Core stability trainingにより運動失調およびバランス障害が改善した重度小脳性および感覚性運動失調の1症例
〔目的〕Core stability training（CST）が運動失調とバランス能力に及ぼす影響について検討した．〔対象と方法〕発症から3年経過した橋出血後の50歳代男性．運動麻痺はなく四肢体幹に重度運動失調，バランス障害，歩行障害を呈していた．週1回60分，理学療法士が自宅訪問し介入した．介入開始から4週間（A期）は，筋力増強練習，寝返り，移乗の練習を行った．その後の4週間（B期）は，それらにCSTを付加した．〔結果〕B期においてのみ，scale for the assessment and rating of ataxiaのスコアが3.5点，Berg balance scaleのスコア...
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| Published in | Rigaku ryoho kagaku Vol. 32; no. 3; pp. 459 - 464 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Tokyo
理学療法科学学会
01.01.2017
Japan Science and Technology Agency |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1341-1667 2434-2807 |
| DOI | 10.1589/rika.32.459 |
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| Abstract | 〔目的〕Core stability training（CST）が運動失調とバランス能力に及ぼす影響について検討した．〔対象と方法〕発症から3年経過した橋出血後の50歳代男性．運動麻痺はなく四肢体幹に重度運動失調，バランス障害，歩行障害を呈していた．週1回60分，理学療法士が自宅訪問し介入した．介入開始から4週間（A期）は，筋力増強練習，寝返り，移乗の練習を行った．その後の4週間（B期）は，それらにCSTを付加した．〔結果〕B期においてのみ，scale for the assessment and rating of ataxiaのスコアが3.5点，Berg balance scaleのスコアが2点改善した．〔結語〕CSTは重度運動失調症例の運動失調とバランス能力を改善する可能性がある． |
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| AbstractList | [Purpose] We aimed to investigate the effects of core stability training (CST) on ataxia and balance disturbance. [Subjects and Methods] A man in his fifties who was at 3 years past the onset of pontine hemorrhage and had severe cerebellar and afferent ataxias, and balance and gait disorders was included in this study. In the first 4 weeks (phase A), a physical therapist visited him at his home and conducted physical therapy, which included muscle strengthening, sit-ups, and transfer training, for 60 minutes per week. After phase A, CST was added to the program for 4 weeks (phase B). [Results] Only in phase B were the scale for the assessment and rating of ataxia and Berg balance scale improved. [Conclusion] CST for patients with severe cerebellar ataxia due to stroke can improve cerebellar and afferent ataxias, and balance. 〔目的〕Core stability training（CST）が運動失調とバランス能力に及ぼす影響について検討した．〔対象と方法〕発症から3年経過した橋出血後の50歳代男性．運動麻痺はなく四肢体幹に重度運動失調，バランス障害，歩行障害を呈していた．週1回60分，理学療法士が自宅訪問し介入した．介入開始から4週間（A期）は，筋力増強練習，寝返り，移乗の練習を行った．その後の4週間（B期）は，それらにCSTを付加した．〔結果〕B期においてのみ，scale for the assessment and rating of ataxiaのスコアが3.5点，Berg balance scaleのスコアが2点改善した．〔結語〕CSTは重度運動失調症例の運動失調とバランス能力を改善する可能性がある． 「要旨」 : 〔目的〕Core stability training (CST) が運動失調とバランス能力に及ぼす影響について検討した. 〔対象と方法〕発症から3年経過した橋出血後の50歳代男性. 運動麻痺はなく四肢体幹に重度運動失調, バランス障害, 歩行障害を呈していた. 週1回60分, 理学療法士が自宅訪問し介入した. 介入開始から4週間 (A期) は, 筋力増強練習, 寝返り, 移乗の練習を行った. その後の4週間 (B期) は, それらにCSTを付加した. 〔結果〕B期においてのみ, scale for the assessment and rating of ataxiaのスコアが3.5点, Berg balance scaleのスコアが2点改善した. 〔結語〕CSTは重度運動失調症例の運動失調とバランス能力を改善する可能性がある. 「I. はじめに」運動失調によるバランス能力障害を改善するためには, 補助のない立位で全身運動を使ったダイナミックなバランストレーニングや歩行練習を, 一日に2時間以上, 週4回以上行う必要がある. |
| Author | 松木, 明好 木村, 大輔 谷, 恵介 阪本, 誠 |
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| References | 5) Ilg W, Schatton C, Schicks J, et al.: Video game-based coordinative training improves ataxia in children with degenerative ataxia. Neurology, 2012, 79: 2056-2060. 17) Criscimagna-Hemminger SE, Bastian AJ, Shadmehr R: Size of error affects cerebellar contributions to motor learning. J Neurophysiol, 2010, 103: 2275-2284. 16) Okubo Y, Kaneoka K, Imai A, et al.: Electromyographic analysis of transversus abdominis and lumbar multifidus using wire electrodes during lumbar stabilization exercises. J Orthop Sports Phys Ther, 2010, 40: 743-750. 1) Ilg W, Brötz D, Burkard S, et al.: Long-term effects of coordinative training in degenerative cerebellar disease. Mov Disord, 2010, 25: 2239-2246. 18) Miyake Y, Kobayashi R, Kelepecz D, et al.: Core exercises elevate trunk stability to facilitate skilled motor behavior of the upper extremities. J Bodyw Mov Ther, 2013, 17: 259-265. 4) Ilg W, Synofzik M, Brötz D, et al.: Intensive coordinative training improves motor performance in degenerative cerebellar disease. Neurology, 2009, 73: 1823-1830. 12) 内山 靖，松田尚之，菅野圭子・他：運動失調症における体幹協調機能ステージの標準化と機能障害分類．理学療法学，1988, 15: 313-320. 14) Schmitz-Hübsch T, du Montcel ST, Baliko L, et al.: Scale for the assessment and rating of ataxia: Development of a new clinical scale. Neurology, 2006, 66: 1717-1720. 15) Schmahmann JD, Rosene DL, Pandya DN: Ataxia after pontine stroke: Insights from pontocerebellar fibers in monkey. Ann Neurol, 2004, 55: 585-589. 11) Collin C, Wade D: Assessing motor impairment after stroke: A pilot reliability study. J Neurol Neurosurg Psychiatry, 1990, 53: 576-579. 10) Freund JE, Stetts DM: Use of trunk stabilization and locomotor training in an adult with cerebellar ataxia: A single system design. Physiother Theory Pract, 2010, 26: 447-458. 3) Miyai I, Ito M, Hattori N, et al. Cerebellar Ataxia Rehabilitation Trialists Collaboration: Cerebellar ataxia rehabilitation trial in degenerative cerebellar diseases. Neurorehabil Neural Repair, 2012, 26: 515-522. 9) Ryerson S, Byl NN, Brown DA, et al.: Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther, 2008, 32: 14-20. 13) Keith RA, Granger CV, Hamilton BB, et al.: The functional independence measure: A new tool for rehabilitation. Adv Clin Rehabil, 1987, 1: 6-18. 7) Shirey M, Hurlbutt M, Johansen N, et al.: The influence of core musculature engagement on hip and knee kinematics in women during a single leg squat. Int J Sports Phys Ther, 2012, 7: 1-12. 2) Marquer A, Barbieri G, Pérennou D: The assessment and treatment of postural disorders in cerebellar ataxia: A systematic review. Ann Phys Rehabil Med, 2014, 57: 67-78. 6) Chung EJ, Kim JH, Lee BH: The effects of core stabilization exercise on dynamic balance and gait function in stroke patients. J Phys Ther Sci, 2013, 25: 803-806. 8) Kim YK, Chun SP, Kang TG, et al.: Effects of core stability training on postural control ability and respiratory function in chronic stroke patients. Adv Sci Technol Lett, 2015, 88: 181-186. |
| References_xml | – reference: 11) Collin C, Wade D: Assessing motor impairment after stroke: A pilot reliability study. J Neurol Neurosurg Psychiatry, 1990, 53: 576-579. – reference: 16) Okubo Y, Kaneoka K, Imai A, et al.: Electromyographic analysis of transversus abdominis and lumbar multifidus using wire electrodes during lumbar stabilization exercises. J Orthop Sports Phys Ther, 2010, 40: 743-750. – reference: 18) Miyake Y, Kobayashi R, Kelepecz D, et al.: Core exercises elevate trunk stability to facilitate skilled motor behavior of the upper extremities. J Bodyw Mov Ther, 2013, 17: 259-265. – reference: 12) 内山 靖，松田尚之，菅野圭子・他：運動失調症における体幹協調機能ステージの標準化と機能障害分類．理学療法学，1988, 15: 313-320. – reference: 10) Freund JE, Stetts DM: Use of trunk stabilization and locomotor training in an adult with cerebellar ataxia: A single system design. Physiother Theory Pract, 2010, 26: 447-458. – reference: 2) Marquer A, Barbieri G, Pérennou D: The assessment and treatment of postural disorders in cerebellar ataxia: A systematic review. Ann Phys Rehabil Med, 2014, 57: 67-78. – reference: 1) Ilg W, Brötz D, Burkard S, et al.: Long-term effects of coordinative training in degenerative cerebellar disease. Mov Disord, 2010, 25: 2239-2246. – reference: 6) Chung EJ, Kim JH, Lee BH: The effects of core stabilization exercise on dynamic balance and gait function in stroke patients. J Phys Ther Sci, 2013, 25: 803-806. – reference: 7) Shirey M, Hurlbutt M, Johansen N, et al.: The influence of core musculature engagement on hip and knee kinematics in women during a single leg squat. Int J Sports Phys Ther, 2012, 7: 1-12. – reference: 3) Miyai I, Ito M, Hattori N, et al. Cerebellar Ataxia Rehabilitation Trialists Collaboration: Cerebellar ataxia rehabilitation trial in degenerative cerebellar diseases. Neurorehabil Neural Repair, 2012, 26: 515-522. – reference: 15) Schmahmann JD, Rosene DL, Pandya DN: Ataxia after pontine stroke: Insights from pontocerebellar fibers in monkey. Ann Neurol, 2004, 55: 585-589. – reference: 14) Schmitz-Hübsch T, du Montcel ST, Baliko L, et al.: Scale for the assessment and rating of ataxia: Development of a new clinical scale. Neurology, 2006, 66: 1717-1720. – reference: 4) Ilg W, Synofzik M, Brötz D, et al.: Intensive coordinative training improves motor performance in degenerative cerebellar disease. Neurology, 2009, 73: 1823-1830. – reference: 8) Kim YK, Chun SP, Kang TG, et al.: Effects of core stability training on postural control ability and respiratory function in chronic stroke patients. Adv Sci Technol Lett, 2015, 88: 181-186. – reference: 9) Ryerson S, Byl NN, Brown DA, et al.: Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther, 2008, 32: 14-20. – reference: 5) Ilg W, Schatton C, Schicks J, et al.: Video game-based coordinative training improves ataxia in children with degenerative ataxia. Neurology, 2012, 79: 2056-2060. – reference: 17) Criscimagna-Hemminger SE, Bastian AJ, Shadmehr R: Size of error affects cerebellar contributions to motor learning. J Neurophysiol, 2010, 103: 2275-2284. – reference: 13) Keith RA, Granger CV, Hamilton BB, et al.: The functional independence measure: A new tool for rehabilitation. Adv Clin Rehabil, 1987, 1: 6-18. |
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| Snippet | 〔目的〕Core stability training（CST）が運動失調とバランス能力に及ぼす影響について検討した．〔対象と方法〕発症から3年経過した橋出血後の50歳代男性．運動麻痺はなく四... 「要旨」 : 〔目的〕Core stability training (CST) が運動失調とバランス能力に及ぼす影響について検討した. 〔対象と方法〕発症から3年経過した橋出血後の50歳代男性. 運動麻... [Purpose] We aimed to investigate the effects of core stability training (CST) on ataxia and balance disturbance. [Subjects and Methods] A man in his fifties... |
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| Title | Core stability trainingにより運動失調およびバランス障害が改善した重度小脳性および感覚性運動失調の1症例 |
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