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[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.

Objective: A total of 183 patients admitted to five hospitals for proximal femoral fractures and psychiatric disorders were examined to determine whether their physical function could be improved by rehabilitation and to identify factors that affected home discharge. Methods: We conducted surveys to collect data regarding patients’ age, sex, type of mental illness, location at time of injury, complications, Charlson Comorbidity Index, Global Assessment of Functioning scale scores, surgical technique, time from surgery to the start of rehabilitation at the target hospital, rehabilitation duration, results of cognitive function tests (e.g., the Mini Mental Status Examination), walking ability before the injury, final walking ability, functional independence measure (FIM) of the patient’s activities of daily living at the start and end of treatments, and discharge destinations. Results: The motor function index showed a significant improvement from an average of 36.0 points at admission to an average of 53.0 points at discharge. Overall, 47.9% of patients who were able to walk before injury could regain gait ability. The discharge rate to the patient’s home was 15.8%. Conclusions: The gait reacquisition rate for patients with femoral neck fractures and mental illness admitted to a psychiatric ward was 47.9%, which was lower than that reported in previous studies, but higher than that for dementia patients. Binomial logistic regression analysis identified the following predictive items for home discharge: whether the fracture occurred at home, FIM cognition item scores at admission, and total and motor item scores at discharge. The derived equation had a high hit rate of 80.9%.

[Purpose] This study aimed to determine the validity and reliability of isometric knee extension muscle strength measurements using a belt-stabilized hand-held dynamometer compared to that using an isokinetic dynamometer with the participant in a sitting posture. [Participants and Methods] Forty-two university students participated. The isometric knee extension muscle strength was measured using a hand-held dynamometer and an isokinetic dynamometer. For both measurements, the participants were in the similar sitting posture. The sitting posture maintained trunk stability, with the hands on the bed, and the non-measurement-side toe touching the floor or table. The intra-class correlation coefficient and the relevance were verified. [Results] Intra-rater correlation coefficient (1, 1) of the two measurements was ≥0.75. A significant difference was found in the measurement value between males and females. No significant difference was found between the measurements value of the two devices. A significant positive correlation was found in the measurement value of two devices in the male participants. [Conclusion] When compared to the standard method of isometric knee extension muscle strength measurements using an isokinetic dynamometer with the participant in the sitting posture, measurements using the belt-stabilized hand-held dynamometer were considered valid and highly reliable in the male participants.

[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.

[Purpose] This study aimed to investigate the relatedness, reliability, and validity of isometric muscle strength measurements of hip abduction and abduction with an external hip rotation in a bent-hip position using a handheld dynamometer with a belt. [Subjects and Methods] Twenty healthy young adults, with a mean age of 21.5 ± 0.6 years were included. Isometric hip muscle strength in the subjects’ right legs was measured under two posture positions using two devices: a handheld dynamometer with a belt and an isokinetic dynamometer. Reliability was evaluated using an intra-class correlation coefficient (ICC); relatedness and validity were evaluated using Pearson’s product moment correlation coefficient. Differences in measurements of devices were assessed by two-way ANOVA. [Results] ICC (1, 1) was ≥0.9; significant positive correlations in measurements were found between the two devices under both conditions. No main effect was found between the measurement values. [Conclusion] Our findings revealed that there was relatedness, reliability, and validity of this method for isometric muscle strength measurements using a handheld dynamometer with a belt.

[Purpose] The aim of this study was to develop a method of measuring isometric shoulder joint muscle strength using a handheld dynamometer with a belt and investigate its test-retest reliability. [Subjects] The subjects comprised 40 healthy adults. [Methods] Six types of isometric shoulder muscle strength were measured twice, and reliability was assessed. [Results] The intraclass correlation coefficient (1, 1) values ranged from 0.976 to 0.902. The result of a Bland-Altman analysis showed differences in the types of errors between measurement items. [Conclusion] The relative reliability of isometric shoulder muscle measurement using a handheld dynamometer with a belt was high. However, analysis of absolute reliability revealed errors that may affect interpretation of values; therefore, it was considered that adapting the greater of two measurement values is appropriate.

[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] This study aimed to investigate the effect of trunk stability on isometric knee extension muscle strength measurement while sitting by performing simultaneous measurements with a handheld dynamometer (HHD) and an isokinetic dynamometer (IKD) in the same seated condition. [Subjects and Methods] The subjects were 30 healthy volunteers. Isometric knee extension muscle strength was simultaneously measured with a HHD and an IKD by using an IKD-specific chair. The measurement was performed twice. Measurement instrument variables and the number of measurements were examined by using the analysis of variance and correlation tests. [Results] The measurement instrument variables and the number of measurements were not significantly different. The correlation coefficients between the HHD and IKD measurements were ≥0.96. [Conclusion] Isometric knee extension muscle strength measurement using the HHD in the sitting position resulted in a lower value than that using the IKD, presumably because of the effect of trunk stability on the measurement. In the same seated posture with trunk stability, no significant difference in measurement values was observed between the HHD and IKD. The present findings suggest that trunk stability while seated during isometric knee extension muscle strength measurement influenced the HHD measurement.

[Purpose] The purpose of this study was to examine the reliability of three isometric knee extension strength measurements (IKE) made with a hand-held dynamometer (HHD) and a belt of healthy elderly living in the community as subjects. [Subjects] The subject cohort consisted of 186 healthy elderly people, aged 65 to 79 years, living in local communities. [Methods] IKE of the leg subjects used to kick a ball was measured. IKE of each subject was measured three times using an HHD-belt at intervals of 30 seconds. The reliability of the larger of the first two measurements (LV2) as well as the third measurement (3V) was investigated. [Results] The intraclass correlation coefficients [ICC (1, 1)] for LV2 and 3V were 0.955. Bland-Altman analysis showed a fixed bias, and the limits of agreement ranged from -5.6 to 4.6. [Conclusion] The ICC results show that the test-retest reproducibility of IKE measurements of healthy elderly subjects using an HHD-belt is high. However, Bland-Altman analysis showed a fixed bias, suggesting the need for three measurements.

[Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and used intraclass correlation coefficients (ICCs) to investigate the reliability of the measurements. We used a receiver operating characteristic curve to investigate the cutoff values for independent walking with walking sticks and non-independent mobility. [Results] ICCs (1, 1) were 0.9 or higher. The cutoff value for independent walking with walking sticks was 0.289 kgf/kg on the non-fractured side, 0.193 kgf/kg on the fractured side, and the average of both limbs was 0.238 kgf/kg. [Conclusion] We consider that the test-retest reliability of isometric knee extension muscle strength measurement of patients who have undergone femoral neck fracture surgery is high. We also consider that isometric knee extension muscle strength is useful for investigating means of independent mobility in the ward.

[Purpose] The aim of this study was to verify the absolute reliability of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD). [Subjects and Methods] The subjects were 33 healthy college students. The measurements were made three times with the HHD fixed using a belt (BFHHD) or with the examiner's hand (conventional method; HFHHD). The absolute reliability of measurements was verified using Bland-Altman analysis, both in the all subjects group and a group of subjects showing measurements less than a fixed limit of 30 kgf. [Results] In the

[Purpose] The aim of this study was to verify the limit of isometric muscle strength of shoulder joint horizontal adduction using handheld dynamometer (HHD) manipulated by hand (referred to as the manipulative-fixed method). [Subjects and Methods] The subjects were 33 healthy college students. The examiner was a healthy college student. Shoulder joint horizontal adductor muscle strength was measured using HHD with the subject in the supine position. The belt-fixed and manipulative-fixed methods were used to secure the HHD sensor unit. The limitations of the manipulative-fixed method were assessed by simple regression analysis, in which the participants were divided into 2 groups according to a branch point. The slope of the straight line of the graph was visualized. [Results] Single regression analysis of the 30 kgf group were not significant. [Conclusion] The manipulative-fixed method is simple to perform. However, there exists the possibility that the actual muscle strength is not measurable by this method. The measurement limit of the shoulder horizontal adduction strength with the manipulative-fixed method was 30 kgf in the case of the examiner in the present study. The fixed limit was also found to influence in the muscle strength of the upper limbs.

[Purpose] The purpose of this research was to study the test-retest reliability of three continuous sets of measurements of isometric knee extension muscle strength of hemiplegic patients, using a handheld dynamometer (HHD) and a belt. [Subjects] The subjects were 26 hospitalized hemiplegic patients (12 men, 14 women) with an average age of 62.4 years. [Method] The subjects sat on a mat table, and three sets of measurements were taken, at intervals of 30 seconds, of isometric knee extension muscle strength with the knee joint at a flexion angle of 90 degrees using an HHD and a belt. The measurements were also taken in a second session on a different day. Reliability was examined using the intraclass correlation coefficient (ICC (1,1)) and multiple comparison as a post-hoc test of one-way variance through repeated measurement. [Results] The ICC of the measurement values taken on the same day on the paralyzed side was 0.98, while in Session 2 it was 0.99; on the non-paralyzed side, it was 0.98 in Session 1 and in Session 2 it was 0.99. On the paralyzed side, main effect was seen in Session 2; the values of the first measurement were significantly smaller than the values of the second and third measurements. And, the highest values were obtained from the third measurement. [Conclusion] The ICC results show the test-retest reliability was high in both sessions. We thought it would be sufficient for measurements to be conducted three times, taking the highest values of those three.

[Purpose] We investigated the effects of compression on the posterior surface of the thorax caused by a pillow used for postural changes on the respiratory function. [Subjects] The subjects were 22 healthy males with no history of ailments of the respiratory and circulatory organs. [Methods] With the subjects placed in the supine position, a half-lateral position with a pillow supporting the posterior surface of the thorax (pillow-supported position (1)), and a half-lateral position with pillows supporting the shoulder girdle and the pelvic band (pillow- supported position (2)), the ventilatory volume per breath (hereinafter TV) and expiratory reserve volume (hereinafter ERV) were measured based on the respiratory function, and at the same time, the distanced moved by the diaphragm was measured using an ultrasonic imaging device. [Results] Significantly lower values for TV were observed in the pillow-supported position (1) in comparison to the other postures. Significantly higher values for ERV were observed in the pillow-supported position (1) in comparison to the other postures. Significantly lower values for the distance moved by the diaphragm were observed in the pillow-supported position (1) in comparison to the other postures. [Conclusion] Ventilation decreased in pillow-supported position (1). We therefore consider that the movement of the diaphragm was reduced due to an expanded state caused by increase in residual air in the lungs.

[Purpose] The purpose of this research was to study the test-retest reliability of isometric knee extension muscle strength measurement using a hand-held dynamometer (HHD) with a belt, with healthy elderly people living in the community as subjects. [Subjects] The subjects were healthy elderly people living in the community, with an average age of 70.5 years, and measurements were made of the leg on the side that was used to kick a ball. [Method] The subjects sat on a mat table, and isometric knee extension muscle strength measurements using a HHD with a belt were conducted twice, at an interval of 30 seconds, with a knee flexion angle of 90 degrees. The measurement values were classified according to the gender of the subjects, and by age group 65-69 years, 70-74 years, and 75 years and above, and studied. Test-retest reliability was studied using the intraclass correlation coefficient (ICC) and checks of the differentials. [Results] The ICC(1,1) between the first and second measurements ranged from 0.85 to 0.92. Apart from the group of men aged 75 years and above, the second measurement values were higher than those of the first. [Conclusion] Test-retest reliability of isometric knee extension muscle strength measurement using a HHD with a belt was high in healthy elderly persons. However, measuring only once, or measuring twice and taking the average was considered inappropriate, since there is the possibility that the values in such cases would be lower than the actual muscle strength.

〔目的〕股関節痛と歩行困難を呈していた症例に対して，応用行動分析学に基づいた介入を行った結果について検討すること。〔対象〕両側変形性股関節症による股関節痛の増強により歩行不可能となり他院での4ヶ月の入院後，当院での外来通院を開始した52歳女性であった。〔方法〕1日で歩行した歩数（歩行量），歩行時痛についてベースライン測定後に行動分析を行い，規定した目標歩行量の遵守と自己記録を行動とした介入を設定した。介入の有効性について，1セッションが約3ヶ月間の7セッションの経過における歩行量，歩行時痛，使用する歩行補助具から検討した。〔結果〕行動は継続され，歩行量のばらつきと歩行時痛が減少し，歩行補助具は両松葉杖からＴ字杖に変化した。［結語］応用行動分析学を用いた今回の介入は，変形性股関節症で慢性的な強い歩行時痛を有していた症例に対して，理学療法士による1日の歩数を制限する指導を長期にわたり遵守させ，痛みと歩行能力の改善に影響したと考えられた。

[Purpose] The aim of this study was to evaluate whether using a belt to restrain a hand-held dynamometer improves reliability of isometric leg muscle strength measurements in healthy subjects. [Subjects] Twenty to 44 healthy subjects participated in the test. [Methods] Two raters, one man and one woman, used a hand-held dynamometer with or without a restraining belt to measure the isometric strengths of the following muscle groups: flexors, extensors, abductors, adductors, internal rotators and external rotators of the hip; flexors and extensors of the knee; and dorsiflexors and plantar flexors of the ankle. [Results] The intraclass correlation coefficient, used to describe interrater agreement, ranged from 0.97 to 0.99 with the belt and from 0.21 to 0.88 without the belt. Pearson's correlation coefficient for measurements with versus without the belt ranged from 0.61 to 0.95 for the man and from 0.31 to 0.87 for the woman. [Conclusion] The interrater reliability of isometric leg muscle strength measurements was improved by use of a belt to restrain the hand-held dynamometer.

[Purpose] The aim of this study was to evaluate the test-retest reliability of isometric muscle strength measurements made using a hand-held dynamometer restrained by a belt. [Subjects] The subjects were 37 healthy adults (18 men and 19 women) with a mean age of 21.9 years. [Methods] Measurements were made on the dominant leg using a hand-held dynamometer (μTas MF-01 or F-1, Anima Corp., Tokyo) and a belt to fix the position of the body part under test. The strengths of the following 10 muscle groups were evaluated: flexors, extensors, abductors, adductors, internal rotators and external rotators of the hip; flexors and extensors of the knee; and dorsiflexors and plantar flexors of the ankle. Each measurement was repeated after at least 30 seconds of rest in three sessions: in the morning, in the afternoon on the same day, and one week later. [Results] The intraclass correlation coefficient (ICC) for the first and second sets of measurements made in each session ranged from 0.75 to 0.97. ICC for the highest measurements of each muscle group in each of the three sessions ranged from 0.56 to 0.91. [Conclusions] The test-retest reliability of isometric muscle strength measurements of the lower limb made using a hand-held dynamometer equipped with a stabilizing belt varies widely, depending on the muscle action tested, and it would be better to repeat the measurements on different occasions.

[Purpose] This study aimed to verify the appropriate number of measurements and the intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD) for geriatric and stroke patients. [Subjects and Methods] The subjects were 40 inpatients, who were divided into two groups: 20 stroke patients in the stroke group (SG), and 20 geriatric patients in the no-stroke group (N-SG). Measurements were performed three times using an HHD with a belt. The reliability was verified using Bland-Altman analysis and the intraclass correlation coefficient (ICC). [Results] ICC (1, 1) was >0.9. A systematic bias was not observed between the first and second measurement values except for the right side in N-SG. A systematic bias between the maximum value obtained during the first and second measurements and third measurement value was observed on the left side in N-SG, and on the non-paralyzed side in SG: the third measurement values were small in both cases. [Conclusion] Intrarater reliabilities were high for shoulder horizontal adductor strength measurements using an HHD with a belt for geriatric and stroke patients. Taking the systematic bias into consideration, these findings suggest that the required number of measurements is two.

[Purpose] The purpose of the present study was to compare the reliability of 2 hand-held dynamometers (HHD-1, 2) with different designs, by performing isometric knee muscle extension measurements two times each. [Subjects] The subjects were 40 young healthy adults. [Methods] The reliability of the measurements was examined using Bland-Altman analysis. [Results] Bland-Altman analysis found a fixed bias in measurements made by HHD-1 with an average limits of agreement (LOA) value of −2.1 kgf. For HHD-2, only random errors were detected, and the minimal detectable change (MDC) was 11.4 kgf. Fixed biases were observed between the two devices with an average LOA value of 2.2 kgf. When the bodyweight ratio was used, fixed biases were observed in measurements made by both devices, and the average value of LOA was −0.03 kgf/kg. The comparison of the two devices revealed only random errors, and MDC was 0.22 kgf/kg. [Conclusion] For HHD measurements using these two devices, the appropriate number of measurements is two times, and comparison of measurement values between the two devices should be avoided.