SummaryThe wheelchair marathon is one of the most difficult sports for participants with much uncertainty regarding the security of the paraplegics. The physical fitness of paraplegics has been examined regularly since The Oita International Wheelchair Marathon (half marathon) was inaugurated (1981). A full marathon (42·195 km) was adopted at The 3rd Meeting (1983). The individual equations between heart rate (HR) and oxygen consumption V02 were drawn from the preliminary test on the subjects who were expected to be among the top finishers in these races. V02 during these races was indirectly estimated and showed a fairly low value (35'0 ± 3,8 ml/kg/min in the full race, 32-7 ± 6-3 ml/kg/min in the half race respectively) in comparison with able-bodied elite runners. However, the paraplegic participants had extremely high HR (171·6 ± 20·5 beats/min, 168·1 ± 9·8) con tinuously throughout the race. Though the ratio of active muscle mass of arms to legs in paraplegic athletes may approximate to near equal, paraplegic arms seem to exert physiologically and mechanically less efficient power. There were no significant differences in physical fitness between the full and the half marathon elite finishers. The cardiovascular function of paraplegic athletes may well be ranked among those of able-bodied athletes in their fitness. Full wheelchair marathon seems to be safe if it is held in an appropriate environment.

SummaryTwenty eight stress tests for 14 wheelchair marathon competitors were performed to determine their physical fitness just before the Oita International wheelchair mara thon since 1984. All the subjects were wheelchair-bound Japanese males and workers at Sun Industry. Oxygen consumption at the maximal workload was significantly larger than that of non-athletic paraplegics and the mean values were 35·0 ± 4·8 ml/kg in competitors and 22·6 ± 5·0 ml/min/kg in non-athletic paraplegics. Eight competitors had more than 2 stress tests and 6 of them had 3 tests from 1984 to 1987. The oxygen consumption at the maximal workload of their third test was very high (46·5 ± 6·8 ml/min/kg) equal to highly trained paraplegics, and was larger than the result of the first test significantly. Their physical fitness was reduced signifi cantly during the off season, however their physical fitness was maintained at a satisfactory higher level than that of non-athletes. This study demonstrated that individual training for wheelchair marathoners had improved the competitors' physi cal fitness over several years.

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Background: We evaluated whether the Walkaide® device could effectively improve walking ability and lower extremity function in post-stroke patients with foot drop. Patients aged 20–85 years with an initial stroke within ≤6 months and a functional ambulation classification score of 3 or 4 were eligible. Materials and Methods: Patients were randomly allocated to the functional electrical stimulation (FES) or control group at a 1:1 ratio. A 40 min training program using Walkaide was additionally performed by the FES group five times per week for 8 weeks. The control group received the 40 min training program without FES. Results: A total of 203 patients were allocated to the FES (n = 102) or control (n = 101) groups. Patients who did not receive the intervention or whose data were unavailable were excluded. Finally, the primary outcome data of 184 patients (n = 92 in each group) were analyzed. The mean change in the maximum distance during the 6-MWT (primary outcome) was 68.37 ± 62.42 m and 57.50 ± 68.17 m in the FES and control groups (difference: 10.86 m; 95% confidence interval: −8.26 to 29.98, p = 0.26), respectively. Conclusions: In Japanese post-stroke patients with foot drop, FES did not significantly improve the 6 min walk distance during the convalescent phase. The trial was registered at UMIN000020604.