Japanese

Title	Pusher現象を呈した脳卒中患者に対する作業療法によりADL改善がみられた一症例 - 身体垂直性の再学習に着目したアプローチと長期経過 -
Subtitle	実践報告
Authors	本間莉那*1, 大瀧亮二*1, 笹原寛*1, 斎藤佑規*2, 竹村直*2
Authors (kana)
Organization	*1社会福祉法人恩賜財団済生会山形済生病院リハビリテーション部, *2社会福祉法人恩賜財団済生会山形済生病院脳神経外科
Journal	作業療法
Volume	40
Number	5
Page	683-690
Year/Month	2021 / 10
Article	報告
Publisher	日本作業療法士協会
Abstract	「要旨」 : Pusher現象を呈する脳卒中患者のうち約80%は, 発症約3ヵ月でPusher現象が消失すると報告されている. Pusher現象が長引く場合, リハビリテーションの効果は低く, ADLの回復に影響を与え, 結果入院期間が長期化するとされている. 今回, 脳卒中発症後3ヵ月以降もPusher現象が残存し, ADLに全介助を要した症例に対して, Pusher現象の発生機序とされている主観的身体垂直 (SPV) の再学習を目的に長期的な作業療法を実施した. 結果, Pusher現象が軽減し, ADLの自立度が向上した. Pusher現象の発生機序や病態を理解したうえでの, 段階的で長期的な作業療法は有効である可能性が示唆された.
Practice	医療技術
Keywords	Pusher現象, ADL, (長期経過), (SPV), Pusher syndrome, Activities of Daily Living (ADL), Long-term process, Subjective Postural Vertical (SPV)

English

Title	Improvement of ADL performance by occupational therapy for a stroke patient with pusher syndrome : Long-term process of relearning of postural vertical
Subtitle	PRACTICAL REPORTS
Authors	Rina Honma*1, Ryoji Otaki*1, Hiroshi Sasahara*1, Yuki Saito*2, Sunao Takemura*2
Authors (kana)
Organization	*1Department of Rehabilitation, Yamagata Saisei Hospital, *2Department of Neurosurgery, Yamagata Saisei Hospital
Journal	JAPANESE OCCUPATIONAL THERAPY RESEARCH
Volume	40
Number	5
Page	683-690
Year/Month	2021 / 10
Article	Report
Publisher	JAPANESE ASSOCIATION OF OCCUPATIONAL THERAPISTS
Abstract	It has been reported that pusher syndrome was eliminated in almost 80% of affected patients within three months after stroke. However, prolongation of pusher syndrome results in reduced ADL performance and extended hospitalization. As Subjective Postural Vertical (SPV) is a mechanism of pusher syndrome, we intervened with long-term occupational therapy which was graded for the components of the SPV. As a result, pusher syndrome was reduced, and ADL performance was improved, indicating that long-term graded occupational therapy increases the understanding the pathogenesis of pusher syndrome.
Practice	Medical technology
Keywords	Pusher syndrome, Activities of Daily Living (ADL), Long-term process, Subjective Postural Vertical (SPV)

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