Journal of Physical Therapy Science最新文献

[Purpose] This study aimed to assess the differences in body composition, including phase angle, extracellular water-to-total body water ratio, and skeletal muscle index, between patients in convalescent rehabilitation and long-term care wards. Understanding these differences is essential for tailoring patient care and rehabilitation strategies given that body composition plays a key role in recovery and functional outcomes. [Participants and Methods] In total, 160 patients (73 males and 87 females) in convalescent rehabilitation wards and 26 patients (9 males and 17 females) in long-term care wards participated in this study. Body composition, height, and weight were measured using an InBody S10 device, which allows measurements in both seated and lying positions. [Results] Significant differences in phase angle, extracellular water-to-total body water ratio, and skeletal muscle index were observed between patients in the convalescent rehabilitation and long-term care wards, with larger differences noted among female participants. Specifically, the skeletal muscle index was lower in the patients from long-term care wards, suggesting reduced muscle mass in this group. [Conclusion] Body composition differed between patients in the convalescent rehabilitation and long-term care wards. These findings highlight the need for personalized care and rehabilitation based on body composition to improve patient outcomes.

[This retracts the article on p. 146 in vol. 35 PMCPMC9889217.].

[This retracts the article on p. 369 in vol. 34 PMCPMC9057682.].

[Purpose] To examine the effects of a combination of static stretching (SS) and dynamic stretching (DS) on muscle function. [Participants and Methods] There were 32 healthy male participants. The hamstrings were the target muscles. Flexibility was measured using the straight leg raise test and muscle output was measured using a manual muscle force meter. The two measurements were compared before and after stretching, and between the group that first performed SS and the group that first performed DS. [Results] Flexibility improved significantly after stretching compared to the level before stretching when either SS or DS was performed first. However, there were no significant differences in muscle output or in between-group comparisons for any indicator. [Conclusion] There were no differences between the stretching techniques, suggesting that either combination of stretching may improve flexibility but with little effect on muscle output.

[Purpose] To evaluate the association between foot sole two-point discrimination and dynamic standing balance. [Participants and Methods] This cross-sectional, observational study included 50 healthy adults. Participants were made to stand on a firm or foam surface with eyes open or closed, and the center of pressure length was measured for static standing balance and limits of stability for dynamic standing balance. Two-point discrimination and muscle strength were assessed using the two-point discrimination test and toe grip strength, respectively. We then analyzed the association with sensory-motor assessment and standing balance. [Results] Significant differences were observed for almost all factors between static and dynamic standing balance. Two-point discrimination was associated with static standing balance, and muscle strength was associated with dynamic standing balance on a firm floor. There was no significant association between two-point discrimination and dynamic standing balance. [Conclusion] These results indicate that foot sole two-point discrimination is not directly associated with dynamic standing balance in healthy adults. Therefore, postural stability must be evaluated considering the specific floor surfaces and sensory conditions in clinical situations, and assessment of dynamic standing balance based only on two-point discrimination should be avoided.

[Purpose] This study aimed to develop an easy-to-operate knee joint for knee-ankle-foot orthoses with four adjustable levels of knee flexion movement and ascertain how different ranges of motion in flexion affect the knee flexion angle during walking. [Participants and Methods] Eight stroke patients participated, for whom knee joints of knee-ankle-foot orthoses were constructed. During walking, the knee flexion angle was measured for the following four knee joint settings: free flexion, 15° of flexion, 30° of flexion, and fixed extension. These measurements were compared to those of eight healthy volunteers from a previous study. [Results] Gait analysis revealed that the knee flexion angle during mid-stance was significantly greater in stroke patients than in healthy volunteers when set to 30° of flexion and in free flexion. [Conclusion] Appropriate adjustment of the range of knee mobility using a knee joint developed for knee-ankle-foot orthoses can prevent disuse atrophy caused by using knee-ankle-foot orthoses with a fixed knee joint.

[Purpose] To examine the impacts of using lumbar-type hybrid assistive limbs during the acute stage of stroke, specifically on motor function involving the trunk and activities of daily living, as compared to conventional physical therapy. [Participants and Methods] This was a single-center randomized controlled trial. Participants were randomly assigned to either the hybrid assistive limb or conventional physical therapy groups and underwent early rehabilitation with and without hybrid assistive limb training for ten 40-minute sessions over 10 days. Motor functions, including trunk function and activities of daily living, were evaluated before and immediately after the rehabilitation. [Results] Fifteen patients (median age, 67 years; hybrid assistive limb, n=7; conventional physical therapy, n=8) completed the study. No adverse events were observed. After training, both groups exhibited significant improvements on Berg Balance Scale, Functional Independence Measure-total, Functional Independence Measure-motor, and Stroke Impairment Assessment Set-motor scores. The conventional physical therapy group further exhibited significant enhancement in the Functional Independence Measure-cognitive and Functional Ambulation Category. The degree of improvement on the Berg Balance Scale was significantly larger in the hybrid assistive limb group than in the conventional physical therapy group. [Conclusion] Early rehabilitation using lumbar-type hybrid assistive limbs can improve trunk function in the early stages of stroke more than conventional physical therapy and may enhance walking ability and activities of daily living.

[Purpose] This study aimed to determine lower extremity asymmetry in healthy males when participating in sports where non-contact injuries are common by comparing lower extremity muscle strength, jumping distance, and change of direction speed between the dominant and non-dominant legs. [Participants and Methods] Study participants included 16 healthy males who had been playing a specific sport for at least four years at the time of measurement. We measured the maximal isometric strength of five muscle groups and conducted six performance tests. The lower-limb symmetry index was calculated as follows: (non-dominant leg/dominant leg) × 100. [Results] Significant differences were found in the strength levels of hip flexors, hip abductors, knee flexors, and knee extensor muscles. The lower-limb symmetry index for all muscles, except for the hip flexors, ranged from 91% to 98%. In the performance tests, significant differences were found in the crossover hop test and the 90° change of direction test. The lower-limb symmetry index ranged from 96% to 103% in all the performance tests. [Conclusion] We suggest that leg dominance be considered in assessments for determining return to sports based on the type of tests employed.

[Purpose] To compare changes in skeletal muscle mass after stroke based on the severity of motor dysfunction. [Participants and Methods] This study included 17 patients who had experienced a stroke. Patients were classified into two groups based on lower limb Brunnstrom stages, i.e., those with stages III and IV (moderate motor dysfunction group; n=9), and those with stages V and VI (mild motor dysfunction group; n=8). Muscle mass was measured at the following time points: within 3 days of stroke onset; at 2 weeks ± 2 days after stroke onset; at 4 weeks ± 2 days after stroke onset; at 8 weeks ± 2 days after stroke onset, and muscle mass indices, i.e., the skeletal muscle mass index (SMI), paralyzed lower limb muscle mass, and non-paralyzed lower limb muscle mass were evaluated. Changes in these muscle mass indices between stroke onset and at 2, 4, and 8 weeks after stroke, i.e., ΔSMI, Δparalyzed lower limb muscle mass, and Δnon-paralyzed lower limb muscle mass, were calculated and the changes in each index over time were compared between the two groups. [Results] The analyses did not reveal any significant intergroup differences. [Conclusion] Even in cases of severe paralysis, appropriate nutritional and exercise therapies may help maintain the muscle mass.

[Purpose] Treadmill-based interventions are widely utilized in rehabilitation due to their advantages of providing controlled environments and enabling individualized training. However, the differences between overground and treadmill walking during the subacute rehabilitation phase remain incompletely understood. This study aimed to compare gait parameters between treadmill walking at varying speeds and overground walking in a subacute rehabilitation setting. [Participants and Methods] A total of 42 inpatients with cerebrovascular and orthopedic conditions were recruited from a convalescent rehabilitation ward. Gait parameters were measured using the Gait Real-time Analysis Interactive Lab (GRAIL) system during comfortable overground walking and treadmill walking at various speeds, including self-selected comfortable speeds and speeds matched to overground walking. Walking speed, stride length, cadence, and step width were calculated without markers and compared across conditions. [Results] The comfortable treadmill walking speed was significantly lower than the overground walking speed (mean [standard deviation]: 0.85 [0.23] m/s vs. 1.20 [0.20] m/s). Stride length was significantly shorter during treadmill walking at comfortable speeds compared to overground walking (0.86 [0.22] m vs. 1.21 [0.18] m), whereas step width was significantly wider (0.17 [0.04] m vs. 0.13 [0.03] m). [Conclusion] Maintaining cadence at reduced treadmill speeds promotes comfortable endurance training in subacute rehabilitation patients.