P-2-01-23
MOTOR FUNCTION OF NON-PARALIZED LIMBS IN THE PATIENTS WITII IIENIPLEGIA AFTER STROKE,RELATED TO GATE ABILITY AND CLINICAL ASPECTS
Yoshikatsu Hamaguchi (Myojo National Sanatorium, Mie, Japan)
[Purpose] Motor function of non-paralized limbs of the post-stroke hemiplegie patients is evaluated, and its relation to the ADL of the patients and their clinical aspects is analysed.
[Method] 40 rehabilitation patients: cerebral hemorrhage (Rt. hemiplegia;18 cases, Lt. hemiplegia; 22 cases). motor function based on MMT of non-paralized lower limb at three months after stroke. (1) ability of ADL: transfer assisted;point O, transfer independent;1, gait with use of the T-cane;2, gait independent;3, each case, scored. (2) cases of MMT4 or 5 are grouped on the use of the wheel chair (A group), on the gait (B). each group related to the laterality of the hemiplegia, dementia and primitive reflex. (3)MMT scores are related to their clinical aspects: ?@Aging ?Acervical and/or lumbal spondylosis ?BArhtropathy of knee and foot joint ?Cdiabetes, hypertension and ECG abnormality ?DBrunnstrom stage of paralyzed leg ?ECT or MRI findings
[result] MMT 0 to 2;4 eases, MMt 3;12, MMT 4;4. (1)averaging ADL scores:l.8 on MMT 0 to 3,2.4 on MMT 4 to 5, each scores are significant (2)group A;8 cases, B;16 cases. A group dominant on Lt. hemiplegia, with dementia and marked primitive reflex (3)correlated to the old age (more than 70), spondylosis, arthropathy and diabetes Brunnstrom stage 1 to 2; dominant to MMT 0 to 3. CT or MRI; putaminal hemorrhage dominant on the MMT 4 or more
[conclusion] Motor function of non-paralyzed limb is a major factor of ADL ability, and related to the Lt. hemiplegia, with dementia and primitive reflex, aging, with complications of spondylosis, diabetes and arthropathy, lower Brunnstrom stage, and putaminal hemorrhage.
P-2-01-24
EFFECTS OF INTENSIVE EXERCISE TO FACILITATE THE FUNCTIONAL RECOVERY OF HEMIPLEGIC LOWER LIMB
K. KAWAHIRA, A. OGATA, S. TOUGOU, T. YOKOYAMA, N. TANAKA (Kagoshima University, Kagoshima, Japan)
We investigated the effect of intensive exercise, repetition of motion pattern to facilitate voluntary movements, on the functional recovery of hemiplegic lower limb.
<Subjects & Methods> Twelve patients with hemiplegia (53.6±10.4 yo, 5.5 ±2.2 weeks after onset) received firstly 2 weeks basic traditional physical therapy (TT) for hemiplegia, and then 2 weeks intensive exercise therapy (IT), in addition to TT. These sessions were repeated alternately for 2 times. IT of the hemiplegic lower limbs included several kinds of assisted or voluntary movements of lower limbs being free from synergy and was repeated more than 100 times a day. Evaluation was done every 2 weeks by Ueda's scale grading the independence from synergy, foot tapping and knee extension/flexion strength measured with Cybex 6000.
<Results> After the first session, improvements of Ueda's grade, foot tapping and knee extension/flexion strength during initial TT and IT were 0.5 grade vs 2.8 grade, 4.5 times/30s vs. 7.3 times/30s, 12.7 Nm vs. 16.8 Nm, 3.9 Nm vs. 7.1 Nm, respectively. Most of those improvements were significant in IT but not TT. Similar improvements were also observed after a second session of IT.
<Conclusion> These functional recoveries after IT were considered not due simply to the improvements of brain edema or/and muscle strength, but due to the improvement of some central neuron network. A more intensive training programs which facilitate the voluntary movements free from synergy will be necessary for the functional recoveries of the hemipleia.
