Objective: We aimed to clarify the relationships between the International Classification of Functioning, Disability and Health (ICF) constructs of Activity and Participation in knee arthroplasty patients so that we could utilize them better in clinical practice to improve activity and participation.
Methods: Working with 118 elderly patients who underwent primary knee arthroplasty, we developed an evaluation to apply to body function, activity, participation, subjective health, and contextual factors. We used path analysis model construction preoperatively and six months post-operatively. We analyzed activity and participation using the ICF core sets for Osteoarthritis.
Results: Pre-operative path analysis showed significant structural pathways between muscular strength and activity, Timed Up and Go (TUG) test and activity, and activity and participation. In addition to the preoperative factor and knee pain and mental component summaries, we also evaluated mental component summaries and activity, gender and participation post-operatively.
Conclusion: The significant pathways suggest that treatments and interventions —such as joint arthroplasty—aimed at improving activity and participation for knee pain have both mental health and contextual factors.

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Purpose: We investigated five-year radiographic changes in the hip joints of children with cerebral palsy (CP) in relation to their Gross Motor Function Classification System (GMFCS) level after selective hip joint muscle-release surgery.
Methods: Thirty-three patients were enrolled in the study, and only those patients with CP classified as GMCFS level III-V and who could be followed for five years after surgery were selected. We evaluated migration percentage (MP), Sharp’s angle (SA), acetabular ridge angle (ARA), Shenton’s line, teardrop distance using radiography preoperatively and at one, three, and five years after surgery. We analyzed the data by two-way repeated-measures analysis of variance, and Bonferroni corrected multiple comparisons.
Results: Compared with preoperative measurements, hip MP significantly decreased in patients at all GMCFS levels at one, three, and five years postoperatively. In patients having GMFCS level III and IV, ARA significantly improved at three and five years postoperatively compared to preoperative measurements.
Conclusions: Hip MP improved in all patients at one year after surgery, indicating that there was no progression of latera subluxation during the five years after surgery. The results of SA and ARA evaluation demonstrated differences in improvement of acetabular shelf coverage in GMFCS level III and IV patients compared to GMCFS level V patients.

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Purpose: Patients with athetoid cerebral palsy typically have low back pain, and the low back pain manifests in different forms, such as continuous or intermittent pain. While the revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2) is used to evaluate the quality of pain. Hence, we aimed to elucidate the relationship between quality of pain and the effect of transcutaneous electrical nerve stimulation (TENS).
Methods: Eight adult patients with athetoid cerebral palsy and low back pain participated in this study. To assess the relationship between quality of pain and the effect of TENS, we used a crossover study design wherein all subjects underwent two different proceduresTENS and sham TENSto compare the immediate effect by SFMPQ-2.
Result: The effect of TENS showed different results based on the SF-MPQ-2 subscale.
Conclusion: As the effect of TENS is influenced by the quality of pain, it is important to evaluate the quality of pain by SF-MPQ-2 before performing TENS.

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Purpose: The purpose of this study is to examine the effectiveness of the McKenzie method (M group) or stretching (S group) or both (M+S group), for patients suffering from chronic non-specific low back pain with a duration of more than 6 months.
Methods: We divided 98 patients that showed the DP into 3 groups; 31 patients M group, 35 patients S group, 32 patients M+S group. We instructed once a week intervention and 4-weeks of self-exercise.
Results: All 3 groups accepted significant improvement before and after the intervention in all items of the VAS, chest lumbar part ROM, SF-36, JOABPEQ, ODI. Only the M+S group was more significantly improved than M group and S group in the item of the ROM. S group and M+S group were more significantly improved than M group in the item of the VAS and the ODI.
Conclusion: All 3 groups showed efficacy in all of pain, physical functions and mental functions before and after the intervention. The comparison between the groups showed a high effect in order of M+S group > S group > M group.

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Purpose: To investigate changes in gait performance and lower limb muscle strength in stroke survivors who continuously attended an adult daycare facility for 2 years.
Method: 126 stroke survivors (mean age, 63.7 years; mean time after stroke onset, 1.3 years) were enrolled in this study. Based on their gait speed at baseline, the participants were classified into the following three groups: 1) household ambulators (<0.4 m/s); 2) limited community ambulators (0.4–0.8 m/s); and 3) full community ambulators (>0.8 m/s). We investigated the gait performance and lower limb muscle strength at baseline and at 3, 6, 12, and 24 months after the subjects started to attend the adult daycare facility. The longitudinal changes of gait performance and lower limb muscle strength were examined.
Results: In the household ambulators, in comparison with baseline, the 10-m gait speed was significantly increased at 6, 12, and 24 months; the lower limb muscle strength on the affected side was significantly increased at 12 and 24 months. In the limited community ambulators, in comparison with baseline, 10-m gait speed was significantly increased at 6, 12, and 24 months, and the lower limb muscle strength on the affected side was increased at 24 months. No significant changes were observed in the full community ambulators.
Conclusion: These findings suggest that gait speed and lower limb muscle strength can improve even in chronic stroke survivors with relatively low gait performance when attending adult daycare facility.

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Purpose: The aim of this study was to determine changes in activities of daily living (ADL) among frail elders in need of care and the burden on their primary caregivers before and after a short-term stay in a geriatric health care facility. A comparison of the time absent from bed in home and facility environments was also conducted.
Methods: Subjects were short-term residential respite care recipients at a single facility in southeast Hyogo Prefecture and their primary caregivers. Primary caregivers reported on changes in ADL among frail elders in need of care and their degree of caregiver burden before and after a short-term stay in a geriatric health care facility. Staff at the health care facility reported on time absent from bed in facility environments. In addition, primary caregivers also reported on time absent from bed in home.
Results: A significant improvement in ADL was observed among frail elders in need of care after a short-term stay. Based on the results of multiple logistic regression analysis, the level of care required and the employment of the primary caregiver were extracted as factors related to significant changes in the burden on primary caregivers. No significant difference was observed in time absent from bed between home and facility environments.
Conclusion: Improvement in ADL was found after a short-term stay in a geriatric health care facility. These results also suggest that the burden of primary caregivers who have a work in daily life or care frail elders in need of high level care reduced or did not change.

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[in Japanese]

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[in Japanese]

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