This study clarified the effects of voluntary training with family outside of regular rehabilitation training on stroke patient's mobility and activities of daily living (ADL), as well as uneasiness of family care after returning home. The subjects were 22 first-ever stroke patients presenting with moderate or high-level hemiplegia who returned home and the family. They were divided into two groups based on the frequency of their families' participation per week: "the high frequency group" and "the low frequency group." The groups were compared by patient background, mobility and ADL. Moreover, the groups' families were compared by family's background, degree of understanding regarding patient symptoms, degree of voluntary training needed to acquire the assistance skills and degree of uneasiness about family care. There were no significant differences in background factor, mobility and ADL in two groups at discharge and after discharge. Mobility after discharge was higher than mobility at discharge in the high frequency group. ADL after discharge was lower than ADL at discharge in the low frequency group. The assistance skills of ambulation in the high frequency group were greater than those in the low frequency group. Voluntary training with high-frequency family participation was contributing to the improvement of mobility after discharge for severe stroke patients and it also learn the assistance skills of ambulation. However, this study no clarified the effects of voluntary training with family on understanding the patients' symptoms and lower family uneasiness regarding the patients' care in two groups.

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【Purpose】 This study aimed to investigate the effects of either the presence or absence of equines and heel height differences on standing centroid oscillation in ambulant patients with cerebral palsy. 【Methods】 Twenty-four patients whose gross motor functions were classified as level I or II were selected (equinus group, 13 patients; non-equinus group, 11 patients) . We examined the impact of age, foot joint torque, the presence or absence of equinus, and heel height differences (0, 7, and 15 mm) on standing centroid oscillation. 【Results】 Age and foot joint torque showed no significant differences between the groups. In the non-equinus group, the total length of body sway and locus length significantly decreased in the 0-mm heel height compared with that in the 7 and 15-mm heel heights, and the rectangular area significantly decreased in the 0-mm heel height compared with that in the 15-mm heel height. The Y-direction unrest center displacement in the equinus group significantly decreased in the 0-mm heel height compared with that in the 7- and 15-mm heel heights. 【Conclusions】 Our results suggest that standing centroid oscillation did not change according to heel height differences in the equinus group but changed in the nonequinus group. In the equinus group, the position of the anteroposterior center of gravity moved forward according to heel height.

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Introduction : In the cooperation of a regional medical network, it is an important issue in interinstitutional patient referrals to transfer and share imaging information among institutions. Medical imaging histories of patients have been increasing important in modern medicine. The important task has been facilitated with spread of digital imaging in medical institutions. However, classical analogue images are still commonly utilized. Purpose : The purpose of this work is to know the recent trend of transition from analogue to digital imaging in medical institutions the majority of which are located in the southeast district in Tokyo.Material and Method : We looked into how many medical images, both X-ray films and digital formats (Portable Data for Imaging : PDI), were transferred in patient referrals to Tokyo Metropolitan Bokuto Hospital from January 2008 to February 2011, and also estimated a percentage of PDI. Results : The transferred medical images dramatically increased in the late 2000s : 322 in 2008, 1568 in 2009 and 2256 in 2010. The percentage of PDI was 17.7% in 2008, 35.7% in 2009, and 49.6% in 2010. Hospitals provided PDI more frequently than clinics : 23.8% vs. 10.7% in 2008, 47.0% vs. 24.9% in 2009, and 60.7 vs. 39.1% in 2010. Large hospitals with over 500 beds most often supplied PDI. Conclusion : The results reflected that digital imaging systems have been increasingly prevalent in referral hospitals, while it is still limited in use in clinics. Utility of PDI is apparent in sharing and transfer of medical imaging, and the standardization is essential for the optimal use. The utilization of PDI should be geared, as digital imaging systems is widespread in primary medical care services.

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