In order to study the role of muscle strength in normal individuals and patients with osteoarthritis of the hip joint, torques of the hip abductor and adductor were isometrically measured by using a BIODEX machine. Eighty-eight normal hip joints and 130 osteoarthritic hip joints were subjected for this study. The 88 normal hip joints consisted of 36 joints in the twenties, 14 in the thirties, 18 in the forties and 20 in the fifties. The 130 osteoarthritic hip joints consisted of 39 joints in the pre-stage, 29 in the early stage, 49 in the advanced stage and 13 in the terminal stage. In the normal hip, the peak torque per body weight (PT/BW) of the abductor was greater in the twenties and thirties than in the forties and fifties. But the PT/BW of the adductor and the ABD/ADD ratio, i. e., the ratio between the PT/BW of the abductor and the adductor, were almost consistent in every generation. In the osteoarthritic hip, the PT/BW of the hip abductor was remarkably smaller in the advanced and terminal stages as compared with the ones in the pre and early stages. The PT/BW of the hip adductor was almost consistent in every stage. The ABD/ADD ratio in the advanced and terminal stages was lower than those in the pre and early stages. This demonstrated that there was an imbalance between the hip abductor and adductor muscle strength in the advanced and terminal stages of the osteoarthritic hip.

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Intermittent oral catheterization (IOC) is a potential treatment for patients with decreased pharyngeal reflexes. The method was tested on 29 hemiplegic stroke patients with feeding dysphagia. In the experimental group, 23 patients (79.3%) became nasal catheter-free, and 20 patients (69.0%) were able to consume ‘specially cooked foods for feeding dysphagia’ (SF) or almost normal foods, a significantly higher incidence (p<0.01) than that for the control group. IOC should prove a useful adjunct to other therapy and management methods used with feeding dysphagia.

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The sway paths of the center of gravity in the static-standing posture (CG-static-standing), the static-sitting posture (CG-static-sitting), and the voluntary shifting-sitting posture (CG-shifting-sitting) of hemiparetic stroke patients were analyzed with a gravicorder. Subjects were 51 patients who included 16women and 35men, whose mean age was 60.7±9.4 years. A control group of 46healthy subjects included 27women and 19men whose mean age was 58.3±20.6 years. In the sway paths of CG-static-standing, subjects stood on the plate of a gravicorder in Romberg's posture and measurements were taken over 50sec. For the sway paths of CG-static-sitting, subjects sat on a chair on the plate of a gravicorder and measurements were taken over 50 sec. In these studies, maximal anterior-posterior (AP) distance and right-left (RL) distance of the sway paths of thecenter of gravity were measured and analyzed. In the sway paths of CG-shifting-sitting, subjects performed voluntary anterior flexion and lateral flexion movements while sitting on the chair; these movements were repeated every 2sec, and measurements were taken over 40seconds. In this study, maximal AP distance in anterior flexion and maxmal RL distance in lateral flexion were measured and analyzed. Hemiparetic stroke patients were classified into groups according to standing ability and ambulatory activity: a standing-independent group (N=40), a standing-impossible group (N=11); an ambulatory-independent group (N=31), an ambulatory-impossible group (N=20). Eleven patients could not be measured in static-standing posture because they could not stand on the plate. However all patients could be measured while static-sitting or shifting-sitting posture. Maxmal RL distance of CG-static-standing and maximal AP, maximal RL distance of CG-static-sitting of the healthy subjects were significantly narrower than that of the patients (p<0.01). Maximal AP distance in anterior flexion and maxmal RL distance in lateral flexion of CG-shifting-sitting of the healthy subjects were wider than that of the patients (p<0.01). The sway paths of CG-static-sitting of patients tended to be narrower, and that of CG-shifting-sitting of patients were significantly wider owing to better standing ability and ambulatory activity. The measurements of the sway paths of the CG are usually made in a standing posture with a gravicorder: Unfortunately, patients who were unable to stand on the plate of a gravicorder could not be measured. We considered that with mesurements of sway paths of the CG in sitting posture, patients who cannot still stand can be measured and examined on the basis of the control of the CG. Objective measurements can be made with a gravicorder, in both stading posture and sitting posture.

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We investigated changes in cross-sectional areas of thigh and calf muscles measured by sequential CT scan. Subjects were 20 stroke patients, mean age 66.8 yearsold, who were admitted within 14 days from the onset. 1) In bed-ridden group, who couldn't walk without assistance until discharge, the cross-sectional areas demonstrated progressive decrease in both paralytic and non-paralytic side. The ratios of the cross-sectional areas at the 2nd, 4th and 8th week to that of admission level were significantly lower; 79-86%, 69-79%, 62-72%, respectively. 2) In the moderately disabled group, who couldn't ambulate independently in the 2nd week, the ratios significantly decreased to 89-95% in the initial 2 weeks but recovered to 94-99% at 8th week. 3) Early walking group, who could walk independently in the 2nd week, could maintain the ratios of 96-100% in the 2nd week. Our results suggested that disuse muscle atrophy occurs even in patients in early stroke rehabilitation program. Although we can improve this with an intensive exercise program, it takes three times longer than the immobilization period.

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We used a noninvasive tissue oximetry to measure oxygen consumption in the exercising limb in normal controls and a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Normal controls showed consistent oxygenation during exercise, while a patient with MELAS showed abnormal oxygenation during exercise.

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