Purpose: The present study was performed with the objectives of elucidating those causes by focusing on the subjects physical and mental capacities―especially the BPSD (Behavioral and psychological symptoms of dementia)―and investigating measures for preventing falls.
Subjects and Methods: The subjects consisted of 45 people who were elderly subjects with cognitive impairment who were living in two Japanese health care facilities for the elderly. They were capable of walking in order to perform the activities of daily living, but they were suspected of having dementia on the basis of MMSE score of 23 points or less. These subjects were analyzed in terms of the BPSD and also their history of falls within the past 6 months, their walking speed, the number of steps they could walk, TUG and MMSE. The data for these parameters were compared between the subject group that had falls and the subject group that had no falls.
Results: The 18 subjects had experienced falls, while the remaining 27 subjects had had no falls. The results indicated that the feature of the falls in cognitive impairment elderly subjects living in health care facilities are not a decrease in physical capabilities, such as the walking speed, and the BPSD, physical aggression.
Conclusions: The findings indicate the feature that falls by elderly cognitive impairment subjects living in health care facilities can be prevented by implementing an approach aimed at improving both the walking ability and the BPSD, physical aggression.

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Purpose: The purpose of this study was to compare the effects of lifting objects with and without knowledge of their weight beforehand on lumbar and pelvic motion and on electromyographic (EMG) activities of erector spinae muscles.
Subjects and Method: Nineteen healthy subjects lifted boxes weighing 20% of their body weight. In the first experiment, the subjects lifted boxes without knowledge of how much they weighed (unknown tasks; U tasks). In the second experiment, the subjects lifted the same boxes with knowledge of how much they weighed (known tasks; K tasks). A digital video camera was used in combination with surface EMG.
Results: The results showed that trunk extension began with predominance of pelvic over lumbar motions and ended with predominance of lumbar over pelvic motions in K tasks, which was reported previously as lumbar pelvic rhythm. In U tasks, similar motions were seen in trunk extension, but the difference was small between the pelvic and the lumbar motions. The EMG peak activities of the erector spinae muscles appeared in the middle phase of trunk extension in K tasks, but in the initial phase in U tasks. Peak activities in the initial phase in U tasks suggested greater load of the lumbar spine due to both the compression force by lumbar muscles of spine and the flexion moment by gravity than in K tasks.
Conclusion: We concluded that the absence of weight information in U tasks led to an increased mechanical load of the lumbar spine, and it may contribute to a higher risk of low back injury in lifting tasks.

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Purpose: The purpose of this study was to examine whether there is an influence of a tourniquet-induced ischemia on disuse muscle atrophy.
Subjects: Forty female 8-week old Wistar rats were used in this study.
Method: The rats were divided into four groups according to the length of immobilization: 4-day group (n = 10), 7-day group (n = 10), 14-day group (n = 10), and 21-day group (n = 10). Each group was then sub-divided into 2 groups: control (n = 5) and experiment (n = 5) groups. The right hind limbs of the experimental rats received an ischemia by a tourniquet for ninety minutes the first experimental day, and the ankle joints were then fixed in full plantar flexion with a cast (Ischemia & Fixation group). The left hind limb of the experimental rats were fixed in full plantar flexion with a cast but without a tourniquet application (Fixation group). Muscle atrophy was defined as a decrease in the area of the soleus muscle fibers.
Results: The results showed that the areas of the soleus muscle fibers of the Ischemia & Fixation group were significantly decreased when compared with the other groups.
Conclusion: The authors suggest that tourniquet-induced ischemia facilitates disuse muscle atrophy in rats.

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Purpose: Mental rotation is a simple method for reminding motor imagery. This study investigated the role of motor imagery in patients with frozen shoulder.
Methods: The subjects were 60 patients with frozen shoulder and 60 healthy adults. A personal computer was used to mental rotation. A photograph of a hand rotated 0, 90, -90, or 180 degrees was displayed on the screen. The reaction time and answer were recorded by pushing a button. Physiotherapy was performed in the patient group. Mental rotation was evaluated before and after intervention.
Results: Before the intervention, the reaction time for mental rotation was delayed significantly in the patient group, and it improved significantly after the intervention.
Conclusion: These results suggest that musculoskeletal impairment influences motor imagery.

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Purpose: The purpose of this study was to investigate the effects of therapeutic exercise on both the physical functions and abilities in patients with mental disorders. In addition, we also investigated the effects of a behavioral science approach on participation in a therapeutic exercise class.
Methods: The subjects consisted of 21 inpatients at a psychiatric hospital (9 in a closed ward, 12 in an open ward). Over a 12-week intervention period (3 times/week), therapeutic exercise (trunk and leg stretching, muscle-strengthening exercise, balance exercise, and gait training) and a behavioral science approach (giving praise following participation in the therapeutic exercise class, the provision of food following therapeutic exercise, the posting of a participation status check poster) were conducted.
Results: Regarding the subjects in the open ward group, both the leg extension distance and maximum stride length significantly increased after the 12-week intervention in comparison to that before intervention. Regarding the subjects in the closed ward group, the rate of participation in the therapeutic exercise class was higher than that for occupational therapy. Giving praise after participation in the therapeutic exercise class was highly rated by the patients with mental disorders as an effective approach for increasing participation in the therapeutic exercise class.
Conclusion: To promote the overall participation in therapeutic exercise classes for patients with mental disorders, it is necessary to devise various novel reinforcement stimuli using a behavioral science approach.

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