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		<h1 class="catchCopy">理学療法介入により改善できる高次脳機能障害を網羅！</h1>
		

		<h1 class="title titleWidth">高次脳機能障害に対する理学療法<span class="version"></span></h1>
		

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					編集：阿部浩明（広南病院リハビリテーション科）
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				<ul class="property"><li class="disc">B5判・252頁・2色刷(一部4色刷)</li><li class="disc">ISBN&nbsp;978-4-8306-4542-6</li><li class="disc">2016年5月25日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">◎脳の構造・機能，脳画像のみかたがわかる<br>高次脳機能障害に対してより適切な理学療法介入を行うためには脳画像から得られる情報が欠かせない．明日からの臨床に役立つ，脳の解剖と画像のみかたを詳細に解説．<br>◎理学療法介入に必要な知識を網羅<br>理学療法による直接的な介入効果がある高次脳機能障害：pusher症候群，半側空間無視，失行，認知障害について，その病態や疫学，メカニズムや責任病巣，そして実際の治療を膨大な知見に基づいて徹底的に解説．</section><section class="preface">序文<br><br>　本書の狙いは，臨床のフィールドで理学療法士が遭遇する頻度の高い高次脳機能障害を伴う患者を担当した時，理学療法士としてどのように障害を理解し，どのように対応すべきか，それらを考える上で最良の書を目指すというものであった．本書を読めば，現時点で知り得る膨大な情報の入手が可能で，詳細な分類やそれぞれの特徴，さらにはメカニズムも含めて理解することができ，明確な根拠を持って治療を選択できる……そのような書とすることを目標として企画した．つまり，障害を抱えた患者と真摯に向き合い，何とか良くしようと四苦八苦する理学療法士に貢献できる書を目指したのである．本書は紛れもなく臨床のフィールドで活躍する理学療法士をターゲットとした書籍である．<br>　非常に多岐にわたる高次脳機能障害が存在し，実際にはその多岐にわたる高次脳機能障害に関わることもあるが，本書では理学療法士がその治療に深く関われるもので，かつ，理学療法士の介入によって改善できるというエビデンスが集積されつつある高次脳機能障害のみを扱うことにした．本書の企画の時点で他の高次脳機能障害を扱うべきか，否かについて十分に検討し，（本書を企画した当時）本書の掲載目標に応えられる内容まで発展を遂げているのは「pusher症候群」，「半側空間無視」，「失行」，「軽度認知障害」であると判断し，4つに限局して取り扱うこととした．これらの高次脳機能障害の定義，疫学，評価，病巣，メカニズム，治療（対応），エビデンスにまでわたり，科学的裏づけを基に広く提示することにした．<br>　本書で最もこだわった点は執筆者の選定である．臨床のフィールドにいる理学療法士に貢献できる書を目指しているため，執筆者は高次脳機能障害に精通した十分な臨床経験を持つ理学療法士でなければならないと考えた．また，何よりこだわったのは，単に臨床経験が豊富というだけではなく，研究者としても高次脳機能障害に関わってこられた理学療法士に詳細に記載していただくことであった．理学療法士を対象とし，高次脳機能障害を解説した書は少なくないが，具体的介入とその根拠まで含め，十分なボリュームを持って記載している書籍はなかったように思う．情報量はこれまでの理学療法士を対象とした高次脳機能障害についての書籍よりもはるかに多く，高次脳機能障害に対する理学療法をより深く理解しようとする者に対し，十分な情報を提供できる書となったであろう．また，引用文献の多さはこれから高次脳機能障害に対する理学療法について研究しようとする者にとっても有益な書籍になったはずである．このことには大変満足している．限られた執筆期間の中で膨大な文献reviewを経て，ご執筆いただいた北里大学メディカルセンターの渡辺　学先生，畿央大学ニューロリハビリテーション研究センターの信迫悟志先生，国立長寿医療研究センターの土井剛彦先生には心から感謝の意を表する．<br>　ニューロリハビリテーションの領域はすさまじい勢いで発展を遂げている．企画した時点で取り上げることができなかったさまざまな高次脳機能障害に対する理学療法が発展を遂げ，やがては根拠に基づく介入によって明確なる有効性を示すまでに進展し，本書で取り扱うことができるようになることを期待している．また，本書で取り扱った高次脳機能障害に対する理学療法効果がさらに検証され，より良い治療法が開発され，患者に貢献できることを切に願う．最後に本書の企画を提案くださった文光堂の中村晴彦さんと，いつも迅速に対応くださり最終段階までお世話になった増谷亮太さんに感謝を申し上げて，序に代えさせていただくこととする．<br><br>2016年5月<br><br>広南病院リハビリテーション科<br>阿部浩明</section><section class="indexes">脳の解剖と脳画像のみかた<br>I　基本的な脳解剖の理解と画像所見の捉え方<br>　１．脳の構造<br>　　①　前頭葉<br>　　②　側頭葉<br>　　③　頭頂葉<br>　　④　後頭葉<br>　２．MR 画像でみる解剖<br>　　①　延髄のスライス<br>　　②　橋のスライス<br>　　③　中脳のスライス<br>　　④　基底核のスライス<br>　　⑤　側脳室体部のスライス<br>　　⑥　中心溝・頭頂部のスライス<br>　　⑦　各部位の同定<br>　３．神経線維の走行<br>　　①　連合線維<br>　　②　投射線維<br>　　③　内包を通る線維束<br>　　④　交連線維<br>II　pusher症候群に対する理学療法<br>　　身体軸が傾斜する姿勢定位障害の理解と理学療法介入<br>　１．pusher症候群とは<br>　２．pushingと鑑別すべき現象 pushingに類似した姿勢定位障害<br>　　①　lateropulsion（側方突進）<br>　　②　thalamic astasia（視床性失立症）<br>　　③　listing phenomenon<br>　３．pushingの評価<br>　４．pushingの出現率<br>　　①　連続症例を対象とした出現率<br>　　②　左半球損傷例と右半球損傷例におけるpushingの出現率<br>　５．pushingを伴う症例の予後<br>　　①　pushingの予後とADL<br>　　②　右半球損傷例と左半球損傷例の予後における差異<br>　６．pushingのメカニズム<br>　　①　姿勢定位に関わる主要な3つの入力系<br>　　②　各種の垂直判断と姿勢の関係<br>　　③　pushingと垂直判断の関係<br>　　④　pushingと前庭機能障害との関連性<br>　　⑤　pushingと体性感覚障害との関連性<br>　　⑥　pushingと半側空間無視との関連性<br>　７．pushingの責任病巣<br>　　①　pushingを引き起こす病巣はどこか<br>　８．pushingに対する理学療法の概念<br>　　①　押すこと自体を抑制する工夫<br>　９．pushingに対する介入効果の検証<br>III　半側空間無視に対する理学療法<br>　　　半側空間を認識できないことに伴う各種障害の理解と理学療法介入<br>　１．半側空間無視とは<br>　　①　半側空間無視の定義<br>　　②　半側空間無視の症状<br>　　③　注意<br>　　④　左右<br>　　⑤　理学療法との関連性<br>　２．半側空間無視と鑑別すべき現象<br>　　①　（同名性）半盲<br>　　②　全般性注意障害<br>　　③　視空間性ワーキングメモリーの障害<br>　３．半側空間無視の評価<br>　　①　評価の目的<br>　　②　一般的な検査<br>　　③　理学療法に必要な検査<br>　　④　その他の検査<br>　４．半側空間無視の疫学<br>　　①　半側空間無視の出現率<br>　　②　半球間差異<br>　　③　サブタイプ<br>　５．半側空間無視を伴う症例の予後とADLへの影響<br>　　①　予後<br>　　②　運動麻痺への影響<br>　　③　ADLへの影響<br>　６．半側空間無視のメカニズム<br>　　①　要素障害説<br>　　②　空間性注意障害説<br>　　③　参照枠障害説<br>　　④　その他の仮説<br>　７．半側空間無視の責任病巣<br>　８．半側空間無視に対する理学療法の概念<br>　　①　直接的アプローチ<br>　　②　間接的アプローチ<br>　　③　代償的アプローチ<br>　９．半側空間無視に対する介入効果の検証<br>　　①　システマティックレビュー<br>　　②　個別治療法の効果検証<br>IV　失行に対する理学療法<br>　　麻痺や感覚障害では説明できない行為の障害の理解と理学療法介入<br>　１．失行とは<br>　２．失行の分類<br>　　①　Liepmannの古典的失行分類<br>　　②　Heilmanらの失行分類<br>　　③　本書における失行分類<br>　３．失行の評価<br>　　①　標準高次動作性検査（SPTA）<br>　　②　国際的に使用されている評価法<br>　　③　具体的な臨床評価<br>　　④　失行における自動性-意図性の解離について<br>　　⑤　その他の失行症状の評価<br>　４．失行の疫学<br>　５．失行の予後とインパクト<br>　６．失行のメカニズムと責任病巣<br>　　①　道具使用障害（使用失行）<br>　　②　道具使用パントマイム障害（パントマイム失行）<br>　　③　自動詞ジェスチャー障害<br>　　④　模倣障害（模倣失行）<br>　　⑤　失行における自動性-意図性の解離<br>　　⑥　着衣障害（着衣失行）<br>　　⑦　口腔顔面失行<br>　７．失行に対する理学療法の概念<br>　８．失行に対する介入効果の検証<br>　　①　ストラテジートレーニング<br>　　②　ジェスチャートレーニング<br>　　③　エラーレスラーニング（Goldenbergらによる直接訓練）<br>　　④　ケーススタディで公表されている訓練<br>　　⑤　新しい治療法<br>V　認知症ならびに軽度認知障害に対する理学療法<br>　　認知症・MCIに伴う認知機能障害の理解と理学療法介入<br>　１．認知症・MCIとは<br>　２．認知症・MCIの疫学<br>　３．認知症（AD）のメカニズム<br>　４．認知症・MCIの評価<br>　　①　脳画像評価<br>　　②　認知機能評価<br>　５．認知症・MCIの予後<br>　　①　認知症の予後<br>　　②　MCIから認知症への移行（conversion）リスク<br>　　③　MCIの生活機能における予後<br>　６．認知症・MCIに対する治療概念<br>　７．認知機能に対する介入効果の検証<br>　　①　認知機能障害を有さない者に対する効果検証<br>　　②　MCIに対する効果検証<br>　　③　ADに対する効果検証<br>　８．認知症患者の認知機能以外に対する介入効果の検証<br>索　引</section></article>
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