Since 1977 we have treated, eighteen cases of spasmodic torticollis without other neurological signs by electromyographic (EMG) feedback therapy. The patients were asked to relax the contracted nuchal muscles by using auditory and visual feedback displays of EMG.
If the patients' heads could turn to the front in sitting posture they were then asked to do the same way in standing posture, followed by stepping posture. We also used “mini-trainer” in order to make the patients possible to train in their ward or homes.
These included eleven men and seven women.
The following were obtained:
1) Total therapeutic efficacy of EMG-feedback: Thirteen patients (72%) showed improvement (ten marked and three moderate to mild) but five (28%) did not.
2) In fifteen patients with severe and moderate torticollis ten showed marked, three showed moderate to mild, two showed no improvement. Three patients with mild torticollis all showed no improvement. That is, the severer the symptom of torticollis was, the more improvement the patient showed with feedback therapy.
3) Summarized features of ten patients with marked improvement were: (1) Ages were among third to fifth decades, (2) Incentives were relatively definite, (3) Symptoms were severe and relief of them were much appreciated, (4) Active for feedback therapy, (5) They had their jobs and volition for social comeback.
4) Summarized features of five patients of no improvement were (1) Incentives were obscure, (2) Symptoms were mild and significance of the feedback therapy was not well understood, (3) They did not feel any inconvenience in doing their jobs.
Computed tomographic scans which were performed in 13 cases reavealed no definite abnormalities.
Most of the patients with spasmodic torticollis had various problems in their homes, jobs, human relationships and personal histories. It seemed necessary that EMG-feedback therapy should be performed with special efforts to solve these problems because spasmodic torticollis might have psychic factors as one of its causes.

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As a basis of making clear the effects of therapeutic exercise in neuromuscular diseases, the histochemical study was performed to elucidate the adaptive transformation of normal rat muscle fiber types after endurance training.
16 young male Wistar rats (4 weeks old) and 24 adult male Wistar rats (12 week old) were trained by free running in their own wheeling drums. After 4 and 8 weeks of training, the soleus and extensor digitorum longus (EDL) muscles were studied. 42 rats in the sedentary and the control groups were put in their own narrow cage for same period. Using histochemical staining for myofibrillar ATPase after preincubation at pH 9.4, pH 4.6 and pH 4.3, four major types of muscle fiber could be identified.
The muscle was continuously adjusted to growth of rats. Between 4 and 12 weeks the proportion of type 1 fiber of soleus muscle increased, and type 2A, 2B and 2C fiber decreased. Thus, it seems reasonable to assume that progressing transformation processes of “2A→2C→1” and “2B→2C→1” had occurred during growth. The proportion of Type 2A and 2C fiber of EDL decreased between 4 and 8 weeks, while the proportion of Type 2B fiber increased. It seems similarly reasonable to assume that transformation processes of “2A→2B” and “2C→2B” had occurred.
Changes in proportion of each fiber types to training have been observed only in young rats. After 8 weeks running, soleus muscles of young rats contained a lower percentage of type 1 and a higher percentage of type 2C fibers than the sedentary rats. EDL muscles contained a higher percentage type 2A and a lower percentage type 2B fiber. These results show that free running gives forces to transformation process of soleus muscle fiber “1→2C” and to transformation process of EDL muscle fiber in the direction of “2B→2A”. However, the facts that there have been no effects on transformation in the adult rats mean that changeableness of transformation varies with age.

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We studied the status of 75 male retired amputees, injured from railway work accidents, to examine the significance of long-term rehabilitation. We concluded that the amputees of upper and lower extremities remained physically strong enough to perform light labor during the first ten years after retirement. At five years after retirement, however, a marked decrease in daily activities and increase in body weight had led to decreased use of prostheses. Usage, repair, and fitting of prostheses fell to 70% of the level at the time of employment. Many amputees found reemployment within a few years after retirement. More than 65% of the amputees were employed at the time of this investigation, among several occupations. Thus a large number of the amputees were actively using damaged or ill-fitting prostheses, repeatedly injuring their stumps, in some cases to extents beyond hope of successful treatment. This state of affairs was due to the changes in circumstances surrounding the amputees after retirement, reducing their motivation to care properly for either their prostheses or their stumps.
Because we now live in a society in which the geriatric segment has recently been undergoing rapid growth, we must organize active follow-up programs for amputees nearing retirement, in close collaboration with employers. From the standpoint of medical and social rehabilitation, various support services for amputees are needed to prevent deterioration of their life environments.

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