本論文は，ACL 損傷予防における科学的基礎を確立するために，ACL 損傷発生率の調査，
着地や切り返し動作における ACL 損傷リスクファクターの検討，二次元画像を用いた膝動作 解析法の検討，ACL損傷予防プログラムの効果についての検討の検討を行った．
その結果，以下の結論を得た．
・日本女子バスケットボールリーグにおける外傷発生の傾向は先行研究と同様であり，ACL損 傷においても，先行研究と同程度の損傷リスクであった．
・片脚着地時の脛骨内旋が ACL 損傷メカニズムに関連していると考えられ，女性における大 きな脛骨内旋，大腿四頭筋優位の筋活動がACL損傷リスクファクターとして示唆された．
・片脚動作は両脚着地に比較し，膝屈曲角度が小さく，脛骨内旋変位量が大きい特徴があり，
特に切り返し方向と足部方向が異なる片脚着地-切り返しでは片脚着地に比較し，脛骨内旋変 位量，外転変位量が大きく，この動作がACL損傷リスクファクターと示唆された．
・体幹前傾角度と膝屈曲角度，体幹前傾角度と脛骨内旋変位量，体幹側方傾斜角度と脛骨内旋 変位量に相関がみられ，膝関節運動のみならず動作中の体幹位置も ACL 損傷リスクファク ター，さらにはメカニズムの一部として考えられた．
・両脚着地時の二次元膝外転角度と三次元膝外転角度の間に有意な回帰関係が得られ，二次元 膝動作解析法を ACL 損傷リスクのスクリーニングに用いることのできる可能性が示唆され た．
・着地肢位に関与する ACL 損傷リスクファクターとしてバランス能力，下肢アライメント・
特性を用いることができる可能性が示唆された．
・ACL損傷予防プログラム内に複数のトレーニング要素を含み，特にジャンプ，バランストレ ーニングに加え，トレーニング中の動作指導を行うプログラムの予防効果が高いと考えられ た．
・ACL損傷予防プログラムの実施により，片脚着地時の膝屈曲角度の増加，ハムストリングス 接地前活動の増加がみられ，一定のACL損傷予防効果があると示唆された．
付録1日本女子バスケットボールリーグ外傷調査用紙 Injury Report Form
Exposure Sheet
付録2 Point Cluster Techniqueアルゴリズム
本研究で用いられたPCTアルゴリズムはAndriacchiら[170]の報告をもとに作成された．
PCTにおいて皮膚マーカーは二種類に区別される．一つは各分節に貼付される群マーカー であり，一つは骨指標に貼付される骨マーカーである．この群マーカーに任意の質量を仮 定し，主軸変換を行うことにより慣性主軸を算出する．PCTにおいて，この慣性主軸が分 節の姿勢を表すために用いられている．主軸変換は慣性テンソルIの固有方程式を解くこ とにより得られる．
(1)
piは i番目の群マーカーの座標値を示し，miはそのマーカーに与えられた任意の質量を示 す．得られた3つの固有ベクトルが慣性主軸の3軸となり，座標変換行列Rを構成する．
(2) Ejはj番目の固有ベクトルを示し，下記式で示される．
(3)
PCT計測においては，まず静止立位時における群マーカーと骨マーカーの位置関係を決
定する．ここで，(2)式Rで表される移動座標系を骨マーカーの参照座標系とする．次に動 作中における群マーカーの計測を行い，求められた(2)式Rを用いて骨マーカー位置を再計 算する．最後に慣性主軸の長軸および再計算された骨マーカー位置より，Groodら[98]の定 義にしたがい，膝関節の回転角度(屈曲・伸展，内転・外転，内旋・外旋)および並進位置(前 後方，上下方，内外方)を算出する．
I=
((pi,y)2+(pi,z)2)⋅mi
i
∑
pi,x⋅pi,y⋅(−mi)i
∑
pi,z⋅pi,x⋅(−mi)i
∑
pi,x⋅pi,y⋅(−mi)
i
∑
((pi,z)2+(pi,x)2)⋅mii
∑
pi,y⋅pi,z⋅(−mi)i
∑
pi,z⋅pi,x⋅(−mi)
i
∑
pi,y⋅pi,z⋅(−mi)i
∑
((pi,x)2+(pi,y)2)⋅mii
∑
⎛
⎝
⎜ ⎜
⎜ ⎜
⎜
⎞
⎠
⎟ ⎟
⎟ ⎟
⎟
R = ( E
1, E
2, E
3)
E
j= ( e
j,x,e
j,y, e
j,z)
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