[Purpose] The purpose of this study was to investigate the factors affecting the discharge destination using FIM at a Recovery Rehabilitation Hospital. [Subjects] Two hundred twenty-six inpatients at our hospital were recruited. [Method] The subjects were assigned to a home group and a facility group according to their discharge destination. The scores of FIM items of both groups on hospitalization and on discharge were analyzed by logistic regression analysis, setting the home group and the facility group as the objective (criterion, response) variables. [Result] In the home group, the scores of items of physical motion, except eating, were significantly higher at discharge than on admission. On the other hand, no significant difference (in the items) was observed in the facility group. In comparison with the scores of FIM at discharge, eleven items in the category of physical motions, except eating, and problem solving and memory, in the category of cognition, were significantly higher in the home group than in the facility group. Furthermore, significant odds ratios were observed in the items of transfer to toilet and dressing lower extremity. [Conclusion] These findings suggest that transfer to toilet and dressing lower extremity are important factors affecting patients’ discharge destination.

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[Purpose] We have developed the 10-second Open-Close Stepping Test (OCS-10), was examined reliability of the measurement values and determination of the measurement time. [Subjects] Determination of the measurement time (Study 1), the subjects were 48 young people (24 males and 24 females), and for the intra-rater and the inter-rater reliability (Study 2), there were two examiners, A and B, and the subjects were 10 young people (4 males and 6 females). [Method] In study 1, measurement time was set to 5, 10, 15, 20 seconds. Then repeated the measurements in the same order. In study 2, examiners A and B made two times with a measurement time was 10 seconds. [Results] In study 1, the intraclass correlation coefficient (ICC) (1.1) was examiners A and B were 0.90 and 0.92, respectively. ICC (2.1) and ICC (3.1) were both 0.96. The intra-rater and the inter-rater systematic errors were not found. [Conclusion] The results show that at a measurement time of 10 seconds, the intra-rater and the inter-rater reliability was good and stable measurement values could be obtained.

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[Purpose] Measurement of the thoracic kyphosis angle with a digital inclinometer may be as accurate as analysis of images captured by X-ray or digital camera. The purpose of this study was to investigate the relationship and degree of coincidence between the thoracic kyphosis angle measured with a digital inclinometer and that derived from an image captured by a digital camera. [Subject] The subjects were 79 healthy young women, mean age 20.2 ± 1.8 years. [Methods] The thoracic kyphosis angle in the upright standing position was derived from an image captured by a digital camera and measured with a digital inclinometer. [Results] The thoracic kyphosis angle of the digital inclinometer was significantly correlated with the angle derived from the digital image analysis (r = 0.66). We could adjust the thoracic kyphosis angle obtained with the digital inclinometer to the thoracic kyphosis angle derived from analysis of the image captured by a digital camera. [Conclusion] The results suggest that a digital inclinometer is an instrument which is simple and easy to use for measuring the thoracic kyphosis angle in the clinic.

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[Purpose] The purpose of this study was to analyze the relationship between the time and power indices of sit-to-stand performance and muscle function during the isokinetic knee extension test in young adults. [Subjects] The study subjects were sixty healthy young adults (30 men and 30 women, mean age 23.4±4.1 years). [Methods] The correlations between Time Index and Power Index of 10 repeated sit-to-stand motions and maximum torque and average power were calculated. [Results] The time index of sit-to-stand performance was not significantly correlated with maximum torque or average power. On the other hand, the power index of sit-to-stand performance was significantly and positively correlated with maximum torque and average power. [Conclusion] These results suggest that mean power using 10 repeated sit-to-stand motions may be used as a brief evaluation method for the muscle function of the lower extremities.

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[Purpose] The aim of this study was to examine the continuous effects of gait training using a locomotion interface for chronic stroke patients. [Subjects] Seven stroke patients participated in this study at 12 months or more after the stroke onset. [Methods] Subjects performed gait training using a locomotion interface 3 times a week for 4 weeks. Patients performed the timed up-and-go test (TUG), and we measured gait speed and isometric muscle strength in hip flexion and extension. [Results] Significant differences were found in gait speed (p=0.039) and TUG (p=0.036) between before intervention and just after intervention. No significant differences were found in gait speed, TUG, or isometric muscle strength in hip flexion and extension among three time points: just after intervention, at the one-month follow-up, and at the 4-month follow-up. [Conclusions] Improvements in the gait and balance ability were after intervention. Furthermore, these improvements were maintained for at least 4 months. Therefore, gait training using a locomotion interface was shown to have continuous effects in this study.

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[Purpose] We assessed the upright postural balance ability of children with mild developmental disorders. [Subjects] The subjects were 17 children with mild developmental disorders (mean age 5.4 years) and 17 healthy children (mean age 5.4 years) as a control group. Informed written consent was obtained from the parents of all the children. [Methods] Postural balance was measured with a stabilometer (Gravicorder Anima Co. Tokyo) during two trials of 30s under the two conditions of static upright posture with eyes open and eyes closed. The data sampling frequency was 20 Hz. Differences between the two groups were analyzed using Student’s t-test and p<0.05 was deemed significant. [Results] Under both conditions, eyes open and eyes closed, standing postural sway and sway speed differed between the two groups (p<0.05). [Conclusion] Children with mild developmental disorders show more instability in postural balance, even with their eyes open, than normal children at a young age. Therefore, we think that mild developmental disorders delay the physical development of children from an early age.

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[Purpose] We investigated the relationship between the performance of motor learning and subjective judgment. [Subjects] Twenty-six healthy young adults participated in this study. We divided participants into an improvement group (n=6) and a no improvement group (n=5). [Methods] Participants were required to reach for a target key on a 49 piece keyboard without vision, and visual feedback was given 1 sec after push of the key. They performed 10 blocks (20 trials in each block). The success ratio was calculated for each block. Judgment of learning (JOL) as a prediction of performance of the next block was measured before each block. [Results] In all the participant’s results, a significant difference was observed between the success ratio and JOL, and there was no significant change in the accuracy of judgment through the blocks. In the groups, there was a significant difference between the success ratio and JOL in both groups, no significant difference of JOL between the groups, and there was no significant change of the accuracy of judgment through the blocks. [Conclusion] The results suggest that there is no relation between the performance of motor learning and the subjective judgment of healthy young adults.

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[Purpose] The activities of the scapular muscles during isometric contraction were measured to examine the mechanism of scapular stability. [Method] The activities of the scapular muscles were measured during isometric contraction of internal and external shoulder rotation at 0 degrees and 90 degrees abduction with three kinds of resistance loads. Scapular muscles were classified into agonists and antagonists of each motion, and the changes in each muscle activity were analyzed. [Results] The integrated electromyograms of both agonists and antagonists increased significantly with increasing resistance load in internal and external rotation at 0 degrees and 90 degrees abduction. In the case of the strongest resistance load at 0 degrees abduction, the integrated electromyograms of the agonists showed from 14 to 24 times as much as the start position and those of antagonist showed from 3 to 5 times that of the start position. At 90 degrees abduction, the integrated electromyograms of agonists showed from 2 to 12 times and those of antagonists showed from 2 to 7 times. [Conclusions] All scapular muscles needed to be active during concentric contraction of shoulder rotation. We consider that the agonists might work against external force and the antagonists might contribute to the stability of the scapula and trunk, in light of a previous study.

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[Purpose] In this study we examined the relationship between physical therapy students’ occupational identity and students’ assumed-competence. [Subjects] The subjects were one hundred seventy-seven physical therapy students. [Method] We performed a survey of the students using the occupational identity scale, assumed-competence scale and self-esteem scale. [Results] The main results were as follows. Students classified as assumed type tended to have lower “self-confidence for selection of a PT as a profession” than self-esteemed types. Assumed types and atrophic types had lower “establishment of a vocational outlook”, and “pride needed as a PT” than self-esteemed types. Assumed and omnipotent types had generally lower “orientation to social contribution” than self-esteemed types. [Conclusion] We conclude that students classified as assumed type need educational support, such as offering them a chance of achieving and encouraging them to acquire a sense of industry and develop their occupational identity.

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[Purpose] The objective of this study was to clarify the effects of vibration stimulus at different application points on the muscle tone of skeletal muscle. [Subjects] The subjects were 15 healthy males with no history of nerve disorders in the lower limbs. [Method] We stimulated the tendon or muscle belly of the triceps surae of the left lower limb for 3 minutes with vibration of 76.6 Hz and 2 mm amplitude, and assessed the muscle tone using the Hmax: Mmax ratio, the ratio of the maximal values of the H and M waves, derived from evoked electromyograms recorded before and after the vibration application. [Results] The Hmax:Mmax ratio decreased with the application of vibration to both the tendon and muscle belly, and the decrease was greater when the vibration was applied to the tendon. [Conclusion] Irrespective of the point of application, vibration inhibited the muscle tone of skeletal muscle, suggesting vibration has an increasing role to play in the clinical setting.

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[Purpose] To examine the effects of coughing exercise on respiratory functions and the autonomic nervous system in patients with Amyotrophic Lateral Sclerosis. [Methods] The subjects were 6 patients in respite admission, and 10 healthy adults (as a control group). The respiratory functions and autonomic nervous system were compared with before and after an intervention of lower loading coughing exercise. [Results] Peak Cough Flow tended to increase after the coughing exercise, and the lower rib cage expanded significantly in the patient group. In the control group, Peak Cough Flow increased, and both the lower and upper rib cage expanded significantly. Cardiac parasympathetic nervous activity showed a pattern identical to the control group. [Conclusion] We suggest that ALS patients are able to use their expiratory muscles efficiently through the learning effect of the coughing exercise in the short-term. We suggest that the function of the autonomic nervous system can also be improved.

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[Purpose] In this study, we used a monofilament algometer to make measurements and examined differences in plantar sensory threshold value between gender and four points on the sole of the foot. [Subjects] The subjects were 85 young persons (47 males and 38 females) without nerve or orthopedic disorders who provided their consent after receiving an explanation of the purpose of this study. [Method] One measurer measured the plantar pressure perception threshold value of each of the subjects. Gender and positional differences were examined using two-way analysis of variance with multiple comparison, Tukey’s test, as a post hoc test. [Results] No gender differences between the four points on the sole of the foot were found. The perception threshold was greatest at the center of the heel, and declined in the order of the hallux, the head of the first metatarsal and the center of the medial longitudinal arch. [Conclusion] The results reveal that the parts of the foot which have the most mechanoreceptors have the lowest perception threshold values.

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[Purpose] We investigated the relationship between the intensity of toe motion and Δ[Oxy-Hb] in motor cortical areas. [Subjects] Twelve healthy adults (7 females and 5 males: 26.9±5.3 years of age) participated in the study. [Methods] The motor tasks were isometric and isotonic right toe flexion. The participants performed the tasks under two conditions: maximum and moderate effort. We measured the motor cortical activity using NIRS, and the extent and amplitude of the activations were compared between the two conditions for each task. [Results] In the isotonic flexion task, the extent of the activation area and the amplitude of Δ[Oxy-Hb] were dependent on the movement intensity. On the other hand, there was no significant difference between the two conditions in the isometric flexion task. [Conclusion] We clarified that cerebral activation is influenced by the task motion and the participant’s effort.

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[Purpose] This study was performed to investigate the influence of changes in posture during feeding on masticatory efficiency. [Subjects] Subjects were 23 healthy young adults. [Methods] The subjects were asked to adopt four postures in a random order. The activity of the masseter muscle was recorded by electromyography from the beginning of chewing to the end. The number of chewing strokes, total chewing time, chewing rhythm and coefficient of variation of chewing rhythm were compared among the postures. [Results] The number of chewing strokes was significantly greater in R30-HN30 than in R90-HN0 . The total chewing time was significantly longer in R30-HN0 and R30-HN30 than in R90-HN0. Burst duration was longest in R30-HN0. Cycle time was significantly longer in R30-HN0 than in R90-HN0. The coefficient of variation of burst duration was significantly greater in R30-HN0 than in R90-HN0. [Conclusion] Masticatory efficiency is the best in R90-HN0.

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[Purpose] The purpose of this study was to investigate the measurement reliability of the medial longitudinal arch of the foot in the standing position and the lower leg maximum anterior tilting (LMAT) position. [Methods] Eight subjects and three testers participated in this study. The arch ratio (AR) and the calcaneus angle (CA) were measured 3 times in each trial, both in the standing position and the LMAT position. Test-retest reliability was established using the ICC (1, k) model for data from the first to the third trials. Inter-tester reliability was established using the ICC (2, k) model for data from the average of the first to third trials for each tester. [Results] In both conditions, AR showed high reliability for all testers. CA showed high reliability for one tester, but the others showed insufficient reliability for use in a clinical setting. [Conclusion] We consider the measurement reliability of CA was affected by accumulation of experience and advancement of palpation. Therefore, the methods should give sufficient reliability for a clinical setting.

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[Purpose] The aim of this study was to examine the influence of visual orientation in the horizontal plane on standing postural sway in a standing rotational movement. [Subjects] The subjects were 18 healthy adults: 7 men and 11 women; average age, 21.7±1.0 years; average height 163.9±8.9 cm; and average weight, 57.6±13.2 kg. [Method] For the rotation task, the subjects stared at vertical lines set in the horizontal plane at 0, 45, 90 and 135 degrees, the four conditions, for 30 s while maintaining a standing posture, and we measured the total path length, the path average area, and the lateral and anterior-posterior maximum displacements of postural sway. In the statistical analysis, we used one-way analysis of variance and a multiple comparison test as a post hoc test, with levels of significance of less than 5%. [Results] A main effect among the conditions was found for total path length and path area, but not for the maximum displacements of lateral and anterior-posterior sway. [Conclusion] In standing rotational movement, the dependency on visual system control was strong at 0 as well as 90 degrees, suggesting environmental interaction with the rotational axis of the body is a factor.

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[Purpose] The purpose of this study was to investigate the influence on the stepping over motion of extension limitation of the knee joint, to understand the characteristics of stepping over motion in knee osteoarthritis. [Subjects] The subjects were 11 healthy subjects. [Method] Subjects stepped over an obstacle of 10 percent of body height with the unlimited left limg with 1) an extension limitation provided by a knee brace of ten degrees of the right knee joint, and 2) without limitation. We measured and compared motions using a 3D motion analysis system and four force plates between the two conditions. [Results] When unilateral knee joint was limited, flexion angles of the hip joint of the swing limb and trunk, center of mass (COM) and center of pressure (COP) inclination angle, and progressive reaction force were significantly higher and the amount of change of the angle of the foot joint of the stance limb was significantly smaller than without limitation. [Conclusion] These results suggest that extension limitation of a unilateral knee joint can become a factor of falls, because it influences movement of the swing limb, stance limb, and trunk in the stepping over motion.

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[Purpose] The purpose of this study was to investigate the effect of visual information when stepping over an obstacle during locomotion. [Subjects and Methos] Thirty healthy young males (ages 20.4±1.7 years old) participated in this study. Participants were required to step over a wooden obstacle on the path under 2 different conditions: 1) An obstacle with no visual information; and 2) A green-taped obstacle showing sufficient contrast. Toe-Clearance (TC) and joint angles of the lower extremities were measured for the non-taped obstacle and the green-taped obstacle. They were measured using a 3D motion analysis system. We defined TC as the minimum distance between the toe of the leading limb and the obstacle in the sagittal plane. [Results] Both TC and hip joint angle were significantly higher in stepping over the green-taped obstacle. [Conclusion] We consider that visual information can assist in recognizing an obstacle before crossing it. The awareness of preliminary avoidance during the approach phase results in emphasis on leading limb elevation control for successful clearance of the obstacle.

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[Purpose] We examined and compared cerebral oxygenation in the frontal lobe when healthy adult subjects used their dominant and non-dominant hands. [Subjects and Method] The subjects were 12 healthy right-handed persons (9 males and 3 females, average age 20.3±0.5 years). They were asked to draw a coil, like a mosquito coil and of the same diameter, in 10 s. They were then asked to draw as quickly as possible a line within the coil without touching the walls of the coil. During performance of these tasks, we measured changes in oxy-hemoglobin (HbO₂) using NIRS and task times for both the dominant and non-dominant hands. [Results] A significant difference was found between HbO₂ during task performance by the dominant hand and the non-dominant hand, and HbO₂ was significantly higher when the non-dominant hand performed the task. [Conclusion] The results suggest that cerebral oxygenation in the frontal lobe increases more when the non-dominant hand is used rather than the dominant hand.

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[Purpose] To determine whether plantar perception training using a hardness discrimination task efficiently improves stabilization of standing postural balance in the oldest patients. [Subjects] Nineteen elderly persons, 75 years of age or older, living in nursing facilities were randomly assigned evenly to either a perception exercise group or a control group. [Method] The perception exercise group was given a task designed to train ability to discriminate different degrees of hardness of foam rubber. The training period was 10 days. Control group subjects were instructed to maintain a standing posture on foam rubber. Before and after training we measured center-of-gravity sway of the standing subjects, and measured the sway path length. [Results] The data revealed a significant reduction in center-of-gravity sway post-training in the perception exercise group as well as a significant increase in the forward displacement of the center of gravity. [Conclusion] These results suggest that plantar perception exercises might efficiently stabilize standing postural balance of the oldest patients.

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[Purpose] We examined the spatiotemporal parameters of hemiplegia patients during gait and their asymmetry, and compared them with those of healthy adults in a simple analysis. We also elucidated the relationship between the asymmetry and severity of hemiplegia as well as walking speed. [Subjects] The subjects were 10 healthy adult females, the healthy group, and 29 hemiplegia patients, the hemiplegia group. [Method] On a 10-meter walkway, the healthy group walked at a comfortable speed, and the hemiplegia group walked at their maximum speed. Using Videobrowser to measure the spatiotemporal parameters, we derived step time (ST) and step length, and calculated their asymmetry ratios. [Results] ST in the hemiplegia group had an asymmetry ratio of 1.3±0.4, which showed a higher value at moderate levels of paralysis, and we found a negative correlation between the asymmetry ratio in ST and walking speed. [Conclusion] The asymmetry in hemiplegic patients’ gait often shows temporal changes, suggesting it is influenced by walking speed or severity of paralysis.

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[Purpose] This study examined the electromyographic characteristics of one-leg standing (OLS) of subjects with functional ankle instability (FAI). [Subjects] The study group consisted of 11 patients with unilateral FAI. [Method] The subjects performed OLS after taking a side step either towards the affected or unaffected side and electromyographic data was collected using an EMG system. [Results] A comparison of the measurements showed that the mean power frequency of the EMG from the tibialis anterior muscle and the peroneus longus muscle were significantly higher on the affected side than on the unaffected side. The percentage of the maximum voluntary contraction of the gluteus medius muscle was significantly lower on the affected side than on the unaffected side. The motion time was significantly prolonged on the affected side than on the unaffected side. [Conclusion] FAI causes characteristic changes in the muscle activity pattern, and a person with FAI needs a much longer time to achieve stability during single-leg standing motion.

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[Purpose] We evaluated scapular movements during shoulder abduction using our new scapular position measurement method employing a tape measure. [Subjects and Method] The subjects were 26 adults without motor or shoulder disorders. The scapular position was measured at 0°, 90°, and 180° shoulder abduction, and scapular movements associated with shoulder abduction were analyzed using one-way analysis of variance and multiple comparison. [Results] Scapular depression significantly differed among the 3 limb positions. Scapular adduction significantly differed between 0° and 90° shoulder abduction. During shoulder abduction, the scapula showed depression / adduction / upward rotation at 90° shoulder abduction and further upward rotation in the final range. [Conclusion] This measurement method, employing a tape measure which is frequently used in clinical practice, is a straightforward method for evaluating scapular movements. In addition, this method may be applicable to evaluation during physical therapy of motor disorders.

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[Purpose] This study examined the relationship of both knees flexor muscles’ activities after harvesting the semitendinous tendon (ST) for anterior cruciate ligament (ACL) reconstruction. [Subjects] The subjects were 9 patients who underwent unilateral ACL reconstruction using an ipsilateral semitendinosus tendon 12 months earlier. [Methods] Isometric knee-flexion torque at 30, 60, 90 and 105 degrees/sec of knee flexion were measured of both lower extremities. We also measured the muscle activity at the same time. [Results] Subjects were divided into two groups based on the value of the lower extremities muscle strength. The two groups were the“recovery group” (recovery of more than 80% of the unreconstructed side), and the“norecovery group” (recovery of less than 80% of the unreconstructed side). The muscle electrical activity in the recovery group showed a decrease on the operated side and the norecovery group showed a decrease in both legs. [Conclusion] Donor muscle activity remained low even after a longtime had passed since reconstruction because of the influence of the tendon collection. Also, the results suggest that the operated side muscle hypoactivity caused healthy side ST muscle hypoactivity.

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[Purpose] This study looked for predictors of walking speed after half a year for patients with knee osteoarthritis (knee OA). [Subjects and Method] Forty-eight outpatients with knee OA (11 men, 37 women; 74.8 ± 7.2 years) were enrolled in this cohort study. The 5m maximum walking speed (5mMWS) was measured as the dependent variable. Candidate predictors included maximum isometric muscle strength of knee extensors and flexors, hamstrings/quadriceps muscle strength ratio, knee pain, and knee range of motion. Multivariate analyses adjusted for confounding factors such as sex, age, height, weight, and pain medications were conducted. [Results] Higher maximum isometric muscle strength of knee extensors and flexors, higher range of motion in knee extension as well as decreased knee pain at baseline significantly predicted a faster 5mMWS. [Conclusions] These findings suggest that the strength of knee extensors, strength of knee flexors, knee extension range of motion and knee pain are important for walking speed in a population with knee OA.

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[Purpose] The purpose of this study was to evaluate the effect of a combined treatment of mirror therapy (MT) and electromyography-triggered neuromuscular stimulation (ETMS) (ETMS-MT) on the upper limb function of stroke patients. [Methods] Following receipt of their written informed consent, eight stroke patients received two 20-minute sessions of ETMS-MT, 5 days a week, for 4 weeks. Electrical stimulation was applied to the wrist and finger extensors of the paretic arms. The upper extremity items of the Fugl-Meyer assessment, active range of motion of wrist extension, hand ratio, box and block test, Wolf motor function test and motor activity log were evaluated before and after the treatment. [Results] After the treatment of 4 weeks, all outcome measures improved significantly. Besides, improvements were specifically seen in the outcomes related to wrist and finger function. [Conclusion] ETMS-MT might enhance functional recovery of the paretic hand of stroke patients. A randomized-controlled trial should be executed to investigate the treatment effect of ETMS-MT.

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[Purpose] This paper presents a review of Kinesio Taping^® theory and basic application methods. In the Kinesio Taping^® method, elastic tape is applied to the skin to improve the circulation of fluids, which is expected to raise the natural healing power. Using a relatively shallow-layer approach to the assessment and modification of tissue disorders, it aims at functional improvement focusing on myofascia. With regard to its effects, it improves muscle function and fluid circulation, suppresses pain and corrects joints, and prolongs the effect of treatments. A feature of Kinesio Taping^® is that the tape itself is applied with little or no stretching. In addition, by changing the stretch or application method of the tape, the target fascia can be changed: low stretch for the dermis, myofascia and muscles; high stretch for the deep layers of the tendon, ligament and joint correction. This distinctive taping method can be used not only for treatment, and its application in physical therapy assessment and greater use in the field of physical therapy can be expected.

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