@article{oai:niigata-u.repo.nii.ac.jp:00025549,
 author = {大久保, 義信 and 平野, 秀利 and 山田, 好秋},
 issue = {2},
 journal = {新潟歯学会雑誌, 新潟歯学会雑誌},
 month = {Dec},
 note = {高齢社会を迎え歯科医師も介護の現場に往診に出かけ,要介護者に接する機会が増えている。この中にあって,口腔ケアや口腔機能向上の必要性が社会に認知され,口腔環境の改善による全身機能改善も期待されているが,運動機能や感覚機能を客観的に評価する手法が確立されていない。本研究は小型・軽量の関節可動域計測装置で寝たきり者の上腕部の運動を計測し,要介護度と比較することで運動能力を評価する方法を検討した。研究にはHHCで担当する要介護者のうち,本人または家族の同意が得られた24名(平均年齢80.2±6.9)の参加を得た。対照群として健常者5名を選別した。関節可動域の計測には加速度センサーを応用した計測システムを使用した。手に加速度センサーを握らせて固定し,屈曲・伸展および回転運動を行わせ関節可動域を計測した。要介護者にも部分的な介助から全面的な介助が必要な者まで,さまざまである。そこでいずれの介護度にも対応でき課題運動を検討した結果,手根の運動が適切であるとの結論を得た。記録が完全な左手根の屈曲・伸展角の平均は要支援者(4名)で116.1度,要介護度1(4名)で68.7度,要介護度2(3名)で72.3度,要介護度3(3名)で74.6度,要介護度4(5名)で60.3度,要介護度5(2名)で34.4度であり,介護度と平均可動域に相関係数0.579(p=0.007)で負の相関が得られた。一方,手根の回転運動を記録し,屈曲・伸展相当の角度を算出した結果,限界運動の66.5%と有意に小さな値であり,かつ要介護度との間に有意な相関係は見いだせなかった(0.327,p=0.152)。With the advent of an aging society, dentists are more frequently required to visit nursing care facilities to treat patients requiring long-term care (care-receivers). Society recognizes the importance of oral care and oral function and the role of a healthy oral environment in the improvement of physical function. Nevertheless, as yet there are no methods for objectively evaluating physical and sensory functions. In this study, we measured the upper arm movement of bed ridden subjects using a joint motion recording system. We then examined the relationship between these results and the patient's care-need grade to establish an evaluation of the patient's physical abilities. Twenty-four (80.2±6.9 year old) subjects or their families consented to participate in this study. They were selected from care-receivers covered by HHC. Five healthy, non-handicapped people were selected as a control group. To measure the range of joint motion, a system applying an accelerometer was used. The patients stabilized the accelerometer by holding it with their hands, and the range of joint motion was measured during bending, stretching and rotating the wrist There are various levels of care-receivers ranging from partial to full care. We evaluated various tasks to see which could be related to a particular care-need grade. Carpal movement was found to be the most appropriate evaluative tool. We found that the average angles of bending and stretching were 116.1° for "Youshienshya" (people requiring support) (n=4), 68.7° for care-need grade 1 (n=4), 72.3° for care-need grade 2 (n=3), 74.6° for care-need grade 3 (n=3), 60.3° for care-need grade 4 (n=5) and 34.4° for care need grade 5 (n=2). Thus, a negative correlation was observed between the care-need grade and average range of motion (correlation coefficient 0.579; p=0.007). On the other hand, we calculated how the angle of rotation of the carpus corresponded to the angles of bending and stretching. Nevertheless, they were only 66.5% of the border movement and no significant correlation was found with the care-need grads (correlation coefficient 0.327; p=0.152).},
 pages = {17--24},
 title = {電子式関節可動域計測装置の要介護度評価への応用},
 volume = {36},
 year = {2006}
}