[Purpose] We investigated the relationship between a national examinations prediction test and undergraduate test in students in the departments of physical therapy and occupational therapy with poor grades. [Participants and Methods] The participants were first-year students with poor grades who enrolled in April 2016 at five rehabilitation colleges (physical therapy subjects: n=275, occupational therapy subjects: n=98). We defined the 3rd tests of the third year as the national examinations prediction test. We used the unpaired t test, chi-square test, logistic regression analysis and receiver operating characteristic curve for the analysis. [Results] In a comparison of the pass and fail groups of the national examination prediction examination for physical therapy (n=142) and occupational therapy (n=33), all tests showed significant differences except for the entrance test and the end of the 1st year test in both departments, and the 2nd year basic test in the occupational therapy department. The result of the third year 2nd basic test of the physical therapy department was identified as related to the result of the national examinations prediction test, and its cutoff value was 49.5 points. [Conclusion] These results suggest the need for learning support in the second and subsequent years for students in physical therapy and occupational therapy departments with poor grades.

[Purpose] The purpose of this study was to clarify the influence of repetitive pitching by adolescent baseball pitchers on joint range of motion (ROM) and muscle flexibility. [Participants and Methods] Body function of 29 pitchers who belonged to junior high school baseball teams was measured before and after a repetitive 75-throw sequence. Measurement items included joint ROM, muscle flexibility, angle of thoracic kyphosis, latissimus dorsi muscle strength, and posterior shoulder tightness. The speed of the pitched balls was measured as an indicator of performance. [Results] Throw-side shoulder joint internal rotation ROM, non-throw-direction trunk rotation ROM, and non-throw-side gastrocnemius muscle flexibility decreased significantly after the throwing sequence, throw-side hip joint inner rotation ROM increased significantly, while pitched-ball speed showed no significant change. [Conclusion] Adolescent baseball players are more likely affected than adults baseball players by rupture of the kinetic chain. Our finding of changes in physical function in the absence of changes in performance suggests rupture of the kinetic chain of normal throwing in these subjects.

[Purpose] To investigate the effects of clinical training experience on the gait analysis ability of physical therapy students. [Participants and Methods] The subjects were 87 physical therapy students and 61 clinical training educators, a total of 148. The Wisconsin Gait Scale was used as a gait analysis index, and the responses of the subjects were compared and analyzed. [Results] There were significant differences in the responses to the 8 items between physical therapy students and clinical training educators before clinical training. Physical therapy students after clinical training and clinical training educators showed a significant difference in their responses to two items. In addition, there was a significant difference in one item in a comparison of the clinical training educators by clinical experience years. [Conclusion] The results suggest that clinical training experience improved the gait analysis ability of physical therapy students, raising it close to that of clinical training educators.

[Purpose] The purpose of this study was to examine the relationships between muscle mass, measured using a household body composition meter, by region and center of pressure (COP) sway in stabilometry and Functional Reach Test (FRT). [Participants and Methods] Forty healthy adult males were enrolled. The COP sway index was measured using a stabilometer while the subjects were standing still. The FRT was performed as a dynamic balance evaluation. Using a household body composition meter, the muscle masses of the whole body, left and right upper limbs, trunk, and left and right lower limbs were measured. [Results] There was no significant correlation between any of the muscle masses and the COP sway index; however, there was a significant moderate positive correlation between trunk muscle mass and FRT. [Conclusion] A relationship between trunk muscle mass and FRT was found; therefore, the use of a household body composition meter may be clinically meaningful.

[Purpose] The purpose of this study was to clarify the current state of observation and experience of lower extremity orthoses in clinical training. [Participants and Methods] The subjects were 44 students of a physical therapy department of a three-year vocational school. A questionnaire survey was conducted immediately after clinical training (once in the second grade, twice in the third grade). The questionnaire consisted of age, gender, types of clinical training facilities, current state of observation and experience of lower extremity orthoses, knowledge and techniques felt necessary for clinical training, interest in orthoses, and triggers of interest in orthoses. [Results] The observation of practice with orthoses had a high frequency (93.2%), but experience with orthoses was not sufficient. In relation to the types of facilities, convalescent rehabilitation wards offered the opportunity of observation and experience of lower extremity orthoses, though these were mostly acute phase orthoses. [Conclusion] It is necessary to reduce the differences in the types of facilities used for clinical training.

[Purpose] Direct arch measurement under quantitative partial weight bearing (DAM-under-qPWB) has been developed as a new method for measuring the medial longitudinal arch. This study examined the reliability and validity of DAM-under-qPWB with respect to the navicular drop test (NDT). [Participants and Methods] The participants were 12 young adults and a total of 24 feet were measured. DAM-under-qPWB was measured under 2 conditions, namely, 50% and 100% weight-bearing. Two testers were responsible for recording the measurements. The inter- and intra-class correlation coefficients for the 2 testers were determined. To quantify the validity, the correlation between DAM-under-qPWB and NDT was determined. [Results] DAM-under-qPWB was confirmed to have high reliability in this study. Correlation analysis revealed a significant correlation between DAM-under-qPWB and the NDT. [Conclusion] The findings of this study suggest that DAM-under-qPWB can be used for the evaluation of the medial longitudinal arch.

[Purpose] This study investigated the relationships among thoracic lateral deviation, asymmetry of the thoracic shape, and asymmetry of the lateral tilt angle of the shank in the stance phase of gait. [Participants and Methods] The participants were 18 healthy males. The measurement items were the thoracic lateral deviation and asymmetry of the thoracic shape at standing rest, and the change of the outer tilt angle of the shank in the stance phase of gait. The cohort was divided into an all subjects group (n=18), a left deviation group (n=15), and a right deviation group (n=3) based on the degree of thoracic lateral deviation. [Results] In the all subjects group, the change of the outer tilt angle of the shank was significantly larger on the right side than on the left side in the early stance phase, and the same significant difference was observed in the left deviation group in both the early and late stance phases. In the late stance phase, the change of the outer tilt angle of the shank negatively correlated with the thoracic lateral deviation and positively correlated with the asymmetry of the lower thoracic shape. [Conclusion] These results suggest that increases of thoracic lateral deviation and asymmetry of the lower thoracic shape elicit greater outward movement of the shank on the right side.

[Purpose] The present study surveyed inhaler technique education and evaluated the relationship between inhalation errors and instruction methods. [Participants and Methods] This was a cross-sectional study involving 48 subjects undergoing inhalation therapy. A questionnaire administered by an interviewer was used to survey the number of times inhalation instruction had been given, whether or not there was instruction by demonstration, the occupation of the inhalation instructor, the inhalation drugs used, the number of past experiences with inhalers, and the perceived efficacy of the inhalation drugs, to assess the relationship between inhalation errors and instruction methods. [Results] 54.2% of patients had been given instructions by demonstration. Instruction by demonstration was a significantly more multidisciplinary approach and patients of this group received instruction more times than the instruction without demonstration group. The group that had been given inhalation instruction more than once showed a significant reduction in inhalation errors compared to the group given instruction only once. The number of occupations involved in giving instruction and inhalation errors were not significantly related. [Conclusion] Multiple rounds of inhalation instruction reduces inhalation error; however, methods of inhalation instruction with a multidisciplinary approach need to be studied further.

[Purpose] This study aimed to clarify the characteristics of each posture time and the sedentary behavior (SB) time of young-old and old-old community-dwelling elderly. [Participants and Methods] The participants were 137 persons attending a general care prevention classroom (22 males, 108 females, age 74.0 ± 4.7 years). Their basic information was recorded, and a questionnaire survey, and physical function evaluation were performed. Triaxial accelerometers were used to measure daily posture time (standing position, sitting position, lying position) and SB time. [Result] The standing time of the old-old group was significantly shorter and their sitting and SB times were significantly longer than those of the young-old group. There was a significant positive correlation between age and sitting and SB times. [Conclusion] To prevent physical deterioration, it is necessary to educate young-old persons on the benefits of shortening SB time and extending standing behaviors.

[Purpose] Selective muscle-release surgery is one of the treatments for the upper limbs of a child with cerebral palsy. In this study, we conducted a questionnaire survey to clarify the relationship between function and ability improvement and satisfaction after selective muscle-release surgery for the upper limb. [Participants and Methods] The questionnaire was sent to the parents of 265 children who underwent selective muscle-release surgery of the shoulder, elbow, and forearm at an orthopedic hospital in Tokyo. In the questionnaire, the presence or absence of function/ability improvement after surgery (muscle tone, respiratory function, gross motor function, play, ADL) and postoperative satisfaction were investigated. We examined the difference in the ratio of satisfaction and the presence or absence of improvement of each function/ability. [Results] We received replies from 20 people, a return rate that met the criteria of this study. When gross motor function and ADL were improved, it was found that many parents were satisfied after surgery. [Conclusion] This study revealed that parents’ satisfaction was high when children’s gross motor function and ADL were improved.

[Purpose] The purpose of this study was to verify the magnitude of errors in muscle strength measurement using a handheld dynamometer (HHD). [Participants and Methods] The study participants were 16 healthy adults (32 limbs). A HHD was used to measure lower limb muscle strength, including hip flexion, extension, abduction, adduction and knee extension. Each measurement was performed two times by two experienced raters to verify the magnitude of errors in intra- and inter-rater measurements. The errors for each measurement were estimated using the % minimum detectable change (%MDC). [Results] The error in intra-rater measurements of hip adduction was within “acceptable” limits. The errors in inter-rater measurements of hip abduction and adduction exceeded “acceptable” limits. The errors of the other items were “acceptable”. [Conclusion] When muscle strength is measured using an HHD, careful attention should be paid to the magnitude of errors found in this study.

[Purpose] To clarify changes in shoulder joint, glenohumeral joint, and scapular movements with thoracic motion restriction. [Participants and Methods] Twenty healthy males performed anterior elevation of both upper limbs in a standing position with and without thoracic motion restriction to compare the shoulder flexion, glenohumeral flexion, and scapular posterior tilt angles. Variations in these changes among participants were also examined. [Results] Thoracic motion restriction significantly reduced the shoulder flexion and scapular posterior tilt angles, whereas significant differences were not observed in the glenohumeral flexion angle. On the other hand, the increases or decreases in the glenohumeral flexion and scapular posterior tilt angles varied among participants. [Conclusion] The decrease in the shoulder flexion angle may be explained by a reduced scapular posterior tilt due to thoracic motion restriction, but the degree of such a change varied among participants.

[Purpose] The purpose of this study was to reveal the prevalence of apathy among community-dwelling elderly and to identify the relationships between apathy and physical and cognitive functions. [Participants and Methods] The subjects were 328 community-dwelling older adults living in Kasama City. We measured their grip strength, and recorded the results of the five-times sit-to-stand test, one-leg standing time, sit and reach distance, and timed up and go test (TUG). In addition, we assessed participants’ cognitive function using 5 cognitive tests (5-Cog) and the Trail Making Test. [Results] The prevalence of apathy was 38.4%. Apathy was significantly related to the physical performance of one-leg standing, sit and reach distance, and TUG. There was no relationship between apathy and cognitive function. [Conclusion] Our data suggest that community-dwelling older adults have apathy and it is an important factor when considering the prevention of physical deterioration.

[Purpose] To clarify the factors inhibiting home return of stroke patients living alone. [Participants and Methods] The subjects were 97 stroke patients who were living alone. We conducted hierarchical cluster analysis with variables of outcome, admission Functional Independence Measure (FIM), age, and inpatient days in order to identify groups having difficulty adjusting to discharge, and made comparisons among the groups. We conducted a text mining analysis after investigating the causes of difficulty in adjusting to discharge using a free-form questionnaire addressed to the relevant staff. [Results] The results of the cluster analysis were classified into 4 groups, and the results of text mining analysis were divided into 7 groups. [Conclusion] The results suggest that the factors inhibiting home return of stroke patients living alone were: higher brain dysfunction, motor paralysis, ADL ability, human resources such as family and supporters, financial problems, care insurance adjustment, and disparity between patient hope and reality.

[Purpose] To investigate whether the Short Physical Performance Battery (SPPB) is useful as a test of the physical performance of older people receiving long-term care. [Participants and Methods] Ninety older people receiving long-term care were recruited for this study. The SPPB and the Berg Balance Scale (BBS) were evaluated as physical performance tests. Then, correlation analysis was performed on the results of the two tests. [Results] Although there was a strong correlation between the two tests, in the scatter diagram, the strength of the correlation was related to the level of the physical performance. That is, the high physical performance group (BBS score ≥38) showed a strong correlation (ρ=0.793) between the two tests, but the low physical performance group (BBS score ≤36) only showed a moderate correlation (ρ=0.625). [Conclusion] The SPPB seems to be a convenient physical performance test for older people receiving long-term care who have a relatively high physical performance.

[Purpose] The purpose of this study was to examine the muscle thickness and echo intensity of the trunk muscles and psoas major with ultrasonography in order to clarify the quantitative and qualitative changes of these muscles between healthy young and elderly females. [Participants and Methods] Twenty healthy young and 20 healthy elderly females were recruited for this study. Muscle thickness and echo intensity of the external oblique, internal oblique, transversus abdominis, lumbar multifidus and psoas major were measured using ultrasonography. [Results] Muscle thicknesses of the external and internal obliques and psoas major were significantly lower in the elderly females than in the young females; however, there were no significant differences between the two age groups in the transverse abdominis and lumbar multifidus. Echo intensities of all muscles were significantly higher in the elderly females than in the young females. [Conclusion] The results of this study indicate that the external and internal obliques and psoas major of healthy elderly females were quantitively less and qualitatively lower than in healthy young females. The transverse abdominis and lumbar multifidus of healthy elderly females were also qualitatively lower than in healthy young females.

[Purpose] The present study aimed to review intervention study designs, target diseases, intervention methods, effects, and outcomes regarding visual spatial disabilities. [Methods] An extensive literature search of several databases that included Japanese articles was performed. [Results] A total of 14 articles met the eligibility criteria. Regarding intervention design, we found 1 quasi-randomized controlled trial (RCT), 2 non-RCTs, and 11 before–after trials. Regarding target diseases, we found 14 articles on stroke and 1 on dementia. There were 10 types of intervention method, with 8 of them resulting in significant improvements in visual spatial disabilities. [Conclusion] Our findings suggest that there are few RCTs on visual spatial disabilities and few studies of conditions other than unilateral spatial neglect associated with stroke.

[Purpose] Patients in the acute phase of cerebral infarction were examined to clarify the influence of the psoas major muscle area at the onset on discharge destinations. [Participants and Methods] Forty-six patients admitted to a hospital within 3 days after the onset of cerebral infarction were classified into 2 groups based on their discharge destinations: home (14) and another hospital (32). On admission, the psoas major muscle was evaluated using abdominal computed tomography (CT) to calculate the psoas muscle mass index (PMI), while retrospectively examining medical records to compare related factors between the 2 groups. Furthermore, multivariate analysis was performed to identify factors influencing discharge destinations. [Results] The PMI, admission National Institutes of Health Stroke Scale (NIHSS) score, pre-admission modified Rankin Scale (mRS) score, and presence/absence of higher brain dysfunction were correlated with the feasibility of discharge to home. Through multivariate analysis, the PMI, admission NIHSS score, and pre-admission mRS score were selected. [Conclusion] The PMI at the onset of cerebral infarction, which was correlated with the feasibility of discharge to home, may be a useful index for the prediction of discharge destinations in the early stage after the onset.

[Purpose] The purpose of this study was to examine whether experience of falls affects the relationship between subjective assessment of walking and objective motor assessment. [Participants and Methods] Sixty-three community-dwelling elderly aged over 65 years old were the participants. They were divided into a fall group (n=13) and a no-fall group (n=50). The Japanese version of the modified Gait Efficacy Scale (mGES), center of gravity sway, and the Timed up and go test (TUG) were evaluated. [Results] There was no association between mGES and the center of gravity sway, irrespective of fall experience. mGES and TUG showed a significant correlation in the no-fall group, but no significant association in the fall group. [Conclusion] The relationship between subjective and objective assessments of walking differed depending on the experience of falls.

[Purpose] The purpose of this study was to investigate the effect of differences in polarity on cerebral blood flow during and after galvanic vestibular stimulation using functional Near-Infrared Spectroscopy (fNIRS). [Participants and Methods] The participants were 20 right-handed young healthy adults who were observed under four stimulus conditions: 1) left anode/right cathode Galvanic Vestibular Stimulation (RC-GVS), 2) RC-sham, 3) right anode/left cathode GVS (LC-GVS), and 4) LC-sham. We monitored and compared cerebral oxyhemoglobin changes (oxy-Hb) using fNIRS before (T1: 0–60 sec), during (T2: 60–120 sec, T3: 120–180 sec) and after (T4: 180–240 sec, T5: 240–300 sec) bipolar GVS. [Results] In RC-GVS, oxy-Hb in the right temporal area significantly increased during and after GVS. In LC-GVS, oxy-Hb in both temporal areas significantly increased or had a tendency to increase during and after GVS. [Conclusion] Our results for brain regions activated during GVS are consistent with those of previous studies. It is possible that brain activation after GVS is related to after effect.

[Purpose] The purpose of this study was to investigate the habits of measuring blood pressure and track the number of daily steps of mild-stroke patients after discharge. [Participants and Methods] The subjects were 10 patients who had been hospitalized with mild stroke, and were provided with discharge support to prevent recurrence of stroke. During the 12 months after their discharge, we tracked their daily steps by pedometer and blood pressure measurement habits. [Results] The blood pressure measurement habit was established in all subjects 12 months after discharge. In addition, compared with the number of steps confirmed at the time of discharge, the number of steps increased in 80% of the subjects. [Conclusion] To prevent recurrence of stroke, discharge support and post-discharge monitoring is highly recommended.

[Purpose] In this study, we examined the immediate effect of an agility exercise involving repetitive opening and closing movements of the lower limbs on the walking speed of the elderly and confirmed its usefulness. [Participants and Methods] The subjects were 14 elderly people aged 65 or over (4 men, 10 women, average age 73.1 ± 5.4 years, height: 158.1 ± 11.2 cm, weight: 53.2 ± 12.2 kg, BMI: 21.2 ± 3.8 kg/m²). The walking speed before and after the repeated lower limb movement was measured and compared. [Results] The walking speed was significantly higher after the lower limb repetitive opening and closing movement, confirming the immediate effect of the agility exercise on walking speed. [Conclusion] The immediate effect on the walking speed of the elderly of the lower limb repetitive opening and closing exercise suggests its usefulness in training.

[Purpose] The purpose of this study was to clarify the influence of changes in lower limb alignment on kinematical variables and gait parameters of bilateral lower limbs before and after total knee arthroplasty. [Participants and Methods] The measurements of three-dimensional motion analysis and ground reaction force of 30 free walking patients who were hospitalized for total knee arthroplasty with bilateral osteoarthritis were compared between before and 6 weeks after surgery. This study calculated the mean value of the knee adduction moment during walking, ground reaction force vertical component, body center of gravity movement distance and walking parameters. [Results] Knee adduction moment on the operative side decreased, and the influence on non-operative kinetic variables and gait parameters were minimal. [Conclusion] On the operative side 6 weeks after surgery, knee adduction moment decreased due to improvement in lower limb alignment. On the non-operative side, the pre-operative gait pattern remained because there was no difference in walking speed, floor reaction force, or center-of-gravity movement distance.

[Purpose] The purpose of this study was to examine the gait characteristics of peripheral arterial disease (PAD) patients without sarcopenia. [Participants and Methods] The subjects were 14 male PAD patients and 11 elderly males in the same age group who did not have sarcopenia. Gait at a comfortable speed, grip strength, isometric knee extension muscle strength, ankle range of motion, and body composition were measured and compared between the two groups. [Results] The PAD group showed a significant decrease in walking speed and stride. However, physical function items and lower limb blood flow showed no significant correlations with walking speed. [Conclusion] PAD patients showed decreased walking speed regardless of muscle mass and strength, suggesting the need for early intervention on gait.

[Purpose] To clarify stepping strategies adopted by elderly people when turning unexpectedly during gait. [Participants and Methods] The study included 20 females, who required support level 1 or 2, but were able to walk independently. They were instructed to turn right or left while walking at normal velocity and turned at a 90 degree angle in that direction, to classify this movement as a spin/step turn. Furthermore, their gait velocity, muscle strength, range of motion, and balance ability were measured. [Results] To turn toward the dominant leg, 9 and 11 performed a spin and step turn, respectively. These numbers when turning to the non-dominant were 8 and 12, respectively. The one-leg standing time was significantly shorter in the step turn group, but there were no significant differences between the groups in other parameters. [Conclusion] When turning unexpectedly during gait, elderly people with a reduced one-leg standing time tend to choose a step turn.

[Purpose] The 4p-syndrome is a rare disease caused by deletion of a gene cluster positioned in the short arm of chromosome 4, and there have been very few studies or case reports of it. This study reports a case, managed by a physical therapist, who showed improvements in functions and abilities when the child entered elementary school. [Participant and Methods] The participant was a girl in the third grade of elementary school, who was enrolled in a class for children with special needs. Visits to the class were conducted by a physical therapist once a month. The conditions of the girl between the first visit and the present were compared. [Results] The girl began responding to auditory and visual stimuli as a result of the intervention, became able to roll over and maintain a sitting position, and changed from gastric to oral intake of food. [Conclusion] Physical therapists can help children with 4p-syndrome develop by being involved in functional training programs conducted in special needs classes of local elementary schools and by providing intervention as a team with the cooperation of class teachers and nurses.