日本臨床神経生理学会学術大会 第50回記念大会

講演情報

シンポジウム

シンポジウム18 片麻痺の歩行障害の運動学的理解と歩行訓練

2020年11月28日(土) 08:30 〜 10:00 第7会場 (2F J)

座長:出江 紳一(東北大学大学院 医工学研究科)、加賀谷 斉(藤田医科大学医学部リハビリテーション医学I講座)

[SP18-4] 片麻痺患者の歩行の運動学的理解に基づくモデルベーストリハビリテーション

大脇大1, 関口雄介2, 本田啓太2, 出江紳一2,3 (1.東北大学 工学研究科 ロボティクス専攻, 2.東北大学 医学系研究科, 3.東北大学 医工学研究科)

Walking rehabilitation for stroke patients with gait disorders is challenging and is of great social importance, potentially resulting in improving the quality of life (QOL). However, a Cochrane review (Mehrholz, 2017) reported that only the walking velocity and endurance increased on treadmill training, while independent ambulation, a major factor associated with improvement in QOL, did not increase.

A recently identified factor that prevents improvements on rehabilitation is "individuality", i.e., gait differences between patients that depend on the affected brain area, stroke severity, and remaining functions. Furthermore, a clear causal link between neurological factors and gait disorders remains unknown. Thus, individuality results in ad-hoc, qualitative, and subjective diagnoses based on the knowledge and experience of each doctor or physical therapist. Consequently, the treatments and interventions are chosen heuristically based on the time limitations and inpatient days in the hospital, leading to insufficient rehabilitation.

To overcome the issues, we now aim to establish a quantitative and accurate walking diagnosis system that enables evaluation of walking individuality in patients. In this presentation, we would like to introduce our approaches for model-based rehabilitation based on biomechanics in stroke patients walking.