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ㄢ㢟ືస ࡣ 30cm 㧗ࡢ ྎୖ࠿ࡽࡢ୧ ⬮ DVJ ࡜ࡋࡓ㸬᭱ึ࡟ ⿕㦂⪅ ࡟ ྎୖ࡟୧

⬮࡛❧ࡓࡏ㸪 ྜᅗ࡜࡜ ࡶ࡟୧⬮࡟࡚ 㣕ࡧ㝆ࡾ 㸪╔ᆅᚋࡍࡄ ࡟ ᭱኱ດ ຊ࡛ 㖄┤᪉

ྥ࡬ࡢࢪࣕࣥ ࣉࢆ⾜ࢃ ࡏࡓ㸬ྎ ୖ࠿ࡽࡢ ╔ᆅ ᫬࠾ࡼࡧࢪࣕ ࣥࣉࡋࡓ ᚋࡢ╔ᆅࡣ 㸪

ྑ⬮ࢆᗋ཯ຊ ィୖ࡟╔ ᆅࡉࡏࡿࡼ࠺ ᣦ♧ࡋࡓ 㸬 ࡲࡓ㸪ࢪࣕ ࣥࣉ᫬࡟ ୧ᡭࢆኳ஭

᪉ྥ࡟ᣲࡆࡉ ࡏ࡞ࡀࡽ 㸦ࣂࢫࢣࢵࢺ ࣮࣎ࣝࡢ ࣜࣂ࢘ࣥࢻື స ࢆ࡜ࡿ ࡼ࠺࡟ 㸧ࢪ

ࣕࣥࣉࡉࡏࡓ㸦ᅗ6-8㸧㸬3 ᅇࡢᡂຌ ヨᢏ ࢆ グ㘓ࡋࡓ㸬ᑦ 㸪௨ୗࡢ ヨᢏࡀࡳࡽࢀ

ࡓሙྜࡣ↓ຠ ࡜ࡋ㸪୍ ᪦ⴠࡕ╔࠿ࡏ ࡓᚋ࡟෌ ヨᢏࢆ⾜ࢃࡏ ࡓ㸬1㸧ྎୖ࠿ࡽࡢ╔

ᆅ࠾ࡼࡧ㖄┤ ᪉ྥ ࡬ࡢ ࢪࣕࣥࣉᚋࡢ ╔ᆅ᫬࡟ ྑ⬮ࡀᗋ཯ຊ ィୖ࡟஌ ࡽ࡞࠿ࡗࡓ ሙྜ㸪2㸧ࢪࣕࣥ ࣉᚋ ࡢ╔ᆅືస࡛ 㸪Ᏻᐃࡋ ࡓ╔ᆅࡀฟ᮶ ࡞࠿ࡗࡓ ሙྜ࡜ࡋࡓ 㸬

a. initial contact b. landing c. take off

ᅗ6-8 ࢻࣟࢵࣉ ࣂ࣮ ࢸ࢕࢝ࣝࢪࣕ ࣥࣉ㸸 㸦a㸧㊊㒊ࡢ୍㒊ࡀᗋ ࡟ ᥋ᆅࡋࡓ᫬㸪

㸦b㸧᭱኱ࡋࡷࡀ ࡳࡇ ࡳ᫬㸪㸦c㸧ᗋ࠿ࡽ ࡘ ࡲඛࡀ㞳ࢀࡓ ᫬

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4. ືసィ 

ືసࡢィ ᪉ ἲ࠾ࡼࡧ ࣓࢝ࣛࢭࢵࢸ ࢕ࣥࢢ㸪 ཯ᑕ࣐࣮࣮࢝ ࡢ㈞௜఩ ⨨➼࡟ࡘ

࠸࡚ࡣ◊ ✲ 5[బ㔝ᮧࡽ, 2012-3]࠾ࡼࡧ◊ ✲ 6 ࡟♧ࡋࡓ㏻ࡾ ࡛࠶ࡿ㸬 5. ࢹ࣮ࢱゎᯒ

ࢹ࣮ࢱゎᯒ ᪉ἲࡶ◊ ✲5[బ㔝ᮧࡽ, 2012-3]࠾ࡼࡧ◊ ✲ 6 ྠᵝ࡛࠶ ࡾ㸪ゎᯒ⠊

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

࠿ࡽ㞳ࢀࡓ᫬ Ⅼ㸦toe off㸪௨ୗ TO㸧ࡲ࡛ ࢆLanding phase ࡜ࡋ࡚ 㸪Landing phase ࡢ IC᫬ ࠿ࡽ 30㸣᫬Ⅼ ࡲ࡛ ࡜ࡋࡓ㸬IC ᫬࠿ ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟

ࡳࡽࢀࡓྛ㡯 ࡢ᭱኱್ ࢆࣃ࣓࣮ࣛࢱ ࡜ࡋࡓ⌮ ⏤ࡣ㸪◊✲ 3㸪4ྠᵝ࡛ 㖄┤᪉ྥ࡬

ࡢ᭱኱ᗋ཯ຊ ࡢࣆ࣮ࢡ ࡀ IC᫬ ᚋ㸪Landing phase ࡢ30㸣᫬Ⅼࡲ࡛ ࡟ࡳࡽ ࢀࡓࡇ

࡜㸪ᐇ㝿ࡢ ACL യᐖࡀ IC ᫬ᚋ࡟ ࡳࡽࢀࡿ ᭱኱ᗋ཯ຊࡢ ࣆ࣮ࢡ௜ ㏆࡛Ⓨ⏕ࡋ࡚

࠸ࡿࡇ࡜ࡀከ ᩘሗ࿌ࡉ ࢀ࡚࠸ࡿⅭ࡛ ࠶ࡿ㸬 ᗋ ཯ຊࢹ࣮ࢱࡣ ㏫ࢲ࢖ࢼ ࣑ࢡࢫࢆ⏝

࠸࡚⭸㛵⠇እ ㌿࣮࣓ࣔ ࣥࢺ ࡜⫤㛵⠇ ෆ㌿࣮ࣔ ࣓ࣥࢺࢆ⟬ฟ ࡋࡓ㸬㛵 ⠇࣮࣓ࣔࣥ

ࢺࡣእⓗ࣮ࣔ ࣓ࣥࢺ࡜ ࡋ࡚ィ⟬ࡋ 㸪 ྛ㛵⠇ࣔ ࣮࣓ࣥࢺࡣᑐ ㇟⪅ࡢ㌟ 㛗࡜య㔜ࡢ

✚࡛㝖ࡍࡿࡇ ࡜࡛ ṇつ ໬ࡋࡓ㸬ࣃࣛ ࣓࣮ࢱࡣ ᭱኱⭸㛵⠇እ ㌿ゅᗘ 㸪 ᭱኱⫤㛵⠇

ෆ㌿ゅᗘ࠾ࡼ ࡧ᭱኱⫤ 㛵⠇ ෆ᪕ゅᗘ 㸪᭱኱⭸ 㛵⠇እ㌿࣮ࣔ ࣓ࣥࢺ 㸪 ᭱኱⫤㛵⠇

ෆ㌿ࣔ ࣮࣓ࣥ ࢺ࠾ ࡼࡧ ᭱኱⫤ 㛵⠇ෆ ᪕ࣔ ࣮࣓ ࣥࢺ㸪 㖄┤᪉ ྥ㸦z ㍈ 㸧࡬ࡢ ᭱኱

ᗋ཯ຊ࡜ࡋࡓ 㸬ࡲࡓ 㸪IC᫬࠿ࡽ 30㸣᫬Ⅼ ࡲ ࡛ ࡢ⭸㛵⠇እ ㌿ゅᗘ ೫ ఩㔞㸪⫤㛵 ⠇ ෆ㌿ゅᗘ೫఩ 㔞㸪⫤㛵 ⠇ෆ᪕ ゅᗘ೫ ఩㔞࡜ࡋ ࡓ㸬

⤫ィᏛⓗゎᯒ ࡣ LHA㸪NDTS㸪AI㸪Q-angle㸪TMA㸪TFA㸪FAA㸪HIR㸪ADKE㸪 ADKF㸪GJLT㸪HAS࡜ DVJ ືస᫬ࡢ Landing phaseࡢ IC ᫬࠿ ࡽ Landing phase ࡢ30㸣᫬Ⅼࡲ࡛࡟ ࡳ ࡽࢀࡓ ᭱኱⭸ 㛵⠇እ㌿ ゅᗘ 㸪᭱኱⫤㛵 ⠇ෆ㌿ ࠾ࡼࡧෆ᪕ゅ ᗘ㸪᭱኱⭸㛵⠇ እ㌿ࣔ ࣮࣓ࣥࢺ 㸪᭱኱ ⫤㛵⠇ ෆ㌿ ࠾ࡼࡧෆ ᪕࣮࣓ࣔ ࣥࢺ 㸪IC ᫬

࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛ ࡟ࡳࡽࢀ ࡓ ⭸㛵⠇እ㌿ ゅᗘ ೫఩ 㔞㸪⫤㛵⠇

ෆ㌿࠾ࡼࡧෆ ᪕ゅᗘ೫ ఩㔞㸪㖄┤᪉ ྥ࡬ࡢ᭱ ኱ᗋ཯ຊ ࡜ࡢ ┦㛵㛵ಀ ࢆ㸪ࣆ࢔ࢯ

ࣥࡢ┦㛵ಀᩘ ࢆ⏝࠸࡚ ᳨ウࡋࡓ㸬ᑦ 㸪᭷ពỈ ‽ࡣ 5㸣ᮍ‶࡜ ࡋࡓ㸬

126

5-6-3. ⤖ᯝ

LHA㸪NDTS㸪AI㸪Q-angle㸪TMA㸪TFA㸪FAA㸪HIR㸪ADKE㸪ADKF㸪GJLT㸪

HASࡢᖹᆒ್㸦sᶆ ‽೫ᕪ㸧ࢆ ⾲ 6-1࡟♧ ࡍ㸬

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Landing phaseࡢIC᫬ ࠿ࡽLanding phaseࡢ30㸣᫬Ⅼࡲ࡛࡟ࡳ ࡽࢀ ࡓ᭱኱⭸㛵

⠇እ㌿ゅᗘ㸪 ᭱኱⫤㛵 ⠇ෆ㌿ ࠾ࡼࡧ ෆ᪕ ゅᗘ 㸪᭱኱⭸㛵⠇ እ㌿࣮ࣔ ࣓ࣥࢺ 㸪᭱

኱⫤㛵⠇ෆ㌿ ࠾ࡼࡧෆ ᪕ ࣮࣓ࣔࣥࢺ 㸪IC ᫬ ࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛

࡟ࡳࡽࢀࡓ⭸ 㛵⠇እ㌿ ゅᗘ ೫఩㔞㸪 ⫤㛵⠇ෆ ㌿ ࠾ࡼࡧෆ᪕ ゅᗘ೫఩ 㔞㸪㖄┤᪉

ྥ㸦z ㍈㸧࡬ࡢ ᭱኱ᗋ ཯ຊࢆ⾲ 6-2 ࡟ ♧ࡍ㸬

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ྛࣃ࣓࣮ࣛࢱ 㛫ࡢ┦㛵 㛵ಀࢆ⾲ 6-3 ࡟♧ࡍ 㸬NDTS ࡜㖄┤᪉ྥ࡬ࡢ ᭱኱ᗋ཯

ຊ࡜ࡢ㛫࡟᭷ ព࡞୰⛬ ᗘࡢ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ㸦r = -0.633㸪p = 0.027㸧㸬AI࡜᭱

኱⫤㛵⠇ෆ᪕ ゅᗘ㸪 ⫤ 㛵⠇ෆ᪕ゅᗘ ೫఩㔞࡜ ࡢ 㛫࡟᭷ព࡞ ୰⛬ᗘࡢ ㈇ࡢ┦㛵ࢆ

♧ࡋ㸦ࡑࢀ ࡒࢀ r = -0.689㸪p = 0.013㸹r = -0.671㸪p = 0.017㸧㸪㖄 ┤᪉ྥ࡬ࡢ᭱

኱ᗋ཯ຊ࡜ࡢ 㛫࡟᭷ព ࡞ 㧗࠸ṇࡢ┦ 㛵ࢆ♧ࡋ ࡓ㸦r = 0.892㸪p < 0.001㸧㸬Q-angle

࡜᭱኱⭸㛵⠇ እ㌿ゅᗘ 㸪⭸㛵⠇እ㌿ ゅᗘ ೫఩ 㔞࡜ࡢ㛫࡟᭷ ព࡞ ୰⛬ ᗘࡢṇࡢ┦

㛵ࢆ♧ࡋ㸦ࡑ ࢀࡒࢀ r = 0.654㸪p = 0.021㸹r = 0.590㸪p = 0.044㸧㸪 ᭱኱⫤㛵⠇

ෆ᪕ゅᗘ࡜ࡢ 㛫࡟᭷ព ࡞ 㧗࠸㈇ࡢ┦ 㛵ࢆ♧ࡋ ࡓ㸦r = -0.744㸪p = 0.005㸧㸬ࡲࡓ㸪

᭱ ኱ ⭸ 㛵 ⠇ እ ㌿ ࣔ ࣮ ࣓ ࣥ ࢺ ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ ࡓ 㸦r =

0.608㸪p = 0.036㸧㸬TMA ࡜᭱኱⫤ 㛵⠇ෆ ᪕ゅᗘ㸪 ⫤㛵 ⠇ෆ᪕ゅ ᗘ೫఩㔞࡜ࡢ

㛫࡟᭷ព࡞୰ ⛬ᗘࡢ ㈇ ࡢ┦㛵ࢆ♧ࡋ ࡓ㸦ࡑ ࢀ ࡒࢀ r = -0.609㸪p = 0.036㸹r = -0.637㸪

p = 0.026㸧㸬TFA ࡜᭱ ኱⫤㛵⠇ෆ᪕ ゅᗘ࡜ࡢ 㛫࡟᭷ព࡞㧗 ࠸㈇ࡢ┦ 㛵ࢆ♧ࡋ㸦ࡑ

ࢀࡒࢀ r = -0.736㸪p = 0.006㸧㸪⭸㛵⠇እ ㌿ゅ ᗘ ೫఩㔞࡜ࡢ 㛫࡟᭷ព ࡞ ୰⛬ᗘࡢ ṇࡢ┦㛵ࢆ♧ ࡋࡓ㸦r = 0.589㸪p = 0.044㸧㸬FAA࡜᭱኱⭸ 㛵⠇ እ㌿ゅᗘ 㸪⭸ 㛵

⠇ እ ㌿ ゅ ᗘ ೫ ఩ 㔞 ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ ࡓ 㸦 ࡑ ࢀ ࡒ ࢀ r = 0.584㸪p = 0.046㸹r = 0.589㸪p = 0.045㸧㸬ADKE࡜᭱኱⫤㛵 ⠇ෆ ㌿ ゅᗘ࡜ࡢ㛫

࡟᭷ព࡞୰⛬ ᗘࡢ ṇࡢ ┦㛵ࢆ♧ࡋ㸦r = 0.596㸪p = 0.041㸧㸪㖄┤᪉ ྥ࡬ࡢ᭱኱

ᗋ཯ຊ࡜ࡢ㛫 ࡟᭷ព࡞ 㧗࠸㈇ࡢ┦㛵 ࢆ♧ࡋࡓ 㸦r = -0.713㸪p = 0.009㸧㸬ADKF

࡜㖄┤᪉ྥ࡬ ࡢ᭱኱ᗋ ཯ຊ࡜ࡢ 㛫࡟ ᭷ព࡞㧗 ࠸㈇ࡢ┦㛵ࢆ ♧ࡋࡓ㸦r = -0.729㸪

p = 0.007㸧㸬HAS ࡜᭱ ኱⭸㛵⠇እ㌿ ゅᗘ 㸪᭱ ኱⫤㛵⠇ෆ㌿ ゅᗘ㸪 ⭸ 㛵⠇እ㌿ゅ

ᗘ ೫ ఩ 㔞 ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸦 ࡑ ࢀ ࡒ ࢀ r = -0.681㸪p = 0.015㸹r = -0.635㸪p = 0.023㸹r = -0.697㸪p = 0.012㸧㸪⫤㛵⠇ ෆ᪕ ゅᗘ೫఩㔞࡜

ࡢ㛫࡟᭷ព࡞ ୰⛬ᗘࡢ ṇࡢ┦㛵ࢆ♧ ࡋࡓ㸦r = 0.611㸪p = 0.035㸧 㸬ࡲࡓ㸪㖄┤

᪉ ྥ ࡬ ࡢ ᭱ ኱ ᗋ ཯ ຊ ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ 㧗 ࠸ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ ࡓ 㸦r = 0.703㸪p =

0.011㸧㸬LHA࠾ࡼ ࡧ HIR㸪GJLT ࡜ྛࣃࣛ ࣓࣮ࢱ࡜ࡢ 㛵 ಀ࡟࠾࠸ ࡚ ࡣ᭷ពᕪࡣ

ㄆࡵࡽࢀ࡞࠿ ࡗࡓ㸬

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130

5-6-4. ⪃ᐹ

ᮏ◊✲ࡣ㸪ACLയᐖࢆ ྵࡵࡓୗ⫥യ ᐖண㜵ࡢ ࡓࡵࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢸࢫࢺ࡜

ࡋ࡚⏝࠸ࡽࢀ ࡚࠸ ࡿ DVJ ືస᫬ࡢୗ⫥࢟ ࢿ ࣐ࢸ࢕ࢡࢫ࣭࢟ࢿ ࢸ࢕ ࢡࢫ࡜ୗ⫥࢔

ࣛ࢖࣓ࣥࢺ㸪 㛵⠇ྍື ᇦ㸪඲㌟ᘱ⦆ ᛶ㸪⫤㛵 ⠇እ㌿➽ຊ࡜ ࡢ㛵㐃ᛶ ࡟ࡘ࠸࡚ ᳨ ド ࡍ ࡿ ࡇ ࡜ ࢆ ┠ ⓗ ࡜ ࡋ ࡚ ⾜ ࡗ ࡓ 㸬DVJ ື స ࡛ ࡳ ࡽ ࢀ ࡿ ⭸ 㛵 ⠇ እ ㌿ ࡸ ⫤ 㛵 ⠇ ෆ

㌿࣭ෆ᪕ືస࠾ࡼ ࡧ 㛵 ⠇࣮࣓ࣔࣥࢺ ࡜㌟యⓗ ≉ᛶ ࡜ࡢ㛵㐃 ᛶࢆ᳨ド ࡍࡿࡇ࡜࡛ 㸪 ࢫࢡ࣮ࣜࢽࣥ ࢢ ࢆ┠ⓗ ࡜ࡋࡓ DVJࢸࢫࢺࡢ ᐇ᪋࡟࠾࠸࡚ 㸪ୗ ⫥യ ᐖࣜࢫࢡ࡟ࡘ

࡞ࡀࡿྍ⬟ᛶ ࡢ࠶ࡿ㌟ య ᐃ 㡯┠ࢆ 㑅ᢥⓗ࡟  ᐃࡶࡋࡃࡣ ᥦ♧࡛ࡁ ࡿࡢ࡛ࡣ࡞

࠸࠿࡜࠸࠺ࡶ ࡢ࡛࠶ࡿ 㸬

ඛ⾜◊✲࠿ࡽ 㸪㟼ⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ࡜ୗ⫥ യᐖ㸪≉࡟⭸ 㛵⠇യᐖ ࡜ࡢ㛵㐃 ᛶ࡟㛵ࡍࡿከ ᩘࡢሗ࿌ ࡀࡳࡽࢀࡿ ࡀ 㸪ୗ⫥㛵 ⠇ࡢ࣐ࣝ࢔ࣛ ࢖࣓ࣥࢺ ࡟ࡼࡾ⏕ࡌ

ࡿ㐣ᗘ࡞㛵⠇ ࡢືࡁࡀ ⭸㛵⠇ࡢእ㌿ ࡸᅇ᪕ࢫ ࢺࣞࢫ࡟ཬࡰ ࡍᙳ㡪࡟ ࡘ࠸࡚ ᳨ド ࡉࢀ࡚࠾ࡾ㸪 ᶵ⬟ゎ๗ Ꮫⓗ࠾ࡼࡧࣂ ࢖࣓࢝ࢽ ࢡࢫⓗ ほⅬ࠿ ࡽ㸪㊊㒊 㸪ୗ⭣㸪⫤

㛵⠇➼ࡢ㐠ື ࠿ࡽ⏕ࡌ ࡿ 㛵⠇㐠ື㐃 㙐ࡢ࣓࢝ ࢽࢬ࣒ ࡟ࡘ࠸ ࡚♧ࡋࡓ ሗ࿌ࡀ」ᩘ

ࡳ ࡽ ࢀ ࡿ[Levangie and Norkin, 2001; Neumann, 2002; Schamberger, 2002; Su-botnick, 1989; Oatis, 2009]㸬㊊㒊ࡢ࢔ࣛ࢖࣓ ࣥࢺ ࠿ࡽ⏕ࡌ ࡿୗ⫥㛵 ⠇㐠ື 㐃㙐࡟

㛵ࡍࡿሗ࿌࡟ ࡼࡿ࡜㸪 㐣๫࡞㊊㒊ᅇ ෆࡀୗ⭣ ෆ᪕㐠ື࡟ᑟ ࡁ㸪ࡉࡽ ࡟ࡣ⭸㛵⠇

እ㌿㐠ື࡟ᑟ ࡃࡇ࡜ࡀ ሗ࿌ࡉࢀ࡚࠾ ࡾ㸪ࡲࡓ ⫤㛵⠇ ࡟ࡘ࠸ ࡚ࡣ㸪⫤ 㛵⠇ ෆ㌿࠾

ࡼࡧෆ᪕㐠ື ࡀ⭸㛵⠇ እ㌿ ࠾ࡼࡧෆ ᪕㐠ື࡟ ᑟࡃࡇ࡜ࡀ ሗ ࿌ࡉࢀ࡚ ࠸ࡿ 㸬㊊㒊 ᅇෆࡀ⭸㛵⠇ ࡟ཬࡰࡍ ᙳ㡪࡟ࡘ࠸࡚ ࡣ㸪Beckettࡽ㸦1992㸧ࡣ㸪㐣๫ ࡞㊊㒊ᅇෆ 㐠ືࡣ⬯㦵ෆ ᪕㐠ື࡟ ᑟࡁ 㸪ࡉࡽ ࡟ࡣ⭸㛵 ⠇ እ㌿㐠ື࡟ᑟ ࡃࡇ࡜ ࡛ACLࡢࢫࢺ

ࣞࢫࡀቑ኱ ࡍࡿ࡜㏙ ࡭ 㸪Tiberio㸦1987㸧ࡣ㸪 ㊥㦵ୗ㛵⠇ ࡢ㐣ᗘ࡞ ᅇ ෆࡣ⬯㦵ෆ ᪕㐠ືࢆ⏕ࡌ 㸪ࡉࡽ࡟ ࡣ኱⭣㦵ࡢᅇ ᪕ 㐠ືࢆ ⏕ࡌࡉࡏࡿࡇ ࡜࡛㸪⭸ ⵹኱⭣㛵⠇

⑊③ ⑕ೃ ⩌ࡢ Ⓨ ⏕ せ ᅉ ࡜࡞ ࡿ ࡇ ࡜ࢆ ሗ ࿌ࡋ ࡚ ࠸ࡿ 㸬Coplan㸦1989㸧 ࡶ㐣 ๫࡞㊊

㒊ᅇෆࡣ⬯㦵 ᅇ᪕ 㐠ື ࢆ⏕ࡌࡉࡏ㸪 ࡉࡽ࡟ࡣ ⭸ 㛵⠇ᅇ᪕㐠 ື࡟ᑟࡃ ࡇ࡜ࢆሗ࿌

ࡋ࡚࠸ࡿ㸬ࡇ ࢀࡽࡢሗ ࿌࠿ࡽ㸪㊊㒊 ᅇෆ㸪ࡍ ࡞ࢃࡕ㊥㦵ୗ 㛵⠇ࡢ 㐣 ๫࡞ᅇෆ㐠

ືࡀ⬯㦵ෆ᪕ 㐠ື࡟ᑟ ࡁ㸪ࡉࡽ࡟ࡣ 㛵⠇㐠ື 㐃㙐࡟ࡼࡾ⭸ 㛵⠇࡬ࡢ ᅇ᪕ ࢫࢺࣞ

ࢫࢆ⏕ࡌࡉࡏ 㸪⤖ ᯝ ACLࡸ⭸⵹኱⭣㛵 ⠇࡬ ࡢ ࢫࢺࣞࢫࢆ ቑຍࡉࡏ ࡿࡇ࡜ࡀ ♧ࡉ

ࢀ࡚࠸ࡿ㸬

131

ᮏ◊✲࠿ࡽᚓ ࡽࢀࡓ ⤖ ᯝ࡟ࡘ࠸࡚㸪NDTS ࡜㖄┤᪉ྥ࡬ࡢ ᭱኱ᗋ཯ ຊ࡜ࡢ 㛫

࡟᭷ព࡞୰⛬ ᗘࡢ ㈇ࡢ ┦㛵ࢆ♧ࡋࡓ㸦r = -0.633㸪p = 0.027㸧㸬NDTSࡢホ౯ࡣ㸪

㊊㒊ᅇෆ㐠ື ࡢ኱ᑠ࡜ ࡜ࡶ࡟㸪 ෆഃ ⦪࢔࣮ࢳ ๛ᛶࡢ㧗ప࡜ 㛵㐃࡙ࡅ ࡚ホ౯ࡉࢀ

ࡿࡀ㸪ࡇ ࢀࡣ NDTSࡀᑠࡉ࠸࡯࡝㸦Ⲵ㔜 ఩࡛ ࡢ ෆഃ⦪࢔࣮ ࢳୗ㝆ࡀ ᑠࡉ࠸࡯࡝㸧 ෆഃ⦪࢔࣮ࢳ ๛ᛶࡀ㧗 ࡃ㸪 ╔ᆅ᫬ࡢ ㊊㒊࢔࣮ ࢳࢆ฼⏝ࡋࡓ ⾪ᧁ྾཰ ࡀෆഃ⦪࢔

࣮ࢳ๛ᛶࡀప ࠸⪅࡟ẚ ࡭࡚ຎࡿࡇ࡜ ࡀ᥎  ࡉ ࢀࡿ㸬୍᪉㸪NDTS ࡀ኱ࡁ࠸࡯࡝

㸦Ⲵ㔜఩࡛ࡢ ෆഃ⦪࢔ ࣮ࢳୗ㝆 ࡀ኱ ࡁ࠸࡯࡝ 㸧 ࢔࣮ࢳ๛ᛶ ࡀపࡃ㸪 ㊊㒊࢔࣮ࢳ

ࢆ฼⏝ࡋࡓ⾪ ᧁ྾཰ࡀ ෆഃ⦪࢔࣮ࢳ ๛ᛶࡀ㧗 ࠸⪅ࡼࡾඃࢀ ࡚࠸ࡿ ࡇ ࡜ࡀ᥎ ࡉ

ࢀࡿ㸬ᮏ◊✲ ⤖ᯝ࠿ࡽ 㸪NDTS ࡀᑠࡉ࠸࡯࡝ ᗋ཯ຊࡀ኱ࡁ ࡃ㸪NDTS ࡀ኱ࡁ࠸

࡯࡝╔ᆅ᫬ࡢ ᗋ཯ຊࡀ ᑠ ࡉ࠸࡜࠸㛵 㐃ᛶࡀㄆ ࡵࡽࢀ㸪㊊㒊 ࢔࣮ࢳ๛ ᛶ ࡢ኱ᑠ࡜

⾪ᧁ྾཰⬟࡜ ࡢ㛵㐃ᛶ ࡀ♧၀ࡉࢀࡓ 㸬

AI࡜᭱኱ ⫤㛵⠇ෆ ᪕ ゅᗘ㸪⫤㛵⠇ෆ ᪕ゅᗘ ೫఩㔞࡜ࡢ㛫 ࡟᭷ព࡞ ୰⛬ᗘࡢ㈇

ࡢ┦㛵ࢆ♧ࡋ㸦ࡑࢀ ࡒ ࢀ r = -0.689㸪p = 0.013㸹r = -0.671㸪p = 0.017㸧㸪㖄┤᪉

ྥ࡬ࡢ᭱኱ᗋ ཯ຊ࡜ࡢ 㛫࡟᭷ព࡞㧗 ࠸ṇࡢ┦ 㛵ࢆ♧ࡋࡓ㸦r = 0.892㸪p < 0.001㸧㸬 AIࡢ㧗ప ࡶ㸪๓㏙ࡋ ࡓෆഃ⦪࢔࣮ ࢳ๛ᛶ ࡢ 㧗ప࡜㛵㐃࡙ ࡅ࡚ホ౯ ࡉࢀࡿࡀ 㸪࢔

࣮ࢳ㧗⋡ࡀ㧗 ࠸࡯࡝ෆ ഃ࢔࣮ࢳ๛ᛶ ࡀ㧗 ࠸ࡇ ࡜ࡀ᥎ ࡉࢀ 㸪╔ᆅ᫬ ࠾ࡼࡧ╔ᆅ ᚋ࡟ࡳࡽࢀࡿ ㊊㒊ᅇෆ ࡢືࡁࡀ ᢚ࠼ ࡽࢀࡿ࡜ ⪃࠼ࡿ㸬ࡉࡽ ࡟㛵⠇㐃 㙐㐠ື ࡟ࡼ

ࡾ㸪ୗ⭣࠿ࡽ ⭸㛵⠇࡟ ࠿ࡅ࡚ࡢ㐣ᗘ ࡞ᅇ᪕㐠 ືࡀᢚไࡉࢀ 㸪⫤㛵⠇ ෆ᪕㐠ືࢆ

ࡶᢚไࡉࡏࡓ ࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃࠼ࡓ 㸬ࡲࡓ㸪 㐣๫࡞ AI ࡢ㧗್ࡣ㸪 ㊊㒊ᅇእഴ

ྥࡀࡳࡽࢀ 㸪⭸㛵 ⠇࢔ ࣛ࢖࣓ࣥࢺ࡟ ࠾࠸࡚ࡣ ෆ཯⭸ ࢆ♧ࡍ ྍ⬟ᛶࡀ ⪃࠼ࡽࢀࡿ 㸬 ࡑࡇ࡛ࡑࢀࡽ ࡢഴྥ ࢆ ࡶࡘ⪅ࡀ㸪╔ ᆅ᫬࠾ࡼ ࡧ╔ᆅᚋ ࡢ⫤ 㛵⠇እ᪕ ᪉ྥ࡬ࡢ㐠

ື࡟ᑟ࠸ࡓࡢ ࡛ࡣ࡞࠸ ࠿࡜ ⪃࠼ࡓ㸬AI ࡜㖄┤ ᪉ྥ࡬ࡢ᭱኱ ᗋ཯ຊ࡜ ࡢ㛵ಀ࡟࠾

࠸࡚㸪᭷ ព࡞㧗࠸ ṇࡢ ┦㛵ࢆ♧ࡋࡓ ࡀ㸪ୖ㏙ ࡋࡓ NDTS࡜᭱኱ᗋ཯ ຊ࡜ࡢ 㛵ಀ

ྠᵝ࡟㸪AIࡀ㧗࠸࡯ ࡝ෆഃ ⦪࢔࣮ ࢳ๛ᛶ ࡀ 㧗࠸ࡇ࡜ࡀ⪃ ࠼ࡽࢀ㸪╔ᆅ᫬ࡢ㊊㒊

࢔࣮ࢳࢆ฼⏝ ࡋࡓ⾪ᧁ ྾཰ ⬟ຊࡀຎ ࡿࡇ࡜࡛ ᗋ཯ຊࡀ኱ࡁ ࡃ࡞ࡾ㸪AIࡀప࠸ ࡯

࡝⾪ᧁ྾཰⬟ ຊࡀඃࢀ ࡿࡇ࡜࡛ᗋ཯ ຊࡀᑠࡉ ࡃ࡞ ࡗࡓࡢ࡛ ࡣ࡞࠸࠿ ࡜ ᥎ ࡋࡓ 㸬

Q-angle࡜᭱኱⭸㛵 ⠇ እ㌿ゅᗘ 㸪⭸㛵 ⠇እ㌿ ゅᗘ ೫఩㔞࡜ ࡢ㛫࡟᭷ ព࡞୰⛬ᗘ

ࡢṇࡢ┦㛵ࢆ ♧ࡋ㸦ࡑ ࢀࡒࢀ r = 0.654㸪p = 0.021㸹r = 0.590㸪p = 0.044㸧㸪᭱

኱⫤㛵⠇ෆ᪕ ゅᗘ࡜ࡢ 㛫࡟᭷ព࡞㧗 ࠸㈇ࡢ┦ 㛵ࢆ♧ࡋࡓ㸦r = -0.744㸪p = 0.005㸧㸬

132

ࡲࡓ㸪᭱ ኱⭸㛵⠇ እ㌿ ࣮࣓ࣔࣥࢺ ࡜ ࡢ㛫࡟᭷ ព࡞୰⛬ᗘࡢ ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ㸦r

= 0.608㸪p = 0.036㸧㸬Q-angle ࡣዪᛶࡣ⏨ ᛶ࡟ẚ࡭㸪ẚ ㍑ⓗ኱ࡁ ࠸ ࡇ࡜ࡀሗ࿌

ࡉࢀ࡚࠸ࡿ[Moul, 1998; Medina McKeon and Hertel, 2009; Horton and Hall, 1989;

Livingston, 1998; Emami et al., 2007; Smith et al., 2008]㸬Q-angle ࡜ୗ ⫥യᐖ࡟㛵 ࡍࡿሗ࿌࡟ࡘ ࠸࡚ࡣ㸪Q-angle ࡢ኱ࡁ࠸⩌ ࡣ ᑠࡉ࠸⩌࡟ẚ ࡭ 㸪᭷ព ࡟ୗ⫥യᐖࣜ

ࢫࢡࡀ㧗࠸ࡇ ࡜ࡸ[Cowan et al., 1996]㸪Q-angle ࡢᕥྑᕪࡀ኱ࡁ ࠸ ࡯࡝ୗ⫥യᐖ

Ⓨ⏕ࣜ ࢫࢡ ࡀ㧗 ࡲࡿ ࡇ ࡜ࡀሗ ࿌ࡉ ࢀ࡚ ࠸ࢀ ࡿ[Shambaugh et al., 1991]㸬ࡲ ࡓ㸪 Q-angle ࡢ ቑ ኱ ࡜ ⭸ ⵹ ኱ ⭣ ⑊ ③ ⑕ ೃ ⩌ ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ 㛵 㐃 ᛶ ࡀ ㄆ ࡵ ࡽ ࢀ ࡓ ࡜࠸

࠺ሗ࿌ࡶ」ᩘ ࡳࡽࢀࡿ[Powers, 2003]㸬ࡇࢀ ࡽࡢከࡃ ࡣ Q-angle ࡢ኱ᑠࡀ㸪⭸㛵

⠇࡬࠿࠿ࡿࢫ ࢺࣞࢫ ࡢ ኱ᑠ࡜ࡢ㛵ಀ ࢆ♧ࡋ࡚ ࠸ࡿ㸬 ᮏ◊✲ ⤖ᯝ࡟࠾ ࠸࡚㸪 ≉࡟

Q-angleࡢ኱ࡁࡉ࡜ ᭱ ኱⭸㛵⠇እ㌿ ゅᗘ 㸪⭸ 㛵⠇እ㌿ゅᗘ ೫఩㔞࡜ ࡢ 㛵ಀ࡟ṇࡢ

┦㛵㸦Q-angle ࡀ኱ࡁ ࠸࡯࡝㸪⭸ 㛵⠇እ㌿ ᪉ ྥ࡬ࡢືࡁࡀ ኱ࡁ࠸ࡇ ࡜ࢆ♧ࡍ㸧ࡀ ᚓࡽࢀࡓࡇ࡜ ࡣ㸪ඛ⾜ ㄽᩥ࠿ࡽከᩘ ሗ࿌ࡉࢀ ࡚࠸ࡿ Q-angle ࡢ኱ᑠ࡜⭸㛵⠇࡬

࠿࠿ࡿࢫࢺࣞ ࢫࡢ኱ᑠ ࠾ࡼࡧ⭸㛵⠇ യᐖⓎ⏕ ࡟ᑟࡃྍ⬟ᛶ ࢆ ᨭᣢࡍ ࡿ⤖ᯝ࡛ ࡶ

࠶ࡿ㸬୍᪉ ࡛ Q-angle ࡜᭱኱⫤㛵⠇ ෆ᪕ゅᗘ 㸪᭱኱⭸㛵⠇ እ㌿࣮ࣔ ࣓ࣥࢺ ࡟ࡘ

࠸࡚ࡣ᭷ព࡞ ㈇ࡢ ┦㛵 ࢆ♧ࡋࡓࡀ㸪 ࡇࢀࡽࡢ 㛵㐃ᛶ࡟ࡘ࠸ ࡚ ヲ⣽࡟ ᳨ウࡍࡿ࡟

ࡣ᭦࡞ࡿ᳨ド ࡀᚲせ࡛ ࠶ࡿ࡜⪃࠼ࡿ 㸬

TFAࡀ ACLയᐖ࡟ཬ ࡰࡍᙳ㡪࡟ࡘ ࠸࡚㸪 ඛ ⾜ㄽᩥ࡟ࡼࡿ ࡜ ACLയᐖ⩌ࡣࢥ

ࣥࢺ࣮ࣟࣝ⩌ ࡟ẚ࡭㸪TFAࡀ᭷ព࡟኱ࡁ ࠿ࡗ ࡓࡇ࡜ࢆ♧ࡋ 㸪ࡑࢀࡣ ㊊㒊እ㌿ ⫥

఩࡛ࡢ╔ᆅ࡟ ࡼࡾ㸪⭸ 㛵⠇ ෆ᪕㐠ື ࢆ⏕ࡌࡉ ࡏ㸪ACL࡬ࡢࢫࢺࣞ ࢫ ࢆቑ኱ࡉࡏ

ࡿࡇ࡜ࡀሗ࿌ ࡉࢀ࡚࠸ ࡿ[Trimble et al., 2002]㸬TMA࡟ࡘ࠸࡚ࡶ ⬯ 㦵እ᤬ゅᗘࡢ ቑຍࡣ㊊㒊ࢆ እ㌿᪉ྥ ࡟ᑟࡃࡇ࡜ࡀ ᥎ ࡉࢀ 㸪⭸㛵⠇ᅇ᪕ ືసࢆ ⏕ ࡌࡉࡏࡿྍ

⬟ᛶࡀ⪃࠼ࡽ ࢀࡿ 㸬ᮏ ◊✲⤖ᯝ࠿ࡽ 㸪TFA ࡜ ᭱኱⫤㛵⠇ෆ ᪕ゅᗘ࡜ ࡢ㛵ಀ࡟࠾

࠸࡚᭷ព࡞㧗 ࠸㈇ࡢ┦ 㛵ࢆ♧ࡋ㸦r = -0.736㸪p = 0.006㸧㸪⭸㛵⠇እ ㌿ゅᗘ ೫఩

㔞࡜ࡢ㛫࡟᭷ ព࡞ ୰⛬ ᗘࡢṇࡢ┦㛵 ࢆ♧ࡋࡓ 㸦r = 0.589㸪p = 0.044㸧㸬ࡲࡓ㸪 TMA࡜᭱኱⫤ 㛵⠇ෆ ᪕ゅᗘ㸪⫤ 㛵⠇ෆ᪕ ゅ ᗘ೫఩㔞࡜ࡢ 㛫࡟᭷ព ࡞୰⛬ᗘࡢ㈇

ࡢ┦㛵ࢆ♧ࡋ ࡓ㸦ࡑ ࢀ ࡒࢀ r = -0.609㸪p = 0.036㸹r = -0.637㸪p = 0.026㸧㸬ඛ㏙

ࡋࡓඛ⾜◊✲ ࡢሗ࿌࠿ ࡽ㸪TFA ࡸ TMA ࡀ⬯㦵࠾ࡼࡧ⭸㛵 ⠇ᅇ᪕࡬ ཬࡰࡍᙳ㡪

࡟ࡘ࠸࡚㸪ᮏ ◊✲⤖ᯝ ࠿ࡽ ࡣ㸪TFAࡢ኱ᑠ ࡜ ⭸㛵⠇እ㌿ゅ ᗘ ೫఩㔞 ࡢ኱ᑠ࡜ࡢ

133

㛵ಀ࡟࠾࠸࡚ ṇࡢ┦㛵 ࡀㄆࡵࡽࢀࡓ ୍᪉࡛ 㸪TMAࡢ኱ᑠ࡜ ᭱኱⫤ 㛵⠇ෆ᪕ゅᗘ

࠾ࡼ ࡧ ⫤ 㛵⠇ ෆ ᪕ ゅ ᗘ ೫఩ 㔞 ࡢ ኱ᑠ ࡜ ࡢ 㛵 ಀ ࠾ࡼ ࡧ TFA ࡢ ኱ ᑠ࡜ ᭱኱ ⫤ 㛵⠇

ෆ᪕ゅᗘࡢ኱ ᑠ࡜ࡢ㛵 ಀ࡟ࡘ࠸࡚ࡣ ㈇ࡢ┦㛵 ࡀㄆࡵࡽࢀࡓ 㸬ࡇࢀࡣ 㸪௒ᅇࡢㄢ 㢟ືసࡢᣦ♧ ࡟࠾࠸࡚ 㸪╔ᆅ᫬ࡢ㊊ 㒊ࡢ᪉ྥ ࡟ࡘ࠸࡚㸪ࡘ ࡲඛࢆ ṇ 㠃࡟ྥࡅ࡚

╔ᆅࡉࡏࡿ➼ ࡢලయⓗ ࡞ ᣦ♧ࢆ୚࠼ ࡞࠿ࡗࡓ ࡇ࡜ ࡀ㸪⫤㛵 ⠇ࡢ ືస ࡟཯ᫎࡋ࡞

࠿ࡗࡓࡢ࡛ࡣ ࡞࠸࠿࡜ ⪃࠼ࡓ㸬኱⭣ 㦵࡟ᑐࡍ ࡿ㊊㒊ࡢእ㌿ ࠾ࡼࡧ⬯ 㦵ࡢእ᤬ࡢ

⛬ᗘࡀ㸪ࡘࡲ ඛࢆṇ㠃 ࡟ྥࡅ࡚╔ᆅ ࡉࡏࡓ᫬ ࡢ ⬯㦵ෆ᪕㸪 ࡑࡋ࡚⭸ 㛵⠇ෆ᪕ 㐠

ື㸪ࡉࡽ࡟ࡣ ⫤㛵⠇ෆ ᪕ 㐠ື࡬࡜㛵 ⠇㐠ື㐃 㙐ࢆ⏕ࡌࡉࡏ ࡿ ྍ⬟ᛶ ࡀ⪃࠼ࡽࢀ

ࡿࡀ㸪TMA ࠾ࡼࡧ TFA ࡀ኱ࡁ࠸ࡶࡢࡣ↓ ព ㆑࡟㊊㒊እ㌿ ⫥఩࡛╔ ᆅࡋࡓྍ⬟

ᛶࡀ⪃࠼ࡽࢀ 㸪╔ᆅᚋ ࡢ ⬯㦵ᅇ᪕ࡸ ⭸㛵⠇ ᅇ ᪕➼ࡢ㐣๫࡞ 㛵⠇ 㐠ື ࡀ⏕ࡌ࡞࠿

ࡗࡓࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃ ࠼ࡓ㸬

FAA࡜᭱኱⭸㛵 ⠇እ ㌿ゅᗘ 㸪⭸㛵⠇እ ㌿ゅ ᗘ ೫఩㔞࡜ࡢ 㛫࡟᭷ព ࡞ ୰⛬ᗘࡢ ṇࡢ┦㛵ࢆ♧ ࡋࡓ㸦ࡑ ࢀࡒࢀ r = 0.584㸪p = 0.046㸹r = 0.589㸪p = 0.045㸧㸬FAA ࡣ㸪኱⭣㦵㢕 㒊๓᤬ゅ ᗘ ࢆ♧ࡍࡶࡢ ࡛࠶ࡿࡀ 㸪 ඛ⾜ㄽᩥ࡟ ࠾࠸࡚㸪 ኱⭣㦵㢕㒊 ๓᤬ゅᗘࡀ኱ ࡁ࠸ࡶࡢ ࡣ㸪Ṍ⾜᫬࡟͆toe-in͇ഴྥࢆ♧ࡍࡇ ࡜ࡀሗ࿌ ࡉࢀ ࡚࠸ࡿ

࡯࠿[Cranel, 1959]㸪╔ ᆅᚋࡢ⭸ࡢ͆knee-in͇ືస࡟ࡶᙳ㡪 ࢆཬࡰ ࡍ ࡇ࡜࠿ࡽ㸪 ᮏ◊✲ㄢ㢟ື స ࡟࠾࠸ ࡚ࡶ FAAࡢ኱ ࡁ࠸⪅ ࡣ ╔ᆅ᫬ࡢ⭸ ࡢ͆knee-in͇ືసࢆቑ ຍࡉࡏࡓࡇ࡜ ࡛㸪⭸㛵 ⠇እ㌿ゅᗘࡢ ቑຍ࡟ ࡘ ࡞ࡀࡗࡓࡢ࡛ ࡣ ࡞࠸࠿ ࡜ ⪃࠼ࡓ㸬

ADKE ࡜ ᭱ ኱ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ᗘ ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸦r = 0.596㸪p = 0.041㸧㸪㖄 ┤᪉ྥ࡬ࡢ᭱ ኱ᗋ཯ຊ ࡜ࡢ 㛫࡟᭷ព ࡞㧗࠸㈇ ࡢ┦㛵ࢆ♧

ࡋࡓ㸦r = -0.713㸪p = 0.009㸧㸬ࡲࡓ㸪ADKF࡜㖄┤᪉ྥ ࡬ࡢ᭱኱ ᗋ཯ຊ࡜ࡢ 㛫

࡟᭷ព࡞㧗࠸ ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ㸦r = -0.729㸪p = 0.007㸧㸬ᗋ཯ຊࡢ ኱ࡁࡉ࡜ୗ

⫥യᐖ࡜ࡢ㛵 㐃࡟ࡘ࠸ ࡚㸪Hewett ࡽ㸦2005㸧ࡣ DVJ ࢱࢫࢡ࡟ࡼࡿ ୗ⫥࢟ࢿ࣐ࢸ

࢕ࢡࢫࢆ࣮࣋ ࢫࣛ࢖ࣥ ࡟⏝࠸࡚ ACLയᐖ⩌ ࡜㠀യᐖ⩌ࢆ ẚ㍑ࡋࡓ ࡜ࡇࢁ㸪ACL യᐖ⩌ࡣ㠀യ ᐖ⩌࡟ẚ ࡭ ࡚ 20㸣㧗࠸ᗋ཯ ຊ ࢆ ♧ࡋ㸪ACLയ ᐖࣜࢫ ࢡࡢ୺せᅉ࡛

࠶ࡿ࡜㏙࡭࡚ ࠸ࡿ㸬ࡲ ࡓ㸪McNair࡜Marshall㸦1994㸧ࡣ㸪╔ᆅ ᫬ ࡟ࡳࡽࢀࡿᗋ

཯ຊ࡜㸪኱⭣ 㦵࡟ᑐࡍ ࡿ⬯㦵๓᪉೫ ఩㔞࡜ࡢ 㛵㐃ᛶࢆ♧ࡋ 㸪╔ᆅ᫬ ࡢᗋ཯ຊࢆ

ῶᑡࡉࡏࡿࡇ ࡜ࡣ ACLയᐖࣜࢫࢡ ࢆῶࡌࡉ ࡏࡿ࡜㏙࡭࡚ ࠸ࡿ㸬ࡲ ࡓ㸪Kernozek 㸦2005㸧ࡽࡣࢻࣟ ࢵࣉ ࣛࣥࢹ࢕ࣥࢢ ࡢ⏨ዪ ࡢ ẚ㍑࡟࠾࠸࡚ 㸪ዪ ᛶࡣ ⏨ᛶ࡟ẚ ࡭㸪

134

᭱኱ᗋ཯ຊ࠾ ࡼࡧ᭱኱ ㊊㛵⠇⫼ᒅゅ ᗘࡀ᭷ព ࡟኱ࡁ࠿ࡗࡓ ࡇ࡜ࢆ♧ ࡋ㸦᭱኱⭸

㛵⠇ᒅ᭤ゅᗘ 㸪᭱኱⫤ 㛵⠇ᒅ᭤ゅᗘ ࡢẚ㍑࡟ ࡘ࠸࡚ࡣ ᭷ព ᕪ࡞ࡋ㸧㸪Decker ࡽ 㸦2006㸧ࡣ㸪ᐇ㦂ᐊࣞ ࡛࣋ࣝࡢ⏨ዪ ࡢ╔ᆅ᫬ ࡢ ୗ⫥ࡢྛ㛵 ⠇࡟࠾ࡅ ࡿ ⾪ᧁ྾཰

࡟ࡘ࠸᳨࡚ド ࡋࡓ࡜ࡇ ࢁ㸪 ዪᛶࡣ⏨ ᛶ࡟ẚ࡭ ╔ᆅ᫬ࡢ㊊㛵 ⠇ྍືᇦ ࡀ኱ࡁࡃ㸪

㊊㛵⠇ᗏᒅ➽ ⩌ࢆ᭷ຠ ࡟฼⏝ࡋ ࡚⾪ ᧁ྾཰ࡀ ⾜ࢃࢀ࡚࠸ࡿ ࡜㏙࡭ࡓ 㸬ᮏ◊✲ࡢ

⤖ᯝ࠿ࡽ㸪㊊ 㛵⠇ ⫼ᒅ ゅᗘ࡜ᗋ཯ຊ ࡜ࡢ 㛵ಀ ࡟࠾࠸࡚᭷ព ࡞㈇ࡢ┦ 㛵ࢆ♧ࡋ㸪 ๓㏙ࡋࡓඛ⾜ ㄽᩥ࠿ࡽ ࡢሗ࿌ࡶྵࡵ ࡚[Kernozak et al., 2005; Decker et al., 2006]㸪 ACLയᐖࢆྵࡵࡓ ୗ ⫥യᐖࡢほⅬ ࠿ࡽ ᳨ウ ࡍࡿ࡜㸪㊊㛵⠇⫼ ᒅゅ ᗘࡀᑠࡉ࠸ ࡶ ࡢࡣ㸪╔ᆅ᫬ ࡢ㊊㛵⠇ ⫼ᒅ㐠ືࢆ᭷ ຠ࡟฼⏝ ࡋࡓ ⾪ᧁ྾཰ ࡀᅔ㞴࡛ ࠶ࡿ ࡇ࡜ࡀ

⪃࠼ࡽࢀ㸪ᗋ ཯ຊࡀ኱ ࡁࡃ ࡞ࡿഴྥ ࡀ♧ࡉࢀ ࡓࡇ࡜ࢆ㏻ࡌ ࡚㸪 ୗ⫥ യᐖࣜࢫࢡ せᅉࡢ୍ࡘ࡟ ࡞ࡿ ྍ⬟ ᛶࡀ♧၀ࡉࢀ ࡓ㸬௚ࡢ ඛ⾜ㄽᩥ࠿ࡽ ࡶ㸪ዪᛶ ࡣ⏨ᛶ࡟ẚ

࡭࡚㸪╔ᆅ᫬ ࡢ⾪ᧁ ⦆ ⾪᪉ἲ࡟ࡘ࠸ ࡚㸪 ㊊㛵 ⠇ࡀ᭷ព࡟స ⏝ࡋ࡚࠸ ࡿ ࡇ࡜ࡀሗ

࿌ࡉࢀ࡚࠸ࡿ[Schmitz et al., 2007; Zhang et al., 2000; Devita and Skelly, 1992;

Schot et al., 1994]㸬

╔ ᆅ ᫬ ࡢ ⭸ 㛵 ⠇ Ᏻ ᐃ ᛶ ࡟ ୗ ⫥ ➽ ⫗ ࡢ స ⏝ ࡢ 㔜 せ ᛶ ࡀ ከ ᩘ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ ࡀ [Zeller et al., 2003; Kiriyama et al., 2009; Hewett et al., 1996; Salci et al., 2004;

Nagano et al., 2007; Fagenbaum and Darling, 2003; Lephart et al., 2002; Pappas et al., 2007; Zazulak et al., 2005; Jacobs et al., 2007]㸪๓㢠㠃࠿ࡽࡳ ࡓ࡜ࡁࡢ ⭸㛵⠇࡬ཬ

ࡰࡍᙳ㡪࡟࠸ ࡚㸪Zazulak ࡽ㸦2005㸧ࡢሗ࿌ ࡛ࡣ㸪∦ ⬮╔ᆅື స᫬ ࡢ⏨ዪࡢẚ㍑

࡛ዪᛶࡣ⏨ᛶ ࡟ẚ࡭ ࡚ ኱Ẋ➽ࡢ➽ά ືࡀ ᭷ព ࡟పࡃ㸪ࡲࡓ ୰Ẋ➽ࡢ ➽άືࡶ᭷

ព࡟ప࠸ഴྥ ࢆ♧ࡋ㸪 ⫤㛵⠇ෆ㌿ ࠾ ࡼࡧෆ᪕ ືసࡢไᚚࡀ ᅔ㞴࡜࡞ ࡾ 㸪⭸㛵⠇

እ㌿࡟ᑟࡃྍ ⬟ᛶࢆ♧ ၀ࡋ ࡚࠸ࡿ㸬ࡲࡓ㸪Zeller㸦2003㸧ࡽࡣ㸪∦ ⬮ࢫࢡ࣡ࢵࢺ

᫬ࡢ⏨ዪࡢୗ ⫥㛵⠇ ゅ ᗘࡢẚ㍑࡟࠾ ࠸࡚㸪ዪ ᛶࡣ⏨ᛶ࡟ẚ ࡭࡚⫤㛵 ⠇ෆ㌿ゅᗘ ࡀ኱ࡁࡃ㸪୰ Ẋ➽࡟ࡼ ࡿ ⫤㛵⠇ࡢࢥ ࣥࢺ࣮ࣟ ࣝ ࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚ ㏙࡭࡚࠸

ࡿ㸬ࡇࢀࡽࡢ ሗ࿌࠿ࡽ 㸪୰Ẋ➽➽ຊ ࡀ⫤㛵⠇ ෆ㌿ ࠾ࡼࡧෆ ᪕ືస 㸪 ⭸㛵⠇እ㌿

ືసࡢไᚚ࡟ ᐤ୚ࡉࡏ ࡚࠸ࡿࡇ࡜ࡀ ࠺࠿ࡀ࠼ ࡿࡀ㸪 ᮏ◊✲ ࡟࠾࠸࡚ 㸪᭱኱⭸㛵

⠇እ㌿ゅᗘ㸪 ᭱኱⫤㛵 ⠇ෆ㌿ゅᗘ㸪 ⭸㛵⠇እ ㌿ゅᗘ ೫఩㔞 ࡜ࡢ 㛫࡟ ᭷ព࡞୰⛬

ᗘࡢ㈇ࡢ┦㛵 ࢆ♧ࡋ㸦 ࡑࢀࡒࢀ r = 0.681㸪p = 0.015㸹r = -0.635㸪p = 0.023㸹r =

-0.697㸪p = 0.012㸧㸪 ⫤㛵⠇ ෆ᪕ゅ ᗘ೫ ఩㔞 ࡜ࡢ㛫 ࡟᭷ព ࡞୰ ⛬ᗘ ࡢ ṇࡢ ┦㛵

135

ࢆ♧ࡋࡓ㸦r = 0.611㸪p = 0.035㸧㸬ࡲࡓ㸪᭱ ኱ᗋ཯ຊ࡜ࡢ 㛫࡟᭷ព ࡞㧗࠸ṇࡢ

┦㛵ࢆ♧ࡋࡓ 㸦r = 0.703㸪p = 0.011㸧㸬ࡇࢀ ࡣ୰Ẋ➽ࡢ➽ ຊࡀ ప࠸ ⪅࡯࡝⭸㛵

⠇እ㌿࠾ࡼࡧ ⫤㛵⠇ෆ ㌿ືస࡟ᑟࡁ 㸪୰Ẋ➽ ࡢ➽ຊࡀ㧗࠸ ⪅࡯࡝⭸ 㛵⠇ ෆ㌿࠾

ࡼ ࡧ ⫤ 㛵 ⠇ እ ㌿ ື స ࡟ ᑟ ࡃ ࡜ ࠸ ࠺ ഴ ྥ ࢆ ♧ ࡍ ࡶ ࡢ ࡛ ࠶ ࡿ 㸬 ඛ ⾜ ◊ ✲ ྠ ᵝ ࡟ [Zazulak et al., 2005; Zeller et al., 2003]㸪ᮏ ◊✲⤖ᯝ࠿ࡽ ࡶ ୰Ẋ➽ ➽ຊ ࡀ⭸㛵⠇

ࡸ⫤㛵⠇ࡢື ⓗୗ⫥࢔ ࣛ࢖࣓ࣥࢺࡢ ࢥࣥࢺࣟ ࣮ࣝ࡟ ᐤ୚ࡉ ࡏࡿ ྍ⬟ ᛶࡀ♧ࡉࢀ 㸪

୰Ẋ➽ࡀୗ⫥ 㛵⠇ࡢࢥ ࣥࢺ࣮ࣟࣝ ࡟ 㔜せ࡞ᙺ ๭ࢆᣢࡘྍ⬟ ᛶࡀ♧၀ ࡉࢀࡓ㸬୍

᪉࡛㸪୰ Ẋ➽➽ຊ ࡜ ⫤ 㛵⠇ෆ᪕ゅᗘ ೫఩㔞࡜ ࡢ㛫࡟ࡣ᭷ព ࡞㈇ࡢ㛵 ಀࡀ♧ࡉࢀ 㸪 ๓㏙ࡋࡓୗ⫥ യᐖࣜࢫ ࢡ ࢆᅇ㑊ࡉࡏ ࡿ≉ᚩⓗ ࡞ືⓗୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺࡢഴྥࡣ

♧ࡉ࡞࠿ࡗࡓ 㸬

⫤㛵⠇ෆ᪕ゅ ᗘ࡜ ACLയᐖ࡜ࡢ㛵 㐃ᛶ࡟ࡘ ࠸࡚ࡣ㸪Hertelࡽ㸦2004㸧࡟ࡼࡾ

ሗ࿌ࡉࢀ࡚࠸ ࡿࡀ㸪ᚋ ࢁྥࡁㄪᰝ࡟ ࡼࡿ ACLയᐖ⩌࡜㠀 യᐖ⩌࡜ ࡢẚ㍑ ࡟࠾࠸

࡚᭷ពᕪࡣぢ ࡽࢀ ࡞࠿ ࡗࡓ㸬ᮏ◊✲࡟ ࠾ ࡅࡿ DVJືస࡜ࡢ㛵㐃ᛶ ࡟ ࡘ࠸࡚㸪⫤

㛵 ⠇ ෆ ᪕ゅ ᗘ ࡜ ྛ 㡯 ┠ 㛫 ࡟ ࠾࠸ ࡚ ᭷ ព ࡞ 㛵 㐃 ᛶ ࡣ ㄆࡵ ࡽ ࢀ ࡞ ࠿ ࡗ ࡓ 㸬GJLT ࡣ ዪ ᛶ ࡣ ⏨ ᛶ ࡜ ẚ ㍑ ࡋ ࡚ 㸪 㧘 ࠸ ࢫ ࢥ ࢔ ࢆ ᣢ ࡘ ࡇ ࡜ ࡀ ከ ᩘ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ ࡀ [Decoster et al., 1991; Quatman et al., 2008]㸪ACLയᐖ⩌࡜㠀യ ᐖ ⩌ ࢆẚ㍑ࡋࡓඛ

⾜ㄽᩥ࡟ࡘ࠸ ࡚㸪Uhorchakࡽ㸦2003㸧ࡣ㸪GJLT ࡢᖹᆒ್࠿ࡽ 1±ᶆ‽೫ᕪࡼࡾ

኱ࡁ࡞ࢫࢥ࢔ ࢆࡶࡘ ⪅ ࡣACLയᐖࣜ ࢫࢡࡀ ቑ኱ࡍࡿ࡜ሗ ࿌ࡋ㸪Ramesh ࡽ㸦2005㸧 ࡣ㸪ACLയᐖ⩌࡛ ࠿ ࡘ GJLT ࡢ㧗࠸ࢫࢥ࢔ ࢆ ᭷ࡋ㸪୰࡛ ࡶ⭸㛵⠇ ᘱ⦆ᛶࡢ㧗࠸

⪅ࡣ᭷ព ࡟ ACLയᐖ ࣜࢫࢡࡀ㧗࠸ ࡇ࡜ࢆ ሗ ࿌ࡋࡓࡀ㸪ᮏ◊✲⤖ ᯝ ࡛⾜ࡗࡓㄢ㢟

ືస࠿ࡽࡳࡽ ࢀࡿୗ⫥ ࢟ࢿ࣐ࢸ࢕ࢡ ࢫ࣭࢟ࢿ ࢸ࢕ࢡࢫ ࡜ࡢ 㛵㐃ᛶ࡟ ࡘ࠸࡚ࡣ᭷

ព࡞㛵ಀࡣㄆ ࡵࡽࢀ࡞ ࠿ࡗࡓ㸬

ᮏ◊✲ࡣ㸪ACLയᐖࢆ ྵࡵࡓୗ⫥യ ᐖண㜵ࡢ ࡓࡵࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢸࢫࢺࡢ

᭷⏝ᛶࢆ᳨ド ࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ࡋ࡚ 㸪DVJືస᫬ࡢୗ⫥࢟ ࢿ࣐ࢸ࢕ ࢡࢫ࣭࢟ࢿ

ࢸ࢕ࢡࢫ࡜ୗ ⫥࢔ࣛ࢖ ࣓ࣥࢺ㸪㛵⠇ ྍືᇦ㸪 ඲㌟ᘱ⦆ᛶ㸪 ⫤㛵⠇እ ㌿➽ຊ࡜ࡢ 㛵㐃ᛶ࡟ࡘ࠸ ࡚ẚ㍑᳨ ウࡋ 㸪ACLࢆྵࡵࡓୗ ⫥ യᐖண㜵ࡢ ࡓࡵࡢࢫ ࢡ࣮ࣜࢽࣥ

ࢢࢸࢫࢺࡢᐇ 㝿࡟࠾࠸ ࡚㸪യᐖ࡟㉳ ᅉࡍࡿྍ ⬟ᛶࡀ࠶ࡿ 㡯 ┠ࢆ㑅ᢥ ⓗ࡟ ᐃࡶ

ࡋࡃࡣᥦ♧࡛ ࡁࡿ ࡢ࡛ ࡣ࡞࠸࠿࡜ ࠸ ࠺ࡶࡢ࡛ ࠶ ࡗࡓ㸬⤖ᯝ ࡣ⭸㛵⠇ እ㌿ 㐠ື࠾

ࡼ ࡧ ⫤ 㛵 ⠇ ෆ ㌿ 㐠 ື ࡸ 㛵 ⠇ ࣔ ࣮ ࣓ ࣥ ࢺ ࡟ ╔ ┠ ࡋ ࡚ ホ ౯ ࡍ ࡿ ሙ ྜ 㸪Q-angle㸪

136

Femoral antevertion angle㸪⫤㛵⠇ እ㌿➽ຊ ࡢ㡯┠ ࢆྵࡵ ࡓホ౯ࡢ ᭷⏝ᛶࡀ♧ࡉ

ࢀ㸪╔ᆅ᫬ࡢ ⾪ᧁ⦆⾪ ⬟ࡢホ౯࡜ࡋ ࡚ ࡣ㸪࢔ ࣮ࢳ㧗⋡࡜㊊ 㛵⠇⫼ᒅ ゅᗘ ࡢ㡯┠

ࢆྵࡵࡓホ౯ ࡢ ᭷⏝ᛶ ࡀ♧ࡉࢀࡓ㸬

5-6-5. ⤖ㄒ

ᮏ◊✲ࡣ㸪ACLࢆྵࡵ ࡓୗ⫥യᐖண 㜵ࡢⅭࡢ ࢫࢡ࣮ࣜࢽࣥ ࢢࢸࢫࢺ ࡜ࡋ࡚᥎ ዡࡉࢀ࡚࠸ࡿ ࢻࣟࢵࣉ ࣂ࣮ࢸ࢕࢝ࣝ ࢪࣕࣥࣉ ࢆㄢ㢟ືస࡟ タᐃࡋ࡚ 㸪㟼ⓗୗ⫥

࢔ࣛ࢖࣓ࣥࢺ ࡸୗ⫥㛵 ⠇ྍືᇦ㸪඲ ㌟㛵⠇ᘱ ⦆ᛶ㸪⫤㛵⠇ እ㌿➽ຊ ࡜╔ᆅືస

᫬࡟ࡳࡽࢀࡿ ୗ⫥࢟ࢿ ࢸ࢕ࢡࢫ࣭࢟ ࢿ࣐ࢸ࢕ ࢡࢫ࡜ࡢ㛵㐃 ᛶࢆẚ㍑ ᳨ウࡍࡿࡇ

࡜ࢆ┠ⓗ࡜ࡋ ࡚⾜࠸ 㸪 ௨ୗࡢ㛵㐃ᛶ ࡀ♧ࡉࢀ ࡓ㸬

1) Navicular drop test score ࡜㖄┤᪉ྥ࡬ ࡢ᭱ ኱ᗋ཯ຊ࡜ࡢ 㛵ಀ࡟᭷ ព࡞ ୰⛬

ᗘࡢ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ 㸬

2) ࢔ ࣮ ࢳ 㧗 ⋡ ࡜ ᭱ ኱ ⫤ 㛵 ⠇ ෆ ᪕ ゅ ᗘ 㸪 ⫤ 㛵 ⠇ ෆ ᪕ ゅ ᗘ ೫ ఩ 㔞 ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព

࡞ ୰ ⛬ ᗘ ࡢ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸪 㖄 ┤ ᪉ ྥ ࡬ ࡢ ᭱ ኱ ᗋ ཯ ຊ ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព ࡞ 㧗

࠸ṇࡢ┦㛵ࢆ ♧ࡋࡓ㸬

3) Q-angle࡜᭱኱⭸㛵 ⠇ እ㌿ゅᗘ 㸪⭸㛵 ⠇እ㌿ ゅᗘ ೫఩㔞࡜ ࡢ㛵ಀ࡟ ᭷ព࡞ ୰

⛬ ᗘ ࡢ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸪 ᭱ ኱ ⫤ 㛵 ⠇ ෆ ᪕ ゅ ᗘ ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព ࡞ 㧗 ࠸ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ ࡓ 㸬 ࡲ ࡓ 㸪 ᭱ ኱ ⭸ 㛵 ⠇ እ ㌿ ࣔ ࣮ ࣓ ࣥ ࢺ ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ

㈇ࡢ┦㛵ࢆ♧ ࡋࡓ㸬

4) Thgh-transmalleolar angle ࡜᭱኱⫤㛵⠇ෆ ᪕ ゅᗘ㸪 ⫤㛵⠇ ෆ᪕ゅᗘ ೫఩㔞࡜

ࡢ㛵ಀ࡟᭷ព ࡞ ୰⛬ᗘ ࡢ㈇ࡢ┦㛵ࢆ ♧ࡋࡓ㸬

5) Thigh-foot angle ࡜᭱኱⫤㛵⠇ෆ᪕ ゅᗘ࡜ࡢ 㛵ಀ࡟᭷ព࡞ 㧗࠸㈇ࡢ ┦㛵ࢆ♧

ࡋ㸪⭸㛵⠇ෆ ㌿ゅᗘ೫ ఩㔞࡜ࡢ㛵ಀ ࡟᭷ព࡞ ୰⛬ᗘࡢṇࡢ ┦㛵ࢆ♧ ࡋࡓ㸬 6) ኱ ⭣ 㦵 㢕 㒊 ๓ ᤬ ゅ ᗘ ࡜ ᭱ ኱ ⭸ 㛵 ⠇ እ ㌿ ゅ ᗘ 㸪 ⭸ 㛵 ⠇ እ ㌿ ゅ ᗘ ೫ ఩ 㔞 ࡜ ࡢ 㛵

ಀ࡟᭷ព࡞୰ ⛬ᗘࡢ ṇ ࡢ┦㛵ࢆ♧ࡋ ࡓ㸬

7) ㊊ 㛵 ⠇ ⫼ ᒅ ゅ ᗘ 㸦 ⭸ 㛵 ⠇ ఙ ᒎ ࠾ ࡼ ࡧ Ⲵ 㔜 ఩ 㸧 ࡜ ᭱ ኱ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ᗘ ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸪 㖄 ┤ ᪉ ྥ ࡬ ࡢ ᭱ ኱ ᗋ ཯ ຊ ࡜ ࡢ 㛵 ಀ ࡟

᭷ ព ࡞ 㧗 ࠸ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ ࡓ 㸬 ࡲ ࡓ 㸪 ㊊ 㛵 ⠇ ⫼ ᒅ ゅ ᗘ 㸦 ⭸ 㛵 ⠇ ᒅ ᭤ ࠾ ࡼ ࡧ Ⲵ 㔜 ఩ 㸧 ࡜ 㖄 ┤ ᪉ ྥ ࡬ ࡢ ᭱ ኱ ᗋ ཯ ຊ ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព ࡞ 㧗 ࠸ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ

137

ࡓ㸬

8) ⫤ 㛵 ⠇ እ ㌿ ➽ ຊ ࡜ ᭱ ኱ ⭸ 㛵 ⠇ እ ㌿ ゅ ᗘ 㸪 ᭱ ኱ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ᗘ 㸪 ⭸ 㛵 ⠇ እ ㌿ ゅ ᗘ ೫ ఩ 㔞 ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸪 ⫤ 㛵 ⠇ ෆ ᪕ ゅ ᗘ ೫

఩ 㔞 ࡜ ࡢ 㛵 ಀ ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ ࡓ 㸬 ࡲ ࡓ 㸪 㖄 ┤ ᪉ ྥ ࡬ ࡢ ᭱

኱ᗋ཯ຊ࡜ࡢ 㛵ಀ࡟᭷ ព࡞ 㧗࠸ṇࡢ ┦㛵ࢆ♧ ࡋࡓ㸬

9) ACL ࢆྵࡵࡓୗ⫥യ ᐖண㜵ࡢࡓࡵ ࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢆ┠ ⓗ࡜ࡋ ࡚ ࢻࣟࢵࣉ

ࣂ ࣮ ࢸ ࢕ ࢝ ࣝ ࢪ ࣕ ࣥ ࣉ ࢆ ⾜ ࢃ ࡏ ࡓ ࡜ ࡁ ࡢ ⭸ 㛵 ⠇ እ ㌿ ື స ࠾ ࡼ ࡧ ⫤ 㛵 ⠇ ෆ ㌿

ື స ࡸ 㛵 ⠇ ࣔ ࣮ ࣓ ࣥ ࢺ ࡟ ╔ ┠ ࡋ ࡚ ホ ౯ ࡍ ࡿ ሙ ྜ 㸪Q-angle㸪Femoral ante-vertion angle㸪⫤㛵⠇ እ㌿➽ຊ ࡢ  ᐃ㡯┠ࢆ ྵࡵࡓホ౯ࡢ ᭷⏝ᛶࡀ ♧ࡉࢀࡓ 㸬

ࡲ ࡓ 㸪 ╔ ᆅ ᫬ ࡢ ⾪ ᧁ ⦆ ⾪ ⬟ ࡢ ホ ౯ 㡯 ┠ ࡜ ࡋ ࡚ 㸪 ࢔ ࣮ ࢳ 㧗 ⋡ ࡜ ㊊ 㛵 ⠇ ⫼ ᒅ ゅ ᗘࢆྵࡵࡓホ ౯ ࡢ᭷⏝ ᛶࡀ♧ࡉࢀࡓ 㸬

138

6

ୗ⫥യᐖண㜵ࢺ࣮ࣞࢽࣥࢢ௓ධ࡜ຠᯝ᳨ド

139

◊ ✲ 7 ୗ ⫥ യᐖ ண㜵 ࢺࣞ ࣮ࢽ ࣥ ࢢ௓ ධࡀ ㊊ ㊑ᶵ ⬟㸪 ㊊ 㒊ᙧ ែ㸪 㟼 ⓗ࣭ ືⓗ ࣂ

ࣛࣥ ࢫ⬟ ຊ ࡟ཬ ࡰࡍ ᙳ 㡪

6-7-1. ⥴ゝ

21 ୡ⣖࡟ධࡾ㸪ࢫ࣏࣮ ࢶ་Ꮫ఍࡟࠾ ࠸࡚ࢫ࣏ ࣮ࢶയᐖண㜵 ࡟ྥࡅࡓ ྲྀࡾ⤌ࡳ

ࡀ✚ᴟⓗ ࡟⾜ࢃ ࢀ࡚࠸ ࡿࡀ㸪 ୰ ࡛ࡶ⭸๓ ༑Ꮠ 㠌ᖏ㸦anterior cruciate ligament㸸 ௨ୗ㸪ACL㸧 യᐖ ண㜵 ࣉࣟࢢ ࣒ࣛ ࡸ ㊊㛵 ⠇യ ᐖண㜵 ࣉࣟࢢ ࣒ࣛ ࡢ௓ ධሗ࿌ ࡀከ

ᩘࡳࡽࢀࡿ 㸬ࢫ࣏ ࣮ࢶ ⌧ሙ࡟࠾ࡅࡿ ୗ⫥യᐖ ண㜵 ࢺ࣮ࣞࢽ ࣥࢢࡢ ᣦ ᑟἲ࡜ࡋ࡚ 㸪 ࢫࢡ࣡ࢵࢺࡸ ࢪࣕࣥࣉ ࠿ࡽࡢ╔ᆅື స᫬࡟ࡳ ࡽࢀࡿ㐣๫࡞ ⭸ 㛵⠇እ ཯⫥఩ࡢᅇ 㑊࡟↔Ⅼࢆᙜ ࡚ࡓ ᣦᑟ ࡀ」ᩘࡳࡽࢀ 㸪ከࡃࡣ ⭸㛵⠇ࡸ⫤㛵 ⠇ࡢືࡁ ࢆព㆑ࡉࡏ ࡓᣦᑟἲ࡛࠶ ࡿࡀ㸪➹ ⪅ࡽࡣࡇࡢࡼ ࠺࡞ᣦᑟ ࡢ࡯࠿࡟ 㸪㊊ ㊑ࡢືࡁ ࡜㛵㐃ࡉࡏ ࡓᣦᑟࡀ㐣๫ ࡞⭸ 㛵⠇ እ཯⫥఩ࡸ⫤ 㛵⠇ෆ㌿ ືసࢆᅇ㑊ࡉ ࡏࡿࡇ࡜ ࡀฟ᮶ࡿࡢ

࡛ࡣ࡞࠸࠿࡜ ⪃࠼ 㸪◊ ✲2 ࡟࠾࠸ ࡚㊊㊑㛤᤼ ⬟ ࠾ࡼࡧ㊊㊑ 㛤᤼ᣦ♧ ࡀ ືⓗୗ⫥

࢔ࣛ࢖࣓ࣥࢺ ࡟ཬࡰࡍ ᙳ㡪[బ㔝ᮧ࡜ධỤ, 2012; బ㔝ᮧ࡜ධ Ụ, 2013]࡟ࡘ࠸࡚

◊✲ࢆ⾜࠸㸪 ᚓࡽࢀࡓ ⤖ᯝ࠿ࡽ㸪≉ ࡟ ∦⬮ࢻ ࣟࢵࣉࣛࣥࢹ ࢕ࣥࢢࢱ ࢫࢡ ࡟࠾࠸

࡚㸪㊊㊑㛤᤼ ⬟ࡀ㧗࠸ ⪅㸪ࡲࡓ㊊㊑ 㛤᤼ᣦ♧ ࢆࡋࡓሙྜࡣ ࡑ࠺࡛࡞ ࠸ ᫬࡜ẚ࡭

࡚᭷ព࡟⭸㛵 ⠇እ㌿ື స ࢆῶࡌࡉࡏ ࡿ࡜࠸࠺ ♧၀ࢆᚓࡓ㸬 ࡲࡓ㸪◊ ✲ 5࡟࠾࠸

࡚ࡣ㊊㊑ᢕᥱ ຊ࡜㟼ⓗ ࠾ࡼࡧືⓗࣂ ࣛࣥࢫ ಖ ᣢ⬟ຊ࡜ࡢ㛵 㐃ᛶ ࡟ࡘ ࠸࡚◊✲ࢆ

⾜࠸㸪ྑ㊊㊑ ᢕᥱຊ࡜ 㔜ᚰືᦂᛶࡢ 㔜ᚰ⥲㌶ ㊧㛗㸪㔜ᚰ ༢ ఩㌶㊧㛗 ࡜ࡢ㛵ಀ࡟

᭷ព࡞㈇ࡢ┦ 㛵ࢆ♧ࡋ 㸪ྑ㊊㊑ᢕᥱ ຊࡢ኱ࡁ ࠸⩌ࡣᑠࡉ࠸ ⩌ ࡜ ẚ㍑ ࡋ㸪㔜ᚰື

ᦂᛶࡢ㔜ᚰ⥲ ㌶㊧㛗࡜ 㔜ᚰ༢఩㌶㊧ 㛗 ࡀ᭷ព ࡟▷࠿ࡗࡓ㸬 ࡲࡓ㸪 ᕥ ㊊㊑ᢕᥱຊ ࡢ኱ࡁ࠸⩌ࡣ ᑠࡉ࠸⩌ ࡜ẚ㍑ࡋ㸪Star Excursion Balance Test㸦௨ୗ 㸪SEBT㸧ࡢ ๓᪉࣮ࣜࢳ㛗 ࡀ᭷ព࡟ 㛗࠿ࡗࡓ ࡇ࡜ ࠿ࡽ㸪 ㊊ ㊑ᢕᥱືస࠾ ࡼࡧ㊊㊑ ᢕᥱຊྥୖ

࢚ࢡࢧࢧ࢖ࢬ ࡀ㸪 㟼ⓗ ࠾ࡼࡧືⓗࣂ ࣛࣥࢫ⬟ ຊྥୖ࡟ ࡘ࡞ ࡀࡿ ྍ⬟ ᛶࢆ♧၀ࡋ ࡓ㸬ࡑࡇ࡛ᮏ ❶࡟࠾࠸ ࡚ࡣ 㸪ୗ⫥യ ᐖண㜵ࢺ ࣮ࣞࢽࣥࢢࡢ ௓ධຠᯝ ᳨ドࢆ⾜࠺

ࡇ࡜࡜ࡋ࡚㸪 ◊✲ 7࡛ ࡣ኱ᏛዪᏊࣛ ࢡࣟࢫ➇ ᢏࢆᑐ㇟࡜ࡋ ࡚㸪㏻ᖖ ⾜ࢃࢀ࡚࠸

ࡿ࢛࣮࣑࢘ࣥ ࢢ࢔ࢵࣉ ࡢ୰ࡢࣇ࢛࣡ ࣮ࢻ ࣛࣥ ࢪࡸࢪࣕࣥࣉ ࠿ࡽࡢ╔ ᆅືస㸪ࢧ

࢖ࢻࢫࢸࢵࣉ ࡸษࡾ㏉ ࡋືస᫬࡟ ͆ ㊊㊑ࢆ㛤 ࠸࡚ᗋࢆᥗࡴ ͇ືసࢆ ᣦ♧ࡍࡿᣦ ᑟἲࡀ㊊㊑㛤 ᤼⬟㸪 ㊊ ㊑ᢕᥱຊ㸪㊊ 㒊ᙧែ㸪 㟼ⓗ࠾ࡼࡧື ⓗࣂࣛࣥ ࢫ⬟ຊ࡟ཬ

140

ࡰࡍᙳ㡪࡟ࡘ ࠸࡚ ẚ㍑ ᳨ドࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ ࡋ ࡚⾜ࡗࡓ㸬 ௬ㄝࡣ㸪 ࢛࣮࣑࢘ࣥ

ࢢ࢔ࢵࣉ࡛⾜ ࢃࢀ࡚࠸ ࡿྛ✀ືస ᫬ ࡟͆㊊㊑ ࢆ㛤࠸࡚ᗋࢆ ᥗࡴ ͇࡜ ࠸࠺ືసᣦ ᑟἲࡣ㸪㊊㊑ 㛤᤼⬟ 㸪 ㊊㊑ᢕᥱຊ㸪 㟼ⓗ࠾ࡼ ࡧືⓗࣂࣛࣥ ࢫ ⬟ຊࢆ ྥୖࡉࡏࡿ

࡯࠿㸪⯚≧㦵 ỿ㝆ᗘࢸ ࢫࢺ㸦navicular drop test score㸸௨ୗ㸪NDTS㸧ࢆῶᑡࡉ ࡏ㸪࢔࣮ࢳ㧗 ⋡ࡣቑຍ ࡉࡏࡿ࡜࠸࠺ ࡶࡢ࡛࠶ ࡿ 㸬

6-7-2. ᑐ㇟࡜᪉ἲ 1. ᑐ㇟

ᑐ㇟⪅ࡣ㸪㛵 ᮾ኱Ꮫዪ Ꮚࣛࢡࣟࢫࣜ ࣮ࢢ 1 㒊 ࡟ᡤᒓࡍࡿ኱ ᏛዪᏊࣛ ࢡࣟࢫ㑅 ᡭ20ྡ㸦ᖹᆒ ᖺ㱋㸦±ᶆ ‽೫ᕪ㸧㸸19.4±1.2ṓ㸪㌟㛗㸸160.0±5.0cm㸪య 㔜㸸54.7±5.4kg㸪 BMI㸸21.4±1.4kg/m2㸧 ࡛ ࠶ ࡗࡓ 㸬 ᑐ ㇟ ⪅ ࡟ 㸪 ᮏ ◊ ✲ࢆ ⾜ ࠺ ๓ ࡟ ◊ ✲ ࡢ ┠ ⓗ㸪ㄪ ᰝ᪉ἲ㸪೔⌮ ⓗ㓄៖➼ ࡟㛵ࡍࡿㄝ᫂ ࢆ⾜࠸㸪 ྠពࢆᚓࡓ㸬 ࡞࠾㸪ᮏ ◊✲ࡣ᪩✄

⏣኱Ꮫ ேࢆᑐ㇟ ࡜ࡍ ࡿ◊✲࡟㛵ࡍ ࡿ೔⌮ᑂ ᰝጤဨ఍ࡢᢎ ㄆࢆᚓ࡚ ⾜ࡗࡓ㸦 ᢎㄆ

␒ྕ2010-037㸧㸬

141

2. ᪉ἲ

⦎⩦๓࡟⾜ࢃ ࢀ࡚࠸ࡿ ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ㸦20 ศ㸧࡛ᐇ᪋ࡉ ࢀ࡚ ࠸ࡿྛ✀ື

స࡟ ࠾ ࠸ ࡚㸦 ⾲ 7-1㸧 㸪╔ ᆅ ື స᫬ ࡟ ྍ⬟ ࡞ 㝈ࡾ 㸪 ㊊ ㊑㛤 ᤼ ࠾ࡼ ࡧ ㊊㊑ ᢕ ᣢࢆ

ព㆑ࡉࡏ࡚⾜ ࢃࡏࡓ㸬 ≉࡟ࢪࣙࢠࣥ ࢢ㸪ࢫࢺ ࣞࢵࢳ ࣥࢢ㸪 యᖿࢺࣞ ࣮ࢽࣥࢢᚋ

࡟⾜ࢃࢀ ࡓ Line to line㸦ࣛ࢖ࣥ㛫㊥ 㞳 10m㸧 ࡛ࡢ࢛࣮࣑࢘ ࣥࢢ ࢔ࢵ ࣉ᫬࡟㊊㊑

㛤᤼࠾ࡼࡧ㊊ ㊑ᢕᣢ ື సࢆᣦ♧ࡋࡓ 㸬ᐇ 㝿ࡢ ᣦᑟ࡟ ࡘ࠸࡚ ࡣ➹⪅ࡢ ᣦ♧ࡢࡶ࡜ 㸪 ᖖ࡟⌧ሙ࡟ᖏ ྠࡋ࡚࠸ ࡿᑓᒓࢺ࣮ࣞ ࢼ࣮࡟ࡼ ࡗ࡚ ࡑࢀࡽࡢ ᣦ♧ࡀ⾜ ࢃࢀࡓ 㸬௓

ධᮇ㛫ࡣ 2011 ᖺ 6 ᭶㹼2012 ᖺ 3 ᭶ࡲ࡛࡜ ࡋ㸪௓ධᮇ㛫 ๓ᚋ ࡟  ᐃࡋࡓ ྛ㡯┠

ࢆẚ㍑ࡋࡓ㸬 ྛ ᐃ㡯 ┠࡜ ᐃ᪉ἲ ࢆ௨ୗ࡟ ♧ࡍ㸬

a. ㊊㊑㛤᤼⬟

㊊㊑㛤᤼⬟ࡢ  ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲2[బ㔝ᮧᏛ࡜ ධỤ୍᠇, 2012]࡟♧ࡋࡓ㏻ࡾ ࡛ ࠶ࡿ㸬

b. ㊊㊑ᢕᥱຊ

㊊㊑ᢕᥱຊࡢ  ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲ 5 ࡟ ♧ࡋࡓ㏻ ࡾ࡛࠶ࡿ 㸬 c. NDTS

NDTSࡢ ᐃ᪉ἲࡢ ヲ ⣽࠾ࡼࡧࣃࣛ ࣓࣮ࢱ ࡣ ◊✲ 6 ࡟♧ࡋ ࡓ㏻ࡾ࡛ ࠶ࡿ㸬

142

d. ࢔࣮ࢳ㧗⋡

࢔࣮ࢳ㧗⋡ࡢ  ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲ 6 ࡟ ♧ࡋࡓ㏻ ࡾ࡛࠶ࡿ 㸬 e. 㔜ᚰືᦂᛶ

㔜ᚰືᦂᛶࡢ  ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲ 5 ࡟ ♧ࡋࡓ㏻ ࡾ࡛࠶ࡿ 㸬 f. SEBT

SEBTࡢ ᐃ᪉ἲࡢヲ ⣽࠾ࡼࡧࣃࣛ ࣓࣮ࢱ ࡣ ◊✲ 5࡟♧ࡋ ࡓ㏻ࡾ࡛ ࠶ࡿ㸬 3. ⤫ィᏛⓗᡭἲ

௓ධ๓ᚋࡢ ㊊㊑㛤᤼ ⬟㸪㊊㊑ᢕᥱຊ㸪NDTS㸪࢔࣮ࢳ㧗⋡㸪㔜ᚰ ືᦂᛶ㸪SEBT

࡛ᚓࡽࢀࡓྛ ࣃ࣓࣮ࣛ ࢱࡢẚ㍑࡜ࡋ 㸪⤫ィᏛ ⓗ᳨ᐃࡣ㸪ᑐ ᛂࡢ࠶ ࡿ t ᳨ᐃࢆ⏝

࠸ࡓ㸬඲࡚ࡢ ⤫ィฎ⌮ ࡟ࡣ⤫ィゎᯒ ࢯࣇࢺ࢘ ࢙࢔㸦SPSS Statistics Student Version

19.0㸧ࢆ⏝࠸㸪᭷ព ☜ ⋡ࢆ 5%ᮍ‶࡜ࡋࡓ㸬

6-7-3. ⤖ᯝ 1. ㊊㊑㛤᤼⬟

㊊㊑㛤᤼⬟ ࡢ௓ධ๓ ᚋࡢ⤖ᯝࢆ⾲ 7-2 ࡟♧ ࡍ㸬㊊㊑㛤᤼ ⬟ࡢ௓ධ ๓ᚋࡢẚ㍑

࡟࠾࠸ ࡚㸪ྑ ㊊ࡢ ㊊㊑ 㛤᤼⬟ ࡣ௓ධ๓ 21.4s13.8㸣㸦 ᖹᆒsᶆ‽ ೫ᕪ㸧 ࠿ࡽ௓

ධᚋ26.5s13.5㸣࡬࡜ ᭷ព࡟ቑຍ ࡋ ࡓ㸦p = 0.042㸧㸬ࡲࡓ㸪 ᕥ㊊ ࡢ㊊㊑㛤᤼⬟

ࡶ௓ධ๓ 18.7s16.0㸣࠿ࡽ௓ධ ᚋ 28.9s17.7㸣࡬࡜᭷ព࡟ ቑຍ ࡋࡓ 㸦p = 0.012㸧

143

2. ㊊㊑ᢕᥱຊ

㊊㊑ᢕᥱຊࡢ ௓ධ๓ᚋ ࡢ⤖ᯝࢆ⾲ 7-3 ࡟♧ࡍ 㸬㊊㊑ᢕᥱຊ ࡢ௓ධ๓ ᚋࡢẚ㍑

࡟࠾࠸࡚㸪ᗙ఩ጼໃ ࡛ ࡢྑ㊊ࡢ㊊㊑ ᢕᥱຊࡣ 㸪௓ධ๓ 10.7s3.0kg㸦ᖹᆒsᶆ‽

೫ᕪ㸧࠿ ࡽ௓ධ ᚋ 13.0s3.1kg࡬࡜ ᭷ព࡟ቑ ຍ ࡋࡓ㸦p < 0.001㸧㸬ࡲࡓ㸪ᕥ ㊊ࡢ

㊊㊑ᢕᥱຊࡶ ௓ධ ๓ 10.7s3.3kg࠿ࡽ ௓ධᚋ 12.6s2.7kg࡬࡜᭷ ព ࡟ቑຍ ࡋࡓ㸦p

< 0.001㸧㸬❧ ఩ጼໃ࡛ ࡢྑ㊊ࡢ㊊㊑ ᢕᥱຊࡣ ௓ධ๓ 14.0s2.9kg࠿ ࡽ௓ධᚋ 16.8 s3.8kg ࡬࡜᭷ព ࡟ቑ ຍ ࡋࡓ㸦p = 0.001㸧㸬ࡲࡓ㸪ᕥ㊊ ࡢ㊊㊑ᢕ ᥱຊࡶ௓ධ๓ 14.1s3.5kg࠿ࡽ௓ ධ ᚋ 16.6s4.2kg࡬ ࡜᭷ ព࡟ቑຍ ࡋࡓ 㸦p = 0.001㸧㸬

ドキュメント内 Injury Surveillance and Injury Prevention in Female Lacrosse (ページ 128-147)

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