To clarify the influence of aging on the excitability of spinal motor neuron function, seventeen healthy older subjects (8 males and 9 females) with a mean age of 58.3 ± 10.8 (41-81) years were studied using F-waves. The results of F-waves on the healthy older subjects were compared to those of healthy younger subjects in a previous study. In addition, F-waves were also studied in thirty hemiplegic patients (15 males and 15 females) in the chronic stage with unilateral neurogical damage (mean age of 58.3 ± 19.2 (49-79) years), in order to examine the influence of isometric contraction on the excitability of spinal motor neuron function on the unaffected side in cerebrovascular disease (CVD).
F-waves of the opponens pollicis muscle were measured after median nerve stimulation (supramaximal, 0.5Hz) under the following conditions: 1) relaxation (no contraction) ; 2) 25% maximal isometric contraction; 3) 50% maximal isometric contraction; 4) 75% maximal isometric contraction; 5) 100% (maximum) isometric contraction. Contraction duration was 40 sec. The persistence, amplitude ratio of F/M and phase (number of peaks) of F-waves were analyzed for 20 trials. The amplitude ratio of F/M and phase were expressed as the mean value of 20 trials.
The result of F-waves during relaxation was the same between younger and older subjects. However, amplitude ratio of F/M significantly decreased in the older subjects (t-test : p < 0.01) compared to those in the younger subjects. This results suggest that excitability in the spinal motor neuron function during isometric contraction decreases significantly with age in the healthy subjects.
No significant difference was found between the unaffected side in CVD patients and the tested side in older subjects in the result of F-waves during either relaxation or isometric con-traction. Since various types of CVD were included in this study, relationship between the spinal motor neuron function on the unaffected side and characteristics of neurological disturbance on the affected side must be studied further.

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Respirophonatory and pulmonary functions were measured before and after pulmonary therapy in nine tetraplegic patients of the high level lesion and five tetraplegic patients of the low level lesion, compared with ten normal controls. The group of nine tetraplegic patients of the high level lesion had shorter maximum phonation time (mean 5.5 sec), smaller maximum intensity level (mean 73.4dB), and more frequent breathes during oral reading on a standard passage (mean 37.0 times), and only three of the nine patients were able to count from one to twenty without breathing though all of the other groups could do so. All measurements of pulmonary functions (Forced Vital Capacity, %FVC; Forced Expiratory Volume_1.0FEV_1.0%; Peak Expiratory Flow Rate, PEFR) were lower than two other groups. The frequency of breathes during oral reading and PEFR in the tetraplegic patients of the high level lesion changed significantly after the pulmonary therapy.

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The purporse of this study was to examine the trunk function in relation to the classification of disability in patients with rheumatoid arthritis (RA). Twenty three female patients who were diagnosed as RA served as the subjects and their mean age was 57.4 ± 13.0 years. Eleven female (mean age was 52.4 ± 6.0 years) volunteered as the control subjects. For all subjects, their posture and range of motion (ROM) of the trunk, chest expansion, trunk musclular strength and bone mineral density (BMD) were assessed. As a result, the round back was recognized in most RA patients and ROM of the trunk was restricted, especially in direction of extension. Weakness of muscular strength was also found in trunk extensors. These results indicate that the functional impairment of the trunk in RA patients consists of many factors including ROM, muscular weakness as well as anthropometric changes.

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Dynamic characteristics of trunk movement of hemiplegic patients, when they were sitting and imposed to incline to lateral side, were already reported from the visual and dynamic points of view.
The relationship among this characteristics during sitting and that of during one leg standing and during gait was studied by 3-D movement analysis system, force plate and electric myography recorder for 20 hemiplegic patients. Also their ability was evaluated and compared with the ability of trunk movement.
As a result, the balance was made by using the counter weight of the body during one leg standing. Forward and backward movement was used instead of lateral movement during one leg standing to keep the balance by the sound side. Same strategies of balance were found during sitting activity.
Hemiplegic gait patterns were not fluent as the normal patterns, and paused between each step. So the gait could be stated as the sequence of the static one leg standing but no relationship between trunk movement and ADL test was found.

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Atelectasis is a common pulmonary complication of pediatric cardiovascular surgery. Chest physiotherapy may be more effective if it could be performed prior to the development of atelectasis during the post-operative period. In order to know risk fators for post-operative atelectasis, we conducted a retrospective study by analyzing pre-operative data of 171 patients in whom cardiovascular surgery was performed in 1989 and 1990.
Post-operative atelectasis developed in 64% of the patients. In the patients aged less than 3 years, congestive heart failure, airway disease and pulmonary hypertension associated with high pulmonary blood flow were observed to be statistically significant risk factors. Post-operative atelectasis developed most frequently in left lower Robe and in the period of post-extubation.

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Developmental progress of 24 extremely low-birth-weight (< 1000g) infants admitted to the NICU was studied prospectively. Each subject was assessed regularly for neuro-developmental status, and received early intervention by physical therapists. Infants were divided into three groups, Normal/expected age (15), cerebral palsy (4), and mental retardation (5) at developmental assessment. Although infants of normal group showed some delay in the first extensor stage, they indicated a “catch-up” in gross motor development in the following stage. Duration and oxygen level of mechanical ventilation was significantly correlated with poor developmental progress.

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Patients with left hemiplegia due to stroke sometimes show an agnosia-like syndrome in daily life. If the result of conventional static examination for agnosia is negative for such patients, one would consider them to be careless and pay little attention.
In the present contribution, we address the value of a dynamic examination using a computer game on television to identify such agnosia-like syndrome, being not detectable by the conventional method and discuss the necessity of rehabilitation for it's restoration.
The feature of game software used in the dynamic examination forced the patients into grasping totally situations of the screen and responding to them accurately and rapidly. On the examination of right-handed patients for agnosia, the patients with hemiplegia showed almost the same response as the healthy controls did, whereas the patients with left hemiplegia showed clearly an agnosia-like syndrome in their left side.
These results indicate that the agnosia syndrome should be evaluated both statistically and dynamically, and it's restoration requires rehabilitation exercise to gain rapid response.

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The purpose of this study was to investigate the influence of voluntary muscle contraction in the lower extremity on excitability of contralateral alpha-motoneuron evoked Hoffman-reflex (H-reflex).
Seven healthy male subjects performed eighteen kinds of isometric contraction of the skeletal muscle that were flexion and extension in hip, knee and ankle joint with three kinds of %MVC (Maximum Voluntary Contraction) to the right lower extremity. We observed the H-reflex amplitude of the left soleus muscle. The amplitude of H-reflex during isometric muscle contraction was compared with that of the rest.
When the right soleus muscle contracted, the H-reflex amplitude of the left soleus muscle increased specifically. No remarkable change was, however, observed while the other muscle contracted.
These results suggest that the excitability level of an alpha-motoneuron is increased by the contraction of contralateral homonymous muscle.

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The depressive states are one of the obstacles in physical therapy. We evaluated the depressive states of the 118 home-bound disabled due to cerebral vascular accident and the 113 non-disabled over 60 years of age. We used Self-rating Depression Scale (SDS).
The results were as follows:
(1) There was no difference between the disabled and the non-disabled in the depressive state. But in both groups the mean scores were higher than normal adult score.
(2) Psychologically, the disabled felt more depressed than the non-disabled.
(3) In the disabled, those who move with assist in the house were more depressed than those who were able to move by themselves. On the contrary, age, sex, period from onset of CVA, function of the paralyzed upper extremity and type of family situation were not related.
From these results, we think appropriate physical therapy and proper understanding of their situation are essential.

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Maximum lateral displacement of the center of gravity (MLDCG) toward the sound and affected sides before and after weight-shift treatment was measured in fifteen hemiplegic patients with three levels of deep sensation (normal, weak, absent; five patients in each of three groups) and five normal controls. Analysis of variance in three factors (deep sensation, side, weight-shift treatment) showed main effects of side and weight-shift treatment on MLDCG. MLDCG was longer in the sound side than in the affected side, and was longer before treatment than after treatment. The increment of MLDCG from pre-treatment to post-treatment was also larger in the affected side than in the sound side. MLDCG in the sound side of the hemiplegic patients without sensation was the shortest among the four groups. It was concluded that MLDCG decreased as a function of disturbed deep sensation and increased with weight-shift treatment.

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To predict postoperative complications following pulmonary resection, pre-operative Ventilation Threshold point (VT) was determined in 25 high risk patients. All the patient showed low VT, and post-operative complications were noted in 28.0% of them. The patients with Vo₂max below 60% were particularly prone to high incidence of post-operative complications.
Pre-operative VT may thus be concluded useful as an index for predicting the occurrence of post-operative complications following pulmonary resection.

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