右足関節・足部と左股関節に対して理学療法を施し立ち上がり動作の安全性・安定性が向上した悪性リンパ腫脊髄転移後の一症例

抄録

We performed physical therapy for a patient with spinal cord metastasis after malignant lymphoma one year ago. Posterior instability was observed in the buttocks while standing up; therefore, the patient lacked safety and stability during this action. The motions of the flexion phase in standing up were as follows: (1) spatial anterior and lateral tilting of the leg, and (2) pelvic anterior tilting with flexion of the hip. These abnormal motions were considered to have been caused by high muscle tones in the right ankle and foot muscles. Therefore, we considered that it might be difficult for the patient to perform pelvic anterior tilting with hip flexion; and this would have made standing up difficult as well. We prescribed direct stretching and strength training for the right ankle and foot muscles. However, the pelvic anterior tilting with hip flexion showed no improvement. Therefore, pelvic anterior tilting with hip flexion was not solely caused by the ankle and foot. On re-examination, abnormal motion with left hip flexion muscle weakness was observed. Physical therapy was performed to treat these hip, ankle, and foot conditions. Consequently, the patient showed improvement in spatial anterior and lateral tilting of the leg, and pelvic anterior tilting with the flexion of the hip during the flexion phase. The patient also improved with respect to safety and stability while standing up.