肩関節痛に配慮した複合的な上肢機能練習により，日常生活における麻痺手の使用行動が向上した脳卒中後の一例—症例報告

Improvement of post-stroke behavior of paralyzed hands in daily life through complex upper limb function exercises in consideration of shoulder joint pain: A case study

要旨：脳卒中後に麻痺側上肢の肩関節痛を呈した対象者に，肩関節の疼痛や心理状況に合わせて上肢機能練習を行った．特に，Transfer Packageでは麻痺手の活動によって生じた痛みの程度や使用感も記録するよう依頼し，痛みへの対処法や環境調整を含めた指導を行った．その結果，麻痺側肩の疼痛が軽減し，日常生活における麻痺手の使用頻度も改善した．肩関節痛のある上肢麻痺例では，それらに配慮してTransfer Packageを行うことが有用であるように思われた．

　Upper limb function exercises were performed for subjects who presented with shoulder joint pain in the paralyzed upper limb after stroke according to the shoulder joint pain and psychological condition. In particular, in the Transfer Package, we requested that the degree of pain caused by the activity of the paralyzed hand and the feeling of use be recorded, and provided guidance including how to deal with the pain and environmental adjustment. As a result, the pain in the shoulder on the paralyzed side was reduced, and the frequency of use of the paralyzed hand in daily life increased. The Transfer Package appears useful among patients with upper limb paralysis with shoulder joint pain.