The aim of this study was to determine whether Very Low Intensity Exercise (VLIE) affects the changes in Fasting Blood Glucose (FBG), triglyceride (TG), High Density Lipoprotein cholesterol (HDL-Ch).
The subjects were 5 males with NIDDM aged from 51 to 58.
They performed the larghetto walking program (40 kcal × 3 /day, an hour after each meal during 25 minutes for 3 days) after 1400kcal diet therapy of two weeks.
Statistical differences between the pre and post FBG, TG, HDL-ch were performed by Student's t-test.
In the result, there were no significant differences between pre and post FBG, TG, HDL-Ch. The effect of VLIE on insulin receptor sensitibity may be lower than Low Intensity's effect.
This intensity is of least risky compared with moderate and heavy intensity exercise for NIDDM who may have macro and micro vascular complications.
We believe that VLIE is very important to enhance the beneficial effect of exercise therapy for patients with NIDDM and disabled persons with complications.

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To clarify the neurophysiological basis of the physical therapy, especially facilitation technique in which contralateral motor neuron function is influenced by voluntary isometric contraction, we investigated contralateral F-waves during voluntary isometric contraction of the elbow flexor muscles.
Twelve right-handed subjects (5 males and 7 females) with mean age of 20.8 (20-23) years were studied. F-waves of the contralateral opponens pollicis muscle were measured under the following conditions of contraction of the elbow flexor muscles: 1) relaxation (no contraction); 2) 25% maximal isometric contraction; 3) 50% maximal isometric contraction; 4) 75% maximal isometric contraction; and, 5) 100% (maximum) isometric contraction.
Persistence of F-waves was 54.5 ± 29.3% under condition 1, 62.6 ± 22.5% under condition 2, 72.6 ± 25.7% under condition 3, 81.0 ± 18.5% under condition 4, and 85.3 ± 15.8% under condition 5. As the degree of contraction increased, persistence showed significantly higher (ANOVA p < 0.05), especially those of 75% and 100% contraction were significantly higher (t-test p < 0.01) than that of the relaxation.
Amplitude ratio of F/M was 1.56 ± 0.87% under condition 1, 1.61 ± 0.61% under condition 2, 1.78 ± 0.67% under condition 3, 2.12 ± 0.76% under condition 4, and 2.36 ± 0.95% under condition 5. As the degree of contraction increased, amplitude ratio of F/M of the contralateral F-wave were gradually higher (ANOVA p < 0.05), especially those of 75% and 100% contraction were significantly higher (t-test p < 0.01 and p < 0.05) than that of the relaxed.
No significant differences among the 5 conditions in latency, duration or phase (number of peaks) were noted.
These results suggest that increase in the degree of isometric contraction enhanced the excitability and number of anterior horn cells excited on the contralateral side of the spinal cord.

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This study was conducted to clarify differences between the real number of steps and those recorded with a pedometer in hemiplegic patients. Daily activities was calculated from the average number of steps a day of 3 times by a pedometer.
The results obtained were as follows;
1. Errors (differences between the real number of steps and those recorded with a pedometer) obtained in hemiplegic patients were more remarkable than those in the aged people.
As for hemiplegic patients, the number of steps in affected side were more than in the unaffected leg.
2. Errors in hemiplegic patients negatively correlated with walking rate, walking speed and stride length, but not with walking time.
3. Coefficient variations in hemiplegic patients were more than those in the aged people.
4. Errors in patients of BRS III and IV using a cane and/or a brace at walking were observed more than those of BRS V and VI who could walk without assistance.
5. The number of steps a day in hemiplegic patients of BRS V and VI showed no difference in the aged people.

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We evaluated infant gait patterns by simple method converting gait image into computer graphics drawn by stick picture. Kinematical data were collected during comfortable walking on a floor by 20 children with cerebral palsy (spastic diplegia) and 10 normal children. As a result of that, It was possible to find specific differences between normal children and children with cerebral palsy, and to analyse abnormal gait pattern, called crouching gait.
The major differences between normal children and children with cerebral palsy were cruising speed, range of motion of knee joint, dynamic alignment of hip joint and knee joint, up and down movement of center of gravity, step length and ratio of stance phase duration to swing phase duration. We also recognised correlation between age and cruising speed in normal children, between step length and cruising speed in children with cerebral palsy. We proposed that the features of crouching gait as follows :
(1) As regards their cruising speed, children with cerebral palsy were slower than normal children. There was no correlation between age and cruising speed.
(2) Both hip joint and knee joint of them did not have extension range.
(3) As regards their movement of center of gravity, there was no difference between normal children and children with cerebral palsy.
(4) As regards their step length, children with cerebral palsy were smaller than normal children.
(5) As regards their stance phase, children with cerebral palsy were longer than normal children.

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Ten hemiplegics who can walk received aerobic training for about three months. After training, a significant increase in VT was observed, and most hemiplegics showed improvement in their walking. It was found that skin temperature of the affected thigh after excercise remained significantly low and that enhanced HR respose was observed in three cases. It was suggested that some hemiplegics had autonomic nerve dysfunction.

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In treating a patient for whom it was difficult to perform manipulations under local anesthesia during the muscular frozen phase of stiff and painful shoulder, we attempted combined treatment with the SSP method. After initiating SSP treatment changes in the pain threshold level and in the limen of twoness perception capacity showed a gradual tendency through time to increase (p < 0.05) (p < 0.01), and it became possible to conduct manipulations under local anesthesia. At one week after treatment by this method, a tendency towards an increase in the self-supported shoulder joint flex angle and gripping strength were observed (p < 0.005), and the patient was able to use her right upper limb for daily life movements, and difficult movements disappeared. If this method is selected for indicated cases taking into due account ethical background and contraindications, then it is thought it may be an effective approach.

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The purpose of this study was to investigate torque-velocity relationships during concentric and eccentric contractions of the quadriceps and hamstrings muscles. The left leg of thirty college female students (mean age, 19.7 ± 0.9 years) were tested at three angular velocities (30°/sec, 60°/sec and 90°/sec) in two contraction types (concentric and eccentric). In the testing mode of concentric contraction, quadriceps and hamstrings produced significantly lower peak torque at higher angular velocity (p < 0.01). In the testing mode of eccentric contraction, peak torque of quadriceps showed no significant difference among 30°/sec, 60°/sec and 90°/sec (p < 0.01), whereas peak torque of the hamstrings was significantly greater at the higher angular velocity (p < 0.01). H/Q ratio showed significantly greater values at the higher angular velocity in the concentric contraction (p < 0.01), but not significantly in the eccentric contraction. E/C ratio of the quadriceps and hamstrings muscles showed significantly greater values with the increase of angular velocity (p < 0.01) and the differences between concentric and eccentric torques became larger with the increase of angular velocity. The findings are useful when planning to progress the intensity of the testing and training of the quadriceps and hamstrings muscles according to patients tolerance.

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Physical therapy for incomplete knee extension after Total Knee Replacement (TKR) has up to now consisted primarily of manual exercise. Relying on simple exercise, however, increases the possibility of postoperative pain, depending on the methods used, and an improved approach is needed. For this study, Dynasplint and Functional Electrical Stimulation (FES) were used as the first step in improving TKR therapy.
Dynasplint is capable of continuously extending the knee, using constant and precisely controlled power, to gradually extend the shortened tissue. In addition, FES, when the stimulus conditions are correctly set, can be used to target specific muscle constructions. These two methods, when used together, do not generate much pain, suggesting that their combined use is effective in treatment of incomplete knee extension. Integrated with conventional exercise therapy, this method offers faster and more effective treatment for incomplete knee extension as compared with conventional exercise therapy.

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Controlability of upright balance at static state and just after sudden backward tilting of a floor board was compared between the aged and young subjects using a stabilograph for 30 seconds. The upright balance was estimated by sway length and area of center of body gravity.
Subjects were seventeen aged people (mean 68.1 years old) and ten young people (mean 21.2 years old).
Angles of the backward tilting of a floor board were set as 0 (at rest), 3, 6, 9 degrees and subjects could not predict the tilting trigger timing. Results were as follows:
1) Both the sway length and the area of the aged group at static condition and when tilting were larger than those of the young group.
2) In the both groups, the sway length and the area increased with an increase in the angle of the tilting.
3) The sway length of the aged group was 13-20% higher, and the sway area 26-61% higher than those of the young.
4) Ratio of the sway area at 3 deg/0 deg, 6 deg/3 deg, 9 deg/6 deg was 3.72, 1.22, 1.70, respectively, in the aged group and 4.75, 1.16, 1.77, respectively, in the young.
5) Upright balance when tilting a floor board was mostly controlled by forward and backward directional force.

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This study was conducted to examine whether there was a difference in the sense of force between the hands. Weber's ratios of each hand on weight discrimination were obtained using eight different weights (range 100 g to 5.0 kg) for forty seven healthy subjects (23 males, 24 females) aged 19 to 39 years (x=26, SD=5). The data for each hand were analyzed statistically. No significant difference between the hands for discriminating weights could be detected. It may be not necessary to distinguish the hands when discriminating force, for instance when doing manual muscle test, within the weight range of this study.

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This study was performed to invetigate osteoporosis accompanying apoplexia and its related factors, and to clarify the relationship between osteoporosis and fracture. The subjects consisted of 210 patients. A total of 10 items were investigated as factors associated with osteoporosis: age, sex, duration after the onset of apoplexia, grade of paralysis, lumbago, muscle strength of the sound side of the lower extremity, dementia, superficial and deep sensations of the sound side of the lower extremity, and disability level.
Result showed that osteoporosis occurred in 34 of the 210 patients (16.2%), and its incidence was significantly higher in females (p < 0.01). The incidence increased significantly as the degree of ADL independence decreased (p < 0.05).
Twenty-one of the 210 patients (10.0%) suffered fracture: 18 patients suffered vertebral fracture and 3 suffered fracture of the femoral neck. The incidence of vertebral fracture was significantly higher (23.5%; p < 0.01) when osteoporosis was present, whereas femoral-neck fracture was common in relatively younger patients in whom osteoporosis was not seen. These findings indicate that we need to pay particular attention to osteoporosis and take measures to prevent falling during the rehabilitation of patients with apoplexia.

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A functional disorder of the urinary bladder in 173 patients after stroke (85 males and 88 females, 62.9 ± 11.5 years old) was examined by gas cystometry and the results were discussed with emphasis on its possible association with the disturbance of the lower limb function. After the occurrence of stroke, 50.9% of the patients were found to have a functional disorder of the urinary bladder, the majority of them being characteristic of an uninhibited bladder. It should be noted that the patients, who have the bladder failure, tend to be older and also are liable to complicate a disturbance of the lower limb function. Seventy-six patients were able to participate in the re-examination within 6 months. A restoration of the bladder function was observed in 16 of 46 patients receiving both therapeutic exercise and drug treatment. In particular, the patients, who had an inhibited bladder on admission, made a significant recovery, where the other criteria including the volume of residual urine, the frequency of urination, and the ADL score for the lower limbs also returned to normal. These results suggest that there exists a positive correlation between the functional disorders of the bladder and the lower limbs in patients after stroke, and such disorders are restored to a certain extent by the combination of the therapeutic exercise with the drug treatment.

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We examined the relationship between the torque of the quadriceps muscle (vastus medialis: VM, rectus femoris: RF, vastus lateralis: VL) and the median power frequency (MdPF) of the surface electromyography (surface EMG) in 11 normal adults. The torque at maximal voluntary contraction (MVC) was calculated with the knee flexed 60 degrees by an Ariel machine (arm & leg type), and the MdPF of each muscle was compared at 100% MVC, 50% MVC and 25% MVC. We studied the characteristic features of the MdPF in the ranges from 10Hz to 45Hz, from 46Hz to 80Hz, and from 81Hz to 200Hz. The MdPFs of VM and VL in the range from 10Hz to 200Hz at 100% MVC were significantly greater than those at 25% MVC. The MdPF of RF in the range from 10Hz to 45Hz at 100% MVC was significantly greater than that at 25% MVC. The MdPF of VM in the range from 46Hz to 80Hz at 100% MVC was significantly greater than that at 25% MVC. The MdPF of each muscle in the range from 46Hz to 80Hz at 100% MVC was slightly greater than that at 25% MVC.
These results suggest that the pattern of activity of the muscles might be indicated by power spectral analysis of the surface EMG.

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[in Japanese]

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The purpose of this study was to evaluate the factors that influence ambulation in patients with acute central cervical spinal cord injury.
The subjects consisted of three male patients in their fifties who were injured while drinking alcohol. Muscular strength, function of upper extremities, deep reflexes, and transfer abilities were evaluated and discussed throughout the course of recovery.
The precipitating factors deciding the anticipating prognosis of ambulation were the courses of recovery of the trunk and lower extremity muscular strength and the degree of the spasticity below the level of injury. For the first six months, it is necessary to plan muscular strengthening exercise with special attention to the degree of spasticity, the disability level, and job specifications.

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