布団とベッド上における介護初心者と介護熟練者のおむつ交換時の腰部負荷の差異 Low back load differences between novice and skilled caregivers when changing a diaper on a futon and a bed

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Abstract

Objectives : To clarify the difference in low back load between novice and skilled caregivers in diaper changing on a futon and a bed. Methods : Agonist trunk and lower-limb muscle activity during diaper changing in 26 novice and 21 skilled caregivers was examined using a surface electromyograph attached to 8 agonist muscles, including the left and right lumbar erector spinae, rectus abdominis, vastus lateralis, and semitendinosus.  The low back loads during diaper changes on the futon and bed were measured.  The maximum voluntary contractions of the 8 muscles were normalized (%MVC) to compare their mean integrals between the novice and skilled caregivers on the futon and bed, and analyzed using t-tests, paired t-tests, and two-way analysis of variance. Using MyoResearch XP Software, diaper changing measurements were simultaneously videotaped to perform real-time analysis of movements and muscle activity. Results : For care time, novices took significantly longer to perform a diaper change on the futon and bed compared with skilled caregivers. The bilateral erector spinae in the novice caregivers was significantly greater on the bed than on the futon, but there was no significant difference in the rectus abdominis. In skilled caregivers, there was no significant difference in erector spinae and the rectus abdominis between the futon and bed. On the futon, no significant differences were observed in the left and right erector spinae and rectus abdominis between the novice and skilled caregivers. On the bed, the right erector spinae was significantly greater in novice compared with the skilled caregivers. For the bilateral vastus lateralis and semitendinosus, muscle activity in novice caregivers was significantly greater compared with skilled caregivers on the futon and bed. Skilled caregivers tended to maintain their posture by standing with their femora supported by the bed mattress throughout care activity on the bed. Discussion : It may be necessary for novice caregivers to acquire higher-level skills, such as creating a supporting point on the bed throughout caring activity. This will allow care activities to be performed efficiently with a reduced lumber load, while making full use of the convenience of beds and the lower height difference from caregiver to receiver.【目的】布団上とベッド上において、介護の初心者と熟練者間のおむつ交換時の介護動作 と腰部負荷の違いを明らかにする。 【方法】介護の初心者26名と熟練者21名を対象とし、表面筋電計を用いて布団上と在宅介 護ベッド上でのおむつ交換時の左右の体幹及び下肢の主動作筋活量 (腰部脊柱起立筋、腹 直筋、外側広筋、半腱様筋) を計測した。各筋の%MVC (Maximum voluntary contraction) の積分値を算出し、t 検定、対応のある t 検定、2 元配置分散分析を用いて、布団上とベッ ド上の初心者と熟練者を比較した。MyoResearch XP Softwareを用いて、筋活量と介護動 作をリアルタイムに画像分析した。 【結果】介護時間は、布団上とベッド上で、初心者の方が熟練者よりも有意に長かった。初 心者では、両側の脊柱起立筋はベッド上の方が布団上よりも有意に高かったが、腹直筋に は違いがなかった。熟練者では、脊柱起立筋と腹直筋と布団上とベッド上では違いがな かった。布団上では、左右の脊柱起立筋と腹直筋は、初心者と熟練者では違いがなかった。 ベッド上では、右の脊柱起立筋は初心者の方が熟練者よりも有意に高かった。両側の外側 広筋と半腱様筋は、布団上とベッド上で、初心者の方が有意に高かった。熟練者は、ベッ ド上での介護時は常に大腿部でマットレスに支点を作っておむつ交換をしていた。 【考察】布団上では、介護初心者は習得した介護を実践しやすかったと示唆される。ベッ ド上での介護時は、ベッドの利便性と要介護者との高低差が少ないことを活用して、常に ベッドに支点を作って介護する技術の習得が必要である。Thesis of Kyota Kaoru / 京田 薫 博士論文 金沢大学医薬保健学総合研究科(保健学専攻)

Journal

  • 金沢大学つるま保健学会誌

    金沢大学つるま保健学会誌 36(2), 25-34, 2012

    金沢大学つるま保健学会 = the Tsuruma Health Science Society, Kanazawa University

Codes

  • NII Article ID (NAID)
    120005122993
  • NII NACSIS-CAT ID (NCID)
    AA11599711
  • Text Lang
    ENG
  • Article Type
    departmental bulletin paper
  • Journal Type
    大学紀要
  • ISSN
    1346-8502
  • NDL Article ID
    024214021
  • NDL Call No.
    Z19-950
  • Data Source
    NDL  IR 
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