ニューロリハビリテーションからみた適応的歩行

Adaptive Gait from the Neurorehabilitation Perspective

近年，歩行の神経機構や運動機能回復のメカニズムが明らかにされ，そうした知見をリハビリテーションの臨床に活かす試みがある。ニューロリハビリテーションとは神経科学の知見をリハビリテーションの臨床に活かす試みであり，本論ではニューロリハビリテーションからみた適応的歩行と題して概説した。特に，脳卒中後に生じる歩行障害に着目し，その特徴，ならびにニューロリハビリテーションの戦略を網羅的に解説した。

Abstract

Recent studies have reported the neural mechanisms underlying gait and motor function recovery; neurorehabilitation involves application of these findings to clinical rehabilitation. This article focuses on post-stroke gait disorders. Gait disorder in patients with hemiplegic stroke is characterized by reduced walking speed, which is attributable to merged muscle synergies and a decreased trail limb angle. This paper describes the aforementioned factors and recent clinical research that confirms the role of the volume of gait as the most important factor, as well as evidence of various intervention methods. Furthermore, it is necessary to experience walking in various contexts and environments to achieve adaptive gait.