麻ひ側立脚期に下部体幹の崩れを呈するクモ膜下出血後左片麻ひ患者の一症例―下部体幹と麻ひ側肩甲帯の関連性に着目して―:－下部体幹と麻痺側肩甲帯の関連性に着目して－
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We report the rehabilitation of a patient with chronic left side paralysis caused by SAH. When walking, from the time the heel of the patient's paralyzed side contacted the ground to the time of mid stance, the patient's pelvis tilted anteriorly, rotated to the left, and lumbar vertebrae bent backwards and the paralyzed side of the shoulder girdle eleveated, extended, and paralyzed and collapsed forward. We examined the relationship between the paralyzed lower trunk and the paralyzed shoulder girdle. We performed three different patterns of physical therapy a total of twelve times over three months. Pattern A: physical therapy for the paralyzed lower trunk; Pattern B: physical therapy for the paralyzed shoulder girdle; Pattern C: both. After physical therapy of patterns A and B we observed no noticeable effect, but after the treatment of pattern C the patient's sitting, walking and weight shift to the paralyzed side when standing improved. In this case, it was not enough to treat only one side to improve the unusual muscle tone of the paralyzed lower trunk and the shoulder girdle, so we also considered the relationship between the primary problem of unusual muscle tone of the paralyzed lower trunk, and then considered the problem of unusual muscle tone of the paralyzed lower trunk, including the shoulder girdle, and treated both at the same time. Through this experience, we again confirmed the importance of understanding each part of a patient's problems and the relationship between them.
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