Journal of Physical Therapy Science最新文献

[Purpose] The mechanism of action and the position and site of Radial pressure wave therapy are unclear. This study aimed to evaluate the effect of shoulder position on muscle stiffness after radial pressure wave therapy. [Participants and Methods] This randomized, double-blind, parallel-group controlled trial included 32 orthopedic clinic participants. Using the block replacement method, patients were randomly assigned to a stretching group (IR group) or a shortening group (0 group) in a 1:1 ratio. Muscle stiffness was measured using ultrasonography (GE LOGIQ S8) with a 9 MHz linear transducer in B mode. Measurements were performed along the long axes of the teres minor, infraspinatus, and deltoid muscles. Radial pressure wave therapy were applied only to the teres minor (3.0 bar, 12 Hz, 2,000 shots). Muscle stiffness testers were blinded to the upper limb position during Radial pressure wave therapy. [Results] Teres minor muscle stiffness was significantly decreased within and between groups, and the deltoid muscle stiffness was significantly decreased within groups in the IR group. [Conclusion] Radial pressure wave therapy applied with the muscle extended reduced muscle stiffness more than Radial pressure wave therapy applied in the shortening position.

[Purpose] This pilot study aimed to assess the health literacy of urban community-dwelling older adults participating in exercise classes to inform future educational interventions. [Participants and Methods] We included 58 older adults from Ward A in Tokyo who attended exercise classes and completed a physical fitness assessment in November 2022. The participants were surveyed using a modified version of the European Health Literacy Survey Questionnaire to evaluate their ability to access, understand, appraise, and apply health information for healthcare and disease prevention. [Results] Of the surveyed participants, 74% expressed that healthcare information easy to understand and apply, whilst 64% had difficulty appraising the information. Similarly, 74-90% expressed that accessing, understanding, and applying information related to disease prevention is easy; however, 52% struggled with appraising the information. [Conclusion] This study highlights a gap in the ability of older adults to critically evaluate health information, emphasizing the need for targeted interventions to improve appraisal skills and support informed health decision-making.

[Purpose] This study aimed to examine the effect of body weight-supported overground training on gait recovery in a patient with severe stroke-induced hemiplegia. [Participants and Methods] The participant was a woman in her 40s with severe hemiplegia following a stroke. A single-case ABAB design was employed. Standard physiotherapy was provided in the first and third phases, while physiotherapy combined with body weight-supported overground training was administered in the second and fourth phases. Walking speed, Timed Up and Go test, Brunnstrom recovery stage (BRS) and Fugl-Meyer Assessment (FMA) for motor function, and motor-functional independence measure (m-FIM) for activities of daily living (ADL) were performed to assess efficacy of body-weight-supported overground training. [Results] Walking speed improved from 0.26 m/s at admission to 0.37 m/s in the first phase, 0.58 m/s in the second phase, 0.45 m/s in the third phase, and 0.50 m/s in the fourth phase, reaching 0.40 m/s with a T-cane at discharge. m-FIM scores increased steadily from 20 points at admission to 74 points at discharge, while BRS and FMA showed minimal improvement. [Conclusion] Body weight-supported overground training may enhance walking ability, functional performance, and ADL independence in patients with severe stroke-induced hemiplegia.

[Purpose] This study aimed to clarify the reliability and validity of a skin elasticity meter for evaluating the skin mechanical properties. [Participants and Methods] We conducted a prospective observational study using data from 35 patients diagnosed with unilateral lower extremity edema caused by cancer-related. We evaluated the skin's mechanical properties (relative parameter; R0, distensibility; R2, gross elasticity; R5, net elasticity; R6, viscoelasticity; R7, biological elasticity) of the thigh and lower leg using a skin elasticity meter. Intra-rater reliability was calculated using interclass correlation (ICC). Validity was also examined by comparing the edema and non-edema sides of the data obtained using a skin elasticity meter and correlating them with the circumferential diameter difference. [Results] ICC values ranged from 0.787 to 0.997 for each site. A significant difference in skin mechanical properties (offset + R0, R2, R6, and R7) of the upper extremities was observed between the lymphedema and non-lymphedema groups. A correlation was found between the R0 + offset between the R0 + offset parameter and the difference in circumference. [Conclusion] This study suggested that the skin elasticity meter is a reliable and valid method for evaluating the mechanical properties of the skin in patients with lower extremity cancer-related edema.

[Purpose] An unexpected finding was previously observed that hip flexion torque was maximal in the deep flexion position. This study aimed to compares the short-term effects of strength training using a machine with load torque based on the hip flexion angle-torque characteristics identified in our prior study to those of an existing weight stack machine. [Participants and Methods] Seventeen participants were divided into two groups. The conventional training group (CT group) trained with a weight stack resistance machine. The non-conventional training group (non-CT group) trained with a prototype machine based on the hip flexion angle-torque characteristics identified in our previous study. Both groups trained twice weekly for four weeks. Maximum isometric hip flexion torque at 0°, 30°, 60°, 90°, and 105° was measured before and after training, and compared between the groups. [Results] Maximum isometric hip flexion torque showed an interaction between training type and training duration only at 105° of hip flexion, with significantly higher torque observed in the non-CT group. [Conclusion] Short-term training based on the hip flexion angle-torque characteristics identified in our prior study was effective in significantly strengthened muscles in the deep hip flexion range.

[Purpose] To determine the age in months of bilateral hand use during the infancy period of preterm infants with birth weight <1,500 g. [Participants and Methods] This retrospective, observational study included 57 infants with no neurodevelopmental handicaps (average weight at birth 963.2 ± 298.2 g, gestational age 28.4 ± 3.1 weeks), who were transferred to the neonatal intensive care unit at a medical center in Japan between 2010 and 2014. The patients were classified into two groups based on weight at birth: 32 infants with birth weights <1,000 g (Group A) and 25 with birth weights between 1,000 and 1,499 g (Group B). Data on the ages at which bilateral hand use was attained ("playing with both hands together", "transferring a toy between the two hands", and "grasping two toys, one in each hand") were collected from the respective medical records and compared between the two groups. [Results] Significantly delayed bilateral hand use was detected in Group A compared to that in Group B for "transferring a toy between the two hands" (90th percentile, 7.2 months compared to 6.3 months). For the other two items, no differences were detected between the two groups. [Conclusion] The development of bilateral hand use during infancy differed among infants with very low birth weight and was delayed in the group with a lighter birth weight group.

[Purpose] The potential of using optokinetic stimulation (OKS) in conjunction with virtual reality (VR) for balance training merits further investigation. We examined the effects of a single exposure to OKS through VR on the visual dependence of postural sway and control among healthy adults. [Participants and Methods] A two-minute virtual reality (OKS) task was performed by 30 healthy adults without balance impairment. The center of gravity was measured before and after completing the task in the standing position with the eyes open and closed to ascertain the Romberg ratio, which is a measure of visual dependence. [Results] The Romberg ratio of the VR + OKS group significantly decreased from before to after task completion. [Conclusion] The findings indicate that OKS applied with VR enhances visual dependence. These findings facilitate the future use of VR in postural control rehabilitation.

[Purpose] We previously confirmed that a plastic ankle-foot orthosis with a joint having a built-in T-strap could correct ankle joint supination in able-bodied participants during stance phase without initial contact. In the present study, we examined the adaptability of a newly prototyped T-strap made of soft thermoplastic resin (plastic ankle-foot orthosis T-strap) by evaluating the pressure exerted on the center of the lateral malleolus. These results were compared to results obtained with a conventionally used leather T-strap. [Participants and Methods] We compared the pressure exerted on the center of the lateral malleolus by the plastic ankle-foot orthosis T-strap and a leather T-strap on one leg of each of eight able-bodied participants. Each leg was cast to fabricate eight custom ankle-foot orthoses. [Results] The applied pressure was significantly reduced with the plastic ankle-foot orthosis T-strap than that with the leather T-strap in all three phases-loading response, mid-stance, and terminal stance. [Conclusion] The plastic ankle-foot orthosis T-strap displayed better adaptability than did the leather T-strap. The tested plastic ankle-foot orthosis T-strap may be used as a more reliable alternative to a conventional leather T-strap.

[Purpose] Morphological changes in the dual-layered structure of the heel fat pad under varying loads, differences between the dominant and non-dominant feet, and changes over one month are not understood. This study aimed to examine these factors, as understanding normal conditions provides insights into identifying abnormal conditions. [Participants and Methods] Forty healthy Japanese adults (80 feet) participated in this study. The heel fat pad was divided into a macrochamber layer (extending from the calcaneal tuberosity to the fibrous septum, including the macrochambers) and a microchamber layer (extending from the microchambers to the skin). The thickness of each layer in the dominant and non-dominant feet was measured under four conditions: non-load, sitting, 50% load, and 80% load. The compressibility indices were calculated and compared. The same investigations were performed one month later. [Results] Changes in thickness from non-load to 80% load mainly occurred in the macrochamber layer (compressibility index=0.40), with minimal changes observed in the microchamber layer (compressibility index=0.76). No significant differences were observed, although a difference of a few millimeters was observed. Similar results were obtained in the second examination, which was conducted after one month. [Conclusion] These results likely represent the morphological changes in the normal heel fat pad under varying loads.

[Purpose] We aimed to assess the reliability of body composition measurements for individual limbs using a bioimpedance analyzer, with a focus on determining the minimal detectable change for each site. [Participants and Methods] This study included 55 healthy Japanese university students (28 men and 27 women). Each participant underwent two measurements using an InBody S10 body composition analyzer. Intraclass correlation coefficients and minimal detectable change values were calculated for muscle mass, water content, and phase angle at various limb sites. [Results] Muscle mass and water content measurements demonstrated high reliability across all limb sites, with intraclass correlation coefficients ranging from 0.996 to 0.998. Phase angle measurements also showed high reliability for the limbs, with values ranging from 0.936-0.975; however, reliability was lower for the trunk, with a value of 0.854. The minimal detectable change values indicated that detecting differences in trunk phase angle required a larger change than that required for limb sites. [Conclusion] Limb-specific measurements of body composition were highly reliable, showing stable and consistent muscle mass and water content. However, the low reliability of trunk phase angle measurements suggests that factors affecting trunk measurements warrant further exploration for accurate assessment.