抄録
We encountered a patient, who underwent therapeutic exercise following surgery for spondylolisthesis, showing a hunchback with pain in the gluteus maximus and rectus femoris muscles on standing. Pain was caused by the hunchback posture and we suggested the necessity of its correction for pain reduction. However, active therapeutic exercise for the trunk was contraindicated because the patient was still under observation for postoperative bone union. During investigating the cause of the hunched back, we assumed that it was due to functional disorder of the lower limbs. Aiming at pain reduction with improvement of the hunched back, we performed 3 types of therapeutic exercise focusing on the lower limbs and pelvis on different days. When theraputic exercise for lower limb dysfunction (Therapeutic exercise A) was performed, the standing posture remained unchanged. After analyzing the results, adjustment of the standing posture by guiding the pelvis (Therapeutic exercise B) was performed in the week following Therapeutic exercise A, again with no change. After re-analyzing the results, Therapeutic exercise B was performed immediately after Therapeutic exercise A starting the following week (Therapeutic exercise C), and a satisfactory outcome was achieved after Therapeutic exercise C. Based on this experience, we concluede it is necessary to sufficiently investigate and improve the influence of the lower limbs and pelvis, not only the trunk, in patients showing a hunched back posture.
