It is very important to prevent patients with femoral neck fracture from developing disuse syndrome due to bed rest. This study investigated postoperative physical fitness of patients with femoral neck fracture. We performed the exercise testing with arm ergometry on 56 patients with femoral neck fracture (age = 80.3 ± 7.6 years old [mean ± SEM]) within one week after the operation. In the exercise testing, the maximum O₂ uptake (peak VO₂/kg [ml/min/kg]) was measured. The subjects were divided based on the age and ADL classification, then peak VO₂/kg was compared among groups.
The results were as follows:
(1) Peak VO₂/kg in patients of their sixties was significantly higher than that in patients of their seventies, eighties and nineties. Whereas, patients of their seventies, eighties and nineties showed no significant differences from each other.
(2) Based on ADL classification, the peak VO₂/kg in Rank-J group (able to walk outside) was significantly higher than that in Rank-A group (only able to walk inside).
Our results indicated that physical fitness declined in surgically treated patients with femoral neck fracture over 70 years old or in the Rank-A group.

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The purpose of this research is to understand the mechanism of multi-joint movement in bifunctional muscles, especially the difference in muscular activity ratio of different parts. In ten healthy adults (six men, four women), muscular activity of rectus femoris (RF) among bifunctional muscles was investigated during four trial exercises; ①knee extension, ②hip flexion, ③knee joint and hip joint total flexion, and ④knee joint and hip joint total extension. The surface electromyogram of RF of four parts from proximal electrode to the most distal electrode was measured using electromyography, and the rate of the muscular activity was compared among trial exercises and parts of electrodes. In the central electrode position where a muscle cross-section area serves as the maximum, no difference in muscular activity was seen among the trial exercises. Moreover, when RF played only a cooperative role like during exercises ① and ②, the muscular activity was hardly changed by the parts of the same muscle. During exercise ④, however, in the proximal electrode near a hip joint, muscular activity became small, and became large in the distal electrode near a knee joint. During exercise ③, the reverse phenomenon happened. The results suggest that, in bifunctional muscles which achieve a cooperative action and antagonism action of two adjoining joints simultaneously, the mechanism similar to reciprocal innervation may exist in its muscle.

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Paying special attention to the effect of increase in sensory information for different foot parts on standing postural control, the present research was aimed at the elucidation of roles of information for foot mechanical sensory receptors. Subjects were 14 healthy female students. The subjects stood on four different types of foot plates (no stimulus, stimulus on the middle medial part of the foot anterior region, stimulus on the lateral part of the foot anterior region, and stimulus on the foot posterior region), which were fitted to the feet of each subject. Sway of the center of foot pressure was measured during static standing, and the shift area was then measured and analyzed by the cross test. Analysis by the cross test on backward shift area revealed that stimulus on foot posterior region induced a significantly greater increase in shift area, compared with no stimulus and stimulus on the lateral part of the foot anterior region. The results suggest that an increase in mechanical sensory information on the foot posterior part may play a role in providing important information for increasing backward shift area of the center of foot pressure under the condition of lowered visual information.

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The purpose of this study was to develop a clinical findings assessment table for physically disabled schizophrenic patients from the viewpoint of physical therapists, which enables the physical therapists to evaluate the psychosis easily and accurately.
The subjects were physically disabled schizophrenic patients undergoing physical therapy at Tokyo Metropolitan Matsuzawa Hospital. There were a total of 129 patients, consisting of 58 males (49.8 ± 13.4 years old, mean ± SD), and 71 females (52.7 ± 15.9 years old).
We developed an original psychosis scale consisting of 38 items rated on a four-point scale. The model was prepared by exploratory factor analysis of 11 items, after confirming their content validity. It was improved using the modification index obtained by comfirmatory factor analysis (structural equation modeling). As a result, a second-order latent variable model consisting of eight items was adopted.
We believe that the use of this clinical findings assessment table, which consists of eight items, is beneficial for evaluation of the severity of psychosis in physically disabled schizophrenic patients from the viewpoint of physical therapists.

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[in Japanese]

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This report describes the clinical experiences of “non-affected side preceding forward approach” namely, the method to descend stairs by turning forward to stairs, unloading affected lower extremity (L/E) after non-affected L/E and placing both feet on the same step in hemiplegic patients. Three hemiplegic inpatients (two cases with intracerebral hemorrhage in chronic phase and one with brain tumor) who could not descend stairs by traditional approach due to the marked adduction of affected L/E. At the onset of the exercise, all the patients had moderate motor paresis (Brunnstrom stage III) and mild or moderate hypesthesia including both superficial sense and deep sense of affected L/E. They were independent in all activities of daily living (ADL) except for descending stairs and bathing. Although all the patients needed a handrail on descending stairs by non-affected side preceding forward approach, they became independent in descending stairs within a week after the onset of the exercise. In addition, no adverse effects such as joint pain, increase in spasticity of affected L/E and falling on descending stairs due to non-affected side preceding forward approach were observed from the onset of the exercise to follow-up period after discharge (approximately two years) in all the patients. These results suggest that non-affected side preceding forward approach would be one of the means to improve in ADL of hemiplegic patients who cannot descend stairs by traditional approach.

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