理学療法ジャーナル57巻1号

2023年01月発行

特集 多様化する急性期理学療法

プレハビリテーション—整形外科領域

著者： 和田治¹ 飛山義憲²

所属機関： ¹あんしん病院リハビリテーション科 ²順天堂大学保健医療学部理学療法学科

ページ範囲：P.44 - P.49

Point

●人工膝関節全置換術のプレハビリテーションは術前エクササイズ（preoperative exercise）と術前教育（preoperative education）から構成される

●術前エクササイズでは，大腿四頭筋筋力と可動域の改善を目標としたエクササイズ指導を実施する

●術前教育では患者の手術に対する期待値の調整や，術後のイメージ，退院後の生活に関しての患者理解を深めることを目的とする

参考文献

1）Fortin PR, et al：Outcomes of total hip and knee replacement：preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum 1999；42：1722-1728

2）Wang L, et al：Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials. BMJ Open 2016；6：e009857. doi：10.1136/bmjopen-2015-009857

3）Jette DU, et al；American Pysical Therapy Association：Physical therapist management of total knee arthroplasty. Phys Ther 2020；100：1603-1631

4）Calatayud J, et al：High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty：a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2017；25：2864-2872

5）Evgeniadis G, et al：Effects of pre- or postoperative therapeutic exercise on the quality of life, before and after total knee arthroplasty for osteoarthritis. J Back Musculoskelet Rehabil 2008；21：161-169

6）Mizner RL, et al：Voluntary activation and decreased force production of the quadriceps femoris muscle after total knee arthroplasty. Phys Ther 2003；83：359-365

7）Mizner RL, et al：Early quadriceps strength loss after total knee arthroplasty. The contributions of muscle atrophy and failure of voluntary muscle activation. J Bone Joint Surg Am 2005；87：1047-1053

8）Pua YH, et al：Predicting individual knee range of motion, knee pain, and walking limitation outcomes following total knee arthroplasty. Acta Orthop 2019；90：179-186

9）McDonald S, et al：Preoperative education for hip or knee replacement. Cochrane Database Syst Rev 2014；2014：CD003526. doi：10.1002/14651858.CD003526.pub3

10）Moyer R, et al：The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty：a systematic review and meta-analysis. JBJS Rev 2017；5：e2. doi：10.2106/JBJS.RVW.17.00015

11）Fawaz WS, et al：Allowed activities after primary total knee arthroplasty and total hip arthroplasty. Orthop Clin North Am 2020；51：441-452

12）Bourne RB, et al：Patient satisfaction after total knee arthroplasty：who is satisfied and who is not? Clin Orthop Relat Res 2010；468：57-63

13）Dalla-Costa G, et al：Improving disability assessment in multiple sclerosis clinical practice. J Neurol Sci 2017；383：166-168

14）Hataji O, et al：Smart watch-based coaching with tiotropium and olodaterol ameliorates physical activity in patients with chronic obstructive pulmonary disease. Exp Ther Med 2017；14：4061-4064

15）Koshy AN, et al：Smart watches for heart rate assessment in atrial arrhythmias. Int J Cardiol 2018；266：124-127

16）Voelker R：Smart watch detects seizures. JAMA 2018；319：1086

17）Crawford DA, et al：Use of a smartphone-based care platform after primary partial and total knee arthroplasty：a prospective randomized controlled trial. Bone Joint J 2021；103-B（6 Supple A）：3-12

18）Crawford DA, et al：Early outcomes of primary total hip arthroplasty with use of a smartphone-based care platform：a prospective randomized controlled trial. Bone Joint J 2021；103-B（7 Supple B）：91-97

19）飛山義憲，他：人工膝関節置換術前後のリハビリテーションプロトコルの実施状況と内容に関する全国調査．理学療法学2021；48：353-361