実生活の使用頻度の改善が認められなかった脳卒中後軽度上肢麻痺者に修正CI療法を実施した例

Implementation of the modified constraint-induced movement therapy for a stroke patient: A case study

要旨：麻痺手の機能改善に比べて，実生活での使用頻度の改善を認めなかった軽度片麻痺上肢に対して修正CI療法を実施した．事例は50歳代の男性，右片麻痺である．介入3週間で上肢機能は良好に回復してきたが，生活での上肢の使用頻度は改善しなかった．そのため，上肢用作業選択意思決定支援ソフトを用いて目標設定を行い，修正CI療法による介入を行った．結果，Fugl-Meyer Assessment，簡易上肢機能検査，Motor Activity Logが改善し，目標設定した多くの項目が麻痺手を利用して達成された．さらに，退院後も継続して上肢機能の改善が認められた．

　We performed a modified CI therapy for a patient with mild hemiplegia of the upper limbs. The patient was unable to improve frequency of usage of the affected arm in real life as much as the function of the affected arm. The case was a man in his 50s with hemiplegia of the right side. Three weeks of occupational therapy intervention saw improvement in upper limb function, but not in frequency of upper limb use. Therefore, target setting was done using upper-limb work selection decision support software, and modified CI therapy was performed. As a result, simplified upper limb function test, Fugl-Meyer Assessment, and Motor Activity Log improved, and many targeted items were achieved using the paralyzed hands. Continuous improvement of upper limb function was confirmed after discharging.