Objective: This study aimed to identify the clinical characteristics of patients achieving independent gait through Robot-Assisted Gait Training, based on their condition at the onset of the training.Methods: The subjects were patients after stroke who underwent 4 weeks of gait training using the Hybrid Assistive Limb® (HAL, Cyberdyne, Inc.). The assessment items were Functional Ambulation Categories (FAC), Stroke Impairment Assessment Set (SIAS), Fugl-Meyer Assessment (FMA) for lower extremity, Berg Balance Scale (BBS), Functional Independence Measure (FIM), and Hasegawa Dementia Scale-Revised (HDS-R). Patients with a FAC score of 3 or higher were classified as the independent group, while those with a FAC score of 2 or lower were classified as the assistance group. A univariate analysis was conducted with a significance level set at 5%.Results: Ten patients were in the independent group (mean age 73.2±13.8 years), while 7 patients were in the assistance group (mean age 83.6±6.1 years). The independent group demonstrated significantly higher scores in SIAS total score, BBS, FIM, and HDS-R (p<0.05). Additionally, the SIAS subscales assessing knee joint function, lower limb range of motion, abdominal muscle strength, verticality, and quadriceps muscle strength on the non-paralyzed side were all significantly higher in the independent group (p<0.05).Conclusion: Patients achieving independent gait through training with HAL were younger, exhibited lower levels of functional disability, demonstrated better balance, and showed a greater capacity to perform activities of daily living and cognitive function.

Objective: This study aimed to identify the clinical characteristics of patients achieving independent gait through Robot-Assisted Gait Training, based on their condition at the onset of the training.Methods: The subjects were patients after stroke who underwent 4 weeks of gait training using the Hybrid Assistive Limb® (HAL, Cyberdyne, Inc.). The assessment items were Functional Ambulation Categories (FAC), Stroke Impairment Assessment Set (SIAS), Fugl-Meyer Assessment (FMA) for lower extremity, Berg Balance Scale (BBS), Functional Independence Measure (FIM), and Hasegawa Dementia Scale-Revised (HDS-R). Patients with a FAC score of 3 or higher were classified as the independent group, while those with a FAC score of 2 or lower were classified as the assistance group. A univariate analysis was conducted with a significance level set at 5%.Results: Ten patients were in the independent group (mean age 73.2±13.8 years), while 7 patients were in the assistance group (mean age 83.6±6.1 years). The independent group demonstrated significantly higher scores in SIAS total score, BBS, FIM, and HDS-R (p<0.05). Additionally, the SIAS subscales assessing knee joint function, lower limb range of motion, abdominal muscle strength, verticality, and quadriceps muscle strength on the non-paralyzed side were all significantly higher in the independent group (p<0.05).Conclusion: Patients achieving independent gait through training with HAL were younger, exhibited lower levels of functional disability, demonstrated better balance, and showed a greater capacity to perform activities of daily living and cognitive function.

Novel coronavirus disease (COVID-19) spread worldwide. In Japan, From April 16 to May 25, 2020, a state of emergency was declared and people were “strongly requested to refrain from going out unnecessarily and thoroughly reduce contact with others.” As a result, the number of steps of all generations was expected to be lower than usual due to the novel coronavirus disease pandemic. This study investigated the weather walking steps decrease in the collegiate student due to COVID-19. A total of 221 collegiate students used their smartphones to enter the average number of steps taken every month from January to May. The number of steps taken by all students was 4,988±2,345 steps in January, 5182±2,516 steps in February, 5,118±2,291 steps in March, 3,281±1,689 steps in April, and 2,834±1,676 steps in May. A comparison between sex groups showed that the number of steps in April and May was significantly different (p<0.05), which means that the steps of women group was lower than that of men. These results suggest that the number of steps taken by students decreased with the outbreak of the novel coronavirus disease.

The aim of this study was to evaluate the transition of the tensor fasciae latae (TFL) and the iliotibial band (ITB) hardness after repetitive hip abduction exercise (RE) and the effect of vibration stimulation immediately after RE. Nine healthy man performed the RE (20 reps×5 sets) and the TFL and the ITB hardness were measured before and after RE. Participants were performed RE by 2 conditions(i.e. with and without vibration stimulation after RE). The results showed that with no vibration condition, hardness of the TFL significantly increased immediately, 15 min, 30 min, and 24 hours and the ITB significantly increased immediately, and 24 hours after RE compared with before RE, respectively. With vibration condition, vibration after RE, both of the TFL and the ITB hardness significantly increased only immediately after compared with before RE. On the other hand, TFL and ITB hardness significantly decreased 15 min, 30 min, and 24 hours compared with immediately after RE. In addition, with vibration condition, TFL and ITB hardness significantly decreased 15 min, 30 min, 24 hours compared with no vibration condition, respectively. This study indicated that the ITB hardness might be increased with excessive activity of TFL, and the vibration stimulation immediately after exercise is effective for decreasing the hardness.

Cross-leg sitting is locus posture performed well in Asian area, and a lifestyle and culture are thought to affect it. It is usually essential to cross-leg sitting carried out in the case of Zen meditation to maintain cross-leg sitting locus in a relaxed state to perform locus posture in floor, and to perform it in hip joint flexion of bilateral feet, abduction, and lateral rotation position in the meditation for a long time. The spinal column of cross-leg sitting was intended that aligning it confirmed backbone in lumbar vertebrae being displaced than rest standing position in the kyphosis direction or raising a bearing surface whether aligning it changed into lordotic projection from the lumbar vertebrae kyphosis direction. The thoracic vertebra angle and the lumbar vertebrae angle measured it using SpinalMouse®. We decided to measure a thoracic vertebra angle, a lumbar vertebrae angle when we changed the height of the target rest standing position and the bearing surface of cross-leg sitting. The thoracic vertebra angle did not change by raising the bearing surface of cross-leg sitting, however the lumbar vertebrae angle changed. It showed a significant correlation between hip joint flexion, abduction, an external rotation angles and the change of the lumbar vertebrae angle. Results of this study suggested that lumbar, aligning it changed to lordosis in the high cross-leg sitting thing that we changed. The quantity that aligning it biases into lordosis of the lumbar part is related to the flexion of the hip joint, abduction, external rotation flexibility.

INTRODUCTIONAn observational study was carried out to estimate the strength of the relationships among balance, mobility and falls in hemiplegic stroke inpatients. The objective was to examine factors that may aid in the prediction of the likelihood of falls in stroke patients.

METHODSA total of 53 stroke patients (30 male, 23 female) aged 67.0 ± 11.1 years were interviewed regarding their fall history. Physical performance was assessed using the Berg Balance Scale (BBS) and the Functional Independence Measure (FIM) scale. Variables that differed between fallers and non-fallers were identified, and a discriminant function analysis was carried out to determine the combination of variables that effectively predicted fall status.

RESULTSOf the 53 stroke patients, 19 were fallers. Compared with the non-fallers, the fallers scored low on the FIM, and differed with respect to age, time from stroke onset, length of hospital stay, Brunnstrom recovery stage and admission BBS score. Discriminant analysis for predicting falls in stroke patients showed that admission BBS score was significantly related to the likelihood of falls. Moreover, discriminant analysis showed that the use of a significant BBS score to classify fallers and non-fallers had an accuracy of 81.1%. The discriminating criterion between the two groups was a score of 31 points on the BBS.

CONCLUSIONThe results of this study suggest that BBS score is a strong predictor of falls in stroke patients. As balance is closely related to the risk of falls in hospitalised stroke patients, BBS might be useful in the prediction of falls.

Accidental Falls ; prevention & control ; Aged ; Discriminant Analysis ; Female ; Hemiplegia ; complications ; Humans ; Male ; Middle Aged ; Postural Balance ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Stroke ; complications ; Stroke Rehabilitation

The purpose of this study was to determine the muscle activity during cutting in female basketball player. Eight female basketball players participated in this study. Each subject was instructed to do two steps of approach run, and change direction to the right laterally. Cutting motion is divided two into a phase: knee joint flexion phase and extension phase. Bipolar surface EMG electrodes, spaced 30 mm apart and oriented parallel to the muscle fascicles were secured over the muscle bellies of the Vastus Medialis (VM), Vastus Lateralis (VL), Biceps Femoris (BF), and Semimembrasosus (SM) musculature. EMG recordings were employed to measure the ratio of activation between the medial-to-lateral Hamstring and Quadriceps, and Hamstring and Quadriceps. All the subject had 10-15 degrees knee angle during cutting. In flexion phase, Quadriceps acted more significantly than Hamstring (p<0.05). Moreover, VM activity acted larger than VL, and BF activity acted larger than SM in each phases (p<0.05) All the subject reveal a similar pattern: Quadriceps act largely in flexion phase, which may increase anterior tibial shear forces, strain on the anterior cruciate ligament. Moreover, medial muscle activity acted larger than lateral muscle in Quadriceps, and lateral muscle activity acted larger than medial muscle in Hamstring in each phase. All the subject had 10-15 degree knee angle during cutting, therefore, a variation in lateral and medial muscle may trigger knee valgus.

The aim of the present study was to investigate whether personal hamstring muscular activation increased by landing with the trunk bent forward. First, 14 healthy female university students were instructed to perform normal drop landing from a 40 cm-high box on both legs. Second, subjects were directed to perform drop landing with the trunk bent forward. Using images obtained from a high-speed video camera, the upper center of mass was calculated in the sagittal plane for determining the differences in these landings. For 0.1 second after toe contact, the muscular activation of quadriceps femoris and hamstring muscles was analyzed using an electromyogram (EMG), and these findings were compared between the 2 types of landings. There was no significant difference in the activation of quadriceps femoris, but the activation tended to decrease during landing with the trunk bent forward. However, the activation of hamstring muscles increased significantly during landing with the trunk bent forward compared with that during normal landing. During landing with the trunk bent forward, the activation of hamstring muscles increased, and the activation of quadriceps femoris tended to decrease. Because contraction of hamstring muscles decreases tension in the anterior cruciate ligament, the findings of this study may help in the prevention of anterior cruciate ligament (ACL) injury.

Purpose: The purpose of this study was to determine whether the impact on the body during landing in dancers is less than in non-dancers by using accelerometers and motion analyzer.Method: Eleven ballet dancers and 11 non-dancers participated in this study. Each subject was instructed to perform 3 types of landing from a height of 30cm: landing, silent landing and raise up landing. Markers were put on the iliac crest, greater trochanter, knee joint, lateral malleolus. The peak vertical and horizontal accelerations of the lumbar, peak vertical acceleration of the greater trochanter and the peak flexion angles of the hip and knee joints were measured after the trials.Result: In the raise up landing, the peak vertical acceleration of the lumbar region in dancers was less than that in non-dancers (p < 0.01), and the peak knee-flexion angle in dancers was greater than that in non-dancers (p < 0.01). There were no differences between the peak hipflexion angles of dancers and non-dancers.Conclusion: The impact on the lumbar during raise up landing was less in dancers. In raise up landing, the trunk tends to be fixed when the dancer stands upright. Moreover, dancers attenuated the shock to the lumbar region by increasing the knee-flexion angle to a greater extent than the non-dancers did. This result may indicate the importance of the knee joint flexion in attenuating the shock during landing and show that dancers excel in using their knees flexibly.

Purpose: Our aim was to investigate if such trunk muscular activation at standing could have an effect on their trunk muscular activation at leaning backward and forward and the strength of trunk isometric flexion and extension. Methods: The Electromyography (EMG) of lumbar paraspinals (LP) and rectus abdominis (RA) were recorded for 18 healthy volunteers at three positions (standing, leaning backward and leaning forward). In addition, the strength of maximum isometric of trunk flexion and extension were measured at sitting position. Then the flexion/extension (F/E) ratio was calculated. Results: 18 healthy volunteers were classified into Flexor group (n=5) and Extensor group (n=13). The RA-EMG of Extensor group was significantly larger than that of Flexor group at leaning backward position. Extensor group, also, had a higher strength of trunk isometric extension than that of Flexor group. Flexor group had a higher F/E ratio than that of Extensor group. Conclusion: A meaning of this study was to investigate that there were subjects who were higher paraspinals or rectus abdominis activation. Such difference was caused from muscular activation at working upper body and demonstrating of muscular strength, and this study may be helpful to develop study of physical therapy from now on.