＜シンポジウム21―3＞神経変性疾患と脳卒中のリハビリ；理論と実践
神経疾患に対するリハビリテーションの理論と実践
原 行弘
日本医科大学千葉北総病院リハビリテーション科〔〒270―1694 千葉県印西市鎌刈1715〕
Our understanding of motor learning, neuro-plasticity and functional recovery after the occurrence of brain lesion has grown significantly. New findings in basic neuroscience provided stimuli for research in motor rehabilitation. Electrical stimulation can be applied in a variety of ways to the neurological impairment. Especially, electromyography (EMG) initiated electrical muscle stimulation improves motor dysfunction of the hemiparetic arm and hand. Triggered electrical stimulation is reported to be more effective than non-triggered electrical stimulation in facilitating upper extremity motor recovery. Power-assisted FES induces greater muscle contraction by electrical stimulation in proportion to the voluntary integrated EMG signal picked up. Daily power-assisted FES home program therapy with the novel equipment has been able to improve wrist, finger extension and shoulder flexion effectively. Combined modulation of voluntary movement, proprioceptional sensory feedback and electrical stimulation might play an important role to facilitate impaired sensory-motor integration in power-assisted FES therapy. It is recognized that increased cerebral blood flow in the sensory-motor cortex area on the injured side during power-assisted FES session compared to simple active movement or simple electrical stimulation in a multi-channels Near-infrared spectroscopy (NIRS) study to non-invasively and dynamically measure hemoglobin levels in the brain during functional activity.
Full Text of this Article in Japanese PDF (494K)
(臨床神経, 51：1063−1065, 2011)
key words：リハビリテーション，脳可塑性，機能的電気刺激，神経機能画像，機能障害
（受付日：2011年5月20日）
