• 検索結果がありません。

SEBT ࡢ௓ධ๓ ᚋࡢ⤖ ᯝࢆ⾲ 7-7 ࡟♧ࡍ㸬SEBT ࡢ௓ධ๓ᚋࡢẚ ㍑࡟࠾࠸࡚ 㸪 A㸦anterior㸸๓᪉ 㸧࡟ ࡘ࠸ ࡚ࡣ 㸪ᕥ ྑ ࠸ࡎ ࢀ ࡟࠾ ࠸࡚ ࡶ᭷ ព ᕪࡣ ࡳ ࡽࢀ ࡞࠿ ࡗ ࡓ㸦ᕥ㸸p = 0.699, ྑ㸸p = 0.722㸧㸬PM㸦posteromedial㸸ᚋ ෆ᪉㸧࡟ࡘ࠸࡚ࡣ㸪

ྑࡣ௓ධ ๓ 114.2s6.0㸦ᖹᆒsᶆ‽೫ᕪ㸧 ࠿ ࡽ௓ධᚋ 117.5s4.7 ࡛᭷ព࡟ቑຍ ࡉࡏ㸦p = 0.006㸧㸪ᕥ࡟ࡘ࠸࡚ ࡶ 114.6s7.0 ࠿ࡽ 117.6s5.2 ࡬࡜᭷ព࡟ቑຍࡉ ࡏࡓ㸦p = 0.018㸧㸬PL㸦posterolateral㸸ᚋእ ᪉ 㸧࡟ࡘ࠸࡚ࡣ㸪ྑ ࡣ ௓ධ๓ 110.1 s5.3 ࠿ࡽ௓ධᚋ 113.2s5.3 ࡛᭷ព࡟ቑຍࡉ ࡏ㸦p = 0.005㸧㸪ᕥࡢ PL࡟ࡘ࠸࡚

ࡶ110.1s8.2 ࠿ࡽ 112.8s6.2࡬࡜᭷ព ࡟ቑຍ ࡉࡏࡓ㸦p = 0.042㸧㸬

6-7-4. ⪃ᐹ

ᮏ◊✲ࡣ㸪 ୗ⫥ യᐖ ண㜵ࢺ࣮ࣞࢽ ࣥࢢࡢ௓ ධຠᯝ᳨ド ࡜ ࡋ࡚㸪 ኱ ᏛዪᏊࣛࢡ

ࣟࢫ㑅ᡭࢆᑐ ㇟࡜ࡋ 㸪 ㏻ᖖ⾜ࢃࢀ࡚ ࠸ࡿ࢛࢘ ࣮࣑ࣥࢢ࢔ࢵ ࣉ࣓ࢽࣗ ࣮ ࡛⾜ࢃࢀ

࡚࠸ࡿࣛࣥࢪ ࡸࢪࣕࣥ ࣉ࠿ࡽࡢ╔ᆅ ືస㸪ࢧ ࢖ࢻࢫࢸࢵࣉ ࡸษࡾ㏉ ࡋືస᫬࡟

͆㊊㊑ࢆ㛤࠸ ࡚ᗋࢆᥗ ࡴ ͇ࢆᣦ♧ࡋ ࡓᣦᑟἲ ࡀ㸪㊊㊑㛤᤼ ⬟㸪 ㊊㊑ ᢕᥱຊ㸪㊊

㒊ᙧែ㸪㟼ⓗ ࠾ࡼࡧື ⓗࣂࣛࣥࢫ⬟ ຊ࡟ཬࡰ ࡍᙳ㡪ࢆ ẚ㍑ ᳨ドࡍࡿ ࡇ࡜ࢆ┠ⓗ

࡜ࡋ࡚⾜ࡗࡓ 㸬

㊊㊑㛤᤼⬟ ࡟ࡘ࠸࡚ 㸪௓ධᚋ࡛ᕥ ྑ࡜ࡶ࡟ ㊊㊑ࢆ㛤᤼ ࡉ ࡏࡿ๭ྜ ࢆ᭷ព࡟ቑ ຍࡉ ࡏ ࡓ 㸦⾲ 7-2㸧㸬 ≉࡟ ௓ ධ ๓࡟ ࠾ ࠸࡚ 㸪 ྑ㊊ ㊑ ࡟ ẚ࡭ ࡚ ᕥ㊊ ㊑ ࡢ㛤 ᤼ ⬟ࡀ

147

ప࠸ഴྥࡀࡳ ࡽࢀࡓࡀ 㸦p = 0.178㸧㸪௓ධᚋ ࡟࠾࠸࡚ࡣᕥ ㊊㊑ࡢ㛤 ᤼⬟ࡀቑຍ ഴྥࢆ♧ࡋࡓ 㸦p = 0.391㸧㸬ࡲࡓ㸪 ࡑࡢ࡯࠿ ᭱኱㊊㊑㛤᤼ ࡜ ᭱኱㊊ ㊑㛤᤼ᗘࢆ

ẚ㍑ ࡋ ࡓ 㸦⾲ 7-8㸧㸬 ᭱኱ ㊊ ㊑ 㛤᤼ ࡣ 㸪ྍ ⬟ ࡞㝈 ࡾ ㊊ ㊑㛤 ᤼ ࢆ⾜ ࢃ ࡏࡓ ࡜ ࡁࡢ ẕ㊑࠿ࡽᑠ㊑ ࡲ࡛ࡢ㊥ 㞳ࢆ♧ࡋ㸪㊊ ㊑㛤᤼ᗘ ࡣ㸪᭱኱㊊㊑ 㛤᤼᫬ࡢ ್࠿ࡽ㸪Ᏻ 㟼᫬ࡢྠ㊊㊑ 㛫㊥㞳ࡢ ᕪࢆ♧ࡍ㸬ࡇ ࡢ⤖ᯝ࠿ ࡽ㸪᭱኱㊊㊑ 㛤᤼࡟ࡘ ࠸࡚㸪௓ධ ๓ࡣᕥ㊊㊑࡟ ẚ࡭ྑ㊊ ㊑ࡀࡼࡃ㛤ࡃ ഴྥࡀぢ ࡽࢀࡓࡀ㸪ࢺ ࣮ࣞࢽࣥ ࢢᚋ࡛ࡣ㸪 ᕥྑࡢ㊊㊑࡜ ࡶ࡟ྠ⛬ ᗘ㛤᤼ྍ⬟࡟ ࡞ࡗ࡚࠸ ࡓ㸬ࡲࡓ 㸪㊊ ㊑㛤᤼ᗘ࡟ ࡘ࠸࡚ࡣ 㸪

௓ධ๓ࡣᕥ㊊ ㊑࡟ẚ࡭ ྑ㊊㊑ࡢᏳ㟼 ᫬࠿ࡽ᭱ ኱㛤᤼᫬ࡢᕪ ࡀ኱ࡁ࠿ ࡗࡓࡀ㸪ࢺ

࣮ࣞࢽࣥࢢᚋ ࡛ࡣ㸪ᕥ ㊊㊑ࡢ㛤᤼ࡢ ᕪࡢ᪉ࡀ ኱ࡁࡃ㸪ࡼࡾ 㛤᤼ᗘࡀ ቑຍࡋ ࡚࠸

ࡓ㸬

㊊㊑㛤᤼ືస ࡣ㸪㊊㒊 ෆᅾ➽࡛࠶ࡿ ẕ㊑እ㌿ ➽ 㸪ᑠ㊑እ㌿ ➽ 㸪⫼ഃ 㦵㛫➽࡛

⾜ࢃࢀࡿ࡯࠿[Oatis, 2009]㸪▷㊑ఙ➽ ࠾ࡼࡧ㛗 ẕ㊑ఙ➽࡟ࡼ ࡗ࡚ࡶ⾜ ࢃࢀ࡚࠸ࡿ 㸬

௒ᅇ⾜ࡗࡓ࢘ ࢛࣮࣑ࣥ ࢢ࢔ࢵࣉ᫬ࡢ ᣦᑟἲࡢ ୍ࡘ࡜ࡋ࡚ྲྀ ࡾධࢀࡓ ͆㊊㊑ࢆ㛤

࠸࡚ᗋࢆᥗࡴ ͇ࡢືస ᣦ♧ࡀ㸪ྠస ⏝➽ࢆᙉ ࡃ⥭ᙇࡉࡏࡓ ࡇ࡜࡜㸪 ࡉࡽ࡟ࡣࡑ

ࢀࢆ㛗ᮇ㛫࡟ ࢃࡓࡾ ⧞ ࡾ㏉ࡋ⥅⥆ࡋ ࡚ᣦ♧ࢆ ୚࠼ࡓࡇ࡜࡛ ㊊㊑㛤᤼ ⬟ຊࡢྥୖ

࡟ࡘ࡞ࡀࡗࡓ ࡢ࡛ࡣ࡞ ࠸࠿ ࡜᥎ ࡋ ࡓ㸦 ⾲ 7-2㸪⾲ 7-8㸧㸬

㊊㊑ ᢕ ᥱ ຊ࡟ ࡘ ࠸ ࡚ࡣ 㸦⾲ 7-3㸧 㸪ᗙ ఩ ࠾ࡼ ࡧ❧ ఩ ጼ ໃ࡛ ࡢ   ᐃ್ ࡜ࡶ ࡟௓

ධᚋ࡟࠾࠸࡚ ᭷ព࡟ቑ ຍ ࡋࡓ㸬௓ධ ๓ᚋࡢ㊊ ㊑ᢕᥱຊࡢᕥ ྑᕪ࡟ࡘ ࠸࡚ ࡣ㸪࠸

ࡎࢀࡶ᭷ព࡞ ᕪࡣ ࡳࡽ ࢀ࡞࠿ࡗࡓ㸬 ௒ᅇࡢ◊ ✲࡛⾜ࡗࡓ㊊ ㊑ᢕᥱຊ ࡢ ᐃ᪉ἲ ࡣ㸪㏻ᖖ⾜ࢃ ࢀ࡚࠸ࡿ ᗙ఩࡛ࡢ ᐃ ࡟ຍ࠼㸪 ❧఩࡛ࡢ ᐃ ࡶ ⾜ ࠺ࡇ ࡜࡜ࡋࡓ㸬

148

ࡇࢀࡣ㸪ᮏ◊ ✲࡛⾜ࡗ ࡓ㊊㊑㛤᤼ື స ࡸ㊊㊑ ᢕᥱືసࡀ㸪 ࢛࣮࣑࢘ ࣥࢢ࢔ࢵࣉ

࡛⾜ࢃࢀ࡚࠸ ࡿࣛࣥࢪ ࡸࢫࢸࢵࣉື స㸪 ࢪࣕ ࣥࣉ࠿ࡽࡢ ╔ ᆅືస ➼ ࡍ࡭࡚❧఩

ጼໃ࡛⾜ࢃࢀ ࡚࠸ࡿⅭ ࡛࠶ࡿ㸬⤖ᯝ 㸪ᗙ఩࡜ ❧఩᫬ࡢ㊊㊑ ᢕᥱຊᖹ ᆒ್ࡢᕪ࡟

ࡘ࠸࡚ẚ㍑ࡋ ࡚ࡳࡿ࡜ 㸦⾲ 7-3㸧㸪௓ධ ๓ࡢ ྑ㊊㊑࡛ 3.3kg㸪ᕥ㊊ ㊑ 3.4kg㸪௓

ධᚋࡢྑ㊊㊑ ࡛ 3.7kg㸪ᕥ㊊㊑ 4.0kg ࡢᕪࡀ ࡳࡽࢀࡓ 㸬ࡇ ࢀࡽࢆᖹ ᆒ໬ࡍࡿ࡜ 㸪

ྑ㊊㊑࡛ᖹᆒ 3.5kg㸪 ᕥ㊊㊑࡛ 3.7kg㸪 ᕥྑ ྜࢃࡏ࡚ᖹᆒ 3.6kg ࡢ ᗙ఩࡜❧఩᫬

ࡢ㊊㊑ᢕᥱຊ ࡢᕪࡀࡳ ࡽࢀࡓ㸬 ㊊㊑ ᢕᥱືస ࡟ స⏝ࡍࡿ➽ ࡣ㸪 ㊊㒊 ෆᅾ➽࡛࠶

ࡿ▷ẕ㊑ᒅ➽ࠊ㛗ẕ㊑ ᒅ➽ࠊẕ㊑ෆ㌿ ➽㸪▷ ㊑ᒅ➽㸪▷ᑠ㊑ ᒅ➽㸪⫼ഃ㦵㛫➽㸪 ᗏഃ㦵㛫➽㸪⹸ ᵝ➽ ࡛ ࠶ࡿࡀ[Oatis, 2009]㸪㊊㊑㛤᤼⬟ྠ ᵝ࡟㸪࢘ ࢛࣮࣑ࣥࢢ࢔

ࢵࣉ᫬࡟⾜ࢃ ࡏࡓ ͆㊊ ㊑ࢆ㛤࠸࡚ᗋ ࢆᥗࡴ ͇ ࡢືసᣦ♧ࡀ ྠస⏝➽ ࢆᙉࡃ཰⦰

ࡉࡏ㸪ࡉࡽ࡟ ࡣࡑࢀࢆ 㛗ᮇ㛫࡟ࢃࡓ ࡾ ⧞ࡾ㏉ ࡋ⥅⥆ࡋ࡚ື సᣦ♧ࢆ ୚࠼ࡓࡇ࡜

࡛ࢺ࣮ࣞࢽࣥ ࢢຠᯝࢆ ᭷ព࡟ᚓࡿࡇ ࡜ࡀฟ᮶ ࡓࡢ࡛ࡣ࡞࠸ ࠿࡜⪃࠼ ࡓ㸬 NDTS ࡟ࡘ࠸࡚ ࡣ㸦⾲ 7-4㸧㸪௓ ධ๓ᚋࡢ ẚ ㍑࡟ ࠾࠸࡚㸪 ᕥྑ ࠸ࡎ ࢀࡶ 0.8㹼 1mm⛬ ᗘࡢῶᑡ ഴྥ ࢆ♧ࡋ ࡓࡀ 㸪᭷ពᕪࡣ ࡳࡽࢀ࡞࠿ࡗ ࡓ㸦ྑ㸸p = 0.166㸪ᕥ 㸸 p = 0.111㸧㸬ඛ⾜◊✲ ࠿ࡽ㸪Ⲵ㔜఩ ࡛ࡢ ẕ㊑ እ㌿➽࡟ࡼࡿ ㊊㊑ᒅ᭤ స⏝ࡀ㊊㒊 ෆഃ⦪࢔࣮ࢳ ࡢᨭᣢ࡟ 㔜せ࡞ᙺ๭ࢆ ᯝࡓࡋ࡚ ࠸ࡿࡇ࡜ࡀከ ᩘሗ࿌ࡉ ࢀ࡚ ࠸ࡿࡀ [Fiolkowski et al., 2003; Headlee et al., 2008; Jung et al., 2012; Mann and Inman, 1964; Wong, 2007]㸪㊊㊑㛤᤼ືసࡸ ㊊㊑ᢕᥱ ືస࡟ࡼࡾ㸪 ẕ㊑እ㌿ ➽ ࡸ㛗࣭▷

ẕ㊑ᒅ➽➼ࡢ ➽స⏝ࡀ ෆഃ⦪࢔࣮ࢳ ๛ᛶࢆ㧗 ࡵ㸪 ௓ධ๓࡟ ẚ࡭ ௓ධ ᚋࡣ NDTS ࡀᑠࡉࡃ࡞ࡿ ࡜ண ࡋ ࡓ ࡀ㸪ᖹᆒ್ ࡛ప್ࢆ ♧ࡋ ࡓࡶࡢࡢ ᭷ពᕪࡣ ㄆࡵࡽࢀ࡞

࠿ࡗࡓ㸬

࢔࣮ࢳ㧗⋡ࡢ ௓ධ๓ᚋ ࡢẚ㍑ 㸦⾲ 7-5㸧࡟ ࡘ ࠸࡚ࡶ NDTS ྠᵝ࡟ 㸪㊊㊑㛤᤼

ࡸ㊊㊑ᢕᥱື స࡟ࡼࡾ 㸪 ẕ㊑እ㌿➽ ࡸ㛗࣭▷ ẕ㊑ᒅ➽➼ࡢ ➽స⏝ࡀ ෆഃ⦪࢔࣮

ࢳ๛ᛶࢆ㧗ࡵ ࡿࡇ࡜࡛ ࢔ ࣮ࢳ㧗⋡ࡢ ྥୖ࡟ᐤ ୚ࡉࡏࡿࡢ࡛ ࡣ࡞࠸࠿ ࡜᥎ ࡋࡓ ࡀ㸪ᚓࡽࢀࡓ ⤖ᯝࡣ௓ ධᚋࡣᕥྑ㊊ ࡜ࡶ࡟࢔ ࣮ࢳ㧗⋡ࢆቑ ຍࡉࡏࡓ 㸬 ẕ㊑እ㌿

➽ࡢస⏝ࡀ㊊ 㒊ෆഃ⦪ ࢔࣮ࢳࡢᨭᣢ ࣭ᣲୖ࡟ ᐤ୚ࡉࡏ࡚࠸ ࡿࡇ࡜ࡀ ከᩘሗ࿌ࡉ

ࢀ࡚࠸ࡿࡀ㸪Jung㸦2012㸧ࡣ㸪toe-curl ࢚ࢡ ࢧࢧ࢖ࢬࡸ short-foot ࢚ࢡࢧࢧ࢖ࢬ

ࢆ⾜ࢃࡏࡓ࡜ ࡇࢁ㸪≉ ࡟❧఩࡛ ࡢ short-foot ࢚ࢡࢧࢧ࢖ࢬ ᚋ࡟᭷ព ࡟⾲㠃➽㟁 ᅗ࡟࠾࠸࡚㧗 ್ࢆ♧ࡋ 㸪 ෆഃ⦪࢔࣮ ࢳࢆ᭷ព ࡟ ᣲୖࡉࡏࡓ ࡜ሗ࿌ࡋ ࡚࠸ࡿ㸬ࡲ

149

ࡓ㸪Wong㸦2007㸧 ࡣ 㸪In-vitro ࡛ẕ㊑እ㌿ ➽ࢆ཰⦰ࡉࡏ ࡓ᫬࡟ෆ ഃ⦪࢔࣮ࢳࢆ

ᣲୖࡉࡏ㸪ẕ ㊑እ㌿➽ ࡣ㟼ⓗ࡞ෆഃ ⦪࢔࣮ࢳ ᨭᣢస⏝ ࡔࡅ ࡛࡞ࡃ 㸪 Ṍ⾜᫬࡟࠾

ࡅࡿືⓗ࡞ෆ ഃ⦪࢔࣮ ࢳᨭᣢస⏝ࢆ ࡶࡘࡇ࡜ ࢆ♧၀ࡋ࡚࠸ ࡿ㸬 ࡑࡢ ࡯࠿㊊㒊ෆ ᅾ➽௨እ࡟ࡶ ㊊ᗏ⭝⭷ ࡸ㊊ᗏ➽⭷ࡀ ㊊㒊࢔࣮ ࢳࢧ࣏࣮ࢺ࡟ ᐤ୚ࡋ࡚ ࠸ࡿࡇ࡜ࡀ

」ᩘሗ࿌ࡉࢀ ࡚࠾ࡾ[Thordarson et al, 1997; Carlson et al., 2000; Franco, 1987]㸪ᮏ

◊✲࡟࠾ࡅࡿ ͆㊊㊑ࢆ 㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࡢື సᣦ♧ࡀ㊊㒊 ࢔࣮ࢳ๛ ᛶࡢྥୖ࡟

ᐤ୚ࡉࡏࡓࡇ ࡜ࡀ♧၀ ࡉࢀࡓ㸬

㔜ᚰ ື ᦂ ᛶ࡟ ࡘ ࠸ ࡚ࡣ 㸪௓ ධ ๓ ᚋࡢ ẚ ㍑ ࡟ ࡘ ࠸࡚ 㸦 ⾲ 7-6㸧 㸪 㔜ᚰ ༢఩ ㌶㊧

㛗ࡢᕥ⬮❧఩ ᫬ࡢࡳ ᭷ ពᕪࡀㄆࡵࡽ ࢀ㸦 ௓ධ ๓2.86s0.88mm/⛊࠿ ࡽ௓ධᚋ3.46 s0.91mm/⛊㸪p = 0.031㸧㸪ࡑࡢ௚඲࡚ࡢ 㡯 ┠ ࡢ᭷ពᕪࡣ ㄆࡵࡽࢀ ࡞࠿ࡗࡓ㸬㔜 ᚰືᦂᛶࢸࢫ ࢺࡣ㸪ᅛ ᭷ឤぬჾࡸ⚄ ⤒➽༠ㄪ ᛶ ࡢホ౯ࡢ୍ ࡘ࡜ ࡋ࡚ ⏝࠸ࡽࢀ࡚

࠾ ࡾ 㸪 ࡑ ࢀ ࡽ ࡣ ࣂ ࣛ ࣥ ࢫ ಖ ᣢ ⬟ ຊ ࡢ ホ ౯ ࡢ ୍ ࡘ ࡜ ࡋ ࡚ ⏝ ࠸ ࡽ ࢀ ࡚ ࠸ ࡿ[᫬ ⏣, 1995; ᪁ࡽ, 2006; Ỉ⃝࡜ᑐ㤿, 2009; ᮃ᭶࡜ᓟᓥ, 2000; Guskiewicz and Perrin., 1996]㸬௒ᅇࡢ◊ ✲࡛ ⾜ࡗࡓ᪉ἲࡣ 㸪㛤 ║࡛ ࡢ∦⬮❧఩ጼ ໃ࡛ࡢࣂ ࣛࣥࢫ ಖᣢ⬟

ຊࡢホ౯࡜ࡋ ࡓ㸬㔜ᚰ ືᦂᛶࢸࢫࢺ ࡣ㸪࢔ࢫ ࣮ࣜࢺࢆᑐ㇟ ࡜ࡋ ࡓ㊊ 㛵⠇യᐖ࡟

ᑐ ࡍ ࡿ ホ ౯ ἲ ࡢ ୍ ࡘ ࡜ ࡋ ࡚ ከ ᩘ ⏝ ࠸ ࡽ ࢀ ࡚ ࠸ ࡿ[Wikstrom, 2006; Zech, 2010;

Beynnon, 2002]㸬ᮏ◊ ✲࡛⏝࠸ࡓࣃ ࣓࣮ࣛࢱ ࡟ࡘ࠸࡚㸪㔜ᚰ⥲㌶ ㊧ 㛗 ࡣ㔜ᚰⅬࡢ

⥲⛣ື㊥㞳ࢆ ♧ࡋ ࡚࠾ ࡾ㸪㌟యືᦂ ࡢᏳᐃᛶ ࢆホ౯ࡍࡿ ௦ ⾲ⓗ࡞್ ࡛࠶ ࡿ㸬㔜 ᚰ༢఩㠃✚㌶ ㊧㛗ࡣ㔜 ᚰືᦂ㠃✚ ࡢ 1cm2ᙜ ࡓࡾࡢ⛣ື㊥ 㞳ࢆ♧ࡋ 㸪㔜ᚰእ࿘ 㠃

✚ࡣືᦂࡢእ ࿘ࢆᅖࡴ 㠃✚ ࢆ♧ࡍ 㸬㔜ᚰ ▴ᙧ 㠃✚ࡣ㔜ᚰື ᦂࡢ๓ᚋ ᭱኱ࢆ⦪㍈ 㸪 ᕥྑ᭱኱ࢆᶓ ㍈࡜ࡋࡓ ᅄゅᙧࡢ㠃✚ ࡢࡇ࡜ࢆ ♧ࡍ 㸬㔜ᚰ▴ ᙧ㠃✚ࡣ 㸪അ↛኱ࡁ

࡞ືᦂࡀ⏕ࡌ ࡓ㝿࡟ィ  ࡉࢀࡿ␗ᖖ ࡟኱ࡁ࡞ ್ࢆྵࡳ㸪㌟ యືᦂ ࡀ ᭱ࡶ኱ࡁࡃ

࡞ࡗࡓ㠃✚࡜ ࡞ࡿ㸬ᮏ ◊✲࡛⾜ࡗࡓ͆㊊㊑ 㛤 ᤼࠾ࡼࡧ㊊㊑ ᢕᥱ ͇ᣦ ᑟࡢ௓ධࡣ㸪 㟼ⓗࣂࣛࣥࢫ ಖᣢ⬟ຊ ࡟୍㒊࡟࠾࠸ ࡚ᙳ㡪ࡀ ㄆࡵࡽࢀ㸪ከ ࡃࡣ ᙳ㡪 ࡀㄆࡵࡽࢀ

࡞࠿ࡗࡓ㸬ࡇ ࢀࡣ㸪ᮏ ◊✲࡛⾜ࢃࢀ ࡓᑐ㇟⪅ ࡀⱝᖺ࢔ࢫࣜ ࣮ࢺ࡛࠶ ࡾ㸪㐠ື⬟

ຊࡀ㧗࠸ࡇ࡜ ࡀ᥎ ࡉ ࢀࡿᑐ㇟⪅ࡢ ሙྜࡣ㸪 㛤║࡛ࡢ∦⬮ ❧఩ጼໃ ࡜࠸ࡗࡓ⡆

༢࡞ㄢ㢟ືస ࡛ࡣ࡞ࡃ 㸪㛢║࡛ࡢ∦ ⬮❧఩ጼ ໃࢆ࡜ࡽࡏࡓ ࠺࠼࡛ࡢ ẚ㍑㸪ࡲࡓ 㛤║∦⬮❧఩ ጼໃ࡛࠶ ࡗ࡚ࡶጼໃಖ ᣢ᫬㛫ࢆ 㛗ࡃࡍࡿ➼㸪 ㄢ㢟 ᮲௳ ࢆ㧗ࡃࡋ࡚

ẚ㍑ࡍࡿࡢࡀ ᮃࡲࡋ࠸ ࡜⪃࠼ࡓ㸬

150

SEBT ࡣ㸪 ືⓗ ୗ ⫥ࣂ ࣛࣥ ࢫ⬟ ຊࡢ ホ ౯࡟ ⏝ ࠸ࡽ ࢀࡿ ࢸࢫ ࢺἲ ࡛ ࠶ ࡿࡀ 㸪ከ ࡃࡣୗ⫥യᐖ[Plisky et al., 2006; Filipa et al., 2010; Bressel et al., 2007; Robinson et al., 2008]㸪㊊㛵⠇ യᐖ[Olmsted et al., 2002; Hertel et al., 2006; Hertel et al., 2008; Chaiwanichsiri et al., 2005; Gribble et al., 2004; Gribble et al., 2007; Sefton et al., 2009; de Noronha et al., 2012; O'Driscoll et al., 2011]㸪⭸㛵⠇യᐖ[Herrington et ak., 2009]ࡢホ౯࡟ࡘ࠸ ࡚ሗ࿌ࡋ࡚ ࠸ ࡿඛ⾜ㄽ ᩥࡀከᩘࢆ༨ ࡵࡿ㸬࡞ ࠾㸪ᮏ◊✲

࡛⾜ࡗࡓ SEBT ホ౯᪉ ἲࡣ㸪Hertel ࡽ㸦2006㸧ࡀ᥎ዡࡋ࡚ ࠸ࡿ᪉ἲ ࢆཧ⪃࡟㸪

㏻ᖖ8 ᪉ྥ㸦A㸦๓᪉ 㸧㸪๓ෆ᪉ 㸪ෆ᪉ 㸪PM㸦ᚋෆ᪉ 㸧㸪ᚋ᪉ 㸪PL㸦ᚋእ᪉ 㸧㸪

እ ᪉ 㸪 ๓ እ ᪉ 㸧 ࡢ ࣜ ࣮ ࢳ ㊥ 㞳 ࡛ ࡢ ホ ౯ ࡀ ⾜ ࢃ ࢀ ࡿ ࡀ 㸪 ᮏ ◊ ✲ ࡛ ࡣ A㸪PM㸪PL ࡢ3 ᪉ྥ࡛ ࡢ࣮ࣜࢳ㊥ 㞳 ࡛ẚ㍑᳨ド ࢆ⾜࠺ࡇ ࡜࡜ࡋࡓ㸬௨ ୗ࡟♧ࡍ ඛ⾜ㄽᩥࡢ ሗ࿌ࡣ㸪ከࡃ ࡣ8 ᪉ྥ ࠿ࡽホ౯ࡉࢀ ࡓෆᐜ࡛ ࠶ࡾ㸪ᮏ◊✲ ࡛⾜ࡗࡓ ࣮ࣜࢳ᪉ྥ

࡜ ୍ 㒊 ␗ ࡞ࡗ ࡚ ࠸ ࡿ 㸬SEBT ࢆ ⏝ ࠸ ࡓ ホ ౯ ࡟ ࠾ ࠸ ࡚ 㸪 ≉࡟ ㊊ 㛵 ⠇ യ ᐖ ࡜ SEBT

࡟㛵ࡍࡿሗ࿌ ࡀከ࠸ࡀ 㸪Gribbleࡽ㸦2004㸧ࡣ៏ᛶ㊊㛵⠇୙ Ᏻᐃ⑕㸦chronic ankle instability㸸௨ ୗ 㸪CAI㸧 ࢆࡶ ࡘ ⪅ ࡢ യ ᐖ ⬮ ഃ ࡜ 㠀യ ᐖ ⬮ ഃࢆ ẚ ㍑ 㸦8 ᪉ྥ ࡛ ホ ౯ 㸧 ࡋ ࡓ ࡜ ࡇ ࢁ 㸪 യ ᐖ ⬮ ഃ ࡣ 㠀 യ ᐖ ⬮ ഃ ࡟ ẚ ࡭ ࡚ ࣜ ࣮ ࢳ ㊥ 㞳 ࡢ ๭ ྜ ࡀ 㸪A㸪 ෆ ᪉ 㸪 ᚋ ᪉ ࡟ ࠾ ࠸ ࡚ ᭷ ព ࡟ ᑠ ࡉ ࠿ ࡗ ࡓ ࡇ ࡜ ࢆ ሗ ࿌ ࡋ 㸪Hertel ࡽ 㸦2006㸧 ࡣ 㸪CAI

ࢆࡶࡘയᐖ⬮ ഃ࡜㠀 യ ᐖ⬮ഃࡢẚ㍑ ࡟࠾࠸࡚ 㸪യᐖ⬮ഃࡣ㠀 യᐖ⬮ ഃ࡟ẚ࡭㸦8 ᪉ྥ࡛ホ౯㸧㸪๓ෆ᪉ 㸪ෆ᪉㸪PL ࡟࣮ࣜ ࢳ ㊥㞳ࡢ๭ྜࡀ ᭷ព࡟ᑠ ࡉ࠿ࡗࡓࡇ࡜

ࢆሗ࿌ࡋ㸪≉ ࡟ PL࡜ CAI ࡜ࡢᙉ ࠸㛵㐃ᛶ ࢆ ♧ࡋࡓࡇ࡜ࢆ ሗ࿌ ࡋ࡚ ࠸ࡿ㸬ࡲࡓ㸪 CAI ࢆ ࡶ ࡘ യ ᐖ ⬮ ഃ ࡜ ࢥ ࣥ ࢺ ࣟ ࣮ ࣝ ⩌ ࡢ ྠ ഃ ⬮ ࡢ ẚ ㍑ ࡟ ࠾ ࠸ ࡚ 㸪Olmsted ࡽ 㸦2002㸧ࡣ㸪യᐖ⬮ഃ ࡜㠀യᐖ⬮ഃ ࡢẚ㍑࡟ ࠾࠸࡚㸪 യᐖ ⬮ഃࡣ㠀 യᐖ⬮ഃ࡟

ẚ࡭㸪඲᪉ྥ ࡢᖹᆒ್ ࡢẚ㍑࡟࠾࠸ ࡚࣮ࣜࢳ ㊥㞳ࡢ๭ྜࡀ ᭷ព࡟ᑠ ࡉ࠿ࡗࡓࡇ

࡜ࢆሗ࿌ࡋ㸪Hertel ࡽ 㸦2006㸧ࡣ㸪CAI ࢆࡶ ࡘയᐖ⬮ഃ࡜ ࢥࣥࢺࣟ ࣮ࣝ⩌ࡢྠ

ഃ⬮ࡢẚ㍑㸦8 ᪉ྥ࡛ ホ౯㸧࡟࠾࠸ ࡚㸪๓ෆ ᪉㸪ෆ᪉㸪PL ࡛ࣜ ࣮ ࢳ㊥㞳ࡢ๭ྜ

ࡀ᭷ព࡟ᑠࡉ ࠿ࡗࡓࡇ ࡜ࢆሗ࿌ࡋࡓ 㸬ࡑࡢ࡯ ࠿㸪⭸㛵⠇യ ᐖ࡜ SEBT ࡜ࡢ㛵ಀ

ࢆሗ࿌ࡋࡓඛ ⾜ㄽᩥ࡟ ࡘ࠸࡚ࡣ㸪Herrington ࡽ㸦2009㸧ࡣ㸪ACL ୙඲⩌࡜ࢥࣥ

ࢺ࣮ࣟࣝ⩌࡜ ࡢẚ㍑㸦8 ᪉ྥ࡛ホ౯㸧࡟࠾ ࠸ ࡚㸪ACL ୙඲⩌ࡣࢥ ࣥࢺ࣮ࣟࣝ⩌

࡟ẚ࡭㸪A㸪እ᪉㸪PM ࡢ࣮ࣜࢳ㊥㞳 ࡢ๭ྜࡀ ᭷ព࡟ᑠࡉ࠿ ࡗࡓࡇ࡜ ࢆሗ࿌ࡋ࡚

࠸ࡿ㸬ࡇࢀࡽ ࡢሗ࿌࠿ ࡽ㸪㊊㛵⠇࠾ ࡼࡧ⭸㛵 ⠇യᐖࢆ᭷ࡍ ࡿࡶࡢ ࡜ SEBT ࡜ࡢ

151

㛵ಀ࡟࠾࠸࡚ 㸪≉ ࡟ A㸪ෆ᪉㸪PL ࡢ ࣮ࣜࢳ ㊥㞳ࡢ๭ྜࡀ ᑠࡉ࠸ࡇ ࡜ࡀ࠺࠿ࡀ࠼

ࡿ㸬ᮏ◊✲ࡢ ⤖ᯝࢆ௓ ධ๓ᚋ᳨࡛ド ࡋ࡚ࡳࡿ ࡜ 㸦⾲ 7-7㸧㸪A ࡟ࡘ ࠸࡚ࡣᕥྑ

⬮࠸ࡎࢀࡶ᭷ ពᕪࡀ ㄆ ࡵࡽࢀ࡞࠿ࡗ ࡓࡀ㸦ᕥ 㸸p = 0.699, ྑ㸸p = 0.722㸧㸪PM

࡟ࡘ࠸࡚ࡣᕥ ྑ⬮ඹ࡟ ᭷ព࡟ቑຍࡉ ࡏ㸦ࡑࢀ ࡒࢀ p = 0.006㸪0.018㸧㸪PL ࡟ࡘ

࠸࡚ࡶᕥྑ⬮ ඹ࡟᭷ព ࡟ቑຍࡉࡏࡓ㸦ࡑࢀࡒ ࢀ p = 0.005㸪0.042㸧㸬ඛ⾜ㄽᩥ࠿

ࡽࡣ㸪⚄⤒➽ ࢺ࣮ࣞࢽ ࣥࢢ[Filipa et al., 2010; Lindblom et al., 2012; O'Driscoll et al., 2011]ࡸࣂࣛࣥࢫࢺ ࣮ࣞࢽࣥࢢ[McKeon et al., 2008]㸪CAI࡟ ᑐ ࡍࡿࣜࣁࣅࣜ

ࢸ ࣮ ࢩ ࣙ ࣥ ࣉ ࣟ ࢢ ࣛ ࣒ ࡢ ௓ ධ ࡀ SEBT ࡢ ࣜ ࣮ ࢳ ㊥ 㞳 ࡟ ཬ ࡰ ࡍ ᙳ 㡪[Hale et al.,

2007]࡟ࡘ࠸࡚ከᩘ ሗ ࿌ࡉࢀ࡚࠸ࡿ ࡀ㸪Filipaࡽ㸦2010㸧ࡣ⚄⤒ ➽ ࢺ࣮ࣞࢽࣥࢢ

ᚋ࡟ A㸪PM㸪PL ࡢ 3 ᪉ྥࡢ࣮ࣜࢳ ㊥㞳⥲ィ ࡢ๭ྜࡀ᭷ព ࡟ቑຍࡋ ࡓࡇ࡜ࢆሗ

࿌ࡋ㸪Lindblom ࡽ㸦2012㸧ࡣ㸪A㸪PM㸪PL ࡢ 3 ᪉ྥࡢ඲ ࡚ࡢࣜ ࣮ࢳ㊥㞳ࡀྥ

ୖࡋ࡚ ࠸ࡓࡇ ࡜ࢆ ሗ࿌ ࡋࡓ㸬 ࡲࡓ㸪McKeon ࡽ㸦2008㸧ࡣ ࣂࣛ ࣥࢫ ࢺ࣮ࣞ ࢽࣥ

ࢢࣉࣟࢢ࣒ࣛ ⤊஢ᚋ࡟ ࠾࠸࡚㸪3 ᪉ྥࡢ ࠺ ࡕ PM㸪PL ࡛᭷ព࡞ ྥୖࢆ♧ࡋࡓ ࡇ

࡜ࢆሗ࿌ࡋ 㸪Haleࡽ㸦2007㸧ࡣ 㸪ࣜࣁࣅ ࣜࢸ ࣮ࢩࣙࣥࣉࣜ ࢢ࣒ࣛ⤊ ஢ᚋ࡟ 8 ᪉

ྥࡢホ౯ࢆ⾜ ࠸㸪PM㸪PL㸪L࡛᭷ព࡞ቑຍ ࡀࡳࡽࢀࡓ࡜ ሗ࿌ࡋ ࡚ ࠸ࡿ㸬ඛ⾜◊

✲⤖ᯝ࡜ᮏ◊ ✲⤖ᯝࢆ ྜࢃࡏ᳨࡚ド ࡍࡿ࡜㸪 ≉࡟ A㸪PM㸪PL ᪉ྥ࡬ࡢᨵၿࡀ 㢧ⴭ࡛࠶ࡿࡇ ࡜ࡀ♧ࡉ ࢀࡓ㸬ᮏ◊✲ ⤖ᯝ࠿ࡽ 㸪A ࡟ᑐࡍ ࡿ௓ධຠᯝ ࡀ ㄆࡵࡽࢀ

࡞࠿ࡗࡓࡢࡣ 㸪Aࡢ ࣜ ࣮ࢳ㊥㞳ࡣ㊊ 㛵⠇⫼ᒅ ゅᗘ[Hoch et al., 2010]㸪⭸㛵⠇ᒅ

᭤ゅᗘࡸ⫤㛵 ⠇ෆ㌿ ࠾ ࡼࡧෆ᪕ゅᗘ[Robinson et al., 2008]㸪ࡑࡢ࡯ ࠿኱⭣ᅄ㢌➽

➽άືࡢᙳ㡪[Earl and Hertel, 2001]ࢆཷࡅ࡚࠸ࡿࡇ࡜ࡀඛ ⾜ㄽᩥ࠿ ࡽከᩘሗ࿌

ࡉࢀ࡚࠾ࡾ㸪 ࡑࢀࡽࢆ ྵࡵࡓ᳨ウࡶ ᚲせ࡛࠶ ࡿ ࡜⪃࠼ࡓ㸬

ᮏ◊✲⤖ᯝ࠿ ࡽ㸪◊ ✲ 5 ࡢ⪃ᐹྠ ᵝ࡟㸪 ࢫ ࣏࣮ࢶയᐖண 㜵 ࡟╔┠ ࡋ᳨࡚ウࡍ

ࡿ࡜㸪ࣛࣥࢪ ࡸࢪࣕࣥ ࣉ࠿ࡽࡢ╔ᆅ ືస㸪ࢧ ࢖ࢻࢫࢸࢵࣉ ࡸษࡾ㏉ ࡋືస᫬࡟

㊊㊑ࢆ㛤࠸࡚ ᗋࢆᢕᣢ ࡍࡿືసᣦ♧ ࡣ㸪㊊㊑ ᢕ➽ຊࡸ㊊㊑ 㛤᤼⬟ࢆ ྥୖࡉࡏࡿ

࡜࡜ࡶ࡟㸪ື ⓗୗ⫥ࣂ ࣛࣥࢫ⬟ຊࢆ ྥୖࡉࡏ ࡿࡇ࡜࠿ࡽ㸪 ୗ⫥യᐖ 㸪≉࡟ ㊊㛵

⠇ࡸ⭸㛵⠇യ ᐖࡢண㜵 ࡟ᐤ୚ࡉࡏࡿ ࡢ࡛ࡣ࡞ ࠸࠿࡜⪃࠼ࡓ 㸬

ᮏ◊✲ࡢ㝈⏺ Ⅼ࡜ࡋ࡚ 㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ ࡀタ ᐃࡉࢀ࡚࠸࡞ ࠸࡜ࡇࢁ ࡟࠶ࡿ㸬 ࢺ࣮ࣞࢽࣥࢢ ⩌࡜㠀ࢺ ࣮ࣞࢽࣥࢢ⩌ ࢆタᐃ ࡋ ࡓẚ㍑࡟ࡼࡾ 㸪௓ධࡢ ᭷⏝ᛶࡢ᳨

ド࠾ࡼࡧࡑࡢ ホ౯ࡀࡼ ࡾྍ⬟࡟࡞ࡿ ࡜⪃࠼㸪 ௒ᚋࡢ᳨ウㄢ 㢟࡜ࡍࡿ 㸬

152

6-7-5. ⤖ㄒ

኱ᏛዪᏊࣛ ࢡࣟࢫ➇ ᢏࢆᑐ㇟࡜ࡋ ࡚㸪㏻ᖖ ⾜ࢃࢀ࡚࠸ࡿ ࢛࣮࣑࢘ ࣥࢢ࢔ࢵࣉ

ࡢ୰࡛⾜ࢃࢀ ࡚࠸ࡿ ࣛ ࣥࢪࡸࢪࣕࣥ ࣉ࠿ࡽࡢ ╔ᆅືస㸪ࢧ ࢖ࢻࢫࢸ ࢵࣉࡸษࡾ

㏉ࡋືస᫬࡟ ͆㊊㊑ࢆ 㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࢆᣦ ♧ࡋࡓᣦᑟἲ ࡀ㸪㊊㒊 ᶵ⬟ࡸ㊊㒊 ᙧែ㸪㟼ⓗ࠾ ࡼࡧືⓗ ࣂࣛࣥࢫ⬟ຊ ࡟ཬࡰࡍ ᙳ㡪ࢆ ẚ㍑᳨ ドࡍࡿࡇ ࡜ ࢆ┠ⓗ࡜

ࡋ㸪௨ୗࡢ⤖ ㄽࢆᚓࡓ 㸬

1) ㊊㊑㛤᤼⬟࡟ ࡘ࠸࡚㸪 ᕥྑ㊊㊑࠸ࡎ ࢀࡶ ᭷ព ࡟ቑຍࡉࡏࡓ 㸬

2) ㊊㊑ᢕᥱຊ࡟ ࡘ࠸࡚㸪 ᗙ఩࠾ࡼࡧ❧ ఩ ጼໃ࡛ ࡢᕥྑࡢ㊊㊑ ᢕᥱຊ ࠸ ࡎࢀ

ࡶ᭷ព࡟ቑຍ ࡉࡏ ࡓ㸬

3) ࢔࣮ࢳ㧗⋡࡟ ࡘ࠸࡚ࡣ 㸪ᕥྑ ㊊࠸ࡎ ࢀࡶ ᭷ព ࡟ቑຍࡉࡏࡓ 㸬

4) 㔜ᚰືᦂᛶ࡟ ࡘ࠸࡚ࡣ 㸪㔜ᚰ༢఩㌶ ㊧㛗ࡢᕥ ⬮❧఩᫬ࡢࡳ ᭷ព࡟ቑ ຍࡉ ࡏࡓࡀ㸪௚ࡢ ඲࡚ࡢ㡯 ┠࡟ࡣᙳ㡪ࢆ ཬࡰࡉ࡞ ࠿ࡗࡓ㸬

5) SEBT࡟ࡘ࠸࡚ࡣ㸪ᚋ ෆ᪉࠾ࡼࡧᚋ እ᪉ࡢࣜ ࣮ࢳ㊥㞳ࡢ๭ ྜ࡟࠾࠸ ࡚ᕥ

ྑ⬮࠸ࡎࢀࡶ ᭷ព࡞ ቑ ຍࡀㄆࡵࡽࢀ ࡓ㸬

6) ࢛࢘ ࣮࣑ ࣥࢢ ࢔ࢵ ࣉ ᫬ ࡟⾜ ࢃࢀ ࡚࠸ ࡿ ࣛ ࣥࢪ ࡸࢪ ࣕࣥ ࣉ࠿ ࡽࡢ ╔ᆅ ືస 㸪 ࢧ࢖ࢻࢫࢸࢵ ࣉࡸษࡾ ㏉ࡋືస᫬࡟ ͆㊊㊑ࢆ 㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࢆᣦ ♧ࡍ

ࡿᣦᑟἲࡣ㸪 ㊊㊑ᶵ⬟ ࠾ࡼࡧືⓗࣂ ࣛࣥࢫ⬟ ຊࢆྥୖࡉࡏ ࡿ࡜࠸࠺ ⤖ᯝ

ࢆ㏻ࡋ࡚㸪ୗ ⫥യᐖண 㜵ࢆ┠ⓗ࡜ࡋ ࡓᣦᑟ᪉ ἲ࡟࡞ࡿྍ⬟ ᛶࡀ♧၀ ࡉࢀ

ࡓ㸬

153

◊ ✲ 8 ኱Ꮫ ዪᏊ ࣛ ࢡ ࣟࢫ ➇ᢏ ࢆ ᑐ㇟ ࡜ࡋ ࡓ ୗ⫥ യᐖ ண 㜵ࢺ ࣮ࣞ ࢽ ࣥࢢ ௓ධ ࡀ യᐖ Ⓨ⏕ ᩘ ࠾ࡼ ࡧ യ ᐖ Ⓨ⏕ 㢖ᗘ ࡟ ཬࡰ ࡍᙳ 㡪

6-8-1. ⥴ゝ

௒᪥㸪ࢫ࣏ ࣮ࢶയᐖ ண㜵 ࡢᐇ㊶࡜ ࡑࡢຠᯝ ᳨ド࡟ࡘ࠸࡚ ከᩘࡢሗ ࿌ࡀࡳࡽࢀ

ࡿࡀ㸪≉࡟ୗ ⫥യᐖண 㜵 ࣉࣟࢢ࣒ࣛ ࡟㛵ࡍࡿ ሗ࿌ࡀከᩘࡳ ࡽࢀ 㸪ࡑ ࢀࡽࡢ௓ධ ࡀ᭷⏝࡛࠶ࡿ ࡜ࡢぢゎ ࡀ♧ࡉࢀ࡚࠸ ࡿ[Alentorn-Geli et al., 2009; Griffin et al.,

2006]㸬ୗ⫥യᐖண 㜵 ࢺ࣮ࣞࢽࣥࢢ ࡢ୍ࡘ࡛ ࠶ࡿ⭸๓༑Ꮠ 㠌ᖏ㸦anterior cruciate

ligament㸸௨ୗ㸪ACL㸧യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ࢆ౛࡟࡜ࡿ࡜ 㸪ࣂࢫ ࢣ ࢵࢺ࣮࣎ࣝ㸪

ࢧࢵ࣮࢝㸪ࣁࣥࢻ࣎ ࣮ ࣝ ➼࡛㸪௓ ධᮇ㛫 ࡣ 6 㐌㛫࠿ࡽ 12 㐌㛫 ࡀከ ࡃ㸪㢖ᗘࡣ㐌 2㹼3 ᅇ⛬ᗘ㸪᫬ 㛫ࡣ ୍ᅇ࡟ࡘࡁ 10㹼30 ศ ⛬ᗘᐇ᪋ࡉࢀ ࡚࠸ࡿ㸬 ࡲࡓ㸪௓ධ᪉ ἲࡢ≉ᚩ࡜ࡋ ࡚㸪⦎⩦ ๓࡟⾜ࢃࢀࡿ ࢘ ࢛࣮࣑ ࣥࢢ࢔ࢵࣉࡢ ୰ ࡛⾜ࢃ ࢀ࡚࠸ࡿ Ⅼ

࡟ ࠶ ࡿ 㸬 ࢺ ࣞ ࣮ ࢽ ࣥ ࢢ ᫬ 㛫 ࡣ 㸪 ㏻ ᖖ ࡢ ࢘ ࢛ ࣮ ࣑ ࣥ ࢢ ࢔ ࢵ ࣉ ᫬ 㛫 ࡟ ྜ ࢃ ࡏ ࡚ 15 ศ㹼20 ศ⛬ᗘ࡛࠶ ࡿ 㸬ࡇࢀࡣ 㸪യᐖ ண㜵 ࢆ ┠ⓗ࡜ࡋࡓࢺ ࣮ࣞࢽࣥ ࢢ ࡢⅭࡔࡅ࡟

᫬㛫ࢆ࠿ࡅࡿ ࡇ࡜ࡀᅔ 㞴࡛࠶ࡿ ࡜ࡢ ⌧ሙࡢព ぢࢆ཯ᫎ ࡉࡏ 㸪࢛࣮࢘ ࣑ࣥࢢ࢔ࢵ

ࣉ᫬࡟ྛ✀ࢺ ࣮ࣞࢽࣥ ࢢ ࢆྲྀࡾධࢀ ࡿ࡜࠸࠺ ᪉ἲࡀ࡜ࡽࢀ ࡚࠸ࡿ㸬 ୗ⫥യᐖண 㜵ࢺ࣮ࣞࢽࣥ ࢢࡢෆᐜ ࡟ࡘ࠸࡚ࡣ㸪 ᭱ึ࡟㐺 ษ࡞ጼໃ ࡸୗ ⫥࢔ࣛ࢖ ࣓ࣥࢺ ࢆ⋓

ᚓࡉࡏࡿࡇ࡜ ࢆ┠ᶆ࡟ ࡋ࡚㸪ࢺ࣮ࣞ ࢽࣥࢢ ึ ᮇ࡟࠾࠸࡚ࡣ 㐺ษ࡞࢔ ࢫࣞ ࢳࢵࢡ

࣏ࢪࢩࣙࣥࡢ ⋓ᚓࢆ┠ ᶆ࡟ᣦᑟࡉࢀ ࡚࠸ࡿ㸬 ࡑࢀࡣ㸪ࠕ⭸ ࢆ ࡋࡗ࠿ ࡾ ᭤ࡆ㸪⫪

ࢆᚋࢁ࡟ᘬ࠸ ࡚⬚ࢆᙇ ࡾ㸪┠⥺ࢆୗ ࡆ࡞࠸ࡼ ࠺࡟ 㸬ࠖࠕ㊊ ᖜࢆ⫪ᖜ ⛬ᗘ࡟㛤࠸

࡚య㔜ࢆẕ㊑ ⌫࡟஌ࡏ ࡿ 㸬ࠖ࡜࠸࠺ ࡶࡢ࡛࠶ ࡿ[Myer et al., 2004; Myer et al., 2005]㸬ࢺ࣮ࣞࢽ ࣥࢢ ✀┠ࡸ㈇Ⲵࢆ ₞㐍ⓗ࡟ ቑຍࡉࡏ࡚࠸ ࡃࡀ㸪ࢫ ࢡ࣡ࢵࢺ㸪ࢪ

ࣕࣥࣉ࠿ࡽࡢ ╔ᆅືస 㸪ࣛࣥࢪ㸪࣍ ࢵࣆࣥࢢ ືస➼㸪ከࡃ ࡢࢺ࣮ࣞ ࢽࣥࢢ✀┠

࡟࠾࠸࡚ࡇࡢ ጼໃࢆᇶ ᮏ ጼໃ࡜ࡋ࡚ ⩦ᚓࡉࡏ 㸪≉࡟ࢫࢱ࣮ ࢺ᫬ ࠾ࡼ ࡧࣇ࢕ࢽࢵ

ࢩࣗ᫬࡟࠾࠸ ࡚㸪㐺ษ ࡞࢔ࢫࣞࢳࢵ ࢡ࣏ࢪࢩ ࣙࣥ ࢆ࡜ࡽࡏ ࡿࡇ࡜ࢆ ព㆑ࡉࡏ࡚

⾜ࢃࡏ࡚࠸ࡿ[Myer et al., 2004]㸬ࡲࡓ㸪 ᇶᮏ ጼໃ ࢆ࡜ࡿ᫬ ࡟㸪ࠕ⭸ ࡀᖖ࡟ࡘࡲ

ඛࡢୖ࡟఩⨨ ࡍࡿࡼ࠺ ࡟ ࡍࡿࠖ࡜࠸࠺ ᣦᑟࡶ ྵࡲࢀ࡚࠾ࡾ㸪࠸ࢃࡺ ࡿ͆knee-in͇

ືస࡟࡞ࡽ࡞ ࠸ࡼ࠺࡟ ὀពႏ㉳ࡉࡏ ࡚࠸ࡿ㸬 ᮏㄽᩥࡢ◊ ✲2㸪5㸪7 ࡟࠾࠸࡚㸪

㊊㊑㛤᤼ືస ᣦ♧࠾ࡼ ࡧ ㊊㊑ᢕᥱຊ ࡀືⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺࡸࣂࣛ ࣥࢫಖᣢ⬟

154

ຊ࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚ ᳨ドࡋࡓࡀ 㸪◊ ✲ 8 ࡛ࡣ㸪◊ ✲ 7 ࡟⥆ࡁ኱ ᏛዪᏊࣛࢡ

ࣟࢫࢆᑐ㇟࡜ ࡋࡓ㏻ᖖ ࡢ࢛࣮࣑࢘ࣥ ࢢ࢔ࢵࣉ ࣓ࢽ࣮࡛ࣗ ⾜ ࢃࢀ࡚࠸ ࡿ ࣛࣥࢪࡸ

ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪ࢧ࢖ࢻࢫ ࢸࢵࣉ ࡸ ษࡾ㏉ࡋືస ᫬࡟ 㸪͆ ㊊㊑ࢆ㛤࠸

࡚ᗋࢆᥗࡴ͇ ࢆᣦ♧ࡍ ࡿᣦᑟἲࡀ㸪 ୗ⫥യᐖ Ⓨ⏕⋡ ➼࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ẚ

㍑᳨ドࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ ࡓ㸬௬ㄝ ࡣ⥲യᐖ Ⓨ⏕⋡ࢆపୗ ࡉࡏ㸪യ ᐖࡢ㒊఩࡟

ࡘ࠸࡚ࡣ㸪㊊ 㛵⠇㸪⭸ 㛵⠇ࢆྵࡵࡓ ୗ⫥യᐖ Ⓨ⏕⋡ ࢆపୗ ࡉࡏࡿ࡜ ࠸࠺ࡶࡢ࡛

࠶ࡿ㸬

155

6-8-2. ᑐ㇟࡜᪉ἲ 1. ᑐ㇟࡜᪉ἲ

ᑐ㇟⪅ࡣ◊ ✲7 ྠᵝ㸪 㛵ᮾ኱ᏛዪᏊ ࣛࢡࣟࢫ ࣮ࣜࢢ 1 㒊࡟ ᡤᒓࡍࡿ ኱ᏛዪᏊ

ࣛࢡࣟࢫ㑅ᡭ ࡛࠶ࡾ㸪1 ᖺ┠ 46 ྡ㸦ᖹᆒᖺ 㱋㸦±ᶆ‽೫ᕪ㸧㸸20.1 ± 1.3ṓ㸪㌟

㛗㸸159.1 ± 5.2cm㸪య 㔜㸸53.1 ± 5.5kg㸪ࣛ ࢡࣟࢫ➇ᢏ Ṕ 22.0 ± 16.3ࣨ᭶㸧㸪2 ᖺ┠55 ྡ㸦ᖹᆒ ᖺ㱋 19.5 ± 1.1ṓ㸪㌟ 㛗 158.7 ± 4.9cm㸪య 㔜 53.6 ± 5.4kg㸪ࣛ

ࢡࣟࢫ➇ᢏ Ṕ22.6 ± 13.2 ࣨ᭶㸧࡜ࡋࡓ㸬௓ ධ ᪉ἲࡣ㸪⦎⩦ ๓࡟⾜ࢃ ࢀ࡚࠸ࡿ ࢘

࢛࣮࣑ࣥࢢ࢔ ࢵࣉ࡛⾜ ࢃࢀ࡚࠸ࡿྛ ືస ᫬࡟ 㸪㊊㒊ࡢ ╔ᆅືస ᫬࡟ ྍ⬟࡞㝈ࡾ 㸪

㊊㊑㛤᤼࠾ࡼ ࡧ㊊㊑ᢕ ᣢࢆព㆑ࡉࡏ ࡚⾜ࢃࡏ ࡓ 㸬≉࡟ࢪࣙ ࢠࣥࢢ㸪 ࢫࢺࣞࢵࢳ

ࣥࢢ㸪యᖿࢺ ࣮ࣞࢽࣥ ࢢᚋ࡟⾜ࢃࢀࡓ Line to Line࡛ࡢືస᫬࡟ ᙉ ㄪࡋ࡚ᣦ♧

ࢆฟࡋࡓ㸦 ⾲ 8-1㸧㸬௓ධᮇ㛫 ࡣ 2011ᖺ 6 ᭶㹼2012ᖺ 3᭶ࡲ ࡛ ࡜ࡋ㸪യᐖ Ⓨ⏕

⋡➼ࡢẚ㍑ᮇ 㛫ࡣ2010ᖺ6᭶㹼2011ᖺ3᭶ ࡜2011ᖺ6᭶㹼2012ᖺ3᭶࡜ ࡋࡓ㸬 ᑦ㸪ᮏ◊✲ࢆ ⾜࠺࡟࠶ ࡓࡾ㸪 ᑐ㇟⪅ ࡟᪉ἲࡸ ೔⌮ⓗ㓄៖➼ ࡢㄝ᫂ࢆ ⾜࠸㸪ྠព

ࢆᚓࡓ㸬᪩✄⏣኱ Ꮫ ேࢆᑐ㇟࡜ࡍࡿ ◊✲࡟㛵 ࡍࡿ೔⌮ᑂᰝ ጤဨ఍ ࡢ ᢎㄆࢆᚓ࡚

ᐇ᪋ࡋࡓ㸦ᢎ ㄆ␒ ྕ 2010-037㸧㸬

156

2㸬യᐖㄪᰝෆᐜ

യᐖㄪᰝෆᐜ ࠾ࡼࡧ᪉ ἲ࡟ࡘ࠸࡚ࡣ 㸪 ◊ ✲ 1[బ㔝ᮧࡽ, 2012]ྠᵝ࡛࠶ࡿ㸬ࡑ ࡢ௚⦎⩦࣭ヨྜ᫬ࡢ യ ᐖ㸪യᐖࡢ ᅇᩘ㸪➇ᢏ ᚟ᖐࡲ࡛ࡢᮇ 㛫 ࡟ࡘ࠸ ࡚཰㞟ࡋࡓ 㸬 യᐖࡢᐃ⩏࠾ ࡼࡧ ➇ᢏ ᚟ᖐࡲ࡛ࡢᮇ 㛫 ࡟ࡘ࠸ ࡚ࡶ ◊✲ 1 ྠᵝ࡛࠶ࡾ 㸪യᐖⓎ⏕

⋡ ࡟ ࡘ ࠸ ࡚ ࡣ ‘1,000 athlete–hours㸦 ௨ ୗ 1000AHs㸧’࠾ ࡼ ࡧ‘1,000 athlete–

exposures㸦௨ୗ 1000AEs㸧’ࡢ༢఩ࢆ⏝࠸ ࡚ ⟬ฟࡋࡓ㸬௓ ධ๓ᚋࡢ ẚ㍑㡯┠ ࡣ 㸪

യᐖࡢ㒊఩㸪 യᐖࡢ✀ 㢮㸪യᐖࡢཎ ᅉ㸪യᐖ ࡢᅇᩘ㸪➇ᢏ ᚟ᖐࡲ࡛ ࡢᮇ㛫ࡢྛ

㡯┠ࡢയᐖⓎ ⏕⋡࡜ࡋ ࡓ㸬

6-8-3. ⤖ᯝ

യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ࡢ௓ධᮇ㛫 ࡣ 㸪2011ᖺ 6 ᭶㹼2012ᖺ 3 ᭶ ࡲ࡛ࡢ 10 ࣨ

᭶㛫㸪௓ධ᪥ ᩘࡣ 304᪥㛫࡛࠶ࡗࡓ 㸬 ௓ධ๓ ᚋࡢ⦎⩦࠾ࡼ ࡧヨྜࡀ ⾜ࢃࢀࡓᅇ

ᩘࡣ㸪௓ධ ๓ 183 ᅇ㸪 ௓ධᚋ 190 ᅇ࡛࠶ࡾ 㸪1 㐌㛫࠶ࡓࡾࡢ ⦎⩦ ࠾ ࡼࡧヨྜᅇ

ᩘࡣ㸪௓ධ ๓4.2 ᅇ/㐌㸪௓ධᚋ 4.4 ᅇ/㐌࡛࠶ ࡗࡓ㸬

1㸬യᐖⓎ⏕⋡

௓ධ๓ᚋࡢയ ᐖⓎ⏕ᩘ ࠾ࡼࡧയᐖⓎ ⏕⋡ࢆ ⾲ 8-2 ࡟♧ࡍ㸬௓ ධ๓ ᚋࡢ ⥲ AHs

࠾ࡼࡧ⥲ AEsࡣ㸪௓ ධ๓ 11,916.8AHs࠾ࡼࡧ 5,593AEs㸪௓ධᚋ 11,417.6AHs࠾

ࡼ ࡧ 5,371AEs ࡛ ࠶ ࡗ ࡓ 㸬 ⦎ ⩦ ᫬ ࡢ AHs ࠾ ࡼ ࡧ AEs ࡟ ࡘ ࠸ ࡚ ࡣ 㸪 ௓ ධ ๓ 11,447.8AHs ࠾ࡼࡧ 5,065AEs㸪௓ධᚋ 10,721.0AHs ࠾ࡼࡧ 4,508AEs ࡛࠶ࡗࡓ㸬 ヨྜ᫬ࡢ AHs ࠾ࡼࡧ AEs ࡟ࡘ࠸࡚ ࡣ㸪௓ධ ๓ 469.0AHs ࠾ࡼࡧ 528AEs㸪௓ධ

ᚋ 696.6AHs ࠾ࡼࡧ 863AEs ࡛࠶ࡗࡓ 㸬௓ධ ๓ᚋࡢ AHs ࢆ ྜィࡍ ࡿ࡜㸪 ⦎⩦᫬

22,168.8AHs㸦Total AHs ࡢ 95%㸧㸪ヨྜ᫬ 1165.6AHs㸦5.0%㸧࡛⦎⩦᫬ࡀ࡯࡜

ࢇ࡝ࢆ༨ࡵ࡚ ࠸ࡓ㸬ࡲ ࡓ௓ධ๓ᚋ ࡢ AEs ࢆ ྜィࡍࡿ࡜㸪⦎ ⩦᫬ 9,573AEs㸦Total

AEsࡢ 87.3%㸧㸪ヨྜ ᫬ 1,391㸦12.7%㸧࡛࠾࠾ࡼࡑ 9๭ࢆ ⦎⩦᫬ࡀ ༨ࡵ࡚࠸ࡓ 㸬

௓ධ๓ᚋࡢയ ᐖ Ⓨ⏕ᩘ ࡟ࡘ࠸࡚ࡣ 㸪௓ ධ๓ 143౛㸦യᐖⓎ⏕⋡ ࡣ 12.00 (10.03 — 13.97)/1000AHs (࢝ ࢵ ࢥ ෆ ࡣ 95㸣 ಙ 㢗 ༊ 㛫 ࢆ ♧ ࡍ)࠾ ࡼ ࡧ 25.57 (21.38 — 29.76)/1000AEs㸧࡛㸪 ௓ධᚋ 102 ౛㸦യᐖⓎ ⏕⋡ 8.93 (7.20 — 10.67)/1000AHs

࠾ࡼࡧ 18.99 (15.31 — 22.68)/1000AEs㸧࡛࠶ ࡗࡓ㸬⦎⩦࣭ヨྜ᫬ ࡛ ẚ㍑ࡍࡿ࡜㸪

⦎⩦᫬ࡢ௓ධ ๓യᐖⓎ ⏕ᩘ 135 ౛㸦യᐖⓎ ⏕⋡ 11.79 (9.80 — 13.78)/1000AHs

157

࠾ࡼࡧ 26.65 (22.16 — 31.15)/1000AEs㸧㸪௓ ධᚋ92 ౛㸦യᐖⓎ ⏕ ⋡ 8.58 (6.83 — 10.33)/1000AHs࠾ࡼࡧ 20.41 (16.24 — 24.58)/1000AEs㸧㸪ヨྜ ᫬ࡢ௓ධ๓യ ᐖ

Ⓨ⏕ᩘ8 ౛㸦17.06 (5.24 — 28.88)/1000AHs࠾ࡼࡧ 15.15 (4.65 — 25.65)/1000AEs㸧㸪

௓ධᚋ 10౛㸦യ ᐖⓎ ⏕⋡ 14.36 (5.46 — 23.25)/1000AHs ࠾ࡼࡧ 11.59 (4.41 — 18.77)/1000AEs㸧 ࡛ ࠶ ࡗ ࡓ 㸬 ⦎ ⩦ ࣭ ヨ ྜ ᫬ ࡢ ௓ ධ ๓ ᚋ ࡢ യ ᐖ Ⓨ ⏕ ᩘ ࢆ ྜ ࢃ ࡏࡿ

࡜㸪⦎⩦ ᫬ 227౛㸪ヨ ྜ᫬ 18౛࡛㸪⦎ ⩦᫬ ࡟Ⓨ⏕ࡋࡓയ ᐖࡀ඲య ࡢ 9๭௨ୖࢆ

༨ࡵ࡚࠸ࡓ㸬

158

159

2㸬യᐖࡢ㒊఩ู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡

യᐖࡢ㒊఩ู ࡟ࡼࡿ ௓ ධ๓ᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ࢆ ⾲8-3㸪⾲8-4㸪 ᅗ 8-1 ࡟ ♧ ࡍ 㸬 ௓ ධ ๓ ᚋ ࡛ ᭱ ࡶ യ ᐖ Ⓨ ⏕ ⋡ ࡀ ప ୗ ࡋ ࡓ 㒊 ఩ ࡣ 㸪 ㊊ 㒊/ࡘ ࡲ ඛ ࡛ 0.92/1000AHs࠿ࡽ 0.35/1000AHs࠾ࡼࡧ 1.97/1000AEs ࠿ࡽ 0.74/1000AEs࡛࠶ࡗ ࡓ 㸦 യ ᐖ Ⓨ ⏕ ᩘ 11 ౛ ࠿ ࡽ 4 ౛ ࡬ ῶ ᑡ 㸧 㸬 ḟ ࡟ ୗ ⭣ ࡛ 1.17/1000AHs ࠿ ࡽ 0.79/1000AHs࠾ࡼࡧ 2.50/1000AEs ࠿ࡽ 1.68/1000AEs ࡛࠶ࡗࡓ 㸦യ ᐖⓎ⏕ᩘ 14

౛࠿ࡽ 9 ౛ ࡬ῶᑡ㸧 㸬௨ୗ㸪⫤㛵 ⠇ 0.42/1000AHs ࠿ࡽ 0.09/1000AHs ࠾ࡼࡧ 0.89/1000AEs ࠿ࡽ 0.19/1000AEs㸦യᐖⓎ⏕ ᩘ 5 ౛࠿ ࡽ 1 ౛࡬ ῶ ᑡ 㸧㸪㰡ᚄ㒊 0.67/1000AHs ࠿ࡽ 0.35/1000AHs ࠾ࡼࡧ 1.43/1000AEs ࠿ࡽ 0.74/1000AEs㸦യᐖ

Ⓨ⏕ᩘ 8౛࠿ ࡽ 4 ౛࡬ ῶᑡ㸧㸪⭜᳝/ୗ⫼㒊 1.09/1000AHs࠿ࡽ 0.79/1000AHs ࠾

ࡼࡧ 2.32/1000AEs ࠿ࡽ 1.68/1000AEs㸦യᐖ Ⓨ⏕ᩘ 13 ౛࠿ࡽ 9 ౛ ࡬ῶᑡ㸧࡛࠶

ࡗࡓ㸬

160

161

ᅗ 8-1 ௓ධ๓ ᚋࡢയᐖ ࡢ㒊఩ูയᐖ Ⓨ⏕ᩘ ࡜ ࡑࡢ๭ྜ

162

3㸬യᐖࡢ✀㢮ู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡

യᐖࡢ✀㢮ู ࡟ࡼࡿ ௓ ධ๓ᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ࢆ⾲ 8-5 ࡟♧ ࡍ㸬

௓ධ๓ᚋ࡛᭱ ࡶⓎ⏕⋡ ࡀపୗࡋࡓയ ᐖࡢ✀㢮 ࡣ㸪⭝⅖/೺࿘ᅖ⅖ ࡛ 2.43/1000AHs

࠿ࡽ 1.31/1000AHs ࠾ࡼࡧ 5.19/1000AEs ࠿ ࡽ 2.79/1000AEs ࡛࠶ ࡗࡓ㸦യᐖⓎ⏕

ᩘ 29 ౛ ࠿ ࡽ 15 ౛ ࡟ ῶ ᑡ 㸧 㸬 ḟ ࡟ ᡴ ᧞/⾑ ⭘/᣸ യ ࡛ 2.01/1000AHs ࠿ ࡽ 1.14/1000AHs࠾ࡼࡧ 4.29/1000AEs ࠿ࡽ 2.42/1000AEs ࡛࠶ࡗࡓ 㸦യ ᐖⓎ⏕ᩘ 24

౛ ࠿ ࡽ 13 ౛ ࡟ ῶ ᑡ 㸧 㸬 ௨ ୗ 㸪 ᤬ ᣸ 2.77/1000AHs ࠿ ࡽ 1.93/1000AHs ࠾ ࡼ ࡧ 5.90/1000AEs࠿ࡽ 4.10/1000AEs㸦യᐖⓎ ⏕ ᩘ 33 ౛࠿ࡽ 22 ౛࡟ῶ ᑡ 㸧㸪➽⫗③ /ࢫ ࣃ ࢬ ࣒ 2.60/1000AHs ࠿ ࡽ 2.10/1000AHs ࠾ ࡼ ࡧ 5.54/1000AEs ࠿ ࡽ

4.47/1000AEs㸦യᐖⓎ ⏕ᩘ 31౛࠿ࡽ 24 ౛࡟ ῶᑡ㸧࡛࠶ࡗ ࡓ㸬

163

4㸬യᐖࡢཎᅉู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡

യᐖࡢཎᅉู ࡟ࡼࡿ ௓ ධ๓ᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ࢆ⾲ 8-6 ࡟♧ ࡍ㸬

௓ ධ ๓ ᚋ ࡛ ᭱ ࡶ Ⓨ ⏕ ⋡ ࡀ ప ୗ ࡋ ࡓ യ ᐖ ࡢ ཎ ᅉ ࡣ 㸪 ᥋ ゐ ᆺ യ ᐖ 㸦 ௚ ࡢ 㑅 ᡭ 㸧 ࡛ 2.27/1000AHs࠿ࡽ 1.40/1000AHs࠾ࡼࡧ 4.83/1000AEs ࠿ࡽ 2.98/1000AEs࡛࠶ࡗ ࡓ㸦യᐖⓎ⏕ ᩘ 27 ౛࠿ࡽ 16 ౛࡟ῶᑡ㸧㸬 ḟ࡟㠀᥋ゐᆺ യᐖ࡛ 2.35/1000AHs

࠿ࡽ 1.66/1000AHs ࠾ࡼࡧ 5.01/1000AEs ࠿ ࡽ 3.54/1000AEs ࡛࠶ ࡗࡓ㸦യᐖⓎ⏕

ᩘ 28 ౛ ࠿ ࡽ 19 ౛ ࡟ ῶ ᑡ 㸧 㸬 ௨ ୗ 㸪 ౑ ࠸ ࡍ ࡂ 㸦 ᚎ ࠎ ࡟ 㸧3.94/1000AHs ࠿ ࡽ 3.33/1000AHs࠾ࡼࡧ 8.40/1000AEs ࠿ࡽ 7.08/1000AEs㸦യᐖⓎ⏕ᩘ 47 ౛࠿ࡽ 38

౛ ࡟ ῶ ᑡ 㸧 㸪 ౑ ࠸ ࡍ ࡂ 㸦 ᛴ ࡟ 㸧1.34/1000AHs ࠿ ࡽ 0.88/1000AHs ࠾ ࡼ ࡧ 2.86/1000AEs࠿ࡽ 1.86/1000AEs㸦യᐖⓎ ⏕ ᩘ 16 ౛࠿ࡽ 10 ౛࡟ῶ ᑡ 㸧㸪᥋ゐᆺ യᐖ㸦ື࠸࡚ ࠸ࡿ≀㸧 ࡛ 1.43/1000AHs ࠿ࡽ 1.05/1000AHs ࠾ࡼࡧ 3.04/1000AEs

࠿ࡽ2.23/1000AEs ࡛࠶ࡗࡓ㸦യᐖ Ⓨ⏕ ᩘ 17 ౛࠿ࡽ 12 ౛࡟ῶ ᑡ 㸧࡛࠶ࡗࡓ㸬

164

165

5㸬ཷയᅇᩘ࡟ࡼ ࡿയ ᐖⓎ⏕ᩘ ࠾ࡼ ࡧയᐖⓎ ⏕⋡

ㄪᰝᮇ㛫୰࡟ Ⓨ⏕ࡋࡓ ௓ධ๓ᚋࡢയ ᐖࡢᅇᩘ ࠾ࡼࡧയᐖⓎ ⏕⋡ࢆ ⾲ 8-7 ࡟♧

ࡍ㸬௓ධ๓ᚋ ࡛᭱ࡶⓎ ⏕⋡ࡀపୗࡋ ࡓയᐖࡢ ᅇᩘࡣ㸪ึᅇ ཷയ࡛Ⓨ ⏕ᩘ 101౛

࠿ࡽ 60 ౛࡬࡜పୗࡋ 㸪യᐖⓎ⏕⋡ ࡣ 8.48/1000AHs ࠿ࡽ 5.26/1000AHs ࠾ࡼࡧ 18.06/1000AEs ࠿ࡽ 11.17/1000AEs ࡟పୗࡋ ࡓ㸬ḟ࡟ 2 ᅇ ┠㸦෌ཷ യ㸧࡛ 19 ౛

࠿ࡽ 14 ౛㸪Ⓨ⏕ ⋡ࡣ 1.59/1000AHs ࠿ࡽ 1.23/1000AHs ࠾ࡼࡧ 3.40/1000AEs ࠿

ࡽ2.61/1000AEs ࡟ప ୗࡋࡓ 㸬

166

167

6㸬➇ᢏ᚟ᖐࡲ࡛ ࡢᮇ 㛫࡜യᐖⓎ⏕ ᩘ࠾ࡼࡧ യᐖⓎ⏕⋡

ㄪᰝᮇ㛫୰࡟ Ⓨ⏕ࡋࡓ ௓ධ๓ᚋࡢ ➇ ᢏ᚟ᖐࡲ ࡛ࡢᮇ㛫࡜യ ᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡ࢆ ⾲8-8࡟♧ ࡍ㸬௓ධ๓ᚋ ࡛᭱ࡶప ୗࡋࡓ᚟ᖐࡲ ࡛ࡢᮇ㛫 ࡣ㸪1㹼2 ᪥

࡛2.85/1000AHs࠿ࡽ1.84/1000AHs࠾ࡼࡧ6.08/1000AEs࠿ࡽ 3.91/1000AEs࡛࠶

ࡗࡓ㸦യᐖⓎ ⏕ᩘ 34 ౛࠿ࡽ 21 ౛࡟ῶᑡ㸧 㸬ḟ࡟ 3㹼7 ᪥࡛ 4.20/1000AHs ࠿ࡽ

3.59/1000AHs࠾ࡼࡧ 8.94/1000AEs ࠿ࡽ 7.63/1000AEs㸦യᐖⓎ⏕ᩘ 50 ౛࠿ࡽ 41

౛ ࡟ ῶ ᑡ 㸧 㸪 ௨ ᚋ 㸪4 㐌 㹼6 ࣨ ᭶ ࡛ 1.34/1000AHs ࠿ ࡽ 0.61/1000AHs ࠾ ࡼ ࡧ 2.86/1000AEs ࠿ࡽ 1.30/1000AEs㸦യᐖⓎ⏕ ᩘ 16 ౛࠿ࡽ 7 ౛࡟ ῶ ᑡ 㸧㸪1㹼2 㐌

࡛2.35/1000AHs ࠿ࡽ 1.75/1000AHs࠾ࡼࡧ 5.01/1000AEs ࠿ࡽ 3.72/1000AEs㸦യ ᐖⓎ⏕ᩘ 16 ౛࠿ ࡽ 7 ౛࡟ῶᑡ㸧࡛ ࠶ࡗࡓ㸬

168

169

6-8-4. ⪃ᐹ

ᮏ◊✲ࡣ㸪 ୗ⫥ യᐖ ண㜵ࢺ࣮ࣞࢽ ࣥࢢࡢ ௓ ධຠᯝ᳨ドࢆ ⾜࠺ࡇ࡜ ࡜ࡋ㸪኱Ꮫ ዪᏊࣛࢡࣟࢫ ➇ᢏࢆᑐ ㇟ ࡟㸪㏻ᖖ⾜ ࢃࢀ࡚࠸ ࡿ࢛࣮࣑࢘ࣥ ࢢ࢔ࢵࣉ ࣓ࢽ࣮ࣗ ࡛

⾜ࢃࢀ࡚࠸ࡿ ࣛࣥࢪࡸ ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪ࢧ࢖ࢻࢫ ࢸࢵࣉ ࡸ ษࡾ㏉ࡋື

స᫬࡟͆㊊㊑ ࢆ㛤࠸࡚ ᗋࢆᥗࡴ ͇ࢆ ᣦ♧ࡍࡿ ືసᣦᑟἲࡀ 㸪ୗ⫥യ ᐖⓎ⏕⋡➼

࡬ཬࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ ẚ㍑᳨ドࡍࡿ ࡇ࡜ࢆ┠ ⓗ࡜ࡋ ࡚⾜ࡗ ࡓ㸬

௓ධ๓ᚋࡑ ࢀࡒ ࢀ 10 ࣨ᭶㛫ࡢ Total AHs࡜ Total AEsࡣ㸪௓ධ ๓ 11,916.8AHs

࠾ࡼࡧ 5,593AEs㸪௓ධ ᚋ 11,417.6AHs࠾ࡼࡧ 5,371AEs࡛㸪࡯ࡰྠᩘ ࡛࠶ࡗࡓ㸬

ࡲࡓ㸪௓ධ๓ ᚋࢆྜࢃ ࡏࡓ⦎⩦᫬࡜ ヨྜ᫬ ࡢ Total AHs࡜ Total AEs࡜ࡢẚ㍑࡛

ࡣ㸪◊ ✲ 1ࡢ⤖ᯝ ࡜ ྠ ᵝ࡟㸪⦎ ⩦᫬࡟༨ ࡵࡿ ๭ྜࡀ ࠾࠾ࡼ ࡑ 9๭௨ ୖ࡛࠶ࡗࡓ㸬

⥲യᐖⓎ⏕ᩘ ࡟㛵ࡋ࡚ ࡣ㸪௓ධ ๓ 143౛㸪௓ධᚋ 102౛࡛࠶ࡗࡓ㸬 ⥲യᐖⓎ⏕

⋡࡛ẚ㍑ࡍࡿ ࡜㸪 ௓ධ ๓12.00 (10.03 — 13.97)/1000AHs ࠾ࡼࡧ 25.57 (21.38 — 29.76)/1000AEs㸪 ௓ ධ ᚋ 8.93 (7.20 — 0.67)/1000AHs ࠾ ࡼ ࡧ 18.99 (15.31 —

22.68)/1000AEs ࡛࠶ࡾ㸪⥲യᐖⓎ⏕ ⋡ ࢆῶᑡ ࡉࡏࡓ㸬⦎⩦ ࣭ヨྜ᫬ ࡢ⥲യᐖⓎ

⏕ᩘࡣ㸪⦎⩦ ᫬ࡢ௓ධ ๓ 135 ౛㸪௓ධᚋ ࡛ 92 ౛࡛࠶ࡾ㸪 യᐖⓎ ⏕⋡ ࡣ௓ධ๓ 11.79 (9.80 — 13.78)/1000AHs࠾ࡼࡧ 26.65 (22.16 — 31.15)/1000AEs㸪௓ධᚋ 8.58 (6.83 — 10.33)/1000AHs ࠾ࡼࡧ 20.41 (16.24 — 24.58)/1000AEs ࡛࠶ࡗࡓ㸬ヨྜ᫬

ࡢ ௓ ධ ๓ 8 ౛ 㸪 ௓ ධ ᚋ 10 ౛ ࡛ ࠶ ࡾ 㸪 യ ᐖ Ⓨ ⏕ ⋡ ࡣ ௓ ධ ๓ 17.06 (5.24 — 28.88)/1000AHs ࠾ࡼࡧ 15.15 (4.65 — 25.65)/1000AEs㸪௓ධᚋ 14.36 (5.46 — 23.25)/1000AHs࠾ࡼࡧ 11.59 (4.41 — 18.77)/1000AEs ࡛࠶ࡗࡓ 㸬⦎⩦࣭ヨྜ ᫬ ࠸ ࡎࢀ࡟࠾࠸࡚ ࡶയᐖⓎ ⏕⋡ࢆ ῶᑡࡉ ࡏࡓ㸬ࡇ ࢀࡽࡢ⤖ᯝ࠿ ࡽ㸪 ⦎⩦ ࣭ヨྜ᫬㸪 ࡑࡢྜィ࠸ࡎ ࢀ࡟࠾࠸ ࡚ࡶ௓ධ ࡟ࡼ ࡿയᐖⓎ ⏕⋡ࡢῶᑡࡀ ☜ㄆࡉࢀ ࡓ 㸬യᐖࡢ 㒊఩ู࡛ࡳࡿ ࡜㸪≉࡟ യᐖⓎ⏕⋡ࡢ ῶᑡࡀࡳ ࡽࢀࡓࡢࡀ ㊊ 㒊/ࡘࡲඛ㸪ୗ⭣㸪⫤

㛵⠇࡛࠶ࡗࡓ 㸬௒ᅇࡢ ୗ⫥യᐖண㜵 ࢺ࣮ࣞࢽ ࣥࢢࡣ㸪 ㊊㛵 ⠇ࡸ ⭸㛵 ⠇യᐖࡢண 㜵 ࢆ ≺ ࠸ ࡜ ࡋ ࡓ ࡶ ࡢ ࡛ ࠶ ࡗ ࡓ ࡀ 㸪 ࡑ ࢀ ࡽ ࡢ യ ᐖ Ⓨ ⏕ ⋡ ࢆ ࡳ ࡿ ࡜ 㸪 ㊊ 㛵 ⠇ ࡣ 2.01/1000AHs ࠿ࡽ 1.93/1000AHs㸪4.29/1000AEs ࠿ࡽ 4.10/1000AEs ࡬࡜ῶᑡࡋ 㸦 യ ᐖ Ⓨ ⏕ ᩘ ࡣ 24 ౛ ࠿ ࡽ 22 ౛ ࡬ ῶ ᑡ 㸧 㸪 ⭸ 㛵 ⠇ ࡣ 1.34/1000AHs ࠿ ࡽ 1.93/1000AHs㸪2.86/1000AEs ࠿ࡽ 4.10/1000AEs࡬࡜ቑຍࡋࡓ㸦യᐖ Ⓨ⏕ᩘ ࡣ 16

౛࠿ࡽ 22౛࡬ቑ ຍ 㸧㸬⭸㛵⠇ࡢ യᐖⓎ⏕ ⋡ ࡢῶᑡࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓࡀ 㸪㊊㛵 ⠇

170

ࡢയᐖⓎ⏕⋡ ࡀࢃࡎ࠿ ࡛ࡣ࠶ࡿࡀ ῶ ᑡࡋࡓ㸬 ㊊㛵⠇യᐖⓎ ⏕⋡ࡢῶ ᑡ࡟ࡘ࠸࡚

⪃ᐹࡍࡿ࡜㸪 ❧఩ጼໃ ࡛ࡣ㊊㒊 ࡢࡳ ࡀᗋ࡜᥋ ゐࡋ ࡓ≧ែ࡜ ࡞ࡾ 㸪㊊ ᗏ࠾ࡼࡧ㊊

㒊࠿ࡽࡢ᝟ሗ ࡀ ጼໃㄪ ᩚࡸ㐠ືࢆ⾜ ࠺㝿 ࡟㔜 せ࡞᝟ሗ※࡜ ࡞ࡿ㸬ࡑ ࡢ᝟ሗࡣ ➽

⫗㸪⭝㸪㠌ᖏ 㸪༙᭶㸪 㛵⠇ໟ㸪⁥⭷ ➼࡟ Ꮡᅾ ࡍࡿᅛ᭷ཷᐜ ჾ ࠿ࡽࡢ ᝟ሗ࡛࠶ࡿ

ࡀ㸪ࡇࢀࡽࡢ ᝟ሗࡀ୰ ᯡ⚄⤒⣔ࢆ௓ ࡋ࡚㐠ື ไᚚ࡟㛵ࡍࡿ ᚲせ࡞᝟ ሗࡀ➽⫗ࡸ

㛵⠇࡟㏦ࡽࢀ ࡿ[Hervéou and Messéan, 1995]㸬ࡇࢀࡽࡢ ឤぬ᝟ሗ ࡣ 㸪ࡑࡢཷᐜჾ

࡛࠶ࡿ ࣓࢝ ࣀࣞ ࢭࣉ ࢱ ࣮ 㸦mechanoreceptor㸪 ᶵᲔཷ ᐜჾ 㸧 ࡀ ᗋ࠿ ࡽ ࡢຊᏛ ⓗ࡞

᝟ሗࢆཷࡅ࡚ ⾜ ࢃࢀ࡚ ࠸ࡿ[ᐑᓥࡽ, 2012]㸬ࡲࡓ㸪㊊㊑࡟ ࡣ࣓࢝ࣀ ࣞࢭࣉࢱ࣮ ࡢ ศᕸᐦᗘࡀ㧗 ࡃ㸪㊊㊑ ࢺ࣮ࣞࢽࣥࢢ ࡣ ࣓࢝ࣀ ࣞࢭࣉࢱ࣮ ࢆ ㈿άࡉࡏ 㸪⚄⤒㐠ື

ჾ༠ㄪࢆᨵၿ ࡉࡏࡿ࡜ ࡜ࡶ࡟㸪㊊ᗏ ➽⩌࠿ࡽ ⭌⭡➽㸪 ࣁ࣒ ࢫࢺࣜࣥ ࢢ ࡬ࡢ➽㐃 㙐཯ᛂࢆㄏⓎ ࡉࡏࡿࡇ ࡜㸪ࡑࡋ࡚ ㊊ 㛵⠇࿘ᅖ ➽ࡢ➽཯ᛂࢆ ㄏⓎࡉࡏ ࡿ࡜㏙࡭ࡽ

ࢀ࡚࠸ࡿ[஭ཎ, 1996; Hervéou and Messéan, 1995]㸬ࡇࢀࡽࡢሗ ࿌ ࠿ ࡽࡳࡽࢀࡿࡼ

࠺࡟㸪㊊㊑㛤 ᤼ࡸ㊊㊑ ᢕᣢ➼ࡢ ࢺࣞ ࣮ࢽࣥࢢ ࡟ࡼࡿ㊊㊑ ᶵ ⬟ྥୖࡣ 㸪❧఩ ືస

᫬ࡢ㊊㊑㐠ື ࡟ࡼ ࡾ㸪 ㊊㊑࡛ᚓࡽࢀ ࡿឤぬཷ ᐜჾࡢỈ‽ࡀ 㧗ࡲ ࡾ㸪 ➽⫗࡬ࡢ㐺 ษ࡞᝟ሗࡀࡼ ࡾ᪩ࡃ㏦ ࡽࢀࡿࡇ࡜࡛ እຊ࡟ᑐ ࡍࡿ཯ᛂไᚚ 㸪ࡍ࡞ࢃ ࡕࣇ࢕࣮ࢻ

ࣂࢵࢡไᚚ࡟ ࡼࡾ ㊊㒊 ࡢᶵ⬟ⓗᏳᐃ ᛶ࡟ ᐤ୚ ࡉࡏࡓࡢ࡛ࡣ ࡞࠸࠿࡜ ⪃࠼ࡓ 㸬ࢫ ࢸࢵࣉືసࡸ ࢪࣕࣥࣉ ࠿ࡽࡢ╔ᆅ᫬ ➼࡟㊊㊑ 㛤᤼࠾ࡼࡧ㊊ ㊑ᢕᣢࢆ ព㆑ࡉࡏ࡚

⾜ࢃࡏࡿࡇ࡜ ࡀ㸪㊊㊑ ᢕᥱຊࡸ㊊㊑ 㛤᤼⬟ࡢ ྥୖ࡜࡜ࡶ࡟ 㸪≉࡟㊊ 㒊ࡢ ⚄⤒➽

༠ㄪᛶࡀࡼࡾ ྥୖࡍࡿ ࡇ࡜㸪ࡑࡋ࡚ ㊊㒊࠿ࡽ ࡢ᝟ሗࡀ୰ᯡ ⚄⤒⣔ࢆ ௓ࡋ࡚➽⫗

➼࡬ࡢ࿨௧ఏ 㐩ࡀ⣲᪩ ࡃ⾜ࢃࢀࡇ࡜ ࡛㸪㊊㒊 ࡢᏳᐃᛶࡀࡼ ࡾྥୖࡋ 㸪㊊㛵⠇യ ᐖࡢῶᑡ࡟ࡘ ࡞ࡀࡗࡓ ࡢ࡛ࡣ࡞࠸࠿ ࡜᥎  ࡋ ࡓ㸬ࡲࡓ㸪ᮏ ㄽᩥ ◊ ✲5 ࡢ㊊㊑ ᢕ ᥱຊ࡜㟼ⓗ࠾ ࡼࡧືⓗ ࣂࣛࣥࢫ⬟ຊ ࡜ࡢ㛵㐃 ᛶ ᳨࡛ドࡋࡓ 㸪㊊㊑ᢕ ᥱຊࡢඃࢀ

ࡿ⪅ࡣ㊊㒊࢔ ࣮ࢳ๛ᛶ ࡀ㧗ࡲࡿ࡜ࡇ ࡛㊊㒊ࡢ Ᏻᐃᛶࡀྥୖ ࡋ㸪 㟼ⓗ ୗ⫥ࣂࣛࣥ

ࢫಖᣢ⬟ຊ࡟ ᐤ୚ࡉࡏ ࡓࡇ࡜㸪ࡑࡋ࡚๓ ᪉࡬ ࡢືⓗࣂࣛࣥ ࢫಖᣢ⬟ ຊ ࡟ࡶඃࢀ 㸪

㊊㊑ࢆྵࡵࡓ ๓㊊㒊࡛ ࡢጼໃಖᣢ⬟ ຊ࡟ᐤ୚ ࡉࡏࡓ ࡇ࡜࡛ ╔ᆅືస ᫬ࡢ㊊㊑ᢕ ᣢືసࡀືⓗ ୗ⫥ࣂࣛ ࣥࢫಖᣢ⬟ຊ ࡟ᙳ㡪ࢆ ཬࡰࡋ ࡓ࡜࠸ ࠺⤖ㄽ࠿ ࡽࡶ ㊊㛵⠇

യᐖࡢῶᑡ࡟ ᐤ୚ࡉࡏ ࡓ ࡢ࡛ࡣ࡞࠸ ࠿࡜ ⪃࠼ ࡓ㸬◊✲ 7 ࡢୗ⫥യᐖ ண㜵ࢺ࣮ࣞ

ࢽࣥࢢ௓ධࡀ ㊊㊑ᶵ⬟ 㸪㊊㒊ᙧែ㸪 㟼ⓗ࣭ື ⓗࣂࣛࣥࢫ⬟ ຊ ࡟ཬࡰ ࡍᙳ㡪 ࡟ࡘ

࠸࡚ࡢ᳨ド࡛ ࡣ㸪㊊㊑ 㛤᤼ࡸ㊊㊑ᢕ ᣢືసࢆ ព㆑ࡉࡏ ࡓࢺ ࣮ࣞࢽࣥ ࢢࡣ 㸪ᑠ㊑

171

እ㌿➽ࡸẕ㊑ እ㌿➽ࡢ ㊊㒊ෆᅾ➽ࡢ ➽⥭ᙇ ࡟ ࡼࡾ㸪㊊㒊࢔ ࣮ࢳ๛ᛶ ࢆ㧗ࡵࡿࡇ

࡜㸪ࡑࡋ࡚㊊ 㒊እᅾ➽ ࡢ➽ᙇ࡟ࡼࡗ ࡚ࡶ ㊊㒊 ࢔࣮ࢳ๛ᛶ ࢆ 㧗ࡵࡿࡇ ࡜࠿ࡽ 㸪㊊

㊑ᢕᥱຊࡸ㊊ ㊑㛤᤼⬟ ࡢྥୖ࡜࡜ࡶ ࡟㊊㒊 ࡢ Ᏻᐃᛶ࡟ᐤ୚ ࡉࡏ㸪㊊ 㛵⠇യᐖࡢ ῶᑡ࡟ᐤ୚ࡉ ࡏࡓ ࡢ࡛ ࡣ࡞࠸࠿࡜᥎  ࡋࡓ㸬 ᮏ◊✲⤖ᯝ࠿ ࡽ㸪 ⭸㛵 ⠇യᐖ࡟ᑐ ࡍࡿ௓ධຠᯝ ࡣࡳࡽࢀ ࡞࠿ࡗࡓ㸬ඛ ⾜◊✲࡛ ࠶ࡿ ㊊㊑㛤᤼ ࠾ࡼࡧ㊊ ㊑ᢕᣢືస ࡀືⓗୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺ࡟ཬࡰࡍᙳ 㡪㸦◊ ✲ 2㸧ࡸ㊊㊑ ᢕᥱຊ ࡜ 㟼ⓗ࠾ࡼࡧື

ⓗࣂࣛࣥࢫ⬟ ຊ࡜ࡢ㛵 㐃ᛶ㸦◊✲ 5㸧㸪ୗ⫥ യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ௓ධࡀ ㊊㊑

ᶵ⬟ࡸ㟼ⓗ࠾ ࡼࡧືⓗ ࣂࣛࣥࢫ⬟ຊ ࡟ཬࡰࡍ ᙳ㡪 㸦◊✲ 7㸧࠿ࡽ㸪 ㊊㊑ᢕᥱຊ

࠾ࡼࡧ㊊㊑㛤 ᤼⬟ࡢྥ ୖࡀືⓗୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺࡢ▹ṇࡸ ືⓗࣂࣛ ࣥࢫ⬟ຊࢆ

ྥୖࡉࡏࡿࡇ ࡜࡛㸪⭸ 㛵⠇യᐖࡢῶ ᑡ࡟ᐤ୚ ࡉࡏࡿ࡜᥎  ࡋࡓࡀ㸪 ㊊㊑ ᢕᥱ➽

ຊࡸ㊊㊑㛤᤼ 㐠ື ࡀ⭸ 㛵⠇࡟ཬࡰࡍ ᙳ㡪࡟ࡘ ࠸࡚ ⤖ㄽ࡙ࡅ ࡿ࡟ࡣ㸪 ࡑࢀࡽࡢ࣓

࢝ࢽࢬ࣒ࢆヲ ⣽࡟᳨ド ࡍࡿᚲせࡀ࠶ ࡾ㸪௒ᚋ ࡢ◊✲ㄢ㢟 ࡜ ࡉࢀࡿ 㸬 ᭱ࡶയᐖⓎ

⏕⋡ࡢῶᑡࡀ ࡳࡽࢀࡓ ㊊㒊/ࡘࡲඛ࡟ࡘ࠸࡚㸪ྠയᐖ㒊఩ࡢ ௓ධ๓ࡢ യᐖࡢ ✀㢮 ࡢከࡃࡀ⭝⅖ ࡛࠶ࡗࡓ 㸬 ⭝⅖ࡣ៏ᛶ 㞀ᐖࡢ୍ ࡘ࡛࠶ࡿࡀ㸪 ㊊㊑ࢺࣞ ࣮ࢽࣥࢢ࡟

ࡼࡿ㊊㒊ࡢ࢔ ࣮ࢳ๛ᛶ ࡀ㧗ࡲࡿࡇ࡜ ࡛ ㊊㒊ࡢ Ᏻᐃᛶࢆྥୖ ࡉࡏ㸪 ࡉ ࡽ࡟ࡣ㊊㒊

࢔ࣛ࢖࣓ࣥࢺ ࡢ▹ṇ࡟ ࡘ࡞ࡀࡗࡓࡇ ࡜ ࡛៏ᛶ 㞀ᐖࡢῶᑡ࡟ ᐤ୚ࡉࡏ ࡓ ࡶࡢ࡜᥎  ࡍࡿ㸬

യᐖࡢ✀㢮࡟ ࡘ࠸࡚㸪 ௓ධᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ ࢆ᭱ࡶ పୗࡉࡏ ࡓࡢ ࡣ㸪 ⭝⅖/⭝ ࿘ᅖ ⅖ 㸪 ḟ࡟ ᡴ᧞/⾑ ⭘/᣸ യ㸪 ᤬᣸ ࡢ㡰 ࡛࠶ ࡗࡓ 㸬 ≉ ࡟㛵 ⠇ യ ᐖ࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚⪃ᐹࡍࡿ࡜ 㸪᤬᣸ ࡟ ࡼࡿയᐖࡢῶ ᑡࡀ㢧ⴭ ࡛࠶ࡗࡓ㸬

ୗ⫥㛵⠇യᐖ ண㜵࡟ᅛ ᭷ឤぬჾ ࡜⚄ ⤒➽༠ㄪ ᛶࡢྥୖ ࢆ≺ ࠸࡜ࡋࡓ ࢺ࣮ࣞࢽࣥ

ࢢࡀከᩘ⾜ࢃ ࢀ࡚࠸ࡿ ࡀ 㸪ඛ㏙ࡋࡓ ㊊㊑ࢺࣞ ࣮ࢽࣥࢢࡀ ࣓ ࢝ࣀࣞࢭ ࣉࢱ࣮ ࢆ㈿

άࡉࡏ㸪⚄⤒ 㐠ືჾᙉ ㄪࢆᨵၿࡉࡏ ࡿ[஭ཎ, 1996]࡜࠸ࡗࡓሗ࿌ ࠿ ࡽࡶ㸪㊊㊑㛤

᤼࠾ࡼࡧ㊊㊑ ᢕᣢືస ࡀ⚄⤒➽༠ㄪ ᛶࢆྥୖ ࡉࡏࡓࡇ࡜ࡀ ᤬᣸യᐖ ࡢῶᑡ࡟ ᐤ

୚ࡉࡏࡓࡢ࡛ ࡣ࡞࠸࠿ ࡜⪃࠼ ࡓ㸬ࡲ ࡓ㸪ඛ⾜ ◊✲㸦 ◊✲ 5㸪7㸧࡛ ࡢ᳨ド࡛㸪㊊

㊑ᢕᥱຊ࡜ୗ ⫥ࣂࣛࣥ ࢫಖᣢ⬟ຊ࡜ ࡟᭷ព࡞ 㛵㐃ᛶࢆ♧ࡋ ࡓࡇ࡜㸪 ㊊㊑ᢕᥱຊ ࡢඃࢀࡿ⪅ࡣ ࡑ࠺࡛࡞ ࠸⪅࡜ẚ࡭࡚ 㸪๓᪉ࡢ ࡳ࡛ࡣ࠶ࡗࡓ ࡀືⓗࣂ ࣛࣥࢫಖᣢ

⬟ຊ࡟ඃࢀ࡚ ࠸ࡓࡇ࡜ 㸪 ㊊㊑ෆᅾ➽ ࠾ࡼࡧ㊊ 㒊እᅾ➽ࡢ➽ ⥭ᙇࡀ࢔ ࣮ࢳ๛ᛶࢆ

㧗ࡵ㸪㊊㒊Ᏻ ᐃᛶ࡟ᐤ ୚ࡉࡏࡿ࡜࠸ ࡗࡓ⪃ᐹ ࠿ࡽࡶ㸪ࡑࢀ ࡽࡀ ᤬᣸ യᐖࡢῶᑡ

172

࡟ᐤ୚ࡉࡏࡓ ࡜᥎ ࡍ ࡿ 㸬

യᐖࡢཎᅉู ࡟ࡼࡿ ௓ ධᚋࡢയᐖⓎ ⏕ᩘ࠾ࡼ ࡧയᐖⓎ⏕⋡ ࡢኚ໬࡟ ࡘ࠸࡚ࡣ 㸪

᭱ࡶపୗࡉࡏ ࡓയᐖࡢ ཎᅉࡣ᥋ゐᆺ യᐖ㸦௚ ࡢ㑅ᡭ㸧㸪ḟ ࡟㠀᥋ゐ ᆺ യᐖ㸪౑

࠸ࡍࡂ࡛࠶ࡗ ࡓ㸬 ࡇࢀ ࡟ࡘ࠸࡚ࡶ◊ ✲ 2㸪5㸪7 ᳨࡛ドࡉࢀ ࡓ㊊㊑ 㛤᤼⬟ ࡸ㊊㊑

ᢕᥱຊࡀୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺ▹ṇࡸ㟼 ⓗ ࠾ࡼࡧ ືⓗࣂࣛࣥࢫ ⬟ຊ ྥୖ ࡟ᐤ୚ࡉࡏ 㸪 യᐖⓎ⏕⋡ῶ ᑡ࡟ࡘ࡞ ࡀࡗࡓྍ⬟ᛶ ࡀ⪃࠼ࡽ ࢀࡿࡀ㸪᥋ゐ ᆺ യᐖࡣ ୺࡟እⓗせ ᅉ࡟ࡼࡗ࡚Ⓨ ⏕ࡍ ࡿയ ᐖ࡛࠶ࡾ㸪ᮏ ◊✲࡛ᚓ ࡽࢀࡓ⤖ᯝ࠿ ࡽ⪃ᐹࡍ ࡿࡢࡣᅔ㞴

࡛࠶ࡿ࡜⪃࠼ ࡓ㸬

യᐖࡢᅇᩘ࠾ ࡼࡧയᐖ Ⓨ⏕⋡ ࡟ࡘ࠸ ࡚㸪 ≉࡟ യᐖⓎ⏕⋡ࡀ పୗࡋࡓ ࡢࡣึᅇ

ཷയ࡛࠶ࡗࡓ ࡀ㸪 ◊ ✲ 1 ࠾ࡼࡧඛ⾜ㄽ ᩥ[బ㔝ᮧࡽ㸪2012]ࡢ⤖ ᯝ࡛ ♧ࡉࢀࡓ 2 ᅇ┠௨ୖࡢ෌ യᐖࡢ๭ ྜࡀ඲യᐖࡢ 1/4 ࢆ༨ࡵࡿࡇ࡜ࡀ኱ ᏛዪᏊࣛ ࢡࣟࢫയᐖ ࡢ≉ᚩ࡛࠶ࡾ 㸪ึᅇཷ യࡢῶᑡࡣ㸪 ࡑࢀ௨ᚋ ࡟Ⓨ⑕ࡍࡿྠ 㒊఩ࡢയ ᐖ ࡢῶᑡ࡟

ᐤ୚ࡉࡏࡿ࡜ ⪃࠼ࡿ㸬

௓ධ๓ᚋࡢ➇ ᢏ᚟ᖐࡲ ࡛ࡢᮇ㛫࡜യ ᐖⓎ⏕ᩘ ࠾ࡼࡧയᐖⓎ ⏕⋡ ࡟ࡘ ࠸࡚㸪᭱

ࡶῶࡌࡉࡏࡓ ᚟ᖐࡲ࡛ ࡢᮇ㛫 ࡢⓎ⏕ ⋡ࡣ 1㹼2 ᪥࡛࠶ࡾ 㸪ḟ࡟ 3㹼7 ᪥㸪4㐌㹼6

ࣨ᭶࡛࠶ࡗࡓ 㸬ࡇ ࢀࡽ ࡢ⤖ᯝ࠿ࡽ㸪7 ᪥௨ෆ ࡢẚ㍑ⓗ▷ᮇ 㛫࡛ࡢ➇ ᢏ᚟ᖐ ྍ⬟

࡞യᐖࡢῶᑡ ࡜㸪4㐌 㹼6 ࣨ᭶࡜࠸࠺ ୰࣭㛗 ᮇ 㛫࡛ࡢ➇ᢏ ᚟ᖐྍ⬟ ࡞ യᐖࡢῶᑡ ࡀࡳࡽࢀࡓ㸬ࡇࢀࡣ㸪യᐖࡢ✀㢮ࡢ ୰ ࡛യᐖ Ⓨ⏕⋡ ࡢపୗ ࡀ㢧ⴭ࡛ ࠶ࡗࡓ ᡴ᧞/

⾑ ⭘/᣸ യ ࠾ ࡼ ࡧ ➽ ⫗ ③/ࢫ ࣃ ࢬ ࣒ ࡜ ࠸ ࡗ ࡓ ẚ ㍑ ⓗ ▷ ᮇ 㛫 ࡛ ࡢ ᚟ ᖐ ࡀ ண   ࡉ ࢀ ࡿ യᐖࡢῶᑡࡀ ᙳ㡪ࡋࡓ ࡢ࡛ࡣ࡞࠸࠿ ࡜ ⪃࠼ࡓ 㸬ࡲࡓ㸪୰࣭ 㛗ᮇ ࡢ➇ ᢏ᚟ᖐᮇ㛫 ࡢῶᑡ࡟ࡘ࠸ ࡚ࡣ㸪៏ ᛶയᐖࡢ୍ࡘ ࡛࠶ࡿ ⭝ ⅖/⭝࿘ᅖ⅖ࡢ㢧ⴭ࡞ ῶᑡࡀ㸪യᐖ

Ⓨ⏕⋡ࡢῶᑡ ࡟ ᐤ୚ࡋ ࡓࡢ࡛ࡣ࡞࠸ ࠿࡜ ⪃࠼ ࡓ㸬

ᮏ◊✲࡛⾜ࡗ ࡓ ୗ⫥യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢࡣ 㸪௓ධᮇ 㛫⣙43㐌㛫㸦304᪥㛫㸧㸪 ࢺ࣮ࣞࢽࣥࢢ 㢖ᗘࡣ㐌 ࠶ࡓࡾ ⣙ 4 ᅇ 㸪1ᅇ ࡟ ⾜ࡗࡓ᫬㛫 ࡣ 20 ศ⛬ ᗘ࡛࠶ ࡿ 㸬ከ

ᩘࡢඛ⾜ㄽᩥ ࠿ࡽࡳࡽ ࢀࡿண㜵ࢺࣞ ࣮ࢽࣥࢢ ࡣ㸪 ௓ධᮇ㛫 ⣙ 6㐌࠿ ࡽ 12㐌㛫㸪 㢖ᗘࡣ㐌 2㹼3 ᅇ㸪᫬ 㛫ࡣ 1 ᅇ࡟ࡘ ࡁ 10 ศ ࠿ࡽ 30 ศ⛬ᗘ࡛ ࠶ࡗ ࡓ㸬ᮏ◊✲࡜ඛ

⾜ㄽᩥ࡜ࡶ࡟ 㸪௓ධࡢ ࢱ࢖࣑ࣥࢢ࡟ ࡘ࠸࡚ࡣ 㸪⦎⩦๓࡟⾜ ࢃࢀ ࡚࠸ ࡿ࢛࣮࣑࢘

ࣥࢢ࢔ࢵࣉࡢ ୰࡛ᐇ᪋ ࡉࢀ࡚࠸ࡿ 㸬 ඛ⾜ㄽᩥ ࡜ࡢ㐪࠸ࡣ㸪 ᮏ◊✲ࡣ ௓ධᮇ㛫ࡀ 㛗࠸Ⅼ࡜㸪㐌 ࠶ࡓࡾࡢ ࢺ࣮ࣞࢽࣥࢢ ᅇᩘ ࡀከ ࠸Ⅼ࡛࠶ࡿ㸬 ࢺ࣮ࣞࢽ ࣥࢢෆᐜ࡟

173

ࡘ࠸࡚ࡣ㸪ඛ ⾜◊✲࡛ ࡣ ࣉࣛ࢖࣓ࢺ ࣜࢵࢡせ ⣲ ࢆྲྀࡾධࢀ ࡓࢺ࣮ࣞ ࢽࣥࢢࡀከ ࡃࢆ༨ࡵ㸪ࣂ ࣛࣥࢫ⬟ ຊྥୖࢆ≺࠸ ࡜ࡋࡓ ࢺ ࣮ࣞࢽࣥࢢࡶ 」ᩘࡳࡽ ࢀࡿ㸬ࢪࣕ

ࣥࣉࢺ࣮ࣞࢽ ࣥࢢࡸ ࣂ ࣛࣥࢫࢺ࣮ࣞ ࢽࣥࢢࡣ 㸪 ⚄⤒➽ࢥࣥ ࢺ࣮ࣟࣝ ࡸᅛ᭷ឤぬ ჾࡢྥୖ࡟↔ Ⅼࢆᙜ࡚ ࡓ ࢺ࣮ࣞࢽࣥ ࢢ࡛࠶ࡿ 㸬ᮏ◊✲ ࡛⾜ࡗࡓ ࢺࣞ ࣮ࢽࣥࢢࡣ 㸪 ࢪࣕࣥࣉࢺࣞ ࣮ࢽࣥࢢ ࡸࣂࣛࣥࢫࢺ ࣮ࣞࢽࣥ ࢢ ࡛ࡣ࡞ࡃ㸪 ㏻ᖖ⾜ࢃ ࢀ࡚࠸ࡿ ࢘

࢛࣮࣑ࣥࢢ࢔ ࢵࣉ ࡢ✀ ┠࡜ࡋ࡚⾜ࢃ ࢀ࡚࠸ࡿ ࣛࣥࢪ㸪᪉ྥ ㌿᥮㉮㸪 ษࡾ࠿࠼ࡋ

ືస㸪ࢧ࢖ࢻ ࢫࢸࢵࣉ 㸪ࢲࢵࢩࣗ࠿ ࡽࡢ ࢫࢺ ࢵࣉ➼ࡢືస ᫬࡟͆㊊ ㊑ࢆ㛤࠸࡚

ᗋࢆᥗࡴ͇ື సࢆ⾜ࢃ ࡏ ࡿ࡜࠸ࡗࡓ ᣦᑟἲࢆ ⏝࠸ࡓⅬ࡟኱ ࡁ࡞≉ᚩ ࢆᣢࡘࡀ㸪 ᮏㄽᩥ◊ ✲ 2 ࡛㸪㊊㊑ 㛤᤼ᣦ♧ࡀ㸪≉࡟ࣛࣥ ࢹ࢕ࣥࢢືస ᫬ࡢ ͆knee-in͇➼ࡢ

ືⓗୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࢆไᚚࡏࡿ࡜ ࠸࠺⤖ㄽ ࠿ࡽ㸪ࡲࡓ㸪 ◊✲ 5 ࡛ ㊊㊑ᢕᥱຊ ࡢඃࢀࡿ⪅ࡣ ㊊㒊࢔࣮ ࢳ๛ᛶࡀ㧗ࡲ ࡿࡇ࡜࡛ ㊊㒊ࢆᏳᐃࡉ ࡏ㸪 㟼ⓗ ୗ⫥ࣂࣛࣥ

ࢫಖᣢ⬟ຊྥ ୖ࡟ᐤ୚ ࡉࡏࡿࡇ࡜㸪 ㊊㊑ᢕᥱ ຊࡢඃࢀࡿ⪅ ࡣ๓᪉࡬ ࡢືⓗࣂࣛ

ࣥࢫಖᣢ⬟ຊ ࡀඃࢀ㸪 ∦⬮࠾ࡼࡧ୧ ⬮╔ᆅື స᫬ࡢ㊊㊑ᢕ ᣢືసᣦ ♧ࡀ ㊊㛵⠇

ࡸ⭸㛵⠇യᐖ ࡢῶᑡ࡟ ᐤ୚ࡉࡏࡿྍ ⬟ᛶࢆ♧ ၀ ࡋࡓࡇ࡜㸪 ◊✲ 7 ࡛ 㸪㊊㊑㛤᤼

ືసࡸ㊊㊑ᢕ ᣢືస ᣦ ♧ࡣ㸪ᑠ㊑እ ㌿➽ࡸẕ ㊑እ㌿➽ࡢ ㊊ 㒊ෆᅾ➽ ࡸ㊊㒊እᅾ

➽ࡢ➽⥭ᙇ࡟ ࡼࡾ㸪 ㊊ 㒊࢔࣮ࢳࡢ๛ ᛶ ࡀ㧗ࡲ ࡿࡇ࡜࡛㸪㊊ 㒊ࡢᏳᐃ ᛶ࡟ᐤ୚ࡉ ࡏࡓࡇ࡜㸪ࡑ ࡋ࡚㊊㊑ ࢺ࣮ࣞࢽࣥࢢ ࡀ ㊊㊑ࡢ ࣓࢝ࣀࣞࢭࣉ ࢱ࣮ࢆά ᛶ໬ࡉࡏ㸪 እຊ࡟ᑐࡍࡿ ࣇ࢕࣮ࢻ ࣂࢵࢡไᚚ࡟ ࡼࡾ㊊㒊 ࡢᶵ⬟ⓗᏳᐃ ᛶ࡟ᐤ୚ ࡉࡏࡿ࡜࠸

࠺ඛ⾜ㄽᩥ࠿ ࡽࡢሗ࿌ ࢆྵࡵ࡚ 㸪㊊ 㛵⠇യᐖ ࢆྵࡵࡓୗ⫥ ඲యࡢയ ᐖⓎ⏕⋡ࡢ ῶᑡ࡟ᐤ୚ࡉ ࡏࡓྍ⬟ ᛶࡀ♧၀ࡉࢀ ࡓ㸬

ᮏ◊✲ࡢၥ㢟 Ⅼ࡜ࡋ࡚ 㸪 ◊✲ 7 ྠᵝ 㸪ࢥࣥࢺ ࣮ࣟࣝ⩌ࢆタ ᐃࡋ࡚࠾ ࡽࡎ㸪௓

ධ⩌࡜ࢥࣥࢺ ࣮ࣟࣝ⩌ ࡢẚ㍑᳨ドࡀ ᚲせ࡛࠶ ࡿ࡜⪃࠼ࡿ㸬 ࡲࡓ㸪ᑐ ㇟⪅ᩘ࡜ࢺ

࣮ࣞࢽࣥࢢ௓ ධᮇ㛫࡟ ࡘ࠸࡚㸪 ࢺࣞ ࣮ࢽࣥࢢ ௓ධຠᯝ᳨ド ࡟ࡣ 㸪ᩘ ⓒே௨ୖࢆ

ᑐ㇟࡜ࡋࡓ◊ ✲ࡀ㸪ࡉ ࡽ࡟ࡣࡼࡾ㛗 ࠸௓ධᮇ 㛫ࡀᚲせ࡛࠶ ࡿ࡜⪃࠼ 㸪 ᮏ◊✲࡛

⾜ࡗࡓᑐ㇟⪅ ᩘ࡜௓ධ ᮇ㛫࡟ࡼࡾ ᚓ ࡽࢀࡓ⤖ ᯝ ࠿ࡽ⤖ㄽࢆ ฟࡍࡢࡣ 㝈⏺ࡀ࠶ࡿ

࡜⪃࠼ࡿ㸬

174

6-8-5. ⤖ㄒ

኱ᏛዪᏊࣛࢡ ࣟࢫ➇ᢏ ࢆᑐ㇟࡜ࡋ ࡓ 㸪ୗ⫥യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢ ௓ ධࡀୗ⫥

യᐖⓎ⏕⋡➼ ࡬ཬࡰࡍ ᙳ㡪࡟ ࡘ࠸࡚ ẚ㍑᳨ド ࡍࡿࡇ࡜ࢆ┠ ⓗ࡜ࡋ㸪 ㏻ᖖ⾜ࢃࢀ

࡚࠸ࡿ࢛࣮࢘ ࣑ࣥࢢ࢔ ࢵࣉ࣓ࢽ࣮ࣗ ࡢ ୰ࡢࣛ ࣥࢪࡸࢪࣕࣥ ࣉ࠿ࡽࡢ ╔ᆅ ືస㸪 ࢧ࢖ࢻࢫࢸࢵ ࣉ➼ࡢ ື స᫬࡟͆㊊㊑ ࢆ㛤࠸࡚ ᗋࢆᥗࡴ ͇ࢆ ᣦ♧ࡍࡿ ືసᣦᑟἲ ࡢ௓ධ࡟ࡼࡾ ᚓࡽࢀࡓ ⤖ᯝࡣ 㸪௓ධ ᚋࡣ௓ධ ๓࡜ẚ㍑ࡋ࡚ 㸪

1) ⥲യᐖⓎ⏕ᩘ ࠾ࡼࡧ ⥲ യᐖⓎ⏕⋡ࢆ ῶᑡࡉࡏ ࡓ㸬

2) യ ᐖ ࡢ 㒊 ఩ ࡟ࡘ ࠸ ࡚ ࡣ 㸪 ୺ ࡟ ㊊ 㒊/ࡘ ࡲ ඛ 㸪 ୗ ⭣ 㸪 ⫤ 㛵 ⠇യ ᐖ Ⓨ ⏕ ⋡ ࢆ ῶ ᑡ ࡉࡏࡓ㸬ࡲࡓ㸪ࢃ ࡎ࠿ ࡛ࡣ࠶ࡿࡀ㊊ 㛵⠇യᐖ Ⓨ⏕⋡ࢆῶᑡ ࡉࡏࡓ㸬ୗ⫥඲య ࡢ യ ᐖ Ⓨ ⏕ ⋡ࡢ ῶ ᑡ ࡀ 㢧 ⴭ ࡛ ࠶ ࡗ ࡓ㸬 യ ᐖ ࡢ ✀ 㢮 ࡟ ࡘ ࠸ ࡚ࡣ 㸪 ⭝ ⅖/೺ ࿘ ᅖ

⅖㸪ᡴ᧞/⾑⭘/᣸യ㸪᤬᣸യᐖⓎ⏕⋡ ࢆῶᑡࡉ ࡏࡓ㸬യᐖࡢཎ ᅉ ࡟ࡘ ࠸࡚ࡣ㸪 ᥋ゐᆺയᐖ㸦 ௚ࡢ㑅ᡭ 㸧㸪㠀᥋ゐᆺയ ᐖ㸪౑ ࠸ࡍࡂ㸦ᚎࠎ ࡟㸧࡟ࡼ ࡿയᐖⓎ

⏕⋡ࢆῶᑡࡉ ࡏ ࡓ㸬

3) യᐖࡢᅇᩘ࡟ ࡘ࠸࡚ ࡣ 㸪≉࡟ึᅇཷയ Ⓨ⏕⋡ ࢆῶᑡࡉࡏ 㸪➇ ᢏ᚟ᖐ ࡲ࡛ࡢᮇ 㛫࡟ࡘ࠸࡚ࡣ㸪1㹼2 ᪥ ࡜ 3㹼7 ᪥࡛➇ᢏ ᚟ᖐ ྍ⬟࡛࠶ࡗࡓ യᐖ Ⓨ⏕ ⋡ࢆῶᑡ ࡉࡏࡓ㸬

4) ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ࣓ ࢽ࣮ࣗ ࡛⾜ࢃ ࢀ࡚࠸ࡿ ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪ࢧ࢖

ࢻࢫࢸࢵࣉ 㸪ࣛࣥࢪ ➼ ࡢືస᫬࡟㊊ ㊑㛤᤼ ࠾ ࡼࡧ㊊㊑ᢕᣢ ࢆ ᣦ♧ࡍ ࡿᣦᑟἲ ࡣ㸪㊊㊑ᢕᥱຊ ࡸ㊊㊑ 㛤᤼⬟ ࢆྥୖ ࡉࡏ 㸪㟼 ⓗ࠾ࡼࡧືⓗ ୗ⫥ࣂࣛ ࣥࢫ⬟ຊ

ࢆྥୖࡉࡏࡿ ࡜࠸࠺ ඛ ⾜⤖ᯝࢆ㏻ࡋ ࡚㸪ୗ ⫥ യᐖⓎ⏕⋡ࡢ ῶᑡ ࡀ㢧 ⴭ࡟♧ࡉ

ࢀࡓࡇ࡜࠿ࡽ 㸪ୗ⫥ യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢࡢ ᣦᑟἲࡢ୍ࡘ ࡟࡞ࡿྍ ⬟ᛶࡀ♧

၀ࡉࢀࡓ㸬

175

7

⥲ྜ⪃ᐹ

176

⥲ྜ ⪃ᐹ

ᮏ◊✲ࡣ㸪ࢫ ࣏࣮ࢶയ ᐖ ண㜵ࡢྲྀࡾ ⤌ࡳ࡜ࡋ ࡚㸪van Mechelen ࡽ ࡀ♧ࡋࡓ 4 ẁ㝵ࣔࢹࣝࢆ ౛࡟኱Ꮫ ዪᏊࣛࢡࣟࢫ ➇ᢏࢆᑐ ㇟ ࡟㸪ࢫ࣏࣮ ࢶയᐖࡢ ᐇែࡢᢕᥱ

࡜യᐖண㜵ࡢ ᐇ㊶ ࢆࢸ ࣮࣐࡟㸪㊊㛵 ⠇࡜⭸๓ ༑Ꮠ㠌ᖏയᐖ ࡟↔Ⅼࢆ ᙜ࡚࡚ ◊✲

࠾ࡼࡧ᳨ドࢆ ⾜ࡗࡓ㸬 ᮏ◊✲࡛ᚓࡽ ࢀࡓ ⤖ᯝ ࡜⤖ㄽࢆ௨ୗ ࡟♧ࡍ㸬

Ϩ㸬኱ᏛዪᏊ ࣛࢡࣟࢫ ➇ᢏࢆᑐ㇟࡟ 㸪യᐖࡢ 㒊఩࣭✀㢮࣭ ཎᅉ➼ࡢ യᐖࡢ≉ᚩ

ࢆ᫂ࡽ࠿࡟ࡍ ࡿࡇ࡜ࢆ ┠ⓗ࡟㸪2 ᖺ㛫ࡢയᐖ ㄪᰝࢆ⾜࠸㸪 ᚓࡽࢀࡓ ୺࡞⤖ᯝ

ࢆ௨ୗ࡟♧ࡍ 㸦◊ ✲ 1㸧㸬

1) ඲യᐖࡢ 9 ๭௨ୖࡀ ⦎ ⩦᫬࡟Ⓨ⏕ࡋ 㸪ヨྜ ᫬ ࡟Ⓨ⏕ࡋࡓയ ᐖࡣ 1 ๭ ⛬ᗘ

࡛࠶ࡗࡓ㸬

2) ᭱ࡶ ከࡃ Ⓨ⏕ ࡋࡓ യᐖ 㒊఩ ࡣ ͂ ㊊㛵 ⠇̓ 㸪ḟ ࡟͂ ⭸㛵 ⠇̓ ࡛㸪 ୗ⫥ ࡢയ ᐖ࡟ࡘ࠸࡚ࡣ ඲യᐖ ࡢ 7 ๭⛬ ᗘࢆ༨ࡵ ࡚࠸ ࡓ㸬യᐖࡢ✀ 㢮 ࡛᭱ࡶ ከ࠸ࡢ ࡣ͂ ᤬᣸ ࡛̓ 㸪യ ᐖࡢ ཎᅉ ࡟ࡘ ࠸࡚ ࡣ ͂ ౑࠸ ࡍࡂ ̓࡟ ࡼࡿ ࡶࡢ ࡀ ᭱ ከ࡛

࠶ࡗࡓ㸬

3) ኱Ꮫ ዪᏊ ࣛࢡ ࣟࢫ ࡢ୺ ࡓࡿ യᐖ ࡢ≉ ᚩࡣ ͂㠀 ᥋ゐ ᆺࡢ ㊊㛵 ⠇᤬ ᣸ ̓ ࡛࠶

ࡗࡓ㸬

4) ඲യᐖࡢ 3 ๭ ⛬ᗘࡀ㸪 ྠ㒊఩ࡢ෌ཷ യࢆ㈇ࡗ ࡚࠸ࡓ 㸬

5) ᏛᖺูയᐖⓎ ⏕⋡࡟ࡘ ࠸࡚ ࡣ㸪4ᖺ⏕ ࡢയᐖ Ⓨ⏕⋡ࡀ᭱ࡶ 㧗ࡃ㸪1ᖺ⏕࡜

ẚ࡭࡚࠾࠾ࡼ ࡑ 2ಸ㧗 ࠸Ⓨ⏕⋡ࢆ♧ ࡋࡓ 㸬

6) ࣏ࢪࢩูࣙࣥ ࡟ࡳࡓയ ᐖ Ⓨ⏕ᩘࡣ㸪 ࣑ࢵࢻࣇ ࢕ࣝࢲ࣮ࡀ᭱ ࡶ ከ࠿ࡗ ࡓ㸬 7) ኱Ꮫ࠿ࡽࣛࢡ ࣟࢫ➇ᢏ ࢆ㛤ጞ ࡋࡓࡶ ࡢࡀ඲య ࡢ 95㸣⛬ᗘࡳࡽࢀ ࡓ 㸬 ϩ㸬◊✲ 2 ࡛ࡣ㸪ୗ⫥ യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ௓ධ᳨ウࡢࡓ ࡵࡢᇶ♏ ⓗ◊✲࡜ࡋ

࡚㸪㊊㊑ᶵ⬟ ࡜ືⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ ࡜ࡢ㛵 㐃ᛶࡸ㊊㊑ᶵ ⬟ࡀືⓗ ୗ⫥࢔ࣛ

࢖࣓ࣥࢺ࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸᳨࡚ウ ࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ࡋ㸪 ∦⬮ࢫࢡ ࣡ࢵࢺ㸪

∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ ࢕ ࣥࢢ㸪࢝ࢵࢸ ࢕ࣥࢢ ࢆ ㄢ㢟ືస࡟タ ᐃࡋ ࡚⾜ ࠸㸪௨ୗ

ࡢ⤖ㄽࢆᚓࡓ 㸬

1) ∦⬮ ࢫࢡ ࣡ࢵ ࢺ᫬ ࡜∦ ⬮ࢻ ࣟࢵ ࣉࣛ ࣥࢹ ࢕ࣥ ࢢ᫬ ࡢ ㊊ ㊑㛤 ᤼⬟ ࡜⭸ ෆ᪉ ೫఩ ⋡㸪 ⭸እ ཯⋡ 㸪⫤ 㛵⠇ ෆ㌿ ゅࡢ ࢫࢱ ࣥࢹ ࢕ࣥ ࢢ࣏ ࢪࢩ ࣙࣥ ࠿ࡽ ࢫࢡ

࣡ࢵࢺ࣏ࢪࢩ ࣙࣥࡲ࡛ ࡢኚ໬㔞 ࡜ࡢ 㛫࡟᭷ព ࡞㈇ࡢ┦㛵ࡀ ㄆࡵࡽࢀ ࡓ㸬

177

2 ) ㊊ᣦ 㛤᤼ ⬟ࡢ ᑠ࣭ ୰࣭ ኱⩌ ࡢẚ ㍑࡟ ࠾࠸ ࡚㸪 ∦⬮ ࢻࣟ ࢵࣉ ࣛࣥ ࢹ࢕ ࣥࢢ

࡛ࡣ 㸪㊊ ㊑㛤 ᤼⬟ ࡟ඃ ࢀ࡚ ࠸ࡿ ࡶࡢ ࡣ୰ ➼ᗘ ࡟㊊ ㊑㛤 ᤼ࡢ ࡛ࡁ ࡿࡶ ࡢ࡟

ẚ࡭ ࡚᭱ ኱ࡋ ࡷࡀ ࡳࡇ ࡳ᫬ ࡢ⭸ ෆ᪉ ೫఩ ⋡ࡀ ࡼࡾ ᑠ࡛ ࠶ࡗ ࡓ㸬 ㊊㊑ 㛤᤼

⬟࡟ ඃࢀ ࡚࠸ ࡿࡶ ࡢࡣ ୰➼ ᗘ࡟ ㊊㊑ 㛤᤼ ࡢ࡛ ࡁࡿ ࡶࡢ ࠾ࡼ ࡧ㊊ ㊑㛤 ᤼⬟

࡟ஈ ࡋ࠸ ࡶࡢ ࡟ẚ ࡭᭱ ኱ࡋ ࡷࡀ ࡳࡇ ࡳ᫬ ࡢ⭸ እ཯ ⋡ࡀ ࡼࡾ ᑠ࡛ 㸪╔ ᆅ᫬

࠿ࡽ ᭱኱ ࡋࡷ ࡀࡳ ࡇࡳ ᫬ࡲ ࡛ࡢ ⭸ෆ ᪉೫ ఩⋡ ࡢኚ ໬㔞 ࡀࡼ ࡾᑠ ࡛࠶ ࡗࡓ 㸬

㊊㊑ 㛤᤼ ⬟࡟ ඃࢀ ࡚࠸ ࡿࡶ ࡢࡣ ୰➼ ᗘ࡟ ㊊㊑ 㛤᤼ ࡢ࡛ ࡁࡿ ࡶࡢ ࡟ẚ ࡭╔

ᆅ᫬ ࠿ࡽ ᭱኱ ࡋࡷ ࡀࡳ ࡇࡳ ᫬ࡲ ࡛ࡢ ⭸እ ཯⋡ ࡢኚ ໬㔞 ࡶࡼ ࡾᑠ ࡛࠶ ࡗࡓ 㸬

╔ᆅ ᫬ࡢ ⫤㛵 ⠇ෆ ㌿ゅ 㸪╔ ᆅ᫬ ࠿ࡽ ᭱኱ ࡋࡷ ࡀࡳ ࡇࡳ ᫬ࡲ ࡛ࡢ ⫤㛵 ⠇ෆ

㌿ゅ ࡢኚ ໬㔞 ࠸ࡎ ࢀࡶ ࡀ㸪 ㊊㊑ 㛤᤼ ⬟࡟ ඃࢀ ࡚࠸ ࡿࡶ ࡢࡣ ୰➼ ᗘ࡟ ㊊㊑

㛤᤼ ࡢ࡛ ࡁࡿ ࡶࡢ ࠾ࡼ ࡧ ㊊ ㊑㛤 ᤼⬟ ࡟ஈ ࡋ࠸ ࡶࡢ ࡟ẚ ࡭㸪 ࡼࡾ ᑠ࡛ ࠶ࡗ ࡓ㸬

3) ㊊㊑ 㛤᤼ ᣦ♧ ࡢ᭷ ↓ࡢ ẚ㍑ ࡛ࡣ 㸪 ∦ ⬮ࢻ ࣟࢵ ࣉࣛ ࣥࢹ ࢕ࣥ ࢢ࡟ ࠾࠸ ࡚㸪

࢖ࢽ ࢩࣕ ࣝࢥ ࣥࢱ ࢡࢺ ࡢ⭸ ෆ᪉ ೫఩ ⋡࠾ ࡼࡧ ⭸እ ཯⋡ ࢆ᭷ ព࡟ ቑຍ ࡉࡏ 㸪

ࣛࣥ ࢹ࢕ ࣥࢢ ࣏ࢪ ࢩࣙ ࣥࡢ ⫤㛵 ⠇ෆ ㌿ゅ ࢆ᭷ ព࡟ ῶᑡ ࡉࡏ ࡓ㸬 ࡋ࠿ ࡋ࢖

ࢽࢩ ࣕࣝ ࢥࣥ ࢱࢡ ࢺ࠿ ࡽࣛ ࣥࢹ ࢕ࣥ ࢢ࣏ ࢪࢩ ࣙࣥ ࡲ࡛ ࡢ⭸ እ཯ ⋡ࡢ ኚ໬

㔞ࡣ᭷ព࡟ῶ ᑡࡋࡓ㸬

4) ㊊㊑㛤᤼ࡀඃ ࢀࡿࡶࡢ ࡣ㸪㊊ ㊑㛤᤼࠾ ࡼࡧ㊊ ㊑ᢕᣢ ືసࡢ ᣦ♧࡜࡜ ࡶ࡟㸪

≉࡟ ∦⬮ ࢻࣟ ࢵࣉ ࣛࣥ ࢹ࢕ ࣥࢢ ࡟࠾ ࠸࡚ ⭸㛵 ⠇እ ཯ࢆ ࡼࡾ ไᚚ ࡋࡓ 㸬㊊

㊑㛤 ᤼⬟ ࢆ㧗 ࡵࡿ ࢚ࢡ ࢧࢧ ࢖ࢬ ࡜ࠕ ㊊㊑ ࢆ㛤 ࠸࡚ ᗋࢆ ᥗࡴ ࠖ࡜ ࠸࠺ ືస ᣦ♧ ࡣ㸪 ࢪࣕ ࣥࣉ ࠿ࡽ ࡢ╔ ᆅື స࡟ ࡚ከ Ⓨࡍ ࡿ⭸ ๓༑ Ꮠ㠌 ᖏയ ᐖࢆ ྵࡵ

ࡓୗ ⫥യ ᐖண 㜵࡟ ࡘ࡞ ࡀࡿ ྍ⬟ ᛶࡢ ࠶ࡿ 㐠ື ᣦᑟ ἲࡢ ୍ࡘ ࡜ࡋ ࡚ࡑ ࡢ᭷

⏝ᛶࡀ♧၀ࡉ ࢀࡓ㸬

Ϫ㸬ዪᏊࣛࢡ ࣟࢫ യᐖ Ⓨ⏕ࡢཎᅉ㸪 യᐖ࣓࢝ ࢽࢬ࣒ࢆ᫂ࡽ ࠿࡟ࡍࡿ ࡇ࡜ ࢆ┠ⓗ

࡜ࡋ㸪≉࡟യ ᐖ㔜⑕ᗘ ࡢ 㧗࠸⭸๓༑ 㠌ᖏ യᐖ Ⓨ⏕࣓࢝ࢽࢬ ࣒ ࡟╔┠ ࡋ࡚ືసศ ᯒࢆ⾜ࡗࡓ㸬 ㄢ㢟ືస ࡣࢻࣟࢵࣉ ࣂ ࣮ࢸ࢕࢝ ࣝ ࢪࣕࣥࣉ࡜ ࢝ࢵࢸ࢕ ࣥࢢືస ࡛

178

࠶ࡾ㸪ࣛࢡࣟ ࢫࢫࢸ࢕ ࢵࢡࡢಖᣢ ࠶ ࡾ࣭࡞ࡋ ࡛⾜ࢃࡏࡓ࡜ ࡁࡢ ືⓗ ୗ⫥࢔ࣛ࢖

࣓ࣥࢺࡢኚ໬ ࢆẚ㍑᳨ ドࡋ 㸦◊ ✲ 3㸪4㸧㸪 ᚓࡽࢀࡓ⤖ᯝ ࡣ㸪

1) ࣛࢡ ࣟࢫ ࢫࢸ ࢕ࢵ ࢡ ࢆ ಖᣢ ࡉࡏ ࡚⾜ ࢃࡏ ࡓ ࢻ ࣟࢵ ࣉࣂ ࣮ࢸ ࢕࢝ ࣝ ࢪ ࣕࣥ

ࣉືసࡣ㸪ಖ ᣢ࡞ࡋࡢ ᫬࡜ẚ࡭࡚㸪 ⭸㛵⠇ᒅ ᭤ゅᗘ ࡀ᭷ព ࡟ ῶᑡࡋ ࡓ㸬 2) ࣛࢡ ࣟࢫ ࢫࢸ ࢕ࢵ ࢡ ࢆ ಖᣢ ࡉࡏ ࡚⾜ ࢃࡏ ࡓ࢝ ࢵࢸ ࢕ࣥ ࢢື సࡣ 㸪ಖ ᣢ࡞

ࡋࡢ᫬࡜ẚ࡭ ࡚㸪⫤㛵 ⠇ෆ㌿ゅᗘ ࡀ ᭷ព࡟ቑ ຍࡋࡓ㸬

3) ࣛࢡ ࣟࢫ ➇ᢏ ≉Ṧ ᛶࡢ ୍ࡘ ࡛࠶ ࡿࢫ ࢸ࢕ ࢵࢡ ࢆಖ ᣢࡋ ࡓ≧ ែ࡛ ࡢࢪ ࣕࣥ

ࣉ࠿ࡽࡢ╔ᆅ ࡸ࢝ࢵࢸ ࢕ࣥࢢືసࡣ㸪⭸๓༑ 㠌ᖏയᐖせᅉ ࡢ୍ࡘ࡛ ࠶ࡿ㸪

⭸㛵 ⠇ᒅ ᭤ゅ ᗘࡢ ῶᑡ ࠾ࡼ ࡧ⫤ 㛵⠇ ෆ㌿ ゅᗘ ࡢ ቑ ຍࢆ ⏕ࡌ ࡉࡏ 㸪ዪ Ꮚࣛ

ࢡࣟ ࢫ࡛ Ⓨ⏕ ࡍࡿ ⭸๓ ༑㠌 ᖏയ ᐖ࣓ ࢝ࢽ ࢬ࣒ ࡢ୍ ࡘ࡜ ࡋ࡚ ᪂ࡓ ࡞▱ ぢ࡜

࡞ࡿྍ⬟ᛶࡀ ♧၀ࡉࢀ ࡓ㸬

ϫ㸬◊✲ 5㸪◊✲ 6 ࡛ࡣ⭸๓༑㠌ᖏ യᐖࢆྵ ࡵࡓୗ⫥യᐖ ண㜵ࡢࡓ ࡵࡢࢫࢡࣜ

࣮ࢽࣥࢢࢸࢫ ࢺࡢ୍⪃ ᐹ࡜ࡋ࡚ ⾜࠸㸪◊✲ 5 ㊊㊑ᢕᥱຊ࡜ 㟼ⓗ࠾ࡼ ࡧືⓗࣂ

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

⬟ຊ࡟ཬࡰࡍ ᙳ㡪࡟ ࡘ ࠸࡚௨ୗࡢ⤖ ㄽࢆᚓࡓ 㸬

1) ྑ㊊ ㊑ᢕ ᥱຊ ࡜㔜 ᚰື ᦂᛶ ࡢ 㔜 ᚰ⥲ ㌶㊧ 㛗㸪 㔜ᚰ ༢఩ ㌶㊧ 㛗 ࡜ ࡢ㛫 ࡟᭷

ព࡞㈇ࡢ┦㛵 㛵ಀࢆ♧ ࡋࡓ㸬

2) ྑ㊊ ㊑ᢕ ᥱຊ ࡢ኱ ࡁ࠸ ⩌ࡣ ᑠࡉ ࠸⩌ ࡜ẚ ㍑ࡋ 㸪㔜 ᚰື ᦂᛶ ࡢ 㔜 ᚰ⥲ ㌶㊧

㛗࡜㔜ᚰ༢఩ ㌶㊧㛗 ࡟ ࠾࠸࡚㸪᭷ព ࡟㌶㊧㛗 ࡀ ▷࠿ࡗࡓ㸬

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

4) ㊊㊑ ᢕᥱ ຊ ࡣ 㸪㟼 ⓗࣂ ࣛࣥ ࢫಖ ᣢ⬟ ຊ࡟ 㛵㐃 ᛶࢆ ♧ࡋ ࡓࡇ ࡜㸪 ࡲࡓ 㸪㊊

㊑ᢕ ᥱຊ ࡢ኱ ᑠࡀ 㟼ⓗ ࠾ࡼ ࡧື ⓗࣂ ࣛࣥ ࢫಖ ᣢ⬟ ຊࡢ ୍㒊 ࡟ᙳ 㡪ࢆ ཬࡰ

ࡋ㸪 ㊊㊑ ᢕᥱ ືస ࠾ࡼ ࡧ㊊ ㊑ᢕ ᥱຊ ྥୖ ࢚ࢡ ࢧࢧ ࢖ࢬ ࡀ㸪 㟼ⓗ ࠾ࡼ ࡧື

ⓗࣂࣛࣥࢫ⬟ ຊྥୖ࡟ ࡘ࡞ࡀࡿྍ⬟ ᛶࡀ♧၀ ࡉࢀࡓ㸬

㟼ⓗୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࡸୗ⫥㛵⠇ྍ ືᇦ㸪඲ ㌟㛵⠇ᘱ⦆ᛶ 㸪⫤㛵⠇ እ㌿➽

ຊ࡜ࢻࣟࢵࣉ ࣂ࣮ࢸ࢕ ࢝ࣝ ࢪࣕࣥࣉ ືస᫬ࡢ ୗ⫥࢟ࢿ࣐ࢸ ࢕ࢡࢫ࣭࢟ࢿࢸ࢕

ࢡࢫ࡜ࡢ㛵㐃 ᛶ 㸦◊ ✲ 6㸧࡟ࡘ࠸࡚ ࡣ㸪௨ ୗࡢ⤖ㄽࢆᚓ ࡓ㸬

179

1) Q-angle㸪Femoral anteversion angleࡢ኱ᑠ࡜ 㸪᭱኱⭸㛵 ⠇እ㌿ゅ ᗘ ࠾ࡼࡧ

⭸㛵 ⠇እ ㌿ゅ ᗘ೫ ఩㔞 ࡢ኱ ᑠ ࡜ ࡢ㛵 㐃ᛶ ࡀㄆ ࡵࡽ ࢀ㸪 ⫤㛵 ⠇እ ㌿➽ ຊࡢ

኱ᑠ ࡜㸪 ᭱኱ ⭸㛵 ⠇እ ㌿ゅ ᗘ࠾ ࡼࡧ ⭸ 㛵 ⠇እ ㌿ゅ ᗘ೫ ఩㔞 ࡢᑠ ኱ ࡜ ࡢ㛵 㐃ᛶࡀㄆࡵࡽ ࢀࡓ 㸬

2) ࢔࣮ ࢳ㧗 ⋡࠾ ࡼࡧ ㊊㛵 ⠇⫼ ᒅゅ ᗘ࡜ ᗋ཯ ຊ࡜ ࡢ㛵 ಀ࡟ ࠾࠸ ࡚㸪 ࢔࣮ ࢳ㧗

⋡ࡢ 㧗ప ࡜㸪 ᗋ཯ ຊࡢ ኱ᑠ ࡜ࡢ 㛵㐃 ᛶࡀ ㄆࡵ ࡽࢀ 㸪 ㊊ 㛵⠇ ⫼ᒅ ゅᗘ ࡢ኱

ᑠ࡜㸪ᗋ཯ຊ ࡢᑠ኱࡜ ࡢ㛵㐃ᛶࡀㄆ ࡵࡽࢀ ࡓ 㸬

3) ⭸๓ ༑㠌 ᖏയ ᐖ ࢆ ྵࡵ ࡓୗ ⫥യ ᐖண 㜵ࡢ ࡓࡵ ࡢࢫ ࢡࣜ ࣮ࢽ ࣥࢢ ࢆ┠ ⓗ࡜

ࡋ࡚ 㸪ࢻ ࣟࢵ ࣉ ࣂ ࣮ࢸ ࢕࢝ ࣝࢪ ࣕࣥ ࣉࢆ ⾜ࢃ ࡏࡓ ࡜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 antevertion angle㸪⫤㛵⠇ እ㌿➽ຊࡢ  ᐃ㡯┠ࢆ ྵࡵࡓ ホ౯ࡢ᭷⏝ᛶ ࡀ♧ࡉࢀ ࡓ㸬ࡲࡓ㸪╔ᆅ᫬ࡢ ⾪ᧁ ⦆⾪⬟ࡢホ౯ 㡯┠࡜ࡋ ࡚ 㸪

࢔࣮ࢳ㧗⋡࡜ ㊊㛵⠇⫼ ᒅゅᗘ ࢆྵࡵ ࡓホ౯ ࡢ ᭷⏝ᛶࡀ♧ࡉ ࢀࡓ㸬

Ϭ㸬㏻ᖖ⾜ࢃ ࢀ࡚࠸ࡿ ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ࣓ ࢽ࣮ࣗ ࡢ୰࡛ ᐇ᪋ࡉࢀ ࡚࠸ࡿ ࣛࣥ

ࢪࡸࢪࣕࣥࣉ ࠿ࡽࡢ╔ ᆅືస㸪ࢧ࢖ ࢻࢫࢸࢵ ࣉࡸษࡾ㏉ࡋ ືస᫬࡟ ͆㊊㊑ࢆ

㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࡢື సᣦᑟἲࢆ ୗ ⫥യᐖண 㜵ࢺ࣮ࣞࢽࣥ ࢢ ࡜ࡋ࡚ ௓ධࡉࡏ 㸪

◊✲ 7࡟࠾࠸ ࡚ࡣ ㊊㊑ ᢕᥱຊ㸪㊊㒊 ᙧែ㸪 㟼 ⓗ࠾ࡼࡧືⓗ ࣂࣛࣥࢫ ⬟ຊ ࡟ཬ

ࡰࡍᙳ㡪ࢆ㸪 ◊✲ 8 ࡟ ࠾࠸࡚ࡣയᐖ Ⓨ⏕⋡➼ ࡟ཬࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ ௓ධຠᯝ

᳨ドࢆ⾜ࡗࡓ 㸬 ⤖ㄽࡣ ௨ୗࡢ㏻ࡾ࡛ ࠶ࡿ 㸬

1) ㊊㊑㛤᤼⬟㸪 ㊊㊑ᢕᥱ ຊ㸪࢔࣮ࢳ㧗 ⋡࡟ࡘ࠸ ࡚㸪 ௓ධᚋࡣ ௓ධ๓࡜ ẚ㍑

ࡋ࡚㸪ᕥྑ㊊ ࠸ࡎࢀ ࡟ ࠾࠸࡚ࡶ᭷ព ࡟ቑຍ ࡋ ࡓ㸬

2) Star excursion balance test ࡟ࡘ࠸࡚ࡣ㸪ᚋෆ ᪉࠾ࡼࡧᚋእ ᪉࡟ ࡘ࠸ ࡚㸪ᕥ

ྑ⬮࠸ࡎࢀࡶ ௓ධᚋ࡟ ᭷ព࡟ྥୖࡋ ࡓ㸬

3) ࣛࣥࢪࡸࢪࣕ ࣥࣉ࠿ࡽ ࡢ╔ᆅືస㸪 ࢧ࢖ࢻࢫ ࢸࢵࣉࡸษࡾ ㏉ࡋືస ᫬࡟

͆㊊㊑ࢆ㛤࠸ ࡚ᗋࢆᥗ ࡴ ͇ືసࢆᣦ ♧ࡍࡿᣦ ᑟἲࡣ㸪㊊㊑ ᶵ⬟࠾ࡼ ࡧື

ⓗࣂࣛࣥࢫ⬟ ຊࢆྥୖ ࡉࡏࡿ࡜࠸࠺ ⤖ᯝ࠿ࡽ 㸪ୗ⫥ യᐖண 㜵ࢆ┠ⓗ ࡜ࡋ ࡓᣦᑟ᪉ἲ࡟ ࡞ ࡿྍ⬟ ᛶࡀ♧၀ࡉࢀ ࡓ㸬

4) യᐖⓎ⏕⋡࡟ ࡘ࠸࡚ࡣ 㸪 ⥲യᐖⓎ⏕ ⋡ ࢆῶᑡ ࡉࡏࡓ㸬യᐖ ࡢ㒊఩ ࡟ ࡘ࠸

࡚ࡣ㸪≉ ࡟ ㊊ 㒊/ࡘ ࡲ ඛ 㸪 ୗ ⭣ 㸪 ⫤ 㛵 ⠇ യ ᐖ Ⓨ ⏕ ⋡ ࢆ ῶ ᑡ ࡉ ࡏ ࡓ 㸬 ࡲ ࡓ 㸪

180

ࢃࡍ࠿࡛ࡣ࠶ ࡿࡀ㊊㛵 ⠇യᐖⓎ⏕⋡ ࢆῶᑡࡉ ࡏࡓ㸬

5) യᐖࡢ✀㢮࡟ ࡘ࠸࡚ࡣ 㸪⭝⅖/೺࿘ᅖ⅖㸪ᡴ ᧞/⾑⭘/᣸യ㸪᤬᣸ ࡢ യᐖⓎ

⏕⋡ࢆῶᑡࡉ ࡏ 㸪യᐖ ࡢཎᅉ࡟ࡘ࠸ ࡚ࡣ㸪 ᥋ ゐᆺയᐖ㸦௚ ࡢ㑅ᡭ㸧 㸪㠀 ᥋ゐᆺയᐖ㸪 ౑࠸ࡍࡂ 㸦ᚎࠎ࡟㸧 ࡟ ࡼࡿയᐖ Ⓨ⏕⋡ࢆῶᑡ ࡉࡏ ࡓ㸬 6) യᐖࡢᅇᩘ࡟ ࡘ࠸࡚ࡣ 㸪≉࡟ ึᅇཷ യ࡜࡞ࡿ യᐖⓎ⏕⋡ࢆ ῶᑡࡉࡏ ࡓ㸬 7) ➇ᢏ᚟ᖐࡲ࡛ ࡢᮇ㛫 ࡟ ࡘ࠸࡚ࡣ㸪1㹼2 ᪥ ࡜ 3㹼7 ᪥࡛➇ᢏ᚟ ᖐྍ⬟ ࡛࠶

ࡿẚ㍑ⓗ▷ᮇ 㛫࡛᚟ᖐ ྍ⬟࡞ യᐖⓎ ⏕⋡ࢆప ୗࡉࡏࡓ㸬

8) ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ࣓ ࢽ࣮࡛ࣗ⾜ࢃ ࢀ࡚࠸ࡿ ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪 ࢧ࢖ࢻࢫࢸࢵ ࣉ㸪ࣛࣥ ࢪ➼ࡢ ືస᫬ ࡟㊊㊑㛤 ᤼࠾ࡼࡧ㊊㊑ ᢕᣢࢆᣦ ♧ࡍ

ࡿᣦᑟἲࡣ㸪 ◊✲ 7࡛ ᚓࡽࢀࡓ㊊㊑ ᢕᥱຊࡸ ㊊㊑㛤᤼⬟㸪 ືⓗୗ⫥ ࣂࣛ

ࣥࢫ⬟ຊࢆྥ ୖࡉࡏࡿ ࡜࠸࠺⤖ᯝ ࢆ ㏻ࡋ࡚㸪 ≉࡟ୗ⫥യᐖ Ⓨ⏕⋡ࢆ ῶࡌ ࡉࡏ㸪ୗ⫥യ ᐖண㜵ࢺ ࣮ࣞࢽࣥࢢࡢ ᣦᑟἲࡢ ୍ࡘ ࡜࡞ࡿྍ ⬟ᛶࡀ♧ ၀ࡉ

ࢀࡓ㸬

ᮏ◊✲ࡣ㸪ዪ Ꮚࣛࢡࣟ ࢫ➇ᢏࢆᑐ㇟ ࡜ࡋ࡚㸪 യᐖࡢᐇែㄪ ᰝ㸪ୗ⫥ യᐖࡢ୰

࡛㔜⑕ᗘࡢ㧗 ࠸⭸๓༑ Ꮠ㠌ᖏയᐖ࣓ ࢝ࢽࢬ࣒ ࡢゎ᫂㸪 ୗ⫥ യᐖண㜵 ࢺ࣮ࣞࢽࣥ

ࢢࡢ௓ධ㸪ୗ ⫥യᐖண 㜵ࡢࡓࡵࡢࢫ ࢡ࣮ࣜࢽ ࣥࢢ ࢸࢫࢺࡢ ᭷⏝ᛶ࡟ ࡘ࠸࡚㸪㊊

㛵⠇യᐖ࡜⭸ ๓༑Ꮠ㠌 ᖏയᐖ࡟╔┠ ࡋ᳨࡚ウ ᳨࣭ドࢆ⾜ࡗ ࡓ 㸬 ㊊㊑ 㛤᤼࠾ࡼࡧ

㊊㊑ᢕᣢືస ࢆᣦ♧ࡍ ࡿᣦᑟἲ࡟ࡼ ࡿ ୗ⫥യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢ ௓ ධࡣ㸪⥲യ ᐖⓎ⏕⋡ࢆῶ ᑡࡉࡏ㸪 ≉࡟ୗ⫥യᐖ Ⓨ⏕⋡ ࢆ ῶᑡࡉࡏࡓ㸬 ⭸㛵⠇യ ᐖⓎ⏕⋡ ࡢ ῶᑡࡣࡳࡽࢀ ࡞࠿ࡗࡓ ࡀ 㸪㊊㛵⠇യ ᐖⓎ⏕⋡ ࢆࢃࡎ࠿࡛ࡣ ࠶ࡿࡀ ῶ ᑡࡉࡏࡓ㸬

ࡲࡓ㸪᤬᣸࡟ ࡼࡿയᐖ Ⓨ⏕⋡ ࡀῶᑡ ࡋࡓ㸬ࡇ ࢀࡣ㸪╔ᆅື స᫬࡟㊊ ㊑㛤᤼࡜㊊

㊑ᢕᣢࢆᣦ♧ ࡋࡓ ᣦᑟ ࡟ࡼࡾ㸪㊊㊑ 㛤᤼⬟࡜ ㊊㊑ᢕᥱຊ ࡀ ྥୖࡋ㸪 ㊊㒊࢔࣮ࢳ

๛ᛶࡀ㧗ࡲࡿ ࡇ࡜࡛㊊ 㒊Ᏻᐃᛶ࡟ᐤ ୚ࡉࡏ㸪 㟼ⓗ࠾ࡼࡧື ⓗୗ⫥ࣂ ࣛࣥࢫಖᣢ

⬟ຊࢆྥୖࡉ ࡏࡿࡇ࡜ 㸪ࡲࡓ㸪㊊㊑ ࢺ࣮ࣞࢽ ࣥࢢࡀ ⚄⤒➽ ༠ㄪᛶࢆ ྥୖࡉࡏࡿ

ࡇ࡜࡛㸪≉࡟ ㊊㒊ࡢᶵ ⬟ⓗᏳᐃᛶ ྥ ୖ࡟ᐤ୚ ࡉࡏ ࡓࡇ࡜ࡀ ㊊㛵⠇യ ᐖࡢῶᑡࡸ

ୗ⫥യᐖⓎ⏕ ⋡ࡢῶᑡ ࡟ࡘ࡞ࡀࡗࡓ ྍ⬟ᛶࢆ ♧၀ࡋࡓ 㸬

181

8

ࡲ࡜ࡵ

182

ࡲ࡜ ࡵ

ᮏㄽᩥࡣ㸪ࢫ ࣏࣮ࢶയ ᐖண㜵࡟ྥࡅ ࡓྲྀࡾ⤌ ࡳ࡟㛵ࡋ࡚ከ ᩘࡢㄽᩥ ࡛ᘬ⏝ࡉ

ࢀ࡚࠸ࡿ van Mechelenࡢ 4 ẁ㝵ࣔࢹ ࣝࢆཧ ⪃࡟ 㸪ࠕዪᏊࣛࢡࣟ ࢫ ࢆࣔࢹࣝ࡜ࡋ

࡚ࡢࢫ࣏࣮ࢶ യᐖࡢᐇ ែ࡜ண㜵ࡢᐇ ㊶ ࠖ࡜ࡋ ࡚㸪㊊㛵⠇࡜ ⭸๓༑Ꮠ 㠌ᖏ യᐖ࡟

↔Ⅼࢆᙜ࡚㸪 ኱ᏛዪᏊ ࣛࢡࣟࢫࢆᑐ ㇟࡟◊✲ ࡜᳨ドࢆ⾜ࡗ ࡓ㸬ᮏ◊ ✲࡟ࡼࡾ㸪 ዪᏊࣛࢡࣟࢫ യᐖࡢᐇ ែࡢᢕᥱ㸪യ ᐖ࣓࢝ࢽ ࢬ࣒ࡢ⌮ゎ㸪 യᐖண㜵 ࢺ࣮ࣞࢽࣥ

ࢢࡢ௓ධ࠾ࡼ ࡧയᐖண 㜵ࢺ࣮ࣞࢽࣥ ࢢ ࡢ௓ධ ຠᯝ᳨ド㸪ࡲ ࡓ㸪 ୗ⫥ യᐖண㜵ࡢ ࡓࡵࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢸࢫࢺἲ ࡀ᳨ ドࡉࢀࡓ ࡇ࡜ࡣ 㸪ࡇࡢ ୍㐃ࡢࣔ ࢹࣝࡀ௚ࡢ ࢫ࣏࣮ࢶࡢയ ᐖண㜵 ࡜ ᐇ㊶࡟ྥࡅࡓ ྲྀࡾ⤌ࡳ ࢆ⾜࠺㝿ࡢ୍ ຓ࡜࡞ ࡾ 㸪௒᪥ࢫ࣏

࣮ࢶ་Ꮫ఍ࡀ ᥎ዡࡋ࡚ ࠸ࡿࢫ࣏࣮ࢶ യᐖண㜵 ࡢ☜❧࡟ྥࡅ ࡓ ◊✲ࡢ ࡉࡽ࡞ࡿⓎ

ᒎ࡟ᐤ୚ࡍࡿ ࡶࡢ࡜⪃ ࠼ࡿ㸬

183

ᘬ ⏝ ᩥ⊩

Abstracts from the IOC World Conference on Prevention of Injury & Illness in Sport. Br. J. Sports Med 45: 310-384, 2011.

Agel, J. et al.: Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13-year review. Am. J. Sports Med 33: 524-530, 2005.

Agel, J. et al.: Descriptive epidemiology of collegiate women's basketball inj uries:

National Collegiate Athletic Association Injury Surveillance System, 1988 -1989 through 2003-2004. J. Athl. Train 42: 202-210, 2007.

Alentorn-Geli, E. et al.: Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: a review of prevention programs aimed to modify risk factors and to reduce injury rates. Knee. Surg. Sports Traumatol Arthrosc 17: 859-79, 2009.

Allen, M.K., Glasoe, W.M.: Metrecom measurement of navicular drop in subjects with anterior cruciate ligament injury. J. Athl. Train 35: 403-406, 2000.

Alonso, J.M. et al.: Sports injuries surveillance during the 2007 IAAF World Athletics Championships. Clin. J. Sport Med 19: 26-32, 2009.

Andresen, B.L. et al.: High school football injuries: field conditions and other factors. Wis. Med. J 88: 28-31, 1989.

Anderson, M.K. et al.: Foundation of athletic training. Prevention, assessment, and management. Lippincott Williams & Wilkins, Philadelphia, Fourth ed, 638-697, 2009.

Andriacchi, T.P. et al.: A point cluster method for in vivo motion analysis: applied to a study of knee kinematics. J. Biomech. Eng 120: 743-749, 1998.

Arendt, E.A., Dick, R.: Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am. J. Sports Med 23:

694-701, 1995.

Arendt, E.A. et al.: Anterior cruciate ligament injury patterns among collegiate men and women. J. Athl. Train 34: 86-92, 1999.

184

Arnason, A. et al.: Soccer injuries in Iceland. Scand. J. Med. Sci. Sports 6:

40-45, 1996.

Backous, D.D. et al.: Soccer injuries and their relation to physical maturity. Am. J.

Dis. Child 142: 839-842, 1988.

Bahr, R. et al.: A twofold reduction in the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study. Scand. J. Med. Sci. Sports 7: 172-177, 1997.

Bahr, R., Krosshaug, T.: Understanding injury mechanism: a key component of preventing injuries in sport. Br. J. Sports Med 39: 324-329, 2005.

Baker, M.M.: Anterior cruciate ligament injuries in the female athlete. J. Women's Health (Larchmt) 7: 343-349, 1998.

Barrett, J., Bilisko, T.: The role of shoes in the prevention of ankle sprains. Sports Med 20: 277-280, 1995.

Baumhauer, J.F. et al.: A prospective study of ankle injury risk factors. Am. J. Sports Med 23: 564-570, 1995.

Beckett, M.E. et al.: Incidence of hyperpronation in the ACL injured knee: a clinical perspective. J. Athl. Train 27: 58-62, 1992.

Bernier, J.N., Perrin, D.H.: Effect of coordination training on proprioception of the functionally unstable ankle. J. Orthop. Sports Phys. Ther 27: 264-275, 1998.

Beynnon, B.D. et al.: Ankle ligament injury risk factors: a prospective study of college athletes. J. Orthop. Res 19: 213-220, 2001.

Beynnon, B.D et al.: First-time inversion ankle ligament trauma: the effects of sex, level of competition, and sport on the incidence of inj ury. Am. J. Sports Med 10:

1485-1491, 2005.

Beynnon, B.D. et al.: Predictive factors for lateral ankle sprains: a literature review.

J. Athl. Train 37: 376-380, 2002.

Bing, Yu., Garrett, W.E.: Mechanism of non-contact ACL injuries. Br. J. Sports Med 41: 47-51, 2007.

Boden, B.P. et al.: Mechanisms of anterior cruciate ligament injury. Orthopedics 23:

185 573-578, 2000.

Boden, B.P. et al.: Video analysis of anterior cruciate ligament injury: abnormalities in hip and ankle kinematics. Am. J. Sports Med 37: 252-259, 2009.

Bonci, C.M.: Assessment and evaluation of predisposing factors to anterior cruciate ligament injury. J. Athl. Train 34: 155-164, 1999.

Bere, T. et al.: Kinematics of anterior cruciate ligament ruptures in World Cup alpine skiing: 2 case reports of the slip-catch mechanism. Am. J. Sports Med 41: 1067-1073, 2013.

Borotikar, B.S. et al.: Combined effects of fatigue and decision making on female lower limb landing postures: central and peripheral contributions to ACL injury risk.

Clin. Biomech (Bristol, Avon) 23: 81-92, 2008.

Borowski, L.A. et al.: Yard EE, Fields SK, Comstock RD. The epidemiology of US high school basketball injuries, 2005-2007. Am. J. Sports Med 36: 2328-2335, 2008.

Bressel, E. et al.: Comparison of static and dynamic balance in female collegiate soccer, basketball, and gymnastics athletes. J. Athl. Train 42: 42-46, 2007.

Brody, D.M.: Techniques in the evaluation and treatment of the injured runner.

Orthop. Clin. North. Am 13: 541-58, 1982.

Brynhildsen, J. et al.: Previous injuries and persisting symptoms in female soccer players. Int. J. Sports Med 11: 489-492, 1990.

Burton A.W., Miller, D.E.: Movement skill assessment, Human Kinetics, 41-60, 1988.

Caraffa, A. et al.: Prevention of anterior cruciate ligament injuries in soccer. A prospective controlled study of proprioceptive training. Knee Surg. Sports Traumatol.

Arthrosc 4: 19-21, 1996.

Carlson, R.E. et al.: The biomechanical relationship between the tendoachilles, plantar fascia and metatarsophalangeal joint dorsiflexion angle. Foot Ankle Int 21:

18-25, 2000.

Carter, E.A. et al.: Common game injury scenarios in men's and women's lacrosse .

186 Int. J. Inj. Contr. Saf. Promot 17: 111-118, 2010.

Caswell, S.V. et al.: Video incident analysis of head injuries in high school girls' lacrosse. Am. J. Sports Med 40: 756-762, 2012.

Chaiwanichsiri, D. et al.: Star excursion balance training: effects on ankle functional stability after ankle sprain. J. Med. Assoc. Thai 88: 90-94, 2005.

Chappell, J.D., Limpisvasti, O.: Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks. Am. J. Sports Med 36: 1081-1086, 2008.

Chaudhari, A.M.: Sport-dependent variations in arm position during single-limb landing influence knee loading: implications for anterior cruciate ligament injury. Am.

J. Sports Med 33: 824-830, 2005.

Chomiak, J. et al.: Severe injuries in football players. Influencing factors. Am. J.

Sports Med 28(5 Suppl): S58-68, 2000.

Cibulka, M.T.: Determination and significance of femoral neck anteversion. Phys.

Ther 84: 550-558. 2004.

Hervéou, C, Messéan, L (ⴭⴭ); ஭ ཎ ⚽ಇ,୰ ᒣᙲ ୍ (ヂ): ⭸࣭㊊㛵⠇࣭ ㊊㒊ࡢ᪂ ࡋ࠸ ⚄⤒㸫㐠 ືჾ༠ㄪカ⦎, Proprioceptive exercise ࡢ ᐇ㝿, ་ ṑ⸆ฟ∧, ᮾ ி,

➨4 ∧, 2-29, 1995.

Coplan, J.A.: Rotational motion of the knee: a comparison of normal and pronating subjects. J. Orthop. Sports Phys. Ther 10: 366-369, 1989.

Cowan, D.N. et al.: Lower limb morphology and risk of overuse injury among male infantry trainees. Med. Sci. Sports Exerc 28: 945-52, 1996.

Cranel, L.: Femoral torsion and its relation to toeing-in and toeing-out. J. Bone Joint Surg. Am 41: 421-428, 1959.

Decker, M.J. et al.: Gender differences in lower extremity kinematics, kinetics and energy absorption during landing. Clin. Biomech (Bristol, Avon) 21: 297-305, 2006.

Decoster, L.C. et al.: Generalized joint hypermobility and its relationship to injury patterns among NCAA lacrosse players. J. Athl. Train 34: 99-105, 1999.

de Loës, M. et al.: A 7-year study on risks and costs of knee injuries in male and

ドキュメント内 Injury Surveillance and Injury Prevention in Female Lacrosse (ページ 150-200)

関連したドキュメント