学位論文 人工股関節全置換術後の股関節外転運動時の臥位姿勢の違いが術後機能に及ぼす影響

池松, 幸二

2017-03-25
内容記述
THA後の股関節外転運動で臥位姿勢の違いが,筋力・筋活動・関節可動域・疼痛・歩行能力にどのような影響を及ぼすかについて検討することを目的とした.THAを施行する16名を対象とし,測定は術前・術後3日・術後10日に行った.背臥位群と腹臥位群に振り分け,それぞれ股関節中間位を開始肢位として,最大努力での静止性両側股関節外転運動を行った.臥位姿勢および期間を2要因とした反復測定分散分析を行った.歩行時の中殿筋活動開始時期で交互作用を認めた.中殿筋活動開始時期では,術後10日での背臥位群より腹臥位群で有意に早く,腹臥位群での術前より術後3日で有意に遅延し,腹臥位群での術後3日より術後10日で有意に遅延が軽減した.THA後における腹臥位での股関節外転運動は背臥位での股関節外転運動より,中殿筋活動開始時期の遅延を軽減させる可能性を示唆した.
The purpose of this study was to show that the decubitus position in abducting the hip affects muscular strength, muscular activities, range of motion, pain and walk abilities after total hip arthroplasty (THA) . Subjects were the patients receiving THA. We assessed them as follows, preoperative, postoperative day 3rd, and postoperative day 10th. They were divided into the group of the spine position and the group of the prone position. In each groups, the patients quiescently abducted opposite sides' hip in maximum efforts from hip neutral position. We used the two-way repeated measures analysis of variance with two factors being decubitus position and time. The interaction was recognized regarding the time when start gluteus medius' activities in walking. In postoperative day 10th, this time were significantly more quickly in the group of the prone position than in the group of the spine position. In the group of the prone position, this time were significantly slower in postoperative day 3rd than in preoperative, and this time were significantly more quickly in postoperative day 10th than in postoperative day 3rd. It was suggested that abducting hip in the prone position reduced the delay of the time when start gluteus medius' activities more than abducting hip in the spine position.
首都大学東京, 2017-03-25, 修士(理学療法学)
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