脳卒中片麻痺患者の手・指の関節拘縮と痙性の減弱に及ぼす徒手他動運動と空圧装置の他動運動との効果比較

Comparison of Manual and Air Glove Passive Exercise for Hand Joint Stiffness and Spasticity in CVA Hemiplegic Patients

要旨：脳卒中後片麻痺患者計100名を4群に分け手指関節拘縮除去あるいは手指屈筋痙性減弱を目的として，徒手他動運動あるいは空圧装置による他動運動を，各群3週間実施した．実験期間中は目的に適した他の治療はせずに，通常の作業療法等のみ実施した．実験は病院，担当医，患者の同意を得て，明記した治療・評価方法を担当作業療法士に訓練して実施した．手・指の関節可動域あるいは手・指屈筋痙性は，各週の治療前後の2回と第3週の最終治療実施前の，計7回測定した．徒手他動運動も空圧他動運動も，第3週の最終治療実施前と第1週治療前に有意差なく，治療効果は明確でなかった．しかし，3週間の治療実施前後に有意差を認め，徒手他動運動と空圧他動運動各々に，関節拘縮と痙性の増悪を予防する効果があった．したがって空圧他動運動は，関節拘縮と痙性の予防のための治療として，徒手他動運動に代替し得た．

　100 post cerebral vascular accident hemiplegic patients in four groups were given exercises with manual or with air pressure glove for three weeks aimed at eliminating finger joint contracture or reducing flexor spasticity.

　Other treatment pertinent to the objective were suspended during the period of the tests and only normal occupational therapy was implemented. With the consent of the hospital, the physician in charge and the patients, the occupational therapy supervisor was trained in the specified methods of treatment and appraisal and then administered the test. The joint range of motion of hand and fingers and the spasticity of hand and fingers were measured seven times, that is, twice each week before and after treatment and before the final treatment at the end of the third week.

　Both the exercises with manual and exercise with air pressure glove, there was no significant difference between the measurement before the third week's final treatment and before the first week's treatment, so the effect of the treatment was not clear. However, a significant difference was observed before the first week's treatment and after the third week's treatment. The exercises with manual and the exercises with air pressure glove were each effected in preventing joint contraction and spasticity from becoming worse. Therefore, as a treatment for prevention of joint contraction and spasticity, the exercise with manual could be replaced by exercises with air pressure glove.