[Purpose] The purpose of this study was to examine the effect of a preoperative exercise program focused on the six-minute walking distance (6MWD) and presented in a pamphlet for patients with gastrointestinal cancer who were scheduled for surgery. [Participants and Methods] A total of 12 different types of exercise were presented to a total of 28 patients with gastrointestinal cancer. Their physical functions, including 6MWD, were evaluated before exercise introduction, preoperatively (at the end of exercise), and postoperatively. The change in 6MWD from the first to the preoperative evaluation was compared among the improvement, maintenance, and decline groups. [Results] The improvement group comprised 10 patients. Postoperative 6MWD significantly decreased in the maintenance and decline groups, but there was no significant difference in the improvement group. Preoperative weight loss was observed to reduce postoperative 6MWD in the maintenance and decline groups compared with the improvement group. [Conclusion] The preoperative exercise program performed at this hospital was effective in preventing postoperative 6MWD reduction in some patients with gastrointestinal cancer, but the results suggest the necessity of also considering weight loss.

[Purpose] To investigate the effects on daily life of urinary incontinence among middle-aged and elderly women. [Participants and Methods] The participants were 262 women over 40 years of age who were living independently. They were given an anonymous paper questionnaire, including the Japanese version of the Incontinence Impact Questionnaire (IIQ) to survey the impact of urinary incontinence on daily life. Descriptive statistics, logistics regression analysis (stepwise method), and factor analysis (principal component analysis, varimax method) were performed using the statistical analysis software, IBM SPSS 25.0. [Results] The average age of the participants was 56.1 ± 10.0 years old: 111 (42.4%) had urinary incontinence, 39 (14.9%) had urinary incontinence in the past, and 112 (42.7%) had none at all. The types of urinary incontinence were: 62 (55.9%) stress urinary incontinence, 13 (11.7%) urge incontinence, and 36 (32.4%) mixed urinary incontinence. In logistic regression analysis, significant factors were: age and the following IIQ items: Q5 (walk, swim, move body with sport), Q11 (go to local gatherings), Q19 (what dress to wear), Q30 (embarrassed) (p<0.01); and Q6 (enjoying entertainment: movies, concerts, etc.), Q8 (going out of the house for more than 30 minutes by car or bus), Q23 (activities restricted due to concerns about smell) (p<0.05). Factor analysis identified (daily life behavior), (leisure behavior) and (interested interpersonal behavior) as relevant factors, and Cronbach’s coefficient for the three factors was 0.975. [Conclusion] Urinary incontinence affected middle-aged and elderly women’s QOL causing psychological anxiety in basic daily living, interpersonal relationships, and social activities.

[Purpose] The purpose of this study was to examine the influence of femoral anteversion on the lower limb, trunk, and pelvis joint angles and muscle activities during unanticipated cutting motion. [Participants and Methods] The subjects were 15 female athletes. Femoral anteversion was measured by Craig’s test. The motion task was an unanticipated cutting motion. The joint angles and muscle activities were measured using a three-dimensional motion analysis system and surface electromyography. The correlation coefficient between each measurement and femoral anteversion was calculated. [Results] The mean value of femoral anteversion was 11.9 ± 2.6˚. A significant negative correlation was found between femoral anteversion and the peak and excursion of the knee valgus angle. [Conclusion] The relationship between femoral anteversion and the knee valgus angle in this study was different from that reported in a previous study. The knee valgus angle may be affected by task differences.

[Purpose] In this study, we aimed to verify the trunk motion characteristics of anticipatory postural adjustments (APAs) of the elderly at gait initiation. [Participants and Methods] The subjects were 10 healthy young controls and 10 elderly persons. Measurements were made using a center of gravity measurement instrument, surface electromyograms, and accelerometers. Accelerometers were attached to the neck (C7), lower back (L3) and pelvis (S1), and surface electromyograms of the bilateral gluteus medius and erector spinae muscles were recorded. [Results] In the elderly, activities of the gluteus medius of the stepping side and the erector spinae of the stance side were recognized prior to the onset of movement of the center of pressure (COP). In controls, however, no activity was observed in the bilateral erector spinae muscles. Accelerometer analysis showed displacement of the upper trunk toward the stepping side in the control, while it was toward the stance side in the elderly. [Conclusion] APAs at gait initiation in the elderly were characterized by the activity of the erector spinae muscle of the stance side and upper trunk displacement toward the stance side.

[Purpose] To kinematically and dynamically analyze the shift of the center of gravity, ground reaction force exerted on the buttocks to lower extremity, and thoracic to pelvic angle when executing reaching movements of the upper limb in a sitting position, and clarify their characteristics. [Participants and Methods] Twenty healthy young participants performed the task of reaching their right hand out forward in a sitting position to measure the amounts of change in the center of gravity, vertical component of the ground reaction force, and trunk and pelvic angles during the period from when adopting the initial position to when holding a target. [Results] The reaching movements were executed, with the center of gravity shifting toward the target, but the ground reaction force kept on the non-reaching buttocks. The amount of change in each angle was as follows: thoracic angle: anterior tilt, right tilt, and left rotation; pelvic angle: anteflexion, right tilt, and left rotation; and pelvic-to-thoracic relative angle: anterior tilt, right tilt, and left rotation. Thus, the results were generally similar. [Conclusion] It was suggested that healthy people execute forward-reaching movements, while maintaining a certain amount of change in the ground reaction force exerted on the non-reaching buttocks as a basis for their motor strategies.

[Purpose] To determine the characteristics of the infrapatellar fat pad movement in the low range of knee flexion. [Participants and Methods] Twenty-three healthy young subjects were studied using an ultrasound imaging system to measure the position of the two tissues adjacent to the infrapatellar fat pad. They were measured at the distal and central parts of the infrapatellar fat pad, at 0, 15, 30, and 45 degrees of knee flexion. [Results] At the distal part of the infrapatellar fat pad, the largest rate of change in position was between 0 and 15 degrees. At the central part, there was no significant difference in position between 0 and 15 degrees. [Conclusion] The movement of the infrapatellar fat pad is characterized by maximal deformation at the distal part but little deformation in the central part, in the range between 0 and 15 degrees of knee flexion.

[Purpose] The feasibility of continuously exercising at home using neuromuscular electrical stimulation (NMES) for home-visit rehabilitation service users was examined, including the physical effects of this method. [Participants and Methods] NMES was applied to both quadriceps femoris muscles of 9 home-visit rehabilitation service users for 8 weeks. The rate of continuously exercising, knee extensor torque produced during maximal voluntary contraction (knee extensor maximal voluntary contraction (MVC) torque), anterior femoral muscle thickness, lower limb muscle mass, and gait velocity were measured. [Results] The rate of continuously exercising was 85.3 ± 16.4%. After the 8-week intervention, significant improvements were only observed in the knee extensor MVC torque on the affected side (from 0.9 ± 0.4 to 1.1 ± 0.5 Nm/kg, p<0.05). [Conclusion] It may be feasible for service users to continuously exercise at home using NMES, and such exercise may improve the knee extensor MVC torque on the affected side, although further studies are required for its generalization.

[Purpose] To develop preventive perspectives on medial tibial stress syndrome (MTSS), university long-distance runners’ status of injury and physical functions related to the history of MTSS, specifically the influences of pedal edema, were examined. [Participants and Methods] A questionnaire survey was conducted, involving 50 long-distance runners to perform various types of measurement in 12 (6 males and 6 females) randomly selected. The measurement items were: the leg volume, Shin oedema test (SOT) score, hip internal and external rotation ranges of motion, and fallen arch distance. [Results] Among the 50 runners, 40 had a history of MTSS. The diurnal variation in the leg volume was more marked in the MTSS than control group. There were no differences in the other measurement items. [Conclusion] Runners with a history of MTSS may be more vulnerable to swollen leg and MTSS.

[Purpose] To determine whether the movement direction and angle of the scapula can be accurately measured by a smartphone application, and whether it can be used for clinical research. [Participants and Methods] Ten healthy men were tasked with upper limb forward elevation and belt-tying movement. Using a three-dimensional movement analysis device and smartphone application (Angle Meter), the scapula anterior tilt and upward rotation angles during each task were measured. [Results] For all subjects, the results calculated by the three-dimensional movement analysis device and the smartphone application were similar. [Conclusion] Using the smartphone application is one of the useful methods for evaluating the alignment of the scapula during upper limb forward elevation and belt-tying movement, and we considered it useful for the evaluation of the shoulder joint.

[Purpose] We compared the difference and interaction effect between conventional training and clinical clerkship (CCS) by examining their effects on the scores for specialized and practical problems equivalent to the national examination. [Participants and Methods] Before and after comprehensive clinical training of conventional training or CCS (12 weeks), practical problems equivalent to the national examination were set, and the scores before and after conventional training and CCS were compared. [Results] There was no interaction between the two factors of the training type and before and after the training period, but the scores significantly improved after both conventional training and CCS. [Conclusion] Both conventional training and CCS improved the scores. There was no significant difference in their effects on the scores of the practical problems, and both training systems improved knowledge. The usefulness of CCS was shown.

[Purpose] To clarify clinical practice-related difficulties perceived by physical therapy students and their clinical instruction requests. [Participants and Methods] Semi-structured interviews were conducted with 16 students who had completed clinical practice, and content analysis was performed. [Results] Among the categories with larger numbers of recorded units, 15 represented clinical practice-related difficulties perceived by students. They included C11, difficulties related to assessment and therapeutic interventions for patients, and C6, difficulties related to questions asked by students and advice provided by clinical instructors. Similarly, 17 categories explained clinical instructions requested by students including: D8, desirable student-clinical instructor communication, and D10, instructions to help students accurately understand each case by promoting clinical reasoning. [Conclusion] The results clarified clinical practice-related difficulties perceived by students, and suggest measures to resolve such difficulties based on their clinical instruction requests.

[Purpose] We examined the immediate effect of intermittent compression of the gluteus maximus and hamstrings on anterior pelvic tilt. [Participants and Methods] The subjects were 11 healthy males. The subjects received 3 minutes of intermittent compression stimulus to the gluteus maximus and hamstrings in the sitting position. We measured the thoracic posterior depression, lumbar anterior depression, and sacral inclination angle in the upright position and trunk flexion positions, and defining the range of flexion as the difference between them, we compared them before and after the intervention. [Results] After the intervention, the sacral inclination angle in the upright position increased, while the thoracic vertebra and lumbar anterior angles decreased. The sacral inclination angle increased in the trunk flexion position as well as its range of motion. [Conclusion] The results suggest that compression stimulation to the gluteus maximus and hamstrings increases anterior pelvic tilt.

[Purpose] The purpose of study was to determine the effects of a 12-week dual task exercise using MOTOTILE on functional fitness and cognitive control in frail older adults. [Participants and Methods] Pre-test, the 36 participants (mean age, 75 years old) were assigned to two groups based on Mini Mental State Examination (MMSE) scores: group 1 (n=27), 27 points or more, and group 2 (n=9): 26 points or less. All subjects performed a dual task exercise. Functional fitness and cognitive control were assessed at pre- and post-test. [Results] Significant differences in time effect were noted for the timed up & go test, stepping, five-repetition sit-to-stand test, toe grip strength, Flanker task and Stroop task, but there were no significant differences between the two groups in improvement rates or magnitudes of change. [Conclusion] MOTOTILE dual task exercise programs seem effective in improving lower body function and cognition in frail older adults.

[Purpose] Changes in exercise tolerance in an early stage after pneumonectomy using video-assisted thoracoscopic surgery (VATS) and thoracotomy were compared. [Participants and Methods] A total of 98 patients (age: 70.0 ± 7.9, male: 67, female: 31), who had undergone pneumonectomy, were divided into 2 groups: VATS (79) and thoracotomy (19). Their 6-minute-walk distance (6MWD) were measured before and after surgery, and the 6MWD recovery rate was calculated by dividing the postoperative value by the preoperative one in each case. The 6MWD recovery rate was compared between the 2 groups. Furthermore, multiple regression analysis was performed with the 6MWD recovery rate as a dependent variable. Postoperative evaluation was conducted at 6.2 ± 3.2 days after surgery. [Results] The 6MWD recovery rate was significantly lower in the thoracotomy than VATS group, revealing that the rate significantly varies according to the surgical procedure. [Conclusion] Exercise tolerance in an early stage after pneumonectomy may be influenced by surgical procedures, as it takes longer for recovery after thoracotomy compared with VATS.

[Purpose] To verify the reliability of a precordial flexibility test for simple and convenient thoracic mobility assessment. [Participants and Methods] The participants were 15 healthy adults, and the raters were 3 persons with different lengths of experience. The participants adopted a lateral recumbent position on a bed, with both hips and knees flexed at an angle of 90°. The raters fixed their pelvis, twisted their shoulder girdle backwards, and measured the distance between their posterior acromion and the bed. The reliability of the precordial flexibility test was analyzed using the intra-class correlation coefficient (ICC) and Bland-Altman plot. [Results] The intra- and inter-rater reliability was confirmed by ICC (1,1)=0.80–0.92 and ICC (2,1)=0.71–0.90, respectively. Additionally, proportional biases for the intra- and inter-rater reliability based on the Bland-Altman plot were –0.25 to 0.16. [Conclusion] The intra- and inter-rater reliability of the precordial flexibility test was sufficiently high, supporting its clinical applicability.

[Purpose] This study examined the reliability of a method for measuring thoracolumbar mobility using a smartphone application. [Participants and Methods] A total of 10 healthy males were recruited, and 2 individuals (1 physical therapy student and 1 physical therapist) were the examiners. The participants flexed the thoracolumbar region in a sitting position. The examiners took a picture using a smartphone and measured the angle of thoracolumbar mobility using the application. Interclass correlation coefficients (ICC) were calculated to estimate the relative reliability. [Results] The method for measuring thoracolumbar mobility using the smartphone application had high reliability (ICC: 0.831; 95% confidence interval for minimal detectable change: 7.5 mm). [Conclusion] These results demonstrate the high reliability of a smartphone application in the quantitative assessment of thoracolumbar mobility. In addition, examiner proficiency had a low impact on this measurement method.

[Purpose] To consider relationships among adverse events and physical condition and exercise therapy effect in patients with blood tumors during chemotherapy. [Participants and Methods] The participants were patients with blood tumors in hospital for chemotherapy who were prescribed rehabilitation. The evaluation items were: the Cancer Functional Assessment Set (cFAS) and motor Functional Independence Measure (mFIM) as exercise effect indicators, and the Geriatric Nutritional Risk Index (GNRI) as nutrition indicators. The evaluation items of adverse events were 18 items of the Common Terminology Criteria for Adverse Events v5.0 (CTCAEv5). All were evaluated before and after the exercise therapy. The relationship among number of adverse events and cFAS, mFIM and GNRI was analyzed. [Results] There were significant improvements in cFAS and mFIM. Negative correlations were found between the number of adverse events and cFAS, mFIM and GNRI. [Conclusion] The results suggest the possibility of relationships between onset of adverse events and physical function and nutritional status. They also suggest the possibility of exercise therapy benefiting basic movements, activities of daily living, mobility and standing balance regardless of the degree of adverse events or nutritional status.

[Purpose] To clarify the influence of the physical activity level on exercise tolerability and heart rate recovery (HRR) after exercise. [Participants and Methods] Eighteen healthy students put on a physical activity meter to measure their amount of exercise and number of steps as physical activity parameters. They also underwent an exercise stress test to measure their peak oxygen uptake (peakVO₂/kg) and recovery heart rate at intervals of 1 minute until 5 minutes after exercise to analyze the correlations between these values and the amount of exercise/number of steps. [Results] There were no correlations between the physical activity parameters and peakVO₂/kg. The amount of exercise was not correlated with HRR, but the number of steps was correlated with it. [Conclusion] The physical activity level may not influence exercise tolerability. Among the physical activity parameters, the amount of exercise representing exercise intensity may not influence HRR, whereas the number of steps not representing such intensity may influence it.

[Purpose] To clarify the relationships among the life space, motor function, and activity of patients with cerebrovascular disease using day care rehabilitation services. [Participants and Methods] Forty patients with hemiplegia caused by cerebrovascular disease, who lived at home using day care rehabilitation services, were assessed based on the Life-Space Assessment (LSA), Stroke Impairment Assessment Set (SIAS), knee extensor strength, Timed Up & Go test (TUG), 10-m maximal-effort walk test, sway test, and Functional Independence Measure (FIM). [Results] The mean total LSA score was 41.2 ± 23.8. Through analysis with LSA as a dependent variable, TUG was selected. [Conclusion] There is a correlation between the life space and TUG score of patients with cerebrovascular disease using day care rehabilitation services.

[Purpose] To compare physiological responses and shortness of breath when standing and sitting in the recovery process after submaximal exercise. [Participants and Methods] A submaximal exercise stress test was conducted for 12 healthy university students. Their systolic pressure level, heart rate, double product, oxygen uptake, respiratory minute and tidal volumes, respiratory rate, and shortness of breath were measured under 2 recovery conditions, sitting and standing, at 4 points: immediately and 3, 6, and 9 minutes after exercise. [Results] The systolic pressure level did not differ between the 2 postures, whereas the heart rate was higher throughout measurement, and the double product was also higher at 3 minutes after exercise under the standing recovery condition. The difference in the posture after exercise did not influence the other parameters. [Conclusion] The results suggest that in the recovery process after exercise, the heart rate compensates for an insufficient stroke volume to keep the circulating blood volume stable, and the level of stress to the heart at the early stage is higher when standing, but the oxygen debt repaid is similar, and there are no differences in the ventilatory parameters or shortness of breath between the 2 postures.

[Purpose] The purpose of this study was to examine the concurrent validity of the ventilation function measured by a spirometer, the Maximum Phonation Time (MPT), and the Maximum Expiratory Time. [Participants and Methods] The subjects were 23 healthy persons who did not have any respiratory-related abnormalities. The subjects were examined for basic attributes, the ventilation function test with a spirometer, MPT, and Maximum Expiratory Time. The relationships between MPT and Maximum Expiratory Time and each evaluation item were investigated. [Results] There were significant positive correlations between MPT and Maximum Expiratory Time, vital capacity, and %vital capacity. Maximum Expiratory Time did not correlate with any spirometer respiratory function test. [Conclusion] MPT may be a simple method for measuring vital capacity.

[Purpose] This study investigated the efficacy of chest physical therapy for children hospitalized with acute severe asthma. [Participants and Methods] The study included 20 children with acute severe asthma but without major neurological impairment. The mean age of the children was 2.5 ± 1.3 years. Findings on admission and clinical care were examined. The children were categorized into chest physical therapy and non-chest physical therapy groups, and the evaluation items were compared between the two groups. [Results] No significant intergroup differences were observed in oxygen weaning and length of hospitalization. [Conclusion] These results suggest that chest physical therapy enables neither early oxygen weaning nor early discharge of children hospitalized with acute severe asthma.

[Purpose] The purpose of this study was to investigate the relationship between Functional Assessment for Control of Trunk (FACT) and physical function in community-dwelling elderly using the long-term care insurance service. [Participants and Methods] The subjects were 126 persons (72 male, 54 female, average age 77.3 ± 8.6 years). They were examined for FACT, grip strength, maximum walking speed, Timed Up and Go test (TUG), chair stand test for 30 seconds (CS30), one-leg standing time, and movement independence, and the correlations between FACT and physical functions were investigated. [Results] FACT moderately correlated with maximum walking speed, TUG, CS30, one-leg standing time, and movement independence. [Conclusion] FACT is related to balance ability, lower limb muscle strength, and maximum walking speed in community-dwelling elderly using the long-term care insurance service, and is possibly an index of movement independence.

[Purpose] To investigate the relationship between exercise habits and age and the Life Space Assessment (LSA) in elderly people living in mountainous areas. [Participants and Methods] The participants were 657 elderly people living in mountainous areas. The participants completed a self-administered questionnaire survey. The survey items were age, gender, exercise habits, and LSA. [Results] LSA scores were significantly higher in the group with exercise habits than in the group without exercise habits. There was no relationship between age and LSA in the group with exercise habits, but there was a relationship between age and LSA in the group without exercise habits. [Conclusion] Exercise habits were suggested to be a factor in maintaining LSA.

[Purpose] The aim of the study was to examine the association between deglutition and sleep quality in community-dwelling elderly. [Participants and Methods] The participants were 400 elderly aged ≥65 years, who completed an internet questionnaire. The Japanese version of the Pittsburgh Sleep Quality Index (PSQIJ) and Dysphagia Risk Assessment for Community-dwelling Elderly (DRACE) were evaluated. [Results] The 400 participants were divided into a sleep disorder group and a non-sleep disorder group. Sleep disorders were associated with the DRACE. [Conclusion] The results suggest that sleep quality is related to deglutition. It is important to investigate the relationship between deglutition and sleep quality.

[Purpose] This study focused on patients with malnourished proximal femoral fractures. Walking ability at discharge was examined and factors related to walking ability were sought. [Participants and Methods] The participants were 66 patients with proximal femoral fractures. Walking ability at discharge was examined, and the characteristics of each group classified by walking ability were investigated. [Results] At discharge, 22 persons (34%) were in the independent group, 24 (36%) in the monitoring group, and 20 (30%) in the assistance group. In the comparison among groups, significant differences were found in the walking ability before injury, the walking ability during hospitalization, and the cognitive function during hospitalization. [Conclusion] Persons in the independent group had been able to walk independently before the injury. In addition, they were characterized by high walking ability and cognitive function at the time of hospitalization. The results suggest these factors are related to walking ability.

[Purpose] The purpose of this research was to clarify the influences on abdominal muscles of tilt angle changes in passive standing on a tilt table. [Participants and Methods] The subjects were 5 healthy men. A surface electromyograph was used to measure the muscle activities of the external oblique and internal oblique abdominal muscles, and the gluteus medius, rectus femoris and biceps femoris of the right lower leg. The subjects stood on a tilt table and the tilt angles were changed for from 40° to 80° in 10° increments. Passive standing was maintained for 10 seconds at each angle and the muscle activities were measured for 3 seconds, when the wave form was stable, integrated and compared. [Results] The internal oblique muscle showed significantly high values at 40°, 70°, 80°, and at 60° its value was significantly higher than that of 50˚. No significant differences were found among the different tilt angles in the muscle activities of the external oblique, gluteus medius, rectus femoris, and biceps femoris. [Conclusion] These results show that using a tilt table at angles over 60° might be a method for selectively activating the internal oblique muscle.

[Purpose] The purpose of this study was to examine the benefits of a Rehabilitation Travel Project (Rehabilitation Travel). [Participant and Methods] The subject was a female in her 80s who had left hemiplegia due to cerebral hemorrhage. She was self-supporting indoors, but needed an accompanying caregiver when walking with a T-cane outdoors. The modified Gait Efficacy Scale (mGES), Modified Fall Efficacy Scale (MFES), Ikigai-9, and Life Space Assessment (LSA) were evaluated at one month before rehabilitation travel (before travel), just before the rehabilitation travel (just before travel) and one month after the rehabilitation travel (after travel). [Results] MFES and LSA showed little change among the three periods; mGES improved from just before travel to after the travel; and Ikiiga-9 improved at just before and after travel compared to before travel. [Conclusion] The results suggest that rehabilitation travel can be one means of improving self-efficacy and purpose of life.