関節病に対する水中運動の有用性

抄録

Objectives: Japanese orthopedists can play an important role in care prevention in an aging society. According to the report of nursing care levels published by the Ministry of Health, Labour and Welfare, a major cause of requiring light care is bone and joint disease, while, on the other hand, a major cause for requiring more extensive care is cerebral infarction and dementia, among others. This fact suggests that Japanese orthopedists should be given the opportunity to promote care prevention related to bone and joint disease. We report the effect and significance of an underwater exercise scheme that we conducted as care prevention and community support projects.
Subjects and Methods: We conducted two sets of underwater exercises (a knee pain course and an obesity course) for elderly people with knee osteoarthritis and overweight people in two municipal areas (Ino town and Muroto city, Kochi Prefecture, Japan). Fifty-three elderly people (Ino town) and 50 (Muroto city) with knee osteoarthritis participated in this study. Overweight participants in Ino town and Muroto city numbered 37 and 23, respectively. The underwater exercise in this study consisted of stretching, strength training, and underwater walking. The obesity group was taught aerobic exercises that were regulated using the Karvonen formula (k = 0.4). Underwater exercise was done for 60 min at a time, two or three times a week. Elderly people with knee osteoarthritis carried out these exercises for 6 weeks, and overweight people carried them out for 20 weeks. Muscle strength (quadriceps and gluterus medius) was evaluated using a hand-held dynamometer and UP & GO tests in the joint disability and obesity groups. Moreover the former was investigated using the Japanese Knee Osteoarthritis Measure (JKOM) and the latter’s weight, abdominal circumference, and blood pressure was measured.
Results: Muscle strength of the lower extremities significantly increased in the joint disability and the obesity groups. The joint disability group significantly improved from 32.4 to 24.3 in the visual analog scale score of the JKOM. The obesity group significantly decreased in weight, abdominal circumference, and blood pressure.
Conclusion: Underwater exercise makes it possible to alleviate the load on the knee joint as a result of the buoyancy principle and enables exercise that requires larger forces than that on land through the use of water viscosity. Underwater exercise, therefore, is intensive, efficient, and effective. From the standpoint of health promotion and prevention of nursing care, underwater exercise is of great significance as an exercise for elderly people with joint disorders.