理学療法ジャーナル47巻9号

2013年09月発行

講座 理学療法診療ガイドライン・6

地域理学療法の診療ガイドライン

著者： 金谷さとみ¹

所属機関： ¹社会医療法人博愛会菅間記念病院在宅総合ケアセンター

ページ範囲：P.837 - P.845

はじめに

　近年，超高齢社会の到来も相まって，疾病予防について，個人レベルのみならず，公衆衛生学的に社会水準で検討することが重視され，要介護状態になる原因疾患が死亡の原因とは異なることも明らかになり，疾患ではみえてこない「生活」を長期的にとらえる研究が盛んに行われるようになった．理学療法は疾患治療だけでなく，後遺症による障害，そして地域生活にもかかわる必要がある．そのため，地域生活に焦点をあてた地域理学療法のガイドラインを作成することの意義は大きい．

　理学療法診療ガイドラインには虚弱高齢者の項目がすでにあり，他の疾患別のガイドラインにも「在宅」に関する項目がある．地域理学療法ガイドラインの作成について依頼があった際，どこを基点にどのようにまとめればよいか，理学療法士に何をガイドすればよいのか，初めはこの部分に非常に時間を費やした経緯がある．このガイドラインでは，疾患別のガイドラインとは異なり，地域のあらゆる場面で，理学療法士の活動をいっそう効果的にするものを集約することとした．対象は高齢者とし，一般高齢者から要介護状態の高齢者までの幅広い対象に，地域理学療法提供の手がかりとなるものを選定した．参考としたガイドライン，引用したデータベースは表1に挙げる．また，評価の推奨グレードおよび介入の推奨グレードとエビデンスレベルを表2に記載した．

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