ࢹ࣮ࢱゎᯒ

ᚓࡽࢀࡓ୕ ḟඖᗙᶆ ࢹ࣮ࢱ࠿ࡽ㸪Grood ࡜ Suntay㸦1983㸧ࡀ ᥦၐࡋࡓ㛵⠇ ᗙ ᶆ⣔ࢆ⏝࠸࡚ ⭸㛵⠇ᒅ ᭤ゅᗘ࠾ࡼࡧ እ㌿ゅᗘ 㸪⫤㛵⠇ᒅ᭤ ゅᗘ࠾ࡼ ࡧෆ㌿ゅᗘ

ࢆ⟬ฟࡋࡓ㸬 ࡲࡓ㸪ᗋ ཯ຊࢹ࣮ࢱ࠿ ࡽ㸪㏫ࢲ ࢖ࢼ࣑ࢡࢫࢆ ⏝࠸࡚⭸ 㛵⠇እ㌿ࣔ

࣮࣓ࣥࢺ࠾ࡼ ࡧ⫤㛵⠇ ෆ㌿࣮࣓ࣔࣥ ࢺࢆ⟬ฟ ࡋࡓ㸬㛵⠇ࣔ ࣮࣓ࣥࢺ ࡣ㸪እⓗࣔ

࣮࣓ࣥࢺ࡜ࡋ ࡚ィ⟬ࡋ ࡓ㸬ྛ㛵 ⠇࣮࣓ࣔ ࣥࢺ ࡣᑐ㇟⪅ࡢ㌟ 㛗࡜య㔜 ࡢ✚࡛㝖ࡋ 㸪 ṇつ໬ࡋࡓ㸬 ゎᯒ⠊ᅖ ࡣᗋ཯ຊィ࠿ ࡽᚓࡽࢀ ࡓࢹ࣮ࢱ࠿ࡽ 㸪㊊㒊ࡢ ୍㒊ࡀᗋ࡟

ᅗ 3-2 㸦a㸧 ࢝ ࣓ ࣛ タ ⨨ ఩ ⨨ ࡜ 㸦b㸧 ࣐ ࣮ ࢝ ࣮ ㈞ ௜ ఩ ⨨

㸦a㸧 㸦b㸧

86

᥋ᆅࡋࡓ᫬Ⅼ㸦initial contact㸸௨ୗ㸪IC㸧࠿ ࡽ ࡘࡲඛࡀᗋ࠿ ࡽ㞳ࢀࡓ ᫬Ⅼ㸦toe off㸸 ௨ୗ㸪TO㸧ࡲ࡛࡜ࡋ 㸪ࡇࡢᮇ㛫ࢆ Landing phase ࡜ࡋࡓ㸬ࣃ ࣓ࣛ ࣮ࢱࡣ㸪࢟ࢿ

࣐ࢸ࢕ࢡࢫ࡟ ࠾࠸࡚ࡣ 㸪Landing phase ࡢ඲᫬ 㛫ࢆ 100㸣࡜ࡋࡓሙྜ ࡢ㸪IC ᫬࠿

ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ ࡳࡽࢀࡓ ᭱኱⭸㛵⠇ᒅ ᭤ゅᗘ࠾ ࡼࡧ᭱኱⭸

㛵⠇እ㌿ゅᗘ 㸪᭱኱⫤ 㛵⠇ᒅ᭤ゅᗘ ࠾ࡼࡧ᭱ ኱⫤㛵⠇ෆ㌿ ゅᗘ࡜ࡋ 㸪࢟ࢿࢸ࢕

ࢡࢫ࡟࠾࠸࡚ ࡣ㸪IC ᫬࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ ࡳ ࡽࢀࡓ᭱኱⭸㛵

⠇ እ ㌿ ࣔ ࣮ ࣓ ࣥ ࢺ ࠾ ࡼ ࡧ ᭱ ኱ ⫤ 㛵 ⠇ ෆ ㌿ ࣔ ࣮ ࣓ ࣥ ࢺ ࡜ ࡋ ࡓ 㸬 ᑦ 㸪IC ᫬ ࠿ ࡽ

Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ࡳ ࡽࢀࡓ ྛ 㡯ࡢ᭱኱್ࢆ ࣃ࣓ࣛ ࣮ ࢱ࡜ࡋࡓ⌮

⏤ࡣ㸪㖄┤᪉ ྥ࡬ࡢ᭱ ኱ᗋ཯ຊࡢࣆ ࣮ࢡ ࡀ IC ᫬ᚋ㸪Landing phase ࡢ30㸣᫬Ⅼ

ࡲ࡛࡟ࡳࡽࢀ ࡓࡇ࡜㸪 ࡲࡓ㸪ᐇ㝿ࡢ ACLയᐖࡀ IC ᫬ᚋ ࡟ࡳࡽࢀ ࡿ᭱኱ᗋ཯ຊ ࡢ ࣆ ࣮ ࢡ ௜ ㏆ ࡛ Ⓨ ⏕ ࡋ ࡚ ࠸ ࡿ ࡇ ࡜ ࡀ ከ ᩘ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ Ⅽ ࡛ ࠶ ࡿ[Koga et al.,

2010;㸪Krosshaug et al., 2007]㸬⤫ィᏛⓗゎᯒ ࡣྛヨ⾜᮲௳ 㛫࡟࠾࠸ ୍࡚ඖ㓄⨨

ศᩓศ ᯒࢆ ⏝࠸㸪 ᭷ព ᕪࡢᚓ ࡽࢀ ࡓ 㡯┠ ࡟ᑐ ࡋ㸪Bonferroni ἲࢆ⏝ ࠸ ࡚ከ 㔜ẚ

㍑᳨ᐃࢆ⾜ࡗ ࡓ㸬 ࡞࠾ 㸪᭷ពỈ‽ ࡣ5㸣ᮍ‶ ࡜ࡋࡓ㸬

4-3-3. ⤖ᯝ

NH㸪RH㸪RHTྛヨ⾜ ᮲௳࡟࠾ࡅ ࡿ IC᫬ࡢ ඲ᑐ㇟⪅ࡢ඲ ヨᢏࡢ ᖹ ᆒ⭸㛵⠇ᒅ

᭤ゅᗘ࠾ࡼࡧ ⭸㛵⠇እ ㌿ゅᗘ㸪⫤㛵⠇ᒅ ᭤ゅ ᗘ࠾ࡼࡧ⫤㛵 ⠇ෆ㌿ゅ ᗘ 㸪IC ᫬࠿

ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛ࡢ ᭱኱⭸㛵 ⠇ᒅ᭤ゅᗘ࠾ ࡼࡧ᭱኱ ⭸㛵⠇እ㌿

ゅᗘ㸪᭱኱⫤ 㛵⠇ᒅ᭤ ゅᗘ࠾ࡼࡧ᭱ ኱⫤㛵⠇ ෆ㌿ゅᗘ㸪᭱ ኱⭸㛵⠇ እ㌿࣮࣓ࣔ

ࣥࢺ࠾ࡼࡧ᭱ ኱⫤㛵⠇ ෆ㌿࣮࣓ࣔࣥ ࢺࢆ⾲ 3-1 ࡟♧ ࡍ㸬ࡲࡓ 㸪 ྛ ヨ⾜᮲௳࡟࠾

ࡅࡿLanding phase ࡢ඲ᑐ㇟⪅ࡢ඲ ヨᢏࡢᖹ ᆒ⭸㛵⠇ᒅ᭤࣭ఙᒎゅ ᗘ࠾ࡼࡧ ᖹᆒ

⭸㛵⠇ෆ㌿࣭ እ㌿ゅᗘ 㸪 ᖹᆒ⫤㛵⠇ ᒅ᭤ ࣭ఙ ᒎゅᗘ࠾ࡼࡧ ᖹᆒ ⫤㛵 ⠇ෆ㌿࣭እ

㌿ゅᗘ㸪ᖹᆒ ⭸㛵⠇እ ㌿ ࣭ෆ㌿࣮ࣔ ࣓ࣥࢺ 㸪 ᖹᆒ⫤㛵⠇ෆ ㌿࣭እ㌿ ࣮࣓ࣔࣥࢺ ࡢ᫬⣔ิኚ໬ ࢆᅗ 3-3 ࡟♧ࡋࡓ㸬᭷ ពᕪࡀㄆ ࡵࡽࢀࡓ ヨ⾜ ᮲௳㛫ࡢ ࣃ࣓࣮ࣛࢱ

ࡣ㸪IC ᫬࠿ࡽ Landing phase ࡢ 30%᫬Ⅼࡲ ࡛ࡢ᭱኱⭸㛵 ⠇ᒅ᭤ゅ ᗘ࡟࠾࠸࡚ 㸪

RHTࡣRH ࡜ẚ ࡭࡚᭷ ព࡟ῶᑡࡋࡓ㸦p < 0.05㸧㸬ࡑࡢ௚ࡢヨ ⾜᮲ ௳㛫࡟࠾ࡅࡿ

ྛࣃ࣓࣮ࣛࢱ ࡢẚ㍑࡟ ࠾࠸࡚᭷ពᕪ ࡣࡳࡽࢀ ࡞࠿ࡗࡓ㸬

87

88

(a)

(b)

(c)

(d)

89

4-3-4. ⪃ᐹ

ᮏ◊✲ࡣ㸪ዪ Ꮚࣛࢡࣟ ࢫ㑅ᡭࢆᑐ㇟ ࡜ࡋ࡚㸪 ࣛࢡࣟࢫࡢ➇ ᢏ≉Ṧᛶ ࡢ 1ࡘ࡛

࠶ ࡿ ࢫࢸ ࢕ ࢵ ࢡ ࡸ ┠ ᶆ ≀ ࡢ ᭷↓ ࡛ ࡢ ᮲ ௳ ୗ ࡛ DVJ ࢆ ⾜ ࢃ ࡏ ࡓ࡜ ࡁ ࡢ ୗ⫥ ࢟ ࢿ

࣐ࢸ࢕ࢡࢫ࣭ ࢟ࢿࢸ࢕ ࢡࢫ࡟ཬࡰࡍ ᙳ㡪࡟ࡘ ࠸࡚ẚ㍑᳨ウ ࡍࡿࡇ࡜ ࢆ ┠ⓗ࡜ࡋ

࡚⾜࠸㸪ᚓࡽ ࢀࡓ⤖ᯝ ࡣ᭱኱⭸㛵⠇ ᒅ᭤ゅᗘ ࡟࠾࠸࡚㸪ࢫ ࢸ࢕ࢵࢡ ಖᣢ࠶ࡾ࡟

┠ᶆ≀ࢆຍ࠼ ࡓ᮲௳ࡣ 㸪┠ᶆ≀ࡀ↓ ࠸ሙྜࡢ ᮲௳࡜ẚ㍑ࡋ ᭷ព࡟ῶ ᑡ ࡋࡓ㸬ඛ

⾜◊✲࠿ࡽ 㸪ዪᛶ ࢔ࢫ ࣮ࣜࢺࡣ⏨ᛶ ࢔ࢫ࣮ࣜ ࢺ࡟ẚ࡭ 㸪DVJ ືస᫬ࡢ⭸㛵⠇እ

㌿ゅᗘ࠾ࡼࡧ ⫤㛵⠇ෆ ㌿ゅᗘࡀ኱ࡁ ࡃ㸪⭸㛵 ⠇ᒅ᭤ゅᗘࡀ ᑠࡉ࠸࡜ ࠸ࡗࡓୗ⫥

࢔ࣛ࢖࣓ࣥࢺ ࢆ♧ࡋ㸪 ࡑࢀࡽࡢ≉ᚩ ⓗ࡞ືⓗ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺࡀዪ ᛶ࢔ࢫ࣮ࣜ

ࢺࡢACL യᐖ せᅉࡢ ୍ࡘ࡛࠶ࡿࡇ ࡜ࡀ」ᩘ ሗ࿌ࡉࢀ࡚࠸ ࡿ[Hewett et al., 2006;

Renstrom et al., 2008]㸬ࡑࡢ࡯ ࠿ Deckerࡽ㸦2003㸧ࡣ㸪ࢻࣟࢵࣉ ࣛࣥࢹ࢕ࣥࢢ

(e)

(f)

90

࡟࠾࠸࡚ዪᛶ ࡣ⏨ᛶ࡟ ẚ࡭㸪⭸㛵⠇ ᒅ᭤ゅᗘ ࡀ᭷ព࡟ῶᑡ ࡋ࡚࠸ࡓ ࡇ࡜ࢆሗ࿌

ࡋ㸪Yuࡽ㸦2005㸧ࡣ㸪ࢫࢺࢵࣉࢪࣕ ࣥࣉࢱࢫ ࢡ࡟࠾࠸࡚ ዪ ᛶࡢ᭱኱ ⭸㛵⠇ᒅ᭤

ゅᗘࡀ᭷ព࡟ ῶᑡࡋࡓ ࡇ࡜ࢆሗ࿌ࡋ ࡚࠸ࡿ㸬DVJࢸࢫࢺ࡛ᚓࡽࢀ ࡓ ⭸㛵⠇࢟ࢿ

࣐ࢸ࢕ࢡࢫ࠾ ࡼࡧ࢟ࢿ ࢸ࢕ࢡࢫࡢࢹ ࣮ࢱࢆ࣋ ࣮ࢫࣛ࢖ࣥ࡜ ࡋ࡚⏝࠸ 㸪ACL യᐖ

⩌࡜ẚയᐖ⩌ ࢆẚ㍑᳨ ドࡋࡓ๓ྥࡁ ◊✲[Hewett et al., 2005]࠿ࡽࡣ㸪ACL യᐖ

⩌ࡣ㠀യᐖ⩌ ࡟ẚ࡭᭷ ព࡟⭸㛵⠇እ ཯ゅᗘࡀ ኱ࡁ࠿ࡗࡓ࡯ ࠿㸪▮≧ 㠃࠿ࡽࡳࡓ

᭱኱⭸㛵⠇ᒅ ᭤ゅᗘ ࡀ ᭷ព࡟ᑠࡉ࠿ ࡗࡓࡇ࡜ ࡀ♧ࡉࢀࡓ[Hewett et al., 2005]㸬ࡲ

ࡓ Nunley ࡽ㸦2003㸧 ࡣ㸪X ⥺ࢆ⏝࠸ࡓゎ๗ ᏛⓗほⅬ࠿ࡽ ⏨ዪࡢ ACL യᐖࣜࢫ

ࢡࢆ᳨ドࡋࡓ ࡜ࡇࢁ㸪 ྠࡌ⭸㛵⠇ᒅ ᭤ゅᗘ࡛ ࡢ኱⭣ᅄ㢌➽ ཰⦰࡟ࡼ ࡿ⬯㦵๓᪉

๧᩿ຊࡣ㸪ዪᛶ ࡣ⏨ᛶ ࡟ẚ࡭࡚኱ࡁ ࡃ㸪ACL࡬ࡢఙᙇࢫࢺ ࣞࢫࡀࡼ ࡾ㧗ࡲࡿࡇ

࡜ࢆሗ࿌ࡋ࡚ ࠸ࡿ㸬

ࢫࢸ࢕ࢵࢡಖ ᣢ࠶ࡾ࡛ ┠ᶆ≀࠶ࡾ࣭ ࡞ࡋࡢ᮲ ௳ୗࡢືసẚ ㍑࡟࠾࠸ ࡚㸪ࢫࢸ

࢕ࢵࢡಖᣢ࠶ ࡾ࡛┠ᶆ ≀࡞ࡋࡢືస ࡣ㸪╔ᆅ ࠿ࡽࢪࣕࣥࣉ ࡜࠸ࡗࡓ ẚ㍑ⓗ༢⣧

࡞ືసࢆ㐙⾜ ࡋࡼ࠺࡜ ࡍࡿព㆑ࡢࡳ ࡛⾜࠼ࡿ ࡀ㸪ࢫࢸ࢕ࢵ ࢡ ಖᣢ࠶ ࡾ࡛┠ᶆ≀

࠶ࡾࡢືసࡣ 㸪╔ᆅ࠿ ࡽࢪࣕࣥࣉ࡟ ࠿ࡅ࡚┠ ᶆ≀ࡀ࠶ࡿࡇ ࡜࡟ࡼࡾ 㸪ࡑࡢ┠ᶆ

≀࡟ྥ࠿ࡗ࡚ ࡼࡾ㧗ࡃ 㣕ࡰ࠺࡜ࡍࡿ ព㆑࠾ࡼ ࡧ┠⥺ࢆࡼࡾ 㧗ࡃಖᣢ ࡉࡏࡼ࠺࡜

ࡍࡿព㆑ࡀᙉ ࡃാࡁ㸪 ୗ⫥㸪≉࡟⭸ 㛵⠇ࡢᒅ ᭤ゅᗘࢆࡼࡾ ኱ࡁࡃࡉ ࡏ࡚㧗ࡃ㣕 ࡪ࡜࠸ࡗࡓព ㆑ࡀᙅࡃ ࡞ࡿࡇ࡜࡛㸪 ⤖ᯝ⭸㛵 ⠇ᒅ᭤ゅᗘࡢ ῶᑡ࡟ࡘ ࡞ࡀࡗࡓࡢ

࡛ࡣ࡞࠸࠿࡜ ⪃࠼ࡓ㸬 ᭷ពᕪࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓࡀ㸪⫤㛵⠇ ᒅ᭤ゅᗘ ࡟࠾࠸࡚ࡶ

RHTࡣ RH ࠾ ࡼࡧ NH ࡜ẚ࡭ᑠࡉ࠸ ഴྥࢆ♧ ࡋ࡚࠸ࡓ㸦 ᅗ 3-3 (b)㸪⾲ 3-1㸧㸬 ඛ⾜◊✲࠿ࡽ 㸪ᐇ㝿 ࡢ ➇ᢏ୰࡟Ⓨ⏕ ࡋࡓ ACLയᐖ᫬ࡢࣅ ࢹ࢜⏬ീ ࢆ㐃⥆ࡋ࡚ゎ ᯒࡋࡓࢹ࣮ࢱ ࡟ࡼࡿ࡜ 㸪⭸㛵⠇㍍ᗘ ᒅ᭤఩ࡀ 㐃⥆ࡋ࡚ࡳࡽ ࢀ࡚࠸ࡓ ࡇ࡜ࡀሗ࿌

ࡉࢀ࡚࠸ࡿ[Boden et al., 2009]㸬ࡇࢀࡽࡢ ඛ ⾜◊✲࠿ࡽ ࡶ ACL യ ᐖせᅉࡢ୍ࡘ

࡟╔ᆅືస୰ ࡢ⭸㛵⠇ ᒅ᭤ゅᗘࡀᑠ ࡉ࠸ࡇ࡜ ࡀ♧ࡉࢀ࡚࠸ ࡿࡀ㸪ᮏ ◊✲࡟࠾࠸

࡚ࡶ IC᫬࠿ࡽ᭱ ኱⭸ 㛵⠇ᒅ᭤ゅᗘ ࡟㐩ࡍࡿ ࡲ࡛ࡢᖹᆒ⭸ 㛵⠇ᒅ᭤ ゅᗘࡣ㸪RHT ࡣRH࠾ࡼ ࡧ NH࡟ ẚ ࡭ప್ࡢഴྥ ࢆ♧ࡋ࡚ ࠸ࡓ㸦ᅗ 3-3 (a)㸧㸬ᮏ◊✲࡛⟬ฟ ࡉࢀࡓ್࡟ࡘ ࠸࡚㸪RHT ࡜ RH ࡢ᭱኱ᖹ ᆒ ⭸㛵⠇ᒅ᭤ゅ ᗘࡢᕪ ࡣ 3.8r࡛࠶ࡗ ࡓࡀ㸪࠸ࡎ ࢀࡢඛ⾜ ㄽ ᩥ࠿ࡽ ࡶ ACLയᐖ⩌ ࡜ࢥࣥࢺ࣮ࣟ ࣝ⩌࡜ࢆ ẚ㍑ࡋࡓሙྜ

ࡢࣛࣥ ࢹ࢕ࣥ ࢢ᫬ ࡢ ⭸ 㛵⠇ᒅ ᭤ゅᗘ ࡢᑠࡀ ACL യᐖ ࣜࢫࢡ ࡜࡞ ࡿࡇ࡜ ࡀከᩘ

91

ሗ࿌ࡉࢀ࡚࠾ ࡾ㸪⌧ ሙ ᣦᑟ࡟࠾࠸࡚ ࡣACL യᐖண㜵ࡢⅭ ࡟⭸㛵⠇ ᒅ᭤ゅᗘ࡟╔

┠ࡋࡓᣦᑟࡀ 㔜せ࡛࠶ ࡿ࡜⪃࠼ࡿ㸬 㧗ࡃୖࡀ ࡗࡓ࣮࣎ࣝࢆ ࢫࢸ࢕ࢵ ࢡࢆ୧ᡭ࡛

ಖᣢࡋࡓ≧ែ ࡛ࢪࣕࣥ ࣉࡋ࡚࢟ࣕࢵ ࢳ࡟⾜ࡃ ࡜࠸ࡗࡓᒁ㠃 ࡣ㸪ᐇ㝿 ࡢ➇ᢏሙ 㠃

࡛ࡶከࡃࡳࡽ ࢀ㸪௒ᅇ ࡢᐇ㦂࡛⾜ࡗ ࡓኳ஭࡟ ྞࡋࡓ࣮࣎ࣝ ࢆ┠ᶆ≀ ࡜ࡋ࡚タᐃ ࡋ㸪ࢫࢸ࢕ࢵ ࢡࢆಖᣢ ࡉࡏࡓ≧ែ࡛ ࡑࡢ┠ᶆ ≀࡟ྥ࠿ࡗ࡚ ࡼࡾ㧗ࡃ ࢪࣕࣥࣉࡉ ࡏࡿ࡜࠸ࡗࡓ ືసᵝᘧ ࡣ㸪➇ᢏ≉Ṧ ᛶࢆ⪃៖ ࡋࡓ ୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࢆホ౯ࡍࡿ

ࡓࡵࡢㄢ㢟ື సࡢ୍ࡘ ࡟࡞ࡾ࠺ࡿྍ ⬟ᛶࡀ♧ ၀ࡉࢀࡓ㸬௒ ᅇࡢᐇ㦂 ࡟࠾࠸࡚㸪 ࢫࢸ࢕ࢵࢡಖ ᣢ࠶ࡾ࡛ ┠ᶆ≀࠶ࡾ࣭ ࡞ࡋࡢ᮲ ௳㛫࠿ࡽ㸪▮ ≧㠃࡟࠾ ࡅࡿ⭸㛵⠇

࡬ࡢᙳ㡪ࡀㄆ ࡵࡽࢀࡓ 㸬ACLയᐖண㜵ࡢࡓࡵ ࡢࢫࢡ࣮ࣜࢽ ࣥࢢ࡜ࡋ ࡚㏻ᖖ⏝࠸

ࡽࢀ࡚࠸ ࡿ DVJ ࢸࢫࢺ࡟ຍ࠼ 㸪ࣛࢡࣟ ࢫࡢ ➇ᢏ≉Ṧᛶ࡟ ᛂࡌࡓື సᵝᘧ࡛⾜ࢃ

ࡏࡿࡇ࡜㸪ࡍ ࡞ࢃࡕࢫ ࢸ࢕ࢵࢡࢆ୧ ᡭ࡛ಖᣢ ࡉࡏࡓ᮲௳࡟ ຍ࠼㸪┠ ᶆ≀ࢆຍ࠼

ࡓ᮲௳࡛⾜ࢃ ࡏࡿࡇ࡜ ࡀືⓗୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺࢆホ౯ࡍࡿ ୍ࡘࡢᣦ ᶆ࡜࡞ࡾ㸪 ACLࢆྵࡵࡓୗ⫥ യ ᐖࣜࢫࢡࢆ᳨ ウࡍࡿ୍ ຓ࡜࡞ࡿྍ⬟ ᛶࡀ♧ࡉ ࢀ ࡓ㸬ᮏ◊✲

ࡢ㝈⏺ࡣ㸪ẚ ㍑ᑐ㇟⪅ ᩘࡀᑡ࡞࠸ࡇ ࡜࡟࠶ࡿ 㸬ඛ⾜ ㄽᩥ࠿ ࡽࡶ ሗ࿌ ࡉࢀ࡚࠸ࡿ

ࡼ࠺࡟[Pollard et al., 1994]㸪ୗ⫥㛵⠇ゅ ᗘ ࡢ೫఩ࡣಶே ᕪࡀ኱ࡁ ࡃ㸪ᖹᆒ໬ࡉ

ࢀࡓ್࠿ࡽࡑ ࢀࡽࡢഴ ྥࢆ❧ドࡍࡿ ࡟ࡣ㸪ࡉ ࡽ࡟ᑐ㇟⪅ᩘ ࢆቑࡸࡋ ᳨࡚ウࡍࡿ

ᚲせࡀ࠶ࡿ㸬

4-3-5. ⤖ㄒ

኱ᏛዪᏊࣛࢡ ࣟࢫ㑅ᡭ ࢆᑐ㇟࡜ࡋ㸪 ࣛࢡࣟࢫ ࢫࢸ࢕ࢵࢡࡢ ಖᣢࡸ᧯ సࡀ ࢻࣟ

ࢵࣉࣂ࣮ࢸ࢕ ࢝ࣝ ࢪࣕ ࣥࣉືస᫬ࡢ ୗ⫥࢟ࢿ ࣐ࢸ࢕ࢡࢫ࣭ ࢟ࢿࢸ࢕ ࢡࢫ࡟ཬࡰ

ࡍᙳ㡪࡟ࡘ࠸ ࡚ẚ㍑᳨ ウࡋ㸪 ╔ᆅ᫬ ࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ࡳࡽ

ࢀࡓ᭱኱⭸㛵 ⠇ᒅ᭤ゅ ᗘ࡟࠾࠸࡚㸪 ࢫࢸ࢕ࢵ ࢡಖ᫬࠶ࡾ࡟ ┠ᶆ≀ࢆ ຍ࠼ࡓ᮲௳

ࡣ㸪┠ᶆ≀ࡀ ࡞࠸ሙྜ ࡢ᮲௳࡜ẚ㍑ ࡋ᭷ព࡟ ῶᑡࡉࡏࡓ㸬 ዪᏊࣛࢡ ࣟࢫ㑅ᡭࢆ

ᑐ㇟࡜ࡋ ࡓ ACLയᐖ ண㜵ࡢࡓࡵࡢ ࢫࢡ࣮ࣜ ࢽࣥࢢ࡜ࡋ࡚ 㸪ࢫࢸ ࢕ ࢵࢡࢆಖᣢࡉ ࡏ㸪ࡉࡽ࡟ࡣ ┠ᶆ≀ࢆ ຍ࠼ࡓ᮲௳ୗ ࡛ࡢࢻࣟ ࢵࣉ ࣂ࣮ࢸ࢕ ࢝ࣝ ࢪࣕ ࣥࣉࢸࢫࢺ ࡣ㸪ACLࢆྵࡵࡓୗ⫥ യᐖࣜࢫࢡࢆ ᳨ウࡍ ࡿ ࡓࡵࡢ୍ຓ࡜ ࡞ࡿྍ⬟ ᛶࡀ♧၀ࡉ

ࢀࡓ㸬

92

◊

◊ ✲ 4 ࣛࢡ ࣟࢫ ࢫ ࢸ ࢕ࢵ ࢡࡢ ಖ ᣢࡢ ᭷↓ ࡀ ࢝ࢵ ࢸ࢕ ࣥ ࢢື స᫬ ࡢ ୗ⫥ ࢟ࢿ ࣐ ࢸ࢕ ࢡࢫ ࣭ ࢟ࢿ ࢸ࢕ ࢡ ࢫ࡟ ཬࡰ ࡍ ᙳ㡪

4-4-1. ⥴ゝ

ዪᏊࣛࢡࣟࢫ ࡢ⭸๓༑ Ꮠ㠌ᖏ㸦anterior cruciate ligament㸸௨ୗ 㸪ACL㸧യᐖⓎ

⏕⋡ࡣ㸪NCAA㸦National Collegiate Athletic Association㸪඲⡿኱ Ꮫ య⫱༠఍ 㸧ࡢ ሗ࿌࡟ࡼࡿ࡜ 㸪ẚ㍑ⓗ 㧗࠸ࡇ࡜ࡀ࠺ ࠿ࡀ࠼ࡿ[Hootman et al., 2007]㸬ࣛࢡࣟࢫࡣ 㸪 ࢫࢸ࢕ࢵࢡ㸦 ࢡࣟࢫ㸧 ࢆ୧ᡭ࡛ಖᣢ ࡋ ࡓ≧ែ ࡛࢝ࢵࢸ࢕ࣥ ࢢࡸࢪࣕ ࣥࣉືసࢆ

⾜࠺Ⅼࡀ➇ᢏ ≉Ṧᛶ ࡜ ࡋ࡚ᣲࡆࡽࢀ ࡿ㸬

ACLയᐖࡢ୺࡞Ⓨ ⏕ ᶵ㌿࡛࠶ࡿ ࢝ ࢵࢸ࢕ࣥ ࢢືస ࡟ࡘ࠸ ࡚㸪ࡑࡢ യᐖ࣓࢝ࢽ ࢬ࣒ࢆゎ᫂ࡍ ࡿࡓࡵࡢ ᡭἲࡢ୍ࡘ࡟ 㸪ືస୰ ࡟ࡳࡽࢀࡿୗ ⫥࢟ࢿ࣐ ࢸ࢕ࢡࢫ࣭

࢟ࢿࢸ࢕ࢡࢫ ࢆศᯒࡍ ࡿ࡜࠸ࡗࡓࣂ ࢖࣓࢜࢝ ࢽࢡࢫⓗᡭἲ ࡀ⏝࠸ࡽ ࢀ࡚࠸ࡿ㸬

౛࠼ࡤᐇ㦂ᐊ ෆ࡛⾜ ࢃ ࢀ࡚࠸ࡿᩘ࣓ ࣮ࢺࣝࡢ ຓ㉮࠿ࡽࡢ᪉ ྥ㌿᥮㉮ ➼࡛࠶ࡿ㸬

௒᪥㸪ࡑࢀࡽ ࡢㄢ㢟ື సࢆ⾜ࢃࡏࡓ ᫬ࡢ ⭸ࡸ ⫤㛵⠇ࡢ㛵⠇ ゅᗘࡸ 㛵 ⠇࣮࣓ࣔࣥ

ࢺࢆ⏨ዪ࡛ẚ ㍑ࡋࡓ࡜ ࡇࢁ㸪⏨ᛶ࡟ ẚ࡭࡚ ዪ ᛶࡢ⭸㛵⠇እ ㌿ゅᗘࡸ ⫤㛵⠇ෆ㌿

ゅᗘࡀ኱ࡁ࠸ ࡇ࡜㸪⭸ 㛵⠇እ㌿࣮ࣔ ࣓ࣥࢺࡸ ⫤㛵⠇ෆ㌿ࣔ ࣮࣓ࣥࢺ ࡀ ኱ࡁ࠸ࡇ

࡜ࡀሗ࿌ࡉࢀ ࡚࠾ࡾ 㸪ࡑࢀࡽ ࡀ ACLയᐖ࣓ ࢝ࢽࢬ࣒ࡢ୍ ࡘ࡛࠶ࡿ ࡜࠸࠺ぢゎ ࡛

୍⮴ࡋ࡚࠸ࡿ[Quatman and Hewett, 2009; Hewett et al., 2006]㸬࢝ࢵ ࢸ࢕ࣥࢢືస

ࢆㄢ㢟ືస࡟ タᐃࡋ࡚ ⾜ࢃࡏࡓ᫬ࡢ ⏨ዪࡢୗ ⫥࢟ࢿ࣐ࢸ࢕ ࢡࢫ࣭࢟ ࢿࢸ࢕ࢡࢫ ࡢẚ㍑࡟ࡘ࠸ ࡚㸪⭸㛵 ⠇࡟㛵ࡋ࡚ࡣ 㸪Malinzakࡽ㸦2001㸧㸪McLean ࡽ㸦2004㸧㸪 Fordࡽ㸦2003㸧࡟ࡼࡿ ࡜ 㸪ዪᛶ ࡣ⏨ᛶ࡟ ẚ࡭ ࡚⭸ 㛵⠇እ㌿ ゅᗘࡀ኱ ࡁࡃ㸪McLean

ࡽ㸦2005㸧࡟ࡼࡿ࡜ዪ ᛶࡣ⏨ᛶ࡟ẚ ࡭࡚⭸ 㛵 ⠇እ㌿࣮࣓ࣔ ࣥࢺࡀ ኱ ࡁ࠸ࡇ࡜ࡀ ሗ࿌ࡉࢀ࡚࠸ ࡿ㸬ࡲࡓ 㸪⫤㛵⠇࡟㛵ࡋ ࡚ࡣ㸪Pollardࡽ㸦2007㸧࡟ࡼࡿ࡜㸪ዪᛶ ࡣ ⏨ ᛶ ࡟ ẚ ࡭ ࡚ ⫤ 㛵 ⠇ ෆ ᪕ ゅ ᗘ ࡀ ኱ ࡁ ࠿ ࡗ ࡓ ࡇ ࡜ ࢆ ♧ ࡋ ࡓ ࡯ ࠿ 㸪Pollard ࡽ 㸦2004㸧ࡣ㸪⏨ዪ࡜ࡶ ࡟⫤㛵⠇እ㌿ ⫥఩ࢆ♧ ࡋࡓࡀ㸪ዪᛶ ࡣ⏨ᛶ࡟ ẚ࡭࡚ࡼࡾ

ෆ㌿᪉ ྥ࡬ ࡢືࡁ ࢆ♧ ࡋ࡚࠸ ࡓࡇ ࡜ࢆሗ ࿌ࡋ ࡓ㸬ࡲ ࡓ㸪Pollard ࡽ 㸦2007㸧ࡣ 㸪 ዪᛶࡣ⏨ᛶ࡟ ẚ࡭࡚⫤ 㛵⠇ෆ㌿࣮ࣔ ࣓ࣥࢺࡀ ኱ࡁ࠿ࡗࡓࡇ ࡜ࢆሗ࿌ ࡋ࡚࠸ࡿ㸬 ࡇࢀࡽࡢሗ࿌ ࠿ࡽ ዪᛶ ࡣ⏨ᛶ࡟ẚ࡭ 㸪࢝ࢵࢸ ࢕ࣥࢢືస᫬ ࡢ⭸㛵⠇ እ㌿ゅᗘࡸ

⫤㛵⠇ෆ᪕ゅ ᗘ㸪⭸㛵 ⠇እ㌿࣮࣓ࣔ ࣥࢺ ࡸ⫤ 㛵⠇ෆ㌿࣮ࣔ ࣓ࣥࢺࡀ ኱ࡁ࠸࡯࠿ 㸪

93

⫤㛵⠇ෆ㌿᪉ ྥ࡬ࡢ ື సഴྥࢆ♧ࡍ ࡜࠸ࡗࡓ ≉ᚩࡀࡳࡽࢀ ࡚࠸ࡿ㸬 ࡋ࠿ࡋ࡞ࡀ

ࡽ௒᪥ࡲ࡛⾜ ࢃࢀ࡚ࡁ ࡓືసᐇ㦂ࡣ 㸪ᛶᕪࡢ 㐪࠸ࢆ᳨ウࡍ ࡿ┠ⓗ࡛ 㸪ẚ㍑ⓗ༢

⣧࡞ㄢ㢟ືస ࢆ⾜ࢃࡏ ࡓୖ࡛ࡢẚ㍑ ᳨ドࡀ⾜ ࢃࢀ࡚࠸ࡿ㸬 ࡑࡇ࡛➹ ⪅ࡽࡣ ዪᛶ

࡟↔Ⅼࢆ࠶࡚㸪ACLയ ᐖ㢖ᗘࡀ㧗࠸ ➇ᢏࢆᑐ ㇟࡜ࡋ࡚㸪➇ᢏ ≉Ṧᛶ ࡀ⪃៖ࡉࢀ

ࡓືసᵝᘧࢆ ⏝࠸ࡓ᳨ ドࡀ ᚲせ࡛࠶ ࡿ࡜⪃࠼ ࡓ㸬 ྛ➇ᢏ࡛ ⾜ࢃࢀ࡚ ࠸ࡿ ࢝ࢵࢸ

࢕ࣥࢢࡸࢪࣕ ࣥࣉືస ࢆ 㸪➇ᢏ≉Ṧ ᛶࡀ⪃៖ ࡉࢀࡓືసᵝ ᘧ࡟タᐃ ࡋ ࡚⾜ࢃࡏ ࡓ᫬ࡢືసศ ᯒ࡟ࡼࡾ 㸪 ➇ᢏู࡟ࡳ ࡓയᐖⓎ ⏕࣓࢝ࢽࢬ࣒ ࡀゎ࡛᫂ ࡁࡿࡢ࡛ࡣ

࡞࠸࠿࡜࠸࠺ ࡶࡢ࡛࠶ ࡿ㸬 ᮏ◊✲࡟ ඛ❧ࡕ㸪 ➹⪅ࡽࡣ኱Ꮫ ⏕ዪᏊࣛ ࢡࣟࢫࢆᑐ

㇟࡟㸪ࢻࣟࢵ ࣉࣂ࣮ࢸ ࢕࢝ࣝ ࢪࣕࣥ ࣉ᫬࡟࠾ ࡅࡿࣛࢡࣟࢫ ࢫࢸ࢕ࢵ ࢡࡢಖᣢࡸ

᧯సࡀୗ⫥࢟ ࢿ࣐ࢸ࢕ ࢡࢫ࣭࢟ࢿࢸ࢕ ࢡࢫ࡟ ཬࡰࡍᙳ㡪 ࡟ ࡘ࠸࡚ሗ ࿌ࡋ[బ㔝ᮧ

ࡽ, 2012-2]㸪ࣛࢡࣟࢫ ࢫࢸ࢕ࢵ ࢡࢆಖ ᣢࡉࡏ ࡓ≧ែ࡛ ࡢࢻࣟ ࢵࣉ ࣂ ࣮ࢸ࢕࢝ ࣝ ࢪࣕࣥࣉືస ࡛㸪┠ᶆ ≀ࢆຍ࠼࡚⾜ ࢃࡏࡓ᫬ ࡣ┠ᶆ≀ࡢ࡞ ࠸᫬ ࡜ẚ ࡭㸪⭸㛵⠇

ᒅ᭤ゅᗘࡀ᭷ ព࡟ῶᑡ ࡋࡓ࡜⤖ㄽ࡙ ࡅ࡚࠸ࡿ 㸬ᮏ◊✲ࡣ㸪ዪᏊ ࣛࢡ ࣟࢫ ࡢACL യᐖ࣓࢝ࢽࢬ ࣒࡟ࡘ࠸ ᳨࡚ド ࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ࡚㸪኱Ꮫ ዪᏊࣛࢡ ࣟࢫ㑅ᡭ ࢆ ᑐ㇟࡜ࡋ࡚㸪 ࢝ࢵࢸ࢕ ࣥࢢືసࢆㄢ 㢟ືస ࡟ タᐃࡋ㸪➇ᢏ ≉Ṧᛶࡢ ୍ࡘ࡛࠶ࡿ

ࣛࢡࣟࢫࢫࢸ ࢕ࢡࢆಖ ᣢࡉࡏ ࡚࢝ࢵ ࢸ࢕ࣥࢢ ືస ࢆ⾜ࢃࡏ ࡓ᫬࡜ࡑ ࠺࡛࡞࠸᫬

ࡢୗ⫥࢟ࢿ࣐ ࢸ࢕ࢡࢫ 㸪࢟ࢿࢸ࢕ࢡ ࢫ࡟ࡘ࠸ ࡚ẚ㍑᳨ドࡍ ࡿࡇ࡜࡜ ࡋࡓ㸬 ௬ㄝ ࡣ㸪ࢫࢸ࢕ࢵ ࢡࢆಖᣢ ࡉࡏ࡚⾜ࢃࡏ ࡓ ᫬ࡢ࢝ ࢵࢸ࢕ࣥࢢື స ࡣ ಖᣢ ࡞ࡋࡢ᫬࡜

ẚ࡭㸪⭸㛵⠇ እ㌿ゅᗘ ࡸ⭸ 㛵⠇እ㌿ ࣮࣓ࣔࣥ ࢺ㸪⫤㛵⠇ ෆ ㌿ゅᗘࡸ ⫤㛵⠇ෆ㌿

࣮࣓ࣔࣥࢺࡀ ቑຍࡍࡿ ࡜࠸࠺ࡶࡢ࡛ ࠶ࡿ㸬

4-4-2. ᑐ㇟࡜᪉ἲ 1. ᑐ㇟

኱ᏛዪᏊࣛࢡ ࣟࢫ㑅 ᡭ10ྡ㸦ᖺ 㱋㸦 ᖹᆒ±ᶆ‽೫ᕪ㸧㸸 19.4 ± 1.0ṓ㸪㌟㛗 158.6

± 5.3 cm㸪య㔜 55.7 ± 5.6 kg㸪 ࣛࢡࣟࢫ ➇ᢏ Ṕ 24 ± 11.8ࣨ᭶㸧ࢆ ᑐ㇟࡜ࡋࡓ㸬 ㄢ㢟ືసࢆ⾜ ࠺࡟࠶ࡓ ࡾ 㸪ୗ⫥ࡢയ ᐖ➼࡟ࡼ ࡾᨭ㞀ࢆࡁࡓ ࡉ࡞࠸ ⪅ ࡜ࡋࡓ㸬஦

๓࡟◊✲ࡢ┠ ⓗ㸪᪉ ἲ 㸪೔⌮ⓗ㓄 ៖➼࡟㛵 ࡍ ࡿㄝ᫂ࢆ⾜࠸ 㸪ྠព ࢆ ᚓ ࡚⾜ࡗࡓ㸬 ᮏ◊✲ࡣ 㸪᪩✄⏣ ኱Ꮫ ேࢆᑐ㇟࡜ࡍ ࡿ◊✲࡟ 㛵ࡍࡿ೔⌮ᑂ ᰝጤဨ఍ ࡢᢎㄆࢆᚓ

࡚ᐇ᪋ࡋࡓ㸦 ᢎㄆ␒ ྕ 2010-037㸧㸬

94

2. ㄢ㢟ືస

ㄢ 㢟 ື స ࡣ ࢝ ࢵ ࢸ ࢕ ࣥ ࢢ ື స ࡛ 㸪 ࢫ ࢱ ࣮ ࢺ ᆅ Ⅼ ࠿ ࡽ ྜ ᅗ ࡜ ࡜ ࡶ ࡟ 㸪5m ࡢ ຓ

㉮ࢆࡘࡅ࡚㸪ᗋ཯ຊィ ୖ࡟฼ࡁ⬮㸦 ඲౛㸪ྑ ⬮㸧ࢆ╔ᆅࡉ ࡏ㸪ᕥ᪉ ྥ 45r᪉ྥ

࡟᪉ ྥ ㌿ ᥮ࡋ ࡚ ㉮ࡾ ᢤ ࡅࡿ ᵝ ᘧ ࡜ࡋ ࡓ 㸦ᅗ 4-1㸧 㸬 ࡞࠾ 㸪 ࢝ࢵ ࢸ ࢕ ࣥࢢ ື సࡣ ๓᪉࡟ே㸦ᩛ ࢳ࣮࣒ࡢ 㑅ᡭ 㸧ࡀ❧ࡗ ࡚࠸ࡿࡀ ࠸ࡿࡇ࡜ࢆ ᝿ ീࡉࡏࡓ ࢝ࢵࢸ࢕ࣥ

ࢢືస࡜ࡋࡓ 㸬ㄢ㢟ື సࢆ௨ୗ ࡢ 3᮲௳࡛⾜ ࢃࡏࡓ㸬1.ࢫࢸ࢕ࢵࢡ ಖᣢ࡞ࡋ㸦not holding a stick㸸௨ ୗ 㸪NH㸧㸦ᅗ 4-2-a㸧㸪2.฼ࡁᡭഃ ࡟୧ᡭ࡛ ࢫ ࢸ࢕ࢵࢡࢆಖ ᣢ㸦඲౛㸪ྑᡭ㸧㸦holding a stick with right hand side:௨ୗ㸪RH㸧㸦ᅗ 4-2-b㸧㸪 3.㠀฼ࡁᡭ ഃ࡟୧ᡭ ࡛ ࢫࢸ࢕ࢵࢡࢆ ಖᣢ㸦඲ ౛㸪ᕥᡭ 㸧㸦holding a stick with left

hand side㸸௨ୗ㸪LH㸧㸦ᅗ4-2-c㸧㸬ྛ᮲ ௳ ࡛ࡢㄢ㢟ືస ࡟ࡘ࠸࡚ 㸪5ᮏࡢᡂຌ

ヨ ᢏ ࢆ グ 㘓 ࡋ ࡓ 㸬 ௨ ୗ ࡟ ᡂ ຌ ヨ ᢏ ࡢ ᮲ ௳ ࢆ ♧ ࡍ 㸬1)ຓ ㉮ ᫬ ࡢ ࢫ ࣆ ࣮ ࢻ ࡀ 4㸫

4.5m/s ෆ࡛࠶ࡿࡇ ࡜ 㸪2)࢝ࢵࢸ࢕ࣥ ࢢືస ᫬࡟ྑ⬮ࡀᗋ ཯ຊィୖ ࡟㋃ࡳ㎸ ࡲࢀ

࡚࠸ ࡿ ࡇ࡜ 㸪3)ᴃ ෇ ㉮ ⾜࡟ ࡞ ࡗ࡚ ࠸ ࡞ ࠸ࡇ ࡜ 㸦࢝ ࢵ ࢸ࢕ ࣥ ࢢ ືస ࡟ ࡞ࡗ ࡚ ࠸ࡿ

ࡇ࡜㸧㸪4)᪉ྥ㌿᥮ ᚋ㸪タ⨨ࡋ࡚ ࠶ࡿ ࢥ࣮ࣥෆ ࢆ㉮ࡾᢤࡅ࡚ ࠸ࡿࡇ࡜㸦ᅗ 4-1㸧㸪

5)ື స୰ 㸪 ᖖ ࡟ࢫ ࢸ ࢕ ࢵࢡ ࢆ ୧ᡭ ࡛ ಖ ᣢࡋ ࡚ ࠸ࡿ ࡇ ࡜࡜ ࡋ 㸪 ௨ୖ ࡢ ᮲௳ ࡀ ‶ࡓ ࡉࢀ࡚࠸࡞࠸ ሙྜࡣ↓ ຠ࡜ࡋ࡚෌ヨ ᢏࢆ⾜ࢃ ࡏࡓ㸬

ᅗ 4-1 ࢝ ࣓ ࣛ ࢭ ࢵ ࢸ ࢕ ࣥ ࢢ ࡜ ㉮ ⾜ ᅗ

95

3. ືసィ 

ືసࡢィ ࡣ 㸪 ◊ ✲ 3[బ㔝ᮧࡽ, 2012-3]ྠᵝ ࡟ 8ྎࡢ㉥እ ⥺࣓࢝ࣛ 㸦Motion

Analysis ♫〇㸧࡜ᗋ ཯ ຊィ㸦Kistler ♫〇㸧ࢆ౑⏝ࡋ ࡓ 㸬཯ᑕ ࣐࣮ ࣮࢝ࡣࢧࣥࣉ

ࣜࣥࢢ࿘Ἴ ᩘ 240Hz㸪 ᆅ㠃཯ຊࡣࢧ ࣥࣉࣜࣥ ࢢ࿘Ἴᩘ 2400Hz ࡛ࡑ ࢀࡒࢀィ  ࡋࡓ㸬ᑐ㇟⪅ ࡬ࡢ࣐࣮ ࣮࢝㈞௜ࡶ◊ ✲ 3 [బ㔝ᮧࡽ, 2012-3] ྠᵝ࡛㸪ྑୗ⫥ཬ ࡧ㦵┙ࡢ⓶⭵ ୖ 㸪ࡑࡢ ௚ࢩ࣮ࣗࢬ࡟ ィ 36Ⅼ ㈞௜ࡋࡓ㸬

4. ࢹ࣮ࢱゎᯒ

ࢹ࣮ࢱゎᯒ ࠾ࡼࡧ⟬ ฟ᪉ἲ ࡶ◊ ✲3 [బ㔝ᮧࡽ, 2012-3] ྠᵝ࡛࠶ࡿ㸬ゎᯒ⠊

ᅖࡣ㊊㒊ࡢ୍ 㒊ࡀᗋ࡟ ᥋ᆅࡋࡓ᫬Ⅼ 㸦initial contact㸪௨ୗ IC㸧࠿ ࡽࡘࡲඛࡀᗋ

࠿ࡽ㞳ࢀࡓ᫬ Ⅼ㸦toe off㸪௨ୗTO㸧ࡲ࡛ࢆLanding phase࡜ࡋ࡚㸪IC᫬ ࠿ࡽLanding

phaseࡢ 30㸣᫬Ⅼࡲ࡛ ࡢࢹ࣮ࢱࢆ⟬ ฟࡋࡓ 㸬ࣃ࣓࣮ࣛࢱࡣ㸪IC ᫬ ࡢ⭸㛵⠇ᒅ᭤

ゅᗘ㸪⭸㛵⠇ እ㌿ゅᗘ 㸪⫤㛵⠇ᒅ᭤ ゅᗘ㸪⫤ 㛵⠇ෆ㌿ゅᗘ 㸪IC ᫬ ࠿ࡽ Landing

phase ࡢ 30㸣᫬Ⅼࡲ࡛ ࡟ࡳࡽࢀࡓ᭱ ኱⭸ 㛵⠇ ᒅ᭤ゅᗘ㸪᭱ ኱⭸ 㛵⠇ እ㌿ゅᗘ㸪

᭱኱⭸㛵⠇ෆ ᪕ゅᗘ㸪 ᭱኱⫤㛵⠇ᒅ ᭤ゅᗘ㸪 ᭱኱⫤㛵⠇ෆ ㌿ゅᗘ㸪 ᭱኱⫤㛵⠇

ෆ᪕ゅᗘ㸪᭱ ኱⭸㛵⠇ እ㌿࣮࣓ࣔࣥ ࢺ㸪᭱኱ ⭸ 㛵⠇ෆ᪕ࣔ ࣮࣓ࣥࢺ 㸪᭱኱⫤㛵

⠇ෆ㌿࣮࣓ࣔ ࣥࢺ㸪᭱ ኱⫤㛵⠇ෆ᪕ ࣮࣓ࣔࣥ ࢺ࡜ࡋࡓ 㸬IC᫬࠿ ࡽ Landing phase ࡢ30㸣᫬Ⅼࡲ࡛࡟ ࡳ ࡽࢀࡓ ྛ㡯ࡢ ᭱኱್ࢆ ࣃ࣓࣮ࣛࢱ࡜ ࡋࡓ⌮⏤ ࡣ㸪◊✲ 4 ྠ ᵝ࡟㖄┤᪉ྥ ࡬ࡢ᭱኱ ᗋ཯ຊࡢࣆ࣮ ࢡࡀ IC ᫬ᚋ㸪Landing phase ࡢ 30㸣᫬Ⅼࡲ

ᅗ4-2 ヨ ⾜ ᮲ ௳ 㸦a㸧 ࢫ ࢸ ࢕ ࢵ ࢡ ಖ ᣢ ࡞ ࡋ 㸦NH㸧 㸪 㸦b㸧 ࢫ ࢸ ࢕ ࢵ ࢡ ࢆ ୧ ᡭ ࡛

ྑ ᡭ ഃ ࡟ ಖ ᣢ 㸦RH㸧 㸪 㸦c㸧 ࢫ ࢸ ࢕ ࢵ ࢡ ࢆ ୧ ᡭ ࡛ ᕥ ᡭ ഃ ࡟ ಖ ᣢ 㸦LH㸧

96

࡛࡟ࡳࡽࢀࡓ ࡇ࡜㸪ࡲ ࡓ㸪ᐇ㝿ࡢ ACL യᐖࡀ IC ᫬ᚋ࡟ ࡳࡽࢀࡿ ᭱኱ᗋ཯ຊࡢ

ࣆ ࣮ ࢡ ௜ ㏆ ࡛ Ⓨ ⏕ ࡋ ࡚ ࠸ ࡿ ࡇ ࡜ ࡀ ከ ᩘ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ Ⅽ ࡛ ࠶ ࡿ[Koga et al., 2010;㸪Krosshaug et al., 2007]㸬⤫ィᏛⓗゎᯒ ࡣ 㸪ྛヨ⾜᮲ ௳㛫 ࡟࠾ ࠸୍࡚ඖ㓄

⨨ศᩓ ศᯒ ࢆ⏝࠸ 㸪 ᭷ ពᕪࡢ ᚓࡽ ࢀࡓ 㡯 ┠࡟ ᑐࡋ㸪Bonferroni ἲࢆ ⏝࠸࡚ ከ㔜 ẚ㍑᳨ᐃࢆ⾜ ࡗࡓ㸬 ඲ ࡚ࡢࣃ࣓࣮ࣛ ࢱࡢẚ㍑ ࡟࠾࠸࡚㸪᭷ ពỈ‽ ࢆ 5㸣ᮍ‶࡜

ࡋࡓ㸬

4-4-3. ⤖ᯝ

NH㸪RH㸪LH ࡢྛヨ ⾜᮲௳࡛ࡢ IC ᫬ ࡢ⭸ 㛵⠇ᒅ᭤ゅᗘ 㸪⭸㛵⠇ እ㌿ゅᗘ㸪

⫤㛵⠇ᒅ᭤ゅ ᗘ㸪⫤㛵 ⠇ෆ㌿ゅᗘ㸪IC ᫬ ࠿ ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟

ࡳࡽࢀࡓ᭱኱ ⭸ 㛵⠇ᒅ ᭤ゅᗘ㸪᭱኱ ⭸ 㛵⠇እ ㌿ゅᗘ㸪᭱኱ ⭸ 㛵⠇ෆ ᪕ゅᗘ㸪᭱

኱⫤㛵⠇ᒅ᭤ ゅᗘ㸪᭱ ኱⫤㛵⠇ෆ㌿ ゅᗘ㸪᭱ ኱⫤㛵⠇ෆ᪕ ゅᗘ㸪᭱ ኱⭸ 㛵⠇እ

㌿࣮࣓ࣔࣥࢺ 㸪᭱኱⭸ 㛵⠇ෆ᪕࣮ࣔ ࣓ࣥࢺ㸪 ᭱኱⫤㛵⠇ෆ ㌿࣮࣓ࣔ ࣥࢺ㸪᭱኱

⫤㛵⠇ෆ᪕ࣔ ࣮࣓ࣥࢺ ࡢ⤖ᯝࢆ⾲ 4-1࡟♧ࡍ 㸬IC᫬ࡢ ⫤㛵⠇ෆ ㌿ ゅ ᗘ࡟࠾࠸࡚ 㸪 LHࡣNH ࡟ẚ ࡭࡚᭷ ព࡟኱ࡁࡃ㸦LH vs. NH: 4.2s8.8rvs. -0.2s7.8r, p = 0.031㸧

㸦ᅗ4-3㸧㸪IC ᫬࠿ࡽ Landing phase ࡢ 30%᫬Ⅼࡲ࡛࡟ࡳ ࡽࢀࡓ ᭱ ኱⫤㛵⠇ᒅ᭤

ゅᗘ࡟࠾࠸࡚ 㸪RH ࡣNH࡟ẚ࡭࡚ ᭷ព࡟኱ ࡁࡃ㸦RH vs. NH: 48.6s6.4rvs. 45.4 s6.7r, p = 0.036㸧㸦 ᅗ 4-4㸧㸪᭱኱ ⫤㛵⠇ ෆ㌿ゅᗘ࡟ ࡘ ࠸࡚ࡣ 㸪RH࠾ࡼࡧ LH ࡣ NH ࡟ẚ࡭࡚᭷ព ࡟ ኱ࡁ࠿ࡗࡓ 㸦RH vs. NH: 5.4s5.9rvs. 1.1s7.7r, p = 0.007; LH vs. NH: 5.4s8.1rvs. 1.1s7.7r, p = 0.015㸧㸦ᅗ 4-5㸧㸬ࡑ ࡢ௚ࡢヨ⾜

᮲௳㛫࡟࠾ࡅ ࡿྛࣃࣛ ࣓࣮ࢱࡢẚ㍑ ࡟࠾࠸࡚ ᭷ពᕪࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓ㸬

97

98

4-4-4. ⪃ᐹ

ᮏ◊✲ࡣ㸪ዪ Ꮚࣛࢡࣟ ࢫ 㑅ᡭࢆᑐ㇟ ࡜ࡋ࡚㸪 ࣛࢡࣟࢫࡢ➇ ᢏ≉Ṧᛶ ࡢ 1ࡘ࡛

࠶ࡿࢫࢸ࢕ࢵ ࢡ ࢆಖᣢ ࡉࡏࡓ ᮲௳ୗ ࡛࢝ࢵࢸ ࢕ࣥࢢືసࢆ ⾜ࢃࡏࡓ ࡜ࡁࡢ ୗ⫥

࢟ࢿ࣐ࢸ࢕ࢡ ࢫ࣭࢟ࢿ ࢸ࢕ࢡࢫ ࡢኚ ໬࡟ࡘ࠸ ࡚ẚ㍑᳨ウࡍ ࡿࡇ࡜ࢆ ┠ⓗ࡜ࡋ࡚

⾜ࡗࡓ㸬⤖ᯝ ࡣ IC ᫬ ࡢ⫤㛵⠇ෆ㌿ ゅᗘ࡟࠾ ࠸࡚ LHࡣ NH࡟ẚ࡭ ࡚኱ࡁࡃ㸪IC

99

᫬࠿ࡽ Landing phase ࡢ 30%᫬Ⅼࡲ࡛࡟ ࠾ ࠸࡚㸪 ᭱኱⫤ 㛵⠇ᒅ᭤ ゅᗘࡀ RH ࡣ

NH࡟ẚ࡭࡚ ኱ࡁࡃ㸪᭱኱⫤㛵⠇ෆ ㌿ゅᗘ ࡀ RH࠾ࡼ ࡧ LHࡣNH ࡟ẚ࡭࡚ ᭷ព

࡟኱ࡁ࠿ࡗࡓ 㸬ࡇࢀࡽ ࡢ⤖ᯝ࠿ࡽ㸪 ⫤㛵⠇ෆ ㌿ゅᗘ࡟ ╔┠ ࡍࡿ࡜㸪 ࢫࢸ࢕ࢵࢡ

ࢆಖᣢࡋࡓ≧ ែ࡛ࡢ࢝ ࢵࢸ࢕ࣥࢢື సࡣ㸪 ࢫ ࢸ࢕ࢵࢡࢆಖ ᣢࡋ࡞࠸ ᫬࡜ẚ࡭࡚

⫤㛵⠇ෆ㌿ື సࢆࡼࡾ ቑຍࡉࡏࡿ࡜ ࠸࠺ࡶࡢ ࡛࠶ࡗࡓ㸬ࡇ ࢀࡣ㸪ࢫ ࢸ࢕ࢵࢡࢆ

ಖᣢࡋࡓ≧ែ ࡛ࡢ࢝ࢵ ࢸ࢕ࣥࢢືస ࡣ㸪ࢫࢸ ࢕ࢵࢡࢆಖᣢ ࡋ࡞࠸᫬ ࡜ẚ࡭㸪᪉

ྥ㌿᥮᫬࡟๓ ᪉࡟ே㸦 ᩛ ࢳ࣮࣒ࡢ㑅 ᡭ㸧ࡀ࠸ ࡿࡇ࡜ࢆ ᝿ീ ࡉࡏࡓ ࢝ ࢵࢸ࢕ࣥࢢ

ືస࡟ࡼࡾ㸪 ╔ᆅࡋࡓ ⬮ഃ 㸦඲౛㸪 ྑ⬮ഃ㸧 ࡟㸪ࢫࢸ࢕ࢵ ࢡ᧯స࡜ ྠ᫬࡟ యᖿ

ࢆྑ⬮ഃ࡟ഴ ᩳࡉࡏ ࡓ ࣇ࢙࢖ࢡືస 㸦ࣇ࢙࢖ ࣥࢺືస㸧 ࢆ ࡜ࡿ࡜ྠ ᫬࡟㸪యᖿ ࡢࣂࣛࣥࢫಖ ᣢࡢⅭ࡟ ╔ᆅࡋࡓ⬮࡜ ཯ᑐഃࡢ 㦵┙ࢆୗࡆࡿ ࡇ࡜࡛㸪 ጼໃಖᣢ࡟

ᐤ୚ࡉࡏࡓ࡜ ⪃࠼㸪 ࡑ ࡢ௦ൾస⏝ࡢ ⤖ᯝ㸪╔ ᆅ⬮ഃࡢ⫤㛵 ⠇ෆ㌿ゅ ᗘࡀ኱ࡁࡃ

࡞ࡗࡓࡢ࡛ࡣ ࡞࠸࠿࡜ ᥎ ࡋࡓ㸬ࡍ ࡞ࢃࡕ㸪 ࢫࢸ࢕ࢵࢡ࡜ ྠ᫬࡟య ᖿࡀྑ⬮ഃ

࡬ഴᩳࡍࡿࡇ ࡜࡛㔜ᚰ ࡀྑഃ࡬⛣ື ࡍࡿ㸬ࡑ ࡢࣂࣛࣥࢫಖ ᣢࡢⅭ࡟ ཯ᑐഃࡢ㦵

┙ࢆୗࡆ࡚㐺 ᛂࡉࡏࡓ ࡜⪃࠼ࡓ㸬 ࡲ ࡓ㸪᪉ྥ ㌿᥮ືస࡟ 㸪 ╔ᆅ ⬮ഃ ࡜཯ᑐࡢ㦵

┙ࢆୗࡆࡿࡇ ࡜࡛㸪 ษ ࡾ㏉ࡋືసࢆ ࡼࡾ⾜࠸ ࡸࡍࡃࡉࡏ ࡓ ࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃࠼

ࡓ㸬୧ᡭࢆ⮬ ⏤࡟౑⏝ ࡉࡏࡓ࢝ࢵࢸ ࢕ࣥࢢື సࡣ㸪㌟యࡢ ࣂࣛࣥࢫ ಖᣢࡢࡓࡵ

࡟㸪୧ᡭࢆ᧯ సࡋ࡚㌟ యࡢࣂࣛࣥࢫ ಖᣢ࡟ᐤ ୚ࡉࡏࡿࡇ ࡜ ࡀฟ᮶ࡿ ࡀ㸪୧ᡭ࡛

ࢫࢸ࢕ࢵࢡࢆ ಖᣢࡋࡓ ≧ែࡢ࢝ࢵࢸ ࢕ࣥࢢື సࡣ㸪୧ᡭ ࡢ ౑⏝ࡀไ 㝈ࡉࢀࡿ ࡓ

ࡵ࡟㸪యᖿࢆ ᧯సࡋࡓ 㸦 ഃ᪉ഴᩳࡉ ࡏࡓ㸧ࣇ ࢙࢖ࢡືస㸦 ࣇ࢙࢖ࣥ ࢺືస㸧 ࡀ ồࡵࡽࢀ㸪ࡑ ࡋ࡚ ࡲࡓ 㸪ࡑࡢᚋࡍࡄ ࡟᪉ྥ㌿ ᥮ືసࡶồࡵ ࡽࢀࡿ㸬 ࡇࢀࡽࡢື

సࡀ▐᫬࡟⾜ ࢃࢀࡿ 㐣 ⛬࡟࠾࠸࡚㸪 యᖿ ഃ᪉ ഴᩳ࡟ࡼࡿᑐ ᛂ㸪ࡲࡓ 㸪⣲᪩࠸ษ

ࡾ㏉ࡋືసࡢ ᑐᛂࡢⅭ ࡟㸪཯ᑐഃࡢ 㦵┙ࢆୗ ࡆࡿ࡜࠸ࡗࡓ 㦵┙᧯స ࡀ⾜ࢃࢀ ࡓ ࡇ࡜࡛㸪⫤㛵 ⠇ෆ㌿ゅ ᗘ ࡀቑຍࡋࡓ ࡢ࡛ࡣ࡞ ࠸࠿࡜᥎ ࡋ ࡓ㸬 ࡑࡋ ࡚ࡑࡢືస ࡢ‽ഛࡀ╔ᆅ ๓࠿ࡽ⾜ ࢃࢀ࡚࠾ࡾ㸪IC ᫬ࡢ⫤ 㛵⠇ෆ㌿ゅᗘ ࢆࡶቑຍ ࡉࡏࡓࡢ࡛

ࡣ࡞࠸࠿࡜⪃ ࠼ࡓ㸬

ඛ⾜ㄽᩥ࡟࠾ ࠸࡚[Chaudhari et al., 2005]㸪࢝ ࢵࢸ࢕ࣥࢢື సࢆ୧ᡭ ࢆ⮬⏤࡟

౑⏝ࡉࡏࡓ᫬ ࡜࣮࣎ࣝ ࡸࣛࢡࣟࢫࢫ ࢸ࢕ࢵࢡ ࢆಖᣢࡉࡏ࡚ ⾜ࢃࡏ ࡓ ᫬ࡢ⭸㛵⠇

እ཯࣮࣓ࣔࣥ ࢺ࡟ཬࡰ ࡍᙳ㡪࡟ࡘ࠸ ࡚ ◊✲ࡉ ࢀࡓ ሗ࿌࡛ࡣ 㸪ࣛࢡࣟ ࢫࢫࢸ࢕ࢵ

ࢡࢆಖᣢࡉࡏ ࡚⾜ࢃࡏ ࡓ ᫬ࡣ㸪୧ᡭ ࢆ⮬⏤࡟ ౑⏝ࡉࡏࡓ ᫬ ࡜ẚ࡭㸪 ᭷ព࡟⭸㛵

100

⠇እ཯࣮࣓ࣔ ࣥࢺࢆቑ ຍࡉࡏࡓ㸬 ࡇ ࡢ⤖ᯝࢆ ᳨ドࡍࡿ࡟࠶ ࡓࡾ 㸪⭸ 㛵⠇እ཯ࣔ

࣮࣓ࣥࢺࡢቑ ຍ㔞࡜㸪 ࢝ࢵࢸ࢕ࣥࢢ ືస᫬ࡢ ྑᡭഃࡢᡭ㸦 ᪉ྥ㌿᥮ ࡍࡿ᪉ྥ࡜

཯ᑐഃࡢᡭ㸧 ࡢ఩⨨㛵 ಀ ࡟ࡘ࠸᳨࡚ ウࡉࢀࡓ 㸬ࡇࢀࡣ㸪᪉ ྥ㌿᥮᫬ ࡟ 㸪᪉ྥ㌿

᥮ࡍࡿ᪉ྥ࡜ ࡣ཯ᑐഃ ࡢᡭ 㸦ྑᡭ㸧 ࡀ㸪ࢫࢸ ࢕ࢵࢡࢆಖᣢ ࡉࡏࡓ ᫬ ࡣ㌟యࡢ୰

ᚰഃ࡟఩⨨ࡋ 㸪୧ᡭࢆ ⮬⏤࡟౑⏝ࡉ ࡏ ࡓ࡜ࡁ ࡣ㌟యࡢ୰ᚰ ࠿ࡽࡼࡾ ഃ᪉࡬㞳ࢀ

ࡓሙᡤ࡟఩⨨ ࡋ ࡚࠸ࡿ ࡇ࡜ࡀ☜ㄆࡉ ࢀ 㸪㌟య ࡢ୰ᚰ࠿ࡽྑ ᡭࡲ࡛ࡢ ㊥㞳࡜ ⭸㛵

⠇እ཯࣮࣓ࣔ ࣥࢺ ࡢ㛵 㐃ᛶࢆ᳨ドࡋ ࡓ࡜ࡇࢁ 㸪㌟యࡢ୰ᚰ ࠿ࡽྑᡭ ࡲ࡛ࡢ㊥㞳 ࡀ▷࠸࡯࡝⭸ 㛵⠇እ཯ ࣮࣓ࣔࣥࢺࡀ ኱ࡁ ࡃ࡞ ࡿഴྥࡀ♧ࡉ ࢀࡓ㸬ࡇ ࡢせᅉࡣ㸪

࢝ࢵࢸ࢕ࣥࢢ ᫬ࡢయᖿ ࡢᏳᐃ໬ࢆಖ ᣢࡉࡏࡿ ࡓࡵ࡟㸪୧ᡭࡀ⮬ ⏤࡟ ౑࠼ࡿ᫬ࡣ 㸪

≉࡟ྑᡭࢆఙ ࡤࡋࡓ≧ ែ㸦⫝㛵⠇ࢆ ఙᒎࡉࡏ ࡓ≧ែ㸧ࢆస ࡿࡇ࡜࡛ యᖿࡢᏳᐃ

໬࡟ᐤ୚ࡉࡏ ࡚࠸ࡿ࡜ ㏙࡭㸪୧ᡭ㸦 ྑᡭ㸧ࡀ ఙࡤࡏ࡞࠸≧ ែ㸦ࢫࢸ ࢕ࢵࢡࡸ࣎

࣮ࣝࢆಖᣢࡋ ࡓ≧ែ㸧 ࡢ᫬ࡣయᖿ㸦 ➽⩌㸧ࢆ ฼⏝ࡋ࡚ࡑࡢ ືసࢆ௦ ൾࡉࡏ ࡚࠸

ࡿ࡜㏙࡭࡚࠸ ࡿ㸬 ࡑࡋ ࡚ࡑࡢ௦ൾస ⏝ࡀ⭸㛵 ⠇ እ཯࣮࣓ࣔ ࣥࢺ ࡢቑ ຍ࡟ᙳ㡪ࢆ

ཬࡰࡋࡓ࡜㏙ ࡭࡚࠸ࡿ 㸬

ࡇࢀࡽࡢሗ࿌ ࡣ㸪࢝ࢵ ࢸ࢕ࣥࢢືస ᫬ࡢ୧ᡭ ࡢไ㝈ࡀ⭸㛵 ⠇እ཯ࣔ ࣮࣓ࣥࢺ

࡟ཬࡰࡍᙳ㡪 ࡟㛵ࡍࡿ ࡶࡢ࡛࠶ࡿࡀ 㸪୧ᡭࡢ ไ㝈ࡀ 㸪⭸ࡸ ⫤㛵⠇ࡢ ࢟ࢿ࣐ࢸ࢕

ࢡࢫࡸ࢟ࢿࢸ ࢕ࢡࢫ࡬ ࡢᙳ㡪ࢆཬࡰ ࡍྍ⬟ᛶ ࡶ♧၀ࡉࢀ࡚ ࠸ࡿ㸬 ࡑ ࡢ࡯࠿యᖿ

ഃ᪉ഴᩳ࡜ACLയᐖ ࣓࢝ࢽࢬ࣒࡟ 㛵ࡍࡿሗ ࿌࡟ࡼࡿ࡜[Hewett and Myer, 2011]㸪

ഃ᪉࡬ࡢయᖿ ഴᩳࡣ⭸ 㛵⠇እ㌿㈇Ⲵ ࢆቑຍࡉ ࡏࡿせᅉ ࡜࡞ ࡿࡇ࡜ࢆ ㏙࡭࡚࠸ࡿ 㸬 ࡇࢀࡣ㸪࢝ࢵ ࢸ࢕ࣥࢢ ࡸࢪࣕࣥࣉ࠿ ࡽࡢ∦⬮ ╔ᆅ᫬࡟㸪 య ᖿࡀ╔ᆅ ⬮ഃ࡬ഴᩳ

ࡋࡓ᫬࡟㸪㔜 ᚰࡀྠഃ ᪉ྥ࡬⛣ືࡍ ࡿࡇ࡜࡛ 㸪⭸㛵⠇ࢆ୰ ᚰ࡜ࡋ ࡚ యᖿ࠾ࡼࡧ

኱⭣ࡢయ⠇ࡀ ࡼࡾ኱ࡁ ࡞ ࣞࣂ࣮࢔࣮ ࣒࡜ࡋ࡚ స⏝ࡋ㸪 ⭸㛵 ⠇እ㌿㈇ Ⲵࢆቑ኱ࡉ ࡏࡿ࡜㏙࡭࡚ ࠸ࡿ㸬 ࡲ ࡓ㸪యᖿഃ᪉ ഴᩳ࡜⭸ 㛵⠇እ㌿㈇Ⲵ ࡢቑຍ࡟ క࠸ጼໃಖ ᣢࡢⅭ࡟⫤㛵 ⠇ෆ㌿ࢺ ࣝࢡ ࡀቑຍࡋ 㸪ࡑࢀࡽ ࡶࡲࡓ⭸ 㛵⠇ እ㌿࣮ࣔ ࣓ࣥࢺࢆቑ ຍࡉࡏࡿせᅉ ࡛࠶ࡿ࡜ ㏙࡭࡚࠸ࡿ 㸬ࡇ ࢀࡽࡢ ሗ࿌࠿ࡽࡶ㸪య ᖿഃ᪉ ഴᩳࡀ ACL യᐖ࣓࢝ࢽࢬ ࣒ࡢ୍ࡘ ࡟ ⫤㛵⠇ෆ㌿ ᪉ྥ࡬ࡢ ືࡁ ࡀ㛵୚ࡋ ࡚࠸ࡿࡇ ࡜ࡀ♧ࡉࢀ

࡚࠸ࡿ㸬

ᮏ◊✲⤖ᯝ࠿ ࡽ㸪 ࢫࢸ ࢕ࢵࢡࢆಖᣢ ࡉࡏࡓ≧ ែ㸪ࡍ࡞ࢃࡕ ୧ᡭࡢไ 㝈ࢆຍ࠼

ࡓ᫬ࡢ࢝ࢵࢸ ࢕ࣥࢢື సࡀ㸪 ⫤㛵⠇ ෆ㌿ゅᗘ ࡟ᙳ㡪ࢆཬࡰ ࡍ࡜࠸࠺ ᪂ࡓ࡞▱ぢ

101

ࢆᚓࡿࡇ࡜ࡀ ฟ᮶ࡓ 㸬 ඛ⾜ㄽᩥ࠿ࡽ 㸪 ᐇ㦂ᐊ ࡛ࣞ࣋ࣝࡢ ྛ ✀ㄢ㢟ື సࢆ⾜ࢃࡏ ࡓ࡜ࡁࡢୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺࡢ≉ᚩ࡜ ࡋ࡚㸪 ࣛ ࣥࢽࣥࢢືస ࡟࠾࠸࡚ ࡣ㸪ዪᛶࡣ

⏨ᛶ࡟ẚ࡭ ࡚Landing phase ࡢ60㸣ࡲ࡛ࡢᮇ 㛫࡟࠾࠸࡚㸪 ⫤㛵⠇ෆ ㌿ ゅᗘࡀ᭷

ព࡟኱ࡁ࠿ࡗ ࡓࡇ࡜ࡀ ሗ࿌ࡉࢀ㸦Ferber, 2004㸧㸪⫤㛵⠇ ෆ㌿ゅᗘ ࡢቑຍࡀ⭸㛵

⠇እ㌿ືసࡢ ቑຍ࡟ᐤ ୚ࡉࡏࡿ ࡜㏙ ࡭࡚࠸ࡿ 㸬ࡲࡓ 㸪⫤㛵 ⠇ෆ㌿ゅᗘ ࡢቑຍࡣ㸪

⫤㛵⠇࿘ᅖ➽ ࡢᙅࡉ࡜ 㛵㐃 ࡀ࠶ࡿ࡜ ㏙࡭࡚࠸ ࡿ㸬࢝ࢵ ࢸ࢕ࣥࢢ ືస ࡟࠾࠸࡚ࡣ 㸪

Pollardࡽ㸦2004㸧ࡣ㸪ዪᛶࡣ⏨ᛶ࡟ ẚ࡭࡚⫤ 㛵⠇እ㌿ゅᗘ ࡀᑠ࡛࠶ ࡾ㸪ࡼࡾෆ

㌿᪉ྥ࡬ࡢື ࡁࢆ♧ࡋ ࡚࠸ࡓࡇ࡜ࢆ ሗ࿌ࡋ㸪Mcleanࡽ㸦2004㸧ࡣ㸪ዪᛶࡣ⏨ᛶ

࡟ẚ࡭࡚⫤㛵 ⠇እ㌿ゅ ᗘࡀᑠࡉ࠿ࡗ ࡓࡇ࡜ࢆ ሗ࿌ࡋ࡚࠸ࡿ 㸬 ᮏ ◊✲ ⤖ᯝ࡟࠾࠸

࡚᭷ពᕪࡣᚓ ࡽࢀ࡞࠿ ࡗࡓ ࡀ㸪᭱ ኱⫤㛵⠇ ෆ ᪕࣮࣓ࣔࣥࢺ ࡟ࡘ࠸࡚ 㸪RHࡣNH

࡟ẚ࡭࡚኱ࡁ ࠸ഴྥࢆ ♧ࡋ࡚࠸ࡓ㸦RH vs. NH: 0.41s0.86Nm/(㌟㛗*య㔜) vs.

0.37s0.06Nm/(㌟㛗*య 㔜), p = 0.070㸧㸬ACLയᐖ᫬ࡢ⭸㛵 ⠇ࡸ ⫤㛵 ⠇ࡢືస≉

ᚩࢆ♧ࡋ ࡓ Hewett ࡽ㸦2005㸧ࡢሗ࿌࡟ࡼ ࡿ ࡜ 㸪╔ᆅືస᫬ ࡟ࡳࡽ ࢀࡿ ≉ᚩⓗ࡞

⭸㛵⠇እ㌿ື సࡸ⫤㛵 ⠇ෆ㌿ືసࢆ ͆Dynamic valgus͇࡜⛠ࡋ 㸪ACLയᐖせᅉ

࡜࡞ࡿືస⫥ ఩࡛࠶ࡿ ࡜㏙࡭࡚࠸ࡿ㸦 ᅗ 4-3㸧㸬ࡲࡓ㸪Quatman࡜Hewett㸦2009㸧 ࡣ㸪╔ᆅືస ᫬࡟ዪᛶ ࡀ♧ࡍୗ⫥ ࢔ ࣛ࢖࣓ࣥ ࢺ ࡢ≉ᚩ࡜ࡋ ࡚㸪 ⭸㛵 ⠇እ㌿ࡸ⫤

㛵⠇ෆ㌿࣭ෆ ᪕ືసࢆ ᣲࡆ㸪ࡑࢀࡽ ࡢ」ྜⓗ ࡞ 㛵⠇ືస࡟ ࡼࡾ㸪⭸ 㛵⠇࠾ࡼࡧ

⭸㛵⠇㠌ᖏ࡬ ࡢ㈇Ⲵࢆ ቑ኱ࡉࡏࡿ࡜ ㏙࡭࡚࠸ ࡿ 㸦ᅗ 4-4㸧㸬

ᅗ 4-3 Dynamic valgus [Hewett, 2005] ᅗ 4-4 Multiplanar loading mechanism in women [Quatman and Hewett, 2005]

102

ᮏ◊✲⤖ᯝ࡟ ࠾࠸࡚ 㸪୺࡞ ACLയᐖ ࣓࢝ࢽ ࢬ࣒࡛࠶ࡿ ⭸ 㛵⠇እ㌿ ゅᗘࡸ⭸㛵

⠇እ㌿࣮࣓ࣔ ࣥࢺ ࡢ᭷ ព࡞ቑຍࡣࡳ ࡽࢀ࡞࠿ ࡗࡓࡀ㸪⫤㛵 ⠇ෆ㌿ゅ ᗘࡢ ᭷ព࡞

ቑຍࡀࡳࡽࢀ ࡓ㸬ࡇ ࢀ ࡽࡢ⤖ᯝ࠿ࡽ 㸪ዪᏊ ࣛ ࢡࣟࢫࡢ ACLയᐖ࣓ ࢝ࢽࢬ࣒ࡢ୍

ࡘ࡜ࡋ࡚㸪ࣛ ࢡࣟࢫ ➇ ᢏ≉Ṧᛶ࡛࠶ ࡿ ࢫࢸ࢕ ࢵࢡࢆಖᣢࡋ ࡓ≧ែ࡛ ࡢ࢝ࢵࢸ࢕

ࣥࢢືసࡣ㸪 ⫤㛵⠇ෆ ㌿ືసࢆ ࡼࡾ ቑຍࡉࡏ ࡿ࡜࠸࠺⤖ᯝ ࠿ࡽ㸪ዪ Ꮚࣛࢡࣟࢫ ࡢACLയᐖ࣓ ࢝ࢽࢬ ࣒ࡢ ୍ࡘࡢ▱ ぢ࡜࡞ࡿ ྍ⬟ᛶࡀ ♧၀ ࡉࢀࡓ㸬

ᮏ◊✲ࡢㄢ㢟 ືసࡣ 㸪 ࢫࢸ࢕ࢵࢡಖ ᣢ࠶ࡾ࣭ ࡞ࡋ ࡢ᮲௳ୗ ࡛ࡢ࢝ࢵ ࢸ࢕ࣥࢢ

ືస࡛࠶ࡗࡓ ࡀ㸪௒ᚋ 㸪┠ᶆ≀ࢆタ ᐃࡋࡓ≧ ἣୗ࡛ࡢ࢝ࢵ ࢸ࢕ࣥࢢ ືసࢆ⾜ࢃ

ࡏࡓ࡜ࡁࡢẚ ㍑࡟ࡼࡾ 㸪ࡼࡾ≉ᚩⓗ ࡞ ୗ⫥࢔ ࣛ࢖࣓ࣥࢺࡢ ኚ໬ࢆ ࡳ ࡿࡇ࡜ࡀ࡛

ࡁࡿࡢ࡛ࡣ࡞ ࠸࠿࡜⪃ ࠼ࡓ㸬ࡲࡓ㸪 ࢜ࣇ࢙ࣥ ࢩࣈ࡞ືసࡢ ẚ㍑࡜࠸ ࠺Ⅼ࡛ࡣ㸪

࣮࣎ࣝࢆಖᣢ ࡉࡏࡓ≧ ែ࡛ 㸪ࢫࢸ࢕ ࢵࢡࢆ᧯ సࡉࡏ࡞ࡀࡽ ࢝ࢵࢸ࢕ ࣥࢢࢆ⾜ࢃ

ࡏࡓ᫬ࡢ᳨ウ ࡶᚲせ࡛ ࠶ࡿ࡜⪃࠼ࡓ 㸬

4-4-5. ⤖ㄒ

ዪᏊࣛࢡࣟࢫ 㑅ᡭࢆᑐ ㇟࡜ࡋ࡚㸪ࣛ ࢡࣟࢫࢫ ࢸ࢕ࢡࢆಖᣢ ࡉࡏ ࡚࢝ ࢵࢸ࢕ࣥ

ࢢືసࢆ⾜ࢃ ࡏࡓ࡜ࡁ ࡢ ୗ⫥࢟ࢿ࣐ ࢸ࢕ࢡࢫ ࣭࢟ࢿࢸ࢕ࢡ ࢫ ࡢኚ໬ ࡟ࡘ࠸࡚ẚ

㍑᳨ウࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ࡚⾜࠸㸪 ࢫࢸ࢕ࢵ ࢡಖᣢ࠶ࡾࡣ ಖᣢ࡞ࡋ ࡟ẚ࡭࡚ 㸪 Initial contact ᫬ ࡢ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ᗘ ࢆ ᭷ ព ࡟ ቑ ຍ ࡉ ࡏ 㸪Initial contact ᫬ ࠿ ࡽ

Landing phaseࡢ 30%᫬Ⅼࡲ࡛ࡢ᭱ ኱⫤㛵⠇ ෆ㌿ゅᗘࢆ᭷ ព࡟ቑຍ ࡉࡏࡓ㸬ዪᏊ

ࣛࢡࣟࢫࡢ➇ ᢏ≉Ṧᛶ ࡢ୍ࡘ࡛࠶ࡿ ࢫࢸ࢕ࢵ ࢡࢆಖᣢࡋࡓ ≧ែ࡛ࡢ ࢝ࢵࢸ࢕ࣥ

ࢢືసࡣ㸪ಖ ᣢ࡞ࡋ࡟ ẚ࡭ ࡚⫤㛵⠇ ෆ㌿ ゅᗘ ࢆቑຍࡉࡏࡿ ࡜࠸࠺⤖ ᯝ࠿ࡽ㸪 ዪ Ꮚࣛࢡ ࣟࢫࡢ ACL യ ᐖ࣓࢝ ࢽࢬ࣒ ࡢ୍ ࡘ࡜ ࡋ࡚᪂ ࡓ࡞▱ ぢ࡜ ࡞ࡿ ྍ⬟ᛶ ࡀ♧

၀ࡉࢀࡓ㸬

103

➨

➨ 5 ❶

ୗ⫥ᙧែ࠾ࡼࡧୗ⫥➽ຊ࡜㟼ⓗ࣭ືⓗࣂࣛࣥࢫ

⬟ຊ࠾ࡼࡧୗ⫥࢔ࣛ࢖࣓ࣥࢺ࡜ࡢ㛵㐃ᛶ

104

◊

◊ ✲ 5. ㊊ ㊑ᢕ ᥱ ຊ ࡜ 㟼ⓗ ࠾ࡼ ࡧ ືⓗ ࣂࣛ ࣥ ࢫ⬟ ຊ ࡜ ࡢ 㛵㐃 ᛶ

5-5-1. ⥴ゝ

࢔ࢫ࣮ࣜࢺࡢ ୗ⫥യᐖ せᅉࡢ୍ࡘ࡟ ୗ⫥ࡢ⚄ ⤒࣭➽ᶵ⬟ࡸ ጼໃไᚚ ⬟ ຊࡢప

ୗࡀ࠶ࡿ㸬ࡲ ࡓ㸪ጼໃ ไᚚ⬟ຊࡢホ ౯᪉ἲ࡜ ࡋ࡚㸪❧఩ጼ ໃ࡛ࡢ㟼 ⓗࣂࣛࣥࢫ

ࡶࡋࡃࡣືⓗ ࣂࣛࣥࢫ ಖᣢ⬟ຊ ࢸࢫ ࢺࡀ⏝࠸ ࡽࢀ࡚࠸ࡿ 㸬 ጼໃไᚚ ⬟ຊ࡟ᐤ୚

ࡉࡏࡿᅉᏊࡢ ୍ࡘ࡟㊊ ㊑ᢕᥱຊࡀᣲ ࡆࡽࢀࡿ 㸬㊊㊑ᢕᥱຊ ࡣ㸪㊊㊑ ࡛ᆅ㠃ࢆ ᥗ

ࡴຊࡢࡇ࡜࡛ ࠶ࡾ㸪▷ ẕ㊑ᒅ➽㸪㛗 ẕ㊑ᒅ➽ 㸪⹸ᵝ➽㸪▷ ㊑ᒅ➽㸪 㛗㊑ᒅ➽࡞

࡝ࡢస⏝࡟ࡼ ࡾ㉳ࡇࡿ ከ㛵⠇㐠ື࡛ ࠶ࡿࡀ[Oatis, 2009]㸪㊊㊑ᢕᥱຊ ࡜ጼໃไᚚ

⬟ຊ࡜ࡢ㛵㐃 ᛶ࡟㛵ࡍ ࡿඛ⾜◊✲ ࡟ ࠾࠸࡚㸪 ࡑࢀࡽࡀ㧗㱋 ⪅ࡢ㌿ಽ 㜵Ṇ࡟ᐤ୚

ࡉࡏ࡚࠸ࡿࡇ ࡜ࡀከᩘ ሗ࿌ࡉࢀ࡚࠸ ࡿ㸬ᑠᯘ ࡽ㸦1999㸧ࡣ㧗㱋⪅ࢆ ᑐ㇟࡟㊊㊑

ᢕᥱຊྥୖࢺ ࣮ࣞࢽࣥ ࢢࢆ⾜࠸㸪ࢺ ࣮ࣞࢽࣥ ࢢ⩌ࡣࢥࣥࢺ ࣮ࣟࣝ⩌ ࡜ẚ㍑ࡋ㸪

᭷ព࡟㔜ᚰື ᦂࡢῶᑡ ࡀㄆࡵࡽࢀ㸪 ㊊㊑ᢕᥱ ຊࢺ࣮ࣞࢽࣥ ࢢࡀ㌿ಽ ண㜵࡟ࡘ࡞

ࡀࡿࡇ࡜ࢆ♧ ၀ࡋ࡚࠸ ࡿ 㸬ᮌ⸨ࡽ㸦2000㸧ࡣ㸪ᑐ㇟⪅ࡢ㌿ ಽ᪤ Ṕ ࡢ᭷↓ࢆㄪ ᰝࡋ㸪㌿ಽ⩌ ࠾ࡼࡧ㠀 ㌿ಽ⩌࡟ศࡅ ࡚㊊㊑ᢕ ᥱຊࢆẚ㍑ࡋ ࡓ࡜ࡇࢁ 㸪㌿ಽ⩌ ࡢ

㊊㊑ᢕᥱຊࡀ ᭷ព࡟ ᙅ ࠿ࡗࡓࡇ࡜ࢆ ሗ࿌ࡋ࡚ ࠸ࡿ㸬ࡇࢀࡽ ࡢሗ࿌࠿ ࡽ㸪㧗㱋⪅

ࡢ㌿ಽண㜵⟇ ࡢ୍ࡘ࡟ 㸪 ㊊㊑ᢕᥱຊ ࡢྥୖࡀ ᭷⏝࡛࠶ࡿࡇ ࡜ࡀ ࠺࠿ ࡀ࠼ࡿ㸬ࡲ

ࡓ㸪ⱝᖺ⪅ࢆ ᑐ㇟࡜ࡋ ࡓ㊊㊑ᢕᥱຊ ࡜ጼໃไ ᚚ⬟ຊ࡜ࡢ㛵 㐃ᛶ࡟ࡘ ࠸࡚ࡶ 㸪㊊

㊑ ᢕ ᥱ ຊ ࡀ 㧗 ࠸ ࡶ ࡢ ࡣ ጼ ໃ ไ ᚚ ⬟ ຊ ࡀ 㧗 ࠸ ࡜ ࠸ ࠺ ሗ ࿌ ࡶ 」 ᩘ ࡳ ࡽ ࢀ ࡚ ࠾ ࡾ[ຍ

㎶ࡽ, 2002; ᮧ⏣, 2004; ᮧ⏣ࡽ, 2002]㸪㧗 㱋⪅࠾ࡼࡧ ⱝ ᖺ⪅࡜ࡶ ࡟ ㊊㊑ᢕᥱຊ ࡢྥୖࡀጼໃ ไᚚ⬟ຊ ࡟ ᐤ୚ࡉࡏ࡚ ࠸ࡿࡇ࡜ ࡀ ♧ࡉࢀ࡚࠸ ࡿ㸬

ືⓗࣂࣛࣥࢫ ಖᣢ⬟ຊ ࡣ㸪㐠ືࢫ࢟ ࣝ㸪ࣃࣇ ࢛࣮࣐ࣥࢫࡢ ᇶ♏࡜࡞ ࡾ㸪ືⓗ

ࣂࣛࣥࢫࡢḞ ዴࡣ㐠ື ࢫ࢟ࣝࡀప࠸ ࡇ࡜ࡀሗ ࿌ࡉࢀ࡚࠸ࡿ[Burton et al., 1998]㸬

ືⓗࣂࣛࣥࢫ ⬟ຊࡢホ ౯᪉ἲࡢ୍ࡘ ࡟ 㸪Time Up and Go Test㸪Functional Reach Test࡞࡝ࡀ⏝࠸ࡽࢀ࡚ ࠸ࡿ ࡀ㸪㏆ᖺ 㸪࢔ࢫࣜ ࣮ࢺࢆᑐ㇟࡜ ࡋࡓືⓗ ࣂࣛࣥࢫ⬟

ຊࡢホ౯᪉ἲ ࡜ࡋ࡚㸪Star Excursion Balance Test㸦௨ୗ㸪SEBT㸧࡟ࡼࡿሗ࿌ࡀ ከᩘࡳࡽࢀ࡚ ࠸ࡿ[Plisky et al., 2006; Gray, 1995; Hertel et al., 2002; Kinzey et al., 1998; Olmsted et al., 2002; బࠎᮌࡽ, 2009]㸬SEBT ࡣ∦⬮❧఩ጼໃ ࢆಖᣢࡉࡏ࡞

ࡀࡽ཯ᑐഃࡢ ⬮࡛ࡢ ࣜ ࣮ࢳ㛗ࢆホ౯ ࡍࡿࢸࢫ ࢺἲ࡛࠶ࡿࡀ 㸪࣮ࣜࢳ ᪉ྥࡣ㸪 ๓

105

ᚋ࠾ࡼࡧෆእ ᪉ྥ ࡜࠸ ࡗࡓᵝࠎ࡞᪉ ྥ࡬⾜࠺ ࡇ࡜࠿ࡽ㸪ື ⓗୗ⫥ࣂ ࣛࣥࢫ⬟ຊ ࡢ ホ ౯ ἲ ࡜ ࡋ ࡚ ᥎ዡ ࡉ ࢀ ࡚ ࠸ ࡿ 㸦 బ ࠎ ᮌࡽ, 2009㸧 㸬 ࡲ ࡓ 㸪   ᐃ ᪉ ἲ ࡀ ⡆ ౽ ࡛

࠶ࡿࡇ࡜ࡶྵ ࡵ࡚ 㸪ࢫ ࣏࣮ࢶ⌧ሙ࡛ ࡢ฼⏝౯ ್ ࡀ㧗࠸ࡇ࡜ ࡶ」ᩘሗ ࿌ࡉࢀ࡚࠸

ࡿ[Plisky et al., 2006]㸬ࡑࡢ௚㸪ୗ ⫥യᐖࣜࢫ ࢡࡢண ࡜ࡋ ࡚ࡢ᭷⏝ ᛶ࡟ࡘ࠸࡚

ࡶホ౯ࡉࢀ࡚ ࠾ࡾ㸪 ࢔ ࢫ࣮ࣜࢺࡸⱝ ᖺ⪅ࢆᑐ ㇟࡜ࡋࡓࢸࢫ ࢺ ἲ ࡜ࡋ ࡚ᗈࡃ⏝࠸

ࡽࢀ࡚࠸ࡿ[Gray, 1995; Hertel et al., 2002; Kinzey et al., 1998; Olmsted et al., 2002]㸬

ᮏㄽᩥ◊ ✲ 2 ࡟࠾࠸࡚ 㸪∦⬮ࢫࢡ࣡ ࢵࢺ㸪∦ ⬮ࢻࣟࢵࣉࣛ ࣥࢹ࢕ࣥ ࢢ㸪࢝ࢵ

ࢸ࢕ࣥࢢືస ࢆ㊊㊑㛤 ᤼࠾ࡼࡧ㊊㊑ ᢕᣢࡢᣦ ♧ୗ࡛⾜ࢃࡏ ࡓ᫬ࡢື ⓗୗ⫥࢔ࣛ

࢖࣓ࣥࢺ࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ሗ࿌ ࡋࡓࡀ㸪 ◊✲ 5࡛ࡣ 㸪㊊㊑ᢕᥱ ຊ ࡜㟼ⓗ࠾

ࡼࡧືⓗࣂࣛ ࣥࢫ⬟ຊ ࡜ࡢ㛵㐃ᛶ࠾ ࡼࡧ㊊㊑ ᢕᥱຊࡢ኱ᑠ ࡀ㟼ⓗ ࠾ ࡼࡧືⓗࣂ

ࣛࣥࢫ⬟ຊ࡟ ཬࡰࡍᙳ 㡪࡟ࡘ࠸࡚ ᳨ ドࡍࡿࡇ ࡜࡜ࡋࡓ㸬 ᮏ ◊✲ࡢ ┠ ⓗࡣ㸪኱Ꮫ ዪᏊ࢔ࢫ࣮ࣜ ࢺࢆ ᑐ㇟ ࡜ࡋ࡚㸪㊊㊑ ᢕᥱຊ ࡜ 㟼ⓗ࠾ࡼࡧື ⓗࣂࣛࣥ ࢫ⬟ຊ ࡜ࡢ 㛵㐃ᛶ࡟ࡘ࠸ ࡚㸪ࡲࡓ ㊊㊑ᢕᥱຊࡢ ኱ᑠࡀ㟼 ⓗ ࠾ࡼࡧືⓗ ࣂࣛࣥࢫ ⬟ຊ ࡟ཬࡰ

ࡍᙳ㡪࡟ࡘ࠸ ࡚ẚ㍑ ᳨ ドࡍࡿࡇ࡜࡛ ࠶ࡿ㸬

5-5-2. ᑐ㇟࡜᪉ἲ 1. ᑐ㇟

ᑐ㇟⪅ࡣ㸪኱Ꮫዪ Ꮚࣛ ࢡࣟࢫ㑅 ᡭ 33 ྡ࡜ࡋ ࡓ㸬ᑐ㇟⪅ࡢᖹᆒ ᖺ㱋㸦±ᶆ‽೫ ᕪ㸧ࡣ 19.4 ± 1.2ṓ㸪㌟㛗 160.0 ± 6.2cm㸪య 㔜 54.7 ± 5.4kg㸪BMI21.4 ± 1.4kg/m²

࡛࠶ࡗࡓ㸬஦ ๓࡟ᮏ◊ ✲࡛⾜࠺ ᐃ ෆᐜ㸪೔ ⌮ⓗ㓄៖࡟ࡘ ࠸࡚ᩥ᭩ ࠾ࡼࡧཱྀ㢌

࡟࡚ㄝ᫂ࢆ⾜ ࠸㸪᭩ 㠃 ࡟࡚ྠពࢆᚓ ࡚⾜ࡗࡓ 㸬ᮏ◊✲ࡣ 㸪᪩✄⏣ ኱ Ꮫ ேࢆᑐ㇟

࡜ ࡍ ࡿ ◊ ✲ ࡟ 㛵 ࡍ ࡿ ೔ ⌮ ᑂ ᰝ ጤ ဨ ఍ ࡢ ᢎ ㄆ ࢆ ᚓ ࡚ ᐇ ᪋ ࡋ ࡚ ࠸ ࡿ 㸦 ᢎ ㄆ ␒ ྕ 2013-015㸧㸬

106

2. ᪉ἲ a. ㊊㊑ᢕᥱຊ

㊊㊑ᢕᥱຊࡣ ᅗ 5-1 ࡟♧ࡍ㊊㊑ᢕᥱ ຊ ᐃჾ 㸦➉஭ᶵჾᕤ ᴗᰴᘧ఍ ♫〇㸪㊊

㊑➽ຊ ᐃჾ 㸧ࢆ⏝࠸ ࡚⾜ࡗࡓ㸬  ᐃ᪉ἲࡣ 〄㊊࡟࡚㸪 ㊊ ㊑ࡢ㊑⠇ 㛫㛵⠇ࡀ㊊

㊑ᢕᣢࣂ࣮࡟ ࠿࠿ࡿࡼ ࠺࡟ ㋖㒊࠾ࡼ ࡧ㋖㒊࡟ ᐦ╔ࡉࡏࡿ ᚋ 㒊ࣉ࣮ࣞ ࢺ ࡢ఩⨨ࢆ

ㄪ⠇ࡋࡓ㸬㊊ ㊑ᢕᣢࣂ ࣮࡟࠿࠿ࡿ㊊ ㊑ࡢᮏᩘ ࡣ㸪ᑐ㇟⪅ࡀ ᭱ࡶຊࢆ ධࢀࡸࡍ࠸

᫬ࡢ㊊㊑ᩘ࡜ ࡋ㸪≉࡟ ไ㝈 ࡣࡋ࡚࠸ ࡞࠸㸬  ᐃࡣᗙ఩࠾ࡼ ࡧ❧఩࡛ ⾜࠸㸪ࡑࢀ

ࡒࢀᕥྑ 2 ᅇࡎࡘ  ᐃࡋࡓ㸬ࣃࣛ ࣓࣮ࢱࡣ 㸪2 ᅇࡢ ᐃ್ࡢᖹ ᆒ ್࡜ࡋࡓ㸬࡞

࠾㸪ᕥྑࡢ  ᐃࡢ㡰␒ ࡣࣛࣥࢲ࣒࡟ ⾜ࡗࡓ㸬

b. 㔜ᚰືᦂᛶ

㔜ᚰືᦂᛶࡢ  ᐃࡣ㸪 ᅗ 5-2 ࡟♧ࡍ 㔜ᚰືᦂ ィ㸦 ࢔ࢽ࣐ᰴ ᘧ఍♫〇 㸪ࢢࣛࣅ

ࢥ࣮ࢲ GP-7㸧ࢆ ⏝࠸ ࡚ ᐃࡋࡓ 㸬  ᐃࡣ 㸪᪥ᮏᖹ⾮⚄⤒ ⛉Ꮫ఍࡛ ᐃࡵࡽࢀࡓ㔜

ᚰືᦂ᳨ᰝࡢ ᇶ‽[᪥ ᮏᖹ⾮⚄⤒⛉ Ꮫ఍, 2005]࠾ࡼࡧඛ⾜◊ ✲[ᮧ⏣㸪2004]ࢆཧ

⪃࡟௨ୗࡢ᪉ ἲ࡛⾜ࡗ ࡓ㸬⿕㦂⪅࡟ 㸪〄㊊࡛ ࣉ࣮ࣞࢺ୰ኸ ࡟∦⬮࡛ ࡘࡲඛࢆṇ 㠃࡟ྥࡅ࡚⭸ 㛵⠇ࢆఙ ᒎࡉࡏࡓ≧ែ ࡛❧ࡓࡏ ࡓ 㸬❧⬮ഃࡢ ཯ᑐഃࡢ ⬮ࡣ 㸪⭸㛵

⠇90 ᗘ࡛⫤㛵⠇ ࡣఙ ᒎ 0 ᗘ࡟ಖᣢ ࡉࡏࡓ㸬୧⭎ࢆ⬚ࡢ๓ ࡛஺ᕪࡋ 㸪୧ᡭࢆ⫪ࡢ

ୖ࡟ᙜ࡚ࡉࡏ ࡓ㸬ྜᅗ ࡜࡜ࡶ࡟㸪2m ๓ ᪉ࡢ ቨ࡟♧ࡋࡓ×༳ࢆ 30 ⛊㛫ὀどࡉࡏ ࡓ㸬 ᐃࡣ㸪 ᕥ⬮࠾ࡼ ࡧྑ⬮ࡢ∦⬮ ❧఩⫥఩ ࡛ࡑࢀࡒ ࢀ1 ᅇࡎࡘ⾜ ࢃࡏࡓ㸬ᕥ

ᅗ5-1 ㊊㊑ᢕᥱ ຊ  ᐃჾ

107

⬮࠾ࡼࡧྑ⬮ ࡢ ᐃࡢ 㡰␒ࡣ㸪ࣛࣥ ࢲ࣒࡟⾜ ࡗࡓ㸬㔜ᚰື ᦂ ᐃ࠿ ࡽᚓࡽࢀࡓ

⤖ᯝ࠿ࡽ㸪௒ᅇࡢ ᐇ 㦂 ࡛⏝࠸ࡓࣃࣛ ࣓࣮ࢱࡣ 㸪㔜ᚰ⥲㌶ ㊧㛗㸪㔜ᚰ ༢఩㌶㊧㛗㸪 㔜ᚰ༢఩㠃✚ ㌶㊧㛗㸪 㔜ᚰእ࿘㠃✚ 㸪㔜ᚰ▴ ᙧ㠃✚ ࡜ࡋࡓ 㸬

c. SEBT㸦Star Excursion Balance Test㸧

SEBTࡣ㸪ᅗ5-3࡟♧ ࡋ ࡓ ᐃჾල㸦Y Balance Test, Move2Perform, Evansville, IN㸧

ࢆ⏝࠸ࡓ㸬 ᐃ ᪉ἲࡣ 㸪⿕㦂⪅࡟ ᐃ ჾࡢ୰ ኸBOXୖ࡟ᨭᣢ⬮㸦   ᐃ⬮ഃ㸧ࡢ

㊊ࢆ⨨࠸࡚❧ ࡓࡏ 㸪୧ ᡭࡣ⭜࡟ ᙜ࡚ ࡉࡏࡓ 㸬ᨭᣢ⬮ࡢ཯ᑐ ⬮ࡢ㊊㒊 ࡢࡘࡲඛ࡛㸪 ๓᪉㸦anterior㸸௨ୗ 㸪A㸧㸪ᚋෆ᪉ 㸦posteromedial㸸௨ୗ㸪PM㸧㸪ᚋእ᪉ 㸦posterolateral㸸௨ୗ㸪PL㸧࡟ఙࡧࡓ࣏࣮ ࣝ࡟ タ⨨ࡉࢀ࡚࠸ ࡿࢫࣛ࢖ ࢻBOXࢆ㸪

ྍ⬟࡞㝈ࡾࡘ ࡲඛ࡛㐲 ᪉࡬ᢲࡋࡓᚋ 㸪ࢫࢱ࣮ ࢺ⫥఩࡟ᡠࡿ ࡇ࡜࡜ࡋ ࡓ㸬  ᐃ๓

࡟㸪Hertelࡽ㸦2000㸧ࡀ᥎ዡࡋ࡚࠸ ࡿࡼ࠺࡟ Ᏻᐃࡋࡓ್ࢆ ᚓࡿࡓࡵ 㸪ྛ᪉ྥ࡟6 ᅇࡢ⦎⩦ࢆ⾜ ࢃࡏࡓ㸬  ᐃ୰࡟௨ୗ ࡢヨᢏࡀ ࡳࡽࢀࡓሙྜ ࡣ↓ຠ࡜ ࡋ㸪෌ヨᢏ

ࢆ⾜ࢃࡏࡓ㸬1)ᨭᣢ⬮ ࡢ཯ᑐഃࡢ㊊ ࡀᆅ㠃࡟ ╔࠸ࡓሙྜ㸬2)ᨭᣢ⬮ ࡢ㊊㒊ࡀࢫ ࢱ࣮ࢺ఩⨨࠿ ࡽື࠸ࡓ ሙྜ㸦㋖㒊ࡀ ᾋ࠸ࡓሙ ྜࡶ↓ຠ㸧㸬3)᭱㛗ࣜ ࣮ࢳᚋ㸪ࣜ

࣮ࢳࡋࡓഃࡢ ⬮ࢆࢫࢱ ࣮ࢺ఩⨨ࡲ࡛ ᡠࡍࡇ࡜ ࡀ ฟ᮶࡞࠿ࡗ ࡓሙྜ㸬4)∦ᡭ࠾ࡼ

ࡧ୧ᡭࡀ⭜࠿ ࡽ㞳ࢀࡓ ሙྜ࡜ࡋࡓ㸬 ᐃࡣ㸪ᕥ⬮ 㸪ྑ⬮ู ࡟A㸪PM㸪PL᪉ྥ࡟

ࡑࢀࡒࢀ3ᅇ⾜ࡗ ࡓ㸬 ࡲࡓᕥ⬮࠾ࡼ ࡧྑ⬮ࡢ  ᐃࡢ㡰␒ࡣ ࣛࣥࢲ࣒ ࡟⾜ࡗࡓ㸬3 ᅇࡢᚓࡽࢀࡓ ್ࡢᖹᆒ ್ࢆ⿕㦂⪅ࡢ ⬮㛗㸦ୖ ๓⭠㦵Ჲ࠿ࡽ ㊊㛵⠇ෆ ᯝࡲ࡛ࡢ㛗

ᅗ 5-2 㔜ᚰືᦂ ィ

108

ࡉ㸧࡛㝖ࡋࡓ ್࡟100ࢆ஌ࡌ࡚ṇつ ໬ࡋࡓ್ ࢆࣃ࣓࣮ࣛࢱ ࡜ࡋࡓ[Gribble and Hertel, 2003]㸬

3. ẚ㍑᳨ウ㡯┠

㊊㊑ᢕᥱຊ ࡜㔜ᚰື ᦂᛶࡢ 㔜ᚰ⥲ ㌶㊧㛗㸪 㔜ᚰ ༢఩㌶㊧ 㛗㸪㔜ᚰ ༢఩㠃✚㌶

㊧㛗㸪㔜ᚰ እ࿘㠃✚ 㸪㔜ᚰ▴ᙧ㠃✚ 㸪SEBT ࡢ A㸪PM㸪PL࡜ࡢ┦ 㛵㛵ಀࢆ㸪ࡲ

ࡓ㸪㊊㊑ᢕᥱ ຊࢆ ᑠ⩌ 㸪኱⩌ࡢ 2 ⩌࡟ศࡅ㸪 ྛ⩌ࡢ㔜ᚰື ᦂᛶ࠾ࡼ ࡧ SEBT ࡢ

ྛࣃ࣓࣮ࣛࢱ ࢆẚ㍑ࡋ ࡓ㸬 4. ⤫ィᏛⓗᡭἲ

㊊㊑ᢕᥱຊ࡜ 㔜ᚰືᦂ ᛶࡢ 㔜ᚰ⥲㌶ ㊧㛗㸪㔜 ᚰ ༢఩㌶㊧㛗 㸪㔜ᚰ༢ ఩㠃✚㌶

㊧㛗㸪㔜ᚰእ࿘ 㠃✚ 㸪㔜ᚰ▴ᙧ㠃✚㸪SEBTࡢ A㸪PM㸪PL࡜ࡢ┦ 㛵㛵ಀ࡟ࡘ࠸

࡚ࡣࣆ࢔ࢯࣥ ࡢ┦㛵 ಀ ᩘࢆ⏝࠸᳨࡚ ウࡋ 㸪ࡲ ࡓ㸪㊊㊑ᢕᥱ ຊࡢᑠ⩌ 㸪኱ ⩌ࡢẚ

㍑࡟ࡘ࠸࡚ࡣ ᑐᛂࡢ࡞ ࠸ t ᳨ᐃࢆ⏝࠸ࡓ㸬࡞ ࠾㸪඲࡚ࡢ⤫ ィฎ⌮࡟ ࡣ⤫ィゎᯒ ࢯࣇࢺ࢙࢘࢔ 㸦SPSS Statistics Student Version 19.0㸧ࢆ⏝࠸㸪 ᭷ ព☜⋡ࢆ 5%ᮍ

‶࡜ࡋࡓ㸬

ᅗ 5-3 SEBT㸦Star Excursion Balance Test㸧

109

5-5-3. ⤖ᯝ

ᕥྑࡢ㊊㊑ᢕ ᥱຊ㸪SEBT㸪㔜ᚰືᦂᛶࡢྛ ࣃ࣓࣮ࣛࢱ ࢆ ⾲ 5-1࡟ ♧ࡍ㸬

㊊㊑ᢕᥱຊ(kg) 15.0 ± 3.8 14.9 ± 4.0 㔜ᚰືᦂᛶ

㔜ᚰ⥲㌶㊧㛗(cm) 91.3 ± 25.6 88.9 ± 23.8

㔜ᚰ༢఩㌶㊧㛗(cm/⛊) 3.0 ± 0.9 3.0 ± 0.8

㔜ᚰ༢఩㠃✚㌶㊧㛗(cm/cm²) 29.8 ± 18.0 29.3 ± 16.7

㔜ᚰእ࿘㠃✚(cm²) 4.0 ± 2.0 3.8 ± 1.5

㔜ᚰ▴ᙧ㠃✚(cm²) 9.8 ± 4.8 9.2 ± 3.7

SEBT*

A 0.66 ± 0.66 0.66 ± 0.06

PM 1.14 ± 0.05 1.14 ± 0.06

PL 1.10 ± 0.06 1.10 ± 0.08

A, PM, PL䛾ᖹᆒ 0.96 ± 0.05 0.97 ± 0.06

⾲5-1䚷㊊㊑ᢕᥱຊ䞉SEBT䞉㔜ᚰືᦂᛶ (ᖹᆒ ± ᶆ‽೫ᕪ)

ྑ ᕥ

*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾

඲䛶䛾䝟䝷䝯䞊䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊

඲䛶N.S.

110

ྑ㊊㊑ᢕᥱຊ ࡜ 㔜ᚰື ᦂᛶ㸪SEBT ࡜ࡢ┦㛵 㛵ಀ ࢆ⾲ 5-2࡟ ♧ࡍ㸬 ྑ㊊㊑ᢕ ᥱຊ࡜㔜ᚰື ᦂᛶ ࡢ㔜 ᚰ⥲㌶㊧㛗㸪 㔜ᚰ ༢఩ ㌶㊧㛗࡜ࡢ㛵 ಀ࡟᭷ព ࡞ ప࠸㈇ࡢ

┦㛵ࢆ♧ࡋࡓ 㸦࠸ࡎࢀ ࡶ r = -0.354㸪p = 0.043㸧㸦ᅗ 5-4㸪ᅗ 5-5㸧 㸬ࡑࡢ௚ࡢ

ྛ㡯┠࡜ࡢ㛵 ಀ࡟ ࡘ࠸ ࡚ࡣ᭷ពᕪࡣ ࡳࡽࢀ࡞ ࠿ࡗࡓ㸬

㔜ᚰ⥲

㌶㊧㛗

㔜ᚰ༢఩

㌶㊧㛗

㔜ᚰ༢఩

㠃✚㌶㊧㛗

㔜ᚰእ࿘

㠃✚

㔜ᚰ▴ᙧ 㠃✚

-.354^* -.354^* -.054 -.070 -.063

SEBT A

SEBT PM

SEBT PL

SEBT A, PM, PL

䛾ᖹᆒ

.272 .320 .002 .252

⾲5-2䚷ྑ㊊㊑ᢕᥱຊ䛸㔜ᚰືᦂᛶ䞉SEBT* 䛸䛾┦㛵㛵ಀ

ྑ㊊㊑ᢕᥱຊ

ྑ㊊㊑ᢕᥱຊ

*: p < 0.05

*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾 ඲䛶䛾䝟䝷䝯䞊䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊

ᅗ 5-4 ྑ ㊊ ㊑ ᢕ ᥱ ຊ ࡜ 㔜 ᚰ ⥲ ㌶ ㊧ 㛗 ࡜ ࡢ 㛵 ಀ

ᅗ 5-5 ྑ ㊊ ㊑ ᢕ ᥱ ຊ ࡜ 㔜 ᚰ ༢ ఩ ㌶ ㊧ 㛗 ࡜ ࡢ 㛵 ಀ

111

ྑ㊊㊑ᢕᥱຊ ࡢᑠ⩌࠾ ࡼࡧ኱⩌ࡢᖹ ᆒ್ 㸦sᶆ‽೫ᕪ㸧 ࢆ ⾲ 5-3࡟ 㸪ྑ㊊㊑

ᢕᥱຊࡢᑠ⩌ 㸪኱⩌ ࡢ SEBT㸪㔜ᚰືᦂᛶ ࡢྛࣃ࣓࣮ࣛ ࢱࢆ ⾲ 5-4࡟♧ࡍ㸬ྑ

㊊㊑ᢕᥱຊࡢ ᑠ⩌㸪኱ ⩌ࡢ㔜ᚰ⥲㌶ ㊧㛗࡜㔜 ᚰ༢఩㌶㊧㛗 ࡢẚ㍑࡟ ࠾࠸࡚㸪኱

⩌ࡣᑠ⩌࡟ẚ ࡭㸪᭷ព ࡟ ㌶㊧㛗ࡀ▷ ࠿ࡗࡓ㸦 ࠸ࡎࢀࡶp = 0.043㸧㸬௚ࡢ⩌㛫ẚ

㍑࡟࠾࠸࡚ࡣ ᭷ពᕪࡣ ࡳࡽࢀ࡞࠿ࡗ ࡓ㸬

㊊㊑ᢕᥱຊ(kg) 11.6 ± 2.0* 17.9 ± 2.1*

*: ᑠ⩌ vs. ኱⩌, p < 0.01

⾲5-3䚷ྑ㊊㊑ᢕᥱຊ䛾ᑠ⩌䛸኱⩌ (ᖹᆒ ± ᶆ‽೫ᕪ) ᑠ⩌(n=15) ኱⩌(n=18)

SEBT*

A 0.63 ± 0.07 0.68 ± 0.06

PM 1.13 ± 0.06 1.15 ± 0.04

PL 1.10 ± 0.05 1.09 ± 0.07

A, PM, PL䛾ᖹᆒ 0.95 ± 0.05 0.97 ± 0.04

㔜ᚰືᦂᛶ

㔜ᚰ⥲㌶㊧㛗(cm) 101.1 ± 26.3^a) 83.2 ± 22.7^a) 㔜ᚰ༢఩㌶㊧㛗(cm/⛊) 3.4 ± 0.9^b) 2.8 ± 0.8^b) 㔜ᚰ༢఩㠃✚㌶㊧㛗(cm/cm²) 30.6 ± 17.1 29.2 ± 19.3 㔜ᚰእ࿘㠃✚(cm²) 4.1 ± 1.7 3.9 ± 2.3

㔜ᚰ▴ᙧ㠃✚(cm²) 10.0 ± 4.0 9.6 ± 5.5

⾲5-4䚷ྑ㊊㊑ᢕᥱຊ䛾ᑠ⩌䞉኱⩌䛾ྛ䝟䝷䝯䞊䝍䛾ẚ㍑ (ᖹᆒ ± ᶆ‽೫ᕪ) ᑠ⩌(n=15) ኱⩌(n=18)

*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾඲䛶䛾䝟䝷䝯䞊 䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊

a), b): ᑠ⩌ vs. ኱⩌, p < 0.05.

112

ᕥ㊊㊑ᢕᥱຊ ࡜㔜ᚰື ᦂᛶ㸪SEBT ࡜ࡢ┦㛵 㛵ಀࢆ⾲ 5-5 ࡟♧ ࡍ 㸬ᕥ㊊㊑ᢕ ᥱຊ ࡜㔜 ᚰື ᦂᛶ 㸪SEBT ࡜ࡢ㛵 ಀ࡟ ࡘ࠸ ࡚㸪 ඲࡚ ࡢ㡯 ┠ 㛫 ࡟ ࠾ ࠸࡚ ᭷ព ᕪࡣ

ࡳࡽࢀ࡞࠿ࡗ ࡓ㸬

㔜ᚰ⥲

㌶㊧㛗

㔜ᚰ༢఩

㌶㊧㛗

㔜ᚰ༢఩

㠃✚㌶㊧㛗

㔜ᚰእ࿘

㠃✚

㔜ᚰ▴ᙧ 㠃✚

-.257 -.256 .173 -.307 -.300

SEBT A

SEBT PM

SEBT PL

SEBT A, PM, PL䛾

ᖹᆒ

.305 .208 .040 .209

⾲5-5䚷ᕥ㊊㊑ᢕᥱຊ䛸㔜ᚰືᦂᛶ䞉SEBT* 䛸䛾┦㛵㛵ಀ

඲䛶N.S.

ᕥ㊊㊑ᢕᥱຊ ᕥ㊊㊑ᢕᥱຊ

*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾 ඲䛶䛾䝟䝷䝯䞊䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊

113

ᕥ㊊㊑ᢕᥱຊ ࡢᑠ⩌࠾ ࡼࡧ኱⩌ࡢᖹ ᆒ್ 㸦sᶆ‽೫ᕪ㸧 ࢆ ⾲ 5-6 ࡟ 㸪ᕥ㊊㊑

ᢕᥱຊࡢᑠ⩌ 㸪኱⩌ ࡢ SEBT㸪㔜ᚰືᦂᛶ ࡢྛࣃ࣓࣮ࣛ ࢱࢆ ⾲ 5-7 ࡟ ♧ࡍ㸬ᕥ

㊊㊑ᢕᥱຊࡢ ᑠ ⩌ 㸪኱ ⩌ࡢྛࣃ࣓ࣛ ࣮ࢱࡢ ẚ ㍑࡟࠾࠸࡚㸪SEBT ࡢ A ࡟࠾࠸࡚

኱⩌ࡣᑠ⩌࡟ ẚ࡭㸪᭷ ព࡟࣮ࣜࢳ㛗 ࡀ㛗࠿ࡗ ࡓ㸦p = 0.020㸧㸬௚ࡢ⩌㛫ẚ㍑࡟

࠾࠸࡚ࡣ᭷ព ᕪࡣࡳࡽ ࢀ࡞࠿ࡗࡓ㸬

㊊㊑ᢕᥱຊ(kg) 11.6 ± 1.5* 18.3 ± 2.6*

⾲5-6䚷ᕥ㊊㊑ᢕᥱຊ䛾ᑠ⩌䛸኱⩌ (ᖹᆒ ± ᶆ‽೫ᕪ) ᑠ⩌(n=17) ኱⩌(n=16)

*: ᑠ⩌ vs. ኱⩌, p < 0.01

SEBT*

A 0.64 ± 0.05^a) 0.69 ± 0.06^a)

PM 1.13 ± 0.06 1.16 ± 0.07

PL 1.09 ± 0.06 1.11 ± 0.09

A, PM, PL䛾ᖹᆒ 0.95 ± 0.04 0.98 ± 0.06

㔜ᚰືᦂᛶ

㔜ᚰ⥲㌶㊧㛗(cm) 93.8 ± 15.8 83.6 ± 29.7

㔜ᚰ༢఩㌶㊧㛗(cm/⛊) 3.1 ± 0.5 2.8 ± 1.0

㔜ᚰ༢఩㠃✚㌶㊧㛗(cm/cm²) 26.1 ± 13.3 32.7 ± 19.6

㔜ᚰእ࿘㠃✚(cm²) 4.1 ± 1.2 3.4 ± 1.8

㔜ᚰ▴ᙧ㠃✚(cm²) 10.1 ± 2.9 8.2 ± 4.2

*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾඲䛶䛾䝟䝷䝯䞊 䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊

a): ᑠ⩌ vs. ኱⩌, p < 0.05.

⾲5-7䚷ᕥ㊊㊑ᢕᥱຊ䛾ᑠ⩌䞉኱⩌䛾ྛ䝟䝷䝯䞊䝍䛾ẚ㍑ (ᖹᆒ ± ᶆ‽೫ᕪ) ᑠ⩌(n=17) ኱⩌(n=16)

114

5-5-4. ⪃ᐹ

ᮏ◊✲ࡣ㸪኱ ᏛዪᏊ࢔ ࢫ࣮ࣜࢺࢆ ᑐ ㇟࡜ࡋ࡚ 㸪㊊㊑ᢕᥱຊ ࡜㟼ⓗࣂ ࣛࣥࢫ࠾

ࡼࡧືⓗࣂࣛ ࣥࢫ⬟ຊ ࡜ࡢ㛵㐃ᛶ࡟ ࡘ࠸࡚㸪 ࡲࡓ㸪 ㊊㊑ᢕ ᥱຊ ࡢ኱ ᑠࡀ㟼ⓗࣂ

ࣛࣥࢫ࠾ࡼࡧ ືⓗࣂࣛ ࣥࢫ⬟ຊ ࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ẚ㍑ ᳨ウࡍࡿ ࡇ࡜ࢆ┠ⓗ

࡜ࡋ࡚⾜ࡗࡓ 㸬ᚓࡽࢀ ࡓ⤖ᯝࡣ㸪 ྑ ㊊㊑ᢕᥱ ຊ࡜㔜ᚰືᦂ ᛶࡢ 㔜ᚰ ⥲㌶㊧㛗㸪 㔜ᚰ༢఩㌶㊧ 㛗࡜ࡢ㛵 ಀ࡟᭷ព࡞㈇ ࡢ ప࠸┦ 㛵ࢆ♧ࡋ㸦࠸ࡎ ࢀࡶ r = -0.354㸪p

= 0.043㸧㸪ྑ㊊ ㊑ᢕᥱ ຊࡢ ኱⩌ࡣᑠ ⩌࡟ẚ࡭ ࡚㸪㔜ᚰ⥲ ㌶㊧㛗࡜ 㔜 ᚰ༢఩㌶㊧

㛗࡟࠾࠸࡚᭷ ព࡟㌶㊧ 㛗ࡀ ▷࠿ࡗࡓ㸦࠸ࡎ ࢀ ࡶ p = 0.043㸧㸬ࡇࢀࡣ ㊊㊑ᢕᥱຊ ࡀ㧗࠸⪅ࡣ㔜 ᚰືᦂᛶ ࡢ 㔜ᚰ⥲㌶㊧ 㛗㸪㔜ᚰ ༢఩㌶㊧㛗ࡀ ▷ࡃ㸪 ㊊ ㊑ᢕᥱຊࡀ ప࠸⪅ࡣ㔜ᚰ ືᦂᛶࡢ 㔜ᚰ⥲㌶㊧㛗 㸪㔜ᚰ ༢ ఩㌶㊧㛗ࡀ㛗 ࠸㛵ಀ࡟ ࠶ࡿࡇ࡜ࢆ

ព࿡ࡍࡿ㸬㊊ ㊑ᢕᥱ ື సࡣ㊊㊑ᒅ᭤ ືసࡀక ࠸㸪ࡑࡢືస ࡟స⏝ࡍ ࡿ➽ࡣ㸪㊊

㒊ෆᅾ➽࡛࠶ ࡿ ▷ẕ㊑ ᒅ➽ࠊ㛗ẕ㊑ᒅ ➽ࠊẕ ㊑ෆ㌿➽㸪▷㊑ ᒅ➽㸪▷ᑠ㊑ᒅ➽㸪

⫼ഃ㦵㛫➽㸪ᗏ ഃ㦵㛫 ➽㸪⹸ᵝ➽[Oatis, 2009]࡛࠶ࡿ㸬ඛ⾜ㄽᩥ࠿ ࡽ㸪Ⲵ㔜఩࡛

ࡢẕ㊑እ㌿➽ ࡟ࡼࡿ㊊ ㊑ᒅ᭤స⏝ࡀ ㊊㒊ෆഃ ⦪࢔࣮ࢳࡢᨭ ᣢ࡟㔜せ ࡞ᙺ๭ࢆᯝ ࡓࡋ࡚࠸ࡿࡇ ࡜ࡀከᩘ ሗ࿌ࡉࢀ࡚ ࠸ ࡿ࡯࠿[Fiolkowski et al., 2003; Headlee et al., 2008; Jung et al., 2012; Mann and Inman, 1964; Wong, 2007]㸪ෆഃ⦪ ࢔࣮ࢳ๛ᛶ࡟

㊊ᗏ⭝⭷ࡸ㊊ ᗏ➽⭷ࡶ ࢔࣮ࢳࢧ࣏࣮ ࢺ࡟ᐤ୚ ࡋ࡚࠸ࡿࡇ࡜ ࡀ」ᩘሗ ࿌ࡉࢀ࡚ ࠸

ࡿ[Carlson et al., 2000; Franco, 1987; Thordarson et al, 1997]㸬㊊㊑ᢕ ᥱຊࡢඃࢀ࡚

࠸ࡿ⪅ࡣ㸪∦ ⬮❧఩᫬ ࡢ㊊㊑࡟ࡼࡿ ᗋࡢᢕᣢ ຊࡶ㧗ࡃ㸪ෆ ഃ⦪࢔࣮ ࢳࡢᨭᣢᛶ ࡀ㧗ࡲࡿࡇ࡜ 㸪ࡲࡓ㸪 ẕ㊑እ㌿➽ࡸ ᑠ㊑እ㌿ ➽࡜࠸ࡗࡓ㊊ 㒊ෆᅾ➽ ࡢ➽⥭ᙇ ࡟

ࡼࡾ㊊㒊࢔࣮ ࢳ๛ᛶ ࡀ 㧗ࡲࡿࡇ࡜ࡶ ሗ࿌ࡉࢀ ࡚࠾ࡾ[Kapandji, 1987]㸪ࡑࢀࡽࡢ

㊊㊑㐠ືࡀ∦ ⬮❧఩᫬ ࡢ㊊㒊ࡢᏳᐃ ᛶࢆ㧗ࡵ 㸪ࡑࡢ⤖ᯝୗ ⫥඲యࡢ ࣂࣛࣥࢫಖ ᣢ⬟ຊྥୖ࡟ ᐤ୚ࡉࡏ ࡓࡢ࡛ࡣ࡞࠸ ࠿࡜᥎  ࡋࡓ㸬

ᕥ㊊㊑ᢕᥱຊ ࡢ ኱⩌࡜ ᑠ⩌ࡢẚ㍑࡟ ࠾࠸࡚ࡣ 㸪SEBT ࡢ A ࡟࠾࠸࡚ ኱⩌ ࡀᑠ

⩌࡟ẚ࡭㸪᭷ ព࡟࣮ࣜ ࢳ㛗ࡀ㛗࠿ࡗ ࡓ㸬 ඛ⾜ ◊✲࠿ࡽ㸪ᒣ ཱྀࡽ㸦1989㸧ࡣ㸪㊊

㊑ᒅ᭤➽ຊ࡜ ㊊ᅽ୰ᚰ ືᦂ࡜ࡢ㛵㐃 ᛶࢆ᳨ド ࡋࡓ⤖ᯝ㸪㊊ ㊑ ᒅ᭤➽ ຊ ࡀ๓ᚋ᪉

ྥ࡬ࡢᏳᐃᛶ ࡟ᐤ୚ࡉ ࡏ࡚࠸ࡿ࡜㏙ ࡭࡚࠸ࡿ 㸬ࡲࡓ㸪 ຍ㎶ ࡽ㸦2002㸧ࡣ㸪඲㊊

㊑㸦➨ 1㊑㹼 ➨ 5 ㊑㸧 ࡢ㊊㊑ᢕᣢຊ 㸪ẕ㊑㸦 ➨ 1 ㊑㸧ࡶࡋ ࡃࡣ ➨ 2 ㊑㹼➨ 5 ㊑ ࡢ㊊㊑ᢕᣢຊ ࡜๓᪉ࣜ ࣮ࢳືస᫬ࡢ ㊊ᅽ୰ᚰ ⛣ື㊥㞳࡜ࡢ 㛵㐃ᛶ࡟ ࡘ࠸᳨࡚ド

115

ࡋࡓ⤖ᯝ㸪඲ ㊊㊑ ࡢᢕ ᣢຊࡀ᭱ࡶ๓ ᪉࡬ࡢࣂ ࣛࣥࢫಖᣢ࡟ 㛵ಀࡋ㸪 ḟ࡟ẕ㊑㸪 ࡑࡋ࡚➨ 2㊑ 㹼➨ 5㊑ ࡢ㡰࡛࠶ࡗࡓ ࡇ࡜ࡀሗ ࿌ࡉࢀ㸪୰࡛ ࡶẕ㊑㸦 ➨ 1㊑㸧ࡢ ᢕᣢຊࡀ๓᪉ ࡬ࡢࣂࣛ ࣥࢫಖᣢ࡟ᐤ ୚ࡉࡏ㸪 㔜ᚰ๓᪉఩⨨ ᫬ࡢࠕᨭ ᣢస⏝ࠖ ࢆ ᣢࡘ࡜⪃ᐹࡋ ࡚࠸ࡿ㸬 ㎷㔝࡜⏣୰㸦2007㸧ࡣ㸪ẕ㊑㸦 ➨ 1 ㊑㸧࡜ ➨ 2 ㊑㹼 ➨ 5

㊑ࡢ㊊㊑ᅽ㏕ ຊ࡜ ๓᪉ ࣮ࣜࢳືస᫬ ࡢ㊊ᅽ୰ ᚰ఩⨨࡜ࡢ㛵 㐃ᛶ࡟ࡘ ࠸᳨࡚ドࡋ ࡓ⤖ᯝ㸪 ➨ 2 ㊑㹼 ➨ 5 ㊑ࡢ㊊㊑ᅽ㏕ ຊ࡜ ๓᪉ ࣮ࣜࢳືస᫬ ࡢ㊊ᅽ୰ ᚰ఩⨨࡜ࡢ 㛵ಀ࡟࠾࠸࡚ ᭷ព࡞ṇ ࡢ┦㛵ࢆㄆࡵ ࡓࡀ㸪 ≉ ࡟ẕ㊑ᅽ㏕ຊ ࡜๓᪉࡬ ࡢ㊊ᅽ୰ᚰ

఩⨨࡜ࡢ㛵㐃 ᛶࡀ㧗 ࠿ ࡗࡓࡇ࡜ࢆሗ ࿌ࡋ࡚࠸ ࡿ㸬

ࡇࢀࡽࡢሗ࿌ ࢆྜࢃࡏ ᳨࡚ウࡍࡿ࡜ 㸪㊊㊑ᢕ ᥱຊࡢඃࢀࡿ ⪅ࡣ㊊㒊 ࢔࣮ࢳ๛

ᛶࡀ㧗ࡲࡿ࡜ ࡇ࡛㊊㒊 ࡢᏳᐃᛶࡀྥ ୖࡋ㸪 㟼 ⓗୗ⫥ࣂࣛࣥ ࢫಖᣢ⬟ ຊ࡟ᐤ୚ࡉ ࡏࡿࡇ࡜㸪ࡲ ࡓ㸪㊊㊑ ᢕᥱຊࡢඃࢀ ࡿ⪅ࡣ㸪 ๓᪉࡬ࡢືⓗ ࣂࣛࣥࢫ ಖᣢ⬟ຊ ࡟ ᐤ୚ࡉࡏࡿྍ ⬟ᛶࡀ♧ ၀ࡉࢀࡓ㸬 ᮏ ◊✲⤖ᯝ ࠿ࡽ㸪ࢫ࣏࣮ ࢶയᐖண 㜵࡜࠸࠺ほ

Ⅼ࠿ࡽ╔┠ࡍ ࡿ࡜㸪㊊ ㊑ ᢕᥱຊࢆྥ ୖࡉࡏࡿ ࡇ࡜㸪ࡑࡋ࡚ ∦⬮❧఩ ᫬࠾ࡼࡧ∦

⬮╔ᆅືస᫬ ࡟㊊㊑࡛ ᗋࢆᢕᣢࡍࡿ ືస ᣦ♧ ࢆ⾜࠺ࡇ࡜ࡀ 㟼ⓗ࠾ࡼ ࡧືⓗࣂࣛ

ࣥࢫ⬟ຊྥୖ ࡟ᐤ୚ࡉ ࡏ㸪ࡉࡽ࡟ࡣ ୗ⫥യᐖ 㸪≉࡟ ㊊㛵⠇ ࡸ⭸㛵⠇ യᐖ ࡢண㜵

࡟ᐤ୚ࡉࡏࡿ ࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃࠼ࡓ 㸬

㊊㊑ᢕᥱຊ࡜ 㟼ⓗࣂࣛ ࣥࢫ ಖᣢ⬟ຊ ࡜ࡢ㛵㐃 ᛶ࠾ࡼࡧ㊊㊑ ᢕᥱຊࡢ ኱ᑠ ࡀ㟼

ⓗࣂࣛࣥࢫಖ ᣢ⬟ຊ࡟ ཬࡰࡍᙳ㡪㸪 ࡲࡓ㸪㊊ ㊑ᢕᥱຊࡢ኱ ᑠࡀ ๓᪉ ࡬ࡢືⓗࣂ

ࣛࣥࢫಖᣢ⬟ ຊ࡟ཬࡰ ࡍᙳ㡪࡟ࡘ࠸ ࡚ ୍㒊࡟ ࠾࠸࡚ ㄆࡵࡽ ࢀࡓ㸬㊊ ㊑ᢕᥱຊࡢ

ྥୖࡣ㸪๓㊊ 㒊ࢆྵࡵ ࡓ ㊊㒊ࡢᏳᐃ ᛶ࡟ᐤ୚ ࡉࡏ㸪 㟼ⓗ࠾ ࡼࡧືⓗ ୗ⫥ࣂࣛࣥ

ࢫಖᣢ⬟ຊࢆ ྥୖࡉࡏ ࡿ ྍ⬟ᛶࡀ♧ ၀ࡉࢀࡓ 㸬

5-5-5. ⤖ㄒ

኱ᏛዪᏊ࢔ࢫ ࣮ࣜࢺࢆ ᑐ㇟࡜ࡋ࡚㸪 ㊊㊑ᢕᥱ ຊ ࡜㟼ⓗࣂࣛ ࣥࢫ࠾ࡼ ࡧືⓗࣂ

ࣛࣥࢫ⬟ຊ࡜ ࡢ㛵㐃ᛶ 㸪࠾ࡼࡧ㊊㊑ ᢕᥱຊ ࡢ ኱ᑠࡀ㟼ⓗࣂ ࣛࣥࢫ࠾ ࡼࡧືⓗࣂ

ࣛࣥࢫ⬟ຊ࡟ ཬࡰࡍᙳ 㡪࡟ࡘ࠸࡚ ᳨ ドࡍࡿࡇ ࡜ࢆ┠ⓗ࡜ࡋ ࡚⾜࠸㸪 ௨ୗࡢ⤖ㄽ

ࢆᚓࡓ㸬

1) ྑ ㊊ ㊑ ᢕ ᥱ ຊ ࡜ 㔜 ᚰ ື ᦂ ᛶ ࡢ 㔜 ᚰ ⥲ ㌶ ㊧ 㛗 㸪 㔜 ᚰ ༢ ఩ ㌶ ㊧ 㛗 ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព࡞㈇ࡢప࠸ ┦㛵ࡀㄆ ࡵࡽࢀࡓ㸬

116

2) ྑ ㊊ ㊑ ᢕ ᥱ ຊ ࡢ ኱ ࡁ ࠸ ⩌ ࡣ ᑠ ࡉ ࠸ ⩌ ࡜ ẚ ㍑ ࡋ 㸪 㔜 ᚰ ື ᦂ ᛶ ࡢ 㔜 ᚰ ⥲ ㌶ ㊧ 㛗

࡜㔜ᚰ༢఩㌶ ㊧㛗 ࡟࠾ ࠸࡚㸪᭷ព࡟ ㌶㊧㛗ࡀ ▷࠿ࡗࡓ㸬

3) ᕥ㊊㊑ᢕᥱ ຊࡢ ኱ ࡁ࠸ ⩌ࡣᑠࡉ࠸ ⩌ ࡜ẚ ㍑ࡋ 㸪Star Excursion Balance Test ࡢ๓᪉࣮ࣜࢳ 㛗 ࡟࠾࠸ ࡚㸪᭷ព࡟ࣜ ࣮ࢳ㛗ࡀ 㛗࠿ࡗࡓ㸬

4) ㊊㊑ᢕᥱຊࡣ 㸪㟼ⓗ ࣂ ࣛࣥࢫಖᣢ⬟ ຊ࡜ࡢ㛵 㐃ᛶࢆ♧ࡋࡓ ࡇ࡜㸪ࡲ ࡓ㸪㊊

㊑ ᢕ ᥱ ຊ ࡢ ኱ ᑠ ࡀ 㟼 ⓗ ࠾ ࡼ ࡧ ື ⓗ ࣂ ࣛ ࣥ ࢫ ಖ ᣢ ⬟ ຊ ࡢ ୍ 㒊 ࡟ ᙳ 㡪 ࢆ ཬ ࡰ ࡋ 㸪

㊊㊑ᢕᥱືస ࠾ࡼࡧ㊊ ㊑ᢕᥱຊྥୖ ࢚ࢡࢧࢧ ࢖ࢬࡀ㸪 㟼ⓗ ࠾ࡼࡧ ື ⓗࣂࣛ

ࣥࢫ⬟ຊྥୖ ࡟ ࡘ࡞ࡀ ࡿྍ⬟ᛶࡀ♧ ၀ࡉࢀࡓ 㸬

117

◊◊✲6 㟼 ⓗୗ ⫥࢔ ࣛ ࢖࣓ ࣥࢺ ࠾ ࡼࡧ ⫤㛵 ⠇ እ㌿ ➽ຊ ࡜ ࢻࣟ ࢵࣉ ࣂ ࣮ࢸ ࢕࢝ ࣝ ࢪࣕ ࣥࣉ ᫬ ࡢୗ ⫥࢟ ࢿ ࣐ࢸ ࢕ࢡ ࢫ ࣭࢟ ࢿࢸ ࢕ ࢡࢫ ࡜ࡢ 㛵 㐃ᛶ

5-6-1. ⥴ゝ

௒᪥㸪ࢫ࣏࣮ࢶ ་Ꮫ ศ 㔝࡛ࡣ͂ࢫ࣏࣮ ࢶയᐖ ண㜵 ̓࡟↔Ⅼࡀ ࠶࡚ࡽ ࢀ 㸪㏆ᖺ㸪

⭸๓༑Ꮠ㠌ᖏ㸦anterior cruciate ligament㸸௨ ୗ㸪ACL㸧യᐖண㜵 ࣉ ࣟࢢ࣒ࣛ࡟㛵 ࡍࡿ◊✲ሗ࿌ ࡀከᩘࡳ ࡽࢀࡿ㸬ࡲࡓ㸪ACLയ ᐖண㜵ࢆ┠ⓗ ࡜ࡋࡓࢫ ࢡ࣮ࣜࢽࣥ

ࢢࢸࢫࢺࡢ୍ ࡘ࡜ࡋ࡚ 㸪ࢻࣟࢵࣉ ࣂ࣮ࢸ࢕ ࢝ ࣝ㸦ᆶ┤ 㸧ࢪࣕࣥ ࣉ㸦drop vertical jump㸸௨ୗ㸪DVJ㸧ࢸࢫࢺࡀ᥎ዡࡉࢀ ࡚࠸ࡿ[Hewett et al., 2006; Noyes et al., 2005]㸬 ࡇࢀࡣ╔ᆅື స᫬࡟ࡳ ࡽࢀࡿ㐣๫࡞ ⭸㛵⠇እ ཯⫥఩➼࡟╔ ┠ࡋ 㸪≉ ᚩⓗ࡞ୗ⫥

࢔ࣛ࢖࣓ࣥࢺ ࢆ࿊ࡍࡿ ⪅ࢆࢫࢡ࣮ࣜ ࢽࣥࢢ ࡋ ࡚㸪ACLയᐖࣜࢫࢡࢆ ุูࡍࡿ ࡇ

࡜ࢆ┠ⓗ࡜ࡋ ࡓ ࢸࢫࢺ ἲ࡛࠶ࡿ 㸬ᐇ㦂ᐊ ෆ࡛ ⾜ࢃࢀࡓ DVJືసࡸ ྎୖ࠿ࡽࡢ╔

ᆅືస᫬ࡢୗ ⫥࢔ࣛ࢖ ࣓ࣥࢺࢆ ศᯒ ࡋࡓሗ࿌ ࡟ࡼࡿ࡜㸪≉ ࡟ዪᛶ࢔ ࢫ࣮ࣜࢺ ࡣ

⏨ᛶ࢔ࢫ࣮ࣜ ࢺ࡟ẚ࡭ 㸪⭸㛵⠇እ཯ ゅᗘ㸪 ⫤ 㛵⠇ෆ㌿ゅᗘ ࡸ⫤㛵⠇ ෆ᪕ゅᗘࡀ

኱ࡁ࠸ࡇ࡜ࡸ[Borotikar et al., 2008; Ford et al., 2003; Ford et al., 2006; Hewett et al., 2006; Hughesa et al., 2009; Kernozak et al., 2006; Pappas et al., 2007; Russell et al., 2006; Schmitz et al., 2009; Zeller et al., 2003]㸪ᗋ཯ຊࡀ᭷ព ࡟ 㧗࠸ࡇ࡜ࡀከ

ᩘሗ࿌ࡉࢀ࡚ ࠸ࡿ[Pappas et al., 2007; Salci et al., 2004; Schmitz et al., 2007 ]㸬௒

᪥㸪ዪᛶ࢔ࢫ ࣮ࣜࢺ ࡀ ♧ࡍ≉ᚩⓗ࡞ ືⓗୗ⫥ ࢔ࣛ࢖࣓ࣥࢺ ࡀዪᛶ࢔ ࢫ࣮ࣜࢺࡢ ACLയᐖࡀከ࠸せ ᅉ ࡢ ୍ࡘ࡜ࡉࢀ㸪╔ ᆅື స᫬ࡢ 㐣๫࡞ ⭸㛵⠇እ ཯⫥఩ࡸ⫤㛵

⠇ෆ㌿࠾ࡼࡧ ෆ᪕ືస 㸪ࡑࡋ࡚㧗࠸ ᗋ཯ຊࡀ യᐖࣜࢫࢡ࡜ ࡞ࡿࡇ࡜ ࡛ ࢥࣥࢭࣥ

ࢧࢫࡀᚓࡽࢀ ࡚࠸ࡿ[Renstrom et al., 2008]㸬

ACL യ ᐖ ࡢ ෆ ⓗ せ ᅉ ࡢ ୍ ࡘ ࡛ ࠶ ࡿ ㌟ య ⓗ ≉ ᛶ ࡜ ࡢ 㛵 㐃 ᛶ ࡟ 㛵 ࡍ ࡿ ඛ ⾜ ሗ ࿌ ࡣ㸪ከࡃࡣᚋࢁ ྥࡁ◊ ✲ ࡟ࡼࡿࡶࡢ ࡛࠶ࡿࡀ 㸪ACLയᐖ⩌࡜㠀യ ᐖ ⩌࡜ࡢ㟼ⓗ

ୗ ⫥ ࢔ ࣛ ࢖ ࣓ ࣥ ࢺ ࡸ 㛵 ⠇ ྍ ື ᇦ ➼ ࡢ ẚ ㍑ ᳨ ド ࡟ 㛵 ࡍ ࡿ ࡶ ࡢ ࡀ ᩓ ぢ ࡉ ࢀ ࡿ [Beckett et al., 1992; Bonci, 1999; Hertel et al., 2004; Loudon et al., 1996; Moul, 1998; Myer et al., 2008; Ramesh et al., 2005; Shelbourne et al., 1998; Swanik et al., 2007; Uhorchak et al., 2003; Woodford-Rogers et al., 1994]㸬ࡑࢀࡽࡣ Q-angle[Bonci, 1999; Hertel et al., 2004; Loudon et al., 1996]㸪⯚≧㦵ỿ㝆ᗘ ࢸࢫࢺ㸦Navicular drop

118

test score㸸௨ୗ㸪NDTS㸧[Allen and Glasoe, 2000; Beckett et al., 1992; Bonci, 1999;

Hertel et al., 2004; Loudon et al., 1996; Smith et al., 1997; Woodford-Rogers et al., 1994]㸪඲㌟ᘱ⦆ ᛶࢸ ࢫࢺ㸦General joint laxity test㸸௨ୗ㸪GJLT㸧[Ramesh et al., 2005; Uhorchak et al., 2003]㸪⬯㦵᤬㌿ ゅᗘ㸦Thigh-transmalleolar angle㸸௨ୗ㸪 TMA㸧[Bonci, 1999]㸪⫤㛵⠇ෆ᪕ゅ ᗘ㸦Hip internal rotation㸸௨ୗ㸪HIR㸧[Hertel et al., 2004]➼࡛࠶ࡿ㸬 ࡲࡓ㸪ᐇ㦂ᐊ ࣞ࣋ࣝ ࡛ ࡢࣂ࢖࣓࢜࢝ ࢽࢡࢫⓗ ࡟᳨ドࡉࢀ

ࡓືసᐇ㦂࡟ ࠾࠸࡚㸪 ⫤㛵⠇እ㌿➽ ຊ࡜ືⓗ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺ࡜ࡢ 㛵㐃ᛶ ࡟ࡘ

࠸࡚ከᩘሗ࿌ ࡉࢀ࡚࠸ ࡿ ࡯࠿[Zazulak et al., 2005; Zeller et al., 2003]㸪ࢪࣕࣥࣉ

࠿ࡽࡢ ╔ᆅ᫬ ࡟ ⏕ ࡌࡿ ᗋ཯ຊ ࡢ኱ᑠ࡜ ACL യᐖ࡜ ࡢ㛵㐃 ᛶ࡟ ࡘ࠸ ࡚ࡶ 」 ᩘሗ

࿌ࡉࢀ࡚࠸ࡿ[Pappas et al., 2007; Salci et al., 2004; Schmitz et al., 2007]㸬ࡑࡢ࡯

࠿╔ᆅ᫬࡟ࡳ ࡽࢀࡿ▮ ≧㠃࠿ࡽࡳࡓ ⭸㛵⠇㸪 ⫤㛵⠇㸪㊊㛵 ⠇ࡢ 㛵⠇ ྍືᇦࡸ╔

ᆅ⾪ᧁ྾཰࡬ ཬࡰࡍᙳ 㡪࡟ 㛵ࡍࡿሗ ࿌ࡶ 」ᩘ ࡳࡽࢀࡿ[Decker et al., 2006; De-vita and Skelly, 1992; Kernozak et al., 2005; Schot et al., 1994; Zhang, 2000]㸬㊊㒊㸪

ୗ⭣㸪⭸㛵 ⠇࠾ࡼࡧ ⫤ 㛵⠇ࡢ 㟼ⓗ࠾ ࡼࡧືⓗ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺ ࡜ ACLയᐖ࣓࢝

ࢽࢬ࣒࡜ࡢ㛵 㐃ᛶ ࡟ࡘ ࠸࡚ࡣ㸪㛵⠇ 㐠ື㐃㙐 ࡜ࡋ࡚ 㸪㐣ᗘ ࡞㊊㒊ᅇ ෆ ືసࡀ⬯

㦵ෆ᪕࡟ᑟࡁ[Anderson et al., 2009]㸪ࡉࡽ࡟ ⭸㛵⠇እ཯㸦 ⭸㛵⠇ෆ ᪕㸧࠾ࡼࡧ ⫤ 㛵 ⠇ ෆ ㌿ ࣭ ෆ ᪕ ື స ࡟ ᑟ ࡃ ࡜ ࠸ ࡗ ࡓ 㐠 ື 㐃 㙐 ࡀ ♧ ࡉ ࢀ ࡚ ࠸ ࡿ[Powers, 2003;

Schamberger, 2002; Tiberio, 1987]㸬ࡇࢀࡽ ࡢከᩘࡢሗ࿌ ࠿ࡽ㸪㌟ య≉ᛶ࡜ ACL യᐖ࡜ ࡢ㛵㐃 ᛶ ࡸ ACL യᐖࣜࢫ ࢡ࡜࡞ ࡿ ╔ᆅື స᫬ࡢ ⭸㛵 ⠇እ ཯ࡸ⫤ 㛵⠇ෆ

㌿ືస࡟ࡘ࠸ ࡚♧ࡉࢀ ࡚࠸ࡿࡀ 㸪ᮏ◊✲࡛ ࡣ 㸪㌟య≉ᛶ ࡀACL യ ᐖࣜࢫࢡ࡜࡞

ࡿ╔ᆅືస᫬ ࡢ⭸㛵⠇ እ཯ࡸ⫤㛵⠇ ෆ㌿ືస ࡜ࡢ㛵㐃ᛶ࡟ ࡘ࠸᳨࡚ ドࡍࡿࡇ࡜

ࢆ┠ⓗ࡜ࡋ࡚㸪㊊㒊㸪ୗ⭣㸪⭸㛵⠇㸪⫤ 㛵⠇ ࡢ㟼ⓗ࢔ࣛ࢖ ࣓ࣥࢺ㸪㛵⠇ྍືᇦ㸪

ୗ ⫥ ➽ ຊ ➼ ࡢ ㌟ య ⓗ ≉ ᛶ ࡜ ࢫ ࢡ ࣜ ࣮ ࢽ ࣥ ࢢ ࢸ ࢫ ࢺ ࡜ ࡋ ࡚ ᥎ ዡ ࡉ ࢀ ࡚ ࠸ ࡿ DVJ

ືస᫬ࡢୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺ࡜ࡢ㛵㐃 ᛶ࡟ࡘ࠸ ࡚ ᳨ドࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ࡚ ⾜ࡗ ࡓ㸬

119

5-6-2. ᑐ㇟࡜᪉ἲ 1. ᑐ㇟

ᑐ㇟ࡣ㸪኱Ꮫ ዪᏊ ࢔ࢫ ࣮ࣜࢺ 12ྡ࡛࠶ ࡾ㸪ᖹᆒᖺ㱋㸦±ᶆ‽೫ᕪ㸧ࡣ 19.3 ± 0.9

ṓ㸪㌟㛗 159.2 ± 5.4cm㸪య㔜 55.3 ± 5.1kg ࡛ ࠶ࡗࡓ㸬஦๓ ࡟ᮏᐇ㦂 ࡛⾜࠺ㄢ㢟

ືసࡢᐇ᪋࡟ ࠶ࡓࡾ㸪 ୗ⫥࡬ࡢᨭ㞀 ࡀ ࡞࠸ࡇ ࡜ࢆ☜ㄆࡋࡓ 㸬ࡲࡓ㸪 ᑐ㇟⪅࡟◊

✲ࡢ┠ⓗࡸ᪉ ἲ㸪೔⌮ ⓗ㓄៖➼࡟㛵 ࡍࡿㄝ᫂ ࢆ⾜࠸㸪ྠព ࢆᚓ ࡓ㸬 ᑦ㸪ᮏ◊✲

࡛⾜ࡗࡓᐇ㦂 ᑐ㇟⪅ࡣ 㸪◊✲ 3࡛ ⾜ࡗࡓᐇ㦂 ᑐ㇟⪅ࡀ୍㒊 ྵࡲࢀ࡚ ࠸ࡿ㸬ᮏ◊

✲ࡣ㸪᪩ ✄⏣኱Ꮫேࢆ ᑐ㇟࡜ࡍࡿ◊ ✲࡟㛵ࡍ ࡿ೔⌮ᑂᰝጤ ဨ఍ ࡢᢎ ㄆࢆᚓ࡚ᐇ

᪋ࡋࡓ㸦ᢎㄆ ␒ྕ 2010-037㸧㸬 2.  ᐃ᪉ἲ

a. 㟼ⓗୗ⫥࢔ࣛ ࢖࣓ ࣥࢺ

௨ୗ࡟ྛ ᐃ 㡯┠ ࠾ࡼ ࡧ ᐃ᪉ἲࢆ ♧ࡍ㸬࡞ ࠾㸪඲࡚ࡢ  ᐃ ࡣྑ⬮ ࢆᑐ㇟

࡟⾜ࡗࡓ㸬

1) Leg-heel angle㸦௨ୗ㸪LHA㸧

୧⬮❧఩ ࡛ࡘࡲඛ ࢆṇ㠃࡟ྥࡅ ࡚㸪୧⬮ ࡟ᆒ➼࡟య㔜 ࢆ࠿ࡅࡉ ࡏ ࡚❧ࡓࡏ ࡓ≧ែ࡛㸪ୗ ⭣㒊㐲 ఩ 3 ศࡢ 1 ࡜ ㋖㦵ࢆ஧ ➼ศࡍࡿ⥺ࡢ ࡞ࡍ ゅᗘ ࢆ ᐃࡋࡓ [Haight, 2005]㸦ᅗ 6-1㸧㸬

ᅗ6-1 Leg-heel angle ᐃ[Haight, 2005]

120

2) NDTS㸦Navicular drop test score㸪⯚≧㦵 ỿ㝆ᗘࢸࢫࢺ 㸧

Brody㸦1982㸧ࡢ ᪉ἲࢆཧ⪃࡟ ⾜ࡗࡓ 㸬᭱ึ࡟➃ᗙ఩ ࡛㊊㛵⠇ ࢆࢽ࣮ࣗࢺࣛ

࣏ࣝࢪࢩ ࣙࣥ࡟ ಖᣢࡉ ࡏࡓ≧ែ ࡛[Brody, 1982]㸪ᗋ࠿ࡽ⯚ ≧ 㦵⤖ ⠇ࡲ࡛㧗 ࡉ 㸦mm㸧 ࢆ   ᐃ ࡋ 㸪 ḟ ࡟ ❧ ఩ ጼ ໃ ࢆ ࡜ ࡽ ࡏ 㸪 ୧ ⬮ ࡟ ᆒ ➼ ࡟ య 㔜 ࢆ ࠿ ࡅ ࡉ ࡏ ࡓ

≧ែ࡛㸪ྠࡌࡃᗋ࠿ ࡽ ⯚≧㦵⤖⠇ࡲ ࡛㧗ࡉ㸦mm㸧ࢆ ᐃ ࡋࡓ㸦 ᅗ 6-2㸧㸬➃ ᗙ఩ጼໃ᫬࡟ ᚓࡽࢀࡓ ್㸦mm㸧ࢆ❧఩ ጼໃ ᫬࡟ᚓࡽࢀࡓ ್㸦mm㸧࡛ῶࡌࡓ

್ࢆ NDTS࡜ࡋࡓ㸬

ᅗ 6-2 Navicular drop test ᐃ[Beckett, 1992]

3) ࢔࣮ࢳ㧗⋡㸦Arch index㸸௨ୗ㸪AI㸧

ඛ⾜ㄽᩥ[McCrory et al., 1997]ࢆཧ⪃࡟㸪୧⬮❧఩࡛ࡘ ࡲඛࢆṇ 㠃࡟ྥࡅ ࡚ 㸪 ୧⬮࡟ᆒ➼࡟ య㔜ࢆ࠿ ࡅࡉࡏ ࡚❧ࡓ ࡏࡓ ≧ែ ࡛㸪ᗋ࠿ࡽ⯚ ≧㦵 ⤖⠇ ࡲ࡛ࡢ㧗 ࡉ㸦mm㸧ࢆ ᐃ ࡋࡓ 㸬ḟ࡟㊊㛗㸦mm㸧ࢆ  ᐃࡋࡓ㸬㊊ 㛗ࡣ㸪㋖ 㦵ᚋ➃࠿ࡽ

㊊㊑ඛ➃㸦᭱ 㛗㒊㸧ࡲ ࡛ࡢ㊥㞳࡜ࡋ ࡓ㸬୧⬮ ❧఩᫬ࡢᗋ࠿ ࡽ⯚≧㦵 ⤖⠇ࡢ㧗 ࡉ㸦mm㸧ࢆ㊊ 㛗㸦mm㸧࡛㝖ࡋࡓ್ ࡟ 100ࢆ஌ࡌࡓ್ ࢆ AI࡜ ࡋࡓ 㸬

121

4) Q-angle

୧⬮❧఩࡛ࡘ ࡲඛࢆṇ 㠃࡟ྥࡅ ࡚㸪 ୧⬮࡟ᆒ ➼࡟య㔜ࢆ࠿ ࡅ ࡚❧ࡓ ࡏࡓ≧

ែ࡛ ᐃࡋࡓ 㸬 ୖ๓⭠ 㦵Ჲ࡜⭸⵹㦵 ୰ኸ࠾ࡼ ࡧ⭸⵹㦵୰ኸ ࡜⬯㦵⢒ 㠃ࢆ⤖ࢇ

ࡔ⥺ࡢ࡞ࡍゅ ᗘࢆ ᐃ ࡋࡓ[Loudon et al., 1996]㸦ᅗ 6-3㸧㸬

ᅗ 6-3 Q-angle  ᐃ[Bonci, 1999]

5) TMA㸦Thigh-transmalleolar angle㸪⬯㦵 ᤬㌿ゅᗘ 㸧

ඛ⾜ㄽᩥ[Staheli et al., 1985]ࢆཧ⪃࡟㸪 ⭡⮩఩࡟࡚⭸ 㛵⠇ 90°ᒅ᭤఩㸪㊊㛵

⠇୰㛫఩࡟ಖ ᣢࡉࡏࡓ ≧ែ࡛ ᐃࡋ ࡓ㸬 ෆᯝ ࡜እᯝࢆ⤖ࢇ ࡔ⥺ ࡜኱ ⭣㒊ࡢ㛗

㍈ࡢ࡞ࡍゅᗘ ࢆ ᐃࡋ ࡓ 㸦ᅗ 6-4㸧㸬

ᅗ6-4 Thigh-transmalleolar angle ᐃ[Güven, 2009]

122

6) Thigh-foot angle㸦௨ୗ㸪TFA㸧

ඛ⾜ㄽᩥ[Stuberg et al., 1991]ࢆཧ⪃࡟㸪⭡⮩఩࡟࡚⭸ 㛵⠇ 90°ᒅ᭤఩㸪㊊㛵

⠇୰㛫఩࡟ಖ ᣢࡉࡏࡓ ≧ែ࡛ ᐃࡋ ࡓ㸬 ㊊㒊 㛗㍈࡜኱⭣㒊 ࡢ㛗㍈ ࡢ ࡞ࡍゅᗘ

ࢆ ᐃࡋࡓ㸦 ᅗ 6-5㸧 㸬

ᅗ 6-5 Thigh-foot angle  ᐃ[Stuberg, 1991]

7) ኱⭣㦵㢕㒊๓᤬ ゅ ᗘ㸦Femoral anteversion angle㸧㸦Craig’s test㸧㸦௨ୗ㸪 FAA㸧

ඛ⾜◊✲[Cibulka, 2004]ࢆཧ⪃࡟㸪⭡⮩ ఩ ࡟࡚⭸ 㛵 ⠇ 90°ᒅ᭤఩ ࡛㸪኱⭣㦵

኱ ㌿ Ꮚ ࡀ ᭱ ࡶ እ ഃ ࡟ ఩ ⨨ ࡋ ࡓ ᫬ ࡢ ⬯ 㦵 ࡜ 㖄 ┤ ⥺ ࡢ ࡞ ࡍ ゅ ᗘ ࢆ   ᐃ ࡋ ࡓ 㸦 ᅗ 6-6㸧㸬

ᅗ 6-6 Femoral anteversion angle[Nguyen and Shultz, 2007]

123

b. 㛵⠇ゅᗘ

1) HIR㸦Hip internal rotation㸪⫤㛵⠇ ෆ᪕ゅ ᗘ 㸧

᪥ ᮏ ᩚ ᙧ እ ⛉ Ꮫ ఍ ࠾ ࡼ ࡧ ࣜ ࣁ ࣅ ࣜ ࢸ ࣮ ࢩ ࣙ ࣥ ་ Ꮫ ఍ ࡢ 㛵 ⠇ ྍ ື ᇦ ⾲ ♧ ࡞

ࡽࡧ࡟ ᐃἲ ࢆཧ⪃࡟ ⾜ࡗࡓ[㛵⠇ྍືᇦ ⾲ ♧࡞ࡽࡧ࡟  ᐃἲ, 1995]㸬➃ᗙ఩

⫥఩࡟࡚⫤㛵 ⠇ ෆ᪕ゅ ᗘࢆ ᐃࡋࡓ 㸬

2) ㊊ 㛵 ⠇ ⫼ ᒅ ゅ ᗘ 㸦 ⭸ 㛵 ⠇ ఙ ᒎ 㸪 Ⲵ 㔜 ఩ 㸧 㸦Ankle dorsiflexion with knee extension㸸௨ୗ㸪ADKE㸧

HIR ྠ ᵝ ࡟ 㛵 ⠇ ྍ ື ᇦ ⾲ ♧ ࡞ ࡽ ࡧ ࡟   ᐃ ἲ ࢆ ཧ ⪃ ࡟ ⾜ ࡗ ࡓ[㛵 ⠇ ྍ ື ᇦ ⾲

♧࡞ࡽࡧ࡟  ᐃἲ, 1995]㸬❧఩࡛ ⭸㛵⠇ࢆఙ ᒎ఩࡟ࡉࡏ࡚ 㸪㋖ ࢆᾋ ࠿ࡏ࡞࠸

࡛㊊㛵⠇ࢆྍ ⬟࡞㝈ࡾ ⫼ᒅࡉࡏࡓ ᫬ ࡢ㛵⠇ゅ ᗘ ࢆ ᐃࡋࡓ 㸬

3) ㊊ 㛵 ⠇ ⫼ ᒅ ゅ ᗘ 㸦 ⭸ 㛵 ⠇ ᒅ ᭤ 㸪 Ⲵ 㔜 ఩ 㸧 㸦Ankle dorsiflexion with knee flexion㸸௨ୗ㸪ADKF㸧

ADKE ྠᵝ㸪㛵 ⠇ྍ ືᇦ⾲♧࡞ࡽ ࡧ࡟ ᐃ ἲࢆཧ⪃࡟⾜ ࡗࡓ[㛵 ⠇ྍືᇦ⾲

♧࡞ࡽࡧ࡟  ᐃἲ, 1995]㸬❧఩࡛ ⭸㛵⠇ࢆᒅ ᭤఩࡟ࡉࡏ࡚ 㸪㋖ ࢆᾋ ࠿ࡏ࡞࠸

࡛㊊㛵⠇ࢆྍ ⬟࡞㝈ࡾ ⫼ᒅࡉࡏࡓ ᫬ ࡢ㛵⠇ゅ ᗘ ࢆ ᐃࡋࡓ 㸬 c. ඲㌟ᘱ⦆ᛶ

1) GJLT㸦General joint laxity test㸧

  ᐃ 㡯 ┠ ࡣ 㸪 ᅜ ෆ ࡛ ከ ᩘ ᘬ ⏝ ࡉ ࢀ ࡚ ࠸ ࡿ ᮾ ኱ ᘧ ඲ ㌟ ᘱ ⦆ ᛶ ࢸ ࢫ ࢺ[୰ ᔱ ࡽ,

1984]࡛ᐇ᪋ࡉࢀ࡚ ࠸ ࡿ 7 㡯┠㸦ᡭ㤳㸪 ⫝ 㸪⫪㸪⬨ᰕ㸪 ⫤㛵⠇㸪 ⭸㸪㊊㛵⠇ 㸧

࡜ࡋࡓ㸬⥲ ィ7 Ⅼ࡜ࡋ ࡚㝧ᛶⅬᩘࢆ ⟬ฟࡋࡓ 㸬 d. ⫤㛵⠇➽ຊ

1) HAS㸦hip abduction strength㸪⫤㛵⠇እ㌿ ➽ຊ 㸧

ᚐᡭ➽ຊ  ᐃἲ[Kendall et al., 2005]ࢆཧ⪃ ࡟㸪ഃ⮩఩ 㸪⭸㛵 ⠇ ఙ ᒎ఩࡜ࡋ㸪

⫤㛵⠇እ ㌿ 30r⫥఩ ࢆ࡜ࡽࡏࡓ≧ ែ ࡛㸪኱ ⭣㦵እഃୖ㢛 ࡟ࣁࣥࢻ ࣊ࣝࢻࢲ࢖

ࢼ࣓࣮ࣔࢱ࣮㸦MicroFET, Hogan Health Industries Inc.㸧ࢆ࠶࡚㸪5 ⛊㛫᭱኱ດ ຊ࡛ ࡢ ⫤ 㛵⠇ እ ㌿ 㐠ື ࢆ ⾜ ࢃ ࡏ ࡓ㸦 ᅗ 6-7㸧 㸬ᚓ ࡽ ࢀ ࡓ್ ࢆ ㌟ 㛗࡜ య㔜 ࢆ஌

ࡌࡓࡶࡢ࡛㝖 ࡋ ࡚㸦N/(㌟㛗™య㔜)㸧ṇつ໬ ࡋࡓ㸬

ドキュメント内 Injury Surveillance and Injury Prevention in Female Lacrosse (ページ 89-128)