Duchenne型筋ジストロフィー(DMD)患者における車椅子の種類と機能障害との関係  [in Japanese] The Relationship between Wheelchair Type and Impairments among Patients with Duchenne Muscular Dystrophy  [in Japanese]

移動手段に車椅子を使用しているDuchenne型筋ジストロフィー(DMD)患者52名を対象として,車椅子の種類別(手動,簡易電動,電動,介助型)に脊柱変形,上肢筋力,ADL,呼吸機能,人工呼吸器の有無および装着時間,座位バランスを比較した.電動および介助型使用例は36名,そのうち脊柱変形なしは2名,脊柱変形ありは34名であった.使用している車椅子の種類により,上肢筋力,ADL,呼吸機能,座位バランスには,それぞれ有意な差を認めた(p<0.001).人工呼吸器使用例は全例,電動または介助型を使用しており,呼吸器装着時間には,有意差を認めた(p<0.001).また,それぞれの機能における各車椅子使用群ごとの中央値を求めたことで,臨床症状に基づく車椅子処方の目安が示された.

The aim of this study is to investigate the relationship between wheelchair type and impairments among patients with Duchenne muscular dystrophy (DMD). Participants were 52 patients with DMD who used wheelchairs for daily locomotion. We assessed muscle strength, spinal deformity, sitting balance, respiratory function and ADL among 4 groups using different types of wheelchairs (manual wheelchair, manual wheelchair attached with powered component, powered wheelchair, and assist type wheelchair). Spinal deformity was related with wheelchair type. Muscle strength, peak flow and FIM motor score were significantly different among the four groups. The duration of daily use of ventilators was significantly different between the powered wheelchair users and the completely dependent group.