著者
Fumiya Mizuno Satoko Koganemaru Hiroshi Irisawa Akira Saito Takashi Mizushima
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.6, pp.20210041, 2021 (Released:2021-10-23)
参考文献数
34

Objective: Knee valgus during jump landing is a cause of knee injuries during sports activities. Body recognition is important for maintaining the knees and other body parts in their proper positions. The aim of this study was to investigate whether knee valgus during jump landing in healthy young women is related to the inaccuracy of recognition of bilateral knee positions in the squatting position.Methods: In 39 healthy young women, the degree of knee valgus was evaluated during the drop vertical jump test using the ratio of the knee separation distance to the ankle separation distance. The accuracy of recognition of bilateral knee positions in the squatting position was evaluated by having the blindfolded subjects indicate with their index fingers the subjective positions of their bilateral patellae by placing their fingers on a horizontal bar positioned in front of them 3 cm below the navel. The difference ratio of the recognized distance to the actual distance between the bilateral patellae was measured as an inaccuracy index.Results: The degree of knee valgus during the drop vertical jump test was positively correlated with the degree of inaccuracy of the recognized knee position with the knees in the neutral position (r=0.358, P=0.025).Conclusions: In healthy young women, knee valgus during jump landing was significantly correlated with the inaccuracy in knee position recognition in the squatting posture. This finding suggests that the assessment of knee position recognition in the squatting position could be useful as a screening tool for preventing knee injuries on jump landing during sports activities.
著者
Tomoko Yamaguchi Masafumi Kubota Hiroaki Naruse Koichiro Kuwatsuru Tsuyoshi Miyazaki
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.6, pp.20210032, 2021 (Released:2021-08-26)
参考文献数
31
被引用文献数
3

Objectives : This study aimed to describe the injuries and illnesses that occurred at the 18th National Sports Festival for Persons with Disabilities in Japan, which was attended by more than 3000 athletes from beginner to elite levels.Methods : Records from medical stations set up at the venues for each sport were reviewed. The incidence rates (IRs) were calculated as the number of medical station visits per 1000 athlete-days. The backgrounds of injuries and illnesses were investigated.Results : In total, 3277 athletes attended the festival, and 134 eligible medical station visits were analyzed. Overall, 102 athletes complained of injuries. For the whole schedule of the festival, IRs were 15.5 for injuries and illnesses and 11.8 for injuries alone. For injuries and illnesses, high IRs were seen in soccer (39.8), basketball (25.6), and foot baseball (22.4); for injuries alone, high IRs were also seen in soccer (33.6), basketball (25.6), and foot baseball (16.8). The most frequent symptoms were internal symptoms (n=32), contusions (n=30), and wounds (n=24). Joint sprains occurred in various sports, whereas muscle strains happened mainly in disciplines demanding sprinting or high agility. Of the 55 cases that occurred during events or public rehearsals, 45 were traumatic, whereas the relation to sports activities was not described in 51 cases. Of participants with internal symptoms, 11 were suggested to have viral infections. We identified 21 injuries caused by falls.Conclusions : Minor trauma and viral infection were the most frequently observed symptoms among injuries and illnesses, respectively. Structured medical records and organized surveillance systems should be utilized to improve data collection and understand the onset of injury and illness.
著者
山内 秀樹 米本 恭三
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.3, pp.212-217, 1997-03-18 (Released:2009-10-28)
参考文献数
15
被引用文献数
4 3

廃用後の適切なリハビリテーションに関する基礎的資料を得ることを目的とし,活動制限解除後の筋機能の回復に及ぼす等尺性運動の効果を若齢期と老齢期において検討した.若齢,老齢期ともに活動制限に伴いヒラメ筋重量,最大張力,単収縮の収縮・弛緩時間の減少が認められた.活動制限解除後の最大張力の回復は若齢期と老齢期で差がみられず,また最大張力の回復に及ぼす運動の効果も認められなかった.一方,収縮・弛緩時間の回復は若齢期に比べ老齢期で遅延し,運動により促進される傾向が認められた.以上の結果は老齢期における廃用後の筋機能の回復に対するリハ訓練の重要性を示唆する.
著者
石田 暉 加藤 俊一 林 克郎 神内 擴行 及川 由香
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.28, no.1, pp.11-19, 1991-01-18 (Released:2009-10-28)
参考文献数
14
被引用文献数
2 1

骨髄移植は,従来の薬物療法で効果がないとされる重症の白血病等に対して選択される治療法である.しかしながら,その治療結果として,心臓,肺,筋骨格,神経系等の多臓器にわたる身体的問題点や,ICU症候群等の心理的問題点を生ずることとなる.これらの諸問題に対し著者らは1983年より41例の骨髄移植後の患者に対し,impairment,disabilityに留まらず,handicapも考慮した幅広いリハビリテーションアプローチを導入し,良好な結果を得た.今後は他の臓器移植後の患者に対しても総合的なリハビリテーションアプローチは広く応用されるものと考える.
著者
Minoru Murayama Sumiko Yamamoto
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.5, pp.20200021, 2020 (Released:2020-09-11)
参考文献数
21
被引用文献数
2 4

Objective: Previous studies have suggested that the use of an ankle–foot orthosis may cause disuse atrophy of the tibialis anterior muscle. The objective of this study was to explore gait and muscle activity changes in patients in the recovery phase of stroke with 2-month use of an ankle–foot orthosis that provided plantarflexion resistance.Methods: The participants were 19 patients in the recovery phase of stroke who were prescribed an ankle–foot orthosis that provided plantarflexion resistance. We measured ankle and shank tilt angles as well as electromyography activity of the tibialis anterior and the soleus during 10-m walk tests. Measurements were taken on three occasions. The first was 2 weeks after delivery of the orthosis, 1 and 2 months after the initial measurement, and the third 2 months later. Changes in gait parameters were analyzed between the first and second measurements and between the second and third measurements.Results: Between the second and third measurements, significant increases were observed in plantarflexion and shank forward tilt angles and the activity ratio of the tibialis anterior during loading response compared with other phases.Conclusions: Plantarflexion movement induced by an ankle–foot orthosis with plantarflexion resistance could increase the activity ratio of the tibialis anterior during loading response.
著者
市川 徳和 江口 寿栄夫
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.24, no.3, pp.163-167, 1987-05-18 (Released:2009-10-28)
参考文献数
12

広い意味での脳損傷児という概念に立って水頭症を合併せる二分脊椎児と脳性麻痺痙直型両麻痺児に対して,認知・知覚-運動障害を心理学的検査にて調査した.二分脊椎児9例,脳性麻痺児19例で年齢は6~15歳である.検査は田研・田中Binet知能検査,WISC-R知能検査,Frostig視知覚発達検査,Bender-Gestalt検査の4種類を全例に施行した.精神発達遅滞を思わす症例を除いても高頻度に認知・知覚-運動障害を両者に合併していたが,脳損傷児の小児リハビリテーションを進める上で重要な点と考える.
著者
Hiroaki Tsukamoto Kimio Saito Toshiki Matsunaga Takehiro Iwami Hidetomo Saito Hiroaki Kijima Manabu Akagawa Akira Komatsu Naohisa Miyakoshi Yoichi Shimada
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.6, pp.20210009, 2021 (Released:2021-02-06)
参考文献数
20
被引用文献数
3

Objectives: The purpose of this study was to clarify the diagnostic accuracy of the mobile assessment of varus thrust using inertial measurement units (IMUs).Methods: A total of 80 knees in 49 patients were enrolled in this study. On visual analysis of gait to determine the presence or absence of varus thrust, 23 knees were assigned to the Present group, 17 to the Ambiguous group, and 40 to the Absent group. The peak knee varus angular velocities (PVVs), measured by quantitative gait analysis using nine-axis IMUs, were compared between these three groups. A receiver operating characteristic curve for the relationship between the visual assessment of varus thrust (Present and Ambiguous) and the measured PVV was created, and the cut-off PVV for visualized varus thrust was determined as the highest point for both sensitivity and specificity.Results: The mean PVVs were significantly different between the three groups (Present, 47.7 ± 8.2 degree/s, Ambiguous, 34.1 ± 10.5 degree/s, and Absent, 28.1 ± 8.3 degree/s, respectively, ANOVA P=0.000). The PVV cut-off value for visualized varus thrust was 28.1 degree/s, yielding a sensitivity of 0.957 and a specificity of 0.579.Conclusions: A PVV <28.1 degree/s is useful for ruling out varus thrust during gait. This quantitative varus thrust assessment method using IMUs has clinical utility as a screening test.
著者
Ryosuke Matsuki Noriaki Kojima Koki Watanabe Akira Hotta Yohei Kubori Keisuke Oura Tomoyuki Morisawa Hidehiko Koyama Toshihiko Ebisu Takuya Hashino
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.5, pp.20200027, 2020 (Released:2020-11-06)
参考文献数
22
被引用文献数
2

Objectives: The goal of this study was to determine the effects of an intensive care unit (ICU) rehabilitation protocol with dedicated therapists on the physical function and activities of daily living (ADL) of patients on discharge from the ICU.Methods: This retrospective study included patients who started rehabilitation during their ICU stay. Patients were divided into three groups: the Usual Care group (before the introduction of the rehabilitation protocol), the Protocol group (after the introduction of the rehabilitation protocol), and the PT + Protocol group (with a dedicated therapist in addition to the rehabilitation protocol). The standard interventions in the Protocol group and the PT + Protocol group were set according to the protocol based on the level of consciousness and strength of each individual patient. Patients’ age, APACHE II score, length of ICU stay, length of hospital stay, and the Functional Status Score for the ICU (FSS-ICU) and Medical Research Council score (MRC score) on discharge from the ICU were compared among the three groups.Results: There were no significant differences among the three groups in age and APACHE II score. The MRC and FSS-ICU scores were significantly higher in the PT + Protocol and Protocol groups than in the Usual Care group. Furthermore, the lengths of ICU stay and hospital stay were lower in the PT + Protocol group than in the Usual Care group.Conclusions: Introduction of the rehabilitation protocol improved the limb strength and ADL of patients. Moreover, the presence of dedicated therapists in addition to the protocol reduced the lengths of ICU and hospital stays.
著者
宮下 智
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.4, pp.223-229, 1998-04-18 (Released:2009-10-28)
参考文献数
20
被引用文献数
1 1

従来,筋力評価に関する研究は等速性筋力測定装置を用い,ピークトルク値を比較検討することが多かった.しかし,筋力の強い者が必ずしも怪我に強いとは言いきれない側面が近年指摘され,測定項目や方法についての問題提起がなされている.そこで本研究は膝関節屈曲伸展運動時,ピークトルクを発生する時の関節角度と角速度の関係に注目し,最大筋力を発揮する際の過程を探った.対象は現役スポーツ選手,男子10名(26.7±3.9歳),女子18名(20.1±2.8歳).その結果,ピークトルクを発揮する時は,男女に関係なく,関節角度と角速度の有意な相関関係の上に筋出力されることがわかった.このことはピークトルクがどの関節角度で,どの角速度上で発揮されているかを明らかにするものであり,この結果から具体的な運動処方につなげることができる新しい筋出力特性の評価法であると結論した.
著者
Koshi Matsuoka Aki Watanabe Takayuki Kawaguchi Koji Misawa Keiichi Murakami Michinari Fukuda
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.5, pp.20200031, 2020 (Released:2020-12-22)
参考文献数
38
被引用文献数
1

Objectives: There are few scales that reflect the function of the stroke-affected arm as it relates to the performance of daily activities while also indicating the difficulty of scale items. In this study, we developed the Activities Specific Upper-extremity Hemiparesis Scale (ASUHS) to evaluate daily activities performable by the affected arm after stroke. We also clarified the validity, reliability, and item difficulty of the scale.Methods: The participants were 145 patients with stroke who were consecutively admitted to a convalescent rehabilitation ward. The unidimensionality of ASUHS was assessed by principal component analysis. Analyses of item discrimination and content validity were conducted to assess the overall validity. Reliability was evaluated by assessing internal consistency and inter-rater reliability. Item difficulties were determined by Rasch analysis.Results: Unidimensionality, high discrimination, and good content validity were shown for all items. ASUHS consists of a dominant hand scale and non-dominant hand scale. Both scales showed good internal consistency (Cronbach’s α coefficient = 0.99) and substantial inter-rater reliability (Cohen’s Kappa coefficient = 0.74 and 0.75, respectively). Item difficulty was determined as being in the range –8.71 to +5.18 logit.Conclusions: This study suggested good validity and reliability of ASUHS. Furthermore, because the item difficulties of daily activities performed by the affected arm were clarified, therapists can use ASUHS to identify the process that should be the next focus for training. Consequently, therapists may be able to train patients in daily activities that match the affected arm’s ability step by step rather than determining training activities empirically.
著者
Sae Uezono Yusuke Ishibashi Shouichi Kuramochi Seiji Kaganoi Takuhiro Ikeda Takahiro Shimohira Munenori Katoh
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.5, pp.20200019, 2020 (Released:2020-08-26)
参考文献数
21

Objective: A total of 183 patients admitted to five hospitals for proximal femoral fractures and psychiatric disorders were examined to determine whether their physical function could be improved by rehabilitation and to identify factors that affected home discharge.Methods: We conducted surveys to collect data regarding patients’ age, sex, type of mental illness, location at time of injury, complications, Charlson Comorbidity Index, Global Assessment of Functioning scale scores, surgical technique, time from surgery to the start of rehabilitation at the target hospital, rehabilitation duration, results of cognitive function tests (e.g., the Mini Mental Status Examination), walking ability before the injury, final walking ability, functional independence measure (FIM) of the patient’s activities of daily living at the start and end of treatments, and discharge destinations.Results: The motor function index showed a significant improvement from an average of 36.0 points at admission to an average of 53.0 points at discharge. Overall, 47.9% of patients who were able to walk before injury could regain gait ability. The discharge rate to the patient’s home was 15.8%.Conclusions: The gait reacquisition rate for patients with femoral neck fractures and mental illness admitted to a psychiatric ward was 47.9%, which was lower than that reported in previous studies, but higher than that for dementia patients. Binomial logistic regression analysis identified the following predictive items for home discharge: whether the fracture occurred at home, FIM cognition item scores at admission, and total and motor item scores at discharge. The derived equation had a high hit rate of 80.9%.
著者
園田 茂 才藤 栄一 道免 和久 千野 直一 木村 彰男
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.30, no.4, pp.273-278, 1993-04-18 (Released:2009-10-28)
参考文献数
11
被引用文献数
5 2

脳血管障害において,機能障害評価は必須である.しかし既存の評価法は十分とは言い難かった.そこでわれわれはBuffalo symposiumの勧告に準じて機能障害評価法Stroke Impairment Assessment Set (SIAS)を作成した.SIASは運動,腱反射,筋緊張,感覚,可動域,疼痛,体幹,高次脳,健側機能評価を含んでいる.このSIASを用いて発症4週以内の脳血管障害患者66名を評価し,クラスター分析にて群分けを行った.SIASの得点分布は弛緩性完全麻痺を示す得点以外はほぼ均等であった.またクラスター分析にて全般低下群,健側機能良好群など予後予測に有用と思われる4群に分けられた.以上よりSIASは簡便で有用な機能障害評価表と考えられた.

1 0 0 0 OA 脳機能局在

著者
後藤 昇 後藤 潤
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.38, no.4, pp.296-302, 2001-04-18 (Released:2009-10-28)
参考文献数
20
被引用文献数
2 4

The functional localization of the cerebrum is described from the anatomical point of view. In the central nervous system, neurons or nerve fibers with the same function gather to form gray matters or nerve fiber bundles. This article briefly describes and discusses about morphology of the telencephalon, structures of the cerebral cortex and functional localization of the cerebral cortex. On the surface of the telencephalon, there are many sulci and gyri. Several sulci such as the central, lateral, parietooccipital, etc. subdivide the pallium into five lobes: frontal, parietal, occipital, temporal and insular. The insula is covered by the operculi frontale, frontoparietale et temporale. Under the microscopic observation of cerebral corteces, they consist of six cortical layers which vary from part to part. Since Brodmann (1909) divided the cortical areas into 52, we can explain cerebral areas properly for example, Brodmann's cytoarchitectonic areas 4, 3-1-2, 17, 41, 44, etc. Regarding cerebral functional localizations, Broca (1861) proposed first a theory of cerebral functional localization on motor speech after examining a patient with motor aphasia. Penfield and Rasmussen (1950) published a monograph entitled “The cerebral cortex of man: A clinical study of localization of function”. They studied cerebral functions at various parts using many patients with brain damages prior to surgical treatments. Their study have covered sensorimotor representation of the body, head and eye movement, representation of autonomic system, vocalization and arrest of speech, secondary sensory and motor representation, vision, hearing and equilibration, memory, sensory perception, etc. This review article plays up several important points of past researches on human beings.
著者
Yasuhisa Fukawa Wataru Kakuda Seiya Yoshida Masashi Zenta Osamu Itano Risa Kiko Hiroaki Tani Akira Kubo
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.4, pp.20190005, 2019 (Released:2019-02-06)
参考文献数
20
被引用文献数
2

Background: The clinical importance of postoperative rehabilitation for cancer patients has recently attracted much attention. However, it remains uncertain whether early rehabilitation can prevent infectious complications in patients undergoing gastrointestinal cancer surgery. Methods: The study group consisted of 259 patients who underwent laparoscopic or open surgery for gastrointestinal cancer at our institution between December 2012 and November 2016. Our department proposed a new early rehabilitation protocol for such patients to encourage physical activity after surgery. The protocol was clinically introduced on July 21, 2015. We divided the study subjects into two groups: those who were admitted before the introduction of the new protocol and those admitted after. The frequency of infectious complications, including respiratory infections, and the length of hospital stay after surgery were compared between the two groups. Results: No adverse cardiovascular event associated with the early rehabilitation protocol was experienced. After the protocol was introduced, more than 80% of patients started exercising on the first day after surgery. For patients undergoing open surgery, the frequency of infectious complications was significantly reduced with the introduction of the protocol (p<0.05). Moreover, when open surgery was performed, the protocol significantly shortened the length of hospital stay (p<0.05). Conclusion: Our proposed early rehabilitation protocol for patients who have undergone gastrointestinal cancer surgery was considered to be safe and feasible. The protocol may prevent infectious complications and shorten the hospital stay after such surgery.
著者
住田 幹男
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.5, pp.282-291, 2000-05-18 (Released:2009-10-28)
参考文献数
41
被引用文献数
1

Recent advances in rehabilitation process have resulted in shorter length of hospital stay and better functional ability for the spinal cord injured patients. The incidence of spinal cord injury in the elderly population is much higher in Japan when compared with other western countries. The mortality rate of the spinal cord injured patients aged 60 years and over is six times as high as that of the general elderly population. The leading causes of death in post injury period are pulmonary disorders and sepsis instead of urinary disorders that were prevalent in former decades. There have been many reports that the elderly patients have poorer prognosis than their younger counterparts. In order to reduce the mortality rate and to improve poor prognosis, we have to pay more attention to pulmonary disorders in the same way as we have done to urinary disorders. The discharge rate to nursing homes is several times as high for the elderly as compared with younger patients. We have to organize a comprehensive long life care system for the elderly group in the community.
著者
伊東 元 橋詰 謙 齋藤 宏 中村 隆一
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.22, no.3, pp.164-165, 1985-05-18 (Released:2009-10-28)
参考文献数
7
被引用文献数
11 3

健常男性20名に最大速度で歩行を行わせ,速度,歩幅,歩行率と大腿四頭筋の最大等尺性収縮トルク(MVC)およびMotor time(MT,急速膝伸展時の筋活動開始から運動開始までの潜時)との連関を検討した.速度の有意な決定因は体重,MVCで,体重が軽くMVCが大きいと速度が速かった.速度は歩幅,歩行率と正の相関を示すが,歩幅と歩行率との間には負の相関があった.この歩幅と歩行率の両者にとって有意な決定因はMTで,MTが短いと歩幅は大きくなり,MTが長いと歩行率は大きくなった.
著者
猪飼 哲夫 米本 恭三 宮野 佐年 小林 一成 福田 千晶 杉本 淳 安保 雅博
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.29, no.7, pp.569-575, 1992-07-18 (Released:2009-10-28)
参考文献数
32
被引用文献数
10 9

脳卒中片麻痺患者にともなう肩関節亜脱臼の座位におけるX線学的評価を行い,経時的変化について検討した.骨頭下降率とAHI(肩峰骨頭間距離)比の間には有意の相関を認めた.胸椎部の側弯は亜脱臼群の約4割に認められ大多数は麻痺側凸を呈していたが,肩甲骨の下方回旋はわずか1例のみであった.肩関節痛とROM制限は亜脱臼群に多く,6ヵ月以上経過した症例に特に多く観察された.初診時にBrunnstrom stageがIII以上の症例に,また片麻痺の回復によりstageが上がってくる症例に亜脱臼が改善する傾向が認められた.亜脱臼が改善する症例が存在することは,早期の亜脱臼に対して,ポジショニングや筋促通の必要性が示唆された.
著者
山永 裕明 中西 亮二 今村 重洋 出田 透 浅山 滉
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.22, no.2, pp.79-85, 1985-03-18 (Released:2009-10-28)
参考文献数
22

被殻出血患者33例についてCT所見を中心として上肢,歩行機能,失語症,ADLについて予後の検討を行った.その結果,(1)実用手に15.1%しかならず上肢機能の予後は悪かった.(2)57.6%が独歩となり,観血群で38.5%,保存群70%と後者が有意に独歩になりやすかった.(3)独歩群の年齢は52.5±12.4歳,非独歩群は60.6±6.7歳で前者が有意に年齢が低かった.(4)観血群では,独歩群39.6±12.7歳,非独歩群59.9±6.2歳で前者が有意に年齢が低かった.(5)尿失禁があると有意に独歩率が低かった.(6)27.2%に失語症を認めた.(7)ADLと移動能力の間に有意の相関を認めた.(8)CT上,内包後脚に影響ない例の予後は良好だが,他はCTのみで予後判定は困難であった.