Psychological Factors Mediate the Relationship between Physical Activity and Goal Attainment for Occupational Therapy Practice: An Observational Study in Japan.

Occupational therapy can improve physical activity, anxiety, and goal achievement after high tibial osteotomy. However, the role of psychological factors in physical activity and goal attainment after high tibial osteotomy is unclear. We examined how psychological factors mediate the relationship between physical activity and goal achievement. Participants included 55 individuals post-high tibial osteotomy. Physical activity and performance and satisfaction in everyday tasks had a significant indirect effect on the anxiety and depression. Anxiety and depression mediated the physical activity-goal attainment relationship. Thus, occupational therapy practices focusing on anxiety and depression may be important in post- high tibial osteotomy rehabilitation.

Automatic feature selection for performing Unit 2 of vault in wheel gymnastics.

We propose a framework to analyze the relationship between the movement features of a wheel gymnast around the mounting phase of Unit 2 of the vault event and execution (E-score) deductions from a machine-learning perspective. We first developed an automation system from a video of a wheel gymnast performing a tuck-front somersault to extract the four frames highlighting its Unit 2 performance of the vault event, such as take-off, pike-mount, the starting point of time on the wheel, and final position before the thrust. We implemented this automation using recurrent all-pairs field transforms (RAFT) and XMem, i.e., deep network architectures respectively for optical flow estimation and video object segmentation. We then used a markerless pose-estimation system called OpenPose to acquire the coordinates of the gymnast's body joints, such as shoulders, hips, and knees then calculate the joint angles at the extracted video frames. Finally, we constructed a regression model to estimate the E-score deductions during Unit 2 on the basis of the joint angles using an ensemble learning algorithm called Random Forests, with which we could automatically select a small number of features with the nonzero values of feature importances. By applying our framework of markerless motion analysis to videos of male wheel gymnasts performing the vault, we achieved precise estimation of the E-score deductions during Unit 2 with a determination coefficient of 0.79. We found the two movement features of particular importance for them to avoid significant deductions: time on the wheel and angles of knees at the pike-mount position. The selected features well reflected the maturity of the gymnast's skills related to the motions of riding the wheel, easily noticeable to the judges, and their branching conditions were almost consistent with the general vault regulations.

Effects of Occupational Therapy Practice on Patient Outcomes after High Tibial Osteotomy: A Non-randomized Study in Japan.

We examined the effectiveness of occupational therapy intervention combined with standard rehabilitation in patients undergoing high tibial osteotomy (HTO). Overall, 115 patients with HTO for knee osteoarthritis were examined. An intervention group (n = 50), who received occupational therapy and standard rehabilitation, was compared to a control group (n = 65), who underwent standard rehabilitation only (n = 65). Compared with the control group, the intervention group had significantly lower Hospital Anxiety and Depression Scale depression and anxiety scores (both p < 0.05), with between-group differences showing large- and medium-effect sizes, respectively (d = 1.06 and 0.61). Results suggest occupational therapy with rehabilitation during hospitalization improves depression and anxiety rates in patients post-HTO.

Respiratory function and comfort levels in three different defecatory simulation postures in the elderly.

BACKGROUND: Elderly people experience a heavy physical burden due to deteriorated respiratory function owing to prolonged sitting defecation posture due to constipation. In recent years, to reduce the physical burden of defecation, arm support handrails, which support the arms in a forward-leaning posture, have become more widely available; however, their impact on breathing comfort has not yet been verified. This study's purpose was to compare the respiratory function of elderly people in traditional defecation postures and the arm-supported, forward-leaning position using the handrail, and thus verify whether the supported position has a positive effect. METHODS: The trunk leaning angle, respiratory function, thoracic range of motion, and subjective comfort of 57 healthy elderly people were measured and compared in each of the three sitting defecation postures: upright, forward-leaning, and arm-supported forward-leaning. RESULTS: The arm-supported, forward-leaning position involves a trunk leaning angle of 61.84° ± 7.47°, and vital capacity of the respiratory function, thoracic range of motion (axillary region), and subjective comfort in this position are all shown to be significantly higher than those in the other postures. CONCLUSION: The arm-supported, forward-leaning defecation posture provides a high degree of freedom in the abdomen due to proper forward-leaning, while the upper limb support improves the mobility of the upper thorax, thus ensuring high lung volume. In addition, the increased stability provides a comfortable feeling. Therefore, we conclude that the arm-supported, forward-leaning position is more effective for defecation than the general defecation position.

The effects of a defecation posture, supported by the upper limbs, on respiratory function.

[Purpose] In this study, we aimed to determine which typical postures or an arm-supported posture were more comfortable and conducive to respiratory function, during seated defecation. [Participants and Methods] In 73 healthy adults, we measured and compared respiratory function and subjective contentment associated with 3 sitting defecation postures: upright, forward-leaning, and arm-supported forward-leaning. [Results] Vital capacity (VC), forced vital capacity (FVC), maximal expiratory pressure (MEP), and subjective comfort were significantly greater in the arm-supported forward-leaning position than in the other 2 positions. [Conclusion] The arm-supported forward-leaning position for defection increased the VC and was subjectively comfortable. Moreover, the high MEP in this position, compared with the other 2 positions, may have facilitated strain. A detailed examination of the cause for the observed increase in comfort was beyond the scope of this study; therefore, this effect requires further investigation.

Actual use of and satisfaction associated with rollators and "shopping carts" among frail elderly Japanese people using day-service facilities.

Purpose This study aimed at clarifying the actual use of and satisfaction with rollators and "shopping carts" (wheeled walkers with storage) among frail elderly people, who were certified by a long-term care insurance system as users of facilities that provide day-service nursing care and rehabilitation. Methods We identified 1247 frail elderly people who used day-service facilities, and evaluated their actual use of, and satisfaction with, rollators and shopping carts. Results Forty-four (3.5%) individuals used rollators, and 53 (4.3%) used shopping carts. The shopping cart group contained more individuals who were certified as care level 1 (26.4%), than the rollator group (20.5%), and 52.8% of the shopping cart group was certified as care levels 1-3. The scores for "repairs and services" and "follow-up" from the Quebec User Evaluation of Satisfaction with assistive Technology second version (QUEST 2.0) survey were significantly higher in the rollator group than in the shopping cart group. Conclusions The QUEST 2.0 scores revealed that shopping cart users exhibit insufficient "repairs and services" and "follow-up" scores. As frail elderly people with poor care status accounted for >50% of the shopping cart group, these individuals urgently need walking aids that are tailored to their care status. Implications for Rehabilitation We conclude that walking aid fitting must be tailored to each persons care status, and suggest that a system should be established to allow occupational or physical therapists to provide this fitting Moreover, our analysis of the QUEST2.0 service scores revealed that repairs, services, and follow-up are insufficient to meet the needs of shopping cart users.

Changes in Cerebral Hemodynamics during Complex Motor Learning by Character Entry into Touch-Screen Terminals.

INTRODUCTION: Studies of cerebral hemodynamics during motor learning have mostly focused on neurorehabilitation interventions and their effectiveness. However, only a few imaging studies of motor learning and the underlying complex cognitive processes have been performed. METHODS: We measured cerebral hemodynamics using near-infrared spectroscopy (NIRS) in relation to acquisition patterns of motor skills in healthy subjects using character entry into a touch-screen terminal. Twenty healthy, right-handed subjects who had no previous experience with character entry using a touch-screen terminal participated in this study. They were asked to enter the characters of a randomly formed Japanese syllabary into the touch-screen terminal. All subjects performed the task with their right thumb for 15 s alternating with 25 s of rest for 30 repetitions. Performance was calculated by subtracting the number of incorrect answers from the number of correct answers, and gains in motor skills were evaluated according to the changes in performance across cycles. Behavioral and oxygenated hemoglobin concentration changes across task cycles were analyzed using Spearman's rank correlations. RESULTS: Performance correlated positively with task cycle, thus confirming motor learning. Hemodynamic activation over the left sensorimotor cortex (SMC) showed a positive correlation with task cycle, whereas activations over the right prefrontal cortex (PFC) and supplementary motor area (SMA) showed negative correlations. CONCLUSIONS: We suggest that increases in finger momentum with motor learning are reflected in the activity of the left SMC. We further speculate that the right PFC and SMA were activated during the early phases of motor learning, and that this activity was attenuated with learning progress.

Monitoring Local Regional Hemodynamic Signal Changes during Motor Execution and Motor Imagery Using Near-Infrared Spectroscopy.

The aim of this study was to clarify the topographical localization of motor-related regional hemodynamic signal changes during motor execution (ME) and motor imagery (MI) by using near-infrared spectroscopy (NIRS), as this technique is more clinically expedient than established methods (e.g., fMRI). Twenty right-handed healthy subjects participated in this study. The experimental protocol was a blocked design consisting of 3 cycles of 20 s of task performance and 30 s of rest. The tapping sequence task was performed with their fingers under 4 conditions: ME and MI with the right or left hand. Hemodynamic brain activity was measured with NIRS to monitor changes in oxygenated hemoglobin (oxy-Hb) concentration. Oxy-Hb in the somatosensory motor cortex (SMC) increased significantly only during contralateral ME and showed a significant interaction between task and hand. There was a main effect of hand in the left SMC. Although there were no significant main effects or interactions in the supplemental motor area (SMA) and premotor area (PMA), oxy-Hb increased substantially under all conditions. These results clarified the topographical localization by motor-related regional hemodynamic signal changes during ME and MI by using NIRS.

Excitability of the primary motor cortex increases more strongly with slow- than with normal-speed presentation of actions.

INTRODUCTION: The aim of the present study was to investigate how the speed of observed action affects the excitability of the primary motor cortex (M1), as assessed by the size of motor evoked potentials (MEPs) induced by transcranial magnetic stimulation (TMS). METHODS: Eighteen healthy subjects watched a video clip of a person catching a ball, played at three different speeds (normal-, half-, and quarter-speed). MEPs were induced by TMS when the model's hand had opened to the widest extent just before catching the ball ("open") and when the model had just caught the ball ("catch"). These two events were locked to specific frames of the video clip ("phases"), rather than occurring at specific absolute times, so that they could easily be compared across different speeds. MEPs were recorded from the thenar (TH) and abductor digiti minimi (ADM) muscles of the right hand. RESULTS: The MEP amplitudes were higher when the subjects watched the video clip at low speed than when they watched the clip at normal speed. A repeated-measures ANOVA, with the factor VIDEO-SPEED, showed significant main effects. Bonferroni's post hoc test showed that the following MEP amplitude differences were significant: TH, normal vs. quarter; ADM, normal vs. half; and ADM, normal vs. quarter. Paired t-tests showed that the significant MEP amplitude differences between TMS phases under each speed condition were TH, "catch" higher than "open" at quarter speed; ADM, "catch" higher than "open" at half speed. CONCLUSIONS: These results indicate that the excitability of M1 was higher when the observed action was played at low speed. Our findings suggest that the action observation system became more active when the subjects observed the video clip at low speed, because the subjects could then recognize the elements of action and intention in others.