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Publications (4)0 Total impact

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    ABSTRACT: 理学療法士がどの程度,またどのように人工呼吸管理に関与しているかを明らかにするために,全国470施設を対象に,人工呼吸器装着中の呼吸理学療法(Chest Physiotherapy for patients withmechanical ventilation; CPT-MV)に関するアンケート調査を行い,272施設から回答を得た(回収率57.9%)。そのうち,CPT-MVを行っていると答えた施設は176施設(64.7%)であった。CPT-MVを行う際に最もよく用いる手技としては呼吸介助法,スクイーズィング,四肢の関節可動域練習・筋力増強練習の順に多かった。過去1年間でCPT-MV中に人工呼吸器関連のトラブルがあったと答えた施設は104施設(59.1%)で,その内訳は,ファイティング,気道への結露流入,気道内圧上昇の順に多かった。また,人工呼吸器関連以外のトラブルでは,筋・肋骨・脊椎の疼痛や不快感,不整脈,呼吸困難,急激な血圧変動,低酸素血症の順に多かった。それらトラブル発生時には看護師や医師への報告は高率で行なわれていた一方で,事故報告書を作成している施設はわずかであった。272施設中,CPT-MVを行っていないと答えた施設は35.3%あり,今後CPT-MVの普及のためには医学的効果の証明と,啓発,理学療法士自身の知識と技術の向上の必要性が挙げられた。 The purpose of this study was to identify chest physiotherapy techniques most often utilized by physiotherapists in Japan to patients with mechanical ventilation. Various troubles related to chest physiotherapy were also investigated. In each prefecture, ten hospitals where larger numbers of beds existed were selected and a questionnaire about chest physiotherapy for patients with mechanical ventilation (CPT-MV) was mailed to totally 470 hospitals. Two hundreds and seventy-two hospitals responded and the response rate was 57.9%. The CPT-MV was performed in 176 hospitals (64.7%). Chest physiotherapy techniques most often utilized were breathing assist, chest compression, joint range of motion exercise and muscle strengthening exercise. One hundred and four hospitals (59.1%) reported the troubles related to mechanical ventilation such as fighting, rising internal airway pressure and dewy inflow to airway during CPT-MV for past one year. Pain and discomfort of thoracic cage, arrhythmia, dyspnoea, blood pressure fluctuation and hypoxemia were also reported. On the other hand, physiotherapists made quite few incident reports when such troubles occurred. Responded physiotherapists suggested that scientific evidence of CPT-MV, enlightenment of CPT-MV and improvement of physiotherapist's knowledge are necessary for future CPT-MV popularization
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    ABSTRACT: 本研究の目的は,恒常性のある「見る」運動(一点注視)と多様性のある「見る」運動(分散注視)が,それぞれクローズドスキルの運動学習に及ぼす影響を明らかにすることであった。本研究ではクローズドスキルの運動課題としてダーツを用いて行われた。Day1からDay3までの練習期間において,分散注視型の注視課題を与えた群の得点は低い値を示し向上もみられなかった。しかし,注視課題を与えずに行ったPost Test及び保持テストの得点がPre Testの得点を上回った。また,一点注視群の得点との間には逆転現象が見られた。本研究で得られた結果は,多様性注視課題をもって練習を行うことで,多様性筋運動による練習と同等もしくはそれに近い効果が得られる可能性があることを示唆している。 The purpose of this study was to show clearly the effects of “closed observation” and “dispersed observation” give the motor learning of the closed skills. In this study we used darts as the motor task. During practice period, Day1 to Day3, “dispersed observation” group showed low scores and their scores didn't improve. However, in post test and keeping of skills test, their scores exceeded pre test and reversed “closed observation” group's.  The results of this study showed possibility of to practice with “variability vision control” is equal or nearly to practice with “variability movement”.
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    ABSTRACT: 閉塞性肺疾患患者の運動耐容能評価用に開発された漸増シャトルウォーキングテスト(ISWT)は最高酸素摂取量(peak V^^・O_2)を一次回帰直線式から予測できるとされているが,今までにISWT中の酸素摂取量(V^^・O_2)動態を連続的に1呼吸ずつ測定した研究はなく,実際にISWT中のV^^・O_2が直線的に増加するかどうかは疑問である。そこで,本研究の目的は,ISWT中のV^^・O_2増加の直線性を検討することである。健常人12例に対し,ISWTとトレッドミル上でのISWTの負荷プロトコルを用いた運動負荷試験(TET)を無作為の順番で行った。両テスト中はV^^・O_2をポータブル呼気ガス分析装置によりbreath by breath法を用いて測定した。ISWTとTET中のV^^・O_2と総歩行時間又は総歩行距離からの一次回帰直線式を算出し,peak V^^・O_2の実測値と予測値を比較した。その結果,実測peak V^^・O_2は総歩行時間から求めた予測peak V^^・O_2より有意に1Met以上高く,一方,総歩行距離からの予測peak V^^・O_2とは1ml/kg/min程度しか差を認めなかった。これらの結果から,ISWTの結果からpeak V^^・O_2を予測する場合は総歩行距離を用いることが望ましいと考えられた。 The incremental shuttle walking test (ISWT) was developed for the evaluation of exercise capacity in patients with chronic obstructive pulmonary disease. A previous study reported that peak oxygen consumption (V^^・O_2) was predictable using single regression line against the total walking distance of ISWT. However, it is still unclear whether V^^・O_2 really increases continuously and straight linearly during ISWT since no study has measured changes in V^^・O_2 continuously using breath-by-breath method. The purpose of this study is to determine whether peak V^^・O_2 is predictable according to the total walking distance of ISWT. Twelve healthy men participated in this study. The ISWT and treadmill-walking test using same protocol of ISWT were performed at random. The V^^・O_2 was continuously measured using breath-by-breath method with a portable gas analyzer (AT-1100, Anima, Co., Japan) during ISWT. Straight linear increase in V^^・O_2 both against the total walking distance of ISWT and against the total walking time of ISWT were evaluated using a single regression analysis, and predicted peak V^^・O_2 was calculated. Finally, the measured peak V^^・O_2 was compared with the calculated values. Measured peak V^^・O_2 showed only 1 ml/kg/min difference from the predicted peak V^^・O_2 against the total walking distance. Measured peak V^^・O_2 was 1 Met or significantly higher than the predicted peak V^^・O_2 against the total walking time. In conclusion, peak V^^・O_2 of ISWT was predictable using single regression line against the total walking distance of ISWT in normal subjects. Further study to determine the predictability of peak V^^・O_2 of the ISWT is necessary before implementation to patient population