Thesis or Dissertation 脳血管障害患者における視覚映像傾斜と体外離脱体験が主観的垂直認知に及ぼす即時的影響 : ヘッドマウント・ディスプレイを用いて

中村, 学  ,  網本, 和  ,  遠藤, 敦士  ,  澤, 広太  ,  若泉, 志穂  ,  間宮, 敬佑  ,  石神, 佳祐

本研究は映像傾斜や体外離脱体験が脳血管障害患者の垂直認知能力へ与える影響を明らかにすることを目的とした.対象は脳血管障害患者10名,健常高齢者4名とした.ベースラインとなる垂直認知能力を測定し,映像傾斜後, 体外離脱体験の付与後に再度垂直認知能力を測定した.結果,半側空間無視が重度であるほどベースラインの主観的視覚垂直は動揺性が大きく,半側空間無視が重度であるほど映像傾斜後の主観的視覚垂直は麻痺側へ偏倚していた.群間(半側空間無視とPusherの有無) と条件間(ベースラインと映像傾斜後と体外離脱体験後) に交互作用がある傾向にあったが,事後検定で有意な差はみられなかった.垂直認知能力や映像傾斜による効果は半側空間無視の程度によって変化する可能性があること,また,映像傾斜による視覚的操作が半側空間無視ありPusherあり群において身体垂直を改善する可能性があることが示唆された.
Introduction, Purpose: There have been reported that approaches to improve the biased subjective verticality perception in stroke patients with unilateral spatial neglect (USN) and/or Pusher syndrome (PS). The purpose of this study was to investigate ① the difference between verticality perception of stroke patients and healthy subjects, ② the correlation for the verticality perception and Neuropsychological test, and the effects of image tilt (IT) and out-of-body experiences (OBE) for subjective visual vertical (SVV) and subjective postural vertical (SPV) in stroke patients, ③ the difference in the existence of USN and PS for SVV and SPV in stroke patients. Methods: Ten stroke patients and four healthy subjects were assessed for SVV and SPV at baseline and after a session of IT and OBE. At IT session, subjects saw a 30° anti-clockwise tilting image for three minutes. At OBE session, subjects saw a 30° anti-clockwise tilting their back image with tapping their shoulder for three minutes. Results: There were significant negative correlations among the variability of SVV and Behavioral Inattention Test (BIT) in baseline (r=-0.64, p<0.05) and there were also significant positive correlations among the mean of SVV and BIT after the image tilt (r=0.64, p<0.05). The results of two-way ANOVA showed that there tended to be interactions among patient's groups (N-/P-, N+/P-, N+/P+) and conditions (baseline, after IT, after OBE) (p<0.1), but there was not significance in post hoc analysis. Discussion: Present study suggest that the effects of IT and OBE is modified according to the severity of USN, and the tilting image ameliorate the mean SPV in patients with USN and PS.
首都大学東京, 2016-03-25, 修士(理学療法学)

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