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The pharmaceutical remedy had already been invented buy discount fluticasone on-line, and this was a remedy for the masses order fluticasone australia. The period of post-industrial production began in the latter part of this century purchase fluticasone line. Like all new epochs, it came quietly at first, heralded by almost unnoticed changes in the means of production. Their demise gave birth to cleaner machines, able to create even greater but less visible power. A revolution in the method of production changes everything, even our ideas and our relationships. The change which is upon us now, from material power to invisible information-based power, is a vortex. In the most conservative and power-based sciences the transition from the old physically based knowledge to the new more imaginative age has been hard won. The knowledge of the sciences which grew out of the industrial revolution consisted of immutable abstractions welded to social power. I, were touched by the image of the scientific investigator who operates with a deadly detachment and laboratory efficiency, and science came thus to be invoked by Americans to preserve than from subversives within as well as from enemies without. Chapter One The American Origins of Scientific Medicine Powerful medical drugs easily destroy the historically rooted pattern that fits each culture to its poisons; they usually cause more damage than profit to health, and ultimately establish a new altitude in which the body is perceived as a machine run by mechanical and manipulating switches. American medical orthodoxy throughout the first half of the nineteenth century consisted of homoeopathic and herbal practices used mainly by the rural population. Allopathy has come to be the prevailing orthodox medical practice in America and Europe. Despite the fact that allopathic medicine practised many forms of treatment, such as bleeding, which were later found to have no scientific foundation, allopaths maintained a sublime confidence in their professional discipline. The insistence of homoeopaths that they could treat the whole person, and their assertion that they could deal with not only the physical but also the emotional and spiritual, left them open to accusations of religious mysticism. Those doctors who were brave enough to make public their practice of homoeopathy were expelled from the growing state medical societies. One of the arguments most frequently used by allopaths against homoeopaths was that they charged large amounts of money for treatment. On the whole at this time, salaries for allopathic physicians were low, and there was a need for them to develop some kind of strategy for wage protection. One way in which higher standards and therefore higher esteem could be introduced to the allopathic profession was by rationalisation. Lurking behind many of the professional desires of the allopaths was their confident belief in the universal correctness of science. The Medical Follies; An Analysis of the Foibles of Some Healing Cults, including Osteopathy, Homoeopathy, Chiropractic, in 1925. Rockefeller : Patron of Scientific Medicine For the first quarter of the twentieth century the Rockefeller officers developed a definite strategy for their capital investment in medicine. The strategy sometimes supported and often opposed different interests in medicine, but such alliances and conflicts were never accidents 6 on the part of the foundation. It was a concept which was taken up very quickly by both the allopathic professional elites and industry. This marriage of medicine and industry was particularly apt because in the practice of allopathy neither the mind, the emotions nor the soul, were involved in any degree as causal agents in illness or its treatment. Such reductionistic material theories of the person were a perfect adjunct to the material theories of engineering which had produced the wealth for the new industrial middle class. The profit which industry hoped to gain from medical science was not only financial nor just related to the advancement of mutually advantageous technology and chemistry. The greatest profits would come from an idea which was then merely a glimmer in the eye of industry. The welfare and the control of the human body and its processes were throughout the first half of the 20th century a matter of vital importance to industrialists. Before the development of sophisticated machinery, the human body was the essential link in the process of industrial production. The most important patron of scientific medicine in America, and consequently throughout the world, in the twentieth century has been the Rockefeller family. By the end of the nineteenth century he was keen to offload some of his wealth into charitable and educational causes. When his money first intervened in the world of medicine, whatever his own personal intention, the result was the consolidation of the growing partnership of medicine and industry. The new model was one which leant heavily towards industry and biological research while utilising copious quantities of synthetic pharmaceuticals. His individualistic and idiosyncratic philanthropy was replaced by a corporate plan based upon materialism and scientific development. He had argued that his philanthropy should deal equitably with homoeopathy but this view was vehemently opposed by Frederick T. Of that science 9 you, perhaps more than any other single man, are entitled to be called the financial father. Because so many schools questioned their rating, the Council asked the Carnegie Endowment for the Advancement of Teaching to report on the matter. At this time Rockefeller interests already had considerable influence within the Carnegie Foundation. Another Flexner brother, Bernard, later became a founding member of the Council on Foreign Relations and a Trustee of the Rockefeller Foundation. The Flexner Report set an absolute standard for medical education in America, absolute because those schools which its on-going assessment found wanting were denied the right to award meaningful professional qualifications by state examining boards. By the end of the First World War, the number of medical schools in America had been reduced from 650 in the first 12 decade of the century to 50. Consequently, the effect of the Flexner Report was not only academic: disproportionate cuts meant that medical care for affected l3 groups dropped drastically. Following the Flexner Report, Rockefeller joined with Carnegie to begin funding medical education. By 1938 contributions from all foundations to medical l4 schools exceeded $150 million. Rockefeller and Carnegie began immediately to shower hundreds of millions of dollars on those better medical schools that were vulnerable to control. Those that did not conform were denied the funds and the prestige that came with those funds, and were forced out of business. The Carnegie Foundation, like the Rockefeller Foundation, had previously poured resources into black education of all kinds, believing that black leaders should be educated. The Flexner Report represented the beginning of industrial control over medicine in America. Control over medical education ultimately meant control of the content and direction of research. The Carnegie and Rockefeller Foundations were by this time absolutely sure of where they needed to take medicine.

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On hospital day 3 cheap fluticasone line, he was orientated and could follow one- values cheap fluticasone 100 mcg with amex, a red graph shows the number of pixels when the image of step commands buy 500mcg fluticasone with amex. Despite clearance of parasitemia on hospital day the paralyzed hand is made two values, and the graph of the pea 4, he developed expressive aphasia, intentional tremors and could green is a number of pixels when the difference between a healthy only intermittently obey commands. Electroen- an index that was quantitatively appreciable of the passage of the cephalogram showed mild diffuse encephalopathy without epilepti- therapeutic gain and the improvement was suggested. On hospital day 7, his verbal output improved but he was noted to have cerebellar speech. Improvements were seen in his behaviour, mood and Functional Independence Measure. As there is no ‚Äúgold standard‚ÄĚ to guide rehabilitation in strate disruption of neurocognition, particularly those mediated by survivors of severe malaria, it remains a challenge to rehabilitate subcortical and frontal regions. All this results pointed on high patient`s awareness about their sleeping problems. Material Rehabilitation Institute of Neuromuscular Disease in Gangnam Sev- and Methods: Ten subjects with hemiparesis participated in this erance Hospital were studied from Jan 1 , 1999 to Mar 31 2015. Pulmonary function and respiratory muscle strength quantitative comparisons assessing gait parameters, including the were measured in sitting position. This deformity is character- ized by fexion of the methacarphophalangeal joints, extension of the Introduction/Background: Dystrophic myopathy is a big subtype proximal interphalangeal joints, fexion of the distal interphalangeal of myopathic disorders which leads to weakness and disability. It is also called ‚Äėrheumatoid-like‚Äô deformity main pathogenesis is the mutation of encoding gene responsible for due to typical image. It causes hand posture abnormality and impairs producing cell membrane stabilizing proteins. According to high the life quality of patients by reduction in dexterity, pain and deform- prevalence of muscle dystrophies in whole word and our country ity. Patients were engaged in a stepwise progres- the ideal approach for prevention, early diagnosis, treatment and sion of interventions focused on restoration of normal function, rehabilitation of patients so helping them and their families to have with copious positive reinforcement on mastering each step in the a higher quality of life. Concurrently, patients were engaged in psychologic evaluation, assessing life stressors and potential symptom reinforc- ers, with subsequent interventions as appropriate. Symptom duration and chiatry, Physical Rehabilitation, Kodaira, Japan, 2National Center treatment duration were moderately correlated (r=0. Hospital- National Center of Neurology and Psychiatry, Neurol- Conclusion: Inpatient behavioral treatment of motor conversion ogy, Kodaira, Japan disorder symptoms appears effective in a rehabilitation setting, with lasting treatment effects. We suggest using lower leg orthoses for patients which can be provided walking stability. Results: 1University of Malaya, Medicine, Kuala Lumpur, Malaysia Eighty-two patients were identifed. Contralateral neglect is common showed abnormal gait and frequent falls due to knee instability, in cortical strokes. Healthy young people have slight leftward at- drop foot and ankle sprain injuries. All the patients were able to tentional bias due to right hemispheric dominance (pseudoneglect). The The main reasons for ceasing the use of orthosis were pain, did not objective of the study was to evaluate whether the elderly people feel the necessity to use orthosis, increased walking instability and exhibit a rightward attentional bias in line bisection, as compared to beginning of use wheelchair. The results of this audit indicated and did not have history of stroke and transient ischaemic attack. A consider- All participants performed line bisection test and star cancellation able reason is their personality trait and cognitive function. In line bisection test, participants were instructed to place a er, we could not fnd suffcient cognitive data of the patients. A deviation of we couldn‚Äôt reveal any factors for showing usefulness of orthoses more than 6 mm from the midpoint indicates unilateral spatial ne- treatment. In star cancellation test, the stimuli were large 52 large stars, 13 letters and 10 short words interspersed with 56 smaller stars. Introduction/Background: Conversion Disorder is a clinically chal- lenging entity in which neurologic symptoms such as motor weak- 612 ness are not found to have an organic cause. Kikuhara , disorder symptoms involving gait (eg hemiparesis, paraparesis, 1 4 1 2 5 tetraparesis). Asato 1National Tama-zenshoen Sanatorium, Department of Rehabilita- cal, neurologic, or psychiatric disease ‚Äď no patients met exclusion criteria. All patients were treated in an inpatient rehabilitation unit tion, Higashi-Murayama, Japan, 2Keio University School of Medi- setting. Treatment utilized a behavioral approach, with an explana- cine, Department of Rehabilitation Medicine, Shinjuku-ku, Japan, tion to the patient that their symptoms were due to stress related 3Tokyo National Hospital, Department of Rehabilitation, Kiyose, interruption of communication between the brain and the affected Japan, 4National Tokyo Medical Center, Department of Rehabili- body parts. The affected body parts were immobilized (typically by tation, Meguro-ku, Japan, 5National Tama-zenshoen Sanatorium, having the patient either in bed or in a wheelchair) except when Department of Surgery, Higashi-Murayama, Japan J Rehabil Med Suppl 55 Poster Abstracts 179 Introduction/Background: The patients with Hansen‚Äôs disease are M. Rheu- one of the major concerns of these patients, the number of studies matology Div. Material and Methods: 4 Malaysia, Marmara University- School of Medicine, Cardiology, Five patients with sequelae of Hansen‚Äôs disease were included in Istanbul, Turkey this study. It has 5 subdomains: anginal stabil- foot pressure was assessed using F-scan system. Results: Although ity, physical limitation, anginal frequency, treatment satisfaction no signifcant correlation was observed between the touch sensation and disease perception. Patients who were diagnosed of severe sensory disturbance and high weight bearing. Conclusion: coronary artery disease and angina by a cardiologist were recruited It is legitimate that the body weight is borne on the part without se- into the study. Cronbach alpha was calculated for internal consist- vere sensory disturbance consistent with previous studies. Face validity was assessed via cogni- the particular pattern seems the pathogenesis of the plantar ulcer tive debriefng interviews with patients. Convergent and divergent in which high weight bearing is constrained to a plantar part with validities were assesed for determine the construct properties of sensory loss dues to the severe deformity of joints or the paresis. Kim 1Chonnam National University Medical School and Hospital, Phys- therapy intensity and medical supervision during programme. The exercise intensity method prescribed for these patients should Results: Mitofen has the expressed impact on mechanisms of tissue differ over time since the onset of acute myocardial infarction. After a course of recovery correction, it was observed: increase 616 of activity and mood (85%), jet uneasiness when forming adverse weather conditions decreased. Hsu2 activation of endogenous bioregulators, restoration of adaptation 1 shifts and the weather climatic factors increasing tolerance of an Kaohsiung Medical University Hospital, Department of Rehabili- 2 organism to external adverse effects. Data were examined by normality distribution Introduction/Background: Intermittent claudication is the most test before processed by further statistics. These results suggest that exercise training for hip fexor functional correction of the organism for meteosensitive persons muscle may increase walking distance and mitigate calf pain during with arterial hypertension. Extent of change of tolerance to weather conditions 619 under the infuence of a course of recovery correction was esti- mated. A total of 43 pa- 1 1 2 tients (15 elderly patient (‚Č• 60) and 28 younger patient (< 60)) were in- W. Chung-Han 1Chi-Mei Medical center- Chiali, Department of Physical Medicine cluded in this study.

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Goodman accepted the job and within a short time was engrossed in a mountain of material about germanium cheap fluticasone online. From the beginning best purchase fluticasone, it was the immunological information that Goodman found fascinating generic 250 mcg fluticasone free shipping. She read about how germanium modulated the immune system and how it had been used to fight cancer. Papers published in Japan showed precisely the effect which the mineral had upon the immune system. Although she had begun her work with a degree of cynicism, Goodman found that the results in many of the vast number of papers she reviewed were impressive and recorded by reputable scientists. Coming to the end of her work for Monica Bryant, she decided that even if she could not find funding for such work the information should be published. When she had finished her review, assessing the claims made for germanium, she began a search for someone who might help her publish a book. Monica Bryant Monica Bryant has committed most of her life to the field of human nutrition and health. With others, she has brought to British nutrition the experience and the learning of the American field leaders, and an experience of Scandinavian and German approaches to biological medicine. On her own initiative, she was involved in work to improve prison nutrition and attended the first meeting at the House of Lords on this issue. In the mid-eighties she lectured in nutrition at the University of Sussex for four years. In 1984, on a visit to Denmark, she learnt about probiotics, the use of beneficial lactic acid producing bacteria to maintain health. In February 1986 she published one of the first British articles on the use of probiotics for human 64 health. Monica Bryant felt proud of the fact that she was a pioneer in bringing probiotics to Britain. This approach to health seemed timely when doctors were getting disillusioned with the adverse effects and over-use of antibiotics. Probiotics were a natural way to redress the imbalances created in the intestinal flora through the use of drugs and stressful lifestyle habits. In Europe, lacto-fermented foods are commonly used for their health-giving qualities. In 1986, with her business just keeping afloat, Bryant was offered the agency, in Britain, for germanium. Germanium had not previously been marketed in Britain as it had in other European countries. Being a responsible person, Bryant felt the need to obtain a review by a scientist of all the information currently available about germanium. Monica Bryant could see that germanium had a wide range of established uses: it had an oxygen-enhancing effect, and helped interferon production, as well as modulating the immune system in other ways. In 1986, she set up an agency called Symbiogenesis; a number of major companies acted as distributors for her. No claims were made for germanium and the information on the packets was kept to a few lines which Bryant had cleared with the Products Advertising Authority. Then Monica Bryant developed her own probiotic product, giving it the trade name Symbion. The supplier for the particular bacterial strain which Monica Bryant used in Symbion was a man called Yves Delatte. Delatte delivered the bacteria directly from the University of Dundee, where it had been made up. Yves Delatte Yves Delatte is a European, a man who has spent much of his life shuttling between France, Holland, Finland and Britain. In 1979, Delatte was working with a French company, developing probiotics for use in animal welfare. He was working principally with mink which, because of constant inbreeding in captivity, have a weak immune system. In 1986, Delatte and his work were taken up by a Swedish company, Kemi Interessen, part of the Kema Nobel group. The company wanted to develop his ideas and work on probiotics, for use in animal welfare, again with mink. His work with Kemi Interessen took Delatte to mink farms in Ireland and Scotland, and during this time he settled in England. He worked for only a year with Kemi Interessen, and left following disagreements about the direction which his research should take. This was a difficult time for Delatte, for as well as leaving his job, he had to stay for two months in a Finnish hospital with one of his daughters after she became seriously ill. In 1987, after his daughter had recovered, Delatte came to England again, to tie up his work and his papers. During the first months of 1988, unsure about his future, he continued his research working alone, using probiotics with mink, dogs and horses. What he would have liked to do was set up a business and get his research on a firmer footing. In the summer of 1988, he began to consider the possibility of using lactic-bacteria for humans with immuno-suppressive illnesses. By that time Delatte had been using probiotics in animal welfare for a period of fifteen years, and had developed considerable knowledge. In London, he talked to Dr Dorothy Brey, a researcher in the Department of Protozoology, at the London University School of Hygiene and Tropical Medicine. With Dr Brey, and mainly at her suggestion, Delatte patented his probiotic formula. Delatte gave Emblam 10 per gram, quantities of lactic bacteria, mixed with milk powder to bulk it out. Delatte was careful to ensure that Emblam first obtained the authority of his general practitioner before taking the treatment. The general practitioner soundly advised him that, at worst, the remedy would do him no harm. Happy with his treatment, Michael Emblam sent three other people to Delatte and so began a small cohort of people, who started to see him regularly and to whom he gave probiotic treatments. For the first few months of this work, Delatte charged no-one for the preparation. The substance was costing him about £800 a kilo and he was giving out three or four kilos a month. Dreer persuaded Delatte to set up in business and produce a properly packaged product which could be distributed through doctors or alternative practitioners. Up until the autumn of 1988, Delatte had been importing the basic constituent of his probiotic treatment from America.

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Demograph- very well implemented and suffciently standardized in many coun- ic data was showed as followed: male: 12; age: 79 generic 100mcg fluticasone with mastercard. Fall incidence is the patients from 2008 to 2014 which our department of Geriatrics 3/15 buy generic fluticasone 500mcg line. Fall has a moderate correlation orthopaedic and internal/cardiological departments generic fluticasone 500mcg amex. It does not as well as 286 cardiological/internal patients with an average age disturb the movement of the larynx. Each subject was fxed to the stable posture of the head and is possible to obtain a suffcient functional progress for all patients asked to swallow a spoonful of jelly and 3mL of water. Displacement of the bright spot matrix was analyzed and 737 calculated laryngeal elevation time. Lan2 measured laryngeal elevation time using a newly-developed optical 1China Medical University, Department of Physical Therapy, Tai- laryngeal organ motion analysis system. Positive correlation was chung, Taiwan, 2China Medical University, Department of Health found between age and the laryngeal elevation time in water swal- Risk Management, Taichung, Taiwan, 3China Medical University, lowing, whereas no signifcant correlation in jelly swallow. Katsuki1 has been little available evidence about the barriers and facilita- tors of people‚Äôs health in the community caring centers in Taiwan. Par- formula and that can be directly connected to feeding tubes with an ticipants were also invited to wear a wrist-band physical activity re- adapter. Results: Overall, 127 participants id enteral formula and an adapter reduced the time of nursing work completed the questionnaires (age: 74. Material and of those, 5 also agreed to wear the physical activity record- and Methods: Five trained nurses were recruited for the evaluation. With the good validity of wearable health tion, and cleaning were measured with a stopwatch. Results: Left orthopedic events were more common rehabilitation between the two groups. Material and Methods: A 73-year-old woman pre- 1 National Taiwan University Hospital - Hsinchu branch, Physical sented to our facility with neck and upper extremity radiating pain Medicine and Rehabilitation, Hsinchu, Taiwan for 2 months. Electromyography and nerve to the data of Ministry of Health and Welfare, it suggested that elderly conduction studies revealed right C7 nerve root compression with population is expected to rise above the fourteen percent threshold moderate denervation, right C5 and C6 irritation without denerva- in 2018, making Taiwan an ‚Äúaged society‚ÄĚ. The degree of foraminal stenosis inaccordance with the degree needs of this rapidly increasing elderly population, the government of neurological disturbances. She was planned to have operation if has been promoting long-term care programs and building a com- no improvement occur after rehabilitation program. In addition, the government was given asymmetrically (right traction force more than left side) on designed a national long-term care insurance system, and has started cervical area starting from 10 minutes and customized every therapy. Many elderly ity with cervico, massage and laser, pain gradually reduced from people who suffered from chronic illness or injuries need care and visual analogue scale 7‚Äď8 until 0. Conclusion: Cervico regard to the care of disabled elderly people, who make up about as dynamic traction has been proven to be effective in alleviate pain twenty percent of all elderly people, we provided home-based physi- in geriatry with cervical radiculopathy. Further research are needed cal therapy for this population after they discharge from the hospital. Material and Methods: Three hundred forty seven patients received home based physical therapy from 2011 to 2015 in our hospital. Physical therapists provided one session per week, and six sessions per year at most. We show gratitude to National Taiwan Uni- eligible and were screened on their abstracts. Recently, the based on residence prior to admission: 1) hospital, 2) home, and 3) possibility of vibrator stimuli reducing dyskinesia was reported. Material and Methods: 70-year-old woman who suffered limb contains 18 tasks composed of 13 motor tasks and 5 cognitive dyskinesia due to chronic subdural hematoma. Conclusion: rehabilitation therapy showed the effect on geriatric residents who We determined that short-term vibrator stimuli has the potential to were considered to be ‚Äúnot disabled‚ÄĚ among those who transferred improve dyskinesia through this case. In this case, the enhanced proprioceptive information induced by vibrator stimuli may improve dyskinesia. Material and Methods: A trunk fexion and extension and the specifc ranges of motion review was performed by obtaining publication of all papers from have been recommended to objectively assess muscle function in various databases reporting on postural control and gait pattern in chronic low back pain patients. The keywords age (<40 versus 40 to 60 versus >60 years) and sex related differ- used for literature searching were ‚Äėpostural control‚Äô, ‚Äėbalance‚Äô, ences during a standardized trunk fexion-extension task. Material ‚Äėspatiotemporal gait parameters‚Äô, ‚Äėdiabetes mellitus‚Äô, and ‚Äėdiabetic and Methods: A total of 216 patients [62 aged 60‚Äď90 years (33 peripheral neuropathy‚Äô. The searching was limited to English, aca- females), 84 aged 40‚Äď59 years (44 females), and 70 aged 18‚Äď39 J Rehabil Med Suppl 55 Poster Abstracts 217 years (34 females)] performed testing by holding static positions tive method of gait training. The lumbar extensor mus- chronic stroke patients who were more than six months post-stroke cle activity and the ranges of motion at the hip and lumbar spine participated in this study. All participants were randomly assigned were recorded and calculated from L5 and T4 levels. Ridge regressions investigated mill training, foot switches were attached to the participants‚Äô heel the impact of physical-functional and psychological variables on and Microsoft visual C++ 2011 software was used. Results: Measurements pants started to walk and make an initial contact on their less af- revealed highest muscle activity at standing in the oldest and fected side, the software sensed the foot pressure through the foot the female group. Patients over 60 years showed lowest activity switch and provided real-time auditory stimulation for the partic- changes from standing to the half (increments) and from half to the ipants. Patients in the treadmill group received had higher gross trunk ranges of motion than males. Conclusion: This standardized trunk fexion- sessment of static balance and gait abilities: Balancia (software), extension task involving isometric test positions is feasible for Timed Up and Go Test. Results: Signifcant differ- pattern and the kinematics changed according to age and sex. Kigawa2 ods: Five patients who had subacute hemiplegia over 3 months, 1Hanno City, Japan, 2Hanno-Seiwa Hospital, Rehabilitation Cent- less than 12 months after they were diagnosed as stroke patient by er, Hanno City, Japan, 3Saitama Medical University- International physician were participated. In addition occupational performance satisfac- walking with lateral Nordic pole and T-cane in the stroke patient. After walk speed was stable, we caluculated integrated vale of myoelectric potential (mV. Kim2 support the weight with use of T cane, which could cause the risk 1Sahmyook University, Physical Therapy, Seoul, Republic of Ko- of carpal tunnel syndrome. Tekin1 Introduction/Background: The purpose of this study was to meas- 1 Gulhane Military Medical Academy - Haydarpasa Research and ure the effectiveness of a rehabilitation program in a population of Training Hospital, Physical Medicine and Rehabilitation, Istanbul, patients with ataxic neuropathy and to determine the infuence of age on the gains observed in static and dynamic conditions. Mate- Turkey rial and Methods: Twenty two patients with characterized bilat- Introduction/Background: Spasticity in stroke patients is one of eral sensory ataxia were included in this study. It may affect patients‚Äô self-care and criterion was proprioceptive loss with a decrease in joint position activities of daily living and disrupts the patient‚Äôs appearance, bal- sense at the big toe level or reduced turning torque perception at ance and walking pattern. All had clinical, electrophysiological and histologi- of focal and multifocal spasticity such as streching, bracing, oral cal data corresponding to a well defned polyneuropathy. Material and Methods: The instrumental evaluation of balance and gait was performed us- A 57-year-old woman with 41 months history of stroke resulting ing a force Platform and a Locometre. The rehabilitation program in right hemiplegia was admitted to our outpatient clinic.