著者

大中 礼香 野口 翔平 増田 蓉二郎 玉置 昌孝 井上 隆文 中道 哲朗 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.13, pp.77-86, 2013 (Released:2013-12-28)

参考文献数

8

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In this study, we examined the patterns of activity of the trunk muscles during weight shifting to one side of the lower limbs in the standing position in five patients with Parkinson’s disease and trunk malalignment. In the movement task, the patients first shifted their weight to one side of the lower limbs and attempted to move the maximum distance in which they could shift their weight to the moving limb in 1 s. Then, the patients held the posture with the maximum weight shift for 1 s and returned to the starting position in the next 1 s. The patterns of activity of the bilateral multifidus, iliocostalis, and longissimus muscles as well as that of the internal oblique and gluteus medius muscles on the weight-bearing side were analyzed. Compared with that of the starting position, we observed an increase in thoracic kyphosis during the movement task, and this was common to all of the patients. In addition, although we observed coronal plane inclination of the pelvis associated with hip joint movement during the movement task, 4 of the 5 patients did not show any change in trunk alignment compared with that in the starting position. The patterns of activation had the following characteristic tendencies: activation of the bilateral longissimus muscles was observed in the starting position in all patients, activation of the longissimus and iliocostalis muscles on the nonweight-bearing side was increased in 4 of the 5 patients, and activation was weak in the internal oblique and gluteus medius muscles on the weight-bearing side in 4 of the 5 patients. We observed a significant difference between the muscle activation patterns reported by previous studies of healthy subjects and those of our present study. When using weight shifting to one side of the lower limbs in the standing position as an exercise therapy for patients with Parkinson’s disease, activation of the internal oblique, gluteus medius, and multifidus muscles on the weight-bearing side increases. Therefore, it is necessary to implement exercises with the intention of performing the movements, with the pelvis in a horizontal position and the trunk in a vertical position. Moreover, it is necessary to ensure that activation of the bilateral longissimus muscles or that of the iliocostal muscle on the nonweight-bearing side does not differ from the activation of the starting position.