首先被提及的是上行及下行系统.在偏瘫患者的治疗过程中,上行传导系统主要传导本体感觉信息,但其他的感觉信息也会被整合其中.患者的姿势控制,尤其是核心控制能力,是其步行功能、上肢和手功能及日常生活活动的基础.由于患者多存在身体图式的缺失,因此必须恢复其身体图式以产生先行性姿势调节活动.最后介绍1例慢性病例的治疗过程,该患者在其47岁时由于脑梗死造成了右侧偏瘫.由于患者偏瘫侧下肢表现出强烈的内翻现象,因此在她发病8个月后入院时,需要配戴踝足矫形器和肘拐辅助行走.起初患者不能抬起右侧上肢.在经过4年的门诊治疗后,现在患者在步行中内翻现象消失,不再需要配戴踝足矫形器和肘拐；患者也可以举起并控制偏瘫侧上肢伸入衬衫的袖子里.%The ascending and descending systems were described first. In the treatment for stroke patients, main information of ascending systems is proprioception, and the other sensations should be integrated into it. Postural control, especially core control, is the background for walking, arm and hand function, and activities of daily living. Patients have loss of body schema, so it must be recovered to make anticipatory postural adjustments. At last I introduced the actual treatment for a chronic case who suffered right hemiplegia caused by a cerebral infarction when she was 47 years old. As she had strong equinovarus, she walked with a short leg brace and a Lofstrand crutch when she came to our hospital at 8 months after stroke. And she could not keep right arm in apace first. She got the treatment as an outpatient around 4 years. Now she walks without an equinovarus, and she does not need a brace and a cane. She can also lift and carry her affected arm into a long sleeve of a shirt now.
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