非麻痺側上肢を用いた感覚弁別課題により右上肢の痛みが軽減した左脳出血の一症例

Abstract

[Purpose] This paper reports a case in which sensory discrimination tasks performed using the nonparalyzed and paralyzed upper limbs, in this order, effectively reduced pain in the latter. [Participant and Methods] The patient was a 40-year-old female with a complaint of pain at rest in her right upper limb 6 months after left cerebral hemorrhage. As various symptoms such as allodynia were present, complex regional pain syndrome (CRPS) type 1 was determined to be the cause of the pain. The therapeutic approaches included: a tactile discrimination task using balls that varied in hardness, surface roughness, and size; and a hot-cold discrimination task using water of different temperatures. The patient performed these tasks for 30 minutes each day for a period of 1 week, with her non-paralyzed upper limb first, and then with her paralyzed upper limb. [Results] The patient’s correct answer rate was higher than when she used only her paralyzed upper limb. Within 1 week of intervention, her right upper limb pain at rest was reduced. [Conclusion] The results support the effectiveness of sensory discrimination tasks also using the non-paralyzed upper limb when it is difficult to perform these tasks with the paralyzed upper limb only.