Purpose: This study examined the relationship between preoperative physical activity and lower limb function before and after minimally invasive surgery for total hip arthroplasty (MIS-THA).
Material and method: Between July 2008 and December 2008, this prospective study enrolled 107 patients with osteoarthritis scheduled for MIS-THA. Sixty-six female patients were followed for 6 months postoperatively. The patients were divided into two groups according to physical activity (kcal/week) in the preoperative period: kcal/week ≥ 1,000, 44 patients; kcal/week < 1,000, 22 patients. Physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ). We used the IPAQ to assess physical activity in the preoperative period, and determined the isometric hip abductor strength, pain score, 10-m timed gait test, range of motion, Japanese Orthopedic Association Hip Score (JOA), work style, and barriers around the home. The evaluations were conducted preoperatively and at 2 and 6 months postoperatively. We examined the correlation between physical activity and pre- and postoperative hip abductor strength.
Results: The preoperative JOA, 10-m timed gait test, and work style differed significantly in the kcal/week < 1,000 group. Other factors did not differ significantly between the two groups. There was a significant correlation between the pre- and postoperative hip abductor strength at 2 months between the two groups. There was no significant correlation between physical activity and hip abductor strength.
Conclusion: This study found no relationship between preoperative physical activity and hip abductor strength in MIS-THA. In the kcal/week < 1,000 group, physical activity was affected by the preoperative JOA, 10-m timed gait test, and work style. The preoperative hip abductor muscle strength was a more important determinant of the postoperative hip abductor muscle strength in MIS-THA than physical activity.

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Purpose: The purposes of this study were to assess the trend of measurement errors, and to provide with clinically useful indexes for the standard error of measurement (SEM) and minimal detectable change (MDC) while measuring isometric knee extension strength using hand-held dynamometer with stroke patients.
Methods: Fifty-five stroke patients participated. Strength measurement was performed by two raters. One rater performed 2 measurement sessions of 2 repeated measurements. The other rater performed only second session. Bland-Altman analysis was used to assess the trend of measurement errors. Generalizability theory was used to estimate SEM and MDC in various measurement conditions in which the numbers of sessions or repetitions were changed.
Results: There were no fixed measurement errors, while proportional measurement errors were seen in both intrarater and interrater model. SEM and MDC were 1.8 kgf and 4.9 kgf in the intrarater model, 2.1 kgf and 5.8 kgf in the interrater model. They decreased under measurement conditions in which the numbers of sessions or repetitions were changed.
Conclusions: These results suggest that a clinically relevant measurement condition is 2 or 3 repeated measurements in a single session in the intrarater model, and 3 repeated measurements by a single rater in the interrater model.

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Purpose: The purpose of this study was to ascertain whether we could predict falls by the examination of vibration sense using a tuning fork.
Subject: The subjects were 62 community-dwelling elderly outpatients and day-care clients who could walk by themselves, and who had no disorders of cognitive function on the central nervous system.
Methods: We assessed them with an examination of vibration sense using a tuning fork and three performance tests (Timed “Up & Go” test, Modified functional reach test, Timed 10m walk test). In addition, subjects were monitored for six months after those assessments to learn whether they experienced a fall. They were then divided into a “fallers” group and a “non-fallers” group, and the measured values were compared. We calculated the cutoff value with Receiver Operating Characteristic (ROC) curve analysis on each performance test and vibration sense.
Results: There were 22 fallers (35.5%) during the six months, and the results for vibration sense of the non-fallers group were superior to those of the fallers group. The area under the ROC curve of vibration sense was equal to that of performance tests (0.83). The degree of sensitivity of vibration sense to falls was 77% (specificity: 68%, accuracy: 71%) when the cutoff value was estimated as 5.5 seconds.
Conclusion: The results suggested that the examination of vibration sense using a tuning fork is useful for fall prediction.

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Purpose: The purpose of this study was to draft of effective training methods of transversus abdominis muscle time is necessary to acquisition, tending to be difficult as for the coaching.
Methods: The subjects were healthy males who were examined in a sitting position with a stably maintained physiological lumber flexure under the following six conditions: grounding of both feet (stable or unstable seating face and plantar face), extended opposite knee joint (stable or unstable seating face and plantar face), extended opposite knee joint with a heavy burden (a bob of 2kg), and supine position. The thicknesses of the transversus abdominis, internal abdominal oblique muscle, and external abdominal oblique muscle were measured by ultrasound imaging under each condition and differences in these data were evaluated.
Results: Compared with measurements in the supine and seated positions with both feet in contact with the ground, the thickness of the transversus abdominis was significantly larger (p < 0.05) under the other four conditions. The thickness of the internal abdominal oblique muscle was significantly larger with an extended opposite knee joint (unstable seating face and plantar face) and an extended opposite knee joint with a heavy burden (p < 0.05).
Conclusion: These results suggest that conditions of an extended opposite knee joint (stable seating face and plantar face) in the sitting position with a stably maintained physiological lumber flexure and a sitting position with both feet in contact with the ground are effective for training since they promote selective constriction of the transversus abdominis.

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Purpose: The purpose of this study was to test the influence of task-oriented training combined with peripheral nerve sensory stimulation (PSS) on upper extremity function in 3 patients with hemiparetic stroke.
Methods: A single-subject design (A-B) with multiple baselines was used. Three stoke patients were randomly assigned to 1 of 3 treatment protocols with different baseline periods. Sham treatment was applied in baseline phase (A). PSS treatment was applied in treatment phase (B). Sham or PSS treatment was applied for 1 hour to peripheral nerves in the paretic hand followed by task-oriented training using the Box and Block Test (BBT) tasks 20 times. Average BBT score changes were analyzed in the training. In addition, BBT was measured at 24 hours after PSS treatment.
Results: All subjects exhibited greater improvement in average BBT scores after PSS treatment than after Sham treatment {case 1: + 4.9 (p < 0.05), case 2: +3.1, case 3: +5.7 (p < 0.05)}. The improvements were maintained after 24 hours. There were no adverse events, and PSS treatment compliance was good.
Conclusion: PSS for 1 hour may enhance the effects of task-oriented training in stroke patients, and the effects may last for at least 24 hours after PSS treatment.

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