Asymmetry, including scoliosis compensatory to leg length difference, is commonly thought to degrade one’s performance and to predispose one to injury. We examined differences between persons with and without leg length discrepancy in ability to control motion during fatiguing trunk flexions and extensions. Loss of control was measured by the amount of unintended rotation and lateral flexion during the flexions and extensions. Fifteen subjects with leg length discrepancy and fifteen without flexed and extended their trunks with maximum effort and speed for as long as possible against resistance equal to 70 per cent of maximum isometric flexion. The excursion of flexion and extension did not include the last 15 degrees of the fully available range of motion in either direction. The two groups did not differ in variance of excursion into rotation and lateral flexion or in the number of repetitions completed to fatigue. We interpret this to mean that no difference was detected between subjects with and without leg length discrepancy in degree of neuromuscular control of the trunk during this particular testing procedure.
The number of physical therapists treating preterm infants in NICUs is increasing. Preterm infants are by definition still essentially in the intrauterine stage. Accordingly, there are as yet few guidelines concerning physical therapy for preterm infants. In this study, the development of fetus behavior was monitored by real-time ultrasonography. A total of 50 fetuses between 8 and 18 weeks of gestation were observed in terms of the development of general movements, movements of the upper extremities, and movements of the lower extremities. Movements of the neck were subsequently analyzed in detail. Fetal movement began with quick lateral bending of the neck and trunk, and the volume and quality of movements changed considerably during the period of observation. This change is due to the progress of the central nervous system. It is commonly thought that the progress of central nervous system is completely dependent on genetic inheritance. However, this study suggests the possibility that such progress is at least partially induced by afferent impulses from the periphery. Now that physical therapy is often recommended for immature infants, the developmental process of fetus behavior needs to be more fully examined.
The purpose of this study was to investigate the relationship among coxalgia, gait pattern, activities of daily living (ADL)-functions and range of motion (ROM) of the hip joint in clients who had undergone Chiari pelvic osteotomy for osteoarthritis of the hip accompanied with acetabular displagia. Out of 56 clients who received mailed questionnaires 36 (33 females and 3 males) with a mean age of 40.1 years responded. Score measures established by the Japanese Orthopeadeic Association (JOA) were used to compare the above factors pre- and postoperatively. In addition, Spearman’s rank correlation was used for analysis of coxalgia and the clients’age for the postoperative phase. The mean total JOA score for the postoperative period was significantly higher than that for the preoperative phase. The mean total score for coxalgia and gait pattern for the postoperative phase was significantly higher than that for the preoperative phase. However, the mean total JOA score ROM of the hip in the postoperative phase was significantly lower than that for the preoperative phase. The mean total JOA score pre- and postoperative ADL-functions showed no significant difference. Although a correlation was present between coxalgia and the clients’age scores, there was no correlation between coxalgia and postoperative phase scores. These findings indicate that coxalgia increases with client’ advancing age. Therefore, such clients should be advised to reduce their ADL-functions and a home exercise program should be implemented.
This study investigated minimal muscle strength on knee extension as well as muscle endurance required for independent walking. Seventy-seven elderly (29 males and 48 females, mean age: 81.3 years) participated in this study. Subjects were divided into two groups (the independent group and the dependent group) based on the Barthel index score. We measured muscle strength and muscle endurance on knee extension. Muscle endurance was evaluated using the‘sit-to-stand’test which measured the number of times the subject could rise from a chair within 30 sec. Muscle strength on knee extension was evaluated as a percentage of body weight, calculated from the maximal isometric strength of the knee extensors. The results showed a significant difference in muscle strength on knee extension and the number of repetitions on the ‘sit-to-stand’test (p<.0l) between the independent group and the dependent group. The discriminating criterion for muscle strength on knee extension between the two groups was 45.5%, while the number of repetitions on the ‘sit-to-stand’test was 5.6 times. This study suggested that the elderly may need to maintain their muscle strength on knee extension at 45.5% of their body weight and 'sit-to-stand’ ability at 5.6 times/30 sec to retain their ability to walk independently.
For the dinical application of the Sensory Organization Test (SOT) in the Equi test system devised by L.M. Nashner, for the purpose of evaluating equilibrium function in the standing posture, we have conducted a basic analysis on SOT and prepared SOT databases. The subjects in this study were 19 healthy males and 26 healthy females between 20 to 85 years of age (average age: 46). We studied the characteristics of the sensory organization function of integrating vestibular sense information and inaccurate postural information in healthy persons by changing the sway gain of postural information input from bodily sense and visual sense, and by monitoring changes in equilibrium function due to aging. The results of this study, show that for elderly persons and patients with equilibrium function disorder, the condition of 1.0 sway gain (disturbance intensity), results in heavy psychological and physiological burdens and a danger of falling. Therefore we considered the optimum amount of disturbance stimulation to be 0.75 sway gain in all age groups. SOT using external disturbance stimulation caused by postural deviation reflected the aging alteration of equilibrium function, and it is a useful examination method for evaluating equilibrium disorder and the clinical conditions of elderly persons.
The relationship between aging and grip and key pinch strength has been investigated. However, there have been few comparative studies focusing upon the strength of aged community dwellers and institutional residents. The purpose of this study was to compare these strength of the right dominant hand between community dwellers and institutional residents using a hand dynamometer and a pinch gauge. Two hundred and five subjects, 54 male and 38 female community dwellers (CD group), and 23 male and 90 female institutional residents (IR group), participated in this study. Their mean age was 79.5 years (range=70-89). For each grip and key pinch strength test, the standardized position recommended by the American Society of Hand Therapists and Mathiowetz et al. was used. The male grip strength decreased with aging at a declining rate with significance (r=0.43 and p<0.0015 in CD group, and r=0.44 and p<0.0349 in IR group). The male key pinch strength apparently decreased with increasing age (r=0.35 and p<0.0113) in CD group, while no siginificance was found (p<0.1034) with a declining rate (r=0.35) in IR group. The female grip strength showed decreasing linear regression with aging (r=0.45 and p<0.0054) in CD group, but a less moderate one (r=0.29 and p<0.0062 in IR group). The female key pinch strength was observed with significant difference (r=0.37 and p<0.0252) in CD group and a more apparently mild one in IR group (r=0.22 and p<0.0446). It is characteristic that the regression lines of the two groups in the females were closer than those in the males. It may be understood that the amount of females’daily hand activities such as handling items in the kitchen and washing might be differentiated in the living places to a lesser extent from the males’. The females in both groups may be expected to retain a greater percentage of manual activity in their daily life than the males. The correlation between aging and muscle strength clearly reflected the characteristics of the grip and key pinch strength of the aged in different environmental status. The present study provides therapists with valuable information about the treatment in clinical setting when making a program which involves grip and pinch activities for the aged.
Since plyometric exercise typically involves an unknown force, safety considerations prompt a kinetic analysis prior to utilizing the exercise for patients. A recently developed device, the Impulse machine, provides a means of plyometric exercise with fine adjustment of the force. The force applied to the subject during the Impulse exercise, however, partly depends on the subject’s effort, so kinetic and kinematic characteristics of the exercise need to be examined. Twelve college-aged women performed elbow flexion for the experiment. The participants performed two types of exercise, tonic and phasic, at five randomly assigned inertial loads (1.47, 3.74, 6.01, 8.28, and 10.55 kg). Tonic exercise involves continuous contraction of the elbow flexors, albeit with variation in intensity and type of contraction during the exercise, whereas phasic exercise consists of alternate contraction and relaxation of the elbow flexors. A WATSMART three-dimensional motion analysis system was used to determine kinetic and kinematic characteristics of the exercise. Differences in force, angular velocity, and power between tonic and phasic exercise, and among five loads, were tested using a two-way analysis of variance. For angular velocity and power, concentric and eccentric activities were analyzed separately. With the inertial load at 10.55 kg, the mean (± standard deviation) maximal tension on the Impulse machine was 145 (± 34.3) N for tonic exercise and 177 (± 34.0) N for phasic exercise. Maximal angular velocity was 383 (± 116.7) deg/sec for eccentric activity and 349 (± 92.9) deg/sec for concentric activity during tonic exercise, and 493 (± 172.8) deg/sec for eccentric activity and 414 (± 126.1) deg/sec for concentric activity during phasic exercise. As the load was raised, maximal force significantly increased (p<.05) while maximal angular velocity significantly decreased (p<.05).
The purpose of this study was to identify the key muscles used for wheelchair driving in quadriplegics. Fifteen subjects with complete quadriplegia for at least 2.5 years after cervical spinal cord injury who were routinely using a wheelchair were divided into Group C6 and Group C7/8 according to the level of motor impairment, and were examined to establish the relationship between their remaining muscle strength and their ability at driving wheelchairs. The isometric maximal strengths of the shoulder horizontal adductors, shoulder extensors, shoulder flexsors, and elbow flexors were measured with a hand-held dynamometer, and expressed as the percentage of their weight. The ability to drive a wheelchair was evaluated with regard to the following three points. 1) Wheelchair velocity (m/s). 2) 3-min run distance (m). 3) Turning (times). Significant correlations were observed between the shoulder horizontal adductor strength and the value of each parameter of wheelchair driving ability, the shoulder flexor strength and each ability of wheelchair driving, the elbow flexor strength and the 3-min run distance in group C6. But no significant correlation was observed between the muscle strength and the values of parameters of wheelchair driving ability in Group C7/8. The shoulder horizontal adductors and shoulder flexors are considered to be key muscles in wheelchair driving in Group C6, in Group C7/8, besides these muscles, driving ability is considered to be dependent on the strength of the triceps brachii and driving pitch.
This experiment, conducted with the cooperation of 30 healthy university students, was a comparative study of how dynamic balance is affected by various types of footwear on an immobilized foot-ankle joint. Results indicated an increase of muscular exertion related to control of posture when the foot-ankle joint was immobilized. When various shock absorption materials were used, extended latency was evident and when the bottom surface of the foot was stimulated, as by the protuberances of the “health-sandals” type of footwear, increased cerebrum skin perception was noted. In light of these indicators we had anticipated a faster reaction time, but in fact, delayed reaction time and reduced reaction strength were recognized in direct relation to height of heel and between various materials and types of footwear. The present experiments are indicative of the very close relation between afferent information from proprioceptors—in particular, the sole nerve endings and the muscle spindles in adjacent regions—and the nervous system nuclei which process it. In closing, we remark that these experiments serve to demonstrate that certain commonly worn footwear, such as slippers, are surprisingly hazardous insofar as they slow down reactions and their stimulation of the soles has adverse effects on posture reactions. Going barefoot would therefore appear the best, as indeed the most natural, way to maintain steady posture. Alternatively, use of footwear with thin soles that have only low absorption of dynamic shock may be advised.
The present study was an investigation of motives for entering physical therapy school in terms of understanding students’ awareness and attitude. Multiple regression analysis was performed on the resulting correlation coefficients between scores representing identity, moratorium, self-esteem, physical therapist image, and motives for entering school. Furthermore a path diagram was prepared centering on motives for entering school. We found that physical therapist image and moratorium were related to motives for entering school (R2=0.152, p<0.01). The data also suggested that moratorium is an important factor in relation to motives for entering school, while identity did not exhibit a significant correlation in contributing to such motivation. The factors that may be responsible for this result remain unexplained, and it is necessary to consider subscales for each category in order to allow more detailed analysis.