著者

宮本 雅史 伊藤 博元

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.11, no.1, pp.92-96, 2005 (Released:2007-12-14)

参考文献数

9

---

慢性腰痛に対する運動療法は重要な保存的治療法である.しかし現在の医療制度の中では,その治療効果についての科学的根拠が確立されていないという理由から,診療報酬を削減される危機に陥っている.従来のシステマテックレビューには個々の論文の間で慢性腰痛の定義や治療効果を判定するためのアウトカム指標が統一されていないことや,運動療法の種類や対照群の治療法がさまざまであるなどの問題点が指摘されている.近年,Liddle SDらはこれらの点に改善を加えた新しいシステマテックレビューを行い,運動療法は慢性腰痛患者に対し特に腰痛の特異的機能評価の観点から効果的に作用すると報告した.国内でも現在,慢性腰痛に対する運動療法に関する質の高いRCTが進行中であり,運動療法の有効性に対する評価を見直すべき時期にきているといえるであろう.

著者

元文 芳和 伊藤 博元

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.2, no.1, pp.42-46, 2006 (Released:2006-03-10)

参考文献数

8

被引用文献数

1 1

---

Many patients require a medical check-up as an outpatient with the chief complaint of low back pain, because the morbidity of low back pain is high. Many cases of acute lumbago resolve spontaneously, but some cases shift to chronic lumbago. Low back pain is classified as somatic pain and radicular pain resulting from the lumbar area, and other pain originating in the abdomen and pelvic viscera. We describe it mainly as low back pain and inter vertebral disc herniation. At the time of diagnosing inter vertebral disc herniation, the straight leg raising test is a very useful physical examination and MRI is the best examination for imaging studies. The therapeutic principle is conservative treatment, because symptoms of inter vertebral disc herniation may improve naturally. Surgical treatment is chosen when severe nerve damage, such as bladder problems or dropfoot, is present and patients are in significant pain.

著者

青木 孝文 今野 俊介 宮本 雅史 伊藤 博元

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.13, no.1, pp.84-87, 2007 (Released:2008-01-22)

参考文献数

7

---

慢性腰痛患者に対し簡便な運動療法を指導し,その臨床的効果について検討した.方法は座位で体幹を左右に回旋させるのみの極めて簡単な方法である.ただし,一方向に回転させてからその位置で3秒同一姿勢を保持させ,それを反対側にも行って,これを5~10往復,1日3回行うように指導した.運動実施後1カ月の調査では,腰痛がほとんど消失したり,かなり改善して効果の顕著な症例が全体の70%に及んだ.本法は脊柱周囲の筋群に対するストレッチ効果が高いものと推定されるが,今後筋電図学的検討なども加えながら詳細に検討する予定である.

著者

伊藤 博元 白井 康正 井伊 京一郎 横内 正直 石川 雅人 柴崎 徹 沢泉 卓哉

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.2, pp.195-197, 1986-07-28 (Released:2012-11-20)

参考文献数

7

---

Methods of reduction of anterior dislocations of the shoulder have commonly used the Kocher or Hippocratic maneuvers.Many surgeons had prefered the Kocher leverage technique, but recently some authors have not recommended their use because of the possibility of increasing damage to the capsule, soft tissues and injuring the axillary vessels and the brachial plexus. While Milch recommended the forward elevation maneuvers for reduction of anterior dislocations of the shoulder as the simple and safe techniques.Twenty cases were performed with the forward elevation maneuver for the shoulder dislocation in our hospitals. The patients are placed in a supine position on the examining table, intravenous and intramuscular medication are not required. The patients are instructed to relax as much as possible while the maneuver is performed, the arm is very slowly and gently abducted untill 90 degrees.The horizontal adduction on the 90 degrees plane is applied to 90 degrees flextion position, forward flexion is continued untill reduction is carryed out. Nineteen of 20 cases were obtained complete reduction without assistants and anesthesia by this techniques, another one case was needed the muscle relaxant due to severe pain.

著者

橋口 宏 江川 慶長 伊藤 博元

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.30, no.3, pp.485-488, 2006-08-18 (Released:2012-11-20)

参考文献数

5

被引用文献数

3

---

The purpose of this study was to analyze factors that influence the outcome of nonsurgical treatment for partial-thickness rotator cuff tears (PTRCTs). Sixty-one patients with PTRCT included 34 women and 27 men with a mean age of 55.7 years old were evaluated.43 patients had a history of trauma such as a fall or traffic accident. The types of PTRCT were revealed by MRI. A bursal-sided tear of the cuff was observed in 32patients, a joint-sided tear in 20 and an intratendinous tear in 9. All the patients were treated nonsurgically for a mean duration of 5.7 months. Satisfactory results were achieved in 28 patients.33 patients with unsatisfactory results eventually required surgery. Factors of the 33 nonresponsive patients to the 28 responsive patients to treatment were compared. The factors were as follows; characteristics of the patients, range and strength of the shoulder motion, and radiographic factors, such as size of the subacromial spur and acromial morphology. All data were statistically evaluated using a logistic analysis. The significance level was set at P < 0.05, and odds ratios were figured. Identified factors that had a significant difference between the two groups were age, size of the subacromial spur, bursal side tear, and range of forward elevation (FE) and external rotation (ER). Positive correlation was demonstrated in age and range of the motions, and negative correlation in size of the spur. Each ratio of age, size of the spur, bursal. side tear, FE and ER was 3.33, 2.55, 33.33, 1.1 and 1.11respectively. This study suggested that the younger the age, a bursal-sided tear, a large subacromial spur and motion restriction of the shoulder are factors that induce a poor outcome of nonsurgical treatment for PTRCTs.