大腿骨頸部骨折患者と非骨折患者別にみた視覚情報と生活因子

Comparison of Visual Functions and Lifestyles between Hip Fracture and Non-fracture Patients

　大腿骨頸部骨折患者と非骨折患者における視覚情報の相違と生活因子の特徴を明らかにすることを目的に，平均年齢81歳の大腿骨頸部骨折患者と非骨折患者の視機能を測定し，生活因子との関連を検討した．その結果，コントラスト感度では，骨折患者は非骨折患者に比較して1.5と3および18cycle/degreeの周波数領域とも低下していた．生活因子別にみた骨折患者と非骨折患者の比較では，50歳代以後に骨折既往歴を有する者および転倒歴のある者は，骨折患者に多い傾向であった．同様に，活動能力が低い者は非骨折群に比べて骨折群に多い傾向であった．また，有意差はないが，遠近感がなくなったと回答した者は，骨折群に多かった．活動能力別にみた骨折患者と非骨折患者の比較では，手段的活動能力で骨折群が有意に低かった．骨折を予防するための環境整備と物の形や距離が認識できるような対策を考えること，転倒経験や骨折既往歴を有する者には視覚情報を考慮していくことが重要と考えられた．

　To establish an effective discharge guidance plan for fracture prevention, contrast sensitivity was measured to evaluate the cognition of visual sense among hip fracture patients with a mean age of 81 years, and the relationship with life factors was examined. The contrast sensitivity in fracture patients was lower compared to that of the non-fracture patients for 1.5, 3 and 18 cycle/degree frequency domain, respectively. Concerning the life factors, subjects with their fracture history over 50 years of age and those with falling history were relatively more frequent in the fracture patients compared to those of non-fracture patients (p＜0.1). Similarly, subjects with low physical activity were relatively more frequent in the fracture patients than in the non-fracture patients (p＜0.1). The subjects who replied that they recognized no perspective sensation were also more frequent in the fracture patients but not statistical significant. Concerning the physical activity the implemental one was significantly lower in the fracture patients compared to the non-fracture patients. It has been demonstrated that the guidance for preventing the fracture should include countermeasures which induce environmental improvement for the prevention of tipping over and recognization of the shape of things and its distance. Furthermore, the discharge guidance is also important for considering visual information to persons with tipping over experience and fracture history.