[Purpose] In a physical therapy education vocational college, we carried out an attitude survey toward physical therapy research. [Subjects] The subjects were 42 students attending a “physical therapy research method” course. [Methods] The survey consisted of two free writing questions and four multiple choice questions (6 items in total) about physical therapy research, and basic mathematical knowledge. [Results] Ninety percent of students had difficulty with physical therapy research. However, 50% of them wanted to study and research after graduation. Many students lacked basic mathematical knowledge. [Conclusions] In the vocational college, many students had difficulty with research methods. I in order to overcome their difficulty, it will be necessary to teach basic mathematical knowledge to them, and to understand their abilities.

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[Purpose] We investigated whether or not the fat-free mass index (FFMI) can be used instead of the body mass index (BMI) as an assessment of physical nourishment reflecting the strength-weakness of the elderly. [Subjects] The subjects were 34 healthy young men, aged (mean ± SD) 19.3 ± 0.4 years, and 22 elderly men with high activity levels, aged 71.2 ± 3.6 years. [Methods] We measured the subjects’ physical composition with an impedance method body composition analyzer, and compared the results of the old and the young subjects. [Results] Even though the BMI and fat index of the elderly men with high levels of activity were significantly higher than those of the young men, their FFMI showed no significant difference. [Conclusion] Since the FFMI is not affected by age related changes in fat volume, it could be used as an index of physical nourishment.

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[Purpose] We introduced the daily brief report (DBR) method, a teaching method focusing on learners, to physical therapy lectures, and investigated the effect of the method and the characteristics of the students. [Subjects and Methods] Based on the results of a questionnaire administered to 43 university students and 56 vocational training school students attending the classes, we compared the results with the data of Uta, performed categorical principal component analysis, and analyzed them using the text mining method. [Results] Compared with conventional group education, more than half of the physical therapy students perceived the DBR method positively, and we found that they held a sense of wanting to learn by themselves. [Conclusion] Our results suggest that it is possible to raise students’ motivation levels by introducing the DBR method into lecture classes, and through making students write reports every time, it can be said that the DBR method has the advantages of individually raising students’ motivation to learn and correcting their mistakes which is absent from conventional group education.

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[Purpose] To clarify the intention-behavior relationship among stroke patients after discharge from hospital. [Subjects] The subjects were 45 stroke patients. [Methods] We conducted surveys using the Social Activities Scale (SAS) and Intention of performing Social Activities Scale (I-SAS) at hospital discharge (T1), 3 months after discharge (T2), and 6 months after discharge (T3). Changes in I-SAS were analyzed using one-way ANOVA, and changes in SAS were analyzed using Student’s t-test. The relationship between the two scales was investigated using hierarchical multiple regression analysis. [Results] Between T2 and T3 patients’ social activities decreased. Social activity at T2 was that predicted by intentions at T1, but the result of social activity at T3 showed that it could not be predicted by intentions at T2. [Conclusion] At 6 months after discharge, patients’ social activities had declined, suggesting the emergence of an intention-behavior gap.

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[Purpose] The purpose of this study was to determine the most suitable compression magnitude and duration for inhibition of spasticity of the soleus muscle. [Subjects] The subjects were 18 community-dwelling cerebrovascular disorder patients in the chronic phase. [Methods] Measurements of the threshold and the maximum values of the H and M waves were conducted under combinations of five magnitudes and three durations of compression using elastic supporter on soleus muscle: 0, 20, 30, 40 and 50 mmHg, and 1, 3 and 5 minutes. Six clinical indexes for evaluating the spasticity of the soleus muscle were also measured. [Results] The excitation of spinal motoneurons on the paretic side significantly increased compared to the non-paretic side and the excitation showed a correlation with the number of clonuses. Excitation of spinal motoneurons on the paretic side under compression of 40 mmHg for 5 minutes and 30 mmHg for 3 minutes was significantly decreased compared to that without any compression. [Conclusion] Compressions of 40 mmHg for 5 minutes and 30 mmHg for 3 minutes were effective combinations of magnitude and duration for the inhibition of spasticity of the soleus muscle.

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[Purpose] To investigate the changes that occurr in body hemodynamics during high-intensity exercise. [Subjects] The subjects were 11 sedentary healthy men. [Methods] In the supine position the subjects performed a straight-leg raise exercise 10 times with an 80% load of maximal voluntary contraction. The hemodynamics were analyzed before and after the exercise. [Results] The systolic blood pressure and low/high frequency ratio of the heart rate fluctuation were found to significantly decrease, but the baroreflex sensitivity significantly increased. The total peripheral vascular resistance was significantly reduced within one to two minutes after termination of the exercise. [Conclusion] Termination of high-intensity resistance exercise leads to relaxation of the peripheral vasculature and increase in the intravascular volume due to a decrease in the total peripheral vascular resistance. Also, sympathetic nerve hyperactivity continues for some time.

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[Purpose] This study aimed to verify the balance disorder factor of inpatients injured in falls using the mini balance evaluation systems test. The test consists of four different balance systems. [Subjects] Thirteen inpatients injured in falls participated in this study. [Methods] The balance ability of all subjects was measured using the Berg balance scale and mini balance evaluation systems test at the times of entry into the convalescence rehabilitation ward and of discharge. [Results] All systems significantly improved from the time of entry into the convalescence rehabilitation ward to the time of discharge. The scores of the postural responses and dynamic gait were significantly lower than those of the other systems. [Conclusion] These results suggest that patients injured in falls have reduced abilities associated with postural responses and dynamic gait. Therefore, we consider that establishing effective interventions to enhance these abilities are needed to prevent repeat falls.

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[Purpose] We analyzed the change in rotational angular velocity of the shoulder girdle and pelvic girdle induced by repetitive pitching. [Subjects] Eight collegiate baseball team players participated in this research. [Methods] Rotational angular velocity of the shoulder girdle and pelvic girdle during 60 pitches were recorded by a high-speed camera in the horizontal plane. We compared the rotation angle and rotational angular velocity of the shoulder and pelvic girdles between the first and last 10 pitches in the acceleration phase. [Results] In the group that maintained or increased their ball speeds the relative shoulder girdle rotational angular velocity did not change. [Conclusion] Thrower may unconsciously diminish the change of relative shoulder girdle rotation angular velocity to maintain ball speed in a fatigued condition.

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[Purpose] The purpose of this study was to investigate the effectiveness of transcutaneous xenon (Xe) light irradiation of skeletal muscle as a pretreatment of muscle stretching. [Subjects and Methods] Thirteen healthy volunteers participated in this study. They received two 10-minute interventions as follows: 1) Xe light irradiation of the bilateral triceps surae (TS) muscles (Xe-LITS) at prone rest, and 2) prone rest without Xe-LITS (control). Passive range of motion of ankle dorsiflexion (passive D/F ROM) and TS muscle hardness, which were measured at prone rest, were examined before and after the Xe-LITS and control treatments. [Result] Although a significant decrease in TS muscle hardness was observed after in the Xe-LITS and the control, groups, a significant increase in passive D/F ROM was observed only after Xe-LITS. [Conclusion] These results suggest that Xe light irradiation of skeletal muscle can serve as a pretreatment of muscle stretching.

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[Purpose] The purpose of this study was to investigate the effectiveness of neuromuscular electrical stimulation (NMES) as a pretreatment of muscle stretching. [Subjects and Methods] Sixteen healthy volunteers participated in this study. They received three types of 15-minute intervention as follows: 1) NMES based on the Ia inhibition (Ia-NMES), 2) NMES based on Ib inhibition (Ib-NMES), and 3) rest without NMES (control). Both the Ia- and Ib-NMES were performed with the aim of improving hamstrings extensibility. Hamstrings muscle hardness and the distance of long sitting body anteflexion before and after the NMES and control treatments were examined. [Results] Only the Ib-NMES caused a significant decrease in hamstring muscle hardness. On the other hand, the Ia-NMES as well as the Ib-NMES prevented decrease in the distance of long sitting body anteflexion which was observed after the control treatment. [Conclusion] These results raise the possibility that NMES might be effective as a pretreatment of muscle stretching.

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[Purpose] To clarify the factors influencing the exercise habits of knee osteoarthritis (KOA) patients who have been recommended to exercise. [Subjects and Methods] We conducted a multi-facility collaborative survey, distributing 300 questionnaires about pain and psychological factors to KOA patients over the age of 50. [Results] Statistical analysis with corrections for confounding factors of the 120 replies, divided into no exercise habit (64 persons) and exercise habit (56 persons) groups, revealed that WOMAC function and sense of self-efficacy of exercise were factors related to the two groups, whereas pain was not. [Conclusion] It appears that continuation of the exercise habit of recommended physical activities is related to preference for exercise, lowering of physical function and confidence in ability to perform exercise, rather than pain or psychological factors.

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[Purpose] To investigate whether the motor assessment scale (MAS) can serve as a useful index for the prediction of ADL of stroke patients with lower levels of functional independence. [Subjects] Fourteen stroke patients who scored 80 points or less at admission on the Functional Independent Measure (FIM). [Methods] With the functional gain of FIM from admission to discharge as the objective variable, and the functional gains of the MAS, Berg balance scale, stroke impairment assessment set (SIAS), and daily living functional assessment from admission to one month as explanatory variables, we performed single regression analysis. [Results] MAS at one month, the gain in MAS at one month, and SIAS at one month were identified as useful variables. [Conclusion] Our results suggest that MAS and SIAS could be useful in the prediction of ADL of patients with moderate and severe stroke.

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[Purpose] The purpose of this study was to consider the factors influencing the activities of daily living (ADL) of elderly stroke patients who were discharged to home from a convalescence rehabilitation ward. [Subjects and Methods] The subjects were 24 stroke patients aged 75 years old and over who were discharged from our convalescence rehabilitation ward to home. Evaluation items were demographics, clinical course, presence or absence of voluntary training with family participation at our hospital, the Japan stroke scale and Barthel index (BI) at discharge, frequency of outpatient rehabilitation, frequency of voluntary training at home, and BI at 6 months after discharge. Associations between BI at 6 months after discharge and the other evaluation items were studied. [Results] BI at 6 months after discharge was influenced by duration of hospitalization, presence or absence of voluntary training with family participation, frequency of voluntary training at 6 months after discharge, and gender. [Conclusion] These results indicate that shorter hospitalization including voluntary training with family participation and continued training at home are factors contributing to the improvement of ADL after discharge.

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[Purpose] The purpose of this study was to clarify usage of long-term care insurance services by home-bound disabled elderly. [Subjects] Data were collected from 85 home-bound disabled elderly receiving home care support services who were living at home in Kobe city, Hyogo. [Methods] We carried out the investigation of long-term care insurance services using data based on care plan implementation records. [Results] It was revealed that service availability tended to be higher than in a preceding study Assistive implements and rehabilitation in the day care services were used by more people in the severe care group than the slight care group. [Conclusion] These results suggest that as the need of nursing care level becomes higher, the use of the assistive implements and the necessity of rehabilitation also rises.

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[Purpose] The purpose of this study was to determine the immediate effects of a therapeutic exercise using an active therapeutic movement device (ATM^®2) on trunk and hip range of motion. [Subjects] Twenty healthy male individuals were enrolled and randomly allocated to the intervention group or control group. [Methods] Subjects in the intervention group performed trunk flexion exercise using the ATM^®2 and those in the control group performed the same exercises without the ATM^®2. Finger Floor Distance (FFD) and hip flexion range of motion were measured before and immediately after the intervention, and the effects were compared between the two groups. Significance was accepted for values of p<0.05. [Results] The intervention group demonstrated significantly greater improvements in FFD than the control group. There was no improvement in hip flexion range of motion in the intervention group. [Conclusion] Therapeutic exercise using the ATM^®2 is effective at improving the FFD of healthy male individuals.

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[Purpose] To examine physical, psychological, and functional measures to evaluate the effects of an intervention in the elderly. [Subjects] Two hundred thirty-two community-dwelling elderly (mean age 76.7±5.8yrs), who participated in the secondary prevention program implemented by Kagoshima-City. [Methods] The program was held twice a week for three months, 24 times in total. The outcomes were physical strength tests, a survey of life and cognition containing 9 questions, the basic checklist, and a follow-up questionnaire after 1 year. Physical strength was compared using the paired t test, and survey data were compared using the Wilcoxon signed rank test. [Results] Significant improvements in mental, physical, and functional measures were found. [Conclusion] We found various exercise effects through data analysis. More consideration will be needed to set clear standards for deciding the effect using 5-m walking speed and one-leg standing with eyes open.

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[Purpose] We held health promotion classes using music or exercise for the middle aged and elderly, and compared their changes in mood based on attendance frequency. [Subjects] There were 58 subjects (67.4 ± 9.1 y) in the music class, and 57 subjects (67.5 ± 9.0 y) in the exercise class. [Methods] We held each of the health promotion classes once a month, 10 times in the year. At the start and end of each of the classes the Japanese version of the profile of mood states (POMS) short version was administered, and the subjects were divided into high attendance and low attendance groups. [Results] Significant differences in items of the POMS subscales were found between the high and low attendance groups. Also there were differences in the items found to have significant differences between the two types of health class. [Conclusion] The results show that differences emerged in mood changes that were dependent on the type of class and attendance frequency.

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[Purpose] The purpose of this study was to determine the factors influencing the recovery of the ability to perform activities of daily living (ADL) using medical treatment including rehabilitation. [Subjects] This study included subjects who were hospitalized at Tsukuba Memorial Hospital and had been advised to participate in a rehabilitation program for disuse syndrome. [Methods] Their ability to perform ADL was evaluated at the initial assessment and at discharge. Furthermore, we analyzed the factors influencing improvement in the ability to perform ADL. [Results] Multiple regression analysis revealed that the following four items were associated with improvements in the ability to perform ADL: Functional Independence Measure (FIM) motor item scores before hospitalization, knee extension muscle strength, hip flexion range of motion, and the presence of pneumonia at the initial assessment. [Conclusion] The results suggest that FIM motor item scores before hospitalization, knee extension muscle strength, hip flexion range of motion, and the presence of pneumonia at the initial assessment all influence improvements in the ability to perform ADL.

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[Purpose] To verify the reliability of an assessment method of toe movement sense, utilizing the ability to adjust toe movement on a wobble board, and to examine the results of this method for different age groups and the dominant and non-dominant sides. [Subjects] The subjects were 122 healthy young men and women aged between 18 and 89. [Methods] We assessed the ability to adjust movement through only the movement of the toes during the performance of set tasks on a wobble board (DYJOC Board Plus) restricted to tilt in the anteroposterior direction. [Results] We verified this method has high reliability. The ability to adjust movement of the elderly was significantly lower than that of the other age groups, and that of their non-dominant side was significantly lower than that of their dominant side. [Conclusion] We consider that it is possible to use this assessment as one method of assessing the movement sense of the toes. Also, the correction of the balance of left-right movement sense is very important in the elderly.

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[Purpose] The purpose of this study was to investigate the effects of aging on the squat task. [Subjects] Nineteen healthy elderly individuals participated (mean age: 70.5 years). [Methods] The squat task with eyes closed was performed on a force platform. The center of mass was recorded with a three-dimensional motion system and the reaction time, amplitude, and downward velocity of the center of mass were analyzed. [Results] There was no significant difference in the reaction times of the participants in their 60s and 70s. The downward amplitude and velocity of those in their 70s were lower than those in their 60s. Also, elderly participants in their 70s showed a tendency of increased anterior-posterior amplitude compared with those in their 60s. [Conclusion] The results suggest that the squat task becomes slower and more shallow with aging. There is a possibility that change in the motion of the center of mass in the sagittal plane is influenced by aging.

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[Purpose] The purpose of this study was to investigate the muscle activation patterns during posture transition in patients shortly after total hip arthroplasty (THA) in order to understand their postural control mechanisms. [Subjects] The subjects were 9 THA patients. [Methods] The subjects performed posture transition from double leg stance to single leg stance and the onsets of muscle activity were measured using an electromyograph. [Results] The onset of muscle activity in the operated limb of the biceps femoris was significantly later in the eyes open and closed states, and that of the adductor longus was significantly faster in the eyes closed state. [Conclusion] THA patients may preserve postural stability by using a strategy that is different on the operated side from that on the non-operated side.

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[Purpose] This study investigated correlations between the repetitive saliva swallowing test (RSST) and brain regions involved in swallowing using diffusion tensor imaging (DTI). [Subjects] Forty-eight healthy Japanese right-handed volunteers (37 men, 11 women; age, 27-75 years) [Methods] DTI was conducted on a 1.5-T MRI system. Each region of interest (ROI) was manually selected from brain regions found to be involved in swallowing in an f-MRI study. Fractional anisotropy and apparent diffusion coefficient (ADC) values of each ROI were measured using a workstation, and the correlations between these values and RSST were analyzed using Spearman’s rank correlation coefficient. [Results] ADC values of the left insula correlated with RSST. [Conclusion] The insula integrates the sensory-motor system for swallowing and may be associated with the swallowing motion, whereas the left insula may contribute to voluntary, continual swallowing.

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[Purpose] To investigate the necessary conditions for wheelchair user stroke patients to be discharged to home from a recovery stage rehabilitation ward. [Subjects] The subjects were 68 wheelchair user stroke patients who were discharged to home (Home group), or a facility or a convalescence ward (FacCon group). [Methods] The Home (28 persons) and FacCon (40 persons) groups were compared, and factors related to the discharge destination were extracted using logistic regression analysis. [Results] In logistic regression analysis, “eating” and “toileting” were identified as discharge destination factors. Furthermore, we found a tendency for the discharge destination intention on hospital admission to be reflected in the final discharge destination. [Conclusion] The requirements for discharge to home of wheelchair user stroke patients were found to be toileting and eating, and it also important for both the patients and their family to share the desire of return to home from the time of hospital admission.

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[Purpose] To clarify the effectiveness of peroneus muscle training methods from the perspective of muscle activity amounts. [Subjects] The subjects were 88 legs of 44 healthy women. [Methods] Using surface electromyography, we measured the muscle activity of the peroneus muscle during external rotation resistance exercise (ExtRot group) with a Theraband, calf raise exercise (CalRai group), and external rotation exercise in the standing position with weight load on the ball of the foot (ExRoBF group). [Results] The peroneus longus showed high muscle activities in the order of ExRoBF, CalRai, and ExtRot, and significant differences among all of the exercise groups. [Conclusion] Performing external rotation in the standing position with loading on the ball of the foot is a more effective training method for the peroneus muscle than external rotation with resistance.

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[Purpose] We investigated the reproducibility of sideways walking time and compared it with existing indices of dynamic balance to determine whether it can be used as an index of dynamic balance ability. [Subjects] The subjects were 26 elderly persons (8 males, 18 females) who were capable of outdoor walking. [Methods] We measured their sideways walking times, eyes open single leg standing times, and timed up and go test (TUG) times. [Results] The intraclass correlation coefficients, ICC(1,1), of left and right sideways walking times showed high values, and a strong positive correlation was found between the sideways walking times and the TUG time. [Conclusion] Measurement reproducibility of sideways walking times was excellent. Furthermore, since a strong correlation was found with the TUG time, a highly reliable index of dynamic balance, the results show that sideways walking time can be used as an index of dynamic balance.

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[Purpose] This study examined the influence of stair ascent-descent ability on the motor function, activity amount, and physical function of the community-dwelling elderly. [Subjects] The subjects were 37 community-dwelling elderly over the age of 65. [Methods] We divided the subjects into those who could climb and descend stairs independently and those who could not, and measured and compared their motor function, activity amounts and physical function. [Results] Compared to the group which could climb and descend stairs independently, the group which could not showed significantly lower values in the Life Space Assessment, the Fall Efficacy Scale, grip strength, continuous walking distance, subjective assessment of health, and history of falls in the last one year. [Conclusion] The results of this study suggest that the assessment of stair ascent-descent activity has potential as an early indicator of support/care needs as well as in their prevention.

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[Purpose] To clarify rotator cuff muscular activity in the raised position in closed kinetic chain (CKC) exercise. [Subjects] Twenty-nine cases were studied, 19 men and 10 women (average age 21.5 ± 4.7 years old, average body weight 60.1 ± 11.4 kg, average grip strength 34.35 ± 6.9 kg). [Methods] To determine the effects of CKC exercise on the upper limb, we measured the surface EMG of the infraspinatus, trapezius (upper fiber) and deltoid (middle fiber) muscles with the arm elevated. [Results] Our measurements revealed that at 150° elevation in the scapular plane of the upper limb, with 5% body weight load, the EMG activity of the infraspinatus muscle is approximately 30% maximum voluntary contraction (MVC). [Conclusion] The raised position in CKC exercise is effective in physical therapy for functional recovery of the infraspinatus muscle.

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[Purpose] The objective of this study was to examine whether or not the repeated plantar-dorsiflexion test in the sitting position can be used as a predictor of falls. [Subjects] The subjects were 50 elderly persons over the age of 60. [Methods] We divided the subjects into falls and no falls groups and conducted the repeated plantar-dorsiflexion test, the timed up and go test, the functional reach test, the five-meter maximum walking speed test, and the standing on tip-toe test. [Results] We found differences between the two groups for all of the motor functions, and in the results of logistic regression analysis, the repeated plantar-dorsiflexion test and the standing on tip-toe test were identified as the variables associated with fall history. [Conclusion] We consider the repeated plantar-dorsiflexion test, which can be performed in a sitting position, and is safe, and can be conducted by personnel other than physical therapists, will be very useful as a predictor of falls.

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[Purpose] The purpose of this study was to clarify the effect of total-learning and two different partial-learning methods by measuring body sway. [Subjects] The subjects were thirty-six healthy college students who were allocated to three groups (A, B, and C) at random. [Methods] The subjects were asked to throw a ball with the non-dominant hand while sitting on a Balance Ball as a function test. Group A performed the task according to the total-learning method. In group B, the subjects first practiced maintaining balance on the Balance Ball and then threw the ball. Group C performed the task of group B in the reverse order. The length of body sway per unit time (LNG/T; cm / sec) was compared between before and after the learning session. [Results] There was a significant decrease in LNG/T shown by Group B. [Conclusion] This result indicates that postural control influences the function test. This observation suggests that prior achievement of postural control significantly improves motor learning.

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[Purpose] Although importance has been attached to quality of life (QOL) in recent years, few studies have reported factors related to QOL. Therefore, we investigated the differences in items and assessment methods of QOL evaluation measures. [Subjects] The subjects were 27 elderly subjects with chronic low back pain who were attending a geriatric day-care facility. [Methods] We used the Roland-Morris disability questionnaire (RDQ) and Japan low back pain evaluation questionnaire (JLEQ) as assessments of QOL, and the visual analogue scale (VAS) as an assessment of the level of low back pain. We also measured each motor function and conducted an activities of daily living (ADL) survey. [Results] Multiple regression analysis identified knee extension strength and load carrying activities as factors when RDQ was the object variable, and pain and load carrying activities as factors when JLEQ was the object variable. [Conclusion] The results indicate that for the elderly with low back pain, load carrying activities are one item related to their QOL. Furthermore, an item unrelated to low back pain was identified as a factor of RDQ; therefore, we consider the JLEQ provides a better assessment of the features of low back pain.

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[Purpose] To assess the effects on gait of a stroke survivor of motor imagery therapy with visual and verbal feedback performed at home. [Subject] One hemiplegic stroke patient. [Methods] In addition to standard physical therapy, we administered motor imagery with visual and verbal feedback twice a week for 3 weeks. [Results] We observed an improvement in the subject’s gait stability and safety, and the improvement was maintained at 2 months after the end of therapy. [Conclusion] The results suggest that this method will be useful in home-visit rehabilitation therapy for stroke patients.

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[Purpose] To report the efficacy of rehabilitation therapy focusing on the pronation limitation of the forearm, which obtained a good result for a patient with de Quervain disease. [Subject] The subject was a woman in her 40s who complained of pain in the radial side of the thumb of the right hand. [Methods] We performed a pain test, an orthopedic test, range of motion (ROM) measurement, and a carpal bone arch assessment, and on the basis of the results, we conducted therapy for the limitation of pronation of the right forearm. [Results] We observed improvement in the patient’s complaint through correction of the carpal arch, and improvement in forearm pronation ROM. [Conclusion] In rehabilitation for de Quervain disease, in addition to assessment of the affected part, assessment of, as well as therapy for, the other upper limb joints is necessary.

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[Purpose] We focused on the assessment and care of the swallowing and coughing of an elderly patient with dysphagia. The purpose of present study was to wean the patient off mechanical ventilation (MV) by the prevention of ventilation associated pneumonia (VAP). [Subjects] An elderly patient with dysphagia who had not been weaned off MV. [Methods] We focused on respiratory monitoring of oxygenation, the rapid-shallow index, swallowing, coughing, and the physical action. We carried out physiotherapy that focused on improving the range of motion of the tongue bone and the mobility of the suprahyoid muscles. [Results] The patient was successfully weaned off MV after 60 days of admission. She did not contract VAP while in the hospital. [Conclusion] We suggest that VAP can be prevented in mechanically ventilated patients by care for swallowing and coughing which assists weaning from MV.

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[Purpose] The purpose of this paper is to report the unusual course of physical therapy administered to a patient convalescing at home with a pelvic fracture caused by a fall, and complicated by bilateral peroneal nerve palsy. [Subject] The subject was a thin, 71-year-old woman, 160 cm tall, and 45 kg in weight. She had a history of diabetes, but showed no decline in cognitive or mental function. [Methods] Physical therapy of early weight-bearing exercise was conducted in an ad hoc manner, with an elastic bandage supporting leg function. [Results] After 3 months intervention, trunk and lower extremity muscle strengths had improved from level 2 to 3~4, and ankle dorsiflexion strength had increased from 1 and 2 on the left and right sides to 2 and 4, respectively. The subject’s walking ability improved from supervised walking with an assistive device to walking with a stick. [Conclusion] Our case needed time to recover from disuse muscle weakness and bilateral peroneal nerve palsy.

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Recently, we used diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) for visualization and quantitative evaluation of nerve fibers. In this report, we outline the principles of DTI and DTT. In addition, we discuss some DTI studies of the corticospinal tract and superior longitudinal fasciculus. DTT of the corticospinal tract is useful as a prognostic tool for assessing the motor functions of patients with stroke. DTT of the superior longitudinal fasciculus is thought to help in understanding the symptom of unilateral spatial neglect. However, various issues such as the voxel size for MRI and the tensor model of DTI as well as the arbitrariness in setting the region of interest should be considered when using DTT results in rehabilitation planning and for assessing its effects.

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