著者
冨田 祐司 宮野 佐年 渡辺 修 大橋 正洋 片桐 伯真 久保 義郎
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
リハビリテーション医学 (ISSN:0034351X)
巻号頁・発行日
vol.36, no.9, pp.593-598, 1999-09-18 (Released:2009-09-04)
参考文献数
21
被引用文献数
3 4

脳外傷患者の社会復帰を検討する際の指標としてのWAIS-Rの有用性について検討した.対象は, 55歳以下, 実用的な屋外歩行が可能で, 失語症がない重症脳外傷患者60例である.社会復帰状況を, 就労群と福祉的就労を含む非就労群に分け, 各知能指数と11の下位検査について検討した.就労群で言語性知能指数 (VIQ) 90.4±14.6, 動作性知能指数 (PIQ) 80.5±14.2, 非就労群でVIQ82.3±14.2, PIQ62.3±13.0で, 非就労群のPIQの低下が顕著であった.判別分析を行うと, PIQとその下位検査の絵画配列と符号が両群の判別に有用であった.これらは社会的能力をよく反映し, 重症脳外傷患者の社会復帰を知的側面から検討する場合, 有用な指標になる.
著者
才藤 栄一 小徳 勇人 保坂 隆 浜田 暁子 寺川 ゆかり 中嶋 真須美 豊倉 穣 田中 博 神内 拡行 石田 暉 村上 恵一
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
リハビリテーション医学 (ISSN:0034351X)
巻号頁・発行日
vol.26, no.1, pp.51-58, 1989-01-18 (Released:2009-10-28)
参考文献数
24

医療者110名へのアンケートにより医療者のリハ患者に対する陰性感情を検討した.(1)回収率75%.問題患者は対象246名中45名18%であった.(2)疾患では脳血管障害,脳外傷で問題率が高く,脳血管障害では重度障害例ほど多数の看護婦が問題視した.(3)全職種が問題とした症例は,陳旧性重度脳血管障害や各医療者の経験の浅い脊損などであった.(4)問題理由のうち,医療者側の因子が15%を占めた.以上の結果は,障害の重篤さやチームの問題などが,陰性感情,即ち陰性逆転移を生じる原因となることを意味している.従って,陰性逆転移の認識,役割論的観点からの検討,チーム構造の明確さ,チームの学習機能の充実などが,より良い医療者-患者関係の樹立に必要であろう.
著者
猪飼 哲夫 辰濃 尚 宮野 佐年
出版者
社団法人 日本リハビリテーション医学会
雑誌
リハビリテーション医学 (ISSN:0034351X)
巻号頁・発行日
vol.43, no.12, pp.828-833, 2006 (Released:2006-12-29)
参考文献数
15
被引用文献数
20 27

バランス機能は歩行能力に影響する因子の一つと考えられる.そこで歩行能力の代表的な評価法である最大歩行速度 (Maximum Walking Speed: MWS) と各種バランス検査を,若年者群と高齢者群で検討した.身長は若年者群ではMWS, Functional reach (FR),タンデム肢位での重心動揺,Timed Up and Go test (TUG) と相関したが,高齢者群では関係は認められなかった.若年者群ではMWSは,タンデム肢位外周面積,TUGと相関したが,これは身長の影響によると考えられた.高齢者群ではMWSは,FR,タンデム肢位総軌跡長,TUGと相関した.高齢者では歩行能力は静的・動的両者のバランス機能に影響されることが示唆された.
著者
田中 宏太佳 緒方 甫 蜂須賀 研二 合志 勝子 丸山 泉
出版者
社団法人日本リハビリテーション医学会
雑誌
リハビリテーション医学 : 日本リハビリテーション医学会誌 (ISSN:0034351X)
巻号頁・発行日
vol.27, no.6, pp.459-463, 1990-11-18
被引用文献数
5

健常中高年男性を対象に,万歩計での歩行量の測定と体部CTでの大腿中央部の筋横断面積の算出,それにCybex IIでの大腿四頭筋とハムストリンクスの筋ピーク・トルク値の計測を行った.日常生活の活動性中等度群(1日平均歩行量4.0×10^3以上8.0×10^3未満)の大腿四頭筋の筋ピーク・トルク値の平均は,軽度群(1日平均歩行量4.0×10^3未満)に比べて有意に大きかった.筋横断総面積やハムストリンクスの横断面積の値は,日常生活の活動性中等度群では軽度群に比べて有意に大きかった.したがって健常中高年者では廃用性筋萎縮を防ぐために,1日約4.0×10^3以上の日常生活の活動性を維持することが大切である.
著者
長谷 公隆
出版者
社団法人日本リハビリテーション医学会
雑誌
リハビリテーション医学 : 日本リハビリテーション医学会誌 (ISSN:0034351X)
巻号頁・発行日
vol.43, no.8, pp.542-553, 2006-08-18
参考文献数
43
被引用文献数
7

Quiet standing posture is organized by supporting, stabilizing, and balancing the body mass against gravity. The center-of-body-mass is controlled in space within a relatively small base of support. Accordingly, ankle and hip mechanisms are used to control the upright posture in an inverted pendulum-like behavior. Body sway is often estimated from center-of-pressure (COP) measures derived from force plate data. Postural control in the anterior-posterior and medial-lateral directions during quiet standing is achieved by separate strategies; therefore, COP measurements should be analyzed in each direction. Various methods of COP analyses including stabilogram diffusion analysis have been developed, but to reveal the mechanism for reorganization of posture against motor or sensory disturbances, the average location to control body sway within the base of support has to be measured. The body schema is determined depending on both the internal and external environments, for example, the loss of sensory monitoring from a unilateral leg moves the center-of-body sway backwards. Compensatory mechanisms, such as an increased role of hip strategy, are used to maintain the anterior-posterior equilibrium. Lower-limb amputees or hemiparetic patients are not able to utilize the affected ankle mechanism and anterior-posterior COP movement is increased under the sound leg more than under the affected leg. The effects of l-dopa or brain stimulation on the postural control in patients with Parkinson's disease have been estimated by COP-based measurement We can identify the clinical outcomes of rehabilitative treatments by analyzing the patient's optimized standing posture.
著者
前田 真治 岡崎 健
出版者
社団法人日本リハビリテーション医学会
雑誌
リハビリテーション医学 : 日本リハビリテーション医学会誌 (ISSN:0034351X)
巻号頁・発行日
vol.19, no.4, pp.231-236, 1982-07-18
被引用文献数
1

従来, 慢性関節リウマチ(RA)患者のsystemic index(Lansburyの方法)のgrip strengthを測定する際に成人用水銀血圧計の圧迫帯(cuff)のゴム袋を正確に2回折りたたんだ大きさ8.5×14.0cmのカフを用いて, あらかじめ20mmHgになるように脹らませたものを力一杯握りしめ左右の手で3回試み, その最高値平均をもって握力記載値としていたが, 日常外来診察時のような場合は, やや小さめの6.5×14.0cmのカフのような日本人の小さな手に合った大きさを用い, 測定間隔を30秒以上あけ, リウマチによる変化を認める手について左右を2回ずつ測定し, その左右各々の最高値, あるいは全体の最高値を測定値とするのが良いと思われた.
著者
近藤 和泉
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
リハビリテーション医学 (ISSN:0034351X)
巻号頁・発行日
vol.37, no.4, pp.230-241, 2000-04-18 (Released:2009-10-28)
参考文献数
29
被引用文献数
2 2

There are now various therapeutic interventions for cerebral palsied children. Many of them were developed based on the theoretical speculation or empiricism, because it was difficult to know the pathophysiological process, which occurred in the injured brain before its development. It, however, is believed that synaptic formation and synaptic rearrangement play a main role in the first instance of motor development. In the therapeutic approach for cerebral palsied children, we should adopt the appropriate strategy based on the knowledge of neuro-developmental science. As same as the other diseases, for the cerebral palsy, we also should treat the various levels of problems, which was classified by WHO as impairments, disabilities (activities), and handicaps (participation). Therapeutic interventions for children with cerebral palsy have been directed mainly toward impairments of this pathological condition, such as spasticity, joint contracture and abnormal movement pattern. We should pay attention for the cerebral palsied children also to their function in the home activities and participation to the social affairs. At the end of the 20th century health professionals are expected to produce evidence of the effectiveness of the treatments that they provided to the clients. What we require in addition are measures that capture the “health status” of people. We have not been making enough effort to evaluate the effectiveness of therapeutic intervention for cerebral palsied children with the scientific documentation. In North America, various scales have been developed in the recent decades under the concept of the framework for health measurement indices. These scales were also standardized and were endurable for multi-institute's use. In the area of rehabilitation of cerebral palsied children, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) were developed with this new concept. In this review article, the summary and the process of standardization in Japan of these scales were presented.
著者
銅治 英雄 村田 淳 浅野 由美 守屋 秀繁 吉永 勝訓
出版者
社団法人日本リハビリテーション医学会
雑誌
リハビリテーション医学 : 日本リハビリテーション医学会誌 (ISSN:0034351X)
巻号頁・発行日
vol.44, no.5, pp.286-292, 2007-05-18
参考文献数
27
被引用文献数
1 1

The purpose of this study was to resolve the confusion existing in the terminology for describing foot motion, particularly the definitions of inversion and eversion. First, the definitions of foot motion used by the Japanese Association of Rehabilitation Medicine and the Japanese Orthopedic Association were compared with those used by the American Orthopaedic Foot and Ankle Society (AOFAS) and with those used by the International Society of Biomechanics (ISB), to identify agreements and differences. Next, the terminology utilized in the literature was explored by examining several major textbooks and related academic papers retrieved through a search of the PubMed medical literature database. In the definitions of AOFAS and ISB, inversion and eversion, which correspond to triplane motions in the definition used in Japan, were regarded as motions in the coronal plane. Terminology in the textbooks was very diverse. 0f the 141 academic papers explored, 92 papers (66%) regarded inversion/ eversion as coronal plane motion, and 4 papers (3%) regarded it as a triplane motion. In the remaining 43 papers (31%), the definition was unspecified. In academic articles addressing foot motions, to avoid confusion in terminology, the definitions of inversion and eversion need to be specified.
著者
細川 賀乃子 近藤 和泉 岩田 学
出版者
社団法人日本リハビリテーション医学会
雑誌
リハビリテーション医学 : 日本リハビリテーション医学会誌 (ISSN:0034351X)
巻号頁・発行日
vol.43, no.1, pp.51-62, 2006-01-18
参考文献数
35
被引用文献数
1

Lymphedema is defined as a swelling of the arms or legs induced by an obstruction in lymph fluid circulation or by an abnormality in lymph fluid production. In most patients, lymphedema can be diagnosed from the clinical history and physical examination. The lymphangiogram and lymphangioscintigraphy are also used as additional diagnostic tools. Lymphedema developed from an obstruction of the lymphatic system is called secondary lymphedema. Lymphedema is classified into two categories : primary and secondary, and primary lymphedema is rare and is caused by a defect at birth or a congenital lymph system abnormality. The most frequent complication with lymphedema is cellulites. The protein-rich lymph fluid can be a source of bacteria proliferation leading to cellulites, which is an infection in the subcutaneous layers. But if therapy is started from the onset, the risk of infection in edema patients can be lessened. The primary management of lymphedema consist of conservative treatment called complex decongestive physical therapy : CDP or decongestive lymphatic therapy : DLT. The treatment includes skin care, manual lymph drainage, compression therapy, and exercise with bandage or compression garment. If the conservative management does not produce a sufficient effect or the edema worsens, surgical interventions such as microsurgical lymphaticovenular anastomosis and other techniques may be indicated. In Japan, the health insurance system does not offer enough support for patients with lymphedema. The treatment of lymphedema from the early stage is usually effective, and it is therefore necessary for clinicians to have a working knowledge of lymphedema management.