Kinesie Paradoxaleの一例 : 歩行障害の考察

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The author reported a case of symptomatic parkinsonism with KINESIA PARADOXA and discussed the problems of gait disorder in KINESIA PARADOXA. Although the patient, 44-year-old housewife, had no difficulty in walking up and down the stairs, she was unable to walk on a flat monotonous floor because of difficulty in swinging her right foot foward. There were no apparent psychological or physical reasons to explain the gait disorder except for minimal weakness and rigidospasticity in all extremities. The movement of the center of floor reaction was recorded, when the patient stood on the force plate (San'ei Company, Japan) and initiated her first step. The force plate study findings were as follows ; 1) static balance while standing was excellent, 2) voluntary displacement of center of floor reaction while standing was markedly reduced, 3) on initiating first step, there was no propulsive force and was an oscillation from side to side with gradual forward falling. The patient was asked to use a cane with a short horizontal bar at the bottom, in order to encourage KINESIA PARADOXA which is evoked by visual stimulus only. However, she preferred a pulling-up strap attached to the right foot rather than the cane which necessitated constant visual control. The patient did not show remarkable response to ordinary kinesitherapy or drugs including El-dopa. Although there have several reports on KINESIA PARADOXA as a clinical sign since Souques and Babinski (1921), the author could not find adequate explanation of this phenomenon in the literature. It is, however, accepted that visual compensation for defective feedback mechanism like the one in parkinsonism is very important.
社団法人日本リハビリテーション医学会の論文
1977-08-18

Kinesie Paradoxaleの一例 : 歩行障害の考察

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