Physical therapy research最新文献

Objective: The aim of this study was to examine the relationship between the frequency and duration of physical therapy (PT) and the development of hospitalization-associated disability (HAD) in hospitalized geriatric patients with heart failure (HF).

Methods: This single-center, retrospective, observational study included hospitalized patients with HF aged 65 years or older who had received PT. Data regarding demographics, comorbidities, laboratory findings, medications, rehabilitation, and activities of daily living (ADLs) status were collected from electronic medical records. Based on the average frequency and duration of PT, patients were divided into three groups: Group 1, ≥3 days/week and ≥120 minutes/week; Group 2, ≥3 days/week and <120 minutes/week; and Group 3, <3 days/week and <120 minutes/week. Logistic regression analysis was performed to identify the association between the average frequency and duration of weekly PT and the incidence of HAD.

Results: In all, 105 patients (mean age, 84.8 years; proportion of women, 59%) were enrolled in the study, and 43 (41.0%) patients exhibited HAD at discharge. In the multivariate logistic regression analysis, Group 2 (odds ratio [OR], 3.66) and Group 3 (OR, 6.71) had a significantly elevated risk of developing HAD using Group 1 as the reference, even after adjusting for age, ADLs before admission, cognitive function, and severity of HF.

Conclusion: This study showed that a lower frequency and shorter duration of PT are associated with developing HAD in hospitalized geriatric patients with HF. However, further prospective studies are required to confirm these findings.

Objective: The purpose of this study was to identify the risk factors for the development of chronic lower back pain in older workers.

Methods: This was a prospective cohort study using an Internet survey of workers aged 60-75 years, with a baseline survey conducted in September 2022 and a follow-up survey in October 2023. A total of 2257 participants who did not have chronic lower back pain in the baseline survey were included in the analysis, and the risk factors for chronic lower back pain were examined by logistic regression analysis.

Results: The median age of the analyzed participants was 63.0 years, and the incidence of chronic lower back pain was 9.0%. Logistic regression analysis revealed that poor sleep habits (adjusted odds ratio [aOR]: 1.66, 95% confidence interval [CI]: 1.21-2.26), poor eating habits (aOR: 1.44, 95% CI: 1.03-2.01), no physical activity (aOR: 1.45, 95% CI: 1.00-2.09), and high stress (aOR: 1.62, 95% CI: 1.13-2.32) were significantly associated with the occurrence of chronic lower back pain.

Conclusion: A comprehensive multidisciplinary collaboration program incorporating the assessment and management of lifestyle habits and mental health issues should be developed and implemented to prevent chronic lower back pain in older workers.

Objective: Assessment of the vertical ground reaction force (VGRF) during landing tasks is crucial for physical therapy in sports. The purpose of this study was to determine whether the VGRF during a single-leg landing can be estimated from a two-dimensional (2D) video image and pose estimation artificial intelligence (AI).

Methods: Eighteen healthy male participants (age: 23.0 ± 1.6 years) performed a single-leg landing task from a 30-cm height. The VGRF was measured using a force plate and estimated using center of mass (COM) position data from a 2D video image with pose estimation AI (2D-AI) and three-dimensional optical motion capture (3D-Mocap). The measured and estimated peak VGRFs were compared using a paired t-test and Pearson's correlation coefficient. The absolute errors of the peak VGRF were also compared between the two estimations.

Results: No significant difference in the peak VGRF was found between the force plate measured VGRF and the 2D-AI or 3D-Mocap estimated VGRF (force plate: 3.37 ± 0.42 body weight [BW], 2D-AI: 3.32 ± 0.42 BW, 3D-Mocap: 3.50 ± 0.42 BW). There was no significant difference in the absolute error of the peak VGRF between the 2D-AI and 3D-Mocap estimations (2D-AI: 0.20 ± 0.16 BW, 3D-Mocap: 0.13 ± 0.09 BW, P = 0.163). The measured peak VGRF was significantly correlated with the estimated peak by 2D-AI (R = 0.835, P <0.001).

Conclusion: The results of this study indicate that peak VGRF estimation using 2D video images and pose estimation AI is useful for the clinical assessment of single-leg landing.

Family-centered care is recommended as the best practice in pediatric physiotherapy. It is a philosophy that pediatric physiotherapists should be familiar with, as it relates to the health of the child as well as the family. However, family-centered care has not been adequately taught in physiotherapy education in Japan. The term "Ryouiku" was coined in 1940 in Japan. The concept of the Ryouiku is essentially Evidence-Based Medicine and is the very essence of family-centered care with a focus on function. By re-thinking the Ryouiku and applying it to pediatric physiotherapy education in Japan, "glocal" family-centered care can be practiced in a Japanese setting.

Objectives: The Berg Balance Scale (BBS) is a core measure of balance function in patients with stroke. Latent rank theory (LRT) is a statistical method that enables the degree of functional impairment to be ranked from the sub-items of a rating scale; each rank can then be characterized. Identification of the characteristics of balance function by rank would be beneficial for interventions to improve balance function in patients with stroke. This study aims to use LRT to rank and characterize patients with stroke balance impairment.

Methods: This was a multicenter retrospective analysis of 293 patients with subacute stroke. We used LRT and the BBS to estimate the optimal rankings based on the goodness-of-fit index and the information criterion. We compared the obtained ranks with the level of walking independence for each rank.

Results: The evaluation of the patient's BBS scores revealed that balance impairment could be divided into six ranks. The average BBS score for each rank rose from 27.1 for rank 1 to 53.9 for rank 6. The scores of the BBS sub-items for each rank also differed. The level of walking independence by rank ranged from rank 1 for assisted walking to rank 6 for independent outdoor walking.

Conclusions: Balance function in patients with subacute stroke was ranked sixth in the BBS, with varying characteristics identified for different ranks. This result helped to determine the therapy to improve the balance function of patients with stroke.

A decline in muscle strength is a key factor responsible for physical dysfunction in older individuals. Both loss of muscle quantity and quality are associated with muscle strength decline. While the gold standard method for evaluating muscle mass and quality is magnetic resonance imaging, it is not suitable for clinical settings because of the measurement and analysis costs. Bioelectrical impedance analysis (BIA) and B-mode ultrasonography are clinically useful alternatives for skeletal muscle assessment owing to their feasibility and noninvasiveness. The recent advancements in the techniques for BIA and ultrasonography have improved their accuracy in assessing skeletal muscle quantity and quality, making them useful in detecting age-related and disease-specific alterations. This review comprehensively analyzes the advantages of using BIA and ultrasound imaging for assessing skeletal muscle quantity and quality and detecting muscle degeneration. We summarize the recent findings regarding age-related changes in muscle characteristics and the associations of muscle degeneration with physical dysfunction in patients with knee osteoarthritis. Furthermore, we discuss the clinical application of skeletal muscle assessment using BIA and ultrasound for evaluating training effects and exercise prescription.

Objective: This study investigated the factors that influence Ikigai among people aged 75 years and older using home medical and nursing care with home-visit rehabilitation.

Methods: This cross-sectional study involved 66 home-visit rehabilitation users aged 75 years or older who received home medical and nursing care at 2 home-care nursing stations. The following attributes were evaluated: Ikigai-9, life-space assessment (LSA), home-based LSA (Hb-LSA), Frenchay activities index (FAI), functional independence measure (FIM), self-efficacy for activities of daily living (SEADL), self-efficacy scale for going out among community-dwelling elderly (SEGE), and physical function. The correlation between Ikigai-9 scores and each assessment was examined. Multiple regression analysis was performed using the Ikigai-9 as the dependent variable and the correlated items as independent variables.

Results: The Hb-LSA, FAI, FIM, SEADL, and SEGE were correlated with Ikigai-9. Among the correlated items, the FAI was selected for multiple regression analysis.

Conclusion: Home-visit rehabilitation users aged 75 and over may be more likely to feel Ikigai if they have higher instrumental ADLs.

Objective: In this study, we aimed to determine the effects of 2-week neuromuscular electrical stimulation (NMES) on quadriceps muscle atrophy and lower extremity motor score in individuals with subacute incomplete cervical spinal cord injury (SCI).

Methods: This stratified randomized controlled trial, conducted in the advanced critical care center of a university hospital, comprised 49 individuals with American Spinal Injury Association (ASIA) impairment scale grade C and D incomplete cervical SCI. The participants were stratified based on the ASIA impairment scale grade and randomly assigned to the control (n = 25) or NMES (n = 24) group. The control group participants received only conventional rehabilitation; the NMES group participants received conventional rehabilitation plus NMES in the quadriceps muscles of both lower limbs. The primary endpoints were quadriceps muscle thickness and L3 ASIA lower extremity motor score (L3 motor score), measured at the study's initiation and after 2 weeks.

Results: The quadriceps muscle thickness changes on the stronger and weaker sides were -14.2% ± 11.3% and -15.1% ± 13.8%, respectively, in the NMES group and -25.7% ± 16.8% and -26.0% ± 13.3%, respectively, in the control group, indicating significantly lesser reduction on both sides in the NMES group (p <0.05). The L3 motor scores on the stronger and weaker sides were 0.8 ± 1.2 and 1.3 ± 1.4 (NMES group) and 0.4 ± 0.8 and 0.4 ± 0.8 (control group), respectively, indicating significant improvement only on the weaker side (p <0.05).

Conclusions: For subacute incomplete cervical SCI, 2 weeks of NMES reduces quadriceps muscle atrophy and improves the L3 motor score values on the weaker side compared with standard treatment.

Objective: This study aimed to develop the Japanese version of the Posture and Postural Ability Scale (PPAS) and verify its inter- and intra-rater reliability, construct validity, and internal consistency in individuals with cerebral palsy (CP) in Japan.

Methods: This cross-sectional study recruited 73 children and adults with CP at all Gross Motor Function Classification System (GMFCS) levels. The translation procedure was performed by three Japanese physiotherapists and the developer of the original version. Intra- and inter-rater reliability were evaluated using the weighted kappa coefficients, and construct validity was based on the correlation coefficients between PPAS and GMFCS. Cronbach's alpha coefficients were calculated to assess internal consistency.

Results: Weighted kappa coefficients for intra- and inter-rater reliability exceeded 0.81 for all items. The correlation coefficients between the PPAS and GMFCS were negative and showed "moderate" to "very strong" in almost all items (ρ = -0.66 to -0.91), except for one item (ρ = -0.37). Cronbach's alpha coefficients exceeded 0.80 in all four positions.

Conclusion: This study supports the Japanese version of the PPAS with excellent intra- and inter-rater reliability, good construct validity, and internal consistency in the Japanese CP population.

Objective: To investigate skeletal muscle indices influencing the anaerobic threshold (AT) measured by cardiopulmonary exercise testing (CPX).

Methods: This study included 125 consecutive men (median age: 66.0 years) diagnosed with acute myocardial infarction who underwent CPX before discharge. Participants were categorized into two groups based on their AT: the AT-lowering and AT-maintaining groups, comprising those with AT <11 and ≥11 ml/min/kg, respectively. Skeletal muscle indices that influenced AT, strengths of such influences, and respective cutoff values were investigated using multiple logistic regression analysis, decision-tree analysis, and the random-forest method. Skeletal muscle indices included grip strength, knee extension strength, lower-limb skeletal muscle index, phase angle (PhA), lower-limb PhA, arm circumference (AC), and calf circumference.

Results: Lower-limb PhA, AC, age, and body mass index (BMI) influenced AT (model X² test: p <0.05; Hosmer-Lemeshow test: p = 0.98). Among the skeletal muscle indices, Gini impurity reduction was the highest in the lower-limb PhA. The cutoff values for AT were ≥4.0° for BMI <24 kg/m² and ≥6.4° for BMI ≥24 kg/m².

Conclusion: Lower-limb PhA was the most influential skeletal muscle index affecting AT. PhA measured using body composition analyzers is useful to identify exercise-limiting factors and determine the effectiveness of exercise because it can be easily performed shortly.