著者

光田 尚代 高木 綾一 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.35-39, 2012 (Released:2012-12-27)

参考文献数

13

被引用文献数

2

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Quadriceps setting is widely used as a muscle strengthening exercise for the quadriceps femoris muscle. It is frequently employed from the early post-operative stage for patients receiving knee joint replacement surgery, such as total knee arthroplasty, at our hospital. Quadriceps setting is frequently performed with ankle joint dorsiflexion in the supine position. Patients performing quadriceps setting often say “I can’t understand where to flex the muscle in the leg.” Therefore, we analyzed this exercise in patients receiving knee joint treatments such as total knee replacement surgery. The patients were explained in a simple and easy-to-understand manner the correct way of performing quadriceps setting for efficient restoration of the quadriceps femoris muscle activity. In addition, we devised a quadriceps setting exercise involving knee extension and ankle dorsiflexion with the heel pressed down, encouraging simultaneous contraction of the quadriceps and gluteus maximus muscles, and analyzed the effectiveness of this exercise on quadriceps femoris muscle activity.

著者

水元 裕樹 池澤 秀起 光田 尚代 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.15, pp.101-106, 2015 (Released:2016-01-06)

参考文献数

6

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A stroke patient with left hemiplegia was at risk of falling to the right side when turning left, due to, lack of displacement to the left side of the center of gravity which resulted in instability to the right side when turning. Therapy was administered for the left hip joint abductor muscle, left obliquus internus abdominis muscle, and obliquus externus abdominis muscle, but this did not improve turning movements. Therefore, therapy then focused on the alignment of the upper trunk, right shoulder joint, and the right latissimus dorsi muscle. As a result of the new therapy, the center of gravity shifted to the left side thereby reducing the risk of fall. It is our opinion that the right lateral bending of the upper trunk was caused by hypertonia of the right latissimus dorsi muscle, and that hypertonia of the right latissimus dorsi muscle had prevented the patient from shifting her center of gravity to the left side.

著者

梶迫 美沙子 光田 尚代 高木 綾一 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.101-108, 2012 (Released:2012-12-27)

参考文献数

5

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A patient with a trochanteric fracture of the left femur presented at our hospital. Initially, muscle strengthening of the left lower leg was attempted. This led to subsequent improvement in muscle weakness, and the patient could walk by herself with a cane. However, when she tried walking without a cane, the movement of her first step seemed unstable. We realized that the major impairment was instability at the first step of walking. To resolve this issue, we aimed at practical improvement of the instability. We focused on alignment of the pelvis and trunk, and on the center of pressure at the first step of walking. Efficient, smooth walking is possible due to a reverse reaction phenomenon derived from the standing position in a healthy person. However, in the present case, the movements of the center of pressure and the patient’s standing position at the first step were different from the general pattern. We concentrated on improving her posture and control in the standing upright position. Thereafter, the patient’s standing upright position and the center of pressure at the first step changed remarkably and she acquired smooth walking following the first step.

著者

福田 圭志 中村 英美 光田 尚代 井尻 朋人 鈴木 俊明

出版者

日本転倒予防学会

雑誌

日本転倒予防学会誌 (ISSN:21885702)

巻号頁・発行日

vol.4, no.1, pp.53-59, 2017-06-10 (Released:2018-06-22)

参考文献数

35

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【目的】主要な転倒リスク評価により後方転倒を予測できるか検証することを目的とした。【方法】対象は独歩または杖歩行可能な地域在住高齢者 61 名とした。対象者を過去 1 年間で転倒経験なし(Ⅰ群),後方転倒以外の転倒経験あり(Ⅱ群),後方転倒経験あり(Ⅲ群)の 3 群に分類した。3 群に対して 5 回椅子立ち上がりテスト(Five-Times-Sit-To-Stand Test: 以下,FTSST),通常歩行速度,Timed Up & Go Test(以下,TUG),片脚立位時間を計測した。なお,片脚立位では足の着地位置が,前方,後方,中間のどの方向へ着地するのかを 5 回測定した。各評価結果の 3 群間の比較には Steel-Dwass 法を用いた。また,各群の片脚立位の足の着地位置が前方着地と後方着地,中間着地のどの方向に関連するかを χ2 独立性の検定を用いて検証した。【結果】Ⅰ群とⅢ群間の比較では,FTSST はⅠ群が 14.2 ± 4.7s,Ⅲ群が 19.4 ± 6.3s,通常歩行速度はⅠ群が 0.8 ±0.2m/s,Ⅲ群が 0.6 ± 0.1m/s,TUG はⅠ群が 12.6 ± 4.7s,Ⅲ群が 16.9 ± 5.7s と,いずれもⅢ群が有意に劣っていた(p < 0.05)。Ⅰ群とⅡ群間ではすべてに有意差はなかった。片脚立位における測定時間は 3 群間で有意差はなかった。また,片脚立位の挙上側足の着地位置に関しても,3 群ともに足の着地位置と転倒方向の関連性はなかった。【結論】現在,多く用いられる転倒リスク評価のみでは後方転倒の予測は難しいが,後方転倒は下肢筋力や立ち上がり,歩行,方向転換能力のより低い高齢者に生じやすいことが示された。