Physical Therapy Japan
Online ISSN : 2189-602X
Print ISSN : 0289-3770
ISSN-L : 0289-3770
Volume 43, Issue 6
Displaying 1-11 of 11 articles from this issue
Research Reports (Original Article)
  • Mikiko HASEGAWA, Osamu NITTA, Tetsuo IKAI
    2016 Volume 43 Issue 6 Pages 439-444
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: September 26, 2016
    JOURNAL FREE ACCESS

    Objective: The aim of this study was to examine the reliability and validity of the Gross Motor Function Measure (GMFM) as gross motor function measure for Fukuyama Congenital Muscular Dystrophy (FCMD) patients.

    Method: Subjects were 38 FCMD patients (20 males and 18 females), and the average age was 10.5 years (3-20 years old). One physical therapist evaluated the motor function of all patients by using the GMFM, and at the same time, confirmed the motor function level in Fukuyama Congenital Muscular Dystrophy (motor function level). To investigate the reliability and validity, and to obtain measurement of the internal consistency at Cronbach’sα, the test retest method was utilized to calculate standard error of measurement (SEM) of interclass correlation coefficient (ICC). The validity examined the correlation between of GMFM and motor function level and the correlation of age and exercise capability in every aspect in coefficient correlation of Spearman.

    Results: All aspects were 0.96 or more in the ICC, and Cronbach’sα was 0.96, and SEM were 2.1–4.3%. GMFM is correlated with all motor function level, 0.90 or more. From a scatter diagram, the relations of age with every aspect were able to be confirmed, the correlation was 0.70–0.75.

    Conclusion: GMFM high reliability and validity as gross motor ability evaluation scale of FCMD could be confirmed.

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  • Tetsuo AKIYAMA, Noboru SEKIYA, Daisuke NAKAMURA, Arinori KAMONO
    2016 Volume 43 Issue 6 Pages 445-452
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: September 27, 2016
    JOURNAL FREE ACCESS

    Purpose: In recent studies, the potential utility of prosthesis/orthosis with a functional sole shape and gait evaluation through the sole shape has been suggested by the coordinate transformation of center of pressure (COP) trajectories from laboratory-based coordinate systems into body-based coordinate systems. However details of the functional plantar shape during normal walking are yet to be completely elucidated. The present study aimed to clarify intra- and inter-subject variation, differences due to conventions of the local coordinate system and applied methods of curve-fitting, and the speed dependency of sole shapes.

    Method: Subjects walked along an 8-m walkway at five different speeds. Center of foot pressure and three-dimensional kinematics were measured. The measured data were transformed into two types of body-based coordinate systems, and two types of curve-fitting were then performed.

    Results and conclusions: Intra- and inter-subject COP trajectory variation was extremely small. At extreme speeds, particularly at the fastest, the trajectory variationincreased in a few subjects. Coordinate transformation type was not found to affect trajectory consistency, whereas cubic curve approximation was slightly better than circular approximation. The relationship between major events during the walking cycle and COP trajectory was found to be speed dependent. Thus, the circular shape of COP trajectory obtained using the leg coordinate system indicates the potential utility of this shape for gait evaluation and orthosis/prosthesis with a fixed ankle joint, expect for use during fast walking.

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  • Mifuka OUCHI, Kumiko KATO, Shigeyuki SUZUKI
    2016 Volume 43 Issue 6 Pages 453-460
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: September 28, 2016
    JOURNAL FREE ACCESS

    Purpose: We investigated the effect of pelvic floor muscle training (PFMT) on pelvic floor function, urogenital symptoms, and quality of life (QOL) in patients with mild pelvic organ prolapse (POP) using objective outcome measures.

    Method: Women who were diagnosed with stage II POP by a urologist were included in this study. All participants underwent PFMT for 16 weeks. A physical therapist asked them to attend six appointments for individual intervention during the study period. We assessed pelvic floor muscle strength, degree of pelvic organ descent, urogenital symptoms, and QOL scores and compared them between baseline and after PFMT.

    Results: Seventeen female participants aged 67.5 ± 7.0 years were included in this study. Pelvic floor muscle strength and the descent of the anterior vaginal wall were significantly improved after PFMT (p < 0.05). There was significant improvement of voiding frequency, stress urinary incontinence, post micturition dribble, and vaginal bulge interfering with emptying bowels (p < 0.05). The scores of physical limitations (p < 0.05) and emotions (p < 0.01) in the QOL questionnaire were significantly improved compared with the baseline results.

    Conclusion: The present study indicates that PFMT may improve pelvic floor muscle function, position of the anterior vaginal wall, some urogenital symptoms, and QOL in patients with mild POP.

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  • Tomohiro OKA, Yoshinori HIYAMA, Osamu WADA
    2016 Volume 43 Issue 6 Pages 461-468
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: September 29, 2016
    JOURNAL FREE ACCESS

    Purpose: This study aimed to evaluate pain control using the self-check sheet following early discharge after total knee arthroplasty (TKA), and to determine its effectiveness for prevention of pain and maintenance of range of motion (ROM) in the early postoperative period.

    Methods: Fifty-five patients who had undergone TKA participated in this study. The patients were randomized into one of two groups: the self-check intervention group or the control group. I explained how to manage pain by myself after the discharge both groups, self-check sheet was distributed by the self-check intervention group. Pain associated with walking, pain associated with going up and down stairs, and the ROM of the knee were evaluated. A comparison between the two groups of the differences with 5 days and 2 weeks after TKA were analyzed via student t-test.

    Results: There was a significant difference between pain with walking, pain with going up and down stairs, and knee flexion ROM. They were improved by the self-check intervention group.

    Conclusions: Pain management using the self-check sheet after early discharge of TKA patients was effective for prevention of pain and maintenance of ROM in the early postoperative period.

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  • Tsuyoshi TATEMOTO, Tomofumi YAMAGUCHI, Shigeo TANABE, Yohei OTAKA, Kun ...
    2016 Volume 43 Issue 6 Pages 469-476
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: October 14, 2016
    JOURNAL FREE ACCESS

    Purpose: The purpose of the study was to examine the effects of scalp-cortex distance on motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) in the lower limb motor cortex.

    Methods: Ten healthy adults participated in the study. The MEPs evoked by TMS of the left primary motor cortex of the lower limb were assessed. The stimulation intensity was set at 100%, 110%, 120%, 130%, and 140% of the resting motor threshold (rMT). MEPs were recorded from the right tibialis anterior muscle. The distance between the scalp and the left precentral gyrus was calculated from T1-weighted magnetic resonance images of the brain. We examined the correlations between the scalp-cortex distance and the values of rMT, MEP amplitude, and the root mean square value (RMS) of electromyogram signal in a 100 ms window between 20 ms and 120 ms after TMS using Spearman’s rank correlation coefficients.

    Results: There were significant correlations between the scalp-cortex distance and the MEP amplitude at 140% rMT, and between the scalp-cortex distance and RMS at 140% rMT.

    Conclusion: Our findings suggest that the scalp-cortex distance affects the TMS evaluation of the lower limb motor cortex excitability.

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  • Kazuki FUJITA, Hiroichi MIAKI, Takao NAKAGAWA, Hideaki HORI, Yasutaka ...
    2016 Volume 43 Issue 6 Pages 477-485
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: October 15, 2016
    JOURNAL FREE ACCESS

    Purpose: The purpose of this study was to investigate the impact of botulinum toxin type A (BoNT-A) administered for lower limb spasticity on the gaits of hemiplegic stroke patients.

    Methods: Subjects comprised 15 chronic stroke patients at least 6 months after their stroke. A total of 300 units of BoNT-A was injected into the gastrocnemius, soleus, tibialis posterior, flexor digitorum longus and/or flexor hallucis longus according to each patient’s condition. Each subject was asked to walk 10 m, and lower limb electromyography (EMG), gait velocity, gait cycle, and stride length were measured before and 2 weeks after BoNT-A injections. For EMG analysis, the gait cycle was divided into phases (i.e., loading response, single support, pre-swing, and swing), and the average amplitude and coactivation index of each phase were calculated.

    Results: After BoNT-A treatment, there was a significant increase in the muscle activity of tibialis anterior (97.3%–111.0%), significant decrease in the muscle activity of soleus (176.3%–142.4%), and significant increase in the coactivation index of rectus femoris and biceps femoris (112.9%–129.5%) during the loading-response phase. There were no significant differences in spatial or temporal parameters before and after treatment.

    Conclusion: BoNT-A treatment changed soleus muscle activity during gait, which resulted in changes in the muscle activity of tibialis anterior and the coactivation of knee joint. However, the lack of change in spatial and temporal parameters indicated that walking ability was not improved by BoNT-A treatment alone. Therefore, while BoNT-A treatment resulted in changes in lower limb muscle activity, it is unlikely that it alone can improve spatial and temporal parameters.

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  • An Investigation using Multiple Baseline Design Across Participants
    Yuji KAWABATA, Yuta KARIMATA
    2016 Volume 43 Issue 6 Pages 486-492
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: October 18, 2016
    JOURNAL FREE ACCESS

    Purpose: To clarify whether the decrescent insertion of a shoe lift is effective for reducing perceived leg length discrepancy after total hip arthroplasty.

    Methods: Six patients who underwent primary unilateral total hip arthroplasty were included. The study was a multiple baseline design across participants. The independent variable was the presence or absence of a shoe lift, and the dependent variable was the perceived leg length discrepancy. In phase A, range of motion exercises, muscle strengthening exercises, and gait exercises were performed by the patients. In phase B, gait exercises using the shoe lift were performed by the patients in addition to the exercises in phase A. Six patients were randomly assigned; two patients performed phase A exercises on postoperative days 3–9 and phase B exercises on postoperative days 10–30, two patients performed phase A exercises on postoperative days 3–16 and phase B exercises on postoperative days 17–30, and two patients performed phase A exercises on postoperative days 3–23 and phase B exercises on postoperative days 24–30.

    Results: Results of the randomization test revealed that the reduction of the perceived leg length discrepancy was significantly higher in phase B than in phase A.

    Conclusion: The results suggest that it is useful to insert a shoe lift to reduce perceived leg length discrepancy after total hip arthroplasty.

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  • Yuki TAKEDA, Yosuke ISHINO, Mariko TAKEDA, Kuniaki YAMASHITA, Atsuo SA ...
    2016 Volume 43 Issue 6 Pages 493-500
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: October 25, 2016
    JOURNAL FREE ACCESS

    Purpose: It has been widely reported that walking speed is related to the lower limb muscle strength in the paretic side of convalescent and chronic stroke patients, but only weakly related to the non-paretic side. However, there is lack of research on acute stroke patients. The purpose of this research was to clarify the relationship between paretic / non-paretic lower limb muscle strength and walking speed in acute stroke patients.

    Methods: The subjects were 118 hospitalized stroke patients, who were assessed within the 30 days following stroke onset. The extension muscle strength of the isometric knee joint on the paretic and non-paretic side were evaluated using (1) analysis of variance and multiple comparison of 3 groups based on walking speed; (2) correlation analysis of all patients and of 3 groups based on walking speed, and (3) multiple variable regression with the walking speed as a dependent variable.

    Results: Results showed a moderate correlation between strong muscle strength of paretic / non-paretic isometric knee joint extension and fast walking speed. The extension muscle strength of the isometric knee joint on the paretic side was extracted as a significant explanatory variable by multiple variable regression. These results were not found for the non-paretic side.

    Conclusion: The findings showed that lower limb muscle strength of the paretic side was related to walking speed in not only convalescent and chronic, but also in acute stroke patients.

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Brief Report
  • Takeshi OHNUMA, Tsutomu ABE, Shinobu FUKUYAMA, Hiroyuki ABE, Miki KOYA ...
    2016 Volume 43 Issue 6 Pages 501-507
    Published: 2016
    Released on J-STAGE: December 20, 2016
    Advance online publication: September 14, 2016
    JOURNAL FREE ACCESS

    Purpose: The purpose of this retrospective study was to follow the change in long-term care levels in users of home-visit rehabilitation service.

    Methods: Home-visit rehabilitation service users were evaluated (n=510, mean age ± SD, 76.4 ± 11.5) who had used the service for more than 1 year. We investigated the frequency of home-visit rehabilitation each week, participation in other rehabilitation services, and the presence of early intervention home-visit rehabilitation. The change in long-term care levels between the start of home-visit rehabilitation to the timing of this initial investigation were compared. A logistic regression analysis was conducted to investigate the factors associated with care levels changes.

    Results: Long-term care levels were significantly improved at the timing of investigation compared with levels at the start of the home-visits. Factors that were associated with improvement for long-term care levels were age (odds ratio [OR] = 0.967, 95%confidence intervals [CI]: 0.950–0.983, p < 0.001), and the early intervention of home-visit rehabilitation (OR = 1.950, 95%CI: 1.076–3.533, p < 0.05). Factors that deteriorated long-term care levels were age (OR = 1.049, 95%CI: 1.027–1.070, p < 0.001).

    Conclusion: Early intervention of home-visit rehabilitation may promote improvement for levels of long-term care. For people requiring long-term care, starting home-visit rehabilitation as soon as possible is helpful for supporting and continuing a stable home life.

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