Objectives: There have been few studies in those the effect of inspiratory muscle training on respiratory muscle endurance was studied. Also, there are controversies in the effect of the inspiratory muscle training on exercise capacity. The purpose of this study was to examine the effect of increased respiratory muscle force due to 60% PImax inspiratory muscle training on respiratory muscle endurance and exercise capacity in the healthy young subjects. Methods: The inspiratory muscle training with 60% of PImax using Threshold^<TM> was conducted for 4 weeks in 16 healthy young students. Lung function, respiratory muscle force, respiratory muscle endurance by incremental inspiratory threshold loading test and exercise capacity by treadmill exercise test were evaluated at 1, 2, 3 and 4 week. In addition, peakVO_2 by treadmill exercise test was evaluated before training and at 2 weeks and 4 weeks after training. Results: Inspiratory muscle force at 3 and 4 week, inspiratory muscle threshold load at 2, 3 and 4week were significantly improved (p<0.01) compared with the pre-training values, and the increase of respiratory muscle force and the increase of respiratory muscle endurance was in positive correlation. Whereas, peakVO_2 was not improved significantly at 2 and 4week compared with the pre-training values. Conclusions: These data suggest that increased respiratory muscle force due to 60% PImax inspiratory muscle training might improve respiratory muscle endurance, but not exercise capacity.

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The purpose of this study was to investigate the sequential changes in peak cough flow (PCF), vital capacity (VC), and postoperative pain after laparotomy, and to determine the relationship among these measurements in patients undergoing laparotomy. Thirty patients undergoing elective surgery underwent measurement of PCF, VC, and postoperative pain at rest and during cough. These measurements were performed preoperatively and on postoperative days 1 to 9 and 13. PCF, VC, and postoperative pain were measured by peak flow meter, Wright respirometer, and visual analog scale (VAS), respectively. Correlations among these measurements were assessed using Pearson correlation coefficient. Sequential changes of these measurements were compared using a one-way ANOVA, and multiple comparisons were performed with Tamhane test. PCF was significantly depressed from day 1 through day 5, and VC was significantly reduced from day 1 through day 6 after surgery, compared with preoperative values. Recovery of VC and postoperative pain at rest and during cough were significantly correlated to recovery of PCF. Moreover, PCF and VC were significantly correlated. Our results help clarify sequential changes in PCF and the relationship between PCF, VC, and postoperative pain. These findings support the use of physical therapy techniques in perioperative patients, such as breathing exercises for increasing VC, and assisted cough for decreasing postoperative pain.

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Purpose: The purpose of this study was to investigate the usefulness of the sitting ability at 10 days post-stroke as a factor of prognosis for walking ability within 1 month post-stroke. Methods: The subjects were 79 stroke patients suffering a first stroke. First, we divided the patients into two groups, those who could walk (independence and observation) and those who could not (partial or total assistance) on day 20 and day 30 post-stroke, and performed univariate analysis (χ^2 test and t-test) with age, consciousness disorder, higher cortical function disorder, paralysis of each of the lower limbs, and sitting ability as the variables. Then, with the object variable as ability to walk on day 20 and day 30 post-stroke, and explanatory variables as age, consciousness disorder, higher cortical function disorder, paralysis of each of the lower limbs and sitting ability, we performed multivariate analysis (logistic regression). Result: In the univariate analysis significant differences were found for consciousness disorder, higher cortical function disorder, paralysis of each of the lower limbs, and sitting ability, between ability to walk and lack of ability to walk (p<0.05). However, in multivariate analysis, only two factors, sitting ability and paralysis of each of the lower limbs, were found to be significant (p<0.05). Conclusions: Sitting ability at 10 days post-stroke may be useful as a walking prognosis factor.

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Introduction: The objective of this study was to determine the rate of contracture progression and the direction of loss in joint movement, and to identify the relationship between the muscular and articular factors leading to contractures in acute spinal cord injuries. Methods: Twenty female Wistar rats were allocated to one of 5 equal sized groups that were assessed respectively at preinjury, 3, 5, 7, or 14 days after spinal cord injuries. The degree of contractures was assessed by measuring the femorotibial angle on both hindlimbs with the use of a goniometer. Knee joint motion was measured for flexion and extension. Myotomy of the transarticular muscles was then performed and range of motion was measured again. Results: The spinal cord-injured animals demonstrated a flaccid paralysis during the first 7 days postinjury and thereafter spastic paralysis. Contractures progressed for 14 days after spinal cord injuries, regardless of changes in muscle tone. Loss in joint movements was produced almost exclusively by a loss in the extension range of motion. Both the muscles and the articular structures contributed to the progression of the contracture, and these components are factors in the promotion of contracture development. In particular, the muscular factors were greater than the articular factors in extension angular displacement in which the range of motion was restricted. Discussion: Based on our findings of contractures in acute spinal cord injuries, in addition to the changes of the articular structures, more attention should be directed to the changes of the muscles.

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The ilio-femoral ligament is known to cause flexion contracture of the hip joint. However, no quantitative analysis to measure the effect of stretching positions on the ilio-femoral ligament has yet been performed. Strains on the superior and inferior ilio-femoral ligaments in 8 fresh/frozen trans-lumbar cadaver hip joints were measured using a displacement sensor, and the range of movement of the hip joints was recorded using a 3Space Magnetic Sensor. Reference length (L0) for each ligament was determined to accurately measure strain on the ligaments. Strain on the superior ilio-femoral ligament in the hip at 10 to 20 degrees adduction with maximal external rotation and maximal external rotation was statistically significantly larger than the value obtained from maximal extension (p<0.05). Strain on the inferior ilio-femoral ligament in the hip of maximal extension and 20 degrees external rotation with maximal extension was statistically significantly larger than the value obtained from maximal abduction (p<0.05). Few other hip positions demonstrated positive strain on the ilio-femoral ligament. The superior and inferior ilio-femoral ligaments were found to have selective stretching positions which provided large strain values. A series of selective stretches for the ilio-femoral ligaments may contribute to achieve an attractive treatment for flexion contracture of the hip joint.

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Immobilization of the shoulder joint caused contracture the soft tissue at around the joint and led to limitation of motion. Especially, humeral head was shifted at anterior-superior by posterior capsule contracture of glenohumeral joint. Decreased flexibility of posterior capsule of glenohumeral joint would be cause of impingement against the acromion, it led to rotator cuff tears. Stretching procedure of posterior capsule of glenohumeral joint is important technique for prevention and improvement of impingement against the acromion and rotator cuff tears. Various stretching procedure have been reported to stretch the posterior capsule of the shoulder joint; however, no consensus has been reached. The purpose of this study is to determine the appropriate stretching positions for the posterior capsule of the glenohumeral joint. Eight fresh cadaveric shoulders were used to measure strain of the posterior capsule of the glenohumeral joint in internal rotation with eight different arm positions. By using a strain gauge, strain of the capsule was measured at each three portions; upper, middle and lower fiber. The largest strain in the upper fiber was obtained in internal rotation at 0 degree of elevation and 30 degrees of extension, that in the middle fiber was obtained in internal rotation at 30 degrees of elevation, those in the lower fiber were obtained in internal rotation at 30 degrees and 60 degrees of elevation, and at 30 degrees of extension. Those strain values were statistically significantly larger than the reference length (p<0.05). No statistically significant strain of the capsules was obtained at internal rotation of horizontal adduction and 90 degrees abduction. Stretching position of posterior capsule of glenohumeral joint was similar to that of the infraspinatus muscle which had been reported previously.

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