進行性筋ジストロフイー症の下肢関節拘縮に対する徒手矯正の経験

抄録

It is now well known that disturbance of gait in progressive muscular dystrophy (PMD) is mainly due to the weakness of musculature of the lower extremities & the trunk, and to the contracture caused by imbalance between the flexors and the extensors. In twenty-eight cases of hospitalized Duchenne type the relationship between the contracture of their lower extremities and the ability of walking was investigated. It was elucidated from the study of each joints of lower extremities that contracture of the hip and knee joints played the main role in the disability of walking. Therefore, the method of manipulation of those joints is important in the management of PMD. After six months of treatment, about half of the cases showed some improvement thcugh all the cases showed gradual loss of ability in the activities of daily living. Then to make secure the evidence of the effect of manipulation, we selected four cases as a control group to stop manipulation, whose condition were not so severe. After five months all the cases of the control group showed deterioration in both contracture and ability of walking. About one-third out of the remaining sixteen cases under the treatment showed deterioration in regard to contracture and about two-thirds showed deterioration in ability of Walking.
From those facts it may be considered that manipulation will prevent or delay the occurence of contracture and the disability of walking.