The purpose of this study is to predict the outcome (final independence level) in stroke rehabilitation early with a simple clinical method.
Our subjects consisted of 406 acute stroke patients who were admitted to a community hospital within one month after the onset. There average age was 67.0 years.
We used a combination of three factors to predict the final independence level of each patient. These factors were (1) patient's age, (2) independence levels on admission, two weeks after admission, one month after that and (3) clinical signs. We classified independence level into three: ambulant (AMB), independent in sitting (SIT), totally dependent (DEP). We divided clinical signs into motor disturbance and other 12 signs such as consciousness disturbance, dementia, night delirium, aphasia, left hemispatial agnosia.
Main results were as follows:
(1) Patients who were SIT on admission finally became AMB.
(2) Patients who were DEP on admission but had mild hemiparesis of Brunnstrom's recovery stage IV to VI finally became AMB.
(3) Patients who were DEP on admission but became SIT within one month after that finally became AMB.
(4) Among the patients who remained DEP one month after admission, certain patients continued to be DEP, who were 60 years or older and had delayed consciousness disturbance, dementia, bilateral hemiplegia or severe heart disease.
Based on these results, we composed a set of criteria for the early prediction, which could definitely predict the final independence level in 70% of the stroke cases on admission, in 80% two weeks after admission and in 90% one month after admission.

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The present study was carried out determine the physiological intensities of cerebral palsy children during swimming exercises. Heart rate responses during swimming exercises were recorded continuously by telemetry in 5 severe cerebral palsy subjects of 9-11 years of age. Maximum heart rates ranged from 128 to 198beats/min and mean heart rates were 99-163beats/min. Mean heart rates during swimming were 149 and 163beats/min in athetotic subjects and 99, 105 and 121beats/min in spastic subjects. There was tendency that heart rate of the athetotics was more increased than that of spastic subjects.
There was significant correlation between oxygen intake and heart rate during swimming exercises in a mild spastic subject. Maximum oxygen intake obtained during treadmill walking was about 25% higher than the oxygen intake measured when the same cerebral palsy child was swimming.

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We usually use the pressure of the cuff of an ordinary sphygmomanometer as an index of grip strength of rheumatoid arthritis (RA) patient.
According to the original method of Lansbury, the cuff of 8.5×14.0cm in size is inflated up to the pressure of 20mmHg, then is squeezed as hard as possible by the patient and the mean of the highest pressure value in three trials in each hand is regarded as the grip strength.
However, the inflated cuff of this size seems to be too large for Japanese RA patients.
We examined the grip strength of RA patients using the cuff of 6.5×14.0cm and compared the values with those measured by the larger cuff or hand dinamometer.
The highest value in two trials having the interval of more than 30 seconds should be thought to show an accurate grip strength.
The cuff of the smaller size seemed to be suitable for Japanese RA patients than the original one by Lansbury.

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This study was attempted to scrutinize the methods employed by many researchers to design profiles so-called predictors for outcomes in stroke. It is considered that outcomes in stroke should be more accuratelly predicted by specified syndromes resulting from stroke than by isolated symptoms. In accordance with this idea we report on our classification of the neurologic syndromes for the purpose of predicting outcomes mainly in the ambulatory ability and also on the results which have been found to be statistically satisfactory for its validity. The material consisted of 228 stroke patients whose average age was 58 years. The neurologic syndromes were classified as follows:
1) Hemiparesis syndrome. (62 cases)
1a: mainly hemiparesis (32 cases)
1b: either dysesthesia or deep sensory deficit or involuntary movement with hemiparesis. (24 cases)
1c: pseudobulbar palsy with hemiparesis. (6 cases)
2) Hemiplegia syndrome. (60 cases)
2a: mainly hemiplegia. (44 cases)
2b: either dysesthesia or deep sensory deficit with hemiplegia. (16 cases)
3) Ataxia syndrome. (6 cases) Mainly ataxia with or without cranial nerve signs.
4) Aphasia, agnosia, apraxia syndrome. (76 cases) Syndrome indicated by either aphasia or agnosia or apraxia.
4a: these symptoms with hemiparesis. (15 cases)
4b: these symptoms with hemiplegia. (61 cases)
5) Dementia syndrome. (19 cases)
5a: Dementia with hemiparesis. (7 cases)
5b: Dementia with hemiplegia. (12 cases)
6) Miscellaneous syndrome. (5 cases) Syndrome not to belong to any other syndromes.
Attempts were made to analyse statistically the differences of the independency-ratio in the ambulatory ability on discharge between each neurologic syndrome and the significant results were obtained at the p<0.05 or p<0.01 level in the almost all combination of the neurologic syndromes. Upon this statistical evaluation, identification of these neurologic syndromes seemed to add a perspective to the stroke rehabilitation and prognostication and to have valuable for the practical daily management of stroke.

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