[Purpose] The use of a mouth guard has been recommended for the prevention of injuries in contact sports such as rugby football. The objective of this study was to clarify whether there was a change in the muscle activity of the masseter and cervical muscles during maximum isometric neck exercise while wearing a mouth guard. [Subjects and Methods] The subjects of this study were 16 healthy male rugby football club members. Cervical muscle strength and muscle activity of the right masseter, sternocleidomastoid, and splenius muscles were evaluated with and without use of a mouth guard during maximum isometric neck exercise in 8 directions. [Results] While wearing a mouth guard, cervical muscle strength and the muscle activity of the masseter muscle significantly increased during exercise in all 8 directions, and the muscle activity of the sternocleidomastoid significantly increased during exercise in 4 directions. On the other hand, the muscle activity of the splenius showed no difference in activity in any direction, with or without a mouth guard. [Conclusion] Mouth guard use is not only protective; it may also enhance cervical muscle strength.

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[Purpose] To clarify the effect on trunk rotational range of motion (ROM) of functional residual capacity (FRC) increase, using the modified wing test (mWT) as a measure of rib cage-hip joint flexibility and standard ROM tests of thoracolumbar rotation (sRT). [Subjects and Methods] The subjects were 54 healthy young persons. For FRC, subjects inhaled 500, 1,000, 1,500, and 2,000 ml of air from a 2,000-ml capacity cylinder at the resting expiratory level, and changes in the outcome measures due to increases in FRC were investigated using two-way factorial analysis of variance. [Results] Significant main effects and interactions were found. Trunk ROM measured by mWT was larger than that measured by sRT, and at more than 1,000 ml, increases in FRC decreased ROM, markedly according to mWT. [Conclusion] According to both tests, trunk ROM decreased with FRC increase.

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[Purpose] The present study determined the cutoff values of the Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest for discriminating ambulatory independence, and compared the accuracy of the three cutoff values for patients in a convalescence rehabilitation ward. [Subjects and Methods] Sixty-nine patients in a convalescence rehabilitation ward were assessed using the BESTest, Mini-BESTest, and Brief-BESTest, and cutoff values were calculated for discriminating their ambulatory independence. [Results] The cutoff values for ambulatory independence determined using the BESTest, Mini-BESTest, and Brief-BESTest were 72% (area under the curve, AUC: 0.90; sensitivity, 87.9%; specificity, 88.9%), 18/28 (AUC, 0.84; sensitivity, 85.7%; specificity, 78.1%), and 14/24 (AUC, 0.85; sensitivity, 85.7%; specificity, 78.1%) points, respectively. [Conclusion] All the tests discriminated ambulatory independence with equal accuracy.

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[Purpose] To investigate the effects on spinal cord excitability, as measured by evoked electromyography H waves, of a continuous stretching exercise and a repeated dynamic exercise. [Subjects and Methods] The lower limbs of 14 healthy adults with no history of neurological disorders were investigated. The H wave of the soleus muscle was measured using evoked electromyography under three conditions: at rest, continuous stretching, and repeated dynamic exercise. [Results] After continuous stretching, no significant difference was found from at rest; however, a significant decrease in H wave amplitude was found after repeated dynamic exercise. Also, after the repeated dynamic exercise, the percentage change in H wave amplitude was significantly lower than that after continuous stretching. [Conclusion] The results showed that spinal cord excitability under the repeated dynamic exercise was significantly lower than that under the continuous stretching exercise.

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[Purpose] A group recreation intervention was conducted for elderly subjects with dementia, and changes in their behavioral and psychological symptoms of dementia (BPSD) were investigated in a randomized controlled trial. [Subjects and Methods] Forty-eight residents of a care facility for the elderly who had dementia were randomly divided into two groups. The intervention group (n=23) participated in a group recreation intervention jointly conducted by physical and occupational therapists twice a week for 3 months. The control group (n=25) participated in recreation supervised by care-workers over the same period, at the same time and frequency as the intervention group. Comparison of the two groups was performed using two-way factorial analysis of variance. [Results] Significant interactions were found between measurement items related to BPSD and QOL. [Conclusion] The results suggest that it is possible to reduce BPSD by conducting group recreation interventions for elderly persons with dementia residing in care facilities.

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[Purpose] This study clarified the relationships of aging and long-term care insurance certification (LTC) with fluidity in the sit-to-walk task. [Subjects and Methods] The subjects were 10 community-dwelling elderly individuals with LTC and 9 healthy elderly individuals. The gradients of the regression lines of the Fluidity Index (FI) and clinical measurements in which age was used as the independent variable were compared between the two groups. [Results] Only the gradient of the FI regression line was significantly different between the two groups. [Conclusion] The results showed that FI was more susceptible to aging, impairment and disability than standard clinical measurements.

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[Purpose] To clarify the factors perceived by clinical educators (CEs) to be problematic in teaching students motion analysis in physical therapy clinical training. [Subjects and Methods] Sixty-four CEs were asked about problems in motion analysis education in a free-response questionnaire, and quantitative text analysis of the responses was performed. [Results] Words characterizing factors and the results of categorizing and illustrating their co-occurrence indicated that students’ cognitive, psychomotor and emotive domains, and CEs teaching methods and teaching plans were specific issues in motor analysis education. [Conclusion] When CEs encounter problems in motor analysis education, each of the factors should be investigated, since it is important for students to be given constructive guidance.

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[Purpose] The purpose of this study was to investigate changes in ankle plantarflexion/dorsiflexion muscle strength, joint position sensation, and joint flexibility during the menstrual cycle. [Subjects and Methods] The subjects were 6 students in a university female volleyball team who had no menstrual cycle disorders, no history of surgery to the right lower thigh, and no history of varus/valgus sprains of the ankle in the previous 3 months. Ankle joint plantarflexion/dorsiflexion muscle strength was measured at constant angular velocities of 30 and 120 degrees/s to calculate the body weight ratio of ankle joint plantarflexion/dorsiflexion muscle strength. Ankle joint position sense was measured at set angles of 15° plantarflexion, and 0° and 15° dorsiflexion, and the angle of error was calculated. For ankle joint flexibility, the passive torques of the ankle joint at 20° and maximum dorsiflexion were measured. [Results] No significant differences in ankle muscle strength, joint position sense or joint flexibility were seen between menstrual cycle phases. [Conclusion] These findings suggest that the menstrual cycle does not affect ankle function.

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[Purpose] To investigate the efficacy of physical therapy addressing the activities of daily living (ADL) ability and psychological functions of psychiatric inpatients exhibiting physical complications. [Subjects and Methods] The Barthel Index and Global Assessment of Physical Functioning scores of psychiatric inpatients were collected from medical records at the start and end of physical therapy. [Results] The scores of both assessments were significantly higher on completion of the physical therapy. [Conclusion] The results suggest that physical therapy for psychiatric inpatients with physical complications can improve not only ADL ability, but also psychological function.

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[Purpose] To clarify the feelings of first-year physical therapy students regarding clinical training and the reasons behind those feelings. [Subjects and Methods] Thirty-eight first-year physical therapy students were asked to choose words expressing their feelings associated with clinical training, and the reasons were analyzed using quantitative text analysis. [Results] Words chosen expressing feelings were: frightening, demanding, stress, awful, difficult, enjoyable, tough, severe, and anxiety; and the reasons given for these choices showed eight sub-groups in a co-occurrence network. [Conclusion] Even though first-year students held positive feelings toward learning through clinical practice, knowledge and skill are needed when interacting with real patients, and it seems that they held negative feelings about the necessity of adjusting to a new environment and much of the work and issues involved.

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[Purpose] This study investigated the relationship between voluntary cough intensity and respiratory, physical, oral and swallowing functions of the community-dwelling elderly. [Subjects and Methods] One hundred forty-three community-dwelling elderly persons over the age of 65 participated in this study. Voluntary cough intensity was evaluated by cough peak flow (CPF), and respiratory function was evaluated by forced vital capacity (FVC), maximal inspiratory pressure (MIP), maximal expiratory pressure, and chest and abdominal wall mobility. Physical function was evaluated by the 30-second chair-stand and Timed Up and Go tests. The oral and swallowing functions were evaluated by oral diadochokinesis and the repetitive saliva swallowing test. [Results] The percentage of the elderly subjects with abnormal CPF (CPF <240 L/min) was 16%. The respiratory, physical and swallowing functions were significantly lower in the group with abnormal CPF. Multiple regression analysis revealed FVC and MIP were significantly associated with CPF. [Conclusion] The results indicated that 16% of community-dwelling elderly decreased CPF, suggesting the importance of keeping FVC and MIP in order to maintain CPF.

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[Purpose] The purpose of this study was to examine how multiple local muscles work in different postures. [Subjects and Methods] The subjects were 28 healthy young men (mean age: 22.4±1.9 years old). Muscle thicknesses of the right side of the second and fifth lumbar multifidus [LM(L2), LM(L5)], erector spinae (ES), transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were evaluated in different postures using an ultrasound imaging system. [Results] The muscle thickness of LM(L2) significantly increased, the most in the recumbent position and the least in the standing position. The muscle thickness of LM(L5) significantly increased, the most in the standing position. The muscle thicknesses of ES, TrA, and IO significantly increased, more in the sitting and standing positions than in the recumbent position. However, there were no significant changes in the muscle thickness of EO. [Conclusions] The results suggest that each trunk muscle has individual characteristics of trunk muscle thickness variation with changes in posture.

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[Purpose] This study examined the determinants of physical therapy students’ process of choosing a place of employment, with the aim of supporting their smooth job search activities. [Subjects and Methods] Among the fourth-year students who belonged to the Department of Physical Therapy of our university as of April 2016, 144 consenting to cooperate with a questionnaire survey were studied. [Results] As determinants of their process of choosing a place of employment, the students attached importance to supervising physical therapists’ understanding, executives’ understanding of rehabilitation, and the establishment of high-quality technical guidance in the clinical setting. Through principal component analysis, personal and regional affinity, working conditions, environments for postgraduate education, the location, and self-realization were extracted as principal components. [Conclusion] Interpersonal relationships based on supervising physical therapists’ understanding and the establishment of high-quality training systems in hospitals/facilities were shown to determine physical therapy students’ process of choosing a place of employment.

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[Purpose] To examine the factors that affect recovery of walking ability of patients with disuse syndrome. [Subjects and Methods] The subjects were 52 patients diagnosed as having disuse syndrome. At discharge, they were classified as an independent walking group and a non-independent walking group, and multiple logistic regression analysis was performed on items of physical function, cognitive function, and blood test data to determine the factors influencing gait recovery, and their cut-off values were determined from ROC curves. [Results] Three items, knee extension muscle strength, physical activity, and TP (total protein), were identified as factors related to independent walking, and their cut-off values were: knee extension muscle strength, 0.35 kgf/kg; physical activity amount, 9.9 MET-hours/week; and TP, 6.4 g/dl. [Conclusion] The results suggest that lower limb muscle strength, total physical activity such as walking and rising from a bed, and total protein as a static nutrition index are related to the recovery of gait among patients with disuse syndrome.

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[Purpose] To investigate the reproducibility of the lateral reach test (LRT) and the relationships between LRT and FRT, and FRT of both upper limbs (dual FRT); and to examine their applicability in the evaluation of dynamic balance. [Subjects and Methods] The subjects were 21 healthy male and female adults. Using a functional reach measuring instrument, we measured bilateral LRT, bilateral FRT, and dual FRT, and calculated the intraclass correlation coefficients (ICC) of LRT and dual FRT. We also investigated the relationship between them, and compared the variation in the distance of each reach. [Results] Measures of LRT and dual FRT had high reproducibility with ICCs of 0.907 and 0.977, respectively. Also, LRT, FRT, and dual FRT showed significant correlations, and also correlated with height. When normalized for height, LRT and FRT each showed strong bilateral correlations, but no correlation was found between LRT and FRT or dual FRT. As functional characteristics of LRT and FRT, it was found that LRT showed bilateral symmetry and FRT bilateral asymmetry. Further, the dominant hand made no difference to LRT, while it had a significant effect on FRT. [Conclusion] The results show LRT is highly reproducible and bilaterally symmetrical. LRT and FRT provide different evaluations of motor function, and the results show that LRT may potentially be more suitable for measuring lateral dynamic balance than FRT. Regarding the evaluation of dynamic balance, it appears necessary to measure both LRT and FRT or dual FRT for anterior and bilateral evaluation.

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[Purpose] The purpose of this study was to examine the effect of foot-ground clearance during walking on acceleration of the upper limbs in order to develop a simple walking assistance system using a smart device. [Subjects and Methods] The subjects were 10 healthy young men. They were asked to walk with “Normal steps” (NS) and “High steps” (HS) on a treadmill, and the acceleration of the forearm was measured using a smartphone. [Results] For eight of the subjects, acceleration of the forearm in HS gait was significantly larger than that of NS gait. [Conclusion] It was found that acceleration of the upper limb tends to increase as foot-ground clearance increases during walking. Therefore, there is a possibility that the relative foot-ground clearance of HS and NS gait by individuals can be discriminated using a smart device attached to an upper limb.

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[Purpose] To clarify variations in the isometric quadriceps and hamstrings strength at different knee joint angles and points of time within a 1-year period after total knee arthroplasty (TKA). [Subjects and Methods] In 14 patients, who had been diagnosed with knee osteoarthritis and undergone TKA, measurement was performed at 5 points: before and at 3 weeks and 3, 6, and 12 months after surgery. Using the multi-purpose muscle function testing system BIODEX, the muscle strength was measured at knee flexion angles of 30°, 60°, and 90° to calculate the peak torque/weight and hamstrings/quadriceps ratios. [Results] The quadriceps strength at knee flexion angles of 60° and 90° was significantly reduced at 3 weeks after compared with before surgery. At 12 months after surgery, it was significantly increased at knee flexion angles of 30° and 60°. [Conclusion] The results suggest that the quadriceps strength at a knee flexion angle of 90° decreases after TKA, and it takes a longer time to recover.

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[Purpose] To examine circulatory dynamics in the lumbar erector spinae (LES) and multifidus (MF) and their activity levels during trunk extension in sitting and standing positions, in order to obtain myophysiological evidence for the effectiveness of physical therapy to manage low back pain. [Subjects and Methods] The study involved 15 healthy adult males, who executed trunk extension in sitting and standing positions as a motor task. Circulatory dynamics in the LES and MF during the motor task were examined by comparing relative changes in hemoglobin (Oxy-Hb, deOxy-Hb, total-Hb) and muscle activity levels at different trunk extension angles. [Results] The Oxy-Hb levels of the LES and MF in a sitting position and that of the LES in a standing position rose with an increase in the angle. [Conclusion] Increasing Oxy-Hb levels, trunk extension in sitting and standing positions may be useful as part of intervention for ischemic low back pain.

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[Purpose] To examine the effects of providing information regarding low back pain on care workers’ catastrophic thoughts on such pain and recognition of its prognosis, as well as their relationships with the presence/absence and level of the pain. [Subjects and Methods] A lecture-based workshop was held for 29 care workers to provide them with information regarding low back pain. The participants were divided into: low back pain and non-low back pain groups, to compare their scores before and after the intervention. [Results] Scores representing the recognition of low back pain prognosis significantly increased after the intervention in both the low back pain and non-low back pain groups. Those representing catastrophic thoughts markedly improved in the latter, while there were no significant differences in the scores in the former. [Conclusion] The provision of related information may improve catastrophic thoughts on low back pain and recognition of its prognosis among care workers with it. It may also improve the recognition among those without such pain.

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[Purpose] To confirm the necessity of considering students’ Grit scores when determining their stages of vocational identity development. [Subjects and Methods] A questionnaire survey was conducted, involving 85 students of the Department of Physical Therapy of a health care college, to examine their scores from a vocational identity scale for health care students (vocational identity scale) and the Japanese-version Short Grit Scale (Grit-S), in addition to basic attributes. The relationship between scores from the 2 scales and their subscales was analyzed using Spearman’s rank correlation coefficient. [Results] There was a significant positive correlation between the students’ scores from the Grit-S and vocational identity scale, including their subscales. [Conclusion] Grit scores may represent vocational identity.

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[Purpose] To clarify the characteristics of patients living at home, admitted to and discharged from our comprehensive community-based care (CCC) ward to destinations other than home. [Subjects and Methods] A total of 111 patients living at home, admitted to and discharged from the ward within the period between January and the end of July 2016, were divided into home and non-home groups, based on their discharge destinations. Between the 2 groups, the name of the diagnosis, age, sex, duration of hospitalization in the acute care ward, duration of CCC ward stay, category of occupation providing rehabilitation-based intervention, total and daily numbers of rehabilitation units, and the toileting ability and mobility on admission and discharge were compared. [Results] The duration of CCC ward stay was longer, with lower toileting ability and mobility on both admission and discharge, in the non-home (8) compared with home (103) group. Furthermore, on comparing the name of the diagnosis, cerebrovascular diseases were observed more frequently in the former group. [Conclusion] It was suggested that discharge to home is more difficult when a cerebrovascular disease is present, or the toileting ability and mobility on admission are low.

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[Purpose] The aim of this study was to estimate the optimal load for exercise therapy based on cardiopulmonary exercise testing (CPX). [Subjects and Methods] Thirty-four patients were subjected to CPX, echocardiography and ankle brachial pressure index (ABI) measurements. Early diastolic filling velocity (E), atrial filling velocity (A), and peak early diastolic velocity of the mitral annulus (e’) were measured by echocardiography, and then E/A and E/e’ were calculated. The relationships between the optimal load for exercise therapy and the echocardiographic indexes and ABI were analyzed using multiple regression and their accuracies were examined. [Results] Independent determinants of the optimal load for exercise therapy were E/e’ and ABI. Multiple regression determined the optimal load for exercise therapy as 21.98－1.06×E/e’+23.70×ABI (adjusted R²=0.365). [Conclusion] The results suggest that the optimal load for exercise therapy for inpatients with heart disease can be estimated from E/e’ and ABI.

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[Purpose] The aims of this study were to investigate the locomotive function and physical strength of ground golf (GG) players. [Subjects and Methods] The subjects were 508 community-dwelling older adults who participated in a health survey. [Results] Compared with the control group (ORs: 1.00) of both males and females, the GG players group showed a lower odds ratio (males, 0.324; females, 0.315) of locomotive syndrome risk level 1 (decline in locomotive function has already begun). The odds ratio (0.277) of locomotive syndrome risk level 2 (decline in locomotive function is already advanced) was also low among males. Even in the 2-step test, the GG players group showed higher values than the control group. [Conclusion] GG players have a lower risk of being judged as having locomotive syndrome risk levels 1 and 2 than elderly people of the same age.

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[Purpose] Phantom limb pain varies with pain characteristics. We report here, the results obtained after various interventions applied in accordance with phantom limb pain characteristics. [Subjects and Methods] Patient A presented with deep pain resulting from a below-knee amputation, and patient B presented with superficial pain resulting from an above-elbow amputation. For patient A, the plan was to control the phantom limb pain using mirror therapy and voluntary movement intervention. For patient B, the plan was to eliminate the phantom limb itself by administering a sensory discrimination task to the stump. [Results] Patient A acquired voluntary phantom limb movement, accompanied by elimination of the phantom limb pain. Patient B had improved stump sensory function, which induced a change in the type of phantom limb, eliminating the phantom limb pain. [Conclusion] In the present cases, good results were obtained from different interventions applied in accordance with the phantom limb pain characteristics.

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