Gait pattern of adult hemiplegic patients were analysed using biomechanical techniques such as force plates and X-Y tracker of TV system. Thirty-three hemiplegia (mean, 44.4 years old) and 6 normal volunteers (mean, 37.7 years old) were studied. The impairment of the motor function of the affected leg was evaluated by the Brunnstrom Stage (stage III 8, IV 9, V 8 and VI 8 cases). Subjects were instructed to walk at a comfortable speed and a cadence without cane or brace on the 10 meter walkway, in which four force plates were mounted. Away from the walkway to both sides about 5 meters, a pair of TV cameras for X-Y tracker were setted.
Electrical signal from these equipments were analysed by the PDP-12 minicomputer. With lowering of the motor function of the affected leg, the walking speed became slow, the walking base became wide, the walking cycle prolonged, and the stance phase of the affected leg was slightly shortened and the stance phase of the non-affected leg was markedly prolonged. About the sagittal rotation pattern, with lowering of the moter function of the affected leg, there was a dominance of extension pattern of the knee and ankle of the affected leg and slightly flexion pattern of the non-affected knee and hip. About the floor reaction force, the affected leg of the low motor function showed poor supporting and propulsive pattern, and non-affected leg showed marked compensatory balancing pattern.
It was supposed that the affected leg of the low motor function performed little roles for walking. Therefore, it seemed to be important to promote the compensatory functions of the non-affected leg as well as to improve the impairment of the affected leg.

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This study attempted to classify the normal hand movement patterns frequently seen during handling objects. Five normal subjects, ranging in age from 20 to 45 years, handled 93 objects one at a time in the predetermined situations. The movements of the hands and their projected images in the mirror were recorded using 16mm movie film at the rate of 32 times per second. Slow projection of the film, approximately 1 or 2 frames per second, allowed to devide the process of the movements into minimal movement units, which consisted of the motions of five fingers of a hand. Each movenent unit was coded as to finger motion, hand movement pattern, function and other related factors. The movement patterns were classified using the data base management system. Finally, 7781 units were analysed.
It was found that 88.5 percent of the movement units were consisted of 1 or 2 types of finger motion. In 24% of all the units, the finger motions differed between the thumb and the index finger, and between the index and the other ulnar fingers. The movement pattern “OXOOO”, in which only the index finger moved, was the most typical one of this type, and constituted 9% of all the movement units. In about 21% of all the units, the finger motion differed between the thumb and the other fingers. The typical patterns of this type were “XOOOO”, in which only the thumb moved, and “XYYYY”, in which the thumb and the other fingers moved differently. Each of these two patterns occupied another 9% of all the units. The pattern “XXXXX”, in which all the finger motions were identical, was seen in 9% of all the units too. The above four patterns as well as the other 12 patterns constituted 68% of all the movement units. The relations of these 16 typical movement patterns with the functions were also examined.

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Because a great number of persons with cerebrovascular disease suffer from various physical impairments, the need for sexual counselling is high and thus research on sexual activity of stroke patients is important. The purpose of this study was to bring to light some of the effects of physical impairment on sexual activity in stroke patients.
We studied 137 persons (110 men 55±11 years of age and 27 women 55±8 years of age) living at home and capable of sexual activity after having had strokes. The periods between onset of stroke and this study were 18±16 months among the men and 27±16 months among the women. We conducted a structured interview with each person and had the person fill out a questionnaire. CT scans were obtained to determine the locus of each lesion, but the interval from stroke to CT scan differed among the patients.
We found it meaningful to divide the men into three groups according to age: 49 years and below, 50 to 59 years, and 60 years and older. Sexual desire was revived in 97, 76, and 60 per cent of the subjects of each group, respectively. Those actually engaging in sexual intercourse after the stroke included 79, 62, and 49 per cent of the younger, middle, and older groups, respectively. The dampening effect of age on sexual recovery was not simply limited to sexual intercourse, but also encompassed morning erections, orgasms, and ejaculations. Ability to walk, independence in activities of daily living, and intact cognition were favorably related to sexual recovery. Impairment in perception or in use of the affected arm had little to do with sexual recovery. Locus of the cerebrovascular lesion likewise had no particular association with level of sexual activity, although multiple bilateral lesions were noted to have some effect.
Thirty-two per cent of the women expressed having sexual desires, but 60 percent of them actually engaged in sexual intercourse. Age had a dampening effect on sexual activity in the women as well.

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Somatosensory evoked potentials (SEPs) elicited by electrical stimulation of the median nerve at the wrist were recorded over the contralateral scalp in 66 persons with cerebrovascular disease (44 with cerebral hemorrhage and 22 with cerebral infarction) who had reached stable plateaus in functional recovery. Loci of the lesions were determined by computerized axial tomography and possible associations of the SEP findings with motor or sensory dysfunction were examined.
Extensive lesions in the cerebral cortex, whether due to infarction or to hemorrhage, gave rise to severe sensorimotor dysfunction in the contralateral arm, and SEPs from median nerve stimulation of the affected arm could not be recorded. Bleeding into the thalamus, posterior limb of the internal capsule, or dorsal portion of the pons resulted in many instances of relatively light motor involvement but marked sensory impairment. In none of these cases did the median nerve SEP appear.
Conversely, some patients with small infarcts had not progressed beyond the stage of synergic movements in motor recovery but suffered no more than slight sensory involvement. In these instances the SEP appeared clearly, resembling the contralateral intact SEP.
Patients with clinically severe sensory involvement exhibited no SEPs; in each case the lesion affected a structure of the lemniscal pathway: the dorsal portion of the pons, the thalamus, or the posterior limb of the internal capsule. SEPs remained intact in patients whose symptoms were motor but not sensory, and SEPs are also known to be recordable in persons under general anesthesia. These findings suggest that disappearance of the scalp SEP to contralateral median nerve stimulation results from damage to a sensory conduction pathway. Absence of the SEP thus appears to qualify as objective evidence of sensory damage in the patient with cerebrovascular disease.

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[in Japanese]

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