臨床神経学
Online ISSN : 1882-0654
Print ISSN : 0009-918X
ISSN-L : 0009-918X
55 巻 , 5 号
選択された号の論文の16件中1~16を表示しています
原著
  • Kiyomi Nagumo, Yumiko Kunimi, Susumu Nomura, Masatosi Beppu, Keizo Hir ...
    2015 年 55 巻 5 号 p. 311-319
    発行日: 2015年
    公開日: 2015/05/30
    ジャーナル フリー
    Objective: Ataxic gait can be remarkably improved by a simple method called the “handkerchief guide” involving the patient and caregiver holding opposite ends of a handkerchief and walking together. Our objective was to assess the effect of the handkerchief guide on gait in patients with cerebellar ataxia.
    Methods: Gait analysis was carried out on seven patients with degenerative cerebellar disease (DCD), seven patients with unilateral cerebellar vascular disease (CVD), and seven healthy control (HC) subjects. All subjects performed two walking tasks: free walking (FW) and handkerchief-guided walking (HGW) on a 10 m pathway. In the HGW condition, each subject walked with the caregiver while maintaining slight tension on the handkerchief. The HCs and patients with DCD held the handkerchief with their right hand, while the patients with unilateral limb ataxia due to CVD grasped it with their affected and unaffected hands in different trials. We measured 10 gait parameters.
    Results: The HGW attenuated body-sway, lengthened step, and increased gait velocity in patients with cerebellar ataxia. In DCD, the HGW significantly improved seven parameters. In CVD, HGW with the affected hand improved five parameters, and HGW with the unaffected hand improved seven parameters.
    Conclusions: The HGW stabilized upright posture in patients with cerebellar ataxia during level-ground walking, probably by enabling subconscious postural adjustments to minimize changes in the arm and hand position relative to trunk, and in arm configuration. This led to improvement of gait performance. The handkerchief guide may be useful for walk training in patients with cerebellar ataxia.
    Abbreviations: COM, center of mass; COG, center of gravity (projection of the COM onto the ground plane); COP, center of pressure; CVD, cerebellar vascular disease; DCD, degenerative cerebellar disease; FW, free walking; HAT, head, arms, and trunk segment; HC, healthy control; HGW, handkerchief-guided walking.
  • 近藤 正樹, 大道 卓摩, 向井 麻央, 藤並 潤, 中川 正法, 水野 敏樹
    2015 年 55 巻 5 号 p. 320-326
    発行日: 2015年
    公開日: 2015/05/30
    ジャーナル フリー
    認知症をともなう筋萎縮性側索硬化症(amyotrophic lateral sclerosis with dementia; ALS-D)は前頭・側頭葉の機能障害を特徴とするが,われわれは構成障害,頭頂葉血流低下をみとめたALS-Dの2症例を経験した.症例1は球麻痺型で前頭・側頭葉機能障害にともなう認知症症状を呈し,積木構成,図形模写が障害されていたが,手指形態模倣は良好であった.症例2は下肢型で軽度の前頭葉機能低下に加え,図形模写,積木構成の軽度障害がみられた.2症例でみとめた構成障害は右,左大脳半球障害として報告された内容の特徴が混在し,アルツハイマー型認知症でみられる構成障害と類似していた.また,自己身体による課題(手指形態模倣)より客体を素材とした課題(図形模写,積木構成)で顕著であった.
症例報告
短報
Letters to the Editor
Reply from the Author
地方会抄録
会告
編集後記
feedback
Top