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Japanese Occupational Therapy Research Volume 20, Issue 4 （August 2001）

作業療法 20巻4号（2001年8月発行）

Japanese English

◆研究と報告

RAのMP関節尺側偏位に対する装具の効果 Effect of orthosis for ulnar deviation due to RA 福田恵美子 ¹ , 千葉和彦 ² Emiko Fukuda ¹ , Kazuhiko Chiba ² ¹東北文化学園大学 ²双葉義肢製作所 ¹Tohoku Bunka Gakuen University of Medicaland Welfare ²Futaba Artificial Limb Factory キーワード：リウマチ , 尺側偏位 , 装具 , ADL , 握力 , Rheumatoid arthritis , Ulnar deviation , Orthosis , ADL(APDL) , Grip power Keyword: リウマチ , 尺側偏位 , 装具 , ADL , 握力 , Rheumatoid arthritis , Ulnar deviation , Orthosis , ADL(APDL) , Grip power pp.332-337

発行日 2001年8月15日 Published Date 2001/8/15

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要旨：RAは活動性の活発な時期に女性に発症しやすく，日常生活のみならず社会生活においても障害となる変形を来たしやすい疾患である．筆者らは，対象者から訴えの多かった尺側偏位変形に注目し，新奇な装具を作って1991年から適用し，類似装具2種類と握力・ADL状況において比較検討を行ってきた．対象者は全例女性で，尺側偏位に気づいて処方された10例である．stageⅡ；5例，stageⅢ；5例，classⅠ；2例，classⅡ；6例，classⅢ；2例である．装具装着時の平均年齢は49±5．5歳(41〜57歳)である．

　新奇な装具は，他の装具に比べて対象者が気になる違和感は少なく日常生活において常時継続的に使用され，運動痛の軽減や日常生活の活動性が高められ，評価においては握力とADL状況において有用であった．

　The aims of this study was to know the effect of originally made orthosis for ulnar deviation of 10 RA female clients in 1991.

　Methods: We drew a comparison between originally made orthosises and two other likeness orthosises. The method of verdict on effect was measurement of grip power to dominant hand and ADL (involved partial APDL) evaluation. 5 out of 10 clients were stage II, and the rest of them were stage III on classification of steinbrocker. Their average age was 49 + 5.5 ages (41〜57 ages).

　Results ＆ Discussion: To correct ulnar deviation, a orthosis usually made to correct 2^nd finger through 5^th finger toward from ulnar side to radial side. However, for II ＆ III stage client, this original orthosis was made to correct the 2^nd ＆ 3^rd finger only. About 1 cm width, by 10cm length bar was applied along 2^nd finger's lateral side up to MP joint. Since this bar gave firm support, it caused the 4^th ＆ 5^th finger to move and work more easily with the 2^nd ＆ 3^rd finger. This resulted in: (1) made 3 finger pinch easier, (2) released pain at MP joint, (3) improved 4^th and 5^th finger deformity due to skin contact area lessened; this increased the hand sensory area which encouraged hand use, (5) regained grip power, therefore, daily working hours prolonged and daily activation was increased.