[Purpose] The aim of this study was to reveal the interrelations between parameters of center of pressure (COP) movement, and to identify parameters showing the common features of standing balance. [Subjects] The subjects were 24 healthy adults. [Methods] We measured subjects' COP motion for 10 seconds in 4 static upright postures (opened-feet, closed-feet, Mann's posture, one-legged) selected from the Berg balance scale. [Results] Only 1 factor was identified by factor analysis in the area surrounded by the maximal amplitude rectangle (REC.AREA). For the other parameters of COP movement, 2 factors were identified. [Conclusion] REC.AREA expressed the common characteristics of standing balance, so it could be possible to evaluate standing balance by REC.AREA.

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[Purpose] The aim of this study was to verify the effect on the measured values of examiners with the finger-floor distance of forward flexion in standing as an index, with respect to the effect on the elasticity of the soft tissues of the back of the thigh due to the inhibition of stretching pain used as diffuse noxious inhibitory controls (DNIC), and to investigate the difference between experienced and inexperienced examiners. [Subjects] The subjects were 42 healthy persons, 17 males and 25 females, with an average age of 20.7 years. [Methods] Three examiners measured the finger-floor distance of forward flexion, 3 times consecutively at intervals of about 1 minute, in a day, and we examined the effect the different examiners had on the measured value. In addition, in order to investigate the effect of degree of proficiency on the measured value, 2 examiners performed 2 measurements in a day. [Results] No significant differences were found among the measurements performed in a single day by the three examiners, but a significant difference was found with regard to the effect on the measurement values by two examiners with different levels of proficiency. [Conclusion] A satisfactory result was obtained for the effect of manual calisthenic therapy using DNIC when performed by those with a relatively high degree of proficiency.

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[Purpose] The aim of this study was to investigate the duration of the effect of diffuse noxious inhibitory controls (DNIC) on the finger-floor distance of standing forward flexion with healthy persons as subjects. [Subjects] The subjects were 33 healthy persons, 15 males and 18 females, with an average age of 21.1 years. [Methods] First, the finger-floor distance of standing forward flexion was measured, then with DNIC intervention, the measurement of the finger-floor distance of standing forward flexion was performed once as before during the intervention, 2 hours post-intervention, and on the day following intervention. [Results] A significant main effect was found with regard to the finger-floor distance in one-way analysis of variance. Significant differences between the intervention value and the other values were found by multiple comparison (Tukey HSD). [Conclusion] The effect of the DNIC intervention which temporarily improved the finger-floor distance of standing forward flexion had disappeared at 2 hours post-intervention, and was similarly absent on the following day.

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[Purpose] In this study we investigated the Alberta Infant Motor Scale (AIMS), focusing on the bias of the percentile ranks, in order to find out if it is possible to utilize it for Japanese infants. [Subjects] The 73 subjects, for whom we received parental consent, were mostly attending 5 nurseries. [Methods] Physical therapists translated the AIMS text and assessed the subjects following the guidelines. [Results] Among the 73 subjects, 8 were below the 5% level, 4 were in the 5-10% rank, 10 were in the 10-25% rank, 14 were in the 25-50% rank, 10 were in the 50-75% rank, 3 were in the 75-90% rank, and 24 were over the 90% level. Furthermore, when the subjects were limited to those less than 1 year of age, the results could not be said not to be a significant fit (p=0.422), and the fitness was not bad. [Conclusion] In the AIMS percentile ranks of motor development of Japanese infants, a tendency to show low values was shown.

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[Purpose] The purpose of this study was to measure the verbal working memory capacity of elderly subjects in the community by a reading span test (RST) of Japanese. [Subjects] The subjects were 11 elderly females aged 72.2 ± 5.8 years. [Method] Frontal lobe activity was evaluated during this test on the basis of changes in oxygenated hemoglobin (HbO₂) measured by near-infrared spectroscopy. [Results] Significant increases in HbO₂ were observed during 2-sentence tasks from task 1, immediately after initiation of the RST, to task 5. The increases were maintained until the end of the RST. [Conclusion] These results show that activity in the frontal lobe increases during the RST in the elderly, and working memory participates in the cognitive function of the frontal lobe.

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[Purpose] The aim of the present study was to investigate the reproducibility and the validity of measurement for the sniff nasal inspiratory pressure (SNIP). [Subjects] Forty healthy volunteers (20 men and 20 women), aged 22.2 ± 3.4 years old, participated. [Methods] Force of abdominal elevation was adopted as an assessment of inspiratory muscle strength, and the correlation between the SNIP and the force of abdominal elevation was analyzed to evaluate the validity. [Results] The SNIP measurement showed good reproducibility based on the intraclass correlation coefficient. There was a significant correlation between the SNIP and the force of abdominal elevation in both men and women. [Conclusion] These results suggest that SNIP is acceptable for assessment of inspiratory muscle strength.

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[Purpose] We assessed the TK-03C soft tissue stiffness meter (STSM) (Tokushukeisoku Corporation, Japan) for inter/intra-rater reliability. This device measures load and displacement simultaneously. [Subjects] Ten students from the Physical Therapy Department were the subjects. [Methods] The 10 subjects measured the surface stiffness of three elastomer samples with known mechanical properties: a polyurethane test piece and two sorbos test pieces. They each took 7 consecutive readings using the STMS at the same site on each test piece. We calculated the displacement for a load of 10 N. [Result] The overall rating reliability for all sites was high: site1, coefficient of variation (CV) (range)=5.3 (2.6-10.0); site2, CV=3.9 (2.3-6.1); site3, CV=5.0 (2.2-9.2). The intra-rater reliability of the 10 subjects was high showing an intra-class correlation coefficient (ICC) (1·1) ≥0.97. The inter-rater reliability was also high; ICC(2·1)=0.96. In addition, the hardness of the three test pieces were significantly different (p<0.01). [Conclusion] It seems that this STSM is a reliable and useful device for objective quantitative evaluation of soft tissue stiffness.

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[Purpose] We compared lesson consciousness between self-learning and traditional teaching classes and investigated the correlation with willingness to learn. [Subjects] The subjects were 116 students attending a physical therapy vocational school. [Methods] We conducted self-learning and traditional teaching classes and compared them by performing factor analysis on the results of a lesson consciousness questionnaire; we also sought correlation with the results of a willingness to learn questionnaire. [Results] In the results of the factor analysis of the self-learning class, the subscale scores of Factor 1 (self-originating approach to learning) as well as Factor 3 (exchanges with classmates) were higher than those of the traditional teaching class. Moreover, we found that Factor 1 was mainly based on self-motivation, and that Factor 3 was correlated with suitability for college. [Conclusion] We consider self-learning classes are a form of teaching which can raise levels of self-motivation and suitability for college.

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[Purpose] For 55 cerebrovascular hemiplegic patients, muscle strength of both of the affected and non-affected limbs, Brunnstrom stage of lower limbs, deep sensation, and the weight-bearing rate on both of the affected and non-affected limbs were studied for correlation with the 6-minute walk distance. [Subjects] The average age of the patients was 65.1 years, the average time from the onset of stroke was 98.7 days. [Methods] The correlations between the 6-minute walk distance and the above variants were analyzed with stepwise multiple regression analysis. [Results] The weight bearing rate on the affected limb correlated significantly with the 6-minute walk distance. Thirty-four out of the 36 patients with more than 80% weight-bearing rate on the affected limb achieved a 6-minute walk distance of more than 300 m, and all of the patients who had more than 90% weight-bearing rate on the affected limb achieved a 6-minute walking distance of more than 500 m. [Conclusion] We concluded that the weight-bearing rate on the affected limb correlated most significantly with the 6-minute walk distance.

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[Purpose] We examined the relation between spine curvature angle and lower limb muscle strength in elderly females. [Subjects] The subjects were 52 community-dwelling elderly females (78.2 ± 6.1 years old). [Methods] We measured thoracic spine kyphotic angle, lumbar spine lordosis angle, quadriceps femoris muscle strength and lower limb loading force, and their inter-relations were analyzed with Pearson's correlation coefficient. [Results] Lumbar spine lordosis angle was significantly correlated with quadriceps femoris muscle strength and lower limb loading force. However, thoracic spine kyphotic angle showed no significant correlation with the lower limb muscle strength. [Conclusion] These results suggest that elderly females whose lumbar spine lordosis angle decreases have weaker quadriceps femoris muscle strength and lower limb loading force.

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[Purpose] The purpose of this study was to investigate the relationship between pull test and falls in the previous year in patients with Parkinson's disease over Hoehn & Yahr Stage three. [Subjects] The participants were 24 patients with Parkinson's disease over Hoehn & Yahr stage 3. [Methods] We investigated the relationship between pull test and falls, and determined the optimal cutoff point for prediction of people at high risk of fall from the receiver operating characteristic (ROC) curve. [Results] The distribution of the pull test was significantly different between fallers and non-fallers. Using a cutoff score of 1, the pull test showed high sensitivity and specificity for identifying fallers (sensitivity: 94.7%, specificity: 60.0%). [Conclusions] We suggest that the pull test with a cutoff score of 1 might be a useful tool for distinguishing people at high risk of fall in the patients with Parkinson's disease over Hoehn & Yahr Stage 3.

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[Purpose] In this study, we examined the relationship between vibration sense and falls, and calculated the cutoff scores of vibration sense to distinguish fallers from nonfallers. [Subjects] The subjects of this study were 63 elderly persons who were able to walk by themselves, who had no disorders of cognitive function on the central nervous system. [Methods] The subjects were divided into a fallers group and a nonfallers group based on their history of falls, and they were assessed for vibration sense using a tuning fork and three performance tests (Timed "up & go" test, Modified functional reach test, Timed 10 m walk test). [Results] The vibration sense of fallers was significantly lower than that of nonfallers (p<0.01). We observed a correlation between vibration sense and each performance test. The area under the Receiver Operating Characteristic curve of vibration sense was larger than that for each performance test (0.89). Vibration sense at a cutoff score of 5.62 seconds had strong sensitivity to falls (82%) and specificity (83%). [Conclusion] These results suggest that the examination of vibration sense using a tuning fork is useful for predicting the risk for falls.

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[Purpose] In this study physical therapy students were given a problem-based learning (PBL) tutorial, and the achievement levels of self-learning and group learning were investigated and compared. [Subjects and Method] In 2007, with 120 1st ~ 3rd year physical therapy students as subjects, we surveyed the achievement levels of self-learning and group learning with a 15-item questionnaire immediately after conducting a PBL tutorial. [Results] Although there were differences between the achievement levels of self-learning and group learning in all the academic years, the results for the same items were similar. In particular, in the choice of study items and concept of problem, the study plan and its execution showed a comparatively low tendency. In the overall analysis of all the academic years, the self-learning achievement level was low compared to the group learning achievement level, and the difference between them was significant. [Conclusion] In a PBL tutorial, study envisaging clinical practice is possible, but for students to effectively learn clinical reasoning, the necessity of group learning was reconfirmed.

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[Purpose] In this study, we examined the spinal alignment of patients with lumbar facet syndrome (LFS), and compared the alignment of LFS with those of healthy subjects and subjects with previous history of low back pain. We also discuss the characteristic spinal alignment of LFS patients. [Subjects and Methods] This study examined 18 LFS patients and 56 healthy adult persons who were measured in the standing posture, forward-bending posture (thoracic kyphosis, lumbar lordosis, sacral inclination and spine column inclination) and range of forward-bending. [Results] In LFS, the range of motion for forward-bending was decreased. In addition, thoracic kyphosis had a correlation with lumbar lordosis, and lumbar lordosis had a correlation with sacral inclination. In healthy subjects, sacral inclination had a correlation with thoracic kyphosis, and lumbar lordosis had a correlation with sacral inclination. In subjects with previous history of low back pain, lumbar lordosis only correlated with sacral inclinated. [Conclusion] We conclude that sacral inclination is more important for alignment of LFS.

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[Purpose]A functional drop in attention has been cited as a factor of falls. In this study we investigated whether or not it is possible to prevent falls among the community-dwelling elderly by raising the attention function. [Subjects and Method] The subjects were 63 community-dwelling elderly persons (average age, 83.3 ± 5.9 years) who were not receiving care under the long-term care insurance program. They were divided into an attention training and exercise intervention group of 21 persons, an exercise intervention only group of 21 persons, and a control group of 21 persons. The two intervention groups performed a standard exercise intervention at a frequency of once a week for 6 months, and the attention training group additionally performed attention training. [Result] We found an improvement effect for attention function and walking ability under the dual task condition of the attention and exercise training group. Furthermore, the rate of occurrence of falls decreased from 24% to 10% during the intervention, but only in the attention and exercise training group. [Conclusion] In the prevention of falls, improvement of the function of attention is important.

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[Purpose] We investigated whether or not it is possible to use the sitting position legs open and close test as an index for prevention of falls among the elderly people. [Subjects] Seventy-five elderly people (12 males and 63 females; average age 78.3 ± 5.3 years) attending our hospital as outpatients were divided into a falls group and a no-fall group based on their histories of falls in the last one year. [Method] The sitting position legs open and close test was performed twice with an interval of at least 30 sec after one practice by both groups, and the greatest value of the performance number was adopted. [Results] We found a significant reduction in the performance number of the falls group compared to the no-fall group. [Conclusion] There is a possibility that the sitting position legs open and close test can be used as an index for the prevention of falls among the elderly people.

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[Purpose] The purpose of this study was to investigate postural control on stable and unstable surfaces of healthy young and elderly adults. [Subjects] Subjects were 14 healthy young and 10 elderly adults. [Methods] The mean range of angular fluctuation, total angular change and mean angle were measured during standing on a wobble board. Postural control on a stable surface was measured using a platform with a center of foot pressure recorder. We measured the length of the displacement of the center of gravity (LNG) and the root mean square area (RMS) while standing for 20 seconds, and the anterior-posterior distance (A-P) while moving the centre of gravity as far forward and backward as possible. [Results] Total angular change and A-P were significantly greater in the young group than in the elderly group. [Conclusion] Young people have greater abilities than elderly people to move their center of gravity voluntarily and to correct balance.

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[Purpose] The purpose of this study was to clarify the influence of optical flow on reach distance and the influence of posture and optical flow on self estimation of physical ability in the functional reach test (FRT). [Subject] The subjects were 46 healthy students. [Methods] Subjects estimated reach distance and performed FRT in each of four conditions: sitting position and standing position without optical flow, and sitting on a moving electric wheelchair and walking with optical flow. [Results] No significant differences were observed in the reach distance and the estimation error (absolute value). In both postures, the estimation error (plus-or-minus value) was larger with optical flow than without it. In standing posture, the ratio of persons who made excessive estimation was significantly higher in walking than standing. [Conclusion] The results suggest that optical flow induces excessive self estimation of physical ability, which is especially, remarkable when moving in the same upright posture of FRT performance. In physical therapy, when performing the tasks accompanying optical flow, we think that it is necessary to take into consideration the minus and plus aspects of overestimation under the influence of optical flow.

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[Purpose] This research considered a practice program consisting of the use of the Chaining Method in walking with a simulated prosthetic femur, and studied the influence this practice exerts on skills in walking with a prosthetic leg. [Subjects and Methods] The subjects consisted of 20 able-bodied people who had no experience of walking with a simulated artificial leg. The intervention group practiced using the Chaining Method, while the control group practiced after having been given the entire instructions all at once. Records were kept of the time taken to achieve the walk, the total number of times the knee was bent during the walk, and the total number of times straying from the path, for each leg. Subsequently, measurements were taken every week during a two-month period. [Results] Significant differences were found between the two groups in the amount of time taken to walk before and after practice. Also, in just a two-month period, the intervention group showed the benefit of intervention in the same evaluation items, compared to the control group. [Remarks] We think that, in using the Chaining Method, the intervention group could practice by focusing only on insufficient movements, which resulted in adoption and retention of the sequence of movements.

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[Purpose] This study investigated the improvement of weight-bearing (WBR) on the affected limb of 19 cerebrovascular hemiplegic patients who didn't show improvement of the lower limb Brunnstrom stage. [Subjects] The average age of patients was 66 years, and their average period of hospitalization was 51.6 days. [Methods] We measured independence of indoor gait, lower limb Brunnstrom stage, WBR of the affected and non-affected limbs, muscle strength of both the affected and non-affected limbs and deep sensation at start and end of hospitalization. [Results] At discharge, independence of indoor gait, WBR on the affected limb, and muscle strength of the affected and non-affected lower limbs had significantly improved. The WBR on the affected limb had significantly improved from 72.8 to 83.4% at discharge. [Conclusion] The WBR on the affected limb is improved even in the patients with no improvement in lower limb Brunnstrom stage.

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[Purpose] We investigated the characteristics of electromyographic trunk muscle activities and the relationship between the trunk muscle activities and postural sway during one-leg standing. [Subjects] Ten people (25.1 ± 4.4 years old) participated in this study. [Methods] Electromyographic trunk muscle activities and postural sway were evaluated during one-leg standing and twoleg standing. [Results] Thoracic and lumbar erector spinae and external oblique on the side of the raised leg were activated significantly more higher in one-leg standing than in two-leg standing. Lumbar multifidus and internal oblique on the side of standing leg had a tendency to be activated higher in one-leg standing. After some trunk muscle activities on the side of the raised leg and postural sway correlated significantly. [Conclusion] The results suggest that trunk muscle activities influence the balance ability during one-leg standing.

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Locomotion disorder patients often complain of shortness of breath or fatigue easily during muscle strength and walking training. In this study, we performed physical therapy for knee osteoarthritis (OA) on knee OA patients with cardiac symptoms as subjects and investigated the changes in the circulation response and the Borg scale. [Subjects] The 35 subjects (including 5 males) were either inpatients or outpatients attending our hospital. [Method] Physical therapy for knee OA was performed 4 times a week for 4 weeks. The circulation response measurement was performed after one minute of continuous sit-to-stand activity. [Results] After the sit-to-stand activity on the fourth week, systolic blood pressure, pulse pressure and the double product were found to be significantly lower than those of the first week. In addition, a significant decrease in the Borg scale was also found. [Conclusion] The intervention for knee OA was beneficial even for patients with concurrent cardiac symptoms.

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[Purpose] We investigated the characteristics of electromyographic trunk muscle activities and the relationship between the trunk muscle activities and postural sway during unstable sitting. [Subjects] Ten people (25.1 ± 4.4 years old) participated in this study. [Methods] Electromyographic trunk muscle activities and postural sway were evaluated during unstable sitting and stable sitting. [Results] Abdominal muscles were activated significantly more higher in unstable sitting than in stable sitting. Also, rectus abdominis, thoracic and lumbar erector spinae muscles activities that could be classified as global muscle activity and postural sway correlated significantly, but local muscle activity did not. [Conclusion] The results suggest that rectus abdominis, thoracic and lumbar erector spinae muscle activities that can be classified as global muscle activity influence the balance ability during unstable sitting.

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[Purpose] In this study we investigated the points needing attention in scenario setting and learning support provided by the tutor in problem-based learning (PBL) tutorials. [Subjects and Methods] We performed a survey of 118, 1st to 3rd year physical therapy students regarding learning support provided by the tutor and the scenario setting used on the final day of each academic year's PBL tutorial. [Results] The overall assessment of the scenario setting by each academic year was generally high, but among the items, the volume of information provided for scenarios 1 ~ 3 was rated lower than the others. Among 2nd year students, all items of scenario 3 were rated low, and among scenarios 1 ~ 3, a significant difference was seen in this assessment. Tutor assessment by all students was in the main a comparatively high assessment, but "Was your tutor there when needed?" was lowly rated. [Conclusion] We thought that students were mostly satisfied with learning support provided by tutors and the scenario settings. The survey results suggest the need for improvement in information materials for the scenario settings and for tutors to spend more time sitting in on group discussions.

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[Purpose] The purpose of this study was to investigate the relationship between pre-operative physical ability and post-operative ambulation after minimally invasive surgery: Total hip arthoplasty (mini-one antero-lateral incision (mini-one)). [Subjects] The subjests were 82 patients who underwent mini-one. [Methods] We classified the patients into 2 groups by ambulation: group A, 54 patinets who walked within 3 days, and group B, 28 who walked after 4 days. We investigated the relationships between post-operative ambulation and pre- and post-operative physical ability. [Results] In group A, hip abductor muscle strength and 10 m gait time, Functional Reach, and one-side disease in the pre-operative period were significantly better than in group B (p<0.05). [Conclusion] The results suggest that hip abductor muscle strength and 10 m gait time, Functional Reach, and one-side disease in the pre-operative period are predictors of ambulation after mini-one.

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[Purpose] The purpose of this study was to examine the influence on autonomic nervous system functions of exercise for preventing advance of physical disability in elderly people. [Subjects] Twenty-six hospital residents with a mean age of 78 ± 7 yrs participated in this study. [Method] They performed a specially designed low-intensity training session consisting of flexibility exercises, muscle fatigue resistance using an elastic band, and balance training, twice a week for 12 weeks. We measured physical function, blood pressure, pulse, and autonomic function before and after exercises. [Results] There were no significant changes of blood pressure or heart rate. A significant difference was observed in the sympathetic nervous system. The mean parasympathetic nervous system was significantly decreased. [Conclusion] The results indicate that the exercise for elderly people improved their autonomic nervous system function.

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