[Purpose] The purpose of this study was to investigate the relationship between muscle activity in the shoulder girdle area and trunk rotation during pitching. [Subjects and Methods] Subjects were high school baseball pitchers. The subjects were divided into two groups: having a history of shoulder pain (n=8), and controls (n=10). Items of investigation were the angles of rotation of the chest and pelvis, changes in these angles, and muscle activities in the vicinity of the shoulder girdle during pitching, which were determined by surface electromyography frequency analysis. [Results] Those with a history of shoulder pain showed a significantly lower amount of change in the angle of rotation of the chest during the cocking phase and a significantly higher amount during the acceleration phase, a significantly lower amount of change in the angle of rotation of the pelvis during the cocking phase, and significantly lower muscle activity of the lower trapezius and serratus anterior muscles in the shoulder girdle area during the cocking phase. [Conclusion] As a strategy to prevent further injury to shoulders already injured by pitching, it is necessary to increase the qualitative function of the muscles to improve the balance between shoulder girdle muscle activity and trunk rotation.

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[Purpose] Our objective was to clarify what supervisors clinical training think are “likable behaviors” of clinical training students. [Method] In an initial survey, we asked supervisors of clinical training what they thought were “likable behaviors” of students in a freestyle report survey. In a second survey, the supervisors were asked to prioritize the 148 behaviors identified by the first survey. [Results] The supervisors of clinical training thought “being able to greet a patient clearly” etc. were likable behaviors of students, and other items concerned with attitudes to patients were ranked highly. On the other hand, students knowledge, personal appearance, and daily note taking were ranked lowly. [Conclusion] The results suggest that although supervisors of clinical training attach importance to attitudes and greetings to patients, they do not attach importance to students’ daily note taking, appearance or knowledge.

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[Purpose] We examined the short-term effects of two types of stretch utilized in the specific techniques of proprioceptive neuromuscular facilitation (PNF). [Subjects] The subjects were 20 healthy adult males. [Method] We used two techniques categorized under “repeated stretch” from among the PNF specific techniques. Before and after PNF, we measured the reaction time (RT) of elbow flexion, and examined the maintenance of its effect. [Results] In the Repeated Stretch group, we found a shortening of RT, compared to before PNF, which lasted for 20 min from immediately after PNF. In the Slow Reversal group, we found a significant effect only at immediately after PNF. [Conclusion] Since the shortening of RT was maintained for 20 min in the Repeated Stretch group, it is possible to apply this intervention in the clinical application of physical therapy techniques.

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[Purpose] The purpose of the present study was to clarify the points of risk assessment made in clinical judgments by physical therapists (PT) with over ten years’ clinical experience, and to examine the accuracy of their fall prediction. [Subjects and Method] At first, we carried out a focus group interview of 11 participant PTs, and we classified and abstracted the abnormal aspects of motion leading to a fall to make a TUG check list. Next, for 6 PTs, we examined the accuracy of their fall prediction according to the TUG check list after showing video clips of 21 elderly persons. [Result] Visual analogue scale (VAS) score was highly correlated to the conventional screening tests and concordant with the personal history of fall. Check list item “Sitting-down motion problem” was also significantly related to the history of falls and showed a high predictive accuracy. [Conclusion] The accuracy of the fall prediction in the clinical judgments of PTs with over ten years’ clinical experience was high. The addition of the observation of sitting TUG down to the test can be expected to improve the conventional screening test for fall.

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[Purpose] The purpose of this study was to clarify the effect of step length on toe weight-bearing and motion in the metatarsophalangeal joint. [Subjects] Nineteen young male volunteers without lower limb injuries participated in this study. [Method] A three-dimensional motion analysis system and force platform were used to examine toe weight-bearing and the metatarsophalangeal joint extension angle during gait. The subjects were asked to walk using three step lengths: short, natural, and long. [Results] Toe weight-bearing and the metatarsophalangeal joint extension angle were at maximum at the beginning of the pre-swing phase. Both values increased significantly with increasing step length. [Conclusions] These results indicated that the influence of step length and gait velocity on toe weight-bearing and motion of the metatarsophalangeal joint. Sufficient range of motion and flexor moment at the metatarsophalangeal joint are important toe functions.

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[Purpose] The purpose of this study was to examine the influence of different elbow joint positions on shoulder joint external rotation movement using reach motion behind the auricle of the ear, measured with ultra-sound sonography. [Subjects] The subjects were twenty healthy males (average age 22.7±2.07 years old) without orthopedic or neurological problems. [Methods] We investigated the humeral external rotation angle change at 90 degrees and 0 degrees of elbow joint flexion with 90 degrees flexion of the shoulder joint. [Results] We found a significant increase in humeral external rotation in all subjects at elbow flexion of 90 degrees, compared to elbow extension of 0 degrees. [Conclusion] The results suggest that elbow joint flexion movement with glenohumeral external rotation movement is necessary for improvement of the ability to reach behind the auricle of the ear.

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[Purpose] In this study, we investigate the characteristics of patients who received home visit investigations (home visit) before discharge. [Subjects] The subjects were 136 patients of our hospital who were discharged to home. We categorized them into two groups: the home visit group and the non-home visit group. [Methods] We compared them on the basis of rehabilitation records. [Results] Logistic regression analysis identified three factors: disease classification (OR: 4.797, 95%CI 1.15–20.08, p=0.032), length of hospital stay (OR: 0.965, 95%CI 0.93–0.99, p=0.016) and wheelchair driving independence at admission (OR: 0.008, 95%CI 0.01–0.03, p=0.009). [Conclusion] For patients who have central nervous system disease or cannot move independently in a wheelchair at admission, we need to consider home visits at an early stage.

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[Purpose] In this study, we investigated the criterion-related validity of ankle plantar force measurements made with a hand-held dynamometer (HHD). [Subjects] The subjects were 36 legs of 18 healthy adult males (average age 30.8±7.3). [Method] We measured ankle plantar flexion strength, knee extension strength, and vertical jump height. [Results] Significant correlations between ankle plantar flexion strength, and knee extension strength and vertical jumping distance were found. [Conclusion] The proposed, simple ankle plantar flexion strength measurement method met the external criterion validity, suggesting it is a convenient and useful measurement method.

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[Purpose] We examined the relationship between anticipatory postural adjustments and brain activity of the pre-motor area in lifting of objects with ambiguous visual information. [Subjects] The subjects were 15 healthy males. [Method] We prepared three containers having the same weight but different sizes, and gave the subjects the task of lifting them. We measured the trunk muscle activities of the APAs, and cerebral blood flow response in the pre-motor area just prior to the lifting movement. [Results] Just before lifting the large object, increases in blood flow response and APA muscle activities were observed. Moreover, cases of inaccurate prediction of weight based on visual information were observed. [Conclusion] The results suggest that information about size generates nervous activity in the pre-motor area, and as a result of this, APA muscle activities are initiated. This indicates the importance of providing patients preparing to perform a lifting task with appropriate visual and weight information.

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[Purpose] The purpose of this study was to examine the influence on motor function of backward walking exercise with changing cadence. [Subjects] Subjects were six older adults (older group), seven younger adults (younger group), and seven junior high school students (boys group). [Method] Each subject performed backward walking exercise for 3 minutes in time with a metronome which was used to alter the cadence from the usual walking speed every 30 seconds to 50% speed. Motor-function evaluations were backward walking exercise rate, the Timed Up and Go test (TUG), the 5m maximal gait speed, the Single-leg Standing time, the sitting-stepping test, and the Chair-stand test (CS-30). [Result] The 5m maximal gait speed and CS-30 showed significant differences in each group. [Conclusion] Backward walking exercise showed some differences with age, suggesting it is useful for the improvement of motor function.

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[Purpose] We examined whether the CS-30 is a useful assessment method of exercise tolerance, one of the items reflecting exercise capacity, of male interstitial pneumonia (IP) patients. [Subjects] The subjects were 20 male IP patients. [Method] The primary measure was the CS-30, and secondary measures were respiratory function, muscle strength, exercise tolerance, ADL, and health-related QOL. We examined the relationship between the CS-30 and the secondary measures using Pearson correlation analysis. [Results] We found significant correlations between the CS-30 and upper and lower limb strength, 5-m maximum walking speed, TUG time, and the 6-min walking distance in the male IP patients. [Conclusion] The results suggest that the CS-30 is a simple and easy assessment method of exercise tolerance which reflects exercise capacity.

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[Purpose] This study was conducted to clarify the minimum detectable change (MDC), and the intra-day, inter-day, and intra-rater reliabilities of measurements of spinal curvature in the prone position with a Spinal Mouse. [Subjects] The subjects were 20 healthy adult males. [Method] Measurements were made twice on two separate days, and through the intra- and inter-day ICC, SEM, and MDC₉₅, we investigated the intra-rater reliability. [Results] The intra-day ICC ranged from 0.85~0.95, and the inter-day ICC ranged from 0.77~0.91. The inter-day results suggest that changes in thoracic kyphosis, lumbar lordosis, and sacral inclination angles greater than 7.5, 4.0, and 4.8°, respectively, are true variations. [Conclusion] The results suggest that the measurement of spinal curvature in the prone position with the Spinal Mouse can be made with high reliability.

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[Purpose] The purpose of this study was to investigate the effect the length of time from practice to test has on the distance covered in the 15-m Incremental Shuttle Walk and Run Test (15m ISWRT). in order to establish its reproducibility. [Subjects] Fifty-four healthy young volunteers. [Method] The subjects were split into 3 groups (1 day later, a week later, four weeks later) based on the length of time from practice to test. After perform ing one practice of 15m ISWRT, the subjects performed two 15m ISWRT tests (Test 1, Test 2) after the prescribed periods. The reproducibility of the 15m ISWRT was examined by comparing the distances covered in Test 1 and Test 2 in each group. [Result] The ICC of all groups for the two distances were very high. However, in Bland-Altman analysis, a systematic error was found for the four-weeks-later group. [Conclusion] The results suggest the time from practice to test for the 15m ISWRT should be within one week. It should be noted that some systematic error was shown by the four-weeks-later group.

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[Purpose] The aim of this study was to determine the relationships among fear of falling (FOF), history of fall, physical function, and perceptual difference between actual and estimated performance (perceptual error) of elderly people living in the community. [Subjects] Eighty-two community-dwelling elderly people. [Methods] We examined the participants’ physical function using grip strength, trunk flexibility, one-leg standing time, the functional reach test, gait speed, the timed up and go test, and walking time of the Standardized Walking Obstacle Course. We also evaluated their FOF, history of falls, and their perceptual error to determine their relationships. The data were analyzed by two-way ANOVA or the Kruskal Wallis test. [Results] A significant relationship was found between several physical functions and FOF; however, there were no significant relationships among the other factors. [Conclusion] Our results suggest that FOF develops before experience of fall, and that the decline of physical function might affect the development of FOF. In addition, our results also imply not only physical function but also perceptual error might be related to the development of FOF.

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[Purpose] The immediate effect and 4-week follow-up result of direct stretching (DS) of the tensor fasciae latae muscle (TFLM) of a patient diagnosed as having acute non-specific low-back pain is reported. [Subjects] The subject was a 60-year-old female diagnosed as having acute non-specific low-back pain. [Method] The study had a single case, AB design, in which a pain relief position was adopted in the A period, and DS of the TFLM was performed in the B period. With pain on a visual analog scale (VAS), finger-floor distance (FFD), and posterior lumbar flexibility (PLF) as assessment indices, the data were analyzed using the binomial test. [Results] In the B period, VAS, FFD, and PLF showed significant improvements compared to the A period, and the patient's complaints of lumbar pain stopped after 2 weeks. [Conclusion] The results suggest that DS of the TFLM has an immediate effect on acute non-specific lumbar pain.

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[Purpose] The purpose of this study was to examine the mechanism of scapular stability by measuring the order of activity in scapular muscles in the trials with an external load. [Subjects] Seventeen healthy males participated in this study. [Methods] The trials were isometric work against an external load with shoulder internal and external rotation at 0 degree abduction under two conditions: with and without information about the timing of the external load. We measured the time to the start of activities in the agonist at the glenohumeral joint (GHJ), and the agonist and antagonist at the scapulothoracic joint (STJ) in these trials. [Results] The time to the start of activities in the agonist at GHJ and the agonist at STJ were the same in all the trials, but that of the antagonist at STJ was significantly later than those of the agonists at GHJ and STJ. [Conclusions] The current findings indicate that the agonist at STJ must have the function of counteracting the external load, just like the agonist at GHJ. On the other hand, the antagonist at STJ must control the scapular position which tries to change due to the traction force from the agonist at STJ.

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[Purpose] The objective of this study was to study the effect on the initiation of wheelchair propulsion from stationary sitting when pelvic posterior tilt was inhibited by a wheelchair cushion. [Subjects] The subjects were 18 hemiplegic patients who were capable of sitting in, and propelling a wheelchair. [Method] We used electromyography and a 3D motion analysis system to measure the posterior pelvic tilt angle, the muscle activity of the long head of the biceps femoris (BFLH), and the propulsion speed in the initiation of wheelchair propulsion from stationary sitting with three different types of cushion. [Results] The cushion which had the thigh pad removed on the propulsion side, having an anchor function, inhibited posterior pelvic tilt during initiation of propulsion from stationary sitting, BFLH activity was low, and fast propulsion was enabled. [Conclusion] The results suggest that inhibiting posterior pelvic tilt in stationary wheelchair sitting influences the propulsion initiation action.

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[Purpose] This purpose of this study was to investigate the influence of different partial body bathing methods on total hemoglobin in the contralateral forearm. [Subject] Ten healthy persons who had no history of autonomic nerve or circulatory system pathology participated in this study. [Methods] The total hemoglobin in the contralateral forearm was measured using near-infrared spectroscopy under three experimental conditions: the warm bath condition, the contrast bath condition, and the no bath condition as the control. The partial baths under the three experimental conditions were taken for twenty minutes. The rate of change of hemoglobin was calculated on the basis of the resting value. [Results] The hemoglobin value of the contrast bath condition was significantly higher than those of the other two conditions during and after taking the partial bath. [Conclusion] This result suggests that contrast bathing might be better able to increase the total hemoglobin on the contralateral side due to the influence of the contralateral thermal effect.

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[Purpose] The purpose of this study was to validate the pelvic rolling test by determining the intra-rater and inter-rater reliabilities, as well as its ability to detect asymmetric alignment of the innominates. [Subjects] Ten healthy individuals aged between 19 and 21 years were enrolled. [Methods] Two testers and two assistants did the pelvic rolling test with an inclination of the pelvis measuring instrument with subjects in the dorsal position, and the bilateral inclination of pelvis degree was measured. [Results] The intra-rater and inter-rater reliabilities of the pelvic rolling test were very high and high, respectively. It detected asymmetric innominate alignment in all the subjects. [Conclusion] The pelvic rolling test is reliable and sensitive in the detection of asymmetric innominate alignment and is recommended for a clinical use.

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[Purpose] The purpose of this study was to investigate the influence of stimuli delivered via the insole to different parts of the sole of the foot on center of pressure sway. [Subjects] Forty healthy persons who had no history of lower extremity pathologies participated in this study. [Method] Center of pressure sway was measured using a postural sway recorder under four experimental conditions: the whole part stimulus condition, the forefoot condition, the heel condition and the no stimulus condition as the control. An insole with convexes was used to stimulate the sole of the foot. In the no stimulus condition, the insole without convexes was used. [Results] Under the forefoot condition, the rectangular and circumferential areas, showed significantly lower values than the no stimulus condition. [Conclusion] This result suggests that stimulus applied to the sole of the forefoot using an insole might decrease the center of pressure sway.

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[Purpose] The robot suit HAL was used for a lecture, and its effect regarding what the students learned was examined. [Method] Students’ freestyle reports before and after the lecture were analyzed using the technique of text mining. [Result] Although many words about the image of HAL were seen in the reports before the lecture, words such as a patient and physical therapy, increased after the lecture. Moreover, in cluster analysis, clusters, phrases such as “possibility of HAL in the physiotherapy field” and the “practicality of HAL in the rehabilitation field”, were formed. [Conclusion] We showed that the possibility of the leading edge of rehabilitation technology came to be considered by actually dealing with HAL from the viewpoint of students who study physiotherapy, and that the lecture had a certain educational effect.

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[Purpose] We investigated the suitability and usefulness of range of motion exercises (ROM-ex) utilizing humeral neck axis rotation (ROTH) for elderly patients with shoulder joint contracture. [Subjects] The subjects were 20 females with an average age of 86.6±7.2 years. [Method] We conducted conventional ROM-ex and ROM-ex with ROTH, 20 times each, and measured the angles of flexion, abduction, adduction, and external rotation (position 1). [Results] After conventional ROM-ex, significant differences were not found; however, we found significant increases in all ROM values following ROM-ex with ROTH. [Conclusion] The results suggest that ROM-ex with ROTH is useful as a method for improving ROM limitation due to immovability.

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[Purpose] We investigated the effect on feelings of burden of care staff collaboratively working with physical therapists (PTs). [Subjects] The subjects were 28 care staff. [Method] We conducted a 13-item questionnaire survey, using the Japanese version of the Zarit Burden Interview with the items related to family removed, and compared the results between the group of care staff collaborating with PTs, and the group of caregivers who were not. [Results] The Zarit score of the group of care staff not collaborating with PTs was higher than that of the group of care staff collaborating with PTs. Furthermore, from within caregivers’ burden, we extracted factors of service responses, service trends, and care staff feelings of burden. [Conclusion] To reduce the caregivers’ burden of care staff, it is important to prevent the decline of the discretionary power of care staff through the establishment of team-style work performance. Furthermore, when PTs collaborate with care staff, promotion of the standardization of assistance methods, based on evaluation of vital functions and motor learning theory, is a useful approach.

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[Purpose] This study investigated the effects of pelvic floor muscle and transversus abdominis muscle training on pelvic floor and transversus abdominis muscles’ function. [Subjects] The subjects were 31 healthy young women. [Methods] The subjects were divided into 3 groups: a pelvic floor muscle training group, a transversus abdominis muscle training group, and a control group. The functions of the pelvic floor muscles (amount of the bladder neck movement) and the transversus abdominis muscle (increases in muscle thickness) were measured using B-mode ultrasound. [Results] After the intervention, changes in the bladder neck movement in the supine position were significantly greater in the two training groups than in the control group. There was no significant difference between the two training groups in the changes in the bladder neck movement. [Conclusion] Our results suggest that both pelvic floor muscle training and transversus abdominis muscle training are effective at improving the pelvic floor muscle function of young women.

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[Purpose] The purpose of this study was to determine the immediate effects of the BasicSeven exercise program using a stretch pole on trunk extension and pressure distribution in the supine position. [Subjects] Twenty healthy male individuals were enrolled and randomly allocated to either the intervention group or the control group. [Methods] Subjects in the intervention group performed the BasicSeven exercises using the stretch pole, and those in the control group performed the same exercises without the stretch pole. Trunk extension range of motion and pressure distribution in the supine position were measured before and immediately after the intervention, and the effects were compared between the two groups. Statistical significance was accepted for values of p<0.05. [Results] The intervention group demonstrated significantly greater improvements in trunk extension range of motion and pressure distribution in the supine position than the control group. [Conclusion] In conclusion, the BasicSeven exercises using the stretch pole is effective at improving trunk extension range of motion and pressure distribution in the supine position.

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[Purpose] In the gait of healthy adults, the ankle and hip joints play complementary roles and show a trade-off relationship. The objective of this study, was to investigate whether there is an immediate effect on the ankle and hip joints of cerebral palsy subjects in gait with enhanced ankle push-off. [Subjects] The subjects were a child and an adult with cerebral palsy and right side hemiplegia who could walk continuously for more than 10 m. [Method] We measured normal gait and enhanced ankle push-off gait with a 3D motion analysis system utilizing force plates and infra-red cameras, and calculated the ankle-hip joint (A2/H3) ratio at ankle push-off. Comparisons were made using the Mann-Whitney U test. [Results] We found an increase in the hip extension moment during enhanced ankle push-off gait, but the A2/H3 ratio did not show a significant increase. [Conclusion] In the performance of enhanced ankle push-off gait by the adult and child with cerebral palsy, it was not the ankle joint activity that was compensated, but that of the hip joint.

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[Purpose] Brainstem stroke is characterized by central apnea with a decreased level of consciousness that often necessitates intervention by mechanical ventilation (MV). We report a unique case of a patient who was weaned off MV after 7 years. [Subjects] A male who required MV presented with apnea and decreased level of consciousness after sustaining damage to his brainstem 7 years previously. Several attempts to wean him off MV were unsuccessful. [Methods] We focused on evaluation of physical action, consciousness, respiratory rhythm, and respiratory fatigue. We carried out physiotherapy practice that focused on gait training to extend the time the patient spent in a seated position. [Results] The patient was successfully weaned off MV after 37 days of therapy. He was discharged from hospital 59 days after the initiation of therapy. [Conclusion] We believe that the results of this study will improve physiotherapy practice in the management of patients.

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