The Immediate Effect of Backward Walking Exercise on the Posture and Postural Control of a Patient with Parkinson s Disease

Size: px

Start display at page:

Download "The Immediate Effect of Backward Walking Exercise on the Posture and Postural Control of a Patient with Parkinson s Disease"

Timothy Ball
5 years ago
Views:

1 症例研究 The Immediate Effect of Backward Walking Exercise on the Posture and Postural Control of a Patient with Parkinson s Disease 1) 1) 1) 1) 2) YASUTAKA NIKAIDO, RPT 1), HISATOMO SATO, RPT 1), RYUJI TAKAYAMA, RPT 1), HIROSHI OHNO, RPT 1), RYUICHI SAURA, MD, PhD 2) 1) Department of Rehabilitation, Osaka Medical College Hospital: 2 7 Daigaku-machi, Takatsuki-city, Osaka, , Japan. TEL FAX reh055@poh.osaka-med.ac.jp 2) Department of Rehabilitation Medicine, Division of Comprehensive Medicine, Osaka Medical College Rigakuryoho Kagaku 26(4): , Submitted Feb. 7, Accepted Mar. 24, ABSTRACT: [Purpose] The stooped posture, which limits various motions and increases the risk of falling, is one of the symptoms accompanying Parkinson s Disease (PD). It was recently reported that backward walking exercise improved the posture and the ability of forward walking of PD patients. However, the detailed mechanisms of these effects still remain unclear. The purpose of this study was to clarify the mechanisms of the immediate effects of backward walking exercise on the posture and postural control of a patient with PD. [Subject] The backward walking exercise and evaluation of the changes in terms of the posture and postural control abilities were conducted for a PD patient (Hoehn & Yahr Stage III) with moderate stooped posture. [Methods] We evaluated the change of the posture, the center of gravity (COG), and the center of pressure (COP) using a force plate and a three-dimensional motion analysis system in 3 kinds of tasks performed by the patient: the static standing posture, the functional reach test (FR) and the cross test (CT). The measurements were performed just before and after a 5-minute backward walking exercise. [Results] In the static standing posture, both COG and COP moved backward and the stooped posture seemed to be moderately improved just after the backward walking exercise. Also, the extent of ankle strategy in postural control in the FR task increased in comparison with the hip strategy, and both COG and COP moved more forward in the CT task after the backward walking exercise. [Conclusion] The results suggest that the backward walking exercise moderately improved the stooped posture and postural control through greater dependence on ankle strategy than on hip strategy, and these effects lead to increased stability in both standing and walking of the patient with PD. Key words: Parkinson s disease, backward walking, postural control 要旨 :Parkinson s Disease: PD PD PD PD Hoehn & Yahr III Functional Reach Test FR Cross Test CT FR CT キーワード : 1) : TEL FAX )

2 I. はじめに 15 m 5 Parkinson Disease PD Hoehn Yahr H-Y III 1,2) PD Center of Gravity: COG 3,4) 5,6) PD 2) 7) 8,9) 8,9) PD 10) PD Functional Reach Test FR Cross Test VICON460 AMTI 10 cm Hz 2 m 30 COG Center of foot Pressure: COP COG FR 12) 3 cm 60 cm 90 COG COP Cross Test 13) 14) COG 1 4 COG 4 II. 対象と方法 COG PD 2 H-Y III COG COG COP 1 3 pull test 11) 1 III. 結果 1 COG 18.0 mm COP 13.5 mm 33.7 mm mm mm

3 551 FR 2 COG COP COP 15.2 mm Cross Test 3 COG 87.7 mm mm COP 99.9 mm mm 79 mm mm COG COP 表 1 mm IV. 考察 COG COP COP 10 : : cm 15) COG mm mm COP 10 2) 3,4) 表 2 FR mm COG mm N m N m 表 3 Cross Test COG mm

4 Pull test mm COG COP 16) MVC 8,9) 10 PD COP 17,18) 19-21) FR COG COP FR FR 22) Kage 12) FR Cross Test COG COP Cross Test 23) COG COP COG 24,25) PD 26) 27) FR Cross test PD 引用文献 1) Tiple D, Fabbrini G, Colosimo C, et al.: Camptocormia in Parkinson disease an epidemiological and clinical study. J Nuerol Neurosurg psychiatry. 2009, 80: ) (1): ) (1): ) Morris ME: Movement disorders in people with Parkinson disease A model for physical therapy. Phys Ther, 2000, 80: ) (6): ) (11): ) : ) : ) (6): ) : ) Hunt AL, Kapil D, Sethi D, et al.: The pull test: A history. Mov Disord, 2006, 21(7): ) Kage H, Okuda M, Nakamura I, et al.: Comparison of the One-Arm and Two-Arm Functional Reach Test in Young Adult. J Phys Ther Sci, 2009, 21: ) : ) Cross test (3): ) pp ) (5): ) Marchese R, Bove M, Abbruzzese G: Effect of cognitive and

5 553 motor tasks on postural stability in Parkinson s disease: A posturographic study. Mov Disord, 2003, 18: ) Rocchi L, Chiari L, Horak FB: Effects of deep brain stimulation and levodopa. J Neurolog Neurosurg Psychitry, 2002, 73: ) Wood BH, Bilclough JA, Bowron A, et al.: Incidence and prediction of falls in Parkinson s disease:a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry, 2002, 72: ) Scmit JM, Riley MA, Dalvi A, et al.: Deterministic center of pressure patterns characterize postural instability in Parkinson s disease. Exp Brain Res, 2006, 168: ) Stack E, Ashburn A, Jupp K: Postural instability during reaching task in Parkinson s disease. Physiother Res Int, 2005, 10: ) Wernick-Robinson M, Kerbs DE, Giorgetti MM: Functional reach: Does it really measure dynamic balance? Arch Phys Med Rehabili, 1999, 80(5): ) Cross test (1): ) Horak FB, Diener HC, Nashner LM: Influence of central set on human postural responses. J Neurophysiol, 1989, 62(4): ) Manchester D, Woollacott M, Zederbauer-Hylton N, et al.: Vestibular and somatosensory contributions to balance control in the older adult. J Gerontol, 1989, 44(4): ) Bisop M, Brunt D, Pathare N, et al.: Change in distal muscle timing may contribute to sliowness during sit to stand in Parkinson s disease. Clin Biomech, 2005, 20: ) (4):

2nd. Comparison of Self-stretch Methods for Secondary Internal Rotation Limitation in Injured Throwing Shoulders: Evaluation of the Direct Effect

2nd. Comparison of Self-stretch Methods for Secondary Internal Rotation Limitation in Injured Throwing Shoulders: Evaluation of the Direct Effect 31 1 13 17 2016 原著 2nd Comparison of Self-stretch Methods for Secondary Internal Rotation Limitation in Injured Throwing Shoulders: Evaluation of the Direct Effect 1,2) 1) 1) 3) 3) KENTARO KAWAI, RPT,