本谷 郁雄

The clinical skills of physical therapists (PTs) are crucial, as high-quality clinical competence leads to trustworthy patient care, reliable assessments, and effective therapeutic choice. Clinical practice hours (CP hours) may be used to validate theoretical knowledge acquired during training, especially among novice PTs. This exploratory, single-center, cross-sectional study examined the relationship between total CP hours during undergraduate education and novice PTs’ clinical competence. The small convenience sample comprised 25 newly recruited PTs employed by the Department of Rehabilitation at a general hospital in Japan between April 2022 and April 2023. CP hours were surveyed using Google Forms. Clinical competence was assessed using the Objective Structured Clinical Examination, employing two tasks frequently performed in clinical settings: range-of-motion exercises and muscle-strengthening exercises. Total CP hours during undergraduate education were significantly and positively correlated with clinical competence for range-of-motion exercise (ρ = 0.68; 95% CI, 0.3450–0.8677, p < 0.001). A positive trend was observed for muscle strengthening exercise (MSex) (ρ = 0.197; 95% CI, −0.3061–0.6029, p = 0.346), suggesting a ceiling effect for MSex, with relatively low correlation but high acquisition levels, even with fewer total CP hours. Overall, this study revealed a significant correlation between total CP hours during undergraduate education and novice PTs’ clinical competence.

Background/Objectives: Advanced age in Parkinson’s disease (PD) is linked to worse motor function, more severe symptoms, and impaired activities of daily living (ADLs). Lee Silverman Voice Treatment (LSVT)® BIG may be suitable for older patients, as it can be adapted to individual abilities. This study evaluated whether age affects the effectiveness of LSVT® BIG on gait speed, motor symptoms, ADLs, and quality of life (QoL) in PD. Methods: In this retrospective, single-center cohort study, 22 patients with PD were divided into an older group (≥65 years; n = 16) and a younger group (<65 years; n = 6). All participants completed 16 one-hour, face-to-face LSVT® BIG sessions. Gait speed was assessed with the 10-m walk test; motor symptoms with Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III; ADLs with MDS-UPDRS Part II; and QoL with the Parkinson’s Disease Questionnaire-39 Summary Index. Two-way mixed-design analysis of variance with aligned rank transformation was used for statistical analysis. Results: Significant improvements were observed for all outcomes (gait speed, motor symptoms, ADLs, and QoL) after the intervention. A significant effect of age group was found for gait speed, with younger patients walking faster overall. No significant interaction between timepoint and group was observed for any measure. Conclusions: LSVT® BIG appears to improve gait speed, motor symptoms, ADLs, and QoL in patients with PD, regardless of age, suggesting it is an effective intervention for both older and younger patients.

In individuals with Parkinson’s disease (PD), bradykinesia severity is related to physical activity (PA) inside homes. We aimed to investigate the effectiveness of the Lee Silverman Voice Treatment (LSVT)® BIG intervention in increasing at-home PA in individuals with PD. To evaluate the effect of the intervention, we compared pre- and post-intervention scores on the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Parts 3 and 2, as well as the time spent at home in three categories of PA intensity. For statistical testing, paired t-tests were used when the data met the assumptions of normality, and the Wilcoxon signed-rank test was applied otherwise. Differences were considered statistically significant at p < 0.05. This preliminary retrospective observational study included 10 eligible individuals with PD (4 males). The participants’ mean age was 71.0 ± 10.8 years, with median Hoehn and Yahr stage 3 [interquartile range: 1 to 4]. The MDS-UPDRS Part 3 score, bradykinesia score calculated from a part of that score, and the MDS-UPDRS Part 2 score significantly improved after the intervention (Wilcoxon signed-rank test, p < 0.05). The time spent in sedentary behavior (SB) significantly decreased from 516.4 ± 72.6 to 484.0 ± 70.0 min, whereas that spent in light PA (LPA) significantly increased from 137.8 ± 46.2 to 169.5 ± 32.1 min (paired t-test, p < 0.05). The time spent on moderate-to-vigorous PA (MVPA) did not change significantly (paired t-test, p = 0.533). The results suggested that LSVT® BIG is an effective intervention for increasing at-home PA in individuals with PD. In addition, regarding the specific details of the increase, the time spent on MVPA may not change, and the increase may be mainly attributed to increased LPA and reduced sedentary time.

BACKGROUND: Newly graduated physical therapists require effective training to enhance their clinical skills. On-the-job training (OJT) and off-the-job training (Off-JT) are commonly used methods, but their comparative effectiveness remains unclear. This study aimed to compare the effectiveness of OJT and Off-JT in improving the clinical competencies of newly graduated physical therapists. MATERIAL AND METHODS: A crossover study was conducted involving 13 newly graduated physical therapists. Participants alternated between OJT and Off-JT interventions. The objective-structured clinical examination assessed four key skills—joint range of motion measurement, muscle testing, assistance in getting up, and assistance in transferring. Evaluations were conducted at four time points. A Mann–Whitney U -test was used to compare the change in average scores between the two groups from Assessment 1 to Assessment 2. A two-way analysis of variance was conducted to analyze the interaction effects of training methods and assessment timing. RESULTS: Off-JT was more effective than OJT in improving clinical skills, especially in muscle testing and patient assistance tasks. Both training methods enhanced joint range of motion measurement skills; however, no significant differences were found between the groups. Some tasks showed performance declines in the final assessment, indicating the necessity of continued practice. CONCLUSIONS: Off-JT provides a more effective approach for improving clinical skills, particularly for tasks that require specialized knowledge and structured learning. However, OJT remains valuable for reinforcing routine clinical tasks. Future research should explore the long-term effects of these training methods on various clinical competencies.

Background/Objectives: Individuals with Parkinson’s disease (PD) often experience four major motor symptoms—tremor, rigidity, bradykinesia, and postural instability/gait disorder. Although these symptoms have been shown to affect activities of daily living, their impact on the level of at-home physical activity (PA) in this population remains unexplored. We aimed to investigate the relationship between the four major motor symptoms of PD and at-home PA in these individuals. Methods: This retrospective cross-sectional study included 17 individuals with PD. We examined the relationship between the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale Part 3 score and the time spent in three PA intensities (sedentary behavior, light PA [LPA], and moderate-to-vigorous PA) within the home. Pearson’s correlation coefficient was used for statistical analysis. Results: In the initial step analysis, a significant negative correlation was observed between the overall motor symptom score and the time spent in LPA inside the home (rs [95% confidence interval]: −0.72 [−0.93 to −0.25]; p < 0.01). In the second step analysis, a significant negative correlation was observed between the bradykinesia score and the time spent in LPA inside the home (rs: −0.74 [−0.92 to −0.30]; p < 0.01). Conclusions: Among the four major motor symptoms, only the severity of bradykinesia influenced the time spent in LPA inside the home. Thus, rehabilitation treatment focusing on bradykinesia may be beneficial for increasing the time spent in LPA inside the home for individuals with PD.