Objective: Improving the ability patients with stroke to get out of bed to avoid long bedridden periods is an important public health problem. However, few studies have examined the various methods for rising from bed in individuals with stroke. The aim of this study was to clarify differences in movement duration and trunk angle amplitude during supine-to-sit motion according to the abduction angle of the non-paretic upper limb in individuals after stroke.

Method: Thirteen poststroke patients were instructed to rise from bed under three conditions for abduction of the non-paretic upper limb (30, 60, and 90 degrees), and the duration and amplitude of the trunk angle were analyzed by three-dimensional motion analysis. The movement task was divided into Phase 1 (from the start of center of mass movement to On Elbow) and Phase 2 (from On Elbow to the maximum vertical center of mass position in a sitting posture). Main effects were tested by repeated-measures analysis of variance or the Friedman test in data for three conditions, and if the main effect was observed, the paired t-test with correction for multiple comparisons or the Wilcoxon signed rank test was performed. The significance level of multiple comparisons with Bonferroni correction was p < 0.0167.

Results: The movement duration was significantly shorter in the 90 degree task than in the 30 degree task. In terms of trunk angle, lateral flexion during phase 2 was significantly less in the 60 and 90 degree conditions than in the 30 degree condition (p < 0.0167).

Conclusion: As the movement duration was shorter and lateral bending was less when the non-paretic upper limb was abducted by 60 or 90 degrees than 30 degrees, individuals with stroke are recommended to abduct their upper limb on the non-paretic side at least 60 degrees when they rise from bed.

Coordinated muscle activity can be elicited by inducing passive stepping for individuals with spinal cord injury. This neural activity, so-called “locomotor-like muscle activity” is considered as a result of elicitation of spinal locomotor circuits. The aim of this study is to test if the characterization of locomotor-like muscle activity can be effectively work as a new evaluation method for the gait function in patients with spinal cord injury. We here attempted to conduct analysis for locomotor-like muscle activity obtained from 44 individuals with chronic spinal cord injury. All subjects participated robot-assisted passive stepping with the measurement of seven key muscles in each lower limb. We obtained spatiotemporal map in accordance with the innervated spinal segment of each muscle and its relevance to the gait phase. The results demonstrated that (1) sacral segment activity during stance phase was augmented in response to load application in both complete and incomplete SCI, and (2) lower lumber segment activity during early stance phase could be elicited by voluntary activation in incomplete SCI. Importantly, spastic activity which presumably due to SCI specific activity can be clearly characterized. The proposed evaluation method has a potential usefulness for the residual locomotor function in patients with SCI.

Purpose: The Balance Evaluation Systems Test (BESTest) is sometimes used to assess the balance of spinocerebellar ataxia (SCA) in individual patients. Keyform has, in recent years, been attracting attention to improve clinical interpretability. The purpose of this study was to develop keyform for each section of the BESTest in patients with SCA.

Methods: The BESTest was evaluated in 81 patients with SCA. After confirming unidimensionality and internal reliability, item fit and difficulty levels for each section of the BESTest were obtained using Rasch analysis, and the keyform was drawn up.

Results: Unidimensionality could not be confirmed for Sections I and II, and good internal reliability was obtained for all sections except Section V. In addition, the item fit of two items was not confirmed, and the difficulty level of each item was calculated using Rasch analysis. The keyform was developed after excluding, from the analysis, the two sections in which dimensionality could not be confirmed and the two items in which the degree of fit was poor.

Conclusion: This keyform, which was developed for SCA patients, will be a valuable tool for appropriate physical therapy goal setting and treatment planning for individual SCA patients because it enables visualization of the difficulty level of the balance task in the keyform.

Aim: The effect of the combination of stretching and the focal muscle vibration on the spastic gastrocnemius muscle on gross motor function in a child with spastic hemiplegic cerebral palsy was investigated using a single case study (ABAB design).

Methods: The participant was 2 years and 11 months old child with right spastic hemiplegic cerebral palsy who had spasticity in the gastrocnemius muscles. The study design was a single-case ABAB design. Standard stretching (Phase A1 and A2) and standard continuous stretching combined with focal muscle vibration on the gastrocnemius muscle (Phase B1 and B2) were performed, and outcomes were compared after each phase. Each stretching session of Phase A (10 repetitions of 1 minute) and B (5 repetitions of 2 minutes) had a duration of 10 minutes per session. In both phases, task-oriented exercises were performed for the three motor tasks derived from the GMFM item map. Outcomes were ankle dorsiflexion range of motion in the knee extension position (ROM-DFKE), modified Tardieu scale (MTS) for the gastrocnemius muscle, and gross motor function measure {GMFM-66, item D (standing), item E (walking and running)}.

Results: The ROM-DFKE and R1 values (the angle at which resistance occurs when the ankle joint was rapidly dorsiflexed) of MTS improved only in the B phase. GMFM-66, Item D, and Item E scores were improved at the end of the study compared to the beginning. Those scores improved only after Phase B2 when compared to other Phases.

Conclusion: The stretching with focal muscle vibration may contribute to the improvement of gross motor function more than standard stretching.