We examined the corelationship between the visual verticality and the sitting balance in patients with higher brain dysfunctions after stroke. Neglect patients (N = 19) showed severe disorders of the visual verticality, which located counter-clockwised (contralesional) direction at cornal plane. Aphasic patients (N = 15) indicated, in contrast, slight disorders of the visual verticality in clockwised (contralesional) direction. Disorders of the visual verticality would affect both static and dynamic sitting balance which were measured by monitoring the center of pressure, and the analysis of truncal movements.

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The purpose of this study was to analyze the effect of progressive resistance exercise with a bicycle ergometer on static standing balance in healthy subjects. The subjects were 50 healthy volunteers whose mean age was 26.5 (range, 19 to 65 years). Each subject stood on a force plate with the eyes closed before and after the exercise for a minute. The shifting lengths, the mean displacement of center of gravity in right-left direction, Root-Mean-Square value (RMS), velocity of body sway, the power spectrum of body sway and of its velocity were calculated by using Gravicorder. With respect to the power spectrum, the oscillations were ranged into frequency bands of 0.002-0.1 Hz, 0.1-0.2 Hz, 0.2-0.5 Hz, 0.5-1 Hz, 1-2 Hz, and 2-5 Hz. The percentual power spectrum density in each band was obtained. The results obtained before and after the progressive resistance exercise in each element were compared. The results were as follows. The correlation between RMS and velocity of body sway measured before the exercise was significant (p < .005). The mean displacement of the center of gravity in left-right (X) direction after the exercise shifted to the right compared to the value measured before the exercise (p < .005). The value of body sway in the 0.02-0.1 Hz band in the anterior-posterior (Y) direction obtained after the exercise was significantly related to the value of the velocity of body sway in the same band in “Y” direction obtained after the exercise. The value of body sway in the 2-5 Hz band in “Y” direction obtained after the exercise was significantly related to the value of the velocity of body sway in the same band in “X” direction obtained after the exercise (p < .005). These results suggested that the progressive resistance exercise might contribute to facilitation in the propriceptive system and the vestibular system.

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We measured the grasping power of mental disordered patients for ten times to see if the “maximum” strength evaluated by therapists coincides with their true “maximum”. The subjects consisted of three groups, the first is schizophrenic group (n = 23), the second is alcholism group (n = 18), and the third is healthy control group (n = 19). The result was that the fatigue curves of schizophrenia group and alcholism group were quite different from that of healthy control group. It was concluded that mental disordered persons had a tendency to assume their muscle power inconsciously in advance.

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In initial physical therapy assessment, to evaluate patients as total persons, relevant information should be obtained by interview. However, this requires special skills not always possessed by students of physical therapy. Thus, to conduct interviews, the simulation of clinical situation is introduced.
Sessions for this purpose consist of lectures and simulative and clinical practice. Simulated patient is considered a hemiplegic patient due to brain trauma, and acted out by a teacher. Interviews are conducted by two students, using the suggestions of another teacher. Interview quality is assessed by other students. The results are made into a check list and questionnaires are answered.
Satisfactory results were obtained in most cases, and thus the present approach was concluded to impart adequately the required skills for conducting interviews. However, the simulation model should be modified to meet the needs of each case, and thus further study will be required.

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The diaphragmatic evoked potentials (DEP) by electric stimulation to phrenic nerves were recorded in 8 healthy young people, and their respiratory functions (%VC, %FVC, FEV_1.0% and %MMF) were also checked. Amplitude and latency of DEP were compared between supine and sitting positions.
Results were as follows:
1) The latencies of DEP were not significant different between left and right intercostal parts. The mean amplitude of DEP was 6.4 msec at the sitting position and 7.1 msec at the supine. Latency of the supine position was slightly longer than that of the sitting.
2) The mean amplitude at the supine position was 313.4〜360.7μV (the 7th intercostal part), and 320.5〜326.1μV (the 8 th intercostal part). The mean amplitude at the sitting position was 383.9〜417.3μV (the 7th intercostal part), 387.9〜433.9μV (the 8th intercostal part). The mean amplitude of sitting position was significantly bigger than that of the supine position.
3) This method was revealed to be a useful test for the analysis of disturbance in the phrenic nerve or the diaphragma.

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The purpose of this study was to investigate the relationship between muscular strength, average rectified signals of EMG (ARS) and angular velocity under concentric (COC) and eccentric contractions (ECC) for extensor and flexor muscles in the knee. The subjects were healthy 9 male and 11 female college students. Peak and averaged torques were obtained at three velocities (30, 120, 200°/sec) using a KIN・COM isokinetic dynamometer, which were corrected for the effect of gravity (the latter was ACT). Synchronized ARS was recorded from rectus femoris and medial hamstring muscles.
The results were as follows;
The corrected peak torque and ACT were gradually decreased with the increase in angular velocity on flexors and extensors in the phase of COC. But during the phase of ECC on extensors, those values were relatively constant with the increase in angular velocity. On the contrary, ACT/ARS were gradually increased with the increase in angular velocity on extensors in the phase of ECC, which was in agreement with the many previous results on isolated muscles.
It is speculated that ECC is inhibited by nervous system protected from muscle injury and is more dependent on series elastic component with an increase in the angular velocity.

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The purpose of this study was to determine the causes other than pain and leg-length discrepancy that could generate the limping found in the frontal plane in patients with osteoarthritic hip. Subjects were 34 patients with osteoarthritic hip, who were divided into four groups according to the degree of limping in the frontal plane. The isometric torque of the hip abductor muscles was measured using a REHAMATE kinetic evaluation and training machine. In addition, measurements of range of motion (ROM) and on roentgenograms of the hip joint were performed.
Major findings of this study were:
1. Superolateral displacement of the femoral head seen in patients with osteoarthritis of the hip increased significantly as limping appeared and developed (p < 0.05).
2. The hip abductor muscle torque decreased significantly when limping developed terminally (p < 0.05).
3. Except for extension, ROM of the hip was maintained for a normal gait in all four groups; there were no significant differences in extension among the four groups.
It is postulated that both weakness of the hip abductor muscles and superolateral displacement of the femoral head are major causes of the limping found in the frontal plane in patients with osteoarthritic hip.

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The purpose of this study was to analyse the functional roles of muscles as rising to a standing position from a sitting position on a chair recorded by the comprehensive system developed for the kinesiological analysis. The system was composed of a VTR set, a force plate, a surface EMG and an original mat switch that made those records synchronized.
Rising from the sitting position on a chair begins with trunk forward bending. The force of vertical reaction under the feet just decreased as soon as the rising movement started, and it then steeply augmented. The decrease in the force of vertical reaction was presumed that hip flexors and ankle dorsi-flexors active at the initial stage produced the force to lift up the lower extremities which was the same force to initiate the trunk forward bending.

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MACS (Mastery and Assessment of Clinical Skills) was conducted to evaluate the clinical practices of third year students of physical therapy. Results from MACS, questionnaires to supervisors (SVs) and present conventional evaluation forms were examined and clarification was made of the following.
① Assessment by finer criteria of MACS is better. ② The usefulness of MACS in teaching PT practice is more in the second half of clinical practice. ③ Communication between SVs is very important. ④ A challenging approval system (double examination) is quite important.

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We applied the Apley scratch test (AST) to patients with shoulder joint disability (52 shoulders in total) to determine its usefulness as a clinical measurement.
1. In the first test the patient was asked to reach behind his head and touch the flattened triangular area of the opposite scapula. This is regarded as a screening examination of abduction and external rotation. The most significant correlation observed was between this first test and flexion (r = -0.68, p < 0.01), and a significant correlation was also observed between this first test and elbow flexion. So we must take into account that this first test is affected by synthetic movement of the upper extremity.
2. In the second test, to determine the range of internal rotation and adduction, the patient was asked to reach behind his back and touch the inferior angle of the opposite scapula. A significant correlation was observed between this second test and internal rotation (r = -0.78, p < 0.01), but not observed for adduction.
3. As the AST reflected not only the active range of motion but also the state of what we call the “keppatsu” and “kettai” motions of daily life, we were able to use the AST as an index of the difficulty of these motions.
4. The AST was little affected by wrist or finger joint movements, so there was no problem caused by the use of finger tips during the performance of the ASTs.

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During the period from October 1987 to March 1989, we provided home-visiting services for 337 disabled people in Yokohama. A total of 186(55%) of these subjects received services concerning bathing. This paper presents the results of analysis in terms of the way of bathing, the number and the type of attendants, remodeling of bathroom, and rehabilitation equipment for bathing in 92 cases.
Results are summarized as follows;
1) The most common type of service was the combination of partial remodeling of bathrooms and introduction of rehabilitation equipment. 2) We could not considerably reduce the number of attendants needed and improve the way of bathing. 3) With our guidance in the way of bathing such as holding rails and keeping a stable sitting position, we could reduce the amount of burden on the attendant and make bathing safer for the disabled. 4) For most cases, physical therapists or occupational therapists repeatedly showed the disabled and their attendants how to take a bath before and after refurnishing their bathrooms.
Remodeling of bathrooms were usually limited to be partial due to the environmental limitation, economic situation and the preference of family. From our experience, it seemed important to demonstrate the most appropriate way of bathing after refurnishing.

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The measure, form, and materials of various parts of 69 wheelchairs used by patients with quadriplegia from 1982 to 1988 (20 in 1982-84, 23 in 1985-86, and 26 in 1987-88) were compared to study their changes and recent trends.
The height and the width of the seat and the caster diameter were reduced, but the inclination of the seat was increased in 1987-88 as compared with those in 1982-84. The material of the frame changed increasingly from stainless steel to aluminum alloys, and the desk-type armrests were replaced by simple frames along tires. Footrests more often became the fixed type from the swing-out type, and their material changed from plastics to leather belts.
These observations suggest that recent wheelchairs for patients with quadriplegia are becoming smaller, lighter, and more compact in consideration of daily activities, maneuverability and appearances.

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In severe celebral palsied children, chronic respiratory dysfunction due to upper-airway obstraction and chest mobility restriction is a serious problem. Other health problems such as digestive dysfunction consequently become worse so that the life of the individual is endangered. This problem was solved by maintaining an upper-airway with a Nasopharyngeal Airway Tube and improving the efficiency of ventilation by chest physical therapy. The latter consisted of manual breathing assistance techniques. In this manner respiratory and general conditions improved as did also, consequently quality of life of the children and their families.

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