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Background The development of computer-assisted technologies to diagnose anterior cruciate ligament (ACL) injury by analyzing knee magnetic resonance images (MRI) would be beneficial, and convolutional neural network (CNN)-based deep learning approaches may offer a solution. This study aimed to evaluate the accuracy of a CNN system in diagnosing ACL ruptures by a single slice from a knee MRI and to compare the results with that of experienced human readers. Methods One hundred sagittal MR images from patients with and without ACL injuries, confirmed by arthroscopy, were cropped and used for the CNN training. The final decision by the CNN for intact or torn ACL was based on the probability of ACL tear on a single MRI slice. Twelve board-certified physicians reviewed the same images used by CNN. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the CNN classification was 91.0%, 86.0%, 88.5%, 87.0%, and 91.0%, respectively. The overall values of the physicians’ readings were similar, but the specificity was lower than the CNN classification for some of the physicians, thus resulting in lower accuracy for the human readers. Conclusions The trained CNN automatically detected the ACL tears with acceptable accuracy comparable to that of human readers.

[Purpose] The purpose of this study was to examine the agreement between the values obtained by using a hand-held dynamometer with a belt (belt-HHD) and an isokinetic dynamometer (IKD) for the measurement of isometric knee flexion and extension muscle strength. We also studied the factors influencing the measurement. [Participants and Methods] Overall, 26 healthy young adults (16 males, 10 females) participated in the study; the mean age was 21 years. Knee flexion and extension muscle strength were measured by three methods: 1) belt-HHD, 2) conventional IKD with the participant sitting on an attached chair (conv-IKD), and 3) modified IKD with the participant sitting on the same mat table as HHD (mod-IKD). [Results] In the measurement of knee extension, mod-IKD and conv-IKD showed a fixed bias and a proportional bias, conv-IKD and belt-HHD showed a fixed bias, and belt-HHD and mod-IKD showed a fixed bias. In the measurement knee flexion, conv-IKD and mod-IKD showed a proportional bias, belt-HHD and conv-IDK showed a fixed bias, and mod-IKD and belt-HHD showed a fixed bias. In each combination, the measured values were larger in the latter due to errors. However, the types and values of errors differed when analysis was conducted based on gender. [Conclusion] In order to increase the agreement between the values, it is necessary to revise the fixing method of the trunk, and the fixing method of the belt and the sensor pad in belt-HHD.

This study aimed to determine the reliability of ultrasound to measure the distance between interspinous processes of the lumbar spine at the segmental level (i.e., L1-L2, L2-L3, L3-L4, and L4-L5).Ten men with no history of orthopedic diseases or dysfunctions were included in this study. In total, 720 images of the lumbar spines of participants were analyzed (10 participants, 4 segments, 3 trials, 3 positions, 2 examiners). With participants in three different positions, images of each segment specifically focused on the distance between lumbar interspinous processes. Bland-Altman analysis (BAA) was used to determine intra- and inter-rater reliability.Intra-rater intraclass correlation coefficient (ICC) values (1, 1) were found to range from 0.840 to 0.988, whereas inter-rater ICC values (2, 1) ranged from 0.605 to 0.876. BAA results confirmed a fixed bias regarding the L4-L5 of the lumbar spine segment in the flexion position.Inter-rater reliability decreased throughout this study; however, results showed that using ultrasound to measure the distance between lumbar segmental interspinous processes could be applied in clinical settings to evaluate lumbar segmental mobility.

[Purpose] The intra- and inter-examiner reliabilities of lumbar interspinous process distances measured by ultrasound imaging were examined. [Subjects and Methods] The subjects were 10 males who had no history of orthopedic diseases or dysfunctions. Ten lumbar interspinous images from 360 images captured from 10 subjects were selected. The 10 images were measured by nine examiners. The lumbar interspinous process distance measurements were performed five times by each examiner. In addition, four of the nine examiners measured the distances again after 4 days for test-retest analysis. In statistical analysis, the intraclass correlation coefficient was used to investigate relative reliability, and Bland-Altman analysis was used to investigate absolute reliability. [Results] The intraclass correlation coefficients (1, 1) for intra-examiner reliability ranged from 0.985 to 0.998. For inter-rater reliability, the intraclass correlation coefficient (2, 1) was 0.969. The intraclass correlation coefficients (1, 2) for test-retest reliability ranged from 0.991 to 0.999. The Bland-Altman analysis results indicated no systematic error. [Conclusion] The results indicate that ultrasound measurements of interspinous process distance are highly reliable even when measured only once by a single person.

To investigate a more available model for the early phase of motor learning after action observation combined with motor imagery training in elderly people. To address the purpose, we focused on a slow, unskilled model demonstrating an occasional error.A total of 36 elderly people participated in the current study and were assigned to either the unskilled or skilled model observation groups (n = 12, respectively), or the control group (n = 12). The participants in the observation groups observed the assigned a video clip of an unskilled or skilled model demonstrating a ball rotation task. During the observation, the participants were instructed to imagine themselves as the person in the video clip. The participants in the control group read a scientific paper during the equivalent period of action observation and motor imagery. We measured ball rotation performance (the time required for five rotations, the number of ball drops) in pre- and post-intervention (observation combined with motor imagery training for intervention groups or reading for control group).Ball rotation performance (ball rotation speed) significantly improved in the unskilled model observation group compared to the other two groups.Intervention for action observation using unskilled model combined with motor imagery was effective for improving motor performance during the early phase of motor learning.

INTRODUCTION Self-management is an effective way to manage chronic low back pain (LBP) and is frequently recommended. However, the psychological aspects, including grit (ie, perseverance and passion for long-term goals), of the habit of self-management remain unclear. OBJECTIVE To investigate the relationship between grit and the self-directed exercise. DESIGN Cross-sectional observational study. SETTING Community-dwelling older adults. PARTICIPANTS Fifty-nine older adults with LBP (30 men, 29 women; mean age 72 ± 5 years, range 65-82 years). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Primary outcome measures included grit scores on the Short Grit Scale and the number of months performing self-directed exercise. Correlation and multiple regression analyses were performed to determine the relationship between participants' grit and duration of self-directed exercise. RESULTS A significant positive correlation between grit and the duration of self-directed exercise habits was observed (r = 0.49, P

[Purpose] This study assessed the reliability and validity of an ultrasound-based imaging method for measuring the interspinous process distance in the lumbar spine using two different index points. [Subjects and Methods] Ten healthy males were recruited. Five physical therapy students participated in this study as examiners. The L2-L3 interspinous distance was measured from the caudal end of the L2 spinous process to the cranial end of the L3 spinous process (E-E measurement) and from the top of the L2 spinous process to the top of the L3 spinous process (T-T measurement). Intraclass correlation coefficients were calculated to estimate the relative reliability. Validity was assessed using a model resembling the living human body. [Results] The reliability study showed no difference in intra-rater reliability between the two measurements. However, the E-E measurement showed higher inter-rater reliability than the T-T measurement (Intraclass correlation coefficients: 0.914 vs. 0.725). Moreover, the E-E measurement method had good validity (Intraclass correlation coefficients: 0.999 and 95% confidence interval for minimal detectable change: 0.29 mm). [Conclusion] These results demonstrate the high reliability and validity of ultrasound-based imaging in the quantitative assessment of lumbar interspinous process distance. Of the two methods, the E-E measurement method is recommended.

[Purpose] To investigate whether for observational learning involving a ball rotation task, an unskilled model showing clumsy finger movements is more effective than a skilled model‏. [Subjects and Methods] Thirty-six young adults were randomly assigned to one of three groups. The unskilled model observation group observed a video of a ball rotation task practiced by a person for a short time. The skilled model observation group observed another video of the same task practiced by the person for a relatively long time. The non-observation group did not observe any video. Regarding rotation speed, the unskilled model was faster than the participants' but slower than the skilled model. The unskilled model had the highest number of ball drops. [Results] After the observation, the unskilled model observation group showed significantly faster rotation speed than the other groups. There were no significant differences between the groups in the number of ball drops. [Conclusion] An unskilled model whose performance is better than the participants' is beneficial for improving motor performance but a model showing less skill than the participants is not.