One hundred patients given rehabilitation programs during a period of about 7 years for the sequelae of cerebrovascular accicents at the Okayama Rhosai Hospital were reviewed for an evaluation of therapy. Physiotherapy employed consisted of an active exercise, particluarly ambulation exercise training. All the cases obtained recovery of the function of the lower extremities to the point of single crutch walking after an average period of 2.7 months, but recovery of the function of the upper extremities were not so good.
Most of the technical problems have been solved, but there are still unsolved defficulties in the approach to upper extremity training, mental and speech disturbances and paraplegic ataxia.
Mortality rate does not seem to be increased during and after rehabilitation programs. From various viewpoints a conclusion has been reachedon the advisability of providing rehabilitation programs for the sequelae of cerebrovascular accidents.
Cardiovascular specialists are to be responsible for these situations with an assistance of physical therapists. However, under the present Japaense circumstances where there is yet no speciality system, internists should take care of these problems. It is quite natural that this can be effectively carried out with collaboration of orthopedic surgeons and neurologists.

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Psychological background in rehabilitation of the patients at our department was surveyed by paper questionnaire method, those who have shown psychological problems were 40-53%, further in the research of comparison among kinds of diseases, there were two groups of having prominent problems, i. e. bone tuberculosis and rheumatoid arthritis. There were also 10-20% mentioning psychosomatic reactions in broad sense, and other group was analysed by a case study in order to learn the psychosomatic diseases. Standing at the point of view that rehabilitation is to approach comprehensively the patients for returning to their own communities, the author have organized the thought of rehabilitation. As for the core of psychological support, its techniques should be taken from clinical psychology and psychosomatic medicine; therefore on the psychological treatment the author have researched the basic possible items.

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By the projection of phantom-limb of 19 amputees (5 cases of them are defectives in upper extremity, 13 cases defective in lower extremity and 2 cases defective in extremities) the following results are obtained.
The phantom-limb is not always accompanied by the phantomlimb pain, whereas the disppearance of phantom-limb does naturally mean the disappearance of phantom limb pain. Since the phantom-limb can be irased by psychological treatment, it is quite possible that the phantom-limb pain can be wiped out likewise.
The fact that the phantom-limb is closely related to the way the phantom-limb pain ocurr seems to corraborate that the motor area is related to the sensory area or cerebral cortex. There is a tendency observed that the phantom-limb pain is more acute in the place where the phan-limb is felt more keenly, than any other place: in the cases of upper extremity defect the nearer the phantom-limb locates to the finger tip, especially that of the thumb, the more acute becomes the pain, and in the cases of lower extremity defect the pain is especially acute in the parts near the first toe of fore foot and the heel. And there is another tendency that an amputee feels strongly the phantom-limb and the phantom-limb pain in the wound received before amputation. The phantom-limb pain and the pain on the amputated stump are of the same nature and both have the characteristics of central pain. It can generally be said that the phantom-limb pain takes precedence over the pain on the amputated stump, but when the phantom-limb with pain is for enough from the amputated stump, the phantom-limb pain and the pain on the amputated stump are felt separately, while in the case that the phantom-limb and the amputated stump are near each other the pains are hardly distinguishable. Two kinds of pain above mentioned are apt to be affected by mental conditions and climate. Conesquently, many of amputees who complain strongly of phantom-limb, phantom-limb pain and pain on the amputated stump often show a psychic sbnormality.
The phantom-limb is reversible; in other words, it is possible that the phantom-limb, which was once disappeared, will re-appear to the patient. And if the enviroment, to which the patient returns, is not satisfactory, the phantom-limb re-appears even to the patient who showed the satisfactory remedial effect of the orthopedic exercise including the psychological approach in a hospital or inatitution. Amputees sometimes find themselves having troubles in daily life, when phantom-limb do not correspond with artificial limbs. This fact must be taken into consideration in rehabilitation of patients of irreducible diseases. In other words the patients must be given the psychological reorientation or so-colled “brain washing” according to the conditional reflex throry towards the final stage if recovery of function in their future.

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For the past three years, over 300 cases of Bell's palsy have been studied clinically and electromyographically. In this paper, the effect of 5c/s rectangular pulse wave current with amplitude modulation to the paretic facial nerves without degeneration is presented.
Method:
Fifty-one patients without degeneration of the facial nerve were selected by the intensity-time curve (i/t-curve) as well as the electrical reaction of degeneration. These cases were divided at random into the following three groups.
A-group: Patients in this group were indicated to carry out at home voluntarily (1) active exercise of facial muscles, (2) hot fomentation of the paralysed face, and (3) massage of the face by themselves.
B-group: Patients in this group visited the clinic as outpatients everyday, and were administered a non-effective electrotherapy (this was done by a false, non-stimulative apparatus which corresponded to a placebo) and massage by a masseur. The patients in B-group were also indicated to follow at home the same measure as A-group.
C-group: Patients in this group were indicated to visit the clinic as outpatients everyday, and were applied the low frequent (5c/s) rectangular pulse wave current with amplitude modulation and massage by a masseur. These patients were also indicated to do at home the same measure as A-group. Preliminarily, therapeutic responses of four groups treated by 5c/s, 50c/s, and 1, 000c/s of rectangular pulse wave current and galvanisation respectively were compared. The group treated by 5c/s current showed better, but not significant result. So, the auther selected 5c/s rectangular pulse wave current for this study.
Results:
All cases had been examined every week and when the patient showed no sign of facial palsy more, cure of the palsy was checked, and duration of the disease was calculated. The average value of duration in days were as follows:
A-group; 40.3±7.2 B-group; 36.5±5.4 C-group; 36.1±5.9
There was no statistically significant difference among them.
Conclusion:
In case of the patients without degeneration of the facial nerve, the abovementioned electrotherapy was not essential. And the voluntary exercise therapy as well as the massage was sufficient to cure them.

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