Work beliefs and experiential learning among proficient physical therapists in Japan: developing a method to support belief formation.

[Purpose] This study aimed to elucidate the content of work beliefs related to proficiency among physical therapists in Japan. [Participants and Methods] Participants included 50 therapists who met the definition of proficiency to participate in a questionnaire survey conducted between October 2017 and March 2019. Participants were asked to freely describe their daily work beliefs, including their thoughts, values, and ideals. This content was coded and categorized using open coding; a hierarchical cluster analysis (Ward's method) was conducted of the proficient therapists with the individuals and belief categories as the variables. All belief categories were classified into three groups. [Results] Three work beliefs were identified as follows: 1) practices that emphasize building relationships in the field, 2) broad practices with physical therapist pride (responsibility and enthusiasm), and 3) practices with awareness of treatment outcomes and social benefits. [Conclusion] A better understanding of the three aforementioned work beliefs would facilitate good support for and development of physical therapists. We recommend continuing to elucidate the three work beliefs identified among proficient therapists and verify their educational effects.

The recovery time required for rat joint contractures treated with joint fixation with unweighting of the hind limbs.

[Purpose] The purpose of this study was to investigate whether the recovery period of joint contractures differ between treatments with joint fixation with unweighting of the hind limbs and joint fixation alone. [Subjects and Methods] Twelve 10-week-old male Wistar rats were divided into a group with joint fixation of the right ankle joints in full plantar flexion for 1 week (F) and a group with joint fixation and hind limb suspension (FS). Thereafter, the rats were removed from the joint fixation and hind limb suspension for 2 weeks. The ankle dorsiflexion angles during the recovery process of the joint contractures were measured. [Results] The ankle dorsiflexion angles of the F group from the day joint fixation was removed to the seventh recovery day were significantly lower than the pre-experiment values. The ankle dorsiflexion angles of the FS group from the day joint fixation and hind limb suspension were removed to the 10th recovery day were significantly lower than the pre-experiment values. [Conclusion] We found that the period required for the recovery of joint contractures treated with joint fixation with unweighting of the hind limbs was longer than that with joint fixation alone.

Effects of joint immobilization and hindlimb unloading on collagen fibers of soleus muscles in rats.

[Purpose] The purpose of this study was to determine whether collagen fibers cause a difference in a contracture resulting from a combination of joint fixation and hindlimb unloading as compared to joint fixation only. [Subjects and Methods] The subjects of this study were 21 female Wistar rats divided into 4 groups as follows: Control Group (CON, n=7); Joint Fixation Group (JF, n=7), Hindlimb Unloading Group (HU, n=7), Joint Fixation Plus Hindlimb Unloading Group (JF+HU, n=7). This study was conducted for 1-week. Ankle joint range of motion and positive areas of collagen using fluorescent stain were analyzed. [Results] Ankle joint range of motion in JF + HU showed an increase compared to that of JF. Positive areas of Type I collagen in JF+HU showed an increase as compared with that of JF. [Conclusion] The results of this study suggested that the difference in a contracture caused by only joint immobilization and by a combination of joint immobilization and hindlimb unloading were significantly associated with Type I collagen.

A study of the relationships of changes in pain and gait after tourniquet-induced ischemia-reperfusion in rats.

[Purpose] The purpose of this study was to determine the relationships of changes in pain and gait after ischemia reperfusion was induced by tourniquet in rats. [Subjects and Methods] The subjects were six ten-week-old male Wistar rats. Ischemia was induced in the left lower limbs of the experimental rats at a pressure of 300 mmHg for 90 minutes. Pain behavior evaluations were measured using the von Frey test in all the rats' hind limbs. A consistently increasing plantar stimulus was applied until the rats exhibited an escape behavior. For the evaluation of gait, a two-dimensional motion analysis system was used to measure the distance from the calcaneus to the floor (DCF) and toe extension angle (TEA) during gait. The evaluations were performed in the normal state, 3 hours after ischemia-reperfusion, and daily until 7 days after ischemia-reperfusion. [Results] Compared with the normal state, the means of the pain threshold showed a significant decrease until 4 days after ischemia. In addition, both TEA and DCF continued to show a significant decrease at 7 days after ischemia as compared with the normal state. [Conclusion] This study revealed that hyperalgesia occurs after ischemia-reperfusion, and recovery of hyperalgesia occurred earlier than gait dysfunction recovery.

Effects of skin stretching without joint movement on skin extensibility of rats.

[Purpose] This study examined the possibility of maintaining skin extensibility by stretching the skin involved in disuse joint contracture. [Subjects and Methods] The study was carried out using 18 male Wistar rats. The rats were randomly allocated to three groups. The control group received no intervention for the right ankle joint, the fixation group received one-week's fixation of the right ankle joint in maximum plantar-flexion with a cast, and the stretching group received continuous stretching of the skin over the Achilles tendon for 30 min once daily for one week with the cast removed during the skin stretching, but the joint was not moved. On the final day, skin extensibility of the skin from the posterior aspect of the ankle joint was determined using a tensile strength tester and a length-tension curve. [Results] Statistical analysis of the data revealed significant differences in the skin extensibility among the three groups. The stretching group showed significantly greater improvement of skin extensibility than the fixation group. [Conclusion] Skin stretching without moving the joint was demonstrated to be useful for maintaining skin extensibility.

Study on changes in skin extensibility during the development of joint contracture due to joint immobilization in rats.

[Purpose] The purpose of this study was to elucidate whether skin extensibility decreases when a contracture develops as a result of joint immobilization. [Subjects] This study was conducted on six female Wistar rats. [Methods] The rats were divided into two experimental groups. In the immobilized group, the right ankle joints were immobilized in complete plantar flexion by plaster casts for two weeks. In the control group, the left ankle joints had no intervention. On the final day, skin extensibility was determined from a length-tension curve by collecting skin from the posterior aspect of the ankle joint and using a tensile strength tester. [Results] Compared with the control group, the immobilized group showed a significant decrease in skin extensibility. [Conclusion] The results demonstrated that the extensibility of the skin itself decreases when joint contracture develops.

Effect of stretch on improvement of muscular contractures in rats.

[Purpose] The purpose of this study was to investigate how a stretching torque affects muscular contractures. [Subjects] The subjects of this study were 48 male Wistar rats. [Methods] Subjects were divided into 4 groups as follows: Group 1 was the control; Group 2 had muscles in continuous fixation; Group 3 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 0.3N for a period of 30 minutes after continuous fixation; and Group 4 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 3.0N for a period of 30 minutes after continuous fixation. Joint fixation periods were for 2 and 4-weeks. Ankle joint range of motion and soleus flexibility were analyzed. [Results] For the 2-week joint fixation, soleus flexibility in Group 4 showed an increase compared with that of Group 3. For both fixation periods, range of motion in Group 4 showed an increase compared with that of Group 3. [Conclusion] For both fixation periods, stretching improved joint range of motion. In the 2-week joint fixation, soleus flexibility improved. However, soleus flexibility did not improve in the 4-week joint fixation.

Preventive effects of antioxidants and exercise on muscle atrophy induced by ischemic reperfusion.

[Purpose] This study aimed to determine whether muscle atrophy induced by ischemic reperfusion injury in rats can be prevented by the administration of antioxidants and exercise. [Subjects] Rats were randomly divided into five groups: non-treated, ischemic, exercise, ascorbic acid and exercise, and tocopherol and exercise. [Methods] The relative weight ratio of the soleus muscle and the length of the soleus muscle fiber cross-section minor axis were used for the evaluation of muscle atrophy. Pain was assessed as the weight-bearing ratio of the ischemic side. A multiple comparison test and the paired t-test were used for the statistical analyses. [Results] Compared with the non-treated group, the relative weight ratios of the soleus muscle and the lengths of the soleus muscle fiber cross-section minor axis significantly decreased in the other groups. Excluding the non-treated group, the relative weight ratios of the soleus muscle were heaviest in the tocopherol and exercise group. Excluding the non-treated group, the lengths of the soleus muscle fiber cross-section minor axis were longest in the tocopherol and exercise group, followed by the ischemic, exercise, and ascorbic acid and exercise groups. The amount of antioxidant substances did not decrease on the weight-bearing ratio of the ischemic side. [Conclusion] In this study, using an experimental rat model, we confirmed that antioxidants and exercise effect muscle atrophy induced by ischemic reperfusion. The results show that muscle regeneration was facilitated by phagocytosis in the tocopherol and exercise group.

Effect of skin resection on the improvement of joint contractures in rats.

The effect of skin resection on joint contracture was determined by comparing the first measurement of range of motion after cast removal and the second measurement after the skin resection. This study aimed to verify that both the joint movement during the measurement and skin affect range of motion. [Subjects] Twelve female Wistar rats were used. [Methods] The right hind limb ankle of each rat was immobilized in complete plantar flexion in a cast. In the resection group (n = 6), the skin of the right hind limb ankle was removed surgically, but not in the non-resection group (n = 6). In the resection group, the first measurement of the dorsiflexion angle was obtained after the cast was removed, and the second measurement was obtained after skin resection. In the non-resection group, both measurements of the dorsiflexion angle were obtained soon after the cast was removed. [Results] Compared with the non-resection group, the resection group showed a significant increase between the first and second measurements of range of motion. [Conclusion] These results show that range of motion is substantially affected by skin, in addition to joint movement, during measurement.

Effect of an Intermittent Eight-hour Joint Fixation Period on Joint Contractures in Rats.

[Purpose] It has been shown that an eight-hour joint fixation daily (i.e. for the remaining 16 hours, rats were set free in the cage without joint fixation) for one week induces a joint contracture. The purpose of this study was to investigate the difference between an 8 hours continuous joint fixation and an 8 hours intermittent joint fixation per day (two 4 hours joint fixations) in the development of joint contractures in rats. [Subjects and Methods] The subjects of this study were 34 Wistar rats. On the first day, all of the rats' right ankle dorsiflexion angles were measured. The right hind limbs of all the rats were fixed in plantar flexion, and then the rats were divided into three groups as follows: Group 1 was in continuous fixation for 24 hours a day; Group 2 was in continuous fixation for 8 hours a day; Group 3 was in intermittent fixation for 8 hours a day. The fixation was performed daily for seven consecutive days. On the last day, ankle dorsiflexion angles of all the rats were measured after the casts had been removed. [Results] The development of joint contractures was statistically significant for Groups 1 and 2. [Conclusion] Our results indicate that 8 hours a day of continuous fixation induces a joint contracture, but 8 hours a day of intermittent fixation does not.