Rigakuryoho Kagaku
Online ISSN : 2434-2807
Print ISSN : 1341-1667
Current issue
Showing 1-26 articles out of 26 articles from the selected issue
ORIGINAL ARTICLE
  • Akari SUZUKI, Hideo KANEKO
    2020 Volume 35 Issue 5 Pages 597-601
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] This study investigated the effect of a voluntary cough intensity improvement program for community-dwelling elderly. [Participants and Methods] Thirty-four elderly people were divided into an intervention group (n=17) and a control group (n=17). The intervention group continued the program five days a week for four weeks. The program included three items: supine position on the half-cut pole, expiratory muscle training, and check of voluntary cough intensity. Before and after the program, cough peak flow (CPF) and pulmonary function, respiratory muscle strength, chest and abdominal wall mobility were measured. [Results] After the program, CPF and maximal inspiratory pressure of the intervention group had significantly increased. [Conclusion] The results suggest that the voluntary cough intensity improvement program may be helpful for improving CPF and maximal inspiratory pressure in the community-dwelling elderly.

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  • Megumi TAKASHIMA, Yukari HORIMOTO
    2020 Volume 35 Issue 5 Pages 603-606
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The purpose of this study was to clarify the characteristics of self-efficacy and self-regulated learning in physical therapists. [Participants and Methods] The subjects were 52 physical therapists with at least 6 years of experience. Questionnaire surveys were conducted using items of the Japanese version of the Motivated Strategies for Learning Questionnaire (MSLQ) Motivation Scale and the General Self-Efficacy Scale (GSES). For the analysis, the respondents were divided into two groups according to their GSES level, and a test for the difference in MSLQ was performed. [Results] The MSLQ items that differed between the two groups were 10 out of 31 items, and test anxiety was strong only in the group with low self-efficacy. [Conclusion] Reducing test anxiety may be one way of promoting self- regulated learning.

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  • Yasushi KURIHARA, Hiroshi KARASUNO, Hironori OHSUGI, Tadamitsu MATSUDA
    2020 Volume 35 Issue 5 Pages 607-613
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] To investigate physical function factors affecting the modified Star Excursion Balance Test (mSEBT) results of female collegiate softball athletes. [Participants and Methods] The subjects comprised 20 members of a female collegiate softball club. mSEBT lower limb reach distance in three directions (anterior, postmedial, postlateral), upper and lower limbs’ range of motion, flexibility of trunk, and muscle strength (trunk and lower limbs) were measured and their relationships were analyzed. [Results] mSEBT lower limb reach distance in the anterior direction significantly correlated with ankle dorsiflexion range of motion and hip abductor muscle strength on the pivot foot. mSEBT lower limb reach distance in the postmedial and postlateral directions significantly correlated with trunk and hip abductor muscle strength on the pivot foot. [Conclusion] Ankle dorsiflexion range of motion and hip abductor muscle strength on the pivot foot, and trunk muscle strength were identified as physical function factors affecting the mSEBT results of female collegiate softball athletes.

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  • Nobuhide AZUMA, Tomonari SUGANO, Shinya SUGAWARA, Masahiro KOSAKA
    2020 Volume 35 Issue 5 Pages 615-619
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The participants of an injury prevention workshop sponsored by Fukui Prefecture high school baseball league, in which physical therapists gave lectures, were surveyed for satisfaction and item improvement of the workshop. [Participants and Methods] Items of the workshop needing improvement were identified using customer satisfaction analysis and text-mining of a questionnaire answered by 38 third-grade junior high school students who hoped to play high school baseball. [Results] The workshop showed a high satisfaction rate of 97.4%, and “venue” and “time” were identified as items requiring improvement. [Conclusion] Though a high satisfaction was obtained by introducing practical skills in the workshop, more consideration was necessary for the “venue” and allocation of “time” in the workshop.

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  • Shuntaro TAMURA, Makoto KOBAYASHI, Yasuyuki SAITO, Tomoyuki ASAKURA, S ...
    2020 Volume 35 Issue 5 Pages 621-627
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] To revise a fall assessment method to create a valid and simple assessment for use in acute care wards. [Participants and Methods] This retrospective study included 1309 inpatients. Risk factors were extracted and weighted based on the results of a fall assessment sheet and the presence or absence of falls. Then, the revised fall score and prediction accuracy were calculated. For the revised score, risk was classified according to the latent rank. [Results] The number of fall factors was reduced from 39 to seven. The sensitivity and specificity of prediction and the area under the curve for the conventional and revised scores were 88.5%, 43.0%, and 0.700 vs. 65.6%, 71.0%, and 0.718, respectively. The number of falls significantly differed for each potential rank according to the revised scores. [Conclusion] Fall prediction based on revised scores and risk classification using latent rank theory is appropriate.

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  • Taiki FURUMOTO, Ayane KATAYAMA, Yuka KAWAMURA, Ken TOMONARI
    2020 Volume 35 Issue 5 Pages 629-633
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The purpose of this study was to clarify the preoperative factors that predict muscle weakness 6 months after total knee arthroplasty (TKA). [Participants and Methods] The subjects were 108 patients who underwent unilateral TKA for a diagnosis of knee osteoarthritis. Muscle strength was recorded as the value obtained by dividing the maximum isometric knee extension torque by the body weight before, and 2 weeks, 3 months, and 6 months after the operation. Basic attributes, knee range of motion, thigh muscle morphology, and muscle strength were selected as preoperative factors. Multiple regression analysis was used to determine the preoperative factors affecting the muscle strength 6 months after surgery. [Results] Preoperative femoral muscle cross-sectional area and muscle strength were factors predicting muscle strength 6 months after surgery (p<0.01, R2=0.45). [Conclusion] The results suggest that patients with muscle weakness remaining 6 months after TKA are likely to have muscle atrophy and weakness of the thigh before surgery.

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  • Mami KOYAMA, Yukari HORIMOTO, Megumi TAKASHIMA
    2020 Volume 35 Issue 5 Pages 635-638
    Published: 2020
    Released: October 20, 2020
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    [Purpose] To clarify the factors affecting work-life satisfaction levels of occupational therapists and physical therapists. [Participants and Methods] The subjects were 145 graduates of our school, 65 occupational therapists and 80 physical therapists, in their first to ninth years of employment. We surveyed their degree of satisfaction with occupational life (11 items) using a web questionnaire. [Results] Factors influencing the satisfaction of their overall work life were job satisfaction (standardized regression coefficient: 0.279), job content (0.275), education/skill development (0.210), human relations/communication (0.150), wages (0.149), and employment stability (0.119). [Conclusion] The results suggest that the factors implicated in self-growth and career are important.

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  • Kensuke KOBAYASHI, Sadamu ISHIKAWA, Yoshiyuki WADA, Mitsunori TOKUDA, ...
    2020 Volume 35 Issue 5 Pages 639-646
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] To examine whether the effects of repetitive facilitative exercises combined with electrical stimulation and vibration stimulation (combined RFE) on paralysis improvement in the upper limb are influenced by the treatment initiation time and paralysis severity. [Participants and Methods] The subjects were 211 stroke patients (195 upper limbs, 202 fingers) in the acute phase to chronic phase. Ueda’s 12-step hemiplegia function test was used to evaluate hemiplegia. [Results] The improvement of upper limbs and fingers by the combined RFE was significant regardless of the level and stage of paralysis. [Conclusion] Combined RFE improves hemiplegia regardless of the level and stage of paralysis.

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  • Shingo KATAYAMA, Kensuke TAKESHIGE, Misuzu SAIKI, Yoshihiro FURUTANI, ...
    2020 Volume 35 Issue 5 Pages 647-651
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The purpose of this study was to compare the effect of static stretch and myofascial release. [Participants and Methods] Sixteen healthy adults were randomly assigned to two groups of eight participants each. Their mean age was 29.9 ± 5.8 years. The evaluation indices used were heel-to-floor distance at maximum elevation in the single leg raise (SLR), feeling of tension at maximum elevation (VAS), and a short-form self-report measure to assess relaxation effects (S-MARE). [Results] There were significant changes in SLR and VAS after the static stretch and myofascial release interventions, with increased SLR and decreased VAS. S-MARE showed a significant increase after the intervention only with the myofascial release. [Conclusion] Myofascial release was the most effective intervention examined in this study. However, it is difficult to determine the effectiveness of the interventions from only the findings of this study. It is necessary to select the appropriate interventions according to individuals’ unique conditions.

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  • Naoyuki MOTOJIMA, Toshiyuki KOUNO
    2020 Volume 35 Issue 5 Pages 653-658
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The purpose of this study was to determine the differences in electromyographic activities of hemiplegic stroke patients who succeeded and failed the sit-to-stand (STS) during the recovery phase. [Participants and Methods] Twenty stroke patients who succeeded in the STS, and 20 stroke patients who failed in the STS participated in this study. Leg muscle activation times from the time of seat-off during the STS were analyzed using surface electromyography. The differences between the groups were compared. [Results] The tibialis anterior, rectus femoris and biceps femoris activated before seat-off in both groups. However, in the failed group the gastrocnemius also activated before seat-off. Activation of the gastrocnemius was significantly earlier than in the success group. Furthermore, in the failure group, the activation of the muscles of the hip and ankle joints occurred almost at the same times. [Conclusion] These results suggest that the cause of stroke patients failing the STS is these abnormal muscle activation patterns.

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  • Toshiki MIZUNO, Yumi HIGUCHI, Tetsuya UEDA, Masakazu IMAOKA, Emiko TOD ...
    2020 Volume 35 Issue 5 Pages 659-665
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] To investigate the effect of a postoperative program with added trunk muscle training for proximal femoral fractures. [Participants and Methods] Postoperatively, patients admitted to a convalescent rehabilitation ward were categorized into a control group (normal physiotherapy; 9 patients) and an intervention group (added trunk muscle training; 9 patients). Before and after the 4-week intervention, patients' trunk function, walking ability, balance function, lower limb muscle strength, pain, and fall self-efficacy scale were measured, and changes between the two groups were compared. [Results] In the intervention group, trunk function (thickness of the abdominal rectus, thoracic erector spinae and external abdominal oblique muscles, and endurance of the abdominal muscle), walking ability (timed up-and-go test), and balance function (Berg Balance scale) significantly improved compared to the control group. [Conclusion] These findings suggest that trunk muscle training may promote the recovery of walking ability and balance function in postoperative patients.

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  • Seigen BUN, Tetsuya UEDA, Hiromi NOMURA, Rie KATADA, Tatsuya MATSUMOTO ...
    2020 Volume 35 Issue 5 Pages 667-672
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The purpose of this study was to examine the factors involved in the early determination of discharge destination of patients older than 65 years who undergo surgery after proximal femoral fractures. [Participants and Methods] Sixty-five subjects who underwent surgery after proximal femoral fractures were divided into two groups: those discharged to home, and those discharged to hospital. The patients’ information was collected from medical records, and factors related to the discharge destination were analyzed. [Results] The recovery prediction of the physical therapist on the first postoperative day (odds ratio 8.9) and wheelchair transfer (odds ratio 8.3) were identified as factors related to the early determination of patients’ discharge destination. [Conclusion] The results of this study suggest that the recovery prediction of the physical therapist on the first postoperative day and the patient’s ability to perform wheelchair transfer may be factors for the early determination of the patient's discharge destination.

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  • Ryo SATO, Yohei SAWAYA, Takahiro SHIBA, Tamaki HIROSE, Minami SATO, Ma ...
    2020 Volume 35 Issue 5 Pages 673-677
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] To clarify the relationship between depression and sarcopenia in Japanese elderly receiving day-care through the long-term care insurance system. [Participants and Methods] Seventy-nine community-dwelling individuals (45 males and 34 females) aged more than 65 years, who required support level 1, level 2, or care level 1 support and were receiving day-care through the long-term care insurance system were enrolled. We examined the relationship between the prevalence of sarcopenia and the degree of depression, muscle strength, physical function, and skeletal muscle mass index. [Results] A significant association between the degree of depression and the prevalence of sarcopenia was only observed in males. In addition, a significant decrease in skeletal muscle mass index was observed in males as their depression worsened. No significant difference was observed in females. [Conclusion] This study found that there is a gender difference in the relationship between depression and sarcopenia. A relationship between depression and sarcopenia was found among elderly males who received day care through the long-term care insurance system.

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  • Yuichi ISAJI, Atsuyuki INUI, Yutaka SATO, Kenta HIROSE, Takumi YAMADA
    2020 Volume 35 Issue 5 Pages 679-683
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] We performed myofascial release on the patella for knee osteoarthritis (OA) patients and investigated the changes in the knee joint flexion range of motion and infrapatellar fat pad (IFP). [Participants and Methods] This study included 25 medial type primary knee osteoarthritis patients: 70.9 ± 9.9 years old, OA grade 2.1 ± 1.0. The heel buttock distance (HBD) and the thickness of the IFP measured using ultrasonography were measured before and after the treatment. Three myofascial release methods (patella separation release, infra, and supra patella release) were conducted for three minutes. [Results] After the treatment, HBD improved from an average of 14.2 cm to 10.1 cm, and the thickness of IFP decreased from an average of 21.6 mm to 20.7 mm. [Conclusion] Myofascial release on the patella was effective at reducing the HBD. The clinical significance of the change in IFP thickness needs to be further investigated.

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  • Tamaki HIROSE, Yohei SAWAYA, Takahiro SHIBA, Ko ONODA, Akira KUBO
    2020 Volume 35 Issue 5 Pages 685-688
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] This study determined the proportions of elderly certified for long-term care or support with ankle-brachial index (ABI) scores of 0.90 or below, and those with ABI scores of between 0.91 and 0.99, as well as disease factors. [Participants and Methods] The ABI of 130 elderly persons was measured using a blood pressure pulse-wave monitoring device (VaSera VS-2000) before their exercise therapy for ambulatory rehabilitation. [Results] In this study, 21.6% of the elderly had ABI scores of 0.90 or below, which indicates they had arteriosclerosis obliterans (ASO). In addition, 13.8% had ABI scores between 0.91 and 0.99, which is within the borderline range. The proportion of those with ASO and those within the borderline range was 35.4%. However, there were no significant differences in the disease factors. [Conclusion] The result for the risk of lower limb obstructive atherosclerosis in the elderly requiring long-term care or support was higher than has previously been reported.

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  • Takafumi SAKAI, Ryuji SAKAMOTO
    2020 Volume 35 Issue 5 Pages 689-692
    Published: 2020
    Released: October 20, 2020
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    [Purpose] To clarity the characteristics of the center-of-pressure (COP) trajectory during continuous backward walking on treadmill. [Participants and Methods] Thirteen healthy students walked backwards on a treadmill with a foot pressure distribution measurement and analysis system beneath the belt for 30 minutes. Using the obtained foot pressure data, we calculated the durations of the stance and single-leg support phases based on the COP trajectory from heel-ground contact to takeoff. Subsequently, we estimated the amounts of variation in the anteroposterior and lateral directions at the intersection point of the COP trajectory. We also calculated the stride length and cadence as temporal distance factors. [Results] During backward walking, there were significant increases in the duration of the single-leg support phase and amounts of variation in both the anteroposterior and lateral directions. [Conclusion] When walking backwards, the single-leg support phase prolongs, and the stride length decreases, possibly to maintain stability by adjusting the step length.

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  • Takayuki ASAMI, Kazuki HOTTA, Yusuke ISHII, Wataru SAKAI, Sho KOJIMA, ...
    2020 Volume 35 Issue 5 Pages 693-698
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The purpose of this study was to evaluate the changes in skin temperature and blood flow in the big toe of the contralateral inactive leg during single-leg cycling. [Participants and Methods] A single-leg pedaling exercise that used the right leg was performed by 13 healthy adult males (age 21.2 ± 0.2 years, height 172.5 ± 7.1 cm, weight 62.5 ± 6.8 kg, BMI 21.0 ± 1.6 kg/m2) in a reclined position. The exercise protocol involved four minutes of rest in a reclined position, three minutes of warm-up (load: 5 W), a period of incremental exercise (10 W/min), and a three-minute cool down (load: 0 W). Skin temperature and blood flow were continuously measured from baseline in the left big toe. The maximum work rate was measured during the period of incremental exercise. [Results] The skin temperature and skin blood flow in the contralateral inactive limb were not significantly different between rest and 10–100% exercise. Participants were divided by skin blood flow into two groups: those whose skin blood flow deviated during incremental exercise (deviance group, n=7) and those who did not show blood flow deviance (non-deviance group, n=6). Maximum exercise time and maximum work rate were significantly higher in the deviance group (max exercise time, 565.71 ± 61.73 sec; max work rate, 99.00 ± 9.96 W) than in the non-deviance group (max exercise time, 477.50 ± 59.49 sec; max work rate, 84.33 ± 9.83 W) (p<0.05). [Conclusion] The results of this study suggest that skin temperature and blood flow in the stationary leg during loaded exercises do not vary from the at-rest state. Therefore, we suggest that it is difficult to increase the skin blood flow of the big toe in the stationary leg by single-leg pedaling exercise.

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  • Yumi OKAYAMA, Shinichi DAIKUYA
    2020 Volume 35 Issue 5 Pages 699-703
    Published: 2020
    Released: October 20, 2020
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    [Purpose] To clarify the relationship between the constant velocity muscle force of the hip flexor muscle group and surface electromyography (EMG) due to the number of repetitions of dynamic stretching (DS). [Participants and Methods] Seven healthy males participated in this study. The DS performed in this study was hip flexion repetitions of 10, 20, 30, 40 and 50 times. The peak torque of hip flexion was measured before and after DS. EMG of the rectus femoris, tensor fasciae latae and adductor longus were recorded simultaneously with the peak torque measurement. [Results] The peak torque showed a significantly high value only after performing DS 20 times. Although the integrated EMG values and the median power frequency showed no difference between before and after DS, a scalogram showed brightness convergence. [Conclusion] The peak torque increased after DS was performed 20 times, and it was confirmed that muscular performance changed without changes in muscle activity.

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  • Takeshi AKIMOTO, Kenji KAWAMURA, Takaaki WADA, Tatsuya KONO, Naomichi ...
    2020 Volume 35 Issue 5 Pages 705-710
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The purpose of this study was to investigate whether joint function and physical ability differ according to the presence of pain during knee joint extension in knee osteoarthritis (knee OA). [Participants and Methods] Thirty-one female patients with knee OA were included. The presence of pain during knee extension was assessed under three conditions: (1) active knee extension, (2) stepping, and (3) one-legged squatting. In addition, knee extension range of motion (ROM), knee extension strength, 5-meter walking distance (5MWT), Timed Up & Go Test (TUG) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were evaluated. [Results] The WOMAC score was significantly higher, knee extension strength and ROM were significantly lower, and 5MWT (maximum speed) and TUG were significantly slower in the group with pain during active knee extension. Moreover, the group with pain during stepping had a significantly slower 5MWT (comfortable speed). [Conclusion] In patients with knee OA, pain during knee extension was associated with poorer knee joint function and lower gait speed.

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  • Sho SUGITA, Shuhei FUJIMOTO, Kanako KOMUKAI, Motohide KOBAYASHI, Shota ...
    2020 Volume 35 Issue 5 Pages 711-718
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] This study clarifies the assessment by, and intervention of rehabilitation professionals for patients with post-stroke depression. [Participants and Methods] Fifteen rehabilitation professionals (physical therapists, occupational therapists, and speech-language-hearing therapists) participated in a semi-structured interview and theme analysis. From this theme analysis, 73 codes were extracted from the word-for-word records: 20 comprised the primary category, and 10 the secondary category. [Results] The results indicate that rehabilitation professionals assess post-stroke depression by “interpret the condition of experiencing depressive symptoms” based on daily observations such as “pessimistic speech,” “depression” and “loss of motivation.” Also, rehabilitation professionals use correspondence and intervention for patients with post-stroke depression by “saying something to boost confidence,” “interventions improving the degree of independence,” and “interventions aligned with the patient.” [Conclusion] Rehabilitation professionals interpret the condition of experiencing depressive symptoms from the daily speech of patients with post-stroke depression and assessments, and work to improve their degree of independence with confidence-boosting statements.

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  • Masashi ZENTA, Tomohiro HATTORI, Yuki OGAWA, Seiya YOSHIDA, Satoshi KI ...
    2020 Volume 35 Issue 5 Pages 719-727
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] It is thought that quadriceps muscle strength of patients with respiratory diseases is related to their daily living activities (ADL). However, quadriceps force (QF) requires patient effort and often cannot be measured. This study examined the relationship between quadriceps muscle thickness and ADL. [Participants and Methods] The study included 39 patients with chronic respiratory failure. The muscle thicknesses of the rectus femoris and the vastus medialis were measured. The Nagasaki University Respiratory ADL Questionnaire (NRADL) was used for ADL evaluation. In addition, lung function tests, echocardiography tests, and biochemical tests were conducted. For the analysis, Spearman’s correlation coefficient was calculated and multiple regression analysis was performed. [Results] Body mass index (BMI), quadriceps muscle thickness (Qt), %DLco, serum albumin (ALB) and FiO2 showed significant correlations with total NRADL. In addition, Qt and %DLco were identified by multiple regression analysis as being related to total NRADL. [Conclusion] The results of this study show that Qt is related to NRADL. Therefore, it should be possible to estimate ADL from the Qt of patients with chronic respiratory failure.

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  • Miwako ISHII, Sumiko YAMAMOTO
    2020 Volume 35 Issue 5 Pages 729-734
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] The validity of the measurement of the direction of pelvic motion using a 3D motion analysis with skin markers during a sit-to-stand task was determined. [Participants and Methods] Fifteen healthy subjects were recruited and the motion of 30 sacroiliac joints in total were captured during the task. The markers on the skin surfaces of bony landmarks of the pelvis were set in a relaxed seated position and in the position just before seat-off. The angle of the innominate motion relative to the sacrum was calculated from the initiation of the task to the instant of seat-off and compared between the two conditions. [Results] In the 2 conditions, the direction of sacroiliac motion coincided in all joints. [Conclusion] The results suggest that in order to determine the direction of sacroiliac motion a procedure applying the markers on the skin surface in a seated position can be used to study sit-to-stand movement.

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  • Yoshikazu HIRASAWA, Ryosuke MATSUKI, Hideaki TANINA, Toshihiko EBISU, ...
    2020 Volume 35 Issue 5 Pages 735-739
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] This study aimed to clarify the relationship between upper limb, lower limb, trunk muscle mass and insulin resistance in male patients with type 2 diabetes. [Participants and Methods] The participants were 136 male patients with type 2 diabetes. The upper limb muscle mass (ULM), lower limb muscle mass (LLM) and trunk muscle mass (TM) were divided by body weight (Wt) and their relationships with the homeostasis model assessment – insulin resistance (HOMA-IR) were investigated. [Results] HOMA-IR showed significant negative correlations with ULM/Wt, LLM/Wt, and TM/Wt in all patients and the obese group. However, there was no significant correlation with ULM/Wt in the non-obese group. The area under curve (AUC) cut-off values for HOMA-IR of LLM/Wt and TM/Wt were higher than that of ULM/Wt. [Conclusion] The finding suggests that LLM/Wt or TM/Wt are indicators of insulin resistance in male patients with type 2 diabetes.

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CASE STUDY
  • Makoto TAKAHASHI, Manabu KUWAZURU, Koji IWAMOTO, Yukio MIYAUCHI
    2020 Volume 35 Issue 5 Pages 741-749
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] This study investigated the effect of a systemic approach for a baseball player who had internal impingement symptoms in the throwing shoulder. [Participant and Methods] The case was a high school baseball player who had internal impingement findings of posterior labrum injury and greater tubercle lesion. To ameliorate pain during pitching, a shoulder joint pain management program and a functional improvement program for the upper extremity, trunk and lower extremity were conducted for 40 minutes once a week for 10 months. [Results] The player’s shoulder pain in pitching disappeared and it became possible for him to throw at 90% strength. [Conclusion] The results suggest that an approach for the upper extremity, trunk and lower extremity muscle group is useful for internal impingement symptoms.

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  • Junji NARITA, Koichi AKIYAMA, Toshiyuki MIURA, Rina TSUNODA, Nao KOJIM ...
    2020 Volume 35 Issue 5 Pages 751-755
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    [Purpose] This paper reports a patient with a worsened breathing condition due to SARS-CoV-2 infection, treated with extracorporeal membrane oxygenation (ECMO) for life-saving support and physical therapy for disuse syndrome prevention. [Patient and Course of Treatment] The patient was a 69-year-old male, who rode on a cruise ship, and subsequently became infected with SARS-CoV-2. He was admitted to a hospital on February 11. Mechanical ventilation and ECMO for him were initiated on February 16 and 17, respectively. The patient was transferred to our hospital on February 20, with an ECMO device attached. ECMO and mechanical ventilation for him were discontinued on February 25 and 29, respectively. He was transferred from an intensive care unit to a negative pressure room on March 5. Before admission to this room, he underwent nursing assessment. He was discharged to home on March 21, when he became able to perform ADL and walk independently again. [Conclusion] The physical therapy approaches performed in this case were similar to those for severe respiratory failure due to pneumonia. During physical therapy, the patient’s SpO2 level markedly varied. Chest X-ray showed an infiltrative shadow in the left upper lung field until discharge, suggesting an imbalance in the ventilation‐perfusion ratio.

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REVIEW
  • Satoshi MATSUNO
    2020 Volume 35 Issue 5 Pages 757-763
    Published: 2020
    Released: October 20, 2020
    JOURNALS OPEN ACCESS

    This paper outlines a recently introduced additional fee for using equipment designed to increase the amount of exercise a patient does within the Japanese healthcare system. The relevant equipment includes active flexion/extension and flexion/extension rotation devices (walking assistance robots); walking neuromuscular electrical stimulators; and passive motion exercise training devices for active upper limbs (upper-limb robots). Conditions for adding the fee to the medical bill are: the healthcare procedure item, Cerebrovascular Disease Rehabilitation I or Cerebrovascular Disease Rehabilitation II, has been calculated; movement disorders of the upper or lower limbs associated with an acute onset of stroke/spinal cord injury are present; and a rehabilitation plan created by a physician, physiotherapist, or occupational therapist clearly states the need to use equipment for increasing exercise amounts. Altogether, 150 points can be added, once a month, to medical fees in such situations. Currently, the use of such equipment that is eligible for the additional fee is limited to cerebrovascular disease. Hence, further research is needed to provide evidence that the use of equipment for increasing the amount of exercise is also effective for other diseases so the range of diseases to which the fee can be applied will be expanded.

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