This study evaluated the efficacy of a movement therapy program designed by the authors in patients who suffered primarily from lumbar pain and were diagnosed as having reactive pain. The program is intended to have patients learn how to inhibit excessive muscle strain of the lumbar region through a series of muscle stretching exercises. Changes in pain prompted by continued movement therapy and objective effect of a single round of movement therapy designed to produce its characteristic effect were investigated. For objective evaluation, the frequency of arm reciprocation per unit time was measured. The results indicated that continued movement therapy alleviated pain in 16 of 19 patients. Normalization of arm reciprocation frequency was seen after one round of movement therapy in 45 patients.

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The shape of toe flexion caused by hemiplegia and its influence on motor function and gait ability were investigated in 48 patients with hemiplegia due to cerebrovascular disease. The occurrence and patterns of toe flexion were evaluated by photographs taken while sitting and walking barefoot.
More of the patients who could not walk barefoot, were associated with toe flexion. The patients with toe flexion were characterized as having lower motor functions and slower walking rate. Toe flexion was classified into three flexion patterns, i. e., claw toe, hammer toe, and mallet toe. In the group of patients who could not walk barefoot, claw toe was observed most often. The patients with a claw toe had lower motor functions and slower walking rate than the patients with a hammer toe. Functional differense between claw toe and hammer toe is suggested.

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The purpose of this study was to investigate how hemodynamic responses are influenced by changes in both angular velocity and exercise repetition during isokinetic trunk rotatory exercise. This study was performed in six healthy adult men at three different angular velocities (60, 90, and 120 deg/sec) and with three different exercise repetitions (5, 10, and 15 repetitions). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were measured non-invasively with a sphygmomanometer. The time to pre exercise value (recovery time) for HR, SBP, DBP, and MBP was measured. In addition, peak HR, SBP, DBP, MBP, and Rate-Pressure. Product (RPP; HR × SBP × 10^-2) were measured. Peak HR, SBP, DBP, MBP, and RPP significantly increased at each angular velocity and each repetition as compared with the control values (p < 0.05).
At the same angular velocity, peak HR significantly increased with sustained repetitions for each of the studied angular velocities, i.e., 10 repetitions > 5 repetitions, 15 repetitions > 5 repetitions and 15 repetitions > 10 repetitions. Peak SBP significantly increased with sustained repetitions at 60 deg/sec, i.e., 10 repetitions > 5 repetitions and 15 repetitions > 5 repetitions. Both peak DBP and peak MBP significantly increased with sustained repetitions at 60 deg/sec, i.e., 10 repetitions > 5 repetitions and 15 repetitions > 5 repetitions and at 90 deg/sec, i.e., 10 repetitions > 5 repetitions and 15 repetitions > 5 repetitions and at 120 deg/sec, i.e., 15 reptitions > 5 repetitions and 15 repetitions > 10 repetitions. Peak RPP significantly increased with sustained repetitions at 60 and 90 deg/sec, i.e., 10 repetitions > 5 repetitions arid 15 repetitions > 5 repetitions. The recovery time for HR, SBP, DBP, and MBP progressively increased with the number of repetitions.
At the same execise repetition, peak HR significantly increased with sustained repetitions for each of the studied repetitions, i.e., 60 deg/sec > 120 deg/sec. Peak DBP significantly increased for 10 and 15 repetitions, i.e., 60 deg/sec > 120 deg/sec. Peak RPP significantly increased for 5 repetitions, i.e., 60 deg/sec > 90deg/sec.
These findings indicate that the following are important to safely measure the hemodynamic response to isokinetic trunk rotatory exercise:
(1) The number of repetitions should be kept low, at slower angular velocity.
(2) The angular velocity should be kept at faster speed, for many exercise repetitions.

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This study was to investigate the ambulation status at follow-up period in cerebral vascular disease patients (N = 85, mean age of 66.4 years old) who had not acquired the independent gait at the discharge. Multivariate statistical analysis (Quantification analysis type Ⅱ) of the data revealed the followings.
1 ) Mild hemiparetic and young patients at discharge showed greater gait independence at the follow-up time.
2 ) Primary factors on the ambulation status at the follow-up were the severity of the sitting balance and the walking level at discharge.
3 ) Categories of age, Brunnstrom stage, and higher cortical functions at discharge were considered as second factors for predicting the ambulation status in the chronic phase.

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We analyzed the accidents occurred during physical therapy, and discussed causative factors and accident preventions.
The accident was defined as the events the physical therapy programs had to be discontinued, and the examinations by the doctor were done or some medical treatment for the patients was given in the ward. The number of the accidents was 12. These were the following: laceration by falling down to the floor, 8 episodes; recurrence of primary disease, 2 cases; a fracture of femur; a patellar tendon plasmotomy; and a quarrel between the patients.
According to review of these episodes, we divided the causative factors into four categories. They were the problem of the environment, that of the patients, that of the staffs, and other considerable problem. Then we discussed the best plans for accident prevention.
Patients are treated under direct observation of physical therapists during physical therapy, so the responsibility of physical therapists for a patient is important. Accident prevention programs must be carried out carefully and continuously by all staffs.

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We have applied Step-lock knee joint to Knee Ankle Foot Orthosis (KAFO) for practical use. The purpose of this study was to investigate the actual conditions that the KAFO with Step-lock knee joint have been used in fifteen subjects (11 hemiplegic patients, 4 bilateral hemiplegic patients), and to clarify the indication and effectiveness of this knee joint.
The findings on this investigation were as follows;
1) The subjects who were prescribed with KAFO with Step-lock knee joint had the severe motor dysfunction of the lower limb, such as spasticity of knee flexor muscles, knee flexion contracture in the affected side, and weakness in the sound side. Most subjects revealed one of these motor dysfuntion.
2) The Step-lock knee joint provided multipurpose usage of KAFO, because the Step-lock knee joint allows the range of motion to extend unrestrictedly up to 135 degrees through a series of nine automatic locking positions, and it also allows the subject to lock and unlock easily with one hand. This actually made it possible to provide self locking on knee extension (9 cases), to reduce assistance on standing and transfer activities (6 cases), to put the prolonged stretching of knee flexor muscles (10 cases), and to acquire gait activities (15 cases).
3) It was therefore suggested that Step-lock knee joint made it possible to provide wide and practical usage of KAFO with effective results.

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Leg lengthening with callus distraction using external fixator has recently been applied to the patients with chondrodystrophic dwarfism. We have experienced the leg lengthening for the patients with achondroplasia, of which distraction rates were around 40%, and physical therapy after the leg lengthening. For the leg lengthening, each leg was lengthened independently in order that the patient is able to walk as soon as possible. Both during and after the lengthening, ROM exercise is required to avoid the myogenic restriction.
In a serious case, it is necessary to prescribe a use of special equipments from the early stage of the lengthening. Before the leg lengthening, it is also necessary to provide patients with instructions and training for improving their ambulation, strengthening balance abilities, and acquiring better suppleness.

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Brain stem hemorrhage used to be less considered for rehabilitation because of poor prognosis. Recently several studies reported cases with small hemorrhage in brain stem identified by highly developed CT and MRI. In our studies, ten cases with brain stem hemorrhage that escaped from their vital danger were evaluated of gait ability and clinical symptoms at the time of their admission and discharge. On discharge only 2 cases showed independent gait, 5 cases indicated assist gait and 3 cases were impossible to walk. Cases who showed independent gait had already stabilized their sitting balance with Brunnstrom stage Ⅵ of their legs since admission and they revealed unilateral ataxia on discharge.

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