著者

藤本 将志 伊藤 陸 小島 佑太 池田 幸司 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.22, pp.33-39, 2022 (Released:2022-12-23)

参考文献数

5

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We recommend performing a top-down physiotherapy evaluation rather than a bottom-up evaluation. During an assessment, it is desirable to detect problems at the impairment level and narrow them down to one problem in terms of order and relevance. By intervention for narrowed-down problems and re-evaluation of changes, a clearer physical therapy can be developed. In this study, we introduce abnormal postures and movements that are characteristics of patients with musculoskeletal diseases involving lumbar and hip joint impairment. Furthermore, we present one problem focusing on muscle weakness and decreased muscle tone as the possible underlying cause of impairment. We explain intervention methods for this impairment using kinematic and anatomical viewpoints and electromyography.

著者

白井 孝尚 井尻 朋人 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.36, no.3, pp.433-437, 2021 (Released:2021-06-20)

参考文献数

23

被引用文献数

1 1

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〔目的〕結帯動作は肩甲骨前傾,下方回旋が重要である.肩甲骨前傾,下方回旋に関与する僧帽筋上部線維が弛緩しにくい場合の結帯動作に与える影響を知ることを目的とした.〔対象と方法〕健常成人20名の僧帽筋上部線維に電気刺激を与え,弛緩しにくい状態を再現させた結帯動作と電気刺激を与えない結帯動作を実施させた.肩関節外転,伸展,内旋角度や肩甲骨前傾,上方回旋角度,結帯距離を比較した.〔結果〕電気刺激により結帯距離の延長,肩甲骨前傾角度減少,上方回旋角度増大を認めた.〔結語〕僧帽筋上部線維の筋緊張は,結帯動作に影響することが示された.結帯動作の実用性改善には,僧帽筋上部線維の筋緊張や肩甲骨運動が重要であることが示唆された.

著者

白井 孝尚 井尻 朋人 鈴木 俊明

出版者

公益社団法人 日本リハビリテーション医学会

雑誌

The Japanese Journal of Rehabilitation Medicine (ISSN:18813526)

巻号頁・発行日

vol.57, no.12, pp.1197-1203, 2020-12-18 (Released:2021-03-13)

参考文献数

18

被引用文献数

3 3

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目的:結帯動作には2種類の動作方法が存在する.移動させる上肢と同側の肩甲骨付近を触れる外転方法と,対側の肩甲骨付近を触れる内転方法である.本研究は,各方法時の肩甲骨運動と筋活動を知ることを目的とした.方法:健常男性10名に外転方法と内転方法を行わせた.肩甲骨上方回旋・前傾・内旋角度を三次元動作解析装置で計測し,多重比較法で比較した.僧帽筋上部線維・中部線維・下部線維,前鋸筋の筋活動を表面筋電計で計測し,分析した.結果:外転方法は肩甲骨が前傾・上方回旋した.内転方法は下垂~L5・T12で肩甲骨が前傾・上方回旋し,L5・T12より高位で下方回旋した.僧帽筋上部線維の筋活動は,外転方法では下垂~T7で常に増大したが,内転方法ではT12より高位で減弱した.結論:内転方法の獲得には,肩甲骨の前傾や下方回旋,僧帽筋上部線維の筋活動に着目したリハビリテーション治療が重要となる.

著者

早田 荘 赤松 圭介 藤本 将志 田尻 恵乃 水上 俊樹 貝尻 望 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.10, pp.57-62, 2010 (Released:2011-01-13)

参考文献数

1

被引用文献数

1

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The efficacy of physical therapy for a patient with impaired hair-washing motion due to dysfunction of the inferior fibers of the trapezius was assessed. Surface electromyography was performed to investigate the clinical implications, and to elucidate the relationship between changes in the speed of elbow joint flexion-extension during simulated hair-washing motion and the corresponding activities of the superior, intermediate, and inferior fibers of the trapezius and of the caput longum of triceps brachii. In a sitting position, the subject moved the shoulder joint approximately 110 degrees in flexion and the elbow joint approximately 45 degrees horizontally on the measured side, and performed flexion-extension of the elbow joint in which the middle finger on the measured side reciprocated between the torus occipitalis and vertex in a hair-washing motion-simulating task. The motion speed was set at 40, 80, 120, and 160 motions per minute using a metronome and electromyograms of the superior, intermediate, and inferior fibers of the trapezius and the caput longum of triceps brachii were measured for 10 seconds 3 times during each task. Electromyogram waveforms of these fibers at each speed and the influence of changes in the elbow joint flexion-extension speed on the relative integrated electromyogram value were investigated. In the caput longum of triceps brachii, the amplitude of the electromyogram waveform in a single elbow joint flexion-extension motion was compared among the tasks at different speeds. The waveform amplitude increased and the relative integral value tended to increase as the elbow joint flexion-extension speed increased only in the inferior fibers of the trapezius. These findings suggest that to evaluate and improve hair-washing motion in patients with impairment of the scapulothoracic joint, the arm should be maintained in an elevated position during this motion. Furthermore, attention should be paid to the activity of the inferior fibers of the trapezius, which are assumed to be involved in stabilization of the scapula during the elbow joint flexion-extension motion, in this posture.

著者

田中 大志 高森 絵斗 早田 荘 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.15, pp.117-125, 2015 (Released:2016-01-06)

参考文献数

8

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We report on the use of physical therapy for a patient with right hemiplegia experiencing difficulty with getting up from a bed after cerebral infarction. Based on a previous study, the aim was for the patient to get up by rolling over to the non-paralyzed side to attain the sitting position. Observation of the getting up action of the patient revealed that the trunk flexion and rotation of the non-paralyzed side were insufficient. Therefore, the patient tried to lift the upper body by pushing with the non-paralyzed side elbow on the bed. However, the patient had difficulty performing the getting up action, because the upper body fell down to the rear due to paralysis on the side of rotation of the trunk. Our assessment showed hypotonia in both parts of the rectus abdominis, and in the external oblique muscle and serratus anterior muscle of the paralyzed side. Hypertonia was also found in the posterior fibers of the deltoid muscle and upper fibers of the latissimus dorsi muscle on the non-paralyzed side. After 1 week of physical therapy, the impairments improved and the patient was able to perform the getting up movement.

著者

堀口 怜志 井尻 朋人 鈴木 俊明

出版者

一般社団法人 大阪府理学療法士会生涯学習センター

雑誌

総合理学療法学 (ISSN:24363871)

巻号頁・発行日

vol.2, pp.9-16, 2022 (Released:2022-06-30)

参考文献数

37

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【目的】整形外科術後患者に対するリハビリテーションを実施する上で,筋緊張異常への評価・治療が必要となる。近年,臨床において簡易に骨格筋や軟部組織の評価として超音波測定装置が多く用いられており,筋活動を測定することも提案されている。本研究の目的は,超音波測定装置を用いた筋束長評価によって,低強度の筋活動が評価可能か否かを明らかにすることとした。【方法】対象は,健常者9名16肢とした。課題は最大随意収縮の30%以下の等尺性膝関節伸展課題とし,表面筋電計と超音波測定装置を用い筋電図積分値相対値と筋束長変化量相対値を同時測定し,曲線回帰分析を用いて筋束長と筋活動量の関係性を求めた。【結果】曲線回帰分析の結果はr2 = 0.736(p < 0.001)であり,筋電図積分値相対値が増加するほど筋束長変化量相対値が増加することが強く示唆された。【結論】外側広筋に対する低強度の筋活動の評価として,超音波測定による筋束長評価を用いることができる可能性が示唆された。

著者

龍神 正導 弓永 久哲 米田 浩久 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.6, pp.145-150, 2006 (Released:2007-01-30)

参考文献数

2

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We report a case in which significant edema was found in the paralyzed foot, which showed ankle plantar flexion, varus position and toe flexion in walking, disturbing the walking movement because of insufficient load to the forepart of the foot. In this case, the patient's foot grounded first with its post-outside when standing on the paralyzed foot due to abnormal alignment on the paralyzed side. Therefore the knee joint couldn't move forward, causing knee joint flexion and trunk anteversion and compensatory tone elevation of both back muscles. We performed therapy to correct the abnormal alignment of the paralyzed foot, which remedied the compensatory tone elevation of both back muscles due to loading of the paralyzed foot sufficiently. We conclude that it is necessary to ensure the foot is fully loaded when perfoming physical therapy for patients who have trouble with the trunk due to the foot during walking.

著者

木下 拓真 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.11, pp.57-63, 2011 (Released:2012-01-06)

参考文献数

6

被引用文献数

1

---

This study examined how differences in the center of foot pressure in the sagittal plane affect the activity of muscles surrounding the hip joint in healthy young male subjects. With the subjects standing on one leg, integrated electromyography values of the muscles surrounding the hip joint, the point of center of pressure in the sagittal plane (Y-axis center displacement), and the trace length of the center of pressure in the frontal plane (X-axis trace length) were measured for three different loads with the center of foot pressure in the forefoot, midfoot and hindfoot regions. There was no significant difference in X-axis trace length between the three loading conditions. The activities of the rectus femoris, tensor fasciae latae and adductor magnus muscles were higher when the load was borne on the hindfoot than in the other two loading conditions. This indicates that these muscles have a flexor effect on the hip joint in the sagittal plane, and that they control the posterior movement of the center of gravity of the body. In addition, we consider these muscles control the center of gravity of the body in the coronal plane at the hip joint.

著者

門田 美咲 井上 直人 北原 拓 黒川 拓馬 渕野 航平 柳川 洸輔 福本 悠樹 谷 万喜子 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.18, pp.60-63, 2018 (Released:2018-12-20)

参考文献数

11

被引用文献数

1

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This study aimed to clarify the effect of physical therapy using acupuncture stimulation at the Shangdu point on spinal neural function. This study examined the F-wave excitability of the spinal neural function in 15 healthy subjects using pressure stimulation at the Shangdu point. F-wave persistence significantly decreased at 5, 10, and 15 minutes after treatment, compared with the resting state. F-wave persistence significantly decreased at 0, 5, 10, and 15 minutes after treatment, compared with that during application of pressure. F-wave persistence significantly decreased at 5, 10, and 15 minutes after treatment, compared with that at the 0 time point. Pressure at the Shangdu point inhibits the excitability of the spinal neural function.

著者

松田 大哉 野口 翔平 清水 啓介 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.18, pp.64-69, 2018 (Released:2018-12-20)

参考文献数

11

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To investigate the effects on postural change and muscle activity in foot muscles during lateral weight shift while wearing an AFO. The subjects were 15 healthy men (average age 24.9 ± 2.5 years old). They performed a lateral weight shift in the standing position to the right lower limb while wearing an AFO on the right foot, then repeated the process without one. In each instance, postural change and electromyograms (EMG) of the peroneus, foot supinator muscles, and tibialis anterior were measured. When initiating the lateral weight shift while wearing the AFO, hip adduction on the moving side resulted in pelvic depression on the non-moving side. Continuation of the lateral weight shift also resulted in lateral flexion of the thoracolumbar area on the moving side, as well as outward inclination of the lower limb on the moving side. Compared to the barefoot lateral weight shift, there was a trend toward overall decrease in muscle activity in the peroneus, foot supinator muscles, and tibialis anterior. During a lateral weight shift while wearing an AFO, the AFO limits both foot pronation and supination. It can be surmised that this function of the AFO results in reduced muscle activity of the peroneus, used for grounding the foot, as well as in reduced muscle activity of the foot supinator muscles and tibialis anterior, which are used to restrict outward inclination of the lower limbs.

著者

早田 荘 楠 貴光 藤本 将志 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.15, pp.39-44, 2015 (Released:2016-01-06)

参考文献数

11

被引用文献数

4

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The purpose of this study was to clarify the activities of the longissimus, multifidus, and iliocostalis muscles at different angles of shoulder joint flexion. The subjects were 14 healthy males (mean age, 23.7 ± 1.9 years). Electromyograms of the longissimus, multifidus, and iliocostalis muscles were recorded at shoulder flexion angles of 0, 30, 60, 90, 120, and 150 degrees in a seated position. The relative values of the integrated electromyograms (iEMG) of the longissimus muscle on the side of shoulder joint flexion gradually increased up to the flexion angle of 90 degrees and gradually decreased thereafter. The longissimus iEMG value was significantly higher at 90 degrees than at 150 degrees. There were no changes in the relative values of the other muscles. We conclude that the longissimus muscle on the side of shoulder joint flexion contributes to the maintenance of posture.

著者

木田 知宏 伊藤 陸 楠 貴光 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.18, pp.76-82, 2018 (Released:2018-12-20)

参考文献数

4

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One-sided lower limb raising motion during sitting is carried out in various daily living activities. In clinical practice, we often encounter patients experiencing instability during maintenance of the sitting posture. When such patients lift the lower limb of one side, the balance of the sitting posture is disturbed, leading to instability at the back and the side, necessitating assistance for basic daily chores in some cases. Physiotherapy training includes practice exercises for raising the legs to various heights for patients who find it difficult to raise the lower limb of one side in the sitting position. We hypothesized that movement of the spine, the pelvis, and a change in the pressure center of the seating surface accompany lifting of the lower limbs, and analyzed the spinal, pelvic, and limb positions using two-dimensional image analysis in physical movement, and the center of pressure displacement responses to changes in the height of unilateral lower limb elevation in the sitting position. The objective was to examine the characteristics of COP displacement. In the 30% elevation task, displacement of the right and left COP locus was observed in response to lower limb elevation, and with regard to the longitudinal COP locus, there was a tendency of the COP locus to displace backward after the COP shifted forward. In the 90% elevation task, COP displacement to the support side and the rear side was observed. Considering these facts, a pattern of characteristic COP displacement corresponding to the change in height of the leg lifting was seen. In healthy volunteers, it has been observed that the supporting side hip joint is always held in internal rotation, and that the load is applied at the sole so that efficient operation with less COP displacement occurs. In cases of instability in one side lower limb elevation, it has been suggested that evaluation of the alignment of the supporting side hip joint is as important as that of the elevated lower limb and the trunk.

著者

池田 幸司 藤本 将志 安井 重男 渡邊 裕文 大沼 俊博 赤松 圭介 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.9, pp.83-88, 2009 (Released:2010-01-16)

参考文献数

3

被引用文献数

4

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In the clinical field, we have provided physical therapy for cases presenting with Trendelenburg sign on walking caused by reduced muscle strength of the abductor muscle group of the hip joint on the weighted side. The Trendelenburg sign can occur in the early stage or after the middle stage of the stance phase, showing various patterns. In this study, we focused on the relationship between Trendelenburg sign occurring in the early stage or after the middle stage of the stance phase and the abductor muscle group of the hip joint on the weighted side. The subjects were asked to flex their hip joint and bend the body forward with 95% of the body weight loaded on one side of the body in an upright position, and remain in this position with the angle from the initial position at 5, 10, 15, 20, and 25 degrees. We evaluated the influence of changes in the angle of the hip joint on integration values of electromyograms of the abductor muscle group of the hip joint (the tensor fascia lata muscle, gluteus medius muscle, and superior part of the gluteus maximus muscle) on the weighted side, using surface electromyograms. As a result, the relative integration value of the electromyograms of the tensor fasciae lata muscle and gluteus medius muscle on the weighted side significantly decreased as the angle of the hip joint increased. On the other hand, the relative integration value of electromyograms of superior part of the gluteus maximus muscle on the weighted side significantly elevated as the angle of the hip joint increased. The hip joint on the weighted side underwent flexion, and was subjected to an abduction force, as the angle of hip joint changed when one of the lower extremities was loaded. It was considered that superior part of the gluteus maximus muscle, which also belongs to the extensor muscle group of the hip joint, was primarily involved as a braking force. The results of this study suggest that the evaluation and treatment of superior part of the gluteus maximus muscle is important in controlling the dropping of the pelvis toward the non-weighted side (adduction of the hip joint of the standing leg) and its anterior inclination (flexion of the hip joint of the standing leg) in cases presenting with Trendelenburg sign.

著者

伊藤 陸 貝尻 望 藤本 将志 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.15, pp.49-52, 2015 (Released:2016-01-06)

参考文献数

5

被引用文献数

1

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To analyze walking turns, the influence the hip joint external rotation angle of the stepping limb in the standing position has on electromyographic activities of the upper and lower gluteus maximus muscle fibers was examined. The subjects were 10 healthy males with a mean age of 24.2. The standing position was defined as the position in which subjects stepped forward from a standing position. The hip joint external rotation angle of the starting position was changed, and the electromyographic activities of the upper and lower gluteus maximus muscle fibers were measured at each angle. The integrated electromyographic relative value of the upper gluteus maximus fiber significantly increased with the increase of the hip joint external rotation angle. The integrated electromyographic relative value of the lower gluteus maximus fiber also showed a tendency to increase. It is our opinion that the upper and lower gluteus maximus muscle fibers participate in the maintenance of the extension and external rotation of the support side hip through the actions of hip extension and external rotation. In addition, the support side hip performs adduction with increase in the angle of hip external rotation, indicating that the upper gluteus maximus fiber increases hip abduction to brake it.

著者

木津 彰斗 末廣 健児 石濱 崇史 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.20, pp.52-58, 2020 (Released:2020-12-28)

参考文献数

9

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This study examined and compared the pelvic tilt angle and movement characteristics of a forward-reaching task at different speeds in the sitting position. Seven healthy males each performed a forward-reaching movement toward a target 20 cm ahead within periods of 2 seconds, 1 second, and 0.5 second. It was found that the thoracic vertebra tended to bend immediately after the initiation of movement in all the tasks. Additionally, in the 2-second and 1-second tasks, the pelvis showed a change in angle, tilting forward at initiation of the movement. In the 0.5-second task, however, the pelvis exhibited a slight change in angle, tilting backward to maintain posture at the initiation of movement.

著者

松田 直佳 神部 智紀 好井 直輝 清原 直幸 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.20, pp.135-140, 2020 (Released:2020-12-28)

参考文献数

4

---

We performed physical therapy for a patient with a right trochanteric fracture who complained of staggering while walking. From the right initial stance to the right mid-stance phases, the right hip joint abducted and the trunk tilted towards the right. The patient presented with poor extension of the right knee joint due to knee osteoarthritis. Thus, we focused on the hip joint adductor muscles. We performed physical therapy and observed improvement in the patient’s gait as the strength of her hip joint adductor muscles increased.

著者

池澤 秀起 高木 綾一 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.30, no.2, pp.261-264, 2015 (Released:2015-06-24)

参考文献数

7

被引用文献数

1

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〔目的〕腹臥位での下肢空間保持課題において,肩関節外転角度の変化が下肢空間保持側と反対側の僧帽筋下部線維の筋活動に与える影響を検討した.〔対象〕健常男性16名とした.〔方法〕課題は腹臥位での下肢空間保持とし,肩関節の外転角度を変化させ,各々の肢位での筋活動を比較した.測定筋は下肢空間保持側と反対側の僧帽筋下部線維とした.〔結果〕下肢空間保持側と反対側の僧帽筋下部線維の筋活動は,肩関節外転角度が0度・30度・60度に対して90度・120度において有意に増大した.〔結語〕僧帽筋下部線維は脊柱の固定に加え,上肢を重さとして利用するために肩甲骨の上方回旋作用にも関与したのではないかと考えられた.

著者

淵本 恵 辻 智美 貝尻 望 藤本 将志 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.16, pp.101-107, 2016 (Released:2016-12-29)

参考文献数

3

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In this report, we describe the physical therapy prescribed for a patient with right hemiplegia following cerebral hemorrhage. The patient had difficulty in swinging off the toes because of right hip flexion during walking. This posture did not allow sufficient right hip joint extension from the right loading response to mid stance. In the left swing phase, right hip joint medial rotation from the flexion position caused her trunk to lean forward. She recovered to the right rear direction by right lateral bending and extension of the thoracic and lumbar spine, and right shoulder extension. Even in the terminal stance, right hip joint flexion persisted. The patient increased her right hip joint flexion in the right swing phase. Her walk weight movement was insufficient because right hip joint flexure was increased in the right terminal stance. As a result, the right foot caught on the floor during the right swing. We regarded gluteus maximus weakness to be the chief issue causing right hip joint flexion in the stance phase and conducted physiotherapy accordingly. We report the progress in gait improvement as a result of the prescribed physiotherapy.

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.