理学療法ジャーナル54巻11号

2020年11月発行

特集 歩行PART 1　脳神経疾患と歩行

脳性麻痺による歩行障害の評価と治療

著者： 大畑光司¹

所属機関： ¹京都大学大学院医学研究科人間健康科学系専攻

ページ範囲：P.1303 - P.1308

Point

●脳性麻痺による歩行障害を考える際には，対象者のもつ発達障害をまず明確にする必要がある

●歩行障害に対する治療の第一選択は課題特異的な歩行トレーニングである

●ロボットを用いたトレーニングは歩行機能の発達や維持に有効であり，さらなる技術の発展が望まれる

参考文献

1）Lepage C, et al：Association between characteristics of locomotion and accomplishment of life habits in children with cerebral palsy. Phys Ther 1998；78：458-469

2）Barbeau H：Locomotor training in neurorehabilitation：emerging rehabilitation concepts. Neurorehabil Neural Repair 2003；17：3-11

3）Booth ATC, et al：The efficacy of functional gait training in children and young adults with cerebral palsy：a systematic review and meta-analysis. Dev Med Child Neurol 2018；60：866-883

4）Baker R, et al：The gait profile score and movement analysis profile. Gait Posture 2009；30：265-269

5）Moreau NG, et al：Effectiveness of rehabilitation interventions to improve gait speed in children with cerebral palsy：systematic review and meta-analysis. Phys Ther 2016；96：1938-1954

6）Schranz C, et al：Does home-based progressive resistance or high-intensity circuit training improve strength, function, activity or participation in children with cerebral palsy? Arch Phys Med Rehabil 2018；99：2457-2464

7）Carvalho I, et al：Robotic gait training for individuals with cerebral palsy：a systematic review and meta-analysis. Arch Phys Med Rehabil 2017；98：2332-2344

8）Sloot LH, et al：Self-paced versus fixed speed walking and the effect of virtual reality in children with cerebral palsy. Gait Posture 2015；42：498-504

9）Valentin-Gudiol M, et al：Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay. Cochrane Database Syst Rev 2011；CD009242. doi：10.1002/14651858.CD009242.pub2

10）Mattern-Baxter K, et al：Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy：a quasi-randomized controlled trial. Arch Phys Med Rehabil 2013；94：2061-2067

11）Butler PB, et al：Refinement, reliability, and validity of the segmental assessment of trunk control. Pediatr Phys Ther 2010；22：246-257

12）Curtis DJ, et al：The central role of trunk control in the gross motor function of children with cerebral palsy：a retrospective cross-sectional study. Dev Med Child Neurol 2015；57：351-357

13）Curtis DJ, et al：The functional effect of segmental trunk and head control training in moderate-to-severe cerebral palsy：a randomized controlled trial. Dev Neurorehabil 2018；21：91-100

14）Flores MB, et al：Trunk control and gross motor outcomes after body weight supported treadmill training in young children with severe cerebral palsy：a non-experimental case series. Dev Neurorehabil 2019；22：499-503

15）van Hedel HJ, et al：Robot-assisted gait training might be beneficial for more severely affected children with cerebral palsy. Dev Neurorehabil 2016；19：410-415

16）Morgan P, et al：Gait function and decline in adults with cerebral palsy：a systematic review. Disabil Rehabil 2014；36：1-9

17）Bottos M, et al：Functional status of adults with cerebral palsy and implications for treatment of children. Dev Med Child Neurol 2001；43：516-528

18）Moll LR, et al：The paradox of normalization through rehabilitation：growing up and growing older with cerebral palsy. Disabil Rehabil 2013；35：1276-1283

19）Opheim A, et al：Walking deterioration and gait analysis in adults with spastic bilateral cerebral palsy. Gait Posture 2013；37：165-171

20）Parent A, et al：Muscle fatigue during a short walking exercise in children with cerebral palsy who walk in a crouch gait. Gait Posture 2019；72：22-27

21）Kawasaki S, et al：Gait improvements by assisting hip movements with the robot in children with cerebral palsy：a pilot randomized controlled trial. J Neuroeng Rehabil 2020；17：87. doi：10.1186/s12984-020-00712-3