[Purpose] This study investigated the relationship between leg extensor torque and hip flexor and extensor muscle strengths of males and females. [Subjects] The subjects were 53 healthy adults with no disorders of the lower limbs. [Methods] For both males and females, we measured the peak torque relative to body weight of the right and left legs during extension, as well as hip flexor and extensor muscle strengths relative to body weight. We then examined the relationship between leg extension torque and hip flexor and extensor strengths using Spearman correlation coefficients. [Results] We found strong to moderate correlations between male left and right extension torque and hip flexor and extensor strengths, and moderate to weak correlations between female left and right extension torque and hip flexor and extensor strengths. [Conclusion] In males, hip flexor and extensor muscles play a large role in producing leg extension torque, whereas their contribution is less in females.

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[Purpose] The aim of this study was to investigate the effect of heat stimulation (HS) before exercise on muscle fatigue resistance. [Subjects and Method] Eight healthy males participated in this study, and underwent two sessions: 1) 20-minute HS to the thigh, 2) 20-minute rest without HS to the thigh (control). After each session, the subjects performed contraction of the quadriceps femoris muscle equivalent to 50% of maximum voluntary contraction for 60 seconds for the evaluation of muscle fatigue resistance. During the task, surface electromyogram median power frequency (MDPF) was acquired from the vastus medialis, vastus lateralis and rectus femoris muscles. [Results] After HS, no significant decreases in MDPF were observed in the vastus medialis and vastus lateralis muscles. After the control, however, significant decreases in MDPF were observed in all the muscles. [Conclusion] These results show that heat stimulation can enhance muscle fatigue resistance.

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[Purpose] This study aimed to determine factors related to low back pain (LBP) from changes in the physical characteristics. [Subjects] Thirteen elite junior divers who were followed from 13 to 15 years old. [Methods] The change in each item between the ages of 13 and 15 years old were analyzed by one-way analysis of variance. [Results] Significant main effects were recognized between each age of height, weight, standing long jump, vertical jump, back muscle strength, sit-ups for 30 seconds, and handstand continuance time. [Conclusion] LBP possibly occurs owing to increase in weight after 15 years old.

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[Purpose] We investigated the usefulness of assessment tools used in fall prevention classroom. [Subjects] The subjects were 33 community-dwelling elderly women. [Method] Assessment tools for measurement were selected based on motor function, stride time variability, gait parameters, such as root mean square (RMS), and level of daily activities. In univariate analysis, stride time variability was found to be significantly greater for fallers than for non-fallers. The cut-off value and the area under the curve (AUC) were determined from the receiver-operating-characteristic (ROC). [Results] Significant differences were observed between the fallers group and no-fallers group in stride time variability and level of daily activities. Logistic regression analysis showed stride time variability and level of daily activities were significantly associated with falls. AUC of stride time variability was 0.79, and that of the level of daily activities was 0.20. The degree of sensitivity of stride time variability for falls was 69% (specificity: 85%, accuracy: 79%) when the cut-off value was estimated to be 2.26%. [Conclusion] Our study suggests that stride time variability is a useful assessment tool for predicting falls.

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[Purpose] We investigated the effect hip flexion angle has on spinal curvature during rod exercise. [Subjects] The subjects were 40 healthy adults aged 21.1±0.5 years. [Methods] We measured thoracic kyphosis and lumbar lordosis angles in standing still (Condition A), as well as at hip flexion angles of 0° (Condition B), 30° (Condition C), 60° (Condition D), 90° (Condition E), and 120° (Condition F) during performance of the rod exercise, and compared the six conditions. [Results] Thoracic kyphosis in Condition A showed a significantly smaller value than those of all the other conditions, and was significantly smaller than Condition F in Condition B. Lumbar lordosis showed a significantly larger value in Condition F compared to all the other conditions, and showed a significantly smaller value than those of all the other conditions, except for Condition B, in Condition A. [Conclusion] Increasing the angle of hip flexion in the rod exercise can extend the thorax by restricting lumbar extension.

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[Purpose] We investigated whether or not motor ability and functional capacity of community-dwelling elderly living on an isolated island differed between males and females and between age groups. [Subjects and Methods] Using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG Competence) and the motor fitness scale, we conducted a survey of all 73 elderly residents. [Results] Functional capacity of both males and females did not differ between age groups. Motor ability declined with age among females, but not among males. [Conclusion] We speculate that males’ motor ability did not decline, because only those with high motor ability had remained on the island, as a decline would have made it difficult for them to perform fisheries work. When conducting a survey of the functional capacity of community-dwelling elderly, the addition of a motor ability survey enhances regional and gender differences.

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[Purpose] The purpose of this study was to develop a Clinical Competence Evaluation Scale in Physical Therapy (CEPT). This scale was designed to be used in continuing education for physical therapists. We examined the reliability of the scale. [Method] Based on our previous qualitative study, a CEPT was developed with 53 items. The 90 participants in this study included novice physical therapists with less than 3 years’ experience (n=30), as well as principal (n=30) and sub-tutors (n=30) who were mentoring the less experienced participants. Using CEPT, the novice physical therapists performed a self-evaluation, and the principal and sub-tutors evaluated the novice physical therapists. [Results] The score of the CEPT of the novice physical therapists was lower than those of the principal and sub-tutors. The intra-rater reliabilities of each item and total scores of the novice physical therapists and principal tutors ranged from moderate to high. Inter-rater reliability between the principal and the sub-tutors was low. [Conclusion] These results suggest that the intra-rater reliabilities of CEPT range from moderate to high.

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[Purpose] The purpose of this study was to examine the influence of static knee alignment on knee-in and tibial rotation, and the relationship between knee-in and tibial rotation angle during a single leg drop landing. [Subjects] One hundred three women were classified into 3 groups: valgus (7), neutral (10) and varus (10) based on static alignment of their knees. [Method] Three-dimensional motion analysis was carried out during a single leg drop landing from a platform 30 cm in height. [Results] The variation of knee-in angle in the the varus group was significantly greater than that in the valgus group. The tibia was internally rotated in the valgus group and externally rotated in the varus group. There was a correlation between the variation of knee-in angle and the variation of the tibial rotation angle. [Conclusion] The direction of tibial rotation was influenced by static knee alignment, and the variation of knee-in angle was influenced by the direction of the tibial rotation.

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[Purpose] The purpose of this study was to clarify the characteristics of the kinematic coupling behavior of the calcaneus and the shank. [Subject] Sixteen young healthy subjects participated in this study. [Method] Motion of the calcaneus and the shank during active inversion-eversion of the foot in the standing position was recorded using a 3-dimensional motion analysis system. In addition, the relationships between the kinematics and the physical findings of the leg were investigated. [Results] The calcaneus inversion-eversion and the shank external-internal rotation were linked to each other in constant ratios. The ratio showed individual differences of 4 times or more, and a right-left difference in nine of the 16 subjects. The range of motion of the subtalar joint was related to the ratio. [Conclusion] The ratio of kinematic coupling behavior of the calcaneus inversion-eversion and the shank external-internal rotation was constant in the same limb, but showed variance between individuals and right and left limbs of the same subject.

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[Purpose] We investigated the sexual dimorphism of lower limb alignment and investigated the relationship of characteristics of injury occurrence in males and females. [Subjects] Twenty-five healthy male (50 legs) and 25 healthy female (50 legs) university students. [Method] The Q-angle, leg heel angle, and arch height ratio were measured as aspects of lower limb alignment. In addition, the range of motion of subtalar joint pronation and supination, and knee joint extension were measured. [Result] The Q-angle, range of motion of subtalar joint pronation and supination, and range of motion of knee joint extension were significantly greater in females than in males. [Conclusion] Sexual dimorphism in lower limb alignment and range of motion may affect the characteristics of injury occurrence in males and females. However, in order to clarify these relationships, they need to be investigated more fully.

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[Purpose] The purposes of this study were to investigate the health related quality of life (HRQOL) and physical activity, and to establish the criterion for postoperative physical activity levels that do not overload the hip joint. [Subjects] Subjects were 71 females who had osteoarthritis of the hip joint and had received Chiari pelvic osteotomy. [Method] Level of physical activity was evaluated using an activity recorder which measured the number of steps as well as the duration of activity according to exercise intensity. Patients with 40 or more points on the Harris hip score were categorized as the no-pain group, and those with 30 or less points as the pain group. HRQOL was evaluated by means of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). We analyzed the relationship between the physical activity level and pain in patients with unilateral coxarthrosis, and clarified the criteria of the physical activity level representing excessive stress on the hip joint by the receiver operating characteristic (ROC). [Result] The patients with bilateral osteoarthritis had lower physical functioning QOL and physical activity than the patients with unilateral osteoarthritis. The threshold value of the number of steps that aggravated hip joint pain based on the ROC was 8981 steps/day, and the sensitivity and specificity were 0.75 and 0.79, respectively. [Conclusion] We can improve HRQOL by understanding appropriate physical activity levels.

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[Purpose] The purpose of this study was to examine the influence of walking environment on the gait pattern of frail elderly people. [Subject] Fifteen frail elderly women volunteered for this study (mean age 85.1±5.3 years). [Method] Measurements were conducted under two conditions. In condition 1, participants walked close to a wall. For condition 2, they walked out of reach of the wall. Measurement indicators were body acceleration (Intensity Exercise: IE), body sway and walking speed. The participants were separated into two groups based on the error sum of delta of acceleration (IE). [Result] In the high-IE group under condition 2, body sway was larger than that of the low-IE group. The body sway under condition 1 was not significantly different between the high-IE group and low-IE group. [Conclusion] The walking environment of condition 1 lessens the risk of falls regardless of IE.

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[Purpose] The purposes of this study were to verify the flow of arterial blood in the paralyzed side legs and the safe treatment pressures for patients with the cerebrovascular disorders. [Subject] A total of 19 chronic cerebrovascular disorder patients volunteered for this study. [Method] Subjects were positioned prone. Pressures of 0, 20, 30, 40, and 50 mmHg were applied to the lower thigh on the paralyzed side, and the blood flow volume of the posterior tibial artery was measured at 1, 3, and 5 min after pressure. [Results] The blood flow volume of the paralyzed leg declined compared to the non-paralyzed leg. No significant differences were found in the paralyzed side blood flow volume between any of the pressure intensities or times. [Conclusion] The paralyzed side lower extremity blood flow decreased in the chronic stage cerebrovascular disorder patients, but 20~50 mmHg pressures for 1~5 min did not cause inhibition of blood flow, suggesting that these pressures are appropriate for safely treating such patients.

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[Purpose] We investigated the effects on muscle function of active individual muscle stretching (AID). [Subjects] The subjects were the right legs of 30 healthy male students. [Method] The subjects were divided into an AID group, which performed stretching, and a control group which did not. Using a goniometer and Cybex equipment, we examined and compared between groups, and before and after stretching. [Results] For flexibility and muscle strength output, we found a significant increase in flexibility and a significant decrease in muscle strength output in the AID group after the intervention. [Conclusion] The results suggest that AID induces an increase in flexibility, and a temporary decrease in muscle output strength.

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[Purpose] We investigated through postural sway the postural response, reaction time, and peak muscle activities and times in response to an external perturbation of differing intensity after standing balance adaptation. [Subjects] The subjects were 10 healthy persons. [Method] Subjects stood on top of a movable plate set on a postural sway recorder. External perturbation at the same intensity (Pert A) was delivered 10 times. For the eleventh trial, an external perturbation of lower intensity (Pert B) was delivered, and we investigated and compared the differences between Pert A and Pert B. [Results] Postural sway showed a significant increase for Pert B, and we found a significant delay in the peak activity time of the tibialis anterior, and a significant lowering of the peak value of the rectus femoris. We did not find a significant difference between the reaction times. [Conclusion] The results suggest that when an external perturbation of differing intensity is delivered after standing balance adaptation, muscle strength is not exerted efficaciously.

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[Purpose] This study investigated the learning effects of repetitive perturbations on muscle synergies during automatic postural responses (APR) induced by unexpected horizontal surface translations. [Subjects] Nine healthy young subjects participated in this study. [Method] Each subject was instructed to maintain equilibrium without stepping after perturbations in the backward-forward direction under stable or unstable conditions. Each subject practiced 540 trials over a 6-day period. The displacements of seven markers used to calculate center of mass (COM) were captured using a motion analysis system and electromyogram signals were recorded at the same time. [Results] The peak velocity of COM during APR decreased with practice, and was accompanied by increases in muscle activities, namely “knee co-contraction” and “sway-forward” synergies in the backward-perturbed direction under the unstable condition. [Conclusion] The results suggest that the central nervous system enhances particular muscle synergies with practice, specifically the co-contraction of knee joints and the coordinated activity patterns of proximal muscles combined with distal muscles, during APR under mildly unstable conditions.

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[Purpose] We investigated changes in perioperative gastrointestinal cancer patients’ physical function between before and after surgery, and the influence of gender and surgical procedure on the changes. [Subjects] The subjects were 50 perioperative gastrointestinal cancer patients, 27 males and 23 females with an average of 62.5±10.7 years, who were categorized by gender and two surgical procedures. [Method] We measured the 6-min walking distance (6MWD) of each patient before and after surgery, and calculated the postoperative distance as a percentage of the preoperative distance (%6MWD). [Results] For all patients, and by gender and surgical procedure, postoperative 6MWD significantly decreased. Further, for %6WMD we found main effects of both gender and surgical procedure. [Conclusion] A significant postoperative decrease in physical function of perioperative gastrointestinal cancer patients was found after surgery, and our results suggest the possibility that gender and surgical procedure are factors influencing the changes in postoperative physical function. We consider that information on gender and surgical procedure of perioperative gastrointestinal cancer patients is important information, because it indicates changes in postoperative physical function.

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[Purpose] To study the difference of the excitability of spinal neural function at 30 and 50% maximum voluntary contraction (MVC) motor imagery. [Subjects] Subjects were 15 healthy subjects with a mean age of 25.4±4.75 years. [Method] We recorded the F-wave under 3 conditions: the rest condition; the 30 and 50%MVC motor imagery condition, when subjects were asked to imagine the contraction of holding a pinch meter; and the after imagery condition, immediately, and 5, 10 and 15 minutes after imagery. [Result] Both persistence and the amplitude ratio of F/M during 30 and 50%MVC motor imagery were significantly higher than that at rest. The relative value of 50%MVC motor imagery to rest was not significant different from that of 30%MVC motor imagery. [Conclusion] The results suggest that motor imagery increases the excitability of spinal neural function, and that 30%MVC motor imagery sufficiently increases the excitability of the spinal neural function.

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[Purpose] The purpose of this study was to determine the effects of different exercises on skeletal muscle after ischemic reperfusion. [Subjects] Fifteen eight-week-old Wistar female rats were randomly divided into four experimental groups: normal, ischemic, light-exercise, and heavy-exercise. [Method] Ischemia was induced in 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 ischemic group, the means of the soleus muscle fiber cross section minor axes significantly decreased in the heavyexercise group. [Conclusion] Our results suggest that heavyexercise after ischemic reperfusion of the skeletal muscle may cause muscle atrophy.

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[Purpose] The purpose of this study was to investigate the possibility of using a hybrid assistive limb^® (HAL^®) for clinical rehabilitation. [Subjects] Ten patients participated in this study. [Methods] Subjects performed gait training for 20-30 minutes using HAL^®. Ten-meter comfortable and maximum walking speed times were measured before and after HAL^® training. [Results] Four patients improved their 10-meter comfortable walking speed times, and the other 3 patients improved their 10-meter maximum walking speed times. The 7 patients made positive comments about ambulation activities both with HAL^® fitted and after HAL^® had been removed. There was no serious adverse event during HAL^® training. [Conclusion] Our data suggest that patients, who made positive comments about ambulation activities both with HAL^® fitted and after HAL^® had been removed, could safely improve their walking speed after HAL^® training.

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[Purpose] This study investigated the methods that physical therapists use to assess the walking independence of hemiparetic stroke patients, and the factors related to walking independence. [Method] English-language and Japanese-language studies were identified through searches of MEDLINE and ICHUSHI up to December 2011. [Result] Inclusion criteria were satisfied by 39 trials. The test batteries used to determine walking independence were FIM, FAC, and doctors and physical therapist decisions. Factors related to walking independence were walking ability, lower extremity function of the affected side, cognitive disorder, and higher cerebral dysfunction. However, their values and significance were not defined. [Conclusion] Results of this review suggest that walking independence of stroke patients is determined by qualitative evaluation. Therefore, comprehensive evaluation scales are necessary for physical therapists to objectively ascertain walking independence.

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