寒冷療法実施時におけるH反射，M波の変化

理学療法における寒冷療法の効果について安静時，寒冷終了時，15分後のH反射・M波のリクルートメントカーブ（RC）を導出した．RCより，Hmax／Mmax比，H閾値／M閾値比，Hslp／Mslp比を求め，安静時と比較検討した．同一被験者のH反射，M波の各測定時の振幅は低下してした．Hmax／Mmax比，H閾値／M閾値比，Hslp／Mslp比は，各測定時において統計的有意差は認められないものの，安静時と比較して低下する傾向を示した．　これらの結果より寒冷刺激は，脊髄運動ニューロンプールの抑制に関与するが，その影響は筋に対する抑制が大きいものと考えられた．To study the effect of cryotherapy in physiotherapy, the recruitment curve (RC) of Hoffman refrex (H-reflex) and motor wave (M-wave) was evoked at rest, at completion of cryotherapy and after 15 minutes. The Hmax/Mmax ratio (Hmax/Mmax), H threshold/M threshold ratio (Hth/Mth) and H slope/M slope ratio (Hslp/Mslp) were calculated from RC and were compared with the values at rest. The amplitudes of H-reflex and M-wave at completion of cooling and after 15 minutes decreased in all subjects. The Hmax/Mmax, Hth/Mth and Hslp/Mslp were not significant statistically at each measurement but showed a trend of decrease compared with the values at rest. These results suggested that the cooling is effctive on the inhibition of muscles while it contributes to the inhibition of the motoneuron pool

ベーネッシュ運動記載法を用いた歩行評価

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

新入学生の理学療法士イメージと進学志望動機との関連

長崎県内3校の理学療法学科に入学した新1年生102名を対象に，理学療法士に対するイメージと進学志望動機との関連について検討した．理学療法士イメージは学生の進学志望動機と性別に関係なく関連性があった．理学療法についての啓蒙活動の重要性の一端を示唆するものであった．また，進学志望動機については規定要因の関わりに性差を認めたが，その内容については今後の検討課題である．The present study was designed to clarify the correlation between physical therapist image and motives for entering school. The internal consistency of scales for physical therapist image and motives for entering school were Cronbach\u27s coefficient 0.88 and 0.87 repectively. We found that physical therapist image was related to motives for entering school (r=0.38, p<0.01), and that correlations determined by gender were absent. However difference by gender was found to be significant for motive for entering school (p=0.007), and this result is partially in accord with previous studies

先天性表皮水疱症に対する理学療法-症例報告-

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

理学療法学科学生の意欲低下についての研究

理学療法学科学生102名を対象に，その意欲低下について学業，授業，学校の3領域に分け，これに関与するといわれている要因との関連について検討した．これらの尺度間の相関係数から，意欲低下全体と各下位尺度を目的変数に，アイデンティティ，モラトリアム，自尊感情，進学志望動機を説明変数として重回帰分析を行った．その結果，いずれの重相関係数も有意であった．また，標準偏回帰係数が有意な関連は，意欲低下全体とモラトリアム（β＝0.300，p<0.01），学業とアイデンティティ（β＝－0.201，p<0.05）および自尊感情（β＝－0.257，p<0.05），授業とモラトリアム（β＝0.333，p<0.01）および自尊感情（β＝0.214，p<0.01），学校とアイデンティティ（β＝－0.347，p<0.01）において認められた．意欲低下は3領域で異なる関連性を示し，このことは学生との対応において問題の実態を把握し，各領域との関連要因を考慮する必要のあることを示唆するものである．The present study was designed to clarify correlations between problem behavior in enervated students and related factors, that is, identity, moratorium, self-esteem, and motives for entering school. Enervation in students, a disturbance of mental health, is an important facet of quality of life. The enervation or volitional degeneracy observed was divided into three areas: schoolactivity enervation, class enervation, and school institution enervation. Multiple regression analysis was performed on the resulting correlation coefficients among scores representing identity, moratorium, self-esteem, and motives for entering school. We found that moratorium directly impacted on overall enervation (R2=0.166, p<0.01). Similarly, the factors affecting schoolactivity enervation were identity and self-esteem (R2=0.135, p<0.01), those affecting class enervation were moratorium and self-esteem (R2=0.209, p<0.01), while that impacting on school institution enervation was identity (R2=0.148, p<0.01). Thus, in educational intervention regarding enervation, consideration of the problematic content is especially important in order to enhance the students\u27 quality of life

The mental health status of children who have been evacuated or migrated from rural areas in Fukushima prefecture after the Fukushima daiichi nuclear power station accident: results from the Fukushima health management survey

Introduction: We evaluated the mental health status of children residing in Kawauchi village (Kawauchi), Fukushima Prefecture, after the 2011 accident at the Fukushima Daiichi Nuclear Power Station, based on the children's experience of the nuclear disaster. Methods: We conducted this cross-sectional study within the framework of the Fukushima Health Management Survey (FHMS);FHMS data on age, sex, exercise habits, sleeping times, experience of the nuclear disaster, and the "Strengths and Difficulties Questionnaire (SDQ)" scores for 156 children from Kawauchi in 2012 were collected. Groups with and without experience of the nuclear disaster - "nuclear disaster (+)" and "nuclear disaster (-)" - were also compared. Results: Our effective response was 93 (59.6%);the mean SDQ score was 11.4±6.8 among elementary school-aged participants and 12.4±6.8 among junior high school-aged ones. We statistically compared the Total Difficulties Scores (TDS) and sub-item scores of the SDQ between "elementary school" and "junior high school" or "nuclear disaster" (+) and (-). There was no significant difference between these items. Conclusions: We found indications of poor mental health among elementary and junior high school-aged children in the disaster area immediately following the accident, but no differences based on their experience of the nuclear disaster. These results indicate the possibility of triggering stress, separate to that from experiences related to the nuclear disaster, in children who lived in affected rural areas and were evacuated just after the nuclear disaster

A Single Amino Acid Mutation in SNAP-25 Induces Anxiety-Related Behavior in Mouse

Synaptosomal-associated protein of 25 kDa (SNAP-25) is a presynaptic protein essential for neurotransmitter release. Previously, we demonstrate that protein kinase C (PKC) phosphorylates Ser187 of SNAP-25, and enhances neurotransmitter release by recruiting secretory vesicles near to the plasma membrane. As PKC is abundant in the brain and SNAP-25 is essential for synaptic transmission, SNAP-25 phosphorylation is likely to play a crucial role in the central nervous system. We therefore generated a mutant mouse, substituting Ser187 of SNAP-25 with Ala using “knock-in” technology. The most striking effect of the mutation was observed in their behavior. The homozygous mutant mice froze readily in response to environmental change, and showed strong anxiety-related behavior in general activity and light and dark preference tests. In addition, the mutant mice sometimes exhibited spontaneously occurring convulsive seizures. Microdialysis measurements revealed that serotonin and dopamine release were markedly reduced in amygdala. These results clearly indicate that PKC-dependent SNAP-25 phosphorylation plays a critical role in the regulation of emotional behavior as well as the suppression of epileptic seizures, and the lack of enhancement of monoamine release is one of the possible mechanisms underlying these defects