脳卒中後のpusher syndrome の重症度およびその改善経過とsubject visual verticality の偏倚との関連
【目的】本研究の目的は，pusher syndrome（以下，PS）を呈した脳卒中片麻痺者におけるsubject visual verticality（以下，SVV）の偏倚量の推移とPS の重症度およびPS の改善経過との関連について明らかにすることである。【方法】対象は，理学療法初回介入時にSVV の測定が可能であったPS 例14 名とした。調査期間はSVV の初回評価から3 週間とした。週2 回，計6 回の各測定時のPS の重症度とSVV の偏倚量の変化の推移，ならびに2 項目の相関関係を調査した。【結果】PS の重症度とSVV の偏倚量は有意に改善した。しかし，両者の改善する時期は異なり...
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| Published in | 理学療法学 Vol. 44; no. 5; pp. 340 - 347 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本理学療法士学会
2017
日本理学療法士協会 Japanese Society of Physical Therapy |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0289-3770 2189-602X |
| DOI | 10.15063/rigaku.11270 |
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| Abstract | 【目的】本研究の目的は，pusher syndrome（以下，PS）を呈した脳卒中片麻痺者におけるsubject visual verticality（以下，SVV）の偏倚量の推移とPS の重症度およびPS の改善経過との関連について明らかにすることである。【方法】対象は，理学療法初回介入時にSVV の測定が可能であったPS 例14 名とした。調査期間はSVV の初回評価から3 週間とした。週2 回，計6 回の各測定時のPS の重症度とSVV の偏倚量の変化の推移，ならびに2 項目の相関関係を調査した。【結果】PS の重症度とSVV の偏倚量は有意に改善した。しかし，両者の改善する時期は異なり，すべての測定時期で有意な相関を認めなかった。【結論】SVV の偏倚量の推移はPS の重症度とその改善経過に関連しない可能性が高いと思われた。 |
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| AbstractList | 【目的】本研究の目的は，pusher syndrome（以下，PS）を呈した脳卒中片麻痺者におけるsubject visual verticality（以下，SVV）の偏倚量の推移とPS の重症度およびPS の改善経過との関連について明らかにすることである。【方法】対象は，理学療法初回介入時にSVV の測定が可能であったPS 例14 名とした。調査期間はSVV の初回評価から3 週間とした。週2 回，計6 回の各測定時のPS の重症度とSVV の偏倚量の変化の推移，ならびに2 項目の相関関係を調査した。【結果】PS の重症度とSVV の偏倚量は有意に改善した。しかし，両者の改善する時期は異なり，すべての測定時期で有意な相関を認めなかった。【結論】SVV の偏倚量の推移はPS の重症度とその改善経過に関連しない可能性が高いと思われた。 「要旨」 【目的】本研究の目的は, pusher syndrome(以下, PS)を呈した脳卒中片麻痺者におけるsubject visual verticality(以下, SVV)の偏倚量の推移とPSの重症度およびPSの改善経過との関連について明らかにすることである. 【方法】対象は, 理学療法初回介入時にSVVの測定が可能であったPS例14名とした. 調査期間はSVVの初回評価から3週間とした. 週2回, 計6回の各測定時のPSの重症度とSVVの偏倚量の変化の推移, ならびに2項目の相関関係を調査した. 【結果】PSの重症度とSVVの偏倚量は有意に改善した. しかし, 両者の改善する時期は異なり, すべての測定時期で有意な相関を認めなかった. 【結論】SVVの偏倚量の推移はPSの重症度とその改善経過に関連しない可能性が高いと思われた. Purpose: We investigated the time course of deviation of subject visual verticality (SVV) and the severity of pusher syndrome (PS) to clarify whether improvement of deviated SVV is associated with improved severity of PS.Method: We recruited 14 patients with PS who could assess deviation of SVV at the first physical therapy session day. The assessment of deviation of SVV and severity of PS using the Scale for Contraversive Pushing (SCP) in 14 hemiparetic stroke patients with PS was performed twice a week for 3 weeks. We also analyzed the relationship between deviation of SVV and SCP.Results: SCP and SVV were significantly improved. However, the deviation of SVV and severity of PS were not correlated at each time measurement. In addition, there were differences in the timings of recovery in SVV and SCP.Conclusion: Improvement in deviated SVV does not appear to be correlated to improvement in severity of PS. 【目的】本研究の目的は，pusher syndrome（以下，PS）を呈した脳卒中片麻痺者におけるsubject visual verticality（以下，SVV）の偏倚量の推移とPS の重症度およびPS の改善経過との関連について明らかにすることである。【方法】対象は，理学療法初回介入時にSVV の測定が可能であったPS 例14 名とした。調査期間はSVV の初回評価から3 週間とした。週2 回，計6 回の各測定時のPS の重症度とSVV の偏倚量の変化の推移，ならびに2 項目の相関関係を調査した。【結果】PS の重症度とSVV の偏倚量は有意に改善した。しかし，両者の改善する時期は異なり，すべての測定時期で有意な相関を認めなかった。【結論】SVV の偏倚量の推移はPS の重症度とその改善経過に関連しない可能性が高いと思われた。 |
| Author | 阿部, 浩明 大鹿糠, 徹 辻本, 直秀 大橋, 信義 |
| Author_FL | ABE Hiroaki TSUJIMOTO Naohide OKANUKA Toru OHASHI Nobuyoshi |
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| DocumentTitleAlternate | Relationship between the Deviation of Subject Visual Verticality and Time Course of Severity of Pusher Syndrome in Acute Stroke Patients |
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| References | 16) Saj A, Honoré J, et al.: The visual vertical in the pusher syndrome: influence of hemispace and body position. J Neurol. 2005; 252: 885–891. 9) Bonan IV, Guettard E, et al.: Subjective visual vertical perception relates to balance in acute stroke. Arch Phys Med Rehabil. 2006; 87: 642–646. 17) Johannsen L, Fruhmann Berger M, et al.: Subjective visual vertical (SVV) determined in a representative sample of 15 patients with pusher syndrome. J Neurol. 2006; 253: 1367–1369. 30) Barra J, Chauvineau V, et al.: Perception of longitudinal body axis in patients with stroke: a pilot study. J Neurol Neurosurg Psychiatry. 2007; 78: 43–48. 1) Birch HG, Proctor F, et al.: Perception in hemiplegia: I. Judgment of vertical and horizontal by hemiplegic patients. Arch Phys Med Rehabil. 1960; 41: 19–27. 19) Paci M, Matulli G, et al.: The subjective visual vertical in patients with pusher behaviour: a pilot study with a psychophysical approach. Neuropsychol Rehabil. 2011; 21: 539–551. 22) Mansfield A, Fraser L, et al.: Is perception of vertical impaired in individuals with chronic stroke with a history of ‘pushing’? Neurosci Lett. 2015; 590: 172–177. 3) Barra J, Oujamaa L, et al.: Asymmetric standing posture after stroke is related to a biased egocentric coordinate system. Neurology. 2009; 72: 1582–1587. 23) Bonan IV, Leman MC, et al.: Evolution of subjective visual vertical perturbation after stroke. Neurorehabil Neural Repair. 2006; 20: 484–491. 20) Baier B, Janzen J, et al.: Pusher syndrome: its cortical correlate. J Neurol. 2012; 259: 277–283. 7) 沼田憲治，川名隆二，他：半球損傷患者の垂直判断と体幹バランスの関係について．理学療法学．1989; 16: 71–75. 13) Pedersen PM, Wandel A, et al.: Ipsilateral pushing in stroke: incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1996; 77: 25–28. 12) 田代真奈美，網本 和，他：脳血管障害例の退院時ADL 規定因子の分析：Pusher 現象の影響．理学療法学．1998; 25: 432–436. 18) Pérennou DA, Mazibrada G, et al.: Lateropulsion, pushing and verticality perception in hemisphere stroke: a causal relationship? Brain. 2008; 131: 2401–2413. 8) 網本 和，杉本 諭，他：半側空間無視例における視覚的垂直定位障害と坐位平衡機能の関連について．理学療法学．1992; 19: 1–6. 15) Karnath HO, Ferber S, et al.: The origin of contraversive pushing: evidence for a second graviceptive system in humans. Neurology. 2000; 55: 1298–1304. 5) Brandt T, Dieterich M, et al.: Vestibular cortex lesions affect the perception of verticality. Ann Neurol. 1994; 35: 403–412. 11) Abe H, Kondo T, et al.: Prevalence and length of recovery of pusher syndrome based on cerebral hemispheric lesion side in patients with acute stroke. Stroke. 2012; 43: 1654–1656. 14) Danells CJ, Black SE, et al.: Poststroke “pushing”: natural history and relationship to motor and functional recovery. Stroke. 2004; 35: 2873–2878. 6) Yelnik AP, Lebreton FO, et al.: Perception of verticality after recent cerebral hemispheric stroke. Stroke. 2002; 33: 2247–2253. 28) Baccini M, Paci M, et al.: Scale for contraversive pushing: cutoff scores for diagnosing “pusher behavior” and construct validity. Phys Ther. 2008; 88: 947–955. 26) Utz KS, Keller I, et al.: Multimodal and multispatial deficits of verticality perception in hemispatial neglect. Neuroscience. 2011; 188: 68–79. 27) Karnath HO, Brötz D: Instructions for the Clinical Scale for Contraversive Pushing (SCP). Neurorehabil Neural Repair. 2007; 21: 370–371. 10) Bonan IV, Hubeaux K, et al.: Influence of subjective visual vertical misperception on balance recovery after stroke. J Neurol Neurosurg Psychiatry. 2007; 78: 49–55. 24) Kerkhoff G: Multimodal spatial orientation deficits in left-sided visual neglect. Neuropsychologia. 1999; 37: 1387–1405. 2) Barra J, Benaim C, et al.: Are rotations in perceived visual vertical and body axis after stroke caused by the same mechanism? Stroke. 2008; 39: 3099–3101. 4) DeCencio DV, Leshner M, et al.: Verticality perception and ambulation in hemiplegia. Arch Phys Med Rehabil. 1970; 51: 105–110. 29) Oldfield RC: The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971; 9: 97–113. 21) 西村由香，吉尾雅春，他：脳卒中患者の自覚的視性垂直位：Pushing 現象と半側空間無視に着目した自覚的視性垂直位の特徴．理学療法学．2011; 38: 516–523. 25) Saj A, Honoré J, et al.: Subjective visual vertical in pitch and roll in right hemispheric stroke. Stroke. 2005; 36: 588–591. 31) Krewer C, Luther M, et al.: Time course and influence of pusher behavior on outcome in a rehabilitation setting: a prospective cohort study. Top Stroke Rehabil. 2013; 20: 331–339. |
| References_xml | – reference: 14) Danells CJ, Black SE, et al.: Poststroke “pushing”: natural history and relationship to motor and functional recovery. Stroke. 2004; 35: 2873–2878. – reference: 31) Krewer C, Luther M, et al.: Time course and influence of pusher behavior on outcome in a rehabilitation setting: a prospective cohort study. Top Stroke Rehabil. 2013; 20: 331–339. – reference: 5) Brandt T, Dieterich M, et al.: Vestibular cortex lesions affect the perception of verticality. Ann Neurol. 1994; 35: 403–412. – reference: 6) Yelnik AP, Lebreton FO, et al.: Perception of verticality after recent cerebral hemispheric stroke. Stroke. 2002; 33: 2247–2253. – reference: 12) 田代真奈美，網本 和，他：脳血管障害例の退院時ADL 規定因子の分析：Pusher 現象の影響．理学療法学．1998; 25: 432–436. – reference: 19) Paci M, Matulli G, et al.: The subjective visual vertical in patients with pusher behaviour: a pilot study with a psychophysical approach. Neuropsychol Rehabil. 2011; 21: 539–551. – reference: 24) Kerkhoff G: Multimodal spatial orientation deficits in left-sided visual neglect. Neuropsychologia. 1999; 37: 1387–1405. – reference: 29) Oldfield RC: The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971; 9: 97–113. – reference: 4) DeCencio DV, Leshner M, et al.: Verticality perception and ambulation in hemiplegia. Arch Phys Med Rehabil. 1970; 51: 105–110. – reference: 8) 網本 和，杉本 諭，他：半側空間無視例における視覚的垂直定位障害と坐位平衡機能の関連について．理学療法学．1992; 19: 1–6. – reference: 10) Bonan IV, Hubeaux K, et al.: Influence of subjective visual vertical misperception on balance recovery after stroke. J Neurol Neurosurg Psychiatry. 2007; 78: 49–55. – reference: 18) Pérennou DA, Mazibrada G, et al.: Lateropulsion, pushing and verticality perception in hemisphere stroke: a causal relationship? Brain. 2008; 131: 2401–2413. – reference: 28) Baccini M, Paci M, et al.: Scale for contraversive pushing: cutoff scores for diagnosing “pusher behavior” and construct validity. Phys Ther. 2008; 88: 947–955. – reference: 2) Barra J, Benaim C, et al.: Are rotations in perceived visual vertical and body axis after stroke caused by the same mechanism? Stroke. 2008; 39: 3099–3101. – reference: 9) Bonan IV, Guettard E, et al.: Subjective visual vertical perception relates to balance in acute stroke. Arch Phys Med Rehabil. 2006; 87: 642–646. – reference: 20) Baier B, Janzen J, et al.: Pusher syndrome: its cortical correlate. J Neurol. 2012; 259: 277–283. – reference: 22) Mansfield A, Fraser L, et al.: Is perception of vertical impaired in individuals with chronic stroke with a history of ‘pushing’? Neurosci Lett. 2015; 590: 172–177. – reference: 30) Barra J, Chauvineau V, et al.: Perception of longitudinal body axis in patients with stroke: a pilot study. J Neurol Neurosurg Psychiatry. 2007; 78: 43–48. – reference: 13) Pedersen PM, Wandel A, et al.: Ipsilateral pushing in stroke: incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1996; 77: 25–28. – reference: 21) 西村由香，吉尾雅春，他：脳卒中患者の自覚的視性垂直位：Pushing 現象と半側空間無視に着目した自覚的視性垂直位の特徴．理学療法学．2011; 38: 516–523. – reference: 25) Saj A, Honoré J, et al.: Subjective visual vertical in pitch and roll in right hemispheric stroke. Stroke. 2005; 36: 588–591. – reference: 26) Utz KS, Keller I, et al.: Multimodal and multispatial deficits of verticality perception in hemispatial neglect. Neuroscience. 2011; 188: 68–79. – reference: 1) Birch HG, Proctor F, et al.: Perception in hemiplegia: I. Judgment of vertical and horizontal by hemiplegic patients. Arch Phys Med Rehabil. 1960; 41: 19–27. – reference: 17) Johannsen L, Fruhmann Berger M, et al.: Subjective visual vertical (SVV) determined in a representative sample of 15 patients with pusher syndrome. J Neurol. 2006; 253: 1367–1369. – reference: 16) Saj A, Honoré J, et al.: The visual vertical in the pusher syndrome: influence of hemispace and body position. J Neurol. 2005; 252: 885–891. – reference: 23) Bonan IV, Leman MC, et al.: Evolution of subjective visual vertical perturbation after stroke. Neurorehabil Neural Repair. 2006; 20: 484–491. – reference: 3) Barra J, Oujamaa L, et al.: Asymmetric standing posture after stroke is related to a biased egocentric coordinate system. Neurology. 2009; 72: 1582–1587. – reference: 11) Abe H, Kondo T, et al.: Prevalence and length of recovery of pusher syndrome based on cerebral hemispheric lesion side in patients with acute stroke. Stroke. 2012; 43: 1654–1656. – reference: 15) Karnath HO, Ferber S, et al.: The origin of contraversive pushing: evidence for a second graviceptive system in humans. Neurology. 2000; 55: 1298–1304. – reference: 7) 沼田憲治，川名隆二，他：半球損傷患者の垂直判断と体幹バランスの関係について．理学療法学．1989; 16: 71–75. – reference: 27) Karnath HO, Brötz D: Instructions for the Clinical Scale for Contraversive Pushing (SCP). Neurorehabil Neural Repair. 2007; 21: 370–371. |
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| Snippet | 【目的】本研究の目的は，pusher syndrome（以下，PS）を呈した脳卒中片麻痺者におけるsubject visual verticality（以下，SVV）の偏倚量の推移とPS の重症度およびPS の改... 「要旨」 【目的】本研究の目的は, pusher syndrome(以下, PS)を呈した脳卒中片麻痺者におけるsubject visual verticality(以下, SVV)の偏倚量の推移とPSの重症度およびPSの改... Purpose: We investigated the time course of deviation of subject visual verticality (SVV) and the severity of pusher syndrome (PS) to clarify whether... |
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| Title | 脳卒中後のpusher syndrome の重症度およびその改善経過とsubject visual verticality の偏倚との関連 |
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| ispartofPNX | 理学療法学, 2017, Vol.44(5), pp.340-347 |
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