[Purpose] In this paper we examine the changes in and current state of proprioceptive neuromuscular facilitation (PNF) education in physical therapy vocational schools. [Subjects and Method] Questionnaires were sent to physical therapy vocational schools teaching in 2003 and 2008, and 107 and 114 replies were received, respectively. The contents of PNF lectures were compared between the two surveys. [Results] PNF lectures were delivered in about 90% of schools in both years. In the comparison between the two years, the percentage of schools using the terms "PNF" or "Neuromuscular Facilitation Therapy" as the title for lectures increased. Regarding the content of lectures, there was a declining number of schools teaching specialist techniques or applied movements. [Conclusion] There were differences in lecture hours and lecturers PNF experience, leading to the conclusion that PNF is not taught at the same level among schools. Accordingly, sufficient provision of post-graduate courses and training is desirable.

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[Purpose] The purpose of this study was to clarify changes in diaphragm activity and abdominal muscle activity during repeated measurements of maximal inspiratory pressure (PImax) that lead to an increase in PImax. [Methods] Eleven healthy male subjects underwent 20 PImax and 3 maximal expirator pressure (PEmax) measurements. Electromyography of the diaphragm and abdominal muscles (rectus abdominis, external oblique, internal oblique) were recorded by surface EMG during PImax and PEmax measurement. Short PImax (average of the first 3 highest values with <5% variability) and long PImax (average of the 3 highest values with <5% variability from all recorded measurement) were determined, and these PImax and the root-mean-square (RMS) amplitude of each muscle were compared. [Results] Compared to short PImax period, the long PImax and diaphragm RMS amplitude in the long PImax period were significantly increased. The RMS amplitude of abdominal muscles showed no significant increases, but the coefficient of variation of the internal oblique muscle RMS amplitude decreased. There was a significant negative correlation between the percentage of the RMS amplitude relative to PEmax in the short PImax period and the ratio of changes in RMS amplitudes for long PImax and short PImax. [Conclusion] The results suggest that increased PImax during repeated measurement is derived from not only an increase of diaphragm recruitment but also control of internal oblique muscle recruitment.

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[Purpose] The object of this study was to examine the application and outcomes of exercise therapy based on clinical anatomy of the shoulder joint. [Subjects] The subjects were 20 men diagnosed as having frozen shoulder: mean age, 54.0 ± 3.3; 14 right and 6 left shoulders. [Method] After performing conventional exercise therapy, physical therapy based on clinical anatomy was performed. The treatment consisted of: 1) upper arm axis rotation utilizing the shoulder joint range of motion (ROM); 2) direct extension of the fifth and sixth heads of the muscle belly of the subscapular muscles; 3) application of light massage to the intersection of the teres minor muscle and the triceps brachii; and 4) application of light massage to the suprascapular vein. Treatments 1) to 4) were all applied in a random manner. According to the presence or absence of scapula immobility, shoulder joint flexion, abduction and internal and external rotation as well as The Japanese Orthopaedic Association (JOA) score, which assesses general shoulder function and pain, were assessed, and their values at the end of 4 weeks intervention were investigated with the t test. [Results] Significant increases in shoulder joint ROM, flexion, abduction, and internal and external rotation were found with both scapula mobility and immobility. The JOA score showed a significant increase from 15.0 ± 6.0 to 25.7 ± 3.0. [Conclusion] We consider that for conditions in which extension of the shoulder in the upward direction causes pain in the peripheral secondary shoulder joints or for decreases of ROM in the scapulohumeral joint, exercise therapy based on clinical anatomy should be tried before surgery as an effective measure of conservative treatment.

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[Purpose] Using ultrasonography diagnostic equipment, measurement of the extension distance of the anterior talofibular ligament (ATFL) was performed at rest and in the anterior drawer test (ADT), and the intra-rater and inter-rater reproducibility was examined. [Subjects] Ten ankles of 8 university students who had suffered an ankle sprain within the last 12 months were the subjects. [Method] Ultrasonographic images were captured with an 8 MHz linear probe on the anterolateral ankle at rest and at the time of ADT. The distance between the talus and the lateral malleous was measured as the ATFL extension on a PC, and the intra-rater and inter-rater reproducibility was examined using intraclass correlation coefficients (ICC). We also compared the correspondence of the talus - lateral malleous distance at rest as well as at the time of ADT with the t test. [Results] At both rest and at the time of ADT, high intra-rater and inter-rater reproducibilities were found. We found a significant difference between the talus - lateral malleous distance at rest, 16.5 ± 3.9 mm, and when performing the ADT, 20.9 ± 4.9 mm. [Conclusion] From the aspects of both safety and reproducibility, we confirmed the utility of quantitative assessment using ADT with ultrasonographic imaging for ankle sprains.

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[Purpose] Disorders of the body image such as phantom limb and dysesthesia occur in patients with traumatic spinal cord injury. However, patients with traumatic spinal cord injury can acquire movement abilities in rehabilitation. The purpose of this paper was to the reveal changes in the body images of patients with spinal cord injury. [Subject and Methods] We interviewed a patient with spinal cord injury (Th12, complete paraplegia) and analyzed the results using the Modified Grounded Theory Approach. [Results] Conception of 2 items, (1) perception of remained area and paralyzed area and (2) sense modality for perception, was provided. [Conclusions] It is possible that changes in disordered body images were caused by somatosensory perception of the remained area due to their motions and the paralyzed area was sensed by visual perception. In addition, we think that dysesthesia of the paralyzed area could be used for body cognition and construction of the body image in the case of spinal cord injury patients.

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[Purpose] We examined the relationships between the lower limb function of frail elderly persons and the timed up-and-go (TUG) test and walking speed. [Subjects] The subjects were 134 frail elderly persons (60 men, 74 women) with an average age of 78.4 ± 8.6 years. [Method] We examined the relationships between items of lower limb function tests such as lower limb strength and lower limb loading force and the TUG test and walking speed for each gender with Pearson's correlation coefficient. [Results] Significant correlations between both TUG and walking speed were found with all the items of the lower extremity function test, showing their appropriateness as assessment scales for apprehending lower limb function of the frail elderly. Judging the relationships from the strength of the correlation, walking speed had a stronger relationship than the TUG test with all of the items. [Conclusion] The results suggest that walking speed better reflects the lower extremity function of frail elderly persons than the TUG test.

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[Purpose] The present study was conducted to evaluate dachshunds that had lumbar disc herniation with persistent gait disturbance and to assess the method of physiotherapy intervention. [Subjects] Among dachshunds with a diagnosis of lumbar disc herniation, three with severe paraplegia that could not walk unaided were the targets of this study. [Methods] We evaluated the outcome of rehabilitation for these animals and clarified problems with respect to neurological function and movement. Then we set goals for rehabilitation and devised a program to solve these problems. [Conclusions] Physiotherapy for dogs is a new field. For appropriate decision-making when performing animal physiotherapy, further clinical investigation and scientific assessment are required.

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[Purpose] The purpose of this research was to structure and analyze the experience of physiotherapists practicing in their 3rd year of the terminal stage physiotherapy by qualitative research. [Subjects] The subjects were two physiotherapists practicing in their 3rd year. [Methods] We structured a terminal stage physiotherapy experience model using M-GTA based on SCQRM using the language data obtained by interview. [Results] This experience model showed conflicts between the physiotherapists' desire to do something and relations with the patient, and the emotional highs and lows experienced through them cause of both the low motivation and the feeling of powerlessness. [Conclusion] We revealed a one generation process of a sense of powerlessness and low motivation in the terminal physiotherapy by a structure model.

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[Purpose] It has been reported that the inter-rater and intra-rater reliability of measuring joint angles with the image processing and analysis software, Image-J, is high; however, it has also been indicated that an error arises when a rotation is involved. Despite this, we could find no reports which examined the scale of the error owing to the degree of rotation. Accordingly, we examined and compared the degree of error in the measured value when set rotations were applied, using a goniometer model and a human model. [Method] With the goniometer as well as the knee flexed at 30°, we took images with a digital camera of the limb position with rotation applied at 10° intervals from 20° internally to 50° abduction. We measured the angles on the obtained images with Image-J and found errors from 30^°. [Results] In the goniometer model, from 20° abduction to 20° internally, and in the human model, from 30° abduction to 20 ° internally, the errors were less than 5°, but outside these ranges errors greater than 5° were found. [Conclusion] At angles greater than 20 ~ 30° abduction, the possibility of measurement errors over 5° with Image-J was high, suggesting that the reliability of the results of 2D analysis with Image-J is low in cases of rotation greater than these.

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[Purpose] We examined the relationships between subjective masticatory ability and indices related to metabolic syndrome for specific health check-up participants. [Subjects] The subjects were 56 specific health check-up participants. [Method] We compared the results of anthropometric measurements, blood tests, bite strength, and a questionnaire on eating habits with good and poor subjective masticatory ability. [Results] Bite strength was significantly higher in the good group, and in the comparison of the blood tests, Hb_A1c was significantly lower in the good group. With regard to the questionnaire, the good group took longer over lunch, ate meals slowly, and had a tendency to avoid light meals. [Conclusion] Those with good subjective masticatory ability took care over the speed and content of meals, and had a strong bite. The results also suggest a relationship between subjective masticatory ability and Hb_A1c.

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[Purpose] We examined the speed of the blood flow in the vena femoralis to verify the effects of an elastic stocking, intermittent air pressure and active ankle movement on the prevention of deep vein thrombosis. [Subjects] The subjects were 16 healthy men who had no history of vascular lesion. [Method] We performed a comparative study on the speed of blood flow speed in the vena femoralis among five conditions: at rest, wearing elastic stockings, intermittent air pressure, and active ankle movements of 40 or 80 times a minute. [Results] The blood flow speed was 30.7 ± 5.2 cm/s at rest, 29.1 ± 6.6 cm/s wearing the elastic stocking, 50.4 ± 19.3 cm/s with intermittent air pressure, and 50.7 ± 21.7 cm/s and 59.3 ± 38.4 cm/s for active ankle movements of 40 and 80 times a minute, respectively. Significant differences were found between volitional movement at 80 times a minute and wearing a stocking and at rest. [Conclusion] Active movement of 80 times a minute increased the blood flow speed, suggesting that changes are not seen with external stimuli or slow muscle pumping.

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[Purpose] The purpose of this study was to investigate the features of the static posture and the lateral trunk movement in the sitting and standing positions affected by the walking ability of hemiplegic patients. [Subjects] The subjects were 8 hemiplegic patients, four of whom were independent in level of walking, and four of whom were not. [Methods] A 3D motion analysis system and four force plates were used to measure the movement of lateral weight shifts. The angle and the position of the pelvis and the upper trunk and floor reaction force were calculated. Each result was examined for significant differences between independence in walking or not. [Results] In the sitting position, the backward inclination of the pelvis and the rotation of the upper-trunk during the static sitting position, and the backward inclination of the pelvis during lateral shift to the non-paretic side, and the rotation of the upper-trunk during lateral shift to the paretic side were smaller in independent walking patients. In standing, the tilt of the upper-trunk during static standing and the rate of loading on the paretic limb at the shift to the paretic lower limb were characteristic points between the independent walkers and those who could not. [Conclusion] In the sitting position the compensation during the movement to the paretic side was different from that to the non-paretic side. Some features of movements were common in both the sitting and standing positions and they could be key points for functional evaluation and physical treatment.

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[Purpose] The purpose of this study was to investigate the actual conditions of urinary incontinence and the primary factors in puerperant and pregnant mothers. [Subjects] Subjects were 560 puerperal women at 30 postpartum days. [Methods] The data was gathered by questionnaire and from clinical records. There were twenty-one items in the questionnaire, which included the characteristics, life-style, and items of urinary incontinence. [Results] Of the 602 questionnaires distributed, 560 (95.4%) were returned. The urinary incontinence group comprised 54.5%. Among the urinary incontinence groups, Stress Urinary incontinence was 69.8%, Mixed Urinary incontinence was 20.0%, and Urgency Urinary incontinence was 10.2%. Urinary incontinence was experienced by 86.3% during pregnancy, with most experiencing it at eight months of pregnancy. Factors related to urinary incontinence in the logistic analysis result were: the style of delivery (p<0.038), age (p<0.01), primipara/ pluripara (p<0.05). [Conclusion] It is necessary to begin physical exercises of muscles in the pelvic floor group in the early pregnancy period and to continue them.

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[Purpose] We investigated the influence of different positions of the ankle joint on the movement of the knee. [Subjects and Method] Thirty healthy men, participated in the study. An isokinetic dynamometer Biodex was used to perform the movement of the knee. At a constant velocity of 60°/sec, with 4 different ankle positions: dorsiflexion, extension, dorsiflexion to extension, extension to dorsiflexion. In each case the extension and flexion torque and torque/weight were measured. [Results] In flexion of the knee with ankle dorsiflexion, torque, torque/weight and power were significantly greater than in the other ankle positions. [Conclusion] In knee training it is more effective to use dorsiflexion of the ankle.

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[Purpose] In this study, using a standing board with an ankle brace set at 15° of dorsiflexion, we achieved continuous extension of the triceps surae under the gravitational force of the patient's own weight for two Parkinson's disease patients and investigated the immediate effect. [Subjects] The subjects were two Parkinson's disease patients. Case 1 was a 56-year-old woman rated III on the Hoehn-Yahr scale and 2 on the Japanese scale of needs of care. Case 2 was a 63-year-old man rated IV on the Hoehn-Yahr scale and 3 on needs of care. [Method] For this study we used an ABA single-subject design. Conventional physical therapy alone was implemented in the baseline period (A). Next, in addition to conventional therapy, continuous extension of the triceps surae through the standing board was implemented in the intervention period (B). Finally, Period A was repeated, as a follow-up for the effect of the continuous extension of the triceps surae. The functional reach (FR) test, timed up and go test (TUG) and maximum walking speed were assessed at the end of each therapy period in a random order. We analyzed the presence or absences of increases or decreases in FR, TUG and maximum walking speed in Period B, using binomial distribution probabilities. [Results] For both Cases 1 and 2, we found that FR and maximum walking speed at the end of Period B had significantly increased in comparison to their values at the end of Period A. However, no significant difference was found for TUG for Case 1. [Conclusion] In the present study, the results suggest that using a standing board as a method for continuously extending the triceps surae of Parkinson's disease patients had immediate effect as a means for increasing FR and maximum walking speed; however, there was no effect on TUG.

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[Purpose] We investigated the inter- and intra-rater reliabilities of lower limb loading force measurements in the sitting position. [Subjects] The subjects were 10 hemiplegic stroke patients with an average age of 67.0 ± 10.4. [Method] The examiners were three physical therapists with different years of professional experience. From the reproducibility of the measurement values, we analyzed the inter- and intra-rater reliabilities. [Results] For intra-rater reliability, higher intraclass correlation coefficients (ICC: 0.866-0.994) were shown with longer years of experience, but even for relatively little experience the value was above the 95% confidence limit of 0.7. Furthermore, ICC of inter-rater reliability on the unaffected side was 0.898, and 0.970 on the hemiplegic side, both showing good reproducibility. [Conclusion] We confirmed the reliability of the measurement method of lower limb loading force in the sitting position for hemiplegic stroke patients, and that it is an assessment method which can be used irrespective of the examiner's years of experience.

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[Purpose] We evaluated the clinical efficacy of concentric inpatient hospital rehabilitation (CIHR) for HTLV-1 associated myelopathy (HAM). We estimated the change of activity of daily living (ADL) using objective clinical parameters before and after rehabilitation. [Subjects] Fifteen HAM patients (male 3, female 12, mean age 51.9) at the chronic stable stage participated in this study. [Methods] These HAM patients were hospitalized for rehabilitation for six weeks periods at our hospital. We assessed the usefulness of CIHR therapy by the Functional Independence Measure (FIM) ratings and Osame's Motor Disability Score (OMDS) before and after rehabilitation. We also evaluated the changes of each FIM subcategory, especially focusing on gait ability. [Results] FIM ratings showed statistically significant increases after CIHR. Especially, the walking ratings in FIM and OMDS showed statistically significant improvements after CIHR. FIM subcategories related to lower limb movement improved remarkably whereas subcategories related to bladder and bowel management were without significant changes. [Conclusion] The improvement of ADL by CIHR was confirmed, mainly as a remarkable improvement in the gait ability. Concentric rehabilitation for HAM patients may be a promising therapy for improvement of ADL.

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[Purpose] We investigated how much the lumbar lordosis angle (spinal curvature?) changes with the elevation angle of the arms in load elevation work. [Subjects] The subjects were 14 healthy women with an average age of 21.7 ± 3.8. [Method] With both hands holding a box of 2 kg weight, we measured the lumbar lordosis and thoracic kyphosis angles in postures with the arms elevated at 0, 60, 90 and 120°, and compared the results. [Results] At arm angles of greater than 90°, a significant increase in the lumbar lordosis angle and a significant decrease in the thoracic kyphosis angle were found. [Conclusion] The results suggests that a plan of self-control of the lumbar lordosis angle should be the target of patients with lower back pain in load elevation work with arm elevations of less than 90°.

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[Purpose] The purpose of this study was to investigate the resistance force and the limitation factor up to the joint's end-range after joint immobility. [Subjects] Eighteen adult female Wistar rats were used in this study. [Methods] Both their ankle joints were immobilized using casts for the duration of 1, 2, or 4 weeks. At the end of each period the casts were removed, and skin resection was carried out. For the right ankle joints, the resistance force up to the joint's end-range was measured. For the left ankle joints, the measurements were also performed after myotomy. [Results] The resistance force increased on both sides after 1 week of immobilization. The degree of the resistance increased after 2 and 4 weeks of immobilization. [Conclusion] There is a general tendency to presume that the arthrogenic factor is dominant over the muscular factor. Arthrogenic factors contributed to joint restriction up to the joint's end-range over 4 weeks immobilization.

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[Purpose] The purpose of this study was to clarify the characteristic of gait of elderly people with kyphosis. [Subjects] The subjects were 12 healthy elderly persons and 12 elderly persons with kyphosis. [Methods] We measured the index of kyphosis as a quantitative assessment of kyphosis, and divided the subjects into two groups using the index of kyphosis. We employed a 3-dimensional motion analysis system and 6 force platforms to capture kinetic and kinematic data of gait. The experimental condition was walking at a self-selected speed. We repeated the measurements in three trials. [Results] Elderly people with kyphosis decreased maximum hip abduction moment in the late stance phase and increased pelvic posterior tilt and pelvic rotation. [Conclusion] These results suggest that alignment changes of elderly people with kyphosis cause biomechanical changes in the frontal plane.

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[Purpose] In this study, in order to analyze the effect of shoulder joint mobility on spinal curvature during arm elevation, we examined and compared the relationship of arm elevation with spinal curvature in frozen shoulder patients before and after shoulder joint range of motion (ROM) training. [Subjects and Method] With 15 frozen shoulder of 10 men and 5 women as subjects, we measured thoracic kyphosis and lumbar lordosis angles at arm elevations of 0, 90 and 120° before and after ROM training, and compared the results. [Results] Before ROM training, thoracic kyphosis showed significant decreases at arm elevation angles of 90° and above, and lumbar lordosis showed a significant increase at arm elevation of 120°. However, after ROM training, thoracic kyphosis showed a significant increase only at 120° and no significant differences in lumbar lordosis were found at any arm elevation angles. [Conclusion] An unphysiological extension of the spine occurred at arm elevations of 90° or more, therefore frozen shoulder results in excessive extension of the spine, suggesting that the mutual interaction of thoracolumbar vertebrae in response to arm elevation is dependent on shoulder joint ROM.

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[Purpose] The first purpose of this study was to consider whether muscle strength can be improved by mental practice. The second purpose was to compare the effectiveness of mental practice between "easy to imagine people" and "hard to imagine people". [Method] Twenty-four subjects were divided into three groups: muscle strength training with isometric muscle contractions "Group MS", easy to imagine people "Group Im-High" and hard to imagine people "Group Im-Low". Baseline and final measures of maximum isometric muscle strength of the quadriceps femoris muscle were compared after a four week training period. [Result] Comparisons among the groups showed no significant differences in muscle improvement. Comparisons within each group showed significant muscle strength improvement. [Conclusion] These results suggest that muscle strength may be improved by mental practice.

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[Purpose] The purpose of this study was to clarify the status of use of assessment indices for stroke patients in academic papers. [Method] We performed a review of all articles, case studies, notes and case reports appearing in Rigakuryoho Kagaku and Rigaku Ryohogaku in the last 5 years, and compared the results with those of a survey by the Japanese Association of Rehabilitation Medicine (JARM). [Results] Research with stroke patients as subjects formed 10% of the total, and in terms of assessment indices, the Brunnstrom stage was most frequently used, followed by indices related to Activities of Daily Living (ADL), i.e. the Functional Independence Measure and Barthel Index. In comparison with the results of the JARM survey, a difference was seen in the frequency of use of assessment indices not related to ADL. [Conclusion] We conducted a survey on the trends in use of assessment indices for stroke patients, and surveys for other diseases may be necessary. We suggest that it is desirable that such surveys are performed with the Japanese Physical Therapy Association and related societies as principals, and that they should take place regularly in the future.

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[Purpose] The purpose of this study was to clarify the construct validity and inter-tester reliability of a novel method for conducting the static balance test (SBT) using 52 hemiplegic patients. [Methods] Performance was evaluated using a four-point ordinal scale (Grades 1-4) in the following five postures: sitting, standing with legs apart, standing with legs together, one-leg standing on the non-paretic leg, and one-leg standing on the paretic leg. In addition, in order to verify inter-tester reliability, another five examiners assessed balance performance using recorded video clips. [Results] For the posture maintenance task, the number of patients decreased as the posture became unstable. In addition, according to scores on the 4-point ordinal scale, the number of patients decreased as the level of difficulty increased. The alpha coefficient showed that the internal consistency of the SBT was 0.88. Furthermore, the intraclass correlation among the examiners was 0.92, and the reproducibility of the assessment standards for balance performance was favorable. [Conclusions] These results suggest that the SBT is a clinically useful test for assessing the balance performance of hemiplegic patients.

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[Purpose] The objective of this study was to clarify the effect on muscle strength and gait of a long pad used as an Iritani-type arch support by the measurement of pelvic acceleration, femoral muscle activities and temporal changes in the load-bearing phase during gait, and changes in hip adductor and abductor muscle strengths while standing. [Subjects] The subjects were 15 healthy men with an average age of 25.1 ± 3.2. [Method] Using electromyography, an accelerometer, a foot switch and a hand-held dynamometer, we measured femoral muscle activites, acceleration in the frontal plane and temporal changes in the load-bearing phase and changes in hip adductor and abductor muscle strengths in walking and standing both with and without the long pad, and analyzed the results with the t test. [Results] With the affixation of the long pad, the load-bearing phase began earlier, an increase in medial acceleration was seen, biceps femoris activity decreased in the early stance phase and rectus femoris and gluteus maximus activities increased, while in the latter half of the stance phase, a decrease in the activity of the adductor longus was seen. In addition, hip abductor muscle strength increased on the side of the long pad affixation. [Conclusion] Affixation of the long pad showed its potential for changing medial acceleration and femoral muscle activities during gait and increasing hip abductor muscle strength.

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[Purpose] We examined relationships between toe-grip strength and foot flexibility and shape in frail elderly women. [Subjects] One hundred four legs of 52 frail elderly women were the subjects. [Method] Toe-grip strength, foot flexibility, the arch ratio and foot length were measured and relationships with toe-grip strength were analyzed with Pearson's correlation coefficient. [Results] A significant correlation was found between foot flexibility and toe-grip strength, whereas no significant relationships were found for the arch ratio or the foot length. [Conclusion] For frail elderly women, higher foot flexibility suggests stronger toe-grip strength.

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[Purpose] This study investigated the effects of self-exercise at home on maintenance of physical function in elderly people. [Subjects] The subjects were 15 elderly people (68-91 years old). [Methods] Subjects individually received self-exercise guidance every other week and performed self-exercise for 2 months. Hand grip, knee extension force, one-legged standing time, functional reach length, flexibility of trunk flexion, 10 m gait speed and timed up and go were measured before and after self-exercise. [Results] Timed up and go showed a significant difference between before and after self-exercise. [Conclusions] The result of this study suggests that self-exercise maintained physical function in elderly people. When subjects recognize that exercise is necessary, their physical functions can be kept regardless of the place, but it is necessary to monitor the progress of self-exercise.

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[Purpose] In this study, we investigated and compared the effects on muscle stiffness of `dry' and `wet' heatpack treatments. [Subjects] Both legs of 10 healthy adults (7 men, 3 women, average age 22.3 ± 6.8) were the subjects. [Method] Heatpacks were applied to the back of the lower thighs for 20 minutes with subjects lying in the prone position. For the wet treatment, the heatpack was wrapped in 8 layers of cotton towels, and for the dry treatment, in 3 layers of cotton towels after wrapping in a vinyl bag. The stiffness of the medial head of the gastrocnemius muscle was measured before and after the heatpack treatments. [Results] Both wet and dry heatpack treatments significantly reduced muscle stiffness compared to pretreatment. There was also a significant difference between the two treatments, with the wet treatment reducing muscle stiffness significantly more than the dry treatment. [Conclusion] The results suggests heatpacks are an effective treatment for reducing muscle stiffness, especially the effect of the wet treatment which was greater than that of the dry treatment.

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[Purpose] The purpose of the present study was to clarify the factors associated with the persistence rate of home exercise (HE) to promote an improvement in treatment results post-operation. [Method] The participants were 17 people who had received single intervertebral laminotomy due to lumbar spinal disease. They were divided into two groups based on the persistence rate of HE in the investigation period (high group vs. low group). Self-efficacy, pre-onset physical activity level, and recognition of motor task were investigated. [Result] There were significant differences in pre-onset physical activity level, self-efficacy, and recognition of motor task between the two groups. [Conclusion] The factor that influenced the HE persistence rate of post-laminotomy patients was able to be determined, suggesting a plan for an HE guidance method to improve treatment results.

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[Purpose] We report the case of a patient with cervical spinal cord injury who received intrathecal baclofen as physical therapy. [Results] The patient's Ashworth scale (mean) spasticity score was 3.0, and the transfer activity between bed and wheelchair was five points on the Functional Independence Measure before intrathecal baclofen treatment. Falls during transfer activity occurred three times a month. After two months of intrathecal baclofen treatment the patient's Ashworth scale (mean) was 2.0, the transfer activity score became six points, and no falls occured in the hospital. [Conclusion] Spasms were relieved by intrathecal baclofen treatment, which led to improvement of the transfer activity.

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[Purpose] The purpose of this study was to clarify the necessity for cooperation between PTs and OTs in home visit rehabilitation. [Subjects] The subjects were PTs and OTs working in institutions providing home visit rehabilitation in Tokyo as well as users. [Methods] A questionnaire survey was performed by mail. [Results] The subjects in each occupation understood the necessity for cooperation, with importance being attached to the specialty of each occupation, but there were almost no established systems for this cooperation in their institutions. Clients' needs were great regarding items concerning improvement in gait and impairment but slight in items concerning ADL and leisure activities. The subjects considered that the specialty of PTs included items concerning dysfunction of the lower limbs and trunk, gait, bed and transfer activities, and respiration, and that of OTs included items concerning ADL and leisure activities. [Discussion] To overcome the problems of subjects, the types of specialist sent on visits for home visit rehabilitation should be evaluated each time based on the medical condition and needs.

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