᪩✄⏣ᏛᑂᰝᏛㄽᩥ
༤ኈ㸦ࢫ࣏࣮ࢶ⛉Ꮫ㸧
ዪᏊࣛࢡࣟࢫ➇ᢏ࡛ࡢࢫ࣏࣮ࢶയᐖࡢ ᐇែண㜵ࡢᐇ㊶
Injury Surveillance and Injury Prevention in Female Lacrosse
㸰㸮㸯㸱ᖺ㸵᭶
᪩✄⏣ᏛᏛ㝔 ࢫ࣏࣮ࢶ⛉Ꮫ◊✲⛉
బ㔝ᮧ Ꮫ
SANOMURA, Manabu
◊✲ᣦᑟᩍဨ㸸⚟ᯘ ᚭ ᩍᤵ
┠ ḟ
➨
➨1 ❶ ᗎㄽ ... 1
➨ 1⠇ ᗎ ... 2
➨2 ⠇ ᮏㄽᩥࡢ ᵓᡂ ... 21
➨2 ❶ Ꮫዪ Ꮚࣛࢡ ࣟࢫࡢയ ᐖㄪᰝ ... 23
◊✲ 1 Ꮫዪ Ꮚࣛࢡ ࣟࢫࡢ 2ᖺ 㛫ࡢയᐖ ㄪ ᰝ ... 24
2-1-1 ⥴ゝ ... 24
2-1-2 ᑐ㇟ ᪉ἲ ... 26
2-1-3 ⤖ᯝ ... 27
2-1-4 ⪃ᐹ ... 42
2-1-5 ⤖ㄒ ... 52
➨3 ❶ ㊊㊑㛤 ࡀື ⓗୗ⫥ ࣓ࣛ ࣥࢺ ཬࡰࡍᙳ 㡪 ... 53
◊✲ 2 ㊊㊑㛤 ⬟ ࠾ ࡼࡧ㊊㊑㛤 ᣦ♧ࡀ ື ⓗୗ⫥ࣛ ࣓ࣥࢺ ཬࡰࡍᙳ 㡪 ̿∦⬮ ࢫࢡ࣡ࢵ ࢺ 㸪∦⬮ࢻࣟ ࢵࣉࣛࣥ ࢹ ࣥࢢ㸪࢝ ࢵࢸࣥ ࢢ ືస࡛ࡢ ศᯒ̿ ... 54
3-2-1 ⥴ゝ ... 54
3-2-2 ᑐ㇟ ᪉ἲ ... 55
3-2-3 ⤖ᯝ ... 63
3-2-4 ⪃ᐹ ... 74
3-2-5 ⤖ㄒ ... 80
➨4 ❶ ࣛࢡࣟ ࢫࢫࢸ ࢵࢡࡢ ಖᣢ ࡸ ᧯సࡀ ືⓗୗ⫥ ࣛ ࣓ࣥࢺ ཬࡰࡍ ᙳ㡪 ... 81
◊✲ 3 ࢻࣟࢵ ࣉ ࣂ࣮ ࢸ࢝ࣝࢪ ࣕࣥࣉ ࠾ࡅࡿࣛࢡ ࣟࢫࢫࢸ ࢵࢡࡢಖ ᣢࡸ᧯సࡀ ୗ⫥࢟ࢿ ࣐ ࢸࢡࢫ࣭ ࢟ࢿࢸ ࢡ ࢫཬࡰࡍ ᙳ㡪 ... 82
4-3-1 ⥴ゝ ... 82
4-3-2 ᑐ㇟ ᪉ἲ ... 83
4-3-3 ⤖ᯝ ... 86
4-3-4 ⪃ᐹ ... 89
4-3-5 ⤖ㄒ ... 91
◊✲ 4 ࣛࢡࣟ ࢫࢫࢸ ࢵࢡࡢಖ ᣢࡢ᭷↓ ࡀ ࢝ࢵࢸࣥ ࢢືస ࡢ ୗ⫥࢟ࢿ ࣐ࢸࢡࢫ ࣭࢟ࢿࢸ ࢡࢫཬࡰ ࡍᙳ㡪 ... 92
4-4-1 ⥴ゝ ... 92
4-4-2 ᑐ㇟ ᪉ἲ ... 93
4-4-3 ⤖ᯝ ... 96
4-4-4 ⪃ᐹ ... 98
4-4-5 ⤖ㄒ ... 102
➨ ➨5 ❶ ୗ⫥ᙧ ែ ࠾ࡼ ࡧୗ⫥➽ ຊ㟼 ⓗ࣭ື ⓗࣂࣛࣥ ࢫ⬟ຊ ࠾ࡼࡧ ୗ⫥ࣛ ࣓ࣥࢺ ࡢ㛵 㐃ᛶ ... 103
◊✲ 5 ㊊㊑ᢕ ᥱຊ 㟼ⓗ࠾ࡼࡧ ືⓗࣂࣛ ࣥ ࢫ⬟ຊ ࡢ 㛵㐃ᛶ ... 104
5-5-1 ⥴ゝ ... 104
5-5-2 ᑐ㇟ ᪉ἲ ... 105
5-5-3 ⤖ᯝ ... 109
5-5-4 ⪃ᐹ ... 114
5-5-5 ⤖ㄒ ... 115
◊✲ 6 㟼ⓗୗ ⫥ࣛ ࣓ࣥࢺ࠾ ࡼࡧ⫤㛵 ⠇ እ㌿➽ຊ ࢻࣟࢵࣉ ࣂ ࣮ࢸ࢝ ࣝࢪࣕࣥࣉ ࡢୗ ⫥ ࢟ ࢿ࣐ࢸࢡ ࢫ࣭࢟ࢿ ࢸ ࢡࢫࡢ 㛵㐃ᛶ ... 117
5-6-1 ⥴ゝ ... 117
5-6-2 ᑐ㇟ ᪉ἲ ... 119
5-6-3 ⤖ᯝ ... 126
5-6-4 ⪃ᐹ ... 130
5-6-5 ⤖ㄒ ... 136
➨6 ❶ ୗ⫥യ ᐖ ண㜵 ࢺ࣮ࣞࢽ ࣥࢢ ධ ຠ ᯝ᳨ド ... 138
◊✲ 7 ୗ⫥യ ᐖண㜵 ࢺ࣮ࣞࢽࣥ ࢢධࡀ ㊊ ㊑ᶵ⬟㸪㊊ 㒊ᙧែ㸪 㟼 ⓗ࣭ືⓗ ࣂࣛࣥࢫ⬟ ຊཬࡰ ࡍ ᙳ㡪 ... 139
6-7-1 ⥴ゝ ... 139
6-7-2 ᑐ㇟ ᪉ἲ ... 140
6-7-3 ⤖ᯝ ... 142
6-7-4 ⪃ᐹ ... 146
6-7-5 ⤖ㄒ ... 152
◊✲ 8 Ꮫዪ Ꮚࣛࢡ ࣟࢫ➇ᢏࢆ ᑐ㇟ࡋ ࡓ ୗ⫥ യᐖண 㜵ࢺ࣮ࣞ ࢽ ࣥࢢධ ࡀയᐖⓎ⏕ ᩘ࠾ࡼࡧ യ ᐖⓎ⏕㢖ᗘ ཬࡰࡍ ᙳ 㡪 ... 153
6-8-1 ⥴ゝ ... 153
6-8-2 ᑐ㇟ ᪉ἲ ... 155
6-8-3 ⤖ᯝ ... 156
6-8-4 ⪃ᐹ ... 169
6-8-5 ⤖ㄒ ... 174
➨ ➨7 ❶ ⥲ྜ⪃ ᐹ ... 175
⥲ྜ⪃ᐹ ... 176
➨8 ❶ ࡲࡵ ... 181
ࡲࡵ ... 182
ᘬ⏝ᩥ⊩ ... 183
ᴗ⦼୍ぴ ... 209
ㅰ㎡ ... 212
1
➨
➨ 1 ❶
ᗎㄽ
2
➨
➨1 ⠇ ᗎ 1-1. ⥴ゝ
21 ୡ⣖ධࡾ㸪ࢫ࣏࣮ ࢶ་Ꮫ࡛ࡣ ࢫ࣏࣮ࢶ യᐖᑐࡍࡿ ண㜵 ↔ Ⅼࡀྥࡅ
ࡽࢀ㸪ୡ⏺ྛ ᅜ࠾࠸ ࡚ከᩘࡢ◊✲ ࡀ 㐍ࡵࡽ ࢀ࡚ ࠸ࡿ㸬ࢫ ࣏࣮ࢶ യ ᐖண㜵ྥ
ࡅࡓྲྀࡾ⤌ࡳ ࡢ᪉ἲࡣ ࡉࡲࡊࡲ࡛࠶ ࡿࡀ㸪ࡑ ࢀࡽࡢ☜❧ࡢ ࡓࡵࡣ ከゅⓗ࡞
ࣉ࣮ࣟࢳࡀᚲ せ࡛࠶ࡾ 㸪ᚋ㸪ࡼࡾ ከࡃࡢ◊ ✲ ᳨ドࡀᚲ せ࡛࠶ࡿ ࡀ㸪᪩ᮇࡢ
☜❧ࡀᮇᚅࡉ ࢀ࡚࠸ࡿ 㸬 യᐖண㜵ἲ ࡢᐇ㊶࠾ ࡼࡧࡑࡢ☜❧ ࡢࡓࡵ 㸪ከᩘࡢ ඛ
⾜ㄽᩥࡽẁ 㝵ⓗ ࣔࢹ ࣝࡀ⤂ࡉࢀ ࡚࠸ࡿ㸬 ࡑࡢ୍ࡘയ ᐖせᅉ ࡢ 」ྜⓗࣔࢹ
ࣝࡀ࠶ࡿ㸦ᅗ1㸧[Meeuwisse, 1994]㸬ࡇࢀ ࡣ 㸪യᐖせ ᅉ ࢆෆᅉ ⓗ࣭እᅉⓗせᅉ
ศࡅ࡚⪃࠼ࡽ ࢀ࡚࠸ࡿ ࡀ㸪ෆᅉⓗせ ᅉ ࡘ࠸ ࡚ࡣᖺ㱋㸪ᰂ ㌾ᛶ㸪 ཷ യ᪤ Ṕ㸪 య ᆺ 㸦somatotype㸧 㸪 ࡑ ࡢ ࣂ ࣓ ࢝ ࢽ ࢡ ࢫ 㸪 ࢥ ࣥ ࢹ ࢩ ࣙ ࢽ ࣥ ࢢ 㸪 ㌟ య ࡢ ᡂ
⇍ᗘ㸦maturation stage㸧➼ࡀヱᙜ ࡋ㸪እᅉ ⓗ せᅉࡘ࠸ ࡚ࡣኳೃ 㸪 ࣇ࣮ࣝࢻ ࡢ≧ែ㸪࣮ࣝ ࣝ㸪ල ➼ࡀヱᙜࡍࡿ 㸬ࡇࢀࡽ ࡢ ෆᅉⓗ࠾ࡼ ࡧእᅉⓗ せᅉࡀࢫ
࣮ࣜࢺࡢയᐖ Ⓨ⏕ᙳ 㡪ࢆཬࡰࡋ㸪 ࡉࡽ ࡣ യᐖࢆㄏⓎࡍ ࡿ㇟㸪 ࡍ࡞ࢃࡕയ ᐖᶵᗎࡼࡾ യᐖࡀⓎ ⏕ࡍࡿ㸬ࡇࢀ ࡽࡢ୍㐃 ࡢയᐖࣔࢹࣝ ࡣ ෆᅉⓗ ࣭እᅉⓗせ ᅉࡽയᐖ ⮳ࡿࡲ࡛ ࡢ ༴㝤せ⣲ ࡋ࡚ᤊ࠼ ࡽࢀ࡚࠸ࡿࡀ 㸪ࢫࣜ ࣮ࢺ ෆᅾ ࡍࡿ༴㝤せ⣲ ࢆ᪩ᮇⓎ ぢࡋ㸪 㐺ษ ᑐᛂࡍࡿ ࡇࡀയᐖண 㜵 ࡢࡓࡵ 㔜せ࡛࠶
ࡿࡇࡀ♧ࡉ ࢀ࡚ ࠸ࡿ[Meeuwisse, 1994]㸬
ᅗ1 A new multifactorial model of athletic injury epidemiology [Meeuwisse, 1994]
3
ᅗ1 ࡛♧ࡋࡓ യᐖせᅉ ࣔࢹࣝࡀ Bahr Krosshaug㸦2005㸧ࡼࡾᨵ Ⰻࡉࢀࡓ 㸦ᅗ2㸧[Bahr and Krosshaug, 2005]㸬ࡇࢀࡣ 㸪ࢫ࣏࣮ ࢶയᐖⓎ ⏕ せ ᅉ࡞ࡿෆᅉ
ⓗ࣭እᅉⓗせ ᅉࡘ࠸ ࡚ 㸪ࡼࡾヲ⣽ ♧ࡉࢀ ࡚࠾ࡾ㸪ෆᅉ ⓗせᅉ ࡘ࠸࡚ࡣᖺ 㱋㸪ᛶᕪ㸪㌟ య⤌ᡂ㸪 ᗣ㸪యຊ㸪 ゎ๗Ꮫⓗ 㸪ᢏ⾡㸪⌮ Ꮫ ➼ ࡀ࠶ ࡆࡽࢀ㸪እ ᅉⓗせᅉࡘ ࠸࡚ࡣ㸪 ࢫ࣏࣮ࢶ せᅉ 㸦ࢥ࣮ࢳ ࣥࢢ㸪࣮ࣝࣝ 㸪ᑂุ➼ 㸧 㸪ྛ✀㜵 ල㸪⏝ල㸪⎔ ቃ ➼ࡀ࠶ ࡆࡽࢀ࡚࠸ࡿ 㸬ࡇࢀࡽ ࡢせᅉࡀ യᐖ Ⓨ⏕ࡢᙳ 㡪ࢆཷࡅࡸ
ࡍࡃ࡞ࡿࡇ 㸪ࡑࡋ࡚ ࡇ ࢀࡽࡢせᅉ ࡽ യᐖ ࡀண ࡉࢀࡿ ࢫ࣮ࣜ ࢺࢆ Ⓨぢࡍ
ࡿࡇ㸪ࡲ ࡓ㸪യ ᐖ ࡢ ᐇ㝿࠾࠸࡚ ࡣ㸪ࣉ ࣞ ࣮≧ἣ ࡸ㑅ᡭ ࠾ࡼࡧᩛ 㑅ᡭ ࡢືࡁ㸪
㌟యຊᏛ㸦㐠 ື࣓࢝ࢽ ࢬ࣒㸧 㸪ヲ⣽ ࡞ྛ㛵⠇ ࡢືࡁ ➼ࡀയ ᐖⓎ⏕ࡢ せᅉ ࡞ࡿ
ࡇࡀ♧ࡉࢀ ࡚࠸ࡿ 㸬
ᅗ 2 Comprehensive model for injury causation [Bahr and Krosshaug, 2005]
ࢫ࣏࣮ࢶയᐖ せᅉࢆ♧ ࡍ」ྜⓗࣔࢹ ࣝࡘ࡙ ࠸࡚㸪ࢫ࣏࣮ ࢶ യᐖண 㜵ࡢᐇ㊶
ࣔࢹࣝࡋ࡚ 㸪ከᩘ ᘬ ⏝ࡉࢀ࡚࠸ ࡿ van Mechelenࡽ㸦1992㸧ࡀ ᥦ ၐࡋࡓ 4 ẁ㝵
ࣔࢹࣝࡀ࠶ࡿ㸦 ᅗ 3㸧㸬ࡇࢀࡣ 㸪4 ࡘࡢ ࢫࢸ ࢵࣉࢆ⤒࡚ࢫ ࣏࣮ࢶയ ᐖண㜵 ἲࢆ☜
4
❧ࡉࡏࡿ࠸ ࠺⪃࠼᪉ ࢆᅗᘧࡋࡓ ࡶࡢ࡛࠶ ࡿ 㸬ࡑࢀ ࡒࢀࡢࢫ ࢸࢵ ࣉࡘ࠸࡚ 㸪
➨1 ࢫࢸࢵࣉ ࡛ࡣ㸪യ ᐖࡢ㢖ᗘࡸ㔜 ᗘࢆ᫂ ࡽࡍࡿࡇ ࡋ 㸪യᐖࡢ㒊࣭
✀㢮࣭ཎᅉ➼ ࢆ᫂ࡽ ࡍࡿ㸪 യᐖⓎ⏕ ᩘࡸയᐖⓎ⏕ ⋡㸪㔜 ᗘ㸪ཷയ≧
ἣ➼ࡢㄪᰝ ࡼࡾ㸪യ ᐖࡢᐇែ࠾ࡼ ࡧയᐖ ࡢ ≉ᚩࢆࡼࡾヲ ⣽ᢕᥱ ࡍࡿ 㸬➨ 2 ࢫࢸࢵࣉ࡛ࡣ 㸪യᐖࡢ ཎᅉ㸪࣓࢝ࢽ ࢬ࣒ࢆ᫂ ࡽࡍࡿ ࡇ ࡋ㸪 ≉㢖Ⓨࡋ
࡚࠸ࡿയᐖ ᑐࡍࡿ യ ᐖࡢཎᅉ㸪࣓ ࢝ࢽࢬ࣒ ࢆゎ᫂ࡍࡿ 㸬 ࡑࡋ࡚ ➨3 ࢫࢸࢵ ࣉ
࡛ࡣ㸪➨ 1࠾ ࡼࡧ ➨ 2 ࢫࢸࢵࣉ࡛ࡢ ᳨ドෆᐜ ᇶ࡙࠸࡚㸪 യᐖண㜵 ࣉࣟࢢ࣒ࣛ
ࢆ⪃ࡋ㸪ࢫ ࣏࣮ࢶ⌧ ሙ࡛ࡢධࢆ ⾜࠺㸬᭱ ᚋ➨ 4ࢫࢸ ࢵࣉ࡛ 㸪 ➨ 3ࢫࢸࢵ
ࣉ࡛ᐇࡉࢀ ࡓධຠ ᯝ᳨ド㸪 ➨ 1 ࢫࢸࢵ ࣉࡽ➨ 3 ࢫ ࢸࢵࣉࡲ ࡛⾜ࢃࢀࡓ ෆᐜ࠾ࡼࡧ᳨ ド⤖ᯝ ᑐࡍࡿ᳨ウ ࢆ⾜࠸㸪 ⥲ྜ ุᐃ➼ࢆ ⾜࠺㸬ࡑ ࡋ࡚ࡲࡓ➨
1 ࢫࢸࢵࣉ ᡠࡾ㸪 ྛ ẁ㝵ࢆ⤒࡞ࡀ ࡽ᳨ドࢆ ⧞ࡾ㏉ࡋ࡚࠸ ࡃ㸬ࡇࡢ ⥅⥆ⓗ࡞ᐇ
ࡼࡾ㸪ࢫ ࣏࣮ࢶയ ᐖண㜵 ἲࡀ☜ ❧ࡉࢀ ࡚ ࠸ࡃ࠸࠺ࡶ ࡢ࡛࠶ࡿ 㸬ࡇࡢ 4 ẁ 㝵ࣔࢹࣝࡽ 㸪ࢫ࣏࣮ ࢶയᐖண㜵 ྥࡅࡓྲྀ ࡾ⤌ࡳࡋ࡚ 㸪 ึࡵ ࢫ࣏࣮ࢶയ ᐖࡢᐇែࢆ᫂ ࡽࡍ ࡿࡇ㸪ࡍ࡞ ࢃࡕࢫ࣏ ࣮ࢶയᐖㄪᰝ ࡽጞ ࡵ ࡿ࠸࠺ࡇ
࡛࠶ࡿ㸬
ᅗ3 Four step sequence of injury prevention research [van Mechelen, 1992].
5
1-2. ࢫ࣏࣮ࢶയᐖ ㄪ ᰝἲ
᪥㸪ࢫ࣏࣮ ࢶയᐖㄪ ᰝࡣᅜෆ㸪ᾏ እ࠾࠸ ࡚ከᩘࡢ➇ᢏ ࡛ᐇࡉ ࢀ ࡚࠸ࡿ
ࡀ㸪ࡑࢀࡽࡢ ㄪᰝ᪉ἲ ࡣ㸪ྛ➇ᢏᅋ యࡀ➇ᢏ ≉Ṧᛶࢆ⪃៖ ࡋ ࡚㸪⊂ ⮬ࡢㄪᰝἲ ࡀ⪃ࡉࢀᐇ ࡉࢀ࡚ ࠸ࡿ 㸬ࡇࢀࡽ ࡢㄪᰝ ࡽᚓࡽࢀࡓ⤖ ᯝࡣ 㸪ྠ ➇ᢏ࡛ࡢ
ࣞ࣋ࣝ㸪ᖺ 㱋㸪ᛶู ➼ ࡼࡿᑐ㇟ ⪅ูࡢẚ ㍑᳨ウࡀྍ⬟ ࡛࠶ࡿࡀ 㸪ࡢ➇ᢏ
ࡢẚ㍑ࡀᅔ 㞴࡛࠶ࡿ ሙྜࡀከ࠸㸬 ࡑࢀࡣ㸪 യᐖࡢ㒊ࡸ ✀㢮㸪ཎ ᅉ㸪㔜ᗘ
➼ࡢ㡯┠ࡀ⤫ ୍ࡉࢀ࡚ ࠸࡞࠸Ⅽ࡛࠶ ࡿ㸬ࡲࡓ 㸪യᐖࡢᐃ⩏ ࡘ࠸࡚ ࡶ ␗࡞ࡿሙ
ྜࡀ࠶ࡿ㸬 ࡑࡇ࡛ ㏆ᖺ 㸪ᅜ㝿࢜ࣜ ࣥࣆࢵ ࢡጤ ဨ㸦International Olympic Com-
mittee㸸௨ୗ㸪IOC㸧ࡀ ࡞ࡾ㸪ึࡵ ࡚➇ ᢏࢆᑐ㇟ࡋ ࡓ ⤫୍ࡋ ࡓㄪᰝ᪉ἲ
ࡀ☜❧ࡉࢀࡓ[Junge et al., 2006]㸬ࡇࡢㄪᰝ᪉ ἲࡣ㸪ᅋయ➇ ᢏ 㸪 ಶே ➇ᢏ࠸ࡎࢀ
࠾࠸࡚ࡶᑐ ᛂฟ᮶ࡿ ࡇ㸪ࡑࡋ࡚ ࢜ࣜࣥࣆ ࢵ ࢡࡢࡼ࠺ 」ྜⓗ ➇ᢏࡀ㛤ദ ࡉࢀࡿ ࠾࠸࡚ࡶ ྠ୍ㄪᰝ᪉ἲ ࡛ ࡢㄪᰝ ࡀྍ⬟࡛࠶ࡾ 㸪ྛ➇ᢏ 㛫࠾ࡅࡿ
യᐖࡢẚ㍑᳨ ドࡀྍ⬟ ࡞ࡗ࡚࠸ࡿ 㸬⌧ᅾ㸪 ࡇࡢࡼ࠺࡞ୡ ⏺⤫୍ᇶ ‽ࡢയᐖㄪ ᰝ᪉ἲࡀ☜❧ ࡉࢀ㸪ྛ ᅜࡢ➇ᢏᅋయ ࠾࠸࡚ ࡶྠ୍ᇶ‽࡛ ࡢയᐖㄪ ᰝࡀ ᐇࡉ
ࢀࡿࡇࡀᮇ ᚅࡉࢀ࡚ ࠸ࡿ 㸬ୡ⏺ࣞ ࡛࣋ࣝ ࡢ യᐖㄪᰝࡢྲྀ ࡾ⤌ࡳ ࡘ࠸࡚ࡣ㸪 ᅜ㝿ࣞ࣋ ࣝ ࡛ ࡢയ ᐖㄪᰝࡀᐇ ࡉࢀ࡚࠾ ࡾ㸪FIFA ࣮࣡ࣝࢻ࢝ ࢵࣉ[Dvorak et al., 2011; Dvorak et al., 2007; Junge et al., 2004 -1; Junge et al., 2004-2; Junge and Dvorak, 2007]㸪IAAF ୡ⏺㝣ୖ➇ᢏ 㑅ᡭᶒ [Alonso et al., 2009]㸪IHFୡ⏺ࣁ
ࣥࢻ࣮࣎ࣝ㑅 ᡭᶒ[Langevoort et al., 2007]㸪FINA ୡ⏺ ỈὋ➇ᢏ 㑅ᡭᶒ
[Mountjoy et al., 2010]ࡀ㸪ࡲࡓ㸪 ࢪᆅᇦ ࡛ࡢᅜ㝿ࢧࢵ ࣮࢝[Yoon et al.,
2004]ࡢሗ࿌ࡶࡳࡽ ࢀ ࡿ㸬࢜ࣜࣥࣆ ࢵࢡ➇ᢏ ࡢയᐖㄪ ᰝ ࠾࠸ ࡚ ࡣ㸪IOCࡀ
సᡂࡋࡓ⤫୍ ᇶ‽࡛ࡢ യᐖㄪᰝࡀ 2004 ᖺࢸࢿ࢜ࣜࣥࣆ ࢵࢡ➇ᢏ ࡽᐇ
ࡉࢀ㸦ࢸ ࢿ࢜ࣜࣥ ࣆࢵࢡ࡛ ࡣ 8 ࡘࡢᅋయ ➇ᢏ࡛ᐇ㸧[Junge et al., 2007]㸪 ࡉࡽ 2008ᖺி࢜ ࣜࣥࣆࢵࢡ ࠾࠸࡚ 㸪ึࡵ࡚ಶே➇ ᢏ ᅋయ ➇ᢏࢆྵࡵࡓ
➇ᢏࢆᑐ㇟ ࡋ ࡓྠ ୍ᇶ‽࡛ࡢയ ᐖㄪᰝࡀ ᐇࡉࢀࡓ[Junge et al., 2009]㸬
ி࢜ࣜࣥࣆࢵ ࢡ ➇ᢏ ࡛ ᐇ㝿⾜ ࢃࢀࡓയ ᐖㄪᰝ ࢆ 㸪ࡑࡢᴫ せࢆㄝ᫂ࡍ
ࡿ㸬➇ᢏᮇ㛫 ୰Ⓨ⏕ ࡋࡓയᐖࡣ㸪 യᐖㄪᰝ ⏝⣬[Junge et al., 2006]㸪㑅ᡭࡢ
Ⓩ㘓␒ྕ㸪➇ ᢏ✀┠㸪 ཷയ᪥㸪ཷ യࡢ≧ ἣ㸪യᐖࡢ㒊 㸪യᐖ ࡢ✀㢮㸪യ ᐖࡢཎᅉ㸪㏻ ᖖࡢࢺࣞ ࣮ࢽࣥࢢࡶࡋ ࡃࡣヨྜ ཧຍฟ᮶࡞ ࠸᥎ᐃ ࡉࢀࡿ᪥ᩘ
6
➼ࢆグධࡍࡿ㸬യᐖࡢ 㒊ࡣ 24 ࣨᡤ㸪യᐖ ࡢ✀㢮 19㸪യᐖࡢཎ ᅉ 12 ࡀྛࣜࢫ ࢺᣲࡆࡽࢀ 㸦⾲ 1㸧㸪ࡑࢀࡒࢀ ࡅࡽࢀ ࡓࢥ࣮ࢻ␒ྕ ࢆグධ ࡋ ሗ࿌ࡍࡿࢩ ࢫࢸ࣒࡞ࡗ ࡚࠸ࡿ 㸬
⾲ 1 യᐖࡢ㒊 ࣭✀ 㢮࣭ཎᅉࡢྛ 㡯┠ࢥ ࣮ࢻ␒ྕ
യᐖࡢ㒊㸦24㸧
㢌㒊యᖿ㸦8㸧
1.㢦㸦 ┠㸪⪥ 㸪㰯 ࢆྵ ࡴ㸧 2.㢌㒊
3.㢁㒊/㢁᳝
4.⬚᳝/ୖ⫼㒊 5.⬚㦵/⫘㦵 6.⭜᳝/ୗ⫼㒊 7.⭡㒊
8.㦵┙/㦵/Ẋ㒊
ୖ⫥㸦8㸧 11.⫪㒊/㙐㦵 12.ୖ⭎
13.⫝ 14.๓⭎
15.ᡭ㛵⠇
16.ᡭ 17.ᅄᣦ 18.ẕᣦ
ୗ⫥㸦8㸧 21.⫤㛵⠇
22.㰡ᚄ㒊 23.⭣
24.⭸ 25.ୗ⭣
26.࢟ࣞࢫ⭝
27.㊊㛵⠇
28.㊊㒊/㊊㊑
യᐖࡢ✀㢮㸦19㸧
1.⬻㟈┞㸦 ព㆑႙ኻ ࢆ ㄆࡵ࡞࠸ࡶࡢ 㸧 2.㦵ᢡ㸦እ യᛶ㸧
3.⑂ປ㦵ᢡ 㸦࣮࢜ࣂ ࣮ ࣮ࣘࢫ㸧 4.ࡢ㦵യ ᐖ
5.⬺⮻㸪ள ⬺⮻
6.⭝᩿
7.㠌ᖏ᩿ Ᏻᐃᛶ ࠶ ࡾ 8.㠌ᖏ᩿ Ᏻᐃᛶ ࡞ ࡋ
9.㸦㛵 ⠇ and/or 㠎ᖏയᐖ㸧
10.༙᭶ᯈ or㌾㦵യᐖ
11./⫗㞳ࢀ/➽᩿
12.ᡴ᧞/⾑⭘/യ 13.⭝⅖/⭝࿘ᅖ⅖ 14.ᾮໟ⅖ 15./⓶യᐖ 16.ṑࡢയᐖ
17.⚄⤒യᐖ/⬨᳝യᐖ
18.➽⫗③ orࢫࣃࢬ࣒
19.ࡑࡢ
യᐖࡢཎᅉ㸦12㸧
1.࣮࢜ࣂ࣮ ࣮ࣘࢫ㸦 ᚎ ࠎⓎ㸧 2.࣮࢜ࣂ࣮ ࣮ࣘࢫ㸦 ᛴ Ⓨ㸧 3.㠀᥋ゐᆺ യᐖ
4.௨๓ࡢയ ᐖ㒊ࡢ Ⓨ 11.᥋ゐᆺയᐖ㸦 ࡢ 㑅ᡭ㸧
12.᥋ゐയᐖ㸦ື ࠸࡚ ࠸ࡿ≀㸧㸦 㸪࣮࣎ࣝ 㸧 13.᥋ゐയᐖ㸦ື ࠸࡚ ࠸࡞࠸≀㸧㸦 㸪ࢿࢵ ࢺ㸧 14.࣮ࣝࣝ㐪㸦 ๎ ⾜Ⅽ㸧
21.ࣇ࣮ࣝࢻࡢ ≧ែ
22.ኳೃ
23.⏝ලḞ㝗 24.ࡑࡢ
7
IOC Injury Surveillance System ࡼࡗ࡚ᐇ 㝿 ⾜ࢃࢀ ࡓ 2008ᖺ ி࢜ࣜࣥࣆ
ࢵࢡࡢയᐖㄪ ᰝ⤖ᯝ ࡘ࠸୍࡚㒊ㄝ ᫂ࡍࡿ[Junge et al., 2009]㸬ᑐ㇟➇ᢏᩘ 32
➇ᢏ㸪㑅ᡭ Ⓩ㘓⪅⥲ ᩘ 10977ྡ࡛㸪⥲യᐖⓎ ⏕ᩘࡣ 1055࡛࠶ࡗ ࡓ 㸬യᐖⓎ ⏕
⋡ࡣ㸪96.1 㸭1000 㑅ᡭⓏ㘓⪅ᩘ ࡛࠶ ࡗࡓ 㸬 ⥲യᐖⓎ⏕ ᩘ 1055 ࡢ࠺ࡕ㸪ヨ
ྜ୰Ⓨ⏕ࡋ ࡓയᐖᩘ ࡣ 633 㸦73.8㸣㸧㸦 ࢹ࣮ࢱ㊊ࡀ ☜ㄆ ࡉࢀ ࡓ 197 ࡣ 㝖እ㸧㸪ࢺࣞ ࣮ࢽࣥࢢ ୰Ⓨ⏕ࡋࡓ യᐖᩘ ࡣ 225 㸦26.2㸣㸧㸦ࢹ࣮ࢱ㊊ࡀ
☜ㄆࡉࢀ ࡓ 7 ࡣ㝖እ 㸧ሗ࿌ࡉࢀ࡚ ࠸ ࡿ㸬➇ ᢏูࡳࡿ 㸪᭱ࡶയ ᐖⓎ⏕ྜ
ࡀ㧗࠸➇ᢏࡣ ࢧࢵ࣮࢝ ࡛㸪Ⓩ㘓㑅ᡭ ᩘ 496 ྡ୰ 156 ྡ㸦31.5㸣㸧㸪ḟࢸࢥࣥ
ࢻ࣮࡛ 126ྡ୰34 ྡ㸦27.0㸣㸧㸪㝣ୖ࣍ ࢵ ࢣ࣮382 ྡ୰78 ྡ㸦20.4㸣㸧㸪ࣁࣥ
ࢻ࣮࣎ࣝ334ྡ ୰58ྡ㸦17.4㸣㸧㸪࢚࢘ ࢺ ࣜࣇࢸࣥ ࢢ255ྡ୰43ྡ㸦16.9㸣㸧㸪
࣎ࢡࢩࣥ ࢢ 281ྡ୰ 42 ྡ㸦14.9㸣㸧㸪ࢯࣇ ࢺ࣮࣎ࣝ 119ྡ୰ 16 ྡ㸦13.4㸣㸧㸪
㔝⌫189ྡ୰ 21 ྡ㸦11.1㸣㸧ࡢ㡰࡛ ࠶ࡗࡓ 㸬യᐖࡢ ୰࡛㸪᭱ ࡶ ከࡃࡘࡅࡽࢀ
ࡓデ᩿ྡࡣࠕ㊊㛵⠇ ࡢ ࡛ࠖ 81㸦ሗ࿌ ࡉࢀࡓയᐖ ྡ㸪1108 ࡢ 7.3㸣ࢆ
༨ ࡵ ࡿ 㸧 㸪 ࡘ ࡙ ࠸࡚ ࠕ ⭣ 㒊 ࡢ ➽ യ ࠖ75 㸦6.8㸣 㸧 ࡛ ࠶ ࡗ ࡓ 㸬 㒊 ู ࡛ ࡳ
ࡿ 㸪 ᭱ ࡶ ከ ࠸ യ ᐖ ࡢ 㒊 ࡣ ⭣ 㸦13.3㸣 㸧 ⭸ 㸦12.1㸣 㸧 㸪 ࡘ ࡙ ࠸ ࡚ ୗ ⭣ 㸪
㊊㛵⠇࡛࠶ࡾ 㸪㢌㒊 യ ᐖ㸦9.4㸣㸧ࡶࡲࡓ㸪ୖ ⨨ࡋࡓ യᐖ㒊 ࡢ୍ࡘ࡛࠶
ࡗࡓ㸬യᐖࡢ 㒊ࢆୖ ⫥࣭ୗ⫥࣭య ᖿ࣭㢌㢕 㒊ࡢ 4ࡘ ศࡅ࡚ ẚ㍑ ࡍࡿ㸪ୗ
⫥ࡢയᐖࡀ᭱ ࡶከࡃ 600 㸦54.2㸣㸧㸪ḟ ୖ⫥ 218 㸦19.7㸣㸧㸪యᖿ 149
㸦13.4㸣㸧㸪㢌㢕㒊 133 㸦12.0㸣㸧ࡢ㡰 ࡛࠶ࡗࡓ㸬യᐖ ࡢཎᅉ ู࡛ࡳࡿ㸪
᭱ࡶከ࠸യᐖ ࡢཎᅉࡣ 㸪ࡢ㑅ᡭ ࡢ᥋ゐ ࡼࡿയᐖࡀ 282 㸦32.9㸣㸧࡛
యࡢ⣙ 1/3 ࢆ༨ࡵ࡚࠾ ࡾ㸪㠀᥋ゐᆺ യᐖࡀ 172 㸦20.0㸣㸧㸪࢜ ࣮ࣂ࣮࣮ࣘࢫ 㸦ᛴ③ࡳࡀ Ⓨ⏕ 㸧ࡀ 110 㸦12.8㸣㸧㸪ࡘ࡙ ࠸࡚ྠᵝ࢜ ࣮ࣂ࣮ࣘ ࣮ࢫ㸦ᚎ ࠎ
③ࡳࡀⓎ⏕ 㸧ࡀ 78 㸦9.1㸣㸧࡛࠶ ࡗࡓ 㸬ࢺ࣮ࣞࢽࣥ ࢢࡸヨྜ ࢆ୰᩿ࡋ࡞ࡅ
ࢀࡤ࡞ࡽ࡞ ࡗࡓയᐖ ࡀ 844 ୰ 419 㸦49.6㸣㸧࡛㸪⣙༙ ᩘ ࢆࡶ༨ࡵ࡚࠸
ࡓ㸪་ᖌ ࡼࡾ 1 㐌㛫௨ෆࡢ୰ ᩿ࡀ᥎ᐃ ࡉࢀࡓയᐖ ࡀ 275㸦33.0㸣㸧㸪 1㐌㛫ࡽ 1 ࣨ ᭶ࡢ୰ ᩿ࡀ᥎ᐃࡉࢀ ࡓയᐖ ࡀ 93 㸦11.2㸣㸧㸪ࡉࡽࡣ 4 㐌 㛫௨ୖࡢ୰᩿ ࡀ᥎ᐃࡉ ࢀࡓയᐖ ࡀ 41 㸦4.9㸣㸧ࡳࡽࢀࡓ 㸬4 㐌㛫௨ୖࡢ୰
᩿ࡀ᥎ᐃࡉࢀ ࡓ41 ࡢയᐖࡢෆヂ ࡣ㸪㦵 ᢡ 13 㸪㠌ᖏ᩿ 8㸪➽യ 6 㸪
⬺⮻5 㸪 ࢟ࣞࢫ⭝ ᩿ 3㸪 3 ࡛࠶ࡗࡓ㸬 㦵ᢡࡢ ྜࡀ㧗࠸➇
8
ᢏࡣࢸࢥࣥࢻ ࣮࡛ 6 㸦4.8㸣㸧㸪ḟ ࣁ ࣥࢻ࣮࣎ࣝ 4 㸦3.0㸣㸧㸪࣎ࢡࢩ ࣥ ࢢ5 㸦1.8㸣㸧㸪ࢧ ࢵ࣮࢝6㸦1.2㸣㸧㸪㝣ୖ➇ᢏ 10 㸦0.5㸣 㸧࡛࠶ࡾ 㸪⬺
⮻㸭⭝ࡶࡋࡃ ࡣ㠌ᖏ᩿ ࡢྜࡀ㧗 ࠸➇ᢏࡣ ࢸࢥࣥࢻ࣮ ࡛ 4㸦3.2㸣㸧㸪ᰂ㐨
8㸦2.1㸣㸧㸪ࣁࣥࢻ࣎ ࣮ࣝ 7㸦2.1㸣㸧㸪࢘ ࢚ࢺࣜࣇࢸ ࣥ ࢢ 5 㸦2.0㸣㸧㸪
ࣞࢫࣜࣥࢢ 5㸦1.5㸣㸧࡛࠶ࡗ ࡓ㸬⬻ 㟈┞ࡘ ࠸࡚ࡣ࣎ࢡࢩ ࣥࢢ࡛ 2 㸦0.7㸣㸧㸪 ࢧࢵ࣮࡛࢝ 3 㸦0.6㸣㸧㸪ࡑࡢ 1 ࡛ 㔝⌫㸪ࣂࢫࢣ ࢵࢺ࣮࣎ ࣝ㸪࣍ࢵࢣ࣮ 㸪 ᰂ㐨㸪ࢸࢥࣥ ࢻ࣮㸪⮬ ㌿㌴㸪࢝ࢾ࣮ 㸭࢝ࣖࢵ ࢡ࡛ࡳࡽ ࢀ ࡓ 㸬⏨ ዪูࡢയᐖ
࡛ࡣ⏨ᛶ 549 㸦54.2㸣㸧㸪ዪᛶ 464 㸦45.8㸣㸧ࡢሗ࿌ࡀ ࡳࡽ ࢀࡓ㸬 ࡇࢀࡽ
ࡢሗ࿌ࡢࡼ࠺ 㸪➇ ᢏ ࠾࠸࡚⤫ ୍ࡉࢀࡓ ㄪᰝ᪉ἲࡼ ࡿ ⤖ᯝࡣ 㸪ࡢ➇ᢏ
ࡢẚ㍑᳨ウ ࡀྍ⬟ ࡞ࡾ㸪ྛ ➇ᢏูࡢ യᐖ ࡢ≉ᚩࡀࡼࡾ ᫂ࡽ ࡞ࡿ 㸬 ᪥㸪 IOC ࡼࡾ 㸪ࢫ࣏࣮ࢶ യᐖண㜵ྥ ࡅࡓྲྀࡾ ⤌ࡳࡀ ከᩘ⾜ ࢃࢀ࡚࠸ ࡿࡀ㸪2011 ᖺ4 ᭶ࣔࢼ ࢥ࡛㛤ദ ࡉࢀࡓୡ⏺ࢫ ࣏࣮ࢶയ ᐖ࣭ண 㜵་Ꮫ͆The 3rd World Congress on Injury Prevention, The IOC World Conference on Prevention of Injury &
Illness in Sport͇ࡢദ ࡞ࡾ㸪ᙜᏛ࠾ ࠸ ࡚ከᩘࡢയᐖ ㄪᰝሗ࿌ ࡀ⾜ࢃࢀࡓ [IOC World Conference on Prevention of Injury & Illness in Sport, 2011 ]㸬ࡲࡓ㸪ୡ
⏺ྛᅜࡢ௦⾲ ⪅ࡼࡿ ࢫ࣏࣮ࢶ་Ꮫ ࢆ୰ᚰ ࡋࡓ ࢫ࣏࣮ࢶ യᐖண㜵 㛵ࡍࡿ ከ
ᩘࡢࢩ࣏ࣥࢪ ࣒࢘ࡸ࣡ ࣮ࢡࢩࣙࢵࣉ 㸪◊✲ Ⓨ ⾲ ➼ࡀ⾜ࢃࢀ ࡚࠸ࡓ[Abstracts from the IOC World Conference on Prevention of Injury & Illness in Sport, 2011 ; Sanomura and Irie, 2011(abstract); బ㔝ᮧ, 2012]㸬
1-3. ୗ⫥യᐖࡑ ࡢ せᅉ
ୗ⫥യᐖ࣓࢝ ࢽࢬ࣒ ࡘ࠸࡚㸪ୗ⫥ യᐖ㛵 ࡍࡿඛ⾜ㄽᩥ ࡽ㸪እ ᅉⓗせᅉ
ࡋ࡚㸪 ࣞ࣋ࣝ㸪 ᢏ⾡ࣞ࣋ࣝ㸪 ࢩ࣮ࣗࢬ ࡢࢱࣉ㸪ࢧ ࣮ࣇ࢙ ࢫ 㛵ࡍࡿ
ሗ࿌ࡀከᩘࡳ ࡽࢀ㸪ෆ ᅉⓗせᅉ㛵 ࡍࡿሗ࿌ ࡽࡣ㸪ᖺ㱋 㸪ᛶᕪ㸪 ᭶⤒࿘ᮇ㸪 യᐖ᪤ Ṕ࠾ ࡼࡧ㐺ษ ࡞ࣜࣁࣅࣜࢸ ࣮ࢩࣙࣥ 㸪᭷㓟⣲ⓗ⬟ ຊ㸪యᆺ 㸪ࡁ⬮
㠀ࡁ⬮ഃ ࡢയᐖⓎ ⏕ࡘ࠸࡚㸪ᰂ ㌾ᛶ㸪➽ຊ㸪ࣂࣛࣥࢫ ⬟ຊ㸪➽Ⓨⅆ㛫㸪
ୗ⫥࿘ᚄᅖ㸪 ጼໃไᚚ ⬟ຊ㸪ゎ๗Ꮫ ⓗࣛ ࣓ࣥࢺ㸪㊊㒊 ᙧែ ➼ ࡘ࠸࡚」ᩘ
ࡳࡽࢀࡿ[Murphy et al., 2003]㸬እᅉⓗせᅉࡢ ୍ࡘ࡛࠶ࡿ ࣞ࣋ࣝ ࡘ࠸࡚ࡣ 㸪
⦎⩦ヨྜ ࡢയᐖ Ⓨ⏕⋡ࡢẚ㍑ ࡘ࠸࡚ ከᩘࡢሗ࿌ࡀ ࡳࡽࢀࡿ 㸪⭸๓
9
༑Ꮠ㠌ᖏ㸦anterior cruciate ligament㸸௨ ୗ㸪ACL㸧യᐖⓎ⏕⋡ࡢ ẚ ㍑ ࡘ࠸࡚ࡶ
」ᩘሗ࿌ࡉࢀ ࡚࠸ࡿ㸬 ➇ᢏࡣࢧࢵ࢝ ࣮㸪ࣂࢫ ࢣࢵࢺ࣮࣎ࣝ 㸪ࢧࢵ࢝ ࣮㸪ࣂ࣮ࣞ
࣮࣎ࣝ㸪࣓ ࣜ࢝ࣥࣇ ࢵࢺ࣮࣎ࣝ㸪 ࢫ࣍ ࢵࢣ࣮ࡢ ሗ࿌ ࡛࠶ࡿࡀ 㸪ከࡃࡢ➇ ᢏ࠾࠸࡚㸪 ヨྜࡢ യᐖ Ⓨ⏕⋡ࡀ ⦎⩦ࡢ യᐖⓎ⏕⋡ ẚ࡚ 㧗 ࠸Ⓨ⏕⋡ࢆ
♧ࡋ࡚࠸ࡓ㸬 ≉ࣁࣥ ࢻ࣮࣎ࣝ࠾ ࠸࡚ ࡣ 24 ಸ㧗ࡃ[Seil et al., 1998]㸪ࢫ
࣍ࢵࢣ࣮࡛ ࡣ25 ಸ 㧗 ࠸[Stuart and Smith, 1995]࠸࠺ሗ࿌ࡶ࠶ ࡿ 㸬ACL യᐖⓎ
⏕⋡ࡘ࠸࡚ ࡣ㸪ࣁࣥ ࢻ࣮࣎ࣝࡢヨ ྜࡢ യ ᐖⓎ⏕⋡ࡀ⦎ ⩦ẚ ࡚ 30 ಸ㧗
࠸[Myklebust et al., 1998]࠸࠺ሗ࿌ࡶࡳ ࡽ ࢀࡓ㸬ࡑࡢ ࣛࢡࣟ ࢫ࠾࠸࡚ࡶ
⦎ ⩦ ẚ ࡚ ヨ ྜ ࡢ യ ᐖ Ⓨ ⏕ ⋡ ࡀ 㧗 ࠸ ࠸ ࠺ ሗ ࿌ ࡀ 」 ᩘ ࡳ ࡽ ࢀ ࡚ ࠸ ࡿ [Dick et al., 2012; Hinton et al., 2005; Matz and Nibbelink, 2004]㸬
ᢏ⾡ࣞ࣋ࣝ ࡼࡿയ ᐖ Ⓨ⏕⋡ࡢẚ ㍑ ࡘ࠸ ࡚ 㸪Peterson ࡽ㸦2000㸧ࡼࡿࢧ
ࢵ࣮࢝㛵ࡍ ࡿ ሗ࿌ ࡼࡿ 㸪ᢏ⾡ ࣞ࣋ࣝࡢ ప࠸⩌ࡣ㧗࠸ ⩌ẚ㍑ ࡋ࡚㸪യᐖ
Ⓨ⏕㢖ᗘࡀ 2 ಸ㧗ࡗ ࡓࡇࢆሗ࿌ ࡋ㸪Chomiakࡽ㸦2000㸧ࡶࢧ ࢵ࣮࢝➇ᢏࡢ ẚ㍑࡛㸪ᢏ⾡ ࣞ࣋ࣝࡢ ప࠸⩌ࡣ㧗࠸ ⩌ ẚ㍑ ࡋ࡚യᐖⓎ⏕ 㢖ᗘ ࡀ 2 ಸ㧗ࡗࡓ ࡇࢆሗ࿌ࡋ ࡚࠸ࡿ㸬 ୍᪉ 㸪ྠ➇ᢏ ࡢẚ㍑ ࠾࠸࡚㸪 ᢏ⾡ ࣞ࣋ࣝࡢ 㧗࠸⩌ࡣప
࠸ ⩌ ẚ ㍑ ࡋ ࡚ 㸪 യ ᐖ Ⓨ ⏕ 㢖 ᗘ ࡀ 㧗 ࡗ ࡓ ࡢ ሗ ࿌ ࡶ ࡳ ࡽ ࢀ ࡚ ࠾ ࡾ[Hopper et al., 1995]㸪ᢏ⾡ࣞ࣋ࣝ യᐖ Ⓨ⏕㢖 ᗘ㛵ࡋ ࡚ࡣ୍⮴ࡋࡓ ぢゎࡣᚓ ࡽࢀ࡚࠸࡞
࠸㸬
ࢧ࣮ࣇ࢙ࢫ ࡀ ୗ⫥യ ᐖཬࡰࡍᙳ 㡪ࡘ࠸ ࡚ࡣ㸪ேᕤⰪ ࡢയᐖⓎ ⏕㢖ᗘࡀ ኳ↛Ⱚ➼ࡢࢧ ࣮ࣇ࢙ ࢫ ࡛ࡢയᐖⓎ ⏕㢖ᗘ ẚ㍑ࡋ࡚㧗࠸ ࠸ ࠺ሗ ࿌ࡀከᩘࡳ
ࡽ ࢀ ࡿ 㸬 ࣓ ࣜ ࢝ ࣥ ࣇ ࢵ ࢺ ࣎ ࣮ ࣝ ࠾ ࠸ ࡚ 㸪Powell㸦1992㸧 ࡣ 㸪 ே ᕤ Ⱚ ኳ ↛ ⰪࡢയᐖⓎ⏕ 㢖ᗘࢆẚ ㍑ࡋ࡚㸪ேᕤⰪ࡛ ࡢ ⭸ 㛵⠇ࡀ㧗 ࡗࡓ ࡇ ࢆሗ࿌ࡋ 㸪 ຍ࠼࡚ ACLയ ᐖⓎ⏕ ⋡ࡶ㧗ࡗࡓ ࡇࢆሗ ࿌ࡋ࡚࠸ࡿ㸬Arnason ࡽ㸦1996㸧ࡣ ࢧࢵ࣮࢝࠾ ࠸࡚ 㸪ே ᕤⰪ࡛ࡢയᐖ Ⓨ⏕⋡ࡣ ኳ↛Ⱚẚ㍑ ࡋ࡚ 㸪2 ಸ㧗࠸Ⓨ⏕
⋡ࢆ ♧ ࡋ ࡓࡇ ࢆ ሗ࿌ ࡋ࡚ ࠸ ࡿ 㸬 ࡲ ࡓ 㸪Olsen ࡽ㸦2003㸧 ࡣ㸪 ࣁ ࣥ ࢻ࣎ ࣮ ࣝ
࠾࠸࡚㸪ᮌ〇 ࡢᗋ ே ᕤⓗసࡽࢀ ࡓᗋ࡛ࡢ യᐖ Ⓨ⏕⋡ࢆ ሗ࿌ࡋࡓ 㸬 ≉ዪᛶ
࠾࠸࡚㸪ே ᕤⓗస ࡽࢀࡓᗋ࡛ࡢ യᐖⓎ⏕ ⋡ࡀ㸪ᮌ〇ࡢ ᗋẚ㍑ ࡋ࡚㧗࠸Ⓨ
⏕⋡ࢆ♧ࡋ࡚ ࠸ࡓ㸬ྠ ࡌࡃ Olsen ࡽ㸦2003㸧ࡢሗ࿌ࡽࡶ 㸪ேᕤⓗ సࡽࢀࡓ ᗋ࡛ࡢയᐖⓎ ⏕ᩘࡀ㸪 ᮌ〇ࡢᗋẚ ㍑ࡋ࡚㧗 ࠸ഴྥࢆ♧ࡋ ࡚࠸ࡓ㸬 ேᕤⰪࡶࡋ
10
ࡃࡣேᕤ࡛స ࡽࢀࡓᗋ ࡛ࡢയᐖⓎ⏕ ⋡ࡀ㧗࠸ ࡇࡀከᩘሗ ࿌ ࡉࢀ࡚ ࠸ࡿࡀ㸪ࡇ
ࢀࡣᗋ㠃ࢩ ࣮ࣗࢬࡢ ᥋ゐ㠃࡛ࡢᦶ ᧿ᢠࡀ 㧗ࡲࡿࡇ࡛ 㸪ᛴ⃭࡞ ࢫࢺࢵࣉ㸪
࢝ࢵࢸࣥࢢ 㸪ࣆ࣎ࢵ ࢺືస 㸪 㛵⠇ࡸ➽ ⫗ 㸪㌾㦵㸪⭝ 㸪㠌ᖏ ࡢఙᙇࢫࢺ
ࣞ ࢫ ࡸ ㌿ ࢫ ࢺ ࣞ ࢫ ࡀ ࡿ ࡇ ࡀ せ ᅉ ࡛ ࠶ ࡿ ⪃ ࠼ ࡽ ࢀ ࡚ ࠸ ࡿ[Heidt et al., 1996; Inklaar, 1994]㸬
ෆ ᅉ ⓗ せ ᅉ ࡘ ࠸ ࡚ ࡣ 㸪 ᛶ ᕪ യ ᐖ 㛵 ࡍ ࡿ ሗ ࿌ ࡛ ࡣ 㸪 ࢧ ࢵ ࢝ ࣮ ࠾ ࠸ ࡚
Backous ࡽ㸦1988㸧ࡣዪᛶࡣ ⏨ᛶ ẚ 㸪⥲ യᐖⓎ ⏕⋡ ࡀ㧗 ࡗࡓ ࡇࢆ ሗ࿌
ࡋ㸪ࣂࢫࢣࢵ ࢺ࣮࣎ࣝ ࠾࠸࡚㸪Hosea ࡽ㸦2000㸧ࡣዪᛶ ࡣ⏨ᛶ ẚ㸪㊊㛵
⠇ ࡢ യ ᐖ Ⓨ ⏕ ⋡ ࡀ 㧗 ࡗ ࡓ ࡇ ࢆ ሗ ࿌ ࡋ ࡚ ࠸ ࡿ 㸬 ୍ ᪉ ࡛ 㸪Baumhauer ࡽ 㸦1995㸧ࡣ㸪ࣇ࣮ࣝ ࢻ࣍ࢵࢣ࣮㸪 ࢧࢵ࣮࢝ 㸪ࣛࢡࣟࢫࡢ ㊊㛵⠇ യᐖⓎ⏕
⋡ࢆẚ㍑ࡋࡓ ࡀ㸪⏨ዪ 㛫ᕪࡣ࡞ ࡗࡓࡇ ࢆሗ࿌ࡋ㸪Beynnon ࡽ㸦2001㸧ࡶ
ྠ➇ᢏࡢẚ㍑ ࠾࠸࡚ 㸪⏨ዪᕪࡣࡳ ࡽࢀ࡞ ࡗࡓࡇࢆሗ ࿌ࡋ࡚࠸ ࡿ㸬 ࡑࡢ
ࢧࢵ࣮࢝➇ ᢏ࠾࠸ ࡚㸪⏨ዪࡢയ ᐖㄪᰝࢆ ⾜ ࡗࡓࡇࢁ 㸪യᐖ ࡢ⏨ዪࡢẚ
㍑࠾࠸࡚ᕪ ࡣࡳࡽࢀ ࡞ࡗࡓࡀ㸪 ୗ⫥ ࡢയ ᐖࡘ࠸࡚ࡣ ㊊㛵⠇㠌 ᖏ യᐖࡣ⏨
ᛶࡣዪᛶẚ 3 ಸ㧗 ࠸Ⓨ⏕⋡ࢆ♧ ࡋ 㸪୍᪉ 㸪⭸㛵⠇㠌ᖏ യᐖࡘ ࠸࡚ࡣዪᛶ ࡣ⏨ᛶẚ ࡚3 ಸ㧗 ࠸Ⓨ⏕⋡ࢆ♧ ࡋ ࡚࠸ࡓ[Lindenfeld et al., 1994]㸬ࡲࡓ㸪⭸
㛵⠇യᐖࡘ ࠸࡚㸪⥲ യᐖⓎ⏕⋡ ࡢ ⏨ዪᕪࡣ ࡳࡽࢀ࡞ࡗ ࡓࡀ㸪⭸ 㛵⠇യᐖ
ࡘ ࠸ ࡚ ࡣ ዪ ᛶ ࡣ ⏨ ᛶ ẚ ࡚ 60㸣 ࡢ 㧗 ࠸ Ⓨ ⏕ ⋡ ࢆ ♧ ࡋ ࡓ ࡇ ࡀ ሗ ࿌ ࡉ ࢀ ࡓ
㸪ACL യ ᐖ ࡘ ࠸ ࡚ ࡣ 3.6 ಸ 㧗 ࠸ Ⓨ ⏕ ⋡ ࢆ ♧ ࡋ ࡓ ࡇ ࡀ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ [Messina et al., 1994]㸬ከᩘࡢඛ⾜ㄽ ᩥ ࡽ㸪 ୗ⫥ࡢയᐖ ࡘ࠸࡚㸪 ㊊㛵⠇യᐖ
Ⓨ⏕⋡ࡢ⏨ዪ ᕪࡘ࠸ ࡚ ⤖ㄽࡣᚓࡽ ࢀ࡚࠸࡞ ࠸ࡀ㸪⭸㛵 ⠇യᐖ㸪≉ ACL യᐖ
Ⓨ⏕⋡ࡢẚ㍑ ࡛ࡣዪᛶ ࡣ⏨ᛶẚ ࡚യᐖ Ⓨ ⏕⋡ࡀᴟࡵ࡚ 㧗࠸ࡇ ࡀ ሗ࿌ࡉࢀ
࡚ ࠾ ࡾ 㸪2㹼8 ಸ ࡢ യ ᐖ Ⓨ ⏕ ⋡ ࡢ 㧗 ࡉ ࡀ ♧ ࡉ ࢀ ࡚ ࠸ ࡿ[Liederbach et al., 2008;
Stevenson et al., 1998; Agel et al., 2005; Olsen et al., 2003; Arendt et al., 1999;
Myklebust et al., 1998; Ireland, 1999; Gray et al., 1985 ]㸬
യᐖ᪤ Ṕࡢ ᭷↓യ ᐖ Ⓨ⏕ࡢ㛵 ಀࡘ࠸ ࡚ࡣ㸪 ≉㊊ 㛵⠇യᐖ 㛵ࡍࡿ
ሗ࿌ࡀከᩘࡳ ࡽࢀࡿ㸬 ࢧࢵ࣮࢝㸪ࣂ ࢫࢣࢵࢺ ࣮࣎ࣝ㸪ࣂࣞ ࣮࣮࣎ࣝ ࡽࡢሗ࿌
࡛ࡣ㸪㊊㛵⠇ യᐖࡢ᪤ Ṕࢆࡶࡘ⪅ ࡣ㸪ྠ㒊 ࡢയᐖⓎ⏕ ࣜࢫࢡࡀ 㧗࠸ࡇࡀ ሗ࿌ࡉࢀ࡚࠸ ࡿ[McKay et al., 2001; Bahr et al., 1997; Surve et al., 1994]㸬ࡑࡢ
11
ࣂࢫࢣࢵࢺ ࣮࣎ࣝࡢ ⭸㛵⠇യᐖࡢ ᪤ ࢆࡶ ࡘ⪅യᐖⓎ ⏕ࡢ㛵 ಀࡘ࠸࡚
ࡶ 㸪 ྠ 㒊 ࡢ ᪤ ࢆ ࡶ ࡘ ⪅ ࡣ യ ᐖ Ⓨ ⏕ ࣜ ࢫ ࢡ ࡀ 㧗 ࠸ ࡇ ࡀ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ [Messina et al., 1994]㸬ࡇࢀࡽࡣ㸪㐣 ཤⓎ⏕ ࡋࡓ ྠ㒊ࡢ യᐖⓎ ⏕⋡ࡢ㛵 ಀࡀ♧ࡉࢀ࡚ ࠸ࡿࡀ㸪 ึᅇയᐖᚋ ⾜ࢃࢀࡿ 㐺ษ࡞ ⒪ࡸ ࣜࣁࣅࣜ ࢸ࣮ࢩࣙࣥ
ࡢᐇࡢ᭷↓ ࡀᙳ㡪ࡋ ࡚࠸ࡿ⪃࠼ ࡽࢀ㸪 ➽ ຊࡸࣂࣛࣥࢫ ⬟ຊ ࡢప ୗ㸪㠌ᖏࡢ
༑ ศ ࡞ ᅇ ≧ ែ ࡛ ࡢ ➇ ᢏ ᖐ ࡀ യ ᐖ ࢆ Ⓨ ࡉ ࡏ ࡿ せ ᅉ ࡞ ࡗ ࡚ ࠸ ࡿ 㸬
Ekstrand Gillquist㸦1983㸧ࡣ㸪ࢧ ࢵ࣮࢝㑅 ᡭࢆᑐ㇟ ࡋ ࡚㸪㐺 ษ࡞ࣜࣁࣅ
ࣜࢸ࣮ࢩࣙࣥ ࡀཎᅉ࡛ ྠ㒊ࡢയ ᐖࢆⓎ ࡉࡏࡓࡶࡢࡀ25.8㸣ࡳࡽࢀࡓࡇ 㸪
Chomiak ࡽ 㸦2000㸧ࡣ㸪ྠࡌࡃࢧࢵ ࣮࢝㑅ᡭ ࢆᑐ㇟㸪 㐺ษ࡞ฎ ⨨ࡸࣜࣁࣅ
ࣜࢸ࣮ࢩࣙࣥ ࡀཎᅉ࡛ 㸪ྠ㒊 ࡢയᐖ ࢆⓎ ࡉࡏࡓࡶࡢ ࡀ㸪⣙ 24㸣ࡳࡽࢀࡓ
ሗ࿌ࡋ࡚࠸ ࡿ㸬
ࡁ⬮ഃࡶࡋ ࡃࡣ㠀 ࡁ⬮ഃⓎ ࡋࡓ യᐖ ࡢྜ㛵ࡍ ࡿㄪᰝሗ ࿌ࡼࡿ
㸪Baumhauer ࡽ㸦1995㸧ࡣ㸪ࢧࢵ ࣮࢝㸪ࣇ ࣮ࣝࢻ࣍ࢵ ࢣ࣮㸪ࣛ ࢡࣟࢫࢆᑐ
㇟ࡋ࡚㸪ྑ ⬮ࡀࡁ ⬮࡛࠶ࡿ⩌ ᕥ⬮ࡀ ࡁ⬮࡛࠶ࡿ⩌ ࢆẚ㍑ ࡋ㸪ᕥ⬮ࡀ
ࡁ⬮࡛࠶ࡿ ⩌࠾࠸ ࡚㸪㊊㛵 ⠇ࡀ ከࡃ Ⓨࡋ࡚࠸ࡓ ࡇࢆሗ ࿌ࡋ࡚࠸ࡿ 㸬
Ekstrand Gillquist ࡽ㸦1983㸧ࡼࡿ㸪ྠ ࡌࡃࢧࢵ࣮࢝ 㑅ᡭࢆᑐ ㇟ ࡋࡓㄪ
ᰝ ࡛ 㸪92.3㸣 ࡀ ࡁ ⬮ ഃ ㊊ 㛵 ⠇ യ ᐖ ࢆⓎ ࡋ ࡓ ࡇ ࢆ ሗ ࿌ ࡋ࡚ ࠸ ࡿ 㸬 ዪ Ꮚ ࢚
࣮ࣜࢺࢧࢵ࢝ ࣮ࢆᑐ㇟ ࡋࡓㄪᰝ࡛ ࡣ[ Faude et al., 2006]㸪ࡁ⬮ഃ ㊊㛵⠇യ ᐖࡀከࡃⓎ⏕ ࡋࡓ 㸪⭸㛵⠇യᐖ ࡶࡁ⬮ ഃከࡃⓎ⏕ ࡋࡓࡇ ࢆሗ࿌ࡋ࡚
࠸ࡿ㸬ᅜ㝿ࣞ ࣋ࣝࡽ ࣞࢡ࢚࣮ࣜࢩ ࣙࣥࢫ ࣮ࣜࢺࡲ࡛ࢆ ᑐ㇟ࡋ ࡓ㊊㛵⠇
㛵ࡍࡿയ ᐖㄪᰝ ࡼࡿ[Yeung et al., 1994]㸪ࡁ⬮ഃⓎ⏕ ࡋࡓྜࡀ㧗
࠸ࡇࢆሗ࿌ ࡋ ࡚࠸ࡿ 㸬Orchard㸦2001㸧ࡣ㸪࣮࢜ࢫࢺࣛࣜ ࣥࣇࢵ ࢺ࣮࣎ࣝ
࠾࠸࡚㸪⭣ ᅄ㢌➽➽ യࢆⓎࡋ ࡓ⪅ࡀ㸪 ࡁ⬮ഃከ ࡗࡓࡇ ࢆሗ࿌ࡋ
࡚࠸ࡿ㸬ࡲࡓ 㸪ᕥ⬮࠾ ࡼࡧྑ⬮ࡼ ࡿ യᐖࡢ ẚ㍑࡛ࡣ㸪ዪ Ꮚࢧࢵ࢝ ࣮ࢆᑐ㇟
ࡋࡓㄪᰝ࡛ࡣ[Engström et al., 2005]㸪ྑ⬮ യᐖࡀከ࠸ഴ ྥࡀ♧ࡉ ࢀࡓ 㸪㧗
ᰯ࣭Ꮫࢧࢵ ࣮࢝㸪ࣂ ࢫࢣࢵࢺ࣮࣎ ࣝ㸪ࣛࢡ ࣟࢫ㸪ࣇ࣮ ࣝࢻ࣍ࢵ ࢣ࣮ࢆᑐ㇟
ࡋࡓ㊊㛵⠇ ࡢയ ᐖㄪᰝ ࠾࠸ ࡚ࡶ[Beynnon, 2005]㸪ྑ⬮ ከ ࡃⓎ⏕ࡋ࡚
࠸ࡓࡇࡀሗ ࿌ࡉࢀ࡚ ࠸ࡿ 㸬୍᪉࡛ 㸪㊊㛵⠇ ࠾ࡼࡧୗ ⫥യᐖ ࡁ⬮࣭㠀
ࡁ⬮ഃ࡛ࡢ യᐖⓎ⏕ ⋡ ࠾࠸࡚㸪 ࡑࡢᕪࡣ ࡳࡽࢀ࡞ࡗ ࡓࡢሗ ࿌ࡶከᩘࡳ
12
ࡽࢀ࡚࠾ࡾ[Beynnon et al., 2001; Seil et al., 1998; Surve et al., 1994]㸪ࡁ⬮ഃ
ẚ㍑ⓗയᐖࡀ ከࡃⓎ ࡋ࡚࠸ࡿ ഴྥ ࡀࡳࡽࢀ ࡿࡀ ⤖ㄽࡣᚓ ࡽࢀ࡚ ࠸ ࡞࠸㸬 㛵⠇ᘱ⦆ᛶ യᐖࣜࢫ ࢡࡢ 㛵ಀ ࡘ࠸࡚ࡣ 㸪 ࡑࡢഴྥࡣ ♧ࡉࢀ࡚ ࠸ࡿ ࡀ୍
ᐃࡋࡓぢゎࡣ ᚓࡽࢀ࡚ ࠸࡞࠸ 㸬Ostenberg Roos㸦2000㸧ࡣࢧࢵ ࣮࢝ ࠾࠸࡚㸪 㛵⠇ᘱ⦆ᛶࡢ 㧗࠸ࡶࡢ ࡑ࠺࡛࡞࠸ ࡶࡢࢆẚ ㍑ࡋ㸪㛵⠇ᘱ ⦆ᛶࡢ㧗 ࠸ࡶࡢࡣୗ
⫥യᐖⓎ⏕ࣜ ࢫࢡࡀ4ಸ㧗ࡗࡓࡇ ࢆሗ࿌ ࡋ࡚࠸ࡿ 㸬ࡲࡓ 㸪Södermanࡽ㸦2001㸧 ࡣ㸪ྠࡌࡃࢧ ࢵ࣮࢝ࢆ ᑐ㇟ࡋ࡚㸪 㛵⠇ᘱ⦆ ᛶࡢ㧗࠸ࡶࡢ ࡣୗ⫥യ ᐖࣜࢫࢡࡀ 3.1 ಸ㧗ࡗࡓ ࡇࢆ ሗ࿌ࡋࡓ㸬ࡲ ࡓ㸪ACL യᐖ㌟ᘱ ⦆ᛶ ࡢ㛵㐃ᛶ ࡘ
࠸࡚ࡣ㸪849 ྡࡢኈᐁ Ꮫᰯ⏕ࢆᑐ㇟ ࡋ ࡚㸪ACLയᐖ⩌ 㠀യᐖ ⩌ࢆẚ㍑ࡋ ࡓࡇࢁ㸪ACL യᐖ ⩌ ࠾࠸࡚㌟ ᘱ⦆ᛶࡀ 㧗ࡗࡓࡇ ࢆሗ࿌ࡋ[Uhorchak et
al., 2003]㸪Ramesh ࡽ㸦2005㸧ࡣ㸪ACLയᐖ ⩌ࢥࣥࢺࣟ ࣮ࣝ⩌ࢆ ẚ㍑ࡋ㸪ACL
യᐖ⩌ࡣ㌟ ᘱ⦆ᛶࡀ 㧗ࡗࡓࡇ ࢆሗ࿌ࡋ ࡓ㸬⭸㛵⠇ᘱ ⦆ᛶ⭸ 㛵⠇യᐖ
ࡢ㛵㐃ᛶࡘ ࠸࡚ࡣ 㸪Ekstrand Gillquist㸦1983㸧ࡣ㸪ࢧࢵ࢝ ࣮ࢆ ᑐ㇟ࡋ࡚㸪
⭸㛵⠇ࡢෆ ࣭እ㸪 ๓᪉࣭ᚋ᪉ࡢ ᘱ⦆ᛶࢆ ᳨ᰝࡋ㸪ࡑࢀ ࡽࡢᘱ⦆ ᛶࡀ㧗࠸ࡶ
ࡢࡣയᐖࣜࢫ ࢡ ࡀ㧗 ࡗࡓࡇ ࢆሗ ࿌ࡋ㸪Chomiak ࡽ 㸦2000㸧ࡣ ྠ➇ᢏࢆᑐ㇟
ࡋ࡚㸪⭸㛵 ⠇ࡢ๓᪉ ࣭ᚋ᪉ ᘬࡁᘬ ࡋࢸࢫࢺ 㸪ෆ࣭እ ࢫࢺࣞࢫ ࢸࢫࢺ 㸪ࡑ ࡢࣛࢵࢡ࣐ ࣥࢸࢫࢺ ࢆᐇࡋ㸪⭸ 㛵⠇ᘱ⦆ ᛶࡢቑຍࡀ⭸ 㛵⠇㊊ 㛵⠇യᐖࡢ
༴㝤ᅉᏊ࡞ ࡿ㏙ ࡚࠸ࡿ㸬
㛵⠇ྍືᇦ ୗ⫥യᐖ ࡢ㛵㐃ᛶ ࡘ࠸࡚ࡣ 㸪Södermanࡽ㸦2001㸧ࡣ㸪ዪᏊ ࢧࢵ࣮࢝࠾ ࠸࡚㸪⭸ 㛵⠇ఙᒎゅᗘ ࡀ 10r௨ୖ࠶ࡿࡶࡢ ࡣ㸪ୗ⫥ യᐖࣜࢫࢡࡀ 㧗ࡲࡿࡇࢆ ሗ࿌ࡋ࡚ ࠸ࡿ ࡀ㸪㊊㛵 ⠇⫼ᒅゅ ᗘ ࠾ࡼࡧࣁ࣒ ࢫࢺࣜࣥ ࢢࡢᰂ㌾ᛶ
യ ᐖ ࣜ ࢫ ࢡ ࡢ 㛵 ಀ ࡘ ࠸ ࡚ ࡣ ᭷ ព ࡞ ሗ ࿌ ࡣ ࡳ ࡽ ࢀ ࡚ ࠸ ࡞ ࠸ 㸬Beynnon ࡽ 㸦2001㸧ࡣ㸪ྠ➇ᢏࡢ ዪᛶ ࡢ㊥㦵ୗ 㛵⠇ࡢᅇ ෆ᪉ྥࡢື ࡁࡀ㊊㛵 ⠇യᐖ ࡢࣜࢫࢡ࡞ ࡾ㸪Kaufman ࡽ㸦1999㸧ࡣ㸪ᚋ ㊊㒊ࡢᅇෆゅ ᗘࡀ ࡁ ࠸⪅ࡣ㸪
࢟ࣞࢫ⭝⅖ࡢ ࣜࢫࢡせ ᅉࡢ୍ࡘ࡞ ࡿ ㏙ ࡚࠸ࡿ㸬ࡑࡢ 㸪㛵 ⠇ྍືᇦ
ୗ⫥യᐖ㛵 ࡍࡿሗ࿌ ࡀከᩘࡳࡽࢀ ࡿࡀ[Wiesler et al., 1996; Barrett and Bilisko, 1995]㸪୍⮴ࡋࡓぢ ゎ ࡣ ᚓࡽࢀ࡚࠸ ࡞࠸㸬
ゎ ๗ Ꮫ ⓗ ࣛ ࣓ ࣥ ࢺ ୗ ⫥ യ ᐖ ࡢ ሗ ࿌ ࡘ ࠸ ࡚ ࡣ 㸪Souryal Freeman 㸦1993㸧ࡀ㸪902 ྡࡢ㧗ᰯ⏕ࢫࣜ ࣮ࢺࢆᑐ ㇟㸪⭣㦵 㢛㛫❐ᖜ ᣦᩘ㸦notch
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width index㸸௨ୗ㸪NWI㸧 ACL യᐖࡢ 㛵㐃ᛶࢆ᳨ド ࡋ㸪⏨ዪ ࢫ࣮ࣜ ࢺඹ
ACLയᐖ⪅ ࡢ NWIࡀ㸪㠀യᐖ ⪅ẚ ࡚ ᑠࡉࡗࡓࡇ ࢆሗ࿌ ࡋ 㸪LaPrade
Burnett㸦1994㸧ࡣ㸪Ꮫࣂࢫࢣࢵ ࢺ࣮࣎ࣝ 㸪ࢧࢵ࣮࢝ 㸪ࣂ࣮ࣞ ࣎ ࣮ࣝ㸪య᧯ 㸪
ࣇࢵࢺ࣮࣎ࣝ 㸪ࢫ ࣍ࢵࢣ࣮ ࡢ ィ 213 ྡࡢ NWI ࢆ ᐃࡋ 㸪ACL യᐖ⪅㠀 യᐖ⪅ẚ㍑ ࡋࡓࡇ ࢁ㸪⏨ዪ ࡶ യᐖ ⪅ ࡢNWIࡀᑠࡉ ࡗࡓ ࡇࢆሗ࿌ࡋ
࡚࠸ࡿ㸬ࡋ ࡋ࡞ࡀࡽ 㸪NWI ACL യᐖ࣓ ࢝ࢽࢬ࣒ࡢ 㛵㐃ᛶ ࡘ࠸࡚ࡣ ᭦
࡞ࡿ᳨ウࡀᚲ せࡉࢀ 㸪NWI ࡀᑠ ࡢࡶࡢࡀ ACL യᐖⓎ⏕⋡ࡀ㧗 ࠸࠸࠺ ഴྥ
ࡀ♧ࡉࢀ࡚࠸ ࡿࡀ୍ᐃ ࡢぢゎࡣᚓࡽ ࢀ࡚࠸࡞ ࠸ 㸬
ࡑࡢ Shambaughࡽ㸦1991㸧ࡣࣂࢫ ࢣࢵ ࢺ࣮࣎ࣝ࠾ ࠸࡚㸪ୗ ⫥യᐖ ࡀⓎ
⏕ࡋࡓᑐ㇟⪅ ࡢQ-angle ࡢᕥྑᕪࡀ ࡁ ࡃ㸪യᐖࢆ㈇ࡗࡓ ⬮ഃ ࡢ Q-angle ࡀࡁ
ࡗࡓࡇࢆ ሗ࿌ ࡋ㸪 ࡲࡓ㸪Ⲵ㔜 ࡛ࡢᚋ㊊ 㒊㸦㋖㦵㸧ࡢ እゅᗘ ࡢᕥྑᕪࡀ
ࡁࡃ㸪യᐖࢆ㈇ ࡗࡓ ㊊ഃࡢゅᗘࡀ ࡼࡾࡁ ࡗࡓࡇࢆ ሗ࿌ࡋ ࡚ ࠸ࡿ㸬Cowan
ࡽ㸦1996㸧ࡣ㸪246 ྡࡢ㌷ேࢆㄪᰝ ࡋ㸪㐣ᗘ ࡞⭸ 㛵⠇እ ࢆ࿊ࡍࡿ ⪅ Q-angle
ࡀ15r௨ୖࡁ࠸⪅ ៏ᛶⓗ࡞ୗ⫥ യᐖࡀࡳ ࡽࢀࡓࡇࢆ ሗ࿌ࡋ 㸪Wen ࡽ㸦1998㸧
ࡣ㸪255ྡࡢ៏ᛶⓗ࡞ ୗ⫥ 㞀ᐖࢆࡶ ࡘᑐ㇟⪅ ᑐࡋ㸪Tubercle sulcus angle㸦⭸
㦵 ୰ ኸ ⬯ 㦵 ⢒ 㠃 ࡢ ⤖ ࢇ ࡔ ⥺ ᗋ ࡽ ࡢ ᆶ ┤ ⥺ ࡢ ࡞ ࡍ ゅ ᗘ(ᗙ ࡚ ᐃ)㸧
⭸ 㛵 ⠇ ෆ ࣭ እ ࣛ ࣓ ࣥ ࢺ 㸪 ୗ ⫥ 㛗 ࢆ ᐃ ࡋ ࡓ ࡇ ࢁ 㸪Tubercle sulcus
angleࡢゅᗘࡀࡁ࠸ ⪅⭸ 㛵⠇ෆ ࣛ ࣓ࣥࢺࢆ࿊ࡍ ࡿ⪅ ࡣ㸪ୗ⭣㞀ᐖⓎ⏕
ࡢせᅉ࡞ ࡿࡇࢆ ሗ࿌ࡋ࡚࠸ࡿ 㸬
1-4. ACLയᐖࡑࡢせ ᅉ࣭യᐖ࣓࢝ ࢽࢬ࣒
ୗ⫥യᐖࡣࢧ ࢵ࣮࢝㸪 ࣂࢫࢣࢵࢺ࣎ ࣮ࣝ㸪ࣁ ࣥࢻ࣮࣎ࣝ㸪 ࣛࢡࣟࢫ ࠾࠸࡚ യᐖࡢ࠾࠾ࡼ ࡑ6㹼7⛬ᗘࢆ༨ࡵ ࡿࡀ[Messina et al., 1994; Peterson et al., 2000;
Chomiak et al., 2000; బ㔝ᮧࡽ, 2012; బ㔝ᮧࡽ, 2013; Dick et al., 2012; Mats and Nibbelink, 2004; Junge and Dvorak, 2007; Jørgensen, 1984; Dick et al., 2007]㸪≉
ዪᛶ ࢫࣜ ࣮ࢺࡢ ⭸㛵 ⠇യᐖ Ⓨ⏕ ⋡ࡣ⏨ ᛶ ࢫ࣮ࣜ ࢺ ẚ࡚ 㧗࠸[Messina et al., 1994; Zelisko et al., 1982; Lindenfeld et al., 1994; de Loës et al., 2000; Gray et al., 1985; Schmidt-Olsen et al., 1991; Miyasaka et al., 1991]㸬ࡲࡓ㸪 ዪᛶࢫ࣮ࣜ
ࢺ≉␗ⓗ യᐖⓎ ⋡ࡢ㧗ࡉࢆ♧ ࡋ࡚࠸ࡿ ࡢࡀ ACLയᐖ Ⓨ⏕⋡ ࡛࠶ ࡿࡀ㸪ࣂ
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ࢫࢣࢵࢺ࣮࣎ ࣝ㸪ࢧࢵ ࣮࢝㸪ࣁࣥࢻ ࣮࣎ࣝ ࡽࡢሗ࿌ࡀከ ᩘࢆ༨ࡵ ࡿ㸬 ࡇࢀࡽ
ࡢ➇ᢏඹ㏻ ࡍࡿືస ࡣ㸪ࢲࢵࢩࣗ ࡽࡢᛴ ⃭࡞ࢫࢺࢵࣉ ࡸᛴ⃭࡞ ᪉ྥ㌿㸪
ࣆ࣎ࢵࢺ࠾ࡼ ࡧ࢝ࢵࢸ ࣥࢢ㸪ࢪࣕ ࣥࣉࡽ ࡢ╔ᆅືసࡀ 㢖Ⓨࡋ࡚ ⾜ࢃࢀ࡚࠸
ࡿⅬ࠶ࡿ㸬 ࡲࡓ㸪ࡇ ࢀࡽࡢືసࡀ ඹ㏻ࡋ࡚ ⾜ࢃࢀ࡚࠸ࡿ ࡢ➇ᢏ ࡋ࡚ࡣ㸪
≉⡿ᅜ࡛┒ ࢇ࡛࠶ࡿ ࣛࢡࣟࢫ➇ᢏ ࡀ࠶ࡆࡽ ࢀࡿࡀ㸪ࣛ ࢡࣟࢫ➇ ᢏ ࡢACL യᐖ
Ⓨ⏕⋡ࡶ NCAA ࢹ࣮ ࢱࢆࡳࡿ㝈ࡾ Ỵࡋ࡚ప ࡃࡣ࡞࠸[Hootman, 2007]㸬ዪᛶࢫ
ࣜ ࣮ ࢺ ACL യ ᐖ ࡀ ከ ࠸ ⌮ ⏤ ࡣ ከ ᒱ ࢃ ࡓ ࡿ ࡀ[Bahr and Krosshaug, 2005;
Baker, 1998; Bing and Garrett, 2007; Faunø and Wulff Jakobsen, 2006; Flynn et al., 2005; Griffin et al., 2000; Griffin et al., 2006; Hewett et al., 2006; Hewett et al., 2007; Hutchinson et al., 1995; Hutchinson and Ireland, 1995; Ireland, 1999; Ireland et al., 1997; Ireland and Nattiv, 2004; Ireland and Ott, 2004; Joy et al., 2009; Kelly, 2008; Yu and Garrett, 2007; Quatman and Hewett, 2009; Griffin et al., 2006; Hewett et al., 2006; Renstrom et al., 2008; Shimokochi and Shultz, 2008]㸬ACLയᐖࡣ㸪≉
ዪᛶࢫࣜ ࣮ࢺࡢയ ᐖⓎ⏕⋡ࡀ㧗 ࠸ࡇ㸪 ➇ᢏᖐࡲ࡛ ᪩ࡃ࡚ ࡶ 6ࣨ᭶⛬
ᗘࢆᚲせࡋ 㸪㔜ᗘ ࡢ㧗࠸യᐖࡢ ୍ࡘ࡛࠶ ࡿࡇ㸪ࡲࡓ 㸪ཷയ ⋡ࡶపࡃࡣ
࡞࠸ࡇࡽ 㸪≉ 2000 ᖺ௨㝆㸪ACL യ ᐖண㜵╔┠ ࡋࡓྲྀࡾ ⤌ࡳࡀ㐍ࡳ㸪
᪥㸪ከᩘࡢ ACL യ ᐖண㜵ࣉࣟࢢ ࣒ࣛࡀ⪃ ࡉࢀ࡚࠸ࡿ 㸬 ࡲࡓ㸪 ྠ ACL യᐖ࣓࢝ࢽࢬ ࣒ࡢゎ᫂ ࡶ㐍ࡳ㸪ᐇ 㝿ࡢACLയ ᐖࡢࣅࢹ࢜ ⏬ീ㦵 ᱁ࣔࢹࣝࢆ
࣐ ࢵ ࢳ ࡉ ࡏ ࡚ ศ ᯒ ࡍ ࡿ ᢏ ἲ 㸦MBIM techniques㸸model-based image-matching techniques㸧ࡢ㐍Ṍࡼ ࡾ㸪ࡑࡢヲ⣽ ࡀ᫂ࡽ ࡞ࡗ࡚ࡁ࡚ ࠸ࡿ[Bore et al., 2013;
Koga et al., 2010; Krosshaug et al., 2007]㸬 ௨ ᚋ 㸪ACLയ ᐖ せ ᅉ ࡘ ࠸ ࡚ ㏙ ࡿ 㸬
Ireland ࡽ㸦2002㸧ࡣ ACL യᐖࡢ༴㝤ᅉᏊ ࢆ㸪ෆⓗᅉᏊ ࠾ࡼࡧእ ⓗᅉᏊ㸪」
ྜⓗ࡞ᅉᏊ ศ㢮ࡋ࡚ ㏙࡚࠾ࡾ㸪 ෆⓗᅉᏊ ࢆ ୗ⫥ࣛ ࣓ࣥࢺ㸪 ⭸ 㛵⠇㐣ఙ ᒎ㸪⭣ 㦵㢛㛫❐ ࡢࢧ ࢬ ࡸᙧ≧ 㸪࣍ࣝ ࣔࣥ ࡼࡿᙳ㡪➼ ࡋ 㸪ࡇ ࢀࡽࢆ͆not controllable͇㏙࡚ ࠸ࡿ㸬ࡲࡓ㸪እⓗᅉᏊ ࢆ➽ຊࡸࢥࣥ ࢹࢩࣙ ࢽࣥࢢࡋ㸪 ࡇࢀࡽࢆ͆controllable͇㏙࡚ ࠸ࡿ㸬ࡉ ࡽ Ireland ࡽ㸦2002㸧ࡣ㸪ዪᛶࡳ
ࡽࢀࡿୗ⫥ ࣓ࣛࣥ ࢺࡢ≉ᚩࡋ ࡚㸪⭣ 㦵๓ゅ ᗘ ࡸ Q-angle㸪⬯㦵እゅ ᗘࡢቑ㸪㊊ 㒊ᅇෆ➼ ࢆ♧ࡋ㸪ࡑࢀ ࡽࢆ ͆miserable malalignment syndrome͇
⛠ࡋࡓ㸬ࡲࡓ 㸪ዪᛶ ࢫ࣮ࣜࢺࡢ ࢪ ࣕࣥࣉ ࡽࡢ╔ᆅጼ ໃࡳࡽ ࢀࡿ⭸ 㛵⠇
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࠾ࡼࡧ⫤㛵⠇ ᒅ᭤ࡀᑠ ࡛㸪⭸ 㛵⠇ እゅᗘ ࡀ ࡁ࠸⫥ ࢆACL യ ᐖ࣓࢝ࢽࢬ࣒
ࡢ୍ࡘࡋ࡚ ♧ࡉࢀ࡚ ࠾ࡾ 㸪ࡑࢀࡽ ࢆ͆position of no return͇⛠ ࡋ࡚࠸ࡿ㸬 ACL യᐖ ᙳ㡪 ࢆཬ ࡰࡍゎ ๗Ꮫⓗ せᅉ ࡘ ࠸࡚ࡣ 㸪㊊㒊 ᅇෆ 㸪⭸ 㛵⠇㐣 ఙᒎ 㸪 Q-angle㸪⭣㦵㢛㛫 ❐ᖜ㸪⭣㦵 ๓ゅ ᗘ 㸪⬯㦵እゅ ᗘ㸪⫤㛵 ⠇ෆ᪕࣭እ᪕ ゅ ᗘ ➼ ࡢ ሗ ࿌ ࡀ ከ ᩘ ࡳ ࡽ ࢀ ࡿ 㸪 ㌟ ᘱ ⦆ ᛶ ࡸ ⭸ 㛵 ⠇ ᘱ ⦆ ᛶ 㸪 ࡑ ࡢ BMI 㸦Body mass index㸧㸪࣍ࣝࣔࣥࡢᙳ 㡪ࡘ࠸ ࡚ࡢ ሗ࿌ࡶ」 ᩘࡳࡽࢀ ࡿ㸬
ዪᛶࡢ ACLയ ᐖ ࣓࢝ ࢽࢬ࣒ࡢゎ᫂ ࡢⅭ 㸪ࣂ࣓࢝ࢽࢡ ࢫⓗᡭἲ ࡀ ከᩘ⏝࠸
ࡽࢀ࡚࠸ࡿ㸬ᐇ 㝿ࡢཷ യሙ㠃ࢆ ⏬ീ ゎᯒࡋࡓ ◊✲ㄽᩥࡽ ࡣ㸪ACLཷയ⫥ࡢ ከ ࡃ ࡣ ⭸ 㛵 ⠇ እ ⫥ ࡛ ࠶ ࡿ ࡇ ࡀ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ[Olsen et al., 2004; Kross- haug et al., 2007; Boden et al., 2009; Hewett et al., 2009; Krosshaug et al., 2007]㸬ࡇ
ࢀࡽࡢዪᛶ ࢫ࣮ࣜࢺ ࡀ ♧ࡍ≉ᚩⓗ ࡞⫥ࢆ 㸪 ྛ✀ㄢ㢟ື సࢆ⾜ࢃ ࡏࡓࡢࣂ
࣓࢜࢝ࢽࢡ ࢫⓗ ࡞᳨ ド࠾࠸࡚ࡣ 㸪Ferber ࡽ㸦2003㸧ࡣ㸪ࣛࣥࢽ ࣥࢢືస ࡢୗ⫥ࣛ ࣓ࣥࢺࡢ ⏨ዪ ࡢẚ㍑ࢆ ⾜࠸㸪❧ ⬮┦࠾࠸࡚ ዪᛶࡣ⏨ ᛶẚ㸪
⭸㛵⠇እ࠾ ࡼࡧ⫤㛵 ⠇ෆ㌿ ゅᗘࡀ ᭷ពቑ ຍࡋࡓࡇࢆ ሗ࿌ࡋ࡚ ࠸ࡿ㸬ࡲ ࡓ㸪 Hewett㸦2006㸧ࡽ ࡣ 㸪 ∦⬮ ࣍ࢵ ࣉື స ࠾ ࠸ ࡚㸪 ዪᛶ ࡣ⏨ ᛶ ẚ 㸪⫤ 㛵⠇ ෆ
㌿ゅᗘࡀቑຍ ࡋ࡚࠸ࡓ ࡇࢆሗ࿌ࡋ 㸪Yu ࡽ㸦2005㸧ࡣࢫࢺࢵࣉࢪ ࣕࣥࣉ ࢱࢫࢡ
࠾࠸࡚㸪⭸ 㛵⠇እ ゅᗘࡀቑຍࡋ ࡓࡇࢆ ሗ࿌ࡋࡓ㸬ࡉ ࡽࢫࢡ ࣡ࢵࢺࡸࢪ
ࣕࣥࣉࡽࡢ ╔ᆅ 㸪࢝ ࢵࢸࣥࢢື స ࠾ ࡅࡿ⏨ዪࡢẚ ㍑࠾࠸ ࡚ࡣ㸪Zeller
ࡽ㸦2003㸧ࡣ∦⬮ࢫࢡ ࣡ࢵࢺ࠾࠸ ࡚㸪ዪᛶ ࡣ⏨ᛶẚ 㸪⭸ 㛵⠇ እゅᗘ࠾
ࡼࡧ⫤㛵⠇ෆ ㌿ゅᗘࡀ ቑຍࡋࡓࡇ ࢆሗ࿌ࡋ ࡚࠸ࡿ㸬Kernozakࡽ㸦2005㸧ࡣࢻ
ࣟࢵ ࣉࣛ ࣥࢹ ࣥ ࢢ ࠾࠸ ࡚㸪 ⭸ 㛵 ⠇እ ゅ ᗘࡀ ቑຍ ࡋࡓ ࡇ ࢆ ሗ ࿌ ࡋ 㸪Ford
ࡽ㸦2003㸧ࡣࢻࣟࢵࣉ ࢪࣕࣥࣉ࠾ ࠸࡚㸪ྠ ᵝ⭸ 㛵⠇እ ゅ ᗘࡀ ቑຍࡋࡓࡇ
ࢆሗ࿌ࡋࡓ 㸬McLean ࡽ㸦2004㸧ࡣ࢝ࢵ ࢸ ࣥࢢືస ࠾࠸࡚㸪Malinzak ࡽ 㸦2001㸧ࡣࢡࣟࢫ࢝ࢵ ࢸࣥࢢ࠾ ࠸࡚㸪ྠ ᵝዪᛶࡢ⭸ 㛵⠇እ ゅᗘࡀ᭷ព
ቑຍࡋࡓࡇ ࢆሗ࿌ ࡋ ࡚࠸ࡿ㸬ࡲࡓ㸪Hewett ࡽ㸦2007㸧ࡣ㸪ࢧࢵ࣮࢝㸪ࣂࢫ ࢣࢵࢺ࣮࣎ࣝ 㸪ࣂ࣮ࣞ ࣮࣎ࣝ㑅 ᡭ 205ྡࢆᑐ㇟ࡋࡓ๓ྥ ࡁ◊✲ ࠾࠸࡚㸪 ࢻ
ࣟࢵࣉࢪࣕࣥ ࣉࢱࢫࢡ ࡛ᚓࡽࢀࡓୗ ⫥࢟ࢿ ࣐ ࢸࢡࢫࢆ࣋ ࣮ࢫࣛ ࣥࡋ ࡚㸪 ACLയᐖ⪅㠀യ ᐖ ⪅ࡢୗ⫥ࣛ ࣓ࣥࢺ ࢆẚ㍑ࡋ ࡓ ࡇࢁ㸪ACLയᐖ⪅ࡣ㠀 യᐖ⪅ẚ ࡚⭸㛵⠇ እゅᗘࡀ᭷ ពቑຍ ࡋ࡚࠸ࡓࡇ ࢆሗ࿌ࡋ ࡓ㸬ࡇࢀࡽ
16
ከᩘࡢሗ࿌ ࡽࡳࡽࢀ ࡿࡼ࠺㸪ዪ ᛶࡀ♧ࡍ ⭸ 㛵⠇እゅ ᗘࡸ⫤㛵 ⠇ෆ㌿ゅ ᗘ ࡢቑຍ ࠸ࡗ ࡓ≉ ᚩⓗ ࡞ ୗ⫥ ࣛ ࣓ࣥ ࢺ ࡀ ACL യᐖ せᅉࡢ ୍ ࡘ࡛࠶ ࡿࡇ
ࡀከᩘࡢࣞࣅ ࣮ࣗ ࡽ ሗ࿌ࡉࢀ࡚࠸ ࡿ[Yu and Garrett, 2007; Bahr and Krosshaug, 2005; Griffin et al., 2000; Kelly, 2008; Hewett et al., 2007; Quatman and Hewett, 2009; Griffin et al., 2006; Hewett TE et al., 2006; Renstrom et al., 2008 ]㸬
1-5. ACLയᐖࢆྵࡵࡓ ୗ⫥ യᐖண㜵 ࣉࣟࢢࣛ ࣒
ACLയᐖண㜵ࣉࣟ ࢢ ࣒ࣛࡣ㸪⚄⤒➽ ༠ㄪᛶ ࢆ≺࠸ࡋ ࡚㸪ࢫࢡ࣡ ࢵࢺ ࡸࣛࣥ
ࢪືస㸪࣍ࢵ ࣆࣥࢢ 㸪 ࢪࣕࣥࣉືస ➼ࡀ⾜ࢃ ࢀ࡚࠸ࡿࡀ 㸪 ≉╔ᆅ ືసࡳ
ࡽࢀࡿ⭸㛵⠇ እࡸ⫤ 㛵⠇ෆ㌿ືస ࡢቑຍ ࠸ࡗࡓືⓗୗ ⫥ࣛ ࣓ࣥࢺ ╔
┠ࡋ㸪ࡑࢀࡽ ࡢ㐣࡞ ືࡁᑐࡋὀ ពႏ㉳ࡉ ࡏࡿࡶࡢ ࡀከ ᩘࡳࡽࢀ ࡿ 㸬ࡑࢀࡽ
ࡣ ୗ ⫥ ࡢ ࠸ ࢃ ࡺ ࡿ ͆knee-in͇ ື స ࡢ ᅇ 㑊 ࡛ ࠶ ࡾ 㸪 ᐇ 㝿 ࡢ ᣦ ᑟ ⌧ ሙ ࠾ ࠸ ࡚ ࡣ 㸪 ࢫࢡ࣡ࢵࢺࡸ ࣍ࢵࣆࣥ ࢢ㸪 ࢪࣕࣥࣉ ࡽࡢ╔ ᆅ ືసࠕ ࡘࡲඛࡢ ୖ⭸ࡀ
⨨ࡍࡿࡼ࠺ࠖ[Olsen et al., 2005; Petersen et al., 2005; Söderman et al., 2000; Myer et al., 2005; Myer et al., 2004; Myklebust et al., 2003; Hewett et al., 2006; Hewett et al., 1996]㸪ṇ㠃 ࡽぢࡓࡁ ࠕ∎ඛ㸪 ⭸㸪⫤㛵⠇ࢆ ⤖ࢇࡔ⥺ ࡀ୍┤⥺
࡞ࡿࡼ࠺ࡋ 㸪≉⭸ ࡀෆഃධࡽ ࡞࠸ࡼ࠺ ࡍࡿࠖ[ὠ⏣ΎỈ, 2008]➼ࡢᣦ ᑟࡀ⾜ࢃࢀ࡚ ࠸ࡿ 㸬ከ ✀࠶ࡿ ACLയ ᐖண㜵 ࣉࣟࢢ࣒ࣛࡣ 㸪ࡑࡢ ከ ࡃࡣ⚄⤒➽༠ ㄪᛶࡢྥୖࢆ ≺࠸ࡋ ࡚ᵓᡂࡉࢀࡓ ࡶࡢࡀከ ࠸ࡀ㸪௨ୗ ྛࣉࣟࢢ ࣒ࣛ ࡢෆᐜ
ධ⤖ᯝ ࡘ࠸࡚♧ ࡍ㸬
1. Henningࡽ㸦Griffin et al., 2000㸧
ዪᏊࣂࢫࢣ ࢵࢺ࣮࣎ ࣝࢆᑐ㇟ࡋ ࡚㸪ືస ᣦᑟࢆ⾜ ࠸㸪ᣦᑟ ෆᐜࡣ㸪ࢪ
ࣕࣥࣉࡽࡢ ╔ᆅ㸪ࣆ ࣎ࢵࢺ ࡸᛴ⃭ ࡞᪉ྥ㌿ ືస ⭸ 㛵⠇ࢆࡋ ࡗࡾᒅ᭤
ࡉࡏࡓ≧ែ࡛ ⾜࠺ࡇ ࢆᣦ♧ࡋ࡚࠸ ࡿ㸬⭸ 㛵 ⠇ᒅ᭤࡛ࡢ ືసࢆᙉ ㄪࡋࡓࡢࡣ
͆quad-cruciate interaction͇㸦⭣ᅄ㢌➽㸫 ༑Ꮠ㠌ᖏస⏝ 㸧ࡢ⪃࠼ ᪉ᇶ࡙࠸࡚
࠾ࡾ㸪ࡑࢀࡣ ㍍ᗘ⭸㛵 ⠇ᒅ᭤࡛ࡢ ⭣ᅄ㢌 ➽ࡢᙉ࠸⦰ ࡣ㸪⬯㦵 ๓᪉೫ࢆ
ቑຍࡉࡏ 㸪ACLࡢఙ ᙇࢫࢺࣞࢫࢆ ቑຍࡉࡏ ࡿ࠸࠺ࡶࡢ ࡛࠶ࡿ 㸬ධ⤖ᯝࡣ 㸪
ධ๓ࡢ ACL യᐖ Ⓨ ⏕⋡ࡀ 0.33 ௳/ᖺ࡛࠶ ࡗࡓࡢᑐࡋ㸪 ධᚋ ࡣ 0.25 ௳/ᖺ
࡞ࡾ㸪ῶᑡഴྥ ࢆ♧ࡋ ࡓ㸦⾲ 2㸧㸬ࡇࡢࣉࣟ ࢢ࣒ࣛࡣ 1990ᖺ⤂ ࡉࢀ࡚࠸ࡿ
17
ࡀ㸪ㄽᩥ࡞ࡗ ࡚ ࠸࡞ ࠸ࡓࡵ㸪Griffinࡽ㸦2000㸧ࡼࡾㄝ᫂ ࡉࢀࡓ ෆᐜࢆཧ⪃
㏙࡚࠸ࡿ 㸬
2. Ettingerࡽ㸦Ettinger et al., 1995㸧
ࢫ࣮࢟ࢆᑐ ㇟ࡋ 㸪 ࡋ࡚ࣅࢹ ࢜ࡼࡿ ண㜵 ࣉࣟࢢࣛ ࣒ᩍ⫱࡛ ࠶ࡿ㸬ࡑࡢ ෆᐜࡣ㸪ཷയሙ 㠃 ࢆぢ ࡏࡿࡶ㸪ACL യ ᐖ࣓࢝ࢽࢬ࣒ ࡢ⌮ゎ യᐖண㜵
ᑐࡍࡿㄆ㆑ࢆ 㧗ࡵࡿࡇ ࢆ≺࠸ࡋ 㸪യᐖண 㜵ࡢᐇ㝿ࡘ ࠸࡚ㄝ᫂ ࡋ࡚࠸ࡿ㸬 ࡇࡢධ⤖ᯝ ࡣ㸦⾲2㸧㸪ධ๓ࡢ Ⓨ⏕⋡ 26.6௳/ᖺࡽ㸪ධ ᚋ 10 ௳/ᖺῶ ᑡࡉࡏࡓ㸬
3. Caraffaࡽ㸦Caraffa et al., 1996㸧
ᡂே⏨Ꮚࢧ ࢵ࣮࢝㑅 ᡭ600ྡ㸦ධ⩌ 300ྡ㸪ࢥࣥࢺࣟ ࣮ࣝ ⩌ 300ྡ㸧ࢆᑐ
㇟ࡋࡓ 㸪1 ᅇ 20 ศ㸪㐌3 ᪥㸪30 ᪥㛫 ࡢࣉ ࣟࢢ࣒࡛ࣛ࠶ ࡾ㸪 ࡋ࡚ࣂࣛࣥࢫ
࣮࣎ࢻࢆ⏝ ࡋ࡚⾜ࢃ ࢀࡓࣂࣛࣥࢫ ࢺ࣮ࣞࢽ ࣥࢢ࡛࠶ࡿ㸬 ࡇࢀࡣ㸪 ᅛ᭷ឤぬჾ
↔Ⅼࢆ࠶࡚ ࡓࢺ࣮ࣞ ࢽࣥࢢἲ࡛࠶ ࡿ㸬 ධ ⤖ᯝࡣ㸦⾲ 2㸧㸪ධ ⩌ࡢയᐖⓎ
⏕⋡ 0.15 ௳/ࢳ࣮࣒/ࢩ࣮ࢬࣥ㸪ࢥࣥ ࢺ࣮ࣟࣝ ⩌ ࡢയᐖⓎ⏕ ⋡ 1.15 ௳/ࢳ࣮࣒/ࢩ
࣮ࢬ࡛ࣥ㸪᭷ ពῶᑡ ࡉࡏ ࡓ㸬 4. Hewettࡽ㸦Hewett et al., 1999㸧
㧗ᰯ⏕⏨ዪ ࡢࢧࢵ࢝ ࣮㸪ࣂࢫ ࢣࢵࢺ࣎ ࣮ࣝ㸪ࣂ࣮࣮ࣞ࣎ࣝ ࢆᑐ㇟ ⾜ࢃࢀࡓ㸬
1ᅇ 60㹼90 ศ㸪㐌 3 ᅇ㸪6㐌㛫ࡢࣉ ࣟࢢࣛ ࣒࡛࠶ࡾ㸪 ࡋ࡚⚄ ⤒➽༠ㄪᛶ ࡢ
ྥୖࢆ≺࠸ ࡋࡓࣉࣟ ࢢ࣒࡛ࣛ࠶ࡿ 㸬ෆᐜ ࡣ 㸪ࣉࣛ࢜ ࣓ࢺࣜ ࢡ ࢫ 㸪ࣂࣛࣥࢫ 㸪 ᰂ㌾ᛶ㸪➽ຊ ྥୖࡢせ ⣲ࢆྵࢇ࡛࠸ ࡿ㸬 ධ ⩌366ྡࡢዪᏊࢥࣥ ࢺ࣮ࣟࣝ⩌
463ྡࡢዪᏊ࠾ ࡼࡧ 434ྡࡢ⏨Ꮚࢆẚ ㍑ࡋࡓ 㸬ධ⤖ ᯝࡣ㸦 ⾲ 2㸧㸪ධ⩌ ࡢയ ᐖⓎ⏕⋡ 0.12/1000 athlete-exposures㸦௨ ୗ㸪AEs㸧㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ 0.43/1000 AEs
࡛㸪᭷ពῶ ᑡࡉࡏ ࡓ 㸬ࡇࡢ◊✲࡛ ⾜ࢃࢀࡓ ண㜵ࣉࣟࢢࣛ ࣒ࡀᇶ♏ ࡞ࡾ㸪ᚋ
Mandelbaumࡽࡼ ࡾ “PEP program: prevent injury and enhancement perfor- mance program” ࡀᥦၐࡉࢀࡿ[Mandelbaum et al., 2005; బ㔝ᮧ, 2013-1]㸬
5. Södermanࡽ㸦Söderman et al., 2000㸧
211 ྡࡢዪᏊ ࢧࢵ࢝ ࣮㑅ᡭ㸦ධ ⩌ 121 ྡ 㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ 100 ྡ㸧ࢆᑐ㇟
ࡋ࡚⾜ࢃࢀ ࡓ㸬 ࡋ࡚ ⚄⤒➽༠ ㄪᛶࡢྥ ୖࢆ≺࠸ࡋ ࡓࣉࣟࢢ ࣒࡛ࣛ࠶ࡾ 㸪
ࣂࣛࣥࢫ࣮࣎ ࢻࢆ⏝ ࡋࡓ ࣂࣛࣥࢫ ࢺ࣮ࣞࢽ ࣥࢢ ࢆ 5✀┠ ⾜ࢃࡏ ࡓ 㸬1 ᅇ10㹼
18
15ศ㸪᭱ึࡢ 30 ᪥㛫 ࡣẖ᪥ᐇ㸪ࡑ ࢀ௨ᚋ ࡣ㐌 3 ᅇᐇ ࡋ㸪࠾࠾ ࡼࡑ 30 㐌㛫
⾜ࢃࢀࡓ㸬ධ ⤖ᯝࡣ㸦⾲2㸧㸪ධ⩌ࡢയ ᐖⓎ⏕⋡ 0.12/1000 player-hours㸦௨
ୗ㸪PHs㸧㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ 1.36/1000 PHs ࡛㸪᭷ពᕪࡣ ࡳࡽࢀ࡞ ࡗࡓ㸬 6. Heidtࡽ㸦Heidt et al.㸪2000㸧
300 ྡࡢዪᏊ ࢧࢵ࢝ ࣮㸦ධ⩌ 42 ྡ㸪ࢥ ࣥࢺ࣮ࣟࣝ ⩌ 258ྡ㸧ࢆᑐ㇟⾜ࢃ
ࢀࡓ㸬ෆᐜࡣ ⚄⤒➽༠ ㄪᛶࡢྥୖࢆ ≺࠸ࡋ ࡓࣉࣟࢢ࣒ࣛ ࡛࠶ࡾ㸪 ࢺ࣮ࣞࢽࣥ
ࢢࡣ㸪ࣉࣛ ࣓࢜ࢺࣜ ࢡ ࢫ㸪ᰂ㌾ᛶ 㸪➽ຊ 㸪 ࢪࣜࢸ㸪 ᚠ⎔ჾ⣔ ࢆ⾜ࡗ࡚࠸
ࡿ㸬1ᅇ 60㹼90 ศ㸪㐌 3 ᅇ㸪7 㐌㛫ࡢࣉࣟ ࢢ࣒࡛ࣛ࠶ࡿ 㸬 ධ⤖ ᯝࡣ㸦 ⾲ 2㸧㸪
ධ⩌ࡢയᐖ Ⓨ⏕ ྜ 2.4㸣㸦1 㸧㸪ࢥ ࣥࢺ࣮ࣟࣝ⩌ 3.1㸣㸦8 㸧࡛࠶ࡗࡓ ࡀ᭷ពᕪࡣࡳ ࡽࢀ࡞ ࡗࡓ㸬
7. Myklebust ࡽ㸦Myklebust et al., 2003㸧
ዪᏊࣁࣥࢻ ࣮࣎ࣝࢆ ᑐ㇟ 2ᖺ㛫 ࡢධㄪ ᰝࢆ⾜ࡗࡓ㸬 ධ ๓ 942ྡ㸪ධ 1ᖺ┠ 855ྡ㸪2 ᖺ┠ 850ྡࡀᑐ㇟࡛࠶ࡗ ࡓ 㸬ࢺ࣮ࣞࢽࣥࢢ ࡣ⚄⤒➽ ༠ㄪᛶࡢྥ
ୖࢆ≺࠸ࡋ ࡓࡶࡢ࡛ ࠶ࡾ㸪ࣉࣛ ࣓࢜ࢺࣜ ࢡࢫ㸪ࣂࣛࣥ ࢫ㸪ࢪ ࣜࢸ࡛࠶
ࡿ㸬ࡇ ࡢࣉࣟ ࢢࣛ ࣒ࡢ ≉ᚩࡣ 㸪ࣇࣟ ࢺ ࣮ࣞ ࢽࣥࢢ ࣡ࣈ ࣝ㸦wobble㸧࣮࣎ࢻ
ࢆ⏝ࡋࡓࢺ ࣮ࣞࢽࣥ ࢢ㸪Ᏻᐃ࡞ ࣐ࢵࢺୖ ࡛ࡢࢺ࣮ࣞࢽ ࣥࢢࢆྲྀ ࡾධࢀࡓⅬ
࠶ࡿ㸬ࣉࣞ ࢩ࣮ࢬࣥ ࡣ 1 ᅇ 15 ศ㸪 㐌 3 ᅇ 㸪7 㐌㛫㸪ࣥ ࢩ࣮ࢬ ࣥࡣ 1 ᅇ 15 ศ㸪㐌 1ᅇ㸪41㐌㛫⾜ ࢃࡏࡓ㸬ධ ⤖ᯝࡣ㸦 ⾲ 2㸧㸪ධ๓ࡢ യᐖⓎ ⏕⋡ 0.14/1000 PHs㸪ධ1ᖺ┠ ࡢയᐖ Ⓨ⏕⋡ 0.13/1000 PHs㸪ධ2ᖺ┠ࡢയᐖ Ⓨ⏕ ⋡ 0.09/1000 PHs ࡞ࡾ㸪ῶᑡഴྥ ࡀ☜ㄆࡉࢀࡓ ࡀ᭷ព ᕪ ࡣࡳࡽࢀ࡞ ࡗࡓ 㸬ࡋ ࡋ㸪࢚ࣜ
࣮ࢺ⩌࠾࠸ ࡚㸪ࣉࣟ ࢢ࣒ࣛࢆ㐙 ࡋࡓ⩌ ᮍ㐙 ࡢ⩌ࢆ ẚ㍑ ࡋࡓ ሙྜ㸪㐙
⩌࠾࠸࡚᭷ ព࡞ῶᑡ ࡀ ㄆࡵࡽࢀࡓ 㸬 8. Mandelbaumࡽ㸦Mandelbaum et al., 2005㸧
ࡇ ࡢ ࣉ ࣟ ࢢ ࣛ ࣒ ࡣ 㸪 ዪ Ꮚ ࢧ ࢵ ࢝ ࣮ 㑅 ᡭ ࢆ ᑐ ㇟ ࡋ ࡓ ͆PEP program: prevent injury and enhancement performance program͇ ࡋ ࡚ ᥦ ၐ ࡉ ࢀ ࡓ ࡶ ࡢ ࡛ ࠶ ࡿ [Mandelbaum et al., 2005]㸬1041ྡࢆᑐ㇟ 㸪2 ᖺ㛫ࡢධ ㄪᰝࢆ ⾜ࡗࡓ㸬1 ᖺ
┠ࡣධ ⩌ 1,042ྡ㸪ࢥࣥࢺ࣮ࣟࣝ ⩌ 1,902ྡ㸪2ᖺ┠ࡣ ධ⩌ 844ྡ㸪ࢥࣥࢺ
࣮ࣟࣝ⩌ 1,913 ྡ࡛࠶ࡗࡓ㸬ࢺ࣮ࣞ ࢽࣥࢢ ࡣ ⚄⤒➽༠ㄪᛶ ࡢྥୖࢆ ≺࠸ࡋࡓ
ࡶࡢ࡛࠶ࡾ㸪 ࣉࣛ࢜ ࣓ࢺࣜ ࢡࢫ㸪 ࣂࣛࣥࢫ 㸪 ➽ຊ㸪ࢪ ࣜࢸ 㸪 ᰂ㌾ᛶ࡛࠶
19
ࡾ㸪ࡑࡢ ࣅࢹ࢜ࢸ ࣮ࣉࡼࡿᣦ ᑟࡶྵࡲ ࢀ࡚࠸ࡿ㸬ࡲ ࡓ㸪ࡇࡢ ࣉࣟࢢ࣒ࣛ
ࡢ≉ᚩࡣ㸪࢛࢘ ࣮࣑ࣥ ࢢࢵࣉ ᑟධࡋ࡚ ࠸ࡿ Ⅼ࠶ࡿ㸬1 ᅇ 20 ศ㸪㐌 3 ᅇ
ࢆࢩ࣮ࢬࣥᮇ 㛫୰⾜ ࡗࡓ㸬 ධ⤖ ᯝࡣ 㸦 ⾲ 2㸧㸪ධ 1 ᖺ┠ࡣධ⩌ࡢയᐖ
Ⓨ⏕⋡ 0.05/1000 AEs㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ࡢ യ ᐖⓎ⏕⋡ 0.47/1000 AEs㸪ධ 2 ᖺ
┠ ࡣ 㸪 ධ ⩌ ࡢ യ ᐖ Ⓨ ⏕ ⋡ 0.13/1000 AEs㸪 ࢥ ࣥ ࢺ ࣟ ࣮ ࣝ ⩌ ࡢ യ ᐖ Ⓨ ⏕ ⋡
0.51/1000 AEs࡞ࡾ 㸪࠸ࡎࢀࡢ ᖺࡶ᭷ព ῶᑡࡉࡏࡓ 㸬ࡲࡓ 㸪2 ᖺ㛫ࡢ⥲യᐖ
Ⓨ⏕⋡ࡘ࠸ ࡚ࡶ㸪 ධ⩌ 0.09/1000 AEs㸪ࢥࣥࢺ࣮ࣟࣝ ⩌ 0.49/1000 AEs ࡛᭷
ពῶᑡࡉࡏ ࡓ㸬PEP programࡣࠊMandelbaum ࡽࡢࢢࣝ ࣮ࣉ F-MARC㸦FIFA Medical Assessment and Research Centreࠊᅜ㝿ࢧࢵ࣮࢝㐃┕ ་ Ꮫホ ౯◊✲ࢭࣥࢱ
࣮㸧ࡢඹྠ ࡛సᡂࡉ ࢀ ࡚࠾ࡾ㸪F-MARC ࡽ 2003 ᖺࠕThe 11ࠖ㸪2006 ᖺ
ࠕThe 11+ࠖ࠸ࡗࡓ ㊊㛵⠇ࡸ⭸㛵 ⠇യᐖண 㜵ࣉࣟࢢ࣒ࣛ ࡀⓎ⾲ࡉ ࢀ ࡚࠸ࡿ[బ 㔝ᮧ, 2013-2]㸬
9. Olsenࡽ㸦Olsen et al., 2005㸧
⏨ዪࣁࣥࢻ ࣮࣎ࣝ㑅 ᡭࢆᑐ㇟ࡋ 㸪ධ ⩌ 958ྡ㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ 879ྡࢆ
ㄪᰝࡋࡓ㸬ࢺ ࣮ࣞࢽࣥ ࢢ ࡣࣉࣛ࢜ ࣓ࢺࣜ ࢡ ࢫ㸪ࣂࣛࣥࢫ 㸪➽ຊ࡛ ࠶ࡿ㸬ࡇࡢ
ࣉࣟࢢ࣒ࣛࡢ ≉ᚩࡣ㸪 ࢛࣮࣑࢘ࣥࢢ ࢵࣉ ྲྀࡾධࢀ࡚ ࠸ࡿ ࡇ 㸪ࣂࣛࣥ
ࢫࢺࣞ ࣮ࢽࣥ ࢢ ࠾࠸ ࡚㸪࣡ ࣈࣝ㸦wobble㸧 ࣮࣎ࢻ ࡸᏳ ᐃ࡞ ࣐ࢵ ࢺࢆ ⏝ࡋ ࡓࢺ࣮ࣞࢽࣥ ࢢࢆྲྀࡾ ධࢀࡓ ࡇ㸪 ࡉࡽ ࣛ ࣥࢽࣥࢢ㸪࢝ ࢵࢸࣥ ࢢ㸪ࢪࣕࣥ
ࣉ࠾ࡼࡧ╔ᆅ ືసࡢ ⭸ 㛵⠇㊊㒊 ࡢືࡁ ᑐࡍࡿព㆑ࢆ ᙉㄪࡉࡏ ࡚⾜ࢃࡏࡓ
Ⅼ࠶ࡿ㸬1ᅇ 15㹼20 ศ㸪㐌 1ᅇ 㸪32 㐌㛫ࡢ ࣉࣟࢢ࣒࡛ࣛ 㸪ධ⤖ ᯝࡣ㸦⾲ 2㸧㸪
ධ⩌࡛ 3㸪ࢥ ࣥࢺ ࣮ࣟࣝ⩌ ࡛ 14 Ⓨ⏕ ࡋ㸦ෆ㸪PCL 2㸪MCL 1Ⓨ㸧㸪
᭷ពῶᑡࡉ ࡏࡓ㸬
10. Petersonࡽ㸦Petersen et al., 2005㸧
ዪᏊࣁࣥࢻ ࣮࣎ࣝࢆ ᑐ㇟㸪ධ ⩌ 134ྡ㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ 142ྡࢆᑐ㇟
ࡋࡓ㸬ࢺ࣮ࣞ ࢽࣥࢢࡣ 㸪 ࣉ࣓ࣛ࢜ ࢺࣜ ࢡࢫ 㸪ࣂࣛࣥࢫࡢ せ⣲ࢆྵ ࢇࡔࡶࡢ࡛
࠶ࡿ㸬ࡇࡢࣉ ࣟࢢ࣒ࣛ ࡢ≉ᚩࡣ㸪ࣂ ࣛࣥࢫ ࣎ ࣮ࢻࢆ⏝ࡋ ࡓࣂࣛࣥ ࢫࢺ࣮ࣞࢽ
ࣥࢢࢪࣕࣥ ࣉࢺ࣮ࣞ ࢽࣥࢢࢆከ✀ ┠ ⾜ࡗ࡚ ࠸ࡿⅬ࠶ࡿ 㸬ࣉࣞࢩ ࣮ࢬࣥࡣ 1 ᅇ10 ศ࡛㐌 3 ᅇ ࢆ 8 㐌㛫㸪 ࣥࢩ࣮ࢬ ࣥࡣ 1 ᅇ 10ศ࡛㐌 1ᅇ ࢆ 32 㐌㛫ᐇࡋ ࡓ㸬ධ⤖ᯝࡣ㸦 ⾲ 2㸧㸪ධ⩌࡛യᐖⓎ ⏕ ⋡ 0.04/1000 AEs㸪ࢥࣥࢺ࣮ࣟࣝ⩌
20
0.21/1000 AEs࡛㸪᭷ពᕪࡣࡳࡽࢀ ࡞ࡗࡓ 㸬
11. Pfeiffer ࡽ㸦Pfeiffer et al., 2006㸧
1439ྡࡢ㧗ᰯዪ Ꮚ ࢧࢵ࣮࢝㸪ࣂࢫ ࢣࢵࢺ ࣮࣎ࣝ㸪ࣂ࣮ࣞ ࣮࣎ࣝ ࢆᑐ㇟㸪
ධ⩌577ྡ㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ 862ྡࢆㄪᰝࡋ ࡓ㸬ࢺ࣮ࣞࢽ ࣥࢢࡣ ࣉ ࣓ࣛ࢜ࢺ
ࣜࢡࢫ㸪ࢪ ࣜࢸ ࡢ せ⣲ࢆྵࡳ㸪 ከ✀┠ࡢ ࢪࣕࣥࣉ࣍ ࢵࣆࣥࢢ 㸪ࢪࣜࢸ
ືసࢆ⾜ࢃ ࡏ࡚࠸ࡿ Ⅼ ≉ᚩࢆࡶ ࡘ㸬1 ᅇ 20 ศ࡛㐌 2ᅇ㸪9㐌㛫 ᐇࡋࡓ㸬
ධ ⤖ ᯝ ࡣ 㸦 ⾲ 2㸧 㸪 ධ ⩌ ࡛ യ ᐖ Ⓨ ⏕ ⋡ 0.167/1000 AEs㸪 ࢥ ࣥ ࢺ ࣟ ࣮ ࣝ ⩌ 0.078/1000 AEs࡛㸪᭷ ពᕪࡣࡳࡽࢀ ࡞ࡗࡓ 㸬ࡇࡢࣉ ࣟࢢ࣒ࣛ ࡣ͆Knee ligament injury prevention program͇ 㸪KLIP program ⛠ࡉࢀ࡚࠸ࡿ 㸬
12. Gilchristࡽ㸦Gilchrist et al., 2008㸧
ᏛዪᏊࢧ ࢵ࣮࢝㑅 ᡭ1435ྡࢆᑐ㇟ 㸪ධ⩌ 583 ྡ㸪ࢥ ࣥࢺ ࣮ࣟࣝ⩌ 852
ྡࢆㄪᰝࡋࡓ 㸬ࢺ࣮ࣞ ࢽࣥࢢෆᐜࡣ 㸪 ࣉࣛ ࣓࢜ࢺࣜ ࢡࢫ 㸪➽ຊ㸪 ࣂࣛࣥࢫ㸪 ᰂ㌾ᛶ㸪ࢪ ࣜࢸࡢ せ⣲ࢆྵࢇࡔ ࡶࡢ㸦PEP program㸪Mandelbaum et al., 2005㸧
࡛࠶ࡾ㸪≉ᚩ ࡣ㸪 ࢛࢘ ࣮࣑ࣥࢢࢵ ࣉᑟ ධࡋ ࡓⅬ࡛࠶ ࡿ㸬ࡲࡓ 㸪ࡇࢀࡽࡢ ࢺ࣮ࣞࢽࣥࢢ ຍ࠼࡚ ࣅࢹ࢜Ꮫ⩦ࡶ ⾜ࢃࢀࡓ 㸬㐌 3 ᅇ㸪12 㐌㛫ᐇ ࡋ 㸪ධ⤖
ᯝࡣ㸦⾲ 2㸧㸪 ධ⩌ ࡛യᐖⓎ⏕ ⋡ 0.199/1000 AEs㸦7 㸧㸪ࢥ ࣥࢺ࣮ࣟࣝ⩌
0.340/1000 AEs㸦18 㸧㸪㠀᥋ゐᆺ യᐖ࡛ ධ⩌ 0.057/1000 AEs㸦2 㸧㸪ࢥࣥ
ࢺ࣮ࣟࣝ ⩌ 0.189/1000 AEs㸦10 㸧࡛ῶ ᑡഴ ྥࢆ♧ࡋࡓࡀ 㸪᭷ព ᕪ ࡣࡳ ࡽࢀ࡞
ࡗࡓ㸬ࡓࡔ ࡋ㸪⦎⩦ Ⓨ⏕ࡋ ࡓ ACLയ ᐖࡢࡳ㸪ධ ⩌ 0.000/1000 AEs㸦0
㸧㸪ࢥࣥࢺ ࣮ࣟࣝ ⩌ 0.148/1000 AEs㸦6 㸧࡛᭷ព࡞ ῶᑡࡀ ㄆ ࡵࡽࢀࡓ 㸬 13. Kinaiࡽ㸦Kinai et al., 2010㸧
ዪᏊࢧࢵ࢝ ࣮㑅 ᡭ 1506 ྡࢆᑐ㇟ 㸪ධ ⩌ 729ྡ㸦49 ࢳ࣮࣒ 㸧㸪 ࢥࣥࢺࣟ
࣮ࣝ⩌ 777ྡ㸦48 ࢳ࣮࣒㸧ࢆㄪᰝࡋࡓ㸬ࢺࣞ ࣮ࢽࣥࢢෆᐜ ࡣ㸪ୗ⫥ ➽ຊ㸪యᖿ㸪
ࣂࣛࣥࢫࡢせ ⣲ࢆྵࢇ ࡛࠸ࡿ㸬ࣉࣞࢩ ࣮ࢬࣥ ࡛࠶ࡿ ᭱ึ ࡢ 3 ࢣ᭶㛫 ࡣ㐌 2 ᅇ㸪1 ᅇ20㹼25 ศ㸪ࢩ࣮ࢬ ࣥධࡗ࡚ ࡽࡢ ⣙ 6ࢣ᭶㛫ࡣ 㐌 1 ᅇᐇࡋ ࡓ㸬ධ⤖ᯝ
ࡣ㸦⾲ 2㸧㸪 ධ⩌࡛ 0㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ ࡛ 5 Ⓨ⏕ࡋ ࡓ㸬
14. Waldénࡽ㸦Waldén et al., 2012㸧
12㹼17 ṓࡢዪᏊ ࢧ ࢵ࣮࢝㑅 ᡭ 4564ྡ㸦230 ࢳ࣮࣒㸧ࢆᑐ㇟ 㸪ධ⩌ 2479
ྡ㸦121ࢳ࣮࣒㸧㸪ࢥ ࣥࢺ࣮ࣟࣝ ⩌ 2085ྡ㸦109 ࢳ࣮࣒㸧 ࢆㄪᰝ ࡋࡓ㸬1 ᅇ 15
21
ศ࡛ᵓᡂࡉࢀ ࡚࠾ࡾ㸪 ⚄⤒➽༠ㄪᛶ ࡢྥୖࢆ ≺࠸ࡋࡓ࢘ ࢛࣮࣑ࣥ ࢢࢵࣉ ࣓ ࢽ࣮ࣗࡋ࡚ ⾜ࢃࢀ 㸪 యᖿ㸪ࣂࣛࣥ ࢫ㸪ୗ⫥ ࣓ࣛࣥࢺ ╔┠ࡋ ࡓෆᐜ࡛࠶
ࡗࡓ㸬ࢩ࣮ࢬ ࣥᮇ㛫୰ 㸪㐌 2 ᅇᐇ ࡋ㸪 ධ ⤖ᯝࡣ㸦 ⾲ 2㸧㸪ධ ⩌࡛ 7 㸪 ࢥࣥࢺ࣮ࣟࣝ ⩌ ࡛ 14 Ⓨ⏕ࡋ㸪᭷ ពῶᑡ ࡉࡏࡓ㸬
௨ୖ㸪ACL യᐖண㜵 ࣉ ࣟࢢ࣒ࣛ 㛵 ࡍࡿඛ⾜ ㄽᩥ ࡢ୍㒊ࢆ ⤂ࡋࡓ ࡀ㸪ྛࣉ
ࣟࢢ࣒ࣛࡢᐇ ࠶ࡓ ࡗ࡚ࡣ㸪ྛ ➇ᢏࡢ ≉Ṧ ᛶᑐᛂࡋࡓ ࣉࣟࢢࣛ ࣒ࢆసᡂࡋ 㸪
ධࡉࡏࡿࡇ ࡀ᥎ዡ ࡉࢀ ࡚࠸ࡿ㸬
➨
➨2 ⠇ ᮏㄽ ᩥ ࡢᵓ ᡂ
ᮏㄽᩥࡣ㸪ࢫ࣏ ࣮ࢶ യ ᐖண㜵ࣔࢹࣝ ࡢ୍ࡘ ࡋ࡚ van Mechelen ࡽ㸦1992㸧ࡀ ᥦၐࡍࡿ 4ẁ 㝵ࣔࢹࣝ ࡢᅗᘧࢆ 㸪Ꮫ ዪ Ꮚࣛࢡࣟࢫࢆ ᑐ㇟ ࡋ ࡚㸪1㸧Ꮫ ዪᏊࣛࢡࣟࢫ യᐖㄪᰝ 㸪2㸧യᐖண㜵ࢺ࣮ࣞࢽ ࣥࢢ ධࡢࡓ ࡵࡢᇶ♏ ⓗ◊✲ࡋ
࡚㸪㊊㊑ື సࡀືⓗ ୗ ⫥࣓ࣛࣥ ࢺཬࡰ ࡍᙳ㡪ࡘ࠸ ࡚ ࡢ ẚ㍑ ᳨ウ㸪3㸧ࣛ
ᩥ⊩ ẚ㍑ෆᐜ
Henning 䜙䠄2000䠅 ධ๓ vs. ධᚋ䠄Ⓨ⏕௳ᩘ/ᖺ䠅 0.33 vs. 0.25
Ettinger 䜙䠄1995䠅 ධ๓ vs. ධᚋ䠄Ⓨ⏕௳ᩘ/ᖺ䠅 26.6 vs. 10.0
Caraffa 䜙䠄1996䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝏䞊䝮/䝅䞊䝈䞁䠅 0.15 vs. 1.15† Hewett 䜙䠄1999䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.12 vs. 0.43† Söderman 䜙䠄2000䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 PHs*䠅 0.12 vs. 1.36 Hedit 䜙䠄2000䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ(ྜ)䠅 1䠄2.4%䠅 vs. 8䠄3.1%䠅 Myklebust 䜙䠄2003䠅 ධ1ᖺ┠ vs. 2ᖺ┠ vs. 3ᖺ┠䠄Ⓨ⏕௳ᩘ/1000 PHs*䠅
Mandelbaum 䜙䠄2005䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈1ᖺ┠䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.05 vs. 0.47†
ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈2ᖺ┠䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.13 vs. 0.51†
ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈2ᖺ㛫䛾⥲ィ䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.09 vs. 0.49†
Olsen 䜙䠄2005䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝅䞊䝈䞁䠅 3 vs. 14†
Peterson 䜙䠄2005䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.04 vs. 0.21 Priffer 䜙䠄2006䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.167 vs. 0.078 Gilchrist 䜙䠄2008䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.199 vs. 0.340
ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈⦎⩦䛾䜏䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅 0.000 vs. 0.148†
Kinai 䜙䠄2010䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝅䞊䝈䞁䠅 0 vs. 5
Waldén䜙䠄2012䠅 ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝅䞊䝈䞁䠅 7 vs. 14†
യᐖⓎ⏕⋡
0.14 vs. 0.13 vs. 0.09
*ACL: anterior cruciate ligament.
*1000 AEs: 1,000 athlete-exposures.
*1000 PHs: 1,000 player-hours.
†: ᭷ព䛺ῶᑡ䛜ㄆ䜑䜙䜜䛶䛔䜛䠊
⾲2䚷ACL*യᐖண㜵䝥䝻䜾䝷䝮ධ䛸ACLയᐖⓎ⏕⋡
22
ࢡࣟࢫ➇ᢏ≉ Ṧᛶࡢ୍ ࡘ࡛࠶ࡿࣛࢡ ࣟࢫࢫࢸ ࢵࢡࢆಖᣢ ࡋࡓ≧ែ ࡛ࡢࢻࣟࢵ
ࣉࣂ࣮ࢸ࢝ ࣝࢪࣕࣥ ࣉ࢝ࢵࢸ ࣥࢢືస ࡢືⓗୗ⫥ ࣓ࣛ ࣥࢺ ࡢẚ㍑
᳨ウ㸪4㸧ୗ ⫥യᐖண 㜵 ࢆ┠ⓗࡋࡓ ࢫࢡ࣮ࣜ ࢽࣥࢢࢸࢫࢺ ࡢ ᭷⏝ᛶ ࡢ ᳨ド㸪5㸧
ୗ⫥യᐖண㜵 ࢺ࣮ࣞࢽ ࣥࢢࡀ㊊㊑ᶵ ⬟㸪㊊㒊 ࣓ࣛࣥࢺ 㸪 㟼ⓗ࠾ ࡼࡧືⓗୗ
⫥ࣂࣛࣥࢫ⬟ ຊཬࡰ ࡍᙳ㡪㸪 ࡑࡋ ࡚ 6㸧ୗ ⫥യᐖண㜵ࢺ ࣮ࣞࢽࣥ ࢢࡀᏛዪ Ꮚࣛࢡࣟࢫࡢ യᐖⓎ⏕ ⋡ཬࡰࡍᙳ 㡪ࡘ࠸ ࡚ ᳨ウ᳨࣭ド ࡍࡿ ෆᐜ ࡞ࡗ࡚࠸
ࡿ㸬ࡲࡓ㸪യ ᐖࡘ࠸ ࡚ࡣ㸪 ㊊㛵⠇ യᐖ ACLയᐖ↔Ⅼࢆ ᙜ࡚ ࡚⾜ࡗࡓ 㸬
➨1 ❶࡛ࡣ㸪 ࢫ࣏࣮ࢶ യᐖண㜵ࡢྲྀ ࡾ⤌ࡳ㸪 യᐖⓎ⏕せᅉ 㸪യᐖண 㜵ࣉࣟࢢ
࣒ࣛࡘ࠸࡚ ⤂ࡋ㸪 ᮏ❶᭱ᚋ࡚ ᮏㄽᩥࡢ ᵓᡂࡘ࠸࡚ ㏙࡚࠸ ࡿ㸬 ➨ 2 ❶
࡛ࡣ㸪യᐖࡢ 㒊 㸪✀ 㢮㸪ཎᅉ➼ࢆ ᫂ࡽ ࡍࡿ㸪യ ᐖⓎ⏕ᩘ ࡸയᐖⓎ⏕
⋡㸪㔜ᗘ➼ ࡢᏛዪ Ꮚࣛࢡࣟࢫࡢ യᐖࡢᐇ ែ ࢆ᫂ࡽ ࡍࡿࡇ ࢆ┠ⓗࡋ
࡚㸪ᏛዪᏊ ࣛࢡࣟࢫ ࡢ 2 ᖺ㛫ࡢ യᐖㄪᰝ ࢆ ⾜ࡗࡓ㸦◊ ✲ 1㸧 㸬 ➨ 3 ❶࡛ࡣ㸪
ୗ⫥യᐖண㜵 ࢺ࣮ࣞࢽ ࣥࢢධ᳨ウ ࡢࡓࡵࡢ ᇶ♏ⓗ◊✲ ࡋ࡚㸪 ㊊ ㊑㛤⬟࠾
ࡼ ࡧ ㊊ ㊑ 㛤 ᣦ ♧ ࡀ ື ⓗ ୗ ⫥ ࣛ ࣓ ࣥ ࢺ ཬ ࡰ ࡍ ᙳ 㡪 㸫 ㊊ ㊑ 㛤 ᣦ ♧ ୗ ࡢ
∦⬮ࢫࢡ࣡ࢵ ࢺ㸪∦⬮ ࢻࣟࢵࣉࣛࣥ ࢹࣥࢢ 㸪࢝ࢵࢸࣥࢢ ືస࡛ ࡢศᯒ㸫 ࡘ࠸࡚ẚ㍑᳨ ウࡋࡓ 㸦 ◊✲ 2㸧㸬➨ 4 ❶࡛ࡣ㸪≉㔜ᗘ ࡢ㧗࠸ዪ Ꮚࣛࢡࣟࢫ യᐖࡢ୍ࡘ࡛ ࠶ࡿ ACLയᐖ࣓࢝ࢽ ࢬ࣒ࢆ᫂ ࡽࡍࡿࡇ ࢆ┠ⓗ ࡋ࡚㸪ᇶ ♏
ⓗ◊✲ࡋ࡚ ࣛࢡࣟࢫ ࢫࢸࢵࢡࡢ ಖᣢࡸ᧯ సࡀࢻࣟࢵࣉ ࣂ࣮ࢸ ࢝ࣝ ࢪࣕࣥ
ࣉࡢୗ⫥ ࣓ࣛࣥ ࢺཬࡰࡍᙳ 㡪 㸦◊ ✲ 3㸧ࣛࢡ ࣟࢫࢫࢸ ࢵࢡࡢಖᣢ ࡢ᭷↓ࡀ࢝ࢵ ࢸࣥࢢ ືసࡢୗ⫥ ࢟ࢿ࣐ࢸ ࢡࢫ࣭࢟ࢿ ࢸࢡࢫ ཬࡰࡍᙳ 㡪㸦◊✲ 4㸧ࡘ࠸ ࡚ ẚ㍑᳨ドࢆ⾜ ࡗࡓ㸬 ➨ 5 ❶࡛ࡣ㸪 ୗ⫥യ ᐖ ண㜵ࡢࡓࡵ ࡢ ࢫࢡ࣮ࣜࢽࣥ ࢢࢸࢫࢺ ࡢ୍⪃ᐹࡋ ࡚㸪㊊㊑ ᢕᥱຊ㟼ⓗ ࠾ࡼࡧື ⓗࣂࣛࣥࢫ
⬟ຊࡢ㛵㐃 ᛶ㸦◊ ✲ 5㸧㸪ࡑࡋ ࡚ୗ⫥ᙧ ែ㸪ୗ⫥➽ຊ 㸪㟼ⓗୗ ⫥࣓ࣛࣥ
ࢺࡸୗ⫥㛵⠇ ྍືᇦ ࢻࣟࢵࣉࣂ࣮ ࢸ࢝ࣝ ࢪࣕࣥࣉࡢ ୗ⫥ࣛ ࣓ࣥࢺ ࡢ㛵㐃ᛶ㸦◊✲ 6㸧 ࡘ࠸᳨࡚ドࡍ ࡿࡇ ࡋࡓ㸬➨ 6 ❶࡛ࡣ㸪 ୗ⫥യᐖண㜵 ࢺ࣮ࣞࢽࣥࢢ ࡢධࢆ ⾜ ࠸㸪ୗ ⫥യᐖண 㜵ࢺ ࣮ࣞࢽࣥࢢ ࡀ ㊊㊑ᶵ⬟ 㸪㊊㒊ᙧ ែ㸪 㟼ⓗ࠾ࡼࡧື ⓗࣂࣛࣥ ࢫ⬟ຊ ཬࡰ ࡍᙳ㡪 㸦 ◊✲ 7㸧㸪യᐖⓎ⏕ 㢖ᗘ ཬࡰ
ࡍᙳ㡪㸦◊ ✲8㸧ࡘ ࠸࡚ ධຠᯝ ᳨ドࢆ ⾜ ࡗࡓ㸬ࡑࡋ࡚ ᭱⤊❶࡛ ࠶ࡿ➨ 7㸪8
❶࠾࠸࡚ᮏ ◊✲ࡢ ⥲ ྜ⪃ᐹ㸪ࡲ ࡵࡋࡓ 㸬
23
➨
➨ 2 ❶
ᏛዪᏊࣛࢡࣟࢫࡢയᐖㄪᰝ
24
◊
◊ ✲ 1 Ꮫ ዪᏊ ࣛࢡ ࣟࢫ ࡢ 2 ᖺ㛫 ࡢ യᐖ ㄪ ᰝ
2-1-1. ⥴ゝ
ࣛࢡࣟࢫ➇ᢏ ࡣ ⌧ᅾ㸪 ⡿ᅜ࡛᭱ࡶ┒ ࢇ⾜ࢃ ࢀ࡚ ࠾ࡾ㸪㏆ ᖺࡢ➇ᢏ ேཱྀ ࡢቑ ຍࡶⴭࡋ࠸[US Lacrosse, 2011]㸬ᮏ㑥࠾ ࠸ ࡚ ࡣ㸪≉ Ꮫࣛࢡࣟ ࢫ➇ᢏࡀ┒ࢇ
⾜ࢃࢀ࡚࠾ ࡾ 㸪 ㏆ᖺ ࡑࡢ➇ᢏேཱྀ ࡢቑຍࡶ ⴭࡋ࠸㸬⡿ᅜ ࡢࣛࢡࣟ ࢫ➇ᢏேཱྀ
ࡣ㸪2011ᖺࡢⓏ㘓 ⪅ ᩘ[US Lacrosse, 2011]ࡀ 684,730ྡ㸦⏨ Ꮚ 424,169ྡ㸪ዪᏊ
260,561ྡ㸧࡛࠶ࡾ 㸪࢝ࢸࢦู࣮ࣜ ࡛ࡳࡿ 㸪࣮ࣘ ࢫ 361,275 ྡ㸦 ⥲Ⓩ㘓 ⪅ᩘࡢ
52.8㸣㸧㸪㧗ᰯ⏕ 275,281ྡ㸦40.2㸣㸧㸪Ꮫ ⏕ 33,929ྡ㸦5.0㸣㸧㸪♫ே 14,065 㸦2.1㸣㸧㸪ࣉ ࣟ 180 ྡ㸦0.1㸣ᮍ‶㸧 ࡛࠶ ࡿ㸬Ꮫ⏕ࡢ ෆヂࡘ ࠸࡚ࡣ㸪 ⏨Ꮚ
20,397ྡ㸦 Ꮫ⏕Ⓩ㘓 ⪅ᩘࡢ 60.1㸣㸧㸪ዪ Ꮚ 13,532 ྡ㸦39.9㸣㸧࡛࠶ࡿ㸬ᮏ㑥
ࡢࣛࢡࣟࢫ➇ ᢏேཱྀ ࡘ࠸࡚ࡣ㸪2011ᖺࡢ⥲Ⓩ㘓⪅ᩘࡣ Ꮫ⏕♫ ேࡢ࢝ࢸ ࢦ࣮ࣜࢆྜࢃ ࡏ࡚ 14,856ྡ㸦㧗ᰯ⏕௨ୗࡢ Ⓩ 㘓⪅ᩘࡣ☜ㄆ ࡉࢀ࡚࠸ ࡞࠸㸬ࡲࡓ 㸪
ࣉࣟࡢ࢝ࢸࢦ ࣮ࣜࡣᏑ ᅾࡋ࡞࠸ 㸧࡛ ࠶ࡾ㸪ࡑ ࡢෆヂࡣ⏨Ꮚ 5,729 ྡ㸦⥲Ⓩ㘓⪅
ᩘࡢ38.6㸣㸧㸪ዪᏊ 9,127ྡ㸦61.4㸣㸧࡛࠶ ࡿ㸬ࡲࡓ㸪⥲Ⓩ㘓⪅ ᩘ ࡢ࠾࠾ࡼ ࡑ 8
ࡀᏛ⏕㸪2 ࡀ♫ ே ᥎ᐃࡉ ࢀ࡚࠾ࡾ 㸪Ꮫ⏕Ⓩ㘓 ⪅ᩘࡣ 12,000 ྡ⛬ᗘ
⪃࠼ࡽࢀࡿ 㸬ࡉࡽ ࡑࡢ 45㸣⛬ᗘࡀ⏨ Ꮚ㸪55㸣⛬ᗘࡀዪ Ꮚ᥎ᐃ ࡉࢀ࡚࠾ࡾ 㸪
Ꮫ⏕ዪᏊ➇ ᢏேཱྀ ࡢ ᪉ࡀࡸࡸከ࠸ ഴྥ࠶ ࡿ 㸦᥎ᐃⓏ㘓 ᩘࡣ⏨ Ꮚ 5,400 ྡ㸪
ዪᏊ 6,600 ྡ⛬ᗘ㸧㸦 ⥲Ⓩ 㘓⪅ᩘ࠾ ࡼࡧ⏨ዪ ࡢⓏ㘓⪅ᩘ㸪 ྛ࢝ࢸࢦ ู࣮ࣜࡢⓏ
㘓⪅ᩘࡢྜ ࡢ᥎ᐃ࠾ ࡼࡧᏛ⏕ࡢ ⏨ዪࡢⓏ 㘓⪅ᩘࡢྜ ࡢ᥎ᐃ ࡘ࠸࡚ࡣ᪥
ᮏࣛࢡࣟࢫ༠ ࡽࡢ ⫈ྲྀࡼࡿ㸧 㸬࢝ࢸࢦ ู࣮ࣜࡢⓏ㘓 ⪅ᩘࢆࡳ ࡿ㸪 ⡿ᅜ
࡛ࡣ࣮ࣘࢫ࠾ ࡼࡧ㧗ᰯ ⏕ࡢ➇ᢏேཱྀ ࡀᴟࡵ࡚ ከ࠸ ࡇࡀఛ ࠼ࡿ 㸦ࣘ ࣮ࢫ㧗ᰯ
⏕ࡢⓏ㘓⪅ᩘ ࢆྜࢃࡏ ࡚ ⥲Ⓩ㘓⪅ᩘ ࡢ 93.0㸣ࢆ༨ࡵࡿ㸧ࡀ㸪ᮏ㑥࡛ ࡣᏛ⏕ࡢ
➇ᢏேཱྀࡀᴟ ࡵ࡚ከ࠸ ࡇࡀ᥎ ࡉ ࢀ ࡚࠸ࡿ 㸬Ꮫ⏕ࡢ➇ ᢏேཱྀ ࡘ࠸࡚ ẚ㍑
ࡋ࡚ࡳࡿ㸪 ⡿ᅜ 33,929 ྡ㸪ᮏ㑥 12,000 ྡ㸦᥎ᐃ㸧࡛ ࠶ ࡿ 㸪⏨ዪู࡛ẚ
㍑ࡋ࡚ࡳࡿ 㸪ዪᏊࡣ ⡿ᅜ 13,532 ྡ㸪᪥ᮏ 6,600ྡ㸦᥎ᐃ㸧࡛ ࠶ࡾ 㸪Ꮫ⏕ዪ Ꮚࡢ࢝ࢸࢦࣜ ࣮ࡔࡅ࡛ ẚ㍑ࡍࡿ㸪 ࡢ࢝ࢸ ࢦ࣮ࣜẚ ࡚ࡑࡢᕪ ࡣ ẚ㍑ⓗᑠ ࡉ࠸࠸࠼ࡿ 㸬
ࣛࢡࣟࢫࡣࢡ ࣟࢫ㸦 ࢫ ࢸࢵࢡ㸧ࢆ᧯సࡋ ࡞ ࡀࡽ࣮࣎ࣝࢆ ࣃࢫ㸪࢟ ࣕࢵࢳࡋ㸪
25
┦ᡭࢦ࣮ࣝ ࢩ࣮ࣗࢺ ࢆࡋ࡚ᚓⅬࢆ ➇࠺➇ᢏ ࡛࠶ࡿࡀ 㸪ࣛࣥࢽ ࣥࢢ㸪ࢲࢵࢩࣗ㸪
࢝ࢵࢸࣥࢢ 㸪ࢪࣕࣥ ࣉືస➼ࡶ ྜ ࢃࡏ࡚⾜ ࢃࢀ࡚࠸ࡿⅬ ࡀࣛࢡࣟ ࢫࡢ➇ᢏ≉
Ṧᛶ࠸࠼ࡿ[Dick et al., 2007]㸬ࣛࢡࣟࢫ ➇ ᢏࡣ⏨ዪࡢࣝ ࣮ࣝࡀ␗ ࡞ࡾ㸪⏨Ꮚ ࡣ࣓࣊ࣝࢵࢺ ࡸࣇ࢙ ࢫ࣮࢞ࢻ㸪ࢩ ࣙࣝࢲ࣮ ࣃࢵࢻ㸪࢚ࣝ ࣮࣎ࣃࢵ ࢻ㸪࣮࣒
ࣃࢵࢻ㸪ࢢࣟ ࣮ࣈ㸪࣐ ࢘ࢫ࣮࢞ࢻ➼ ࡢࣇࣝ ഛࡀ⩏ົࡅ ࡽࢀ࡚ ࠸ ࡿ㸪ࣉ
ࣞ ࣮ ࡘ ࠸ ࡚ ࡣ ࢥ ࣥ ࢱ ࢡ ࢺ ࣉ ࣞ ࣮ ࡸ ࢫ ࢸ ࢵ ࢡ ࡼ ࡿ ጉ ᐖ ࡀ ㄆ ࡵ ࡽ ࢀ ࡚ ࠸ ࡿ [National Collegiate Athletic Association, 2012]㸬୍᪉㸪ዪᏊࡣ࣐ ࢘ ࢫ࣮࢞ࢻࡢࡳ
㸦 ᮏ 㑥 ࡛ ࡣ ࢞ ࣮ ࢻ ࡢ ╔ ࡘ ࠸ ࡚ ࣝ ࣮ ࣝ つ ᐃ ࡉ ࢀ ࡚ ࠸ ࡞ ࠸ ࡀ 㸪 ⡿ ᅜ ࡛ ࡣ 2005ᖺࡽࡑࡢ ╔ ࡀ ⩏ົࡅࡽ ࢀ࡚࠸ࡿ 㸧࡛㸪ࡢഛ ࡣ≉ つᐃࡉ ࢀ࡚࠸
࡞࠸ࡀ㸪ࣉࣞ ࣮ࡘ࠸ ࡚ࡣࢥࣥࢱࢡ ࢺࣉ࣮ࣞ ࡸᨾព࡞ࢫࢸ ࢵࢡ ࡼࡿ᥋ゐࡸ
ጉᐖࡣ⚗Ṇࡉ ࢀ࡚࠸ࡿ[Diamond and Gale., 2001; Hinton et al., 2005]㸬ࡑࡢࡼ ࠺࡞
࣮ࣝࣝࡢ㐪࠸ ࡀ࠶ࡿ࡞ ࡛ 㸪≉ዪ Ꮚࣛࢡࣟ ࢫ➇ᢏ 㛵ࡍ ࡿയᐖሗ ࿌ࡀ㸪ᾏእ
ࡽከᩘࡳࡽ ࢀࡿ[Dick et al., 2007; Hinton et al., 2005; Carter et al., 2010]㸬ඛ⾜
◊✲ࡼࡿ 㸪യᐖ㒊 ࡘ࠸࡚ࡣ ୗ⫥ࡢയ ᐖࡀከࡃ[Dick et al., 2007; Hinton et al., 2005; Carter et al., 2010; Matz and Nibbelink, 2007 ]㸪୰࡛ࡶ㊊㛵 ⠇ࡸ⭸㛵⠇ࡢ യᐖࡀከ࠸ࡇ [Dick et al., 2007; Hinton et al., 2005; Matz and Nibbelink, 2007]㸪 യᐖࡢ✀㢮 ࡘ࠸࡚ࡣ ࡀከ࠸ࡇ ࡀሗ࿌ ࡉࢀ࡚࠸ࡿ[Dick et al., 2007; Hin- ton et al., 2005]㸬ࡲࡓ㸪⭸๓༑Ꮠ㠌 ᖏ㸦anterior cruciate ligament㸸௨ୗ㸪ACL㸧 യᐖࡢയᐖሗ ࿌ࡶ 」ᩘ ࡳࡽࢀࡿ[Mihata et al., 2006; Hootman et al., 2007]㸬ࣛࢡ
ࣟࢫ➇ᢏ≉Ṧ ᛶࡢ୍ࡘ ࡛࠶ࡿࢫࢸ ࢵࢡࢆ ⏝ࡋࡓ࣮࣎ࣝ ᧯స࡞ ࡼ ࡾ㸪㑅 ᡭࡢ㌟య⾪ ✺ࡋ࡚Ⓨ ⏕ࡍࡿᡴ᧞യ ᐖ[Diamond and Gale., 2001; Hinton et al., 2005; Matz and Nibbelink, 2007; Lincoln et al., 2007]㸪ࡑࡢ㸪㢌 㒊 ࠾ࡼࡧ㢦 ࡢ ᡴ ᧞ യ ᐖ 㛵 ࡍ ࡿ ሗ ࿌ ࡶ ከ ᩘ ࡳ ࡽ ࢀ ࡿ[Dick et al., 2007; Diamond and Gale., 2001; Matz and Nibbelink, 2007; Lincoln et al., 2007; Caswell et al., 2012; Golden- berg and Hossler, 1995; Otago et al., 2007; Waicus and Amith, 2002; Webster et al., 1999]㸬ࡑࡢ⬻ 㟈┞[Marar et al., 2012]ࡢሗ࿌ࡶࡳࡽࢀ࡚ ࠸ࡿ㸬ࡋ ࡋ࡞ࡀࡽ 㸪 ࡇࢀࡽࡢከࡃ ࡢሗ࿌ࡣ ᾏእࡽࡼ ࡿࡶࡢ࡛ ࠶ࡾ㸪ᅜෆዪ Ꮚࣛࢡࣟ ࢫ➇ᢏࡢയ ᐖሗ࿌ࡣᴟࡵ ࡚ᑡ࡞ࡃ 㸪ࡑࡢᐇែࡣ ᫂ࡽ ࡉࢀ࡚࠸࡞࠸ 㸬 ➹⪅ࡽ ࡣᮏ◊✲
ඛ❧ࡕ㸪Ꮫ ዪᏊࣛࢡ ࣟࢫࢆᑐ㇟ ࡋࡓ 1ᖺ 㛫ࡢയᐖㄪᰝ[బ㔝 ᮧ ࡽ, 2012-1]ࢆ
