Of 15 hemiplegic outpatients, upper limb function was evaluated by the 12-grade hemiplegia functional test at discharge and after discharge (296 ± 169 days in average). Functional performance of paralytic upper limb in daily life was also examined by an interview, and the frequency of use of paralytic upper limb was described in scores in order to investigate the relation with upper limb function. As a result, the more patients use paralytic upper limb in daily life, the more possibility exists that upper limb function improves after discharge. Especially in patients of over stage IV of upper limb at discharge, the tendency was marked. During hospitalization, it is important to lead patients to use paralytic upper limb inevitably and to move both hands positively like washing hands.

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We investigated the effects of changes in outcome trends of patients with Parkinson disease (PD) before and after the induction of the long-term care insurance (LTCI) by the functional independence measure (FIM). Subjects consisted of 18 PD patients (11 male and 7 female; 65.2 ± 9.4 years old) hospitalized in the Hyogo Rehabilitation Central Hospital before the induction of the LTCI, and 25 PD patients (13 male and 12 female; 69.7 ± 6.5 years old) after the induction of the LTCI. After the induction of LTCI, the rate of home care rehabilitation decreased from 72% to 64%. The FIM total score at the time of discharge was significantly higher than that at the time of admission both before and after the induction of LTCI (p<0.001). Both the FIM total score at the time of admission and discharge were not influenced by the induction of LTCI. However, the average hospitalization period became significantly longer (p<0.05). These were considered to result from the induction of LTCI in the social rehabilitation for PD patients. A detailed examination on LCTI is needed to make more PD patients stay at home and return to social life.

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The purposes of this study were 1) to compare respiratory and cardiovascular responses during arm elevation exercise in unilateral and bilateral arms and 2) to clarify the effect of change in respiratory pattern on respiratory and cardiovascular responses during both exercises of twelve healthy young volunteers, respiratory and cardiovascular responses were examined during two exercises. In both exercises breathing patterns consisted of two conditions; natural breathing and breathing with an extended expiration time. The results were as follows: In both arm elevation exercises, respiratory and cardiovascular responses were stronger under breathing with an extended expiration time than under natural breathing. Oxygen consumption (VO₂/kg) tended to be higher during bilateral arm elevation exercise, but under the breathing with an extended expiration time, there was no difference between the exercises. Rating of perceived exertion (RPE) was higher during unilateral arm elevation. There results suggest that unilateral arm elevation exercise may induce less load to respiratory and cardiovascular system than bilateral arm exercise, under the condition muscle strength of upper extremity are sufficiently maintained. In addition, breathing with an extended expiration time may contribute to decline of oxygen demand during bilateral arm elevation exercise.

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The purpose of this study was to examine the effectiveness of walking on a balance beam as the simple evaluation method of dynamic balance. In healthy female subjects, body sway in static standing, weight shift in the Cross Test, lower extremity muscle strength, flexibility and walking time on a balance beam were measured. The multiple regression analysis with an objective variable of walking time on a balance beam revealed that a significant explanatory variable was body sway during single-limb standing with the eyes open. The multiple regression analysis with an objective variable of static balance indicated that significant explanatory variables were lower extremity muscle strength and flexibility, not walking time on a balance beam. These suggest that walking on a balance beam may be an index of dynamic balance, not static balance. It is also suggested that lower extremity muscle strength may play an important role in static balance not only in the elderly but also in healthy subjects.

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Community-Based Rehabilitation (CBR) is generally described as "rehabilitation rooted in the area", and is an effective way of giving rehabilitation services to many clients in the developing countries where there are few medical facilities and specialists. This article outlines CBR, and introduced my experience of CBR in Malaysia.

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Between Malaysia and Malawi, where I worked, there were differences in types of ambulatory aids and technology of producing them. Due to poor economic situation in Malawi, these aids are produced using cheap local materials. This article describes the production and supply system of ambulatory gadgets in these two countries.

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