Ground reaction forces, temporal factors, and distance factors of hemiplegic gait were measured by the force plates. Subjects were 145 patients with hemiplegia, 106 males and 39 females, whose ages were from 25 to 84 years. The measurements were done more than 6 months after the onset of cerebrovascular diseases. The principal component analysis was executed on quantitative parameters calculated from three components of ground reaction forces. The quantitative parameters were the symmetry, the reappearance, the smoothness, and the sway indices introduced by Yamazaki and the deceleration, the acceleration, and the weight bearing indices introduced by Miyazaki. The relations between principal component scores and clinical estimations of hemiplegic gait, which were the mobility level, the visual assessment of the truncal sway, the visual assessment of the ability of weight bearing on affected legs, and the step sequence during gait, were investigated. Three major principal components were found significant. The first principal component score correlated significantly to all clinical estimations (r_s, from 0.44 to 0.63) and the gait speed (r=0.88). Significant correlations were also found between the score of the second principal component and the symmetric ratio, which meant stance phase of affected leg/stance phase of sound leg (r=0.47), and the score of the third principal component and the decelerate index (r=0.88). It was found that the first, the second, and the third principal components indicated the level of general walking ability, the gait symmetry, and the deceleration factor during gait, respectively. It will be possible to evaluate the hemiplegic gait of stroke patients quantitatively using 3 principal component scores shown here.

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The purpose of this study was to investigate the effect of endurance exercise at an intensity corresponding to anaerobic threshold (AT) on improvement of cardiorespiratory fitness not only in stroke patients below 59 years of age but also in those who were above 60 years. Twenty-two patients who performed the endurance exercise were divided into two groups by age at the time of starting the endurance exercise: one group consisted of 9 subjects who were below 59 years of age and the other group consisted of 13 subjects who were above 60 years of age. AT was adopted as an index of cardiorespiratory fitness in this study. Endurance exercise was performed on a bicycle ergometer for 30 minutes a day, 5 days a week and for 4 weeks. Intensity of endurance exercise was determined based on AT detected before taking the endurance exercise. Pre- and post-exercise AT in each group was compared by means of Wilcoxon signed-ranks test. Improvement of AT after endurance exercise for 4 weeks were statistically significant in both groups. This result suggested that endurance exercise based on AT was effective in the improvement of cardiorespiratory fitness both in patients with stroke who were below 59 years and also in those who were above 60 years of age.

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The purpose of this study was to evaluate the short term effects of continuous passive range-of-motion exercise (CPROM-E) on passive resistive torque of the hip and knee. The subjects were 4 healthy adults and 6 spastic patients. During the CPROM-E, the joint angle and the load torque of the hip and knee were measured, and surface electromyogram of the vastus medialis and medial hamstrings was recorded. Peak torque of the joints or peak amplitude of the integrated electromyogram (I-EMG) was plotted against time of exercise, and the slope of the plots were analyzed by the t-test. In the healthy subjects, the peak torque of the hip decreased steadily and significantly (p<0.0001) by about 5 percent after CPROM-E, although the peak amplitude of I-EMG was not always reduced. In the spastic patients, the peak torque of the hip decreased significantly (p=0.01), by about 35 percent, and the peak amplitudes of I-EMG also decreased significantly (p=0.0003 and p=0.01, respectively). In one patient, the peak torque of the knee was analyzed and was found to decrease significantly (p<0.0001). However, there was no consistent change in the H-wave amplitude of the medial head of the gastrocnemius. Both reflex and non-reflex components of the joint resistance may play a role in reduction of the joint torque during CPROM-E.

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