Physical fitness or endurance is an important factor to keep the hemiplegic patients living actively. In healthy subjects, endurance can be well predicted by measuring maximal oxygen uptake during exercise. But it is generally difficult for hemiplegics to exercise vigorously on treadmill or with bicycle. We established graded body bending exercise to measure physical endurance and applied it to hemiplegic patients.
Ten healthy male and 10 hemiplegics were given the task to bend their trunk forward and backward in sitting position (20, 35, and 50 repeats/minute gradedly for 9 minutes). Heart rate and oxygen consumption were monitored every minute. Then regression coefficient between heart rate and oxygen consumption (HR-O₂ coefficient) was calculated. To measure the maximal oxygen uptake, healthy male also performed the multistage treadmill testing in accordance with Bruce's protocol.
There was a significant correlation (r=0.84) between HR-O₂ coefficient and maximal oxygen uptake (p<0.05). The rank correlation between HR-O₂ coefficient and the degree of daily exercise in the hemiplegics was significantly high (r_s=0.73).
In conclusion, our body bending exercise protocol is useful to predict physical fitness or endurance of hemiplegics.

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We have investigated respiratory function of 15 severely handicapped children who had retractive breathing, stridor, chest deformity, scoliosis, clubbing fingers and recurrent respiratory infections. The present study was focused on the changes of arterial oxygen saturation during sleep and awake, and various postures such as the lateral, sitting, supine and prone positions. Even in awake, 6 out of 15 patients showed severe desaturation (SaO₂<90%) and other 5 showed mild desaturation (SaO₂<92%). After falling asleep, most patients manifested severer desaturation due to hypoventilation or apnea. Marked change in SaO₂ was observed when they changed their positions. In general, the best oxygenation was obtained in the prone and lateral positions, and the worst in the supine position. In six children with chronic lung disease, SaO₂ was improved when they were laid with the sick lung downward, and five with scoliosis improved when the convexity site was placed down to the bed. The desaturation was partly explained by the upper airway obstruction, lung restriction, mismatching of ventilation and circulation, and dysfunction of respiratory center. We made various designs of positioning block supporting each of the children in his most appropriate position and obtained better oxygenation. Therefore, we would suggest that the braces should be more widely applied to severely handicapped children.

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Force plate studies during ramp and stair walking would reveal more informations than level walking analysis. But such studies have been rarely reported.
We had done the force plate studies during ramp and stair walking in normal subjects. They were ten normal males aged from 24 to 58 (av. 47.6) years old.
The experimental system consisted of two force plates with strain gauge, side by side. A wooden eight degree slope box or a wooden three-steps stair box was placed on each force plate. A microcomputer was used for data analysis. Each subject walked on force plate under all three conditions: without any boxes, the slope boxes and the stair boxes. Under each condition, the subject walked at two metronome controlled cadences: 60 and 100 steps per minute. Thus, in each walking condition ten regular steps were normalized, averaged and plotted.
The curve of fore-aft floor reaction during slope walking showed the least restraint and the largest propulsion force when compared with the other conditions. During stair walking the vertical force change (i. e. the distance from peak to bottom of the vertical floor reaction curve) was greatest and the fore-aft force change was smallest.
The lateral force change was larger in the condition of ramp or stair walking than level walking. These each curve change was more marked at the faster tempo.

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Eighty six totally dependent inpatients due to cerebrovascular diseases ranging 70-89 years of age (44 men, 42 women) were examined and the following results were obtained.
I. Discharge placements:
1) Percentage of discharge to home was 26.7% (23 cases) and are decreasing in recent years.
2) Percentage of movement in other institutions was 73.3% (63 cases).
a) Most of the cases moved in geriatric hospitals for long stay (49 cases).
b) Most of the cases without relatives moved in nursing homes (p<0.01).
c) The cases in the seventies moved in hospitals for rehabilitation more than those in eighties (p<0.1)
II. Determing factors for discharge to home (p<0.01 or 0.05):
1) Patients in good condition.
2) Home doctors in existence.
3) Main and sub-attendants in existence.
4) Agreement or praise on home care by family members and acquaintances.
5) Living together with family members before hospitalization.
6) Private room for each patient in existence.

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[in Japanese]

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