Toyoshima Sho, Ichikawa Yukiho, Ikeda Naoto, Sezaki Yui, Yokoi Yuka, Morishita Katsuyuki
Department of Rehabilitation Science, Graduate School of Health Sciences, Josai International University: 1 Gumyo, Togane, Chiba 283-8555, Japan.
Department of Rehabilitation, Rakusai Shimizu Hospital, Japan.
J Phys Ther Sci. 2025 May;37(5):231-239. doi: 10.1589/jpts.37.231. Epub 2025 May 1.
[Purpose] This study aimed to examine the effect of body weight-supported overground training on gait recovery in a patient with severe stroke-induced hemiplegia. [Participants and Methods] The participant was a woman in her 40s with severe hemiplegia following a stroke. A single-case ABAB design was employed. Standard physiotherapy was provided in the first and third phases, while physiotherapy combined with body weight-supported overground training was administered in the second and fourth phases. Walking speed, Timed Up and Go test, Brunnstrom recovery stage (BRS) and Fugl-Meyer Assessment (FMA) for motor function, and motor-functional independence measure (m-FIM) for activities of daily living (ADL) were performed to assess efficacy of body-weight-supported overground training. [Results] Walking speed improved from 0.26 m/s at admission to 0.37 m/s in the first phase, 0.58 m/s in the second phase, 0.45 m/s in the third phase, and 0.50 m/s in the fourth phase, reaching 0.40 m/s with a T-cane at discharge. m-FIM scores increased steadily from 20 points at admission to 74 points at discharge, while BRS and FMA showed minimal improvement. [Conclusion] Body weight-supported overground training may enhance walking ability, functional performance, and ADL independence in patients with severe stroke-induced hemiplegia.
[目的] 本研究旨在探讨减重地面训练对重度脑卒中偏瘫患者步态恢复的影响。[参与者与方法] 参与者为一名40多岁的女性,因脑卒中导致严重偏瘫。采用单病例ABAB设计。在第一阶段和第三阶段提供标准物理治疗,而在第二阶段和第四阶段实施物理治疗结合减重地面训练。通过步行速度、计时起立行走测试、Brunnstrom恢复阶段(BRS)和运动功能Fugl-Meyer评估(FMA)以及日常生活活动(ADL)的运动功能独立性测量(m-FIM)来评估减重地面训练的疗效。[结果] 步行速度从入院时的0.26 m/s提高到第一阶段的0.37 m/s、第二阶段的0.58 m/s、第三阶段的0.45 m/s和第四阶段的0.50 m/s,出院时使用T形手杖的步行速度达到0.40 m/s。m-FIM评分从入院时的20分稳步提高到出院时的74分,而BRS和FMA的改善最小。[结论] 减重地面训练可能会提高重度脑卒中偏瘫患者的步行能力、功能表现和ADL独立性。