It is recognized that elevation of the arm consists of a synchronous mechanism involving not only movements of the shoulder girdle but also of the trunk. This study was carried out to analyze the synchronous mechanism between scapular tilting around the transverse axis and spinal movement on the sagittal plane.
The lateral plane of the scapula and the thoracic spine were photographed by roentgenoscopy during forward elevation of both arms (30 to 180 degree) in 30 normal volunteers. The roentgenographic parameters of the movements of scapular downward tilting (the motion of the superior border of the scapula moving backward and downward) and extension of the thoracic spine (Th 4-Th 7) were measured on a perpendicular line.
The results obtained were as follows:
(1) The thoracic spine extended with elevation of the arms.
(2) At the time of 180 degree elevation, the average range of scapular downward tilting was 12.4±3.5 degrees with a range of from 4.0 to 19.0.
(3) The range of extension of the thoracic spine for the 21 subjects whose range of scapular downward tilting was within the standard deviation was from 0 to 17.5 degrees at 180 degree elevation of the arms.
It is postulated that when there is maximal extension of the thoracic spine, there is little scapulothoracic articulation. The author, therefore, surmises that the range of scapulothoracic articulation defines one of the synchronous movements between the shoulder girdle and the spine at the time of elevation of the arm.

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This study was conducted to determine the standard data on muscle strength and the cross sectional areas of thighs of 18 healthy middle-aged and elderly men. Daily activity was calculated from the average number of steps a day during one week by a pedmeter, Muscle peak torques of knee extensors and flexsors were examined with an isokinetic dynamometer, and muscle cross sectional areas of mid-thighs were evaluated with a computed tomography.
The mean peak torques of knee extensors and flexsors were 14.1±2.8kg·m, 7.6±1.5kg·m in the men whose daily average amount of walking was more than 4×1, 000 and less than 8×1, 000. The cross sectional area of the former and the latter were 56.3±6.4cm², 30.4±5.9cm².
It was postulated that daily activity of more than 4×1, 000 might be needed to prevent disuse atrophy in healthy middle-aged and elderly men.

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Multiply-handicapped children pose difficult seating problems with their residual primitive reflexes, abnormal muscle tone, deformities and contractures of spine and extremities. To establish a rational seating approach to these children, We analyzed the seating problems in 37 severely involved cases at our seating clinic.
The seating problems as seen in these children could be grouped into four main categories, i. e., seating posture, care problems, ADL, growth and development. Always considering these four main problems, our basic seating approach was as follows. First, we started with stabilization of the proximal parts (pelvis and trunk), and then we added necessary components to shoulder girdle, extremities, head and neck (distal parts) by a step-by-step approach. In this way, we could provide satisfactory seating systems to the multiply-handicapped children.

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One hundred and eighty-one chronic stroke patients with unilateral cerebral lesions were examined by means of SEP, CT, and clinical sensory testing, and the correlations between the findings were discussed.
The middle latency, median nerve SEPs after stimulation on the affected side were compared with those with stimulation of the non-affected side. These SEPs were classified into three types (SEP-T) according to the degree of waveform deficit; Type I; no peaks except P0 and “widespread” N 18, Type II; deficits of some wave peaks, Type III; all peaks (P0, N I, P I, N II, P II, and N III) present within a 100-msec period.
The CT findings were classified with a 5-point scoring system (CT-S; 0-4 points) in proportion to the involvement of the lemniscal system, that is, the thalamus, posterior limb of the internal capsule, posterior part of the corona radiata, and the sensory cortex. Points were scored as to the total number of involved parts, with a maximum of 1 point per site.
Testing for position sense deficits (PS-D) were performed and the results recorded in five grades as an epicritic sensory function assessment.
As a whole, these modalities were well correlated with each other (Spearman's rank correlation; SEP-T vs PS-D, r=0.81; CT-S vs PS-D, r=0.41; SEP-T vs CT-S, r=0.40). However, the discriminative power of SEP-T for predicting the degree of PS-D was much higher than that of CT-S. It is concluded that, SEP testing is a more reliable method for assessing the epicritic sensory functions than is CT testing. The main reason for this is considered to be that SEP directly reflects the functional events of sensation, whereas CT indirectly predicts sensory function through morphological assessment of the sensory pathways.
Type II SEP, with incomplete deficit of SEP waveforms, were divided into two typical subtypes according to waveform characteristics as follows; Type II-A; N I and P I present, with no later peaks. Type II-B; preserved N II and P II with absence of N I and P I. Type II-A patients showed severe sensory deficits with lesions of the sensory cortex observed on CT. On the other hand, Type II-B patients had mild sensory dysfunctions with deep cerebral lesions (CT findings in thalamus and/or internal capsule). These findings suggest that the later peaks (N II and P II) of middle latency SEP reflect the critical process of the formation of the epicritic sensations, and so, not only short latency but also middle latency SEP must be evaluated for the purpose of prediction of epicritic sensory function in the stroke patient.

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[in Japanese]

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