I. はじめに CTSIB 6 30 CTSIB 1) 1 4) 5) 3,12) 9) 3) COP; center of pressure 11) Genthon 2 COP 25.6 mm 12) 7) 6) 7,8) 9) 10) II. 対象と方法 1 10) 25 6)
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1 原著 Relationships between Adaptation to Various Sensory Inputs on Static Standing Balance and Impairments of Patients with Post-stroke Hemiplegia 1,2) 2) NANAMI OKAWARA 1,2), SHIGERU USUDA 2) 1) Public Nanokaichi Hospital: 643, Nanokaichi, Tomioka, Gunma , Japan. TEL takacho17@gmail.com 2) Gunma University Graduate School of Health Sciences Rigakuryoho Kagaku 30(3): , Submitted Oct. 31, Accepted Dec. 25, ABSTRACT: [Purpose] To investigate relationships between adaptation to various sensory inputs and impairments of patients with post-stroke hemiplegia by measuring postural sway. [Subjects and Methods] Twenty-five patients with post-stroke hemiplegia participated in this study. Postural sway while standing was measured by posturography under eight standing conditions (visual conditions: eyes open or eyes closed; surface conditions: firm floor, foam rubber, and foam rubber under the affected and sound sides) for 30 sec each. The associations between dependence on visual input and the support surface ratio and standardized clinical measures of balance, gait ability and quantified somatosensory disturbances (touch, vibration) were examined. [Results] Dependence on the support surface ratio increased under the eyes-closed and foam rubber conditions. Dependence on visual input and the support surface ratio showed little correlation with standing balance, gait ability score, or superficial sensory disturbance of the affected side under most conditions. [Conclusion] Patients with hemiplegia show a reduced ability to adapt to the support surface condition of the sound side. Key words: hemiplegia, static balance, adaptation to supporting surface 要旨 : 25 8 キーワード : 1) : TEL )
2 I. はじめに CTSIB 6 30 CTSIB 1) 1 4) 5) 3,12) 9) 3) COP; center of pressure 11) Genthon 2 COP 25.6 mm 12) 7) 6) 7,8) 9) 10) II. 対象と方法 1 10) 25 6) 15 1,2) 2 Brunnstrom recovery stage Br.stage 12) Berg balance scale BBS 13) Timed up Shumway-Cook 9) and go test TUG 14) Functional ambulation The category FAC 15) FAC clinical test of sensory interaction in balance CTSIB
3 ) Semmes-Weinstein Monofilaments SWM; North Coast Medical SWM 4 16) g SWM ICC= ) Rydel-Seiffer RS; BONIMED 128 Hz RS 17) firm floor: FF foam rubber: FR eyes open: EOeyes closed: EC 4 foam rubber at the affected side: FRa : foam rubber at the sound side: FRs COP FFEO FFEC FREO FREC 4 FRaEO FRaEC FRsEO FRsEC 30 FFEC FRaEC FREO FRsEO FR AIREX Balance-pad plus AIREX AG kpa 55 kg/m kpa mm AIREX Balance-pad 18) FRa FRs AIREX COP TWIN GRAVICORDER G Hz COP 30 COP 2) COP 3 m 2 3 COP FRa/FF FRs/FF FR/FF EC/ EO 1.0 SPSS Statistics 20 COP 2 Bonferroni COP BBS TUG Spearman 5 16
4 表 1 n= Br. Stage II 1 III 3 IV 6 V 13 VI 2 BBS * TUG * FAC SWM g * RS* * n=24 n=22 Br.Stage: Brunnstrom recovery stage, BBS: Berg balance scale, TUG: Timed up and go test, FAC: Functional ambulation category, SWM: Semmes-Weinstein monofilaments, RS: Rydel seiffer III. 結 果 FRa-FR p<0.05 Spearman BBS TUG FFEO FFEC FREO FREC 30 FRa FRs 30 EO-EC FRs 3 4 Br.Stage BBS TUG FAC RS as FF FRa SWM ss BBS TUG IV. 考 察 4 FRa-FRs p< FRa 3 EO-EC p< EO-EC p<0.05 FRa/FF-FR/FF FRs/FF-FR/FF p<0.05 FRa/FF-FRs/FF 30 FFEO FRaEO FFEC FRaEC FRsEO FREO FRsEC FREC FREC 12 FRa-FRs
5 349 表 2 cm 30 EO EC No. FF FF n=25 FRa n=25 FRs n=21 FR n=20 n=24 FRa n=21 FRs n=17 FR n= * * * 12 FF: firm floor, FR: foam rubber, FRa: foam rubber at the affected side, FRs: foam rubber at the sound side, EO: eyes open, EC: eyes closed. FR 19) FRa-FRs 20) 3) FRs FRa COP EO-EC FRa 3 FRa FRa 4 2 4) FRs FR
6 表 3 n=12 EO EC EC/EO FRa/FF FRs/FF FR/FF FRa/FF FRs/FF FR/FF FF FRa FRs FR EO FRa/FF 0.60* 0.73** * FRs/FF 0.72** ** FR/FF EC FRa/FF FRs/FF FR/FF ** EC/EO FF FRa FRs 0.01 Spearman * p<0.05 ** p<0.01 FR/FF EO FR/FF EC FR EC/EO FF: firm floor, FR: foam rubber FRa: foam rubber at the affected side FRs: foam rubber at the sound side EO: Eyes Open EC: eyes closed FRa/FF: FRs/FF: FR/FF: EC/ EO: 表 4 n=12 EO EC EC/EO FRa/FF FRs/FF FR/FF FRa/FF FRs/FF FR/FF FF FRa FRs FR Br.Stage BBS TUG FAC SWM as SWM ss * RS as * * RS ss Spearman * p<0.05 ** p<0.01 FF: Firm floor, FR: Foam rubber, FRa: Foam rubber at the affected side, FRs: Foam rubber at the sound side, EO: Eyes open, EC: Eyes closed, Br.Stage: Brunnstrom recovery stage, BBS: Berg balance scale, TUG: Timed up and go test, SWM: Semmes-Weinstein monofilaments, RS: Rydel seiffer, as: affected side, ss: sound side FRa/FF: FRs/FF: FR/FF: EC/EC: FR/FF EO-EC FR FRa-FR FR 4 FRa EO-EC FRs 3 FRs 3
7 351 Kim 21) 3 FRs Br.Stage BBS TUG FAC FF FRa BBS TUG COP 10) COP COP COP 2) 12 1) 謝辞 MWS 引用文献 1) Mansfield A, Danells CJ, Black JL, et al.: Determinants and consequences for standing balance of spontaneous weightbearing on the paretic side among individuals with chronic stroke. Gait Posture, 2013, 38(3): ) Marigold DS, Eng JJ.: The relationship of asymmetric weightbearing with postural sway and visual reliance in stroke. Gait Posture, 2006, 23(2): ) Handrickson J, Patterson KK, Inness EL, et al.: Relationship between asymmetry of quiet standing balance control and walking post-stroke. Gait Posture, 2014, 39(1): ) Barra J, Oujamaa L, Chauvineau V, et al.: Asymmetric standing posture after stroke is related to a biased egocentric coordinate system. Neurology, 2009, 72(18): ) Pai Y-C, Rogers MW, Hedman LD, et al.: Alterations in weight-transfer capabilities in adults with hemiparesis. Phys Ther, 1994, 74(7):
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