[Palliative rehabilitation of two patients with terminal stage cancer: a visit to patient's home and the provision of advice by a nurse and rehabilitation staff members before discharge--from physical therapist's perspective].

We report two patients with terminal stage cancer who spent some days at their home after a physical therapist, occupational therapist, nurse, and medical social worker all visited the patients' homes and advised the patients' family in regard to the appropriate care before the patients were discharged as a strategy for palliative rehabilitation. Case 1: A patient suffering from terminal stage cancer was bed-ridden because of a pathological fracture of the femur. After palliative rehabilitation, the patient was able to get out of the bed and improved her daily living activity level through physical therapy. She spent some days at home according to the results of the pre-discharge home visit guidance to her family. Case 2: A patient suffering from terminal stage cancer manifested symptoms of fatigue and generalized muscular weakness. After palliative rehabilitation, her muscle strength and physical endurance were improved by physical therapy and adjustment of the bed height. Because she was eager to go home, we took her to her home before being discharged, and she was able to spend a few hours at home. Pre-discharge home visit guidance by a nurse and rehabilitation staff members to the patient' s family in regard to appropriate home care may therefore be a good means of satisfying such patients' desire to see their home once more and thereby improve their quality of life.

[Walking assist robot and its clinical application].

The walking assist robot was developed to improve gait disturbance in patients with severe disabilities. The robot had a trunk supporter, power generator and operating arms which held patient's lower extremities and simulated walking, a control unit, biofeedback system, and a treadmill. We applied the robot-aided gait training to three patients with severe gait disturbance induced by stroke, axonal Guillan-Barré syndrome or spinal cord injury, and the walking assist robot turned out to be effective in improving the gait disturbance.

[Physical therapy for four patients with severe axonal Guillain-Barré syndrome in acute stage].

We describe four male patients suffering from quadriplegia caused by axonal Guillain-Barré syndrome. They were diagnosed with axonal Guillain-Barré syndrome based on their clinical course and electrophysiological findings. Three patients had severe pain, two had marked elevation of serum creatine kinase, one had finger contracture, and two required mechanical ventilation. Two of the patients recovered during the period from nadir to discharge in the Hughes functional grading scale and Barthel index. A physical therapist should understand the characteristics of severe axonal Guillain-Barré syndrome in an acute stage, and consider the psychological status of the patients.

[The clinical effect of lateral wedge on hemiplegic weight bearing].

The purpose of this study was to investigate the influence of the lateral wedge on asymmetrical weight bearing and posture in hemiplegic gait. The subjects were 2-female and 4-male moderate stroke patients, average age 54 +/- 6 yr. The time from onset was 127 +/- 69.7 days. A 7 mm-thick wedged insole was applied to the affected side for a week. Before and after that, the vertical ground reaction force, single supporting period and side movement of the trunk were recorded during walking. As a result, we found that the vertical ground reaction ratio and single supporting period ratio of the affected side (affected/unaffected) were significantly increased (P < 0.05), and also that the lateral sway of the trunk was remarkably decreased (P < 0.05). Our results indicate that the application of the lateral wedge for a week improved asymmetrical weight bearing and gait ability in moderate hemiplegic patients. Also we believe that a randomly sampled comparison study should be performed in the near future.