[Purpose] We assessed whether abdominal belts can facilitate static and dynamic postural balance in the elderly. [Subjects] The subjects were fourteen healthy elderly persons (mean age 70.0 ± 6.8 yrs) with no significant medical history of neurological or orthopedic disease. [Methods] Performance of static and dynamic postural standing balance with or without an abdominal belt was measured using a Gravicorder G-620 stabilometer (Anima Co.). [Results] No significant difference was found in static balance between the two conditions, whereas a significant difference was observed in dynamic balance. [Conclusion] These results suggest that wearing an abdominal belt causes higher abdominal pressure and improved dynamic postural balance due to adjusted postural tone.

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[Purpose] Recently, the task of imagining a certain motion has begun to be applied to rehabilitation. The recovery of subject's walking function is a major purpose, but it is controversial whether the higher motor-related area becomes active during walking imaging. We revealed by functional imaging that the higher motor-related area becomes active in rhetoric to image walking. [Subjects] The subjects were 12 healthy adults (2 men and 10 women, mean age 24.1 ± 5.6 years). [Methods] The subjects cerebral blood flow (CBF) was measured during imagining walking under conditions A and B. In condition A, the subjects were directed to imagine walking. In condition B, they were directed to imagine walking thinking that their heels sink into a soft sandy beach. [Results] CBF of the left dorsal premotor area, both supplementary motor areas and the left primary motor area significantly increased in condition B (p>0.05). [Conclusion] The directions for walking imaging by rhetoric activate the motor-related area.

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[Purpose] We investigated the relationship between arthralgia of the knee joint and muscle strength of the quadriceps femoris in elderly women. [Subjects] The subjects were 94 legs of 47 elderly women (mean age 77.9 ± 6.2 years) who visited an orthopedic clinic for care. [Methods] We measured the muscle strength of the quadriceps femoris, muscle thickness and maximum femoral girth, and the measurements were compared between the arthralgia group (49 legs) and non-arthralgia (45 legs) group. [Results] The muscle strength of the quadriceps femoris in the non-arthralgia group was significantly positively correlated with maximum femoral girth (r=0.56) and muscle thickness (r=0.64), but not in the arthralgia group. [Conclusion] These results suggest that current reported measurements of muscle strength of the quadriceps femoris in the elderly with arthralgia of knee joint may not measure latent maximum muscle strength. Therefore, we think a new method needs to be devised for the measurement of maximum muscle strength.

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[Purpose] We aimed to make clear the traits of the respiratory function of children with severe motor and intellectual disabilities by examining their relation to experience of pneumonia within two years. [Subjects] The subjects were 15 children suffering severe motor and intellectual disabilities admitted to the Ibaraki Prefectural University of Health Science Hospital for the purpose of rehabilitation. All had normal blood oxygen saturation level during sleep. [Methods] The children's parents were asked whether or not their child had suffered pneumonia within the last two years. Each subject's tidal volume per body weight and respiratory rate were measured during sleep at rest, and examined in relation to the history of pneumonia. [Results] While subjects who had suffered pneumonia within the last two years showed no difference in terms of tidal volumes per body weight during sleep, their respiratory rates during sleep were significantly higher than those of the subjects with no experience of pneumonia within the last two years. [Conclusion] This result clearly shows that children suffering severe motor and intellectual disabilities who have experienced pneumonia within the last two years tended to have higher respiratory rates during sleep, which suggests that their ineffective respiratory pattern continues during sleep at rest.

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[Purpose] We examined the effect of exercise intervention by walking (30 minutes 3 times a week) on physical, cognitive and psychological functions of the elderly in a randomized controlled trial. [Subjects] The subjects were 69 community-living elderly (mean age 72.0 ± 4.4 year). [Methods] We appraised the subjects' body, cognitive and psychological functions before and after walking, and compared them. [Results] In twenty-five subjects (intervention group) who continued the walking for 12 weeks, 6 minutes walking distance after the intervention became longer. Also, their psychology (for example subjective sense of well-being), living life satisfaction and motivation in life seemed to improve after the intervention. However, there were no significant differences of body function, like upper and lower limb strength and standing balance, and cognitive function between before and after intervention. In the control group (29 subjects), no significant difference was found in any measurement. [Conclusion] We suggest that exercise intervention by walking can be useful in care prevention and health promotion for the elderly. It will be necessary to consider intervention's term, and frequency, and the exercise intensity in future studies.

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[Purpose] We investigated the factors involved in lateral thrust in gait of knee osteoarthritis (OA) patients. [Subjects] The subjects were 16 knee OA patients. [Method] Lateral thrust at the time of peak acceleration, the peak frequency of acceleration and lateral average frequency in gait derived from an accelerometer were used as the objective variables, and grade of knee OA, femorotibial angle, gait velocity, knee extension strength, and the muscle activities of the vastus medialis (VM) and vastus lateralis (VL) during gait were used as the explanatory variables. [Results] In weighted regression analysis, VM at the start of muscle activity was found to be a factor of the peak frequency of acceleration, and VL from the start of muscle activity until heel contact was found to be a factor of lateral average frequency from integrated electromyograms. [Conclusion] The results suggest the necessity of an approach which activates the muscles before heel contact in movement therapy for knee osteoarthritis patients.

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[Purpose] To understand stair ascent and descent motions, we examined the muscle activities of the vastus medialis (VM) and vastus lateralis (VL) and the ground reaction force (GRF) in the supporting leg of eight young healthy males. We also compared these data with level walking data. [Result] The muscle activities of VM and VL during the ascent motion were the highest among the three tasks. The muscle activity ratios of VM and VL during ascending and descending differed from that during level walking. The VM contribution increased in the ascent and descent tasks compared with level walking. There was no significant difference for the vertical GRF among the tasks. Although the anterior-posterior GRF during the ascent motion was similar to that during level walking, the anterior-posterior GRF during the descent motion was different from that of the ascent motion and level walking. Further, the medial-lateral GRF during ascending and descending were different from that during level walking. [Conclusion] The results of this study suggest that the increased VM contribution of the supporting leg may be related to the change of medial-lateral GRF during ascent and descent. This finding will add knowledge to the rehabilitation and physical therapy of ascent and descent motions for elderly people and patients with motor disorders.

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[Purpose] The purpose of this study was to clarify the influence of different stairstep heights and aging on toe clearance during stair-climbing. [Subjects] The subjects were 10 young women and 10 community-dwelling elderly women. [Methods] We measured toe-clearance during stair-climbing with different stairstep heights: 5 cm, 10 cm and 15 cm. [Results] Two-way ANOVA showed that toe clearance of the elderly were significantly greater than toe clearance of the young regardless of stairstep height. [Conclusion] The results suggest that during stair-climbing feedback on toe clearance was received from the first step, leading to adjustment in subsequent steps, which was unaffected by differences in stairstep height.

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[Purpose] Employing a comfortable posture and with the trunk leaning forward with the upper limbs supported in bicycle ergometer exercise, we clarified the effects and characteristics of posture from the respiratory responses. [Subjects] The subjects were 9 healthy young adults, average age 23.1 ± 0.8. [Method] Two groups, the TF group (trunk inclined forward with the upper limbs supported) and the HH group (gripping the handlebar), performed automatically regulated fixed heart rate load exercise for 20 min, and we compared the respiratory responses. [Result] The TF group respirated less as a result of prolonged expiration, and had superior ventilation efficiency. [Conclusion] The TF group's pedaling posture was found to have physical characteristics similar to a comfortable posture, suggesting it would be beneficial for chronic respiratory failure patients, who characteristically display shallow, rapid breathing in continuous exercise on a bicycle ergometer.

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[Purpose] In this study, we were aimed to clarify the position for measuring lower leg circumferences. [Subjects] The subjects were 102 healthy Japanese (50 males, 52 females). [Methods] The lower leg length was measured from the center of the lateral malleolus to the head of the fibula inferior extremity, among which seals were placed at a 1 cm intervals. We measured the circumference at each, locus and identified the greatest lower leg circumferences. [Results] A significant difference was not found between men and women in the position of the greatest lower leg circumference, but males had significantly greater lower leg greatest circumferences. [Conclusion] For healthy young subjects, irrespective of muscle or fat volumes, the position of the greatest circumference of the lower leg was more or less consistent.

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[Purpose] We evaluated lower limb strength and balance ability of obese children, and compared them with those of non-obese children in order to understand the physical characteristics of obese children and to contribute to an exercise therapy program. [Subjects] The subjects were 13 obese and 60 non-obese elementary school children aged 9 to 12. [Method] Isometric knee extension strength and one leg standing time with eyes open and closed of all the subjects were assessed. [Results] The one leg standing time with eyes closed of obese children was significantly lower than that of the others, but no differences in isometric knee extension strength or one leg standing time with eyes open were found. [Conclusion] It can be considered that the physique of obese children is a factor of one leg standing time with eyes closed, since knee extension strength was not. In considering exercise therapy for obese children, a program of exercise therapy aiming to improve the physique should be considered rather than simple balance training alone.

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[Purpose] In this study, we measured the peak expiratory flow (PEF) as an index of the cough intensity of stroke patients both with and without dysphagia and compared it with non-stroke subjects to evaluate factors associated with cough intensity. [Subjects] The subjects were 46 stroke patients who had developed stroke within the past six months and 24 non-stroke control. [Methods] Stroke patients were divided into two groups: a dysphagia group comprising 22 patients with dysphagia, and 24 patients without dysphagia. An electronic peak-flow meter was used to measure the PEF. We examined the following factors associated with cough intensity: age, body height, body weight, body mass index(BMI), Brunnstrom Recovery Stage, Barthel index, serum albumin level, and dysphagia grade. [Results] PEF declined in value in order of the control group, patients without dysphagia, and patients with dysphagia. The body weight, BMI, PEF, serum albumin, and Barthel index of the dysphagia group were significantly lower those of the control group. The PEF of the stroke patients was used as an objective variable and the following factors were analyzed using stepwise multiple regression equation: serum albumin level, body height, and dysphagia grade. [Conclusion] The results suggest that the cough intensity of stroke patients is lower than that of non-stroke subjects, an observation that may be associated with the malnutrition due to dysphagia.

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[Purpose] In this study, we elucidated the effects of different methods of visual perception (static and dynamic) on stepping-over motion during walking in a straight line or while turning 90 degrees. [Subjects] The participants were 31 healthy students. [Methods] The subjects performed tasks involving stepping over obstacles under four different conditions. In each condition, body sway measurements were taken immediately after subjects stepped over the obstacle, and clearance distance (between the subject's foot and the obstacle) during the stepping-over motion was measured. [Results] No significant differences in either rectangular area or root mean square area were seen for subjects' center of pressure among the conditions. Measurement of toe clearance showed that for both walking conditions (walking in a straight line and turning 90 degrees while walking towards the obstacle) the proximity of the limb to the obstacle was significantly closer in the dynamic than in the static condition. While turning 90 degrees, heel clearance during stepping-over motion was significantly closer to the obstacle in the dynamic condition than in the static condition. In the dynamic condition, heel clearance during stepping-over motion was significantly closer to the obstacle when turning 90 degrees than when walking in a straight line. [Conclusion] The results suggest that the multiple observations required to change locomotive direction, while approaching an obstacle in the travel path, allows the dimensional features of the object and the relationship between whole-body movements during locomotion and the obstacle to be perceived more three-dimensionally and more appropriately, contributing to improved kinematic control when stepping over the obstacle.

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[Purpose] In this study, we examined changes of electromyogram activity in hip muscles under different load conditions and angles of hip abduction during hip abduct isometric shrinkage movement. [Subjects] The subjects were twelve healthy adults with a mean age of 21.2 years. [Methods] The subjects performed isometric shrinkage movement for hip abduction with different load conditions (0%, 2%, 4%, and 6% of body weight) and different angles of hip abduction (0°, 10°, 20°). Electromyography (EMG) of the gluteus medius, gluteus maximus, tensor fasciae latae were measured in the motor task. [Results] EMG of the gluteus medius increased from quantity of load of 4% and abduct angle 20°. EMG of tensor fasciae latae increased from quantity of load of 2% and abduct angle 10°. [Conclusion] These findings suggest that not only load condition but also angles of hip abduction are important.

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[Purpose] In this study, we compared muscle activities in one foot bridging motion with those in hip abduction motion to examine its effectiveness. [Subjects] The subjects were twelve healthy adults with a mean age of 21.2 years. [Methods] The subjects were requested to perform isometric shrinkage for hip abduction with changes of load (0%, 2%, 4%, and 6% of body weight) and range of hip abduction (0°, 10°, and 20°) and bridging on one foot. Electromyography (EMG) of the gluteus medius, gluteus maximus, tensor fasciae latae were measured in the motor task. [Results] There was no difference in EMG between one foot bridging motion and hip abduction motion. [Conclusion] These results suggest that the one foot bridging motion is effective for muscle strengthening.

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[Purpose] The purpose of the present study was to examine the reliability, content validity and criterion validity of the customer satisfaction scale based on need satisfaction (CSSNS) that we are currently developing for health care services. [Subjects and Method] Referring to a previous study and our preliminary study, we assumed that customer satisfaction is composed of five needs: competence, autonomy, relatedness to participant, relatedness to service provider and physiological need. A psychologist checked the 19 items we developed for the CSSNS. To examine criterion validity, the following four external criteria were prepared: customers' satisfaction, intention to return, intention to change, and recommendation to others. The data of 250 subjects using rehabilitation services were used for factor analysis, calculating of Cronbach's alpha coefficient and correlation analysis. [Results] The results of the factor analysis confirmed the five factors that we assumed in advance. Cronbach's alpha coefficients showed the high internal consistency of CSSNS and its subscales. The correlation analysis showed a significant positive relationship between total CSSNS score and scores of each criterion. [Conclusion] The reliability, content validity, and criterion validity of CSSNS were confirmed.

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[Purpose] To investigate the objective effectiveness of ultrasound therapy, an experimental study was carried out. [Subjects] Sixteen adult female Wistar rats were used in this study. [Methods] Their right ankle joints were immobilized using casts for a week. For eight rats, the casts were removed once a day, and they were exercised with treadmill running after ultrasound exposure (US group). The other rats performed treadmill running without ultrasound exposure (Control group). The range of motion of the ankle joints were compared on the last day. [Results] There was a significant decrease in the degree of severity of the contractures in the US group, as compared to the Control group (p=0.0267). [Conclusion] This result shows the effectiveness of ultrasound therapy on preventing joint contractures in rats.

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[Purpose] We investigated the effect of using a cane on thetrunk and lower limb muscle activities in a standing position with the trunk bent using an apparatus that simulates the physical experience of the elderly. [Subjects] The subjects were 12 healthy young people: 9 males, 3 females, average age 20.0 ± 0.7. [Method] We measured the muscle activities in quiet standing under 3 conditions: A, normal standing; B, wearing the apparatus; and C, wearing the apparatus and using a cane. Quiet standing was measured for 30 sec, and the middle 10 sec was used for analysis. The muscles examined were: the erector spinae, rectus abdominis, gluteus maximus, gluteus medius, rectus femoris, biceps femoris, anterior tibialis, and gastrocnemius. [Results] In condition B, compared to A we found a significant increase in the muscle activities of the anti-gravity muscles. In condition C, compared to B we found significant decreases in the muscle activities of the erector spinae, gluteus maximus and gastrocnemius. In condition C, compared to A we found significant increases in the muscle activities of the gluteus maximus and biceps femoris. [Conclusion] The results suggest that the effect of using a cane on muscle activities during standing with the trunk bent is a reduction in the activities of the extensor muscles of the ankle, hip and trunk.

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[Purpose] We evaluated the effect of exercise consultation on physical activity and the resultant exercise behavior change 6 months later for patients with type 2 diabetes. [Subject] A total of 71 patients with type 2 diabetes were given exercise prescriptions and received exercise information individually. [Method] Changes from baseline to 6 months were assessed in 1) the transtheoretical model of stage of change (precontemplation, contemplation, determination, action, maintenance), 2) self-efficacy, and 3) balance of decision making. [Results] The prescription of physical exercise increased the ratios of action and maintenance stages (p<0.05). Time restrictions were significantly decreased in the maintenance stage compared to the determination and action stages (p<0.05, respectively). Laziness was significantly decreased in the maintenance stage compared to the action stage (p<0.05). [Conclusions] Time constraints and laziness were the most given reasons for not engaging in physical activity in lower exercise behavior change.

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[Subjects and Methods] In this study, we measured the time required for sitting up and evaluated its relationship with the function of the upper and lower extremities on the hemiplegic and non-hemiplegic sides and the trunk in 20 subjects with hemiplegia (mean age: 65.4 ± 11.3 years old). [Results] Simple correlation and multiple regression analyses revealed that the function on the non-hemiplegic side (quadriceps force) and trunk control as assessed by the trunk control test were factors affecting the time required to sit up. [Conclusion] The results suggest that the sitting up action is more affected by the function of the trunk and the upper and lower extremities on the unaffected side rather than on the hemiplegic side, and physiotherapy to improve the function of the trunk and the upper and lower extremities is important for patients with hemiplegia to be able to sit up smoothly.

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[Purpose] The purpose of this study was to investigate the decrease in muscle tone induced by linear polarized near-infrared ray (LPNR) irradiation on the gastrocnemius and tibial nerves, and to consider the neural and peripheral components and time since onset of corebrovascular disease (CVD). [Subjects and Method] Forty-two CVD patients participated in this study. They were randomly divided into 3 groups. The N group was irradiated on the tibial nerve, G group was irradiated on the gastrocnemius, and C group was not irradiated. Rl and R2 of the modified tardieu scale (MTS) were measured 4 times: before and after irradiation, after irradiation on the fifth day and five days after the last irradiation. Subgroups were established for differences in time since onset of CVD (short group, long group) and quality of muscle rection (QMR) of the MTS (QMR of 2 and under, QMR of 3 and up). [Results] The immediate effect on R1 mainly reflected the neural components of muscle tone in N group of short group was significantly different from other groups. [Conclusion] The results suggest that LPNR irradiation of the nerves is effective at suppressing neural components of muscle tone in subjects with short times since onset of CVD.

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[Purpose] We investigated the characteristics of the deltoid muscle (anterior, middle and posterior fibers) using surface electromyography. [Subjects] The subjects were 16 healthy young males, average age 22.9 ± 2.9. [Method] At maximum isometric voluntary contraction (MVC), 50% MVC and 25% MVC we obtained integrated electromyograms (IEMG) and median power frequencies (MdPF), and compared them. [Results] We found significant decreases in IEMG with decrease in %MVC for all of the muscle fibers. For the anterior and middle fibers, we found significant increases in MdPF with decrease in %MVC; however, no significant differences were found for the anterior fibers among the muscular contractions. [Conclusion] Since the deltoid muscle has a unique relationship with MdPF, we conjecture that it cannot be seen as having a role as an `outer muscle' but rather has activities that are both continuous and preparatory at the same time.

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[Purpose] Severely mentally and physically handicapped children usually have a decubitus posture for a long time, and tend to have scoliosis and thoracic deformity due to disproportion of myotonia and gravitational effects. It is also reported that the thorax deforms asymmetrically as scoliosis becomes severe. However, the objective evaluation of thoracic deformity has not been performed. We aimed to examine the thoracic deformity by quantitative chest compression in this study. [Subjects and Methods] We used the evaluation of quantitative chest compression as proposed by Goldsmith et al. and Imagawa et al. and examined 17 adults with serious handicaps (average age 42.12 ± 9.82 years old) and 18 healthy adults (average age 40.56 ± 10.05 years old). [Results] The average proportions of chest compression were 0.63 ± 0.08 in adults with serious handicaps, and 0.72 ± 0.06 in normal adults. We observed a significant difference between them. Also, a significant correlation was found between chest compression and the weights of adults with serious handicaps (r=0.463). The height and BMI were not significantly correlated with chest compression. [Conclusion] The results suggest that quantitative chest compression is good at characterizing the thoracic deformity of adults with serious handicapps.

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[Purpose] We report the outcome of hip traction therapy for pain on the non-operated side for a case with bilateral osteoarthritis of the hip who received unilateral total hip arthroplasty. [Subjects] The subject was a female in her fifties who had late stage bilateral hip osteoarthritis, and who could walk about 500 m using a T-shaped cane prior to surgery. [Method] The assessment items were pain assessed by a pain meter and 10m walking speed. [Results] The patient commenced walking with a T-shaped cane 1 week after surgery, was discharged after 3 weeks, and resumed work after 4 weeks. Pain on the non-operated side and 10m walking speed were both improved by hip traction therapy. [Conclusion] In cases of unilateral total hip arthroplasty for bilateral hip osteoarthritis, we anticipate that discharge will be facilitated by the inclusion in the clinical program of hip traction therapy on the non-operated side.

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The amount of mechanical load quantified by a cycle ergometer is the product of the pedal weight and the pedal rate. In this study, we determined the influence of different pedal rates on oxygen supply and metabolic demand. The results show that oxygen supply at a high pedal rate did not limit the oxygen consumption response. Moreover, the effectiveness of a high pedal rate was shown in energy consumption in the metabolic demand system; both glucose metabolism and the mobilization muscle fiber were efficient. In addition, rather than constant mechanical load exercise, a constant heart rate load at a high pedal rate is a more effective exercise with better risk management.

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Aerobic fitness may be defined as the ability to deliver oxygen to the muscle and to utilize it to generate energy during exercise. The evaluation of VO_2max and peak VO₂ is performed in the physical therapy field. These indices mainly reflect the ability to deliver oxygen to the muscle. However, these indices do not evaluate exercise tolerance appropriately when the factor of exercise limitation is the ability of the muscle to utilize oxygen. This study shows that τ of VO₂ reflects the ability to utilize oxygen in the muscle, and thus, should be uesd as an index of the exercise tolerance.

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