Objectives: We examined changes in motor function over time in Fukuyama congenital muscular dystrophy (FCMD) patients.

Methods: The subjects were 57 FCMD patients. Motor functions were evaluated using the gross motor function measure (GMFM). The subjects were grouped according to genotype, and GMFM score transitions were observed for each individual. We determined each GMFM score monthly and performed a regression analysis for all data obtained, using a least-squares method. The age at peak GMFM score (peak age) was also studied based on regression analysis results for all cases and for each clinical severity.

Results: The monthly course of GMFM scores showed a biphasic pattern comprised of a rapidly increasing phase, followed by a slowly decreasing phase. According to genotypes, the range of GMFM scores was greater in compound heterozygotes than in homozygotes. The peak motor function ages of severe, typical and mild cases, based on an approximated graph for each, were 20, 48 and 68 months, respectively. The peak GMFM score in typical cases was 28 for homozygous and 18 for compound heterozygous cases.

Conclusion: Changes in FCMD motor function over time showed a rapidly increasing phase, followed by a slowly decreasing phase. The peak ages, in the approximated graphs, differed according to clinical severity. Among typical cases, compound heterozygotes tended to have poorer motor skills than homozygotes.

Objective: To examine the effects of posture differences on the thickness of the abdominal trunk muscles in the final range of continuous vocalization.

Methods: Thirty healthy individuals (15 men and 15 women) were included in this study. The transversus abdominis, internal oblique, and external oblique muscles were measured in the final range of resting expiration and continuous vocalization using ultrasonography. The vocal task was the vowel /o/ sound and the amount of vocalization was controlled at 60–70 dB. The three postures were supine, sitting, and standing. The thickness of the three abdominal muscles were compared between tasks and between postures. The rate of change in thickness of these muscles was also compared between postures and between genders.

Results: The thickness of the transversus abdominis and internal oblique muscles was significantly greater during the vocalization task than during resting expiration in all the postures for both men and women. The rate of change in thickness of the transversus abdominis muscle was significantly higher in the supine posture than in standing posture in men. In addition, in both men and women, the rate of change in thickness of the transversus abdominis muscle was higher than that of the internal oblique and external oblique muscles. No significant difference was observed in the rate of change in thickness of the transversus abdominis and internal oblique muscles between men and women.

Conclusions: Continuous vocalization was observed a significant increase in the thickness of the transversus abdominis in all postures regardless of gender.

Objective: The purpose of this study was to investigate the effects of independence and methods of mobility on positivity of attitude during leisure activity in an outpatient rehabilitation service for long-term care.

Methods: Ninety-seven elderly persons (mean age, 83.2 ± 7.3 years; 30 men, 67 women) who underwent outpatient rehabilitation service for long-term care participated in this study. Positivity of attitude during leisure activity was assessed by one evaluator using items related to activity and interpersonal relationships in a behavioral rating scale for the elderly. Mobility independence was classified as assistance, supervision, or independence, and method of mobility was classified as wheelchair or walking. Age, sex, diagnosis, required care level in daily living, upper limb function, cognitive function, posture during leisure activity were recorded as other independent variables. The odds ratio was calculated by generalized estimating equations to analyze the effects of these independent variables on the positivity of attitude during leisure activity.

Results: High mobility independence and high cognitive function were significantly associated with high activity and enhanced interpersonal relationships during leisure activity. Having a wheelchair for mobility significantly increased activity. The odds ratios were greater for mobility independence than for cognitive function.

Conclusion: Even when taking method of mobility and level of cognitive function into consideration, independence of mobility influenced positivity of attitude in leisure activity.

Objective: While anterior cruciate ligament injury in female athletes are generally well documented, there are a lack of reports for female gymnasts. The purpose of this study was to clarify the occurrence of anterior cruciate ligament (ACL) injuries in female gymnasts.

Method: The subject number were 283 female gymnasts who visited in Funabashi Orthopedic Hospital and were diagnosed with knee joint diseases and disorders. The incidence and age of each disease were investigated. We investigated the height, weight, Body Mass Index, complications, level of competition, event (vault, uneven bars, balance beam, floor exercise) at the time of injury, injury mechanism, injured side, direction of twist at the time of skill execution, and type of skill performed at the time of injury in patients with anterior cruciate ligament injuries, and examined the relationship between injured side and direction of twist.

Results: ACL injuries occurred at the second highest rate among knee joint diseases, with the most common age of occurrence being 16 and 17 years old. The majority of injuries occurred on the floor exercise, and the majority of injuries occurred on the landing. The most common complication was lateral meniscus injury. The relationship between the injured side and the direction of the twist was observed, and the injury on the opposite side of the twist direction was significantly more frequent.

Conclusion: The relationship between the injured side and the direction of twist was characteristic of ACL injuries in female gymnastics, reflecting the specificity of the sport.

Objectives: This study aimed to categorize neighborhood environment and examine the factors of the elderly that improve the life space in each environment.

Methods: A total 106 elderly people attending day care facilities participated in this study. Life-space assessment (LSA), abbreviated neighborhood environmental walkability scale, basic attributes, and physical, and psychosocial factors were measured. A cluster analysis was used to categorize the neighborhood environment. The LSA scores were divided into two groups, a high-score group and a low-score group under each environment, with cutoff score of 56. The factors of the elderly were compared between the two groups.

Results: The neighborhood environment was classified into three types using cluster analysis. On comparison between the high and low-score groups, a significant difference was found in the long-distance mobility in the poor-status environment, whereas a significant difference was found in the hobbies and social support scale in the good-status environment.

Conclusion: These results suggested that the physical and psychosocial factors of the elderly that the life space differ in each environment.

Objectives: This study examines the related factors and cut-off values for determining walking independence at discharge in patients who required mechanical ventilation in the critical care ward.

Methods: We enrolled 100 patients who had been on mechanical ventilation for > 24 h. The patients were divided into the independent and dependent groups as per their walking ability at discharge. Outcome measures for determining the walking independence were examined with multiple logistic regression analysis for factors, such as patient characteristics and blood test data on admission in the critical care ward and the mental function, physical function, and physical activity status during their stay in the critical care ward. Moreover, the cut-off values for each extraction factor and the prediction model score were calculated from the receiver operating characteristic curve.

Results: Multiple logistic regression analysis showed that age, serum total protein (TP) value, and intensive care unit mobility scale (IMS) were significantly associated with the walking ability at discharge. Furthermore, the cut-off value of each parameter and score were as follows: age, 79 y; TP value, 6.1 g/dL; and IMS, level 6 (marching on spot); and the prediction model score, 0.72.

Conclusions: The results of this study suggest that age, TP, and IMS might be related to walking independence at discharge in patients who required mechanical ventilation in the critical care ward.

Objective: We investigated the association between perioperative factors, including the postoperative Cumulated Ambulation Score for 3 days after operation (3-day CAS) and walking ability evaluated 2 weeks postoperatively in elderly patients with hip fracture.

Methods: The study included 187 patients with hip fractures, who were categorized into two groups based on their walking ability evaluated 2 weeks postoperatively. One group included 99 patients who could not walk or could walk only with the use of parallel bars, and the other group included 88 patients who could walk using a walker. Multiple logistic regression analysis was performed based on preinjury and preoperative patient information, surgical factors, and 3-day CAS. Additionally, we calculated cutoff values based on the receiver operating characteristic curve.

Result: Preinjury Barthel Index (BI), fracture type, and 3-day postoperative CAS as variables associated with walking ability that was evaluated 2 weeks postoperatively. The cutoff values used to determine patients' walking ability using a walker 2 weeks postoperatively were 92.5 points for the preinjury BI and 3.5 points for the 3-day CAS.

Conclusion: We observed that in addition to the preinjury BI and fracture type, the 3-day CAS was useful to determine patients' walking ability using a walker, 2 weeks postoperatively.

Objective: This study aimed to highlight the differences between the measurements of the carrying angle from the body surface by goniometry and radiography.

Methods: The carrying angle of 194 elbows of 97 healthy subjects was measured. From the body surface, the angle between the upper arm and forearm was measured using a goniometer. For radiological measurement, two methods were adopted: one measured the angle between the humeral and ulnar axes, whereas the other measured the angle between the humeral axis and line connecting the superior radioulnar joint and the radial tuberosity. The carrying angles measured by each method were compared, and the effects of the body shape factors on each method were analyzed.

Results: There was a significant difference in carrying angle measurement between the methods, and the angle in the body surface method was the smallest. In the analyses of the body surface method, the maximum circumference of the forearm and upper arm length were statistically significant contributors. In the analyses of the radiological methods, the forearm length was a statistically significant contributor.

Conclusion: It should be considered that body shape factors affect the carrying angle measurement; a significant difference was noted in the measurements between the body surface and radiological methods. For use in sports medicine, the development of a measurement method from the body surface similar to that of the radiological methods is necessary.