In China, the cultivation of physical therapists is an urgent issue because of an increasing elderly population and also because of the increase of the disabled, though traffic accidents and industrial accidents. In this research, we investigated the status of physical therapists' education, their role in the clinical field and their education after graduation in China. We found Chinese physical therapists have a longer academic career, and are older and have shorter experience as physical therapists, because most Chinese physical therapists have change career from the medical and nursing fields. The highest number of the patients treated by physical therapists in China is cerebrovascular disease, at around half and the highest disability is hemiplegia, similarly, around half. From the viewpoint of social recognition of physical therapists, the name of "physical therapist" and physical therapists' work mission are still not fully understood and accepted in China. The number of physical therapists per population of 10,000 is very small, being 0.1 physical therapists in China against 1.6 physical therapists in Japan. The present status of physical therapy in China shows an extreme shortage of physical therapists both in quality and quantity in China. We conclude that it is needed to increase the number of professionals physical therapists, and also to improve the education of physical therapists in China.

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In order to accurately estimate the muscle fiber conduction velocity (MFCV), the normalized peak-averaging technique (NPAT) has been proposed. Electromyograms (EMGs) were recorded using surface array electrodes during the isometric contractions of biceps brachii muscles of ten healthy volunteers. The EMGs recorded from the vicinity of endplates, were grouped as EMG data 1, and those from a site far enough from the endplates and tendons were grouped as EMG data 2. The spread of MFCVs caused by different motor units was simulated using computer software. The MFCVs obtained from EMG data 2 agreed with the MFCVs reported previously, whereas EMG data 1 showed abnormally large MFCV values. The spread of MFCVs estimated from EMG data 1 showed a significantly large standard deviation compared with that estimated from EMG data 2. These results suggest the potential usefulness of NPAT for estimating MFCV and obtaining detailed information about muscle activity.

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The purpose of this study was to find out what influences dysfunction of kneel-sitting has on activities of daily living (ADL) for community dwelling elderly persons. The subjects were 173 community dwelling elderly attending a community care program for fall prevention, and an assessment of ADL was made using a self-assessment questionnaire as well as the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence.Analysis of 136 valid returns showed that 43 persons (31.6%) had kneel-sitting dysfunction, and the most commonly reported cause was "knee pain" or pain related complaints (61.4%). In comparison with those without kneel-sitting dysfunction, those with kneel-sitting dysfunction had significantly lower total scores and subcategorical scores of instrumental independence of the TMIG index of competence, and many refrained from participating in ceremonial occasions and community events.

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The present study examined the relation between motor ability and regional specificity. A motor performance test was administered to 687 (197 males and 490 females, aged 17 to 92) dwellers in Kasari town of Amami island. The test consisted of measurement of grip strength, sitting trunk flexion, one-leg standing, walking at maximum speeds. The results indicated that motor performances except for sitting trunk flexion of females deteriorated with aging. Significant correlations between motor performances were detected grip strength and walking at maximum speeds. Individual differences (coefficient of variation) in grip strength, walking at maximum speeds increased with aging. An age-related decline was confirmed in balance.

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The purpose of this study was to investigate the classification of forward trunk inclination posture during sit-to-stand (STS). Three-hundred and nineteen female subjects (aged 22 to 87 years, mean age 57.9), who could perform activities of daily living (ADL) independently, participated in this study. The angle of forward trunk inclination during STS was analyzed using a two-dimensional movement analysis system. The results revealed no significant difference in the angle of forward trunk inclination among age groups. The angle of forward trunk inclination was classified by hierarchical cluster analysis into Types I-V. Cluster analysis revealed significant distinctions between Types II and III, and Types III and IV (p<0.05). No significant correlation coefficient was found between the cluster groups and contextual factors (physical fitness and living environment) by covariance structure analysis. The angle of forward trunk inclination was clarified as suitable for forward trunk inclination posture guide during STS. It is suggested that it is necessary to investigate the influence due to actions resulting from changed kinetic patterns in ADL stereotypes concerning and the character of the subjects.

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The objective of this study was the development of a trial apparatus for measuring knee joint proprioception, the verification of the reliability of its measurements, and the appraisal of its potential for clinical use. Two examiners measured knee joint threshold value and position sense of the 20 knees of 10 healthy females. The examination of position sense was from 90 degrees extension at an angular velocity of 0.1 degree/sec, and at 85, 75 and 65 degrees the measured angle difference was measured. Between examiners the reliability of the threshold value was ICC (3,1) = 0.73, and the reliability of position sense was ICC (3,1) = 0.86, showing a high reliability of measurement. The results suggest that the knee joint proprioception measurement apparatus which we designed and built, would be valid for objective assessment.

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The purpose of this study was to elucidate the postural sway control mechanism which cannot be evaluated by a traditional gravicorder alone. The sway of center-of-gravity by a gravicorder and the sway of body by a triaxial accelerometer in static standing, were measured simultaneously, and relationships among the measured items were considered. In the results, there was a significant correlation between the total length of sway path measured by a gravicorder and accelerations measured by a triaxial accelerometer. This result certified the appropriateness of evaluation of postural sway measured by a triaxial accelerometer. Until now, we have studied the characteristics of the sway of center-of-gravity that was drawn in a 2-dimensional plane. The results suggest that the characteristics of way center-of-gravity can be elucidated in 3-dimensional space using these apparatus. Therefore, the possibility that the physical characteristics of the sway of body connected with center-of-gravity control can be elucidated and the possibility that the center-of-gravity control mechanism, which has been studied by a gravicorder alone, can be elucidated were shown.

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The aim of this study was to execute proprioceptive neuromuscular facilitation (PNF) with consideration of sports action characteristics, to demonstrate its effectiveness on sports actions, as well as to determine whether or not there was an additional effect on sports action when PNF was executed in a posture in which the overflow effect due to diffusion action was thought to appear large. Fifteen healthy female students were asked to perform the far throwing task and the center of gravity (COG) sway on the non-axial leg was measured in one-legged standing as well as under 3 conditions at the time of throwing. The 3 conditions were: the control condition, the sitting position with the sole of the foot not grounded and PNF executed on the throwing arm (sole not grounded), and the sitting position with the sole of the foot grounded and PNF similarly executed (sole grounded), a condition in which the overflow effect was thought to be marked. The root mean square of area of COG sway was significantly reduced under all three conditions (p<0.05), and the distance thrown in the two PNF conditions was significantly longer (p<0.05). Furthermore in comparison with the sole not grounded condition, in the sole grounded condition the results of the far throwing task were significantly better (p<0.05). From the results we conclude that for the throwing movement in baseball, the results can be improved by execution of PNF considering throwing movement characteristics, and furthermore, and for actions in which the mechanism is unclear, PNF executed in a posture in which the overflow effect is considered large, is even more effective.

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The purpose of this study was on the one hand, basic research into the knee in and toe out leg position lessening stress on the anterior cruciate ligament (ACL), and also the clarification of a factor resolving the contradiction of so-called easily occurring, non-contact type ACL injuries in this position. With 20 healthy females (average age, 21.6 ± 4.6) as subjects we measured the ground reaction force in one step movement with 3 dynamic alignments: knee in & toe out, knee out & toe in, and a neutral position with the knee and foot facing forward. In one step movement, the ground reaction force of knee out & toe in acted more in the lateral direction than that of the neutral position. In contrast, knee in & toe out ground reaction force acted inwardly to the rear, and additionally, at the time of movement, front-rear braking effort was poor. According to the results, we consider that in knee out & toe in, because a lateral shear force was generated on the femur which was receiving lateral torque from the tibia, tension on the ACL was heightened by toe in, making ACL injury easier to occur. Also, in knee in & toe out we consider that as stresses build up simultaneously, and shear force is generated in the forward direction on the femur, which is receiving torque in the forward direction from the tibia, which is exhibiting weakened brake force in the forward direction, ACL injury incidence would be higher.

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In order to find out the relationship between thigh muscle strains and the muscle strength ratios of the muscle strengths of the inner and lateral hamstrings and quadriceps femoris, we measured the knee flexion and extension strengths in the toe in, toe out and neutral positions of 27 university students participating in sports activities. The students were classified into two groups, those who had experienced thigh muscle strain (10 persons, injury group), and those who had not (17 persons, control group), and subjects' limbs were further subdivided into injured legs and uninjured legs in the injury group, and control legs (34) of the control group. Two students in the injury group, a field eventer and a volleyball player, had experienced quadriceps muscle strain, and there was a tendency for their quadriceps muscle strength on the injury side to be relatively weak. The muscle strengths of quadriceps and hamstrings of the eight students who had experienced hamstring injury, were higher than control legs in the injured legs. Especially, the hamstring muscle strength of those who had experienced lateral hamstring injury was stronger than that of control legs. We concluded that there is a possibility that the special movement characteristics of an event and relative weakness of the quadriceps muscle strength are factors in the incidence of quadriceps muscle strain, and that for lateral hamstring injuries, the role of regulation of contraction and relaxation in the counteraction to muscle movement is large, or its unpreparedness makes injury easier to occur.

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The purpose of this study was to investigate if there was a relationship between the stability of landing from jump, and the performance ability of the jump and the switchover movement after landing. Nineteen healthy women were measured in 6 trials for the center of pressure (COP) using a stability analysis system, during stop after landing from jump in both legs on a force plate, and the performance time from switchover after jump landing in both legs to placing a ball on the head. For the COPs after landing from jump, the average value of the anteroposterior maximal distance (YD) was longer than that of the lateral maximal distance (XD), whereas the average value of the coefficient of variation (CV) of XD was higher than that of YD. The performance time correlated significantly only with the average value of XD. It was considered that anteroposterior direction control rather than lateral direction control was used to stabilize the whole body after landing from jump, but this control reaction might not affect the performance ability. In contrast, the lateral direction control reaction might prescribe a part of performance ability.

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With the objective of clarifying the relationship between unilateral spatial neglect (USN) and practical independence of hemiplegic gait following stroke, we investigated the relationship between independence of hemiplegic gait and the presence or absence of USN, and its severity, among 42 inpatient subjects of our subacute rehabilitation unit who could walk independently in the rehabilitation room. No relationship was found between the degree of severity of USN on admission and independence of hemiplegic gait 3 months later, but a relationship was found between degree of severity of USN at 3 months after admission and independence of hemiplegic gait at the same time. However, the discriminant contribution ratio of the degree of severity of USN in independence of hemiplegic gait was only 14.4%, so we conjecture that a factor other than USN has a greater influence on independence of hemiplegic gait.

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The purpose of this study was to clarify which of the excitability effect caused by tonic vibration reflex, or the inhibitory effect from vibration stimulation, affected muscle stiffness in muscle fatigue. With 20 healthy students (average age, 24.4) as subjects, we investigated and compared the changes in muscle stiffness in the cases of applying or not applying vibration stimulation for 5 minutes directly after equivalent exercise measures to achieve muscle fatigue. At maximum effort, muscle fatigue was created by the equivalent exercise measure, and recovery from the consequent increase in muscle stiffness showed a delay of more than 5, but less than 15 minutes, due to the application of vibration stimulation. The excitability effect due to the tonic vibration reflex significantly affects fatigued muscles, and in addition we conjecture that through the accumulation of metabolites in the affected area due to lowering of the elimination effect of blood flow cut off, vibration stimulation was not effective at reducing muscle stiffness. However, since muscle stiffness recovered to pre-exercise levels within 15 minutes of the end of exercise, we consider that the increase in muscle stiffness was transitory, and comparatively short in nature.

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We investigated the relationship between aging and dysphagia, using frequency of choking, among ninety-seven frail elderly residents of our geriatric health services facility, who we divided into those having sequela of stroke and those without.Compared to those without sequela, the frequency of choking during meal times was 2.4 times as high in those with sequela of stroke, but no relation was found with aging. However among those without sequela of stroke, the frequency of choking was significantly greater among the very aged, over 85 years of age, than the less aged, under 85 years of age. Among those with sequela of stroke, it was considered that the frequency of choking was principally influenced by cerebral injury, and among those without sequela, by deterioration of chewing strength due to Parkinsonism, dementia and medicinal side-effects, and deterioration of reserve due to asymptomatic cerebral infarction, etc.The risk of dysphagia rises from around the age of 85 among those without sequela of stroke, indicating the necessity of paying due attention to them, together with those showing sequela of stroke.

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The objective of this study was to investigate the effectiveness in early post operative rehabilitation of a dynamic joint control training machine, toe-heel pedal exercise machine, recently developed for lower limb joint orthopedic patients, such as those receiving artificial hip and artificial knee replacement surgery. Currently, early exercises take place on the bed, and are principally open kinetic chain exercises for strengthening the femoral quadriceps muscle. Looking to improve recovery time and speed discharge from hospital, we investigated apparatus and exercise therapy methods involving closed kinetic chain exercises which resemble those of activities of daily living, and developed the toe-heel pedal exercise machine.In order to study the effect electromyographically, we made a comparison of the iEMGs of 24 legs of 12 healthy males, at the start of action in toe-heel pedaling and flat pedaling, targeting the quadriceps femoris (vastus medialis) and sole of the foot muscle (flexor digitrum brevis). The results confirmed that at the start of action in toe-heel pedaling there was large muscle activity in both muscles, and we concluded that the toe-heel pedal exercise machine could be used for clinical applications.

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The aim of this study was to investigate the difference of clinical findings to determine whether deep venous thrombosis (DVT) was complicated or not in the operated lower extremity. Subjects were 35 females with osteoarthritis of the hip who had undergone total hip arthroplasty (THA). We evaluated pain (Hommans sign or tenderness), edema, heat, superficial venous dilation and multiple findings on the operated side on the day physical therapy was restarted. DVT complications were diagnosed by venography. We divided patients into two groups: the 12 patients with DVT complication belonged to group P, and the 23 patients without DVT were in group N. In comparison of symptoms between two groups, only pain was statistically different. The other symptoms tended to be more apparent in patients belonging to group P than group N, but 5 of 12 patients in the group P had a free floating thrombosis (FFT) which progresses easily to a pulmonary embolism, and clinical findings were fewer on the lower extremity with FFT. We should confirm the existence of DVT by not only clinical findings, but also by venography before the start of physical therapy.

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