[Purpose] The activities of the gluteus minimus during single leg stance on flat and unstable surfaces were compared to electromyographically examine whether the muscle contributes to hip joint stability. [Participants and Methods] Fine-wire electrodes were attached to the gluteus minimus and gluteus medius of 13 healthy adults (7 males and 6 females) to measure the activities of these muscles during single leg stance on a flat surface, AIREX^®, and BOSE^®. [Results] Gluteus minimus muscle activity increased among females when standing on BOSE^® as a surface with the most unstable weight-bearing area. Furthermore, the level of such activity when standing on BOSE^® was higher among females than among males. [Conclusion] In females compared with males, the femoral head is less covered by the acetabulum, and the distance from the gravity line to the center of the femoral head is longer, resulting in instability. Based on this, the level of gluteus minimus muscle activity may have been higher among females than among males to more effectively maintain their hip joint stability. The results suggest that the gluteus minimus plays an important role in maintaining hip joint stability.

[Purpose] To confirm whether unilateral foot brace fixation causes lateral differences during the Functional Reach (FR) Test. [Participants and Methods] Eleven healthy university students performed FR with (fixation condition) and without (non-fixation condition) a short leg brace with a metal support placed on their left lower extremity for unilateral ankle immobilization to measure their left and right upper limb reach distances and body sway levels. [Results] On comparing left and right upper limb reach distances under the fixation and non-fixation conditions, the values were lower under the fixation condition on both sides. Furthermore, under the fixation condition, the reach distance was longer, and the rectangular area of reach was larger when reaching using the contralateral (right) upper limb. [Conclusion] Unilateral foot brace fixation may shorten both ipsilateral and contralateral upper limb reach distances, with lateral differences.

[Purpose] This study examined whether the height of a lift attached to the bottom of one shoe for compensation influences subjective leg length discrepancy (LLD) and gait pattern change due to objective LLD when walking; and whether a rehearsal with such compensation is effective for familiarity. [Participants and Methods] Nine university students rehearsed walking for 10 minutes with 1 or 3 cm-high lift attached to the bottom of one shoe for compensation to familiarity themselves. Their gait patterns when walking 10 m were measured before and after the rehearsal, focusing on subjective LLD (the sense of discomfort) and gait pattern change due to objective LLD (values obtained with a triaxial accelerometer) for comparison. [Results] There were no objective LLD-related changes in the gait pattern, but the sense of discomfort, representing subjective LLD, improved after the 10-minute rehearsal with the 3 cm-high lift for compensation. [Conclusion] When the discrepancy is 3 cm, 10-minute walking for familiarity may be effective to reduce subjective LLD without changing the gait pattern.

[Purpose] This study examined the relationships between the change in number of steps and changes in physical function, pain, and self efficacy after hospital discharge following total hip arthroplasty (THA). [Participants and Methods] Twenty women (aged 64.1 ± 7.1 years) with hip osteoarthritis who underwent THA participated in this study. Outcome measures were determined preoperatively, at hospital discharge, and 1 month post discharge and included number of steps, self efficacy, knee extension strength, the timed up and go test, and pain. The associations between the change in number of steps and the other variables were investigated. [Results] The number of steps was significantly lower at discharge than preoperatively and at 1 month post discharge, but it had recovered at 1 month post discharge. The change in self efficacy showed a significant correlation with the change in number of steps. [Conclusion] Our results suggest that the change in number of steps after THA correlates with changes in self efficacy.

[Purpose] The purpose of this study was to examine the co-contraction of the knee during one foot standing in total knee arthroplasty (TKA) patients and to investigate the relation between the co-contraction and balance function. [Participants and Methods] Nine subjects (TKA group) at four weeks after TKA and 10 healthy, age-matched controls (healthy group) participated in this study. The subjects performed a one foot standing task, and the co-contraction index (CI) of the knee was measured. [Results] There was a significant difference between the two groups in CI. In the TKA group, there was a significantly negative correlation between the CI during the transition phase of the task and FRT. [Conclusion] The results suggest that the center of gravity movement with change in posture is affected by the co-contraction of the knee in TKA patients.

[Purpose] The aim of this study was to investigate whether the Vastus Medialis Oblique (VMO)/ Vastus Lateralis (VL) ratio, with and without normalization of electromyographic signals, is affected by different movement periods and velocities. [Participants and Methods] Eleven healthy subjects were studied. They repeated isokinetic knee extension-flexion tasks at three different angular velocities five times, and three maximum isometric knee extension efforts (MVE) at 60-degree knee flexion using an isokinetic exercise machine. Surface electromyography was used to obtain the electrical signals from VL and VMO during each task. The VMO/VL ratio was calculated using the sEMG signal with and without normalization by the MVE value. [Results] The VMO/VL ratio with normalization was larger than that without normalization, and the standard deviations of both ratios showed a similar tendency. As the knee extended, the VMO/VL ratio gradually became smaller. There were no significant differences in the VMO/VL ratio among the movement velocities. [Conclusion] The results indicate that sEMG signal normalization is necessary for inter-subject comparison.

[Purpose] The purpose of this study was to histopathologically determine whether treatment of the knee joint with vibrational stimulation during the cast fixation period could prevent changes in the infrapatellar fat pad. [Participants and Methods] Fourteen, 9-week-old, male Wistar rats were divided into 3 groups based on treatment strategies: Group C, control rats reared normally (n=5); Group I, rats that were immobilized (n=5); and Group V, rats treated with vibrational stimulation during immobilization (n=4). The right hindlimb was immobilized by cast fixation. In group V, vibration stimulation was applied for 15 minutes every day for 2 weeks. [Results] Adipose cells of different sizes and fibrosis were observed in groups I and V. The cross-sectional areas of fat cells were significantly different among the groups. [Conclusion] Vibrational stimulation may have a preventive effect on changes in fat cells associated with joint immobility.

[Purpose] The aim of this study was to clarify the effects of different ankle positions on muscle activities during active range of motion exercise of the knee joint with a slider board. [Participants and Methods] Twelve healthy men participated in this study. The subjects performed knee joint flexion and extension movements in the sitting position with their feet on a slider board, and the activities of the quadriceps, hamstring, and gastrocnemius muscles were measured using electromyography. The muscle activities were compared between the two conditions of ankle dorsiflexion and plantar flexion. [Results] The muscle activities of the hamstrings and gastrocnemius significantly increased in plantar flexion compared with those of dorsiflexion during knee joint extension movement. [Conclusion] Our results suggest that ankle joint dorsiflexion is a more suitable ankle position for minimizing the muscle activities of antagonists in knee joint extension with a slider board.

[Purpose] The purpose of this study was to compare the physical recovery of patients who underwent total knee arthroplasty (TKA) in hospital, with their preoperative condition and a healthy group. [Participants and Methods] The knee range of motion, walking pain, isometric knee extension strength, 10-m walking speed, and Timed Up & Go test (TUG) times of 26 TKA patients were compared with those of 19 healthy controls preoperatively, and at 2 and 4 weeks, 3 months, and 1 year post-TKA. [Results] Post-operative walking pain, range of motion of knee extension, 10-m walking speed, and TUG improved compared to their preoperative values. However, the range of motion of knee flexion and isometric knee extensor strength remained insufficient. In the healthy group comparison, TKA patients’ walking pain, isometric knee extensor strength, 10-m walking speed, and range of motion of knee extension recovered to similar levels, but range of motion of knee flexion and balance remained insufficient. [Conclusion] The results of this study suggest that the range of motion of knee flexion and isometric knee extensor strength remain insufficient compared to preoperative values, and the range of motion of knee flexion and balance remain insufficient, compared to healthy individuals.

[Purpose] The aim of this study was to investigate the relationships between physical function and automobile driving ability, while considering the influences of age and cognitive functioning in older adults. [Participants and Methods] The participants were 48 adults who were <65 years (adult group) and 18 adults aged ≥65 years (older group). All the participants held valid driver’s licenses and drove cars regularly. To assess driving ability, we calculated the number of errors while operating the gas and brake pedals using a driving simulator. Further, muscle strength, walking speed, the Timed Up and Go Test (TUG), and Trail Making Test (TMT) were measured. [Results] In the adult group, only age was significantly related to driving ability. Conversely, in the older group, positive associations between driving ability and both TUG and TMT were significant. [Conclusion] The results suggest that physical function, independent of cognitive functioning, significantly influences the driving ability of older adults.

[Purpose] The time-course effects of individual (ID) and active individual (AID) muscle stretching exercises on jump performance were examined. [Participants and Methods] The jump performance levels (jump heights) of 20 healthy males were measured before, immediately after, and at 5 and 10 minutes after ID/AID stretching and compared between the 2 stretching exercises and among different points. [Results] Both stretching exercises significantly reduced jump heights immediately, but there were no significant differences between them or at 5 or 10 minutes after them. [Conclusion] Both ID and AID stretching exercises reduced jump heights as an immediate effect, suggesting their effectiveness for muscle relaxation as a purpose of static stretching.

[Purpose] To clarify the difference in the effect (motivation of exercise) obtained by different types of exercise guidance for diabetes patients. [Participants and Methods] The subjects were 50 diabetes patients who attended either a diabetes lecture or diabetes awareness event held at our hospital (lecture, n=35; awareness event, n=15). We conducted a motivational questionnaire (BREQ-2) on exercise and compared the results of before and after the instruction. [Results] Among the lecture participants, the non-autonomous adjustment style improved with intrinsic motivation. Among the awareness event participants, the non-autonomous adjustment style did not improve, while the more autonomous adjustment style improved. [Conclusion] The results suggest that improvement of different motivational adjustment styles for exercise can be obtained through different types of instruction.

[Purpose] The purpose of this study was to examine the progression of motor learning and the soleus H-reflex changes induced by repetitive training of two tasks with different difficulty levels. [Participants and Methods] Twenty-one healthy adults were assigned to two groups: high and low difficulty training groups. They performed a motor task on a wobble board according to their group level of difficulty. The task error, the soleus H-reflex, and electromyography were measured at baseline and at the end of the training. [Results] The amplitude of the soleus H-reflex and the tibialis anterior muscle activity declined after training in the high difficulty training group. The task error declined significantly more in the low difficulty training group. [Conclusion] The results of the present study suggest that task difficulty modulates the progression of motor learning which is accompanied by a change in spinal motor neuron activity induced by training.

[Purpose] The purpose of our research was to clarify the relationships between body fat and physical function evaluations. [Participants and Methods] The participants were 70 company employees. Body fat percentage, the 2-step test, and 30-seconds chair-stand test (CS30) were measured at the same time for a total of 3 days, and statistical analysis was performed to calculate Pearson’s correlation coefficient. [Results] There was a negative correlation between body fat percentage and CS30. [Conclusion] Although CS30 tended to increase as the body fat percentage decreased, the results suggest that body fat percentage and the two-step test are not related in workers.

[Purpose] The usefulness of ultrasound therapy (US) after surgery for distal radius fracture was examined. [Participants and Methods] Postoperative patients with distal radius fracture were divided into 2 groups receiving (US Group; 11 hands of 11 patients) and not receiving (Non-US Group, 12 hands of 11 patients) US. US irradiation was performed once daily for 7 consecutive days from the day after surgery; thus, there were a total of 7 US irradiations. The forearm circumference and forearm/wrist ranges of motion were measured on the day after surgery and at 1, 2, 3, 4, 8, and 12 weeks after it. [Results] Forearm circumferences at 1 (US Group) and 2 weeks (Non-US Group) after surgery onward significantly differed from those on the day after it. As for the range of motion, significant differences were only observed in palmar flexion; compared with those on the day after surgery, the values significantly improved at 1 week after it in both groups, and the improvement rate was 444.2% in the US and 273.1% in the Non-US Group. [Conclusion] The results support the usefulness of US to improve swelling and the palmer flexion range of motion in the early stages after surgery for distal radius fracture.

[Purpose] We examined whether the excitability of spinal motor neurons changes over time during 5 minutes of motor imagery of exercise load. [Participants and Methods] First, in order to select subjects who could continue the motor imagery for 5 minutes, an evaluation was made using the Uchida-Klepelin psychiatric examination. Thirteen healthy subjects, excepting those rated as lacking concentration, were included in the study. Next, an exercise task of 50% maximum voluntary contraction (MVC) of pinch force was practiced. Then motor imagery of the exercise task was performed for 5 minutes, and the F wave was recorded in the first and last minutes of the motor imagery. [Results] The frequency of appearance of the F wave and the amplitude F/M ratio did not differ between the two periods. [Conclusion] This result suggests that the excitability of the spinal nerve motor neurons can be sustained for 5 minutes of motor imagery of 50%MVC of pinch grip.

[Purpose] To identify factors preventing the use of outcome indices in community-based physical therapy. [Participants and Methods] A mail questionnaire survey was conducted, involving professionals performing physical therapy based on the Long-term Care Insurance System of Ibaraki Prefecture. [Results] Through factor analysis, an optimal solution, consisting of 5 factors (<organizational factors>, <outcome index-related factors>, <practitioner-related factors>, <co-worker-related factors>, and <service user-related factors>) with 20 items was achieved. [Conclusion] Among these factors preventing the use of outcome indices, <organizational factors> specifically revealed differences in views according to the sex, age, and length of work experience in community-based physical therapy.

[Purpose] To evaluate the measurement accuracy of lower leg volumes using a container filled with water and to verify the volumes by using a simulated edema lower leg. [Participants and Methods] Sixteen healthy adults (10 males, 6 females) participated in this study. Their lower legs were inserted twice into a container filled with water. The amount of displaced water overflow was measured. The intraclass correlation coefficient (ICC(1,1)) and Bland-Altman analysis (B-A) were used to determine the reliability of this method, and the minimal detectable change (MDC) was calculated. The amount of displaced water overflow was also assessed using a simulated edema lower leg. [Results] The ICC(1,1) was 0.980. No systematic error was found in B-A. The MDC of measurement error was 159 ml. The amount of displaced water overflow was more than MDC when the simulated edema lower leg was inserted. [Conclusion] The accuracy of the measurement was confirmed in this study. The results suggest that this overflow method can be used to evaluate lower leg volume.

[Purpose] The purpose of this study was to explore whether the dual-task walking ability (walking straight with a search task) of stroke survivors would predict falls during the 3-month period after discharge. [Participants and Methods] The subjects were 34 stroke survivors with independent walking ability who were discharged from a convalescent rehabilitation hospital. We measured Stroke Impairment Assessment Set, knee extension strength, Berg Balance Scale, Mini Mental State Examination, Trail Making Test-A and Functional Independence Measure. Walking abilities of single- (10-m walk) and dual- (10-m walk with search) tasks were also assessed. The change rate of dual to single-task ability was calculated (SD change rate). The subjects were followed for falls for 3 months after discharge, and 11 subjects who had fallen were classified as the fall group, and 23 subjects who did not fall were classified as the non-fall group. [Results] Using a Cox proportional hazards model, the SD change rate was determined to be a significant predictor of falls. [Conclusion] The dual-task of straight walking with a search task could predict falls by stroke survivors.

[Purpose] The aim of this study was to analyze the relationship between cardiac function, vascular function, muscle strength index and the optimal load for exercise therapy, in order to establish a simple equation for estimating the optimal load for exercise therapy. [Participants and Methods] The subjects were 21 hemodialysis patients. The measurement items were left ventricular diastolic function, cardio ankle vascular index, muscle mass, grip strength and knee extension muscle strength. The optimal load weight ratio was defined as the value obtained by dividing the optimal load for exercise therapy by the body weight. [Results] Grip strength and knee extension muscle strength showed significant correlations with the optimal load weight ratio. Knee extension muscle strength was an independent determinant of the optimal load weight ratio, and the regression equation had moderate accuracy. [Conclusion] The results suggest that the optimal load for exercise therapy can be estimated from the knee extension muscle strength of hemodialysis patients.

[Purpose] The purpose of this study was to investigate the effects of a 3-week exercise-based intervention program for elderly fibromyalgia inpatients on pain, physical and attention abilities, quality of living (QOL) and cerebral blood flow. [Participants and Methods] Two elderly fibromyalgia (FM) patients participated. Pre- and post-evaluation of pain-related scales, physical ability, attention ability, QOL and cerebral blood flow in the dorsolateral prefrontal cortex (DLPFC) were carried out and compared. [Results] Both patients exhibited great improvement in QOL, physical ability, and all pain-related scales except Numerical Rating Scale. Improvements in attention ability and cerebral blood flow in the DLPFC were observed in one patient but not in the other. [Conclusion] The execution of this program resulted in improvements in physical activity, pain and QOL of the elderly FM patients. On the other hand, the effects of this program on cerebral blood flow and higher nervous activities were obscure and need to be investigated in more detail in the future.