[Purpose] We administered anabolic steroids (AS) to hemiplegic stroke patients and investigated the effect of the AS treatment in combination with general physical and occupational therapy focusing on gait and activities of daily living. [Subjects] The subjects were 19, initial onset, hemiplegic stroke patients who were in the recovery rehabilitation ward of our hospital. [Method] The subjects were randomly assigned to an AS treatment group (AS group) and a control group which did not receive AS. We measured isokinetic knee extension torque as the lower limb strength of the affected side. The intervention period was 6 weeks, and we compared the progress of lower limb strength of the two groups. [Results] In the study of all cases, no significant difference was found between the two groups in rate of muscle strength increase. However, for the cases with only slight paralysis, the muscle strength of the AS group had increased significantly compared to the control group after 6 weeks. [Conclusion] The results suggest administration of AS augments lower limb muscle strength of the affected side of hemiplegic stroke patients with slight paralysis.

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The purpose of this study was to examine the effect of reclining angles of wheelchair on spirometric indices and respiratory muscles. [Methods] Twenty-seven healthy male subjects participated in this study. We used three reclining conditions: ‘BASE’ was the angle at which a patient felt most comfortable, ‘FORWARD’ was the angle tilted forward from BASE by 10 degrees, and ‘BACKWARD’ was the angle tilted backward from BASE by 10 degrees. We evaluated pulmonary function with spirometry and muscle activities with electoromyography in each condition. [Results] For spirometry, expiratory residual volume in FORWARD was the highest compared with another 2 conditions. There were significant difference between the 3 conditions in the activity of the obliquus externus abdominis (OEA). [Conclusion] These results suggest that angles more forward than the angle at which subjects felt most comfortable would increase expiratory residual volume to activate OEA.

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[Purpose] The purpose of this study was to investigate the relationship between the health-related quality of life (QOL) and the severity of low back pain (LBP) or the disability due to LBP in care workers (CWs). [Subjects] One hundred eighty-nine CWs participated in this study. [Methods] The severity of their LBP for the past month, the Roland-Morris Disability Questionnaire (RDQ) and Short-Form 36 -Item Health Survey (SF-36) were investigated. [Results] The severity of LBP and the total score of RDQ didn’t influence “role-physical” and “social functioning”. The items of “bodily pain” (BP), “physical functioning” (PF) and “mental health” (MH) influenced the severity of LBP and PF and BP also influenced the total score of RDQ. [Conclusions] We conjecture that LBP in CWs tends to limit intense sports and activities.

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[Purpose] The purpose of this study was to compare the plantar sensation of individuals with knee osteoarthritis (KOA) with controls, and to examine the effect of plantar sensation on the postural sway in individuals with KOA. [Subjects] Sixteen KOA patients and seventeen control participants volunteered. [Methods] Plantar sensations were assessed using Semmes-Weinstein Monofilaments. The path length of center of pressure (LNG), root mean square area and LNG/envelope area (LNG/E.AREA) were measured in the standing position under two different surface conditions (firm and foam). [Result] In the KOA group, the portion of patients whose plantar sensation at the area of 1st metatarsal head was more sensitive than that of 5th metatarsal head was larger than in the control group. Although there was no significant correlation between plantar sensation and LNG/E.AREA in the control group, there was a significant negative correlation in the KOA group. [Conclusion] This result suggests that plantar sensation plays an important role in the postural control of individuals with KOA.

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[Purpose] The purpose of this study was to determine the motor learning effect of a combination of verbal instructions incorporating internal focus of attention (IFA) or external focus of attention (EFA), with knowledge of results (KR), on postural optimization training using functional reach (FR). [Subjects] Twenty-two university students without disability who volunteered to participate in this study were randomly assigned to the IFA group or the EFA group. [Methods] The horizontal distance between the lateral malleolus and the fingertip (FR distance) and the location of the center of gravity were measured at the following times: pre-test, 1st retention test, and 2nd retention test. After the pre-test measurement, participants performed 10 FR trials daily for five consecutive days (practice phase) and received verbal instructions and KR. FR distance was measured in all trials. [Results] The FR distance of the EFA group was significantly larger during the practice phase and the 1st and 2nd retention tests compared to the pre-test measurement; however, no significant difference in the FR distance was observed in the IFA group. [Conclusion] The results of this study suggest that the level of similarity between instructions and extrinsic feedback may influence the learning effect.

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[Purpose] In sit-to-stand, the center of gravity (COG) is transferred from the buttocks to the narrow base of support of the feet, and raising the COG to the standing position is an action with a large dynamic demand, in which the motion of the trunk becomes important for COG transfer. The purpose of this study was to clarify, using young and elderly subjects, how the anterior movement of the trunk (split into trunk and pelvis segments) and lower limb joint movements influence the sit-to-stand action. [Method] Using a 3D motion analysis system and a force plate, we derived the angles of greatest trunk flexion (TA) and pelvic anterior inclination (PA), the fastest speed of center of mass motion (VCM), the absolute angles of the trunk and pelvis segments (TAA and PAA) and the relative angle of the trunk segment to the pelvis (RA) at the moment of buttocks lift-off, as well as the hip and knee joint moments at maximum extension (HM and KM). To find the differences between the actions of the young and the elderly we calculated the correlations between these items. [Results] For the young persons, we found significant negative correlations between KM and TA and RA of maximum flexion, and for the elderly, we found significant negative correlations between KM and TA and PA. In addition, despite the absence of differences in time taken for sit-to-stand, VCM in the forward direction of the elderly was faster than that of the young. [Conclusion] These results suggest the elderly use anterior inclination, and trunk and pelvis flexion to raise the speed of the center of mass (COM) in the forward direction to enable them to raise their COM, whereas the young use anterior inclination of the trunk segment to enable them to raise their COM.

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[Purpose] It was said that cervical rotation is very important for deskwork. In this study, we investigated cervical rotation to see if there were differences between L-R heights of acromions. [Subjects] Subjects were 13 healthy adult males. [Methods] The distance between the spinous process and scapula were measured in a neutral position, 20 degrees right rotation and 20 degrees left rotation. L-R height differences of acromions and distances between the spinous process and scapula were analyzed using correlation coefficients. [Results] The lower the right acromion was relative to the left one, the greater the distance between the cervical spinous process and the scapula moved to the left at 20 degrees right rotation. Similarly, the higher the right acromion was relative to the left one, the greater the spinous process of the thoracic spine moved to the right at 20 degrees left rotation. [Conclusion] The greater the L-R height difference of the acromions, the more the cervical and thoracic spine moved to the lower side.

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[Purpose] Stress urinary incontinence is a major complication of radical prostatectomy. Pelvic floor muscle training (PFMT) is the established treatment for this type of incontinence. In this study, we evaluated the dynamic movement of the pelvic floor using magnetic resonance imaging (MRI). [Subjects] Seven healthy volunteer males participated in this study. [Methods] We ordered control of urination (halts voiding or tighten the tension of the anus muscles) and measured the distance of each indication: the distance between the pelvic bone and coccygeal bone (P-C), the distance between the pelvic floor and coccygeal bone (F-C), and the distance between the pelvic bone and bladder neck (P-B). [Results] The effect of ordering urination control was to decrease the distance of P-C and increase the distance of F-C and P-B in the MRI results. Ordering a voiding halt resulted in a decreased distance of P-C and ordering tighten tension of the anus muscles resulted in increased distance of F-C. [Conclusion] In this study, we revealed the different movements of the pelvic floor muscles during PFMT using MRI. These results indicate that different orders effect different muscles and we may find more effective ways of PFMT utilizing these results.

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[Purpose] Deep muscles of the trunk are attracting attention because of their involvement in motor control and as proprioceptors. The aim of this study was to examine the effects of exercise intervention focusing on these muscles on postural sway. [Subjects] Twenty patients who could stand and walk independently participated in this study. [Method] Subjects were assigned randomly to perform one of two motor tasks: drawing in the abdomen, or leg exercise. Postural sway was measured using center of pressure (COP) before the intervention, and exercise was performed for 3 min. Subjects rested for 3 min, then COP was measured again. COP before and after the exercise was compared between the two groups. [Results] In the group with the task of drawing in the abdomen, significant decreases were observed in total length of COP, envelope area, and rectangular area, and a significant increase was observed in length/envelope area ratio. In the leg exercise group, no significant changes were seen between before and after the intervention. [Conclusion] These results suggest that exercise intervention for deep muscles of the trunk may help to stabilize postural sway.

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[Purpose] In order to examine hamstring stretch for tight hamstrings muscle, we measured muscle stiffness, Straight Leg Raising (SLR), Finger Floor Distance (FFD) and knee extensor strength after hamstrings stretch with three different speeds using an isokinetic machine. [Subject] 20 young male who couldn’t reach the floor when they stood were participated in this study. [Method] All subjects were randomly assigned into two groups such as experimental and control group. People in experimental group conducted hamstring stretch five times of 10 seconds in the morning, daytime and evening for a week. Muscle stiffness, SLR, FFD, knee extensor strength with three different speeds (60, 120, 180°/sec) were measured before and after 7-day interventions. [Result] SLR and knee extensor torque at -30 deg of knee extension at 180°/sec in experimental group were more increased than those in control group.

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[Purpose] The purpose of this study was to examine the utility of vibration sense test in fall risk management. [Subjects] The subjects were 50 community-dwelling elderly persons. [Methods] We measured subjects’ vibration sense, timed “up & go” test (TUG), knee extension strength, and fear of fall and activity. Subjects were then divided into a “fallers” group and a “non-fallers” group, and the measured values of the two groups were compared. We also examined whether fear of fall, activity or other measures were correlated with falls. [Results] The results for vibration sense, TUG and fear of fall of the non-fallers group were superior to those of the fallers group. Fear of fall and activity had a significant correlation with physical performance but not with vibration sense. [Conclusion] Vibration sense was not related to fear of fall and activity, suggesting vibration sense tests are useful for the fall risk evaluation of the elderly with high physical performance.

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[Purpose] The purpose of this study was to clarify the factors affecting the quality of life (QOL) of family caregivers living with home-based care stroke patients. [Subjects] Data were collected from 25 home-based care stroke patients receiving rehabilitation services at a day-care center (mean age of 72.8±11.1) and their 25 family caregivers (mean age of 59.8±12.2) who were living at home in Kobe city, Hyogo. [Method] Capacity to perform ADL was assessed using the Functional Independent Measures (FIM) for the home-based care stroke patients. The care burden, QOL and health status of the family caregivers were also evaluated. [Results] There was no significant correlation between ADL of home-based care stroke patients and family caregivers’ QOL. It was also revealed that the factors affecting the QOL of the family caregivers were determined by their burden and the status of their physical/mental condition. [Conclusion] These results suggest that in order to improve family caregivers’ QOL, rehabilitation should be continued to maintain their function and social support is necessary to reduce the burden of family caregivers.

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[Purpose] The purpose of this study was to compare the effect of assisted cough (AC) for cough function and wound pain after upper abdominal surgery. [Subject] The subjects were 24 patients who had received upper abdominal surgery. [Method] SVC, PCF and wound pain score were measured five times from preoperative to the postoperative seventh day with and without AC. [Results] Subjects’ SVC and PCF decreased the most on the first postoperative day. The recovery rate of PCF correlated with that of SVC. Wound pain score at rest and coughing was correlated with the recovery rate of PCF. In addition, AC was found to be effective for increasing PCF and decreasing wound pain. AC was effective up to postoperative day five. [Conclusion] We conclude that AC is useful for patients with decreased cough function and wound pain.

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[Purpose] The purpose of this study was to examine the effect of changing the height of a stool on leg load during sit-to-stand motion in the third trimester. [Subjects] The subjects were eight healthy pregnant women and eight healthy non-pregnant women 20–30 years of age. [Methods] We measured the sit-to-stand motion from 400- and 450-mm high stools using a three-dimensional motion analysis system. [Results] Using the higher stool, the knee joint extension moment significantly decreased in both pregnant and non-pregnant women. For the non-pregnant women, the vertical floor reaction force significantly decreased when using the higher stool, but there was no significant difference for the pregnant women. There was no significant difference in Borg scale scores for the pregnant women between the two stool heights. [Conclusion] The results of the present study suggest that a higher stool height does not make standing up easier for pregnant women in their third trimester.

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[Purpose] We investigated methods for strengthening the transverse abdominis. [Subjects] Twelve healthy subjects participated in this research. [Method] The thicknesses of the external oblique, internal oblique and transverse abdominis were measured on both the right and left sides using ultrasonography. The position of the measurements were as follows: A) the supine position, B) lying on a stretch pole (with upper limb support), C) lying on a stretch pole (without upper limb support). [Results] The thicknesses of the transverse abdominis showed significant difference among the positions, but there was no significant difference in the external oblique and internal oblique muscles. The transverse abdominis showed a significant difference between A and B, and A and C. [Conclusion] A stretch pole was effective for exercising the transverse abdominis.

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[Purpose] The purpose of this study was to investigate the effect of low-load training of the gluteus medius with skin cooling stimulus (SCS) on its muscle strength and activity. [Subects] The subjects were 32 healthy adult males with a mean age of 21.2 years. [Method] The subjects were divided into a SCS group and a control group, and carried out hip joint abduction exercises at a low load for 6 weeks. The maximum strength of isometric hip abduction and surface EMG of the gluteus medius were measured every other week. Integrated EMG and the mean power frequency were calculated at maximum isometric voluntary contraction (MIVC) and a load of 30% MIVC, and the results were normalized and compared with the values obtained at the start of the exercises. In addition, we measured subcutaneous skin thickness, and skin surface and deep tissue temperatures. [Results] MVIC significantly increased in the SCS group after 4 weeks of training in the SCS group. There was a significant increase in iEMG after 6 weeks of training, but no changes were found in mean power frequency. [Conclusion] We found low-load training of the gluteus medius with SCS had a significant muscle strengthening effect. We suggest exercise intensity, muscle activity characteristics of type I fibers and promotion of motor unit recruitment through skin cooling the muscle were reflected in the increase in muscle strength; however, we could not determine whether an increase in type II muscle fiber activity was involved.

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[Purpose] In order to verify which balance tests are useful for Parkinson’s disease (PD) patients, we examined the relationship between activities of daily living (ADL) and various balance tests frequently used in clinical practice for PD patients. [Subjects] The subjects were 20 PD patients with a mean age of 72.4 years. [Method] We measured timed up-and-go (TUG), single leg standing, and functional reach as well as center of gravity sway (envelope area and total path length), and investigated their relationships with the Functional Independence Measure motor scale (FIM-M) and its sub-scales using Pearson’s correlation coefficients. [Results] We found significant correlations between TUG and FIM-M and its sub-scales of Transfer and Locomotion, but not Self-Care and Sphincter Control. Significant relationships with FIM-M or its sub-scales were not found for the other balance tests. [Conclusion] The results suggest that among the balance tests investigated, only TUG is related to ADL of PD patients.

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[Purpose] The purpose of this study was to histologically examine the regeneration process of skeletal muscle following ischemia. [Subjects] Male Wistar rats of 8 weeks of age. [Methods] Ischemia of the right anterior tibial muscles was induced using clamping of the anterior tibial artery. Muscle injuries were evaluated by measurement of plasma creatine phosphokinase (CPK) activity. Two, 5, 14, 21, and 28 days after ischemia, anterior tibial muscles were removed. Cross-sections of the muscle were cut and stained with HE. Ischemia for 2 hours produced a transient increase of CPK activity compared with the value before ischemia. [Results] After 2 days of ischemia, the muscular area on the ischemic side had decreased by 30%, but it had recovered after 28 days. Centronuclei appeared after 5 days. The number of interstitial nuclei significantly increased after 2 days of ischemia. [Conclusion] The results indicate that reperfusion promotes muscle regeneration from ischemia within 4 weeks.

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[Purpose] The purpose of this study was to assess the effectiveness of a low-intensity exercise program through measurement of the physiological indices. [Methods] Seventeen community dwelling elderly persons (mean age 76 years) participated in this study. We instructed the subjects to practice a low-intensity exercise program twice a week for 3 months. The exercise program consisted of low intensity muscle training such as walking, stretching and recreation sports for 90 minutes. We assessed the physiological performance both before and after the exercise period. Aortic stiffness was measured using the cardio ankle vascular index (CAVI), body muscle and fat amounts were measured with a body composition analyzer, and respiratory functions with an autospirometer. [Results] After the exercise period, the CAVI data had significantly decreased, but HR, blood pressure, total muscle and fat amounts did not change significantly. The forced expiratory volume in one second (FEV1.0) had increased, although the forced vital capacity (FVC) did not change. [Conclusions] The low intensity exercise improved physiological function and was effective at reducing aortic stiffness in the elderly.

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