[Purpose] To investigate the effects of task prioritization on dual-task performance of patients with stroke. [Subjects] Forty-seven subjects with stroke who were able to walk independently or under supervision. [Method] The dual-task was the 10 m walking test while enouncing 3-digit numbers backwards (backward digit span). Dual-task performance was measured under two different conditions: paying attention equally to both walking and backward digit span (Dual-Task Complex: DTC), and paying attention mainly to backward digit span (Dual-Task backward digit span: DTB). [Result] Walking speed and cadence decreased, and the number of all answers and correct answers increased in DTB compared with DTC. [Conclusion] It is necessary to clearly specify the task prioritization, when we use dual-task as a predictor of falls or measure the walking ability of patients with stroke.

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[Purpose] The objective of this study was to investigate the effect of exercise intervention using a horse-riding simulator on frail seniors. [Subjects] The subjects were 28 frail seniors. [Method] The exercise intervention period and non-intervention period were 12 weeks. Before and after these periods, the times of one-leg standing with eyes open, Functional Reach Test, 5 m walking test, Timed Up and Go Test, thoracic kyphosis angle, lumbar flexure angle, and sacral inclination angle were measured. [Result] All measurements except the thoracic kyphosis improved. [Conclusion] The results indicate that exercise intervention using a horse-riding simulator was effective at improving the physical ability and spinal alignment of frail seniors.

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[Purpose] We examined items of ADL improvement in serious cases. [Subjects] The subjects were 77 stroke patients with FIM-motor scores of less than 50 at admission. [Method] We retrospectively investigated age, sex, type of disease, length of time from onset to admission to the convalescence rehabilitation ward, length of stay in the convalescence rehabilitation ward, length of time from onset to discharge, length of time of hospitalization, and FIM from medical records. We divided the subjects into two groups. The improvement group consisted of patients with FIM-motor scores of 50 or more at discharge. The no-improvement group consisted of patients with FIM-motor scores of less than 50 at discharge. We compared the two groups using Student’s t-test or the Mann-Whitney U test and conducted multiple logistic-regression analysis. [Result] Multiple logistic regression analysis identified gains in locomotion and dressing lower body. [Conclusion] The items of FIM improved were locomotion and dressing lower body. We should pay attention to these items in serious cases.

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[Purpose] The purpose of this study was to objectively classify the results of a national survey of the risk management (RM) environment of physical therapy (PT) departments in acute-phase hospitals, in addition to understanding the current situation of RM. [Subject] The subjects were 247 institutions among 8,818 hospitals registered in the Health, Welfare, Medical Information Network in August, 2009 that were automatically extracted after searching under the subject of medical treatment and examination/treatment conditions. [Method] Hospital overview, composition of the PT department, manual for corresponding with condition changes, equipment condition of RM apparatus, written request for PT, reports, approval of hospital function evaluation, and the presence of nurses in the PT department were investigated by mail and classified using cluster analysis. [Results] Valid responses were obtained from 148 institutes, which were broadly divided into 7 clusters. In the policy of each department, a significant difference was observed in the mean value of bed numbers along with the degree of policies. Regarding the equipping of RM apparatus, a significant difference was observed in the number of workers depending on the type of apparatus available. [Conclusion] Some characteristics of each cluster varied according to the establishment criteria of the PT facilities and approval of hospitals with specific functions. An organization managing both the soft- ware and hardware is necessary for management of the PT department.

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[Purpose] The purpose of this study was to determine the differences between the effects of pedaling, treadmill walking and squatting on muscle activities. [Subjects] Nine healthy subjects (mean age 21.8±2.1 years) participated in this study. [Method] Electromyographic activity during pedaling, treadmill walking and squatting was measured in eight muscles. Pedaling was performed at 60 and 120 W. Treadmill walking was performed at 4 and 6 km/h. Squats were performed once a second with 0°–90° knee flexion. [Result] The quadriceps femoris activity was significantly greater in squatting and pedaling (120 W). The hamstring activity was significantly greater in squatting and pedaling (120 W). The gastrocnemius activity was significantly greater in treadmill walking (6 km/h). The tibialis anterior activity was significantly greater in treadmill walking (6 km/h) and squatting. [Conclusion] Pedaling and squatting are effective for muscle strengthening of the quadriceps femoris. However, for high muscle activity of the gastrocnemius, treadmill walking is more effective than squatting or pedaling. For high muscle activity of the tibialis anterior, treadmill walking and squatting are more effective than pedaling.

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[Purpose] In this study, we investigated the effect of exercise using a horse-riding simulator on the walking ability of university students. [Subjects] The subjects were 29 healthy university students. [Method] The subjects were randomly divided into two groups, an exercise group and a control group. The exercise group was composed of 14 subjects who performed exercise using a horse-riding simulator. The control group was composed of 15 subjects who did not perform the exercise. The intervention period was 4 weeks. Before and after the intervention period, the 10-m walking test was conducted. [Result] In the exercise group, the post-intervention values of the 10-m walking time and step length at maximal pace were significantly improved relative to their pre-intervention values. [Conclusion] The results indicate that exercise using a horse-riding simulator was effective at improving some of the characteristics of walking ability of university students.

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[Purpose] The purpose of this study was to investigate the effects of the position of an object, on postural adjustments during reaching movements in the sitting position. [Subjects] The subjects were 10 healthy volunteers. [Method] Subjects reached with the right hand for a plastic bottle (500 ml) placed in different positions. The object was placed straight ahead, 45° toward the right side, and 45° toward the left side. The movement was measured using a 3D motion analysis system and force plates. Three dimensional angles of the pelvis and the trunk were calculated, and the transitions of the center of mass and the center of pressure were investigated. [Result] The relative angle of the trunk to the pelvis showed a leftward rotation in all the tasks. The lateral inclination of the pelvis was leftward when reaching to the left side and straight ahead, but it was rightward when reaching to the right side. The center of mass moved in the direction of the target, but the center of pressure moved in the direction opposite to the target at the beginning of the movement. [Conclusion] These results suggested that the subjects reached for the object placed in different positions by changing postural adjustment.

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[Purpose] To investigate the characteristics of the activities of the muscles surrounding the knee during single-leg squatting performed by patients with anterior cruciate ligament (ACL) injury. [Subjects] Nine ACL injury patients and eight healthy subjects. [Method] The task was single-leg squats with knee flexion of 20 to 50°, and the muscles investigated were the vastus medialis (VM), vastus lateralis (VL), and the inner and lateral hamstring muscles. For each of the muscles, we compared %MVC, the normalized value of the maximal voluntary contraction (MVC) obtained from the integrated electromyograms, of the injured and healthy sides of the patients, and the dominant side of the healthy subjects. [Results] Compared to the healthy side, %MVC of the injured side VM and VL were smaller, and those of the inner and lateral hamstrings were larger. [Conclusion] The activities of the knee muscles of ACL injury patients during single-leg squats suggest that these muscles function to stabilize anterior instability.

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[Purpose] We examined the characteristic appearances of the H-reflex and F-wave of the soleus with increases in stimulus intensity in healthy subjects as a preliminary study to explore the clinical application of their appearances. [Subjects] The subjects were 10 healthy individuals. [Method] With subjects supine, the H-reflex and F-wave were recorded from the soleus with increases in stimulus intensity. Characteristic appearances were classified according to the method used in the study of Suzuki et al., which classified the appearances into four patterns in cases of CVD with upper extremity involvement. [Results] Characteristic appearances of the H-reflex and F-wave of the soleus were classified as type 3 for the 10 healthy subjects. [Conclusion] The findings for the healthy subjects reveal that the F-wave started appearing when the H-reflex appeared with high-intensity stimuli. In future, these findings can be used in an objective functional evaluation if combined with functional evaluation of movement during the assessment of neurological function in physiotherapy.

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[Purpose] In this study, hypothesizing that balance ability is related to trunk muscle strength, we conducted balance exercises for the trunk muscles, seeking to improve balance ability which is a risk factor of falls, and investigated their effects. [Method] Healthy young subjects performed balance exercises for the trunk muscles, two times a week for 12 weeks, and we investigated the exercise effect. The evaluated items were static and dynamic balance, muscle strength and flexibility. We used a Biodex to evaluate trunk muscle strength, and a Balance Master to evaluate mCTSIB and LOS. We also used performance tests to assess the overall change. [Result] The effect of ES was large on static balance (EOF.SI), dynamic balance (TUG), and trunk muscle strength, confirming the efficacy of the balance exercise. [Conclusion] The results demonstrate the relationship between trunk muscle strength and balance.

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[Purpose] We examined the differences in brain activities of motor imagery between dexterity movement (DM, finger-to-thumb opposition movement tasks) and gross movement (GM, rotary motion tasks of the shoulder joint). [Subjects] Ten healthy young adults participated in this study (mean age 21.3±1.1). [Method] The participants performed DM and GM. These tasks were performed by motor imagery and voluntary movement (self-initiated movement and externally triggered movement). The changes of blood flow volume in the sensory-motor related areas were observed using near-infrared spectroscopy (NIRS). [Results] The motor imagery of DM did not significantly change in comparison with those of voluntary movements in any of the areas. The motor imagery of DM significantly increased in comparison with those of GM in the area of the premotor cortex and the sensory-motor cortex. [Conclusion] These results suggest the possibility that motor imagery of DM led to increases in neuronal activity that were greater than those of GM.

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[Purpose] This study examined the effects of the robot suit HAL on ambulatory ability. [Method] The verification test data of 45 subjects who could walk with HAL fixed to their body were used for analysis, and the subjects were divided into adaptation and non-adaptation groups to compare the walking speed, step rate, and satisfaction level. Ambulatory improvement effects were also analyzed using the free text data of the adaptation group. [Result] In both groups, the walking speed and step rate decreased after fixation. The satisfaction level was significantly higher in the adaptation group. Regarding ambulatory improvement effects, 5 categories were extracted, such as “improvements in gait.” [Conclusion] Although the performance level, such as the walking speed and step rate, decreased temporarily, the tesults reveal that improvements in gait can be expected.

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[Purpose] We investigated whether or not the profile of mood states (POMS) is effective as an index in educational management and ascertaining the academic achievements of students. [Subjects] The subjects were 37 (31 males, 6 females) physical therapy students. [Method] We divided the subjects on the basis of their end-of-term examination results into High and Low groups, and compared their scores in POMS evaluations, which were conducted once a month from April to July 2012. [Results] Compared to the Low group, the High group had significantly lower POMS scores for the items of tension-anxiety, depression-dejection, fatigue-inertia and confusion-bewilderment, while that of vigor-activity was significantly higher. [Conclusion] Since POMS results are related to the academic achievement of students as well as their mental health, there is a possibility that POMS will be useful as an index in educational management and the ascertainment of academic achievement.

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[Purpose] We investigated how accurately orthopedic patients shifted their partial body weight on the affected and unaffected lower limbs after orthopedic surgery. [Subjects and Method] Thirteen orthopedic patients after orthopedic surgery and eleven healthy adults were asked to accurately load one third and two thirds of body weight on either the affected or unaffected (left or right for healthy controls) lower limb. [Result] The orthopedic patients showed significantly larger RMSE (root mean square error) when loading two thirds of body weight on their affected lower limb than in the other conditions. Both the orthopedic patients and healthy participants showed the ‘central tendency’ effect in this task. The orthopedic patients particularly showed a significant central tendency effect when they shifted one third of body weight to the affected limb. [Conclusion] Therapists should use a much lighter target load to prevent likely overshooting, when patients perform a partial weight bearing task with a light target load (i.e., the early stage of rehabilitation). Therapist should carefully conduct this task for patients, preventing likely undershooting and large variability, when patients shift a large target load (i.e., the late stage of rehabilitation).

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[Purpose] Some people suffering from physical problems use mobility devices. This research clarified the difference in psychological resistance to mobility devices (cane, four-wheeled walker, wheel chair, and electrically powered scooters) according to age group. [Subjects] Ordinary subjects aged from 20 to 100. [Method] An anonymous written survey was distributed to general citizens, and 675 responses were returned (collection rate of 82.9%). [Result] Young people in their 20s through 40s had higher psychological resistance toward all devices than senior citizens. Also, people in their 60s had higher psychological resistance toward four-wheeled walkers than people over the age of 70. [Conclusion] Since this research clarified that young people have high resistance to mobility devices, it is necessary to examine a strategy to the lower psychological resistance of citizens, especially those of the young generation.

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[Purpose] The purpose of this study was to examine the characteristics of displacement of the body while using a horse riding simulator, and to construct a theory to improve the body function through the motion of the horse riding simulator. [Subjects] The subjects were 30 healthy men and women. [Method] The displacement of the head, trunk, and pelvis while using the horse riding simulator were measured using a three-dimensional analyzer. [Result] The head movement was contradictory to the motion of the horse riding simulator. Moreover, the movement distance of the head was significantly smaller than that of the pelvis. [Conclusion] The segmental movements of the head, trunk, and pelvis were observed to maintain balance while using the hose riding simulator.

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[Purpose] The purpose of this study was to investigate the influence of inter-onset interval (IOI) shift below the threshold of conscious recognition on the control of reactive movement. [Subjects and Method] Fourteen healthy subjects performed the reaction time tasks, raising their right ankles in response to auditory stimuli under three conditions: 1) periodic auditory stimuli with IOI of 1500 ms, and only the last stimulus interval shifted to 2) 1425 ms and 3) 1200 ms, in successive stimulus sequences with an IOI of 1500ms. Electromyographic reaction times (EMG-RT) of the last stimulus were compared among the three conditions. [Result] EMG-RT of condition 3 was significantly delayed compared to conditions 1 and 2. There was no significant difference between conditions 1 and 2. [Conclusion] Periodic rhythmic stimulation is predicted to have some time width, and reactive movement can be performed without delay in conditions of an IOI shift below the threshold of conscious recognition.

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[Purpose] We investigated the factors strongly associated with the step-over action post-stroke hemiplegia patients. [Subjects] The subjects were 18 post-stroke hemiplegia patients in the maintenance phase who could walk independently outside. [Method] We measured the step-over action with obstacle heights of 10, 20 and 30% of the trochanter malleolar distance, and performed simple regression analysis to determine the relationships between the maximum step-over height and the knee extension strength of the hemiplegic and unaffected sides, the stance times of both legs, trunk impairment scale (TIS) scores, time since stroke onset, and age. Then, with maximum step-over height as the objective variable, and the four items with the highest r² values in the simple regression analysis as explanatory variables, we performed multiple regression analysis. [Results] TIS and the unaffected side knee extension strength were identified as explanatory variables with a contribution ratio of 71.9%. [Conclusion] The results suggest that among the items investigated in the present study, trunk function contributes the most to the performance of the step-over action.

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[Purpose] To examine the effects of repetitive finger movements performed at different frequencies on the sensory system of the ipsilateral upper arm using somatosensory evoked potentials. [Subjects] Thirteen healthy adults participated in the study. [Methods] We recorded SEPs by stimulating the right median nerve during movement of the right index finger and at rest. The subjects were given motor tasks, involving repetitive flexion and extension of the metacarpophalangeal joint of the right index finger, and the movement frequencies tested were 0.5 Hz, 1 Hz, and 3 Hz. [Results] The amplitude of the positive peak appearing 23 ms after stimulation (P23) and the amplitude of the negative peak appearing 20 ms after stimulation (N20) were significantly lower at the movement frequency of 3 Hz than at the other frequencies. [Conclusion] Restraint was observed in the first somatosensory area during repetitive finger movements, and this restraint was higher during finger exercises performed at a high frequency.

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[Objective] To determine the motor learning effects of two types of instruction procedure on postural optimization training using functional reach (FR). [Subjects] Twenty-eight able-bodied university students (17 males, 11 females), who volunteered to participate in this studys, were assigned randomly to an ItE group, to an EtI group or to a control group. The ItE group received external focus of attention (EFA) with knowledge of results (KR) after internal focus of attention (IFA) with knowledge of performance (KP). The EtI group received IFA with KP after EFA with KR. [Methods] The horizontal distance between the lateral malleolus and the fingertip (FR distance) and the location of the center of gravity were measured at pre-test and at the first (1 day after practice) and second (7 days after first retention test) retention tests. After the pre-test, participants performed 10 daily FR trials on four consecutive days (practice phase). The ItE group and EtI group received different verbal instructions and feedback for two days at time. The control group received no instructions on any of the four days. The FR distance was measured after all trials. [Results] The ItE group was divided into high performers and low performers. The EtI group’s performance was significantly higher on the second, third, and fourth days of the practice phase, and in the first and second retention tests when compared to the pre-test. [Conclusions] The results of this study suggest that EtI can improve the performance on a few individuals. However, ItE might improve performance remarkably when subjects are able to understand IFA with KP appropriately in the first practice phase.

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[Purpose] The purpose of this study was to investigate the image students have of handicap using an objective index. [Subjects] The subjects were 163 physical therapy students: 47 first-year, 56 second-year, and 60 third-year students. [Method] Students scored their image of a cerebrovascular disorder patient on a modified Barthel index (BI), and we statistically examined the differences among the academic years. [Results] There were no differences among the academic years in the total BI score, and students’ image of independence was feeding, and need of assistance was bathing. There were differences among the academic years in students’ image of feeding, fitting an orthosis, bathing, transfer to the bath, and more than 50 m transfer by wheelchair. [Conclusion] The results show that there are some items of students’ image of handicap that are affected by academic progress, and other items that are not.

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[Purpose] This study examined the effect of hip, knee, and ankle joint movement on the production of anterior-posterior ground reaction force impulses during walking by elderly individuals. [Subjects] The subjects were forty elderly people and 40 younger people. [Method] Gait analyses involved measurement of the anterior–posterior ground reaction force impulses as well as measurements of hip, knee, and ankle joint movement. [Result] Only knee joint movement was related to the anterior–posterior ground reaction force impulses in elderly men, whereas hip, knee, and ankle joint movements were related to the generation of these force impulses in younger men. Knee and ankle joint movements were related to production of these force impulses in both elderly and younger women. [Conclusion] Our results suggest that the elderly use knee joint movement to produce anterior-posterior ground reaction force impulses during walking.

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[Purpose] This study investigated thoracic and abdominal skin movement during respiration. [Subject] Ten male subjects volunteered to participate in this study. [Method] Motion of the subjects in the supine position was captured using a three-dimensional motion analysis system. Markers were attached to the thoracic and abdominal areas. The measured area was divided by horizontal lines into the upper thoracic, lower thoracic, upper abdominal, and lower abdominal subareas, and longitudinally into the center, lateral [L,R], and middle [L,R]. Data were analyzed at maximum deep inspiration and deep expiration relative to the average coordinates of respiration. [Result] Skin movement of the upper abdominal region showed maximal skin movement during deep breathing with subsequent movement of the lower thoracic region, the upper thoracic region, in order. Regarding the skin movement direction of each part, the upper thoracic movement was vertical, the lower thoracic movement was vertical and sagittal, and the upper abdominal movement was greater in all directions. [Conclusion] Our results indicate that the skin movement direction reflects the physiological movement of the thorax during respiration.

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[Purpose] We examined the influence of the chest excursion exercise for enhancement of peak expiratory flow and chest mobility for a client with stroke. [Subject] The subject was a 65-year-old female with left cerebral hemorrhage. [Methods] We evaluated the time course change of peak expiratory flow and chest expansion differences before and after four kinds of chest excursion exercises for six days. [Results] Just after the chest excursion exercise, peak expiratory flow tended to reduce, and chest expansion difference tended to expand. Peak expiratory flow and chest expansion differences tended to increase with lapse of the exercise phase. [Conclusion] The chest excursion exercise increased peak expiratory flow, lung capacity, and chest mobility. Furthermore, chest excursion exercise improved the ability of sputum expectoration by coughing.

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