人工股関節置換術前後の作業遂行能力の推移の検討—Assessment of Motor and Process Skillsを用いた検証

Improvement in ADL performance before and after total hip arthroplasty through occupational performance : Verification using Assessment of Motor and Process Skills

要旨：左人工股関節骨頭置換術を施行された60歳代後半の男性に対して，クリティカルパスに準じた作業療法の介入の妥当性を検証するために，AMPSを用いた作業遂行能力の経時的な評価を行った．AMPSの能力値は術後3日目の評価で低下していたが，ソックスエイド等を用いた代償的手段による介入で即時的に顕著な向上を示した．術後3週間の退院時には，自助具を用いずとも地域で独居が可能なレベルに至った．クリティカルパスでは限られた入院期間において，いかに早期かつ短期間に作業遂行能力の向上を図るかが要求され，作業療法での支援により術後早期，ならびに退院期において適切にADLを拡大できることが示唆された．

　This case discusses a 70-year-old man who underwent a total arthroplasty of the left hip. The purpose of this study was to inspect the validity of the occupational therapy intervention based on the critical path using the Assessment of Motor and Process Skills (AMPS). 3 days post operation revealed decreased AMPS logits, but with compensatory intervention by stocking aids etc, the subject exhibited increased facility. At 3 weeks post operation, the stocking aids became partially unnecessary, and his performance reached the level of being able to live independently in the community. In the critical path, the occupational performance will be demanded for improvement in the early post operation stages and in the short term during a limited hospitalization period. It is suggested that occupational therapy can improve ADL both in the early post-operation stages and after discharge from the hospital.