This study was carried out in order to analyze the effectiveness of trimming in the plastic A. F. O. (ankle-foot-orthosis) with emphasis on the flexibility of the orthosis.
The results were as follows:
1. The decelerating force was dominated on the side with plastic A. F. O. both in hemispiral and posterior leaf types, which, however, caused a restriction of push-off in gait cycle.
2. The peak value of plantar and dorsal flexion of the ankle tended to increase in accordance with trimming, and the effective limitation of plantar flexion was found from toe-off to heel-strike in gait cycle. The range of motion was greater in anterior leaf type as compared with posterior leaf type.
3. In advancing trimming, ankle adduction became obvious in the swing phase, which was more remarkable in patients with moderate spasticity.

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The object of this study was to elucidate the post-Operative recovery process of the patients who had experienced modified Chiari pelvic osteotomy at Kanazawa Medical University Hospital. We periodically evaluated thirty one patients whom we were able to follow up more than three months. Test items were muscle strength, range of joint motion, pain, ambulatory ability and activities of daily living. The involved joints were thirty four in total.
The each test data of pre and post operation were statistically examined and the results revealed remarkable improvements in muscle strength including muscle endurance and pain relief for a period of one to two years. Ambulatory ability also remarkably improved. The average clinical score of osteoarthritis of the hip joint standardized by Japanese Otrhopedic Surgery Association was improved from 71.5 at pre-operation to 90.6 at post-operation for a period of one year. The reason of pain relief might have been due to the reduction of stress by means of surgical re-construction of abnormal hip joints, and prevention of excess lateral movements of the head of the femur by means of strengthening of gluteus medius. Therefore, joint-play movement disorder which is one of the joint dysfunction may be a major factor to cause the hip joint pain.

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The purpose of this study was to determine the effect of PNF (proprioceptive neuromuscular facilitation) on static standing balance. Six subjects with hemiplegia resulting from a cerebrovascular accident, ranging in age from 55 to 78 years, participated in the study. Each subject stood on a force plate with the eyes closed for measurement of static standing balance before and after PNF approach to treatment in a 2-month period. One trial length was 1 minute. Each trial was analyzed by means of a computer. Shifting length, root-mean-square value, mean displacement in right-left direction (MX) and area of the center of gravity during static standing posture were obtained. A two-way analysis of variance for repeated measures was performed on each parameter obtained from static standing balance to examine their improvement. The F-ratios indicated that no significant improvement was present during 1-week. But during 1-month, shifting length measured after treatment was significantly improved (p < 0.005). During 2-month, parameters except for MX were significantly improved (p < 0.001). The results of this study suggest that a certain period was needed to obtain a significant effect of PNF approach on static standing balance in hemiplegic patients.

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The purpose of this study was to investigate the influence of sustained chronic anterior cruciate ligament (ACL) insufficiency on the strengths of quadriceps and hamstrings muscles. The subjects of this investigation consisted of sixty-six patients, who had never trained for strengthening their thigh muscles, and divided into two groups as male group (n = 30) and female group (n = 36). The maximal strengths of quadriceps and hamstrings muscles were measured isokinetically at both 60°/sec and 180°/sec by using a Cybex II isokinetic dynamometer. A weight adjusted peak torque was calculated by dividing body weight into the peak torque produced by quadriceps and hamstrings.
The weight adjusted peak torque for the quadriceps of the involved leg was significantly decreased in both male and female groups at both test speeds. On the other hand, this value for the hamstrings of the involved leg was significantly decreased in the female group but insignificantly in the male group. The quadriceps deficits were significantly greater than hamstrings at 60°/sec but not significantly at 180°/sec. Hamstrings/quadriceps ratio for the involved leg was significantly higher than the uninvolved leg at 60°/sec, but not significantly at 180°/sec.
Sustained ACL insufficient knee joint has affected the quadriceps muscle at both speeds and in both groups. However, the influence on hamstrings muscle might be dependent on sex differences.

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We reported the experience of home care ventilation for two cases - dystrophia musculorum progressive and amyotrophic lateral sclerosis. This exeperience suggested us some important prerequisites to establish home care ventilation as a safe and socially acceptable medical practice in Japan : (1) stable physical and mental condition of patients under assisted ventilation, (2) firm desire and understanding of the patient and family members for the life at home with mechanical ventilation, (3) sufficient care-giving capacity at home, (4) availability and maintenance facilities of adequate ventilators, (5) medical support system in emergency, (6) regional network of care givers and comedical professionals. Additionally it seems very important that physical therapists participate in regional medical activities outside the institutions and support patients to live more active with their remaining capacities.

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In 30 hemiplegic patients, gait speed at a pedestrian crossing and that for 10-m indoors were measured in order to confirm whether gait speed indoors was also displayed outdoors.
The results indicated that gait speed indoors was not displayed effectively at a pedestrian crossing. It seems that environmental and psychological factors and the necessity for reacting to situations influence the gait speed outdoors.
This study suggests that gait speed indoors is not an appropriate indicator of that outdoors.

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Recently we have noticed that many young patients, diagnosed as ankle instability, tended to complain not only of ankle pain, but also of other arthralgia. Consequently, it appeared to us that these arthralgia were based on general joint laxity. So we conducted a comparative study between general joint laxity devised by Kuriyama (1984) and ankle instability.
Fifty-eight cases (116 ankles) of general joint laxity, whose ages were from 12 to 29 years old (average, 18. 1 yrs.), male 5 cases, female 53 cases, were investigated. They were classified under 3 different categories;
A) Those with a history of ankle sprain (37 cases: 56 ankles: 48.3 %).
B) Those with more than 3 years involvement in sports (40 cases: 80 ankles: 69.0 %).
C) Those with no experience or less than 3 years involvement in sports (18 cases: 36 ankles: 31.0 %).
All 3 categories went through the following tests; stress X-ray (anterior talar displacement: ATD, talar tilt angle: TTA), and swing of center of gravity (C. O. G.) on one leg standing (SD AREA, Root Mean Sqare: RMS). Results of these tests were compared to that of normal ankles (ATD: 30 ankles, ADT: 200 ankles, swing of C. O. G.: 50 ankles) without general joint laxity and ankle sprain.
Of the 40 cases in Group B, 30 cases (46 ankles, 57.5 %) had a history of ankle sprain. Of the 18 cases in Group C, 7 cases (10 ankles, 27.8 %) had a history of ankle sprain. From these data, it appeared that ankle sprain is connected with a person's involvement in sports (p < 0.01).
In addition, the results. showed that despite their involvement in sports, the 32 cases in Group A showed significantly larger range in stress X-ray and swing of center of gravity compared with normal ankles (p < 0.01), while those without any history of ankle sprain showed normal range.
These findings suggested that the history of ankle sprain was closely related to the ankle instability in the cases of general joint laxity and that a person with general joint laxity received sprain easily through sports or other physical activities.

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We made a survey of the living conditions of patients with respiratory failure in accordance with the diagnostic standards set up by a group of the Ministry of Health and Welfare that study and investigate respiratory failure, a specified disease. Our survey showed that the patients with respiratory failure had a number of characteristics in common. Most of them were old: they were around sixty. Their chief underlying disease was COPD and they were mostly suffering from the sequelae of pulmonary tuberculosis. They had a small family: usually they had a family of less than three and in most cases old people made up each of the families. They were being assisted by their wives or husbands for the most part. Thus it would be desirable to try to let those patients make every possible effort to do all in their power without anyone's assistance. They should try to rely on their own powers especially when they go to the hospital or when they eliminate sputum, for in these cases the physical strength of those who assist them is greatly needed. As for physiotherapy, we focused our attention on abdominal breathing. Our patients understood what we taught them, and most of them went on practising it even after they left the hospital. But the fact that about a half of the job of physiotherapy was done by the physicians made us, physiotherapists, keenly aware of much inadequacy of physiotherapy services.

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Correlation between walking ability of the patients with cerebrovascular accident (CVA) and the lesion sites of infarction and hemorrhage was evaluated in 81 patients, (mean age: 67.3 years, 46 males and 35 females). The infarction and hemorrhage sites were divided into 4 areas according to the computed tomography (CT) findings; 1) posterior crus of internal capsule, 2) putamen, 3) thalamus and 4) area of semioval center (SC). The patients who had lesions in the posterior crus of internal capsule showed impaired walking ability. Even if there is no lesion in the posterior crus, the walking prognosis was bad when the lesions in putamen and SC area exist. X^z analysis showed that the degree of the CVA lesion relates with the severity of the patient's walking ability in all sites except for thalamus. Multiple regression analysis revealed that the posterior crus of internal capsule and the anterior and posterior portion of SC area were independently and significantly related to the variation in walking ability of the patients.
From these findings, we concluded that analysis and identification of infarction and hemorrhage sites on CT may, in part, contribute to the determination of the prognosis of walking ability of the patients with CVA.

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The porpose of this study was to analyze the effectiveness of the treatment using isometric contraction on frozen shoulder compared with that of the treatment using stretching movement.
Thirty three patients with frozen shoulder were divided into two groups: 16 patients were treated with stretching and 17 patients with isometric contraction. They underwent treatment five, ten, twenty times, and their ROM was evaluated after the treatment.
A significant difference (p < 0.01) in ROM was observed between the two groups.
There are two reasons for this result. One reason is that the isometric contraction may stretch the connective tissue of the musculotendinous junction (MTJ). The other reason is based on the alternation of the viscoelastic properties of the intramuscular connective tissue as a result of an increase in actual muscle temperature caused by contraction.
It was concluded that the isometric training might be more efficient and effective than the stretching training for the treatment of frozen shoulder.

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The purpose of this study was to evaluate the skillful level of the manual breathing assist technique and also to investigate the effect of the instructional methods in the continuing education organized by School of Allied Medical Sciences, Shinshu University, 1988. The number of the participants was 12 (10 males and 2 females, all Physical Therapists). Teaching program consisted of 6 days, and 2 / 3 hours of the course was used as practical education. Evaluation was performed by 3 instructors at the beginning and at the end of the course. The manual breathing assist technique was evaluated by using the subjective evaluation scale. The scale had 5 items. Position, direction and timing of assist were special elements of the manual breathing assist technique. Assisting feeling (pain or discomfort) and touch were common elements of manual therapy.
Average score at the beginning or ending or the evaluation was 44 ± 18% and 92 ± 3% respectively. There was a significant difference between them. Among 5 items, timing of assist was comparatively easy to be mastered. As compared with this, assisting feeling was low score. Because this element was an integrated factor of the other 4 items.
We concluded that the base of the manual breathing asssist technique was comfortable light touch, and this touch was necessary for all manual techniques as well as the manual breathing assist technique. In order to master the manual breathing assist technique, man-to-man instruction was indispensable.

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