The purpose of this research is to ascertain the characteristics that differentiate spastic spinal paraplegia (SSP) from spastic diplegia of cerebral palsy (CP・SD), and the points that should be taken into consideration in the treatment of SSP by physical therapists. We report on ways of physical therapists can prevent, by therapeutic exercise, abnormal development of SSP children. Eleven SSP children are analyzed through clinical charts, and with video-films, photographs, and Bobath's postural tone test in comparison with CP (SD) children who had had lumbago and foot pain. No child with SSP was born at a birth weight of less than 2,500g, unlike the typical scenario for CP (SD) children (p < 0.01). All children acquired the ability to walk at 2.6 ± 1.4 years on average (ranging from 1 year to 5 years 1 month). Eight achieved independent without braces, one with short leg braces, two with Lofstrand crutches and short leg braces. SSP children were clearly superior to diplegic children in terms of normal extensor patterns of the lower extremities and selective movements of individual joints. Lumbago was present in 5 (45.4%) at 7.8 ± 1.3 years and foot pain was present in 4 (36.3%) at 8.5 ± 2.6 years of our 11 cases. Postural tone of the lower trunk tended to be low in SSP. In order to obtain walking and prevent lumbago, physical therapists should make efforts to promote sustained coactivation of the lower trunk musculature early in the course of treatment.

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There are tennis players who feel some pain of their proximal forearm. The symptom is called “tennis elbow”. It is thought that the extensor carpi radialis brevis muscle (ECRB) is related to the mechanism of the tennis elbow and the forearm support band is effective to the tennis elbow. Then we examined whether ECRB was related to the pain when swinging the racket and hitting the ball or not, using magnetic resonance imaging (MRI). ECRB got high signal intensity in the image due to their muscle edema. Next we examined if the forearm support band was effective in which swinging the racket (concentric contraction of ECRB) or hitting the ball (eccentric contraction) as the band prevented increase of the signal intensity. The band protected the muscle edema more effectively in hitting the ball than in swinging the racket, as the defined effective ratio [ER] of eccentric contraction (0.79) was smaller than that of concentric contraction (1.01).

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We studied thoracoabdominal motion during rest and exercise in fifteen patients with chronic respiratory disease who could walk without oxygen supplement, and compared to the results with those in twenty five unaffected subjects. No significant decrease was observed in the magnitude of thoracoabdominal motion during rest and light exercise in patients with chronic respiratory disease. There was also no significant change in the rate of thoracic to abdominal motion on breathing. Furthermore, neither thoracic nor abdominal breathing motion exerted influences on pulmonary function and ventilatory efficiency. Thoracoabdominal motion in patients with chronic respiratory disease was not proved to change specifically in response to oxygen demand, and the patients might not consistently benefit from forced diaphragmatic breathing. Accordingly clinical significance of diaphragmatic breathing exercise should be reevaluated.

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Taking notice of the fact that Sadogashima is a solitary island having a geographical condition of comparatively small population kinetics, we recently followed up those 247 cases of femoral neck fracture, aged above 65 years, who had undergone hospitalization during the period of 10 years from 1983 to 1993, to examine the influence of moving ability at discharge on survival rate for these cases. Those who required wheel-chair nursing at discharge exhibited significantly lower survival rate, compared with those who could walk indoors with support or who could walk outdoors independently. The results suggest that a decrease in moving ability at discharge may exert an adverse effect on survival rate.

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The connection form of the posterior rotator cuff (infraspinatus and teres minor) and articular capsule was observed with the naked eye on 7 shoulders (5 right side shoulder and 2 left side shoulders) of 7 cadavers for dissection practice (4 males and 3 females). The infraspinatus and posterior capsule were closely contacted by areolar tissue, as if lining the capsule, while direct linkage by muscle fiber was not recognized between them. Between teres minor and the posterior capsule, muscle fiber of the capsule side of teres minor was found to directly enter into the area from the posterior of recessus axillaris to the posterior downward of the capsule. The functions of infraspinatus were considered to support posterior capsule from the back and to form the fulcrum in order to transmit the self contraction force efficiently to greater tubercle. In addition to the fulcrum-forming function by fibers stopped at greater tubercle, the functions of teres minor were considered to protect muscle fibers of the capsular side from impingement at the time of shoulder joint movement of external rotation and to assist the static supporting mechanism at the time of shoulder joint elevation.

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