慢性期脳卒中者の下肢に対する健側非拘束下modified constraint-induced movement therapyの効果

抄録

Constraint-induced movement therapy (CIMT) has been a well-established rehabilitative method for upper limb paralysis in patients post-stroke. In recent years, its application to lower limb paralysis (Lower limb CIMT, L-CIMT) has been reported. However, the reported intensive lower limb trainings do not seem enough to target behavioral modifications in an individual's daily life. In this study, we investigated the effects of L-CIMT including the transfer package to induce behavioral transformation in normal daily life of patients with lower limb paralysis. The L-CIMT including the transfer package was administered to three patients with chronic-phase stroke without any constraint on the healthy lower limb for 3.5 hours a day, 5 days a week for 3 weeks. As a result, standing balance and walking ability were improved immediately and within 6 months after the intervention, respectively. All three cases experienced increased daily opportunities for standing and walking. We believe that L-CIMT including the transfer package can bring both short- and long-term improvements in standing balance and walking ability. This can lead to an increase in the frequency of standing and walking in daily living, along with an expanded range of action in ADL and IADL in patients with chronic-phase stroke.