Agreement in the Postural Assessment of Older Adults by Physical Therapists Using Clinical and Imaging Methods.

Postural assessment is one of the indicators of health status in older adults. Since the number of older adults is on the rise, it is essential to assess simpler methods and automated ones in the future. Therefore, we focused on a visual method (imaging method). The purpose of this study is to determine the degree of agreement between the imaging method and the palpation and visual methods (clinical method). In addition, the influence of differences in the information content of the sagittal plane images on the assessment was also investigated. In this experiment, 28 sagittal photographs of older adults whose posture had already been assessed using the clinical method were used. Furthermore, based on these photographs, 28 gray and silhouette images (G and S images) were generated, respectively. The G and S images were assessed by 28 physical therapists (PTs) using the imaging method. The assessment was based on the Kendall classification, with one of four categories selected for each image: ideal, kyphosis lordosis, sway back, and flat back. Cross-tabulation matrices of the assessments using the clinical method and imaging method were created. In this table, four categories and two categories of ideal and non-ideal (KL, SB, and FB) were created. The agreement was evaluated using the prevalence-adjusted bias-adjusted kappa (PABAK). In addition, sensitivity and specificity were calculated to confirm the reliability. When comparing the clinical and imaging methods in the four posture categories, the PABAK values were -0.14 and -0.29 for the S and G images, respectively. In the case of the two categories, the PABAK values were 0.57 and 0.5 for the S and G images, respectively. The sensitivity and specificity were 86% and 57% for the S images and 76% and 71% for the G images, respectively. The four categories show that the imaging method is difficult to assess regardless of the image processing. However, in the case of the two categories, the same assessment of the clinical method applied to the imaging method for both the S and G images. Therefore, no differences in image processing were observed, suggesting that PTs can identify posture using the visual method.

Estimation of factors contributing to level differences in Japanese university decathlon athletes.

This study aimed to estimate the factors that cause differences in competition level based on the competition performance structure among university student decathletes in Japan. The results of factor analysis using the maximum likelihood method (Oblimin rotation), assuming a five-factor structure estimated from parallel analysis and the information criterion, revealed the following competitive performance structures: "running speed and body projection," "running endurance," "rotational throwing power," "translational throwing power," and "vertical leaping power." Some of these were similar to the competitive performance structures of the world's top athletes, but they were found to have a unique structure: two throwing powers. The analysis results using latent rank theory allowed us to evaluate them on a seven-point scale. The calculated item reference profile, difficulty index, and discrimination index for each rank indicated that shot put and 100 and 400 m performance formed the basis of decathlon performance. In addition, high jump and pole vault, which fall under the category of "vertical leaping power," retained high difficulty and discrimination and were revealed to affect the stage of achievement of overall performance in the decathlon.

Dissociation of perception and motor execution of lower limb in multi-directional movements.

Estimating the action capability is vital for humans to move their bodies successfully. Researchers have proposed reachability as an overestimation of motor abilities by judging unreachable distances as reachable. The existing literature has mainly investigated the sagittal direction, but multi-directional reachability is unexplored. This study examined the relationship between perception and motor using the reaching of the lower limbs in multiple directions. We asked 16 adults to reach targets projected onto the floor at 21 locations (seven directions and three distances) to estimate the reaching time. We found that the reaching time slowed as the direction increased toward the contralateral side, but the subjective reaching time did not change with direction. Multiple regression analysis showed that the subjective reaching time could be calculated accurately, mainly using the duration from the toe leaving the ground to movement completion. These results suggest that changes in direction may not be perceived precisely by the motor system of the lower limbs and that the subjective reaching time was strongly affected by the time after the toe left the ground. Our findings provide novel insights into the relationship between motor and perception in multiple directions, which may provide a new strategy for the maximal performance of lower-limb movement.

Direction and distance dependency of reaching movements of lower limb.

Efficient body movement is required in our daily lives, as it facilitates responding to the external environment and producing movements in various directions and distances. While numerous studies have reported on goal-directed movements in the frontal direction during gait initiation, there is limited research on the efficient movement of the lower limbs in multiple directions and distances. Therefore, we aimed to examine changes in the kinematics of lower-limb reaching movements to determine skilled motor ability in terms of direction and distance. Sixteen adults (10 male participants) were requested to reach targets projected on the floor in seven directions and at three distances for a total of 21 points. The reaching time slowed down for the contralateral side (right foot to left-sided target) and was caused by a slower start of the toe movement. To identify the cause of this delay, we analyzed the onset of movement at each joint and found that movement to the contralateral side starts from the hip, followed by the knee, and subsequently the toe. The time-to-peak velocity was also calculated, and the motion required to reach the target in the shortest time varied depending on direction and distance. These results suggested that movement kinematics vary with direction and distance, resulting in a slower reaching time on the contralateral side. The results of our study hold promise for potential applications in sports and rehabilitation.

Spinal alignment measurement with Kinect sensor is valid for thoracic kyphosis but not for lumbar lordosis.

BACKGROUND: Spinal alignment evaluation is commonly performed in the clinical setting during rehabilitation. However, there is no simple method for its quantitative measurement. Recently, the depth cameras in Kinect sensors have been employed in various commercial and research projects in the healthcare field. We hypothesized that the time-of-flight technology of the Kinect sensor could be applied to quantitatively evaluate spinal alignment. The purpose of this study was to develop a simple and noninvasive evaluation for spinal alignment using the Kinect sensor and to investigate its validity. METHODS: Twenty-four healthy men participated in the study. Measurement outcomes were the thoracic kyphosis and lumbar lordosis angles in the standing position, using a Spinal Mouse, the validity of which has been previously reported, and the Kinect sensor. In the measurement by the Kinect sensor, a program was created to obtain the three-dimensional coordinates of each point within an area marked on the monitor, and the sums of the angles at each vertebral level were calculated for the thoracic and lumbar areas. Pearson's correlation coefficient was used to analyze the relationship between the Kinect sensor and Spinal Mouse measurements of thoracic kyphosis and lumbar lordosis angles. RESULTS: There was a significant positive and moderate correlation between the thoracic kyphosis measurements taken by each device. Contrarily, there was no significant correlation in the lordosis angle between measurements using the Kinect sensor and Spinal Mouse. CONCLUSIONS: Our results demonstrated the validity of measuring the thoracic kyphosis angle using the Kinect sensor. This indicates that the depth camera in the Kinect sensor is able to perform accurate thoracic alignment measurements quickly and noninvasively.

Spine Alignment in Standing and Maximal Upper Limb Elevation in Baseball Players with Lumbar Spondylolysis and Those without Low Back Pain.

The changes in lumbar lordosis angle (LL) and sacral slope angle (SS) related to upper limb elevation and thoracic kyphosis angle (TK) in baseball players with spondylolysis remain unclear. Herein, we investigated baseball players with spondylolysis and those without low back pain, comparing LL and SS with upper limb elevation within and between groups and TK between groups. Baseball players with spondylolysis were enrolled as subjects, and baseball players without low back pain were enrolled as controls (n = 8 each). X-rays were obtained in the standing position and with maximal elevation position of the upper limb (elevation position). LL and SS were measured in the standing and elevated positions, and TK was measured in the standing position. LL was significantly larger in individuals with spondylolysis than controls. The SS of the control group was significantly larger in the elevated position than in the standing position, while the SS of the spondylolysis group was not significantly different between positions. SS was significantly larger in the spondylolysis group than in the control group, only in the standing position. Physical therapy for spondylolysis should focus on hyperlordosis alignment in the standing and maximal elevation positions of both upper limbs, sacral hyper-slope alignment in the standing position, and decreased sacral slope motion.

Effect of quantitative partial valgus stress during baseball pitching on ball velocity and subjective pitch-effort.

BACKGROUND: Excessive elbow valgus stress can often cause pitching elbow injuries, and rehabilitation is usually required before an athlete can resume playing. However, there is a lack of information on the partial load rehabilitation of pitching elbow injuries caused by valgus extension overload based on elbow valgus stress. The purpose of this study was to clarify how quantitative partial elbow valgus stress while pitching affects ball velocity and subjective pitch-effort. METHODS: Forty-six male baseball pitchers participated in this study. Each player wore a wearable device on the elbow that collected their pitch parameters. Ball velocity was measured using a radar gun. Each elbow valgus stress was measured while each player was instructed to throw 5 fastballs at full effort. Then, based on the average stress of the 5 throws (100% partial valgus stress), the 75% and 50% stresses were calculated (75% and 50% partial valgus stress, respectively). Each pitcher continued to pitch until the number of pitches thrown at the targeted elbow stress reached 5. Each player was asked about their subjective pitch-effort after completing each type of partial valgus stress pitch. Outcomes were statistically evaluated using either a 1-way repeated measures analysis of variance or 2-way analysis of variance. RESULTS: The ball velocity was 72% (95% confidence interval [CI], 69%-75%) and 58% (95% CI, 55%-61%) during the 75% and 50% partial valgus stress, respectively (P < .001). Subjective pitch-effort was 41% (95% CI, 38%-44%) and 19% (95% CI, 16%-22%) while pitching at 75% and 50% partial valgus stress, respectively (P < .001). CONCLUSIONS: It may be desirable to instruct pitchers to throw at less than 20% subjective pitch-effort of the max if they want to pitch at 50% partial valgus stress. Elbow valgus stress might correlate with ball velocity at 75% partial valgus stress pitch. These results could enable clinicians and coaches to perform safer return-to-throwing programs and prevent excessive load on the elbow.

Comparison of alignment and spondylolysis fracture angle in bilateral and unilateral spondylolysis.

OBJECTIVES: Spondylolysis occurs bilaterally or unilaterally and bilateral spondylolysis increases the risk of developing isthmic spondylolisthesis. The characteristics of the lumbar lordosis angle (LLA), sacral slope angle (SSA), and spondylolysis fracture angle (SFA) in bilateral spondylolysis compared with those in unilateral spondylolysis have not been clarified. The purpose of this study was to compare the LLA, SSA, and SFA of bilateral and unilateral spondylolysis. MATERIALS AND METHODS: Thirty-eight patients with lumbar spondylolysis who visited our clinic for an initial visit and 15 age-matched patients with a chief complaint of low back pain were included as controls. Computed tomography films were used to classify all spondylolysis patients into two groups: those with bilateral fractures (bilateral) and those with unilateral fractures (unilateral). The LLA and SSA were measured using lateral X-ray films and the SFA was measured using computed tomography films. RESULTS: The LLA was significantly higher in all spondylolysis patients than in the control group (p = .026). There was no significant difference in SSA between the spondylolysis and control groups (p = .28). The LLA was significantly higher in the bilateral group than in the unilateral group (p = .018). There was no significant difference in SSA between the bilateral and unilateral groups (p = .15). The SFA was significantly lower in the bilateral group than in the unilateral group (p = .024). CONCLUSIONS: This study suggests that physical therapy for spondylolysis may be considered bilaterally and unilaterally.

Dynamic three-dimensional shoulder kinematics in patients with massive rotator cuff tears: a comparison of patients with and without subscapularis tears.

BACKGROUND: Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined. METHODS: This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared. RESULTS: The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. -1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles. CONCLUSIONS: In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.

Relationship between Standing Trunk Extension Angle and Medial Elbow Injuries in Young Baseball Pitchers.

Purpose: The purpose of this study was to investigate the relationship between the standing trunk extension angle and medial elbow injuries. Subjects and methods: The study participants were 90 male baseball pitchers (10−12 years) belonging to youth baseball teams. Pitching elbow injuries were evaluated by an orthopedic surgeon using ultrasound scans and physical examination findings. A single optical three-dimensional motion analysis system was used for the trunk extension measurements, with three-dimensional coordinates captured. The overall, upper, and lower trunk angles were then analyzed. Results: Trunk extension angle during standing trunk extension was significantly smaller among participants who were positive for medial elbow injuries on ultrasound scans (positive: 71.4° ± 10.3°; negative: 75.7° ± 9.2°; t = 2.05, p < 0.05). The upper trunk extension angle was significantly smaller than the lower trunk extension angle among participants who were positive for medial elbow injuries on physical examination (upper: 33.0° ± 6.9°; lower: 41.2° ± 8.2°; t = −2.42, p < 0.05). Conclusions: Trunk extension angle during standing trunk extension is associated with medial elbow injuries. Evaluating the trunk extension angle as multiple segments rather than a single rigid body is valuable.

Elucidation of abductor digiti minimi activity in chronic ankle instability.

[Purpose] This study aimed to compare the muscle activity around the foot and ankle joints, notably of the abductor digiti minimi, between affected and unaffected sides of individuals with chronic ankle instability. [Participants and Methods] Twelve adult males with chronic ankle instability in one ankle (age, 27.7 ± 5.4 years; height, 172.5 ± 8.1 cm; weight, 67.5 ± 8.1 kg) were included and underwent surface electromyography assessments in multiple positions on both affected and unaffected sides. Measurements were obtained for eight muscles including the abductor digiti minimi. Each measurement included a 5-s segment of the stable waveform, with the root mean square-processed and normalized to the resting position set to 1. [Results] Abductor digiti minimi activity on the affected side was significantly reduced during maximal toe extension/abduction with both ankle dorsiflexion and plantarflexion. Peroneus longus activity on the affected side was significantly greater during maximal toe extension/abduction with ankle plantarflexion; peroneus longus and tibialis anterior muscle activities were significantly greater on the affected side during maximal toe extension/abduction with ankle dorsiflexion. [Conclusion] In the absence of load, muscle imbalance in the intrinsic and extrinsic muscles of the foot was suggested. However, no significant differences were observed under loading conditions.

Motion Analysis Focusing on Rotational Movements of Professional Female Baseball Pitchers: Comparison with Male University Baseball Pitchers.

PURPOSE: The purpose of this study was to compare pitching motion of the professional female baseball pitchers with the male university baseball pitchers focused on the pelvic and thoracic movements. SUBJECTS AND METHODS: The participants were 15 healthy professional female baseball pitchers (11 right-handers and 4 left-handers; age, 21.7 ± 3.2 years; height, 162.5 ± 5.1 cm; weight, 59.0 ± 6.6 kg) and 14 healthy male university baseball pitchers (12 right-handers and 2 left-handers; age, 19.9 ± 0.8 years; height, 176.4 ± 3.0 cm; body mass, 73.1 ± 3.0 kg). Throwing motion was captured by three-dimensional motion analysis system. Kinematic data of the lead hip, pelvis, thorax, and dominant shoulder were collected and the joint angle at maximum external rotation phase and ball release phase were compared. RESULTS: The female baseball pitchers rotated pelvis and thorax more than the male at the maximum external rotation phase and ball release phase (p < 0.05). At the same, the pelvis and thorax of the female baseball pitchers were tilted significantly closer to horizontal plane than the male (p < 0.05). The pelvis and thorax of the male baseball pitchers was tilted to non-dominant lateral side. CONCLUSIONS: The results of this study indicate that the pelvic and thoracic movements of the professional female baseball pitchers was different from male university pitchers.

Influence of motor instruction words on body movements in step-over motions.

[Purpose] To quantitatively analyze the characteristics of movements evoked by certain motor instruction words on the basis of measurements of ankle elevation and related body movements in step-over motion tasks. [Participants and Methods] Sixty-one healthy adult participants were presented with motor instructions and asked to step over an obstacle in accordance with the instructions. The motor instructions were as follows: "Raise your XX (body part) up YY (expression)" in four combinations using "thigh" and "knee" for body part and "high" and "firmly" for expression. Using Kinect to analyze movements, ankle elevation, trunk-anteversion angle, hip-flexion angle, and knee-flexion angle were measured and statistically processed. [Results] With respect to body part, there was no significant difference in the mean and standard deviation (individual variation) values for ankle elevation. With respect to expression, hip joint and knee joint were bent significantly more for "high" than for "firmly", and although the mean value for ankle elevation was high, ankle elevation standard deviation (individual variation) values were significantly lower for "firmly" than for "high". [Conclusion] Explicit motor instruction words such as "high" may be effective in improving performance, while ambiguous motor instruction words like "firmly" may be effective in stabilizing movements.

Healing Effect of Subcutaneous Administration of Granulocyte Colony-Stimulating Factor on Acute Rotator Cuff Injury in a Rat Model.

Granulocyte colony-stimulating factor (G-CSF) is a cytokine that mobilizes bone marrow-derived cells (BMDCs) to peripheral blood and has been clinically used to treat neutropenia. Previously, we reported that BMDCs migrated into the rotator cuff repair site via peripheral blood in the healing process. However, techniques to accelerate the healing process using the peripheral blood pathway have not been established. We evaluated whether G-CSF has a noteworthy effect on improving rotator cuff healing by enhancing the influx of BMDCs into the peripheral blood. We used Sprague-Dawley rats and chimeric rats, selectively expressing green fluorescent protein (GFP) in BMDCs. Their bilateral supraspinatus tendons were resected and sutured to the greater tuberosity of the humerus using the Masson-Allen technique, and G-CSF was subcutaneously injected for 5 days after surgery. Several GFP-positive cells were observed around the enthesis in the G-CSF-treated group compared with that in the Control group. Histological analysis revealed that the tendon-to-bone maturing scores and the Safranin O-stained cartilaginous areas were significantly higher in G-CSF-injected rats than in the control rats at weeks 4 and 8 after surgery. Consistently, the ultimate force to failure in the G-CSF-treated group significantly increased compared with the Control group at weeks 4 and 8 after surgery. These results suggest that BMDCs mobilized into the peripheral blood after G-CSF administration migrated to the rotator cuff repair area and effectively enhanced rotator cuff healing by promoting tenocyte and cartilage matrix production. In conclusion, the BMDC mobilization technique by G-CSF treatment via peripheral blood will provide a potential therapeutic approach for rotator cuff healing with clinically relevant applications. Impact statement As the retear rate following rotator cuff repair is high, new methods to aid its healing are required. Granulocyte colony-stimulating factor (G-CSF) has been used clinically and may represent a novel approach to treating rotator cuff tear. Herein, using a rat model, we elucidate the kinetics of bone marrow-derived mesenchymal stem cells at the repair site following G-CSF administration and describe the underlying mechanism by which G-CSF can help promote the repair of the rotator cuff.

Relationship between gait speed and trunk muscles in frail elderly individuals.

[Purpose] The external and internal abdominal muscles may be related to gait speed; however, this has not yet been elucidated. In this study, we aimed to clarify the relationship between gait speed and trunk muscle thickness in elderly individuals. [Participants and Methods] The participants were 12 elderly individuals (4 males and 8 females, mean age 83.4 years old, SD ± 0.5) that attend a day service center. We measured the 5 m free gait speed, the 5 m fastest gait speed, and the thickness of five trunk muscles (the rectus abdominis [divided into three parts: upper, central, and lower], external oblique, internal oblique, transverse abdominis, and iliopsoas muscles). [Results] There were positive correlations between the free gait speed and the thickness of the lower rectus abdominis, internal oblique, and transverse abdominis muscles. There were also positive correlations between the fastest gait speed and the thickness of the lower rectus abdominis, internal oblique, and transverse abdominis muscles. [Conclusion] Incorporating muscle strength training of the lower rectus abdominis, internal oblique, and transverse abdominis muscles into existing lower limb muscle training protocols is important to effectively maintain the gait speed of elderly individuals.

Relationship Between Physical Fitness at the End of Preseason and the Inseason Game Performance in Japanese Female Professional Baseball Players.

Watanabe, Y, Yamada, Y, Yoshida, T, Matsui, T, Seo, K, Azuma, Y, Hiramoto, M, Miura, Y, Fukushima, H, Shimazu, A, Eto, T, Saotome, H, Kida, N, and Morihara, T. Relationship between physical fitness at the end of preseason and the inseason game performance in Japanese female professional baseball players. J Strength Cond Res 33(6): 1580-1588, 2019-This study examined anthropometric and fitness profiles of Japanese female professional baseball players and investigated the relationship between players' physical fitness and inseason game performance. Fifty-seven players who were registered in the Japan Women's Baseball League (JWBL) participated. Height, body mass, grip strength, back strength, knee extension and flexion strength, hamstring extensibility, vertical jump height, and horizontal jump distance were measured at preseason (February and March) in 2013. Game performance during the 2013 season (March-November) was obtained from official JWBL statistics. Vertical jump height showed significant positive correlations with individual performance records (e.g., total bases [r = 0.551], slugging percentage [r = 0.459], and stolen bases [r = 0.442]). Similar relationships were observed between horizontal jump distance and performance statistics in most cases. By contrast, grip, back, and lower-limb strength, as well as hamstring extensibility were not significantly correlated with game performance. Stepwise regression analysis selected vertical jump height as an independent variable, significantly correlating with several game performance measures (e.g., total bases: adjusted R = 0.257). Also, vertical jump height and body mass index were identified as independent variables significantly associated with stolen bases (adjusted R = 0.251). Maximal jump performance, rather than simple isometric muscle strength or flexibility, is a good performance test that can be used at the end of preseason to predict inseason batting and stolen base performance. Our findings demonstrate the importance of constructing preseason training programs to enhance lower-limb muscular power that is linked to successful inseason performance in female baseball players.

Hip, Trunk, and Shoulder Rotational Range of Motion in Healthy Japanese Youth and High-school Baseball Pitchers.

OBJECTIVE: The rotational range of motion (ROM) in the upper extremities, trunk, and lower extremities is important for throwing motion. However, unlike for the shoulders, the differences relating to age and throwing-side in trunk and lower extremity ROMs in baseball pitchers are unknown. This study examined the effects of age and dominance on the ROMs of the trunk and upper and lower extremities. METHODS: The study included 356 young baseball pitchers aged 9-17 years who participated in off-season baseball camps. The subjects comprised 155 youth pitchers (aged 9-14 years) and 201 high-school pitchers (aged 15-17 years) who were able to throw at full force without pain. The neck, shoulder, trunk, and hip rotational ROMs on the dominant and non-dominant side were measured by well-trained physical therapists. The differences between throwing sides and between age groups were examined using two-way analysis of variance. RESULTS: Shoulder external rotation on the dominant side was greater than that on the non-dominant side. Shoulder external and internal rotational ROMs were maintained regardless of age, whereas the trunk rotational ROM significantly increased with age. CONCLUSIONS: The effects of age and dominance on ROMs of the neck, trunk, and upper and lower extremities in Japanese youth and high-school baseball pitchers were clarified. These data could be used as a specific reference and as target values for the rehabilitation of throwing injuries in young athletes.

Evaluation of left-right difference of impulse in impact forces at stance phase: comparison of measurements on flat land and stairs.

[Purpose] The purpose of this study was to investigate the measurement method and parameters to simply evaluate the condition of the knee that are necessary for preventing locomotive syndrome as advocated by the Japan Orthopedic Association. [Subjects and Methods] The subjects installed acceleration sensors in lateral condyles of the tibia and measured acceleration and load under the conditions of walking on a flat ground and walking using stairs; the difference between the impulse of impact forces (acceleration × load) of the two knees was defined as a simple evaluation parameter. [Results] Simple evaluation parameters were not correlated with age during walking on a flat ground, but during walking using stairs, it was almost flat up to the age of 20-40 years, and after the age of 49 years, based on the quadratic curve approximation (R2=0.99), a correlation of simple evaluation parameters with age could be confirmed. [Conclusion] The simple evaluation parameter during walking using stairs was highly correlated with age, suggesting a contribution to preventing locomotive syndrome by improving reliability. In the future, we plan to improve reliability by increasing the data, and establish it as a simple evaluation parameter that can be used for preventing locomotive syndrome in elderly people and those with KL classification grades 0-1.

Effect of standing postural deviations on trunk and hip muscle activity.

[Purpose] It is very important to consider effects that postural deviations has on muscle activity when treating low back pain. Therefore, activities of trunk and hip joint muscles in healthy adults while they attempted three postural conditions of neutral, sway-back, and lordosis was compared and evaluated in this study. [Subjects and Methods] The subjects comprised 17 healthy adult male volunteers. The muscle activity and spinal curve were measured while the subjects attempted different postural conditions (neutral, sway-back, and lordosis) as defined in the text. [Results] Activity of trunk and hip inner muscles was decreased in sway-back posture, and only activity of the trunk back muscles was increased in lordosis. [Conclusion] This results were suggested that postural deviations affected muscle control in the lumbo-pelvic area.

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients.

OBJECTIVE: Rotator cuff tears can influence shoulder kinematics and severely impair function. However, there have been no studies on three-dimensional (3D) shoulder kinematics in massive rotator cuff tear (MRCT) patients. Hypothesizing that MRCT patients could demonstrate significantly changed scapular kinematics during arm elevation in the scapular plane, we compared 3D scapular kinematics in the scapular plane between MRCT patients and healthy elderly subjects. METHODS: We assessed 15 shoulders of 11 MRCT patients and 16 shoulders of 16 healthy subjects. With the subjects seated, we used an electromagnetic tracking system to calculate the upward rotation, posterior tilt, and internal rotation of the scapula at 10° increments from 30° to 120° with respect to the thorax. We performed two-way analysis of covariance with the initial position of the scapular motion as the covariate and performed multiple comparisons using the Bonferroni method. RESULTS: MRCT patients exhibited significantly higher scapular upward rotation than did the healthy subjects (P < 0.05). There were no significant differences between groups with regard to posterior tilt and internal rotation. CONCLUSIONS: This study indicated that when MRCT patients elevated their arms, they exhibited a significantly higher scapular upward rotation at low- to mid-range elevations compared with that of healthy subjects. This difference may have resulted from a compensatory effect in response to the decreased elevation torque caused by the loss of rotator cuff function. These results may assist rehabilitation strategies to improve active arm elevation in MRCT patients.