In order to describe characteristics common to hemiplegic gait, the present study examined the gait of a hemiplegic patient (Br. stage of lower limb: 4, 18 weeks from the onset) by a 3-dimensional motion analysis system, and compared the results with those of normal gait. Measured items were changes in center of gravity, ground reaction force of the both affected and unaffected sides, joint angle, joint moment, and joint power. In normal gait, a center of gravity was low during the double support, and became higher during the single-limb support. In hemiplegic gait, this motion was not seen at the heel contact of the affected side. This is considered to result from abnormal muscle activities of foot dorsiflexion and hip extension at the heel contact. With these results, the importance of body weight locomotion from the affected side to the unaffected side was discussed.

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Although clinical assessment of functional mobility is an important component of physical therapy in stroke patients, its complex nature makes it difficult to assess adequately. This paper illustrates a problem-solving process, assumption underlying physical therapy intervention and useful points of view to assess mobility problems in clinisal settings. In addition, the paper introduces a battery of measures, which should be used to evaluate physical therapy outcomes.

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Motor control during gait was reviewed from its voluntary and active natures. Motor control of higher voluntary nature was described from the viewpoint of "System Approach", and that of higher active nature was introduced mainly by the functions of Central Pattern Generator, of which role has recently been defined.

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The former part of the review introduces the conceptual framework of treatment described in various investigations of motor control, and task-oriented approaches applied in the treatment. In the latter part, the concept and assessment of the strategy levels required for the actual gait analysis and treatment.

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It is observed recently that typical Wernicke-Man's postures are decreasing. Most of patients have hypotonia in the affected pelvis, trunk and shoulder girdle nowadays. One of the main causes may be that cerebral infarctions increase much more than cerebral bleedings. Miyai et al.(1999) hypothesized that hypotonia was caused by the lesion of corticoreticulospinal pathway from the premotor cortex. Physical therapy should be administered to treat the sustained coactivation of torso and pelvic musculatures against the gravity of the affected side for stability in the stance phase, and to control the harmonious contraction of trunk and thoracic musculatures of both sides to regain the smooth swing phase of the affected leg. Desensitization of the affected feet are imperative in order to obtain physiological bases of support.

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Reeducation of walking is given by graded and guided tasks in motor learning. Method of efficient motor learning is resistive exercise, because resistance stimulates receptor of deep sensation easily. The causes of pathological walking are poor movements of the pelvis. I explain hoe to facilitate good movement of the pelvis in PNF method. In addition, I explain the relationship between movements of pelvis and walking exercise.

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The purposes of this study were to categorize the functional recovery process of stroke patients, to examine factors relating to the category, and to elucidate the characteristics of each categorized group. Subjects were 131 hemiplegic patients after stroke. The factors affecting the duration of recovery were the initial value of Motor Age (MOA), the duration from the onset to admission, and intellectual deterioration. Subjects who required long time for recovery of MOA were characterized by the low initial value of MOA, short duration from the onset to admission, and no intellectual deterioration. The factors affecting Manual Function Score (MFS) were the initial value of MFS and age. Subjects who required long time for recovery of MFS were featured by the low initial value of MFS and ages of their fifties and seventies. The factors affecting Barthel Index (BI) were the initial value of BI, age and duration from the onset to admission. Subjects who required long time for recovery of BI were characterized by the low initial value of BI, long duration from the onset to admission, and age under 60.

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The purpose of this study was to clarify how movement is controlled at the first step by the swing leg of gait initiation on a low friction floor. Nine healthy subjects (age: 22.6 ± 3.0 years) participated in the study. On both high and low friction floors, movements of the first step were measured using a force plate and a motion analysis system. The length of the first step and the time difference from heel contact to toe contact by the swing leg on the low friction floor were significantly smaller than those on the high friction floor, and the maximum vertical distance between the lateral malleolus of the swing leg and the floor on the low friction floor was significantly higher than that on the high friction floor. These findings suggest that the movement of the first step of gait initiation on a low friction floor may be controlled in such a way that the step length is reduced, the foot is raised higher, and the foot lands flat on its sole.

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Safety in motions, an integral part of life at home of chronic stroke patients, was evaluated by the behavior assessment method, and factors and influence related to the safety were examined. Of 34 inpatients aged 65.2 ± 12.7 years in average, functional ability and self management ability were evaluated in the four activities, wheelchair, transfer, gait and toilet. The results were compared with those evaluated by a physical therapist, and analyzed by the relation with conditions after discharge. The results were also compared with subjective safety in motions of each patient, and the extent of unilateral neglect. It was indicated that safety in motions related greater to self management ability than functional ability, and that patients who were judged to have higher safety in motions by PT tended to stay at home after discharge. Evaluation of safety in motions by PT did not always correlate to subjective safety of each patient, and patients with unilateral neglect were liable to consider their safety in motions higher than the actual state. These results suggest that physical therapy assessment should be done not only by the viewpoint of functional ability, but also by that of safety in motions including self management ability.

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The 13th Congress of the World Confederation for Physical Therapy (WCPT) at Yokohama in 1999 showed the importance of global communication among physical therapists. Although there are various physical therapy organizations that give opportunities to interchange nationally and internationally, little is known about organizations for physical therapy students. In this paper, several dimensions of communication among physical therapy students are examined using the Internet. It is found that there is no organization for physical therapy students in Japan, and that some countries have the organizations with significant activities. Since communication among students through the organizations develops their abilities as future physical therapists, the establishment of international organization for physical therapy students in Japan will be discussed immediately.

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We investigated the effect of changes in weight on muscles in motions of raising objects among 9 healthy subjects. We measured IEMG (integrated electromyogram) and % MVC (% maximal voluntary contraction) using an electromyograph, and the following results were obtained. 1. It was indicated that with an increase in weight of objects, the load of Trapezius and Biceps brachii became larger than that of Erector Spinae and Rectus femoris. 2. Compared with other muscles, %MVC of Biceps brachii was lager, and that of Rectus femoris was smaller. Especially, %MVC of Rectus femoris did not show marked changes with an increase in weight of objects.

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The purposes of this study were to evaluate the activities of daily living (ADL) in inpatients with schizophrenia by using the functional independence measure (FIM) and to clarify the difficulty, the similarity and the relation among ADL. Subjects consisted of 131 randomized controlled trials of 478 in patients with schizophrenia of Tokyo Metropolitan Matsuzawa Hospital as of October, 2000. The difficulty in ADL was judged from the mean value and the standard deviation of each item. The similarity and the relation among ADL were clarified by the cluster analysis. As a result, 18 items were categoriezed into three clusters. The difficulty and the structure of ADL in patients with schizophrenia were different from those of patients without schizophrenia. We presumed that there was a close relation between the motor function and the psychological function. It is necessary to make the program for each cluster for improving ADL of patients with schizophrenia.

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