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脳血管障害例の座位姿勢制御における視覚的垂直定位の影響を身体軸傾斜との関連から検討した。右麻痺7例，左麻痺8例，健常若年者9名及び健常高齢者4名に，視覚的垂直定位と，傾斜した視覚指標への身体軸傾斜を測定した。片麻痺例は身体軸傾斜が健常者より有意に小さく，麻痺側傾斜時にその傾向が著明であったが，運動麻痺の重症度と身体軸傾斜との間に有意な相関を認めなかった。視覚的垂直定位の標準偏差は左麻痺例で他の3群より有意に大きく，身体軸傾斜の標準偏差は左麻痺例の左傾斜時に大きい傾向を認めた。視覚的垂直定位の標準偏差は身体軸傾斜時の動揺に影響し，左麻痺例で顕著であると示唆された。

In 1997, the members of Japan Stroke Society presented the Japan Stroke Scale (JSS) for the acute stage, and in 2000 the Japan Stroke Scale of Motor (JSS-M) with the items of motor system required for the independence of activities of daily living (ADL). JSS-M consists of eight major items. We classified subjects with nine points or less into group A, with 10-19 points into group B and with 20 points or more into group C according to JSS scores for the acute stage at the baseline. In JSS scores, higher scores means more intense severity of disability. Subjects were 46 cases with cerebral hemorrhage and 63 cases with cerebral infarction, 109 cases in total. Age: cases with cerebral hemorrhage had a mean age of 58.3 ± 14.7, while those with cerebral infarction had a mean age of 69.2 ± 11.0: males 67, and females 42. The rate of improvement of cerebral hemorrhage was higher than that of cerebral infarction in groups A and B. The rate of improvement was the highest in Gait in groups A and B, and Dysphagia and Complex Movement followed in order after that; in group B the rate of improvement of Hand and Arm followed after Complex Movement. The mean rate of improvement of JSS was 98% in group A, 66.7% in group B, and 57.8% in group C. JSS-M is a very useful evaluation, but the study of evaluation methods of trunk and upper limb function required.

Evaluation of disorders constitutes an important part of work in rehabilitation medicine. But all of the objective evaluation methods for quantifying ADL have both advantages and disadvantages, and they are often difficult to use. Evaluation and judgment of ADL should be carried out in terms of movements simplified as much as possible. An ADL Score Study Group, consisting of medical co-workers, has been organized, and they have proposed a tentative plan for patients with paraplegia due to spinal cord injury. Method; ADL items were limited to 10, with sub-items limited to two to three per item, to simplify the ADL score as much as possible. The evaluation was carried out in accordance with the followings; 0 point, requiring full assistance, 1 point, partial assistance, 2 points, possible to do activities with insufficient perfectness, 3 points, possible to do activities independently, with a maximum of 99 points. Subjects were 35 patients with complete paralysis due to spinal cord injury. Thirty four persons were males and one was female. Results; Evaluation scores were 81 points for Group A (Spinal cord injury T1-7), 85 points for Group B (Spinal cord injury T8-L1), 95 points for Group C (Spinal cord injury L2 or lower). It was demonstrated that the evaluation of two items, reach and walking, was sufficient for independent patients with paraplegia due to spinal cord injury.

Making a functional prognosis for patients with traumatic incomplete spinal cord injuries is extremely important not only for the patients themselves, in attempting to achieve independence in activities of daily living and social rehabilitation, but also for medical co-workers, the family and almost everyone in the society. However, only very few reports deal with this subject, and rehabilitation is often conducted aimlessly. In the present study we tried at our department to summarize the functional prognosis of patients with spinal injuries and set up a preliminary standard for rehabilitation. The present study included 75 patients with Frankel class C, D, E, incomplete spinal injury who underwent rehabilitation training in the past ten years at our department. The level of the injury was the cervical cord in 53 patients and the thoracic or lumbar cord in 22 patients. The average age of the patients was 36.2 years. Seventy of the patients were male and 5 female. The time of the final evaluation after the injury was on the average 11.8 months (SD=5.9 months). When muscle power of the lower extremities three months after injury reached [4], patients accomplished independent walking 6.8 months after the injury. When muscle power of the lower extremities 6.5 months after injury reached [3-], patients accomplished semi-independent walking with the help of a wheelchair 8.7 months after the injury. Patients with a muscle power of more than [3-] in the upper extremities could walk independently. Among patients with incomplete injury of the cervical cord 64% gained independence in ADL 8.6 months after the injury, but patients with central paralysis or strong spasticity required assistance.