[Purpose] To provide practical suggestions for the clinical application of robotic exoskeletal orthoses, we conducted a retrospective survey of patients with spinal cord lesions. [Participants and Methods] We studied the records of patients with spinal cord lesions who were trained using the ReWalk system (ReWalk Robotics). These records included the neurological level of injury, American Spinal Injury Association Impairment Scale, time since injury, total training time, adverse events, level of assistance required, dropouts, and reasons for dropout. [Results] Twenty-eight patients were trained with the ReWalk system at least once. Three of them underwent a modified training program owing to their severe paralysis. Eight patients dropped out from the regular training program or required a moderate or greater level of assistance. Twelve patients regained ambulation with the ReWalk system in indoor environments on a flat surface. The remaining five achieved ambulation with the ReWalk system in outdoor environments, including on slopes. Thirty-four adverse events were recorded. These events resolved within a few days with rest, adhesive dressing bandages, or other means. [Conclusion] The feasibility and safety of the training program and the outcomes achieved were comparable to those in previous studies. The device fit may need more careful attention.

[Purpose] To investigate the relationship between thoracic asymmetry in the seated position, sagittal head position, and trunk movement patterns during the sit-to-stand motion. [Participants and Methods] Twenty-three healthy adults participated. Using a three-dimensional motion analysis system, we calculated the anteroposterior diameter ratios (right/left) of the upper and lower thorax at rest and measured the sagittal displacement of the head relative to the thorax. During the sit-to-stand task, we analyzed trunk movement relative to the pelvis and hip joint flexion-extension angles. [Results] Of the 23 participants, 20 exhibited leftward thoracic deviation relative to the pelvis. In these cases, trunk flexion preceded hip flexion, reaching maximum flexion before the hip joint. Significant leftward trunk rotation also occurred during the transition from flexion to extension, compared with that in the initial position. A correlation was observed between upper thoracic asymmetry and trunk flexion and between forward head displacement and trunk flexion. [Conclusion] Thoracic asymmetry and sagittal head position were associated with trunk movement patterns during sit-to-stand. These factors may be important considerations for physical therapy interventions aimed at improving sit-to-stand performance.

[Purpose] Quantitative assessment of reactive balance often requires large, costly equipment, limiting its use in clinical practice. This study investigated the inter-rater reliability of the instrumented lean-and-release (iLEAN) test, a manual reactive balance assessment designed to provide a practical alternative for physiotherapists. [Participants and Methods] Sixteen healthy young women completed the iLEAN test in standing, where reactive balance control was assessed in forward, left, right, and backward directions. During tests, an assessor applied the iLEAN device against the shoulder and released support once the participant reached a target lean load, which was progressively increased until balance could not be regained with a single step. Inter-rater reliability was analyzed using intraclass correlation coefficients (ICC, model 2,1) and Bland–Altman plots. [Results] The ICCs (95% confidence intervals) for the iLEAN scores were 0.60 (0.17–0.84) for forward, 0.75 (0.34–0.92) for left, 0.80 (0.45–0.94) for right, and 0.83 (0.58–0.94) for backward. Bland–Altman analysis revealed no systematic bias between raters across all directions. [Conclusion] This study provides preliminary evidence that the iLEAN test has acceptable inter-rater reliability for assessing reactive balance, with the backward condition demonstrating the highest reliability and sensitivity to change.

[Purpose] We examined the inter-rater reliability of the affected-side weight-bearing ratio in patients who have undergone proximal femoral fracture surgery. [Participants and Methods] Ten patients with hip fractures were included in this study. Weight-bearing ratios were measured five times daily on postoperative days 3, 5, and 7. Three physical therapists independently assessed the patients. [Results] High intra-class correlation coefficients were observed across all days and measurement trials. The coefficient of variation (CV) showed no significant difference between days. CV was negatively associated with weight-bearing ratio but was not influenced by pain, body-mass index, age, sex, or surgical procedure. [Conclusion] In patients with proximal femoral hip fractures, weight-bearing ratio measurements on the affected side demonstrated high inter-rater reliability, even in a single trial from postoperative day 3. Pain during weight-bearing may contribute to variability in measurements, particularly in patients with low weight-bearing ratios. This method is feasible, minimally burdensome, and can be implemented in various rehabilitation environments without the need for specialized equipment. Future studies should examine its generalizability across multiple facilities and assess its reliability in patients with cognitive impairment.

[Purpose] Self-perceived voice disorders (VD) and hearing loss (HL) are common communication barriers in older adults, yet their combined impact on social participation remains underexplored. This study examined the additive effects of self-perceived VD and HL on frequency of going out (FGO) and social interactions in community-dwelling older Japanese adults. [Participants and Methods] In this longitudinal study, 134 adults aged ≥65 years were surveyed at baseline and one year later. Self-perceived VD and HL were assessed using Voice Handicap Index-10 (cutoff ≥5) and Hearing Handicap Inventory for the Elderly-Screening Version (cutoff ≥8). FGO was measured as days per week participants went outside, and social interaction was assessed using the Lubben Social Network Scale-6. [Results] Repeated-measures analyses showed that self-perceived VD was associated with decreased FGO. Participants with both self-perceived VD and HL showed an additional decrease of about 1 day per week after one year. Participants with either impairment alone or with neither showed no significant change. No significant associations were observed between VD or HL and LSNS-6 family or friend subscale scores. [Conclusion] Co-occurring self-perceived VD and HL may exacerbate social isolation by limiting expressive and receptive communication. Addressing even one of these conditions could help maintain mobility and social interaction.

[Purpose] The relationship between corticospinal tract (CST) integrity and upper limb motor function after stroke is well studied, but its association with lower limb motor function remains unclear. In addition, the analysis by type of stroke are remains insufficient. This study examined the relationship between CST integrity, lower limb motor function, and walking ability in subacute stroke patients, considering type of stroke. [Participants and Methods] In this study, 27 patients with cerebral infarction and 13 patients with intracerebral hemorrhage were included. Diffusion tensor imaging (DTI) assessed CST integrity using the fractional anisotropy ratio (rFA) at the cerebral peduncle. Motor function was evaluated with the Fugl–Meyer Assessment of Lower Extremity (FMA-LE), the affected-side muscle strength with a handheld dynamometer, and walking ability with Functional Ambulation Categories (FAC). Group differences between types of stroke and correlations between rFA and motor function were analyzed. [Results] Patients with intracerebral hemorrhage had significantly lower rFA. rFA correlated with FMA-LE and lower limb muscle strength, except for hip extensors. Walking ability was also associated with rFA and FAC. [Conclusion] CST integrity as assessed by DTI was associated with motor function of the affected-side lower limb and walking ability in subacute stroke patients and warrant further study.

[Purpose] This study aimed to clarify the utility of Phase Angle by examining its relationship with muscle endurance and whole-body endurance in healthy young Japanese males. [Participants and Methods] This cross-sectional exploratory study included 24 healthy young male participants, aged 19.1 ± 0.3 years. Body composition by Bioelectrical impedance analysis, including whole body Phase Angle, was measured. To assess the muscle endurance of the quadriceps femoris and hamstrings, participants performed a test using an isokinetic dynamometer. The angular velocity was set at 180°/sec, a standard velocity used in endurance assessments. Oxygen uptake and heart rate were measured during a multistage continuous treadmill test, and maximum oxygen uptake was estimated by calculating a linear regression equation based on the relationship between heart rate and oxygen uptake. Pearson’s product-moment correlation analysis was performed to examine associations between Phase Angle, maximum oxygen uptake, and isokinetic measurement variables. [Results] Only Phase Angle showed significant correlations with extension 180°/sec maximum peak torque/body mass (%), muscle fatigue, and maximum oxygen uptake. [Conclusion] These results suggest that Phase Angle can be identified as a potential marker associated with muscle and whole-body endurance in young, healthy Japanese men. Phase Angle measurements may offer valuable insights for assessing physical condition in this population.

[Purpose] We aimed to investigate the relationship between thoracic alignment asymmetry and side-to-side differences in femoral head deviation. [Participants and Methods] Twenty-six healthy adults participated in this study. We used three-dimensional motion analysis and ultrasonography to measure changes in femoral head deviation during isometric hip rotation and examine the relationship between thoracic alignment asymmetry and side-to-side differences. [Results] We observed that the femoral head deviated anteriorly during external rotation and posteriorly during internal rotation. At rest, the femoral head showed greater anterior deviation on the left side compared to the right. Task-induced femoral head deviation changes were greater on the right during external rotation and greater on the left during internal rotation. Moreover, we observed a positive correlation between the lower thoracic shape asymmetry and resting femoral head deviation. [Conclusion] Our findings suggest that lower thoracic asymmetry is associated with side-to-side differences in resting femoral head deviation and is potentially mediated through kinematic chain interactions.

[Purpose] This study aimed to clarify third-year students’ awareness of end-of-life care, using questionnaire items. [Participants and Methods] The participants were 81 third-year students enrolled in 2024 (post-clinical training group; post-G), and 84 third-year students enrolled in 2025 (pre-clinical training group; pre-G). This study was a cross-sectional observational study using questionnaire surveys for end-of-life care throughout the 2025 first (pre-G) and 2024 second (post-G) semesters. To examine whether completion of the 4-week clinical training was associated with awareness of end-of-life care, analyses were performed between two groups using the chi-square test. [Results] Regarding preferred place to spend final days, 79% selected home. In the final 3 months of life, 85% of students preferred to be allowed to die naturally to some extent, whereas 9% favored life-prolonging treatment only. A significant difference was found between pre-G and post-G in this item. [Conclusion] Commonly expressed wishes were for a natural death, dying at home, and being told of the status of their illness. It was suggested that, through clinical training, students may be able to develop perspectives more attuned to the experiences of patients and families.

[Purpose] To evaluate plantar fascia thickness during static standing and calf raise positions using ultrasound imaging and to examine its relationship with medial longitudinal arch height ratio and physical factors. [Participants and Methods] We measured plantar fascia thickness in 30 healthy adults (18 males, 12 females) using ultrasound at a site 1.5 cm distal to the calcaneal origin in static standing and calf raise positions. Additionally, we assessed their medial longitudinal arch height ratio (arch height using navicular height divided by foot length) and other physical characteristics to examine possible correlations. [Results] Ultrasound measurements of plantar fascia thickness showed high reliability in both static standing and calf raise positions, with thickness reduced significantly from standing to the calf raise position. In the overall analysis, plantar fascia thickness was positively correlated with body weight in both positions, and a positive correlation between plantar fascia thickness and height was observed in the standing position. In contrast, no significant correlations were found between plantar fascia thickness and the medial longitudinal arch height ratio or body mass index in the overall analysis, nor between plantar fascia thickness and physical parameters in sex-specific analyses. In males, the change in plantar fascia thickness between positions was negatively correlated with age; however, no significant correlations were observed in the overall sample or in females. [Conclusion] Plantar fascia thickness decreases during calf raises compared with standing and is influenced by body weight, supporting that the calf raise position places stretching stress on the plantar fascia and may be used for evaluating load response and physical function.

[Purpose] While forced exhalation with balloon-blowing has been reported to facilitate abdominal muscle activity, few studies have examined its effects using imaging. We aimed to compare abdominal muscle morphology across three conditions, end-inspiration, end-forced expiration, and end-forced expiration with balloon-blowing, between a balloon-blowing exercise expert and a novice with chronic low back pain, assessed using ultrasound imaging. [Participants and Methods] A 61-year-old male expert and a 51-year-old male novice participated. The thicknesses of the transversus abdominis, internal oblique, and external oblique were measured using ultrasound imaging during end-inspiration, end-forced expiration, and end-forced expiration with balloon-blowing. The thickness and contraction ratios, calculated by dividing the thickness at end-forced expiration by that at end-inspiration, were compared within and between participants. [Results] The expert demonstrated a 1.33 mm thicker transversus abdominis and a 4.95 mm thicker internal oblique than those of the novice at end-inspiration. Balloon-blowing increased all muscle thicknesses in both participants compared with end-inspiration. The contraction ratios of the muscles during forced expiration with balloon blowing were 1.14- to 1.80-fold higher than the ratios at end-forced expiration in both participants. [Conclusion] These findings suggest the potential usefulness of balloon-blowing for activating abdominal muscles, especially in individuals with chronic low back pain.