Purpose: To alleviate dyspnea, physical therapists often instruct patients with chronic lung disease to do diaphragmatic breathing and coordination between their breathing and exercise rhythms. However, the relationship between breathing patterns and exercise coordination remains unknown. This study aimed to investigate the influence of two breathing patterns on coordination between breathing and exercise rhythms.
Methods: Incremental exercise testing was performed with a ergometer in 10 healthy male subjects and ventilatory threshold (VT) determined. Exercise intensity was defined as according with two workloads corresponding to 60%VT and 100%VT, respectively. Subjects used two breathing patterns, spontaneous and diaphragmatic. Subjects cycled four different exercise protocols for 6 minutes (two intensities and two breathing patterns). During cycling, leg movements, respiratory parameters and thoracoabdominal perimeters were continuously recorded. Coordination was considered to be present when the phase interval between the leg movement cycle and inspiration (or expiration) displayed a constant value ± 0.10 seconds for at least four consecutive breaths.
Results: The degree of coordination (%COORD) wasn't significantly different between the two breathing patterns. When breathing and cycling rhythms were coordinated, oxygen uptake was significantly higher than when not coordinated at workloads of 60%VT with spontaneous breathing (p < 0.05). However, between group differences for all other exercise parameters were not significant. Nor was there significant coordination between %COORD and oxygen uptake, and %COORD and oxygen equivalent.
Conclusion: These results suggested that breathing control does not affect %COORD, and that coordination between breathing and cycling rhythms does not necessarily cause a reduction in oxygen uptake at workloads corresponding to 60-100%VT.

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Purpose: In the present study, we analyzed the relationship between the amount of time spent away from bed and the ability to perform activities of daily living (ADLs) in a large population of older individuals requiring care, with the aim of determining the amount of time such individuals must spend away from bed in order to maintain their ability to perform ADLs.
Methods: Participants were 6,178 older individuals requiring care (mean age, 80.7 ± 8.0 years), 65.8% of whom were women. A total of 3,350 (54.2%) participants had been admitted to facilities, while the other 2,828 (45.8%) were living at home and using long-term care insurance. Participants were classified according to the level of required care as well as whether they were living in facilities or at home. The risk of impairment of ADLs among participants who spent 6-10, 3-6, or < 3 hours away from bed relative to those who spent ≥ 10 hours away from bed was investigated with adjustments for sex, age, illness, and basic motor skills.
Results: Participants who spent 3-6 hours away from bed had the highest odds ratio for impairment of ADLs relative to those who spent ≥ 10 hours away from bed. Participants who spent < 3 hours away from bed tended not to have an increased odds ratio.
Conclusion: Long hours spent away from bed was closely correlated with a favorable function in ADLs, and the level of independence in ADLs decreased as the amount of time spent away from bed decreased. The finding that the odds ratio of participants who spent < 3 hours away from bed did not increase may be attributed to the fact that many of these participants had poor physical function in sitting up, standing up, and walking.

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Purpose: This study investigated the influence of pelvic alignment in the sagittal plane on the range of rotation of the thorax, pelvis, and spine, and the movement of the center of mass during active rotation in standing.
Methods: This study examined 17 males with no musculoskeletal disorders. Using a three-dimensional motion analysis system, we measured the range of rotation of their thorax, pelvis, and spine, and the posterior and lateral movement of the center of mass during active rotation in standing. The anterior pelvic tilt in the starting position included three conditions: normal standing (neutral), 5 degrees anterior of neutral (anterior position), and 5 degrees posterior of neutral (posterior position). We compared the range of rotation and the movement of the center of mass in the three conditions.
Results: Regarding rotation, in the anterior and posterior positions, the range of thoracic, pelvic, and spinal rotation was significantly smaller than in the neutral position. In the posterior position, the range of spine rotation was significantly smaller than in the anterior position. Regarding the movement of the center of mass, in the anterior position, posterior movement was significantly smaller than in the neutral position and lateral movement was significantly larger than in the neutral position. In the posterior position, the posterior and lateral movements were significantly larger than in the neutral position.
Conclusions: These data suggest that pelvic alignment in the sagittal plane influences the range of rotation of the thorax, pelvis, and spine and the movement of the center of mass during active rotation in standing.

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Purpose: This study examined the factors influencing the maximal walking speed of patients with severe hip osteoarthritis.
Methods: Thirty-nine women with unilateral severe hip osteoarthritis participated in this study. The 10-meters maximal walking speed (MWS), range of motion (ROM) of the affected hip, maximal isometric muscle strengths around the bilateral hip and knee joints, and walking pain were measured. To determine whether any factor could predict the MWS, a step-wise multiple regression analysis was performed with MWS as the dependent variable and age, ROM, muscle strengths, walking pain, and the use of cane as independent variables.
Results: The multiple regression analysis demonstrated that the knee extensor strength on the unaffected side, hip abductor strength on the affected side, walking pain and the use of cane were significant contributors to MWS, accounting for 62% of the variability.
Conclusions: It was thought that the knee extensors on the unaffected side acted as accelerator compensating for the decreased ability on the affected side, and the hip abductors on the affected side acted as stabilizer of pelvic and trunk movements. From these results, we postulated that the strengths of the knee extensors on the unaffected side and hip abductors on the affected side and walking pain were particularly important factors determining the ability to walk in patients with severe hip osteoarthritis.

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Purpose: To identify the correlates to life-space in older adults using a structural equation modeling.
Methods: The participants were 322 older adults (average age 74.0 ± 5.5 years; men 96; women 225) who had a health checkup for preventing care needs. The life-space assessment (LSA) and general health, physical performance, physical/human environments, and engaging in hobbies as potential correlates to the LSA were measured by face to face survey. Structural equation modeling was used for identifying inter-relationships between the measurements.
Results: The structural equation modeling constructed the final model which was related between general health, physical performance, and physical/human environments and the LSA and between engaging in hobbies and physical function. The standardized estimation values in general health, physical performance, human environment, and physical/human environment to the LSA and in engaging in hobbies to physical function were -0.17 (p < 0.05), 0.11 (p < 0.05), 0.14 (p < 0.05), and -0.11 (p < 0.05), respectively. The overall fit of the model was statistically judged to be satisfactory (GFI = 0.93, AGFI = 0.90, RMSEA = 0.06).
Conclusion: General health and physical performance may play a key role to examine the improvement the life-space in healthy older adults.

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Purpose: The incremental shuttle walking test (ISWT) is used to estimate the peak oxygen uptake (peakV̇O₂) of individuals with chronic obstructive pulmonary disease (COPD). However, in Japanese older COPD, the application of the regression equation for estimated peakV̇O₂ is unknown. The purpose of this study was to compare estimated peakV̇O₂ and actual peakV̇O₂ using the ISWT.
Methods: Twenty clinically stable COPD patients (mean [SD] age = 77 [4] years; mean [SD] % predicted forced expiratory volume in 1 second = 65.9 [12.5]) were recruited from those with prior participation in an out-patient pulmonary rehabilitation program. Subjects carried out the ISWT, and determined walking distance. The test was used with a portable metabolic meter to measure actual peakV̇O₂. Estimated peakV̇O₂ was calculated using the single regression equation reported by Singh SJ et al. Subsequently, the measurement error of the estimated peakV̇O₂ was calculated 100 times using random numbers. Analysis of covariance (ANCOVA) testing was used to compare actual peakV̇O₂ and estimated peakV̇O₂ included measurement error, this analysis was also repeated 100 times.
Results: There was no significant difference between estimated and actual peakV̇O₂ by ANCOVA (p < 0.05) during 97 times.
Conclusions: The single regression equation reported by Singh SJ et al. was shown to be applicable for a population of older COPD.

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Purpose: The purpose of this study was to determine the factors associated with continuous home care services and effects of home-visit rehabilitation service in older individuals requiring home care.
Methods: Five facilities were randomly assigned to home-visit rehabilitation service and home-visit nursing or care service groups. The home-visit rehabilitation group included 33 older individuals (mean 78.8 ± 6.2 years) who participated in our study. Thirteen older individuals (mean 82.9 ± 7.5 years) who used home-visit nursing or care services constituted the control group. Older for three months and were assessed for grip strength, chair-stand test, functional independence measure, bedside mobility scale, vitality index, and the amount of time out of bed at baseline and after three months.
Results: In both groups, over 30% participants dropped out after 3 months. In the home-visit rehabilitation group, vitality index in participants who could not continue the home-visit rehabilitation were significantly lower as compared to individuals continued using home-visit rehabilitation. Assessment of interactions between time and group by repeated measure ANOVA adjusted for age and sex revealed a significant difference for the amount of time out of bed per day (p < 0.05). However, differences between two groups for physical functions, daily living functions, bedside mobility performance and caregiver burden were not significant.
Conclusion: These results suggested that the vitality was one of factors associated with continuous home-visit rehabilitation services. The home-visit rehabilitation might contribute to providing habitual exercise and increase the amount of time out of bed.

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Purpose: The purpose of this study was to describe the features of gait and activities of daily living (ADL) progress of two patients with toxic paraplegia (L1 level) due to intrathecal chemotherapy.
Methods: Based on clinical records for 1 year in term of Walking Index for Spinal Cord Injury (WISCI) and Functional Independence Measure (FIM), a retrospective study was executed.
Results: WISCI for both cases improved from level 0 to 15 in 3 months. FIM at 2 months after onset of gait disorder improved from 48 to 97 for case 1, and from 77 to 114 for case 2. WISCI and FIM showed improvement 1 year later.
Conclusion: The findings suggest that gait ability and ADL of two patients with toxic paraplegia (L1 level) due to intrathecal chemotherapy was greatly improved in a certain period, and improved for a long term afterwards.

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