2009 年 9 巻 p. 105-116
We experienced a patient with post-stroke left hemiplegia exhibiting Pusher's syndrome, who required assistance to maintain sitting and standing positions and to standing up. Hypotonia on the hemiplegic side and hypoesthesia were considered to be the basic problems with the posture and movement of this patient. Moreover, hypotonia of abdominal muscles on the non-hemiplegic side was assumed to be the main cause of Pusher's syndrome, a characteristic of this case. This condition may have induced excessive extension and abduction of upper and lower limbs on the nonhemiplegic side (Pusher's syndrome) in order to maintain posture and movement, leading to the requirement for excretory assistance. The hypotonic abdominal muscles on the non-hemiplegic side were trained through physical therapy, and Pusher's syndrome of upper and lower limbs on the non-hemiplegic side was improved. Following this, postures and movements were modified in consideration of bilateral symmetric sensory input, and movements necessary for toilet use were improved.