Purpose: The purpose of this study was to extract the kinetic and kinematic factors of the sit-to-stand (STS) movement of stroke patients. To determine these factors, we analyzed the relationship between patient kinetic and kinematic data and indices of physical ability.
Methods: Thirty four subjects who had experienced stroke performed the STS movement from a stool, and their movement was measured by a motion analysis system (VICON). The relationship between kinetic and kinematic data and indices of physical ability (gait speed, the functional independence measure, and the Fugl-Meyer Assessment) was analyzed using the Spearman rank correlation coefficient.
Result: The execution time of STS and the ratio of the load on the affected side at seat-off correlated with many physical ability indices. The anteroposterior movement range of the center of pressure during STS correlated with the following kinetic and kinematic factors. The duration of momentum phase, which began with initiation of movement and ended just before the buttocks were lifted from the chair (Phase 1) correlated with the lower limb functions of the affected side as well as with the balance function. The duration of extension phase, which began with maximal ankle dorsiflexion and ended with hip extension (Phase 3) correlated with the balance function.
Conclusions: The following kinetic and kinematic factors were determined to be useful as indices for the mechanical evaluation of STS movement in stroke patients: execution time of STS, ratio of the load in the affected side at seat-off, and the anteroposterior movement range of the center of pressure during STS. Results revealed that the lower limb functions of the affected side are important to Phase 1 while the balance function is important to both Phase 1 and Phase 3.

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Purpose: The purpose of this study was to assess the difference of between the effect of muscle strengthening and combined functional training with muscle strengthening on everyday function in community-dwelling elderly individuals who had risks for functional decline.
Subjects: Sixty eight specified elderly subjects using adult day-care service were participated in the study, and were assigned to muscle strength group and functional training group.
Methods: The muscle strength group (n = 40) performed resistance training with leg press machine which intensity was 60% maximum voluntary contraction, and conducted strength training with weight in lower extremity muscles. The functional training group (n = 28) were executed balance and gait exercise consisted of standing balance exercise on form mat and tandem walking, and walking exercise with weight and long distance walking, in addition to muscle strength training. The subjects were measured 1 repetition maximum of leg press machine (1RM), one leg standing time (OLS), functional reach test (FR), timed “Up & Go” test (TUG), maximum walking speed (MWS), Tokyo Metropolitan Institute of Gerontology index, the basic checklist and self-perceived health in before and after the training. The exercise intervention was performed for 3 months, 1 time weekly.
Results: The functional training group showed significant improvements in TUG, MWS and self-perceived health than the muscle strength group after exercise intervention. There were main effects in 1RM, OLS, FR, however, no interactions were found.
Conclusion: The results suggested that the combination of functional training and muscle strength training was useful to maintain/improve gait performances and self-perceived health than muscle strength training only in the specified elderly individuals.

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Purpose: The purpose of this study was to develop a new scale, the Stroke Physical Performance Scale (SPPS), based on the Rasch model. The SPPS evaluates physical performance in a standing position and during ambulation related to the activities of daily living (ADL) of stroke patients.
Methods: A preliminary scale was developed that consisted of 25 items representing physical performance selected by observation of the ADL. This scale was tested for stroke patients (N = 102) in 2 rehabilitation hospitals using 5-level rating categories. Their responses were analyzed using the Rasch model to select rating categories and items. After the development of the SPPS, we investigated its unidimensionality and reliability.
Results: The rating category analysis integrated the category of “supervision” into “light assistance”, so that rating involved 4-level categories. The item selection analysis excluded 9 items, the SPPS therefore became a 16-item scale, which fitted the Rasch model. The SPPS demonstrated good unidimensionality and reliability.
Conclusion: The SPPS was constructed as a scale to evaluate physical performance in a standing position and during ambulation related to the ADL of stroke patients. It may be valuable to evaluate changes in physical performance using an interval scale both in a clinical setting and for clinical research.

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Purpose: We aimed to evaluate whether synchronization between cardiac and locomotor rhythms during walk results from an entrainment or occurs just by chance.
Method: Nine healthy men participated in this study. Each subject walked at the frequency of his heart rate on a treadmill. Synchrogram and histogram data during the walk were generated based on the electrocardiogram and foot switch signals. We also generated surrogate data by randomly sorting the original data of the locomotor rhythm, and then compared the two data.
Result: The cardiac-locomotor synchronization was observed in 7 of the 9 subjects. There was a significant difference between the original and the surrogate data. This result may indicate that the observed synchronization between the cardiac and locomotor rhythms represented entrainment.
Conclusion: Walking at the frequency of heart rate would induce the cardiac-locomotor synchronization by entrainment.

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Purpose: We aimed to return using the toilet of a patient with distal myopathy by using exercise therapy.
Methods: The patient was a 65-year-old woman who had developed depression and had therefore experienced long-term immobility. She had developed deteriorating the muscular strength and was restricted to diaper use. On alleviation of the depression, the patient wanted to use the toilet by herself. We used PNF muscle strengthening exercises to help the patient regain continence, while taking care to prevent overuse syndrome. This therapy was performed in 7 stages and we assessed the results in each stage. We also assessed the patient's muscular strength by using a handheld dynamometer and measured muscle thickness by ultra sonography.
Results: After 4 weeks, the patient's muscular strength improved. After 8 weeks, she could operate the toilet without wearing her under-pants and pants.
Conclusions: The muscular strength of a distal myopathy patient who has experienced long-term immobility can be improved by exercise, while taking care to prevent overuse syndrome.

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Purpose: The purpose of this study is to clarify the process of regaining the activities of daily living (ADL) of stroke patients and femoral neck fracture patients.
Method: From the data registered in the rehabilitation patient database produced by the Japanese Association of Rehabilitation Medicine, 1,820 cases of stroke and 247 cases of femoral neck fracture were extracted and studied. With the Rasch analysis, difficulty and fit index were obtained for each of 13 items related to movement in the functional independence measure (FIM).
Result: In the case of stroke, there existed the ADL group with intermediate difficulty. In the case of femoral neck fracture, the difficulty of changing dressing-upper body was lower than that in the case of stroke, but the order of ADL difficulty was not so different between the two cases.
Conclusion: Based on analysis of this database the study found that there are differences in the ADL structures between the stroke patients and the patients with femoral neck fracture. The difference occurs from the different functional disorder levels: the stroke patients have the unilateral paralysis of upper and lower extremities, while the patients with femoral neck fracture have injury of a single extremity. It is considered that understanding the ADL structures of both diseases provides useful knowledge for the advancement of the ADL assessment and physical therapy.

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