（1）脳性麻痺患者の手根骨の変化
Carpal changes in cerebral palsy patients
整形外科と災害外科Vol.43(1994)No.1p417-420
https://www.jstage.jst.go.jp/article/nishiseisai1951/43/1/43_1_417/_pdf
In cerbral palsy patients, muscles are hypertonic from childhood, and therefore strong continuous pressure is applied between the radial and carpal bones of the wrist joint.
We have treated 40 cerebral palsy patients (80 wrists) ranging in age from 15 to 46 years with a mean of 25.2 years.
Plain posteroanterior were taken of both wrists in all these patients regardless of their symptoms.
All wrists showed 25％ of minus ulnar variance, and the radiolunate angle was -3.46±12.36, and showed a DISI pattern.
Scapholunate dissociation was observed in five wrists.
DISI pattern seems to have been caused by continuous pressure caused by extensors and flexors between the radial and carpal bones
（2）脳性麻痺児における手指屈筋解離について
Release operation of flexion contracture of the fingers for spastic paralysis
整形外科と災害外科Vol.35(1986-1987)No.1p224-229
https://www.jstage.jst.go.jp/article/nishiseisai1951/35/1/35_1_224/_pdf
In most cases with spastic paralysis of the upper extremity, the elbow is held in flexion with pronation of the forearm and flexion of the wrist and fingers.
Because of this is deformed posture, little effective voluntary control of the hand is possible.
From 1979 to 1985, the release operation was performed in eight cases of spastic paralysis and two cases of athetosis.
The results of flexor release and associated procedures in this series were demonstrated.
（3）脳性麻痺前腕回内変形に対する手術的矯正について
Surgical correction for pronation contracture of the forearm in cerebral palsy
整形外科と災害外科Vol.38(1989-1990)No.1p270-273
https://www.jstage.jst.go.jp/article/nishiseisai1951/38/1/38_1_270/_pdf
Between 1980 and 1988, lengthening of the pronator teres and flexor carpi radialis was performed in 56 pronation deformities of the forearm in 55 patients with cerebral palsy.
Twenty of these were monitored and the mean age at the time of surgery was 17 years and 7 months.
The mean period of follow-up was 1 year and 5 months.
Before surgery, the mean active supination was 1.7 degrees.
At the end of the follow-up, it was improved to 39 degrees.
According to Sakellarides' evaluation system, there were 8 excellent, 3 good, 4 fair, and 6 poor results.
We found that this method was effective to correct a pronation deformity excluding fixed Contracture cases.
There were 6 poor results in the fixed contracture cases.
The causes of these results were discussed.
（4）脳性麻痺に合併した頸椎症性脊髄症に対する後方固定手術‐ボツリヌス毒素を併用した2症例‐
The Japanese Journal of rehabilitation medicine Vol.47(2010)No.8p569-575
https://www.jstage.jst.go.jp/article/jjrmc/47/8/47_8_569/_pdf
There have been several reports on surgical interventions in patients with adult cervical spondylotic myelopathy associated with cerebral palsy.
We performed posterior fusion with pedicle and/or lateral mass screws combined with preoperative intramuscular injections of botulinum toxin in two patients.
Two weeks before the surgery, we injected the patients with the botulinum toxin to alleviate cervical pain and to reduce the involuntary movement associated with cerebral palsy.
Surgical results were good in both patients without rigid external fixation.
Both patients were able to undergo rehabilitation after the surgery as soon as possible without any complication.
We think that our pre surgical treatment with botulinum toxin is a useful optional treatment for cervical spondylotic myelopathy associated with cerebral palsy
（5）脳性麻痺の弛緩姿勢 リラクゼーションチェアの人間工学
Relaxed posture of cerebral palsy children an ergonomic study of their relaxation chair
人類学雑誌Vol.83(1975)No.4p295-308
https://www.jstage.jst.go.jp/article/ase1911/83/4/83_4_295/_pdf
As one of the studies of human posture, the author noticed abnormal muscle tones of cerebral palsy children and measurements were conducted on levels of acceleration of muscle tones in the relaxed posture.
Ten types of chairs with different seat tilts and back rest inclinations were chosen and changes in muscle contraction were mentioned electromyographically.
Nine subjects all severely involved cerebral palsy children.
Angle of each type of chair is as follows：
A type: Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 5 degrees from vertical line to the front.
B type： Seat at an angle of 15 degrees to the horizontal line and back rest at a level of 10 degrees from vertical line to the back.
C type： Seat at an angle of 10 degrees to the horizontal line and back rest at level of 10 degrees from vertical line to the back.
D type： Seat at an angle of 5 degrees to the horizontal line and back rest at a level of 10 degrees from vertical line to the back.
E type： Seat is same degree with horizontal line and back rest at a level of 10 degrees from vertical line to the back.
F type： Seat at an angle of 15 degrees to the horizontal line and back rest at level of 20 degrees from vertical line to the back.
G type: Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 20 degrees from vertical line to the back.
H type： Seat is same degree with horizontal line and back rest at a level of 20 degrees from vertical line to the back.
I type： Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 30 degrees from vertical line to the back.
J type： Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 40 degrees from vertical line to the back.
As a general tendency of the relationship between EMG level and the ten types of chairs, it was found that EMG decreased as the angle of the relaxation chair increased.
The effects on the EMG level of three factors such as type of chair, sample muscles, and subject were tested by the analysis of variance.
The results were as follows：
Factor of type of chair: F＝3.984(f1＝8, f2＝64), factor of muscle： F＝10.723(f1＝5, f2＝40), and factor of subject： F＝21.38 (f1＝8, f2＝320).
These values were significant at the 1％ level.
The EMG level was compared between the above 10 types of chairs and the sum of the EMG levels of different muscles in percentages to that of A type was B type 64％, for C type 50％, for D type 62％, for E type 60％, for F type 42％, for G type 30％, for H type 32％, and for I type 42％.
The EMG level in case of G and H types was decreased to about Two-Thirds of that of A.
As for the interaction on the EMG level of the three factors of the variance ratio was computed at 1.38(f1＝40, f2＝320) in the case of chair and subject, at 6.566 (f1＝40, f2＝320) in the case of those of muscle and subjects.
The level of the latter two cases were significant at the 1％ level.
However, the interaction of the factors of chair and muscles was not significant.
This shows the effect of chair on the EMG level independent from the kind of muscle tested.
Therefore, it can be concluded that the G type was the most adequate one among the 10 types of chair tested from the view point of suppressing involuntary muscular contraction of the patient
（6）脳性麻痺児に対する治療学としてのBobath Approach
脳と発達Vol.12(1980)No.5p443-448
https://www.jstage.jst.go.jp/article/ojjscn1969/12/5/12_5_443/_pdf
（7）座位保持を目的とした車椅子の開発
日本義肢装具学会誌Vol.7(1991-1992)No.1p47-53
https://www.jstage.jst.go.jp/article/jspo1985/7/1/7_1_47/_pdf
（8）脳性麻痺児における歩行時の効率に対する空間時間的変数の影響
https://www.jstage.jst.go.jp/article/rika/24/2/24_2_155/_pdf
The purpose of this study was to determine influences of spatio-temporal gait parameters on walking efficiency of children with cerebral palsy.
Subjects were 9 children with spastic diplegia who could walk.
Mean ± SD of age was 12.8 ± 3.5 years (range: 7 yrs 5 mo-18 yrs 9 mo).
Methods
We measured gait speed, step length and cadence in 10-m gait as spatio-temporal gait parameters, and pulse rate, walking speed and calculated the Physiological Cost Index (PCI) during 4 min walking as parameters of walking efficiency.
Pearson's correlation coefficients were obtained for the spatio-temporal gait parameters and walking efficiency parameters.
Results
No significant correlation was found between the pulse rate during 4 min walking and the spatio-temporal parameters.
There were significant positive correlations between walking speed during 4 min walking and 10-m walking speed (p＜0.05), and step length in 10-m gait (p＜0.01), but no significant correlation was found between walking speed during 4 min walking and cadence in 10-m gait.
There were significant negative correlations between PCI and walking speed (p＜0.01), and step length in 10-m gait (p＜0.05), but no significant correlation was found between PCI and cadence in 10-m gait.
Conclusion
Because walking efficiency was high when walking speed was fast and/or step length was wide, we consider that the factors for high walking efficiency in children with cerebral palsy are fast walking speed and wide step length.
･････････････
（9）肩関節脱臼後に腋窩神経麻痺を伴った腱板広範囲断裂の治療経験
Treatment of massive rotator cuff tear with axillary nerve palsy after dislocation of shoulder
整形外科と災害外科Vol.56(2007)No.4p525-528
https://www.jstage.jst.go.jp/article/nishiseisai/56/4/56_4_525/_pdf
We report two good results after arthroscopic rotator cuff repair for massive rotator cuff tear with axillary nerve palsy after dislocation of the shoulder.
Case 1:
A 60 year-old man had fallen and dislocated his right shoulder.
He visited our hospital six weeks after the injury because he was unable to raise his right shoulder.
Muscle atrophy was found in the right deltoid.
Numbness was found on the lateral-side of the right shoulder.
Arthroscopic rotator cuff repair was performed three months after the injury.
Before surgery, JOA score was 31 points, and improved to 94 points one year after surgery.
Case 2:
A 47 year-old man had fallen and dislocated his right shoulder.
He visited our hospital three weeks after the injury, because he was unable to raise his right shoulder.
Muscle atrophy was found in the right deltoid.
Numbness was found on the lateral-side of the right shoulder.
Denervation potential was observed in the right deltoid by electromyogram.
Arthroscopic rotator cuff repair was performed one month after the injury. Before surgery, JOA score was 45 points, and improved to 93 points six months after surgery.
Considering degeneration of the rotator cuff, early operation may be planned for the treatment of massive rotator cuff tear if nerve recovery prospects can be seen
･････････････
小児全身性ジストニア
ジストニア
アテトーゼ
バリズム
痙直型
↓パパの説明文がせつない( ; ω ; )てんかんのコントロールは難しい
ジスキネジア
脳性麻痺リハビリガイドライン
http://www.jarm.or.jp/wp-content/uploads/file/member/member_publication_isbn9784307750387.pdf
側彎症しおり
http://square.umin.ac.jp/iwate-sokuwan/_pdf/guidebook.pdf
Carpal changes in cerebral palsy patients
整形外科と災害外科Vol.43(1994)No.1p417-420
https://www.jstage.jst.go.jp/article/nishiseisai1951/43/1/43_1_417/_pdf
In cerbral palsy patients, muscles are hypertonic from childhood, and therefore strong continuous pressure is applied between the radial and carpal bones of the wrist joint.
We have treated 40 cerebral palsy patients (80 wrists) ranging in age from 15 to 46 years with a mean of 25.2 years.
Plain posteroanterior were taken of both wrists in all these patients regardless of their symptoms.
All wrists showed 25％ of minus ulnar variance, and the radiolunate angle was -3.46±12.36, and showed a DISI pattern.
Scapholunate dissociation was observed in five wrists.
DISI pattern seems to have been caused by continuous pressure caused by extensors and flexors between the radial and carpal bones
（2）脳性麻痺児における手指屈筋解離について
Release operation of flexion contracture of the fingers for spastic paralysis
整形外科と災害外科Vol.35(1986-1987)No.1p224-229
https://www.jstage.jst.go.jp/article/nishiseisai1951/35/1/35_1_224/_pdf
In most cases with spastic paralysis of the upper extremity, the elbow is held in flexion with pronation of the forearm and flexion of the wrist and fingers.
Because of this is deformed posture, little effective voluntary control of the hand is possible.
From 1979 to 1985, the release operation was performed in eight cases of spastic paralysis and two cases of athetosis.
The results of flexor release and associated procedures in this series were demonstrated.
（3）脳性麻痺前腕回内変形に対する手術的矯正について
Surgical correction for pronation contracture of the forearm in cerebral palsy
整形外科と災害外科Vol.38(1989-1990)No.1p270-273
https://www.jstage.jst.go.jp/article/nishiseisai1951/38/1/38_1_270/_pdf
Between 1980 and 1988, lengthening of the pronator teres and flexor carpi radialis was performed in 56 pronation deformities of the forearm in 55 patients with cerebral palsy.
Twenty of these were monitored and the mean age at the time of surgery was 17 years and 7 months.
The mean period of follow-up was 1 year and 5 months.
Before surgery, the mean active supination was 1.7 degrees.
At the end of the follow-up, it was improved to 39 degrees.
According to Sakellarides' evaluation system, there were 8 excellent, 3 good, 4 fair, and 6 poor results.
We found that this method was effective to correct a pronation deformity excluding fixed Contracture cases.
There were 6 poor results in the fixed contracture cases.
The causes of these results were discussed.
（4）脳性麻痺に合併した頸椎症性脊髄症に対する後方固定手術‐ボツリヌス毒素を併用した2症例‐
The Japanese Journal of rehabilitation medicine Vol.47(2010)No.8p569-575
https://www.jstage.jst.go.jp/article/jjrmc/47/8/47_8_569/_pdf
There have been several reports on surgical interventions in patients with adult cervical spondylotic myelopathy associated with cerebral palsy.
We performed posterior fusion with pedicle and/or lateral mass screws combined with preoperative intramuscular injections of botulinum toxin in two patients.
Two weeks before the surgery, we injected the patients with the botulinum toxin to alleviate cervical pain and to reduce the involuntary movement associated with cerebral palsy.
Surgical results were good in both patients without rigid external fixation.
Both patients were able to undergo rehabilitation after the surgery as soon as possible without any complication.
We think that our pre surgical treatment with botulinum toxin is a useful optional treatment for cervical spondylotic myelopathy associated with cerebral palsy
（5）脳性麻痺の弛緩姿勢 リラクゼーションチェアの人間工学
Relaxed posture of cerebral palsy children an ergonomic study of their relaxation chair
人類学雑誌Vol.83(1975)No.4p295-308
https://www.jstage.jst.go.jp/article/ase1911/83/4/83_4_295/_pdf
As one of the studies of human posture, the author noticed abnormal muscle tones of cerebral palsy children and measurements were conducted on levels of acceleration of muscle tones in the relaxed posture.
Ten types of chairs with different seat tilts and back rest inclinations were chosen and changes in muscle contraction were mentioned electromyographically.
Nine subjects all severely involved cerebral palsy children.
Angle of each type of chair is as follows：
A type: Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 5 degrees from vertical line to the front.
B type： Seat at an angle of 15 degrees to the horizontal line and back rest at a level of 10 degrees from vertical line to the back.
C type： Seat at an angle of 10 degrees to the horizontal line and back rest at level of 10 degrees from vertical line to the back.
D type： Seat at an angle of 5 degrees to the horizontal line and back rest at a level of 10 degrees from vertical line to the back.
E type： Seat is same degree with horizontal line and back rest at a level of 10 degrees from vertical line to the back.
F type： Seat at an angle of 15 degrees to the horizontal line and back rest at level of 20 degrees from vertical line to the back.
G type: Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 20 degrees from vertical line to the back.
H type： Seat is same degree with horizontal line and back rest at a level of 20 degrees from vertical line to the back.
I type： Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 30 degrees from vertical line to the back.
J type： Seat at an angle of 10 degrees to the horizontal line and back rest at a level of 40 degrees from vertical line to the back.
As a general tendency of the relationship between EMG level and the ten types of chairs, it was found that EMG decreased as the angle of the relaxation chair increased.
The effects on the EMG level of three factors such as type of chair, sample muscles, and subject were tested by the analysis of variance.
The results were as follows：
Factor of type of chair: F＝3.984(f1＝8, f2＝64), factor of muscle： F＝10.723(f1＝5, f2＝40), and factor of subject： F＝21.38 (f1＝8, f2＝320).
These values were significant at the 1％ level.
The EMG level was compared between the above 10 types of chairs and the sum of the EMG levels of different muscles in percentages to that of A type was B type 64％, for C type 50％, for D type 62％, for E type 60％, for F type 42％, for G type 30％, for H type 32％, and for I type 42％.
The EMG level in case of G and H types was decreased to about Two-Thirds of that of A.
As for the interaction on the EMG level of the three factors of the variance ratio was computed at 1.38(f1＝40, f2＝320) in the case of chair and subject, at 6.566 (f1＝40, f2＝320) in the case of those of muscle and subjects.
The level of the latter two cases were significant at the 1％ level.
However, the interaction of the factors of chair and muscles was not significant.
This shows the effect of chair on the EMG level independent from the kind of muscle tested.
Therefore, it can be concluded that the G type was the most adequate one among the 10 types of chair tested from the view point of suppressing involuntary muscular contraction of the patient
（6）脳性麻痺児に対する治療学としてのBobath Approach
脳と発達Vol.12(1980)No.5p443-448
https://www.jstage.jst.go.jp/article/ojjscn1969/12/5/12_5_443/_pdf
（7）座位保持を目的とした車椅子の開発
日本義肢装具学会誌Vol.7(1991-1992)No.1p47-53
https://www.jstage.jst.go.jp/article/jspo1985/7/1/7_1_47/_pdf
（8）脳性麻痺児における歩行時の効率に対する空間時間的変数の影響
https://www.jstage.jst.go.jp/article/rika/24/2/24_2_155/_pdf
The purpose of this study was to determine influences of spatio-temporal gait parameters on walking efficiency of children with cerebral palsy.
Subjects were 9 children with spastic diplegia who could walk.
Mean ± SD of age was 12.8 ± 3.5 years (range: 7 yrs 5 mo-18 yrs 9 mo).
Methods
We measured gait speed, step length and cadence in 10-m gait as spatio-temporal gait parameters, and pulse rate, walking speed and calculated the Physiological Cost Index (PCI) during 4 min walking as parameters of walking efficiency.
Pearson's correlation coefficients were obtained for the spatio-temporal gait parameters and walking efficiency parameters.
Results
No significant correlation was found between the pulse rate during 4 min walking and the spatio-temporal parameters.
There were significant positive correlations between walking speed during 4 min walking and 10-m walking speed (p＜0.05), and step length in 10-m gait (p＜0.01), but no significant correlation was found between walking speed during 4 min walking and cadence in 10-m gait.
There were significant negative correlations between PCI and walking speed (p＜0.01), and step length in 10-m gait (p＜0.05), but no significant correlation was found between PCI and cadence in 10-m gait.
Conclusion
Because walking efficiency was high when walking speed was fast and/or step length was wide, we consider that the factors for high walking efficiency in children with cerebral palsy are fast walking speed and wide step length.
･････････････
（9）肩関節脱臼後に腋窩神経麻痺を伴った腱板広範囲断裂の治療経験
Treatment of massive rotator cuff tear with axillary nerve palsy after dislocation of shoulder
整形外科と災害外科Vol.56(2007)No.4p525-528
https://www.jstage.jst.go.jp/article/nishiseisai/56/4/56_4_525/_pdf
We report two good results after arthroscopic rotator cuff repair for massive rotator cuff tear with axillary nerve palsy after dislocation of the shoulder.
Case 1:
A 60 year-old man had fallen and dislocated his right shoulder.
He visited our hospital six weeks after the injury because he was unable to raise his right shoulder.
Muscle atrophy was found in the right deltoid.
Numbness was found on the lateral-side of the right shoulder.
Arthroscopic rotator cuff repair was performed three months after the injury.
Before surgery, JOA score was 31 points, and improved to 94 points one year after surgery.
Case 2:
A 47 year-old man had fallen and dislocated his right shoulder.
He visited our hospital three weeks after the injury, because he was unable to raise his right shoulder.
Muscle atrophy was found in the right deltoid.
Numbness was found on the lateral-side of the right shoulder.
Denervation potential was observed in the right deltoid by electromyogram.
Arthroscopic rotator cuff repair was performed one month after the injury. Before surgery, JOA score was 45 points, and improved to 93 points six months after surgery.
Considering degeneration of the rotator cuff, early operation may be planned for the treatment of massive rotator cuff tear if nerve recovery prospects can be seen
･････････････
小児全身性ジストニア
ジストニア
アテトーゼ
バリズム
痙直型
↓パパの説明文がせつない( ; ω ; )てんかんのコントロールは難しい
ジスキネジア
脳性麻痺リハビリガイドライン
http://www.jarm.or.jp/wp-content/uploads/file/member/member_publication_isbn9784307750387.pdf
側彎症しおり
http://square.umin.ac.jp/iwate-sokuwan/_pdf/guidebook.pdf