Postoperative function and psychological status were studied in 50 patients with musculoskeletal malignancies of the lower limbs. Postoperative functional evaluation of the operated limb was made using the Musculoskeletal Tumor Society scoring system (1993), and psychological evaluation was made using the Arthritis Impact Measurement Scale. The patients were divided into an amputation group and a limb-salvage group, and the latter was further divided into a bone tumor group and a soft tissue tumor group. No difference was observed in the degree of satisfaction about the operation or psychological condition among the three groups. However, in the bone tumor group, a poor functional outcome was associated with poor psychological status.

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This study was conducted to clarify the relationship between the motive for exercise and physical activity, and the relationship between the motive and basic physical fitness in the elderly. The subjects were 110 residents in two types of nursing home. They measured the newly developed exercise motive scale for the elderly, daytime step rate, grip strength, leg strength, and vital capacity. Scores of the exercise motive scale for the elderly significantly related to daytime step rate, grip strength, leg strength, and vital capacity, respectively, excluding the effects of age, gender, height, and weight by the multiple regression analysis. It was suggested that the exercise motive contributed to the level of physical exercise in the elderly people. The stimulation of motive for exercise is encouraged in the elderly people for their health promotion.

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We used transcranial magnetic stimulation to record motor evoked potentials (MEP) from the lower limb muscles in 33 patients with cerebrovascular diseases (CVD) and 20 normal subjects. MEPs were recorded from the abductor hallucis (AH) muscles both at rest and during mild contraction of the muscles. The central motor conduction time (CMCT) was calculated by subtracting the peripheral conduction segment, measured using the shortest latency F wave recorded in the AH, from the MEP onset latency. Amplitude of the MEP was expressed as MEP/M wave amplitude ratio. Compared with the unaffected side, CMCT was significantly prolonged and the MEP/M wave amplitude ratio was significantly lower on the affected side in the patients. In some patients with severe hemiparesis, no response was obtained on the affected side, even under the facilitated condition with contraction of the muscles. There was no significant difference between the MEP characteristics on the right and left sides in normal subjects. With the exception of the MEP/M wave amplitude ratio in relaxed AH muscle, these characteristics in affected limbs correlated significantly with the extent of volitional movement of those limbs. This test was valuable to evaluate the level of hemiparesis without being influenced by abnormal synergic movements. The present study indicated that the value of these MEP characteristics may serve as important parameters in evaluating functional recovery of paretic limbs in hemiparetic patients.

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Unilateral spatial agnosia (USA) has been commonly seen in patients of right-sided hemispheric lesion. The incidence and duration of USA in cases of right subcortical lesions have been rarely reported. USA test, modified from Ohdoi's method, was given to 12 cases of right putaminal hemorrhage. USA was noted in 7 cases. Repeated examinations, starting from the acute stage, revealed a high incidence of USA. The symptom lasted for 3-4 weeks in mild cases (average antero-posterior CT diameter of lesions, 32mm), and for 3-4 months in severe cases (average diameter, 57mm). The USA continued for more than 10 months in a severely disabled case.
In comparison between cases with and without USA, the duration and incidence of USA were closely related to the degrees of neurological deficits (hemiparesis, sensory deficit, hemianopsia and conjugate eye deviation) and hematoma size on CT.
USA was commonly noted in cases of right putaminal hemorrhage as well as right cortical lesions. On beginning the rehabilitation in cases of such subcortical lesions, USA should always be kept in mind, as a possible higher cortical dysfunction, in order to make training-process effective and results more fruitful.

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The purpose of this study was to assess the effect of quadriceps setting exercise for the prevention of disuse atrophy of the medial vastus muscle by turns-amplitude analysis of surface electromyography. The subjects were 19 women with unilateral coxarthrosis deformans, 43 to 75 years of age, who were admitted for total hip replacement surgery. They were divided into 2 groups: group I (8 patients) who were not instructed to exercise their contralateral healthy leg, and group II (11 patients) who were instructed to exercise throughout the postoperative bed-rest period. Surface electromyography of the medial vastus muscle was examined in the healthy leg before and after the bed-rest period. Differences between groups I and II were evaluated with regard to changes after the bed-rest period. The interference pattern at quadriceps setting was evaluated by the product of turns per second and mean amplitude. It was found that the elecrtomyographic activity after bed-rest was significantly better in group II than in group I.
This study suggests that quadriceps setting exercise may be efficacious for preventing disuse atrophy in the medial vastus muscle.

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