杖歩行における心血管系の負荷に関する研究 : 部分荷重歩行における杖の影響について

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The cardiovascular stress of 60% partialweight-bearing gait was studied in 9 normal male subjects aged from 23 to 34. Double crutch (DC), single crutch (SC) and single Lofstland crutch (SLC) were used for the walking device. Walking modalities were 3 point gait for DC walking, and 2 point gait for SC and SLC walking. First, the subjects ambulated for 5 minutes without crutches (control walking), then ambulated for the same time with various crutches at 50 m・min^-1 and on a O% grade on the treadmill. So 4 tasks were given to the each subject. In determining the order of crutch using, the Latin square design was used to avoid the effect of sequence. Heart rates (HR) and oxygen consumption (VO_2) were measured at sitting, standing and every minute during 5 minutes walking. Systolic blood pressure (SBP) was measured at sitting, standing and 1st, 3rd and 5th minute, and Borg's rated perceived exersion (RPE) at 1st, 3rd and 5th minute during walking. Rate pressure product (RPP) was determined by aproduct of HR and SBP. The results were summarized as follows : 1: There were no significant differences of V0_2 among 3 crutch walkings. VO_2 of the 5th minute were 14.6±2.6, 15.1±2.9 and 15.4±2.3 ml・kg^-1・min^-1 for DC, SLC and SC walking, respectively. Those values were approximately 1.5 times to the control walking. 2: There were also nosignificant differences of HR but were obvious differences of SBP among 3crutch walkings(P<0.01). The mean HR of 5th minute for each crutch walking increased by 12, 14 and 19 bpm over the mean HR that obtained for control walking and the mean SBP increased by 10, 20 and 30 mmHg for DC, SLC and SC walking, respectively. 3: RPP response was similar to SBP's one. So, cardiovascular stress was clearly demonstrated greater in order of DC, SLC, and SC walking. 4: RPE showed similar tendency to SBP or RPP, and significant correlations with SBP, VO_2 and RPP were observed for SC (γ=0.58, P<0.01 for SBP and V0_2, γ=0.39, P<0.05 for RPP) and for SLC walking (γ=0.50, P<0.01 for SBP, γ=0.48, P<0.05 for VO_2). 5: These results suggest that the observed differences among 3 crutch walking are a function of the degree of isometric contraction of the push up muscles in the upper extremities. And indicating crutch walking to cardiac or cardiac prone patients, DC walking should be prescribed up to the time when at least more than 80% partialweight-bearing is permitted.
社団法人日本理学療法士協会の論文
1985-02-10

杖歩行における心血管系の負荷に関する研究 : 部分荷重歩行における杖の影響について

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