脳卒中後片麻痺を呈した小児例に多角的なアプローチに加え，家族参加型のTransfer packageの実施が奏功した事例—意思決定とモチベーション管理に焦点を当てた実践

Occupational therapy focusing on decision-making and motivation management of a child with post-stroke hemiplegia who successfully implemented a transfer package with family participation in addition to a multifaceted approach: A case study

要旨：【はじめに】左片麻痺を呈した小児の脳卒中者に対して，Constraint-induced movement therapy（以下，CI療法）に加えて家族参加型Transfer package（以下，TP）と自主練習を併用した介入を実施したので結果を報告する．【介入】家族が同席したうえで，装具・電気刺激装置を併用したCI療法を1日1時間，ロボットを用いた自主練習を30分/日を11週実施した．【結果】上肢機能評価において改善を示し，復学に対して前向きな発言が聞かれるといった心理的変化を認めた．【考察】精神的に不安定であった小児例に対して，家族参加型TPや自主練習はモチベーションの維持やモニタリングの改善につながり，麻痺手のみならず，心理面への変化を及ぼす可能性が考えられた．

　[Introduction] We report the results of interventions in which a family-participatory Transfer package (TP) and voluntary practice were used in addition to CI therapy for stroke patients with left hemiplegia. [Intervention] CI therapy with orthoses and electrical stimulators was performed for 1 hour a day with the family present. A 30-minute day was carried out for 11 weeks. [Results] Psychological changes were observed, such as improvement in upper limb function evaluation and positive remarks regarding returning to school. [Discussion] For child who were mentally unstable, family-participatory TP and voluntary practice lead to maintenance of motivation and improvement of monitoring, and not only paralyzed hands but also psychological changes. The possibility of exerting it was considered.