左足部・足関節への運動療法後に体幹の問題に対しても運動療法をおこなったことでT字杖歩行動作の実用性向上を認めた脳梗塞後左片麻痺患者の一症例

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  • 福本 悠樹
    関西医療大学保健医療学部　臨床理学療法学教室
  • 鈴木 俊明
    関西医療大学保健医療学部　臨床理学療法学教室

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  • Stability of the left leg stance during walking by a patient with left hemiplegia after cerebral infarction was improved by physiotherapy for the trunk, ankle, and foot
  • ヒダリアシブ ・ アシカンセツ エ ノ ウンドウ リョウホウ ゴ ニ カラダ カン ノ モンダイ ニ タイシテモ ウンドウ リョウホウ オ オコナッタ コト デ Tジ ツエ ホコウ ドウサ ノ ジツヨウ セイコウ ジョウ オ ミトメタ ノウ コウソク ゴ サ ヘンマヒ カンジャ ノ イチ ショウレイ

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<p>We performed physical therapy for a patient with left hemiplegia following cerebral infarction 4 years earlier. The patient had excess outward posterolateral tilt in the left leg stance during walking. Moreover, the pelvis tilted down and to the right with adduction of the left hip because of the progressive outward lateral left lower-leg tilt. The patient's gait motion showed an early initial contact on the left side. Abnormal motion was observed, with excess tone in the left peroneal and tibialis posterior muscles. Furthermore, left ankle dorsiflexion was restricted. Accordingly, we prescribed direct stretching for the left tibialis posterior and facilitation of the left peroneal muscles. However, the pelvic tilt to the right and adduction of the left hip showed no improvement. Therefore, the pelvic tilt to the right and adduction of the left hip were not caused by the ankle and foot problem. On re-examination, abnormal motion was observed, with abnormal muscle tone for horizontal driving on the left internal oblique muscle of the abdomen. Physical therapy was performed to address this trunk, ankle, and foot condition. Consequently, the patient showed improvement in left lower-leg excess outward posterolateral tilt, and pelvic tilt down and to the right, along with adduction of the left hip. Moreover, the patient attained stability in the left leg stance during walking.</p>

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