(1) The purpose of this study is to establish an index of physical fitness and methodology of measuring physical fitness in the hemiplegic patient due to cerebrovascular accident, and to compare the physical fitness in the hemiplegic patients with that in normal persons of the comparable age.
(2) The oxygen uptake at the heart rate (H. R.) of 100 or 120 beats/min. (V_O2100, V_O2120) was considered to be a valid index of physical fitness in the hemiplegic patients.
(3) It was found that there was a linear relationship between H. R. and V_O2 in the hemiplegics in 5th or 6th decade who had the IV Brunnstrom stage in the lower extremity as long as H. R. was smaller than 120 beats/min. Using this relationship between H. R. and V_O2, it was possible to intrapolate V_O2100 and V_O2120.
(4) Physical fitness was measured in the hemiplegics in the 5th and 6th decade (hemi plegicgroup), and the normal men in the 5th and 6th decade (normal group). Each of the four subgroups consisted of 15 men. V_O2100 and V_O2120 in each subject were measured in indirect method,
1) Subjects were asked to walk on treadmill slowly (walking speed was about 50% of speed in the comfortable walk) for 5 minutes.
2) Consequently, they were asked to walk fast (walking speed was about 120% of speed in the comfortable walk) for 5 minutes.
3) After 5-10 minutes of rest, they were asked walk with comfortable speed on treadmill that was inclined at 5 degrees. H. R. and V_O2 of the last 1 minute were measured in each condition. Using these data, V_O2100 and V_O2120 of each subject were calculated.
(5) V_O2100 and V_O2120 of hemiplegic group were significantly lower than that of normal group in both decades. From this result, it was concluded that physical fitness in the hemiplegic patients in the 5th and 6th decade was lower than that in normal men in the same age.
(6) It might be considered that fall in stroke volume of the heart was one of the factors that caused deterioration of physical fitness in the hemiplegic patients.

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We studied the below-knee prostheses of 111 injured workers and retirees over a period of four years (1979-1982). We noted signs of wear and damage, including break sites and break frequency, and examined the causes of damage. The typical prosthesis was PTB type with a SACH foot; this mechanically sophisticated arrangement suited the wearers well because most of them were involved in light labor. The average endurable life of a socket or parts was much shorter for Syme and PTES prostheses than for PTB and KBM prostheses. This tendency was especially notable in unilateral below-knee amputees, for whom type of prosthesis and intensity of daily activity were more strongly related to damage than length of the stump. Among bilateral amputees, intensity of daily activity was not closely related to extent of damage of the prosthesis, rather frequent breakage was attributable to unstable gait and movement. Among bilateral amputees with a BK on one side and an AK on the other, low frequency of breakage was attributable to a relatively low intensity of daily activity.
Frequently damaged sites of the socket varied according to type of prosthesis. One site frequently damaged in all types was the hamstring channel, i. e., the region in contact with the medial hamstrings. This site was structurally weak because of forces contiunally acting to widen the channel, and reactive forces during knee flexion in gait further aggravated this region. Greater precision in distributing intrasocket pressure evenly may thus be valuable in improving the shape and quality of prosthetic sockets.

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33 cases of putaminal hemorrhage (PH) classified by CT analysis were investigated on the prognosis of upper limb motor function, gait, ahasia and ADL.
The results were as follows:
1) Good recovery of motor function in upper affected limb was observed in 15.1 per cent of the patients.
2) Fifty seven point six per cent of overall subject recovered independent gait, of which, 38.5 per cent was in surgically treated group and 70 per cent in conservative one. The prognosis of gait ability in conservative group was better than in surgical one.
3) The mean age was significantly younger in independent group [52.5±12.4 years: mean±SD] than dependent one [60.6±6.7 years].
4) In the surgical treatment group, the mean age of the independent gait groupe [39.6±12.7] was significantly younger than that of the dependent gait group [59.9±6.2]
5) Poor prognosis of the gait was observed in the patients with urinary incontinence.
6) 27.2 per cent of the patients with PH had aphasia.
7) There was a significant correlation between ADL and ambulation.
8) Good prognosis was observed in the patients without hematoma effects over the posterior limb of internal capsule by CT scan.

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One-hundred and five patients of lower extremity amputee (mean age, 45 years old), who were operated in our hospital and exercised by rehabilitation team from 1968 to 1982, were examined retrospectively. And the indication of post-operative stump managements were discussed. Causes of amputation were disvascular condition of lower limb (41 limbs), malignant tumor (44 limbs), trauma (11 limbs) and others. Level of amputation were 7 limbs of hip disarticulations, 49 limbs of above knee amputation, 43 limbs of below knee amputation and others. Post-operative stump managements which we practiced were 10 limbs of controlled environmental treatment (CET), 45 limbs of immediate post-operative prosthetic fitting (IPPF), 7 limbs of rigid dressing, 33 limbs of soft dressing and others.
Main factors for choice of post-operative stump managements were pre-operative risks such as general conditions, cardio-respiratory diseases, mental functions, advanced age and others. Practically, there were so many patients to whom we had no choice but to do the soft dressing. In such cases, primary wound healing were poor. Other factors affecting choice of post-operative stump managements were 1) technical level of rehabilitation team, 2) cooperation of rehabilitation team and surgeons, 3) pre-operative evaluations about functional prognosis and needs of patients, 4) conditions of patients during operation.

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[in Japanese]

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[in Japanese]

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