[Purpose] We investigated the status of exercise habits and the relationship between exercise habits and potential factors including pain, gait function, self-efficacy, and social support in patients with hip disorders. [Subjects] The subjects were 90 patients with hip disorders (61.8 ± 11.1 years of age, 79 females). [Methods] Exercise habits were classified into two groups (no exercise habits and exercise habits). Pain and gait function were measured with hip function score. Exercise self-efficacy and exercise social support were measured using questionnaires. [Results] Thirty-eight of 90 subjects reported having exercise habits. Sixteen of 38 subjects had a habit of exercising in the pool. In multiple logistic regression, there was a relationship between exercise habits and exercise self-efficacy. [Conclusion] These results suggest that physical therapists should take into consideration not only hip function but psychosocial aspects when they provide home-based rehabilitation for patients with hip disorders.

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[Purpose] The purpose of this study was to investigate changes in motor unit activity associated with early recovery of muscle strength after knee arthroplasty. [Subjects] The subjects were eleven patients who received unicompartmental knee arthroplasty. [Methods] The maximum strength of isometric knee extension and surface electromyographic activity of the right vastus lateralis were measured before and after the operation and until discharge. Average integrated electromyographic activity at maximum isometric knee extension and mean power frequency calculated by fast Fourier transform were normalized by the values at five days after the operation. [Results ]The strength of maximum isometric knee extension decreased immediately after the operation and then gradually recovered. Mean power frequency decreased significantly after the operation. [Conclusion] The results suggest that synchronization is an important factor for recovery of the strength of isometric knee extension in the early postoperative period.

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[Purpose] We investigated which indices are effective for determining the functional walking ability of hemiplegic stroke patients. [Subjects] The subjects were 62 hemiplegic stroke patients (independent walking group, 34; unable to walk independently, 28) with more than a month since the onset of stroke. [Method] We evaluated the subjects with the `Stops talking when walking' (SWWT) test, and four sub-items of the Functional Balance Scale (FBS: standing, transfers, forward reach, 360° turn) the cognitive and motor functions which are considered necessary at the time of walking. The FBS was evaluated as the number of items successfully achieved. For statistical analysis, the differences in the evaluated items between the two groups were examined. Those found to have significant differences were used as independent variables in logistic regression analysis with degree of functional walking as the dependent variable. [Results] We determined that independent walking was possible when: 1) FBS 4 items were achieved and walking continued in SWWT; 2) FBS 4 items were achieved and stopped walking in SWWT; and 3) FBS 3 items were achieved and walking continued in SWWT. [Conclusion] By adopting a novel index evaluating cognitive function during walking together with FBS from the novel perspective of numbers of items achieved, we consider that it is possible to arrive at a more practical evaluation of functional walking ability. We intend to actively pursue this line of research, to investigate the validity of our evaluation index.

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[Purpose] In this study, we investigated the effects on the movement-related cortical potential of voluntary movement and observation of the action. [Subjects] The subjects were 8 healthy adults who were right-handed according to the Edinburgh handedness inventory. [Method] The subjects grasped a cup on a table. In Task A they performed elbow flexion, and in Task B they observed another person perform the same movement. The subjects movement-related cortical potentials were measured during both tasks. The measurement location was Cz of the international 10-20 method. Electromyograms of the biceps brachii were measured, and the initial rise of the wave was used as the trigger point. The items determined were the latency of the movement-related cortical potential and its maximum amplitude. [Results] In both tasks movement-related cortical potentials were observed, but no significant differences were found between the tasks in either the latency or amplitude. [Conclusion] The results reveal that the same movement-related cortical potential appears at the time of observing a movement as when performing it voluntarily.

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[Purpose] This study investigated the effect of muscular strength reinforcement through electrical stimulation and eccentric contraction. [Subjects] The subjects were 20 healthy volunteers. [Methods] Low frequency electric stimulation was given to the vastus medialis, rectus femoris, vastus lateralis and a muscular exercise of eccentric contraction by flexure exercise of the knee joint was performed. Subjects trained for 20 minutes 3 times a week for 4 weeks. The quadriceps femoris muscle strength and thigh circumference diameter were measured at the beginning the exercise, and two and four weeks later. [Results] The quadriceps femoris muscle strength increased significantly by 22.9% two weeks later, and 44.3% four weeks later in comparison with the beginning the exercise. In addition, the thigh circumference diameter increased significantly four weeks later. [Conclusion] This method using a joint movement was an effective exercise method for the muscular strength reinforcement.

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[Purpose] The purpose of this study was to clarify awareness related to the body arising at the time of walking of healthy adults. [Subjects] The subjects were 48 healthy adults aged between 20-30 years: mean age, 25.7 ± 3.6 years. [Method] The subjects performed 10 m of indoor barefoot walking, and at the same time a semi-structured interview about body sensation was conducted. The replies to the interview questions were recorded on paper, and the language was analyzed using the approach of the revised Grounded Theory. [Results] In the experimental extraction of key points from the verbal data recorded, three concepts, "my body feels something is out of place," "a feeling between me and the external environment," and "a body image of which I am easily conscious," underlaid the content of the definition. [Conclusion] These results are reports of awareness solely as relationships with the body or the environment. It is considered that awareness of the body is awareness of the relationship. In the clinical setting, even in the guidance of patients, we propose that it is important to emphasize the search for awareness of the relationship.

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[Purpose] The purpose of this study was to compare external knee adduction moment of gait initiation and steady-state gait in people with knee osteoarthritis and normal adults. [Subjects and Methods] Ten females with severe bilateral knee osteoarthritis (KOA) and 9 female healthy adults (HA) performed gait initiation and steady-state gait. External knee adduction moment of the stance limb was measured using 3D motion analysis and force plates. [Results] The results show only a main effect of group, not a main effect of task. [Conclusion] External knee adduction moment was similar between gait initiation and steady-state gait.

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[Purpose] The purpose of this study was to identify subjects with post-stroke hemiparesis at the early stage who can be indicated for short-term intervention with Body Weight Supported Treadmill Training (BWSTT). [Subjects] The subjects were 28 post-stroke hemiparesis patients. [Methods] The subjects received BWSTT with 20% of their weight supported for 5 consecutive days. Classification & Regression Trees (CRT) were used to classify the subjects. The dependent variable was change in walking speed across the intervention, and the independent variables were age, type of disease, number of days from onset, Brunnstrom Recovery Stage of lower extremity (BRS), walking speed before intervention, and swing symmetry (symmetry). [Results] The predictive value was 19.6 m/min in the asymmetry group (n=11) with BRS of ≥V and symmetry ≤0.90; 7.2 m/min in the high walking ability group (n=6) with BRS of ≥V and symmetry ≥0.91; and 8.1 m/min in the moderate hemiparesis group (n=11) with BRS of ≤IV. The coefficient of determination was 0.60. [Conclusion] Short-term BWSTT intervention for post-stroke hemiparesis at the early stage may be indicated for subjects who maintain higher motor function of the affected lower extremity but show asymmetry in walking pattern.

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[Purpose] The purpose of this study was to investigate whether there were age-related differences in lower extremity joint power and energy in forward stepping or side stepping. [Subjects] The subjects were 10 healthy younger and 12 healthy older women. [Methods] A three-dimensional motion analysis system with force plates was used to gather data. Lower extremity peak negative joint power, negative energy and time to absorb energy, were examined during the single-leg-support phase of stepping. [Results] In forward stepping, older women exhibited smaller lower extremity negative energy and a longer time to absorb energy than younger women. In side stepping, older women exhibited smaller lower extremity peak negative joint power and a longer time to absorb energy at the hip. [Conclusion] An inability to absorb energy quickly puts older women at more risk of falls.

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[Purpose] The purpose of this study was to determine how the myonuclear number and its domain size are affected by myofibril cross-sectional area reduction in muscle atrophy of the soleus muscle of rats. [Subjects] Forty-five male Wistar rats, 7 weeks old, were used in the experiments. [Methods] We divided the rats into 4 groups, 3 days, 7 days, 10 days, and 14 days of hindlimb unloading, to analyze muscle atrophy. [Results] Myonuclear numbers statistically decreased between day-7 and day-14 of unloading in comparison with the control. However, the domain size decreased significantly in the first 7 days of unloading. [Discussion] Both myonuclear number and domain size decreased in atrophy; however, the times of reduction of myonuclear number and domain size were different. The results suggest that the term of hindlimb suspension influences the reloading effect.

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[Purpose] We investigated the changes in thoracic kyphosis and lumbar lordosis angles when a foot was placed on stools of different heights. [Subjects] The subjects were 13 healthy women (21.7 ± 3.8 years) working at a medical university. [Method] We compared the changes of the kyphosis and lordosis angles of the subjects with one foot placed on stools, 10, 20 or 30 cm in height. [Results] Significant decreases in the lumbar lordosis angles where found between the postures of quiet standing and stepping forward, and one-leg stool-stepping at heights of 20 and 30 cm. No significant differences were found for the thoracic kyphosis angles. [Conclusion] The results suggest that one-leg stepping on a 20-cm high stool could become an index in ADL guidance aiming to reduce lumbar lordosis for patients with low-back pain.

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[Purpose] This study investigated the relationship between the study of science subjects and the results of kinesiology. [Subjects] The subjects were 214 university students. [Methods] The relative proportions of study of science subjects in high school and university were investigated. Students received kinesiology lectures and had a term examination. The relationship between the study of science subjects and the results of kinesiology was investigated. [Results] No difference was seen in the result and number of re-examinations of kinesiology students between science course students and non-science course students. [Conclusions] I consider that the result of the kinesiology exam was not affected by taking sciences subjects. This was because the study of science is only one of the requirements for learning kinesiology.

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[Purpose] We investigated the clinical significance of maintenance of 30-second one-leg standing with eyes open by elderly men through its relationship with physical function. [Subjects] The subjects were 57 elderly men who participated in a health survey. [Method] For those who could maintain one-leg standing for 30 s (Poss group) and those who could not (Nposs group), we performed analysis of covariance for spinal alignment in the sagittal plane, quadriceps femoris strength, toe-grip strength, maximum walking speed, Timed Up and Go (TUG) test, 10-m obstacle course, and 6-min walking distance with age as the covariate. [Results] With the exception of the thoracic kyphosis angle all of the other measured items showed significant differences between the two groups, and the Poss group showed high ability [Conclusion] The clear difference in physical function between those who could maintain one-leg standing for 30 s and those who could not, suggests that this measure has clinical significance.

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[Purpose] In this study, we examined the incidence rate and predictive factors of respiratory complications in patients after pulmonary resection surgery. [Methods] For all 146 cases for which pulmonary resections were performed, we researched the presence or absence of respiratory complications in medical records, retrospectively, and calculated the incidence rate and incidence days for respiratory complications. We also looked for predictive factors of respiratory complications using logistic regression analysis. [Results] The incidence rate of respiratory complications after surgery showed an extremely low value of 4.1% (6 cases out of 146 cases) and the incidence day was 2.2 ± 2.2 days from surgery. The possibility or impossibility of preoperative outdoor self-walking (odds ratio 15.2) and the presence or absence of chronic respiratory disease (odds ratio 9.9) influenced the appearance of respiratory complications independently. [Conclusion] Compared to previous reports, the incidence rate of respiratory complications after pulmonary resection surgery is declining trend and we anticipate that its predictive factors have also changed.

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[Purpose] We looked for factors which are closely related to peak VO₂. [Subjects] Thirty healthy men (mean age: 22.9 ± 2.1 years) were the subjects. [Methods] Subjects performed cardiopulmonary exercise using an ergometer with a ramp exercise (30 Watt/min). We measured their peak VO₂ by expired gas analysis, evaluated oxygenation in the vastus lateralis using near-infrared spectroscopy during exercise and calculated the deoxygenation level. Moreover we measured muscle strength and muscle endurance. The data were analyzed by stepwise multiple regression analysis. [Results] Deoxygenation level and muscle strength were chosen as explanatory variables. The standard partial regression coefficients were 0.442 and 0.347, respectively. [Conclusions] Deoxygenation level and muscle strength were closely related to peak VO₂ in the local muscle function. Thus, exercise which increases these variables is effective at increasing peak VO₂.

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[Purpose] In this study our objective was to clarify whether unilateral leg strength or bilateral leg strength is important for walking and standing ability of hemiplegic stroke patients. [Subjects] The subjects were 53 hemiplegic stroke patients with lower limbs at Brunnstrom stage III or higher. [Method] Subjects' isokinetic leg extension strength was measured and divided by body weight to compute `leg power' (LP). We also measured subjects' parameters in the 10-m walking test and their performance in the 30-second stand up test (CS-30). [Results] LP on the hemiplegic side showed low levels reflecting the degree of paralysis. Walking ability showed the strongest correlation with LP on the hemiplegic side, and CS-30 showed the highest correlation with the sum of LP of each side. Furthermore bilateral LP divided by the sum of LP of each side showed a high value in the group with severe hemiplegia, and was negatively correlated with walking ability and CS-30. [Conclusion] We consider that LP of the hemiplegic side is important for walking, and that for standing ability, LP of both sides is important. Moreover, the results suggest that leg extension exercises performed simultaneously on both sides by patients with severe hemiplegia would improve the function of the hemiplegic limb.

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[Purpose] The aim of this study was to clarify the effect of a gravel surface on standing balance and overstepping an obstacle in walking. [Subjects] The subjects were 16 students. [Method] We measured center of gravity (COG) sway in static standing and the floor reaction force in overstepping an obstacle while walking on a flat surface and gravel. [Results] In quiet standing on the two surfaces, we found no significant differences for COG sway in path length, rectangular area, root mean square area, and the maximum amplitudes of sway in the X and Y directions. Compared with the flat surface, the floor reaction force in overstepping while walking on the gravel showed significant reductions in the second peak of vertical load and the anterior-posterior peak load. [Conclusion] The results reveal that the gravel surface had no effect on static balance, but in walking a defect appeared in double knee action, and the kick at the time of toe-off was weaker.

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[Purpose] To demonstrate the influence of plantar sensation on stair ascent, we analyzed kinetics and kinematics of stair ascent before and after plantar cooling intervention. [Subjects and Method] Eight healthy young men participated in this study. We measured stair ascent movement using a three-dimensional motion analysis system and six force plates before and after plantar cooling intervention by ice blocks. [Results] The trunk bending angle, the low back joint, the hip joint and the ankle joint moment increased but the knee joint moment decreased after plantar cooling intervention. [Conclusion] Subjects' forefoot had predominant sensation because plantar sensation was numbed by cooling. Plantar cooling caused a larger trunk bending angle; thus, the low back, the hip, the ankle joint moment increased but the knee joint moment decreased. These findings suggest that plantar sensation might influence kinetic and kinematic strategies of the low back and lower extremity joints during stair ascent.

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[Purpose] The purpose of this study was to investigate the relationship between students' feelings of shyness and social skills, as well as the changes in shyness and social skills after practical training. [Subjects] The subjects were 88 students and 57 qualified physical and occupational therapists. [Method] Before and after 3 weeks of practical training, we performed surveys of the students using the trait shyness scale and KiSS-18 for social skills. We also performed the same surveys with the qualified therapists as subjects. [Results] The students showed a significant rise in the trait shyness scale after the practical training, but there was no significant change was found in their social skills. Significant correlations were found between the trait shyness scale and KiSS-18 scores among students both before and after training as well as among the qualified therapists. [Conclusion] The findings of this study were that after practical training, students' feelings of shyness increased significantly, but their social skills were unchanged. We consider that heightened feelings of shyness after the practical training was one factor behind the lack of improvement in social skills, therefore, in-school inter-personal skill education is of importance.

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[Purpose] In this study, we examined the brain mechanisms for the perception of gaze direction by observation from behind using functional near-infrared spectroscopy (fNIRS). [Subjects and Methods] Oxyhemoglobin (Oxy Hb) levels were measured in 7 healthy adults under the following three conditions: 1) a task involving gaze shift by own head movement, 2) a task involving observation of another's gaze shift from behind, and 3) a task involving perception of gaze direction by observation from behind. The Wilcoxon signed-rank test was used for statistical analysis. [Results] A significant increase of Oxy Hb was observed in the left prefrontal cortex under Condition 1, in the left superior temporal sulcus under Condition 2, and in both the left superior temporal sulcus and bilateral premotor cortices under Condition 3. [Conclusion] Activation of the prefrontal cortex when perceiving the direction of another's gaze by observing him or her from behind may represent mirror neuron activity simulating one's own head movement or perceiving the goals of an observed individual's actions.

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[Purpose] We investigated the significance and clinical utility of the measurement value of the lower limb loading force measurement method in the sitting position through the correlation of lower limb strength and ability to maintain a sitting position. [Subjects] the subjects were 15 hemiplegia patients (10 men, 5 women) with an average age of 74.7 ± 5.3 years. [Method] We measured the lower limb loading force ratio, the lower limb strength ratio and ability to maintain a sitting position and performed correlation analysis on these measurements. [Results] Significant positive relationships were found among all of the measurements. Not only the lower limb loading ratio, but also the lower limb strength ratio showed a correlation with ability to maintain sitting. [Conclusion] The results suggest that the lower limb loading force measurement method in the sitting position can comprehensively and quantitatively assess trunk function as well as lower limb function of hemiplegic stroke patients.

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[Purpose] In this study, we investigated the utility of the Frail CS-10, a modified version of the 30-second chair stand test for the frail elderly, and the relationship between lower limb strength and walking ability in frail elderly persons. [Subjects] The subjects were 117 elderly persons, 54 men and 63 women, who were either frail or certified as in need of low levels of care with an average age of 77.9 ± 9.0 years. [Method] We investigated the relationships among Frail CS-10, quadriceps femoris strength, walking speed and the Timed Up and Go (TUG) test by determining Pearson's correlation coefficient for each gender. [Results] Significant relationships were found for both genders between Frail CS-10 and quadriceps femoris strength (as an index of lower limb strength) and walking speed and the TUG test (as an indices of walking and standing balance abilities). [Conclusion] The results suggest that Frail CS-10 is a simple and convenient test which reflects not only lower limb strength but also the walking and balance abilities of frail elderly subjects.

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[Purpose] The purpose of this study was to investigate the foot pressure while walking of people who have floating toe deformity. [Subjects] We chose 20 people with normal toes to participate in the control group and 20 people with toes that were not in contact the floor to participate in the floating toe group. [Methods] We used the F-scan system to investigate the foot pressure in both groups. From these results, we chose the maximum pressure of each toe and the length of the pathway of the center of gravity while walking. [Results] Compared to the control group, the floating toe deformity group showed a decreased maximum pressure in each toe, and the pathway of the center of gravity did not reach the toes. [Conclusion] The people who have a floating toe deformity do not build a base of support. As a result, it is difficult to move the center of foot pressure forward when walking. In addition, people that have a floating toe deformity have concentrated pressure on the plantar metatarsal heads, and, therefore, floating toe deformities can cause foot alignment anomalies.

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[Purpose] In this study we investigated the effectiveness of elastic stockings for inhibiting lower limb edema in female workers. [Subjects] The subjects were 30 female workers (average age: 45.1 ± 9.8 years) who mainly performed their work standing. [Method] The experiment consisted of 3 week-long stages: week 1, the baseline, when the subjects wore normal stockings; week 2, the intervention, when the subjects wore elastic stockings; and week 3, the follow-up, when the subjects wore normal stockings again. We compared daily lower limb circumference changes among the stages. [Results] The circumferences of both the left and right lower limbs at the maximum, the left lower limb at the minimum and the left forefoot showed significant reductions in rates of change in the intervention period compared with the baseline period. [Conclusion] The results suggest that wearing elastic stockings is an effective way of inhibiting lower leg edema.

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[Purpose] The objective of this study was to clarify the differences in right and left lower limb function. [Subjects] The subjects were 24 healthy students. [Method] In the half-knee squat position, a perturbative stimulus was delivered to the pelvis with a weight. The stimulus was delivered from both sides with the dominant and non-dominant side legs extended, and the center of gravity (COG) sway and the floor reaction force were measured and compared among the four conditions. [Results] Maximum lateral COG sway was significantly smaller when the perturbation was delivered to the dominant side with the dominant leg extended, than when it was delivered to the non-dominant side with the non-dominant leg extended. Also, maximum vertical floor reaction force was significantly smaller when the perturbation was delivered to the dominant side with the non-dominant leg extended, than when it was delivered to the non-dominant side with the dominant leg extended. [Conclusion] The above results suggest that the non-dominant leg is better at coping with perturbation, and show one of the differences in function between the dominant and non-dominant legs.

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[Purpose] The role and effect of group work (GW) using behavior change theory in participatory diabetes prevention classes was investigated. [Subjects] The participants were 3 men and 5 women with borderline diabetes (mean age 57.6 ± 11.2 years). [Methods] In the classes, lectures and practical training given by a health nurse 12 times, GW was performed 6 times. The participants were interviewed about lifestyle had, their blood examined, and blood pressure and degree of obesity measured before and after the intervention. After the class, the participants evaluated the content of GW. [Results] Half of the participants' lifestyles improved after the intervention, but blood pressure, results of blood tests and degree of obesity had not changed after the intervention. More than half of the participants evaluated the content of GW as "really useful". [Conclusion] GW using behavior change theory and lectures and practical training improved lifestyle, but the intervention was ineffective in improving the results of blood tests and degree of obesity.

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[Purpose] The implementation and issues of therapeutic exercise given by physical therapists (PTs) who teach exercise to diabetics was investigated by questionnaire. [Subjects] The subjects were PTs in 722 facilities with a Japan Diabetes Society certified doctor. [Methods] We sent a questionnaire to the subjects, and collected it. [Results] The collection rate was 81 percent. The facilities in which a PT teaches exercise to diabetics were less than 40 percent. Issues raised included "physical therapy for diabetics cannot be reimbursed as a medical treatment fee" and "a PT cannot effectively teach a motivationally deficient diabetic to exercise". [Conclusion] These results suggest it is not easy to give physical therapy to diabetics under the healthcare insurance system, and paying attention to the nature of the disease and a team approach is important for the therapeutic exercise.

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[Purpose] The effect of presenting a target on estimation of reach in the sitting position was examined. [Subjects] Participants were twenty-five healthy young adults (mean age 23.5 ± 3.6 years). [Methods] Participants estimated the distance of reach with or without a target. We calculated error distance and absolute error distance between estimated and actual distance. [Results] The error distance in the condition with a target was significantly more than the condition without a target. However, no significant difference was observed in the absolute error distance between the two conditions. Ninety-two percent of participants tended to overestimate (estimated>actual) in the condition with the target, while they underestimated (estimated<actual) in the condition without a target. [Conclusion] The results of present study demonstrate the effect of target existence on estimation of reach.

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[Purpose] We investigated the relationship between hand function and finger muscle strength, sense of touch and reaction time in elderly females certified in need of low levels of care. [Subjects] The subjects were 23 elderly females (46 hands; average age, 83.4 ± 4.2 years) certified in need of low levels of care, who were attending a day-care rehabilitation facility. [Method] Hand function, finger muscle strength (grip and pinch strength), sense of touch and reaction time were measured and the relationships with hand function were investigated using Pearson's correlation coefficient. [Results] Significant inverse correlations were found between hand function and light reaction time and sense of touch. However no significant correlations were found between hand function and grip and pinch strengths. [Conclusion] The hand function of elderly females certified in need of low levels of care is influenced by reaction time and sense of touch rather than finger muscle strength.

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[Purpose] We investigated the results of an intervention based on applied behavior analysis for a case presenting with difficulty in walking and hip joint pain. [Subjects] The subject was a 52-year-old female who was finding it increasingly difficult to walk because of increasing pain arising from osteoarthritis of both hips, who visited us as an outpatient 4 months after hospitalization at another facility. [Method] We performed behavior analysis after baseline measurements of pain experienced during walking and number of steps taken each day. We made a behavioral intervention of keeping a personal record and sticking to the prescribed target for the number of steps to be taken every day. We investigated the effectiveness of the intervention over 7 sessions with approximately 3 months between sessions through use of walking aids, pain experienced during walking and number of steps taken. [Results] As the intervention progressed, the dispersion in the number of steps taken and the pain experienced in walking decreased; walking aids changed from two crutches to a T-cane. [Conclusion] The present intervention, utilizing applied behavior analysis for a case experiencing chronic intense pain when walking due to hip osteoarthritis, of daily step limits directed by a physical therapist was observed over the long term, and we consider it influenced the improvement of walking ability and pain.

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