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The purpose of this study is to outline the physical therapy services and its service delivery. In Kyoto prefecture, 66 hospitals provided physical therapy services (30.3% of 2l8 hospitals). There were 39 hospitals in Kyoto city (59.1%) and 3 hospitals were registered as "Sogo-Rehabilitation-Shisetsu", the highest class of physical therapy. A questionnaire survey revealed that 7 hospitals provided the service delivery of physical therapy to the patient's residence. These results indicate that physical therapy services have well developed into the medical services at hospitals and that, especially in urban area, the services has progressed. On the other hand, however, the service delivery of physical therapy is rather poorly developed.

This study compared the torque-velocity relationship between eccentric and concentric contraction of the hip abductor during maximal voluntary contraction. Four healthy males and six healthy females (mean age 22.2 years old) were tested in three velocities (30°, 90°, 150°/sec) concentrically and eccentrically using an isokinetic dynamometer. The highest torque of three maximal efforts was considered the peak torque. Eccentric peak torque was greater than concentric peak torque. Concentric peak torque decreased as angular velocity increased from 30°/sec to 150°/sec. Eccentric peak torque increased as angular velocity increased from 30°/sec to 90°/sec, whereas decreased from 90°/sec to 150°/sec.

Injuries of the ankle joint, especially those involving lateral ligamentous structures are the most frequent type of acute injuries in sports activities. The purpose of this study is to present the specificities and rationale of rehabilitation in these injuries. The forced supination of the ankle joint in plantar flexion will tear the anterior talofibular ligament which is located nearly vertical to the line of stress. If the force is excessive, the calcaneofibular and posterior talofibular ligament will also be torn, and marked instability of the ankle joint will be aggravated. Conservative treatment is usually chosen for the first and second degree of injury according to DePalma's classification, and operative reconstruction of ligaments is performed for the third degree of injury which is routinely confirmed by X-ray studies. Primary care in the acute stage consisting of proper immobilization, icing and elevation of the ankle joint is essential for better results in conservative treatment. The rehabilitation process after reconstruction of ligaments in athletes consists of three steps: 1) medical care 2) medical rehabilitation and 3) athletic rehabilitation. The athletes return to athletic competition after rehabilitation with some type of preventive external support to the ankle joint and with instruction to prevent recurrent injury.

The relations between oxygen uptake and Brunnstrom's recovery stage, speed of walking, age and sex were investigated in nineteen hemiparetic patients. Nine of them were males and ten were females. Their mean age was 59.3. There were thirteen cases of cerebral hemorrhage and six of cerebral infarction. Oxygen uptake was determined by analysis of expired gas collected in a Douglas bag during walking. The mean of oxygen uptake was 12.85±4.14(S.D.) mlO_2/kg/min. There were no significant relationships between oxygen uptake and Brunnstrom's recovery stage, speed of walking or age. However, oxygen uptake in females was significantly less than in males. We speculated that males walked with more effort than females and found that several patients required more oxygen than normal subjects in unrestrained walking.

The purpose of this study was to examine gross anatomy of the suprascapular nerve using 20 cadavers (14 male and 6 female), with special reference to the anomalous branch to the supraspinatus muscle and funicular pattern in the scapular notch. The branch to the supraspinatus muscle did not ramify proximal to the scapular notch, whereas the suprascapular artery passed under the superior transverse scapular ligament in 17.5% of the cadavers. Fourty percent of the scapular notches were type II by the classification of Rengachary. There was no adhesion between the suprascapular nerve and superior transverse scapular ligament which varied in size and toughness; the inferior transverse scapular ligament was, however, thin in 72.5%. Pseudoneuromas found just proximal to the superior transverse scapular ligament had no correlation with supraspinatus and infraspinatus muscle atrophy, which were not remarkable. The branch to the supraspinatus muscle superomedial in the scapular notch were located just below the superior transverse scapular ligament where friction neuritis was said to be occasionally seen. The present findings suggest that infraspinatus muscle atrophy is caused by suprascapular entrapment neuropathy at the spinoglenoid notch rather than at the scapular notch.

The bed-ridden senile cases tend to sustain fractures involving the spine, femoral neck, ribs and the distal end of the radius because of fragility of bone resulting from osteoporomalacia. As these fractures are often undisplaced without local symptoms, they are occasionally overlooked. The aim of initial treatment of these fractures is: relief of pain, bed exercise for activation of the cardiovascular and respiratory system and early ambulation. Complications associated with these fractures should be prevented by early diagnosis and proper initial treatment.

The purpose of this study was to discuss the clinical target of indoor independent gait in thirty-six hemiplegic inpatients, whose mean age was 59.4, twenty-two males and fourteen females, nineteen were caused by cerebral hemorrhage and seventeen were caused by cerebral infarction. The gait speed, time and distance while walking free or usually within twenty minutes in fifty meter hallway were measured and the degree of motor paresis was assessed with Brunnstrom's recovery stages. The patients were divided into independent group and dependent one on the evaluation, wether they walked independently without use of wheelchairs in any locomotive activities in hospital living or not. There were significant differences between two groups in regard to walking speed and distance, but no differences in walking time and the degree of motor paresis. The patients who belonged to the independent group walked at a speed more than 20.3 meter per minute and more than 200 meter on distance and the patients who belonged to the dependent group walked at a speed less than 21.1 meter per minutes and less than 391 meter on distance. It was proposed to use the range more than 21.1 meter per minute on speed and 391 meter on distance as a clinical target zoon of hemiplegic independent gait in hospital.