The purpose of this study was to describe the nature and implications of strength deficits on the sides ipsilateral and contralateral to stroke. Subjects consisted of 16 patients who experienced a first stroke (2-40 days before testing) with hemiparesis (7 left, 9 right). The strengths of proximal (shoulder abduction, hip flexion), middle (elbow flexion and knee extension), and distal (wrist extension, ankle dorsiflexion) muscle actions were measured by hand-held dynamometry. Muscle strength deficits were calculated by subtracting measured forces from predicted forces determined from regression equations. The Functional Independence Measure was used to grade independence in transfers and gait. Analysis of variance (ANOVA) showed that the patients’ strength was impaired bilaterally. Further ANOVAs demonstrated that impairments did not differ significantly from proximal to distal on the side contralateral to the lesion but that impairments were significantly greater proximally than distally on the side ipsilateral to the lesion. Muscle strength impairments tended to correlate significantly with one another (within and between sides) and with functional independence. The results challenge some traditional views of the muscle strength deficits that accompany stroke.
The changes in the R-R interval and systolic blood pressure (SBP) in response to Aschner Reflex and Czermak-Hering Reflex were investigated in 14 healthy male subjects. The bradycardic effect of those reflexes was confirmed, and a two-way analysis of variance (ANOVA) revealed that the Aschner method induced greater bradycardia effect compared with the Czermak-Hering method. Aschner Reflex may, however, exert dangerously strong bradycardia effect depending on a patient, and Czermak-Hering Reflex is therefore suitable for risk management by a physical therapist. Czermak-Hering Reflex was demonstrated to have a depressor effect occasionally carrying risk to the patients with disorders of active stimulus generation, especially with atrial fibrillation. It was therefore suggested that Czermak-Hering Reflex should only be used with caution for the patients with paroxysmal atrial tachycardia.
This paper presents our investigation of the effects of therapeutic exercise on the number of white blood cells and on the T-cell activity, in the peripheral blood of chronic hemodialysis patients. A significant decrease in the number of lymphocytes, and a significant increase in the number of monocytes were observed in peripheral bloods collected from patients before exercise training, as compared with those from healthy persons. No difference in the number of neutrophiles was observed between the patients and healthy persons. The number of monocytes, in the hemodialysis patients, decreased to a normal level after exercise but the number of lymphocytes did not change after 3 weeks exercise. A significant reduction in T-cell activity, determined by the response to PHA, was observed in patients both at pre- and post-exercise. Significantly higher blastogenic responses were found in patients after exercise, when compared with those before exercise, suggesting that the therapeutic exercise was effective at increasing T-cell activity. A higher rate of recovery of T-cell activity was observed in patients with low-responding T-cells. T-cell activity in hemodialysis patients was closely related to their usual daily number of steps, but not to their exercising capacity.
In order to determine the effect of exercise posture on the cardiovascular and respiratory systems during mild exercise, nine healthy young males participated in this study. Cycle exercise was performed at 50 W and 150 W in both sitting and supine postures. The relative work intensity was on average 25%VO2max for 50 W and 50%VO2max for 150 W. Cardiac output and stroke volume were larger in the supine than in the sitting posture. The lower arteriovenous oxygen difference in the supine posture indicated a relative ineffectiveness of oxygen supply by the blood flow in the exercising muscles. Blood pressure and total peripheral resistance posture were lower in the supine than in the sitting posture, despite lower perfusion pressure in the exercising muscles, suggesting the relief of sympathetic nervous activity by the loading of arterial and cardiopulmonary baroreceptors. Heart rate was higher in the supine posture, suggesting a contribution from the cardiac depressor reflex in mild exercise. We concluded that despite the absence of metaboreflex during mild exercise, the cardiorespiratory responses in the different postures were at least apparently similar to those during moderate and heavy exercises.
The purpose of this investigation was to evaluate the effects of taping the ankle on functional performance. On the side step movement, EMG and floor reaction forces were collected and a three-dimensional motion analysis was performed. The peak value of the perpendicular, fore, after, and lateral components of floor reaction forces with the ankle taped were significantly higher than with the ankle untaped (p<0.05). Rising time from landing to the peak value with taping was significantly shorter than without taping (p<0.05). Results of three-dimensional motion analysis revealed that the mean time from landing to stopping the trunk was 1.31 sec. with the ankle on the untaped, and 2.76 sec. with the ankle taped. These results indicated that the balancing and shock absorbing performance of the foot were reduced by taping the ankle.
The effect of body position on cardiopulmonary response was assessed by the following protocols: 1) Cardiopulmonary exercise testing with a bicycle ergometer (20 W/min) was performed on nine healthy men (mean age; 19.9 years) in a sitting and a supine position. Oxygen uptake, heart rate and blood pressure were measured during the test. Noradrenaline and Angiotensin II were analyzed at rest and after exercise. 2) Single-level exercise testing at 100 W was performed. The cardiac index was computed from the cardiac output, which was measured using the dye-dilution technique at rest and during exercise. The results were as follows: 1) Anaerobic threshold was lower in the supine than in the sitting. 2) Noradrenaline and Angiotensin II were slightly lower in the supine than in the sitting. 3) The cardiac index at rest was slightly greater in the supine, and that during 100 W exercise was the same in both positions. It is concluded that the blood flow to active muscle during 100 W exercise is lower in the supine than in the sitting. The etiology of lower anaerobic threshold in the supine is thought to be due to lowered blood flow to active muscle.
Posteroanterior pressure is a common manual technique used for the clinical assessment and treatment of vertebral column disorders. The purpose of this article is to describe the clinical biomechanics of the posteroanterior pressure to the spine. To establish the biomechanical effect of the posteroanterior pressure on the vertebral column, the applied load is defined by two components of force and the moment produced by that force. The clinical implications are also described in terms of the componenents of force and the moment produced by the posteroanterior pressure.
During living time in the ward, the intensive training was performed on 35 stroke hemiplegic patients who could not accomplish independent ADL even after 6-month or more physical therapy. According to patients’ motor development levels, the training was composed of rising from a bed, standing-up, gait with assist and independent gait. The training was mainly conducted by a nurse or physician, and the changes in ADL and gait function were assessed by Barthel Index and the 10 m maximum walking speed, respectively, 7 times in total; before training, twice a week for 12 weeks. ADL and gait function were improved markedly 2 weeks after the initiation of training in the ward. The results indicated that not only the training in the training room but also the intensive training in the ward plays an integral role in functional recovery of stroke hemiplegic patients. ADL correlates with gait function, and improvement in gait function in the ward therefore exerts major effects on improvement in ADL.