Purpose To investigate the reliability and validity of the Alberta Infant Motor Scale (AIMS) in Japan, and to determine whether the AIMS score obtained by pediatric physical therapists with different ...levels of experience differed. Subjects The subjects who were assessed were 40 healthy infants (23 males, 17 females) whose parents gave their written consent to participation in this study. Methods 40 healthy children were videotaped and evaluated using the AIMS by three physical therapists who were providing physical therapy for the children on weekdays and three physical therapists who were providing physical therapy for the children once per week. The AIMS and the Kyoto Scale of Psychological Development (KSPD) were administered to confirm criterion-related validity. Results Reliability of the AIMS was good to high (ICC = .86∼.99), and the correlation between the AIMS and the KSPD was high (r = .97∼.98). Physical therapists with little experience in pediatric physical therapy could perform an assessment. Conclusion Both the reliability and the validity of the AIMS were high. Level of pediatric expertise did not affect a rater's reliability.
Purpose The purpose of this study was to clarify the structure of activities of daily living and their characteristics based on the relationship with their difficulty levels and the gaps between the ...actual activity level achieved in daily living (performance ADL) and the potential activity level that can be performed under supervision (capability ADL). Subjects The subjects of this study were 255 stroke patients. Methods Performance ADL and capability ADL were evaluated using the functional independence measure, and the scores were converted to an interval scale by Rasch analysis to compare item difficulty and gaps. Results Scores of performance ADL were lower than those of capability ADL. The gaps between capability ADL and performance ADL on admission had not decreased at the time of discharge. ADL items could be categorized into three difficulty levels of high, moderate and low by interval scales. Some ADL items tended to develop gaps, while others did not. The correlation between difficulty level and the gap was extremely low, and ADL items of higher difficulty did not always have greater gaps. Conclusion We confirmed that the improvement of capability ADL precedes that of performance ADL in the process of ADL improvement.
Stroke patients are at a higher risk of falling than the community-dwelling elderly, and many falls are due to contact with an obstacle. This study compared the effects of the simultaneous addition ...of a cognitive task during obstacle crossing between stroke patients and community-dwelling older adults (control subjects). Participants comprised 20 stroke patients who could walk with or without supervision and 20 control subjects matched for age and height with the stroke patients. Participants were asked to cross a 4-cm-high obstacle while walking at a self-selected speed. The number of failures and the spatial and temporal parameters were compared between a single-task condition (i.e., crossing task only) and a dual-task condition (i.e., verbal fluency task: listing vegetables or animals). Under the dual-task condition, six stroke patients (30%) and three community-dwelling elderly individuals (15%) failed to complete the motor task. Task failure was only due to heel-obstacle contact after toe clearance. In both groups, obstacle-heel distance after clearance was reduced, and the time from heel contact to toe clearance and stride time were significantly increased under dual-task condition versus single-task condition. In addition, group-task interaction for the time from heel contact to toe clearance of the obstacle was significant; this increase in time was significantly greater under dual-task condition in stroke patients than in control subjects. Obstacle crossing in stroke patients involved an increase in crossing performance time and a risk of heel-obstacle contact after crossing. These tendencies appeared stronger under the dual-task condition.
Purpose This study aimed to clarify the current status of physical therapy accident prevention education, and discover how safety education should be addressed at schools. Subjects The subjects of ...this study were 208 people holding positions in schools with a physical therapy program. Methods This study was conducted through an anonymous self-administered postal questionnaire. The details of the survey covered six categories including curriculum and collaboration with clinical training institutes. Results Regarding current curriculum, 77.3% of schools had a description relating to physical therapy accident prevention in their aims and objectives for clinical training and 54.7% indicated a need to improve teaching content so that it is arranged consistently. Regarding collaboration with clinical training institutes, 7.6% undertook collaborative initiatives in accident prevention education, 34% had opportunities for discussion, and 68.6% had arrangements in place for dealing with accidents. Conclusion It is evident that physical therapy schools are lagging behind in medical safety education. With regard to the future of safety education, there are expectations for the establishment of attainment objectives for graduation and consistency in teaching under a specific view, suggesting that awareness of physical therapy accident prevention education will rise.
Purpose To clarify the motor development of healthy infants, we conducted a longitudinal observation survey of healthy Japanese infants. Subjects Healthy infants participated in this study (9 males ...and 5 females age 5-13 months old, birth weight: 2, 474-3, 964 g). Infants belonged to three daycare centers. Method An examiner visited the infants at a daycare center monthly, and examined their motor development using the Alberta Infant Motor Scale (AIMS). Results Eleven infants, out of 14, showed higher AIMS than the average at some ages in months and lower AIMS than the average at some ages. Conclusion The longitudinal survey confirmed that infants have certain periods when they become capable of new movements and other periods when their development stagnates. It also confirmed that the supine sleep position has no influence on infants' motor development acquisition. This suggests that the impact of physiological motor development must be considered when infants receiving PT become capable of new movement.
Purpose This study aimed to examine problematic behaviors of mentally handicapped children receiving pediatric physical therapy, through applying the Japanese version of the Aberrant Behavior ...Checklist(ABC-J) to persons receiving pediatric physical therapy. Subjects Subjects were 26 handicapped children who had received pediatric physical therapy (18 males and 8 females, aged from 1 year and 4 months to 19 years and 10 months). The raters were 5 physical therapists and 1 occupational therapist. Methods The subjects were rated using ABC-J. Results Twenty-four of 26 subjects showed "Irritability", 23 subjects showed "Lethargy", 13 subjects showed "Stereotypy", 23 subjects showed "Hyperactivity", 12 subjects showed "Inappropriate speech". Conclusion "Irritability" "Lethargy" and "Hyperactivity" showed comparatively a stronger tendencies. However, all items were graded high in comparison with reports for Down syndrome. The results of this study suggest that the subjects of pediatric physical therapy show problem in problematic behaviors.
Purpose This study aimed to clarify the current status of physical therapy accident prevention education, and discover how safety education should be addressed at schools. Subjects The subjects of ...this study were 208 people holding positions in schools with a physical therapy program. Methods This study was conducted through an anonymous self-administered postal questionnaire. The details of the survey covered six categories including curriculum and collaboration with clinical training institutes. Results Regarding current curriculum, 77.3% of schools had a description relating to physical therapy accident prevention in their aims and objectives for clinical training and 54.7% indicated a need to improve teaching content so that it is arranged consistently. Regarding collaboration with clinical training institutes, 7.6% undertook collaborative initiatives in accident prevention education, 34% had opportunities for discussion, and 68.6% had arrangements in place for dealing with accidents. Conclusion It is evident that physical therapy schools are lagging behind in medical safety education. With regard to the future of safety education, there are expectations for the establishment of attainment objectives for graduation and consistency in teaching under a specific view, suggesting that awareness of physical therapy accident prevention education will rise.
Purpose: The purpose of this study was to develop a new scale, the Stroke Physical Performance Scale (SPPS), based on the Rasch model. The SPPS evaluates physical performance in a standing position ...and during ambulation related to the activities of daily living (ADL) of stroke patients. Methods: A preliminary scale was developed that consisted of 25 items representing physical performance selected by observation of the ADL. This scale was tested for stroke patients (N = 102) in 2 rehabilitation hospitals using 5-level rating categories. Their responses were analyzed using the Rasch model to select rating categories and items. After the development of the SPPS, we investigated its unidimensionality and reliability. Results: The rating category analysis integrated the category of “supervision” into “light assistance”, so that rating involved 4-level categories. The item selection analysis excluded 9 items, the SPPS therefore became a 16-item scale, which fitted the Rasch model. The SPPS demonstrated good unidimensionality and reliability. Conclusion: The SPPS was constructed as a scale to evaluate physical performance in a standing position and during ambulation related to the ADL of stroke patients. It may be valuable to evaluate changes in physical performance using an interval scale both in a clinical setting and for clinical research.
Objective:
To investigate the feasibility of peripheral sensory nerve stimulation combined with task-oriented training in patients with stroke during inpatient rehabilitation.
Design:
A pilot ...randomized crossover trial.
Setting:
Two rehabilitation hospitals.
Subjects:
Twenty-two patients with subacute stroke.
Interventions:
Participants were randomly assigned to two groups and underwent two weeks of training in addition to conventional inpatient rehabilitation. The immediate group underwent peripheral sensory nerve stimulation combined with task-oriented training in the first week, followed by another week with task-oriented training alone. The delayed group underwent the same training in reverse order.
Main measures:
Outcome measures were the level of fatigue and Wolf Motor Function Test. Patients were assessed at baseline, one and two weeks.
Results:
All participants completed the study with no adverse events. There was no significant difference in level of fatigue between each treatment. From baseline to one week, the immediate group showed larger improvements than the delayed groups in the Wolf Motor Function Test (decrease in mean time (± SD) from 41.9 ± 16.2 seconds to 30.6 ± 11.4 seconds versus from 46.8 ± 19.4 seconds to 42.9 ± 14.7 seconds, respectively) but the difference did not reach significance after Bonferroni correction (P = 0.041). Within-group comparison showed significant improvements in the Wolf Motor Function Test mean time after the peripheral sensory nerve stimulation combined with task-oriented training periods in each group (P < 0.01).
Conclusion:
Peripheral sensory nerve stimulation is feasible in clinical settings and may enhance the effects of task-oriented training in patients with subacute stroke.
Mirror therapy (MT) and electromyography-triggered neuromuscular stimulation (ETMS) are both effective treatments for impaired upper limbs following stroke. A combination of these two treatments ...(ETMS-MT) may result in greater gain than either treatment alone.
The feasibility and possible effects of ETMS-MT upon upper extremity function were investigated in stroke patients.
Thirteen post-acute stroke patients were randomly assigned to an immediate ETMS-MT group or a delayed ETMS-MT group and then underwent an 8-week training program. The immediate ETMS-MT group received ETMS-MT in addition to physical and occupational therapy (PT+OT) for 4 weeks. They then received only PT+OT for the next 4 weeks. In the delayed ETMS-MT group, interventions were provided in the reverse order. The main outcome measure was the Fugl-Meyer Assessment (FMA).
The immediate ETMS-MT group showed significantly greater gain in FMA in the first 4 weeks. The delayed ETMS-MT group showed significantly greater gain in active range of motion during the latter 4 weeks. No adverse effects were reported following ETMS-MT.
ETMS-MT might be as effective as independent MT or ETMS without causing any side effects. Future research should focus upon the direct comparisons between independent and combined interventions.
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