Yoshitaka Otani

Relationships between Gross Motor Abilities and Problematic Behaviors of Handicapped Children in Different Age Groups

[Purpose] In this study, we examined problematic behaviors of independent-walking and non-independent-walking handicapped children in the infant, school child and adolescent development phases, using the Japanese version of the Aberrant Behavior Checklist (ABC-J) to determine if such behaviors relate to their gross motor abilities. [Subjects and Methods] The subjects were 86 handicapped children who were receiving physical therapy. The subjects were classified into three groups by age. Using the Gross Motor Function Classification System (GMFCS), each group was further divided into an independent-walking group and non-independent-walking group. Thirteen physical therapists and 8 occupational therapists, who were treating the subject children, rated the subjects using the ABC-J. [Results] Significant differences were observed between the independent-walking and the non-independent-walking groups in the stereotypy and lethargy scores of infants. [Conclusion] For schoolchildren and adolescents, no significant differences were observed between the independent-walking and the non-independent-walking groups in their problematic behavior scores.

The effects of various visual conditions on trunk control during ambulation in chronic post stroke patients

Downward gazing is commonly observed among patients after a stroke during standing or walking as they struggle to maintain equilibrium. In this study, we aimed to evaluate the effects of fixed gazing and downward gazing on trunk control ability during gait. Sixteen subjects after a stroke (age: 51.3±4.9years) and seven healthy subjects (age: 65.1±3.4years) participated in this study. Participants walked 10m at a comfortable speed while they faced forward (no gaze point), gazed forward (with a fixed gaze point), gazed downward, and gazed downward while concealing their legs. Trunk acceleration was measured using tri-axial accelerometers attached to the back of the upper (C7 spinous process) and lower (L3 spinous process) trunk. The coefficient of attenuation (CoA) of acceleration at the trunk was computed to assess trunk control ability. Results in the stroke group showed that the CoA during fixed-point and downward gazing was better than that while facing forward with no gaze point (p<0.001). In the stroke group, the CoA during gazing downward with their legs concealed was worse than that during downward gazing. Our findings indicate that patients after a stroke might use visual information for reducing their neck oscillation (C7) during fixed-point and downward gazing. Our results indicate that the visual information during downward gazing might work the same as during fixed-point gazing.

Relationships between problematic behaviors and motor abilities of children with cerebral palsy.

[Purpose] This study aimed to examine whether motor abilities of children with cerebral palsy are related to their problematic behaviors. [Subjects] The subjects were children with mental retardation who were undergoing physical therapy. [Methods] Twenty-one examiners, 13 physical therapists, and 8 occupational therapists treated and examined the subjects by using the Japanese version of the Aberrant Behavior Checklist. The Japanese version of the Aberrant Behavior Checklist scores were compared between the Gross Motor Function Classification System I to III (12 subjects) and Gross Motor Function Classification System IV and V groups (17 subjects). [Results] Lethargy and stereotypy scores significantly differed between the groups, proving that patients with Gross Motor Function Classification System levels IV and V have more severe problematic behaviors. [Conclusion] In this study, only five types of problematic behaviors, namely irritability, lethargy, stereotypy, hyperactivity, and inappropriate speech, were examined. Despite this limitation, the study clarifies that problematic behaviors of children with cerebral palsy, except lethargy and stereotypy, have little relationship with their motor abilities.

Effect of Eye-Object Distance on Body Sway during Galvanic Vestibular Stimulation

Gazing at objects at a near distance (small eye-object distance) can reduce body sway. However, whether body sway is regulated by movement in the mediolateral or anteroposterior direction remains unclear. Galvanic vestibular stimulation (GVS) can induce body tilting in the mediolateral or anteroposterior direction. This study examined the directionality of the eye-object distance effect, using body-tilting GVS manipulations. Ten healthy subjects (aged 21.1 ± 0.3 years) stood on a force plate covered with a piece of foamed rubber and either closed their eyes or gazed at a marker located 0.5 m, 1.0 m, or 1.5 m in front of them. The GVS polarities were set to evoke rightward, forward, and backward body tilts. To compare the effects of eye-object distance in the mediolateral and anteroposterior directions, the root mean square (RMS) of the center of pressure (COP) without GVS was subtracted from the COP RMS during GVS. For swaying in the mediolateral direction, significant visual condition-related differences were found during rightward and forward GVS (p < 0.05). Thus, reductions in mediolateral body sway are more evident for smaller eye-object distances during rightward GVS. It would be appropriate to use body-tilting GVS to detect the directionality of the eye-object distance effect.

Comparison of physical activities of female football players in junior high school and high school

[Purpose] This study aimed to compare physical activities between junior high school and high school female football players in order to explain the factors that predispose to a higher incidence of sports injuries in high school female football players. [Subjects and Methods] Twenty-nine female football players participated. Finger floor distance, the center of pressure during single limb stance with eyes open and closed, the 40-m linear sprint time, hip abduction and extension muscle strength and isokinetic knee flexion and extension peak torque were measured. The modified Star Excursion Balance Test, the three-steps bounding test and three-steps hopping tests, agility test 1 (Step 50), agility test 2 (Forward run), curl-up test for 30 seconds and the Yo-Yo intermittent recovery test were performed. [Results] The high school group was only significantly faster than the junior high school group in the 40-m linear sprint time and in the agility tests. The distance of the bounding test in the high school group was longer than that in the junior high school group. [Conclusion] Agility and speed increase with growth; however, muscle strength and balance do not develop alongside. This unbalanced development may cause a higher incidence of sports injuries in high school football players.

The role of physical therapists in introducing assistive products for the home-bound elderly disabled.

[Purpose] This study explored the roles of physical therapists (PTs) in introducing assistive products, which are essential for living securely and stably at home, and examined how PTs can fulfill these roles more efficiently and effectively. [Subjects and Methods] A questionnaire on introducing assistive products was administered to PTs working at randomly selected hospitals, health-care facilities for the elderly requiring long-term care, home-visit nursing stations, and other such facilities and to PTs providing physical therapy directly to the home-bound elderly disabled. The subjects of the study were 77 PTs who returned valid responses. [Results] For awareness of systems for assistive product’s introduction, PTs were more aware of the system based on the Long-Term Care (LTC) Insurance Act than the system based on the Act on Welfare for the Home-Bound Elderly Disabled. For PTs handling assistive product’s introduction for the home-bound elderly disabled, approximately 91% of the respondents answered that they had handled some cases of assistive product’s introduction, and PTs with longer clinical experience had handled more assistive product’s introduction cases. [Conclusion] The results demonstrated that PTs understand the work involved in introducing assistive products work well and that they handle it. The results, however, also suggested that educational and operational improvements are urgently required for PTs introducing assistive products essential for the lives of the home-bound elderly disabled.