著者

三浦 雄一郎 長崎 進 福島 秀晃

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.7-11, 2015 (Released:2016-01-06)

参考文献数

9

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Table manners are as important as just eating a meal. With the spread of food culture, Japanese culture has been influenced by overseas eating habits. The upper limb is moved into a certain position to have a meal. When performing functional therapy, a knowledge of these movement chains is important because the shoulder, elbow, forearm, wrist, and finger joints are mutually related. In clinical practice, the relationship between the joints is immediately noticeable by movement compensation that is generally recognized and helpful to gauge the effects of physical therapy. However, the exercise chain of the forearm, elbow, and shoulder joints may not display obvious movement compensation, thereby making it difficult to detect functional decline. The movement used to pick up food with chopsticks, a fork, or a hand during meals is known as the reach movement. There are two types of reach movement: of a range that is smaller than the length of the arms, or beyond the length of the arms. Generally, the movement used during meals is mainly of the former type, but the latter type may also be used in some food cultures. This report describes the exercise chain of the forearm, elbow, and shoulder joints, and the movement chain involving the trunk and the shoulder girdle, in consideration of these factors.

著者

上村 拓矢 長崎 進 三浦 雄一郎 福島 秀晃 森原 徹

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.127-134, 2015 (Released:2016-01-06)

参考文献数

11

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The serratus anterior muscle is an important muscle for scapular joint function. It is innervated by the long thoracic nerve, and its function is to stabilize the medial border and inferior angle of the scapula. Generally, exercises that emphasize the protraction and upward rotation of the scapula (wall push-up plus, dynamic hag, push-up plus) have been recommended for strengthening the serratus anterior. However, because greater activation of the pectoral muscles is likely to occur during these exercises, there is a possibility that efficient serratus anterior muscle activity will not be obtained. In this study, a patient was subjected to physical therapy after right long thoracic nerve paralysis resulted in fatigue during shoulder flexion at 120° or higher. General strengthening exercises for the serratus anterior muscle were incorporated, but sufficient effects were not achieved. Therefore, our training focused on improving serratus anterior contraction patterns through facilitation, while reducing the activation of the pectoralis major. These exercises improved shoulder joint motor function and reduced fatigue during flexion better than general strengthening exercises. We consider that it is necessary to focus on facilitation and contraction patterns to improve serratus anterior activation after long thoracic nerve injury.