CLINICAL SURVEY ON 300 APHASIC PATIENTS IN. Shinichi WATABE, Shunichi SASAO and Itaru KIMURA. (Miyagi Byoin National Sanatorium, Miyagi)

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1 IRYO Vol.41 (10) 52 patients, and they were divided into four groups before admission. They were compared for their limb and hand function (Brunnstrom stage), ambulation, degrees of "ADL" disturbances (Barthel index). A similar study was made in 1978 by K. Hachisuka et al. Our data was compared with theirs. The number of patients, the days required for rehabilitation, their function (Br. stage) and "ADL" scores were almost the same. A great difference was found in ambulation. In 1978, most of our patients under the rehabilitation treatment were capable of walking by themselves upon discharge. Today many of our discharged patients are unable to walk without assistance. What is the reason for this? It has been suggested that the patients admitted to our hospital for rehabilitation have much more severe conditions. The following several differences were found : they were older than in 1978 ; some patients had bilateral hemiparesis ; some had ataxia ; some had a disturbance of higher cortical function, and/or dementia. Another point to be considered is the fact that the patients remain hospitalized for a shorter period. In 1978, those patients had to wait for over 13 months to be admitted for rehabilitation stayed for 26.4 months. Today those patients of the same waiting period were hospitalized for rehabilitation for only 7.0 months. This discrepancy between 1978 and today needs to be evaluated. The question is why the patients in 1978 remained for over 2 years for the treatment. Was it the degree of impairment or other complications such as psychological problems, age, and/or family condition and other vital factors? In our hospital from 1981 rehabilitation doctors were in complete charge of stroke patients. This means that it is important to concern not only for prime rehabilitation care but also to concern for both physical and mental condition of the patient and their family. In order to obtain successful results we think it very important to establish a close relationship between the patient and family. This will guarantee more successful rehabilitation. CLINICAL SURVEY ON 300 APHASIC PATIENTS IN MIYAGI BYOIN NATIONAL SANATORIUM Shinichi WATABE, Shunichi SASAO and Itaru KIMURA (Miyagi Byoin National Sanatorium, Miyagi) Three hundred patients with aphasia (240 men and 60 women, ages ranging from 10 to 88) were investigated in the study. They were all inpatients in Miyagi Byoin National Sanatorium from 1976 to 1985 for specific speech therapy. The results obtained were as follows 1) Male to female ratio of the 300 patients was 4:1. Their age distribution showed 9.2% below 30 years old, 22.6% in 40's, 33.6% in 50's, 26.0% in G0's and only 8.6% above 70

2 Oct years old. Hence, a total of 820 of the patients were classified into 40 `60 year-old range. 2) Type of aphasia :40% of 300 patients were categorized into motor aphasia, 23% into amnestic aphasia, 15% into sensory aphasia and 11% into total aphasia. 3) Cause of aphasia :280 cases(93%) were from cerebrovascular diseases. Head trauma, brain tumor and others were seen in 12, 4 and 4 cases, respectively. In cerebrovascular origin, hematoma was more frequently seen in yonger generations, on the other hand, infarction was more frequently seen in older generations. 4) Most remarkable improvement was noted in patients with amnestic aphasia, on the contrary, only insufficient effect was obtained in patients with total aphasia. 5) Prominent effect was obtained in patients who started speech therapy within 3 months. In chronic cases such as in cases over 6 months after onset of symptoms, improvement was usually poor. However, we should remind of some improvement in cases of over 12 months after the onset. 6) Our conclusion is that speech therapy should start as soon as possible following the onset of symptoms in order to obtain sufficient results. Reports of Joint Study Unit THE EFFECTS OF REHABILITATION IN PATIENTS WITH RECURRENT STROKES The Joint Study Unit of Rehabilitation in Japanese National Sanatorium The purpose of this study was to elucidate the effects of rehabilitation in the patients with recurrent strokes at the end of therapy. One hundred and thirty-six patients discharged from 25 national sanatoriums between April 1983 and March 1984, were examined using a questionnaire. The questionnaire consisted of three parts for physician, nursing staff and physiotherapist or occupational therapist. Forty-one percent of the patients improved in ambulation and 22.6 percent in the activities of daily living. The results suggest that the rehabilitation for patients suffering from recurrent stroke is associated with less favorable outcome than a single stroke, as shown in the published reports. The frequency of emotional disorder in these patients was as same as in patients with a single episode.

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