Objective: This study investigated the extent to which Japanese healthcare providers implemented rehabilitation protocols before and after total knee arthroplasty (TKA).

Methods: We sent a questionnaire to 442 hospitals and clinics that performed rehabilitation before and after TKA surgery. This questionnaire asked whether they implemented the rehabilitation protocol before and after TKA and whether the protocol was evidence-based. In addition to descriptive analysis, we used logistic regression analysis to examine differences in the number of hospitals and clinics that implemented the protocol considering the number of TKA surgeries.

Results: A total of 185 hospitals responded to the questionnaire. The number of hospitals that implemented the preoperative rehabilitation protocol (45.4%) was smaller than that of those that implemented the postoperative rehabilitation protocol (87.6%). Although we found no significant differences in the number of hospitals that implemented the preoperative rehabilitation by the number of TKA surgeries, there was a significant difference in the number of hospitals that implemented the postoperative rehabilitation by the number of TKA surgeries. Furthermore, we found no significant difference in the number of hospitals that implemented preoperative or postoperative rehabilitation by the location of the hospital.

Conclusions: Fewer hospitals implemented the rehabilitation protocol before TKA compared to after TKA. The number of hospitals that implemented the postoperative rehabilitation protocol varied with the number of TKA surgeries.

Objective: This study aimed to clarify whether the presence of mild cognitive impairment (MCI) limits the effects of sub-acute phase physical therapy (PT) on activities of daily living (ADL) improvement in patients with heart failure.

Methods: This was a single-center case-control study. In total, 155 patients who performed ADL independently before hospital admission were included in the analysis. The patients were divided into an MCI and a control group. Physical function before and after PT in the hospital were compared between the groups. Additionally, multiple regression analysis was used to evaluate the associated factors of the Barthel index (BI) at hospital discharge.

Results: At the commencement of PT, short physical performance battery (SPPB) and BI were significantly lower in the MCI group. At hospital discharge, the MCI group had significantly lower SPPB and 6-minute walking distance. However, there were no significant differences in BI at hospital discharge between the groups. Multivariate analysis showed that SPPB was associated with BI at hospital discharge.

Conclusion: Heart failure patients with MCI had a higher risk of BI decline at admission than patients in the control group, but the effect of PT on BI improvement was found to be similar regardless of MCI status. This may allow heart failure patients with MCI to perform ADL independently again.

Objectives: This study aimed to investigate the relationships between ultrasound (US) and physical examination findings of the medial epicondyle of humerus based on baseball elbow screening conducted in Hakodate City, Hokkaido, in 2019.

Methods: The subjects were 259 elementary school baseball players. US findings were classified into positive and negative groups. The players were listening for their physical characteristics and conducted the physical examination. Items with significant differences between the two groups were investigated in a logistic regression analysis.

Results: Results indicated that 30 and 205 players had positive and negative US findings, respectively. There were significant differences between the two groups in the age, height, position, history of elbow pain, pain at end-range elbow flexion/extension, tenderness of the medial epicondyle of humerus (TD), moving valgus test (MVT). The logistic regression analysis extracted age, TD, and MVT.

Conclusions: Among players with positive US findings, high odds ratios were found for age, TD and MVT.

Objective: To investigate the association between apathy and physical activity in elderly individuals requiring support and nursing care.

Methods: The physical activity scale for the elderly, apathy, health locus of control, self-rated health, and short physical performance battery were evaluated in 65 elderly individuals requiring support and nursing care. In the statistical analysis, the physical activity scale for the elderly results were divided into three groups: low, moderate, and high. Then, each variable was compared among the three groups. Additionally, multiple regression analysis was performed with physical activity scale for the elderly as the dependent variable and each evaluation item as independent variables.

Results: Compared with the high physical activity group, the low physical activity group showed significantly worse values for the apathy score, health locus of control scale, and measured 4-m walking time in the short physical performance battery. The apathy score and 4-m walking time remained significant factors even on multiple regression analysis.

Conclusion: Apathy and 4-m walking time were associated with the physical activity in elderly individuals requiring support and nursing care.

Objectives: By contrasting elite male swimmers without a history of low back pain, the aim of this study is to explain the characteristics of trunk alignment during a streamlined position in elite male swimmers with a history of low back pain.

Methods: A total of 24 male elite swimmers were divided into two groups: one with a history of low back pain and the other without (LP: 9 swimmers with low back pain, NP: 15 swimmers without low back pain). The trunk alignments during a stance and a streamlined position on the ground were assessed to investigate the differences in the flexibilities of the shoulder girdle, ribcage, and hip. To compare the outcomes of the two groups, a T-test was performed.

Results: During the streamlined position, there was a significant difference in the pelvis, trunk, and lumbar angle, while there were no significant differences during the stance position. In comparison with NP, the lumbar lordosis angle, pelvic anterior tilting angle, upper trunk posterior tilting angle, and upper trunk extension angle were all greater in LP. Moreover, the flexibility of the lower ribcage was also found to be slightly lower in LP during the streamlined position, with no differences in the stance position.

Conclusions: We clarified that swimmers with a history of low back pain were unable to control their trunk alignment during a streamlined position. In LP, the lack of flexibility in the lower ribcage was shown, implying that it may be a major contributor to excessive lumbar lordosis in a streamlined position.

Purpose: The purpose of this study was to examine the effects of low-frequency intervention combining exercise therapy with the Gait Exercise Assist Robot (GEAR) in patients with chronic hemiplegic stroke.

Methods: The participant was a 47-year-old male patient with stroke with right hemiparesis (13 months post-stroke). This study used an ABAB single-case design. The participant underwent a combination of ground-based walking exercise and physical therapy during the A period and exercise with the GEAR and physical therapy during the B period. Both periods were conducted twice a week for 4 weeks for a total of 16 weeks. The walking speed, step length, cadence, physical and cognitive function, and gait pattern were evaluated.

Results: The walking speed improved during the initial and secondary B period, cadence increased during the secondary B period, and gait pattern improved before and after the intervention.

Conclusion: Low-frequency intervention combining exercise with the GEAR and physical therapy appears to improve gait ability in patients with chronic stroke hemiplegia.

Objective: This study aimed to describe the effects of body weight-supported treadmill training (BWSTT) on two stroke patients with cerebellar ataxia.

Methods: Two inpatients post cerebellar infarction (a female, about 50 years old; and a male, about 60 years old) participated in this study. This study was conducted in an A-B-A single-subject research design. The baseline phase (A) and intervention phase (B) lasted for 10 days. The patients received physical therapy focusing on limb and trunk coordination, standing balance, and overground walking training in phase A. In phase B, these patients underwent BWSTT in conjunction with the therapies performed in phase A. Outcome measures included maximum walking speed, step length, cadence, the Timed Up and Go test, the Scale for the Assessment and Rating of Ataxia (SARA), the Berg Balance Scale (BBS), the Functional Assessment for Control of Trunk, and the Functional Ambulation Category.

Results: In both cases, maximum walking speed was significantly improved in the intervention phase (B) compared to the baseline phase (A). On the other hand, there was no difference in the SARA (gait, stance, and heel-shin slide) and BBS between phases A and B.

Conclusions: BWSTT can improve ambulatory function in stroke patients with cerebellar ataxia.

Objective: This research sheds light on the relationship between work engagement, workaholism, and lower back pain in nurses from a perspective of mental health. The study focused on the labor productivity of nurses in real-world settings.

Methods: Seventy-three female ward nurses participated in this study. An anonymous, self-administered questionnaire survey was conducted with the participants. Survey items were as follows: labor productivity, work engagement, workaholism, the presence and duration of lower back pain.

Results: In terms of absolute presenteeism, a significant positive correlation was observed between the work engagement scores, but no significant correlation was observed between the workaholism scores. Significantly lower scores for work engagement were observed in the lower back pain group than in the non-lower back pain group. No significant difference was observed between these groups in terms of workaholism.

Conclusion: The presence or absence of non-specific low back pain and work performance were independent factors explaining work engagement, suggesting the importance of positive mental health.