理学療法ジャーナル55巻6号

2021年06月発行

特集 Inner & Intrinsic Muscles—筋による関節の安定化，姿勢調整機能を探る

腰部多裂筋に対する評価とmotor control training

著者： 隈元庸夫¹

所属機関： ¹北海道千歳リハビリテーション大学健康科学部リハビリテーション学科理学療法学専攻

ページ範囲：P.647 - P.653

Point

●Local stability muscleである深層多裂筋とglobal stability muscleである表層多裂筋が腰部の動的安定化と分節制御に関与する

●制御されていない動きの「部位と方向」，「並進運動と関節運動」を評価し，「マネジメント計画の立案」を行う

●制御されていない動きを修正し，腰部安定化することがmotor control trainingの目的となる

参考文献

1）Comerford MJ, et al：Movement and stability dysfunction-contemporary developments. Man Ther 2001；6：15-26

2）Stokes M, et al：Rehabilitative ultrasound imaging of the posterior paraspinal muscles. J Orthop Sports Phys Ther 2007；37：581-595

3）Bergmark A：Stability of the lumber spine. A study in mechanical engineering. Acta Orthop Scand Suppl 1989；230：1-54

4）Moseley GL, et al：External perturbation of the trunk in standing humans differentially activates components of the medial back muscles. J Physiol 2003；547：581-587

5）Resende EMS, et al：Superficial and deep lumbar multifidus layers of asymptomatic individuals：intraday and interday reliability of the echo intensity measurement. Eur Spine J 2021；30：227-231

6）Wilke HJ, et al：Stability increase of the lumbar spine with different muscle groups. a biomechanical in vitro study. Spine（Phila Pa 1976）1995；20：192-197

7）Sahrmann SA：Diagnosis and treatment of movement impairment syndromes. Mosby, St. Louis, 2002

8）Comerford M, et al（著），佐藤晃一（監訳）：キネティックコントロール—制御されていない動きのマネジメント．pp3-22，ブックハウス・エイチディ，2017

9）Berglund L, et al：Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness：a randomized controlled trial. Spine（Phila Pa 1976）2017；42：E876-E882

10）Aasa B, et al：Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain：a randomized controlled trial. J Orthop Sports Phys Ther 2015；45：77-85

11）Boococka M, et al：Influencing lumbar posture through real-time biofeedback and its effects on the kinematics and kinetics of a repetitive lifting task. Gait Posture 2019；73：93-100

12）Zheng Y, et al：Effect of core stability training monitored by rehabilitative ultrasound image and surface electromyogram in local core muscles of healthy people. Pain Res Manag 2019；9130959. doi：10.1155/2019/9130959

13）隈元庸夫，他：骨盤帯との関係で生じる腰部疾患の機能解剖学的病態把握と理学療法．理学療法2015；32：991-999

14）Moseley GL, et al：External perturbation of the trunk in standing humans differentially activates components of the medial back muscles. J Physiol 2003；547：581-587

15）Xin Li, et al：Trunk muscle activity during pressure feedback monitoring among individuals with and without chronic low Back pain. BMC Musculoskelet Disord 2020；21：569. doi：10.1186/s12891-020-03565-y

16）Hides JA, et al：Predicting a beneficial response to motor control training in patients with low back pain：a longitudinal cohort study. Eur Spine J 2019；28：2462-2469