The purpose of this study was to investigate the effects of the change of position of an object in relation to the subject and the change of the nature of the object, on the postural adjustments during seated reaching movements in healthy subjects and in hemiplegic patients. The subjects were 12 healthy volunteers who were neurologically intact (healthy group) and 10 hemiplegic patients (patient group). Subjects reached with the right hand to lift and drink water from two types of cups under three different reach conditions: straight forward, 45゜toward the right side, and 45゜across the body toward the left side. The subjects in the patient group reached out with the unaffected hand. The hand reach time, vertical ground reaction force, and EMG activity were analyzed for each of the six conditions. A significant object position effect was found with the vertical ground reaction force variable and the leg muscle activity in the hemiplegic patients. A two-way analysis of variance was conducted. In both groups, the effect of the change of the object on postural adjustment was significant, and the effect of the change of the position of the object on postural adjustment was not significant. However, it is suggested that the change of the position and a change in the nature of the object strongly influence postural adjustment in hemiplegic patients. It was found that the postural adjustments during reach is different for the two groups.

View full abstract

The fractures of the femoral neck of senior persons have a lot of complications and exert some influences on the abilities to walk after the fractions. We tried the total treatment with the postural reflex and realized early independent walk among the patients.
We examind the effects of the treatment in relation to the muscular strength and balance.
The subjects were senior persons with the fractures of the femoral neck, and they also had some complications; dementia, pain of the knee, being bedridden, incomplete paralysis of the lower limbs and chronic rheumatism. They were able to walk independently 2 to 4 weeks after the initiation of the treatment, and we examined the muscle strength of lower limbs, the distance of movement of balance and walking velocity.
The extension muscle strength of the hip joints was maximum and had some relations to the walking velocity. The value of right and left of the dynamic standing posture had a relation to the walking velocity. The results suggest that not only the muscle strength of the lower limbs but also the reaction of the muscle in the postural reflex is important.

View full abstract

The aim of this study was to assess reliability and validity of Index of Postural Stability (IPS); a new index for assessing postural stability using forceplates. Nineteen healty subjects and 21 patients with balance disorder mainly due to neurological diseases were participated in this study. IPS was defined following equation; IPS=log [(area of stability limit + area of postural sway)/area of postural sway]. Each subject stood still with medial border of his/her feet 10 cm apart on the forceplates. Postural away was measured during 10 seconds in the central position and anterior, posterior, right and left weight shifting position on a base of support, respectively. The area of postural sway was calculated as the mean of sway area of five positions. The area of stability limit was defined as the length between the center of sway in right weight shifting position and left weight shifting position multiplied by the length between anterior position and posterior position. Reliability of IPS was assesssd by intra-class correlation between two measurements on different day. Validity of IPS was assessed by its relation to Berg Balance Scale (BBS). Intra-class correlation between-days measurement of IPS was high (ICC=0.999). And the correlation of IPS with BBS was also high (rs=0.855). In this study, reliability and validity of IPS were both high, we therefore conclude IPS is a good index for assessing the ability of postural stability.

View full abstract

The purposes of this study were to clarify the 24 hr-data of heart-rate characteristics in disabled elderly persons at home, and to prove the relationship between time in a sitting posture and the 24 hr-data of heart-rate, and the relationship between the type of daily physical activities and the same heart-rate data. Twenty disabled elderly patients with CVA (the mean age of 73.9 ± 5.3 years) and ten healthy elderly individuals (the mean age of 73.3 ± 3.2 years) participated in this study, who were living at home. 1) 24-hr heart-rate, 2) daily physical activities, and 3) the type of such activities were measured.
The results indicated the following: 1) the mean heart rate in sleep was higher and the rate of increase in heart rate while awake was lower than those of the healty elderly persons, 2) the rate of increase in heart rate while awake increased with the increase in time in a sitting posture, 3) the rate of increase in heart rate while awake increased with the expanding variety of daily physical living activities. We concluded that when exercise is prescribed for disabled elderly at home, we should note the mean heart rate in sleep. And the rate of increase of heart beat while awake can be used as an indicator for the level of physical activity. The longer duration of the sitting posture and the increase in the variety of daily physical activities are effective means to increase the overall physical activity level.

View full abstract

Good results were previously obtained for a reflex sympathetic dystrophy (RSD) patient through therapeutic exercise with pain relief in collaboration with the Department of Anesthesiology.
For 11 cases with RSD of the upper extremity the similar treatment was administered in this study, and changes in movement disorders and clinical symptoms were investigated before and after exercise. Attentions were directed to functional movement disorder, limitation of ROM, pain, allodynia, swelling, vasomotor disorder and dystrophic symptoms. Score determination was based on RSD Score introduced by Gibbsons et al.
Functional movement disorder, limitation of ROM and clinical symptoms were totally improved, but allodynia and dystrophic symptoms showed no significant improvement. These results suggest the effectiveness of the combined treatment of pain relief and exercise therapy for patients with RSD. Further studies would be necessary for chronic patients, and patients with serious allodynia or dystrophic symptoms.

View full abstract