Objective: To compare physical function and 24-h activity in home-care patients with Parkinson’s disease with those in healthy elderly people.
Methods: Physical function (range of motion, muscle strength, activities of daily living, gait, and balance) was measured in 10 home-care patients with Parkinson’s disease (PD group) and 10 healthy elderly subjects (healthy group). As an indicator of the amount of physical activity per day, a triaxial accelerometer was used to measure the 24-h total impulse value; simultaneously, behavior recorders were used to measure 24-h posture.
Results: The healthy group scored significantly higher in activities of daily living, walking speed, and balance. No significant difference was observed between groups in terms of range of motion, muscle strength, cadence, amount of physical activity per day, and number of postural changes. However, the PD group spent significantly more time per day standing and in a supine position.
Conclusion: In the PD group, the amount of physical activity per day was comparable to that in the healthy elderly group, despite the decreased levels of activity caused by their impaired performance in activities of daily living. Range of motion and muscle strength may have been maintained by these patients’ self-training and by training at day-care centers. Our results suggest the importance of practicing postural transfers from the standing and supine positions and of intervention and guidance that aim to improve impaired performance in daily living.
（目的：在宅パーキンソン患者の身体機能と24時間の活動状況の特徴を健常高齢者との比較から明らかにする。対象と方法：在宅パーキンソン患者(PD群)10名と健常高齢者(高齢者群)10名を対象として、身体機能については関節可動域，下肢筋力，日常生活活動，歩行能力，バランス能力を測定した。一日の活動量については三軸加速度計を用いて24時間の総力積値を測定し、指標とした。同時に行動記録計を用いて24時間の姿勢動態を測定した。結果：日常生活活動，歩行速度，バランス能力は高齢者群の方が有意に上回っていた。関節可動域，下肢筋力，歩行率，一日の活動量と姿勢変換回数については両群間に有意差を認めなかった。しかし，1日の姿勢で立位及び背臥位の占める割合はPD群が有意に高かった。結語：PD群では生活場面での動作障害により活動能力は低下するが，1日の活動量は高齢者群と同等であり、関節可動域や下肢筋力は自主トレーニングやディケアの訓練により維持できることが明らかとなった。これらのことから，立位や背臥位からの姿勢変換練習や生活場面の動作障害の改善を目的とした介入や指導の重要性が示唆された。）
65:190-198,2014
Hideyuki NAKAE, Hitoshi TSUSHIMA
