[Purpose] This study examined factors related to the prediction of toilet independence of hemiplegic stroke patients. [Participants and Methods] The subjects were 88 hemiplegic stroke patients whose toileting was not independent when admitted to the convalescence rehabilitation ward. Factors related to independence of toileting at discharge and the prediction of independence were analyzed retrospectively using medical records. [Results] In multiple logistic regression analysis, significant factors related to toileting independence were age, Functional Independence Measure (FIM) items of transfer to toilet and problem solving, and days after stroke onset. In addition, the regression equation with the addition of the FIM item of locomotion was able to discriminate between independence and dependence of toileting at discharge with a probability of 85.2%. [Conclusion] These results suggest that they may be useful for setting appropriate evidence-based goals and physical therapy interventions for the acquisition of toileting independence by hemiplegic stroke patients.

[Purpose] The purpose of this study was to assess the relationship between the alignment of the shoulder complex and the center of pressure (COP), when assuming the cocking phase of pitching motion. [Participants and Methods] The subjects were 22 healthy men. We measured five shoulder complex alignments and trunk rotation angles using a goniometer and an electronic vernier caliper, while the subjects assumed the right throwing cocking phase with trunk right rotation and the right shoulder in the horizontal rotation position. We measured COP of standing using a stabilometer. [Results] The trunk rotation angle and scapulothoracic joint adduction were smaller and the glenohumeral joint horizontal abduction was larger, when the COP was located posteriorly or laterally. [Conclusion] The results suggest that pitching motions performed with a posterior center of gravity posture may cause excessive shoulder horizontal abduction in the cocking phase.

[Purpose] The purpose of this study was to investigate the relationship between walking ability and self-efficacy in patients with knee osteoarthritis. [Participants and Methods] Sixty-seven patients with knee osteoarthritis were enrolled. Measurement outcomes were the 10-m walking speed, timed up and go test (TUG), the modified gait efficacy scale, rest pain, walking pain, isometric knee extension strength, toe-grip strength, and the pain catastrophizing scale. [Results] Pearson’s correlation coefficient indicated factors related to the 10-m walking speed and TUG were the modified gait efficacy scale, isometric knee extension, toe-grip strength and the pain catastrophizing scale. Multiple regression analysis indicated that the modified gait efficacy scale and isometric knee extension strength affect walking ability among other factors. [Conclusion] These results show that the modified gait efficacy scale is an important physical therapy assessment for patients with knee osteoarthritis.

[Purpose] This study investigated the influence of different ways of carrying luggage on the center of pressure (COP) sway and upper body center of gravity (UCOG). [Participants and Methods] The subjects were 22 healthy adults. Luggage was carried under four conditions: no luggage, backpack, holding a handbag, and carrying a shoulder bag. COP was evaluated by measuring the total locus length (TLL) and the locus lengths (LL) in the lateral and anteroposterior directions. The UCOG sway was evaluated by measuring the root mean square (RMS) in the lateral and anteroposterior directions. [Results] Compared to the no luggage condition, the TLL, and lateral and anterior-posterior LL of the three luggage-carrying conditions were significantly lower. The anteroposterior RMS values of the backpack and shoulder bag conditions were significantly lower than that of the no luggage condition. [Conclusion] The results suggest that carrying a backpack or a shoulder bag may contribute to stabilization of standing in the anteroposterior direction.

[Purpose] This study examined the immediate effect of physical therapy using ‘Spider’ on the balance ability of post-stroke hemiplegic patients. [Participants and Methods] Ten chronic stroke patients with hemiplegia (age: 73.5 ± 8.2) received the Functional Reach Test (FR) and Timed Up & Go Test (TUG) before and after exercise therapy (10 squats and 10 steps with the non-paralyzed side preceding) using ‘Spider’ (Spider condition) or no device (control condition). Two-way analysis of variance was performed before and after each condition. [Results] Interactions with FR and TUG were observed under both conditions, as the distance significantly increased in the former, and the time significantly shortened in the latter after the therapy. [Conclusion] Exercise therapy using ‘Spider’ was suggested to have a favorable immediate effect on the balance ability of stoke patients with hemiplegia.

[Purpose] The purpose of this study was to assess the relative and absolute reliability of knee extensor muscle strength measurements of healthy young persons. [Participants and Methods] The participants were 9 healthy young men. Measurement of knee extensor muscle strength was performed using a Locomoscan® which can assess the long sitting position. Measurements of the right side lower limb were performed twice. The test-retest reliability was estimated using the intra-class correlation coefficient [ICC (1,1)] and Bland-Altman analysis. [Results] The mean knee extensor muscle strength of the first measurement was 0.81 ± 0.18 N/kg, and 0.83 ± 0.10 N/kg for the second. The relative reliability was substantial, ICC (1,1)=0.68. Bland-Altman analysis found a proportional bias, a systematic error, in the absolute reliability. [Conclusion] Although the relative reliability was substantial, absolute reliability was not guaranteed. We consider that a systematic error was introduced by the experimental procedure, either through reproduction of the measurement position or number of determinations.

[Purpose] The Ministry of Health, Labour and Welfare of Japan mandated mental health checks for business establishments with 50 or more staff from 2015. We outsource these checks and have them performed twice per year. A perceived lack of coordination amongst managers in recent years has led to results indicating a high health risk amongst managers when subjects were classified as either managers or general staff in a group analysis performed in December 2018. Structural reform based on Donabedian’s approach was implemented in order to improve the health risk values. [Participants and Methods] Health risk values measured before and after the intervention were investigated for 44 rehabilitation department staff. [Results] Although no improvements were noted in the health risk values, the staff turnover rate improved. Thus, measures for managers appeared to help prevent general staff turnover. [Conclusion] We hope that mental health checks will be implemented at a large number of facilities and that organizational analysis will be performed in order to aid the improvement of organizational management.

[Purpose] The effect of trunk function on the predictive index of falls was studied in postoperative hip fracture (HF) patients. [Participants and Methods] The subjects were 20 postoperative HF patients. Timed Up & Go Test (TUG), trunk function (seated Functional Reach Test, seated Lateral Reach Test, seated posture, seated trunk flexion, extension, and lateral flexion angles), lower extremity function (knee extensor strength, hip abductor strength, and lower extremity loading rate), and pain during loading were assessed 3 to 4 weeks after the operation. [Results] A moderate negative correlation was found between TUG and seated lumbar lordosis, seated Lateral Reach Distance (LRD) of the affected side, hip abductor strength of the healthy side, and lower extremity loading rate. [Conclusion] The results suggest that the trunk function of postoperative HF patients is related to TUG performance time as well as lower extremity function.

[Purpose] To examine the health-related quality of life of community-dwelling elderly by age group in the early stage of the coronavirus disease (COVID-19) pandemic. [Participants and Methods] The subjects were 201 older adults who had attended a university open lecture at least once in the past. Responses to a questionnaire, sent to the participants on April 1st, 2020, were compared with those collected after the most recent open lecture. The questionnaire items included age, outing frequency, and the Short Form-36 item health survey ver.2 (SF-36). [Results] For those in their 60s and 70s, the scores for “Physical functioning”, “Social functioning” and “Mental health” were significantly lower after the start of the COVID-19 pandemic than before. For those in their 80s, there was no significant difference between the SF-36 scores recorded before and after the start of the COVID-19 pandemic. [Conclusion] Care for older adults in an emergency situation should be tailored according to age group.

[Purpose] To clarify gait-related changes in plantar ankle flexor muscle tone on the paralyzed side during movement in upper motor neuron syndrome. [Participants and Methods] The ankle plantar flexors’ resistance and the amount of increase in it on the paralyzed side during rest and movement were measured using a hand-held dynamometer, involving 2 patient groups (14 with spinal cord disease and 22 with cerebrovascular disease) to examine differences in resistance before and after gait, compare the 2 groups, and clarify the correlations with other parameters. [Results] Resistance during rest and movement significantly increased after gait in both groups, and the increase in resistance during movement was marked in the cerebrovascular disease group. There were no significant differences between the groups in the amount of increase in resistance after gait. The change rate for the amount of increase in resistance was moderately, negatively correlated with the maximum loading rate and lower limb function on the paralyzed side in the spinal cord disease group, and with the Brunnstrom Stage, age, and plantar tactile perception in the cerebrovascular disease group. [Conclusion] Ankle plantar flexor muscle tone on the paralyzed side during movement increased after gait, and it was correlated with lower limb function and plantar sensory impairment on the paralyzed side.

[Purpose] To clarify the relationships among swallowing, nutrition, and sarcopenia in patients with respiratory diseases. [Participants and Methods] A total of 59 (42 male and 17 female) respiratory medicine patients with a mean (± standard deviation) age of 65.5 ± 16.1, height of 161.3 ± 9.8 cm, and weight of 66.8 ± 24.2 kg were assessed using the following parameters: nutritional status based on scores from the Mini Nutritional Assessment-Short Form (MNA-SF); swallowing function based on tongue pressure and scores from the Eating Assessment Tool-10 (EAT-10); and sarcopenia based on the hand grip strength and calf circumference. [Results] Eight (13.6%) patients were identified with malnutrition based on their MNA-SF scores. Sarcopenia was present in 15 (25.4%). The history of mental stress or acute disease over the past 3 months and Body Mass Index value were correlated with tongue pressure. The MNA-SF score was an independent factor for sarcopenia. [Conclusion] The prevalence of sarcopenia was high among respiratory medicine patients, and malnutrition, rather than tongue pressure, was associated with it.

[Purpose] The purpose of this study was to examine the effect of the amount of compression stimulation on muscle stiffness of the rectus femoris and maximum isometric knee extension strength. [Participants and Methods] The subjects were 30 men with no prior history of medical issues concerning the lower limbs and spinal column. Muscle stiffness, using an ultrasonic device, maximum isometric knee extension strength, and pain were measured before and after 20, 60, and 90 mmHg compression stimulation. There was a significant difference in muscle stiffness before and after 20 mmHg compression stimulation. [Results] Muscle output tended to improve after 20 mmHg compression stimulation compared to the result after 90 mmHg compression stimulation. Pain was significantly higher after 90 mmHg pressure stimulation. [Conclusion] Pressure stimulation of 20 mmHg on the rectus femoris is painless, and is also thought to contribute to the improvement of muscle flexibility and muscle output.

[Purpose] To obtain useful data for postoperative approaches to the hip muscles of patients with knee osteoarthritis (OA) undergoing unicompartmental knee arthroplasty. [Participants and Methods] Preoperative patients were divided into 2 age- and sex-matched groups: non-knee OA (18) and knee OA (17). For each patient, hip extensor, abductor, and external rotator strength measurements were performed twice using a hand-held dynamometer. [Results] The hip extensor and abductor muscle strength was significantly reduced in the knee OA group. On comparing the muscle strength between operative and nonoperative sides in the knee OA group, there were no significant differences in any of the 3 directions. [Conclusion] The hip muscle strength was suggested to bilaterally decrease in preoperative patients with knee OA.

[Purpose] This study investigated the factors influencing the physical activity (PA) of surgical patients with gastrointestinal cancer. [Participants and Methods] The participants were 28 patients scheduled for elective gastrointestinal cancer surgery (22 men and six women, aged 70.5 ± 8.7 years). Physical functions measured at baseline (before surgery) included body composition, isometric knee extension force, grip strength, 6-minute walking distance, respiratory function evaluation, and one-leg standing time. Baseline laboratory data, including serum albumin (Alb), C-reactive protein (CRP), and total protein levels were also collected. [Results] PA significantly decreased after surgery compared to baseline. Postoperative PA significantly correlated with the Alb level, CRP level, and body fat percentage. [Conclusion] Improvement in PA after surgery in patients with gastrointestinal cancer may be associated with the nutrition status, immune response, and body composition before surgery. Comprehensive interventions before surgery may prevent decreased PA after surgery in patients with gastrointestinal cancer.

[Purpose] The purpose of this study was to investigate the validity of the bioelectrical impedance analysis (BIA) method in measuring the skeletal muscle mass of patients with perioperative gastrointestinal cancer. [Participants and Methods] This study included 21 patients scheduled for elective gastrointestinal cancer surgery (17 males and 4 females with a mean age of 69.1 ± 8.5 years). Body composition was evaluated using a BIA body composition analyzer, the BIA method. Physical function was measured as grip strength, isometric knee extension strength, and thigh circumference. All parameters were measured before and after surgery. [Results] The skeletal muscles before and after surgery showed a significant positive correlation with physical function. [Conclusion] The BIA method used for skeletal muscle measurement of perioperative gastrointestinal cancer patients shows validity when the external standard is physical function.

[Purpose] To clarify the effect of exercise therapy on the transcutaneous oxygen pressure (PtcO₂) in the periphery of the lower limbs. [Participants and Methods] Twenty healthy adults without cardiovascular disease were enrolled in this study. Exercise therapy was conducted under two conditions, resistance exercise (RE condition) and aerobic exercise (AE condition), and changes in the percutaneous partial pressure of oxygen were monitored under both conditions. [Results] In the AE condition, PtcO₂ during exercise was significantly lower than in the RE condition, but there was no significant correlation between changes in PtcO₂ and SpO₂ in the lower limbs in either condition. [Conclusion] It is possible to conduct single-joint resistance exercises without causing as large a decrease in PtcO₂ as in aerobic multi-joint exercises.

[Purpose] This study aimed to clarify the relationship between gait independence and the functional assessment for control of trunk (FACT) in community-dwelling elderly people who need support or care. [Participants and Methods] The subjects were 100 elderly people requiring support or care who used gait at home as their means of locomotion. Their degree of independence was classified according to the functional independence measure (FIM) of gait function (gait FIM). The relationships between gait FIM, grip strength, the timed up and go (TUG) test, maximum walking speed, CS30, one-leg standing time, and FACT were investigated. The relationships between gait FIM and FACT subordinate items were also examined. [Results] The results revealed that gait FIM was associated with TUG in females, and TUG and FACT in males. In addition, the degree of independence of gait and the subordinate items of FACT were related to question 5 (move the buttocks from the seat surface for 3 seconds or more) and question 8 (walking forward and backward) for both males and females. [Conclusion] FACT is associated with gait independence in males, and the trunk function associated with gait independence was lateral shift of the center of gravity.

[Purpose] This study aimed to investigate the influence of cognitive and physical training using a tablet application for community-dwelling elderly. [Participants and Methods] Among 355 elderly living in the community, 126 who were able to implement all interventions without dropping out were included in the study. Participants performed a cognitive and physical function program using a tablet application for 90 minutes, once a week, 12 times. Measurement items used to evaluate the intervention were: cognitive and mental function, physical function, lifestyle, and frailty scales. All assessments were performed before and after the intervention period. [Results] All the measurement items had improved after the intervention (p<0.01). [Conclusion] The results of this study suggest that the intervention training using a tablet application targeting cognitive and physical function contributed to improvements in the cognitive and physical functions of community-dwelling elderly.

[Purpose] The purpose of this study was to investigate the functional factors related to hemiplegic patients’ ability to ascend and descend steps. [Participants and Methods] Forty hemiplegic patients participated in this study. Age, gender, height, body mass index, type of stroke, time from stroke onset, distribution of paralysis, ability to ascend and descend steps, Brunnstrom recovery stage score of the lower extremity, proprioceptive deficits, unaffected knee extensor muscle strength, and weight-bearing ratios of the affected and unaffected lower extremities were examined. [Results] According to logistic regression analysis, the weight-bearing ratio of the affected lower extremity was a significant factor related to the ability to ascend and descend steps. When the cutoff value was set to 77.5%, the area under the curve was 0.838, indicating discriminating ability. [Conclusion] We examined functional factors’ relationships with hemiplegic patients’ ability to ascend and descend steps. A higher weight-bearing ratio on the paralyzed side indicated a better ability to ascend and descend steps.

[Purpose] The purpose of this study was to clarify the effects of adaptation to the practice training facility, social skills, and apathy on students’ motivation to learn in clinical practice. [Participants and Methods] 163 students (128 valid respondents) being trained during clinical practice periods participated in this study. We measured motivation to learn, adaption to the practice training facility, social skills, and apathy using psychological scales. The questions on the scales other than apathy were modified using terms suitable for clinical practice. All scales were measured by a questionnaire survey method, and relationships were examined using partial correlation analysis and path analysis. [Results] The path analysis indicated that students’ motivation to learn was directly or indirectly affected by adaption to the practice training facility, social skills, and apathy. [Conclusion] In order to improve students’ motivation to learn, it will be necessary to raise adaptation to the practice training facility and social skills, but not apathy.

[Purpose] To investigate the effectiveness of using Integrated Volitional control Electrical Stimulation (IVES) at improving motor paralysis and gait function of mild acute stroke patients. [Participants and Methods] Twenty-four subjects with first acute stroke were randomly assigned to a normal rehabilitation group (n=13) or a functional electrical stimulation (FES) group (n=11). The FES group received electrical stimulation in addition to the same treatment as the normal rehabilitation group. All subjects were assessed at baseline, at 1 week after treatment, and at discharge, and the results were analyzed using two-way analysis of variance, followed by post hoc tests with the Dunnett test to compare treatment effects between the two groups. [Results] Motor function of the affected ankle dorsiflexion, muscle strength of the affected hip flexion and ankle dorsiflexion, walking speed, and 2-minute walking distance results were significantly better in the FES group than in the normal rehabilitation group at discharge. [Conclusion] The use of IVES in addition to normal rehabilitation improves motor paralysis and gait function in mild acute stroke.

[Purpose] Rising from supine (RS) is an important functional movement that should be analyzed by physical therapists to improve functional ability. However, no previous study has reported kinematic data of RS. [Participants and Methods] Healthy males performed RS with trunk rotation of Sarnacki’s description. RS was recorded using four video cameras (30 fps). The local coordinate reference system was calculated using three-dimensional analysis. The joint angles of the upper extremity joints and trunk were compared between the normal speed task (n=6) and the slow speed task (n=5). The unpaired t-test was used for statistical analysis. [Results] On the supported side in the slow speed task, the angle of rotation of the trunk and internal rotation of the shoulder joint were significantly greater than in the normal speed task (p<0.05). [Conclusion] A significant increase in shoulder joint angles of the supported side in the slow speed task was useful for displacing the center of mass of the upper body within the base of support formed by the upper extremities.

[Purpose] To investigate the recovery status using the Hop test one year after anterior cruciate ligament reconstruction (ACLR). [Participants and Methods] The participants were 218 cases after ACLR. The recovery rate of the Limb Symmetry Index (LSI) ≥90% for Vertical Hop (VH), Single Leg Hop (SLH), and Triple Hop (TH) at 1 year after ACLR were examined separately as well as all Hop tests together. [Results] The recovery rates of VH, SLH, and TH were 67.9%, 78.4%, and 78.9% respectively. VH had the lowest recovery rate. The recovery rate for all Hop tests was 59.2%. [Conclusion] About 40% of cases had LSI <90% in the Hop test. In particular, the recovery rate of VH tended to be lower.

[Purpose] To evaluate whether normal knee joint extensor muscle groups can absorb shock during the loading response phase of gait after total knee arthroplasty (TKA) preserving the bicruciate ligaments. [Participants and Methods] Eight TKA patients one year after surgery and 12 healthy elderly patients of the same age group were the subjects. Lower limb kinematics and kinetics were measured in the sagittal plane during walking using three-dimensional motion analysis. [Results] The vertical component of the ground reaction force, knee extension moment and centrifugal knee power during the loading response phase of gait were significantly lower in the TKA group than in the healthy group. The TKA group tended to have a lower knee flexion angle during walking than the healthy group. [Conclusion] Even with the preservation of bicruciate ligaments, the shock absorbing function of the knee joint extensor muscle group was not fully utilized during gait by the TKA patients.

[Purpose] To ascertain the degree of anxiety experienced by physical therapy students in their college life owing to activity restrictions imposed by the COVID-19 pandemic. [Participants and Methods] To investigate the anxiety level, we conducted an online questionnaire survey of 377 1st to 4th-year students belonging to the Faculty of Physical Therapy, International University of Health and Welfare, Otawara, Tochigi, Japan. [Results] The median anxiety scores were found to be 7–8 for all items. Upon comparison, job hunting activity was significantly higher among the 3rd and 4th graders than among the 1st and 2nd graders. Besides, practical training was observed to be significantly higher among the third graders than in any other group of students. In the practical skills class, both the 2nd and 3rd graders had significantly higher involvement than the 1st and 4th graders. [Conclusion] It was shown that the restriction of activities imposed by COVID-19 is a significant factor causing anxiety among physical therapy students during the course of their college life.

[Purpose] It is said that early mobilization, the standing position, and ambulatory exercise prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) in stroke patients in the acute phase. We began ambulatory exercise at the early onset stage using a knee ankle foot orthosis, but experienced a cerebral hemorrhage case who developed DVT, PE. [Participants and Methods] The case was a female in her 80s with left hemiplegia due to right thalamic hemorrhage. [Results] Wheelchair riding began on the first day of the intervention, and ambulatory exercise was started on day 4 using a knee ankle foot orthosis. A CT scan with D-dimer high level showed DVT in a left thigh vein and PE in the right pulmonary artery on day 24. [Conclusion] Motor paralysis and dehydration, constipation, and an anatomical problem were considered factors behind the development of DVT and PE.

[Purpose] The Balance Evaluation Systems Test (BESTest) is a rating scale that allows for the specific evaluation of six balance control systems. We report on our experience with a case of progressive supranuclear palsy who showed improved balance ability after goal setting and intervention using the BESTest. [Participants and Methods] The case was a 78-year-old female who had frequent falls due to progressive supranuclear palsy. The main complaint was stumbling. Decreased lower limb muscle strength and impaired balance control systems of predictive and reactive postural control were thought to be the causes of decreased activity and walking ability. Interventions with task difficulty adjusted according to the degree of independence of movement were implemented. [Results] After about three weeks of intervention, the case was able to return to her home with improved walking ability. At the two-month follow-up, a decrease in the number of falls was noted. [Conclusion] The use of the BESTest in clinical decision-making suggests that it may make interventions for balance disorders more effective.

[Purpose] This paper reports a case, in which orthotherapy was effective to improve an extensor thrust pattern (ETP) that had developed due to cerebral infarction 3 years previously, and worsened with its recurrence, aiming to obtain new findings in this therapy. [Participant and Methods] A post-stroke hemiplegic patient was treated with physical therapy using an original knee-ankle-foot orthosis (KAFO). The therapy, provided at a frequency of 40 to 60 minutes/day, 7 times/week. [Results] The patient achieved independence in gait with KAFO on Day 17, with ankle-foot orthosis (AFO) on Day 53, and with no orthosis on Day 80. The therapy successfully reduced the ETP during gait, enabling the patient to walk independently with a cane or no orthosis. [Conclusion] Orthotherapy may be useful for an ETP worsening with the recurrence of cerebral infarction.