[Purpose] To clarify the association between preoperative physical activity and postoperative ambulation based on physical activity intensity, and independent of functional capacity and depression, in patients with gastrointestinal cancer. [Participants and Methods] Seventy patients who underwent surgery for primary colorectal or gastric cancer were enrolled. Preoperative moderate-to-vigorous-intensity physical activity, light-intensity physical activity, and sedentary behavior were assessed using an accelerometer. The primary outcome was the days to postoperative first ambulation (capable of independently and continuously walking 150 m). Functional capacity and depression, as confounders, were evaluated by measuring the 6-minute walk distance and using the Hospital Anxiety and Depression Scale. [Results] Of the 70 patients, 28 had insufficient accelerometer data, and 42 were included in the analysis. Preoperative light-intensity physical activity, but not moderate-to-vigorous-intensity physical activity and sedentary behavior, was negatively associated with the days to postoperative first ambulation, after adjusting for age, preoperative functional capacity, and preoperative depression. [Conclusion] Preoperative light-intensity physical activity was associated with the days to postoperative ambulation independently of age, functional capacity, and depression. Hence, predicting delayed ambulation by preoperative light-intensity physical activity in patients with gastrointestinal cancer may be useful.

[Purpose] The purpose was to examine relationships between variables characterizing the 20-second stepping test movement pattern, assessed with an infrared depth sensor (Kinect^TM), and measurements of dynamic and static balance. [Participants and Methods] A total of 27 independent-living, older adults (7 males and 20 females) participated in this study. For each participant, the stepping test total movement distance, movement displacement, knee movement distance, and step number were calculated from Kinect closed joint-point coordinate data. Dynamic and static balance were assessed using a NeuroCom Balance Master Platform system. [Results] The stepping test total movement distance had a moderate negative correlation with endpoint excursion (r=−0.469) and a moderate positive correlation with total movement distance, corrected for knee movement distance (r=0.557). Step numbers had a moderate negative correlation with stepping test total movement distance (r=−0.667) and total movement distance, corrected for knee movement distance (r=−0.531). Division into high and low-balance sub-groups (based on endpoint excursion or sway velocity scores) revealed that stepping test total movement distances and movement displacements were greater, and step numbers were fewer, in low balance groups. [Conclusion] The stepping test, combined with a Kinect^TM-assessed movement pattern provides a simple, objective, reliable means for assessing balance in community-dwelling, independent-living older adults.

[Purpose] Children with cerebral palsy require more gait energy than healthy children. The association between gait abnormalities and gait efficiency remains unclear. We investigated the association between gait abnormalities, balance, and maximum step length to determine contributors to gait efficiency in children with cerebral palsy. [Participants and Methods] The study included 33 patients with cerebral palsy, who could walk without the use of walking aids. All participants were instructed to walk for 6 min, and the Total Heart Beat Index was calculated as a measure of walking efficiency. The Edinburgh Visual Gait Score was used to assess gait abnormalities. Additionally, the maximum step length was recorded, and all participants performed the Berg Balance Scale. Correlation analysis and stepwise multiple regression analysis were used to confirm the association between the aforementioned parameters and the Total Heart Beat Index. [Results] The Edinburgh Visual Gait Score was correlated with the heel lift during the stance, knee position during the terminal swing of gait as factors associated with the Total Heartbeat Index. The Berg Balance Scale was correlated with turning 360°, standing with feet together. [Conclusion] Our findings emphasize the need for treatment strategies focused on gait abnormalities and balance.

[Purpose] In Japan, community-gathering initiatives for older residents often involve support from rehabilitation professionals. However, the quality of this support varies. This study aimed to clarify the rehabilitation professionals’ competency-acquisition process for establishing better support methods and processes, thereby reducing regional and individual differences. [Participants and Methods] The study included 10 rehabilitation professionals (nine physical therapists and one occupational therapist; eight males and two females, aged 34−57 years) with 2–7 years of experience facilitating community gatherings. Semi-structured interviews and the modified grounded theory approach were used. [Results] The results of this study identified 38 concepts, 15 subcategories, and finally the following 6 categories pertaining to the effective support process of care prevention: “not confident”, “prepare for support”, “form a rapport”, “know the field”, “implement effective support”, and “utilize support experiences”. [Conclusion] To prevent long-term frailty among older residents, rehabilitation professionals should 1) establish a system for ensuring their participation in the project, 2) understand the core principles of community rehabilitation, 3) facilitate residents’ initiatives, and 4) mediate group activities. Apart from conventional physical-therapy skills, rehabilitation professionals must acquire specific competencies to support community gatherings as a part of their education, such as providing indirect group support rather than direct individual support.

[Purpose] To examine changes in physical activity levels between admission and discharge in patients hospitalized after stroke and fracture. [Participants and Methods] Patients with stroke (n=36) or fracture (n=41) wore an accelerometer during the daytime for three days after admission and before discharge. Physical activity was divided into sedentary behavior (SB), light-intensity (LIPA), and moderate-to-vigorous (MVPA), and then compared between hospital admission and discharge using the Wilcoxon signed-rank test. The characteristics of patients with or without changes in SB during hospitalization were compared using the Mann–Whitney U test. [Results] The median LIPA time in patients after stroke and fracture increased from 107.5 and 106.7 minutes on admission to 122.0 and 127.3 minutes at discharge, and the median MVPA time increased from 2.7 and 0.7 minutes on admission to 4.2 and 2.7 minutes at discharge, respectively. In particular, LIPA in non-therapy time increased for patients both after stroke and fracture. No differences in characteristics were observed between with or without changes in SB regardless of differences in diagnoses. [Conclusion] These findings indicate that while physical activity levels increased during hospitalization, they remained below World Health Organization recommendations for MVPA, and patient characteristics alone may not account for increased activity levels.

[Purpose] To present the case of the amelioration of chronic pain and disability in a patient suffering from failed back surgery syndrome. [Participant and Methods] A 27-year-old male with chronic low back pain was treated with a Coflex^® intra-spinous instrument, however, it was removed shortly after due to poor outcome including worsening pain and disability. Radiographic assessment revealed significant posterior translation of the thorax complicated by significant loss of the normal lumbar lordosis and a left lateral translated thoracic cage posture. Chiropractic Biophysics^® technique was applied over a 5.5-month period leading to structural spine improvements as well as improved pain, Oswestry disability index (ODI) and quality of life (QOL). [Results] There was a 21 mm reduction in posterior thoracic translation, a 6.2° improvement in lumbar lordosis and a 16 mm reduction in lateral thoracic translation corresponding with improved ODI and QOL scores. A 6 year follow-up showed successful outcome despite some degenerative changes in the spine at the prior surgical level. [Conclusion] This case adds to the growing literature showing the efficacy of non-surgical spinal rehabilitative methods in improving outcomes in patients with spinal deformity and associated disabilities. This case also demonstrates necessity of the continued criterion standard of spinal radiography for biomechanical assessment.

The authors would like to apologize for the mistakes in Tables 2–4.

Incorrect:

The number of samples for robust, prefrailty, and frailty in Table 2 are 46, 61, and 13, respectively.

The number of samples for robust and frailty in Table 3 are 69 and 51, respectively.

The number of samples for robust, prefrailty, and frailty in Table 4 are 38, 27, and 55, respectively.

Correct:

The number of samples for robust, prefrailty, and frailty in Table 2 are 37, 37, and 8, respectively.

The number of samples for robust and frailty in Table 3 are 56 and 26, respectively.

The number of samples for robust, prefrailty, and frailty in Table 4 are 35, 25, and 22, respectively.