関西理学療法
Online ISSN : 1349-9572
Print ISSN : 1346-9606
ISSN-L : 1346-9606
1 巻
選択された号の論文の9件中1~9を表示しています
特集:整形外科疾患における動作分析の重要性について考える
  • ―力学的負荷に着目した動作分析とアライメント―
    大工谷 新一
    2001 年 1 巻 p. 1-5
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    Observational motion analysis is an important method for evaluating impairments of patients after bone and joint surgery. For adequate motion analysis it is necessary to understand the following: relationship between impairments and mechanical stress to bone and joint; that nature of mechanical stresses does occur; the relationship between mechanical stress and alignment of extremities; and the basic information of individual diagnosis. In this study, taking into consideration the requirements noted above we investigated the construct of observational motion analysis for patients with bone and joint surgery. Within this construct, in addition to mechanical stress, alignment and basic information, it is thought that timing of joint motion, neurological mechanism of motion and locomotion of center of gravity are important, too, and also need to be well understood. Patients with bone and joint surgery have many types of impairment. So physical therapists have to perform not only routine tests and measurements but also adequate motion analysis if they are to improvement of patients' function.
  • 三浦 雄一郎
    2001 年 1 巻 p. 7-13
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    To evaluate physical functions in patients with chronic low back pain, it is important to evaluate trunk muscle function. Anatomical and electromyographical studies of trunk muscles in healthy subjects and patients with chronic low back pain are introduced in this paper. Many articles is published have asserted that the action of trunk muscles of patients with chronic low back pain is different from that of healthy subjects. In my research, electromyography (EMG) of trunk muscles during hip extension in the prone position was used in patients with chronic low back pain and healthy subjects. EMG showed that the action of trunk muscles during this motion in patients with chronic low back pain was weaker than that in healthy subjects, but EMG of trunk muscles during this motion after therapeutic exercises indicated improvement in patients with chronic low back pain. It has been said that EMG evaluation of the trunk muscles is an important method to use in patients with chronic low back pain.
  • ―術後管理に対する表面筋電図を用いた動作分析の応用―
    谷埜 予士次, 熊崎 大輔, 舌 正史, 大工谷 新一, 森 裕展
    2001 年 1 巻 p. 15-24
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    We performed physical therapy after reconstruction of the posterior cruciate ligament (PCL) on a Japanese Taekwondo player. In physical therapy after the reconstruction of PCL, we had to protect PCL from mechanical stress. To protect the reconstructed PCL in this case, we predicted the traction stress for PCL by motion analysis using surface electromyography (EMG). In order to avoid the traction stress on PCL, we checked the muscle activity of the quadriceps femoris and the hamstrings during various kinds of muscle strengthening exercises for the lower extremity in the closed kinetic chain (CKC). The muscle contraction of hamstrings with knee flexion caused the posterior displacement of the tibia, and the traction load on PCL was increased with a contraction of hamstrings. On the other hand, because the muscle contraction of the quadriceps femoris produced anterior sharing force of the tibia, the contraction of the quadriceps femoris could protect the PCL from traction load. Therefore, we selected the muscle strengthening exercises in which the muscle activity of the hamstrings was lower and the muscle activity of the quadriceps femoris was higher. Twelve weeks post operation, the muscle strength of the quadriceps femoris had reached a level compatible with returning to competition, and since the patient had no pain or instability of the knee, we had him perform athletic training (jogging, running, step drill, etc.). He could practice athletic training without any pain or feeling instability of the knee. After 19 weeks post operation, we had him perform kick training gradually under the doctor's permission, and to prevent the hamstrings tearing as well as increasing the performance of kicking, we started him on muscle strengthening exercises of the hamstrings with the kick training gradually. After about 27 weeks post operation, the patient could practice all Taekwondo training without any knee pain or feeling instability of the knee, and after about 43 weeks post operation, he competed successfully in the All Japan Taekwondo Championship and becoming. In conclusion, because we selected the muscle strengthening training avoiding traction load on the PCL, the patient could carry out athletic training and Taekwondo training in safety after the operation.
  • ―スポーツ動作許可後にみられた再受傷の恐怖感に着目して―
    大工谷 新一
    2001 年 1 巻 p. 25-30
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    Physical therapy for a Japanese college woman basketball player with anterior cruciate ligament (ACL), medial collateral ligament (MCL) and medial meniscus (MM) injury was performed. The main problem in this case was fear of re-injury due to a feeling of instability in the knee during basketball. Her fearfulness and a feeling of instability in the knee were induced by the dynamic mal-alignment of the trunk and lower extremities during basketball movement, muscle weakness in knee extension with rapid movement and incorrect motor learning in the early phase of rehabilitation after injury. In physical therapy, it was emphasized that improvement of running, step-cutting and splinting with good alignment of the trunk and lower-extremities, muscle strengthening by knee extension with rapid movement and correct motor learning are important. As the result of physical therapy dynamic alignment of the trunk and lower extremities during basket movement and muscle strength for knee extension with rapid movement were improved. Her fearfulness and unstable feeling in the knee during basketball movement were alleviated. And 34 days later, she was able to play for more than 30 minutes in inter-collegiate games.
  • 西守 隆, 矢田 敦子
    2001 年 1 巻 p. 31-34
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    The purpose of this study is to examine the effect of the range of motion (ROM) in pronation of the transverse tarsal joint on trunk motion in standing and hemi-standing. We investigated whether ROM on pronation of the transverse tarsal joint affected trunk rotation in standing and hemi-standing. Subjects were eight healthy persons (five males and three females), sixteen lower extremities. Each subject had bilateral ROM on pronation of the transverse tarsal joint measured with a goniometer, and classified sa the hypo-mobility side (ROM on pronation of transverse tarsal joint <10°) or normal-mobility side (ROM on pronation of the transverse tarsal joint ≥10°). And each subject also had ROM of trunk rotation measured on the supporting side in standing and hemi-standing with a goniometer. We compared the normal-mobility side with the hypo-mobility side as to the ROM of trunk rotation in standing and hemi-standing. Compared with the normal-mobility side, the ROM of trunk rotation was significantly decreased on the hypo-mobility side in hemi-standing (p<0.01). Consequently, the limitation of ROM in pronation of the transverse tarsal joint increases the degree of eversion of the subtalar joint in hemi-standing, and increases the degree of eversion of the subtalar joint in hemi-standing causing loss of stability of the lower extremities in hemi-standing. As a result of this study, we believe that on the hypo-mobility side, loss of stability of the lower extremities disturbs the cooperative connection between the lower extremities and the pelvis in hemi-standing. We concluded that trunk rotation in hemi-standing on the hypo-mobility side is decreased due to disturbance of the cooperative connection between the lower extremities and the pelvis in hemi-standing.
トピックス
  • 鈴木 俊明, 谷 万喜子, 鍋田 理恵, 若山 育郎
    2001 年 1 巻 p. 35-41
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    To investigate spasticity and associated reaction in patients with cerebrovascular diseases (CVD), we reported on the two following points: 1) neurophysiological factors of spasticity and 2) characteristics of the spinal neural function in the affected arm during voluntary movement of the leg with the H-reflex in research on associated reaction in patients with CVD. 1) Spasticity was characterized by an increase in of spinal reflex. Factors increasing spinal reflex were separated into the increasing of excitatory fibers from the central nervous system (CNS), afferent sensory fibers, efferent motor fiber and muscle function, and the decreasing of inhibitory fibers from CNS, presynaptic inhibition, and function of renshaw cell. 2) H-reflex, one of evaluations of the spasticity, was recorded from the affected abductor pollicis brevis in relaxation (rest 1), straight leg raising (SLR) task for 15 sec. (task 1), relaxation (rest 2) and SLR task for 15 sec. (task 2) in 3 patients (cases 1-3) with CVD. Muscle tonus of the affected arm was moderate-severe (Case 1), moderately (Case 2) and slightly (Case 3) hypertonus. The amplitude ratio of H/M in the affected arm was analyzed before and during the task. In case 1, the amplitude ratio of H/M in tasks 1 and 2 was significantly higher than that in rest 1. The amplitude ratio of H/M during task 2 was significantly higher than that in task1. In case 2, the amplitude ratio of H/M in tasks 1 and 2 was significantly higher than that in rest 1. No significant difference between the task 1 and 2 was noticed in the amplitude ratio of H/M. In case 3, no significant difference in all conditions was noticed in the amplitude ratio of H/M. It is suggested that a good relationship between spinal neural function of the affected arm during voluntary movement of the leg and the muscle tonus of the affected arm was seen in patients with CVD.
原著
  • 上野 真志保, 廣瀬 浩昭
    2001 年 1 巻 p. 43-46
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    The purpose of this study was to determine the optimal time of stretching to increase flexibility of the hamstring muscles, as defined by measuring the degree of SLR. Nineteen subjects (ten males and nine females), ranging in age from 21 to 25 years, without known musculoskeletal impairments of their spine or lower extremities, participated. A goniometer was used to measure the range of hip flexion with knee extension (the range of SLR) during the 120-second static stretching. The degree of SLR significantly increased (p<0.05) until 75 seconds under sustained hamstring muscle stretching. No significant increase in the degree of SLR occurred during from 75 to 120 seconds. The results of this study suggest that 75-second duration is the effective amount of time to sustain hamstring muscle stretching in order to increase flexibility of the hamstring muscles.
症例報告
  • 福羅 憲子, 木下 友子, 横山 咲子, 小蔵 早苗
    2001 年 1 巻 p. 47-52
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    We performed physical therapy for the patient with parasitic micro hydatid to the brain and spinal cord whose main symptom was difficulty in walking. Hydatid diseases are caused by parasitic of a larva in the tissue, and it is thought that the symptom depend on the parasitic place. In tests and measurements in physical therapy for this patient, all of the results (i.e., sensory examination, manual muscle testing and so on.) were intact, but it was clear that there was an imbalance in the activities of the trunk muscles and a decline of the activity of the quadriceps femoris in the dynamic scene. The physical therapy for this patient was performed to normalize the activities of the trunk muscles and quadriceps femoris. Through treatment, this patient was able to more easily shift the weight in the frontal plane in sitting and standing and the patients walking ability improved. From the result of this physical therapy, we suggest that observational motion analysis is an important method of physical therapy evaluation for patients with hydatid parasitic infestation with movement disorders.
  • 大沼 俊博, 渡邊 裕文, 蔦谷 星子, 三好 裕子, 鈴木 俊明
    2001 年 1 巻 p. 53-58
    発行日: 2001年
    公開日: 2005/06/07
    ジャーナル フリー
    We have done therapeutic exercises for a 24-year female patient with contracture of a flexed elbow joint because of long term fixation after right supracondylar fracture. After exercising, the Range Of Motion (ROM) of the elbow joint was improved but she complained chiefly that she could not perform coodinate activities with the upper extremity on the affected side in Activities of Daily Living (ADL). We recorded the muscular activities on both biceps brachii muscles and triceps brachii muscles both by means of surface electromyography. We observed that these muscular activities on the affected side were delayed compared with those of the sound side; so we started both to switch of motion exercises and of ROM exercises for the elbow joint. As a result, delayed muscular activity on the affected side came to have a similar pattern to those on the sound side about 4 months after beginning the exercises. Further more, she could perform coodinate activities of the upper extremity on the affected side in ADL. These results suggest that it is important to analyze assessment and effect when doing therapeutic exercises with surface electromyography.
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