Physiological Cost Index (PCI) of 18 hemiplegic patients was obtained by using a change in heart rate (HR) during 3-min walk, and the value was compared with the required time for 10 m walk and a change in HR in a standing-up motion. 1) Hemiplegic patients showed a significantly higher PCI than healthy controls. There was a significant negative correlation between PCI and repetitions of standing-ups and ΔHR₁ (difference in HR between static condition and after 10 m walk). 2) The significantly longer required time for 10 m walk was observed in hemiplegic patients than in controls. However, higher ΔHR₁, was shown in controls than in patients. 3) Controls showed significantly higher frequencies of standing-ups (68 times) compared with patients (55 times), and controls exhibited a significantly higher endurance index than hemiplegic patients (P<0.05). There was, however, no differencein HR between them. 4) The required time for 10 m walk had a significantly negative correlation with every indices measured in this study.

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In order to examine daily changes in patients with chronic cerebrovascular disease in the R-R interval and QT ratio, electrocardiograph. The R-R interval was found to become shorter during the day and longer during the night in both groups. QT ratio of CVD patients was significantly higher than that of controls throughout the experimental period, reaching the highest value at noon. The elongation of QT interval, a clinical precusor of lethal ventricular dydrhthmia, is frequently induced by exercise program in the morning for CVD patients.

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For the purpose of examining the effectiveness of respiratory training, EMG activity of diaphragm and respiratory pattern (T_tot, TI, TE, and TI/T_tot) were studied in 3 tetraplegic patients and 30 healthy adults after the deep breathing exercise, Souffle exercise, or exercise with the abdomen loaded. EMG activity of diaphragm after the Souffle exercise was found to increase significantly in healthy adults, and to show a tendency to increase in tetraplegic patients. That after the exercise with the abdomen loaded was significantly lower in tetraplegic patients than in healthy adults. Compared with T_tot at rest, that after the deep breathing exercise became longer in both subjects. TI after the Souffle exercise became longer in tetraplegic patients, resulting in TI/T_tot over 50%. It was concluded that the Souffle exercise is more effective for tetraplegic patients than the exercise with the abdomen loaded, suggesting the effectiveness of the Souffle exercise as respiratory training.

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The purpose of this study was to clarify the effect of the conductive heaton the extensibility of muscles. Heat was provided for 10 minutes by a hydrocollator hot pack on the posterior portion of the thigh in 16 volunteers. Goniometric measurements of passive flexion of the hip joint with the straight leg raising on one leg were taken before, immediately after, and 10 minutes after the treatment of the heat.
A control study was conducted on another leg. As a result, no improvement in the extensibility of muscles was shown by the application of the conductive heat of the hydrocollator hot pack.

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In order to analyze the condition of sudden knee bending, the changes in knee angle andmuscle activity of knee extensors were examined by using 8 healthy subjects.
The bjects were ordered to stand on one leg, bend a knee, and stop bending motion as involuntarily as possible. We were found to show almost the same period from the initiation to the completion of knee bending (422±4.2 msec) and the same knee angle at the completion (58±5.4°). It was also found that the knee angle at the completion of knee bending coincided with that at which knee extensor can be strongest and work most actively. The motion to stop bending appeared 150 msec after the initiation of knee bending at the knee angle of over 30° (angular velocity, approximately 280 DPS). At that time, knee extensor revealed relatively higher torque value which suggests that the muscle may be in optimum condition for stopping bending.

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In order to examine factors associated with falls, we performed an interview survey to 78 elderly subjects who had experienced a fracture due to falls. The contents of the survey included fractured region, medical history, physical condition, and circumstances at the time of falling. 1) The ratio male to female of the subjects was 1 : 2.8 and the fractured region observed most frequently was the neck of femur (52.6%). 2) Of these subjects, 85.0% had medical problems in circulatory, nervous, and kinetic systems. 3) The decrease in attention level to the circumstances was found to be a major cause for falls; inattention to height difference, distracted at tention, carelessness for the slippy ground, etc. From the results obtained, it would be important for the elderly to avoid falls that they should lead their lives as active as possible and that their personal arrangements should always be well prepared.

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The posture of human beings depends so highly on the related position between pelvis and lumbar region that changes in the position due to a longitudinal, horizontal, or vertical sway of the center of gravity may be one of the causative agent for postural imbalance. For the purpose of examining the relationship between the torsional deformity and postural imbalance, we measured the angle of torsion of the second sacral vertebrae and the second lumbar vertebrae in a prone position of 809 outpatients. The torsional deformity, especially that to the right side, was observed frequently in the patients, having a significant relation to the incidence of postural imbalance. With increasing ages, a decrease in horizontal level was found both in pelvis and lumbar region, which resulted in an increase in the torsional deformity to the left side. It was suggested from the morphological viewpoint that the indirect deformity of sacroiliac joint due to the declination of the sacred bone may be a primary cause for postural imbalance.

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Leg length inequality (LLI) was artificially made by placing a rubber sole of 1 - 5cm high under a left foot of four healthy adults, and they were ordered to walk on the force place. Gait parameters examined consisted of speed and time factors, ground reaction forces, displacements of the body's center of gravity(COG), displacement volume, and the total walk of COG done per unit mass and distance walked. The effects of LLI and individual difference on those parameters were statistically analyzed. It was found that most of speed and time factors were possible affected by the LLI, but the variation of these factors by the LLI were minimum. The vertical displacement width was found to become longer by the approximately 3 cm due to the 5 cm LLI. On the other hand, the lateal and force-aft displacement widths were not affected by the LLI. The total work of COG done per unit mass and distance walked was increased in the gait with LLI of 4 cm and over. It was suggested that the LLI less than 4 cm have little effect on mechanical efficiency of gait.

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In order to determine the step length for the maximum walking speed, ten healthy males(mean age, 23.1 years; mean body height, 172.7 cm) were ordered to walk straight 10 m as fast as possible with their conventional (free step), shorter (short step) and longer step lengths(long step). It was found that the maximum walking speed was observed in walking with free step. In addition, for the purpose of examining how changes in the step length affect energy cost during walking, four healthy males (mean age, 29.0 years; mean body height, 173.3 cm) were instructed to walk Treadmill with four different step lengths(30, 60, 70, and 80% of body height) at the speed of 2, 4, and 6 km/h for 3 min. The oxygen consumption for 1 min and the heart rate for 15 sec just after each experiment were recorded. It was also found that the speed became faster during walking with % step length of 30 and 60 %, and that it remained unchanged during walking with % step length of 70 and 80%. The results obtained here indicate that the optimum % step length to induce the maximum walking speed is approximately 70%, and that walking with longer step length requires larger oxygen consumption, which suggests its inefficiency.

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We measured isometric trunk extension toruque values (TV) in 29 normal subjects (22 males, 7 females) with Lumbar Extension Machine (LEM). The effects of sex differences and lumbar extension angle(LFA), and serial changes after 6 weeks' exercise of trunk extensor on trunk extension strength were investigated.
1) It was shown that the TV was more larger on male group than female one, and that the larger LFA was, larger TV was 2) TV was significantly incresed after the exercises, same as 1). However, there were many individual differences on a increasing rate of TV, and it was difficult to find a clear relationship between TV and LFA.
3)The significantly decrease on all LFAwas manifested on retesting six months later.

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In this lecture critical assesment of the medical literature was introduced. We must read critically every articles in journals no matter whether be peer-reviewed or not. A structured abstract is an excellent guide to read themedical journal literature systematically. Critical assesment of the literature can be to find rhetoric biases occurring in the research process of collecting, evaluating, and unifying information. It can also be said an effort to understand and reduce the readers'bias.

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