针对脑卒中患者的Bobath治疗方法.pdfVIP

中国康复理论与实践2011 年9 月第17卷第9 期Chin J Rehabil Theory Pract, Sep. 2011, Vol. 17, No.9 - 805 - ·专题· 针对脑卒中患者的Bobath 治疗方法① 古澤正道 陈立嘉 译 [摘要] 首先被提及的是上行及下行系统。在偏瘫患者的治疗过程中，上行传导系统主要传导本体感觉信息，但其他的感觉信 息也会被整合其中。患者的姿势控制，尤其是核心控制能力，是其步行功能、上肢和手功能及日常生活活动的基础。由于患者多 存在身体图式的缺失，因此必须恢复其身体图式以产生先行性姿势调节活动。最后介绍1例慢性病例的治疗过程，该患者在其47 岁时由于脑梗死造成了右侧偏瘫。由于患者偏瘫侧下肢表现出强烈的内翻现象，因此在她发病8 个月后入院时，需要配戴踝足矫 形器和肘拐辅助行走。起初患者不能抬起右侧上肢。在经过4 年的门诊治疗后，现在患者在步行中内翻现象消失，不再需要配戴 踝足矫形器和肘拐；患者也可以举起并控制偏瘫侧上肢伸入衬衫的袖子里。 [关键词] Bobath 理论；脑卒中；姿势控制；核心控制；身体图式 Bobath Approach to the Adults with Stroke FURUSAWA Masamichi. CHEN Li-jia trans. Department of Rehabilitation, Bobath Memori- al Hospital, 1-6-5 Higashinakahama, Joto-ku, Osaka City 536-0023, Japan Abstract: The ascending and descending systems were described first. In the treatment for stroke patients, main information of ascend- ing systems is proprioception, and the other sensations should be integrated into it. Postural control, especially core control, is the back- ground for walking, arm and hand function, and activities of daily living. Patients have loss of body schema, so it must be recovered to make anticipatory postural adjustments. At last I introduced the actual treatment for a chronic case who suffered right hemiplegia caused by a cere- bral infarction when she was 47 years old. As she had strong equinovarus, she walked with a short leg brace and a Lofstrand crutch when she came to our hospital at 8 months after stroke. And she could not keep right arm in apace first. She got the treatment as an outpatient around 4 years. Now she walks without an equinovarus, and she does not need a brace and a cane. She can also lift and carry her a