[Purpose] In order to establish a useful rehabilitation program for knee osteoarthritis (OA) patients, we tried to measure calf muscle oxygenation at various walking speeds. [Methods] The subjects were 7 older females with knee OA (OA group) and 7 older females who were not suffering from OA (non-OA group). All subjects performed treadmill walking at three different speeds for 2 minutes each with a rest period in between. The walking speeds were: 75% free gait speed (75%FGS), free gait speed (100%FGS), and 125% free gait speed (125%FGS). We measured muscle oxygenation {blood volume (BV) and oxygenated hemoglobin (oxy-Hb)} at the medial head of the gastrocnemius muscle (GM) and the tibialis anterior muscle (TA) using near-infrared spectroscopy (NIRS). The differences of BV and oxy-Hb (Δ) were calculated from the mean value ten seconds before the start of walking and the mean value ten seconds after the end of walking for each condition. [Results] In the OA group both BV and oxy-Hb of GM and TA showed no significant differences among the conditions. In the non-OA group, however, the oxy-Hb of TA showed significant differences between the 75%FGS and 125%FGS conditions. [Conclusion] The different muscle oxygen patterns of the OA and non-OA groups might be explained by differences in the calf muscle pumping action during gait.

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[Purpose] In this study we examined the educational effect of measures for the National License Exam for visually impaired students specializing in physical therapy. [Subjects] The subjects were 7 fourth-year students (age: 24.7 ± 3.9 years) specializing in physical therapy at our college. [Methods] At a frequency of once a week we held a mock exam. We clarified which subjects each student was having difficulty with and implemented measures to help them to learn effectively. [Results] At the start of the intervention, the students’ average scores were 138.7 ± 21.1, and at the end they were 177.7 ± 29.9. Furthermore, in the National License Exam, their scores were 202.9 ± 17.5, and their pass rate was 100%. [Conclusion] The measures enabled effective study to progress via learning from mistakes and time supervision, and we consider they were linked to the dramatic increase in the students’ exam scores.

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[Purpose] This study examined the measurement error of malleolar torsion based on the reliability of the measurement method which is an index of tibial torsion. [Methods] We used the intraclass correlation coefficient (ICC) and Bland-Altman analysis to determine the reliability, and examined the measurement error after the confirmation of the systematic error using the standard error of measurement (SEM) and minimal detection change (MDC). [Results] A systematic error was not found for qualified professionals in the intra-rater and the inter-rater reliabilities. The MDC of the measurement error was less than 3 degrees. [Conclusion] The reliability of the measurement confirms the usefulness of the measurement error as a parameter that differs according to measurement experience and skill.

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[Purpose] The purpose of this study was to evaluate the characteristics of the range of shoulder rotation in humeral retroversion in a disabled throwing shoulder. [Subjects] The subjects were 38 male pitchers with disabled throwing shoulders. [Methods] Using ultrasound, we measured and compared the range of shoulder rotation, and the influence of humeral retroversion on the pitching and non-pitching sides. [Results] The pitching side average humeral retroversion was 11 degrees greater than that of the non-pitching side. The pitching side had an average external rotation angle that was 9 degrees greater than that of the non-pitching side, the inner rotation angle showed an average decrease of 18 degrees, and total arc showed an average decrease of 9 degrees. All the differences were significant. [Conclusion] These results suggest that range of shoulder rotation in a disabled throwing shoulder is influenced by the boniness of humeral retroversion, and the shoulder soft-parts organization nature.

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[Purpose] This study aimed to explore the effects of electrical stimulation (ES) of abdominal muscles on voluntary cough intensity and trunk function in stroke patients. [Methods] A total of 23 stroke inpatients undergoing rehabilitation were included. Patients were divided into an ES group of 10 patients, which concomitantly received electrical stimulation for 4 weeks, and a control group of 13 patients. Respiratory muscle strength was assessed using maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Voluntary cough intensity was assessed by measuring peak cough flow (PCF) and sound pressure level (SPL). Trunk function was assessed using the trunk control test (TCT) and the time required to rise from a supine to a seated position. [Results] In the ES group, MEP, MIP, PCF and SPL at 4 weeks were significantly increased from the baseline. In the control group, no significant difference was found in any parameter. The TCT score significantly increased in both groups, but no significant difference was noted in the ratio of change between the groups. The mean percent decrease in the time required to rise from a supine to a seated position was 18.4% in the ES group and 8.7% in the control group, suggesting that ES of the abdominal muscles may improve trunk function. [Conclusion] These results suggest that, ES of the abdominal muscles of stroke patients might increase voluntary cough intensity and improve trunk function.

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[Purpose] We investigated the relationship between a simplified version of the trail making test (S-TMT) and the Japanese version of the trail making test (J-TMT). [Subjects] Twenty-nine elderly people and 18 healthy young people were enrolled in this study. [Methods] We calculated times of TMT part A and part B and the ratio of TMT using S-TMT and J-TMT and then compared the two tests. [Results] The time of TMT and the ratio of TMT showed moderate correlations between the two tests. Although the time of S-TMT was significantly shorter than the time of J-TMT, the ratio of TMT did not show a difference between the two tests. [Conclusion] S-TMT takes only a few minutes and has a moderate correlation with J-TMT. These results suggest that S-TMT may be clinically useful as an evaluation of attention.

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[Purpose] The aim of this study was to develop a social activity scale (SAS) and an implementation intention scale (I-SAS) for post-stroke patients. [Subjects] The subjects were 53 stroke patients at 3 months after discharge from hospital. [Methods] We constructed the SAS by reorganizing the revised frenchay activity index. We assessed the reliability of the SAS and I-SAS using Cronbach's α coefficient and the test-retest method, and the validity by linear regression with SAS as the criterion variable and I-SAS as the explanatory variable. [Results] We identified two subscales, showing basic activity (4 items) and energetic activity (5 items) in both SAS and I-SAS, and high values were found for Cronbach's α and correlation in the test-retest method. The results of the regression analysis showed that intention was a predictive factor of activity. [Conclusion] Both SAS and I-SAS were confirmed to have sufficient reliability and validity.

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[Purpose] To investigate the relationship between motor function and the movement pattern of getting up from the floor. [Subjects] Sixty-seven community-dwelling elderly persons: age 80.3 ± 7.0 years, height 149.2 ± 6.6 cm, weight 51.2 ± 8.6 kg, BMI 23.0 ± 3.7 kg/m². [Methods] We divided the getting up from the floor movement into 4 patterns, measured getting up from the floor ability, isometric knee extension strength, and 10m walking speed, and conducted the timed up-and-go (TUG) and functional reach (FR) tests. [Results] Multiple logistic regression analysis identified 10 m walking speed and knee extension strength as the variables which determined whether or not the arms were used in getting up from the floor. [Conclusion] When knee extension strength, FR, and TUG values are good, it is possible to perform the action of getting up from the floor, an action that is rather difficult. Furthermore, we consider that knee extension strength and 10 m walking speed are involved in whether or not the arms are used.

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[Purpose] The purpose of this research is to compare the influence of various standing postures on the pelvic movement direction and gluteus medius activity of the opposite side with the pelvis fixed by passive resistance during lateral pelvic movement exercises, in order to gain electromyographic evidence for closed kinetic chain (CKC) exercise methods for hip abductor muscle training. [Subjects] The subjects were 20 healthy adults. [Method] The exercise task of moving the pelvis laterally to the left was performed with both thighs internally rotated, externally rotated, and in the neutral position, with maximum load and a load of half the body weight on the right leg. [Result] The muscle activity of the right gluteus medius was greatest when the movement task was performed with internal rotation of the thighs and maximum load. [Conclusion] Even though the exercise of moving the pelvis laterally with the pelvis fixed in one-leg standing is difficult, its possibility in abductor muscle CKC training is electromyographically supported.

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[Purpose] To analyze the relationships between sitting ability, eating and swallowing function, and urinary incontinence. [Subjects] The subjects were 128 hospital patients who were receiving physical therapy. [Method] We collected data on sitting ability, eating and swallowing function, and urinary incontinence from physical therapy assessments and nursing records, and analyzed relationships between all combination pairs. [Results] Sitting ability category 3, had a low level of eating and swallowing function, and the sitting ability categories and 10 grades of eating and swallowing function were the same. Furthermore, urinary incontinence was often seen when sitting ability category was low, and those in the urinary incontinence group had low levels of eating and swallowing function. However, those with sitting ability category 1 had good eating and swallowing function, and few of them had urinary incontinence. [Conclusion] It is important to first address sitting ability, when trying to improve eating and swallowing function and urinary incontinence.

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[Purpose] The purpose of this study was to elucidate the effects of static stretching of human skeletal muscles on relaxation. [Subjects] Ten healthy, adult subjects were the subjects. [Method] A motor controller was used to drive the ankle joint to stretch the triceps surae muscle at a constant angular velocity (15°/sec). Electrocardiograph (ECG), instantaneous respiratory flow (ILV), blood pressure, ankle angle and plantar pressure were monitored continuously during prestretching (PreST), stretching (ST) and poststretching (PostST) for 10-minutes each. We performed power spectral analysis of the heart rate variability (HRV) calculated by fast Fourier transformation (FFT). [Results] Enhancement of HF, attenuation of LF/HF and decrease of the respiratory cycle were shown at the end of PostST, suggesting an increase of parasympathetic outflow and attenuation of sympathetic outflow. However, the evaluation of good feeling was higher at just after ST (30−60 seconds). [Conclusion] Static stretching of the triceps surae muscle induces psychological relaxation.

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[Purpose] To examine the reproducibility of the measured values of the seated continuous dorsiflexion test, a test we designed. [Subjects] There were 16 subjects (1 male, 15 females) in the intra-rater reproducibility test, and 14 (2 males, 12 females) in the inter-rater reproducibility test; all subjects were aged 65 or over. [Methods] Measurements for the intra-rater reproducibility were performed by one examiner on two days separated by two or more days. Measurements for the inter-rater reproducibility were performed by two examiners on each of the subjects. The intra- and inter-rater reproducibilities were assessed using the intra-class correlation coefficients, ICC(1,1) and ICC(2,1), respectively. [Results] For intra-rater reproducibility, ICC(1,1) was 0.915, and for inter-rater reproducibility, ICC(2,1) was 0.932. [Conclusion] The reproducibility of our test was good, and we consider it will be useful in clinical practice as it is easy and safe to perform.

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[Purpose] In a previous paper, we reported that stretching of the triceps surae muscle for 10 minutes induces mental relaxation through an increase in parasympathetic activity, on the basis of spectral analysis of heart rate variability. However, some previous physiological studies of animal mechanoreceptors have indicated that stretching of the skeletal muscle leads to both persistent attenuation of parasympathetic activity and transient weak sympathetic activity. [Subjects] Ten healthy, adult subjects were the subjects. [Methods] In order to elucidate the activity of the autonomic function while the muscle was being stretched, we conducted time-frequency spectral analysis of the heart rate variability, and analysis of the heart rate, and blood pressure. [Results] We found that heart rate increased transiently without an elevation of systolic blood pressure, that HF was attenuated, and that during stretching all of the subjects experienced good feelings. [Conclusion] When comfortis experienced, decrement of parasympathetic nerve action is found during stretching.

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[Purpose] The purpose of this study was to examine the relationship between the extension-sensitivity induced by dorsiflexion of the ankle joint and muscle stiffness. [Subjects] Eleven healthy, adult subjects were the subjects. [Methods] Three types of extension-sensitivity were defined: at the time when the subject feels extension (FE1), at the time when the subjects feels good extension mentally (FE2), and at the time when the subject feels pain (FE3). External force, angle of the joint and muscular length at the times corresponding to these sensitivities were recorded using Doppler ultrasonography. The muscle stiffness was calculated from the ultrasound images. [Results] Pressure and joint angle between FE2 and FE3 showed very little difference. A reduction in muscle fascicle length (defense reflex to pain), and an increase in muscle stiffness was shown by five subjects in FE3. [Conclusion] The force corresponding to FE2 was about 2 times that of FE1. The extension-sensitivity in static stretching was characterized by a slight difference in physical parameters between FE2 and FE3.

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[Purpose] The present study examined the utility of a method assessing bridging strength through its relationships with other physical functions. [Subjects] The subjects were 32 elderly males living in the community. [Methods] Using Pearson’s correlation coefficient, the relationships were examined between bridging strength and other physical functions. A multiple regression analysis was also conducted to examine the factors influencing bridging strength. [Results] Significant correlations were noted between bridging strength and knee muscles, FRT, and time able to stand on one leg. Two factors influencing the ability to form a bridge were determined: the strength of the muscles used to stretch and bend the knees and FRT. [Conclusion] Bridging strength of the elderly reflects the strength of the muscles used to stretch and bend the knees and their balance ability. This measure may be useful in clinical practice as a simple functional assessment method.

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[Purpose] The purpose of this research was to structure a cognitive model of terminal stage physiotherapy for physiotherapy students, and to propose educational and practical issues based on the cognitive model. [Subjects] The subjects were 9 physiotherapy students. [Methods] We structured the cognitive model using M-GTA-based on SCQRM using language data obtained by interview. [Results] The cognitive model showed an internal driving force of the physical therapist and driving force of the action based on environment and situation. [Conclusion] We propose that educational and practical issues based on the model are improvement of the environment in terminal stage physiotherapy, and the provision of death education, medical care and social systems.

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[Purpose] To examine whether peripheral nerve electrotherapy together with exercise is effective for functional instability after ankle sprain. [Subjects] The subjects were seven males with a history of ankle sprain. All had a sprained ankle score of ≤80 points on Karlsson’s functional instability test. [Methods] The subjects’ total COP path length of one leg standing for 30 seconds was measured. We compared the average value on an unstable balance board under the same conditions both with and without TENS. [Results] The COP length of the sprained side was significantly longer during standing on one leg than that of the non-sprained side before TENS. The COP length decreased significantly on the sprained side compared with non-sprained ankle when TENS was conducted. [Conclusion] The COP length improved when TENS was included in the training.

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[Purpose] The purpose of this study was to clarify the relationship between pelvic lateral tilt during lateral body weight shifting in the upright sitting position and the hip joint abductors on the weight-shifted side, and to investigate the influence of the unilateral gluteal region load on the integrated electromyographic activity of each muscle. [Subjects] This study recruited 16 healthy male volunteers (mean age, 27.1 ± 6.6 years). [Methods] With the subjects sitting upright, different weight loads were randomly applied on the unilateral gluteal region during unilateral weight shift. The electromyographic activities of the upper fibers of the gluteus medius, tensor fascia latae, and gluteus maximus muscles on the weight-shifted side were recorded under each load. The relative values of the integrated electromyographic activities of the muscles were compared among the different loads. [Results] Each muscle showed a significant increase in the relative value of the integrated electromyographic activity at weight loads of up to 85%. However, significant decreases were observed in the gluteus medius and tensor fascia latae muscles at weight loads of 90% or higher. [Conclusion] Participation of the hip joint abductors on the weight-shifted side is important for the promotion of pelvic lateral tilt with lateral weight movement in the upright sitting position.

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[Purpose] In the landing action, we clarified, the influence of trunk muscle activity on lower limb muscle activities and lower extremity alignment. [Subjects and Methods] The subjects were eight healthy women with no orthopedic disease in the lower extremities. In single-leg landing, the activities of the internal oblique and multifidus were compared with the changes in the activities of the lower extremity muscles and lower limb alignment. [Results] When trunk muscle activity level was high, femorotibial angle displacement was reduced. In addition, trunk muscle activity was related to the activities of the rectus femoris and biceps femoris. [Conclusion] Activity improvement of multifidus and internal oblique is related to activity improvement in the rectus femoris and biceps femoris, as well as the lower extremity alignment.

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[Purpose] The purpose of this study was to clarify the displacements of center of pressure (COP) and center of gravity (COG) in anticipatory postural adjustments (APAs) during multi-direction gait initiation (GI). [Subjects] Twenty healthy young adults participated in this study. [Methods] Kinetic and kinematic variables were collected during GI for five conditions: forward, left 30°, right 30°, right 90°, backward. The subjects initiated multi-directional GI with their right lower limbs. The variables were measured using the Vicon system and an AMTI force platform. [Results] Mediolateral (M-L) and anteroposterior (A-P) displacement of COP and acceleration of COG were significantly different depending on the direction of GI. [Conclusion] These results suggest that displacement of both COP and COG in APAs are important for control of step direction.

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[Purpose] The purpose of this study was to clarify the relationship between lateral thrust and rotation of the knee during walking by people with knee osteoarthritis. [Subjects] Thirteen knee osteoarthritis patients and eight control subjects participated in this study. [Methods] Kinematic data during the stance phase were collected using a high speed camera and tri-axial angular velocimeters. [Results] The external rotation angular velocity of the lower thigh of mild knee osteoarthritis patients was more significantly decreased than that of the control subjects. Angles of knee varus, inclination of the lower thigh and acromion during walking by severe knee osteoarthritis patients were more significantly increased than those of the other groups. Lateral thrust was related to the external rotation angular velocity the lower thigh during walking. [Conclusion] Our results suggest that knee osteoarthritis subjects have decreased angular velocity of external rotation of the lower thigh during walking, and that lateral thrust increased in accordance with the stage of pathology of knee osteoarthritis.

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[Purpose] This study investigated the acute effects of ballistic stretching (BS) on the muscle and tendon of the gastrocnemius medialis muscle (GCM). [Subjects] Twenty male individuals participated in this study. [Methods] BS consisted of stretching the gastrocnemius by indirectly moving the non-dominant ankle joints from plantar flexion to maximum dorsiflexion using the dominant knee active flex/extension at a rate of one bounce per second for a total duration of three minutes. Movement of the myotendinous junction (MTJ) of GCM was measured before and after the stretching exercise using ultrasonography. The difference between the MTJ position in a quiet standing position before and after the stretching exercises was used to determine the muscle elongation. The tendon elongation was calculated using the estimated muscle tendon unit and the muscle elongation. [Results] The ankle dorsiflexion angle significantly increased after BS. The differences of muscle elongation and tendon elongation were not significant between before and after BS. [Conclusion] The BS method of this study did not produce structural change in the tendon. A stronger muscle contraction may be necessary to increase tendinous extensibility.

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[Purpose] This study investigated the initial postural sway characteristics of 30 seconds of one-leg standing. [Subjects] The subjects were 30 healthy adults. [Methods] We measured the locus length per unit area, X-Y unit locus length, and total locus length of 30 seconds of one-leg standing, We performed correlation analysis to compare the 10 one-second segments of the first 10 seconds and the three 10-second segments of the 30 seconds. [Results] There was no correlation of any postural sway value with locus length per unit area in any one-second segment of the first 10 seconds. X-Y unit locus length and total locus length was higher than the other 10-second ? segments in the initial 10 seconds, and was higher than the other 1-sec ? segments in the first second. Locus length per unit area was low in the initial 10 seconds and it was lower than the 8th second in the first 4 seconds. [Conclusion] Our results suggest that the speed and distance of the center of gravity sway increases, but the dependence on deep sensory systems was low.

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[Purpose] The purpose of this study was to examine the validity of measurement of the malleolar torsion angle, which indicates the tibial torsion, by a goniometer. [Methods] We examined the correlation between the malleolar torsion angle obtained by a goniometer and the value obtained by a three dimensional motion analysis system. [Results] The malleolar torsion angle measured by the goniometer and the value obtained by the three-dimensional motion analysis system showed high correlations of 0.74 and 0.89 for ICC (2,1) and for ICC (3,1), respectively. [Conclusion] We confirmed high correlations between measurements obtained by a goniometer and a three dimensional motion analysis system. The present result suggests that measurement methods using a goniometer have a certain amount of validity in measurement of the malleolar torsion angle.

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[Purpose] To examine the correlation between hamstring activity during squatting before anterior cruciate ligament (ACL) surgery and quadriceps strength at 6 months after surgery. [Subjects] The subjects were 12 persons who received anatomical double bundle ACL surgery. [Method] Activity of the hamstring muscle in squatting before surgery and quadriceps muscle strength relative to body weight at 6 months after surgery were measured, and the correlation was determined. [Results] We found a negative correlation between the hamstring muscle activity of squatting before surgery and the quadriceps muscle strength relative to body weight at 6 months after surgery. [Conclusion] The results suggest that for patients receiving ACL reconstruction surgery, those with high hamstring muscle activity in squatting will have low quadriceps muscle strength, in spite of performing CKC exercise, for which risk management is good, in the acute post-surgery period.

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[Purpose] The purpose of this research is to investigate the combined effects of an ankle foot orthosis with oil damper (AFO-OD) and triceps surae muscle training on the gait of a chronic stroke patient. [Subjects] A 77-year-old man with left hemiplegia was recruited for this study. [Methods] Outcomes were assessed using the ten-meter walking test and the six-minute walking test. The subject underwent triceps surae muscle training for 3 months. [Results] AFO-OD had immediate effects on gait. Maximum walking speed and 6-minute walking distance increased with the AFO-OD. The combined effects were improvements in maximum walking speed and step length. [Conclusion] AFO-OD and triceps surae muscle training improved the walking ability of a chronic stroke patient.

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