[Purpose] The purpose of this study was to clarify the relationship between spinal curvature and hip joint angle during pelvic tilt movement in the sitting position. [Subjects] The subjects were 18 healthy adult males (mean age: 24.7±3.7). [Methods] We measured the pelvic tilt angle, hip joint angle, and spinal curvature (upper thoracic spine, lower thoracic spine and lumbar spine) during pelvic tilt movement with a three-dimensional motion analysis system. [Results] The hip flexion, the lower thoracic extension and the lumbar extension increased with increasing pelvic anterior tilt in the sitting position. The hip extension, lower thoracic flexion and lumbar flexion increased with pelvic posterior tilt. The movable range of pelvic tilt exhibited positive correlation with the movable range of the lower thoracic spine (anterior tilt: r=0.47, posterior tilt: r=0.54). [Conclusion] The pelvis movement and the hip and spine motion influenced each other. The results suggest that the movable range of pelvic tilt is required to maintain spinal mobility, because there was a positive correlation between the movable range of the pelvic tilt and that of the lower thoracic spine.

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[Purpose] In everyday life, we often sit for long periods of time. However, there is no literature addressing the effect of static sitting time on the Sit-to-Walk time of elderly people. We wanted to clarify this effect. [Subjects] The participants were 24 elderly people and 8 young people. [Method] Measurements were taken, once after sitting and a second time after the sitting position had been held for 20 minutes. Sit-to-Walk, the Functional Reach Test and a stabilograph were measured consecutively. [Results] The elderly people showed a tendency of lower ability of movement after holding the sitting position for 20 minutes. [Conclusion] The effect of static sitting position time should be considered not only in the risk management of elderly people but also in the effective conduct of kinesiotherapy just after rest.

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[Purpose] In order to know neuronal compensation or plasticity, we studied the immunohistochemical development of the cerebral cortex and white matter of Down syndrome (DS), using an antibody to PGP9.5, which is expressed predominantly in differentiating neurons. [Subjects and Method] The immunohistochemical study was performed on 24 human brains with DS, from neonate to adult, using an antibody to PGP9.5. The evaluation was done semiquantitatively in the cerebral cortex and white matter was compared with those of age-matched controls. [Results] PGP9.5-immunoreactive neurons were decreased in the third and fifth layer of cerebral cortices with DS from neonate to childhood compared with controls, but remained in the second and fourth layers. Positive neurons were increased in the pyramidal and granular cell layers in the cortices of young adults with DS. Moreover, in DS elderly adults with Alzheimer type dementia, there were strongly positive neurons and weakly positive neurons mixed in the cortex. [Conclusion] In the cortex with DS, the decrease of immunoreactive neurons in the cortex of infants with DS may be related to delayed development of dendrites and synapses. The increase of immumoreactive neurons in the granular layer of the cortex in DS adults suggests neuronal compensation or plasticity.

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[Purpose] The purpose of this study was to investigate the influence of music on the perception of dyspnea, fatigue of the lower extremities and expired gas analysis during walking. [Subjects and Method] In a crossover study, 13 young males completed ESWT with and without music at 40% VO_2peak followed by a cardiopulmonary exercise test. [Results] Perceptions of dyspnea and fatigue of the lower extremities were significantly lower under the music condition compared to the without music condition. Similarly, the music condition resulted in significantly higher enjoyment when compared to the without music condition. The influence of the music increased with increasing exercise duration. VO₂/W was significantly higher with music than without music, but the other expired gas analysis data did not differ with listening to music. [Conclusion] The results of this study suggest that listening to music during exercise would enable longer exercise duration with decreased fatigue and increased enjoyment.

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[Purpose] We investigated factors which influence the ability of hemiplegic stroke patients to propel a wheelchair indoors. [Subjects] The subjects were 59 hemiplegic stroke patients, 35 males and 24 females. [Method] Candidate factors of Brunnstrom stage, standing balance, sitting balance, grip strength, abdominal muscle strength, lower limb muscle strength of the paretic and non-paretic sides, and cognitive function were assessed and compared with subjects' abilities to propel a wheelchair. The factors affecting ability to propel a wheelchair were analyzed using logistic regression. [Results] Factors affecting ability to propel a wheelchair were identified as standing balance and abdominal muscle strength. [Conclusion] The results indicate that standing balance and abdominal muscle strength are important for hemiplegic stroke patients to acquire the ability to propel a wheelchair indoors.

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[Purpose] We investigated the effects on cardiorespiratory responses during exercise with acute exposure to low to high oxygen environments under normal air pressure. [Subjects] The subjects were 7 healthy adult males. [Method] Using the membrane separation method, we established 3 oxygen concentration conditions, low, normal and high, at normal air pressure. Subjects performed a ramped load exercise on a bicycle ergometer under each condition, and we measured the cardiorespiratory response from at rest to the end of exercise. We made a comparative study of cardiorespiratory reactions between the low and normal, and normal and high oxygen concentrations. [Results] Compared to the normal oxygen concentration, at the low concentration, the load on the cardiorespiratory organs significantly increased. In particular, at loads above the anaerobic threshold the load on the respiratory organs had an increasing trend. Large differences were not found between the high and normal oxygen concentration conditions. [Conclusion] The results show that acute exposure to a low oxygen environment at normal air pressure has a similar effect on cardiorespiratory load as acclimatization to a low pressure low oxygen environment.

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[Purpose] We examined the movements of the lower leg, calcaneus and forefoot during gait and analyzed the relations of each segment in the limb, the relations with right and left leg movements of each subject, and the relations with arch height ratio. [Subjects] We examined 23 legs of 12 healthy adult males. [Method] Using a 3D motion analysis system, we measured the gait of subjects at their chosen walking speed. The analysis focused on varus and valgus of the movement. [Results] Regarding the relationships of each segment in the same limb, there was no correlation between heel valgus immediately after initial contact and forefoot valgus in the late stance phase. There was a high correlation in each individual between the movements of the left and right calcaneus as well as both forefeet. There was no correlation between the arch height ratio and calcaneus valgus or forefoot valgus. [Conclusion] There are a variety of movements of the foot during gait; however, from the results we understand that there is symmetry of movement in the right and left legs of an individual.

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[Purpose] We investigated which muscle strength related best to the locomotion ability of hemiplegic stroke patients: the knee extensor strength as an open kinetic chain, or the leg extensor strength as a closed kinetic chain. [Subjects] The subjects were 23 hemiplegic stroke patients. [Method] We used a hand-held dynamometer to measure the knee extensor strength, a commercially available meter to measure leg extensor strength, and the totals of the three items of transfer to bed/wheelchair, ambulation, and stairs of the Functional Independent Measure to assess locomotion ability. [Results] The correlation coefficient of leg extensor strength and locomotion ability was significantly higher than the correlation coefficient of knee extensor strength and locomotion ability. [Conclusion] These results suggest that leg extensor strength is more useful than knee extensor strength as a measure of the muscle strength of the affected lower limb of hemiplegic stroke patients.

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[Purpose] The purpose of this study was to clarify the reliability and validity of the Balance Evaluation Systems Test (BESTest). [Subjects] The subjects were 39 inpatients (mean age, 71.7 years, SD 10.8). [Methods] The BESTest, Berg Balance Scale (BBS), Timed "Up-and-Go" test (TUG), and 10 m maximum walking speed (10MWS) were measured. We used Cronbach's alpha to assess section and total scores of the BESTest, correlation coefficients to examine within section scores of the BESTest, and correlation coefficients to investigate relationships between BESTest scores and BBS, TUG, and 10MWS. [Results] From 2.6% to 25.6% of subjects got perfect scores in section scores, and 2.6% got perfect scores in total scores. Cronbach's alphas were 0.594 to 0.887 for section scores and 0.911 for total scores. There were significantly moderate correlations within all sections of the BESTest. BESTest scores had significantly moderate correlations with BBS, TUG, and 10MWS. [Conclusion] These findings suggest that BESTest has a low ceiling effect and high internal consistency and criterion-related validity.

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[Purpose] This study aimed to verify whether the involvement of rehabilitation staff in the discharge process of the frail elderly in cooperation with home-care staff had an effect on acute, sub-acute, and chronic care settings. [Subjects and Methods] An anonymous questionnaire was sent by mail to 1,612 nursing care managers in Hyogo Prefecture. The questionnaire investigated the most recent discharge cases and discharge processes handled by nursing care managers. [Results] The results from 783 responses revealed the following: 1) The acute care setting accounted for 65% of hospital settings for the frail elderly, who were discharged home. 2) The frequency of pre-discharge home visit guidance and joint care conference, as well as guidance and advice on post-discharge continuous rehabilitation, was lowest in the acute care setting. 3) The level of involvement of home-care rehabilitation staff in pre-discharge joint care conferences was low in all settings. [Conclusion] Strengthening of cooperation among nursing care managers, hospital rehabilitation staff and home-care rehabilitation staff in the discharge process is particularly required in an acute care settings.

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[Purpose] The purpose of this study was to clarify the time-dependent effect of vibration on the muscle tone of the the triceps surae. [Subjects] We examined the legs of 18 healthy males (mean age: 22.1±4.4 years) with no history of neurological disorders. [Method] Using a vibration stimulus device, we applied a 76.6 Hz vibration stimulus with an amplitude of 2 mm for 10 min to the left leg above the Achilles tendon. Using an evoked electromyograph, we measure the amplitudes of the H and M waves during the vibration stimulus. From the measurements, we calculated the H/M ratio and assessed the muscle tonus of the triceps surae. [Results] The H/M ratio began falling 1 min after the start of the vibration stimulus and continued falling until 3 min after the start of the vibration stimulus. [Conclusion] We clarified that the muscle tone of the triceps surae was inhibited by the vibration stimulus from immediately after the start of the intervention, and that the effect was greatest at 3 min after the start of the intervention.

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[Purpose] The object of this study was to investigate the effects of different methods of distal area stimulation on muscle fatigue experimentally induced in the forearm. Using changes in grip strength as an index, we investigated the effects on muscle fatigue of three stimuli (acupuncture, tapping with the needle tube, and superficial pain) delivered to sanyinjiao (SP6). [Subjects and Method] We randomly divided the subjects, 18 healthy subjects, into acupuncture, needle tube tapping, and superficial pain stimulation groups, and each group performed two trials, with and without stimulus. We performed measurements of handgrip strength after 10 min of rest, immediately after exercise with load, and 10 min after stimulation. To induce muscle fatigue, each subjects performed grip exercise until "all out" using a handgrip with a load of 50% of the maximum grip strength of the non-dominant hand. The area stimulated was SP6. [Results] Both with and without stimulus, each group showed a reduction in grip strength immediately after exercise, which subsequently recovered to the at rest level. In the needle tube tapping stimulus group, the recovery of grip strength immediately after the grip exercise was large compared to the no intervention condition. [Conclusion] The results of this study indicate the effectiveness of distal area micro-stimulation for muscle fatigue. Furthermore, they also indicate that acupuncture stimulus to the distal area of muscles suffering fatigue is probably ineffective at relieving fatigue.

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[Purpose] The purpose of this study was to investigate the relationship between sitting position legs open-close stepping and falls. [Subjects] The subjects were 67 elderly people (10 males and 57 females: average age 78.3±5.3 years) who could walk independently. [Methods] Subjects were divided into three groups based on the number of falls in the past one year: no-fall group, one fall group, and multiple falls group. The sitting position legs open-close stepping was performed twice with an interval of at least 30 seconds after one practice by each group, and the greatest test score of each subject was adopted. [Results] We found significantly lower scores in the test results of the one fall group and multiple falls group compared to the no fall group. No significant differences were found between the test scores of the one fall group and the multiple falls group. [Conclusion] We suggest that this test could be applied in the future as a falls risk assessment test for elderly people.

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[Purpose] The purpose of this study was to determine whether the muscle metaboreflex affects cardiovascular responses with a cold stimulus. [Subjects] The subjects were 9 healthy males. [Methods] Each subject performed a 2-min isometric handgrip (IHG) at 30% of maximum voluntary contraction, followed by a 2-min post exercise muscle ischemia (PEMI) to activate the muscle metaboreflex. IHG and PEMI were sustained with or without a cold stimulus (immersion of feet in ice water). [Results] During IHG, systolic blood pressure (SBP) and heart rate (HR) increased progressively under both conditions. After exercise, SBP in the PEMI was kept higher than at rest, while HR decreased and returned to control value. There were no significant differences in SBP and HR values with or without the cold stimulus. [Conclusion] The present results suggest that a cold stimulus does not affect cardiovascular responses during PEMI.

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[Purpose] The purpose of this study was to investigate the ROM of knee flexion before and after total knee arthroplasty (TKA), with the object of establishing prediction methods for postoperative ROM in the early stage. [Subjects] The subjects were 190 legs of 126 patients osteoarthritis (OA): 81, 122 joints; rheumatoid arthritis (RA): 45, 68 joints). [Methods] We measured ROM from a week before to 6 weeks after TKA. Based on disease and on preoperative ROM, we classified subjects into OA and RA groups and three ROM (good, medium and poor) groups. [Results] The good group showed good progress after TKA and the poor group showed little improvement. However, there were no differences in the restorative percentages of the OA and RA groups and of the three ROM groups. The percentage between the 1st and 2nd weeks was about 50% and between the 2nd and 3rd weeks was about 25% of the whole recovery. [Conclusion] These findings indicate that is possible to predict the ROM by the degree of recovery between the 1st and the 2nd weeks after TKA.

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[Purpose] The purpose of this study was to determine the effects of exercise after ischemic reperfusion on skeletal muscle. [Subjects] Twenty-five eight-week-old Wistar female rats were randomly divided into five experimental groups: normal, ischemic, non-ischemic, exercise, and no-exercise. [Method] Ischemia was applied to the right lower limbs of the experimental rats. Exercise was started the day after ischemic reperfusion occurred. The relative weight ratios of the soleus muscles and the soleus muscle fiber cross-section minor axes were used for the evaluation of muscle atrophy. [Results] Compared with the normal group, the means of the soleus muscle fiber cross section minor axes significantly decreased in the exercise group. [Conclusion] Exercise after ischemic reperfusion decreased edema of the skeletal muscle, which suggests that exercise is effective for the prevention of muscle atrophy.

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[Purpose] We assessed the clinical application of the setting pressure, which was determined with a mercury sphygmomanometer, as an indication for the quantitative evaluation of the isometric muscular contractile force on the quadriceps femoris muscle setting exercise. [Subjects] The subjects were the 24 legs of 24 healthy persons (with a mean age of 20.3 years) which they used to kick a ball. [Methods] We determined the isometric muscular contractile force (the setting force: F) in each exercise by setting a target level of increasing the varnishing pressure in the popliteal region (the setting pressure: P) at intervals of 10 mmHg. The knee extension moment (M) and the setting force [F_fair (F_f)] on exertion of muscle strength by the quadriceps femoris MMT3 (fair) were calculated according to a formula. [Results] There was a highly positive correlation between F and P (F = 0.716P + 1.034). There was also a highly positive correlation between F_f and M (F_f = 1.959M + 5.699). [Conclusions] The setting pressure reflected the isometric muscular contractile force. It was also possible to evaluate the muscle strength of the quadriceps femoris MMT3 from the setting pressure.

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[Purpose] In this study we examined the relationship between interpersonal stress events during practical training and students' stress responses after practical training, to clarify the relationships between interpersonal stress events and protective factors of resilience. [Subjects] The subjects were fifty-eight physical therapy students. [Method] Three weeks after two practical training, sessions separated by 3 months we performed surveys of the students using the psychological stress response scale, the interpersonal stress event scale and the resilience scale. [Results] The interpersonal inferiority complex, which is a subscale of the interpersonal stress event scale, significantly correlated with the stress response scale. Significant correlations were also found among the resilience scale, the psychological stress response scale and the interpersonal stress event scale. [Conclusion] The results of this study show that after practical training, the levels of students' stress responses were still influenced by the interpersonal stress events that they experienced during practical training. Students' traits of resilience will support recovery from the interpersonal stress events during practical training and reduce interpersonal inferiority complex and interpersonal dislocation.

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[Purpose] The objective of this study was to survey the citation trends of physical therapy research papers in Japan, and to clarify their influence on physical therapy research quantitatively and qualitatively. [Method] Using the references cited by authors of original papers published in two Japanese journals, Rigakuryohogaku and Rigakuryoho Kagaku, we performed an analysis based on items the numbers of cited papers as well as the citation frequency. [Results] For Japanese journals, there were many citations for the two physical therapy journals at the focus of our study. For English journals, there were many citations of journals concerned with rehabilitation and other specialist subjects. Furthermore, regarding the quality of the each cited journal, the quality of the two journals was high. [Conclusion] The large influence of these two journals on physical therapy research was clear from the high citation frequency of the two journals and their high quality as academic journals.

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[Purpose] The purpose of this study was to investigate the influence of spinal curvature on the shear force applied to the buttocks while sitting comfortably on a chair. [Subjects] The subjects were 10 elderly people with kyphosis in a facility providing health care services for the elderly. For comparison, 11 healthy young male subjects were recruited. [Method] To compare the shear force in elderly individuals with kyphosis with that in healthy young individuals, the shear force was measured using a force plate while subjects sat comfortably on a chair. [Results] The shear force recorded in the elderly subjects (8.4 ± 1.4 [%BW]) was significantly lower than that in the young subjects (9.5 ± 0.7 [%BW]). [Conclusions] The results suggest the possibility that the shear force applied to the buttocks in elderly individuals with kyphosis is decreased compared with that in healthy young individuals without kyphosis.

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[Purpose] In this case study, we investigated effects of transcutaneous xenon-ray irradiation around the lumbar sympathetic ganglion (Xe-LSGI) on complex regional pain syndrome type 1 (CRPS1) observed in the lower extremity (LE). [Subject] The subject was a 30-year-old male who presented with continuing pain after right foot sprain. CRPS1 was diagnosed in him nine months after the foot sprain. [Methods] The subject underwent 10-minute Xe-LSGI once per day. Skin temperature of the right toe and pain of the right foot were assessed before and after each Xe-LSGI. The active range of motion of the right ankle joint and the maximum load rate to the right LE during standing were also assessed after each Xe-LSGI. [Result] Among the assessment items, therapeutic effects related to Xe-LSGI were observed in skin temperature of the right toe, pain of the right foot, and maximum load rate to the right LE during standing. [Conclusion] These results raise the possibility that Xe-LSGI may be an effective treatment for patients with CRPS1 observed in the LE.

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To establish the basis of physical therapy, many reports investigating the reliability of physical therapy assessment methods have been published in recent years. Among the methods for investigating reliability, there are those utilizing relative reliability and those utilizing absolute reliability. The majority of investigations of reliability of physical therapy assessments have been the former, however, in the case of assessment methods for clinical applications, the latter would provide comparatively better information. In this paper, after a summary of types of error, I explain Bland-Altmann analysis, which is an investigation method for absolute reliability, as well as minimal detectable change.

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