著者
小島 佑太 辻 智美 伊藤 陸 早田 荘 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.17, pp.133-138, 2017 (Released:2017-12-29)
参考文献数
1

We administered physical therapy for a patient who presented with right hemiplegia after cerebral infarction. When lowering clothing with the left hand for toileting, the patient risked falling posteriorly to the right. Therefore, therapy focused on enabling the removal of underclothing. Healthy subjects remove underclothing with the use of left elbow extension and left lateral bending of the trunk, while moving the pelvis in a right lateral direction. However, this patient was unable to adequately bend the trunk to the left and could not lower underclothing on the left side. In addition to not being able to control right lateral movement of the pelvis, she had rearward displacement of the right buttock, and risked falling posteriorly to the right. Physical examination and observation of motion revealed decreased tone of the right external abdominal oblique and the posterior fibers of the gluteus medius; the lower fibers of the gluteus maximus were considered the main problem. Physical therapy enabled the patient to undress for self-toileting by focusing on the impaired muscles.
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.