片麻痺者の体幹機能観察ポイントの検討—座位における非麻痺側上肢のリーチ姿勢分析の試みから

Observational evaluation of trunk control in hemiplegic subjects : A primary study on posture analysis of reaching function in a sitting position

要旨：片麻痺者における非麻痺側上肢動作時の体幹機能を反映する観察ポイントを見出すため，健常者5名と片麻痺者31名を対象に，床反力計と三次元動作解析装置を用い，座位での非麻痺側上肢側方リーチの最大到達点における姿勢を計測した．健常者と片麻痺者では，リーチ側への床反力割合，側方移動距離，骨盤傾斜角度に有意差があった．片麻痺者では，骨盤傾斜角度が床反力と側方移動距離に有意な相関を示した．このことから，骨盤傾斜角度は，体幹の動きを伴う上肢動作の重要な観察ポイントであると考えられた．また上部体幹の回旋と下部体幹の回旋の間にも有意な相関があり，上下体幹回旋の関係性も観察すべきであると思われた

　Evaluation of trunk control in hemiplegic patients during the movement of unimpaired upper limbs is important in clinical practice. The posture of maximum lateral reach of the unimpaired arm in a sitting position was measured by forceplates and a 3D motion analysis system to determine the adequate observational viewpoints of trunk control. Thirty one hemiplegic patients and five healthy control subjects participated in this study. Significant differences were found between the two groups in the floor reaction force applied to the reaching side, reaching distance, and the pelvis inclination angle. In hemiplegic patients the degree of pelvis angle correlated significantly with the floor reaction force and the reach distance. It is suggested that the degree of pelvis inclination was an important parameter to evaluate the trunk control ability. A significant correlation was also found between the rotation angle of the pelvis and that of the upper trunk, indicating that observing trunk rotation seems to be important.