Functional electrical stimulation (FES) using percutaneous intramuscular wire electrodes was applied to restore standing and walking ability for a Patient with T6 complete paraplegia. Before using FES, a therapeutic electrical stimulation (TES) was applied to the paralyzed lower extremities to reduce spasticity and to increase strength and fatigue resistance of the muscles. Control of standing by FES was started after one month from the start of TES. After 3-year TES program, he could tolerate to stand by FES for more than one hour, and thus, utilizing this Standing activity for his daily tasks after discharge. Walking by FES without using any orthoses was firstly achieved in a parallel bar, and then we tried control of walking by FES under the usage of a rolling walker. During this trial, the stimulation pattern was improved and control switches attached to the walker's arm were developed. After confirming reliability and safety of walking by FES, his walking has been challenged by the circumstances of his life. It is suggested that our FES system could supply practical standing and walking ability for the paraplegic.

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The purpose of this study was to examine the motor development tendencies of extremely low birth weight infants until a corrected age of 12 months. The subjects of the analysis were 8 extremely low birth weight infants without major handicaps (cerebral palsy, mental retardation, epilepsy). They were evaluated by the Munich functional developmental diagnostic test at a corrected age of 4, 6, 8, 10 and 12 months. We selected four items (prone, sit, stand, and grasp) from the total of eight. Marked delay was more than 2 months of corrected age. There was marked delay in prone abilities at a corrected age of 4 months, and there were two reasons for this marked delay: Muscle fibers and muscle tone of the infants were immature, and their upper extremities were restrained to prevent attempts to pull out endotracheal and feeding tubes. The results indicated that gross motor development caught up to the age level at a corrected age of 12 months.

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The purpose of this study was to clarify whether the difference of Voluntary contraction strength in fluences the power spectrum of the surface electromyogram in each muscle of lower Limbs. Twenty healthy males (21.9 ± 1.3 year-old) were examined. The power spectrums of five muscles in each person were measured including gluteus medius muscle, tensor fasciae latae muscle, rectus femoris muscle, lateral hamstrings, and gastrocnemius muscle. And muscle strength at 100, 50, and 25% of the maximal voluntary contraction in isometric contraction was measured, and the median power frequency was calculated from the surface EMG signals by fast Fourier transform. In addition, the integration values of the individual muscles in each contraction strength were calculated.
As a result, the spectral characteristics at lowered muscle strength were classified into three patterns (an increase, a decrease, and no change of the median power frequency). In addition, from the outcomes of integrated electromyogram (IEMG), the decrease ratio of muscle activity in excess of that of muscle strength was shown. These results suggested that the characteristics of contraction strength and style of activity in the individual muscles of lower limbs were 1) the difference of the ratio of muscular fiber type I・II of individual muscles (the difference of spectrum change between fast muscles system and slow muscle systems), 2) the synchronization effect of the motor units which work advantageously in the type I fiber, and 3) curve relation between muscle strength and IEMG. Furthermore, from the characteristic of the sur face electromyography, the problem of quantification of a more exact high frequency band was suggested because the influence of the interference of the wave became larger in high contraction strength.

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The objective of this study is to investigate the factors, including Pusher sign, relating to ADL self-support upon discharge from the information obtained at the first medical examination in 103 patients (67 years old on average) with cerebrovascular diseases. The patients were divided into the two groups based on the Barthel Index, an ADL self-support group with the index over points 60, and a non-self-support group with the index lower than points 60. As factors determining ADL, the following five items were extracted and analyzed using logistic analysis: patient's age, the severity of early stage paralysis of inferior limbs, Pusher sign, unilateral spatial negligence (USN) and dementia.
As a result, the severity of inferior limb paralysis, Pusher sign and dementia were found to be important as ADL-determining factors as reported previously, while USN and the age were not significant as factors. Thus, the existence of Pusher sign was reconfirmed to be of particular importance as an ADL-determining factor.

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Assessment was made of strength development through exercise with a Treadmill in a cardiac rehabilitation program (short term) and an appropriate period for exercise is suggested. In the program, 20 male patients with relatively slight acute myocardiac infarction participated. Exercise was started at 1 week subsequent to the onset of the first infarction. Ventilatory gas was analyzed throughout the study, and the anaerobic threshold (AT) was determined. Oxygen uptake (Mets) was measured with a portable system (Treadmill and ward walking). The following results were obtained:
1. Mets of the exercise with a Treadmill significantly exceeded those for ward walking.
2. Mets of the exercise with a Treadmill and those for step entrance or AT were essentially the same.
3. The rate pressure product (RPP) of exercise with the Treadmill and those for step entrance, or ward walking were basically the same.
These results indicate that exercise with a Treadmill is beneficial at the end of ward walking soon after the onset of the first infarction.

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The purpose of this study was to uncover the factors affecting continuation of home programs by postoperative patients with osteoarthritic hips after leaving hospital (OA patients).
The subjects of this investigation were 30 OA patients (2 males and 28 females, mean age 60.5 ± 15.3 years, mean program length after hospital discharge 68.8 ± 39.7 months). Subjects were asked about continuation of their prescribed home programs, hip function, etc. Specifically, home programs were defined as the four following factors: use of a cane, prohibition to carry heavy baggage, muscle strengthening exercises, and avoidance of certain bodily positions.
There was a general tendency for subjects to discontinue home programs, but at least one home program was carried out. Factors which influenced muscle strengthening exercises in home programs were examined by multiple logistic regression. Muscle strengthening exercises may have been influenced by patient's consciousness of limping (β = 0.149, odds ratio [OR] = 7.50, p < 0.05). The factors which influenced consciousness of limping were also examined by multiple logistic regression. Consciousness of limping may have been influenced by the kind of operation (osteotomy or total hip replacement; β = 3.03, OR = 20.8, p < 0.05), range of activity area (β = 1.78, OR = 5.9, p < 0,05), and improvement of the gait function (β = 1.62, OR = 5.0, p < 0.05).

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We can evaluate the fiber types of skeletal muscles by EMG frequency analysis. In this study, we investigated the EMG frequency spectrum of gluteus medius in patients with osteoarthritis (OA) of the hip. We designated four groups; pre and initial OA group (defined by the Japanese orthopedic association), terminal OA group, control A group (healthy control group age matched for the pre and initial OA group) and control B group (control group age matched for the terminal OA group). Each subject took two kinds of exercise tests (10 second test and 60 second test). They abducted their hip and maintained force of maximal voluntary contraction (MVC) for durations of 10 and 60 seconds during which we measured muscular strength (MS). At the same time, EMG were recorded from gluteus medius, and we performed frequency analysis. From these data, we calculated the mean power frequency (MPF) and root mean square (RMS). In the 60s test, we also calculated the decreasing ratio of EMG frequency over a time course. The MPF, especially high frequency band (80-200Hz), in patients with hip OA was lower than that in controls. During MVC, MPF declined following various patterns. The decreasing ratio was more marked in pre and initial OA and control A groups rather than in terminal OA and control B. These patterns of MPF were not similar to RMS and MS. In summary, (1) low frequency dominant spectrum of EMG in the gluteus medius was characteristic in patients with hip OA, and (2) frequency decline during MVC was remarkable in young subjects, both OA patients and normal subjects. Clinically, we think these EMG frequency parameters are very useful in evaluation of fiber types of skeletal muscle.

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