In this study, forty-one hemodialysis outpatients performed a daily walking exercise. For this exercise, patients were instructed to walk beyond a daily target number of steps for three consecutive weeks. The target number of steps was defined as 120% of the average number of steps per day prior to the exercise. The effects of this exercise were examined by comparing the six-minute walking distance (6MD), and physiological cost index (PCI) before and after performing the exercise. The results were as follows: the target numberof steps during the exercise period was achieved by 19 of 41 patients; 6MD of target achieving patients was significantly increased by this exercise; the difference in PCI before and after this exercise was not statistically significant. This study suggests that the present exercise triggered an increase in the number of steps per day and improved the actual walking performance as measured by 6MD.
A preliminary study was carried out to compare the walking speed (WS), walking distance, oxygen consumption and oxygen cost in hemiplegic patients. In the first test of 10-min walking, observation of WS and walking distance revealed the boundary areas between the patients who depended on a wheelchair (group D, n=18) and those who did not and could walk alone (group I, n=26). The boundary WS and boundary walking distance ranged from 20.1 to 30.0 m/min and from 201 to 300 meters, respectively. In the second test which focused on the boundary WS, oxygen consumption and oxygen cost of groups TI (7 patients of group I), BI (5 of group I), BD (3 of group D) and TD (3 of group D) were measured. As a result, oxygen consumption and oxygen cost of TI, BI, BD and TD were13.6, 10.0, 14.5 and 10.0 ml/kg/min and 0.351, 0.358, 0.628 and 0.779 ml/kg/m, respectively. TI walked at a speed of more than 30.1 m/min, BI and BD walked at the boundary WS, and TD walked at a speed of less than 20.0 m/min.The values of oxygen cost differed remarkably between the groups BI and BD. BI walked more efficiently than BD.
We have examined to the changes of the FIM score with the Brunnstrom stage and evaluated the ADL structures in rehabilitation for hemiparetic stroke patients. The total FIM score, on admission, was significantly higher as the grade on the Brunnstrom stage, in upper and lower extremities of hemiparetic stroke patients, increased. After 10 weeks rehabilitation, the change in the total FIM score of patients starting rehabilitation within 19 weeks of the occurrence of stroke was increased significantly compared with those of patients who had experienced stroke more than 20 weeks earlier. The change in the total FIM score, after rehabilitation, of patients with stroke in the left hemisphere was increased significantly compared with those of patients with stroke in the right hemisphere. We concluded that FIM is effective in rehabilitation assessment as a means of categorizing a patient’s condition, and as data for program evaluation.
The purpose of this study was to assess the criterion-referenced validity of the beats above baseline index (BABI) in relation to physiological cost index (PCI) by having subjects walk with leg length discrepancy and to evaluate the need to supplement shoe height to compensate for leg length discrepancy based on the changes in BABI and PCI in 8 healthy men. The exercise task in the experiments was continuous walking of a 200-m distance along a figure “8”-shaped path, each circle of which was 30 m long. The degree of task difficulty varied among 5 different gaits with leg length discrepancies of 0 cm to 4 cm under two conditions: comfortable walking speed and maximal walking speed. The criterion-referenced validity of BABI in relation to PCI was high at r=0.85-0.89, demonstrating that BABI can be applied to walking tasks. There were no significant differences between time for task completion, walking speed, stride length or cadence at the two walking speeds when leg length discrepancy was no more than 4 cm. At the comfortable walking speed, however, there were significant individual differences between BABI and PCI at differences in leg length of 4 cm and 0 cm, of 4 cm and 1 cm, and of 4 cm and 2 cm. When gait withleg length discrepancies is considered from the standpoint of task difficulty assessed by BABI and energy expenditure assessed by PCI, supplementing shoe height is considered necessary at leg length differences of 4 cm or more
The purpose of this study was to examine the relationships between the toe pressure exerted by, and the tactile sensitivity of the great toe, and to describe two newly developed measures of postural stability. The subjects of the study were 21 healthy volunteers. The subjects were divided into two age groups, the young group (mean 21.0 ± 1.6 years, 7 males and 6 females), and the elderly group (mean 71.4 ± 2.8 years, 4 males and 4 females). First experiment (balance test): The instrument for measuring standing balance was a force plate and data were analyzed to provide two main variables; 1) Body sway index (SI: mm) and Foot pressure (%BW/cm2). The subjects were asked to stand as motionless as possible for 20 seconds. The valuables of body sway were measured under 4 conditions: normal surface with eyes open or closed and soft surface with eyes open or closed. Second experiment (tactile sense test): The experiment utilized a new system which was developed for measuring the tactile sensation. The tactile threshold value was measured with the subject seated in a chair, the back supported, and hip and knee flexed at 90 degrees. The contactor pulled and pushed the toe longitudinally along it axis at a constant velocity of 1 mm/s. There were significant differences between the young and elderly groups in the tactile sense of the great toe. No significant difference between age groups was found for postural sway while the subjects stood on the normal surface with eyes open; however, when they stood on the soft surface with their eyes open or closed, the elderly showed significantly more sway than the young. Moreover, the maximal great toe pressure of the elderly group was significantly greater than that of the young group. The results suggest that reduced tactile sense, deprivation of visual information, and muscle weakness in the toes are all important factors associated with postural instability.
The purpose of this study was to assess the physiological influences of exercise and whole thermotolerance (sauna) stress with respiratory gas analysis in obese patients. The following results were obtained. (1) Maximal oxygen uptake (VO2 max) and maximal heart rate (HR max) on exercise were remarkably increased compared with resting, while VO2 max had a mild increase and HR max had a moderate increase on sauna stress. (2) The relation between VO2 and HR was positive on exercise in obese patients. (3) The respiratory quotient (RQ) was significantly decreased after sauna stress, although it was increased after exercise. In conclusion, energy expenditure would be attributable to not only glucose but also fat metabolism on sauna stress, while it would be mainly attributable to glucose metabolism on exercise.
The purpose of this study was to characterize the activity levels of the thigh muscles (Vastus medialis oblique muscle, VMO; Rectus Femoris muscle, RF; Vastus Lateralis muscle, VL; and Biceps Femoris muscle, BF) during 4 basic patterns of Proprioceptive Neuromuscular Facilitation (PNF) techniques of the lower extremity with the knee straight. Ten healthy adult volunteers (5 men and 5 women, with a mean age of 21.7 ± 3.2 years) who were knowledgable about PNF patterns were involved in this study. Surface electromyography (Furusawa Labo) was performed and recorded by bipolar miniature silver-silver chloride electrodes, from which rectified filtered electromyograms (RFEMG) obtained. Each PNF pattern was examined under maximal isometric contraction against manual resistance in the lengthened range. Normalized data (%RFEMG) were analyzed using one-way analysis of variance and Tukey's multiple comparison. The results allowed us to divide PNF patterns into two types: the type containing a flexor component, and that containing an extensor component. In the first type of PNF, %RFEMG was highest in RF > VL > VMO > BF and in second type of PNF, %RFEMG was highest in BF > VMO > VL > RF. RF was found to be primarily active in the first type of PNF, while BF was primarily involved in the second type of PNF. VMO tended to be involved in PNF patterns containing components of adduction and external rotation. VL activity did not differ significantly among PNF patterns.
This study used force platforms and a three-dimensional motion analysis system to examine the relationship between pre- and post-operative brake force and the joint angle of the knee during walking. Ten female patients with unilateral osteoarthritis of the knee and a control group of five healthy female subjects were studied. Before surgery, the average brake force (ABF) in the OA group was significantly lower than that of the control subjects. Compared to that before surgery, the ABF at four and twelve weeks after surgery was significantly increased, but remained lower than that of the control subjects. The ABF is part of the inertia energy mainly absorbed by knee flexion and ankle plantar flexion. The decrease in ABF in OA subjects indicated an insufficiency in the eccentric contraction of the quadriceps muscle in the early stance phase. Thus, it was considered that the difference between the improvement in kinematic and kinetic factors indicated the need to develop new post-operative rehabilitation techniques.