P-2-01-21
INFLUENCE OF DISUSE SYNDROME AND AGE ON THE TOTAL BODY MOTION IN STROKE HEMIPLEGICS
Yayoi Okawa, Kikuo Ota and Satoshi Ueda (Teikyo University, Ichihara, Japan)
SUBJECTS AND METHOD: A standardized test of the total body motion (with 44 subtests) was administered to total of 126 stroke hemiplegic patients admitted to two rehabilitation hospitals, one with conventional rehabilitation program with little consideration to prevention of disuse syndrome (81cases) and the other with "positive rehabilitation program" with conscious efforts against it (45 cases). The comparison was made between two different programs in relation to age-dependent differences.
RESULTS: The performance rate of five total body motions (standing up from a chair, gait without cane or brace, standing on the uninvolved foot, keeping half-kneeling posture with the uninvolved foot put forward, and hopping on the uninvolved foot) was significantly higher in non-aged patients (below 65 years) than the aged (65 and over) in the hospital with conventional program. However, in patients on the positive program the difference between two age groups was much smaller and mostly non- significant. Age-dependent difference in "performance ADL" in ward and back home was also marked in the "conventional" group but none (the aged being as good as the non-aged) in "positive" group.
CONCLUSION: The "age-dependent" difference in total body motion could be attributed in the most part not to the age by itself, but to the adverse effect of disuse syndrome since it could be almost abolished by an innovative rehabilitation approach that makes a great effort, among others, to prevent disuse syndrome.
P-2-01-22
DIFFERENCE OF "CAPABILITY" AND "PERFORMANCE" A D L AND HOW TO OVERCOME IT BY IMPROVING BOTH
Kikuo Ota, Yayoi Okawa (Teikyo University, Ichihara, Japan), Harumi Sekiguchi and Shigemi Nakamura (Aida Memorial Hospital, Moriya, Japan)
PURPOSE: Activities of daily living (ADL) must be understood in two different levels. They are "capability" ADL (the level of ADL independence when tested or trained) and "performance" ADL (the level when performed in everyday life). The purpose of this study is to prove the difference between "capability" and "performance" ADL and then to find out ways to overcome it by improving both.
SUBJECTS AND METHOD: Ninety-eight stroke hemiplegic patients (54 males and 44 females; 54 right and 44 left hemiplegics; mean age of 61.1 yr.) were evaluated on "capability" ADL (locomotion in PT gymnasium, ADL training room, outdoor, and ward in relation to such activities as toiletting and grooming, etc.) and "performance" ADL (locomotion in relation to toiletting both during day and at night, grooming, etc.)
RESULT: 1) Of those patients who could walk, in gym, continuously for 50 meters, only 87,3% were independent in "capability" of locomotion in relation to toiletting in the ward; and markedly lower percentage of 12.8% were independent in "performance" of the same activity.
2) However, a proper choice and use of different combination of braces and canes by a same patient in relation to different situations have revealed to improve both levels of ADL considerably in those who could walk continuously for 50 meters: e.g. 100% independence in "capability" of locomotion in relation to toiletting in the ward; and 78.9% independence in "performance" of the same activity.
CONCLUSION: A great discrepancy exists between "capability" and "performance" ADL. However, it could be overcome by a conscious approach including, as far as practical locomotion is concerned, a proper choice and use of different combination of braces and canes by a same patient in relation to different situations.
