To establish the rehabilitation program based on the apropriate evaluation of the disability of a patient is the most important problem in carrying out the exercise therapy. The evaluation of delicate activities of the affected upper extremity using peg board and block cap is added to the manual evaluation method which was reported in our previous paper. The results of this evaluation were classified in to six groups by their scores. By analyzing the results which were gained by this evaluation method, some problems concerning the method of evaluation and inhibitory factors which influence the recovery of hemiplegic upper extrities were discussed.
Activities of daily living (ADL) of the aged in-patients of Yokufukai Geriatric Hospital were surveyed. The level of independence in ambulation, self-feeding, dressing, bathing and toilet activities, as well as the spatial range of ambulation or living were determined for each patient. An ADL index was then calculated from the results; full independence in each of the items being awarded 2 points, semidependence 1 point, and full dependence a 0. The index thus ranges from a 0 of total dependence to a 12 of full independence. Of the 235 patients, 67 were males and 168 were females. Two were in the sixth decade, 40 to the seventh, 108 to the eighth, and 86 were over eighty. The majority were chronic cases, and about 70% had stayed in the hospital more than a year. The results of the survey were: 1) Independent ambulation without support was possible in 40% of the subjects, ambulation with a cane in 15% and confinement in wheelchairs and/or beds was seen in 43% of the cases. The spatial range of ambulation or living was generally restricted, about 85% being unable to go beyond their own wards. In self-feeding, 76% could use chopsticks and 6.4% were fully dependent. About 62% needed assistance in dressing. Assistance in bathing was required in 75% of the subjects. Fortyfive per-cent of the subjects could go to the toilet, 24% used bedside commodes and 31% were kept with diapers. 2) The mean score of the ADL index was 5.7. The total cases could be devided into three groups according to their grades; 34% belonged to mild impairment in ADL (score 8-11), 26% to moderate impairment (3-7) and 33% to severe impairment (0-3). 3) A progressive decline in index score was seen to occur with age. 4) Those patients with cerebrovascular accidents exhibited lower score than patients of suffering from other non-cerebrovascular disease.