The purpose of this study was to analyze the disability among patients with ataxia, as a measure of the evaluation system about coordination of patients and then it would apply this evaluation to the treatment about coordinated mechanism of the trunk.
In this study, 40 ataxia patients were diagnosed as spino cerebellar degeneration (SCD) and as cerebrovascular disease. The average age was 55.6 years ranging from 20 to 79. Those patients were evaluated by the standard neurological examination (deep tendon reflexes, muscle strength and deep sensation), coordinated examination system of upper and lower extremities and 4 steps classification stage for coordinated mechanism of the trunk from the original method of authors. Among some patients, deflection of center of gravity during both seating and standing posture was measured.
In the result, coordinated mechanism of the trunk was related more closely to movement abilities than coordinated function of lower extremities. There was a significant correlation between deflection of the center of gravity during a seating posture and coordinated classification of the trunk.
Those data revealed that the coordination of the trunk was activiated separately from function of lower extremities. Much data about mechanism of the trunk and considering functional disorder are much important to give some evaluation and treatment among patients with ataxia.

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The objects of this study were to investigate the correlations between Brunnstrom Stage and Postural Reflex Mechanism Testing in Stroke patients. The subjects for this study were 87 stroke patients (male 59, female 28). They were 15 to 83 years old with an average of 62.0 years.
The results of this study were as follows :
1. Upper and lower limbs Stage and this Score showed significant difference in any Stage (lower limbs Stage I : p<0.05, others : p<0.01).
2. Comparing sound side and affected one in stages II and III, significant difference was seen at one percent level of confidence.
3. Significant difference was seen in upper limbs Stages V and VI, lower Stages III and IV, IV and V, V and VI at five percent level of confidence.
4. Brunnstrom Stage and Postural Reflex Mechanism Testing Score showed middle to high level coefficient of correlation (upper limbs sound side : r=0.555, affected side : r=0.825, lower sound side : r=0.613, affected side : r=0.872).

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According to the progress of therapeutic exercise, clinically available techniques have been gaining ground.
As a matter of fact, we wish we could evaluate the effectiveness more objectively. In engineering, especially in IE (Industrial Engineering), the concept of Learning Curve has applied to many problems.
Log Linear Model which has been most widely used was shown as follows.
    log Ac = －n・log x + log t₁
      (Ac : cumulative mean, t₁ : the first time,
      x : number of repetition, n : learning factor)
Five healthy subjects (two males, three females, aged 21 to 29), wearing high heels of cork in their left foot, participated in the study. Subjects walked freely across a force plate which recorded the three dimensional components of the ground reaction force of four steps and other kinematic parameters.
We investigated the learning process by the concept of Learning Curve. Almost every parameter of gait applied to the equation of Log Linear Model. In this research, learning ratio was 96 to 99 percent.
We concluded that Learning Curve could determine the optimum duration and times of exercise.

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Our Institure has a subject of therapeutic exercise as active teaching method to our students. The results obtained from the students' questionnaires have made it clear that there are weak points as well as strong points in this teaching method.
The students were greatly motivated towards self-learning by being handed a handbook prior to the class. In the seminar class, interaction among the learners stimulated them to study one another, which led educational effect to be improved. By receiving both practical training given at the institute and clinical lectures at the assigned hospital, their motivation to learning was promoted and they could acquire skill and attitude as well. Preparing and presenting a report to the class are useful for getting his own knowledge into shape, and at the same time for the rest of the class it was a chance for them to understand the ideas of their classmates. Having been accustomed to attend at classes in passive attitude, the students are weak in having a discussion. Without preparation for the class, the learners are unable to join the class. Those who can't get a clear understanding in the class would have a feeling that they are left behind due to the gradual enlargement of the gap, in terms of the amount of knowledge, between those with preparation and without it. Though a large amount of time was consumed in the process of learning, the amount of knowledge acquired is much smaller than they expected to. And this evil efficiency makes the learners uneasy.
According to the questionnaires, the students had a good impression on this teaching method. The weaknesses of the method are necessary to be improved by making the students understand the fact that the purposes of the class are not limited to acquirement of knowledge.

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To solve feeding problems is very important for therapists. I treated infants with feeding problems, aged from 1 to 20 months old, based on the neurodevelopmental approach. The subjects were divided into two groups.
Group I ; children with the dysfunctions of central nervous system. (9 cases)
Group II ; children without the dysfunctions of central nervous system. (4 cases)
There were three causes of their problems,
1) Existence of abnormal muscle tone and postural-motor pattern
2) Insufficiency or lack of normal oral sensory-motor experiences, and
3) Abnormality of oral structure.
In the treatment, I inhibited abnormal postural-muscle tone and facilitated normal sensory-motor experiences. The treatment was performed on the basis of individual assessment.
As a result, seven of the Group I and all of the Group II could improve their oral motor function.
Through this treatment, the improvement of oral-motor function needs total approach to not only oral part but head, trunk... that is whole body (especially for the Group I). And we also have to pay attention to the secondary problems of the children of Group II.

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A new exercise program of the quadriceps and the hamstrings muscle after anterior cruciate ligament (ACL) reconstruction was developed. In the early stage of the muscle exercise, exercise of the quadriceps by maximum isometric contraction should be performed with the knee flexion at more than 70 degrees. Exercise of the hamstrings by maximum isometric contraction can be carried out regardless of flexion angle. The maximum simultaneous isometric contraction of the quadriceps and the hamstrings can be performed with the knee position nearly extended. The program consists of those new muscle exercise methods. The effects of the muscle program was evaluated clinically. Muscle torque of the quadriceps and the hamstrings were measured in 29 patients using Cybex II at 3, 6, 9 and 12 months after ACL reconstruction. The subjects were divided into two groups. Eleven men and eight women in group 1 underwent the new muscle exercise program, and six men and four women in group 2 the conventional program, in which quadriceps exercise was forbidden for six months after ACL reconstruction. All muscle torque were measured at 90 degrees of knee flexion because quadriceps force did not give anterior drawer force to the tibia at this flexion angle.
The ratio of quadriceps torque in an affected side to that in a unaffected side in group 1 were 73% in both men and women before reconstruction, and 83% in men and 67% in women one year after reconstruction. The ratio of hamstrings torque in group 1 was 73% in both men and women before reconstruction, and 89% in men and 87% in women one year after reconstruction. In group 2, the ratio one year after reconstruction of quadriceps torque was 55% in men and 33% in women, and that of hamstrings torque was 77% in men and 63% in women. Effects to the quadriceps and hamstrings of the new muscle exercise program were superior to those of the conventional program with statistical significance. However, effects in women were inferior to those in men.

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There are many studies reporting how rectus femoris and hamstrings as the two-joint muscles from hip joint through knee joint operate the knee joint movements. Few studies, however, have taken it into consideration that how gastrocnemius as the two-joint muscle from knee joint through ankle joint operate the knee joint movements.
The present study was designed to examine in what manner stretch of gastrocnemius caused by dorsi-flexion affects the knee joint movements during isokinetic movements using Cybex II through the analysis of torque and integrated EMG.
From the results obtained, it was discussed that how the two-joint muscles operate the two-joint movements of sports activities, and accordingly the mechanism of sports injuries and the points to be noticed in the rehabilitation were suggested.

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We developed a home care system of team management for ventilator-dependent patients and applied it successfully to two such individuals.
Physical therapy modalities consist of reeducation of effective breathing patterns, bronchial drainage and prevention of disuse syndrome. The role of the physical therapist is an integral part of such a comprehensive care which aims at achieving a higher quality of patients' life.

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To evaluate the relationship between cerebral ventricular size and motor function and effect of rehabilitation, we examined cerebroventricular indices (CVI) on CT scans (bicaudate, bifrontal, bioccipital and bicentral CVI) in 21 patients with parkinsonism and in 83 patients with cerebrovascular accident (CVA). The mean value of bicaudate CVI in patients with parkinsonism was 22.1±4.6%, and was significantly greater (p<0.05) than that in patients with CVA. In patients with parkinsonism, the gait disturbance was milder and the significant improvement of motor function during rehabilitation was observed (p<0.05) in patients with smaller CVI (<22.1%) compared with those with greater CVI (>22.1%). In patients with CVA, bicaudate, bioccipital and bicentral CVI were significantly greater (p<0.05) in patients with severe CVA than those with mild CVA, although the difference in motor function and activity of daily living was not statistically significant between the patients with greater and smaller CVI.
These results suggest that the increase in CVI, especially bicaudate CVI, may be specifically detected in patients with parkinsonism and that the measurement of CVI on CT scans may be useful for the evaluation of the effect of rehabilitation and of the improvement of motor function in parkinsonism.

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The object of this study was to learn the pursuit movement in spinal ataxia. The progression of ataxic motor function is very slow or not progressive. The function of body shifting from right to left and left to right in standing was measured 14 times before physical therapy and 7 times after physical therapy for 582 days. The subject for the study was a spinal ataxic patient (female) whose age was 26 years old. The height was 150 cm, the weight was 40 kg and foot length was 20.5 cm.
The dynamic characteristics of the pursuit movement in spinal ataxia were analyzed by five parameters. The parameters of follow-up control are three and those of constant-value control are two.
The results are as follows.
(1) Three parameters of follow-up control showed almost normal but fluctuated frequently. Each parameters improved a little during physical therapy for 582 days and just after physical therapy.
(2) Two parameters of constant-value control were significantly bigger than those of normal, showing almost no improvement.
(3) But variance of a few parameters could improve just after physical therapy.

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