Purpose: The study aim was to examine differences between two gait variables —auto correlation (AC) and harmonic ratio (HR) —derived from trunk accelerometry, and whether the variables were associated with age and falls.
Methods: In the study, 989 older adults (mean age: 73.6 years) underwent gait analysis using a triaxial accelerometer attached to the lower trunk, and completed a questionnaire on their history of falls. Data were processed to calculate the AC and HR for each direction (vertical direction, mediolateral direction and anteroposterior direction).
Results: Factor analysis indicated differences between AC and HR. Comparison of age-based groups showed that AC and HR were mostly lower in the groups aged ≥80 years (p < 0.05). HR in all directions and AC in vertical direction were associated with falls (p < 0.05).
Conclusions: AC and HR acquired from trunk accelerometry revealed differences during gait. Both variables were associated with age and falls.

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Purpose: To investigate the effects of afferent inhibition (AI) using electrical stimulation on short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) in the brain.
Methods: Twelve healthy individuals participated in this study. The motor evoked potentials (MEPs) were measured using nine stimulation conditions: two paired-pulse transcranial magnetic stimulations (TMSs), SICI and ICF; two AI stimulations, short-latency AI (SAI) and long-latency AI (LAI); a combination of these stimulations; and single TMS. The amplitudes of MEPs elicited by each paired stimulation were compared with that elicited by single TMS.
Results: The SAI did not affect SICI and ICF. On the other hand, LAI did not influence SICI, but it attenuated ICF.
Conclusion: LAI affects the facilitation circuit of the brain cortex.

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Purpose: Assuming that exercises are conducted in care facilities and at home, differences between them related to self-confidence should be estimated by the type of exercise. The magnitude of the difference should be judged by that of the effect. Furthermore, the relation should be shown between self-confidence to perform each exercise and a feeling of self-efficacy (SE), predictive effects of action.
Subjects: Subjects of this study were 114 people requiring support or care.
Methods: Assuming exercise at care facilities and at home, the self-confidence to perform each exercise was surveyed using a five-point scale. Additionally, the degree of SE was scored using a home exercise barrier SE scale (HEBS).
Results: Self-confidence in exercises assumed to be performed at home was significantly lower than that at care facilities, indicating a high level of effect. It was also significantly low for all exercises. The self-confidence for exercises was significantly and positively correlated with HEBS scores.
Conclusion: Using an acceptable psychological index such as self-confidence is expected to facilitate planning of exercise contents that are more appropriate to individual subjects.

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Purpose: The purpose of this study was to investigate whether multiple organ failure assessment measured after surgery predicted the achievement of early postoperative rehabilitation goal in patients undergoing type A acute aortic dissection (AAAD) repair.
Methods: We enrolled 180 AAAD patients (mean age of 65 ± 12 years, 92 males) who had undergone surgery. The sequential organ failure assessment (SOFA) score was used after surgery to measure the degree of multiple organ failure. For the postoperative duration, we investigated the number of days it took patients to successfully complete a 100-meter walk without assistance. The achievement of the early postoperative goal was defined as <15 days. Significant factors that affected achievement of the early postoperative rehabilitation goal were extracted. Cut-off values were determined by using multivariate logistic regression analysis and receiver operating characteristic curves.
Results: Of 180 AAAD patients, 74 did not achieve the early postoperative rehabilitation goal. The SOFA score at 1, 2 and 3 days after surgery were significantly higher in non-achieved patients than achieved patients (p ＜0.01 for all). The SOFA score for the first day after surgery was a significant predictor of achievement of early the postoperative rehabilitation goal (OR, 2.01; 95 % CI, 1.32–3.06; p<0.001). The SOFA score cut-off value was determined to be 6.5, with a sensitivity of 0.84 and a specificity of 0.71.
Conclusions: The SOFA score at first day after surgery is an independent predictor of achievement of early postoperative rehabilitation goal in patients undergoing AAAD repair, with a cut-off value of 6.5.

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Purpose: This study aimed to analyze effects of and factors related to exercise therapy in patients with cervical degenerative disease using the McKenzie method.
Method: Fifty-two patients diagnosed with cervical degenerative disease at our hospital participated in this study. Patients were subjected to exercise therapy and education for daily neck posture based on mechanical diagnosis using the McKenzie method, and the directional preference was decided. The effect of this therapy was evaluated using the active ROM of cervical spines (hereafter, ROM), Neck Disability Index (NDI), JOACMEQ, VAS, and SF-8 before therapy and 1 week as well as 1, 2, and 3 months after therapy. Statistical analysis was performed using mixed-effects model for repeated measures. In addition, we analyzed which factors may correlate with the effects of exercise therapy.
Results: Compared with before therapy, ROM and VAS scores significantly improved 1 week after therapy. Compared with before therapy, NDI, JOACMEQ, and SF-8 scores significantly improved 1 month after therapy. Multifactorial analysis demonstrated that medication correlated with the treatment progress of extension ROM. Moreover, deskwork and cervical alignment correlated with ROM, VAS, NDI, and SF-8.
Conclusion: Effects of exercise therapy in patients with cervical degenerative disease based on mechanical diagnosis included significantly improved symptoms, cervical function, disabilities of daily living, and health-related QOL. These effects correlated with medication, deskwork, and cervical alignment. These results suggested that neck posture in daily life causes cervical disorders.

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Purpose: The aim of this study was to compare score distributions and fall prediction accuracies between the Balance Evaluation Systems Test (BESTest), Mini-BESTest, Brief-BESTest, and Berg Balance Scale (BBS).
Methods: The BESTest, Mini-BESTest, Brief-BESTest, and BBS were performed for 57 subjects hospitalized with stroke and fracture. Balance tests were measured at discharge, and the incidence of falls was investigated 6 months after discharge. For each test, the ceiling effect and skewness were quantified. The receiver operating characteristic curve was used to identify area under the curve (AUC), sensitivity, and specificity for predicting falls.
Results: A ceiling effect and deviation in bias in the distribution were identified only on BBS. For fall prediction accuracy, AUC and sensitivity were highest with the Mini-BESTest, and specificity was highest with the BBS.
Conclusion: These results suggest the Mini-BESTest allows more detailed evaluation of balance ability than the BBS and offers moderate accuracy for predicting falls.

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Purpose: We aimed to investigate the sustainability of the effects of exercise therapy combined with environmental adjustment on patients with chronic schizophrenia and drug-induced extrapyramidal symptoms.
Subjects: We studied 24 patients with chronic schizophrenia and drug-induced extrapyramidal symptoms who had been hospitalized in a closed ward of a psychiatric hospital.
Methods: The intervention period was 4 weeks, which included exercise therapy (40 minute exercise sessions at 2 sessions/week, for a total of 8 sessions) combined with environmental adjustment using a video camera and a behavior checklist of patients. Twelve weeks of post-intervention assessment was used to evaluate the sustainability of the effects of combined exercise and environmental adjustment on patient symptoms and physical function.
Results: On completion of the intervention period, negative symptoms were lower and physical function was higher than baseline. However, intervention-related improvements in symptoms and physical activity returned to baseline levels by 8 weeks post-intervention.
Conclusions: The results of the present study suggest that exercise therapy combined with environmental adjustment may be effective for improving negative symptoms and physical function in patients with chronic schizophrenia and drug-induced extrapyramidal symptoms.

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Purpose: For acute stroke rehabilitation, sufficient risk management of clinical conditions and management for complications are important. Particularly, muscle atrophy as a disuse syndrome is often found in patients, presenting an obstacle for reconstructing movement. This study was conducted to ascertain muscle thickness from both the hemiplegia side and non-hemiplegia side immediately after the onset, to elucidate the change over time.
Methods: Ten patients with hemiplegia caused by first stroke were examined within 24 hours after onset. Measurement items include the muscle thickness of hemiplegia and non-hemiplegia sides (vastus lateralis (VL) and tibialis anterior (TA)), circumference (thigh circumferences of 5 cm and 10 cm; low knee circumference). Measurement dates were the seven successive days from the first day of illness to the seventh day, and then the 14th day, the 21st day, and the 28th day.
Result: The decreased muscle thickness, of which random errors of VL and TA were greater than 1 mm and 2 mm, respectively, had occurred on both the hemiplegia side and non-hemiplegia side from the second day of illness and persisted until the 28th day of illness. Two way lay-out disperse analysis revealed no interaction of the day of illness by measured position but a main effect on VL and TA on the days of illness (p < 0.05). As for the thigh circumferences, the main effect was accepted between firstday of illness and a measurement limb．As for the leg circumferences, the main effect was accepted on a day of illness (p < 0.05).
Conclusions: These findings suggest that patients of acute hemiplegia manifest disuse syndrome very early, irrespective of motor paralysis to cause muscle atrophy. Therefore, acute rehabilitation for disuse syndrome prevention should be conducted sufficiently under strict risk management in both sides with and without hemiplegia immediately after onset.

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