30 3 345 352 2015 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 370-2343, Japan. TEL+81 274-62-5100 E-mail: takacho17@gmail.com 2) Gunma University Graduate School of Health Sciences Rigakuryoho Kagaku 30(3): 345 352, 2015. Submitted Oct. 31, 2014. Accepted Dec. 25, 2014. 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) : 643 370-2343 TEL 0274-62-5100 2) 2014 10 31 2014 12 25
346 30 3 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
347 0 5 6 15) Semmes-Weinstein Monofilaments SWM; North Coast Medical 800-821-9319SWM 4 16) 3.22 4.08 g SWM ICC=0.78 16) Rydel-Seiffer RS; BONIMED 128 Hz 0 8 9 3 3 1 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 4 30 8 COP FFEO FFEC FREO FREC 4 FRaEO FRaEC FRsEO FRsEC 30 FFEC FRaEC FREO FRsEO FR AIREX Balance-pad plus AIREX AG 25 20 kpa 55 kg/m 3 260 kpa 410 500 60 mm AIREX Balance-pad 18) FRa FRs AIREX COP TWIN GRAVICORDER G-6100 30 20 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
348 30 3 表 1 n=25 13 12 Br. Stage II 1 III 3 IV 6 V 13 VI 2 BBS * 42.6 11.3 19 56 TUG * 30.8 43.6 6.3 204.0 FAC 2 4 3 8 4 7 5 6 SWM g * 2.5 2.7 0.2 8.4 21.0 38.6 0.5 127.7 RS* 5.7 1.5 3.3 8 5.1 2.1 0 8 * 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 25 13 12 66.9 13.9 60.3 40.3 1 BBS TUG 42.6 11.3 30.8 43.6 2 30 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<0.05 2 4 FRa 3 EO-EC p<0.05 3 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
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 1 21.6 64.1 42.2 82.6 33.4 57.9 53.3 142.9 2 28.7 54.7 54.7 89.2 46.4 73.1 82.6 151.2 3 29.9 67.8 71.5 91.9 52.5 106.0 130.8 286.0 4 32.6 43.1 49.4 75.6 29.4 66.6 73.7 91.5 5 33.5 75.7 90.6 106.5 47.2 72.3 136.3 162.8 6 35.0 41.2 82.5 105.2 37.8 73.4 94.6 260.9 7 39.8 58.2 43.4 59.3 40.5 73.5 66.4 132.9 8 39.9 61.9 119.9 121.4 59.3 109.4 203.3 298.4 9 43.3 95.3 78.4 78.5 44.1 94.7 97.9 165.9 10 47.1 45.7 45.0 104.8 55.1 64.6 82.9 120.2 11 51.3 140.2 147.0 168.6 53.0 100.5 91.8 246.7 12 62.9 95.5 97.2 178.5 130.3 163.5 187.1 274.2 13 36.4 59.7 84.2 142.0 40.7 75.4 74.1 14 30.4 51.6 90.0 107.3 47.8 60.0 120.9 15 47.1 64.3 101.8 107.9 68.3 83.4 119.0 16 65.9 90.1 93.3 131.4 123.6 173.7 174.8 17 84.8 162.0 134.8 225.1 92.9 208.1 161.9 18 41.7 71.0 89.3 107.7 86.4 141.9 19 97.0 128.8 151.8 255.4 137.5 210.9 20 129.4 121.1 173.2 174.0 153.4 210.6 21 48.9 69.9 71.1 52.9 22 76.1 86.2 96.9 122.5 23 59.3 150.4 76.6 24 126.7 138.0 113.0 25 275.0 222.3 * 38.8 70.3 76.8 105.2 52.4 87.9 108.4 194.5 * 11.2 28.4 33.1 36.0 26.1 29.4 47.1 73.2 * 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
350 30 3 表 3 n=12 EO EC EC/EO FRa/FF FRs/FF FR/FF FRa/FF FRs/FF FR/FF FF FRa FRs FR 1.9 0.6 2.0 0.7 2.8 0.7 1.8 0.3 2.1 0.6 4.0 1.4 1.3 0.4 1.3 0.4 1.5 0.4 1.9 0.6 EO FRa/FF 0.60* 0.73** 0.11 0.03 0.39 0.33 0.63* 0.32 0.15 FRs/FF 0.72** 0.20 0.57 0.75** 0.29 0.04 0.33 0.36 FR/FF 0.15 0.13 0.39 0.48 0.36 0.30 0.02 EC FRa/FF 0.54 0.52 0.50 0.11 0.53 0.38 FRs/FF 0.50 0.22 0.26 0.27 0.30 FR/FF 0.01 0.10 0.48 0.71** EC/EO FF 0.25 0.54 0.23 FRa 0.45 0.41 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 0.070 0.200 0.106 0.352 0.235 0.188 0.576 0.470 0.000 0.446 BBS 0.313 0.095 0.018 0.246 0.313 0.243 0.067 0.004 0.254 0.355 TUG 0.315 0.399 0.091 0.126 0.147 0.084 0.217 0.168 0.035 0.070 FAC 0.038 0.023 0.061 0.038 0.153 0.000 0.351 0.031 0.305 0.252 SWM as 0.270 0.105 0.109 0.207 0.119 0.049 0.200 0.070 0.102 0.382 SWM ss 0.224 0.109 0.200 0.109 0.357 0.004 0.312 0.697* 0.210 0.560 RS as 0.131 0.384 0.329 0.611* 0.177 0.011 0.583* 0.452 0.049 0.392 RS ss 0.350 0.534 0.548 0.410 0.057 0.078 0.484 0.240 0.329 0.110 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
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