脳卒中片麻痺患者における発症早期からのズボン上げ下ろし動作練習の経過

Progress in pulling up and down trousers in the acute phase of stroke patients

要旨：本研究の目的は，脳卒中片麻痺患者に対して発症早期から健側縦手すりを用いたズボン上げ下ろし動作練習の経過を分析し，その特徴と自立を左右する因子を明らかにすることである．作業療法開始時，高次脳機能障害を伴っておらず健側大腿四頭筋のMMTが5の場合，下肢Br-stage Ⅴなら動作は1週で自立し，下肢Br-stageⅢ・Ⅳなら2〜3週で自立，下肢Br-stage Ⅰ・Ⅱなら6〜7週で自立した．つまり初回時の下肢Br-stageが低くとも動作は自立できた．高次脳機能障害の合併はズボン上げ下ろし動作の自立を阻害する大きな要因であった．今後は，高次脳機能障害を合併していても動作能力が高まる方法を検討することが課題である．

　The aim of this study is to investigate the progress of practicing pulling up and down trousers using a handrail on the non-affected side in acute phase stroke patients. Our results suggest that stroke patients were not affected by higher cortical dysfunction. The MMT score on the quadriceps was 5, and they were independent in pulling up and down trousers at 1 week at Brunstromm stage 5, at 2〜3 weeks at Brunstromm stage 3 and 4, and at 6〜7 weeks at Brunstromm stage 1 and 2. Stroke patients are dependent in pulling up and down trousers in cases of higher cortical dysfunction. The progress of these cases should be followed as much as possible, and we have to develop independence in cases involving higher cortical dysfunction in the future.