パーキンソン病における上肢の協調性収縮の軽減と機能改善のための集中的従来型リハビリテーション：症例報告

Upper limb dysfunction significantly impairs activities of daily living in patients with Parkinson's disease (PD). This dysfunction is partially attributable to abnormal muscle contraction. Although robot-assisted therapy improves upper limb function in patients with PD, these devices are expensive and not easily accessible in standard rehabilitation facilities. Non-robotic interventions, such as repetitive large-amplitude movements, improve upper-limb performance; however, whether these conventional exercises could improve co-contraction remains unclear. Herein, we present the case of a 70-year-old man with PD (Hoehn and Yahr Scale, stage 2) who presented with bradykinesia and difficulty moving his right arm. He underwent a two-week intensive rehabilitation program (1 h per day for five days a week) focusing on upper limb training. Following the intervention, the nine-hole peg test times and mean co-contraction index during reaching showed clinically significant improvements in both upper limbs, exceeding the minimal detectable change. This functional recovery was accompanied by a physiological reduction in muscle co-contraction. These results suggest that intensive conventional rehabilitation could be an effective and accessible alternative to robotic therapy for modulating muscle tone.