The relationship between the ratio of the supraspinatus muscle thickness measured by ultrasound imaging and glenohumeral subluxation in stroke patients: a cross-sectional study.

Introduction: Glenohumeral subluxation (GHS) is a common complication in stroke patients with hemiplegia, occurring in approximately 17-81% of cases. This study aims to evaluate the relationship between shoulder muscle thickness and the degree of subluxation using ultrasound imaging. Methods: A cross-sectional study of 61 stroke patients with hemiplegia was conducted, measuring supraspinatus muscle thickness, deltoid muscle thickness, and acromion-greater tuberosity (AGT). Logistic regression and ROC analyses were used. ROC curves, calibration plots, and decision curves were drawn on the training and validation sets. Results: According to logistic regression analysis, the ratio of supraspinatus muscle thickness was statistically significant (OR: 0.80; 95% CI: 0.70-0.92; p < 0.01), and it was an independent factor for evaluating the presence or absence of GHS. An AUC of 0.906 (95% CI, 0.802-1.000) was found in the training set; meanwhile, the AUC in the validation set was 0.857 (95% CI, 0.669-1.000), indicating good performance. According to the training set ROC curve, the most effective statistical threshold was 93%, with a sensitivity of 84% and a specificity of 96%. Discussion: The ratio of supraspinatus muscle thickness is a valuable criterion for evaluating GHS risk, supporting targeted rehabilitation interventions.

Short-term intervention effect analysis of neuromuscular joint facilitation in patients who experienced stroke with shoulder subluxation: a clinical randomized controlled trial.

[Purpose] Shoulder subluxation is a common complication of acute stroke that affects clinical rehabilitation training and hinders the recovery of upper limb motor function. This study explored the short-term interventional effects of neuromuscular joint facilitation in patients who experienced stroke with shoulder subluxation. [Participants and Methods] We recruited 36 patients who experienced stroke with shoulder subluxation. All patients were randomly divided into two groups: the neuromuscular joint facilitation group (n=18) and the control group (n=18). The control group underwent routine rehabilitation treatment. The intervention in the neuromuscular joint facilitation group involved neuromuscular joint facilitation of the shoulder joint in four modes based on conventional rehabilitation treatment. Four different interventions were administered. The thickness of the supraspinatus muscle and the acromion-greater tuberosity distance were measured using ultrasound to observe the curative effect. [Results] In neuromuscular joint facilitation group, the thickness of supraspinatus muscle, acromion-greater tuberosity distance and acromion-greater tuberosity distance difference were significantly different before and after intervention. In the control group, there were no significant difference before and after intervention. [Conclusion] Neuromuscular joint facilitation intervention improved the thickness of the supraspinatus muscle, shortened the distance between the acromion and the greater tubercle, and improved shoulder subluxation in patients who experienced stroke.

Symptom recurrence and associated factors in postoperative patients with lumbar degenerative disease.

[Purpose] This study aimed to examine gradual changes in and relationships among preoperative and 3-month postoperative endpoints in patients with lumbar degenerative disease. [Participants and Methods] The study included 160 diagnosed with lumbar degenerative diseases who underwent surgery. Patients were divided into two groups: "good progress" and "recrudescence". Changes in the Japan Orthpedics Associations (JOA) score, JOA back pain evaluation questionnaire (JOABPEQ), and numeric rating scale (NRS) preoperatively and 3 months postoperatively, and their associations, were analyzed. [Results] Differences were found in preoperative NRS for low back pain, JOA score (other findings) at 3 months postoperatively, and NRS for low back pain at 3 months postoperatively. The causal analysis yielded paths for "daily life", "pain", and "social/psychological aspects", starting with "lumbar spine disorders". [Conclusion] The subjective symptoms, objective findings, lumbar spine dysfunction, gait dysfunction, and numbness at 3 months postoperatively yielded relevant information regarding the participants activities of daily living, pain, and social and psychological aspects, providing a perspective for monitoring postoperative patients.

Minimal Detectable Changes in the Five Times Sit-to-Stand Test in Older Japanese Adults with Sarcopenia Requiring Long-Term Care.

Background and Objectives: Although the importance of sarcopenia control has been suggested, there are no minimal detectable change (MDC) studies of older adults with sarcopenia, to our knowledge, and the criteria for determining the effectiveness of interventions are unknown. The purpose of this study was to calculate the MDC in the five times sit-to-stand test (FTSST) in older Japanese adults with sarcopenia and use it as an index to determine the effectiveness of future interventions. Materials and Methods: This was a cross-sectional study conducted in January and February 2023. The participants of this study were older Japanese adults using daycare rehabilitation. Thirty-eight participants performed the FTSST twice a week. Grip strength, walking speed, and skeletal muscle mass were measured to determine the presence of sarcopenia. The diagnosis of sarcopenia was defined as low skeletal muscle mass and low muscle strength and/or low physical function, based on the Asian Working Group for Sarcopenia 2019 diagnostic criteria. Participants were further classified as sarcopenic or non-sarcopenic. Intraclass correlation coefficients (ICCs) and MDCs were calculated for the overall, sarcopenia, and non-sarcopenia groups using the two FTSST measures. The average and difference of the two variables were used to calculate the MDC. Results: Overall, the ICC (1,1) was 0.94, MDC was 2.87 s, and MDC% was 23.3%. The sarcopenia group had an ICC (1,1) of 0.93, MDC of 3.12 s, and MDC% of 24.0%. The non-sarcopenia group had an ICC (1,1) of 0.95, MDC of 2.25 s, and MDC% of 19.2%. Conclusions: Despite the limitation of the data being only from this study population, we found that a change of ≥3.12 s or ≥24.0% in the FTSST of older adults with sarcopenia was clinically meaningful and may help to determine the effectiveness of sarcopenia treatment. The improvement or decline in older Japanese adults with sarcopenia should be determined by changes in the FTSST over a longer period of time than that for other conditions.

Characteristics of falls and their fear in older adults requiring long-term care.

[Purpose] Older adults requiring long-term care have a higher rate of falls than older adults who do not. This study aimed to examine the relationship between falls and fear of falling and their characteristics from the perspective of older adults requiring long-term care based on a sub-item in the Modified Falls Efficacy Scale. [Participants and Methods] This study included 51 older adults who were certified as needing long-term care. Fear of falling was measured using the Modified Falls Efficacy Scale. The Modified Falls Efficacy Scale and basic information, such as cognitive function, history of falls, level of care required, and age, were collected and analyzed based on the fall or non-fall groups. [Results] The fall and non-fall groups had 27 and 24 participants, respectively. Comparisons between the groups showed significant differences in the Modified Falls Efficacy Scale scores. Binomial logistic regression analysis results showed that "crossing the street (pedestrian crossing)" was significantly associated with falls (odds ratio=0.75). [Conclusion] In this study, falls were associated with fear of falling; specifically, among the Modified Falls Efficacy Scale items, "crossing the street (pedestrian crossing)" was significantly associated with falls.

Students' level of satisfaction with graduation research during the COVID-19 pandemic.

[Purpose] We investigated the effects of the state of emergency declared following the spread of coronavirus disease on the level of satisfaction with graduation research. [Participants and Methods] The study included 320 students who graduated from a university in northern Tochigi Prefecture between March 2019 and 2022. Participants were categorized into the non-coronavirus group (graduation in 2019 and 2020) and the coronavirus group (graduation in 2021 and 2022). Levels of satisfaction with the content and rewards of graduation research were assessed using a visual analog scale. [Results] Levels of satisfaction with the content and rewards of graduation research were >70 mm in both groups and were significantly higher in females in the coronavirus group than in the non-coronavirus group. [Conclusion] The study highlights that despite the pandemic, educational engagement can improve students' satisfaction with graduation research.

Body mass index combined with (waist + hip)/height accurately screened for normal-weight obesity in Chinese young adults.

OBJECTIVES: Only a few studies have explored the prevalence of normal-weight obesity in young adults or the development of a simple evaluation index for body fat percentage. Therefore, this study aimed to examine the prevalence of normal-weight obesity in young Chinese adults and use anthropometric measurements to develop an evaluation index. METHODS: In total, 1322 college students participated in the study and were divided into the normal-weight lean, normal-weight obese, and overweight and obese groups based on their body mass index and body fat percentage. The differences in body composition, circumference, and circumference ratio among these three groups were examined. RESULTS: When exploring the correlation between the circumference ratio and body fat percentage, the circumference ratio was suitable for early screening of abnormal body fat percentage, and the cutoff value was calculated. Body composition and circumference were significantly different among the three groups: (waist + hip)-to-height, hip-to-height, and waist-to-height ratios were strongly correlated with body fat percentage. CONCLUSIONS: (Waist + hip)-to-height ratio can be used as a simple evaluation index for indicating abnormal body fat percentage when higher than 1.032 in male and 1.047 in female individuals. Downregulating the normal upper limit for body mass index to 24.4 and 23.8 kg/m2 in male and female individuals, respectively, is recommended. Body mass index combined with (waist + hip)-to-height ratio allowed for more accurate screening of normal-weight obesity as an easy and cost-free evaluation measure for abnormal body fat percentage.

Characteristics of Japanese Older Adults Whose Trunk Muscle Mass Decreased during the COVID-19 Pandemic.

The coronavirus (COVID-19) pandemic significantly affected the physical and mental functions in older adults, resulting in "corona-frailty". This 2-year prospective study characterized changes in quantitative measures and corona-frailty among a cohort of community-dwelling older women. Changes were evaluated using face-to-face interactions with 39 Japanese women (mean age: 76.1 ± 5.9) in 2019 (pre-pandemic baseline) and 2021 (follow-up during the pandemic). Quantitative measurements of handgrip strength, walking speed, calf circumference, body composition, and background factors were evaluated. Body weight and trunk muscle mass significantly decreased at follow-up. Multiple regression analysis, using change in trunk muscle mass as the dependent variable and background factors as independent variables, identified that decrease in trunk muscle mass was associated with "being robust at baseline" and answering "Yes" to the question of "Do you go out less frequently compared with last year"? The 2-year trunk muscle mass change for each baseline frailty stage showed a significant decrease only in the robust group (-8.0%). The decrease in trunk muscle mass might be related to pandemic-induced lifestyle restraint, suggesting that robust older adults who are healthy and active should take measures that focus on trunk muscles to avoid "corona-frailty".

Body Fat Percentage and Normal-Weight Obesity in the Chinese Population: Development of a Simple Evaluation Indicator Using Anthropometric Measurements.

Few studies explore the associations between body fat percentage (BFP) prediction and evaluation indicators for Chinese with normal-weight obesity. We aimed to explore convenient and cost-free BFP evaluation indicators to routinely monitor BFP status in Chinese patients with normal-weight obesity. Participants (N = 164) were divided into three groups according to body mass index (BMI) and BFP: normal-weight lean, normal-weight obese, and overweight and obese. Differences in body composition and circumference were compared to examine the relationship between BFP and circumference, determine a simple evaluation indicator reflecting BFP, and identify cutoff values for normal-weight obesity circumference. Significant differences in body composition and circumference were observed among the three groups. The correlation between thigh/height, hip/height, (hip + waist)/height, and BFP was stronger than that with BMI. The (hip + waist)/height ratio was the indicator most reflective of BFP (95% confidence interval: 3.004−9.018, p = 0.013), and a ratio above 1.115 (95% confidence interval: 0.936−0.992, p < 0.001) was predictive of normal-weight obesity. Furthermore, we suggest that the upper value for a normal BMI in Chinese individuals be lowered to 23.4 kg/m2 (95% confidence interval: 0.984−0.999, p < 0.001). The (hip + waist)/height ratio can be used with body mass index for a more accurate evaluations of BFP abnormalities and health risks.

Immediate effects of neuromuscular joint-facilitation bridging exercises on walking ability and balance function in stroke patients.

[Purpose] This study aimed to examine the immediate effects of a pelvic neuromuscular joint-facilitation intervention on the walking and balance ability of patients with hemiplegia caused by cerebrovascular accidents. [Participants and Methods] A total of 15 patients with hemiplegia caused by cerebrovascular accidents underwent a neuromuscular joint-facilitation lumbar-pattern intervention (intervention group), a bridge exercise (bridge intervention group), or a neuromuscular joint-facilitation bridge intervention (neuromuscular joint-facilitation bridge group). Each intervention was randomly administered at 7-day intervals. Measurement items included the timed up-and-go test, functional reach test, 10-m maximum walking speed test, and load in the standing position. Measurements were taken before and after the intervention in each group. [Results] The timed up-and-go test result was significantly shorter in the neuromuscular joint-facilitation intervention group. Timed up-and-go test results, functional reach, 10-m walking time, and standing load (non-paralyzed side) significantly improved in the neuromuscular joint-facilitation bridge group. [Conclusion] The neuromuscular joint-facilitation bridge intervention was immediately effective in patients with hemiplegia caused by cerebrovascular accidents and improved their walking and balance ability.

The reliability and effectiveness of shoulder joint evaluation by ultrasonography in stroke patients: deltoid muscle thickness, acromion-humeral distance, acromion-lesser tuberosity distance.

[Purpose] This study aimed to evaluate the reliability of the intraclass correlation coefficient (ICC) in measuring deltoid muscle thickness (DMT) at different angles, acromion-humeral distance (AHD), and acromion nodule tuberosity (ALT) distance in a resting position in stroke patients using ultrasonography. [Participants and Methods] We included 40 stroke patients. During the measurement of parameters by ultrasonography, we measured the deltoid muscle thickness on both sides at three test angles (0°, 30°, and 60° abduction) and AHD and ALT on both sides at 0° angle. The ICC was used to assess intra- and interrater reliability. The relationship between the hemiplegic and non-hemiplegic sides and each angle were analyzed using a two-way repeated-measure analysis of variance (ANOVA). [Results] When the shoulders were at three testing angles (0°, 30°, and 60° abduction), the deltoid muscle thickness of the hemiplegic and non-hemiplegic sides showed good reliability; the AHD and ALT of the shoulder joint at 0° angle equally showed good reliability. There was a significant difference in each abduction angle of the shoulder joint between the thickness of the hemiplegic and non-hemiplegic deltoid. [Conclusion] Measuring deltoid muscle thickness by ultrasonography showed excellent reliability and can be used in stroke patients.

Evaluation of supraspinatus muscle changes in the shoulder joint of stroke patients with hemiplegic and shoulder subluxation using ultrasonography: comparison between affected and unaffected sides.

[Purpose] The shoulder joint has a very unstable structure yet a significantly wide range of motion. Weakness of the muscles around the shoulder joint may cause shoulder joint subluxation. This study aimed to determine changes in supraspinatus muscle thickness between different shoulder abduction angles using ultrasonography and to compare differences in supraspinatus muscle thickness changes between the affected and unaffected sides depending on shoulder joint subluxation. [Participants and Methods] Forty hemiplegic patients with stroke were recruited (20 patients with and 20 without shoulder subluxation). Using ultrasonography, we measured supraspinatus muscle thickness at three shoulder joint abduction angles and calculated the differences in supraspinatus muscle thickness. Depending on subluxation, we separately analyzed the thickness and variations in the supraspinatus muscle on both the affected and unaffected sides. [Results] In stroke patients with shoulder subluxation, the difference in supraspinatus muscle thickness was significantly less in the affected side than in the unaffected side. [Conclusion] The thickness and rate of supraspinatus muscle thickness change was significantly less in the affected side than in the unaffected side in stroke patients with shoulder subluxation.

Effect of hip external rotator muscle contraction on pelvic floor muscle function and the piriformis.

INTRODUCTION AND HYPOTHESIS: There is a lack of in-depth understanding of the muscles surrounding the pelvic floor muscle (PFM). The study aimed to investigate the functional relationship between PFM and hip external rotator muscles by observing the piriformis muscle thickness and displacement of the bladder base under different contraction conditions of the hip external rotator and/or PFM. We hypothesized that PFM function would be the strongest when the hip external rotator and PFM contracted simultaneously and that during PFM contraction, the piriformis muscle would act as an auxiliary muscle and show coactivation. METHODS: The participants included 13 healthy adult women (mean age 23.8 ± 2.8 years). The three contraction conditions were PFM contraction, hip external rotator contraction, and simultaneous contraction of the hip external rotator and PFM. During the tasks, the piriformis muscle thickness and bladder base displacement were measured using ultrasonography and compared among the contraction conditions using one-way analysis of variance. RESULTS: Significant differences were noted in bladder base displacement among the three contraction conditions (P < 0.01), with PFM contraction having the highest value. The piriformis muscle thickness showed the greatest increase in simultaneous contraction. CONCLUSIONS: In our study, we showed PFM contraction positively influences piriformis contraction, while PFM function operationalized by bladder base displacement was highest during PFM contraction alone.

Curative effect of long-term intervention using a new device in patients with chronic low back pain.

[Purpose] This study aimed to observe the changes in the thickness of the transverse abdominis muscle after long-term training with a new device using ultrasound imaging and to determine the impact of these changes on chronic low back pain (CLBP). [Participants and Methods] This study included 60 participants with CLBP, who were divided into groups that adopted different positions during the training regimen: new device intervention group (NDG), sitting training group (STG), and supine training group (SPTG). Patients in the NDG used the new device during training. We measured the thickness of the transverse abdominis muscle and determined the pain level using the visual analog scale (VAS). [Results] After 8 weeks of training, the thickness of the transverse abdominis muscle changed in all the three groups, with the change being significantly greater in the NDG than in the other groups. Additionally, the VAS results indicated that the pain relief was highest when the new device was used. [Conclusion] The thickness of the transverse abdominis muscle increased the most in patients who were trained with the new interventional device, and the CLBP was significantly relieved in them.

Analysis of the relationship between the transversus abdominis and lower back pain using an ultrasound.

[Purpose] This study aimed to observe the thickness of the transverse abdominis muscle in different contraction states using ultrasound, and to investigate the diagnostic capability of transverse abdominal muscle thickness for nonspecific lower back pain. [Participants and Methods] This study included 108 healthy adults (30-50 years old), consisting of 33 participants with low back pain (13 males, 20 females; defined as those who had experienced low back pain for more than six months) and 75 participants without low back pain (22 males, 53 females). The body mass index, body trunk muscle mass, and transverse abdominal muscle thickness, measured at a static state, during the end of inspiration, end of expiration, transverse abdominis contraction, and simultaneous pelvic floor and transverse abdominis muscle contraction, were measured. [Results] Chronic low back pain was correlated with the transverse abdominis muscle thickness during simultaneous transverse abdominis and pelvic floor muscle contraction. [Conclusion] The thickness of the transverse abdominis muscle during simultaneous transverse abdominis and pelvic floor muscle contraction was a viable diagnostic index for evaluating the degree of chronic lower back pain.

Student satisfaction with initiatives for the national examination during the COVID-19 pandemic.

[Purpose] To examine the impact of the state of emergency declared with the spread of coronavirus disease (COVID) on the initiatives for the national examination. [Participants and Methods] The participants were 257 students who graduated from the International University of Health and Welfare, in March of the years 2019-2021 (non-COVID group; graduation in 2019 and 2020, COVID group; graduation in 2021). The levels of satisfaction with the department's initiatives, test scores, and frequency of mock examinations were assessed using a visual analog scale. [Results] The COVID group was significantly more satisfied with the department's initiatives and frequency of mock examinations than the non-COVID group. [Conclusion] The results suggest that despite the pandemic, it is possible to improve student satisfaction through measures to familiarize students with the examination.

Effects of inner muscle resistance exercise on stress urinary incontinence: a randomized clinical controlled trial.

[Purpose] This study investigated the effects of co-contraction resistance exercises of the transverse abdominal and pelvic floor muscles in middle-aged females with stress urinary incontinence. [Participants and Methods] We included 32 females with stress urinary incontinence and divided them into two groups: the inner muscle training group and the pelvic floor muscle group. The thickness of the transverse abdominal muscle was measured during four tasks: (1) rest, (2) maximum contraction of the transverse abdominal muscle, (3) maximum contraction of the pelvic floor muscle, and (4) maximum co-contraction of the transverse abdominal and pelvic floor muscles. In the latter three tasks, measurements were obtained while the participants performed resistance movements using a Thera-band®. A home program was conducted in both groups, and the intervention lasted for 8 weeks. [Results] The cure rates for SUI were 87.5% and 68.8% in the inner muscle training and pelvic floor muscle groups, respectively. After the intervention, the thickness of the transverse abdominal muscle significantly increased in the inner muscle training groups performing maximum co-contraction of the transverse abdominal and pelvic floor muscles and maximum contraction of the transverse abdominal muscle. [Conclusion] Inner muscle training exercises are more effective than pelvic floor muscle exercises in improving inner muscle function and urinary incontinence in middle-aged females.

The effects of neuromuscular joint facilitation treatment using neck patterns on the acoustic analysis of swallowing sounds in healthy adults.

[Purpose] We aimed to investigate the changes in the swallowing sounds of healthy adults during neuromuscular joint facilitation treatment using neck patterns. [Participants and Methods] A total of 20 healthy adults (10 males and 10 females; mean age, 29.2 ± 6.3 years) swallowed 10 mL of water four times under three conditions (after the neuromuscular joint facilitation neck-flexion resistance pattern, after the Shaker-type exercise, and during relaxed sitting without prior exercise [control]), randomly ordered with an interval greater than 3 days. Swallowing sounds for each water swallow were recorded using cervical auscultation. [Results] The mean amplitude of swallowing sound intensity and the mean spectral frequency were significantly higher after the neuromuscular joint facilitation neck-flexion resistance pattern and the Shaker-type exercise, in comparison with those in the control group. [Conclusion] Neuromuscular joint facilitation training with the neck-flexion resistance pattern influenced swallowing sounds to the same degree as the Shaker-type exercise, implying that this resistance pattern may enhance suprahyoid muscle contraction.

Measurement reliability and cooperative movement of the pelvic floor and transverse abdominal muscles.

[Purpose] This study examined the measurement reliability and cooperative movement of the pelvic floor and transverse abdominal muscles. [Participants and Methods] The participants were seven healthy adult females. Transverse abdominal muscle thickness and bladder floor elevation were measured under the following conditions during active exercise and during resistance exercise: the resting state, maximum contraction of the transverse abdominal muscle, maximum contraction of the pelvic floor muscle, and maximum co-contraction of the transverse abdominal and pelvic floor muscles. Measurements were taken at rest and under each exercise condition. [Results] The intraclass correlation coefficients of transverse abdominal muscle thickness and bladder floor elevation showed high reproducibility under all conditions. The maximum contraction of the pelvic floor muscle showed a high correlation with the maximum co-contraction of the transverse abdominal muscle and pelvic floor muscle during resistance exercise. A significant regression line was found between transverse abdominal muscle thickness and bladder floor elevation under all conditions. The regression equation was as follows: transverse abdominal muscle thickness=0.113 bladder floor elevation+0.377 (r2=0.21). [Conclusion] This study demonstrated that the measurement reliability of the transverse abdominal and pelvic floor muscles is high, and that both muscles exhibit cooperative movement.

Effect of the COVID-19 lockdown period on the physical condition, living habits, and physical activity of citizens in Beijing, China.

[Purpose] We aimed to explore the effects of the COVID-19-induced lockdown in Beijing. [Participants and Methods] We distributed a web-based questionnaire survey among 1,029 Beijing citizens to inquire about their physical condition, living habits, and physical activity before and during home isolation. [Results] In the context of forced home isolation due to COVID-19, both males and females reported reductions in daily steps and weekly exercise time and significant increases in daily physical activity time and daily sitting time. The proportions of smokers, patients with metabolic syndrome, and patients with internal diseases were higher in males than in females; females had lower daily step counts and spent more time sitting. [Conclusion] The COVID-19 lockdown affected the physical condition, living habits, and physical activity of both males and females; females were more affected than males. People should be cognizant of the various effects of COVID-19 lockdowns on the body. We recommend a reasonable diet and appropriate home exercise. There is a need to develop training methods and evaluation tools for home exercises in COVID-19 lockdowns.