骨盤前傾および後傾座位での傾斜反応における内腹斜筋，多裂筋の筋活動の変化

研究報告Original articles〔目的〕本研究は，骨盤前傾および後傾座位での傾斜反応における内腹斜筋，多裂筋の筋活動の変化について検討した．〔対象〕健常成人男性8 名，平均年齢28.4 ± 3.2 歳であった．〔方法〕骨盤前傾および後傾座位にて右側方傾斜時の左右の内腹斜筋，多裂筋の筋電図積分値を測定し，安静時の筋電図積分値を100% として比較を行った．〔結果〕筋電図積分相対値は，骨盤後傾座位では有意差を示さなかったが，骨盤前傾座位において右内腹斜筋は，10°右側方傾斜時と比べ20°右側方傾斜時に有意に増加した．左内腹斜筋は，安静時に比べ10°右側方傾斜時に有意に増加した．右多裂筋は，有意差がなかったが，左多裂筋は安静時に比べて10°右側方傾斜，20°右側方傾斜で有意に増加した．〔結論〕座位で体幹筋群の筋活動を高める傾斜反応の誘導は，骨盤前傾座位にて誘導することが重要であることが示された．Purpose：We investigated the activity of the internal abdominal oblique and multifidus muscles during forward and backward pelvic tilting in different seated positions. Subjects：The study included 8 young males（ mean age, 28.4 ± 3.2 years）. Methods：We obtained the integral values of electromyography signals for the right and left internal abdominal oblique and multifidus muscles when the body was seated at rest and titled to the right in the forward and backward pelvic tilting positions. Results：All integral values for both muscles did not show any significant differences when obtained during backward pelvic tilting. With regard to the forward pelvic tilting position, the values for the right internal abdominal oblique muscle were significantly higher during right-sided tilting at 20° than during right-sided tilting at 10°. The values for the left internal abdominal oblique muscle were significantly higher during right-sided tilting at 10° than at rest.Although the values for the right multifidus muscle were not significantly different between positions, those for the left multifidus muscle were significantly higher during right-sided tiltingat 10° and 20° than at rest. Conclusion：The results indicate that guidance during forward pelvic tilting is important increasing the activity of trunk muscles in the seated position

端座位および直立位における足趾圧迫力とアーチ高率との関係：臨床的な足部の機能と構造の評価の検討

研究報告Original Articles〔目的〕本研究は，端座位と直立位における足趾圧迫力とアーチ高率を測定し，足趾圧迫力とアーチ高率の関係性について調査した．〔対象〕対象は，平均年齢31.0±4.5歳の若年成人男性11名であった．〔方法〕方法は，端座位と直立位での足趾圧迫力とアーチ高率を測定した．〔結果〕足趾圧迫力は，端座位と比べ直立位において有意に増加した．一方でアーチ高率は端座位と比べ直立位において有意に低下した．直立位における足趾圧迫力は，アーチ高率と有意な正の相関を示した．〔結論〕臨床において直立位における足趾機能や足部構造の評価の必要性が示された．[Purpose] We measured the force generated by toe pressure and the arch ratio, both in sitting and standing positions, and investigated the differences in and relations among these data.[Subjects] Subjects were 11 young males (mean age. 31.0 ± 4.5 years ).[Method] Measurement items comprised the force generated by toe pressure and the arch ratio, both in sitting and standing positions.[Results] Force generated by toe pressure in the standing position was greater than that in the sitting position, but the arch ratio in the standing position was lower than that in the sitting position. Force generated by toe pressure in the standing position significantly correlated with the arch ratio in both positions.[Conclusion] The study shows importance of assessing the function and structure of the toes and feet in the standing position in a clinical setting

聖隷クリストファー大学リハビリテーション学部における授業開放週間（オープンウィーク）とピアレビューの試み

実践報告Practical repor

Evaluation of Quality of Life in Japanese Normal Pregnant Women

To evaluate QOL changes during pregnancy in developed country, we analyzed 159 pregnant Japanese women (67 nulliparous and 92 multiparous) who had no complications during pregnancy. Subjects were asked to complete the Medical Outcomes Study Short Form (SF-36) every 4 weeks up to 24 weeks of gestation, and every 2 weeks from 24 weeks of gestation until delivery. Subscales that reflect "Physical functioning (p?0.001)", "Role-physical (p?0.001)" and "Bodily pain (p?0.001)" showed significant declines throughout the entire pregnancy. On the other hand, subscales that reflect "Vitality," "General health" and "Mental health" did not change substantially with gestational age. Furthermore, subscales that reflect "Physical functioning," "Role physical," "General health" showed no significant differences between nulliparous and multiparous women. Although subscales that reflect "Bodily pain," "Vitality," "Social functioning," "Role emotional" and "Mental health" showed significant differences between nulliparous and multiparous women, these subscales showed significant interactions. Our results suggest that pregnant women need support, regardless of the number of deliveries. Appropriate supports to pregnant women will be available to improve the birth rate in developed countries

業務確認表の達成率から新人教育の課題を考える

研究論文Original article　当院では，10 年前からプリセプターと新人セラピストで，年に3 回業務確認表（以下，確認表）を用いて，振り返りを行っていたが，結果検証が不十分で次年度へ引き継ぎが適切に行えていなかった．今回，2018 年度の新人16 名の確認表の達成率を振り返り，問題点を検討した．その結果，確認表の達成基準が明確，かつ日常業務化された業務は高達成率であったが，非日常業務やコミュニケーションを伴う項目，1 年以内に未経験である項目は低達成率であった．今後，確認表の達成基準の明確化，調整や連携等の業務，非日常業務やより専門性を伴う業務については新たな確認表の作成や振り返り方法の見直しを検討していく必要性がある．　For the past 10 years, we have been utilizing a work confirmation chart which is reviewed three times a year between the advisor and new therapists at our hospital. However, the outcomes were never sufficiently verified for it to transfer over to the following year. Thus, we reviewed the achievement rate of the confirmation chart for 16 new therapists in FY2018 and discussed challenges. As a result, the achievement rate was high for tasks for which the standard was clear and became daily tasks, but the achievement rate was low for non-daily items, tasks that require communication, and items that were not experienced within the first year. These results suggested the necessity to clarify the achievement criteria of the checklist;to create a new checklist for tasks which require management and collaboration, or non-routine tasks that require special skills; and to reconsider the review methods for future improvement

聖隷クリストファー大学リハビリテーション学部における2016 年度ピアレビュー実施状況とアンケート調査結果報告

実践報告Practical reports　本報告では，聖隷クリストファー大学リハビリテーション学部において2016 年度春セメスターに実施したピアレビューの実施方法と実施状況，アンケート調査結果について報告し，ピアレビュー実施の意義と今後の課題について整理をした．アンケート調査の結果から，ピアレビューについて自分では気づけない授業改善に役立つ指摘がもらえたことを「よかった」と感じている教員がほとんどであり，ピアレビューがFD 活動を行っていくうえで有意義な機会となることが確認された．しかし，評価項目の項目内容や項目数，記述方法の工夫，レビュアーの選出やピアレビューの実施にあたりレビュイー，レビュアー双方が負担を生じないために必要な配慮について学部FD 委員会から促す等の改善を要する点も明らかとなった．　The current study describes the method of faculty peer reviews and the status of faculty peer reviews implemented in the spring semester of 2016, and reported the results of a questionnaire survey about the peer reviews, in order to gain insight about the significance of the peer reviews and future issues. The results of the survey showed that most of the faculty members felt that it was good to be able to receive feedback that they would not otherwise have received, as the feedback would be useful in improving the quality of their teaching. The results suggested that the peer reviews would provide a meaningful opportunity in conducting faculty development (FD) activities. However, the results also revealed that improvements were needed about the content and the number of items, rating methods by reviewers, and selection of reviewers. In addition, it would be helpful for the FD committee to encourage peer review to be performed with consideration on reviewer-reviewee relationships so that the peer review process would not become a burden on both the reviewee and the reviewer

若年成人女性における仙腸関節部愁訴の発生要因の検討

研究報告Original Articles［目的］本研究は，若年成人女性を対象に，仙腸関節不安定テストによる仙腸関節部愁訴と身体特性および体幹筋力との関連について調査することを目的とした．［方法］対象者は若年成人女性100名（平均年齢21.1±1.0 歳）とした． 4つの仙腸関節不安定テスト（Patrick test，Newton test変法，Gaenslen test，仙腸関節引き離しテスト）を実施し，1つ以上で仙腸関節部に疼痛や違和感を訴えた者を愁訴あり群と分類した．また，身体特性，等速性体幹筋力の測定を行った．［結果］仙腸関節不安定テストによる愁訴あり群は，対象者100名中23名であった．愁訴あり群の身長は，愁訴なし群に比べ，有意に高い値を示した（160.6±5.7 cm vs 158.1±5.2 cm，p＜0.05）．その他の身体特性，体幹筋力においては，愁訴あり群となし群の間で有意差がなかった．［結論］若年成人女性において，身長が高いという身体特性が，仙腸関節部愁訴の要因の一つである可能性が示唆された．また，仙腸関節の安定性を体幹の動的な粗大筋力のみで把握することは難しい．[Purpose]　The purpose of this study was to investigate the physical characteristics and trunk muscular strength of young adult women with sacroiliac joint discomfort by means of instability tests.[Methods]　One hundred women (mean age, 21.1 ± 1.0 years) participated in the study. After undergoing four instability tests, i.e. Patrick test, modified Newton test, Gaenslen test, and sacroiliac distraction test, the study participants were classified into a sacroiliac joint discomfort group and a non-discomfort group. Physical characteristics (height, weight, body mass index, body fat percentage, and waist circumference) were recorded, and isokinetic trunk muscle strength was assessed.[Results] Twenty-three participants experienced discomfort according to instability tests. Participants’ height in the sacroiliac joint discomfort group was significantly greater than that in the non-discomfort group (160.6 ± 5.7 cm vs 158.1 ± 5.2 cm, p < 0.05). However there were no significant inter-group differences with regard to the other parameters measured.[Conclusion]　In young adult women, a taller stature may contribute to sacroiliac joint discomfort. The stability of the sacroiliac joint should not be assessed on the basis of the dynamic gross trunk muscle strength alone

COPD 急性増悪後1 年間における再入院に関連する入院中の因子

研究論文Original Articles【目的】本研究の目的は，COPD 急性増悪患者を対象に，退院後1 年間の再入院に関連する因子を明らかにすることであった．【方法】対象は2014 年4 月から2016 年9 月にCOPD 急性増悪の診断で入院し，退院後1 年間の追跡が可能な46 例（平均年齢78.0 ± 8.0 歳）であった．退院後1 年間の再入院の有無で2 群に分け，入院時のデータを電子カルテより収集し，分析を行った．【結果】再入院群は15 例，非再入院群は31 例であった．2 群間の比較では過去の増悪歴（60% vs 29%,p=0.04）に有意差があり，理学療法開始までの日数（5.0 ± 3.0 日vs 3.4 ± 1.7 日，p=0.07）は有意差がなかった．多重ロジスティック回帰分析の結果，過去の増悪歴（OR：4.45，95%CI：1.09-18.2）と理学療法開始までの日数（OR：1.41，95%CI：1.03-1.93）が退院後1 年間の再入院と関連していた．【結論】本研究の結果，急性増悪後の理学療法介入開始の遅延は，退院後1 年間の再入院リスクを増加させる可能性が示唆された．急性増悪後早期の理学療法介入は，再入院の予防に有効である可能性がある．Purpose　The purpose of this study was to clarify the factors related to readmission for one year after discharge in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease（ COPD）.Method　Among patients who were admitted with a diagnosis of acute exacerbation of COPD between April 2014 and September 2016, 46 patients （mean age 78.0 ± 8.0 years old） who could be followed-up for one year after discharge were evaluated. The subjects were divided into two groups based on whether or not they were re-hospitalized within one year after being discharged, and data from the time of the first admission was collected from their electronic medical records and analyzed.Result　15 patients were included in the readmission group and 31 patients in the non-readmission group. There was a significant difference in previous history of exacerbations （60% vs. 29%, p = 0.04） between the two groups, and a borderline difference in the number of days to commencement of physical therapy （5.0 ± 3.0 days vs. 3.4 ± 1.7, p = 0.07）. Multiple logistic regression analysis revealed that previous history of exacerbations（ OR: 4.45, 95% CI: 1.09 - 18.2） and the number of days to commencing physical therapy （OR: 1.41, 95% CI: 1.03 - 1.93） were related to readmission rate.Conclusion　The findings of this study suggest that a delay in the start of physical therapy after acute exacerbation of COPD might increase the risk of readmission for one year after discharge of the patient from the hospital. Early physical therapy intervention after acute exacerbation of COPD might be effective in preventing readmission due to further exacerbations