軟部組織硬度計による生体硬度測定の信頼性の検討
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(2) ⷐᣦ. ߩߢޔᨐ‛ߪ⊹ࠍ߆ߕߦ㘩ߴࠆ࡞ࡁࠚࡈࡐޕ㘶ᢱ߽Ⓧᭂ⊛ߦ៨ࠆࡦࡔࡊࠨޕ. (⋡⊛)ᧄ⎇ⓥߢߪ㧘エㇱ⚵❱⎬ᐲ⸘ߦࠃࠆ↢᷹ቯߩା㗬ᕈߦߟߡᬌ⸛ߒߚ㧚㧔ᣇᴺ㧕エ. ࠻߽ࠃ㧔߹ߢ⏕ታߥലႎ๔ߪߥࠃ߁ߛ߇㧕ޕ. ㇱ⚵❱⎬ᐲ⸘(․ᱶ⸘᷹␠㧧TK-03C)ߪ⩄㊀ߣᄌࠍหᤨߦ᷹ቯߔࠆߎߣ߇น⢻ߥ߽ߩࠍ. ԛ ᧪ࠆߛߌ▵㘩ޔಽߩࠞࡠࠍប߃ࠆޕ⣻ಽ⋡ߪᤄ߆ࠄߩᢎ⸠ޕCR ߪ⠧ൻߦ. ↪ߒߚ㧚᷹ቯㇱࠍ⣄ᩇ┙╭㧘௯Ᏺ╭ㇱ㧘ౝࡂࡓࠬ࠻ࡦࠣࠬ㧘ౝ⣦⣻╭ߩ╭ ⣻ਛᄩㇱߣߒ㧘ߔߴߡฝࠍ᷹ቯߒߚ㧚ᬌᩏ⠪ߪ 3 ฬߣߒߡ㧘ߘࠇߙࠇ 3 ࿁ᓳ᷹ቯߐߖ㧘. ߁∛᳇ࠍ㒐ߋޕ Ԝ シߩㆇേ⽶⩄ޔシߩ‛ℂൻቇೝỗ㧔᷷ᾲ㧕ߥߤૐೝỗߢࠨ࠴ࡘࠗࡦࠍᵴᕈ. ⩄㊀ 5N㧘10N ᤨߩᄌ୯(চ)ࠍ᳞ߚ㧚߹ߚኻ⽎ߪ㧘ᧄ⎇ⓥߦหᗧࠍᓧߚᢛᒻᄖ⑼⊛∔ᖚ. ൻߔࠆ㧔ࡎࡔࠪࠬലᨐ㧕ޕ. ߩᣢᓔߩߥஜᏱᚑੱ↵ᕈ 1 ฬߣߒ㧘ᬌᩏ⠪ߪ㧘ᧄ⎇ⓥߦหᗧࠍᓧߚ㧘ℂቇ≮ᴺ჻ 3 ฬߣ. ⠧ൻߦߪᄙߊߩ࿃ሶ߇㑐ࠊߞߡߡޔੱᏅ߇ߢࠆߩߪᒰὼߢࠆ߇ߥࠎߎޔᏱ⼂⊛ߥߎ. ߒߚ㧚 㧔⚿ᨐ㧕᷹ቯᤨߩᄌേଥᢙߪ㧘ోߡ 5%એਅߢߞߚ㧚ᬌᩏ⠪ౝା㗬ᕈߪ㧘3 ੱోߡ߇. ߣߢᱫߧ߹ߢర᳇ߥ↢ᵴ߇ㅍࠄࠇࠇ߫߹ߎߣߦᐘߢࠆޕ. ICC(1㨯1)=0.95 એߢߞߚ㧚߹ߚ㧘ᬌᩏ⠪㑆ା㗬ᕈߪ ICC(2㨯1)=0.98 ߢߞߚ㧚㧔⚿⺆㧕 ࿁↪ߒߚエㇱ⚵❱⎬ᐲ⸘ߪ⩄㊀ߣᄌࠍหᤨߦ᷹ቯߔࠆߎߣ߇น⢻ߢࠅ㧘ߐࠄߦߘ. ⻢ㄉੌߪ⺑✚ߩߎޔᓼኹᄢቇࠃࠅߩᐔᚑ 20 ᐕᐲੱ⎇ⓥ⾌ߩេഥߦࠃࠆޔߚ߹ޕ࿑ߩォ౮. ߩା㗬ᕈ߽㜞ߎߣ߆ࠄエㇱ⚵❱⎬ᐲ⹏ଔߩቯ㊂⊛⹏ଔߦᵴ↪ߢ߈ࠆߎߣ߇␜ໂߐࠇߚ㧚. ߥߤߢ SE 㜞ᯅశำߩេഥࠍ߃ߚ⻢ߦ߽ߣޕᗧࠍߒ߹ߔޕ. Abstract. ᢥ₂ 㧝㧕࿖┙␠ળ㒾ੱญ㗴⎇ⓥᚲ㧦ੱญ⛔⸘⾗ᢱ㓸ޔ2008.. (PURPOSE)We assessed the soft tissue stiffness meter (STSM; TOKUSHUKEISOKU Corporation, TK-03C, Japan) for inter/intra-rater reliability. This device measures load. 㧞㧕㋈ᧁశઁ⋙⸶㧦࡞ࡆࡦ∛ℂቇ⥃ޔᐥකቇ߳ߩၮ⋚ᦠޔᐫޔ2007. 㧟㧕⍹Ꮉ౻ᧁ✬㧦⠧ൻߩࡔࠞ࠾࠭ࡓࠍតࠆޔකቇߩࠁߺޔ188㧔1㧕, 1999. 㧠㧕⍹Ꮉ౻ᧁડ↹㧦⠧ൻޔኼᓮ߳ߩࠕࡊࡠ࠴ޔታ㛎කቇ 23(19), 2005.. and displacement simultaneously.㧔METHODS㧕1 healthy subject (with no history of. 㧡㧕⊕ᴛථੑ✬㧦ࠛࠗࠫࡦࠣ⎇ⓥߩᦨ೨✢ޔකቇߩࠁߺޔ217(7),2006,. orthopedic problem). Three physical therapists measured the surface stiffness of fore. 㧢㧕ችፒᔀડ↹㧦⚦⢩ᦼߣ⚦⢩ᱫޔ⠧ൻࠍߟߥߋᓎ⠪ߚߜޔታ㛎කቇޔ24(11),2006.. human body parts; intrinsic back muscles, upper trapezius, hamstrings and. gastrocnemius of medial side. We each took 3 consecutive readings using the STMS at the right site on each of the human body parts. We calculated the displacement for a. 㧣㧕ᄢౝዄ⟵ડ↹㧦⠧ൻߣ∔ᖚ∛ޔᘒߩℂ⸃ߣ⸻ᢿᴦ≮ߩㅴᱠޔකቇߩࠁߺޔ222(5),2007. 㧤㧕Sarin,KK, et al : Conditioned telomerase induction causes proliferation of hair follicle stem cells. Nature 436,1048 – 1052, 2005. 㧥㧕Bodnar,AG, Quellette,M et al.: Extension of life-span by introduction of telomerase into normal human cells. Science 279,349-352,1998.. load of 5N and 10N. 㧔RESULT㧕The overall rating reliability for all sites was high;. 10㧕⊒↢ᢎ⑼ᦠ. coefficient of variation (CV)<5.0. The intra-rater reliability of the three therapists were. 11㧕Friedman,DB and Johnson,TE : A mutation in the age-1 gene in Caenorhabditis. high showing an intra-class correlation coefficient (ICC) (1㨯1) ҈0.95. The inter-rater reliability was also high; ICC( 2㨯1)= 0.98. (CONCLUSION)Thus, it seems that this STSM is a reliable and useful device for objective quantitative evaluation of soft tissue stiffness.. elegans lengthen life and reduces hermaphrodite fertility. Genetics 118,75-86,1988. 12㧕㍿ፉ㓁৻⌀৻㇢ડ↹㧦⠧ൻߣࡔ࠲ࡏ࠭ࡓᓮߩℂ⸃ޔታ㛎කቇޔ25(12),2007. 13 㧕 Kenyon,C : The plasticity of aging : Insight from long-lived mutants. Cell. 120,449-460, 2005. 14) Masaro, EJ : Overview of caloric restriction and aging. Mechnism of Aging,Development. 126, 913-922, 2005. 15). Fontana,L, Meyer,TE et al : Long-term caloric restriction is highly effective in. reducing the risk for atherosclerosis in humans. PNAS, 101(17),6659-6667, 2004. 16). Wood,JF, Rogina,B, : Sirtuin activators mimic caloric restriction and delay aging in. metazoans. Nature 430,686-689,2004.. 56. 53.
(3) 4㧚⠨ኤ. 1㧚ߪߓߦ. ⥃ᐥ႐㕙ߦ߅ߌࠆエㇱ⚵❱⎬ᐲߩ᷹ቯߪ㧘ਥߦ⸅⸻ߢࠅ㧘ℂቇ≮ᴺ჻ߩਥⷰ⊛⹏ଔߣ. ‛ߦߪ☼ᕈߣᒢᕈߣ߇ሽߔࠆ㧚☼ᕈߣߪ㧘‛ℂቇ⊛ߦᵹߩᶧⷐ⚛㑆ߦᡂജ߇. ߥࠆߚ㧘ߘߩ⹏ଔߩౣᕈ߿ା㗬ᕈߦ߅ߡߪ᥉ㆉᕈ߇ᓧࠄࠇߥߎߣ߇⁁ߢࠆ㧚. ߊᕈ⾰ߢࠅ㧘ᒢᕈߪᄖജߦࠃࠅᄌᒻߒߚ‛߇ߘߩᄖജ߇㒰߆ࠇߚᤨ㧘రߦᚯࠈ߁ߣ. ߘߩߚ㧘エㇱ⚵❱⎬ᐲߦ߅ߌࠆቴⷰ⊛⹏ଔᜰᮡ߇᳞ࠄࠇࠆߎߣ߆ࠄ㧘STSM ࠍ↪ࠆ. ߔࠆᕈ⾰ࠍ߁ 1)㧚ߎࠇࠄߩᕈ⾰߇⛊ߺว㧘‛ߩ⎬ߐ߇ᒻᚑߐࠇߡࠆ㧚. ቯ㊂ൻߩ⹜ߺ߇ⴕࠊࠇߡࠆ㧚⍫㊁ࠄ 6)ߪ㧘↢エㇱ⚵❱ߪ☼ᒢᕈߢࠆ߇㧘ജቇ⊛ᕈ⾰. ੱߦ߅ߌࠆ⎬ߐߩ৻ߟߩᜰᮡߢࠆエㇱ⚵❱⎬ᐲ UQHVVKUUWGUVKHHPGUU㧧565 ߣߪ㧘. ߪᄌᒻㅦᐲߦ߹ࠅଐሽߒߥߣ߁ߎߣ߆ࠄ㧘ᒢᕈߣߒߡߩ᷹ቯᴺߦ৻ቯߩᅷᒰᕈ߇. ྾⢇㧘ᐙߩ㛽㧘㑐▵㧘⢷⣻ㇱౝ⤳ࠍ㒰ߚ⊹⤏㧘⊹ਅ⚵❱㧘╭⡺㧘⣷㧘㕢Ꮺ㧘⚻㧘ⴊ. ࠆߎߣࠍ␜ߒߡࠆ㧚৻ᣇ㧘ᢧ⮮ 7)ߦࠃࠆߣ㧘⹏ଔ⠪ߩ⠌ᾫᐲߦࠃࠆ⺋Ꮕ߿⹏ଔ⠪㑆⺋Ꮕ. ▤ߔߴߡࠍ⚵❱ߩ⎬ߐߢࠆ㧚ߘߩ⎬ᐲߩᄌൻߪ㧘りߩ㆑ᗵߣߒߡਥⷰ⊛ߦᝒ߃. ߪㆱߌࠄࠇߕ㧘᷹ቯ୯ߩା㗬ᕈ߿ᅷᒰᕈߦߪ㒢⇇߇ࠆߣߒߡࠆ㧚. ࠄࠇߡࠆ㧚⥃ᐥߦ߅ߡ 565 ߩ⇣Ᏹߪ㧘∩ߺ߿㑐▵นേၞ㒢ߩ৻ⷐ࿃ߣߥࠅ㧘ਥߦ⸅. ᚒ ߪޘ8),9)߹ߢߦ㧘ࠕࡓઃ߈ߩ STSM(TRY-ALL ␠㧘NEUTONE TDM-NA1). ⸻ߦࠃࠆਥⷰ⊛ߥᣇᴺߦࠃߞߡ⹏ଔߐࠇߡࠆ㧚ߒ߆ߒ㧘565 ߩቴⷰ⊛⹏ଔᚻᴺ߇⏕┙ߐࠇ. ࠍ↪ߒߡ㧘ห৻ᬌᩏ⠪ߦࠃࠆ 80 ⣉ߩ⣦⣻╭ౝ㗡╭⣻ਛᄩㇱߩ᷹ቯࠍⴕ㧘ICC㧔1㨯1㧕. ߡ߅ࠄߕ㧘⥃ᐥᵴ↪ߐࠇߡࠆߣߪ⸒߇ߚ㧚 エㇱ⚵❱⎬ᐲ⸘ UQHVVKUUWGUVKHHPGUUOGVGT㧧565/ ࠍ↪ߚ⎇ⓥߢߪ㧘∨ᡨ㧘∨❗㧘. =0.79 એߩା㗬ᕈࠍ␜ߒ㧘ห৻ᬌᩏ⠪ߦࠃࠆ 3 ࿁ߩ➅ࠅߒߩ᷹ቯߦࠃࠆା㗬ᕈ߇ ICC. 㧕. 㧕. 㧩0.90 એߣ߁⚿ᨐ߆ࠄ㧘ᓳ᷹ቯߩᔅⷐᕈߦߟߡႎ๔ߒߚ㧚ߒ߆ߒ㧘⊹⤏ߦኻߔࠆ. ⣲⣘ߥߤߦࠃࠆᄌൻ. ߩᣇะ߿ജߩቯ㊂ൻ߇࿎㔍ߢࠆߎߣ߆ࠄ㧘ᣂߚߥ⸘᷹ߔࠆߚߩࡄࡔ࠲ࠍᬌ. ߩᄌൻ. ⸛ߔࠆᔅⷐᕈ߇␜ໂߐࠇߚ㧚ߘߎߢ㧘ᧄ⎇ⓥߢ⩄㊀㊂ߣᄌ㊂ࠍหᤨߦ᷹ቯน⢻ߥ STSM. ߮⥃ᐥߩਔ㕙߆ࠄߩ࠺࠲㓸Ⓧ߽චಽߢߪߥ㧚. ࠍ↪ߒߚ㧚ߎߩ STSM ߪ㧘వⴕ⎇ⓥߢ㗴ߣߐࠇߚ⩄㊀㊂ࠍⷙቯߒߚ㓙ߩᄌ㊂ࠍ⸘᷹. ᚒ ߪޘ㧕㧘⩄㊀ߣᄌࠍࠕ࡞࠲ࠗࡓߦ᷹ቯน⢻ߢࠆ 565/ ࠍ↪ߒߡ㧘⇣ߥࠆ ⒳㘃. ߔࠆߎߣ߇น⢻ߢࠅ㧘ⶄᢙߩࠨࡦࡊ࡞⎬ᐲ᷹ቯߦ߅ߡᬌᩏ⠪ౝ㨯㑆ߩਔ⠪ߢ㜞ା㗬ᕈ. ߩ⎬ᐲࠨࡦࡊ࡞ࠍ᷹ቯߒ㧘ᬌᩏ⠪ౝା㗬ᕈ㧘ᬌᩏ⠪㑆ା㗬ᕈߩᬌ⸛ࠍⴕߞߚ⚿ᨐ㧘 ੱߩ. ࠍᓧࠄࠇߚ 5)㧚. ᬌᩏ⠪ ౝା㗬ᕈߪ ߔߴߡߦ߅ ߡ⚖ౝ⋧ 㑐ଥᢙ (Intraclass correlation coefficients㧧. ↢᷹ቯߦ߅ߌࠆା㗬ᕈߪ㧘Arokoski ࠄ 10)ߪ㧘28 ฬߩⵍ㛎⠪ߩ௯Ᏺ╭㧘ਃⷺ╭㧘⢋↲. ICC)+%%㧔㨯㧕㧩 એߩା㗬ᕈࠍ␜ߒߚ㧚߹ߚᬌᩏ⠪㑆ା㗬ᕈߪ㧘+%%㧔㨯㧕㧩. ╭ߦኻߒߡ᷹ቯࠍⴕߞߚ⚿ᨐ㧘㧑CV=4.31㨪12.6㧑ߩ᷹ቯ⺋Ꮕߪ↢ߓࠆ߽ߩߩ㧘㊂⊛ߥ⹏ଔ ߣߒߡ↪ߣㅀߴߡࠆ㧚ᧄ⎇ⓥߩ⚿ᨐࠃࠅ㧘↢᷹ቯߦ߅ߌࠆ➅ࠅߒߩ᷹ቯߢߪ㧘ߔ. ߩା㗬ᕈࠍ␜ߒߚ㧚ߐࠄߦ㧘 ⒳㘃ߩࠨࡦࡊ࡞㑆ߦ߅ߡᗧߥ⎬ᐲߩᏅ߇ࠄࠇߚ㧔R. ߴߡ 4㧑એਅߢߞߚ㧚ߐࠄߦᬌᩏ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈߦߟߡ㧘Landis11). ߘߎߢ࿁ᚒߪޘ㧘⩄㊀ߣᄌࠍ᷹ቯน⢻ߢࠆ 565/ ࠍ↪ߒߡ㧘↢᷹ቯߦࠃࠆᬌᩏ. ߩ Kappa ଥᢙߩᜰᮡࠍ ICC ߩ್ቯߦᔕ↪ߒߚၮḰ(ICC҈0.8)ࠍ↪ߡᬌ⸛ߒߚ㧚ߘߩ⚿ᨐ㧘. ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈߩᬌ⸛ࠍⴕߞߚ㧚. 4 ╭ߢࠆⵍ㛎╭ߪ㧘ߘࠇߙࠇ⩄㊀ᣇะ߇⇣ߥࠆ╭ߢࠆ߇㧘ⵍᬌ╭ߏߣߢ㜞ା㗬ᕈ߇ᓧ. . ࠄࠇߚ㧚ᧄ⎇ⓥ⚿ᨐ߆ࠄ㧘ߎߩ STSM ࠍ↪ߚエㇱ⚵❱⎬ᐲߩቯ㊂⊛⹏ଔߪ㜞ା㗬ᕈ߇. 㧚ᣇᴺ. ࠆ⸘᷹ᣇᴺߢࠆߎߣ߇␜ໂߐࠇߚ㧚ߒ߆ߒ㧘ᧄ⎇ⓥߦ߅ߡฦⵍᬌ╭ߦ߅ߌࠆᦨㆡߥ. ኻ⽎ߪ㧘ᧄ⎇ⓥߦหᗧࠍᓧߚᢛᒻᄖ⑼⊛∔ᖚߩᣢᓔߩߥஜᏱᚑੱ↵ᕈ 1 ฬ(ᐕ㦂 20 ᱦ㧘. ⩄㊀㊂ߦߟߡߩ㧘ᬌ⸛ߪ߅ߎߥࠊࠇߡߥߚ㧘ᦨㆡߥ⩄㊀㊂ߩᬌ⸛ߦߟߡߪᓟ. ㊀ 62kg㧘BMI 21.0)ߦኻߒߡ STSM ᷹ቯࠍᧄ⎇ⓥߦหᗧࠍᓧߚ㧘ℂቇ≮ᴺ჻ 3 ฬ㧔⚻㛎. ߩ⺖㗴ߢࠆ㧚. ᐕᢙ 4-6 ᐕ㧕ߦߡ᷹ቯࠍታᣉߒߚ㧚. ᓟߪ㧘ஜᏱੱߦ߅ߌࠆエㇱ⚵❱⎬ᐲߩၮḰ୯ࠍᚑߒ㧘⥃ᐥᔕ↪ࠍⷞ㊁ߦࠇߚ∔ᖚ. ᷹ቯㇱߪ㧘ฝߩ⣄ᩇ┙╭㧔L4-5 ࡌ࡞㧕ߣ௯Ᏺ╭ㇱ㧘ฝਅ⢇ߩౝࡂࡓࠬ࠻. ߩエㇱ⚵❱⎬ᐲߩ․ᕈߥߤߦߟߡߩᬌ⸛ࠍㅴߡߊᔅⷐᕈ߇ࠆ㧚߹ߚ㧘STSM ߩ. ࡦࠣࠬ㧘ౝ⣦⣻╭ߩ╭⣻ਛᄩㇱߣߒߚ㧚. ⥃ᐥᔕ↪ߪℂቇ≮ᴺߩࠛࡆ࠺ࡦࠬࠍ᭴▽ߔࠆߢ߽㊀ⷐߢࠅ㧘ၮ␆߅ࠃ߮⥃ᐥߩਔ㕙߆. ᷹ቯߦߪ⩄㊀ߣᄌࠍหᤨߦ᷹ቯน⢻ߥ STSM(․ᱶ⸘᷹␠㧘TK-03C)ࠍ↪ߒߚ㧚ᧄ. ࠄ࠺࠲ࠍ㓸Ⓧߒߡߊߎߣ߇㊀ⷐߢࠆߣ⠨߃ࠄࠇߚ㧚. ⎇ⓥߦ↪ߒߚ STSM ߪ㧘ߒᒰߡㇱవ┵ߩᓘ 30Ǿ㧘ᄌ᷹ቯ▸࿐ 30mm㧘⩄㊀᷹ቯ▸. 㧕. ߿╭∋ഭ. 㧘߹ߚ⚻ቇ⊛∔ᖚ߿ࡦࡄᕈ㕒⣂ᕈ∔ᖚߥߤߩ 565. ߦߟߡᬌ⸛ߐࠇߡࠆ߇㧘ߘߩା㗬ᕈߦ㑐ߒߡ⏕ߢߪߥ㧚ߐࠄߦၮ␆߅ࠃ. 㧨㧕㧚. ࿐ 30N ߢࠅ㧘േ߭ߕߺࠕࡦࡊ 2ch ߣធ⛯ߔࠆߎߣߦࠃࠅหᤨߦ᷹ቯน⢻ߥ߽ߩߢࠆ(࿑ 1)㧚. 5㧚⻢ㄉ ࿁ߩ⎇ⓥߦදജߒߡ㗂ߚ㧘⮮ࡂࡆ࠹࡚ࠪࡦቇ㒮ߩ⊝᭽ߣ㧘ߏᜰዉ㗂߈߹ߒߚ. ᷹ቯᣇᴺߪ㧘ℂቇ≮ᴺ჻ 3 ฬߦࠃࠅ㧘ฦⵍᬌ╭ߩ╭⣻ਛᄩㇱߦࠄ߆ߓශࠍઃߌ㧘ߘ. వ↢ᣇߦᗵ⻢↳ߒߍ߹ߔ㧚߹ߚ㧘දജࠍ㗂ߚⵍ㛎⠪ߩ⊝᭽ߦᗵ⻢⥌ߒ߹ߔ㧚. ߩ⋥ࠃࠅ STSM ߦࠃࠅ᷹ቯߒߚ㧚ᬌᩏ⠪ߦߪ㧘Ԙ߈ᚻࠍ↪ࠆߎߣ㧘ⵍᬌ╭ߦኻߒߡ. . ԙု⋥ߦߔࠆߎߣ㧘ԙࠁߞߊࠅߣߔࠆߎߣࠍᜰ␜ߒߚ㧚. ᢥ₂ ർ↰⠹ม㧘↰Ꮞᒄਯ㧘⦼ጊ⑲ᄥ㇢㨯ઁ㧦╭∋ഭߦࠃࠆ❗ᤨߩ╭⎬ᐲᄌൻ㧚,,5RQTV5EK㧘 60. 57.
(4) ᧄ⎇ⓥߢߪ㧘േ߭ߕߺࠕࡦࡊ(㔚ᬺ␠㧘PCD-300A)ߦ⋥ធធ⛯ߒ㧘ࠨࡦࡊࡦࠣ. 3㧚⚿ᨐ. ᵄᢙ 100Hz ߢ 25 ⑽㑆ߦ 3 ࿁ߩ᷹ቯࠍⴕ㧘1 ᷹ቯߏߣߦ⩄㊀㊂ߣᄌ୯ߩ㑐ଥߦߟߡ࿁. ో 36 ࿁㧔4 ╭3 ࿁3 ฬ㧕ߩ᷹ቯߦ߅ߌࠆ⩄㊀㊂ߣᄌ୯ߩ࿁Ꮻ⋥✢ߩ৻⥌ᐲߩᜰᮡ. Ꮻ⋥✢ࠍ᳞㧘⩄㊀㊂ 5N ߅ࠃ߮ 10N ᤨߩᄌ୯(mm)ࠍ▚ߒߚ(࿑ 2)㧚. ߢࠆቯଥᢙᐔဋ୯(▸࿐)ߪ㧘0.98(0.96-0.99)ߢߞߚ㧚. ⛔⸘ቇ⊛ᬌ⸛ߪ㧘߹ߕ⩄㊀㊂ߣᄌ୯ߩ㑐ଥߦߟߡ㧘᷹ቯߏߣߦቯଥᢙ(R2)ࠍ᳞ߚ㧚 ᬌᩏ⠪ౝߩ᷹ቯ࿁ᢙߦ㑐ߔࠆା㗬ᕈߦߟߡߪ㧘ⵍᬌ╭ߏߣߩ᷹ቯ⚿ᨐࠃࠅᄌേଥᢙ. ➅ࠅߒߦࠃࠆ᷹ቯߦ߅ߌࠆⵍᬌ╭ߏߣߩ㧑CV㧩meanrSD ߪ㧘⩄㊀㊂ 5N ߅ࠃ߮ 10N ᤨߩ⚿ᨐࠍ 1 ߦ␜ߒߚ㧚߹ߚᬌᩏ⠪ౝା㗬ᕈߦߟߡߪ㧘ฦᬌᩏ⠪ߩ⩄㊀㊂ 5N ߅ࠃ߮. (coefficient of variation㧧CV)ࠍ▚ߒߚ㧚߹ߚ㧘ᬌᩏ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈߦ. 10N ᤨߩ ICC(1㨯1)㧩0.95 એߣߥࠅ㧘㜞ା㗬ᕈࠍ␜ߒߚ( 2)㧚. ߟߡߪ㧘ICC ࠍ▚ߒߡᬌ⸛ߒߚ㧚. ߐࠄߦ㧘ᬌᩏ⠪㑆ା㗬ᕈߦߟߡߪ㧘⩄㊀㊂ 5N ᤨߢ ICC㧩0.981㧘10N ᤨߢߪ ICC㧩0.903 ߣ㜞ା㗬ᕈࠍ␜ߒߚ( 2)㧚. ᬌᩏ⠪ౝା㗬ᕈ %8. േ䈵䈝䉂䉝䊮䊒. 0. 0. ฝ⣄ᩇ┙╭ .. r. r. ฝ௯Ᏺ╭ㇱ. r. r. ฝ⣦⣻╭ౝ. r. r. ฝౝࡂࡓࠬ࠻ࡦࠣࠬ. r. r. (㔚ᬺ␠䋬PCD-300A). ࿑㧦᷹ቯᣇᴺ 565/㧔TOKUSHUKEISOKU Corporation, Japan 㧧6-%. displacement (mm). ᷹ቯߦߪ⩄㊀ߣᄌࠍหᤨߦ᷹ቯน⢻ߥ565/ ࠍ↪ߒ㧘േ߭ߕߺࠕࡦࡊEJߣធ⛯ߔࠆߎߣ ߦࠃࠅหᤨߦ᷹ቯน⢻ߥ߽ߩࠍ↪ߒߚ㧚 ᷹ቯㇱߪ㧘⣄ᩇ┙╭㧔.ࡌ࡞㧕㧘 ௯Ᏺ╭ㇱ㧘ౝࡂࡓࠬ࠻ࡦࠣࠬ㧘ౝ⣦ ⣻╭ߩ╭⣻ਛᄩㇱߣߒ㧘ߔߴߡฝߩߺ᷹ቯ ߒߚ㧚 ᷹ቯᣇᴺߪ㧘ℂቇ≮ᴺ჻ฬߦࠃࠅ㧘ฦⵍᬌ ╭ߩ╭⣻ਛᄩㇱߦࠄ߆ߓශࠍઃߌ㧘ߘߩ ࠍ565/ߦࠃࠅ᷹ቯߒߚ㧚.
(5) න㧔㧕. ᬌᩏ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈ ᬌᩏ⠪ౝା㗬ᕈ. mm. ⩄㊀㊂ ⩄㊀. +%% 㨯 0. 0. ᬌᩏ⠪#. . . ᬌᩏ⠪$. 㧔㧕 . ᬌᩏ⠪%. . . ᄌ. ᬌᩏ⠪㑆ା㗬ᕈ P㧩. +%% 㨯 . .
(6) ᢙ୯ ⚖ౝ⋧㑐ଥᢙ ା㗬㑆 ਅ㒢㒢. Hz. ࿑㧦᷹ቯ࠺࠲ ࠨࡦࡊࡦࠣᵄᢙ*\ߢ㧘⑽㑆ߦ࿁ߩᓳ᷹ቯࠍⴕߞߚ㧚 ᷹ቯᤨߦ⩄㊀㊂ 0 㧘0߅ࠃ߮0ᤨߩᄌ୯ OO ࠍ▚ߒߚ㧚. 58. 59.
(7) ᧄ⎇ⓥߢߪ㧘േ߭ߕߺࠕࡦࡊ(㔚ᬺ␠㧘PCD-300A)ߦ⋥ធធ⛯ߒ㧘ࠨࡦࡊࡦࠣ. 3㧚⚿ᨐ. ᵄᢙ 100Hz ߢ 25 ⑽㑆ߦ 3 ࿁ߩ᷹ቯࠍⴕ㧘1 ᷹ቯߏߣߦ⩄㊀㊂ߣᄌ୯ߩ㑐ଥߦߟߡ࿁. ో 36 ࿁㧔4 ╭3 ࿁3 ฬ㧕ߩ᷹ቯߦ߅ߌࠆ⩄㊀㊂ߣᄌ୯ߩ࿁Ꮻ⋥✢ߩ৻⥌ᐲߩᜰᮡ. Ꮻ⋥✢ࠍ᳞㧘⩄㊀㊂ 5N ߅ࠃ߮ 10N ᤨߩᄌ୯(mm)ࠍ▚ߒߚ(࿑ 2)㧚. ߢࠆቯଥᢙᐔဋ୯(▸࿐)ߪ㧘0.98(0.96-0.99)ߢߞߚ㧚. ⛔⸘ቇ⊛ᬌ⸛ߪ㧘߹ߕ⩄㊀㊂ߣᄌ୯ߩ㑐ଥߦߟߡ㧘᷹ቯߏߣߦቯଥᢙ(R2)ࠍ᳞ߚ㧚 ᬌᩏ⠪ౝߩ᷹ቯ࿁ᢙߦ㑐ߔࠆା㗬ᕈߦߟߡߪ㧘ⵍᬌ╭ߏߣߩ᷹ቯ⚿ᨐࠃࠅᄌേଥᢙ. ➅ࠅߒߦࠃࠆ᷹ቯߦ߅ߌࠆⵍᬌ╭ߏߣߩ㧑CV㧩meanrSD ߪ㧘⩄㊀㊂ 5N ߅ࠃ߮ 10N ᤨߩ⚿ᨐࠍ 1 ߦ␜ߒߚ㧚߹ߚᬌᩏ⠪ౝା㗬ᕈߦߟߡߪ㧘ฦᬌᩏ⠪ߩ⩄㊀㊂ 5N ߅ࠃ߮. (coefficient of variation㧧CV)ࠍ▚ߒߚ㧚߹ߚ㧘ᬌᩏ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈߦ. 10N ᤨߩ ICC(1㨯1)㧩0.95 એߣߥࠅ㧘㜞ା㗬ᕈࠍ␜ߒߚ( 2)㧚. ߟߡߪ㧘ICC ࠍ▚ߒߡᬌ⸛ߒߚ㧚. ߐࠄߦ㧘ᬌᩏ⠪㑆ା㗬ᕈߦߟߡߪ㧘⩄㊀㊂ 5N ᤨߢ ICC㧩0.981㧘10N ᤨߢߪ ICC㧩0.903 ߣ㜞ା㗬ᕈࠍ␜ߒߚ( 2)㧚. ᬌᩏ⠪ౝା㗬ᕈ %8. േ䈵䈝䉂䉝䊮䊒. 0. 0. ฝ⣄ᩇ┙╭ .. r. r. ฝ௯Ᏺ╭ㇱ. r. r. ฝ⣦⣻╭ౝ. r. r. ฝౝࡂࡓࠬ࠻ࡦࠣࠬ. r. r. (㔚ᬺ␠䋬PCD-300A). ࿑㧦᷹ቯᣇᴺ 565/㧔TOKUSHUKEISOKU Corporation, Japan 㧧6-%. displacement (mm). ᷹ቯߦߪ⩄㊀ߣᄌࠍหᤨߦ᷹ቯน⢻ߥ565/ ࠍ↪ߒ㧘േ߭ߕߺࠕࡦࡊEJߣធ⛯ߔࠆߎߣ ߦࠃࠅหᤨߦ᷹ቯน⢻ߥ߽ߩࠍ↪ߒߚ㧚 ᷹ቯㇱߪ㧘⣄ᩇ┙╭㧔.ࡌ࡞㧕㧘 ௯Ᏺ╭ㇱ㧘ౝࡂࡓࠬ࠻ࡦࠣࠬ㧘ౝ⣦ ⣻╭ߩ╭⣻ਛᄩㇱߣߒ㧘ߔߴߡฝߩߺ᷹ቯ ߒߚ㧚 ᷹ቯᣇᴺߪ㧘ℂቇ≮ᴺ჻ฬߦࠃࠅ㧘ฦⵍᬌ ╭ߩ╭⣻ਛᄩㇱߦࠄ߆ߓශࠍઃߌ㧘ߘߩ ࠍ565/ߦࠃࠅ᷹ቯߒߚ㧚.
(8) න㧔㧕. ᬌᩏ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈ ᬌᩏ⠪ౝା㗬ᕈ. mm. ⩄㊀㊂ ⩄㊀. +%% 㨯 0. 0. ᬌᩏ⠪#. . . ᬌᩏ⠪$. 㧔㧕 . ᬌᩏ⠪%. . . ᄌ. ᬌᩏ⠪㑆ା㗬ᕈ P㧩. +%% 㨯 . .
(9) ᢙ୯ ⚖ౝ⋧㑐ଥᢙ ା㗬㑆 ਅ㒢㒢. Hz. ࿑㧦᷹ቯ࠺࠲ ࠨࡦࡊࡦࠣᵄᢙ*\ߢ㧘⑽㑆ߦ࿁ߩᓳ᷹ቯࠍⴕߞߚ㧚 ᷹ቯᤨߦ⩄㊀㊂ 0 㧘0߅ࠃ߮0ᤨߩᄌ୯ OO ࠍ▚ߒߚ㧚. 58. 59.
(10) 4㧚⠨ኤ. 1㧚ߪߓߦ. ⥃ᐥ႐㕙ߦ߅ߌࠆエㇱ⚵❱⎬ᐲߩ᷹ቯߪ㧘ਥߦ⸅⸻ߢࠅ㧘ℂቇ≮ᴺ჻ߩਥⷰ⊛⹏ଔߣ. ‛ߦߪ☼ᕈߣᒢᕈߣ߇ሽߔࠆ㧚☼ᕈߣߪ㧘‛ℂቇ⊛ߦᵹߩᶧⷐ⚛㑆ߦᡂജ߇. ߥࠆߚ㧘ߘߩ⹏ଔߩౣᕈ߿ା㗬ᕈߦ߅ߡߪ᥉ㆉᕈ߇ᓧࠄࠇߥߎߣ߇⁁ߢࠆ㧚. ߊᕈ⾰ߢࠅ㧘ᒢᕈߪᄖജߦࠃࠅᄌᒻߒߚ‛߇ߘߩᄖജ߇㒰߆ࠇߚᤨ㧘రߦᚯࠈ߁ߣ. ߘߩߚ㧘エㇱ⚵❱⎬ᐲߦ߅ߌࠆቴⷰ⊛⹏ଔᜰᮡ߇᳞ࠄࠇࠆߎߣ߆ࠄ㧘STSM ࠍ↪ࠆ. ߔࠆᕈ⾰ࠍ߁ 1)㧚ߎࠇࠄߩᕈ⾰߇⛊ߺว㧘‛ߩ⎬ߐ߇ᒻᚑߐࠇߡࠆ㧚. ቯ㊂ൻߩ⹜ߺ߇ⴕࠊࠇߡࠆ㧚⍫㊁ࠄ 6)ߪ㧘↢エㇱ⚵❱ߪ☼ᒢᕈߢࠆ߇㧘ജቇ⊛ᕈ⾰. ੱߦ߅ߌࠆ⎬ߐߩ৻ߟߩᜰᮡߢࠆエㇱ⚵❱⎬ᐲ UQHVVKUUWGUVKHHPGUU㧧565 ߣߪ㧘. ߪᄌᒻㅦᐲߦ߹ࠅଐሽߒߥߣ߁ߎߣ߆ࠄ㧘ᒢᕈߣߒߡߩ᷹ቯᴺߦ৻ቯߩᅷᒰᕈ߇. ྾⢇㧘ᐙߩ㛽㧘㑐▵㧘⢷⣻ㇱౝ⤳ࠍ㒰ߚ⊹⤏㧘⊹ਅ⚵❱㧘╭⡺㧘⣷㧘㕢Ꮺ㧘⚻㧘ⴊ. ࠆߎߣࠍ␜ߒߡࠆ㧚৻ᣇ㧘ᢧ⮮ 7)ߦࠃࠆߣ㧘⹏ଔ⠪ߩ⠌ᾫᐲߦࠃࠆ⺋Ꮕ߿⹏ଔ⠪㑆⺋Ꮕ. ▤ߔߴߡࠍ⚵❱ߩ⎬ߐߢࠆ㧚ߘߩ⎬ᐲߩᄌൻߪ㧘りߩ㆑ᗵߣߒߡਥⷰ⊛ߦᝒ߃. ߪㆱߌࠄࠇߕ㧘᷹ቯ୯ߩା㗬ᕈ߿ᅷᒰᕈߦߪ㒢⇇߇ࠆߣߒߡࠆ㧚. ࠄࠇߡࠆ㧚⥃ᐥߦ߅ߡ 565 ߩ⇣Ᏹߪ㧘∩ߺ߿㑐▵นേၞ㒢ߩ৻ⷐ࿃ߣߥࠅ㧘ਥߦ⸅. ᚒ ߪޘ8),9)߹ߢߦ㧘ࠕࡓઃ߈ߩ STSM(TRY-ALL ␠㧘NEUTONE TDM-NA1). ⸻ߦࠃࠆਥⷰ⊛ߥᣇᴺߦࠃߞߡ⹏ଔߐࠇߡࠆ㧚ߒ߆ߒ㧘565 ߩቴⷰ⊛⹏ଔᚻᴺ߇⏕┙ߐࠇ. ࠍ↪ߒߡ㧘ห৻ᬌᩏ⠪ߦࠃࠆ 80 ⣉ߩ⣦⣻╭ౝ㗡╭⣻ਛᄩㇱߩ᷹ቯࠍⴕ㧘ICC㧔1㨯1㧕. ߡ߅ࠄߕ㧘⥃ᐥᵴ↪ߐࠇߡࠆߣߪ⸒߇ߚ㧚 エㇱ⚵❱⎬ᐲ⸘ UQHVVKUUWGUVKHHPGUUOGVGT㧧565/ ࠍ↪ߚ⎇ⓥߢߪ㧘∨ᡨ㧘∨❗㧘. =0.79 એߩା㗬ᕈࠍ␜ߒ㧘ห৻ᬌᩏ⠪ߦࠃࠆ 3 ࿁ߩ➅ࠅߒߩ᷹ቯߦࠃࠆା㗬ᕈ߇ ICC. 㧕. 㧕. 㧩0.90 એߣ߁⚿ᨐ߆ࠄ㧘ᓳ᷹ቯߩᔅⷐᕈߦߟߡႎ๔ߒߚ㧚ߒ߆ߒ㧘⊹⤏ߦኻߔࠆ. ⣲⣘ߥߤߦࠃࠆᄌൻ. ߩᣇะ߿ജߩቯ㊂ൻ߇࿎㔍ߢࠆߎߣ߆ࠄ㧘ᣂߚߥ⸘᷹ߔࠆߚߩࡄࡔ࠲ࠍᬌ. ߩᄌൻ. ⸛ߔࠆᔅⷐᕈ߇␜ໂߐࠇߚ㧚ߘߎߢ㧘ᧄ⎇ⓥߢ⩄㊀㊂ߣᄌ㊂ࠍหᤨߦ᷹ቯน⢻ߥ STSM. ߮⥃ᐥߩਔ㕙߆ࠄߩ࠺࠲㓸Ⓧ߽චಽߢߪߥ㧚. ࠍ↪ߒߚ㧚ߎߩ STSM ߪ㧘వⴕ⎇ⓥߢ㗴ߣߐࠇߚ⩄㊀㊂ࠍⷙቯߒߚ㓙ߩᄌ㊂ࠍ⸘᷹. ᚒ ߪޘ㧕㧘⩄㊀ߣᄌࠍࠕ࡞࠲ࠗࡓߦ᷹ቯน⢻ߢࠆ 565/ ࠍ↪ߒߡ㧘⇣ߥࠆ ⒳㘃. ߔࠆߎߣ߇น⢻ߢࠅ㧘ⶄᢙߩࠨࡦࡊ࡞⎬ᐲ᷹ቯߦ߅ߡᬌᩏ⠪ౝ㨯㑆ߩਔ⠪ߢ㜞ା㗬ᕈ. ߩ⎬ᐲࠨࡦࡊ࡞ࠍ᷹ቯߒ㧘ᬌᩏ⠪ౝା㗬ᕈ㧘ᬌᩏ⠪㑆ା㗬ᕈߩᬌ⸛ࠍⴕߞߚ⚿ᨐ㧘 ੱߩ. ࠍᓧࠄࠇߚ 5)㧚. ᬌᩏ⠪ ౝା㗬ᕈߪ ߔߴߡߦ߅ ߡ⚖ౝ⋧ 㑐ଥᢙ (Intraclass correlation coefficients㧧. ↢᷹ቯߦ߅ߌࠆା㗬ᕈߪ㧘Arokoski ࠄ 10)ߪ㧘28 ฬߩⵍ㛎⠪ߩ௯Ᏺ╭㧘ਃⷺ╭㧘⢋↲. ICC)+%%㧔㨯㧕㧩 એߩା㗬ᕈࠍ␜ߒߚ㧚߹ߚᬌᩏ⠪㑆ା㗬ᕈߪ㧘+%%㧔㨯㧕㧩. ╭ߦኻߒߡ᷹ቯࠍⴕߞߚ⚿ᨐ㧘㧑CV=4.31㨪12.6㧑ߩ᷹ቯ⺋Ꮕߪ↢ߓࠆ߽ߩߩ㧘㊂⊛ߥ⹏ଔ ߣߒߡ↪ߣㅀߴߡࠆ㧚ᧄ⎇ⓥߩ⚿ᨐࠃࠅ㧘↢᷹ቯߦ߅ߌࠆ➅ࠅߒߩ᷹ቯߢߪ㧘ߔ. ߩା㗬ᕈࠍ␜ߒߚ㧚ߐࠄߦ㧘 ⒳㘃ߩࠨࡦࡊ࡞㑆ߦ߅ߡᗧߥ⎬ᐲߩᏅ߇ࠄࠇߚ㧔R. ߴߡ 4㧑એਅߢߞߚ㧚ߐࠄߦᬌᩏ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈߦߟߡ㧘Landis11). ߘߎߢ࿁ᚒߪޘ㧘⩄㊀ߣᄌࠍ᷹ቯน⢻ߢࠆ 565/ ࠍ↪ߒߡ㧘↢᷹ቯߦࠃࠆᬌᩏ. ߩ Kappa ଥᢙߩᜰᮡࠍ ICC ߩ್ቯߦᔕ↪ߒߚၮḰ(ICC҈0.8)ࠍ↪ߡᬌ⸛ߒߚ㧚ߘߩ⚿ᨐ㧘. ⠪ౝା㗬ᕈ߅ࠃ߮ᬌᩏ⠪㑆ା㗬ᕈߩᬌ⸛ࠍⴕߞߚ㧚. 4 ╭ߢࠆⵍ㛎╭ߪ㧘ߘࠇߙࠇ⩄㊀ᣇะ߇⇣ߥࠆ╭ߢࠆ߇㧘ⵍᬌ╭ߏߣߢ㜞ା㗬ᕈ߇ᓧ. . ࠄࠇߚ㧚ᧄ⎇ⓥ⚿ᨐ߆ࠄ㧘ߎߩ STSM ࠍ↪ߚエㇱ⚵❱⎬ᐲߩቯ㊂⊛⹏ଔߪ㜞ା㗬ᕈ߇. 㧚ᣇᴺ. ࠆ⸘᷹ᣇᴺߢࠆߎߣ߇␜ໂߐࠇߚ㧚ߒ߆ߒ㧘ᧄ⎇ⓥߦ߅ߡฦⵍᬌ╭ߦ߅ߌࠆᦨㆡߥ. ኻ⽎ߪ㧘ᧄ⎇ⓥߦหᗧࠍᓧߚᢛᒻᄖ⑼⊛∔ᖚߩᣢᓔߩߥஜᏱᚑੱ↵ᕈ 1 ฬ(ᐕ㦂 20 ᱦ㧘. ⩄㊀㊂ߦߟߡߩ㧘ᬌ⸛ߪ߅ߎߥࠊࠇߡߥߚ㧘ᦨㆡߥ⩄㊀㊂ߩᬌ⸛ߦߟߡߪᓟ. ㊀ 62kg㧘BMI 21.0)ߦኻߒߡ STSM ᷹ቯࠍᧄ⎇ⓥߦหᗧࠍᓧߚ㧘ℂቇ≮ᴺ჻ 3 ฬ㧔⚻㛎. ߩ⺖㗴ߢࠆ㧚. ᐕᢙ 4-6 ᐕ㧕ߦߡ᷹ቯࠍታᣉߒߚ㧚. ᓟߪ㧘ஜᏱੱߦ߅ߌࠆエㇱ⚵❱⎬ᐲߩၮḰ୯ࠍᚑߒ㧘⥃ᐥᔕ↪ࠍⷞ㊁ߦࠇߚ∔ᖚ. ᷹ቯㇱߪ㧘ฝߩ⣄ᩇ┙╭㧔L4-5 ࡌ࡞㧕ߣ௯Ᏺ╭ㇱ㧘ฝਅ⢇ߩౝࡂࡓࠬ࠻. ߩエㇱ⚵❱⎬ᐲߩ․ᕈߥߤߦߟߡߩᬌ⸛ࠍㅴߡߊᔅⷐᕈ߇ࠆ㧚߹ߚ㧘STSM ߩ. ࡦࠣࠬ㧘ౝ⣦⣻╭ߩ╭⣻ਛᄩㇱߣߒߚ㧚. ⥃ᐥᔕ↪ߪℂቇ≮ᴺߩࠛࡆ࠺ࡦࠬࠍ᭴▽ߔࠆߢ߽㊀ⷐߢࠅ㧘ၮ␆߅ࠃ߮⥃ᐥߩਔ㕙߆. ᷹ቯߦߪ⩄㊀ߣᄌࠍหᤨߦ᷹ቯน⢻ߥ STSM(․ᱶ⸘᷹␠㧘TK-03C)ࠍ↪ߒߚ㧚ᧄ. ࠄ࠺࠲ࠍ㓸Ⓧߒߡߊߎߣ߇㊀ⷐߢࠆߣ⠨߃ࠄࠇߚ㧚. ⎇ⓥߦ↪ߒߚ STSM ߪ㧘ߒᒰߡㇱవ┵ߩᓘ 30Ǿ㧘ᄌ᷹ቯ▸࿐ 30mm㧘⩄㊀᷹ቯ▸. 㧕. ߿╭∋ഭ. 㧘߹ߚ⚻ቇ⊛∔ᖚ߿ࡦࡄᕈ㕒⣂ᕈ∔ᖚߥߤߩ 565. ߦߟߡᬌ⸛ߐࠇߡࠆ߇㧘ߘߩା㗬ᕈߦ㑐ߒߡ⏕ߢߪߥ㧚ߐࠄߦၮ␆߅ࠃ. 㧨㧕㧚. ࿐ 30N ߢࠅ㧘േ߭ߕߺࠕࡦࡊ 2ch ߣធ⛯ߔࠆߎߣߦࠃࠅหᤨߦ᷹ቯน⢻ߥ߽ߩߢࠆ(࿑ 1)㧚. 5㧚⻢ㄉ ࿁ߩ⎇ⓥߦදജߒߡ㗂ߚ㧘⮮ࡂࡆ࠹࡚ࠪࡦቇ㒮ߩ⊝᭽ߣ㧘ߏᜰዉ㗂߈߹ߒߚ. ᷹ቯᣇᴺߪ㧘ℂቇ≮ᴺ჻ 3 ฬߦࠃࠅ㧘ฦⵍᬌ╭ߩ╭⣻ਛᄩㇱߦࠄ߆ߓශࠍઃߌ㧘ߘ. వ↢ᣇߦᗵ⻢↳ߒߍ߹ߔ㧚߹ߚ㧘දജࠍ㗂ߚⵍ㛎⠪ߩ⊝᭽ߦᗵ⻢⥌ߒ߹ߔ㧚. ߩ⋥ࠃࠅ STSM ߦࠃࠅ᷹ቯߒߚ㧚ᬌᩏ⠪ߦߪ㧘Ԙ߈ᚻࠍ↪ࠆߎߣ㧘ⵍᬌ╭ߦኻߒߡ. . ԙု⋥ߦߔࠆߎߣ㧘ԙࠁߞߊࠅߣߔࠆߎߣࠍᜰ␜ߒߚ㧚. ᢥ₂ ർ↰⠹ม㧘↰Ꮞᒄਯ㧘⦼ጊ⑲ᄥ㇢㨯ઁ㧦╭∋ഭߦࠃࠆ❗ᤨߩ╭⎬ᐲᄌൻ㧚,,5RQTV5EK㧘 60. 57.
(11) ᐨ⺰ ᨵ┹ᛛߪᛛⴚ⊛ߦߪᛩᛛޔ࿕ᛛ߆ࠄ᭴ᚑߐࠇࠆᩰ㑵ᛛߢࠅ┹ߩߘޔᛛ․ᕈ߆ࠄࠬࡐ࠷៊்ߩࠬࠢ ߪ㜞ޕਛߢ߽⤒៊்ߪᦨ߽ฃ்㗫ᐲߩ㜞៊்ߩ৻ߟߣߐࠇ 1-6)߽߆ߒޔᲧセ⊛㊀∝ߦߥࠅ߿ߔޕᏒᎹ 1). 㧘 㧚 (KUEJGT## 2TGUUWTGCNIQOGVT[QXGTPQTOCNOWUENG5VCPFCTFXCNWGUXCNKFKV[CPF. ࠄߩႎ๔ߦࠃࠇ߫ޔ8 ᱦ߆ࠄ 19 ᱦ߹ߢߩᨵㆬᚻߦ߅ߡ⤒㑐▵ߩ៊்₸ߪ 182 ฬਛ 58 ฬ(31.8㧑)ߣᦨ߽㜞 ߊޔᄢቇ↢߅ࠃ߮⼊ኤቭߢߪ 331 ฬਛ 77 ฬ(23.3㧑)ߣޔ⢋㑐▵⿷ޔ㑐▵߅ࠃ߮⿷⿾ߩᰴߦ㜞㗫ᐲߢ⊒↢ߒ ߡࠆ ࠄߚ߹ޕ6㧕ߪޔ2001 ᐕ 4 ߆ࠄ 2002 ᐕ 9 ߹ߢߩ㑆ߦࠬࡐ࠷ࠢ࠾࠶ࠢࠍฃ⸻ߒߚ↵ᕈᨵ ㆬᚻߦ߅ߌࠆ⤒៊்ߩഀวߪ⚂ 30㧑ޔᅚᕈᨵㆬᚻߦ߅ߡߪ⚂ 40㧑ߢࠅޔᨵㆬᚻߢߪ⤒៊்ߩฃ்߇ ᦨ߽ᄙ߆ߞߚߣㅀߴߡࠆޕ. TGRTQFWEKDKNKV[QHRTGUUWTGVJTGUJQNF2CKP㧘 ጊ৻ⴕ㧘Ꮉᚻାⴕ㧘᳓㑆ᱜẴ㧦ஜᏱ⠪㐳ᯂᚻᩮિ╭ㇱߦ߅ߌࠆ⍴ᤨ⊛ዮિㆇേ⽶⩄ ᤨ߮⽶⩄ᓟߩ╭⎬ᐲߩᄌൻߦߟߡ㧚ᤘකળ㧘㧘 㧦́㧚 -CT5--CT2-/CPKC, 6KUUWGVQPQOGVT[CWUGHWNVQQNHQTCUUGUUKPIHKNCTKCN N[ORJGFGOC.[ORJQNQI[㧘 㧕#MKTC6CMCPCUJK*KTQUJK-CTCUWPQ/WPGPQTK-CVQWGVCN 4GNKCDKNKV[QHVJGWUG. ፉ↰ 4)ߪޔ ᨵߦࠃࠆ⤒㑐▵ߩ៊் 50 ࠍኻ⽎ߦߒߚ⎇ⓥߦ߅ߡޔ ⤒೨චሼ㕢Ꮺ 㧔anterior cruciate ligament; ACL)ࠍ៊்ߒߚ 16 ోߢ⤒ߚ߹ޔᓟචሼ㕢Ꮺ㧔posterior cruciate ligament; PCL㧕ࠍ៊்ߒߚ 8 ਛ 7 ߢޔ ᨵ┹ᛛߩ⛮⛯ߦᡰ㓚߇ߞߚߣႎ๔ߒߡࠆ╩ߦࠄߐޕ⠪ߪ⥃ᐥޔ㊀∝ᐲߩ㜞⤒៊்ࠍ⚻㛎ߒߚㆬᚻ ߢߪޔ ޟᖚ⢇ߦ㊀߇ដ߆ߞߚ⁁ᘒߢࠍ⤒ޔౝߦᝳࠆࠃ߁ߥേࠍߔࠆߣ⤒ߩജ߇ᛮߌߣ࠶ࠢࠟޔ፣ࠇߡߒ ߹߁(ࠊࠁࠆ giving way⤒ޔ፣ࠇ)ߚޔᛛࠍដߌࠆߩ߇ᔺޠ ޔ ⽶ߦ⤒ߡߒߚޟᜂߩដ߆ࠄߥᛛߢ߽ዋߒ. QHCUQHVVKUUWGUVKHHPGUUOGVGT#%26 ⍫ ㊁ ᔘ 㧘 㚍 ⟵ ⾆ 㧘 ᧄ ବ ਯ 㧦 ∩ ၞ ୯ ห ᤨ ⸘ ᷹ ဳ ↢ ↪ ⚵ ❱ ⎬ ᐲ ⸘ & ޟKIKVCN 2CNRQOGVGTߩޠ㐿⊒㧔╙㧝ႎ㧕㧚ᣣᧄᚻᛛ≮ᴺቇળ㔀㧘㧘㧥 㧝 㧚 ᢧ⮮⑲ਯ㧦∩ߺߦ㑐ㅪߔࠆ↢ᖱႎߩ᷹ቯᴺ㧚ℂቇ≮ᴺ㧘㧘㧦㧚 㜟᪸ᤩ㧘ട㧘ὖ㊁ᄢ㨯ઁ エㇱ⚵❱⎬ᐲ⸘ߦ߅ߌࠆౣᕈ㧘ା㗬ᕈߩᬌ⸛ߣ⥃ᐥᔕ ↪㧚ኾ㐷ࡂࡆ࠹࡚ࠪࡦ㧘㧘㧦㧚 㜟᪸ᤩ㧘ὖ㊁ᄢ㧘Ⴎ↰ℙ⟤㨯ઁ ⒳㘃ߩエㇱ⚵❱⎬ᐲ⸘ߦ߅ߌࠆౣᕈ㧘ା㗬ᕈߩᬌ⸛㧚. ߢ߽ࡃࡦࠬ߇፣ࠇߚࠅߔࠆߣ∩ߺ߇↢ߓࠆߩߤߥޠਇᗵࠍ⸷߃ࠆㆬᚻߩࠍ⚻㛎ߒߡ߈ߚޔߜࠊߥߔޕ ᨵ┹ᛛߦ߅ߡ⤒៊்ߪ⊒↢㗫ᐲ߇㜞ߩߺߢߪߥߊߩߘޔᓟߩㆬᚻ↢ᵴߦᓇ㗀ࠍ߷ߔ㊀ᄢߥ㗴ߢ. ℂቇ≮ᴺ⑼ቇ㧘㧘 㧦㧚 㧕,CTK2##TQMQUWMK,CTMMC6WWNC (GTUKDKNKV[QHVJGWUGQHCPQXGNUQHVVKUUWG UVKHHPGUUOGVGT 2*5+1.1)+%#./'#574/'06. ࠆߣ⠨߃ࠄࠇࠆޕ ⤒៊்ᓟ┹ޔᛛᓳᏫࠍߒߚ㓙ߩᨵㆬᚻߩਇᗵ߿∩ߺߪࡄࡈࠜࡑࡦࠬߩૐਅߦ❬߇ࠆߩߺߢߪߥߊޔ. .CPFKU,4-QEJ)) 6JGOGCUWTGOGPVQHQDUGTXGTCITGGOGPVHQTECVGIQTKECNFCVC $KQOGVTKEU . ౣ៊்ߩෂ㒾ᕈ߽㜞ࠆ߆߽ߒࠇߥޔߡߞ߇ߚߒޕᨵㆬᚻ߇⤒៊்ᓟ߽┹ᛛࠍ⛮⛯ߒߡߊߚߦߪޔ ⸘↹⊛ߥࠕࠬ࠹ࠖ࠶ࠢࡂࡆ࠹࡚ࠪࡦࠍታᣉߒޔਇᗵ߿∩ߺࠍ⸃ᶖߒߡ߅ߊߴ߈ߢࠈ߁ߚߩߘޕ ߦߪ┹ᛛ․ߩേ߈ࠍ⠨ᘦߒߚࡊࡠࠣࡓߩᚑ߇ᔅⷐߢࠅ்៊⤒ߦ․ޔᓟߦਇᗵ߿∩ߺߥߤߩ⸷߃ ߇ᄙᨵേࠍℂ⸃ߒߡ߅ߊߎߣߪ㊀ⷐߥߎߣߢࠆߣ⠨߃ࠆޕ ട߃ߡޔਇᗵ߿∩ߺࠍ↢ߓߐߖࠆേߦኻߔࠆ㑐ㅪⷐ࿃ߩಽᨆ߽ᔅⷐߢࠈ߁↵ޔ߫߃ޕᅚߢߪਅ⢇ ߩ╭ജߪ⇣ߥࠅߦ⊛⥸৻ޔᅚሶㆬᚻߩ╭ജߪ↵ሶㆬᚻࠃࠅ߽ૐߚ߹ޕᅚᕈߪ⚻ᦼߩᓇ㗀ࠍฃߌᅚᕈࡎ ࡞ࡕࡦߩჇട߇ߺࠄࠇࠆ߇߇ࠇߘޔ㕢Ꮺߩᒆ✭ᕈߩჇᄢࠍ↢ߓߐߖࠆน⢻ᕈ߽ᜰ៰ߐࠇߡࠆ 7,8)ߩࠄࠇߎޕ ╭ജ߿㑐▵ᒆ✭ᕈߩ㆑ߪޔਇᗵ߿∩ߺߩήߦ㑐ㅪߒߡࠆ߆߽ߒࠇߥޔߦࠄߐޕవㅀߩፉ↰ 4)ߪޔ ACL ៊்ࠍฃ்ߒߚ႐วޟᖚ⢇ߩߺߢ㊀߇ᡰ߃ࠄࠇߥޠ ޔ ޟಿ⣉߇ᕁ߈ߞߡដߌࠄࠇߥߤߥޠᛛࠍដ ߌߦߊ㓙ߦ∩ߺ߿ਇᗵࠍ⸷߃ࠆ႐ว߇ᄙߊޔPCL ៊்ߢߪ․ߦ⿷ᛛࠍដߌࠄࠇߚߣ߈ߩ⸷߃߇ᄙ߆ߞߚ ߇ޔᛛࠍដߌࠆ㓙ߩ⸷߃ߪ ACL ៊்ߣᲧセߒዋߥߊޔേߩᄢ߈ߥ㒢ߪߺࠄࠇߥ߆ߞߚߣߒ்៊ޔㇱߦ ࠃߞߡฃ்ᓟߦ∩ߺ߿ਇࠍ⸷߃ࠆേ߇⇣ߥࠆߎߣࠍႎ๔ߒߡࠆߦࠄߐޕ㊀ߩᓇ㗀߽ήⷞߔࠆߎߣߪ ߢ߈ߥ┻ޕౝ 5)ࠄߪޔᨵㆬᚻߩ⤒㕢Ꮺ៊்ᓟޔ㊀ߩ㊀⠪߶ߤ┹ᛛᓳᏫ₸߇ᖡ߆ߞߚߣႎ๔ߒߡࠆޕ. 64. 61.
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