[Purpose] We made a retrospective study of infants’ crawling experience to clarify its relationship with their standing posture. [Subjects and Methods] We conducted a questionnaire survey of the guardians of 38 infants with no history of orthopedic or neurologic disorders, who were aged between 3 and 6, and were attending a kindergarten. The survey items were: crawling history (yes or no), and the starting ages in months of crawling and standing while using support. The infants standing postures were captured on video, and pelvic tilt and hip internal and external rotation were assessed. [Results] Pelvic tilt was unaffected by crawling history, but the majority of infants with no history of crawling and those who stood using support before crawling had a standing posture showing internal rotation of the hip joint. [Conclusion] There is a possibility that crawling experience affects hip joint position.
[Purpose] The purpose of this study was to clarify the influence of spinal cord injury level on wheelchair tennis movements. [Subjects and Methods] The subjects were 13 male wheelchair tennis players with spinal cord injury. They were classified into two groups: high paraplegia due to thoracic level spinal injury (T3–T9), and low paraplegia due to thoracolumbar level spinal injury (T10–L1). The following 6 items associated with competition movements were evaluated: grip, muscle strength (shoulder abduction, elbow extension, trunk flexion), linear wheelchair propulsion movement, figure-of-8 propulsion movement, pivot turn, and reach movement (anterior, lateral). [Results] The low paraplegia group had significantly higher values of trunk flexion muscle strength and reach movements (anterior, lateral) than the high paraplegia group. There were no significant differences in the grip, shoulder abduction and elbow extension muscle strengths, linear and figure-of-8 wheelchair propulsion movements, or pivot turn between the two groups. [Conclusion] Spinal cord injury level affects trunk flexion muscle strength and reach movements, but not wheelchair propulsion movements.
[Purpose] This study investigated the validity of estimating the diaphragm movement from abdominal wall movement measurements using a simple breathing movement-measuring device (BMMD). [Subjects and Methods] Fifteen healthy young males participated in this study. When breathing based on distances targeted by the BMMD (10, 20, 30 mm) on the abdominal wall (Dab) was performed, the distances of diaphragm movement (Ddi) and of a reflective marker on the abdominal wall (Dma) were measured by ultrasonography and three-dimensional motion analysis, respectively, and Ddi was corrected for the vertical displacement of the ultrasonic probe (Ddi-c). [Results] Compared to Dab, Dma, Ddi, and Ddi-c significantly increased. The regression equations for Ddi and Ddi-c derived from Dab or Dma showed high coefficients of determination. [Conclusion] The results demonstrate that Dab measurements may be useful for estimation of Ddi and Ddi-c of healthy young males.
[Purpose] To clarify the contributions of the thoracic and cervical spines to translational head movements. [Subjects and Methods] A kinetic analysis of the rotational angles of each vertebra from C3 to T5 in anterior and posterior translational head movements of 12 healthy females in the supine position was performed using MRI. [Results] It was found that translational head movements of 15 mm elicited movements in the thoracic vertebrae. Furthermore, some subjects showed ventral movement by all of the vertebrae from C3 to T5, while other subjects showed ventral to dorsal movement in either the cervical vertebrae or some of the vertebrae to T5. [Conclusion] In the cervical and thoracic spine, there is a point where the curvature changes from lordosis to kyphosis, and our results, showing differences in the subjects’ vertebral movements, confirm that there are individual differences in this point. This suggests the necessity of considering not only cervical vertebrae, but also thoracic vertebrae when making translational head movements.
[Purpose] Three types of therapies for osteoporotic back pain were investigated. [Subjects and Methods] The subjects were 51 females with back pain without vertebral fracture, who presented bone mineral densities of less than 80% of the young adult mean (YAM). The following therapies were conducted: exercise (n=4: mean age, 74.5 ± 12.2 years), osteoporosis drugs (n=21: mean age, 76.8 ± 8.4 years), and combined therapy with exercise and drugs (n=21: mean age, 77.2 ± 7.6 years). Pain intensity measured on the visual analog scale (VAS), YAM, and urinary type I collagen cross-linked N-telopeptide (uNTX) were measured at baseline and six months after the therapeutic interventions. [Results] After six months, VAS and YAM were unchanged in all of the groups, while uNTX of the combined therapy group showed a statistically significant decrease, indicating suppression of bone absorption by combined therapy. [Conclusion] The results suggest that combined therapy with exercise and osteoporosis drugs normalizes bone metabolism, resulting in a decrease in uNTX.
[Purpose] To clarify the effects on toe-grip strength of standing with toe and heel loading. [Subjects and Methods] Twenty-four feet of 12 healthy adults were the subjects of this study. Subjects’ toe-grip strength was measured before and after standing on a platform, which loaded the heel and toes, for 10, 30 and 60 s. The tasks were performed in a random order with more than a day between each task. [Results] Toe-grip strengths of both the dominant and non-dominant feet significantly increased after standing on the platform for 10 s, but no significant differences were found after standing durations of 30 and 60 s. [Conclusion] The results suggest that standing for 10 s with toe and heel loading is an exercise which immediately increases toe-grip strength.
[Purpose] To clarify the trends in use of assessment indices for convalescence rehabilitation patients in original papers. [Subjects and Methods] In the five years from 2011 to 2015, original papers mainly about convalescence rehabilitation patients appearing in the Journal of Physical Therapy Science and Rigakuryohogaku were surveyed for assessment indices’ use as well as their frequency of use. [Results] There were many assessment indices with constant reliability, validity, and ordinal scales; however, their frequency of use differed depending on the study design. [Conclusion] We intend to continue researching assessment indices verifying the benefits of convalescence rehabilitation to identify those with the potential to become standard indices.
[Purpose] The purpose of this study was to determine the change in muscle activity and the angle of the lower extremity elicited by running while focusing on dorsiflexion. [Subjects and Methods] Seven collegiate long-distance runners participated in this study. The subjects performed two types of running on a treadmill: normal running (NR), and running with focus on dorsiflexion at heel contact (DR). The muscle activities of the lower extremity were obtained using a wireless sensor. [Results] DR increased the angle between the sole of the foot and the horizontal plane. The angular velocity of dorsiflexion at the absorptive phase was lower during DR. In addition, DR elicited increased activity in the tibialis anterior at pre-heel contact, and in the rectus femoris in the stance phase. [Conclusion] In DR, the decrease in the stretching stress on the Achilles tendon and the increase in the activities of muscles used for shock absorption are expected to diminish the load on the Achilles tendon.
[Purpose] Cooperation between different types of duties is indispensable for patient support in medical institutions. Therefore, we investigated the rehabilitation intervention methods and actual factors affecting the psychological stress experienced by care workers while performing their duties, when rehabilitation practitioners offered information to care staff. [Subjects and Methods] A questionnaire survey and saliva sampling were conducted of 30 care staff employed in a dementia hospital. [Results] The results of POMS, a subjective stress assessment method, showed significant differences among duties in the tension-anxiety and anger-hostility items. sAMY showed a significant difference between diaper exchange and other duties. [Conclusion] Rehabilitation practitioners provide information on individual patients’ care needs and methods based on medical assessments of their physical and mental functions, and they need to cooperate with care staff while giving consideration to avoiding raising their stress levels.
[Purpose] The purpose of this study was to investigate the relationship between characteristics of the physical function of community-dwelling elderly exhibiting the paradox phenomenon (<1.0) of the Romberg ratio (RR) derived from postural sway tests. [Subjects and Methods] We made assessments of physical function, and surveyed the fall history and feelings of self-efficacy in fall prevention of 211 community-dwelling adults who were independent in daily living activities. The subjects were divided on the basis of a RR of 1.0, and each group’s assessments were compared. [Results] The RR<1.0 group had longer timed up-and-go and 5-meter walking times, and their feelings of self-efficacy in fall prevention were significantly higher than those of the RR≥1.0 group. [Conclusion] A divergence was found between the feelings of self-efficacy in fall prevention of the RR<1.0 group and their physical performance.
[Purpose] The objectives of this study were to measure the physical and mental functions of elderly Peritoneal dialysis (PD) patients, and to investigate their relationships with activities of daily living (ADL). [Subjects and Methods] The grip strength (GF), knee extension strength (KEF), 6-minute walking distance (6MWD), 10-meter walking speed (10mWV), SPPB, FIM and MMSE of 23 of PD patients aged over 65 (average age: 73.6 ± 5.3 years) were measured. The proportions of results below the standard level were calculated for each item, and the relationship of each item with FIM was investigated. [Results] More than half of the patients’ GF, KEF and 6MWD values were lower than the standard values. Significant relationships with FIM were found for 10mWV (r=0.48), SPPB (r=0.52), and MMSE (r=0.49). [Conclusion] The low physical function levels of the elderly PD patients in this study were related to their ADL abilities, and we consider that maintaining or raising physical function is necessary for maintaining ADL.
[Purpose] To examine the effect of a care-prevention strength training program using a behavioral scientific method on frequency of performance and adherence to an anti-gravity muscle training program. [Subjects and Methods] Eleven community-dwelling elderly persons participated in this study. The frequency of training per week was examined and compared before, immediately after, and 6-months after the intervention. [Results] At 6 months after intervention, 9 participants had continued to perform the training. The training frequency was 0 times/week before the intervention, but it was 6 times/week after the intervention, and 3 times/week at 6 months after the intervention. In addition, frequency of training immediately and 6-months after intervention was significantly higher than that before the intervention. [Conclusion] The results suggest that using a behavioral scientific method may be effective for adherence to lower limb anti-gravity muscle training for the elderly.
[Purpose] The purpose of this study was to examine the effect of foot angle on rotation of the lower extremity while descending stairs. [Subjects and Methods] Fifteen subjects participated in this study. Subjects stepped down from a 20-cm platform under 5 foot angle conditions with contact of their right leg: neutral, toe-out of 5 and 10°, and toe-in of 5 and 10°. Rotation of the lower extremity was measured with triaxial accelerometers from the start of ankle dorsiflexion to maximum dorsiflexion. [Results] No significant differences were found among the conditions in knee angle. However, the external rotation angles of the thigh under the toe-in condition were significantly smaller than that of toe-out of 10°, and internal rotation of the knee was also smaller. [Conclusion] In descent of stairs with toe-out, rotation of the thigh is restricted, and this becomes a factor affecting overloading of the knee, suggesting that not only the activity of the foot, but also thigh rotation and knee function are important.
[Purpose] In this study, wall squats were performed with the buttocks, outside of the legs and 5th metatarsals in contact with a custom-built nook with an adjustable corner angle. The subjects who made movements to depart from this squatting position were judged the wall-squat abnormal (WSA) group. The study was performed to clarify whether the characteristics of WSA from WS with nook angles of 50 and 70° took the same form as those of 90°. [Subjects and Methods] The subjects were 50 males and 50 females (mean age: 21.7 ± 3.7 years). The form of their WS at nook angles of 50, 70 and 90° were evaluated. [Results] Subjects judged to have WSA in 90°WS were judged to have the same tendencies of WSA in 50° and 70°WS. [Conclusion] There is a possibility that mechanical stresses occur in knee flexion movements of WSA subjects, even in daily living activities.
[Purpose] The purpose of this study was to clarify the relationship between the muscle mass and respiratory function of healthy adults. [Subjects and Methods] The subjects were 32 males and 19 females with a mean age of 19.4 ± 0.8 years. The subjects’ muscle mass was measured, and grip strength, toe-grip strength, forced vital capacity (FVC), %FVC, one-second forced expiratory volume (FEV1), and the FEV1/FVC ratio were also determined. The appendicular skeletal muscle mass index (SMI) was calculated using the measurements, and its relationships with the items of physical function were investigated. [Results] SMI of the subjects was 7.49 ± 0.62 kg/m2 for males and 6.30 ± 0.49 kg/m2 for females, and significant positive correlations between SMI and grip strength (r=0.763) and FVC (r=0.779) were found. [Conclusion] A positive correlation was found between SMI and the grip strength and FVC of healthy adults.
[Purpose] The purpose of this study was to examine whether various postures and gait can be determined using a wearable triaxial accelerometer under simulated hospital conditions. [Subjects and Methods] Ten healthy adults were recruited for this study. A triaxial accelerometer was attached to their left thorax. The experimental tasks were: 1) the basic postures of supine, sitting and standing, 2) changing the reclining angle while lying in a bed, and 3) walking and moving in a wheelchair. [Results] The Y-axis accelerations of sitting, standing and lying in bed with a reclination angle > 60 degrees were lower than that of the lying posture. The triaxial composite acceleration during walking was higher than that of moving a wheelchair, and increased as the walking speed increased. [Conclusion] An upright posture could be determined by a Y-axis acceleration of less than –0.7 G, and walking and wheelchair movement could be determined by a triaxial composite acceleration of more than 1.3 G.
[Purpose] To clarify the effect of a kyphotic posture on the measured values of body composition. [Subjects and Methods] The subjects were 50 healthy males. Body compositions were measured and calculated for three postures: normal posture (N); kyphotic posture, index of kyphosis 19.4±2.0, artificially induced by a jig and normal height (KN), and the kyphotic posture and the kyphotic posture height (KH). [Results] No significant differences in any of the measures were found for the N and KN postures. For the KH posture, the somatic fat mass was significantly higher, and the lean body mass, appendicular muscle and skeletal mass, and the skeletal muscle index were significantly lower than those of the other postures. [Conclusion] Decrease in height due to kyphosis affects body composition measurements, and for cases with large kyphotic deformity, estimation of normal height is recommended.
[Purpose] Electromyography (EMG) was used to examine the activities of the muscles surrounding the hip joint which are involved in maintaining internal and external rotation in the sitting posture. [Subjects and Methods] The subjects were 10 healthy males, 20 lower limbs. EMG of the gluteus maximus upper fibers, gluteus medius, and tensor fasciae latae muscles was performed in the sitting posture. The activities during internal and external rotation of the hip joint at 10, 20, and 30° were compared among the angles. [Results] Integrated EMG of the gluteus maximus upper fibers at 30° of internal rotation was significantly greater those at 10 and 20° internal rotation. Integrated EMGs of the gluteus medius and tensor fasciae latae muscles at 30° internal rotation were significantly greater than those at 10° internal rotation. [Conclusion] The gluteus maximus upper fibers are involved in maintaining internal rotation at hip flexion of 90° without participating in the maintenance of external rotation.
[Purpose] The purpose of this study was to reveal the effectiveness of physical fitness training for a patient with tibial plateau fracture and pulmonary sarcoidosis. [Subjects and Methods] The subject was a 65-year-old female with both tibial plateau fracture and pulmonary sarcoidosis. The results of the respiratory function test, cardiopulmonary exercise test and Nagasaki University respiratory activities of daily living questionnaire (NRADL) at the start of the intervention and after 2, 5 and 8 months of physical fitness training were compared. [Results] The results indicated that the physical fitness training improved the patient’s exercise tolerance, NRADL, and range of activity. [Conclusion] This study suggests the effectiveness of physical fitness training for a patient with tibial plateau fracture and pulmonary sarcoidosis.
[Purpose] To verify the effect of the prone position on periodic respiration and apnea in an extremely low birth weight (ELBW) infant. [Subjects and Methods] The subject was an ELBW infant who showed periodic respiration and apnea from a corrected age of 37 weeks. For the purpose of managing respiration, the infant was positioned in the prone position for 3 weeks. Then, the immediate and 24-hour changes were assessed, using endermic arterial oxygen saturation (SpO2) as an index, after placing the infant back in the supine position. Respiration abnormalities before and after the 3-week intervention were also assessed. [Results] Both the 5-minute (immediate) and 24-hour changes in SpO2 showed raised average values with reduced variation. The frequencies of respiration abnormalities were: apnea, 5 times pre-intervention, and zero post-intervention; and periodic respiration, 5 times pre-intervention, and once post-intervention. [Conclusion] The results suggest that the frequency of respiration abnormalities can be reduced by respiration management using the prone position.
[Purpose] We aimed to investigate the effects of core stability training (CST) on ataxia and balance disturbance. [Subjects and Methods] A man in his fifties who was at 3 years past the onset of pontine hemorrhage and had severe cerebellar and afferent ataxias, and balance and gait disorders was included in this study. In the first 4 weeks (phase A), a physical therapist visited him at his home and conducted physical therapy, which included muscle strengthening, sit-ups, and transfer training, for 60 minutes per week. After phase A, CST was added to the program for 4 weeks (phase B). [Results] Only in phase B were the scale for the assessment and rating of ataxia and Berg balance scale improved. [Conclusion] CST for patients with severe cerebellar ataxia due to stroke can improve cerebellar and afferent ataxias, and balance.
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