著者

和田 善行 池上 聡子 石川 定 降矢 芳子 川平 和美

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.34, no.5, pp.569-574, 2019 (Released:2019-10-28)

参考文献数

16

被引用文献数

2

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〔目的〕促通反復療法(Repetitive Facilitative Exercise:RFE)の痙縮減弱効果を検討すること.〔対象と方法〕慢性期脳卒中片麻痺患者30名に対して促通反復療法を中核とする治療(50回ずつ3セット,ADL練習,他:計100分)を週7回の頻度で4週間実施した.痙縮の評価にmodified Ashworth scaleを用い,麻痺肢の15関節運動について初回のRFEの前後,翌日のRFE前,4週間のRFE終了日のRFE前に実施し,RFEの痙縮減弱効果を検討した.〔結果〕RFEの痙縮減弱効果は即時効果と4週間の蓄積効果の全ての関節運動において有意であった.〔結語〕RFEは多くの痙縮筋への痙縮減弱の効果を有する.

著者

谷掛 万里 降矢 芳子 形岡 博史 川原 誠 平野 牧人 上野 聡

出版者

公益社団法人 日本リハビリテーション医学会

雑誌

The Japanese Journal of Rehabilitation Medicine (ISSN:18813526)

巻号頁・発行日

vol.45, no.8, pp.535-540, 2008-08-18 (Released:2008-09-18)

参考文献数

16

被引用文献数

1

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A 19-year-old girl was admitted to our hospital with nausea, vomiting, hiccups, constipation and syncope. After hiccups or vomiting sinus arrest developed and lasted more than 5-8 seconds. She lost consciousness every one hour. Based on an electrocardiographic diagnosis of sick sinus syndrome (SSS), a temporary pacemaker was implanted. The next day, although her syncope and bradycardia disappeared, she had orthostatic tachycardia of over 120 beats/minute and swelling of the legs, which led to a diagnosis of postural orthostatic tachycardia syndrome (POTS). Neurologically, she showed the right-sided tongue deviation and parasympathetic system disorders revealed by coefficient of variation of R-R interval (CVR-R), the Achner eye-ball pressure test, the valsalva ratio, and the head-up-tilt test. Brain MRI disclosed a small hyperintense lesion on a T2-weighted image with gadolinium enhancement in the right dorsal medulla including the hypoglottis nucleus and the posterior nucleus of vagus. After steroid pulse therapy (methyl prednisolone 1 g/day×3 days, 5 times) was administered, this lesion became smaller and finally disappeared. Before the lesion disappeared, she was able to begin rehabilitation by wearing elastic stockings and treatment with midodrine hydrochloride. The following year, she developed other MRI-proven brain lesions, suggestive of demyelination. Such a spinal and temporal distribution of lesions led to a diagnosis of multiple sclerosis (MS). A case of POTS caused by MS has not been reported previously, however, MS often affects the medullary paraventricular regions associated with autonomic failures. Autonomic failures often prevent patients from experiencing early rehabilitations. We should promptly give symptomatic treatment against autonomic failures, which leads to good patient recovery not only in patient vitality but also functionality.