This study examined the presence and the causes of variance of length of stay in hospital. We studied 16 individuals with femoral neck fracture and 19 individuals with trochanteric fracture applied the liaison clinical pathway in 8 hosiptals in Kure City. This length of stay in hospital mean it is from operation to discharge in first hospital and is from operation to discharge in second hospital.The incidence of rate in length of stay in hospital from operation to discharge in first hospital is 50.0% in femoral neck fracture and 36.8% in trochanteric fracture, chiefly is caused of management of discharge and informed-consent. The incidence of rate in length of stay in hospital from operation to discharge in second hospital is 12.5% in femoral neck fracture and 47.4% in trochanteric fracture, chiefly is caused of delay of acquirement of walking ability and postoperative-pain. The Smooth information-transmission among hospital-staffs and relevant informed-consent from doctors to patients and families is important in first hospital. Reviewing goal setting of length of stay in hospital by variance analysis and management of Long-term Care Insurance is important in second hospital.

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Purpose The present study defined an exercise to produce a muscular response corresponding to a kinesthetic sense following force perturbation (target force) from a robotic device as a "Kinetic-Equilibrating (K-E)" task. First, an experiment was performed to determine what parameters would be appropriate to evaluate differences in kinesthetic and motor functions during the K-E task. Furthermore, it was investigated whether the result of the K-E task included kinesthetic and motor functions that had been evaluated by traditional force and joint angle reproduction. Methods Healthy young adults participated in this study. The subjects took K-E task examination and reproduction examination before and after the repetitive K-E task exercise. Mainly the knee joint extension was included in each examination. As a parameter for evaluating kinesthetic and motor function as a result of K-E task examination, position alteration of the human-machine interface portion (foot rest) was measured. Integrated values of the position differential value (PosKeAE) as absolute error, standard deviation of PosKeAE values from those repeatedly measured (PosKeVE) variable error, and standard deviation of position differential value (PosKeFL) as fluctuation were calculated. In the reproduction examinations, the differences between targeted force level or joint angle and executed force level or joint angle were measured as error scores (Force; FrcReAE, Joint angle; PosReAE). The standard deviation of the error score measured during each reproduction examination was calculated as a variable error score (Force; FrcReVE, joint angle; PosReVE). As the score of fluctuation, the standard deviation of force and joint angle curve within the representative period, as determined by self-declaration signals, was calculated (Force; FrcResFL, Joint angle; PosReFL). The examinations were repeated 5 times, and the averaged value of each parameter was adopted as the individual representative value. Results All three parameters of the K-E task examination improved after K-E repetitive exercise. Four combinations of parameters of the K-E task examination and parameters of force and joint angle reproduction indicated significant correlation. Conclusions The result of K-E task suggests that the three parameters adopted in this study are related to functional differences induced by repetitive exercise. Relationship between parameters of the K-E task and reproduction examination indicates that the results from the K-E task examination were not fully independent, but also may have related to some kinesthetic and motor functions evaluated in the reproduction examination.

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「Purpose」 In medical practice, a device is needed that can measure gait easily and indicate degree of abnormality. We displayed acceleration data in the form of lissajous figures and developed software that could make material available for explanation to patients. We investigated the usefulness of this device in medical practice by examining lissajous figures before and after total hip arthroplasties. 「Methods」 21 patients with hip osteoarthritis were sampled. Three-dimensional wireless accelerometers (sampling: 200Hz) were placed over the middle of the lower back and held there with surgical tape around the subject's waist. Accelerometer data of about 20m of gait obtained. 「Results」 3 people had symmetrical improvement, 3 people had disappearance of spiny wave patterns, and 5 people had both symmetrical improvement and disappearance of spiny wave patterns. The fast Fourier transform was used to obtain a power spectrum from the averaged acceleration. Power values in the high frequency domain (5-50Hz) decreased after total hip arthroplasty (p<0.05). 「Discussion & Conclusion」 We interpret symmetrical improvement and disappearance of spiny wave patterns to indicate smoother gait.

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The aim of this study was to examine the effectiveness of perioperative physiotherapy after open surgery for abdominal aortic aneurysm. The subjects were 27 patients who performed perioperative physiotherapy (physiotherapy group) and 39 patients who didn't performed perioperative physiotherapy (non-physiotherapy group) retrospectively. The effectiveness of perioperative physiotherapy made a comparison with non-physiotherapy group about three items of (1) postoperative complication (respiratory complication, ileus and delirion) (2) timing of peroral diet-start, and (3) the duration of hospital stay. We performed 6-minute walking test before and after operation in physiotherapy group and evaluated the percentage of 6-minute walking distance (6MWD) recovery as the degree of physical function recovery (%6MWD = postoperative 6MWD/preoperative 6MWD×100) too. As a result, there was not significant difference in the incidence of pulmonary complication between two groups. However, the rates of postoperative ileus and delirium were significantly reduced in the physiotherapy group. The timing of peroral diet-start was significantly shorter in physiotherapy group and the length of stay after operation in physiotherapy group (17.3±4.6 days) was significantly shorter than that in non-physiotherapy group (24.6±9.0 days). The 6MWD after operation in physiotherapy group recoverd up to ninety-two percent average at discharge. We suggest that perioperative physiotherapy shortened timing of peroral diet-start and quickened the recovery of patient's physical function after operation, which contributed to reduce the length of stay after operation.

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