The purposes of this study were to investigate the effects of high-intensity resistance training on strength and physical functions and to examine the relationships between initial functional statuses and the improvements of the functional performance measurements in the frail older people.
Subjects were 69 persons aged 65 years or older (the average age was 78.6 ± 7.6) who participated in Comprehensive Geriatric Training (CGT). CGT including high-intensity resistance training and balance training was performed for three months. Strength and functional performance were evaluated at the beginning and completion of the intervention. Strength was measured by one repetition maximum protocol (1RM). We evaluated the changes of the measurements, and the relationships between initial measurements and the improvement of functional performance measurements.
Participant's 1RM and functional performance such as the maximum walking speed or one leg standing time improved significantly after the training. There was no difference between men and women in improvements of strength and functional performance measurements. Some functions were not influenced by their characteristics and initial physical functions. But some functions that were thought to be difficult for the frail elderly people had relations to their age and initial physical functions.
In this research, we demonstrated the effectiveness of the high-intensity resistance training for the frail elderly and that there were some relationships between the improvements and their physical characteristics in the frail older people. These findings of present study should be useful for the exercise intervention to the frail older people.

View full abstract

The purpose of this study was to investigate the relationship between Nonparetic Side Knee Extensor Power (NKEP) and walking ability in acute hemiplegic patients who could not walk independently. The subjects were 29 acute stroke patients in the period of 1 month from the onset who needed assistance to walk. The subjects were divided into two groups based on their FIM walking score 3 months after the onset (dependent group: FIM walking score 1, 2, 3, 4, 5. independent group: FIM walking score 6, 7). The maximal force during NKEP was measured by a torque machine (CYBEX II⁺) at the speed of 30°/sec, and the peak torque per body weight was calculated. The Wilcoxon signed rank sum test, and the Kruskal-Wallis test were employed to examine the effect of NKEP and walking ability. Follow-up NKEP analyses of each group showed that NKEP 3 months after the onset was significantly higher than 1 month after the onset in both groups. Follow-up NKEP analyses of the two groups showed that NKEP 1 month after the onset in the two groups was not significantly different between the two groups 3 months after the onset. There was also no significant difference between the two groups in the follow-up NKEP increment rate. In patients who could not walk independently in the period of 1 month from the onset, there was little relationship between NKEP and walking ability in the acute period. In order to improve walking ability, it is not sufficient to achieve an increase in NKEP alone in the acute period, but it is also necessary to investigate non-NKEP-related factors affecting gait, such as paretic side knee extensor power, paretic side load rate, and sitting or standing balance. It is considered necessary to select the optimium approach for each specific length of onset or for individual cases.

View full abstract

The purpose of this study was to clarify the frequency characteristics of muscle fatigue during dynamic contractions. Using wavelet transform, we conducted frequency analyses of surface EMG signals during fatigue tests in repetitive isokinetic muscular contractions. Eight healthy male subjects performed thirty repetitive maximum isokinetic contractions of knee flexion and extension at an angular velocity of 180 degrees per second on an isokinetic dynamometer. The torque was calculated and surface EMG signals in the right vastus medialis muscle were recorded. After frequency analysis of EMG signals during knee extension with continuous wavelet transform, at low frequency ranges less than 45 Hz and at high frequency ranges greater than 75 Hz during each contraction, we calculated the mean power frequency (MePF), total power (TP), the ratio of low frequency range against total power (LF/TP) and the ratio of high frequency range against it (LF/TP).
The results of the study were: MePF had a tendency to decline as the number of contractions increased over time. TP increased during the first half of the contractions, but decreased slightly after that. LF/TP decreased just after the beginning of the tests but increased after that. However, HF/TP showed a tendency to decrease. From these results, it is possible to capture the changes of frequency characteristics in dynamic contraction with wavelet transform, which was not be able to be analyzed with traditional methods.

View full abstract

In a touch test using Semmes-Weinstein Monofilaments (MF), we studied whether the stimulation being added to a foot bottom before the test influences the test results.
Subjects were 34 type II diabetes mellitus patients. The first touch test was performed in four places of a foot bottom just after 10-min gait, the same touch test was then continued after rest lying in a bed for 10 minutes, and the first result was compared with the second one.
The stimulus threshold value (Target force) after rest (RMT) was significantly decreased from the value after gait (GMT) in three places of a foot bottom. Furthermore, with respect to the level change in the stimulus threshold between RMT and GMT, there was a significant change in one place of a foot bottom and a not significant but slightly noticeable difference in another place. Of the subjects who changed more than one level, 78% showed a negative level change by rest. In addition, among 17 subjects, level changes were observed in one or more places of a foot bottom. The significant difference was not observed between two groups; those who indicated changes and who not, in clinical data, physical examination, and therapeutic regimen.
These results suggest that enough rest is necessary for the measurment of the touch test using Semmes-Weinstein Monofilaments because there is a probability that the results was influenced by tactile threshold level between just after gait and at rest.

View full abstract

The purpose of this study was to investigate the reliability of the new evaluation method for exercise work by controlling pedaling torque to a constant heart rate level during exercise. Ten healthy subjects with no history of bone and joint injury volunteered to this study. They underwent two trials, 18 minutes each, at 50 cadences per minute in the new method. HR, mechanical work, oxygen consumption (VO₂), systolic blood pressure (SBP), and ratings of perceived exertion (RPE) were measured during the exercise. The coefficient of variation (CV) was calculated as an index of HR regulation. Reliability for each variable was assessed by calculating intra-class correlation coefficients (ICC). The average for HR during exercise was nearly equal to the target HR, and the CV was from 1.7% to 1.9%. A good test-retest reliability was obtained in mechanical work, VO₂, SBP and RPE, showing ICC values of 0.95-0.97, 0.96-0.99, 0.97, 0.94, respectively (p < 0.01). In conclusion, this evaluation method for exercise work is reliable and valuable and can be clinically applicable in terms of frequent assessment without any volitional fatigue.

View full abstract

The main purposes of this study were to examine trunk muscle activities using EMG while raising the hand in all fours, and to compare the results with those of the grade 5 (normal) manual muscle testing (MMT5). This study also aimed at investigating whether each abdominal muscle works as prime or assistant mover in the MMT5. The surface EMG of the seven right trunk muscles were measured in nine healthy male subjects.
Both of the external oblique (EO) and the internal oblique (IO) were activated against applied rotational movements of the trunk while raising the hand in all fours. The paraspinae muscle around T9 was more activated than L5/S1 on the raised hand side, and the L5/S1 were more activated than the T9 on the non-raised side. The ratio of activities of the rectus abdominis (RA) in this position to in MMT5 was lower compared with those of EO and IO. The ranges of the ratio were 0.2 to 0.6 in the case of the paraspinae muscle.
It was suggested that the raising the hand in all fours could facilitate an appropriate muscle activity pattern for stabilization of the lumbar spine without increasing RA activities. Moreover, these results suggested that, as muscle endurance training requires about 15 to 40 per cent of the maximum voluntary contraction, the raising the hand in all fours could be effective in endurance training for back muscles, such as for the persons whose maximum voluntary contraction was weak, but equal to MMT5. The percentage of EO activities was too high so that there might be a lack of reliability in terms of measurement of MMT5 of the oblique.

View full abstract

Previous researchers reported that the Pusher sign was observed in hemiplegic patients after stroke, which appeared unrelated to the affected hemisphere side and specific region as well as to whether the patients had visual spatial agnosia or not. They also claimed that the patients had a fear of inclination of the trunk to the unaffected side. This also suggests that the psychological features of the patients affect the factors which cause the Pusher sign.
If the hemiplegic patients who has shown a difference between the affected side and unaffected side in righting reactions or equilibrium reactions, we can assume that they have such a psychological tendency although they does not show the clear signs. The purpose of this study is to examine the relationship between the asymmetrical response in the righting reactions or the equilibrium reactions and the psychological features in view of the self-examination of the patient who does not have clear Pusher sign in his reaction to trunk inclination. The subjects were 30 hemiplegic patients. According to the results of self-examination when the trunk was inclined bilaterally in a sitting posture, the subjects were classified into 5 groups. Fifteen out of 30 patients indicated more fear of trunk inclination to the unaffected side than that to the affected side. In addition, 10 out of these 15 patients exerted resistance in the trunk during inclination to the unaffected side. These results suggest that “fear” of trunk inclination to the unaffected side may be a clinical feature common to hemiplegic patients regardless of the existence of the Pusher sign. It is also suggested that not only bilateral trunk muscle activity but also psychological features related to bilateral trunk inclination should be taken into consideration in the functional evaluation of the trunk in hemiplegic patients.

View full abstract

The purpose of this study was to investigate the effects of exercise using a walking-training machine on physical function in community-dwelling elderly persons. Subjects were eighteen elderly (72.6 ± 4.4 years), ambulatory, community-dwelling volunteers who had been recruited by direct mail. Walking-training program consisted of 15-min treadmill walking twice a week for 4 weeks. For enhancement of a postural control ability during walking, perturbation was introduced by a sudden random deceleration of one side of a walking belt during training. Intensity of the perturbation was progressively increased each week. Gait ability, balance, muscle strength, flexibility, reaction time, and postural control ability were measured as the assessment of the effects of the walking-training. Results were that, in comparison with baseline, gait ability, balance, flexibility and postural control ability were significantly improved after intervention. In other items there was no significant change. Further, no accidental falls and injuries occurred during the training. Our walking training efficiently improved gait, balance, and postural control ability. In addition to improvement of gait and balance, the training may enhance other physical functions. Exercise using a walking-training machine may be efficient for preventing falls in the community-dwelling elderly.

View full abstract