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Title 脊髄小脳変性症のニューロリハビリテーション治療
Subtitle 教育講座
Authors 藤本宏明, 宮井一郎
Authors (kana)
Organization 森之宮病院神経リハビリテーション研究部
Journal The Japanese Journal of Rehabilitation Medicine
Volume 58
Number 5
Page 536-543
Year/Month 2021 / 5
Article 報告
Publisher 日本リハビリテーション医学会
Abstract 「はじめに」脳損傷後の運動機能回復は, 麻痺肢を使用することで生じる脳の可塑性(use-dependent plasticity)に依存しており, 脳活動変化がリハビリテーション治療の結果として生じているならば, use-dependent plasticityを促進するための原則として, 課題指向型の練習量を確保することが必要である. また, 脳の可塑性を誘導するには, 単なる麻痺肢使用だけでなく, 運動学習が重要である. 運動学習には運動順序学習(motor sequence learning)と適応学習(adaptation)があり, 前者には運動遂行能力の向上やADL動作の獲得, 後者には環境変化に対する代償能力向上がある. ともに運動学習の過程として, 早い学習期, ゆっくりした学習期を経て学習保持に至る. 運動順序が固定化された後に自動化され, 最終的に身体で覚えることになるが, これらには大脳基底核や小脳が関連し, 適応学習の中心が小脳と考えられている.
Practice 医療技術
Keywords 脊髄小脳変性症, 運動失調, 運動学習, Goal Attainment Scale, neuromodulation
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