上肢支持手すりを用いた排泄シミュレーション姿勢の検証—姿勢構造に伴う呼吸運動様式の変化

Validation of excretion simulation posture using an upper limb support handrail: Changes in respiratory movements associated with postural structure

要旨：健常若年成人男性19名を対象に，排泄姿勢である前傾座位と上肢支持手すりを用いた上肢支持前傾座位において3次元動作解析装置を用いた姿勢計測（脊柱角度，体幹角度，骨盤角度，大腿角度，臀部の高さ，円背指数）と胸壁計測（呼吸変化量），床反力計を用いた臀部荷重率，表面筋電計を用いた体幹筋活動量を計測し，姿勢を比較検討した．上肢支持前傾座位が前傾座位に比べて臀部の高さ，呼吸変化量が有意に高値を示し，上部脊柱角度，体幹角度，骨盤角度，円背指数，臀部荷重率，腹部体幹筋活動量が有意に低値を示した．上肢支持前傾座位は脊柱後彎を抑制し，上肢の支持性を向上させることで呼吸運動を良好にする姿勢であることが示唆された．

　We have been interested in a posture with the Arm-supported Forward-leaning Position (Arm-FP) during defecation. Variations in posture which are both clinically comfortable and facilitate breathing have not been investigated. The purpose of this study was to examine the difference in postures between Forward-leaning Position (FP) and Arm-FP. To achieve this, the indices of posture and the respiratory movements were compared to clarify the comfort of Arm-FP. The subjects were 19 healthy young adult males. Two postures were compared for forward tilt angle (spine, trunk, pelvis, and thigh), buttocks height and loading rate, thoracic kyphosis index, and amount of change in chest wall movement at deep breathing (upper, lower thoracic, and abdominal ventilation volumes). A three-dimensional motion analysis system incorporating four force plates was used. A surface electromyography system was also used to measure the trunk muscle activity. As a result, Arm-FP showed significantly higher values than FP in buttock height, upper thoracic inspiratory volume, lower thoracic expiratory volume, and abdominal tidal volume. Arm-FP showed significantly lower values than EP in forward tilt angles (upper spine, trunk, pelvis), thoracic kyphosis index, buttock loading rate, and the abdominal trunk muscle activity. It was suggested that Arm-FP is a posture that reduces the spine kyphosis and improves respiratory movement by improving arm support.