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The purpose of this study was to investigate the effects of neck and shoulder pain (NSP) and the position of the head and neck on the intramuscular circulation of the cervical muscles such as the trapezius and levator scapulae muscles in young females. Ten NSP subjects (mean age: 20.9 ± 0.5 years) and ten non-NSP subjects (mean age: 20.6 ± 0.7 years) were recruited to this study. Near-infrared spectroscopy (NIRS) was used to non-invasively measure total haemoglobin (Total-Hb), oxygenated haemoglobin (Oxy-Hb), and deoxygenated haemoglobin (Deoxy-Hb) of the trapezius and levator scapulae muscles. The measurements of Total-Hb, Oxy-Hb, and Deoxy-Hb were taken in the neutral position, immediately after the maximally flexed (extended) position, and after 30 s in the maximally flexed (extended) position. In flexion, no significant main effect or interaction was observed with Total-Hb and Oxy-Hb. A significant interaction was observed with Deoxy-Hb (p 0.01). There was no significant difference in the changes over time in the NSP group (p = 0.91). However, in the non-NSP group, a significant increase was noted at the neutral position to immediately after the maximally flexed position (p 0.01) and at the end of maintaining the maximally flexed position (p 0.01). In extension, no significant main effect or interaction was observed with Total-Hb and Oxy-Hb. A significant interaction was observed with Deoxy-Hb (p 0.01). In the NSP group, no significant difference was observed in the changes over time (p = 0.91). In the non-NSP group, however, a significant decrease was observed from the neutral position to immediately after the maximally extended position (p 0.01). The results of this study indicate that maintaining either maximal cervical flexion or extension may affect venous blood flow on non-NSP group. However, no effect on NSP group was observed due to existing diminished intramuscular circulation.

A deficiency in lumbar muscle blood circulation is considered to be a major risk factor for non-specific low back pain. The aim of this study was to investigate changes in relative circulation over time in the lumbar multifidus in different positions on sitting.Twelve healthy subjects (7 males, 5 females, average age: 20.9 years) without low back pain for the past 12 months were recruited. Near-infrared spectroscopy (NIRS) was used to non-invasively measure total haemoglobin (Total-Hb) and oxygenated haemoglobin (Oxy-Hb) in the lumbar multifidus at the L5-S1 segment. Subjects were asked to move into either 60-degree trunk-flexed or 20-degree trunk-extended position from the starting (standing in neutral) position in 3 s, timed by a metronome, and to maintain these positions for 30 s. The measurements of Total-Hb and Oxy-Hb were compared at -3 (neutral position), 0, 10, 20, and 30 s in each flexed and extended position on sitting.In flexion, Total-Hb and Oxy-Hb of the lumbar multifidus were significantly decreased from a neutral (-3 s) to flexed (0 s) position (Total-Hb: p = 0.002, Oxy-Hb: p = 0.004); however, there were no significant differences in the flexed position. In extension, Total-Hb and Oxy-Hb of the lumbar multifidus were significantly increased from 0 to 10 s (Total-Hb: p 0.001, Oxy-Hb: p 0.001); however, there were no significant differences from the neutral (-3 s) to extended (0 s) position, or from 10 to 30 s.The results of this study indicate that the intramuscular circulation of the lumbar multifidus decreases immediately once the trunk starts moving into a flexed position on sitting. On the other hand, the intramuscular circulation of the lumbar multifidus increases for up to 10 s once the trunk starts moving into an extended position.

[Purpose] The characteristics of neck and shoulder pain (NSP) in different age populations have not been sufficiently examined. Therefore, the purpose of this study was to compare and verify the cervicothoracic spinal alignment and neck flexor muscle endurance of young and older adult females with and without NSP. [Participants and Methods] We assessed 72 female participants (39 young participants, 33 elderly participants, 43 NSP, 29 non-NSP) aged 18-82 years who were recruited for this study. Cervicothoracic spinal alignment measurements were obtained with forward head alignment (FHA) along with the upper thoracic angle. The neck flexor endurance test was performed. [Results] There were no significant age-by-group interactions for any of the assessment variables. However, the upper thoracic angle and neck flexor muscle endurance showed significant effects in the groups. Age also had significant effects on FHA and upper thoracic angle. [Conclusion] These results suggested that the neck flexor muscle endurance was more appropriate as an evaluation tool for older adult females with NSP. It was also suggested that the cervical flexor muscle endurance and upper thoracic angle were more appropriate as evaluation tools for young adult females with NSP.

[Purpose] Increased compensatory pelvic movement is remarkable in limping patients with hip osteoarthritis (OA). However, a method of improving limping has not been established. The purpose of this study was to identify the effects of two types of Nordic walking by analyzing the pelvic movement and muscle activities of adults with hip OA. [Subjects and Methods] Ten patients with OA of the hip performed Japanese-style Nordic walking (JS NW), European-style Nordic walking (ES NW), and Ordinary walking (OW), and the muscle activities around the hip joint and pelvic movements were analyzed. [Results] The pelvic rotation angle was significantly larger in ES NW than in JS NW. In the stance phase, hip abductor muscle activity was significantly decreased in JS NW compared to both OW and ES NW. In the swing phase, rectus abdominis muscle activity was significantly increased in both JS NW and ES NW compared to OW and lumbar erector spinae activity was significantly lower in JS NW than in OW. [Conclusion] JS NW style may reduce the compensatory pelvic rotation in patients with hip OA. JS NW might be better for joint protection and prevention of secondary disorders of the hip in OA patients.

Background: The purpose of the study was to investigate the longitudinal time course of quality of life (QOL) in patients under conservative care and patients who received total hip arthroplasty (THA) by comparing their QOL scores along with the rehabilitation and life style parameters. Methods: Sixty-three female patients (age 58.7±7.1 years) of hip osteoarthritis under continuous conservative treatment were surveyed 4 times in two years by SF-36v2 (a modified version of rating scale SF-36) and an additional questionnaire developed by us. Results: Six patients that received THA during period of survey were designated as the THA group. Among the remaining 57 patients, 37 patients answered all four subsequent questionnaires were designated as non-THA group. The non-THA group was further divided into the rehabilitation continuing group in the hospital (RC group; n=8) and the discontinuing group (non-RC group; n=29) from the results of the questionnaire. The scores of physical functioning at the time of the first survey were significantly lower in the THA group compared to the non-THA group (p

リハビリテーションの臨床現場では，患者の機能を簡便かつ定量的に評価できることが求められている．本研究では，我々が開発した CCDカメラと力覚センサを用いた 2次元逆動力学解析システムを用いて，片麻痺患者の上肢運動機能を評価した．運動タスクは，ほとんどの患者が運動でき，かつ再現性が高い 1軸のレバー回転（定トルク）とした．被験者は，痙性麻痺の軽度な片麻痺患者 10名（以下，片麻痺群）と比較検討のため健常者 10名（以下，健常群）とし，関節可動域と関節モーメントの変化や隣接関節の協調運動を検討した．その結果，関節可動域は，両群とも同様な軌跡であったが，健常群は片麻痺群と比べ，手関節を広範囲に用いる傾向にあった．関節モーメントは，健常群では全例において肩関節と肘関節を優位に用いる傾向にあった．片麻痺群では肩関節と肘関節を優位に用いる群と変化の少ない群とが認められた．健常群は運動タスクの開始時から肘関節，肩関節の順で有意に増大し，片麻痺群では 20度以降から肩関節が有意に増大した．この結果は，軽度な片麻痺群が痙性麻痺により，各関節の選択的な随意運動ができなかったことを反映している．このことより，臨床場面で我々が開発した解析システムによって，軽度片麻痺患者の上肢運動機能を評価できることが示唆された．

理学療法士（以下；PT）教育の一環として，地域住民と直接交流のできる地域活動を実施する事は非常に意義深い。学生にとって臨床現場での実習に加え，地域活動は地域住民の医療・保健・福祉の現状を理解する場としても適している。地域活動をPT教育カリキュラムの一環として組み込むために，その試行としての地域活動に学生を参加させ，学生にアンケート調査を行ったので報告する。結果，ほとんどの学生は本試みに賛同し，理由として地域高齢者との交流が持てる事を挙げた。地域活動の中で1）人と接する機会を得る，2）問題解決能力を磨く，3）理学療法への問題意識を持つ，4）主体性を持つ事の4項目を目的に行った。学生は高齢者との交流を通して，主に対人関係（接遇，意思伝達，精神的援助等）の重要性を学ぶことができ，臨床現場への応用，自己学習にも有効との事であった。以上の事から，地域活動は学生へのPT教育の一環として有用な事象になり得ることが考えられる。

Material and methods Twenty-five female patients with ASD (mean age 64.3 years) who underwent fusion surgery were included for analysis. Diagnosis was lumbar scoliosis in 10 patients, kyphoscoliosis in 11, and kyphosis in 4. Radiographic measurement of spinal alignment and CSA of lumbar trunk muscles including psoas major and lumbar extensor muscles measured by Magnetic Resonance Imaging (MRI) were evaluated. The CSAs of trunk muscles were measured at the cranial endplate of L4 vertebra for a comparative estimation of muscle size. A negative value indicated lordosis in evaluation of spinal alignment.