著者

森原 徹 小椋 明子 立入 久和 久保 俊一 黒川 正夫 三浦 雄一郎 福島 秀晃

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.715-718, 2011 (Released:2011-12-21)

参考文献数

8

被引用文献数

3

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In the motion of shoulder flexion(0-90 degree), the scapula was upward rotated at the center of acromioclaviclular joint. In the abduction, the scapula was upward rotated and depressed with the clavicle elevation and retraction. The purpose of this study is to evaluate the muscle functions around the scapula by electromyographic analysis during the flexion and abduction of the shoulder. EMG activities of upper, middle, and inferior trapezius muscle, and serratus anterior, were examined in 5 static positions from 0 degrees to 150 degrees for 5 seconds in each position during exercises of shoulder flexion and abduction in 6 healthy volunteers. We used Telemyo System 2400(Noraxon USA Inc) and analyzed by MyoVideo and MyoResearch. The relative activity of upper trapezius muscle did not increase, and the muscle activity of serratus anterior was increased significantly during the early phase of flexion. The relative activity of upper, middle trapezius muscle has gradually increased during the early phase of abduction. The scapular upward rotation pattern was different between that in flexion and abduction. This study indicated that the symptom of accessory nerve palsy is disorder of abduction, and the main symptom of long thoracic nerve palsy is the inhibition of shoulder flexion.

著者

三浦 雄一郎 福島 秀晃

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.8, pp.25-34, 2008 (Released:2009-01-15)

参考文献数

5

被引用文献数

6

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In patients with disorder of the shoulder joint, the the activities of daily Living (ADL), "reach a shelf over the head", "move to a medially rotated position" and "open and shut a sliding door", often become difficult. ADL of reach a shelf over the head needs the function of flexion and abduction of the shoulder joint. ADL of open and shut a sliding door needs the function of horizontal abduction and adduction with the same flexion angle of the shoulder joint. To understand the movement function of the shoulder joint, it is necessary to distinguish to it from the function of the shoulder girdle and the function of the gleno-humeral joint. We think that it helps the physical therapy approach (the evaluation, the cure) to shoulder joint disease to pay attention to movement while sitting or supine in order to understand the function of the shoulder girdle. Evaluating the function of the gleno-humeral joint and the rotator cuff function corresponding to the direction of the movement and the angle change must also be considered.

著者

福島 秀晃 三浦 雄一郎 森原 徹

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.17, pp.3-16, 2017 (Released:2017-12-29)

参考文献数

12

被引用文献数

2

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The shoulder joint is called a complex, and consists of the sternoclavicular, acromioclavicular, scapulothoracic, and glenohumeral joints. It has a wide range of motion and contributes to the smoothness of upper limb function. The motor function of the upper limb is a complicated mechanism because the influence of the peripheral joints affects the shoulder joints, and it is difficult to understand. Electromyographic analysis of the shoulder joint function is useful for objectively presenting the effect of exercise therapy. Therefore, in this paper, we present the clinical applications of EMG data of shoulder joint function. Specifically, we focus on the following: 1) Understanding of muscle activity patterns according to the direction of movement of the shoulder joint and the elevation angle, taking into consideration the mechanism of the shoulder joint. 2) The shrug sign (shoulder shrinkage phenomenon) is a compensatory motion of shoulder joint disease cases. In addition to the activities of the elevator and retractor muscle groups of the shoulder girdle during this operation, the muscle activity of the supraspinatus muscle is also analyzed and discussed regarding its clinical applications. 3) Exercise posture (supine or lateral) promotes or suppresses treatment of the target muscles and re-education of muscle activity due to posture can be expected.

著者

福島 秀晃 三浦 雄一郎

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.13, pp.23-32, 2013 (Released:2013-12-28)

参考文献数

7

被引用文献数

5

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To evaluate the scapulo-humeral rhythm of patients with a clinical condition, not only a quantitative evaluation (range of motion) but also a qualitative evaluation (a structural method that measures scapular upward rotation) is required. This study investigated the effectiveness of an analysis that assessed the scapular-girdle dynamics, in which the direction and translation of the coordinates were analyzed using electromyograms of the scapular muscle activities of the elevated upper limb. Scapula upward rotation did not show a difference during shoulder flexion and abduction. The difference between shoulder flexion and abduction was more prominent when we used a structural method that measured scapular upward rotation including clavicle movement. When considering a structural method that measures scapular upward rotation during shoulder flexion and abduction, the function of the scapular muscle must be taken into account, since it may worsen and develop into a clinical condition. The direction of gravity that acts on the shoulder joint changes when the shoulder position changes during exercise. Therefore, a change is observed in the mechanical energy of the shoulder. It should be possible to design a therapeutic-exercise program that includes exercise positions that improve the function of the scapular and shoulder muscles to treat shoulder disorders.

著者

福島 秀晃 三浦 雄一郎 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.6, pp.85-89, 2006 (Released:2007-01-30)

参考文献数

15

被引用文献数

5

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Lateral shift in sitting is indispensable in daily life, and it has a big influence on the activities of daily living (ADL) in standing-up and walking. The purpose of this study was to clarify the function of each fiber of the trapezius-muscle during lateral shift in sitting by normal subjects using surface electromyography. The integrated electromyogram (IEMG) of the trapezius muscle in the non-shift side, tended to increase. Specifically, in the lower part fiber trapezius muscle, IEMG at 20 cm distance was significantly greater than others. On the other hand, IEMG of the trapezius muscle in the shift side tended to increase with the lateral distance of movement. In the middle fiber of trapezius muscle, IEMG at 20 cm distance was significantly greater than others. It was thought that the activity of the fiber of the lower part of the trapezius muscle in the non-shift side participated in braking the upper part of the trunk inclination which accompanies the increase of the distance. It was thought that the activity of the fiber of the middle part of the trapezius muscle in shift side participated in preservation of the controlled scapula. To stabilize the upper part of trunk to improve sitting, it is necessary to aim at the function of the fiber of the lower part of the trapezius muscle in the non-shift side.

著者

三浦 雄一郎 福島 秀晃 森原 徹 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.12, pp.29-34, 2012 (Released:2012-12-27)

参考文献数

17

被引用文献数

5

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The aim of this study was to clarify the function of the abdominal muscles in stabilizing the trunk during shoulder flexion. We used surface electromyographic (EMG) data from the rectus abdominis (RA) and external oblique abdominis (EO) muscles of 7 healthy male subjects (age 29.4 ± 4.7 years). Muscle activities of the right anterior deltoid, serratus anterior (SA), RA, and EO muscles were recorded while maintaining right shoulder flexion. The subjects held a plumb-bob of 5% of body weight. The angles of shoulder flexion were 30°, 60°, 90°, and 120°, and they were maintained for a full 5 s in each position. EMG activities of EO during shoulder flexion of 120° and 90° were significantly greater than that during shoulder flexion of 30° (p<0.05). EMG activity of SA during shoulder flexion of 120° was significantly greater than that during shoulder flexion of 30° (p<0.05). EMG activity of RA during shoulder flexion of 120° was significantly higher than those during shoulder flexion of 30° and 60° (p<0.05). The abdominal muscles are necessary to stabilize rotation of the trunk when the scapula is moved and rotated upward by concentric contraction of SA. Therefore, EO on the side of movement plays a major role in controlling trunk rotation toward the contralateral side. Although the activity level of RA was low, we consider that the finding that this muscle showed significantly greater EMG activity was due to its activity in efficiently fixing the rectus sheath while acting in concert with EO. In physical therapy evaluating motor function of the upper extremities, it is important to evaluate the abdominal muscles as well.

著者

立入 久和 森原 徹 仲川 春彦 木田 圭重 祐成 毅 堀井 基行 久保 俊一 三浦 雄一郎 福島 秀晃 黒川 正夫

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.719-722, 2011 (Released:2011-12-21)

参考文献数

9

被引用文献数

3

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Shrug exercise, which is one of the treatments for stiff shoulder and rotator cuff tear, is commonly performed. This exercise is also performed to relax the shoulder after surgery for rotator cuff repair. The effectiveness of shrug exercise for the rotator cuff has not been analyzed. The purpose of this study was to analyze the shrug exercise and to evaluate the usefulness of the shrug. Five asymptomatic male volunteers who had no history of shoulder abnormalities were examined. SSP (supraspinatus) muscle was measured by fine-wire electrodes and ISP (infraspinatus) muscle was measured by surface electrodes. At the time of non-shrug (group N) and shrug (group S), %MVC (maximal voluntary contraction) was calculated in the position of 0, 30, 60, 90 degrees flexion. %MVC of SSP in the position of 0,30,60,90 degrees flexion were 2,8,13,15% in group N, and 32,35,23,32% in group S. %MVC of SSP were increased at each angle. %MVC of ISP were 6,16,25,38% in group N, and 10,17,25,42% in group S. It has been reported that %MVC over 20% is high activity. %MVC of SSP showed over 20% at shrug position in this study, which was considered that shrug motion caused eccentric contraction of SSP muscle with the scapula elevating. From this study, it is considered that shrug excise is useful for cuff training, but may be overloaded on SSP in the early stage after surgery.

著者

三浦 雄一郎

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.22, pp.45-50, 2022 (Released:2022-12-23)

参考文献数

8

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Conventional evaluation methods are not sufficient for finding sports dysfunction. The reason for this is that athletes have exceptional muscle strength and range of motion as a result of adaptation to sports. In anticipation of these characteristics, we need to be creative in our evaluation methods and treatment. In this paper, I would like to discuss the evaluation of upper limb and trunk dysfunction based on the characteristics of motor function of athletes, and how we can try to improve them.

著者

布谷 美樹 森原 徹 三浦 雄一郎 福島 秀晃 鈴木 俊明

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.7, pp.81-84, 2007 (Released:2008-01-18)

参考文献数

4

被引用文献数

1

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We experienced cases that can elevate the humerus but can't maintain the position in shoulder flexion. It is generally thought that the inner muscles stabilize the humeral head in the glenoid, and the deltoid, which is one of the outer muscles, elevates the humerus during shoulder flexion. Kido et al. recently reported that all portions including the anterior, middle and posterior deltoid muscles have functions in stabilizing the shoulder. In this study, in order to evaluate the activity of the deltoid muscle, not only the anterior portion but the middle and posterior portions were analyzed at several positions of flexion by surface electromyography (EMG). Our results show that the deltoid muscle activity of the anterior portion increased with flexion, and especially the activity at over 90°C flexion was significantly increased over that at 30°C flexion. The activity of the middle and posterior portions over 120°C flexion were significantly increased over those at 30°C and 60°C flexion. In addition, at 150°C flexion, the activities of the middle and posterior deltoid muscles were significantly increased over that at 90°C flexion. This study demonstrates that the anterior portion of the deltoid muscle, mainly has the function of active flexion, and the middle and posterior portions as well as the inner muscles have functions which stabilize the glenohumeral joint during shoulder flexion.

著者

三浦 雄一郎

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.1, pp.7-13, 2001 (Released:2005-06-07)

参考文献数

12

被引用文献数

5

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To evaluate physical functions in patients with chronic low back pain, it is important to evaluate trunk muscle function. Anatomical and electromyographical studies of trunk muscles in healthy subjects and patients with chronic low back pain are introduced in this paper. Many articles is published have asserted that the action of trunk muscles of patients with chronic low back pain is different from that of healthy subjects. In my research, electromyography (EMG) of trunk muscles during hip extension in the prone position was used in patients with chronic low back pain and healthy subjects. EMG showed that the action of trunk muscles during this motion in patients with chronic low back pain was weaker than that in healthy subjects, but EMG of trunk muscles during this motion after therapeutic exercises indicated improvement in patients with chronic low back pain. It has been said that EMG evaluation of the trunk muscles is an important method to use in patients with chronic low back pain.

著者

三浦 雄一郎

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.19, pp.12-16, 2019 (Released:2019-12-26)

参考文献数

9

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In rehabilitation, progress in the order of passive, automatic assistance, automatic, and resistance exercises is common. Automatic assistance exercise occupies an important position as preparation for automatic exercise acquisition, but it is easily influenced by the experience and skill of the therapist. Therefore, in this study, we focused on the automatic assistance movement necessary for the handling technique of the upper extremity. The relationship between the amount of upper limb assistance and shoulder muscle activity and the muscle activity pattern between automatic and automatic assistance exercises were examined. The points in the handling technique of the upper limb are described.

著者

岩崎 滉平 三浦 雄一郎 福島 秀晃 長﨑 進 上村 拓矢 飛田 勇樹 木田 圭重

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.20, pp.98-103, 2020 (Released:2020-12-28)

参考文献数

6

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In fishing, the act of moving the rod while winding in the line is called the rattling operation. Here we present a case of shoulder stiffness that occurred during rattling in a patient who earlier had had a rotator cuff repair by arthroscopy. The rattling movement is performed by mild external rotation of the shoulder joint. Our case had difficulty performing the movement due to a decrease in the function of the supraspinatus muscle, and stiffness was occurring on the upper surface of the left shoulder. This also negatively influenced our case’s fishing results. Physical therapy involving stimulation of the supraspinatus muscle was performed, paying attention not to over exercise the upper trapezius muscle fibers. With improvement in the function of the supraspinatus muscle, the rattling movement became possible, the stiffness disappeared, and our case’s fishing results improved. The rattling movement is highly dependent on rotator cuff function.

著者

三浦 雄一郎 福島 秀晃

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.10, pp.25-31, 2010 (Released:2011-01-13)

参考文献数

1

被引用文献数

1

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The lower limb comprises the hip joint, knee joint, and ankle joint. These joints are connected to each other and provide overall support to the lower limb. Knee-in and knee-out that occur while ascending and descending the stairs or when standing up produce tensile and compressive stresses inside or outside the knee joint, which in turn cause pain. This paper introduces a method for determining the lower limb joint which is chiefly responsible for knee-in and knee-out. It also discusses how to implement range of motion exercises in patients with joint dysfunction. The trunk comprises the pelvis, spine, and thorax. The spine consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae. Although these bones generate only small movements individually, these bones function together to provide a wide range of body motion. This paper introduces a method for qualitatively evaluating body motion, in addition to conventional quantitative methods such as the range of motion test.

著者

加古原 彩 三浦 雄一郎 福島 秀晃 布谷 美樹 田中 伸幸 近藤 克征

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.6, pp.137-143, 2006 (Released:2007-01-30)

参考文献数

7

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In this article, we describe physical therapy for a case of decline in muscular strength caused by axillary nervous paralysis with a dislocation of the shoulder joint. This case was characterized by difficulty in flexional movement in the scapulothoracic joint in primary flexion of the shoulder joint because of the adduction and lift of the scapula. We defined the alignment on the several phases that the specific movement of scapula appears. We practiced scapula alignment and performed electromyographic assessment. In this case, in addition to a decline of muscular activity in the deltoid muscle, the upper, middle and lower fibers of the trapezius muscle started to move before the anterior fibers of the deltoid muscle. So, we supposed that this phenomenon caused the disorder, the specific movement of the scapula. We observed the start of activity of the deltoid and trapezius muscles and administered a pendular movement as a therapeutic exercise. Improvement in both excursion of flexion and in patterns of muscular activity in the deltoid and trapezius muscles were confirmed. Furthermore, with repetition of kinesiatrics in the sitting position on the edge of a bed following results was acquired; an increase in muscular activation in the anterior fibers of the deltoid muscle and a muscle activation with same order. This lead to improvement of stability of the scapula because of a decrease in adduction and lift of the scapula in the start position. From the above, we suggest that choice of the method of kinesic therapy, paying attention to the posture of patients and paying attention to the stability of scapulothoracic joint is important.

著者

三浦 雄一郎

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.5, pp.41-46, 2005 (Released:2006-01-26)

参考文献数

2

被引用文献数

1

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It is difficult to understand the biomechanics of the control and stability of the spine and pelvis. The factors for this are that the orientation of the muscle fibers in the abdominal muscles are diverse and the abdominal muscles are composed of layers. Therapeutic approaches for impairment of the abdomen need the theory of the biomechanics of the spine and pelvis. This paper proposes several theories of the biomechanics of the spine and pelvis. These theories are called: soil function, double ladder structure, air bag function and sacroiliac joint stability. These functions are expained in this paper.

著者

三浦 雄一郎 長崎 進 福島 秀晃

出版者

関西理学療法学会

雑誌

関西理学療法 (ISSN:13469606)

巻号頁・発行日

vol.15, pp.7-11, 2015 (Released:2016-01-06)

参考文献数

9

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Table manners are as important as just eating a meal. With the spread of food culture, Japanese culture has been influenced by overseas eating habits. The upper limb is moved into a certain position to have a meal. When performing functional therapy, a knowledge of these movement chains is important because the shoulder, elbow, forearm, wrist, and finger joints are mutually related. In clinical practice, the relationship between the joints is immediately noticeable by movement compensation that is generally recognized and helpful to gauge the effects of physical therapy. However, the exercise chain of the forearm, elbow, and shoulder joints may not display obvious movement compensation, thereby making it difficult to detect functional decline. The movement used to pick up food with chopsticks, a fork, or a hand during meals is known as the reach movement. There are two types of reach movement: of a range that is smaller than the length of the arms, or beyond the length of the arms. Generally, the movement used during meals is mainly of the former type, but the latter type may also be used in some food cultures. This report describes the exercise chain of the forearm, elbow, and shoulder joints, and the movement chain involving the trunk and the shoulder girdle, in consideration of these factors.

著者

福島 秀晃 三浦 雄一郎 布谷 美樹 鈴木 俊明 森原 徹

出版者

公益社団法人 日本理学療法士協会

雑誌

理学療法学Supplement

巻号頁・発行日

vol.2006, pp.A0600, 2007

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【目的】肩関節疾患患者が肩甲骨挙上筋群の過剰収縮と前鋸筋の収縮不全によって、肩関節屈曲初期より肩甲骨の不安定性を呈することを頻繁に経験する。そのため理学療法では前鋸筋の筋力強化や筋再教育、肩甲骨挙上筋群の抑制が必要となる。前鋸筋の筋力強化は諸家の報告により様々な方法が紹介されているが、これらの方法を有疾患患者に適応した場合、肩甲骨挙上筋群の過剰収縮を招きやすく本来の目的を達成しているかは疑問を感じる。本研究目的は、肩関節屈曲運動にて運動肢位を変化させた時の僧帽筋上部・下部線維、前鋸筋下部線維の筋活動を筋電図学的に分析し、肩甲胸郭関節の安定化に対する運動療法を再考することである。<BR>【方法】対象は健常男性5名両側10肢(平均年齢30.2±4.3歳、平均身長177.8±8.7cm、平均体重76.2±8.5kg)。対象者には事前に本研究の目的・方法を説明し、了解を得た。測定筋は僧帽筋上部線維、下部線維、前鋸筋下部線維、三角筋前部線維とし、筋電計myosystem1200(Noraxon社製)を用いて測定した。具体的な運動課題は座位、背臥位の各肢位にてそれぞれ肩関節を0°、30°、60°、90°、120°、150°屈曲位を5秒間保持させ、それを3回施行した。分析方法は座位での肩関節屈曲0°位の筋電図積分値を算出し、これを基準に各肢位、各角度での筋電図積分値相対値(以下、相対値)を算出した。各筋の相対値を各角度にて座位と背臥位間で対応のあるt検定を行った。<BR>【結果】僧帽筋上部線維の相対値は屈曲60°~150°間にて座位と比べ背臥位にて有意に減少した。僧帽筋下部線維および前鋸筋下部線維の相対値は屈曲30°では座位と比べ背臥位にて増加傾向を示したが、90°~150°間では有意に減少した。三角筋前部線維の相対値は屈曲30°では座位と比べ背臥位にて有意に増加し、60°~150°間では有意に減少した。<BR>【考察】背臥位での肩甲帯は胸郭に対し平面位となり、僧帽筋上部線維の活動は重力の影響が軽減される肢位である。肩関節屈曲60°より肩甲骨は上方回旋することから、屈曲60°以上での活動減少は、背臥位という運動肢位が僧帽筋上部線維の活動を発揮させにくい肢位であることが示唆された。三角筋前部線維の相対値は背臥位での屈曲30°にて有意に増加した。これは肩関節屈曲30°で生じる肩関節への力学的な伸展モーメントは背臥位の方が増大することから、これに抗するための筋活動増加であると考える。三角筋前部線維の活動は、肩甲骨と上腕骨の連結を行い、その伝達された力は浮遊骨である肩甲骨に不安定性を生じさせる。背臥位での屈曲30°で僧帽筋下部線維、前鋸筋下部線維の相対値が増加傾向を示したのは、肩甲骨の不安定性に対する制動の役割が座位よりも大きいことが示唆された。

著者

三浦 雄一郎 福島 秀晃 布谷 美樹 田中 伸幸 山本 栄里 鈴木 俊明

出版者

公益社団法人 日本理学療法士協会

雑誌

理学療法学Supplement Vol.32 Suppl. No.2 (第40回日本理学療法学術大会 抄録集)

巻号頁・発行日

pp.A0634, 2005 (Released:2005-04-27)

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【はじめに】我々はNgらによる腹筋群の解剖学的研究を参照とし、歩行時における個々の体幹筋の機能について報告してきた。内腹斜筋単独部位は立脚期に筋活動が増大し、骨盤の安定化に作用していることが示された。今回、上肢の運動に伴う体幹筋の機能に着目した。上肢の運動に伴う体幹筋の筋電図学的研究では、Hodgeらによると一側上肢を挙上運動させた時に反対側の腹横筋が三角筋の筋活動よりも先行して活動すると報告している。しかし、上肢挙上時における同側体幹筋の筋電図学的報告は少ない。そこで肩関節屈曲時の同側の体幹筋に着目し、その機能について検討したので報告する。【方 法】対象は健常者5名(男性3名、女性2名、平均年齢32±5歳)両側10肢とした。筋電計はマイオシステム(NORAXON社製)を用いた。運動課題は端座位での肩関節屈曲位保持とし、屈曲角度は下垂位、30°、60°、90°、120°、150°、180°とした。各屈曲肢位における上肢への負荷は体重の5%の重錘を持たせることとした。測定筋は運動側の三角筋前部線維、前鋸筋、腹直筋、外腹斜筋とした。サンプリングタイムは3秒間、測定回数は3回とし、平均値をもって個人のデータとした。下垂位における各筋の筋積分値を基準値とし、各角度における筋積分値相対値を求めた。各筋に対し角度間における一元配置の分散分析および多重比較検定を実施した。対象者には本研究の目的・方法を説明し、了解を得た。【結 果】三角筋の筋積分値相対値は肩関節屈曲120°まで徐々に増大し、それ以上では変化を認めなかった。前鋸筋の筋積分値相対値は屈曲角度増大に伴い漸増的に増大した。腹直筋の筋積分値相対値は屈曲角度に関係なく変化が認められなかった。外腹斜筋の筋積分値相対値は肩関節屈曲60°で増大し、屈曲角度60°以上で漸増的にが増大した。【考 察】 肩関節を屈曲させる際、上腕骨の運動に伴って肩甲骨の上方回旋運動が生ずる。前鋸筋は肩甲骨を上方回旋させる作用があり、肩甲骨の外転方向の柔軟性と前鋸筋の求心性収縮が必要となる。しかし、前鋸筋は起始部が第1肋骨から第8肋骨の前鋸筋粗面(肋骨の外側面)であることから前鋸筋のみ求心性収縮が生じた場合、肋骨外側面を肩甲骨内側縁にひきつける力が生ずる。結果として体幹の反対側への回旋運動が生ずることになる。また、座位姿勢は骨盤上で脊柱を介して胸郭がのっている状態であり、きわめて不安定な状態であることから、この反対側の体幹回旋は容易に生じやすいことが考えられる。運動側の外腹斜筋はこの体幹の反対側への回旋を制御し、体幹安定化に作用していることが推察される。

著者

福島 秀晃 三浦 雄一郎 森原 徹(MD) 鈴木 俊明

出版者

社団法人 日本理学療法士協会近畿ブロック

雑誌

近畿理学療法学術大会 第51回近畿理学療法学術大会

巻号頁・発行日

pp.88, 2011 (Released:2011-10-12)

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【はじめに】前鋸筋は上位8~10肋骨から起始し、肩甲骨に付着する筋で上部、中部、下部線維に区分される。肩甲上腕リズムの観点からも肩甲骨運動に重要な筋であり、肩甲骨と胸郭との安定性にも関与している。上肢挙上時の肩甲骨運動と前鋸筋の機能に関する研究は多数あるが、前鋸筋の下部線維を対象としたものが多く、前鋸筋中部線維(以下、中部線維)に関する報告は少ない。本研究目的は肩関節屈曲、外転運動での中部線維の機能を筋電図学的に検証することである。 【対象と方法】 対象は事前に研究の趣旨を説明し、同意を得ることができた健常男性8名(平均年齢28.8±5.4歳、平均身長177.6±6.8_cm_、平均体重72.3±9.7_kg_)の右上肢とした。筋電計はmyosysytem1200(Noraxon社製)を用いた。中部線維の電極貼付位置はRichardら(2004)の方法に準じ広背筋と大胸筋の間で第3肋骨レベルに貼付した。運動課題は端坐位での上肢下垂位から肩関節屈曲と外転方向に30°毎挙上し120°まで各角度5秒間保持し、これを3回施行した。分析方法は3回の平均値を個人データとし上肢下垂位の筋電図積分値を基準に運動方向ごとに各角度での筋電図積分値相対値(以下、相対値)を算出した。次に_丸1_各運動方向における角度間での分散分析(tukeyの多重比較)、_丸2_角度ごとでの屈曲と外転間での対応のあるt検定にて比較した。 【結果】 中部線維の相対値は屈曲、外転方向ともに角度増加に伴い漸増傾向を示した。_丸1_屈曲では30°と比較して90°および120°において有意に増加した(p<0.01)。外転では30°と比較して120°において有意に増加した(p<0.05)。_丸2_各角度において屈曲と外転間での相対値には有意差は認められなかった。 【考察】 中部線維は第2,3肋骨から起始し、肩甲骨内側縁に付着し肩甲骨の外転作用を有する。肩関節屈曲、外転運動における肩甲骨運動について我々は座標移動分析法(2008)を用いて検討したところ肩甲棘内側端は屈曲では120°まで外側方向に外転では90°まで内側方向へ90°以降外側方向へ移動することを報告した。このことから肩関節屈曲における中部線維の機能は肩甲骨の外転運動に関与したと考えられる。一方、肩関節外転では肩甲棘内側端は内側方向へ移動することから中部線維の肩甲骨外転作用に対して肩甲骨運動は拮抗している状態である。しかし、中部線維の相対値は肩関節屈曲と有意差を認めなかったことから肩関節外転における中部線維の筋活動は肩甲骨運動に関与するのではなく、肩甲骨と胸郭との安定性に関与したと考えられた。また、肩関節外転120°で有意に相対値が増加したことは肩甲棘内側端が内側から外側方向へ移動が転換される角度であり、中部線維は肩甲胸郭関節の安定から肩甲骨運動に機能転換されることが示唆された。

著者

三浦 雄一郎 福島 秀晃 森原 徹 鈴木 俊明

出版者

日本腰痛学会

雑誌

日本腰痛学会雑誌 (ISSN:13459074)

巻号頁・発行日

vol.14, no.1, pp.122-128, 2008 (Released:2008-12-22)

参考文献数

6

被引用文献数

2 1

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腰椎椎間板ヘルニアと診断された慢性腰痛症患者2名に対し,歩行時における体幹筋の筋活動について表面筋電図を測定し,健常群と比較,検討した.症例Aでは内腹斜筋の筋活動は歩行周期を通して平坦化していた.また,腰背筋筋活動パターンは立脚期中期,遊脚期にも筋活動が増加し,多相性を呈した.常時腰背筋の筋緊張を高めることが脊柱可動性低下の一要因であると考えられた.症例Bにおける歩行時の腰背筋筋活動パターンは左側多裂筋,最長筋,腸肋筋ともに多相性パタ-ンを呈した.運動療法後は最長筋,腸肋筋,多裂筋ともに健常群のパターンに類似したが,多裂筋は立脚期中期および遊脚期中期の筋活動増大が残存した.ラセーグ徴候陽性,SLR角に変化を認めなかったことからブレーキング作用が生じたと考えられる.慢性腰痛症患者に対して表面筋電図を用いて問題点を明確にすることが運動療法の内容,治療効果判定を判断するために重要であると考える.