[Purpose] The purpose of this study was to clarify whether or not sciatic nerve gliding decrease can be differentiated in patients with nonspecific low back pain by the slump test. [Participants and Methods] Nonspecific low back pain patients were classified into a negative group (n=24) and a positive group (n=14) by the slump test, and the sciatic nerve gliding distance was compared between the 2 groups and a healthy group of 20 persons. [Results] The sciatic nerve gliding distance was significantly lower in the positive group than in the healthy group, but there was no significant difference between the negative group and the positive group. [Conclusion] A positive slump test in nonspecific low back pain suggests that sciatic nerve gliding may be reduced.
[Purpose] To determine the outcome measures used and the reasons for selecting them in convalescence rehabilitation wards as part of research contributing towards their establishment and dissemination. [Participants and Methods] Five hundred physical therapist managers were surveyed using open-ended questions. In the analysis, outcome measures were classified into two groups, locomotor disorders and cerebrovascular diseases, depending on the disease with the highest number of subjects, and compared. Content analysis was conducted on the reasons for outcome measure use. [Results] The Functional Independence Measure (86.2%) and Brunnstrom Recovery Stage (80.9%) were the most used outcome measures. A comparison between the two groups regarding the use of outcome measures showed significant differences in the Mini Mental State Examination (MMSE), Numerical Rating Scale, standing on one leg, and the Barthel Index. Their frequencies of use were higher in the locomotor disease group. Content analysis divided the reasons for selecting outcome measures into ten main categories, and the proportion “having well-founded evidence” was higher. [Conclusion] It was found that the Functional Independence Measure and Brunnstrom Recovery Stage were frequently used in convalescent rehabilitation wards, and that “having well-founded evidence” was an important reason for selecting them.
[Purpose] To clarify the characteristics of scapular muscles when sitting up from a side-lying position with the shoulder flexed at different angles. [Participants and Methods] Thirteen healthy adult males initially lay on the right side with the shoulder flexed at an angle of 0° (Condition 1) or 60° (2), and then moved to an on-elbow position (propping the upper body with one elbow to raise it). During this movement, muscle activity was measured with surface electromyography electrodes attached to 4 muscles: the posterior fibers of the deltoid, middle and inferior fibers of the trapezius, and external abdominal oblique. Comparing measurement values between the 2 conditions, the activity levels of the target muscles before/after peak contraction and after the end of the movement were calculated. [Results] The activity levels of the inferior fibers of the trapezius before/after peak contraction and those of all muscles after the end of the movement were higher under Condition 1 compared with 2. [Conclusion] The pattern of scapular muscle activity during a side-lying-to-sitting movement may vary according to the shoulder flexion angle in the initial position.
[Purpose] The purpose of this study was to investigate the effects of proficiency in muscle hardness measurement, which is used as an evaluation in physical therapy, and the use of different equipment types and positioning on the intra-rater and the inter-rater reliabilities. [Participants and Methods] The participants were 12 healthy adult males. Using three types of hardness meter, three experts and three beginners measured the muscle hardness of the lumbar erector spinae, rectus femoris, and triceps brachii in two positions: relaxed and stretched. [Results] For the intra-rater and inter-rater relative reliabilities, a comparison of the average measured values showed they had high reliability, and in the stretched position, the measurement reliability for each muscle tended to be higher for both groups of examiner. For the absolute intra-rater reliability, systematic bias was observed for the youngest examiner measurements in both groups. [Conclusion] Differences in proficiency and positioning influence the measurement reliability of muscle hardness.
[Purpose] The purpose of this study was to clarify physical therapists’ levels of competencies and their changes over time. [Participants and Methods] The participants of the research were 38 physical therapists who belonged to 7 medical facilities and had passed the National Physical Therapist Examination in 2013. The research was conducted using CEPT, and it assessed how physical therapists’ competencies changed during the first 3 years after they acquired their qualification. [Results] There was a significant difference in the total score of CEPT, especially immediately after obtaining the qualification and after 1-3 years of experience. From the early stage of the years of experience, there were items that scored high and items that increased with experience. The characteristics of the change of the score of each item were classified into three types. [Conclusion] The level of physical therapists’ competencies varied depending on the content. Also, it was found that there are features that improve at a relatively early stage and there are characteristics that improve with some experience.
[Purpose] To identify preoperative factors influencing the knee extensor strength after opening wedge high tibial osteotomy (OWHTO). [Participants and Methods] A total of 54 knees of 47 patients (mean age: 60.6 ± 7.2) treated with OWHTO in the study facility were assessed based on the knee extensor strength 1 and 3 years after surgery in comparison with the preoperative Japan Orthopaedic Association score, knee range of motion, and knee extensor strength. Furthermore, the postoperative muscle strength was evaluated by calculating the rate of change from the preoperative value. [Results] The mean rates of improvement in the knee extensor strength 1 and 3 years after surgery compared with the preoperative values were 20.6 ± 47.0% and 32.6 ± 58.8%, respectively; the rate was higher at the latter point. At both points, the preoperative knee extensor strength was the major factor that influenced the rate of change in the knee extensor strength after surgery. [Conclusion] There were more noticeable improvements in the muscle strength after OWHTO among patients with a marked decline in the knee extensor strength before it.
[Purpose] This study developed a chart for predicting the independence of ambulation of patients, including those with cognitive impairment, in a convalescence ward. [Participants and Methods] One hundred sixty-three patients in a convalescence rehabilitation ward were enrolled in this study. Physical and cognitive functions, balance ability, and activities of daily living were evaluated within three weeks of admission to the rehabilitation ward. Based on this information, a decision tree for predicting independence of ambulation at discharge was developed. [Results] Walking speed, cognitive function and balance ability were extracted as significant predictors. [Conclusion] Walking speed, cognitive function and balance ability within three weeks of admission predicted independence of ambulation of patients, including those with cognitive impairment, at discharge.
[Purpose] To investigate the effect of controlled starting position condition on the forward reaching distance during Functional Reach Test (FRT). [Participants and Methods] Sixteen healthy males participated in this study. The range of distribution of the right acromion, greater trochanter, center of pressure, and forward reaching distance were analyzed in the controlled starting condition and uncontrolled starting condition during FRT. [Results] The range of distribution of the right acromion position, greater trochanter position, center of pressure, and forward reaching distance were significantly smaller in the controlled starting condition than in the uncontrolled condition. [Conclusion] The range of distribution of the starting position and the forward reaching distance were smaller during controlled starting condition than the uncontrolled condition of the FRT.
[Purpose] The purpose of this study was to clarify the factors that affect decrease in the frequency of going out, including the viewpoint of overactive bladder symptoms, among community-dwelling elderly people who use general preventive care services. [Participants and Methods] Decrease in the frequency of going out, living conditions, physical function, overactive bladder symptoms, and cognitive function of 44 community-dwelling elderly people were investigated and examined using multiple logistic regression analysis. [Results] Factors affecting the frequency of going out were diverse. They included physical function, cognitive function, depression, IADL, and overactive bladder symptoms, with overactive bladder symptoms having the greatest effect. [Conclusion] The results suggest that as a support for decrease in the frequency of going out, it is necessary to not only implement the contents of the current preventive care services, but also to evaluate and intervene for the prevention and aggravation of overactive bladder symptoms.
[Purpose] The purpose of this study was to clarify whether sway back is related to sedentary behavior in young college students. [Participants and Methods] The subjects were 56 healthy young college students. Sway angle was used to evaluate sway back. For the sway angle, markers were attached to the subject’s acromion, greater trochanter, and outer malleolus, and the angle was calculated from images of standing at rest taken from the side with a digital camera. Sedentary behavior was measured by wearing a physical activity meter which measured daytime activity for one week. [Results] Stepwise multiple regression analysis revealed no association between sway angle and sedentary behavior. [Conclusion] The results suggest that sway back is not associated with sedentary behavior in young college students even when the sedentary behavior was long.
[Purpose] The present study investigated the gaze behavior of stroke patients during walking outdoors, when they need to deal with several environmental constraints, such as rough terrain, steps, and roads. [Participants and Methods] The participants were six stroke patients and six younger adults. The participants walked on an outdoor walking course while wearing an eye mark recorder (EMR-9). [Results] The stroke patients fixated their steps and road surfaces significantly longer than the younger adults. The stroke patients also showed less frequency of gaze behavior for left and right confirmation than the younger adults. [Conclusion] The stroke patients tended to look down and fixated predominantly on the ground surface. Accordingly, their gaze behavior is unlikely to be modified by responses to environmental constraints.
[Purpose] We report a case of prolonged bilateral lateral humeral epicondylitis with pain catastrophizing and depression whose symptoms improved with pectoralis major stretching. [Participant and Methods] The case was a male patient in his 40s who had had bilateral lateral humeral epicondylitis for more than 2 years. In the initial evaluation, the Numerical Rating Scale, Kraushaar & Nirschl classification, Disabilities of the Arm, Shoulder and Hand (DASH) score, Pain Catastrophizing Scale, Hospital Anxiety and Depression Scale, and elbow and wrist joint range of motion (ROM) were assessed. In the interim evaluation, shoulder ROM, the Horizontal Flexion Test, and scapula abduction rate were added to the initial evaluation items. The final evaluation was the same as the interim evaluation. [Results] All of the evaluation points were significantly improved by pectoralis major stretching. [Conclusion] Pectoralis major stretching reduces the internal rotation of the upper limbs and the scapula abduction rate, is effective at improving the ROM of internal rotation of the shoulder joint, and is considered useful for lateral humeral epicondylitis. The psychological evaluation items also improved as pain was reduced.
[Purpose] To evaluate the effect of acute respiratory rehabilitation intervention for a patient with severe pneumonia and intensive care unit acquired weakness (ICU-AW) due to COVID-19. [Participant and Methods] The case was a male in his 50s with severe pneumonia due to COVID-19. We performed respiratory rehabilitation according to the stage of severity with the goal of ventilator withdrawal. When physical therapy was started, when sitting on the bed, when the ventilator was withdrawn, and when leaving the intensive care unit, the items of breathing, muscle strength, and movement ability were evaluated and the degrees of improvement were examined. [Results] Compared with the start of respiratory rehabilitation, improvements were observed in each evaluation item of breathing, muscular strength, and movement ability when leaving the intensive care unit. [Conclusion] The results suggest that the intervention of respiratory rehabilitation was effective at improving each evaluation item of breathing, muscular strength, and movement ability.
[Purpose] This paper reports the result of vestibular rehabilitation based on the cause of gait disturbance inferred by gait analysis under different speed conditions. [Participant and Methods] The participant was a 54-year-old male with multiple system atrophy-cerebellar variant (MSA-C). Gait analysis of different speed conditions (preferred, fast, slow) revealed greater gait variability under the slow speed condition. We surmised that the gait disturbance was caused by disequilibrium due to lesions in the flocculus or nodulus in the cerebellum, and prescribed vestibular rehabilitation for 9 days. [Results] After the rehabilitation treatment, performance on a force platform, the Functional Gait Assessment score, and gait variability under the slow speed condition had improved. [Conclusion] Focusing on the speed dependence of gait variability, vestibular rehabilitation led to an improvement in the gait stability of a patient with MSA-C.
[Purpose] In this study, we report the improvement of walking ability of a patient with persistent postoperative pain after total knee arthroplasty after performing a task to improve perceptual function. [Participant and Methods] The participant, a woman in her eighties, underwent outpatient physical therapy because of decreased perceptual function, pain during walking, and lack of improvement in walking ability. Interventions included a knee and ankle joint position perception task, a hardness discrimination task, and a task to recognize alignment changes. Evaluation was based on the number of correct responses to the knee and ankle positional awareness and hardness discrimination tasks. [Results] The knee and ankle joint positional awareness improved and the number of correct answers to the hardness discrimination task increased. In addition, pain during walking disappeared, and perceptual function, fear of movement, self-efficacy, and walking ability all improved. [Conclusion] The results suggest that interventions to enhance perceptual function are necessary for patients after total knee arthroplasty after consideration of fear of movement and self-efficacy.