The first purpose of this study was to determine why two patients with bilateral osteoarthritis of the hip had a positive unilateral Trendelenburg sign on the side with greater hip abduction force, The second objective was to reconsider the evaluation of muscle strength in patients with musculoskeletal disorders through the experience of these two cases.
Evaluation of two women, 52 and 63 years old, showed that the strength of hip abduction in the limb with the positive Trendelenburg sign was normal on manual muscle testing. When the isometric torque of the hip abductor muscles (experimental torque) was measured using a REHAMATE kinetic evaluation and training machine, the values were greater on the positive Trendelenburg side. Neck shaft angle of the femur and the degree of superolateral displacement of the femoral head on roentgenograms were larger on the positive Trendelenburg side. When the experimental torque was compared with the theoretical torque, which was the value obtained by multiplying 0.82 times that of total body weight by the distance from the center of the femoral head to the pubic symphysis on the roentgenograms, in both affected and unaffected limbs, the ratios (experimental/theoretical) were smaller for the affected limb in both patients.
It was postulated that the positive Trendelenburg sign in these cases was due to valgus of the femoral neck and extreme superolateral displacement of the femoral head in the affected hip, which produced body weight moment increasing beyond the torque of the hip abductor muscles when the patients performed the one-legged stance.
In the future, when evaluating muscle strength in patients with musculoskeletal disorders, we must not only compare the magnitudes of muscle strength between sides and with that in normal subjects, but also evaluate whether patients can generate sufficient muscle strength to perform a movement with much consideration into anatomical changes of the joint.

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The purpose of this study is to examine the availability of movement therapy we designed and gave to patients suffering from knee pain which was diagnosed as osteoarthritis (OA) in 14 cases.
The aim of this movement therapy is to let them relearn how to inhibit hypertonic muscles around the knee joint by normal contraction of knee joint extensors.
By this movement therapy, the limitation of knee extension was decreased and the ability of knee extension and Screw Home Movement (SHM) were regained. Then the alignment of knee joint was guided in stabler position.
As a result of using this method much of knee pain was reduced or banished compared with the method of SLR (p <. 01) or stretch of hamstrings.
Furthermore EMG in bearing weight on an affected side leg could be inhibited on a more normal level.

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It is essential for physical therapists of a severe cerebral palsied child to cope efficiently with respiratory functions with a view to the sustenance of one's life and the promotion of one's health. The therapeutic principles are as follows. Foremost, a physical therapist works toward normalizing postural tones at the trunk and neck of his patients. Secondly, he strives to help improve the antigravitic control of their head and the symmetrical antigravitic extension activities of their trunk. Thirdly, he facilitates the rib cage expanding movement by increasing flexibility of their thorax. The above-mentioned therapeutic efforts are all designed for a therapist to stimulate the development of harmonious thoracico-abdominal respiration. The researchers applied a long term respiratory training based on the above principles to two severe cerebral palsied children. An analysis of the respiratory conditions before and after the treatment period was made. The researchers have created and used a respiratory functions assessment chart with the following items: antigravitic head sustaining ability and respiratory rate determined by numerical value; thoracic shape and breathing pattern marked by nongraded category; and phlegmy expectoration and wheezing frequency measured by graded category. Futhermore, the respective movements of thorax and abdomen on the respirometer, and arterial oxygen saturation were recorded. A point of consideration regarding the first case treatment was to induce deep thoracico-abdominal respiration while attempting to augment the thoracic flexibility. A goal for the second case was to acquire regular respiratory rhythm by inhibiting extensor spasms and stabilizing the trunk and head. In both cases after the treatment, the researchers clearly noticed the following things: time increase of head sustention, acquisition of deep thoracico-abdominal respiration accompanied by decreased respiratory rate, and shift from sea-saw respiration to thoracico-abdominal respiration. Additionally, respirogram analyses of each case confirmed both the improvement in the harmonious coordination between thorax and abdomen, and the stabilized condition of the breathing rhythm. In contrast with their conditions before the treatment course, both subjects now suffer cold less often and they have not contracted pneumonia since then. These results suggest that the long term respiratory training predicated on the forenamed principles can help to remedy the respiratory problems of severe cerebral palsied children.

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The object of this study is to determine the accuracy of our new compliance meter system of the soft tissues. This meter was composed of a strain gauge, a linear gauge and a controllable adaptor of three dimension. The voltage of the strain gauge was measured at balanced with 100 g intervals from 100 g to 2,000 g and then calculated the correlation between the voltage and the weight. And the effects on inclining the pellotte at five and ten degrees from vertical line was examined. The compliance of the sponge block, forearm and anterior part of the lower leg was measured respectively by this meter. The compliance was indicated by the voltage of the gauge when the pellotte was pressed down by 5, 10, 15, 20mm depth on the materials.
The results were as follows:
(1) The regression line of the correlation between the weight and the voltage of the strain gauge was V(v)=0.0031F(g)-0.0098, and its coefficient was 0.9998.
(2) The force at five degrees inclination was not significantly different from the force at zero degree, but at ten degrees it was significantly different.
(3) The values of the compliance of the forearm were variable by different days and times.
(4) Values of the compliance of the anterior part of the lower leg were constant even on different times.

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Assessment was made of muscle endurance by fatigue-Oriented muscle strength training. For this purpose, number of repetitions and electromyographical activity on rectus femoris muscle during SLR exercise were recorded in 7 patients with TKR and femoral neck fracture. To determine the relationship between strength and endurance, a strength fluctuation curve during SLR repetition by the maximum effort was obtained for selected cases. The repetition maximum (RM) method appeared to increase muscle activity due to psychological encouragement. Muscle endurance was somewhat enhanced by the present training. By this method, patients giving-way symptom in the case of TKR, was improved during a short period. And reversed phenomenon, the hip flexor of fracture side was noted to become stronger than that of the sound side, in the case of a femoral neck fracture.

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The introduction in 1989 of the medical insurance requiring all the people to join it has been helping to shrink the shortage of job openings or positions for physical therapists in the Republic of Korea. The Korean Physical Therapy Association has a membership of some 6,000 physical therapists out of whom less than 4,000 are actually engaged in physical therapy. The 2-year training long practiced at junior colleges has been prolonged to 3-year ones since March in 1991. There are two 4-year-long colleges providing such a course, too. Approximately 50 out of about 200 occupational therapists in total are, in effect, actively involved.
The inadequateness of the medical insurance system makes it extremely difficult to receive a consecutive course of treatment on a long term basis. For patients have to shoulder half of their medical fees on their own and also no official health insurance policies grant them to gain the treatment under the same name of diagnosis for 6 months running in a year. It does follow that the system disfavors those such as stroke patients and cerebral palsied children who require a long-term therapeutic exercise. There exist roughly 100 speech therapists in R. O. K. No law has been enacted to grant patients the right to enjoy medically insured treatments, which leaves them no choice but to pay off ￥ 2,000 what it all costs them per treatment. The expense is a large amount of burden on them. Most of the handicapped are admitted in institutions. There are only few kindergarten and treatment centers there. Thoughtlessness on the part of the municipal government anthorities has created a situation where the Pusan Cerebral Palsy Center or the only one kindergarten and treatment center in Pusan with a population of 3.5 million now faces the fate of relocation, due to its status. It is not yet legally compulsory for institutes for the handicapped to offer them education in line with proper school education that is not to be enjoyed by quite a few handicapped children. They are underprivileged in real life to such an extent that a considerable number or handicapped children are often found among those lost at a big festival site and the like. R. O. K. had been achieving her economic growth mainly in the area of industry through exportation until the Seoul Olympic Games in 1988 but at present exportation is sluggish because of the repeated depreciation of Won. It is expected nationwide that domestic demands should be expanded and at the same time handicapped children and their families are raising the requests that the government should procure and appropriate some social overhead capital early enough and in time and perfect the social security. It is most likely that the Korean nation, who has gained confidence by dint of their economic development, will be able to work out such big problems as these. My coauthors and an author myself sincerely hope the above-mentioned can be fulfilled.

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A large number of studies on low back pain in the rural area have been performed for the last few decades, but there are very few studies on low back pain in the farmers from epidemiological and physical therapeutic points of view. In this study epidemiological problems of farming relevant to low back pain were studied among 55 farmers participating in growing the vegetables in Sumoto, Awaji Island, Hyogo Prefecture.
The results were as follows:
1) Physical characteristics of farmers with low back pain were; flexibility of the spine was excellent, though muscular endurance of the spine was not satisfied.
2) Their improper working postures were highly connected with occurrence of low back pain.
From these results it may be suggested that daily exercise for a certain period is necessary to alleviate low back pain and the instruction of proper posture during their working from epidemiological point of view is also indispensable for the prevention of low back pain.

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[in Japanese]

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[in Japanese]

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Respiratory functions or forty eight patients with Subacute myelo-optico neuropathy (SMON) were examined and compared with the disability of their daily activities.
They were consisted of 11 males and 37 females, whose ages were from 39 to 82 years. They were classified into three age groups.
The content of the present respiratory functions were ratio of vital capacity (%VC), forced vital capacity (%FVC), forced expiratory volume for one second (FEV_1.0%) and, 50% and 70% of forced expiratory flow (V50, V25).
These results were as follows;
There were the same negative correlations of age with %VC, %FVC, FEV_1.0%, V50 and V25 in these SMON patients as the healthy aged controls. On the other hand, there were 9 cases (8 females and 1 male) with less than 70% of %VC, FEV_1.0% in all cases. Patients with respiratory dysfunctions had a little lowered motor disturbance, which mean disability of their activities of daily living (ADL), for examples, on maintenance of sitting position and or daily gait. With daily activities, the ratio of patients who limited only to lie or sit in the room all day was approximately 70%. It is, therefore, necessary for SMON patients within the age of seventy years to be given the suitable guidance in order to keep their ADL.

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The essential aim of breathing is to circulate gas in the alveoli pulmonis for the sustenance of life and metabolism. The circulation is also taken advantage of as a source of power to utter sounds words, which is a most efficient means of communication among us, A physical therapist and a speech therapist have recently made concerted efforts to conduct a ten-month-long course of treatments on a cerebral dyskinesia child who had developed the malfunctioning of the utterance. The results has shown that as the child improved in the respiratory pattern so did he in the utterance as a whole. Futhermore the child's improvement in the respiratory pattern brought about the longer voice making time at a stretch and the bettered conditions of sitting balance and voice creating function respectively. In our thesis on this occasion we discussed possible ways to realize the improvement as we introduce a part of our particular treatment.

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