Patients with chronic airflow limitation (CAL) such as chronic bronchitis, chronic asthma and emphysema, often report breathlessness with routine daily tasks which involve upper limb activities. To date, however, there is no standard upper limb exercise test available for the assessment of patients with CAL and to evaluate the effects of therapeutic interventions. therefore, the aim of the present study was to develop an unsupported incremental upper limb exercise test (UIULX test) for the assessment and management of patients with CAL. Repeated measures, quasi-experimental design was used with nine patients with CAL (mean age 61.6 years, mean predicted %FEV₁ 40.0%). The within-subject reproducibility of the symptom-limited UIULX test in patients with CAL was assessed by performing the UIULX test on three occasions. The UIULX test involved lifting a light weight bar at a constant rate (30 rpm) using an incremental protocol during which the vertical lift increased by 15 cm every minute. The weight of the bar was progressively increased once subjects reached the maximal vertical height. Endurance time, the pattern and magnitude of the cardiorespiratory responses, and the intensity of dyspnoea and rating of perceived exertion (RPE) at the termination of the test were examined. Intraclass correlation coefficients showed high reproducibility for endurance time (0.976), VO₂ max (0.954), maximal minute ventilation (0.957), maximal respiratory frequency (0.950), maximal tidal volume (0.934), HR max (0.914). High reproducibility was also demonstrated for the pattern of increases VO₂, VCO₂, minute ventilation, respiratory frequency, tidal volume and HR. The intensity of dyspnoea and RPE for the upper limbs at the termination of the test did not show significant differences among the three trials. The UIULX test is reproducible in both patients with CAL and normal subjects. Further study to determine the validity of the unsupported upper limb exercise test is necessary before implementation in the clinical setting.

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The purpose of this study was to examine cardiovascular response to automobile driving by patients in the early recovery phase of acute myocardial infarction (AMI) and to consider the risks.
Twenty-six patients who strongly desired to drive a car due to involved necessity in daily life were included in this study. Each patient underwent an automobile driving test twice: four and five weeks after the onset of AMI. During vehicle operation, heart rate (HR) and electrocardiogram (ECG) were continuously monitored and recorded using an ECG transmission system. Systolic blood pressure (SBP) was measured by a portable sphygmomanometer. Incidences of arrhythmia or abnormal ST-T changes occurring during driving were compared to those during: 1) 24-hour monitoring with Holter ECG; 2) graded exercise test (GXT) performed before the driving test; and 3) exercise training at anaerobic threshold (AT) level. Cardiovascular parameters (SBP, HR and RPP: rate pressure product) were compared between the first and second driving test. Further, these were compared with those during exercise training.
Results were as follows: 1) there were no differences in occurrence of abnormal ECGs among the four different procedures; 2) peak HR obtained during the first test was not significantly different from that in the second test; 3) peak SBP and peak RPP obtained in the first test were significantly higher than those in the second test; and 4) peak RPP and HR during driving were significantly lower than those obtained during exercise training, whereas peak SBP was not different between the two tests.
From these results, cardiovascular load while driving a car in the early recovery phase of AMI appears to be slight and driving could be allowed if serious arrhythmia or ischemic change does not occur during Holter monitoring, during GXT, or while exercise training.

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The objective of this study is to clarify how motor performance of the elderly who use dentures are influenced by the presence and absence of their dentures. Grip strength and bar gripping reaction time were determined in 11 healthy elderly subjects aged between 66 and 94 (mean: 75.1) under two test conditions: biting with dentures and biting without dentures. The results showed that the grip strength measured under biting without dentures was significantly lower than that with dentures. Although the difference was not significant, the reaction time measured under biting without dentures was longer than that with dentures. These results suggest that some sorts of motor performance of the elderly who use dentures may be influenced by whether they wear their dentures or not.

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The purpose of this study is to examine the treatment of Physical Therapy in the mass media, and to analyze social acceptance of this form of rehabilitation. The survey was based on articles appearing in the national newspapers, the Yomi-uri, the Asahi and the Mainichi during the six year period from 1990 to 1995.
The articles on Physical Therapy were located using “Nikkei News Telecom” database software. A total of 398 articles was classified into eight categories; (1. nursing care, 2. establishment of new hospitals, 3. community-based rehabilitation (CBR), 4. handicapped children, 5. education, 6. sports, 7. therapy, 8. others) and analyzed according to their characteristics.
The results showed that the total number of articles was on the increase. Articles about “CBR” were most numerous (34%), compared with those about “therapy” (9%). It was worthy of notice that articles in the “sports” category had increased since 1994. The results of this study suggest that people are in general acceptance of CBR performed by qualified physical therapists.

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A new method to measure movement-related cortical potentials (MRCP) using an external stimulation guidance was developed for easy application to patients with movement disorder. Normal findings for MRCPs associated with the gait were determined in 30 normal subjects aged between 20 and 79 years. There were at least 5 subjects in each decade of the age range. The external guidance was a hand on a clock which moved from 9 o'clock to 12 o'clock during 5 sec. Subjects standing 1.5 m in front of the clock took 2 steps when the hand pointed to 12 o'clock (trigger). EEGs before and after the starting point of the gait were recorded in each subject. EEGs were also recorded during non-gait movement when the hand on the clock pointed to 12 o'clock. The mean difference waveforms were obtained by subtracting the mean waveform for non-gait from that for gait MRCP. The gait MRCP showed a slow potential shift in all subjects which corresponded to the Bereitschaftspotential (BP). The BP started from 1,082 ± 320 msec before the trigger with symmetric distribution. The mean amplitude of the BP at the trigger was 7.8 ± 3.6 μ V. and tended to increase with age. The BP became steeper from 501 ± 175 msec preceding gait in 21 subjects which corresponded with negative slope (NS'). The frequency of NS' increased with age. NS' is known to become clear and the amplitude increases with complex tasks compared with simple tasks, so the present results suggest that gait may transform from simple to complex with age.

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Health service institutions for the aged currently tend to have long stays. In order to discharge residents as soon as possible, some trial programs, such as the temporary-go-home program. are attempted. The primary purpose of this study was to examine the home situation and the factors related to burden of home care. After categorizing into two groups, a group of 258 persons who felt burdened, and another consisted of 68 persons who did not feel any burden, both were studied comparatively. According to the result of the qualification method of the second type, factors, such as abnormal patient behavior, sharing of care taking duties, places accepted, and places preferred by care workers were correlated. This study indicated that care burden varies according to the places accepted. Due to these complex factors, it is noted that knowledge about senility or abnormality and the support for caretakers is necessary to mitigate the burden of care.

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One of the reasons that respiratory dysfunction occurs in the children with severe motor and intellectual disabilities are obstruction of breath caused by glossoptosis.
We tried movement therapy to improve ventilation via the chest for a child who had respiratory dysfunction caused by glossoptosis.
In order to keep the airway open and to maintain the effect of movement therapy, we also manufactured a brace to prevent glossoptosis. When the child was wearing the brace, the obstruction of breath and the heart rate were decreased, and the PaO₂ improved.
The child's respiratory function showed excellent progress after our treatment using movement therapy with a brace.

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