回復期リハビリテーション病棟に入院した脳血管障害（CVD）および廃用症候群（DS）の症例を自宅退院例（subgroupI）と施設入所例（subgroupII）に分類し,各疾患群のsubgroup間で入院前の生活状況，入院後のADLの推移，疾病発症から回復期リハ病棟入退院までの時間的経過の比較検討を行った．CVD群 32 例中，subgroupI（19 例）とII（13 例）の間に平均年齢の有意差を認めた（65.4±14.0 歳 vs. 80.3±10.9 歳）．入院前の生活状況は各subgroup間で差を認めなかったが，subgroup Iではsubgroup IIと比べて入退院時の総合FIM，運動FIMおよび認知FIMの各点数はいずれも有意に高く，運動FIMの移乗と移動の項目では退院時に有意な点数の改善を示した．一方，DS 22 例中，subgroupI（11例）とII（11例）に年齢差はなく（80.5±11.0 歳 vs. 81.5±11.2 歳），subgroup Iでは同居者数は多く，入院後に運動FIMのセルフケアと移乗の項目で点数の有意な上昇が認められた．自宅退院には運動ADLの向上が求められ，CVD群では年齢や認知症度が，DS群では同居者数がその影響因子として加わることが示唆された．

抄録全体を表示

We report a 47-year-old right-handed male patient with pure word deafness after suffering an intracerebral hemorrhage. He had been working as a high school teacher before the onset of his stroke. He was emergently admitted to our hospital due to left putaminal hemorrhage and treated conservatively after admission. The patient's neurological findings showed that although his auditory comprehension was severely impaired, he was still able to communicate using written language. Pure-tone audiometry didn't detect any sensorineural hearing impairment. After the diagnosis of pure word deafness was clinically made, we educated the patient and his family, as well as the associated medical staff at our department, about this condition so that they could understand his pathological situation. In addition, we introduced a rehabilitation program for lip-reading and showed him a technique for using articulatory voice production in usual conversation. As a result of our attempts, he developed the ability to communicate using lip-reading skills after 2 months of rehabilitation and successfully returned to his previous work because of the communicative competence he acquired. We also make some proposals for helping other patients with auditory agnosia to return not only to their regular daily activities but also to return to gainful employment, as patients with this condition seem to have special difficulties benefiting from the present welfare service system in Japan.

抄録全体を表示

　
中心性頸髄損傷—急性期臨床像の特徴と治療転帰との関連—…富永　俊克，黒川　陽子，住田　幹男， 徳弘　昭博，古澤　一成，元田　英一　218

中心性頸髄損傷における排尿障害の病態と排尿管理について…長島　政純，田中　克幸　223

運動機能の回復について…時岡　孝光　225

中心性頸髄損傷—能力障害，転帰と健康関連QOL—…横山　　修　230

抄録全体を表示