著者
大工谷 新一
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.21-26, 2006 (Released:2007-01-30)
参考文献数
3
被引用文献数
4

This article describes the intervention for improvement of the limitation of range of ankle dorsal flexion. A limited range of ankle dorsal flexion is caused by shortening of antagonist musde or joint capsule, decrease of joint play and disorder of the axis of dorsal flexion. Especially, a disorder of the joint axis is the most important finding among all causes. Disorder of the joint axis has a close relation with shortening of the soft tissue around the ankle joint. Especially, there are some typical parts, in which shortening of the soft tissue is related to disorder of the ankle motion axis. These parts were identified as the D-point (Daikuya's normalizing point for ankle axis). Compression and stretching to the D-point normalized ankle axis disorder. Normalizing the ankle axis is an important strategy in physical therapy for the limitation of the range of ankle dorsal flexion, because normal soft tissue is loosened and shortened tissue is untouched in physical therapy for an abnormal ankle axis.
著者
西守 隆 大工谷 新一
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.4, pp.37-41, 2004 (Released:2005-03-11)
参考文献数
4

Interpretation and integration are defined as tying up a patient's capacity for action and measurement results. This paper explains the interpretation and integration divided into the following five. “Solving relativity of impairment and active limitation”. “Solving the cause of impairment”. “Solving the correlation of impairment”. “Solving the correlation of active limitation”. “Inferring a prognosis of impairment from references or improvement of clinical physical therapy”. Interpretation and integration are the most important parts of physiotherapy evaluation.
著者
大工谷 新一 小野 淳子 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
巻号頁・発行日
pp.7, 2009 (Released:2009-09-11)

【はじめに】 筆者らはスポーツ外傷後の神経筋機能を評価する目的で,理学療法評価に電気生理学的検査を取り入れている.今回,スポーツ動作中に足関節内反捻挫を受傷したバスケットボール選手に対する電気生理学的検査で特異的な所見を得たので報告する.【対象】 対象は本件に関する説明に同意を得た21歳の男子大学バスケットボール選手であった.診断は左足関節内反捻挫(II度損傷)であった.現症としては,応急処置が奏功した結果,腫脹と疼痛,可動域制限はそれぞれ軽度であった.筋力検査は疼痛のため不可能であった.ADLレベルは,歩行は疼痛自制内で可能であるものの,段差昇降には時間を要し,走行は不可であった.【方法】 電気生理学的検査として,ヒラメ筋からH反射を導出した.具体的には,筋電計Viking Questを用いて,安静腹臥位で足尖をベッド外へ出した状態の被験者の膝窩部脛骨神経に電気刺激を16回加えて,H反射を記録した.電気刺激強度は,振幅感度を500μV/divとした画面上でM波出現が同定できる最小強度とした.H反射の記録後,同部位に最大上刺激を加え,最大M波を記録した.H反射振幅とM波振幅の平均値を求めた後に各々の比(振幅H/M比)を算出して,受傷前,受傷後3日,受傷後1ヶ月の振幅H/M比を比較した.【結果】 受傷前,受傷直後,受傷後1ヶ月の振幅H/M比は,非受傷側で0.17,0.88,0.21,受傷側では0.62,1.23,0.58であり,受傷直後に顕著に増大していた.また,得られた波形の外観上の特徴として,受傷直後の受傷側には長潜時反射様の律動的波形がH反射出現後に記録された.【考察】 振幅H/M比は脊髄神経機能の興奮性を示す指標である.また,下肢における長潜時反射は脳幹または大脳皮質の興奮性を表す指標となる.本症例では,受傷直後に両側についてヒラメ筋に関連する脊髄神経機能の興奮性に著しい増大が認められた.また,通常は安静時には導出されない長潜時反射も受傷直後の受傷側において記録された.これより,本症例においては足関節内反捻挫の受傷によって,一過性の脊髄神経機能の興奮性の増大が両側性に認められ,受傷側においては脳幹より上位の神経機能の興奮性も増大していたことが明らかとなった.この機序としては,受傷そのものによる脊髄神経機能への影響と,受傷した状態でADLに適応する過程で脊髄神経機能に及ぼされる影響の2つの観点から考慮する必要がある.受傷そのものによる脊髄神経機能への影響としては,疼痛を回避するために脊髄反射が亢進していた可能性や腫脹による関節内圧の変化などが考えられ, ADLに適応していく過程で脊髄神経機能に及ぼされた影響としては,受傷直後の不安定感や疼痛を回避するために,ヒラメ筋などの足関節周囲筋群の緊張性収縮を常時亢進させた状態で姿勢保持や動作遂行を繰り返していた影響があった可能性が推察された.
著者
谷埜 予士次 熊崎 大輔 舌 正史 大工谷 新一 森 裕展
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.15-24, 2001
被引用文献数
1

We performed physical therapy after reconstruction of the posterior cruciate ligament (PCL) on a Japanese Taekwondo player. In physical therapy after the reconstruction of PCL, we had to protect PCL from mechanical stress. To protect the reconstructed PCL in this case, we predicted the traction stress for PCL by motion analysis using surface electromyography (EMG). In order to avoid the traction stress on PCL, we checked the muscle activity of the quadriceps femoris and the hamstrings during various kinds of muscle strengthening exercises for the lower extremity in the closed kinetic chain (CKC). The muscle contraction of hamstrings with knee flexion caused the posterior displacement of the tibia, and the traction load on PCL was increased with a contraction of hamstrings. On the other hand, because the muscle contraction of the quadriceps femoris produced anterior sharing force of the tibia, the contraction of the quadriceps femoris could protect the PCL from traction load. Therefore, we selected the muscle strengthening exercises in which the muscle activity of the hamstrings was lower and the muscle activity of the quadriceps femoris was higher. Twelve weeks post operation, the muscle strength of the quadriceps femoris had reached a level compatible with returning to competition, and since the patient had no pain or instability of the knee, we had him perform athletic training (jogging, running, step drill, etc.). He could practice athletic training without any pain or feeling instability of the knee. After 19 weeks post operation, we had him perform kick training gradually under the doctor's permission, and to prevent the hamstrings tearing as well as increasing the performance of kicking, we started him on muscle strengthening exercises of the hamstrings with the kick training gradually. After about 27 weeks post operation, the patient could practice all Taekwondo training without any knee pain or feeling instability of the knee, and after about 43 weeks post operation, he competed successfully in the All Japan Taekwondo Championship and becoming. In conclusion, because we selected the muscle strengthening training avoiding traction load on the PCL, the patient could carry out athletic training and Taekwondo training in safety after the operation.<br>
著者
福島 綾子 高田 あや 谷埜 予士次 大工谷 新一
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.4, pp.109-113, 2004 (Released:2005-03-11)
参考文献数
6

This report described the effect of remote acupuncture therapy for a scoliosis patient with low back pain. It was considered that the cause of the low back pain was contraction of the erector spinae. Contraction pain of the erector spinae was induced by trunk malalignment due to reduced trunk stabilization. Trunk instability was induced by reduced activity of the obliquus abdominis. Therefore, in order to increase the activity of the obliquus abdominis, remote acupuncture therapy was performed on the GB41 (Ashirinkyu). GB41 was a reaction point on the Gallbladder Meridian through the obliquus abdominis. As a result of remote acupuncture therapy, low back pain and trunk instability were reduced because the activity of the obliquus abdominis was increased.