[Purpose] To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in the treatment of postoperative pain and pulmonary functions (vital capacity: VC; cough peak flow: CPF) of patients who had received abdominal surgery. [Methods] Thirty-five patients were randomly allocated to receive TENS (TENS group) or sham TENS (placebo group) or no TENS (control group) 1 hour a day for 3 days postoperatively. A 0-100 visual analog scale was used to assess pain at pre-, mid-, and post-intervention on the 3rd postoperative day. Pulmonary functions were evaluated by spirometry at preoperation and at pre-, mid-, and post-intervention on the third postoperative day. [Results] The TENS group had significant reductions in postoperative pain compared with the placebo group and control group. There was also improvement in pulmonary functions (VC, CPF) at mid- and post-TENS, but not in the placebo TENS or control groups. [Conclusion] TENS is a valuable strategy for alleviating postoperative pain following abdominal surgery and improves pulmonary functions.

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[Purpose] We examined the relationships among PBL tutorials’ favorable ratings and effort as well as potential common factors. [Subjects] The subjects were fifty-six 4th and 3rd year physical therapy university students. [Method] After a PBL tutorial, we conducted a survey of favorable ratings and effort. [Results] Among the favorably rated items, we found “ease of learning” was significantly highly correlated with all the other items, and among the effort items, we found “group discussion” was significantly highly correlated with each of the tasks. We found two common factors for favorable rating and four for effort, which accounted for a cumulative contribution rate of approximately 50%. [Conclusion] Favorable rating and effort in PBL have many mutually related parts, suggesting that the abilities required in clinical practice are related.

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[Purpose] The purpose of this study was to estimate muscle forces during stair-climbing using electromyography-assisted optimization (EAO), to evaluate the validity of estimated muscle forces and to calculate bone-to-bone forces at the knee joint. [Subjects] Subjects were 6 healthy males. [Method] The muscle forces were initially estimated from electromyography (EMG) and physiological muscle properties. Joint torques obtained from the estimated muscle forces were adjusted using EAO. The bone-to-bone force at the knee joint was calculated based on the adjusted muscle forces. [Result] Applying EAO, the muscle forces exhibited good correlation with corresponding EMG patterns. The bone-to-bone force at the knee joint showed maximum values in the stance phase, 39.4±3.3 N/kg (mean±SD) in step-over-step, and 17.4±4.5 N/kg in step-by-step. [Conclusion] Our results suggest the use of EAO in estimating muscle forces during dynamic tasks is valid.

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[Purpose] The objectives of this study were to investigate the dynamics of blood oxygen in the brain in the performance of various walking styles. [Subjects] The subjects were 70 healthy young adults. [Method] The dynamics of blood oxygen in the brain were measured using functional near-infrared spectroscopy. The tasks on the treadmill were forward and backward walking in the standing and kneeling positions. [Results] The right prefrontal cortex, the right premotor cortex, and the supplementary motor area were significantly activated in backward walking compared to forward walking. In addition, the left sensorimotor area and the somatosensory area were significantly activated in the kneeling position compared to the standing position. [Conclusion] These results suggest that the patterns of brain activation might be different in different positions and directions of walking, and, the kneeling position or backward walking might have more pronounced treatment effects than others.

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[Purpose] We investigated cardiovascular responses and blood flow of the common carotid artery during head-up tilt (HUT) in patients with cerebrovascular accidents (CVA). [Subjects] Ten male patients with CVA and 9 healthy elderly males participated in the present study. [Method] Blood pressure, heart rate, and common carotid artery (CCA) blood flow values were measured every 1 min before and during 10 min of 60-degree HUT. [Result] Mean blood pressure in CVA patients fell in the first minute of HUT with increased heart rate, but subsequently blood pressure returned to the level at rest after 2 minutes of HUT. The CVA group showed a significantly larger CCA diameter with a significant decrease in mean blood flow velocity, but showed no significant difference in blood flow volume compared with healthy elderly subjects. Although CCA blood flow diameter and volume tended to be lower in the CVA patients during HUT, there was no significant difference between the two groups. [Conclusion] With this understanding of cardiovascular and CCA blood flow responses during orthostatic stress in CVA patients, we conclude that getting such patients to stand erect in their treatment is safe and should proceed smoothly.

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[Purpose] We investigated the effect of an exercise intervention for the elderly living in a mountainous area. [Subjects] The exercise group comprised 20 persons (average age, 70.6±6.4), and the control group comprised 11 persons (average age, 73.1±5.6), all of whom lived in a mountainous area. [Method] The exercise group attended an exercise class for 3 months. We measured physical strength and body sway, and performed the Japanese version of the short-form profile of mood states (SF-POMS) for both groups, both before and after the exercise classes. We also distributed a lifestyle recorder, and measured the amount of physical activity during the period of the exercise classes. [Results] After the exercise classes, the exercise group showed more items of improvement in physical strength, body sway, and SF-POMS, than the control group. [Conclusion] The exercise classes were effective at improving the physical and mental health of subjects living in a mountainous region.

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[Purpose] We investigated the effect of exercise on salivary amylase levels. [Subjects] The subjects were university students. [Method] Both male and female subjects performed exercise of equal intensity, and their salivary amylase levels were measured pre-exercise, post-exercise, and every five minutes thereafter for thirty-five minutes. [Result] The post-exercise salivary amylase level showed no significant difference from the pre-exercise level in the male group whereas that of the female group showed significant increases. Regarding temporal changes in the salivary amylase levels, the male group showed no distinctive change, whereas the female group demonstrated a bimodal change, although individual differences in time intervals was noted. [Conclusion] These results suggest a difference in the effect of exercise on salivary amylase levels between males and females.

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[Purpose] To investigate the effects of trunk muscle-strengthening exercise in post-operative patients with proximal femoral fractures. [Subjects] Nineteen post-operative patients (81.6±7.9 years) with proximal femoral fractures were randomly assigned to either a trunk muscle-strengthening exercise plus conventional exercise group (TEG, n=10) or a conventional exercise group (CEG, n=9). [Methods] TEG performed a trunk muscle-strengthening exercise 5 times a week for 4 weeks. Assessments at baseline and post-intervention included trunk muscle strength, 10-m walking time, the functional reach test (FRT), and the timed up and go test (TUG). [Results] The TEG demonstrated significant improvements in trunk muscle strength, 10-m walking time, FRT, and TUG. The CEG demonstrated a significant improvement only in 10-m walking time. There were no significant differences between both groups. [Conclusion] These results suggest that trunk muscle-strengthening exercise may have a positive effect on the gait and balance ability of post-operative patients with proximal femoral fractures.

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[Purpose] The purpose of this study was to examine the relationship between muscle activity and joint moment and age-related changes during sit-to-stand motion. [Subjects] Both young healthy women (n=16) and elderly healthy women (n=16) participated in this study. [Method] Lower limb joint moments were obtained using a three-dimensional motion analysis system and force plates. The muscle activities were recorded using surface electromyography. We analyzed the hip and knee moments and integrated electromyograms (IEMG). [Result] Some elderly adults demonstrated a greater peak knee extension moment than the peak hip extension moment, and the IEMG of the gluteus maximus and gluteus medius were both significantly higher than those of the young group. [Conclusion] Some elderly adults tended to show a decrease in their hip extension moment, and the muscle activities of the gluteus maximus and gluteus medius were observed to continuously increase during sit-to-stand motion.

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[Purpose] We have established an in-school clinical training system to smooth the transition to clinical practice and improve the quality of students’ learning, and we surveyed students’ understanding and trends of use of it. [Subjects] The subjects were 34 students specializing in physical therapy in the Faculty of Health Science of Tsukuba University of Technology. [Method] We conducted a survey about the in-school clinical training. [Results] Significant differences among academic years were found in the actual conduct of clinical training, knowledge of the facilities, efforts to raise communication ability, and desire to participate in the in-school clinical training. We also found significant differences among academic years in the state of implementation of the clinical training. [Conclusion] The in-school clinical training was instrumental in motivating students’ learning, and raised their in-school recognition of hands-on skills for clinical practice.

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[Purpose] We conducted a range of motion (ROM) exercise utilizing anatomical neck of the humerus circulation (ANHAC) for elderly patients with shoulder joint contracture, and investigated its immediate effects and suitability. [Subjects] The subjects were 15 elderly persons, 1 male and 14 females, with an average age of 86.5±7.1 years. [Method] We conducted conventional ROM exercise and ROM exercise utilizing ANHAC 30 times each. We measured shoulder joint flexion at the time of scapula fixation, and flexion, abduction, adduction, and external rotation with the scapula without fixation and abducted. [Results] After conventional ROM exercise, a significant increase was found only in flexion during scapula fixation. After the ROM exercise utilizing ANHAC, we found significant increases in all the measured items both with and without scapula fixation. [Conclusion] The results suggest ROM exercise utilizing ANHAC is a method which can effectively improve shoulder ROM.

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[Purpose] This study assessed the validity of using the Activity Monitoring Evaluation System (A-MES), which has been developed in Japan to measure the motion of posture over time, in measurements of physical activity levels of elderly hemiplegics in their daily living by comparing the measurement results with their actual motion. [Subjects] The subject was one young elderly person with Brunnstrom recovery stage 3 of the upper and lower extremities. [Method] We measured the motions of daily living of the subject for 1200 seconds with A-MES under the direction of the examiner, and the measurement results and video records were compared to evaluate the concordance rate. [Result] There was a high concordance rate between the A-MES results and the video records. The non-concordance rates of decubitus and the sitting position were below 3% throughout the time performing the respective positions, that of gait was below 8.2%, that of wheelchair driving was below 9.8%, and that of standing was below 25.0%. [Conclusion] The results clearly demonstrate that A-MES can be used to objectively and accurately evaluate physical activities of daily living of elderly hemiplegics.

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[Purpose] The purpose of this study was to examine whether an inclination towards exercise and the level of physical activity influences quality of life (QOL) of predialysis patients with chronic kidney disease (CKD). [Subjects] The subjects were 74 predialysis CKD patients. [Method] We investigated age, gender, employment, physical activities (International Physical Activity Questionnaire), QOL (SF-36 health survey), inclination towards exercise in these individuals, and looked for relationships among the items. The patients were divided into 2 groups, namely, the high physical activity group and the low physical activity group, on the basis of the amount they exercised and the exercise standard 2006. We compared age, gender, employment, physical activity, renal function, and QOL measures between the 2 groups. [Result] There were no significant correlations between physical activities, inclination towards exercise and QOL. Notably, however, the age and mental components of QOL were significantly higher among patients in the high physical activity group than among patients in the low physical activity group. [Conclusion] These results suggest that a high level of physical activity may affect the mental component of QOL in predialysis CKD patients.

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[Purpose] The purpose of this study was to examine the measurement precision of the portable metabolic system (METAMAX 3B) and compare it with that of the stationary metabolic system (AE-310S). [Subjects] Twenty-three healthy young volunteers. [Method] We performed the multistep exercise test twice and measured the oxygen uptake (VO₂) and its associated variables, carbon dioxide production (VCO₂) and expir atory ventilation (VE) with both METAMAX 3B and AE-310S. Then, we investigated the reproducibility of the METAMAX 3B and AE-310S by comparing their measurements of VO₂, VCO₂, and VE. [Result] The ICCs of each variable measured by METAMAX 3B and AE-310S were 0.98 for Test1 vs. Test2. Bland-Altman analysis of the METAMAX 3B results showed only fixed bias for VO₂ and VCO₂, whereas VE showed both fixed bias and proportional bias. [Conclusion] Although METAMAX 3B showed very high ICC in comparison with AE-310S, the results suggest that it generates some systematic bias.

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[Purpose] The purpose of this study was to investigate the activity of the crural muscle during the foot-gripping action, and examine the role of the crural muscle in foot-gripping strength. [Subjects] The subjects were 19 healthy adult females. [Method] We compared the normalized integrated electromyograms (%IEMG) of the tibial anterior, medial head of the gastrocnemius, and soleus muscles in ankle dorsiflexion and plantar flexion. [Result] The results for each muscle showed about 30 to 45% IEMG of maximum voluntary contraction. A significant positive correlation was found between foot-gripping strength and %IEMG of the tibial anterior muscle. [Conclusion] These results suggest that the crural muscle co-contracts during the foot-gripping action, and the activity of tibial anterior muscle plays a specifically important role.

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[Purpose] To evaluate whether the inter-rater reliability of the qualifiers’ scale of the ICF Core Set in the Activity and Participation component for osteoarthritis can be improved by complementing the Ministry of Health, Labour and Welfare’s “Standard for the Activity and Participation (draft)” with an additional set of specifications created by our team. [Subjects] Twenty knee osteoarthritis and total knee arthroplasty (TKA) patients were evaluated after the operation. [Method] Three physiotherapists evaluated the difference in the inter-rater reliability between with or without using the additional set of specifications. [Result] With the use of the additional set of specifications, the inter-rater reliability improved. [Conclusion] By setting clearer standards for each category as was done by adding the new set of specifications, the inter-rater reliability will be improved when evaluating the post-operative activity and participation of osteoarthritis patients and TKA patients.

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[Purpose] To determine the effects on motor efficiency (NE) of differences in the duration of single-leg standing during alternate feet and step through in stair climbing. [Subjects] A total of 11 healthy men. [Methods] Subjects climbed stairs using alternate feet or step through at a vertical speed of 3.5 m/min with two durations of single-leg standing: normal ascent, in which the duration naturally matched step frequency, and shortened ascent, in which the duration was shortened while matching the step frequency. For each type of ascent, stair climbing was performed for 3 minutes and NE was calculated by measuring the oxygen uptake (VO₂) and heart rate. The paired t-test was performed for VO₂ and NE during ascent for comparison of the two durations. [Results] VO₂ was lower during shortened ascent when compared to normal ascent, while NE was higher during shortened ascent when compared to normal ascent. [Conclusion] NE during stair climbing can be improved by shortening the duration of single-leg standing.

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[Purpose] The purpose of this study was to investigate the immediate changes in locomotor pattern resulting from gait training for hemiparetic patients with the knee joint immobilized on the non-paretic side. [Subjects] The subjects were six hemiparetic patients who could walk in supervised or independent conditions. [Methods] The subjects walked with the joint immobilized knee on the non-paretic side in the extension position by a knee brace. We measured two-dimensional motion and gait cycles during normal walking before and after gait training with the knee brace. [Results] The single limb support time for the paretic side was significantly longer after gait training with the knee brace. Five subjects had an increased maximum extension angle of the knee joint in the stance phase of the paretic side, but one subject had a decreased maximum extension angle. [Conclusion] These results suggest that gait training with the knee joint immobilized on the non-paretic side can initiate changes in locomotor patterns of paretic lower limbs during walking because of the difficulty of swinging the immobilized limb.

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[Purpose] To investigate the change of care situation and caregiver burden of old stroke patients at home before and after the introduction of long-term care insurance. [Subjects] The subjects were 79 home-care stroke patients and their caregivers. [Method] Activities of daily living (ADL), usage situation of care services, care situation and caregiver burden were assessed using a mail-in survey. [Result] The patients’ and their caregivers’ ages were older after the care insurance introduction. Significant differences were not found in ADL, rehabilitation, caregiver, care situation and caregiver burden. In contrast, there was a change in the contents of care service. [Conclusion] The home-care stroke patients used long-term care insurance, and they could continue their lives at home because of the various services. It is important to establish support systems for care at home due to the severe caregiver burden.

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[Purpose] The purpose of this study was to investigate the relationship between anterior trunk movement and the glenohumeral joint angle during arm anterior elevation. [Subjects] Subjects were 15 normal adults. [Methods] We measured arm anterior elevation angle and scapula rotation angle with both arms at maximal anterior elevation, and measured the x coordinate of the trunk observation point with both arms in anterior elevation movement. We calculated Pearson’s correlation coefficient to examine the correlation between the quantity of movement of the trunk observation point and glenohumeral joint and scapula rotation angles with both arms in anterior elevation. [Results] A significant correlation was found between the quantity of movement of the trunk observation point with both arms in anterior elevation from 150 degrees to maximal anterior elevation and the glenohumeral joint and scapula rotation angles with both arms at maximal anterior elevation. [Conclusion] We think that the movement quantity of the trunk observation point with both arms in anterior elevation from 150 degrees to maximal anterior elevation was associated with the glenohumeral joint and the scapula rotation angles with both arms at maximal anterior elevation.

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[Purpose] We investigated the influence of a drop in exercise frequency on baseball players’ body function. [Subjects] The subjects were baseball club players (13 men) whose exercise frequency decreased in comparison with their high school days. [Method] Measurement criteria were weight, body fat, skeletal muscle mass, muscle strength, range of motion of joints and shoulder flexibility. We gathered information on exercise regimes and amount of stretching. [Result] External rotation strength of the shoulder strengthened over 1 year, but range of motion (internal rotation of the hip and rotation of the thoracic and lumbar spine) and shoulder flexibility decreased over 1 year. [Conclusion] The results show that as the baseball players’ exercise frequency decreased, there was a decrease in range of motion and flexibility.

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[Purpose] To investigate the relationships between pre-landing ankle muscle activities and ankle position at ground contact during single-leg drop landing. [Subjects] Nine healthy subjects (4 men and 5 women, a total of 18 legs) participated in this study. [Methods] The ankle dorsiflexion and inversion angles, EMG activities of the peroneus longus (PL), tibialis anterior (TA), and gastrocnemius medialis (GM) were recorded during a single-leg drop landing from a 30-cm high box. The integrated EMG (IEMG) activity during the pre-landing (100 ms before ground contact), muscle activity ratio for the ankle plantarflexor and dorsiflexor, and the invertor and evertor muscles were calculated using each IEMG activity. [Results] There was a significant positive correlation between TA pre-landing IEMG activity and ankle inversion angle at ground contact, as well as GM pre-landing IEMG activity and ankle dorsiflexion angle at ground contact. Moreover, TA IEMG activity relative to PL and GM IEMG activities were significantly associated with ankle inversion angle at ground contact. [Conclusion] These results suggest that the pre-landing ankle muscle activities and their ratios are associated with ankle position at ground contact.

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[Purpose] We evaluated the effects of attentional instruction on dual-task training for motor and cognitive tasks. [Subjects] Sixty healthy adults were enrolled in this study. [Method] We investigated each task’s performance before and after the dual-task training performed with the following instructions: attentional focus on motor task, attentional focus on cognitive task, no attentional instruction, and no training. [Result] Motor task performance and difficult motor task performance improved under the no attentional focus instruction. [Conclusion] The results indicate that for healthy adults, the no attentional focus instruction plays a potentially more effective role in improving motor task performance.

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[Purpose] We examined the influence of different head angles at the time of neck flexion on voluntary cough intensity. [Subjects] The subjects were 15 healthy adult women. [Method] The head angle was positioned in flexion, the neutral position, and extension with the neck in 30 degrees flexion. We measured cough peak flow (CPF), and maximum phonation time (MPT) of each head position and compared them. [Result] Although there were no significant differences in CPF and MPT among the different head positions, in the neck flexion + head flexion position, CPF tended to be lower than in the other 2 positions. In the neck flexion + head extension position, correlation was observed between CPF and MPT. [Conclusion] The results suggest that voluntary cough intensity at the time of neck flexion in the aspiration preventive position is affected by head angle.

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[Purpose] Subjects practiced crossing a net for 2 minutes, once a week for 6 weeks, and we measured the effects on net-crossing distance, and total path length, unit path length, unit path area, and circumferential area of body sway. [Subjects] The subjects were 12 men with an average age of 23.8 years. [Method] We conducted balance training of crossing a four-meter-long net, set at a height of 30 cm, for 2 minutes, once a week for 6 weeks. Before and after the training, we measured and compared the net-crossing distance and body sway on both legs and on one leg, with both the eyes open and closed. [Results] The net-crossing distance significantly increased after the training. There were significant reductions in: total path length, unit path length, and unit path area in one-leg standing on the right leg with the eyes open; in total path length and unit path length in one-leg standing on the right leg with the eyes closed; and in unit path area in one-leg standing on the left leg with the eyes open. [Conclusion] Net-crossing practice for 2 minutes once a week for 6 weeks improved balance factors.

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[Purpose] The objective of this research was to investigate the relationship between jump actions involving changes in direction and hip and knee muscle strength. [Subjects] The subjects were 32 healthy adults (average age, 21.05 years) with no medical history of orthopedic problems of the lower limbs. The subjects were given an explanation of the study protocol prior to the experiment and their consent to participation was obtained. [Method] Using the BIODEX isokinetic muscle strength measuring device, we measured hip and knee joint extension and flexion strengths 3 times. Three types of jump action were performed, 6 m hopping on one leg, figure of 8 jumping, and slalom jumping, and the times taken to reach the goal were recorded. Correlations between muscle strengths and jump times were investigated using Pearson’s correlation coefficient. [Results] We found significant correlations between each of the muscles strengths and each of the jump actions. [Conclusion] Jump actions involving changes in direction were more strongly related to muscle strength than jump action in a straight line, and the relationship was especially strong for knee flexion strength.

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[Purpose] In this study we examined the relationship among physical therapy students’ motivation in learning, parents’ involvement during the period of career decision making and students’ self-determination in course selection. [Subjects] The subjects were one hundred seventy-seven physical therapy students. [Method] We performed a survey of the students using the motivation style scale, self-determined course selection scale and scales of communication with parents about their career decision making. [Results] The main results were as follows. Students’ motivation in learning significantly correlated with self-determination in the course selection. Supportive types and mutual-negotiation types had significantly higher self-determination in the course selection and identified regulation than parent-led types. [Conclusion] We conclude that parents’ involvement such as encouraging and making clear difference of opinion during the period of career decision making, influence their children’s higher self-determination in career decision making and motivation in learning.

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