運動イメージの想起が難しい脳卒中上肢運動麻痺患者へのミラーセラピーの効果—2症例での検討

The effects of Mirror Therapy on patients with stroke-induced upper limb motor paralysis who have difficulty recalling movement images: A two-case study

要旨：脳卒中後，運動イメージ（以下，MI）が低下した上肢運動麻痺患者の訓練に，ミラーセラピー（以下，MT）を組み合わせることで，MIや上肢運動機能を向上させるのではないかと仮説を立て検討した．対象は課題指向型練習を実施しているが，改善が芳しくなく，MIの想起が難しい2症例とした．MT導入期には課題指向型練習に加えて10分間のMTを約1ヵ月間実施した．その結果，2症例ともFMA-UEとSTEFの改善を認め，さらにMI評価であるMIQ-RS，メンタルクロノメトリーも改善した．MIが低下している患者の訓練にMTを組み合わせることでMIや上肢運動機能が改善する可能性が示唆された．

　[Introduction] We hypothesized that combining Mirror Therapy (MT) with training for patients with upper limb motor paralysis with reduced Motor Imagery (MI) after stroke might improve both MI and upper limb motor function, and we tested this hypothesis. [Methods] Two cases were selected in which task-oriented training was performed, but showed both limited improvement and difficulty in MI recall. During the introduction phase of MT, 10 minutes of MT were added to the task-oriented training for approximately one month. [Results] Both cases showed improvements in FMA-UE and STEF as well as MI assessments including MIQ-RS and mental chronometry. [Conclusions] The combination of MT in the training of patients with reduced MI suggests the potential for improvement in MI and upper limb motor function.