[Purpose] This study examined the gender difference in the relationship between the Functional Reach Test (FRT) and physical function in elderly people requiring long-term care. [Participants and Methods] The subjects were 16 males and 28 females. The physical functions measured were grip strength, quadriceps muscle strength (QMS), and toe-grip strength (TGS), and standing balance was measured by FRT. [Results] Partial correlation analysis with the degree of care required as a control variable showed significant positive correlations between FRT and QMS and TGS in males. In females, age and FRT showed a significant negative correlation, but QMS and TGS did not. [Conclusion] Physical function factors related to FRT in elderly people requiring long-term care differed by gender. The results suggest that lower limb muscle strength may play an important role in males, whereas FRT appears to be age-related in females.

[Purpose] This study was conducted to clarify the relationship between the two-year change in each domain of the Kihon Checklist and initiations of long-term care in community-dwelling elderly. [Participants and Methods] Handwritten questionnaires, including the Kihon Checklist, were distributed in 2012 and 2014 to a cohort of elderly people. The scores in each domain of the checklist in 2012 were subtracted from those in 2014 and defined as the deterioration in the Kihon Checklist score. We analyzed the data of 11174 individuals from the perspective of the relationship between initiations of long-term care in 2015–2017 and the deterioration in the Kihon Checklist scores. [Results] Physical function deterioration, nutrition deterioration, homebound state deterioration, cognitive function deterioration and depressive mood deterioration were significantly associated with new certifications of long-term care. [Conclusion] It is necessary to use the Kihon Checklist continually or to monitor progress over the medium term for early preventive intervention.

[Purpose] The purpose of this study was to classify the fall risk level of stroke patients in the convalescent phase, and to clarify the relationship between score changes in the functional independence measure (FIM) and falls. [Participants and Methods] Eighty-six stroke patients admitted to a convalescent hospital were classified into low, medium, and high fall risk groups. The FIM scores at admission and 30 days after admission were compared between fallers with non-fallers in each fall risk group, as well as the difference between these scores. [Results] The fall rate was significantly higher in the high-risk group than in other groups. In the medium-risk group, the difference of scores between FIM at admission and 30 days later was significantly higher in fallers than in non-fallers. [Conclusion] In the medium-risk group, rapid changes in motor function may lead to falls. The evaluation of the time course of FIM may be useful in fall prevention measures.

[Purpose] To kinematically analyze the characteristics of thoracic and pelvic angles during sit-to-walk movements in young and older adults, and clarify differences between them. [Participants and Methods] Sit-to-walk movements were measured in 14 young and 12 older adults using a 3-axis inclinometer, load switch system, and video camera recorder. [Results] The anterior thoracic and pelvis tilt angles at foot-off (FO) during the first step were smaller, and the period from lift-off (LO) to FO was longer in older compared with young adults. Furthermore, in older adults, the amounts of change in the anterior thoracic tilt angle at FO and in the anterior pelvic tilt angle until FO were positively correlated with Functional Reach Test results. [Conclusion] Both groups lifted off with anterior thoracic and pelvic tilts, but FO took place with these tilts were not maintained in older adults. The results also revealed the necessity of tilting the pelvis, in addition to the thorax, forward to shift from standing to walking within a short time, suggesting that older adults needed to adopt a different movement strategy from that of young adults due to a decline in balance function.

[Purpose] External focus (EF) instructions have been shown to be more effective than internal focus (IF) instructions for improving motor performance. However, there is a possibility that the more effective type of instruction depends on the skill level and the intervention period. The purpose of this study was to examine which of IF and EF instructions was more effective for continuous training of untrained tasks. [Participants and Methods] Sixty-two university students were assigned to either the IF or EF groups. They trained for 14 consecutive days using IF or EF instructions for a pitching task with their non-dominant hand, and ball speed was measured. [Results] There was no significant interaction for changes in ball speed, but there was a significant main effect of time, and the ball speed of all participants increased significantly. [Conclusion] The results suggest that IF instruction is as effective as EF instruction in the continuous training of untrained tasks.

[Purpose] This study examined the changes in physical activity (PA) levels before and during the COVID-19 outbreak of older Japanese community-dwelling adults participating in exercise programs. [Participants and Methods] This observational study recruited 15 older adults. Participants were required to continuously wear an accelerometer on an elastic band on their hips for a week. Average daily duration of light, moderate, and total PA (min/day), as well as daily steps were calculated. Life-space assessment (LSA) scores were also assessed using a questionnaire. [Results] Although all participants reached 5 levels (from home to out of town) before the COVID-19 state of emergency declaration, 20% of them did not reach 5 levels during the state of emergency. Thus, there were no significant changes in any of the physical activity parameters and LSA before and during the declaration of emergency. [Conclusion] This study concludes that there was no significant decrease in physical activity levels among older community-dwelling adults participating in exercise programs before the COVID-19 outbreak in April 2020.

[Purpose] The effect of a knee-ankle-foot orthosis (KAFO) on walking ability and its continued use by stroke patients with hemiplegia in a convalescence rehabilitation ward in an acute care hospital was investigated. [Participants and Methods] Eighteen hemiplegic stroke patients with severe motor palsy were divided into two groups according to their use of KAFO. The functional independence measure (FIM), walking, stairs, and orthosis use at discharge were investigated. [Results] Both groups showed improvements in FIM, walking, and stairs over time, but there were significant differences in the FIM, walking, stairs, and orthosis removal rate at discharge from the convalescence rehabilitation ward between the two groups. [Conclusion] KAFO may improve walking and stairs and enable orthosis removal when patients are discharged from convalescence rehabilitation wards in acute care hospitals.

[Purpose] To examine the current status of clinical practice with collaborative working, which has been incorporated into the curriculum of this department, and confirm its effects. [Participants and Methods] A total of 124 physical therapy students, who had completed clinical practice during the fourth year within the period between 2017 and 2019, were the subjects. Their Objective Structured Clinical Examination (OSCE) scores and professional identity (ID) scores were measured before and after clinical practice. Additionally, a questionnaire survey to clarify the details of this practice was conducted. [Results] The students’ ID scores were significantly higher after clinical practice than before it. The ID scores after clinical practice positively correlated with the duration of intervention for patients during it. On the other hand, there was no significant correlation between OSCE scores and clinical experience. [Conclusion] In future clinical practice, students will be expected to improve their clinical skills by providing a more practical and partial intervention for a large number of patients.

[Purpose] The purpose of this study was to compare job satisfaction and job stress of rehabilitation professionals among organizational climate types. [Participants and Methods] We conducted a survey of 102 rehabilitation professionals working in general hospitals using the Organizational Climate Scale and the Brief Job Stress Questionnaire, and compared job satisfaction and job stress for each type of organizational climate. [Results] There were 89 respondents. Job satisfaction, environmental stress, job discretion, job fitness, job satisfaction, supervisor support, and coworker support showed significant differences among organizational climate types, and job stress was low in an active organizational climate compared with the other three types. [Conclusion] The organizational climate was found to be related to job satisfaction and job stress. In dealing with job stress and job satisfaction, it is necessary to consider not only the individual but also the organizational climate.

[Purpose] This study clarified the actual situation of placement activities and the employment requirements of physical therapy students using a questionnaire survey. [Participants and Methods] A questionnaire survey on placement activity was conducted of 104 of 133 fourth-year students, enrolled in the Physical Therapy Course of Tohoku Bunka Gakuen University in 2018–2019, who agreed to cooperate in this study. [Results] One hundred two students hoped to find employment, and 100 of them gained employment in medical institutions. Seven of the 28 students that were offered employment in the Kanto region wanted to return to their hometown in the future. Students focused on salary, welfare benefits, and interpersonal relationships as important factors when they chose a workplace. [Conclusion] This study revealed the first employment place of most students was a medical institution, and important requirements for students seeking employment were salary, welfare, and interpersonal relationships.

[Purpose] We implemented preventive measures against COVID-19 infection for physical therapy undergraduate students and identified students’ current state of physical activity. [Participants and Methods] A questionnaire survey was administered to 377 physical therapy undergraduate students in grades 1–4 regarding COVID-19 preventive measures, purpose of going out, frequency of going out, means of going out, and average number of steps per week. [Results] The implementation rate of basic COVID-19 preventive measures was 90% or more. The purposes and frequency of going out were restricted, in compliance with government requests. The median number of steps was 1838. [Conclusion] As for the COVID-19 preventive measures, the implementation rate of “hand washing / gargle, cough etiquette / mask” was higher than those of other items. Since the number of steps was far below the target value, a longitudinal survey is required to investigate the amount of physical activity.

[Purpose] The dynamic stability of stroke patients who have not yet achieved independent walking were examined using the margin of stability (MOS). [Participants and Methods] The gait of 28 stroke patients (independent gait: n=14; non-independent gait: n=14) was measured using a 3D motion analysis device. As an index of dynamic stability, we calculated lateral, posterior, and anteroposterior MOS during paralyzed and non-paralyzed single-leg support. [Results] In the non-independent group, the lateral width was significantly smaller and the posterior width was significantly larger in the single-leg supporting period on the non-paretic side. The independent group showed significantly large negative values of anterior width on both the paralyzed and non-paralyzed sides. [Conclusion] In the non-independent group, weakness of dynamic stability on the unaffected side direction was observed, suggesting that the dynamic stability on the affected side as well as in the anterior-posterior direction might have been compensated for by controlling step width and step length.

[Purpose] To clarify the consequences of excretory behavior at discharge in typical populations, independence and non-independence were investigated and categorized for each excretory movement process in patients with cerebrovascular accidents and proximal femur fractures who were hospitalized in a convalescent rehabilitation ward. [Participants and Methods] For 63 patients with cerebrovascular accidents and 47 patients with proximal femur fractures in a convalescent rehabilitation ward, the independence of the excretory movement process at the time of admission was examined using cluster analysis for categorization and independence prognosis. [Results] Both patient groups were categorized into three similar populations, but the final outcomes of excretory behavior was different. [Conclusion] The results suggest that grouping subjects from the aspect of the excretory movement process at the time of admission could serve as an early intervention guideline for prognosis.

[Purpose] The purpose of this study was to clarify the relationship between step ability using the Tether-release method and falls in the past year in the community-dwelling elderly. [Participants and Methods] The subjects were divided into two groups based on whether or not they had fallen in the past year: a fall group (n=8), and a non-fall group (n=28). The step ability was measured as the maximum body leaning weight ratio. [Results] A significant difference in the maximum body leaning weight ratio was observed between the fall and non-fall groups (p=0.038). Logistic regression analysis revealed a significant association between falls and the maximum body leaning weight ratio (odds ratio: 0.840; 95% confidence interval: 0.711–0.992). [Conclusion] The results suggest that there may be a relationship between the step ability measured by the Tether-release method and falls among the community-dwelling elderly.

[Purpose] This study investigated distance learning conducted after the state of emergency announced during the COVID-19 pandemic to determine issues arising from distance learning, and to propose specific countermeasures. [Participants and Methods] The replies to a questionnaire survey sent to 169 first to third year students enrolled in a physical therapist training school were analyzed using KHCorder3. [Results] Four problems were identified: the lecture environment, audiovisual situation, understanding of lesson contents, and the physical condition of students. [Conclusion] Based on these findings we propose specific countermeasures for emergency classes of preparedness, planning, and practice. In the future, teachers and students will also have to improve their ability to utilize ICT. In addition, technical and clinical practice issues need to be considered.

[Purpose] The purpose of this research was to investigate the pathogenesis of anosognosia in hemiplegia (AHP) by focusing on somatosensory disturbance and unilateral spatial neglect (USN) which are considered to be associated with AHP. [Participants and Methods] Three case reports and an author’s case were the subjects of this study. The pathogenesis of AHP was investigated by focusing on lesion and the presence of somatosensory disturbance and USN. [Results] We consider that the dorsolateral prefrontal cortex (DLPFC) and the putamen/globus pallidus, which were both common lesions of the neither somatosensory disturbance nor unilateral spatial neglect (NSU) group, are associated with the pathogenesis of AHP. [Conclusion] As the DLPFC is associated with self-monitoring and the putamen/globus pallidus is associated with components of executive function, we consider that functional disturbance in the associated loop is a factor that triggered the pathogenesis of AHP in the NSU group.

[Purpose] The effect of applying titubation as a stimulus to the trunk on body flexibility was compared between males and females. [Participants and Methods] An experiment, where 20 healthy adults were treated with titubation as a stimulus, or only maintained a supine position, was conducted using a crossover design. Before and after stimulation, the body pressure, muscle hardness, spinal mobility, skin extensibility, trunk flexion with the legs extended, and subjective sleep quality were assessed. [Results] With titubation as a stimulus, the contact area increased, the mean body pressure decreased, the thoracic kyphosis angle with a maximum trunk flexion decreased, spinal mobility increased, the distance reached by flexing the trunk with the legs extended increased, and lumbar muscle hardness decreased in males, whereas the contact area and skin extensibility increased, and the mean body pressure decreased in females. [Conclusion] Titubation as a stimulus increased body flexibility in both sexes, specifically muscles and joints as deep soft tissues in males, and the skin as a superficial soft tissue in females.

[Purpose] The purpose of this study was to examine the method of analysis of central nervous system factors in a muscle strengthening exercise. [Participants and Methods] The participants comprised 12 healthy adult males. The right biceps muscle strengthening program lasted 6 weeks and was carried out for 4 days a week. The measurements included maximum muscle strength of the biceps, surface electromyography, and the change in muscle thickness measured by ultrasonography. As a central nervous system factor, a discrete wavelet transform in the electromyographic analysis was used to calculate the median instantaneous frequency spectrum and the spectrum root mean square values. [Results] The maximum muscle strength, spectrum median and root mean square values, and muscle thickness changed significantly during the program. [Conclusion] The analysis method used in this study could be applied as an evaluation index of motor function by capturing changes, such as central nervous system factors.

[Purpose] The effect of gait training using functional electrical stimulation (FES) on the propulsion force and the swing strategy of convalescent hemiplegic stroke patients was examined. [Participants and Methods] The subjects were 26 hemiplegic stroke patients. The intervention period was 30 days. The FES group performed gait training while FES was applied to the tibialis anterior muscle during the swing phase, and the control group performed normal gait training. Physical function evaluation and gait analysis were performed before and after the intervention. [Results] The walking speed, propulsion force, and the maximum value of preswing ankle power significantly increased in the FES group. [Conclusion] FES of the tibialis anterior muscle of convalescent hemiplegic stroke patients may improve the swing strategy by improving propulsion force and ankle plantar flexion motion.

[Purpose] Changes in the range of motion of the thumb and the trajectory of the ball caused by the task of rotating two balls with the palm were evaluated. [Participants and Methods] This study included 11 healthy adults who were asked to rotate two balls for one minute using the left palm. The same exercise was practiced for three sessions. The range of motion of the thumb and the changes in the trajectory of the ball, before and after the exercise, were compared. Specifically, the range of motion of the metacarpal bone of the thumb in the frontal and sagittal planes and the length of the trajectory of the ball moving on the palm were measured. [Results] The range of motion of the thumb and the trajectory length of the ball after the exercise were less than those observed before the exercise. [Conclusion] The task of rotating two balls with the palm narrowed the range of motion of the thumb and reduced the trajectory length of the ball, resulting in an increase in the number of rotations of the ball.

[Purpose] The aim of this study was to clarify the effect of a pelvic floor muscle (PFM) exercise using vibration stimulation and visual-feedback (FB). [Participants and Methods] Ten healthy men participated in this study. PFM exercise was conducted using a dedicated cushion under four conditions: without vibration, with only vibration, without vibration but with FB, and with vibration and FB. The participants performed 6 sets of 10-second contraction of the PFM. The maximum voluntary contraction (MVC) of the PFM was measured using surface electromyography pre- and post-exercise. [Results] The post-exercise MVC values of PFM exercise combined with vibration, FB, and vibration with FB were significantly higher than pre-exercise. The post-exercise MVC value of PFM exercise combined with vibration and FB had the greatest effect. [Conclusion] PFM exercise combined with vibration and FB may better improve muscle activity of PFM.

[Purpose] The purpose of this study was to investigate effective intervention for patients with vertebral compression fractures (VCF) who have high levels of catastrophic thinking about pain. [Participant and Methods] The participant was an elderly male who was diagnosed with a VCF and admitted to a hospital. An intervention that emphasized successful experiences was conducted, and the degree of pain (Numeric Rating Scale), catastrophic thinking about pain (Pain Catastrophizing Scale: PCS), anxiety-depression state (Hospital Anxiety and Depression Scale), activities of daily living (motor domain of Functional Independence Measure: mFIM), and amount of activity were evaluated. [Results] The total score of the PCS at admission was 44 points and that of the mFIM was 23 points. After the intervention, improvements in the PCS score to 32 points, and the mFIM score to 60 points were observed. [Conclusion] The results suggest that for patients with severely painful VCF, interventions that emphasize successful experiences, applied through a multidisciplinary collaboration from the early stage of hospitalization, may improve the pain catastrophizing level and prevent prolonged pain.