立ち上がり動作時に右後方への転倒傾向を認めた第6頸髄不全損傷四肢麻痺患者の理学療法

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  • 刀坂 太
    六地蔵総合病院　リハビリテーション科
  • 早田 荘
    六地蔵総合病院　リハビリテーション科 関西医療大学大学院　保健医療学研究科
  • 赤松 圭介
    六地蔵総合病院　リハビリテーション科
  • 大沼 俊博
    六地蔵総合病院　リハビリテーション科
  • 渡邊 裕文
    六地蔵総合病院　リハビリテーション科
  • 鈴木 俊明
    関西医療大学大学院　保健医療学研究科

書誌事項

タイトル別名
  • Physical Therapy Conducted for a Quadriplegic Patient Prone to Falling Backwards to the Right during the Standing Up Movement after Incomplete Sixth Cervical Spinal Cord Injury
  • 症例報告 立ち上がり動作時に右後方への転倒傾向を認めた第6頸髄不全損傷四肢麻痺患者の理学療法
  • ショウレイ ホウコク タチアガリ ドウサジ ニ ミギ コウホウ エ ノ テントウ ケイコウ オ ミトメタ ダイ6 ケイズイフゼン ソンショウ シシ マヒ カンジャ ノ リガク リョウホウ

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We report the physical therapy conducted for a quadriplegic patient after incomplete sixth cervical spinal cord injury. The patient had difficulties in transfer movements with a tendency to fall backwards to the right during standing up movements. We therefore analyzed the patient’s standing up movement. First, we improved the abnormal muscle tone. Then we applied sensory stimulation to the right foot sole. Subsequently, the movement of standing up was practiced, focusing on awareness of the load on the right lower extremity (physical therapy A). We observed an improvement in the flexion phase of the standing up movement and also in the sitting posture. However, joint dorsiflexion and inversion of the right ankle occurred in the phase during which the patient’s hip was lifted. Moreover, the anteromedial part of the right foot sole moved away from the floor. Anterior tilting of the lower leg with dorsiflexion of the right ankle joint was not observed. Hence, we considered that the patient needed to keep the anteromedial part of the right foot sole in contact with the floor surface by ankle joint eversion movement using the action of the right peroneus longus. Furthermore, in addition to physical therapy A, we treated the patient for hypotonia of the right peroneus longus (physical therapy B). Subsequently, the patient regained the ability to perform anterior tilting of the lower leg with the anteromedial portion of the right foot sole grounded on the floor during the standing up movement.<br>

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