在宅高齢者の介護予防に向けたフットケアプログラムの開発—第2報：高齢者によるフットケアの効果の検討

Development of the Foot Care Program for Health Promotion and Disease Prevention for Elderly Persons Living at Home: Second Report: Effect of Foot Care Performed by Elderly Persons

要旨

　目的：高齢者自身が実施したフットケアによる足部の形態・機能および立位・歩行能力の変化を検討し，介護予防の視点からフットケアの有効性を検証した．

　方法：生きがいデイサービスを利用している高齢者にフットケアの指導的介入を実施し，介入の1週間前，6週間後，介入終了後に足部の実態・機能，立位・歩行能力を測定し，変化の比較を行った．

　結果：研究対象者は7人の在宅高齢者であった．フットケアによる手段的ADLおよび転倒不安感には変化はなかったが，自己効力感は若干の向上がみられた．足部の変調は，循環状態や筋疲労に関する項目が改善した．足部の皮膚異常も改善や消失がみられた．感覚機能では右の踵部以外の測定部位で有意に向上し（p＜0.05），循環機能も有意に向上した（p＜0.05）．立位・歩行能力も期間全般にわたり有意に向上した（p＜0.05）．

　結論：高齢者によるフットケアは，足部の機能およびADLの維持に不可欠な立位・歩行能力を向上させ，介護予防として意義がある可能性が示唆された．

　Purpose: This study was conducted to confirm the effects of foot care performed by elderly persons by observing changes in the structure and function of their feet, and testing balance and walking performance. Additionally, we examined the validity of foot care for health promotion and disease prevention.

　Method: Foot-care methods, such as foot baths, keratin removal, foot massages and exercises, were taught to elderly persons living at home. In addition, we compared the three changes in the structure and function of their feet, testing balance and walking performance before and after these foot care interventions were conducted.

　Results: The subjects consisted of seven elderly persons living at home. Instrumental Activities of Daily Living (IADL) and the Falls Efficacy Scale (FES) were unaltered. However, the patients' self efficacy was slightly altered. Problems with their feet, including blood circulation and muscle fatigue, improved. Keratinized and callused soles were replaced by normal, healthy skin. The sensation of touch and pressure was sensitive. The surface temperature of the skin and peripheral blood flow significantly improved, as well as balance and walking performance.

　Conclusion: Maintaining balance and walking performance is necessary for elderly individuals to accomplish daily living activities. It was proved that foot care performed by elderly persons, themselves, may contribute to health promotion and disease prevention as well as improve the condition of their feet.