脳卒中片まひの臨床分類とそのリハビリテーションにおける応用

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  • Clinical Classification of Hemiplegia and Its Application on Rehabilitation

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Classification of hemiplegia has not been accomplished though this disease is very frequent. The clinical picture of hemiplegia presents as uniform appearance from one standpoint but from the other stand point it has many variety of manifestation, in the degree of motor impairment, potentiality of improvement, degree of spasticity and their distribution pattern.<br>This classification is provided by two fundamental principles, 1) Classify by the localization of lesion when it can be clarified. 2) If it is not clear, classify by the intensity, distribution pattern, and chronological sequence of spasticity.<br>Thus following eight types are determined.<br>(A) Type showing spastic posture from early stage<br>A-1 Rigidity type<br>A-2 Immediate Wernicke-Mann type<br>(B) Type showing flaccid posture in early stage<br>B-1 Delayed Wernicke-Mann type<br>B-2 Hypotonic type<br>B-3 Prolonged atonic type<br>(C) Syndromes that the lesion is clear.<br>C-1 Ponto-bulbo-cerebellar syndrome<br>C-2 Thalamo-basal-ganglia syndrome<br>C-3 Circumscribed cortical syndrome<br>(D) Unclassified group<br>Those groups have characteristics respectively, and they are useful for the estimation of prognosis, precaution against complication, and choice of therapeutic procedure.

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