We categorized the bathing-care movements at nursing homes into the following 3 model tasks (detailed work, constant-pressure movement, transport movement of heavy objects) and, targeting the 12 present matrons there (aged 22-55, average age: 38), and made measurements to assess physical strain and working posture. For all model tasks, there were 7 different working heights; 6 calculated in relation to body measurements, and 1 appropriate working height. Strong similarities were recognized between factor movements at the actual bathing area and model tasks. Although suitable working-heights for some model-tasks differed, for all tasks, the appropriate maximum height was that about 10% below the level of spina iliaca anterior superior. The appropriate working height limited the intensity of physical strain and elevated work achievements. A working height at 60% of the spina iliaca anterior superior put greater strain on the support part of the lumbar vertebrae for a standing posture in comparison to other postures, and it is recommended to work in kneeling postures for heights lower than this.

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Beats Above Baseline Index (BABI) is obtained by the required time for task finish and change in heart rate, and is applied to the evaluation of task difficulty. The purpose of the present study was to examine the test-retest reliability of BABI and the criterion-referenced validity of BABI in relation to oxygen intake. Sixteen healthy adults without leg length inequality performed 30 sets of climbing-ups and-downs of a step at the optimal rate. The steps used were 10, 20, 30, and 40 cm high, and 7 kinds of pairs were prepared. High test-retest reliability of BABI was confirmed, but the criterion-referenced validity of BABI in relation to metabolic equivalents (METs) was not clarified in the present task. Using the multiple comparison test, BABI could be divided into 4 groups according to the task difficulty. Measurement of movement capacity using the 4 tasks, one task from each BABI group, may therefore enable the assessment of exercise efficiency and usefulness of orthoses. The present study confirmed the reliability of BABI in the steady-state task of climbing up and down steps, suggesting an applicability of BABI to various task.

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The present study examined the effectiveness of prone position for respiratory dysfunction of patients with parkinsonism. Ten patients with parkinsonism (10 with restrictive and 9 with obstructive pulmonary dysfunctions) were asked to maintain prone position on elbows on a triangular mat 20 cm high for 10 min, and their respiratory function and thoracic distensibility were measured. The measurement position was a static supine position with lower extremities flexed, and respiratory function was measured by a spirometer. Thoracic distensibility was evaluated by a difference in thoracic circumference (points of axilla, papilla, and xiphoid process) between the maximum inspiration and expiration. After 10-min prone position, the patients showed significant increases in %VC, FEV1.0%, and thoracic distensibility. The results confirmed that respiratory management of prone position is simple and effective for patients with parkinsonism.

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Postural response disorders in patients with parkinsonism not only lead to difficulties in activities of daily living (ADL) but also cause fallings. In order to evaluate the disorder of standing postural response of patients with parkinsonism, and to examine the characteristics of the disorders, we performed the Postural Stress Test (PST) of backward stress on 10 patients with parkinsonism and 10 control subjects. Backward stress corresponded to 60 cm falling energy of 1.0% BW, and longitudinal body sway was recorded after the stress. Body sway of static standing (S.D.-Area) was also measured for 20 sec. The patients with more difficulties in ADL showed longer potential time from backward stress to equilibrium response, and larger backward body sway. The results indicate that the characteristics of postural response disorder of patients with parkinsonism appear in PST of backward stress, not in S.D.-Area, suggesting the clinical usefulness of PST.

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Physical therapists need to build up appropriate hypotheses about anatomical structures which can cause symptoms, based on the subjective information about area of pain from the patient. These hypotheses are tested and clarified during the subjective examination and physical examination as well as treatment. It is, however, difficult to enumerate the appropriate anatomical structures without knowledge and experience. The purpose of this article is to describe the anatomical structure which can cause shoulder pain and signs obtained from objective examination to help efficient clinical reasoning.

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The diverse syndrome of metabolic disorders derived from insulin dysfunction is generically designated as diabetes mellitus (DM). This review describes the blood sugar control, with a particular emphasis on physiological function of insulin, and then explains the specific forms of DM and its causative factors. It further reviews the clinical examination method for the diagnosis of DM, and introduces primary complications of DM as well as their clinical examination methods.

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Patients receiving pharmacotherapy frequently perform physical therapy simultaneously, and the effects of both therapies correlate each other, not maintain independent functions. In this first part, basic pharmacokinetics and effects of physical therapy on pharmacokinetics were reviewed. Pharmacokinetics consists of 4 steps; absorption, distribution, metabolism, and excretion. Each step has variables such as the bioavailability which shows the process of absorption, the volume of distribution which indicates the distribution in whole body, and the clearance which shows disappearance of drugs through metabolism and excretion, and those variables are influenced by physical therapy. The effect of most drugs correlates well with the concentration in blood, and the concentration is highly dependent on pharmacokinetics. The effect of drugs is therefore influenced by physical therapy. In case adverse effects of drugs appear during physical therapy, the possible effects of physical therapy on pharmacokinetics should be considered.

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