[Purpose] The present study examined the electromyographic onset of the lumbar multifidus during shoulder flexion and extension and investigated the influence of standing position with different pelvic alignments in the frontal plane before arm movement. [Subjects and Methods] Intramuscular and surface electrodes recorded the electromyographic onset of the deep fibers of the lumbar multifidus (DM), and the superficial fibers of the multifidus (SM), anterior deltoid and posterior deltoid. Nine healthy participants performed rapid, unilateral shoulder flexion in response to audio stimuli in three standing positions: quiet standing, left pelvis dropped position, and left pelvis raised position. [Results] Repeated two-way analysis of variance found that the main effect of the standing position was significant when shoulder flexion was performed. No interaction was detected between standing position and muscles. [Conclusion] These results suggest that the electromyographic onsets of DM and SM are influenced by standing position with different pelvic alignments in the frontal position.

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[Purpose] We conducted a survey of students and clinical educators’ perceptions of difficulty regarding the assessment of skills in physical therapy, to clarify points of agreement and disagreement, in order to facilitate the provision of clinical practice education. [Subjects and Methods] Sixty-eight students, who had just completed clinical practice assessments, and 43 clinical educators were surveyed about subjective perceptions of difficulty regarding the 27 items of the physical therapy assessment. [Results] Motion analysis, integration and interpretation, and identifying the problem were reported to be ‘difficult’ by most of the students and clinical educators, with a stronger tendency shown by students. [Conclusion] Because there are some skill items which both students and clinical educators indicated difficult, and some which most of the students indicated difficult, it will be necessary to investigate factors affecting perceptions of difficulty.

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[Purpose] The purpose of this study was to investigate the time course of knee extension lag (Lag) up to 3 months after total knee arthroplasty (TKA) to clarify its relationship with preoperative knee extension range of motion (ROM). [Subjects and Methods] The subjects were 22 patients diagnosed as having bilateral varus knee osteoarthritis who received primary TKA. Lag was measured at 1, 2, 3 and 4 weeks, and 3 months after TKA. Hierarchical multiple regression analysis was performed using Lag at 3 months post-TKA as the objective variable, and the preoperative values of the operated-side knee pain, bilateral knee flexion and extension ROM, and bilateral femoral-tibial angles as the explanatory variables. [Result] Lag of more than 5° was found in 19 (86.4%) patients at 1 week, and 9 (40.9%) patients at 3 months post-TKA. The preoperative operated-side knee extension ROM significantly contributed to Lag at 3 months post-TKA. [Conclusion] The results suggest that preoperative operated-side knee extension ROM is related to Lag at 3 months post-TKA.

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[Purpose] To clarify the effect of lower leg rotation on knee joint extension torque and work load in knee extension exercise. [Subjects and Methods] The subjects were 20 healthy male adults. Knee extension torque was measured using a Biodex System 3. Maximum isokinetic knee extension exercise was performed from knee flexion of 90 to 30° at angular velocities of 60, 180 and 300°/sec. The value, time and angle of peak torque, and the initial and final work loads were compared among the neutral, and externally and internally rotated positions of the lower leg. [Results] At an angular velocity of 60°/sec, the neutral position elicited significantly greater average values of peak torque, and both the initial and final work loads than either the externally or internally rotated leg positions. [Conclusion] These results suggest that strengthening knee extension torque with the lower leg internally and externally rotated might help to prevent injury.

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[Purpose] A review was conducted to study the effects of physical exercise by patients with lung and colorectal cancer. [Subjects and Methods] The authors searched PubMed, PEDro, and CINAHL up to April 24th 2013. Two authors independently extracted the data. [Results] Twenty-nine trials were systematically reviewed. The results suggest that exercise is effective at improving the cardiorespiratory fitness and quality of life of the patients with lung and colorectal cancer. [Conclusion] This analysis helps describe the characteristics of cancer rehabilitation programs which can increase cancer patients’ cardiorespiratory fitness and quality of life.

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[Purpose] The purpose of this study was to examine the prognosis of independent walking and the actual rate of independent walking among patients transferred from a general hospital to a psychiatric hospital due to difficulties with their rehabilitation. We also investigated the effectiveness of placement of physical therapists in psychiatric hospitals. [Subjects and Methods] The subjects were 87 patients who received post-operative rehabilitation for femoral neck fracture at Hirakawa Hospital in a period covering seven years and three months. Walking ability was investigated using multiple regression analysis with basic information such as patients’ ages and diagnoses. The walking ability predicted on the basis of the multiple regression analysis in combination with that based on the initial FIM was also investigated. [Results] Among patients who could walk before fracture, 45.5% were able to walk again. When the predictions of multiple regression and FIM were in agreement, the correct prediction rate was 87.5%. [Conclusion] Since the percentage of correct predictions was relatively high, we consider this method to be useful.

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[Purpose] The purpose of this study was to clarify the effects of physical therapists’ ways of communicating to motivate patients. [Subjects and Methods] The subjects were 37 inpatients (17 males, 20 females, aged 69.9 ± 12.6). We investigated and compared the effects of positive phrases with those of negative phrases, by survey, in the three situations: using the toilet, walking, and experience of pain. [Results] The results suggest that positive phrases used in the three situations were effective at increasing patients’ motivation, whereas negative phrases were not. [Conclusion] Physical therapists who encouraged patients with positive phrases effectively increased their motivation.

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[Purpose] To compare the shoulder functions of the pitching and non-pitching sides of patients with throwing shoulder injuries. [Subjects and Methods] The subjects were 44 male baseball players. Scapulohumeral and scapulothoracic shoulder-joint functions (7 ROM items, 13 strength measures) of the pitching and non-pitching sides were compared. [Results] On the pitching side, the retroversion angle of the humeral head and the secondary external rotation angle were significantly large, whereas the values of the secondary internal rotation angle, horizontal flexion test, scapular retraction test, inner muscle strength, and the strength of the muscle fibers of the lower trapezius muscle were either significantly lower, or smaller. [Conclusion] The results suggest that characteristic differences in shoulder functions related to ROM and muscle strength of the pitching and non-pitching sides seen in cases of throwing shoulder injury are strongly related to shoulder pain at the time of throwing.

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[Purpose] The purpose of this study was to retrospectively clarify the factors related to falls and tumbles occurring over three years in a long-term care facility. [Subjects and Methods] The subjects were 285 elderly residents with a history of falls in the past three years. The features of falls by subjects with low and high care needs were compared. [Results] Falls and tumbles were frequently observed among subjects with third- or fourth-grade care needs, elderly women with dementia and musculoskeletal disease, and subjects with muscle weakness, contracture of the lower limbs, or physical pain. Also, many of the fallers used a wheelchair and needed assistance with items of ADL. [Conclusion] The results suggest that many falls and tumbles are experienced by subjects with high care needs. More work is needed to compare fallers with non-faller subjects.

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[Purpose] To clarify the effect of changes in flexion torque and angle in knee flexion exercises on the muscle activity of the quadriceps femoris, an antagonist of flexion. [Subjects and Methods] The subjects were 12 healthy adults. An isometric knee flexion exercise was performed with the knee flexed at 30 and 90°. The muscle activities of the rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) were measured using electromyography. [Results] The muscle activity of RF at knee flexion of 30° was significantly lower than that of 90°. In contrast, the muscle activity of VL was significantly greater at knee flexion of 30° than that of 90°. [Conclusion] The results suggest that in open kinetic chain knee flexion exercises, the posterior cruciate ligament experiences stress at knee flexion of 90°, suppressing the muscle activity of RF.

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[Purpose] To investigate the physical factors of medial tibial stress syndrome (MTSS) in long-distance college runners, through toe range of motion (ROM) and lower leg muscle cross-sectional area (CSA) measured by MRI. [Subjects and Methods] The subjects were 30 male long-distance runners (mean ± SD age, 20.1 ± 1.5 years; height 169.9 ± 4.5 cm; weight, 59.5 ± 4.0 kg). The subjects were divided into two groups, based on the results of a survey of MTSS history, and toe ROM and lower leg muscle CSA were compared between the two groups. [Results] In the group with no history of MTSS, the extension ROM of the second metatarso-phalangeal joint was significantly higher. No significant difference in lower leg muscle CSA was found. [Conclusion] The results suggest that ROM limitation of the second metatarso-phalangeal joint is related to the occurrence of MTSS.

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[Purpose] This study investigated the ideal reclining angle for bicycle ergometry in relation to individuals’ anaerobic thresholds (AT) and hemodynamics. [Subjects and Methods] The participants were 14 sedentary healthy men with a mean age of 20.8 years, mean body mass of 64.5 kg, mean height of 171.1 cm and a mean body mass index of 22.0 kg/m². Reclining angles of 20°, 45° and 70° were used, and hemodynamic changes were measured until AT was reached. [Results] Compared to the resting period, mean blood pressure at a reclining angle of 70° was significantly increased, and sympathetic nerve activity at 20°. Oxygen intake increased significantly at 45° and 70° compared with that of 20°. [Conclusion] A reclining angle of 45° may be the most efficient. For hypotensive individuals elevating the legs is desirable, while the gravity-dependent position is best for normal and hypertensive individuals.

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[Purpose] To investigate the effects of self-regulated learning strategies, learning targets, and goal orientation on examination results. [Subjects and Methods] The subjects were 80 first-year physical therapy students (mean age, 19.2 years) of a 3-year vocational training college. A survey of self-regulated learning strategies, learning targets, and goal orientation was conducted, and the results were compared between students divided into high- and low-score groups based on their examination results. [Results] Significant differences were found between the groups in the self-regulated learning items of planning strategy and monitoring strategy, and in the learning targets item of achievement importance tendency. [Conclusion] There is a possibility that differences in self-regulated learning strategies and learning targets influence the results of examinations.

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[Purpose] The purpose of this study was to determine the influence of an intradialytic quantitative exercise intervention with paced constant pedal rates. [Subjects and Methods] Twenty-seven hemodialysis outpatients (19 men, 8 women, aged 67 ± 10 years) performed an intradialytic ergometer exercise in a supine position using paced constant pedal rates for 12 weeks. [Results] The elderly patients who were able to perform 70% (1,260 revolutions) of a target of 60 rpm for 30 min (1,800 rev), showed significant improvements in the 6-minute walk distance (6MWD) and long-sitting forward flexion. In multiple logistic regression analysis, diabetic nephropathy and performance in the 6MWD were risk factors that interfered with the patients’ ability to perform 70% of the target value. [Conclusion] In intradialytic exercise, 1,260 revolutions is a cut-off point, and the gait function of diabetic nephropathy patients who exceed this pedal rate may improve.

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[Purpose] We investigated the influence of different measurement order of normal walking and fastest walking on the 10-meter walk test (10MWT). [Subjects and Methods] Fifty healthy adults performed the 10MWT in the order of normal walking and fastest walking (NoF), and fastest walking and normal walking (FaN). Evaluation items were normal walking time, fastest walking time and NRS (Numerical Rating Scale) of subjective normal walking speed. The results were compared using the paired t-test. [Results] There were no significant differences between the conditions in fastest walking time or NRS, but the normal walking time of the FaN condition was significantly shorter. [Conclusion] When the fastest walking time is measured first, there is a possibility that it influences the result of the normal walking, because of kinesthetic after-effects.

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[Purpose] The purpose of this study was to objectively clarify the features of discomfort with campus life of freshman physical therapy students by comparing students of two universities. [Subjects and Methods] The subjects were 88 students of A university and 98 students of B university who had entered university in 2015. Concerning the average scholarship on admission, based on the standard deviation for success, A was slightly inferior to B. Using the College Life Anxiety Scale (CLAS), feelings of maladjustment to college, anxiety with campus life, and anxiety about assessment were investigated about 2 months after admission. [Results] The students of A university had significantly high scores of anxiety with campus life and anxiety about assessment. However, there were no significant differences between the two universities in maladjustment to college, which has been reported to be largely related to dropping out of university. [Conclusion] This study had certain fundamental limitations, e.g. the small number of subjects from only two universities. However, it clarified that the maladjustment to college which freshman students felt soon after admission had no significant relationship with scholarship on admission, and was consistent with that of freshmen soon after admission.

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[Purpose] This study aimed to determine the effect of an individual’s ability to select an appropriate joint position on physical performance. [Subjects and Methods] Forty-six young females participated in this study. Their ability to select an appropriate knee joint position was determined based on two different knee joint angles. The first was the angle at which the participants expected to show the miximum knee extensor strength, and the second was the angle at which their strength actually peaked. The subjects were divided into two groups according to their ability to select an appropriate knee joint position. We measured the subjects’ sprint and vertical jump performance, and examined performance differences between the two groups. [Results] The subjects that exhibited a greater ability to select an appropriate knee joint position demonstrated significantly better sprint and jump performance. [Conclusion] The ability to select an appropriate joint position has a large effect on physical performance.

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[Purpose] To clarify influences of neck and head extension on single-leg landing. [Subjects and Methods] Thirty-one healthy young women (average age, 20.1 years old) participated in this study. Single-leg landings from a 30 cm-height platform were performed by all of the participants with the head and neck extended and in the neutral position. The maximum knee flexion, valgus angles, and anteflexion, retroflexion, and lateral bending angles of the trunk, and the landing position of the two postures were measured and compared. [Results] The knee valgus angle was significantly greater in the neck and head extended posture than in the neutral posture. There were no significant differences in knee flexion, anteflexion, retroflexion, lateral bending of the trunk, or landing position. [Conclusion] Single-leg landing with the neck and head extended is associated with an increase in knee valgus angle. This suggests that neck and head extension is one of the causes of non-contact anterior cruciate ligament injury.

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[Purpose] This study examined the relationship between the amount of physical activity and physical function, pain and catastrophizing after total knee arthroplasty (TKA). [Subjects and Methods] The subjects were 31 knees of 31 patients. Physical activity, knee extensor strength, 5-time chair-standing test (SS-5), the Timed Up and Go test (TUG), pain, and catastrophizing were evaluated at 4 weeks after TKA. [Results] Significant correlations were found between physical activity and knee extensor strength, SS-5, and TUG. No significant correlations were found between physical activity and pain and catastrophizing. [Conclusion] The results suggest that physical activity is related to physical function at 4 weeks after TKA.

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[Purpose] Left ventricular diastolic function is one of the determinants of exercise tolerance. Limited information exists regarding the role of left ventricular function in predicting exercise capacity and the impact of age-and gender-related differences. The present study was performed to identify the determinants of exercise capacity in consecutive patients using echocardiography. [Subjects and Methods] To investigate the feasibility of the optimal prescription for exercise using echocardiographic indexes, we studied 21 consecutive patients (mean age, 65.9 ± 9.0 years). We measured the peak early diastolic velocity of transmitral flow (E) and e’ at the lateral border of the mitral annulus and calculated the E/e’ ratio. After echocardiography, we measured the exercise load (Ex Watt) using cardiopulmonary exercise tests. [Results] Among the echocardiographic indexes, the E/e’ ratio showed the highest correlation coefficient with Ex Watt. [Conclusion] The evaluation of left ventricular diastolic function using echocardiography is useful for determining the optimal prescription for exercise.

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[Purpose] This study aimed to clarify the association between depression and participation in community activities among older adults living alone. [Subjects and Methods] The subjects were 9,004 community-dwelling older adults who did not require nursing care. Self-administered questionnaires were conducted to evaluate the community activity participation and living arrangements of the older adults. Depressive status was evaluated using the Kihon Checklist, a screening tool used to identify pre-frail older adults in Japan. [Results] For both males and females, those who lived alone and did not participate in any community activity showed a higher tendency of depression than those who lived alone and did participate in community activities. There was no difference in depressive state between the older adults living alone and participating in community activities, and those who were not living alone. [Conclusion] Based on the beneficial association between healthy mental status and community activities shown by older adults who live alone, we conclude that it is important to encourage older adults who live alone to participate in community activities.

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[Purpose] To compare the prevalence of pseudo-floating toe (PFT) according to age and gender using a low-floor pedoscope developed for adults. [Subjects and Methods] A total of 336 (141 males and 195 females) individuals aged 30 to 79 were studied. A low-floor pedoscope with a height of 90 mm was developed. The images of the foot plantar surface obtained with this instrument were binarized. Based on the data, PFT was classified by 2 raters with different levels of experience of classifying the condition, and the inter-rater reliability of the classification was examined. The subjects with one or more toes failing to contact the floor when standing were regarded as individuals with PFT, and their age- and gender-based ratios were compared. [Results] The inter-rater reliability of the PFT classification was sufficient. There were no age- or gender-related differences in the ratios of individuals with PFT. [Conclusion] The prevalence of PFT was similar among the different age groups and between males and females.

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[Purpose] The purpose of this study was to identify the error range of the iWakka assessment method of grip force adjustment ability. [Subjects and Methods] The grip force adjustment abilities of 27 healthy individuals enrolled in this study were measured twice using iWakka. Bland-Altman analysis was used to evaluate the data. [Results] The analysis found no evidence of a fixed bias or a proportional bias. The minimum detectable change for the dominant hand was 1.2 g, and the minimum detectable change for the non-dominant hand was 2.1 g. [Conclusion] This study identified the error range of iWakka assessment method for grip force adjustment ability.

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[Purpose] This study aimed to identify physical factors affecting both the Seated Side Tapping test (SST) and mobility. [Subjects and Methods] The subjects were 27 females. SST required subjects to move their bodies bilaterally as quickly as possible while seated, and the time taken to perform this task was measured. Mobility was evaluated as the 20-m sprint speed. The following physical functions were also assessed: muscle strength of the trunk and lower limbs, movement velocity of the upper and lower limbs, flexibility of the trunk, and balance during sitting. [Results] Both SST and mobility were found to be significantly correlated with the muscle strengths of the trunk, knee extension and ankle plantar flexion, and movement velocity of the upper and lower limbs. [Conclusion] The results suggest that both SST and mobility are affected by various physical factors including trunk function, leg muscle strength, and movement velocity.

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[Purpose] This study investigated the effect of repetitive facilitation exercises (RFE) with electrical and vibratory stimulation for chronic hemiplegia patients who were using day-care rehabilitation. [Subjects and Methods] Forty-three patients were divided into two groups: a physical therapy with repetitive facilitation exercises (RFE) group, and a control group without RFE. We measured upper limb and finger functions using the 12-grade hemiplegia functional test before and 12 weeks after the beginning of rehabilitation treatment. A value of P < 0.05 was considered statistically significant. [Results] The improvements in all measurements were greater in the RFE group than in the control group. [Conclusion] A rehabilitation program including RFE with electrical and vibratory stimulation may be useful for patients with chronic hemiplegia who are day-care users.

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[Purpose] The circumstances of falls in a residential care facility for the aged were investigated and analyzed according to the time of day, to clarify the characteristics of individual factors of falls. [Subjects and Methods] The first falls of 94 residents of a care facility in Fukushima City were investigated. Age, gender, height, weight, care level, activity category, dementia category, ADL assessment, grip strength, Hasegawa Scale, 10-meter gait, BPSD of the subjects, and the place of the fall were assessed and compared according to the time of the fall. [Result] There were 39 falls in the day (09:01~17:00), 32 falls in the evening (17:01~01:00), and 23 falls in the morning (01:01~09:00). Fallers in the morning period had significantly shorter height and BPSD nighttime insomnia, and a larger number of corridor falls. [Conclusion] Short subjects with nighttime insomnia using corridors in the small hours and early morning have a high risk of fall, and therefore require attention.

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[Purpose] To clarify the effectiveness of a video of a practical skills lecture, distributed on the internet for revision purposes, through analysis of its actual use. [Subjects and Methods] The subjects were 101, 2nd-year physical therapy students of the International University of Health and Welfare. Use of the video and students’s results were investigated, and a survey of items related to the viewing circumstances of the video, its content, and content requests and opinions was conducted. [Results] The number of views and viewing time of the video increased just before the exam compared with just after release, and the students with poorer results showed a tendency to use the video more. The video was viewed by more than 60% of the students, and more than 70% of them viewed the video in the 3 days before their exam. [Conclusion] A video for revision of physical therapy practical skills was made available on the internet. Its convenience was rated highly, and many students used it before their practical skills exam. The results also suggest that the video was useful for individual revision by students with low levels of understanding.

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[Purpose] We report the treatment course of a patient who showed a delay in regaining pre-injury levels of physical function and activities of daily living (ADL) due to disuse syndrome caused by bed rest after a vertebral fracture. [Subjects and Methods] A male in his 70s sustained an L2 vertebral fracture with no clear mechanism of the injury. After bed rest for about 3 weeks, ambulation was permitted; however, due to disuse-associated decreases in muscular endurance and general endurance, he found unassisted walking difficult. Therefore, to improve exercise tolerance, physical therapy consisting of repeated sit-to-stands, bicycle ergometer training, and machine exercise was initiated. [Results] After the physical therapy, the subject showed improvements in general as well as muscular endurance, began to walk unassisted, and regained his pre-injury level of ADL. [Conclusion] Our results suggest that disuse syndrome due to prolonged bed rest is an important prognosticating factor of poor ADL improvement after vertebral fracture. Further studies are necessary to evaluate the effectiveness of therapeutic interventions to improve muscular as well as general endurance during the bed rest period.

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[Purpose] Rehabilitation is important for clinics in community-based integrated care systems. The aim of this study was to clarify the perspectives of clinical rehabilitation of doctors, nurses, physical therapists and social workers (staff) working at the same clinic. [Subjects and Methods] We gave a lecture about rehabilitation and conducted questionnaire surveys of the staff before and after the lecture. Questionnaire responses were compared. [Results] Staff showed improved awareness of rehabilitation after the lecture. [Conclusion] These results suggest that rehabilitation education and training system at clinics is essential for staff.

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[in Japanese]

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