Foot arch height,toe flexor strength,and dynamic balance ability in collegiate female dancers and non-dancers

[Purpose] To characterize the foot arch height, toe flexor strength, and dynamic balance ability of collegiate female dancers and age-matched non-dancers. [Participants and Methods] This study included 20 healthy college-aged female dancers (21.6 ± 0.8 years) and 20 age-matched females (19.7 ± 1.0 years) with no previous experience in sports as non-dancers. Foot arch height was determined by measuring the height of the navicular tuberosity in the standing position using a ruler. Toe flexor strength was measured while seated on a chair using a toe grip dynamometer. Dynamic balance ability was evaluated based on the reach distance measured using a professional Y-balance test kit. [Results] The collegiate dancers had higher foot arches, greater toe flexor strength, and longer Y-balance test reach distance than the non-dancers. [Conclusion] The foot arch height, toe flexor strength, and dynamic balance ability of collegiate female dancers were adapted through years of training and were superior to those of non-dancers.     

Elucidation of abductor digiti minimi activity in chronic ankle instability

[Purpose] This study aimed to compare the muscle activity around the foot and ankle joints, notably of the abductor digiti minimi, between affected and unaffected sides of individuals with chronic ankle instability. [Participants and Methods] Twelve adult males with chronic ankle instability in one ankle (age, 27.7 ± 5.4 years; height, 172.5 ± 8.1 cm; weight, 67.5 ± 8.1 kg) were included and underwent surface electromyography assessments in multiple positions on both affected and unaffected sides. Measurements were obtained for eight muscles including the abductor digiti minimi. Each measurement included a 5-s segment of the stable waveform, with the root mean square-processed and normalized to the resting position set to 1. [Results] Abductor digiti minimi activity on the affected side was significantly reduced during maximal toe extension/abduction with both ankle dorsiflexion and plantarflexion. Peroneus longus activity on the affected side was significantly greater during maximal toe extension/abduction with ankle plantarflexion; peroneus longus and tibialis anterior muscle activities were significantly greater on the affected side during maximal toe extension/abduction with ankle dorsiflexion. [Conclusion] In the absence of load, muscle imbalance in the intrinsic and extrinsic muscles of the foot was suggested. However, no significant differences were observed under loading conditions.     

Relationship between the characteristics of lower extremity function and activities of daily living in hospitalized middle-aged and older adults with subacute cardiovascular disease

[Purpose] To clarify the relationship between lower extremity function and activities of daily living and characterize lower extremity function in hospitalized middle-aged and older adults with subacute cardiovascular disease. [Participants and Methods] The Short Physical Performance Battery, 6-minute walk distance, and functional independence measure tests were conducted in 79 inpatients with subacute cardiovascular disease (mean age, 76.7 ± 11.9 years; 34 females). Multiple regression analysis used the functional independence measure score as the dependent variable and the Short Physical Performance Battery and 6-minute walk distance scores as independent variables. Cross-tabulations were performed for each age group, and patients who performed the Short Physical Performance Battery and 6-minute walk distance tests were divided into two groups by their respective cutoff values. [Results] Only the Short Physical Performance Battery (β=0.568) and 6-minute walk distance (β=0.479) scores were adopted as significant independent variables in each multiple regression model. The age <75 years group had the most patients with both good lower extremity function and aerobic capacity, whereas the age ≥75 years group had the most patients with both functions impaired. [Conclusion] Although cardiovascular disease is generally associated with decreased aerobic capacity, many older patients with cardiovascular disease in this study had decreased lower extremity function, too.     

Effect of the Intrinsic Foot Muscle Exercise Combined with Interphalangeal Flexion Exercise on Metatarsalgia with Morton’s Toe

[Purpose] This study examined the effects of the intrinsic foot muscle exercise combined with interphalangeal flexion exercise on metatarsalgia with Morton’s toe. [Subject] A 38-year-old male with Morton’s toe, who complained of pain in his left metatarsophalangeal joints was the subject. [Methods] The pressure pain threshold, peak contact pressure of the metatarsophalangeal region during gait, and the navicular drop were measured before and after the intrinsic foot muscles exercises combined with interphalangeal flexion exercise. [Results] After exercising for 2 weeks, the pressure pain threshold increased from 1 to 1.5 kg, while the peak contact pressure decreased from 0.63 to 0.50 kg/cm², and the navicular drop improved from 5 to 8 mm. [Conclusion] The results show that the combined exercises alleviated the pain while walking by reducing the excessive pressure on the metatarsophalangeal region, and the improvement of gait with Morton’s toe.Key words: Contact pressure, Interphalangeal flexion, Metatarsalgia     

Association between toe grasping strength and accelerometer-determined physical activity in middle-aged and older women

[Purpose] To test the hypothesis that toe grasping strength is associated with daily physical activity in older adults. [Subjects] Fifty-seven Japanese women, aged 52–78 years, volunteered. [Methods] Toe grasping and knee extension strength were measured. Physical activity was also measured, using an accelerometer, and the total duration of each level of exercise intensity (light, moderate, and vigorous) and average step counts were calculated. Subjects were separated into two groups on the basis of accelerometer-determined step counts: LOW (n=28, <8000 steps/day) and HIGH (n=29, ≥8000 steps/day). [Results] Body mass index and body composition (% fat and fat-free mass) were similar between the two groups. Absolute and relative toe grasping strengths (divided by body weight) were greater in HIGH than in LOW. However, both absolute and relative knee extension strength were similar between the groups. Relative toe grasping and knee extension strength correlated with all 3 intensities of physical activity and average step count. After adjusting for age, the duration of light plus moderate physical activity and average step counts correlated to toe grasping strength but not to knee extension strength. [Conclusion] Our results suggest that toe grasping strength may be associated with the amount of light intensity daily physical activity.Key words: Accelerometer, Isometric contraction, Foot muscle strength     

Foot pressure analysis of adults with flat and normal feet at different gait speeds on an ascending slope

[Purpose] This study was conducted to determine the difference in foot pressures between flat and normal feet at different gait speeds on an ascending slope. [Subjects] This study enrolled 30 adults with normal (n=15) and flat feet (n=15), with ages from 21 to 30 years old, who had no history of neurological disorders or gait problems. A treadmill was used for the analysis of kinematic features during gait, using a slope of 10%, and gait velocities of slow, normal, and fast. [Methods] A foot pressure analyzer was used to measure changes in foot pressure. [Results] Compared to the normal subjects, the foot pressure of the flatfoot subjects showed a significant increase in the 2–3rd metatarsal region with increasing gait speed, whereas there were significant decreases in the 1st toe and 1st metatarsal regions with increasing gait speed. [Conclusion] The body weight of adults with flatfoot was concentrated on the 2–3rd metatarsal region during the stance phase and increased with walking speed on the ascending slope due to weakening of function of the medial longitudinal arch.Key words: Flatfoot, Foot pressure, Ascending slope     

Physical therapist-led swimming lessons for children with cerebral palsy: a report of 2 cases

[Purpose] The purpose of this study was to report that a physical therapist qualified for swimming instruction can provide swimming instruction to children with spastic paraplegia due to cerebral palsy. We examined the role of the physical therapist in the support. [Participants and Methods] Two elementary school children with cerebral palsy participated in this study. The swimming program consisting of 6 sessions was performed over 6 months in an indoor swimming pool. Each session lasted for 30 minutes and was instructed by a trained physical therapist. The 5 categories for evaluation were motor function, muscle tone, activities of daily living, swimming skill, and satisfaction level. [Results] Case A showed improvement in streamline floating distance and 15-m time. Case B could not swim 15 m in the first session but completed 15 m within 102 s in the last session. The 3 other categories besides swimming skills did not improve. [Conclusion] With a skilled physical therapist’s instruction, children with cerebral palsy may improve their swimming skills over a limited number of sessions without any adverse events.Key words: Children with a cerebral palsy, Swimming instruction, Physical therapist     

Effect of backpack position on foot weight distribution of school-aged children

[Purpose] In the present study, we aimed to determine the effects of backpack position on foot weight distribution of standing school-aged children. [Subjects] Thirty school-aged children volunteered to participate in this study. [Methods] The subjects randomly performed four types of carrying a backpack: no backpack (condition-1), carrying a backpack at C7 (condition-2), carrying a backpack at 10 cm below C7 (condition-3), and carrying a backpack at 20 cm below C7 (condition-4). [Results] Statistically significant differences were noted in the anterior and posterior pressure values, and in the anterior-to-posterior ratio, among the four conditions (p < 0.05). Post-hoc analysis indicated that the pressure value of condition-4 was significantly lower in the anterior foot region and higher in the posterior foot region than in condition-2 and condition-3. In addition, the anterior-to-posterior ratio was lower in condition-4 than in condition-2 and condition-3. [Conclusion] These findings suggest that carrying a backpack in a higher position, with fastening of the shoulder strap, may be more favorable for normalizing the foot weight distribution.Key words: Backpack position, Weight distribution, Children     

Effect of asymmetrical buttock pressure on forces exerted in buttock movement when using a reclining chair

[Purpose] To clarify the effect of asymmetrical buttock pressure on the shear forces exerted on a buttock. [Participants and Methods] Sixteen healthy adult males participated in this study. A cushion 0 or 2 cm high was placed on the left side of the seat for all participants. The 0- and 2-cm height conditions were called “without difference condition” and “difference condition”, respectively. The back support was inclined at increasing angles, starting at the upright position, to a fully reclined position, and back to the upright position. [Results] With the “difference condition”, the force on the left buttock was 147.4% body weight and that on the right buttock was 105.6% body weight. In contrast, with the “without difference condition”, there was no significant difference in the force on the left buttock and right buttock in terms of percent body weight. [Conclusion] Our results suggest that asymmetrical buttock pressure while in the sitting position causes a difference in shear force exerted on the left and right buttocks when using a reclining chair.Key words: Reclining wheelchair, Buttocks pressure, Side inclination of the pelvis     

The perioperative changes in physical function and physique of patients with gastrointestinal cancer

[Purpose] The purpose of this study was to observe the long-term change in physical function and physique from perioperative to discharge of patients with gastrointestinal cancer. [Subjects and Methods] Subjects were 47 perioperative patients with gastrointestinal cancer [25 men and 22 women aged 61.3 ± 11.0 years (mean ± SD)]. Six-minute walk distance was measured for physical function and body mass index and calf circumference were measured for physique. These items were evaluated at three time points: before surgery, after surgery, and after discharge. [Results] Significant declines in physical function and physique were observed temporarily after surgery. Physical function improved equally before surgery in after discharge. On the other hand, postoperative physique was significantly lower than that observed pre-operatively. [Conclusion] These results suggest that the perioperative changes in physical function and physique follow different courses in patients with gastrointestinal cancer.Key words: Gastrointestinal cancer, Physical function, Physique     

Effect of ski simulator training on kinematic and muscle activation of the lower extremities

[Purpose] This study aimed to verify the effectiveness of an augmented reality-based ski simulator through analyzing the changes in movement patterns as well as the engagement of major muscles of the lower body. [Subjects] Seven subjects participated in the study. All were national team-level athletes studying at “K” Sports University in Korea who exhibited comparable performance levels and had no record of injuries in the preceding 6 months (Age 23.4 ± 3.8 years; Height 172.6 ± 12.1 cm; Weight 72.3 ± 16.2 kg; Experience 12.3 ± 4.8 years). [Methods] A reality-based ski simulator developed by a Korean manufacturer was used for the study. Three digital video cameras and a wireless electromyography system were used to perform 3-dimensional motion analysis and measure muscle activation level. [Results] Left hip angulation was found to increase as the frequency of the turns increased. Electromyography data revealed that the activation level of the quadriceps group’s extension muscles and the biceps femoris group’s flexing muscles had a crossing pattern. [Conclusion] Sustained training using an augmented reality-based ski simulator resulted in movements that extended the lower body joints, which is thought to contribute to increasing muscle fatigue.Key words: Ski simulator, Kinematic, EMG     

The Relationship between Physical Function and Postural Sway during Local Vibratory Stimulation of Middle-aged People in the Standing Position

[Purpose] The purpose of this study was to examine the relationship between physical function and postural sway during local vibratory stimulation of middle-aged subjects in an upright position. [Subjects] The subjects were 25 healthy community-dwelling middle-aged people. [Methods] We measured postural sway using a Wii board while vibratory stimulations of 30, 60, or 240 Hz were applied to the subjects’ lumbar multifidus or gastrocnemius muscles. Physical function was evaluated by 5-m usual gait speed and grip strength. [Results] Gait speed was strongly correlated to the anteroposterior body sway in the upright position during 30 Hz gastrocnemius muscles vibration (GMV). [Conclusion] Postural sway during 30 Hz GMV was strongly associated with gait speed and showed a posterior displacement. These findings show that the lower leg’s response to balance control under 30 Hz proprioceptive stimulation might be a good indicator of declining gait function.     

Dynamic balance ability in single-leg drop jump landing in junior female athletes after shin splints—assessment from a preventive perspective

[Purpose] To develop assessment/rehabilitation indices for prevention of chronic and recurrent shin splint injuries among sport athletes, we analyzed the plantar center of pressure trajectories after drop-jump landing on one leg, and compared the foot function on the injured and healthy sides. [Participants and Methods] The participants were 10 female athletes who received consultation at our facility due to shin splints of the lower leg. The exercise task was the “single-leg drop jump landing test”, in which the participants maintained a static posture on one leg for 8 s after landing. Using the collected data, the peak value of the vertical component of the floor-reaction force at the landing and the rectangular areas at 20–200 ms and 1–5 s after landing were calculated and compared between the healthy and affected sides. [Results] The peak value of the vertical component and the rectangular area at 20–200-ms were significantly larger on the affected side. However, the value for the 1–5-s rectangular area was significantly larger on the healthy side. [Conclusion] The feedforward function may have been reduced on the affected side in comparison with that on the healthy side, and the reduction in dynamic balance early after landing may have increased the influence of the non-vertical component. The 1–5-s rectangular area was smaller on the affected side than that on the healthy side, suggesting that the feedback function excessively worked on the affected side and caused immobility by excessively locking the joint in single-leg balance and reducing body sway.     

Children with flat feet have weaker toe grip strength than those having a normal arch

[Purpose] This study investigated the relationship between toe grip strength and foot posture in children. [Subjects and Methods] A total of 619 children participated in this study. The foot posture of the participants was measured using a foot printer and toe grip strength was measured using a toe grip dynamometer. Children were classified into 3 groups; flatfoot, normal, and high arch, according to Staheli’s arch index. The differences in demographic data and toe grip strength among each foot posture group were analyzed by analysis of variance. Additionally, toe grip strength differences were analyzed by analysis of covariance, adjusted to body mass index, age, and gender. [Results] The number of participants classified as flatfoot, normal, and high arch were 110 (17.8%), 468 (75.6%), and 41 (6.6%), respectively. The toe grip strength of flatfoot children was significantly lower than in normal children, as shown by both analysis of variance and analysis of covariance. [Conclusion] A significant difference was detected in toe grip strength between the low arch and normal foot groups. Therefore, it is suggested that training to increase toe grip strength during childhood may prevent the formation of flat feet or help in the development of arch.Key words: Flatfoot, Toe grip strength, Children     

Effect of the long-term care prevention project on the motor functions and daily life activities of the elderly

[Purpose] The purpose of this study was to verify the effects of the long-term care prevention project and develop an effective program. [Subjects] A total of 81 elderly people (age, 79 ± 5.1 years; height, 149.2 ± 9.2 cm; weight, 54.2 ± 11.4 kg). [Methods] Grip, knee extension muscular strength, 10 m walking speed, and Timed Up and Go time were measured for evaluation of motor functions, and the “Locomo 25”, a 25-question risk assessment questionnaire, was used as the judgment criterion for evaluation of daily life activities, with measurements being taken at the beginning of the project and after three months. [Results] In the motor functions evaluation, significant differences were observed in 10 m walking speed, Timed Up and Go time, and knee extension strength. In the daily life activities evaluation, scores for pain, rising movement, standing movement, indoor walking, outdoor walking, and fear of falling were significantly reduced. In addition, a significant correlation was also observed between motor functions and daily life activities. [Conclusion] The result of this study indicated that the long-term care prevention project is effective in maintaining or improving muscular strength and mitigating pain in the elderly and that it is an effective program for maintaining daily life activities. We were also able to show that it would be effective to develop programs with a low exercise intensity that can be performed on a continuing by the elderly.Key words: Long-term care prevention project, Motor functions, Daily life activities     

Effects of sensorimotor foot training on the symmetry of weight distribution on the lower extremities of patients in the chronic phase after stroke

[Purpose] To assess the effects of sensorimotor foot stimulation on the symmetry of weight distribution on the feet of patients in the chronic post-stroke phase. [Subjects and Methods] This study was a prospective, single blind, randomized controlled trial. In the study we examined patients with chronic stroke (post-stroke duration > 1 year). They were randomly allocated to the study group (n=8) or to the control group (n=12). Both groups completed a standard six-week rehabilitation programme. In the study group, the standard rehabilitation programme was supplemented with sensorimotor foot stimulation training. Each patient underwent two assessments of symmetry of weight distribution on the lower extremities with and without visual control, on a treadmill, with stabilometry measurements, and under static conditions. [Results] Only the study group demonstrated a significant increase in the weight placed on the leg directly affected by stroke, and a reduction in asymmetry of weight-bearing on the lower extremities. [Conclusion] Sensorimotor stimulation of the feet enhanced of weight bearing on the foot on the side of the body directly affected by stroke, and a decreased asymmetry of weight distribution on the lower extremities of patients in the chronic post-stroke phase.Key words: Rehabilitation, Sensorimotor foot training, Stroke     

Reproducibility and validity of the 50-meter walking test in community-dwelling elderly

[Purpose] This study aimed to investigate the reproducibility and validity of the 50-m walking test. [Subjects] Reproducibility was investigated in 19 community-dwelling elderly women (mean age, 76.3 years), and validity was investigated in 31 community-dwelling elderly individuals (12 men and 19 women; mean age, 75.7 years). [Methods] The time taken to walk 50 m, the time taken to walk each 10-m section (laps 1–5), the time taken to walk 10 m, and grip strength were measured. In addition, the functional reach test (FRT), one-leg standing test, and timed up and go (TUG) test were performed. [Results] In a reproducibility analysis, the interclass correlation coefficient (1,1) was 0.97. In a Bland-Altman analysis, no systematic error was found. The measured values from the 50-m walking test included a measurement error of 1.5 s, and the acceptable margin of error was confirmed to be 3.1 s. In a validity analysis, the 50-m walking test score was significantly correlated with the 10-m walking and TUG test scores. [Conclusion] Our results suggest that the 50-m walking test score may be a useful index of the walking ability of community-dwelling elderly.Key words: 50-meter walk test, Reproducibility, Validity     

Factors associated with falls in community-dwelling older adults: an analysis based on subscales of the frailty screening index

[Purpose] We aimed to obtain new findings by investigating the relationship between the presence or absence of falls and the results from the Frailty Screening Index (FSI), which can be easily carried out. [Participants and Methods] A total of 780 community-dwelling older adults (age ≥65 years) were classified based on whether they had fallen in the past year as those who had fallen at least once (fall group), and those who had not (non-fall group). We compared the study groups using sub-items of the FSI to extract more specific fall-related factors. The FSI is a questionnaire that comprises five items with simple ‘yes/no’ responses. [Results] The following three out of five sub-items of the FSI were extracted as fall-related factors: 1) “no” to the question, “Do you do physical exercise, like walking, at least once a week?”; 2) “yes” to the question, “Do you think you walk slower than before?”; and 3) “yes” to the question, “Have you felt tired for no reason (in the past two weeks)?” [Conclusion] The study results suggest the significance of paying attention to participant responses to the sub-items on the FSI, instead of merely determining their frailty risk based on their total score.Key words: Falls, Frailty, Community-dwelling older adults     

Effects of self-selected dehydration and meaningful rehydration on anaerobic power and heart rate recovery of elite wrestlers

[Purpose] This study aimed to verify the effects of self-directed weight loss on lower- and upper-body power, fatigue index, and heart rate recovery immediately before a meaningful competition (12 hours of recovery). In addition, this study tested the hypothesis that weight loss provides advantages in strength and power, as the relative power of the wrestlers is higher than that of opponents in the same weight class who do not reduce weight. [Subjects and Methods] Eleven well-trained wrestlers volunteered for the study. At baseline, their mean ± SD age, body mass, and height were 20.45 ± 2.69 years, 74.36 ± 9.22 kg, and 177 ± 5.71 cm, respectively. Repeated-measures one-way analysis of variance was performed to analyze differences. [Results] Rapid weight loss achieved by restriction of energy and fluid intake resulted in exercise-impaired decreases in peak power and increased fatigue index. Moreover, weight loss by dehydration negatively affected cardiovascular stability. [Conclusion] Most of the negative effects of rapid weight loss disappear after a 12-hour recovery period, and relative peak power increases after weight loss.Key words: Power, Dehydration, Rehydration and recovery     

Reliability and validity of the Japanese version of the short questionnaire to assess health-enhancing physical activity (SQUASH) scale in older adults

[Purpose] We tested the reliability and validity of the Japanese version of the Short Questionnaire to Assess Health-enhancing Physical Activity scale in asymptomatic older adults and sought to confirm discriminator validity in women with osteoarthritis. [Subjects] The participants included an asymptomatic comparison group (men and women) and women with knee or hip osteoarthritis. [Methods] The test-retest method was used to assess reliability. The International Physical Activity Questionnaire was chosen to assess criterion-related validity. Discriminator validity was assessed by comparing the asymptomatic and osteoarthritis groups. [Results] Mean age for the asymptomatic groups was 63 ± 6 years for men (n = 23) and 61 ± 7 years for women (n = 51), and it was 63 ± 9 years for the osteoarthritis group (n = 32). The total score and scores for all items, except for heavy housework items, were significantly correlated with the retest. Criterion-related validity showed significantly weak to moderate correlations between the respective scale categories. For discriminator validity, the total scores and scores for bicycle commuting, light housework, and three leisure items differed significantly between the asymptomatic and osteoarthritis groups. [Conclusion] The Short Questionnaire to Assess Health-enhancing Physical Activity scale is a reliable and valid measure in asymptomatic older adults, and can discriminate between osteoarthritic and asymptomatic women.Key words: Physical activity scale, Older adults, Osteoarthritis