The effectiveness of rehabilitation in patients with HTLV-1 associated myelopathy HAM was evaluated. The HAM patient is characterized by chronic progressive spastic paraplegia with dysuria and muscular weakness of the lower trunk, as well as the pelvic and hip muscles. However, the muscular strength of the lower limbs and feet is relatively well maintained. The 12 subjects enrolled in this study included 2 men and 10 women. Their average age was 53.2 years, their average duration of disease was 20.5 years, and they were involved in training for an average of 41 days. The rehabilitation program involved muscular strength training of the lower trunk, pelvic, and hip muscles. After all patients completed the rehabilitation program, a significant improvement was seen in the truncal flexors, the truncal extensors, and the truncal rotators in the lower trunk. As for the hip muscles, a significant improvement was seen in the iliopsoas, the gluteus maximus, and the gluteus medius. The improvement was evaluated using Osame s Motor Disability Score OMDS , the Functional Independence Measure FIM and the Barthel Index. The patients improvements in motor function and ADL suggest that rehabilitation was effective. Jpn J Rehabil Med .

We evaluated the clinical efficacy of concentric inpatient hospital rehabilitation (CIHR) for HTLV-1 associated myelopathy (HAM). We estimated the change of activity of daily living (ADL) using objective clinical parameters before and after rehabilitation. [Subjects] Fifteen HAM patients (male 3, female 12, mean age 51.9) at the chronic stable stage participated in this study. [Methods] These HAM patients were hospitalized for rehabilitation for six weeks periods at our hospital. We assessed the usefulness of CIHR therapy by the Functional Independence Measure (FIM) ratings and Osame's Motor Disability Score (OMDS) before and after rehabilitation. We also evaluated the changes of each FIM subcategory, especially focusing on gait ability. [Results] FIM ratings showed statistically significant increases after CIHR. Especially, the walking ratings in FIM and OMDS showed statistically significant improvements after CIHR. FIM subcategories related to lower limb movement improved remarkably whereas subcategories related to bladder and bowel management were without significant changes. [Conclusion] The improvement of ADL by CIHR was confirmed, mainly as a remarkable improvement in the gait ability. Concentric rehabilitation for HAM patients may be a promising therapy for improvement of ADL.

Objective : To demonstrate the importance of physical motor function using the unified Parkinson s disease rating scale UPDRS and three-dimensional motion analysis in Parkinson s disease rehabilitation strategies. Participants : Seventeen inpatients with Parkinson s disease. Intervention : Physical training to improve joint mobility, muscle strength and muscle stretch to increase physical capacity was conducted for about four weeks. Results The mean total scores of UPDRS significantly decreased from 37.9 13.2 before training to 27.3 11.2 after training . The ADL scores of the UPDRS decreased from 12.4 6.9 before training to 9.5 6.3 after training . The motor scores decreased from 22.5 7.5 to 15.3 6.5. Furthermore, muscle rigidity and akinesia, two key Parkinson symptoms, were improved as shown by assessment of the UPDRS motor scores. And physical function of the trunk, and upper and lower extremities was also improved. Finally, the increment of stride length and walking velocity and range of motion ROM at the hip and pelvic joints were observed by assessment of three-dimensional motion analysis. Conclusion : This study suggests that improvement of Parkinson symptoms and increment of ROM at the pelvic and lower limbs by physical training may improve stride length and walking velocity. Jpn J Rehabil Med .