Purpose Facial expressions are formed by the coordination of facial muscles and reflect changes in emotion. Nurses observe facial expressions as way of understanding patients. This study conducted basic research using facial myogenic potential topography to visually determine changes in the location and strength of facial muscle activity associated with voluntary facial expression to examine relationships with facial expressions. Methods Participants comprised 18 healthy adults (6 men, 12 women; mean age, 24.3 ± 4.3 years). Facial myogenic potentials were measured from 19 electrodes arranged concentrically on the face, and topographic analysis was conducted. Using potential changes and topograms, the muscle activity associated with nonvoluntary facial expression and voluntary facial expressions of happiness and disgust were classified according to the characteristics of expressions. To classify homogeneous groups among the reaction of disgust, hierarchical cluster analysis was utilized. Results One characteristic of the facial expression of happiness was activity in areas including the greater zygomatic muscle. With the facial expression of disgust, characteristic changes were seen in areas including the corrugator supercilii. Cluster analysis of the expression of disgust showed four homogeneous subgroups. Conclusion With facial myogenic potential topography, facial expressions can be evaluated objectively without being influenced by face shape or countenance. Color changes in topograms showed subtle changes in expressions that could not be supplemented with statistical processing alone, and these were useful in identifying individuality. Topography is thus expected to be utilized to supplement basic knowledge of facial expressions for a better understanding of patients.

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Purpose. The purpose of this study is to investigate the treatment efficacy of total knee arthroplasty (TKA) on locomotive syndrome (LS) focusing on total clinical decision limit (CDL) stage 3 leading to revealing the motor function indicators that can predict LS improvement in knee osteoarthritis patients who had received TKA. Methods. This prospective cohort study was conducted in 47 patients evaluated as total CDL stage 3 before TKA who received primary TKA on the operated side and were diagnosed with Kellgren-Lawrence grade 2, 3, or 4 knee osteoarthritis on the nonoperated side. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA. Results. Of the 47 subjects who were evaluated to be in total CDL stage 3 before TKA, 13 patients (27.7%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 83.3%. Even if the CDL of the two-step test before TKA was higher than 1 and if the 3 m-Timed Up and Go test (3m-TUG) before TKA was 9.6 or less, the improvement rate was 50%. Conclusions. As of three months after surgery, TKA can improve LS in about 30% of knee osteoarthritis patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.

To reduce the risk of long-term care, it is important to prevent the functional decline of the locomotorium of elderly individuals early in life. This study aimed to clarify locomotive syndrome (LS) in Japanese office workers. The participants included 263 workers that mainly performed deskwork. Participants performed the LS risk test and completed a self-administered questionnaire survey that focused on lifestyle-related diseases, anxiety about physical strength, pain in the locomotorium, and health-related quality of life. Sixty participants (22.8%) were at risk for LS, and 17.5% of these participants were in their 20s. Of the participants at risk for LS (LS group), 30.0% had anxiety about physical strength, which was a significantly high ratio compared to the 14.3% of participants who expressed anxiety about physical strength, but were not at risk for LS (non-LS group) (χ 2 = 6.479, p < .05). There were significant differences between risk for LS and pain in the back and hip joints (χ 2 = 5.813, p < .05, χ 2 = 4.895, p < .05). The LS group had a significantly lower mean physical summary score than the non-LS group (t = 3.286, p < .01). Thus, an intervention to prevent LS is important during the early stages, and signs such as pain in the locomotorium and anxiety about physical strength must not be overlooked.

The awkward movements and postures associated with childcare activities can lead to musculoskeletal symptoms in the neck and shoulders. “Dakko” is a method for carrying a child in Japan, and recently it has been reported to cause shoulder stiffness. To our knowledge, the relationship between childcare activities and the physical load on the neck and shoulders is poorly understood. The present study aims to clarify the muscle load on the neck and shoulder region through dakko simulations. First, the association between dakko movements and trapezius muscle activity is clarified by image and electromyogram analyses. Based on this clarification, the distributions and intensity of the muscle load from repetitive dakko movements are clarified using myogenic potential topography. During dakko movements, trapezius muscle activity was observed when lifting up and setting down the child, but not when holding the child. For the repetitive movements, myogenic electrical potentials were observed in the trapezius region after movement load, and individual characteristics of participants were revealed in both the load distributions and the recovery process. Repetitive dakko movements likely induced sustained muscle tonus in the trapezius, which may be a factor related to shoulder stiffness.

SummaryIn this paper, we propose a framework for representing performance skill. Firstly, we notice the importance of performance skill representation. We introduce five different representation targets: performance tasks, performance rules, pre-shaping actions, dynamic integrity constraints, and performance states. Performance task description consists of a sequence of performance tasks and expressions. It acts as a goal description in planning. Performance rules describe model performance methods for given tasks including how to shape body parts and how to use various muscles. Pre-shaping action rules are similar to performance rules. Its role is to pre-shape in between consecutive tasks to prepare for the next task. Dynamic integrity constraints specify constraints to be satisfied during performance. They provide such general rules as prohibiting simultaneous strong activations of agonist and antagonist. Performance states are for describing real performance done by players including professionals and amateurs. The aim of the framework is to provide a uniform scheme for representing model performance methods given performance score such as music score. The representation framework will define targets of inducing formal skill rules as well as describing performance states automatically from biomechanical performance data. It also is related to a fundamental research issue of attributes finding/selection in discovering useful rules for skillful performance. We conclude our paper by stating future research direction.

Background:In 2020, the Japanese Orthopaedic Association added a new clinical decision limit (CDL), stage 3, to evaluate the stages of locomotive syndrome (LS). However, so far there has been no study of total knee arthroplasty (TKA) to examine the efficacy of LS treatment and there are no motor function indicators to predict LS improvement, focusing on stage 3. The purpose of this study is to investigate the treatment efficacy of TKA on LS focusing on total CDL stage 3 leading to revealing the motor function indicators that can predict LS improvement in patients who had received TKA.Methods:This prospective cohort study was conducted with 59 patients among 70 patients who underwent TKA, with total CDL stage 3 before TKA evaluation. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA.Results:Of the 59 subjects who were evaluated to be in total CDL stage 3 before TKA, 17 patients (28.8%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 77.8%. Even if the CDL of the two-step test before TKA was higher than 2 and if the 3m-Timed Up & Go test (3m-TUG) before TKA was 9.15 or less, the improvement rate was 60%.Conclusions:As of three months after surgery, TKA can improve LS in about 30% of patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.