Maximum Load on Crutch and the Load on Shoulder and Elbow Joints While Waking with a Crutch

本研究の目的は一側上肢で杖を用いた歩行の際に、杖にかかる最大荷重率および杖使用側の肩・肘関節にかかる負担度を4種類の杖で比較検討することである。健常成人を対象として、T字杖(T杖)、四点杖(Q杖)、ロフストランド杖(L杖)および松葉杖(A杖)に最大荷重をさせた平地歩行を行った。動作解析には三次元動作解析装着(VICON512)および床反力計(AMTI)を使用した。負担度は動作中の関節モーメントの値を、筋力測定機器(KIN-COM)により測定した随意最大肩内転・肘伸展モーメントの値で除して正規化した。最入荷重率はT杖で体重の44.9%、Q杖で59.2%、L杖で66.7%、A杖で73.6%であった。負担度はT杖では肩関節21.0%、肘関節61.5%、Q杖は26.3%と60.9%であり、肘関節が肩関節より有意に大きな値を示した(p<0.01)。一方、L杖では59.0%と43.2%、A杖では38.8%と57.8%であり有意な差はみられなかった(p>O.1)。これらの結果は部分荷重歩行訓練を指導する際の杖を選択する指標の一つになると考えられる。The purpose of this study was to investigate the load on the shoulder and the elbow joints during walking with a crutch. Nine healthy adults participated in this study. 0ne leg of each subject was assumed to be an affected limb. All subjects used four kinds of crutches such as T-cane (T), Quadripod cane (Q), Lofstrand crutch (L) and Axillary crutch (A) with an upper extremity of sound side during walking. They were told to load their body weight on the crutch as much as possible. The movement was measured with 3D motion analysis system (VICON512)and force plates (AMTI).As a result, the rates of the maximum load on the crutch showed 44.9% in T, 59.2% in Q, 66.7% in L and 73.6% in A. The load on the elbow joint was significantly larger than that on the shoulder joint in T and Q (p<0.01),while the load on the shoulder joint was larger than that on the elbow joint in L and A (p>0.1).These results can be employed as an indicators when we recommend a suitable cane or crutch for individual patient who needs walking aid