Purpose: This study investigated the effects of movement velocity and contraction pattern on muscle damage during a single bout of resistance training. Methods: Forty healthy young men were randomly assigned to four groups: the Normal Slow group (NS; 5 seconds for concentric and eccentric phases), Concentric Slow group (CS; 7 seconds for concentric phase, 3 seconds for eccentric phase), Eccentric Slow group (ES; 3 seconds for concentric phase, 7 seconds for eccentric phase), and Normal Speed group (N; 1 second for concentric and eccentric phases). The total resistance training time for elbow flexor muscles was standardized to 300 seconds. Maximal isometric strength (MS), muscle thickness (MT), muscle echo-intensity (EI), and muscle hardness (MH) were measured before, immediately after, 1 day after, and 2 days after training. Results: There were no differences in the muscle activity during resistance training between the groups. All groups showed significant decreases in MS and increases in MT and EI immediately after training. There were no significant differences in the rate of change of these muscle properties between groups. Conclusion: These results suggest that there is less influence of movement velocity and contraction pattern during a single bout of resistance training standardized total training time or muscle activity on damage of skeletal muscle.
Purpose: To report the performance of range of motion exercises based on ultrasonographic assessment of heterotopic ossification after supracondylar fracture of the femur. Methods: The subject was a woman in her sixties with a supracondylar fracture of the femur. We performed ultrasonography to investigate a mass that developed medial to the patella postoperatively. Results: No ossification was detected by radiographic examination at 1 month postoperatively. Ultrasonography showed that the mass was a hematoma with hyperechoic and hypoechoic regions. The hyperechoic regions seemed to be callus. The hematoma was located in the pre-femoral fat pad between the femur and the vastus medialis muscle, and was adherent to vastus medialis. Ossification was detected by radiography at 2 months postoperatively. Ultrasonography showed that the ossification was continuous with the femur and there was breakdown of the adhesions with vastus medialis. Range of motion exercises were continued until knee flexion of 155 degrees were achieved. Conclusions: We could assess the progression and extent of heterotopic ossification and could judge the performance of range of motion exercises by ultrasonography.
Purpose: The purpose of this study was to reveal correlations between the posture and movement of the trunk and lower limbs and the hopping height in the ground contact phase of two-legged hopping in the place and to clarify factors influencing the hopping height. Methods: The subjects were 19 healthy males. The hopping at 130 of motion pitch per minute was measured by using a three-dimensional motion analysis system and a force plate. The ground contact phase was divided into the first-half and latter-half phases on the basis of a point of the time when the hip reached its lowest level in a vertical direction (point of lowest hip joint level), then correlations between the following parameters and the hopping height were analyzed: Postures at the ground contact point, point of lowest hip joint level, and takeoff point; motion range in the first-half and latterhalf phases; and timing of motion direction change-over (motion change-over time). Results: There were correlations of the hopping height with the heights of the hip at point of lowest hip joint level, the motion range of the thorax and hip joint in the first-half phase, the moving range of the hip joint in the first-half and latter-half phases, and with motion change-over time for the thorax and the knee joint. Two parameters, i.e., motion change-over times for the knee joint and the moving range of the hip joint in the latter-half phase, were extracted as predictive factors for the hopping height. Conclusion: The factors of determination of the hopping height were revealed to be only the parameters involved with lower limb, though movement of the thorax and lower limb was correlated with the hopping height.
Purpose: The aim of this study was to determine the immediate effects of functional electrical stimulation (FES) on kinematic and kinetic gait variables and oxygenation in medial sensorimotor cortices (mSMC). Methods: We performed gait analysis using Vicon motion capture system and brain oxygenation in mSMC using near-infrared spectroscopy (NIRS) in eight subjects with acute cerebral infarction. FES was performed during walking on the tibialis anterior muscles and gastrocnemius of the paretic limb during the swing and terminal stance phases, respectively. Results: Gait velocity, paretic hip flexion, knee extension, and ankle plantar flexion moments in the stance phase significantly increased when FES was performed during walking compared with those with walking before FES. Moreover, these improvements of gait quality were carried over after performing FES. Oxygenated hemoglobin levels in unaffected mSMC were significantly lower during walking with FES than that during walking without FES. Conclusion: FES can improve weight shifting to the paretic limb during the stance phase and improve propulsion as a roll-off function in the late stance. Furthermore, FES may inhibit cortical excitability in unaffected mSMC.
Purpose: This study aimed to investigate the effect of standing up on the same day after primary total knee arthroplasty (TKA)． Methods: Seventy-five patients with knee osteoarthritis participated in this study. They were randomized to one of three groups: standing, sitting, or bed rest. Three hours after surgery, patients in the standing group stood up, those in the sitting group sat up, and those in the bed rest group only performed calf pumps. Outcome measures included range of motion, quadriceps strength, 10-m walking test, Timed Up and Go test score, and D-dimer levels, both one month before and on the fourth day after surgery. In addition, we measured C-reactive protein (CRP) levels and performed ultrasonographic examination for deep vein thrombosis (DVT) on postoperative day 4. Results: There were no differences in baseline variables and postoperative motor function and CRP among the three groups. The standing group showed a significantly lower incidence of DVT than the other two groups. In addition, the bed rest group showed higher D-dimer levels than the other two groups. Conclusions: Standing up on the same day after primary TKA shows potential as a treatment for preventing DVT.
Purpose: The purposes of this study were to compare cardiopulmonary responses among four gait patterns and investigate the relationship between the optimal gait pattern and energy cost upon ankle immobilization. Method: Thirty-seven healthy men participated in the study. Subjects were randomly assigned to one of four groups and instructed to walk using the specific gait pattern with or without (control) immobilization of the right ankle. The gait patterns were as follows: (1) external rotation gait (external rotation of the right hip and a toe-out gait; (2) circumduction; (3) toe gait (foot flat in initial contact and forefoot in contact from midstance to pre-swing; and (4) behind step gait (step at the back of the immobilized foot). Subjects walked on a treadmill at an incremental speeds (1.0, 2.0, 3.0, 4.0 and 5.0 km･h–1). In addition, for each speed, eight subjects walked on a treadmill in free gait (no intentional dictation of gait pattern) with an ankle immobilized, and their observed walking patterns were categorized. Result: Cardiopulmonary responses and energy cost per meter varied according to the gait pattern. Among the subjects who were allowed to choose their own gait patterns, none selected a gait pattern that required high energy cost and/or energy cost per meter. Conclusion: Each gait pattern had unique characteristics. It is considered that individuals select optimal gait patterns to minimize energy costs.
Purpose: To investigate the association between very early initiation of rehabilitation (VEI) and a rehabilitation provision system for acute stroke patients by performing an analysis according to the day of admission. Methods: Data of stroke patients (n = 2,307; 8 hospitals) from the Japan Rehabilitation Patients Database in Japan were examined. The patients were divided into the following five groups according to the day of admission: (1) weekday with no holidays (Monday to Thursday), (2) weekday with a holiday, (3) Friday, (4) Saturday and Sunday, and (5) holiday. We defined VEI as rehabilitation commencing within 3 days of stroke admission. Multiple logistic regression analysis was used to evaluate VEI, involvement of rehabilitation specialists as an attending doctor, and the ratio of rehabilitation staff members to beds. Results: We found that VEI for acute stroke patients was significantly associated with involvement of a rehabilitation specialist and a high ratio of rehabilitation staff members to beds (p < 0.05). Conclusion: Our results suggest that when providing VEI for acute stroke patients, it may be effective to promote the involvement of a rehabilitation specialist as an attending doctor, and increase the number of rehabilitation staff members.
Purpose: The purpose of this study was examine the effects of hip joint angles in sagittal plane on the hip external and internal rotator force. Methods: Thirty-two healthy volunteers (male: sixteen people, female: sixteen people, mean age: 21.9 ± 3.8years, range: 18-33 years) participated in this study. There were 4 condition that measured the hip joint angles in that plane extension 10 degree, flexion 0 degree, flexion 45 degree and flexion 90 degree. The maximum isometric external and internal rotational force were measured with hip joint abduction 0 degree, rotation 0 degree and knee joint flexion 90 degree. Results: External rotator force at extension 10 degree was significantly lower than at flexion 45 degree in female, in addition to Flexion 0 degree was significantly lower than flexion 45 degree and 90 degree in both male and female. Those two sex have internal rotation force at extension 10 degree and flexion 0 degree were significantly lower than at flexion 45 degree and 90 degree in common. Conclusion: The effects of hip joint angles in sagittal plane on the hip external rotator force was small, on the other hand internal rotation force increased as hip joint angle of flexion.
Purpose: The purpose of this study was to analyze the effect of different pelvic alignment and voluntary contraction strength on electromyographic activity of the lumbar multifidus (LM) and erector spinae muscles (ES). In addition, we examined the activity of the LM in the absence of overactive ES. Methods: Ten healthy men participated in this study. We studied the back muscles at 3 pelvic positions (moderate anterior tilt, neutral, and moderate posterior tilt) and 6 different voluntary contraction strengths (0％， 10％， 25％， 50％， 75％， and 100％ maximum voluntary contraction: MVC). The participants performed a task that involved isometric contraction of the back muscles during pelvic anterior tilt in a prone position at the edge of the bed with the legs hanging. The main outcome measure was the normalized LM/ES ratio assessed by using surface electromyography for the right ES and right LM. Results: The LM/ES ratio was more activated in the neutral position than in the moderate anterior and moderate posterior pelvic tilt position at 10％MVC. In neutral position, it was more activated at 10％MVC than 100％MVC. Conclusions: The present findings suggest that the neutral pelvic positions with mild resistance facilitated lumbar multifidus activity in the absence of overactive ES.
Purpose: The aim of this study was to clarify factors that can affect lower extremity muscle strength in stable interstitial pneumonia (IP). Methods: We examined the relationship between lower extremity muscle strength and respiratory function, dyspnea, and exercise tolerance in 107 patients with stable IP. Result: Isometric knee extension strength was associated with % DLco, the modified Medical Research Council (mMRC) dyspnea scale, and the 6-minute walk test. Moreover, logistic regression analysis to determine an dependent variable for whether a value of 0.50 kgf/kg of isometric knee extension strength caused movement impairment revealed the mMRC dyspnea scale grade as a factor that affected isometric knee extension strength (odds ratio 0.480, 95% CI 0.242–0.953). In addition, when the mMRC scale was Grade 1 or more, the results indicated that more than one half of the IP patients had a level of lower extremity muscle strength that fell below the level at which movement impairment begins. Conclusion: Lower limb muscle strength in IP patients was related to the level of respiratory failure, exercise tolerance, and dyspnea. Especially, it was revealed that when dyspnea is exacerbated in daily life, it can lead to a reduction in lower extremity muscle strength that may impair mobility.
Purpose: In this study, we measured the multifidus muscle cross-sectional area in normal adults using an ultrasound imaging device, to clarify factors influencing the difference in this cross-sectional area between males and females and to develop method to correct for this difference. Methods: Subjects comprised 63 normal adults (30 males and 33 females) with no anamnestic history of lumbar pain. We measured the cross-sectional area of their lumbar multifidus muscles using an ultrasound imaging device. Results: Regarding multifidus muscle cross-sectional area measurement, data from 25 males indicated a larger difference compared with data from females, indicating significance. However, a significant difference was not observed between males and females in multifidus muscle cross-sectional area measurement when divided by height and weight. The cross-sectional area showed a significant relationship with height, weight and BMI; however, only weight was adopted in stepwise multiple regression analysis. Conclusions: To obtain accurate multifidus muscle cross-sectional area measurement that did not relate to the body, we suggest that this should be divided by weight. In addition, it was suggested the ratio of weight to the multifidus muscle cross-sectional area can be applied as unified basis between males and females for clinical application.
