植木鉢を地面に置く動作時に右下肢への体重移動が困難であった右人工股関節全置換術後患者の理学療法

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  • 伊森 理貴
    六地蔵総合病院　リハビリテーション科
  • 上田 透
    六地蔵総合病院　リハビリテーション科
  • 刀坂 太
    六地蔵総合病院　リハビリテーション科
  • 楠 貴光
    六地蔵総合病院　リハビリテーション科
  • 大沼 俊博
    六地蔵総合病院　リハビリテーション科
  • 鈴木 俊明
    関西医療大学大学院　保健医療学研究科

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  • Physical therapy for a patient with right total hip arthroplasty who had difficulty with weight transfer to the right lower limb when putting a flower pot on the ground
  • 症例報告 植木鉢を地面に置く動作時に右下肢への体重移動が困難であった右人工股関節全置換術後患者の理学療法
  • ショウレイ ホウコク ウエキバチ オ ジメン ニ オク ドウサジ ニ ミギ カシ エ ノ タイジュウ イドウ ガ コンナン デ アッタ ミギ ジンコウ コカンセツ ゼン チカン ジュツゴ カンジャ ノ リガク リョウホウ

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<p>We performed physical therapy for a patient with right total hip arthroplasty whose stability was impaired by left forward inclination of the trunk when putting a flower pot on the ground with the afflicted right side leg forward. In the observation of the action of placing the flower pot on the ground, in weight transfer to the right lower limb, excessive hip adduction resulted in left forward inclination of the trunk, and the patient's stability was impaired by the center of gravity trying to deviate from the base plane. After that, weight transfer to the left lower limb was accompanied by a rearward inclination of the right lower limb due to right ankle plantar flexion and knee extension, and right hip and chest flexion occurred because weight transfer to the right lower limb was poor. The patient could not move a flower pot to the front of the right foot. We measured muscle activities by EMG during imitation of the movement of putting a flower pot on the ground, to clarify the muscle activities necessary for that task. The muscle activities of the posterior gluteus medius and upper gluteus maximus, which is are hip abductor muscles, increased. On the basis of behavior observation of the patient and the results of EMG, we thought that weakness in the posterior gluteus medius and upper gluteus maximus was a major problem. So, we performed physical therapy focussing on strengthening exercises. As a result, excessive hip adduction, resulting from the left forward inclination of the trunk decreased, and the patient was able to transfer weight to the right lower limb, accompanied by a forward tilting of the lower leg by right knee flexion and ankle extension, allowing the patient to put a flower pot on the ground.</p>

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