[Purpose] This study aimed to investigate the influence of seat-forward tilt angles on improving upper limb dexterity in seated tasks and to contribute to the development of seating strategies. [Participants and Methods] Seventeen healthy men (age, 20.0 ± 0.5 years; height, 175.1 ± 4.9 cm; and body weight, 63.8 ± 6.7 kg) participated in this study. The forward tilt angles of the seat were set at 0°, 15°, and 30°, with knee pads used in all conditions. The Purdue Pegboard task was used to assess upper limb dexterity, with participants inserting pins into holes in the board for 60 s. Additionally, a visual analog scale was used to evaluate the perceived ease of the task. [Results] The Purdue Pegboard task scores were 30.0 ± 2.5, 30.6 ± 2.7, and 32.5 ± 2.9 for the 0°, 15°, and 30° conditions, respectively. The visual analog scale scores were 75.3 ± 9.8, 76.4 ± 14.6, and 84.1 ± 11.1 for the 0°, 15°, and 30° conditions, respectively. Both measurements showed significantly higher values under the 30° condition than under the other two conditions. [Conclusion] These results suggest that a tilt angle of 30° provides the most significant ease and upper limb dexterity.

[Purpose] To evaluate the efficacy of the “forward-tilting posture” (the trunk tilted forward against a table) in a wheelchair in relieving gluteal pressure. [Participants and Methods] Thirty-six healthy adults were instructed to sit in a wheelchair assuming the following three postures: (1) both feet placed on the foot support with the trunk upright (“basic sitting posture”), (2) both feet placed on the foot support with the trunk tilted forward against a table (“forward-tilting posture A”), and (3) both feet placed on the floor with the trunk tilted forward against a table (“forward-tilting posture B”). A seat-type sensor pad placed on a wheelchair cushion was used to measure the maximum gluteal pressure and gluteal contact area. [Results] The maximum gluteal pressures in “forward-tilting postures A” and “forward-tilting postures B” were significantly lower than those in the basic sitting posture. The maximum gluteal pressure in “forward-tilting posture B” was significantly lower than that in “forward-tilting posture A”. The gluteal contact area in “forward-tilting posture B” was significantly larger than that in “forward-tilting posture A”. [Conclusion] The study results indicate that the “forward-tilting posture” in a wheelchair effectively relieves gluteal pressure.

[Purpose] This study investigated differences in the convergence mode of post-step sway between young and older adults using a step-down task to identify fall causes in older adults and assess consecutive postural adjustments. [Participants and Methods] This study included 15 young and 15 older adults (nine females and six males in each group). The participants stepped down from a standing position to a force platform 10 cm lower and maintained a one-leg standing position. The center-of-pressure total trajectory length was assessed using a force plate and regression equations for time and sway were derived from the associated time-series data for both groups. [Results] An inversely proportional aspect was observed for both groups, with significantly different coefficients and constants. The center-of-pressure total trajectory length per second from foot contact was significantly different between 2–3 s and 4–5 s in the older group but not in the younger group. [Conclusion] The results suggest a difference in the convergence mode of dynamic balance between the two groups, with young adults exhibiting a more rapid balance-sway reduction than older adults. The novel computational approach used in this study may be useful for dynamic balance measurements.

[Purpose] To examine the influence of exercise using the Valsalva maneuver on vital signs. [Participants and Methods] Twenty-five healthy university students participated in the study. All participants were instructed to perform the squat under two loading intensities, that is, with barbell weights of 40% and 80% of body weight, under two conditions: no breath-holding (Control group) and breath-holding (Valsalva group). Blood pressure, pulse pressure, lactic acid level, and Borg scale scores were measured before and after each exercise session. [Results] Systolic blood pressure, mean blood pressure, and pulse pressure increased in the 80% Control, 40% Valsalva, and 80% Valsalva groups. [Conclusion] The use of the Valsalva maneuver could influence the vital signs of young, healthy participants.

[Purpose] Although standing balance and functions of each proprioceptor decline with age in older adults, data regarding the types and percentages of proprioceptors susceptible to decline are unavailable. In this study, we investigated the rate of decline in each proprioceptor area in older adults and also the effect of aging on the association between postural balance and proprioception. [Participants and Methods] This study performed between November 2012 and July 2022 included both young and older adults. Vibration stimuli were applied to the gastrocnemius and lumbar multifidus muscles at 30–250 Hz to assess the effects of the easily attenuated proprioceptors. The independent t-test showed a decline in proprioception in older adults. A χ² test was performed to determine proprioceptors that were susceptible to attenuation in older adults. [Results] The results revealed that many older adults had reduced muscle spindles (low and high frequencies) in their lower legs and trunk (low frequency). [Conclusion] Proprioceptive ability is lower in older adults than in younger individuals. Therefore, activation programs to treat the reduced intrinsic receptive responsiveness may be required for rehabilitation of older adults.

[Purpose] Abnormal anterior interval kinematics may be associated with knee pain and loss of knee motion. We investigated the anterior interval kinematics during passive knee extension in individuals with knee osteoarthritis (OA). [Participants and Methods] The anterior interval space was evaluated in 13 healthy knees (healthy group) and 11 knees with OA (knee OA group) at 30° and 15° knee flexion using ultrasonography. We measured the angle between the anterior tibia and patellar tendon, known as the patellar tendon–tibial angle (PTTA). [Results] The PTTA significantly increased as the angle of knee flexion decreased in the healthy group. In the knee OA group, the PTTA did not change significantly at 30° and 15° knee flexion. The knee OA group had a considerably higher PTTA at 30° knee flexion and a smaller amount of change in PTTA during knee angle changes than the healthy group. However, after adjusting for age and body mass index (BMI), no significant differences were observed between groups. [Conclusions] Differences in the anterior interval kinematics during knee motion between groups may be due to aging and high BMI. Further research is required to address most of the factors influencing these abnormalities.

[Purpose] To determine how different head-neck positions (HNPs) influence the hand grip strength (HGS) of medical personnel with non-pathological neck pain (NPNP). [Participants and Methods] A cross-sectional study recruited 46 healthcare professionals: 21 (45.7%) with NPNP and 25 (54.3%) without. A dynamometer, cervical range of motion, and visual analogue scale measured HGS, HNPs, and NPNPs. Participants were instructed to squeeze the handgrip dynamometer handle in 90-degree elbow flexion as much as possible from a seated position to measure HGS from the neutral head position (NHP), 40° head neck flexion (HFP40°), and 30° head neck extension (HEP30°). [Results] The mean HGS for the dominant hand in NHP, HFP40°, and HEP30° was 29.27 kg (± 9.03), 27.24 kg (± 9.08), and 26.37 kg (± 9.32), while for the non-dominant hand it was 27.45 kg (± 9.62), 25.23 kg (± 9.36), and 24.61 kg (± 10.17). There was no significant correlation between HNPs and HGS. However, the only significant difference was between dominant HGS in the NHP and non-dominant HGS in the HEP30°. [Conclusion] NPNP had no significant influence on HGS in any of the three HNPs for either hand. Future studies should include other HNPs and other potential variables such as age, gender, weight, and pain intensity.

[Purpose] Shoulder subluxation is a common complication of acute stroke that affects clinical rehabilitation training and hinders the recovery of upper limb motor function. This study explored the short-term interventional effects of neuromuscular joint facilitation in patients who experienced stroke with shoulder subluxation. [Participants and Methods] We recruited 36 patients who experienced stroke with shoulder subluxation. All patients were randomly divided into two groups: the neuromuscular joint facilitation group (n=18) and the control group (n=18). The control group underwent routine rehabilitation treatment. The intervention in the neuromuscular joint facilitation group involved neuromuscular joint facilitation of the shoulder joint in four modes based on conventional rehabilitation treatment. Four different interventions were administered. The thickness of the supraspinatus muscle and the acromion-greater tuberosity distance were measured using ultrasound to observe the curative effect. [Results] In neuromuscular joint facilitation group, the thickness of supraspinatus muscle, acromion-greater tuberosity distance and acromion-greater tuberosity distance difference were significantly different before and after intervention. In the control group, there were no significant difference before and after intervention. [Conclusion] Neuromuscular joint facilitation intervention improved the thickness of the supraspinatus muscle, shortened the distance between the acromion and the greater tubercle, and improved shoulder subluxation in patients who experienced stroke.

[Purpose] Compare four quick (approximately 60 s), reliable methods of assessing %body-fat (%BF) among young (Y, 18–34 years), middle-age (M, 35–59 years), and older (O, 60–88 years) healthy-adults. [Participants and Methods] One-hundred-eighty healthy males-and-females were equally (n=30) divided into Y, M, and O age groups to assess %BF. The %BF methods were: 1) Bioelectrical-impedance-Inbody770 (IB)–criterion reference; 2) Body-mass-index (BMI); 3) Abdominal-and-hip circumferences (CIR); and 4) Skinfold (SF). [Results] %BF were significantly different among the four body-fat methods and among the three age-groups for both males-and-females. %BF among IB,BMI,CIR, and SF were, respectively, 15.7 ± 4.7%, 19.6 ± 3.2%, 17.3 ± 3.5%, and 12.1 ± 4.1% for Y-males; 18.3 ± 5.7%, 22.8 ± 3.6%, 19.6 ± 3.6%, and 15.6 ± 4.5% for M-males; 24.4 ± 6.5%, 25.8 ± 3.3%, 24.0 ± 4.5%, and 20.0 ± 4.1% for O-males; 24.9 ± 6.9%, 28.9 ± 4.1%, 29.4 ± 4.6%, and 22.4 ± 6.3% for Y-females; 25.1 ± 7.0%, 31.4 ± 4.7%, 33.0 ± 4.5%, and 25.0 ± 4.5% for M-females; 35.1 ± 6.3%, 35.5 ± 4.3%, 38.4 ± 4.8%, and 26.4 ± 3.7% for O-females. [Conclusion]The most accurate %BF-methods to use in clinical settings are CIR for Y-and-M-males, CIR and BMI for O-males, SF for Y-and M-females, and BMI for O-females. The least accurate %BF methods are BMI and SF for Y-males, BMI for M-males, SF for O-males, BMI and CIR for Y-and M-females, and SF for O-females. While all 4-methods of assessing %BF can easily and quickly be employed in clinical settings, some methods significantly underestimate or overestimate %BF and yield different results among varying age groups and sex. These findings help identify people at early health risk of cardiometabolic disease, with O-males and O-females at higher risk.

[Purpose] This study aimed to clarify the association between phase angle (PhA) and the level of independence in daily living among institutionalized super older females requiring nursing care. [Participants and Methods] This three-facility cross-sectional study enrolled 173 nursing home residents (mean age 91.0 years, standard deviation 4.9 years) divided into five groups, from 80+ to 100+ years of age, in 5-year increments. PhA, skeletal muscle mass index, body fat percentage, body mass index, and Barthel Index were measured in the five groups. We measured the relationship between age and PhA and analyzed partial correlation coefficients using these items. The adjusted variables differed significantly among the five groups. [Results] The overall PhA was 2.91 degrees, with a 2.36-degree PhA in patients aged >100 years. Age differences were found between the PhA and the Barthel Index. A significant correlation (0.66) was identified between the PhA and the Barthel Index. The age-adjusted partial correlation coefficient between the PhA and the Barthel Index was 0.56, indicating a moderately significant positive correlation. [Conclusion] This study identified an association between PhA and independence in daily living among female nursing home residents aged 80–107 years, indicating that the PhA is an excellent indicator of physical condition.

[Purpose] This study aimed to test whether a combination of specific postures and movements can increase trunk muscle activity in older adults. [Participants and Methods] Forty-six community-dwelling older adults (mean age: 83.9 ± 4.5 years) were living independently without the need for nursing care. The thicknesses of the external oblique, internal oblique, and transversus abdominis muscles were measured during the following three tasks: task I, natural sitting posture; task II, specific sitting posture to promote activity of the deep trunk muscles; and task III, task II plus a pushing down motion using both upper limbs. During each task, an ultrasound imaging device was used to measure the thicknesses of the external oblique, internal oblique, and transversus abdominis muscles on both the left and right sides according to the time required for expiration. [Results] Significant differences were found in the thicknesses of the internal oblique and transversus abdominis muscles between tasks II and III. Among the three muscles, the transversus abdominis showed the highest increase in thickness. [Conclusion] High activity of the trunk muscles, especially the transverse abdominis, can be achieved via specific sitting positions/tasks and further manipulations to increase the intra-abdominal pressure in both upper limbs.

[Purpose] This study aimed to measure the analgesic effects and efficacy of radial extracorporeal shock wave therapy, for which no consensus has been reached regarding optimal treatment parameters. [Participants and Methods] The study included 40 feet of 40 patients with plantar fasciitis. The visual analogue scale was used to determine the immediate and cumulative effects of radial extracorporeal shock wave therapy as well as the efficacy rate. Efficacy was calculated as a percentage visual analogue scale change of ≥20 mm and visual analogue scale improvement of ≥60%. [Results] Immediate and continued efficacy of radial extracorporeal shock wave therapy was observed and recorded. Efficacy rates based on a percentage visual analogue scale change of ≥20 mm and visual analogue scale improvement of ≥60% were both 57.5%. [Conclusion] Radial extracorporeal shock wave therapy has immediate and cumulative analgesic effects on plantar fasciitis. However, cumulative results of interventions with various treatment parameters are required to determine the optimal treatment parameter settings for diffuse pressure wave therapy for plantar fasciitis.

[Purpose] This study aimed to investigate the association between whole-body reaction time and maximum jump height as elements of agility performance requiring maximum jumping when measured separately as closed-skill sports or as a complex of open-skill sports and their association with skeletal muscle mass. [Participants and Methods] This study included 54 healthy adult volunteers. Reaction time and jump height in response to a light stimulus were measured separately (the “simple condition”) and simultaneously (the “complex condition”), and the associations between the values under these two conditions were investigated. The associations between the skeletal muscle mass and the two elements under both conditions were also investigated. [Results] No correlation was found between the reaction times measured under the simple and complex conditions; however, a significant correlation was evident for the jump height. Skeletal muscle mass correlated significantly with jump height but not with reaction time. [Conclusion] The study results suggest that the relationship between open- and closed-skill sports differs between reaction time and jump height. Therefore, closed-skill sports training may be insufficient for improving open-skill sports and cognitive function and may affect decision-making strategies.

[Purpose] This study aimed to examine falls among older adults in Japanese households and determine the risk associated with each fall location. [Participants and Methods] This study included 99 participants (249 fall events) who received daycare rehabilitation at a nursing care facility. Data on fall circumstances were collected from the medical records and accident reports. The analyzed variables included age, medical status, level of care required, fall history, location, and mode of transportation during the falls. [Results] Falls occurred most commonly in bedrooms. Falls at an entrance were associated with no assistive device (OR: 1.76, 95% CI: 1.06–1.80) and 1 history of falls (OR: 1.22, 95% CI: 1.03–3.10). Risk factors for falls in bedrooms included Parkinson’s disease (OR: 1.83, 95% CI: 1.11–1.87), orthopedic disease (OR: 1.11, 95% CI: 1.15–3.43), and cane walking (OR: 1.08, 95% CI: 1.33–4.13). Falls in a hallway were associated with no assistive device (OR: 1.75, 95% CI: 1.15–1.91). [Conclusion] Bedrooms and hallways in Japanese households were identified as locations with a high risk of falls. The unique architectural and cultural features of Japanese homes may contribute to this risk. Rehabilitation programs should consider individual fall histories, medical conditions, and differences in mobility.

[Purpose] When using chopsticks with a standard grip, the lower chopstick is held firmly; the upper chopstick dominates the motion between open and closed postures. This study’s primary aim was to evaluate the stability of the lower chopstick when maneuvering with the dominant hand. The secondary goal was to test whether using chopsticks with the non-dominant hand improves the stability of the lower chopstick. [Participants and Methods] The study included 34 healthy adults as participants. Motion capture was used to assess the stability of a lower chopstick held with the dominant hand and explore the effect of training on lower chopstick stability with the non-dominant hand. [Results] Prior to non-dominant hand chopstick training, the stability of the lower chopstick was significantly greater when held with the dominant hand than when held with the non-dominant hand. However, after 10 days of non-dominant hand chopstick training, the stability of the lower chopstick held with the non-dominant hand improved significantly. [Conclusion] This study’s findings provide important insights into the effectiveness of non-dominant hand training in patients who need to use their non-dominant hands.

[Purpose] This study aimed to examine the characteristics of preoperative physical activity and its impact on the postoperative period in patients who underwent surgery for esophageal cancer. [Participants and Methods] The participants were 30 patients who were diagnosed with esophageal cancer, underwent surgery, and fulfilled their conditions. Preoperative physical activity was measured using the step count, and metabolic equivalents as the amount of physical activity. We examined the relationships between preoperative step count and METs, patient demographics, treatment-related factors, preoperative physical function, and activities of daily living. Moreover, we examined the relationships of preoperative step count and METs with postoperative mobilization, physical activity, physical function, and activities of daily living. [Results] Preoperative step count was related to age, Glasgow prognostic score, and preoperative functional independence and associated with step count on postoperative days 7–13, METs on postoperative days 7–9, 6-min walking distance, and functional independence measures at discharge. [Conclusion] Improving the nutritional status and increasing preoperative physical activity by walking for esophageal cancer may help improve physical activity after postoperative day 7, exercise tolerance, and activities of daily after discharge.

[Purpose] This study aimed to clarify the changes in the scapulothoracic joint and upper trunk angles and postural control during right–left hand-behind-back (HBB) movement. [Participants and Methods] The participants were 20 healthy right-handed men. We measured the HBB movement while standing using a three-dimensional motion capture system. Changes in the internal rotation angle of the scapulothoracic joint, upper trunk rotation angle, and center of pressure (COP) were examined to assess potential right–left differences between the analyzed positions. [Results] As the thumb touched the buttocks, upper trunk contralateral and scapulothoracic joint internal rotations were observed and the COP on the non-HBB side was significantly displaced laterally. There were no right–left differences in the changes between the analyzed positions for all measures. [Conclusion] Upper trunk contralateral rotation and postural control were conducted without right–left differences during HBB movement. These results suggest that upper trunk movement and standing postural control are involved in HBB movement. Therefore, it is useful to focus on the scapulothoracic joint angle, upper trunk rotation angle, and standing postural control during physical therapy evaluation and treatment with HBB movement.

[Purpose] Although prone positioning is used to increase oxygenation in various respiratory conditions, this positioning can lead to facial and limb pressure ulcers. The aim in this study was to investigate body pressure variations in the prone position for different facial orientations and upper extremity positions. [Participants and Methods] Nineteen healthy young women participated in this study. Body pressure (maximum body pressure on the face, chest, elbows, and knees) was measured in six different prone positions with different face orientations and upper extremity positions, and the median value of each body pressure measurement was compared among postures. [Results] Face pressure tended to decrease when face orientation coincided with the raised side of the upper limb. In contrast, elbow pressure tended to be lower when the orientation of the face did not coincide with that of the raised side of the upper limb. [Conclusion] Pressure on the face and elbows can be reduced by placing the upper limbs in the prone position. This suggests that targeted and specific positioning may be useful for limiting the incidence and severity of pressure ulcers in these areas.

[Purpose] The aim in this study was to evaluate the impact of caregiver understanding of their ability to perform activities of daily living (ADLs), movement abilities, diseases, and attitudes on the prevalence of occupational low back pain. [Participants and Methods] A cross-sectional survey was conducted of caregivers of older adults living in residential care facilities. Of the 150 questionnaires distributed, 71 were valid. The survey collected data on demographics, low back pain status using a numerical rating scale, and familiarity with ten ADLs and five diseases (stroke, rheumatoid arthritis, fractures, Parkinson’s disease, and dementia). [Results] In this study, 52% of the participants reported lower back pain. Significant factors included an understanding of repositioning in ADLs, familiarity with stroke and rheumatoid arthritis, and attitudes toward using patients’ residual functions. Participants with limited knowledge of repositioning and stroke, a better understanding of rheumatoid arthritis, and those who did not consider residual function were more prone to lower back pain. [Conclusion] Our findings highlight the importance of enhancing caregiver education on ADL movements and disease specifics, particularly stroke and rheumatoid arthritis, and promoting the use of patients’ residual capabilities. Improved training and information sharing among caregivers may reduce the risk of occupational low back pain.

[Purpose] This study aims to investigate the effects of robotic exoskeleton-assisted gait training on a pediatric patient with peripheral polyneuropathy. [Participant and Methods] A 10-year-old boy with lower extremity weakness attributed to peripheral polyneuropathy underwent a two-week program comprising 10 rehabilitation sessions of powered robotic exoskeleton-assisted gait training (REGT). He was evaluated before and after treatment using the 10-meter walk test, 6-minute walk test, Berg Balance Scale, the Timed Up and Go Test, the Functional Reach Test, the Modified Functional Reach Test, hip and knee flexion/extension angles, and cardiopulmonary exercise testing. [Results] The patient demonstrated improved gait speed, balance, joint mobility, cadence, the maximum oxygen consumption and metabolic equivalents after the REGT. [Conclusion] Robotic exoskeleton devices could provide additional benefits to pediatric patients with peripheral polyneuropathy, pending larger studies to confirm the significance of treatment.

[Purpose] No established method for appropriately developing clinical thinking in physical therapy currently exists. This study examined whether clinical thinking can be appropriately developed using a problem-solving model. [Participants and Methods] Physical therapy students were asked to develop clinical thinking in the same two cases: one class using the problem-solving model and the other class using International Classification of Functioning, Disability and Health concepts. Each clinical thought was scored and compared based on consistency. [Results] In both cases, students who used the problem-solving model scored higher. [Conclusion] The hierarchical structure of the problem-solving model clarified the relationship between each element and this was easy to maintain, suggesting that it facilitated appropriate clinical thinking.