Thesis or Dissertation 大腿骨臼蓋インピンジメント患者に対する体幹安定化プログラムが症状に及ぼす影響

青山, 倫久

pp.1 - 11 , 2015-03-25
・目的 大腿骨臼蓋インピンジメント(Femoroacetabular impingement:以下FAI)は,近年臨床場面で目にする機会が増えている.しかしFAIの保存療法はエビデンスに乏しくまだ確立されていない.本研究の目的はFAI症例に対する体幹トレーニングの症状軽減効果を調べることである.・方法 FAIと診断された女性患者16名を体幹トレーニング群8例と対照群8例の2群に分け,対照群は股周囲筋トレーニングを行い,体幹トレーニング群は体幹安定化プログラムを加え4週間実施した.評価項目は身体特性,NRS,股関節機能スコア(MHHS・Vail Hip Score),股関節可動域,股周囲筋力,サイドブリッジ保持時間とし,介入前と4週後に測定した.統計解析は2群を対応のない因子,介入前後を対応のある因子とした二元配置分散分析を行った.・結果 Vail Hip Scoreに交互作用(p<.05)を認め,MHHSとNRSと共に体幹トレーニング群で有意な改善を認めた(p<.01).・結論 体幹トレーニングはFAI症例の股関節機能を改善する可能性が示唆された.
[Purpose] Femoroacetabular impingement (FAI) has been increasingly defined as a source of hip pain and become the most frequent indication for hip arthroscopy. However, conservative treatment for FAI has still remained controversial. The purpose of this study was to examine the efficacy of the additional trunk stabilization exercise for treating conservatively the patients with FAI. [Methods] Sixteen FAI female patients who met the inclusion criteria were enrolled in this study. There were cam type of FAI in 14 cases, and combined in 2 cases. Patients were divided into two groups of Trunk stabilization exercise group (8 cases ) and Control group (8 cases), Trunk exercise group received the additional trunk stabilization exercise program (Plank and Bird & Dog) to general exercise program (including gluteal muscle), while Control group received only general exercise for four weeks. Outcomes were based on these parameters of ①physical characteristics, ②Tegner Activity Score, ③Numeric Rating Scale: NRS, ④hip function score (Modified Harris Hip Score: MHHS · Vail Hip Score), ⑤range of hip joint, ⑥muscle strength of hip, ⑦side bridge, ⑧femoral neck anteversion were measured before and at 4 weeks after intervention. Efficacy of intervention was analyzed using two-way ANOVA. [Results] There were no significant differences of all parameters between both groups before intervention. We recognized the interaction effect on Vail Hip Score (p<0.05). Both hip function scores and NRS improved more in Trunk exercise group than Control group (p<0.01). We also found significant main effect on range of motion of hip abduction (p <0.05). [Conclusion] An additional trunk stabilization exercise could be effective to improve hip function for treating conservatively patients with FAI.

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