著者
渡邊 裕文 大沼 俊博
出版者
The Academy for Kansai Physical Therapy
雑誌
関西理学療法 (ISSN:13469606)
巻号頁・発行日
vol.8, pp.13-15, 2008

The activity of bathing involves multiple motions that consist of basic abilities and functions of the upper limbs. This paper aims to describe "the motion of stepping over the bathtub" that is a necessary activity of bathing. We describe these motions, and simulate the motion which can reproduced in the rehabilitation room, from sitting to long sitting on a platform. We divided these motions into three phases and explain the movement of normal adults and adults with hemiplegia, as well as the points of treatment about each phase.<br>
著者
大沼 俊博 渡邊 裕文 藤本 将志 赤松 圭介 谷埜 予士次 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.11-22, 2013 (Released:2013-12-28)
参考文献数
9
被引用文献数
13

In a clinical setup, difficulty in maintaining posture and controlling movements while bending, lateral bending, or performing rotation of the thoracic and lumbar region due to reduced activities of the abdominal oblique, multifidus, longissimus, and iliocostalis muscles, when in the seated and standing positions, and during walking, is often encountered. We trained patients with postural and control difficulties to shift their body weight laterally from one limb to the other while standing to increase the activities of the trunk muscles and improve the seated, standing, and gait postures. The activities of the trunk muscles, that serve as clinical indicators, were evaluated using electromyography and measurement of tissue stiffness. In the present study, we present the results of our research on the activities of the trunk muscles in the sitting and standing positions, and during sustained lateral shifting of body weight from one limb to the other while standing, and discuss their clinical implications.
著者
大沼 俊博 渡邊 裕文 蔦谷 星子 三好 裕子 山口 剛司 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.2, pp.103-107, 2002 (Released:2005-05-21)
参考文献数
2
被引用文献数
1

To evaluate of sustained elevation of a paralyzed superior limb, we performed physical therapy for the limb in a patient with postapoplectic hemiplegia. During the physical therapy, sustained elevation of the paralyzed superior limb was achieved by activating muscle groups in the lower trunk and gluteal region controlled by the corticoreticular spinal tract, and by accelerating continuation of associated righting reflex. These findings suggest that postural adjustment of the body center and proximal extremities is required in hemiplegic patients to achieve functional improvement of a paralyzed superior limb.
著者
渡邊 裕文 大沼 俊博
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
no.8, pp.13-15, 2008

The activity of bathing involves multiple motions that consist of basic abilities and functions of the upper limbs. This paper aims to describe "the motion of stepping over the bathtub" that is a necessary activity of bathing. We describe these motions, and simulate the motion which can reproduced in the rehabilitation room, from sitting to long sitting on a platform. We divided these motions into three phases and explain the movement of normal adults and adults with hemiplegia, as well as the points of treatment about each phase.<br>
著者
二五田 美沙 早田 恵乃 藤本 将志 大沼 俊博 渡邊 裕文 田中 祥子 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.95-101, 2013 (Released:2013-12-28)
参考文献数
2

A patient with left hemiplegia following cerebral infarction could not maintain a sitting position. Treatment in this position was difficult for the patient because of a tendency to fall toward the paralyzed side (left side) when sitting, and associated anxiety. Therefore, with the aim of maintaining the sitting position, physiotherapy was started in this position for a week to treat hypotonia of the internal and external oblique muscles of the abdomen, longissimus muscle, and multifidus muscle, which was the primary condition. However, it was difficult to maintain a sitting position. Thus, we considered that it was necessary to treat hypotonia by placing the patient in a supine position to improve the ability to maintain the sitting position. After 3 days of practicing to turn to the non-paralyzed side (right side), and sitting-up exercises to increase the activity of the internal and external oblique muscles of the abdomen, longissimus muscle, and multifidus muscle, the patient was able to sit independently without support. To treat the condition and help maintain a sitting position, as well as to reduce the anxiety of falling, it is necessary to initially treat the patient in a supine position.
著者
田尻 恵乃 藤本 将志 赤松 圭介 大沼 俊博 渡邊 裕文
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.9, pp.105-116, 2009 (Released:2010-01-16)
参考文献数
2

We experienced a patient with post-stroke left hemiplegia exhibiting Pusher's syndrome, who required assistance to maintain sitting and standing positions and to standing up. Hypotonia on the hemiplegic side and hypoesthesia were considered to be the basic problems with the posture and movement of this patient. Moreover, hypotonia of abdominal muscles on the non-hemiplegic side was assumed to be the main cause of Pusher's syndrome, a characteristic of this case. This condition may have induced excessive extension and abduction of upper and lower limbs on the nonhemiplegic side (Pusher's syndrome) in order to maintain posture and movement, leading to the requirement for excretory assistance. The hypotonic abdominal muscles on the non-hemiplegic side were trained through physical therapy, and Pusher's syndrome of upper and lower limbs on the non-hemiplegic side was improved. Following this, postures and movements were modified in consideration of bilateral symmetric sensory input, and movements necessary for toilet use were improved.
著者
大沼 俊博 渡邊 裕文
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.39-42, 2006 (Released:2007-01-30)
参考文献数
8
被引用文献数
1

We report on physical therapy and its evaluation in patients with impaired deep sensation. Evaluation in physical therapy should be performed not only in the static states but also in the situations and postures causing abnormal actions. In physical therapy, treatment with the patient being aware (use of feedback such as that by visual sensation) provides clues that improve problems. For improvement in impaired deep sensation and recovery of motor function, their association should be considered, and the induction of normal actions is important.
著者
大沼 俊博 藤本 将志 楠 貴光 渡邊 裕文 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.18, pp.11-18, 2018 (Released:2018-12-20)
参考文献数
4

Therapists identify major dysfunction by analyzing seated posture and standing-up motion, with the aim of treating the dysfunction and implementing training for maintenance of seated posture and standing-up motion. Treatments to improve posture and motion will encourage exercise and can be based on kinesiology and anatomy. This article considers the following: 1) methods for assessment of seated posture based on kinesiology and anatomy; 2) standing-up motion; 3) handling skills of seated posture and standing-up motion; and 4) the relationships between a symptomatic area and seated posture/standing-up motion.
著者
木田 知宏 伊藤 陸 藤本 将志 大沼 俊博 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.19, pp.34-41, 2019 (Released:2019-12-26)
参考文献数
11

In patients with musculoskeletal and central nervous system diseases, even if the sitting and standing postures can be maintained to some extent, the instability of the hip joint and pelvic area may limit the muscle activity when the lower limbs are raised. By presenting electromyographic studies and images of the hip joint and pelvis during the above-mentioned movements, this study introduces points of clinical evaluation and treatment.
著者
安井 重男 藤本 将志 渡邊 裕文 大沼 俊博 赤松 圭介 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.8, pp.69-73, 2008 (Released:2009-01-15)
参考文献数
5
被引用文献数
3

We have experimented with physical therapy for patients with difficulty of body weight transfer due to hyperactivity of the latissimus dorsi and muscular contractions. For lateral body weight transfer, training changed the distance of lateral transfer in the sitting position. Recent electromyographic (EMG) studies on the latissimus dorsi reported activities in its upper and lower fibers in the scapular brachial joint during trunk exercise. However, the activities of this muscle on lateral transfer in the sitting position have not been analyzed. In this study, we examined the influence of changes in the distance of lateral transfer in the sitting position using the EMG of the upper and lower fibers of the latissimus dorsi. Initially, in the end-sitting position (starting limb position), in which the bilateral arms were folded, we measured integrated EMG (iEMG) for the upper and lower fibers of the bilateral latissimus dorsi. Subsequently, the shoulder girdle was transferred in the lateral direction at distances of 5, 10, 15, and 20 cm without inclining or rotating the line between the bilateral acromions, while maintaining the head in the vertical position, with both feet placed on the ground from the starting limb position. We determined the respective iEMGs. There were no significant lateral transfer distance-related changes in the relative iEMG for the upper and lower fibers of the mobile side latissimus dorsi. Furthermore, the value for the upper fibers of the non-mobile side increased with the distance of lateral transfer. In addition, the value for the lower fibers of the non-mobile side also elevated with the lateral transfer distance; at a distance of 20 cm, the value was significantly higher than those at distances of 5 and 10 cm. Based on the results of this study, it may be important to evaluate the abdominal oblique muscles, dorsolumbar muscles, and latissimus dorsi in performing lateral body weight transfer. Training chang the distance of lateral transfer in the sitting position of patients with difficulty of lateral transfer . In addition, the actions of the upper fibers of the latissimus dorsi differed from those of the lower fibers, suggesting the necessity of assessing these fibers individually.
著者
池田 幸司 大沼 俊博 渡邊 裕文 藤本 将志 赤松 圭介 鈴木 俊明
出版者
理学療法科学学会
雑誌
理学療法科学 (ISSN:13411667)
巻号頁・発行日
vol.29, no.3, pp.421-424, 2014 (Released:2014-07-03)
参考文献数
11
被引用文献数
2 1

〔目的〕端座位での側方体重移動時における骨盤の側方傾斜と移動側股関節外転筋群の関連を明確にするため,一側殿部への荷重量がこれらの筋の筋電図積分値に及ぼす影響を検討することとした.〔対象〕健常男性16名(平均年齢27.1 ± 6.6歳)とした.〔方法〕端座位より一側殿部の荷重量の総荷重量に対する比率を変化させて,移動側中殿筋・大腿筋膜張筋・大殿筋上部線維の筋電図を測定し,各筋の課題間での筋電図積分値相対値を比較した.〔結果〕筋電図積分値相対値はすべての筋で荷重量85%まで有意に増加した.中殿筋と大腿筋膜張筋では荷重量90%以上で有意に減少した.〔結語〕端座位での側方体重移動に伴う骨盤の側方傾斜を促すには移動側股関節外転筋群の関与が重要である.
著者
刀坂 太 楠 貴光 早田 荘 赤松 圭介 藤本 将志 大沼 俊博 渡邊 裕文 三輪 成利 鈴木 俊明
出版者
理学療法科学学会
雑誌
理学療法科学 (ISSN:13411667)
巻号頁・発行日
vol.33, no.1, pp.121-126, 2018 (Released:2018-03-01)
参考文献数
9
被引用文献数
3

〔目的〕中殿筋と大殿筋の股関節に対する作用を明確にするために各線維を分け,股関節伸展および外転保持時の筋活動を検討した.〔対象と方法〕対象は健常男性10名とし,平均年齢は24.4歳であった.超音波画像診断装置を用いて中殿筋,大殿筋の各筋線維およびこれらが重層する部位を描出した.そして股関節伸展課題および外転課題にて1 kgごとに4 kgまでの重量負荷を加え,各筋線維の筋電図を測定した.〔結果〕股関節伸展課題では中殿筋後部線維,重層部位および大殿筋上部線維の筋活動は4 kgの重量負荷にて増大した.また股関節外転課題では中殿筋の各線維の筋活動は4 kgの重量負荷にて増大し,重層部位の筋活動は3 kg以上の重量負荷にて増大した.〔結語〕中殿筋,大殿筋の各筋線維は各々の作用に対する筋活動の増大を認めたが,大殿筋上部線維は股関節外転課題に関与しなかった.
著者
渡邊 裕文 大沼 俊博 藤本 将志 水上 俊樹
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.11, pp.5-11, 2011 (Released:2012-01-06)
参考文献数
1

In this paper, we introduce some approaches that have been used for hemiplegic patients with serious sensory disturbance in our hospital's convalescence rehabilitation ward. The highest function level in the present case was sitting in a leaning position, and this patient needed assistance in all the activities of daily living. Our treatment aimed to adjust the alignment of the trunk and the neck and improve the mobility of the non-paralyzed upper and lower limbs. Herein, we discuss our goal, potential outcome, and problems of impairment through the treatment and sitting posture in the wheelchair before and after treatment.
著者
大沼 俊博 渡邊 裕文 蔦谷 星子 三好 裕子 山口 剛司 赤松 圭介 藤本 将志 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.31 Suppl. No.2 (第39回日本理学療法学術大会 抄録集)
巻号頁・発行日
pp.B0551, 2004 (Released:2004-04-23)

【はじめに】臨床場面において歩行の立脚期に体幹・骨盤・下肢に不安定性を認める患者の理学療法を経験することがある。この時立脚側の支持性向上を図る目的で、片脚立位にて非支持側股関節を外転させての練習を実施することがある。我々は先行研究にて前方台へのステップ保持が、体幹筋や下肢筋の筋積分値に与える影響について検討してきた。今回我々は片脚立位における非支持側股関節外転角度を変化させた場合の両側外腹斜筋、内腹斜筋および腰背筋群の筋積分値変化について検討し、若干の知見を得たので報告する。【対象と方法】対象は、整形外科、神経学的に問題のない健常男性7名、平均年齢は28.9歳であった。まず被験者に安静立位保持をさせた。この状態で筋電計ニューロパック(日本光電社)を用いて、双極導出法にて両側外腹斜筋、内腹斜筋、腰背筋群の筋積分値を測定した。外腹斜筋の電極は第8肋骨下縁に電極間距離2cmにて配置し、内腹斜筋は両側上前腸骨棘を結ぶ線より2cm下方の平行線と鼠径部との交点、および2cm内方へ電極を配置した。さらに両側腰背筋群の電極は第3腰椎棘突起側方3cmおよび上方2cmの位置へ配置した。測定時間は10秒間とし、3回測定した。次に非支持側の下肢において股関節外転角度を0°、15°、30°、45°、60°と変化させ、同様に筋積分値を測定した。この時の股関節外転角度は非支持側上前腸骨棘を通る床面への垂線を基本軸とし、大腿中央線を移動軸とした。また骨盤の傾斜角度を確認するため、両側の上前腸骨棘にマーカーを貼付し、前方よりビデオ撮影した。【結果および考察】骨盤傾斜角度は、股関節外転角度の増大に伴い増加した。外腹斜筋の筋積分値は両側共に有意な変化を認めなかった。内腹斜筋、腰背筋群については両側共に股関節外転角度の増大に伴い増加した。三浦らによると、外腹斜筋は動作と同期して活動しやすく、体幹回旋時の求心性収縮作用に関与すると述べている。またSnijdors、三浦らは、片脚立位や歩行の立脚期において、仙腸関節へ生じる剪断力に対して内腹斜筋の筋活動はそれを防ぐ効果があると報告している。さらに市橋らは立位での非支持側股関節外転時、支持側の中臀筋に筋活動の増加を認めたと報告し、またCastaingは片脚立位の場合、支持側の中臀筋、大臀筋、大腿筋膜張筋が骨盤の非支持側への傾斜を制御すると報告している。本結果から両側外腹斜筋に関しては、本課題では体幹回旋動作がなく、求心性収縮の要素がなかったため筋積分値に変化を認めなかったと考える。また両側内腹斜筋に関しては、非支持側股関節外転位での片脚立位時に生じる仙腸関節への剪断力の増加に対して筋積分値の増加を認めたと考える。さらに両側腰背筋群に関しては、本課題では支持側中臀筋、大臀筋、大腿筋膜張筋と共に骨盤の非支持側への傾斜に対する制御に関与したと考える。
著者
松本 明彦 津江 正樹 赤松 圭介 大沼 俊博 渡邊 裕文 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.129-136, 2013 (Released:2013-12-28)
参考文献数
4

We report the case of a patient who, after posterior lumbar fixation for lumbar spinal canal stenosis, presented with difficulty in reaching the gluteal cleft with the right upper limb from the dorsal side while wiping after excretion and inevitably used the left upper limb. Through observation of a simulated wiping motion with the right upper limb, a decrease in the ability to perform the following movements was suspected: moving the pelvis from a posterior to an anterior inclination with flexion, internally rotating the left hip joint, extending the trunk, elevating the right pelvis and flexing the trunk to the right side, and rotating the trunk to the right. Examination based on these observations identified decreased tonus of the bilateral internal oblique muscles of the abdomen and multifidus and longissimus muscles, and increased tonus of the bilateral iliocostal muscles to be the primary causes. Therefore, surface electromyography was performed, and electromyographic waveform patterns of the aforementioned trunk muscles during simulated wiping motion with the right upper limb were compared with those of healthy subjects. No activity was detected in the bilateral internal oblique muscles of the abdomen. The patterns of the other muscles were similar, albeit with decreased activity. During physical therapy, the patient retained the physiological curvature of the spine, with the pelvis in the center of the anterior and posterior inclinations and the trunk extended in a sitting position. Furthermore, right pelvic elevation and right rotation of the trunk accompanied by right-sided flexion were promoted while shifting the body weight in the left anterior direction. Satisfactory wiping motion with the right upper limb was acquired through this therapy. This case report suggests that when examining the wiping motion after excretion, it is necessary to evaluate the ability to elevate the pelvis and flex and rotate the trunk to the required side while retaining the physiological curvature of the spine.
著者
山口 剛司 渡邊 裕文 蔦谷 星子 大沼 俊博 三好 裕子 赤松 圭介 藤本 将志 若林 志保子 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.3, pp.139-144, 2003 (Released:2005-04-12)
参考文献数
2

Lateral shift of the center of gravity for the treatment of cerebral angiopathic paralysis was investigated. These patients show increased tension in the dorsolumbar muscles on the paralyzed side, and have difficulty in shifting their weight toward the paralyzed side. Prior to the restoration of standing and walking motions, it is necessary to improve the sitting posture. In this study, we treated cerebral angiopathic paralysis by 2 lateral methods of shifting the center of gravity by inducing movement of the trunk alone and simultaneous movements of the trunk, pelvis and lower limbs. The effects of the treatment by these methods were evaluated with muscle integration values and observation of the posture of the patients. The muscular activity pattern of the muscles in the trunk became closer to normal, and posture and motion were improved when movements of the trunk, pelvis and lower limbs were simultaneously induced. It was suggested that simultaneous induction of the trunk, pelvis and lower limbs was important for treatment based on lateral shift of the center of gravity.
著者
大沼 俊博 渡邊 裕文 蔦谷 星子 三好 裕子 山口 剛司 藤本 将志 赤松 圭介 若林 志保子 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.3, pp.101-104, 2003 (Released:2005-04-12)
参考文献数
8
被引用文献数
2

During 45°-flexion of the hip joint, actions on the pelvis and integral values of abdominal muscle groups were measured by maintaining SLR at 3 different angles of hip joint abduction (0°, 15°, and 30°) to evaluate the relationship between the two. The results of this study suggest that rotating and anteverting actions occur on the pelvic side ipsilateral of SLR when the SLR is held at 30°-abduction of the hip joint in healthy volunteers. In addition, integral values of the abdominal scalenus ipsi- and contralateral of SLR and those of the rectus muscle of the abdomen ipsilateral of SLR obtained by maintaining SLR at 30°-abduction of the hip joint were significantly larger than those obtained at 0°-abduction of the hip joint (p<0.05). Integral values of the rectus muscle of the abdomen contralateral of SLR increase with the angle of hip joint abduction. These results suggest that attention should be focused on hip joint abduction angles during SLR exercise to increase the activity of the entire abdominal muscle groups.
著者
伊藤 陸 早田 荘 藤本 将志 大沼 俊博 渡邊 裕文 鈴木 俊明
出版者
理学療法科学学会
雑誌
理学療法科学 (ISSN:13411667)
巻号頁・発行日
vol.32, no.3, pp.443-447, 2017 (Released:2017-06-23)
参考文献数
13
被引用文献数
1

〔目的〕端座位で股関節内旋位,外旋位を保持した際の股関節周囲筋の筋活動について筋電図を用いて検討した.〔対象と方法〕健常男性10名の両下肢20肢とした.端座位,股関節内旋・外旋10°,20°,30°の肢位で大殿筋上部線維,中殿筋前部線維,大腿筋膜張筋の筋電図を測定し,各股関節内旋角度間と各股関節外旋角度間で比較した.〔結果〕大殿筋上部線維は股関節内旋10°,20°と比較して30°で,中殿筋前部線維,大腿筋膜張筋は股関節内旋10°と比較して30°で有意に増加した.股関節外旋角度間ではいずれも変化を認めなかった.〔結語〕大殿筋上部線維は,股関節屈曲90°では股関節外旋保持には関与せず,股関節内旋保持に関与することがわかった.
著者
大沼 俊博 藤本 将志 赤松 圭介 渡邊 裕文 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.15-23, 2012 (Released:2012-12-27)
参考文献数
7
被引用文献数
1

In clinical practice, sensory tests are performed for patients with a disorder to establish a diagnosis or verify a hypothesis concerning sensory impairment. The hypothesis is set up by the therapist through observational assessment and a graphic display of movements based on a top-down approach. This paper discusses sensory testing based on a top-down approach by presenting effective clinical methods to identify sensory impairments.