【論文摘要】Effect of Weight Bearing Training on Walking Ability in a Patient With Right Basal Ganglia Infarction: A Case Report

【論文摘要】承重訓練對行走能力的效果：右側基底核梗塞個案報告

陳靜紋(Jing-Wun Chen) ； 彭繼徵(Ji-Jheng Peng) ； 岩玉懷(Yu-Huai Yen)

《物理治療》 45卷4期 (2020/12) Pp. 326-326

https://doi.org/10.6215/FJPT.202012.P17

摘要

Background and Purpose: Patients after a stroke could actively move one's extremities, but he/she could not walk due to unable weight bearing of affected side during stance phase and unable to control leg movement during swing phase, which would influence foot placement at initial contact. Sit-to-stand and single-leg stepping forward exercise could promote weight bearing of the affected leg and weight transfer between two legs. The aim was to investigate the effect of sit-to-stand exercise and stepping forward exercise on walking ability in a patient with right basal ganglia infarction. Methods: This is a 76-year-old woman with left hemiplegia. She could sit to stand with minimal assistance, but her dynamic and static sitting and standing balance are poor. Weight bearing training included sit-to-stand exercise and step forward exercise for total of 15 minutes per day. Initially, sit-to-stand exercise was performed 50 times per day for 3 days. Then, sit-to-stand and stepping forward exercise were performed 25 times per day for another 5 days. The patient treated with sit-to-stand exercise by bearing with both legs under support, and then progressed with a single leg for weight bearing. Stepping forward exercise was also intervened by stepping forward in sound side to increase the weight bearing duration of the affected side under safety support. Distance of assisted walking was recorded as a primary outcome. Results: Totally, the patient completed 8 sessions of sit-to-stand exercise and single leg stepping forward training. After training for two sessions, the patient could ambulate several steps when affected leg worn gaiter and partial support under the therapist's assistance. After training for five sessions, the patient could walk for 30 meters, but the therapist's assistance was still needed during swing phase and initial contact in affected side. Finally, after training for 8 sessions, the walking distance was improved to 60 meters and her affected side could be moved spontaneously under therapist's guidance and adjustment. Conclusion: Weight bearing training could improve the walking ability to facilitate ambulation in the case of hemiplegia caused from right basal ganglia infarction. Clinical Relevance: Sit-to-stand and single leg stepping forward exercise might consider as a possible functional training to increase the independent ambulation in patients with basal ganglia dysfunction.