Purpose: The purpose of this study was to investigate that the characteristic of the step leg motion that increase elbow valgus torque.

Method: Twenty-seven youth baseball pitchers participated in this study. Elbow valgus torque measurement and video analysis were performed on outdoor mound. The participants divided by the qualitative assessment of stride knee motion, then compared elbow valgus torque and flexion angle of step knee joint between both groups.

Result: There was significant greater flexion knee joint angle at maximum external rotation and ball release and greater joint torque of elbow and less ball speed for the forward movement group.

Conclusion: This group showed inadequate bracing the knee of step leg. It caused increasing elbow torque. To evaluate the stride leg motion is important for assessment of risk on elbow injury.

Purpose: The acute motor functional prognosis was evaluated in patients with branch atheromatous disease (BAD).

Method: Overall, 101 patients with BAD were enrolled from March 2016 to February 2019. Patients with paralysis in their upper limbs and lower limbs were classified into good and bad groups based on their paralysis status at discharge. The patients' age, gender, paralyzed side, National Institute of Health Stroke Scale (NIHSS) at admission, lesion area, infarct area, rehabilitation start date, Fugl-Meyer Assessments (FMA) of the upper and lower limbs, starting Mini-mental State Examination (MMSE) score, hospitalization days, OT session, and PT session were analyzed. Thereafter, univariate and logistic regression analyses were performed.

Results: The univariate analysis revealed significant differences in age, NIHSS at admission, infarct area, FMA, MMSE at initiation, and hospital days in both patients with paralysis in their upper and lower limbs. The logistic regression analysis revealed that FMA was an independent factor in both patients with paralysis in their upper and lower limbs. The cut-off values were 18 for the upper limb (area under the curve, 0.94; sensitivity, 0.80; and specificity, 0.93) and 19 for the lower limb (area under the curve, 0.88; sensitivity, 0.80; and specificity, 0.82).

Conclusion: The initial FMA in patients with BAD was most relevant to motor functional prognosis from the acute phase in the upper and lower limbs.

Purpose: The aim of this study was to evaluate the characteristics of sagittal knee joint kinematics and quadricep muscle activity during stair climbing in patients after total knee arthroplasty (TKA).

Methods: Eight and ten limbs were included in the TKA and control groups, respectively. The maximum knee extension moment (KEM) and maximum afferent and centrifugal knee power during stair climbing stance phases were measured by a three-dimensional motion analysis system. Maximum muscular activity of the quadriceps femoris was measured by surface electromyography.

Results: The knee joint load and afferent power in stair ascent of the TKA group was significantly lower than that of the control group. The centrifugal power in stair descent of the TKA group was significantly lower than that of the control group. Quadriceps activity during stair ascent was significantly higher in the TKA group than in the control group, and the descending muscle activity was low in both groups.

Conclusion: One year post-operation, TKA patients strongly contract the quadriceps during stair climbing, but the joint load and afferent power decreased during ascension and the centrifugal power decreased during descension.

Purpose: This study aimed to investigate the effectiveness of electrostimulation of the quadriceps for 4 days in the acute phase after total hip arthroplasty (THA).

Methods: In total, 52 women with hip osteoarthritis participated in this study. They were randomized to the control and intervention groups. The intervention group (n = 26; age 64.4 ± 8.9 years) underwent electrostimulation of the quadriceps twice a day during knee extension exercises for 4 days. The control group (n = 26; age 66.0 ± 9.9 years) performed knee extension exercises twice a day without electric muscle stimulation for 4 days. Additionally, both groups received the standard protocol in our hospital. Quadriceps strength, gait speed, and pain during gait in both groups were assessed 1 month before surgery and on Day 4 after surgery. Changes in quadriceps strength and gait speed were quantified as relative (percent) changes from the preoperative values (Δquadriceps strength and Δgait speed). Changes in pain during gait were quantified as relative (difference) changes from the preoperative values (Δpain during gait). The Mann–Whitney U test and unpaired t-test were used to compare these values between the groups. Significance was set at P < 0.05.

Results: Compared with the control group, the intervention group showed greater Δquadriceps strength (P = 0.014), Δgait speed (P = 0.009), and Δpain during gait (P = 0.027).

Conclusions: Electrostimulation of the quadriceps for 4 days in the acute phase after THA improves knee extensor strength and gait speed, and reduces pain during gait.

Purpose: The purpose of this study was to assess the effects of external glenohumeral rotation position on the posterior glenohumeral distance (PGHD) in asymptomatic throwing shoulders.

Methods: Eleven asymptomatic male college baseball players (11 throwing shoulders) participated in this research. The PGHD was calculated using MRI scans. MRI measurement positions were 90° of shoulder abduction with external rotations of 90°, 100°, and 110°.

Results: Measures of PGHD were significantly less during 110° external rotation compared to 90° external rotation.

Conclusion: The PGHD was significantly less when shoulder abduction occurred in more externally rotated positions.

Purpose: Approximately 80% of community-dwelling older adults present with musculoskeletal pain accompanied by low gait speed and grip strength. This study investigated the effects of acute or chronic back and knee pain on gait speed and grip strength in community-dwelling older adults.

Methods: This study included 735 community-dwelling older adults (aged ≥65 years, mean age 74.8 years, 62.9% women) (Tarumizu study 2018). Type of pain (acute vs. chronic) was determined using a questionnaire. We investigated the association between acute or chronic pain and low gait speed (<1.0 m/s) and low grip strength (men <26 kg, women <18 kg).

Results: Of the 735 participants, 347 (47.2%) reported no pain, 144 (19.6%) reported acute pain, and 244 (33.2%) reported chronic pain. Low back and knee pain were observed in 121 participants (16.5%), of which 46 (38.0%) reported acute pain and 75 (62.0%) reported chronic pain. Logistic regression analysis revealed that low gait speed was significantly associated with chronic pain (adjusted odds ratio 2.55, p = 0.001) but not with acute pain (adjusted odds ratio 1.19, p = 0.632) (adjusted for age, sex, the 15-item Geriatric Depression Scale, medication use, the Appendicular Skeletal Muscle Mass Index, and grip strength). Notably, no association was observed between pain and low grip strength.

Conclusion: Community-dwelling older adults with chronic low back and knee pain showed low gait speed.

Purpose: This study investigated the combined effects of the McKenzie method, deep cervical muscle exercise, and physical agents in patients with degenerative disorders of the cervical spine.

Methods: Study participants included 112 patients diagnosed with degenerative disorders of the cervical spine at our hospital. The patients were divided into three therapeutic groups, which were treated with: the McKenzie method and physical agents (MDT group, 51 cases); the McKenzie method, deep cervical muscle exercise, and physical agents (DCME group, 43 cases); and physical agents alone (physical agents group, 18 cases). The effects of these therapies were evaluated using the active ROM of cervical spines (hereafter, CROM), Neck Disability Index (NDI), JOACMEQ, Visual Analogue Scale (VAS) scores for neck pain, and SF-8 before therapy and 1, 2, 3, and 5 months after therapy. Statistical analysis was performed using the mixed-effects model for repeated measures.

Results: The following evaluation items showed interaction. Compared with before therapy, CROM, NDI, JOACMEQ, and SF-8 scores were significantly improved 1 month after therapy in the MDT and DCME groups. VAS scores significantly improved 1 month after therapy in the MDT and DCME groups, and 2 months after therapy in the physical agents group. These effects were highest in the MDT group, followed by the DCME group and the physical agents group.

Conclusion: Compared to physical agents alone, MDT and DCME resulted in greater symptomatic, functional, and psychological improvement.

Purpose: This retrospective study aimed to clarify the associations between nutritional status and walking ability at discharge in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: We enrolled 101 patients hospitalized for AECOPD and who underwent physical therapy. Walking ability was assessed by Functional Independence Measure (FIM). The subjects were classified into the independent group (FIM ≥6) and non-independent group (FIM <6) by walking ability at discharge. The presence of malnutrition (% ideal body weight <80%) and adequacy of caloric intake (% estimated target calories: intake/estimated target calories × 100) were examined as indices of nutritional status. Multivariate logistic regression analysis was performed to assess whether nutritional status affected walking ability at discharge (FIM ≥6 or FIM <6) adjusted by age, A-DROP, and severity of airflow obstruction.

Results: Despite being independent before hospitalization, 21 patients could not walk independently at discharge, and 31 patients had malnutrition before admission. The average % estimated target calories was 78.7 ± 31.7%. Multiple logistic regression analysis showed presence of malnutrition (OR 3.9, 95% CI 1.3–11.7, p<0.05) and % estimated target calories (OR 0.7, 95% CI 0.5–0.9, p<0.05) to be significantly associated with walking ability at discharge.

Conclusion: Nutritional status affected walking ability of AECOPD patients at discharge. Therefore, nutritional status should be evaluated when providing effective exercise and adequate nutritional therapy during hospitalization. These findings may imply that oral nutritional supplements should be provided immediately after hospitalization for patients with inadequate caloric intake.

Purpose: This study aims to assess the relationship between blood data and the safety and feasibility of physical therapy in lymphoma patients with cytopenia.

Methods: Total 79 patients with lymphoma who underwent chemotherapy were included in this study. All patients received exercise therapy (13 on the Borg scale) six days per week, 20 min per day. Physical therapy adherence (implementation/scheduled days) was calculated after stratification according to the white blood cell and platelet counts. In addition, the occurrence of adverse events was investigated.

Result: The median physical therapy adherence rate of the patients was high at 96.8% (range, 61.7%-100.0%), and no adverse events were observed during or after the physical therapy. However, the adherence rate significantly decreased when the white blood cell count was <1,000/µL and platelet count was <20,000/µL (p < 0.001).

Conclusion: The results of this study suggest the safety of exercise therapy in patients with lymphoma. In addition, the results suggest that decreased white blood cell and platelet counts are associated with poor physical therapy adherence.

Purpose: This study aimed to assess the reliability and validity of the Japanese version of the Trunk Impairment Scale (TIS-J) for patients with spastic cerebral palsy.

Methods: A cross-sectional study was conducted, in which a total of 69 patients were enrolled. The reliability of the results were tested for 20 patients by intra-rater and inter-rater reliabilities and minimal detectable change at 95% confidence interval (MDC95), and construct validity by comparing them with the Gross Motor Function Classification System scores.

Results: The intra-class and interclass correlation coefficients for test–retest reliability were 0.90–0.99. The intra-rater MDC95 values for static sitting balance, dynamic sitting balance, coordination, and total score were 0.44, 1.35, 0.44, and 0.96, respectively, while the inter-rater MDC95 values for the same were 1.54, 1.97, 1.15, and 2.37. The Spearman correlation coefficient were –0.63, –0.76, –0.30, and –0.74. It revealed a good relationship for validity between the change in score for the dynamic sitting balance and total TIS-J scores.

Conclusions: The TIS-J was found to be reliable and valid for patients with spastic cerebral palsy.