The purpose of this study was to determine the effects of the biomechanical variables on the maximum walking speed for 10m distance (MWS) during the early gait training in the hemiparetic stroke patients. The subjects were 18 male hemiparetic stroke patients who had never walked since the stroke onset. The biomechanical variables measured were the standing balance and the isokinetic strength (IK) for extension of the both knees. The standing balance was composed of 3 variables: 1) the sway path on station (SP), 2) the percentage of the distance moved forward and backward to the foot length on station (FB%), and 3) the percentage of the distance moved left and right to the width between the lateral margin of the feet on station (LR%). After the patients recovered the ability to walk 10m distance as a result of the physical therapy, they then received the computer assisted gait training (CAGT) for the duration of 8 weeks. The stepwise multiple regression analyses indicated that IK of the non-affected side was the determinant of MWS at the beginning of the independent walking, LR% and the time since stroke onset were the determinants of MWS after the 8 weeks, and the time since stroke onset and the gain of LR% were the determinants for the gain of MWS during the 8 weeks. The results of this study lead to a conclusion that in the early gait training the improvement of the weight-shifting activity to the affected side definitely relates to the recovery of walking speed for the hemiparetic stroke patients.

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The intratester reliability of goniometric measurements at the four hip joint motions (flexion, 90°-90° test, abduction, spreading-out) were studied. Nineteen patients with spastic cerebral palsy between the age of 2 and 13 years (mean 5 years and 2 month) were assessed. The angle which was just measured when a tester felt the resistance on the lower extremity by fast stretch procedure was defined as “spasms-angle (s-a)”. And the s-a would be one of the quantitative evaluations of the spasticity of cerebral palsy. This method is simple and available for clinicians. The results of intratester average differences and standard deviation obtained through three repeated angular measurements on one joint motion were as follows: 5.70±3.92° on Straight Leg Raising (SLR) s-a, 3.96±2.80° on Hamstrings (HAM) s-a, 3.85±2.54° on Abduction (ABD) s-a, 5.93±3.72° on Spreading-Out (S-O) s-a. Over 90% of measurements differences showed within 11 degrees. The results indicated high intratester reliability.

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After discharge from a rehabilitation hospital, persons with motor and/or cognitive disabilities may not be able to maintain health effectively without adequate personal assistance with activities of daily living (ADL) and rehabilitation services in their locality.
In this report, we compared three-year-outcome of 75 cerebral stroke patients who admitted for treatment and medical rehabilitation in Miyagi National Hospital from 1989 to 1994. Of 75 patients, 42 discharged to the Control-A-District where executes standard welfare services, and other 33 patients to the Model-B-District where carrys out relatively sufficient personal assistance of ADL and visiting rehabilitation services being operated by almost twice numbers of visiting nurses, helpers, physical and occupational therapists, when compared to the control district.
Follow-up survey of the 75 patients revealed that both the numbers of reattack cases and severely disabled patients through three years after discharged period were significantly lower in the group of the Model-B-District, when compared to the subjects in the Control-A-District.
Even in the Model-B-District, the absolute number of the personal ADL-assistance and maintaining rehabilitation staffs are still insufficient for all the discharged stroke patients who needs to maintain their motor and/or cognitive abilities.
The results of this study suggest that a substantial system from a rehabilitation hospital to each locality should be established in all the districts throughout the country for decreasing the number of the severe disabilities in post-stroke patients.

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We evaluated the effect of body position (seated, supine and prone) on knee flexor muscle strength. Ten healthy women (mean age; 21yr) performed isokinetic knee movement on a KIN/COM^TR dynamometer. The parameters recorded were peak torques (PT) and average torques (AT) during concentric (CON) and eccentric (ECC) contraction at 60°/sec on each position. ECC torques were significantly greater than CON torques. CON AT and ECC AT on seated position were significantly larger than on prone and supine. Seated CON and ECC PT were also the largest. ECC/CON ratios were not significantly different among the three positions, indicating that body position had similar effects on CON and ECC torque production.
Knee flexor torques on seated and prone were measured in one subject once a week for 8 weeks. Coefficients of variation of 8 measurements on both positions were comparable.
In conclusion, seated position is a position that produces the highest torques with acceptable reliability, and because of ease of positioning, is recommended for routine clinical use.

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