理学療法ジャーナル57巻6号

2023年06月発行

特集 脳卒中の予後予測と目標設定

脳卒中後歩行障害の予後予測と目標設定

著者： 関口雄介¹

所属機関： ¹東北大学病院リハビリテーション部

ページ範囲：P.658 - P.664

Point

●脳卒中片麻痺患者の歩行障害の特徴やメカニズムについて理解する

●歩行障害の回復メカニズムについては神経科学的視点から，回復過程や予後予測については臨床評価指標を用いて疫学的視点から理解する

●患者の目標設定は客観的指標を用いた予後予測を参照し，患者の希望を踏まえて行う

参考文献

1）Fulk GD, et al：Predicting home and community walking activity poststroke. Stroke 2017；4：406-411

2）Hsiao H, et al：Mechanisms to increase propulsive force for individuals poststroke. J Neuroeng Rehabil 2015；12：40. doi：10.1186/s12984-015-0030-8

3）Platts MM, et al：Metabolic cost of over ground gait in younger stroke patients and healthy controls. Med Sci Sports Exerc 2006；38：1041-1046

4）Balbinot G, et al：Mechanical and energetic determinants of impaired gait following stroke：segmental work and pendular energy transduction during treadmill walking. Biol Open 2020；9：bio051581. doi：10.1242/bio.051581

5）Farris DJ, et al：Revisiting the mechanics and energetics of walking in individuals with chronic hemiparesis following stroke：from individual limbs to lower limb joints. J Neuroeng Rehabil 2015；12：24. doi：10.1186/s12984-015-0012-x

6）Honda K, et al：Effects of aging on whole-body center of mass movement and lower limb joint kinematics and kinetics during deep-squat movement. J Biomech 2022；134：110996. doi：10.1016/j.jbiomech.2022.110996

7）Nott C R, et al：Relationships between frontal-plane angular momentum and clinical balance measures during post-stroke hemiparetic walking. Gait Posture 2014；39：129-134

8）Soulard J, et al：Motor tract integrity predicts walking recovery：a diffusion MRI study in subacute stroke. Neurology 2020；94：e583-e593. doi：10.1212/WNL.0000000000008755

9）Lim SB, et al：Brain activity during real-time walking and with walking interventions after stroke：a systematic review. J Neuroeng Rehabil 2021；18：8. doi：10.1186/s12984-020-00797-w

10）Jørgensen HS, et al：Recovery of walking function in stroke patients：the Copenhagen Stroke Study. Arch Phys Med Rehabil 1995；76：27-32

11）Buvarp D, et al：Predicting longitudinal progression in functional mobility after stroke：a prospective cohort study. Stroke 2020；51：2179-2187

12）Richards CL, et al：Hemiparetic gait following stroke. Part Ⅱ：recovery and physical therapy. Gait Posture 1996；4：149-162

13）Mahendran N, et al：Accelerometer and global positioning system measurement of recovery of community ambulation across the first 6 months after stroke：an exploratory prospective study. Arch Phys Med Rehabil 2016；97：1465-1472

14）Preston E, et al：Prediction of independent walking in people who are nonambulatory early after stroke：a systematic review. Stroke 2021；52：3217-3224

15）Wee SK, et al：Longitudinal analysis of the recovery of trunk control and upper extremity following stroke：an individual growth curve approach. Top Stroke Rehabil 2022；29：58-73

16）Indredavik B, et al：Medical complications in a comprehensive stroke unit and an early supported discharge service. Stroke 2008；39：414-420

17）Sackley C, et al：The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke 2008；39：3329-3334

18）Bower K, et al：Dynamic balance and instrumented gait variables are independent predictors of falls following stroke. J Neuroeng Rehabil 2019；16：3. doi：10.1186/s12984-018-0478-4

19）Frame HB, et al：The influence of lateral stabilization on walking performance and balance control in neurologically-intact and post-stroke individuals. Clin Biomech（Bristol, Avon） 2020；73：172-180

20）Smith MC, et al：The TWIST algorithm predicts time to walking independently after stroke. Neurorehabil Neural Repair 2017；31：955-964

21）Smith MC, et al：The TWIST tool predicts when patients will recover independent walking after stroke：an observational study. Neurorehabil Neural Repair 2022；36：461-471

22）Persson CU, et al：Clinical tests performed in acute stroke identify the risk of falling during the first year：postural stroke study in Gothenburg （POSTGOT）. J Rehabil Med 2011；43：348-353

23）Alzayer L, et al：The accuracy of individual Berg Balance Scale items compared with the total Berg score for classifying people with chronic stroke according to fall history. J Neurol Phys Ther 2009；33：136-143

24）Blennerhassett JM, et al：Changes in balance and walking from stroke rehabilitation to the community：a follow-up observational study. Arch Phys Med Rehabil 2012；93：1782-1787

25）Krasny-Pacini A, et al：Goal Attainment Scaling in rehabilitation：a literature-based update. Ann Phys Rehabil Medicine 2013；56：212-230

26）新妻邦泰，他：脳梗塞におけるMuse細胞を用いた治療戦略．血液フロンティア2019；29：185-195