[Purpose] Reaching is an important functional ability. We investigated the effect of advanced age and stool modification on sitting reach distance. [Participants and Methods] Twenty-four participants (twelve older adults 70 ± 4 years and twelve young adults 29 ± 4 years) reached forward and laterally while sitting on an adjustable stool with 0°, 10° forward, 10° backward, 10° right or 10° left inclination of the seat, with and without footrest and front, back or side leg support. [Results] The outcome of this exploratory study revealed that young adults reached farther than older adults across all the directions of reach and seat conditions. While the inclined seat was utilized, both young and older adults reached farthest in the forward direction. Additional leg supports allowed to reach further; however, older adults were not able to reach in the forward direction as far as young adults. When reaching in the lateral direction, leg support had minimal effect on the reach distance. [Conclusion] Age affects the sitting functional reach ability. Future research should focus on investigating the efficiency of interventions to enhance performance of functional tasks in sitting older adults.
[Purpose] To investigate the characteristics and factors associated with independence in the activities of daily living in patients with amyotrophic lateral sclerosis at diagnosis based on clinical phenotypes. [Participants and Methods] Fifty-seven participants diagnosed with amyotrophic lateral sclerosis were assessed using the Barthel Index. Participants were classified into three clinical phenotypes (bulbar-onset, upper limb-onset, and lower limb-onset), and the total and subitem scores were compared. To statistically examine factors associated with independence in the activities of daily living, the participants were divided into two groups: Barthel Index of 100 and ≤95. [Results] The total, bulbar-onset, upper limb-onset, and lower limb-onset Barthel Index scores were 87.9 ± 17.7, 96.7 ± 5.9, 92.5 ± 11.9, and 70.0 ± 22.2, respectively. The Total Barthel Index and lower limb-related activities of daily living scores were significantly lower in the lower limb-onset group, and knee extension muscle strength was identified as a factor associated with independence, with a cutoff value of 32.0%. [Conclusion] Patients with lower limb onset had more impairments in lower limb-related activities of daily living than those with other clinical phenotypes. To maintain independence in patients with amyotrophic lateral sclerosis at diagnosis, it is necessary to improve knee extension muscle strength through exercise and perform environment adjustments using the cutoff values as indicators.
[Purpose] This study aimed to assess the motor function status of ambulatory patients with Duchenne muscular dystrophy in 2020, which included a 3-month period of behavioral restriction due to the coronavirus disease of 2019 (COVID-19) pandemic, in comparison to the previous 2 years. [Participants and Methods] A retrospective analysis was conducted on 12 patients (children with mean age: 9.58 ± 3.43 years in 2020). Parameters such as lower leg maximum circumference, 10-m running time, rising-from-the-floor time, ankle joint range-of-motion, 6-min walk distance, and North Star Ambulatory Assessment score were evaluated. [Results] Significant increases in the maximum right thigh circumference and prolonged 10-m running time were observed in 2020. Interestingly, an unexpected improvement in ankle dorsiflexion angle was noted in both ankles. No other statistically significant differences were observed among the assessed time points. [Conclusion] These findings highlight the critical importance of continuous exercise and rehabilitation for ambulatory children with Duchenne muscular dystrophy, emphasizing the potential of rehabilitation to mitigate and restore the transient motor function deterioration observed during periods of behavioral restrictions.
[Purpose] The coronavirus disease of 2019 (COVID-19) pandemic and its associated restrictions have raised concerns regarding the lack of exercise among college students. Videos on digital platforms have addressed this issue, although their effects on student behavior are unclear. The present study investigated whether the simultaneous distribution of e-learning and exercise videos among college students during the lifting of behavioral restrictions during the COVID-19 pandemic was effective in promoting health. [Participants and Methods] We conducted a randomized controlled trial in which 100 college students were recruited. The data of 61 students (e-learning and exercise video group=21, exercise video group=20, and control group=20) who completed baseline surveys were analyzed. The preliminary outcomes were physical activity, health habits, eHealth literacy, health-related quality of life, subjective well-being, and psychological stress. A mixed-model repeated-measures analysis of variance was used to compare these variables before and after the intervention. [Results] Health practice and eHealth literacy scales exhibited significant interactions in the e-learning and exercise video groups compared to the other groups. [Conclusion] The combined distribution of e-learning and exercise videos did not significantly enhance physical activity among college students during the COVID-19 pandemic; however, health literacy and habits improved.
[Purpose] We aimed to examine factors at admission that are related to independence in stair climbing at discharge among patients with vertebral compression fractures. [Participants and Methods] The study included 179 female patients with vertebral compression fractures. A decision tree model was created to predict independence in stair climbing at discharge based on Dementia Scale-Revised, skeletal muscle mass index body mass index, grip strength, number of vertebral fractures, and number of injuries at admission. [Results] Analysis with the decision tree model showed that skeletal muscle mass index at admission, age, and grip strength were predictors for independence in stair climbing at discharge. [Conclusion] Patients with vertebral compression fractures who have a low skeletal muscle mass index and grip strength on admission may require assistance with stair climbing upon discharge.
[Purpose] This study aimed to determine the relationship between preoperative and discharge assessments in patients undergoing around-the-knee osteotomy. [Participants and Methods] We enrolled patients admitted to our hospital who underwent around-the-knee osteotomy. We measured knee joint range of motion, pain numeric rating scale, pain catastrophizing scale, hospital anxiety and depression scale, and 10-m walk time were measured preoperatively and before discharge. Pre-post comparisons and correlation testing were performed. [Results] A total of 18 patients were analyzed. Resting and exercise pain numeric rating scale, knee flexion and extension range of motion, and pain catastrophizing scale were significantly better during discharge. A significant correlation was observed between the preoperative pain catastrophizing scale total score and 10-m walking time, knee flexion and extension range of motion, pain catastrophizing scale total score, and hospital anxiety and depression scale-depression subscale preoperatively. [Conclusion] Appropriate postoperative rehabilitation after around-the-knee osteotomy improved physical function and cognitive/psychological evaluation at discharge. The correlation between the preoperative pain catastrophizing scale total score and 10-m walking time at discharge suggests that the prolonged walking pain that occurred preoperatively may have affected the cognitive and psychological evaluation of pain.
[Purpose] This study aimed to determine the effectiveness of the Arthrokinematic Approach (AKA)-Hakata method for patients with low back pain (LBP). [Participants and Methods] The participants were 39 patients with LBP who visited a medical facility between June 1, 2022, and November 30, 2022. The intervention period was 8 weeks, with five treatment sessions, and the patient assessments were performed using patient self-reported measures of LBP and motor function assessment. [Results] The AKA-Hakata method showed significant differences in all of the items evaluated in the longitudinal comparison of patients. Additionally, an interaction was observed only in the Roland-Morris Disability Questionnaire between the two groups classified using the Subgrouping for Targeted Treatment Back Screening Tool. [Conclusion] The results of this study showed that treatment with the AKA-Hakata method may have an early therapeutic effect on the physical and psychosocial risks in daily life. The results of this study indicated that the AKA-Hakata method is effective for the treatment of LBP. However, this study only evaluated a relatively short treatment period of five sessions. Further research on the long-term treatment effect is needed in order to optimize the treatment duration in detail and investigate the effectiveness of the AKA-Hakata method.
[Purpose] This study aimed to clarify the relationship between scapular internal rotation and upper-trunk movement during hand-behind-back movements of the right and left hands. [Participants and Methods] We included 20 healthy right-handed men and measured their hand-behind-back movements while sitting, using a three-dimensional motion capture system. We examined the relationship between scapular internal rotation and upper-trunk movements during hand-behind-back movements with the right and left hands. [Results] The right scapular internal rotation angle was negatively correlated with the anteroposterior tilt angle of the upper-trunk, and increased scapular internal rotation was associated with an increased posterior tilt of the upper-trunk. Moreover, the left scapular internal rotation angle was significantly correlated with the upper-trunk anteroposterior tilt angle and upper-trunk rotation angle, and increased scapular internal rotation correlated with increased anterior tilt of the upper-trunk and contralateral rotation. [Conclusion] Scapular internal rotation during hand-behind-back movements was associated with upper-trunk movement, with differences observed between the right and left hands. It is useful to evaluate and treat the movement of the upper-trunk and scapulothoracic joint on both sides to increase scapular internal rotation during hand-behind-back movements.
[Purpose] This study examined the effectiveness of active learning-based transfer movement training provided to caregivers by physical therapists. [Participants and Methods] This study enrolled 29 participants (age: 47.0 ± 10.1 years, 22 female participants) working at a residential care home. The participants were shown a video in which caregivers experienced difficulty in transferring a patient; this was followed by group discussions. To verify the effectiveness of this educational intervention, a questionnaire including six items related to reducing the burden on caregivers, daily living care, and rehabilitation was administered to the participants at three time points (before training, three days after training, and one month after training). Multiple comparisons were performed, and the effect size (r) was calculated. [Results] Significant differences were observed between the responses obtained before training and three days after training and between the responses obtained before training and one month after training for all six items. The effect sizes (r) after three days and one month of training were above 0.6 for all six items. [Conclusion] The training improved the assessment skills of caregivers, and its effects persisted after one month, suggesting the effectiveness of active learning-based transfer movement training.
[Purpose] Changes in forearm interosseous membrane dynamics during forearm rotation relative to the shoulder joint position remain poorly understood. The purpose of this study was to clarify interosseous membrane dynamics during forearm rotation in shoulder abduction and external rotation positions. [Participants and Methods] We conducted open magnetic resonance imaging on 17 healthy forearms in the prone position. Three limb positions were set for measuring the forearm rotation angle: intermediate, maximum pronation, and maximum supination. Images were obtained with the shoulder joint abducted at 90°and externally rotated at 90°. The forearm interosseous membrane angle was measured at three points: the apex of the forearm interosseous membrane, the radius, and the ulna. The measurement of the interosseous angle was repeated thrice. [Results] Sufficient intra-rater reliability was confirmed for the forearm interosseous membrane angle measurement. The interosseous membrane of the forearm showed a mean dorsal convex shape during forearm pronation (141.7° ± 0.83°), and the mean palmar convex shape during forearm supination (−141.6° ± 0.64°). [Conclusion] This study provides useful information for future research by quantifying the dynamics of the interosseous membrane of the forearm, which is an important soft tissue for forearm rotation. The establishment of a quantitative evaluation method for forearm interosseous morphological changes will help further elucidate forearm rotation movements during sports activities.
[Purpose] Taping is often performed to prevent injury and injury recurrence. However, it is unclear how taping affects landing and jumping kinematics in patients undergoing anterior cruciate ligament reconstruction. Therefore, this study aimed to determine the kinematic effects caused by taping during single-leg vertical jumps in patients with anterior cruciate ligament reconstruction. [Participants and Methods] Ten young patients who underwent anterior cruciate ligament reconstruction were included. The maximum knee joint flexion angle, peak value of the vertical component of the floor reaction force, maximum knee joint eversion angle, and jumping height during a single-leg vertical jump were measured using a three-dimensional motion analyzer and compared among the following three groups: without taping, with protective taping using elastic tape, and with protective taping using non-elastic tape. [Results] There were no significant differences in the peak value of the vertical component of the floor reaction force or the maximum knee joint flexion angle among the three groups. The maximum knee joint eversion angle and jumping height were significantly lower in the elastic tape and non-elastic tape groups than in the non-taping group. [Conclusion] Anterior cruciate ligament taping does not affect the magnitude of the impact on the body and can decrease knee joint eversion. However, jumping height was lower in the two taping groups than in the no-taping group. There were no significant differences in the items studied between the two taping groups.
[Purpose] To examine the effectiveness of acute and outpatient cardiac rehabilitation for severe intensive care unit (ICU)-acquired weakness. [Participant and Methods] A 79-year-old woman, diagnosed with takotsubo syndrome. A percutaneous catheter-based transvalvular left ventricular assist device was used from day 2 to day 8, extracorporeal membrane oxygenation from day 3 to day 9, and inotropic support from day 1 to day 15. The patient was weaned from the ventilator on day 59, transferred to another hospital on day 67, and discharged home on day 152. From days 16 to 65 and 177 to 262, she underwent inpatient rehabilitation and outpatient cardiac rehabilitation, respectively, at our hospital. [Results] After inpatient rehabilitation at our hospital, her Medical Research Council score improved from 16 to 46. In outpatient cardiac rehabilitation, her 6-minute walk distance improved from 385 to 473 m, and her Kansas City Cardiomyopathy Questionnaire score improved from 88.6 to 100. [Conclusion] The results suggest that acute rehabilitation can effectively improve muscle strength, whereas outpatient cardiac rehabilitation can effectively improve exercise tolerance and quality of life in patients with severe ICU-acquired weakness.
[Purpose] We document the significant improvement in posturography and spinal deformity by Chiropractic BioPhysics® (CBP®) technique methods. [Participant and Methods] A 78-year-old male presented with 20 years of chronic hip and lower back pain and stiffness. The pain was 5/10 and disability was 38%. The patient also complained of walking difficulty and balance problems. Radiographic assessment demonstrated a significant thoracolumbar kyphosis and anterior C7-S1 sagittal vertical axis (SVA). Force plate posturography showed high centre of pressure (COP) parameter values including the total path length, particularly for the vestibular condition of the modified clinical test of sensory integration and balance (mCTSIB). [Results] The patient was treated with 36 sessions of CBP corrective exercises and spinal traction as well as PowerPlate balance and gait exercises. Assessment after 4-months showed improvements in sleep, pain, disability, and mobility. There was a 79 mm reduction in SVA and improved postural control in many parameters including a 49 cm and 22 cm reduction in COP total path length for the vestibular and visual trials on the mCTSIB, respectively. The pain and disability were reduced to 0/10 and 22%. [Conclusion] This case demonstrates the significant improvement in postural control as quantified by the mCTSIB with the reduction of excessive SVA as demonstrated on post-treatment x-rays.