ABSTRACT:For 21 hemiplegia patients we measured the rising up maneuver time and the center of pressure (COP) in the single elbow support position to find out which physical functions influence it and prevent the rising up maneuver, for treatment strategies. The rising up maneuver time and COP in the single elbow support position using a force plate under the static and dynamic conditions were measured. For the physical function, we measured the range of motion of trunk rotation, hemiplegia motor function, flaccidity of the shoulder girdle on the hemiplegic paralysis side, trunk rotation muscle strength, motor functions of the neck, trunk and pelvis, COP of the muscle strength of upper limb in the single elbow support position and in sitting on the edge of a bed position under static and dynamic conditions. The rising up maneuver time had a significant negative correlation with COP Y axis maximal movement distance (YD) in the single elbow support position under the dynamic condition. For stepwise multiple linear regression analysis, range of motion of trunk rotation, hemiplegia motor function, flaccidity of the shoulder girdle on the hemiplegic paralysis side, COP of the muscle strength of upper limb in the single elbow support position and sitting on the edge of a bed position under static and dynamic condition were adopted for YD interpretation. The analysis suggests dynamic stability in hemiplegia patients is a factor in performing a rising up maneuver smoothly. Furthermore, performing a rising up maneuver smoothly needs complex physical functions requiring multi-faceted approaches to each individual case.

The purposes of this study were to compare muscle strength during closed kinetic chain (CKC) exercise of upper extremity in different abduction angle directions of shoulder joint, and to clarify the relationship between the muscle strength and locomotion activities. Sixteen healthy women aged 19.0 ± 1.2 years (mean ± SD) participated in this study. The extensor muscle strength during CKC exercise of upper extremity was measured under nine conditions, which combined each shoulder abduction angle of 0, 15 and 30 degree with each velocity of 60, 180 and 300 degree/ sec. Ability of three locomotion activities, the wheelchair driving time on a 10 m path, the number of repeatable pushups in 30 second and the ratio of weight bearing relieved by loading on T-cane to body weight, was measured under subject's maximum effort. Muscle strength during CKC exercise of upper extremity became significantly smaller with an increase in shoulder abduction angle at all exercise velocities. The muscle strength did not correlate with the wheelchair driving time and the number of repeatable push-ups. But, it significantly correlated with the ratio of weight bearing relieved by loading on T-cane to body weight under 60, 180 degree/sec at all angle directions and under 300 degree/ sec at 0° abduction. With an increase in shoulder abduction angle, muscle strength during CKC exercise of upper extremity became significantly smaller at every velocity. This suggests that humeral adduction action of latissimus dorsi muscle may contribute mostly. As for the relationship between muscle strength and locomotion activities, it was found that the ability to load weight on T-cane correlated with muscle strength at 60, 180 degree/sec. This may be because this task does not require high skill, whereas wheelchair driving and push-up require performance skill and muscle endurance in addition to muscle strength. In conclusion, the direction specificity of muscle strength during CKC exercise of upper extremity was shown, but the influence of the direction specificity on locomotion activities was not clarified.

Abstract. The present investigation aimed to clarify the physical functional abilities involved in the disturbance of smooth rising from a supine position in hemiplegic patients. The study compared task performance time and functional abilities between patients rising from a supine position with or without gripping the edge of the bed. Subjects comprising 21 hemiplegic patients were divided into 2 groups: those who needed to grip the edge of the bed to rise from a supine position (Group G, n=7); and those who did not (Group NG, n=14). The 2 groups displayed no significant differences in background characteristics other than age, with mean age for Group G significantly higher than that for Group NG. Rising performance time and 11 items for physical functional abilities were measured in all subjects. Rising performance time was significantly higher in Group G than in Group NG (p<0.05). Neck-trunk-pelvis motor function was lower (p<0.01), muscle tone was abnormal in more subjects (p<0.05) and strength of trunk rotation to the unaffected side was weak in more subjects (p<0.05) in Group G than in Group NG. No other physical functional abilities differed significantly between groups. These results suggest that patients rising from a supine position by gripping the edge of the bed display restricted task performance, and the main factors leading to a requirement for grip assistance seem to be abnormality and disability of trunk functions.