Journal of Physical Therapy Science最新文献

[Purpose] This study examined gait asymmetry through analyzing gait trajectories and asymmetry of the lower limb moment of the frontal plane in normal and blindfolded gaits. [Participants and Methods] A three-dimensional motion analyzer and force plates were used to determine the thoracic lateral deviation and asymmetrical ratios of the upper and lower thoracic shapes in the standing position of 20 healthy adult men. The progression angle pelvic and thoracic rotation angles; and asymmetry of the hip, knee, and ankle moments in the frontal plane in full- and no-vision gaits were measured. [Results] The thorax deviated to the left relative to the pelvis, and the upper and lower thoracic shapes were asymmetric. The no-vision gait trajectory exhibited a significantly deviated to the left, and the pelvis and thorax were significantly rotated to the left compared with those of the full-vision gait. Asymmetry of the knee moment at the mid-stance and the ankle moment at the loading response were significantly lower under no-vision gait than during full-vision gait. [Conclusion] The proprioceptive trunk information was unbalanced in able-bodied participants. Imbalances in proprioceptive information may cause asymmetric motion of the knee and ankle during gait.

[Purpose] We aimed to analyze the kinematic characteristics of the foot trajectory of the trailing limb in a crossing motion during gait when the height of an obstacle is varied. [Participants and Methods] The participants were 12 healthy adult males (age: 24.2 ± 0.9 years). The participants performed 11 tasks: normal gait and crossing an obstacle with a height ranging from 10% to 100% of the height from the floor to the knee joint crease at 10% intervals during gait. The parameters included the clearance height, foot trajectory, swing phase duration, stride, toe distance, and heel distance. [Results] In the crossing condition, the foot trajectory changed with the obstacle height, with some participants showing unimodal trajectories when the obstacle height was ≥30% of the knee joint height. The trend test results show a trend from bimodal to unimodal trajectories with increasing obstacle heights. [Conclusion] The trailing limb of a young participant's crossing motion during gait showed kinematic changes in the foot trajectory, adjusting from bimodal to unimodal as the obstacle height increased, suggesting that this may be a specific strategy for dealing with high obstacles.

[Purpose] This study retrospectively examined the physical characteristics of patients with chronic obstructive pulmonary disease who experienced decreased physical activity due to low-frequency pulmonary rehabilitation. [Participants and Methods] Eighty outpatients with stable chronic obstructive pulmonary disease were included. Participants were categorized into two groups based on changes in physical activity after six months of low-frequency pulmonary rehabilitation. Those whose daily step count decreased by 600 steps or more were classified as the decreased group, while the others were classified as the non-decreased group. [Results] The decreased group had a lower predicted value of forced expiratory volume in one second compared to the non-decreased group. Additionally, a greater proportion of participants in the decreased group lived in hilly areas compared to those living in flat areas. [Conclusion] It may be important to consider appropriate intervention strategies at the initial assessment of low-frequency pulmonary rehabilitation, especially for individuals with reduced forced expiratory volume in one second and those living in hilly environments.

[Purpose] This study aimed to determine whether a common left-right asymmetry exists in frontal plane movement during gait and to explore its relationship with resting standing posture. [Participants and Methods] Twenty-five healthy adult male participants with no history of surgery were assessed during standing and gait using a three-dimensional motion analysis system. The maximum lateral movement of the trunk and center of mass, peak of the vertical ground reaction force, and lateral position of the center of pressure were compared between the left and right stance phases. The relationship between asymmetry in standing posture and gait was also evaluated. [Results] Most participants exhibited a leftward thoracic deviation relative to the pelvis while standing. During gait, lateral movement of the center of mass, first peak of the vertical ground reaction force, and lateral position of the center of pressure were all significantly greater during the left stance phase compared with the right. Additionally, greater leftward thoracic deviation in the standing posture was associated with larger asymmetry in lateral trunk and center of mass movement during gait. [Conclusion] A consistent left-right asymmetry was observed in both resting standing posture and gait. Leftward thoracic deviation in standing appears to shift the center of mass to the left during gait, potentially contributing to inefficient gait patterns.

[Purpose] This study aimed to determine the accuracy of combining general movements assessment and head magnetic resonance imaging in predicting cerebral palsy in preterm and low birth weight infants. [Participants and Methods] This retrospective observational study analyzed clinical routine data of patients admitted to the neonatal intensive care unit of a university hospital between 2010 and 2017. The study included 154 very low birth weight infants (mean gestational age 28.8 ± 3.1 weeks, birth weight 1003.7 ± 307.4 g). The infants were classified into a cerebral palsy group or a non-cerebral palsy group. We examined whether combining general movements assessment and head magnetic resonance imaging findings were associated with the development of cerebral palsy. Additionally, we calculated the sensitivity and specificity of each assessment. [Results] All assessments were associated with the presence or absence of cerebral palsy. Among them, the highest sensitivity and specificity, 92.7% and 97.9%, respectively, were observed in infants with abnormal head magnetic resonance imaging findings or poor general movements, even if the head magnetic resonance imaging was not classified as abnormal. [Conclusion] The combination of general movements assessment and head magnetic resonance imaging findings is useful for predicting cerebral palsy.

[Purpose] This study aimed to investigate the associations among physical activity, sedentary patterns, and walking spaces in patients hospitalized after stroke. [Participants and Methods] This cross-sectional observational study included 52 patients (mean age, 72.6 ± 11.3 years) hospitalized following stroke. A triaxial accelerometer worn at the waist on the nonparetic side was used to estimate the time spent in sedentary behavior, light intensity physical activity, and moderate-to-vigorous intensity physical activity. Duration of sedentary behavior was categorized into two groups (either short bouts of 1 to 29 min or prolonged bouts of 30 min or more). Walking ability was categorized into four groups: Group D, walking dependence; Group R, walking independence within the room; Group W, walking independence within the ward; and Group F, walking independence within the facility. [Results] Groups W and F showed significantly longer durations of light intensity physical activity and shorter durations of prolonged sedentary behaviors (more than 30 min) compared to Group D. No differences in light intensity physical activity, sedentary behavior, or prolonged sedentary bouts were observed between groups R and D. Multivariate regression analysis revealed that walking ability was significantly associated with time spent in sedentary behavior and light intensity physical activity. [Conclusion] Increasing physical activity levels during hospitalization in patients with stroke depends not only on walking independence but also on the extent of available walking space.

[Purpose] This study aimed to investigate the changes in physical function during hospitalization and their impact on the outcomes of patients with transthyretin amyloidosis cardiomyopathy who experienced acute decompensated heart failure and underwent acute cardiac rehabilitation. [Participants and Methods] A matched cohort of 18 and 54 patients with and without transthyretin amyloidosis cardiomyopathy, respectively, was created and analyzed. [Results] Compared to patients without transthyretin amyloidosis cardiomyopathy, those with transthyretin amyloidosis showed similar improvements in grip strength, quadriceps isometric strength, short physical performance battery, and usual gait speed during hospitalization. However, transthyretin amyloidosis cardiomyopathy was associated with a significantly increased risk of both rehospitalization due to heart failure and all-cause mortality. [Conclusion] Although the extent of changes in physical function during hospitalization was similar in patients with and without transthyretin amyloidosis cardiomyopathy, transthyretin amyloidosis cardiomyopathy was associated with poorer outcomes.

[Purpose] This study aimed to compare the motor skills of typically developing children with different movement experiences, specifically classical ballet and gymnastics. [Participants and Methods] The participants included 52 typically developing children aged 4-6 years (25 boys and 27 girls) from Kindergarten. The boys engaged in weekly gymnastics and girls engaged in weekly classical ballet under the guidance of specialized instructors. Motor skills were assessed using the 25-m run, tennis ball throw, double-leg continuous jump, and standing long jump tests incorporated in the motor skills test. Balance ability was evaluated using static standing tests with eyes open and closed on a firm floor and foam rubber pad, each for 30 s. The total locus length and circumferential area were calculated. [Results] The boys demonstrated significantly greater throwing distance in tennis ball throws and superior performance in the standing long jump than girls. In the balance test, girls exhibited greater stability than boys in the static standing with eyes open on firm as well as foam rubber pad conditions, as measured by the total locus length. In addition, girls in the following test conditions had smaller circumferential areas than boys: static standing with eyes open and closed on a firm floor and static standing with eyes closed on a foam rubber pad. [Conclusion] These findings suggest that early childhood motor skills vary according to the type of movement experienced.

[Purpose] This study aimed to clarify the effects of telerehabilitation on physical function and activities of daily living in patients with amyotrophic lateral sclerosis through a literature review. [Participants and Methods] We conducted a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews reporting guidelines. The PubMed, Scopus, Web of Science, and ProQuest databases were searched. Study design, type of interventions, telerehabilitation methods, adherence, effectiveness, adverse events, and patient satisfaction were extracted from the selected literature. [Results] Four case-series and one case-control study were identified. The interventions included respiratory muscle training (two studies), aerobic exercise, stretching, and comprehensive physical therapy (one study each). Various modalities were used, including videoconferencing, on-demand instructional videos, and real-time monitoring of vital signs using wearable devices. No serious adverse events were reported in any study. The dropout rate was 0-21%, and the compliance rate was 90%, indicating high adherence. Improvements in respiratory function and ADL were observed following respiratory rehabilitation. Patient satisfaction with telerehabilitation was high. [Conclusion] Telerehabilitation may improve adherence, respiratory function, and activities of daily living in patients with amyotrophic lateral sclerosis. However, its effects on other aspects of physical function remain unclear. Further high-quality studies are needed to establish evidence-based practices.

[Purpose] To compare the characteristics of shoulder range of motion (ROM), muscle tightness, and streamlined body position in female para swimmers with unilateral forearm deficiency (UFD) to those in swimmers with vision impairment (VI). [Participants and Methods] Female Japanese para swimmers with UFD (n=7) and VI (n=5) were included. Limb circumference, shoulder ROM, lower extremity muscle tightness, gross muscle strength, and streamlined body position were measured. [Results] The maximum upper arm circumference of the deficient arm and shoulder ROM for dominant and deficient flexion, deficient extension, and dominant and deficient external rotation were significantly lower in swimmers with UFD than in those with VI. [Conclusion] Female para swimmers with UFD are characterized by decreased ROM of the shoulder on the dominant and the deficient arms, quadriceps tightness, greater dominant grip strength, and compensated streamlined body position compared to swimmers with VI.