] A middle-aged male presented complaining of severe left shoulder pain evolving since receiving a COVID-19 vaccination. The pain was severe and throbbed into the neck. Posture analysis showed a chronic stooped posture with forward head posture and thoracic hyperkyphosis. Treatment included 42 sessions of Chiropractic Biophysics^® technique and a shoulder rehabilitation program using three-dimensional vibration. [Results] At 4-months, the patient reported no neck or shoulder pain. There was a 60% decrease in neck disability. The forward head decreased 34 mm, thoracic hyperkyphosis decreased 13°, and T1–T12 forward lean decreased 73 mm, among other radiographic parameters. Re-assessment after 26-months showed maintenance of the treatment induced posture/x-ray corrections and shoulder pain relief. [Conclusion] This case demonstrates immediate and long-term improvement in a patient suffering from COVID-19 vaccine SIRVA, concomitant with neck pain and disability as well as significant radiographic postural/spinal deformity. These conditions all improved and were maintained at a 2 year follow-up without further treatment.

[Purpose] Diffusion-tensor fractional anisotropy has been used for outcome prediction in stroke patients. We assessed the clinical applicability of the two major fractional anisotropy methodologies—fractional anisotropy derived from segmentation maps in the standard brain (region of interest) and fractional anisotropy derived from standardized automated tractography—in relation to outcomes. [Participants and Methods] The study design was a retrospective survey of medical records collected from October 2021 to September 2022. Diffusion-tensor imaging was conducted in the second week after stroke onset. Outcomes were assessed using the total score of the motor component of the Stroke Impairment Assessment Set (null to full, 0 to 25). Correlations between fractional anisotropy and the outcomes were then assessed. [Results] Fourteen patients with hemorrhagic stroke were sampled. The fractional anisotropy from standardized automated tractography of the corticospinal tract on the lesion side (mean ± standard deviation, 0.403 ± 0.070) was significantly and tightly correlated (r=0.813) with the outcomes (13.4 ± 9.2), whereas the fractional anisotropy from a region of interest set in the cerebral peduncle on the lesion side (0.548 ± 0.064) was not significantly correlated with the outcomes (r=0.507). [Conclusion] The findings suggest that fractional anisotropy derived from standardized automated tractography can be more applicable to outcome prediction than that derived from a region of interest defined in the standard brain.