[Purpose] To clarify the effects on muscle tonus and joint range of motion of lying on a cushion made of microbeads, and to compare them with lying on a normal bed. [Subjects and Methods] Nine hemiplegic stroke patients, aged 52 to 84, in the recovery phase. The joint range of motion, muscle tonus, and the muscle hardness of the upper trapezius were measured before and after the subjects lay supine on the microbead cushion and a bed for 20 minutes, and the changes and magnitude of changes were statistically analyzed using the t test, and their differences between the two conditions were compared. [Results] After lying on the microbead cushion, significant differences were observed in the paretic side elbow flexion and the angle of cervical rotation to the left. Muscle tonus and hardness were reduced in many cases. [Conclusion] The results suggest that, for stroke patients, the microbead cushion elicits an increase in joint range of motion and decreases in muscle tonus and hardness.

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[Purpose] The validity of a joint position sense test method for the elbow joint using a smartphone inclinometer application was examined and compared with conventional goniometry. [Subjects and Methods] The examiners were 3 physical therapists, and the tested subjects were 10 healthy young males. The reliability of the inclinometer was tested by analyzing values measured by the 3 examiners of the elbow joint and a stationary object with an inclination of 30 degrees. The validity of the joint position sense test results obtained using the smartphone was analyzed in a comparison with measurements obtained using a goniometer. [Results] No significant inter-rater differences were found among the measured values. The comparison of the smartphone values with the goniometry measurements showed there was a strong correlation between the two methods. [Conclusion] Because the sense of joint position can be measured using a smartphone, it may have a wide range of practical applications in the future.

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[Purpose] The purpose of this study was to assess the practical use of a prototype cane which quantitatively measures loads using a strain gauge. [Subjects] Ten healthy adults were recruited. [Methods] The reliability of the load-measuring cane was assessed using a universal testing machine. For the practical use assessment, cane loads during gait were measured and analyzed using the intraclass correlation coefficient (ICC). [Results] The correlation between the output voltage of the load measuring cane and the load measured by the universal testing machine was excellent (r=0.99~1.00). The hysteresis measurement error was within 2-5%. In addition, the ICC of the healthy subjects exceeded 0.8. These results indicate the load-measuring cane has excellent reliability. [Conclusion] The load-measuring cane is simple and inexpensive and it may become a useful clinical assessment device.

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[Purpose] To derive an equation estimating the appendicular muscle mass of elderly inpatients from the maximum calf circumference (CLFmax). [Subjects and Methods] One hundred one elderly inpatients: 57 males, 44 females, aged 74.8 ± 5.1 years. A multiple regression model with the appendicular muscle mass determined by dual-energy X-ray absorptiometry as the dependent variable, and independent variables of gender, BMI, and CLFmax was used to derive a regression equation estimating the appendicular muscle mass. [Results] According to the regression model, the inputs of gender, BMI and CLFmax could explain 80% of the appendicular muscle mass. [Conclusion] This simple estimation formula for appendicular muscle mass, using CLFmax as an index, potentially has widespread applications as an assessment tool in clinical practice for elderly inpatients.

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[Purpose] Comprehension of hemodynamics during dynamic exercise is clinically important. The purpose of this study was to investigate changes in participants’ baroreceptor reflex sensitivity (BRS) at three reclining angles during rest and dynamic exercise. [Subjects and Methods] The participants were 14 sedentary healthy males with a mean age of 20.8 years, mean body mass of 64.5 kg, mean height of 171.1 cm, and a body mass index of 22.0 kg/m². The reclining angles were 20°, 45° and 70°, and the change in BRS was measured until the anaerobic threshold (AT) was reached. [Results] During rest, BRS at a reclining angle of 70° showed a significant decrease compared to that at 20°. During dynamic exercise performed at the three reclining angles BRS showed no change until AT. [Conclusion] Lower BRS during rest may depend on the reclining angle. Reclining angle may not affect BRS during dynamic exercise until AT is reached.

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[Purpose] The purpose of this study was to clarify the recomendable activities for post-stroke patients. [Subjects and Methods] A survey of 60 stroke patients living at home was conducted by post. The questionnaire comprised 21 questions on activity, psychological adjustment to disability, and quality of life. [Results] The results of cluster analysis divided patients into three types: diverse activity, low activity, and functional recovery specialist types. The diverse activity subjects had the highest scores for the factors of acceptance of psychological adjustment to disability, and feelings of self-efficacy, as well as quality of life. Compared to the low activity subjects, the functional recovery specialist subjects had higher scores for the factors of acceptance of psychological adjustment to disability, and feelings of self-efficacy. [Conclusion] The results suggest that, when providing support encouraging greater activity, with objective of improving quality of life, it is important to encourage the performance of some activities for low activity type subjects, and the performance of activities other than those related to functional recovery for functional recovery specialist type subjects.

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[Purpose] To clarify the changes in body sway of elderly subjects with chronic low back pain induced by the application of local vibratory stimulus. [Subjects and Methods] Twenty-eight elderly subjects with chronic low back pain who had been hospitalized for lumbar disorders. Postural sway was measured with vibration applied to the left and right gastrocnemius and paraspinal muscles of 30, 60, and 240 Hz. center of pressure (COP) was compared among the frequencies, and the relationships of COP, pain measured on a visual analog scale (VAS), spinal muscle strength, and the cross-sectional area of the paraspinal muscles at each frequency were investigated. [Results] At 240 Hz vibration applied to the paraspinal muscles, COP postural control was shown only in anterior movement. VAS and spinal muscle strength showed moderate correlations with COP at vibrations applied to the paraspinal muscles of 60 Hz and 240 Hz, respectively. [Conclusion] With respect to trunk proprioception, it is necessary to perform assessments using various proprioceptive stimuli.

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[Purpose] To investigate the possibility of studying via e-learning, through analysis of the correlations among internet literacy and experience of e-learning via implementation of the national examination format e-learning initiative. [Subjects and Methods] Second- and third-year physical therapy students. The learning effect was analyzed using academic assessments of before and after e-learning, and groups with and without experience of e-learning in a two-factor mixed-design analysis of variance. The correlation between the level of internet literacy and the e-learning result was also investigated. [Results] The mean scores of 2nd- and 3rd-year students rose after the implementation of the e-learning. In the analysis of variance of the 2nd-year students, a main effect of the intra-examinee factor was found, and the interaction effect was significant. [Conclusion] It is considered that the learning effect of the e-learning initiative is high among the 2nd-year students.

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[Purpose] This study examined the kinematic characteristics of the stand-to-sit (STS) motion of patients with lumbar canal stenosis (LCS). [Subjects and Methods] The subjects were 24 patients with LCS and 18 age-matched asymptomatic controls. Kinematic data of STS motion was analyzed using video images collected by a digital video camera. [Results] In the downward phase, knee flexion movement of the LCS subjects was significantly smaller than that of the controls, and acceleration and deceleration of trunk and hip joint angles of the LCS subjects alternated more often. In the backward phase, shift of center of mass (COM) and posterior tilt angle of the pelvis of the LCS subjects were significantly larger than those of the controls, and acceleration and deceleration of knee joint angle of the LCS subjects alternated more often. [Conclusion] These findings suggest that LCS patients lack coordination of the trunk and lower limbs in the downward phase. In the backward phase, the magnitudes of the backward shift of COM and backward tilt of the pelvis were large, suggesting that the LCS subjects used a strategy requiring more knee extension power.

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[Purpose] The purpose of this study was to describe the scapulohumeral rhythm of young and elderly subjects during shoulder abduction in order to elucidate the effects of aging. [Subjects and Methods] The subjects were 21 young and 17 elderly males. Shoulder abduction was measured using a three-dimensional motion analysis system. We conducted three-dimensional kinematic measurements of the scapula. [Results] The average overall scapulohumeral rhythm was 3.5:1 in the young, and 4.4:1 in the elderly. [Conclusion] The present study determined the difference due to aging in scapulohumeral rhythm. The results of this study provide important knowledge that can be used in the field of physiotherapy.

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[Purpose] The purpose of the study was to assess whether physical activity (PA) is associated with health-related quality of life (HRQOL) in adult survivors of aggressive non-Hodgkin lymphoma (NHL). [Subjects and Methods] This study included 100 outpatients with NHL (median age 65.0 years; 6 months to 8 years after diagnosis) at an urban university hospital. Multiple regression analysis was performed to assess the association between PA and HRQOL obtained via a self-administered questionnaire. [Results] HRQOL was positively associated with PA, but not with mental health. [Conclusion] The results suggest that PA may enhance HRQOL of adult survivors of NHL.

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[Purpose] The purpose of this study was to clarify the relationship between exercise tolerance and health-related quality of life (HRQOL), determined by the 36-Item Short-Form Health Survey (SF-36), in lung cancer patients during the the perioperative period. [Subjects and Methods] Thirty-one patients scheduled to undergo lung cancer resection were enrolled. The patients’ results in the 6-minute walk test (6MWT), for exercise tolerance, and the SF-36, for HRQOL, were evaluated before and after lung resection surgery. The relationship between exercise tolerance and HRQOL was then retrospectively analyzed. [Results] Values of physical functioning, role physical, role emotional, bodily pain, vitality, and social functioning were lower after surgery. Furthermore, exercise tolerance was found to be correlated with physical functioning, general health, and the physical component summary. [Conclusion] 6MWT was shown to correlate with the summary of the physical component in lung cancer patients during the perioperative period.

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[Purpose] This paper identifies problems in the implementation of flipped classrooms in the field of physical therapy, examines measures to resolve these problems, and evaluates the pedagogical approach. [Subjects and Methods] The participants were 99 second-year students enrolled in the General Theory of Kinesiology at the Department of Physical Therapy, School of Health Sciences, the International University of Health and Welfare. After each preparatory video lecture, the students completed a questionnaire assessing their understanding and opinions of the video. In addition, the students answered free-response questions regarding their evaluations, opinions, and impressions of the classes. [Results] The survey responses indicated a high understanding and positive evaluations of the preparatory video lectures. No significant difference in class evaluation was found between the flipped classroom and traditional teaching methods. [Conclusion] Problems arising during implementation of the flipped classroom method were handled appropriately, and the method was introduced smoothly.

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[Purpose] The aim of this study was to examine the validity of an image analysis freeware for calculating physical angles in two dimensions. [Subjects and Methods] Eleven young adults (5 males, 6 females) analyzed a moving image while performing the sit-to-stand movement using image analysis freeware in order to estimate hip flexion, knee flexion and ankle dorsiflexion angles. The time and subjective fatigue of the task were measured. The angles estimated using the image analysis freeware were compared with the angles calculated using motion analysis share software. [Results] The average time spent analyzing 115 images was approximately 20 minutes, and the subjective fatigue degree was approximately 30 mm on a visual analog scale. The differences in the maximum values of joint angles between the two methods were 0.12 ± 0.25° for the hip joint, 0.14 ± 0.30° for the knee joint, and 1.02±0.38° for the ankle joint. [Conclusion] The results of this study indicate that this image analysis freeware is a useful tool for simple motion analysis.

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[Purpose] In recent years, from the viewpoint of medical education reform, the implementation of competency diagnosis, as an assessment method of specialists’ practical abilities, has garnered attention, and this study investigated whether competency shows different characteristics depending on the examinees’ duty domains. [Subjects and Methods] The subjects were 150 physical therapists (age, 35.1 ± 7.3 years; clinical experience, 11.6 ± 6.8 years) with 5 or more years of clinical experience who were working at 18 facilities in 8 prefectures. An examination of their competency in basic societal skills was conducted via the internet, and the characteristics of 5 professional duty domains were compared. [Results] There were significant differences in “ability to respond to requests,” and “ability to act competently” between the acute stage and at-home stage duty domains, and in “ability to act independently” between the convalescent stage and educational institution duty domains. [Conclusion] Differences appeared in the characteristics of the work required according to the type of institution and work. This diagnostic method is very versatile, and its use in competency and attitude appraisals is anticipated.

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[Purpose] To clarify the effects of wearing compression wear on oxygen uptake and heart rate. [Subjects and Methods] The subjects consisted of 26 healthy men. Cardiopulmonary exercise testing was carried out while the subjects used a treadmill, and oxygen uptake, heart rate, the respiratory exchange ratio, and respiratory rate were measured under two conditions of not wearing any clothing and wearing compression wear. [Results] The heart rates (beats/min) prior to, during, and following the cardiopulmonary exercise testing were 84.4 ± 11.8, 156.9 ± 12.3, and 110.2 ± 22.1, respectively, in the naked group and 81.2 ± 11.9, 151.7 ± 14.7, and 102.0 ± 10.4, respectively, in the compression wear group, with a significantly lower rate observed in the latter group. No significant difference was observed between the wearing conditions in terms of oxygen uptake, respiratory exchange ratio, or respiratory rate. [Conclusion] Compression wear was found not to affect oxygen uptake; however, it decreased the heart rate during exercise.

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[Purpose] To develop a short form of the Simple Test for Evaluating Hand Function (STEF), to evaluate upper-extremity function while sitting in a wheelchair. [Subjects and Methods] Fifty-one healthy adults. The subjects underwent 10 STEF subtests while sitting in a wheelchair. With the time needed to complete each subtest as a variable, principal component analysis was performed to extract subtests showing greater principal component loadings, to identify components for the short form. [Results] Short forms, consisting of 4 (small cubes, large balls, medium cubes, and pins) and 5 (small cubes, large balls, medium cubes, wooden disks, and pins) of the 10 STEF tests showed high levels of internal consistency. The total time to complete the short form significantly correlated with that needed to complete the 10 tests. [Conclusion] The short form of the STEF was confirmed to have sufficient internal consistency and concurrent validity.

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[Purpose] The purpose of this study was to validate a method for analyzing gait patterns determined by the center of mass (CoM) using an accelerometer. [Subjects and Methods] A tri-axial accelerometer was attached to the lower back of 11 healthy young males. Vertical and lateral CoM displacement were assessed using the accelerometer and a 3D motion capture system under 8 different walking conditions. The validity of the accelerometer-based CoM was evaluated by comparison with the motion capture-based CoM using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. [Results] ICCs corresponding to inter-rater reliability were good-to-excellent for vertical CoM displacement (0.73-0.94) and fair-to-good for lateral CoM displacement (0.31-0.71). However, Bland-Altman analysis revealed systematic bias, in which accelerometer-based CoM was overestimated. [Conclusion] The motion of the CoM measured by this accelerometer fixed to the trunk can be used for simplified analysis of human locomotion. The results demonstrate the great potential in clinical practice of accelerometry as a user-friendly, cost-effective and valid gait analysis tool.

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[Purpose] To determine a method which preferentially trains the gluteus minimus over the the gluteus medius, from the muscle activities of isotonic abduction exercise. [Subjects and Methods] The subjects were 14 healthy adults. Fine wire electrodes were implanted in the gluteus minimus and gluteus medius, and the integrated EMG values and average frequencies of isotonic abduction exercise at loads of 20%, 40%, and 60% of maximum muscle strength were calculated. [Results] At all of the exercise loads, the muscle activity of the gluteus minimus was greater than that of the gluteus medius, and the muscle activity ratio (g. minimus/g. medius) was highest at the load of 20% maximum muscle strength. No difference among the loads was found for average frequency. [Conclusion] For preferential training of the gluteus minimus over the gluteus medius in isotonic abduction exercise, a low load is best.

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[Purpose] The purpose of this study was to clarify the short-term effects of a repetitive cross-over step training for postural stability and postural strategies during one-leg standing. [Subjects and Methods] Fourteen healthy young adults participated in this study. In the test sessions before and after training, subjects maintained one-leg standing for up to 15 sec. In the training session, each subject repeatedly practiced the cross-over step in 100 trials. The distance from the center of pressure (COP) to the body’s center of mass (COM) (COP-COM distance), and the body weight distribution and COP change mechanisms were evaluated to determine the effects of the practice. [Results] The results showed that the COP-COM distance during one-leg standing had shortened, together with increase of the body weight distribution mechanism in the acceleration phase and of COP-change mechanism in the deceleration phase after the practice. [Conclusion] Repetitive cross-over stepping changes postural strategies, improving postural stability during one-leg standing by reducing the COP-COM distance.

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[Purpose] To evaluate the severity of hemiparesis at which mirror therapy (MT) becomes effective for upper-extremity motor recovery of stroke patients. [Subjects and Methods] Fourteen convalescent stroke patients were randomly assigned to the MT group or control group, and the differences of the effect of MT on upper-extremity motor function between the patients who could not actively extend their fingers [(-) group] and those who could actively extend their fingers [(+) group] at pretreatment were investigated. [Results] In the (+) group, the finger motor function improved more in the MT group than in the control group. However, no significant differences were found in the motor function of the MT and control groups in the (-) group. [Conclusion] These results suggest that MT is effective for finger motor function of stroke patients who can actively extend the finger.

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[Purpose] This study investigated whether the four-square step test (FSST) can predict falls among community-dwelling frail elderly subjects. [Subjects and Methods] The subjects were 42 community-dwelling frail elderly persons (mean age: 77.3 ± 6.4 years, range: 65-94 years; 17 men) who visited a geriatric health service facility. The FSST data were prospectively collected and scored by an experienced physical therapist. The outcome measure was the occurrence of falls during a 6-month follow-up after the baseline assessment. The sensitivity, specificity, and positive and negative likelihood ratios were calculated for the FSST scores. [Results] Falls were observed for 19.4% of the subjects. The FSST scores significantly correlated with gait speed and other dynamic balance outcomes, but not with the occurrence of falls. Based on the 15-s cut-off score, the sensitivity, specificity, positive and negative likelihood ratios were 50.0%, 25.0%, 1.04, and 0.96, respectively. [Conclusion] The FSST does not accurately predict future falls among community-dwelling frail elderly people. A limitation of this study was its small sample size, which limits the generalizability of the findings.

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[Purpose] To clarify the trends in the use of assessment indices for the community-dwelling elderly in physical therapy research in Japan. [Subjects and Methods] The assessment indices used for the community-dwelling elderly and the frequency of their appearances in the academic journals, Rigakuryoho Kagaku and Physical Therapy Japan, in the 3 years from Jan. 2012 to Dec. 2014 were surveyed. [Results] Assessment indices such as the timed up-and-go test and physical frailty test which are recommended in the Physical Therapy Practice Guideline occupied the top rankings. The assessment indices identified in this survey had reliability and validity, and many used interval or proportional scales. [Conclusion] Based on these results, we would like to investigate which assessment indices are useful in community physical therapy.

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[Purpose] To clarify the levels of satisfaction with study and life according to route of college entry, type of college commute, and gender. [Subjects and Methods] One hundred three students (51 males, 52 females) who entered the International University of Health and Welfare in 2014, who gave their consent to participation. At the end of the first semester, end of July 2014, satisfaction with study and life were assessed using a visual analogue scale, and the results were compared among college entry routes, type of college commute, and gender. [Results] For both males and females, satisfaction with study scored about 65 points, and satisfaction with campus life was higher at about 70 points. There were no significant differences among college entry routes, but females commuting from home reported significantly higher satisfaction with study than those living alone. [Conclusion] Levels of satisfaction with both study and life were high, and levels of satisfaction with study were higher among female students commuting from home.

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[Purpose] The purpose of this study was to investigate the safety and efficacy of belt-electrode skeletal muscle electrical stimulation (B-SES) for a patient with malignant lymphoma complicated by paraparesis who was undergoing chemotherapy. [Subjects and Methods] A septuagenarian male with malignant lymphoma complicated by paraparesis was recruited for this study. Physical therapy was performed using B-SES (20 mins/day, 6 days/week) and muscle thickness was measured using ultrasonography. Adverse events were assessed using the Common Terminology Criteria for Adverse Events (CTCAE). The muscle thickness, CTCAE, and ASIA score assessments were performed at 1, 5, and 10 weeks after chemotherapy. [Results] The muscle thickness was thicker than at week 1 at weeks 5 and 10. CTCAE showed no change between 1, 5, and 10 weeks. [Conclusion] The results suggest that B-SES is able to prevent muscle atrophy and can be safely used for patients with malignant lymphoma complicated by paraparesis who are undergoing chemotherapy.

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