Economic Effects of Physical Therapy Interventions in the Facility of Health Care Services for the Elderly

個別理学療法を行っている介護老人保健施設における理学療法の効果を経済的側面からみた。要介護度,厚生省(当時)の「障害老人の日常生活自立度」(以下寝たきり度)及び「痴呆性老人の日常生活自立度」(以下痴呆度)から直接費用削減効果を推計した。また排泄状況について入所判定時,入所時,理学療法施行後を比較検討しオムツ使用量より間接費用削減効果をみた。理学療法法施行後では寝たきり度(p<0.05)は改善した。要介護度に置き換えてみると1施設(75人定員)1日当たり,17710円の削減となる。また終日オムツ利用者数も改善し(p<0.05)これらの人が夜間のみオムツ使用したとすると1施設(75人定員)1日あたり7164円の削減となる。なお,必要な理学療法期間は半年以内であろうと推定できThe report analyzed the effects of physical therapy interventions in facilities of health care services for the elderly from the economic standpoint. First, a direct reduction in expenses was estimated by care degree, Independence Degree of Daily Living in the Handicapped Elderly (bed-ridden degree) and Independence Degree of Daily Living in the Elderly with Dementia (dementia degree), presented by the Ministry of Health and Welfare at that time. Second, the excretory condition was compared among at the time of evaluation for admission, at admission, and after physical therapy intervention, for the purpose of estimating an indirect reduction in expenses caused by a decrease in diapers used. After physical therapy intervention, bed-ridden degree was significantly improved (p<0.05). Calculating this in terms of care degree, a reduction of expenses was 17,710 Japanese yen per facility (75beds) per day. The number of persons who used diapers throughout the day was significantly decreased (p<0.05). A reduction of 7,164 Japanese yen per facility (75beds) per day will be realized provided that persons who need diapers all day only use them at night. The necessary period of physical therapy intervention was considered within 6 months for the elderly in facilities of health care services

Study of Kinetic and Electromyography of Dream Plastic Ankle Foot Orthoses while Walking and Stair Descending

本研究の目的は、「装具なし」、「プラスチック製短下肢装具」(以下、P-AFO)、「摩擦制動継手付短下肢装具 (ドリームブレース : Dream Plastic Ankle Foot Orthoses)」(以下、DP-AFO) 装着の3条件で、装具装着側下肢の力学的および筋電図学的解析を行うことである。インフォームド・コンセントの得られた健常成人を対象に、一側下肢の足部に装具を装着し、平地歩行および階段降り動作を行った。使用機器は、三次元動作解析装置および床反力計を使用し、装具装着側下肢の関節角度、関節モーメントの測定および筋電図の記録を行った。解析は、装具装着側下肢が床面および階段面に接地している区間を3条件で比較検討した。その結果、ドリームブレースは、正常歩行に近似した関節角度、関節モーメントおよび筋活動を再現していることが明らかになった。The purpose of this study was to investigate a kinetic and electromyogram analysis of the Dream Plastic Ankle Foot Orthoses (DP-AFO) while walking and descending staircases. One healthy adult participated in this study. DP-AFO was attached to one of the legs of the subject, assuming that the limb was affected. The movement was measured with 3D motion analysis system (VICON 512) and force plates (AMTI). We compared the state of the limb, when the foot was touching the floor or the stair. As a result, it was clarified that the DP-AFO reproduces the joint angle, the joint moment, and the EMG activities of normal walking