With the revival of interest in the mechanical derangement of the spine in this century and the demonstration that many forms of neurogenic pain were attributable to intervertebral disc protrusion or degenerative change of spine, traction began to be used in the treatment of painful conditions arising in the spine.

Cervical traction in contrast to lumbar traction is more widely used because of its effectiveness. But, to be effective, sustained cervical traction requires forces up to 35-45 pounds, which the patient can not tolerate for long periods due to pain and discomfort. The discomfort experienced by the patient from such large forces led to the, development of applying intermittent traction.

To study differences in results between the classical sustained and intermittent methods, experimental cervical traction with one fourth body weight was carried out on 13 normal adults and cervical spondylotic patients. The increase in the length of cervical spine and the discomfort which the patients felt were analyzed with the following results;

1. During each traction, average increase in the intervertebral disc space was 0.9-1.0 mm. There was no difference between the two methods. 5th disc space showed the largest increase and followed by the 6th space.

2. Average increase in the entire length of cervical spine during traction was 4.9mm in intermittent and 4.4mm in sustained traction.

3. 5 minutes after removal of traction, average increase in the entire length of cervical yertebra was 1.4-1.5mm.

4. A minimum of 25 pounds is needed for the increase in the cervical disc space in adults.

5. Patients experienced more discomfort in sustained traction than in intermittent traction, larger traction forces could be better tolerated by those on intermittent traction.

It was found from this study that intermittent traction is a more useful and effective method than sustained traction in treating several cervical spine conditions, because with a given traction weight similar effect can be obtained with lesser discomfort.

It is well known among physicians, employees and members of the Compensation Committee that there are many cloudy areas in the evaluation of persons who have sustained back injuries.

The physician's report can seldom be relied on wholly when it is mainly based on employee's statement regarding his injury.

The existing Table of Grades of Disability presently used by Labour Office is so simple and ambiguous, relative to back injury, that different opinions frequently occur, even though examining members attempt to be scientific and impartial.

This paper illustratrates a practical way of applying the Table of Grades of Disability as well as dimension of grades in relationship to the initial injury.

Electromyographic and Nerve Conduction Studies were carried out in 23 hemiplegic patients, 19 men and 4 women, for evidence of lower motor neuron involvement.

Patients ranged from 5 to 63 years in age and the majority had hemiplegia or hemiparesis secondary to cerebrovascular accident. 13 patients were right and 10 were left hemiplegia.

Careful histories were taken and examination made in an attempt to rule out all possible causes of peripheral nerve involvement resulting from diabetes mellitus, alcoholism, malnutrition or trauma.

The nerve conduction velocities in ulnar and peroneal nerves bilaterally in 17 hemiplegic patients with relation to skin temperature and calf circumference were studied.

Using concentric needle electrodes, electromyographic study was performed on the affected limbs in 23 hemiplegic patients.

The results obtained were summarized as follows.

1. Motor and sensory nerve conduction velocities in ulnar and peroneal nerves bilaterally in hemiplegic patients revealed a statistically significant slowing in the affected limbs compared with the normal limbs, but within normal limit.

2. Skin temperature of affected limb in both upper and lower, and calf circumference of affected limb were significantly lower than that of normal limb in hemiplegia.

3. Correlation between a low skin temperature and decreased motor nerve conduction velocity in the affected limb was found.

4. On EMG examination of affected upper limb, fibrillation potentials and positive sharp waves were found in 30.43% of hemiplegia and 85.71% of them had duration of 1 month to 6 months.