Patients with Parkinson's disease (PD) may develop pulmonary dysfunction, but the pathogenesis remains unclear. We investigated a correlation between thoracoabdominal movements and pulmonary function in 17 patients with PD and 14 healthy controls. We measured vital capacity (VC) and forced vital capacity (FVC) using an autospirometer, and measured chest and abdominal movements using a respiratory inductive plethysmography by fixing transducers on the rib cage and umbilicus. Patients with PD had significantly decreased %VC (90.3 ± 17.1 vs 105.8 ± 13.9%), chest movement (256.0 ± 98.0 vs 375.2 ± 126.7%VT) and abdominal movement (200.1 ± 73.4 vs 247.4 ± 100.2%VT) with 100%VT being an average volume of chest and abdomen at rest during measurement of VC. Patients with PD also had significantly decreased %FVC (74.4 ± 20.6 vs 97.6 ± 14.1%), chest movement (228.0 ± 106.5 vs 344.5 ± 126.4%VT, 225 ± 114.1 vs 334.4 ± 132.9%VT) and abdominal movement (151.9 ± 70.6 vs 207.6 ± 104.7%VT, 138.3 ± 88.4 vs 168.3 ± 79.0%VT) with 100%VT being an average volume of chest and abdomen at rest during forced maximal inspiration and expiration.
Based on the results, we conclude that a reduction of %VC in patients with PD correlated with chest movements, while a reduction of %FVC correlated with chest and abdominal movement in patients with PD.

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A relationship between locomotive tolerance, especially oxygen uptake, and left ventricular function after onset of acute myocardial infarction was studied in 90 patients (mean age: 56 ± 9, male: 88, female: 2). Left ventricular function was measured with quantitative gated single photon emission tomography (SPECT) at acute phase (<7 days) and 2 weeks after onset. Stunned myocardium (SM), late recovery of regional dysfunction, in infarct area was evaluated by dual isotope, BMIPP/Tl, scintigraphy at acute phase. Oxygen uptake during 50 meters walk stress test at acute phase and that during ladder climbing test 2 weeks after onset were measured. The peak oxygen uptake was not correlated with left ventricular function at rest. The peak oxygen uptake during cardiac rehabilitation for salvage group (presence of SM) was significantly higher than that for non-salvage group (absence of SM) (1.78 ± 0.52 vs 1.48 ± 0.40, p<0.01).
Thus, a recovery of left ventricular function was able to be estimated by measurement of peak oxygen uptake during cardiac rehabilitation.

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The purpose of this study was to test the construct validity of “the psychological Quality of Life (QOL) Index” for stroke patients, with structural equation modeling and known-groups technique.
The subjects were 115 survivors more than one year after their first stroke, who had adequate cognitive function and lived in their community. As for the index, two second-order factorial models (with three first-order factors) have been previously proposed (one was composed of twelve items, another nine). First of all, the better fitted model was selected using confirmatory factor analysis. Secondly, the factorial invariance of the selected model was examined with 227 elderly community residents, using simultaneous factor analysis. Thirdly, it was tested whether the score of psychological QOL could be discriminated by the previously proposed predictors of psychological well-being in stroke survivors, in expected ways.
The model containing 9 items fitted well to the data. The simultaneous factor analyses showed both the stroke survivors and the elderly residents had the same model structure. The mean QOL score was significantly lower than that of the elderly sample. The scores were discriminated by the predictors, such as impairments, disabilities, and depression state.
These results supported the construct validity of the QOL index for stroke patients.

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The purpose of this study was to examine the construct validity of the hypothesized factorial model of ADL-IADL Measure (Saitoh, et al. 2000) in people after stroke, with a confirmatory factor analytic procedure. The subjects were 196 stroke survivors living at home (male 99, female 97), aged from 37 to 93. The analysis showed that the second-order factor model which includes as primary factor “self-care (Feeding, Personal toilet, Getting on and off toilet, Bathing self, and Dressing)” and “IADL (Using public transportation, Preparing meals, Shopping for daily necessities, and Managing deposits)” and excludes “mobility (Moving from wheelchair to bed and returning, Walking on level surface, Ascending and descending stairs)” had a satisfactory GFI of 0.919, but AGFI and RMSEA did not reach the criteria. Attempts were continued further to improve the model, using explanatory factor analysis. As a result, the modified factorial model was re-constructed by excepting the observable variable “bathing self” which loaded on both factors. The model was an excellent fit to the data. Reliability coefficient of the model was satisfactory. Criterion-related validity was supported by significant associations with age, the criterion of independence in everyday life, the self-rated health, and taking formal health services. These results indicated that the construct validity of the ADL-IADL measure can be supported by excepting the items of mobility and bathing self in people after stroke.

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Angelman syndrome (AS) with the major symptom of severe mental retardation is characterized by ataxic gait, which is also called puppet-like gait and is associated with paroxysms of laughter. Here, we reported clinical findings of an AS patient under continuous treatment for 4 years (y) and one month (mo) from 10 mo after birth. The clinical courses were assigned into three phases. In the first phase (from 10 mo to 2 y and 7 mo of age), the ataxic symptoms were improved and the patient became able to do hand-over-hand walking. In the second phase (from 2 y and 8 mo to 3 y and 9 mo of age), the specific behavior of AS developed, resulting in hypertone of the upper trunk muscles. Therefore, treatments to repress the hypertone were performed, and indoor walking became possible at the age of 3 y and 9 mo. However, puppet-like gait still remained. In the third phase (from 3 y and 10 mo to 4 y and 11 mo), physical therapy was successively given, and puppet-like gait was improved along with a decrease in hypertone. Furthermore, it became possible for the patient to self-repress the AS behaviors when the surrounding people endeavored to deal with the patient calmly.

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