In this paper, we studied on the straight leg raising angle in Japanese healthy adults, and reported some findings concerning to the evaluation of the straight leg raising test which was widely use in the diagnosis of lumbarr disk herniation.
On 946 males and 842 females of 20 to 69 years of age, measurement was made of maximal angle of hip flexion with extended knee enabling them to passively raising up the leg slowly without resistance.
The results obtained revealed critical values of the straight leg raising angle of 65 degrees for male and 75 degrees for female.
The evaluation of straight leg raising test needs to take the followings into consideration; male and female show sexual variation in normal values of straitht leg raising angle, with significantly larger angles for female, and there are no difference between the right and left legs in values, and there are high correlation between the right and left legs.
Tight hamstrings were observed in 12.5% of healthy male and 13.2% of healthy female, with a predominance in fifties and sixties for male and in twenties for female.

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In order to establish the quantitative method to evaluate the effect of therapy and rehabilitation on clinical status of patients with multiple sclerosis, we divided 31 patients into four clinical formas: spinal form, optico-spinal form, brainstem-cerebello-spinal form, and optico-brainstem-cerebello-spinal form, and used McAlpine's and Kurtzke's method for assessment of their degree of disability. Improvement indexes were calculated by subtraction of Kurtzke's 6 different functional scores, i. e. pyramidal, cerebellar, brainstem, sensory, bladder and bowel, and visual function scores, at dischage from those at admission. In case of McAlpine's score, we compared scores st admission with those at discharge.
As a whole, the patients showed significant improvement from 2.55±1.43 (mean±SD) at admission of McAlpine's score to 1.74±0.95 at discharge. When using Kurtzke's method, improvement index was 3.22±2.32 and this value was also significant.
Brainstem-cerebello-spinal form showed most striking improvement assessed by McAlpine's method, and optico-brainstem-cerebello-spinal form gained best result when Kurtzke's method was used.
This discrepancy of results obtained using these different methods, might be due to the fact that McAlpine's method reflects mainly the pyramidal function and Kurtzke's method reflects the cerebellar and brainstem functions. Actually both brainstem and cerebellar functions scores showed most remarkable improvement by assessment with Kurtzke's method. The spinal form showed the poorest outcome by assessment of both methods.
We would like to emphasize that it is necessary to consider clinical forms and use quantitative scores of disabled functions, to assess the prognosis of the patients with multiple sclerosis.

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Severely impaired cerebral palsy children who are unable to sit by themselves must mostly be confined to bed. They have many impediments to overcome in their rehabilitation.
Children with cerebral palsy, especially those with involuntary dyskinetic movements, need suitable positioning to inhibit tonic reflexes. A position suitable for achieving relaxation in the cerebral palsy child can usually be suggested by the parents or other people who care for the child. Based on this information, we make a bucket-seat type of seating support orthosis that provides the child with relaxation and functional positioning.
At the beginning of fabrication a negative mold is made using special equipment. After a trial fitting to confirm optimum positioning and requierd attachments, e. g., safety belt, apron, headrest, or cut-out table, the orthosis is made from thermoplastic material and covered with a cushion.
For the past five years we have fitted 26 orthoses for cerebral palsied adults and children. The relaxed sitting position provided by this orthosis enables the user not only to develop latent abilities in the function of upper extremities, but also to reach a higher level of mental motivation.
We present the fabrication technique, some case reports, and a follow-up study of the seating support orthosis.

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We analyzed several hand movements of two tetraplegics and one hemiplegic using functional electrical stimulation (FES). For this purpose, we made a ten-channel stimulator on an experimental basis. Stimulation was carried out using cathodal rectangular pulse trains at 20Hz with a pulse duration of 0.2 msec. Stimulus amplitude was varied from 0 to -25V and adjusted to obtain the desired muscle contraction. The electrodes we used were percutaneous stainless steel wires after Caldwell and Peckham. Six nerves supplying the muscles of the forearm and hand were stimulated separately or simultaneously.
As to individual motion of the hand, five patterns were obtained as follows:
1. Extention of the thumb and fingers by stimulation of a deep branch of the radial nerve.
2. Opposition and abduction of the thumb by stimulation of a recurrent branch of the median nerve.
3. Flexion of the thumb by stimulation of muscle branches to the flexor pollicis longus.
4. Flexion of the fingers by stimulation of muscle branches to the flexor digitorum superficialis and profundus.
5. Flexion of the MP joints of the thumb and fingers with thumb adduction by stimulation of the ulnar nerve.
It is necessary to combinate these motions to obtain practical hand movements for ADL. For this purpose, two or three nerves were stimulated in combination, and four patterns of of the movements were obtained as follows:
1. Opening of the hand with the thumb in opposition by stimulation of a deep branch of the radial nerve and a recurrent branch of the median nerve.
2. Power grasp or precision grasp by stimulation of a recurrent branch of the median nerve, muscle branches to the flexor digitorum superficialis, profundus and flexor pollicis longus.
3. Lateral pinch by stimulation of muscle branches to the flexor digitorum superficialis, profundus and flexor pollicis longus.
4. A movement that holds a newspaper or a hand of cards by stimulation of the ulnar nerve and a recurrent branch of the median nerve.

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Intrafusal muscle fiber can be classified into two histochemical types based on ATPase reaction; type 1 with low ATPase activity and type 2 with high activity.
The left crural muscles of rats were denervated by crushing the sciatic nerve and contralateral muscles were used as a control. The intrafusal muscles of the musculi ext. dig. longus were observed and their transverse areas were measured. The following results were obtained:
1. The standard rat muscle spindle has three type 1 fibers and one type 2 fiber.
2. Type 1 fibers showed more severe atrophy than type 2 fibers after denervation.
3. The area of the type 2 fiber became larger after denervation.
The above observations were consistent with our observations of extrafusal muscle.

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Although various methods of evaluating involuntary movement in the upper extremities have been reported, they focus on the results, rather than process of performance. The function of the upper extremities can be divided into a kinetic one and a controllability.
The author has developed an electric detector to evaluate these upper extremity functions and investigated the quantitative method of evaluation of performance using an FFT analyzer and a microcomputer.
When the sensor of the detector is picked up and held, the pressure on the sensor of the position are recorded continuously. Several parameters can be obtained from these original recordings.
The subjects included 20 patients with involuntary movement in the upper extremities and 20 normal controls. There were no significant differences between the patients and controls in the kinetic functions that could be evaluated by two parameters of the recordings, that is, “rising time” and “time delay”. Therefore, the author has analyzed the power spectrum of the force and position as the evaluation of controllability. Maximum frequency and total power in the power spectrum increased in patients, compared with normal controls. As the load was added to the sensor, maximum frequency and total power increased in controls. This tendency was more marked in the power spectrum of the force. Depending upon the type of disease, differences in the pattern of the power spectrum were recognized. Based on these results, the author plans to develop a more quantitative method of evaluating involutary movement.

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[in Japanese]

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[in Japanese]

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