摘要
在大腦損害中，前大腦動脈硬化所造成的額葉梗塞會導致失行步態。這種步態障礙與高齡或退化性動脈硬化有密切相關，屬鈴神經系統的老化現象。Meyer和Barron定義其為：「在沒有任何感覺損傷或運動虛弱的情況下，失去使用下肢步行的能力。」 在步態上最顯著的臨床特徵為：啟動困難，步伐慢、短，出現曳足而行或滑行的步態。步行中欲加速、減速、改變方向或踢到異物時病人往往會回復曳足現象或停步，甚至有時會向後跌倒。 步態記錄顯示情況嚴重的病人，髖關節和膝關節節抗重力肌肉在整個步態記錄中一直持續相當高程度的活動力，毫無間斷。髖、膝、踝關節的角變位則很慢很小。 由於導致失行步態主要是神經系統的老化現象，在病理變化上具有不可逆特性，因此治療的主要目標放在幫助病人瞭解疾病的本質，協助病人適應其功能限制。在病人的周圍安排安全的環境是最主要的治療原則。
關鍵字
無資料並列摘要
In cerebral lesion, infarction of the frontal lobes dut to arteriosclerosis of the anterior cerebral arteries may result to apraxia of gait. This type of gait dysfunction is highly related to senile or decrescent arteriosclerotic change in the aging nervous system, Meyer and Barron defined apraxia of gait as: ”the loss of ability to use the lower limbs in the act of walking which cannot be accounted for on the basis of demonstrable sensory impairment or motor weakness.” The striking clinical features of this disorder are: retarded initiation of movement of the feet in attemping to walk and once this inertia has been overcome, a characteristically slow, short-stepped, shuffling or sliding gait in which the patient’s feet seem to adhere to the floor. When attempting to accelerate, decelerate, change direction or intrusion of something, he may resume his shuffling, stop, and occasionally fall backward. Gait records reavealed that, in severe case, the antigravity muscles acting over the hip and knee joints were continuously active at a relatively high level throughout the gait cycle, and the angular displacement was and small in the hip, knee, and ankle joints. Because of the essentially irreversible character of the pathological change of this problem, management of this gait disorder resulting from aging nervous system is aimed primarily at helping the patient understand the nature of his disability and assisting him in adjusting to the limitation imposed. Arranging for a safe surrounding is the most helpful principle.