We built an angular velocity measurement system which can be applied to clinical motion analysis using 3 axis angular velocity sensors. Although it connects three sensors simultaneously, it is a compact system, and it is able to measure angular velocity without restraint of motion. We equipped three places, a subject's thigh, lower thigh, and foot, with the sensors, and derived the angular velocity generated at the leg joints at the time of a walking. The result reflected the motion of the 3-dimensional space of each joint. The data of 1 walk cycle was picked out from the measurement data. It had captured the motion of the double knee action, foot inversion, foot adduction, and more. It is also possible to output analog data to an Excel file, thereby allowing detaild numerical analysis. Moreover, calculation of movement angle and angle acceleration is also possible from the measured angular velocity, giring flexibility to analysis methods. We now need to establish effective tools for the analysis of the measurement data.

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The purpose of this study was to clarify empirically that incontinence after cerebrovascular disease has validity for prognosis or prediction of ADL. We classified 116 hemiplegia patients into 2 groups, incontinence and continence, then stratified the incontinence group into a resolved group and a continuing group, and compared Barthel index scores on admission to hospital, and three months and six months after admission for each group. Since the Barthel index contains an item for incontinence, we made the full score 80 points to exclude the influence of this item. The incontinence group comprised 64% of the patients and had a significantly lower score than the continence group 6 months after hospital admission. It was revealed that incontinence has the validity for prognosis or prediction of ADL between incontinent and continent patients. Since, incontinence on entering hospital is a changing factor in the subsequent treatment process, by stratifying the incontinence group into a resolved group and continuing group, it became clear that the prognosis of the resolved group was good. Incontinence as a single factor alone on entering hospital is not enough to predict the prognosis of incontinence being resolved, it is suggested that consideration is needed to take account of patients' changing condition after entering hospital.

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In this study, we measured the time of one-leg standing with vision and no vision, and performed the Multi-Directional Reach Test then compared between two groups: fallers and non-fallers. We studied the relationship with numbers of falls as well as correlations of the three evaluations and examined how we should be viewing balance ability as a factor of elderly peoples' falling. The result: the falling group showed significantly low values in every measurement and the greater the numbers of falling, the lower is the value. In the falling group, we found a significant correlation in every evaluation. Therefore, these results suggest the need to evaluate the balance ability by both maintenance ability of center of pressure and shift ability of center of pressure.

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We measured the brachial-ankle PWV (baPWV) after 60 watt exercising by bicycle ergometer for five minutes of 7 healthy young men (25 ± 4 years) and 7 middle-aged men (51 ± 4 years), and analyzed the changes in baPWV before and after the exercising. The resting baPWV before exercise was significantly higher in the middle-aged group compared to the young group (p<0.001). In both groups, baPWV after 6 minutes motor stress showed significantly lower values compared to resting baPWV (p<0.05). After 20 minutes exercising, baPWV declined 7 and 5 % in the young group and the middle-aged group, respectively. Heart rate (HR) increased by exercise recovered to normal levels in twelve minutes after exercise for both groups. From these results, by transient motor stress, it was seen that baPWV continued declining despite recovering HR after exercise, reconfirming exercise effects arterial dilatation.

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We studied reproducibility and validity of lower limb supporting force with commercial scales in 43 elderly people with dysfunction (average age 84.8 ± 6.5). The measured reproducibility of lower limb supporting force was generally good with an intraclass correlation coefficient of 0.823. Lower limb supporting force, standardized as the ratio of lower limb supporting force to body weight, showed a significant positive correlation with BI and walking speed, suggesting the validity of lower limb support value. In discriminant analysis of 25 subjects with walking ability and 18 subjects without, a lower limb supporting force: body weight ratio of 42.9% gave the best result, correctly classifying 86.0% of the subjects. From these results, lower limb supporting force measured by this method is useful as a simple evaluation of lower limb function of elderly people with dysfunction, and they suggest the possibility of it becoming an indicator of whether walking is possible or not.

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The purpose of this study was to analyze the influence of wearing a belt on hemiplegic patients in the rising up maneuver time. The rising up maneuver time in the single elbow support position and the center of pressure (COP) of single elbow support position with and without the belt were measured for 24 hemiplegic patients. There was no difference in the rising up maneuver time between wearing the belt and without it. COP of static subjects in the single elbow support position, total length was significantly longer with belt wearing compared to without belt wearing. The other COP parameters in static subjects and every COP in dynamic subjects showed no differences between with or without the belt. There were no differences in basic attributes and COP value between the group in which the rising maneuver time shortened and the group in which it was prolonged by wearing the belt in the single elbow support position. Therefore, it was thought that sway of hemiplegic patients' upper body was increased by wearing the belt but the ability to move the upper body was not influenced, and the rising up maneuver time wasn't changed.

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The present study was undertaken to examine the effects of reduced hip extension while walking on displacement of the center of gravity in patients soon after total hip arthroplasty (THA). The subjects of this study were 9 women who had undergone unilateral THA 4 weeks previously and 11 healthy women. Using a force plate and a three-dimensional motion analyzer we measured: 1) gait velocity, 2) flexion-extension motion of hip and knee joints, 3) displacement of the center of gravity, 4) positive work volume during each double-supporting phase, and 5) the total internal work done per unit mass and distance walked. In the THA group, the hip extension decreased and flexion-extension motion of the knee was absent during the stance phase. When the amount of positive work during each double-supporting phase was analyzed for the THA group, the amount of positive work after the heel contact phase was significantly greater on the operated side than on the intact side. The data obtained concerning the total internal work done per unit mass and distance walked indicated a lack of efficient displacement of the center of gravity. These results suggest that the decrease in hip extension while walking after THA can reduce the upward driving force in pushing off and inhibit knee motion control during the stance phase on the side where surgery was performed, suppressing smooth displacement of the center of gravity.

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There have been a lot of studies about the biomechanics of Anterior Cruciate Ligament (ACL) injured people during gait. It was reported that ACL injured people showed decrease of knee extension moment at the early stance phase in the gait cycle. We hypothesized that the knee extension moment of ACL injured people decreased not only in gait but also in descending stairs. We compared lower extremity joint moment and joint angle in descending stairs between 7 control subjects and 3 ACL injured subjects using a three-dimensional motion analysis system. Two ACL injured subjects showed larger knee extension moment and smaller ankle plantar flexor moment than those of the control subjects. The other ACL injured subject showed knee extension moment similar to control subjects and larger ankle plantar flexor moment. No change was noticed in knee joint angle between control subjects and ACL injured subjects. These results show that the ACL injured subjects exerted a large knee joint moment in descending stairs.

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The purpose of this study was to examine the effect of physiotherapy on the disuse syndrome in were hematopoietic stem cell transplantation patients' bioclean room treatment period. The subjects 17 of 35 patients who received hematopoietic stem cell transplantation in a period covering one year. Before and after transplantation, the patient's grip, muscle strength of lower extremity, endurance, amount of hemoglobin, and flexibility were evaluated. The patient did independent practice of muscle strength and stretching in the bioclean room every day. Furthermore, individual practice of muscle strength and stretching was usually carried out together with a physical therapist 3 times per week in the standing position. Compared with before transplantation, muscle strength, endurance, and flexibility fell after transplantation. The amount of Hb before and after transplantation was almost unchanged, and a low value was shown as compared with normal values. In spite of having performed physiotherapy during the bioclean room stay, the physical fitness before transplantation was unmaintainable. It was thought that the main causes were the activity restrictions in the bioclean room. In addition, the influence of adverse drug reaction, corpuscular reduction, undernutrition, and treatment related symptoms were also considered to have played a part.

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The purpose of this study was to examine the effect of differences in weight distribution on work intensity of sit-to-stand performance. Twelve healthy adults (12 male, average age: 22.7 ± 1.3) performed a three-minute sit-to-stand task with weight bearing on one side at three target levels (50, 60, and 70% of body weight) and their oxygen consumption and heart rate were measured. Metabolic energy cost was increased with increment of difference in body weight distribution between the left and right foot. We suggest that asymmetrical body weight distribution adversely effects sit-to-stand performance.

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The objective of this study was to examine the relationship between intelligence and activities of daily living (ADL) at the survey time, on discharge from hospital, and before hip fracture among elderly persons who had suffered proximal femoral fracture (hip fracture). The subjects were 84 persons (average age 81.1 ± 7.1) who had suffered hip fracture, and their intelligence, ADL before hip fracture, ADL on discharge from hospital and at the survey time were assessed and analyzed for relationships. All of the ADL measures showed significant correlations with intelligence. Subjects with intelligence decline showed ADL significantly lower than before hip fracture on discharge from hospital and at the survey time, with marked declines in bathing, dressing, walking and toilet activities. In canonical correlation analysis, the first order variables were dressing, walking and toilet activities at the survey time and because these and similar variables had a large influence on ADL before hip fracture it was understood that these items correlated highly with intelligence. Among second order variables, bathing and eating showed different characteristics to the other variables. This study was conducted only on subjects receiving treatment at a single facility and the influence of regional variations and differences in treatments among facilities cannot be denied; thus we cannot deny the possibility of a different outcome if a study covering several facilities were conducted. Furthermore, there is a need to examine physical therapies which are effective at securing good ADL in patients with intelligence decline due to hip fracture, through the analysis of detailed assessment of difficulty of actual movements.

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It is said that pregnant women should prevent movements which cause abdominal pressure and excessive joint load. Ascending and descending stairs are movements that cause these kinds of problems. A previous study showed that these kinds of risks in descending stairs were higher than that of ascending stairs. The purpose of this study was to show the effect of pregnancy on lower extremity loads during descending stairs. We compared lower extremity joint moments in six healthy women with and without a jacket simulating pregnancy during descent of two types of stairs. We captured motion data and floor reaction forces using a three-dimensional motion analysis system and four force plates. The results show that knee extension moments were significant larger in descending stairs with the jacket. Also, knee extension moment was affected by the weight of the jacket and trunk bending angle.

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The objective of this study was to measure brachial-ankle pulse wave velocity (baPWV) in 200 cerebrovascular disorder (CVD) patients with hemiplegia (146 male and 54 females; 61 ± 11 years old) to investigate the clinical characteristics. The baPWV and ankle-brachial index (ABI) were measured to analyze the paralyzed and non-paralyzed sides using the formula PWV/ABI (Colin, Komaki). We examined the relationship between the obtained baPWV data and the Functional Independence Measure (FIM). The following results were obtained. (1) The baPWV was significantly higher on the paralyzed side than on the non-paralyzed side (p<0.0001), although the ABI was not different. (2) There was no significant difference in the baPWV on the paralyzed side between cerebral infarction and cerebral hemorrhage patients. (3) There was a positive correlation between the baPWV on the paralyzed side and age (r=0.56), and a negative correlation between the baPWV and FIM score (r = -0.29). In CVD patients with hemiplegia due to motor disorders, the baPWV was significantly higher on the paralyzed side, suggesting a decrease in the arterial extensibility due to motor paralysis. It was useful to understand the clinical characteristics.

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We measured maximum gait speed, maximum tapping, maximum stepping, grip strength and leg strength of 22 healthy young subjects to study the influence of the agility of upper and lower limbs on the maximum gait speed. We found no significant correlation between the maximum tapping and the maximum stepping as indices of agility of upper and lower limbs, respectively. Correlation analysis showed that the correlations between the maximum gait speed and maximum stepping, and leg strength were significant (p<0.05), and multiple linear regression analysis showed that the maximum stepping was the most significant variable in the maximum gait speed. The agility of upper and lower limbs was found to be un-correlated. It is, thus, thought that the abilities of agility were different in different parts. Therefore, in assessing agility, it was important to measure the agility of the parts of interest. It was suggested that by measuring maximum stepping the maximum gait speed could be predicted, because subjects whose maximum stepping was faster had a faster gait speed.

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The purpose of this study was to clarify the relation between the basic activities of frail elderly persons and dysphagia. As stroke is the most common cause of dysphagia, we divided frail elderly persons into two groups: those who had experienced stroke and those who had not. The subjects were frail elderly people in an intermediate welfare facility; 39 had experienced stroke and 61 had not experienced stroke. For the evaluation of basic activities, the ability of "maintaining a sitting position", "maintaining a standing position" and "walking" were checked; for the evaluation of dysphagia, frequency of choking was checked. The results showed that for the people with of experience stroke there was a correlation between basic activities and frequency of choking, and among people with ability of "standing" and "walking", those "rarely choking" were significantly large in number. Also compared with the people with ability of "sitting" the proportion of those choking was low. For the people with no of experience stroke, there were no correlation between the two. The proportion of those choking among those with "standing" and "walking" abilities was about half that of those with no "standing" and "walking" abilities. Also, 56% of people with stroke and 23% of people with no stroke experienced choking. Therefore, not only people with stroke, but people with no stroke, frail elderly persons whose basic activities are declining can suffer from dysphagia. Among the frail elderly persons with stroke, it is suggested that the ability of "standing" is the clinically important index to predict the risk of dysphagia.

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Using an accelerograph for objective evaluation of gait is a focus of attention, but the characteristic pattern for a basic index is not clear. In this study, we aimed to identify a common characteristic pattern from the normalized acceleration data of young people. An accelerometer was attached to the sacrum of pelvis and 3 different directions, back to front (X-axis), right and left (Y-axis) and above and below (Z-axis), were measured for 20 young people during normal walking. The acceleration pattern was extracted after normalizing the data to study the characteristic points. Among the same subjects, the characteristic pattern of acceleration in each direction showed a definitive tendency. In the mean data of 20 people, only X-axis showed the reflection of individual characteristics. Furthermore, in the Z-axis, the individual characteristic pattern was also reflected, but within the same subject group, the scatter tended to be regular so it was not necessarily evident in the data of 20 people. From the above results, in the pelvic acceleration of healthy young persons in walking, a characteristic pattern exists which has in common average values of the group as a whole as well as individual subjects.

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Frozen pavements and snowfall exposes the elderly to the threat of falling during the winter. Using the Timed Up and Go Test we examined the physical ability of elderly people able to leave a house or building both in the winter season and non-winter seasons in high snow falling areas. Using 85 elderly subjects we classified them into 2 groups. The first group were able to go outside in either season (independent group) and the second group avoided or restricted going outside during the winter season (independent restricted group). We then carried out the Timed Up and Go Test. Significant delays in the TUGT were acknowledged for the independent restricted group in comparison with the independent group (p<0.01). Also, setting a boundary of 15.5 sec in the examination using discriminant characteristic analysis, it was possible to discriminate well between the independent group and the independent restricted group (discriminant rate 95.3%, sensitivity 78.8%). It is thought that this result indicates the physical ability level of the elderly who live in snowfall areas and are able to go outside in all seasons. It is also useful information for an assessment standard. However, since some subjects, even within the independent group had fallen before inside, it is thought that falling outside would occur regardless of whether or not a standard physical ability existed.

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