This paper focuses on the understanding of the muscle imbalance concept. In this concept, the upper and lower crossed syndrome are considered as typical musculoskeletal disorders. To understand these syndromes, we need to evaluate shortened muscles and weakened muscles in an appropriate manner. Also, motion analyses of patients should be added as an important and effective tool for understanding movement disorder. Static posture and dynamic movement such as single leg standing and gait should be evaluated and itegrated with other types of physical evaluation. Comprehensive evaluation including musculoskeletal evaluation and pathological kinesiology would help to increase the effect of physical therapy.

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In this paper we give an account of the development of physical therapy and discuss the motor relearning program and the task-oriented approach as new physical therapy interventions. Physical therapy intervention for the central nervous system focusing on stroke, should aim not just to improve paralysis, as therapy focused on the practical aspects of daily living is being requested.

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This paper presents the assessment and therapeutic approaches to unilateral spatial neglect from the view of physical therapy. In characteristics, the symptoms of spatial neglect are different in type and severity and show complexity with hemianopia or other complications. In assessment, the importance of comparing several pencil and paper tests is pointed out and the observation of influence of spatial neglect on posture and movements of patients, as well as understanding the mental status of their family. In therapeutic approaches, what to do in consideration of the characteristics and the object of intervention needs to be decided. Furthermore, in addition to conventional techniques, recently introduced methods are applying focus on sensory-motor plastic stimulation as prism adaptation and the side mirror approach.

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In the course of a patient with neurological problems relearning his functional activities, the therapist has to assess his potential for recovery and to remove the factors which obstruct the patient's abilities to function. Most patients have problems with their postural control and it disturbs their functional activities. Taking into account the appearance of voluntary movements needing anticipatory postural adjustments, and the many different kinds of sensory information needed for postural control, the processes of relearning postural control are important as the neurological base of adaptive behavior. This paper focuses on components of postural control from the clinical aspect, and the assessment and treatment approach for patients who have neurological problems.

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The purpose of this study was to consider the influence of aging on foot-gripping function by comparing the measured value of foot-gripping strength and the time taken to reach the maximum grip strength of 15 healthy men (30 legs) and 21 local elderly men (42 legs). From the results, the foot-gripping strength of elderly people was 48.3%, the time taken to reach the maximum was 214.3%, and the grip strength was 71.2% of healthy adults. The results suggest that the foot-gripping function such as foot-gripping strength and the time taken to reach the maximum are more influenced by aging than grip strength. The results suggest the significance and importance of scientifically researching not only foot-gripping strength which has been indicated as being relevant to falls, but also foot-gripping function and the time taken to reach the maximum grip strength which may also be related to occurrence of falls.

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Aim: The sternoclavicular joint (SCJ) articulates the upper limbs and the trunk is thought to deeply participate with the movement of the upper limbs. The SCJ has an articular disc which provides function as a spheroid joint. The purpose of this study was to investigate the SCJ disc histopathologically. Materials and Methods: Human SCJ discs obtained from autopsy cases without arthro-skeletal diseases, were investigated histopathologically, using a light microscope. Results: We observed the findings of tear, myxoid degeneration and chondrocyte cloning in the SCJ discs. Almost all discs showed surface avulsion like hangnails. Conclusions: The histopathological findings of the SCJ discs in this study correspond approximately with the reports of menisci. The avulsion like hangnails may indicate a distinctive style of fibrillation of the SCJ disc.

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The purpose of this study was to clarify the relationship between kyphosis and breathing in elderly people. Hand grip power, pulmonary function, maximal inspiratory mouth pressure (PImax), maximal expiratory mouth pressure (PEmax), and breathing patterns were compared between the kyphosis group and the normal group. In the kyphosis group, hand grip power, PImax, PEmax, peak flow (PEF) and %PEF were significantly lower than in the normal group. During spontaneous breathing, there was a significantly different breathing pattern between the kyphosis group and the normal group. There was more chest movement in the kyphosis group, and more abdomen movement in the normal group. The kyphosis group had significantly decreased volume of abdominal movement during spontaneous breathing and slow vital capacity maneuvers.

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In this study, we evaluated motor function and cognition of elderly people and studied their relevance to falls. We divided 101 people into two groups: fallers and non-fallers. The items measured were probe reaction time while stepping, Trail Marking Test part-A, Timed Up and Go Test, 10 m free speed walking and the time taken for a step cycle. The results for the Timed Up and Go Test, 10 m free speed walking, probe reaction time while stepping and Trail Marking Test part A in the falling group were significantly extended and the coefficient of variation of time of step cycle was also significantly increased. From the evaluation of the logistic regression analysis with a fall as the dependent variable and the ROC curve, the cut-off value of probe reaction time while stepping was 497 msec. These results suggest that the probe reaction time while stepping is effective for the evaluation of fall risk in elderly people.

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In this study, we compared and analyzed the foot-gripping strength, quadriceps femoris muscle strength and the time taken to reach the maximum grip strength on the dominant and non-dominant feet of 15 healthy men (mean age: 22.4 ± 5.7, mean height: 170.2 ± 5.4 cm, mean weight: 62.3 ± 8.7 kg) (30 legs). The dominant foot was determined as the foot which kicks a ball, the function foot, and the foot which launches out the long jump was determined as the supporting leg. Comparing between the function foot and the non-function foot, the supporting foot and non-supporting foot, there were no significant differences in foot-gripping strength, quadriceps femoris muscle strength and the time taken to reach the maximum grip strength. This study could not show any significance in the foot-gripping function of the dominant and non-dominant feet and the quadriceps femoris function. We will need to consider analysis of other variables.

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As an objective motion analysis which can be used easily in clinical physical therapy, a two-dimension motion analysis by video camera was considered. We studied the inter-rater and intra-rater reliability of physical angle measurement while walking using motion analysis software. We obtained stable reliability both in inter-rater and intra-rater reliability, suggesting the possibility of getting high reliability with measurement by experienced investigators. If we can obtain sufficient reproducibility of objective measurement under established shooting conditions, such as model of camera, position of tripod, angle, zoom adjustment and a maker application spot, we consider this method will be spread widely in clinical settings as an easy-to-use two-dimensional motion analysis.

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The purpose of this study was to clarify the usefulness of pulmonary compliance determination in patients undergoing artificial respiration. The relation of pulmonary compliance level used for weaning to tidal volume and to success/failure of weaning was investigated in 221 respiratory failure patients undergoing artificial respiration. The results indicated a significant positive correlation between pulmonary compliance and tidal volume. There were many cases of tidal volume below 5 ml/body weight when pulmonary compliance was less than 30 ml/cmH₂O. Furthermore, the pulmonary compliance cut-off value (32 ml/cmH₂O) used to judge success/failure of weaning showed high precision for discrimination. Because these results indicate a close relation of pulmonary compliance to tidal volume and success/failure of weaning, we believe the determination of pulmonary compliance to be a useful index in the assessment of patients undergoing artificial respiration.

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A subjective evaluation sheet and a file creation were introduced to our University classes and we investigated whether students' study was changed and aimed to consider how to introduce a portfolio to our classes in the future. We introduced a subjective goal and evaluation sheet (Method 1) and a way to create files (Method 2) to 193 students. In a questionnaire after the methods' introduction, students' comments were collected. More than 50% of students thought that the methods were effective, but the students who thought the methods were useful for their study and classes were 40%. In the case of usage of portfolio in classes, we will need to take account of individual differences in learning area and accomplishment, and consider the academic subjects for its introduction and the evaluation method of learning.

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We studied the effectiveness of an intervention program for preventing falls in 385 elderly people who participated in an exercise class aimed at preventing falls and fractures, and examined the factors effective in fall prevention. Intervention twice weekly for 6 months resulted in a significant decline in Geriatric Depression Scale (short form) scores, and a significant improvement in the time taken to stand up and to walk 6 meters. A significant decrease in the number of falls was observed in association with the following factors: age ≥70 years, lower back pain, use of ≥3 drugs, experience of falls, ≥3 risk factors for falling, and a score of ≤29 on the Fall Efficacy Scale. Low-frequency intervention can be effective for maintaining and improving the physical functioning of elderly people in the community. Consideration of the factors causing the elderly to fall is important.

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This study investigated the relationships among subjective view of health, motor ability , functional capacity, lifestyle and social attributes based on data obtained from community dwelling elderly persons. The number of elderly men and women participating in the study was 223 (average age: 76.4 years). The number of measurement items was 3 items of motor ability,13 items of functional capacity, 5 items of social attributes and subjective view of health. The results of the analysis indicate that subjects with the poor health group had lower scores for each item than those in the good health group. Significant correlations between subjective view of health and motor abilities, functional capacity and lifestyle were found. Height, weight, BMI, functional capacity and lifestyle in all subjects, were also associated with subjective view of health.

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This study investigated the relationships among lifestyle, motor ability, functional capacity and social attributes based on data obtained from community dwelling elderly persons. The number of elderly men and women participating in the study was 221 (average age: 76.5 years). Haga's Quesionaire-22 was used as an indicator of lifestyle, with 22 points or higher (perfect score) indicating a healthy lifestyle. Information on 3 items of motor ability, 13 items of functional capacity and 5 items of social attributes was also obtained. The results of the analysis indicate that subjects with better lifestyle had higher average scores for motor ability and functional capacity than those with poor lifestyle. Lifestyle, motor ability, functional capacity, and physical condition were significantly correlated with each other. These results suggest that improvement of lifestyle in old age is considerably effective for preventing decline in functional capacity, motor ability and physical condition.

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We asked 12 healthy women to perform a single leg landing on a force plate from a 40 cm board with three lower extremity alignments, Neutral, Knee-in & Toe-out and Knee-out & Toe-in, and electromyographic data and ground reaction force were measured. The maximum muscle discharge and the integral of the rectus femoris muscle, the integral of the lateral vastus muscle and the ground reaction force to inside of the body in the conditions of Knee-in & Toe-out were significantly larger than those in Neutral. The ground reaction force to outside of the body in Knee-out & Toe-in was significantly large. The results show that by contracting the rectus femoris and lateral vastus muscles, the tibia is drawn out, and a shear force occures on the inside of the tibia in response to the ground reaction force received by the femur in the Knee-in & Toe-out condition. Thus we consider that ACL damage happens easily. In the Knee-out & Toe in conditions, we consider ACL damage can happen easily because in addition to raising the extension force on the ACL through rotation of the lower leg, a shear force occurs on the outside of the tibia in reaction to the femur.

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This study examined the relationship between foot arch ratio and centre of foot pressure in the mediolateral direction (CFP). Twenty women were divided into three groups with four, eight and eight participants, respectively, according to their foot arch ratio. Group 1 had an arch ratio of less than 11%, group 2 between 11% and 15%, and group 3 larger than 15%. The mean (SD) arch ratio of group 1 was 10.7 (0.2)%, group 2 11.8 (0.5)%, and group 3 16.7 (1.2)%, with the latter being significantly higher than that of the other two groups. CFPs of groups 1 and 2 were found to be significantly displaced to the medial side of the foot compared to that of group 3. These findings suggest that CFP in the mediolateral direction can be used as an assessment tool for persons with flat feet. The arch ratio may also be considered as a useful parameter when measuring for an arch support.

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The purpose of this study was to clarify wherher sitting up of hemiplegic patients with stroke had a relation with space perception or somatosensory. Subjects were 26 hemiplegic patients after stroke (mean age 64.0) and were assessed in the time to rise from supine to sitting and in functions by the wooden blocks test of the Wechsler Adult Intelligence Scale-Revised, sensory tests and abdominal power test of the Stroke Impairment Assessment Scale, Brunnstrom stage, trunk range of motion and Hasegawa's Dementia Scale-Revised. Assessment of sitting up time had high reliability (ICC(1,1)=0.86). Minimum time and average time on sitting up had significantly negative correlations with the block test and sensory tests. This finding suggests that sitting up of hemiplegic patients after stroke is related to space perception and somatosensory.

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Arthrokinematic approach-Hakata method, includes the role of therapeutic movement technique in addition to manual pain therapy. Resistive component movement is one of these methods. In this study, we performed the therapy to both sides knee jount of elderly people without history of central nervous disease using only manual methods, and changes in dynamic balance ability before and after the approach were investigated. The subjects were 20 elderly people who could gait by themselves who were divided into two groups of 10 by random selection of cards: with the performance of resistive component movement (mean age, 77) and without the movement (mean age, 76). The dynamic balance ability was evaluated with Timed Up & Go Test (TUG). The results show that the TUG value of the group with resistive component movement after the performance was significantly decreased (p<0.05), suggesting that this manual technique is useful for improvement of dynamic balance ability. We can propose resistive component movement as a therapy for the improvement of dynamic balance ability in clinical settings.

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In this study, we investigated the relationship among Berg Balance Scale, the fall history for the past one year, and locomotion level for 22 nursing home residents and 23 day-care users. There were no significant differences in total score of the Berg Balance Scale, fall history and locomotion level between nursing home residents and day-care users. However the fall risk of the nursing home residents was about 13% higher than that of day-care users when total scores of the Berg Balance Scale were converted to fall risk. Furthermore, there were significant differences in two items of the Berg Balance Scale, turning trunk and stool stepping, between the two groups. It is considered that dynamic balance ability influenced these results and the distinguishing characteristics of the two groups. Although the total score of the Berg Balance Scale did not correlate with fall history in either group, the total of the Berg Balance Scale correlated with locomotion level. This indicates that it is impossible for the total of the Berg Balance Scale to predict fall, but the total of the Berg Balance Scale may predict the level of locomotion to some degree.

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