As a part of studies on disuse syndrome in hemiplegia, muscle power [isokinetic torque, isometric torque] in the “unaffected” upper and lower extremities of 72 hemiplegic patients was measured with a Cybex II isokinetic dynamometer. These patients had been receiving training in a rehabilitation hospital and were mostly ambulatory with or without assistance. The same measurement was made in normal subjects matched with the patients in the age and sex.
The analysis of the results revealed the following.
1) Peak torque value and isometric torque values in the upper extremity (elbow flexion and extension) and lower (knee flexion and extension) of hemiplegic patients were significantly lower than those of normal subject. The ratios were 42.2-82.6%.
2)There was negative relationship between the muscle power and the period of time after the stroke. This was interpreted that the muscle weakness in “unaffected” side is not due to latent central motor paralysis but to disuse atrophy.
3) The results of this study may suggest that disuse muscle atrophy is not being prevented in present rehabilitation program.

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Children with cerebral palsy (CP) exhibit physical disabilities with abnormal patterns of movement and perceptual-motor disorders. Some researchers have reported that independence in activities of daily living (ADL) of CP children is related to these factors.
Examination of sixty such clients in our Children's Orthopedic Centers was carried out, with ages ranging from 11 to 23 years, using the motor age tests of both the upper and lower limbs and the revised K's Developmental Tests for cognitive-adaptive abilities. Independence in ADL was assessed on self-care activities, such as transfers, feeding, toileting, dressing and bathing. Also examined were fifteen 9- and 10-year-old CP children who had the possible ability to achieve independence in ADL. The motor age of the lower limb was higher than 20 months for them to be able to ambulate without support and was higher than 10 months to enable them to become independent with wheelchairs, walking frames, crutches or sticks. It was however difficult to distinguish borderlines of the motor age for the various ambulatory aids. CP child, whose developmental quotient in cognitive-adaptive abilities was below 15, required supervision to walk to a destination, even though he possessed a functional gait.
The motor age of the upper limb in most of the children was higher than 30 months to enable them to become independent in self-care activities and their developmental quotient was above 15, so that notification of micturition was possible. Bathing required more than 58 months in motor age of the upper limb and was the last activity to achieve independence.

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A study was carried out retrospectively to find out the developmental sequence of children with cerebral palsy. Data were collected from 70 CP children in our centers, whose motor age of upper and lower limbs had been recorded for over ten years and 24 CP children whose cognitive-adaptive abilities had been assessed for over one year using the revised K's Developmental Test.
The functional development of all the limbs in terms of motor age continued until about 15 years of age, though there were many cases in which the limb function deteriorated thereafter. The motor age of lower limb was higher than 9 months at five or six years old for children to be able to ambulate without support until fifteen years old. There existed also exception that motor age was 14 months at six years old for one child who could not move at all in the center without help because of the poor co-ordination of balance with progressive joint contracture. The motor age of upper limb was higher than 18 months at five years old and higher than 25 moms at ten years old for CP children to be indepedent in the most of activities of daily living.
The developmental quotient of their cognitive-adaptive abilities deteriorated gradually until about ten years of age. It was sometimes difficult to predict precisely their functional prognosis during early childhood from motor age tests and the revised K's Developmental Test. It was however important to maintain the function that had already been gained.

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[in Japanese]

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