Purpose: To clarify the effects of guidance in home exercise on physical function and the amount of activity in home-care patients with Parkinson’s disease (PD).
Methods: A 2-month home exercise intervention consisting of self-administered exercise by patients (self-exercise) and home-visiting exercise therapy by a physical therapist (visiting exercise) was conducted in 10 home-care patients with PD to compare changes in physical function, activities of daily living, and postural status between before and after intervention.
Results: Increased number and duration of self-exercise sessions, decreased number of chief complaints, and alleviation of fear of falling were observed after the intervention.
In terms of physical function, a significant increase in range of motion and muscle strength of the upper extremity and trunk were observed, although no significant changes were found in activities of daily living, gait, and balance.
Although there was no significant change in the total amount of daily physical activity, the analysis of daily posture changes revealed a significant reduction in the percentage of time spent lying down and a significant increase in the percentage spent sitting after the intervention.
Conclusion: Guidance in home exercise in home-care patients with PD can be effective in making self-exercise a habit, improving range of motion, muscle strength, and standing balance, and reducing the time spent in a supine position.
(在宅PD患者を対象とした自主練習と個別運動療法による2か月間の介入が，身体機能および一日の活動量や姿勢動態にどのような変化を与えるかを明らかにするため，運動療法による介入前後の評価結果を比較検討した。その結果，自主練習実施回数と実施時間の増大，主訴数の減少と転倒恐怖感の改善が介入前後に有意差を認めた。身体機能では，肩関節屈曲および体幹伸展の角度，股屈曲筋力および膝伸展筋力が有意に増加していた。その一方，Functional Independence Measureや歩行速度および歩行率，Timed Up and Go testやFunctional Reach Test，Functional Balance Scaleなどは有意な変化が認められなかった。活動量や姿勢動態では，活動量の指標である総力積，姿勢変換回数などには有意な変化は認められず，介入前後の変化としては一日に占める臥位時間割合の減少，座位時間割合の増加として有意な変化を認めた。本研究における介入によって，自主練習の習慣化，関節可動域や下肢筋力，立位バランス能力の向上，臥位時間を減少させる効果が示唆された。)
26:1701-1706,2014
Hideyuki NAKAE，Hitoshi TSUSHIMA
