Search

【目的】本研究は膝関節の持続牽引に伴う関節裂隙の距離変化（離開距離）を解析し，関節牽引を効果的に行うための示唆を得ることを目的とした。【方法】健常成人42名を牽引強度が異なる3群（100・150・200 N群）に割りつけた後，50°屈曲位に設定した膝関節を牽引し，牽引前と牽引中（5・10・30・60・120・180秒）の関節裂隙の超音波画像から離開距離を解析した。【結果】3群ともに牽引開始直後に有意な離開が生じていたが，100 N群では離開距離の経時的変化を認めず，150・200 N群では，牽引開始から10秒後以降に離開距離の有意な経時的増大を認めた。5・10秒では3群の離開距離に有意差を認めなかったが，30秒以降では，150・200 N群の離開距離は100 N群より有意に大きかった。【結論】関節牽引を用いて膝関節の結合組織の伸長を得るためには，100 Nより大きな牽引強度と10 秒より長い牽引時間が必要なことが示唆された。, Purpose: The purpose of this study was to understand how to effectively perform joint traction by analyzing the distance change of the joint space (separation distance) induced by continuous traction of the knee joint. Method: A total of 42 healthy subjects were divided into three groups based on traction strength (100, 150, and 200 N group). We then analyzed the separation distance using ultrasound images of the joint space, before and during knee joint traction (5, 10, 30, 60, 120, 180 s) at 50° flexion angle. Result: All groups showed statistically significant separation immediately after the start of the traction; however, separation distance did not change over time in the 100 N group. On the other hand, we observed a significant chronological increase in separation distance in the 150 N and 200 N groups at 10 s after the start of the traction. There were no significant differences in separation distances among the three groups for 5 s and 10 s; however, after 30 s, separation distances in the 150 N and 200 N groups were significantly greater than that of the 100 N group. Conclusion: These results suggest that extending the connective tissue of the knee joint using traction requires traction strengths greater than 100 N and traction times longer than 10 s., 首都大学東京, 2016-03-25, 博士（理学療法学）, 甲第629号

【目的】本研究は膝関節の牽引に伴う脛骨と大腿骨間の距離変化(離開距離)を解析することで,関節角度と牽引強度の違いが及ぼす影響を検討し,特に最大ゆるみの肢位に関する示唆を得ることを目的とした。【方法】対象は健常者18名(男女各9名,平均25.1歳)とした。方法は,関節角度7水準(完全伸展位・25・35・45・55・70・90°)と牽引強度2水準(100・200N)を組み合わせた条件で右下腿を長軸方向へ牽引し,その際の膝関節裂隙の超音波画像から離開距離を解析した。【結果】100Nでは55°屈曲位の離開距離が完全伸展位より有意に大きかった。200Nでは25・35・45・55°の離開距離が完全伸展位より有意に大きく,45・55°の離開距離が90°より有意に大きかった。200N牽引時の関節角度と離開距離の関係を示す回帰式から推定した最大離開距離となる肢位は51°屈曲位だった。【結論】100Nより200Nで牽引した際の離開距離が大きくなることと,正常膝関節の最大ゆるみの肢位は約51°屈曲位であることが示唆された。, Purpose: The purpose of this study was to examine the influence of the different joint angles and traction forces, especially to indicate the maximally loose-packed position by analyzing the change of joint space width (separation distance) that accompanies the traction of knee joint. Method: The subjects were 18 healthy adult subjects (9 male and female, average age of 25.1 years old). The method was to tug their right knees toward long axis direction of the right lower leg with 7 levels of joint angle (completely extended position, 25, 35, 45, 55, 70, 90 degrees) and 2 levels of traction force (100・200N), and analyzed the separation distance by examining the ultrasound images of the joint spaces. Result: With 100 N, 55 degrees flexion angle showed greater separation distance than completely extended position. With 200 N, the distance are larger with 25, 35, 45, and 55 degrees than completely extended position, and 45 and 55 degrees showed greater separation distance than 90 degrees. Based on the regression formula of the relationship between the joint angle and separation distance with 200 N, the knee angle that shows the maximum separation was estimated as 51 degrees. Conclusion: The study showed that separation distance is larger with 200 N than 100 N. It also suggested that maximally loose-packed position of a normal knee joint is about 51 degrees.