Impairments of the lower limbs, observed in patients with hemiplegia after cerebral apoplexy, are mainly caused by the inhibitive factors such as loose-type and spastic-type hemiplegia, sensory impairments, or articular contracture. Among these factors, spastic hemiplegia is the major target of physical therapy in this disease. There is atendency to show a typical position of the limbs peculiar to cerebral apoplexy, with flexion of the upper limb and extension of the lower limb, this being called Wernicke-Mann. In the standing position, however, some cases were observed where the lower limb was flexed, and the patients were unable to walk dre to the superiority of the flexor muscle. A study of this inexplicable phenomenon suggested that it was different to the knee-flexion involved in the loose-type hemiplegia in its mechanism of onset, as well as its difference from foot flexion and spastic paraplegia. The authors therefore evaluated six patients during the period from July 1977 to December 1982 (four male and two female patients), included were four patients with right hemiplegia and two with left hemiplegia. As a result, symptoms such as decrease in the will to move (with normal conversation and symptom different from akinetic mutism), nervousness upon movement (a sense of anxiety), acceleration of tendon reflex, contracture and sensory impairment. These patients received dynamic, long ower-limb orthoses (including Type-PP LLB), with knee pads to help them walk with the assistance of a T-cane. However, only one case could reduce the short lower-limb orthosis or Walk without assistance. All other patients showed poor results.

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Since skin temperature is influenced by internal and external functions, it is difficult to analyze it quantitatively. We tried, however, quantitative analysis of it with thermography. For convenience of the experiment, we worked out MTI (Mean Temperature Index) on the basis of TI (Thermographic Index) of A. J. Collins. Subjects were 16 normal adults (males) and they were between the age of 19 and 37, mean 25.2 years old. We took thermograms of lower limbs 7 times at the interval of 20 min, when they lay down quiet on the bed more than 2 hours after meal. In order to analyze these thermograms, we divided lower limbs into three parts: thigh, knee and leg. Thermograms are shown in isothermal lines. The results obtained are as follows: 1. Mean values of MTI during experiment indicated the narrow range of distribution. That is; lower Limbs Right 3.87, Left 3.84, Thigh R. 4.08, L. 3.89, Knee R. 3.63, L. 3.59, and Leg R. 3.50, L. 3.47. 2. Skin temperature of lower limbs settled 60 min after lying down on the bed. 3. The period of MTI transition patterns was getting short in order of thigh, knee and leg. 4. The value of MTI decreased in order of thigh, knee and leg. 5. MTI method makes it possible to analyze skin temperature quantitatively, and also to utilize thermography for examining thermal effect.

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