[Purpose] To investigate the relationship between a national examinations prediction test and undergraduate tests. [Participants and Methods] Students enrolled in April 2015 at five rehabilitation colleges were included. We defined the 3rd test of the third year as the national examinations prediction test. The unpaired t-test, Pearson's correlation coefficient and receiver operating characteristic curve were used in the analysis. [Results] In the comparison of the examinations between physical therapy departments (n=297) and occupational therapy departments (n=104), with the exception of the basic items of the national examination, all of the admission tests, first year student final tests, basic items of second year student final tests, and the basic items of the national examinations prediction test showed significant differences. The national examinations prediction test showed significant positive correlations with all the tests, and their cut-off values were identified. [Conclusion] The national examinations prediction test and all tests are related and their cutoff values were clarified.

[Purpose] This study investigated the correlation of the cognitive functions with fall history. [Participants and Methods] The mental and physical conditions of the participants were assessed using the Mini-Mental State Examination, the Tokyo Metropolitan Institute of Gerontology Index of Competence, the Life-Space Assessment - Japanese edition, and the 10-meter Walk Test. Reaction Time and Premotor Time were measured while subjects were performing the Simple Reaction Task, the Go/No-go Reaction Task, and the Probe Reaction Task. [Results] The Premotor Times which correspond to the cognitive process were significantly longer in the fall group. [Conclusion] Delay of the cognitive process increases the risk of falls.

[Purpose] The effect of shoe instep fixation on elderly people’s balance ability was examined using the Index of Postural Stability (IPS). [Participants and Methods] Twelve community-dwelling elderly people stood upright and with their bodies tilting at the maximum in all directions for 10 seconds in each case to measure their centers of plantar pressure using a sway meter. Their IPS values were calculated and compared based on the number of Velcro tapes used for shoe instep fixation. [Results] The IPS value did not vary according to the number of Velcro tapes. On the other hand, the area of stability limit as an IPS component was significantly larger when more Velcro tapes were used. [Conclusion] Shoe instep fixation did not influence elderly people’s IPS values, but it was suggested to expand their stability limits.

[Purpose] Our objective was to survey the occurrence of lateral falls among community-dwelling elderly individuals, and to examine the relevant characteristics of physical and mental functions. [Participants and Methods] Our subjects were 70 community-dwelling elderly individuals capable of walking independently. We interviewed those who had experienced falls within the past year about the direction and circumstances of the fall. We also performed assessments using two measures of cognition and the Falls Efficacy Scale (FES), and measured seven physical measures: the forward and lateral reach test, one-leg standing with eyes open, ratio of knee extensor strength to body weight, grip strength, 5m maximum walking speed, and the Timed Up & Go test (TUG). The results were compared between the lateral-fall group and the non-lateral fall group. [Results] Of 23 subjects with fall experience, nine (39%) had experienced a lateral fall. While the most common cause of falling among the non-lateral fall group was “stumbling, becoming caught,” the most common cause in the lateral-fall group was “tripping over the feet.” The number of falls was greater in the lateral-fall group. Among the measures of physical and mental function, the four items of FES, one-leg standing with eyes open, 5m maximum walking speed, and TUG showed significant differences between the fall groups, with lower ability values in the lateral-fall group. [Conclusion] The results suggest that compared to those who fell in a non-lateral direction, individuals who fell laterally had low fall self-efficacy, and lower abilities of static balance, walking and moving.

[Purpose] To clarify the relationship between the muscle cross-sectional areas (MCSA) of each longitudinal muscle region and the muscle torque of the lower leg while sitting. [Participants and Methods] The participants were 30 healthy young males and females. The participants sat with the ankle in the neutral position. MCSA images were obtained using gravity MRI, which can be performed in any body position. Five points of the soleus, anterior tibialis, and medial and lateral heads of the gastrocnemius were selected and measured. Muscle torque was measured using a hand-held dynamometer. [Results] The muscle torque correlated with the MCSA of the distal 1/4 and the most distal parts of the female lateral heads of the gastrocnemius. The muscle torque correlated with the proximal 1/4 part of the male anterior tibialis, and the middle and the maximum MCSA parts of the female anterior tibialis. [Conclusion] The MCSA of the parts related to maximum muscle torque depend on both muscle and gender, and it is necessary to consider the longitudinal part of the muscle when estimating the muscle torque from images.

[Purpose] The purpose of this study was to examine the association between locomotive syndrome and higher-level competence in community-dwelling elderly people. [Participants and Methods] The participants were 338 elderly people (aged 75.9 ± 6.3 years [mean ± standard deviation]). The Japan Science and Technology Agency Index of Competence (JST-IC) consists of four subscales (use of new equipment, information gathering, life management, social participation), and was used to assess the higher-level competence. The subjects were categorized into two groups, locomotive syndrome (n=58) or non-locomotive syndrome (n=280), based on their scores on the 5-item Geriatric Locomotive Function Scale (GLFS-5). Student’s t-test was used to analyze the statistical differences between the two groups. Logistic regression was used to assess the relationship between the JST-IC total score, four subscales and locomotive syndrome. [Results] The JST-IC total score and those of all the subscales were significantly lower in the locomotive syndrome group than in the non-locomotive syndrome group. Logistic regression analysis revealed that JST-IC and social participation were factors related to locomotive syndrome among the elderly. [Conclusion] Our results show that locomotive syndrome is associated with higher-level competence in community-dwelling elderly people.

[Purpose] The current situation of infection control education in educational institutions for physical therapists was investigated, and the educational contents of universities and colleges were compared. [Participants and Methods] An anonymous self-administered mailed questionnaire was sent to 263 educational institutions for physical therapists. The questionnaire consisted of 45 items concerning infection control education regarding education implementation and educational methods. [Results] The response rate was 30.8%. The highest rate of educational implementation was “standard precautions,” which accounted for 75.8%. Universities had implemented 9 items in education significantly more than colleges, including the hand-washing method by rubbing, but, in both cases, the education implementation rate was low at 40% or less. [Conclusion] The implementation rates of general contents for infection control were high, while many educational institutions had low educational implementation rates for detailed contents in which physical therapists were less likely to be involved.

[Purpose] The purpose of this study was to compare students’ level of interests in aspects of physical therapy for women’s health before and after a physical therapy class. [Participants and Methods] Before and after a physical therapy class, 41 students ranked, in order of their level of interest, the following seven items related to physical therapy for women’s health: an overview of pregnancy and childbirth, weight gain, low back pain, incontinence, internal secretion and the respiratory and circulatory organs, maternity blues, and the experience of pregnancy. [Results] “Low back pain” had a high interest ranking both before and after the class. Interest in “incontinence” significantly increased after the class. [Conclusion] The participants had few opportunities to learn about incontinence, which may explain their increased interest in this item. Knowledge of incontinence is clinically important; therefore, it is important to learn about it in a class dealing with women’s health.

[Purpose] To classify the floor pressing patterns, that combines the floor pressing forces and times, exerted by different part of the forefoot area (distal phalanx and metatarsal bones) during gait. [Participants and Methods] Nine healthy males participated. Vectors, representing the floor pressing force by the base of each distal phalanx (hallux, middle finger, and little finger) and head of each metatarsal (first and fifth) of the right foot, were measured. The values obtained through 27 trials (9 participants x 3 trials) were examined using cluster analysis, adopting the Ward method. [Results] Horizontal components were classified into 3, and anteroposterior and vertical components were classified into 2 groups. When focusing on anteroposterior components, similar foot pressing patterns were observed in 23 out of 27 trials (approximately 85%). [Conclusion] The vectors of the floor pressing force by different parts of the forefoot area during gait were classified. When focusing on anteroposterior components, similar floor pressing patterns were observed in approximately 85% of all trials.

[Purpose] To confirm the usefulness of the walking rehabilitation support tool “Tree” to improve the walking distances and ability of patients with post-stroke hemiplegia. [Participants and Methods] Six patients with post-stroke hemiplegia were studied, adopting a between-subject multiple baseline AB design. The duration of the study was 15 days, which were divided into Period A for general walking training and Period B for walking training using “Tree”. The distance walked and MET during 20-minute walking training and the speed, step length, and cadence when walking 10 m after training were measured in each patient. [Results] There were significant increases in the walking distance, walking speed, and step length during Period B compared with A, but neither the MET nor cadence significantly varied between the 2 periods. [Conclusion] “Tree” may be useful to improve the walking distances of patients with post-stroke hemiplegia during walking training and their step lengths and walking speeds after it.

[Purpose] To clarify the factors related to the distance of the seated center of pressure path (D-COP) in the sitting lateral reach task. [Participants and Methods] The subjects were 17 healthy adults. They performed a sitting right-side reach task with the right hand. Correlations of D-COP with the lateral reach distance (LR-D), the thorax and pelvic angles (Th-A, Pel-A), and the magnitude of the righting reaction converted into an angle were investigated. [Results] D-COP was found to correlate with LR-D, Pel-A of the frontal plane, and the horizontal planes of Th-A and Pel-A. Multiple regression analysis identified LR-D and Pel-A as significant correlations. [Conclusion] Factors related to D-COP in the sitting lateral reach task are LR-D, and Pel-A of the frontal plane.

[Purpose] Mental rotation (MR) using body-related stimuli is a potentially useful method of mental practice. To test its efficacy, the present study investigated whether individuals continued MR even after repeated exposure to the body-related stimuli. [Participants and Methods] Twenty-two healthy young adults were grouped into either a single MR-stimulus group or a multiple MR-stimuli group (12 stimuli). They judged the laterality of a set of rotated hand stimuli as quickly as possible for four days (384 trials). [Results] In both groups, the maximum angle was 180°, and the reaction times were slower as the rotation angle increased. [Conclusion] The results show that even when the task is repeatedly carried out, the image manipulation of MR is maintained. This result suggests that a MR task may be effective as a practical method of simple mental practice.

[Purpose] To clarify the relationship between spinal kyphosis and the parameters of respiratory function in older adults certified with long-term care insurance. [Participants and Methods] The subjects were 126 older adults (69 males and 57 females) receiving day-care rehabilitation. Their respiratory functions and muscle strength were measured. The correlations between the calculated kyphosis index and the measured values were assessed. [Results] The kyphosis index showed a significant negative correlation with forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0), ratio of FEV1.0 to FVC (%FEV1.0), and peak expiratory flow rate (PEFR) in all subjects. The kyphosis index showed significant negative correlations with %FVC, FEV1.0, %FEV1.0, FEV1.0%, %FEV1.0%, PEFR, and %PEFR in male subjects, but the correlations were not significant in the female subjects. [Conclusion] This study showed that kyphosis adversely affects respiratory function, and that gender differences exist in this feature.

[Purpose] The purpose of this study was to investigate the presence of asymmetry in the thickness of the latissimus dorsi muscles (LD) and the relations of the asymmetry to pelvic lateral tilt angle and respiratory function during forced expiration. [Participants and Methods] The subjects were 20 healthy males. Measurement items were the thicknesses of the bilateral LDs, pelvic lateral tilt angle and respiratory function. [Results] During resting expiration, the right LD was significantly thicker than the left LD. There was a correlation between the lateral asymmetry of the thicknesses of the LD and %IC. During forced expiration, the thickness of the left LD increased. The asymmetry in the thickness of the LD correlated with the pelvic lateral tilt angle during forced expiration and with %PE max. [Conclusion] These results suggest that asymmetry in the thickness of the LD is involved in %IC, %PE max, and pelvic stabilization in the frontal plane.

[Purpose] To investigate relationships between body composition and gait speed in young females. [Participants and Methods] Forty young females were recruited for this study, and their gait speed, cadence, body weight, total muscle mass, and right and left leg muscle mass, SMI and FFMI were measured. For statistical analysis, the measured and calculated values were compared, and Pearson’s correlation coefficient was calculated. A single regression analysis was performed on the correlated items. [Results] The females' gait speed showed weak positive correlations with the total muscle mass, right and left leg muscles mass, and SMI. [Conclusion] The results suggest that total muscle mass, right and left leg muscle mass, and SMI may be indicators of gait speed in young females.

[Purpose] The purpose of this study was to examine the number of 50 m walking acquisition days and hospitalization days in consideration of the interaction of cardiac and renal function in elderly patients with heart failure. [Participants and Methods] The subjects were elderly heart failure patients. We assessed gender, age, presence or absence of dementia, Geriatric Nutritional Risk Index, type of cardiac dysfunction, 50 m walking acquisition days, hospitalization days, et cetera. We compared the differences in the number of 50 m walking acquisition days and hospitalization days among renal dysfunction classifications in HFrEF and HFpEF. [Results] Two-way analysis of variance found no significant interaction, but significant main effects of renal dysfunction on 50 m walking acquisition days and hospitalization days were found. [Conclusion] The results suggest that severe renal dysfunction affects 50 m walking acquisition days and hospitalization days of patients with heart failure.

[Purpose] The relationships between the life spaces (LSA) and various functions (fall-related self-efficacy: FES; social networks: LSNS-6; and motor functions) of community-dwelling elderly people belonging to 2 different age groups were examined. [Participants and Methods] The study involved 77 elderly people aged 65-74 and 76 aged 75 and older to compare their MMSE, LSA, FES, LSNS-6, and motor function test (TUG, standing from a chair 5 times, and two-step test) scores. [Results] LSA scores were correlated with TUG scores among elderly people aged 65-74 and with FES, LSNS-6, and TUG scores among those aged 75 and older. [Conclusion] The life spaces of elderly people aged 75 and older may be influenced not only by their motor functions, but also their self-efficacy and social networks.

[Purpose] To investigate the specialty areas selected by senior students at two clinical training facilities for the compilation of basic material for educating physical therapy students. [Participants and Methods] Data on specialty areas in which 99 physical therapy students trained during their placement at two clinical facilities in fiscal 2016 were used. The students were enrolled with the Department of Physical Therapy, International University of Health and Welfare. Three specialty areas (Neurological, Musculoskeletal, and Cardiovascular/Pulmonary/Metabolic) were selected. The distribution of combinations of specialty areas in which each student trained during their placement at both clinical facilities was analyzed with reference to these three specialties. [Results] Among the students, 61.6% trained in two specialty areas, and 38.4% trained in a single area. The percentage distributions by specialty area were 50.5%, 37.4%, and 12.1% for the neurological, musculoskeletal, and cardiovascular/pulmonary/metabolic specialties, respectively. [Conclusion] 61.6% of senior students trained in two specialty areas during clinical practice and 38.4% trained in only one specialty area.

[Purpose] To clarify the effect of wearing an abdominal belt on dynamic standing balance. [Participants and Methods] The forward reach test (distance), 5-m tandem gait test (time), and repeated stepping test (time) were conducted for 14 healthy university students when wearing and not wearing an abdominal belt for comparison. [Results] Neither the forward reach distance nor time needed for 10-m tandem gait varied between when wearing and when not wearing an abdominal belt, whereas the time needed for repeated stepping was significantly shorter when wearing it. [Conclusion] In the case of healthy participants, the effect of wearing an abdominal belt was most marked on repeated stepping of all the 3 motor tasks requiring dynamic standing balance, possibly due to the level of difficulty of this task and its movement characteristics.

[Purpose] The purpose of this study was to clarify the characteristics of the muscle activities of the gastrocnemius during increases of walking speed. [Participants and Methods] The subjects were 10 healthy persons. Surface electromyography of the gastrocnemius was performed during walking. During increases of the walking speed from 2.5 km/h to 4.0 km/h (acceleration phase I), and from 4.0 km/h to 5.5 km/h (acceleration phase II), the integrated electromyography value (IEMG) of the gastrocnemius was calculated and examined. [Results] IEMG of the medialis was significantly higher than that of the lateralis in both acceleration periods I and II (p<0.05); and IEMGs of the medialis and lateralis were significantly higher in acceleration period II than in acceleration period I (p<0.05). [Conclusion] The muscle activity of the gastrocnemius medialis was larger than that of the gastrocnemius lateralis muscle during acceleration in progressive walking.

[Purpose] The objective of this research was to verify the effects of static stretching (SS) and ultrasound therapy (US) on normal adults, and to clarify the effectiveness of their combination. [Participants and Methods] The subjects were 13 normal adult males. ROM, deep tissue temperature, and deep tissue blood flow before and after US and SS treatments under different conditions on the muscle-tendon junction of the triceps surae muscle were compared. The conditions were: (1) simultaneous implementation, (2) implementing SS after US, (3) implementing only US, and (4) only SS. [Results] Significant increases in the range of motion of ankle dorsal flexion were found for condition (1), in comparison with all the other conditions, and for condition (2) in comparison with conditions (3) and (4). [Conclusion] It is important to simultaneously implement US in order to increase the effectiveness of SS. High tissue temperature may enhance the result of SS.

[Purpose] The psychological aspects of women with experience of urinary incontinence were investigated, to clarify anxieties about urinary incontinence and coping behavior, and to obtain practical knowledge for supporting pelvic floor muscle exercise. [Participants and Methods] Eleven middle-aged and elderly women who lived independent lives and had experience of urinary incontinence were the subjects of qualitative descriptive research. [Results] Their average age was 60.1 ± 4.0 years old and the interviews lasted 21.3 ± 6.6 minutes. Ten categories and 18 codes were identified for 4 items. [Conclusion] Urinary incontinence was considered a consequence of aging. The subjects were embarrassed by it, but wanted to do something to improve it. Pelvic floor muscle exercises were known to be effective, but the right exercise methods were not known.

[Purpose] To determine the most comfortable excretion posture by comparing breathing functions when adopting 2 different excretion postures. [Participants and Methods] The breathing functions, chest and waist circumferences, and subjective comfort of 30 healthy adults when sitting with their trunk upright and when sitting with it tilting forward as 2 different excretion postures were measured and compared. [Results] The inspiratory reserve and maximal inspiratory volumes were greater when sitting with the trunk upright. In contrast, the expiratory reserve volume was greater when sitting with the trunk tilting forward. Moreover, the chest circumference (axillary fossa/xiphoid process) was longer, and the rate of answering “comfortable” was higher when sitting with the trunk tilting forward than when sitting with it upright. [Conclusion] Although the lung capacity did not vary according to the excretion posture, there were differences in the expiratory and inspiratory volumes between the 2 postures. As sitting with the trunk tilting forward was suggested to be more comfortable than sitting with it upright, further studies may be needed to identify factors contributing to such comfort.

[Purpose] To investigate the intra- and inter-rater reliabilities of measurements of the iliopsoas thickness, and the change in iliopsoas thickness due to hip flexion. [Participants and Methods] The participants were 13 healthy young males. Iliopsoas thickness was measured in hip flexion of 0, 15, 30, 45 and 60 degrees at the center of the groin area using sonography. The intra- and inter-rater reliabilities of measurements of iliopsoas thickness were calculated, and the iliopsoas thickness was compared among the hip flexion positions. [Results] When hip joint flexion was 45˚ or less, both the intra- and inter-rater reliabilities of measurements of the iliopsoas thickness were high. Systematic bias was not found at any of the hip flexion angles. The iliopsoas thickness increased with hip flexion. [Conclusion] Highly reproducible data can be obtained by measuring iliopsoas thickness at hip flexion of 45˚ or less. However, as the thickness of the iliopsoas thickness changes with hip flexion, making it necessary to consider the hip flexion angle when measuring it.

[Purpose] We report the effect of a combination therapy of low frequency repetitive transcranial magnetic stimulation (rTMS) to the primary motor area of the lower limb on the nonlesional hemisphere and intensive physical therapy (PT) on a stroke patient with lower limb hemiparesis. [Participants and Methods] The subject was a 70-year-old male with left hemiplegia 14 months after stroke onset. The primary motor area which presents ankle dorsiflexion in the nonlesional hemisphere was identified using functional MRI prior to rTMS application. One treatment session consisted of 20-minutes 1 Hz low frequency rTMS and 60 minutes PT. Two sessions were conducted per day. A total of 21 sessions were performed during a 15-day hospital stay. [Results] Compared to hospitalization, at discharge, improvements were seen in MAS of the left soleus muscle, FRT, BBS, cane walking time, TUG, and FIM. [Conclusion] At one month after discharge, the patient was able to walk without a cane. It can be said that the combination therapy was an effective treatment method for this patient.

[Purpose] This paper reports a post-stroke hemiplegic patient treated with intensive physical therapy and botulinum toxin injection to improve his walking ability, focusing on the effect of this combined therapy on his ankle plantar flexors. [Participant and Methods] A 60-year-old male at 7 months after cerebral infarction. The male performed ankle plantar flexor stretching, muscle training involving knee extensors, and walking training after botulinum toxin injection for 4 weeks. His levels of ankle plantar flexor spasticity, ankle ranges of motion, lower limb Motricity Index values, lower limb electrocardiograms on the paralytic side during gait, and temporal/distance-related factors before and after the combined therapy were compared. [Results] The patient’s level of ankle plantar flexor spasticity decreased, lower limb muscle strength increased, rectus femoris activity during the single-leg support phase was promoted, and walking speed improved. [Conclusion] A combination of intensive physical therapy and botulinum toxin injection may be effective to improve active motor functions, such as the walking speed.

[Purpose] To confirm the usefulness of a cutoff value list (see the literature on stroke) to prevent falls among post-stroke patients on post-acute rehabilitation wards by assessing their gait independence and fall risk levels. [Participants and Methods] Post-stroke patients were divided into 2 groups based on the period when the list was adopted: pre-adoption: 123 discharged from the study center in FY2016; and adoption: 119 discharged from it in FY2017, to compare FIM scores and the incidences of falls before and after the adoption. Furthermore, a questionnaire survey was conducted, involving 28 physical therapists. [Results] There were significant differences in the incidence of falls and total FIM score on discharge (p<0.05). In the questionnaire survey, values representing the therapists’ views on the <feasibility of determining gait independence levels upon deliberations with various other types of profession based on performance test results and risk factors associated with falls> significantly increased after the adoption (p<0.05). [Conclusion] The use of the cutoff value list may also change physical therapists’ awareness.