We measured the sitting postural sway of 39 hemiplegic patients under some plane conditions using force plate, then compared their values of three groups among right, left hemiplegic and hemineglect groups.
The result was that right hemiplegic group showed remarkable instability under the plane tilting toward the sound side; however, hemineglect group was unstable under all conditions. The left hemiplegic group had no difference from normal group. Moreover, the plane condition to present greater sway was the sound side in right hemiplegic group, the affected side in both hemineglect and left hemiplegic groups. In short, each group presented greater sway in the left side regardless of their paretic sides.
It was supposed that their trunk laterality since pre-onset had still some influence on those values of postural sway.

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We have applied the Estimation Table of Surgical Pre-and Post-Operative Respiration, as proposed by Mabuchi . to patients who received thoracotomy in our hospital to examine those items on which should be given the greatest importance among risk factors and counterplans for them by means of chest physical therapy. The subjects were 13 patients with postoperative pulmonary complications, 20 patients therewithout, and control group out of 162 patients receiving thoracotomy and pre- and post-operative chest physical therapy. Estimation was made on age, past history of respiratory disease, smoking condition, obesity, preoperative pulmonary function test (%FVC, FEV_1.0%), preoperative arterial blood gas analysis (PaO₂, PaCO₂), preoperative respiratory capacity, operating time, bleeding volume, postoperative state of consciousness, postoperative respiratory capacity, wound pain and expectorating capacity. As a result, the pulmonary complication group showed high Brinkman index and low postoperative respiratory capacity and expectorating capacity. From the above, pre- and post-operative estimations are important especially on Brinkman index, and respiratory and expectorating capacities. Chest physical therapy should be applied to patients especially in consideration of these results.

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For the purpose of muscle strengthening, electrical stimulation of high frequency was administered on quadriceps muscle of 10 healthy adult males. The stimulation of 50 KHz modulated at a low frequency of 50 Hz was given three times a day for 6 weeks. It was found that the maximum voluntary contraction was significantly increased by 2.2±1.7 kg・m (p<0.01) after the 6-week stimulation. There were, however, no changes in the circumference of thigh and cross-sectional area of quadriceps muscle. The result suggests the effectiveness of high frequency electrical stimulation for muscle strengthening in healthy subjects.

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We studied the silent period and its relation to isometric contraction in healthy subjects, who were not athletes. Their mean age was 21.4 years. The silent period was recorded at opponens pollicis muscle by electrical stimulation followed by 25%, 50%, 75% and 100% of the maximum voluntary isometric contraction.
The silent period was significantly shorter during 75% isometric contraction.
This suggests that the motor neuron system may be more excited during 75% isometric contraction compared to other levels, and that the 75% level may be most suitable for preparing some types of movements.

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Thermoregulatory capacity and exercise endurance during exercise were studied in patients with impaired sweating capacity due to severe burns. Two patients with deep second-and third-degree healed burns, (Burn Index : 70 and 73.5, respectively) underwent an exercise test using a bicycle ergometer in a comfortable environment (ambient temperature of 26〜28℃ and 40% relative humidity). Oxygen consumption, sweat rate, esophagus temperature, skin blood flow, skin temperature and heart rate were recorded during the exercise. The peak value of actual oxygen consumption (peak VO₂) was 71.6% and 75.4% of the predicted maximum (pred. VO₂max), respectively. They were lower than the normal ratio (85% or higher). No sweating response was observed in the areas which had suffered from third-degree burns, but normal thermoregulatory mechanisms were maintained to some extent throughout the exercise. These results indicate that the overall ability to control body temperature during exercise was relatively maintained in patients with impaired sweating capacity due to large areas of burned skin. It was suggested that impaired sweating capacity may hardly be a limiting factor for exercise tolerance of patients with severe burns.

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[in Japanese]

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[in Japanese]

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We performed postural drainage in 2 Duchenne Muscular Dystrophy (DMD) patients who experienced acute aggravation of respiratory failure. Combination of postural drainage with NIPPV was effective, and the patients returned to their former daily lives on the ward. Endotracheal intubation was performed in case l because of pneumonia and atelectasis of the left lower lobes on the 9th day of illness and mechanical ventilation was begun on day 11. Postural drainage was instituted on day 16. We performed NIPPV jointly on day 52. Weaning from mechanical ventilation was started on day 78, and the endotracheal tube was removed. Mechanical ventilation by endotracheal intubation was carried out in Case 2 on the 9th day of illness because of aspiration pneumonia in the right upper Robe and postural drainage was begun on day 35. NIPPV was jointly used on day 232. Weaning from mechanical ventilation was started on day 266, and the endotracheal tube was removed. Squeezing, shaking and compression with vibration were the most effective postural drainage maneuvers. Combination therapy consisting of postural drainage and NIPPV reduced the fatigue of DMD patients during physical therapy and facilitated the removal of discharges secretions from the trachea. This method of non-invasive pulmonary physical therapy should be adopted as a mean of improving the QOL of DMD patients.

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The paper aims to describe the present situation of physical therapists in Malaysia and the activities of Malaysian Physiotherapist Association (MPA) in order to promote the mutual understanding between the physical therapists in Malaysia and in Japan. The data were obtained through the author's involvement with welfare work during her two years' stay in Malaysia as a member of Japan Overseas Cooperation Volunteers in 1990-92 and through her visit to a hospital in Kuala Lumpur in 1994.
Urban and rural areas have different sets of medical facilities and treatments in Malaysia. Urban residents could expect highly advanced medical treatment mainly from public hospitals, whereas rural dwellers have comparatively poorer facilities.
There are about three hundred physical therapists in Malaysia, eighty percent of them working in public hospitals. Due mainly to the shortage of staffs in the public hospital they cannot provide sufficient treatment to most patients, though their standard is high. There is only one institute for the education and training of physical therapists in the country. After graduation, students are offered some occasions for further training organized by MPA and others.
MPA, organized in 1963, has been trying to advance physiotheraphy in Malaysia. The association is currently organizing many preparatory activities for the Asian Confederation for Physical Therapists to be held in 1996.

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