Arm crank ergometer (ACE)での下肢障害者のAnaerobic threshold (AT)の再現性と妥当性を検討した.対象は脊髄損傷(脊損)20例,下肢切断(切断)14例,骨関節疾患(骨関節)29例.ACEで各下肢障害者のATと最高酸素摂取量(VO₂Peak)を測定,3週間以内に再測定した.再現性はIntraclass Correlation Coeffcient (ICC)にて,妥当性はATとVO₂PeakをPearsonの相関係数にて検定した.ATの検出率は脊損90%,切断71%,骨関節83%,ICCは脊損0.877,切断0.939,骨関節0.937,ATとVO₂とのPearsonの相関係数は脊損0.748,切断0.762,骨関節0.706であった.ACEでの下肢障害のATには再現性と妥当性が認められ,下肢障害のphysical fitnessの指標として有用である.

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The Counseling Centers for the Rehabilitation of People with Physical Disabilities are administrative agencies established in each prefecture as required by the Law for the Welfare of People with Physical Disabilities. With the enactment of this law in 1949, the Counseling Centers were designated as centers for specialized technology to perform a pivotal role in the implementation of welfare policy for the disabled. The Counseling Centers provide counseling, evaluation, and guidance, and conduct inquiries into the kinds of services required by disabled persons, in conjunction with the welfare services delivered by local governments. Specifically, the Centers evaluate an individual's need for medical rehabilitation services, introduce the use of rehabilitation facilities, and counsel on issues related to prosthetic, orthotic, and other technical aids. Counseling and support are also provided to individuals returning to work and community life. The Centers assist prefectural governments by offering specialized medical and technical expertise to aid in the official certification of physically disabled individuals and by promoting rehabilitation programs in the community. For villages, towns, and municipal governments, the Centers coordinate the delivery of welfare services, assist in collecting and disseminating technical and specialized information for educational purposes, and conduct training for staff of local government agencies. Physiatrists play an important role in each Center's counseling and evaluation programs by providing medical evaluations that serve as the basis for an individual's social and occupational rehabilitation objectives. When fitting prosthetic and orthotic devices, for example, because of the precision fit required to compensate for functional disability, the physiatrist is intimately involved in the entire process, from prescription of the device to final evaluation of the individual's adaptation to it. Social conditions have changed dramatically in the fifty plus years since the enactment of the Law for the Welfare of Physically Disabled Persons. Over this time the needs of disabled persons have also greatly increased and diversified in nature. In response to these changing conditions, the year 2003 will mark the beginning of a new welfare system. Accordingly, the services offered by the Counseling Centers for the Rehabilitation of People with Physical Disabilities will also be reviewed. The overall reform of the general medical system is also moving forward. The task confronting the field of rehabilitation medicine is one of developing a new system, and rethinking each aspect, from evaluating the occurrence of disabilities to implementing medical rehabilitation services and restructuring the lives of the disabled in the community.

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