脳卒中後の片麻痺とリハビリテーション・プログラム

Postapoplectic hemiplegia and its rehabilitation programs.

　脳卒中後の片麻痺では，共同運動が正常な分離運動に置きかわったり，過度の反射の出現，筋活動の減少あるいは協調性の悪化などを引き起こす。軟部組織の拘縮などの運動制限が加わったり，運動感覚の障害や空間認識能が欠落して感覚情報の統合も歪められていることもあり，歩行能力は大きく障害される。

In hemiplegia caused by cerebral vascular attack, the synergy appears in place of normal isolated movement. The reflex becomes hyperactive, the muscular activity decreases or the coordination becomes worse. The contracture of soft tissue, the restriction in range of joint movement, the deficiency in motor sense and the visual spatial agnosia also cause gait disorders.

Asymmetry in the hemiplegic gait is quite different from normal gait. This is due to the shorter single stance phase of the affected side, because the sound leg cannot be swung far ahead during bearing the body weight and maintaining the standing balance by only the paretic leg.