The disturbance of the respiratory function of the hemiplegic patients due to stroke was shown and its restoration by the simple respiratory exercise, blowing of the water-sealed double connected bottles, was also reported.
Subjects and Methods The subjects studied were 24 hemiplegic patients due to stroke with good communicative functions. They never had evident cardiac and broncho-pulmonary diseases on physical and roentgenographic examinations. Respiratory function tests, vital capacity (VC), forced expiratory volume per second (FEV_1.0), diaphragmatic movements on deep inspiration and arterial gas analysis were followed in patients during the admission.
All hemiplegic patients were subjected to the ordinary rehabilitation program for hemiplegia. Then 12 patients (mean age of 59.3 ± 11.3 yrs) received additional respiratory training, blowing the water-sealed double connected bottles (500 ml) to move water from one to the other, for 10 min twice a day for 1-3 months.
Results Vital capacity of 24 hemiplegic patients was significantly decreased (10.4 ± 6.7%) against 21.4 ± 7.7% of the healthy controls. Arterial gas analysis at rest, however, showed no adnormalities. Twelve patients who had received the respiratory exercise for 1-3 months showed a significant increase in %VC and diaphragmatic movements bilaterally. The improvements in %VC and the diaphragmatic movements showed a positive correlation and these also correlated positively with the improvement of ADL score. Although 12 patients who had received oridinary hemiplegic rehabilitation also showed an increase in ADL score, their respiratory functions did not show any significant improvements. Arterial gas analysis at rest, however, did not show any significant changes in both groups.
Summary Respiratory function was disturbed even in simple hemiplegic patients by neurological or dysuse origin. It was concluded in the present study that %VC of hemiplegic patients was significantly improved after the combined program of ordinary hemiplegic rehabilitation and a simple respiratory exercise.

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The purpose of this study was to discuss the usefulness of lumbar extension exercises for patients with acute lumbar disc disorders. The subjects were 34 inpatients who were given classical conservative therapies, and 69 outpatients who used lumbar extension exercises. To evaluate the therapeutic effects on both groups of patients, we measured finger-floor distance (FED) with or without pain, gave the SLR test, and measured the severity of lower back and lower extremity pain within 3 weeks of the treatments. As objective symptoms, the FED and SLR tests showed more improvement in inpatients than in outpatients. But 79.7% of the outpatients experienced little or no lower back and lower extremity pain compared to only 52.9% of the inpatients. Lumbar extension exercises can be done by outpatients, and used for selecting patients who may or may not be able to avoid surgery. Therefore, we recommend that patients with acute disc disorders do a lumbar extension exercises routinely as a useful conservative therapy.

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The purpose of this study is to obtain the basic data to evaluate various slopes on the sidewalk in order to make sure of safe outdoor locomotion on foot or by a wheelchair.
As a result, we recognized that there were barriers when people who had a disability in walking or utilized a wheelchair crossed the slopes. We think that positive preventative methods―to make the degree of these slopes smaller, and so on―must be taken.
In addition, it is important for handicapped people to practice crossing the slopes enough in exercise for the activities of daily living before leaving hospital.

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We measured 3 m crawling time on hands and knees in 10 patients, 3 m crawling time on haunches in 11 patients, and grasping power in 32 patients every month during the periods from January 1983 to January 1991. All subjects had Duchenne Muscular Dystrophy (DMD) who had been able to be measured through one year.
In order to compare the differences between the motor function changes at home and those in hospital, we calculated the average changes per a month during at home because of long term vacation, and those during in hospital.
The results obtained were as follows:
1) Crawling time on hands and knees increased by 9.6 seconds in one year, and crawling time on haunches increased by 21.5 seconds in one year, but grasping power little changed.
2) Motor function in DMD patients seemed to get worse during at home than in hospital.
These results suggested that deterioration of motor function of DMD patients was not able to be stopped, but the therapeutic exercise and physical activities in hospital might help to maintain their motor function.

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Evaluations of activities in patients are very important for home practice of physical therapy. In addition to that, leading more adequately for patients, it is also necessary to consider the sphere of their living, their attitude toward life, and their supporting conditions. This study considers the relation among these factors.
One hundred sixty nine poststroke patients at home in Kobe city who were visited by public health nurses with us were studied. We evaluated their activities and states of daily living during care service and leading practice. Our results indicate that patients who have high ability in basic activities tend to have wider sphere of living and more active attitude toward life. On the other hand, even those who can walk without help often have more limited sphere of living when they take passive attitude toward life. The supporting conditions of the patients also seem to influence their attitude toward life and the sphere of living. These factors are considered to be strongly related to each other. Therefore, it is important for us to take these factors into consideration when we conduct physical therapy for patients at home.

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Left hemineglect patients often show a Pusher sign that is pushing their base of supports by the sound limb and is falling into the affected side.
We defined the severity of Pusher sign which was demonstrated in the sitting, standing and walking in 22 stroke patients with left hemineglect. The Pusher sign was prominent in the walking than in the sitting position. The severity of Pusher sign was not entirely correlated with the severity of left hemineglect and there were some cases who showed a recovery change with time course.

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The objectives of this study were to clarify the reasons why students were unsuccessful in their clinical practice during their third year and to see if there is any correlation between their academic achievements in their second year and their performance in their clinical practice in their third year. We examined the records of 153 graduates at the Aichi College of Physical Therapy.
The results were as follows :
1. The number of candidates who were successful at all three institutions was 125 (81.7%). The number of candidates who were unsuccessful at one or more institutions was 28 (18.3%).
2. The major reasons for lack of success were; insufficient knowledge of Physical Therapy, insufficient levels of technical skill, and problems on the human relations level (44.4%).
3. There was no correlation between academic achievements in the second year and their performance in the clinical practice in their third year.

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In 1990, the Department of Health and Welfare began a “Stroke Information System”. Based on it, the Osaka Prefecture instituted a Home-Visiting Rehabilitation Program aimed at preventing the patient from becoming bedridden. This program is known as “the Stroke Regional Care Encouragement Project”. In that year, Daito City began a model project, too. The effects have realized to discover potential patients earlily and to implement early care, including health, medical and welfare services. In its process, the patients requiring rehabilitation went to the hospital on clinic, so that preventing the invalid from becoming bedridden.
Furthermore, the care has began for patients who had lost their ability to speak due to strokes. In the aging society, physical therapists should play an important role as one of community resources in providing comprehensive and continuous rehabilitation services timely for preventing the invalid from becoming bedridden.

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