Objective: To clarify the relationship between three-dimensional mechanical axis (3D-MA) passing points on the proximal tibial surface and the knee joint kinematics and radiographic coronal alignment.

Methods: Seventy-five participants (93 knees) with knee osteoarthritis (OA) (Hokkaido University classification, stage II-V) were included. Three-dimensional motion analysis was performed using an optical motion capture system while walking to examine the knee joint kinematics and the trajectory of 3D-MA passing points.

Results: The displacements of the x-component of the 3D-MA passing points (3D-MAx) were qualitatively similar to varus and valgus knee kinematics and demonstrated a significant moderate correlation with the radiographic alignment. There was an increase in the 3D-MAx medial displacement between the initial contact and peak value in severe cases, along with a decrease in the change in knee flexion angle during the loading response phase.

Conclusion: 3D-MA is a multiplex index that reflects static knee alignment and dynamic knee kinematics. Evaluation of the load axis dynamics during gait may help clarify the mechanism that underlies the progression of OA.

Objective: The present study aimed to examine whether instrumental and affective attitudes are associated with exercise behavior, mediated by self-efficacy and self-regulation.

Methods: A baseline internet survey was conducted with 500 individuals aged 50–74 years. Among them, 394 individuals responded to the six-month follow-up survey. After adjusting for demographic factors, the associations between instrumental attitude, affective attitude, self-efficacy, self-regulation, and exercise behaviors were examined using path analyses.

Results: In the cross-sectional and longitudinal models of path analyses, both self-regulation and self-efficacy significantly regressed on exercise behavior. Furthermore, affective attitude was significantly associated with both self-regulation and self-efficacy, whereas instrumental attitude was significantly associated with self-regulation but not with self-efficacy.

Conclusions: The present study indicated that affective attitude influenced exercise behavior, mediated by both self-regulation and self-efficacy. However, the influence of instrumental attitude on exercise behavior, mediated by self-regulation and self-efficacy, remains unascertained.

Objective: This study investigated the relationship between skeletal muscle mass, estimated by the psoas muscle area on abdominal computed tomography, and functional prognosis, in proximal femur fracture patients.

Methods: One hundred and thirteen recovery ward patients were divided into the skeletal muscle mass loss group and a control group. We compared their clinical history and functional prognoses. Multiple regression analysis, with Functional Independence Measure (FIM) gain as the objective variable, was performed to examine the relationship between skeletal muscle mass and the results.

Results: The mean age of the patients was 83.5 ± 8.3 years. Thirty-five patients were males, and 78 were females. There were a total of 56 patients in the skeletal muscle mass loss group. Compared to the control group, the skeletal muscle mass loss group members were older, more, had significantly lower cognitive FIM at admission, lower total FIM at discharge, and FIM gain. Multivariate analysis showed a significant association between skeletal muscle mass loss and FIM gain.

Conclusion: Skeletal muscle mass loss, estimated by the area of the psoas muscle in patients with proximal femur fractures, may be associated with a poor functional prognosis.

Objective: The purpose of this study was to investigate the neural activity in the brain during the temporal and spatial changes of a gait image by EEG analysis.

Methods: We examined the characteristics of neural activity in the brains of eight healthy young subjects under the conditions of temporal and spatial changes of a walking image by EEG microstate segmentation method.

Results: The supplementary motor area and the anterior segment of the wedge were commonly activated during the temporal and spatial changes in the gait image. The frontal eye area and the superior parietal lobule were predominantly activated during the temporal change, and the frontal eye area, frontal pole, and superior parietal lobule were predominantly activated during the spatial change.

Conclusion: It was suggested that different brain regions were activated when the gait image was changed spatially and temporally. These results suggest that the temporal and spatial characteristics of the gait image need to be considered when it is used as an optimized intervention method.

Objectives: Patients with interstitial lung disease are known to show functional decline due to dyspnea on exertion. However, the incidence of hospital-acquired disability (HAD) associated with hospitalization and its impact on clinical outcomes remains unclear.

Methods: A prospective observational study was conducted by two study participating hospitals. Patients were hospitalized for respiratory failure who had been diagnosed with interstitial lung disease before, or who had been diagnosed with interstitial lung disease by a physician on high-resolution computed tomography at admission and underwent rehabilitation between June 2018 and December 2020. HAD was defined as a decrease of more than 5 points in the total Barthel index score at discharge compared to that before admission. Multiple regression analysis was performed to examine the influence of HAD on the length of hospital stay.

Results: Of 66 patients analyzed (median age 77 years, 47 males), 32 (48%) had HAD. In multiple regression analysis, HAD was identified as an independent determinant of the length of hospital stay (β = 0.34, 95% confidence interval = 3.86–25.52).

Conclusion: We found that HAD occurred at a high rate in patients with interstitial lung disease and affected clinical outcomes, including the length of hospital stay.

Objective: To predict walking independence in patients with capsular and thalamic hemorrhage three months after symptom onset using acute phase computed tomography (CT) images.

Methods: A total of 134 patients with capsular and thalamic hemorrhage, who were admitted to a rehabilitation ward, were included in the study. CT images were taken within 12 hours after symptom onset, and a deep residual network was used to predict walking independence three months after symptom onset. The C statistic, sensitivity, specificity, F value, and Matthews Correlation Coefficient (MCC) were calculated to determine prediction accuracy.

Results: The prediction accuracy [mean value (95% CI)] calculated from the C statistic, sensitivity, specificity, F value, and MCC was 0.89 (0.70 – 0.94), 0.91 (0.76 – 0.95), 0.83 (0.69 – 0.88), 0.87 (0.80 – 0.92), and 0.82 (0.76 – 0.89), respectively.

Conclusion: Acute phase CT image findings of patients with capsular and thalamic hemorrhage can be used to predict walking independence three months after symptom onset.

Objective: We examined whether neuromuscular electrical stimulation (NMES) in outpatient cardiac rehabilitation (CR) assists physical function and performance in a heart transplant patient.

Method: A 40-year-old patient underwent heart transplantation due to hypertrophic cardiomyopathy followed by outpatient CR after discharge. The study design was A (basic level period)–B (intervention period)–A (basic level period), and each period was of 8 weeks. The patient underwent outpatient CR once weekly for the entire study period. NMES was performed on the thighs and lower legs for 50 min/day, 5 times/week at home only during the intervention period. The objective variables in this study were exercise capacity, muscle strength, and usual walking speeds. The measurement points were the 0th week (M1), 8th week (M2), 16th week (M3), and 24th week (M4).

Results: Changes in oxygen consumption at anaerobic threshold (AT) were 16.7 mL/min/kg, 20.6 mL/min/kg, 22.8 mL/min/kg, and 17.9 mL/min/kg, and lower limb muscle strength was 0.69%, 0.70%, 0.76%, and 0.74 % body weight; the usual walking speeds were 1.17 m/s, 1.36 m/s, 1.41 m/s, and 1.37 m/s (M1, M2, M3, and M4, respectively).

Conclusion: NMES may have synergistic effects on outpatient CR in patients following transplantation.

Objectives: Although accurately evaluating the independence of walking in acute-phase patients with ischemic stroke is important, no quantitative study has been performed on attentional deficit. The purpose of this study was to clarify factors associated with walking independence of patients during hospitalization using the Moss Attention Rating Scale (MARS), Stop Walking When Talking test (SWWT), and Berg Balance Scale (BBS).

Methods: Eighty-six patients with ischemic stroke within two weeks after onset were enrolled. Discriminant accuracy of walking independence was compared between the BBS score and discriminant score calculated by multivariate logistic regression analysis.

Results and Conclusion: The BBS, MARS, and SWWT were selected as determinant factors of walking independence. Discriminant accuracy based on the discriminant score calculated using the BBS, MARS, and SWWT was higher than that based on the BBS alone.

Objective: The purpose of this study was to identify psychological stress among physical therapists who provide physical therapy to patients with novel coronavirus disease (COVID-19) in the containment zone.

Methods: A survey was conducted using an internet-based questionnaire system. In addition to basic personal information, the content of the physical therapy, the burden of infection control, and psychological stress were surveyed.

Results: Of the 584 individuals analyzed, only six physical therapists did not state that they feel “stressed” about physical therapy conducted in the containment zone. In addition to anxiety over the possibility of being infected, social stress – such as being discriminated against due to prejudice from others – were also identified. The most common types of psychological stress were “infection of family members and others” (88.5%) and “infection of oneself” (82.0%).

Conclusion: Almost all physical therapists who provide direct physical therapy in the containment zone to patients with COVID-19 showed signs of psychological stress.