Tomioka Kazutoshi, Matsumoto Shuji, Ikeda Keiko, Uema Tomohiro, Sameshima Jun-Ichi, Sakashita Yuji, Kaji Tomokazu, Shimodozono Megumi
Department of Rehabilitation, Tarumizu Municipal Medical Center Tarumizu Chuo Hospital, Japan.
Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
J Phys Ther Sci. 2017 Feb;29(2):212-215. doi: 10.1589/jpts.29.212. Epub 2017 Feb 24.
[Purpose] This study investigated the short-term effects of a combination therapy consisting of repetitive facilitative exercises and orthotic treatment. [Subjects and Methods] The subjects were chronic post-stroke patients (n=27; 24 males and 3 females; 59.3 ± 12.4 years old; duration after onset: 35.7 ± 28.9 months) with limited mobility and motor function. Each subject received combination therapy consisting of repetitive facilitative exercises for the hemiplegic lower limb and gait training with an ankle-foot orthosis for 4 weeks. The Fugl-Meyer assessment of the lower extremity, the Stroke Impairment Assessment Set as a measure of motor performance, the Timed Up & Go test, and the 10-m walk test as a measure of functional ambulation were evaluated before and after the combination therapy intervention. [Results] The findings of the Fugl-Meyer assessment, Stroke Impairment Assessment Set, Timed Up & Go test, and 10-m walk test significantly improved after the intervention. Moreover, the results of the 10-m walk test at a fast speed reached the minimal detectible change threshold (0.13 m/s). [Conclusion] Short-term physiotherapy combining repetitive facilitative exercises and orthotic treatment may be more effective than the conventional neurofacilitation therapy, to improve the lower-limb motor performance and functional ambulation of chronic post-stroke patients.
[目的] 本研究调查了由重复性促进运动和矫形器治疗组成的联合疗法的短期效果。[对象与方法] 对象为慢性脑卒中后患者(n = 27;男性24例,女性3例;年龄59.3±12.4岁;发病后病程:35.7±28.9个月),其活动能力和运动功能受限。每位受试者接受为期4周的联合疗法,包括针对偏瘫下肢的重复性促进运动以及使用踝足矫形器进行步态训练。在联合疗法干预前后,对下肢的Fugl-Meyer评估、作为运动表现指标的中风损伤评估量表、定时起立行走测试以及作为功能性步行指标的10米步行测试进行了评估。[结果] 干预后,Fugl-Meyer评估、中风损伤评估量表、定时起立行走测试和10米步行测试的结果均有显著改善。此外,快速10米步行测试的结果达到了最小可检测变化阈值(0.13米/秒)。[结论] 重复性促进运动和矫形器治疗相结合的短期物理治疗可能比传统的神经促进疗法更有效,可改善慢性脑卒中后患者的下肢运动表现和功能性步行能力。