Journal of Physical Therapy Science Vol. 7(1995) No. 2

The consistency of seven measures of paretic upper extremity motor performance was examined in 10 patients who experienced a stroke a mean 6.3 days before entering the study. Motor performance was measured using dynamometers, the Motricity Index, and timed alternating movement. All motor performance measures correlated significantly with one another on the first and fifth assessment days (r_s≥0.707). Within day Cronbach’s alphas were high (≥0.9116). The measures were correlated strongly across days. Only the Motricity Index score for shoulder abduction differed significantly between days. The results showed that the measures investigated were consistent within and between days. As they appear to be measuring the same construct, there is little need to employ all if the intent is to characterize motor performance of the paretic upper extremity soon after stroke. A select few measures should be sufficient for such a characterization.

The purpose of this study was to examine cardiorespiratory responses during exercise tests as determined by the cycle ergometer in thirty-seven mildly obese patients, aged 28 to 69 years old participated [Body Mass Index (BMI); 28.1 ± 1.5 kg/m²] and 26 moderately obese patients, aged 20 to 67 years old (BMI; 32.7 ± 1.7 kg/m2). To evaluate the physical fitness, a graded cycling exercise test was performed, monitoring gas exchange, ventilation and heart rate. The following results were obtained: (1) BMI and percentage fat (% fat) had a positive correlation in obese patients. (2) The maximum oxygen uptake (VO₂ max) and maximum heart rate (HR max) did not change in either group, while the maximum oxygen uptake per body weight (VO₂ max/W) in moderately obese male patients decreased significantly compared with that in mildly obese male patients (p<0.05). (3) LOAD per body weight (LOAD/W) in moderately obese patients decreased significantly as compared to mildly obese patients (p<0.01). (4) VO₂ max, HR max and VO₂ max/W at anaerobic threshold (AT point) did not change in either group. These results suggest that physical fitness would be relatively diminished in obese patients.

The purpose of this study was to examine speed and mode specificity of strength training by comparing concentric and eccentric isokinetic exercises for extensors and flexors of the knee. The subjects were 28 healthy college students, randomly assigned to three groups: concentric training, eccentric training, and control. Peak torques corrected for the effect of gravity were obtained at four velocities (60, 120, 180, and 240 deg/sec) using a KIN-COM III isokinetic dynamometer. The control group was evaluated twice at an interval of 3 weeks, and the other groups were evaluated before training, 3 weeks later and 6 weeks. The concentric and eccentric groups trained with 6 to 8 sets of 10 maximal voluntary isokinetic contractions at 180 deg/sec. Training sessions were held three times a week for 6 weeks. The results showed that the concentric and eccentric strength of both flexors and extensors increased only slightly in the concentric group, but the eccentric group showed significant gains in concentric and eccentric strength at most speeds, in both flexors and extensors. The control group showed no significant change in concentric or eccentric strength at any speed. We concluded that the eccentric mode of isokinetic exercise increases strength more effectively than the concentric mode. Neither form of exercise at 180 deg/sec appears to have effects specific to speed or mode.

The flexibility of posture was examined by adjusting one body part to the line of the center of gravity (LCG). Fifteen healthy subjects participated in the experiment and their LCGs were determined with a force plate. The difference between the body part and LCG as recorded by a videocamera before adjustment was compared with that after adjustment. The results obtained were 1) the center of gravity was positioned more anteriorly than is generally believed to be the case, 2) the position of the head was before LCG, and both the shoulder and the knee were behind it, 3) the knee was stable at adjusting one of the other parts of body, and the shifting length of the head and hip were related to the adjusting length of these lower parts, i.e. the head was related to the shoulder and the hip was to the knee. We discussed the young people’s posture, and the stability of the knee to body alignment. In physical training aimed at adjusting posture, it was suggested that the alignment of lower extremities, especially the hip, must be controlled.

The author has compiled a list of 76 items to be learned by students in the Field Work Performance (FWP) program with the notion of framing a general idea of the Physical Therapy Practical Process (PTPP), and used these items to prepare a Self-Evaluation Achievement Checklist (SEA-Checklist) in the form of a questionnaire. Based on the SEA-Checklist, research has been carried out on the performance levels of students who have been engaged in clinical training. This study was carried out on students with mistakes in the FWP. Three types of instruction methods were carried out: the individual objective setting and executing type (A); the individual objective proposed type (B); and the experienced objective setting type (C). The study was performed by using these three methods and an examination of determined effects was made to learn if any difference can be found in learning PTPP. The chi-square test was carried out from the number of passing items and nonpassing items of each type. No significant difference was observed between any group at the beginning of the training. It was also found that the marks and the passing rates for all groups increased significantly after the training. A significant difference (p<0.05) was observed between types A and C, but not between types A and B, and types B and C. To review penetration of the effect of learning, when the level of rating criteria was raised one rank, to “almost satisfactory” from “achieved in some way” in the 7-stage rating, significant differences between types A and B (p<0.01) on the one hand, and those between types A and C on the other were confirmed. In determination of the effects of the three types of instruction for those with wrong steps in the FWP, it was noted that type A was the most effective method, type C was less effective, and type B was intermediate. It was possible to identify students with wrong steps in the FWP by using the SEA-Checklist obtained in the first study and to grasp the contents of the wrong steps. Working out the plans for overall targets and individual student targets was made easier. In FWP instruction, it was effective not only to post an overall target, but also to adopt the instructing method to correct each case as it may require by evaluating the situation as the students were actually engaged in FWP. In a sense, the use of instruction of individual target setting and excuting type (type A) turned out to be effective. Although the current situation does not allow use of this method, it was suggested that the execution of a instruction method of at least an individual target proposed type (type B) was required. This method was considered effective for the students with no mistakes in FWP.

Instrumentation surgery was applied to patients with spinal cord injury with the aim of correcting spinal deformity and assisting the patient in maintaining stability. In cases where long Harrington rods were used, however, trunk balance often became instable due to the loss of mobility of the spinal column. Using a weight balance analyzer, the sway of sitting balance was measured in L1 completely paraplegic patients fixed with Harrington rods and in those under conservative treatment. Abdominal and back muscle strength was measured using a Cybex II. In patients treated with Harrington rod, the sway of sitting balance was intense, especially during anterior movement. Dynamic sitting balance was inferior. Decreases in torque were not remarkable in isometric contraction of trunk muscles, while marked decreases were observed during isokinetic contraction. These results suggest that dynamic movement of the trunk muscles was restrained in cases fixed with Harrington rods due to stiffness of the spine, despite the fact that muscle strength was maintained.