[Purpose] This study aimed to calculate the windlass mechanism in one walking cycle (WC) using the medial longitudinal arch (MLA) height and compare its mechanism with joint moments, angles, and center of gravity movement. [Participants and Methods] The study analyzed the gait of 20 healthy adults (14 males, six females) using a three-dimensional motion analyzer to calculate several parameters. [Results] In the terminal stance, the MLA height reached 20.6 ± 6.0 mm (minimum value) at 49% WC. Simultaneously, the ankle dorsiflexion angle, ankle internal plantarflexion moment, and forward shift of the center of gravity reached the maximum values. At 62% WC, the MLA height was 26.8 ± 4.8 mm and reached maximum during the stance phase, indicating a windlass mechanism. Additionally, the MLA height was 61.7 ± 22.7 mm at 69% WC, indicating an MLA spiking phenomenon. [Conclusion] The MLA height was lowest at 49% WC due to reverse windlass mechanism. Although the windlass mechanism was activated at 62% WC, it was functionally equivalent to the swing phase. Push-off was impossible during the swing phase. At 69% WC, the swing phase showed a second windlass mechanism.

[Purpose] The sense of vision is omitted in blind soccer, and sound source localization to grasp the position of the ball is extremely important. The purpose of this study was to clarify whether there is a difference in ability in sound source localization in its approaching condition between visually impaired and sighted people, using the source actually used in blind soccer ball competitions. [Participants and Methods] Eighteen participants were divided into two groups; 10 sighted people and eight visually impaired people. The participants were asked to press a switch when a rolling blind soccer ball was sensed in any one of the four directions. We recorded time error as the difference between the time when the ball passed the optical sensor set under the participant’s feet and when the participant pressed the switch. [Results] The time error in response increased with the ball speed in all cases; however, its dependence on the ball speed was significantly different between the two groups. [Conclusion] The visually impaired participants made less time errors in response to the localization of the ball than the sighted participants, even when the ball speed increased. The results indicate that visually impaired people have better sound source localization ability than sighted people do.

[Purpose] This study was aimed at evaluating the clinical indicators for predicting ambulation at 3 months after putaminal hemorrhage. [Participants and Methods] The participants were 84 inpatients with putaminal hemorrhage. The patients’ background characteristics and computed tomography findings at the time of the onset of putaminal hemorrhage were obtained from their medical records. Impaired consciousness, severity of hemiplegia, higher brain dysfunction, sensory impairment, activities of daily living, and ambulatory ability were evaluated. Logistic regression analysis was performed to identify factors associated with ambulation at 3 months, and receiver operating characteristic curve analysis was conducted to determine the predictive value of the identified factors and the optimal cut-off values. [Results] Ventricular rupture, severity of hemiplegia (determined using the 12-grade hemiplegia function test), and Functional Independence Measure cognitive score were found to be independent predictors of prognosis. Severity of hemiplegia was the strongest predictor of ambulation, with a sensitivity of 80.4% and specificity of 100% when the cut-off was set at grade 6 (the ability for coordinated movement of the extensor and flexor muscles of the hip joint). [Conclusion] The severity of hemiplegia, Functional Independence Measure cognitive score, and ventricular rupture were independently associated with ambulation in patients with putaminal hemorrhage. The ability of the hip joint movement is one of the most important factors in ambulation prognosis.

[Purpose] The incidence of floating toes in children is increasing. Although the anteroposterior center of pressure in children is present posteriorly, its relationship with the floating toe is unclear. This study aimed to clarify the relationship between the position of the anteroposterior center of pressure and the floating toe in an upright posture in children. [Participants and Methods] In this cross-sectional study, a Win-Pod (Medicapteurs) platform was used to measure the position of the anteroposterior center of pressure in 208 boys and 195 girls from Japanese elementary schools. Using images of the plantar footprint, floating toes were assessed and the floating toe score was calculated. [Results] The anteroposterior center of pressure position was situated 32.3 ± 8.2% from the heel. The floating toe score of all the participants was 3.5 ± 2.4, with a very high rate of 98%. The floating toe score had a significant, moderate correlation with age, height, weight, and the anteroposterior center-of-pressure position. Multivariate analysis revealed an association between the floating toe score and the anteroposterior center-of-pressure position, height, and weight. [Conclusion] There is significant relationship between the anteroposterior center-of-pressure position and the floating toe score in an upright posture in Japanese elementary school students.

[Purpose] This pilot study aims to investigate the effects of inhaling lychee-scented candles on stress and sleep quality among adults and the elderly. [Participants and Methods] Thirty participants were randomly assigned to either the control (n=15) or experimental (n=15) groups. The experimental group inhaled the scent from the lychee soy wax candle prior to going to bed for four weeks (20 minutes/session, three days/week). Perceived stress was assessed using the Suanprung Stress Test-20 (SPST-20), while sleep quality was assessed using the Thai-Pittsburgh Sleep Quality Index (Thai-PSQI). All outcomes were determined at the baseline two weeks to four weeks after scent inhalation. [Results] The results indicated significant differences in sleep quality between the two groups. The experimental group showed a statistically significant improvement in sleep quality compared to the control group. Although, there was no difference between groups, the experimental group presented significant decrease in stress as time passed whereas the opposite trend was seen for the control group. [Conclusion] This preliminary study suggests that the inhalation of lychee soy wax candles over a four-week period improved sleep quality in adults and the elderly but had no effect on reducing stress.

[Purpose] The aim of this study was to examine whether the forward tilt of the sacrum, which can be measured using an inclinometer, correlates with pelvic tilt and is therefore suitable for therapeutic use as part of a postural assessment for treatment planning or for preventive screening. [Participants and Methods] In 121 athletes (22 females, 99 males), we measured the forward tilt of the sacrum in habitual stance using a digital inclinometer attached to the skin at the level of the posterior superior spinae. At the same time, the forward tilt of the pelvis was determined using videography. For this purpose, we determined the angle between two marker spheres placed on the posterior and anterior superior spinae and the horizontal using sagittal posture photographs. [Results] Taking age as a control variable, we found a significant correlation of moderate strength between pelvic tilt and sacral tilt in men. In women, there was a significant correlation with a strong effect. [Conclusion] The measurement of sacral tilt using an inclinometer positioned on the skin between the posterior superior spinae correlates statistically significantly with pelvic tilt and is therefore suitable as an easy-to-use diagnostic tool for therapeutic use in treatment planning and evaluation.

[Purpose] This study aimed to investigate whether modification of vastus medialis activity can delay the varus thrust. [Participants and Methods] Ten participants (Kellgren–Laurence grades I: n=2, II: n=6, and III: n=2) diagnosed with knee osteoarthritis were enrolled. The intervention involved free walking on a 10-m walkway at any speed after donning a functional electrical stimulation set to contract the vastus medialis before heel contact. Using a Vicon Nexus ground reaction force meter and a wireless electromyograph DELSYS, varus thrust, maximal knee extension angle, maximal knee adduction moment, and vastus medialis onset time were assessed both before and after intervention. [Results] A significant difference in varus thrust was detected from before to after the intervention (2.7 ± 1.1° vs. 2.2 ± 1.3°). Both the vastus medialis activation time (−0.06 ± 0.09 vs. −0.21 ± 0.1) and the knee-joint extension angle (8.7 ± 5.1° vs. 5.5 ± 5.9°) decreased following intervention, whereas the knee adduction moment significantly increased (0.50 ± 0.20° vs 0.56 ± 0.18°). [Conclusion] Wearing the functional electrical stimulation set caused the vastus medialis to act earlier in response to heel strike, thereby improving the knee-joint extension angle and suppressing varus thrust.

[Purpose] Extant techniques for palpating nodules, a diagnostic criterion of myofascial trigger points, lack high reliability. Therefore, this study aimed to investigate the effects of training and practice using a novel muscle-nodule-palpation simulator. [Participants and Methods] Sixteen university students (age range: 19–22 years) were randomly assigned to the training (n=8) and control (n=8) groups and used the muscle-nodule-palpation simulator to determine the position and orientation of the muscle nodule embedded in the model. During the experiment, only the participants in the training group were allowed to practice nodule detection while viewing the model through its transparent material. Subsequently, both groups underwent a performance evaluation. [Results] The training group exhibited greater improvement in performance than the control group. The means and standard errors of the improvement in the proportion of successful localization of the muscle nodule were 0.14 ± 0.06 for the control group and 0.42 ± 0.09 for the training group. [Conclusion] Training using the muscle-nodule-palpation simulator improved palpation technique for nodule localization.

[Purpose] A new wireless laser Doppler blood flowmeter has facilitated easier, more stable measurement of skin perfusion during exercise. However, earlobe blood flow during the cardiopulmonary exercise test remains unascertained. This study aimed to clarify the characteristics of earlobe blood flow during incremental exercise load in healthy individuals. [Participants and Methods] Among 25 healthy males (age 23.6 ± 2.5 years), cycle ergometer-based symptom-limited cardiopulmonary exercise test, after 4 minutes of rest, was conducted with a 4-minute 20W warm-up and a continuous 2W-increase in the work rate every 6 seconds; earlobe blood flow was measured using a wireless laser Doppler blood flowmeter. [Results] Compared with that at rest, earlobe blood flow increased significantly from 50% of exercise peak intensity to a maximum of 1.7 times, but decreased immediately after exercise. The earlobe blood flow %change did not significantly correlate with hemodynamic parameters and its inflection point 36.4% Load_peak was significantly lower than the anaerobic metabolic threshold 58.1% Load_peak. [Conclusion] In healthy participants, earlobe blood flow during cardiopulmonary exercise test increased gradually with low-intensity exercise from approximately 1.5 times the resting rate and approached the anaerobic metabolic threshold with a maximum of 1.7 times the resting earlobe blood flow, but decreased quickly after exercise.

[Purpose] We aimed to develop a noninvasive specific ultrasonographic assessment of the talonavicular joint during loading to facilitate the analysis of treatment of flatfoot. [Participants and Methods] Sixty healthy participants underwent ultrasound imaging of the talonavicular joint while sitting and standing. The talonavicular angle was defined as the intersection of the line connecting the navicular and talar heads and the line connecting the talar head and sustentaculum tali. Talonavicular coverage was assessed using X-ray images of 15 participants. [Results] Ultrasonographic assessment of the talonavicular joint showed a lateral shift of the navicular relative to the head of the talus from sitting to standing. The talonavicular angle was significantly larger when standing than in the sitting position. The difference in talonavicular angle values between sitting and standing significantly correlated with the differences in the talonavicular coverage values. [Conclusion] We showed that ultrasonographic talonavicular angle assessment has good reliability and moderate validity for detecting significant alignment changes in the talonavicular joints due to loading. In the future, this evaluation method should be performed before and after exercise therapy to assess and develop appropriate exercise therapy for flatfoot.

[Purpose] Although many studies have shown that patients have difficulty in climbing or descending stairs after undergoing total knee replacement, no study so far has compared the difficulty of stair ascent and descent based on objective indicators. This study compared stair ascending and descending processes based on three indicators and clarified which was more difficult. [Participants and Methods] We defined 1) movement method, 2) the necessity for handrail use, and 3) speed as objective indicators. Seventy-eight patients who underwent total knee replacement participated in this study. Three months after the surgery, we examined 1) whether the patients could ascend or descend in a step-over-step or step-by-step manner, 2) whether the patients required handrail support, and measured 3) the time required to ascend and descend for four steps. [Results] The step-by-step movement and handrail requirement rates associated with stair descent were higher than the corresponding rates associated with stair ascent. In addition, the time required for stair descent was greater than that required for ascent. [Conclusion] We found that stair descent was more challenging than stair ascent in terms of all three objective indices: movement method, handrail use, and speed. The results indicate that rehabilitation after total knee replacement should focus more on stair descent than on stair ascent.