The purpose of this study was to examine whether intermittent stretching accelerates amelioration on limitation of ankle joint mobility and disuse muscle atrophy in immobilized rat soleus muscle. Male Wistar rats (n=30) were divided randomly into control (C, n=5) and experimental (n=25) groups. In the experimental group, bilateral ankles of each rat were fixed in full plantar flexion with plaster casts for 4 weeks. The experimental group was divided into 3 subgroups: 1) immobilization alone (Ⅰ; n=5), 2) spontaneous recovery (no stretching exercise) for 1 (n=5) or 2 (n=5) weeks after cast removal (NS), and 3) stretching exercise for 30min/day (6 days/week, 1 cycle/4 s) for 1 (n=5) or 2 (n=5) weeks after cast removal (S). Range of motion on dorsiflexion was significantly higher in S than NS. Muscle fiber cross-sectional area of soleus muscle was significantly decreased in Ⅰ compared with C, and was significantly higher in S than NS. Numerous necrotic fibers were apparent in NS than S. These findings indicate that intermittent stretching accelerates amelioration on limitation of joint mobility and disuse muscle atrophy.

View full abstract

This study investigated the relationship between a previous vertebral fracture and motor function, functional capacity, and falls in patients with osteoporosis. The subjects in this cross-sectional survey included 35 outpatient women who had been given drug treatment for postmenopausal osteoporosis (average age, 72.0±6.4 years; average calcaneal bone mineral density, 0.64±0.06g/cm²). Previous vertebral fractures were assessed on thoracic and lumbar region radiographs; vertebral fracture was defined according to the criteria of the Japanese Society for Bone and Mineral Research. The diagnosis and treatment given at the time were also recorded. Lower limb muscle strength, grip strength, maximum gait speed, the Timed Up & Go test (TUGT), and the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) were measured to evaluate motor function and functional capacity. To assess falls, a history of previous falls was obtained and the patients' fear of falling was assessed using the Modified Fall Efficacy Scale (MFES). Subjects were divided into 2 groups for the purpose of the statistical analysis: patients with fracture and patients without fracture. Compared to patients without fracture, the maximum gait speed and effectance had deteriorated in patients with fracture (p<0.05). In addition, more patients had fallen in the fracture group than in the group without fracture. Of note, age and bone mineral density were not different between the groups. Our data suggest that osteoporotic vertebral fracture is related to deterioration of gait speed and effectance, as well as a tendency to fall. These have been reported to be risk factors that cause disability of ADL and IADL, as well as being associated with hip fracture. Therefore, vertebral fractures, some of which may not be clinically evident, may decrease the functional independence of the elderly.

View full abstract

The purpose of this study was to clarify the changes in ADL level from hospital admission to discharge, and to investigate the factors that deteriorated ADL at discharge in elderly patients with acute pneumonia. Fifty-three elderly patients (34 males) aged over 75 years (mean 81.0±5.8 years) were assigned to four groups based on ADL at discharge; Group 1, bedridden, Group 2, assisted self-care with help required while walking, Group 3, independent self-care with help required while walking, and Group 4, independent self-care with walking capability. At discharge, there were 8 (15%), 11 (21%), 9 (32%) and 25 (47%) patients in Group 1, 2, 3, and 4, respectively. Twenty-nine patients (55%) were discharged to their homes, 17 patients (32%) were transferred to rehabilitation facilities, and 7 patients (13%) were sent to a facility for long-term care. Ninety percent of patients who could discharge to their homes were included in Group 3 or 4. To return home from hospital, self-care needs to be established. The APACHE Ⅱ score, period of bed rest, psychotic symptoms, difficulty of swallowing were found to have significant effects on ADL decline. It is necessary to establish both early mobilization and improvement in the physical activities as part of the treatment of pneumonia so as not to decline ADL.

View full abstract

To demonstrate how movement patterns (MPs) change when a child rises from supine to erect standing, the movements of 17 healthy children (mean age±SD=3y 9mo±4mo) were recorded on videotape, beginning from their initial year in kindergarten. MPs were categorized into three bodily regions: upper extremities (UE), axial region (AX), and lower extremities (LE). Nine children consistently exhibited the same pattern throughout the study for UE and 6 of them for AX, whereas none of them demonstrated such consistency for LE. In both UE and LE, certain changes were observed between the initial session (mean age±SD=3y 9mo±4mo) and the first-year follow-up (mean age±SD=4y 9mo±4mo), but no such changes of a generalizable nature were seen in the following year. In UE, the most common change in the first year was from initiating the movement by pushing on the floor with both hands near each other over on one side of the trunk, to initiation by pushing with the hands apart, one on each side of the trunk. In AX, the children tended to rise with less body rotation one year after the initial session. This study demonstrated relatively great change in MP between 3 and 4 years of age. Of interest to physiotherapists should be the relative consistency of MP in UE and AX. Attempting to judge development on the basis of MP in LE would be more difficult in children 3 to 5 years old.

View full abstract

Application of ultrasound changes skin permeability. The change of skin permeability is affected by nonthermal actions and thermal actions. However, the studies about nonthermal actions have not been reported sufficiently. In the present study, we examined whether nonthermal effects of ultrasound would enhance water molecules transport through the excised frog abdominal skin. Ten frogs' skins were used for this experiment. The skin internal surface was exposed to 1MHz continuous ultrasonic vibration at the intensity of 0.5W/cm² with a 10.7cm² transducer of 3.7cm in diameter for 10min. Since application of ultrasound generates heat, a heat-only application was devised using the frog Ringer's solution heated to the same level of temperature as that after application of ultrasound to investigate the effect on molecules transport. Application of ultrasound produced a significant increase in transdermal transport of water molecules, and a heat-only application produced a significant decrease. These results were opposite to each other, suggesting that the nonthermal effects of ultrasound were responsible for enhanced water molecules through the skin.

View full abstract

In recent years, many study reports have been submitted about the effect of functional recovery of the paralyzed limb by constraint induced movement therapy (CIT). However, since CIT limits the healthy limb for a long time, it is problematic for clinical use. In this study we tried modified constraint induced therapy (mCIT) which was CIT revised conditions that we could carry out practically. The subject was a patient with disturbance of right lower limb voluntary movement due to cerebral infarction of the left medial frontal lobe including the supplementary motor area. The patient's non-paralyzed knee was fixed in an elastic knee brace for two days. After mCIT, it appeared that voluntary movement of the right lower limb had improved with marked improvements in various movements and gait ability. These changes in two days exceeded the natural recovery process after a cerebrovascular accident and we judged it to have been effected by mCIT. The background to these improvements is thought to be the supplementary motor area, which activates early in the process of motor recovery and dominates the limbs of both sides.

View full abstract