軽度上肢麻痺を呈した回復期脳卒中患者に対する持続的神経筋電気刺激下の促通反復療法とTransfer Packageの併用治療を実施した一例

The effects of repetitive facilitative exercise under continuous neuromuscular electrical stimulation in combination with a transfer package for upper-limb paralysis after stroke: A case report

要旨：軽度左上肢麻痺症例に対し，入院からの4週間は持続的神経筋電気刺激下の促通反復療法を単独で実施し，4週時からの2週間はTransfer Packageを併用した．4週間の単独治療後に上肢機能と物品操作能力，上肢使用の動作の質に改善を認めたが，上肢使用の頻度を評価するAmount of Use（以下，AOU）の改善量は0.07点にとどまった．その後，2週間の併用治療終了後にAOUの改善量は1.43点を示し，上肢使用の頻度の改善を得た．この異なる特徴をもつ治療の併用は上肢機能と物品操作能力，上肢の使用頻度と動作の質に良好な影響を与える可能性が示唆された．

　A patient with mild hemiplegia of the upper-left limb was treated with continuous neuromuscular electrical stimulation (RFE under cNMES) alone for four weeks after admission and with a transfer package for a subsequent two weeks. After four weeks of monotherapy, improvement was observed in the following areas:upper limb function, ability to manipulate objects, and quality of movement of the affected upper limb. However, subjective improvement in the Amount of Use (AOU) during daily activities was only 0.07 points. Following two weeks of combined treatment using the transfer package, the AOU showed an improvement of 1.43 points, indicating enhanced frequency of upper limb use. The results suggest that the combination of RFE under cNMES with a transfer package for upper limb paralysis may have a positive effect on upper limb function, the ability to manipulate objects, the frequency of upper limb use, and quality of movement.