Objective: This study aimed to clarify the relationship between the level of herniation and paraspinal muscle atrophy in patients with lumbar disc herniation (LDH) by measuring the paraspinal muscles' cross-sectional area (CSA).

Methods: We retrospectively analyzed data obtained from 54 patients with LDH (level of herniation; 25 patients in L4/5, 29 patients in L5/S1). The muscle CSA measurements at each spinal level (lower vertebral endplate of L1 to L5 and upper vertebral endplate of L5 and S1) were determined by outlining the paraspinal muscles' fascial boundary (i.e., multifidus, erector spinae, psoas major, and quadratus lumborum). The muscle CSA of the affected side and the non-affected side were compared in each slice.

Results: The CSA of the affected side's multifidus was lower than on the non-affected side in slices of L4, L5, and S1 in patients with an LDH of L4/5. Moreover, the multifidus' CSA on the affected side was lower than on the non-affected side in slices of L5 and S1 in patients with an LDH of L5/S1. On the other hand, the psoas major's CSA, quadratus lumborum, and erector spinae were not significantly different in all slices.

Conclusion: Muscle atrophy may occur only in the multifidus of the affected side in the affected level and the adjacent vertebrae among patients with an LDH between single vertebrae.

Objective: This study aimed to investigate the effect of pulmonary rehabilitation (PR) on physical activity in patients with interstitial lung disease (ILD).

Methods: Fourteen patients with idiopathic pulmonary fibrosis (IPF) and 17 patients with other ILD (non-IPF) received PR for 10 weeks. We evaluated physical activity (i.e., daily step count) and clinical measures before and after PR.

Results: There were significant improvements in 6-min walk distance (IPF: 442 vs 453 m, p = 0.047; non-IPF: 395 vs 470 m, p = 0.033) and quadriceps strength (IPF: 73.0 vs 85.5 Nm, p = 0.009; non-IPF: 62.5 vs 76.5 Nm, p = 0.035) after PR compared to baseline, whereas physical activity showed no significant change (IPF: 3,121 vs 2,056 steps, p = 0.363; non-IPF: 2,275 vs 2,510 steps, p = 0.499).

Conclusions: PR did not improve physical activity in patients with ILD. Further studies that focus on improving physical activity are needed.

Objectives: We aimed to evaluate the safety and efficacy of neuromuscular electrical stimulation (NMES) for the prevention of muscle weakness in elderly patients with acute heart failure.

Methods: Patients aged 75 years or older who hospitalized for acute heart failure were randomly assigned to control or NMES group. After evaluating patient background on day 0, we examined safety assessment of NMES group and efficacy assessments of each group involving skeletal muscle function (quadriceps muscle thickness and knee extensor strength) and physical functional assessment (10-m walk test, 6-min walk test, Short Physical Performance Battery, and Barthel index) at the end of the 2-week intervention.

Results: 8 patients of control group (mean age of 83-year) and 10 patients of NMES group (87-year) were analyzed. Patients in NMES group showed no adverse events during the intervention. While the patients in NMES group showed significant predominance in muscle thickness (control vs. NMES; 9.6 ± 2.7 mm vs. 13.8±2.8 mm, p = 0.012) and knee extension strength (0.20±0.10 Kgf/kg vs. 0.38±0.10 Kgf/kg, p = 0.016) compared with the patients in control group at the end of the intervention, they showed no further advantages in the physical function.

Conclusion: These results suggest that NMES is safely applicable for elderly patients with acute heart failure and also that NMES might be beneficial for preventing skeletal muscle deconditioning.

Objective: This study aimed to investigate the differences in upper-limb function and self-care among children and adolescents with spastic cerebral palsy (CP) by Manual Ability Classification System (MACS) level and age, and to clarify the differences in upper limb function between children with cerebral palsy at MACS level I and control children.

Methods: Sixty-four children and adolescents with CP at MACS levels I–III and 29 healthy controls were enrolled. Participants with CP were classified into youngest and oldest groups by MACS level. Box and Block Test (BBT), grip strength, and self-care on the Pediatric Evaluation of Disability Inventory were assessed and compared among categories.

Results: BBT findings did not differ between the youngest and oldest groups of participants with CP at any MACS level; however, grip strength and self-care were higher in the oldest group at some MACS levels. The control group had higher upper-limb gross dexterity and grip strength than the oldest group at all MACS levels.

Conclusions: The effects of MACS level and age should be considered in determinations of upper-limb functions and self-care among children and adolescents with CP. These findings suggest that upper-limb dexterity may vary at the MACS level, and the developmental course may be different in children with CP than in normal children, and that children with CP at MACS level I may have inferior upper-limb function to that of control children.

Objective: Concurrent chemo-radiotherapy (CCRT) is the standard treatment for cervical cancer, however, several adverse events, such as fatigue, make it difficult to implement cancer rehabilitation (CR). This study aimed to investigate the implementation rate of CR and the risk factors of low CR implementation during CCRT in patients with cervical cancer.

Methods: We enrolled 17 patients with cervical cancer. The CR implementation rate was calculated from the number of days of CR implementation in the CR implementation period. The background factors, body composition, physical function, and biochemical examinations before CCRT were compared. The independent factors and profiles associated with cancer rehabilitation implementation were evaluated by decision-tree analysis. We examined the CR of each factor derived from the decision-tree analysis using ANOVA analysis and Tukey's multiple comparison test.

Results: The median implementation rate of CR during the CCRT period was 55%. In the decision-tree analysis, CS-5 was selected as the initial split, and the patients with CS-5≥7.3 sec, 75% of all the patients, showed a low implementation rate. Furthermore, in a patient with CS-5≥7.3 sec, grip strength was selected as the second split. All patients with < 22.5 kg of grip strength showed a low implementation rate. In addition, old age, slow CS-5, low grip strength, and presence of sarcopenia were the characteristics of the low implementation rate group.

Conclusions: We demonstrated that, older people, low physical function, low muscle strength were associated with a low rate of CR during CCRT in cervical cancer.

Objective: To examine the efficacy of Body Weight Supported Overground Training (BWSOT) in a patient with subacute stroke.

Method: A 73-year-old male patient had right hemiparesis due to a stroke. The ABA experimental single-case design was used. The patient received conventional physical therapy at baseline and an additional; BWSOT at the intervention phase, respectively, for 2 weeks. Gait speed (GS), 6-minute walking distance (6MWD), Trailing Limb Angle (TLA), and paretic ankle plantar moment (APM) were evaluated at the end of each period.

Result: GS and 6MWD improved at all periods; however, improvement at the intervention period was observed than at baseline. TLA and paretic APM also improved with improving gait ability.

Conclusion: BWSOT was considered a rehabilitation strategy that improves kinematic and dynamic parameters, as well as gait ability in patients with subacute stroke.

Objective: This study aimed to analyze the clinical characteristics of patients with severe coronavirus disease (COVID-19) and their progress in physical therapy.

Methods: The subjects were COVID-19 patients who were admitted to our center and underwent physical therapy. The patients' sex, body mass index, medical history, disease severity status of COVID-19, ventilator and extracorporeal membrane oxygenation (ECMO) machine use, pre-hospital activities of daily living (ADL), terms of hospital stay, outcome, and physical therapy progress (measured as the number of days elapsed before the patient could perform sitting, standing, or walking) were recorded. The patients were divided into 3 groups according to age: 50–60s, 70s, and 80s. Afterward, the survey items mentioned were statistically analyzed.

Results: Of the 123 included patients with severe COVID-19, 87 were males and 36 were females, with an average age of 74 years. The achievement rate of 5 m walking ability at 30 days was 43% in the 50–60s group, 49% in 70s group, and 44% in 80s group.

Conclusion: Our findings showed that more than half of all the COVID-19 patients in all age groups had difficulty in achieving walking ability after approximately 1 month. It was suggested that the recovery from decline of ADLs in patients with severe COVID-19 was difficult in the short term regardless of age group.