We measured the cardio ankle vascular index (CAVI) using a pulse wave test instrument for 47 patients who had requested physical therapy for disorders of their bone joints, cerebral blood vessels and cardiovascular diseases. CAVI, which indicates the tendency of arterial sclerosis in the extremities, showed significant differences between two groups: one suffering from more than two disorders out of high blood pressure, angina cordis and diabetes, and the other being the other patients' group. The former group also showed significant differences with or without a history of angina cordis. These results may show the development of serious disturbances of peripheral circulation or coronary artery diseases, indicating a need for caution when conducting therapeutic exercises. Compulsory pulse wave testing before therapeutic exercises could possibly provide beneficial information on exercise load.

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We studied the effectiveness of preventive care of physical therapy provided by the preventive care business "Simple Rehabilitation" in Tokyo, Shinagawa ward. The subjects were 66 elderly people with care needs (24 men and 42 women; mean age: 77.4). Grip strengths before and after the rehabilitation were 18.1 to 20.9 kg, the times of one-leg standing with eyes open were 9.7 and 16.0 sec, functional reach were 19.6 and 25.4, forward flexion in the long sitting position was 20.3 and 24.8, the 10 m walking time were 16.2 and 13.6 sec, and the, TMIG index of competence were 8.6 and 9.7, respectively, showing significant improvement in every test. We think the reason behind the improvement is the introduction of exercises suitable for each person's needs, besides the standardized group exercise, having an effect on the general physical strength as a result.

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The purpose of this study was to reveal the ankle joint moments, arising from different shapes and mechanics of plantar flexion control during walking. The subject was 52-year-old man who was not limited in lower limb range of motion. Peroneal nerve palsy was temporarily induced using a regional anesthetic by artificial means. The orthoses were P-AFO (T85) with Tamarach joint (L85), P-AFO with a hydraulically controlled joint (GSD) and a shoehorn shaped without joint P-AFO (SHB). We compared the walking among these orthoses and healthy walking and drooping foot (DF). In the early stance phase, a big moment occurred with SHB and T85 compared with healthy walking, and GSD and DF were at the same level. Therefore, we think an auxiliary moment rarely occurred with GSD. The results suggest that to bring out the joint function to its maximum, it is important to convey the moment to the foot joint by a reaction force by means of a foot plate covering from the heel to the MP joint.

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The purpose of this study was to examine whether the sole cutaneous sensory and sole muscle spindle afferent signals or crural muscle (tibialis anterior: TA, soleus: Sol) spindle afferent signals contribute to dynamic postural control by cooling of the sole and crus. The subjects were 12 healthy young adult males (age: 21.3 ± 2.9, height: 170.8 ± 6.2 cm, weight: 65.3 ± 6.0 kg). The platform backward and forward translations were executed before cooling condition (control), and under cutaneous temperature below 20 degree C after cooling (cutaneous sensory, muscle spindle and muscle strength were inactive) and cutaneous temperature over 20 degree C after cooling (cutaneous sensory and muscle spindle were inactive) conditions. After applying platform translations, the first maximum displacements (cm) and peak time of COG and COP (ms) were selected. Latencies of Sol and TA EMG activities (RT) were measured in each condition. Latencies of Sol and TA EMG activities were not affected by cooling. In the first maximum displacements, peak times of COG and COP in the cutaneous temperature over 20 degree C after sole cooling and platform backward translation condition were significantly delayed compared to the control, however, there was no significant delay for the forward translation condition. The results suggest that sole cutaneous and muscle spindle afferent signals contribute were to reflexive postural reaction in platform backward translation, than Sol spindle afferent signals and that sole cutaneous afferent signals are not much related to reflexive postural reaction in platform forward translation.

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Reliability with regards to the evaluation of the ankle dorsal flexion range of motion (hereinafter referred to as "DFROM") is still low. DFROM measurements were tested using a hand-held dynamometer (hereinafter referred to as "HHD") in order to improve reliability of this measurement. The subjects were 10 patients with cerebrovascular disease (average age: 69.3 years old) with over three months from the onset, who had no history of foot orthopaedic diseases. DFROM measurement was carried out by applying pressure on the metatarsal bone head area of the sole of the foot in the dorsal flexion direction using the HHD, and DFROM was recorded with a digital camera. Three types of regression formula were created for the predictive value and DFROM at 100 N pressure was calculated by these regression formulas. Interclass correlation coefficient (ICC) was 0.99, "Excellent" for both actual measurements and the 3 types of predictive value. A point in common with previous studies that gave highly reliable measurements and this study is that constant pressure was applied in the dorsal extension direction when measuring DFROM.

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In this study, we used the number of zero crosspoints (ZCP) obtained from the acceleration value of the body and investigated the utility of an accelerometer in the dynamic balance evaluation of the elderly. The subjects participating in this study were nine elderly persons capable of executing a crossover step and eleven young subjects. We divided the step movement from the vertical ground reaction force of a separation-type force plate into quiet stance and single stance phases. Furthermore, we calculated the quantity of deflection and the ZCP for the elderly and young subjects and compared these values. The results obtained revealed that the value for the elderly subjects was significantly lower than that for the young subjects in the single stance phase (p<0.01). The results suggest that we can evaluate the characteristics of the postural regulation of the elderly in dynamic balance in detail by considering the number of ZCP as an index.

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To investigate the perception of verticality in the sitting position by the elderly with care needs, we measured the error between the angles that the elderly considered as the vertical in the sitting position and the actual angle for the elderly in need of care who were in their care units for more than 6 months. We also measured the same angles for healthy elderly persons and healthy young people as a control group. The relationship with rest times and with the ability of daily life was also examined in order to research the cause. The perception of verticality of the elderly with long-term care needs was quite variable and had a tendency to deviate backward compared to healthy elderly and healthy young people, showing the process of using vision for judgment was different. Furthermore, the higher the ability of daily life was in the elderly with long-term care needs, the smaller the difference in the angle was, showing convergence of correct angle differences to the value. These results suggest that searching for the optimum perceptual approach for the task and tying it into exercises, as well as getting subjects to consciously experience verticality in need of long term care.

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Some reports that a cerebral function changes exist according to a musculoskeletal disease. Depression is related to decrease of function in the left frontal lobe. The purpose of this study was to examine the effect of the affected side on depression. One hundred and thirty-six patients with lower extremity joint disorders participated in this study. Depression was measured by the self depression scale (SDS). To determine associations between SDS and other factors, multiple linear regression analysis was performed with the depression score as the dependent variable and the affected side, hypertension, hyperlipidemia, diabetes mellitus, pain (visual analog scale), health assessment questionnaire and age as independent variables. Disease on the right side was significantly associated with SDS. This result may suggest that, in patients with disease on the right side depression is more likely because of decrease of function in the left frontal lobe. It is important to approach rehabilitation both somatically and psychologically.

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This study examined the reliability of a toe pressure meter developed by the authors that can measure the force of pusing the ground by the toes. This toe pressure meter is much smaller than conventional foot-gripping force meters and was designed to enable measurements of handicapped and eldery persons who have limited joint mobility. We examined ten healthy adult males (mean age 20.3 ± 2.6 years) and the average of toe pressure was 20.8 ± 5.0 kg. With regard to measurement reproduction, toe pressure had an intraclass correlation coefficient (ICC)=0.99, suggesting it has adequate reproducibility for application in a clinical setting.

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Thirty patients with periarthritis scapulohumeris (PS) with an average of 64.7 ± 28.5 days since diagnosis performed two training methods (A: ROM training within the patients comfort zone; and B: ROM training raising the arms to the maximum at a fixed horizontal adduction angle) and the pain at the maximum ROM angle and range were compared. Method A gave a larger ROM angle and less pain at the maximal range. The results of this research suggest that, when administering ROM training to PS patients, it would be useful to confirm their individual comfort zones.

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A round back, what it is called a hump back, is frequently seen in the elderly people. A round back is thought to influence balance and gait ability, but we could not find a report of how the level of round back influences them. In this study, we measured vertebral column alignment using a Spinal Mouse, balance ability (by one-foot standing with eyes open) and gait ability (10 m walking time and 3 minutes walking distance) of 28 elderly people (5 men and 23 women, mean age 79.2). The results showed a significant correlation between round back and balance ability. It was confirmed that when the angle of anterior inclination of the trunk and the degree of round back was bigger, balance and gait agility declined, suggesting the need for assessments which include posture.

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In this study we measured and compared foot-gripping strength and one-leg standing duration time of 14 elderly people with knee osteoarthritis (OA) and 14 healthy elderly people, and investigated whether or not OA affected them. The results showed a significant positive correlation in both OA and healthy people of foot-gripping strength with one-leg standing duration time. Besides, in a comparison of the OA group and healthy group, we confirmed the in foot-gripping strength, foot-gripping strength per kg of body weight and one-leg standing duration, all showing significantly lower values in the OA group. From these results, the foot-gripping test and one-leg standing duration are related irrespective of OA. We also suggest that the risk of fall may increase due to decline of foot-gripping strength in the elderly with OA.

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In this study, we measured foot-gripping strength, grip-strength and muscle strength of the quadriceps femoris of 189 community-dwelling elderly and investigated their characteristics by gender and age. We found a gender differences in foot-gripping strength in which women's strength was only 65% of men's, and the women's foot-gripping strength weakend with age with a significant decline after 80 years of age. These findings suggest that the evaluation of foot-gripping strength, which has been indicated as being relevant to falls and exercise to improve the foot-gripping strength, are important, especially in elderly people over 80 years-old.

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The purpose of this study was to investigate whether falls can be predicted by walking under a dual-task condition. The study subjects were 46 elderly people living in the community. Measurements were the 10 m walking time with free walking, and the 10 m walking time under a dual-task condition; the change in walking time (Δ walking time) was calculated. Sixteen elderly people fell within 6 months of the evaluation. There was no significant difference in the free walking time of the fall and no-fall groups; however there were significant differences in the dual-task walking time and d walking time (p<0.05) between the fall and no-fall groups. These results suggest that, a future fall is predictable with Δ walking time.

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The purpose of this study was to consider the biochemical findings such as albumin, weight and age by two-way layout analysis of variance and post hoc with feeding independence based on the FIM (functional independence measure) and gender as contributing factors. The subjects were chronically hospitalized elderly people (40 men, 61 women, age 82 ± 11) who could feed orally. Significant values of total cholesterol (p<0.01), albumin (p<0.001) and weight (p<0.005) were found in feeding independence. From the result that albumin in particular, showed a significantly lower value (p<0.05) in accordance with a lower level of feeding independence, we suggests that nutrition support for cases with lower level of feeding independence is needed. In the comparison of gender differences, women were older than men (p<0.005) and had lower albumin (p<0.05) and lower weight (p<0.0001), suggesting a need for more attention to their condition of nutrition.

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We investigated physical therapists' understanding and the actual implementation of "Strength-Training of Muscles with Spasticity". Four hundred twenty-two physical therapists (PT) from all districts of Japan were screened using a questionnaire, and the number of responders was 221 (51.6%). The number of who had affirmative understanding about "Strength-Training of Muscles with Spasticity" was 175 (79.2%); however, 49 persons (22.2%) who were affirmative about understanding were negative about actual implementation. The major reason for non-implementation was "Spasticity was worsened, preventing recovery". These results suggest that a lot of responders had affirmative understanding about "Strength-Training of Muscles with Spasticity", but they had negative attitudes to actual implementation because of a shortage of evidence and no common understanding.

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The purpose of this study was to investigate the characteristics of the backward stepping reaction in the elderly by estimation of the acceleration of the center of foot pressure (COP) and its relationship with muscular strength. The study participants were 10 elderly people who were capable of executing a backward stepping movement and 13 young subjects. We measured the acceleration of COP at the time of the stepping movement by using a separation-type force plate. Furthermore, we estimated the muscular strength of the antigravity muscles using a hand-held dynamometer. By using multiple regression analyses, we found muscular strength was the explanatory variable of the acceleration of the COP. Muscular strengths of the peroneus longus and the quadriceps femoris were detected as significant explanatory variables in the elderly age group and that of gluteus medius was detected as a significant explanatory variable in the younger age group. These results demonstrate that there was a difference between the 2 age groups with regard to backward stepping reaction, and muscular strength was identified as one of the factors contributing to the backward stepping reaction in the elderly population.

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The purpose of this study was to verify in which part of the sole of the foot sensory perception takes place in learning partial weight bearing (PWB) and discernment of weight (DOW). The subjects were healthy adults, 11 mmales, 10 females. Using the F-scan, we measured the center of foot pressure and the peak of foot contact pressure in learning PWB and DOW. Two conditions (1/2 and 1/3 of weight) were measured in PWB, and four conditions (weight on the front or back of the foot in the seated and standing positions) were measured in DOW. We could not find a difference in the extent of sensory perception, but there was a wide dispersion sensory perception in the standing DOW task. We consider that improvement in PWB skill is achived by applying foot pressure through the big toe and metatarsal which support the flexibility of the leg joints.

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The present study aimed to clarify the items for assessment and criteria for cervical myelopathy. The subjects were 55 patients with cervical myelopathy. Frequency distributions were determined for each subcategory of typical scales as well as relationships between subcategories. The results show the necessity for assessment by measuring not only degree of independence but also skillfulness and difficulty of performance and consideration of whether sensory disturbance in the trunk is present, and also whether sensory disturbance affects activities of daily living. In bladder-rectal disturbance, we should first ask whether delayed start of voiding and/or pollakiuria are present. From now on, investigations of disability structure and interventional tasks will be performed based on these items to practice effective physical therapy for cervical myelopathy.

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The effects of a cognitive motor task of the foot sole upon standing posture balance stability were examined in a glioblastoma case with impairment of standing posture balance. In the foot sole discrimination task, the patient, in a sitting position, was required to put his foot on a board that was unstable in the abscissa or ordinate axes and to maintain the board horizontally, and moreover to judge the location of a weight that was loaded on either side of the board. This cognitive motor task was performed 10 times for each foot and the number of correct judgments was recorded. Also, sway of the center of gravity in a standing position with eyes open or closed was measured every 3 or 4 days. The standing postural sway decreased with cognitive motor learning, suggesting that control of standing posture balance can be established effectively through cognition of the shift in the center of gravity using internal somatosensory information, and also that this type of cognitive motor task is useful as a training strategy for standing posture balance impairment.

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The use of the internet in medical education is expanding along with the progress of IT Technology. In the midst of drastic changes in education strategy and methods of learning, we review what e-learning is, aspects of it and its history, as well as present controversial topics and the actual situation of its use in a medical education. Furthermore, we review how we should utilize e-learning in physical therapy education in the future and what we should aspire to do with it.

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We give a summary of the method of motor learning according to the locations of the lesions caused by cerebrovascular accidents. The locations are classified as follows: a) from area 4 to the corona radiate; b) in the lower position of the internal capsule; c) in the reticular formation; d) in the limbic system; e) in the parietal lobe, temporal lobe, or occipital lobe; and f) in the frontal lobe.

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When voluntary movement occurs three components of neuromagnetic fields are seen: a readiness field from about 1.5 seconds before the start of movement; a motor field just before the start of movement; and immediately after the movement a movement evoked field. These waveforms are together called movement related cerebral fields (MRCF). There are many things which are still unclear about the significance of each waveform component of MRCF, and elucidating the source of the electric currents and the significance of each of the waveforms, and their practical application to motor learning and motor control is the subject of our research. At this seminar we would like to give a simple overview of neuromagnetic cortical activation, introduce three fields of research related to neuromagnetic mapping, as well as explain as far as possible the future direction of neuromagnetic mapping research.

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