[Purpose] The purposes of this study were to assess the fundamental motor skill (FMS) of children with Down syndrome (DS) and to compare their FMS proficiencies to those of chronological age-matched and gender-matched typically developing children (TDC). [Participants and Methods] This cross-sectional study involved a total of 60 participants (30 children with DS and 30 TDC). The FMS proficiency of participants was assessed by using the test of gross motor development, second edition (TGMD-2). The data were analyzed using independent samples t-tests to verify the differences between the two groups and gender. The effect size of Cohen’s d was also determined for comparing the two groups. [Results] The results showed that there were significant differences between children with DS and the TDC on locomotor and object control standard scores, and the gross motor quotient (GMQ). However, there were no significant gender-based differences in the locomotor and object control standard scores and the GMQ in both groups. [Conclusion] Based on the current results, the FMS proficiency of children with DS is lower than the TDC. Therefore, a therapeutic intervention program is necessary for children with DS to improve their FMS proficiency.

[Purpose] To determine whether the 25-item Japanese Health Locus of Control (25-JHLC) scale satisfies a 5-factor structure among Japanese with musculoskeletal disorders. [Participants and Methods] The primary inclusion criterion was people undergoing physical therapy for musculoskeletal disorders in two medical facilities. The 25-JHLC scale and demographic data were obtained by conducting an anonymous survey. Confirmatory factor analysis was used to analyze data from the 25-JHLC scale in 200 patients with musculoskeletal disorders. Fits for the 5-factor structure (1-internal; 2-family; 3-professional; 4-chance; and 5-supernatural) and the 2-factor structure (1-internal; and 2-external, including family, professional, chance, and supernatural) were studied. The goodness-of-fit criteria included chi-squared/degree of freedom, goodness-of-fit index, adjusted goodness-of-fit index, and root mean square error of approximation. [Results] The mean (standard deviation) age of the participants was 46.3 (18.3) years of age. The 2-factor structure satisfied no criteria; however, the 5-factor structure satisfied two criteria for acceptable fit (chi-squared/degree of freedom, and root mean square error of approximation). [Conclusion] This study found that the 5-factor structure of the 25-JHLC scale can be accepted to some extent among Japanese with musculoskeletal disorders without comorbidities.

[Purpose] We investigated the relationship of quality of life (QOL) with cognitive function, physical function, and activity ability, and aimed to identify functions related to QOL improvement, among elderly people who use day-care rehabilitation. [Participants and Methods] The participants were 37 elderly rehabilitation users, whose QOL was assessed using the Health Organization QOL26 (WHOQOL26), which consists of a 26-item self-report questionnaire. Cognitive function was assessed using the Mini-Mental State Examination, while physical function was assessed with seated forward bending, knee extension, grip, 30-second chair stand test, timed up and go test, and gait speed. Activity ability was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG index). [Results] A positive correlation was found between five WHOQOL26 categories (psychological QOL, social QOL, environmental QOL, total QOL, and QOL average) and social role in the TMIG index. There was also a positive correlation between four WHOQOL26 categories (psychological QOL, social QOL, environmental QOL, and QOL average) and instrumental activity of daily living in the TMIG index. To identify factors influencing the QOL score, association with TMIG index was investigated. Social role in the TMIG index was a positive factor in psychological and social QOL. [Conclusion] Enhancing social role is important to improve QOL of elderly rehabilitation users.

[Purpose] We aimed to investigate the relationship of thoracic asymmetry in standing position with asymmetry of the internal ankle moment in the frontal plane during gait. [Participants and Methods] The following measurements were recorded in 22 healthy adult males using a 3D motion analyzer and force plates: thoracic lateral deviation, asymmetrical ratios of the upper and lower thoracic shape, internal ankle moment in the frontal plane, mediolateral deviations of the center of mass and center of pressure. [Results] In the standing position, the thorax was deviated to the left relative to the pelvis, and the upper and lower thoracic shapes were asymmetrical. During gait, significant lateralities were observed in the internal ankle moment in the frontal plane, mediolateral deviations of the center of mass and the center of pressure. Significant positive correlations were observed between the asymmetrical ratio of the lower thoracic shape and both the asymmetry of the internal ankle moment in the frontal plane and the mediolateral deviation of the center of pressure. [Conclusion] These results suggest that thoracic asymmetry is associated with mediolateral control of the ankle during gait.

[Purpose] Very few studies have been conducted on the benefits of water exercise for older adults with sarcopenic obesity. Whether the water exercise intervention is effective for improving sarcopenia and/or obesity remains unclear. This study aimed to investigate the effects of water exercise on body composition and components of metabolic syndrome in older females with sarcopenic obesity. [Participants and Methods] Participants (aged ≥60 years) were divided into a water exercise group and a control group. Water-based strength and endurance exercises were performed three times a week for 12 weeks. Lean soft tissue mass, fat mass, and body fat percentage were measured by dual-energy x-ray absorptiometry. [Results] Two-way analysis of variance revealed significant interactions (time × group) for total body fat percentage and leg body fat percentage. In the exercise group, leg body fat percentage significantly decreased after the intervention, but no significant change was observed in the control group. The components of metabolic syndrome showed no significant interactions in either group (time × group). [Conclusion] No significant changes were observed in the components of metabolic syndrome. However, 12-week water exercise may be effective for reducing fat mass in females with sarcopenic obesity.

[Purpose] We aimed to identify possible solutions to enhance evidence-based practice (EBP) in rehabilitation professionals in Japan. [Participants and Methods] A three-round Delphi method was undertaken among a cohort of clinical therapists (328 physical therapists, 55 occupational therapists, and 6 speech therapists). In the first round, the participants listed possible solutions for promoting EBP, other than 12 solutions presented in a previous study; subsequently, a new list was created. In the second round, a newly-created list of solutions was presented, and the participants responded on a 5-point Likert scale on how much they agreed with the solutions promoting EBP in Japanese rehabilitation professionals. In the third round, the distribution of responses obtained in the second round was presented, and participant’s agreement was again assessed on a 5-point Likert scale. [Results] Across the three rounds, data were collected from 33.7% to 47.0% of all eligible participants. After the first round, 17 possible solutions were developed, and a list of 29 solutions was used in the second round. After the third round, 10 solutions reached the predetermined criteria for consensus. [Conclusion] In this study, ten possible solutions to promote EBP were proposed by the Japanese rehabilitation professionals.

[Purpose] Accelerometry indices are a promising and simple method to quantify gait stability. However, the long-term relationship between gait stability and walking ability in patients with stroke has not been fully investigated. The purpose of this study was to longitudinally examine the relationship between gait regularity and harmony at admission and gait speed at discharge in inpatients with subacute mild stroke. [Participants and Methods] Sixteen patients with subacute stroke (median age, 69.5 years [1st–3rd interquartile range, 58.0–73.8 years]; 13 males) were enrolled in the study. A Spearman’s rank correlation coefficient was calculated for step regularity, stride regularity, the harmonic ratio at admission, and the walking speed at discharge. We also calculated the partial rank order correlation, controlling for balance ability. [Results] The vertical step regularity, harmonic ratio, and anterior-posterior harmonic ratio were all positively correlated with the walking speed at discharge. Positive correlations with vertical step regularity and harmonic ratio were found in partial rank order correlations when controlled for balance ability. [Conclusion] Vertical step regularity and gait harmony had predictive validity for discharge gait speed in patients with subacute stroke.

[Purpose] The purpose of this study was to investigate the effect of the lumbar stability exercise on the range of motion (ROM) and height difference of the shoulder and to provide basic data to prevent musculoskeletal disorders for improvement of the quality of life of older adults. [Participants and Methods] Twenty older adults without musculoskeletal problems were divided into the lumbar stability exercise group and the passive upper arm exercise group and performed exercise for 30 minutes, 3 times a week for 5 weeks. The shoulder flexion, abduction, extension, and height difference between shoulders were measured. A paired t-test was applied for comparative analysis of data before and after exercise in both groups. [Results] In the lumbar stability exercise group, the shoulder flexion, abduction and height difference were significantly different. In the passive upper arm exercise group, the abduction was significantly different. [Conclusion] Since it was proved that the height difference and range of motion of shoulder are improved when the lumbar stability exercise is indirectly carried out without directly doing shoulder exercise, it is suggested that the lumbar stability exercise is strongly recommended for clinical uses to improve functions in older adults.

[Purpose] The recurrence rate of diabetic foot ulcers is high and is related to kinematic factors. Achilles tendon lengthening has been shown to reduce the recurrence rate of foot ulcers by increasing the range of motion in the ankle joint and decreasing the plantar load. However, there are few reports on the effects of Achilles tendon lengthening in Japanese patients, but the results are yet to be clarified. This study aims to investigate the effects of Achilles tendon lengthening on physical function and ambulatory state in patients with diabetic foot ulcers. [Participants and Methods] This study initially included 10 patients with diabetic ulcers who had undergone Achilles tendon lengthening between April 2013 and March 2020. We retrospectively evaluated the factors available from the medical records. [Results] The dorsiflexion range of motion in the ankle joint increased by 10.5 degrees on average after surgery, while the plantar load decreased by 19.1 percent, while gait speed and stride length remained unchanged. [Conclusion] Achilles tendon lengthening for diabetic foot ulcers increased the range of motion in the ankle joint and decreased the plantar load without changing the ambulatory state.

[Purpose] This study evaluated the effect of low-level laser therapy on inflammatory signs in an arthritis rat model as a foundation for elucidating the mechanism of the anti-inflammatory effect. [Materials and Methods] Eigteen Wistar rats were divided into three groups: group I (arthritis without low-level laser therapy), group II (arthritis with low-level laser therapy), and the control group (sham arthritis control). Arthritis was induced in the right knee by injecting a mixture of kaolin and carrageenan. Low-level laser therapy was continued for seven days after the onset of arthritis by 60 times of repeated irradiation for 10 seconds in the right knee joint area. The joint transverse diameter, pressure pain threshold in the affected knee joint, and mechanical paw withdrawal threshold at the distant site were evaluated the day before the injection and one, three, and seven days after the injection. Pathological changes were observed. [Results] Group II showed better improvement in swelling and pain in the affected knee joint and secondary hyperalgesia at the distance site when compared to group I. In group II, there was only mild infiltration of synovial cells, and the progression of arthritis was suppressed compared with that of group I. [Conclusion] Low-level laser therapy can mitigate swelling and inflammatory pain in the affected knee joint and prevent secondary hyperalgesia.

[Purpose] The present study aimed to identify the physical functions associated with health-related quality of life in older adults with knee osteoarthritis. [Participants and Methods] A total of 132 participants were included in this study in two groups: the knee osteoarthritis group (n=66) and the control group (n=66). We compared the results of the Medical Outcomes Study 36-Item Short-Form Health Survey with the physical function measures related to health-related quality of life. In the knee osteoarthritis group, we examined the relationship between the degree of knee pain and health-related quality of life. [Results] The knee osteoarthritis group showed a significantly shorter one-leg standing time, lower maximum walking speed, and significantly longer time to complete the Sit-to-Stand-5 and Timed Up and Go tests than the control group. The knee osteoarthritis group had significantly lower 36-Item Short-Form Health Survey scores than the control group on seven subscales and significantly lower scores for physical component summary and role or social component summary. In the knee osteoarthritis group, physical component summary and role or social component summary were correlated with Sit-to-Stand-5, Timed Up and Go, and maximum walking speed. We observed a correlation between physical component summary and knee pain on joint loading. [Conclusion] In older adults with knee osteoarthritis, rehabilitation approaches aimed at achieving a smooth transition from sitting to standing may increase social participation and improve health-related quality of life.

[Purpose] We aimed to evaluate the effects of an intervention consisting of intramuscular lidocaine injection in combination with physical therapy on the standing posture, balance ability, and walking ability in patients with Parkinson’s disease who had camptocormia after deep brain stimulation. [Participants and Methods] The participants were nine patients with Parkinson’s disease who had previously undergone deep brain stimulation. The intervention comprised a lidocaine injection into the abdominal external oblique muscles for five days in combination with physical therapy, including body weight-supported treadmill training for two weeks. Before and after the intervention, the total and upper camptocormia angles were used to assess the standing posture; the Berg balance scale was used to assess the balancing ability; and maximum walking speed and stride length were used to assess the walking ability. [Results] The total and upper camptocormia angles, and Berg balance scale improved significantly more after the intervention than before. Before and after the intervention, there was no significant difference in maximum walking speed, but the stride length was significantly greater after the intervention than before. [Conclusion] The intervention was effective in alleviating camptocormia and improving the balance and walking abilities of patients with Parkinson’s disease with camptocormia after deep brain stimulation.

[Purpose] This study aimed to investigate the prevalence of frailty among community-dwelling elderly females, and to examine its relation to motor function and the main risk factors of frailty. [Participants and Methods] The participants were 67 community-dwelling elderly females, aged 76.2 ± 7.7 years. We performed measurements of physical parameters, motor functions (such as grip strength), timed up and go test (TUG), walking speed, and frailty (measured using the Kihon Checklist [KCL]). [Results] KCL scores were 31.3%, 31.3%, and 37.3% in the frailty, pre-frailty, and robust groups, respectively. The frailty group was older than the pre-frailty and robust groups. Additionally, the different groups showed significant differences in grip strength, TUG, and walking speed. The highest median KCL score was for depression, followed by physical function. As a results, frailty was evident even among health-conscious elderly people. [Conclusion] It is essential to identify frailty at an early stage and identify its preventive factors, in order to extend the healthy life expectancy of the local population.

[Purpose] This pilot study aimed to investigate the relative and absolute reliability of variables obtained from an acceleration-based gait analysis conducted at comfortable and maximal gait speeds in individuals with chronic stroke. [Participants and Methods] This study included 25 community-dwelling individuals with chronic stroke. The participants wore triaxial accelerometers, while an observed walking trial was performed at comfortable and maximal speeds on two separate days 1 week apart. Relative reliability was evaluated using the intraclass correlation coefficient, and absolute reliability was evaluated using the Bland–Altman analysis, standard error of measurement, and minimal detectable change. [Results] The intraclass correlation coefficient of gait varied according to the acceleration-based gait analysis, ranging from 0.70 to 0.99. The Bland–Altman analysis revealed no systematic bias in both comfortable and maximal gait speed conditions. Most of the minimal detectable changes were smaller at maximal gait speed than at comfortable gait speed. [Conclusion] Acceleration-based gait analysis is a reliable method, particularly in maximal gait speed conditions. It may be used to assess the effect of rehabilitation interventions in individuals with chronic stroke.

[Purpose] The purpose of this study was to examine effects on gait indices produced by a short-term intervention of pedaling combined with integrated volitional control electric stimulation in an older patient with stroke. [Participant and Methods] This study was a single-case ABA (A-control, B-treatment) design. Each phase lasted four consecutive days (12 days total). Ten minutes of pedaling were performed daily. In Phase B, pedaling was combined with integrated volitional control electric stimulator on the rectus femoris of the affected side. The primary outcomes were the coefficient of variation, a measure of stride time homogeneity during gait; and the root mean square, a measure of trunk sway in the triaxial direction (mediolateral, vertical, anteroposterior) during gait. Assessments were measured before the intervention (day 0) and after the end of each phase (days 4, 8, and 12). [Results] Changes from the previous coefficient of variation were +1.13%, −3.95%, and +0.82% in Phases A, B, and A’, respectively, with the greatest improvement occurring after Phase B. The root mean square improved the most with −5.13 for mediolateral after Phase B, −3.33 for vertical, and −6.99 for anteroposterior after Phase A. [Conclusion] A short-term intervention consisting of pedaling combined with integrated volitional control electric stimulation may contribute to the improvement of gait abnormalities.

[Purpose] To investigate the effects of long-term body-weight-supported treadmill training on walking ability and physical function in an elderly individual with incomplete cervical spinal cord injury. [Participant and Methods] The patient was a 68 year-old male with an incomplete spinal cord injury at the C3/C4 level, incurred when he was 56 years old. He initiated home-based body-weight-supported treadmill training using a body-weight-supported treadmill installed at his home. His walking ability was measured as the percentage of body weight load reduction, and his physical function was evaluated using manual muscle testing and measuement of the range of motion of his lower limbs. [Results] The physical function of the lower limbs was improved, maintained, or showed delayed decline until 9.5 years post-injury. [Conclusion] Long-term body-weight-supported treadmill training may improve, maintain, or at least delay the decline of the physical function of participants for several years, without causing any remarkable complications.