Based on their functional limitation profile (FLP), a structural analysis was attempted on the quality of life (QOL) of 118 rheumatoid arthritis outpatients. According to their responses, more than half were capable of unassisted walking, self-care, and locomotion, approximately one-half were not involved in household chores, and 60% have noted reduced activity in recreational programs. Approximately 30% of patients reported their awareness of psychological problems. The effects of these findings on the overall FLP and the relationship among items were analyzed by using Hayashi's quantification methods of the first and third types. It was found that the physical functions, social activities, and psychological states are of equal significance; and an examination of these items is mandatory in the evaluation of QOL.

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The limits of locomotive prognosis of spastic cerebral palsy is largely defined by extent of brain damage and age in spite of early treatment. Proof of the above was demonstrated in this more than 11 years longitudinal study. The sample comprised 73 cases, who were born between 1968 and 1987 and needed therapeutic exercises. The limits of age on locomotive prognosis were: 7 years old in outdoor walking, 10 and half years old in outdoor crutch walking and 6 years and eight months old in crawling on hands and knees. Complications relating to mental retardation and epilepsy appear to impede the developmental sequence for acquiring gross motor function. As pediatric rehabilitation includes the accumulation of therapeutic exercises and interdisciplinary collaborations, the energy, expense, time and cost effectiveness required to develop the total abilities of handicapped children, need primary consideration.

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Therapeutic effects and the adverse reactions of focal botulinum toxin injection were investigated in six (3 men and 3 women) patients with blepharospasm. The average and standard deviation of their age were 60.0±9.7 years. Two to five years (mean±SD: 2.5±1.3 years) had passed since the onset of their initial symptoms. Blepharospasm were improved by the injection in all patients. Adverse reactions, noted in the three out of six patients, were not rare compared with previous reports on this treatment. They however were not serious and disappeared quickly. Therapeutic and adverse effects of this treatment on the nerve and muscle were discussed.

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There are now various therapeutic interventions for cerebral palsied children. Many of them were developed based on the theoretical speculation or empiricism, because it was difficult to know the pathophysiological process, which occurred in the injured brain before its development. It, however, is believed that synaptic formation and synaptic rearrangement play a main role in the first instance of motor development. In the therapeutic approach for cerebral palsied children, we should adopt the appropriate strategy based on the knowledge of neuro-developmental science. As same as the other diseases, for the cerebral palsy, we also should treat the various levels of problems, which was classified by WHO as impairments, disabilities (activities), and handicaps (participation). Therapeutic interventions for children with cerebral palsy have been directed mainly toward impairments of this pathological condition, such as spasticity, joint contracture and abnormal movement pattern. We should pay attention for the cerebral palsied children also to their function in the home activities and participation to the social affairs. At the end of the 20th century health professionals are expected to produce evidence of the effectiveness of the treatments that they provided to the clients. What we require in addition are measures that capture the “health status” of people. We have not been making enough effort to evaluate the effectiveness of therapeutic intervention for cerebral palsied children with the scientific documentation. In North America, various scales have been developed in the recent decades under the concept of the framework for health measurement indices. These scales were also standardized and were endurable for multi-institute's use. In the area of rehabilitation of cerebral palsied children, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) were developed with this new concept. In this review article, the summary and the process of standardization in Japan of these scales were presented.

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