Purpose: There has been increasing clinical interest in the quantification of daily physical activity (PA) in patients with lung cancer. However, it has not often been measured in patients undergoing lung surgery. We aimed to investigate the changes and factors related to perioperative PA in patients who have undergone lung surgery.

Methods: This prospective observational study assessed 40 patients (24 males and 16 females, 69.6 ± 8.6 years old) who had undergone thoracoscopic lung resection. Outcome measures included pulmonary function, motor function, health-related quality of life, and PA. PA was measured with a three-axis accelerometer at four timepoints: preoperatively at home, perioperatively at the inpatient ward, after discharge, and two months after surgery. We examined the association between preoperative factors and recovery rate of PA.

Results: The number of steps was significantly lower at the inpatient ward and after discharge than preoperatively at home, but it recovered two months after surgery. Oxygen desaturation during the 6-min walk test was independently associated with recovery rate of PA.

Conclusion: PA was recovered within two months after thoracoscopic lung resection. Preoperative exercise-induced hypoxemia may be a useful predictive factor for PA after lung resection surgery.

Purpose: The purpose of this study was to investigate the influence of the severity of the disorder and malnutrition on the number of days for patients who had a stroke to regain independent ambulation, by using a covariance structure analysis.

Methods: The subjects were 116 patients aged >65 years who had a stroke and hospitalized in convalescent rehabilitation wards. The latent variables related to the number of days for regaining independent ambulation consisted of the severity of the disorder and malnutrition in stroke. Based on a path-coefficient analysis and statistically significant differences, we created a hypothetical model connected with the number of days for regaining independent ambulation. The corrected and improved model was used in the covariance structure analysis.

Results: The number of days for regaining independent ambulation was related to the severity of the disorder, but its relationship with malnutrition was not strong in the <75-year age group. It was related to both the severity of the disorder and malnutrition in the >75-year age group. The factor related to malnutrition was dysphagia.

Conclusion: The present study revealed that malnutrition especially effected the number of days for regaining independent ambulation in very elderly people with dysphagia.

Purpose: This study aimed to investigate the effect of delayed shoulder exercise program on the incidence of lymphedema in Japanese patients after breast cancer surgery.

Methods: One hundred fourteen Japanese women who had undergone a surgery for breast cancer participated in this study. Fifty-seven patients started shoulder exercises on the day after operation and the other 57 patients were restricted from performing shoulder exercises for the first 7 postoperative days. The incidence of lymphedema and shoulder movement were compared between groups.

Results: Lymphedema, defined by a limb volume difference of 200 ml or more, was observed in three patients (5.3%) in the early exercise group and in five patients (8.8%) in the delayed exercise group, and there were no significant differences between groups. At discharge, restricted range of motion was significantly larger in the delayed exercise group than in the early exercise group.

Conclusion: Our results suggested that a program of delayed shoulder exercise did not contribute to a decrease in the incidence of lymphedema in Japanese patients after breast cancer surgery.

Purpose: The purpose of this study was to examine the differences in kinematic and kinetic variables during single leg squatting before and after anterior cruciate ligament (ACL) reconstruction using a semitendinosus tendon and a gracilis tendon and the differences between uninjured legs and injured legs.

Methods: The subjects were 11 patients who underwent ACL reconstruction (24.9 ± 6.9 years old, 8 men and 3 women). Using a force plate and a 3-dimensional motion analysis system, we measured knee joint moment ranges of motion (ROM), trunk and lower limbs joint angle on sagittal plane during a single leg squat descent phase before and 9 weeks after ACL reconstruction. We compared the values for uninjured legs and injured legs and also compared the values preoperatively and postoperatively.

Results: Before and after surgery, the knee flexion angle ROM of the injured legs was significantly smaller than that of the uninjured legs, trunk forward flexion ROM of the injured legs was significantly larger than that of the uninjured legs, and knee joint moment ROM of the injured legs was significantly smaller in the extension direction than that of the uninjured legs. The posterior tilt of the pelvis ROM of the injured legs was significantly increased after surgery.

Conclusions: The results showed that knee joint moment ROM was small in the extension direction after surgery and suggested that recovery of knee joint extension function is poor. Factors that affect knee joint moment ROM after surgery are thought to be trunk forward flexion ROM, knee flexion ROM, and posterior tilt of the pelvis ROM. The results suggested the importance of observing single leg squatting.