実践的歩行訓練による慢性期片麻痺者の訓練効果

Functional Progress in Gait Perfomance of Chronic Stroke Patients by Practical Training

　［要旨］発症後6か月以上経過した脳血管障害後慢性期片麻痺者の歩行能力を実用性の面から検討した．対象は身体障害者更生施設で理学療法を受けた45名である．入所時に比べ退所時には10m歩行速度と最大歩行距離は有意に改善していたが，下肢Brunnstromステージの変化はなかった．実用的歩行能力では，入所時，大半が屋内または自宅周辺に限られていた．公共交通機関を利用しての屋外歩行が可能な者は入所時8.9％であったが，退所時は88.9％が可能となっていた．

　結果から，歩行の実用性は発症後6か月以上を経過しても改善することが示唆され，屋外での訓練や生活場面に合った実践的アプローチが有用と考えられた．

　We investigated about gait function of 45 hemiparetic patients with at least six months from onset of stroke. These subjects had been treated by physical therapists in a rehabilitation institute for the physically handicapped during the previous five years. From admission to discharge, they significantly improved in 10 m gait velocity and maximal gait distance, but changes were seen in Brunnstrom recovery stage of the lower extremities. As far as the capability of actual function of gait was concerned, most subjects were obliged to remain limited to home or the neighborhood. On admission to the institute only 8.9％ could walk outdoors using public transportation, but 88.9％ of the subjects became able to walk by the time of discharge. These results show that gait function significantly progressed even when the starting point of training was over 6 months from stroke onset. Training outdoors and a practical approach to actual life situations were considered effective in this approach.