The features of changes with time in disuse muscle atrophy of the lower limbs and trunk in hemiplegic patients were examined and a program for prevention and improvement of disuse muscle atrophy was assessed for effectiveness.
Twenty four hemiplegic patients due to cerebrovascular accidents were examined. The index of percent cross-sectional area of muscle (%CSA ; percentage of area having CT numbers of normal muscle from 30 to 120 Hounsfield unit) of each patient was measured by computed tomography (CT) for paravertebral muscle, gluteus medius, gluteus maximus and quadriceps femoris on sound and hemiplegic sides. Changes with time in disuse muscle atrophy were determined based on %CSA at admission and discharge (%CSA at discharge -%CSA at admission).
Changes with time in disuse muscle atrophy were found to arise from three factors ; muscles on the sound side, gluteus medius and gluteus maximus on the hemiplegic side and gluteus maximus on the sound side. The first factor was found correlated with changes with time in Functional Independence Measure while the second and third factors were not. Changes with time in the three muscles related to the second and third factors would thus appear specific to another five muscles.

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The goal of the present study is to clarify the usefulness of the assessment of the ability to keep standing, stand on one foot with the both eyes open, and stand up from a seated position, for predicting the gait prognosis of patients who previously had cerebral apoplexy. Subjects were 81 patients (average age : 63.9 ± 11.43 years) who had required assistance in walking at the time of admission. These patients were divided into three groups according to the length of time after the onset of cerebral apoplexy ; 1) within 2 months, 2) from 2 to 3 months, and 3) more than 3 months. Their abilities to keep standing, stand on one foot with the both eyes open, and stand up from a seated position were examined at the time of admission, and their gait was assessed at the time of discharge. In the group 1), patients who could walk independently at the time of discharge were those who had been able to keep standing for more than 30 seconds at the time of admission. In the group 2), patients who could walk independently at the time of discharge were those who had been able to stand on either foot or to stand up from a chair lower than the length of their lower leg at the time of admission. In the group 3), patients who could walk independently at the time of discharge were those who had been able to stand on either foot (more than two seconds on a healthy foot) or to stand up from a chair lower than 80% of the length of their lower leg at the time of admission. These findings suggest that the assessment of the ability to keep standing, stand on one foot with the both eyes open, and stand up from a chair at admission is useful for predicting the gait prognosis of patients who previously had cerebral apoplexy.

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Ten knees (3 right, 7 left) from cadavers (5 males, 5 females) for dissection practice were studied with regard to the pennate angles of the vastus medialis. The pennate angle at the frontal plane was measured at the following three points: the most proximal point of the fiber that inserts the aponeurosis of quadriceps femoris, the most proximal point of the fiber that inserts the patella, and the most distal point of the fiber that inserts the patella. The pennate angle of the vastus lateralis was measured for comparison. The pennate angle at the sagital plane was measured at the midpoint of the width of the fibers of the vastus medialis and the vastus lateralis inserting the patella. The pennate angle at the vastus medialis of the frontal plane was significantly obtuse toward the distal from the proximal. Also, it was found to be significantly obtuse compared to the vastus lateralis. The similar result was observed for the sagital plane: the angle of vastus medialis was significantly obtuse compared to that of vastus lateralis. Therefore, in order to conduct an effective therapeutic exercise for the vastus medialis, a consideration of differences in pennate angles among various parts of the vastus would be recommended to enable the induction of effective and appropriate movements for the knee-joint.

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The objective of this study was to investigate the relationship between the decline of skin temperature before an operation and the time to recover muscle strength after an operation in the lower extremities in patients with lumbosacral radiculopathy. The skin temperature of both big toes in forty patients with unilateral L5-root disability due to lumbar disc herniation was measured by thermography before and every two weeks after the operation in an air conditioned room. Also the muscle strength of the dorsiflexor and inversion muscles of the ankle joint in the affected side was measured. The patients who had a decrease of skin temperature greater than 1.0℃ before the operation compared with the unaffected side required more time to regain muscle strength in the dorsiflexor and inversion muscles after the operation than those whose difference in skin temperature was smaller than 1.0℃. This result suggests that by measuring the skin temperature in the lower extremities before an operation, one may be able to predict the time to recover muscle strength in the lower extremities after an operation in patients with lumbosacral radiculopathy.

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The present study investigated the effects of resources available for primary caregivers of stroke patients at home on their caregiving burden and discussed an intervention strategy that may reduce caregiving burden. A total of 97 caregivers participated in this study. We assessed the functional status of stroke patients, resources available for caregivers, and examined caregivers' burden by a subjective scale. Resources studied included health status, employment status, recreation, informal support and formal social support. Caregivers' burden was analyzed according to seven aspects of burden; general burden, concern about health and care, restriction of social activity, mental fatigue, release from care and deterioration of human relations. The data were analyzed using a partial correlation analysis and a multiple regression analysis. The findings indicated that employment status, health status and recreation played important roles in caregivers' burden. Furthermore, the effects of these factors differed according to the aspect of subjective burden. The results suggest that maintenance of caregivers' health status, temporary release from caregiving and leisure activities are important for reducing the burden of caregivers of stroke patients.

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Six trials to obtain the maximum kinetic values in each of 6 different motor function tests (MFT) were performed for post-apoplectic hemiplegic patients. The number of trials to record the highest and the lowest values for the first in the 6 trials was determined, and the actual measurement values of each trial were recorded for each subject (n = 20-33).
MFT were grip strength (GS), knee extension force (KEF) of affected and unaffected sides, walking speed (WS) and one leg-standing time of the unaffected side (OLST). Based on the results of these tests, the differences in the appearance pattern of the highest values among the MFT were examined.
The results suggested the validity of multiple measuring for all MFT. Also, relatively simple and fatiguing MFT such as GS and KEF indicated the highest value with a smaller number of repetitions of trials, compared with WS and OLST.
In addition, to obtain the highest value in each MFT, in more than 80% of each subject, 4 repetitions of trials were required for bilateral GS, and 5 repetitions for bilateral KEF. Whereas, WS and OLST required more than 6 repetitions of trials.

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