[Purpose] To evaluate the effects of a Knowledge Translation (KT) program to improve the frequency of use of outcome measures by community-based physical therapists in Ibaraki, Japan. [Participants and Methods] The participants were 17 physical therapists working under the long-term care insurance system. Materials for six outcome measures were distributed, and e-mail communications were conducted for 12 weeks. Surveys were conducted before, after, and 3 months after the intervention. [Results] After the intervention, the frequency of use of five types of outcome measures (the Tokyo Metropolitan Institute of Gerontology Index of Competence, Fall Efficacy Scale, Modified Fall Efficacy Scale, subjective health using a Visual Analogue Scale, and subjective health based on questions with four or five response choices) had improved. Among the 13 participants who increased their use of six types of outcome measure, 9 (69.2%) continued to use the outcome measures at 3 months after the end of the intervention. [Conclusion] These results suggest that the KT program not only improved the frequency of use of the outcome measures, but also had an effect on their continued use.

[Purpose] This study was conducted to examine the immediate effect of sit-up practice designed with step by step difficulty adjustment on Parkinson’s disease (PD) patients’ motion time. [Participants and Methods] The participants were thirteen PD patients. The intervention consisted of 10 to 15 minutes of practice of sit-ups and turning over using the technique of step by step difficulty adjustment. [Results] The median pre-intervention sit-up motion time was 7.5 seconds, and the median post-intervention sit-up motion time was 4.4 seconds, a significant reduction. The degree of improvement in motion time was greater in more severe cases with slower movements (rs: 0.95). [Conclusion] The sit-up practice with step by step difficulty adjustment was considered to be an effective practice since it had the immediate effect of shortening the sit-up motion time of PD patients.

[Purpose] To objectively understand students’ emotions during clinical training and their characteristics, student portfolio assessment reports (students’ self-assessment reports on clinical training) were organized as data and analyzed. [Participants and Methods] The self-assessment reports submitted by 28 third-year students of the Department of Physical Therapy before and after clinical training were analyzed using text mining, and their characteristics were visualized through created co-occurrence networks. [Results] After clinical training, the students realized that pieces of their knowledge were connected through clinical experience. On the other hand, they were shown not to sufficiently associate test/measurement and motor analysis results, and to have little interest in risk management. [Conclusion] The results suggest that test mining helps extract information that cannot be obtained only by reading student portfolio assessment reports, and findings from it are useful for student interviews and clinical training guidance.

[Purpose] The purpose of this study was to examine the effect of superior and inferior subjective teeth alignment on muscle strength during isokinetic elbow extension and flexion. [Participants and Methods] The participants were 20 healthy university students. The participants were asked questions about teeth alignment, and they were divided into superior and inferior groups. Two tasks (biting and not biting) were performed, and the peak torque of isokinetic elbow flexion and extension was measured. The difference between the groups and the tasks were examined. [Results] A main effect was observed between the groups at 60 deg/sec angular velocity. [Conclusion] It was clarified that superior or inferior subjective teeth alignment affects the muscle strength.

[Purpose] As a basis for accurate assessment of musculoskeletal dysfunction in young children, this study examined the influence of prior movement practice on musculoskeletal examination results. [Participants and Methods] A total of 182 young children performed 3 movements: squat, standing forward bend, and single leg stand. They were divided into 2 groups with (motor learning group) and without (control group) practice before each movement, and the rate of being able to perform the movement was compared between the groups and among different school years in each group. [Results] In squat and standing forward bend, the learning effect of prior movement practice was marked on children aged 3–5, as the rates of being able to perform these movements were 90% or higher. As for single leg stand, the rate was significantly higher among children aged 5–6 in both groups. [Conclusion] Prior movement practice may be important to accurately assess musculoskeletal dysfunction in young children.

[Purpose] The purpose of this study was to examine the effects of a training program that combines aerobic exercise and the ability to coordinate exertion of force (ACEF). [Participants and Methods] The study included 10 healthy males and 6 females who were randomly divided into a group which performed 10 minutes of cycling at 60%VO_{2 max} (AE) (n=8) and a group which performed sitting without exercise (CON) (n=8). The ACEF effect was evaluated using a continuous visual isometric grip task, and seven different force trials were performed 8 times each, for a total of 56 times. Three sets per week were performed for four weeks. [Results] In the AE group the number of successful grip tasks significantly increased after training compared to the value obtained before training. However, no significant change was observed in the CON group. [Conclusion] Training that combines aerobic exercise and ACEF may successfully promote ACEF.

[Purpose] To determine factors related to the muscle thickness and ultrasound echo intensity of thigh skeletal muscle in inpatients with subacute stroke. [Participants and Methods] Forty-one patients were included in the study. The muscle thickness and echo intensity of the rectus femoris and vastus medialis (VM) muscles were measured by ultrasound and compared between the affected and unaffected limbs. We examined the relationship between each of muscle thickness and echo intensity with age, body mass index, duration of disease, nutritional status, pre-morbid walking ability, severity of motor paralysis, and walking ability. [Results] There were no significant differences between the affected and unaffected limbs in terms of muscle thickness or echo intensity. The muscle thickness of VM on the affected side was associated with the pre-morbid walking ability, duration of disease, and severity of motor paralysis. [Conclusion] Various factors are associated with muscle thickness and ultrasound echo intensity of the thigh skeletal muscle in patients with subacute stroke.

[Purpose] This study aimed to investigate the physical and mental effects of a newly developed 3-week exercise-based intervention program for patients with fibromyalgia (FM) and the appropriate involvement of physical therapists in this treatment. [Participants and Methods] Questionnaire surveys (JFIQ, BDI-II, and SF-8) and psychological interviews of 12 female patients with FM were conducted before and after the intervention. [Results] The majority of patients showed some improvement in their JFIQ, BDI-II, and SF-8 scores. The patients’ narratives suggested the importance of physical therapists being aware of their pain and distress. [Conclusion] This study showed that the exercise-based program effectively improved both the physical and mental health of the FM patients, and also, that it is important for physical therapists to consider patients’ pain and distress during treatment.

[Purpose] To clarify changes in novice physical therapists’ self-assessed clinical competence scores 10 months after graduation. [Participants and Methods] Ten novices assessed themselves using the Clinical Competence Evaluation Scale in Physical Therapy (CEPT) 1, 4, 7, and 10 months after graduation , and repeated measure analysis of variance and multiple comparisons were performed to compare their scores among the 4 points. [Results] The novices’ scores for＜thoughts＞,＜skills＞,＜conversations＞,＜attitudes＞, and＜self-education＞, and total score significantly improved within 10 months after graduation. Their scores for all major categories, excluding＜self-management＞, tended to decrease in 1 to 4 months. [Conclusion] The period, when novices’ self-assessed clinical competence scores improved, varied among major categories, suggesting that the period, when they require guidance, accordingly varies. The results also indicate the necessity of considering the possibility of novices’ self-esteem related to clinical competence decreasing soon after graduation, when providing guidance for them.

[Purpose] To investigate whether hip morphology is associated with non-contact anterior cruciate ligament (ACL) injury. [Participants and Methods] Twenty patients with ACL injury and 20 control subjects were examined. The acetabulum-head index (AHI) and the center-edge (CE), Sharp, and pelvic inclination angles were measured using frontal hip radiographs. The hip muscle strength was calculated using the agonist/antagonist muscle strength ratio. The knee valgus deviation angle was measured during single-leg squatting. [Results] There were no significant differences in the CE, Sharp, and knee valgus deviation angles between the two groups. However, the AHI was lower and the pelvic inclination angle was higher in the ACL injury group than in the control group (p<0.05 for both). [Conclusion] Lower AHI and an increased angle of pelvic inclination may affect anterior hip instability and ACL injury.

[Purpose] We investigated the effect of upper limb and shoulder girdle alignment on cervical muscle hardness and range of motion. [Participants and Methods] The participants were 20 healthy adult males. The measurement posture was the sitting position, and the upper limb and shoulder girdle alignment measurements were performed under three conditions: loading of both upper limbs, no loading of both upper limbs, no loading of the left upper limb. A biological tissue hardness tester and an ultrasonic three-dimensional motion analysis system were used to measure the cervical muscle hardness and range of motion, respectively. [Results] The cervical muscle hardness of the left and right trapezius muscles significantly reduced when both upper limbs were loaded, and that of the left trapezius muscle significantly reduced when there was no load on left upper limb. The cervical range of motion significantly increased in extension, rotation, lateral flexion when both upper limbs were loaded, and left rotation and right flexion significantly increased when there was no load on the left upper limb. [Conclusion] The results suggest that the upper limb and shoulder girdle alignment affects cervical muscle hardness and range of motion.

[Purpose] This study compared the postural balance among three posture conditions, single leg standing (Condition I), single leg forward stepping (Condition II), and single leg forward stepping from a box (Condition III), and examined the relationship between balance and the foot alignment indices. [Participants and Methods] The participants were 64 college baseball players. The foot alignment indices were the medial longitudinal arch height, the lateral angles of the first and fifth toes, the angle between the first and fifth toes, and the foot width/length ratio. The balance indices were defined as the center of pressure (COP) velocity and area during the acute and stable phases of each condition. [Results] The COP velocity in the acute phase became significantly higher as the load increased on the foot, but significant difference was not observed between the COP velocity in Condition II and Condition III during the stable phase. No significant correlations were found between the foot alignment indices and COP velocity in Condition III. [Conclusion] The postural balance during the acute phase was affected by the movement direction of the center of gravity and the impact force, and the preparatory movement before foot contact might have been affected in the stable phase. It is possible that the center of gravity sway was related to joint movements above the foot in Condition III.

[Purpose] The phase angle is affected by various parameters such as age, body composition and so on, but the extent to which it reflects a patient’s nutritional state is unclear. The purpose of this study was to clarify the usefulness of the phase angle as a nutritional assessment tool for inpatients in a rehabilitation unit. [Participants and Methods] This retrospective study included 207 old patients (67 male, 140 female) admitted to a rehabilitation unit. The relationships between their phase angles and other data such as the Charlson Comorbidity Index, skeletal muscle mass index, motor-Functional Independence Measure, and Geriatric Nutritional Risk Index (GNRI) obtained from medical records were analyzed for each sex. [Results] The phase angle was strongly affected by GNRI in both sexes. [Conclusion] The phase angle is a simple, and non-invasive indicator of nutritional assessment.

[Purpose] This study investigated the effect of smartphone use on simple reaction time during walking. [Participants and Methods] The vocalized response to an auditory stimulus of 39 healthy adults was measured as the simple reaction time. The difference in reaction times between the two conditions of treadmill-based normal walking with and without smartphone use was analyzed. The reaction times were also compared between the two groups of habitual smartphone users and non-habitual users. [Results] There was a significant main effect of condition. In addition, the post-hoc test showed that the reaction times during smartphone use were significantly slower than in the normal walking without smartphone use in both groups. [Conclusion] Regardless of the habit, the reaction time was significantly slower in walking with smartphone use than in normal walking without smartphone use.

[Purpose] A survey was conducted with the aim of clarifying the components and degree of influence of motivation to work of physical therapists. [Participants and Methods] Sixty-one physiotherapists were given a questionnaire survey of 18 items using the 5-case method. Multiple regression analysis and path analysis were conducted on the answers. [Results] It was clarified that the components of motivation to work were evaluation, treatment, human relations, ability improvement, placement, and sense of accomplishment. It became clear that the factors particularly strongly related to motivation to work are evaluation, treatment, and human relations. [Conclusion] The results suggest that as a concrete effort to improve the motivation to work of physical therapists, it is first necessary to improve evaluation and treatment.

[Purpose] The purpose of this study was to determine the factors that influence the length hospital stay of elderly patients with pneumonia who underwent rehabilitation. [Participants and Methods] A total of 192 patients aged 65 years or older hospitalized for pneumonia at our hospital who underwent rehabilitation were classified into two groups: short-term and long-term hospitalization groups, and the factors affecting the length of stay were examined. [Results] The number of days until the start of rehabilitation and the Barthel Index (BI) at the start of rehabilitation were identified as factors influencing the length of stay. [Conclusion] The results suggest that early rehabilitation after hospitalization and a high BI at the start of rehabilitation were associated with a shorter hospital stay.

[Purpose] The relationship between thoracic mobility and shoulder joint function in patients with frozen shoulder was examined using the precordial flexibility test and chest expansion measurement. [Participants and Methods] The participants were 22 individuals diagnosed with frozen shoulder. The correlations between their precordial flexibility test/chest expansion measurement results and the following parameters were investigated during the initial physical therapy: scores based on the Japanese Orthopaedic Association Criteria for the Evaluation of Treatment Outcomes in Diseases of the Shoulder Joint (JOA scores), at-rest and at-movement Visual Analogue Scale (VAS) scores, and the shoulder range of motion (flexion, external rotation with the arm at side, and internal rotation). [Results] Both precordial flexibility test and chest expansion measurement results were correlated with at-rest VAS scores. [Conclusion] Thoracic mobility and rest shoulder pain may be associated in patients with frozen shoulder.

[Purpose] Gait cycle variability and the Mini-Balance Evaluation System Test (Mini-BESTest) were added to the motor function evaluation of a patient with ataxia, and exercise therapy and gait training were investigated. [Participant and Methods] The subject presented with ataxia after stroke. It was considered that the problem of truncal ataxia that developed in each posture was related to standing balance and gait disturbance. Two-point, front-type gait training with independent walking was performed in conjunction with comprehensive exercise therapy for the alleviation of ataxia. [Results] With alleviation of ataxia, gait cycle variation and balance ability improved, and the use of support objects and watchfulness in independent walking was achieved. [Conclusion] Combining gait cycle variability and balance evaluation, such as the Mini-BESTest, enables determination of the timing of independent walking and exercise therapy that clarifies the prioritization of issues relating to each element of postural control.

The purpose of this paper is to focus on the ability to bend easily, to refer to its definitions, as well as age-related changes and sex differences in it, and to clarify the influences of flexibility and joint laxity on the incidence of sports injuries, in order to discuss the effect of stretching and other interventions provided as preventive approaches against such injuries to improve flexibility. The ability to bend easily is primarily expressed as flexibility and joint laxity, both of which decrease with age. Joint laxity is influenced by menstruation cycles in females. Decreased flexibility in each part of the body increases the incidence of sports injuries, and a high degree of joint laxity increases vulnerability to them. Improving flexibility without causing joint laxity is important for the prevention of sports-related injuries. This paper mainly demonstrates the significance of stretching to prevent injuries in various sports events.

This paper introduces the revised Japanese Guidelines for the Management of Stroke 2021 focusing on the contents related to the rehabilitation area. The purpose of this study is to help health care workers assess and select treatments for stroke patients by understanding new treatments and increasing evidence levels of existing treatments in the Japanese Guidelines for the Management of Stroke 2021. In the 2021 revision, the recommendation of treatment using repetitive transcranial magnetic stimulation and transcranial direct current stimulation in rehabilitation area treatment has increased compared to the Japanese Guidelines for the Management of Stroke 2015. Studies have been conducted to verify the effectiveness of existing treatments, and some have improved the level of evidence. On the other hand, some contents have been deleted in the 2021 revision. Based on the guidelines and judgment criteria based on the guidelines, it is suggested that flexible responses to individual patients in clinical practice are important.