脳卒中片麻痺患者の足関節背屈機能障害に対する視覚性運動錯覚の効果：ABABシングルケースデザイン

ABSTRACT The purpose of this study was to investigate the effect of simultaneous intervention with the kinesthetic illusion induced by visual stimulation (KiNvis) and voluntary exercise on ankle dorsiflexion dysfunction in a patient with right-sided stroke hemiparesis. Within an ABAB single-case design, we conducted two phases each lasting five days. Phase A represented the baseline during which only voluntary ankle dorsiflexion (VAD) was performed. Phase B involved simultaneous performance of VAD and KiNvis. We measured the angle of ankle joint dorsiflexion (AJD), and the 10 m maximum walking speed (10MWS). AJD and 10MWS were significantly improved in phase B.東京都立大学学位論文甲第1066号副論

三次元バーチャルリアリティを用いた半側空間無視の評価と治療

Previously, it was difficult to detect mild neglect or a lack of stimulus-driven attention in patients using conventional assessments such as the Behavioral Inattention Test, usually performed on patients with unilateral spatial neglect. Here, we developed a method that randomly generates balloons in the left-right, up-down, and near-far spaces on a monitor using a head-mounted display. A head-mounted display can be used as an objective tool to evaluate and treat mild neglect symptoms by quantifying how quickly and accurately a patient can perceive the appearing balloons. In this study, we evaluated a lack of stimulus-driven attention case that was undetected by the paper and pencil test. We could identify mild neglect with our virtual reality method, as later confirmed using the Catherine Bergego scale. In addition to using virtual reality in a three-dimensional space to effectively detect mild neglect, this method can be used for treatment. After repeated practice under a tilted background space condition, the patient demonstrated a reduction in the time needed to perceive the appearing balloons, suggesting a therapeutic effect.東京都立大学学位論文甲第1160号　副論

機能的アウトカム尺度に基づく半側空間無視のリハビリテーション介入 : システマティックレビューとメタアナリシス

東京都立大

Non-Invasive Brain Stimulation (TMS/tDCS) and Rehabilitation for Stroke and Parkinson’s

The aim of this study was to clarify and compare the efficacies of rehabilitation using transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS), a form of repetitive transcranial magnetic stimulation (rTMS), in convalescing stroke and Parkinson’s disease patients. For both types of stimuli, kinetic analysis and performance analysis of upper limb motor paralysis and gait analysis showed an increase in speed of movement, and an improvement in performance was observed. Both stimuli resulted in significant improvement compared with a sham stimulus. Change in speed of movement and performance was observed with both tDCS and cTBS, but there was not a significantly large difference between the stimuli. Improved movement due to reduction of excessive tension caused by spasticity was observed. In patients with Parkinson’s disease, gait speed and step length were increased. It is suggested that performance was improved because movement became smoother. The efficacy of tDCS and cTBS in patients with motor disorders caused by stroke or Parkinson’s disease will probably be further improved when combined with physical therapy

半側空間無視の評価と治療アプローチ －最近の動向－

半側空間無視Unilateral Spatial Neglect:以下USNに関する評価と治療アプローチの最近の動向について概説した。評価では重症度とタイプに加え日常行動上での異常反応のチェックおよび基本的な起居移動動作の特性を知ることが重要である。またその症状の特性として課題依存性と姿勢変化による反応を分析することが必要であることを指摘した。治療アプローチでは視覚と非視覚系症状と症例の二つの要因を考慮しUSNのタイプすなわちメカニズムに応じた方法を用いることの重要性を論じた。さらに最近注目されているプリズム適応について紹介した。This paper reviews recent developments in assessment and therapeutic approaches to unilateral spatial neglect (USN). In assessment, in addition to the degree and type of injury, checks on abnormal responses in daily activities,as well as knowledge of movement behavior in basic living activities are important. Furthermore, regarding the characteristics of the symptoms, it is indicated that analysis of responses due to postural change and task dependency is important. In therapeutic approaches, visual and non-visual systems, symptoms and cases are considered, and the importance of the utilization of a treatment method which is suitable to the type of USN is discussed. In addition, prism adaptation which has recently become a focus of interest is introduced