The purposes of this study were to clarify the functional recovery process of stroke patients, and to demonstrate characteristics of the patients who had taken a long time to recovery. MOA, MFS, MMS and BI of 131 hemiplegic patients were measured at admission, 1, 2, 3, and 6 months after admission, and the results were converted to standardized scores. The measurement period was divided into the former and latter terms, and an increase of more than 1/4 SD of standardized score between the terms was defined as ‘recovery’. Subjects who showed ‘recovery’ through the both terms were considered long-term recovering group. The ratios of long-term recovering group in order of percentage were BI (28%), MOA, MMS, and MS (4%). The reason why ratio was high in BI can be attributed to a difference in assessment scale. Long-term recovering group was characterized by low MOA, MMS and BI scores at admission, similar functional recovery throughout the measurement period, and no difference in functional recovery compared with short-term recovering group after 6 months.

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The purposes of this study were to demonstrate the functions related to standing-up movement from the floor among hemiplegic patients, and to examine the relationship between the functions and their activities parallel to daily living (APDL). Of 60 patients with post-stroke hemiplegia, 46 patients were classified into 2 groups; those who could stand up from the floor, and those who could not. Those who could stand up showed significantly higher values of muscle strength of the uninvolved leg and rectus abdominis, Brunnstrom stage (Br. stage) of the involved leg, standing balance, and APDL score. Of 14 patients who could not stand up and received conventional physical therapy for 2 months, some became able to stand up and demonstrated improvements in muscle strength of the uninvolved leg and rectus abdominis, Br. stage of the involved leg, standing balance, and APDL score. These results indicate that muscle strength of rectus abdominis, function of both legs and standing balance play important roles in restoration of ability to stand up from the floor in hemiplegic patients, and affect their APDL.

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The purpose of this study was to determine the effects of exercise position and load condition during isotonic exercise on the muscle activity of the gluteus maximus and gluteus medius muscles. Twelve healthy subjects with a mean age of 23.7 years participated in this study. Isotonic exercise for both hip abduction and hip extension were performed under the following four load conditions; no-load, loads of 2%, 4%, 6% body weight using ankle weights, and two exercise positions; side-lying and standing for hip abduction, and prone and standing for hip extension. During isotonic exercise for hip abduction, both the mean %RFEMG and peak %RFEMG of the gluteus maximus and gluteus medius muscles were significantly increased with an increase in load in the side-lying position, but only the mean %RFEMG were significantly increased in the standing position. Muscle activities of the gluteus maximus and gluteus medius muscles in the standing position were lower than those in the prone position during isotonic exercise for hip extension. These findings suggest that the weight loads during isotonic exercise were less effective for the gluteus maximus and gluteus medius muscles in the standing position.

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OBJECTIVES: To clarify the histopathologic findings of the contracture mechanism, we conducted experiments to observe the histopathological changes in joint capsule and articular cartilage after joint immobility in rats. STUDY DESIGN: Three rats had their right knee joints immobilized with a casting fixator for 2 weeks. The fixation group was subjected to maximum hip joint extension, maximum knee joint flexion, and maximum ankle joint plantar flexion. Their left knee joints constituted the free control group. After sacrifice, the six knee joints from the rats were fixed in formalin, decalcified and embedded in paraffin. Staining was done with hematoxylin and eosin stain and elastica van Gieson stain and examination with a light microscope. RESULTS: The capsule thickness and the number of elastic fibers of the fixation group were less than those of the control group. The fibroconnective tissue of the fixation group was denser, and the surface layer of the articular cartilage showed fibrous proliferation, compared with the control group. CONCLUSION: These results suggest the possible occurrence of disuse atrophy in joint capsule and articular cartilage.

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Objective: To clarify the histopathologic findings of the contracture mechanism, we conducted experiments to observe the histopathological changes in the synovium after knee joint immobility in rats. Methods: Three adult male Wistar rats had their right knee joints immobilized with a casting fixator for 2 weeks, and constituted the fixation group. Their left knee joints represented the control group. The excised knee joints were fixed in formalin, decalcified and embedded in paraffin. They were stained with hematoxylin and eosin, and the synovium was examined with a light microscope. Results: Atrophy of synoviocytes, fibrosis of the layer underlying the synovium, dilatation and congestion of the microvasculature were observed in the fixation group. Conclusion: Changes in the synovium of joint contracture observed in this study was considered as a secondary disorder caused by the cast fixation. This suggests that the concept of disuse atrophy would be applieable to the synovium of articular structures.

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The objective of this study is to clarify whether load of a muscle strengthening device for quadriceps muscle of thigh differs according to the exercise speed and individuals during extension-flexion exercise of knee joint. The device was developed in order that the load and changes in degree were introduced to Kin-Com during exercises. Twenty healthy female students performed 13 extension-flexion exercises of knee joint at 4 different speeds. All values of load were significantly different(p<0.01) among 4 speeds and individuals. The results indicate that load on a stress pad of the muscle strengthening device for quadriceps muscle of thigh differs according to exercise speed and individuals during extension-flexion exercise of knee joint.

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In order to increase muscle contraction of musculus gluteus maximus, PNF pattern was performed on upper extremity during bridging (Br), and muscle activities were analyzed. Twelve male subjects received PNF patterns on left upper extremity (extension-abduction-incycloduction, flexion-abduction-excycloduction) during Br. Each PNF pattern was done twice, and the subjects performed the maximum isometric contraction at the middle range for 7 sec. The measured muscles were musculus gluteus maximus and musculus erector spinae of both sides, and the root mean square (RMS) was obtained from 5-sec static data of electromyogram. RMS was statistically examined by the analysis of variance and multiple comparison test, and statistical tests were considered significant at P<0.05. A significant greater muscle activities of musculus gluteus maximus of right side and of musculus erector spinae of both sides were obtained in flexion-abduction-excycloduction pattern, compared with extension-abduction-incycloduction pattern. This suggests that the combination of PNF pattern of upper extremity and Br may affect the medulla spinalis-medulla oblongata-medulla spinalis reflex from the neurophysiological viewpoint.

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The present study was conducted to clarify the clinical findings of a patient with schizophrenia during physical therapy treatment, especially problems presented in preparing and conducting PT program. Subjects were 129 patients with schizophrenia, who received physical therapy due to physical disability, during the period from July 1997 to March 2000. They consisted of 58 males aged 49.8±13.4 years in average and 71 females aged 52.7±15.9 years in average, and their psychotic symptoms were well controlled. According to the assessment scale of mental condition, developed by our PT department, subjects demonstrated five factors; disorder of recognition/volition, disorder of attention, decrease in activity, symptoms of anxiety, and rejection of negation. These five psychotic symptoms should be taken into consideration when preparing and conducting PT program for patients with schizophrenia.

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The present experiment was designed to elucidate the effect of trunk orthosis on a range of motion of flexion and extension of lumbar vertebrae, as well as that on the performance time of standing up from the floor and getting out of the bed. Trunk orthosis used were a custom-made non elastic lumbar-sacral corset (Type A) and a simple elastic corset on the market (Type B). The results revealed a 50% and 10% reduction in trunk mobility, and 50% and 20% elongation in performance time of basic activities, when wearing the Type A orthosis and Type B corset, respectively.

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Myofascial release is aimed at releasing (unraveling) torsion of fascia, not only at expanding fascia. Moderate expansion applied to myofascial restriction induces heat, improves lymphatic drainage, reconstructs myofascial tissues, and resets the sensibility mechanism of soft tissue proprioceptor, that is the most important. These activities result in reprogramming of the central nervous system. In combination with exercise therapy or neurodevelopmental approach, myofascial release will allow patients to learn new movements and to apply the movements to elaborate functional activities, resulting in a forward step to obtain independent function. Accomplishment of optimal function and performance with the minimum energy expenditure is the final goal.

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