[Purpose] To clarify the relationship between handball players’ lower limb muscle strength and jump performance. [Participants and Methods] Senior high school handball players’ peak lower limb extensor torque-to-body weight ratios when performing an isokinetic closed kinetic chain exercise at an angular velocity of 60 deg/sec were calculated, and the correlations between these values and their one-leg vertical jump, alternate-leg 5 bounds, and two-leg jump were analyzed. Subsequently, differences in their muscle strength and one-leg vertical jump between their pitching and non-pitching sides were examined. [Results] Lower limb extensor strength was significantly correlated with alternate-leg 5 bounds and two-leg jump. There were no significant differences between the pitching and non-pitching sides. [Conclusion] Lower limb extensor strength when performing an isokinetic closed kinetic chain exercise may be useful for horizontal jump performance evaluation.

[Purpose] The Functional Independence Measure (FIM) factors affecting the discharge destination of convalescent stroke patients with prescription lower limb orthoses were investigated. [Participants and Methods] The subjects were 82 hemiplegic patients in a convalescence hospital. The subjects were assigned to a home group and a care facility, based on their discharge destination, and their basic characteristics, and scores of the 18 FIM items at admission and discharge were analyzed. Logistic regression analysis of significant improvements was conducted. [Results] The total scores of Stroke Impairment Assessment Set (SIAS) and families living together were significantly higher in the home group. Among the FIM items showing improvement, washing the body, dressing the upper and lower extremities, transfers and stairs were significantly higher in the home group, and memory was significantly higher in the care facility group. Significant odds ratios were observed for the items of stairs and memory. [Conclusion] These results suggest that improvement in the stairs item may be an important factor affecting the discharge destination. Regardless of the discharge destination, increases in physical activities may affect improvement of memory.

[Purpose] This study determined the differences in cardiorespiratory response between forward walking (Fw) and backward walking (Bw) at low speeds. [Participants and Methods] Twelve healthy young men were asked to perform Fw and then Bw for three consecutive minutes at walking speeds of 0.33, 0.67, 1.00, and 1.33 m/s. Cardiorespiratory response parameters, including oxygen uptake (VO₂) and heart rate (HR), were measured for 30 s at the end of each walking speed condition. The oxygen cost was also calculated by dividing walking speed into VO₂. [Results] The mean VO₂ and mean HR of all participants were higher for Bw than for Fw. Furthermore, the mean oxygen cost at 1.00 m/s was lower than at any other speed in Bw. [Conclusion] Bw is performed at low speeds during rehabilitation. The results of this study show that VO₂ and HR were higher in Bw than in FW at low speeds.

[Purpose] To clarify the relationships between muscle strength at various joint angular velocities and postural control. [Participants and Methods] The knee extensor strength and power output levels of 70 healthy male adults were measured at joint angular velocities of 0, 60, 90, 120, 180, 240, and 300 deg/sec to analyze the relationships between these values and cushion factors and total center-of-pressure (COP) locus lengths when performing one-leg drop jump landing. [Results] With an increase in the joint angular velocity, muscle strength significantly decreased, whereas muscle power output significantly increased. Furthermore, muscle strength and power output at a joint angular velocity of 90 deg/sec or higher were negatively correlated with the cushion factor and total COP locus length. [Conclusion] Although muscle strength tends to be measured under isometric conditions or at low velocities in clinical environments, the results of the present study indicate the importance of such strength at intermediate or higher velocities for instantaneous postural control, suggesting muscle power output at these velocities to be a parameter.

[Purpose] The purpose of this study was to evaluate the association between falls and foot deformity among patients with knee osteoarthritis (OA). [Participants and Methods] Ambulatory subjects aged 40 years and over were recruited consecutively as they were added to the waiting list for knee arthroplasty or high tibial osteotomy at Tottori University Hospital between April and September in 2014. Thirty female patients were recruited for this study (mean age 75.0 ± 9.5 years, range 51–85). Leg-heel angle, dorsiflexion, navicular drop test (NDT), arch height index, hallux valgus angle, small toe varus angle, and expanse angle were measured to assess foot dysfunction. Physical performance (muscle strength of knee extension, one-leg standing time, 5-m gait time, Timed up and go test), Japanese Knee Osteoarthritis Measure, and Geriatric Depression Scale were also assessed. [Results] Falls were significantly correlated with NDT according to multivariate analysis. [Conclusion] This finding suggests that foot dysfunction is one of the risk factors of falls among patients with knee OA.

[Purpose] Cerebral palsy children with Gross Motor Function Classification System (GMFCS) level V show stronger asymmetric deformity with age. We investigated the progress of infant Windswept Deformity and the change in the hip joint range of motion. [Participants and Methods] Four cerebral palsy children with GMFCS level V (3 boys, 1 girl, Ohima’s classification 1) received physiotherapy for 60 minutes twice a week. We measured the Goldsmith Index (GI) and hip joint range of motion (HROM) of the children from 2 to 6 years old every three months for two years and examined the changes in values among the eight measurement times. [Results] There was no significant difference in the change of the GI or the HROM. [Conclusion] We couldn’t confirm that the progress of Windswept Deformity and the decrease of the HROM happened in infancy. However, there is a possibility that there is no influence on the GI when HROM does not have clear laterality. Therefore, we consider that the progress of deformity should not be judged on changes in GI alone, and that increases and decreases in HROM should be noted, while attempting to prevent it.

[Purpose] This study investigated the epidemiology of injuries among professional soccer players in Japan Professional Soccer League Division 2 over a 2-year period, using definitions established by the Fédération Internationale de Football Association. [Participants and Methods] Fifty-eight players were the subjects of this study. We investigated the injury rate, injury situation, type of injury, location, severity, and days until return to play. [Results] The incidence rate during practice in 83 cases of injuries occurring in 2 seasons was 3.1/1000 ph, and 10.8/1000 ph during the game. Most injuries were located in the lower extremities, and the most frequent injury was muscle strain. The number of days until return to competition was severe (more than 29 days). [Conclusion] This study showed that measures should be taken to prevent traumatic injuries during preseason practice and during games. Similarly, preventive measures are needed to reduce overuse injuries during the season. In addition to establishing a preventive program for the prevention of injuries, the results suggest that it is necessary to clarify the criteria for return to competition.

[Purpose] We used musculoskeletal simulation to estimate abduction of the shoulder and lateral bending of the spinal column during crutch walking, and investigated the relationship between lateral bending of the spinal column and abduction of the shoulder during double-crutch walking. [Participants and Methods] The participants were five healthy young males. Data of movement during crutch walking was measured using a 3D motion analysis system. Based on the obtained data, shoulder joint abduction and lateral bending of the spinal column during double-crutch walking was estimated using a musculoskeletal simulation. [Results] A significant correlation between the lateral bending angle of the spinal column and abduction angle of the shoulder was found during the crutch stance phase. [Conclusion] A relationship between lateral bending of the spinal column and abduction angle of the shoulder was found, and it was considered that the axillary pad slipping out of the axilla during double-crutch walking was a possible factor.

[Purpose] This study was made to clarify the conditions of temporary blood flow restriction (BFR) that can produce muscle hypertrophy. [Participants and Methods] Five male Wistar rats were subjected to BFR of 200 mmHg in the lower leg muscle using a manchette. Tissue oxygen saturation (StO₂) at the start of BFR was set to 100%, and the lowest StO₂ value within 6 minutes from the start of BFR was set to 0% (%StO₂). StO₂ for each minute was compared from the start until 6 minutes. [Results] % StO₂ showed a downward trend for 3 minutes after the start of BFR, and then decreased only slightly before reaching a plateau. [Conclusion] When %StO₂ is relatively low, there is a greater effect of muscle hypertrophy, and the BFR time is 4 minutes or more. However, the duration of the low %StO₂ state is also considered to be a factor inducing muscle hypertrophy, so further investigation is necessary.

[Purpose] To assess the effect of total knee arthroplasty (TKA) design on gait kinetic parameters. [Participants and Methods] Two different concepts of cruciate retaining (CR) TKA, Journey II (8 knees) which had a relative anterior femoral position, and Persona (7 knees), were included in this study. Three-dimensional gait analysis was performed preoperatively and at 4 weeks postoperatively. The knee joint moments and powers were calculated for the frontal and sagittal planes. [Results] The postoperative peak negative knee extensor power during load response was higher in patients with Journey II than in those with Persona. [Conclusion] The results of this study reflect part of the design concept of the Journey II, which is thought to have resulted in high shock absorbing ability by knee extensor muscles during load response in the early postoperative period after TKA.

[Purpose] To investigate difference in the variations of the knee extensor muscle strength of patients with unilateral total knee arthroplasty (TKA) and bilateral TKA in the 3 years after surgery. [Participants and Methods] Patients with severe bilateral knee osteoarthritis participated in this study. Measurements of knee extensor muscle strength were performed before surgery, and at 1 and 3 years after surgery. For analysis, the subjects were divided into a unilateral TKA group (12 patients) and a bilateral TKA group (12 patients). [Results] The knee extensor muscle strength significantly increased in the bilateral TKA group. However, it showed no significant difference in the unilateral TKA group. [Conclusion] The results suggest that knee extensor muscle strength increases, compared with before surgery, between 1 and 3 years after bilateral TKA of patients with severe bilateral knee osteoarthritis.

[Purpose] The purpose of this study was to investigate whether the spatial coincidence of body parts during action observation improves motor imagery. [Participants and Methods] The participants were 24 right-handed healthy adults (15 males, 9 females, 21.3 ± 4 years old) who were randomly assigned to 3 groups: the proximal observation group, AON group; the distal observation group, AOF group; and a control group). The motor imagery task of this study was mental rotation of the hand (HMRT), and the reaction time was measured. First, HMRT was performed, then each group was observed for hand movement under different conditions. Finally, HMRT was performed again after action observation. [Results] There were no significant differences among the reaction times of the 3 groups before observation, but in the results after observation, the reaction time was significantly faster in the AON group than in the AOF and control groups. [Conclusion] The position of the body during action observation may affect motor imagery ability.

[Purpose] The purpose of this study was to clarify the variations in autonomic nervous system (ANS) activity using heart rate variability analysis during an early mobilization program on the first and second days after coronary artery bypass grafting surgery. [Participants and Methods] The cohort comprised 15 patients who underwent coronary artery bypass grafting surgery on a standby basis. We examined the fluctuation of ANS activity in the supine position, sitting position, and standing position, before and after cardiac surgery, using frequency analysis of heart rate variability. [Results] Low frequency/high frequency (LF/HF) significantly increased and HF values significantly decreased at rest after cardiac surgery compared to preoperative rest. LF/HF increased and HF values decreased significantly compared to their values at rest after cardiac surgery following the implementation of an early mobilization program in the early postoperative period. However, there was no significant difference in the rate of change of LF/HF and HF values before and after cardiac surgery, when posture was changed from supine to standing. [Conclusion] These results suggest that early mobilization can be performed if the rate of change in ANS activity during postural change is comparable to that before cardiac surgery.

[Purpose] The purpose of this study was to determine preoperative prediction factors of independent walking ability after total hip arthroplasty with the Direct Anterior Approach (DAA-THA) for females. [Participants and Methods] The subjects of this study were 53 patients who underwent primary unilateral DAA-THA. Independent walking ability with or without a cane was assessed by observation 14 days after DAA-THA and defined as patients who were able to walk more than 50 m, and also had a timed up and go test (TUG) result of <13.5 seconds. Logistic regression analysis was used to identify factors of independent ambulation ability. [Results] The preoperative prediction factor was 10-m gait speed (cut off 13.4 seconds, sensitivity, 0.714, specificity, 0.935, area under the curve, 0.845). [Conclusion] 10-m gait speed was identified as a factor determining post-operative independent ambulation in females with Crowe I hip osteoarthritis.

[Purpose] The purpose of this study was to examine the reliability of a newly developed foot horizontal arch height measuring device using a laser beam. [Participants and Methods] The twenty feet of ten healthy adults (6 males, 4 females) who gave consent were the subjects. Two examiners measured the foot horizontal arch height twice. The intra-class correlation coefficient was calculated for the intra-examiner reliability using the measurements of one examiner, and for the inter-examiner reliability using the measurements of both examiners. [Results] The intraclass correlation coefficient (ICC) was as high as 0.90 for the intra-examiner reliability, and 0.75 for the inter-examiner reliability. [Conclusion] It is considered that this device has high intra- and inter-examiner reliabilities, and can be a clinically useful measurement device.

[Purpose] This paper reports the practice and effectiveness of an in-hospital collaboration conference (CON) between recovery rehabilitation (RR) and home-visit rehabilitation (HR). [Participants and Methods] CON was held by the two persons in charge: 1 RR and 1 HR. The presence or absence of HR adaptation was examined in CON. Effectiveness was judged using 3 indices [number of cooperation cases (NC), nursing level of cooperation cases (NL), days from discharge to the start of the home visit rehabilitation service (DDS)] during the year before and the year after the introduction of CON. [Results] After the introduction of CON, NC increased from 8 to 32, NL increased from zero to 31.3% of all cases, and DDS decreased from 12.5 to 6.3 days. [Conclusion] CON has been an effective intervention for increasing NC and shortening DDS.

[Purpose] To compare the level of functional satisfaction and expectation of individuals requiring nursing care at home with their main caregivers using a questionnaire survey. [Participants and Methods] Subjects were individuals requiring nursing care who were using Daycare Center A and their main caregivers. A 5-point scale questionnaire was used to assess the following aspects: satisfaction with the current functionality; satisfaction with the amount of care in everyday life; and expectations of regarding future functionality. The answers to each question were compared between the individuals requiring nursing care and their main caregivers. [Results] Compared to their main caregivers, individuals requiring nursing care had significantly higher expectations regarding future functionality. No significant differences were found in the other items. [Conclusion] Individuals requiring nursing care and their main caregivers shared the same perception of the current functionality and the amount of care in everyday life. However, individuals requiring nursing care had higher expectations regarding their future functionality.

[Purpose] The purpose of this study was to measure the physical activity of frail community-dwelling elderly using an accelerometer. [Participants and Methods] Thirty-two elderly persons (11 males and 21 females) who participated in a care prevention class were the subjects. The Mini Mental State Examination (MMSE), Life-Space Assessment (LSA), physical function (grip strength, 5 chair stand-ups, Timed Up and Go test (TUG), eyes open one leg standing time, 5-m maximum walking speed, and standing time from the long sitting position) and physical activity (PA) were evaluated, and standing, sitting, supine, sedentary behavior (SB), low, medium, and high intensity exercise times, and moderate-to-vigorous physical activity (MVPA) were measured using an accelerometer. [Results] Females showed significantly higher values for all physical function assessments except grip strength, significantly shorter sitting and SB times, and significantly longer exercise times in all intensity categories, and a negative correlation coefficient was found between their mobility ability including TUG and PA. [Conclusion] The results suggest that continuation of daily activities at home is necessary for maintaining physical function.

[Purpose] To clarify the effects of trunk proprioceptive neuromuscular facilitation (PNF) and relaxation on the pitching velocity and posture. [Participants and Methods] Twenty healthy university students received trunk PNF, had a rest, or performed a stretch pole (SP) exercise, and their pitching velocities and postures (trunk flexion and extension during the windup phase; and trunk lateroflection, shoulder abduction, and maximum shoulder external rotation during the early cocking/stride) when pitching with full effort were measured. [Results] The pitching velocity was the highest under the PNF condition, followed by the rest and SP conditions, in this order. The pitching posture did not vary among the 3 conditions. [Conclusion] The results revealed that trunk PNF increases the pitching velocity, whereas trunk relaxation decreases it, and variations in the pitching posture measured in the present study do not influence such increases/decreases.

[Purpose] The aim of the present research was to investigate the validity and reliability of the 15 m Incremental Shuttle Run Test (15m ISRT), and to investigate the factors affecting 15m ISRT performance in middle-aged men. [Participants and Methods] Twelve middle-aged males performed three tests in a random order: the 15m ISRT, maximum traveling speed test, and lower leg muscle strength test. [Results] The correlation between 15m ISRT performance and VO₂ was very high, r=0.95 (p<0.01). The only factor associated with 15m ISRT performance was peakVO₂ (R2=0.88). Intraclass Correlation Coefficient (ICC) was very high for predicted peakVO₂ calculated from the 15m ISRT performance vs. measured peakVO₂. [Conclusion] Our findings indicate that the 15m ISRT is valid and reliable for evaluating peakVO₂ of middle-aged adults.

[Purpose] The purpose of this study was to examine the possibility of acquiring autonomy in stair ascent and descent at the time of discharge using the evaluation and medical information at the initial stage of hospitalization in recovery phase rehabilitation. [Participants and Methods] The subjects were 51 patients who had femoral proximal fractures and 71 patients with central nervous system diseases. Logistic regression analysis was conducted using each evaluation item as an independent variable, and stair ascent and descent autonomy at the time of discharge as the dependent variable. The Receiver Operating Characteristic (ROC) curve was determined and the cutoff values were examined using the area under the curve. [Results] Factors influencing stair ascent and descent autonomy were Functional Independence Measure (FIM) toileting for patients with femoral proximal fractures, and FIM bed transfers for those with central nervous system diseases. The cutoff values obtained from the ROC curve were 4.50 or more for both groups of patients. [Conclusion] The results suggest that the evaluation items identified in this study may be used to easily evaluate prognostic predictions of autonomy in stair ascent and descent at discharge.

[Purpose] The purpose of this study was to examine the impact of reality shock on physical therapists by comparing their burnout scale results from before graduation and at three months of employment. [Participants and Methods] The participants were 237 physical therapy students. We conducted a group survey before graduation and a questionnaire by mail after three months of employment. [Results] The results of 46 respondents who responded twice were used as valid responses. Respondents with reality shock had significantly higher mental fatigue after employment. Respondents without reality shock had significantly lower depersonalization after employment and had a higher rate of workplace satisfaction and job satisfaction. [Conclusion] New physiotherapists were found to have reality shock after hiring and a tendency to suffer burnout.

[Purpose] In this study, we report the treatment results and frequency of radial Extracorporeal Shock Wave Therapy (rESWT) for plantar inferioritis. [Participants and Methods] Twelve patients (3 men and 3 legs; 9 females, 10 legs; mean age 68.2 ± 11.4 years old) who were diagnosed as plantar inferioritis received rESWT to the affected part and stretching of the plantar fascia. [Results] The loading pain showed a tendency to decrease gradually every week except in one case. After 2 rESWT treatments, the load pain was significantly reduced. In each case, the load pain was reduced by approximately one half (average 41%), but the pain relief effect was not maintained, increasing slightly after one week. The load pain was reported as less than the average of 10 mm on a Visual Analog Scale (VAS) by 7 people (7 legs) after 5 treatments. The patients who finished treatment after 5 treatments of rESWT were 61% of the whole. [Conclusion]. Treatment of plantar inferioritis with rESWT was useful. The results suggest that 5 treatments is an indicative optimal treatment number.

[Purpose] To clarify the effects of the draw-in maneuver on the thickness of the lateral abdominal muscles and trunk stability. [Participants and Methods] Seventeen healthy young participants’ resting expiratory levels and muscle thickness when performing the draw-in maneuver in a supine position on a floor and stretch pole (SP) were measured. Their trunk stability levels when standing on one leg and walking after the exercise were also measured. [Results] When performing the draw-in maneuver, the thickness of the external oblique muscle decreased, whereas that of the internal oblique muscle increased. There was neither a main nor interaction effect related to the supine position on a floor/SP. An interaction effect was observed on the thickness of the transverse muscle. After the exercise, the total center-of-pressure path length decreased only when standing on one leg. [Conclusion] The draw-in maneuver improved trunk stability when standing on one leg, suggesting that it increases the thicknesses of the internal oblique and transverse muscles, and the increase in the latter case is more marked when adopting a supine position on an SP.

[Purpose] The purpose of this research was to clarify the learning process of physical therapy students in a terminal stage physiotherapy lecture, and to reconsider the role of the lecture. [Participants and Methods] The subjects were 62 physiotherapy students. A structured model using the Modified Grounded Theory Approach (M-GTA) was constructed from language data obtained from comments written after the terminal stage physiotherapy lecture. [Results] The model showed three hierarchical categories: the opportunity to face death, learning inspired by facing death, and improvement of motivation for terminal stage physiotherapy. [Conclusion] We concluded this model is useful for understanding students’ learning process and practical motivation, and helpful for the effective development of terminal stage physiotherapy lectures.

[Purpose] Our hospital provides clinical training using Excel templates for trainees to record medical practices during service hours as simulated medical records. This study examined clinical trainees’ levels of satisfaction with this approach. [Participants and Methods] A total of 9 students, who had participated in clinical training at our hospital within the period between January 2017 and December 2018, were asked to respond to a questionnaire on a 4-point Likert scale. Each question had a space to enter free descriptions, which were encoded and categorized. [Results] The clinical trainees’ levels of satisfaction were high, specifically in categories, including <the effect of simulation-based learning> and <having more time after returning home>. [Conclusion] Our simulated medical recording system may have been useful to provide effective clinical training in terms of clinical experience and time after returning home by assigning training tasks similar to actual clinical services.