We schemed out a new evaluation method for balancing capability which was used for measurement of the maximal range center of gravity during volitional movement and examined its clinical application.
Positions of center of gravity in space was predicted by making use of the segmental method. The rate of the maximal range of volitional movement to the area of support base was calculated under these positions.
For clinical examination, the result of this evaluation method and some motor abilities were compared twice at 3-week intervals using the patients with multiple cerebral infarctions.
After 3 weeks, subjects became impossible to stand up from the floor and their deterioration in standing capability was remarked.
In addition, decrease in range of center of gravity during volitional movements and lowering in center of gravity were observed.
These results suggested that this method was possible to be used for one of the balancing capability assessments in clinical application, disclosing dysfunction in postural and antigravity mechanism deficit of the patient.

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The purpose of this study is to examine the effect of a new treatment for frozen shoulder. This new treatment consisted of the prolonged pulley traction and transcutaneous electrical nerve stimulation (the E-P method). Thirty-nine patients were treated with the E-P method. In regard to the passive range of motion, results were compared with other 28 patients treated with the conventional therapeutic exercises which mainly consisted of the Codman's pendulum exercise.
The mean passive flexion was 125° and abduction was 90° in the two groups before initiation of both programs. After six-month treatment by the E-P method, flexion was 155° and abduction was 130°. While in the patients treated by the conventional therapeutic exercises, flexion was 130° and abduction was 100°. The patients treated by the E-P method showed significant improvement in ROM. In addition, shoulder function was improved to 83 points on the average after six-month treatment by the E-P method. This means that the patients have improved well enough to perform their activities of daily living.
Results of this study demonstrated that the E-P method was more effective for the treatment for frozen shoulder than the conventional method.

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Among 192 cases with unilateral cerebral lesions, their outcome of gait independence was compared between cases showing unilateral spatial neglect (USN, N = 35) and cases showing aphasia (N = 48). Although it was obvious that the patients who had higher brain dysfunctions (HBD) showed a significant lower gait performance than the patients without HBD, no significant difference was demonstrated between USN (34%, gait independence) and the aphasics (45%).
USN patients indicated poorer sitting balance compared with aphasic patients (P < 0.05). USN grades including visual extinction, line bisection, Albert task, and two points findings were significantly correlated with gait performance, especially patients who failed in Albert task (below grade 3) showing very poor gait performance (P < 0.01).

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Questionnaires concerning demand for physical therapists were sent to 296 PT-absent medical institutions in Kochi Prefecture where one of the treatments of orthopedics, internal medicine and physical therapy was performed.
Approximately half of the institutions admitted the need for PT, and the prescribed employment number of PT was 71. Many of those institutions wanted to employ “one fresh graduate”, which suggested an increase in number of institutions with only one PT in the future. Regional difference in PT demand was observed, being most required in Kochi city area and extremely least required in the Aki health and treatment area.
The reasons for the non-employment of PT were insufficiency of equipment, a small number of patients requiring physical therapy, and unprofitability of the PT treatment.

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We examined the relationship between the X-ray findings and the items of physical evaluation in order to find the early detection of dysfunction and disability of patients with osteoarthritis of the hip joint.
Subjects consisted of 15 patients with osteoarthritis of the hip joint (2 males and 13 females, the average age was 36.5 ± 14.8 year-old).
As the X-ray findings, the following six points were measured; center edge angle (CE angle), 2) sharp angle, 3) acetabular head index (AHI), 4) head lateralization ratio (HLR), 5) head ascending ratio (HAR), and 6) deviation of shenton line (DSL). The items of physical evaluation were ROM, MMT, ADL and Oxygen consumption during ambulation in a comfortable velocity.
The subjects who showed higher score of ROM and ADL had a tendency to show low score of HAR and DSL. The score of MMT showed no significant correlation with any other measurement values. However, VO₂ during comfortable velocity ambulation showed significant correlation with AHI, HAR, and DSL. These results suggest that the X-ray findings may play a key role in evaluation of dysfunction or disability of the patients with osteoarthritis of the hip joint.

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The purpose of this study was to investigate the effect of time period in two different interval training modes. The training modes were designed in two ways; one was 2-minute work period and 1-minute relief period (EX A) and the other was 4-minute work period and 2-minute relief period (EX B). The work intensity was the same level, and the relief intensity was set at 50% of work intensity.
Six healthy men were involved in this study, and the effect of different time period was evaluated in terms of HR, SBP, RPE, VO₂, VO₂/RPP.
The results were as follows:
1) There were no significant differences in work period between EX A and EX B in respect to HR (123.1 ± 3.6bpm vs 123.0 ± 4.7bpm), SBP (152.6 ± 2.7mmHg vs 156.0 ± 2.6mmHg), RPE (12.7 ± 1.8 vs 11.3 ± 2.1), and VO₂ (19.96 ± 0.83ml/kg/min vs 20.73 ± 0.61ml/kg/min).
2) There were no significant differences in relief periods between EX A and EX B in respect of HR (111.7 ± 4.2bpm vs 109.0 ± 3.5bpm), SBP (145.4 ± 3.0mmHg vs 143.7 ± 2.7mmHg), and RPE (11.0 ± 2.1 vs 9.7 ± 1.2). However, there was a significant difference in VO₂ (19.41 ± 0.12ml/kg/min vs 17.8 ± 0.19ml/kg/min) and VO₂/RPP (0.069 ± 0.003 vs 0.061 ± 0.008).
In conclusion, 1-minute relief period of interval training mode was more suitable than 2-minute relief period in terms of cardiac mechanical efficiency.

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Some authors reported that hemiplegics with motor impersistence (MI) showed inferior ADL to ones without MI. However, we reported that some MI patients had comparatively good ADL and there after improved it. The purpose of the present study is to prognosticate the ADL of MI patients by applying the multidimensional quantification method II.
The subjects consisted of 21 left hemiplegics with MI. Seven ADL items at the hospital treatment were; the age, incontinence of feces, deep sensory disorder, Brunnstrom stage of affected lower extremity (Br. stage of L/E), right neck rotation (RNR), unilateral spatial neglect (USN) and classification of hemiplegia by HIRAKATA (classification of HIRAKATA). Patients were also evaluated as 4 classes from Barthel Index score on discharge.
The results showed that the correlation ratio was 0.82498 (axis No. 1), and the discriminant rate was 76.2%. Items showing high partial correlation coefficient were RNR, age, classification of HIRAKATA, deep sensory disorder, Br. stage of L/E, incontinence of feces and USN, in this order.
These results suggest that ADL of MI patients such as the age, RNR and classification of HIRAKATA, may be useful for prognosticating their ADL after discharge from the hospital.

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The object of this study was to investigate the correlation between several points of Postural Reflex Mechanism Testing (PRMT) on four integrated levels and walking ability in hemiplegic patients.
The subjects for this study were one hundred patients (male 65, female 35); right hemiplegia 52, left 48. They were 15 to 83 years old with an average of 61.4 years.
Comparing PRMT points and walking ability, they significantly correlated within both affected side (r = -0.743) and unaffected one (r = 0.761) (p < 0.001).
Comparing acquired percentage of several integrated level and walking ability, were recognized significant difference (1.0 to 0.01%), and then shown independent walking at 80% or more with cerebral levels' points of both affected side 50% and unaffected one 80%.

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For the purpose of preventing pulmonary complications after surgery, we prepared a chart to assess the preoperative risk of complications.
We could point out age, activity, psychological state, preoperative respiratory ability and organ operated as factors inducing pulmonary complications from the review of the occurrence of complications. Besides these factors, pulmonary functions (%VC, FEV_1.0%) were included in the preoperative risk chart as check items. After filling up the chart, we recognized high risk on a patient if the score is 14 points or more.
Using this risk chart, occurrence of pulmonary complications has reduced, but another factor seemed also related to complications. Consequently, it is important to take special care of high risk patients, and to pay attention comprehensively to other informations for preventing pulmonary complications.

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Recently, there has been a renewed interest in the detection and treatment of osteoporosis. Dual photon absorptiometry was used for defining the osteoporotic syndrome in terms of bone mass, and for evaluating treatment regimens to prevent bone loss. Bone mineral measurements can be used to assess the risk of fracture and the severity of bone loss. This is valuable when used for monitoring longitudinally bone of patients in order to assess the progress of the disease and the effects of specific therapeutic regimens. There has been no established effective therapy for osteoporosis, so its prevention is the goal. Physical therapists often treat patients with osteoporosis or those who are at high risk of it. Consequently, to provide the optimum care, therapists must be knowledgeable about the disease process and the role of exercise for its prevention and management. A critical level of bone mineral density perhaps exists below that where nonweight-bearing exercises are effective and above that where the stress of weight-bearing is necessary. Bone strength is dependent on stresses induced by muscular and weight-bearing activity. Studies dealing with the response of bone to mechanical stress in gait, in addition to the role of exercise in the prevention of osteoporosis, were reviewed.

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Among the patients who have discharged from our hospital with an ability of T-cane gait during the period from April, 1986 to June, 1988, 40 patients experiencing a femoral neck fracture were evaluated with respect to their activities at home. Their mean age was 80.6 ± 6.8 (standard deviation) years old, and the mean duration term from discharge to follow-up period was 414 days.
Next 5 items were interviewed by telephone; (1) walking ability, (2) ability of self-care, (3) pain in the fractured region, (4) experience of falling, and (5) range of their excursion.
On walking ability, 80% of the evaluated patients had ability of out-door gait, and 100% had indoor gait. Many patients could perform their self-cares ; 77.5% of the patients could perform all of three categories of self-cares, namely urination, dressing and bathing.
Regarding to range of their excursion, 77.5% of the patients, which was the same percentage as that before admission, maintained their out-door activities after discharge from hospital. On the other hand, 30% of the patients reduced their activities, mainly due to impairment to utilize the public transportation. Another reason of their reduction in range of excursion is afraid of falls following fractures, because about 20% of patients had fallen one or more times during 414 days.
From this study, it was suggested that hospital staffs including a physical therapist should attempt to arrange their environment and to guide their daily living to avoid further falling.

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In order to compare the muscle strength between the sound side knee of hemiplegic patient that was confirmed as normal strength level by M. M. T. and normal knee, we measured their extension velocity, extension torque and peak position using ARIEL machine.
The subject group consisted of 15 male hemiplegic patients after cerebral vascular disease, and the control group 10 normal men of similar age as the subject group. We measured above three items according to regular ARIEL technique.
1) Isotonic contraction; velocity and peak position using 1 ft. lb and 10ft. lb resistance. 2) Isokinetic contraction; torque and peak position using 120°/s velocity.
<Result>
① Isotonic contraction at 1ft. lb resistance: Peak speed (velocity) and average speed were significantly lower in hemiplegic patients than in normal subjects.
② Isokinetic contraction at 120°/s velocity: Peak torque and average torque were significantly lower in hemiplegic patients than in normal subjects.
③ Isotonic contraction at 10ft. lb resistance: There was no significant difference in peak speed and average speed between the both groups.
④ No significant difference in peak position was observed between the both groups.
⑤ Peak speed at 1ft. lb and Brounnstrom Recovery Stage were Significantly correlated (r = 0.47 p < 0.05)
<Conclusion>
These results suggested that muscle power of unaffected side of hemiplegic patients was not normal at light resistance, even though the strength is regarded as normal by manual muscle testing.

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The purpose of this study was to compare the reactions or the cardio-pulmonary system of the poststroke hemiplegic patients with those of the healty aged people in basic motions. The stress test included sitting up from supine, standing up from the chair and ambulation. Through this test the whole heart rate and oxygen consumption were measured by the portable appratus.
The result as follows: the ability of ambulation, that is, speed of the patients was 37% compared with the healthy aged people. The efficiency of the energy consumption of the patients was 1/3 and “endurance index” was 1/2 in ambulation. It is significant to evaluate the reactions of the cardio-pulmonary system acurately and easily in order to maintain or improve the physical fitness of the hemiplegic patients.

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