Failure to paint the left quarter of a watercolor and no error in a line drawing: a case report of an art teacher with unilateral spatial neglect.

A 54-year-old art teacher, experienced a right putaminal hemorrhage, and thereafter suffered severe left hemiplegia and unilateral spatial neglect, and was transferred to the rehabilitation department of the University Hospital 1 month after the onset. Although the unilateral spatial neglect was improving, the patient was unable to paint the left quarter of a watercolor, but there was no error in line drawing. The occurrence of errors only in a watercolor suggests that the neural process for painting a watercolor is different from that of line drawing.

[Survey of carbon fiber reinforced plastic orthoses and occupational and medical problems based on a questionnaire administered to companies involved in the manufacture of prosthetics and orthotics].

We surveyed carbon fiber reinforced plastic orthoses (carbon orthoses) and their associated occupational and medical problems based on a questionnaire sent to 310 companies which were members of the Japan Orthotics and Prosthetics Association. Of all the companies, 232 responded: 77 of the 232 companies dealt with ready-made carbon orthoses, 52 dealt with fabricated custom-made orthoses, and 155 did not dealt with carbon orthoses. Although the total number of custom-made carbon ortheses in Japan was 829/ 5 years, there was a difference by region, and one company fabricated only 12 (per 5 years) custom-made carbon orthoses on average. The advantages of the carbon orthosis were the fact that it was "light weight", "well-fitted", had a "good appearance", and "excellent durability", while the disadvantages were that it was "expensive", "high cost of production", of "black color", and required a "longer time for completion", and "higher fabrication techniques". From the standpoint of industrial medicine, "scattering of fine fragments of carbon fibers", "itching on the skin" and "health hazards" were indicated in companies that manufacture the orthosis. In order to make the carbon orthosis more popular, it is necessary to develop a new carbon material that is easier to fabricate at a lower cost, to improve the fabrication technique, and to resolve the occupational and medical problems.

A walker with a device of partial suspension for patients with gait disturbance: body weight supported walker.

We developed a walker, the Body Weight Supported (BWS) Walker, with a device of partial suspension for patients with gait disturbance. It consists of a light frame with casters, a harness, and a winch system. One therapist alone can perform gait training safely with the BWS Walker without any additional physical load, even if a patient has severe gait disturbance, and the therapist can concentrate on evaluating and improving the patient' s standing balance and gait pattern. Because the BWS Walker is less expensive, simpler, and easier to operate than other BWS systems, we believe the BWS Walker can be widely applicable in training for patients with severe and moderate gait disturbance.

Oxygen consumption, oxygen cost and physiological cost index in polio survivors: a comparison of walking without orthosis, with an ordinary or a carbon-fibre reinforced plastic knee-ankle-foot orthosis.

OBJECTIVE: To examine, for polio survivors, whether walking with a carbon-fibre reinforced plastic knee-ankle-foot orthosis (carbon KAFO) is more efficient than walking with an ordinary KAFO or without an orthosis. DESIGN: Consecutive sample. SETTING: Post-polio clinic, University Hospital of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. PARTICIPANTS: Eleven polio survivors who had a carbon KAFO prescribed at the post-polio clinic. INTERVENTIONS: A carbon KAFO was prescribed, fabricated and inspected. MAIN OUTCOME MEASURES: Oxygen consumption, oxygen cost and physiological cost index. RESULTS: An ordinary KAFO weighed 1403 g (standard deviation(SD) 157 g), whereas a carbon KAFO weighed 992 g (SD 168 g). Subjects walking with a carbon KAFO showed a tendency to increase step length, and to increase speed significantly compared with walking without an orthosis and with an ordinary KAFO (paired t-test, p < 0.05). Oxygen consumption per body weight, oxygen cost (O2 consumption for 1-m walk divided by body weight) and physiological cost index ((heart rate at 3-min walk - heart rate at rest) /speed) were significantly lower than those walking without an orthosis (-16%, -35%, -33%; paired t-test, p < 0.05) and were lower than those walking with an ordinary KAFO (-9%, -14%, -15%; paired t-test, p < 0.05). CONCLUSION: The gait efficiency of polio survivors with a carbon KAFO was objectively better than those without an orthosis or with an ordinary KAFO.

Speed and physiological cost index of hemiplegic patients pedalling a wheelchair with both legs.

OBJECTIVE: To determine whether hemiplegic patients can propel a leg-pedalling wheelchair and whether it is easier and faster for them to pedal the wheelchair using both legs alternately than to propel an ordinary wheelchair with their unaffected hand and leg. DESIGN: Within-subject comparison. SUBJECTS: Subjects comprised 10 hemiplegic in-patients (8 males, 2 females), aged 63.7 (SD 12.7) years with severe or moderate gait disturbance due to stroke. METHODS: Subjects were asked to practice propelling the leg-pedalling wheelchair and ordinary wheelchair on both slalom and rectangular courses for a period of 7-10 days. Once they had become skilled in this, the wheelchair speed and patient's heart rate were measured, and a physiological cost index was calculated. RESULTS: Subjects could pedal the leg-pedalling wheelchair using both legs alternately. The speed of this wheelchair was faster than that of the ordinary wheelchair, and the physiological cost index for pedalling it was lower than that for propelling the ordinary wheelchair. However, subjects needed some help in transferring to the leg-pedalling wheelchair. CONCLUSION: The hemiplegic patients could pedal the leg-pedalling wheelchair using both legs alternately faster and more effectively with regard to speed and physiological cost index.