Sitting Disability Due to Impaired Distance Judgment and Disability of Body Orientation : A Case Report

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  • Otaka Akio
    Department of Rehabilitation, Wakayama Medical University Kihoku Hospital.
  • Sumiya Tadashi
    Department of Rehabilitation, Wakayama Medical University Kihoku Hospital.
  • Hirayama Kazumi
    Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences

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Other Title
  • 距離判断障害と自己身体定位障害により着座障害を呈したと考えられる 1 症例

Abstract

<p>  We report a patient who exhibited a sitting disability after infarction in the right medial temporal lobe, upper part of the bilateral fronto-parietal lobe, and the bilateral occipital lobe. The patient tended to sit toward the front of a chair and shift his body direction away from the correct direction when sitting. We speculated that sitting toward the front of the chair resulted from impaired judgment of distance, judging from the patientʼs errors in the forward and backward directions when reaching for dishes, incorrect estimation of the spatial distance of objects, and his remark that “distance is difficult to comprehend.” We inferred the abnormal shift in body direction was related to the patientʼs inability to orient his own body, judging from an effective compensatory strategy of trying to align part of his body with the chair and his remark “I donʼt know how to sit on the chair.” The disordered sitting improved with the use of parallel bars as well as foot and arm supports of a wheelchair. Rehabilitation therapy comprised gradually weaning the patient from the use of foot and arm supports, which provided environmental cues to the patient. This rehabilitation strategy led to improvements in the patientʼs ability to sit on other types of chairs.</p>

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