[Purpose] The purpose of this study was to investigate the relationship between self-efficacy and performance in students of physical therapy. [Subjects] The subjects were 77 students enrolled at a physical therapy department (59 male students, 18 female students, mean age: 21.03 ± 4.4) [Methods] The research was conducted a total of four times before and after college entrance. A questionnaire survey was administered concerning motivation to apply, image of the job, the academic performance self-efficacy scale, the on-the-job-training self-efficacy scale, and motivation. [Results] The higher the preceding self-efficacy was, the greater the subject’s academic performance was. However, irrespective of test results, the subsequent self-efficacy did not increase. [Conclusion] From the outcome of tests, students need to be educated to think why and what kind of questions they answered wrong, and what the possible answers are so that they can make a correct assessment by themselves.

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[Purpose] The present study aimed to assess changes in electroencephalography patterns over time in brain areas activated during a mental rotation task, by considering the relevance of the reaction time of subjects. [Subjects] The subjects were 15 healthy right-handed college students. [Methods] Forty-eight pieces of a hand picture were presented at random in one trial. Brain activity during the task was recorded using high-performance digital electroencephalography. The subjects were classified as fast, middle, and slow groups based on their reaction times. We compared the slow group with the fast group. [Results] In the fast group, brain activity was first observed in the occipital lobe, followed by the temporal lobe and the frontal lobe. In the slow group, brain activity was first observed in the occipital lobe, followed by the parietal lobe and the frontal lobe. [Conclusion] The results suggest that to appropriately activate movement-related brain regions participating in motor learning during a mental rotation task, it is important to give time rather than to demand speed, and that it is necessary for the subject to regard the image as part of his/her own body.

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[Purpose] We investigated the relationship between students’ personality and their attitudes to problem-based learning (PBL) tutorials. [Subjects] The subjects were 55 third-year students of a university physical therapy department. [Methods] After conducting PBL, we assessed students personality using the KT personality test, and conducted a survey of student attitudes to PBL. [Results] The degrees of the five traits ranged from 7.85~11.71. There were no significant differences in attitudes to PBL among the principal traits. The relationship of each type of tendency with attitudes to PBL were: clinical thinking showed a significant positive correlation with convinced belief type and a negative correlation with delicate type and cooperativeness showed a significant positive correlation with self release type. [Conclusion] Our results suggest that one factor related to attitudes to PBL is the degrees of personality.

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[Purpose] The purpose of this study was to investigate the usefulness of the 15 m Shuttle Run Test (15mSWRT) as a modified 20 m Shuttle Run Test (20mSRT). [Subjects] The subjects were 19 healthy young volunteers. [Methods] The subjects performed 15mSRT and 20mSRT in a random order. The usefulness of the 15mSWRT was tested by comparson of the two test performances: distance completed and VO₂ measured by a portable metabolic system. [Results] The correlation between 15mSRT performance and 20mSRT performance was very high, r=0.97. The correlation between the 15mSRT performance and VO₂ was r=0.89 , and it was represented by the regression equation: VO₂=0.0151 distance + 26.281. According to Bland-Altman analysis, the only proportional error was in VO₂ estimated from 15mSRT and VO₂ measured by the portable metabolic system. [Conclusion] These results suggest that 15mSRT is useful as a simple test of endurance capacity that can be performed over a wide range of ages including middle-aged and elderly subjects.

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[Purpose] The purpose of this study was to examine the relationship between physical activity and exercise self-efficacy in patients undergoing hematopoietic stem cell transplantation (HSCT). [Subjects and Methods] Sixty-two HSCT patients, whose physical activity and exercise self-efficacy could be assessed, participated in this study. The mean steps measured with a pedometer as a substitute for physical activity, the exercise self-efficacy questionnaire administered as a substitute for exercise self-efficacy, age, and sex were assessed at the pre- and post-HSCT. The relationships of physical activity with each of the items were analyzed using single and a multiple regression analyses. [Results] Exercise self-efficacy and sex were extracted as predictors of physical activity. [Conclusion] The improvement of exercise self-efficacy may lead to the increase in the physical activity of HSCT patients, who are restricted physically and spatially during HSCT treatment. The results suggest that the approach to psychological aspects, such as exercise self-efficacy should be considered to increase physical activity, to help patients acquire exercise habits, and to prevent deconditioning of HSCT patients.

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[Purpose] The purpose of this study was to verify the validity of two-dimensional motion analysis using three-dimensional motion analysis in the measurement of the pelvic obliquity angle and the hip abduction/adduction angle during gait. [Subjects] Twenty-one healthy subjects gave their informed consent to participation in this study. [Methods] To examine the validity of the pelvic obliquity angle and the hip abduction/adduction angle at right heel contact and left toe-off, intraclass correlation coefficients were calculated and Bland-Altman analysis was performed. Furthermore, we confirmed the causes of differences between measurements using multiple regression analysis. [Results] With the exception of hip abduction/adduction using the patellar center as a landmark, the intraclass correlation coefficients ranged from 0.67 to 0.93. Also, for the pelvic obliquity angle at the right heel contact, a fixed bias arising from pelvic antero-posterior tilt was found. [Conclusion] We conclude that the relatively high validity of two-dimensional motion analysis was verified using three-dimensional motion analysis of gait in the frontal plane.

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[Purpose] Body weight-supported treadmill training (BWSTT) is used to improve the gait ability of patients with hemiplegia. The aim of this study was to determine the effectiveness of BWSTT for patients with hemiplegia during the recovery phase. [Subjects and Methods] Thirty-two patients with hemiplegia participated. They were allocated to (1) level walking training, (2) BWSTT, and (3) combined training groups. Outcome measures were: the 10-m walking time, cadence, stride length, BBS, FIM, and FAC. [Results] The BWSTT group demonstrated a more significant improvement in stride than the combined training group. No significant effects were observed between the groups in any of the other measurements. [Conclusion] During the recovery phase of stroke patients with hemiplegia, walking exercises with BWSTT were not effective at improving gait ability.

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[Purpose] The present study aimed to determine the effect of treadmill gait training with functional electrical stimulation (FES) on the gluteus medius. [Subject and Methods] A 66-year-old man who had a stroke six years previously was studied using the A-B design with 12 weeks of follow up. We applied FES to the gluteus medius for the loading response period from the start of treadmill walking. [Results] After the intervention, gait velocity and symmetry, abduction strength, and stance time increased, while the value on the modified Ashworth scale for the hip adductor muscle decreased. All values were maintained for 12 weeks thereafter. [Conclusion] Treadmill training with FES of the gluteus medius may increase the gait speed of patients with chronic stroke.

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[Purpose] The purpose of the present study was to investigate the relationship between the early phase of rehabilitation participation and the admission motor FIM at the convalescent rehabilitation hospitals using multi-center study data. [Subjects] The subjects were 236 inpatients at 5 convalescent rehabilitation hospitals (average age, 77.7 ± 12.4 years old); hospitalized for stroke, fracture, disuse-syndrome, and spinal cord injury. [Methods] One-week participation after admission was measured with the Pittsburgh rehabilitation participation scale (PRPS). Stepwise multiple regression analysis of the admission motor FIM scores was used, adjusting for demographic and clinical characteristic variables. [Results] The results of the multiple regression analysis for predictors of PRPS showed that age and admission cognitive FIM were significant predictors of PRPS. [Conclusion] At admission, the PRPS is related to the motor FIM at the convalescent rehabilitation hospitals in Japan.

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[Purpose] We investigated the usefulness of the timed up and go (TUG) test incorporating an upper limb task as well as its relationships with muscle strength and static balance. [Subjects] The subjects were 32 elderly persons with low-level care needs (level 1: 20, level 2: 12). [Methods] We measured the time and number of steps taken in the TUG test, and a modified TUG (c-TUG) test in which subjects had to carry a 500cc cup filled with water, and analyzed the results using two-way ANOVA. We also analyzed the relationships of the results with the eyes-open single-leg standing time, as an index of static balance, and grip strength, as an index of muscle strength. [Results] Regarding the TUG performance times, the level of care needs showed significant main and interaction effects for each of the tests. However, for the number of steps taken, only a main effect was found. The TUG time showed significant negative correlations with the indices of static balance and muscle strength, but not the c-TUG test. [Conclusion] Our results suggest that the c-TUG test result is an index better reflecting comprehensive balance factors than the conventional TUG test, and we consider it will be very useful as a balance assessment method for elderly subjects with care needs.

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[Purpose] This study was conducted to clarify the immediate effects of whole-body vibration (WBV) training on range of motion (ROM) of stroke patients with hemiplegia. [Subjects and Methods] The subjects were 30 patients with hemiplegia in our hospital who were able to walk. We classified them into two groups: the WBV group and the non-WBV group. We measured ROM, 10m walking time, Timed Up and Go test (TUG) and static standing balance before and after carrying out the 25Hz WBV training for 2 minutes in the standing position. [Result] ROM significantly improved after WBV training in the WBV group only. [Conclusion] These results indicate that WBV training might have an immediate stretch effect on stroke patients with hemiplegia.

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[Purpose] The purpose of this study was to examine the kinetic and kinematic effects of wearing a backpack with different loads on the standing posture. [Subjects] Sixteen healthy young and 8 healthy elderly subjects participated in this study. [Methods] We measured the standing posture using a three-dimensional motion analysis system and force plates, and compared kinetic and kinematic changes among three different conditions: without a backpack, with a backpack of 5% of body weight (BW) and with 15% of BW. [Results] Lumbar flexion moment and pelvic forward tilt angle significantly increased with increase of weight of the backpack in both subject groups. Hip flexion moment significantly increased in the young subjects and tended to increase in the elderly subjects. [Conclusion] Increase of the weight of the back pack decreased the low back load and this phenomena was observed in both subject groups.

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[Purpose] The aim of this study was to evaluate the effect of phase 2 cardiac rehabilitation on the body composition of patients with acute myocardial infarction (AMI). [Subjects] One hundred seventy-one AMI patients were enrolled in this study. [Methods] We separated the patients into two groups according to the status of phase 2 cardiac rehabilitation: reha group (n=112) and non-reha group (n=59). Body composition was measured at discharge and 4 months after discharge. [Result] Body weight, fat mass and waist circumference of the reha group decreased significantly at 4 months after discharge. Muscle mass and lean body mass in both groups increased significantly at 4 months after discharge. [Conclusion] This study demonstrated that phase 2 cardiac rehabilitation maintained muscle mass and lean body mass in addition to decreasing body weight and fat mass.

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[Purpose] We verified the relationship between single-leg standing and step exercise using center of gravity (COG) sway. [Subjects] The subjects were 10 healthy adults. [Methods] We measured the COG sway of the leading leg in step exercise and single-leg standing. We examined the directional characteristics, velocity and position of COG sway, and determined their relationships with task time using Pearson correlation coefficients. [Results] For the characteristics of the COG sway of stepping up and down, the positional vector plot shows a mediolateral distribution, and the velocity plot a trend of anteroposterior and lateral spread. Furthermore, the positional vector plot of single-leg standing shows a distribution in the medial direction, and the velocity plot mainly a lateral distribution. In addition, a strong positive correlation in lateral COG sway was found between single-leg standing and step exercise. [Conclusion] Our results suggest that sway in the lateral direction counterbalances medial COG sway, and that stepping down and single-leg standing tasks are correlated through lateral COG sway.

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[Purpose] We investigated hamstrings activity and the knee flexion torque immediately after knee extension. [Subjects] Nine healthy male volunteers participated in this study. [Methods] Maximum knee flexion torque of 60°/sec was measured within the range of 30°-80°. The knee extension tasks were conducted in various contractile modes, and at various intensities and angular velocities. [Results] The mean amplitude of the medial hamstrings EMG immediately after each knee extension task was significantly lower, while that of the gastrocnemius was significantly higher. No significant difference in peak torque was observed among the knee flexion tasks. The angle of peak torque during knee flexion became smaller immediately after each knee extension task. [Conclusion] Knee flexion is an effective hamstrings strengthening exercise which facilitates hamstrings activity more than knee flexion immediately after knee extension.

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[Purpose] The purpose of this study was to clarify the activity of oblique muscles during the sitting. [Subjects] The subjects of this study were 7 healthy males, mean age of 30.9 years. [Methods] An electromyography telemetry system (MQ-8, KISSEI COMTEC) was used for the measurements, and fifteen electrodes were arranged over the left oblique muscle. We measured electromyograms of the oblique muscles during lateral weight transfer in the sitting position. [Results] No significant changes were shown by the relative values of the integrated electromyograms as the lateral distance of weight transfer increased. The values of the oblique muscles on the opposite side showed increasing values at all electrodes, and two electrodes over the internal oblique muscle showed significantly higher values. [Conclusion] The results suggest that elevation of the pelvis by the internal oblique muscle on the opposite side is important during lateral weight transfer in the sitting position.

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[Purpose] The purpose of this study was to clarify the optimal pedal rotation speed of passive cycling movement (PCM). [Subjects] Twenty-one subjects (ten men and eleven women). [Methods] After sitting on a cycle ergometer for five minutes, PCM of the lower limb was performed for 5 minutes. Pedal rotation speed was randomly selected as 40, 60, or 80 rpm. [Results] Heart rate of PCM did not change from rest, but oxygen uptake and oxygen pulse significantly increased at each pedal rotation speed compared to rest. [Conclusion] These results suggest that the pedal rotation speed required in order to increase the oxygen pulse by PCM is 40 rpm or more.

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[Purpose] To investigate the effect of periostea on tendon grafts in meniscus reconstruction in rabbits. [Subjects] Twelve Japanese white rabbits were used. [Methods] The extensor digitorum longus tendon was implanted with and without periosteal coating of the grafts in the left knee (periosteum group) and the right knee (non-periosteum group), respectively. Following sacrifice at 2, 4, 8, and 12 weeks after surgery, the rabbits were infused with a mixture of gelatin and vermillion India ink into the abdominal aorta and subjected to visual and histological inspections. [Results] Blood vessel images from the periosteum group were sharper from an earlier time point than those from the non-periosteum group, and showed a shape closes to meniscus. In the periosteum group, histological examinations revealed signs of endochondral ossification at 4 weeks, and cascaded chondrocytes and synovium tissue at 12 weeks after the surgery. In the non-periosteum group, these processes were retarded and incomplete. [Conclusion] The results suggest that coating periosteum on tendon grafts accelerates the pace of reconstruction of the meniscus tissue.

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[Purpose] We examined which type of presentation of visual feedback was effective at eliciting maximal muscle strength in isometric and isokinetic muscle contraction. [Subjects] The subjects were 14 healthy adults. [Method] We measured maximal isometric and isokinetic knee extension strength under two conditions of visual feedback (VF), numerical and graphic presentation, and compared them as percentages of muscle strength without VF. Then, we analyzed the relationships between the percentage changes and the subjective ease of elicitation of muscle strength. [Results] Graphic VF had a large effect on isometric exercise; however, there was no significant difference between the VF presentation methods in isokinetic exercise. A relationship between the ease of elicitation of strength and the change in muscle strength was not found. [Conclusion] Our results suggest that graphic VF is effective when making measurements of maximal muscle strength of isometric contraction.

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[Purpose] This study compared differences between before and after instruction to determine instructional factors for beginners. [Subjects] The subjects were 5 healthy adult males (31.2±1.2 years old) who had no experience of boxing. [Methods] The subjects were requested to hit the target immediately after a light was flashed using right hand straight punches. We divided the punching-motion into four periods based on features quantified using two force platforms and electromyography (EMG), and derived the punch motion speed, the trajectory displacement of center of foot pressure (COP), and the muscle activities. The measurement items were compared for significant differences between before and after instruction. [Results] After instruction, significant reductions were found in motion time, and of COP trajectory displacements in the posterior and right directions in the preparation period, as well increases in the muscle activities of five muscles. [Conclusion] These results suggest that the straight-punching motion instruction given for boxing beginners guidance is effective.

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[Purpose] We examined the incidence of presenteeism among care workers and analyzed the influence of low back pain and psychological factors on it. [Subjects] The subjects were 139 care workers. [Method] We assessed psychological factors, low back pain intensity, and presenteeism of each of the subjects. We modeled the results and examined the goodness of fit and relationships among the items assessed using path analysis. [Results] Presenteeism was reported by 66.9% of the subjects. The goodness of fit of the revised model was satisfactorily high. [Conclusion] Presenteeism is commonplace among care workers, and we confirmed that psychological factors have a significant influence on this problem.

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[Purpose] We examined the effect of Kinesio taping (KT) and its application method on rectus femoris function. [Subjects] Twenty-six thighs of 13 adults without disability. [Method] We measured the muscle thickness, pennation angle, and muscle fiber lengths of the rectus femoris using an ultrasound imaging diagnostic device. Measurements were made in the positions of knee flexion and extension under 3 conditions: without KT, with KT applied in the direction from the muscle insertion to its origin, and with KT applied in the direction from the muscle origin to its insertion. [Results] The muscle thickness in knee flexion significantly increased with taping. The pennation angle significantly increased with taping in both directions, and muscle fiber length also increased with taping in both directions. There were no significant differences in knee extension. [Conclusion] Kinesio taping of the rectus femoris increases its thickness in knee flexion, and the direction of taping changes the pennation angle and muscle fiber length.

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[Purpose] The Euler angles of pelvis motion during quiet standing were investigated. [Subjects] The subjects were 9 young healthy adults. [Methods] An accelerometer and gyro sensor were worn at the midpoint of both posterior superior iliac spines. Trajectories of the computed polar angle and azimuthal Euler angles were projected for one minute on to the X-Y plane during quiet standing with feet together and eyes open. Displacement in the anteroposterior (AP) and lateromedial (LM) directions, and the movement waveform were calculated using computer programs. [Results] The displacement width was not different, but movement in the AP direction indicated a swaying tendency compared with that in the LM direction. The waveform of the 8 participants significantly differed in either the AP or ML direction. [Conclusion] Euler angles could be calculated using tri-axial angular velocities. We suggest that pelvic motion is complicated because of its narrow base of support.

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[Purpose] The purpose of this study was to elucidate views about professionalism held by Japanese physical therapists. [Subjects] The subjects were 123 physical therapy students of a 4-year college. [Methods] We used a questionnaire of 46 items. to ask, “What is required to be professional as a physical therapist?” [Results] Significant differences were found for 4 categories. [Conclusion] The existence of dilemma about self-sacrifice over work was found. Moreover, we consider that the students held two aspects of professionalism: the aspect of the obvious necessity for observance, and the aspect of discretionary judgement.

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[Purpose] The object of this study was to investigate the effects of an arch support insole on the toe flexor muscle function during standing?. [Subjects] The subjects were 22 healthy male students. [Methods] The standing on one leg test was performed by all subjects with and without weight-bearing arch support insoles, and the standing time, movement trace of the vertical component of the center of gravity of the body, and the pinch power of the big and second toes were measured. [Results] The pinch power corresponding to toe flexor muscle strength and the standing time due to instability of the body significantly decreased when using the the insole. Furthermore, a tendency for increased movement of the vertical component of the center of gravity was also seen when using the insole, compared to without it. [Conclusion] The results suggest the possibility that an arch support insole might increase the risk of falling, since the arch function depends on the toe flexor muscle strength.

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[Purpose] We examined how total hip arthroplasty (THA) patients’ hip joint motion and pelvic motion during gait changes after surgery. [Subjects] The subjects were 15 unilateral THA patients. [Method] We used hip joint function criteria as a clinical assessment. Using a 3D motion analysis system, we examined the temporal changes in walking speed, step length, leg symmetry, hip joint angles and moments in flexion and extension, and pelvic tilt. [Results] Walking speed, step length, leg symmetry, and hip joint flexion angle and extension moment significantly improved; however, hip joint extension angle and flexion moment were significantly smaller at 6 and 12 months post-surgery, and the pelvic tilt angle in the late stance phase was significantly greater at 12 months post-surgery. [Conclusion] Increases in walking speed and step length, and improvement in leg symmetry failed to improve hip extension, and anterior pelvic tilt occurred as a compensatory motion.

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[Purpose] The purpose of this study was to elucidate the characteristics of the professionalism of Japanese physical therapy students. [Subjects] The subjects were 63 Japanese and 35 Italian students of physical therapy. [Methods] We used a questionnaire with Likert scale responses to ask: “What is required to be professional as a physical therapist?” [Results] Significant differences between the two countries’ students were found in 26 items of 14 categories. [Conclusion] We guess that the differences in professionalism regarding self-learning arise from different childhood education systems and curriculums of physical therapy.

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[Purpose] We investigated differences in the flexion relaxation phenomenon (FRP) between sitting and standing using electromyography. [Subjects and Methods] We measured the activities of the lumbothoracic spine muscles, and the multifidus, gluteus maximus, and biceps femoris of 10 healthy males. The activities of trunk flexion, at the initiation of extension to restore posture from maximal trunk flexion were measured in the standing, sitting, upright sitting and slump sitting positions. The appearance of FRP, the ratio of muscle activities (FRR), the ratio of the upright/slump muscle activities (Rest FRR), and the ratio of muscle activities excluding the activity at maximal flexion (Movement FRR) were calculated. [Results] The appearance of FRP was high in the standing position, and low in the sitting position. Rest FRR was high in the sitting position, and Movement FRR was high in the standing position. [Conclusion] The appearance of FRP in the sitting position is too infrequent for examination purposes; thus, Rest FRR in the sitting position, and Movement FRR in the standing position are the representative quantitative indices of FRP.

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[Purpose] Using canonical correlation analysis, physical functions related to gait ability were evaluated in subacute stroke patients. [Subjects] Seventy-two stroke patients in convalescent rehabilitation wards were enrolled. [Methods] For gait ability, we evaluated gait velocity and gait variability. For physical function, we evaluated both motor and sensory functions of the affected lower limb, muscle tone of the ankle plantar flexor and muscle strength of both lower limbs. Using canonical correlation analysis, physical functions related to gait ability were explored. [Results] As factors related to gait ability, muscle strength of both lower limbs and motor function of the affected hip were identified by canonical correlation analysis, and muscle strength of the affected lower limb and motor function of the affected hip by multiple regression analysis. [Conclusion] The muscle strength of the unaffected lower limb was determined to be a factor related to gait ability only in canonical correlation analysis.

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[Purpose] We investigated the relationship between fall history and center of gravity sway when vibratory stimulus was applied to the multifidus and triceps surae. [Subjects] The subjects were 17 old-old lumbar spinal disease inpatients (9 males, 8 females; average age 79.4 ± 3.1 years). [Methods] A vibratory stimulus of 60 Hz was alternately applied to the multifidus and triceps surae while the subjects stood with their eyes closed. We divided the subjects into fall and no-fall groups and compared the relative proprioceptive weighting ratios (RPW), number of falls, cross-sectional areas of the lumbar spine muscles, skeletal muscle volume, and the abdominal and spinal muscle strengths. We also determined whether on not there was a correlation between RPW and the number of falls. [Results] The RPW of the fall group showed a decline in lumbar proprioception, and a postural strategy prioritizing the lower leg. A correlation was found between RPW and the number of falls. [Conclusion] Our results suggest RPW is an assessment index which is related to falls.

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[Purpose] To elucidate the gait characteristics of subjects with floating toes. [Subjects] The subjects were 16 floating toe, 16 suspected floating toe, and 16 normal subjects (48 in total), selected from a group of 175 adults. [Methods] Using a contact-type force plate, we measured the ground reaction force (GRF) and center of pressure (COP) sway in the stance phase, and compared them among the three groups of subjects to analyze their gait. [Results] Shortening of the stance time, anteroposterior (AP) sway distance, AP sway distance at toe-off, and mediolateral sway distance at toe-off were found in the floating toe-group. [Conclusion] We infer from the results that, the floating toe subjects did not move their center of gravity to the toes at toe-off, because they could not maintain a stable base of support in that position, and are therefore unable to perform a smooth toe-off.

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[Purpose] There have been few reports of muscle activities during body weight-supported treadmill training (BWSTT) with lower body positive pressure (LBPP) for stroke patients. The purpose of this study was to investigate the characteristics of muscle activities in the lower extremity of the affected side during BWSTT with LBPP using electromyography (EMG). [Methods] The subjects were men in their fifties with left hemiplegia after stroke. EMG of the muscle activities of the vastus medialis (VM), intermediate hamstrings (IH), tibial anterior (TA) and gastrocnemius (GC) was performed during BWSTT under three conditions: full weight (FWB), 25% body weight support (BWS), and 50% BWS. Normalized values of muscle activities by EMG were compared statistically using multiple comparisons (Tukey method) among the three weight-bearing conditions. [Results] The muscle activity of VM decreased with decreasing weight-bearing during BWSTT. Significant decreases in VM in the early stance phase and late swing phase were found, especially between FWB and 50% BWS. IH and GC activities of 50% BWS were greater than those of FWB. [Conclusions] Our results suggest the importance of comprehending the characteristics of gait during BWSTT.

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[Purpose] We examined the effect of exercise therapy, aiming to improve the ability to form internal rhythm, on the rhythmic tapping and freezing of gait (FOG) of a Parkinson’s disease patient. [Subject] One Parkinson’s disease patient who had difficulty in sustaining rhythmic tapping, and in controlling FOG with external visual or auditory cues. [Methods] We provided a 20 min-exercise that facilitates internal rhythm formation for 8 weeks (twice per week), and evaluated the subject’s performance of rhythmic tapping and walking. [Results] We found a gradual increase in the number of repetitions of rhythmic tapping and a reduction in FOG after the intervention. [Conclusion] Exercise to facilitate movements based on internally formed rhythm, instead of external cue, might be a more effective way of improving FOG in Parkinson’s disease.

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