[Purpose] To confirm the validity of a method for detecting events from inertial sensor data in the Timed Up and Go (TUG) Test, and to clarify the changes in the kinetic phase due to the performance velocity. [Participants and Methods] Thirty-two healthy adults performed normal and maximum speed TUG. Each trial was simultaneously measured with an inertial sensor and a three-dimensional motion analysis device. Six events were detected from the measurement data, and their relationships with their appearance times was examined. We also examined the difference in the rate of change in the time required for each kinetic phase between the velocity conditions. [Results] Significant correlations were found between the appearance times of all the events measured by the inertial sensor and the 3D motion analysis device. Only the gait phase showed a significant rate of change between the speed conditions. [Conclusion] The kinetic phase of TUG can be detected with an inertial sensor, suggesting that different velocity conditions only cause changes in the gait phase.

[Purpose] The purpose of this study was to examine the relationships between sections of the Brief-Balance Evaluation Systems Test (BESTest) and the gait speed of inpatients with stroke. [Participants and Methods] Thirty-five hospitalized stroke patients who were able to walk under supervision were enrolled. The Brief-BESTest was conducted and individuals' comfortable walking speed (CWS) was measured. For statistical analysis, Spearman’s rank correlation between each section of Brief-BESTest and CWS was calculated. [Results] There was a strong correlation between CWS and the Brief-BESTest total score, and a moderate correlation with sections I, III, IV, and VI. A weak correlation was found with section V, and no significant correlation was found with Section II. [Conclusion] All sections except II showed an association with CWS. Multiple balance components were associated with the walking speed of inpatients with stroke.

[Purpose] This study clarified the relationship between sedentary behavior and dynapenia in community-dwelling elderly using ambulatory service implementation facilities. [Participants and Methods] The subjects were 161 users of two outpatient nursing homes who met the conditions. A cross-sectional design was adopted for this study. Determination of dynapenia was performed via grip strength (28 kg for men, and 18 kg for women) with reference to the definition of the Asian Working Group for Sarcopenia. [Results] Sedentary behavior showed an association with dynapenia even after controlling for age, sex, physical activity, cognitive function, and comorbidities. [Conclusion] Interventions focusing on sedentary behavior are important for preventing the development and exacerbation of geriatric syndromes in the elderly due to the progression of dynapenia.

[Purpose] This study aimed to clarify the effects of assumed competence and self-esteem on the national examination results of physical therapists. [Participants and Methods] Physical therapy undergraduate students in their senior year (45 males, 45 females, average age 22.3 years) participated in this study. Participants were asked questions about assumed competence and self-esteem using Google Forms, and were categorized into four competence types (Omnipotent, Assumed, Self-respective, and Atrophy), based on the combination of their scores for assumed competence and self-esteem. A correlation analysis was performed using national examination scores and the assumed competence scores of each type of competence. [Results] The correlation coefficient between assumed competence and national examination scores was significant for the Omnipotent (r=–0.558) and the Self-respective (r=0.559) types. [Conclusion] Due to the difference in correlations, national exam guidance strategies should be considered for each type of competence, as determined by assumed competence and self-esteem scores.

[Purpose] The purpose of this study was to objectively clarify the physical and mental activities of physical therapy students (PTS) in clinical training. [Participants and Methods] Seven PTS were fitted with a physical activity meter, and acceleration and heart rate variability were recorded during 7 weeks of practical training. Acceleration was used as an index of physical activity, and heart rate variability, determined by power spectral analysis, was used as an index of autonomic nervous activity. [Results] Physical activity showed the lowest value in the first week, and the highest value in the seventh week. Heart rate increased at weeks 1 and 7 compared with week 4. Sympathetic nerve activity increased in weeks 1, 6 and 7 compared with week 4. Parasympathetic nerve activity was higher in week 4 than in weeks 1 and 2. [Conclusion] Although sympathetic nerve activity (a tension condition) increased in the first and seventh weeks of clinical training, we speculate that clinical training was generally performed with a physiological vital reaction. The results suggest that the increase in the amount of physical activity might have reduced the tension condition.

[Purpose] Factors related to falls were examined in frail/prefrail community-dwelling elderly. [Participants and Methods] The subjects were 40 individuals judged to be frail or prefrail among 56 community-dwelling elderly. The subjects were interviewed regarding their history of falls over the past year, falls self-efficacy, and their living space. Grip strength and walking speed measurement, and the five times sit-to-stand test, walking speed, Timed Up and Go test, the functional reach test, and the longest possible step test were conducted for functional movement assessment. Errors in self-perceived physical ability were also measured. [Results] Errors in the self-perceived physical ability of TUG and the longest possible step test were identified as being larger in the group with multiple falls than in the group with no falls. [Conclusion] The results suggest that frail/prefrail elderly with a history of falls have errors in self-perceived physical function rather than a decline in physical function. Therefore, errors in self-perceived physical function are also findings that could be factors of falls in addition to the traditional relevant factors.

[Purpose] A basic survey was conducted among physical therapists on the relationship between low back pain experience in the sitting position and posture recognition, and the kind of posture. [Participants and Methods] The participants were 52 physiotherapists. The survey items were: 1) low back pain experience, 2) self-awareness of posture, 3) comparison of own posture with model photographs, and 4) presence or absence of posture improvement. The questions were answered on a 5-point scale. [Results] 63.5% of the subjects had experienced low back pain, and 88.5% recognized they had bad posture, with 88.4% identifying a stooped posture in the model photographs. Posture improvement was realized by 86.5%; 63.5% of physiotherapists had experienced low back pain while sitting. [Conclusion] It was found that many people who experienced low back pain had poor posture recognition.

[Purpose] This study investigated the relationship between walking speed, stride length on the paralyzed/non-paralyzed side, step rate and plantar pressure in the early and late stance phases in order to elucidate the mechanism of walking ability improvement in hemiplegic patients. [Participants and Methods] We analyzed the fast walking of 41 hemiplegic stroke patients who could walk 5 m or more on their own. [Results] Positive correlations were found between walking speed, stride length on the paralyzed/non-paralyzed side, step rate and plantar pressure in the early stance phase. Age was identified as an explanatory factor in multiple regression analysis with the step rate as the objective variable. [Conclusion] The results suggest that hemiplegic patients improve their walking ability by increasing the braking force in the early stance phase on the non-paralyzed side to compensate for the load transfer to the forefoot on the paralyzed side during the same period, thereby increasing stride length and step rate. In the younger age group, walking ability was improved by increasing stride length rather than step rate.

[Purpose] To clarify the effect of a training program substituting clinical evaluation training (alternative training) for students without experience of such training on their results of a subsequent Objective Structured Clinical Examination (OSCE). [Participants and Methods] A web questionnaire survey was conducted, involving 68 (male: 39, female: 29, and mean age: 20.8 999 0.4) students in their third year at a healthcare college to examine their views on the alternative training and OSCE. [Results] The valid response rate was 100.0%. Among all students, 33.8% strongly agreed and 54.4% agreed with the statement “The alternative training was helpful to prepare for the OSCE”. The most common difficulty faced when participating it was communication environment. [Conclusion] The alternative training was effective for students to make their knowledge take root, and improve their clinical reasoning skills. Favorable educational effects may be achieved by providing them with individualized feedback.

[Purpose] The purpose of this study was to investigate the relationship between locomotive syndrome (LS) and cognitive decline in community-dwelling older women in Japan. [Participants and Methods] In all, 178 people from a health-check project were enrolled. The measurement items were: the 2-step test, grip strength, walking speed, Skeletal Muscle Mass Index, Mini Mental State Examination, and Geriatric Depression Scale. Statistical examination was performed by comparison among the healthy group and three LS classification groups: L1, L2. [Results] Cognitive function, which was the main survey item, was significantly lower in the L2 group than in the healthy group. In addition, differences between the groups were also observed in grip strength, walking speed, and number of medications. [Conclusion] LS classification and cognitive decline are related in community-dwelling elderly people.

[Purpose] Triaxial accelerometers were used to estimate energy expenditure (EE) during exercise in the sitting position (chair-based exercise: CBE). [Participants and Methods] Twenty-six participants performed 5 min of CBE. Expired gas was collected throughout the exercise to measure EE, which was used as the dependent variable. Acceleration counts were collected from triaxial accelerometers attached to the non-dominant wrist and ankle. Accelerometer count, height, weight, and gender were used as independent variables. Multiple linear regression analysis was performed to estimate EE, and the correlation between estimated EE and measured EE was analyzed. Bland-Altman analysis was also conducted to determine the presence of systematic error. [Results] The most accurate formula was when weight, and gender were input as independent variables (r2=0.78). Estimated EE strongly correlated with measured EE (r=0.88). No systematic error was found. [Conclusion] These results suggest that EE of CBE can be estimated with accuracy by weight and gender.

[Purpose] This study investigated the differences in performance during the practice and retention phases of implicit and explicit learning, using sequence reaction time tasks. We also examined the effect of instruction on task performance. [Participants and Methods] Thirty-two participants (11 males and 21 females) were divided into implicit and explicit learning groups. The sequence reaction time task comprised 12 trials per block. Each group performed five blocks in the practice phase and two blocks in the retention phase. Furthermore, participants in the explicit learning group were given instructions about the fixed sequences in a trial before practice. [Results] The only significant difference between the two groups was in reaction times in the fixed sequence in the task. [Conclusion] The instruction in the sequence reaction time task effectively reduced the reaction time in fixed sequences, with no adverse effect on random sequences.

[Purpose] The purpose of this study was to clarify the effects of static stretching (SS) and muscle compression. [Participants and Methods] The subjects were 14 healthy male college students. Ankle range of motion (ROM) was measured before and after the tasks for the gastrocnemius. The tasks were: SS, SS + 5 kg compression and SS + 10 kg compression. ROM of before and after the tasks were compared as well as the rate of change in ROM between tasks. [Results] ROM significantly increased after all of the tasks, but there were no significant differences among the tasks in the rate of change of each task. [Conclusion] There was no difference in the effect on the ankle dorsiflexion range of motion between SS for the gastrocnemius and SS combined with muscle compression.

[Purpose] This study focused on ankle foot orthosis (AFO) for stroke patients, and examined whether these patients’ physical functions, such as the severity of motor paralysis and sitting balance ability, influence the time needed for them to wear AFO. [Participants and Methods] Nineteen stroke patients during the maintenance period were instructed to wear 3 types of AFO: Shoe Horn Brace, Tamarac Articulated AFO (articulated AFO), and Gait Solution Design, to compare the time needed, and analyze the relationships between this and the severity of motor paralysis, range of motion, muscle tone, and sitting balance ability. [Results] The time was significantly shorter when wearing the articulated AFO. On the other hand, there was a significant correlation between the time and sitting balance ability, regardless of the type of orthosis. [Conclusion] The results suggest that stroke patients’ sitting balance ability may influence the times needed for them to wear these 3 types of AFO.

[Purpose] To clarify the influence of knee pain on the physial functions, including exercise tolerance, and QOL of patients treated with cardiac rehabilitation. [Participants and Methods] The following parameters were measured in 23 patients treated with outpatient cardiac rehabilitation: the Body Mass Index, knee extensor strength, anaerobic threshold point (AT), peak oxygen uptake (Peak VO2), ventilatory equivalent versus carbon dioxide output slope (VE/VCO2 slope), and scores from the Visual Analogue Scale for Knee Pain (VAS), Japanese Knee Osteoarthritis Measure (JKOM), and SF-8 (total, Physical Component Summary: PCS; and Mental Component Summary: MCS). The measurements were performed at the start and end of each cardiac rehabilitation session (totally 12 sessions), and differences in the parameter values of patients with (knee pain group) and without (control group) knee pain between before and after intervention were examined. In addition, baseline values were compared between the 2 groups. [Results] After cardiac rehabilitation, the control group’s JKOM, AT, Peak VO2, VE/VCO2 slope, and SF-8 (total, PCS) scores markedly improved, whereas such improvements were not observed in the knee pain group. [Conclusion] The results suggest that knee pain inhibits improvements in exercise tolerance and the QOL through cardiac rehabilitation.

[Purpose] The wearing pressure of the soft knee orthosis does not change during operation, resulting in insufficient fixation. Therefore, a soft knee orthosis that dynamically changes the wearing pressure is required so that fixation is permanent during operation. In this study, for the development of such an orthosis, we investigated the temporal changes in the wearing pressure of a soft knee orthosis during the rising to stand motion. [Participants and Methods] The subjects were 18 healthy young men. We investigated the temporal changes in the wearing pressure during the standing up motion using soft knee orthoses with different wearing pressures. [Results] A significant difference was observed in the wearing pressure in each phase of the rising motion. The wearing pressure was the highest when the buttocks lifted off the bed. In addition, the wearing pressure tended to increase according to the knee flexion angle. [Conclusion] We were able to confirm the change in the wearing pressure of the soft knee orthosis and the index during the standing up motion. In the future, we will proceed with the development of flexible knee orthoses whose wearing pressure changes dynamically.

[Purpose] How diffuse radial extracorporeal shock wave therapy (rESWT) affected the flexibility of the infrapatellar fat pad (IFP) was investigated. [Participants and Methods] Eight patients (eight knee) complaining of anterior knee pain participated in this study. The thickness of IFP superficial part before and after rESWT irradiation was measured by ultrasound echo and changes in pain were investigated. [Results] The thickness of the IFP superficial layer at 90°knee flexion changed significantly from 7.7 (7.1–8.9) mm to 13.6 (11.3–14.6) mm on the affected side 4 weeks after rESWT irradiation. Pain on a 100mm Visual Analog Scale (VAS) was 71.5 (65.6–84.8) before treatment, and 12.5 (7.5–23.3) after 4 weeks of treatment, a significant difference. [Conclusion] The results suggest that rESWT irradiation for IFP may contribute to an increase in the thickness of the IFP superficial layer and pain relief.

[Purpose] To clarify the influence of visual cues on stepping in patients with Parkinson’s disease (PD patients), their gait initiation was compared between with and without such cues. [Participants and Methods] Twenty-one PD patients stepped randomly with and without visual cues. Before and after this task, the center of foot pressure (COP) and Timed Up & Go Test score during gait initiation were measured. [Results] The amount of change in the COP significantly increased after stepping with or without visual cues. On the other hand, there were significant decreases in the latency time and duration of toe-off on the supporting side without visual cues. Furthermore, the rate of change in the latency time was significantly higher without than with them. [Conclusion] In PD patients, gait initiation may be smoother when stepping without visual cues.

[Purpose] This study examined health literacy and related factors in healthcare students. [Participants and Methods] A total of 193 healthcare school students were investigated using 2 health literacy scales: the 14-item Health Literacy Scale and European Health Literacy Survey Questionnaire 47 (HLS-EU-Q47), in addition to the Self-Management Skill Scale, Perceived Benefits and Barriers to Exercise Scale, Cognitive Reflection-Impulsivity Scale, Metacognitions Questionnaire-30 (MCQ-30), and Big Five. [Results] Five variables were identified as factors related to HLS-EU-Q47: exercise promoters, the school year, MCQ-30 subscale “positive beliefs about worry”, and Big Five subscales “neuroticism” and “extraversion”. [Conclusion] Early education and approaches focusing on these related factors may be required.

[Purpose] To clarify kinetic differences between the support leg and swing leg which are responsible for the predictive postural adjustment of gait initiation. [Participants and Methods] The movements of 18 healthy young participants were measured with a three-dimensional motion analyzer and force plates under normal-speed and maximum-speed gait initiation. [Results] Movement of the combined center of pressure (COP) increased with increasing speed, and lateral direction movement was larger than anterior-posterior movement. However, no interaction with ankle and hip moments was observed. In contrast, regardless of speed, the time difference movement of the COP in the anterior-posterior direction between the support leg and the swing leg was shorter in the swing leg. [Conclusion] There was no difference in the speed adjustment between the support leg and the swing leg. The swing leg needs to move the COP in the posterior direction in a shorter time than the support leg regardless of gait speed.

[Purpose] This research investigated the correlations among the clinical training, mock examination, and the national physical therapy examination scores of physical therapy students, and their self-directed learning readiness, and tried to identify national physical therapy examination related factors. [Participants and Methods] The subjects were 36 third-graders of a three-year physical therapy professional training college in April 2019. Correlation analysis and multiple regression analysis were performed on the research items. [Results] Scores of the national physical therapy examination positively correlated with those of clinical training, all mock examinations, and self-directed learning readiness. Multiple regression analysis identified the fourth mock examination and self-directed learning readiness factors were related to the score in the national physical therapy examination. [Conclusion] This study revealed that self-directed learning readiness positively correlated with the national physical therapy examination scores, and is also a factor related to the national physical therapy examination score.

[Purpose] To clarify the influence of occlusion on the gait of patients with post-stroke hemiplegia. [Participants and Methods] Eighteen patients with primary hemiplegia after stroke and no oromandibular problems were divided into 2 groups: occlusal gait: biting down on a 3-mm-thick mouthguard sheet located on the occlusal surfaces; and control: keeping the lower jaw in rest position. The gait characteristics of the 2 groups were analyzed using a foot pressure distribution measurement system. [Results] In the occlusal gait group, there were significant increases in the gait velocity, cadence, step length on the paralyzed side, and stride length. The distance of the center of pressure (COP) travelled and its rate on the non-paralyzed side during the single-leg support period significantly increased. On the paralyzed side, there was a significant increase in the peak plantar pressure during the second double-leg support period. Additionally, significant decreases in the step width and anteroposterior and lateral changes in the point of intersection in the trajectory of COP were observed. [Conclusion] Occlusion may influence the gait balance and gait function of patients with hemiplegia.

[Purpose] The purpose of this study was to investigate the factors, including physical function, associated with delayed recovery of walking independence of hospitalized elderly heart failure patients. [Participants and Methods] Patients with heart failure aged 65 years or older were included in the study. Medical information and physical functions, such as grip strength and knee extensor strength, were investigated retrospectively, and the relationship with time taken to regain walking independence was examined. [Results] The results of logistic regression analysis showed that brain natriuretic peptide (BNP) and grip strength were the factors associated with delayed independence in walking. [Conclusion] BNP and grip strength were related to the delay in the recovery of walking independence in hospitalized elderly heart failure patients.

[Purpose] To compare the characteristics of care dependency prevention supporters with different levels of motivation for their activities, and identify factors influencing their motivation and behaviors. [Participants and Methods] A mail questionnaire survey was conducted, involving participants of a training course for care dependency prevention supporters, and 190 who had returned valid responses were analyzed. [Results] The following factors were shown to influence the supporters’ motivations for their activities: “being personally participating in social activities”, “contributing to society, which led to participation in the training course”, and “the necessity of learning opportunities to promote volunteer activities”. Furthermore, “contributing to society, which led to participation in the training course”, “communicating with others, which led to participation in the training course ”, and “regularly and continuously performing exercise” were shown to influence their behaviors. [Conclusion] The results suggest the feasibility of increasing these supporters’ motivation by encouraging them to personally participate in social activities, and leading them toward positive behavioral changes by promoting their contribution to society.

[Purpose] This study examined the effect of sarcopenia on changes of the Short Physical Performance Battery (SPPB) in older inpatients. [Participants and Methods] This study recruited 17 older inpatients. Sarcopenia was assessed at the time of the first evaluation, and 11 patients were assessed to have sarcopenia. The improvements in SPPB at 3 weeks from the time of the first evaluation were compared between those with and without sarcopenia using repeated measures analysis of variance. [Results] Although there was no interaction effect in the total SPPB score, both groups showed similar improvements in the total SPPB score after 3 weeks. No interaction effect was also observed in sit-to-stand of SPPB, and a similar trend of improvement was observed, but the sarcopenia group showed lower values than the non-sarcopenia group both at the time of first evaluation and after 3 weeks. [Conclusion] Older inpatients with sarcopenia also showed improvement in SPPB, but may still show a decline in sit-to-stand ability.

[Purpose] An Iritani method simple pad was prescribed for a runner with knee joint pain and its effectiveness at improving symptoms and ease of use were investigated. [Participant and Methods] The subject was a male runner in his 40s, who had left knee osteoarthritis with residual pain after exercise therapy. After prescribing the Iritani method simple pad, a pain evaluation and a questionnaire concerning the pad’s usefulness were conducted. [Results] After prescribing the Iritani method simple pad, NRS significantly reduced, and “satisfactory” was the answer given for all the pad questionnaire items. [Conclusion] The Iritani method simple pad prescribed in this case, which can be attached to the back of an existing insole, is considered to be highly useful because it not only reduces pain but is also easy to use.

[Purpose] To evaluate the effect of Transcutaneous Electrical Nerve Stimulation (TENS) on a patient with pain after spinal compression fracture. [Participant and Methods] A woman in her 80s, who was diagnosed with a compression fracture of the second lumbar vertebra, was administered placebo TENS (the A period) and TENS (the B period), on alternate days for a total of 4 days. For both periods, pain at rest was measured using the Visual Analog Scale (VAS) before and after TENS. The Timed up and Go test (TUG) was performed, and pain after the TUG was also measured using the VAS. [Results] The VAS of pain at rest and pain after TUG as well as the TUG results showed a larger improvement in the B period than in the A period. [Conclusion] The results suggest that TENS may be effective for immediate improvement of pain and exercise performance in patients after spinal compression fracture.