Hayashi Katsuki, Sakaguchi Shigeki
Department of Rehabilitation, Seiai Rehabilitation Hospital, Fukuoka, Japan.
Brain Nerve. 2010 Nov;62(11):1239-51.
Abstract Most stroke patients who have lost the ability to walking hope to recover this walking ability. In such cases, generation of adaptive gait patterns and development of realistic walking systems could aid in the performance of various activities. It is reported that the adaptive gait control patterns are generated by various neural domains, including the cerebral cortex, brainstem, and spinal cord, and are modurated by the basal ganglia and cerebellum. Walking dysfunctions after stroke are caused by abnormal reactivity, perception, cognition, plan for the locomotion and its constitution, muscle tone, and attitudinal reflexes. These abnormalities adversely affect posture and movement pattern, and give rise to dysrhythmia. Additionally, stroke patients suffer from disorders of higher brain functions. Thus, it is more difficult to generate adaptive gait patterns in such patients. However, there are few studies on concrete rehabilitation programs for patients with adaptive gait disturbance. In this paper, we introduce constitutive treatment methods for the recovery of walking function in our clinical setting and the task-oriented rehabilitation strategies for adaptation of realistic walking systems.
摘要 大多数丧失行走能力的中风患者希望恢复这种行走能力。在这种情况下,生成适应性步态模式和开发逼真的行走系统有助于进行各种活动。据报道,适应性步态控制模式由包括大脑皮层、脑干和脊髓在内的各种神经区域产生,并受到基底神经节和小脑的调节。中风后的行走功能障碍是由异常的反应性、感知、认知、运动及其构成的计划、肌张力和姿势反射引起的。这些异常会对姿势和运动模式产生不利影响,并导致心律失常。此外,中风患者还患有高级脑功能障碍。因此,在此类患者中生成适应性步态模式更加困难。然而,针对适应性步态障碍患者的具体康复方案的研究很少。在本文中,我们介绍了我们临床环境中恢复行走功能的构成性治疗方法以及适应逼真行走系统的任务导向康复策略。