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The hip abductor muscles play an important role in postural control. Structural differences in the hip abductor muscles translate to differences in functional activity. This study sought to measure changes in T2 values of the hip abductors after hip abduction exercise over time and to identify variations in activity between the different hip abductor muscle groups. Ten healthy young men (mean age 28.4 [24−32] years) performed 5 sets of 40 repetitions of a hip abduction exercise at 30% maximum voluntary contraction with the right leg. Magnetic resonance imaging was performed before exercise, at intervals during exercise, and at the end of exercise. Subsequently, T2 values were measured for the tensor fasciae latae, gluteus minimus, the anterior, middle, and posterior segments of the gluteus medius, and the upper fibers of the gluteus maximus. T2 values for the gluteus minimus, tensor fasciae latae, and the anterior and middle segments of the gluteus medius were significantly higher at after all exercise compared with before exercise. However, T2 values for the posterior segments of the gluteus medius after 3, 4, and 5 sets of exercise were significantly higher than before exercise. T2 values for the upper fibers of the gluteus maximus after 4 and 5 sets were significantly higher than before exercise. Thus, the variable changes in muscle activity observed in this study were attributable to differences in anatomic structure and reflected intramuscular variation in activity between the hip abductor muscles., 首都大学東京学位論文甲第959号副論文

【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〕骨盤・下肢アライメントの年代間の相違とその性差を検討した．〔対象〕脊柱，下肢に整形外科的既往のない男女141名を，若年群，中年群，高齢群に分けた．〔方法〕骨盤前傾角度，膝伸展角度，骨盤傾斜角度，FTA，Q-angle，大腿骨前捻角，navicular drop test，leg-heel alignmentの測定を行った．〔結果〕高齢群でアライメント変化が著明に現れ，男性は膝屈曲方向，女性は骨盤後傾，股外旋，膝内反・屈曲方向へと変化することが示唆された．また，骨盤前傾角度，FTAは高齢群で性差がなくなることが明らかとなった．〔結語〕男女それぞれのアライメント変化の傾向を考慮し，理学療法を提供していくことが重要であると考える．, [Purpose] The purpose of this study was to examine the alignment of the pelvis and lower extremities in males and females of different age groups. [Subjects] The subjects were 141 healthy persons who were classified into three groups based on age: young, middle-aged, and elderly. [Methods] Anterior pelvic tilt, knee extension angle, lateral pelvic tilt, femoro-tibial angle (FTA), quadriceps angle, femoral anteversion, navicular drop test, and leg-heel alignment were measured. [Results] In the elderly group, significant changes of alignment due to aging were observed. Flexion of the knees was observed in both males and females. Posterior pelvic tilt, external rotation of the hip, and varus of the knees were observed in females. Anterior pelvic tilt and FTA did not show any difference between genders in the elderly group. [Conclusion] It is important to consider the tendency for alignment to change due to aging in each gender when providing physical therapy., 首都大学東京, 2015-03-25, 博士（理学療法学）, 甲第475号

本研究では，骨盤と下肢の姿勢分類と，それに関与するアライメント・関節可動域・筋力との関連について分析した。対象は若年健常者34名（男性15名，女性19名），平均年齢21.9歳であった。アライメント測定は骨盤・下肢の8項目に対して行い，関節可動域・筋力測定（最大等尺性収縮）は股・膝・足関節に対して行った。結果，姿勢はアライメント測定項目のうち大腿骨前捻角・大腿四頭筋角度・矢状面での膝関節角度を特徴として3群（内反膝群・膝過伸展群・外反膝群）に分類された。4群の男女比は内反膝群では男性，膝過伸展群，外反膝群で女性が有意に多かった。内反膝群では股内転・内旋可動域が有意に小さく，股外転筋力が有意に大きくなり，外反膝群ではその逆であった。膝過伸展群では膝伸展・足底屈可動域が有意に大きかった。若年健常者の姿勢は男性1群，女性2群の計3群に分類され，それぞれが特有のアライメント・関節可動域・筋力を有することが示唆された。, The purpose of this study was to analyze correlation of the posture classification of the pelvis and lower extremities with the alignment, range of motion (ROM) and muscle strength. Thirty four young healthy subjects (15 males and 19 females; mean age, 21.9 years) were participated. The measurement of the alignment included 8 items of the pelvis and the lower extremities, and the measurement of ROM and muscle strength (maximal isometric contraction) included the hip joint, knee joint, and the ankle joint. The types of posture were, in total, classified into three different groups: one male group characterized by genu varus, and two female groups characterized by genu recurvatum and genu valgus according to femoral anteversion, quadriceps angle, and knee joint angle (on a sagittal plane). ROM for adduction and internal rotation of the hip joint was significantly decreased and muscle strength for abduction of the hip joint was significantly increased in genu varus. In genu valgus the relation was the reverse of genu varus. ROM for extension of the knee joint and plantar flexion of the ankle joint was significantly increased in genu recurvatum. These results suggest that young healthy subject's posture was classified into one male group and two female groups; moreover, the results also suggest that each of them had characteristic alignment, ROM, and muscle strength., 首都大学東京学位論文甲第475号 副論文

本研究は,超音波画像を用いて膝関節の牽引に伴う関節裂隙の距離変化(離解距離)を解析した際の測定値の信頼性を検証することを目的とした。実験には健常男性10名(平均29.0歳)と,検者2名が参加した。方法は,左膝関節を50°屈曲位に保持した背臥位にて,左下腿を150Nで牽引し,その際の膝関節裂隙の超音波画像から離解距離を求めた。同一の実験手順を検者1名は2回,他方の検者は1回行った。結果,算出した級内相関係数は検者内・検者間ともに約0.8だった。Bland-Altman分析の結果,誤差の種類は検者内・検者間ともに偶然誤差だった。最小可検変化量の95%信頼区間は,検者内で0.7mm,検者間で0.8mmだった。本研究で実施した手法で得た測定値の信頼性はおおむね良好であり,離解距離の解析手段として利用できることが明らかとなった。, The purpose of this study was to verify the reliability of measurement value when width change of joint space (separation distance) due to the traction of the knee joint was analyzed with ultrasound imaging. Participants of this experiment were 10 healthy male (average age of 29 years old) and 2 raters. The method was to tug the left lower leg in 150N while maintaining the left knee joints in 50 degrees in supine position and measure the separation distance using ultrasound imaging. One of the raters performed the same exam procedure twice, and the other rater performed it once. The result showed the interclass correlation coefficient of about 0.8 for both the intra-rater and the inter-rater. The result of Bland-Altman analysis showed that the type of error was accidental error for both the intra-rater and the inter-rater. 95% confidence interval for minimal detectable change was 0.7 mm with the intra-rater and 0.8 mm with the inter-rater. The reliability of the measurement that we got from this study was generally good, and it clarifies that this method can be used in measurement of separation distance.

【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.

本研究の目的は，徒手筋力計（HHD）を柱またはベッド脚に固定用ベルトを用いて固定した方法での筋力測定の信頼性を検討することである。対象は健常成人10名（男性5名，女性5名），20脚とした。2名の検者が膝関節屈曲・足関節背屈・底屈・外がえし・内がえしの最大等尺性筋力を各2回測定した。統計処理は1名の検者の測定から検者内信頼性を，2名の検者の測定から検者間信頼性を級内相間係数にて算出した。結果，級内相間係数（検者内ICC1.1，1.2/検者間ICC2.1，2.2）は，膝関節屈曲0.86，0.94/0.84，0.96，足関節背屈0.94，0.97/0.94，0.97，足関節底屈0.98，0.99/0.97，0.98，足関節外がえし0.90，0.94/0.92，0.98，足関節内がえし0.80．0.91/0.91，0.97であった。これより本法は高い検者内・検者間信頼性を有し，臨床的に有用な測定方法となりうると考える。, The purpose of this study was to examine inter- and intra-rater reliability of isometric muscle strength measurements using a hand-held dynamometer (HHD) fixed to the pillar or treatment plinth leg by a belt. Ten healthy subjects (5 male and 5 female which totals to 20 lower extremities) participated in this study, Two raters used a HHD to measure the maximum isometric muscle strength twice for the following muscle groups : extensors of the knee; dorsiflexors, plantar flexors, evertors, invertors of the ankle. Inter- and intra-rater reliability were evaluated using the intra-class correlation coefficients (ICC). The results of ICC (ICC1.1, 1.2/ICC2.1, 2.2) were 0.86, 0.94/0.84, 0.96 (knee flexors), 0.94, 0.97/0.94, 0.97 (ankle dorsiflexors), 0.98, 0.99/0.97, 0.98 (ankle plantar flexors), 0.90, 0.94/0.92, 0.98 (ankle evertors), 0.80, 0.91/0.91, 0.97 (ankle invertors).These results show that this method can be performed clinically with high reliability., 首都大学東京学位論文甲第475号 副論文