著者

千野 直一 園田 茂 道免 和久 才藤 栄一 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.31, no.2, pp.119-125, 1994-02-18 (Released:2009-10-28)

参考文献数

13

被引用文献数

81 168

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脳血管障害による機能障害は多岐にわたっているために,多面的かつ簡便な機能評価法は少ない.ここに提唱するStroke Impairment Assessment Set (SIAS)は日常臨床で用いる理学・神経学的診断法を主体として,機能項目別に単一手技(single-task assessment)にて評価し,機能段階は0点から3,あるいは5点法とするものである.評価項目には運動機能,筋緊張,感覚,ROM,痛み,体幹,視空間認知,言語機能,健側肢機能を含む.また,レーダ・チャートにて脳卒中患者の各機能障害の程度を一瞥でとらえることもできる.統計学的に検者間の信頼性にも問題がなく,リハビリテーション医療での応用は広いものと考える.

著者

加倉井 周一

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.20, no.2, pp.123-128, 1983-03-18 (Released:2009-10-28)

参考文献数

10

著者

前田 真治 岡崎 健

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.19, no.4, pp.231-236, 1982-07-18 (Released:2009-10-28)

参考文献数

12

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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

鳴海 章人 川手 信行 水間 正澄 北川 寛直 丸加 由紀子 森 義明

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.7, pp.467-470, 2000-07-18 (Released:2009-10-28)

参考文献数

10

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We report rehabilitation of a 73-year-old male who was living alone, and had bilateral legs palsy due to rhabdomyolysis caused by falling asleep with his legs in a crossed leg sitting posture. He was found to be in a complex position of a crossed leg sitting posture and in a prone position; he was transported to an emergency center. He had bilateral legs palsy, muscles atrophy and sensory disturbance. His laboratory data showed increase in serum creatine kinase, creatinine, blood urea nitrogen. A diagnosis of acute renal failure caused by rhabdomyolysis was made, and haemodialysis was instituted. At the beginning of his rehabilitation, he could not sit up and stand up from the bed due to bilateral legs palsy. We attempt to increase his legs muscle strength by physical therapy: siting up exercise, standing up exercise. Three months later, he could sit up, stand up from the bed, and walk in the parallel assist-bars. We considered that rhabdomyolysis caused by compression to his lower limb as crossed leg sitting for a long time (compartmental syndrome), due to difficulty in shifting his posture. And we have to care the patients who have been difficulty in shifting posture due to hemiplegia, dementia, sensory disturbance, living alone, as they might be rhabdomyolysis caused by compartmental syndrome with improper body posture for a long time.

著者

田村 耕成 久保田 一雄 倉林 均

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.1, pp.34-37, 2001-01-18 (Released:2009-10-28)

参考文献数

10

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水治療の対象者は血栓性疾患の危険因子を有する場合が多い.水浴と血栓性疾患との関連性を研究する目的で,入浴負荷可能な健常成人男性10例を対象として40℃20分浴と42℃10分浴の血小板および凝固線溶系に及ぼす影響を検討した.40℃20分浴では組織プラスミノーゲン活性化因子抗原(tPA)が増加し,プラスミノーゲン活性化因子インヒビターI抗原(PAI-I)が減少する傾向が,42℃10分浴ではHt,tPA,PAI-Iが増加する傾向が見られたが有意な差ではなかった.血小板に対する影響はなかった.以上の成績から40~42℃の水温による水治療は血小板および凝固線溶系には影響を与えないと考えられた.

著者

土田 昌一 武田 祐子

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.33, no.2, pp.108-114, 1996-02-18 (Released:2009-10-28)

参考文献数

23

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WISC-Rの迷路課題の解決時の眼球運動をもとに線条体損傷者の注意障害の評価を行った.対象は,全例右利きの慢性期の単一病巣の患者である.左線条体損傷者群27例,右線条体損傷者群28例であり,罹病期間・年齢に有意差はなかった.課題解決パターンを4型に分類した.右側損傷者群には解決動作を中断してその直前しか確認しない解決パターンが認められた.左側損傷者群には,解決中落ち着きなく注意が分散する解決パターンが少数ではあるが認められた.線条体損傷の注意障害として,右側障害は動きの滞ったタイプ(frozen inattention),左側障害では落ち着きのないタイプ(restless inattention)という特徴的な所見を認めた.

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

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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

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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

Kazuya Ikoma Yusuke Hara Masahiro Maki Suzuyo Ohashi Keiichiro Ueshima Toshikazu 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.3, pp.20180004, 2018 (Released:2018-03-10)

参考文献数

17

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Background: We report a rare case of calcific tendinopathy in the posterior tibial tendon (PTT) at the navicular insertion. Case: Conservative treatments other than extracorporeal shock wave therapy (ESWT) were ineffective. Calcium deposition disappeared from the PTT on plain radiographs at 6 months after ESWT. Discussion: In this case, a 14-year-old boy with calcific tendinopathy of the PTT who had not benefited from conservative treatments was effectively treated using ESWT.

著者

近藤 克則

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.12, pp.849-853, 2004-12-18 (Released:2009-10-28)

参考文献数

19

被引用文献数

6 10

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

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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

Shota Kamikura Keishoku Sakuraba and Tatsuhiro Miura

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.3, pp.20180008, 2018 (Released:2018-04-14)

参考文献数

21

被引用文献数

1

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Objective: This study was conducted to clarify the ground reaction force exerted on the foot during athletic movements and to demonstrate the effects of reach balance training (RB-T) on toe grip strength as an injury prevention exercise. Methods: RB-T was undertaken for 2 weeks by 11 male college basketball players and 22 healthy male college students (including 10 participants in the control group). The vertical ground reaction forces during athletic movements were measured using ground reaction force meters. Before and after RB-T intervention, toe grip strength was measured with a toe grip strength meter, and distances of the center of pressure (COP) to the center of the foot during movement were measured using a three-dimensional motion analyzer. Results: The vertical ground reaction force during athletic movement was highest during take-off and decreased in the following order: single-leg front landing, single-leg lateral landing, and turning. The toe grip strength of the BT group and the T group increased after RB-T intervention. For the BT group, RB-T also tended to decrease the COP lateral distance on turning in the dominant leg and the COP front distance on turning and take-off in both legs. Conclusion: RB-T could improve the toe grip strength and stabilize the COP position.

著者

Akira Kido Shozo Yoshida Emiko Shimoda Yukako Ishida Masatoshi Hasegawa Hiroshi Kobayashi Kanya Honoki Hirosei Horikawa Yasuhito Tanaka

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.1, pp.20160009, 2016 (Released:2016-12-21)

参考文献数

15

被引用文献数

1

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Objective: Radiotherapy is an essential component of curative or palliative therapy for patients with uterine cervical cancer. Although advances in radiotherapy have led to longer survival, survivors may consequently be at risk of pelvic insufficiency fracture (PIF). We retrospectively reviewed medical records and clinical outcomes to assess the impact of PIF on walking disability. Methods: Between January 2002 and December 2009, 145 uterine cancer patients treated with radiotherapy in our hospital were reviewed. Among these, 15 patients (10.3%) were diagnosed with PIF. The types of fractures were identified according to the AO/OTA classification system. Medical records were examined to establish the time to first diagnosis of PIF, the type of fracture, and clinical outcomes. Disability was assessed using Barthel index mobility scores. Results: The median time to PIF detection was 16 months. Of the 15 patients with PIF, 14 had type B fractures (7 cases of B2 and 7 cases of B3) and 1 had a type C fracture. Among 11 patients with pelvic pain, 6 achieved pain control but 5 patients with bilateral lesions in the posterior arch or lateral compression of the sacrum developed pain that finally resulted in walking disability and a lower performance status. Conclusions: PIF causes severe motor disturbance in patients with unstable fracture types. Routine imaging checkups were useful during the 5 years after completion of radiotherapy; in nine patients the fracture progressed for longer than 1 year. In cancer rehabilitation for PIF patients, continuous assessment is essential for predicting walking disability.