Departmental Bulletin Paper エアマットレス使用時の枕のあて方が上肢・胸部の筋の硬さと自覚症状に及ぼす影響
Examining the positioning of pillows on an air mattress-Evaluation of muscle stiffness in the upper limbs and thorax and subjectivesymptoms-

浦井, 珠恵  ,  松本, 勝  ,  井内, 映美  ,  小林, 正和  ,  西村, 誠次  ,  須釜, 淳子  ,  Urai, Tamae  ,  Matsumoto, Masaru  ,  Iuchi, Terumi  ,  Kobayashi, Masato  ,  Nishimura, Seiji  ,  Sugama, Junko

41 ( 2 )  , pp.151 - 158 , 2018-01-31 , Wellness and Health Care Society , ウェルネス・ヘルスケア学会
本研究は枕のあて方の違いならびに同一の枕のあて方による臥床開始時と臥床開始 30 分後の上肢・胸部の筋の硬さと自覚症状の違いを比較し、エアマットレス臥床時に最適な枕のあて方を明らかにすることを目的とした。 20 歳代の健康成人 10 名を対象とし、準実験研究を行った。操作変数は枕のあて方3 種類(肩口まで、耳孔まで、枕なし)とし、観察変数は大胸筋・上腕二頭筋・上腕三頭筋・総指伸筋における筋の硬さおよび自覚症状とした。筋の硬さとしてエラストグラフィを用いて Strain ratio を算出した。自覚症状として頭部から腰部の疲労感、苦痛の程度等を 5 段階で評価した。対象者はエアマットレス上で仰臥位となり、臥床開始時と 30 分後にデータを収集した。 臥床開始時の上腕二頭筋の硬さは、肩口まで、耳孔までが枕なしと比較して有意に低値であり、総指伸筋の硬さは、耳孔までが肩口まで、枕なしと比較して有意に低値であった。臥床開始時の苦痛の程度は肩口までが耳孔までと比較して有意に低値であり、首の痛み・痺れ・疲労感は臥床開始時、30 分後ともに耳孔までが肩口まで、枕なしと比較して有意に高値であった。臥床開始 30 分後には、全ての枕のあて方で開始時よりも自覚症状の点数が増加していた。以上より、肩口までがエアマットレス臥床時の枕のあて方として望ましいことが明らかとなった。また、看護師は臥床時間が 30 分間であっても苦痛が増強することを念頭に置き、ケアを行う必要がある。
This study was performed to examine stiffness of the muscles of the upper limbs and thorax and subjective symptoms immediately and 30 minutes after positioning of pillows on an air mattress. Ten healthy subjects participated in the study. We examined the effects of three pillow positions (around the shoulders, by one ear, and no pillow) on subjective evaluation of pectoralis major, biceps brachii, triceps brachii, and musculus extensor digitorum stiffness. Muscle stiffness was measured as strain ratio determined by elastography with a diagnostic ultrasound imaging system. The subjective symptoms evaluated were the degrees of fatigue, pain, hypesthesia and a feeling of shear of the pillow, and others. The subjects lay in the supine position on an air mattress, and data were collected after 0 and 30 minutes.  At the initial time point, the stiffness of the biceps brachii was significantly lower when pillows were placed around the shoulders or at one ear than when there was no pillow. The stiffness in the musculus extensor digitorum at 0 minutes was significantly lower when pillows were placed at one ear than when placed around the shoulders or when no pillow was used. However, the degrees of neck fatigue, pain, and hypesthesia at 0 and 30 minutes was higher when the pillow was placed at the ear compared with other positions; the degree of distress at 0 minutes was also significantly higher when the pillow was placed at the ear than when placed around the shoulders. The degree of subjective symptoms was higher in all positions after 30 minutes compared to the initial time point.  Based on these results, it is recommended to place pillows around the shoulders when lying on an air mattress. Nurses should consider the fatigue of patients lying on an air mattress for at least 30 minutes.

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