著者
大島 博 水野 康 川島 紫乃
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.3, pp.186-194, 2006 (Released:2006-05-01)
参考文献数
19
被引用文献数
2

Bone loss and muscle weakness are important medical concerns observed in astronauts after space flight. Even after a short-duration space flight, muscle atrophy and muscle weakness were observed in back, quadriceps and soleus-gastrocnemius muscles. The primary preventive measure against muscle weakness on the ISS has been exercise. The ISS houses a treadmill, a cycle ergometer, and a resistive exercise device. Individualized preflight exercise programs are planned for crew members based on fitness assessments, mission-specific tasks, and the maintenance of optimal health. A preflight exercise program is scheduled for a minimum of two hours a day, three days a week. Inflight exercise prescription will take into consideration available inflight exercise equipment and the specific needs of the individual crew member. Each inflight exercise program shall include components of cardiovascular, resistive and flexibility exercise. A program is scheduled for a minimum of 2.5 hours a day, six days a week. Postflight rehabilitation activities begin when a crew member returns from space flight. The goal of the rehabilitation program is to provide a planned program of recovery that will prevent additional injury, provide progressive improvement in fitness, and enable a full return to the preflight baseline level. A postflight rehabilitation program may include scheduled rest, assisted walking, swimming pool exercise and traditional exercise. Therapeutic massage, whirlpool, heat/ice and passive stretching also may be incorporated.
著者
大高 洋平 里宇 明元 宇沢 充圭 千野 直一
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.40, no.6, pp.374-388, 2003-06-18 (Released:2009-10-28)
参考文献数
72
被引用文献数
9 8

Fall prevention is one of the major issues in health care in our aging society. The aim of this review is to provide useful information for researchers and practitioners who plan to start fall prevention programs for elderly persons with various risk levels and in different settings. Fifty-three randomized controlled trials (RCTs) and several meta-analyses retrieved with extensive literature search formed the basis for this review. Available evidence suggests that several preventive strategies have been proven beneficial in fall prevention. For the community-dwelling elderly, two RCTs and one meta-analysis demonstrated that an individually tailored home exercise program provided by nurses or physical therapists could reduce the rate of falls and injuries. One RCT suggested that Tai Chi Chuan might have a high potential to reduce falls. Two large RCTs indicated that programs including group exercise classes could also reduce the number of fallers. For people with known risk factors living in the community, three RCTs showed that home visits to address multiple risk factor modification were an effective way to reduce falls. One RCT with a relatively small sample showed that psychotropic withdrawal reduced falls in elderly persons taking psychotropic medication. A subgroup analysis of one RCT showed that home hazard reduction at hospital discharge reduced subsequent falls in patients with a past history of falls. However, more evidence is needed to prove its effectiveness, because this effect was also observed outside of homes. Dual chamber pacemaker for elderly persons with hypersensitive carotid sinus, who were detected when investigated for undiagnosed falls, markedly reduced subsequent falls with or without syncope. In institutional settings, two RCTs showed that comprehensive risk assessment and modification reduced the rate of falls and fractures or the number of recurrent fallers. Three RCTs performed in hospital settings failed to show any effectiveness. However, a meta-analysis of 3 controlled trials and 7 cohort studies with a historical control suggested that fall prevention program in hospitals could be promising. There are some methodological problems in fall prevention research such as the definition, measures, and monitoring method of falls, inadequate sample size and a short follow-up period. In the future, we need research based on strong and comprehensive methodological designs.
著者
三石 敬之 三石 京子 中西 亮二 山永 裕明
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.42, no.6, pp.412-417, 2005 (Released:2006-09-22)
参考文献数
11
被引用文献数
4 2

嚥下障害を呈したWallenberg症候群において, 食塊の輪状咽頭部優位通過側とその経時的変化を検討した. 対象は, Wallenberg症候群29例. 嚥下造影の正面像を観察し, 優位通過側を決定した. 9例に患側が優位通過側である時期がみられた. 5例は患側優位の通過が見られた後, 健側優位の通過へ移行した. 1例は両側不通過, 患側優位, 健側優位の順に変化した. 3例は患側優位の通過のみみられた. 20例は患側優位の時期が確認できなかった. Wallenberg症候群における食塊の輪状咽頭部優位通過側は患側の場合があり, また, 経時的に変化する症例が存在することが確認された. 直接的嚥下訓練における代償法として一側嚥下や頸部回旋を行う際には, 優位通過側の経時的確認が重要であると考えられた. Wallenberg症候群における嚥下障害の病態理解に際して, 患側輪状咽頭筋の弛緩状態を加味する必要があると考えられた.
著者
寺岡 史人 西 眞歩 吉澤 忠博 百瀬 瑞穂 平島 靖江 市川 孝子
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.41, no.6, pp.421-428, 2004-06-18 (Released:2009-10-28)
参考文献数
38
被引用文献数
8 1

嚥下造影検査(以下VF)を行った急性期脳卒中220例について,退院時に経口摂取が可能となったか,一部でも経管栄養を要したかを帰結としてロジスティック回帰分析による予後予測を行った.対象の年齢75±10歳,脳梗塞154例,脳出血66例,平均入院期間106±62日であった.173例(79%)が経口摂取可能となり,47例(21%)では胃瘻等が必要であった.VF上の誤嚥,重度の片麻痺,画像上の両側病変が有意な予測因子として抽出された.得られた予測式で,2項目以上が良好な値であれば,経口摂取可能となる確率は90%以上と予測された.しかし,3変数とも不利な値でも,49%の患者が経口摂取可能となっていた.
著者
小口 和代 才藤 栄一 馬場 尊 楠戸 正子 田中 ともみ 小野木 啓子
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.6, pp.383-388, 2000-06-18 (Released:2009-10-28)
参考文献数
10
被引用文献数
55 72

131名の機能的嚥下障害患者の「反復唾液嚥下テスト」(the Repetitive Saliva Swallowing Test: RSST)と嚥下ビデオレントゲン造影(videofluorography:VF)所見を比較し,RSSTの妥当性を検討した.RSSTはVF所見と相関が高く,カットオフ値として3回/30秒間が妥当であると思われた.誤嚥の有無の判別に関する感度と特異度は,0.98,0.66と,感度が非常に高かった.摂食・嚥下障害の診断・評価としては,まずRSSTでスクリーニングを行い,3回/30秒間未満の場合はさらに詳細な病歴,身体所見をとり,必要と判断されればVFを行い,治療方針を決定するのが適当である.
著者
小口 和代 才藤 栄一 水野 雅康 馬場 尊 奥井 美枝 鈴木 美保
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.6, pp.375-382, 2000-06-18 (Released:2009-10-28)
参考文献数
19
被引用文献数
67 63

機能的嚥下障害スクリーニング法として,「反復唾液嚥下テスト」(the Repetitive Saliva Swallowing Test: RSST)を考案した.30秒間の平均空嚥下回数は若年者(N=30)で7.4回,高齢者(N=30)で5.9回,30秒間の平均人工唾液嚥下回数は若年者で7.7回,高齢者で6.2回であった.空嚥下,人工唾液嚥下ともに高齢者は若年者より有意に嚥下回数が少なかった.一方,若年者,高齢者それぞれの空嚥下と人工唾液嚥下の嚥下回数には有意差を認めなかった.嚥下運動の確認は喉頭挙上の触診で可能であった.高齢者の積算嚥下時間(検査開始から嚥下完了時点までの時間)上限より,RSST 2回/30秒間以下が嚥下障害のスクリーニング値として設定できた.
著者
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.32, no.5, pp.301-306, 1995-05-18 (Released:2009-10-28)
参考文献数
14
被引用文献数
1 1
著者
大高 洋平 里宇 明元 宇沢 充圭 千野 直一
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.40, no.6, pp.389-397, 2003-06-18 (Released:2009-10-28)
参考文献数
41
被引用文献数
2 3

The second part of the review discusses some important issues associated with fall prevention and future perspectives on fall related research. Currently, many kinds of interventions are available for the treatment of patients suffering from osteoporosis, i. e. nutritional supports, medications acting on bone metabolism and exercise. However, a series of meta-analyses showed that only alendronate and risedronate have been proven to prevent non-vertebral fractures in persons with osteoporosis. Anaerobic and weight bearing exercises are known to have a positive effect on the bone mineral density of the spine. There is, however, no reliable data for fracture prevention with exercise alone. Also, the synergistic effect of a combination of these interventions has not been clearly proven. Although there is evidence that the use of hip protectors in institutional settings reduces the rate of hip fractures, this approach faces the problem of patient acceptance and compliance. Psychosocial problems related to falls such as fear of falling, post-fall syndrome and cost-effectiveness of the prevention programs are becoming increasingly important in elderly health care, but little evidence of such has been reported in the literature. In future perspectives on fall relared research, a theory-based approach for fall prevention needs to be included to explore more effective interventions. We must also consider the double-edged effects of interventions that may increase certain fall risk factors while reducing another. Especially, the relation between activities and incidence of falls is important to consider, because increased activity itself may increase the chance of falls. When applying exercise or rehabilitative approaches, the interaction between falls, activity levels, frailty, and injury must be studied much more carefully. In addition, one has to always think about what is the true aim of a program, because the aim of fall prevention goes beyond preventing falls. Although some research has so far been conducted in Europe and the U. S. A. by researchers and practitioners in various fields, the quantity and quality of fall prevention research are still lacking and the available data is therefore insufficient to suggest appropriate decision-making in clinical practice. Especially in Japan, there have been only a few RCTs to determine the effectiveness of fall prevention programs. Because there are many differences in the characteristics of our native population and health care systems vs those of Europe and the U. S. A., it is a critical issue for us to establish fall prevention programs suited to Japanese population and health care system.
著者
久保田 一雄 町田 泉 田村 耕成 倉林 均 白倉 卓夫
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.34, no.1, pp.40-45, 1997-01-18 (Released:2009-10-28)
参考文献数
23

平成2年6月からの5年間に46例のアトピー性皮膚炎患者(男性31例,女性15例,25±11歳)に対して,草津温泉療法(40~42℃,1回10分,1日1~2回)を3~28週行った.その泉質は酸性(pH2.0)-アルミニウム-硫酸塩・塩化物温泉である.32例(70%)で皮膚症状が改善し,さらにそのうち18例で掻痒も改善した.皮膚症状の改善は血清LDHの有意な低下でも裏付けられた.皮膚症状改善例のうち,温泉療法前に皮膚表面に多数の黄色ぶどう球菌が検出された15例では,温泉療法後に13例で消失,2例で減少した.この草津温泉療法による皮膚症状の改善機序として,皮膚病変の増悪因子である黄色ぶどう球菌に対する酸性温泉水の殺菌作用が推定される.
著者
矢形 幸久
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.35, no.8, pp.556-562, 1998-08-18 (Released:2009-10-28)
参考文献数
27
被引用文献数
5 3

本研究は,内側広筋優位の強化を目的とした大腿四頭筋等尺性収縮訓練について調べたものである.5種類の大腿四頭筋等尺性収縮訓練について,健常者群15名(15肢),廃用性筋萎縮がある患者群11名(15肢)における内側広筋,外側広筋,大腿直筋の筋活動を表面筋電図積分波形の最大波高で評価した.その結果,従来的な開運動鎖での四頭筋セッティングに比べ,足部回外位の足底接地で股内転等尺性収縮と同期して行うセッティングにおいて,外側広筋に対する内側広筋の比(VM/VL)は高値を示した.膝伸展等尺性収縮訓練では,股内転等尺性収縮との共同運動を足部回外位の閉運動鎖で行うことにより,内側広筋の収縮が外側広筋より優位となる.
著者
工藤 由理 中野 あずさ 佐藤 厚 今村 徹 佐藤 豊
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.42, no.7, pp.463-468, 2005 (Released:2006-09-22)
参考文献数
12
被引用文献数
5 5

Recent authors reported a cerebellar contribution to cognitive functions such as executive function, personality, spatial cognition, language and memory. Middleton and Strick showed the neuroanatomical projection from the dentate nucleus to dorsolateral prefrontal cortex. Patients with cerebellar diseases were reported to have cognitive impairment in their neuropsychological assessments. The present patient with cerebellar hemorrhage showed disorder of executive function and memory disorder in his neuropsy-chological assessments. In his daily living, we found him to exhibit a distractible affection and disinhibition, which often disrupted the rehabilitation processes. A brain MRI showed no lesions in the bilateral frontal areas but SPECT showed a lower blood flow there. To approach these cases, we should recognize the existence of impaired higher brain function, and not only be mindful of motor deficits.
著者
綿森 淑子
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.32, no.5, pp.290-293, 1995-05-18 (Released:2009-10-28)
参考文献数
13
被引用文献数
2 2
著者
内田 真紀子 蜂須賀 研二 小林 昌之 堂園 浩一朗 田中 正一 緒方 甫 野田 昌作
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.33, no.5, pp.326-329, 1996-05-18 (Released:2009-10-28)
参考文献数
15

We report a 19-year-old man suffering from acute poliomyelitis induced by the attenuated strain of type 3 polio virus. As he had severe muscular weakness in the right lower limb and slight weakness in the left lower limb, we prescribed the following rehabilitation program: active assistive or manual resistive exercises for his right lower limb, resistive exercises for his left lower limb, and gait training with a knee-ankle-foot orthosis. As only two or less than two cases of acute poliomyelitis a year have been reported in Japan, we are following up this patient from the standpoint of preventing post-polio syndrome.