Evaluation of the nutritional condition and the physical fitness of the stroke rehabilitation patients and the hemodialyzed renal failure patients, and exercise therapy for the improvement of their ADL and QOL

对于脑卒中和/或肾衰引起的血液透析患者，在进行康复治疗时，不仅要考虑损伤程度，还要考虑营养状况和身体素质，包括ADL和QOL。虽然后两个因素也影响康复目标，但很少有人注意到这一事实。由于他们很少同意，关于营养状况的数据很少，不足以进行分析。然而，对患者的体质进行了一些分析。在无氧阈下耐力运动8周后，氧亏和τon得到改善，peak-V^^< >O2和max-WR显著增加，ΔV^^< >O2/Δ WR显著降低。这些数据还表明，坡道试验与稳定速率运动负荷试验相结合的运动试验对评估身体健康是有用的。其次，采用手测器进行运动测试，揭示脊髓损伤患者的体能特征。对于肾功能衰竭患者，获得的资料很少。这个原因似乎是大多数患者由于缺乏改善自身不良健康状况的动力而不喜欢运动训练。作为研究之一，内毒素过滤器应用于透析器，以防止血液透析引起的一些并发症。这项试验是有效的，可能有助于带来更好的结果。简要总结了最大V^^< >O2及血液化学分析的部分资料。进一步的研究将继续进行。

Not only the impairment level but also the nutritional condition, and in addition, the physical fitness should be considered at the approach to rehabilitation, inclusive of ADL and QOL, of stroke patients and/or hemodialyzed patients caused by renal failure. Though the latter two factors also influence the rehabilitation goal, few people might pay attention to this fact.Because of their few consent, data on the nutritional condition have been few and inadequate to analyze. However, some analyses of the physical fitness of patients were performed.The improvement of the oxygen deficit and the τon, the significant increase of peak-V^^< >O2 and max-WR, and the gnificant decrease of ΔV^^< >O2/Δ WR were attained after the endurance exercise at the anaerobic threshold for 8 weeks. These data also indicated that exercise testing by a ramp test combined with a steady rate exercise stress test are useful to evaluate the physical fitness. Next, the characteristics of the physical fitness of patients with spinal cord injury were revealed by the exercise testing using the handergometer.Regarding the renal failure patients, few data were obtained. This reason seemed to be that most of the patients would not like the exercise training for lack of the motivation to the improvement of their poor health condition. As one of the studies, the endotoxine-filter was applied in the dializer to prevent some of the complications caused by hemodyalysis. This trial was effective, and might be useful for bringing the better outcome. Few data of the maximal V^^< >O2 and the blood chemical analysis were briefly summarized. The farther research will be continued.