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| 1.
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論文
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出村, 慎一 ; 佐藤, 進 ; 南, 雅樹 ; 小林, 秀紹 ; 野田, 洋平 ; 松沢, 甚三郎 ; 小林, 寛道 ; 青木, 純一郎
概要:
The purposes of this study were to examine reliability and validity of ADL index for older people at home, and relations
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hips between ADL score and various factors (ex. self-assessment of health status and physical fitness level, and exercise frequency/week), and to examine the screening basis for execution of physical fitness test based on distribution of ADL score. A questionnaire consisting of 12 ADL items and a physical fitness test of Ministry of Education, Science and Clture were administered to 5, 715 subjects 65 years or more age (male: 2, 745; female: 2, 970) . As a result of examining test-retest reliability of the ADL index, significant high correlations were shown among 12 ADL items (0.674≤r≤0.886), and in overall score (r=0.943) . The ADL score was significantly related to age and physical fitness test scores, and tended to be higher in subjects with a higher self-assessment of health status and physical fitness level, and with more frequency. It was suggested that these results prove the utility of the present ADL index. Further, as the result of examining relationships between distribution of overall ADL score and physical fitness test scores, the following screening bases were considered to be valid for judgement whether the physical fitness tests could be executed. The three screening bases using overall ADL score were: 1) 12 or under; 2) over 13 to under 24; 3) 24 and over. The four bases using item score were: 1) a category 1 response for items 1, 5 and 6; 2) a category 2 or 3 response for items 1, 5 and 6, and a category 1 response for items 3 and 4; 3) a category 3 response for items 2 and 14; 4) a category 1 response for items 10 and 12.
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田中, 志信 ; 岸上, 博俊 ; 村田, 和香 ; 山越, 憲一
概要:
In order to investigate the relationship between cardiovascular performance and daily activity in the elderly, preliminary experiments were carried out using two ambulatory monitoring systems developed by the authors' group. One system is
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capable of long-term monitoring of human posture in normal daily life, and the other is for non-invasively monitoring beat-by-beat cardiovascular parameters, including blood pressure (BP), heart rate (HR), cardiac output (CO), total peripheral resistance (Rp). Baroreceptor-cardiac reflex sensitivity (BRS) was also calculated as an index for evaluating autonomic regulatory function. The preliminary use of these systems has clearly demonstrated that simultaneous monitoring of beat-by-beat haemodynamic parameters together with data on posture could give valuable information concerning not only orthostatic hypotension, but also on circulatory response to daily physical load.
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大泉啓一郎著
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加藤, 真由美 ; 泉, キヨ子 ; 川島, 和代 ; 中村, 直子
概要:
金沢大学 医 保健看護<br />1)地域高齢者の筋力は,男が18～20kg,女が15～17kgで,75歳未満が17～18kg,75歳以上が14～17kgであった.骨量は男が25～27%,女が25～26%で,75歳未満が25～27%,75歳
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以上が25～26%であった.2)転倒経験者は年間30%で,転倒は屋外での発生が最も多く,天候など環境変化への適応が低下していた.3)筋力の2年間の推移は,男が15kgから16.5kg,女が14.5kgから17.5kgで,75歳未満が15kgから18kg,75歳以上が13kgから17kgと上がった.骨量は男が30%から23%,女が26%から24%,75歳未満及び75歳以上共に26%から24%と減少した.4)2年続けて転倒した6名のうち3名は降圧剤を使用,3名は白内障,3名は下肢筋力が同年代と比較して9～16kgと低値であった<br />原著論文
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| 5.
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出村, 慎一 ; Demura, Shinichi
概要:
高齢者の健康・体力に影響を及ぼす生活諸条件の検討を行うために,理論的妥当性を考慮して各体力領域から体力パフォーマンステストを,また,自覚的健康,及び生活状況調査項目を選択した。まず,高齢者における体格・体力の因子構造を明らかにすると共に,そ
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の性差及び加齢に伴う変化を検討した。次に,横断的資料に基づき,自覚的健康と体力及び生活状況の関係を検討した。また,基礎体力と健康状態,日常生活活動,及び食生活生活との関係についても検討し,基礎体力に関与する生活諸状況について考察を行った。以上の検討から新たに以下のような知見が得られた。1.(1)体格因子として,長育,量・周育及び体脂肪の3因子が解釈され,男女とも量・周育及び長育は加齢と共に小さくなる。(2)体力因子として,筋力,四肢の敏捷性,平衡性及び柔軟性の4因子が解釈され,男女とも加齢に伴い低下する。(3)高齢者における筋力や平衡性は,四肢の敏捷性及び柔軟性より加齢による低下の程度が大きい。2.(1)自覚的健康度と柔軟性因子にのみ有意な関係が認められる。(2)自覚的健康度とBMI及び年齢間に有意な関係は認められない。(3)精神的ストレスによる苛立ちが無いことや就寝前に食事をとらないこと,あるいは社会的貢献やそれに伴う身体活動などの生活状況が自覚的健康感に好影響を及ぼす。3.(1)健康状態,日常生活活動及び食生活の各生活状況は複合して基礎体力に影響を及ぼす。(2)運動習慣,過去の病気や怪我による障害の有無,就寝時間及び年齢は基礎体力の低下に大きな影響を及ぼす。(3)基礎体力は加齢に伴い低下するが周1〜2回程度の運動は加齢に伴う体力の低下を遅延させる効果がある。(4)60歳代と70歳代では基礎体力に及ぼす生活諸条件の影響が異なる。また,一般在宅高齢者及び障害を有する施設入居者を対象とし,日常生活動作を評価する調査票の作成を試み,在宅高齢者の日常生活動作と生活諸状況との関係も検討した。<br />The main purpose of this study was to examine various living conditions affecting health and physical fitness in elderly people. Physical fitness performance tests from each physical fitness element, items on perceived health and living conditions were selected considering theoretical validity. Firstly, factorial structures of physique and physical fitness were examined and the examination of the change of physique and physical fitness with age and its sex difference was done. Secondly, based on a cross-sectional data, the relationships between the degree of perceived health (DPH), and physical fitness and living conditions were examined. The relationships of fundamental physical fitness (FPF) and health-conditions, activities of daily living, and food habits also were examined. The findings in this study can be summarized as follow : 1. (1) In physique domain, three factors were interpreted as body linearity, body bulk and body fat respectively. Body bulk and body linearity in both se xes decrease with age. (2) In physical fitness domain, four factors were interpreted as muscular strength, agility of upper and lower limbs, balance and flexibility respectively, and they show a declining trend with age in both sexes. (3) The influence of aging in muscular strength and balance is greater than that in flexibility and agility of upper and lower limbs. 2. (1) Only the relationship between the DPH and flexibility-factor is significant. (2) There are no significant relations between the DPH,and BMI and age. (3) The living conditions as the irritation by the mental stress and eating before asleep or the social contribution and the physical activities have an influence on the DPH.3. (1) The living conditions as health-conditions, activities of daily living and food habits influence on FPF as a composite factor. (2) The elements of exercise habit, the existence of the trouble caused by past disease and injury, bedtime and age have greater influence on the decline of FPF.(3) FPF shows a decreasing trend with age, but the continuous exercise enforcement on one day or more a week, seems to be effective in postponing the decline of FPF related to age. (4) The influence of ech living condition to FPF differs in the 60 and 70 age levels.<br />研究課題/領域番号:08680102, 研究期間(年度):1996–1997, 平成9(1997)年度科学研究費補助金 基盤研究(C) 研究成果報告書の一部 研究概要(はしがき, 概要, 目次, 諸言)を掲載<br />出典：「高齢者の健康・体力に影響を及ぼす生活諸条件の検討」研究成果報告書 課題番号08680102(KAKEN：科学研究費助成事業データベース（国立情報学研究所）) 本文データは著者版報告書より作成
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世代間交流プロジェクト「りぷりんと・ネットワーク」編著
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| 7.
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須釜, 淳子 ; Sugama, Junko
概要:
金沢大学医薬保健研究域保健学系<br />長時間座位保持高齢者にみられる下肢慢性浮腫に対して振動を加えることによる浮腫軽減効果を検証した。特別養護老人ホーム入居中の高齢者を対象とした。介入群には15分／回の加振を1日3回2週間継続した。介入
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群（7名）において浮腫の程度が対照群（7名）と比較して軽減した者は2名、不変の者は4名、増悪した者は1名であった。軽減した2名において他の5名と比べて介入前の浮腫の重症度が高いという特徴がみられた。下腿から足部にかけて皮下組織に組織間液の貯留がみられる圧痕性の明らかな浮腫がある対象において、振動による浮腫軽減効果が得られやすい可能性がある。<br />The present study aimed to clarify the effect of vibration therapy for reducing chronic leg oedema by in chair-bound elderly individuals. Fourteen participants (intervention group, n=7; control group, n=7) completed the study. In intervention group, 2 were in the decreased group, 4 were in the no-changed group and 1 was in the increased group. Those who were in decreased group have more severe oedema at the baseline. No adverse events occurred during the study. These results suggested that vibration therapy might have an effect to reduce the chronic leg oedema in chair-bound elderly.<br />研究課題/領域番号:26670919, 研究期間(年度):2014-04-01 – 2016-03-31
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| 8.
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淺井, 仁 ; Asai, Hitoshi
概要:
座位姿勢は安静座位姿勢と機能的座位姿勢とに分けられる。機能的座位姿勢は、食事動作、書字動作、タイピングなどの机上動作を遂行するための姿勢である。座位姿勢の制御能力は加齢や疾病などによって低下することがある。座位姿勢の制御が困難になると、日常
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生活動作に負の影響が及ぶ。一方で、座位姿勢は立ち上がり動作の開始姿勢でもある。立ち上がり動作は、体幹の安定性と体幹および骨盤を円滑に前傾させるための制御能力とを必要とする。本稿では以下の 3 つのことについて述べる：1 ）高齢者の座位姿勢の特徴、 2 ）座位姿勢における骨盤の可動性の加齢変化、 3 ）片麻痺患者の立ち上がり動作時における骨盤の可動性の重要性。<br />Sitting posture can be divided into resting sitting and functional sitting positions, with the latter being the position used to perform table and desk tasks, such as feeding, writing, and typing.In the elderly, controllability of the sitting position is impaired by aging and related diseases. This functional impairment has negative effects on activities of daily living. On the other hand, the sitting position is the starting position for sit-to-stand movement. Sit-to-stand movement requires stability and controllability of the trunk, especially smooth forward leaning movement of the trunk and the pelvis. This review discusses: 1) the characteristics of the sitting position in the elderly; 2) the effects of aging on mobility of the pelvis in the sitting position; and 3) the importance of pelvic mobility in sit-to-stand movement in patients with hemiplegia.
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| 9.
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真田, 弘美 ; Sanada, Hiromi
概要:
金沢大学医学部<br />目的:高齢者における発生時の褥瘡の形態と褥瘡発生要因との関係、難治性褥瘡の形態的分類とその特徴から見た看護ケアとの関連を明らかにすることを目的とした。対象:褥瘡部の写真を撮る許可を得られ、発生直後から創部を観察でき
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た115名(男性37名、女性78名)で平均年齢±SDは81.4±7.0歳の入院患者である。主な疾患は脳血管障害であった。方法:1.正常治癒過程を辿った褥瘡の実態と形態的に分類、2.難治性の治癒過程を辿った褥瘡の実態と形態的に分類、3.褥瘡の治癒過程と看護ケアの関連から調査した。深度分類にはNPUAP分類を用いた。なお、ここでいう難治性褥瘡とは、1年以上経過していても治癒に至らない褥瘡とした。結果:1.正常治癒過程を辿った褥瘡では、発生部位は仙骨が44部位と最も多かった。深度別では、治癒期間はStageI〜1Vの順に長期間要した。ポケット形成はStageIIIとIVに認め、全周に形成したのはStageIVのみであった。形態的治癒過程をみると、StageIは発赤の色調によって3つに、StageIIは壊死組織の有無によって2つに、StageIIIはポケットの有無によって2つに、StageIV壊死組織の付着方法とポケットの形状によって5つにパターン化された。2.難治性の治癒過程を辿った褥瘡15部位の実態と形態的に分類では、発生部位は仙骨、尾骨、大転子部、坐骨結節であった。治癒遅延の状態として、肉芽の増殖が遅延や、創縁の肥厚・角化・浸軟・緊張があった。形態的には、表皮化、ポケットの治癒、肉芽の増殖から6つにパターン化された。3.褥瘡の治癒過程と看護ケアの関連から分析では、圧、ずれ、清潔、体位変換のケアを介入することで停滞していた治癒が促進し、仙骨部では拘縮があることによって治癒期間が長期化する傾向があった。以上の結果から、創治癒パターン化したことで、新たな褥瘡の治癒分類が導き出され、これを使用することで治癒を予測でき、効果的なケア介入が可能となる。<br />Purpose: We analyzed the morphology of pressure ulcer and the factor influencing the development of pressure ulcer in elderly patients, to clarify the relationship between morphological stage of incurable pressure ulcer and the care management.Objects: Objects were 115 patients (male 37, female 78) who admitted, mainly by cardiovascular diseases in hospital. Mean age and SD was 81.4± 7.0 tear and the informed consent for photographic examination was taken from all patients.Methods: 1. The pressure ulcered cured in standard, course were classified by the region, the stages of ulcer, and morphology. 2. The pressure ulcers which were incurable for more than one year were classified as same manner. 3. The relationship between the curable course of the pressure ulcer and the care management was analyzed. Staging of depth of pressure ulcers was classified by NPIJAP classification. Result: 1 Main region seen in the pressure ulcers that were normally cured in standard course was sacral region (44 patients). Duration for cure was increased with stage of depth. Formation of the pocket was detected in stage II and IV and the pocket surrounding all margins was only found in stage IV. Stage I was categorized into two subgroup by the degree of redness, stage II into two by the presence of necrotic tissue, stage II into three by the presence of pocket formation, and stage IV into five by the condition of attachment of the necrotic tissue and morphology of pocket.The 13 pressure ulcers incurable within one year were found at sacrum, coccyx, major trochanter, and ischial tuberosities. The etiology of prolonged for cure was estimated to be an in sufficient proliferation of granuloma, thickness, maceration, hyperketoratosis and tension at ulcer margin. The ulcer was morphologically categorized into six subgroups by the epithelization, the cure stage of pocket, and the proliferation of granuloma.3. From the analysis of the relationship between curable course of the pressure ulcer and care management, the introduction of care management with improvement of pressure, slipping, cleanness, and the change of position accelerated the cure of pressure ulcer. The curative period of pressure ulcer at sacrum with contraction was tendency to be long.From these results, a new classification in stage of curative pressure ulcer was found by the categorization of pressure ulcer in the curative stage. Using this method, it will be possible to achieve the estimation of cure and the effective care management.<br />研究課題/領域番号:10672236, 研究期間(年度):1998 – 2000<br />出典：「治癒過程に注目した高齢者の褥創の形態と看護ケアとの関係」研究成果報告書 課題番号10672236（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （ https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-10672236/ ）を加工して作成
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| 10.
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石田, 善敬 ; 川筋, 道雄 ; 榊原, 直樹 ; 藤井, 奨 ; 木下, 敬弘 ; 西田, 聡 ; 渡辺, 洋宇 ; Ishida, Yoshinori ; Kawasuji, Michio ; Sakakibara, Naoki ; Fujii, Sho ; Kinoshita, T. ; Nishida, Satoshi ; Watanabe, Yoh
概要:
金沢大学医薬保健研究域医学系<br />A 71-year-old male is presented as ever the oldest patient of tetralogy of Fallot who underwent succ
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essful radical surgery. Heart murmur was pointed out at the age of 10 years. The patient consulted us because of dyspnea and cough, and was noted to have cyanosis and clubbing fingers. Polycythemia was also detected by hemoglobin of 20.8 g/dl and hematocrit of 58.4%, and a low PaO2 of 48.5 mmHg at room temperature was pointed out. Preoperative echocardiography and cardiac catheterization indicated a ventricular septal defect, overriding of the aorta, and right ventricular outflow tract stenosis with a pressure gradient of 115 mmHg between the right ventricle and the main pulmonary artery. Under cardiopulmonary bypass, the ventricular septal defect was closed with a dacron patch and the right ventricular outflow tract was enlarged by a patch of collagen-coated vascular graft with a commissurotomy of the pulmonary valve. Postoperatively, cyanosis disappeared and the pressure gradient was decreased to 26 mmHg.
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