[Purpose] The purpose of this study was to investigate the relationship between the single-leg up-down (SLUD) test and the weight bearing index (WBI). [Subjects and Methods] The subjects were 202 junior high school baseball players. They were divided into groups based on their scores in the SLUD test on the non-throwing side. Differences between the groups were investigated using one-way analysis of variance and multiple comparison analysis. [Results] The mean WBI of the SLUD test groups of 40, 30, 20, and 10 cm were 0.79 ± 0.18, 0.87 ± 0.20, 1.00 ± 0.19, and 1.04 ± 0.24, respectively. The 20- and 10-cm groups had higher WBI values than the 40- and 30-cm groups. [Conclusion] The results suggest that athletes need a WBI score of 1 or more, and that a SLUD test result of 20 cm may be a useful screening test for lower limb strength.

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[Purpose] This study investigated stress reactions and stress coping skills frequency, and their relationship during clinical training. [Subjects and Methods] The subjects were 88 fourth year students of two physical therapy vocational schools. Stress reactions and stress coping skills were surveyed during clinical training, and differences in the use of stress coping skills for the main stress reactions, as well as the strength of their correlations were investigated. [Results] In the main reactions to stress, the frequency of use of affirmative assessment and acceptance of responsibility type behaviors were significantly high. Regarding the relationships between general stress reactions and coping skills, significant positive correlations were found with confrontation, acceptance of responsibility, and avoidance type behaviors, and significant negative correlations were found with planning and affirmative assessment type behaviors. [Conclusion] The results suggest that negative coping strategies easily increase stress reactions, whereas positive coping strategies easily decrease them.

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[Purpose] This study investigated differences in respiratory function between female university students with and without recurrent non-specific low back pain. [Subjects and Methods] Seventeen female university students with non-specific chronic low back pain (LBP group) and 17 healthy female university students (healthy group) participated in this study. Forced vital capacity (FVC), percentage of predicted forced vital capacity (%FVC), maximal inspiratory and expiratory pressures, chest and abdominal wall mobility (breathing movement scale), and abdominal wall mobility during a leg raise were measured. [Results] FVC, %FVC, the scale values for the upper and lower chest wall mobility, and the scale values for abdominal wall mobility during a leg raise were significantly lower in the LBP group than in the healthy group. [Conclusion] The results suggest that non-specific chronic low back pain may be associated with decreased FVC related to chest and abdominal wall mobility of female university students.

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[Purpose] The purpose of this study was to investigate the brain mechanisms of body ownership through self-touch using the rubber hand illusion method. [Subjects and Methods] Twenty healthy individuals participated in this study. Using functional near-infrared spectroscopy, brain activity was measured under four conditions: 1) self-touch, 2) self rubber hand illusion (illusion induced by touching self with a rubber hand), 3) other-touch (touched by others), and 4) other rubber hand illusion (illusion induced by being touched by a rubber hand held by an experimenter). [Results] The premotor cortex was bilaterally activated under all the conditions. The supplementary motor cortex was only activated in Condition 2. [Conclusion] The results reveal that increase of body ownership due to self-touch is related to the activity of the supplementary motor area.

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[Purpose] To clarify the effects of short-duration static stretching on the strength and flexibility of the rectus femoris muscle. [Subjects and Methods] Thirty healthy young individuals who exercised less than two days per week participated in this study. The right legs of all the subjects were examined. Heel-buttock distance in the prone position, strain ratio measured by ultrasound elastography of the rectus femoris, and knee extension isometric strength were measured before and after 2, 4, 6, 8, 10, and 30 sec of static stretching. [Results] Heel-buttock distance was reduced after all of the stretching times. The strain ratio improved after 8, 10, and 30 sec stretching, and isometric strength decreased after 10 and 30 sec stretching. [Conclusion] These results indicate that muscle strength was preserved after 8 sec of static stretching and flexibility was improved.

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[Purpose] This study investigated differences in forefoot and hindfoot strike patterns on propulsion in running. [Subjects and Methods] The subjects were 18 healthy adults. Forefoot strike running (FR) and hindfoot strike running (HR) were measured using a 3D motion analysis system. [Results] In HR, forward transfer of the center of gravity in the stance phase was large, whereas it was large in the swing phase of FR. In HR, the vertical component of the ground reaction force (GRF) was large in the first half of the stance phase, and in FR, the vertical and anterior components of GFR were large in the latter half. In HR, a large torque was generated in the posterior direction in the first half of the stance phase. [Conclusion] It was found that in HR, forward propulsion was generated through reduction of the impact of heel strike, whereas in FR, it was generated by striking the ground hard.

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[Purpose] To examine the effects and challenges of education using problem-based learning (PBL) tutorial systems, as well as changes in students’ learning behavior. [Subjects and Methods] A free description-style questionnaire survey was conducted over 3 years, involving first to fourth-year students, and quantitative text analysis of their responses was performed. [Results] Through cluster analysis, factors, such as “active participation in PBL classes” and “the development of self-directed learning attitudes”, were extracted. In code analysis of each school year, fourth-year students showed an increase in the number of active attitude-related codes and self-learning-related codes. [Conclusion] Increases in students’ self-directed learning behavior and frequency of self-learning supported the effectiveness of PBL. Advanced-year students with a longer experience of PBL showed behavioral changes toward self-directed learning, suggesting the necessity of developing programs that promote such changes through the entire curriculum.

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[Purpose] To investigate the differences in muscle activities during bicycle ergometer in the supine (SE) and sitting (BE) positions. [Subjects and Methods] The subjects were 11 healthy males. Exercise loads during SE were 10, 20, 30, 43, and 75 W; and during BE were 10, 20, 30, 44, and 76 W. EMG activities of the vastus medialis, rectus femoris, biceps femoris, tibialis anterior, gastrocnemius, soleus, erector spinae and rectus abdominis were recorded. The maximum voluntary contraction (MVC) was used to normalize the recorded EMG activities (%MVC). [Results] As exercise load increased, %MVC also increased in both BE and SE. The %MVC for the tibialis anterior, vastus medialis and erector spinae were significantly lower in SE. [Conclusion] Both SE and BE may be useful as muscle strength training methods for the lower limb; however, the use of this training method for dialysis patients may need further investigation.

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[Purpose] We investigated whether ultrasonography can detect changes in the right and left sternocleidomastoid (SCM) and longus colli (LC) muscles between different loads in the craniocervical flexion test. [Subjects and Methods] The subjects were 12 male and 12 female healthy adults. Still images of the subjects at rest, and at 5 different loads in the craniocervical flexion test, were captured by ultrasonography. The thicknesses of SCM and LC, and the cross-sectional area of LC were measured on the images. [Results] The cross-sectional area of LC on the non-dominant side showed a large value compared with that on the dominant side. In the craniocervical flexion test, the cross-sectional areas of both the right and left LC showed significant increases at loads greater than the intermediate level. [Conclusion] Changes in LC muscle activity can be verified on ultrasonography images, suggesting its usefulness as a test feedback method.

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[Purpose] The purpose of this study was to clarify the relationship between gait ability improvement and physical factors after botulinum treatment and physical therapy. [Subjects and Methods] The subjects were 41 chronic hemiparetic stroke patients with lower limb extensor spasticity. Depending on their cases, BoNT-A injections of 300 units were given to the gastrocnemius, soleus, tibialis posterior, flexor digitorum longus, and/or flexor hallucis longus. Physical therapy was conducted for 4 weeks from the day after the injection. Pearson and Spearman correlation coefficients were used to examine the relationships between the gait-speed improvement rate after the intervention and the items measured before the intervention. [Results] No significant correlations were found between the gait-speed improvement rate and age, weight, or degree of paralysis, but there were significant correlations between the gait-speed improvement rate and MAS, BBS, gait speed, and gait type. [Conclusions] These results suggest that the combination of botulinum treatment and physical therapy improves the gait speed irrespective of age, weight, or degree of paralysis, and that its efficacy is higher in patients with severe spasticity and poor gait ability.

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[Purpose] To investigate the reliability and validity of a toe-grip measurement method using a hand dynamometer, and to examine its usefulness. [Subjects and Methods] The subjects were 9 elderly rehabilitation out-patients. Using a hand dynamometer and a commercial measuring instrument toe-grip strength meter, toe-grip strength was measured, as well as muscle activities at the time of the measurements. The reliability and correlation of the two methods were compared, as well as the the toe-grip strengths, and muscle activities of the anterior tibialis, soleus, and abductor hallucis. [Results] The intra-rater reliabilities of both methods were good. A high correlation was found between the two measurement methods of toe-grip strength, and no differences were found in any of the muscle activities of the two methods. [Conclusion] The toe-grip strength measurement method using a hand dynamometer has high reproducibility and validity, but care is needed since the values obtained with the commercial toe-grip strength meter were different.

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[Purpose] We developed “restorative exercises for cough capacity” that mainly focuses on trunk function. The purpose of this study was to evaluate the specificity of trunk muscle activities during the exercises. [Subjects and Methods] The subjects were 8 healthy volunteers. The exercises were performed while sitting in a chair, and consisted of three types of exercise: chest expansion exercise (four types), spinal extension exercise (seven types), and abdominal wall muscle facilitative exercise (seven types). Oxygen consumption, tidal volume, and electromyography of the abdominal muscles were measured during the exercises. [Results] For the whole exercise, the metabolic equivalent and tidal volume were 1.6 ± 0.8 METs and 1,338.0 ± 610.8 ml, respectively. Furthermore, the total time of active internal abdominal oblique muscle use was significantly greater than those of the other muscles. [Conclusion] The exercises have low exercise intensity and increased the activity of the internal oblique muscle taking part in expiration during voluntary cough. Therefore, this particular exercise program can be expected to enhance the cough capacity of the elderly.

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[Purpose] This study examined the effects of functional socks for female students with hallux valgus. [Subjects and Methods] Fourteen subjects (26 legs) with a hallux valgus angle of 15° or greater were divided into 2 groups for comparison: exercise + socks: 7 subjects (13 legs); and exercise-only: 7 subjects (13 legs). Physical alignment, the range of motion, ankle range of motion and foot muscle strength were measured, as well as the duration of the stance phase and its COP path length, and ground reaction force during walking. [Results] The exercise + socks group showed reduced vertical force at push-off and reduction in the hallux valgus angle when walking. [Conclusion] The functional socks for hallux valgus enhanced the effect of exercise therapy, and exercise therapy reduced the stress on the big toe when walking. The combination of socks with exercise therapy was highly effective for hallux valgus.

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[Purpose] The relationships of agility with the muscles surrounding the knee joint were investigated. [Subjects and Methods] We measured the agility of 12 healthy adults using the Ten Step Test (TST), and investigated its correlations with maximum torque and the amount of work done while measuring isokinetic knee joint flexion and extension strengths at angular velocities of 60, 180, and 300 deg/s. [Results] Significant negative correlations were found between TST and the maximum torque of the low speed range, and the full speed range of the amount of work. [Conclusion] The results suggest that TST is a measure of agility, and is related to the low speed range maximum torque of the dominant leg, and contraction endurance.

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[Purpose] The aim of this study was to clarify the factors affecting the health-related quality of life (QOL) of knee osteoarthritis patients. [Subjects and Methods] The subjects were 115 knee osteoarthritis patients. Health-related QOL, JOA scores, subjective severity, and satisfaction with the surrounding environment, hobby activities, and family relationships, as well as economic condition, optimism index, age, gender, and the presence or absence of other joint diseases were surveyed in interviews. [Results] The four variables determined to be significant in multiple regression analysis of the SF-8 score were the JOA score, subjective severity, satisfaction with the surrounding environment and hobby activities. [Conclusion] The results suggest that when the objective and subjective severity of elderly knee osteoarthritis patients is low, and their satisfaction with the surrounding environment and hobby activities is high, their health-related QOL is also high.

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[Purpose] The purpose of this study was to investigate differences in functional physical characteristics dependent on golf performance and age. [Subjects and Methods] Forty-six golfers participated in this study. The subjects were assigned to four groups depending on their golf performance and age. The physical characteristics of the subjects were assessed using the index developed by the authors based on functional movement screen (FMS). [Results] The results show that the group of young males with a low handicap had a significantly higher FMS score than the other groups. However, no significant differences were found in the total scores among the other groups. [Conclusion] The results indicate that young males with low handicaps possess superior physical characteristics for golf play.

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[Purpose] The aim of this study was to elucidate the effect of a transient 2-minute tightrope walking exercise on the tightrope walking distance, total locus length, unit locus length, unit area locus length, and environmental area. [Subjects and Methods] The subjects were 12 males. For the balance exercise, a 4-m-long tightrope was set at a height of 30 cm and the setup was tested by a 2-min barefoot traverse of the tightrope to ensure that there was no chance of slipping. A stabilometer was used to assess balance via postural sway parameters of two- and one-legged standing over 15 sec with the eyes open and closed. [Results] After the exercise, the total locus length and locus length per unit area of one-legged standing on the right foot with both the eyes open and closed significantly decreased. For the left foot, total locus length and locus length per unit area significantly decreased for the eyes open condition, while the perimeter of the locus area significantly increased. [Conclusion] The tightrope walking exercise affected the static balance of one-legged standing.

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[Purpose] To determine the validity of the multistage incremental chair stand exercise test as an assessment tool for exercise tolerance, and to determine its suitability for different age groups. [Subjects and Methods] Eighty healthy male subjects (aged 19–80 years). Subjects performed the multistage incremental chair stand exercise test, during which the volume of expired gas and blood pressure was measured continuously. We analyzed the relationships of measured maximal VO₂ with predicted maximal VO₂ and the maximal values obtained using a bicycle ergometer. Each indicator was compared among the age groups. [Results] For subjects aged 30–50 years, measured maximal oxygen uptake and predicted maximal oxygen uptake were strongly positively correlated. No such correlation was observed in subjects aged ≥60 years. For the subjects aged 19–24 years, the maximum metabolic equivalent and all other indicators were significantly high. [Conclusion] The multistage incremental chair stand exercise test is not a suitable substitute for exercise tolerance testing using a bicycle ergometer for individuals aged ≥60 years.

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[Purpose] The area of the foot that comes into contact with the ground differs between normal feet and flatfeet. In this study, we examined whether being flatfooted influences plantar perception. [Subjects and Methods] The subjects were 43 young adults (22 with normal arches and 21 with flatfeet). One researcher measured the plantar pressure perception threshold value of each of the subjects. The differences in the plantar pressure perception threshold value between the different areas of the foot were examined using Student’s t-test and the Mann-Whitney U test. [Results] The perception threshold of the hypothenar eminence was lower in subjects with flatfeet than in those with normal arches. [Conclusion] The results reveal that the hypothenar eminence may have a lower load and the lowest perception threshold value in subjects with flatfeet.

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[Purpose] This study examined the characteristics of activities of daily living (ADL) according to the difficulty of individual component movements of older adults in long-term care facilities who required physical care. [Subjects and Methods] In total, 111 older adults requiring long-term care in hospitals or nursing home were enrolled in this study. Four activities, namely eating, toileting, transfers, and locomotion, were assessed using a previously developed assessment instrument. The instrument assesses 141 individual component movements, which are subdivisions of the four activities. The difficulty of each component was determined using a three-point scale, and the difficulties among the four activities were compared. In addition, the component movements were categorized hierarchically according to their difficulty levels in order to evaluate their characteristics. [Results] Eating was significantly easier than the other activities. Movements categorized in the “high difficulty” category required antigravity functions and standing balance. [Conclusion] Differences in the difficulties in ADL in older adults in long-term care facilities existed not only among the four activities but also within each activity.

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[Purpose] Heel raise repetitions and the maximum step length of elderly subjects were compared, and their differences as indices of fall history were investigated. [Subjects and Methods] The subjects were 80 persons over 65 years of age who could walk independently. The number of heel raises performed in 10 seconds, and the maximum step length, the greatest possible forward step distance, were measured and compared between subjects with and without a history of falls. [Results] The number of heel raises and maximum step length of the falls group were significantly less than those of the no-falls group, and their correlation coefficient was r=0.539. Also, the cutoff value for heel raises between the falls and no-falls groups was 10.5 (sensitivity, 80.9%; specificity, 72.7%). [Conclusion] The results show that the heel raise number correlated well with maximum step length, and because it was significantly lower in the falls group, there is a possibility that it is a useful predictor of falls.

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[Purpose] Initial contact position education was given using projections attached to the heel, and its effect on crural muscle activities was investigated. [Subjects and Methods] The subjects were 12 healthy adults. Crural muscle activity of the swing phase was compared among walking without and with projections attached to the inside, outside, and rear of the heel to enhance awareness of the initial contact position during walking. [Results] Compared to walking without projections, the muscle activities of the tibialis anterior and peroneus longus were significantly increased during walking with projections. In comparisons of 20 equal divisions of the swing phase, no significant differences were found between any of the divisions, nor between any of the muscles. [Conclusion] The results show that, in order to plant a specific part of the heel, the dynamics of the foot were anticipatively controlled by the projections, suggesting their potential use in cognitive training.

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[Purpose] To newly develop a training report with clear statements of educational goals and proficiency standards for shared use between physical therapy schools and clinical training facilities, aiming to resolve the problems of the poor objectivity and uniformity of conventional clinical training assessments of trainee physical therapists. [Subjects and Methods] The newly developed training report for use in long-term clinical education. A new rubric was constructed using the concept of performance assessment based on objective assessments of students abilities and the very subjective conventional assessments of instructors. [Results] The new rubric clearly states the evaluation bases and educational goals of the physical therapy school. [Conclusion] The new rubric is an innovative tool for education which has wide-ranging possibilities, as it could be used for the evaluation of new hire programs and personal evaluations as well as clinical education.

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[Purpose] The purpose of this case study was to clarify whether cardiac-locomotor synchronization had clinical significance for a patient with peripheral circulatory disturbance. [Subjects and Methods] One patient with arteriosclerosis obliterans presenting with intermittent claudication was the subject of this case study. The subject walked, paced by heart beat and at three different rhythms on a treadmill. The extent of ischemia in the lower limbs was estimated using local tissue oxygen saturation on the affected posterior surface of the legs. [Results] The local tissue oxygen saturation during walking paced by heart beat was the highest. [Conclusion] This result suggests that cardiac-locomotor synchronization has a positive effect on peripheral circulation in patients with arteriosclerosis obliterans.

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[Purpose] To verify the effect of intradialytic supine ergometer exercise, and to investigate the association of the arteriosclerosis index with physical motor function. [Subjects and Methods] The subjects were 7 patients visiting an outpatient hemodialysis center. The intervention was intradialytic supine ergometer exercise, performed on a bed, and it lasted for 3 months. The exercise intensity began at a low intensity target heart rate of 30% of the maximum calculated by the Karvonen formula and was adjusted by load. [Results] The 6-minute walking distance became longer after the intervention. [Conclusion] The results suggest that gait function was improved by intradialytic exercise. However, adjusting the exercise intensity load was difficult because of the occurrence of early local fatigue. It was thought that a new quantitative exercise prescription is necessary rather than load adjustment.

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