The measurement of muscle strength has generally been used to assess neuromuscular function and the severity of physical disabilities. In this study we examined motor time (MT) and muscle strength produced by isometric maximum voluntary contraction (MVC) of the right quadriceps femoris for the knee extension, neurological signs and walking capacity in patients with spinal paraparesis. The step-wise multiple regression analysis was performed in order to obtain predictors of walking capacity. The result revealed that the most significant predictor was MT, followed by spasticity, but MVC was not a significant predictor. The primary functional impairment in spinal paraplegics is attributed to the decrement of rapid force development, but not to that of isometric maximum force production.

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A well fitting socket is highly important for ambulation involving a lower limb prosthesis. For the above-knee amputee, the fit of the socket plays a particularly critical role in effectively uniting stump and prosthesis. The socket performs the basic functions of suspension, weight bearing, stabilization, and provision of biomechanical sensory feedback. To determine what problems of above-knee prostheses are of practical importance, the author investigated the status of above-knee amputees in Ehime prefecture. It became clear that, in long wear, the suction socket would often develop into a cause for poor fitting.
The author used two biomechanical approaches to study the union between stump and prosthesis in above-knee amputees: 1) roentgenographic observations of the fit in the above-knee socket and 2) measurement of internal pressure of the total-contact-suction type of socket during gait.
The results were as follows.
1) In the roentgenographic study, the above-knee stump was found to move up and down in the suction socket as the subject shifted weight from one leg to the other. The thicker the subcutaneous adipose tissue, the greater the amplitude of such movement. Some of the shorter stumps (about 10cm long) also showed marked anteroposterior displacement in the suction socket. Poor fits were attributed to insufficient union between stump and socket.
2) Internal pressure of the total-contact-suction socket reached a peak negative value during swing phase, due to external suction acting on the bottom of the socket. Wall pressure in phase with the pressure due to suction, attained a minimum in swing phase. Frictional forces due to wall pressure, however, tended to decrease because of sweat, so pressure attributable to suction appeared to be more important than wall pressure for suspensory function.
The results of this biomechanical study showed that a) function of the suction socket, especially suspension, depended principally on suction, and b) function was influenced little, if at all, by altering the position of the stump in the socket. Based on these results, soft inserts made of polyvinyl chloride were used on a trial basis. These inserts enhanced effective suspensory function, leading to clinically favorable results in both very short and very long stumps of above knee amputees.

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The standardization of the evaluation method for the hemiplegic hand was planned after the completion of the standardization of the Function Test for the Hemiplegic Upper (proximal) and Lower Extremities.
Two test-one measuring the functional impairment of the hemiplegic hand and the other evaluating the disability of the involved upper extremity-were concurrently standardized.
The study for the Finger Function Test (FFT) started with 47 subtests which were tested on 107 hemiplegic patients. Twenty-six subtests were selected after the analysis of the above results for reliability and validity. Those subtests were administered on 277 patients. The results were analysed to construct the final set of eight subtests which will allow to classify the hemiplegic hand into 12 (0-12) grades.
The study for the Upper Extremity, Ability Test (UEAT) was performed on the same way, starting with 30 subtests which were reduced subsequently to 12 and finally to five that allows the evaluation in five (0-5) levels of disability.
The correlation coefficient between FFT and UEAT was 0.760, and that between FFT and Function Test for the Upper Extremity was 0.782.

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[in Japanese]

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[in Japanese]

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