Abstract.[Purpose] This review aimed: (1) to obtain all the facts regarding existing goal-setting methods in physical therapy; (2) to clarify the application status of the methods for stroke patients; and (3) to put forth a suggestion for the development of a format prepared by collaboration between stroke patients and physical therapists.[Methods] A systematic search was performed to identify the existing goal-setting methods and to obtain the relevant literature. We reviewed a total of 165 reports. [Results] We identified 8 types of goal-setting methods: Goal Attainment Scaling (GAS), the Canadian Occupational Performance Measure (COPM), goal forum intervention, and others. GAS was evaluated for its validity, reliability, and sensitivity for physically disabled children and the elderly, but there were no reports on the applicability of GAS to stroke patients. The COPM, which is a subjective measurement method using self-reporting, was evaluated for validity, reliability, and sensitivity for occupational therapy patients and physically disabled children. The goal forum intervention is a goal-setting method involving the collaboration of patients and physical therapists with the use of a check-list, but this method was developed for rheumatoid arthritis patients. [Conclusion] We recommend further studies on the development of a goal-setting method using a checklist for stroke patients and the evaluation of the validity and reliability of GAS for stroke patients.

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The biosynthesis of iron-sulfur (Fe-S) clusters in Bacillus subtilis is mediated by the SUF-like system composed of the sufCDSUB gene products. This system is unique in that it is a chimeric machinery comprising homologues of E. coli SUF components (SufS, SufB, SufC and SufD) and an ISC component (IscU). B. subtilis SufS cysteine desulfurase transfers persulfide sulfur to SufU (the IscU homologue); however, it has remained controversial whether SufU serves as a scaffold for Fe-S cluster assembly, like IscU, or acts as a sulfur shuttle protein, like E. coli SufE. Here we report that reengineering of the isoprenoid biosynthetic pathway in B. subtilis can offset the indispensability of the sufCDSUB operon, allowing the resultant Δsuf mutants to grow without detectable Fe-S proteins. Heterologous bidirectional complementation studies using B. subtilis and E. coli mutants showed that B. subtilis SufSU is interchangeable with E. coli SufSE but not with IscSU. In addition, functional similarity in SufB, SufC and SufD was observed between B. subtilis and E. coli. Our findings thus indicate that B. subtilis SufU is the protein that transfers sulfur from SufS to SufB, and that the SufBCD complex is the site of Fe-S cluster assembly.

[Purpose] The aims of this study were to evaluate the type and extent of error in the measurement of range of motion and to evaluate the effect of evaluators’ proficiency level on measurement error. [Subjects and Methods] The participants were 45 university students, in different years of their physical therapy education, and 21 physical therapists, with up to three years of clinical experience in a general hospital. Range of motion of right knee flexion was measured using a universal goniometer. An electrogoniometer attached to the right knee and hidden from the view of the participants was used as the criterion to evaluate error in measurement using the universal goniometer. The type and magnitude of error were evaluated using the Bland-Altman method. [Results] Measurements with the universal goniometer were not influenced by systematic bias. The extent of random error in measurement decreased as the level of proficiency and clinical experience increased. [Conclusion] Measurements of range of motion obtained using a universal goniometer are influenced by random errors, with the extent of error being a factor of proficiency. Therefore, increasing the amount of practice would be an effective strategy for improving the accuracy of range of motion measurements.

Step adjustment under temporal constraint is compromised following stroke. However, how step adjustment occurs under no temporal constraint remains unclear. The aim of this study was to investigate how patients with stroke adjust their step length to step over obstacles under no temporal constraint. Twelve patients with stroke and 12 age-matched and sex-matched individuals without stroke participated in an experiment involving the task of stepping over obstacles. Each participant's steps were measured by a footprint method and classified as a long-step, short-step, or even-step strategy. The differences in step length adjustment between patients with and without stroke were analyzed. Stroke survivors adjusted their step length in different ways depending on whether they led with the affected or the unaffected limb. If patients with stroke stepped over the obstacle by leading with the affected limb, they chose the short-step strategy. This strategy is probably intended to enhance accuracy and maintain stability. In conclusion, patients with stroke utilize a different step adjustment strategy to individuals without stroke, even in the absence of temporal constraint.

Background High-quality training is required to improve the cardiopulmonary resuscitation (CPR) skills. Although it has been reported that the use of a feedback device is effective, the effects of feedback timing and frequency on CPR training have not been investigated. The aim of this study was to clarify the influence of feedback frequency and timing on the acquisition of CPR skills. Methods Sixty-eight undergraduates were first divided into female (n = 32) and male (n = 36) groups, and randomly assigned to one of four groups for each sex: concurrent-100%, concurrent-50%, terminal-100%, and terminal-50% feedback groups. The randomization was performed using a lottery method. This study consisted of a pre-test, practice sessions, a post-test, and a follow-up test. In the practice sessions, the participants performed six 2-minute CPR sessions in accordance with the condition assigned using mannequins and feedback devices. The post-test was conducted 24 hours after the completion of the practice sessions and the follow-up test was conducted 3 months after the completion of the practice sessions. The primary outcome of the study was the overall score at the follow-up test. Results The results of the overall score at the follow-up test for each group were 88.2 ± 9.6% for concurrent-100%, 92.2 ± 6.4% for concurrent-50%, 82.6 ± 16.4% for terminal-100%, and 85.2 ± 16.9% for terminal-50%. We did not find any statistically significant difference for the overall score at the follow-up test among the four groups (p = 0.173). The ANOVA for the test sessions revealed that there were no significant main effects of feedback timing (p = 0.135) or frequency (p = 0.765), and no significant interaction between timing and frequency (p = 0.997). Conclusion The present study reveals that the use of feedback devices is an important factor for higher quality CPR training, regardless of the timing and frequency with which they are used.

[Purpose] The purpose of this study was to clarify the validity of salivary α-amylase as a method of quickly estimating anaerobic threshold and to establish the relationship between salivary α-amylase and double-product breakpoint in order to create a way to adjust exercise intensity to a safe and effective range. [Subjects and Methods] Eleven healthy young adults performed an incremental exercise test using a cycle ergometer. During the incremental exercise test, oxygen consumption, carbon dioxide production, and ventilatory equivalent were measured using a breath-by-breath gas analyzer. Systolic blood pressure and heart rate were measured to calculate the double product, from which double-product breakpoint was determined. Salivary α-amylase was measured to calculate the salivary threshold. [Results] One-way ANOVA revealed no significant differences among workloads at the anaerobic threshold, double-product breakpoint, and salivary threshold. Significant correlations were found between anaerobic threshold and salivary threshold and between anaerobic threshold and double-product breakpoint. [Conclusion] As a method for estimating anaerobic threshold, salivary threshold was as good as or better than determination of double-product breakpoint because the correlation between anaerobic threshold and salivary threshold was higher than the correlation between anaerobic threshold and double-product breakpoint. Therefore, salivary threshold is a useful index of anaerobic threshold during an incremental workload.

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