著者

藤本 将志 渡邊 裕文 蔦谷 星子 大沼 俊博 三好 裕子 赤松 圭介 中道 哲朗 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.5, pp.91-95, 2005 (Released:2006-01-26)

参考文献数

4

被引用文献数

1

---

Lateral shift using one hand while sitting on a seat is an important ability in sitting up, for locomotion, to reach the other side. We sometimes control muscle tone of the trunk to change lateral weight bearing on one hand in hemiplegia caused by cerebrovascular diseases in which movements are difficult to perform because of trunk collapse. In this study, we analyzed the activity of the trunk muscles (obliquus abdominis, obliquus externus abdominis, obliquus internus abdominis and lumbar back) with EMG in changing the weight bearing in lateral shift with one hand while sitting on a seat. The results show that the supporting hand is necessary in sitting on the seat. The supported obliquus abdominis muscles, obliquus externus abdominis muscles and lumbar back muscles acted to maintain and fix the trunk as the weight increased. The supported obliquus external abdominis muscles acted to stabilize the upper trunk and rib cage, and the unsupported obliquus abdominis muscles, obliquus internus abdominis muscles and lumbar back muscles elevated pelvis as the weight decreased. Therefore, it is suggested that in the change of weight bearing in lateral shift the supporting hand serves an important purpose in maintaining trunk stability.

著者

早田 荘 赤松 圭介 藤本 将志 田尻 恵乃 水上 俊樹 貝尻 望 大沼 俊博 渡邊 裕文 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.10, pp.57-62, 2010 (Released:2011-01-13)

参考文献数

1

被引用文献数

1

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The efficacy of physical therapy for a patient with impaired hair-washing motion due to dysfunction of the inferior fibers of the trapezius was assessed. Surface electromyography was performed to investigate the clinical implications, and to elucidate the relationship between changes in the speed of elbow joint flexion-extension during simulated hair-washing motion and the corresponding activities of the superior, intermediate, and inferior fibers of the trapezius and of the caput longum of triceps brachii. In a sitting position, the subject moved the shoulder joint approximately 110 degrees in flexion and the elbow joint approximately 45 degrees horizontally on the measured side, and performed flexion-extension of the elbow joint in which the middle finger on the measured side reciprocated between the torus occipitalis and vertex in a hair-washing motion-simulating task. The motion speed was set at 40, 80, 120, and 160 motions per minute using a metronome and electromyograms of the superior, intermediate, and inferior fibers of the trapezius and the caput longum of triceps brachii were measured for 10 seconds 3 times during each task. Electromyogram waveforms of these fibers at each speed and the influence of changes in the elbow joint flexion-extension speed on the relative integrated electromyogram value were investigated. In the caput longum of triceps brachii, the amplitude of the electromyogram waveform in a single elbow joint flexion-extension motion was compared among the tasks at different speeds. The waveform amplitude increased and the relative integral value tended to increase as the elbow joint flexion-extension speed increased only in the inferior fibers of the trapezius. These findings suggest that to evaluate and improve hair-washing motion in patients with impairment of the scapulothoracic joint, the arm should be maintained in an elevated position during this motion. Furthermore, attention should be paid to the activity of the inferior fibers of the trapezius, which are assumed to be involved in stabilization of the scapula during the elbow joint flexion-extension motion, in this posture.

著者

田中 大志 高森 絵斗 早田 荘 赤松 圭介 大沼 俊博 渡邊 裕文 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.15, pp.117-125, 2015 (Released:2016-01-06)

参考文献数

8

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We report on the use of physical therapy for a patient with right hemiplegia experiencing difficulty with getting up from a bed after cerebral infarction. Based on a previous study, the aim was for the patient to get up by rolling over to the non-paralyzed side to attain the sitting position. Observation of the getting up action of the patient revealed that the trunk flexion and rotation of the non-paralyzed side were insufficient. Therefore, the patient tried to lift the upper body by pushing with the non-paralyzed side elbow on the bed. However, the patient had difficulty performing the getting up action, because the upper body fell down to the rear due to paralysis on the side of rotation of the trunk. Our assessment showed hypotonia in both parts of the rectus abdominis, and in the external oblique muscle and serratus anterior muscle of the paralyzed side. Hypertonia was also found in the posterior fibers of the deltoid muscle and upper fibers of the latissimus dorsi muscle on the non-paralyzed side. After 1 week of physical therapy, the impairments improved and the patient was able to perform the getting up movement.

著者

早田 荘 楠 貴光 藤本 将志 大沼 俊博 渡邊 裕文 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.15, pp.39-44, 2015 (Released:2016-01-06)

参考文献数

11

被引用文献数

4

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The purpose of this study was to clarify the activities of the longissimus, multifidus, and iliocostalis muscles at different angles of shoulder joint flexion. The subjects were 14 healthy males (mean age, 23.7 ± 1.9 years). Electromyograms of the longissimus, multifidus, and iliocostalis muscles were recorded at shoulder flexion angles of 0, 30, 60, 90, 120, and 150 degrees in a seated position. The relative values of the integrated electromyograms (iEMG) of the longissimus muscle on the side of shoulder joint flexion gradually increased up to the flexion angle of 90 degrees and gradually decreased thereafter. The longissimus iEMG value was significantly higher at 90 degrees than at 150 degrees. There were no changes in the relative values of the other muscles. We conclude that the longissimus muscle on the side of shoulder joint flexion contributes to the maintenance of posture.

著者

池田 幸司 藤本 将志 安井 重男 渡邊 裕文 大沼 俊博 赤松 圭介 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.9, pp.83-88, 2009 (Released:2010-01-16)

参考文献数

3

被引用文献数

4

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In the clinical field, we have provided physical therapy for cases presenting with Trendelenburg sign on walking caused by reduced muscle strength of the abductor muscle group of the hip joint on the weighted side. The Trendelenburg sign can occur in the early stage or after the middle stage of the stance phase, showing various patterns. In this study, we focused on the relationship between Trendelenburg sign occurring in the early stage or after the middle stage of the stance phase and the abductor muscle group of the hip joint on the weighted side. The subjects were asked to flex their hip joint and bend the body forward with 95% of the body weight loaded on one side of the body in an upright position, and remain in this position with the angle from the initial position at 5, 10, 15, 20, and 25 degrees. We evaluated the influence of changes in the angle of the hip joint on integration values of electromyograms of the abductor muscle group of the hip joint (the tensor fascia lata muscle, gluteus medius muscle, and superior part of the gluteus maximus muscle) on the weighted side, using surface electromyograms. As a result, the relative integration value of the electromyograms of the tensor fasciae lata muscle and gluteus medius muscle on the weighted side significantly decreased as the angle of the hip joint increased. On the other hand, the relative integration value of electromyograms of superior part of the gluteus maximus muscle on the weighted side significantly elevated as the angle of the hip joint increased. The hip joint on the weighted side underwent flexion, and was subjected to an abduction force, as the angle of hip joint changed when one of the lower extremities was loaded. It was considered that superior part of the gluteus maximus muscle, which also belongs to the extensor muscle group of the hip joint, was primarily involved as a braking force. The results of this study suggest that the evaluation and treatment of superior part of the gluteus maximus muscle is important in controlling the dropping of the pelvis toward the non-weighted side (adduction of the hip joint of the standing leg) and its anterior inclination (flexion of the hip joint of the standing leg) in cases presenting with Trendelenburg sign.

著者

伊藤 陸 貝尻 望 藤本 将志 大沼 俊博 渡邊 裕文 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.15, pp.49-52, 2015 (Released:2016-01-06)

参考文献数

5

被引用文献数

1

---

To analyze walking turns, the influence the hip joint external rotation angle of the stepping limb in the standing position has on electromyographic activities of the upper and lower gluteus maximus muscle fibers was examined. The subjects were 10 healthy males with a mean age of 24.2. The standing position was defined as the position in which subjects stepped forward from a standing position. The hip joint external rotation angle of the starting position was changed, and the electromyographic activities of the upper and lower gluteus maximus muscle fibers were measured at each angle. The integrated electromyographic relative value of the upper gluteus maximus fiber significantly increased with the increase of the hip joint external rotation angle. The integrated electromyographic relative value of the lower gluteus maximus fiber also showed a tendency to increase. It is our opinion that the upper and lower gluteus maximus muscle fibers participate in the maintenance of the extension and external rotation of the support side hip through the actions of hip extension and external rotation. In addition, the support side hip performs adduction with increase in the angle of hip external rotation, indicating that the upper gluteus maximus fiber increases hip abduction to brake it.

著者

淵本 恵 辻 智美 貝尻 望 藤本 将志 大沼 俊博 渡邊 裕文 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.16, pp.101-107, 2016 (Released:2016-12-29)

参考文献数

3

---

In this report, we describe the physical therapy prescribed for a patient with right hemiplegia following cerebral hemorrhage. The patient had difficulty in swinging off the toes because of right hip flexion during walking. This posture did not allow sufficient right hip joint extension from the right loading response to mid stance. In the left swing phase, right hip joint medial rotation from the flexion position caused her trunk to lean forward. She recovered to the right rear direction by right lateral bending and extension of the thoracic and lumbar spine, and right shoulder extension. Even in the terminal stance, right hip joint flexion persisted. The patient increased her right hip joint flexion in the right swing phase. Her walk weight movement was insufficient because right hip joint flexure was increased in the right terminal stance. As a result, the right foot caught on the floor during the right swing. We regarded gluteus maximus weakness to be the chief issue causing right hip joint flexion in the stance phase and conducted physiotherapy accordingly. We report the progress in gait improvement as a result of the prescribed physiotherapy.

著者

渡邊 裕文 大沼 俊博 高崎 恭輔 谷埜 予士次 鈴木 俊明

出版者

理学療法科学学会

雑誌

理学療法科学 (ISSN:13411667)

巻号頁・発行日

vol.29, no.4, pp.561-564, 2014 (Released:2014-09-25)

参考文献数

13

被引用文献数

6 1

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〔目的〕座位での腹斜筋の活動を明確にすることである.〔対象〕本研究に対する同意を得られた健常男性7名とした.〔方法〕テレメトリー筋電計MQ-8を用い,左側腹斜筋に複数の電極を配置し,座位にて側方移動距離を変化させ筋電図を測定した.座位での筋電図積分値に対する相対値を求め,移動距離による相対値の変化を検討した.〔結果〕側方移動距離の増大に対し,移動側腹斜筋群では筋電図積分値相対値に変化が認められず,反対側腹斜筋群ではこの値が全電極で増加傾向を示し,内腹斜筋単独部位とその直上の2電極で有意に増加した.〔結語〕座位で側方体重移動をリハビリテーションに用いる時,移動反対側内腹斜筋による骨盤の挙上作用に着目する必要のあることが示唆される.

著者

渡邊 裕文

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.5, pp.23-29, 2005 (Released:2006-01-26)

参考文献数

15

被引用文献数

1

---

There are a lot of motor related areas in cerebral cortex. This paper describes the premotor area (PM) and supplementary motor area (SMA). These areas belong in area 6 of Brodmann's areas and they are very important for preparation and planning of movement, although each of them has an independent function. We hope this article will help you to understand those functions and your clinical treatment.

著者

髙森 絵斗 水口 真希 早田 恵乃 渡邊 裕文 文野 住文 鈴木 俊明

出版者

理学療法科学学会

雑誌

理学療法科学 (ISSN:13411667)

巻号頁・発行日

vol.30, no.6, pp.939-943, 2015 (Released:2016-01-09)

参考文献数

9

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〔目的〕脳血管障害片麻痺患者の麻痺側母指球筋の筋緊張抑制に対する手太陰肺経の尺沢への経穴刺激理学療法の効果を明らかにすることとした.〔対象〕本研究に同意を得られた脳血管障害片麻痺患者7名とした.〔方法〕尺沢への経穴刺激理学療法施行の前後に麻痺側母指球筋からF波を測定し,安静試行と他の試行との間で振幅F/M比,出現頻度,立ち上がり潜時をそれぞれ比較した.〔結果〕振幅F/M比は安静試行と比較して,経穴刺激理学療法試行中,終了直後,5分後,10分後,15分後に有意に低下した.出現頻度,立ち上がり潜時は,経穴刺激理学療法試行前後の変化を示さなかった.〔結語〕筋緊張抑制目的の経穴刺激理学療法では,脊髄神経機能の興奮性を抑制することが示唆される.

著者

安井 重男 藤本 将志 渡邊 裕文 大沼 俊博 赤松 圭介 中道 哲朗 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.8, pp.69-73, 2008 (Released:2009-01-15)

参考文献数

5

被引用文献数

3

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We have experimented with physical therapy for patients with difficulty of body weight transfer due to hyperactivity of the latissimus dorsi and muscular contractions. For lateral body weight transfer, training changed the distance of lateral transfer in the sitting position. Recent electromyographic (EMG) studies on the latissimus dorsi reported activities in its upper and lower fibers in the scapular brachial joint during trunk exercise. However, the activities of this muscle on lateral transfer in the sitting position have not been analyzed. In this study, we examined the influence of changes in the distance of lateral transfer in the sitting position using the EMG of the upper and lower fibers of the latissimus dorsi. Initially, in the end-sitting position (starting limb position), in which the bilateral arms were folded, we measured integrated EMG (iEMG) for the upper and lower fibers of the bilateral latissimus dorsi. Subsequently, the shoulder girdle was transferred in the lateral direction at distances of 5, 10, 15, and 20 cm without inclining or rotating the line between the bilateral acromions, while maintaining the head in the vertical position, with both feet placed on the ground from the starting limb position. We determined the respective iEMGs. There were no significant lateral transfer distance-related changes in the relative iEMG for the upper and lower fibers of the mobile side latissimus dorsi. Furthermore, the value for the upper fibers of the non-mobile side increased with the distance of lateral transfer. In addition, the value for the lower fibers of the non-mobile side also elevated with the lateral transfer distance; at a distance of 20 cm, the value was significantly higher than those at distances of 5 and 10 cm. Based on the results of this study, it may be important to evaluate the abdominal oblique muscles, dorsolumbar muscles, and latissimus dorsi in performing lateral body weight transfer. Training chang the distance of lateral transfer in the sitting position of patients with difficulty of lateral transfer . In addition, the actions of the upper fibers of the latissimus dorsi differed from those of the lower fibers, suggesting the necessity of assessing these fibers individually.

著者

渡邊 裕文 大沼 俊博 藤本 将志 水上 俊樹

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.11, pp.5-11, 2011 (Released:2012-01-06)

参考文献数

1

---

In this paper, we introduce some approaches that have been used for hemiplegic patients with serious sensory disturbance in our hospital's convalescence rehabilitation ward. The highest function level in the present case was sitting in a leaning position, and this patient needed assistance in all the activities of daily living. Our treatment aimed to adjust the alignment of the trunk and the neck and improve the mobility of the non-paralyzed upper and lower limbs. Herein, we discuss our goal, potential outcome, and problems of impairment through the treatment and sitting posture in the wheelchair before and after treatment.

著者

大沼 俊博 渡邊 裕文 蔦谷 星子 三好 裕子 山口 剛司 赤松 圭介 藤本 将志 鈴木 俊明

出版者

公益社団法人 日本理学療法士協会

雑誌

理学療法学Supplement Vol.31 Suppl. No.2 (第39回日本理学療法学術大会 抄録集)

巻号頁・発行日

pp.B0551, 2004 (Released:2004-04-23)

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【はじめに】臨床場面において歩行の立脚期に体幹・骨盤・下肢に不安定性を認める患者の理学療法を経験することがある。この時立脚側の支持性向上を図る目的で、片脚立位にて非支持側股関節を外転させての練習を実施することがある。我々は先行研究にて前方台へのステップ保持が、体幹筋や下肢筋の筋積分値に与える影響について検討してきた。今回我々は片脚立位における非支持側股関節外転角度を変化させた場合の両側外腹斜筋、内腹斜筋および腰背筋群の筋積分値変化について検討し、若干の知見を得たので報告する。【対象と方法】対象は、整形外科、神経学的に問題のない健常男性7名、平均年齢は28.9歳であった。まず被験者に安静立位保持をさせた。この状態で筋電計ニューロパック(日本光電社)を用いて、双極導出法にて両側外腹斜筋、内腹斜筋、腰背筋群の筋積分値を測定した。外腹斜筋の電極は第8肋骨下縁に電極間距離2cmにて配置し、内腹斜筋は両側上前腸骨棘を結ぶ線より2cm下方の平行線と鼠径部との交点、および2cm内方へ電極を配置した。さらに両側腰背筋群の電極は第3腰椎棘突起側方3cmおよび上方2cmの位置へ配置した。測定時間は10秒間とし、3回測定した。次に非支持側の下肢において股関節外転角度を0°、15°、30°、45°、60°と変化させ、同様に筋積分値を測定した。この時の股関節外転角度は非支持側上前腸骨棘を通る床面への垂線を基本軸とし、大腿中央線を移動軸とした。また骨盤の傾斜角度を確認するため、両側の上前腸骨棘にマーカーを貼付し、前方よりビデオ撮影した。【結果および考察】骨盤傾斜角度は、股関節外転角度の増大に伴い増加した。外腹斜筋の筋積分値は両側共に有意な変化を認めなかった。内腹斜筋、腰背筋群については両側共に股関節外転角度の増大に伴い増加した。三浦らによると、外腹斜筋は動作と同期して活動しやすく、体幹回旋時の求心性収縮作用に関与すると述べている。またSnijdors、三浦らは、片脚立位や歩行の立脚期において、仙腸関節へ生じる剪断力に対して内腹斜筋の筋活動はそれを防ぐ効果があると報告している。さらに市橋らは立位での非支持側股関節外転時、支持側の中臀筋に筋活動の増加を認めたと報告し、またCastaingは片脚立位の場合、支持側の中臀筋、大臀筋、大腿筋膜張筋が骨盤の非支持側への傾斜を制御すると報告している。本結果から両側外腹斜筋に関しては、本課題では体幹回旋動作がなく、求心性収縮の要素がなかったため筋積分値に変化を認めなかったと考える。また両側内腹斜筋に関しては、非支持側股関節外転位での片脚立位時に生じる仙腸関節への剪断力の増加に対して筋積分値の増加を認めたと考える。さらに両側腰背筋群に関しては、本課題では支持側中臀筋、大臀筋、大腿筋膜張筋と共に骨盤の非支持側への傾斜に対する制御に関与したと考える。

著者

渡邊 裕文

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.6, pp.15-19, 2006 (Released:2007-01-30)

参考文献数

7

被引用文献数

1

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Generally diseases which cause disorder of coordinated movement are cerebrovascular diseases, brain tumors, multiple sclerosis, spinal cerebellar and degeneration. Especially, many patients with cerebellum disease have disorders of coordinated movement. This paper describes the function of the cerebellum and disorders of coordinated movement. For physical therapy of disorder of coordinated movement we define the part of instability and provide compensatory fixation. Then, it is important that we facilitate the stabilized movement of patients in a functional setting.

著者

松本 明彦 津江 正樹 赤松 圭介 大沼 俊博 渡邊 裕文 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.13, pp.129-136, 2013 (Released:2013-12-28)

参考文献数

4

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We report the case of a patient who, after posterior lumbar fixation for lumbar spinal canal stenosis, presented with difficulty in reaching the gluteal cleft with the right upper limb from the dorsal side while wiping after excretion and inevitably used the left upper limb. Through observation of a simulated wiping motion with the right upper limb, a decrease in the ability to perform the following movements was suspected: moving the pelvis from a posterior to an anterior inclination with flexion, internally rotating the left hip joint, extending the trunk, elevating the right pelvis and flexing the trunk to the right side, and rotating the trunk to the right. Examination based on these observations identified decreased tonus of the bilateral internal oblique muscles of the abdomen and multifidus and longissimus muscles, and increased tonus of the bilateral iliocostal muscles to be the primary causes. Therefore, surface electromyography was performed, and electromyographic waveform patterns of the aforementioned trunk muscles during simulated wiping motion with the right upper limb were compared with those of healthy subjects. No activity was detected in the bilateral internal oblique muscles of the abdomen. The patterns of the other muscles were similar, albeit with decreased activity. During physical therapy, the patient retained the physiological curvature of the spine, with the pelvis in the center of the anterior and posterior inclinations and the trunk extended in a sitting position. Furthermore, right pelvic elevation and right rotation of the trunk accompanied by right-sided flexion were promoted while shifting the body weight in the left anterior direction. Satisfactory wiping motion with the right upper limb was acquired through this therapy. This case report suggests that when examining the wiping motion after excretion, it is necessary to evaluate the ability to elevate the pelvis and flex and rotate the trunk to the required side while retaining the physiological curvature of the spine.

著者

山口 剛司 渡邊 裕文 蔦谷 星子 大沼 俊博 三好 裕子 赤松 圭介 藤本 将志 若林 志保子 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.3, pp.139-144, 2003 (Released:2005-04-12)

参考文献数

2

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Lateral shift of the center of gravity for the treatment of cerebral angiopathic paralysis was investigated. These patients show increased tension in the dorsolumbar muscles on the paralyzed side, and have difficulty in shifting their weight toward the paralyzed side. Prior to the restoration of standing and walking motions, it is necessary to improve the sitting posture. In this study, we treated cerebral angiopathic paralysis by 2 lateral methods of shifting the center of gravity by inducing movement of the trunk alone and simultaneous movements of the trunk, pelvis and lower limbs. The effects of the treatment by these methods were evaluated with muscle integration values and observation of the posture of the patients. The muscular activity pattern of the muscles in the trunk became closer to normal, and posture and motion were improved when movements of the trunk, pelvis and lower limbs were simultaneously induced. It was suggested that simultaneous induction of the trunk, pelvis and lower limbs was important for treatment based on lateral shift of the center of gravity.

著者

大沼 俊博 藤本 将志 赤松 圭介 渡邊 裕文 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.12, pp.15-23, 2012 (Released:2012-12-27)

参考文献数

7

被引用文献数

1

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In clinical practice, sensory tests are performed for patients with a disorder to establish a diagnosis or verify a hypothesis concerning sensory impairment. The hypothesis is set up by the therapist through observational assessment and a graphic display of movements based on a top-down approach. This paper discusses sensory testing based on a top-down approach by presenting effective clinical methods to identify sensory impairments.