端座位から車椅子への移動動作が看護師の心身に与える影響

Article

目的:看護師と患者の身長が同程度という条件において,車椅子への移動動作における看護師の心身に与える影響を明らかにする.方法:患者の背部で手を組む方法と介助用ベルトを使用する方法の,端座位から車椅子へ移乗を介助する際の看護師の表面筋電図を測定した.上腕二頭筋,胸最長筋,大腿直筋,腓腹筋の筋電図を測定し,筋電図積分値を算出し二群間で比較した.所要時間と動作前後で上肢,腰部,大腿部の苦痛の程度も同様に比較した.結果:対象者は10名.左右上腕二頭筋では,介助用ベルト法の筋電図積分値が有意に高く,右大腿直筋では両手組法が有意に高かった.2群間の所要時間に差は無く苦痛は殆どなかった.結論:看護師と患者の身長が同程度では,①介助用ベルト法は上腕二頭筋の筋活動量が大きい.②介助用ベルト法は起立・着座介助時の腰部の筋活動量が大きい.③両手組法は着座介助時に大腿直筋の筋活動量が大きい.④身体への苦痛は殆どない.

Objectives : The purpose of this study was to assess muscle activity in nurses transferring patients similar to their height from the bed to the wheelchair with or without the use of a gait belt. Methods : The muscle activity of 10 nurses was recorded while they transferred patients from the edge of bed to a wheelchair. Nurses were assigned to two groups as follows : the first group wrapped their arms around the patient from the front, while the other group used a gait belt. Surface electromyograms (EMGs) were recorded in the nurses' biceps brachii, longissimus thoracis, rectus femoris, and gastrocnemius muscles, and then the integrals of the EMG signals were calculated and compared between the two groups. In addition, pain in the arms, waist, and knees of the nurses was assessed and compared before and after patient transfer, as was the time required to complete the procedure. Results : EMG integrals in the right and left biceps brachii muscles were significantly higher among the nurses who used a gait belt. In contrast, EMG integrals in the right rectus femoris muscles were significantly higher among the nurses who did not use a gait belt. No differences were observed between the two groups in the time required to complete the transfer procedure, and only low levels of pain were reported. Conclusions : Based on EMG recordings and pain assessment of nurses while transferring patients similar to their height from the bed to the wheelchair, the following results were found : 1) Using a gait belt for assistance significantly increased biceps brachii muscle activity in nurses ; 2) Using a gait belt for assistance increased muscle activity around the waist in nurses when lifting patients and seating them in a wheelchair ; 3) Wrapping the arms around the back of a patient significantly increased rectus femoris muscle activity in nurses when seating them in a wheelchair ; and 4) Only low levels of pain were reported among nurses when transferring patients from the bed to the wheelchair, regardless of the method used.

原著

群馬県立県民健康科学大学紀要11,49-57,2016