Publications (32)4.53 Total impact
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Article: Bone marrow adipocytes support dexamethasone-induced osteoclast differentiation.
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ABSTRACT: The purpose of this study was to examine the ability of bone marrow adipocytes to support osteoclast differentiation in vitro. The primary bone marrow adipocytes were obtained from bone marrow fluid during prosthesis insertion. NFkappa-B ligand (RANKL), Osteoprotegerin (OPG), and macrophage colony stimulating factor (M-CSF) expressions in bone marrow adipocytes with or without dexamethasone were examined. In a co-culture system with bone marrow adipocytes and osteoclast precursor cells, osteoclast differentiation was assessed by the expression of titrate-resistant acid phosphatase (TRAP) staining. RANKL, OPG, and M-CSF mRNA expressions were confirmed in all individuals. Dexamethasone significantly induced RANKL and OPG expression. The RANKL/OPG ratio was increased by dexamethasone and was significant at 10(-7) M dexamethasone. With 10(-7) M dexamethasone, osteoclast precursor cells differentiated into multinucleated TRAP-positive cells when co-cultured with bone marrow adipocytes. The present study demonstrates for the first time that bone marrow adipocytes can support osteoclast differentiation in vitro.Biochemical and Biophysical Research Communications 04/2009; 382(4):780-4. · 2.48 Impact Factor -
Article: Feasibility and effectiveness of a nurse-led community exercise programme for prevention of falls among frail elderly people: a multi-centre controlled trial.
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ABSTRACT: To determine whether an exercise programme provided by public health nurses is effective in improving physical function and psychological status in elderly people, in reducing falls and risk factors for falls in elderly people, and whether the intervention is a feasible programme within the community. Controlled intervention trial. Participants included 144 persons in the intervention group and 124 persons in the control group, who were living at home, aged over 65 years, and with 5 or more risk factors for falls identified using the questionnaire for fall assessment (Suzuki). For participants in the intervention group, an exercise programme was provided by public health nurses. This comprised a weekly exercise class of 2 hours for 17 weeks, supplemented by daily home exercises. Number of risk factors, physical function and psychological status were compared between the intervention and control groups before and after intervention. The number of further falls during the intervention was also compared between the 2 groups. The programme significantly improved physical function and emotional status, and reduced the number of falls and risk factors for falls. The excellent adherence rate represented broad acceptance of the intervention. The intervention programme was effective and feasible to operate in the community.Journal of Rehabilitation Medicine 08/2007; 39(6):479-85. · 2.05 Impact Factor -
Article: 在宅高齢者に対する転倒予防プログラムの検討 ─低頻度プログラムの適応─
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ABSTRACT: 本研究は転倒骨折予防教室の参加者385名を対象に介入プログラムの効果と転倒予防の適応となる要因について検討し た。週2回6ヶ月間の介入の結果，簡易版Geriatric Depression Scaleは有意に低下し，椅子起立時間，6 m歩行で有意に向上した。転倒数の減少に関わる要因として，年齢70歳以上，腰痛有り，服薬数3つ以上，転倒経験者，転倒リスク数3個以上，Fall Efficacy Scaleの得点29点以下で有意差が認められた。低頻度の運動プログラムでも地域高齢者の身体機能の維持・向上への効果に寄与できることが示唆され，参 加者の転倒要因を考慮することが重要である。 -
Article: 高齢者におけるバランス能力と下肢筋力との関連性について ─性差・年齢・老研式活動能力指標別での検討─
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ABSTRACT: 〔目的〕本研究の目的は，高齢者のバランス能力と下肢筋力との関連性を検討し，性差，年齢，老研式活動能力指標（老 研式）得点別でも検討を行うことである。〔対象〕高齢者69名で，平均年齢は77.4歳であった。〔方法〕バランス能力は静止立位時重心動揺と Functional Reach Test（FRT）とし，下肢筋力は膝伸筋と足背屈筋を測定した。年齢は中央値で78歳以下，79歳以上に分類し，老研式得点は11点未満，11点以上に 分類した。〔結果〕静止立位時重心動揺と下肢筋力は負の相関を認め，FRTと下肢筋力は正の相関を認めた。また女性，79歳以上，11点未満群では静止立 位時重心動揺と下肢筋力で負の相関を認め，女性，78歳以下，11点以上群ではFRTと下肢筋力で正の相関を認めた。〔結語〕高齢者のバランス能力と下肢 筋力の関連性には性差，年齢，老研式得点によって異なる特徴があることが示唆された。 -
Article: 高齢者の介護予防に影響を及ぼす要因－性差と主観的健康感の観点から－
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ABSTRACT: 地方都市における地域在住高齢者の介護予防に関連する要因を，性差と主観的健康感の観点から検討した．自治会に加入する65歳以上の高齢者1602人を対象に行なった質問紙調査は，回答者698人（回収率43.6％），分析対象者634人（有効回答率39.6％）であった．男性の後期高齢者でうつ傾向，女性の後期高齢者で低い主観的健康感，社会活動の低下，運動機能の低下，閉じこもり傾向が認められた．また，男性，女性ともに低い主観的健康感が運動機能の低下と社会活動の低下に関連していた．介護予防プログラムを検討する上で，性差や個別ニーズに合わせた運動機能強化プログラムを含む多様な社会活動の場と機会の充実が不可欠であると考えられた． This study examined the various factors influencing public health efforts in preventing life-style related illnesses and minimizing care needs among the elderly living in local cities from the perspectives of gender difference and self-rated health. A questionnaire survey was distributed to a total of 1602 elderly aged 65 and above who are members of the same community association. Of them, 698（43.8%） took part and results of 634 （39.6%） respondents were eligible for study analysis. Depression among the old-old males, and low self-rated health, decreased engagement in social activities, decreased motor function and tendency to keep indoors among the old-old females were reported. Among both male and female respondents, low self-rated health was associated with decreased motor function and decreased engagement in social activities. The study results suggest that in planning programmes to prevent life-style related illnesses and minimize care needs among the elderly, it is necessary to provide places and opportunities for social activities, including programmes to enhance motor functions, which take into account gender differences and individual needs -
Article: 気道狭窄に対するＴチュ－ブとExpanding Metallic Stent併用の長期挿入症例-気管内Ｔチューブの自己管理指導で成功した１症例-
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ABSTRACT: 肺癌の気管分岐部切除再建術後に生じた気道狭窄に対して，救急処置としてExpanding Metallic StentとＴチューブを留置した．その後，入院中に看護師を中心として自己管理指導を行った．患者自身が自己管理を自宅にて行い，約７年後にＴチューブを除去できた貴重な症例を報告した． Expanding Metallic Stent and T tube were used as an emergency treatment for tracheo-bronchial stenosis which appeared after the carinal reconstruction with right upper sleeve lobectomy to treat a lung cancer patient. The patient was instructed self-care mainly by nurses at the time of admission. This report was a valuable case, which the patient took care of his physical condition by himself at home and consequently lead to the removal of the T tube in approximately seven years -
Article: Living Status and Cardiopulmonary Function of Persons with Severe Cerebral Palsy
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ABSTRACT: 重度脳性麻痺者の心肺機能を施設群と在宅群，アセトーゼ型と痙直型，A-DL自立群と非自立群などに分けて，安静時と運動負荷時の両者で評価した。 結論として， 1．重度脳性麻痺者の呼吸機能は健常者のそれと比較して半減していた。 2．施設群の呼吸機能は在宅群のそれに比較して有意の差で後者がすぐれていた。前者は健常者の約1/3の計測値を示した。 3．社会的自立群は非自立群に比して，ADL の自立や運動機能と関係なく，呼吸機能がすぐれていた。 4．standing 群とnon-standing 群との比較では全体として前者が高い呼吸機能を示した。 5．アセトーゼ群は痙直群と比較して，より高い呼吸機能を有していた。 Most of persons with severe cerebral palsy are caused pain due to osteoarthritis or hypertone as their age advances to 20 or more. As a result, ADL is restricted and living ability drops. On the other hand, those who actively participate in social activity despite the inability of ADL seem to maintain a high livelihood ability and have less pain due to hypertone. A study was carried out in search for the relationship between actual status of living of the persons with severe cerebral palsy and their cardiopulmonary and physical functions. The subjects consisted of 14 persons staying at facilities for the handicapped and 9 staying at home, totaling 23 ; 13 males and 10 females, age ranging from 22 to 42 mean being 31. The cardiopulmonary function was assessed at rest and at physical load. The items of measurement were TV, VE, RR, VO2, VCO2, METS, VO2/W, SaO2, and ALL OUT TIME. A comparison was made respectively between 1. facility and home groups, 2. athetotic type and spastic type groups, 3. deformative thorax and nondeformative groups, 4. ADL self-managing and non managing groups,and 5. socially independent and dependent groups.(Results) 1. The respiratory function,especially VO2/W was lower in the facility group compared to home group. 2. Superior in athetotic type to spastic type. 3. Lower in deformative thorax group compared to non-deformative group. 4. The ADL self-managing group tended to show a better respiratory function (especially ventilation) than the non-self managing group. 5. The socially independent group compared to dependent group was definitely superior in respiratory function (especially ventilation,VO2/W). Most of those whose social independency was high were superior in cardiopulmonary and physical functions even though their mobility was poor. It is very difficult for the severely handicapped to attain social independency but their mind of independency and will power they acquired through their struggles with handicap are more than normal pesons. Their continued activities to participate in social life should be encouraged -
Article: Physical Therapy for Child with Epidermolysis Bullosa A Case Report
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ABSTRACT: 先天性表皮水疱症は厚生省による特定疾患治療研究対象疾患で，いわゆる「難病」指定疾患である．表皮水疱症では，日常生活で外力が加わる部位に反復する水疱を臨床症状の主体とし，軽微な外力による水疱発生が基本であるが，病変活発な時期では特に誘因なく発生する場合もあるという．著者らは，7年間にわたって表皮水疱症接合部型の男児に理学療法を実施してきた．体表面が外界と接触するということは乳幼児の感覚一運動学習過程において必要不可欠な体験であるにもかかわらず，水疱発生によってそのことが阻害され結果的に運動発達の遅れを呈した．今回，問題を残しながらも普通小学校への就学ゴールに達したので，これまでの理学療法経過と若干の考察を加えて報告する． The purpose of this paper is to report on the course and physical therapy for epidermolysis bullosa. Epidermolysis bullosa is designated as a specific rare disease by the Ministry of Health and Welfare. The clinical feature is repeated blister formation that occurs following mechanical stimulation in daily living. The blisters may occur without cause especially at an active time of morbid change, although these are actually caused by slight stimulations. It is absolutely indispensable for sensori-motor learning in the baby that the body surface make contact with the environment. Motor learning is based on having experiences with the interaction between perception and motor. However, it is guessed that no comfort was experienced by the patient via sensory information from the skin. It is probable that he experienced of continuous pain and pruritus, felt as itching of the entire body. Therefore, it is inferred that biased perceptions would be generated and learned. In addition, blisters, erosions, and markedly fragile skin were actually aggravated by sensory inputs made to facilitate developmental intervention. Therapeutic exercise for the patient has been going on since four months from birth, but the patient has been continuing to exhibit retarded motor development. However, the patient was able to enter school normally in spite of having a few problems at present -
Article: Validity and Reliability of Gait Assessment with Benesh Movement Notation-for analysis of the walking of adult hemiplegic patients-
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ABSTRACT: 本研究の目的は，ベーネシュ運動記載法を用いた成人片麻痺患者の歩行分析評価の妥当性と信頼性についての検討である．20例の脳卒中片麻痺患者の歩行を記載し，5つの歩行因子，及び四肢・体幹の要素の記号数を求め，分析した．その結果，歩行因子では位置・角度因子の記号数が他の因子の記号数に比べ有意に多く，四肢・体幹の要素では上肢と下肢の記号数に有意差はなかった．また，Brunnstrom stageが低いほど位置・角度因子や上肢，体幹の記号数が有意に多く，それを反映し記号総数も多かった．以上の結果からBMNの歩行評価の適応とその妥当性と信頼性が認められた．このように観察歩行評価としてのBMNは，有効な客観的臨床歩行評価の方法と認められる． We studied the validity and the reliablity, as well as the indications and limitations of Benesh Movement Notation gait assessment with adult hemiplegic patients. We described the use of BMN for analysis of the walking of 20 adult hemiplegic patients, and analyzed the number of BMN deviational signs which we divided into five classifications of walking factors, in addition to factor for limb and trunk. It was thereby found that: 1.The twenty subjects represented 366 deviational signs that we summarize the performance in terms of standing posture and walking. The Brunnstrom recovery stage (BS) was low with higher numbers of deviational signs, although a significant difference was not observed. 2.For walking factors, the numbers of deviational signs with position/angle factors were significantly higher than many the numbers of deviational signs associated with the other four factor classifications. 3.For walking factors, the numbers of deviation signs increased with low BS, and significant differences were idetified the position/angle and orthosis factor classificatione. The BMN methods consist mainly of the evaluation of gait deviations from visual assessment of position/angle factors and limb and trunk variables. Our results indicate that the BMN method can be used reliably. It should be possible to develop BMN systems with higher reliability levels so that observational gait assessments can be generally recognized as an objective clinical gait evaluation tool -
Article: 在宅高齢者に対する転倒・骨折予防教室の介入効果について : 転倒経験者と非転倒経験者の比較から
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ABSTRACT: 本研究は地域高齢者149名の転倒状況を調査し,転倒既往の有無別に転倒リスク,身体的状況を比較するとともに,転倒骨折予防教室の効果を検討した.運動内容は,20～30分のストレッチ,筋力強化,バランス訓練等を指導した.評価項目は老研式活動能力指標,GDS-15,転倒リスク数,1年間の転倒状況を調査し,体力評価は握力,開眼片足立ち,Functional Reach Test(以下,FR),椅子起立時間などとした.転倒既往有群で転倒回数,転倒リスク数,FR,椅子起立時間の改善が認められた.地域高齢者の転倒予防においては運動指導とともに教育的指導,集団を考慮したプログラムが有効と思われた This study investigated the circumstances of falls experienced by 149 community-dwelling elderly people. We compared falls risks and the physical status of fallers and non-fallers, and evaluated the effectiveness of the falls and fractures prevention program. Physical exercise such as 20-30 min stretching, muscular strength training, and balance training was included in the program. Evaluation was according to the Tokyo Metropolitan Institute of Gerontology Index of Competence, the 15-item version of the Geriatric Depression Scale, the number of falls risks, and the data on the circumstances of falls in a year. Physical capacity was assessed using the results of the hand grasping power test, one leg standing with open eyes test, Functional Reach Test (FR) and sit-to-stand test. After the intervention we found that the frequency of falls, the number of falls risks, FR and sit-to-stand test results were improved in fallers. Physical exercise seemed to be effective, along with education and other programs tailored for groups in falls prevention for community-dwelling elderly people -
Article: 広範囲気道狭窄に対する術後ステント療法の現状と看護要点
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ABSTRACT: 気道狭窄に対し17例の気道ステント留置を行った．この内，気道再建の術後狭窄のステント留置は10例であり，Ｔチューブ使用６例，Expanding Metallic Stent（EMS）２例，EMS併用Ｔチューブ１例，デューモンチューブ１例であった．自己管理により長期観察出来た症例はＴチューブ使用（EMS併用を含む）２例とEMS１例であった． そこで，各ステントの特徴を紹介した．さらに，ここでは広範囲気道狭窄に使用したＴチューブの長期観察の経験を報告し，術後ステント療法，特にＴチューブの問題点と看護師による自己管理指導について論じた． In 17 cases of airway stenosis, 3 different kinds of stent were inserted into the respiratory tract as treatment. Stents were inserted in 10 of the cases following reconstructive surgery of the respiratory tract. A T tube was used in 6 of the cases, an Extending metallic stent (EMS) was used in 2 cases, T tube and EMS combination was used in 1 case and a Duemon tube was used in 1 case. In these cases, 1-T tube, 1-T tube and EMS combination, 1-EMS were observed in outpatient care over a long period of time. In this paper the authors introduced the characteristics of each stent, and gave detailed reports on the T tube and T tube-EMS combination in widespread airway stenotic cases. Furthermore the authors discussed benefits and problems for nurses who work with airway stenotic outpatients -
Article: クラシック音楽とロック音楽の相違による心理的ストレス反応と細胞性免疫能変化
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ABSTRACT: 音楽の種類による心理的，身体的影響の差異はいまだ明らかではない．そこで，整形外科領域で同様の体動制限を受けている症例を対象に，クラシック音楽群４症例とロック音楽群５症例による受動的音楽療法下における心理的ストレス反応と細胞性免疫能を検討した． クラシック群はほとんどの症例において快感を感じ，空想，回想のため思考低下を認めたが，睡眠傾向はほとんど認められなかった．免疫能の指標であるCD4/CD8は音楽療法開始時より終了時に低値を示した．一方，ロック群は快感と不快感を感じる個人差を呈したが，空想，回想は認められなかった．５症例中３症例に睡眠傾向を認めた．CD4/CD8は個人差を認めたが，快感を感じた症例は終了時に低値を認めた． 上記のように，音楽の種類により，心理的，免疫学的差異があり，これらの特徴を理解して音楽療法を評価・活用すべきである． The influence of different kinds of music on psychological and physiological response is unclear. The authors investigated the psychological stress response and the cellular immune reaction to passive classic and rock music therapy in 9 patients who had similar orthopedic operations. Classic music subjects in 3 of the 4 cases indicated a general pleasant feeling, reminisced about past experiences, and reported no drowsiness, while feeling an increased thinking stress. The CD4/8 cellular immune reaction index also decreased. For the subjects of rock music, 2 cases experienced pleasantness and 2 cases experienced unpleasantness. However, no recollection memories were had and thinking ability was not suppressed. 3 of the 5 cases indicated drowsiness. The CD4/8 index declined in the pleasant feeling cases, the same as it did for classic music subjects. This study suggest that the different kinds of music used in passive music therapy may play different physiological as well as psychological roles in stress reduction. Care should be taken to ensure that the intended feelings are induced -
Article: 肺葉切除後ARDSに罹患した横隔神経麻痺症例に対する統合ケアの必要性
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ABSTRACT: 胸部外科の術後呼吸器合併症で最も恐れられているものの一つに術後ARDS（adult respiratory distress syndrome）がある．このような患者は人工呼吸器の管理下におかれ，荒蕪肺やストレスにより，人工呼吸器からの離脱に苦慮することが多い．今回，転移性肺腫瘍（胸腺カルチノイド）の術後にARDSを併発し，人工呼吸器管理を必要とした患者で，医師，看護師，理学療法士ならびに家族の協力により，前回の手術と治療による横隔神経麻痺と軽度の放射線肺炎が併存しながら，人工呼吸器からの離脱と職場復帰に成功した症例を報告した．さらに，このような長期人工呼吸器管理下の患者には，統合ケア－総合的医療スタッフの構築とマニュアルの必要性を強調した． ARDS (adult respiratory distress syndrome) is one of the most dangerous postoperative respiratory complications in thoracic surgery. ARDS patients are on ventilators and it is difficult to wean them from mechanical ventilators because of a destroyed lung and emotional depression. One case in which a patient developed postoperative ARDS after surgical resection of a metastatic lung tumor following the removal of thymic carcinoid, and who required long-term mechanical ventilation was reported. This subject was weaned successfully and returned to work with support from medical doctors, nurses, physical therapists and his family even though he had paralysis of n. phrenicus and mild radio-pneumonia from a previous operation. A demand for an organized comprehensive medical team for each patient and the necessity of creating a manual for long-term ventilator-dependent patients are emphasized in this report -
Article: 試験前後における学生の試験ストレス評価とリンパ球サブセットの変化
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ABSTRACT: 医療系学生の試験ストレス（国家試験）と細胞性免疫担当細胞の関係を検討した．試験群は17名，コントロール群は10名を対象とした．ストレス評価は心理的ストレス反応尺度（PSRS-50R）を使用し，免疫系解析はリンパ球サブセットであるCD4，CD8，CD4/8比を検討した． 試験群におけるストレス反応尺度では試験後において試験前より有意に低値スコア（ストレス解消）へと移行した．一方，試験群における細胞性免疫の試験前・後の変動はCD4で試験後に有意に増加，CD8で不変，CD4/8比で軽度高値をしめした．以上より客観的な試験ストレス評価としてのCD4の有用性を認めた． We studied the relationship between stress and cellular immunity reaction on medical tech students who were facing the state examination. 17 students in the examination group and 10 students in the control group were studied. The PSRS-50R method of the psychological stress reaction assessment was used for stress evaluation. The immune reaction analysis was examined using CD4, CD8, and CD4/8 ratio in T lymphocyte subpopulations. The stress reaction score (PSRS-50R) of the examination group significantly decreased after the exam. Concerning the values of cellular immunity in the examination group after the examination a significant rise in CD4 was seen, CD8 remained stable, while there was a slight rise in the CD4/8 ratio. CD4 was acknowledged as a useful indicator for the objective evaluation of stress during the exam time -
Article: 音楽療法とメラトニンの併用による循環動態と皮膚温度の解析-有効かつ十分なリラックス効果を求めて-
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ABSTRACT: ストレス解消のための音楽は，循環動態の変動を認めることが良く知られている．最近，メラトニンにもリラックス効果が指摘されている．そこで，音楽とメラトニンのストレスに対する相乗効果を検討するために循環動態と指尖部の皮膚温度の測定をおこなった．音楽単独（ボディソニック使用）では血圧低下，脈拍数減少を認めるも，皮膚温度の上昇は認められなかった．メラトニン単独では循環動態の変化はほとんどみとめられず，皮膚温度の軽度上昇を認めた．一方，音楽とメラトニン併用により，血圧低下，脈拍数減少を認め，皮膚温度の有意な上昇を認めた．以上より，音楽とメラトニンの併用は十分なリラックス効果つまり副交感神経優位の状態を作り出す事が出来た． It is known that the relaxing effects of music influence changes in circulation. Recently, it has also been pointed out that melatonin produces a relaxing effect. For these reasons, the authors analyzed the combined effect of music and melatonin on circulation and skin temperature for the purpose of proving a synergistic effect. Three groups: music stimulation only, melatonin stimulation only, and music together with melatonin stimulation were examined. The music stimulation group experienced a lowering of blood pressure and a decreased pulse, but skin temperature that depends closely on the sympathetic nervous system showed no change. The melatonin stimulation group showed no change in circulation, but the skin temperature slowly rose. The music and melatonin combination group had a lowering of blood pressure, a reduced pulse and a rise in skin temperature. The authors suggest that the synergistic effect of music plus melatonin seems to inhibit the sympathetic nervous system, thereby causing the body to relax more completely -
Article: 運動負荷に対する心肺機能の変化-健常者，閉塞性障害者，拘束性障害者-
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ABSTRACT: 本研究の目的は呼吸不全患者の運動負荷に対する心肺機能の変化を知ることである．対象者は，健常者11名と閉塞性障害者，拘束性障害者各1名で，計13名であった．方法は，多段階運動負荷試験を行い，運動前・中・後の一回換気量（TV）・分時換気量（VE）・呼吸数（RR）・酸素摂取量（VO2）・二酸化炭素排出量（VCO2）・METS・酸素摂取量／体重（VO2/W）・呼吸商（RQ）・心拍数（HR）・酸素脈（VO2／HR）・酸素飽和度（SaO2）・ALL-OUT TIMEを測定し，負荷に対する経時的変化と，最大一回換気量，最大分時換気量，最大呼吸数，最大酸素摂取量，最大二酸化炭素排出量，最高METS，最大酸素摂取量／体重，最大心拍数，最大酸素脈，ALL-OUT時の呼吸商，ALL-OUT時の呼吸効率を求めた．その結果は，呼吸不全患者が運動負荷に対する耐用能を著しく低下させていた．その原因は，換気機能とガス代謝の低下によるものと思われた．しかし，心機能は，活動を中止するほど低下していなかった． This study was undertaken to investigate the effect of exercise load on the cardiopulmonary functions in 11 normal subjects, one patient with obstructive lung disease and one patient with restrictive lung disease. The cardiopulmonary functions included the following : all-out time, TV, VE, RR, VO2, METS, VO2/W, RQ, HR, VO2/HR and SaO2. The patient with obstructive or restrictive lung disease showed a decreased tolerance for exercise load as compared with normal subjects. These results appeared to depend on the dysfunction in ventilation and gas metabolism. However, the cardiac functions in these patients were not disturbed to the level to stop the exercise load -
Article: 老人性骨粗鬆症に伴う脊椎圧迫骨折と脊柱変形そして骨量について
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ABSTRACT: 老人性骨粗鬆症における脊柱変形と椎体圧迫骨折そしてMD法による骨量の相互の関係につきX線学的に検討した． 脊柱変形は，胸椎の後弯の増強と腰椎における前弯の増強が特徴的である円背と凹円背の症例が最も多く，椎体の変形は，胸椎の後弯部に一致して圧縮変形や楔状変形がみられ，腰椎の前弯部には，魚椎様変形が多発していた．椎体の圧迫骨折は，凹円背に最も発生頻度が高く，また，全後弯，亀背，凹円背では，腰椎において3椎体以上の圧迫骨折がみられた． 円背では，著明な骨量の低下がみられ，骨粗鬆症による影響が強いと考えられたが，他の変形群では，骨量とは関係がみられなかった． Radiological study was done to assess the relationships among the postural deformities, compression fractures of spine and bone volume with Inoue's MD method on senile osteoporosis. Deformities of the round back and lordotic round back were the most frequent. Those deformities were formed of the increased kyphotic change in the thoratic spine and the increased lordotic change in the lumbar spine. The compression fracture of spine occured frequently in the lordotic round back group and developed in over three vertebra bodies of the lumbar spine in the total lordotic group, gibbus group and lordotic round back group. The flat and wedge vertebra developed in the kyphotic areas of the thoratic spine and the fish vertebra in the lordotic areas of the lumbar spine. The bone volume bacame less in the round back group but there was not significant statistically. The loss of the bone volume didn't affect the development of the compression fracture of spine and the forming of the postural deformity by itself -
Article: 老人片麻痺患者へのHeel Gait Cast療法の試み
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ABSTRACT: 老人片麻痺患者の内反尖足に対してHeel Gait Cast療法を施行し，その効果について検討した． 1．3週間のギプス固定により足関節底屈筋の痙性の軽減が図られた． 2．痙性の軽減にともない，足関節の他動的背屈角度の増大，歩行能力および坂道昇降能力そして，バランス能力などの改善がみられた． 3．本法は老人片麻痺患者の内反尖足に対して有用であると確認できた． 4．今後，症例を増やし，さらに検討していきたい． We studied the effect of Heel Gait Cast for aged patients of hemiplegia with pes eqinovarus. 1．Reduction of ankle plantar flexors spasticity was acquird by plaster splint for three weeks. 2．Following the reduction of spasticity， some abilities improved ； for example, range of passive ankle dorsiflexion, gait ability, ascent and descent of slope, and balance ability. 3．It was confirmed that this treatment is valuable for aged patients of hemiplegia with pes equinovarus. 4．We are going to make a number of cases in the future. Moreover, we shall go on with this study -
Article: 歩行における足部の可動域制限の影響
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ABSTRACT: 異常歩行をきたす症例は，下肢，体幹の可動域制限，筋力の低下，疼痛，痙性などが原因である．その中で，距腿関節や足根中足関節など，足部の可動域制限によるものを多く経験してきた．そこで，足部の可動域制限が歩行に及ぼす影響を床反力，動作解析より検討し，理学療法のあり方について考察を加えた．その結果，heel strike後に荷重に対する調節が行われ，推進力は低下した．歩容においては，膝関節の角度変化に3種類の代償方法が考えられた．したがって，可動域制限を最小にとどめるとともに他の関節周囲筋の筋力強化，早朝からのアーチ機能の維持・向上，靴に対する配慮，工夫が必要と思われた． Abnormal gait is the result of limited range of motion in the lower limbs and trunk, muscle weakness, pain, and spasticity. We often experienced patients who presented with abnormal gait because of limited range of motion in the foot. Thus we investigated the effect of limited range of motion in the foot on gait using force plate and motion analysis, and we considered the status of physical therapy for limited range of motion in the foot. 1) The weight bearing was controled after heel strike 2) The acceleration force decreased. 3) The knee angle variation could be categorized into three patterns. We considered it important, therefore, to minimize limitations on range of movement, to strengthen knee, hip and trunk muscles, to maintain arch function from the early stage, and to consider and improvize the structure of shoes -
Article: 腰痛症患者における不良姿勢と身体機能について
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ABSTRACT: 腰痛症患者90名（男性34名，女性56名）を対象に，不良姿勢に関連する要因を年齢や肥満度，筋力などから検討した．その結果，対象者の51.1％に不良姿勢が観察され，それらは老・高齢期に多く，肥満者も多かった．体幹筋，下肢筋の伸張性は，姿勢の変化に関わらず制限されていた。不良姿勢の要因としては，年齢，肥満度，体幹筋の伸張性が大きく関連していた。また，筋力と年齢，下肢筋の伸張性には，姿勢の変化に関わらず相関が認められ，不良姿勢群では，体幹筋の伸張性と下肢筋の伸張性にも相関が認められた．これらのことより，腰痛症患者に対しては，姿勢矯正や治療体操に加え，的確な運動処方など，全身調整を含めた理学療法の実践が重要であると認識された． This study was carried out to examine the factors related to abnormal posture of patients with low back pain. Subjects were 90 patients (34 males and 56 females) with low back pain. As a result, 1)The incidence of abnormal postures was 51.1% 2)A majority of these patients were the aged and had obesity. 3)The elasticity of spinal muscles and lower limb muscles were poor regardless of whether with abnormal postures or not. 4)Abnormal postures were closely associated with the age, the obesity and the elasticity of spinal muscles. 5)Generally there was a trend that the younger was the age and the greater was the elasticity of lower limb muscles, the better was the scores of muscular power. Moreover the scores of the elasticity of spinal muscles was correlated with that of lower limb muscles in the abnormal posture group. It was recognized that the practice of the adequate therapeutic exercise including the whole body adjustment was indispensable to low back pain
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2007
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Nagasaki University
Nagasaki-shi, Nagasaki-ken, Japan
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