脳卒中患者に対するMTDLPの実践過程において修正CI療法を実施した一事例

Modified Constraint-Induced Movement Therapy for MTDLP in a stroke patient: A case study

要旨：Management Tool for Daily Life Performance（以下，MTDLP）は，重要な生活行為に焦点を当てた介入のプロセスをマネジメントするためのツールである．本報告では，利き手に軽度の運動麻痺を呈した回復期の脳卒中患者に対し，MTDLPの過程で，Constraint-Induced Movement Therapyに準じたプログラムを実践した．早期から活動・参加の改善に向けた社会適応プログラムを実践した結果，箸操作や書字・仕事復帰に関連した上肢操作が可能となった．合意目標に基づき設定した麻痺手の日常生活での使用は活動・参加を拡大させる可能性があることが示唆された．

　The management tool for daily life performance (MTDLP) manages the intervention process while focusing on important daily life activities. In this report, we conducted Constraint-Induced Movement Therapy in MTDLP for a recovering stroke patient with moderate mild motor paralysis in the dominant hand. As a result of sharing the intervention policy to improve the activity and participation from the early stage, the patient was able to operate chopsticks, write, and perform upper limb operations related to returning to work. Therefore, the use of paralyzed hands in daily life, which was set based on the agreed goal, may expand activities and participation.