312275 2792016 原 著 JOABPEQ Effect of the Trunk Extension Endurance Training on Degenerative Lumbar Disease: Evaluation Using JOABPEQ 1,2) 3) 4) 3) 3) 5) 2,6) 1) 7) HIDETOSHI NAKAO, RPT 1,2), TAKAHIRO INABA, RPT 3), TAKESHI MORIFUJI, RPT, PhD 4), YUKAKO UCHIHARA, RPT 3), MOE WATANABE, RPT 3), MOTOHARU KANEKO, MD 5), KAZUAKI KINOSHITA, RPT 2,6), MASASHI HASHIMOTO, RPT, PhD 1), SHINGO OTSUKI, MD 7) 1) School of Rehabilitation Osaka Kawasaki Rehabilitation University: 158 Mizuma, Kaizuka-shi, Osaka 597-0104, Japan TEL+81 72-446-6700 E-mail: nakaoh@kawasakigakuen.ac.jp 2) Osaka Sangyo University Graduate School 3) Department of Rehabilitation, Midori-Kaneko Orthopedic 4) Osaka Yukioka University of Medical and Health Care 5) Midori-Kaneko Orthopedic 6) Faculty of Rehabilitation, Shijonawate Gakuen University 7) Osaka Sangyo University Rigakuryoho Kagaku 31(2): 275 279, 2016. Submitted Sep. 7, 2015. Accepted Nov. 18, 2015. ABSTRACT: [Purpose] The purpose of this study was to carry out trunk back muscle endurance training for degenerative lumbar disease patients, to examine its influence on VAS pain and the JOABPEQ. [Subjects] The subjects were 27 outpatients with degenerative lumbar disease, and an average age of 72.2 ± 8.3 years. [Methods] In the training group (T group), there were 15 subjects who performed back muscle endurance training during exercise; and in the control group (C group), there were 12 subjects who performed only exercise. The endurance of trunk back muscles was measured three times, once every month, as well as VAS pain and the JOABPEQ. [Results] The endurance of trunk back muscle of the T group reached a significantly higher level by the third month, and VAS pain showed a significantly lower level after two or three months. Furthermore, in the C group only lumbar vertebrae dysfunction of JOABPEQ showed a significantly higher level in the second month. [Conclusion] The results suggest that trunk back muscle endurance training for patients with degenerative lumbar disease is effective at alleviating pain and improving ADL. Key words: muscle endurance, JOABPEQ, degenerative lumbar disease 要 旨 : VAS JOABPEQ 27 72.2 8.3 15 T 12 C 1 3 VASJOABPEQ T 3 JOABPEQ 2 VAS 23 ADL キーワード:JOABPEQ 1) :158597-0104 TEL 072-446-6700 2) 3) 4) 5) 6) 7) 2015 9 7 2015 11 18
276 312 I.はじめに JOABPEQ 14) 2013 1 2 1) JOABPEQ 2) 3 3) 4) II. 対 象 と 方 法 1 5) 4,6,79) 27 9 18 T C 10) C 12 5 7 73.5 9.2 T 6) 15 4 11 71.2 7.7 1 13 6 11) 6 2 VASVisual Analogue Scale JOABPEQJOA Back Pain Evaluation Questionnaire 2 JOA 3 1 1 JOA 表 1 n=15 n=12 71.2 7.7 73.5 9.2 411 57 8 5 4 2 2 4 1 1
277 10 1 JOABPEQVAS 1 JOABPEQ 25 1 20 90 90 90 13) VAS Friedman Mann-Whitney U JOABPEQ Fisher JSTAT 5 III. 結 果 1 75.26 2 73.443 66.35T C 3 2T C T VAS C 2 3 3T VAS 2 3 C VAS JOABPEQ 2 T C T C 4 IV. 考 察 ADL 表 2 n=15 n=12 1 2 3 * * 79.9 63.1 204.1 134.8 253.0 138.8 294.9 190.1 98.1 81.5 136.2 175.9 131.4 166.5 127.1 132.4 Mann-Whitney U Friedman *p<0.05 p<0.01*p<0.001 表 3 VAS n=15 n=12 1 2 3 * 5.6 2.2 4.9 2.0 3.4 1.7 3.4 2.0 6.1 1.4 4.5 2.2 5.7 1.6 5.6 1.5 mm Mann-Whitney U Friedman *p<0.05 p<0.01
278 312 表 4 JOABPEQ 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 3 10 2 6 4 2 2 11 2 2 8 2 5 8 2 4 6 2 4 6 5 1 9 2 6 4 5 0 10 2 * 5 5 5 2 8 2 2 11 2 1 10 1 2 11 2 1 10 1 3 10 2 0 11 1 0 13 1 1 9 2 2 12 1 1 9 2 2 12 1 2 9 2 1 14 0 1 11 0 1 14 0 0 12 0 0 15 0 1 11 0 Fisher *p<0.05 Kraus-Waber Sorensen 14) 1 3 15) 1 2 10 12 15) 1 5 1 10 5 4 QOL 16) 17) 8 QOL 2 3 1 QOL
279 18,19) JOABPEQ ADL ADL 2 1 ADL 1 2 JOABPEQ VAS VAS JOABPEQ ADL 引 用 文 献 1) 25 267http://www.mhlw.go.jp/toukei/saikin/hw/ k-tyosa/k-tyosa13/index.html2015827 2) MB Orthop, 2012, 25(7): 5560. 3) 1989, 2(12): 14691477. 4) 2005, 22(6): 691697. 5) Chou R, Qaseem A, Snow V, et al.: Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 2007, 147(7): 478491. 6) Weiner DK, Perera S, Rudy TE, et al.: Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain, A randomized controlled trial. Pain, 2008, 140: 344357. 7) 2011, 40: CD. 8) Hultman G, Nordin M, Saraste H, et al.: Body composition, endurance, strength, cross-sectional area, and density of MM erector spinae in men with and without low back pain. J Spinal Disord, 1993. 6(2): 114123. 9) Lee JH, Hoshino Y, Nakamura K, et al.: Trunk muscle weakness as a risk factor for low back pain. A 5-year prospective study. Spine, 1999, 24(1): 5457. 10) Bo Anderson L, Wedderkopp N, Leoboeuf-Yde C: Association between back pain and physical fitness in adolescents. Spine, 2006, 31(15): 17401744. 11) Kool J, de Bie R, Oesch P, et al.: Exercise reduces sick leave in patients with non-acute non-specific low back pain: a metaanalysis. J Rehabil Med, 2004, 36: 4962. 12) Jørgensen K, Nicholaisen T, Kato M, et al.: Muscle fiber distribution, capillary density, and enzymatic activities in the lumbar paravertebral muscles of young men. Significance for isometric endurance. Spine, 1993, 18(11): 14391450. 13) JOABPEQ, JOACMEQ 2012, pp2535. 14) 2001, 7(1): 3134. 15) Mayer J, Mooney V, Dagenais S: Evidence-informed management of chronic low back pain with lumbar extensor strengthening exercises. Spine J, 2008, 8: 96113. 16) Hongo M, Itoi E, Sinaki M, et al.: Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomaizend controlled trial. Osteoporos Int, 2007, 18(10): 13891395. 17) 8 2009, 24 (2): 221226. 18) Standaert CJ, Weinstein SM, Rumpeltes J: Evidenceinformed management of chronic low back pain with lumbur stabilization exercise. Spine J, 2008, 8: 114120. 19) vangreen JW, Edelaar MJ, Janssen M, et al.: The long-term effect of multidisciplinary back training: a systematic review. Spine, 2007, 32(2): 249255.