᪩✄⏣኱ᏛᑂᰝᏛ఩ㄽᩥ
༤ኈ㸦ࢫ࣏࣮ࢶ⛉Ꮫ㸧
ዪᏊࣛࢡࣟࢫ➇ᢏ࡛ࡢࢫ࣏࣮ࢶയᐖࡢ
ᐇែ࡜ண㜵ࡢᐇ㊶
Injury Surveillance and Injury Prevention
in Female Lacrosse
㸰㸮㸯㸱ᖺ㸵᭶
᪩✄⏣኱Ꮫ኱Ꮫ㝔 ࢫ࣏࣮ࢶ⛉Ꮫ◊✲⛉
బ㔝ᮧ Ꮫ
SANOMURA, Manabu
◊✲ᣦᑟᩍဨ㸸⚟ᯘ ᚭ ᩍᤵ
┠ ḟ
➨ 1 ❶ ᗎㄽ .......................................................................................................... 1
➨ 1 ⠇ ᗎ ............................................................................................................ 2
➨ 2 ⠇ ᮏㄽᩥࡢ ᵓᡂ ....................................................................................... 21
➨ 2 ❶ ኱Ꮫዪ Ꮚࣛࢡ ࣟࢫࡢയ ᐖㄪᰝ .............................................................. 23
◊✲ 1 ኱Ꮫዪ Ꮚࣛࢡ ࣟࢫࡢ 2 ᖺ 㛫ࡢയᐖ ㄪ ᰝ ............................................. 24
2-1-1 ⥴ゝ ...................................................................................................... 24
2-1-2 ᑐ㇟ ࡜᪉ἲ ........................................................................................... 26
2-1-3 ⤖ᯝ ...................................................................................................... 27
2-1-4 ⪃ᐹ ...................................................................................................... 42
2-1-5 ⤖ㄒ ...................................................................................................... 52
➨ 3 ❶ ㊊㊑㛤 ᤼ ࡀື ⓗୗ⫥࢔ ࣛ࢖࣓ ࣥࢺ࡟ ཬࡰࡍᙳ 㡪 ................................ 53
◊✲ 2 ㊊㊑㛤 ᤼⬟ ࠾ ࡼࡧ㊊㊑㛤 ᤼ᣦ♧ࡀ ື ⓗୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࡟ ཬࡰࡍᙳ
㡪 ̿∦⬮ ࢫࢡ࣡ࢵ ࢺ 㸪∦⬮ࢻࣟ ࢵࣉࣛࣥ ࢹ ࢕ࣥࢢ㸪࢝ ࢵࢸ࢕ࣥ ࢢ ືస࡛ࡢ
ศᯒ̿ ................................................................................................................ 54
3-2-1 ⥴ゝ ...................................................................................................... 54
3-2-2 ᑐ㇟ ࡜᪉ἲ ........................................................................................... 55
3-2-3 ⤖ᯝ ...................................................................................................... 63
3-2-4 ⪃ᐹ ...................................................................................................... 74
3-2-5 ⤖ㄒ ...................................................................................................... 80
➨ 4 ❶ ࣛࢡࣟ ࢫࢫࢸ ࢕ࢵࢡࡢ ಖᣢ ࡸ ᧯సࡀ ືⓗୗ⫥ ࢔ࣛ࢖ ࣓ࣥࢺ ࡟ཬࡰࡍ
ᙳ㡪 ....................................................................................................................... 81
◊✲ 3 ࢻࣟࢵ ࣉ ࣂ࣮ ࢸ࢕࢝ࣝࢪ ࣕࣥࣉ᫬ ࡟ ࠾ࡅࡿࣛࢡ ࣟࢫࢫࢸ ࢕ ࢵࢡࡢಖ
ᣢࡸ᧯సࡀ ୗ⫥࢟ࢿ ࣐ ࢸ࢕ࢡࢫ࣭ ࢟ࢿࢸ࢕ ࢡ ࢫ࡟ཬࡰࡍ ᙳ㡪 ...................... 82
4-3-1 ⥴ゝ ...................................................................................................... 82
4-3-2 ᑐ㇟ ࡜᪉ἲ ........................................................................................... 83
4-3-3 ⤖ᯝ ...................................................................................................... 86
4-3-4 ⪃ᐹ ...................................................................................................... 89
4-3-5 ⤖ㄒ ...................................................................................................... 91
◊✲ 4 ࣛࢡࣟ ࢫࢫࢸ ࢕ࢵࢡࡢಖ ᣢࡢ᭷↓ ࡀ ࢝ࢵࢸ࢕ࣥ ࢢືస ᫬ ࡢ ୗ⫥࢟ࢿ
࣐ࢸ࢕ࢡࢫ ࣭࢟ࢿࢸ ࢕ ࢡࢫ࡟ཬࡰ ࡍᙳ㡪 ....................................................... 92
4-4-1 ⥴ゝ ...................................................................................................... 92
4-4-2 ᑐ㇟ ࡜᪉ἲ ........................................................................................... 93
4-4-3 ⤖ᯝ ...................................................................................................... 96
4-4-4 ⪃ᐹ ...................................................................................................... 98
4-4-5 ⤖ㄒ .................................................................................................... 102
➨ 5 ❶ ୗ⫥ᙧ ែ ࠾ࡼ ࡧୗ⫥➽ ຊ࡜㟼 ⓗ࣭ື ⓗࣂࣛࣥ ࢫ⬟ຊ ࠾ࡼࡧ ୗ⫥࢔ࣛ
࢖࣓ࣥࢺ ࡜ࡢ㛵 㐃ᛶ .......................................................................................... 103
◊✲ 5 ㊊㊑ᢕ ᥱຊ ࡜ 㟼ⓗ࠾ࡼࡧ ືⓗࣂࣛ ࣥ ࢫ⬟ຊ ࡜ࡢ 㛵㐃ᛶ ................. 104
5-5-1 ⥴ゝ .................................................................................................... 104
5-5-2 ᑐ㇟ ࡜᪉ἲ ......................................................................................... 105
5-5-3 ⤖ᯝ .................................................................................................... 109
5-5-4 ⪃ᐹ .................................................................................................... 114
5-5-5 ⤖ㄒ .................................................................................................... 115
◊✲ 6 㟼ⓗୗ ⫥࢔ࣛ ࢖࣓ࣥࢺ࠾ ࡼࡧ⫤㛵 ⠇ እ㌿➽ຊ࡜ ࢻࣟࢵࣉ ࣂ ࣮ࢸ࢕࢝
ࣝࢪࣕࣥࣉ ᫬ࡢୗ ⫥ ࢟ ࢿ࣐ࢸ࢕ࢡ ࢫ࣭࢟ࢿ ࢸ ࢕ࢡࢫ࡜ࡢ 㛵㐃ᛶ ................ 117
5-6-1 ⥴ゝ .................................................................................................... 117
5-6-2 ᑐ㇟ ࡜᪉ἲ ......................................................................................... 119
5-6-3 ⤖ᯝ .................................................................................................... 126
5-6-4 ⪃ᐹ .................................................................................................... 130
5-6-5 ⤖ㄒ .................................................................................................... 136
➨ 6 ❶ ୗ⫥യ ᐖ ண㜵 ࢺ࣮ࣞࢽ ࣥࢢ௓ ධ ࡜ຠ ᯝ᳨ド ...................................... 138
◊✲ 7 ୗ⫥യ ᐖண㜵 ࢺ࣮ࣞࢽࣥ ࢢ௓ධࡀ ㊊ ㊑ᶵ⬟㸪㊊ 㒊ᙧែ㸪 㟼 ⓗ࣭ືⓗ
ࣂࣛࣥࢫ⬟ ຊ࡟ཬࡰ ࡍ ᙳ㡪 ............................................................................ 139
6-7-1 ⥴ゝ .................................................................................................... 139
6-7-2 ᑐ㇟ ࡜᪉ἲ ......................................................................................... 140
6-7-3 ⤖ᯝ .................................................................................................... 142
6-7-4 ⪃ᐹ .................................................................................................... 146
6-7-5 ⤖ㄒ .................................................................................................... 152
◊✲ 8 ኱Ꮫዪ Ꮚࣛࢡ ࣟࢫ➇ᢏࢆ ᑐ㇟࡜ࡋ ࡓ ୗ⫥ യᐖண 㜵ࢺ࣮ࣞ ࢽ ࣥࢢ௓ධ
ࡀയᐖⓎ⏕ ᩘ࠾ࡼࡧ യ ᐖⓎ⏕㢖ᗘ ࡟ཬࡰࡍ ᙳ 㡪 .......................................... 153
6-8-1 ⥴ゝ .................................................................................................... 153
6-8-2 ᑐ㇟ ࡜᪉ἲ ......................................................................................... 155
6-8-3 ⤖ᯝ .................................................................................................... 156
6-8-4 ⪃ᐹ .................................................................................................... 169
6-8-5 ⤖ㄒ .................................................................................................... 174
➨ 7 ❶ ⥲ྜ⪃ ᐹ .............................................................................................. 175
⥲ྜ⪃ᐹ ...................................................................................................... 176
➨ 8 ❶ ࡲ࡜ࡵ .................................................................................................. 181
ࡲ࡜ࡵ .......................................................................................................... 182
ᘬ⏝ᩥ⊩ ............................................................................................................. 183
ᴗ⦼୍ぴ ............................................................................................................. 209
ㅰ㎡ ..................................................................................................................... 212
➨1❶
ᗎㄽ
1
➨ 1 ⠇ ᗎ
1-1. ⥴ゝ
21 ୡ⣖࡟ධࡾ㸪ࢫ࣏࣮ ࢶ་Ꮫ఍࡛ࡣ ࢫ࣏࣮ࢶ യᐖ࡟ᑐࡍࡿ ண㜵࡟ ↔ Ⅼࡀྥࡅ
ࡽࢀ㸪ୡ⏺ྛ ᅜ࡟࠾࠸ ࡚ከᩘࡢ◊✲ ࡀ 㐍ࡵࡽ ࢀ࡚ ࠸ࡿ㸬ࢫ ࣏࣮ࢶ യ ᐖண㜵࡟ྥ
ࡅࡓྲྀࡾ⤌ࡳ ࡢ᪉ἲࡣ ࡉࡲࡊࡲ࡛࠶ ࡿࡀ㸪ࡑ ࢀࡽࡢ☜❧ࡢ ࡓࡵ࡟ࡣ ከゅⓗ࡞࢔
ࣉ࣮ࣟࢳࡀᚲ せ࡛࠶ࡾ 㸪௒ᚋ㸪ࡼࡾ ከࡃࡢ◊ ✲ ࡜᳨ドࡀᚲ せ࡛࠶ࡿ ࡀ㸪᪩ᮇࡢ
☜❧ࡀᮇᚅࡉ ࢀ࡚࠸ࡿ 㸬 യᐖண㜵ἲ ࡢᐇ㊶࠾ ࡼࡧࡑࡢ☜❧ ࡢࡓࡵ࡟ 㸪ከᩘࡢ ඛ
⾜ㄽᩥ࠿ࡽẁ 㝵ⓗ ࣔࢹ ࣝࡀ⤂௓ࡉࢀ ࡚࠸ࡿ㸬 ࡑࡢ୍ࡘ࡟യ ᐖせᅉ ࡢ 」ྜⓗࣔࢹ
ࣝࡀ࠶ࡿ㸦ᅗ 1㸧[Meeuwisse, 1994]㸬ࡇࢀ ࡣ 㸪യᐖせ ᅉ ࢆෆᅉ ⓗ࣭እᅉⓗせᅉ࡟
ศࡅ࡚⪃࠼ࡽ ࢀ࡚࠸ࡿ ࡀ㸪ෆᅉⓗせ ᅉ࡟ ࡘ࠸ ࡚ࡣᖺ㱋㸪ᰂ ㌾ᛶ㸪 ཷ യ᪤ Ṕ㸪
య ᆺ 㸦 somatotype㸧 㸪 ࡑ ࡢ ௚ ࣂ ࢖ ࣓ ࢝ ࢽ ࢡ ࢫ 㸪 ࢥ ࣥ ࢹ ࢕ ࢩ ࣙ ࢽ ࣥ ࢢ 㸪 ㌟ య ࡢ ᡂ
⇍ᗘ㸦 maturation stage㸧➼ࡀヱᙜ ࡋ㸪እᅉ ⓗ せᅉ࡟ࡘ࠸ ࡚ࡣኳೃ 㸪 ࣇ࢕࣮ࣝࢻ
ࡢ≧ែ㸪࣮ࣝ ࣝ㸪⿦ල ➼ࡀヱᙜࡍࡿ 㸬ࡇࢀࡽ ࡢ ෆᅉⓗ࠾ࡼ ࡧእᅉⓗ せᅉࡀ࢔ࢫ
࣮ࣜࢺࡢയᐖ Ⓨ⏕࡟ᙳ 㡪ࢆཬࡰࡋ㸪 ࡉࡽ࡟ ࡣ യᐖࢆㄏⓎࡍ ࡿ஦㇟㸪 ࡍ࡞ࢃࡕയ
ᐖᶵᗎ࡟ࡼࡾ യᐖࡀⓎ ⏕ࡍࡿ㸬ࡇࢀ ࡽࡢ୍㐃 ࡢയᐖࣔࢹࣝ ࡣ ෆᅉⓗ ࣭እᅉⓗせ
ᅉ࠿ࡽയᐖ࡟ ⮳ࡿࡲ࡛ ࡢ ༴㝤せ⣲࡜ ࡋ࡚ᤊ࠼ ࡽࢀ࡚࠸ࡿࡀ 㸪࢔ࢫࣜ ࣮ࢺ ࡟ෆᅾ
ࡍࡿ༴㝤せ⣲ ࢆ᪩ᮇⓎ ぢࡋ㸪 㐺ษ࡟ ᑐᛂࡍࡿ ࡇ࡜ࡀയᐖண 㜵 ࡢࡓࡵ ࡟ 㔜せ࡛࠶
ࡿࡇ࡜ࡀ♧ࡉ ࢀ࡚ ࠸ࡿ [Meeuwisse, 1994]㸬
ᅗ1
A new multifactorial model of athletic injury epidemiology [Meeuwisse, 1994]
2
ᅗ 1 ࡛♧ࡋࡓ യᐖせᅉ ࣔࢹࣝࡀ Bahr ࡜ Krosshaug㸦2005㸧࡟ࡼࡾᨵ Ⰻࡉࢀࡓ
㸦ᅗ 2㸧[Bahr and Krosshaug, 2005]㸬ࡇࢀࡣ 㸪ࢫ࣏࣮ ࢶയᐖⓎ ⏕ せ ᅉ࡜࡞ࡿෆᅉ
ⓗ࣭እᅉⓗせ ᅉ࡟ࡘ࠸ ࡚ 㸪ࡼࡾヲ⣽ ࡟♧ࡉࢀ ࡚࠾ࡾ㸪ෆᅉ ⓗせᅉ࡟ ࡘ࠸࡚ࡣᖺ
㱋㸪ᛶᕪ㸪㌟ య⤌ᡂ㸪 ೺ᗣ㸪యຊ㸪 ゎ๗Ꮫⓗ 㸪ᢏ⾡㸪⑓⌮ Ꮫ ➼ ࡀ࠶ ࡆࡽࢀ㸪እ
ᅉⓗせᅉ࡟ࡘ ࠸࡚ࡣ㸪 ࢫ࣏࣮ࢶ せᅉ 㸦ࢥ࣮ࢳ ࣥࢢ㸪࣮ࣝࣝ 㸪ᑂุ➼ 㸧 㸪ྛ✀㜵
ල㸪⏝ල㸪⎔ ቃ ➼ࡀ࠶ ࡆࡽࢀ࡚࠸ࡿ 㸬ࡇࢀࡽ ࡢせᅉࡀ യᐖ Ⓨ⏕ࡢᙳ 㡪ࢆཷࡅࡸ
ࡍࡃ࡞ࡿࡇ࡜ 㸪ࡑࡋ࡚ ࡇ ࢀࡽࡢせᅉ ࠿ࡽ യᐖ ࡀண ࡉࢀࡿ ࢔ࢫ࣮ࣜ ࢺࢆ Ⓨぢࡍ
ࡿࡇ࡜㸪ࡲ ࡓ㸪യ ᐖ ࡢ ᐇ㝿࡟࠾࠸࡚ ࡣ㸪ࣉ ࣞ ࣮≧ἣ ࡸ㑅ᡭ ࠾ࡼࡧᩛ 㑅ᡭ ࡢືࡁ㸪
㌟యຊᏛ㸦㐠 ື࣓࢝ࢽ ࢬ࣒㸧 㸪ヲ⣽ ࡞ྛ㛵⠇ ࡢືࡁ ➼ࡀയ ᐖⓎ⏕ࡢ せᅉ ࡜࡞ࡿ
ࡇ࡜ࡀ♧ࡉࢀ ࡚࠸ࡿ 㸬
ᅗ2
Comprehensive model for injury causation [Bahr and Krosshaug, 2005]
ࢫ࣏࣮ࢶയᐖ せᅉࢆ♧ ࡍ」ྜⓗࣔࢹ ࣝ࡟ࡘ࡙ ࠸࡚㸪ࢫ࣏࣮ ࢶ യᐖண 㜵ࡢᐇ㊶
ࣔࢹࣝ࡜ࡋ࡚ 㸪ከᩘ ᘬ ⏝ࡉࢀ࡚࠸ ࡿ van Mechelen ࡽ㸦1992㸧ࡀ ᥦ ၐࡋࡓ 4 ẁ㝵
ࣔࢹࣝࡀ࠶ࡿ㸦 ᅗ 3㸧㸬ࡇࢀࡣ 㸪4 ࡘࡢ ࢫࢸ ࢵࣉࢆ⤒࡚ࢫ ࣏࣮ࢶയ ᐖண㜵 ἲࢆ☜
3
❧ࡉࡏࡿ࡜࠸ ࠺⪃࠼᪉ ࢆᅗᘧ໬ࡋࡓ ࡶࡢ࡛࠶ ࡿ 㸬ࡑࢀ ࡒࢀࡢࢫ ࢸࢵ ࣉ࡟ࡘ࠸࡚ 㸪
➨ 1 ࢫࢸࢵࣉ ࡛ࡣ㸪യ ᐖࡢ㢖ᗘࡸ㔜 ⑕ᗘࢆ᫂ ࡽ࠿࡟ࡍࡿࡇ ࡜࡜ࡋ 㸪യᐖࡢ㒊఩࣭
✀㢮࣭ཎᅉ➼ ࢆ᫂ࡽ࠿ ࡟ࡍࡿ࡯࠿㸪 യᐖⓎ⏕ ᩘࡸയᐖⓎ⏕ ⋡㸪㔜⑕ ᗘ㸪ཷയ≧
ἣ➼ࡢㄪᰝ࡟ ࡼࡾ㸪യ ᐖࡢᐇែ࠾ࡼ ࡧയᐖ ࡢ ≉ᚩࢆࡼࡾヲ ⣽࡟ᢕᥱ ࡍࡿ 㸬➨ 2
ࢫࢸࢵࣉ࡛ࡣ 㸪യᐖࡢ ཎᅉ㸪࣓࢝ࢽ ࢬ࣒ࢆ᫂ ࡽ࠿࡟ࡍࡿ ࡇ ࡜࡜ࡋ㸪 ≉࡟㢖Ⓨࡋ
࡚࠸ࡿയᐖ࡟ ᑐࡍࡿ യ ᐖࡢཎᅉ㸪࣓ ࢝ࢽࢬ࣒ ࢆゎ᫂ࡍࡿ 㸬 ࡑࡋ࡚ ➨ 3 ࢫࢸࢵ ࣉ
࡛ࡣ㸪➨ 1 ࠾ ࡼࡧ ➨ 2 ࢫࢸࢵࣉ࡛ࡢ ᳨ドෆᐜ ࡟ᇶ࡙࠸࡚㸪 യᐖண㜵 ࣉࣟࢢ࣒ࣛ
ࢆ⪃᱌ࡋ㸪ࢫ ࣏࣮ࢶ⌧ ሙ࡛ࡢ௓ධࢆ ⾜࠺㸬᭱ ᚋ࡟➨ 4 ࢫࢸ ࢵࣉ࡛ 㸪 ➨ 3 ࢫࢸࢵ
ࣉ࡛ᐇ᪋ࡉࢀ ࡓ௓ධຠ ᯝ᳨ド࡜㸪 ➨ 1 ࢫࢸࢵ ࣉ࠿ࡽ➨ 3 ࢫ ࢸࢵࣉࡲ ࡛⾜ࢃࢀࡓ
ෆᐜ࠾ࡼࡧ᳨ ド⤖ᯝ ࡟ ᑐࡍࡿ෌᳨ウ ࢆ⾜࠸㸪 ⥲ྜ ุᐃ➼ࢆ ⾜࠺㸬ࡑ ࡋ࡚ࡲࡓ➨
1 ࢫࢸࢵࣉ࡬ ᡠࡾ㸪 ྛ ẁ㝵ࢆ⤒࡞ࡀ ࡽ᳨ドࢆ ⧞ࡾ㏉ࡋ࡚࠸ ࡃ㸬ࡇࡢ ⥅⥆ⓗ࡞ᐇ
᪋࡟ࡼࡾ㸪ࢫ ࣏࣮ࢶയ ᐖண㜵 ἲࡀ☜ ❧ࡉࢀ ࡚ ࠸ࡃ࡜࠸࠺ࡶ ࡢ࡛࠶ࡿ 㸬ࡇࡢ 4 ẁ
㝵ࣔࢹࣝ࠿ࡽ 㸪ࢫ࣏࣮ ࢶയᐖண㜵࡟ ྥࡅࡓྲྀ ࡾ⤌ࡳ࡜ࡋ࡚ 㸪 ึࡵ࡟ ࢫ࣏࣮ࢶയ
ᐖࡢᐇែࢆ᫂ ࡽ࠿࡟ࡍ ࡿࡇ࡜㸪ࡍ࡞ ࢃࡕࢫ࣏ ࣮ࢶയᐖㄪᰝ ࠿ࡽጞ ࡵ ࡿ࡜࠸࠺ࡇ
࡜࡛࠶ࡿ㸬
ᅗ3
Four step sequence of injury prevention research [van Mechelen, 1992].
4
1-2. ࢫ࣏࣮ࢶയᐖ ㄪ ᰝἲ
௒᪥㸪ࢫ࣏࣮ ࢶയᐖㄪ ᰝࡣᅜෆ㸪ᾏ እ࡟࠾࠸ ࡚ከᩘࡢ➇ᢏ ࡛ᐇ᪋ࡉ ࢀ ࡚࠸ࡿ
ࡀ㸪ࡑࢀࡽࡢ ㄪᰝ᪉ἲ ࡣ㸪ྛ➇ᢏᅋ యࡀ➇ᢏ ≉Ṧᛶࢆ⪃៖ ࡋ ࡚㸪⊂ ⮬ࡢㄪᰝἲ
ࡀ⪃᱌ࡉࢀᐇ ᪋ࡉࢀ࡚ ࠸ࡿ 㸬ࡇࢀࡽ ࡢㄪᰝ࠿ ࡽᚓࡽࢀࡓ⤖ ᯝࡣ 㸪ྠ ➇ᢏ࡛ࡢ኱
఍ࣞ࣋ࣝ㸪ᖺ 㱋㸪ᛶู ➼ ࡟ࡼࡿᑐ㇟ ⪅ูࡢẚ ㍑᳨ウࡀྍ⬟ ࡛࠶ࡿࡀ 㸪௚ࡢ➇ᢏ
࡜ࡢẚ㍑ࡀᅔ 㞴࡛࠶ࡿ ሙྜࡀከ࠸㸬 ࡑࢀࡣ㸪 യᐖࡢ㒊఩ࡸ ✀㢮㸪ཎ ᅉ㸪㔜⑕ᗘ
➼ࡢ㡯┠ࡀ⤫ ୍ࡉࢀ࡚ ࠸࡞࠸Ⅽ࡛࠶ ࡿ㸬ࡲࡓ 㸪യᐖࡢᐃ⩏ ࡟ࡘ࠸࡚ ࡶ ␗࡞ࡿሙ
ྜࡀ࠶ࡿ㸬 ࡑࡇ࡛ ㏆ᖺ 㸪ᅜ㝿࢜ࣜ ࣥࣆࢵ ࢡጤ ဨ఍㸦 International Olympic Committee㸸௨ୗ㸪IOC㸧ࡀ ୺࡜࡞ࡾ㸪ึࡵ ࡚඲➇ ᢏࢆᑐ㇟࡜ࡋ ࡓ ⤫୍ࡋ ࡓㄪᰝ᪉ἲ
ࡀ☜❧ࡉࢀࡓ[Junge et al., 2006]㸬ࡇࡢㄪᰝ᪉ ἲࡣ㸪ᅋయ➇ ᢏ 㸪 ಶே ➇ᢏ࠸ࡎࢀ
࡟࠾࠸࡚ࡶᑐ ᛂฟ᮶ࡿ ࡇ࡜㸪ࡑࡋ࡚ ࢜ࣜࣥࣆ ࢵ ࢡࡢࡼ࠺࡟ 」ྜⓗ࡟ ➇ᢏࡀ㛤ദ
ࡉࢀࡿ኱఍࡟ ࠾࠸࡚ࡶ ྠ୍ㄪᰝ᪉ἲ ࡛ ࡢㄪᰝ ࡀྍ⬟࡛࠶ࡾ 㸪ྛ➇ᢏ 㛫࡟࠾ࡅࡿ
യᐖࡢẚ㍑᳨ ドࡀྍ⬟ ࡟࡞ࡗ࡚࠸ࡿ 㸬⌧ᅾ㸪 ࡇࡢࡼ࠺࡞ୡ ⏺⤫୍ᇶ ‽ࡢയᐖㄪ
ᰝ᪉ἲࡀ☜❧ ࡉࢀ㸪ྛ ᅜࡢ➇ᢏᅋయ ࡟࠾࠸࡚ ࡶྠ୍ᇶ‽࡛ ࡢയᐖㄪ ᰝࡀ ᐇ᪋ࡉ
ࢀࡿࡇ࡜ࡀᮇ ᚅࡉࢀ࡚ ࠸ࡿ 㸬ୡ⏺ࣞ ࡛࣋ࣝ ࡢ യᐖㄪᰝࡢྲྀ ࡾ⤌ࡳ ࡟ ࡘ࠸࡚ࡣ㸪
ᅜ㝿኱఍ࣞ࣋ ࣝ ࡛ ࡢയ ᐖㄪᰝࡀᐇ᪋ ࡉࢀ࡚࠾ ࡾ㸪 FIFA ࣮࣡ࣝࢻ࢝ ࢵࣉ [Dvorak
et al., 2011; Dvorak et al., 2007; Junge et al., 2004 -1; Junge et al., 2004-2; Junge and
Dvorak, 2007]㸪 IAAF ୡ⏺㝣ୖ➇ᢏ 㑅ᡭᶒ኱ ఍ [Alonso et al., 2009]㸪 IHF ୡ⏺ࣁ
ࣥࢻ࣮࣎ࣝ㑅 ᡭᶒ኱఍ [Langevoort et al., 2007]㸪FINA ୡ⏺ ỈὋ➇ᢏ 㑅ᡭᶒ኱఍
[Mountjoy et al., 2010]ࡀ㸪ࡲࡓ㸪࢔ ࢪ࢔ᆅᇦ ࡛ࡢᅜ㝿ࢧࢵ ࣮࢝኱఍ [Yoon et al.,
2004]ࡢሗ࿌ࡶࡳࡽ ࢀ ࡿ㸬࢜ࣜࣥࣆ ࢵࢡ➇ᢏ ኱఍ࡢയᐖㄪ ᰝ ࡟࠾࠸ ࡚ ࡣ㸪IOC ࡀ
సᡂࡋࡓ⤫୍ ᇶ‽࡛ࡢ യᐖㄪᰝࡀ 2004 ᖺ࢔ࢸࢿ࢜ࣜࣥࣆ ࢵࢡ➇ᢏ ኱఍࠿ࡽᐇ
᪋ࡉࢀ㸦࢔ࢸ ࢿ࢜ࣜࣥ ࣆࢵࢡ࡛ ࡣ 8 ࡘࡢᅋయ ➇ᢏ࡛ᐇ᪋㸧 [Junge et al., 2007]㸪
ࡉࡽ࡟ 2008 ᖺ໭ி࢜ ࣜࣥࣆࢵࢡ࡟ ࠾࠸࡚ 㸪ึࡵ࡚ಶே➇ ᢏ ࡜ᅋయ ➇ᢏࢆྵࡵࡓ
඲➇ᢏࢆᑐ㇟ ࡜ࡋ ࡓྠ ୍ᇶ‽࡛ࡢയ ᐖㄪᰝࡀ ᐇ᪋ࡉࢀࡓ [Junge et al., 2009]㸬໭
ி࢜ࣜࣥࣆࢵ ࢡ ➇ᢏ኱ ఍࡛ ᐇ㝿࡟⾜ ࢃࢀࡓയ ᐖㄪᰝ ࢆ౛࡟ 㸪ࡑࡢᴫ せࢆㄝ᫂ࡍ
ࡿ㸬➇ᢏᮇ㛫 ୰࡟Ⓨ⏕ ࡋࡓയᐖࡣ㸪 യᐖㄪᰝ ⏝⣬ [Junge et al., 2006]࡟㸪㑅ᡭࡢ
Ⓩ㘓␒ྕ㸪➇ ᢏ✀┠㸪 ཷയ᪥᫬㸪ཷ യ᫬ࡢ≧ ἣ㸪യᐖࡢ㒊 ఩㸪യᐖ ࡢ✀㢮㸪യ
ᐖࡢཎᅉ㸪㏻ ᖖࡢࢺࣞ ࣮ࢽࣥࢢࡶࡋ ࡃࡣヨྜ ࡟ཧຍฟ᮶࡞ ࠸࡜᥎ᐃ ࡉࢀࡿ᪥ᩘ
5
➼ࢆグධࡍࡿ㸬യᐖࡢ 㒊఩ࡣ 24 ࣨᡤ㸪യᐖ ࡢ✀㢮 19㸪യᐖࡢཎ ᅉ 12 ࡀྛࣜࢫ
ࢺ࡟ᣲࡆࡽࢀ 㸦⾲ 1㸧㸪ࡑࢀࡒࢀ࡟ ௜ࡅࡽࢀ ࡓࢥ࣮ࢻ␒ྕ ࢆグධ ࡋ ሗ࿌ࡍࡿࢩ
ࢫࢸ࣒࡟࡞ࡗ ࡚࠸ࡿ 㸬
⾲ 1 യᐖࡢ㒊 ఩࣭✀ 㢮࣭ཎᅉࡢྛ 㡯┠࡜ࢥ ࣮ࢻ␒ྕ
യᐖࡢ㒊఩㸦24㸧 ୗ⫥㸦8㸧
21.⫤㛵⠇
22.㰡ᚄ㒊
23.኱⭣
24.⭸
25.ୗ⭣
26.࢔࢟ࣞࢫ⭝
27.㊊㛵⠇
28.㊊㒊 /㊊㊑
ୖ⫥㸦8㸧
㢌㒊࡜యᖿ㸦8㸧
1.㢦㸦 ┠㸪⪥ 㸪㰯 ࢆྵ ࡴ㸧 11.⫪㒊/㙐㦵
12.ୖ⭎
2.㢌㒊
13.⫝
3.㢁㒊/㢁᳝
14.๓⭎
4.⬚᳝/ୖ⫼㒊
15.ᡭ㛵⠇
5.⬚㦵/⫘㦵
16.ᡭ
6.⭜᳝/ୗ⫼㒊
17.ᅄᣦ
7.⭡㒊
18.ẕᣦ
8.㦵┙/௝㦵/Ẋ㒊
യᐖࡢ✀㢮㸦19㸧
11.᤬᣸/⫗㞳ࢀ/➽᩿⿣
12.ᡴ᧞/⾑⭘/᣸യ
13.⭝⅖/⭝࿘ᅖ⅖
14.⁥ᾮໟ⅖
15.⿣๰/⓶⭵യᐖ
16.ṑࡢയᐖ
17.⚄⤒യᐖ/⬨᳝യᐖ
18.➽⫗③ or ࢫࣃࢬ࣒
19.ࡑࡢ௚
1.⬻㟈┞㸦 ព㆑႙ኻ ࢆ ㄆࡵ࡞࠸ࡶࡢ 㸧
2.㦵ᢡ㸦እ യᛶ㸧
3.⑂ປ㦵ᢡ 㸦࣮࢜ࣂ ࣮ ࣮ࣘࢫ㸧
4.௚ࡢ㦵യ ᐖ
5.⬺⮻㸪ள ⬺⮻
6.⭝᩿⿣
7.㠌ᖏ᩿⿣ ୙Ᏻᐃᛶ ࠶ ࡾ
8.㠌ᖏ᩿⿣ ୙Ᏻᐃᛶ ࡞ ࡋ
9.᤬᣸㸦㛵 ⠇ and/or 㠎ᖏയᐖ㸧
10.༙᭶ᯈ or ㌾㦵യᐖ
യᐖࡢཎᅉ㸦12㸧
1.࣮࢜ࣂ࣮ ࣮ࣘࢫ㸦 ᚎ ࠎ࡟Ⓨ⑕㸧
2.࣮࢜ࣂ࣮ ࣮ࣘࢫ㸦 ᛴ ࡟Ⓨ⑕㸧
3.㠀᥋ゐᆺ യᐖ
4.௨๓ࡢയ ᐖ㒊఩ࡢ ෌ Ⓨ
11.᥋ゐᆺയᐖ㸦 ௚ࡢ 㑅ᡭ㸧
12.᥋ゐയᐖ㸦ື ࠸࡚ ࠸ࡿ≀㸧㸦౛ 㸪࣮࣎ࣝ 㸧
13.᥋ゐയᐖ㸦ື ࠸࡚ ࠸࡞࠸≀㸧㸦 ౛㸪ࢿࢵ ࢺ㸧
14.࣮ࣝࣝ㐪཯㸦 ཯๎ ⾜Ⅽ㸧
21.ࣇ࢕࣮ࣝࢻࡢ ≧ែ
22.ኳೃ
23.⏝ලḞ㝗
24.ࡑࡢ௚
6
IOC Injury Surveillance System ࡟ ࡼࡗ࡚ᐇ 㝿 ࡟⾜ࢃࢀ ࡓ 2008 ᖺ໭ ி࢜ࣜࣥࣆ
ࢵࢡࡢയᐖㄪ ᰝ⤖ᯝ ࡟ ࡘ࠸୍࡚㒊ㄝ ᫂ࡍࡿ [Junge et al., 2009]㸬ᑐ㇟➇ᢏᩘ 32
➇ᢏ㸪㑅ᡭ Ⓩ㘓⪅⥲ ᩘ 10977 ྡ࡛㸪⥲യᐖⓎ ⏕ᩘࡣ 1055 ౛࡛࠶ࡗ ࡓ 㸬യᐖⓎ ⏕
⋡ࡣ㸪96.1 ౛㸭1000 㑅ᡭⓏ㘓⪅ᩘ ࡛࠶ ࡗࡓ 㸬 ⥲യᐖⓎ⏕ ᩘ 1055 ౛ࡢ࠺ࡕ㸪ヨ
ྜ୰࡟Ⓨ⏕ࡋ ࡓയᐖᩘ ࡣ 633 ౛㸦73.8㸣㸧㸦 ࢹ࣮ࢱ୙㊊ࡀ ☜ㄆ ࡉࢀ ࡓ 197 ౛ࡣ
㝖እ㸧㸪ࢺࣞ ࣮ࢽࣥࢢ ୰࡟Ⓨ⏕ࡋࡓ യᐖᩘ ࡣ 225 ౛㸦26.2㸣㸧㸦ࢹ࣮ࢱ୙㊊ࡀ
☜ㄆࡉࢀ ࡓ 7 ౛ࡣ㝖እ 㸧ሗ࿌ࡉࢀ࡚ ࠸ ࡿ㸬➇ ᢏู࡟ࡳࡿ࡜ 㸪᭱ࡶയ ᐖⓎ⏕๭ྜ
ࡀ㧗࠸➇ᢏࡣ ࢧࢵ࣮࢝ ࡛㸪Ⓩ㘓㑅ᡭ ᩘ 496 ྡ୰ 156 ྡ㸦31.5㸣㸧㸪ḟ࡟ࢸࢥࣥ
ࢻ࣮࡛ 126 ྡ୰ 34 ྡ㸦27.0㸣㸧㸪㝣ୖ࣍ ࢵ ࢣ࣮ 382 ྡ୰ 78 ྡ㸦 20.4㸣㸧㸪ࣁࣥ
ࢻ࣮࣎ࣝ 334 ྡ ୰ 58 ྡ㸦17.4㸣㸧㸪࢚࢘ ࢖ࢺ ࣜࣇࢸ࢕ࣥ ࢢ 255 ྡ୰ 43 ྡ㸦16.9㸣㸧㸪
࣎ࢡࢩࣥ ࢢ 281 ྡ୰ 42 ྡ㸦14.9㸣㸧㸪ࢯࣇ ࢺ࣮࣎ࣝ 119 ྡ୰ 16 ྡ㸦13.4㸣㸧㸪
㔝⌫ 189 ྡ୰ 21 ྡ㸦 11.1㸣㸧ࡢ㡰࡛ ࠶ࡗࡓ 㸬඲യᐖࡢ ୰࡛㸪᭱ ࡶ ከࡃࡘࡅࡽࢀ
ࡓデ᩿ྡࡣࠕ㊊㛵⠇ ࡢ ᤬᣸࡛ࠖ 81 ౛㸦ሗ࿌ ࡉࢀࡓ඲യᐖ ྡ㸪1108 ౛ࡢ 7.3㸣ࢆ
༨ ࡵ ࡿ 㸧 㸪 ࡘ ࡙ ࠸࡚ ࠕ ኱ ⭣ 㒊 ࡢ ➽ ᣸ യ ࠖ 75 ౛ 㸦 6.8㸣 㸧 ࡛ ࠶ ࡗ ࡓ 㸬 㒊 ఩ ู ࡛ ࡳ
ࡿ ࡜ 㸪 ᭱ ࡶ ከ ࠸ യ ᐖ ࡢ 㒊 ఩ ࡣ ኱ ⭣ 㸦 13.3㸣 㸧 ࡜ ⭸ 㸦 12.1㸣 㸧 㸪 ࡘ ࡙ ࠸ ࡚ ୗ ⭣ 㸪
㊊㛵⠇࡛࠶ࡾ 㸪㢌㒊 യ ᐖ㸦 9.4㸣㸧ࡶࡲࡓ㸪ୖ ఩࡟఩⨨ࡋࡓ യᐖ㒊఩ ࡢ୍ࡘ࡛࠶
ࡗࡓ㸬യᐖࡢ 㒊఩ࢆୖ ⫥࣭ୗ⫥࣭య ᖿ࣭㢌㢕 㒊ࡢ 4 ࡘ࡟ ศࡅ࡚ ẚ㍑ ࡍࡿ࡜㸪ୗ
⫥ࡢയᐖࡀ᭱ ࡶከࡃ 600 ౛㸦54.2㸣㸧㸪ḟ ࡟ୖ⫥ 218 ౛㸦19.7㸣㸧㸪యᖿ 149
౛㸦13.4㸣㸧㸪㢌㢕㒊 133 ౛㸦12.0㸣㸧ࡢ㡰 ࡛࠶ࡗࡓ㸬യᐖ ࡢཎᅉ ู࡛ࡳࡿ࡜㸪
᭱ࡶከ࠸യᐖ ࡢཎᅉࡣ 㸪௚ࡢ㑅ᡭ࡜ ࡢ᥋ゐ࡟ ࡼࡿയᐖࡀ 282 ౛㸦 32.9㸣㸧࡛඲
యࡢ⣙ 1/3 ࢆ༨ࡵ࡚࠾ ࡾ㸪㠀᥋ゐᆺ യᐖࡀ 172 ౛㸦20.0㸣㸧㸪࢜ ࣮ࣂ࣮࣮ࣘࢫ
㸦ᛴ࡟③ࡳࡀ Ⓨ⏕ 㸧ࡀ 110 ౛㸦12.8㸣㸧㸪ࡘ࡙ ࠸࡚ྠᵝ࡟࢜ ࣮ࣂ࣮ࣘ ࣮ࢫ㸦ᚎ ࠎ
࡟③ࡳࡀⓎ⏕ 㸧ࡀ 78 ౛㸦9.1㸣㸧࡛࠶ ࡗࡓ 㸬ࢺ࣮ࣞࢽࣥ ࢢࡸヨྜ ࢆ୰᩿ࡋ࡞ࡅ
ࢀࡤ࡞ࡽ࡞࠿ ࡗࡓയᐖ ౛ࡀ 844 ౛୰ 419 ౛㸦49.6㸣㸧࡛㸪⣙༙ ᩘ ࢆࡶ༨ࡵ࡚࠸
ࡓ࡯࠿㸪་ᖌ ࡟ࡼࡾ 1 㐌㛫௨ෆࡢ୰ ᩿ࡀ᥎ᐃ ࡉࢀࡓയᐖ౛ ࡀ 275 ౛㸦33.0㸣㸧㸪
1 㐌㛫࠿ࡽ 1 ࣨ ᭶ࡢ୰ ᩿ࡀ᥎ᐃࡉࢀ ࡓയᐖ౛ ࡀ 93 ౛㸦11.2㸣㸧㸪ࡉࡽ࡟ࡣ 4 㐌
㛫௨ୖࡢ୰᩿ ࡀ᥎ᐃࡉ ࢀࡓയᐖ౛ ࡀ 41 ౛㸦 4.9㸣㸧ࡳࡽࢀࡓ 㸬 4 㐌㛫௨ୖࡢ୰
᩿ࡀ᥎ᐃࡉࢀ ࡓ 41 ౛ ࡢയᐖࡢෆヂ ࡣ㸪㦵 ᢡ 13 ౛㸪㠌ᖏ᩿ ⿣ 8 ౛㸪➽᣸യ 6 ౛㸪
⬺⮻ 5 ౛㸪࢔ ࢟ࣞࢫ⭝ ᩿⿣ 3 ౛㸪᤬ ᣸ 3 ౛࡯ ࠿࡛࠶ࡗࡓ㸬 㦵ᢡࡢ๭ ྜࡀ㧗࠸➇
7
ᢏࡣࢸࢥࣥࢻ ࣮࡛ 6 ౛㸦4.8㸣㸧㸪ḟ ࡟ࣁ ࣥࢻ࣮࣎ࣝ 4 ౛㸦3.0㸣㸧㸪࣎ࢡࢩ ࣥ
ࢢ 5 ౛㸦1.8㸣㸧㸪ࢧ ࢵ࣮࢝ 6 ౛㸦1.2㸣㸧㸪㝣ୖ➇ᢏ 10 ౛㸦0.5㸣 㸧࡛࠶ࡾ 㸪⬺
⮻㸭⭝ࡶࡋࡃ ࡣ㠌ᖏ᩿ ⿣ࡢ๭ྜࡀ㧗 ࠸➇ᢏࡣ ࢸࢥࣥࢻ࣮ ࡛ 4 ౛㸦 3.2㸣㸧㸪ᰂ㐨
8 ౛㸦2.1㸣㸧㸪ࣁࣥࢻ࣎ ࣮ࣝ 7 ౛㸦2.1㸣㸧㸪࢘ ࢚࢖ࢺࣜࣇࢸ ࢕ࣥ ࢢ 5 ౛㸦2.0㸣㸧㸪
ࣞࢫࣜࣥࢢ 5 ౛㸦1.5㸣㸧࡛࠶ࡗ ࡓ㸬⬻ 㟈┞࡟ࡘ ࠸࡚ࡣ࣎ࢡࢩ ࣥࢢ࡛ 2 ౛㸦0.7㸣㸧㸪
ࢧࢵ࣮࡛࢝ 3 ౛㸦 0.6㸣㸧㸪ࡑࡢ ௚ 1 ౛࡛ 㔝⌫㸪ࣂࢫࢣ ࢵࢺ࣮࣎ ࣝ㸪࣍ࢵࢣ࣮ 㸪
ᰂ㐨㸪ࢸࢥࣥ ࢻ࣮㸪⮬ ㌿㌴㸪࢝ࢾ࣮ 㸭࢝ࣖࢵ ࢡ࡯࠿࡛ࡳࡽ ࢀ ࡓ 㸬⏨ ዪูࡢയᐖ
࡛ࡣ⏨ᛶ 549 ౛㸦 54.2㸣㸧㸪ዪᛶ 464 ౛㸦45.8㸣㸧ࡢሗ࿌ࡀ ࡳࡽ ࢀࡓ㸬 ࡇࢀࡽ
ࡢሗ࿌ࡢࡼ࠺ ࡟㸪඲➇ ᢏ ࡟࠾࠸࡚⤫ ୍ࡉࢀࡓ ㄪᰝ᪉ἲ࡟ࡼ ࡿ ⤖ᯝࡣ 㸪௚ࡢ➇ᢏ
࡜ࡢẚ㍑᳨ウ ࡀྍ⬟࡜ ࡞ࡾ㸪ྛ ➇ᢏูࡢ യᐖ ࡢ≉ᚩࡀࡼࡾ ᫂ࡽ࠿࡟ ࡞ࡿ 㸬௒ ᪥㸪
IOC ࡟ࡼࡾ 㸪ࢫ࣏࣮ࢶ യᐖண㜵࡟ྥ ࡅࡓྲྀࡾ ⤌ࡳࡀ ከᩘ⾜ ࢃࢀ࡚࠸ ࡿࡀ㸪 2011
ᖺ 4 ᭶࡟ࣔࢼ ࢥ࡛㛤ദ ࡉࢀࡓୡ⏺ࢫ ࣏࣮ࢶയ ᐖ࣭⑌⑓ண 㜵་Ꮫ఍͆The 3rd World
Congress on Injury Prevention, The IOC World Conference on Prevention of Injury &
Illness in Sport͇ࡢ୺ദ ࡜ ࡞ࡾ㸪ᙜᏛ఍࡟࠾ ࠸ ࡚ከᩘࡢയᐖ ㄪᰝሗ࿌ ࡀ⾜ࢃࢀࡓ
[IOC World Conference on Prevention of Injury & Illness in Sport, 2011 ]㸬ࡲࡓ㸪ୡ
⏺ྛᅜࡢ௦⾲ ⪅࡟ࡼࡿ ࢫ࣏࣮ࢶ་Ꮫ ࢆ୰ᚰ࡜ ࡋࡓ ࢫ࣏࣮ࢶ യᐖண㜵 ࡟㛵ࡍࡿ ከ
ᩘࡢࢩ࣏ࣥࢪ ࣒࢘ࡸ࣡ ࣮ࢡࢩࣙࢵࣉ 㸪◊✲ Ⓨ ⾲ ➼ࡀ⾜ࢃࢀ ࡚࠸ࡓ [Abstracts from
the IOC World Conference on Prevention of Injury & Illness in Sport, 2011 ;
Sanomura and Irie, 2011(abstract); బ㔝ᮧ, 2012]㸬
1-3. ୗ⫥യᐖ࡜ࡑ ࡢ せᅉ
ୗ⫥യᐖ࣓࢝ ࢽࢬ࣒࡟ ࡘ࠸࡚㸪ୗ⫥ യᐖ࡟㛵 ࡍࡿඛ⾜ㄽᩥ ࠿ࡽ㸪እ ᅉⓗせᅉ
࡜ࡋ࡚㸪኱఍ ࣞ࣋ࣝ㸪 ᢏ⾡ࣞ࣋ࣝ㸪 ࢩ࣮ࣗࢬ ࡢࢱ࢖ࣉ㸪ࢧ ࣮ࣇ࢙࢖ ࢫ ࡟㛵ࡍࡿ
ሗ࿌ࡀከᩘࡳ ࡽࢀ㸪ෆ ᅉⓗせᅉ࡟㛵 ࡍࡿሗ࿌ ࠿ࡽࡣ㸪ᖺ㱋 㸪ᛶᕪ㸪 ᭶⤒࿘ᮇ㸪
യᐖ᪤ Ṕ࠾ ࡼࡧ㐺ษ ࡞ࣜࣁࣅࣜࢸ ࣮ࢩࣙࣥ 㸪᭷㓟⣲ⓗ⬟ ຊ㸪యᆺ 㸪฼ࡁ⬮࡜
㠀฼ࡁ⬮ഃ࡬ ࡢയᐖⓎ ⏕࡟ࡘ࠸࡚㸪ᰂ ㌾ᛶ㸪➽ຊ㸪ࣂࣛࣥࢫ ⬟ຊ㸪➽Ⓨⅆ᫬㛫㸪
ୗ⫥࿘ᚄᅖ㸪 ጼໃไᚚ ⬟ຊ㸪ゎ๗Ꮫ ⓗ࢔ࣛ࢖ ࣓ࣥࢺ㸪㊊㒊 ᙧែ ➼࡟ ࡘ࠸࡚」ᩘ
ࡳࡽࢀࡿ[Murphy et al., 2003]㸬እᅉⓗせᅉࡢ ୍ࡘ࡛࠶ࡿ ኱ ఍ࣞ࣋ࣝ ࡟ࡘ࠸࡚ࡣ 㸪
⦎⩦᫬࡜ヨྜ ᫬ࡢയᐖ Ⓨ⏕⋡ࡢẚ㍑ ࡟ࡘ࠸࡚ ከᩘࡢሗ࿌ࡀ ࡳࡽࢀࡿ ࡯࠿㸪⭸๓
8
༑Ꮠ㠌ᖏ㸦 anterior cruciate ligament㸸௨ ୗ㸪ACL㸧യᐖⓎ⏕⋡ࡢ ẚ ㍑ ࡟ࡘ࠸࡚ࡶ
」ᩘሗ࿌ࡉࢀ ࡚࠸ࡿ㸬 ➇ᢏࡣࢧࢵ࢝ ࣮㸪ࣂࢫ ࢣࢵࢺ࣮࣎ࣝ 㸪ࢧࢵ࢝ ࣮㸪ࣂ࣮ࣞ
࣮࣎ࣝ㸪࢔࣓ ࣜ࢝ࣥࣇ ࢵࢺ࣮࣎ࣝ㸪 ࢔࢖ࢫ࣍ ࢵࢣ࣮ࡢ ሗ࿌ ࡛࠶ࡿࡀ 㸪ከࡃࡢ➇
ᢏ࡟࠾࠸࡚㸪 ヨྜ᫬ࡢ യᐖ Ⓨ⏕⋡ࡀ ⦎⩦᫬ࡢ യᐖⓎ⏕⋡࡟ ẚ࡭࡚ 㧗 ࠸Ⓨ⏕⋡ࢆ
♧ࡋ࡚࠸ࡓ㸬 ≉࡟ࣁࣥ ࢻ࣮࣎ࣝ࡟࠾ ࠸࡚ ࡣ 24 ಸ㧗ࡃ[Seil et al., 1998]㸪࢔࢖ࢫ
࣍ࢵࢣ࣮࡛ ࡣ 25 ಸ 㧗 ࠸[Stuart and Smith, 1995]࡜࠸࠺ሗ࿌ࡶ࠶ ࡿ 㸬 ACL യᐖⓎ
⏕⋡࡟ࡘ࠸࡚ ࡣ㸪ࣁࣥ ࢻ࣮࣎ࣝࡢヨ ྜ᫬ࡢ യ ᐖⓎ⏕⋡ࡀ⦎ ⩦᫬࡟ẚ ࡭ ࡚ 30 ಸ㧗
࠸[Myklebust et al., 1998]࡜࠸࠺ሗ࿌ࡶࡳ ࡽ ࢀࡓ㸬ࡑࡢ࡯ ࠿ࣛࢡࣟ ࢫ࡟࠾࠸࡚ࡶ
⦎⩦᫬࡟ẚ࡭࡚ヨྜ᫬ࡢയᐖⓎ⏕⋡ࡀ㧗࠸࡜࠸࠺ሗ࿌ࡀ」ᩘࡳࡽࢀ࡚࠸ࡿ
[Dick et al., 2012; Hinton et al., 2005; Matz and Nibbelink, 2004] 㸬
ᢏ⾡ࣞ࣋ࣝ ࡟ࡼࡿയ ᐖ Ⓨ⏕⋡ࡢẚ ㍑࡟ ࡘ࠸ ࡚ 㸪Peterson ࡽ㸦 2000㸧࡟ࡼࡿࢧ
ࢵ࣮࢝࡟㛵ࡍ ࡿ ሗ࿌࡟ ࡼࡿ࡜ 㸪ᢏ⾡ ࣞ࣋ࣝࡢ ప࠸⩌ࡣ㧗࠸ ⩌࡜ẚ㍑ ࡋ࡚㸪യᐖ
Ⓨ⏕㢖ᗘࡀ 2 ಸ㧗࠿ࡗ ࡓࡇ࡜ࢆሗ࿌ ࡋ㸪 Chomiak ࡽ㸦2000㸧ࡶࢧ ࢵ࣮࢝➇ᢏࡢ
ẚ㍑࡛㸪ᢏ⾡ ࣞ࣋ࣝࡢ ప࠸⩌ࡣ㧗࠸ ⩌࡜ ẚ㍑ ࡋ࡚യᐖⓎ⏕ 㢖ᗘ ࡀ 2 ಸ㧗࠿ࡗࡓ
ࡇ࡜ࢆሗ࿌ࡋ ࡚࠸ࡿ㸬 ୍᪉ 㸪ྠ➇ᢏ ࡢẚ㍑࡟ ࠾࠸࡚㸪 ᢏ⾡ ࣞ࣋ࣝࡢ 㧗࠸⩌ࡣప
࠸ ⩌ ࡜ ẚ ㍑ ࡋ ࡚ 㸪 യ ᐖ Ⓨ ⏕ 㢖 ᗘ ࡀ 㧗 ࠿ ࡗ ࡓ ࡜ ࡢ ሗ ࿌ ࡶ ࡳ ࡽ ࢀ ࡚ ࠾ ࡾ [Hopper et
al., 1995]㸪ᢏ⾡ࣞ࣋ࣝ ࡜യᐖ Ⓨ⏕㢖 ᗘ࡟㛵ࡋ ࡚ࡣ୍⮴ࡋࡓ ぢゎࡣᚓ ࡽࢀ࡚࠸࡞
࠸㸬
ࢧ࣮ࣇ࢙࢖ࢫ ࡀ ୗ⫥യ ᐖ࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚ࡣ㸪ேᕤⰪ ࡢയᐖⓎ ⏕㢖ᗘࡀ
ኳ↛Ⱚ➼ࡢࢧ ࣮ࣇ࢙࢖ ࢫ ࡛ࡢയᐖⓎ ⏕㢖ᗘ ࡜ ẚ㍑ࡋ࡚㧗࠸ ࡜࠸ ࠺ሗ ࿌ࡀከᩘࡳ
ࡽ ࢀ ࡿ 㸬 ࢔࣓ ࣜ ࢝ ࣥ ࣇ ࢵ ࢺ ࣎ ࣮ ࣝ࡟ ࠾ ࠸ ࡚ 㸪 Powell㸦 1992㸧 ࡣ 㸪 ே ᕤ Ⱚ ࡜ ኳ ↛
ⰪࡢയᐖⓎ⏕ 㢖ᗘࢆẚ ㍑ࡋ࡚㸪ேᕤⰪ࡛ ࡢ ⭸ 㛵⠇᤬᣸ࡀ㧗 ࠿ࡗࡓ ࡇ ࡜ࢆሗ࿌ࡋ 㸪
ຍ࠼࡚ ACL യ ᐖⓎ⏕ ⋡ࡶ㧗࠿ࡗࡓ ࡇ࡜ࢆሗ ࿌ࡋ࡚࠸ࡿ㸬Arnason ࡽ㸦1996㸧ࡣ
ࢧࢵ࣮࢝࡟࠾ ࠸࡚ 㸪ே ᕤⰪ࡛ࡢയᐖ Ⓨ⏕⋡ࡣ ኳ↛Ⱚ࡜ẚ㍑ ࡋ࡚ 㸪2 ಸ㧗࠸Ⓨ⏕
⋡ࢆ ♧ ࡋ ࡓࡇ ࡜ ࢆ ሗ࿌ ࡋ࡚ ࠸ ࡿ 㸬 ࡲ ࡓ 㸪Olsen ࡽ㸦2003㸧 ࡣ㸪 ࣁ ࣥ ࢻ࣎ ࣮ ࣝ࡟
࠾࠸࡚㸪ᮌ〇 ࡢᗋ࡜ ே ᕤⓗ࡟సࡽࢀ ࡓᗋ࡛ࡢ യᐖ Ⓨ⏕⋡ࢆ ሗ࿌ࡋࡓ 㸬 ≉࡟ዪᛶ
࡟࠾࠸࡚㸪ே ᕤⓗ࡟స ࡽࢀࡓᗋ࡛ࡢ യᐖⓎ⏕ ⋡ࡀ㸪ᮌ〇ࡢ ᗋ࡜ẚ㍑ ࡋ࡚㧗࠸Ⓨ
⏕⋡ࢆ♧ࡋ࡚ ࠸ࡓ㸬ྠ ࡌࡃ Olsen ࡽ㸦2003㸧ࡢሗ࿌࠿ࡽࡶ 㸪ேᕤⓗ ࡟సࡽࢀࡓ
ᗋ࡛ࡢയᐖⓎ ⏕ᩘࡀ㸪 ᮌ〇ࡢᗋ࡜ẚ ㍑ࡋ࡚㧗 ࠸ഴྥࢆ♧ࡋ ࡚࠸ࡓ㸬 ேᕤⰪࡶࡋ
9
ࡃࡣேᕤ࡛స ࡽࢀࡓᗋ ࡛ࡢയᐖⓎ⏕ ⋡ࡀ㧗࠸ ࡇ࡜ࡀከᩘሗ ࿌ ࡉࢀ࡚ ࠸ࡿࡀ㸪ࡇ
ࢀࡣᗋ㠃࡜ࢩ ࣮ࣗࢬࡢ ᥋ゐ㠃࡛ࡢᦶ ᧿᢬ᢠࡀ 㧗ࡲࡿࡇ࡜࡛ 㸪ᛴ⃭࡞ ࢫࢺࢵࣉ㸪
࢝ࢵࢸ࢕ࣥࢢ 㸪ࣆ࣎ࢵ ࢺືస ᫬࡟㸪 㛵⠇ࡸ➽ ⫗ 㸪㌾㦵㸪⭝ 㸪㠌ᖏ࡬ ࡢఙᙇࢫࢺ
ࣞ ࢫ ࡸ ᤬ ㌿ ࢫ ࢺ ࣞ ࢫ ࡀ ࠿ ࠿ ࡿ ࡇ ࡜ ࡀ せ ᅉ ࡛ ࠶ ࡿ ࡜ ⪃ ࠼ ࡽ ࢀ ࡚ ࠸ ࡿ [Heidt et al.,
1996; Inklaar, 1994]㸬
ෆᅉⓗせᅉ࡟ࡘ࠸࡚ࡣ㸪ᛶᕪ࡜യᐖ࡟㛵ࡍࡿሗ࿌࡛ࡣ㸪ࢧࢵ࣮࢝࡟࠾࠸࡚
Backous ࡽ㸦1988㸧ࡣዪᛶࡣ ⏨ᛶ ࡟ẚ࡭ 㸪⥲ യᐖⓎ ⏕⋡ ࡀ㧗࠿ ࡗࡓ ࡇ࡜ࢆ ሗ࿌
ࡋ㸪ࣂࢫࢣࢵ ࢺ࣮࣎ࣝ ࡟࠾࠸࡚㸪 Hosea ࡽ㸦2000㸧ࡣዪᛶ ࡣ⏨ᛶ࡟ ẚ࡭㸪㊊㛵
⠇ ᤬ ᣸ ࡢ യ ᐖ Ⓨ ⏕ ⋡ ࡀ 㧗 ࠿ ࡗ ࡓ ࡇ ࡜ ࢆ ሗ ࿌ ࡋ ࡚ ࠸ ࡿ 㸬 ୍ ᪉ ࡛ 㸪 Baumhauer ࡽ
㸦1995㸧ࡣ㸪ࣇ࢕࣮ࣝ ࢻ࣍ࢵࢣ࣮㸪 ࢧࢵ࣮࢝ 㸪ࣛࢡࣟࢫࡢ ㊊㛵⠇᤬ ᣸ യᐖⓎ⏕
⋡ࢆẚ㍑ࡋࡓ ࡀ㸪⏨ዪ 㛫࡟ᕪࡣ࡞࠿ ࡗࡓࡇ࡜ ࢆሗ࿌ࡋ㸪 Beynnon ࡽ㸦2001㸧ࡶ
ྠ➇ᢏࡢẚ㍑ ࡟࠾࠸࡚ 㸪⏨ዪᕪࡣࡳ ࡽࢀ࡞࠿ ࡗࡓࡇ࡜ࢆሗ ࿌ࡋ࡚࠸ ࡿ㸬 ࡑࡢ࡯
࠿ࢧࢵ࣮࢝➇ ᢏ࡟࠾࠸ ࡚㸪⏨ዪࡢയ ᐖㄪᰝࢆ ⾜ ࡗࡓ࡜ࡇࢁ 㸪඲യᐖ ࡢ⏨ዪࡢẚ
㍑࡟࠾࠸࡚ᕪ ࡣࡳࡽࢀ ࡞࠿ࡗࡓࡀ㸪 ୗ⫥ ࡢയ ᐖ࡟ࡘ࠸࡚ࡣ ㊊㛵⠇㠌 ᖏ യᐖࡣ⏨
ᛶࡣዪᛶ࡟ẚ ࡭ 3 ಸ㧗 ࠸Ⓨ⏕⋡ࢆ♧ ࡋ 㸪୍᪉ 㸪⭸㛵⠇㠌ᖏ യᐖ࡟ࡘ ࠸࡚ࡣዪᛶ
ࡣ⏨ᛶ࡟ẚ࡭ ࡚ 3 ಸ㧗 ࠸Ⓨ⏕⋡ࢆ♧ ࡋ ࡚࠸ࡓ [Lindenfeld et al., 1994]㸬ࡲࡓ㸪⭸
㛵⠇യᐖ࡟ࡘ ࠸࡚㸪⥲ യᐖⓎ⏕⋡ ࡢ ⏨ዪᕪࡣ ࡳࡽࢀ࡞࠿ࡗ ࡓࡀ㸪⭸ 㛵⠇യᐖ࡟
ࡘ ࠸ ࡚ ࡣ ዪ ᛶ ࡣ ⏨ ᛶ ࡟ ẚ ࡭ ࡚ 60㸣 ࡢ 㧗 ࠸ Ⓨ ⏕ ⋡ ࢆ ♧ ࡋ ࡓ ࡇ ࡜ ࡀ ሗ ࿌ ࡉ ࢀ ࡓ ࡯
࠿ 㸪 ACL യ ᐖ ࡟ ࡘ ࠸ ࡚ ࡣ 3.6 ಸ 㧗 ࠸ Ⓨ ⏕ ⋡ ࢆ ♧ ࡋ ࡓ ࡇ ࡜ ࡀ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ
[Messina et al., 1994]㸬ከᩘࡢඛ⾜ㄽ ᩥ ࠿ࡽ㸪 ୗ⫥ࡢയᐖ࡟ ࡘ࠸࡚㸪 ㊊㛵⠇യᐖ
Ⓨ⏕⋡ࡢ⏨ዪ ᕪ࡟ࡘ࠸ ࡚ ⤖ㄽࡣᚓࡽ ࢀ࡚࠸࡞ ࠸ࡀ㸪⭸㛵 ⠇യᐖ㸪≉ ࡟ ACL യᐖ
Ⓨ⏕⋡ࡢẚ㍑ ࡛ࡣዪᛶ ࡣ⏨ᛶ࡟ẚ࡭ ࡚യᐖ Ⓨ ⏕⋡ࡀᴟࡵ࡚ 㧗࠸ࡇ࡜ ࡀ ሗ࿌ࡉࢀ
࡚ ࠾ ࡾ 㸪 2㹼 8 ಸ ࡢ യ ᐖ Ⓨ ⏕ ⋡ ࡢ 㧗 ࡉ ࡀ ♧ ࡉ ࢀ ࡚ ࠸ ࡿ [Liederbach et al., 2008;
Stevenson et al., 1998; Agel et al., 2005; Olsen et al., 2003; Arendt et al., 1999;
Myklebust et al., 1998; Ireland, 1999; Gray et al., 1985 ]㸬
യᐖ᪤ Ṕࡢ ᭷↓࡜യ ᐖ Ⓨ⏕࡜ࡢ㛵 ಀ࡟ࡘ࠸ ࡚ࡣ㸪 ≉࡟㊊ 㛵⠇യᐖ ࡟ 㛵ࡍࡿ
ሗ࿌ࡀከᩘࡳ ࡽࢀࡿ㸬 ࢧࢵ࣮࢝㸪ࣂ ࢫࢣࢵࢺ ࣮࣎ࣝ㸪ࣂࣞ ࣮࣮࣎ࣝ ࠿ࡽࡢሗ࿌
࡛ࡣ㸪㊊㛵⠇ യᐖࡢ᪤ Ṕࢆࡶࡘ⪅ ࡣ㸪ྠ㒊 ఩ࡢയᐖⓎ⏕ ࣜࢫࢡࡀ 㧗࠸ࡇ࡜ࡀ
ሗ࿌ࡉࢀ࡚࠸ ࡿ[McKay et al., 2001; Bahr et al., 1997; Surve et al., 1994]㸬ࡑࡢ࡯
10
࠿ࣂࢫࢣࢵࢺ ࣮࣎ࣝࡢ ⭸㛵⠇യᐖࡢ ᪤ ࢆࡶ ࡘ⪅࡜യᐖⓎ ⏕࡜ࡢ㛵 ಀ࡟ࡘ࠸࡚
ࡶ㸪ྠ㒊఩ࡢ᪤ ࢆࡶࡘ⪅ࡣയᐖⓎ⏕ࣜࢫࢡࡀ㧗࠸ࡇ࡜ࡀሗ࿌ࡉࢀ࡚࠸ࡿ
[Messina et al., 1994]㸬ࡇࢀࡽࡣ㸪㐣 ཤ࡟Ⓨ⏕ ࡋࡓ ྠ㒊఩ࡢ ෌യᐖⓎ ⏕⋡࡜ࡢ㛵
ಀࡀ♧ࡉࢀ࡚ ࠸ࡿࡀ㸪 ึᅇയᐖᚋ࡟ ⾜ࢃࢀࡿ 㐺ษ࡞ ἞⒪ࡸ ࣜࣁࣅࣜ ࢸ࣮ࢩࣙࣥ
ࡢᐇ᪋ࡢ᭷↓ ࡀᙳ㡪ࡋ ࡚࠸ࡿ࡜⪃࠼ ࡽࢀ㸪 ➽ ຊࡸࣂࣛࣥࢫ ⬟ຊ ࡢప ୗ㸪㠌ᖏࡢ
୙༑ศ࡞ᅇ᚟≧ែ࡛ࡢ➇ᢏ᚟ᖐࡀ෌യᐖࢆⓎ⑕ࡉࡏࡿせᅉ࡜࡞ࡗ࡚࠸ࡿ㸬
Ekstrand ࡜ Gillquist㸦1983㸧ࡣ㸪ࢧ ࢵ࣮࢝㑅 ᡭࢆᑐ㇟ ࡜ࡋ ࡚㸪୙㐺 ษ࡞ࣜࣁࣅ
ࣜࢸ࣮ࢩࣙࣥ ࡀཎᅉ࡛ ྠ㒊఩ࡢ෌യ ᐖࢆⓎ⑕ ࡉࡏࡓࡶࡢࡀ 25.8㸣ࡳࡽࢀࡓࡇ࡜ 㸪
Chomiak ࡽ 㸦2000㸧ࡣ㸪ྠࡌࡃࢧࢵ ࣮࢝㑅ᡭ ࢆᑐ㇟࡟㸪୙ 㐺ษ࡞ฎ ⨨ࡸࣜࣁࣅ
ࣜࢸ࣮ࢩࣙࣥ ࡀཎᅉ࡛ 㸪ྠ㒊఩ ࡢ෌യᐖ ࢆⓎ ⑕ࡉࡏࡓࡶࡢ ࡀ㸪⣙ 24㸣ࡳࡽࢀࡓ
࡜ሗ࿌ࡋ࡚࠸ ࡿ㸬
฼ࡁ⬮ഃࡶࡋ ࡃࡣ㠀฼ ࡁ⬮ഃ࡟Ⓨ⑕ ࡋࡓ യᐖ ࡢ๭ྜ࡟㛵ࡍ ࡿㄪᰝሗ ࿌࡟ࡼࡿ
࡜㸪Baumhauer ࡽ㸦 1995㸧ࡣ㸪ࢧࢵ ࣮࢝㸪ࣇ ࢕࣮ࣝࢻ࣍ࢵ ࢣ࣮㸪ࣛ ࢡࣟࢫࢆᑐ
㇟࡜ࡋ࡚㸪ྑ ⬮ࡀ฼ࡁ ⬮࡛࠶ࡿ⩌࡜ ᕥ⬮ࡀ฼ ࡁ⬮࡛࠶ࡿ⩌ ࡜ࢆẚ㍑ ࡋ㸪ᕥ⬮ࡀ
฼ࡁ⬮࡛࠶ࡿ ⩌࡟࠾࠸ ࡚㸪㊊㛵 ⠇᤬᣸ࡀ ከࡃ Ⓨ⑕ࡋ࡚࠸ࡓ ࡇ࡜ࢆሗ ࿌ࡋ࡚࠸ࡿ 㸬
Ekstrand ࡜ Gillquist ࡽ㸦1983㸧࡟ࡼࡿ࡜㸪ྠ ࡌࡃࢧࢵ࣮࢝ 㑅ᡭࢆᑐ ㇟ ࡜ࡋࡓㄪ
ᰝ ࡛ 㸪92.3㸣 ࡀ ฼ ࡁ ⬮ ഃ ࡟ ㊊ 㛵 ⠇ യ ᐖ ࢆⓎ ⑕ ࡋ ࡓ ࡇ ࡜ ࢆ ሗ ࿌ ࡋ࡚ ࠸ ࡿ 㸬 ዪ Ꮚ ࢚
࣮ࣜࢺࢧࢵ࢝ ࣮ࢆᑐ㇟ ࡜ࡋࡓㄪᰝ࡛ ࡣ [ Faude et al., 2006]㸪฼ࡁ⬮ഃ ࡟㊊㛵⠇യ
ᐖࡀከࡃⓎ⏕ ࡋࡓ࡯࠿ 㸪⭸㛵⠇യᐖ ࡶ฼ࡁ⬮ ഃ࡟ከࡃⓎ⏕ ࡋࡓࡇ࡜ ࢆሗ࿌ࡋ࡚
࠸ࡿ㸬ᅜ㝿ࣞ ࣋ࣝ࠿ࡽ ࣞࢡ࢚࣮ࣜࢩ ࣙࣥ࢔ࢫ ࣮ࣜࢺࡲ࡛ࢆ ᑐ㇟࡜ࡋ ࡓ㊊㛵⠇᤬
᣸࡟㛵ࡍࡿയ ᐖㄪᰝ࡟ ࡼࡿ࡜ [Yeung et al., 1994]㸪฼ࡁ⬮ഃ࡟Ⓨ⏕ ࡋࡓ๭ྜࡀ㧗
࠸ࡇ࡜ࢆሗ࿌ ࡋ ࡚࠸ࡿ 㸬Orchard㸦2001㸧ࡣ㸪࣮࢜ࢫࢺࣛࣜ ࢔ࣥࣇࢵ ࢺ࣮࣎ࣝ࡟
࠾࠸࡚㸪኱⭣ ᅄ㢌➽➽ ᣸യࢆⓎ⑕ࡋ ࡓ⪅ࡀ㸪 ฼ࡁ⬮ഃ࡟ከ ࠿ࡗࡓࡇ ࡜ࢆሗ࿌ࡋ
࡚࠸ࡿ㸬ࡲࡓ 㸪ᕥ⬮࠾ ࡼࡧྑ⬮࡟ࡼ ࡿ യᐖࡢ ẚ㍑࡛ࡣ㸪ዪ Ꮚࢧࢵ࢝ ࣮ࢆᑐ㇟࡜
ࡋࡓㄪᰝ࡛ࡣ[Engström et al., 2005]㸪ྑ⬮࡟ യᐖࡀከ࠸ഴ ྥࡀ♧ࡉ ࢀࡓ࡯࠿ 㸪㧗
ᰯ࣭኱Ꮫࢧࢵ ࣮࢝㸪ࣂ ࢫࢣࢵࢺ࣮࣎ ࣝ㸪ࣛࢡ ࣟࢫ㸪ࣇ࢕࣮ ࣝࢻ࣍ࢵ ࢣ࣮ࢆᑐ㇟
࡜ࡋࡓ㊊㛵⠇ ᤬᣸ࡢയ ᐖㄪᰝ ࡟࠾࠸ ࡚ࡶ[Beynnon, 2005]㸪ྑ⬮࡟ ከ ࡃⓎ⏕ࡋ࡚
࠸ࡓࡇ࡜ࡀሗ ࿌ࡉࢀ࡚ ࠸ࡿ 㸬୍᪉࡛ 㸪㊊㛵⠇ ᤬᣸ ࠾ࡼࡧୗ ⫥യᐖ࡜ ฼ࡁ⬮࣭㠀
฼ࡁ⬮ഃ࡛ࡢ യᐖⓎ⏕ ⋡ ࡟࠾࠸࡚㸪 ࡑࡢᕪࡣ ࡳࡽࢀ࡞࠿ࡗ ࡓ࡜ࡢሗ ࿌ࡶከᩘࡳ
11
ࡽࢀ࡚࠾ࡾ[Beynnon et al., 2001; Seil et al., 1998; Surve et al., 1994]㸪฼ࡁ⬮ഃ࡟
ẚ㍑ⓗയᐖࡀ ከࡃⓎ⑕ ࡋ࡚࠸ࡿ ഴྥ ࡀࡳࡽࢀ ࡿࡀ ⤖ㄽࡣᚓ ࡽࢀ࡚ ࠸ ࡞࠸㸬
㛵⠇ᘱ⦆ᛶ࡜ യᐖࣜࢫ ࢡ࡜ࡢ 㛵ಀ࡟ ࡘ࠸࡚ࡣ 㸪 ࡑࡢഴྥࡣ ♧ࡉࢀ࡚ ࠸ࡿ ࡀ୍
ᐃࡋࡓぢゎࡣ ᚓࡽࢀ࡚ ࠸࡞࠸ 㸬Ostenberg ࡜ Roos㸦2000㸧ࡣࢧࢵ ࣮࢝ ࡟࠾࠸࡚㸪
㛵⠇ᘱ⦆ᛶࡢ 㧗࠸ࡶࡢ ࡜ࡑ࠺࡛࡞࠸ ࡶࡢࢆẚ ㍑ࡋ㸪㛵⠇ᘱ ⦆ᛶࡢ㧗 ࠸ࡶࡢࡣୗ
⫥യᐖⓎ⏕ࣜ ࢫࢡࡀ 4 ಸ㧗࠿ࡗࡓࡇ ࡜ࢆሗ࿌ ࡋ࡚࠸ࡿ 㸬ࡲࡓ 㸪Söderman ࡽ㸦2001㸧
ࡣ㸪ྠࡌࡃࢧ ࢵ࣮࢝ࢆ ᑐ㇟࡜ࡋ࡚㸪 㛵⠇ᘱ⦆ ᛶࡢ㧗࠸ࡶࡢ ࡣୗ⫥യ ᐖࣜࢫࢡࡀ
3.1 ಸ㧗࠿ࡗࡓ ࡇ࡜ࢆ ሗ࿌ࡋࡓ㸬ࡲ ࡓ㸪 ACL യᐖ࡜඲㌟ᘱ ⦆ᛶ࡜ ࡢ㛵㐃ᛶ ࡟ࡘ
࠸࡚ࡣ㸪849 ྡࡢኈᐁ Ꮫᰯ⏕ࢆᑐ㇟ ࡜ࡋ ࡚㸪 ACL യᐖ⩌࡜ 㠀യᐖ ⩌࡜ࢆẚ㍑ࡋ
ࡓ࡜ࡇࢁ㸪ACL യᐖ ⩌ ࡟࠾࠸࡚඲㌟ ᘱ⦆ᛶࡀ 㧗࠿ࡗࡓࡇ ࡜ ࢆሗ࿌ࡋ [Uhorchak et
al., 2003]㸪Ramesh ࡽ㸦2005㸧ࡣ㸪ACL യᐖ ⩌࡜ࢥࣥࢺࣟ ࣮ࣝ⩌ࢆ ẚ㍑ࡋ㸪ACL
യᐖ⩌ࡣ඲㌟ ᘱ⦆ᛶࡀ 㧗࠿ࡗࡓࡇ࡜ ࢆሗ࿌ࡋ ࡓ㸬⭸㛵⠇ᘱ ⦆ᛶ࡜⭸ 㛵⠇യᐖ࡜
ࡢ㛵㐃ᛶ࡟ࡘ ࠸࡚ࡣ 㸪Ekstrand ࡜ Gillquist㸦1983㸧ࡣ㸪ࢧࢵ࢝ ࣮ࢆ ᑐ㇟࡜ࡋ࡚㸪
⭸㛵⠇ࡢෆ཯ ࣭እ཯㸪 ๓᪉࣭ᚋ᪉ࡢ ᘱ⦆ᛶࢆ ᳨ᰝࡋ㸪ࡑࢀ ࡽࡢᘱ⦆ ᛶࡀ㧗࠸ࡶ
ࡢࡣയᐖࣜࢫ ࢡ ࡀ㧗࠿ ࡗࡓࡇ ࡜ࢆሗ ࿌ࡋ㸪 Chomiak ࡽ 㸦2000㸧ࡣ ྠ➇ᢏࢆᑐ㇟
࡜ࡋ࡚㸪⭸㛵 ⠇ࡢ๓᪉ ࣭ᚋ᪉ ᘬࡁᘬ ࡋࢸࢫࢺ 㸪ෆ཯࣭እ཯ ࢫࢺࣞࢫ ࢸࢫࢺ 㸪ࡑ
ࡢ௚ࣛࢵࢡ࣐ ࣥࢸࢫࢺ ࢆᐇ᪋ࡋ㸪⭸ 㛵⠇ᘱ⦆ ᛶࡢቑຍࡀ⭸ 㛵⠇࡜㊊ 㛵⠇യᐖࡢ
༴㝤ᅉᏊ࡜࡞ ࡿ࡜㏙࡭ ࡚࠸ࡿ㸬
㛵⠇ྍືᇦ࡜ ୗ⫥യᐖ ࡜ࡢ㛵㐃ᛶ࡟ ࡘ࠸࡚ࡣ 㸪Söderman ࡽ㸦 2001㸧ࡣ㸪ዪᏊ
ࢧࢵ࣮࢝࡟࠾ ࠸࡚㸪⭸ 㛵⠇ఙᒎゅᗘ ࡀ 10r௨ୖ࠶ࡿࡶࡢ ࡣ㸪ୗ⫥ യᐖࣜࢫࢡࡀ
㧗ࡲࡿࡇ࡜ࢆ ሗ࿌ࡋ࡚ ࠸ࡿ ࡀ㸪㊊㛵 ⠇⫼ᒅゅ ᗘ ࠾ࡼࡧࣁ࣒ ࢫࢺࣜࣥ ࢢࡢᰂ㌾ᛶ
࡜ യ ᐖ ࣜ ࢫ ࢡ ࡜ ࡢ 㛵 ಀ ࡟ ࡘ ࠸ ࡚ ࡣ ᭷ ព ࡞ ሗ ࿌ ࡣ ࡳ ࡽ ࢀ ࡚ ࠸ ࡞ ࠸ 㸬 Beynnon ࡽ
㸦2001㸧ࡣ㸪ྠ➇ᢏࡢ ዪᛶ ࡢ㊥㦵ୗ 㛵⠇ࡢᅇ ෆ᪉ྥ࡬ࡢື ࡁࡀ㊊㛵 ⠇᤬᣸യᐖ
ࡢࣜࢫࢡ࡜࡞ ࡾ㸪 Kaufman ࡽ㸦1999㸧ࡣ㸪ᚋ ㊊㒊ࡢᅇෆゅ ᗘࡀ ኱ࡁ ࠸⪅ࡣ㸪࢔
࢟ࣞࢫ⭝⅖ࡢ ࣜࢫࢡせ ᅉࡢ୍ࡘ࡟࡞ ࡿ࡜ ㏙࡭ ࡚࠸ࡿ㸬ࡑࡢ ࡯࠿㸪㛵 ⠇ྍືᇦ࡜
ୗ⫥യᐖ࡟㛵 ࡍࡿሗ࿌ ࡀከᩘࡳࡽࢀ ࡿࡀ [Wiesler et al., 1996; Barrett and Bilisko,
1995]㸪୍⮴ࡋࡓぢ ゎ ࡣ ᚓࡽࢀ࡚࠸ ࡞࠸㸬
ゎ ๗ Ꮫ ⓗ ࢔ ࣛ ࢖ ࣓ ࣥ ࢺ ࡜ ୗ ⫥ യ ᐖ ࡢ ሗ ࿌ ࡟ ࡘ ࠸ ࡚ ࡣ 㸪 Souryal ࡜ Freeman
㸦1993㸧ࡀ㸪902 ྡࡢ㧗ᰯ⏕࢔ࢫࣜ ࣮ࢺࢆᑐ ㇟࡟㸪኱⭣㦵 㢛㛫❐ᖜ ᣦᩘ㸦notch
12
width index㸸௨ୗ㸪NWI㸧࡜ ACL യᐖ࡜ࡢ 㛵㐃ᛶࢆ᳨ド ࡋ㸪⏨ዪ ࢔ࢫ࣮ࣜ ࢺඹ
࡟ ACL യᐖ⪅ ࡢ NWI ࡀ㸪㠀യᐖ ⪅࡜ẚ࡭ ࡚ ᑠࡉ࠿ࡗࡓࡇ ࡜ࢆሗ࿌ ࡋ 㸪LaPrade
࡜ Burnett㸦1994㸧ࡣ㸪኱Ꮫࣂࢫࢣࢵ ࢺ࣮࣎ࣝ 㸪ࢧࢵ࣮࢝ 㸪ࣂ࣮ࣞ ࣎ ࣮ࣝ㸪య᧯ 㸪
ࣇࢵࢺ࣮࣎ࣝ 㸪࢔࢖ࢫ ࣍ࢵࢣ࣮ ࡢ ィ 213 ྡࡢ NWI ࢆ ᐃࡋ 㸪 ACL യᐖ⪅࡜㠀
യᐖ⪅࡜ẚ㍑ ࡋࡓ࡜ࡇ ࢁ㸪⏨ዪ ࡜ࡶ࡟ യᐖ ⪅ ࡢ NWI ࡀᑠࡉ࠿ ࡗࡓ ࡇ࡜ࢆሗ࿌ࡋ
࡚࠸ࡿ㸬ࡋ࠿ ࡋ࡞ࡀࡽ 㸪NWI ࡜ ACL യᐖ࣓ ࢝ࢽࢬ࣒࡜ࡢ 㛵㐃ᛶ࡟ ࡘ࠸࡚ࡣ ᭦
࡞ࡿ᳨ウࡀᚲ せ࡜ࡉࢀ 㸪 NWI ࡀᑠ ࡢࡶࡢࡀ ACL യᐖⓎ⏕⋡ࡀ㧗 ࠸࡜࠸࠺ ഴྥ
ࡀ♧ࡉࢀ࡚࠸ ࡿࡀ୍ᐃ ࡢぢゎࡣᚓࡽ ࢀ࡚࠸࡞ ࠸ 㸬
ࡑࡢ࡯࠿ Shambaugh ࡽ㸦1991㸧ࡣࣂࢫ ࢣࢵ ࢺ࣮࣎ࣝ࡟࠾ ࠸࡚㸪ୗ ⫥യᐖ ࡀⓎ
⏕ࡋࡓᑐ㇟⪅ ࡢ Q-angle ࡢᕥྑᕪࡀ኱ ࡁ ࡃ㸪യᐖࢆ㈇ࡗࡓ ⬮ഃ ࡢ Q-angle ࡀ኱ࡁ
࠿ࡗࡓࡇ࡜ࢆ ሗ࿌ ࡋ㸪 ࡲࡓ㸪Ⲵ㔜఩ ࡛ࡢᚋ㊊ 㒊㸦㋖㦵㸧ࡢ እ཯ゅᗘ ࡢᕥྑᕪࡀ
኱ࡁࡃ㸪യᐖࢆ㈇ ࡗࡓ ㊊ഃࡢゅᗘࡀ ࡼࡾ኱ࡁ ࠿ࡗࡓࡇ࡜ࢆ ሗ࿌ࡋ ࡚ ࠸ࡿ㸬Cowan
ࡽ㸦1996㸧ࡣ㸪246 ྡࡢ㌷ேࢆㄪᰝ ࡋ㸪㐣ᗘ ࡞⭸ 㛵⠇እ཯ ࢆ࿊ࡍࡿ ⪅࡜ Q-angle
ࡀ 15r௨ୖࡁ࠸⪅ ࡟ ៏ᛶⓗ࡞ୗ⫥ യᐖࡀࡳ ࡽࢀࡓࡇ࡜ࢆ ሗ࿌ࡋ 㸪Wen ࡽ㸦1998㸧
ࡣ㸪255 ྡࡢ៏ᛶⓗ࡞ ୗ⫥ 㞀ᐖࢆࡶ ࡘᑐ㇟⪅ ࡟ᑐࡋ㸪Tubercle sulcus angle㸦⭸
⵹ 㦵 ୰ ኸ ࡜ ⬯ 㦵 ⢒ 㠃 ࡢ ⤖ ࢇ ࡔ ⥺ ࡜ ᗋ ࠿ ࡽ ࡢ ᆶ ┤ ⥺ ࡜ ࡢ ࡞ ࡍ ゅ ᗘ (ᗙ ఩ ࡟ ࡚ ᐃ )㸧
࡜ ⭸ 㛵 ⠇ ෆ ཯ ࣭ እ ཯ ࢔ ࣛ ࢖ ࣓ ࣥ ࢺ 㸪 ୗ ⫥ 㛗 ࢆ ᐃ ࡋ ࡓ ࡜ ࡇ ࢁ 㸪 Tubercle sulcus
angle ࡢゅᗘࡀ኱ࡁ࠸ ⪅࡜⭸ 㛵⠇ෆ ཯࢔ࣛ࢖ ࣓ࣥࢺࢆ࿊ࡍ ࡿ⪅ ࡣ㸪ୗ⭣㞀ᐖⓎ⏕
ࡢ୺せᅉ࡜࡞ ࡿࡇ࡜ࢆ ሗ࿌ࡋ࡚࠸ࡿ 㸬
1-4. ACLയᐖ࡜ࡑࡢせ ᅉ࣭യᐖ࣓࢝ ࢽࢬ࣒
ୗ⫥യᐖࡣࢧ ࢵ࣮࢝㸪 ࣂࢫࢣࢵࢺ࣎ ࣮ࣝ㸪ࣁ ࣥࢻ࣮࣎ࣝ㸪 ࣛࢡࣟࢫ ࡟࠾࠸࡚ ඲
യᐖࡢ࠾࠾ࡼ ࡑ 6㹼 7 ๭⛬ᗘࢆ༨ࡵ ࡿࡀ [Messina et al., 1994; Peterson et al., 2000;
Chomiak et al., 2000; బ㔝ᮧࡽ, 2012; బ㔝ᮧࡽ, 2013; Dick et al., 2012; Mats and
Nibbelink, 2004; Junge and Dvorak, 2007; Jørgensen, 1984; Dick et al., 2007 ]㸪≉࡟
ዪᛶ࢔ ࢫࣜ ࣮ࢺࡢ ⭸㛵 ⠇യᐖ Ⓨ⏕ ⋡ࡣ⏨ ᛶ ࢔ ࢫ࣮ࣜ ࢺ࡟ ẚ࡭࡚ 㧗࠸ [Messina et
al., 1994; Zelisko et al., 1982; Lindenfeld et al., 1994; de Loës et al., 2000; Gray et
al., 1985; Schmidt-Olsen et al., 1991; Miyasaka et al., 1991 ]㸬ࡲࡓ㸪 ዪᛶ࢔ࢫ࣮ࣜ
ࢺ࡟≉␗ⓗ࡟ യᐖⓎ⑕ ⋡ࡢ㧗ࡉࢆ♧ ࡋ࡚࠸ࡿ ࡢࡀ ACL യᐖ Ⓨ⏕⋡ ࡛࠶ ࡿࡀ㸪ࣂ
13
ࢫࢣࢵࢺ࣮࣎ ࣝ㸪ࢧࢵ ࣮࢝㸪ࣁࣥࢻ ࣮࣎ࣝ ࠿ ࡽࡢሗ࿌ࡀከ ᩘࢆ༨ࡵ ࡿ㸬 ࡇࢀࡽ
ࡢ➇ᢏ࡟ඹ㏻ ࡍࡿືస ࡣ㸪ࢲࢵࢩࣗ ࠿ࡽࡢᛴ ⃭࡞ࢫࢺࢵࣉ ࡸᛴ⃭࡞ ᪉ྥ㌿᥮㸪
ࣆ࣎ࢵࢺ࠾ࡼ ࡧ࢝ࢵࢸ ࢕ࣥࢢ㸪ࢪࣕ ࣥࣉ࠿ࡽ ࡢ╔ᆅືసࡀ 㢖Ⓨࡋ࡚ ⾜ࢃࢀ࡚࠸
ࡿⅬ࡟࠶ࡿ㸬 ࡲࡓ㸪ࡇ ࢀࡽࡢືసࡀ ඹ㏻ࡋ࡚ ⾜ࢃࢀ࡚࠸ࡿ ௚ࡢ➇ᢏ ࡜ࡋ࡚ࡣ㸪
≉࡟⡿ᅜ࡛┒ ࢇ࡛࠶ࡿ ࣛࢡࣟࢫ➇ᢏ ࡀ࠶ࡆࡽ ࢀࡿࡀ㸪ࣛ ࢡࣟࢫ➇ ᢏ ࡢ ACL യᐖ
Ⓨ⏕⋡ࡶ NCAA ࢹ࣮ ࢱࢆࡳࡿ㝈ࡾ Ỵࡋ࡚ప ࡃࡣ࡞࠸ [Hootman, 2007]㸬ዪᛶ࢔ࢫ
ࣜ ࣮ ࢺ ࡟ ACL യ ᐖ ࡀ ከ ࠸ ⌮ ⏤ ࡣ ከ ᒱ ࡟ ࢃ ࡓ ࡿ ࡀ [Bahr and Krosshaug, 2005;
Baker, 1998; Bing and Garrett, 2007; Faunø and Wulff Jakobsen, 2006; Flynn et al.,
2005; Griffin et al., 2000; Griffin et al., 2006; Hewett et al., 2006; Hewett et al.,
2007; Hutchinson et al., 1995; Hutchinson and Ireland, 1995; Ireland, 1999; Ireland et
al., 1997; Ireland and Nattiv, 2004; Ireland and Ott, 2004; Joy et al., 2009; Kelly,
2008; Yu and Garrett, 2007; Quatman and Hewett, 2009; Griffin et al., 2006; Hewett
et al., 2006; Renstrom et al., 2008; Shimokochi and Shultz, 2008]㸬 ACL യᐖࡣ㸪≉
࡟ዪᛶ࢔ࢫࣜ ࣮ࢺࡢയ ᐖⓎ⏕⋡ࡀ㧗 ࠸ࡇ࡜㸪 ➇ᢏ᚟ᖐࡲ࡛ ࡟᪩ࡃ࡚ ࡶ 6 ࣨ᭶⛬
ᗘࢆᚲせ࡜ࡋ 㸪㔜⑕ᗘ ࡢ㧗࠸യᐖࡢ ୍ࡘ࡛࠶ ࡿࡇ࡜㸪ࡲࡓ 㸪෌ཷയ ⋡ࡶపࡃࡣ
࡞࠸ࡇ࡜࠿ࡽ 㸪≉ ࡟ 2000 ᖺ௨㝆㸪ACL യ ᐖண㜵࡟╔┠ ࡋࡓྲྀࡾ ⤌ࡳࡀ㐍ࡳ㸪
௒᪥㸪ከᩘࡢ ACL യ ᐖண㜵ࣉࣟࢢ ࣒ࣛࡀ⪃ ᱌ࡉࢀ࡚࠸ࡿ 㸬 ࡲࡓ㸪 ྠ᫬࡟ ACL
യᐖ࣓࢝ࢽࢬ ࣒ࡢゎ᫂ ࡶ㐍ࡳ㸪ᐇ 㝿ࡢ ACL യ ᐖ᫬ࡢࣅࢹ࢜ ⏬ീ࡟㦵 ᱁ࣔࢹࣝࢆ
࣐ ࢵ ࢳ ࡉ ࡏ ࡚ ศ ᯒ ࡍ ࡿ ᢏ ἲ 㸦 MBIM techniques 㸸 model-based image-matching
techniques㸧ࡢ㐍Ṍ࡟ࡼ ࡾ㸪ࡑࡢヲ⣽ ࡀ᫂ࡽ࠿ ࡟࡞ࡗ࡚ࡁ࡚ ࠸ࡿ [Bore et al., 2013;
Koga et al., 2010; Krosshaug et al., 2007]㸬 ௨ ᚋ 㸪 ACL യ ᐖ せ ᅉ ࡟ ࡘ ࠸ ࡚ ㏙ ࡭ ࡿ 㸬
Ireland ࡽ㸦2002㸧ࡣ ACL യᐖࡢ༴㝤ᅉᏊ ࢆ㸪ෆⓗᅉᏊ ࠾ࡼࡧእ ⓗᅉᏊ㸪」
ྜⓗ࡞ᅉᏊ࡟ ศ㢮ࡋ࡚ ㏙࡭࡚࠾ࡾ㸪 ෆⓗᅉᏊ ࢆ ୗ⫥࢔ࣛ࢖ ࣓ࣥࢺ㸪 ⭸ 㛵⠇㐣ఙ
ᒎ㸪኱⭣ 㦵㢛㛫❐ ࡢࢧ ࢖ࢬ ࡸᙧ≧ 㸪࣍ࣝ ࣔࣥ ࡟ࡼࡿᙳ㡪➼ ࡜ࡋ 㸪ࡇ ࢀࡽࢆ͆ not
controllable͇࡜㏙࡭࡚ ࠸ࡿ㸬ࡲࡓ㸪እⓗᅉᏊ ࢆ➽ຊࡸࢥࣥ ࢹ࢕ࢩࣙ ࢽࣥࢢ࡜ࡋ㸪
ࡇࢀࡽࢆ͆controllable͇࡜㏙࡭࡚ ࠸ࡿ㸬ࡉ ࡽ ࡟ Ireland ࡽ㸦2002㸧ࡣ㸪ዪᛶ࡟ࡳ
ࡽࢀࡿୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺࡢ≉ᚩ࡜ࡋ ࡚㸪኱⭣ 㦵๓᤬ゅ ᗘ ࡸ Q-angle㸪⬯㦵እ᤬ゅ
ᗘࡢቑ኱㸪㊊ 㒊ᅇෆ➼ ࢆ♧ࡋ㸪ࡑࢀ ࡽࢆ ͆ miserable malalignment syndrome͇࡜
⛠ࡋࡓ㸬ࡲࡓ 㸪ዪᛶ࢔ ࢫ࣮ࣜࢺࡢ ࢪ ࣕࣥࣉ࠿ ࡽࡢ╔ᆅ᫬ጼ ໃ࡟ࡳࡽ ࢀࡿ⭸ 㛵⠇
14
࠾ࡼࡧ⫤㛵⠇ ᒅ᭤ࡀᑠ ࡛㸪⭸ 㛵⠇ እ཯ゅᗘ ࡀ ኱ࡁ࠸⫥఩ ࢆ ACL യ ᐖ࣓࢝ࢽࢬ࣒
ࡢ୍ࡘ࡜ࡋ࡚ ♧ࡉࢀ࡚ ࠾ࡾ 㸪ࡑࢀࡽ ࢆ͆position of no return͇࡜⛠ ࡋ࡚࠸ࡿ㸬
ACL യᐖ ࡟ᙳ㡪 ࢆཬ ࡰࡍゎ ๗Ꮫⓗ せᅉ ࡟ࡘ ࠸࡚ࡣ 㸪㊊㒊 ᅇෆ 㸪⭸ 㛵⠇㐣 ఙᒎ 㸪
Q-angle㸪኱⭣㦵㢛㛫 ❐ᖜ㸪኱⭣㦵 ๓᤬ゅ ᗘ 㸪⬯㦵እ᤬ゅ ᗘ㸪⫤㛵 ⠇ෆ᪕࣭እ᪕
ゅ ᗘ ➼ ࡢ ሗ ࿌ ࡀ ከ ᩘ ࡳ ࡽ ࢀ ࡿ ࡯ ࠿ 㸪 ඲ ㌟ ᘱ ⦆ ᛶ ࡸ ⭸ 㛵 ⠇ ᘱ ⦆ ᛶ 㸪 ࡑ ࡢ ௚ BMI
㸦Body mass index㸧㸪࣍ࣝࣔࣥࡢᙳ 㡪࡟ࡘ࠸ ࡚ࡢ ሗ࿌ࡶ」 ᩘࡳࡽࢀ ࡿ㸬
ዪᛶࡢ ACL യ ᐖ ࣓࢝ ࢽࢬ࣒ࡢゎ᫂ ࡢⅭ࡟ 㸪ࣂ࢖࣓࢝ࢽࢡ ࢫⓗᡭἲ ࡀ ከᩘ⏝࠸
ࡽࢀ࡚࠸ࡿ㸬ᐇ 㝿ࡢཷ യሙ㠃ࢆ ⏬ീ ゎᯒࡋࡓ ◊✲ㄽᩥ࠿ࡽ ࡣ㸪ACL ཷയ⫥఩ࡢ
ከ ࡃ ࡣ ⭸ 㛵 ⠇ እ ཯ ⫥ ఩ ࡛ ࠶ ࡿ ࡇ ࡜ ࡀ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ [Olsen et al., 2004; Krosshaug et al., 2007; Boden et al., 2009; Hewett et al., 2009; Krosshaug et al., 2007]㸬ࡇ
ࢀࡽࡢዪᛶ࢔ ࢫ࣮ࣜࢺ ࡀ ♧ࡍ≉ᚩⓗ ࡞⫥఩ࢆ 㸪 ྛ✀ㄢ㢟ື సࢆ⾜ࢃ ࡏࡓ᫬ࡢࣂ
࢖࣓࢜࢝ࢽࢡ ࢫⓗ ࡞᳨ ド࡟࠾࠸࡚ࡣ 㸪Ferber ࡽ㸦2003㸧ࡣ㸪ࣛࣥࢽ ࣥࢢືస ᫬
ࡢୗ⫥࢔ࣛ࢖ ࣓ࣥࢺࡢ ⏨ዪ ࡢẚ㍑ࢆ ⾜࠸㸪❧ ⬮┦࡟࠾࠸࡚ ዪᛶࡣ⏨ ᛶ࡟ẚ࡭㸪
⭸㛵⠇እ཯࠾ ࡼࡧ⫤㛵 ⠇ෆ㌿ ゅᗘࡀ ᭷ព࡟ቑ ຍࡋࡓࡇ࡜ࢆ ሗ࿌ࡋ࡚ ࠸ࡿ㸬ࡲ ࡓ㸪
Hewett㸦2006㸧ࡽ ࡣ 㸪 ∦⬮ ࣍ࢵ ࣉື స ࡟࠾ ࠸ ࡚㸪 ዪᛶ ࡣ⏨ ᛶ ࡟ẚ ࡭ 㸪⫤ 㛵⠇ ෆ
㌿ゅᗘࡀቑຍ ࡋ࡚࠸ࡓ ࡇ࡜ࢆሗ࿌ࡋ 㸪Yu ࡽ㸦2005㸧ࡣࢫࢺࢵࣉࢪ ࣕࣥࣉ ࢱࢫࢡ
࡟࠾࠸࡚㸪⭸ 㛵⠇እ཯ ゅᗘࡀቑຍࡋ ࡓࡇ࡜ࢆ ሗ࿌ࡋࡓ㸬ࡉ ࡽ࡟ࢫࢡ ࣡ࢵࢺࡸࢪ
ࣕࣥࣉ࠿ࡽࡢ ╔ᆅ 㸪࢝ ࢵࢸ࢕ࣥࢢື స ᫬࡟࠾ ࡅࡿ⏨ዪࡢẚ ㍑࡟࠾࠸ ࡚ࡣ㸪Zeller
ࡽ㸦2003㸧ࡣ∦⬮ࢫࢡ ࣡ࢵࢺ࡟࠾࠸ ࡚㸪ዪᛶ ࡣ⏨ᛶ࡟ẚ࡭ 㸪⭸ 㛵⠇ እ཯ゅᗘ࠾
ࡼࡧ⫤㛵⠇ෆ ㌿ゅᗘࡀ ቑຍࡋࡓࡇ࡜ ࢆሗ࿌ࡋ ࡚࠸ࡿ㸬Kernozak ࡽ㸦 2005㸧ࡣࢻ
ࣟࢵ ࣉࣛ ࣥࢹ ࢕ࣥ ࢢ ࡟ ࠾࠸ ࡚㸪 ⭸ 㛵 ⠇እ ཯ ゅ ᗘࡀ ቑຍ ࡋࡓ ࡇ࡜ ࢆ ሗ ࿌ ࡋ 㸪Ford
ࡽ㸦2003㸧ࡣࢻࣟࢵࣉ ࢪࣕࣥࣉ࡟࠾ ࠸࡚㸪ྠ ᵝ࡟⭸ 㛵⠇እ ཯ゅ ᗘࡀ ቑຍࡋࡓࡇ
࡜ࢆሗ࿌ࡋࡓ 㸬McLean ࡽ㸦2004㸧ࡣ࢝ࢵ ࢸ ࢕ࣥࢢືస࡟ ࠾࠸࡚㸪 Malinzak ࡽ
㸦2001㸧ࡣࢡࣟࢫ࢝ࢵ ࢸ࢕ࣥࢢ࡟࠾ ࠸࡚㸪ྠ ᵝ࡟ዪᛶࡢ⭸ 㛵⠇እ཯ ゅᗘࡀ᭷ព
࡟ቑຍࡋࡓࡇ ࡜ࢆሗ࿌ ࡋ ࡚࠸ࡿ㸬ࡲࡓ㸪Hewett ࡽ㸦2007㸧ࡣ㸪ࢧࢵ࣮࢝㸪ࣂࢫ
ࢣࢵࢺ࣮࣎ࣝ 㸪ࣂ࣮ࣞ ࣮࣎ࣝ㑅 ᡭ 205 ྡࢆᑐ㇟࡜ࡋࡓ๓ྥ ࡁ◊✲࡟ ࠾࠸࡚㸪 ࢻ
ࣟࢵࣉࢪࣕࣥ ࣉࢱࢫࢡ ࡛ᚓࡽࢀࡓୗ ⫥࢟ࢿ ࣐ ࢸ࢕ࢡࢫࢆ࣋ ࣮ࢫࣛ࢖ ࣥ࡜ࡋ ࡚㸪
ACL യᐖ⪅࡜㠀യ ᐖ ⪅ࡢୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࢆẚ㍑ࡋ ࡓ࡜ ࡇࢁ㸪ACL യᐖ⪅ࡣ㠀
യᐖ⪅࡟ẚ࡭ ࡚⭸㛵⠇ እ཯ゅᗘࡀ᭷ ព࡟ቑຍ ࡋ࡚࠸ࡓࡇ࡜ ࢆሗ࿌ࡋ ࡓ㸬ࡇࢀࡽ
15
ከᩘࡢሗ࿌࠿ ࡽࡳࡽࢀ ࡿࡼ࠺࡟㸪ዪ ᛶࡀ♧ࡍ ⭸ 㛵⠇እ཯ゅ ᗘࡸ⫤㛵 ⠇ෆ㌿ゅ ᗘ
ࡢቑຍ ࡜࠸ࡗ ࡓ≉ ᚩⓗ ࡞ ୗ⫥ ࢔ࣛ࢖ ࣓ࣥ ࢺ ࡀ ACL യᐖ せᅉࡢ ୍ ࡘ࡛࠶ ࡿࡇ࡜
ࡀከᩘࡢࣞࣅ ࣮ࣗ ࠿ࡽ ሗ࿌ࡉࢀ࡚࠸ ࡿ[Yu and Garrett, 2007; Bahr and Krosshaug,
2005; Griffin et al., 2000; Kelly, 2008; Hewett et al., 2007; Quatman and Hewett,
2009; Griffin et al., 2006; Hewett TE et al., 2006; Renstrom et al., 2008 ]㸬
1-5. ACL യᐖࢆྵࡵࡓ ୗ⫥ യᐖண㜵 ࣉࣟࢢࣛ ࣒
ACL യᐖண㜵ࣉࣟ ࢢ ࣒ࣛࡣ㸪⚄⤒➽ ༠ㄪᛶ ࢆ≺࠸࡜ࡋ ࡚㸪ࢫࢡ࣡ ࢵࢺ ࡸࣛࣥ
ࢪືస㸪࣍ࢵ ࣆࣥࢢ 㸪 ࢪࣕࣥࣉືస ➼ࡀ⾜ࢃ ࢀ࡚࠸ࡿࡀ 㸪 ≉࡟╔ᆅ ືస᫬࡟ࡳ
ࡽࢀࡿ⭸㛵⠇ እ཯ࡸ⫤ 㛵⠇ෆ㌿ືస ࡢቑຍ࡜ ࠸ࡗࡓືⓗୗ ⫥࢔ࣛ࢖ ࣓ࣥࢺ࡟ ╔
┠ࡋ㸪ࡑࢀࡽ ࡢ㐣๫࡞ ືࡁ࡟ᑐࡋὀ ពႏ㉳ࡉ ࡏࡿࡶࡢ ࡀከ ᩘࡳࡽࢀ ࡿ 㸬ࡑࢀࡽ
ࡣ ୗ ⫥ ࡢ ࠸ ࢃ ࡺ ࡿ ͆ knee-in͇ ື స ࡢ ᅇ 㑊 ࡛ ࠶ ࡾ 㸪 ᐇ 㝿 ࡢ ᣦ ᑟ ⌧ ሙ ࡟ ࠾ ࠸ ࡚ ࡣ 㸪
ࢫࢡ࣡ࢵࢺࡸ ࣍ࢵࣆࣥ ࢢ㸪 ࢪࣕࣥࣉ ࠿ࡽࡢ╔ ᆅ ືస᫬࡟ࠕ ࡘࡲඛࡢ ୖ࡟⭸ࡀ఩
⨨ࡍࡿࡼ࠺࡟ࠖ[Olsen et al., 2005; Petersen et al., 2005; Söderman et al., 2000; Myer
et al., 2005; Myer et al., 2004; Myklebust et al., 2003; Hewett et al., 2006; Hewett et
al., 1996]࡜࠿㸪ṇ㠃࠿ ࡽぢࡓ࡜ࡁ࡟ ࠕ∎ඛ㸪 ⭸㸪⫤㛵⠇ࢆ ⤖ࢇࡔ⥺ ࡀ୍┤⥺࡟
࡞ࡿࡼ࠺࡟ࡋ 㸪≉࡟⭸ ࡀෆഃ࡟ධࡽ ࡞࠸ࡼ࠺ ࡟ࡍࡿࠖ[ὠ⏣࡜ΎỈ , 2008]➼ࡢᣦ
ᑟࡀ⾜ࢃࢀ࡚ ࠸ࡿ 㸬ከ ✀࠶ࡿ ACL യ ᐖண㜵 ࣉࣟࢢ࣒ࣛࡣ 㸪ࡑࡢ ከ ࡃࡣ⚄⤒➽༠
ㄪᛶࡢྥୖࢆ ≺࠸࡜ࡋ ࡚ᵓᡂࡉࢀࡓ ࡶࡢࡀከ ࠸ࡀ㸪௨ୗ࡟ ྛࣉࣟࢢ ࣒ࣛ ࡢෆᐜ
࡜௓ධ⤖ᯝ࡟ ࡘ࠸࡚♧ ࡍ㸬
1. Henning ࡽ㸦Griffin et al., 2000㸧
ዪᏊࣂࢫࢣ ࢵࢺ࣮࣎ ࣝࢆᑐ㇟࡜ࡋ ࡚㸪ືస ᣦᑟࢆ୺࡟⾜ ࠸㸪ᣦᑟ ෆᐜࡣ㸪ࢪ
ࣕࣥࣉ࠿ࡽࡢ ╔ᆅ㸪ࣆ ࣎ࢵࢺ ࡸᛴ⃭ ࡞᪉ྥ㌿ ᥮ືస᫬ ࡟⭸ 㛵⠇ࢆࡋ ࡗ࠿ࡾᒅ᭤
ࡉࡏࡓ≧ែ࡛ ⾜࠺ࡇ࡜ ࢆᣦ♧ࡋ࡚࠸ ࡿ㸬⭸ 㛵 ⠇ᒅ᭤఩࡛ࡢ ືసࢆᙉ ㄪࡋࡓࡢࡣ
͆quad-cruciate interaction͇㸦኱⭣ᅄ㢌➽㸫 ༑Ꮠ㠌ᖏస⏝ 㸧ࡢ⪃࠼ ᪉࡟ᇶ࡙࠸࡚
࠾ࡾ㸪ࡑࢀࡣ ㍍ᗘ⭸㛵 ⠇ᒅ᭤఩࡛ࡢ ኱⭣ᅄ㢌 ➽ࡢᙉ࠸཰⦰ ࡣ㸪⬯㦵 ๓᪉೫఩ࢆ
ቑຍࡉࡏ 㸪ACL ࡬ࡢఙ ᙇࢫࢺࣞࢫࢆ ቑຍࡉࡏ ࡿ࡜࠸࠺ࡶࡢ ࡛࠶ࡿ 㸬௓ධ⤖ᯝࡣ 㸪
௓ධ๓ࡢ ACL യᐖ Ⓨ ⏕⋡ࡀ 0.33 ௳/ᖺ࡛࠶ ࡗࡓࡢᑐࡋ㸪 ௓ ධᚋ ࡣ 0.25 ௳/ᖺ࡜
࡞ࡾ㸪ῶᑡഴྥ ࢆ♧ࡋ ࡓ㸦⾲ 2㸧㸬ࡇࡢࣉࣟ ࢢ࣒ࣛࡣ 1990 ᖺ࡟⤂ ௓ࡉࢀ࡚࠸ࡿ
16
ࡀ㸪ㄽᩥ࡟࡞ࡗ ࡚ ࠸࡞ ࠸ࡓࡵ㸪Griffin ࡽ㸦2000㸧࡟ࡼࡾㄝ᫂ ࡉࢀࡓ ෆᐜࢆཧ⪃
࡟㏙࡭࡚࠸ࡿ 㸬
2. Ettinger ࡽ㸦Ettinger et al., 1995㸧
ࢫ࣮࢟ࢆᑐ ㇟࡜ࡋ 㸪 ୺࡜ࡋ࡚ࣅࢹ ࢜࡟ࡼࡿ ண㜵 ࣉࣟࢢࣛ ࣒ᩍ⫱࡛ ࠶ࡿ㸬ࡑࡢ
ෆᐜࡣ㸪ཷയሙ 㠃 ࢆぢ ࡏࡿ࡜࡜ࡶ࡟㸪ACL യ ᐖ࣓࢝ࢽࢬ࣒ ࡢ⌮ゎ࡜ യᐖண㜵࡟
ᑐࡍࡿㄆ㆑ࢆ 㧗ࡵࡿࡇ ࡜ ࢆ≺࠸࡜ࡋ 㸪യᐖண 㜵ࡢᐇ㝿࡟ࡘ ࠸࡚ㄝ᫂ ࡋ࡚࠸ࡿ㸬
ࡇࡢ௓ධ⤖ᯝ ࡣ㸦⾲ 2㸧㸪௓ධ๓ࡢ Ⓨ⏕⋡ 26.6 ௳/ᖺ࠿ࡽ㸪௓ධ ᚋ 10 ௳/ᖺ࡟ῶ
ᑡࡉࡏࡓ㸬
3. Caraffa ࡽ㸦Caraffa et al., 1996㸧
ᡂே⏨Ꮚࢧ ࢵ࣮࢝㑅 ᡭ 600 ྡ㸦௓ධ⩌ 300 ྡ㸪ࢥࣥࢺࣟ ࣮ࣝ ⩌ 300 ྡ㸧ࢆᑐ
㇟࡜ࡋࡓ 㸪1 ᅇ 20 ศ㸪㐌 3 ᪥㸪30 ᪥㛫 ࡢࣉ ࣟࢢ࣒࡛ࣛ࠶ ࡾ㸪୺࡜ ࡋ࡚ࣂࣛࣥࢫ
࣮࣎ࢻࢆ౑⏝ ࡋ࡚⾜ࢃ ࢀࡓࣂࣛࣥࢫ ࢺ࣮ࣞࢽ ࣥࢢ࡛࠶ࡿ㸬 ࡇࢀࡣ㸪 ᅛ᭷ឤぬჾ
࡟↔Ⅼࢆ࠶࡚ ࡓࢺ࣮ࣞ ࢽࣥࢢἲ࡛࠶ ࡿ㸬 ௓ධ ⤖ᯝࡣ㸦⾲ 2㸧㸪௓ධ ⩌ࡢയᐖⓎ
⏕⋡ 0.15 ௳/ࢳ࣮࣒ /ࢩ࣮ࢬࣥ㸪ࢥࣥ ࢺ࣮ࣟࣝ ⩌ ࡢയᐖⓎ⏕ ⋡ 1.15 ௳/ࢳ࣮࣒/ࢩ
࣮ࢬ࡛ࣥ㸪᭷ ព࡟ῶᑡ ࡉࡏ ࡓ㸬
4. Hewett ࡽ㸦Hewett et al., 1999㸧
㧗ᰯ⏕⏨ዪ ࡢࢧࢵ࢝ ࣮㸪ࣂࢫ ࢣࢵࢺ࣎ ࣮ࣝ㸪ࣂ࣮࣮ࣞ࣎ࣝ ࢆᑐ㇟࡟ ⾜ࢃࢀࡓ㸬
1 ᅇ 60㹼90 ศ㸪㐌 3 ᅇ㸪6 㐌㛫ࡢࣉ ࣟࢢࣛ ࣒࡛࠶ࡾ㸪୺ ࡜ࡋ࡚⚄ ⤒➽༠ㄪᛶ ࡢ
ྥୖࢆ≺࠸࡜ ࡋࡓࣉࣟ ࢢ࣒࡛ࣛ࠶ࡿ 㸬ෆᐜ ࡣ 㸪ࣉࣛ࢖࢜ ࣓ࢺࣜ ࢡ ࢫ 㸪ࣂࣛࣥࢫ 㸪
ᰂ㌾ᛶ㸪➽ຊ ྥୖࡢせ ⣲ࢆྵࢇ࡛࠸ ࡿ㸬 ௓ධ ⩌ 366 ྡࡢዪᏊ࡜ࢥࣥ ࢺ࣮ࣟࣝ⩌
463 ྡࡢዪᏊ࠾ ࡼࡧ 434 ྡࡢ⏨Ꮚࢆẚ ㍑ࡋࡓ 㸬௓ධ⤖ ᯝࡣ㸦 ⾲ 2㸧㸪௓ධ⩌ ࡢയ
ᐖⓎ⏕⋡ 0.12/1000 athlete-exposures㸦 ௨ ୗ㸪AEs㸧㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ 0.43/1000 AEs
࡛㸪᭷ព࡟ῶ ᑡࡉࡏ ࡓ 㸬ࡇࡢ◊✲࡛ ⾜ࢃࢀࡓ ண㜵ࣉࣟࢢࣛ ࣒ࡀᇶ♏ ࡜ ࡞ࡾ㸪ᚋ
࡟ Mandelbaum ࡽ࡟ࡼ ࡾ “PEP program: prevent injury and enhancement performance program” ࡀᥦၐࡉࢀࡿ[Mandelbaum et al., 2005; బ㔝ᮧ, 2013-1]㸬
5. Söderman ࡽ㸦Söderman et al., 2000㸧
211 ྡࡢዪᏊ ࢧࢵ࢝ ࣮㑅ᡭ㸦௓ධ ⩌ 121 ྡ 㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ 100 ྡ㸧ࢆᑐ㇟
࡜ࡋ࡚⾜ࢃࢀ ࡓ㸬୺࡜ ࡋ࡚ ⚄⤒➽༠ ㄪᛶࡢྥ ୖࢆ≺࠸࡜ࡋ ࡓࣉࣟࢢ ࣒࡛ࣛ࠶ࡾ 㸪
ࣂࣛࣥࢫ࣮࣎ ࢻࢆ౑⏝ ࡋࡓ ࣂࣛࣥࢫ ࢺ࣮ࣞࢽ ࣥࢢ ࢆ 5 ✀┠ ⾜ࢃࡏ ࡓ 㸬1 ᅇ 10㹼
17
15 ศ㸪᭱ึࡢ 30 ᪥㛫 ࡣẖ᪥ᐇ᪋㸪ࡑ ࢀ௨ᚋ ࡣ㐌 3 ᅇᐇ᪋ ࡋ㸪࠾࠾ ࡼࡑ 30 㐌㛫
⾜ࢃࢀࡓ㸬௓ධ ⤖ᯝࡣ㸦⾲ 2㸧㸪௓ධ⩌ࡢയ ᐖⓎ⏕⋡ 0.12/1000 player-hours㸦௨
ୗ㸪PHs㸧㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ 1.36/1000 PHs ࡛㸪᭷ពᕪࡣ ࡳࡽࢀ࡞ ࠿ࡗࡓ㸬
6. Heidt ࡽ㸦Heidt et al.㸪2000㸧
300 ྡࡢዪᏊ ࢧࢵ࢝ ࣮㸦௓ධ⩌ 42 ྡ㸪ࢥ ࣥࢺ࣮ࣟࣝ ⩌ 258 ྡ㸧ࢆᑐ㇟࡟⾜ࢃ
ࢀࡓ㸬ෆᐜࡣ ⚄⤒➽༠ ㄪᛶࡢྥୖࢆ ≺࠸࡜ࡋ ࡓࣉࣟࢢ࣒ࣛ ࡛࠶ࡾ㸪 ࢺ࣮ࣞࢽࣥ
ࢢࡣ㸪ࣉࣛ࢖ ࣓࢜ࢺࣜ ࢡ ࢫ㸪ᰂ㌾ᛶ 㸪➽ຊ 㸪 ࢔ࢪࣜࢸ࢕㸪 ᚠ⎔ჾ⣔ ࢆ⾜ࡗ࡚࠸
ࡿ㸬1 ᅇ 60㹼90 ศ㸪㐌 3 ᅇ㸪7 㐌㛫ࡢࣉࣟ ࢢ࣒࡛ࣛ࠶ࡿ 㸬௓ ධ⤖ ᯝࡣ㸦 ⾲ 2㸧㸪
௓ධ⩌ࡢയᐖ Ⓨ⏕๭ ྜ 2.4㸣㸦1 ౛㸧㸪ࢥ ࣥࢺ࣮ࣟࣝ⩌ 3.1㸣㸦 8 ౛㸧࡛࠶ࡗࡓ
ࡀ᭷ពᕪࡣࡳ ࡽࢀ࡞࠿ ࡗࡓ㸬
7. Myklebust ࡽ㸦Myklebust et al., 2003㸧
ዪᏊࣁࣥࢻ ࣮࣎ࣝࢆ ᑐ㇟࡟ 2 ᖺ㛫 ࡢ௓ධㄪ ᰝࢆ⾜ࡗࡓ㸬 ௓ධ ๓ 942 ྡ㸪௓ධ
1 ᖺ┠ 855 ྡ㸪2 ᖺ┠ 850 ྡࡀᑐ㇟࡛࠶ࡗ ࡓ 㸬ࢺ࣮ࣞࢽࣥࢢ ࡣ⚄⤒➽ ༠ㄪᛶࡢྥ
ୖࢆ≺࠸࡜ࡋ ࡓࡶࡢ࡛ ࠶ࡾ㸪ࣉࣛ࢖ ࣓࢜ࢺࣜ ࢡࢫ㸪ࣂࣛࣥ ࢫ㸪࢔ࢪ ࣜࢸ࢕࡛࠶
ࡿ㸬ࡇ ࡢࣉࣟ ࢢࣛ ࣒ࡢ ≉ᚩࡣ 㸪ࣇࣟ ࢔ࢺ ࣮ࣞ ࢽࣥࢢ ࡜࣡ࣈ ࣝ㸦 wobble㸧࣮࣎ࢻ
ࢆ౑⏝ࡋࡓࢺ ࣮ࣞࢽࣥ ࢢ㸪୙Ᏻᐃ࡞ ࣐ࢵࢺୖ ࡛ࡢࢺ࣮ࣞࢽ ࣥࢢࢆྲྀ ࡾධࢀࡓⅬ
࡟࠶ࡿ㸬ࣉࣞ ࢩ࣮ࢬࣥ ࡣ 1 ᅇ 15 ศ㸪 㐌 3 ᅇ 㸪7 㐌㛫㸪࢖ࣥ ࢩ࣮ࢬ ࣥࡣ 1 ᅇ 15
ศ㸪㐌 1 ᅇ㸪41 㐌㛫⾜ ࢃࡏࡓ㸬௓ධ ⤖ᯝࡣ㸦 ⾲ 2㸧㸪௓ධ๓ࡢ യᐖⓎ ⏕⋡ 0.14/1000
PHs㸪௓ධ 1 ᖺ┠ ࡢയᐖ Ⓨ⏕⋡ 0.13/1000 PHs㸪௓ධ 2 ᖺ┠ࡢയᐖ Ⓨ⏕ ⋡ 0.09/1000
PHs ࡜࡞ࡾ㸪ῶᑡഴྥ ࡀ☜ㄆࡉࢀࡓ ࡀ᭷ព ᕪ ࡣࡳࡽࢀ࡞࠿ ࡗࡓ 㸬ࡋ ࠿ࡋ㸪࢚ࣜ
࣮ࢺ⩌࡟࠾࠸ ࡚㸪ࣉࣟ ࢢ࣒ࣛࢆ᏶㐙 ࡋࡓ⩌࡜ ᮍ᏶㐙 ࡢ⩌ࢆ ẚ㍑ ࡋࡓ ሙྜ㸪᏶㐙
⩌࡟࠾࠸࡚᭷ ព࡞ῶᑡ ࡀ ㄆࡵࡽࢀࡓ 㸬
8. Mandelbaum ࡽ㸦 Mandelbaum et al., 2005㸧
ࡇ ࡢ ࣉ ࣟ ࢢ ࣛ ࣒ ࡣ 㸪 ዪ Ꮚ ࢧ ࢵ ࢝ ࣮ 㑅 ᡭ ࢆ ᑐ ㇟ ࡜ ࡋ ࡓ ͆ PEP program: prevent
injury and enhancement performance program ͇ ࡜ ࡋ ࡚ ᥦ ၐ ࡉ ࢀ ࡓ ࡶ ࡢ ࡛ ࠶ ࡿ
[Mandelbaum et al., 2005]㸬1041 ྡࢆᑐ㇟࡟ 㸪 2 ᖺ㛫ࡢ௓ධ ㄪᰝࢆ ⾜ࡗࡓ㸬 1 ᖺ
┠ࡣ௓ධ ⩌ 1,042 ྡ㸪ࢥࣥࢺ࣮ࣟࣝ ⩌ 1,902 ྡ㸪2 ᖺ┠ࡣ௓ ධ⩌ 844 ྡ㸪ࢥࣥࢺ
࣮ࣟࣝ⩌ 1,913 ྡ࡛࠶ࡗࡓ㸬ࢺ࣮ࣞ ࢽࣥࢢ ࡣ ⚄⤒➽༠ㄪᛶ ࡢྥୖࢆ ≺࠸࡜ࡋࡓ
ࡶࡢ࡛࠶ࡾ㸪 ࣉࣛ࢖࢜ ࣓ࢺࣜ ࢡࢫ㸪 ࣂࣛࣥࢫ 㸪 ➽ຊ㸪࢔ࢪ ࣜࢸ࢕ 㸪 ᰂ㌾ᛶ࡛࠶
18
ࡾ㸪ࡑࡢ࡯࠿ ࣅࢹ࢜ࢸ ࣮ࣉ࡟ࡼࡿᣦ ᑟࡶྵࡲ ࢀ࡚࠸ࡿ㸬ࡲ ࡓ㸪ࡇࡢ ࣉࣟࢢ࣒ࣛ
ࡢ≉ᚩࡣ㸪࢛࢘ ࣮࣑ࣥ ࢢ࢔ࢵࣉ᫬࡟ ᑟධࡋ࡚ ࠸ࡿ Ⅼ࡟࠶ࡿ㸬1 ᅇ 20 ศ㸪㐌 3 ᅇ
ࢆࢩ࣮ࢬࣥᮇ 㛫୰࡟⾜ ࡗࡓ㸬 ௓ධ⤖ ᯝࡣ 㸦 ⾲ 2㸧㸪௓ධ 1 ᖺ┠ࡣ௓ධ⩌ࡢയᐖ
Ⓨ⏕⋡ 0.05/1000 AEs㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ࡢ യ ᐖⓎ⏕⋡ 0.47/1000 AEs㸪௓ධ 2 ᖺ
┠ ࡣ 㸪 ௓ ධ ⩌ ࡢ യ ᐖ Ⓨ ⏕ ⋡ 0.13/1000 AEs 㸪 ࢥ ࣥ ࢺ ࣟ ࣮ ࣝ ⩌ ࡢ യ ᐖ Ⓨ ⏕ ⋡
0.51/1000 AEs ࡜࡞ࡾ 㸪࠸ࡎࢀࡢ ᖺࡶ᭷ព ࡟ ῶᑡࡉࡏࡓ 㸬ࡲࡓ 㸪 2 ᖺ㛫ࡢ⥲യᐖ
Ⓨ⏕⋡࡟ࡘ࠸ ࡚ࡶ㸪௓ ධ⩌ 0.09/1000 AEs㸪ࢥࣥࢺ࣮ࣟࣝ ⩌ 0.49/1000 AEs ࡛᭷
ព࡟ῶᑡࡉࡏ ࡓ㸬PEP program ࡣࠊMandelbaum ࡽࡢࢢࣝ ࣮ࣉ࡜ F-MARC㸦FIFA
Medical Assessment and Research Centreࠊᅜ㝿ࢧࢵ࣮࢝㐃┕ ་ Ꮫホ ౯◊✲ࢭࣥࢱ
࣮㸧࡜ࡢඹྠ ࡛సᡂࡉ ࢀ ࡚࠾ࡾ㸪F-MARC ࠿ ࡽ 2003 ᖺ࡟ࠕThe 11ࠖ㸪2006 ᖺ
࡟ࠕThe 11+ࠖ࡜࠸ࡗࡓ ㊊㛵⠇ࡸ⭸㛵 ⠇യᐖண 㜵ࣉࣟࢢ࣒ࣛ ࡀⓎ⾲ࡉ ࢀ ࡚࠸ࡿ[బ
㔝ᮧ, 2013-2]㸬
9. Olsen ࡽ㸦Olsen et al., 2005㸧
⏨ዪࣁࣥࢻ ࣮࣎ࣝ㑅 ᡭࢆᑐ㇟࡜ࡋ 㸪௓ධ ⩌ 958 ྡ㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ 879 ྡࢆ
ㄪᰝࡋࡓ㸬ࢺ ࣮ࣞࢽࣥ ࢢ ࡣࣉࣛ࢖࢜ ࣓ࢺࣜ ࢡ ࢫ㸪ࣂࣛࣥࢫ 㸪➽ຊ࡛ ࠶ࡿ㸬ࡇࡢ
ࣉࣟࢢ࣒ࣛࡢ ≉ᚩࡣ㸪 ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ᫬ ࡟ ྲྀࡾධࢀ࡚ ࠸ࡿ ࡇ࡜ ࡜㸪ࣂࣛࣥ
ࢫࢺࣞ ࣮ࢽࣥ ࢢ࡟ ࠾࠸ ࡚㸪࣡ ࣈࣝ㸦 wobble㸧 ࣮࣎ࢻ ࡸ୙Ᏻ ᐃ࡞ ࣐ࢵ ࢺࢆ౑ ⏝ࡋ
ࡓࢺ࣮ࣞࢽࣥ ࢢࢆྲྀࡾ ධࢀࡓ ࡇ࡜㸪 ࡉࡽ࡟ ࣛ ࣥࢽࣥࢢ㸪࢝ ࢵࢸ࢕ࣥ ࢢ㸪ࢪࣕࣥ
ࣉ࠾ࡼࡧ╔ᆅ ືస᫬ࡢ ⭸ 㛵⠇࡜㊊㒊 ࡢືࡁ ࡟ ᑐࡍࡿព㆑ࢆ ᙉㄪࡉࡏ ࡚⾜ࢃࡏࡓ
Ⅼ࡟࠶ࡿ㸬1 ᅇ 15㹼 20 ศ㸪㐌 1 ᅇ 㸪32 㐌㛫ࡢ ࣉࣟࢢ࣒࡛ࣛ 㸪௓ධ⤖ ᯝࡣ㸦⾲ 2㸧㸪
௓ධ⩌࡛ 3 ౛㸪ࢥ ࣥࢺ ࣮ࣟࣝ⩌ ࡛ 14 ౛Ⓨ⏕ ࡋ㸦ෆ㸪PCL 2 ౛㸪MCL 1 ౛Ⓨ⑕㸧㸪
᭷ព࡟ῶᑡࡉ ࡏࡓ㸬
10. Peterson ࡽ㸦Petersen et al., 2005㸧
ዪᏊࣁࣥࢻ ࣮࣎ࣝࢆ ᑐ㇟࡟㸪௓ධ ⩌ 134 ྡ㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ 142 ྡࢆᑐ㇟࡜
ࡋࡓ㸬ࢺ࣮ࣞ ࢽࣥࢢࡣ 㸪 ࣉࣛ࢖࣓࢜ ࢺࣜ ࢡࢫ 㸪ࣂࣛࣥࢫࡢ せ⣲ࢆྵ ࢇࡔࡶࡢ࡛
࠶ࡿ㸬ࡇࡢࣉ ࣟࢢ࣒ࣛ ࡢ≉ᚩࡣ㸪ࣂ ࣛࣥࢫ ࣎ ࣮ࢻࢆ౑⏝ࡋ ࡓࣂࣛࣥ ࢫࢺ࣮ࣞࢽ
ࣥࢢ࡜ࢪࣕࣥ ࣉࢺ࣮ࣞ ࢽࣥࢢࢆከ✀ ┠ ⾜ࡗ࡚ ࠸ࡿⅬ࡟࠶ࡿ 㸬ࣉࣞࢩ ࣮ࢬࣥࡣ 1
ᅇ 10 ศ࡛㐌 3 ᅇ ࢆ 8 㐌㛫㸪࢖ ࣥࢩ࣮ࢬ ࣥࡣ 1 ᅇ 10 ศ࡛㐌 1 ᅇ ࢆ 32 㐌㛫ᐇ᪋ࡋ
ࡓ㸬௓ධ⤖ᯝࡣ㸦 ⾲ 2㸧㸪௓ධ⩌࡛യᐖⓎ ⏕ ⋡ 0.04/1000 AEs㸪ࢥࣥࢺ࣮ࣟࣝ⩌
19
0.21/1000 AEs ࡛㸪᭷ពᕪࡣࡳࡽࢀ ࡞࠿ࡗࡓ 㸬
11. Pfeiffer ࡽ㸦Pfeiffer et al., 2006㸧
1439 ྡࡢ㧗ᰯዪ Ꮚ ࢧࢵ࣮࢝㸪ࣂࢫ ࢣࢵࢺ ࣮࣎ࣝ㸪ࣂ࣮ࣞ ࣮࣎ࣝ ࢆᑐ㇟࡟㸪௓
ධ⩌ 577 ྡ㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ 862 ྡࢆㄪᰝࡋ ࡓ㸬ࢺ࣮ࣞࢽ ࣥࢢࡣ ࣉ ࣛ࢖࣓࢜ࢺ
ࣜࢡࢫ㸪࢔ࢪ ࣜࢸ࢕ ࡢ せ⣲ࢆྵࡳ㸪 ከ✀┠ࡢ ࢪࣕࣥࣉ࡜࣍ ࢵࣆࣥࢢ 㸪࢔ࢪࣜࢸ
࢕ືసࢆ⾜ࢃ ࡏ࡚࠸ࡿ Ⅼ࡟ ≉ᚩࢆࡶ ࡘ㸬1 ᅇ 20 ศ࡛㐌 2 ᅇ㸪9 㐌㛫 ᐇ᪋ࡋࡓ㸬
௓ ධ ⤖ ᯝ ࡣ 㸦 ⾲ 2㸧 㸪 ௓ ධ ⩌ ࡛ യ ᐖ Ⓨ ⏕ ⋡ 0.167/1000 AEs㸪 ࢥ ࣥ ࢺ ࣟ ࣮ ࣝ ⩌
0.078/1000 AEs ࡛㸪᭷ ពᕪࡣࡳࡽࢀ ࡞࠿ࡗࡓ 㸬ࡇࡢࣉ ࣟࢢ࣒ࣛ ࡣ͆ Knee ligament
injury prevention program͇ 㸪KLIP program ࡜ ⛠ࡉࢀ࡚࠸ࡿ 㸬
12. Gilchrist ࡽ㸦Gilchrist et al., 2008㸧
኱ᏛዪᏊࢧ ࢵ࣮࢝㑅 ᡭ 1435 ྡࢆᑐ㇟ ࡟㸪௓ධ⩌ 583 ྡ㸪ࢥ ࣥࢺ ࣮ࣟࣝ⩌ 852
ྡࢆㄪᰝࡋࡓ 㸬ࢺ࣮ࣞ ࢽࣥࢢෆᐜࡣ 㸪 ࣉࣛ࢖ ࣓࢜ࢺࣜ ࢡࢫ 㸪➽ຊ㸪 ࣂࣛࣥࢫ㸪
ᰂ㌾ᛶ㸪࢔ࢪ ࣜࢸ࢕ࡢ せ⣲ࢆྵࢇࡔ ࡶࡢ㸦 PEP program㸪Mandelbaum et al., 2005㸧
࡛࠶ࡾ㸪≉ᚩ ࡣ㸪 ࢛࢘ ࣮࣑ࣥࢢ࢔ࢵ ࣉ᫬࡟ᑟ ධࡋ ࡓⅬ࡛࠶ ࡿ㸬ࡲࡓ 㸪ࡇࢀࡽࡢ
ࢺ࣮ࣞࢽࣥࢢ ࡟ຍ࠼࡚ ࣅࢹ࢜Ꮫ⩦ࡶ ⾜ࢃࢀࡓ 㸬㐌 3 ᅇ㸪12 㐌㛫ᐇ᪋ ࡋ 㸪௓ධ⤖
ᯝࡣ㸦⾲ 2㸧㸪 ௓ධ⩌ ࡛യᐖⓎ⏕ ⋡ 0.199/1000 AEs㸦7 ౛㸧㸪ࢥ ࣥࢺ࣮ࣟࣝ⩌
0.340/1000 AEs㸦18 ౛ 㸧㸪㠀᥋ゐᆺ യᐖ࡛௓ ධ⩌ 0.057/1000 AEs㸦 2 ౛㸧㸪ࢥࣥ
ࢺ࣮ࣟࣝ ⩌ 0.189/1000 AEs㸦10 ౛㸧࡛ῶ ᑡഴ ྥࢆ♧ࡋࡓࡀ 㸪᭷ព ᕪ ࡣࡳ ࡽࢀ࡞
࠿ࡗࡓ㸬ࡓࡔ ࡋ㸪⦎⩦ ᫬࡟Ⓨ⏕ࡋ ࡓ ACL യ ᐖࡢࡳ㸪௓ධ ⩌ 0.000/1000 AEs㸦0
౛㸧㸪ࢥࣥࢺ ࣮ࣟࣝ ⩌ 0.148/1000 AEs㸦6 ౛㸧࡛᭷ព࡞ ῶᑡࡀ ㄆ ࡵࡽࢀࡓ 㸬
13. Kinai ࡽ㸦Kinai et al., 2010㸧
ዪᏊࢧࢵ࢝ ࣮㑅 ᡭ 1506 ྡࢆᑐ㇟ ࡟㸪௓ධ ⩌ 729 ྡ㸦49 ࢳ࣮࣒ 㸧㸪 ࢥࣥࢺࣟ
࣮ࣝ⩌ 777 ྡ㸦48 ࢳ࣮࣒㸧ࢆㄪᰝࡋࡓ㸬ࢺࣞ ࣮ࢽࣥࢢෆᐜ ࡣ㸪ୗ⫥ ➽ຊ㸪యᖿ㸪
ࣂࣛࣥࢫࡢせ ⣲ࢆྵࢇ ࡛࠸ࡿ㸬ࣉࣞࢩ ࣮ࢬࣥ ࡛࠶ࡿ ᭱ึ ࡢ 3 ࢣ᭶㛫 ࡣ㐌 2 ᅇ㸪1
ᅇ 20㹼25 ศ㸪ࢩ࣮ࢬ ࣥ࡟ධࡗ࡚࠿ ࡽࡢ ⣙ 6 ࢣ᭶㛫ࡣ 㐌 1 ᅇᐇ᪋ࡋ ࡓ㸬௓ධ⤖ᯝ
ࡣ㸦⾲ 2㸧㸪௓ ධ⩌࡛ 0 ౛㸪ࢥࣥࢺࣟ ࣮ࣝ⩌ ࡛ 5 ౛Ⓨ⏕ࡋ ࡓ㸬
14. Waldén ࡽ㸦Waldén et al., 2012㸧
12㹼17 ṓࡢዪᏊ ࢧ ࢵ࣮࢝㑅 ᡭ 4564 ྡ㸦230 ࢳ࣮࣒㸧ࢆᑐ㇟ ࡟ 㸪௓ධ⩌ 2479
ྡ㸦121 ࢳ࣮࣒㸧㸪ࢥ ࣥࢺ࣮ࣟࣝ ⩌ 2085 ྡ㸦109 ࢳ࣮࣒㸧 ࢆㄪᰝ ࡋࡓ㸬 1 ᅇ 15
20
ศ࡛ᵓᡂࡉࢀ ࡚࠾ࡾ㸪 ⚄⤒➽༠ㄪᛶ ࡢྥୖࢆ ≺࠸࡜ࡋࡓ࢘ ࢛࣮࣑ࣥ ࢢ࢔ࢵࣉ ࣓
ࢽ࣮ࣗ࡜ࡋ࡚ ⾜ࢃࢀ 㸪 యᖿ㸪ࣂࣛࣥ ࢫ㸪ୗ⫥ ࢔ࣛ࢖࣓ࣥࢺ ࡟╔┠ࡋ ࡓෆᐜ࡛࠶
ࡗࡓ㸬ࢩ࣮ࢬ ࣥᮇ㛫୰ 㸪㐌 2 ᅇᐇ ᪋ࡋ㸪௓ ධ ⤖ᯝࡣ㸦 ⾲ 2㸧㸪௓ධ ⩌࡛ 7 ౛㸪
ࢥࣥࢺ࣮ࣟࣝ ⩌ ࡛ 14 ౛Ⓨ⏕ࡋ㸪᭷ ព࡟ῶᑡ ࡉࡏࡓ㸬
⾲2䚷ACL*യᐖண㜵䝥䝻䜾䝷䝮௓ධ䛸ACLയᐖⓎ⏕⋡
ᩥ⊩
യᐖⓎ⏕⋡
ẚ㍑ෆᐜ
Henning 䜙䠄2000䠅
௓ධ๓ vs. ௓ධᚋ䠄Ⓨ⏕௳ᩘ/ᖺ䠅
0.33
vs.
0.25
Ettinger 䜙䠄1995䠅
௓ධ๓ vs. ௓ධᚋ䠄Ⓨ⏕௳ᩘ/ᖺ䠅
Caraffa 䜙䠄1996䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝏䞊䝮/䝅䞊䝈䞁䠅
26.6
vs.
10.0
0.15
vs.
1.15†
Hewett 䜙䠄1999䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.12
vs.
0.12
vs.
0.43†
1.36
Söderman 䜙䠄2000䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 PHs*䠅
Hedit 䜙䠄2000䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ(๭ྜ)䠅
Myklebust 䜙䠄2003䠅
௓ධ1ᖺ┠ vs. 2ᖺ┠ vs. 3ᖺ┠䠄Ⓨ⏕௳ᩘ/1000 PHs*䠅
Mandelbaum 䜙䠄2005䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈1ᖺ┠䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.05
vs.
0.47†
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈2ᖺ┠䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.13
vs.
0.51†
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈2ᖺ㛫䛾⥲ィ䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.09
vs.
0.49†
3
vs.
1䠄2.4%䠅 vs. 8䠄3.1%䠅
0.14 vs. 0.13 vs. 0.09
Olsen 䜙䠄2005䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝅䞊䝈䞁䠅
Peterson 䜙䠄2005䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.04
vs.
14†
0.21
Priffer 䜙䠄2006䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.167
vs.
0.078
Gilchrist 䜙䠄2008䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.199
vs.
0.340
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠈⦎⩦᫬䛾䜏䠄Ⓨ⏕௳ᩘ/1000 AEs*䠅
0.000
vs.
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝅䞊䝈䞁䠅
0
vs.
0.148†
5
Waldén䜙䠄2012䠅
௓ධ⩌ vs. 䝁䞁䝖䝻䞊䝹⩌䠄Ⓨ⏕௳ᩘ/䝅䞊䝈䞁䠅
*ACL: anterior cruciate ligament.
*1000 AEs: 1,000 athlete-exposures.
*1000 PHs: 1,000 player-hours.
†: ᭷ព䛺ῶᑡ䛜ㄆ䜑䜙䜜䛶䛔䜛䠊
7
vs.
14†
Kinai 䜙䠄2010䠅
௨ୖ㸪ACL യᐖண㜵 ࣉ ࣟࢢ࣒ࣛ ࡟㛵 ࡍࡿඛ⾜ ㄽᩥ ࡢ୍㒊ࢆ ⤂௓ࡋࡓ ࡀ㸪ྛࣉ
ࣟࢢ࣒ࣛࡢᐇ ᪋࡟࠶ࡓ ࡗ࡚ࡣ㸪ྛ ➇ᢏࡢ ≉Ṧ ᛶ࡟ᑐᛂࡋࡓ ࣉࣟࢢࣛ ࣒ࢆసᡂࡋ 㸪
௓ධࡉࡏࡿࡇ ࡜ࡀ᥎ዡ ࡉࢀ ࡚࠸ࡿ㸬
➨ 2 ⠇ ᮏㄽ ᩥ ࡢᵓ ᡂ
ᮏㄽᩥࡣ㸪ࢫ࣏ ࣮ࢶ യ ᐖண㜵ࣔࢹࣝ ࡢ୍ࡘ࡜ ࡋ࡚ van Mechelen ࡽ㸦1992㸧ࡀ
ᥦၐࡍࡿ 4 ẁ 㝵ࣔࢹࣝ ࡢᅗᘧࢆ౛࡟ 㸪኱Ꮫ ዪ Ꮚࣛࢡࣟࢫࢆ ᑐ㇟ ࡜ࡋ ࡚㸪1㸧኱Ꮫ
ዪᏊࣛࢡࣟࢫ യᐖㄪᰝ 㸪2㸧യᐖண㜵ࢺ࣮ࣞࢽ ࣥࢢ ௓ධࡢࡓ ࡵࡢᇶ♏ ⓗ◊✲࡜ࡋ
࡚㸪㊊㊑ື సࡀືⓗ ୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ࡟ཬࡰ ࡍᙳ㡪࡟ࡘ࠸ ࡚ ࡢ ẚ㍑ ᳨ウ㸪3㸧ࣛ
21
ࢡࣟࢫ➇ᢏ≉ Ṧᛶࡢ୍ ࡘ࡛࠶ࡿࣛࢡ ࣟࢫࢫࢸ ࢕ࢵࢡࢆಖᣢ ࡋࡓ≧ែ ࡛ࡢࢻࣟࢵ
ࣉࣂ࣮ࢸ࢕࢝ ࣝࢪࣕࣥ ࣉ࡜࢝ࢵࢸ࢕ ࣥࢢືస ᫬ࡢືⓗୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺ ࡢẚ㍑
᳨ウ㸪4㸧ୗ ⫥യᐖண 㜵 ࢆ┠ⓗ࡜ࡋࡓ ࢫࢡ࣮ࣜ ࢽࣥࢢࢸࢫࢺ ࡢ ᭷⏝ᛶ ࡢ ᳨ド㸪5㸧
ୗ⫥യᐖண㜵 ࢺ࣮ࣞࢽ ࣥࢢࡀ㊊㊑ᶵ ⬟㸪㊊㒊 ࢔ࣛ࢖࣓ࣥࢺ 㸪 㟼ⓗ࠾ ࡼࡧືⓗୗ
⫥ࣂࣛࣥࢫ⬟ ຊ࡟ཬࡰ ࡍᙳ㡪㸪 ࡑࡋ ࡚ 6㸧ୗ ⫥യᐖண㜵ࢺ ࣮ࣞࢽࣥ ࢢࡀ኱Ꮫዪ
Ꮚࣛࢡࣟࢫࡢ യᐖⓎ⏕ ⋡࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚ ᳨ウ᳨࣭ド ࡍࡿ ෆᐜ ࡟࡞ࡗ࡚࠸
ࡿ㸬ࡲࡓ㸪യ ᐖ࡟ࡘ࠸ ࡚ࡣ㸪 ㊊㛵⠇ യᐖ ࡜ ACL യᐖ࡟↔Ⅼࢆ ᙜ࡚ ࡚⾜ࡗࡓ 㸬
➨ 1 ❶࡛ࡣ㸪 ࢫ࣏࣮ࢶ യᐖண㜵ࡢྲྀ ࡾ⤌ࡳ㸪 യᐖⓎ⏕せᅉ 㸪യᐖண 㜵ࣉࣟࢢ
࣒ࣛ࡟ࡘ࠸࡚ ⤂௓ࡋ㸪 ᮏ❶᭱ᚋ࡟࡚ ᮏㄽᩥࡢ ᵓᡂ࡟ࡘ࠸࡚ ㏙࡭࡚࠸ ࡿ㸬 ➨ 2 ❶
࡛ࡣ㸪യᐖࡢ 㒊఩ 㸪✀ 㢮㸪ཎᅉ➼ࢆ ᫂ࡽ࠿࡟ ࡍࡿ࡯࠿㸪യ ᐖⓎ⏕ᩘ ࡸയᐖⓎ⏕
⋡㸪㔜⑕ᗘ➼ ࡢ኱Ꮫዪ Ꮚࣛࢡࣟࢫࡢ യᐖࡢᐇ ែ ࢆ᫂ࡽ࠿࡟ ࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ࡋ
࡚㸪኱ᏛዪᏊ ࣛࢡࣟࢫ ࡢ 2 ᖺ㛫ࡢ യᐖㄪᰝ ࢆ ⾜ࡗࡓ㸦◊ ✲ 1㸧 㸬 ➨ 3 ❶࡛ࡣ㸪
ୗ⫥യᐖண㜵 ࢺ࣮ࣞࢽ ࣥࢢ௓ධ᳨ウ ࡢࡓࡵࡢ ᇶ♏ⓗ◊✲࡜ ࡋ࡚㸪 ㊊ ㊑㛤᤼⬟࠾
ࡼࡧ㊊㊑㛤᤼ᣦ♧ࡀືⓗୗ⫥࢔ࣛ࢖࣓ࣥࢺ࡟ཬࡰࡍᙳ㡪 㸫㊊㊑㛤᤼ᣦ♧ୗࡢ
∦⬮ࢫࢡ࣡ࢵ ࢺ㸪∦⬮ ࢻࣟࢵࣉࣛࣥ ࢹ࢕ࣥࢢ 㸪࢝ࢵࢸ࢕ࣥࢢ ືస࡛ ࡢศᯒ㸫 ࡟
ࡘ࠸࡚ẚ㍑᳨ ウࡋࡓ 㸦 ◊✲ 2㸧㸬➨ 4 ❶࡛ࡣ㸪≉࡟㔜⑕ᗘ ࡢ㧗࠸ዪ Ꮚࣛࢡࣟࢫ
യᐖࡢ୍ࡘ࡛ ࠶ࡿ ACL യᐖ࣓࢝ࢽ ࢬ࣒ࢆ᫂ ࡽ࠿࡟ࡍࡿࡇ ࡜ ࢆ┠ⓗ ࡜ࡋ࡚㸪ᇶ ♏
ⓗ◊✲࡜ࡋ࡚ ࣛࢡࣟࢫ ࢫࢸ࢕ࢵࢡࡢ ಖᣢࡸ᧯ సࡀࢻࣟࢵࣉ ࣂ࣮ࢸ࢕ ࢝ࣝ ࢪࣕࣥ
ࣉ᫬ࡢୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺ࡟ཬࡰࡍᙳ 㡪 㸦◊ ✲ 3㸧࡜ࣛࢡ ࣟࢫࢫࢸ ࢕ࢵࢡࡢಖᣢ
ࡢ᭷↓ࡀ࢝ࢵ ࢸ࢕ࣥࢢ ືస᫬ࡢୗ⫥ ࢟ࢿ࣐ࢸ ࢕ࢡࢫ࣭࢟ࢿ ࢸ࢕ࢡࢫ ࡟ཬࡰࡍᙳ
㡪㸦◊✲ 4㸧࡟ࡘ࠸ ࡚ ẚ㍑᳨ドࢆ⾜ ࡗࡓ㸬 ➨ 5 ❶࡛ࡣ㸪 ୗ⫥യ ᐖ ண㜵ࡢࡓࡵ ࡢ
ࢫࢡ࣮ࣜࢽࣥ ࢢࢸࢫࢺ ࡢ୍⪃ᐹ࡜ࡋ ࡚㸪㊊㊑ ᢕᥱຊ࡜㟼ⓗ ࠾ࡼࡧື ⓗࣂࣛࣥࢫ
⬟ຊ࡜ࡢ㛵㐃 ᛶ㸦◊ ✲ 5㸧㸪ࡑࡋ ࡚ୗ⫥ᙧ ែ㸪ୗ⫥➽ຊ 㸪㟼ⓗୗ ⫥࢔ࣛ࢖࣓ࣥ
ࢺࡸୗ⫥㛵⠇ ྍືᇦ ࡜ ࢻࣟࢵࣉࣂ࣮ ࢸ࢕࢝ࣝ ࢪࣕࣥࣉ᫬ࡢ ୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࡜
ࡢ㛵㐃ᛶ㸦◊✲ 6㸧 ࡟ ࡘ࠸᳨࡚ドࡍ ࡿࡇ࡜࡜ ࡋࡓ㸬➨ 6 ❶࡛ࡣ㸪 ୗ⫥യᐖண㜵
ࢺ࣮ࣞࢽࣥࢢ ࡢ௓ධࢆ ⾜ ࠸㸪ୗ ⫥യᐖண 㜵ࢺ ࣮ࣞࢽࣥࢢ ࡀ ㊊㊑ᶵ⬟ 㸪㊊㒊ᙧ ែ㸪
㟼ⓗ࠾ࡼࡧື ⓗࣂࣛࣥ ࢫ⬟ຊ ࡟ཬࡰ ࡍᙳ㡪 㸦 ◊✲ 7㸧࡜㸪യᐖⓎ⏕ 㢖ᗘ ࡟ཬࡰ
ࡍᙳ㡪㸦◊ ✲ 8㸧࡟ࡘ ࠸࡚ ௓ධຠᯝ ᳨ドࢆ ⾜ ࡗࡓ㸬ࡑࡋ࡚ ᭱⤊❶࡛ ࠶ࡿ➨ 7㸪8
❶࡟࠾࠸࡚ᮏ ◊✲ࡢ ⥲ ྜ⪃ᐹ㸪ࡲ࡜ ࡵ࡜ࡋࡓ 㸬
22
➨2❶
኱ᏛዪᏊࣛࢡࣟࢫࡢയᐖㄪᰝ
23
◊ ✲ 1 ኱ Ꮫ ዪᏊ ࣛࢡ ࣟࢫ ࡢ 2 ᖺ㛫 ࡢ യᐖ ㄪ ᰝ
2-1-1. ⥴ゝ
ࣛࢡࣟࢫ➇ᢏ ࡣ ⌧ᅾ㸪 ⡿ᅜ࡛᭱ࡶ┒ ࢇ࡟⾜ࢃ ࢀ࡚ ࠾ࡾ㸪㏆ ᖺࡢ➇ᢏ ேཱྀ ࡢቑ
ຍࡶⴭࡋ࠸[US Lacrosse, 2011]㸬ᮏ㑥࡟࠾ ࠸ ࡚ ࡣ㸪≉࡟኱ Ꮫࣛࢡࣟ ࢫ➇ᢏࡀ┒ࢇ
࡟⾜ࢃࢀ࡚࠾ ࡾ 㸪 ㏆ᖺ ࡑࡢ➇ᢏேཱྀ ࡢቑຍࡶ ⴭࡋ࠸㸬⡿ᅜ ࡢࣛࢡࣟ ࢫ➇ᢏேཱྀ
ࡣ㸪2011 ᖺࡢⓏ㘓 ⪅ ᩘ [US Lacrosse, 2011]ࡀ 684,730 ྡ㸦⏨ Ꮚ 424,169 ྡ㸪ዪᏊ
260,561 ྡ㸧࡛࠶ࡾ 㸪࢝ࢸࢦู࣮ࣜ ࡛ࡳࡿ࡜ 㸪࣮ࣘ ࢫ 361,275 ྡ㸦 ⥲Ⓩ㘓 ⪅ᩘࡢ
52.8㸣㸧㸪㧗ᰯ⏕ 275,281 ྡ㸦40.2㸣㸧㸪኱Ꮫ ⏕ 33,929 ྡ㸦5.0㸣㸧㸪♫఍ே 14,065
㸦2.1㸣㸧㸪ࣉ ࣟ 180 ྡ㸦0.1㸣ᮍ‶㸧 ࡛࠶ ࡿ㸬኱Ꮫ⏕ࡢ ෆヂ࡟ࡘ ࠸࡚ࡣ㸪 ⏨Ꮚ
20,397 ྡ㸦኱ Ꮫ⏕Ⓩ㘓 ⪅ᩘࡢ 60.1㸣㸧㸪ዪ Ꮚ 13,532 ྡ㸦39.9㸣㸧࡛࠶ࡿ㸬ᮏ㑥
ࡢࣛࢡࣟࢫ➇ ᢏேཱྀ࡟ ࡘ࠸࡚ࡣ㸪2011 ᖺࡢ⥲Ⓩ㘓⪅ᩘࡣ኱ Ꮫ⏕࡜♫ ఍ேࡢ࢝ࢸ
ࢦ࣮ࣜࢆྜࢃ ࡏ࡚ 14,856 ྡ㸦㧗ᰯ⏕௨ୗࡢ Ⓩ 㘓⪅ᩘࡣ☜ㄆ ࡉࢀ࡚࠸ ࡞࠸㸬ࡲࡓ 㸪
ࣉࣟࡢ࢝ࢸࢦ ࣮ࣜࡣᏑ ᅾࡋ࡞࠸ 㸧࡛ ࠶ࡾ㸪ࡑ ࡢෆヂࡣ⏨Ꮚ 5,729 ྡ㸦⥲Ⓩ㘓⪅
ᩘࡢ 38.6㸣㸧㸪ዪᏊ 9,127 ྡ㸦61.4㸣㸧࡛࠶ ࡿ㸬ࡲࡓ㸪⥲Ⓩ㘓⪅ ᩘ ࡢ࠾࠾ࡼ ࡑ 8
๭ࡀ኱Ꮫ⏕㸪2 ๭ ࡀ♫ ఍ே࡜ ᥎ᐃࡉ ࢀ࡚࠾ࡾ 㸪኱Ꮫ⏕Ⓩ㘓 ⪅ᩘࡣ 12,000 ྡ⛬ᗘ
࡜⪃࠼ࡽࢀࡿ 㸬ࡉࡽ ࡟ ࡑࡢ 45㸣⛬ᗘࡀ⏨ Ꮚ㸪55㸣⛬ᗘࡀዪ Ꮚ࡜᥎ᐃ ࡉࢀ࡚࠾ࡾ 㸪
኱Ꮫ⏕ዪᏊ➇ ᢏேཱྀ ࡢ ᪉ࡀࡸࡸከ࠸ ഴྥ࡟࠶ ࡿ 㸦᥎ᐃⓏ㘓 ᩘࡣ⏨ Ꮚ 5,400 ྡ㸪
ዪᏊ 6,600 ྡ⛬ᗘ㸧㸦 ⥲Ⓩ 㘓⪅ᩘ࠾ ࡼࡧ⏨ዪ ࡢⓏ㘓⪅ᩘ㸪 ྛ࢝ࢸࢦ ู࣮ࣜࡢⓏ
㘓⪅ᩘࡢ๭ྜ ࡢ᥎ᐃ࠾ ࡼࡧ኱Ꮫ⏕ࡢ ⏨ዪࡢⓏ 㘓⪅ᩘࡢ๭ྜ ࡢ᥎ᐃ࡟ ࡘ࠸࡚ࡣ᪥
ᮏࣛࢡࣟࢫ༠ ఍࠿ࡽࡢ ⫈ྲྀ࡟ࡼࡿ㸧 㸬࢝ࢸࢦ ู࣮ࣜࡢⓏ㘓 ⪅ᩘࢆࡳ ࡿ࡜㸪 ⡿ᅜ
࡛ࡣ࣮ࣘࢫ࠾ ࡼࡧ㧗ᰯ ⏕ࡢ➇ᢏேཱྀ ࡀᴟࡵ࡚ ከ࠸ ࡇ࡜ࡀఛ ࠼ࡿ 㸦ࣘ ࣮ࢫ࡜㧗ᰯ
⏕ࡢⓏ㘓⪅ᩘ ࢆྜࢃࡏ ࡚ ⥲Ⓩ㘓⪅ᩘ ࡢ 93.0㸣ࢆ༨ࡵࡿ㸧ࡀ㸪ᮏ㑥࡛ ࡣ኱Ꮫ⏕ࡢ
➇ᢏேཱྀࡀᴟ ࡵ࡚ከ࠸ ࡇ࡜ࡀ᥎ ࡉ ࢀ ࡚࠸ࡿ 㸬኱Ꮫ⏕ࡢ➇ ᢏேཱྀ࡟ ࡘ࠸࡚ ẚ㍑
ࡋ࡚ࡳࡿ࡜㸪 ⡿ᅜ 33,929 ྡ㸪ᮏ㑥 12,000 ྡ㸦᥎ᐃ㸧࡛ ࠶ ࡿ࡯࠿ 㸪⏨ዪู࡛ẚ
㍑ࡋ࡚ࡳࡿ࡜ 㸪ዪᏊࡣ ⡿ᅜ 13,532 ྡ㸪᪥ᮏ 6,600 ྡ㸦᥎ᐃ㸧࡛ ࠶ࡾ 㸪኱Ꮫ⏕ዪ
Ꮚࡢ࢝ࢸࢦࣜ ࣮ࡔࡅ࡛ ẚ㍑ࡍࡿ࡜㸪 ௚ࡢ࢝ࢸ ࢦ࣮ࣜ࡜ẚ࡭ ࡚ࡑࡢᕪ ࡣ ẚ㍑ⓗᑠ
ࡉ࠸࡜࠸࠼ࡿ 㸬
ࣛࢡࣟࢫࡣࢡ ࣟࢫ㸦 ࢫ ࢸ࢕ࢵࢡ㸧ࢆ᧯సࡋ ࡞ ࡀࡽ࣮࣎ࣝࢆ ࣃࢫ㸪࢟ ࣕࢵࢳࡋ㸪
24
┦ᡭࢦ࣮ࣝ࡟ ࢩ࣮ࣗࢺ ࢆࡋ࡚ᚓⅬࢆ ➇࠺➇ᢏ ࡛࠶ࡿࡀ 㸪ࣛࣥࢽ ࣥࢢ㸪ࢲࢵࢩࣗ㸪
࢝ࢵࢸ࢕ࣥࢢ 㸪ࢪࣕࣥ ࣉືస➼ࡶ ྜ ࢃࡏ࡚⾜ ࢃࢀ࡚࠸ࡿⅬ ࡀࣛࢡࣟ ࢫࡢ➇ᢏ≉
Ṧᛶ࡜࠸࠼ࡿ[Dick et al., 2007]㸬ࣛࢡࣟࢫ ➇ ᢏࡣ⏨ዪࡢࣝ ࣮ࣝࡀ␗ ࡞ࡾ㸪⏨Ꮚ
ࡣ࣓࣊ࣝࢵࢺ ࡸࣇ࢙࢖ ࢫ࣮࢞ࢻ㸪ࢩ ࣙࣝࢲ࣮ ࣃࢵࢻ㸪࢚ࣝ ࣮࣎ࣃࢵ ࢻ㸪࢔࣮࣒
ࣃࢵࢻ㸪ࢢࣟ ࣮ࣈ㸪࣐ ࢘ࢫ࣮࢞ࢻ➼ ࡢࣇࣝ⿦ ഛࡀ⩏ົ௜ࡅ ࡽࢀ࡚ ࠸ ࡿ࡯࠿㸪ࣉ
࣮ࣞ࡟ࡘ࠸࡚ࡣࢥࣥࢱࢡࢺࣉ࣮ࣞࡸࢫࢸ࢕ࢵࢡ࡟ࡼࡿጉᐖࡀ ㄆࡵࡽࢀ࡚࠸ࡿ
[National Collegiate Athletic Association, 2012]㸬୍᪉㸪ዪᏊࡣ࣐ ࢘ ࢫ࣮࢞ࢻࡢࡳ
㸦ᮏ㑥࡛ࡣ࢔࢖࣮࢞ࢻࡢ⿦╔࡟ࡘ࠸࡚࣮ࣝࣝつᐃ ࡉࢀ࡚࠸࡞࠸ࡀ㸪⡿ᅜ࡛ࡣ
2005 ᖺ࠿ࡽࡑࡢ⿦ ╔ ࡀ ⩏ົ௜ࡅࡽ ࢀ࡚࠸ࡿ 㸧࡛㸪௚ࡢ⿦ഛ ࡣ≉࡟ つᐃࡉ ࢀ࡚࠸
࡞࠸ࡀ㸪ࣉࣞ ࣮࡟ࡘ࠸ ࡚ࡣࢥࣥࢱࢡ ࢺࣉ࣮ࣞ ࡸᨾព࡞ࢫࢸ ࢕ࢵࢡ࡟ ࡼࡿ᥋ゐࡸ
ጉᐖࡣ⚗Ṇࡉ ࢀ࡚࠸ࡿ [Diamond and Gale., 2001; Hinton et al., 2005]㸬ࡑࡢࡼ ࠺࡞
࣮ࣝࣝࡢ㐪࠸ ࡀ࠶ࡿ࡞ ࠿࡛ 㸪≉࡟ዪ Ꮚࣛࢡࣟ ࢫ➇ᢏ ࡟㛵ࡍ ࡿയᐖሗ ࿌ࡀ㸪ᾏእ
࠿ࡽከᩘࡳࡽ ࢀࡿ [Dick et al., 2007; Hinton et al., 2005; Carter et al., 2010]㸬ඛ⾜
◊✲࡟ࡼࡿ࡜ 㸪യᐖ㒊 ఩࡟ࡘ࠸࡚ࡣ ୗ⫥ࡢയ ᐖࡀከࡃ [Dick et al., 2007; Hinton et
al., 2005; Carter et al., 2010; Matz and Nibbelink, 2007 ]㸪୰࡛ࡶ㊊㛵 ⠇ࡸ⭸㛵⠇ࡢ
യᐖࡀከ࠸ࡇ ࡜ [Dick et al., 2007; Hinton et al., 2005; Matz and Nibbelink, 2007]㸪
യᐖࡢ✀㢮࡟ ࡘ࠸࡚ࡣ ᤬᣸ࡀከ࠸ࡇ ࡜ࡀሗ࿌ ࡉࢀ࡚࠸ࡿ [Dick et al., 2007; Hinton et al., 2005]㸬ࡲࡓ㸪⭸๓༑Ꮠ㠌 ᖏ㸦 anterior cruciate ligament㸸௨ୗ㸪ACL㸧
യᐖࡢയᐖሗ ࿌ࡶ 」ᩘ ࡳࡽࢀࡿ[Mihata et al., 2006; Hootman et al., 2007] 㸬ࣛࢡ
ࣟࢫ➇ᢏ≉Ṧ ᛶࡢ୍ࡘ ࡛࠶ࡿࢫࢸ࢕ ࢵࢡࢆ౑ ⏝ࡋࡓ࣮࣎ࣝ ᧯స࡞࡝ ࡟ࡼ ࡾ㸪㑅
ᡭࡢ㌟య࡟⾪ ✺ࡋ࡚Ⓨ ⏕ࡍࡿᡴ᧞യ ᐖ [Diamond and Gale., 2001; Hinton et al.,
2005; Matz and Nibbelink, 2007; Lincoln et al., 2007]㸪ࡑࡢ௚㸪㢌 㒊 ࠾ࡼࡧ㢦 ࡬ࡢ
ᡴ ᧞ യ ᐖ ࡟ 㛵 ࡍ ࡿ ሗ ࿌ ࡶ ከ ᩘ ࡳ ࡽ ࢀ ࡿ [Dick et al., 2007; Diamond and Gale.,
2001; Matz and Nibbelink, 2007; Lincoln et al., 200 7; Caswell et al., 2012; Goldenberg and Hossler, 1995; Otago et al., 2007; Waicus and Amith, 2002; Webster et al.,
1999]㸬ࡑࡢ࡯࠿⬻ 㟈┞ [Marar et al., 2012]ࡢሗ࿌ࡶࡳࡽࢀ࡚ ࠸ࡿ㸬ࡋ ࠿ࡋ࡞ࡀࡽ 㸪
ࡇࢀࡽࡢከࡃ ࡢሗ࿌ࡣ ᾏእ࠿ࡽ࡟ࡼ ࡿࡶࡢ࡛ ࠶ࡾ㸪ᅜෆዪ Ꮚࣛࢡࣟ ࢫ➇ᢏࡢയ
ᐖሗ࿌ࡣᴟࡵ ࡚ᑡ࡞ࡃ 㸪ࡑࡢᐇែࡣ ᫂ࡽ࠿࡟ ࡉࢀ࡚࠸࡞࠸ 㸬 ➹⪅ࡽ ࡣᮏ◊✲࡟
ඛ❧ࡕ㸪኱Ꮫ ዪᏊࣛࢡ ࣟࢫࢆᑐ㇟࡜ ࡋࡓ 1 ᖺ 㛫ࡢയᐖㄪᰝ [బ㔝 ᮧ ࡽ , 2012-1]ࢆ
25
ሗ࿌ࡋ࡚࠸ࡿ ࡀ㸪 ᮏ◊ ✲࡟࠾࠸࡚ ࡣ 2 ᖺ㛫ࡢ യᐖㄪᰝࢆ ⾜ ࠸㸪 യᐖ ࡢ㒊఩㸪✀
㢮㸪ཎᅉࡢ࡯ ࠿㸪 ዪᏊ ࣛࢡࣟࢫ㑅ᡭ ࡢ യᐖࡢ ≉ᚩࢆ᫂ࡽ࠿ ࡟ࡍࡿࡇ ࡜ࢆ┠ⓗ࡜
ࡋ࡚⾜ࡗࡓ㸬
2-1-2. ᑐ㇟࡜᪉ἲ
1. ᑐ㇟
ᑐ㇟ࡣ㸪㛵ᮾ ኱ᏛዪᏊ ࣛࢡࣟࢫ࣮ࣜ ࢢ 1 㒊࡟ ᡤᒓࡍࡿ᯾኱ ᏛዪᏊࣛ ࢡࣟࢫ 㑅
ᡭ࡜ࡋ㸪ㄪᰝ ᮇ㛫 ࡣ 2010 ᖺ 4 ᭶࠿ ࡽ 2012 ᖺ 3 ᭶ࡲ࡛ ࡢ 2 ᖺ㛫࡛ ࠶ࡗࡓ㸬ᑐ㇟
ேᩘࡣ㸪1 ᖺ┠ 46 ྡ㸦 ᖹᆒᖺ㱋㸦 ±ᶆ‽೫ᕪ㸧
㸸20.1 ± 1.3 ṓ㸪㌟㛗㸸159.1 ± 5.2cm㸪
య㔜㸸53.1 ± 5.5kg㸪 ࣛࢡࣟࢫ➇ᢏ Ṕ 22.0 ± 16.3 ࣨ᭶㸧㸪2 ᖺ┠ 55 ྡ㸦ᖹᆒᖺ
㱋 19.5 ± 1.1 ṓ㸪㌟ 㛗 158.7 ± 4.9cm㸪య㔜 53.6 ± 5.4kg㸪ࣛ ࢡࣟࢫ➇ ᢏ Ṕ 22.6 ± 13.2
ࣨ᭶㸧࡛࠶ࡗ ࡓ㸬ᮏㄪ ᰝࢆᐇ᪋ࡍࡿ ๓࡟㸪඲ ᑐ㇟⪅࡟ᑐࡋ ࡚᪤ Ṕ ㄪᰝࢆ⾜ࡗ
ࡓ㸬ᑐ㇟⪅࡟ ࡣ஦๓࡟ ◊✲ࡢ┠ⓗࡸ ㄪᰝ᪉ἲ 㸪೔⌮ⓗ㓄៖ ➼࡟㛵ࡍ ࡿㄝ᫂ࢆ⾜
ࡗࡓ㸬ᮏ ◊✲ࡣ᪩ ✄⏣ ኱Ꮫ ேࢆᑐ㇟࡜ ࡍࡿ ◊✲࡟㛵ࡍࡿ ೔⌮ᑂᰝ ጤဨ఍ ࡢᢎㄆ
ࢆᚓ࡚ᐇ᪋ࡋ ࡓ㸦ᢎㄆ ␒ྕ 2010-037㸧㸬ᮏ◊ ✲࡟㛵ࡋ࡚㸪㈨㔠ᥦ౪ 㸪㞠⏝➼ࡢ
฼┈┦཯ࡣᏑ ᅾࡋ࡞࠸ 㸬 2. യᐖㄪᰝ㡯┠ ࡜᪉ ἲ
യᐖㄪᰝ㡯 ┠࡟ࡘ࠸ ࡚㸪 യᐖࡢ㒊 ఩㸪യᐖ ࡢ✀㢮㸪യᐖ ࡢཎᅉ ࡟ ࡘ࠸࡚ࡣ㸪
IOC injury surveillance system[Junge et al., 2008]࡟♧ࡋ࡚࠶ࡿ ྛ㡯┠ ࢆᇶ‽࡜ࡋ
ࡓ㸦യᐖࡢ㒊 ఩ࡢ㢦ࡢ 㡯ࡢࡳ㸪┠㸪㰯 㸪┠࣭㰯௨እࡢ㢦ࡢ ⟠ᡤ ࡢ 3 ࡘࡢ㡯࡟ศ
㢮ࡋࡓ(⾲ 2-2 ࢆཧ↷ )㸧㸬ࡑࡢ௚ࡢ ㄪᰝ㡯┠ ࡣ㸪⦎⩦᫬࣭ ヨྜ᫬ࡢ യᐖ㸪 ࣏ࢪ
ࢩࣙࣥ㸪യᐖ ࡢᅇᩘ㸪 ➇ᢏ᚟ᖐࡲ࡛ ࡢ ᮇ㛫㸪 ་⒪ᶵ㛵࡬ࡢ ཷデ࠾ࡼ ࡧᡭ⾡ࡢ᭷
↓࡛࠶ࡿ㸬Ⓨ ⏕ࡋࡓയ ᐖ࡟ᑐࡍࡿྛ 㡯┠ࡢุ ᩿ ࡣ㸪ࢢࣛ࢘ ࣥࢻୖ࡛ ࡢึᮇホ౯
ࡣࢳ࣮࣒ᑓᒓ ࡢᏛ⏕ࢺ ࣮ࣞࢼ࣮㸦ࢫ ࣏࣮ࢶ⛉ Ꮫ㒊ࢫ࣏࣮ࢶ ་⛉Ꮫ⛉ ࢺ࣮ࣞࢼ࣮
ࢥ࣮ࢫ࡟ᡤᒓ 㸧࡟ࡼࡗ ࡚⾜ࢃࢀ 㸪യ ᐖࡢᐇែ ࡀ᫂☜ ࡟ุ᩿ ฟ᮶࡞࠸ ሙྜࡣ㸪኱
Ꮫෆ࡟タ⨨ࡉ ࢀ࡚࠸ࡿ ࢫ࣏࣮ࢶ་⛉ Ꮫࢡࣜࢽ ࢵࢡ ࡟࠾࠸࡚ 㸪ᩚᙧእ ⛉་㸦ࢫ࣏
࣮ࢶࢻࢡࢱ࣮ 㸧㸪⌮Ꮫ ⒪ἲኈ㸪᪥ᮏ య⫱༠఍ බㄆ ࢔ࢫࣞࢸ ࢕ࢵࢡࢺ ࣮ࣞࢼ࣮ 㸪
NATABOC-ATC ࡟ࡼࡾ⾜ࢃࢀࡓ 㸬യᐖࡢ ᐃ ⩏ࡣ㸪ࠕࣛࢡࣟ ࢫࡢ⦎ ⩦࠾ࡼࡧヨྜ
୰࡟Ⓨ⏕ࡋࡓ እയ࠾ࡼ ࡧ㞀ᐖ࡜ࡋ㸪 1 ᪥௨ୖ ࡢ⦎⩦࠾ࡼࡧ ヨྜࢆఇ ࡲ࡞ࡅࢀࡤ
26
࡞ࡽ࡞࠿ࡗࡓ ࡶࡢࠖ࡜ ࡋࡓ㸬➇ᢏ᚟ ᖐࡲ࡛ࡢ ᮇ㛫࡟ࡘ࠸࡚ ࡣ㸪ࠕയ ᐖⓎ⏕᪥࠿
ࡽ㸪ࣛࢡࣟࢫ ࡢ඲࡚ࡢ ⦎⩦࠾ࡼࡧヨ ྜ࡟ཧຍ ฟ᮶ࡓ᪥ࡲ࡛ ࡢ᪥ᩘࠖ ࡜ࡋࡓ㸬ࡍ
࡭ ࡚ ࡢ യ ᐖ Ⓨ ⏕ ⋡ ࡣ 㸪 1,000 athlete–hours 㸦 ௨ ୗ 㸪 1000 AHs 㸧 ࠾ ࡼ ࡧ 1,000
athlete–exposures㸦௨ୗ㸪1000 AEs㸧ࢆ༢఩ ࡜ࡋ࡚⟬ฟࡋ ࡓ㸬ィ⟬ ᘧࡣ௨ୗࡢ࡜
࠾ࡾ࡛࠶ࡿ㸬
1000 AHs =㸦⥲യᐖⓎ ⏕ᩘ㸭total AHs㸧×1000
1000 AEs =㸦⥲യᐖⓎ ⏕ᩘ㸭total AEs㸧×1000
1 AHs ࡣ㸪୍ேࡢ㑅 ᡭ ࡀ ⦎⩦࠾ࡼࡧ ヨྜ ࡟ 1 ᫬㛫ཧຍࡋࡓ ࡇ࡜ࢆ♧ ࡋ㸪1 AEs
ࡣ㸪୍ே㑅ᡭ ࡀ⦎⩦࠾ ࡼࡧヨྜ ࡟ 1 ᅇཧຍࡋ ࡓࡇ࡜ࢆ♧ࡍ 㸬 ࡞࠾㸪 95㸣ಙ㢗༊
㛫[Jung et al., 2006]ࡶྵࡵ࡚⟬ฟࡋ ࡓ㸬
2-1-3.
⤖ᯝ
1. യ ᐖ Ⓨ ⏕ ⋡
യᐖⓎ⏕ᩘ࠾ ࡼࡧയᐖ Ⓨ⏕⋡ࢆ ⾲ 2-1 ࡟♧ࡍ 㸬2 ᖺ㛫ࡢ total AHs ࠾ࡼࡧ total
AEs ࡣ㸪27,621 ࠾ࡼࡧ 13,437 ࡛࠶ࡾ 㸪⦎⩦࣭ヨྜู࡛ࡳࡿ ࡜㸪⦎⩦ ᫬ 26,213 AHs
࠾ࡼࡧ 11,791 AEs㸪 ヨྜ᫬ 1,408 AHs ࠾ࡼ ࡧ 1,646 AEs ࡛࠶ࡗࡓ 㸬⥲ യᐖⓎ⏕
ᩘࡣ㸪309 ౛࡛⥲യᐖ Ⓨ⏕⋡ࡣ 11.19 (9.94 — 12.43)/1000 AHs㸦࢝ࢵ ࢥෆࡣ 95㸣
ಙ㢗༊㛫ࢆ♧ ࡍ 㸧 ࠾ࡼ ࡧ 23.00 (20.43 — 25.56)/1000 AEs㸪⦎⩦࣭ ヨྜู࡛ࡳࡿ
࡜ 㸪 ⦎ ⩦ ᫬ 283 ౛ 㸦 ⥲ യ ᐖ Ⓨ ⏕ ᩘ ࡢ 91.6㸣 㸧 㸪 യ ᐖ Ⓨ ⏕ ⋡ ࡣ 10.80 (9.54 —
12.05)/1000 AHs ࠾ ࡼ ࡧ 24.00 (21.20 — 26.80)/1000 AEs㸪ヨྜ᫬ 26 ౛㸦8.4㸣㸧㸪
യᐖⓎ⏕⋡ ࡣ 18.46 (11.36 — 25.55)/1000 AHs ࠾ࡼࡧ 15.80 (9.72 — 21.87)/1000
AEs ࡛࠶ࡗࡓ㸬ኳ ೃู ࡛ࡳࡿ࡜ 㸪ᬕࢀࡲ ࡓࡣ ᭎ࡾࡢ᫬ ࡢ total AHs ࠾ࡼࡧ total AEs
ࡣ㸪25,113 ࠾ࡼࡧ 12,015 ࡛࠶ࡾ㸪⦎⩦࣭ ヨ ྜู࡛ࡳࡿ࡜ 㸪 ⦎⩦ ᫬ 23,734 AHs
࠾ࡼࡧ 10,441 AEs㸪 ヨྜ᫬ 1,379 AHs ࠾ࡼ ࡧ 1,574 AEs ࡛࠶ࡗࡓ 㸬㞵ࡲࡓࡣ㞷
ࡢ᫬ࡢ total AHs ࠾ࡼ ࡧ total AEs ࡣ㸪2,508 ࠾ࡼࡧ 1,422 ࡛࠶ࡾ㸪 ⦎⩦࣭ヨྜู
࡛ࡳࡿ࡜㸪⦎ ⩦᫬ 2,478 AHs ࠾ࡼࡧ 1,350 AEs㸪ヨྜ ᫬ 30 AHs ࠾ࡼࡧ 72 AEs
࡛࠶ࡗࡓ㸬യ ᐖⓎ⏕ᩘ ࡣ 㸪ᬕࢀࡲࡓ ࡣ᭎ࡾࡢ ᫬࡛ 282 ౛㸪യᐖⓎ ⏕⋡ࡣ 11.23
(9.92 — 12.54)/1000 AHs ࠾ࡼࡧ 23.47 (20.73 — 26.21)/1000 AEs㸪⦎⩦࣭ヨྜู
࡛ࡳࡿ࡜ 㸪⦎⩦ ᫬ 257 ౛㸦91.1㸣㸧㸪യᐖⓎ ⏕ ⋡ࡣ 10.83 (9.50 — 12.50)/1000 AHs
27
࠾ࡼࡧ 24.61 (21.61 — 27.62)/1000 AEs㸪ヨྜ᫬ 25 ౛㸦8.9㸣㸧㸪 യᐖⓎ⏕⋡ࡣ
18.13 (11.02 — 25.24)/1000 AHs ࠾ࡼࡧ 15.88 (9.66 — 22.11)/1000 AEs ࡛࠶ࡗࡓ㸬
㞵ࡲࡓࡣ㞷ࡢ ᫬ࡢയᐖ Ⓨ⏕ᩘࡣ 27 ౛㸪 യᐖ Ⓨ⏕⋡ࡣ 10.77 (6.70 — 14.83)/1000
AHs ࠾ࡼࡧ 18.99 (11.83 — 26.15)/1000 AEs㸪⦎⩦࣭ヨྜู࡛ࡳࡿ ࡜ 㸪⦎⩦ ᫬ 26
౛㸦96.3㸣㸧㸪യ ᐖⓎ⏕ ⋡ࡣ 10.49 (6.46 — 14.52)/1000 AHs ࠾ࡼࡧ 20.00 (12.31 —
27.69)/1000 AEs㸪ヨྜ ᫬ 1 ౛㸦3.7㸣㸧㸪യᐖ Ⓨ⏕⋡ࡣ 33.59 (-33.25 — 99.44)/1000
AHs ࠾ࡼࡧ 13.89 (-13.33 — 41.11)/1000 AEs ࡛࠶ࡗࡓ㸬
28
29
2㸬യᐖࡢ㒊఩ู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡
യᐖࡢ㒊఩ู ࡟ࡼࡿയ ᐖⓎ⏕ᩘ࠾ࡼ ࡧയᐖⓎ ⏕⋡ࢆ ⾲ 2-2 ࡟♧ࡍ㸬 ⥲യᐖⓎ
⏕ᩘ 309 ౛୰㸪᭱ ࡶከ ࠸യᐖ㒊఩ࡣ ㊊㛵⠇ ࡛ 62 ౛㸦⥲യ ᐖⓎ⏕ ᩘࡢ 20.1㸣㸧㸪
യᐖⓎ⏕⋡ ࡣ 2.24 (1.69 — 2.80)/1000 AHs ࠾ ࡼࡧ 4.61 (3.47 — 5.76)/1000 AEs ࡛
࠶ࡗࡓ㸬ḟ࡟ ⭸㛵⠇ ࡛ 45 ౛㸦14.6㸣㸧㸪 Ⓨ⏕⋡ࡣ 1.63 (1.15 — 2.11)/1000 AHs
࠾ࡼࡧ 3.35 (2.37 — 4.33)/1000 AEs ࡛࠶ࡗࡓ 㸬௨ୗ㸪኱⭣㒊 ࡛ 33 ౛㸦10.7㸣㸧㸪
Ⓨ⏕⋡ࡣ 1.20 (0.79 — 7.04)/1000 AHs ࠾ࡼࡧ 2.46 (1.62 — 3.29)/1000 AEs㸪ୗ⭣
28 ౛㸦9.1㸣㸧㸪Ⓨ⏕ ⋡ 1.01 (0.64 — 1.39)/1000 AHs ࠾ࡼࡧ 2.08 (1.31 — 2.86)/1000
AEs㸪⭜᳝/ୗ⫼㒊 27 ౛㸦8.7㸣㸧㸪Ⓨ ⏕⋡ 0.98 (0.61 — 1.35)/1000 AHs ࠾ࡼࡧ
2.01 (1.25 — 2.77)/1000 AEs ࡢ㡰࡛࠶ࡗ ࡓ 㸬
30
31
3㸬യᐖࡢ✀㢮ู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡
യᐖࡢ✀㢮 ู࡟ࡼࡿ യᐖⓎ⏕ᩘ࠾ ࡼࡧയᐖ Ⓨ⏕⋡ࢆ ⾲ 2-3 ࡟♧ࡍ 㸬᭱ࡶከ࠸
യᐖࡢ✀㢮ࡣ 㸪᤬᣸࡛ ⥲യᐖⓎ⏕ᩘ 309 ౛ ୰ 77 ౛㸦⥲യ ᐖⓎ⏕ ᩘࡢ 24.9㸣㸧
࡛㸪യᐖ Ⓨ⏕⋡ ࡣ 2.79 (2.17 — 3.41)/1000 AHs ࠾ࡼࡧ 5.73 (4.45 — 7.01)/1000 AEs
࡛ ࠶ ࡗ ࡓ 㸬 ḟ ࡟ ➽ ⫗ ③ /ࢫ ࣃ ࢬ ࣒ 76 ౛ 㸦 24.6㸣 㸧 ࡛ 㸪 Ⓨ ⏕ ⋡ ࡣ 2.75 (2.13 —
3.37)/1000 AHs ࠾ࡼࡧ 5.66 (4.38 — 6.93)/1000 AEs ࡛࠶ࡗࡓ㸬௨ୗ 㸪 ⭝⅖/⭝࿘
ᅖ⅖ 52 ౛㸦16.8㸣㸧࡛ 㸪Ⓨ⏕⋡ 1.88 (1.37 — 2.39)/1000 AHs ࠾ࡼࡧ 3.87 (2.82 —
4.92)/1000 AEs㸪ᡴ᧞ /⾑⭘/᣸യ 44 ౛㸦14.2㸣㸧㸪Ⓨ⏕ ⋡ 1.59 (1.12 — 2.06)/1000
AHs ࠾ࡼࡧ 3.27 (2.31 — 4.24)/1000 AEs ࡛࠶ ࡗࡓ㸬
32
4㸬യᐖࡢཎᅉู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡
യᐖࡢཎᅉู ࡟ࡼࡿയ ᐖⓎ⏕ᩘ࠾ࡼ ࡧയᐖⓎ ⏕⋡ࢆ ⾲ 2-4 ࡟♧ࡍ㸬 യᐖࡢཎ
ᅉูࡢ⥲യᐖ Ⓨ⏕ᩘ ࡣ 361 ౛࡛࠶ࡗࡓ㸦1 ࡘࡢയᐖ࡟ᑐ ࡋ࡚」ᩘ ࡢཎᅉࡀྵࡲ
ࢀ࡚࠸ࡓሙྜ 㸪ࡑࢀࡽ ࢆࡍ࡭࡚ຍ⟬ ࡋ࡚⟬ฟ ࡋࡓ㸧㸬᭱ࡶ ከ࠸യᐖ ࡢཎᅉࡣ 㸪
౑࠸ࡍࡂ㸦ᚎ ࠎ࡟㸧 ࡀ 110 ౛㸦യᐖࡢཎ ᅉู࡟ ࡳࡓ⥲ യᐖⓎ⏕ ᩘࡢ 30.5㸣㸧 㸪
യᐖⓎ⏕⋡ ࡣ 3.98 (3.24 — 4.73)/1000 AHs ࠾ ࡼࡧ 8.19 (6.66 — 9.72)/1000 AEs ࡛
࠶ࡗࡓ㸬ḟ ࡟㠀᥋ゐ ᆺ യᐖࡀ 62 ౛㸦17.2㸣㸧㸪Ⓨ⏕⋡ ࡣ 2.24 (1.69 — 2.80)/1000
AHs ࠾ࡼࡧ 4.61 (3.47 — 5.76)/1000 AEs ࡛࠶ ࡗࡓ㸬௨ୗ㸪 ᥋ゐᆺ യ ᐖ㸦௚ࡢ㑅
ᡭ㸧ࡀ 50 ౛㸦13.9㸣㸧㸪Ⓨ⏕⋡ 1.81 (1.31 — 2.31)/1000 AHs ࠾ࡼࡧ 3.72 (2.69 —
4.75)/1000 AEs㸪௨๓ࡢ യᐖࡢ෌ Ⓨ 43 ౛㸦11.9㸣㸧㸪Ⓨ⏕⋡ 1.56 (1.09 — 2.02)/1000
AHs ࠾ࡼࡧ 3.20 (2.24 — 4.16)/1000 AEs ࡛࠶ ࡗࡓ㸬
33
34
5㸬ཷയᅇᩘ࡟ࡼ ࡿയ ᐖⓎ⏕ᩘ ࠾ࡼ ࡧയᐖⓎ ⏕ᩘ ࡜ࡑࡢ๭ ྜ
ㄪᰝᮇ㛫୰࡟ Ⓨ⏕ࡋࡓ യᐖ ࡢⓎ⏕ᅇ ᩘูࡢയ ᐖⓎ⏕ᩘ࡜ࡑ ࡢ๭ྜࢆ ᅗ 2-1 ࡟
♧ࡍ㸬ึ ᅇཷയ ࡀ 205 ౛㸦⥲യ ᐖⓎ⏕ᩘ ࡢ 66.3㸣㸧࡛ ᭱ࡶከࡃ 㸪ḟ ࡟ 2 ᅇ┠㸦෌
ཷയ㸧ࡀ 40 ౛㸦12.9㸣㸧㸪᫖ࢩ࣮ ࢬࣥ௨๓ ࡟Ⓨ ⏕ࡋࡓയᐖࡢ ෌ യᐖ ࡀ 35 ౛㸦11.3㸣㸧
࡛࠶ࡗࡓ㸬
35
6. ࣏ࢪࢩูࣙࣥ ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࡜๭ྜ
࣏ࢪࢩูࣙࣥ ࡟ ࡳࡓയ ᐖⓎ⏕ᩘ࡜ࡑ ࡢ๭ྜࢆ ᅗ 2-2 ࡟♧ࡍ 㸬ཷയ᫬ ࡟࣏ࢪࢩ
ࣙࣥࡀ☜ᐃࡋ ࡚࠸࡞࠿ ࡗࡓ 46 ౛ࢆ㝖እ ࡋ 㸪263 ౛ࢆᑐ㇟࡜ࡋ࡚ ⟬ ฟࡋࡓ㸬᭱ࡶ
യᐖⓎ⏕ᩘࡀ ከ࠸࣏ࢪ ࢩࣙࣥࡣ㸪࣑ࢵ ࢻࣇ࢕ ࣝࢲ࣮࡛ 84 ౛㸦࣏ ࢪ ࢩูࣙࣥ࡟ ࡳ
ࡓ⥲യᐖⓎ⏕ ᩘࡢ 31.9㸣㸧㸪ḟ ࡟ ࢔ࢱࢵ࢝ ࣮ 81 ౛㸦30.8㸣㸧㸪ࢹ࢕ ࣇ࢙ࣥࢲ࣮
76 ౛㸦28.9㸣㸧㸪ࢦ࣮ ࣮ࣜ㸦ࢦ࣮ࣝ ࣮࢟ࣃ࣮ 㸧 22 ౛㸦8.4㸣㸧࡛࠶ ࡗࡓ㸬
36
7㸬➇ᢏ᚟ᖐࡲ࡛ ࡢᮇ 㛫࡜യᐖⓎ⏕ ᩘ࠾ࡼࡧ യᐖⓎ⏕⋡
➇ᢏ᚟ᖐࡲ࡛࡟ᚲせ࡜ࡋࡓᮇ㛫࡜ᮇ㛫ูയᐖⓎ⏕ᩘ࠾ࡼࡧയᐖⓎ⏕⋡ࢆ⾲
2-5 ࡟♧ ࡍ㸬യ ᐖⓎ⏕ ᪥ ࠿ࡽ 3㹼7 ᪥࡛➇ ᢏ᚟ ᖐྍ⬟࡛࠶ࡗ ࡓയᐖ౛ ࡀ 117 ౛㸦⥲
യᐖⓎ⏕ᩘ ࡢ 37.9㸣㸧 ࡛᭱ࡶከࡃ㸪 യᐖⓎ⏕ ⋡ࡣ 4.24 (3.47 — 5.00)/1000 AHs
࠾ࡼࡧ 8.71 (7.13 — 10.29)/1000 AEs ࡛࠶ࡗࡓ㸬ḟ࡟ 1㹼2 ᪥ ࡶࡋ ࡃࡣ 1㹼2 㐌ࡢ
᚟ᖐᮇ㛫ࢆᚲ せ࡜ࡋࡓ യᐖ౛ࡀࡑࢀ ࡒࢀ 63 ౛㸦20.4㸣㸧ࡳࡽࢀ㸪Ⓨ⏕⋡ࡣࡑࢀ
ࡒࢀ 2.28 (1.72 — 2.84)/1000 AHs ࠾ࡼࡧ 4.69 (3.53 — 5.85)/1000 AEs ࡛࠶ࡗࡓ㸬
ࡲࡓ㸪➇ᢏ᚟ ᖐࡲ࡛ ࡟ 4 㐌㛫࠿ࡽ 6 ࣨ ᭶࠿࠿ ࡗࡓയᐖ ࡀ 30 ౛ࡳࡽ ࢀࡓ㸦 9.7㸣㸪
Ⓨ⏕⋡ 1.09 (0.70 — 1.47)/1000 AHs ࠾ࡼࡧ 2.23 (1.43 — 3.03)/1000 AEs㸧㸬
37
38
8㸬་⒪ᶵ㛵࡬ࡢ ཷデ ࠾ࡼࡧᡭ⾡㐺 ᛂࡢ᭷↓
་⒪ᶵ㛵࡬ࡢ ཷデࡢ ᭷ ↓࠾ࡼࡧᡭ⾡ 㐺ᛂࡢ᭷ ↓ ࡟ࡘ࠸࡚ࡣ 㸪309 ౛୰ 62 ౛㸦⥲
യᐖⓎ⏕ᩘ ࡢ 20.1㸣㸧ࡢയᐖ࡟ᑐࡋ ࡚ ཷデࡉ ࢀ࡚࠸ࡓ㸬ࡲࡓ㸪ᡭ⾡ 㐺ᛂ ࡛࠶ࡗ
ࡓയᐖࡣ 2 ౛㸦⥲യᐖ Ⓨ⏕ᩘࡢ 0.6㸣㸧࡛࠶ ࡾ㸪デ᩿ྡࡣ ACL യ ᐖ࡜༙᭶ᯈയ
ᐖ࡛࠶ࡗࡓ㸬
9㸬ᅄ⫥ࡢᕥྑഃ ู ࡢ യᐖⓎ⏕ᩘ࠾ ࡼࡧയᐖ Ⓨ⏕⋡
ᅄ⫥ࡢᕥྑഃ ู࡟Ⓨ⏕ ࡋࡓയᐖⓎ⏕ ᩘ࠾ࡼࡧ ࡑࡢ๭ྜࢆ ᅗ 2-3 ࡟♧ ࡍ㸬ୖ⫥
ࡢ ᕥ ྑ ഃ ࡟ Ⓨ ⏕ ࡋ ࡓ യ ᐖ Ⓨ ⏕ ᩘ ࡟ ࡘ ࠸ ࡚ ࡣ 㸪 ྑ ഃ ࡀ 21 ౛ 㸦 58.3㸣 㸧 㸪 ᕥ ഃ ࡀ
15 ౛㸦41.7㸣㸧࡛࠶ ࡗ ࡓ㸬ୗ⫥ ࡢᕥྑഃ ࡟Ⓨ ⏕ࡋࡓയᐖⓎ ⏕ᩘ ࡟ࡘ ࠸࡚ࡣ㸪ྑ
ഃࡀ 113 ౛㸦49.8㸣㸧 㸪ᕥഃ ࡀ 107 ౛㸦47.1㸣㸧࡛࠶ࡗࡓ 㸬
୧ഃ
7
(3.1%)
ᕥഃ
15
(41.7%)
ྑഃ
21
(58.3%)
ୖ⫥
ୗ⫥
ᅗ2-3 ୖ⫥䞉ୗ⫥䛾ᕥྑู䛾യᐖᩘ䛸๭ྜ
39
ྑഃ
113
(49.8%)
ᕥഃ
107
(47.1%)
10. ᏛᖺูࡢയᐖⓎ ⏕ ᩘ࠾ࡼࡧയᐖ Ⓨ⏕⋡
Ꮫᖺู࡟ ࡳࡓയ ᐖⓎ⏕ ᩘ࠾ࡼࡧ യᐖⓎ ⏕⋡ ࡟ ࡘ࠸࡚ࡣ 㸦ᅗ 2-4, ⾲ 2-6㸧㸪4
ᖺ⏕࡟࠾ࡅࡿ യᐖⓎ⏕ ᩘ ࡀ 105 ౛㸦⥲യᐖⓎ ⏕ᩘࡢ 34.0㸣㸧㸪യᐖ Ⓨ⏕⋡ 15.69
(12.69 — 18.69)/1000 AHs ࠾ࡼࡧ 33.08 (26.75 — 39.41)/1000 AEs ࡛࠶ࡾ㸪࠸ࡎࢀ
ࡶ඲Ꮫᖺ୰᭱ ࡶ㧗࠸⤖ ᯝࢆ♧ࡋࡓ 㸬୍᪉ 㸪᭱ ࡶᑡ࡞࠸യᐖ Ⓨ⏕ᩘ ࡣ 2 ᖺ⏕ ࡛ 47
౛㸦15.2㸣㸧࡛࠶ࡾ 㸪 യᐖⓎ⏕⋡࡟ ࡘ࠸࡚ ࡣ 1 ᖺ⏕ࡀ ᭱ࡶపࡃ 㸪 8.30 (6.42 —
10.18)/1000 AHs ࠾ࡼࡧ 16.85 (13.04 — 20.67)/1000 AEs ࡛࠶ࡗࡓ 㸬
40
41
2-1-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪኱ Ꮫ⏕ዪᏊ ࣛࢡࣟࢫ㑅ᡭ ࢆᑐ㇟࡜ ࡋ࡚㸪Ⓨ⏕ࡋ ࡓ യᐖࡢ 㒊఩㸪✀
㢮㸪ཎᅉࡢ࡯ ࠿㸪 ዪᏊ ࣛࢡࣟࢫ㑅ᡭ ࡢയᐖࡢ ≉ᚩࢆ᫂ࡽ࠿ ࡟ࡍࡿࡓ ࡵ࡟㸪 2 ᖺ
㛫ࡢയᐖㄪᰝ ࢆ⾜ࡗࡓ 㸬total AHs ࡜ total AEs ࡑࢀࡒࢀࡢ⦎ ⩦᫬࡜ヨ ྜ᫬ࡢ๭ྜ
ࢆẚ㍑ࡍࡿ࡜ 㸦 ⾲ 3-1㸧㸪total AHs ࡟ࡘ࠸ ࡚ࡣ ⦎⩦ ᫬ 94.9㸣㸦 26,213 AHs㸧㸪
ヨྜ᫬ 5.1㸣㸦1,408 AHs㸧㸪total AEs ࡟ࡘ࠸࡚ࡣ⦎⩦ ᫬ 87.8㸣㸦 11,791 AEs㸧㸪
ヨྜ᫬ 12.2㸣㸦1,646 AEs㸧࡛࠶ࡾ㸪 ࠸ࡎࢀ ࡶ⦎⩦᫬ ࡀ 9 ๭⛬ᗘ ࢆ ༨ࡵ࡚࠸ࡓ 㸬
ࡇࢀࡽࡢ⤖ᯝ ࠿ࡽ㸪኱ ᏛዪᏊࣛࢡࣟ ࢫ 㑅ᡭࡢ ⦎⩦࡬ࡢཧຍ ᫬㛫 ࠾ࡼ ࡧཧຍᅇᩘ
ࡢ ๭ ྜ ࡀ ᴟ ࡵ ࡚ 㧗 ࠸ ࡇ ࡜ ࡀ ♧ ࡉ ࢀ ࡓ 㸬 ⡿ ᅜ ኱ Ꮫ ዪ Ꮚ ࣛ ࢡ ࣟ ࢫ ࡢ ሗ ࿌ [Matz and
Nibbelink, 2004]࡜ẚ㍑ࡍࡿ࡜㸦඲ ࡚ AEs ࡟ ࡼࡿẚ㍑࡜ࡍ ࡿ㸧㸪⦎ ⩦᫬ࡢ༨ࡵࡿ
๭ྜࡀ⣙ 82㸣㸪ヨྜ ᫬ࡀ⣙ 18㸣࡛࠶ࡿࡇ ࡜㸪Lincoln ࡽ㸦2007㸧ࡢሗ࿌࡟ࡼ ࡿ
࡜⦎⩦᫬ࡀ ⣙ 83㸣㸪ヨ ྜ᫬ࡀ⣙ 17㸣࡛࠶ ࡿ ࡇ࡜࠿ࡽ 㸪ᅜෆࡢ ⦎⩦ ᫬ࡢ total AEs
ࡢ๭ྜࡀẚ㍑ ⓗ㧗ࡃ㸪ヨྜ᫬ࡢ total AEs ࡢ๭ྜࡀᑠࡉ࠸ ഴྥࡀࡳ ࡽࢀࡓ㸬ࡇࢀ
ࡣ㸪ᮏ㑥࡜⡿ ᅜ㸦 NCAA㸸National Collegiate Athletic Association㸪௨ୗ㸪NCAA㸧
ࡢ බ ᘧ ヨ ྜ ᩘ 㸦 ᪥ ᮏ 㸸 5㹼 9 ヨ ྜ 㸪 ⡿ ᅜ (NCAA)㸸 16㹼 23 ヨ ྜ [NCAA women’s
lacrosse, Rankings, 2012]㸧ࡢ㐪࠸࡟ࡼ ࡿࡶࡢ ࡜⪃࠼ࡽࢀࡿ 㸬⥲യᐖ Ⓨ⏕ᩘࡣ 309
౛࡛࠶ࡗࡓ 㸬ෆヂ ࡣ⦎ ⩦᫬ 283 ౛㸪ヨྜ᫬ 26 ౛㸦ࡑࢀ ࡒࢀ⥲യ ᐖ Ⓨ ⏕ᩘࡢ 91.6㸣㸪
8.4㸣㸧࡛࠶ࡾ㸪 ⦎⩦ ᫬ࡢയᐖⓎ⏕ ᩘ ࡀヨྜ ᫬ࡢ 10 ಸ௨ୖࢆ ♧ࡋ ࡓࡀ㸪യᐖⓎ
⏕⋡࡛ẚ㍑ࡍ ࡿ࡜㸪 1000 AHs ࠶ࡓࡾ࡛⦎ ⩦ ᫬ 10.80㸦9.54 — 12.05㸧㸪ヨྜ᫬
18.46㸦11.36 — 25.55㸧࡛ヨྜ᫬ࡢ᪉ ࡀ⣙ 1.7 ಸ㧗ࡃ㸪1000 AEs ࠶ࡓࡾ࡛ࡣ⦎⩦
᫬ 24.00㸦21.20 — 26.80㸧㸪ヨྜ᫬ 15.80㸦9.72 — 21.87㸧࡛⦎⩦᫬ ࡢ᪉ࡀ⣙ 1.5
ಸ㧗࠸Ⓨ⏕⋡ ࢆ♧ࡋࡓ 㸬 ࡇࢀࡽࡢയ ᐖⓎ⏕⋡ ࢆඛ⾜ㄽᩥ࡜ ẚ㍑ ࡍࡿ ࡜㸦☜ㄆࡉ
ࢀࡓඛ⾜ㄽᩥ ࡣ㸪඲ ࡚ 1000 AEs ࢆ༢఩࡜ ࡋ࡚യᐖⓎ⏕ ⋡ࡀ⟬ฟ ࡉࢀ࡚࠸ࡓⅭ 㸪
ᮏ◊✲࡜ࡢẚ ㍑ࡶ 1000 AEs ࠶ࡓࡾࡢ യᐖⓎ ⏕⋡ࢆᑐ㇟࡜ ࡋࡓ㸧㸪⡿ᅜ኱ᏛዪᏊ
ࣛࢡࣟࢫ[Matz and Nibbelink, 2007]ࡢሗ࿌࡛ࡣ㸪⦎⩦ ᫬ 2.7/1000 AEs㸪ヨྜ᫬
8.8/1000 AEs㸪16 ᖺ㛫 ࡢ NCAA Injury Surveillance System㸦௨ୗ 㸪 ISS㸧ࡢ ࢹ࣮
ࢱ[Dick et al., 2007]࡟ ࡼࡿ࡜㸪⦎⩦ ᫬ࡣ 3.30/1000 AEs㸪ヨྜ᫬ࡣ 7.15/1000 AEs
ࢆ♧ࡋ㸪࠸ࡎࢀࡶ ヨྜ ᫬ࡢയᐖⓎ⏕ ⋡ࡀ ⦎⩦ ᫬࡟ẚ࡭࡚࠾ ࠾ࡼ ࡑ 2㹼3 ಸ㧗࠸Ⓨ
⏕⋡ࢆ♧ࡋ࡚࠸ࡓ㸬ࡲࡓ㸪⦎⩦᫬࡜ヨྜ᫬ࡑࢀࡒࢀࡢയᐖⓎ⏕⋡ࢆඛ⾜ㄽᩥ
42
[Dick et al., 2007; Matz et al., 2004] ࡜ẚ㍑ࡍࡿ ࡜㸪യᐖࡢᐃ ⩏ࡢ㐪࠸ ࡣ࠶ࡿࡶࡢ
ࡢ㸪⦎⩦᫬࡛ ࠾࠾ࡼ ࡑ 7㹼9 ಸ㸪ヨྜ ᫬࡛ ࠾࠾ࡼࡑ 2㹼3 ಸ 㧗࠸ Ⓨ⏕⋡ࢆ♧ࡋ ࡚
࠸ࡓ㸬≉࡟⦎ ⩦᫬ࡢയ ᐖⓎ⏕⋡ࡀ㧗 ࠸ࡇ࡜࡟ ࡘ࠸࡚ࡣ㸪➇ ᢏ㛤ጞᖺ 㱋࠿ࡽ᳨ウ
ࡍࡿ࡜㸪⡿ᅜ ࣛࢡࣟࢫ ➇ᢏேཱྀࡣࣘ ࣮ࢫ㸦 15 ṓ௨ୗ㸧ࡀ᭱ከ㸦 361,275 ྡ㸪⥲
Ⓩ㘓⪅ᩘ ࡢ 52.8㸣ࢆ༨ ࡵࡿ㸧[US Lacrosse, 2011]࡛࠶ࡾ㸪➇ᢏ㛤ጞ ᖺ㱋ࡀẚ㍑ⓗ
᪩࠸ࡇ࡜ࡀ⪃ ࠼ࡽࢀࡿ 㸬୍᪉㸪ᮏ㑥 ࡛ࡣ࡯࡜ ࢇ࡝ࡢ㑅ᡭࡀ ኱Ꮫ⏕࠿ ࡽ ࡢ➇ᢏ㛤
ጞ࡛࠶ࡿࡇ࡜ ࠿ࡽ [బ 㔝ᮧࡽ , 2012-1]㸪ᑓ㛛 ⓗ ᢏ⾡ࡸᑓ㛛 ⓗయຊࡢ ᮍ⇍ࡉࡀ せᅉ
࡜࡞ࡾ㸪യᐖ Ⓨ⏕⋡ ࡀ ࡼࡾ㧗࠸ഴྥ ࢆ ♧ࡋࡓ ࡢ࡛ࡣ࡞࠸࠿ ࡜⪃࠼ࡓ 㸬 ࡲࡓ㸪ㄪ
ᰝᑐ㇟ࢳ࣮࣒ ࡢ㏻ᖖࡢ ⦎⩦ࡀ᪩ᮅ࠿ ࡽ⾜ࢃࢀ ࡚࠸ࡿࡇ࡜ ࡛ 㸪㌟యࡀ ༑ศ࡟㐺ᛂ
ฟ᮶࡚࠸࡞࠸ ≧ែ࡛ࡢ ⦎⩦ 㛤ጞ࡟ࡼ ࡾ㸪യᐖ Ⓨ⏕⋡ࡀ㧗ࡃ ࡞ࡗࡓࡢ ࡛ࡣ࡞࠸࠿
࡜᥎ ࡋࡓ㸬ኳೃ ู ࡟ ࡘ࠸࡚㸪total AHs ࡜ total AEs ࡢᬕࢀࡲࡓࡣ ᭎ࡾ ࡢ᫬࡜㞵
ࡲࡓࡣ㞷ࡢ᫬ ࡢ๭ྜ ࢆ ẚ㍑ࡍࡿ࡜㸦⾲ 2-1㸧 㸪total AHs ࡢᬕࢀࡲ ࡓࡣ᭎ࡾࡢ᫬
ࡣ 90.9㸣㸦25,113 AH’s㸧࡛࠶ࡾ㸪㞵ࡲࡓࡣ 㞷ࡢ᫬ࡣ 10.1㸣㸦2,508 AHs㸧㸪total
AEs ࡢᬕࢀࡲ ࡓࡣ᭎ࡾ ࡢ᫬ࡣ 89.4㸣㸦12,015 AEs㸧㸪㞵ࡲࡓࡣ 㞷 ࡢ᫬ࡣ 11.6㸣
㸦1,422 AEs㸧࡛࠶ࡗࡓ 㸬࠸ࡎࢀ ࡶ 90㸣㏆ࡃࡀ ᬕࢀࡲࡓࡣ᭎ ࡾࡢኳೃ ≧ἣୗ࡛⦎
⩦࠾ࡼࡧヨྜ ࡀ⾜ࢃࢀ ࡚࠸ࡓ㸬യᐖ Ⓨ⏕ᩘ ࠾ ࡼࡧയᐖⓎ⏕ ⋡ ࡢẚ㍑ ࡛ࡣ㸪യᐖ
Ⓨ⏕ᩘ࡟ࡘ࠸ ࡚ࡣ ᬕࢀ ࡲࡓࡣ᭎ࡾࡢ ᫬ ࡛ 282 ౛㸦඲യᐖ Ⓨ⏕ᩘ ࡢ 91.3㸣㸧㸪㞵
ࡲࡓࡣ㞷ࡢ᫬ ࡛ 27 ౛㸦8.7㸣㸧࡛࠶ࡗ ࡓࡀ 㸪 യᐖⓎ⏕⋡ ࡟ࡘ࠸࡚ ࡣᬕࢀࡲࡓࡣ
᭎ࡾࡢ᫬ ࡛ 11.23 (9.92 — 12.54)/1000 AHs ࠾ࡼࡧ 23.47 (20.73 — 26.21)/1000 AEs㸪
㞵 ࡲ ࡓ ࡣ 㞷 ࡢ ᫬ ࡛ 10.77 (6.70 — 14.83)/1000 AHs ࠾ ࡼ ࡧ 18.99 (11.83 —
26.15)/1000 AEs ࡛࠶ ࡾ㸪࠸ࡎࢀࡶ㞵 ࡲࡓࡣ 㞷ࡢ᫬ ࡢ᪉ࡀ ࡸࡸప࠸ ഴྥࢆ♧ࡋ࡚
࠸ࡓ㸬ኳೃ࡟ ࡼࡿࢢࣛ ࢘ࣥࢻ≧ែ ࡀ 㸪യᐖⓎ ⏕⋡࡟ཬࡰࡍ ᙳ㡪࡟ࡘ ࠸࡚ሗ࿌ࡉ
ࢀࡓ」ᩘࡢㄽ ᩥࡀࡳࡽ ࢀࡿࡀ [Andresen et al., 1989; Orchard J, 2002; Orchard and
Powell, 2003]㸪≉ ࡟ୗ ⫥ࡢ യᐖ Ⓨ⏕ ⋡ࡢ ẚ㍑ ࡟࠾ ࠸࡚ 㸪 㞵 ኳ᫬ ࡢയ ᐖⓎ ⏕⋡ࡀ
ᬕኳ᫬ࡼࡾప ࠸ࡇ࡜ࡀ ♧ࡉࢀ࡚࠸ࡿ 㸬ࡇࢀࡣ 㞵ኳ࡟ࡼࡾ㸪 ࢢࣛ࢘ࣥ ࢻ ࡀ⃿ࢀ࡚
࠸ࡿࡶࡋࡃࡣ ‵ࡗࡓ ≧ ែ࡟࡞ࡾ㸪ࢩ ࣮ࣗࢬ࡜ ᗋ࡜ࡢᦶ᧿᢬ ᢠࡀ㍍ῶ ࡉࢀࡿࡇ࡜
࡛㸪≉࡟⭸ࡸ ㊊㛵⠇ࡢ ᤬᣸࡟ࡼࡿയ ᐖࡀῶᑡ ࡍࡿࡇ࡜ࡀࡑ ࡢせᅉ࡛ ࠶ࡿ࡜㏙࡭
ࡽࢀ࡚࠸ࡿ[Andresen et al., 1989; Orchard J, 2002; Orchard and Powell, 2003; Heidt
RS Jr et al., 1996]㸬
43
㒊఩ ู ࡢ യᐖ 㸦 ⾲ 2-2㸧࡟ ࡘ ࠸ ࡚ࡣ 㸪 ㊊ 㛵⠇ ࡀ᭱ ࡶ ከ ࠸യ ᐖ Ⓨ ⏕ᩘ 㸪യ ᐖⓎ
⏕⋡࠾ࡼࡧࡑ ࡢ๭ྜ ࢆ ♧ࡋࡓ㸦യᐖ Ⓨ⏕ ᩘ 62 ౛㸪⥲യᐖⓎ ⏕ ᩘ ࡢ 20.1㸣㸧㸬
ḟ࡟⭸㛵⠇㸦45 ౛㸪14.6㸣㸧㸪኱⭣㒊㸦33 ౛㸪10.7㸣㸧㸪ୗ⭣㸦 28 ౛㸪9.1㸣㸧㸪
⭜᳝/ୗ⫼㒊㸦27 ౛㸪 8.7㸣㸧ࡢ㡰 ࡛࠶ࡗࡓ 㸬 ඛ⾜ㄽᩥ ࡢሗ ࿌࠿ࡽࡶ [Dick et al.,
2007; Hinton et al., 2005; Matz and Nibbelink, 2007 ]㸪㊊㛵⠇ࡀ᭱ ࡶ ከ࠸യᐖⓎ⏕
ᩘ࠾ࡼࡧࡑࡢ ๭ྜࢆ♧ ࡋ㸪඲യ ᐖᩘࡢ ⣙ 15㹼25㸣ࢆ༨ࡵ ࡚࠸ࡓ 㸬㊊㛵⠇ࡢḟ࡟
ከ࠿ࡗࡓ⭸㛵 ⠇࡟ࡘ࠸ ࡚ ࡶྠᵝ࡞ഴ ྥࡀ♧ࡉ ࢀ ࡚࠾ࡾ [Dick et al., 2007; Hinton
et al., 2005; Matz and Nibbelink, 2007]㸪඲യᐖ Ⓨ⏕ᩘࡢ ⣙ 12㹼21㸣 ࢆ༨ࡵ࡚࠸ࡓ 㸬
ඛ⾜ㄽᩥ࠾ࡼ ࡧᮏ◊✲ ࡢ⤖ᯝ ࢆྜࢃ ࡏ࡚ 㸪኱ ᏛዪᏊࣛࢡࣟ ࢫ 㑅ᡭࡢ യᐖዲⓎ㒊
఩ࡣ㊊㛵⠇࡜ ⭸㛵⠇࡛ ࠶ࡿࡇ࡜ࡀ♧ ࡉࢀࡓ㸬 ࡑࡢ௚㸪യᐖ ࡢ㒊఩ࢆ 㢌㢕㒊㸪య
ᖿ㸪ୖ⫥㸪ୗ ⫥ࡢ 4 ࡘ ࡟ศ㢮ࡋ࡚ࡑ ࢀࡒࢀࡢ യᐖⓎ⏕ᩘ࠾ ࡼࡧയᐖ Ⓨ⏕⋡ ࢆ㞟
ィࡍࡿ࡜㸦⾲ 2-7㸧㸪㢌㢕㒊ࡣ 18 ౛࡛ ඲യ ᐖ Ⓨ⏕ᩘ ࡢ 5.8㸣㸪യ ᐖⓎ⏕⋡ ࡣ 0.65
(0.35 — 0.95)/1000 AHs ࠾ࡼࡧ 1.34 (0.72 — 1.96)/1000 AEs㸪యᖿ ࡣ 28 ౛࡛ 9.1㸣㸪
Ⓨ⏕⋡ࡣ 1.01 (0.64 — 1.39)/1000 AHs ࠾ࡼࡧ 2.08 (1.31 — 2.86)/1000 AEs㸪ୖ⫥
ࡣ 36 ౛࡛ 11.7㸣㸪Ⓨ ⏕⋡ 1.30 (0.88 — 1.73)/1000 AHs ࠾ࡼࡧ 2.68 (1.80 —
3.55)/1000 AEs㸪ࡑࡋ ࡚ୗ⫥࡟࠾࠸ ࡚ࡣ 227 ౛㸪Ⓨ⏕ ⋡ 8.22 (7.15 — 9.29)/1000
AHs ࠾ࡼࡧ 16.89 (14.70 — 19.09)/1000 AEs ࡛඲യᐖⓎ⏕ᩘ ࡢ 73.5㸣 ࢆ༨ࡵ࡚࠸
ࡓ㸬ୗ⫥യᐖ ᩘࡢ๭ྜ ࡀ ඲യᐖᩘ ࡢ 7 ๭௨ୖ ࢆ༨ࡵ࡚࠸ࡓ ࡀ 㸪ࡇࡢ ഴྥࡣඛ⾜
ㄽᩥ࡛ࡶྠᵝ࡟ࡳࡽࢀ࡚࠾ࡾ㸪඲യᐖᩘࡢ 6 ๭௨ୖࢆୗ⫥യᐖࡀ༨ࡵ࡚࠸ࡓ
[Dick et al., 2007; Matz and Nibbelink, 2007 ]㸬㢌㒊࣭㢦ࡢയᐖ࡟ࡘ ࠸ ࡚ࡣ 10 ౛Ⓨ
⏕ࡋ㸦⾲ 2-2㸧㸪 ⥲യ ᐖᩘ࡟ᑐࡍࡿ ๭ྜ ࡣ 3.1㸣࡛࠶ࡗ ࡓ㸬㢌㒊 ࣭ 㢦ࡢയᐖࡣ 㸪
ዪᏊࣛࢡࣟࢫ ➇ᢏ ࡛≉ ␗ⓗ࡟Ⓨ⏕ࡋ ࡚࠸ࡿയ ᐖ 㒊఩࡛࠶ࡿ ࡀ [Dick et al., 2007;
Diamond and Gale., 2001; Hinton et al., 2005; Matz and Nibbelink, 2007 ; Lincoln et
al., 2007; Caswell et al., 2012; Goldenberg and Hossler, 1995; Otago et al., 2007;
Waicus and Smith, 2002; Webster et al., 1999]㸪 ඛ⾜◊✲࠿ࡽ ࡢሗ࿌ ࡛ ࡣ㸪ࡑࢀࡽ
ࡢയᐖࡢ༨ࡵ ࡿ๭ྜ ࡀ 14.1㸣[Hinton et al., 2005]㸪18.2㸣[Otago et al., 2007]㸪
28.8㸣[Goldenberg and Hossler, 1995]㸪30.1㸣[Diamond and Gale., 2001]㸪35.7㸣
[Matz and Nibbelink, 2007]࡛࠶ࡾ㸪ࡍ࡭࡚ ࡢẚ ㍑࡟࠾࠸࡚ᮏ ◊✲ࡢ⤖ ᯝࡣⴭࡋࡃ
ప࠸ഴྥࢆ♧ ࡋ࡚࠸ࡓ 㸬ࡇࢀࡽࡢඛ ⾜ㄽᩥࡣ ඲࡚ ⡿ᅜ࠿ࡽ ࡢሗ࿌࡛ ࠶ࡿࡀ㸪⡿
44
ᅜ࡜ᮏ㑥ࡢࣉ ࣮ࣞࢫࢱ ࢖ࣝ ࢆẚ㍑ࡍ ࡿ࡜㸪⡿ ᅜࣛࢡࣟࢫࡣ 㸪ࡼࡾ࢔ ࢢࣞࢵࢩࣈ
࡛࠶ࡿࡇ࡜ࡀ ᥎ ࡉࢀ [Caswell et al., 2012]㸪ᮏ㑥࡛ࡢㄪᰝ ᑐ㇟⪅ࡢ 㢌㒊࣭㢦ࡢ
യᐖࡀᑡ࡞࠸ ഴྥࢆ♧ ࡋࡓࡢ࡛ࡣ࡞ ࠸࠿࡜⪃ ࠼ࡓ 㸬ዪᏊ ࣛࢡࣟࢫ ࡢ ACL യᐖ࡟
㛵ࡍࡿሗ࿌ࡶ 」ᩘࡳࡽ ࢀࡿࡀ [Mihata et al., 2006; Hootman et al., 2007]㸪ᮏ◊✲
࡛ࡣ ACL യᐖ Ⓨ⏕ᩘ 1 ౛㸪Ⓨ⏕⋡ ࡣ 0.04 (-0.04 — 0.11)/1000 AHs ࠾ࡼࡧ 0.07
(-0.07 — 0.22)/1000 AEs ࡛࠶ࡗࡓ㸦⾲ 2-8㸧㸬ඛ⾜ㄽᩥ࡛ࡣ㸦 ࡍ࡭ ࡚ 1000 AEs㸧㸪
Hootman ࡽ㸦2007㸧ࡣ 0.17 (0.14 — 0.20)/1000 AEs㸪Mihata ࡽ㸦2006㸧ࡣ 0.18/1000
AEs ࢆ♧ࡋ㸪ᮏ◊✲⤖ ᯝ ࡣ༙ศ௨ୗ ࡢയᐖⓎ ⏕⋡࡛࠶ࡗ ࡓ 㸬ࡇࢀ࡟ ࡘ࠸࡚ࡶ᥎
࡛ࡣ࠶ࡿࡀ 㸪⡿ᅜࣛ ࢡࣟࢫ ࡜ᮏ㑥 ࡜ࡢࣉࣞ ࣮ࢫࢱ࢖ࣝࡢ 㐪࠸࡟ࡼ ࡾ㸪ࡼࡾ࢔
ࢢࣞࢵࢩࣈ࡞ ⡿ᅜࣛࢡ ࣟࢫ࡛ࡢ ACL യᐖⓎ ⏕⋡ࡀ㧗ࡃ 㸪ᮏ㑥࡛ ࡢ ㄪᰝᑐ㇟⪅ࡢ
ACL യᐖⓎ⏕⋡ࡀ ప ࠸ഴྥࢆ♧ࡋ ࡓࡢ࡛ࡣ ࡞࠸࠿࡜⪃࠼ ࡓ 㸬ᅄ⫥ ࡢയᐖⓎ⏕ᩘ
ࢆᕥ ྑ ഃ ู࡛ ẚ ㍑ ࡍ ࡿ ࡜㸦 ᅗ 2-3㸧 㸪 ୖ ⫥࣭ ୗ⫥ ࡜ ࡶ ࡟ ẚ ㍑ ⓗྑ ഃ ࡟ ከ ࡃ Ⓨ⏕
ࡍࡿഴྥࡀ♧ ࡉࢀࡓ㸬 ≉࡟ୖ⫥࡟࠾ ࠸࡚ࡑࡢ ഴྥࡀᙉࡃࡳ ࡽࢀࡓ ࡀ 㸪ࡇࢀࡣྑ
฼ࡁࡢ⪅ࡣ㸪 ࢫࢸ࢕ࢵ ࢡࢆྑᡭࢆୖ ഃ࡟㸪ᕥ ᡭࢆୗഃ࡟఩ ⨨ ࡉࡏ࡚ ಖᣢࡋ㸪ࢫ
ࢸ࢕ࢵࢡࡸ࣎ ࣮ࣝࢆ ୺ ࡟ྑᡭഃ࡛᧯ స 㸦୺࡟ ฼ࡁᡭഃ࡛᧯ స㸧 ࡋ࡚ ࠸ࡿࡇ࡜࠿
ࡽ㸪᥋ゐ➼࡟ ࡼࡿയᐖ ࡀ ẚ㍑ⓗከࡃ Ⓨ⏕ ࡋࡓ ࡢ࡛ࡣ࡞࠸࠿ ࡜᥎ ࡋ ࡓ㸬ୗ⫥ ࡢ
യᐖࡶࢃࡎ࠿ ࡛࠶ࡿࡀ ྑഃ࡟ከࡃⓎ ⏕ࡋ࡚࠸ ࡿ ഴྥࡀ♧ࡉ ࢀࡓ 㸬➇ ᢏࡢ㐪࠸ࡣ
࠶ࡿࡀ㸪ࢧࢵ ࣮࢝➇ᢏ ࡟࠾࠸࡚ࡶྑ ഃ ࡟ከࡃ Ⓨ⏕ࡋ࡚࠸ ࡿ ࡇ࡜ࡀሗ ࿌ࡉࢀ࡚࠸
ࡿ[Beynnon et al., 2005]㸬ࡑࡢ࡯࠿ࣁ ࣥࢻ࣮࣎ ࣝ➇ᢏ [Seil et al., 1998]࡛ࡣ㸪ୖ⫥
ࡣ฼ࡁᡭഃ㸪 ୗ⫥ࡣ฼ ࡁ⬮ഃ࡟ከࡃ Ⓨ⏕ࡋ࡚ ࠸ ࡿࡇ࡜ࡀሗ ࿌ࡉࢀ࡚ ࠸ࡿ 㸬
45
യᐖࡢ✀㢮㸦 ⾲ 2-3㸧 ࡟ࡘ࠸࡚ࡣ㸪 ᭱ࡶከ࠸ യᐖࡢ✀㢮ࡣ ᤬᣸࡛ 309 ౛୰ 77
౛㸦24.9㸣㸧࡛࠶ࡗ ࡓ 㸬ඛ⾜ㄽᩥ࠿ ࡽࡶ [Dick et al., 2007; Hinton et al., 2005]㸪
ࣛࢡࣟࢫ➇ᢏ ࡟࠾࠸࡚ ᤬᣸ࡀ᭱ࡶከ ࠸യᐖࡢ ✀㢮࡛࠶ ࡿࡇ ࡜ࡀሗ࿌ ࡉࢀ࡚࠸ࡿ 㸬
➇ᢏࡢ㐪࠸ࡣ ࠶ࡿࡀ 㸪௚ࡢ⌫ᢏ㸪ࢧࢵ ࣮࢝ [Nielsen and Yde, 1989; Engström et al.,
1991; Faude et al., 2005; Yard et al., 2008] 㸪ࣂࢫࢣࢵࢺ࣎ ࣮ࣝ [Borowski et al.,
2008; Gomez et al., 1996; Messina et al., 1996; Zelisko et al., 1982]㸪ࣁࣥࢻ࣮࣎ࣝ
[Lindblad et al., 1992; Seil et al., 1998] ࡛ࡶ ᤬᣸࡟ࡼࡿയ ᐖࡀ᭱ࡶ ከ࠸ࡇ࡜ࡀ♧
ࡉࢀ࡚࠸ࡓ㸬 ࣛࢡࣟࢫ ➇ᢏࡢ≉␗ⓗ ࡞യᐖࡢ ୍ࡘ࡜ࡋ࡚♧ ࡉࢀ࡚࠸ ࡿᡴ᧞യᐖ
[Diamond and Gale, 2001; Hinton et al., 2005; Matz and Nibbelink, 2007; Lincoln et
al., 2007]ࡣ㸪ᮏ◊✲࡛ ࡣ 44 ౛㸦14.2㸣㸧Ⓨ ⏕ࡋ㸪 4 ␒┠࡟ 㧗࠸യ ᐖⓎ⏕ᩘ ࡜ࡑ
ࡢ๭ྜࢆ♧ࡋ ࡚࠸ࡓ㸦 ⾲ 2-3㸧 㸬ඛ⾜ㄽ ᩥ ࠿ ࡽࡣ[Hinton et al., 2005]㸪඲യᐖⓎ
⏕ᩘࡢ 2 ␒┠ ࡟㧗࠸๭ ྜ㸦 17.9㸣㸧ࢆ♧ࡋࡓ ሗ࿌ࡶࡳࡽࢀ ࡚࠸ࡿ㸬ᡴ᧞യᐖࢆ㸪
യᐖ ࡢ ཎ ᅉࡢ 㡯 㸦 ⾲ 2-4㸧 ࡢ 㸪᥋ ゐ യᐖ 㸦 ௚ ࡢ㑅 ᡭ 㸧 㸪᥋ ゐ യᐖ 㸦 ື࠸ ࡚ ࠸ࡿ
≀ (࣮࣎ࣝ㸪ࢫࢸ ࢕ࢵ ࢡ➼ )㸧㸪᥋ゐ യᐖ㸦 㟼Ṇ≀㸧㸪ࡑࡢ௚ ࡢ 4 㡯࡟ศࡅ࡚㞟
ィࡍࡿ࡜㸪᭱ ࡶከ࠸ࡢ ࡣື࠸࡚࠸ࡿ ≀㸦࣮࣎ ࣝ㸪ࢫࢸ࢕ࢵ ࢡ➼㸧࡜ ࡢ᥋ゐ യᐖ
࡛ 44 ౛୰ 30 ౛㸦 68.2㸣㸧㸪ḟ ࡟௚ࡢ㑅 ᡭ࡜ ࡢ ᥋ゐയᐖ ࡀ 13 ౛㸦 29.5㸣㸧㸪㟼
Ṇ≀࡜ࡢ᥋ゐ യᐖ ࡀ 0 ౛㸪ࡑࡢ ௚ 1 ౛㸦2.3㸣㸧࡛࠶ ࡗࡓ 㸬ࡲࡓ 㸪ື࠸࡚࠸ࡿ≀
㸦࣮࣎ࣝ㸪ࢫ ࢸ࢕ࢵࢡ ➼㸧࡜ࡢ᥋ゐ യᐖ㸦30 ౛㸧ࡢ࡞࠿࡛ 㸪᭱ࡶ ከࡃⓎ⏕ࡋࡓ
യᐖࡢ㒊఩ࡣ 㸪㢌㒊࣭ 㢦࡛࠶ࡗࡓ㸦 8 ౛㸪26.7㸣㸧㸬Dick ࡽ㸦 2007㸧࠿ࡽࡣ㸪
୺࡟࣮࣎ࣝࡸ ࢫࢸ࢕ࢵ ࢡ ࡜ࡢ᥋ゐയ ᐖࡀ㸪⦎ ⩦᫬࡛ 26.0㸣㸪ヨྜ᫬࡛ 35.9㸣ࡢ
๭ྜ࡛Ⓨ⏕ࡋ ࡚࠸ࡓࡇ ࡜ࡀሗ࿌ࡉࢀ ࡚࠸ࡿ㸬 ࡲࡓ㸪≉࡟ ዪ Ꮚࣛࢡࣟ ࢫ 㑅ᡭࡣ⏨
Ꮚࣛࢡࣟࢫ㑅 ᡭ࡜ẚ࡭ 㸪࣮࣎ࣝ࡜ࡢ ᥋ゐ࡟ࡼ ࡿ㢌㒊࣭㢦ࡢ ᡴ᧞യᐖ ࡀከ࠸ࡇ࡜
46
ࡀሗ࿌ࡉࢀ࡚ ࠸ࡿ ࡯࠿ [Diamond and Gale, 2001]㸪┠ࡢയᐖ࡟ ࡘ࠸࡚ ࡣ 㸪⣙ 86㸣
ࡀ ࣎ ࣮ ࣝ ࡶ ࡋ ࡃ ࡣ ࢫ ࢸ ࢕ ࢵ ࢡ ࡜ ࡢ ᥋ ゐ ࡟ ࡼ ࡿ ࡶ ࡢ ࡜ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ [Waicus
and Smith, 2002]㸬
യᐖ ࡢ ཎ ᅉู ࡟ ࡼ ࡿയ ᐖⓎ ⏕ ᩘ ࠾ࡼ ࡧ ࡑ ࡢ๭ ྜ࡟ ࡘ ࠸ ࡚㸦 ⾲ 2-4㸧 㸪᭱ ࡶከ
࠸യᐖࡢཎᅉ ࡣ 㸪 ౑࠸ ࡍࡂ㸦ᚎࠎ࡟ 㸧ࡀ 110 ౛㸦30.5㸣㸧㸪ḟ ࡟ 㠀᥋ゐᆺയᐖ
ࡀ 62 ౛㸦17.2㸣㸧㸪᥋ゐᆺയᐖ㸦௚ࡢ㑅 ᡭ 㸧50 ౛㸦13.9㸣㸧ࡢ 㡰 ࡛࠶ࡗࡓ㸬യ
ᐖࡢཎᅉࡢྛ 㡯┠ ࢆ㸪౑࠸ࡍࡂ㸦ᚎࠎ ࡟㸪ᛴ ࡟ ࢆྵࡴ㸧㸪㠀᥋ゐ ᆺ യᐖ㸪᥋ゐ
ᆺയᐖ㸦 ௚ࡢ㑅ᡭ 㸪ື ࠸࡚࠸ࡿ≀ 㸪㟼Ṇ ≀ ࢆྵࡴ㸧ࡢ 3 ࡘ࡟ ศ㢮 ࡋ࡚ẚ㍑ࡍࡿ
࡜㸪౑࠸ ࡍࡂࡀ 141 ౛㸦ཎᅉู ࡟ࡼࡿ඲ യᐖ Ⓨ⏕ᩘࡢ 39.1㸣㸪യᐖ Ⓨ⏕⋡ 5.10
(4.26 — 5.95)/1000 AHs ࠾ࡼࡧ 10.49 (8.76 — 12.23)/1000 AEs㸧࡜ ࡞ࡾ㸪᭱ࡶ㧗
࠸യᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡ ࢆ♧ ࡋࡓ㸬ḟ ࡟᥋ゐᆺയᐖ ࡛ 90 ౛㸦24.9㸣㸪3.26
(2.59 — 3.93)/1000 AHs ࠾ࡼࡧ 6.70 (5.31 — 8.08)/1000 AEs㸧㸪㠀 ᥋ゐᆺയᐖࡣ
62 ౛㸦17.2㸣㸪2.24 (1.69 — 2.80)/1000 AHs ࠾ ࡼࡧ 4.61 (3.47 — 5.76)/1000 AEs㸧
࡛࠶ࡗࡓ㸬௨ ୖ 3 ࡘࡢ യᐖⓎ⏕ᩘࢆ ྜࢃࡏࡿ ࡜ 293 ౛㸪ཎᅉู࡟ࡼ ࡿ඲യᐖⓎ
⏕ᩘ㸦361 ౛㸧ࡢ 81.1㸣ࢆ༨ࡵ㸪ࡇ ࢀࡽࡢཎ ᅉࡀዪᏊࣛࢡ ࣟࢫ㑅ᡭ ࡢ͂യᐖࡢ
3 ኱ཎᅉ࡛̓࠶ ࡿ࡜࠸ ࠼ࡼ࠺㸬
඲࡚ ࡢ യ ᐖࢆ 㸪 യ ᐖࡢ 㒊఩ ࣭ ✀ 㢮࣭ ཎ ᅉ ู࡟ 㞟ィ ࡋ 㸦 ⾲ 2-9㸧 㸪യ ᐖࡢ ≉ᚩ
ࢆࡼࡾヲ⣽࡟ ᳨ウࡍࡿ ࡜㸪 ㊊㛵⠇ࡢ ᤬᣸࡛㠀 ᥋ゐᆺ࡟ ࡼࡿ യᐖࡀ᭱ ࡶከࡃⓎ⏕
ࡋ࡚࠸ࡓ㸦30 ౛ (യ ᐖࡢ㒊఩࣭✀ 㢮࣭ཎᅉ ู࡟ࡳࡓ⥲യ ᐖⓎ⏕౛ ࡢ 8.3㸣)㸪Ⓨ
⏕⋡ 1.09 (0.70 — 1.47)/1000 AHs ࠾ࡼࡧ 2.23 (1.43 — 3.03)/1000 AEs㸧㸪ḟ࡟⭜
᳝/ୗ⫼㒊ࡢ➽⫗③ /ࢫ ࣃࢬ࣒࡛౑࠸ ࡍࡂ㸦ᚎ ࠎ࡟㸧 ࡟ࡼࡿ യᐖࡀ 23 ౛㸦6.4㸣㸪
Ⓨ⏕⋡ 0.83 (0.49 — 1.17)/1000 AHs ࠾ࡼࡧ 1.71 (1.01 — 2.41)/1000 AEs㸧㸪⭸㛵
⠇ࡢ⭝⅖/⭝࿘ᅖ⅖࡛ ౑࠸ࡍࡂ㸦ᚎ ࠎ࡟㸧 ࡀ 15 ౛㸦4.2㸣㸪Ⓨ⏕ ⋡ 0.54 (0.27 —
0.82)/1000 AHs㸪1.12 (0.55 — 1.68)/1000 AEs㸧࡛࠶ࡗࡓ㸬 ௨ୗ㸪 ㊊ 㛵⠇ࡢ᤬᣸
࡛௚ࡢ㑅ᡭ࡜ ࡢ᥋ゐ ᆺ ࡟ࡼࡿയᐖࡀ 14 ౛㸦3.9㸣㸪Ⓨ⏕⋡ 0.51 (0.24 — 0.77)/1000
AHs㸪1.04 (0.50 — 1.59)/1000 AEs㸧㸪㊊㛵⠇ࡢ᤬᣸࡛௨๓ ࡢയᐖࡢ ෌Ⓨࡀ 10 ౛
㸦2.8㸣㸪Ⓨ⏕ ⋡ 0.36 (0.14 — 0.59)/1000 AHs㸪0.74 (0.28 — 1.21)/1000 AEs㸧࡛
࠶ࡗࡓ㸬ࡑࡢ ௚㸪඲࡚ ࡢയᐖࢆയᐖ ࡢ 㒊఩࣭ ✀㢮ู࡛㞟ィ ࡍࡿ࡜㸪 ㊊㛵⠇ࡢ᤬
᣸ࡀ 63 ౛㸦യᐖ ࡢ 㒊 ఩࣭✀㢮ู࡟ ࡳࡓ⥲യ ᐖⓎ⏕౛ ࡢ 20.4㸣㸪Ⓨ ⏕⋡ 2.28 (1.72
47
— 2.84)/1000 AHs ࠾ࡼ ࡧ 4.69 (3.53 — 5.85)/1000 AEs㸧㸪⭜᳝/ୗ⫼㒊ࡢ➽⫗③/
ࢫࣃࢬ࣒࡛౑ ࠸ࡍࡂ㸦 ᚎࠎ࡟㸧ࡀ 26 ౛㸦8.4㸣㸪Ⓨ⏕⋡ 0.94 (0.58 — 1.30)/1000
AHs ࠾ࡼࡧ 1.93 (1.19 — 2.68)/1000 AEs㸧㸪⭸㛵⠇ࡢ⭝⅖ /⭝࿘ᅖ ⅖ 22 ౛㸦7.1㸣㸪
Ⓨ⏕⋡ 0.80 (0.46 — 1.13)/1000 AHs ࠾ࡼࡧ 1.64 (0.95 — 2.32)/1000 AEs㸧㸪㰡ᚄ
㒊ࡢ➽⫗③/ࢫࣃࢬ ࣒ 20 ౛㸦6.5㸣㸪Ⓨ⏕ ⋡ 0.72 (0.41 — 1.04)/1000 AHs ࠾ࡼࡧ
1.49 (0.84 — 2.14)/1000 AEs㸧࡜࡞ࡾ 㸪㊊㛵⠇ ࡢ᤬᣸࡟ࡼࡿ യᐖࡀ㸪 ዪᏊࣛࢡࣟ
ࢫ㑅ᡭࡢ୺ࡓ ࡿയᐖࡢ ≉ᚩ࡜ࡋ࡚㢧 ⴭ࡟♧ࡉ ࢀࡓ㸬」ᩘࡢ ඛ⾜ㄽᩥ [Dick et al.,
2007; Hinton et al., 2005]࠿ࡽࡶ㸪㊊㛵⠇ ࡢ ᤬᣸࡟ࡼࡿയ ᐖࡀ᭱ࡶ ከ࠸ࡇ࡜ࡀ ♧
ࡉࢀ࡚࠸ࡓࡀ㸪ࡇࡢഴ ྥࡣ ௚ࡢ➇ᢏ㸪ࢧࢵ࢝ ࣮ [Dvorak et al., 2011; Engström et al.,
1991; Faude et al., 2006; Yard et al., 2008; Le Gall et al., 2008 ; Nielsen and Yde,
1989]㸪ࣂࢫࢣࢵࢺ ࣎ ࣮ࣝ [Gomez et al., 1996; Messina et al., 1996; Zelisko et al.,
1982; Leanderson et al., 1993; Meeuwisse et al., 2003]㸪ࣁࣥࢻ࣮࣎ ࣝ [Lindblad et al.,
1992; Jørgensen., 1984]࡟࠾࠸࡚ࡶྠ ᵝ࡞ഴྥ ࡀ♧ࡉࢀ࡚࠸ ࡓ࡯࠿㸪 」ᩘࡢ➇ᢏ
ࢆᑐ㇟࡜ࡍࡿ ࢜ࣜࣥࣆ ࢵࢡ ➇ᢏ኱఍ ࡢയᐖㄪ ᰝሗ࿌ [Junge et al., 2009]㸦32 ➇ᢏ
ࢆᑐ㇟㸧࠿ࡽ ࡶ㸪 ㊊㛵 ⠇ࡢ᤬᣸ࡀ᭱ ࡶከࡃⓎ ⏕ࡋ࡚࠸ࡓࡇ ࡜ࡀ♧ࡉ ࢀ࡚࠸ࡓ 㸬
ࡲࡓ㸪ᮏ ㄪᰝ⤖ᯝ ࠿ࡽ㸪㊊㛵⠇᤬᣸࡜ ࠸ࡗࡓᛴ ᛶእയࡀ㢧ⴭ ࡟♧ࡉࢀ ࡚࠸ࡓࡀ㸪
ࡑࡢ ௚㸪 ⭜᳝ /ୗ ⫼㒊 ࡸ㰡 ᚄ㒊 ࡢ➽ ⫗③ /ࢫ ࣃࢬ ࣒㸪 ⭸㛵 ⠇ࡢ ⭝⅖ /⭝࿘ᅖ ⅖࡜࠸
ࡗࡓ៏ᛶ㞀ᐖ ࡶỴࡋ࡚ ᑡ࡞ࡃ࡞࠸ࡇ ࡜ࡀ♧ ࡉ ࢀࡓ㸬኱Ꮫዪ Ꮚࣛࢡࣟ ࢫ㑅ᡭࡢ ୺
ࡓࡿയᐖࡢ≉ ᚩࡣ㸪͂ 㠀᥋ゐᆺࡢ ㊊ 㛵⠇ࡢ᤬ ᣸ ࡛̓࠶ࡗࡓ ࡀ㸪യᐖ ࡢ㒊఩࡜✀
㢮࡟㝈ᐃࡍࡿ ࡜㸪͂㊊ 㛵⠇ࡢ᤬᣸̓ ࡀ㢧ⴭ࡟ ♧ࡉࢀࡓ 㸬
48
49
യᐖࡢᅇᩘ࡜ ࡑࡢ๭ྜ ࡟ࡘ࠸࡚㸦 ᅗ 2-1㸧㸪෌ཷ യ࡜࡞ࡿ 2 ᅇ ┠㸦 40 ౛ 㸪12.9㸣㸧㸪
᫖ࢩ࣮ࢬࣥ௨ ๓࡟Ⓨ⏕ ࡋࡓയᐖࡢ෌ യᐖ㸦35 ౛㸪11.3㸣㸧㸪3 ᅇ┠ ௨ୖ㸦 6 ౛ 㸪
1.9㸣㸧ࢆྜࢃࡏ ࡿ࡜ 81 ౛㸦26.1㸣㸧࡜࡞ࡾ 㸪඲యࡢ ⣙ 1/4 ࢆ༨ࡵ ࡚࠸ࡓ㸬ࡑࡢ
࡞࠿࡛㸪෌യ ᐖࢆ㈇ࡗ ࡓ᭱ࡶከ࠸യ ᐖࡢ㒊఩ ࡜✀㢮ࡣ㸪㊊ 㛵⠇ࡢ᤬ ᣸㸦 18 ౛㸪
22.2㸣㸧࡛࠶ࡗࡓ 㸬㊊ 㛵⠇᤬᣸ࡢ෌ യᐖࡣ 㸪 ࢧࢵ࣮࢝[Nielsen and Yde, 1989; Le
Gall et al., 2008; Brynhildsen et al., 1990; Ekstrand and Gillquist, 1983]㸪ࣂࢫࢣࢵ
ࢺ࣮࣎ࣝ[Borowski et al., 2008; Leanderson et al., 1993; Agel et al., 2003; McKay et
al., 2001]࡟࠾࠸࡚ࡶከ Ⓨࡋ࡚࠸ࡿഴ ྥࡀ♧ࡉ ࢀ࡚࠾ࡾ㸪ཷ യᚋ㸪᪩ ᮇࡢ㐺ษ࡞
ࣜࣁࣅࣜࢸ࣮ ࢩ ࣙࣥ [Mattacola and Dwyer, 2002]ࡢᐇ᪋ࡸໟ ᣓⓗ࡞ യᐖண㜵ࣉࣟ
ࢢ࣒ࣛ[Thacker et al., 1999]ࡢ㔜せᛶࡀ ከᩘࡢ ㄽᩥ࠿ࡽ♧ࡉ ࢀ࡚࠸ࡿ 㸬
࣏ࢪ ࢩ ࣙ ูࣥ ࡟ ࡼ ࡿയ ᐖ Ⓨ ⏕ ᩘ ࡜ࡑ ࡢ ๭ ྜ࡟ ࡘ࠸ ࡚ 㸦 ᅗ 2-2㸧 㸪᭱ ࡶከ ࠸യ
ᐖ Ⓨ ⏕ ᩘ ࢆ ♧ ࡋ ࡓࡢ ࡣ ࣑ ࢵ ࢻ ࣇ ࢕ ࣝ ࢲ ࣮㸦 31.9㸣 㸧 ࡛ ࠶ ࡗ ࡓ 㸬 ➇ᢏ ࢫ ࢱ ࢖ ࣝ ࡀ
㢮ఝࡋ࡚࠸ࡿ ࢧࢵ࣮࢝ ࡟࠾࠸࡚ ࡶྠ ᵝ࡟㸪࣑ ࢵࢻࣇ࢕ࣝࢲ ࣮ࡀ᭱ࡶ ከ࠸യᐖᩘ
ࢆ♧ࡋ࡚࠸ࡓ[Engström et al., 1991]㸬ࡲࡓ㸪࣏ࢪࢩูࣙࣥ ࡟ࡼࡿ୍ ே࠶ࡓࡾࡢയ
ᐖⓎ⏕ᩘ࡛ẚ ㍑ࡋ࡚ࡳ ࡿ࡜㸪᭱ࡶ 㧗࠸യᐖ Ⓨ ⏕ᩘࢆ♧ࡋࡓ ࡢࡣ࢔ࢱ ࢵ࣮࢝㸦 3.2
౛㸭ே㸭࣏ࢪ ࢩࣙࣥ㸧 ࡛࠶ࡗࡓ㸬
➇ᢏ ᚟ ᖐ ࡲ࡛ ࡢ ᮇ 㛫 ู യᐖ Ⓨ ⏕ ᩘ ࡜ ࡑ ࡢ ๭ྜ ࡟ࡘ ࠸ ࡚ ࡣ㸦 ⾲ 2-5㸧 㸪༙ ᩘ௨
ୖࡢയᐖ౛ ࡀ 7 ᪥௨ ෆ࡟➇ᢏ᚟ᖐ ࡋ࡚࠾ࡾ 㸦 180 ౛㸪58.3㸣㸧㸪ẚ㍑ⓗ▷ᮇ㛫
࡛ࡢ᚟ᖐࡀྍ ⬟࡛࠶ࡗ ࡓയᐖࡀከ࠸ ࡇ࡜ࡀ☜ ㄆࡉࢀࡓࡀ㸪 2 㐌௨ୖ ࡢ᚟ᖐᮇ㛫
ࢆᚲせ࡜ࡋࡓ യᐖ౛ ࡀ 66 ౛㸦21.4㸣㸧㸪4 㐌௨ୖࡢ᚟ᖐ ᮇ㛫ࢆᚲ せ࡜ࡋࡓയᐖ
౛ࡀ 31 ౛㸦10.0㸣㸧☜ㄆࡉࢀࡓ㸬 2 㐌 ௨ୖ ࡢ᚟ᖐᮇ㛫ࢆ ᚲせ࡜ࡋ ࡓ 66 ౛ࡢෆ
ヂࡣ㸪യᐖࡢ 㒊఩࡛ࡳ ࡿ࡜㸪⭸㛵⠇ ࡀ 13 ౛㸦29.5㸣㸧㸪㊊㛵⠇ 9 ౛㸦20.5㸣㸧㸪
ୗ⭣ 6 ౛㸦13.6㸣㸧࡛ ࠶ࡗࡓ㸬യᐖࡢ✀ 㢮࡛ ࡳࡿ࡜㸪᤬᣸ 18 ౛㸦 40.9㸣㸧㸪⭝
⅖/⭝࿘ᅖ⅖ 13 ౛㸦 29.5㸣㸧㸪➽⫗③ /ࢫࣃࢬ ࣒ 7 ౛㸦15.9㸣㸧࡛࠶ ࡗࡓ㸬ࡲࡓ 㸪
ࡇࢀࡽࢆയᐖ ࡢ㒊఩࣭ ✀㢮 ู࡛㞟ィ ࡍࡿ࡜㸪 ㊊㛵⠇ࡢ᤬᣸ ࡀ 9 ౛㸦20.5㸣㸧㸪
⭜᳝/ୗ⫼㒊ࡢ➽⫗③ /ࢫࣃࢬ࣒࠾ࡼ ࡧ⭸㛵⠇ ࡢ༙᭶ᯈ /㌾㦵യᐖࡀ ࡑࢀࡒࢀ 5 ౛
㸦 11.4㸣 㸧 ࡛ ࠶ ࡗ ࡓ 㸬 ඛ ⾜ ㄽ ᩥ ࠿ ࡽ ࡶ 㸪➇ ᢏ ᚟ ᖐ ࡲ ࡛ ࡟ ẚ ㍑ ⓗ㛗 ࠸ ᮇ 㛫 ࢆ ᚲ せ
࡜ࡋࡓയᐖࡢ 㒊఩࣭✀ 㢮ࡀ㊊㛵⠇ࡢ ᤬᣸࡛࠶ ࡿࡇ࡜ࡀከᩘ ሗ࿌ࡉࢀ ࡚࠸ࡿ [Dick
et al., 2007; Hinton et al., 2005; Nielsen and Yde, 1989; Borowski et al., 2008; Junge
50
and Dvorak, 2007; Langevoort et al., 2007; Peterson et al., 2000]㸬኱Ꮫ ዪᏊࣛࢡࣟ
ࢫ㑅ᡭࡢയᐖ ࡢ≉ᚩ࡜ ࡋ࡚㸪㊊㛵⠇ ᤬᣸ࡢയ ᐖⓎ⏕ᩘࡸയ ᐖⓎ⏕⋡ ࡀ᭱ࡶ㧗࠸
ࡇ࡜㸪ࡑࡋ࡚ ྠയᐖࡢ ෌ യᐖࡢⓎ⏕ 㢖ᗘࡀ᭱ ࡶ㧗࠸ࡇ࡜㸪 ࡉࡽ࡟ྠ യᐖࢆⓎ⏕
ᚋ㸪➇ᢏ᚟ᖐ ࡲ࡛࡟ẚ ㍑ⓗ㛗࠸ᮇ㛫 ࢆせࡍࡿ ࡇ࡜ࡀ♧ࡉࢀ ࡓ㸬
་⒪ᶵ㛵࡬ࡢ ཷデࡢ᭷ ↓࡟ࡘ࠸࡚ 㸪ཷデ᭷ ࡾ ࡀ 62 ౛㸦20.1㸣㸧㸪ཷ デ↓ࡋࡀ
247 ౛ 㸦 79.9㸣 㸧 ࡛ ࠶ ࡗ ࡓ ࡀ 㸪 ᮏ ◊ ✲ ࡢ ㄪ ᰝ ᑐ ㇟ ࡛ ࠶ ࡿ ኱ Ꮫ ࡟ ࡣ 㸪 ኱ Ꮫ ᪋ タ ෆ
࡟ࢫ࣏࣮ࢶ་ ⛉Ꮫࢡࣜ ࢽࢵࢡࡀタ⨨ ࡉࢀ࡚࠾ ࡾ㸪ẚ㍑ⓗ་ ᖌࡢデ᩿ ࢆཷࡅࡸࡍ
࠸⎔ቃ࡟࠶ࡗ ࡓ㸬
ᅜෆ࡟࠾ࡅࡿ ዪᏊࣛࢡ ࣟࢫ➇ᢏ㛤ጞ ᖺ㱋࡟ࡘ ࠸࡚㸪ࡑࡢከ ࡃࡀ኱Ꮫ ⏕࠿ࡽ࡛
࠶ࡿࡇ࡜[బ㔝ᮧࡽ , 2012-1]㸪ࡲ ࡓ㸪➇ᢏே ཱྀ࡟ࡘ࠸࡚ࡶ ኱Ꮫ⏕ࡀ ᭱ከ࡛࠶ࡿࡇ
࡜ࡀ᥎ ࡉࢀ ࡚࠸ࡿ㸬 ࡑࡇ࡛㸪኱Ꮫ ⏕ዪᏊࣛ ࢡࣟࢫ㑅ᡭࡢ യᐖࡢ≉ ᚩࢆ㸪Ꮫᖺ
ู࡟ࡳࡓയᐖ Ⓨ⏕⋡࡟ ╔┠ࡋ᳨࡚ウ ࡋࡓ㸦 ᅗ 2-4, ⾲ 2-6㸧㸬Ꮫᖺ ู࡟ࡼࡿയᐖ
Ⓨ⏕⋡ࡣ㸪4 ᖺ ⏕ࡢ യ ᐖⓎ⏕⋡ ࡀ 15.69/1000 AHs ࠾ࡼࡧ 33.08/1000 AEs㸦യᐖ
Ⓨ⏕ᩘ 105 ౛㸪34.0㸣㸧㸪3 ᖺ⏕ࡀ 12.70/1000 AHs ࠾ࡼࡧ 26.40/1000 AEs㸦82
౛㸪26.5㸣㸧㸪2 ᖺ⏕ ࡀ 8.64/1000 AHs ࠾ࡼࡧ 17.36/1000 AEs㸦47 ౛㸪15.2㸣㸧㸪
1 ᖺ⏕ࡀ 8.30/1000 AHs ࠾ࡼࡧ 16.85/1000 AEs㸦75 ౛㸪24.3㸣㸧࡛࠶ࡾ㸪Ꮫᖺࡀ
ୖ఩࡟࡞ࡿ࡯ ࡝യᐖⓎ ⏕⋡ࡀ㧗ࡃ࡞ ࡗ࡚࠸ࡓ 㸦ᅗ 2-4㸧㸬≉ ࡟ 4 ᖺ ⏕ࡣ 1 ᖺ⏕
࡜ẚ࡭࡚㸪࠾ ࠾ࡼ ࡑ 2 ಸ㧗࠸യᐖⓎ ⏕⋡ࢆ♧ ࡋ࡚࠸ࡓ㸬ࡇ ࢀࡣ㸪ࣛ ࢡࣟࢫ➇ᢏ
ṔࡀയᐖⓎ⏕ ⋡࡟ᙳ㡪 ࢆཬࡰࡋ࡚࠸ ࡿࡢ࡛ࡣ ࡞࠸࠿࡜⪃࠼ ࡓ㸬๓㏙ ࡋࡓ࡜࠾ࡾ 㸪
ᅜෆ኱ᏛዪᏊ ࣛࢡࣟࢫ 㑅ᡭࡣ኱Ꮫ⏕ ࠿ࡽ➇ᢏ ࢆ㛤ጞࡍࡿ⪅ ࡀከᩘࢆ ༨ࡵ࡚࠸ࡿ
ࡇ࡜ࡀ᥎ ࡉ ࢀ࡚࠾ࡾ 㸪ධᏛ᫬Ⅼ࡛ ࠸ࢃࡺࡿ ึᚰ⪅࡜࠸࠼ ࡿࣞ࣋ࣝ ࡀከ࠸ࡇ࡜
ࡀ᥎ ࡉࢀࡿ 㸬ࣛࢡࣟ ࢫ➇ᢏࡣࢫࢸ ࢕ࢵࢡࢆ ᧯సࡋ࡚㸪ࣃ ࢫ㸪ࢩࣗ ࣮ࢺࢆ⾜࠺
࡜࠸ࡗࡓ㧗࠸ ᢏ⾡ࡀᚲ せ࡜ࡉࢀ㸪ࡉࡽ࡟ࣛ ࣥ ࢽࣥࢢ㸪ࢲ ࢵࢩࣗ 㸪࢝ ࢵࢸ࢕ࣥࢢ㸪
ࢪࣕࣥࣉືస ➼ࡶ⾜ࢃ ࢀࡿࡇ࡜࠿ࡽ 㸪ࡑࢀࡽ ࡢᢏ⾡࡟ຍ࠼ ࡚㧗࠸య ຊ㠃ࡶせồ
ࡉࢀࡿ➇ᢏ࡛ ࠶ࡿ㸬ࡑ ࡢࡓࡵ㸪ࢫࢸ ࢕ࢵࢡ᧯ సࡸ࢔ࢪࣜࢸ ࢕➼ࡢື సᢏ⾡ࡢ⩦
ᚓࡸయຊࡢྥ ୖ࡟ࡣ㸪 ⤒㦂࡜᫬㛫ࡀ ᚲせ࡛࠶ ࡿ࡜⪃࠼ࡽࢀ ࡿ㸬ࡑࡇ ࡛⦎⩦࠾ࡼ
ࡧヨྜ࡟୰ᚰ ࡜࡞ࡗ࡚ ཧຍࡍࡿ㑅ᡭ ࡀ㸪ࡼࡾ ከࡃࡢ⤒㦂ࢆ ✚ࢇࡔୖ ⣭⏕࡟ẚ㍑
ⓗከ࠸ࡇ࡜ࡀ ᥎ ࡉࢀ 㸪യᐖⓎ ⏕ ⋡ࡀ㧗 ࠸ഴ ྥࢆ♧ࡋࡓࡢ ࡛ࡣ࡞࠸ ࠿࡜⪃࠼ࡓ 㸬
ᮏ◊✲ࡢ㝈⏺ ࡣ㸪ㄪᰝ ᑐ㇟ࡀ 1 ࢳ࣮ ࣒ࡢࡳ࡛ ࠶ࡗࡓⅬ࡛࠶ ࡿ㸬௒ᚋ 㸪ࡼࡾከ
51
ࡃࡢࢳ࣮࣒࣭ ேᩘࢆᑐ ㇟࡜ࡋࡓㄪᰝ ࡟ࡼࡗ࡚ 㸪ࣛࢡࣟࢫയ ᐖࡢ≉ᚩ ࢆࡼࡾヲ⣽
࡟ ♧ ࡍ ࡇ ࡜ ࡀ ྍ ⬟ ࡟ ࡞ ࡿ ࡜ ⪃ ࠼ ࡿ 㸬 ࡑ ࡢ ௚ 㸪 ඛ ⾜ ㄽ ᩥ ࡛ ࡶ ㏙ ࡭ ࡓ ࡀ [బ 㔝 ᮧ ࡽ ,
2012-1]඲࡚ࡢയᐖࡢ 㒊఩㸪✀㢮㸪ཎᅉࡢ ホ ౯ࢆ㸪ᩚᙧእ ⛉་㸪⌮ Ꮫ⒪ἲኈ㸪ࢺ
࣮ࣞࢼ࣮ࡢ᭷ ㈨᱁⪅࡟ ࡼ ࡾ⾜ࢃࢀࡿ ࡇ࡜ࡀᮃ ࡲࡋ࠸࡜⪃࠼ ࡓ㸬
2-1-5. ⤖ ㄒ
኱ᏛዪᏊࣛࢡ ࣟࢫ 㑅ᡭ ࢆᑐ㇟࡜ࡋ ࡓ 2 ᖺ㛫ࡢ യᐖㄪᰝ࡟࠾ ࠸࡚㸪 ௨ ୗࡢയᐖ
ࡢ≉ᚩࡀ♧ࡉ ࢀࡓ㸬
1)
᭱ࡶከ࠸യᐖࡢ㒊఩ࡣ͂㊊㛵⠇࡛̓࠶ࡾ㸪ḟ࡟͂⭸㛵⠇࡛̓࠶ࡗࡓ㸬ୗ
⫥ࡢയᐖࡢ๭ ྜࡀ඲യ ᐖᩘࡢ 7 ๭⛬ ᗘࢆ༨ࡵ ࡚࠸ࡓ㸬
2)
യᐖࡢ✀㢮ࡣ͂᤬ ᣸̓ࡀ᭱ࡶከࡃ 㸪௨ୗ͂ ➽ ⫗③/ࢫࣃࢬ࣒̓͂⭝ ⅖/⭝࿘
ᅖ⅖࡛̓࠶ࡗࡓ㸬͂ᡴ᧞̓࡟ࡘ࠸࡚ࡣ͂ࢫࢸ࢕ࢵࢡࡸ࣮࣎ࣝ࡜ࡢ᥋ゐയ
ᐖ̓࡟ࡼࡿࡶ ࡢࡀ 7 ๭ ⛬ᗘࢆ༨ࡵ࡚ ࠸ࡓ㸬
3)
യᐖࡢཎᅉࡣ ͂౑࠸ࡍ ࡂ̓͂᥋ゐᆺ യᐖ̓͂ 㠀᥋ゐᆺയᐖ ̓ࡀ 3 ኱ཎᅉ
࡜ࡋ࡚♧ࡉࢀ ࡓ㸬
4)
኱ᏛዪᏊࣛࢡࣟࢫ㑅ᡭࡢ୺ࡓࡿയᐖࡢ≉ᚩࡣ͂㠀᥋ゐᆺࡢ㊊㛵⠇᤬᣸̓
࡛࠶ࡗࡓࡀ㸪യᐖࡢ㒊఩࡜✀㢮࡟㝈ᐃࡍࡿ࡜͂㊊㛵⠇᤬᣸̓ࡀࡉࡽ࡟㢧
ⴭ࡟♧ࡉࢀࡓ 㸬
5)
യᐖࡢᅇᩘ࡟ ࡘ࠸࡚㸪 ෌ യᐖࡀ඲യ ᐖࡢ 1/4 ⛬ᗘࢆ༨ࡵ࡚ ࠸ࡓ㸬 ࡲࡓ㸪
᭱ࡶከ࠸෌യ ᐖ౛ࡣ͂ ㊊㛵⠇ࡢ᤬᣸ ࡛̓࠶ࡗ ࡓ㸬
6)
യᐖⓎ⏕ᩘࡀ ᭱ࡶ ከ࠸ ࣏ࢪࢩࣙࣥࡣ ࣑͂ࢵࢻ ࣇ࢕ࣝࢲ࣮ ̓ ࡛࠶ࡗࡓ 㸬
7)
༙ᩘ௨ୖࡢയ ᐖ౛ࡀയ ᐖⓎ⏕᪥࠿ ࡽ 3㹼7 ᪥㛫࡛➇ᢏ᚟ᖐ ฟ᮶࡚࠸ ࡓࡀ㸪
2 㐌௨ୖ࠿࠿ࡗ ࡓയᐖ ౛ࡀ 20㸣⛬ᗘࡳࡽ ࢀ ࡓ㸬
8)
Ꮫᖺูࡢയᐖ Ⓨ⏕⋡ ࡣ 4 ᖺ⏕ࡀ᭱ࡶ㧗 ࡃ㸪 1 ᖺ⏕ࡀ᭱ࡶప࠿ ࡗࡓ 㸬ࡲࡓ㸪
4 ᖺ⏕ࡣ 1 ᖺ⏕ ࡟ẚ࡭ ࡚㸪࠾࠾ࡼ ࡑ 2 ಸ㧗࠸ യᐖⓎ⏕⋡ࢆ ♧ࡋ࡚࠸ ࡓ㸬
9)
യᐖㄪᰝ࡟ࡼࡗ࡚㸪യᐖࡢ≉ᚩࢆࡼࡾヲ⣽࡟᫂ࡽ࠿࡟ࡍࡿࡇ࡜ࡣ㸪௒᪥
ࢫ࣏࣮ࢶ་Ꮫ఍࡛᥎ዡࡉࢀ࡚࠸ࡿ͂ࢫ࣏࣮ࢶയᐖண㜵̓ࡢᐇ㊶࡟ྥࡅࡓ
ྲྀࡾ⤌ࡳࡢ୍ ຓ࡜࡞ ࡿ ࡇ࡜ࡀᮇᚅࡉ ࢀࡿ㸬
52
➨3❶
㊊㊑㛤᤼ࡀືⓗୗ⫥࢔ࣛ࢖࣓ࣥࢺ࡟ཬࡰࡍᙳ㡪
53
◊ ✲ 2 ㊊ ㊑ 㛤᤼ ⬟ ࠾ ࡼࡧ ㊊㊑ 㛤 ᤼ᣦ ♧ࡀ ື ⓗୗ ⫥࢔ ࣛ ࢖࣓ ࣥࢺ ࡟ ཬࡰ ࡍᙳ 㡪 ̿∦ ⬮ࢫ ࢡ ࣡ࢵ ࢺ㸪∦ ⬮ࢻ ࣟࢵ ࣉ ࣛࣥ ࢹ࢕ ࣥ ࢢ㸪࢝ࢵ ࢸ࢕ ࣥ ࢢື స ࡛ࡢ ศᯒ ̿
3-2-1. ⥴ゝ
ࢫ࣏࣮ࢶά ື୰ࡢ⭸ ๓༑Ꮠ㠎ᖏ㸦 anterior cruciate ligament㸸௨ୗ 㸪ACL㸧യᐖ
Ⓨ⏕⋡ࡣዪᛶ ࡟㧗ࡃ [Agel et al., 2005; Olsen et al., 2003]㸪യᐖ᫬ࡢࣅ ࢹ࢜⏬ീㄪ
ᰝ࡟ࡼࡿ࡜ 㸪࢝ࢵࢸ ࢕ ࣥࢢ࠾ࡼࡧ ࢪࣕࣥࣉ ࠿ ࡽࡢ╔ᆅ᫬ ࡟ከⓎࡋ [Boden et al.,
2000; Olsen et al., 2004]㸪ࡑࡢከࡃࡣ ⭸ 㛵⠇እ ཯⫥఩࡛࠶ࡿ ࡇ࡜ࡀሗ ࿌ࡉࢀ࡚࠸
ࡿ[Boden et al., 2009; Krosshaug et al., 2007]㸬
㏆ᖺ㸪ACL യᐖࢆྵࡵ ࡓୗ⫥യᐖண 㜵ࣉࣟࢢ ࣒ࣛࡢ௓ධᡂ ᯝࡀከᩘ ሗ࿌ࡉࢀ 㸪
യᐖண㜵ࣉࣟ ࢢ࣒ࣛࡢ ᐇ᪋ࡀ᥎ዡࡉ ࢀ࡚࠸ࡿ [Grindstaff et al., 2006; Hewett et
al., 1999; Hewett et al., 2006; Mandelbaum et al., 2005; Myklebust et al., 2003 ]㸬ࣉ
ࣟࢢ࣒ࣛ୰ࡢ ືసࡣࢫ ࢡ࣡ࢵ ࢺࡸࢪ ࣕࣥࣉ㸪 ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅື స➼ࡀྵࡲ
ࢀ㸪≉࡟ୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺ࡟╔┠ࡋ 㸪㐣ᗘ࡞ ⭸ 㛵⠇እ཯ࡢ ቑຍ࡟ᑐ ࡋὀពႏ㉳
ࡉࡏࡓᣦᑟࡀ 」ᩘࡳࡽ ࢀࡿ [Mandelbaum et al., 2005; Myer et al., 2004; Myer et al.,
2005; Myklebust et al., 1998; Petersen et al., 2005; ὠ⏣࡜ΎỈ, 2008]㸬ࡑࢀࡽࡣୗ
⫥ࡢ͆ knee-in͇ືస ࡢ ᅇ㑊ࢆ≺࠸࡜ ࡋ㸪ࠕ∎ ඛ㸪⭸㸪⫤㛵⠇ࡀ ୍┤ ⥺࡟࡞ࡿࡼ
࠺࡟ࡋ㸪⭸ࡀෆ ഃ࡟ධ ࡽ࡞࠸ࡼ࠺࡟ ࡍࡿ㸬ࠖ[ὠ⏣࡜ΎỈ, 2008]➼ ࡢືసᣦᑟ࡛
࠶ࡾ㸪㐺ษ࡞ ࢔ࣛ࢖࣓ ࣥࢺࢆ⋓ᚓࡉ ࡏࡿࡓࡵ ࡢ⚄⤒➽༠ㄪ ᛶࡢྥୖ ࢆ≺࠸࡜ࡋ
ࡓᣦᑟἲ࡛࠶ ࡿ㸬ࡑࢀ ࡽࡢከࡃࡣ⭸ ࡸ⫤㛵⠇ 㸪㊊㒊ࡢືࡁ ࢆព㆑ࡉ ࡏ࡚⾜ࢃࡏ
࡚࠸ࡿࡀ㸪ᡃ ࠎࡣࡇࡢ ࡼ࠺࡞ᣦᑟἲ ࡢ࡯࠿࡟ 㸪㊊㊑ࡢືࡁ ࡜㛵㐃ࡉ ࡏࡓᣦᑟࡶ
͆knee-in͇ືసࢆᅇ㑊 ࡉࡏ㸪㐺ษ࡞ୗ ⫥࢔ࣛ ࢖࣓ࣥࢺࡢ⋓ ᚓ࡟ࡘ࡞ ࡀࡿࡢ࡛ࡣ
࡞࠸࠿࡜⪃࠼ ࡓ㸬
㊊㊑ࡢືస࡟ 㛵㐃ࡉࡏ ࡓ㐠ືᣦᑟࡣ ࣜࣁࣅࣜ ࢸ࣮ࢩࣙࣥࡢ 㡿ᇦ࡟࠾ ࠸࡚㸪ࢱ
࢜ࣝࢠࣕࢨ࣮ ࡸ㊊㊑㛤 ᤼㐠ື➼ࡀ⾜ ࢃࢀ࡚࠸ ࡿ࡯࠿ [Mattacola and Dwyer, 2002;
୕ᮌ࡜ⵦ⏣, 2003; ୰Ụ࡜ఀబᆅ, 2011; Wolfe et al., 2001]㸪࢔ ࢫࣞ ࢸ࢕ࢵࢡࣜࣁ
ࣅࣜࢸ࣮ࢩࣙ ࣥࡸࢺࣞ ࣮ࢽࣥࢢ࡟࠾ ࠸࡚ࡶྠ ᵝ࡞࢚ࢡࢧࢧ ࢖ࢬࡀ⚄ ⤒➽༠ㄪᛶ
ࢺ࣮ࣞࢽࣥࢢ ࡢ୍⎔࡜ ࡋ࡚⾜ࢃࢀ࡚ ࠸ࡿ [Anderson et al., 2009; Hirth, 2004; ᓥ
⃝, 2008]㸬ࡇࢀࡽࡢሗ ࿌࠿ࡽ㸪㊊㊑ ࡢືసࡣ ୗ⫥ࡢᶵ⬟ྥ ୖࡢࡓࡵ ࡟㔜せ࡞ᙺ
54
๭ࢆᯝࡓࡋ࡚ ࠸ࡿࡇ࡜ ࡀ࠺࠿ࡀ࠼ࡿ ࡀ㸪 ୗ⫥ യᐖண㜵ࣉࣟ ࢢ࣒࡛ࣛ ⾜ࢃࢀ࡚࠸
ࡿࢫࢡ࣡ࢵࢺ ࠾ࡼࡧࢪ ࣕࣥࣉ࠿ࡽࡢ ╔ᆅ㸪࢝ ࢵࢸ࢕ࣥࢢື స࡟࠾࠸ ࡚ࡶ㊊㊑ື
సࢆព㆑ࡉࡏ ࡓ ᣦ ᑟࡣ 㸪ືⓗୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺࡢᨵၿ࡟ᐤ ୚ࡍࡿࡢ ࡛ࡣ࡞࠸࠿
࡜⪃࠼ࡓ㸬
ᮏ◊✲ࡣ㸪㊊ ㊑㛤᤼ࢆ ᣦ♧ࡋࡓ᫬ࡢ ㊊㊑㛤᤼ ⬟࡜∦⬮ࢫࢡ ࣡ࢵࢺ㸪 ∦⬮ࢻࣟ
ࢵࣉࣛࣥࢹ࢕ ࣥࢢ㸪࢝ ࢵࢸ࢕ࣥࢢ ື స᫬ࡢ⭸ 㛵⠇እ཯➼ࡢ ືⓗୗ⫥ ࢔ࣛ࢖࣓ࣥ
ࢺ࡜ࡢ㛵㐃ᛶ ࠾ࡼࡧ ㊊ ㊑㛤᤼⬟ࡢ኱ ᑠࡀ ືⓗ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺ ࡟ཬ ࡰࡍᙳ㡪࡟
ࡘ࠸࡚㸪ࡲࡓ 㸪 ㊊㊑㛤 ᤼ᣦ♧ࡢ᭷↓ ࡀ ືⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ ࡟ཬࡰ ࡍᙳ㡪࡟ࡘ
࠸࡚ẚ㍑᳨ウ ࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ࡋ ࡓ 㸬௬ㄝࡣ 㸪㊊㊑㛤᤼⬟ ࡀ㧗࠸ ⪅ ࡣ∦⬮ࢫࢡ
࣡ࢵࢺ㸪∦⬮ ࢻࣟࢵࣉ ࣛࣥࢹ࢕ࣥࢢ 㸪࢝ࢵࢸ ࢕ࣥࢢ᫬ࡢ⭸ 㛵⠇እ཯ ࠾ࡼࡧ⫤㛵
⠇ෆ㌿ືసࢆ ࡼࡾไᚚ ࡍࡿࡇ࡜㸪ࡲ ࡓ㸪㊊㊑ 㛤᤼ᣦ♧ ࠶ࡾ ࡣᣦ♧࡞ ࡋ࡟ẚ࡭㸪
ྠㄢ㢟ືస᫬ ࡢ⭸㛵⠇ እ཯࠾ࡼࡧ⫤ 㛵⠇ෆ㌿ ືసࢆࡼࡾไ ᚚࡍࡿ࡜ ࠸࠺ࡶࡢ࡛
࠶ࡿ㸬
3-2-2. ᑐ㇟࡜᪉ἲ
1㸬ᑐ㇟
ᑐ㇟⪅ࡣ 㸪೺ᗣ࡞ య⫱ ኱Ꮫ⏕ዪ Ꮚ 50 ྡ㸦඲౛ ࢫ࣏࣮ࢶάື Ṕ 6 ᖺ௨ ୖ࠶ࡾ㸧㸪
ᖹᆒᖺ㱋㸦±ᶆ‽೫ᕪ 㸧ࡣ 20.0 ± 1.3 ṓ㸪㌟㛗 159.6 ± 5.8cm㸪 య 㔜 55.1 ± 6.3kg
࡛࠶ࡗࡓ㸬ᮏ◊✲ࡣ㸪᪥ᮏయ⫱኱Ꮫ೔⌮ᑂᰝጤဨ఍ࡢᢎㄆࢆᚓ㸦ᢎㄆ␒ྕ ➨
008-H15 ྕ㸧㸪⿕㦂⪅ ࡟ᮏ◊✲ࡢ୺ ᪨ࡸ ᐃ ෆᐜ㸪೔⌮ⓗ 㓄៖࡟ࡘ ࠸࡚ࡢㄝ᫂
ࢆᩥ᭩࠾ࡼࡧ ཱྀ㢌࡟࡚ ⾜࠸㸪᭩㠃࡟ ࡚ྠពࢆ ᚓ࡚⾜ࡗࡓ㸬 ࡲࡓ㸪ᮏ ◊✲࡛ ⾜࠺
ㄢ㢟ືస࡟ࡘ ࠸࡚㸪 ୗ ⫥➼࡬ࡢᨭ㞀 ࡀ࡞࠸ࡇ ࡜ࢆ ☜ㄆࡋࡓ 㸬
2㸬㊊㊑㛤᤼⬟ࡢ ホ౯ ࡜⩌ศࡅ
㊊㊑㛤᤼⬟ࡢ ᐃ࠾ࡼ ࡧホ౯ࡣ㸪᭹ 㒊 [᭹㒊, 1996]ࡢ᪉ἲࢆཧ⪃ ࡟ ⾜ࡗࡓ㸬ᅗ
2-1 ࡟ ♧ ࡍ࡜ ࠾ ࡾ 㸪㊊ ㊑㛤 ᤼ ᫬ ࡜㊊ ㊑ Ᏻ㟼 ᫬ ࡢ➨ Ϩ ㊊ ㊑ඛ ➃ ࠿ࡽ ➨ Ϭ㊊ ㊑ ඛ➃
ࡲ࡛ࡢ㊥㞳ࡢ ᕪࢆ㊊㊑ Ᏻ㟼᫬ࡢྠ㊥ 㞳࡛㝖ࡋ ࡚ 100 ࢆ஌ࡌࡓࡶࡢࢆ ࢫࣃࣥᣦᩘ
㸦%㸧 ࡜ ࡋ ࡓ 㸬 ㊊㊑ 㛤 ᤼ ື సࡣ 㸪 ㊊ ᗏ 㒊 ࠾ࡼ ࡧ ㊊ ㊑ࢆ ㍍ ࡃ ᗋ ࡟ ╔ࡅ ࡓ ≧ ែ࡛ ⾜
ࢃࡏࡓ㸬ᑐ㇟⪅ 50 ྡ ࡢࢫࣃࣥᣦᩘ ࡢࣄࢫࢺ ࢢ࣒ࣛࡣ ᅗ 2-2 ࡟♧ࡍ ㏻ࡾ࡛ 㸪ᗘᩘ
࡟ࡣ኱ࡁ ࡃ 3 ࡘࡢࣆ࣮ ࢡࡀ࠼ࡽࢀࡓ 㸬ᗘ ᩘ 0 ྡ࡛࠶ࡗࡓ㝵 ⣭್ 6.5%ࡲ࡛ࢆ୍ࡘ
55
ࡢ⩌࡜ࡋ࡚ᑠ ⩌㸪 2 ࡘ ࡵࡢࣆ࣮ࢡࢆ ୰ᚰ࡜ࡋ 㝵⣭ 9.0%࠿ࡽ 29.0%ࡲ࡛ࢆ୰⩌㸪
㝵⣭್ 29.0%㉸ࢆ኱⩌ ࡜⩌ศࡅࡋࡓ 㸬ᑠ⩌ ࡣ 11 ྡ㸦ࢫࣃࣥᣦᩘ -1.1 ± 3.7%㸧㸦ᖹ
ᆒ±ᶆ‽೫ᕪ㸧㸪୰⩌ 24 ྡ㸦19.7 ± 5.3%㸧㸪኱⩌ 15 ྡ㸦38.8 ± 6.5%㸧࡛࠶ࡗࡓ㸬
56
୰⩌
n=24
10
9
8
7
ᗘᩘ
6
ᑠ⩌
n=11
኱⩌
n=15
5
4
3
2
49.0~51.5
46.5~49.0
9.0~11.5
11.5~14.0
14.0~16.5
16.5~19.0
19.0~21.5
21.5~24.0
24.0~26.5
26.5~29.0
29.0~31.5
31.5~34.0
34.0~36.5
36.5~39.0
39.0~41.5
41.5~44.0
44.0~46.5
4.0~6.5
6.5~9.0
0
-6.0~-3.5
-3.5~-1.0
-1.0~1.5
1.5~4.0
1
䠄䠂䠅
㝵⣭್
ᅗ2-2 䝇䝟䞁ᣦᩘ䛾䝠䝇䝖䜾䝷䝮䛸⩌ศ䛡
3㸬ㄢ㢟ືస
ㄢ㢟ືసࡣ∦ ⬮ࢫࢡ࣡ ࢵࢺ㸪∦⬮ࢻ ࣟࢵࣉࣛ ࣥࢹ࢕ࣥࢢ㸪 ࢝ࢵࢸ࢕ ࣥࢢࡢ 3
✀㢮࡜ࡋ㸪ࡑ ࢀࡒ ࢀ 3 ᅇࡢ᭷ຠヨᢏ ࡀᚓࡽࢀ ࡿࡲ࡛⾜ࢃࡏ ࡓ㸬඲࡚ ࡢㄢ㢟ືస
ࡣ฼ࡁ⬮㸦඲ ౛㸪ྑ⬮ 㸧࡛ ⾜ࢃࡏ㸪 ฼ࡁ⬮ࡢ ᐃ⩏ࢆࠕ࣮࣎ ࣝࢆྍ⬟ ࡞㝈ࡾ㐲ࡃ
࡟㋾ࡿࡇ࡜ࡀ ࡛ࡁࡿഃ ࡢ⬮ࠖ࡜ࡋࡓ [Ford et al., 2003]㸬㊊㊑㛤᤼᫬ ࡢ ᣦ♧ࡣࠕ㊊
㊑ࢆྍ⬟࡞㝈 ࡾ㛤࠸࡚ 㸦ࡓ࡜࠼㛤࠿ ࡞ࡃ࡚ࡶ 㛤࠿ࡏࡼ࠺࡜ ࡍࡿព㆑ ࢆᣢࡕ࡞ࡀ
ࡽ㸧㸪ᗋࢆᥗ ࡴࡼ࠺࡟ ⾜ࡗ࡚ࡃࡔࡉ ࠸㸬ࠖ࡜ ࡋ㸪ᮏ◊✲ࡢ ௬ㄝ࡟ᙳ 㡪ࢆཬࡰࡍ
ᢏ⾡ⓗᣦ♧ࡸ ព㆑➼࡟ 㛵ࡍࡿᣦ♧ࡣ ୍ษ⾜ࢃ ࡞࠿ࡗࡓ㸬 ྛ ヨᢏࢆ㊊ ㊑㛤᤼ᣦ♧
࡞ࡋ㸦௨ୗ 㸪Neutral㸧࡜ᣦ♧࠶ࡾࡢ ሙྜ㸦 ௨ ୗ㸪Open㸧࡛⾜ ࢃࡏࡓ 㸬௨ୗ࡟ྛ
ㄢ㢟ືసࡢヲ ⣽ࢆ♧ࡍ 㸬
57
a㸬∦⬮ࢫࢡ࣡ࢵࢺ
∦⬮ࢫࢡ࣡ࢵ ࢺࡢ᪉ἲ ࢆᅗ 2-3 ࡟♧ ࡍ㸬฼ࡁ ⬮ࡢࡘࡲඛࢆ ṇ㠃࡟ྥ ࡅ࡚ ❧ࡓ
ࡏ㸪 ᑐഃ ⬮ࡣ ⭸㛵 ⠇ ࢆ 90°⛬ᗘ ᒅ᭤ ࡋ㸪 ㊊ 㒊ࢆ ᨭᣢ ⬮ࡢ ᚋ᪉ ࡟఩ ⨨ࡉ ࡏࡓ 㸬୧
ᡭࡢ⏥ࢆ㍍ࡃ ⭜࡟ᙜ࡚ 㸪┠⥺ࡣṇ㠃 ࡟ྥࡅࡉ ࡏࡓ㸬ࡋࡷࡀ ࡴ῝ࡉࡣ ⭸㛵⠇ᒅ᭤
60°ࡲ ࡛ ࡜ࡋ 㸪ࡋ ࡷࡀ ࡴࢫ ࣆ࣮ ࢻࡣ ࣓ࢺ ࣟࣀ ࣮࣒ ࢆ⏝ ࠸㸪 2 ⛊ ࠿ࡅ ࡚ࡋ ࡷࡀ ࡳ㸪
❧ࡕୖࡀࡿࡇ ࡜࡜ࡋࡓ 㸬ືస୰㸪య ᖿࡸ㦵┙ ࡢ㐣ᗘ࡞ᅇ᪕ ࡸᕥྑ࡬ ࡢഴᩳ㸪㊊
㊑ࢆ㛤࠸࡚ᗋ ࢆᥗࡵ࡚ ࠸࡞࠿ࡗࡓ㸪 ࡶࡋࡃࡣ ㊊㊑ࢆ㛤࠸࡚ ᗋࢆᥗࡶ ࠺࡜ࡍࡿព
㆑ࡀ࡛ࡁ࡞࠿ ࡗࡓሙྜ ࡣ↓ຠ࡜ࡋࡓ 㸬࡞࠾㸪 1 ヨᢏ⤊஢ẖ ࡟୧⬮࡛ ❧ࡓࡏ㸪୍
᪦ⴠࡕ╔࠿ࡏ ࡓ≧ែ࡟ ࡉࡏ࡚࠿ࡽḟ ࡢヨᢏ࡬ ࡜⛣⾜ࡋࡓ㸬 ᩘᅇࡢ⦎ ⩦ࢆ⾜ࢃࡏ
ࡓᚋ࡟ᮏヨᢏ ࡬࡜⛣⾜ ࡋࡓ㸬ࡋࡷࡀ ࡴ๓ࡢ∦ ⬮❧఩᫬Ⅼࢆ ࢫࢱࣥࢹ ࢕ࣥࢢ࣏ࢪ
ࢩࣙࣥ㸦௨ ୗ㸪ST㸧㸪ࡋࡷࡀࡳ㎸ࡳ ᫬ࡢྑୖ ๓⭠㦵Ჲࡀ᭱ ࡶୗ᪉࡟ ఩⨨ࡋࡓ᫬
Ⅼࢆࢫࢡ࣡ࢵ ࢺ࣏ࢪࢩ ࣙ ࣥ㸦௨ୗ㸪SQ㸧 ࡜ ࡋࡓ㸬
b
a
ᅗ2-3 ∦⬮䝇䜽䝽䝑䝖
䝇䝍䞁䝕䜱䞁䜾䝫䝆䝅䝵䞁䠄ST䠅䠄a䠅䛛䜙䠈⭸ᒅ᭤60㼻䜎䛷䛧䜓䛜䜣䛰᫬Ⅼ䜢䝇䜽䝽䝑䝖䝫䝆䝅䝵䞁䠄SQ䠅䠄b䠅䛸䛧䛯䠊
58
b㸬∦⬮ࢻࣟࢵࣉ ࣛࣥ ࢹ࢕ࣥࢢ
∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢࡢ᪉ἲࢆ ᅗ 2-4 ࡟ ♧ࡍ㸬30cm 㧗ࡢ㛗 ᪉ ᙧࡢྎୖ࠿
ࡽ㸪ྎ๓᪉ࡢ ㎶ࡢ 30cm ๓᪉࡟ ᥥ࠸ࡓᯟ ෆ ࡟∎ඛࢆṇ㠃 ࡟ྥࡅࡓ ⫥఩࡛╔ᆅࡉ
ࡏࡓ㸬ࢫࢱ࣮ ࢺࡣ฼ࡁ ⬮ࡢᑐഃ⬮㸦 ඲౛㸪ᕥ ⬮㸧࡛❧ࡕ㸪 ฼ࡁ⬮ࢆ ๓᪉࡟㍍ࡃ
ฟࡋࡓ≧ែ࠿ ࡽ㸪ᣦᐃ ࡉࢀࡓᯟෆ㸦 㛗ࡉ 30cm㸪 ᖜ 15cm㸧࡟฼ ࡁ ⬮࡛㣕ࡧ㝆ࡾ
ࡿࡇ࡜࡜ࡋࡓ 㸬୧ ᡭࡢ ⏥ࢆ㍍ࡃ⭜࡟ ᙜ࡚ 㸪┠ ⥺ࡣฟ᮶ࡿ㝈 ࡾṇ㠃࡟ ྥࡅࡉࡏࡓ㸬
ືస୰㸪యᖿ ࡸ㦵┙ࡢ 㐣ᗘ࡞ᅇ᪕ࡸ ᕥྑ࡬ࡢ ഴᩳ㸪╔ᆅࡋ ࡓ㊊఩⨨ ࡀࡎࢀࡿ㸪
╔ᆅ᫬࡟㊊㊑ ࢆ㛤࠸࡚ ᗋࢆᥗࡵ࡞࠿ ࡗࡓ㸪ࡶ ࡋࡃࡣ㊊㊑ࢆ 㛤࠸࡚ᗋ ࢆᥗࡶ࠺࡜
ࡍࡿព㆑ࡀ࡛ ࡁ࡞࠿ࡗ ࡓሙྜࡣ↓ຠ ࡜ࡋࡓ㸬 ᩘᅇࡢ⦎⩦ࢆ ⾜ࢃࡏࡓ ᚋ࡟ᮏヨᢏ
࡬࡜⛣⾜ࡋࡓ 㸬㣕ࡧ㝆 ࡾࡓᚋ㸪∎ඛ ࡀᗋ࡟᥋ ᆅࡋࡓ᫬Ⅼࢆ ࢖ࢽࢩࣕ ࣝࢥࣥࢱࢡ
ࢺ㸦௨ୗ㸪IC㸧࡜ࡋ㸪IC ᚋ㸪ྑୖ ๓⭠㦵Ჲ ࡀ᭱ࡶୗ᪉࡟ ఩⨨ࡋࡓ ᫬Ⅼࢆࣛࣥࢹ
࢕ࣥࢢ࣏ࢪࢩ ࣙࣥ㸦௨ ୗ㸪 LD㸧࡜ࡋࡓ㸬
a
b
ᅗ2-4 ∦⬮䝗䝻䝑䝥䝷䞁䝕䜱䞁䜾
30cm㧗䛾ྎୖ䛛䜙㣕䜃㝆䜚䛯ᚋ䠈∎ඛ䛜ᗋ䛻᥋ᆅ䛧䛯᫬Ⅼ䜢䜲䝙䝅䝱䝹䝁䞁䝍䜽䝖䠄IC䠅䠄a䠅䠈ICᚋ䠈ྑୖ๓⭠㦵Ჲ䛜᭱䜒
ୗ᪉䛻఩⨨䛧䛯᫬Ⅼ䜢䝷䞁䝕䜱䞁䜾䝫䝆䝅䝵䞁䠄LD䠅䠄b䠅䛸䛧䛯䠊
59
c㸬࢝ࢵࢸ࢕ࣥࢢ
࢝ࢵࢸ࢕ࣥࢢ ࡢ᪉ἲࢆ ᅗ 2-5 ࡟♧ࡍ 㸬5m 㞳 ࢀࡓᆅⅬ࠿ࡽ ຓ㉮ࡉࡏ 㸪ᣦᐃࡋ ࡓ
ᯟෆ㸦㛗ࡉ 45cm㸪ᖜ 45cm㸧࡟ ฼ࡁ⬮㸦඲౛ 㸪ྑ⬮㸧࡛╔ᆅࡋ㸪཯ ᑐഃ㸦ᕥഃ㸧
45°᪉ྥ㸦 ⠊ᅖ 35°㹼55°㸧࡟᪉ྥ ㌿᥮ࡋ࡚ ㉮ ࡾᢤࡅࡿࡇ࡜ ࡜ࡋࡓ㸬ຓ㉮ࢫࣆ࣮ࢻ
ࡣ 4.5㹼5.5m/sec ࡜ࡋ㸪࢝ࢵࢸ࢕ࣥࢢ ᫬࡟ࡣ 㸪ࠕ๓᪉࡟ேࡀ❧ ࡗ࡚ ࠸ࡿࡇ࡜ࢆ᝿
ീࡋ㸪ࡑࡢே ࢆࣇ࢙࢖ ࢡࡋ࡚཯ᑐ᪉ ྥ࡟㉮ࡾ ᢤࡅࡿ㸬ࠖࢆ ࢖࣓࣮ࢪ ࡉࡏࡓ㸬ື
స୰㸪ᴃ෇㉮ ⾜➼ࡢ᫂ ࡽ࠿࡟࢝ࢵࢸ ࢕ࣥࢢື స࡟࡞ࡗ࡚࠸ ࡞࠸ሙྜ ࡸ㸪ᣦᐃࡋ
ࡓᯟෆ࡟╔ᆅ ࡋ࡚࠸࡞ ࠸ሙྜ㸪╔ᆅ ᫬࡟㊊㊑ ࢆ㛤࠸࡚ᗋࢆ ᥗࡵ࡞࠿ ࡗࡓ㸪ࡶࡋ
ࡃࡣ㊊㊑ࢆ㛤 ࠸࡚ᗋࢆ ᥗࡶ࠺࡜ࡍࡿ ព㆑ࡀ࡛ ࡁ࡞࠿ࡗࡓሙ ྜࡣ↓ຠ ࡜ࡋࡓ㸬ᩘ
ᅇࡢ⦎⩦ࢆ⾜ ࢃࡏࡓᚋ ࡟ᮏヨᢏ࡬࡜ ⛣⾜ࡋࡓ 㸬∎ඛ࠶ࡿ࠸ ࡣ㋖ࡀᗋ ࡟᥋ᆅࡋࡓ
᫬Ⅼࢆ࢖ࢽࢩ ࣕࣝ ࢥࣥ ࢱࢡࢺ㸦௨ୗ㸪IC㸧࡜ ࡋ㸪IC ᚋ࡟ࡳ ࡽࢀࡓ ᭱኱⭸ 㛵⠇እ
཯ࡲࡓࡣ᭱኱ ⭸ 㛵⠇ෆ ཯᫬Ⅼࢆࣛࣥ ࢹ ࢕ ࣥ ࢢ ࣏ ࢪ ࢩ ࣙ ࣥ 㸦 ௨ ୗ 㸪 LD㸧 ࡜ ࡋ ࡓ 㸬
a
b
START
5m
c
55䜪
35䜪
45䜪
ᅗ2-5 䜹䝑䝔䜱䞁䜾
5m㞳䜜䛯ᆅⅬ䛛䜙䛾ຓ㉮ᚋ䠈ᣦᐃ䛧䛯ᯟෆ䛻฼䛝⬮䛷╔ᆅ䛧䠈཯ᑐഃ45㼻᪉ྥ䠄⠊ᅖ35㼻䡚55㼻䠅䛻᪉ྥ㌿᥮䛧䛶㉮䜚ᢤ
䛡䜛䛣䛸䛸䛧䛯䠄a䠅䠊∎ඛ䜎䛯䛿㋖䛜ᗋ䛻᥋ᆅ䛧䛯᫬Ⅼ䜢䜲䝙䝅䝱䝹䝁䞁䝍䜽䝖䠄IC䠅䠄b䠅䠈ICᚋ䛻䜏䜙䜜䛯᭱኱⭸እ཯䜎䛯䛿᭱
኱⭸ෆ཯᫬Ⅼ䜢䝷䞁䝕䜱䞁䜾䝫䝆䝅䝵䞁䠄LD䠅䠄c䠅䛸䛧䛯䠊
60
4㸬఩⨨ࢹ࣮ࢱࡢ ཰㞟 ࡜ศᯒ㡯┠
཯ᑕ࣐࣮࣮࢝ 㸦┤ ᚄ 12mm㸧ࢆ 㸪୧⭠㦵 ⛸᭱ እഃⅬ㸪୧ୖ ๓⭠㦵Ჲ 㸪୧኱㌿
Ꮚ㸪ྑ⭸⵹㦵 ୰ኸ࡜ྑ ୖ๓⭠㦵Ჲ࡜ ࡢ୰Ⅼ㸪 ྑ኱㌿Ꮚ࡜ྑ ኱⭣㦵እ ഃୖ㢛࡜ࡢ
୰Ⅼ㸪ྑ⭸⵹ 㦵୰ኸ㸪 ྑ⭸⵹㦵᭱ෆ ഃ࣭እഃ ⦕㸪ྑ኱⭣㦵 ෆഃ࣭እ ഃୖ㢛㸪ྑ
⬯㦵⢒㠃㸪ྑ ⭸㛵⠇⿣ 㝽እഃ㸪ྑ⬯ 㦵ෆഃ㢛 㸪ྑ⭌㦵㢌㸪 ྑ⭌㦵㢌 ࡜ྑ㊊㛵⠇
እᯝ࡜ࡢ୰Ⅼ㸪ྑ⬯㦵 ⢒㠃࡜ྑ㊊㛵 ⠇ෆᯝ࣭እᯝ୰Ⅼ࡜ࡢ ୰Ⅼ㸪ྑ ㊊㛵⠇ෆᯝ࣭
እᯝ㸪ྑ㊊㛵 ⠇ෆᯝ࣭ እᯝࡢ୰Ⅼ㸪 ➨ 1 ୰㊊ 㦵㦵㢌㸪 ➨ 2 ୰㊊㦵㦵 㢌㸪➨ 5 ୰
㊊㦵㦵㢌࡟㈞ ௜ࡋࡓ㸬㧗㏿ᗘ࣓࢝ࣛ㸦 FASTCAM ultima1024㸪PHOTORON㸪Tokyo㸪
Japan㸧ࢆṇ㠃 ࡟タ ⨨ ࡋ㸪∦ ⬮ࢫࢡ ࣡ࢵ ࢺࡣ ࢧࣥࣉ ࣜࣥࢢ ࿘Ἴᩘ 60Hz㸪∦⬮ ࢻ
ࣟࢵࣉࣛࣥࢹ ࢕ࣥࢢ࠾ ࡼࡧ࢝ࢵࢸ࢕ ࣥࢢࡣࢧ ࣥࣉࣜࣥࢢ࿘ Ἴᩘ 250Hz ࡟࡚᧜ᙳ
ࡋࡓ 㸬ᚓ ࡽ ࢀࡓ ⏬ീ ࠿ ࡽ㸪 ஧ḟ ඖ ゎᯒ ࢯࣇ ࢺ 㸦 Frame- DIASϫ 㸪DKH㸪Tokyo㸪
Japan㸧ࢆ⏝࠸࡚ゎᯒ ࡋࡓ㸬
௒ᅇࡢศᯒ࡟ ⏝࠸ࡓࡢ ࡣୖグࡢ㈞௜ ࣐࣮࣮࢝ ࡢ࠺ࡕࡢ 4 Ⅼ ࡢ ࣐࣮࢝ ࣮㸦୧ୖ
๓⭠㦵Ჲ㸪ྑ ⭸⵹㦵୰ ኸ㸪㊊㛵⠇ෆ ᯝ࣭እᯝ୰ Ⅼ㸧࡛㸪ᅗ 2-6 ࡟ ♧ࡍྛ ㊥㞳 ℓ1(cm)㸪
ℓ2(cm)㸪L(cm) ࢆồࡵ 㸪ࡇࢀࡽࡼࡾ ௨ୗ ࡢ 2 ࡘࡢࣃ࣓࣮ࣛ ࢱࢆ⟬ฟ ࡋࡓ㸬
ձ⭸ෆ᪉೫఩ ⋡ (%) 㸻㸦ℓ1㸭L㸧×100
ղ ⭸ እ ཯ ⋡ (%) 㸻 㸦 ℓ1㸩 ℓ2㸭 L㸧 ×100㸦 ྑ ⭸ ⵹ 㦵 ୰ ኸ 㸪 ྑ ୖ ๓ ⭠ 㦵 Ჲ 㸪 ྑ ㊊
㛵⠇ෆᯝ࣭እ ᯝ୰Ⅼࡢ ఩⨨㛵ಀ࡟࠿ ࠿ࢃࡽࡎ ⭸ 㛵⠇እ཯࡛ ࡣࣉࣛࢫ 㸪⭸ 㛵
⠇ෆ཯࡛ࡣ࣐ ࢖ࢼࢫ࡜ ࡞ࡿ㸧
ࡲࡓ㸪୧ୖ๓ ⭠㦵Ჲ㸪 ྑ⭸⵹㦵୰ኸ ࡢ࣐࣮࢝ ࣮ࡼࡾḟ ࡢ 2 ࡘࡢゅᗘ ࢆ ᐃࡋ
ࡓ㸬
ճ⫤㛵⠇ෆ㌿ ゅ (°)㸸୧ ୖ๓⭠㦵Ჲࢆ ⤖ࢇࡔ⥺ ࡢᆶ⥺࡜㸪ྑୖ ๓⭠㦵 Ჲ࡜ྑ⭸
⵹㦵୰ኸࢆ⤖ ࢇࡔ⥺ࡢ ࡞ࡍゅᗘ㸦ෆ㌿᪉ ྥࡣ ࣉࣛࢫ㸪እ㌿᪉ྥ ࡣ࣐ ࢖ࢼࢫ㸧㸬
մ㦵┙ഃ᪉ഴ ᩳゅ (°)㸸୧ୖ๓⭠㦵Ჲ ࢆ⤖ࢇࡔ ⥺࡜Ỉᖹ⥺࡜ ࡢゅᗘ㸦 ᕥୖ๓⭠
㦵Ჲ⥺ࡀྑഃ ࡼࡾ㧗఩ ࡢሙྜࢆࣉࣛ ࢫ㸪ప఩ ࡢሙྜࢆ࣐࢖ ࢼࢫ㸧㸬
61
5. ẚ㍑᳨ウ㡯┠
∦⬮ࢫࢡ࣡ࢵ ࢺືసࡢ ゎᯒࡣ㸪 SQ ᫬ࡢ ྛࣃ ࣓࣮ࣛࢱ࠾ࡼ ࡧ ST ᫬࠿ࡽ SQ ᫬
ࡲ࡛ࡢྛࣃࣛ ࣓࣮ࢱ ࡢ ኚ໬㔞࡜ࡋࡓ 㸬∦⬮ࢻ ࣟࢵࣉࣛࣥࢹ ࢕ࣥࢢ ࠾ ࡼࡧ࢝ࢵࢸ
࢕ࣥࢢືసࡢ ゎᯒࡣ㸪IC ᫬㸪LD ᫬ࡢ ྛࣃࣛ ࣓࣮ࢱ ࠾ࡼ ࡧ IC ᫬࠿ ࡽ LD ᫬ࡲ࡛
ࡢྛࣃ࣓࣮ࣛ ࢱࡢኚ໬ 㔞࡜ࡋࡓ㸬 ᳨ ウ㡯┠ࡣ 㸪 ㊊㊑㛤᤼⬟ ࡜ྛㄢ㢟 ືసࡢྛࣃ
62
࣓࣮ࣛࢱ࡜ࡢ ┦㛵㛵ಀ ࢆ㸪ࡲࡓ㸪 ㊊ ㊑㛤᤼⬟ ࡢᑠ⩌㸪୰⩌ 㸪኱⩌ࡢ ྛ⩌ࡢྛㄢ
㢟ືసࡢྛࣃ ࣓࣮ࣛࢱ ࡢẚ㍑ࢆ㸪ࡑ ࡋ࡚㊊㊑ 㛤᤼ᣦ♧࠶ࡾ ࣭࡞ࡋࡢ ሙྜࡢྛㄢ
㢟ືసࡢྛࣃ ࣓࣮ࣛࢱ ࡢẚ㍑࡜ࡋࡓ 㸬
6㸬⤫ィᏛⓗศᯒ
㊊㊑㛤᤼⬟࡜ ྛㄢ㢟ື సࡢྛࣃ࣓ࣛ ࣮ࢱ࡜ࡢ ┦㛵㛵ಀࢆࣆ ࢔ࢯࣥࡢ ┦㛵ಀᩘ
ࢆ⏝࠸᳨࡚ウ ࡋࡓ㸬 ㊊ ㊑㛤᤼⬟ࡢᑠ ⩌㸪୰⩌ 㸪኱⩌ࡢ⩌㛫 ࡟࠾࠸࡚ 㸪ྛㄢ㢟ື
సࡢྛࣃ࣓ࣛ ࣮ࢱ ࡢ୍ ඖ㓄⨨ศᩓศ ᯒࢆ⾜࠸ 㸪᭷ពᕪ ࡢᚓࡽࢀ ࡓᑐ ㇟⩌࡟ᑐࡋ 㸪
Tukey-Kramer ἲ࡟ࡼ ࡿከ㔜ẚ㍑᳨ ᐃࢆ⾜ࡗ ࡓ㸬ࡲࡓ㸪ྛㄢ㢟ື స ࡟࠾ࡅࡿྛ ࣃ
࣓࣮ࣛࢱ ࡢ Neutral ࡜ Open ࡜ࡢẚ㍑࡟࠾ ࠸ ࡚㸪ᑐᛂࡢ࠶ ࡿ t ᳨ᐃ ࢆ⏝࠸ ࡓ㸬඲
࡚ࡢ⤫ィᏛⓗ ศᯒ࡟ࡼ ࡿ᭷ពỈ‽ ࢆ 5㸣ᮍ‶ ࡜ࡋࡓ㸬
3-2-3.
⤖ᯝ
1㸬∦⬮ࢫࢡ࣡ࢵ ࢺ
∦⬮ࢫࢡ࣡ࢵ ࢺ ᫬㸦Open㸧ࡢྛࣃ࣓࣮ࣛ ࢱ ࢆ⾲ 2-1 ࡟♧ࡍ 㸬
⾲2-1䚷∦⬮䝇䜽䝽䝑䝖᫬䛾ྛ䝟䝷䝯䞊䝍䞊 (n=50) ( mean㼼SD )
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
SQ
55.7
± 11.1
ST䊻SQ
21.3
± 10.4
SQ
56.7
± 19.7
ST䊻SQ
39.6
± 18.4
SQ
15.3
± 5.8
ST䊻SQ
7.2
± 5.5
SQ
2.8
± 3.5
ST䊻SQ
0.4
± 3.4
SQ䠖䝇䜽䝽䝑䝖᫬䠊
ST 䠖∦⬮❧఩᫬䠊
ST 䊻SQ䠖ST ᫬䛛䜙SQ᫬䜎䛷䛾ኚ໬㔞䠊
63
∦⬮ࢫࢡ࣡ࢵ ࢺ᫬㸦Open㸧ࡢ㊊㊑㛤 ᤼⬟࡜ྛ ࣃ࣓࣮ࣛࢱ࡜ ࡢ┦㛵 㛵 ಀࢆ⾲ 2-2
࡟♧ࡍ㸬㊊㊑ 㛤᤼⬟࡜ ⭸ෆ᪉೫఩⋡ 㸪⭸እ཯ ⋡㸪⫤㛵⠇ෆ ㌿ゅ࡜㛫 ࡟᭷ព࡞ ప
࠸㈇ࡢ┦㛵ࡀ ㄆࡵࡽࢀ ࡓ㸦ࡑࢀ ࡒࢀ r = -0.307㸪p = 0.030㸹r = -0.295㸪p = 0.038㸹
r = -0.331㸪p = 0.019㸧㸦ᅗ 2-7㸪ᅗ 2-8㸪 ᅗ 2-9㸧㸬
⾲2-2䚷∦⬮䝇䜽䝽䝑䝖᫬䛾ྛ䝟䝷䝯䞊䝍䛸䛾┦㛵㛵ಀ (n = 50)
㊊㊑㛤᤼⬟
䚷䚷⭸ෆ᪉೫఩⋡
䚷䚷ST 䊻㻌SQ
⭸እ཯⋡
ST 䊻 SQ
⫤㛵⠇ෆ㌿ゅ
ST 䊻 SQ
㦵┙ഃ᪉ഴᩳゅ
ST 䊻 SQ
-.307*
-.295*
-.331*
.208
*: p < 0.05
ᅗ 2-7 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⭸ ෆ ᪉ ೫ ఩ ⋡ ࡢ ST ᫬ ࠿ ࡽ
ᅗ 2-8 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⭸ እ ཯ ⋡ ࡢ ST ᫬ ࠿ ࡽ SQ ᫬
ࡲ࡛ࡢኚ໬㔞࡜ࡢ㛵ಀ
SQ ᫬ ࡲ ࡛ ࡢ ኚ ໬ 㔞 ࡜ ࡢ 㛵 ಀ
ᅗ 2-9 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ࡢ ST ᫬ ࠿ ࡽ
SQ ᫬ ࡲ ࡛ ࡢ ኚ ໬ 㔞 ࡜ ࡢ 㛵 ಀ
64
∦⬮ࢫࢡ࣡ࢵ ࢺ᫬ 㸦Open㸧ࡢ㊊㊑㛤᤼⬟ ࡢ ྛ⩌ࡢྛࣃࣛ ࣓࣮ࢱ ࢆ ⾲ 2-3 ࡟♧
ࡍ㸬ྛ⩌ ࡢ SQ ᫬ࡢ ྛ ࣃ࣓࣮ࣛࢱ࠾ ࡼࡧ ST ᫬࠿ࡽ SQ ᫬ ࡲ࡛ࡢྛ ࣃ࣓࣮ࣛࢱࡢ
ኚ໬㔞࡟ࡣ㸪 ࠸ࡎࢀࡶ ⩌㛫࡛᭷ព࡞ ᕪࡣぢࡽ ࢀ࡞࠿ࡗࡓ㸬
⾲2-3䚷∦⬮䝇䜽䝽䝑䝖᫬䛾㊊㊑㛤᤼⬟䛾ྛ⩌䛾ྛ䝟䝷䝯䞊䝍
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
䚷ᑠ⩌ (n=11)
୰⩌ (n=24)
኱⩌ (n=15)
SQ
59.3 ± 14.8
57.2 ± 8.1
50.7 ± 11.2
ST 䊻 SQ
25.1 ± 13.8
22.4 ± 8.0
16.8 ± 10.0
SQ
63.2 ± 25.2
59.8 ± 12.5
46.9 ± 22.3
ST 䊻 SQ
45.7 ± 22.8
41.7 ± 13.5
31.9 ± 20.3
SQ
17.2 ± 9.1
15.7 ± 4.2
13.2 ± 4.8
ST 䊻 SQ
9.0 ± 8.1
7.8 ± 4.5
4.9 ± 4.2
SQ
1.8 ± 4.6
3.1 ± 3.1
3.1 ± 3.2
ST 䊻 SQ
0.2 ± 4.1
0.4 ± 3.2
1.0 ± 3.2
( mean㼼SD ) ඲䛶N.S.
SQ䠖䝇䜽䝽䝑䝖䝫䝆䝅䝵䞁䠊
ST䠖䝇䝍䞁䝕䜱䞁䜾䝫䝆䝅䝵䞁䠊
ST → SQ䠖ST᫬䛛䜙SQ᫬䜎䛷䛾ኚ໬㔞䠊
65
∦⬮ࢫࢡ࣡ࢵ ࢺ᫬ࡢ Open ࡜ Neutral ࡢྛࣃ ࣓࣮ࣛࢱࢆ⾲ 2-4 ࡟ ♧ࡍ㸬Open
࡜ Neutral ࡢ SQ ᫬࠾ ࡼࡧ ST ᫬࠿ࡽ SQ ᫬ ࡲ࡛ࡢኚ໬㔞 ࡟࠾࠸࡚ 㸪⭸እ཯⋡㸪
㦵┙ഃ᪉ഴᩳ ゅࡀ᭷ព ࡟ቑຍࡋ㸦ࡑ ࢀࡒ ࢀ p < 0.05㸪p < 0.01㸧㸪⫤㛵⠇ෆ㌿ゅ
ࡀ᭷ព࡟ῶᑡ ࡋࡓ㸦 p < 0.01㸧㸬
⾲2-4䚷∦⬮䝇䜽䝽䝑䝖᫬䛾㻌Neutral 䛸㻌Open 䛾ྛ䝟䝷䝯䞊䝍䞊 (n=50)
Neutral
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
Open
P value
SQ
54.2 ± 9.7
55.7 ± 11.1
0.087
ST䊻SQ
19.8 ± 9.1
21.3 ± 10.4
0.087
SQ
52.9 ± 16.9
56.7 ± 19.7
0.029*
ST䊻SQ
35.8 ± 16.0
39.6 ± 18.4
0.029*
SQ
16.7 ± 5.2
15.3 ± 5.8
0.006**
ST䊻SQ
8.6 ± 5.0
7.2 ± 5.5
0.006**
SQ
1.5 ± 3.4
2.8 ± 3.5
0.001**
ST䊻SQ
-0.9 ± 3.2
0.4 ± 3.4
0.001**
* p<0.05, **p<0.01 ( mean±SD )
Neutral䠖㊊㊑㛤᤼ᣦ♧䛺䛧; Open䠖㊊㊑㛤᤼ᣦ♧䛒䜚䠊
SQ䠖䝇䜽䝽䝑䝖᫬䠊
ST 䠖∦⬮❧఩᫬䠊
ST 䊻SQ䠖ST ᫬䛛䜙SQ᫬䜎䛷䛾ኚ໬㔞䠊
66
2㸬∦⬮ࢻࣟࢵࣉ ࣛࣥ ࢹ࢕ࣥࢢ
∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢ᫬㸦 Open㸧ࡢྛࣃ࣓࣮ࣛࢱࢆ ⾲ 2-5 ࡟ ♧ࡍ㸬
⾲2-5䚷∦⬮䝗䝻䝑䝥䝷䞁䝕䜱䞁䜾᫬䛾ྛ䝟䝷䝯䞊䝍䞊 (n=50) ( mean±SD )
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
IC
18.8
± 6.2
LD
41.5
± 10.6
IC䊻LD
22.7
± 8.1
IC
11.7
± 8.5
LD
31.8
± 16.7
IC䊻LD
20.1
± 12.7
IC
-0.6
± 3.1
LD
10.0
± 6.3
IC䊻LD
10.6
± 6.0
IC
6.8
± 2.6
LD
4.6
± 3.7
IC䊻LD
-2.3
± 3.1
IC䠖ᗋ᥋ᆅ᫬䠊
LD䠖ྑୖ๓⭠㦵Ჲ䛜᭱䜒ୗ᪉䛻఩⨨䛧䛯᫬䠊
IC䊻LD䠖IC᫬䛛䜙LD᫬䜎䛷䛾ኚ໬㔞䠊
67
∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢ ᫬㸦Open㸧ࡢ㊊㊑ 㛤᤼⬟࡜ྛࣃ ࣓࣮ࣛࢱ ࡜ࡢ┦㛵
㛵ಀࢆ⾲ 2-6 ࡟ ♧ࡍ㸬 ㊊㊑㛤᤼⬟࡜ ⭸ෆ᪉೫ ఩⋡ ࡢ LD ᫬ ࡜ IC ᫬ ࠿ࡽ LD ᫬ࡲ
࡛ࡢኚ໬㔞࡜ ࡢ㛫࡟ࡑ ࢀࡒࢀ᭷ព࡞ ప࠸㈇ࡢ ┦㛵ࡀㄆࡵࡽ ࢀ㸦ࡑࢀ ࡒࢀ r =
-0.356㸪p = 0.011㸹 r = -0.338㸪p = 0.016㸧㸦 ᅗ 2-10㸪 ᅗ 2-11㸧㸪 ྠᵝ࡟⭸እ཯
⋡ࡢ LD ᫬࡜ IC ᫬࠿ ࡽ LD ᫬ࡲ࡛ࡢኚ ໬㔞 ࡜ࡢ㛫࡟ࡑࢀ ࡒࢀ᭷ព ࡞ ప࠸㈇ࡢ┦
㛵ࡀㄆࡵࡽࢀ ࡓ㸦r = -0.388㸪p = 0.005㸹r = -0.299㸪p = 0.035㸧
㸦 ᅗ 2-12㸪ᅗ 2-13㸧㸬
⫤㛵⠇ෆ㌿ゅࡢ LD ᫬ ࡜ IC ᫬࠿ࡽ LD ᫬ࡲ ࡛ࡢኚ໬㔞 ࡜ ࡢ㛫࡟ࡑ ࢀࡒࢀ᭷ព࡞
୰➼ᗘࡢ㈇ࡢ ┦㛵ࡀㄆ ࡵࡽࢀࡓ㸦ࡑࢀ ࡒࢀ r = -0.422㸪p = 0.002㸹r = -0.451㸪p =
0.001㸧㸦ᅗ 2-14㸪ᅗ 2-15㸧㸬㦵┙ഃ ᪉ഴᩳ ゅ࡜ IC ᫬࠿ࡽ LD ᫬ ࡲ࡛ࡢኚ໬㔞
࡜ࡢ㛫࡟᭷ព ࡞ప࠸ṇ ࡢ┦㛵ࡀㄆࡵ ࡽࢀࡓ㸦 r = 0.312㸪p = 0.028㸧㸦ᅗ 2-16㸧㸬
⾲2-6䚷∦⬮䝗䝻䝑䝥䝷䞁䝕䜱䞁䜾᫬䛾ྛ䝟䝷䝯䞊䝍䛸䛾┦㛵㛵ಀ (n = 50)
䚷䚷䚷䚷䚷⭸ෆ᪉೫఩⋡
䚷䚷䚷䚷䚷LD
㊊㊑㛤᤼⬟
-.356*
䚷䚷䚷 ⭸እ཯⋡
IC䊻LD 䚷䚷䚷䚷䚷LD
-.338*
-.388**
䚷䚷䚷䚷 ⫤㛵⠇ෆ㌿ゅ
IC䊻LD
-.299*
䚷䚷䚷䚷LD
-.422**
䚷䚷䚷䚷 㦵┙ഃ᪉ഴᩳゅ
IC䊻LD 䚷䚷䚷䚷䚷LD
-.451**
.224
IC䊻LD
.312*
**: p < 0.01, *: p < 0.05
ᅗ 2-10 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⭸ ෆ ᪉ ೫ ఩ ⋡ ࡢ LD ᫬
ᅗ 2-11 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⭸ ෆ ᪉ ೫ ఩ ⋡ ࡢ IC ᫬
࠿ ࡽ LD ᫬ ࡲ ࡛ ࡢ ኚ ໬ 㔞 ࡜ ࡢ 㛵 ಀ ࡜ࡢ㛵ಀ
68
ᅗ 2-12 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⭸ እ ཯ ⋡ ࡢ LD ᫬ ࡜ ࡢ
ᅗ 2-13 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⭸ እ ཯ ⋡ ࡢ IC ᫬ ࠿ ࡽ
LD ᫬ ࡲ ࡛ ࡢ ኚ ໬ 㔞 ࡜ ࡢ 㛵 ಀ
㛵ಀ
ᅗ 2-15 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ࡢ IC ᫬
ᅗ 2-14 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ࡢ LD ᫬
࠿ ࡽ LD ᫬ ࡲ ࡛ ࡢ ኚ ໬ 㔞 ࡜ ࡢ 㛵 ಀ
࡜ࡢ㛵ಀ
ᅗ 2-16 ㊊ ㊑ 㛤 ᤼ ⬟ ࡜ 㦵 ┙ ഃ ᪉ ഴ ᩳ ゅ ࡢ IC ᫬
࠿ ࡽ LD ᫬ ࡲ ࡛ ࡢ ኚ ໬ 㔞 ࡜ ࡢ 㛵 ಀ
69
∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢ ᫬㸦Open㸧ࡢ㊊㊑ 㛤᤼⬟ࡢྛ⩌ ࡢྛࣃࣛ ࣓࣮ࢱࢆ
⾲ 2-7 ࡟♧ࡍ㸬LD ᫬ ࡢ⭸ෆ᪉೫఩ ⋡࡟࠾࠸ ࡚㸪኱⩌ࡣ୰⩌ ࡟ẚ࡭ ᭷ព࡟ప್ࢆ
♧ࡋࡓ㸬ࡲ ࡓ㸪IC ᫬ ࠿ࡽ LD ᫬ࡲ ࡛ࡢ⭸ෆ ᪉೫఩⋡ࡢኚ ໬㔞ࡣ 㸪኱⩌ࡣᑠ⩌࠾
ࡼࡧ୰⩌࡟ẚ ࡭᭷ព࡟ ప್ࢆ♧ࡋࡓ 㸬 LD ᫬ ࡢ⭸እ཯⋡࡟ ࠾࠸࡚㸪 ኱⩌ࡣᑠ⩌
࠾ࡼࡧ୰⩌࡟ ẚ࡭᭷ព ࡟ప್ࢆ♧ࡋ ࡓ㸬ࡲࡓ 㸪IC ᫬ ࠿ࡽ LD ᫬ࡲ࡛ ࡢ⭸እ཯⋡
ࡢኚ໬㔞ࡣ㸪 ኱⩌ࡣ୰ ⩌࡟ẚ࡭᭷ព ࡟ప್ࢆ ♧ࡋࡓ㸬 LD ᫬ ࡢ⫤㛵 ⠇ෆ㌿ゅ࡟
࠾࠸࡚㸪኱⩌ ࡣᑠ⩌࠾ ࡼࡧ୰⩌࡟ẚ ࡭᭷ព࡟ ప್ࢆ♧ࡋࡓ 㸬ࡲࡓ㸪 IC ᫬࠿ࡽ
LD ᫬ࡲ࡛ࡢ⫤ 㛵⠇ෆ ㌿ゅࡢኚ໬㔞 ࡣ㸪኱⩌ ࡣᑠ⩌࠾ࡼࡧ ୰⩌࡟ẚ ࡭᭷ព࡟ప
್ࢆ♧ࡋࡓ㸬 ࡑࡢ௚ࡢ 㡯┠࡟࠾࠸࡚ ࡣ᭷ពᕪ ࡣぢࡽࢀ࡞࠿ ࡗࡓ㸬
⾲2-7䚷∦⬮䝗䝻䝑䝥䝷䞁䝕䜱䞁䜾᫬䛾㊊㊑㛤᤼⬟䛾ྛ⩌䛾ྛ䝟䝷䝯䞊䝍
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
䚷ᑠ⩌ (n=11)
୰⩌ (n=24)
኱⩌ (n=15)
IC
19.4 ± 6.4
19.2 ± 5.3
17.7 ± 7.4
LD
44.3 ± 10.5
44.1 ± 9.4 a)
35.2 ± 10.2 a)
IC䊻LD
25.0 ± 7.3 b)
24.9 ± 8.0 c)
17.5 ± 6.8 b) c)
IC
13.9 ± 7.4
12.7 ± 6.8
LD
37.3 ± 16.5 d)
35.7 ± 13.0 e)
21.5 ± 18.5 d) e)
IC䊻LD
23.4 ± 12.0
23.0 ± 11.6 f)
12.9 ± 13.0 f)
IC
-1.2 ± 2.3
-0.6 ± 2.5
-0.4 ± 4.5
LD
12.5 ± 3.6 g)
11.1 ± 4.7 h)
6.4 ± 8.5 g) h)
IC䊻LD
13.7 ± 3.5 j)
11.7 ± 4.5 i)
6.7 ± 7.8 i) j)
IC
7.2 ± 2.3
6.8 ± 2.5
6.6 ± 2.9
LD
3.5 ± 2.1
4.9 ± 3.6
5.0 ± 4.6
IC䊻LD
-3.8 ± 1.5
-2.0 ± 3.1
-1.7 ± 3.7
( mean㼼SD )
IC䠖䜲䝙䝅䝱䝹䝁䞁䝍䜽䝖䠊
LD䠖䝷䞁䝕䜱䞁䜾䝫䝆䝅䝵䞁䠊
IC → LD䠖IC᫬䛛䜙LD᫬䜎䛷䛾ኚ໬㔞䠊
70
8.6 ± 10.9
a) ~ i) p<0.05, j) p<0.01
∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢ ᫬ࡢ Open ࡜ Neutral ࡢྛࣃ࣓࣮ࣛࢱ ࢆ ⾲ 2-8 ࡟♧
ࡍ㸬Open ࡜ Neutral ࡢኚ໬㔞࡟࠾࠸ ࡚㸪IC ᫬ࡢ⭸ෆ᪉೫ ఩⋡࠾ࡼ ࡧ⭸እ཯⋡ࡀ
᭷ព࡟ቑຍࡋ 㸦ࡑࢀࡒ ࢀ p < 0.01㸪p < 0.05㸧㸪LD ᫬ࡢ⫤㛵 ⠇ෆ㌿ ゅࡀ᭷ព࡟
ῶᑡࡋࡓ㸦 p < 0.05㸧㸬IC ᫬࠿ ࡽ LD ᫬ࡲ࡛ ࡢ ኚ໬㔞࡟࠾࠸ ࡚ࡣ㸪⭸ እ཯⋡㸪⫤
㛵⠇ෆ㌿ゅࡀ ᭷ព࡟ῶ ᑡࡋࡓ㸦࠸ࡎ ࢀࡶ p < 0.05㸧㸬
⾲2-8䚷∦⬮䝗䝻䝑䝥䝷䞁䝕䜱䞁䜾᫬䛾 Neutral 䛸 Open 䛾ྛ䝟䝷䝯䞊䝍䞊 (n=50)
Neutral
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
䚷 Open
P value
IC
17.4 ± 5.3
18.8 ± 6.2
0.007**
LD
42.3 ± 11.1
41.5 ± 10.6
0.444
IC䊻LD
24.9 ± 9.3
22.7 ± 8.1
0.055
IC
10.1 ± 7.6
11.7 ± 8.5
0.016*
LD
34.2 ± 17.7
31.8 ± 16.7
0.187
IC䊻LD
24.1 ± 13.7
20.1 ± 12.7
0.029*
IC
-1.1 ± 3.0
-0.6 ± 3.1
0.132
LD
11.3 ± 5.4
10.0 ± 6.3
0.039*
IC䊻LD
12.4 ± 4.5
10.6 ± 6.0
0.016*
IC
6.8 ± 2.7
6.8 ± 2.6
0.707
LD
4.1 ± 3.7
4.6 ± 3.7
0.235
IC䊻LD
-2.6 ± 2.7
-2.3 ± 3.1
0.273
* p<0.05, **p<0.01 ( mean±SD )
Neutral䠖㊊㊑㛤᤼ᣦ♧䛺䛧; Open䠖㊊㊑㛤᤼ᣦ♧䛒䜚䠊
IC䠖ᗋ᥋ᆅ᫬䠊
LD䠖ྑୖ๓⭠㦵Ჲ䛜᭱䜒ୗ᪉䛻఩⨨䛧䛯᫬䠊
IC䊻LD䠖IC᫬䛛䜙LD᫬䜎䛷䛾ኚ໬㔞䠊
71
3㸬࢝ࢵࢸ࢕ࣥࢢ
࢝ࢵࢸ࢕ࣥࢢ ᫬㸦 Open㸧ࡢྛࣃ࣓࣮ࣛ ࢱࢆ ⾲ 2-9 ࡟♧ࡍ 㸬ࣅࢹ࢜ ⏬ീࡢ᳨ド
࠿ࡽ㸪ᴃ෇㉮ ⾜ࡸࣇ࢙ ࢖ࢡືస➼ࡢ ࢝ࢵࢸ࢕ ࣥࢢືస࡟࡞ ࡗ࡚࠸࡞ ࠸ᑐ㇟⪅ࢆ
㝖እࡋࡓ⤖ᯝ 㸪ゎᯒᑐ ㇟⪅ࡣ 39 ྡ࡜࡞ ࡗࡓ 㸬
⾲2-9䚷䜹䝑䝔䜱䞁䜾᫬䛾ྛ䝟䝷䝯䞊䝍䞊 (n=39) ( mean±SD )
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
IC
-21.2 ± 11.8
LD
-16.7 ± 13.4
IC䊻LD
4.4 ± 8.6
IC
17.2 ± 15.4
LD
27.5 ± 21.1
IC䊻LD
10.3 ± 13.5
IC
-5.4 ± 6.5
LD
-1.9 ± 6.6
IC䊻LD
-3.5 ± 3.5
IC
-3.3 ± 4.5
LD
-4.6 ± 5.2
IC䊻LD
1.3 ± 2.8
IC䠖ᗋ᥋ᆅ᫬䠊
LD䠖IC᫬ᚋ䛻䜏䜙䜜䛯᭱኱⭸ෆ཯䜎䛯䛿᭱኱⭸እ཯᫬䠊
IC䊻LD䠖IC᫬䛛䜙LD᫬䜎䛷䛾ኚ໬㔞䠊
࢝ࢵࢸ࢕ࣥࢢ ᫬㸦 Open㸧ࡢ㊊㊑ 㛤᤼⬟࡜ ྛࣃ ࣓࣮ࣛࢱ࡜ࡢ ┦㛵 㛵ಀ ࢆ⾲ 2-10
࡟♧ࡍ㸬㊊㊑ 㛤᤼⬟࡜ ඲࡚ࡢ ࣃ࣓ࣛ ࣮ࢱ࡜ࡢ 㛵ಀ࡟࠾࠸࡚ ᭷ពᕪࡣ ㄆࡵࡽࢀ࡞
࠿ࡗࡓ㸬
⾲2-10䚷䜹䝑䝔䜱䞁䜾᫬䛾ྛ䝟䝷䝯䞊䝍䛸䛾┦㛵㛵ಀ (n = 50)
䚷䚷䚷䚷䚷⭸ෆ᪉೫఩⋡
䚷䚷䚷䚷䚷LD
㊊㊑㛤᤼⬟
.184
䚷䚷䚷 ⭸እ཯⋡
IC䊻LD 䚷䚷䚷䚷䚷LD
-.006
䚷䚷䚷䚷 ⫤㛵⠇ෆ㌿ゅ
IC䊻LD
.158
.016
䚷䚷䚷䚷LD
.139
䚷䚷䚷䚷 㦵┙ഃ᪉ഴᩳゅ
IC䊻LD 䚷䚷䚷䚷䚷LD
-.307
.031
IC䊻LD
.257
඲䛶N.S.
72
࢝ࢵࢸ࢕ࣥࢢ ᫬㸦 Open㸧ࡢ㊊㊑ 㛤᤼⬟ࡢ ྛ⩌ ࡢ ྛࣃ࣓࣮ࣛ ࢱࢆ ⾲ 2-11 ࡟♧ࡍ㸬
࢝ࢵࢸ࢕ࣥࢢ ືస࡟࡞ ࡗ࡚࠸࡞࠸ᑐ ㇟⪅ࢆ㝖 እࡋࡓ⤖ᯝ 㸪ゎᯒ ᑐ㇟ ⪅ ࡀ 39 ྡ࡜
࡞ࡾ㸪ྛ ⩌࡟࠾࠸ ࡚ ᑠ ⩌ 10 ྡ㸪୰ ⩌ 20 ྡ㸪኱⩌ 9 ྡ࡜࡞ ࡗࡓ 㸬ྛ ⩌ࡢ IC ᫬࠿
ࡽ LD ᫬ࡲ࡛ ࡢ⭸እ཯ ⋡ࡢኚ໬㔞࡟ ࠾࠸࡚㸪 ᑠ⩌ࡣ୰⩌࠾ ࡼࡧ኱⩌ ࡟ẚ࡭᭷ព
࡟ప࠸್ࢆ♧ ࡋࡓ㸦p < 0.05㸧㸬ࡑࡢ௚ࡢ 㡯 ┠࡟࠾࠸࡚ࡣ ᭷ពᕪࡣ ぢࡽࢀ࡞࠿ࡗ
ࡓ㸬
⾲2-11䚷䜹䝑䝔䜱䞁䜾᫬䛾㊊㊑㛤᤼⬟䛾ྛ⩌䛾ྛ䝟䝷䝯䞊䝍
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
䚷ᑠ⩌ (n=10)
୰⩌ (n=20)
኱⩌ (n=9)
IC
-21.2 ± 11.2
-23.3 ± 12.4
-16.4 ± 10.9
LD
-22.1 ± 19.1
-16.9 ± 11.4
-10.3 ± 7.2
IC䊻LD
-0.9 ± 13.9
6.3 ± 4.8
6.1 ± 5.6
IC
18.9 ± 15.0
14.2 ± 16.7
21.9 ± 12.7
LD
17.9 ± 28.9
27.7 ± 18.4
37.7 ± 11.8
-1.0 ± 19.2 a) b)
13.5 ± 8.2 b)
15.8 ± 8.4 a)
IC
-5.5 ± 7.6
-5.8 ± 6.6
-4.4 ± 5.8
LD
-3.1 ± 7.8
-2.1 ± 6.8
-0.1 ± 4.9
IC䊻LD
2.4 ± 5.3
3.7 ± 2.8
4.3 ± 2.0
IC
-2.6 ± 5.0
-3.6 ± 4.2
-3.4 ± 4.9
LD
-4.7 ± 7.2
-4.6 ± 4.5
-4.4 ± 4.8
IC䊻LD
-2.1 ± 3.9
-1.0 ± 2.6
-1.1 ± 1.3
IC䊻LD
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
( mean㼼SD ) a) p<0.05 , b) p<0.01
IC䠖䜲䝙䝅䝱䝹䝁䞁䝍䜽䝖䠊
LD䠖䝷䞁䝕䜱䞁䜾䝫䝆䝅䝵䞁䠊
IC→LD䠖IC᫬䛛䜙LD᫬䜎䛷䛾ኚ໬㔞䠊
73
࢝ࢵࢸ࢕ࣥࢢ ᫬ࡢ Open ࡜ Neutral ࡢྛࣃࣛ ࣓࣮ࢱࢆ⾲ 2-12 ࡟♧ ࡍ㸬Open ࡜
Neutral ࡢ඲࡚ࡢࣃࣛ ࣓࣮ࢱ ࡢẚ㍑ ࡟࠾࠸࡚ ᭷ពᕪࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓ㸬
⾲2-12䚷䜹䝑䝔䜱䞁䜾᫬䛾 Neutral 䛸 Open 䛾ྛ䝟䝷䝯䞊䝍䞊 (n=39)
Neutral
⭸ෆ᪉೫఩⋡ (%)
⭸እ཯⋡ (%)
⫤㛵⠇ෆ㌿ゅ ( 䜪)
㦵┙ഃ᪉ഴᩳゅ ( 䜪)
Open
P value
IC
-23.0 ± 11.6
-21.2 ± 11.8
0.109
LD
-18.8 ± 13.1
-16.7 ± 13.4
0.117
IC䊻LD
4.2 ± 9.4
4.4 ± 8.6
0.822
IC
17.4 ± 16.1
17.2 ± 15.4
0.902
LD
28.1 ± 19.8
27.5 ± 21.1
0.733
IC䊻LD
10.8 ± 14.4
10.3 ± 13.5
0.787
IC
-5.7 ± 7.9
-5.4 ± 6.5
0.779
LD
-2.9 ± 7.8
-1.9 ± 6.6
0.332
IC䊻LD
-2.7 ± 3.7
-3.5 ± 3.5
0.254
IC
-3.4 ± 4.7
-3.3 ± 4.5
0.803
LD
-4.6 ± 6.0
-4.6 ± 5.2
0.933
IC䊻LD
1.2 ± 2.5
1.3 ± 2.8
0.835
඲䛶N.S. ( mean±SD )
Neutral䠖㊊㊑㛤᤼ᣦ♧䛺䛧; Open䠖㊊㊑㛤᤼ᣦ♧䛒䜚䠊
IC䠖ᗋ᥋ᆅ᫬䠊
LD䠖IC᫬ᚋ䛻䜏䜙䜜䛯᭱኱⭸ෆ཯䜎䛯䛿᭱኱⭸እ཯᫬䠊
IC䊻LD䠖IC᫬䛛䜙LD᫬䜎䛷䛾ኚ໬㔞䠊
3-2-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪㊊ ㊑㛤᤼ࢆ ᣦ♧ࡋࡓ᫬ࡢ ㊊㊑㛤᤼ ⬟࡜∦⬮ࢫࢡ ࣡ࢵࢺ㸪 ∦⬮ࢻࣟ
ࢵࣉࣛࣥࢹ࢕ ࣥࢢ㸪࢝ ࢵࢸ࢕ࣥࢢ ᫬ ࡢືⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ ࡜ࡢ㛵 㐃ᛶ ࠾ࡼࡧ
㊊㊑㛤᤼⬟ࡢ ኱ᑠ㸪㊊ ㊑㛤᤼ᣦ♧ࡢ ᭷↓ࡀ ື ⓗୗ⫥࢔ࣛ࢖ ࣓ࣥࢺ ࡟ ཬࡰࡍᙳ㡪
࡟ࡘ࠸࡚ẚ㍑ ᳨ドࡍࡿ ࡇ࡜ࢆ┠ⓗ࡜ ࡋ࡚⾜࠸ 㸪∦⬮ࢻࣟࢵ ࣉࣛࣥࢹ ࢕ࣥࢢ࡟࠾
࠸࡚㸪1)㊊㊑㛤᤼⬟࡜ ⭸ෆ᪉೫఩⋡ ࡢ LD ᫬ ࡜ IC ᫬ ࠿ࡽ LD ᫬ ࡲ ࡛ࡢኚ໬㔞࡜
ࡢ㛫࡟ࡑࢀࡒ ࢀ᭷ព࡞ ప࠸㈇ࡢ┦㛵 ࡀ㸪2)⭸እ཯⋡ࡢ LD ᫬࡜ IC ᫬࠿ࡽ LD ᫬
ࡲ࡛ࡢኚ໬㔞 ࡜ࡢ㛫࡟ ࡑࢀࡒࢀ᭷ព ࡞ ప࠸㈇ ࡢ┦㛵ࡀ㸪3)⫤㛵⠇ෆ ㌿ゅ ࡢ LD
᫬࡜ IC ᫬ ࠿ࡽ LD ᫬ࡲ࡛ࡢኚ໬㔞࡜ ࡢ㛫࡟ࡑ ࢀࡒࢀ ᭷ព࡞ ୰➼ᗘࡢ ㈇ࡢ┦㛵ࡀ 㸪
ࡑࡋ࡚ 4)㦵┙ഃ᪉ഴᩳ ゅ࡜ IC ᫬ ࠿ࡽ LD ᫬ ࡲ ࡛ࡢኚ໬㔞 ࡜ ࡢ㛫࡟᭷ ព࡞ ప࠸ṇ
74
ࡢ┦㛵ࡀㄆࡵ ࡽࢀࡓ㸬 ࡲࡓ㸪㊊㊑㛤 ᤼⬟ ࡢྛ ⩌ࡢẚ㍑࡛ࡣ 㸪 1)㊊㊑㛤᤼⬟࡟ඃ
ࢀ࡚࠸ࡿࡶࡢ 㸪ࡍ࡞ࢃ ࡕ኱⩌ࡣ㸪୰ ➼ᗘ࡟㊊ ㊑㛤᤼ࡢ࡛ࡁ ࡿࡶࡢ㸪 ࡍ࡞ࢃࡕ୰
⩌࡟ẚ࡭ 㸪᭱኱ࡋ ࡷࡀ ࡳࡇࡳ᫬ࡢ㊊ ㊑㛤᤼ᣦ ♧ୗࡢ⭸ෆ᪉ ೫఩⋡ࡀ ࡼࡾᑠࡉࡃ 㸪
2)㊊㊑㛤᤼⬟࡟ ඃࢀ࡚ ࠸ࡿࡶࡢࡣ୰ ➼ᗘ࡟㊊ ㊑㛤᤼ࡢ࡛ࡁ ࡿࡶࡢ࠾ ࡼࡧ㊊㊑㛤
᤼⬟࡟ஈࡋ࠸ ࡶࡢ㸦ᑠ ⩌㸧࡟ẚ࡭㸪 ㊊㊑㛤᤼ ᣦ♧ୗࡢ⭸እ ཯⋡ࡀࡼ ࡾᑠࡉࡃ㸪
3)╔ᆅ᫬࠿ࡽ᭱ ኱ࡋࡷ ࡀࡳࡇࡳ᫬ࡲ ࡛ࡢ⭸ෆ ᪉೫఩⋡ࡢኚ ໬㔞ࡀࡼ ࡾᑠࡉࡃ㸪
4)㊊㊑㛤᤼⬟࡟ ඃࢀ࡚ ࠸ࡿࡶࡢࡣ୰ ➼ᗘ࡟㊊ ㊑㛤᤼ࡢ࡛ࡁ ࡿࡶࡢ࡟ ẚ࡭㸪╔ᆅ
᫬࠿ࡽ᭱኱ࡋ ࡷࡀࡳࡇ ࡳ᫬ࡲ࡛ࡢ㊊ ㊑㛤᤼ᣦ ♧ୗࡢ⭸እ཯ ⋡ࡢኚ໬ 㔞ࡶࡼࡾᑠ
ࡉ࠸࡜࠸࠺ࡶ ࡢ࡛࠶ࡗ ࡓ㸬 ࡇࢀࡽࡢ ⤖ᯝࡣ㸪 ㊊㊑㛤᤼⬟ࡀ ඃࢀࡿ⪅ ࡣ⭸ෆ᪉೫
఩⋡㸪⭸እ཯ ⋡㸪⫤㛵 ⠇ෆ㌿ゅᗘࡀ ᑠࡉࡃ㸪 ㊊㊑㛤᤼⬟ࡀ ஈࡋ࠸⪅ ࡣ⭸ෆ᪉೫
఩⋡㸪⭸እ཯ ⋡㸪⫤㛵 ⠇ෆ㌿ゅᗘࡀ ኱ࡁࡃ࡞ ࡿ࡜࠸࠺ࡇ࡜ ࢆព࿡ࡍ ࡿ㸬 ࡲࡓ㸪
㊊㊑㛤᤼⬟ࡀ ࡼࡾඃࢀ ࡿࡶࡢࡣ㸪ࠕ ㊊㊑ࢆ㛤 ࠸࡚ᗋࢆᥗࡴ ࠖ࡜࠸࠺ ᣦᑟࡀ㸪 ࣛ
ࣥࢹ࢕ࣥࢢ᫬ ࡢ ⭸እ཯ ไᚚ࡟ࡼࡾ᭷ ຠ࡛࠶ࡿ ࡇ࡜ࢆ♧ࡋ ࡓ ⤖ᯝ࡛ࡶ ࠶ࡿ 㸬㊊㊑
㛤᤼⬟࡟ࡼࡿ ⭸እ཯ไ ᚚࡢ㐪࠸ࡢ࣓ ࢝ࢽࢬ࣒ ࢆḟࡢࡼ࠺࡟ ᥎ ࡋࡓ 㸬㊊㊑㛤᤼
ືసࡣ㊊㊑ࡢ እ㌿ 㐠ື ࢆ㏻ࡋ࡚ᑠ㊑ እ㌿➽ࡸ ẕ㊑እ㌿➽ ➼ ࡢ㊊㒊ෆ ᅾ➽ࡢ➽⥭
ᙇࢆ㧗ࡵࡿ㸬 ࡇࡢ㊊㒊 ෆᅾ➽ࡢ➽⥭ ᙇࡣ㊊㒊 ࢔࣮ࢳ๛ᛶࢆ 㧗ࡵࡿ࡜ ࡉࢀ࡚࠾ࡾ
[Kapandji, 1987]㸪㊊㊑ 㛤᤼⬟ࡀඃࢀ ࡿࡶࡢࡣ ㊊㊑㛤᤼ᣦ♧ ୗ࡟࠾࠸ ࡚㊊㒊࢔࣮
ࢳ๛ᛶࢆࡼࡾ 㧗ࡵࡿࡇ ࡜ࡀ ࡛ࡁ㸪ࡑ ࡢ⤖ᯝ࡜ ࡋ࡚㊊㒊ᅇෆ ࡢືࡁ ࢆ ࡼࡾᑠࡉࡃ
ࡍࡿࡇ࡜ࡀ࡛ ࡁࡓ࡜᥎ ࡋࡓ㸬㊊㒊 ᅇෆࡢື ࡁࡀᑠࡉ࠸࡜ 㸪╔ᆅ᫬ ࠿ࡽ᭱኱ࡋ
ࡷࡀࡳࡇࡳ᫬ ࡲ࡛ࡢୗ ⭣ෆ᪕ࡢືࡁ ࡶᑠ࡜࡞ ࡾ㸪⭸ 㛵⠇እ ཯ࢆไᚚ ࡛ࡁࡿ㸬
Bonci㸦1999㸧࠾ࡼࡧ Coplan㸦1989㸧ࡀ㸪㊊ 㒊ᅇෆࡢቑຍ ࡣ⬯㦵ෆ ᪕࡟ᑟࡁ㸪
ࡉࡽ࡟ࡣ⭸㛵 ⠇ࡢᅇ᪕ ືసࢆ኱ࡁࡃ ࡉࡏࡿ࡜ ㏙࡭࡚࠸ࡿࡀ 㸪ࡇࢀࡽ ࡢඛ⾜◊✲
ࡣ㸪㊊㒊ᅇෆ ᢚไࡀ⭸ ෆ᪉೫఩ࢆไ ᚚࡉࡏࡓ ࡜࠸࠺ᡃࠎࡢ ᥎ ࢆᨭ ᣢࡍࡿࡶࡢ
࡛࠶ࡿ㸬ࡲࡓ 㸪╔ᆅ᫬ ࡢ⫤㛵⠇ෆ㌿ ゅ㸪╔ᆅ ᫬࠿ࡽ᭱኱ࡋ ࡷࡀࡳࡇ ࡳ᫬ࡲ࡛ࡢ
⫤㛵⠇ෆ㌿ゅ ࡢኚ໬㔞 ࠸ࡎࢀࡶࡀ 㸪 ㊊㊑㛤᤼ ⬟࡟ඃࢀ࡚࠸ ࡿࡶࡢࡣ ୰➼ᗘ࡟㊊
㊑㛤᤼ࡢ࡛ࡁ ࡿࡶࡢ࠾ ࡼࡧ㊊㊑㛤᤼ ⬟࡟ஈࡋ ࠸ࡶࡢ࡟ẚ࡭ 㸪ࡼࡾᑠ ࡛࠶ࡿ࡜࠸
࠺⤖ᯝࡶᚓࡓ 㸬ඛ⾜◊ ✲࡟ࡼࡿ࡜㸪 ⭸ 㛵⠇እ ཯ไᚚ࡟⫤㛵 ⠇࿘ᅖ➽ ࡢാࡁࡀ㔜
せ࡞ᙺ๭ࢆᯝ ࡓࡋ࡚࠸ ࡿࡇ࡜ࡀ」ᩘ ሗ࿌ࡉࢀ ࡚࠸ࡿ㸬 Lephart ࡯ ࠿ 㸦 2002㸧 ࡣ 㸪
∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢ࡟࠾࠸࡚ ╔ᆅᚋࡢ ⫤㛵⠇ෆ᪕ゅ ࡢቑຍࡣ 㸪Ẋ㒊➽➽
75
άືࡢ㐪࠸࡟ ࡼࡿ࡜㏙ ࡭㸪Zazulak ࡯࠿㸦2005㸧ࡣ㸪ྠ ືస࡛ࡢ ╔ ᆅ┤ᚋࡢẊ㒊
➽➽άືࡣዪ ᛶࡀ⏨ᛶ ࡟ẚ࡭ప್࡛ ࠶ࡾ㸪⫤ 㛵⠇ෆ᪕ࢥࣥ ࢺ࣮ࣟࣝ ࡟㔜せ࡞ᙺ
๭ࢆᯝࡓࡋ࡚ ࠸ࡿ࡜㏙ ࡭࡚࠸ࡿ 㸬௒ ᅇᚓࡽࢀ ࡓ⤖ᯝ࡜ࡇࢀ ࡽࡢඛ⾜ ◊✲࡛ࡢሗ
࿌࡜ࢆྜࢃࡏ ࡿ࡜㸪㊊ ㊑㛤᤼⬟ࡢ኱ ᑠࡀୗ⫥ ➽⩌㸪≉࡟Ẋ 㒊➽ࡢ➽ άື࡟ᙳ㡪
ࢆ࠾ࡼࡰࡋ࡚ ࠸ࡿྍ⬟ ᛶࡶ࠶ࡿ࡜⪃ ࠼ࡿ㸬 ㊊ ㊑㛤᤼ᣦ♧࠶ ࡾ࣭࡞ࡋ ࡀ∦⬮ࢻࣟ
ࢵࣉࣛࣥࢹ࢕ ࣥࢢ ᫬ࡢ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺ࡟ཬ ࡰࡍᙳ㡪࡟ࡘ ࠸࡚ࡣ㸪 ㊊㊑㛤᤼ᣦ
♧ୗ࡟࠾࠸࡚ ⭸ෆ᪉೫ ఩⋡࠾ࡼࡧ⭸ እ཯⋡ ࡣ IC ᫬ ࡟ቑຍࡋ 㸪 IC ᫬࠿ࡽ LD ᫬
ࡲ࡛ࡢ⭸እ཯ ⋡ࡢኚ໬ 㔞ࡣῶᑡࡋ࡚ ࠸ࡓ㸬ࡇ ࢀࡣ㊊㊑㛤᤼ ᣦ♧ୗ࡛ ࡣ㸪∎ඛࡀ
᥋ᆅࡋࡓ᫬Ⅼ ࡛ࡍ࡛࡟ ࠶ࡿ⛬ᗘࡢ⭸ 㛵⠇እ཯ ⫥఩࡛࠶ࡿࡀ 㸪ࡑࡢ᫬ Ⅼ࠿ࡽ LD
᫬ࡲ࡛ࡢ㛫ࡢ ⭸ 㛵⠇እ ཯ࡢቑຍ⛬ᗘ ࡣᢚ࠼ࡽ ࢀࡓࡇ࡜ࢆព ࿡ࡍࡿ㸬 ∎ඛࡢ᥋ᆅ
᫬Ⅼ࡛᪤࡟⭸ 㛵⠇እ཯ ⫥఩࡟࠶ࡿ⌮ ⏤࡜ࡋ࡚ ࡣ㸪㊊㊑㛤᤼ ᣦ♧ୗ࡛ ࡣ㸪㊊㊑ࢆ
㛤࠸࡚ᗋࢆᥗ ࡴࡼ࠺࡟ ព㆑ࡋࡓ╔ᆅ ࡣ㊊㊑㛤 ᤼ᣦ♧࡞ࡋ࡟ ẚ࡭㸪╔ ᆅ᫬ጼໃ࡟
㏆࠸ᙧࢆ᥋ᆅ ࡢẁ㝵࡛ ࡍ࡛࡟࡜ࡗ࡚ ࠸ࡓࡓࡵ ࡛ࡣ࡞࠸࠿࡜ ᥎ ࡋࡓ 㸬 LD ᫬ࡲ
࡛ࡢ⭸㛵⠇እ ཯ࡢቑຍ ⛬ᗘࡀᢚ࠼ࡽ ࢀࡓࡇ࡜ ࡟ࡘ࠸࡚ࡣ㸪IC ᫬࡟᪤ ࡟╔ᆅ᫬ጼ
ໃ࡟㏆࠸ᙧࢆ ࡜ࡾ㸪ࡋ ࡷࡀࡳࡇࡳ᫬ ࡟࡜ࡿጼ ໃࡢ‽ഛࡀ╔ ᆅ࡟ඛ⾜ ࡋ࡚⾜࠼࡚
࠸ࡓࡓࡵ㸪IC ᫬ᚋࡢ⭸ 㛵⠇እ཯ࡀ࠶ ࡲࡾቑຍ ࡋ࡞࠿ࡗࡓࡢ ࡛ࡣ࡞࠸ ࠿࡜⪃࠼ࡓ 㸬
ࡲࡓ㸪ࡶ࠺୍ ࡘࡢ⌮⏤ ࡜ࡋ࡚ 㸪ඛ㏙ ࡋࡓෆᐜ ྠᵝ࡟ ㊊㊑㛤 ᤼ືస࡟ ࡼࡾ㸪 ㊊㒊
ࡢෆᅾ➽ࡢ⥭ ᙇ ࡀ ㊊㒊 ࢔࣮ࢳ๛ᛶࢆ 㧗ࡵ 㸪㊊ 㒊ᅇෆࢆᢚไ ࡋ㸪ୗ⭣ ෆ᪕࡜⭸㛵
⠇እ཯ࡢືࡁ ࡢኚ໬ࢆ ࡶᑠࡉࡃࡉࡏ ࡓࡢ࡛ࡣ ࡞࠸ ࠿࡜⪃࠼ ࡓ㸬⫤㛵 ⠇ෆ㌿ゅᗘ
࡟ࡘ࠸࡚ ࡶ IC ᫬ ࠿ࡽ LD ᫬ࡲ࡛ࡢኚ ໬㔞ࢆ ῶᑡࡉࡏࡓ ࡀ㸪ࡇ ࡢ⤖ ᯝ࡟ࡘ࠸࡚ࡶ
ඛ㏙ࡋࡓෆᐜ ྠᵝ࡟ ㊊ ㊑㛤᤼࡟ࡼࡗ ࡚╔ᆅ࡟ ඛ⾜ࡋ࡚ୗ⫥ ඲యࡢ➽ ⥭ᙇࡀ㧗 ࡲ
ࡗࡓࡇ࡜㸪ࡑ ࡋ࡚⫤㛵 ⠇࿘ᅖ➽ࡢ➽ ⥭ᙇࡀ⫤ 㛵⠇ෆ㌿ືస ࡢไᚚ࡟ ᙳ㡪ࢆཬࡰ
ࡋࡓ࡜⪃࠼ࡓ[Lephart et al., 2005; Zazulak et al., 2005] 㸬ࡶࡗ࡜ࡶ㸪㊊㊑㛤᤼ືస
࡜⫤㛵⠇࿘ᅖ ➽➽άື ࡜ࡢ㛵ಀ࡟ࡘ ࠸࡚ࡣ᫂ ࡽ࠿࡟ࡋ࡚࠾ ࡽࡎ㸪௒ ᚋࡢ◊✲ㄢ
㢟࡛࠶ࢁ࠺㸬
∦⬮ࢫࢡ࣡ ࢵࢺ࡛ࡣ 㸪 ㊊㊑㛤᤼⬟ ࡜⭸ෆ᪉ ೫ ఩⋡㸪⭸እ ཯⋡㸪⫤ 㛵 ⠇ෆ㌿ゅ
ࡢࢫࢱࣥࢹ ࢕ࣥࢢ࣏ ࢪ ࢩࣙࣥ࠿ࡽ ࢫࢡ࣡ࢵ ࢺ ࣏ࢪࢩࣙࣥ ࡲ࡛ࡢኚ ໬ 㔞 ࡜ࡢ㛫࡟
᭷ព࡞ప࠸ ㈇ࡢ┦㛵 ࡀ ᚓࡽࢀࡓ㸬 ࡇࢀ ࡶ∦ ⬮ ࢻࣟࢵࣉࣛ ࣥࢹ࢕ࣥ ࢢ ྠᵝ࡟㸪 ㊊
㊑㛤᤼⬟ࡀ ඃࢀࡿ⪅ ࡣ ⭸ෆ᪉೫఩ ⋡㸪⭸እ ཯ ⋡㸪⫤㛵⠇ ෆ㌿ゅᗘ ࡀ ᑠࡉࡃ㸪㊊
76
㊑㛤᤼⬟ࡀ ஈࡋ࠸⪅ ࡣ ⭸ෆ᪉೫఩ ⋡㸪⭸እ ཯ ⋡㸪⫤㛵⠇ ෆ㌿ゅᗘ ࡀ ኱ࡁࡃ࡞ࡿ
ഴྥࢆࡶࡘ ࡇ࡜ࢆព ࿡ ࡍࡿ㸬 ㊊㊑ 㛤᤼ᣦ♧ ࠶ ࡾ࣭࡞ࡋࡀ ⭸㛵⠇እ ཯ ࡸ⫤㛵⠇ෆ
㌿ゅᗘ➼ࡢ ືⓗୗ⫥ ࢔ ࣛ࢖࣓ࣥࢺ ࡟ཬࡰࡍ ᙳ 㡪 ࡟ࡘ࠸࡚ ᚓࡽࢀࡓ ⤖ ᯝࡣ 㸪∦⬮
ࢫࢡ࣡ࢵࢺ࡟ ࠾࠸࡚ 㸪㊊㊑㛤᤼ᣦ♧ ୗࡢ SQ ᫬࠾ࡼࡧ ST ᫬࠿ࡽ SQ ᫬ࡲ࡛ࡢ ኚ
໬㔞ࡀ⭸እ ཯⋡㸪㦵 ┙ ഃ᪉ഴᩳゅ ᗘ࡜ࡶ࡟ ቑ ຍ ࡋࡓ㸬ᡃ ࠎࡣࡑࡢ ࣓ ࢝ࢽࢬ࣒ࢆ
㊊㊑㛤᤼࡜ ࠸࠺ᣦ♧ ࡟ ࡼࡾ㸪 ᑠ㊑ እ㌿➽ࡸ ẕ ㊑እ㌿➽ ➼ ࡢ㊊㊑ࢆ స ືࡉࡏࡿ➽
⫗ࡢ⥭ᙇ࡜ ඹ࡟㸪㊊ ㊑ ࡛ᗋࢆᙉࡃ ᨭ࠼ࡼ࠺ ࡜ ࡍࡿព㆑ࡀ ඛ⾜ࡍࡿ 㸪 ࡑࡢ⤖ᯝ㸪
๓㊊㒊࡜ẕ ㊑⌫ࢆྵ ࡵ ࡓ㊊㒊ෆഃ ࡬ࡢⲴ㔜 ࡀ ㉳ࡇࡾࡸࡍ ࡃ࡞ࡾ㸪 ㊊ 㒊ᅇෆ࠿ࡽ
⭸㛵⠇እ཯ ࡀᑟ࠿ࢀ ࡓ ࡢ࡛ࡣ࡞࠸ ࠿࡜᥎ ࡋ ࡓ㸬ࡉࡽ࡟ ⭸ 㛵⠇ᒅ ᭤ ゅᗘࡀ኱ࡁ
ࡃ࡞ࡿ࡟ࡘ ࢀ࡚㸪㊊ ㊑ ࡛ᗋࢆᙉࡃ ᨭ࠼ࡼ࠺ ࡜ ࡍࡿព㆑ࡀ ࡼࡾᙉࡃ ࡞ ࡾ㸪㊊㒊ෆ
ഃ࡬ࡢⲴ㔜 ࡀࡼࡾ㉳ ࡇ ࡾࡸࡍࡃ࡞ ࡗࡓ࡜᥎ ࡋࡓ㸬ࣅࢹ ࢜⏬ീ࠿ ࡽ ࡶ㊊㊑㛤᤼
ᣦ♧ୗ࡛ࡣ 㸪SQ ᫬ࡢᑡ ࡋᡭ๓᫬Ⅼ࠿ ࡽ⭸ 㛵⠇ እ཯ࡢ⛬ᗘࡀ ࡼࡾ኱ࡁ ࡃ࡞ࡿഴྥ
ࡀከᩘ☜ㄆࡉ ࢀࡓ㸬㊊ ㊑㛤᤼ᣦ♧ୗ ࡛ࡢ SQ ᫬ࡢ⫤㛵⠇ෆ ㌿ゅᗘ࠾ ࡼࡧ ST ᫬࠿
ࡽ SQ ᫬ࡲ࡛ ࡢ⫤㛵⠇ ෆ㌿ゅᗘኚ໬ 㔞ࡢῶᑡ ࡣ㸪㦵┙ഃ᪉ ഴᩳゅᗘ ࡢቑຍ࠾ࡼ
ࡧࡑࡢゅᗘ ኚ໬㔞ࡢ ቑ ຍࡀ⫤㛵⠇ ෆ㌿ゅᗘ ࡜ ゅᗘኚ໬㔞 ࡢῶᑡ࡟ ཯ ᫎࡉࢀࡓࡶ
ࡢ࡜⪃࠼ࡓ㸬
࢝ࢵࢸ࢕ࣥࢢ ࡟ࡘ࠸࡚ ࡣ㸪㊊㊑㛤᤼ ⬟ࡢ ྛ⩌ ࡢẚ㍑࡟࠾࠸ ࡚ ╔ᆅ᫬ ࠿ࡽ᭱኱
ࡋࡷࡀࡳࡇࡳ ᫬ࡲ࡛ࡢ ⭸እ཯⋡ࡢኚ ໬㔞ࡀ㸪 ㊊㊑㛤᤼⬟ࡢ ஈࡋ࠸ࡶ ࡢࡣ୰➼ᗘ
࡟㊊㊑㛤᤼ࡀ ࡛ࡁࡿࡶ ࡢ࠾ࡼࡧ㊊㊑ 㛤᤼⬟࡟ ඃࢀ࡚࠸ࡿࡶ ࡢ࡟ẚ࡭ 㸪ప್࡛࠶
ࡗࡓ㸬ࡇࡢㄢ 㢟ືసࡣ 㸪࢝ࢵࢸ࢕ࣥ ࢢ᫬࡟ࣇ ࢙࢖ࢡືస㸪 ࡍ࡞ࢃࡕ ᶓ᪉ྥ࡬ࡢ
ࢫࢸࢵࣉࢆධ ࢀ࡞ࡀࡽ ཯ᑐ᪉ྥ࡬ษ ࡾ㏉ࡍࡿ ࡜࠸ࡗࡓᵝᘧ ࡢࡓࡵ㸪 ㊊㊑㛤᤼⬟
ࡀஈࡋ࠸ࡶࡢ ࡣ㊊㊑ࢆ 㛤࠸࡚ᗋࢆࡋ ࡗ࠿ࡾ㋃ ࢇᙇࡿࡇ࡜ࡀ ࡛ࡁࡎ㸪 ࣇ࢙࢖ࢡື
స࡟ධࡿ๓ࡢ ㋃㎸ࡳᖜ ࡀᑠ࡜࡞ࡾ㸪 ⭸እ཯⋡ ࡢኚ໬㔞ࡢప ୗ࡟ࡘ࡞ ࡀࡗࡓࡢ࡛
ࡣ࡞࠸࠿࡜⪃ ࠼ࡓ㸬 ㊊ ㊑㛤᤼ᣦ♧ࡢ ᭷↓࡜ࡢ ẚ㍑࡟࠾࠸࡚ ࡣ㸪 ඲࡚ ࡢ㡯┠࡛᭷
ពᕪࡣࡳࡽࢀ ࡞࠿ࡗࡓ 㸬ࡇࢀࡣ㸪㊊ ㊑ 㛤᤼࡜ ࢝ࢵࢸ࢕ࣥࢢ ࡢྠ᫬ࢱ ࢫࢡࡣᢏ⾡
ⓗ࡟㞴ࡋࡃ㸪 㦂⪅ࡢព ᅗࡍࡿືసࡀ ༑ศ࡟⾜ ࠼࡚࠸࡞࠸ࡇ ࡜ࡀせᅉ ࡢ୍ࡘ࡜ࡋ
࡚ᣲࡆࡽࢀࡿ 㸬ᐇ 㝿ࡢ ゎᯒ࡟࠶ࡓࡗ ࡚ 11 ྡ ࢆ㝖እࡍࡿ⤖ ᯝ࡜࡞ࡗ ࡓࡢࡶࡇࡢࡓ
77
ࡵ࡛࠶ࡿ㸬ࡲ ࡓ㸪㊊㊑ 㛤᤼⬟࡜ྛࣃ ࣓࣮ࣛࢱ ࡜ࡢ㛵㐃ᛶ࡟ ࡘ࠸࡚ࡶ ඲࡚ࡢ㡯┠
࡟࠾࠸࡚᭷ព ᕪࡀࡳࡽ ࢀ࡞࠿ࡗࡓ ࡀ 㸪௒ᅇ⾜ ࡗࡓ ᐃࣔࢹ ࡛ࣝࡣ㸪 ㊊㊑㛤᤼ᣦ
♧ࡀ࢝ࢵࢸ࢕ ࣥࢢ᫬ࡢ ⭸ 㛵⠇እ཯➼ ࡟ཬࡰࡍ ᙳ㡪࡟ࡘ࠸࡚ ⤖ㄽ࡙ࡅ ࡿࡢࡣᅔ㞴
࡜⪃࠼ࡓ㸬
ඛ⾜◊✲࠿ࡽ 㸪Hewett ࡽ㸦2005㸧ࡣ⭸㛵⠇እ ཯࠾ࡼࡧ⫤㛵 ⠇ෆ㌿ࢆ కࡗࡓື
స⫥఩ࢆ“Dynamic valgus”࡜ᐃ⩏ࡋ㸪ACL യᐖࣜࢫࢡ࡜ ₯ᅾⓗ࡞ 㛵ಀࡀ࠶ࡿ࡜
㏙࡭㸪ࡑࡢ࡯ ࠿ࣂ࢖ ࢜ ࣓࢝ࢽࢡࢫⓗ ࡞᳨ド࡟ ࠾࠸࡚ࡶ㸪⭸ 㛵⠇እ཯ ࡸ⫤㛵⠇ゅ
ᗘࡢቑຍࡣ ACL യᐖ ࣜࢫࢡࢆ㧗ࡵ ࡿࡇ࡜ࡀ ሗ࿌ࡉࢀ࡚࠸ ࡿ [Bing and William,
2007]㸬㊊㊑㛤᤼ᣦ♧ࡀ ∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢ᫬ࡢ⭸እ ཯⋡࠾ࡼ ࡧ⫤㛵⠇ෆ
㌿ゅᗘࡢቑຍ 㔞ࢆῶᑡ ࡉࡏࡓ࡜࠸࠺ ᮏ◊✲ࡢ ⤖ᯝࡣ㸪㊊㊑ 㛤᤼ᣦ♧ ࡣࢪࣕࣥࣉ
࠿ࡽࡢ∦⬮╔ ᆅືస࡟ ࠾࠸࡚㸪ACL യᐖண㜵 ⟇࡟࡞ࡾ࠺ࡿ ྍ⬟ᛶࡀ ࠶ࡿࡇ࡜ࢆ
♧၀ࡋ࡚࠸ࡿ 㸬
ᮏ◊✲ࡢၥ㢟 ࡢ ୍ࡘ࡜ ࡋ࡚㸪ඛ㏙ࡋ ࡓࡀ ㄢ㢟 ືసࡀࡸࡸ㞴 ࡋ࠸Ⅼ࡟ ࠶ࡿ㸬≉
࡟࢝ࢵࢸ࢕ࣥ ࢢ ࡟࠾࠸ ࡚ࡣ㸪 ௒ᚋ㸪 ࡼࡾṇ☜ ࡞ศᯒࡢࡓࡵ ࡟஦๓࡟ ༑ศ࡞ᢏ⾡
⩦ᚓࡉࡏࡓୖ ࡛ࡢẚ㍑ ࡀᚲせࡔ࡜⪃ ࠼ࡓ㸬ࡲ ࡓ㸪ᮏ◊✲ࡢ 㝈⏺࡜ࡋ ࡚ 㸪๓㢠㠃
࠿ ࡽ ࡢ ஧ ḟ ඖゎ ᯒ ࡛ ࠶ ࡿ ࡜ ࠸ ࠺ ࡇ ࡜ ࡛ ࠶ ࡿ 㸬 McLean ࡯ ࠿ 㸦 2005㸧 ࡣ 㸪 ╔ ᆅ ࠿
ࡽࡢࢪࣕࣥࣉ ᫬ࡢ⭸ 㛵 ⠇እ཯ゅᗘࢆ ஧ḟඖ ゎ ᯒ࡜୕ḟඖゎ ᯒ࡜࡛ẚ ㍑ࡋ㸪Ⰻዲ
࡞ᅇᖐ㛵ಀࡀ ᚓࡽࢀࡓ ࡜ሗ࿌ࡋ ࡚࠸ ࡿࡀ㸪ࡼ ࡾṇ☜࡞ゅᗘ ኚ໬➼ࡢ ཰㞟࡜ゎᯒ
࡟ࡣ㸪୕ḟඖ ⓗືసゎ ᯒ ࡟ࡼࡿࢹ࣮ ࢱ཰㞟ࡀ ᚲせ࡛࠶ࡿࡢ ࡣゝ࠺ࡲ ࡛ࡶ࡞࠸ 㸬
ᮏ◊✲⤖ᯝ࠿ ࡽ㸪ࠕ㊊ ㊑ࢆ㛤࠸࡚ᗋ ࢆᥗࡴ ࠖ ࡜࠸࠺ືసᣦ ♧࡟࠾࠸ ࡚㸪∦⬮
ࢻࣟࢵࣉࣛࣥ ࢹ࢕ࣥࢢ ᫬ࡢ㊊㊑㛤᤼ ⬟࡜⭸ෆ ᪉೫఩⋡㸪⭸ እ཯⋡ 㸪 ⫤㛵⠇ෆ㌿
ゅࡢࣛࣥࢹ࢕ ࣥࢢ࣏ࢪ ࢩࣙࣥ ࡜࢖ࢽ ࢩࣕࣝࢥ ࣥࢱࢡࢺ࠿ࡽ ࣛࣥࢹ࢕ ࣥࢢ࣏ࢪࢩ
ࣙࣥࡲ࡛ࡢኚ ໬㔞࡜ࡢ 㛫࡟ࡑࢀࡒ ࢀ ᭷ព࡞㈇ ࡢ┦㛵ࡀㄆࡵ ࡽࢀ ࡓ㸬 ࡲࡓ㸪㊊㊑
㛤᤼⬟ࡀࡼࡾ ඃࢀࡿࡶ ࡢࡣࢪࣕࣥࣉ ࠿ࡽࡢ╔ ᆅ ືస࡟࠾࠸ ࡚㸪⭸㛵 ⠇እ཯ࢆࡼ
ࡾไᚚࡉࡏ㸪 ࡲࡓ㸪 ㊊ ㊑㛤᤼ືసᣦ ♧ ࠶ࡾࡣ ᣦ♧࡞ࡋ࡟ẚ ࡭㸪 ╔ᆅ ᚋࡢ⭸እ཯
೫఩㔞ࢆࡼࡾ ῶᑡࡉࡏ ࡓࡇ࡜ࡀ♧ࡉ ࢀࡓ㸬㊊ ㊑㛤᤼࠾ࡼࡧ ㊊㊑ᢕᣢ ືసࡢᣦ♧
࡜࡜ࡶ࡟㸪㊊ ㊑㛤᤼⬟ ࢆ㧗ࡵࡿ࢚ࢡ ࢧࢧ࢖ࢬ ࡣ 㸪ࢪࣕࣥࣉ ࠿ࡽࡢ╔ ᆅືస࡟࡚
78
ከⓎࡍࡿ ACL ࢆྵࡵ ࡓୗ⫥ യᐖண 㜵࡟ࡘ࡞ ࡀࡿࣉࣟࢢࣛ ࣒࡛࠶ࡿ ྍ⬟ᛶࡀ♧
၀ࡉࢀࡓ㸬
3-2-5 ⤖ ㄒ
∦⬮ࢫࢡ࣡ࢵ ࢺ㸪∦⬮ ࢻࣟࢵࣉࣛࣥ ࢹ ࢕ࣥࢢ 㸪࢝ࢵࢸ࢕ࣥ ࢢ ࢆㄢ㢟 ືస࡟タ
ᐃࡋ㸪㊊㊑㛤 ᤼ࢆᣦ♧ ࡋࡓ᫬ࡢ ㊊㊑ 㛤᤼⬟࡜ ືⓗୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࡜ࡢ㛵㐃ᛶ
࡟ࡘ࠸࡚㸪ࡲ ࡓ㸪㊊㊑ 㛤᤼⬟ࡢ኱ᑠ ࠾ࡼࡧ㊊ ㊑㛤᤼ᣦ♧ࡢ ᭷↓ࡀ ື ⓗୗ⫥࢔ࣛ
࢖࣓ࣥࢺ࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ẚ㍑ ᳨ドࡍࡿ ࡇ࡜ࢆ┠ⓗ࡜ ࡋ࡚⾜࠸ 㸪௨ୗࡢ⤖
ㄽࢆᚓࡓ㸬
1 ) ∦⬮ࢫࢡ࣡ࢵࢺ᫬ࡢ㊊㊑㛤᤼⬟࡜⭸ෆ᪉೫఩⋡㸪⭸እ཯⋡㸪⫤㛵⠇ෆ㌿ゅ
ࡢࢫࢱࣥࢹ࢕ࣥࢢ࣏ࢪࢩࣙࣥ࠿ࡽࢫࢡ࣡ࢵࢺ࣏ࢪࢩࣙࣥࡲ࡛ࡢኚ໬㔞࡜ࡢ
㛫࡟᭷ព࡞ప ࠸ ㈇ࡢ┦ 㛵ࡀㄆࡵࡽࢀ ࡓ㸬
2 ) ∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ࢕ ࣥࢢ᫬ࡢ㊊㊑ 㛤᤼⬟࡜ ⭸ෆ᪉೫఩⋡ 㸪⭸እ཯ ⋡ ࡢࣛ
ࣥࢹ࢕ࣥࢢ࣏ ࢪࢩࣙࣥ ࡜࢖ࢽࢩࣕࣝ ࢥࣥࢱࢡ ࢺ࠿ࡽࣛࣥࢹ ࢕ࣥࢢ࣏ ࢪࢩࣙ
ࣥࡲ࡛ࡢኚ໬ 㔞࡜ࡢ㛫 ࡟ࡑࢀࡒ ࢀ᭷ ព࡞ప࠸ ㈇ࡢ┦㛵ࡀㄆ ࡵࡽࢀ㸪 ㊊㊑㛤
᤼⬟࡜⫤㛵⠇ ෆ㌿ゅࡢ ࣛࣥࢹ࢕ࣥࢢ ࣏ࢪࢩࣙ ࣥ ࡜࢖ࢽࢩࣕ ࣝࢥࣥࢱ ࢡࢺ࠿
ࡽࣛࣥࢹ࢕ࣥ ࢢ࣏ࢪࢩ ࣙࣥ ࡲ࡛ࡢኚ ໬㔞࡜ࡢ 㛫࡟ࡑࢀࡒࢀ ᭷ព࡞ ୰ ⛬ᗘࡢ
㈇ࡢ┦㛵ࡀㄆ ࡵࡽࢀ ࡓ 㸬㦵┙ഃ᪉ഴ ᩳゅ࡜ ࢖ ࢽࢩࣕࣝࢥࣥ ࢱࢡࢺ࠿ ࡽࣛࣥ
ࢹ࢕ࣥࢢ࣏ࢪ ࢩࣙࣥ ࡲ ࡛ࡢኚ໬㔞࡜ ࡢ㛫࡟᭷ ព࡞ ప࠸ṇࡢ ┦㛵ࡀㄆ ࡵࡽࢀ
ࡓ㸬
3 ) ㊊ᣦ㛤᤼⬟ࡢᑠ࣭୰࣭኱⩌ࡢẚ㍑࡟࠾࠸࡚㸪∦⬮ࢻࣟࢵࣉࣛࣥࢹ࢕ࣥࢢ࡛
ࡣ㸪ձ㊊㊑㛤᤼⬟࡟ඃࢀ࡚࠸ࡿࡶࡢࡣ୰➼ᗘ࡟㊊㊑㛤᤼ࡢ࡛ࡁࡿࡶࡢ࡟ẚ
࡭᭱኱ࡋࡷࡀ ࡳࡇࡳ᫬ 㸪㊊㊑㛤᤼ᣦ♧ ୗࡢ⭸ ෆ᪉೫఩⋡ࡀ ࡼࡾᑠ࡛ ࠶ࡗࡓ㸬
ղ㊊㊑㛤᤼⬟࡟ඃࢀ࡚࠸ࡿࡶࡢࡣ୰➼ᗘ࡟㊊㊑㛤᤼ࡢ࡛ࡁࡿࡶࡢ࠾ࡼࡧ㊊
㊑㛤᤼⬟࡟ஈࡋ࠸ࡶࡢ࡟ẚ࡭᭱኱ࡋࡷࡀࡳࡇࡳ᫬㸪㊊㊑㛤᤼ᣦ♧ୗࡢ⭸እ
཯⋡ࡀࡼࡾᑠ࡛㸪╔ᆅ᫬࠿ࡽ᭱኱ࡋࡷࡀࡳࡇࡳ᫬ࡲ࡛ࡢ⭸ෆ᪉೫఩⋡ࡢኚ
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໬㔞ࡀࡼࡾᑠ࡛࠶ࡗࡓ㸬ճ㊊㊑㛤᤼⬟࡟ඃࢀ࡚࠸ࡿࡶࡢࡣ୰➼ᗘ࡟㊊㊑㛤
᤼ࡢ࡛ࡁࡿࡶࡢ࡟ẚ࡭╔ᆅ᫬࠿ࡽ᭱኱ࡋࡷࡀࡳࡇࡳ᫬ࡲ࡛ࡢ㊊㊑㛤᤼ᣦ♧
ୗࡢ⭸እ཯⋡ࡢኚ໬㔞ࡶࡼࡾᑠ࡛࠶ࡗࡓ㸬մ╔ᆅ᫬ࡢ⫤㛵⠇ෆ㌿ゅ㸪╔ᆅ
᫬࠿ࡽ᭱኱ࡋࡷࡀࡳࡇࡳ᫬ࡲ࡛ࡢ⫤㛵⠇ෆ㌿ゅࡢኚ໬㔞࠸ࡎࢀࡶࡀ㸪㊊㊑
㛤᤼⬟࡟ඃࢀ࡚࠸ࡿࡶࡢࡣ୰➼ᗘ࡟㊊㊑㛤᤼ࡢ࡛ࡁࡿࡶࡢ࠾ࡼࡧ㊊㊑㛤᤼
⬟࡟ஈࡋ࠸ࡶ ࡢ࡟ẚ࡭ 㸪ࡼࡾᑠ࡛࠶ ࡗࡓ㸬
4)
࢝ࢵࢸ࢕ࣥࢢ࡛ࡣ㸪╔ᆅ᫬࠿ࡽ᭱኱ࡋࡷࡀࡳࡇࡳ᫬ࡲ࡛ࡢ⭸እ཯⋡ࡢኚ໬
㔞ࡀ㸪㊊㊑㛤᤼⬟ࡢஈࡋ࠸ࡶࡢࡣ୰➼ᗘ࠾ࡼࡧඃࢀ࡚࠸ࡿࡶࡢ࡟ẚ࡭㸪ࡼ
ࡾᑠ࡛࠶ࡗࡓ 㸬
5)
㊊㊑㛤᤼ᣦ♧࠶ࡾ࣭࡞ࡋ࡜ࡢẚ㍑࡛ࡣ㸪∦⬮ࢫࢡ࣡ࢵࢺ࡟࠾࠸࡚㸪㊊㊑㛤
᤼ᣦ♧࠶ࡾࡣ㸪ࢫࢡ࣡ࢵࢺ࣏ࢪࢩࣙࣥࡢ⭸እ཯⋡࠾ࡼࡧ㦵┙ഃ᪉ഴᩳゅࢆ
ቑຍࡉࡏ㸪⫤㛵⠇ෆ㌿ゅࢆ᭷ព࡟ῶᑡࡉࡏࡓ㸬ࡲࡓ㸪ࢫࢱࣥࢹ࢕ࣥࢢ࣏ࢪ
ࢩࣙࣥ࠿ࡽࢫࢡ࣡ࢵࢺ࣏ࢪࢩࣙࣥࡲ࡛ࡢኚ໬㔞࡟࠾࠸࡚ࡶ㸪⭸እ཯⋡࠾ࡼ
ࡧ㦵┙ഃ᪉ഴ ᩳゅࢆቑ ຍࡉࡏ㸪⫤㛵 ⠇ෆ㌿ゅ ࢆ᭷ព ࡟ῶᑡ ࡉࡏࡓ㸬
6)
∦⬮ࢻࣟࢵࣉࣛࣥࢹ࢕ࣥࢢ࡟࠾࠸࡚㸪࢖ࢽࢩࣕࣝࢥࣥࢱࢡࢺࡢ⭸ෆ᪉೫఩
⋡࠾ࡼࡧ⭸እ཯⋡ࢆ᭷ព࡟ቑຍࡉࡏ㸪ࣛࣥࢹ࢕ࣥࢢ࣏ࢪࢩࣙࣥࡢ⫤㛵⠇ෆ
㌿ゅࢆ᭷ព࡟ῶᑡࡉࡏࡓ㸬ࡋ࠿ࡋ࢖ࢽࢩࣕࣝࢥࣥࢱࢡࢺ࠿ࡽࣛࣥࢹ࢕ࣥࢢ
࣏ࢪࢩࣙࣥࡲ ࡛ࡢ⭸እ ཯⋡ࡢኚ໬㔞 ࡣ᭷ព࡟ ῶᑡࡋࡓ㸬
7)
㊊㊑㛤᤼ࡀඃࢀࡿࡶࡢࡣ㸪㊊㊑㛤᤼࠾ࡼࡧ㊊㊑ᢕᣢືసࡢᣦ♧࡜࡜ࡶ࡟㸪
≉࡟∦⬮ࢻࣟࢵࣉࣛࣥࢹ࢕ࣥࢢ࡟࠾࠸࡚⭸㛵⠇እ཯ࢆࡼࡾไᚚࡋࡓ㸬㊊㊑
㛤᤼⬟ࢆ㧗ࡵࡿ࢚ࢡࢧࢧ࢖ࢬ࡜ࠕ㊊㊑ࢆ㛤࠸࡚ᗋࢆᥗࡴࠖ࡜࠸࠺ືసᣦ♧
ࡣ㸪ࢪࣕࣥࣉ࠿ࡽࡢ╔ᆅືస࡟࡚ከⓎࡍࡿ⭸๓༑Ꮠ㠌ᖏയᐖࢆྵࡵࡓୗ⫥
യᐖண㜵࡟ࡘ࡞ࡀࡿྍ⬟ᛶࡢ࠶ࡿ㐠ືᣦᑟἲࡢ୍ࡘ࡜ࡋ࡚ࡑࡢ᭷⏝ᛶࡀ♧
၀ࡉࢀࡓ㸬
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➨4❶
ࣛࢡࣟࢫࢫࢸ࢕ࢵࢡࡢಖᣢࡸ᧯సࡀືⓗୗ⫥
࢔ࣛ࢖࣓ࣥࢺ࡟ཬࡰࡍᙳ㡪
81
◊ ✲ 3 ࢻ ࣟࢵ ࣉ ࣂ ࣮ ࢸ࢕ ࢝ࣝ ࢪ ࣕࣥ ࣉ᫬ ࡟ ࠾ࡅ ࡿࣛ ࢡ ࣟࢫ ࢫࢸ ࢕ ࢵࢡ ࡢಖ ᣢ
ࡸ᧯ సࡀ ୗ ⫥࢟ ࢿ࣐ ࢸ ࢕ࢡ ࢫ࣭ ࢟ ࢿࢸ ࢕ࢡ ࢫ ࡟ཬ ࡰࡍ ᙳ 㡪
4-3-1. ⥴ゝ
ዪᏊ࢔ࢫ࣮ࣜ ࢺࡢ⭸๓ ༑Ꮠ㠌ᖏ㸦 anterior cruciate ligament㸸௨ ୗ㸪ACL㸧യᐖ
Ⓨ⏕⋡ࡣ⏨ᛶ ࢔ࢫ࣮ࣜ ࢺ࡜ẚ㍑ ࡋ 2㹼8 ಸ㧗 ࡃ [Agel et al., 2005]㸪≉࡟ዪᏊࣂࢫ
ࢣࢵࢺ࣮࣎ࣝ 㸪ࣁࣥࢻ ࣮࣎ࣝ㸪ࢧࢵ ࣮࢝࡞࡝ ࡢ➇ᢏ࡟࠾࠸ ࡚㸪ࢪࣕ ࣥࣉ࠿ࡽࡢ
╔ᆅࡸ࢝ࢵࢸ ࢕ࣥࢢື స᫬࡟ከⓎࡋ ࡚࠸ࡿ [Boden et al., 2000]㸬ዪᏊࣛࢡࣟࢫ➇
ᢏ࡟࠾࠸࡚ ࡶ ACL യ ᐖ⋡ࡣẚ㍑ⓗ 㧗ࡃ [Hootman et al., 2007]㸪ࣛ ࢡࣟࢫ➇ᢏࡢ
≉Ṧᛶ࡜ࡋ࡚ 㸪ࢫࢸ࢕ ࢵࢡ㸦ࢡࣟࢫ 㸧ࢆ୧ᡭ ࡛ಖᣢࡋࡓ≧ ែ࡛ࡢࢪ ࣕࣥࣉ࠾ࡼ
ࡧ࢝ࢵࢸ࢕ࣥ ࢢືస➼ ࡀ⾜ࢃࢀ࡚࠸ ࡿⅬ࡟࠶ ࡿ [Dick et al., 2007]㸬
ACL യᐖ᫬ࡢࣅࢹ ࢜ ゎᯒ࡟ࡼࡿ࡜㸪ࢥ ࣥࢺ ࣮ࣟࣝ࡟ẚ࡭ ⭸㛵⠇እ ཯ ゅᗘࡸ⫤
㛵⠇ෆ㌿ゅᗘ ࡀ኱ࡁ࠸ ࡇ࡜ࡀ♧ࡉࢀ ࡚࠸ࡿ࡯ ࠿㸪▮≧㠃࡟ ࠾࠸࡚ࡣ ⭸㛵⠇ᒅ᭤
ゅᗘࡀᑠࡉ࠸ ഴྥࡀ♧ ࡉࢀ࡚࠸ࡿ [Boden et al., 2009]㸬ᐇ㦂ᐊࣞ࣋ࣝ ࡛ࡢࣂ࢖࣓
࢝ࢽࢡࢫⓗ࡞ ᳨ド ࠿ࡽ ࡶ㸪ࢻࣟࢵࣉ ࣂ࣮ࢸ࢕ ࢝ࣝ㸦ᆶ┤㸧ࢪ ࣕࣥࣉ㸦 drop vertical
jump㸸௨ ୗ 㸪DVJ㸧ࡸ ࢝ࢵ ࢸ ࢕ ࣥ ࢢ ື స᫬ ࡟ 㸪ࡑ ࢀ ࡽ ࡢ≉ ᚩ ⓗ࡞ ୗ ⫥࢟ ࢿ ࣐ࢸ
࢕ࢡࢫࡀ㢧ⴭ ࡟♧ࡉࢀ ࡚࠾ࡾ㸪≉ ࡟ዪᏊ࢔ ࢫ ࣮ࣜࢺ࡟࠾ࡅ ࡿ ACL യᐖࡢ୺࡞せ
ᅉ࡛࠶ࡿࡇ࡜ ࡀሗ࿌ࡉ ࢀ࡚࠸ࡿ [Hewett et al. 2006]㸬ࡑࢀࡽࡢ ືⓗ ୗ⫥࢔ࣛ࢖࣓
ࣥࢺ࡟╔┠ࡋ 㸪⭸ യᐖ ࣜࢫࢡࢆ᳨ウ ࡍࡿࡓࡵ ࡢࢫࢡ࣮ࣜࢽ ࣥࢢࡢ୍ ࡘ࡜ࡋ࡚㸪
DVJ ࢸࢫࢺࡀ᥎ዡࡉ ࢀ ࡚࠸ࡿ [Noyes et al., 2005; Renstrom et al., 2008]㸬ࢫ࣏࣮ࢶ
⌧ሙ࡟࠾࠸࡚ ⭸ 㛵⠇ 㸪≉࡟ ACL യᐖ ண㜵ࡢ ࡓࡵࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࡜ࡋ࡚⏝࠸ࡽ
ࢀ࡚࠸ࡿ DVJ ࢸࢫࢺ ࢆ㸪ᚑ᮶⾜ࢃࢀ ࡚࠸ࡿ ᵝᘧ࡟ຍ࠼㸪➇ ᢏ≉Ṧ ᛶ࡟ᛂࡌࡓᵝ
ᘧ࡛⾜࠺ࡇ࡜ ࡀ㸪 യᐖ ࣜࢫࢡࡢせᅉ ࡜࡞ࡿ≉ ᚩⓗ࡞ୗ⫥ ࢔ ࣛ࢖࣓ࣥ ࢺࡢኚ໬ࢆ
ࡼࡾලయⓗ࡟ ホ౯ฟ᮶ ࡿࡢ࡛ࡣ࡞࠸ ࠿࡜⪃࠼ ࡓ㸬 ᮏ◊✲ࡢ ┠ⓗࡣ ዪ Ꮚࣛࢡࣟࢫ
㑅ᡭࢆᑐ㇟࡜ ࡋ 㸪DVJ ືస࡟࠾ࡅࡿ ࣛࢡࣟࢫ ࢫࢸ࢕ࢵࢡࡢ ಖᣢࡸ᧯ సࡀୗ⫥࢟
ࢿ࣐ࢸ࢕ࢡࢫ ࣭࢟ࢿࢸ ࢕ࢡࢫ࡟ཬࡰ ࡍᙳ㡪࡟ ࡘ࠸࡚ẚ㍑᳨ ウࡍࡿࡇ ࡜ ࡛࠶ࡿ㸬
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4-3-2. ᑐ㇟࡜᪉ἲ
1. ᑐ㇟
ᑐ㇟⪅ࡣ㸪㛵 ᮾ኱Ꮫዪ Ꮚࣛࢡࣟࢫࣜ ࣮ࢢ 1 㒊 ࡟ᡤᒓࡍࡿ኱ ᏛዪᏊࣛ ࢡࣟࢫ㑅
ᡭ 9 ྡ㸦ᖹᆒ ᖺ㱋 20.0 ± 1.3 ṓ㸪㌟ 㛗 159.6 ± 5.8 cm㸪య㔜 55.1 ± 6.3 kg㸪ࣛ ࢡ
ࣟࢫ➇ᢏ Ṕ 24 ± 3.4 ࣨ᭶㸧࡛࠶ࡾ㸪ᮏ◊✲ ࡛ ᪋⾜ࡍࡿㄢ㢟 ືసࡢᐇ ᪋࡟࠶ࡓࡾ㸪
ୗ⫥࡬ࡢᨭ㞀 ࢆࡁࡓࡍ ࡼ࠺࡞እയࡢ ࡞࠸⪅࡜ ࡋࡓ㸬඲ ࡚ࡢᑐ㇟ ⪅࡟ ◊✲ࡢ┠ⓗ 㸪
᪉ἲ㸪೔⌮ⓗ 㓄៖➼࡟ 㛵ࡍࡿㄝ᫂ࢆ ⾜࠸㸪ྠ ពࢆᚓࡓ㸬 ࡞ ࠾㸪ᮏ◊ ✲ࡣ᪩✄⏣
኱Ꮫேࢆᑐ㇟࡜ ࡍࡿ ◊✲࡟㛵ࡍࡿ ೔⌮ᑂᰝ ጤဨ఍ ࡢᢎㄆ ࢆᚓ࡚ᐇ ᪋ࡋ㸦ᢎ ㄆ␒
ྕ 2010-037㸧㸪ᮏ◊✲ ࡟ 㛵ࡍࡿ㈨㔠 ᥦ౪㸪㞠 ⏝➼ࡢ฼┈┦ ཯ࡣᏑᅾ ࡋ࡞࠸㸬 2. ㄢ㢟ືస
ㄢ㢟ືసࡣྎ ୖ࠿ࡽ ࡢ ୧⬮ DVJ ࡜ࡋࡓ㸬⿕ 㦂⪅࡟ 30cm 㧗 ࡢྎୖ ࡟୧⬮࡛❧
ࡓࡏ㸪ྜᅗ࡜ ࡜ࡶ࡟୧ ⬮࡟࡚㣕ࡧ㝆 ࡾ㸪╔ᆅ ᚋࡍࡄ࡟㖄┤ ᪉ྥ࡬ࡢ ᭱኱ດຊ࡛
ࡢࢪࣕࣥࣉࢆ ⾜ࢃࡏࡓ 㸬ྎୖ࠿ࡽ㣕 ࡧ㝆ࡾࡓ ࡜ࡁࡢ╔ᆅ࠾ ࡼࡧ㖄┤ ᪉ྥ࡬ࡢࢪ
ࣕࣥࣉࡋࡓᚋ ࡢ╔ᆅࡣ 㸪ྑ⬮ࢆᗋ཯ ຊィୖ࡟ ╔ᆅࡉࡏࡿࡼ ࠺ᣦ♧ࡋ ࡓ㸬᪋⾜᮲
௳ࡣ㸪୧ᡭࢆ ⮬⏤࡟౑ ⏝ࡉࡏࡓ᮲௳ ࡛ࡢ୧ ⬮ DVJ㸦not holding a stick㸸 ௨ୗ㸪
NH㸧 㸦 ࢪ ࣕ ࣥ ࣉ ᫬ ࡟ ୧ ᡭ ࢆ ኳ ஭ ᪉ ྥ ࡟ ᣲ ࡆ ࡉ ࡏ ࡞ ࡀ ࡽ ࢪ ࣕ ࣥ ࣉ ࡉ ࡏ ࡓ 㸧 㸦 ᅗ
3-1-a㸧㸪ࣛࢡ ࣟࢫࢫࢸ ࢕ࢵࢡࢆྑᡭ ഃ࡟ಖᣢ ࡉࡏࡓ᮲௳࡛ ࡢ୧ ⬮ DVJ㸦holding
a stick with right hand side㸸௨ୗ㸪RH㸧㸦ࢪ ࣕ ࣥࣉ᫬࡟ࢫࢸ ࢕ࢵࢡࡢ ඛ➃ࢆኳ஭
᪉ྥ࡟࠶ࡆࡉ ࡏࡓ㸬ື స୰ࡣ୧ᡭࢆ ࢫࢸ࢕ࢵ ࢡ࠿ࡽ㞳ࡉ࡞ ࠸ࡼ࠺ᣦ ♧ࡋࡓ㸧
㸦ᅗ
3-1-b㸧㸬RH ࡜ྠࡌ᮲ ௳࡟ຍ࠼㸪ኳ ஭࡟ྞࡿ ࡋࡓ࣮࣎ࣝ࡟ ࢫࢸ࢕ࢵ ࢡࡢඛ➃ࢆ
࠶࡚ࡿࡼ࠺ᣦ ♧ࡋࡓ㸦 holding a stick with right hand side with a target㸸௨ୗ㸪RHT㸧
㸦ᐇ㝿࡟ࡣࢫ ࢸ࢕ࢵࢡ ࡢඛ➃ࡀ࣮࣎ ࣝ࡟ᙜࡓ ࡽ࡞࠸㧗ࡉ࡟ ྞࡿࡋࡓ 㸧
㸦ᅗ 3-1-c㸧
ࡢ 3 ᮲௳࡛⾜ ࢃࡏ㸪ࡑ ࢀࡒࢀ 3 ᅇࡢ ᡂຌヨᢏ ࢆグ㘓ࡋࡓ㸬 ࡞࠾㸪ྛ ヨᢏ࡟࠾࠸
࡚㸪1㸧ྎୖ࠿ࡽ ╔ᆅ ᚋ㸪㖄┤᪉ྥ ࡟ࢪࣕࣥ ࣉ࡛ࡁ࡞࠿ࡗ ࡓࡶࡢ㸪 2㸧ྎୖ࠿ࡽ
㣕ࡧ㝆ࡾࡓ࡜ ࡁࡢ╔ᆅ ࠾ࡼࡧࢪࣕࣥ ࣉᚋࡢ╔ ᆅ᫬࡟ᗋ཯ຊ ィୖ࡟ྑ ⬮ࡀ஌ࡽ࡞
࠿ࡗࡓࡶࡢ㸪3㸧DVJ ᚋ㸪Ᏻᐃࡋࡓ ╔ᆅࡀฟ ᮶࡞࠿ࡗࡓࡶ ࡢࡣ↓ຠ ࡜ࡋࡓ㸬
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84
3. ືసィ ືసࡢィ ࡟ ࡣ㸪 8 ྎ ࡢ㉥እ⥺࣓࢝ ࣛ㸦 Motion Analysis ♫〇㸧ཬ ࡧᗋ཯ຊィ
㸦Kistler ♫〇㸧࠿ࡽ ᵓᡂࡉࢀࡿග Ꮫᘧ୕ḟ ඖືసゎᯒ⿦ ⨨ࢆ౑⏝ ࡋ㸪཯ᑕ࣐ ࣮
࣮࢝ࡣࢧࣥࣉ ࣜࣥࢢ࿘ Ἴᩘ 240Hz㸪ᆅ㠃཯ ຊ ࡣࢧࣥࣉࣜࣥ ࢢ࿘Ἴ ᩘ 2400Hz ࡛
ࡑࢀࡒࢀィ ࡋࡓ 㸦 ᅗ 3-2-a㸧㸬ᑐ㇟ ⪅ࡢ ྑୗ⫥ཬࡧ㦵 ┙ࡢ⓶⭵ ୖ࡟ィ 36 Ⅼࡢ
཯ᑕ࣐࣮࣮࢝ ࢆ㈞௜ࡋ ࡓ㸦ᅗ 3-2-b㸧㸬཯ᑕ ࣐࣮࣮࢝ࡢ㈞ ௜㒊఩ࡣ 㸪ᕥྑୖ๓⭠
㦵Ჲ㸪ᕥྑୖ ᚋ⭠㦵Ჲ ࡢ୰Ⅼ㸪 ௨ୗ 㸪ྑ⬮ࡢ ኱㌿Ꮚ㸪኱⭣ 㦵እഃୖ 㢛࠾ࡼࡧෆ
ഃ ୖ 㢛 㸪 እ ᯝ ࠾ ࡼ ࡧ ෆ ᯝ 㸪 ➨ 2 ୰ ㊊ 㦵 㢌 ࡢ 㦵 ᣦ ᶆ 9 Ⅼ ࡜ 㸪 Point Cluster ἲ
[Andriacchi et al., 1998]࡟ᇶ࡙ࡁ኱⭣ 㒊࡟ࡣ 10 Ⅼ㸪ୗ⭣㒊࡟ ࡣ 6 Ⅼࡢ཯ᑕ࣐࣮
࣮࢝ࢆ㈞௜ࡋ ࡓ㸦ᅗ 3-2-b㸧㸬ࡲࡓ㸪ࢩࣗ ࣮ࢬ ࡢ㋖㒊࡟㊊㒊 ࢭࢢ࣓ࣥ ࢺࡢ఩⨨࠾
ࡼࡧ᪉఩ࢆィ ⟬ࡍࡿࡓ ࡵࡢ཯ᑕ࣐࣮ ࣮࢝ ࢆ 3 Ⅼ㈞௜ࡋࡓ㸬
㸦 a㸧
㸦 b㸧
ᅗ 3-2 㸦 a㸧 ࢝ ࣓ ࣛ タ ⨨ ఩ ⨨ ࡜ 㸦 b㸧 ࣐ ࣮ ࢝ ࣮ ㈞ ௜ ఩ ⨨
4. ࢹ࣮ࢱゎᯒ
ᚓࡽࢀࡓ୕ ḟඖᗙᶆ ࢹ࣮ࢱ࠿ࡽ㸪 Grood ࡜ Suntay㸦1983㸧ࡀ ᥦၐࡋࡓ㛵⠇ ᗙ
ᶆ⣔ࢆ⏝࠸࡚ ⭸㛵⠇ᒅ ᭤ゅᗘ࠾ࡼࡧ እ㌿ゅᗘ 㸪⫤㛵⠇ᒅ᭤ ゅᗘ࠾ࡼ ࡧෆ㌿ゅᗘ
ࢆ⟬ฟࡋࡓ㸬 ࡲࡓ㸪ᗋ ཯ຊࢹ࣮ࢱ࠿ ࡽ㸪㏫ࢲ ࢖ࢼ࣑ࢡࢫࢆ ⏝࠸࡚⭸ 㛵⠇እ㌿ࣔ
࣮࣓ࣥࢺ࠾ࡼ ࡧ⫤㛵⠇ ෆ㌿࣮࣓ࣔࣥ ࢺࢆ⟬ฟ ࡋࡓ㸬㛵⠇ࣔ ࣮࣓ࣥࢺ ࡣ㸪እⓗࣔ
࣮࣓ࣥࢺ࡜ࡋ ࡚ィ⟬ࡋ ࡓ㸬ྛ㛵 ⠇࣮࣓ࣔ ࣥࢺ ࡣᑐ㇟⪅ࡢ㌟ 㛗࡜య㔜 ࡢ✚࡛㝖ࡋ 㸪
ṇつ໬ࡋࡓ㸬 ゎᯒ⠊ᅖ ࡣᗋ཯ຊィ࠿ ࡽᚓࡽࢀ ࡓࢹ࣮ࢱ࠿ࡽ 㸪㊊㒊ࡢ ୍㒊ࡀᗋ࡟
85
᥋ᆅࡋࡓ᫬Ⅼ㸦 initial contact㸸௨ୗ㸪IC㸧࠿ ࡽ ࡘࡲඛࡀᗋ࠿ ࡽ㞳ࢀࡓ ᫬Ⅼ㸦 toe off㸸
௨ୗ㸪TO㸧ࡲ࡛࡜ࡋ 㸪ࡇࡢᮇ㛫ࢆ Landing phase ࡜ࡋࡓ㸬ࣃ ࣓ࣛ ࣮ࢱࡣ㸪࢟ࢿ
࣐ࢸ࢕ࢡࢫ࡟ ࠾࠸࡚ࡣ 㸪Landing phase ࡢ඲᫬ 㛫ࢆ 100㸣࡜ࡋࡓሙྜ ࡢ㸪IC ᫬࠿
ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ ࡳࡽࢀࡓ ᭱኱⭸㛵⠇ᒅ ᭤ゅᗘ࠾ ࡼࡧ᭱኱⭸
㛵⠇እ㌿ゅᗘ 㸪᭱኱⫤ 㛵⠇ᒅ᭤ゅᗘ ࠾ࡼࡧ᭱ ኱⫤㛵⠇ෆ㌿ ゅᗘ࡜ࡋ 㸪࢟ࢿࢸ࢕
ࢡࢫ࡟࠾࠸࡚ ࡣ㸪 IC ᫬࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ ࡳ ࡽࢀࡓ᭱኱⭸㛵
⠇ እ ㌿ ࣔ ࣮ ࣓ ࣥ ࢺ ࠾ ࡼ ࡧ ᭱ ኱ ⫤ 㛵 ⠇ ෆ ㌿ ࣔ ࣮ ࣓ ࣥ ࢺ ࡜ ࡋ ࡓ 㸬 ᑦ 㸪 IC ᫬ ࠿ ࡽ
Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ࡳ ࡽࢀࡓ ྛ 㡯ࡢ᭱኱್ࢆ ࣃ࣓ࣛ ࣮ ࢱ࡜ࡋࡓ⌮
⏤ࡣ㸪㖄┤᪉ ྥ࡬ࡢ᭱ ኱ᗋ཯ຊࡢࣆ ࣮ࢡ ࡀ IC ᫬ᚋ㸪Landing phase ࡢ 30㸣᫬Ⅼ
ࡲ࡛࡟ࡳࡽࢀ ࡓࡇ࡜㸪 ࡲࡓ㸪ᐇ㝿ࡢ ACL യᐖࡀ IC ᫬ᚋ ࡟ࡳࡽࢀ ࡿ᭱኱ᗋ཯ຊ
ࡢ ࣆ ࣮ ࢡ ௜ ㏆ ࡛ Ⓨ ⏕ ࡋ ࡚ ࠸ ࡿ ࡇ ࡜ ࡀ ከ ᩘ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ Ⅽ ࡛ ࠶ ࡿ [Koga et al.,
2010;㸪Krosshaug et al., 2007]㸬⤫ィᏛⓗゎᯒ ࡣྛヨ⾜᮲௳ 㛫࡟࠾࠸ ୍࡚ඖ㓄⨨
ศᩓศ ᯒࢆ ⏝࠸㸪 ᭷ព ᕪࡢᚓ ࡽࢀ ࡓ 㡯┠ ࡟ᑐ ࡋ㸪 Bonferroni ἲࢆ⏝ ࠸ ࡚ከ 㔜ẚ
㍑᳨ᐃࢆ⾜ࡗ ࡓ㸬 ࡞࠾ 㸪᭷ពỈ‽ ࡣ 5㸣ᮍ‶ ࡜ࡋࡓ㸬
4-3-3. ⤖ᯝ
NH㸪RH㸪RHT ྛヨ⾜ ᮲௳࡟࠾ࡅ ࡿ IC ᫬ࡢ ඲ᑐ㇟⪅ࡢ඲ ヨᢏࡢ ᖹ ᆒ⭸㛵⠇ᒅ
᭤ゅᗘ࠾ࡼࡧ ⭸㛵⠇እ ㌿ゅᗘ㸪⫤㛵⠇ᒅ ᭤ゅ ᗘ࠾ࡼࡧ⫤㛵 ⠇ෆ㌿ゅ ᗘ 㸪IC ᫬࠿
ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛ࡢ ᭱኱⭸㛵 ⠇ᒅ᭤ゅᗘ࠾ ࡼࡧ᭱኱ ⭸㛵⠇እ㌿
ゅᗘ㸪᭱኱⫤ 㛵⠇ᒅ᭤ ゅᗘ࠾ࡼࡧ᭱ ኱⫤㛵⠇ ෆ㌿ゅᗘ㸪᭱ ኱⭸㛵⠇ እ㌿࣮࣓ࣔ
ࣥࢺ࠾ࡼࡧ᭱ ኱⫤㛵⠇ ෆ㌿࣮࣓ࣔࣥ ࢺࢆ⾲ 3-1 ࡟♧ ࡍ㸬ࡲࡓ 㸪 ྛ ヨ⾜᮲௳࡟࠾
ࡅࡿ Landing phase ࡢ඲ᑐ㇟⪅ࡢ඲ ヨᢏࡢᖹ ᆒ⭸㛵⠇ᒅ᭤࣭ఙᒎゅ ᗘ࠾ࡼࡧ ᖹᆒ
⭸㛵⠇ෆ㌿࣭ እ㌿ゅᗘ 㸪 ᖹᆒ⫤㛵⠇ ᒅ᭤ ࣭ఙ ᒎゅᗘ࠾ࡼࡧ ᖹᆒ ⫤㛵 ⠇ෆ㌿࣭እ
㌿ゅᗘ㸪ᖹᆒ ⭸㛵⠇እ ㌿ ࣭ෆ㌿࣮ࣔ ࣓ࣥࢺ 㸪 ᖹᆒ⫤㛵⠇ෆ ㌿࣭እ㌿ ࣮࣓ࣔࣥࢺ
ࡢ᫬⣔ิኚ໬ ࢆᅗ 3-3 ࡟♧ࡋࡓ㸬᭷ ពᕪࡀㄆ ࡵࡽࢀࡓ ヨ⾜ ᮲௳㛫ࡢ ࣃ࣓࣮ࣛࢱ
ࡣ㸪 IC ᫬࠿ࡽ Landing phase ࡢ 30%᫬Ⅼࡲ ࡛ࡢ᭱኱⭸㛵 ⠇ᒅ᭤ゅ ᗘ࡟࠾࠸࡚ 㸪
RHT ࡣ RH ࡜ẚ ࡭࡚᭷ ព࡟ῶᑡࡋࡓ㸦p < 0.05㸧㸬ࡑࡢ௚ࡢヨ ⾜᮲ ௳㛫࡟࠾ࡅࡿ
ྛࣃ࣓࣮ࣛࢱ ࡢẚ㍑࡟ ࠾࠸࡚᭷ពᕪ ࡣࡳࡽࢀ ࡞࠿ࡗࡓ㸬
86
87
(a)
(b)
(c)
(d)
88
(e)
(f)
4-3-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪ዪ Ꮚࣛࢡࣟ ࢫ㑅ᡭࢆᑐ㇟ ࡜ࡋ࡚㸪 ࣛࢡࣟࢫࡢ➇ ᢏ≉Ṧᛶ ࡢ 1 ࡘ࡛
࠶ ࡿ ࢫࢸ ࢕ ࢵ ࢡ ࡸ ┠ ᶆ ≀ ࡢ ᭷↓ ࡛ ࡢ ᮲ ௳ ୗ ࡛ DVJ ࢆ ⾜ ࢃ ࡏ ࡓ࡜ ࡁ ࡢ ୗ⫥ ࢟ ࢿ
࣐ࢸ࢕ࢡࢫ࣭ ࢟ࢿࢸ࢕ ࢡࢫ࡟ཬࡰࡍ ᙳ㡪࡟ࡘ ࠸࡚ẚ㍑᳨ウ ࡍࡿࡇ࡜ ࢆ ┠ⓗ࡜ࡋ
࡚⾜࠸㸪ᚓࡽ ࢀࡓ⤖ᯝ ࡣ᭱኱⭸㛵⠇ ᒅ᭤ゅᗘ ࡟࠾࠸࡚㸪ࢫ ࢸ࢕ࢵࢡ ಖᣢ࠶ࡾ࡟
┠ᶆ≀ࢆຍ࠼ ࡓ᮲௳ࡣ 㸪┠ᶆ≀ࡀ↓ ࠸ሙྜࡢ ᮲௳࡜ẚ㍑ࡋ ᭷ព࡟ῶ ᑡ ࡋࡓ㸬ඛ
⾜◊✲࠿ࡽ 㸪ዪᛶ ࢔ࢫ ࣮ࣜࢺࡣ⏨ᛶ ࢔ࢫ࣮ࣜ ࢺ࡟ẚ࡭ 㸪DVJ ືస᫬ࡢ⭸㛵⠇እ
㌿ゅᗘ࠾ࡼࡧ ⫤㛵⠇ෆ ㌿ゅᗘࡀ኱ࡁ ࡃ㸪⭸㛵 ⠇ᒅ᭤ゅᗘࡀ ᑠࡉ࠸࡜ ࠸ࡗࡓୗ⫥
࢔ࣛ࢖࣓ࣥࢺ ࢆ♧ࡋ㸪 ࡑࢀࡽࡢ≉ᚩ ⓗ࡞ືⓗ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺࡀዪ ᛶ࢔ࢫ࣮ࣜ
ࢺࡢ ACL യᐖ せᅉࡢ ୍ࡘ࡛࠶ࡿࡇ ࡜ࡀ」ᩘ ሗ࿌ࡉࢀ࡚࠸ ࡿ [Hewett et al., 2006;
Renstrom et al., 2008]㸬ࡑࡢ࡯ ࠿ Decker ࡽ㸦2003㸧ࡣ㸪ࢻࣟࢵࣉ ࣛࣥࢹ࢕ࣥࢢ
89
࡟࠾࠸࡚ዪᛶ ࡣ⏨ᛶ࡟ ẚ࡭㸪⭸㛵⠇ ᒅ᭤ゅᗘ ࡀ᭷ព࡟ῶᑡ ࡋ࡚࠸ࡓ ࡇ࡜ࢆሗ࿌
ࡋ㸪Yu ࡽ㸦2005㸧ࡣ㸪ࢫࢺࢵࣉࢪࣕ ࣥࣉࢱࢫ ࢡ࡟࠾࠸࡚ ዪ ᛶࡢ᭱኱ ⭸㛵⠇ᒅ᭤
ゅᗘࡀ᭷ព࡟ ῶᑡࡋࡓ ࡇ࡜ࢆሗ࿌ࡋ ࡚࠸ࡿ㸬DVJ ࢸࢫࢺ࡛ᚓࡽࢀ ࡓ ⭸㛵⠇࢟ࢿ
࣐ࢸ࢕ࢡࢫ࠾ ࡼࡧ࢟ࢿ ࢸ࢕ࢡࢫࡢࢹ ࣮ࢱࢆ࣋ ࣮ࢫࣛ࢖ࣥ࡜ ࡋ࡚⏝࠸ 㸪ACL യᐖ
⩌࡜ẚയᐖ⩌ ࢆẚ㍑᳨ ドࡋࡓ๓ྥࡁ ◊✲ [Hewett et al., 2005]࠿ࡽࡣ㸪ACL യᐖ
⩌ࡣ㠀യᐖ⩌ ࡟ẚ࡭᭷ ព࡟⭸㛵⠇እ ཯ゅᗘࡀ ኱ࡁ࠿ࡗࡓ࡯ ࠿㸪▮≧ 㠃࠿ࡽࡳࡓ
᭱኱⭸㛵⠇ᒅ ᭤ゅᗘ ࡀ ᭷ព࡟ᑠࡉ࠿ ࡗࡓࡇ࡜ ࡀ♧ࡉࢀࡓ [Hewett et al., 2005]㸬ࡲ
ࡓ Nunley ࡽ㸦2003㸧 ࡣ㸪X ⥺ࢆ⏝࠸ࡓゎ๗ ᏛⓗほⅬ࠿ࡽ ⏨ዪࡢ ACL യᐖࣜࢫ
ࢡࢆ᳨ドࡋࡓ ࡜ࡇࢁ㸪 ྠࡌ⭸㛵⠇ᒅ ᭤ゅᗘ࡛ ࡢ኱⭣ᅄ㢌➽ ཰⦰࡟ࡼ ࡿ⬯㦵๓᪉
๧᩿ຊࡣ㸪ዪᛶ ࡣ⏨ᛶ ࡟ẚ࡭࡚኱ࡁ ࡃ㸪ACL ࡬ࡢఙᙇࢫࢺ ࣞࢫࡀࡼ ࡾ㧗ࡲࡿࡇ
࡜ࢆሗ࿌ࡋ࡚ ࠸ࡿ㸬
ࢫࢸ࢕ࢵࢡಖ ᣢ࠶ࡾ࡛ ┠ᶆ≀࠶ࡾ࣭ ࡞ࡋࡢ᮲ ௳ୗࡢືసẚ ㍑࡟࠾࠸ ࡚㸪ࢫࢸ
࢕ࢵࢡಖᣢ࠶ ࡾ࡛┠ᶆ ≀࡞ࡋࡢືస ࡣ㸪╔ᆅ ࠿ࡽࢪࣕࣥࣉ ࡜࠸ࡗࡓ ẚ㍑ⓗ༢⣧
࡞ືసࢆ㐙⾜ ࡋࡼ࠺࡜ ࡍࡿព㆑ࡢࡳ ࡛⾜࠼ࡿ ࡀ㸪ࢫࢸ࢕ࢵ ࢡ ಖᣢ࠶ ࡾ࡛┠ᶆ≀
࠶ࡾࡢືసࡣ 㸪╔ᆅ࠿ ࡽࢪࣕࣥࣉ࡟ ࠿ࡅ࡚┠ ᶆ≀ࡀ࠶ࡿࡇ ࡜࡟ࡼࡾ 㸪ࡑࡢ┠ᶆ
≀࡟ྥ࠿ࡗ࡚ ࡼࡾ㧗ࡃ 㣕ࡰ࠺࡜ࡍࡿ ព㆑࠾ࡼ ࡧ┠⥺ࢆࡼࡾ 㧗ࡃಖᣢ ࡉࡏࡼ࠺࡜
ࡍࡿព㆑ࡀᙉ ࡃാࡁ㸪 ୗ⫥㸪≉࡟⭸ 㛵⠇ࡢᒅ ᭤ゅᗘࢆࡼࡾ ኱ࡁࡃࡉ ࡏ࡚㧗ࡃ㣕
ࡪ࡜࠸ࡗࡓព ㆑ࡀᙅࡃ ࡞ࡿࡇ࡜࡛㸪 ⤖ᯝ⭸㛵 ⠇ᒅ᭤ゅᗘࡢ ῶᑡ࡟ࡘ ࡞ࡀࡗࡓࡢ
࡛ࡣ࡞࠸࠿࡜ ⪃࠼ࡓ㸬 ᭷ពᕪࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓࡀ㸪⫤㛵⠇ ᒅ᭤ゅᗘ ࡟࠾࠸࡚ࡶ
RHT ࡣ RH ࠾ ࡼࡧ NH ࡜ẚ࡭ᑠࡉ࠸ ഴྥࢆ♧ ࡋ࡚࠸ࡓ㸦 ᅗ 3-3 (b)㸪⾲ 3-1㸧㸬
ඛ⾜◊✲࠿ࡽ 㸪ᐇ㝿 ࡢ ➇ᢏ୰࡟Ⓨ⏕ ࡋࡓ ACL യᐖ᫬ࡢࣅ ࢹ࢜⏬ീ ࢆ㐃⥆ࡋ࡚ゎ
ᯒࡋࡓࢹ࣮ࢱ ࡟ࡼࡿ࡜ 㸪⭸㛵⠇㍍ᗘ ᒅ᭤఩ࡀ 㐃⥆ࡋ࡚ࡳࡽ ࢀ࡚࠸ࡓ ࡇ࡜ࡀሗ࿌
ࡉࢀ࡚࠸ࡿ[Boden et al., 2009]㸬ࡇࢀࡽࡢ ඛ ⾜◊✲࠿ࡽ ࡶ ACL യ ᐖせᅉࡢ୍ࡘ
࡟╔ᆅືస୰ ࡢ⭸㛵⠇ ᒅ᭤ゅᗘࡀᑠ ࡉ࠸ࡇ࡜ ࡀ♧ࡉࢀ࡚࠸ ࡿࡀ㸪ᮏ ◊✲࡟࠾࠸
࡚ࡶ IC ᫬࠿ࡽ᭱ ኱⭸ 㛵⠇ᒅ᭤ゅᗘ ࡟㐩ࡍࡿ ࡲ࡛ࡢᖹᆒ⭸ 㛵⠇ᒅ᭤ ゅᗘࡣ㸪RHT
ࡣ RH ࠾ࡼ ࡧ NH ࡟ ẚ ࡭ప್ࡢഴྥ ࢆ♧ࡋ࡚ ࠸ࡓ㸦ᅗ 3-3 (a)㸧㸬ᮏ◊✲࡛⟬ฟ
ࡉࢀࡓ್࡟ࡘ ࠸࡚㸪RHT ࡜ RH ࡢ᭱኱ᖹ ᆒ ⭸㛵⠇ᒅ᭤ゅ ᗘࡢᕪ ࡣ 3.8r࡛࠶ࡗ
ࡓࡀ㸪࠸ࡎ ࢀࡢඛ⾜ ㄽ ᩥ࠿ࡽ ࡶ ACL യᐖ⩌ ࡜ࢥࣥࢺ࣮ࣟ ࣝ⩌࡜ࢆ ẚ㍑ࡋࡓሙྜ
ࡢࣛࣥ ࢹ࢕ࣥ ࢢ᫬ ࡢ ⭸ 㛵⠇ᒅ ᭤ゅᗘ ࡢᑠࡀ ACL യᐖ ࣜࢫࢡ ࡜࡞ ࡿࡇ࡜ ࡀከᩘ
90
ሗ࿌ࡉࢀ࡚࠾ ࡾ㸪⌧ ሙ ᣦᑟ࡟࠾࠸࡚ ࡣ ACL യᐖண㜵ࡢⅭ ࡟⭸㛵⠇ ᒅ᭤ゅᗘ࡟╔
┠ࡋࡓᣦᑟࡀ 㔜せ࡛࠶ ࡿ࡜⪃࠼ࡿ㸬 㧗ࡃୖࡀ ࡗࡓ࣮࣎ࣝࢆ ࢫࢸ࢕ࢵ ࢡࢆ୧ᡭ࡛
ಖᣢࡋࡓ≧ែ ࡛ࢪࣕࣥ ࣉࡋ࡚࢟ࣕࢵ ࢳ࡟⾜ࡃ ࡜࠸ࡗࡓᒁ㠃 ࡣ㸪ᐇ㝿 ࡢ➇ᢏሙ 㠃
࡛ࡶከࡃࡳࡽ ࢀ㸪௒ᅇ ࡢᐇ㦂࡛⾜ࡗ ࡓኳ஭࡟ ྞࡋࡓ࣮࣎ࣝ ࢆ┠ᶆ≀ ࡜ࡋ࡚タᐃ
ࡋ㸪ࢫࢸ࢕ࢵ ࢡࢆಖᣢ ࡉࡏࡓ≧ែ࡛ ࡑࡢ┠ᶆ ≀࡟ྥ࠿ࡗ࡚ ࡼࡾ㧗ࡃ ࢪࣕࣥࣉࡉ
ࡏࡿ࡜࠸ࡗࡓ ືసᵝᘧ ࡣ㸪➇ᢏ≉Ṧ ᛶࢆ⪃៖ ࡋࡓ ୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࢆホ౯ࡍࡿ
ࡓࡵࡢㄢ㢟ື సࡢ୍ࡘ ࡟࡞ࡾ࠺ࡿྍ ⬟ᛶࡀ♧ ၀ࡉࢀࡓ㸬௒ ᅇࡢᐇ㦂 ࡟࠾࠸࡚㸪
ࢫࢸ࢕ࢵࢡಖ ᣢ࠶ࡾ࡛ ┠ᶆ≀࠶ࡾ࣭ ࡞ࡋࡢ᮲ ௳㛫࠿ࡽ㸪▮ ≧㠃࡟࠾ ࡅࡿ⭸㛵⠇
࡬ࡢᙳ㡪ࡀㄆ ࡵࡽࢀࡓ 㸬ACL യᐖண㜵ࡢࡓࡵ ࡢࢫࢡ࣮ࣜࢽ ࣥࢢ࡜ࡋ ࡚㏻ᖖ⏝࠸
ࡽࢀ࡚࠸ ࡿ DVJ ࢸࢫࢺ࡟ຍ࠼ 㸪ࣛࢡࣟ ࢫࡢ ➇ᢏ≉Ṧᛶ࡟ ᛂࡌࡓື సᵝᘧ࡛⾜ࢃ
ࡏࡿࡇ࡜㸪ࡍ ࡞ࢃࡕࢫ ࢸ࢕ࢵࢡࢆ୧ ᡭ࡛ಖᣢ ࡉࡏࡓ᮲௳࡟ ຍ࠼㸪┠ ᶆ≀ࢆຍ࠼
ࡓ᮲௳࡛⾜ࢃ ࡏࡿࡇ࡜ ࡀືⓗୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺࢆホ౯ࡍࡿ ୍ࡘࡢᣦ ᶆ࡜࡞ࡾ㸪
ACL ࢆྵࡵࡓୗ⫥ യ ᐖࣜࢫࢡࢆ᳨ ウࡍࡿ୍ ຓ࡜࡞ࡿྍ⬟ ᛶࡀ♧ࡉ ࢀ ࡓ㸬ᮏ◊✲
ࡢ㝈⏺ࡣ㸪ẚ ㍑ᑐ㇟⪅ ᩘࡀᑡ࡞࠸ࡇ ࡜࡟࠶ࡿ 㸬ඛ⾜ ㄽᩥ࠿ ࡽࡶ ሗ࿌ ࡉࢀ࡚࠸ࡿ
ࡼ࠺࡟[Pollard et al., 1994]㸪ୗ⫥㛵⠇ゅ ᗘ ࡢ೫఩ࡣಶே ᕪࡀ኱ࡁ ࡃ㸪ᖹᆒ໬ࡉ
ࢀࡓ್࠿ࡽࡑ ࢀࡽࡢഴ ྥࢆ❧ドࡍࡿ ࡟ࡣ㸪ࡉ ࡽ࡟ᑐ㇟⪅ᩘ ࢆቑࡸࡋ ᳨࡚ウࡍࡿ
ᚲせࡀ࠶ࡿ㸬
4-3-5. ⤖ㄒ
኱ᏛዪᏊࣛࢡ ࣟࢫ㑅ᡭ ࢆᑐ㇟࡜ࡋ㸪 ࣛࢡࣟࢫ ࢫࢸ࢕ࢵࢡࡢ ಖᣢࡸ᧯ సࡀ ࢻࣟ
ࢵࣉࣂ࣮ࢸ࢕ ࢝ࣝ ࢪࣕ ࣥࣉືస᫬ࡢ ୗ⫥࢟ࢿ ࣐ࢸ࢕ࢡࢫ࣭ ࢟ࢿࢸ࢕ ࢡࢫ࡟ཬࡰ
ࡍᙳ㡪࡟ࡘ࠸ ࡚ẚ㍑᳨ ウࡋ㸪 ╔ᆅ᫬ ࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ࡳࡽ
ࢀࡓ᭱኱⭸㛵 ⠇ᒅ᭤ゅ ᗘ࡟࠾࠸࡚㸪 ࢫࢸ࢕ࢵ ࢡಖ᫬࠶ࡾ࡟ ┠ᶆ≀ࢆ ຍ࠼ࡓ᮲௳
ࡣ㸪┠ᶆ≀ࡀ ࡞࠸ሙྜ ࡢ᮲௳࡜ẚ㍑ ࡋ᭷ព࡟ ῶᑡࡉࡏࡓ㸬 ዪᏊࣛࢡ ࣟࢫ㑅ᡭࢆ
ᑐ㇟࡜ࡋ ࡓ ACL യᐖ ண㜵ࡢࡓࡵࡢ ࢫࢡ࣮ࣜ ࢽࣥࢢ࡜ࡋ࡚ 㸪ࢫࢸ ࢕ ࢵࢡࢆಖᣢࡉ
ࡏ㸪ࡉࡽ࡟ࡣ ┠ᶆ≀ࢆ ຍ࠼ࡓ᮲௳ୗ ࡛ࡢࢻࣟ ࢵࣉ ࣂ࣮ࢸ࢕ ࢝ࣝ ࢪࣕ ࣥࣉࢸࢫࢺ
ࡣ㸪ACL ࢆྵࡵࡓୗ⫥ യᐖࣜࢫࢡࢆ ᳨ウࡍ ࡿ ࡓࡵࡢ୍ຓ࡜ ࡞ࡿྍ⬟ ᛶࡀ♧၀ࡉ
ࢀࡓ㸬
91
◊ ✲ 4 ࣛࢡ ࣟࢫ ࢫ ࢸ ࢕ࢵ ࢡࡢ ಖ ᣢࡢ ᭷↓ ࡀ ࢝ࢵ ࢸ࢕ ࣥ ࢢື స᫬ ࡢ ୗ⫥ ࢟ࢿ ࣐
ࢸ࢕ ࢡࢫ ࣭ ࢟ࢿ ࢸ࢕ ࢡ ࢫ࡟ ཬࡰ ࡍ ᙳ㡪
4-4-1. ⥴ゝ
ዪᏊࣛࢡࣟࢫ ࡢ⭸๓༑ Ꮠ㠌ᖏ㸦 anterior cruciate ligament㸸௨ୗ 㸪ACL㸧യᐖⓎ
⏕⋡ࡣ㸪NCAA㸦National Collegiate Athletic Association㸪඲⡿኱ Ꮫ య⫱༠఍ 㸧ࡢ
ሗ࿌࡟ࡼࡿ࡜ 㸪ẚ㍑ⓗ 㧗࠸ࡇ࡜ࡀ࠺ ࠿ࡀ࠼ࡿ [Hootman et al., 2007]㸬ࣛࢡࣟࢫࡣ 㸪
ࢫࢸ࢕ࢵࢡ㸦 ࢡࣟࢫ㸧 ࢆ୧ᡭ࡛ಖᣢ ࡋ ࡓ≧ែ ࡛࢝ࢵࢸ࢕ࣥ ࢢࡸࢪࣕ ࣥࣉືసࢆ
⾜࠺Ⅼࡀ➇ᢏ ≉Ṧᛶ ࡜ ࡋ࡚ᣲࡆࡽࢀ ࡿ㸬
ACL യᐖࡢ୺࡞Ⓨ ⏕ ᶵ㌿࡛࠶ࡿ ࢝ ࢵࢸ࢕ࣥ ࢢືస ࡟ࡘ࠸ ࡚㸪ࡑࡢ യᐖ࣓࢝ࢽ
ࢬ࣒ࢆゎ᫂ࡍ ࡿࡓࡵࡢ ᡭἲࡢ୍ࡘ࡟ 㸪ືస୰ ࡟ࡳࡽࢀࡿୗ ⫥࢟ࢿ࣐ ࢸ࢕ࢡࢫ࣭
࢟ࢿࢸ࢕ࢡࢫ ࢆศᯒࡍ ࡿ࡜࠸ࡗࡓࣂ ࢖࣓࢜࢝ ࢽࢡࢫⓗᡭἲ ࡀ⏝࠸ࡽ ࢀ࡚࠸ࡿ㸬
౛࠼ࡤᐇ㦂ᐊ ෆ࡛⾜ ࢃ ࢀ࡚࠸ࡿᩘ࣓ ࣮ࢺࣝࡢ ຓ㉮࠿ࡽࡢ᪉ ྥ㌿᥮㉮ ➼࡛࠶ࡿ㸬
௒᪥㸪ࡑࢀࡽ ࡢㄢ㢟ື సࢆ⾜ࢃࡏࡓ ᫬ࡢ ⭸ࡸ ⫤㛵⠇ࡢ㛵⠇ ゅᗘࡸ 㛵 ⠇࣮࣓ࣔࣥ
ࢺࢆ⏨ዪ࡛ẚ ㍑ࡋࡓ࡜ ࡇࢁ㸪⏨ᛶ࡟ ẚ࡭࡚ ዪ ᛶࡢ⭸㛵⠇እ ㌿ゅᗘࡸ ⫤㛵⠇ෆ㌿
ゅᗘࡀ኱ࡁ࠸ ࡇ࡜㸪⭸ 㛵⠇እ㌿࣮ࣔ ࣓ࣥࢺࡸ ⫤㛵⠇ෆ㌿ࣔ ࣮࣓ࣥࢺ ࡀ ኱ࡁ࠸ࡇ
࡜ࡀሗ࿌ࡉࢀ ࡚࠾ࡾ 㸪ࡑࢀࡽ ࡀ ACL യᐖ࣓ ࢝ࢽࢬ࣒ࡢ୍ ࡘ࡛࠶ࡿ ࡜࠸࠺ぢゎ ࡛
୍⮴ࡋ࡚࠸ࡿ[Quatman and Hewett, 2009; Hewett et al., 2006]㸬࢝ࢵ ࢸ࢕ࣥࢢືస
ࢆㄢ㢟ືస࡟ タᐃࡋ࡚ ⾜ࢃࡏࡓ᫬ࡢ ⏨ዪࡢୗ ⫥࢟ࢿ࣐ࢸ࢕ ࢡࢫ࣭࢟ ࢿࢸ࢕ࢡࢫ
ࡢẚ㍑࡟ࡘ࠸ ࡚㸪⭸㛵 ⠇࡟㛵ࡋ࡚ࡣ 㸪Malinzak ࡽ㸦2001㸧㸪McLean ࡽ㸦2004㸧㸪
Ford ࡽ㸦2003㸧࡟ࡼࡿ ࡜ 㸪ዪᛶ ࡣ⏨ᛶ࡟ ẚ࡭ ࡚⭸ 㛵⠇እ㌿ ゅᗘࡀ኱ ࡁࡃ㸪McLean
ࡽ㸦2005㸧࡟ࡼࡿ࡜ዪ ᛶࡣ⏨ᛶ࡟ẚ ࡭࡚⭸ 㛵 ⠇እ㌿࣮࣓ࣔ ࣥࢺࡀ ኱ ࡁ࠸ࡇ࡜ࡀ
ሗ࿌ࡉࢀ࡚࠸ ࡿ㸬ࡲࡓ 㸪⫤㛵⠇࡟㛵ࡋ ࡚ࡣ㸪Pollard ࡽ㸦2007㸧࡟ࡼࡿ࡜㸪ዪᛶ
ࡣ ⏨ ᛶ ࡟ ẚ ࡭ ࡚ ⫤ 㛵 ⠇ ෆ ᪕ ゅ ᗘ ࡀ ኱ ࡁ ࠿ ࡗ ࡓ ࡇ ࡜ ࢆ ♧ ࡋ ࡓ ࡯ ࠿ 㸪 Pollard ࡽ
㸦2004㸧ࡣ㸪⏨ዪ࡜ࡶ ࡟⫤㛵⠇እ㌿ ⫥఩ࢆ♧ ࡋࡓࡀ㸪ዪᛶ ࡣ⏨ᛶ࡟ ẚ࡭࡚ࡼࡾ
ෆ㌿᪉ ྥ࡬ ࡢືࡁ ࢆ♧ ࡋ࡚࠸ ࡓࡇ ࡜ࢆሗ ࿌ࡋ ࡓ㸬ࡲ ࡓ㸪 Pollard ࡽ 㸦2007㸧ࡣ 㸪
ዪᛶࡣ⏨ᛶ࡟ ẚ࡭࡚⫤ 㛵⠇ෆ㌿࣮ࣔ ࣓ࣥࢺࡀ ኱ࡁ࠿ࡗࡓࡇ ࡜ࢆሗ࿌ ࡋ࡚࠸ࡿ㸬
ࡇࢀࡽࡢሗ࿌ ࠿ࡽ ዪᛶ ࡣ⏨ᛶ࡟ẚ࡭ 㸪࢝ࢵࢸ ࢕ࣥࢢືస᫬ ࡢ⭸㛵⠇ እ㌿ゅᗘࡸ
⫤㛵⠇ෆ᪕ゅ ᗘ㸪⭸㛵 ⠇እ㌿࣮࣓ࣔ ࣥࢺ ࡸ⫤ 㛵⠇ෆ㌿࣮ࣔ ࣓ࣥࢺࡀ ኱ࡁ࠸࡯࠿ 㸪
92
⫤㛵⠇ෆ㌿᪉ ྥ࡬ࡢ ື సഴྥࢆ♧ࡍ ࡜࠸ࡗࡓ ≉ᚩࡀࡳࡽࢀ ࡚࠸ࡿ㸬 ࡋ࠿ࡋ࡞ࡀ
ࡽ௒᪥ࡲ࡛⾜ ࢃࢀ࡚ࡁ ࡓືసᐇ㦂ࡣ 㸪ᛶᕪࡢ 㐪࠸ࢆ᳨ウࡍ ࡿ┠ⓗ࡛ 㸪ẚ㍑ⓗ༢
⣧࡞ㄢ㢟ືస ࢆ⾜ࢃࡏ ࡓୖ࡛ࡢẚ㍑ ᳨ドࡀ⾜ ࢃࢀ࡚࠸ࡿ㸬 ࡑࡇ࡛➹ ⪅ࡽࡣ ዪᛶ
࡟↔Ⅼࢆ࠶࡚㸪ACL യ ᐖ㢖ᗘࡀ㧗࠸ ➇ᢏࢆᑐ ㇟࡜ࡋ࡚㸪➇ᢏ ≉Ṧᛶ ࡀ⪃៖ࡉࢀ
ࡓືసᵝᘧࢆ ⏝࠸ࡓ᳨ ドࡀ ᚲせ࡛࠶ ࡿ࡜⪃࠼ ࡓ㸬 ྛ➇ᢏ࡛ ⾜ࢃࢀ࡚ ࠸ࡿ ࢝ࢵࢸ
࢕ࣥࢢࡸࢪࣕ ࣥࣉືస ࢆ 㸪➇ᢏ≉Ṧ ᛶࡀ⪃៖ ࡉࢀࡓືసᵝ ᘧ࡟タᐃ ࡋ ࡚⾜ࢃࡏ
ࡓ᫬ࡢືసศ ᯒ࡟ࡼࡾ 㸪 ➇ᢏู࡟ࡳ ࡓയᐖⓎ ⏕࣓࢝ࢽࢬ࣒ ࡀゎ࡛᫂ ࡁࡿࡢ࡛ࡣ
࡞࠸࠿࡜࠸࠺ ࡶࡢ࡛࠶ ࡿ㸬 ᮏ◊✲࡟ ඛ❧ࡕ㸪 ➹⪅ࡽࡣ኱Ꮫ ⏕ዪᏊࣛ ࢡࣟࢫࢆᑐ
㇟࡟㸪ࢻࣟࢵ ࣉࣂ࣮ࢸ ࢕࢝ࣝ ࢪࣕࣥ ࣉ᫬࡟࠾ ࡅࡿࣛࢡࣟࢫ ࢫࢸ࢕ࢵ ࢡࡢಖᣢࡸ
᧯సࡀୗ⫥࢟ ࢿ࣐ࢸ࢕ ࢡࢫ࣭࢟ࢿࢸ࢕ ࢡࢫ࡟ ཬࡰࡍᙳ㡪 ࡟ ࡘ࠸࡚ሗ ࿌ࡋ [బ㔝ᮧ
ࡽ, 2012-2]㸪ࣛࢡࣟࢫ ࢫࢸ࢕ࢵ ࢡࢆಖ ᣢࡉࡏ ࡓ≧ែ࡛ ࡢࢻࣟ ࢵࣉ ࣂ ࣮ࢸ࢕࢝ ࣝ
ࢪࣕࣥࣉືస ࡛㸪┠ᶆ ≀ࢆຍ࠼࡚⾜ ࢃࡏࡓ᫬ ࡣ┠ᶆ≀ࡢ࡞ ࠸᫬ ࡜ẚ ࡭㸪⭸㛵⠇
ᒅ᭤ゅᗘࡀ᭷ ព࡟ῶᑡ ࡋࡓ࡜⤖ㄽ࡙ ࡅ࡚࠸ࡿ 㸬ᮏ◊✲ࡣ㸪ዪᏊ ࣛࢡ ࣟࢫ ࡢ ACL
യᐖ࣓࢝ࢽࢬ ࣒࡟ࡘ࠸ ᳨࡚ド ࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ࡚㸪኱Ꮫ ዪᏊࣛࢡ ࣟࢫ㑅ᡭ ࢆ
ᑐ㇟࡜ࡋ࡚㸪 ࢝ࢵࢸ࢕ ࣥࢢືసࢆㄢ 㢟ືస ࡟ タᐃࡋ㸪➇ᢏ ≉Ṧᛶࡢ ୍ࡘ࡛࠶ࡿ
ࣛࢡࣟࢫࢫࢸ ࢕ࢡࢆಖ ᣢࡉࡏ ࡚࢝ࢵ ࢸ࢕ࣥࢢ ືస ࢆ⾜ࢃࡏ ࡓ᫬࡜ࡑ ࠺࡛࡞࠸᫬
ࡢୗ⫥࢟ࢿ࣐ ࢸ࢕ࢡࢫ 㸪࢟ࢿࢸ࢕ࢡ ࢫ࡟ࡘ࠸ ࡚ẚ㍑᳨ドࡍ ࡿࡇ࡜࡜ ࡋࡓ㸬 ௬ㄝ
ࡣ㸪ࢫࢸ࢕ࢵ ࢡࢆಖᣢ ࡉࡏ࡚⾜ࢃࡏ ࡓ ᫬ࡢ࢝ ࢵࢸ࢕ࣥࢢື స ࡣ ಖᣢ ࡞ࡋࡢ᫬࡜
ẚ࡭㸪⭸㛵⠇ እ㌿ゅᗘ ࡸ⭸ 㛵⠇እ㌿ ࣮࣓ࣔࣥ ࢺ㸪⫤㛵⠇ ෆ ㌿ゅᗘࡸ ⫤㛵⠇ෆ㌿
࣮࣓ࣔࣥࢺࡀ ቑຍࡍࡿ ࡜࠸࠺ࡶࡢ࡛ ࠶ࡿ㸬
4-4-2. ᑐ㇟࡜᪉ἲ
1. ᑐ㇟
኱ᏛዪᏊࣛࢡ ࣟࢫ㑅 ᡭ 10 ྡ㸦ᖺ 㱋㸦 ᖹᆒ±ᶆ‽೫ᕪ㸧
㸸 19.4 ± 1.0 ṓ㸪㌟㛗 158.6
± 5.3 cm㸪య㔜 55.7 ± 5.6 kg㸪 ࣛࢡࣟࢫ ➇ᢏ Ṕ 24 ± 11.8 ࣨ᭶㸧ࢆ ᑐ㇟࡜ࡋࡓ㸬
ㄢ㢟ືసࢆ⾜ ࠺࡟࠶ࡓ ࡾ 㸪ୗ⫥ࡢയ ᐖ➼࡟ࡼ ࡾᨭ㞀ࢆࡁࡓ ࡉ࡞࠸ ⪅ ࡜ࡋࡓ㸬஦
๓࡟◊✲ࡢ┠ ⓗ㸪᪉ ἲ 㸪೔⌮ⓗ㓄 ៖➼࡟㛵 ࡍ ࡿㄝ᫂ࢆ⾜࠸ 㸪ྠព ࢆ ᚓ ࡚⾜ࡗࡓ㸬
ᮏ◊✲ࡣ 㸪᪩✄⏣ ኱Ꮫ ேࢆᑐ㇟࡜ࡍ ࡿ◊✲࡟ 㛵ࡍࡿ೔⌮ᑂ ᰝጤဨ఍ ࡢᢎㄆࢆᚓ
࡚ᐇ᪋ࡋࡓ㸦 ᢎㄆ␒ ྕ 2010-037㸧㸬
93
2. ㄢ㢟ືస
ㄢ 㢟 ື స ࡣ ࢝ ࢵ ࢸ ࢕ ࣥ ࢢ ື స ࡛ 㸪 ࢫ ࢱ ࣮ ࢺ ᆅ Ⅼ ࠿ ࡽ ྜ ᅗ ࡜ ࡜ ࡶ ࡟ 㸪 5m ࡢ ຓ
㉮ࢆࡘࡅ࡚㸪ᗋ཯ຊィ ୖ࡟฼ࡁ⬮㸦 ඲౛㸪ྑ ⬮㸧ࢆ╔ᆅࡉ ࡏ㸪ᕥ᪉ ྥ 45r᪉ྥ
࡟᪉ ྥ ㌿ ᥮ࡋ ࡚ ㉮ࡾ ᢤ ࡅࡿ ᵝ ᘧ ࡜ࡋ ࡓ 㸦ᅗ 4-1㸧 㸬 ࡞࠾ 㸪 ࢝ࢵ ࢸ ࢕ ࣥࢢ ື సࡣ
๓᪉࡟ே㸦ᩛ ࢳ࣮࣒ࡢ 㑅ᡭ 㸧ࡀ❧ࡗ ࡚࠸ࡿࡀ ࠸ࡿࡇ࡜ࢆ ᝿ ീࡉࡏࡓ ࢝ࢵࢸ࢕ࣥ
ࢢືస࡜ࡋࡓ 㸬ㄢ㢟ື సࢆ௨ୗ ࡢ 3 ᮲௳࡛⾜ ࢃࡏࡓ㸬1.ࢫࢸ࢕ࢵࢡ ಖᣢ࡞ࡋ㸦not
holding a stick㸸௨ ୗ 㸪NH㸧㸦ᅗ 4-2-a㸧㸪 2.฼ࡁᡭഃ ࡟୧ᡭ࡛ ࢫ ࢸ࢕ࢵࢡࢆಖ
ᣢ㸦඲౛㸪ྑᡭ㸧㸦 holding a stick with right hand side:௨ୗ㸪RH㸧㸦ᅗ 4-2-b㸧㸪
3.㠀฼ࡁᡭ ഃ࡟୧ᡭ ࡛ ࢫࢸ࢕ࢵࢡࢆ ಖᣢ㸦඲ ౛㸪ᕥᡭ 㸧㸦holding a stick with left
hand side㸸௨ୗ㸪LH㸧㸦ᅗ 4-2-c㸧㸬ྛ᮲ ௳ ࡛ࡢㄢ㢟ືస ࡟ࡘ࠸࡚ 㸪5 ᮏࡢᡂຌ
ヨ ᢏ ࢆ グ 㘓 ࡋ ࡓ 㸬 ௨ ୗ ࡟ ᡂ ຌ ヨ ᢏ ࡢ ᮲ ௳ ࢆ ♧ ࡍ 㸬 1)ຓ ㉮ ᫬ ࡢ ࢫ ࣆ ࣮ ࢻ ࡀ 4㸫
4.5m/s ෆ࡛࠶ࡿࡇ ࡜ 㸪2)࢝ࢵࢸ࢕ࣥ ࢢືస ᫬࡟ྑ⬮ࡀᗋ ཯ຊィୖ ࡟㋃ࡳ㎸ ࡲࢀ
࡚࠸ ࡿ ࡇ࡜ 㸪 3)ᴃ ෇ ㉮ ⾜࡟ ࡞ ࡗ࡚ ࠸ ࡞ ࠸ࡇ ࡜ 㸦࢝ ࢵ ࢸ࢕ ࣥ ࢢ ືస ࡟ ࡞ࡗ ࡚ ࠸ࡿ
ࡇ࡜㸧㸪4)᪉ྥ㌿᥮ ᚋ㸪タ⨨ࡋ࡚ ࠶ࡿ ࢥ࣮ࣥෆ ࢆ㉮ࡾᢤࡅ࡚ ࠸ࡿࡇ࡜㸦ᅗ 4-1㸧㸪
5)ື స୰ 㸪 ᖖ ࡟ࢫ ࢸ ࢕ ࢵࢡ ࢆ ୧ᡭ ࡛ ಖ ᣢࡋ ࡚ ࠸ࡿ ࡇ ࡜࡜ ࡋ 㸪 ௨ୖ ࡢ ᮲௳ ࡀ ‶ࡓ
ࡉࢀ࡚࠸࡞࠸ ሙྜࡣ↓ ຠ࡜ࡋ࡚෌ヨ ᢏࢆ⾜ࢃ ࡏࡓ㸬
ᅗ 4-1 ࢝ ࣓ ࣛ ࢭ ࢵ ࢸ ࢕ ࣥ ࢢ ࡜ ㉮ ⾜ ᅗ
94
ᅗ 4-2
ヨ ⾜ ᮲ ௳ 㸦 a㸧 ࢫ ࢸ ࢕ ࢵ ࢡ ಖ ᣢ ࡞ ࡋ 㸦NH㸧 㸪 㸦 b㸧 ࢫ ࢸ ࢕ ࢵ ࢡ ࢆ ୧ ᡭ ࡛
ྑ ᡭ ഃ ࡟ ಖ ᣢ 㸦 RH㸧 㸪 㸦 c㸧 ࢫ ࢸ ࢕ ࢵ ࢡ ࢆ ୧ ᡭ ࡛ ᕥ ᡭ ഃ ࡟ ಖ ᣢ 㸦 LH㸧
3. ືసィ ືసࡢィ ࡣ 㸪 ◊ ✲ 3[బ㔝ᮧࡽ, 2012-3]ྠᵝ ࡟ 8 ྎࡢ㉥እ ⥺࣓࢝ࣛ 㸦 Motion
Analysis ♫〇㸧࡜ᗋ ཯ ຊィ㸦Kistler ♫〇㸧ࢆ౑⏝ࡋ ࡓ 㸬཯ᑕ ࣐࣮ ࣮࢝ࡣࢧࣥࣉ
ࣜࣥࢢ࿘Ἴ ᩘ 240Hz㸪 ᆅ㠃཯ຊࡣࢧ ࣥࣉࣜࣥ ࢢ࿘Ἴᩘ 2400Hz ࡛ࡑ ࢀࡒࢀィ ࡋࡓ㸬ᑐ㇟⪅ ࡬ࡢ࣐࣮ ࣮࢝㈞௜ࡶ◊ ✲ 3 [బ㔝ᮧࡽ, 2012-3] ྠᵝ࡛㸪ྑୗ⫥ཬ
ࡧ㦵┙ࡢ⓶⭵ ୖ 㸪ࡑࡢ ௚ࢩ࣮ࣗࢬ࡟ ィ 36 Ⅼ ㈞௜ࡋࡓ㸬
4. ࢹ࣮ࢱゎᯒ
ࢹ࣮ࢱゎᯒ ࠾ࡼࡧ⟬ ฟ᪉ἲ ࡶ◊ ✲ 3 [బ㔝ᮧࡽ, 2012-3] ྠᵝ࡛࠶ࡿ㸬ゎᯒ⠊
ᅖࡣ㊊㒊ࡢ୍ 㒊ࡀᗋ࡟ ᥋ᆅࡋࡓ᫬Ⅼ 㸦 initial contact㸪௨ୗ IC㸧࠿ ࡽࡘࡲඛࡀᗋ
࠿ࡽ㞳ࢀࡓ᫬ Ⅼ㸦 toe off㸪௨ୗ TO㸧ࡲ࡛ࢆ Landing phase ࡜ࡋ࡚㸪IC ᫬ ࠿ࡽ Landing
phase ࡢ 30㸣᫬Ⅼࡲ࡛ ࡢࢹ࣮ࢱࢆ⟬ ฟࡋࡓ 㸬ࣃ࣓࣮ࣛࢱࡣ㸪IC ᫬ ࡢ⭸㛵⠇ᒅ᭤
ゅᗘ㸪⭸㛵⠇ እ㌿ゅᗘ 㸪⫤㛵⠇ᒅ᭤ ゅᗘ㸪⫤ 㛵⠇ෆ㌿ゅᗘ 㸪 IC ᫬ ࠿ࡽ Landing
phase ࡢ 30㸣᫬Ⅼࡲ࡛ ࡟ࡳࡽࢀࡓ᭱ ኱⭸ 㛵⠇ ᒅ᭤ゅᗘ㸪᭱ ኱⭸ 㛵⠇ እ㌿ゅᗘ㸪
᭱኱⭸㛵⠇ෆ ᪕ゅᗘ㸪 ᭱኱⫤㛵⠇ᒅ ᭤ゅᗘ㸪 ᭱኱⫤㛵⠇ෆ ㌿ゅᗘ㸪 ᭱኱⫤㛵⠇
ෆ᪕ゅᗘ㸪᭱ ኱⭸㛵⠇ እ㌿࣮࣓ࣔࣥ ࢺ㸪᭱኱ ⭸ 㛵⠇ෆ᪕ࣔ ࣮࣓ࣥࢺ 㸪᭱኱⫤㛵
⠇ෆ㌿࣮࣓ࣔ ࣥࢺ㸪᭱ ኱⫤㛵⠇ෆ᪕ ࣮࣓ࣔࣥ ࢺ࡜ࡋࡓ 㸬IC ᫬࠿ ࡽ Landing phase
ࡢ 30㸣᫬Ⅼࡲ࡛࡟ ࡳ ࡽࢀࡓ ྛ㡯ࡢ ᭱኱್ࢆ ࣃ࣓࣮ࣛࢱ࡜ ࡋࡓ⌮⏤ ࡣ㸪◊✲ 4 ྠ
ᵝ࡟㖄┤᪉ྥ ࡬ࡢ᭱኱ ᗋ཯ຊࡢࣆ࣮ ࢡࡀ IC ᫬ᚋ㸪Landing phase ࡢ 30㸣᫬Ⅼࡲ
95
࡛࡟ࡳࡽࢀࡓ ࡇ࡜㸪ࡲ ࡓ㸪ᐇ㝿ࡢ ACL യᐖࡀ IC ᫬ᚋ࡟ ࡳࡽࢀࡿ ᭱኱ᗋ཯ຊࡢ
ࣆ ࣮ ࢡ ௜ ㏆ ࡛ Ⓨ ⏕ ࡋ ࡚ ࠸ ࡿ ࡇ ࡜ ࡀ ከ ᩘ ሗ ࿌ ࡉ ࢀ ࡚ ࠸ ࡿ Ⅽ ࡛ ࠶ ࡿ [Koga et al.,
2010;㸪Krosshaug et al., 2007]㸬⤫ィᏛⓗゎᯒ ࡣ 㸪ྛヨ⾜᮲ ௳㛫 ࡟࠾ ࠸୍࡚ඖ㓄
⨨ศᩓ ศᯒ ࢆ⏝࠸ 㸪 ᭷ ពᕪࡢ ᚓࡽ ࢀࡓ 㡯 ┠࡟ ᑐࡋ㸪 Bonferroni ἲࢆ ⏝࠸࡚ ከ㔜
ẚ㍑᳨ᐃࢆ⾜ ࡗࡓ㸬 ඲ ࡚ࡢࣃ࣓࣮ࣛ ࢱࡢẚ㍑ ࡟࠾࠸࡚㸪᭷ ពỈ‽ ࢆ 5㸣ᮍ‶࡜
ࡋࡓ㸬
4-4-3. ⤖ᯝ
NH㸪RH㸪LH ࡢྛヨ ⾜᮲௳࡛ࡢ IC ᫬ ࡢ⭸ 㛵⠇ᒅ᭤ゅᗘ 㸪⭸㛵⠇ እ㌿ゅᗘ㸪
⫤㛵⠇ᒅ᭤ゅ ᗘ㸪⫤㛵 ⠇ෆ㌿ゅᗘ㸪 IC ᫬ ࠿ ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟
ࡳࡽࢀࡓ᭱኱ ⭸ 㛵⠇ᒅ ᭤ゅᗘ㸪᭱኱ ⭸ 㛵⠇እ ㌿ゅᗘ㸪᭱኱ ⭸ 㛵⠇ෆ ᪕ゅᗘ㸪᭱
኱⫤㛵⠇ᒅ᭤ ゅᗘ㸪᭱ ኱⫤㛵⠇ෆ㌿ ゅᗘ㸪᭱ ኱⫤㛵⠇ෆ᪕ ゅᗘ㸪᭱ ኱⭸ 㛵⠇እ
㌿࣮࣓ࣔࣥࢺ 㸪᭱኱⭸ 㛵⠇ෆ᪕࣮ࣔ ࣓ࣥࢺ㸪 ᭱኱⫤㛵⠇ෆ ㌿࣮࣓ࣔ ࣥࢺ㸪᭱኱
⫤㛵⠇ෆ᪕ࣔ ࣮࣓ࣥࢺ ࡢ⤖ᯝࢆ⾲ 4-1 ࡟♧ࡍ 㸬IC ᫬ࡢ ⫤㛵⠇ෆ ㌿ ゅ ᗘ࡟࠾࠸࡚ 㸪
LH ࡣ NH ࡟ẚ ࡭࡚᭷ ព࡟኱ࡁࡃ㸦LH vs. NH: 4.2s8.8rvs. -0.2s7.8r, p = 0.031㸧
㸦ᅗ 4-3㸧㸪IC ᫬࠿ࡽ Landing phase ࡢ 30%᫬Ⅼࡲ࡛࡟ࡳ ࡽࢀࡓ ᭱ ኱⫤㛵⠇ᒅ᭤
ゅᗘ࡟࠾࠸࡚ 㸪RH ࡣ NH ࡟ẚ࡭࡚ ᭷ព࡟኱ ࡁࡃ㸦RH vs. NH: 48.6s6.4rvs. 45.4
s6.7r, p = 0.036㸧㸦 ᅗ 4-4㸧㸪᭱኱ ⫤㛵⠇ ෆ㌿ゅᗘ࡟ ࡘ ࠸࡚ࡣ 㸪RH ࠾ࡼࡧ LH
ࡣ NH ࡟ẚ࡭࡚᭷ព ࡟ ኱ࡁ࠿ࡗࡓ 㸦RH vs. NH: 5.4s5.9rvs. 1.1s7.7r, p =
0.007; LH vs. NH: 5.4s8.1rvs. 1.1s7.7r, p = 0.015㸧㸦ᅗ 4-5㸧㸬ࡑ ࡢ௚ࡢヨ⾜
᮲௳㛫࡟࠾ࡅ ࡿྛࣃࣛ ࣓࣮ࢱࡢẚ㍑ ࡟࠾࠸࡚ ᭷ពᕪࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓ㸬
96
97
4-4-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪ዪ Ꮚࣛࢡࣟ ࢫ 㑅ᡭࢆᑐ㇟ ࡜ࡋ࡚㸪 ࣛࢡࣟࢫࡢ➇ ᢏ≉Ṧᛶ ࡢ 1 ࡘ࡛
࠶ࡿࢫࢸ࢕ࢵ ࢡ ࢆಖᣢ ࡉࡏࡓ ᮲௳ୗ ࡛࢝ࢵࢸ ࢕ࣥࢢືసࢆ ⾜ࢃࡏࡓ ࡜ࡁࡢ ୗ⫥
࢟ࢿ࣐ࢸ࢕ࢡ ࢫ࣭࢟ࢿ ࢸ࢕ࢡࢫ ࡢኚ ໬࡟ࡘ࠸ ࡚ẚ㍑᳨ウࡍ ࡿࡇ࡜ࢆ ┠ⓗ࡜ࡋ࡚
⾜ࡗࡓ㸬⤖ᯝ ࡣ IC ᫬ ࡢ⫤㛵⠇ෆ㌿ ゅᗘ࡟࠾ ࠸࡚ LH ࡣ NH ࡟ẚ࡭ ࡚኱ࡁࡃ㸪IC
98
᫬࠿ࡽ Landing phase ࡢ 30%᫬Ⅼࡲ࡛࡟ ࠾ ࠸࡚㸪 ᭱኱⫤ 㛵⠇ᒅ᭤ ゅᗘࡀ RH ࡣ
NH ࡟ẚ࡭࡚ ኱ࡁࡃ㸪᭱኱⫤㛵⠇ෆ ㌿ゅᗘ ࡀ RH ࠾ࡼ ࡧ LH ࡣ NH ࡟ẚ࡭࡚ ᭷ព
࡟኱ࡁ࠿ࡗࡓ 㸬ࡇࢀࡽ ࡢ⤖ᯝ࠿ࡽ㸪 ⫤㛵⠇ෆ ㌿ゅᗘ࡟ ╔┠ ࡍࡿ࡜㸪 ࢫࢸ࢕ࢵࢡ
ࢆಖᣢࡋࡓ≧ ែ࡛ࡢ࢝ ࢵࢸ࢕ࣥࢢື సࡣ㸪 ࢫ ࢸ࢕ࢵࢡࢆಖ ᣢࡋ࡞࠸ ᫬࡜ẚ࡭࡚
⫤㛵⠇ෆ㌿ື సࢆࡼࡾ ቑຍࡉࡏࡿ࡜ ࠸࠺ࡶࡢ ࡛࠶ࡗࡓ㸬ࡇ ࢀࡣ㸪ࢫ ࢸ࢕ࢵࢡࢆ
ಖᣢࡋࡓ≧ែ ࡛ࡢ࢝ࢵ ࢸ࢕ࣥࢢືస ࡣ㸪ࢫࢸ ࢕ࢵࢡࢆಖᣢ ࡋ࡞࠸᫬ ࡜ẚ࡭㸪᪉
ྥ㌿᥮᫬࡟๓ ᪉࡟ே㸦 ᩛ ࢳ࣮࣒ࡢ㑅 ᡭ㸧ࡀ࠸ ࡿࡇ࡜ࢆ ᝿ീ ࡉࡏࡓ ࢝ ࢵࢸ࢕ࣥࢢ
ືస࡟ࡼࡾ㸪 ╔ᆅࡋࡓ ⬮ഃ 㸦඲౛㸪 ྑ⬮ഃ㸧 ࡟㸪ࢫࢸ࢕ࢵ ࢡ᧯స࡜ ྠ᫬࡟ యᖿ
ࢆྑ⬮ഃ࡟ഴ ᩳࡉࡏ ࡓ ࣇ࢙࢖ࢡືస 㸦ࣇ࢙࢖ ࣥࢺືస㸧 ࢆ ࡜ࡿ࡜ྠ ᫬࡟㸪యᖿ
ࡢࣂࣛࣥࢫಖ ᣢࡢⅭ࡟ ╔ᆅࡋࡓ⬮࡜ ཯ᑐഃࡢ 㦵┙ࢆୗࡆࡿ ࡇ࡜࡛㸪 ጼໃಖᣢ࡟
ᐤ୚ࡉࡏࡓ࡜ ⪃࠼㸪 ࡑ ࡢ௦ൾస⏝ࡢ ⤖ᯝ㸪╔ ᆅ⬮ഃࡢ⫤㛵 ⠇ෆ㌿ゅ ᗘࡀ኱ࡁࡃ
࡞ࡗࡓࡢ࡛ࡣ ࡞࠸࠿࡜ ᥎ ࡋࡓ㸬ࡍ ࡞ࢃࡕ㸪 ࢫࢸ࢕ࢵࢡ࡜ ྠ᫬࡟య ᖿࡀྑ⬮ഃ
࡬ഴᩳࡍࡿࡇ ࡜࡛㔜ᚰ ࡀྑഃ࡬⛣ື ࡍࡿ㸬ࡑ ࡢࣂࣛࣥࢫಖ ᣢࡢⅭ࡟ ཯ᑐഃࡢ㦵
┙ࢆୗࡆ࡚㐺 ᛂࡉࡏࡓ ࡜⪃࠼ࡓ㸬 ࡲ ࡓ㸪᪉ྥ ㌿᥮ືస࡟ 㸪 ╔ᆅ ⬮ഃ ࡜཯ᑐࡢ㦵
┙ࢆୗࡆࡿࡇ ࡜࡛㸪 ษ ࡾ㏉ࡋືసࢆ ࡼࡾ⾜࠸ ࡸࡍࡃࡉࡏ ࡓ ࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃࠼
ࡓ㸬୧ᡭࢆ⮬ ⏤࡟౑⏝ ࡉࡏࡓ࢝ࢵࢸ ࢕ࣥࢢື సࡣ㸪㌟యࡢ ࣂࣛࣥࢫ ಖᣢࡢࡓࡵ
࡟㸪୧ᡭࢆ᧯ సࡋ࡚㌟ యࡢࣂࣛࣥࢫ ಖᣢ࡟ᐤ ୚ࡉࡏࡿࡇ ࡜ ࡀฟ᮶ࡿ ࡀ㸪୧ᡭ࡛
ࢫࢸ࢕ࢵࢡࢆ ಖᣢࡋࡓ ≧ែࡢ࢝ࢵࢸ ࢕ࣥࢢື సࡣ㸪୧ᡭ ࡢ ౑⏝ࡀไ 㝈ࡉࢀࡿ ࡓ
ࡵ࡟㸪యᖿࢆ ᧯సࡋࡓ 㸦 ഃ᪉ഴᩳࡉ ࡏࡓ㸧ࣇ ࢙࢖ࢡືస㸦 ࣇ࢙࢖ࣥ ࢺືస㸧 ࡀ
ồࡵࡽࢀ㸪ࡑ ࡋ࡚ ࡲࡓ 㸪ࡑࡢᚋࡍࡄ ࡟᪉ྥ㌿ ᥮ືసࡶồࡵ ࡽࢀࡿ㸬 ࡇࢀࡽࡢື
సࡀ▐᫬࡟⾜ ࢃࢀࡿ 㐣 ⛬࡟࠾࠸࡚㸪 యᖿ ഃ᪉ ഴᩳ࡟ࡼࡿᑐ ᛂ㸪ࡲࡓ 㸪⣲᪩࠸ษ
ࡾ㏉ࡋືసࡢ ᑐᛂࡢⅭ ࡟㸪཯ᑐഃࡢ 㦵┙ࢆୗ ࡆࡿ࡜࠸ࡗࡓ 㦵┙᧯స ࡀ⾜ࢃࢀ ࡓ
ࡇ࡜࡛㸪⫤㛵 ⠇ෆ㌿ゅ ᗘ ࡀቑຍࡋࡓ ࡢ࡛ࡣ࡞ ࠸࠿࡜᥎ ࡋ ࡓ㸬 ࡑࡋ ࡚ࡑࡢືస
ࡢ‽ഛࡀ╔ᆅ ๓࠿ࡽ⾜ ࢃࢀ࡚࠾ࡾ㸪IC ᫬ࡢ⫤ 㛵⠇ෆ㌿ゅᗘ ࢆࡶቑຍ ࡉࡏࡓࡢ࡛
ࡣ࡞࠸࠿࡜⪃ ࠼ࡓ㸬
ඛ⾜ㄽᩥ࡟࠾ ࠸࡚ [Chaudhari et al., 2005]㸪࢝ ࢵࢸ࢕ࣥࢢື సࢆ୧ᡭ ࢆ⮬⏤࡟
౑⏝ࡉࡏࡓ᫬ ࡜࣮࣎ࣝ ࡸࣛࢡࣟࢫࢫ ࢸ࢕ࢵࢡ ࢆಖᣢࡉࡏ࡚ ⾜ࢃࡏ ࡓ ᫬ࡢ⭸㛵⠇
እ཯࣮࣓ࣔࣥ ࢺ࡟ཬࡰ ࡍᙳ㡪࡟ࡘ࠸ ࡚ ◊✲ࡉ ࢀࡓ ሗ࿌࡛ࡣ 㸪ࣛࢡࣟ ࢫࢫࢸ࢕ࢵ
ࢡࢆಖᣢࡉࡏ ࡚⾜ࢃࡏ ࡓ ᫬ࡣ㸪୧ᡭ ࢆ⮬⏤࡟ ౑⏝ࡉࡏࡓ ᫬ ࡜ẚ࡭㸪 ᭷ព࡟⭸㛵
99
⠇እ཯࣮࣓ࣔ ࣥࢺࢆቑ ຍࡉࡏࡓ㸬 ࡇ ࡢ⤖ᯝࢆ ᳨ドࡍࡿ࡟࠶ ࡓࡾ 㸪⭸ 㛵⠇እ཯ࣔ
࣮࣓ࣥࢺࡢቑ ຍ㔞࡜㸪 ࢝ࢵࢸ࢕ࣥࢢ ືస᫬ࡢ ྑᡭഃࡢᡭ㸦 ᪉ྥ㌿᥮ ࡍࡿ᪉ྥ࡜
཯ᑐഃࡢᡭ㸧 ࡢ఩⨨㛵 ಀ ࡟ࡘ࠸᳨࡚ ウࡉࢀࡓ 㸬ࡇࢀࡣ㸪᪉ ྥ㌿᥮᫬ ࡟ 㸪᪉ྥ㌿
᥮ࡍࡿ᪉ྥ࡜ ࡣ཯ᑐഃ ࡢᡭ 㸦ྑᡭ㸧 ࡀ㸪ࢫࢸ ࢕ࢵࢡࢆಖᣢ ࡉࡏࡓ ᫬ ࡣ㌟యࡢ୰
ᚰഃ࡟఩⨨ࡋ 㸪୧ᡭࢆ ⮬⏤࡟౑⏝ࡉ ࡏ ࡓ࡜ࡁ ࡣ㌟యࡢ୰ᚰ ࠿ࡽࡼࡾ ഃ᪉࡬㞳ࢀ
ࡓሙᡤ࡟఩⨨ ࡋ ࡚࠸ࡿ ࡇ࡜ࡀ☜ㄆࡉ ࢀ 㸪㌟య ࡢ୰ᚰ࠿ࡽྑ ᡭࡲ࡛ࡢ ㊥㞳࡜ ⭸㛵
⠇እ཯࣮࣓ࣔ ࣥࢺ ࡢ㛵 㐃ᛶࢆ᳨ドࡋ ࡓ࡜ࡇࢁ 㸪㌟యࡢ୰ᚰ ࠿ࡽྑᡭ ࡲ࡛ࡢ㊥㞳
ࡀ▷࠸࡯࡝⭸ 㛵⠇እ཯ ࣮࣓ࣔࣥࢺࡀ ኱ࡁ ࡃ࡞ ࡿഴྥࡀ♧ࡉ ࢀࡓ㸬ࡇ ࡢせᅉࡣ㸪
࢝ࢵࢸ࢕ࣥࢢ ᫬ࡢయᖿ ࡢᏳᐃ໬ࢆಖ ᣢࡉࡏࡿ ࡓࡵ࡟㸪୧ᡭࡀ⮬ ⏤࡟ ౑࠼ࡿ᫬ࡣ 㸪
≉࡟ྑᡭࢆఙ ࡤࡋࡓ≧ ែ㸦⫝㛵⠇ࢆ ఙᒎࡉࡏ ࡓ≧ែ㸧ࢆస ࡿࡇ࡜࡛ యᖿࡢᏳᐃ
໬࡟ᐤ୚ࡉࡏ ࡚࠸ࡿ࡜ ㏙࡭㸪୧ᡭ㸦 ྑᡭ㸧ࡀ ఙࡤࡏ࡞࠸≧ ែ㸦ࢫࢸ ࢕ࢵࢡࡸ࣎
࣮ࣝࢆಖᣢࡋ ࡓ≧ែ㸧 ࡢ᫬ࡣయᖿ㸦 ➽⩌㸧ࢆ ฼⏝ࡋ࡚ࡑࡢ ືసࢆ௦ ൾࡉࡏ ࡚࠸
ࡿ࡜㏙࡭࡚࠸ ࡿ㸬 ࡑࡋ ࡚ࡑࡢ௦ൾస ⏝ࡀ⭸㛵 ⠇ እ཯࣮࣓ࣔ ࣥࢺ ࡢቑ ຍ࡟ᙳ㡪ࢆ
ཬࡰࡋࡓ࡜㏙ ࡭࡚࠸ࡿ 㸬
ࡇࢀࡽࡢሗ࿌ ࡣ㸪࢝ࢵ ࢸ࢕ࣥࢢືస ᫬ࡢ୧ᡭ ࡢไ㝈ࡀ⭸㛵 ⠇እ཯ࣔ ࣮࣓ࣥࢺ
࡟ཬࡰࡍᙳ㡪 ࡟㛵ࡍࡿ ࡶࡢ࡛࠶ࡿࡀ 㸪୧ᡭࡢ ไ㝈ࡀ 㸪⭸ࡸ ⫤㛵⠇ࡢ ࢟ࢿ࣐ࢸ࢕
ࢡࢫࡸ࢟ࢿࢸ ࢕ࢡࢫ࡬ ࡢᙳ㡪ࢆཬࡰ ࡍྍ⬟ᛶ ࡶ♧၀ࡉࢀ࡚ ࠸ࡿ㸬 ࡑ ࡢ࡯࠿యᖿ
ഃ᪉ഴᩳ࡜ ACL യᐖ ࣓࢝ࢽࢬ࣒࡟ 㛵ࡍࡿሗ ࿌࡟ࡼࡿ࡜ [Hewett and Myer, 2011]㸪
ഃ᪉࡬ࡢయᖿ ഴᩳࡣ⭸ 㛵⠇እ㌿㈇Ⲵ ࢆቑຍࡉ ࡏࡿせᅉ ࡜࡞ ࡿࡇ࡜ࢆ ㏙࡭࡚࠸ࡿ 㸬
ࡇࢀࡣ㸪࢝ࢵ ࢸ࢕ࣥࢢ ࡸࢪࣕࣥࣉ࠿ ࡽࡢ∦⬮ ╔ᆅ᫬࡟㸪 య ᖿࡀ╔ᆅ ⬮ഃ࡬ഴᩳ
ࡋࡓ᫬࡟㸪㔜 ᚰࡀྠഃ ᪉ྥ࡬⛣ືࡍ ࡿࡇ࡜࡛ 㸪⭸㛵⠇ࢆ୰ ᚰ࡜ࡋ ࡚ యᖿ࠾ࡼࡧ
኱⭣ࡢయ⠇ࡀ ࡼࡾ኱ࡁ ࡞ ࣞࣂ࣮࢔࣮ ࣒࡜ࡋ࡚ స⏝ࡋ㸪 ⭸㛵 ⠇እ㌿㈇ Ⲵࢆቑ኱ࡉ
ࡏࡿ࡜㏙࡭࡚ ࠸ࡿ㸬 ࡲ ࡓ㸪యᖿഃ᪉ ഴᩳ࡜⭸ 㛵⠇እ㌿㈇Ⲵ ࡢቑຍ࡟ క࠸ጼໃಖ
ᣢࡢⅭ࡟⫤㛵 ⠇ෆ㌿ࢺ ࣝࢡ ࡀቑຍࡋ 㸪ࡑࢀࡽ ࡶࡲࡓ⭸ 㛵⠇ እ㌿࣮ࣔ ࣓ࣥࢺࢆቑ
ຍࡉࡏࡿせᅉ ࡛࠶ࡿ࡜ ㏙࡭࡚࠸ࡿ 㸬ࡇ ࢀࡽࡢ ሗ࿌࠿ࡽࡶ㸪య ᖿഃ᪉ ഴᩳࡀ ACL
യᐖ࣓࢝ࢽࢬ ࣒ࡢ୍ࡘ ࡟ ⫤㛵⠇ෆ㌿ ᪉ྥ࡬ࡢ ືࡁ ࡀ㛵୚ࡋ ࡚࠸ࡿࡇ ࡜ࡀ♧ࡉࢀ
࡚࠸ࡿ㸬
ᮏ◊✲⤖ᯝ࠿ ࡽ㸪 ࢫࢸ ࢕ࢵࢡࢆಖᣢ ࡉࡏࡓ≧ ែ㸪ࡍ࡞ࢃࡕ ୧ᡭࡢไ 㝈ࢆຍ࠼
ࡓ᫬ࡢ࢝ࢵࢸ ࢕ࣥࢢື సࡀ㸪 ⫤㛵⠇ ෆ㌿ゅᗘ ࡟ᙳ㡪ࢆཬࡰ ࡍ࡜࠸࠺ ᪂ࡓ࡞▱ぢ
100
ࢆᚓࡿࡇ࡜ࡀ ฟ᮶ࡓ 㸬 ඛ⾜ㄽᩥ࠿ࡽ 㸪 ᐇ㦂ᐊ ࡛ࣞ࣋ࣝࡢ ྛ ✀ㄢ㢟ື సࢆ⾜ࢃࡏ
ࡓ࡜ࡁࡢୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺࡢ≉ᚩ࡜ ࡋ࡚㸪 ࣛ ࣥࢽࣥࢢືస ࡟࠾࠸࡚ ࡣ㸪ዪᛶࡣ
⏨ᛶ࡟ẚ࡭ ࡚ Landing phase ࡢ 60㸣ࡲ࡛ࡢᮇ 㛫࡟࠾࠸࡚㸪 ⫤㛵⠇ෆ ㌿ ゅᗘࡀ᭷
ព࡟኱ࡁ࠿ࡗ ࡓࡇ࡜ࡀ ሗ࿌ࡉࢀ㸦Ferber, 2004㸧㸪⫤㛵⠇ ෆ㌿ゅᗘ ࡢቑຍࡀ⭸㛵
⠇እ㌿ືసࡢ ቑຍ࡟ᐤ ୚ࡉࡏࡿ ࡜㏙ ࡭࡚࠸ࡿ 㸬ࡲࡓ 㸪⫤㛵 ⠇ෆ㌿ゅᗘ ࡢቑຍࡣ㸪
⫤㛵⠇࿘ᅖ➽ ࡢᙅࡉ࡜ 㛵㐃 ࡀ࠶ࡿ࡜ ㏙࡭࡚࠸ ࡿ㸬࢝ࢵ ࢸ࢕ࣥࢢ ືస ࡟࠾࠸࡚ࡣ 㸪
Pollard ࡽ㸦2004㸧ࡣ㸪ዪᛶࡣ⏨ᛶ࡟ ẚ࡭࡚⫤ 㛵⠇እ㌿ゅᗘ ࡀᑠ࡛࠶ ࡾ㸪ࡼࡾෆ
㌿᪉ྥ࡬ࡢື ࡁࢆ♧ࡋ ࡚࠸ࡓࡇ࡜ࢆ ሗ࿌ࡋ㸪Mclean ࡽ㸦2004㸧ࡣ㸪ዪᛶࡣ⏨ᛶ
࡟ẚ࡭࡚⫤㛵 ⠇እ㌿ゅ ᗘࡀᑠࡉ࠿ࡗ ࡓࡇ࡜ࢆ ሗ࿌ࡋ࡚࠸ࡿ 㸬 ᮏ ◊✲ ⤖ᯝ࡟࠾࠸
࡚᭷ពᕪࡣᚓ ࡽࢀ࡞࠿ ࡗࡓ ࡀ㸪᭱ ኱⫤㛵⠇ ෆ ᪕࣮࣓ࣔࣥࢺ ࡟ࡘ࠸࡚ 㸪RH ࡣ NH
࡟ẚ࡭࡚኱ࡁ ࠸ഴྥࢆ ♧ࡋ࡚࠸ࡓ㸦 RH vs. NH: 0.41s0.86Nm/(㌟㛗 *య㔜) vs.
0.37s0.06Nm/(㌟㛗 *య 㔜), p = 0.070㸧㸬ACL യᐖ᫬ࡢ⭸㛵 ⠇ࡸ ⫤㛵 ⠇ࡢືస≉
ᚩࢆ♧ࡋ ࡓ Hewett ࡽ㸦2005㸧ࡢሗ࿌࡟ࡼ ࡿ ࡜ 㸪╔ᆅືస᫬ ࡟ࡳࡽ ࢀࡿ ≉ᚩⓗ࡞
⭸㛵⠇እ㌿ື సࡸ⫤㛵 ⠇ෆ㌿ືసࢆ ͆Dynamic valgus͇࡜⛠ࡋ 㸪 ACL യᐖせᅉ
࡜࡞ࡿືస⫥ ఩࡛࠶ࡿ ࡜㏙࡭࡚࠸ࡿ㸦 ᅗ 4-3㸧㸬ࡲࡓ㸪Quatman ࡜ Hewett㸦 2009㸧
ࡣ㸪╔ᆅືస ᫬࡟ዪᛶ ࡀ♧ࡍୗ⫥ ࢔ ࣛ࢖࣓ࣥ ࢺ ࡢ≉ᚩ࡜ࡋ ࡚㸪 ⭸㛵 ⠇እ㌿ࡸ⫤
㛵⠇ෆ㌿࣭ෆ ᪕ືసࢆ ᣲࡆ㸪ࡑࢀࡽ ࡢ」ྜⓗ ࡞ 㛵⠇ືస࡟ ࡼࡾ㸪⭸ 㛵⠇࠾ࡼࡧ
⭸㛵⠇㠌ᖏ࡬ ࡢ㈇Ⲵࢆ ቑ኱ࡉࡏࡿ࡜ ㏙࡭࡚࠸ ࡿ 㸦ᅗ 4-4㸧㸬
ᅗ 4-3 Dynamic valgus [Hewett, 2005]
ᅗ 4-4 Multiplanar loading mechanism in
women [Quatman and Hewett, 2005]
101
ᮏ◊✲⤖ᯝ࡟ ࠾࠸࡚ 㸪୺࡞ ACL യᐖ ࣓࢝ࢽ ࢬ࣒࡛࠶ࡿ ⭸ 㛵⠇እ㌿ ゅᗘࡸ⭸㛵
⠇እ㌿࣮࣓ࣔ ࣥࢺ ࡢ᭷ ព࡞ቑຍࡣࡳ ࡽࢀ࡞࠿ ࡗࡓࡀ㸪⫤㛵 ⠇ෆ㌿ゅ ᗘࡢ ᭷ព࡞
ቑຍࡀࡳࡽࢀ ࡓ㸬ࡇ ࢀ ࡽࡢ⤖ᯝ࠿ࡽ 㸪ዪᏊ ࣛ ࢡࣟࢫࡢ ACL യᐖ࣓ ࢝ࢽࢬ࣒ࡢ୍
ࡘ࡜ࡋ࡚㸪ࣛ ࢡࣟࢫ ➇ ᢏ≉Ṧᛶ࡛࠶ ࡿ ࢫࢸ࢕ ࢵࢡࢆಖᣢࡋ ࡓ≧ែ࡛ ࡢ࢝ࢵࢸ࢕
ࣥࢢືసࡣ㸪 ⫤㛵⠇ෆ ㌿ືసࢆ ࡼࡾ ቑຍࡉࡏ ࡿ࡜࠸࠺⤖ᯝ ࠿ࡽ㸪ዪ Ꮚࣛࢡࣟࢫ
ࡢ ACL യᐖ࣓ ࢝ࢽࢬ ࣒ࡢ ୍ࡘࡢ▱ ぢ࡜࡞ࡿ ྍ⬟ᛶࡀ ♧၀ ࡉࢀࡓ㸬
ᮏ◊✲ࡢㄢ㢟 ືసࡣ 㸪 ࢫࢸ࢕ࢵࢡಖ ᣢ࠶ࡾ࣭ ࡞ࡋ ࡢ᮲௳ୗ ࡛ࡢ࢝ࢵ ࢸ࢕ࣥࢢ
ືస࡛࠶ࡗࡓ ࡀ㸪௒ᚋ 㸪┠ᶆ≀ࢆタ ᐃࡋࡓ≧ ἣୗ࡛ࡢ࢝ࢵ ࢸ࢕ࣥࢢ ືసࢆ⾜ࢃ
ࡏࡓ࡜ࡁࡢẚ ㍑࡟ࡼࡾ 㸪ࡼࡾ≉ᚩⓗ ࡞ ୗ⫥࢔ ࣛ࢖࣓ࣥࢺࡢ ኚ໬ࢆ ࡳ ࡿࡇ࡜ࡀ࡛
ࡁࡿࡢ࡛ࡣ࡞ ࠸࠿࡜⪃ ࠼ࡓ㸬ࡲࡓ㸪 ࢜ࣇ࢙ࣥ ࢩࣈ࡞ືసࡢ ẚ㍑࡜࠸ ࠺Ⅼ࡛ࡣ㸪
࣮࣎ࣝࢆಖᣢ ࡉࡏࡓ≧ ែ࡛ 㸪ࢫࢸ࢕ ࢵࢡࢆ᧯ సࡉࡏ࡞ࡀࡽ ࢝ࢵࢸ࢕ ࣥࢢࢆ⾜ࢃ
ࡏࡓ᫬ࡢ᳨ウ ࡶᚲせ࡛ ࠶ࡿ࡜⪃࠼ࡓ 㸬
4-4-5. ⤖ㄒ
ዪᏊࣛࢡࣟࢫ 㑅ᡭࢆᑐ ㇟࡜ࡋ࡚㸪ࣛ ࢡࣟࢫࢫ ࢸ࢕ࢡࢆಖᣢ ࡉࡏ ࡚࢝ ࢵࢸ࢕ࣥ
ࢢືసࢆ⾜ࢃ ࡏࡓ࡜ࡁ ࡢ ୗ⫥࢟ࢿ࣐ ࢸ࢕ࢡࢫ ࣭࢟ࢿࢸ࢕ࢡ ࢫ ࡢኚ໬ ࡟ࡘ࠸࡚ẚ
㍑᳨ウࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ࡚⾜࠸㸪 ࢫࢸ࢕ࢵ ࢡಖᣢ࠶ࡾࡣ ಖᣢ࡞ࡋ ࡟ẚ࡭࡚ 㸪
Initial contact ᫬ ࡢ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ᗘ ࢆ ᭷ ព ࡟ ቑ ຍ ࡉ ࡏ 㸪 Initial contact ᫬ ࠿ ࡽ
Landing phase ࡢ 30%᫬Ⅼࡲ࡛ࡢ᭱ ኱⫤㛵⠇ ෆ㌿ゅᗘࢆ᭷ ព࡟ቑຍ ࡉࡏࡓ㸬ዪᏊ
ࣛࢡࣟࢫࡢ➇ ᢏ≉Ṧᛶ ࡢ୍ࡘ࡛࠶ࡿ ࢫࢸ࢕ࢵ ࢡࢆಖᣢࡋࡓ ≧ែ࡛ࡢ ࢝ࢵࢸ࢕ࣥ
ࢢືసࡣ㸪ಖ ᣢ࡞ࡋ࡟ ẚ࡭ ࡚⫤㛵⠇ ෆ㌿ ゅᗘ ࢆቑຍࡉࡏࡿ ࡜࠸࠺⤖ ᯝ࠿ࡽ㸪 ዪ
Ꮚࣛࢡ ࣟࢫࡢ ACL യ ᐖ࣓࢝ ࢽࢬ࣒ ࡢ୍ ࡘ࡜ ࡋ࡚᪂ ࡓ࡞▱ ぢ࡜ ࡞ࡿ ྍ⬟ᛶ ࡀ♧
၀ࡉࢀࡓ㸬
102
➨5❶
ୗ⫥ᙧែ࠾ࡼࡧୗ⫥➽ຊ࡜㟼ⓗ࣭ືⓗࣂࣛࣥࢫ
⬟ຊ࠾ࡼࡧୗ⫥࢔ࣛ࢖࣓ࣥࢺ࡜ࡢ㛵㐃ᛶ 103
◊ ✲ 5. ㊊ ㊑ᢕ ᥱ ຊ ࡜ 㟼ⓗ ࠾ࡼ ࡧ ືⓗ ࣂࣛ ࣥ ࢫ⬟ ຊ ࡜ ࡢ 㛵㐃 ᛶ
5-5-1. ⥴ゝ
࢔ࢫ࣮ࣜࢺࡢ ୗ⫥യᐖ せᅉࡢ୍ࡘ࡟ ୗ⫥ࡢ⚄ ⤒࣭➽ᶵ⬟ࡸ ጼໃไᚚ ⬟ ຊࡢప
ୗࡀ࠶ࡿ㸬ࡲ ࡓ㸪ጼໃ ไᚚ⬟ຊࡢホ ౯᪉ἲ࡜ ࡋ࡚㸪❧఩ጼ ໃ࡛ࡢ㟼 ⓗࣂࣛࣥࢫ
ࡶࡋࡃࡣືⓗ ࣂࣛࣥࢫ ಖᣢ⬟ຊ ࢸࢫ ࢺࡀ⏝࠸ ࡽࢀ࡚࠸ࡿ 㸬 ጼໃไᚚ ⬟ຊ࡟ᐤ୚
ࡉࡏࡿᅉᏊࡢ ୍ࡘ࡟㊊ ㊑ᢕᥱຊࡀᣲ ࡆࡽࢀࡿ 㸬㊊㊑ᢕᥱຊ ࡣ㸪㊊㊑ ࡛ᆅ㠃ࢆ ᥗ
ࡴຊࡢࡇ࡜࡛ ࠶ࡾ㸪▷ ẕ㊑ᒅ➽㸪㛗 ẕ㊑ᒅ➽ 㸪⹸ᵝ➽㸪▷ ㊑ᒅ➽㸪 㛗㊑ᒅ➽࡞
࡝ࡢస⏝࡟ࡼ ࡾ㉳ࡇࡿ ከ㛵⠇㐠ື࡛ ࠶ࡿࡀ [Oatis, 2009]㸪㊊㊑ᢕᥱຊ ࡜ጼໃไᚚ
⬟ຊ࡜ࡢ㛵㐃 ᛶ࡟㛵ࡍ ࡿඛ⾜◊✲ ࡟ ࠾࠸࡚㸪 ࡑࢀࡽࡀ㧗㱋 ⪅ࡢ㌿ಽ 㜵Ṇ࡟ᐤ୚
ࡉࡏ࡚࠸ࡿࡇ ࡜ࡀከᩘ ሗ࿌ࡉࢀ࡚࠸ ࡿ㸬ᑠᯘ ࡽ㸦 1999㸧ࡣ㧗㱋⪅ࢆ ᑐ㇟࡟㊊㊑
ᢕᥱຊྥୖࢺ ࣮ࣞࢽࣥ ࢢࢆ⾜࠸㸪ࢺ ࣮ࣞࢽࣥ ࢢ⩌ࡣࢥࣥࢺ ࣮ࣟࣝ⩌ ࡜ẚ㍑ࡋ㸪
᭷ព࡟㔜ᚰື ᦂࡢῶᑡ ࡀㄆࡵࡽࢀ㸪 ㊊㊑ᢕᥱ ຊࢺ࣮ࣞࢽࣥ ࢢࡀ㌿ಽ ண㜵࡟ࡘ࡞
ࡀࡿࡇ࡜ࢆ♧ ၀ࡋ࡚࠸ ࡿ 㸬ᮌ⸨ࡽ㸦2000㸧ࡣ㸪ᑐ㇟⪅ࡢ㌿ ಽ᪤ Ṕ ࡢ᭷↓ࢆㄪ
ᰝࡋ㸪㌿ಽ⩌ ࠾ࡼࡧ㠀 ㌿ಽ⩌࡟ศࡅ ࡚㊊㊑ᢕ ᥱຊࢆẚ㍑ࡋ ࡓ࡜ࡇࢁ 㸪㌿ಽ⩌ ࡢ
㊊㊑ᢕᥱຊࡀ ᭷ព࡟ ᙅ ࠿ࡗࡓࡇ࡜ࢆ ሗ࿌ࡋ࡚ ࠸ࡿ㸬ࡇࢀࡽ ࡢሗ࿌࠿ ࡽ㸪㧗㱋⪅
ࡢ㌿ಽண㜵⟇ ࡢ୍ࡘ࡟ 㸪 ㊊㊑ᢕᥱຊ ࡢྥୖࡀ ᭷⏝࡛࠶ࡿࡇ ࡜ࡀ ࠺࠿ ࡀ࠼ࡿ㸬ࡲ
ࡓ㸪ⱝᖺ⪅ࢆ ᑐ㇟࡜ࡋ ࡓ㊊㊑ᢕᥱຊ ࡜ጼໃไ ᚚ⬟ຊ࡜ࡢ㛵 㐃ᛶ࡟ࡘ ࠸࡚ࡶ 㸪㊊
㊑ ᢕ ᥱ ຊ ࡀ 㧗 ࠸ ࡶ ࡢ ࡣ ጼ ໃ ไ ᚚ ⬟ ຊ ࡀ 㧗 ࠸ ࡜ ࠸ ࠺ ሗ ࿌ ࡶ 」 ᩘ ࡳ ࡽ ࢀ ࡚ ࠾ ࡾ [ຍ
㎶ࡽ, 2002; ᮧ⏣, 2004; ᮧ⏣ࡽ, 2002]㸪㧗 㱋⪅࠾ࡼࡧ ⱝ ᖺ⪅࡜ࡶ ࡟ ㊊㊑ᢕᥱຊ
ࡢྥୖࡀጼໃ ไᚚ⬟ຊ ࡟ ᐤ୚ࡉࡏ࡚ ࠸ࡿࡇ࡜ ࡀ ♧ࡉࢀ࡚࠸ ࡿ㸬
ືⓗࣂࣛࣥࢫ ಖᣢ⬟ຊ ࡣ㸪㐠ືࢫ࢟ ࣝ㸪ࣃࣇ ࢛࣮࣐ࣥࢫࡢ ᇶ♏࡜࡞ ࡾ㸪ືⓗ
ࣂࣛࣥࢫࡢḞ ዴࡣ㐠ື ࢫ࢟ࣝࡀప࠸ ࡇ࡜ࡀሗ ࿌ࡉࢀ࡚࠸ࡿ [Burton et al., 1998]㸬
ືⓗࣂࣛࣥࢫ ⬟ຊࡢホ ౯᪉ἲࡢ୍ࡘ ࡟ 㸪Time Up and Go Test㸪 Functional Reach
Test ࡞࡝ࡀ⏝࠸ࡽࢀ࡚ ࠸ࡿ ࡀ㸪㏆ᖺ 㸪࢔ࢫࣜ ࣮ࢺࢆᑐ㇟࡜ ࡋࡓືⓗ ࣂࣛࣥࢫ⬟
ຊࡢホ౯᪉ἲ ࡜ࡋ࡚㸪 Star Excursion Balance Test㸦௨ୗ㸪SEBT㸧࡟ࡼࡿሗ࿌ࡀ
ከᩘࡳࡽࢀ࡚ ࠸ࡿ [Plisky et al., 2006; Gray, 1995; Hertel et al., 2002; Kinzey et al.,
1998; Olmsted et al., 2002; బࠎᮌࡽ, 2009]㸬SEBT ࡣ∦⬮❧఩ጼໃ ࢆಖᣢࡉࡏ࡞
ࡀࡽ཯ᑐഃࡢ ⬮࡛ࡢ ࣜ ࣮ࢳ㛗ࢆホ౯ ࡍࡿࢸࢫ ࢺἲ࡛࠶ࡿࡀ 㸪࣮ࣜࢳ ᪉ྥࡣ㸪 ๓
104
ᚋ࠾ࡼࡧෆእ ᪉ྥ ࡜࠸ ࡗࡓᵝࠎ࡞᪉ ྥ࡬⾜࠺ ࡇ࡜࠿ࡽ㸪ື ⓗୗ⫥ࣂ ࣛࣥࢫ⬟ຊ
ࡢ ホ ౯ ἲ ࡜ ࡋ ࡚ ᥎ዡ ࡉ ࢀ ࡚ ࠸ ࡿ 㸦 బ ࠎ ᮌࡽ , 2009㸧 㸬 ࡲ ࡓ 㸪 ᐃ ᪉ ἲ ࡀ ⡆ ౽ ࡛
࠶ࡿࡇ࡜ࡶྵ ࡵ࡚ 㸪ࢫ ࣏࣮ࢶ⌧ሙ࡛ ࡢ฼⏝౯ ್ ࡀ㧗࠸ࡇ࡜ ࡶ」ᩘሗ ࿌ࡉࢀ࡚࠸
ࡿ[Plisky et al., 2006]㸬ࡑࡢ௚㸪ୗ ⫥യᐖࣜࢫ ࢡࡢண ࡜ࡋ ࡚ࡢ᭷⏝ ᛶ࡟ࡘ࠸࡚
ࡶホ౯ࡉࢀ࡚ ࠾ࡾ㸪 ࢔ ࢫ࣮ࣜࢺࡸⱝ ᖺ⪅ࢆᑐ ㇟࡜ࡋࡓࢸࢫ ࢺ ἲ ࡜ࡋ ࡚ᗈࡃ⏝࠸
ࡽࢀ࡚࠸ࡿ[Gray, 1995; Hertel et al., 2002; Kinzey et al., 1998; Olmsted et al.,
2002]㸬
ᮏㄽᩥ◊ ✲ 2 ࡟࠾࠸࡚ 㸪∦⬮ࢫࢡ࣡ ࢵࢺ㸪∦ ⬮ࢻࣟࢵࣉࣛ ࣥࢹ࢕ࣥ ࢢ㸪࢝ࢵ
ࢸ࢕ࣥࢢືస ࢆ㊊㊑㛤 ᤼࠾ࡼࡧ㊊㊑ ᢕᣢࡢᣦ ♧ୗ࡛⾜ࢃࡏ ࡓ᫬ࡢື ⓗୗ⫥࢔ࣛ
࢖࣓ࣥࢺ࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ሗ࿌ ࡋࡓࡀ㸪 ◊✲ 5 ࡛ࡣ 㸪㊊㊑ᢕᥱ ຊ ࡜㟼ⓗ࠾
ࡼࡧືⓗࣂࣛ ࣥࢫ⬟ຊ ࡜ࡢ㛵㐃ᛶ࠾ ࡼࡧ㊊㊑ ᢕᥱຊࡢ኱ᑠ ࡀ㟼ⓗ ࠾ ࡼࡧືⓗࣂ
ࣛࣥࢫ⬟ຊ࡟ ཬࡰࡍᙳ 㡪࡟ࡘ࠸࡚ ᳨ ドࡍࡿࡇ ࡜࡜ࡋࡓ㸬 ᮏ ◊✲ࡢ ┠ ⓗࡣ㸪኱Ꮫ
ዪᏊ࢔ࢫ࣮ࣜ ࢺࢆ ᑐ㇟ ࡜ࡋ࡚㸪㊊㊑ ᢕᥱຊ ࡜ 㟼ⓗ࠾ࡼࡧື ⓗࣂࣛࣥ ࢫ⬟ຊ ࡜ࡢ
㛵㐃ᛶ࡟ࡘ࠸ ࡚㸪ࡲࡓ ㊊㊑ᢕᥱຊࡢ ኱ᑠࡀ㟼 ⓗ ࠾ࡼࡧືⓗ ࣂࣛࣥࢫ ⬟ຊ ࡟ཬࡰ
ࡍᙳ㡪࡟ࡘ࠸ ࡚ẚ㍑ ᳨ ドࡍࡿࡇ࡜࡛ ࠶ࡿ㸬
5-5-2. ᑐ㇟࡜᪉ἲ
1. ᑐ㇟
ᑐ㇟⪅ࡣ㸪኱Ꮫዪ Ꮚࣛ ࢡࣟࢫ㑅 ᡭ 33 ྡ࡜ࡋ ࡓ㸬ᑐ㇟⪅ࡢᖹᆒ ᖺ㱋㸦±ᶆ‽೫
ᕪ㸧ࡣ 19.4 ± 1.2 ṓ㸪㌟㛗 160.0 ± 6.2cm㸪య 㔜 54.7 ± 5.4kg㸪BMI21.4 ± 1.4kg/m 2
࡛࠶ࡗࡓ㸬஦ ๓࡟ᮏ◊ ✲࡛⾜࠺ ᐃ ෆᐜ㸪೔ ⌮ⓗ㓄៖࡟ࡘ ࠸࡚ᩥ᭩ ࠾ࡼࡧཱྀ㢌
࡟࡚ㄝ᫂ࢆ⾜ ࠸㸪᭩ 㠃 ࡟࡚ྠពࢆᚓ ࡚⾜ࡗࡓ 㸬ᮏ◊✲ࡣ 㸪᪩✄⏣ ኱ Ꮫ ேࢆᑐ㇟
࡜ࡍࡿ◊✲࡟㛵ࡍࡿ೔⌮ᑂᰝጤဨ఍ࡢᢎㄆࢆᚓ࡚ᐇ᪋ࡋ࡚࠸ࡿ㸦ᢎㄆ␒ྕ
2013-015㸧㸬
105
2. ᪉ἲ
a. ㊊㊑ᢕᥱຊ
㊊㊑ᢕᥱຊࡣ ᅗ 5-1 ࡟♧ࡍ㊊㊑ᢕᥱ ຊ ᐃჾ 㸦➉஭ᶵჾᕤ ᴗᰴᘧ఍ ♫〇㸪㊊
㊑➽ຊ ᐃჾ 㸧ࢆ⏝࠸ ࡚⾜ࡗࡓ㸬 ᐃ᪉ἲࡣ 〄㊊࡟࡚㸪 ㊊ ㊑ࡢ㊑⠇ 㛫㛵⠇ࡀ㊊
㊑ᢕᣢࣂ࣮࡟ ࠿࠿ࡿࡼ ࠺࡟ ㋖㒊࠾ࡼ ࡧ㋖㒊࡟ ᐦ╔ࡉࡏࡿ ᚋ 㒊ࣉ࣮ࣞ ࢺ ࡢ఩⨨ࢆ
ㄪ⠇ࡋࡓ㸬㊊ ㊑ᢕᣢࣂ ࣮࡟࠿࠿ࡿ㊊ ㊑ࡢᮏᩘ ࡣ㸪ᑐ㇟⪅ࡀ ᭱ࡶຊࢆ ධࢀࡸࡍ࠸
᫬ࡢ㊊㊑ᩘ࡜ ࡋ㸪≉࡟ ไ㝈 ࡣࡋ࡚࠸ ࡞࠸㸬 ᐃࡣᗙ఩࠾ࡼ ࡧ❧఩࡛ ⾜࠸㸪ࡑࢀ
ࡒࢀᕥྑ 2 ᅇࡎࡘ ᐃࡋࡓ㸬ࣃࣛ ࣓࣮ࢱࡣ 㸪 2 ᅇࡢ ᐃ್ࡢᖹ ᆒ ್࡜ࡋࡓ㸬࡞
࠾㸪ᕥྑࡢ ᐃࡢ㡰␒ ࡣࣛࣥࢲ࣒࡟ ⾜ࡗࡓ㸬
ᅗ 5-1 ㊊㊑ᢕᥱ ຊ ᐃჾ
b. 㔜ᚰືᦂᛶ
㔜ᚰືᦂᛶࡢ ᐃࡣ㸪 ᅗ 5-2 ࡟♧ࡍ 㔜ᚰືᦂ ィ㸦 ࢔ࢽ࣐ᰴ ᘧ఍♫〇 㸪ࢢࣛࣅ
ࢥ࣮ࢲ GP-7㸧ࢆ ⏝࠸ ࡚ ᐃࡋࡓ 㸬 ᐃࡣ 㸪᪥ᮏᖹ⾮⚄⤒ ⛉Ꮫ఍࡛ ᐃࡵࡽࢀࡓ㔜
ᚰືᦂ᳨ᰝࡢ ᇶ‽ [᪥ ᮏᖹ⾮⚄⤒⛉ Ꮫ఍ , 2005]࠾ࡼࡧඛ⾜◊ ✲ [ᮧ⏣㸪 2004]ࢆཧ
⪃࡟௨ୗࡢ᪉ ἲ࡛⾜ࡗ ࡓ㸬⿕㦂⪅࡟ 㸪〄㊊࡛ ࣉ࣮ࣞࢺ୰ኸ ࡟∦⬮࡛ ࡘࡲඛࢆṇ
㠃࡟ྥࡅ࡚⭸ 㛵⠇ࢆఙ ᒎࡉࡏࡓ≧ែ ࡛❧ࡓࡏ ࡓ 㸬❧⬮ഃࡢ ཯ᑐഃࡢ ⬮ࡣ 㸪⭸㛵
⠇ 90 ᗘ࡛⫤㛵⠇ ࡣఙ ᒎ 0 ᗘ࡟ಖᣢ ࡉࡏࡓ㸬୧⭎ࢆ⬚ࡢ๓ ࡛஺ᕪࡋ 㸪୧ᡭࢆ⫪ࡢ
ୖ࡟ᙜ࡚ࡉࡏ ࡓ㸬ྜᅗ ࡜࡜ࡶ࡟㸪 2m ๓ ᪉ࡢ ቨ࡟♧ࡋࡓ ×༳ࢆ 30 ⛊㛫ὀどࡉࡏ
ࡓ㸬 ᐃࡣ㸪 ᕥ⬮࠾ࡼ ࡧྑ⬮ࡢ∦⬮ ❧఩⫥఩ ࡛ࡑࢀࡒ ࢀ 1 ᅇࡎࡘ⾜ ࢃࡏࡓ㸬ᕥ
106
⬮࠾ࡼࡧྑ⬮ ࡢ ᐃࡢ 㡰␒ࡣ㸪ࣛࣥ ࢲ࣒࡟⾜ ࡗࡓ㸬㔜ᚰື ᦂ ᐃ࠿ ࡽᚓࡽࢀࡓ
⤖ᯝ࠿ࡽ㸪௒ᅇࡢ ᐇ 㦂 ࡛⏝࠸ࡓࣃࣛ ࣓࣮ࢱࡣ 㸪㔜ᚰ⥲㌶ ㊧㛗㸪㔜ᚰ ༢఩㌶㊧㛗㸪
㔜ᚰ༢఩㠃✚ ㌶㊧㛗㸪 㔜ᚰእ࿘㠃✚ 㸪㔜ᚰ▴ ᙧ㠃✚ ࡜ࡋࡓ 㸬
ᅗ 5-2 㔜ᚰືᦂ ィ
c. SEBT㸦Star Excursion Balance Test㸧
SEBTࡣ㸪ᅗ5-3࡟♧ ࡋ ࡓ ᐃჾල㸦 Y Balance Test, Move2Perform, Evansville, IN㸧
ࢆ⏝࠸ࡓ㸬 ᐃ ᪉ἲࡣ 㸪⿕㦂⪅࡟ ᐃ ჾࡢ୰ ኸ BOXୖ࡟ᨭᣢ⬮㸦 ᐃ⬮ഃ㸧ࡢ
㊊ࢆ⨨࠸࡚❧ ࡓࡏ 㸪୧ ᡭࡣ⭜࡟ ᙜ࡚ ࡉࡏࡓ 㸬ᨭᣢ⬮ࡢ཯ᑐ ⬮ࡢ㊊㒊 ࡢࡘࡲඛ࡛㸪
๓᪉㸦anterior㸸௨ୗ 㸪 A㸧㸪ᚋෆ᪉ 㸦 posteromedial㸸௨ୗ㸪PM㸧㸪ᚋእ᪉
㸦posterolateral㸸௨ୗ㸪PL㸧࡟ఙࡧࡓ࣏࣮ ࣝ࡟ タ⨨ࡉࢀ࡚࠸ ࡿࢫࣛ࢖ ࢻ BOXࢆ㸪
ྍ⬟࡞㝈ࡾࡘ ࡲඛ࡛㐲 ᪉࡬ᢲࡋࡓᚋ 㸪ࢫࢱ࣮ ࢺ⫥఩࡟ᡠࡿ ࡇ࡜࡜ࡋ ࡓ㸬 ᐃ๓
࡟㸪Hertelࡽ㸦2000㸧ࡀ᥎ዡࡋ࡚࠸ ࡿࡼ࠺࡟ Ᏻᐃࡋࡓ್ࢆ ᚓࡿࡓࡵ 㸪ྛ᪉ྥ࡟ 6
ᅇࡢ⦎⩦ࢆ⾜ ࢃࡏࡓ㸬 ᐃ୰࡟௨ୗ ࡢヨᢏࡀ ࡳࡽࢀࡓሙྜ ࡣ↓ຠ࡜ ࡋ㸪෌ヨᢏ
ࢆ⾜ࢃࡏࡓ㸬1)ᨭᣢ⬮ ࡢ཯ᑐഃࡢ㊊ ࡀᆅ㠃࡟ ╔࠸ࡓሙྜ㸬 2)ᨭᣢ⬮ ࡢ㊊㒊ࡀࢫ
ࢱ࣮ࢺ఩⨨࠿ ࡽື࠸ࡓ ሙྜ㸦㋖㒊ࡀ ᾋ࠸ࡓሙ ྜࡶ↓ຠ㸧㸬 3)᭱㛗ࣜ ࣮ࢳᚋ㸪ࣜ
࣮ࢳࡋࡓഃࡢ ⬮ࢆࢫࢱ ࣮ࢺ఩⨨ࡲ࡛ ᡠࡍࡇ࡜ ࡀ ฟ᮶࡞࠿ࡗ ࡓሙྜ㸬 4)∦ᡭ࠾ࡼ
ࡧ୧ᡭࡀ⭜࠿ ࡽ㞳ࢀࡓ ሙྜ࡜ࡋࡓ㸬 ᐃࡣ㸪ᕥ⬮ 㸪ྑ⬮ู ࡟ A㸪PM㸪PL᪉ྥ࡟
ࡑࢀࡒࢀ3ᅇ⾜ࡗ ࡓ㸬 ࡲࡓᕥ⬮࠾ࡼ ࡧྑ⬮ࡢ ᐃࡢ㡰␒ࡣ ࣛࣥࢲ࣒ ࡟⾜ࡗࡓ㸬 3
ᅇࡢᚓࡽࢀࡓ ್ࡢᖹᆒ ್ࢆ⿕㦂⪅ࡢ ⬮㛗㸦ୖ ๓⭠㦵Ჲ࠿ࡽ ㊊㛵⠇ෆ ᯝࡲ࡛ࡢ㛗
107
ࡉ㸧࡛㝖ࡋࡓ ್࡟ 100ࢆ஌ࡌ࡚ṇつ ໬ࡋࡓ್ ࢆࣃ࣓࣮ࣛࢱ ࡜ࡋࡓ [Gribble and
Hertel, 2003]㸬
ᅗ 5-3 SEBT㸦Star Excursion Balance Test㸧
3. ẚ㍑᳨ウ㡯┠
㊊㊑ᢕᥱຊ ࡜㔜ᚰື ᦂᛶࡢ 㔜ᚰ⥲ ㌶㊧㛗㸪 㔜ᚰ ༢఩㌶㊧ 㛗㸪㔜ᚰ ༢఩㠃✚㌶
㊧㛗㸪㔜ᚰ እ࿘㠃✚ 㸪㔜ᚰ▴ᙧ㠃✚ 㸪SEBT ࡢ A㸪PM㸪PL ࡜ࡢ┦ 㛵㛵ಀࢆ㸪ࡲ
ࡓ㸪㊊㊑ᢕᥱ ຊࢆ ᑠ⩌ 㸪኱⩌ࡢ 2 ⩌࡟ศࡅ㸪 ྛ⩌ࡢ㔜ᚰື ᦂᛶ࠾ࡼ ࡧ SEBT ࡢ
ྛࣃ࣓࣮ࣛࢱ ࢆẚ㍑ࡋ ࡓ㸬
4. ⤫ィᏛⓗᡭἲ
㊊㊑ᢕᥱຊ࡜ 㔜ᚰືᦂ ᛶࡢ 㔜ᚰ⥲㌶ ㊧㛗㸪㔜 ᚰ ༢఩㌶㊧㛗 㸪㔜ᚰ༢ ఩㠃✚㌶
㊧㛗㸪㔜ᚰእ࿘ 㠃✚ 㸪㔜ᚰ▴ᙧ㠃✚㸪SEBT ࡢ A㸪PM㸪PL ࡜ࡢ┦ 㛵㛵ಀ࡟ࡘ࠸
࡚ࡣࣆ࢔ࢯࣥ ࡢ┦㛵 ಀ ᩘࢆ⏝࠸᳨࡚ ウࡋ 㸪ࡲ ࡓ㸪㊊㊑ᢕᥱ ຊࡢᑠ⩌ 㸪኱ ⩌ࡢẚ
㍑࡟ࡘ࠸࡚ࡣ ᑐᛂࡢ࡞ ࠸ t ᳨ᐃࢆ⏝࠸ࡓ㸬࡞ ࠾㸪඲࡚ࡢ⤫ ィฎ⌮࡟ ࡣ⤫ィゎᯒ
ࢯࣇࢺ࢙࢘࢔ 㸦 SPSS Statistics Student Version 19.0 㸧ࢆ⏝࠸㸪 ᭷ ព☜⋡ࢆ 5%ᮍ
‶࡜ࡋࡓ㸬
108
5-5-3. ⤖ᯝ
ᕥྑࡢ㊊㊑ᢕ ᥱຊ㸪 SEBT㸪㔜ᚰືᦂᛶࡢྛ ࣃ࣓࣮ࣛࢱ ࢆ ⾲ 5-1 ࡟ ♧ࡍ㸬
⾲5-1䚷㊊㊑ᢕᥱຊ䞉SEBT䞉㔜ᚰືᦂᛶ (ᖹᆒ ± ᶆ‽೫ᕪ)
ྑ
ᕥ
15.0 ± 3.8
14.9 ± 4.0
91.3 ± 25.6
88.9 ± 23.8
3.0 ± 0.9
3.0 ± 0.8
29.8 ± 18.0
29.3 ± 16.7
4.0 ± 2.0
3.8 ± 1.5
9.8 ± 4.8
9.2 ± 3.7
A
0.66 ± 0.66
0.66 ± 0.06
PM
1.14 ± 0.05
1.14 ± 0.06
PL
1.10 ± 0.06
1.10 ± 0.08
A, PM, PL䛾ᖹᆒ
0.96 ± 0.05
0.97 ± 0.06
㊊㊑ᢕᥱຊ(kg)
㔜ᚰືᦂᛶ
㔜ᚰ⥲㌶㊧㛗(cm)
㔜ᚰ༢఩㌶㊧㛗(cm/⛊)
2
㔜ᚰ༢఩㠃✚㌶㊧㛗(cm/cm )
㔜ᚰእ࿘㠃✚(cm2)
2
㔜ᚰ▴ᙧ㠃✚(cm )
SEBT*
඲䛶N.S.
*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾
඲䛶䛾䝟䝷䝯䞊䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊
109
ྑ㊊㊑ᢕᥱຊ ࡜ 㔜ᚰື ᦂᛶ㸪SEBT ࡜ࡢ┦㛵 㛵ಀ ࢆ⾲ 5-2 ࡟ ♧ࡍ㸬 ྑ㊊㊑ᢕ
ᥱຊ࡜㔜ᚰື ᦂᛶ ࡢ㔜 ᚰ⥲㌶㊧㛗㸪 㔜ᚰ ༢఩ ㌶㊧㛗࡜ࡢ㛵 ಀ࡟᭷ព ࡞ ప࠸㈇ࡢ
┦㛵ࢆ♧ࡋࡓ 㸦࠸ࡎࢀ ࡶ r = -0.354㸪p = 0.043㸧㸦ᅗ 5-4㸪ᅗ 5-5㸧 㸬ࡑࡢ௚ࡢ
ྛ㡯┠࡜ࡢ㛵 ಀ࡟ ࡘ࠸ ࡚ࡣ᭷ពᕪࡣ ࡳࡽࢀ࡞ ࠿ࡗࡓ㸬
⾲5-2䚷ྑ㊊㊑ᢕᥱຊ䛸㔜ᚰືᦂᛶ䞉SEBT* 䛸䛾┦㛵㛵ಀ
㔜ᚰ⥲
㌶㊧㛗
ྑ㊊㊑ᢕᥱຊ
-.354*
SEBT
A
ྑ㊊㊑ᢕᥱຊ
㔜ᚰ༢఩ 㔜ᚰ༢఩ 㔜ᚰእ࿘
㌶㊧㛗 㠃✚㌶㊧㛗
㠃✚
-.354*
SEBT
PM
.272
-.054
SEBT
PL
.320
.002
-.070
㔜ᚰ▴ᙧ
㠃✚
-.063
SEBT
A, PM, PL
䛾ᖹᆒ
.252
*: p < 0.05
*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾
඲䛶䛾䝟䝷䝯䞊䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊
ᅗ 5-4 ྑ ㊊ ㊑ ᢕ ᥱ ຊ ࡜ 㔜 ᚰ ⥲ ㌶ ㊧ 㛗 ࡜ ࡢ
ᅗ 5-5 ྑ ㊊ ㊑ ᢕ ᥱ ຊ ࡜ 㔜 ᚰ ༢ ఩ ㌶ ㊧ 㛗 ࡜ ࡢ
㛵ಀ
㛵ಀ
110
ྑ㊊㊑ᢕᥱຊ ࡢᑠ⩌࠾ ࡼࡧ኱⩌ࡢᖹ ᆒ್ 㸦sᶆ‽೫ᕪ㸧 ࢆ ⾲ 5-3 ࡟ 㸪ྑ㊊㊑
ᢕᥱຊࡢᑠ⩌ 㸪኱⩌ ࡢ SEBT㸪㔜ᚰືᦂᛶ ࡢྛࣃ࣓࣮ࣛ ࢱࢆ ⾲ 5-4 ࡟♧ࡍ㸬ྑ
㊊㊑ᢕᥱຊࡢ ᑠ⩌㸪኱ ⩌ࡢ㔜ᚰ⥲㌶ ㊧㛗࡜㔜 ᚰ༢఩㌶㊧㛗 ࡢẚ㍑࡟ ࠾࠸࡚㸪኱
⩌ࡣᑠ⩌࡟ẚ ࡭㸪᭷ព ࡟ ㌶㊧㛗ࡀ▷ ࠿ࡗࡓ㸦 ࠸ࡎࢀࡶ p = 0.043㸧㸬௚ࡢ⩌㛫ẚ
㍑࡟࠾࠸࡚ࡣ ᭷ពᕪࡣ ࡳࡽࢀ࡞࠿ࡗ ࡓ㸬
⾲5-3䚷ྑ㊊㊑ᢕᥱຊ䛾ᑠ⩌䛸኱⩌ (ᖹᆒ ± ᶆ‽೫ᕪ)
㊊㊑ᢕᥱຊ(kg)
ᑠ⩌(n=15)
኱⩌(n=18)
11.6 ± 2.0*
17.9 ± 2.1*
*: ᑠ⩌ vs. ኱⩌, p < 0.01
⾲5-4䚷ྑ㊊㊑ᢕᥱຊ䛾ᑠ⩌䞉኱⩌䛾ྛ䝟䝷䝯䞊䝍䛾ẚ㍑ (ᖹᆒ ± ᶆ‽೫ᕪ)
ᑠ⩌(n=15)
኱⩌(n=18)
SEBT*
A
0.63 ± 0.07
0.68 ± 0.06
PM
1.13 ± 0.06
1.15 ± 0.04
PL
1.10 ± 0.05
1.09 ± 0.07
A, PM, PL䛾ᖹᆒ
0.95 ± 0.05
0.97 ± 0.04
101.1 ± 26.3a)
83.2 ± 22.7a)
3.4 ± 0.9b)
2.8 ± 0.8b)
30.6 ± 17.1
29.2 ± 19.3
4.1 ± 1.7
3.9 ± 2.3
10.0 ± 4.0
9.6 ± 5.5
㔜ᚰືᦂᛶ
㔜ᚰ⥲㌶㊧㛗(cm)
㔜ᚰ༢఩㌶㊧㛗(cm/⛊)
㔜ᚰ༢఩㠃✚㌶㊧㛗(cm/cm2)
㔜ᚰእ࿘㠃✚(cm2)
2
㔜ᚰ▴ᙧ㠃✚(cm )
*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾඲䛶䛾䝟䝷䝯䞊
䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊
a), b): ᑠ⩌ vs. ኱⩌, p < 0.05.
111
ᕥ㊊㊑ᢕᥱຊ ࡜㔜ᚰື ᦂᛶ㸪 SEBT ࡜ࡢ┦㛵 㛵ಀࢆ⾲ 5-5 ࡟♧ ࡍ 㸬ᕥ㊊㊑ᢕ
ᥱຊ ࡜㔜 ᚰື ᦂᛶ 㸪 SEBT ࡜ࡢ㛵 ಀ࡟ ࡘ࠸ ࡚㸪 ඲࡚ ࡢ㡯 ┠ 㛫 ࡟ ࠾ ࠸࡚ ᭷ព ᕪࡣ
ࡳࡽࢀ࡞࠿ࡗ ࡓ㸬
⾲5-5䚷ᕥ㊊㊑ᢕᥱຊ䛸㔜ᚰືᦂᛶ䞉SEBT* 䛸䛾┦㛵㛵ಀ
㔜ᚰ⥲
㌶㊧㛗
ᕥ㊊㊑ᢕᥱຊ
-.257
SEBT
A
ᕥ㊊㊑ᢕᥱຊ
.305
㔜ᚰ༢఩ 㔜ᚰ༢఩ 㔜ᚰእ࿘
㌶㊧㛗 㠃✚㌶㊧㛗
㠃✚
-.256
SEBT
PM
.208
.173
SEBT
PL
.040
-.307
SEBT
A, PM, PL䛾
ᖹᆒ
.209
඲䛶N.S.
*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾
඲䛶䛾䝟䝷䝯䞊䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊
112
㔜ᚰ▴ᙧ
㠃✚
-.300
ᕥ㊊㊑ᢕᥱຊ ࡢᑠ⩌࠾ ࡼࡧ኱⩌ࡢᖹ ᆒ್ 㸦sᶆ‽೫ᕪ㸧 ࢆ ⾲ 5-6 ࡟ 㸪ᕥ㊊㊑
ᢕᥱຊࡢᑠ⩌ 㸪኱⩌ ࡢ SEBT㸪㔜ᚰືᦂᛶ ࡢྛࣃ࣓࣮ࣛ ࢱࢆ ⾲ 5-7 ࡟ ♧ࡍ㸬ᕥ
㊊㊑ᢕᥱຊࡢ ᑠ ⩌ 㸪኱ ⩌ࡢྛࣃ࣓ࣛ ࣮ࢱࡢ ẚ ㍑࡟࠾࠸࡚㸪 SEBT ࡢ A ࡟࠾࠸࡚
኱⩌ࡣᑠ⩌࡟ ẚ࡭㸪᭷ ព࡟࣮ࣜࢳ㛗 ࡀ㛗࠿ࡗ ࡓ㸦 p = 0.020㸧㸬௚ࡢ⩌㛫ẚ㍑࡟
࠾࠸࡚ࡣ᭷ព ᕪࡣࡳࡽ ࢀ࡞࠿ࡗࡓ㸬
⾲5-6䚷ᕥ㊊㊑ᢕᥱຊ䛾ᑠ⩌䛸኱⩌ (ᖹᆒ ± ᶆ‽೫ᕪ)
㊊㊑ᢕᥱຊ(kg)
ᑠ⩌(n=17)
኱⩌(n=16)
11.6 ± 1.5*
18.3 ± 2.6*
*: ᑠ⩌ vs. ኱⩌, p < 0.01 ⾲5-7䚷ᕥ㊊㊑ᢕᥱຊ䛾ᑠ⩌䞉኱⩌䛾ྛ䝟䝷䝯䞊䝍䛾ẚ㍑ (ᖹᆒ ± ᶆ‽೫ᕪ)
ᑠ⩌(n=17)
኱⩌(n=16)
SEBT*
A
0.64 ± 0.05a)
0.69 ± 0.06a)
PM
1.13 ± 0.06
1.16 ± 0.07
PL
1.09 ± 0.06
1.11 ± 0.09
A, PM, PL䛾ᖹᆒ
0.95 ± 0.04
0.98 ± 0.06
93.8 ± 15.8
83.6 ± 29.7
3.1 ± 0.5
2.8 ± 1.0
26.1 ± 13.3
32.7 ± 19.6
㔜ᚰእ࿘㠃✚(cm2)
4.1 ± 1.2
3.4 ± 1.8
㔜ᚰ▴ᙧ㠃✚(cm2)
10.1 ± 2.9
8.2 ± 4.2
㔜ᚰືᦂᛶ
㔜ᚰ⥲㌶㊧㛗(cm)
㔜ᚰ༢఩㌶㊧㛗(cm/⛊)
㔜ᚰ༢఩㠃✚㌶㊧㛗(cm/cm2)
*SEBT䠖Star excursion balance test, A: ๓᪉, PM: ᚋෆ᪉, PL: ᚋእ᪉. SEBT䛾඲䛶䛾䝟䝷䝯䞊
䝍䛿䝸䞊䝏㛗䜢ୗ⫥㛗䛷㝖䛧䛶100䜢஌䛨䛶ṇつ໬䛧䛯䠊
a): ᑠ⩌ vs. ኱⩌, p < 0.05.
113
5-5-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪኱ ᏛዪᏊ࢔ ࢫ࣮ࣜࢺࢆ ᑐ ㇟࡜ࡋ࡚ 㸪㊊㊑ᢕᥱຊ ࡜㟼ⓗࣂ ࣛࣥࢫ࠾
ࡼࡧືⓗࣂࣛ ࣥࢫ⬟ຊ ࡜ࡢ㛵㐃ᛶ࡟ ࡘ࠸࡚㸪 ࡲࡓ㸪 ㊊㊑ᢕ ᥱຊ ࡢ኱ ᑠࡀ㟼ⓗࣂ
ࣛࣥࢫ࠾ࡼࡧ ືⓗࣂࣛ ࣥࢫ⬟ຊ ࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ẚ㍑ ᳨ウࡍࡿ ࡇ࡜ࢆ┠ⓗ
࡜ࡋ࡚⾜ࡗࡓ 㸬ᚓࡽࢀ ࡓ⤖ᯝࡣ㸪 ྑ ㊊㊑ᢕᥱ ຊ࡜㔜ᚰືᦂ ᛶࡢ 㔜ᚰ ⥲㌶㊧㛗㸪
㔜ᚰ༢఩㌶㊧ 㛗࡜ࡢ㛵 ಀ࡟᭷ព࡞㈇ ࡢ ప࠸┦ 㛵ࢆ♧ࡋ㸦࠸ࡎ ࢀࡶ r = -0.354㸪p
= 0.043㸧㸪ྑ㊊ ㊑ᢕᥱ ຊࡢ ኱⩌ࡣᑠ ⩌࡟ẚ࡭ ࡚㸪㔜ᚰ⥲ ㌶㊧㛗࡜ 㔜 ᚰ༢఩㌶㊧
㛗࡟࠾࠸࡚᭷ ព࡟㌶㊧ 㛗ࡀ ▷࠿ࡗࡓ㸦࠸ࡎ ࢀ ࡶ p = 0.043㸧㸬ࡇࢀࡣ ㊊㊑ᢕᥱຊ
ࡀ㧗࠸⪅ࡣ㔜 ᚰືᦂᛶ ࡢ 㔜ᚰ⥲㌶㊧ 㛗㸪㔜ᚰ ༢఩㌶㊧㛗ࡀ ▷ࡃ㸪 ㊊ ㊑ᢕᥱຊࡀ
ప࠸⪅ࡣ㔜ᚰ ືᦂᛶࡢ 㔜ᚰ⥲㌶㊧㛗 㸪㔜ᚰ ༢ ఩㌶㊧㛗ࡀ㛗 ࠸㛵ಀ࡟ ࠶ࡿࡇ࡜ࢆ
ព࿡ࡍࡿ㸬㊊ ㊑ᢕᥱ ື సࡣ㊊㊑ᒅ᭤ ືసࡀక ࠸㸪ࡑࡢືస ࡟స⏝ࡍ ࡿ➽ࡣ㸪㊊
㒊ෆᅾ➽࡛࠶ ࡿ ▷ẕ㊑ ᒅ➽ࠊ㛗ẕ㊑ᒅ ➽ࠊẕ ㊑ෆ㌿➽㸪▷㊑ ᒅ➽㸪▷ᑠ㊑ᒅ➽㸪
⫼ഃ㦵㛫➽㸪ᗏ ഃ㦵㛫 ➽㸪⹸ᵝ➽ [Oatis, 2009]࡛࠶ࡿ㸬ඛ⾜ㄽᩥ࠿ ࡽ㸪Ⲵ㔜఩࡛
ࡢẕ㊑እ㌿➽ ࡟ࡼࡿ㊊ ㊑ᒅ᭤స⏝ࡀ ㊊㒊ෆഃ ⦪࢔࣮ࢳࡢᨭ ᣢ࡟㔜せ ࡞ᙺ๭ࢆᯝ
ࡓࡋ࡚࠸ࡿࡇ ࡜ࡀከᩘ ሗ࿌ࡉࢀ࡚ ࠸ ࡿ࡯࠿ [Fiolkowski et al., 2003; Headlee et al.,
2008; Jung et al., 2012; Mann and Inman, 1964; Wong, 2007]㸪ෆഃ⦪ ࢔࣮ࢳ๛ᛶ࡟
㊊ᗏ⭝⭷ࡸ㊊ ᗏ➽⭷ࡶ ࢔࣮ࢳࢧ࣏࣮ ࢺ࡟ᐤ୚ ࡋ࡚࠸ࡿࡇ࡜ ࡀ」ᩘሗ ࿌ࡉࢀ࡚ ࠸
ࡿ[Carlson et al., 2000; Franco, 1987; Thordarson et al, 1997]㸬㊊㊑ᢕ ᥱຊࡢඃࢀ࡚
࠸ࡿ⪅ࡣ㸪∦ ⬮❧఩᫬ ࡢ㊊㊑࡟ࡼࡿ ᗋࡢᢕᣢ ຊࡶ㧗ࡃ㸪ෆ ഃ⦪࢔࣮ ࢳࡢᨭᣢᛶ
ࡀ㧗ࡲࡿࡇ࡜ 㸪ࡲࡓ㸪 ẕ㊑እ㌿➽ࡸ ᑠ㊑እ㌿ ➽࡜࠸ࡗࡓ㊊ 㒊ෆᅾ➽ ࡢ➽⥭ᙇ ࡟
ࡼࡾ㊊㒊࢔࣮ ࢳ๛ᛶ ࡀ 㧗ࡲࡿࡇ࡜ࡶ ሗ࿌ࡉࢀ ࡚࠾ࡾ [Kapandji, 1987]㸪ࡑࢀࡽࡢ
㊊㊑㐠ືࡀ∦ ⬮❧఩᫬ ࡢ㊊㒊ࡢᏳᐃ ᛶࢆ㧗ࡵ 㸪ࡑࡢ⤖ᯝୗ ⫥඲యࡢ ࣂࣛࣥࢫಖ
ᣢ⬟ຊྥୖ࡟ ᐤ୚ࡉࡏ ࡓࡢ࡛ࡣ࡞࠸ ࠿࡜᥎ ࡋࡓ㸬
ᕥ㊊㊑ᢕᥱຊ ࡢ ኱⩌࡜ ᑠ⩌ࡢẚ㍑࡟ ࠾࠸࡚ࡣ 㸪 SEBT ࡢ A ࡟࠾࠸࡚ ኱⩌ ࡀᑠ
⩌࡟ẚ࡭㸪᭷ ព࡟࣮ࣜ ࢳ㛗ࡀ㛗࠿ࡗ ࡓ㸬 ඛ⾜ ◊✲࠿ࡽ㸪ᒣ ཱྀࡽ㸦 1989㸧ࡣ㸪㊊
㊑ᒅ᭤➽ຊ࡜ ㊊ᅽ୰ᚰ ືᦂ࡜ࡢ㛵㐃 ᛶࢆ᳨ド ࡋࡓ⤖ᯝ㸪㊊ ㊑ ᒅ᭤➽ ຊ ࡀ๓ᚋ᪉
ྥ࡬ࡢᏳᐃᛶ ࡟ᐤ୚ࡉ ࡏ࡚࠸ࡿ࡜㏙ ࡭࡚࠸ࡿ 㸬ࡲࡓ㸪 ຍ㎶ ࡽ㸦2002㸧ࡣ㸪඲㊊
㊑㸦➨ 1 ㊑㹼 ➨ 5 ㊑㸧 ࡢ㊊㊑ᢕᣢຊ 㸪ẕ㊑㸦 ➨ 1 ㊑㸧ࡶࡋ ࡃࡣ ➨ 2 ㊑㹼➨ 5 ㊑
ࡢ㊊㊑ᢕᣢຊ ࡜๓᪉ࣜ ࣮ࢳືస᫬ࡢ ㊊ᅽ୰ᚰ ⛣ື㊥㞳࡜ࡢ 㛵㐃ᛶ࡟ ࡘ࠸᳨࡚ド
114
ࡋࡓ⤖ᯝ㸪඲ ㊊㊑ ࡢᢕ ᣢຊࡀ᭱ࡶ๓ ᪉࡬ࡢࣂ ࣛࣥࢫಖᣢ࡟ 㛵ಀࡋ㸪 ḟ࡟ẕ㊑㸪
ࡑࡋ࡚➨ 2 ㊑ 㹼➨ 5 ㊑ ࡢ㡰࡛࠶ࡗࡓ ࡇ࡜ࡀሗ ࿌ࡉࢀ㸪୰࡛ ࡶẕ㊑㸦 ➨ 1 ㊑㸧ࡢ
ᢕᣢຊࡀ๓᪉ ࡬ࡢࣂࣛ ࣥࢫಖᣢ࡟ᐤ ୚ࡉࡏ㸪 㔜ᚰ๓᪉఩⨨ ᫬ࡢࠕᨭ ᣢస⏝ࠖ ࢆ
ᣢࡘ࡜⪃ᐹࡋ ࡚࠸ࡿ㸬 ㎷㔝࡜⏣୰㸦 2007㸧ࡣ㸪ẕ㊑㸦 ➨ 1 ㊑㸧࡜ ➨ 2 ㊑㹼 ➨ 5
㊑ࡢ㊊㊑ᅽ㏕ ຊ࡜ ๓᪉ ࣮ࣜࢳືస᫬ ࡢ㊊ᅽ୰ ᚰ఩⨨࡜ࡢ㛵 㐃ᛶ࡟ࡘ ࠸᳨࡚ドࡋ
ࡓ⤖ᯝ㸪 ➨ 2 ㊑㹼 ➨ 5 ㊑ࡢ㊊㊑ᅽ㏕ ຊ࡜ ๓᪉ ࣮ࣜࢳືస᫬ ࡢ㊊ᅽ୰ ᚰ఩⨨࡜ࡢ
㛵ಀ࡟࠾࠸࡚ ᭷ព࡞ṇ ࡢ┦㛵ࢆㄆࡵ ࡓࡀ㸪 ≉ ࡟ẕ㊑ᅽ㏕ຊ ࡜๓᪉࡬ ࡢ㊊ᅽ୰ᚰ
఩⨨࡜ࡢ㛵㐃 ᛶࡀ㧗 ࠿ ࡗࡓࡇ࡜ࢆሗ ࿌ࡋ࡚࠸ ࡿ㸬
ࡇࢀࡽࡢሗ࿌ ࢆྜࢃࡏ ᳨࡚ウࡍࡿ࡜ 㸪㊊㊑ᢕ ᥱຊࡢඃࢀࡿ ⪅ࡣ㊊㒊 ࢔࣮ࢳ๛
ᛶࡀ㧗ࡲࡿ࡜ ࡇ࡛㊊㒊 ࡢᏳᐃᛶࡀྥ ୖࡋ㸪 㟼 ⓗୗ⫥ࣂࣛࣥ ࢫಖᣢ⬟ ຊ࡟ᐤ୚ࡉ
ࡏࡿࡇ࡜㸪ࡲ ࡓ㸪㊊㊑ ᢕᥱຊࡢඃࢀ ࡿ⪅ࡣ㸪 ๓᪉࡬ࡢືⓗ ࣂࣛࣥࢫ ಖᣢ⬟ຊ ࡟
ᐤ୚ࡉࡏࡿྍ ⬟ᛶࡀ♧ ၀ࡉࢀࡓ㸬 ᮏ ◊✲⤖ᯝ ࠿ࡽ㸪ࢫ࣏࣮ ࢶയᐖண 㜵࡜࠸࠺ほ
Ⅼ࠿ࡽ╔┠ࡍ ࡿ࡜㸪㊊ ㊑ ᢕᥱຊࢆྥ ୖࡉࡏࡿ ࡇ࡜㸪ࡑࡋ࡚ ∦⬮❧఩ ᫬࠾ࡼࡧ∦
⬮╔ᆅືస᫬ ࡟㊊㊑࡛ ᗋࢆᢕᣢࡍࡿ ືస ᣦ♧ ࢆ⾜࠺ࡇ࡜ࡀ 㟼ⓗ࠾ࡼ ࡧືⓗࣂࣛ
ࣥࢫ⬟ຊྥୖ ࡟ᐤ୚ࡉ ࡏ㸪ࡉࡽ࡟ࡣ ୗ⫥യᐖ 㸪≉࡟ ㊊㛵⠇ ࡸ⭸㛵⠇ യᐖ ࡢண㜵
࡟ᐤ୚ࡉࡏࡿ ࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃࠼ࡓ 㸬
㊊㊑ᢕᥱຊ࡜ 㟼ⓗࣂࣛ ࣥࢫ ಖᣢ⬟ຊ ࡜ࡢ㛵㐃 ᛶ࠾ࡼࡧ㊊㊑ ᢕᥱຊࡢ ኱ᑠ ࡀ㟼
ⓗࣂࣛࣥࢫಖ ᣢ⬟ຊ࡟ ཬࡰࡍᙳ㡪㸪 ࡲࡓ㸪㊊ ㊑ᢕᥱຊࡢ኱ ᑠࡀ ๓᪉ ࡬ࡢືⓗࣂ
ࣛࣥࢫಖᣢ⬟ ຊ࡟ཬࡰ ࡍᙳ㡪࡟ࡘ࠸ ࡚ ୍㒊࡟ ࠾࠸࡚ ㄆࡵࡽ ࢀࡓ㸬㊊ ㊑ᢕᥱຊࡢ
ྥୖࡣ㸪๓㊊ 㒊ࢆྵࡵ ࡓ ㊊㒊ࡢᏳᐃ ᛶ࡟ᐤ୚ ࡉࡏ㸪 㟼ⓗ࠾ ࡼࡧືⓗ ୗ⫥ࣂࣛࣥ
ࢫಖᣢ⬟ຊࢆ ྥୖࡉࡏ ࡿ ྍ⬟ᛶࡀ♧ ၀ࡉࢀࡓ 㸬
5-5-5. ⤖ㄒ
኱ᏛዪᏊ࢔ࢫ ࣮ࣜࢺࢆ ᑐ㇟࡜ࡋ࡚㸪 ㊊㊑ᢕᥱ ຊ ࡜㟼ⓗࣂࣛ ࣥࢫ࠾ࡼ ࡧືⓗࣂ
ࣛࣥࢫ⬟ຊ࡜ ࡢ㛵㐃ᛶ 㸪࠾ࡼࡧ㊊㊑ ᢕᥱຊ ࡢ ኱ᑠࡀ㟼ⓗࣂ ࣛࣥࢫ࠾ ࡼࡧືⓗࣂ
ࣛࣥࢫ⬟ຊ࡟ ཬࡰࡍᙳ 㡪࡟ࡘ࠸࡚ ᳨ ドࡍࡿࡇ ࡜ࢆ┠ⓗ࡜ࡋ ࡚⾜࠸㸪 ௨ୗࡢ⤖ㄽ
ࢆᚓࡓ㸬
1)
ྑ㊊㊑ᢕᥱຊ࡜㔜ᚰືᦂᛶࡢ㔜ᚰ⥲㌶㊧㛗㸪㔜ᚰ༢఩㌶㊧㛗࡜ࡢ㛵ಀ࡟᭷
ព࡞㈇ࡢప࠸ ┦㛵ࡀㄆ ࡵࡽࢀࡓ㸬
115
2)
ྑ㊊㊑ᢕᥱຊࡢ኱ࡁ࠸⩌ࡣᑠࡉ࠸⩌࡜ẚ㍑ࡋ㸪㔜ᚰືᦂᛶࡢ㔜ᚰ⥲㌶㊧㛗
࡜㔜ᚰ༢఩㌶ ㊧㛗 ࡟࠾ ࠸࡚㸪᭷ព࡟ ㌶㊧㛗ࡀ ▷࠿ࡗࡓ㸬
3)
ᕥ㊊㊑ᢕᥱ ຊࡢ ኱ ࡁ࠸ ⩌ࡣᑠࡉ࠸ ⩌ ࡜ẚ ㍑ࡋ 㸪 Star Excursion Balance Test
ࡢ๓᪉࣮ࣜࢳ 㛗 ࡟࠾࠸ ࡚㸪᭷ព࡟ࣜ ࣮ࢳ㛗ࡀ 㛗࠿ࡗࡓ㸬
4)
㊊㊑ᢕᥱຊࡣ 㸪㟼ⓗ ࣂ ࣛࣥࢫಖᣢ⬟ ຊ࡜ࡢ㛵 㐃ᛶࢆ♧ࡋࡓ ࡇ࡜㸪ࡲ ࡓ㸪㊊
㊑ᢕᥱຊࡢ኱ᑠࡀ㟼ⓗ࠾ࡼࡧືⓗࣂࣛࣥࢫಖᣢ⬟ຊࡢ୍㒊࡟ᙳ㡪ࢆཬࡰࡋ㸪
㊊㊑ᢕᥱືస ࠾ࡼࡧ㊊ ㊑ᢕᥱຊྥୖ ࢚ࢡࢧࢧ ࢖ࢬࡀ㸪 㟼ⓗ ࠾ࡼࡧ ື ⓗࣂࣛ
ࣥࢫ⬟ຊྥୖ ࡟ ࡘ࡞ࡀ ࡿྍ⬟ᛶࡀ♧ ၀ࡉࢀࡓ 㸬
116
◊ ✲ 6 㟼 ⓗୗ ⫥࢔ ࣛ ࢖࣓ ࣥࢺ ࠾ ࡼࡧ ⫤㛵 ⠇ እ㌿ ➽ຊ ࡜ ࢻࣟ ࢵࣉ ࣂ ࣮ࢸ ࢕࢝ ࣝ
ࢪࣕ ࣥࣉ ᫬ ࡢୗ ⫥࢟ ࢿ ࣐ࢸ ࢕ࢡ ࢫ ࣭࢟ ࢿࢸ ࢕ ࢡࢫ ࡜ࡢ 㛵 㐃ᛶ
5-6-1. ⥴ゝ
௒᪥㸪ࢫ࣏࣮ࢶ ་Ꮫ ศ 㔝࡛ࡣ͂ࢫ࣏࣮ ࢶയᐖ ண㜵 ̓࡟↔Ⅼࡀ ࠶࡚ࡽ ࢀ 㸪㏆ᖺ㸪
⭸๓༑Ꮠ㠌ᖏ㸦anterior cruciate ligament㸸௨ ୗ㸪ACL㸧യᐖண㜵 ࣉ ࣟࢢ࣒ࣛ࡟㛵
ࡍࡿ◊✲ሗ࿌ ࡀከᩘࡳ ࡽࢀࡿ㸬ࡲࡓ㸪ACL യ ᐖண㜵ࢆ┠ⓗ ࡜ࡋࡓࢫ ࢡ࣮ࣜࢽࣥ
ࢢࢸࢫࢺࡢ୍ ࡘ࡜ࡋ࡚ 㸪ࢻࣟࢵࣉ ࣂ࣮ࢸ࢕ ࢝ ࣝ㸦ᆶ┤ 㸧ࢪࣕࣥ ࣉ㸦 drop vertical
jump㸸௨ୗ㸪DVJ㸧ࢸࢫࢺࡀ᥎ዡࡉࢀ ࡚࠸ࡿ [Hewett et al., 2006; Noyes et al., 2005]㸬
ࡇࢀࡣ╔ᆅື స᫬࡟ࡳ ࡽࢀࡿ㐣๫࡞ ⭸㛵⠇እ ཯⫥఩➼࡟╔ ┠ࡋ 㸪≉ ᚩⓗ࡞ୗ⫥
࢔ࣛ࢖࣓ࣥࢺ ࢆ࿊ࡍࡿ ⪅ࢆࢫࢡ࣮ࣜ ࢽࣥࢢ ࡋ ࡚㸪ACL യᐖࣜࢫࢡࢆ ุูࡍࡿ ࡇ
࡜ࢆ┠ⓗ࡜ࡋ ࡓ ࢸࢫࢺ ἲ࡛࠶ࡿ 㸬ᐇ㦂ᐊ ෆ࡛ ⾜ࢃࢀࡓ DVJ ືసࡸ ྎୖ࠿ࡽࡢ╔
ᆅືస᫬ࡢୗ ⫥࢔ࣛ࢖ ࣓ࣥࢺࢆ ศᯒ ࡋࡓሗ࿌ ࡟ࡼࡿ࡜㸪≉ ࡟ዪᛶ࢔ ࢫ࣮ࣜࢺ ࡣ
⏨ᛶ࢔ࢫ࣮ࣜ ࢺ࡟ẚ࡭ 㸪⭸㛵⠇እ཯ ゅᗘ㸪 ⫤ 㛵⠇ෆ㌿ゅᗘ ࡸ⫤㛵⠇ ෆ᪕ゅᗘࡀ
኱ࡁ࠸ࡇ࡜ࡸ[Borotikar et al., 2008; Ford et al., 2003; Ford et al., 2006; Hewett et
al., 2006; Hughesa et al., 2009; Kernozak et al., 2006; Pappas et al., 2007; Russell et
al., 2006; Schmitz et al., 2009; Zeller et al., 2003]㸪ᗋ཯ຊࡀ᭷ព ࡟ 㧗࠸ࡇ࡜ࡀከ
ᩘሗ࿌ࡉࢀ࡚ ࠸ࡿ [Pappas et al., 2007; Salci et al., 2004; Schmitz et al., 2007 ]㸬௒
᪥㸪ዪᛶ࢔ࢫ ࣮ࣜࢺ ࡀ ♧ࡍ≉ᚩⓗ࡞ ືⓗୗ⫥ ࢔ࣛ࢖࣓ࣥࢺ ࡀዪᛶ࢔ ࢫ࣮ࣜࢺࡢ
ACL യᐖࡀከ࠸せ ᅉ ࡢ ୍ࡘ࡜ࡉࢀ㸪╔ ᆅື స᫬ࡢ 㐣๫࡞ ⭸㛵⠇እ ཯⫥఩ࡸ⫤㛵
⠇ෆ㌿࠾ࡼࡧ ෆ᪕ືస 㸪ࡑࡋ࡚㧗࠸ ᗋ཯ຊࡀ യᐖࣜࢫࢡ࡜ ࡞ࡿࡇ࡜ ࡛ ࢥࣥࢭࣥ
ࢧࢫࡀᚓࡽࢀ ࡚࠸ࡿ [Renstrom et al., 2008]㸬
ACL യ ᐖ ࡢ ෆ ⓗ せ ᅉ ࡢ ୍ ࡘ ࡛ ࠶ ࡿ ㌟ య ⓗ ≉ ᛶ ࡜ ࡢ 㛵 㐃 ᛶ ࡟ 㛵 ࡍ ࡿ ඛ ⾜ ሗ ࿌
ࡣ㸪ከࡃࡣᚋࢁ ྥࡁ◊ ✲ ࡟ࡼࡿࡶࡢ ࡛࠶ࡿࡀ 㸪ACL യᐖ⩌࡜㠀യ ᐖ ⩌࡜ࡢ㟼ⓗ
ୗ⫥࢔ࣛ࢖࣓ࣥࢺࡸ㛵⠇ྍືᇦ➼ࡢẚ㍑᳨ド࡟㛵ࡍࡿࡶࡢࡀᩓぢࡉࢀࡿ
[Beckett et al., 1992; Bonci, 1999; Hertel et al., 2004; Loudon et al., 1996; Moul,
1998; Myer et al., 2008; Ramesh et al., 2005; Shelbourne et al., 1998; Swanik et al.,
2007; Uhorchak et al., 2003; Woodford-Rogers et al., 1994]㸬ࡑࢀࡽࡣ Q-angle[Bonci,
1999; Hertel et al., 2004; Loudon et al., 1996]㸪⯚≧㦵ỿ㝆ᗘ ࢸࢫࢺ㸦 Navicular drop
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test score㸸௨ୗ㸪NDTS㸧[Allen and Glasoe, 2000; Beckett et al., 1992; Bonci, 1999;
Hertel et al., 2004; Loudon et al., 1996; Smith et al., 1997; Woodford-Rogers et al.,
1994]㸪඲㌟ᘱ⦆ ᛶࢸ ࢫࢺ㸦 General joint laxity test㸸௨ୗ㸪GJLT㸧[Ramesh et al.,
2005; Uhorchak et al., 2003]㸪⬯㦵᤬㌿ ゅᗘ㸦 Thigh-transmalleolar angle㸸௨ୗ㸪
TMA㸧[Bonci, 1999]㸪⫤㛵⠇ෆ᪕ゅ ᗘ㸦Hip internal rotation㸸௨ୗ㸪HIR㸧[Hertel
et al., 2004]➼࡛࠶ࡿ㸬 ࡲࡓ㸪ᐇ㦂ᐊ ࣞ࣋ࣝ ࡛ ࡢࣂ࢖࣓࢜࢝ ࢽࢡࢫⓗ ࡟᳨ドࡉࢀ
ࡓືసᐇ㦂࡟ ࠾࠸࡚㸪 ⫤㛵⠇እ㌿➽ ຊ࡜ືⓗ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺ࡜ࡢ 㛵㐃ᛶ ࡟ࡘ
࠸࡚ከᩘሗ࿌ ࡉࢀ࡚࠸ ࡿ ࡯࠿[Zazulak et al., 2005; Zeller et al., 2003]㸪ࢪࣕࣥࣉ
࠿ࡽࡢ ╔ᆅ᫬ ࡟ ⏕ ࡌࡿ ᗋ཯ຊ ࡢ኱ᑠ࡜ ACL യᐖ࡜ ࡢ㛵㐃 ᛶ࡟ ࡘ࠸ ࡚ࡶ 」 ᩘሗ
࿌ࡉࢀ࡚࠸ࡿ[Pappas et al., 2007; Salci et al., 2004; Schmitz et al., 2007 ]㸬ࡑࡢ࡯
࠿╔ᆅ᫬࡟ࡳ ࡽࢀࡿ▮ ≧㠃࠿ࡽࡳࡓ ⭸㛵⠇㸪 ⫤㛵⠇㸪㊊㛵 ⠇ࡢ 㛵⠇ ྍືᇦࡸ╔
ᆅ⾪ᧁ྾཰࡬ ཬࡰࡍᙳ 㡪࡟ 㛵ࡍࡿሗ ࿌ࡶ 」ᩘ ࡳࡽࢀࡿ[Decker et al., 2006; Devita and Skelly, 1992; Kernozak et al., 2005; Schot et al., 1994; Zhang, 2000]㸬㊊㒊㸪
ୗ⭣㸪⭸㛵 ⠇࠾ࡼࡧ ⫤ 㛵⠇ࡢ 㟼ⓗ࠾ ࡼࡧືⓗ ୗ⫥࢔ࣛ࢖࣓ ࣥࢺ ࡜ ACL യᐖ࣓࢝
ࢽࢬ࣒࡜ࡢ㛵 㐃ᛶ ࡟ࡘ ࠸࡚ࡣ㸪㛵⠇ 㐠ື㐃㙐 ࡜ࡋ࡚ 㸪㐣ᗘ ࡞㊊㒊ᅇ ෆ ືసࡀ⬯
㦵ෆ᪕࡟ᑟࡁ[Anderson et al., 2009]㸪ࡉࡽ࡟ ⭸㛵⠇እ཯㸦 ⭸㛵⠇ෆ ᪕㸧࠾ࡼࡧ ⫤
㛵 ⠇ ෆ ㌿ ࣭ ෆ ᪕ ື స ࡟ ᑟ ࡃ ࡜ ࠸ ࡗ ࡓ 㐠 ື 㐃 㙐 ࡀ ♧ ࡉ ࢀ ࡚ ࠸ ࡿ [Powers, 2003;
Schamberger, 2002; Tiberio, 1987]㸬ࡇࢀࡽ ࡢከᩘࡢሗ࿌ ࠿ࡽ㸪㌟ య≉ᛶ࡜ ACL
യᐖ࡜ ࡢ㛵㐃 ᛶ ࡸ ACL യᐖࣜࢫ ࢡ࡜࡞ ࡿ ╔ᆅື స᫬ࡢ ⭸㛵 ⠇እ ཯ࡸ⫤ 㛵⠇ෆ
㌿ືస࡟ࡘ࠸ ࡚♧ࡉࢀ ࡚࠸ࡿࡀ 㸪ᮏ◊✲࡛ ࡣ 㸪㌟య≉ᛶ ࡀ ACL യ ᐖࣜࢫࢡ࡜࡞
ࡿ╔ᆅືస᫬ ࡢ⭸㛵⠇ እ཯ࡸ⫤㛵⠇ ෆ㌿ືస ࡜ࡢ㛵㐃ᛶ࡟ ࡘ࠸᳨࡚ ドࡍࡿࡇ࡜
ࢆ┠ⓗ࡜ࡋ࡚㸪㊊㒊㸪ୗ⭣㸪⭸㛵⠇㸪⫤ 㛵⠇ ࡢ㟼ⓗ࢔ࣛ࢖ ࣓ࣥࢺ㸪㛵⠇ྍືᇦ㸪
ୗ ⫥ ➽ ຊ ➼ ࡢ ㌟ య ⓗ ≉ ᛶ ࡜ ࢫ ࢡ ࣜ ࣮ ࢽ ࣥ ࢢ ࢸ ࢫ ࢺ ࡜ ࡋ ࡚ ᥎ ዡ ࡉ ࢀ ࡚ ࠸ ࡿ DVJ
ືస᫬ࡢୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺ࡜ࡢ㛵㐃 ᛶ࡟ࡘ࠸ ࡚ ᳨ドࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ࡚ ⾜ࡗ
ࡓ㸬
118
5-6-2. ᑐ㇟࡜᪉ἲ
1. ᑐ㇟
ᑐ㇟ࡣ㸪኱Ꮫ ዪᏊ ࢔ࢫ ࣮ࣜࢺ 12 ྡ࡛࠶ ࡾ㸪ᖹᆒᖺ㱋㸦±ᶆ‽೫ᕪ㸧ࡣ 19.3 ± 0.9
ṓ㸪㌟㛗 159.2 ± 5.4cm㸪య㔜 55.3 ± 5.1kg ࡛ ࠶ࡗࡓ㸬஦๓ ࡟ᮏᐇ㦂 ࡛⾜࠺ㄢ㢟
ືసࡢᐇ᪋࡟ ࠶ࡓࡾ㸪 ୗ⫥࡬ࡢᨭ㞀 ࡀ ࡞࠸ࡇ ࡜ࢆ☜ㄆࡋࡓ 㸬ࡲࡓ㸪 ᑐ㇟⪅࡟◊
✲ࡢ┠ⓗࡸ᪉ ἲ㸪೔⌮ ⓗ㓄៖➼࡟㛵 ࡍࡿㄝ᫂ ࢆ⾜࠸㸪ྠព ࢆᚓ ࡓ㸬 ᑦ㸪ᮏ◊✲
࡛⾜ࡗࡓᐇ㦂 ᑐ㇟⪅ࡣ 㸪◊✲ 3 ࡛ ⾜ࡗࡓᐇ㦂 ᑐ㇟⪅ࡀ୍㒊 ྵࡲࢀ࡚ ࠸ࡿ㸬ᮏ◊
✲ࡣ㸪᪩ ✄⏣኱Ꮫேࢆ ᑐ㇟࡜ࡍࡿ◊ ✲࡟㛵ࡍ ࡿ೔⌮ᑂᰝጤ ဨ఍ ࡢᢎ ㄆࢆᚓ࡚ᐇ
᪋ࡋࡓ㸦ᢎㄆ ␒ྕ 2010-037㸧㸬
2. ᐃ᪉ἲ
a. 㟼ⓗୗ⫥࢔ࣛ ࢖࣓ ࣥࢺ
௨ୗ࡟ྛ ᐃ 㡯┠ ࠾ࡼ ࡧ ᐃ᪉ἲࢆ ♧ࡍ㸬࡞ ࠾㸪඲࡚ࡢ ᐃ ࡣྑ⬮ ࢆᑐ㇟
࡟⾜ࡗࡓ㸬
1) Leg-heel angle㸦௨ୗ㸪LHA㸧
୧⬮❧఩ ࡛ࡘࡲඛ ࢆṇ㠃࡟ྥࡅ ࡚㸪୧⬮ ࡟ᆒ➼࡟య㔜 ࢆ࠿ࡅࡉ ࡏ ࡚❧ࡓࡏ
ࡓ≧ែ࡛㸪ୗ ⭣㒊㐲 ఩ 3 ศࡢ 1 ࡜ ㋖㦵ࢆ஧ ➼ศࡍࡿ⥺ࡢ ࡞ࡍ ゅᗘ ࢆ ᐃࡋࡓ
[Haight, 2005]㸦ᅗ 6-1㸧㸬
ᅗ 6-1
Leg-heel angle ᐃ[Haight, 2005]
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2) NDTS㸦Navicular drop test score㸪⯚≧㦵 ỿ㝆ᗘࢸࢫࢺ 㸧
Brody㸦1982㸧ࡢ ᪉ἲࢆཧ⪃࡟ ⾜ࡗࡓ 㸬᭱ึ࡟➃ᗙ఩ ࡛㊊㛵⠇ ࢆࢽ࣮ࣗࢺࣛ
࣏ࣝࢪࢩ ࣙࣥ࡟ ಖᣢࡉ ࡏࡓ≧ែ ࡛ [Brody, 1982]㸪ᗋ࠿ࡽ⯚ ≧ 㦵⤖ ⠇ࡲ࡛㧗 ࡉ
㸦 mm㸧 ࢆ ᐃ ࡋ 㸪 ḟ ࡟ ❧ ఩ ጼ ໃ ࢆ ࡜ ࡽ ࡏ 㸪 ୧ ⬮ ࡟ ᆒ ➼ ࡟ య 㔜 ࢆ ࠿ ࡅ ࡉ ࡏ ࡓ
≧ែ࡛㸪ྠࡌࡃᗋ࠿ ࡽ ⯚≧㦵⤖⠇ࡲ ࡛㧗ࡉ㸦 mm㸧ࢆ ᐃ ࡋࡓ㸦 ᅗ 6-2㸧㸬➃
ᗙ఩ጼໃ᫬࡟ ᚓࡽࢀࡓ ್㸦 mm㸧ࢆ❧఩ ጼໃ ᫬࡟ᚓࡽࢀࡓ ್㸦 mm㸧࡛ῶࡌࡓ
್ࢆ NDTS ࡜ࡋࡓ㸬
ᅗ 6-2
Navicular drop test ᐃ[Beckett, 1992]
3) ࢔࣮ࢳ㧗⋡㸦 Arch index㸸௨ୗ㸪AI㸧
ඛ⾜ㄽᩥ[McCrory et al., 1997]ࢆཧ⪃࡟㸪୧⬮❧఩࡛ࡘ ࡲඛࢆṇ 㠃࡟ྥࡅ ࡚ 㸪
୧⬮࡟ᆒ➼࡟ య㔜ࢆ࠿ ࡅࡉࡏ ࡚❧ࡓ ࡏࡓ ≧ែ ࡛㸪ᗋ࠿ࡽ⯚ ≧㦵 ⤖⠇ ࡲ࡛ࡢ㧗
ࡉ㸦mm㸧ࢆ ᐃ ࡋࡓ 㸬ḟ࡟㊊㛗㸦 mm㸧ࢆ ᐃࡋࡓ㸬㊊ 㛗ࡣ㸪㋖ 㦵ᚋ➃࠿ࡽ
㊊㊑ඛ➃㸦᭱ 㛗㒊㸧ࡲ ࡛ࡢ㊥㞳࡜ࡋ ࡓ㸬୧⬮ ❧఩᫬ࡢᗋ࠿ ࡽ⯚≧㦵 ⤖⠇ࡢ㧗
ࡉ㸦 mm㸧ࢆ㊊ 㛗㸦 mm㸧࡛㝖ࡋࡓ್ ࡟ 100 ࢆ஌ࡌࡓ್ ࢆ AI ࡜ ࡋࡓ 㸬
120
4) Q-angle
୧⬮❧఩࡛ࡘ ࡲඛࢆṇ 㠃࡟ྥࡅ ࡚㸪 ୧⬮࡟ᆒ ➼࡟య㔜ࢆ࠿ ࡅ ࡚❧ࡓ ࡏࡓ≧
ែ࡛ ᐃࡋࡓ 㸬 ୖ๓⭠ 㦵Ჲ࡜⭸⵹㦵 ୰ኸ࠾ࡼ ࡧ⭸⵹㦵୰ኸ ࡜⬯㦵⢒ 㠃ࢆ⤖ࢇ
ࡔ⥺ࡢ࡞ࡍゅ ᗘࢆ ᐃ ࡋࡓ [Loudon et al., 1996]㸦ᅗ 6-3㸧㸬
ᅗ 6-3 Q-angle ᐃ[Bonci, 1999]
5) TMA㸦Thigh-transmalleolar angle㸪⬯㦵 ᤬㌿ゅᗘ 㸧
ඛ⾜ㄽᩥ[Staheli et al., 1985]ࢆཧ⪃࡟㸪 ⭡⮩఩࡟࡚⭸ 㛵⠇ 90°ᒅ᭤఩㸪㊊㛵
⠇୰㛫఩࡟ಖ ᣢࡉࡏࡓ ≧ែ࡛ ᐃࡋ ࡓ㸬 ෆᯝ ࡜እᯝࢆ⤖ࢇ ࡔ⥺ ࡜኱ ⭣㒊ࡢ㛗
㍈ࡢ࡞ࡍゅᗘ ࢆ ᐃࡋ ࡓ 㸦ᅗ 6-4㸧㸬
ᅗ 6-4 Thigh-transmalleolar angle ᐃ[Güven, 2009]
121
6) Thigh-foot angle㸦௨ୗ㸪TFA㸧
ඛ⾜ㄽᩥ[Stuberg et al., 1991]ࢆཧ⪃࡟㸪⭡⮩఩࡟࡚⭸ 㛵⠇ 90°ᒅ᭤఩㸪㊊㛵
⠇୰㛫఩࡟ಖ ᣢࡉࡏࡓ ≧ែ࡛ ᐃࡋ ࡓ㸬 ㊊㒊 㛗㍈࡜኱⭣㒊 ࡢ㛗㍈ ࡢ ࡞ࡍゅᗘ
ࢆ ᐃࡋࡓ㸦 ᅗ 6-5㸧 㸬
ᅗ 6-5 Thigh-foot angle ᐃ[Stuberg, 1991]
7) ኱⭣㦵㢕㒊๓᤬ ゅ ᗘ㸦 Femoral anteversion angle㸧㸦Craig’s test㸧㸦௨ୗ㸪
FAA㸧
ඛ⾜◊✲[Cibulka, 2004]ࢆཧ⪃࡟㸪⭡⮩ ఩ ࡟࡚⭸ 㛵 ⠇ 90°ᒅ᭤఩ ࡛㸪኱⭣㦵
኱㌿Ꮚࡀ᭱ࡶእഃ࡟఩⨨ࡋࡓ᫬ࡢ⬯㦵࡜ 㖄┤⥺ࡢ࡞ࡍゅᗘࢆ ᐃࡋࡓ㸦ᅗ
6-6㸧㸬
ᅗ 6-6 Femoral anteversion angle[Nguyen and Shultz, 2007]
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b. 㛵⠇ゅᗘ
1) HIR㸦Hip internal rotation㸪⫤㛵⠇ ෆ᪕ゅ ᗘ 㸧
᪥ᮏᩚᙧእ⛉Ꮫ఍࠾ࡼࡧࣜࣁࣅࣜࢸ࣮ࢩࣙࣥ་Ꮫ఍ࡢ㛵⠇ྍືᇦ⾲♧࡞
ࡽࡧ࡟ ᐃἲ ࢆཧ⪃࡟ ⾜ࡗࡓ[㛵⠇ྍືᇦ ⾲ ♧࡞ࡽࡧ࡟ ᐃἲ , 1995]㸬➃ᗙ఩
⫥఩࡟࡚⫤㛵 ⠇ ෆ᪕ゅ ᗘࢆ ᐃࡋࡓ 㸬
2) ㊊ 㛵 ⠇ ⫼ ᒅ ゅ ᗘ 㸦 ⭸ 㛵 ⠇ ఙ ᒎ 㸪 Ⲵ 㔜 ఩ 㸧 㸦 Ankle dorsiflexion with knee
extension㸸௨ୗ㸪 ADKE㸧
HIR ྠ ᵝ ࡟ 㛵 ⠇ ྍ ື ᇦ ⾲ ♧ ࡞ ࡽ ࡧ ࡟ ᐃ ἲ ࢆ ཧ ⪃ ࡟ ⾜ ࡗ ࡓ [㛵 ⠇ ྍ ື ᇦ ⾲
♧࡞ࡽࡧ࡟ ᐃἲ , 1995]㸬❧఩࡛ ⭸㛵⠇ࢆఙ ᒎ఩࡟ࡉࡏ࡚ 㸪㋖ ࢆᾋ ࠿ࡏ࡞࠸
࡛㊊㛵⠇ࢆྍ ⬟࡞㝈ࡾ ⫼ᒅࡉࡏࡓ ᫬ ࡢ㛵⠇ゅ ᗘ ࢆ ᐃࡋࡓ 㸬
3) ㊊ 㛵 ⠇ ⫼ ᒅ ゅ ᗘ 㸦 ⭸ 㛵 ⠇ ᒅ ᭤ 㸪 Ⲵ 㔜 ఩ 㸧 㸦 Ankle dorsiflexion with knee
flexion㸸௨ୗ㸪 ADKF㸧
ADKE ྠᵝ㸪㛵 ⠇ྍ ືᇦ⾲♧࡞ࡽ ࡧ࡟ ᐃ ἲࢆཧ⪃࡟⾜ ࡗࡓ [㛵 ⠇ྍືᇦ⾲
♧࡞ࡽࡧ࡟ ᐃἲ , 1995]㸬❧఩࡛ ⭸㛵⠇ࢆᒅ ᭤఩࡟ࡉࡏ࡚ 㸪㋖ ࢆᾋ ࠿ࡏ࡞࠸
࡛㊊㛵⠇ࢆྍ ⬟࡞㝈ࡾ ⫼ᒅࡉࡏࡓ ᫬ ࡢ㛵⠇ゅ ᗘ ࢆ ᐃࡋࡓ 㸬
c. ඲㌟ᘱ⦆ᛶ
1) GJLT㸦General joint laxity test㸧
ᐃ 㡯 ┠ ࡣ 㸪 ᅜ ෆ ࡛ ከ ᩘ ᘬ ⏝ ࡉ ࢀ ࡚ ࠸ ࡿ ᮾ ኱ ᘧ ඲ ㌟ ᘱ ⦆ ᛶ ࢸ ࢫ ࢺ [୰ ᔱ ࡽ ,
1984]࡛ᐇ᪋ࡉࢀ࡚ ࠸ ࡿ 7 㡯┠㸦ᡭ㤳㸪 ⫝ 㸪⫪㸪⬨ᰕ㸪 ⫤㛵⠇㸪 ⭸㸪㊊㛵⠇ 㸧
࡜ࡋࡓ㸬⥲ ィ 7 Ⅼ࡜ࡋ ࡚㝧ᛶⅬᩘࢆ ⟬ฟࡋࡓ 㸬
d. ⫤㛵⠇➽ຊ
1) HAS㸦hip abduction strength㸪⫤㛵⠇እ㌿ ➽ຊ 㸧
ᚐᡭ➽ຊ ᐃἲ [Kendall et al., 2005]ࢆཧ⪃ ࡟㸪ഃ⮩఩ 㸪⭸㛵 ⠇ ఙ ᒎ఩࡜ࡋ㸪
⫤㛵⠇እ ㌿ 30r⫥఩ ࢆ࡜ࡽࡏࡓ≧ ែ ࡛㸪኱ ⭣㦵እഃୖ㢛 ࡟ࣁࣥࢻ ࣊ࣝࢻࢲ࢖
ࢼ࣓࣮ࣔࢱ࣮㸦 MicroFET, Hogan Health Industries Inc.㸧ࢆ࠶࡚㸪5 ⛊㛫᭱኱ດ
ຊ࡛ ࡢ ⫤ 㛵⠇ እ ㌿ 㐠ື ࢆ ⾜ ࢃ ࡏ ࡓ㸦 ᅗ 6-7㸧 㸬ᚓ ࡽ ࢀ ࡓ್ ࢆ ㌟ 㛗࡜ య㔜 ࢆ஌
ࡌࡓࡶࡢ࡛㝖 ࡋ ࡚㸦N/(㌟㛗™య㔜 )㸧ṇつ໬ ࡋࡓ㸬
123
ᅗ 6-7 ⫤㛵⠇እ ㌿➽ ຊ [Krause, 2007]
3. ㄢ㢟ືస
ㄢ㢟ືస ࡣ 30cm 㧗ࡢ ྎୖ࠿ࡽࡢ୧ ⬮ DVJ ࡜ࡋࡓ㸬᭱ึ࡟ ⿕㦂⪅ ࡟ ྎୖ࡟୧
⬮࡛❧ࡓࡏ㸪 ྜᅗ࡜࡜ ࡶ࡟୧⬮࡟࡚ 㣕ࡧ㝆ࡾ 㸪╔ᆅᚋࡍࡄ ࡟ ᭱኱ດ ຊ࡛ 㖄┤᪉
ྥ࡬ࡢࢪࣕࣥ ࣉࢆ⾜ࢃ ࡏࡓ㸬ྎ ୖ࠿ࡽࡢ ╔ᆅ ᫬࠾ࡼࡧࢪࣕ ࣥࣉࡋࡓ ᚋࡢ╔ᆅࡣ 㸪
ྑ⬮ࢆᗋ཯ຊ ィୖ࡟╔ ᆅࡉࡏࡿࡼ࠺ ᣦ♧ࡋࡓ 㸬 ࡲࡓ㸪ࢪࣕ ࣥࣉ᫬࡟ ୧ᡭࢆኳ஭
᪉ྥ࡟ᣲࡆࡉ ࡏ࡞ࡀࡽ 㸦ࣂࢫࢣࢵࢺ ࣮࣎ࣝࡢ ࣜࣂ࢘ࣥࢻື స ࢆ࡜ࡿ ࡼ࠺࡟ 㸧ࢪ
ࣕࣥࣉࡉࡏࡓ㸦ᅗ 6-8㸧㸬3 ᅇࡢᡂຌ ヨᢏ ࢆ グ㘓ࡋࡓ㸬ᑦ 㸪௨ୗࡢ ヨᢏࡀࡳࡽࢀ
ࡓሙྜࡣ↓ຠ ࡜ࡋ㸪୍ ᪦ⴠࡕ╔࠿ࡏ ࡓᚋ࡟෌ ヨᢏࢆ⾜ࢃࡏ ࡓ㸬1㸧ྎୖ࠿ࡽࡢ╔
ᆅ࠾ࡼࡧ㖄┤ ᪉ྥ ࡬ࡢ ࢪࣕࣥࣉᚋࡢ ╔ᆅ᫬࡟ ྑ⬮ࡀᗋ཯ຊ ィୖ࡟஌ ࡽ࡞࠿ࡗࡓ
ሙྜ㸪2㸧ࢪࣕࣥ ࣉᚋ ࡢ╔ᆅືస࡛ 㸪Ᏻᐃࡋ ࡓ╔ᆅࡀฟ᮶ ࡞࠿ࡗࡓ ሙྜ࡜ࡋࡓ 㸬
a. initial contact
ᅗ 6-8
b. landing
ࢻࣟࢵࣉ ࣂ࣮ ࢸ࢕࢝ࣝࢪࣕ ࣥࣉ㸸 㸦 a㸧㊊㒊ࡢ୍㒊ࡀᗋ ࡟ ᥋ᆅࡋࡓ᫬㸪
㸦b㸧᭱኱ࡋࡷࡀ ࡳࡇ ࡳ᫬㸪㸦 c㸧ᗋ࠿ࡽ ࡘ ࡲඛࡀ㞳ࢀࡓ ᫬
124
c. take off
4. ືసィ ືసࡢィ ᪉ ἲ࠾ࡼࡧ ࣓࢝ࣛࢭࢵࢸ ࢕ࣥࢢ㸪 ཯ᑕ࣐࣮࣮࢝ ࡢ㈞௜఩ ⨨➼࡟ࡘ
࠸࡚ࡣ◊ ✲ 5[బ㔝ᮧࡽ , 2012-3]࠾ࡼࡧ◊ ✲ 6 ࡟♧ࡋࡓ㏻ࡾ ࡛࠶ࡿ㸬
5. ࢹ࣮ࢱゎᯒ
ࢹ࣮ࢱゎᯒ ᪉ἲࡶ◊ ✲ 5[బ㔝ᮧࡽ, 2012-3]࠾ࡼࡧ◊ ✲ 6 ྠᵝ࡛࠶ ࡾ㸪ゎᯒ⠊
ᅖࡣ㊊㒊ࡢ୍ 㒊ࡀᗋ࡟ ᥋ᆅࡋࡓ᫬Ⅼ 㸦 initial contact㸪௨ୗ IC㸧࠿ ࡽࡘࡲඛࡀᗋ
࠿ࡽ㞳ࢀࡓ᫬ Ⅼ㸦 toe off㸪௨ୗ TO㸧ࡲ࡛ ࢆ Landing phase ࡜ࡋ࡚ 㸪Landing phase
ࡢ IC ᫬ ࠿ࡽ 30㸣᫬Ⅼ ࡲ࡛ ࡜ࡋࡓ㸬 IC ᫬࠿ ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟
ࡳࡽࢀࡓྛ㡯 ࡢ᭱኱್ ࢆࣃ࣓࣮ࣛࢱ ࡜ࡋࡓ⌮ ⏤ࡣ㸪◊✲ 3㸪4 ྠᵝ࡛ 㖄┤᪉ྥ࡬
ࡢ᭱኱ᗋ཯ຊ ࡢࣆ࣮ࢡ ࡀ IC ᫬ ᚋ㸪Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛ ࡟ࡳࡽ ࢀࡓࡇ
࡜㸪ᐇ㝿ࡢ ACL യᐖࡀ IC ᫬ᚋ࡟ ࡳࡽࢀࡿ ᭱኱ᗋ཯ຊࡢ ࣆ࣮ࢡ௜ ㏆࡛Ⓨ⏕ࡋ࡚
࠸ࡿࡇ࡜ࡀከ ᩘሗ࿌ࡉ ࢀ࡚࠸ࡿⅭ࡛ ࠶ࡿ㸬 ᗋ ཯ຊࢹ࣮ࢱࡣ ㏫ࢲ࢖ࢼ ࣑ࢡࢫࢆ⏝
࠸࡚⭸㛵⠇እ ㌿࣮࣓ࣔ ࣥࢺ ࡜⫤㛵⠇ ෆ㌿࣮ࣔ ࣓ࣥࢺࢆ⟬ฟ ࡋࡓ㸬㛵 ⠇࣮࣓ࣔࣥ
ࢺࡣእⓗ࣮ࣔ ࣓ࣥࢺ࡜ ࡋ࡚ィ⟬ࡋ 㸪 ྛ㛵⠇ࣔ ࣮࣓ࣥࢺࡣᑐ ㇟⪅ࡢ㌟ 㛗࡜య㔜ࡢ
✚࡛㝖ࡍࡿࡇ ࡜࡛ ṇつ ໬ࡋࡓ㸬ࣃࣛ ࣓࣮ࢱࡣ ᭱኱⭸㛵⠇እ ㌿ゅᗘ 㸪 ᭱኱⫤㛵⠇
ෆ㌿ゅᗘ࠾ࡼ ࡧ᭱኱⫤ 㛵⠇ ෆ᪕ゅᗘ 㸪᭱኱⭸ 㛵⠇እ㌿࣮ࣔ ࣓ࣥࢺ 㸪 ᭱኱⫤㛵⠇
ෆ㌿ࣔ ࣮࣓ࣥ ࢺ࠾ ࡼࡧ ᭱኱⫤ 㛵⠇ෆ ᪕ࣔ ࣮࣓ ࣥࢺ㸪 㖄┤᪉ ྥ㸦 z ㍈ 㸧࡬ࡢ ᭱኱
ᗋ཯ຊ࡜ࡋࡓ 㸬ࡲࡓ 㸪IC ᫬࠿ࡽ 30㸣᫬Ⅼ ࡲ ࡛ ࡢ⭸㛵⠇እ ㌿ゅᗘ ೫ ఩㔞㸪⫤㛵 ⠇
ෆ㌿ゅᗘ೫఩ 㔞㸪⫤㛵 ⠇ෆ᪕ ゅᗘ೫ ఩㔞࡜ࡋ ࡓ㸬
⤫ィᏛⓗゎᯒ ࡣ LHA㸪NDTS㸪AI㸪Q-angle㸪TMA㸪TFA㸪FAA㸪HIR㸪ADKE㸪
ADKF㸪GJLT㸪HAS ࡜ DVJ ືస᫬ࡢ Landing phase ࡢ IC ᫬࠿ ࡽ Landing phase
ࡢ 30㸣᫬Ⅼࡲ࡛࡟ ࡳ ࡽࢀࡓ ᭱኱⭸ 㛵⠇እ㌿ ゅᗘ 㸪᭱኱⫤㛵 ⠇ෆ㌿ ࠾ࡼࡧෆ᪕ゅ
ᗘ㸪᭱኱⭸㛵⠇ እ㌿ࣔ ࣮࣓ࣥࢺ 㸪᭱኱ ⫤㛵⠇ ෆ㌿ ࠾ࡼࡧෆ ᪕࣮࣓ࣔ ࣥࢺ 㸪IC ᫬
࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛ ࡟ࡳࡽࢀ ࡓ ⭸㛵⠇እ㌿ ゅᗘ ೫఩ 㔞㸪⫤㛵⠇
ෆ㌿࠾ࡼࡧෆ ᪕ゅᗘ೫ ఩㔞㸪㖄┤᪉ ྥ࡬ࡢ᭱ ኱ᗋ཯ຊ ࡜ࡢ ┦㛵㛵ಀ ࢆ㸪ࣆ࢔ࢯ
ࣥࡢ┦㛵ಀᩘ ࢆ⏝࠸࡚ ᳨ウࡋࡓ㸬ᑦ 㸪᭷ពỈ ‽ࡣ 5㸣ᮍ‶࡜ ࡋࡓ㸬
125
5-6-3. ⤖ᯝ
LHA㸪NDTS㸪AI㸪Q-angle㸪TMA㸪TFA㸪FAA㸪HIR㸪ADKE㸪ADKF㸪GJLT㸪
HAS ࡢᖹᆒ್㸦sᶆ ‽೫ᕪ㸧ࢆ ⾲ 6-1 ࡟♧ ࡍ㸬
126
Landing phase ࡢ IC ᫬ ࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛࡟ࡳ ࡽࢀ ࡓ᭱኱⭸㛵
⠇እ㌿ゅᗘ㸪 ᭱኱⫤㛵 ⠇ෆ㌿ ࠾ࡼࡧ ෆ᪕ ゅᗘ 㸪᭱኱⭸㛵⠇ እ㌿࣮ࣔ ࣓ࣥࢺ 㸪᭱
኱⫤㛵⠇ෆ㌿ ࠾ࡼࡧෆ ᪕ ࣮࣓ࣔࣥࢺ 㸪 IC ᫬ ࠿ࡽ Landing phase ࡢ 30㸣᫬Ⅼࡲ࡛
࡟ࡳࡽࢀࡓ⭸ 㛵⠇እ㌿ ゅᗘ ೫఩㔞㸪 ⫤㛵⠇ෆ ㌿ ࠾ࡼࡧෆ᪕ ゅᗘ೫఩ 㔞㸪㖄┤᪉
ྥ㸦z ㍈㸧࡬ࡢ ᭱኱ᗋ ཯ຊࢆ⾲ 6-2 ࡟ ♧ࡍ㸬
127
ྛࣃ࣓࣮ࣛࢱ 㛫ࡢ┦㛵 㛵ಀࢆ⾲ 6-3 ࡟♧ࡍ 㸬 NDTS ࡜㖄┤᪉ྥ࡬ࡢ ᭱኱ᗋ཯
ຊ࡜ࡢ㛫࡟᭷ ព࡞୰⛬ ᗘࡢ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ㸦 r = -0.633㸪p = 0.027㸧㸬AI ࡜᭱
኱⫤㛵⠇ෆ᪕ ゅᗘ㸪 ⫤ 㛵⠇ෆ᪕ゅᗘ ೫఩㔞࡜ ࡢ 㛫࡟᭷ព࡞ ୰⛬ᗘࡢ ㈇ࡢ┦㛵ࢆ
♧ࡋ㸦ࡑࢀ ࡒࢀ r = -0.689㸪p = 0.013㸹r = -0.671㸪p = 0.017㸧㸪㖄 ┤᪉ྥ࡬ࡢ᭱
኱ᗋ཯ຊ࡜ࡢ 㛫࡟᭷ព ࡞ 㧗࠸ṇࡢ┦ 㛵ࢆ♧ࡋ ࡓ㸦 r = 0.892㸪p < 0.001㸧㸬Q-angle
࡜᭱኱⭸㛵⠇ እ㌿ゅᗘ 㸪⭸㛵⠇እ㌿ ゅᗘ ೫఩ 㔞࡜ࡢ㛫࡟᭷ ព࡞ ୰⛬ ᗘࡢṇࡢ┦
㛵ࢆ♧ࡋ㸦ࡑ ࢀࡒࢀ r = 0.654㸪p = 0.021㸹r = 0.590㸪p = 0.044㸧㸪 ᭱኱⫤㛵⠇
ෆ᪕ゅᗘ࡜ࡢ 㛫࡟᭷ព ࡞ 㧗࠸㈇ࡢ┦ 㛵ࢆ♧ࡋ ࡓ㸦 r = -0.744㸪p = 0.005㸧㸬ࡲࡓ㸪
᭱኱⭸㛵⠇እ㌿࣮࣓ࣔࣥࢺ࡜ࡢ㛫࡟᭷ព࡞୰⛬ᗘࡢ㈇ࡢ┦㛵ࢆ♧ࡋࡓ㸦r =
0.608㸪p = 0.036㸧㸬 TMA ࡜᭱኱⫤ 㛵⠇ෆ ᪕ゅᗘ㸪 ⫤㛵 ⠇ෆ᪕ゅ ᗘ೫఩㔞࡜ࡢ
㛫࡟᭷ព࡞୰ ⛬ᗘࡢ ㈇ ࡢ┦㛵ࢆ♧ࡋ ࡓ㸦ࡑ ࢀ ࡒࢀ r = -0.609㸪p = 0.036㸹r = -0.637㸪
p = 0.026㸧㸬TFA ࡜᭱ ኱⫤㛵⠇ෆ᪕ ゅᗘ࡜ࡢ 㛫࡟᭷ព࡞㧗 ࠸㈇ࡢ┦ 㛵ࢆ♧ࡋ㸦ࡑ
ࢀࡒࢀ r = -0.736㸪p = 0.006㸧㸪⭸㛵⠇እ ㌿ゅ ᗘ ೫఩㔞࡜ࡢ 㛫࡟᭷ព ࡞ ୰⛬ᗘࡢ
ṇࡢ┦㛵ࢆ♧ ࡋࡓ㸦 r = 0.589㸪p = 0.044㸧㸬FAA ࡜᭱኱⭸ 㛵⠇ እ㌿ゅᗘ 㸪⭸ 㛵
⠇እ㌿ゅᗘ೫఩㔞࡜ࡢ㛫࡟᭷ព࡞୰⛬ᗘࡢṇࡢ┦㛵ࢆ♧ࡋࡓ㸦ࡑࢀࡒࢀ r =
0.584㸪p = 0.046㸹r = 0.589㸪p = 0.045㸧㸬ADKE ࡜᭱኱⫤㛵 ⠇ෆ ㌿ ゅᗘ࡜ࡢ㛫
࡟᭷ព࡞୰⛬ ᗘࡢ ṇࡢ ┦㛵ࢆ♧ࡋ㸦 r = 0.596㸪p = 0.041㸧㸪㖄┤᪉ ྥ࡬ࡢ᭱኱
ᗋ཯ຊ࡜ࡢ㛫 ࡟᭷ព࡞ 㧗࠸㈇ࡢ┦㛵 ࢆ♧ࡋࡓ 㸦 r = -0.713㸪p = 0.009㸧㸬ADKF
࡜㖄┤᪉ྥ࡬ ࡢ᭱኱ᗋ ཯ຊ࡜ࡢ 㛫࡟ ᭷ព࡞㧗 ࠸㈇ࡢ┦㛵ࢆ ♧ࡋࡓ㸦 r = -0.729㸪
p = 0.007㸧㸬HAS ࡜᭱ ኱⭸㛵⠇እ㌿ ゅᗘ 㸪᭱ ኱⫤㛵⠇ෆ㌿ ゅᗘ㸪 ⭸ 㛵⠇እ㌿ゅ
ᗘ ೫ ఩ 㔞 ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ㈇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸦 ࡑ ࢀ ࡒ ࢀ r = -0.681㸪 p =
0.015㸹r = -0.635㸪p = 0.023㸹r = -0.697㸪p = 0.012㸧㸪⫤㛵⠇ ෆ᪕ ゅᗘ೫఩㔞࡜
ࡢ㛫࡟᭷ព࡞ ୰⛬ᗘࡢ ṇࡢ┦㛵ࢆ♧ ࡋࡓ㸦 r = 0.611㸪p = 0.035㸧 㸬ࡲࡓ㸪㖄┤
᪉ ྥ ࡬ ࡢ ᭱ ኱ ᗋ ཯ ຊ ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ 㧗 ࠸ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ ࡓ 㸦 r = 0.703 㸪 p =
0.011㸧㸬LHA ࠾ࡼ ࡧ HIR㸪GJLT ࡜ྛࣃࣛ ࣓࣮ࢱ࡜ࡢ 㛵 ಀ࡟࠾࠸ ࡚ ࡣ᭷ពᕪࡣ
ㄆࡵࡽࢀ࡞࠿ ࡗࡓ㸬
128
129
5-6-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪ACL യᐖࢆ ྵࡵࡓୗ⫥യ ᐖண㜵ࡢ ࡓࡵࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢸࢫࢺ࡜
ࡋ࡚⏝࠸ࡽࢀ ࡚࠸ ࡿ DVJ ືస᫬ࡢୗ⫥࢟ ࢿ ࣐ࢸ࢕ࢡࢫ࣭࢟ࢿ ࢸ࢕ ࢡࢫ࡜ୗ⫥࢔
ࣛ࢖࣓ࣥࢺ㸪 㛵⠇ྍື ᇦ㸪඲㌟ᘱ⦆ ᛶ㸪⫤㛵 ⠇እ㌿➽ຊ࡜ ࡢ㛵㐃ᛶ ࡟ࡘ࠸࡚ ᳨
ド ࡍ ࡿ ࡇ ࡜ ࢆ ┠ ⓗ ࡜ ࡋ ࡚ ⾜ ࡗ ࡓ 㸬 DVJ ື స ࡛ ࡳ ࡽ ࢀ ࡿ ⭸ 㛵 ⠇ እ ㌿ ࡸ ⫤ 㛵 ⠇ ෆ
㌿࣭ෆ᪕ືస࠾ࡼ ࡧ 㛵 ⠇࣮࣓ࣔࣥࢺ ࡜㌟యⓗ ≉ᛶ ࡜ࡢ㛵㐃 ᛶࢆ᳨ド ࡍࡿࡇ࡜࡛ 㸪
ࢫࢡ࣮ࣜࢽࣥ ࢢ ࢆ┠ⓗ ࡜ࡋࡓ DVJ ࢸࢫࢺࡢ ᐇ᪋࡟࠾࠸࡚ 㸪ୗ ⫥യ ᐖࣜࢫࢡ࡟ࡘ
࡞ࡀࡿྍ⬟ᛶ ࡢ࠶ࡿ㌟ య ᐃ 㡯┠ࢆ 㑅ᢥⓗ࡟ ᐃࡶࡋࡃࡣ ᥦ♧࡛ࡁ ࡿࡢ࡛ࡣ࡞
࠸࠿࡜࠸࠺ࡶ ࡢ࡛࠶ࡿ 㸬
ඛ⾜◊✲࠿ࡽ 㸪㟼ⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ࡜ୗ⫥ യᐖ㸪≉࡟⭸ 㛵⠇യᐖ ࡜ࡢ㛵㐃
ᛶ࡟㛵ࡍࡿከ ᩘࡢሗ࿌ ࡀࡳࡽࢀࡿ ࡀ 㸪ୗ⫥㛵 ⠇ࡢ࣐ࣝ࢔ࣛ ࢖࣓ࣥࢺ ࡟ࡼࡾ⏕ࡌ
ࡿ㐣ᗘ࡞㛵⠇ ࡢືࡁࡀ ⭸㛵⠇ࡢእ㌿ ࡸᅇ᪕ࢫ ࢺࣞࢫ࡟ཬࡰ ࡍᙳ㡪࡟ ࡘ࠸࡚ ᳨ド
ࡉࢀ࡚࠾ࡾ㸪 ᶵ⬟ゎ๗ Ꮫⓗ࠾ࡼࡧࣂ ࢖࣓࢝ࢽ ࢡࢫⓗ ほⅬ࠿ ࡽ㸪㊊㒊 㸪ୗ⭣㸪⫤
㛵⠇➼ࡢ㐠ື ࠿ࡽ⏕ࡌ ࡿ 㛵⠇㐠ື㐃 㙐ࡢ࣓࢝ ࢽࢬ࣒ ࡟ࡘ࠸ ࡚♧ࡋࡓ ሗ࿌ࡀ」ᩘ
ࡳ ࡽ ࢀ ࡿ [Levangie and Norkin, 2001; Neumann, 2002; Schamberger, 2002; Subotnick, 1989; Oatis, 2009]㸬㊊㒊ࡢ࢔ࣛ࢖࣓ ࣥࢺ ࠿ࡽ⏕ࡌ ࡿୗ⫥㛵 ⠇㐠ື 㐃㙐࡟
㛵ࡍࡿሗ࿌࡟ ࡼࡿ࡜㸪 㐣๫࡞㊊㒊ᅇ ෆࡀୗ⭣ ෆ᪕㐠ື࡟ᑟ ࡁ㸪ࡉࡽ ࡟ࡣ⭸㛵⠇
እ㌿㐠ື࡟ᑟ ࡃࡇ࡜ࡀ ሗ࿌ࡉࢀ࡚࠾ ࡾ㸪ࡲࡓ ⫤㛵⠇ ࡟ࡘ࠸ ࡚ࡣ㸪⫤ 㛵⠇ ෆ㌿࠾
ࡼࡧෆ᪕㐠ື ࡀ⭸㛵⠇ እ㌿ ࠾ࡼࡧෆ ᪕㐠ື࡟ ᑟࡃࡇ࡜ࡀ ሗ ࿌ࡉࢀ࡚ ࠸ࡿ 㸬㊊㒊
ᅇෆࡀ⭸㛵⠇ ࡟ཬࡰࡍ ᙳ㡪࡟ࡘ࠸࡚ ࡣ㸪Beckett ࡽ㸦1992㸧ࡣ㸪㐣๫ ࡞㊊㒊ᅇෆ
㐠ືࡣ⬯㦵ෆ ᪕㐠ື࡟ ᑟࡁ 㸪ࡉࡽ ࡟ࡣ⭸㛵 ⠇ እ㌿㐠ື࡟ᑟ ࡃࡇ࡜ ࡛ ACL ࡢࢫࢺ
ࣞࢫࡀቑ኱ ࡍࡿ࡜㏙ ࡭ 㸪Tiberio㸦1987㸧ࡣ㸪 ㊥㦵ୗ㛵⠇ ࡢ㐣ᗘ࡞ ᅇ ෆࡣ⬯㦵ෆ
᪕㐠ືࢆ⏕ࡌ 㸪ࡉࡽ࡟ ࡣ኱⭣㦵ࡢᅇ ᪕ 㐠ືࢆ ⏕ࡌࡉࡏࡿࡇ ࡜࡛㸪⭸ ⵹኱⭣㛵⠇
⑊③ ⑕ೃ ⩌ࡢ Ⓨ ⏕ せ ᅉ ࡜࡞ ࡿ ࡇ ࡜ࢆ ሗ ࿌ࡋ ࡚ ࠸ࡿ 㸬 Coplan㸦1989㸧 ࡶ㐣 ๫࡞㊊
㒊ᅇෆࡣ⬯㦵 ᅇ᪕ 㐠ື ࢆ⏕ࡌࡉࡏ㸪 ࡉࡽ࡟ࡣ ⭸ 㛵⠇ᅇ᪕㐠 ື࡟ᑟࡃ ࡇ࡜ࢆሗ࿌
ࡋ࡚࠸ࡿ㸬ࡇ ࢀࡽࡢሗ ࿌࠿ࡽ㸪㊊㒊 ᅇෆ㸪ࡍ ࡞ࢃࡕ㊥㦵ୗ 㛵⠇ࡢ 㐣 ๫࡞ᅇෆ㐠
ືࡀ⬯㦵ෆ᪕ 㐠ື࡟ᑟ ࡁ㸪ࡉࡽ࡟ࡣ 㛵⠇㐠ື 㐃㙐࡟ࡼࡾ⭸ 㛵⠇࡬ࡢ ᅇ᪕ ࢫࢺࣞ
ࢫࢆ⏕ࡌࡉࡏ 㸪⤖ ᯝ ACL ࡸ⭸⵹኱⭣㛵 ⠇࡬ ࡢ ࢫࢺࣞࢫࢆ ቑຍࡉࡏ ࡿࡇ࡜ࡀ ♧ࡉ
ࢀ࡚࠸ࡿ㸬
130
ᮏ◊✲࠿ࡽᚓ ࡽࢀࡓ ⤖ ᯝ࡟ࡘ࠸࡚㸪NDTS ࡜㖄┤᪉ྥ࡬ࡢ ᭱኱ᗋ཯ ຊ࡜ࡢ 㛫
࡟᭷ព࡞୰⛬ ᗘࡢ ㈇ࡢ ┦㛵ࢆ♧ࡋࡓ㸦 r = -0.633㸪p = 0.027㸧㸬NDTS ࡢホ౯ࡣ㸪
㊊㒊ᅇෆ㐠ື ࡢ኱ᑠ࡜ ࡜ࡶ࡟㸪 ෆഃ ⦪࢔࣮ࢳ ๛ᛶࡢ㧗ప࡜ 㛵㐃࡙ࡅ ࡚ホ౯ࡉࢀ
ࡿࡀ㸪ࡇ ࢀࡣ NDTS ࡀᑠࡉ࠸࡯࡝㸦Ⲵ㔜 ఩࡛ ࡢ ෆഃ⦪࢔࣮ ࢳୗ㝆ࡀ ᑠࡉ࠸࡯࡝㸧
ෆഃ⦪࢔࣮ࢳ ๛ᛶࡀ㧗 ࡃ㸪 ╔ᆅ᫬ࡢ ㊊㒊࢔࣮ ࢳࢆ฼⏝ࡋࡓ ⾪ᧁ྾཰ ࡀෆഃ⦪࢔
࣮ࢳ๛ᛶࡀప ࠸⪅࡟ẚ ࡭࡚ຎࡿࡇ࡜ ࡀ᥎ ࡉ ࢀࡿ㸬୍᪉㸪NDTS ࡀ኱ࡁ࠸࡯࡝
㸦Ⲵ㔜఩࡛ࡢ ෆഃ⦪࢔ ࣮ࢳୗ㝆 ࡀ኱ ࡁ࠸࡯࡝ 㸧 ࢔࣮ࢳ๛ᛶ ࡀపࡃ㸪 ㊊㒊࢔࣮ࢳ
ࢆ฼⏝ࡋࡓ⾪ ᧁ྾཰ࡀ ෆഃ⦪࢔࣮ࢳ ๛ᛶࡀ㧗 ࠸⪅ࡼࡾඃࢀ ࡚࠸ࡿ ࡇ ࡜ࡀ᥎ ࡉ
ࢀࡿ㸬ᮏ◊✲ ⤖ᯝ࠿ࡽ 㸪NDTS ࡀᑠࡉ࠸࡯࡝ ᗋ཯ຊࡀ኱ࡁ ࡃ㸪 NDTS ࡀ኱ࡁ࠸
࡯࡝╔ᆅ᫬ࡢ ᗋ཯ຊࡀ ᑠ ࡉ࠸࡜࠸㛵 㐃ᛶࡀㄆ ࡵࡽࢀ㸪㊊㒊 ࢔࣮ࢳ๛ ᛶ ࡢ኱ᑠ࡜
⾪ᧁ྾཰⬟࡜ ࡢ㛵㐃ᛶ ࡀ♧၀ࡉࢀࡓ 㸬
AI ࡜᭱኱ ⫤㛵⠇ෆ ᪕ ゅᗘ㸪⫤㛵⠇ෆ ᪕ゅᗘ ೫఩㔞࡜ࡢ㛫 ࡟᭷ព࡞ ୰⛬ᗘࡢ㈇
ࡢ┦㛵ࢆ♧ࡋ㸦ࡑࢀ ࡒ ࢀ r = -0.689㸪p = 0.013㸹r = -0.671㸪p = 0.017㸧㸪㖄┤᪉
ྥ࡬ࡢ᭱኱ᗋ ཯ຊ࡜ࡢ 㛫࡟᭷ព࡞㧗 ࠸ṇࡢ┦ 㛵ࢆ♧ࡋࡓ㸦 r = 0.892㸪p < 0.001㸧㸬
AI ࡢ㧗ప ࡶ㸪๓㏙ࡋ ࡓෆഃ⦪࢔࣮ ࢳ๛ᛶ ࡢ 㧗ప࡜㛵㐃࡙ ࡅ࡚ホ౯ ࡉࢀࡿࡀ 㸪࢔
࣮ࢳ㧗⋡ࡀ㧗 ࠸࡯࡝ෆ ഃ࢔࣮ࢳ๛ᛶ ࡀ㧗 ࠸ࡇ ࡜ࡀ᥎ ࡉࢀ 㸪╔ᆅ᫬ ࠾ࡼࡧ╔ᆅ
ᚋ࡟ࡳࡽࢀࡿ ㊊㒊ᅇෆ ࡢືࡁࡀ ᢚ࠼ ࡽࢀࡿ࡜ ⪃࠼ࡿ㸬ࡉࡽ ࡟㛵⠇㐃 㙐㐠ື ࡟ࡼ
ࡾ㸪ୗ⭣࠿ࡽ ⭸㛵⠇࡟ ࠿ࡅ࡚ࡢ㐣ᗘ ࡞ᅇ᪕㐠 ືࡀᢚไࡉࢀ 㸪⫤㛵⠇ ෆ᪕㐠ືࢆ
ࡶᢚไࡉࡏࡓ ࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃࠼ࡓ 㸬ࡲࡓ㸪 㐣๫࡞ AI ࡢ㧗್ࡣ㸪 ㊊㒊ᅇእഴ
ྥࡀࡳࡽࢀ 㸪⭸㛵 ⠇࢔ ࣛ࢖࣓ࣥࢺ࡟ ࠾࠸࡚ࡣ ෆ཯⭸ ࢆ♧ࡍ ྍ⬟ᛶࡀ ⪃࠼ࡽࢀࡿ 㸬
ࡑࡇ࡛ࡑࢀࡽ ࡢഴྥ ࢆ ࡶࡘ⪅ࡀ㸪╔ ᆅ᫬࠾ࡼ ࡧ╔ᆅᚋ ࡢ⫤ 㛵⠇እ᪕ ᪉ྥ࡬ࡢ㐠
ື࡟ᑟ࠸ࡓࡢ ࡛ࡣ࡞࠸ ࠿࡜ ⪃࠼ࡓ㸬AI ࡜㖄┤ ᪉ྥ࡬ࡢ᭱኱ ᗋ཯ຊ࡜ ࡢ㛵ಀ࡟࠾
࠸࡚㸪᭷ ព࡞㧗࠸ ṇࡢ ┦㛵ࢆ♧ࡋࡓ ࡀ㸪ୖ㏙ ࡋࡓ NDTS ࡜᭱኱ᗋ཯ ຊ࡜ࡢ 㛵ಀ
ྠᵝ࡟㸪AI ࡀ㧗࠸࡯ ࡝ෆഃ ⦪࢔࣮ ࢳ๛ᛶ ࡀ 㧗࠸ࡇ࡜ࡀ⪃ ࠼ࡽࢀ㸪╔ᆅ᫬ࡢ㊊㒊
࢔࣮ࢳࢆ฼⏝ ࡋࡓ⾪ᧁ ྾཰ ⬟ຊࡀຎ ࡿࡇ࡜࡛ ᗋ཯ຊࡀ኱ࡁ ࡃ࡞ࡾ㸪AI ࡀప࠸ ࡯
࡝⾪ᧁ྾཰⬟ ຊࡀඃࢀ ࡿࡇ࡜࡛ᗋ཯ ຊࡀᑠࡉ ࡃ࡞ ࡗࡓࡢ࡛ ࡣ࡞࠸࠿ ࡜ ᥎ ࡋࡓ 㸬
Q-angle ࡜᭱኱⭸㛵 ⠇ እ㌿ゅᗘ 㸪⭸㛵 ⠇እ㌿ ゅᗘ ೫఩㔞࡜ ࡢ㛫࡟᭷ ព࡞୰⛬ᗘ
ࡢṇࡢ┦㛵ࢆ ♧ࡋ㸦ࡑ ࢀࡒࢀ r = 0.654㸪p = 0.021㸹r = 0.590㸪 p = 0.044㸧㸪᭱
኱⫤㛵⠇ෆ᪕ ゅᗘ࡜ࡢ 㛫࡟᭷ព࡞㧗 ࠸㈇ࡢ┦ 㛵ࢆ♧ࡋࡓ㸦 r = -0.744㸪p = 0.005㸧㸬
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ࡲࡓ㸪᭱ ኱⭸㛵⠇ እ㌿ ࣮࣓ࣔࣥࢺ ࡜ ࡢ㛫࡟᭷ ព࡞୰⛬ᗘࡢ ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ㸦 r
= 0.608㸪p = 0.036㸧㸬Q-angle ࡣዪᛶࡣ⏨ ᛶ࡟ẚ࡭㸪ẚ ㍑ⓗ኱ࡁ ࠸ ࡇ࡜ࡀሗ࿌
ࡉࢀ࡚࠸ࡿ[Moul, 1998; Medina McKeon and Hertel, 2009; Horton and Hall, 1989;
Livingston, 1998; Emami et al., 2007; Smith et al., 2008 ]㸬Q-angle ࡜ୗ ⫥യᐖ࡟㛵
ࡍࡿሗ࿌࡟ࡘ ࠸࡚ࡣ㸪Q-angle ࡢ኱ࡁ࠸⩌ ࡣ ᑠࡉ࠸⩌࡟ẚ ࡭ 㸪᭷ព ࡟ୗ⫥യᐖࣜ
ࢫࢡࡀ㧗࠸ࡇ ࡜ࡸ [Cowan et al., 1996]㸪Q-angle ࡢᕥྑᕪࡀ኱ࡁ ࠸ ࡯࡝ୗ⫥യᐖ
Ⓨ⏕ࣜ ࢫࢡ ࡀ㧗 ࡲࡿ ࡇ ࡜ࡀሗ ࿌ࡉ ࢀ࡚ ࠸ࢀ ࡿ [Shambaugh et al., 1991]㸬ࡲ ࡓ㸪
Q-angle ࡢ ቑ ኱ ࡜ ⭸ ⵹ ኱ ⭣ ⑊ ③ ⑕ ೃ ⩌ ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ 㛵 㐃 ᛶ ࡀ ㄆ ࡵ ࡽ ࢀ ࡓ ࡜࠸
࠺ሗ࿌ࡶ」ᩘ ࡳࡽࢀࡿ [Powers, 2003]㸬ࡇࢀ ࡽࡢከࡃ ࡣ Q-angle ࡢ኱ᑠࡀ㸪⭸㛵
⠇࡬࠿࠿ࡿࢫ ࢺࣞࢫ ࡢ ኱ᑠ࡜ࡢ㛵ಀ ࢆ♧ࡋ࡚ ࠸ࡿ㸬 ᮏ◊✲ ⤖ᯝ࡟࠾ ࠸࡚㸪 ≉࡟
Q-angle ࡢ኱ࡁࡉ࡜ ᭱ ኱⭸㛵⠇እ㌿ ゅᗘ 㸪⭸ 㛵⠇እ㌿ゅᗘ ೫఩㔞࡜ ࡢ 㛵ಀ࡟ṇࡢ
┦㛵㸦Q-angle ࡀ኱ࡁ ࠸࡯࡝㸪⭸ 㛵⠇እ㌿ ᪉ ྥ࡬ࡢືࡁࡀ ኱ࡁ࠸ࡇ ࡜ࢆ♧ࡍ㸧ࡀ
ᚓࡽࢀࡓࡇ࡜ ࡣ㸪ඛ⾜ ㄽᩥ࠿ࡽከᩘ ሗ࿌ࡉࢀ ࡚࠸ࡿ Q-angle ࡢ኱ᑠ࡜⭸㛵⠇࡬
࠿࠿ࡿࢫࢺࣞ ࢫࡢ኱ᑠ ࠾ࡼࡧ⭸㛵⠇ യᐖⓎ⏕ ࡟ᑟࡃྍ⬟ᛶ ࢆ ᨭᣢࡍ ࡿ⤖ᯝ࡛ ࡶ
࠶ࡿ㸬୍᪉ ࡛ Q-angle ࡜᭱኱⫤㛵⠇ ෆ᪕ゅᗘ 㸪᭱኱⭸㛵⠇ እ㌿࣮ࣔ ࣓ࣥࢺ ࡟ࡘ
࠸࡚ࡣ᭷ព࡞ ㈇ࡢ ┦㛵 ࢆ♧ࡋࡓࡀ㸪 ࡇࢀࡽࡢ 㛵㐃ᛶ࡟ࡘ࠸ ࡚ ヲ⣽࡟ ᳨ウࡍࡿ࡟
ࡣ᭦࡞ࡿ᳨ド ࡀᚲせ࡛ ࠶ࡿ࡜⪃࠼ࡿ 㸬
TFA ࡀ ACL യᐖ࡟ཬ ࡰࡍᙳ㡪࡟ࡘ ࠸࡚㸪 ඛ ⾜ㄽᩥ࡟ࡼࡿ ࡜ ACL യᐖ⩌ࡣࢥ
ࣥࢺ࣮ࣟࣝ⩌ ࡟ẚ࡭㸪TFA ࡀ᭷ព࡟኱ࡁ ࠿ࡗ ࡓࡇ࡜ࢆ♧ࡋ 㸪ࡑࢀࡣ ㊊㒊እ㌿ ⫥
఩࡛ࡢ╔ᆅ࡟ ࡼࡾ㸪⭸ 㛵⠇ ෆ᪕㐠ື ࢆ⏕ࡌࡉ ࡏ㸪ACL ࡬ࡢࢫࢺࣞ ࢫ ࢆቑ኱ࡉࡏ
ࡿࡇ࡜ࡀሗ࿌ ࡉࢀ࡚࠸ ࡿ [Trimble et al., 2002]㸬TMA ࡟ࡘ࠸࡚ࡶ ⬯ 㦵እ᤬ゅᗘࡢ
ቑຍࡣ㊊㒊ࢆ እ㌿᪉ྥ ࡟ᑟࡃࡇ࡜ࡀ ᥎ ࡉࢀ 㸪⭸㛵⠇ᅇ᪕ ືసࢆ ⏕ ࡌࡉࡏࡿྍ
⬟ᛶࡀ⪃࠼ࡽ ࢀࡿ 㸬ᮏ ◊✲⤖ᯝ࠿ࡽ 㸪TFA ࡜ ᭱኱⫤㛵⠇ෆ ᪕ゅᗘ࡜ ࡢ㛵ಀ࡟࠾
࠸࡚᭷ព࡞㧗 ࠸㈇ࡢ┦ 㛵ࢆ♧ࡋ㸦 r = -0.736㸪p = 0.006㸧㸪⭸㛵⠇እ ㌿ゅᗘ ೫఩
㔞࡜ࡢ㛫࡟᭷ ព࡞ ୰⛬ ᗘࡢṇࡢ┦㛵 ࢆ♧ࡋࡓ 㸦 r = 0.589㸪p = 0.044㸧㸬ࡲࡓ㸪
TMA ࡜᭱኱⫤ 㛵⠇ෆ ᪕ゅᗘ㸪⫤ 㛵⠇ෆ᪕ ゅ ᗘ೫఩㔞࡜ࡢ 㛫࡟᭷ព ࡞୰⛬ᗘࡢ㈇
ࡢ┦㛵ࢆ♧ࡋ ࡓ㸦ࡑ ࢀ ࡒࢀ r = -0.609㸪p = 0.036㸹r = -0.637㸪p = 0.026㸧㸬ඛ㏙
ࡋࡓඛ⾜◊✲ ࡢሗ࿌࠿ ࡽ㸪TFA ࡸ TMA ࡀ⬯㦵࠾ࡼࡧ⭸㛵 ⠇ᅇ᪕࡬ ཬࡰࡍᙳ㡪
࡟ࡘ࠸࡚㸪ᮏ ◊✲⤖ᯝ ࠿ࡽ ࡣ㸪TFA ࡢ኱ᑠ ࡜ ⭸㛵⠇እ㌿ゅ ᗘ ೫఩㔞 ࡢ኱ᑠ࡜ࡢ
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㛵ಀ࡟࠾࠸࡚ ṇࡢ┦㛵 ࡀㄆࡵࡽࢀࡓ ୍᪉࡛ 㸪TMA ࡢ኱ᑠ࡜ ᭱኱⫤ 㛵⠇ෆ᪕ゅᗘ
࠾ࡼ ࡧ ⫤ 㛵⠇ ෆ ᪕ ゅ ᗘ ೫఩ 㔞 ࡢ ኱ᑠ ࡜ ࡢ 㛵 ಀ ࠾ࡼ ࡧ TFA ࡢ ኱ ᑠ࡜ ᭱኱ ⫤ 㛵⠇
ෆ᪕ゅᗘࡢ኱ ᑠ࡜ࡢ㛵 ಀ࡟ࡘ࠸࡚ࡣ ㈇ࡢ┦㛵 ࡀㄆࡵࡽࢀࡓ 㸬ࡇࢀࡣ 㸪௒ᅇࡢㄢ
㢟ືసࡢᣦ♧ ࡟࠾࠸࡚ 㸪╔ᆅ᫬ࡢ㊊ 㒊ࡢ᪉ྥ ࡟ࡘ࠸࡚㸪ࡘ ࡲඛࢆ ṇ 㠃࡟ྥࡅ࡚
╔ᆅࡉࡏࡿ➼ ࡢලయⓗ ࡞ ᣦ♧ࢆ୚࠼ ࡞࠿ࡗࡓ ࡇ࡜ ࡀ㸪⫤㛵 ⠇ࡢ ືస ࡟཯ᫎࡋ࡞
࠿ࡗࡓࡢ࡛ࡣ ࡞࠸࠿࡜ ⪃࠼ࡓ㸬኱⭣ 㦵࡟ᑐࡍ ࡿ㊊㒊ࡢእ㌿ ࠾ࡼࡧ⬯ 㦵ࡢእ᤬ࡢ
⛬ᗘࡀ㸪ࡘࡲ ඛࢆṇ㠃 ࡟ྥࡅ࡚╔ᆅ ࡉࡏࡓ᫬ ࡢ ⬯㦵ෆ᪕㸪 ࡑࡋ࡚⭸ 㛵⠇ෆ᪕ 㐠
ື㸪ࡉࡽ࡟ࡣ ⫤㛵⠇ෆ ᪕ 㐠ື࡬࡜㛵 ⠇㐠ື㐃 㙐ࢆ⏕ࡌࡉࡏ ࡿ ྍ⬟ᛶ ࡀ⪃࠼ࡽࢀ
ࡿࡀ㸪TMA ࠾ࡼࡧ TFA ࡀ኱ࡁ࠸ࡶࡢࡣ↓ ព ㆑࡟㊊㒊እ㌿ ⫥఩࡛╔ ᆅࡋࡓྍ⬟
ᛶࡀ⪃࠼ࡽࢀ 㸪╔ᆅᚋ ࡢ ⬯㦵ᅇ᪕ࡸ ⭸㛵⠇ ᅇ ᪕➼ࡢ㐣๫࡞ 㛵⠇ 㐠ື ࡀ⏕ࡌ࡞࠿
ࡗࡓࡢ࡛ࡣ࡞ ࠸࠿࡜ ⪃ ࠼ࡓ㸬
FAA ࡜᭱኱⭸㛵 ⠇እ ㌿ゅᗘ 㸪⭸㛵⠇እ ㌿ゅ ᗘ ೫఩㔞࡜ࡢ 㛫࡟᭷ព ࡞ ୰⛬ᗘࡢ
ṇࡢ┦㛵ࢆ♧ ࡋࡓ㸦ࡑ ࢀࡒࢀ r = 0.584㸪p = 0.046㸹r = 0.589㸪p = 0.045㸧㸬FAA
ࡣ㸪኱⭣㦵㢕 㒊๓᤬ゅ ᗘ ࢆ♧ࡍࡶࡢ ࡛࠶ࡿࡀ 㸪 ඛ⾜ㄽᩥ࡟ ࠾࠸࡚㸪 ኱⭣㦵㢕㒊
๓᤬ゅᗘࡀ኱ ࡁ࠸ࡶࡢ ࡣ㸪Ṍ⾜᫬࡟͆toe-in͇ഴྥࢆ♧ࡍࡇ ࡜ࡀሗ࿌ ࡉࢀ ࡚࠸ࡿ
࡯࠿[Cranel, 1959]㸪╔ ᆅᚋࡢ⭸ࡢ͆ knee-in͇ືస࡟ࡶᙳ㡪 ࢆཬࡰ ࡍ ࡇ࡜࠿ࡽ㸪
ᮏ◊✲ㄢ㢟ື స ࡟࠾࠸ ࡚ࡶ FAA ࡢ኱ ࡁ࠸⪅ ࡣ ╔ᆅ᫬ࡢ⭸ ࡢ͆knee-in͇ືసࢆቑ
ຍࡉࡏࡓࡇ࡜ ࡛㸪⭸㛵 ⠇እ㌿ゅᗘࡢ ቑຍ࡟ ࡘ ࡞ࡀࡗࡓࡢ࡛ ࡣ ࡞࠸࠿ ࡜ ⪃࠼ࡓ㸬
ADKE ࡜ ᭱ ኱ ⫤ 㛵 ⠇ ෆ ㌿ ゅ ᗘ ࡜ ࡢ 㛫 ࡟ ᭷ ព ࡞ ୰ ⛬ ᗘ ࡢ ṇ ࡢ ┦ 㛵 ࢆ ♧ ࡋ 㸦 r =
0.596㸪p = 0.041㸧㸪㖄 ┤᪉ྥ࡬ࡢ᭱ ኱ᗋ཯ຊ ࡜ࡢ 㛫࡟᭷ព ࡞㧗࠸㈇ ࡢ┦㛵ࢆ♧
ࡋࡓ㸦r = -0.713㸪p = 0.009㸧㸬ࡲࡓ㸪ADKF ࡜㖄┤᪉ྥ ࡬ࡢ᭱኱ ᗋ཯ຊ࡜ࡢ 㛫
࡟᭷ព࡞㧗࠸ ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ㸦 r = -0.729㸪p = 0.007㸧㸬ᗋ཯ຊࡢ ኱ࡁࡉ࡜ୗ
⫥യᐖ࡜ࡢ㛵 㐃࡟ࡘ࠸ ࡚㸪Hewett ࡽ㸦2005㸧ࡣ DVJ ࢱࢫࢡ࡟ࡼࡿ ୗ⫥࢟ࢿ࣐ࢸ
࢕ࢡࢫࢆ࣮࣋ ࢫࣛ࢖ࣥ ࡟⏝࠸࡚ ACL യᐖ⩌ ࡜㠀യᐖ⩌ࢆ ẚ㍑ࡋࡓ ࡜ࡇࢁ㸪ACL
യᐖ⩌ࡣ㠀യ ᐖ⩌࡟ẚ ࡭ ࡚ 20㸣㧗࠸ᗋ཯ ຊ ࢆ ♧ࡋ㸪ACL യ ᐖࣜࢫ ࢡࡢ୺せᅉ࡛
࠶ࡿ࡜㏙࡭࡚ ࠸ࡿ㸬ࡲ ࡓ㸪McNair ࡜ Marshall㸦1994㸧ࡣ㸪╔ᆅ ᫬ ࡟ࡳࡽࢀࡿᗋ
཯ຊ࡜㸪኱⭣ 㦵࡟ᑐࡍ ࡿ⬯㦵๓᪉೫ ఩㔞࡜ࡢ 㛵㐃ᛶࢆ♧ࡋ 㸪╔ᆅ᫬ ࡢᗋ཯ຊࢆ
ῶᑡࡉࡏࡿࡇ ࡜ࡣ ACL യᐖࣜࢫࢡ ࢆῶࡌࡉ ࡏࡿ࡜㏙࡭࡚ ࠸ࡿ㸬ࡲ ࡓ㸪Kernozek
㸦2005㸧ࡽࡣࢻࣟ ࢵࣉ ࣛࣥࢹ࢕ࣥࢢ ࡢ⏨ዪ ࡢ ẚ㍑࡟࠾࠸࡚ 㸪ዪ ᛶࡣ ⏨ᛶ࡟ẚ ࡭㸪
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᭱኱ᗋ཯ຊ࠾ ࡼࡧ᭱኱ ㊊㛵⠇⫼ᒅゅ ᗘࡀ᭷ព ࡟኱ࡁ࠿ࡗࡓ ࡇ࡜ࢆ♧ ࡋ㸦᭱኱⭸
㛵⠇ᒅ᭤ゅᗘ 㸪᭱኱⫤ 㛵⠇ᒅ᭤ゅᗘ ࡢẚ㍑࡟ ࡘ࠸࡚ࡣ ᭷ព ᕪ࡞ࡋ㸧㸪Decker ࡽ
㸦2006㸧ࡣ㸪ᐇ㦂ᐊࣞ ࡛࣋ࣝࡢ⏨ዪ ࡢ╔ᆅ᫬ ࡢ ୗ⫥ࡢྛ㛵 ⠇࡟࠾ࡅ ࡿ ⾪ᧁ྾཰
࡟ࡘ࠸᳨࡚ド ࡋࡓ࡜ࡇ ࢁ㸪 ዪᛶࡣ⏨ ᛶ࡟ẚ࡭ ╔ᆅ᫬ࡢ㊊㛵 ⠇ྍືᇦ ࡀ኱ࡁࡃ㸪
㊊㛵⠇ᗏᒅ➽ ⩌ࢆ᭷ຠ ࡟฼⏝ࡋ ࡚⾪ ᧁ྾཰ࡀ ⾜ࢃࢀ࡚࠸ࡿ ࡜㏙࡭ࡓ 㸬ᮏ◊✲ࡢ
⤖ᯝ࠿ࡽ㸪㊊ 㛵⠇ ⫼ᒅ ゅᗘ࡜ᗋ཯ຊ ࡜ࡢ 㛵ಀ ࡟࠾࠸࡚᭷ព ࡞㈇ࡢ┦ 㛵ࢆ♧ࡋ㸪
๓㏙ࡋࡓඛ⾜ ㄽᩥ࠿ࡽ ࡢሗ࿌ࡶྵࡵ ࡚ [Kernozak et al., 2005; Decker et al., 2006]㸪
ACL യᐖࢆྵࡵࡓ ୗ ⫥യᐖࡢほⅬ ࠿ࡽ ᳨ウ ࡍࡿ࡜㸪㊊㛵⠇⫼ ᒅゅ ᗘࡀᑠࡉ࠸ ࡶ
ࡢࡣ㸪╔ᆅ᫬ ࡢ㊊㛵⠇ ⫼ᒅ㐠ືࢆ᭷ ຠ࡟฼⏝ ࡋࡓ ⾪ᧁ྾཰ ࡀᅔ㞴࡛ ࠶ࡿ ࡇ࡜ࡀ
⪃࠼ࡽࢀ㸪ᗋ ཯ຊࡀ኱ ࡁࡃ ࡞ࡿഴྥ ࡀ♧ࡉࢀ ࡓࡇ࡜ࢆ㏻ࡌ ࡚㸪 ୗ⫥ യᐖࣜࢫࢡ
せᅉࡢ୍ࡘ࡟ ࡞ࡿ ྍ⬟ ᛶࡀ♧၀ࡉࢀ ࡓ㸬௚ࡢ ඛ⾜ㄽᩥ࠿ࡽ ࡶ㸪ዪᛶ ࡣ⏨ᛶ࡟ẚ
࡭࡚㸪╔ᆅ᫬ ࡢ⾪ᧁ ⦆ ⾪᪉ἲ࡟ࡘ࠸ ࡚㸪 ㊊㛵 ⠇ࡀ᭷ព࡟స ⏝ࡋ࡚࠸ ࡿ ࡇ࡜ࡀሗ
࿌ࡉࢀ࡚࠸ࡿ[Schmitz et al., 2007; Zhang et al., 2000; Devita and Skelly, 1992;
Schot et al., 1994]㸬
╔ᆅ᫬ࡢ⭸㛵⠇Ᏻᐃᛶ࡟ୗ⫥➽⫗ࡢస⏝ࡢ㔜せᛶࡀከᩘሗ࿌ࡉࢀ࡚࠸ࡿࡀ
[Zeller et al., 2003; Kiriyama et al., 2009; Hewett et al., 1996; Salci et al., 2004;
Nagano et al., 2007; Fagenbaum and Darling, 2003; Lephart et al., 2002; Pappas et al.,
2007; Zazulak et al., 2005; Jacobs et al., 2007]㸪๓㢠㠃࠿ࡽࡳ ࡓ࡜ࡁࡢ ⭸㛵⠇࡬ཬ
ࡰࡍᙳ㡪࡟࠸ ࡚㸪Zazulak ࡽ㸦2005㸧ࡢሗ࿌ ࡛ࡣ㸪∦ ⬮╔ᆅື స᫬ ࡢ⏨ዪࡢẚ㍑
࡛ዪᛶࡣ⏨ᛶ ࡟ẚ࡭ ࡚ ኱Ẋ➽ࡢ➽ά ືࡀ ᭷ព ࡟పࡃ㸪ࡲࡓ ୰Ẋ➽ࡢ ➽άືࡶ᭷
ព࡟ప࠸ഴྥ ࢆ♧ࡋ㸪 ⫤㛵⠇ෆ㌿ ࠾ ࡼࡧෆ᪕ ືసࡢไᚚࡀ ᅔ㞴࡜࡞ ࡾ 㸪⭸㛵⠇
እ㌿࡟ᑟࡃྍ ⬟ᛶࢆ♧ ၀ࡋ ࡚࠸ࡿ㸬ࡲࡓ㸪Zeller㸦2003㸧ࡽࡣ㸪∦ ⬮ࢫࢡ࣡ࢵࢺ
᫬ࡢ⏨ዪࡢୗ ⫥㛵⠇ ゅ ᗘࡢẚ㍑࡟࠾ ࠸࡚㸪ዪ ᛶࡣ⏨ᛶ࡟ẚ ࡭࡚⫤㛵 ⠇ෆ㌿ゅᗘ
ࡀ኱ࡁࡃ㸪୰ Ẋ➽࡟ࡼ ࡿ ⫤㛵⠇ࡢࢥ ࣥࢺ࣮ࣟ ࣝ ࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚ ㏙࡭࡚࠸
ࡿ㸬ࡇࢀࡽࡢ ሗ࿌࠿ࡽ 㸪୰Ẋ➽➽ຊ ࡀ⫤㛵⠇ ෆ㌿ ࠾ࡼࡧෆ ᪕ືస 㸪 ⭸㛵⠇እ㌿
ືసࡢไᚚ࡟ ᐤ୚ࡉࡏ ࡚࠸ࡿࡇ࡜ࡀ ࠺࠿ࡀ࠼ ࡿࡀ㸪 ᮏ◊✲ ࡟࠾࠸࡚ 㸪᭱኱⭸㛵
⠇እ㌿ゅᗘ㸪 ᭱኱⫤㛵 ⠇ෆ㌿ゅᗘ㸪 ⭸㛵⠇እ ㌿ゅᗘ ೫఩㔞 ࡜ࡢ 㛫࡟ ᭷ព࡞୰⛬
ᗘࡢ㈇ࡢ┦㛵 ࢆ♧ࡋ㸦 ࡑࢀࡒࢀ r = 0.681㸪p = 0.015㸹r = -0.635㸪p = 0.023㸹r =
-0.697㸪p = 0.012㸧㸪 ⫤㛵⠇ ෆ᪕ゅ ᗘ೫ ఩㔞 ࡜ࡢ㛫 ࡟᭷ព ࡞୰ ⛬ᗘ ࡢ ṇࡢ ┦㛵
134
ࢆ♧ࡋࡓ㸦r = 0.611㸪p = 0.035㸧㸬ࡲࡓ㸪᭱ ኱ᗋ཯ຊ࡜ࡢ 㛫࡟᭷ព ࡞㧗࠸ṇࡢ
┦㛵ࢆ♧ࡋࡓ 㸦 r = 0.703㸪p = 0.011㸧㸬ࡇࢀ ࡣ୰Ẋ➽ࡢ➽ ຊࡀ ప࠸ ⪅࡯࡝⭸㛵
⠇እ㌿࠾ࡼࡧ ⫤㛵⠇ෆ ㌿ືస࡟ᑟࡁ 㸪୰Ẋ➽ ࡢ➽ຊࡀ㧗࠸ ⪅࡯࡝⭸ 㛵⠇ ෆ㌿࠾
ࡼࡧ⫤㛵⠇እ㌿ືస࡟ᑟࡃ࡜࠸࠺ഴྥࢆ♧ࡍࡶࡢ࡛࠶ࡿ㸬ඛ⾜◊✲ྠᵝ࡟
[Zazulak et al., 2005; Zeller et al., 2003]㸪ᮏ ◊✲⤖ᯝ࠿ࡽ ࡶ ୰Ẋ➽ ➽ຊ ࡀ⭸㛵⠇
ࡸ⫤㛵⠇ࡢື ⓗୗ⫥࢔ ࣛ࢖࣓ࣥࢺࡢ ࢥࣥࢺࣟ ࣮ࣝ࡟ ᐤ୚ࡉ ࡏࡿ ྍ⬟ ᛶࡀ♧ࡉࢀ 㸪
୰Ẋ➽ࡀୗ⫥ 㛵⠇ࡢࢥ ࣥࢺ࣮ࣟࣝ ࡟ 㔜せ࡞ᙺ ๭ࢆᣢࡘྍ⬟ ᛶࡀ♧၀ ࡉࢀࡓ㸬୍
᪉࡛㸪୰ Ẋ➽➽ຊ ࡜ ⫤ 㛵⠇ෆ᪕ゅᗘ ೫఩㔞࡜ ࡢ㛫࡟ࡣ᭷ព ࡞㈇ࡢ㛵 ಀࡀ♧ࡉࢀ 㸪
๓㏙ࡋࡓୗ⫥ യᐖࣜࢫ ࢡ ࢆᅇ㑊ࡉࡏ ࡿ≉ᚩⓗ ࡞ືⓗୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺࡢഴྥࡣ
♧ࡉ࡞࠿ࡗࡓ 㸬
⫤㛵⠇ෆ᪕ゅ ᗘ࡜ ACL യᐖ࡜ࡢ㛵 㐃ᛶ࡟ࡘ ࠸࡚ࡣ㸪Hertel ࡽ㸦2004㸧࡟ࡼࡾ
ሗ࿌ࡉࢀ࡚࠸ ࡿࡀ㸪ᚋ ࢁྥࡁㄪᰝ࡟ ࡼࡿ ACL യᐖ⩌࡜㠀 യᐖ⩌࡜ ࡢẚ㍑ ࡟࠾࠸
࡚᭷ពᕪࡣぢ ࡽࢀ ࡞࠿ ࡗࡓ㸬ᮏ◊✲࡟ ࠾ ࡅࡿ DVJ ືస࡜ࡢ㛵㐃ᛶ ࡟ ࡘ࠸࡚㸪⫤
㛵 ⠇ ෆ ᪕ゅ ᗘ ࡜ ྛ 㡯 ┠ 㛫 ࡟ ࠾࠸ ࡚ ᭷ ព ࡞ 㛵 㐃 ᛶ ࡣ ㄆࡵ ࡽ ࢀ ࡞ ࠿ ࡗ ࡓ 㸬 GJLT ࡣ
ዪᛶࡣ⏨ᛶ࡜ẚ㍑ࡋ࡚㸪㧘࠸ࢫࢥ࢔ࢆᣢࡘࡇ࡜ࡀከᩘሗ࿌ࡉࢀ࡚࠸ࡿࡀ
[Decoster et al., 1991; Quatman et al., 2008]㸪ACL യᐖ⩌࡜㠀യ ᐖ ⩌ ࢆẚ㍑ࡋࡓඛ
⾜ㄽᩥ࡟ࡘ࠸ ࡚㸪Uhorchak ࡽ㸦2003㸧ࡣ㸪GJLT ࡢᖹᆒ್࠿ࡽ 1±ᶆ‽೫ᕪࡼࡾ
኱ࡁ࡞ࢫࢥ࢔ ࢆࡶࡘ ⪅ ࡣ ACL യᐖࣜ ࢫࢡࡀ ቑ኱ࡍࡿ࡜ሗ ࿌ࡋ㸪Ramesh ࡽ㸦2005㸧
ࡣ㸪ACL യᐖ⩌࡛ ࠿ ࡘ GJLT ࡢ㧗࠸ࢫࢥ࢔ ࢆ ᭷ࡋ㸪୰࡛ ࡶ⭸㛵⠇ ᘱ⦆ᛶࡢ㧗࠸
⪅ࡣ᭷ព ࡟ ACL യᐖ ࣜࢫࢡࡀ㧗࠸ ࡇ࡜ࢆ ሗ ࿌ࡋࡓࡀ㸪ᮏ◊✲⤖ ᯝ ࡛⾜ࡗࡓㄢ㢟
ືస࠿ࡽࡳࡽ ࢀࡿୗ⫥ ࢟ࢿ࣐ࢸ࢕ࢡ ࢫ࣭࢟ࢿ ࢸ࢕ࢡࢫ ࡜ࡢ 㛵㐃ᛶ࡟ ࡘ࠸࡚ࡣ᭷
ព࡞㛵ಀࡣㄆ ࡵࡽࢀ࡞ ࠿ࡗࡓ㸬
ᮏ◊✲ࡣ㸪ACL യᐖࢆ ྵࡵࡓୗ⫥യ ᐖண㜵ࡢ ࡓࡵࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢸࢫࢺࡢ
᭷⏝ᛶࢆ᳨ド ࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ࡋ࡚ 㸪DVJ ືస᫬ࡢୗ⫥࢟ ࢿ࣐ࢸ࢕ ࢡࢫ࣭࢟ࢿ
ࢸ࢕ࢡࢫ࡜ୗ ⫥࢔ࣛ࢖ ࣓ࣥࢺ㸪㛵⠇ ྍືᇦ㸪 ඲㌟ᘱ⦆ᛶ㸪 ⫤㛵⠇እ ㌿➽ຊ࡜ࡢ
㛵㐃ᛶ࡟ࡘ࠸ ࡚ẚ㍑᳨ ウࡋ 㸪ACL ࢆྵࡵࡓୗ ⫥ യᐖண㜵ࡢ ࡓࡵࡢࢫ ࢡ࣮ࣜࢽࣥ
ࢢࢸࢫࢺࡢᐇ 㝿࡟࠾࠸ ࡚㸪യᐖ࡟㉳ ᅉࡍࡿྍ ⬟ᛶࡀ࠶ࡿ 㡯 ┠ࢆ㑅ᢥ ⓗ࡟ ᐃࡶ
ࡋࡃࡣᥦ♧࡛ ࡁࡿ ࡢ࡛ ࡣ࡞࠸࠿࡜ ࠸ ࠺ࡶࡢ࡛ ࠶ ࡗࡓ㸬⤖ᯝ ࡣ⭸㛵⠇ እ㌿ 㐠ື࠾
ࡼ ࡧ ⫤ 㛵 ⠇ ෆ ㌿ 㐠 ື ࡸ 㛵 ⠇ ࣔ ࣮ ࣓ ࣥ ࢺ ࡟ ╔ ┠ ࡋ ࡚ ホ ౯ ࡍ ࡿ ሙ ྜ 㸪 Q-angle 㸪
135
Femoral antevertion angle㸪⫤㛵⠇ እ㌿➽ຊ ࡢ㡯┠ ࢆྵࡵ ࡓホ౯ࡢ ᭷⏝ᛶࡀ♧ࡉ
ࢀ㸪╔ᆅ᫬ࡢ ⾪ᧁ⦆⾪ ⬟ࡢホ౯࡜ࡋ ࡚ ࡣ㸪࢔ ࣮ࢳ㧗⋡࡜㊊ 㛵⠇⫼ᒅ ゅᗘ ࡢ㡯┠
ࢆྵࡵࡓホ౯ ࡢ ᭷⏝ᛶ ࡀ♧ࡉࢀࡓ㸬
5-6-5. ⤖ㄒ
ᮏ◊✲ࡣ㸪ACL ࢆྵࡵ ࡓୗ⫥യᐖண 㜵ࡢⅭࡢ ࢫࢡ࣮ࣜࢽࣥ ࢢࢸࢫࢺ ࡜ࡋ࡚᥎
ዡࡉࢀ࡚࠸ࡿ ࢻࣟࢵࣉ ࣂ࣮ࢸ࢕࢝ࣝ ࢪࣕࣥࣉ ࢆㄢ㢟ືస࡟ タᐃࡋ࡚ 㸪㟼ⓗୗ⫥
࢔ࣛ࢖࣓ࣥࢺ ࡸୗ⫥㛵 ⠇ྍືᇦ㸪඲ ㌟㛵⠇ᘱ ⦆ᛶ㸪⫤㛵⠇ እ㌿➽ຊ ࡜╔ᆅືస
᫬࡟ࡳࡽࢀࡿ ୗ⫥࢟ࢿ ࢸ࢕ࢡࢫ࣭࢟ ࢿ࣐ࢸ࢕ ࢡࢫ࡜ࡢ㛵㐃 ᛶࢆẚ㍑ ᳨ウࡍࡿࡇ
࡜ࢆ┠ⓗ࡜ࡋ ࡚⾜࠸ 㸪 ௨ୗࡢ㛵㐃ᛶ ࡀ♧ࡉࢀ ࡓ㸬
1)
Navicular drop test score ࡜㖄┤᪉ྥ࡬ ࡢ᭱ ኱ᗋ཯ຊ࡜ࡢ 㛵ಀ࡟᭷ ព࡞ ୰⛬
ᗘࡢ㈇ࡢ┦㛵 ࢆ♧ࡋࡓ 㸬
2)
࢔࣮ࢳ㧗⋡࡜᭱኱⫤㛵⠇ෆ᪕ゅᗘ㸪⫤㛵⠇ෆ᪕ゅᗘ೫఩㔞࡜ࡢ㛵ಀ࡟᭷ព
࡞୰⛬ᗘࡢ㈇ࡢ┦㛵ࢆ♧ࡋ㸪㖄┤᪉ྥ࡬ࡢ᭱኱ᗋ཯ຊ࡜ࡢ㛵ಀ࡟᭷ព࡞㧗
࠸ṇࡢ┦㛵ࢆ ♧ࡋࡓ㸬
3)
Q-angle ࡜᭱኱⭸㛵 ⠇ እ㌿ゅᗘ 㸪⭸㛵 ⠇እ㌿ ゅᗘ ೫఩㔞࡜ ࡢ㛵ಀ࡟ ᭷ព࡞ ୰
⛬ᗘࡢṇࡢ┦㛵ࢆ♧ࡋ㸪᭱኱⫤㛵⠇ෆ᪕ゅᗘ࡜ࡢ㛵ಀ࡟᭷ព࡞㧗࠸㈇ࡢ┦
㛵ࢆ♧ࡋࡓ㸬ࡲࡓ㸪᭱኱⭸㛵⠇እ㌿࣮࣓ࣔࣥࢺ࡜ࡢ㛵ಀ࡟᭷ព࡞୰⛬ᗘࡢ
㈇ࡢ┦㛵ࢆ♧ ࡋࡓ㸬
4)
Thgh-transmalleolar angle ࡜᭱኱⫤㛵⠇ෆ ᪕ ゅᗘ㸪 ⫤㛵⠇ ෆ᪕ゅᗘ ೫఩㔞࡜
ࡢ㛵ಀ࡟᭷ព ࡞ ୰⛬ᗘ ࡢ㈇ࡢ┦㛵ࢆ ♧ࡋࡓ㸬
5)
Thigh-foot angle ࡜᭱኱⫤㛵⠇ෆ᪕ ゅᗘ࡜ࡢ 㛵ಀ࡟᭷ព࡞ 㧗࠸㈇ࡢ ┦㛵ࢆ♧
ࡋ㸪⭸㛵⠇ෆ ㌿ゅᗘ೫ ఩㔞࡜ࡢ㛵ಀ ࡟᭷ព࡞ ୰⛬ᗘࡢṇࡢ ┦㛵ࢆ♧ ࡋࡓ㸬
6)
኱⭣㦵㢕㒊๓᤬ゅᗘ࡜᭱኱⭸㛵⠇እ㌿ゅᗘ㸪⭸㛵⠇እ㌿ゅᗘ೫఩㔞࡜ࡢ㛵
ಀ࡟᭷ព࡞୰ ⛬ᗘࡢ ṇ ࡢ┦㛵ࢆ♧ࡋ ࡓ㸬
7)
㊊㛵⠇⫼ᒅゅᗘ㸦⭸㛵⠇ఙᒎ࠾ࡼࡧⲴ㔜఩㸧࡜᭱኱⫤㛵⠇ෆ㌿ゅᗘ࡜ࡢ㛵
ಀ࡟᭷ព࡞୰⛬ᗘࡢṇࡢ┦㛵ࢆ♧ࡋ㸪㖄┤᪉ྥ࡬ࡢ᭱኱ᗋ཯ຊ࡜ࡢ㛵ಀ࡟
᭷ព࡞㧗࠸㈇ࡢ┦㛵ࢆ♧ࡋࡓ㸬ࡲࡓ㸪㊊㛵⠇⫼ᒅゅᗘ㸦⭸㛵⠇ᒅ᭤࠾ࡼࡧ
Ⲵ㔜఩㸧࡜㖄┤᪉ྥ࡬ࡢ᭱኱ᗋ཯ຊ࡜ࡢ㛵ಀ࡟᭷ព࡞㧗࠸㈇ࡢ┦㛵ࢆ♧ࡋ
136
ࡓ㸬
8)
⫤㛵⠇እ㌿➽ຊ࡜᭱኱⭸㛵⠇እ㌿ゅᗘ㸪᭱኱⫤㛵⠇ෆ㌿ゅᗘ㸪⭸㛵⠇እ㌿
ゅᗘ೫఩㔞࡜ࡢ㛵ಀ࡟᭷ព࡞୰⛬ᗘࡢ㈇ࡢ┦㛵ࢆ♧ࡋ㸪⫤㛵⠇ෆ᪕ゅᗘ೫
఩㔞࡜ࡢ㛵ಀ࡟᭷ព࡞୰⛬ᗘࡢṇࡢ┦㛵ࢆ♧ࡋࡓ㸬ࡲࡓ㸪㖄┤᪉ྥ࡬ࡢ᭱
኱ᗋ཯ຊ࡜ࡢ 㛵ಀ࡟᭷ ព࡞ 㧗࠸ṇࡢ ┦㛵ࢆ♧ ࡋࡓ㸬
9)
ACL ࢆྵࡵࡓୗ⫥യ ᐖண㜵ࡢࡓࡵ ࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢆ┠ ⓗ࡜ࡋ ࡚ ࢻࣟࢵࣉ
ࣂ࣮ࢸ࢕࢝ࣝࢪࣕࣥࣉࢆ⾜ࢃࡏࡓ࡜ࡁࡢ⭸㛵⠇እ㌿ືస࠾ࡼࡧ⫤㛵⠇ෆ㌿
ື స ࡸ 㛵 ⠇ ࣔ ࣮ ࣓ ࣥ ࢺ ࡟ ╔ ┠ ࡋ ࡚ ホ ౯ ࡍ ࡿ ሙ ྜ 㸪 Q-angle 㸪 Femoral antevertion angle㸪⫤㛵⠇ እ㌿➽ຊ ࡢ ᐃ㡯┠ࢆ ྵࡵࡓホ౯ࡢ ᭷⏝ᛶࡀ ♧ࡉࢀࡓ 㸬
ࡲࡓ㸪╔ᆅ᫬ࡢ⾪ᧁ⦆⾪⬟ࡢホ౯㡯┠࡜ࡋ࡚㸪࢔࣮ࢳ㧗⋡࡜㊊㛵⠇⫼ᒅゅ
ᗘࢆྵࡵࡓホ ౯ ࡢ᭷⏝ ᛶࡀ♧ࡉࢀࡓ 㸬
137
➨6❶
ୗ⫥യᐖண㜵ࢺ࣮ࣞࢽࣥࢢ௓ධ࡜ຠᯝ᳨ド
138
◊ ✲ 7 ୗ ⫥ യᐖ ண㜵 ࢺࣞ ࣮ࢽ ࣥ ࢢ௓ ධࡀ ㊊ ㊑ᶵ ⬟㸪 ㊊ 㒊ᙧ ែ㸪 㟼 ⓗ࣭ ືⓗ ࣂ
ࣛࣥ ࢫ⬟ ຊ ࡟ཬ ࡰࡍ ᙳ 㡪
6-7-1. ⥴ゝ
21 ୡ⣖࡟ධࡾ㸪ࢫ࣏࣮ ࢶ་Ꮫ఍࡟࠾ ࠸࡚ࢫ࣏ ࣮ࢶയᐖண㜵 ࡟ྥࡅࡓ ྲྀࡾ⤌ࡳ
ࡀ✚ᴟⓗ ࡟⾜ࢃ ࢀ࡚࠸ ࡿࡀ㸪 ୰ ࡛ࡶ⭸๓ ༑Ꮠ 㠌ᖏ㸦 anterior cruciate ligament㸸
௨ୗ㸪ACL㸧 യᐖ ண㜵 ࣉࣟࢢ ࣒ࣛ ࡸ ㊊㛵 ⠇യ ᐖண㜵 ࣉࣟࢢ ࣒ࣛ ࡢ௓ ධሗ࿌ ࡀከ
ᩘࡳࡽࢀࡿ 㸬ࢫ࣏ ࣮ࢶ ⌧ሙ࡟࠾ࡅࡿ ୗ⫥യᐖ ண㜵 ࢺ࣮ࣞࢽ ࣥࢢࡢ ᣦ ᑟἲ࡜ࡋ࡚ 㸪
ࢫࢡ࣡ࢵࢺࡸ ࢪࣕࣥࣉ ࠿ࡽࡢ╔ᆅື స᫬࡟ࡳ ࡽࢀࡿ㐣๫࡞ ⭸ 㛵⠇እ ཯⫥఩ࡢᅇ
㑊࡟↔Ⅼࢆᙜ ࡚ࡓ ᣦᑟ ࡀ」ᩘࡳࡽࢀ 㸪ከࡃࡣ ⭸㛵⠇ࡸ⫤㛵 ⠇ࡢືࡁ ࢆព㆑ࡉࡏ
ࡓᣦᑟἲ࡛࠶ ࡿࡀ㸪➹ ⪅ࡽࡣࡇࡢࡼ ࠺࡞ᣦᑟ ࡢ࡯࠿࡟ 㸪㊊ ㊑ࡢືࡁ ࡜㛵㐃ࡉࡏ
ࡓᣦᑟࡀ㐣๫ ࡞⭸ 㛵⠇ እ཯⫥఩ࡸ⫤ 㛵⠇ෆ㌿ ືసࢆᅇ㑊ࡉ ࡏࡿࡇ࡜ ࡀฟ᮶ࡿࡢ
࡛ࡣ࡞࠸࠿࡜ ⪃࠼ 㸪◊ ✲ 2 ࡟࠾࠸ ࡚㊊㊑㛤᤼ ⬟ ࠾ࡼࡧ㊊㊑ 㛤᤼ᣦ♧ ࡀ ືⓗୗ⫥
࢔ࣛ࢖࣓ࣥࢺ ࡟ཬࡰࡍ ᙳ㡪 [బ㔝ᮧ࡜ධỤ, 2012; బ㔝ᮧ࡜ධ Ụ , 2013]࡟ࡘ࠸࡚
◊✲ࢆ⾜࠸㸪 ᚓࡽࢀࡓ ⤖ᯝ࠿ࡽ㸪≉ ࡟ ∦⬮ࢻ ࣟࢵࣉࣛࣥࢹ ࢕ࣥࢢࢱ ࢫࢡ ࡟࠾࠸
࡚㸪㊊㊑㛤᤼ ⬟ࡀ㧗࠸ ⪅㸪ࡲࡓ㊊㊑ 㛤᤼ᣦ♧ ࢆࡋࡓሙྜࡣ ࡑ࠺࡛࡞ ࠸ ᫬࡜ẚ࡭
࡚᭷ព࡟⭸㛵 ⠇እ㌿ື స ࢆῶࡌࡉࡏ ࡿ࡜࠸࠺ ♧၀ࢆᚓࡓ㸬 ࡲࡓ㸪◊ ✲ 5 ࡟࠾࠸
࡚ࡣ㊊㊑ᢕᥱ ຊ࡜㟼ⓗ ࠾ࡼࡧືⓗࣂ ࣛࣥࢫ ಖ ᣢ⬟ຊ࡜ࡢ㛵 㐃ᛶ ࡟ࡘ ࠸࡚◊✲ࢆ
⾜࠸㸪ྑ㊊㊑ ᢕᥱຊ࡜ 㔜ᚰືᦂᛶࡢ 㔜ᚰ⥲㌶ ㊧㛗㸪㔜ᚰ ༢ ఩㌶㊧㛗 ࡜ࡢ㛵ಀ࡟
᭷ព࡞㈇ࡢ┦ 㛵ࢆ♧ࡋ 㸪ྑ㊊㊑ᢕᥱ ຊࡢ኱ࡁ ࠸⩌ࡣᑠࡉ࠸ ⩌ ࡜ ẚ㍑ ࡋ㸪㔜ᚰື
ᦂᛶࡢ㔜ᚰ⥲ ㌶㊧㛗࡜ 㔜ᚰ༢఩㌶㊧ 㛗 ࡀ᭷ព ࡟▷࠿ࡗࡓ㸬 ࡲࡓ㸪 ᕥ ㊊㊑ᢕᥱຊ
ࡢ኱ࡁ࠸⩌ࡣ ᑠࡉ࠸⩌ ࡜ẚ㍑ࡋ㸪Star Excursion Balance Test㸦௨ୗ 㸪 SEBT㸧ࡢ
๓᪉࣮ࣜࢳ㛗 ࡀ᭷ព࡟ 㛗࠿ࡗࡓ ࡇ࡜ ࠿ࡽ㸪 ㊊ ㊑ᢕᥱືస࠾ ࡼࡧ㊊㊑ ᢕᥱຊྥୖ
࢚ࢡࢧࢧ࢖ࢬ ࡀ㸪 㟼ⓗ ࠾ࡼࡧືⓗࣂ ࣛࣥࢫ⬟ ຊྥୖ࡟ ࡘ࡞ ࡀࡿ ྍ⬟ ᛶࢆ♧၀ࡋ
ࡓ㸬ࡑࡇ࡛ᮏ ❶࡟࠾࠸ ࡚ࡣ 㸪ୗ⫥യ ᐖண㜵ࢺ ࣮ࣞࢽࣥࢢࡢ ௓ධຠᯝ ᳨ドࢆ⾜࠺
ࡇ࡜࡜ࡋ࡚㸪 ◊✲ 7 ࡛ ࡣ኱ᏛዪᏊࣛ ࢡࣟࢫ➇ ᢏࢆᑐ㇟࡜ࡋ ࡚㸪㏻ᖖ ⾜ࢃࢀ࡚࠸
ࡿ࢛࣮࣑࢘ࣥ ࢢ࢔ࢵࣉ ࡢ୰ࡢࣇ࢛࣡ ࣮ࢻ ࣛࣥ ࢪࡸࢪࣕࣥࣉ ࠿ࡽࡢ╔ ᆅືస㸪ࢧ
࢖ࢻࢫࢸࢵࣉ ࡸษࡾ㏉ ࡋືస᫬࡟ ͆ ㊊㊑ࢆ㛤 ࠸࡚ᗋࢆᥗࡴ ͇ືసࢆ ᣦ♧ࡍࡿᣦ
ᑟἲࡀ㊊㊑㛤 ᤼⬟㸪 ㊊ ㊑ᢕᥱຊ㸪㊊ 㒊ᙧែ㸪 㟼ⓗ࠾ࡼࡧື ⓗࣂࣛࣥ ࢫ⬟ຊ࡟ཬ
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ࡰࡍᙳ㡪࡟ࡘ ࠸࡚ ẚ㍑ ᳨ドࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ ࡋ ࡚⾜ࡗࡓ㸬 ௬ㄝࡣ㸪 ࢛࣮࣑࢘ࣥ
ࢢ࢔ࢵࣉ࡛⾜ ࢃࢀ࡚࠸ ࡿྛ✀ືస ᫬ ࡟͆㊊㊑ ࢆ㛤࠸࡚ᗋࢆ ᥗࡴ ͇࡜ ࠸࠺ືసᣦ
ᑟἲࡣ㸪㊊㊑ 㛤᤼⬟ 㸪 ㊊㊑ᢕᥱຊ㸪 㟼ⓗ࠾ࡼ ࡧືⓗࣂࣛࣥ ࢫ ⬟ຊࢆ ྥୖࡉࡏࡿ
࡯࠿㸪⯚≧㦵 ỿ㝆ᗘࢸ ࢫࢺ㸦 navicular drop test score㸸௨ୗ㸪NDTS㸧ࢆῶᑡࡉ
ࡏ㸪࢔࣮ࢳ㧗 ⋡ࡣቑຍ ࡉࡏࡿ࡜࠸࠺ ࡶࡢ࡛࠶ ࡿ 㸬
6-7-2. ᑐ㇟࡜᪉ἲ
1. ᑐ㇟
ᑐ㇟⪅ࡣ㸪㛵 ᮾ኱Ꮫዪ Ꮚࣛࢡࣟࢫࣜ ࣮ࢢ 1 㒊 ࡟ᡤᒓࡍࡿ኱ ᏛዪᏊࣛ ࢡࣟࢫ㑅
ᡭ 20 ྡ㸦ᖹᆒ ᖺ㱋㸦 ±ᶆ ‽೫ᕪ㸧
㸸19.4±1.2 ṓ㸪㌟㛗㸸160.0±5.0cm㸪య 㔜㸸54.7±5.4kg㸪
BMI㸸 21.4±1.4kg/m 2 㸧 ࡛ ࠶ ࡗࡓ 㸬 ᑐ ㇟ ⪅ ࡟ 㸪 ᮏ ◊ ✲ࢆ ⾜ ࠺ ๓ ࡟ ◊ ✲ ࡢ ┠ ⓗ㸪ㄪ
ᰝ᪉ἲ㸪೔⌮ ⓗ㓄៖➼ ࡟㛵ࡍࡿㄝ᫂ ࢆ⾜࠸㸪 ྠពࢆᚓࡓ㸬 ࡞࠾㸪ᮏ ◊✲ࡣ᪩✄
⏣኱Ꮫ ேࢆᑐ㇟ ࡜ࡍ ࡿ◊✲࡟㛵ࡍ ࡿ೔⌮ᑂ ᰝጤဨ఍ࡢᢎ ㄆࢆᚓ࡚ ⾜ࡗࡓ㸦 ᢎㄆ
␒ྕ 2010-037㸧㸬
140
2. ᪉ἲ
⦎⩦๓࡟⾜ࢃ ࢀ࡚࠸ࡿ ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ㸦 20 ศ㸧࡛ᐇ᪋ࡉ ࢀ࡚ ࠸ࡿྛ✀ື
స࡟ ࠾ ࠸ ࡚㸦 ⾲ 7-1㸧 㸪╔ ᆅ ື స᫬ ࡟ ྍ⬟ ࡞ 㝈ࡾ 㸪 ㊊ ㊑㛤 ᤼ ࠾ࡼ ࡧ ㊊㊑ ᢕ ᣢࢆ
ព㆑ࡉࡏ࡚⾜ ࢃࡏࡓ㸬 ≉࡟ࢪࣙࢠࣥ ࢢ㸪ࢫࢺ ࣞࢵࢳ ࣥࢢ㸪 యᖿࢺࣞ ࣮ࢽࣥࢢᚋ
࡟⾜ࢃࢀ ࡓ Line to line㸦ࣛ࢖ࣥ㛫㊥ 㞳 10m㸧 ࡛ࡢ࢛࣮࣑࢘ ࣥࢢ ࢔ࢵ ࣉ᫬࡟㊊㊑
㛤᤼࠾ࡼࡧ㊊ ㊑ᢕᣢ ື సࢆᣦ♧ࡋࡓ 㸬ᐇ 㝿ࡢ ᣦᑟ࡟ ࡘ࠸࡚ ࡣ➹⪅ࡢ ᣦ♧ࡢࡶ࡜ 㸪
ᖖ࡟⌧ሙ࡟ᖏ ྠࡋ࡚࠸ ࡿᑓᒓࢺ࣮ࣞ ࢼ࣮࡟ࡼ ࡗ࡚ ࡑࢀࡽࡢ ᣦ♧ࡀ⾜ ࢃࢀࡓ 㸬௓
ධᮇ㛫ࡣ 2011 ᖺ 6 ᭶㹼2012 ᖺ 3 ᭶ࡲ࡛࡜ ࡋ㸪௓ධᮇ㛫 ๓ᚋ ࡟ ᐃࡋࡓ ྛ㡯┠
ࢆẚ㍑ࡋࡓ㸬 ྛ ᐃ㡯 ┠࡜ ᐃ᪉ἲ ࢆ௨ୗ࡟ ♧ࡍ㸬
a. ㊊㊑㛤᤼⬟
㊊㊑㛤᤼⬟ࡢ ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲ 2[బ㔝ᮧᏛ࡜ ධỤ୍᠇ ,
2012]࡟♧ࡋࡓ㏻ࡾ ࡛ ࠶ࡿ㸬 b. ㊊㊑ᢕᥱຊ
㊊㊑ᢕᥱຊࡢ ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲ 5 ࡟ ♧ࡋࡓ㏻ ࡾ࡛࠶ࡿ 㸬
c. NDTS
NDTS ࡢ ᐃ᪉ἲࡢ ヲ ⣽࠾ࡼࡧࣃࣛ ࣓࣮ࢱ ࡣ ◊✲ 6 ࡟♧ࡋ ࡓ㏻ࡾ࡛ ࠶ࡿ㸬
141
d. ࢔࣮ࢳ㧗⋡
࢔࣮ࢳ㧗⋡ࡢ ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲ 6 ࡟ ♧ࡋࡓ㏻ ࡾ࡛࠶ࡿ 㸬
e. 㔜ᚰືᦂᛶ
㔜ᚰືᦂᛶࡢ ᐃ᪉ἲ ࡢヲ⣽࠾ࡼࡧ ࣃ࣓࣮ࣛ ࢱ ࡣ◊✲ 5 ࡟ ♧ࡋࡓ㏻ ࡾ࡛࠶ࡿ 㸬
f. SEBT
SEBT ࡢ ᐃ᪉ἲࡢヲ ⣽࠾ࡼࡧࣃࣛ ࣓࣮ࢱ ࡣ ◊✲ 5 ࡟♧ࡋ ࡓ㏻ࡾ࡛ ࠶ࡿ㸬
3. ⤫ィᏛⓗᡭἲ
௓ධ๓ᚋࡢ ㊊㊑㛤᤼ ⬟㸪㊊㊑ᢕᥱຊ㸪NDTS㸪࢔࣮ࢳ㧗⋡㸪㔜ᚰ ືᦂᛶ㸪SEBT
࡛ᚓࡽࢀࡓྛ ࣃ࣓࣮ࣛ ࢱࡢẚ㍑࡜ࡋ 㸪⤫ィᏛ ⓗ᳨ᐃࡣ㸪ᑐ ᛂࡢ࠶ ࡿ t ᳨ᐃࢆ⏝
࠸ࡓ㸬඲࡚ࡢ ⤫ィฎ⌮ ࡟ࡣ⤫ィゎᯒ ࢯࣇࢺ࢘ ࢙࢔㸦 SPSS Statistics Student Version
19.0㸧ࢆ⏝࠸㸪᭷ព ☜ ⋡ࢆ 5%ᮍ‶࡜ࡋࡓ㸬
6-7-3. ⤖ᯝ
1. ㊊㊑㛤᤼⬟
㊊㊑㛤᤼⬟ ࡢ௓ධ๓ ᚋࡢ⤖ᯝࢆ⾲ 7-2 ࡟♧ ࡍ㸬㊊㊑㛤᤼ ⬟ࡢ௓ධ ๓ᚋࡢẚ㍑
࡟࠾࠸ ࡚㸪ྑ ㊊ࡢ ㊊㊑ 㛤᤼⬟ ࡣ௓ධ๓ 21.4s13.8㸣㸦 ᖹᆒsᶆ‽ ೫ᕪ㸧 ࠿ࡽ௓
ධᚋ 26.5s13.5㸣࡬࡜ ᭷ព࡟ቑຍ ࡋ ࡓ㸦p = 0.042㸧㸬ࡲࡓ㸪 ᕥ㊊ ࡢ㊊㊑㛤᤼⬟
ࡶ௓ධ๓ 18.7s16.0㸣࠿ࡽ௓ධ ᚋ 28.9s17.7㸣࡬࡜᭷ព࡟ ቑຍ ࡋࡓ 㸦 p = 0.012㸧
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2. ㊊㊑ᢕᥱຊ
㊊㊑ᢕᥱຊࡢ ௓ධ๓ᚋ ࡢ⤖ᯝࢆ⾲ 7-3 ࡟♧ࡍ 㸬㊊㊑ᢕᥱຊ ࡢ௓ධ๓ ᚋࡢẚ㍑
࡟࠾࠸࡚㸪ᗙ఩ጼໃ ࡛ ࡢྑ㊊ࡢ㊊㊑ ᢕᥱຊࡣ 㸪௓ධ๓ 10.7s3.0kg㸦ᖹᆒsᶆ‽
೫ᕪ㸧࠿ ࡽ௓ධ ᚋ 13.0s3.1kg ࡬࡜ ᭷ព࡟ቑ ຍ ࡋࡓ㸦p < 0.001㸧㸬ࡲࡓ㸪ᕥ ㊊ࡢ
㊊㊑ᢕᥱຊࡶ ௓ධ ๓ 10.7s3.3kg ࠿ࡽ ௓ධᚋ 12.6s2.7kg ࡬࡜᭷ ព ࡟ቑຍ ࡋࡓ㸦p
< 0.001㸧㸬❧ ఩ጼໃ࡛ ࡢྑ㊊ࡢ㊊㊑ ᢕᥱຊࡣ ௓ධ๓ 14.0s2.9kg ࠿ ࡽ௓ධᚋ 16.8
s3.8kg ࡬࡜᭷ព ࡟ቑ ຍ ࡋࡓ㸦p = 0.001㸧㸬ࡲࡓ㸪ᕥ㊊ ࡢ㊊㊑ᢕ ᥱຊࡶ௓ධ๓
14.1s3.5kg ࠿ࡽ௓ ධ ᚋ 16.6s4.2kg ࡬ ࡜᭷ ព࡟ቑຍ ࡋࡓ 㸦p = 0.001㸧㸬
3. NDTS
NDTS ࡢ௓ධ๓ᚋࡢ ⤖ ᯝ ࢆ⾲ 7-4 ࡟ ♧ࡍ㸬 NDTS ࡢ௓ධ๓ᚋࡢ ẚ ㍑࡟࠾࠸࡚ 㸪
ྑ㊊ࡢ NDTS ࡣ௓ධ ๓ 4.7s2.7㸦ᖹᆒsᶆ‽೫ᕪ㸧࠿ࡽ ௓ධᚋ 3.7s2.4 ࡬࡜ῶ
ᑡഴྥࢆ♧ࡋ ࡓࡀ㸪᭷ ពᕪࡣࡳࡽࢀ ࡞࠿ࡗࡓ㸦 p = 0.166㸧㸬ࡲ ࡓ㸪ᕥ㊊ࡢ NDTS
ࡶ௓ධ๓ 4.3s2.5 ࠿ࡽ௓ධᚋ 3.5s2.1 ࡬࡜ῶᑡഴྥࢆ♧ࡋ ࡓࡀ㸪᭷ ពᕪࡣࡳࡽ
ࢀ࡞࠿ࡗࡓ㸦p = 0.111㸧㸬
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4. ࢔࣮ࢳ㧗⋡ ࢔࣮ࢳ㧗⋡ࡢ ௓ධ๓ᚋ ࡢ⤖ᯝࢆ⾲ 7-5 ࡟♧ࡍ 㸬࢔࣮ࢳ㧗⋡ ࡢ௓ධ๓ ᚋࡢẚ㍑
࡟࠾࠸࡚㸪ྑ㊊ࡢ࢔ ࣮ ࢳ㧗⋡ࡣ௓ධ ๓ 18.3s2.6㸣㸦ᖹᆒsᶆ‽೫ ᕪ㸧࠿ࡽ௓ ධ
ᚋ 19.0s2.3㸣࡟᭷ព ࡟ቑຍ ࡋࡓ㸦p = 0.047㸧㸬ࡲࡓ㸪ᕥ ㊊ࡢ࢔࣮ ࢳ㧗⋡ࡶ௓ධ
๓ 17.7s2.7㸣࠿ࡽ௓ ධᚋ 18.8s2.5㸣࡬᭷ ព࡟ቑຍ ࡋࡓ 㸦p = 0.032㸧㸬
144
5. 㔜ᚰືᦂᛶ 㔜ᚰືᦂᛶࡢ ௓ධ๓ᚋ ࡢ⤖ᯝࢆ⾲ 7-6 ࡟♧ࡍ 㸬㔜ᚰືᦂᛶ ࡢ௓ධ๓ ᚋࡢẚ㍑
࡟࠾࠸࡚㸪ྑ⬮ ❧఩᫬ ࡢ 㔜ᚰ⥲㌶㊧ 㛗ࡣ௓ධ ๓ 86.78s27.66mm㸦 ᖹᆒsᶆ‽೫
ᕪ㸧࠿ࡽ௓ධ ᚋ 99.46s21.66mm ࡬㸪ᕥ⬮❧ ఩᫬ࡢ 㔜ᚰ⥲ ㌶㊧㛗ࡣ ௓ධ๓ 85.86
s26.28 ࠿ࡽ௓ධ ᚋ 100.62s26.50mm ࡬ቑຍ ഴྥࢆ♧ࡋࡓ ࡀ㸪᭷ព ᕪࡣࡳࡽࢀ࡞
࠿ࡗࡓ㸦ࡑࢀ ࡒࢀ p = 0.120㸪0.072㸧㸬㔜ᚰ ༢఩㌶㊧㛗࡟ ࡘ࠸࡚ࡣ 㸪ྑ⬮❧఩᫬
ࡣ௓ධ๓ 2.89s0.92mm/⛊࠿ࡽ௓ ධᚋ 3.32s0.73mm/⛊࡬ቑຍ ഴ ྥࢆ♧ࡋࡓࡀ 㸪
᭷ពᕪࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓ㸦 p = 0.108㸧㸬ᕥ ⬮ ❧఩᫬ࡣ௓ධ ๓ 2.86s0.88mm/⛊࠿
ࡽ௓ධᚋ 3.46s0.91mm/⛊࡬᭷ព ࡟ቑຍࡋ ࡓ㸦p = 0.031㸧㸬㔜ᚰ ༢ ఩㠃✚㌶㊧㛗
࡟ࡘ࠸࡚ࡣ 㸪ྑ⬮ ❧఩ ᫬ࡢ௓ධ ๓ 34.89s21.52mm/cm 2 ࠿ ࡽ௓ධ ᚋ 29.14s11.22
mm/cm 2 ࡬ 㸪ᕥ⬮❧ ఩ ᫬ࡢ௓ධ๓ 32.23s19.75 mm/cm 2 ࠿ ࡽ௓ධ ᚋ 30.54s8.45
mm/cm 2 ࡬ῶ ᑡഴྥࢆ ♧ࡋࡓࡀ 㸪᭷ពᕪࡣ ࡳ ࡽࢀ࡞࠿ࡗࡓ㸦ࡑࢀ ࡒ ࢀ p = 0.262㸪
p = 0.738㸧㸬ࡑࡢ ࡯ ࠿ 㔜ᚰእ࿘㠃 ✚࡟ࡘ࠸ ࡚ࡶྑ⬮❧఩ ᫬ࡢ௓ධ ๓ 3.32s1.91
cm 2 ࠿ࡽ௓ධ ᚋ 4.01s2.03 cm 2 ࡬㸪ᕥ⬮❧ ఩ ᫬ࡢ௓ධ ๓ 3.47s1.65 cm 2 ࠿ࡽ௓ධ
ᚋ 3.71s1.48 cm 2 ࡬ 㸪㔜ᚰᣄᙧ㠃 ✚࡟ࡘ࠸ ࡚ࡶྑ⬮❧఩ ᫬ࡢ௓ධ ๓ 8.32s4.50
cm 2 ࠿ࡽ௓ධ ᚋ 13.25s15.65 cm 2 ࡬㸪ᕥ⬮❧ ఩᫬ࡢ௓ධ ๓ 8.45s3.90 cm 2 ࠿ ࡽ௓
ධᚋ 8.82s3.31 cm 2 ࡬ ቑຍഴྥࢆ♧ ࡋࡓࡀ㸪 ࠸ࡎࢀ࡟࠾࠸ ࡚ࡶ᭷ព ᕪࡣࡳࡽࢀ
࡞࠿ࡗࡓ㸦ࡑ ࢀࡒ ࢀ p = 0.328㸪p = 0.648㸹p = 0.214㸪p = 0.747㸧㸬
145
6. SEBT
SEBT ࡢ௓ධ๓ ᚋࡢ⤖ ᯝࢆ⾲ 7-7 ࡟♧ࡍ㸬SEBT ࡢ௓ධ๓ᚋࡢẚ ㍑࡟࠾࠸࡚ 㸪
A㸦anterior㸸๓᪉ 㸧࡟ ࡘ࠸ ࡚ࡣ 㸪ᕥ ྑ ࠸ࡎ ࢀ ࡟࠾ ࠸࡚ ࡶ᭷ ព ᕪࡣ ࡳ ࡽࢀ ࡞࠿ ࡗ
ࡓ㸦ᕥ㸸p = 0.699, ྑ㸸p = 0.722㸧㸬PM㸦posteromedial㸸ᚋ ෆ᪉㸧࡟ࡘ࠸࡚ࡣ㸪
ྑࡣ௓ධ ๓ 114.2s6.0㸦ᖹᆒsᶆ‽೫ᕪ㸧 ࠿ ࡽ௓ධᚋ 117.5s4.7 ࡛᭷ព࡟ቑຍ
ࡉࡏ㸦p = 0.006㸧㸪ᕥ࡟ࡘ࠸࡚ ࡶ 114.6s7.0 ࠿ࡽ 117.6s5.2 ࡬࡜᭷ព࡟ቑຍࡉ
ࡏࡓ㸦p = 0.018㸧㸬PL㸦posterolateral㸸ᚋእ ᪉ 㸧࡟ࡘ࠸࡚ࡣ㸪ྑ ࡣ ௓ධ๓ 110.1
s5.3 ࠿ࡽ௓ධᚋ 113.2s5.3 ࡛᭷ព࡟ቑຍࡉ ࡏ㸦 p = 0.005㸧㸪ᕥࡢ PL ࡟ࡘ࠸࡚
ࡶ 110.1s8.2 ࠿ࡽ 112.8s6.2 ࡬࡜᭷ព ࡟ቑຍ ࡉࡏࡓ㸦 p = 0.042㸧㸬
6-7-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪 ୗ⫥ യᐖ ண㜵ࢺ࣮ࣞࢽ ࣥࢢࡢ௓ ධຠᯝ᳨ド ࡜ ࡋ࡚㸪 ኱ ᏛዪᏊࣛࢡ
ࣟࢫ㑅ᡭࢆᑐ ㇟࡜ࡋ 㸪 ㏻ᖖ⾜ࢃࢀ࡚ ࠸ࡿ࢛࢘ ࣮࣑ࣥࢢ࢔ࢵ ࣉ࣓ࢽࣗ ࣮ ࡛⾜ࢃࢀ
࡚࠸ࡿࣛࣥࢪ ࡸࢪࣕࣥ ࣉ࠿ࡽࡢ╔ᆅ ືస㸪ࢧ ࢖ࢻࢫࢸࢵࣉ ࡸษࡾ㏉ ࡋືస᫬࡟
͆㊊㊑ࢆ㛤࠸ ࡚ᗋࢆᥗ ࡴ ͇ࢆᣦ♧ࡋ ࡓᣦᑟἲ ࡀ㸪㊊㊑㛤᤼ ⬟㸪 ㊊㊑ ᢕᥱຊ㸪㊊
㒊ᙧែ㸪㟼ⓗ ࠾ࡼࡧື ⓗࣂࣛࣥࢫ⬟ ຊ࡟ཬࡰ ࡍᙳ㡪ࢆ ẚ㍑ ᳨ドࡍࡿ ࡇ࡜ࢆ┠ⓗ
࡜ࡋ࡚⾜ࡗࡓ 㸬
㊊㊑㛤᤼⬟ ࡟ࡘ࠸࡚ 㸪௓ධᚋ࡛ᕥ ྑ࡜ࡶ࡟ ㊊㊑ࢆ㛤᤼ ࡉ ࡏࡿ๭ྜ ࢆ᭷ព࡟ቑ
ຍࡉ ࡏ ࡓ 㸦⾲ 7-2㸧㸬 ≉࡟ ௓ ධ ๓࡟ ࠾ ࠸࡚ 㸪 ྑ㊊ ㊑ ࡟ ẚ࡭ ࡚ ᕥ㊊ ㊑ ࡢ㛤 ᤼ ⬟ࡀ
146
ప࠸ഴྥࡀࡳ ࡽࢀࡓࡀ 㸦 p = 0.178㸧㸪௓ධᚋ ࡟࠾࠸࡚ࡣᕥ ㊊㊑ࡢ㛤 ᤼⬟ࡀቑຍ
ഴྥࢆ♧ࡋࡓ 㸦 p = 0.391㸧㸬ࡲࡓ㸪 ࡑࡢ࡯࠿ ᭱኱㊊㊑㛤᤼ ࡜ ᭱኱㊊ ㊑㛤᤼ᗘࢆ
ẚ㍑ ࡋ ࡓ 㸦⾲ 7-8㸧㸬 ᭱኱ ㊊ ㊑ 㛤᤼ ࡣ 㸪ྍ ⬟ ࡞㝈 ࡾ ㊊ ㊑㛤 ᤼ ࢆ⾜ ࢃ ࡏࡓ ࡜ ࡁࡢ
ẕ㊑࠿ࡽᑠ㊑ ࡲ࡛ࡢ㊥ 㞳ࢆ♧ࡋ㸪㊊ ㊑㛤᤼ᗘ ࡣ㸪᭱኱㊊㊑ 㛤᤼᫬ࡢ ್࠿ࡽ㸪Ᏻ
㟼᫬ࡢྠ㊊㊑ 㛫㊥㞳ࡢ ᕪࢆ♧ࡍ㸬ࡇ ࡢ⤖ᯝ࠿ ࡽ㸪᭱኱㊊㊑ 㛤᤼࡟ࡘ ࠸࡚㸪௓ධ
๓ࡣᕥ㊊㊑࡟ ẚ࡭ྑ㊊ ㊑ࡀࡼࡃ㛤ࡃ ഴྥࡀぢ ࡽࢀࡓࡀ㸪ࢺ ࣮ࣞࢽࣥ ࢢᚋ࡛ࡣ㸪
ᕥྑࡢ㊊㊑࡜ ࡶ࡟ྠ⛬ ᗘ㛤᤼ྍ⬟࡟ ࡞ࡗ࡚࠸ ࡓ㸬ࡲࡓ 㸪㊊ ㊑㛤᤼ᗘ࡟ ࡘ࠸࡚ࡣ 㸪
௓ධ๓ࡣᕥ㊊ ㊑࡟ẚ࡭ ྑ㊊㊑ࡢᏳ㟼 ᫬࠿ࡽ᭱ ኱㛤᤼᫬ࡢᕪ ࡀ኱ࡁ࠿ ࡗࡓࡀ㸪ࢺ
࣮ࣞࢽࣥࢢᚋ ࡛ࡣ㸪ᕥ ㊊㊑ࡢ㛤᤼ࡢ ᕪࡢ᪉ࡀ ኱ࡁࡃ㸪ࡼࡾ 㛤᤼ᗘࡀ ቑຍࡋ ࡚࠸
ࡓ㸬
㊊㊑㛤᤼ືస ࡣ㸪㊊㒊 ෆᅾ➽࡛࠶ࡿ ẕ㊑እ㌿ ➽ 㸪ᑠ㊑እ㌿ ➽ 㸪⫼ഃ 㦵㛫➽࡛
⾜ࢃࢀࡿ࡯࠿[Oatis, 2009]㸪▷㊑ఙ➽ ࠾ࡼࡧ㛗 ẕ㊑ఙ➽࡟ࡼ ࡗ࡚ࡶ⾜ ࢃࢀ࡚࠸ࡿ 㸬
௒ᅇ⾜ࡗࡓ࢘ ࢛࣮࣑ࣥ ࢢ࢔ࢵࣉ᫬ࡢ ᣦᑟἲࡢ ୍ࡘ࡜ࡋ࡚ྲྀ ࡾධࢀࡓ ͆㊊㊑ࢆ㛤
࠸࡚ᗋࢆᥗࡴ ͇ࡢືస ᣦ♧ࡀ㸪ྠస ⏝➽ࢆᙉ ࡃ⥭ᙇࡉࡏࡓ ࡇ࡜࡜㸪 ࡉࡽ࡟ࡣࡑ
ࢀࢆ㛗ᮇ㛫࡟ ࢃࡓࡾ ⧞ ࡾ㏉ࡋ⥅⥆ࡋ ࡚ᣦ♧ࢆ ୚࠼ࡓࡇ࡜࡛ ㊊㊑㛤᤼ ⬟ຊࡢྥୖ
࡟ࡘ࡞ࡀࡗࡓ ࡢ࡛ࡣ࡞ ࠸࠿ ࡜᥎ ࡋ ࡓ㸦 ⾲ 7-2㸪⾲ 7-8㸧㸬
㊊㊑ ᢕ ᥱ ຊ࡟ ࡘ ࠸ ࡚ࡣ 㸦⾲ 7-3㸧 㸪ᗙ ఩ ࠾ࡼ ࡧ❧ ఩ ጼ ໃ࡛ ࡢ ᐃ್ ࡜ࡶ ࡟௓
ධᚋ࡟࠾࠸࡚ ᭷ព࡟ቑ ຍ ࡋࡓ㸬௓ධ ๓ᚋࡢ㊊ ㊑ᢕᥱຊࡢᕥ ྑᕪ࡟ࡘ ࠸࡚ ࡣ㸪࠸
ࡎࢀࡶ᭷ព࡞ ᕪࡣ ࡳࡽ ࢀ࡞࠿ࡗࡓ㸬 ௒ᅇࡢ◊ ✲࡛⾜ࡗࡓ㊊ ㊑ᢕᥱຊ ࡢ ᐃ᪉ἲ
ࡣ㸪㏻ᖖ⾜ࢃ ࢀ࡚࠸ࡿ ᗙ఩࡛ࡢ ᐃ ࡟ຍ࠼㸪 ❧఩࡛ࡢ ᐃ ࡶ ⾜ ࠺ࡇ ࡜࡜ࡋࡓ㸬
147
ࡇࢀࡣ㸪ᮏ◊ ✲࡛⾜ࡗ ࡓ㊊㊑㛤᤼ື స ࡸ㊊㊑ ᢕᥱືసࡀ㸪 ࢛࣮࣑࢘ ࣥࢢ࢔ࢵࣉ
࡛⾜ࢃࢀ࡚࠸ ࡿࣛࣥࢪ ࡸࢫࢸࢵࣉື స㸪 ࢪࣕ ࣥࣉ࠿ࡽࡢ ╔ ᆅືస ➼ ࡍ࡭࡚❧఩
ጼໃ࡛⾜ࢃࢀ ࡚࠸ࡿⅭ ࡛࠶ࡿ㸬⤖ᯝ 㸪ᗙ఩࡜ ❧఩᫬ࡢ㊊㊑ ᢕᥱຊᖹ ᆒ್ࡢᕪ࡟
ࡘ࠸࡚ẚ㍑ࡋ ࡚ࡳࡿ࡜ 㸦⾲ 7-3㸧㸪௓ධ ๓ࡢ ྑ㊊㊑࡛ 3.3kg㸪ᕥ㊊ ㊑ 3.4kg㸪௓
ධᚋࡢྑ㊊㊑ ࡛ 3.7kg㸪ᕥ㊊㊑ 4.0kg ࡢᕪࡀ ࡳࡽࢀࡓ 㸬ࡇ ࢀࡽࢆᖹ ᆒ໬ࡍࡿ࡜ 㸪
ྑ㊊㊑࡛ᖹᆒ 3.5kg㸪 ᕥ㊊㊑࡛ 3.7kg㸪 ᕥྑ ྜࢃࡏ࡚ᖹᆒ 3.6kg ࡢ ᗙ఩࡜❧఩᫬
ࡢ㊊㊑ᢕᥱຊ ࡢᕪࡀࡳ ࡽࢀࡓ㸬 ㊊㊑ ᢕᥱືస ࡟ స⏝ࡍࡿ➽ ࡣ㸪 ㊊㒊 ෆᅾ➽࡛࠶
ࡿ▷ẕ㊑ᒅ➽ࠊ㛗ẕ㊑ ᒅ➽ࠊẕ㊑ෆ㌿ ➽㸪▷ ㊑ᒅ➽㸪▷ᑠ㊑ ᒅ➽㸪⫼ഃ㦵㛫➽㸪
ᗏഃ㦵㛫➽㸪⹸ ᵝ➽ ࡛ ࠶ࡿࡀ[Oatis, 2009]㸪㊊㊑㛤᤼⬟ྠ ᵝ࡟㸪࢘ ࢛࣮࣑ࣥࢢ࢔
ࢵࣉ᫬࡟⾜ࢃ ࡏࡓ ͆㊊ ㊑ࢆ㛤࠸࡚ᗋ ࢆᥗࡴ ͇ ࡢືసᣦ♧ࡀ ྠస⏝➽ ࢆᙉࡃ཰⦰
ࡉࡏ㸪ࡉࡽ࡟ ࡣࡑࢀࢆ 㛗ᮇ㛫࡟ࢃࡓ ࡾ ⧞ࡾ㏉ ࡋ⥅⥆ࡋ࡚ື సᣦ♧ࢆ ୚࠼ࡓࡇ࡜
࡛ࢺ࣮ࣞࢽࣥ ࢢຠᯝࢆ ᭷ព࡟ᚓࡿࡇ ࡜ࡀฟ᮶ ࡓࡢ࡛ࡣ࡞࠸ ࠿࡜⪃࠼ ࡓ㸬
NDTS ࡟ࡘ࠸࡚ ࡣ㸦⾲ 7-4㸧㸪௓ ධ๓ᚋࡢ ẚ ㍑࡟ ࠾࠸࡚㸪 ᕥྑ ࠸ࡎ ࢀࡶ 0.8㹼
1mm ⛬ ᗘࡢῶᑡ ഴྥ ࢆ♧ࡋ ࡓࡀ 㸪᭷ពᕪࡣ ࡳࡽࢀ࡞࠿ࡗ ࡓ㸦ྑ㸸p = 0.166㸪ᕥ 㸸
p = 0.111㸧㸬ඛ⾜◊✲ ࠿ࡽ㸪Ⲵ㔜఩ ࡛ࡢ ẕ㊑ እ㌿➽࡟ࡼࡿ ㊊㊑ᒅ᭤ స⏝ࡀ㊊㒊
ෆഃ⦪࢔࣮ࢳ ࡢᨭᣢ࡟ 㔜せ࡞ᙺ๭ࢆ ᯝࡓࡋ࡚ ࠸ࡿࡇ࡜ࡀከ ᩘሗ࿌ࡉ ࢀ࡚ ࠸ࡿࡀ
[Fiolkowski et al., 2003; Headlee et al., 2008; Jung et al., 2012; Mann and Inman,
1964; Wong, 2007]㸪㊊㊑㛤᤼ືసࡸ ㊊㊑ᢕᥱ ືస࡟ࡼࡾ㸪 ẕ㊑እ㌿ ➽ ࡸ㛗࣭▷
ẕ㊑ᒅ➽➼ࡢ ➽స⏝ࡀ ෆഃ⦪࢔࣮ࢳ ๛ᛶࢆ㧗 ࡵ㸪 ௓ධ๓࡟ ẚ࡭ ௓ධ ᚋࡣ NDTS
ࡀᑠࡉࡃ࡞ࡿ ࡜ண ࡋ ࡓ ࡀ㸪ᖹᆒ್ ࡛ప್ࢆ ♧ࡋ ࡓࡶࡢࡢ ᭷ពᕪࡣ ㄆࡵࡽࢀ࡞
࠿ࡗࡓ㸬
࢔࣮ࢳ㧗⋡ࡢ ௓ධ๓ᚋ ࡢẚ㍑ 㸦⾲ 7-5㸧࡟ ࡘ ࠸࡚ࡶ NDTS ྠᵝ࡟ 㸪㊊㊑㛤᤼
ࡸ㊊㊑ᢕᥱື స࡟ࡼࡾ 㸪 ẕ㊑እ㌿➽ ࡸ㛗࣭▷ ẕ㊑ᒅ➽➼ࡢ ➽స⏝ࡀ ෆഃ⦪࢔࣮
ࢳ๛ᛶࢆ㧗ࡵ ࡿࡇ࡜࡛ ࢔ ࣮ࢳ㧗⋡ࡢ ྥୖ࡟ᐤ ୚ࡉࡏࡿࡢ࡛ ࡣ࡞࠸࠿ ࡜᥎ ࡋࡓ
ࡀ㸪ᚓࡽࢀࡓ ⤖ᯝࡣ௓ ධᚋࡣᕥྑ㊊ ࡜ࡶ࡟࢔ ࣮ࢳ㧗⋡ࢆቑ ຍࡉࡏࡓ 㸬 ẕ㊑እ㌿
➽ࡢస⏝ࡀ㊊ 㒊ෆഃ⦪ ࢔࣮ࢳࡢᨭᣢ ࣭ᣲୖ࡟ ᐤ୚ࡉࡏ࡚࠸ ࡿࡇ࡜ࡀ ከᩘሗ࿌ࡉ
ࢀ࡚࠸ࡿࡀ㸪Jung㸦2012㸧ࡣ㸪toe-curl ࢚ࢡ ࢧࢧ࢖ࢬࡸ short-foot ࢚ࢡࢧࢧ࢖ࢬ
ࢆ⾜ࢃࡏࡓ࡜ ࡇࢁ㸪≉ ࡟❧఩࡛ ࡢ short-foot ࢚ࢡࢧࢧ࢖ࢬ ᚋ࡟᭷ព ࡟⾲㠃➽㟁
ᅗ࡟࠾࠸࡚㧗 ್ࢆ♧ࡋ 㸪 ෆഃ⦪࢔࣮ ࢳࢆ᭷ព ࡟ ᣲୖࡉࡏࡓ ࡜ሗ࿌ࡋ ࡚࠸ࡿ㸬ࡲ
148
ࡓ㸪Wong㸦2007㸧 ࡣ 㸪 In-vitro ࡛ẕ㊑እ㌿ ➽ࢆ཰⦰ࡉࡏ ࡓ᫬࡟ෆ ഃ⦪࢔࣮ࢳࢆ
ᣲୖࡉࡏ㸪ẕ ㊑እ㌿➽ ࡣ㟼ⓗ࡞ෆഃ ⦪࢔࣮ࢳ ᨭᣢస⏝ ࡔࡅ ࡛࡞ࡃ 㸪 Ṍ⾜᫬࡟࠾
ࡅࡿືⓗ࡞ෆ ഃ⦪࢔࣮ ࢳᨭᣢస⏝ࢆ ࡶࡘࡇ࡜ ࢆ♧၀ࡋ࡚࠸ ࡿ㸬 ࡑࡢ ࡯࠿㊊㒊ෆ
ᅾ➽௨እ࡟ࡶ ㊊ᗏ⭝⭷ ࡸ㊊ᗏ➽⭷ࡀ ㊊㒊࢔࣮ ࢳࢧ࣏࣮ࢺ࡟ ᐤ୚ࡋ࡚ ࠸ࡿࡇ࡜ࡀ
」ᩘሗ࿌ࡉࢀ ࡚࠾ࡾ [Thordarson et al, 1997; Carlson et al., 2000; Franco, 1987]㸪ᮏ
◊✲࡟࠾ࡅࡿ ͆㊊㊑ࢆ 㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࡢື సᣦ♧ࡀ㊊㒊 ࢔࣮ࢳ๛ ᛶࡢྥୖ࡟
ᐤ୚ࡉࡏࡓࡇ ࡜ࡀ♧၀ ࡉࢀࡓ㸬
㔜ᚰ ື ᦂ ᛶ࡟ ࡘ ࠸ ࡚ࡣ 㸪௓ ධ ๓ ᚋࡢ ẚ ㍑ ࡟ ࡘ ࠸࡚ 㸦 ⾲ 7-6㸧 㸪 㔜ᚰ ༢఩ ㌶㊧
㛗ࡢᕥ⬮❧఩ ᫬ࡢࡳ ᭷ ពᕪࡀㄆࡵࡽ ࢀ㸦 ௓ධ ๓ 2.86s0.88mm/⛊࠿ ࡽ௓ධᚋ 3.46
s0.91mm/⛊㸪p = 0.031㸧㸪ࡑࡢ௚඲࡚ࡢ 㡯 ┠ ࡢ᭷ពᕪࡣ ㄆࡵࡽࢀ ࡞࠿ࡗࡓ㸬㔜
ᚰືᦂᛶࢸࢫ ࢺࡣ㸪ᅛ ᭷ឤぬჾࡸ⚄ ⤒➽༠ㄪ ᛶ ࡢホ౯ࡢ୍ ࡘ࡜ ࡋ࡚ ⏝࠸ࡽࢀ࡚
࠾ ࡾ 㸪 ࡑ ࢀ ࡽ ࡣ ࣂ ࣛ ࣥ ࢫ ಖ ᣢ ⬟ ຊ ࡢ ホ ౯ ࡢ ୍ ࡘ ࡜ ࡋ ࡚ ⏝ ࠸ ࡽ ࢀ ࡚ ࠸ ࡿ [᫬ ⏣ ,
1995; ᪁ࡽ, 2006; Ỉ⃝࡜ᑐ㤿, 2009; ᮃ᭶࡜ᓟᓥ, 2000; Guskiewicz and Perrin.,
1996]㸬௒ᅇࡢ◊ ✲࡛ ⾜ࡗࡓ᪉ἲࡣ 㸪㛤 ║࡛ ࡢ∦⬮❧఩ጼ ໃ࡛ࡢࣂ ࣛࣥࢫ ಖᣢ⬟
ຊࡢホ౯࡜ࡋ ࡓ㸬㔜ᚰ ືᦂᛶࢸࢫࢺ ࡣ㸪࢔ࢫ ࣮ࣜࢺࢆᑐ㇟ ࡜ࡋ ࡓ㊊ 㛵⠇യᐖ࡟
ᑐ ࡍ ࡿ ホ ౯ ἲ ࡢ ୍ ࡘ ࡜ ࡋ ࡚ ከ ᩘ ⏝ ࠸ ࡽ ࢀ ࡚ ࠸ ࡿ [Wikstrom, 2006; Zech, 2010;
Beynnon, 2002]㸬ᮏ◊ ✲࡛⏝࠸ࡓࣃ ࣓࣮ࣛࢱ ࡟ࡘ࠸࡚㸪㔜ᚰ⥲㌶ ㊧ 㛗 ࡣ㔜ᚰⅬࡢ
⥲⛣ື㊥㞳ࢆ ♧ࡋ ࡚࠾ ࡾ㸪㌟యືᦂ ࡢᏳᐃᛶ ࢆホ౯ࡍࡿ ௦ ⾲ⓗ࡞್ ࡛࠶ ࡿ㸬㔜
ᚰ༢఩㠃✚㌶ ㊧㛗ࡣ㔜 ᚰືᦂ㠃✚ ࡢ 1cm 2 ᙜ ࡓࡾࡢ⛣ື㊥ 㞳ࢆ♧ࡋ 㸪㔜ᚰእ࿘ 㠃
✚ࡣືᦂࡢእ ࿘ࢆᅖࡴ 㠃✚ ࢆ♧ࡍ 㸬㔜ᚰ ▴ᙧ 㠃✚ࡣ㔜ᚰື ᦂࡢ๓ᚋ ᭱኱ࢆ⦪㍈ 㸪
ᕥྑ᭱኱ࢆᶓ ㍈࡜ࡋࡓ ᅄゅᙧࡢ㠃✚ ࡢࡇ࡜ࢆ ♧ࡍ 㸬㔜ᚰ▴ ᙧ㠃✚ࡣ 㸪അ↛኱ࡁ
࡞ືᦂࡀ⏕ࡌ ࡓ㝿࡟ィ ࡉࢀࡿ␗ᖖ ࡟኱ࡁ࡞ ್ࢆྵࡳ㸪㌟ యືᦂ ࡀ ᭱ࡶ኱ࡁࡃ
࡞ࡗࡓ㠃✚࡜ ࡞ࡿ㸬ᮏ ◊✲࡛⾜ࡗࡓ͆㊊㊑ 㛤 ᤼࠾ࡼࡧ㊊㊑ ᢕᥱ ͇ᣦ ᑟࡢ௓ධࡣ㸪
㟼ⓗࣂࣛࣥࢫ ಖᣢ⬟ຊ ࡟୍㒊࡟࠾࠸ ࡚ᙳ㡪ࡀ ㄆࡵࡽࢀ㸪ከ ࡃࡣ ᙳ㡪 ࡀㄆࡵࡽࢀ
࡞࠿ࡗࡓ㸬ࡇ ࢀࡣ㸪ᮏ ◊✲࡛⾜ࢃࢀ ࡓᑐ㇟⪅ ࡀⱝᖺ࢔ࢫࣜ ࣮ࢺ࡛࠶ ࡾ㸪㐠ື⬟
ຊࡀ㧗࠸ࡇ࡜ ࡀ᥎ ࡉ ࢀࡿᑐ㇟⪅ࡢ ሙྜࡣ㸪 㛤║࡛ࡢ∦⬮ ❧఩ጼໃ ࡜࠸ࡗࡓ⡆
༢࡞ㄢ㢟ືస ࡛ࡣ࡞ࡃ 㸪㛢║࡛ࡢ∦ ⬮❧఩ጼ ໃࢆ࡜ࡽࡏࡓ ࠺࠼࡛ࡢ ẚ㍑㸪ࡲࡓ
㛤║∦⬮❧఩ ጼໃ࡛࠶ ࡗ࡚ࡶጼໃಖ ᣢ᫬㛫ࢆ 㛗ࡃࡍࡿ➼㸪 ㄢ㢟 ᮲௳ ࢆ㧗ࡃࡋ࡚
ẚ㍑ࡍࡿࡢࡀ ᮃࡲࡋ࠸ ࡜⪃࠼ࡓ㸬
149
SEBT ࡣ㸪 ືⓗ ୗ ⫥ࣂ ࣛࣥ ࢫ⬟ ຊࡢ ホ ౯࡟ ⏝ ࠸ࡽ ࢀࡿ ࢸࢫ ࢺἲ ࡛ ࠶ ࡿࡀ 㸪ከ
ࡃࡣୗ⫥യᐖ[Plisky et al., 2006; Filipa et al., 2010; Bressel et al., 2007; Robinson
et al., 2008]㸪㊊㛵⠇ യᐖ [Olmsted et al., 2002; Hertel et al., 2006; Hertel et al.,
2008; Chaiwanichsiri et al., 2005; Gribble et al., 2004; Gribble et al., 2007; Sefton et
al., 2009; de Noronha et al., 2012; O'Driscoll et al., 2011]㸪⭸㛵⠇യᐖ [Herrington et
ak., 2009]ࡢホ౯࡟ࡘ࠸ ࡚ሗ࿌ࡋ࡚ ࠸ ࡿඛ⾜ㄽ ᩥࡀከᩘࢆ༨ ࡵࡿ㸬࡞ ࠾㸪ᮏ◊✲
࡛⾜ࡗࡓ SEBT ホ౯᪉ ἲࡣ㸪 Hertel ࡽ㸦2006㸧ࡀ᥎ዡࡋ࡚ ࠸ࡿ᪉ἲ ࢆཧ⪃࡟㸪
㏻ᖖ 8 ᪉ྥ㸦A㸦๓᪉ 㸧㸪๓ෆ᪉ 㸪ෆ᪉ 㸪PM㸦ᚋෆ᪉ 㸧㸪ᚋ᪉ 㸪PL㸦ᚋእ᪉ 㸧㸪
እ ᪉ 㸪 ๓ እ ᪉ 㸧 ࡢ ࣜ ࣮ ࢳ ㊥ 㞳 ࡛ ࡢ ホ ౯ ࡀ ⾜ ࢃ ࢀ ࡿ ࡀ 㸪 ᮏ ◊ ✲ ࡛ ࡣ A㸪 PM㸪PL
ࡢ 3 ᪉ྥ࡛ ࡢ࣮ࣜࢳ㊥ 㞳 ࡛ẚ㍑᳨ド ࢆ⾜࠺ࡇ ࡜࡜ࡋࡓ㸬௨ ୗ࡟♧ࡍ ඛ⾜ㄽᩥࡢ
ሗ࿌ࡣ㸪ከࡃ ࡣ 8 ᪉ྥ ࠿ࡽホ౯ࡉࢀ ࡓෆᐜ࡛ ࠶ࡾ㸪ᮏ◊✲ ࡛⾜ࡗࡓ ࣮ࣜࢳ᪉ྥ
࡜ ୍ 㒊 ␗ ࡞ࡗ ࡚ ࠸ ࡿ 㸬 SEBT ࢆ ⏝ ࠸ ࡓ ホ ౯ ࡟ ࠾ ࠸ ࡚ 㸪 ≉࡟ ㊊ 㛵 ⠇ യ ᐖ ࡜ SEBT
࡟㛵ࡍࡿሗ࿌ ࡀከ࠸ࡀ 㸪Gribble ࡽ㸦2004㸧ࡣ៏ᛶ㊊㛵⠇୙ Ᏻᐃ⑕㸦 chronic ankle
instability㸸௨ ୗ 㸪 CAI㸧 ࢆࡶ ࡘ ⪅ ࡢ യ ᐖ ⬮ ഃ ࡜ 㠀യ ᐖ ⬮ ഃࢆ ẚ ㍑ 㸦 8 ᪉ྥ ࡛ ホ
౯ 㸧 ࡋ ࡓ ࡜ ࡇ ࢁ 㸪 യ ᐖ ⬮ ഃ ࡣ 㠀 യ ᐖ ⬮ ഃ ࡟ ẚ ࡭ ࡚ ࣜ ࣮ ࢳ ㊥ 㞳 ࡢ ๭ ྜ ࡀ 㸪 A㸪 ෆ
᪉ 㸪 ᚋ ᪉ ࡟ ࠾ ࠸ ࡚ ᭷ ព ࡟ ᑠ ࡉ ࠿ ࡗ ࡓ ࡇ ࡜ ࢆ ሗ ࿌ ࡋ 㸪 Hertel ࡽ 㸦 2006㸧 ࡣ 㸪 CAI
ࢆࡶࡘയᐖ⬮ ഃ࡜㠀 യ ᐖ⬮ഃࡢẚ㍑ ࡟࠾࠸࡚ 㸪യᐖ⬮ഃࡣ㠀 യᐖ⬮ ഃ࡟ẚ࡭㸦8
᪉ྥ࡛ホ౯㸧㸪๓ෆ᪉ 㸪ෆ᪉㸪PL ࡟࣮ࣜ ࢳ ㊥㞳ࡢ๭ྜࡀ ᭷ព࡟ᑠ ࡉ࠿ࡗࡓࡇ࡜
ࢆሗ࿌ࡋ㸪≉ ࡟ PL ࡜ CAI ࡜ࡢᙉ ࠸㛵㐃ᛶ ࢆ ♧ࡋࡓࡇ࡜ࢆ ሗ࿌ ࡋ࡚ ࠸ࡿ㸬ࡲࡓ㸪
CAI ࢆ ࡶ ࡘ യ ᐖ ⬮ ഃ ࡜ ࢥ ࣥ ࢺ ࣟ ࣮ ࣝ ⩌ ࡢ ྠ ഃ ⬮ ࡢ ẚ ㍑ ࡟ ࠾ ࠸ ࡚ 㸪 Olmsted ࡽ
㸦2002㸧ࡣ㸪യᐖ⬮ഃ ࡜㠀യᐖ⬮ഃ ࡢẚ㍑࡟ ࠾࠸࡚㸪 യᐖ ⬮ഃࡣ㠀 യᐖ⬮ഃ࡟
ẚ࡭㸪඲᪉ྥ ࡢᖹᆒ್ ࡢẚ㍑࡟࠾࠸ ࡚࣮ࣜࢳ ㊥㞳ࡢ๭ྜࡀ ᭷ព࡟ᑠ ࡉ࠿ࡗࡓࡇ
࡜ࢆሗ࿌ࡋ㸪Hertel ࡽ 㸦2006㸧ࡣ㸪CAI ࢆࡶ ࡘയᐖ⬮ഃ࡜ ࢥࣥࢺࣟ ࣮ࣝ⩌ࡢྠ
ഃ⬮ࡢẚ㍑㸦 8 ᪉ྥ࡛ ホ౯㸧࡟࠾࠸ ࡚㸪๓ෆ ᪉㸪ෆ᪉㸪PL ࡛ࣜ ࣮ ࢳ㊥㞳ࡢ๭ྜ
ࡀ᭷ព࡟ᑠࡉ ࠿ࡗࡓࡇ ࡜ࢆሗ࿌ࡋࡓ 㸬ࡑࡢ࡯ ࠿㸪⭸㛵⠇യ ᐖ࡜ SEBT ࡜ࡢ㛵ಀ
ࢆሗ࿌ࡋࡓඛ ⾜ㄽᩥ࡟ ࡘ࠸࡚ࡣ㸪 Herrington ࡽ㸦2009㸧ࡣ㸪ACL ୙඲⩌࡜ࢥࣥ
ࢺ࣮ࣟࣝ⩌࡜ ࡢẚ㍑㸦 8 ᪉ྥ࡛ホ౯㸧࡟࠾ ࠸ ࡚㸪 ACL ୙඲⩌ࡣࢥ ࣥࢺ࣮ࣟࣝ⩌
࡟ẚ࡭㸪A㸪እ᪉㸪PM ࡢ࣮ࣜࢳ㊥㞳 ࡢ๭ྜࡀ ᭷ព࡟ᑠࡉ࠿ ࡗࡓࡇ࡜ ࢆሗ࿌ࡋ࡚
࠸ࡿ㸬ࡇࢀࡽ ࡢሗ࿌࠿ ࡽ㸪㊊㛵⠇࠾ ࡼࡧ⭸㛵 ⠇യᐖࢆ᭷ࡍ ࡿࡶࡢ ࡜ SEBT ࡜ࡢ
150
㛵ಀ࡟࠾࠸࡚ 㸪≉ ࡟ A㸪ෆ᪉㸪PL ࡢ ࣮ࣜࢳ ㊥㞳ࡢ๭ྜࡀ ᑠࡉ࠸ࡇ ࡜ࡀ࠺࠿ࡀ࠼
ࡿ㸬ᮏ◊✲ࡢ ⤖ᯝࢆ௓ ධ๓ᚋ᳨࡛ド ࡋ࡚ࡳࡿ ࡜ 㸦⾲ 7-7㸧㸪A ࡟ࡘ ࠸࡚ࡣᕥྑ
⬮࠸ࡎࢀࡶ᭷ ពᕪࡀ ㄆ ࡵࡽࢀ࡞࠿ࡗ ࡓࡀ㸦ᕥ 㸸 p = 0.699, ྑ㸸p = 0.722㸧㸪PM
࡟ࡘ࠸࡚ࡣᕥ ྑ⬮ඹ࡟ ᭷ព࡟ቑຍࡉ ࡏ㸦ࡑࢀ ࡒࢀ p = 0.006㸪0.018㸧㸪PL ࡟ࡘ
࠸࡚ࡶᕥྑ⬮ ඹ࡟᭷ព ࡟ቑຍࡉࡏࡓ㸦ࡑࢀࡒ ࢀ p = 0.005㸪0.042㸧㸬ඛ⾜ㄽᩥ࠿
ࡽࡣ㸪⚄⤒➽ ࢺ࣮ࣞࢽ ࣥࢢ [Filipa et al., 2010; Lindblom et al., 2012; O'Driscoll et
al., 2011]ࡸࣂࣛࣥࢫࢺ ࣮ࣞࢽࣥࢢ [McKeon et al., 2008]㸪CAI ࡟ ᑐ ࡍࡿࣜࣁࣅࣜ
ࢸ ࣮ ࢩ ࣙ ࣥ ࣉ ࣟ ࢢ ࣛ ࣒ ࡢ ௓ ධ ࡀ SEBT ࡢ ࣜ ࣮ ࢳ ㊥ 㞳 ࡟ ཬ ࡰ ࡍ ᙳ 㡪 [Hale et al.,
2007]࡟ࡘ࠸࡚ከᩘ ሗ ࿌ࡉࢀ࡚࠸ࡿ ࡀ㸪 Filipa ࡽ㸦2010㸧ࡣ⚄⤒ ➽ ࢺ࣮ࣞࢽࣥࢢ
ᚋ࡟ A㸪PM㸪PL ࡢ 3 ᪉ྥࡢ࣮ࣜࢳ ㊥㞳⥲ィ ࡢ๭ྜࡀ᭷ព ࡟ቑຍࡋ ࡓࡇ࡜ࢆሗ
࿌ࡋ㸪Lindblom ࡽ㸦 2012㸧ࡣ㸪A㸪PM㸪PL ࡢ 3 ᪉ྥࡢ඲ ࡚ࡢࣜ ࣮ࢳ㊥㞳ࡀྥ
ୖࡋ࡚ ࠸ࡓࡇ ࡜ࢆ ሗ࿌ ࡋࡓ㸬 ࡲࡓ㸪 McKeon ࡽ㸦2008㸧ࡣ ࣂࣛ ࣥࢫ ࢺ࣮ࣞ ࢽࣥ
ࢢࣉࣟࢢ࣒ࣛ ⤊஢ᚋ࡟ ࠾࠸࡚㸪 3 ᪉ྥࡢ ࠺ ࡕ PM㸪PL ࡛᭷ព࡞ ྥୖࢆ♧ࡋࡓ ࡇ
࡜ࢆሗ࿌ࡋ 㸪Hale ࡽ㸦 2007㸧ࡣ 㸪ࣜࣁࣅ ࣜࢸ ࣮ࢩࣙࣥࣉࣜ ࢢ࣒ࣛ⤊ ஢ᚋ࡟ 8 ᪉
ྥࡢホ౯ࢆ⾜ ࠸㸪PM㸪PL㸪L ࡛᭷ព࡞ቑຍ ࡀࡳࡽࢀࡓ࡜ ሗ࿌ࡋ ࡚ ࠸ࡿ㸬ඛ⾜◊
✲⤖ᯝ࡜ᮏ◊ ✲⤖ᯝࢆ ྜࢃࡏ᳨࡚ド ࡍࡿ࡜㸪 ≉࡟ A㸪PM㸪PL ᪉ྥ࡬ࡢᨵၿࡀ
㢧ⴭ࡛࠶ࡿࡇ ࡜ࡀ♧ࡉ ࢀࡓ㸬ᮏ◊✲ ⤖ᯝ࠿ࡽ 㸪 A ࡟ᑐࡍ ࡿ௓ධຠᯝ ࡀ ㄆࡵࡽࢀ
࡞࠿ࡗࡓࡢࡣ 㸪 A ࡢ ࣜ ࣮ࢳ㊥㞳ࡣ㊊ 㛵⠇⫼ᒅ ゅᗘ [Hoch et al., 2010]㸪⭸㛵⠇ᒅ
᭤ゅᗘࡸ⫤㛵 ⠇ෆ㌿ ࠾ ࡼࡧෆ᪕ゅᗘ[Robinson et al., 2008]㸪ࡑࡢ࡯ ࠿኱⭣ᅄ㢌➽
➽άືࡢᙳ㡪[Earl and Hertel, 2001]ࢆཷࡅ࡚࠸ࡿࡇ࡜ࡀඛ ⾜ㄽᩥ࠿ ࡽከᩘሗ࿌
ࡉࢀ࡚࠾ࡾ㸪 ࡑࢀࡽࢆ ྵࡵࡓ᳨ウࡶ ᚲせ࡛࠶ ࡿ ࡜⪃࠼ࡓ㸬
ᮏ◊✲⤖ᯝ࠿ ࡽ㸪◊ ✲ 5 ࡢ⪃ᐹྠ ᵝ࡟㸪 ࢫ ࣏࣮ࢶയᐖண 㜵 ࡟╔┠ ࡋ᳨࡚ウࡍ
ࡿ࡜㸪ࣛࣥࢪ ࡸࢪࣕࣥ ࣉ࠿ࡽࡢ╔ᆅ ືస㸪ࢧ ࢖ࢻࢫࢸࢵࣉ ࡸษࡾ㏉ ࡋືస᫬࡟
㊊㊑ࢆ㛤࠸࡚ ᗋࢆᢕᣢ ࡍࡿືసᣦ♧ ࡣ㸪㊊㊑ ᢕ➽ຊࡸ㊊㊑ 㛤᤼⬟ࢆ ྥୖࡉࡏࡿ
࡜࡜ࡶ࡟㸪ື ⓗୗ⫥ࣂ ࣛࣥࢫ⬟ຊࢆ ྥୖࡉࡏ ࡿࡇ࡜࠿ࡽ㸪 ୗ⫥യᐖ 㸪≉࡟ ㊊㛵
⠇ࡸ⭸㛵⠇യ ᐖࡢண㜵 ࡟ᐤ୚ࡉࡏࡿ ࡢ࡛ࡣ࡞ ࠸࠿࡜⪃࠼ࡓ 㸬
ᮏ◊✲ࡢ㝈⏺ Ⅼ࡜ࡋ࡚ 㸪ࢥࣥࢺ࣮ࣟ ࣝ⩌ ࡀタ ᐃࡉࢀ࡚࠸࡞ ࠸࡜ࡇࢁ ࡟࠶ࡿ㸬
ࢺ࣮ࣞࢽࣥࢢ ⩌࡜㠀ࢺ ࣮ࣞࢽࣥࢢ⩌ ࢆタᐃ ࡋ ࡓẚ㍑࡟ࡼࡾ 㸪௓ධࡢ ᭷⏝ᛶࡢ᳨
ド࠾ࡼࡧࡑࡢ ホ౯ࡀࡼ ࡾྍ⬟࡟࡞ࡿ ࡜⪃࠼㸪 ௒ᚋࡢ᳨ウㄢ 㢟࡜ࡍࡿ 㸬
151
6-7-5. ⤖ㄒ
኱ᏛዪᏊࣛ ࢡࣟࢫ➇ ᢏࢆᑐ㇟࡜ࡋ ࡚㸪㏻ᖖ ⾜ࢃࢀ࡚࠸ࡿ ࢛࣮࣑࢘ ࣥࢢ࢔ࢵࣉ
ࡢ୰࡛⾜ࢃࢀ ࡚࠸ࡿ ࣛ ࣥࢪࡸࢪࣕࣥ ࣉ࠿ࡽࡢ ╔ᆅືస㸪ࢧ ࢖ࢻࢫࢸ ࢵࣉࡸษࡾ
㏉ࡋືస᫬࡟ ͆㊊㊑ࢆ 㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࢆᣦ ♧ࡋࡓᣦᑟἲ ࡀ㸪㊊㒊 ᶵ⬟ࡸ㊊㒊
ᙧែ㸪㟼ⓗ࠾ ࡼࡧືⓗ ࣂࣛࣥࢫ⬟ຊ ࡟ཬࡰࡍ ᙳ㡪ࢆ ẚ㍑᳨ ドࡍࡿࡇ ࡜ ࢆ┠ⓗ࡜
ࡋ㸪௨ୗࡢ⤖ ㄽࢆᚓࡓ 㸬
1)
㊊㊑㛤᤼⬟࡟ ࡘ࠸࡚㸪 ᕥྑ㊊㊑࠸ࡎ ࢀࡶ ᭷ព ࡟ቑຍࡉࡏࡓ 㸬
2)
㊊㊑ᢕᥱຊ࡟ ࡘ࠸࡚㸪 ᗙ఩࠾ࡼࡧ❧ ఩ ጼໃ࡛ ࡢᕥྑࡢ㊊㊑ ᢕᥱຊ ࠸ ࡎࢀ
ࡶ᭷ព࡟ቑຍ ࡉࡏ ࡓ㸬
3)
࢔࣮ࢳ㧗⋡࡟ ࡘ࠸࡚ࡣ 㸪ᕥྑ ㊊࠸ࡎ ࢀࡶ ᭷ព ࡟ቑຍࡉࡏࡓ 㸬
4)
㔜ᚰືᦂᛶ࡟ ࡘ࠸࡚ࡣ 㸪㔜ᚰ༢఩㌶ ㊧㛗ࡢᕥ ⬮❧఩᫬ࡢࡳ ᭷ព࡟ቑ ຍࡉ
ࡏࡓࡀ㸪௚ࡢ ඲࡚ࡢ㡯 ┠࡟ࡣᙳ㡪ࢆ ཬࡰࡉ࡞ ࠿ࡗࡓ㸬
5)
SEBT ࡟ࡘ࠸࡚ࡣ㸪ᚋ ෆ᪉࠾ࡼࡧᚋ እ᪉ࡢࣜ ࣮ࢳ㊥㞳ࡢ๭ ྜ࡟࠾࠸ ࡚ᕥ
ྑ⬮࠸ࡎࢀࡶ ᭷ព࡞ ቑ ຍࡀㄆࡵࡽࢀ ࡓ㸬
6)
࢛࢘ ࣮࣑ ࣥࢢ ࢔ࢵ ࣉ ᫬ ࡟⾜ ࢃࢀ ࡚࠸ ࡿ ࣛ ࣥࢪ ࡸࢪ ࣕࣥ ࣉ࠿ ࡽࡢ ╔ᆅ ືస 㸪
ࢧ࢖ࢻࢫࢸࢵ ࣉࡸษࡾ ㏉ࡋືస᫬࡟ ͆㊊㊑ࢆ 㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࢆᣦ ♧ࡍ
ࡿᣦᑟἲࡣ㸪 ㊊㊑ᶵ⬟ ࠾ࡼࡧືⓗࣂ ࣛࣥࢫ⬟ ຊࢆྥୖࡉࡏ ࡿ࡜࠸࠺ ⤖ᯝ
ࢆ㏻ࡋ࡚㸪ୗ ⫥യᐖண 㜵ࢆ┠ⓗ࡜ࡋ ࡓᣦᑟ᪉ ἲ࡟࡞ࡿྍ⬟ ᛶࡀ♧၀ ࡉࢀ
ࡓ㸬
152
◊ ✲ 8 ኱Ꮫ ዪᏊ ࣛ ࢡ ࣟࢫ ➇ᢏ ࢆ ᑐ㇟ ࡜ࡋ ࡓ ୗ⫥ യᐖ ண 㜵ࢺ ࣮ࣞ ࢽ ࣥࢢ ௓ධ ࡀ
യᐖ Ⓨ⏕ ᩘ ࠾ࡼ ࡧ യ ᐖ Ⓨ⏕ 㢖ᗘ ࡟ ཬࡰ ࡍᙳ 㡪
6-8-1. ⥴ゝ
௒᪥㸪ࢫ࣏ ࣮ࢶയᐖ ண㜵 ࡢᐇ㊶࡜ ࡑࡢຠᯝ ᳨ド࡟ࡘ࠸࡚ ከᩘࡢሗ ࿌ࡀࡳࡽࢀ
ࡿࡀ㸪≉࡟ୗ ⫥യᐖண 㜵 ࣉࣟࢢ࣒ࣛ ࡟㛵ࡍࡿ ሗ࿌ࡀከᩘࡳ ࡽࢀ 㸪ࡑ ࢀࡽࡢ௓ධ
ࡀ᭷⏝࡛࠶ࡿ ࡜ࡢぢゎ ࡀ♧ࡉࢀ࡚࠸ ࡿ [Alentorn-Geli et al., 2009; Griffin et al.,
2006]㸬ୗ⫥യᐖண 㜵 ࢺ࣮ࣞࢽࣥࢢ ࡢ୍ࡘ࡛ ࠶ࡿ⭸๓༑Ꮠ 㠌ᖏ㸦 anterior cruciate
ligament㸸௨ୗ㸪ACL㸧യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ࢆ౛࡟࡜ࡿ࡜ 㸪ࣂࢫ ࢣ ࢵࢺ࣮࣎ࣝ㸪
ࢧࢵ࣮࢝㸪ࣁࣥࢻ࣎ ࣮ ࣝ ➼࡛㸪௓ ධᮇ㛫 ࡣ 6 㐌㛫࠿ࡽ 12 㐌㛫 ࡀከ ࡃ㸪㢖ᗘࡣ㐌
2㹼3 ᅇ⛬ᗘ㸪᫬ 㛫ࡣ ୍ᅇ࡟ࡘࡁ 10㹼30 ศ ⛬ᗘᐇ᪋ࡉࢀ ࡚࠸ࡿ㸬 ࡲࡓ㸪௓ධ᪉
ἲࡢ≉ᚩ࡜ࡋ ࡚㸪⦎⩦ ๓࡟⾜ࢃࢀࡿ ࢘ ࢛࣮࣑ ࣥࢢ࢔ࢵࣉࡢ ୰ ࡛⾜ࢃ ࢀ࡚࠸ࡿ Ⅼ
࡟ ࠶ ࡿ 㸬 ࢺ ࣞ ࣮ ࢽ ࣥ ࢢ ᫬ 㛫 ࡣ 㸪 ㏻ ᖖ ࡢ ࢘ ࢛ ࣮ ࣑ ࣥ ࢢ ࢔ ࢵ ࣉ ᫬ 㛫 ࡟ ྜ ࢃ ࡏ ࡚ 15
ศ㹼20 ศ⛬ᗘ࡛࠶ ࡿ 㸬ࡇࢀࡣ 㸪യᐖ ண㜵 ࢆ ┠ⓗ࡜ࡋࡓࢺ ࣮ࣞࢽࣥ ࢢ ࡢⅭࡔࡅ࡟
᫬㛫ࢆ࠿ࡅࡿ ࡇ࡜ࡀᅔ 㞴࡛࠶ࡿ ࡜ࡢ ⌧ሙࡢព ぢࢆ཯ᫎ ࡉࡏ 㸪࢛࣮࢘ ࣑ࣥࢢ࢔ࢵ
ࣉ᫬࡟ྛ✀ࢺ ࣮ࣞࢽࣥ ࢢ ࢆྲྀࡾධࢀ ࡿ࡜࠸࠺ ᪉ἲࡀ࡜ࡽࢀ ࡚࠸ࡿ㸬 ୗ⫥യᐖண
㜵ࢺ࣮ࣞࢽࣥ ࢢࡢෆᐜ ࡟ࡘ࠸࡚ࡣ㸪 ᭱ึ࡟㐺 ษ࡞ጼໃ ࡸୗ ⫥࢔ࣛ࢖ ࣓ࣥࢺ ࢆ⋓
ᚓࡉࡏࡿࡇ࡜ ࢆ┠ᶆ࡟ ࡋ࡚㸪ࢺ࣮ࣞ ࢽࣥࢢ ึ ᮇ࡟࠾࠸࡚ࡣ 㐺ษ࡞࢔ ࢫࣞ ࢳࢵࢡ
࣏ࢪࢩࣙࣥࡢ ⋓ᚓࢆ┠ ᶆ࡟ᣦᑟࡉࢀ ࡚࠸ࡿ㸬 ࡑࢀࡣ㸪ࠕ⭸ ࢆ ࡋࡗ࠿ ࡾ ᭤ࡆ㸪⫪
ࢆᚋࢁ࡟ᘬ࠸ ࡚⬚ࢆᙇ ࡾ㸪┠⥺ࢆୗ ࡆ࡞࠸ࡼ ࠺࡟ 㸬ࠖࠕ㊊ ᖜࢆ⫪ᖜ ⛬ᗘ࡟㛤࠸
࡚య㔜ࢆẕ㊑ ⌫࡟஌ࡏ ࡿ 㸬ࠖ࡜࠸࠺ ࡶࡢ࡛࠶ ࡿ [Myer et al., 2004; Myer et al.,
2005]㸬ࢺ࣮ࣞࢽ ࣥࢢ ✀┠ࡸ㈇Ⲵࢆ ₞㐍ⓗ࡟ ቑຍࡉࡏ࡚࠸ ࡃࡀ㸪ࢫ ࢡ࣡ࢵࢺ㸪ࢪ
ࣕࣥࣉ࠿ࡽࡢ ╔ᆅືస 㸪ࣛࣥࢪ㸪࣍ ࢵࣆࣥࢢ ືస➼㸪ከࡃ ࡢࢺ࣮ࣞ ࢽࣥࢢ✀┠
࡟࠾࠸࡚ࡇࡢ ጼໃࢆᇶ ᮏ ጼໃ࡜ࡋ࡚ ⩦ᚓࡉࡏ 㸪≉࡟ࢫࢱ࣮ ࢺ᫬ ࠾ࡼ ࡧࣇ࢕ࢽࢵ
ࢩࣗ᫬࡟࠾࠸ ࡚㸪㐺ษ ࡞࢔ࢫࣞࢳࢵ ࢡ࣏ࢪࢩ ࣙࣥ ࢆ࡜ࡽࡏ ࡿࡇ࡜ࢆ ព㆑ࡉࡏ࡚
⾜ࢃࡏ࡚࠸ࡿ[Myer et al., 2004]㸬ࡲࡓ㸪 ᇶᮏ ጼໃ ࢆ࡜ࡿ᫬ ࡟㸪ࠕ⭸ ࡀᖖ࡟ࡘࡲ
ඛࡢୖ࡟఩⨨ ࡍࡿࡼ࠺ ࡟ ࡍࡿࠖ࡜࠸࠺ ᣦᑟࡶ ྵࡲࢀ࡚࠾ࡾ㸪࠸ࢃࡺ ࡿ͆knee-in͇
ືస࡟࡞ࡽ࡞ ࠸ࡼ࠺࡟ ὀពႏ㉳ࡉࡏ ࡚࠸ࡿ㸬 ᮏㄽᩥࡢ◊ ✲ 2㸪 5㸪7 ࡟࠾࠸࡚㸪
㊊㊑㛤᤼ືస ᣦ♧࠾ࡼ ࡧ ㊊㊑ᢕᥱຊ ࡀືⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺࡸࣂࣛ ࣥࢫಖᣢ⬟
153
ຊ࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚ ᳨ドࡋࡓࡀ 㸪◊ ✲ 8 ࡛ࡣ㸪◊ ✲ 7 ࡟⥆ࡁ኱ ᏛዪᏊࣛࢡ
ࣟࢫࢆᑐ㇟࡜ ࡋࡓ㏻ᖖ ࡢ࢛࣮࣑࢘ࣥ ࢢ࢔ࢵࣉ ࣓ࢽ࣮࡛ࣗ ⾜ ࢃࢀ࡚࠸ ࡿ ࣛࣥࢪࡸ
ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪ࢧ࢖ࢻࢫ ࢸࢵࣉ ࡸ ษࡾ㏉ࡋືస ᫬࡟ 㸪͆ ㊊㊑ࢆ㛤࠸
࡚ᗋࢆᥗࡴ͇ ࢆᣦ♧ࡍ ࡿᣦᑟἲࡀ㸪 ୗ⫥യᐖ Ⓨ⏕⋡ ➼࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ẚ
㍑᳨ドࡍࡿࡇ ࡜ࢆ┠ⓗ ࡜ࡋ ࡓ㸬௬ㄝ ࡣ⥲യᐖ Ⓨ⏕⋡ࢆపୗ ࡉࡏ㸪യ ᐖࡢ㒊఩࡟
ࡘ࠸࡚ࡣ㸪㊊ 㛵⠇㸪⭸ 㛵⠇ࢆྵࡵࡓ ୗ⫥യᐖ Ⓨ⏕⋡ ࢆపୗ ࡉࡏࡿ࡜ ࠸࠺ࡶࡢ࡛
࠶ࡿ㸬 154
6-8-2. ᑐ㇟࡜᪉ἲ
1. ᑐ㇟࡜᪉ἲ
ᑐ㇟⪅ࡣ◊ ✲ 7 ྠᵝ㸪 㛵ᮾ኱ᏛዪᏊ ࣛࢡࣟࢫ ࣮ࣜࢢ 1 㒊࡟ ᡤᒓࡍࡿ ኱ᏛዪᏊ
ࣛࢡࣟࢫ㑅ᡭ ࡛࠶ࡾ㸪1 ᖺ┠ 46 ྡ㸦ᖹᆒᖺ 㱋㸦±ᶆ‽೫ᕪ㸧㸸20.1 ± 1.3 ṓ㸪㌟
㛗㸸159.1 ± 5.2cm㸪య 㔜㸸 53.1 ± 5.5kg㸪ࣛ ࢡࣟࢫ➇ᢏ Ṕ 22.0 ± 16.3 ࣨ᭶㸧㸪2
ᖺ┠ 55 ྡ㸦ᖹᆒ ᖺ㱋 19.5 ± 1.1 ṓ㸪㌟ 㛗 158.7 ± 4.9cm㸪య 㔜 53.6 ± 5.4kg㸪ࣛ
ࢡࣟࢫ➇ᢏ Ṕ 22.6 ± 13.2 ࣨ᭶㸧࡜ࡋࡓ㸬௓ ධ ᪉ἲࡣ㸪⦎⩦ ๓࡟⾜ࢃ ࢀ࡚࠸ࡿ ࢘
࢛࣮࣑ࣥࢢ࢔ ࢵࣉ࡛⾜ ࢃࢀ࡚࠸ࡿྛ ືస ᫬࡟ 㸪㊊㒊ࡢ ╔ᆅືస ᫬࡟ ྍ⬟࡞㝈ࡾ 㸪
㊊㊑㛤᤼࠾ࡼ ࡧ㊊㊑ᢕ ᣢࢆព㆑ࡉࡏ ࡚⾜ࢃࡏ ࡓ 㸬≉࡟ࢪࣙ ࢠࣥࢢ㸪 ࢫࢺࣞࢵࢳ
ࣥࢢ㸪యᖿࢺ ࣮ࣞࢽࣥ ࢢᚋ࡟⾜ࢃࢀࡓ Line to Line ࡛ࡢືస᫬࡟ ᙉ ㄪࡋ࡚ᣦ♧
ࢆฟࡋࡓ㸦 ⾲ 8-1㸧㸬௓ධᮇ㛫 ࡣ 2011 ᖺ 6 ᭶㹼2012 ᖺ 3 ᭶ࡲ ࡛ ࡜ࡋ㸪യᐖ Ⓨ⏕
⋡➼ࡢẚ㍑ᮇ 㛫ࡣ 2010 ᖺ 6 ᭶㹼2011 ᖺ 3 ᭶ ࡜ 2011 ᖺ 6 ᭶㹼2012 ᖺ 3 ᭶࡜ ࡋࡓ㸬
ᑦ㸪ᮏ◊✲ࢆ ⾜࠺࡟࠶ ࡓࡾ㸪 ᑐ㇟⪅ ࡟᪉ἲࡸ ೔⌮ⓗ㓄៖➼ ࡢㄝ᫂ࢆ ⾜࠸㸪ྠព
ࢆᚓࡓ㸬᪩✄⏣኱ Ꮫ ேࢆᑐ㇟࡜ࡍࡿ ◊✲࡟㛵 ࡍࡿ೔⌮ᑂᰝ ጤဨ఍ ࡢ ᢎㄆࢆᚓ࡚
ᐇ᪋ࡋࡓ㸦ᢎ ㄆ␒ ྕ 2010-037㸧㸬
155
2㸬യᐖㄪᰝෆᐜ
യᐖㄪᰝෆᐜ ࠾ࡼࡧ᪉ ἲ࡟ࡘ࠸࡚ࡣ 㸪 ◊ ✲ 1[బ㔝ᮧࡽ, 2012]ྠᵝ࡛࠶ࡿ㸬ࡑ
ࡢ௚⦎⩦࣭ヨྜ᫬ࡢ യ ᐖ㸪യᐖࡢ ᅇᩘ㸪➇ᢏ ᚟ᖐࡲ࡛ࡢᮇ 㛫 ࡟ࡘ࠸ ࡚཰㞟ࡋࡓ 㸬
യᐖࡢᐃ⩏࠾ ࡼࡧ ➇ᢏ ᚟ᖐࡲ࡛ࡢᮇ 㛫 ࡟ࡘ࠸ ࡚ࡶ ◊✲ 1 ྠᵝ࡛࠶ࡾ 㸪യᐖⓎ⏕
⋡ ࡟ ࡘ ࠸ ࡚ ࡣ ‘1,000 athlete–hours 㸦 ௨ ୗ 1000AHs 㸧 ’ ࠾ ࡼ ࡧ ‘1,000 athlete–
exposures㸦௨ୗ 1000AEs㸧’ࡢ༢఩ࢆ⏝࠸ ࡚ ⟬ฟࡋࡓ㸬௓ ධ๓ᚋࡢ ẚ㍑㡯┠ ࡣ 㸪
യᐖࡢ㒊఩㸪 യᐖࡢ✀ 㢮㸪യᐖࡢཎ ᅉ㸪യᐖ ࡢᅇᩘ㸪➇ᢏ ᚟ᖐࡲ࡛ ࡢᮇ㛫ࡢྛ
㡯┠ࡢയᐖⓎ ⏕⋡࡜ࡋ ࡓ㸬
6-8-3. ⤖ᯝ
യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ࡢ௓ධᮇ㛫 ࡣ 㸪2011 ᖺ 6 ᭶㹼2012 ᖺ 3 ᭶ ࡲ࡛ࡢ 10 ࣨ
᭶㛫㸪௓ධ᪥ ᩘࡣ 304 ᪥㛫࡛࠶ࡗࡓ 㸬 ௓ධ๓ ᚋࡢ⦎⩦࠾ࡼ ࡧヨྜࡀ ⾜ࢃࢀࡓᅇ
ᩘࡣ㸪௓ධ ๓ 183 ᅇ㸪 ௓ධᚋ 190 ᅇ࡛࠶ࡾ 㸪 1 㐌㛫࠶ࡓࡾࡢ ⦎⩦ ࠾ ࡼࡧヨྜᅇ
ᩘࡣ㸪௓ධ ๓ 4.2 ᅇ /㐌㸪௓ධᚋ 4.4 ᅇ/㐌࡛࠶ ࡗࡓ㸬 1㸬യᐖⓎ⏕⋡
௓ධ๓ᚋࡢയ ᐖⓎ⏕ᩘ ࠾ࡼࡧയᐖⓎ ⏕⋡ࢆ ⾲ 8-2 ࡟♧ࡍ㸬௓ ධ๓ ᚋࡢ ⥲ AHs
࠾ࡼࡧ⥲ AEs ࡣ㸪௓ ධ๓ 11,916.8AHs ࠾ࡼࡧ 5,593AEs㸪௓ධᚋ 11,417.6AHs ࠾
ࡼ ࡧ 5,371AEs ࡛ ࠶ ࡗ ࡓ 㸬 ⦎ ⩦ ᫬ ࡢ AHs ࠾ ࡼ ࡧ AEs ࡟ ࡘ ࠸ ࡚ ࡣ 㸪 ௓ ධ ๓
11,447.8AHs ࠾ࡼࡧ 5,065AEs㸪௓ධᚋ 10,721.0AHs ࠾ࡼࡧ 4,508AEs ࡛࠶ࡗࡓ㸬
ヨྜ᫬ࡢ AHs ࠾ࡼࡧ AEs ࡟ࡘ࠸࡚ ࡣ㸪௓ධ ๓ 469.0AHs ࠾ࡼࡧ 528AEs㸪௓ධ
ᚋ 696.6AHs ࠾ࡼࡧ 863AEs ࡛࠶ࡗࡓ 㸬௓ධ ๓ᚋࡢ AHs ࢆ ྜィࡍ ࡿ࡜㸪 ⦎⩦᫬
22,168.8AHs㸦Total AHs ࡢ 95%㸧㸪ヨྜ᫬ 1165.6AHs㸦5.0%㸧࡛⦎⩦᫬ࡀ࡯࡜
ࢇ࡝ࢆ༨ࡵ࡚ ࠸ࡓ㸬ࡲ ࡓ௓ධ๓ᚋ ࡢ AEs ࢆ ྜィࡍࡿ࡜㸪⦎ ⩦᫬ 9,573AEs㸦Total
AEs ࡢ 87.3%㸧㸪ヨྜ ᫬ 1,391㸦12.7%㸧࡛࠾࠾ࡼࡑ 9 ๭ࢆ ⦎⩦᫬ࡀ ༨ࡵ࡚࠸ࡓ 㸬
௓ධ๓ᚋࡢയ ᐖ Ⓨ⏕ᩘ ࡟ࡘ࠸࡚ࡣ 㸪௓ ධ๓ 143 ౛㸦യᐖⓎ⏕⋡ ࡣ 12.00 (10.03 —
13.97)/1000AHs ( ࢝ ࢵ ࢥ ෆ ࡣ 95 㸣 ಙ 㢗 ༊ 㛫 ࢆ ♧ ࡍ ) ࠾ ࡼ ࡧ 25.57 (21.38 —
29.76)/1000AEs㸧࡛㸪 ௓ධᚋ 102 ౛㸦യᐖⓎ ⏕⋡ 8.93 (7.20 — 10.67)/1000AHs
࠾ࡼࡧ 18.99 (15.31 — 22.68)/1000AEs㸧࡛࠶ ࡗࡓ㸬⦎⩦࣭ヨྜ᫬ ࡛ ẚ㍑ࡍࡿ࡜㸪
⦎⩦᫬ࡢ௓ධ ๓യᐖⓎ ⏕ᩘ 135 ౛㸦യᐖⓎ ⏕⋡ 11.79 (9.80 — 13.78)/1000AHs
156
࠾ࡼࡧ 26.65 (22.16 — 31.15)/1000AEs㸧㸪௓ ධᚋ 92 ౛㸦യᐖⓎ ⏕ ⋡ 8.58 (6.83 —
10.33)/1000AHs ࠾ࡼࡧ 20.41 (16.24 — 24.58)/1000AEs㸧㸪ヨྜ ᫬ࡢ௓ධ๓യ ᐖ
Ⓨ⏕ᩘ 8 ౛㸦17.06 (5.24 — 28.88)/1000AHs ࠾ࡼࡧ 15.15 (4.65 — 25.65)/1000AEs㸧㸪
௓ධᚋ 10 ౛㸦യ ᐖⓎ ⏕⋡ 14.36 (5.46 — 23.25)/1000AHs ࠾ࡼࡧ 11.59 (4.41 —
18.77)/1000AEs㸧 ࡛ ࠶ ࡗ ࡓ 㸬 ⦎ ⩦ ࣭ ヨ ྜ ᫬ ࡢ ௓ ධ ๓ ᚋ ࡢ യ ᐖ Ⓨ ⏕ ᩘ ࢆ ྜ ࢃ ࡏࡿ
࡜㸪⦎⩦ ᫬ 227 ౛㸪ヨ ྜ᫬ 18 ౛࡛㸪⦎ ⩦᫬ ࡟Ⓨ⏕ࡋࡓയ ᐖࡀ඲య ࡢ 9 ๭௨ୖࢆ
༨ࡵ࡚࠸ࡓ㸬
157
158
2㸬യᐖࡢ㒊఩ู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡
യᐖࡢ㒊఩ู ࡟ࡼࡿ ௓ ධ๓ᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ࢆ ⾲ 8-3㸪⾲ 8-4㸪
ᅗ 8-1 ࡟ ♧ ࡍ 㸬 ௓ ධ ๓ ᚋ ࡛ ᭱ ࡶ യ ᐖ Ⓨ ⏕ ⋡ ࡀ ప ୗ ࡋ ࡓ 㒊 ఩ ࡣ 㸪 ㊊ 㒊 /ࡘ ࡲ ඛ ࡛
0.92/1000AHs ࠿ࡽ 0.35/1000AHs ࠾ࡼࡧ 1.97/1000AEs ࠿ࡽ 0.74/1000AEs ࡛࠶ࡗ
ࡓ 㸦 യ ᐖ Ⓨ ⏕ ᩘ 11 ౛ ࠿ ࡽ 4 ౛ ࡬ ῶ ᑡ 㸧 㸬 ḟ ࡟ ୗ ⭣ ࡛ 1.17/1000AHs ࠿ ࡽ
0.79/1000AHs ࠾ࡼࡧ 2.50/1000AEs ࠿ࡽ 1.68/1000AEs ࡛࠶ࡗࡓ 㸦യ ᐖⓎ⏕ᩘ 14
౛࠿ࡽ 9 ౛ ࡬ῶᑡ㸧 㸬௨ୗ㸪⫤㛵 ⠇ 0.42/1000AHs ࠿ࡽ 0.09/1000AHs ࠾ࡼࡧ
0.89/1000AEs ࠿ࡽ 0.19/1000AEs㸦യᐖⓎ⏕ ᩘ 5 ౛࠿ ࡽ 1 ౛࡬ ῶ ᑡ 㸧㸪㰡ᚄ㒊
0.67/1000AHs ࠿ࡽ 0.35/1000AHs ࠾ࡼࡧ 1.43/1000AEs ࠿ࡽ 0.74/1000AEs㸦യᐖ
Ⓨ⏕ᩘ 8 ౛࠿ ࡽ 4 ౛࡬ ῶᑡ㸧㸪⭜᳝ /ୗ⫼㒊 1.09/1000AHs ࠿ࡽ 0.79/1000AHs ࠾
ࡼࡧ 2.32/1000AEs ࠿ࡽ 1.68/1000AEs㸦യᐖ Ⓨ⏕ᩘ 13 ౛࠿ࡽ 9 ౛ ࡬ῶᑡ㸧࡛࠶
ࡗࡓ㸬
159
160
ᅗ 8-1 ௓ධ๓ ᚋࡢയᐖ ࡢ㒊఩ูയᐖ Ⓨ⏕ᩘ ࡜ ࡑࡢ๭ྜ
161
3㸬യᐖࡢ✀㢮ู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡
യᐖࡢ✀㢮ู ࡟ࡼࡿ ௓ ධ๓ᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ࢆ⾲ 8-5 ࡟♧ ࡍ㸬
௓ධ๓ᚋ࡛᭱ ࡶⓎ⏕⋡ ࡀపୗࡋࡓയ ᐖࡢ✀㢮 ࡣ㸪⭝⅖ /೺࿘ᅖ⅖ ࡛ 2.43/1000AHs
࠿ࡽ 1.31/1000AHs ࠾ࡼࡧ 5.19/1000AEs ࠿ ࡽ 2.79/1000AEs ࡛࠶ ࡗࡓ㸦യᐖⓎ⏕
ᩘ 29 ౛ ࠿ ࡽ 15 ౛ ࡟ ῶ ᑡ 㸧 㸬 ḟ ࡟ ᡴ ᧞ / ⾑ ⭘ / ᣸ യ ࡛ 2.01/1000AHs ࠿ ࡽ
1.14/1000AHs ࠾ࡼࡧ 4.29/1000AEs ࠿ࡽ 2.42/1000AEs ࡛࠶ࡗࡓ 㸦യ ᐖⓎ⏕ᩘ 24
౛ ࠿ ࡽ 13 ౛ ࡟ ῶ ᑡ 㸧 㸬 ௨ ୗ 㸪 ᤬ ᣸ 2.77/1000AHs ࠿ ࡽ 1.93/1000AHs ࠾ ࡼ ࡧ
5.90/1000AEs ࠿ࡽ 4.10/1000AEs㸦യᐖⓎ ⏕ ᩘ 33 ౛࠿ࡽ 22 ౛࡟ῶ ᑡ 㸧㸪➽⫗③
/ ࢫ ࣃ ࢬ ࣒ 2.60/1000AHs ࠿ ࡽ 2.10/1000AHs ࠾ ࡼ ࡧ 5.54/1000AEs ࠿ ࡽ
4.47/1000AEs㸦യᐖⓎ ⏕ᩘ 31 ౛࠿ࡽ 24 ౛࡟ ῶᑡ㸧࡛࠶ࡗ ࡓ㸬
162
4㸬യᐖࡢཎᅉู ࡟ࡼ ࡿയᐖⓎ⏕ᩘ ࠾ࡼࡧയ ᐖⓎ⏕⋡
യᐖࡢཎᅉู ࡟ࡼࡿ ௓ ධ๓ᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ࢆ⾲ 8-6 ࡟♧ ࡍ㸬
௓ධ๓ᚋ࡛᭱ࡶⓎ⏕⋡ࡀపୗࡋࡓയᐖࡢཎᅉࡣ㸪᥋ゐᆺ യᐖ㸦௚ࡢ㑅ᡭ㸧࡛
2.27/1000AHs ࠿ࡽ 1.40/1000AHs ࠾ࡼࡧ 4.83/1000AEs ࠿ࡽ 2.98/1000AEs ࡛࠶ࡗ
ࡓ㸦യᐖⓎ⏕ ᩘ 27 ౛࠿ࡽ 16 ౛࡟ῶᑡ㸧㸬 ḟ࡟㠀᥋ゐᆺ യᐖ࡛ 2.35/1000AHs
࠿ࡽ 1.66/1000AHs ࠾ࡼࡧ 5.01/1000AEs ࠿ ࡽ 3.54/1000AEs ࡛࠶ ࡗࡓ㸦യᐖⓎ⏕
ᩘ 28 ౛ ࠿ ࡽ 19 ౛ ࡟ ῶ ᑡ 㸧 㸬 ௨ ୗ 㸪 ౑ ࠸ ࡍ ࡂ 㸦 ᚎ ࠎ ࡟ 㸧 3.94/1000AHs ࠿ ࡽ
3.33/1000AHs ࠾ࡼࡧ 8.40/1000AEs ࠿ࡽ 7.08/1000AEs㸦യᐖⓎ⏕ᩘ 47 ౛࠿ࡽ 38
౛ ࡟ ῶ ᑡ 㸧 㸪 ౑ ࠸ ࡍ ࡂ 㸦 ᛴ ࡟ 㸧 1.34/1000AHs ࠿ ࡽ 0.88/1000AHs ࠾ ࡼ ࡧ
2.86/1000AEs ࠿ࡽ 1.86/1000AEs㸦യᐖⓎ ⏕ ᩘ 16 ౛࠿ࡽ 10 ౛࡟ῶ ᑡ 㸧㸪᥋ゐᆺ
യᐖ㸦ື࠸࡚ ࠸ࡿ≀㸧 ࡛ 1.43/1000AHs ࠿ࡽ 1.05/1000AHs ࠾ࡼࡧ 3.04/1000AEs
࠿ࡽ 2.23/1000AEs ࡛࠶ࡗࡓ㸦യᐖ Ⓨ⏕ ᩘ 17 ౛࠿ࡽ 12 ౛࡟ῶ ᑡ 㸧࡛࠶ࡗࡓ㸬
163
164
5㸬ཷയᅇᩘ࡟ࡼ ࡿയ ᐖⓎ⏕ᩘ ࠾ࡼ ࡧയᐖⓎ ⏕⋡
ㄪᰝᮇ㛫୰࡟ Ⓨ⏕ࡋࡓ ௓ධ๓ᚋࡢയ ᐖࡢᅇᩘ ࠾ࡼࡧയᐖⓎ ⏕⋡ࢆ ⾲ 8-7 ࡟♧
ࡍ㸬௓ධ๓ᚋ ࡛᭱ࡶⓎ ⏕⋡ࡀపୗࡋ ࡓയᐖࡢ ᅇᩘࡣ㸪ึᅇ ཷയ࡛Ⓨ ⏕ᩘ 101 ౛
࠿ࡽ 60 ౛࡬࡜పୗࡋ 㸪യᐖⓎ⏕⋡ ࡣ 8.48/1000AHs ࠿ࡽ 5.26/1000AHs ࠾ࡼࡧ
18.06/1000AEs ࠿ࡽ 11.17/1000AEs ࡟పୗࡋ ࡓ㸬ḟ࡟ 2 ᅇ ┠㸦෌ཷ യ㸧࡛ 19 ౛
࠿ࡽ 14 ౛㸪Ⓨ⏕ ⋡ࡣ 1.59/1000AHs ࠿ࡽ 1.23/1000AHs ࠾ࡼࡧ 3.40/1000AEs ࠿
ࡽ 2.61/1000AEs ࡟ప ୗࡋࡓ 㸬
165
166
6㸬➇ᢏ᚟ᖐࡲ࡛ ࡢᮇ 㛫࡜യᐖⓎ⏕ ᩘ࠾ࡼࡧ യᐖⓎ⏕⋡
ㄪᰝᮇ㛫୰࡟ Ⓨ⏕ࡋࡓ ௓ධ๓ᚋࡢ ➇ ᢏ᚟ᖐࡲ ࡛ࡢᮇ㛫࡜യ ᐖⓎ⏕ᩘ ࠾ࡼࡧയ
ᐖⓎ⏕⋡ࢆ ⾲ 8-8 ࡟♧ ࡍ㸬௓ධ๓ᚋ ࡛᭱ࡶప ୗࡋࡓ᚟ᖐࡲ ࡛ࡢᮇ㛫 ࡣ㸪1㹼2 ᪥
࡛ 2.85/1000AHs ࠿ࡽ 1.84/1000AHs ࠾ࡼࡧ 6.08/1000AEs ࠿ࡽ 3.91/1000AEs ࡛࠶
ࡗࡓ㸦യᐖⓎ ⏕ᩘ 34 ౛࠿ࡽ 21 ౛࡟ῶᑡ㸧 㸬ḟ࡟ 3㹼7 ᪥࡛ 4.20/1000AHs ࠿ࡽ
3.59/1000AHs ࠾ࡼࡧ 8.94/1000AEs ࠿ࡽ 7.63/1000AEs㸦യᐖⓎ⏕ᩘ 50 ౛࠿ࡽ 41
౛ ࡟ ῶ ᑡ 㸧 㸪 ௨ ᚋ 㸪 4 㐌 㹼 6 ࣨ ᭶ ࡛ 1.34/1000AHs ࠿ ࡽ 0.61/1000AHs ࠾ ࡼ ࡧ
2.86/1000AEs ࠿ࡽ 1.30/1000AEs㸦യᐖⓎ⏕ ᩘ 16 ౛࠿ࡽ 7 ౛࡟ ῶ ᑡ 㸧㸪1㹼2 㐌
࡛ 2.35/1000AHs ࠿ࡽ 1.75/1000AHs ࠾ࡼࡧ 5.01/1000AEs ࠿ࡽ 3.72/1000AEs㸦യ
ᐖⓎ⏕ᩘ 16 ౛࠿ ࡽ 7 ౛࡟ῶᑡ㸧࡛ ࠶ࡗࡓ㸬
167
168
6-8-4. ⪃ᐹ
ᮏ◊✲ࡣ㸪 ୗ⫥ യᐖ ண㜵ࢺ࣮ࣞࢽ ࣥࢢࡢ ௓ ධຠᯝ᳨ドࢆ ⾜࠺ࡇ࡜ ࡜ࡋ㸪኱Ꮫ
ዪᏊࣛࢡࣟࢫ ➇ᢏࢆᑐ ㇟ ࡟㸪㏻ᖖ⾜ ࢃࢀ࡚࠸ ࡿ࢛࣮࣑࢘ࣥ ࢢ࢔ࢵࣉ ࣓ࢽ࣮ࣗ ࡛
⾜ࢃࢀ࡚࠸ࡿ ࣛࣥࢪࡸ ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪ࢧ࢖ࢻࢫ ࢸࢵࣉ ࡸ ษࡾ㏉ࡋື
స᫬࡟͆㊊㊑ ࢆ㛤࠸࡚ ᗋࢆᥗࡴ ͇ࢆ ᣦ♧ࡍࡿ ືసᣦᑟἲࡀ 㸪ୗ⫥യ ᐖⓎ⏕⋡➼
࡬ཬࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ ẚ㍑᳨ドࡍࡿ ࡇ࡜ࢆ┠ ⓗ࡜ࡋ ࡚⾜ࡗ ࡓ㸬
௓ධ๓ᚋࡑ ࢀࡒ ࢀ 10 ࣨ᭶㛫ࡢ Total AHs ࡜ Total AEs ࡣ㸪௓ධ ๓ 11,916.8AHs
࠾ࡼࡧ 5,593AEs㸪௓ධ ᚋ 11,417.6AHs ࠾ࡼࡧ 5,371AEs ࡛㸪࡯ࡰྠᩘ ࡛࠶ࡗࡓ㸬
ࡲࡓ㸪௓ධ๓ ᚋࢆྜࢃ ࡏࡓ⦎⩦᫬࡜ ヨྜ᫬ ࡢ Total AHs ࡜ Total AEs ࡜ࡢẚ㍑࡛
ࡣ㸪◊ ✲ 1 ࡢ⤖ᯝ ࡜ ྠ ᵝ࡟㸪⦎ ⩦᫬࡟༨ ࡵࡿ ๭ྜࡀ ࠾࠾ࡼ ࡑ 9 ๭௨ ୖ࡛࠶ࡗࡓ㸬
⥲യᐖⓎ⏕ᩘ ࡟㛵ࡋ࡚ ࡣ㸪௓ධ ๓ 143 ౛㸪௓ධᚋ 102 ౛࡛࠶ࡗࡓ㸬 ⥲യᐖⓎ⏕
⋡࡛ẚ㍑ࡍࡿ ࡜㸪 ௓ධ ๓ 12.00 (10.03 — 13.97)/1000AHs ࠾ࡼࡧ 25.57 (21.38 —
29.76)/1000AEs㸪 ௓ ධ ᚋ 8.93 (7.20 — 0.67)/1000AHs ࠾ ࡼ ࡧ 18.99 (15.31 —
22.68)/1000AEs ࡛࠶ࡾ㸪⥲യᐖⓎ⏕ ⋡ ࢆῶᑡ ࡉࡏࡓ㸬⦎⩦ ࣭ヨྜ᫬ ࡢ⥲യᐖⓎ
⏕ᩘࡣ㸪⦎⩦ ᫬ࡢ௓ධ ๓ 135 ౛㸪௓ධᚋ ࡛ 92 ౛࡛࠶ࡾ㸪 യᐖⓎ ⏕⋡ ࡣ௓ධ๓
11.79 (9.80 — 13.78)/1000AHs ࠾ࡼࡧ 26.65 (22.16 — 31.15)/1000AEs㸪௓ධᚋ 8.58
(6.83 — 10.33)/1000AHs ࠾ࡼࡧ 20.41 (16.24 — 24.58)/1000AEs ࡛࠶ࡗࡓ㸬ヨྜ᫬
ࡢ ௓ ධ ๓ 8 ౛ 㸪 ௓ ධ ᚋ 10 ౛ ࡛ ࠶ ࡾ 㸪 യ ᐖ Ⓨ ⏕ ⋡ ࡣ ௓ ධ ๓ 17.06 (5.24 —
28.88)/1000AHs ࠾ࡼࡧ 15.15 (4.65 — 25.65)/1000AEs㸪௓ධᚋ 14.36 (5.46 —
23.25)/1000AHs ࠾ࡼࡧ 11.59 (4.41 — 18.77)/1000AEs ࡛࠶ࡗࡓ 㸬⦎⩦࣭ヨྜ ᫬ ࠸
ࡎࢀ࡟࠾࠸࡚ ࡶയᐖⓎ ⏕⋡ࢆ ῶᑡࡉ ࡏࡓ㸬ࡇ ࢀࡽࡢ⤖ᯝ࠿ ࡽ㸪 ⦎⩦ ࣭ヨྜ᫬㸪
ࡑࡢྜィ࠸ࡎ ࢀ࡟࠾࠸ ࡚ࡶ௓ධ ࡟ࡼ ࡿയᐖⓎ ⏕⋡ࡢῶᑡࡀ ☜ㄆࡉࢀ ࡓ 㸬യᐖࡢ
㒊఩ู࡛ࡳࡿ ࡜㸪≉࡟ യᐖⓎ⏕⋡ࡢ ῶᑡࡀࡳ ࡽࢀࡓࡢࡀ ㊊ 㒊/ࡘࡲඛ㸪ୗ⭣㸪⫤
㛵⠇࡛࠶ࡗࡓ 㸬௒ᅇࡢ ୗ⫥യᐖண㜵 ࢺ࣮ࣞࢽ ࣥࢢࡣ㸪 ㊊㛵 ⠇ࡸ ⭸㛵 ⠇യᐖࡢண
㜵ࢆ≺࠸࡜ࡋࡓࡶࡢ࡛࠶ࡗࡓࡀ㸪ࡑࢀࡽࡢയᐖⓎ⏕⋡ࢆࡳࡿ࡜㸪㊊㛵⠇ࡣ
2.01/1000AHs ࠿ࡽ 1.93/1000AHs㸪4.29/1000AEs ࠿ࡽ 4.10/1000AEs ࡬࡜ῶᑡࡋ
㸦 യ ᐖ Ⓨ ⏕ ᩘ ࡣ 24 ౛ ࠿ ࡽ 22 ౛ ࡬ ῶ ᑡ 㸧 㸪 ⭸ 㛵 ⠇ ࡣ 1.34/1000AHs ࠿ ࡽ
1.93/1000AHs㸪2.86/1000AEs ࠿ࡽ 4.10/1000AEs ࡬࡜ቑຍࡋࡓ㸦യᐖ Ⓨ⏕ᩘ ࡣ 16
౛࠿ࡽ 22 ౛࡬ቑ ຍ 㸧㸬⭸㛵⠇ࡢ യᐖⓎ⏕ ⋡ ࡢῶᑡࡣࡳࡽ ࢀ࡞࠿ࡗ ࡓࡀ 㸪㊊㛵 ⠇
169
ࡢയᐖⓎ⏕⋡ ࡀࢃࡎ࠿ ࡛ࡣ࠶ࡿࡀ ῶ ᑡࡋࡓ㸬 ㊊㛵⠇യᐖⓎ ⏕⋡ࡢῶ ᑡ࡟ࡘ࠸࡚
⪃ᐹࡍࡿ࡜㸪 ❧఩ጼໃ ࡛ࡣ㊊㒊 ࡢࡳ ࡀᗋ࡜᥋ ゐࡋ ࡓ≧ែ࡜ ࡞ࡾ 㸪㊊ ᗏ࠾ࡼࡧ㊊
㒊࠿ࡽࡢ᝟ሗ ࡀ ጼໃㄪ ᩚࡸ㐠ືࢆ⾜ ࠺㝿 ࡟㔜 せ࡞᝟ሗ※࡜ ࡞ࡿ㸬ࡑ ࡢ᝟ሗࡣ ➽
⫗㸪⭝㸪㠌ᖏ 㸪༙᭶㸪 㛵⠇ໟ㸪⁥⭷ ➼࡟ Ꮡᅾ ࡍࡿᅛ᭷ཷᐜ ჾ ࠿ࡽࡢ ᝟ሗ࡛࠶ࡿ
ࡀ㸪ࡇࢀࡽࡢ ᝟ሗࡀ୰ ᯡ⚄⤒⣔ࢆ௓ ࡋ࡚㐠ື ไᚚ࡟㛵ࡍࡿ ᚲせ࡞᝟ ሗࡀ➽⫗ࡸ
㛵⠇࡟㏦ࡽࢀ ࡿ [Hervéou and Messéan, 1995]㸬ࡇࢀࡽࡢ ឤぬ᝟ሗ ࡣ 㸪ࡑࡢཷᐜჾ
࡛࠶ࡿ ࣓࢝ ࣀࣞ ࢭࣉ ࢱ ࣮ 㸦 mechanoreceptor㸪 ᶵᲔཷ ᐜჾ 㸧 ࡀ ᗋ࠿ ࡽ ࡢຊᏛ ⓗ࡞
᝟ሗࢆཷࡅ࡚ ⾜ ࢃࢀ࡚ ࠸ࡿ [ᐑᓥࡽ, 2012]㸬ࡲࡓ㸪㊊㊑࡟ ࡣ࣓࢝ࣀ ࣞࢭࣉࢱ࣮ ࡢ
ศᕸᐦᗘࡀ㧗 ࡃ㸪㊊㊑ ࢺ࣮ࣞࢽࣥࢢ ࡣ ࣓࢝ࣀ ࣞࢭࣉࢱ࣮ ࢆ ㈿άࡉࡏ 㸪⚄⤒㐠ື
ჾ༠ㄪࢆᨵၿ ࡉࡏࡿ࡜ ࡜ࡶ࡟㸪㊊ᗏ ➽⩌࠿ࡽ ⭌⭡➽㸪 ࣁ࣒ ࢫࢺࣜࣥ ࢢ ࡬ࡢ➽㐃
㙐཯ᛂࢆㄏⓎ ࡉࡏࡿࡇ ࡜㸪ࡑࡋ࡚ ㊊ 㛵⠇࿘ᅖ ➽ࡢ➽཯ᛂࢆ ㄏⓎࡉࡏ ࡿ࡜㏙࡭ࡽ
ࢀ࡚࠸ࡿ[஭ཎ, 1996; Hervéou and Messéan, 1995]㸬ࡇࢀࡽࡢሗ ࿌ ࠿ ࡽࡳࡽࢀࡿࡼ
࠺࡟㸪㊊㊑㛤 ᤼ࡸ㊊㊑ ᢕᣢ➼ࡢ ࢺࣞ ࣮ࢽࣥࢢ ࡟ࡼࡿ㊊㊑ ᶵ ⬟ྥୖࡣ 㸪❧఩ ືస
᫬ࡢ㊊㊑㐠ື ࡟ࡼ ࡾ㸪 ㊊㊑࡛ᚓࡽࢀ ࡿឤぬཷ ᐜჾࡢỈ‽ࡀ 㧗ࡲ ࡾ㸪 ➽⫗࡬ࡢ㐺
ษ࡞᝟ሗࡀࡼ ࡾ᪩ࡃ㏦ ࡽࢀࡿࡇ࡜࡛ እຊ࡟ᑐ ࡍࡿ཯ᛂไᚚ 㸪ࡍ࡞ࢃ ࡕࣇ࢕࣮ࢻ
ࣂࢵࢡไᚚ࡟ ࡼࡾ ㊊㒊 ࡢᶵ⬟ⓗᏳᐃ ᛶ࡟ ᐤ୚ ࡉࡏࡓࡢ࡛ࡣ ࡞࠸࠿࡜ ⪃࠼ࡓ 㸬ࢫ
ࢸࢵࣉືసࡸ ࢪࣕࣥࣉ ࠿ࡽࡢ╔ᆅ᫬ ➼࡟㊊㊑ 㛤᤼࠾ࡼࡧ㊊ ㊑ᢕᣢࢆ ព㆑ࡉࡏ࡚
⾜ࢃࡏࡿࡇ࡜ ࡀ㸪㊊㊑ ᢕᥱຊࡸ㊊㊑ 㛤᤼⬟ࡢ ྥୖ࡜࡜ࡶ࡟ 㸪≉࡟㊊ 㒊ࡢ ⚄⤒➽
༠ㄪᛶࡀࡼࡾ ྥୖࡍࡿ ࡇ࡜㸪ࡑࡋ࡚ ㊊㒊࠿ࡽ ࡢ᝟ሗࡀ୰ᯡ ⚄⤒⣔ࢆ ௓ࡋ࡚➽⫗
➼࡬ࡢ࿨௧ఏ 㐩ࡀ⣲᪩ ࡃ⾜ࢃࢀࡇ࡜ ࡛㸪㊊㒊 ࡢᏳᐃᛶࡀࡼ ࡾྥୖࡋ 㸪㊊㛵⠇യ
ᐖࡢῶᑡ࡟ࡘ ࡞ࡀࡗࡓ ࡢ࡛ࡣ࡞࠸࠿ ࡜᥎ ࡋ ࡓ㸬ࡲࡓ㸪ᮏ ㄽᩥ ◊ ✲ 5 ࡢ㊊㊑ ᢕ
ᥱຊ࡜㟼ⓗ࠾ ࡼࡧືⓗ ࣂࣛࣥࢫ⬟ຊ ࡜ࡢ㛵㐃 ᛶ ᳨࡛ドࡋࡓ 㸪㊊㊑ᢕ ᥱຊࡢඃࢀ
ࡿ⪅ࡣ㊊㒊࢔ ࣮ࢳ๛ᛶ ࡀ㧗ࡲࡿ࡜ࡇ ࡛㊊㒊ࡢ Ᏻᐃᛶࡀྥୖ ࡋ㸪 㟼ⓗ ୗ⫥ࣂࣛࣥ
ࢫಖᣢ⬟ຊ࡟ ᐤ୚ࡉࡏ ࡓࡇ࡜㸪ࡑࡋ࡚๓ ᪉࡬ ࡢືⓗࣂࣛࣥ ࢫಖᣢ⬟ ຊ ࡟ࡶඃࢀ 㸪
㊊㊑ࢆྵࡵࡓ ๓㊊㒊࡛ ࡢጼໃಖᣢ⬟ ຊ࡟ᐤ୚ ࡉࡏࡓ ࡇ࡜࡛ ╔ᆅືస ᫬ࡢ㊊㊑ᢕ
ᣢືసࡀືⓗ ୗ⫥ࣂࣛ ࣥࢫಖᣢ⬟ຊ ࡟ᙳ㡪ࢆ ཬࡰࡋ ࡓ࡜࠸ ࠺⤖ㄽ࠿ ࡽࡶ ㊊㛵⠇
യᐖࡢῶᑡ࡟ ᐤ୚ࡉࡏ ࡓ ࡢ࡛ࡣ࡞࠸ ࠿࡜ ⪃࠼ ࡓ㸬◊✲ 7 ࡢୗ⫥യᐖ ண㜵ࢺ࣮ࣞ
ࢽࣥࢢ௓ධࡀ ㊊㊑ᶵ⬟ 㸪㊊㒊ᙧែ㸪 㟼ⓗ࣭ື ⓗࣂࣛࣥࢫ⬟ ຊ ࡟ཬࡰ ࡍᙳ㡪 ࡟ࡘ
࠸࡚ࡢ᳨ド࡛ ࡣ㸪㊊㊑ 㛤᤼ࡸ㊊㊑ᢕ ᣢືసࢆ ព㆑ࡉࡏ ࡓࢺ ࣮ࣞࢽࣥ ࢢࡣ 㸪ᑠ㊑
170
እ㌿➽ࡸẕ㊑ እ㌿➽ࡢ ㊊㒊ෆᅾ➽ࡢ ➽⥭ᙇ ࡟ ࡼࡾ㸪㊊㒊࢔ ࣮ࢳ๛ᛶ ࢆ㧗ࡵࡿࡇ
࡜㸪ࡑࡋ࡚㊊ 㒊እᅾ➽ ࡢ➽ᙇ࡟ࡼࡗ ࡚ࡶ ㊊㒊 ࢔࣮ࢳ๛ᛶ ࢆ 㧗ࡵࡿࡇ ࡜࠿ࡽ 㸪㊊
㊑ᢕᥱຊࡸ㊊ ㊑㛤᤼⬟ ࡢྥୖ࡜࡜ࡶ ࡟㊊㒊 ࡢ Ᏻᐃᛶ࡟ᐤ୚ ࡉࡏ㸪㊊ 㛵⠇യᐖࡢ
ῶᑡ࡟ᐤ୚ࡉ ࡏࡓ ࡢ࡛ ࡣ࡞࠸࠿࡜᥎ ࡋࡓ㸬 ᮏ◊✲⤖ᯝ࠿ ࡽ㸪 ⭸㛵 ⠇യᐖ࡟ᑐ
ࡍࡿ௓ධຠᯝ ࡣࡳࡽࢀ ࡞࠿ࡗࡓ㸬ඛ ⾜◊✲࡛ ࠶ࡿ ㊊㊑㛤᤼ ࠾ࡼࡧ㊊ ㊑ᢕᣢືస
ࡀືⓗୗ⫥࢔ ࣛ࢖࣓ࣥ ࢺ࡟ཬࡰࡍᙳ 㡪㸦◊ ✲ 2㸧ࡸ㊊㊑ ᢕᥱຊ ࡜ 㟼ⓗ࠾ࡼࡧື
ⓗࣂࣛࣥࢫ⬟ ຊ࡜ࡢ㛵 㐃ᛶ㸦◊✲ 5㸧㸪ୗ⫥ യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ௓ධࡀ ㊊㊑
ᶵ⬟ࡸ㟼ⓗ࠾ ࡼࡧືⓗ ࣂࣛࣥࢫ⬟ຊ ࡟ཬࡰࡍ ᙳ㡪 㸦◊✲ 7㸧࠿ࡽ㸪 ㊊㊑ᢕᥱຊ
࠾ࡼࡧ㊊㊑㛤 ᤼⬟ࡢྥ ୖࡀືⓗୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺࡢ▹ṇࡸ ືⓗࣂࣛ ࣥࢫ⬟ຊࢆ
ྥୖࡉࡏࡿࡇ ࡜࡛㸪⭸ 㛵⠇യᐖࡢῶ ᑡ࡟ᐤ୚ ࡉࡏࡿ࡜᥎ ࡋࡓࡀ㸪 ㊊㊑ ᢕᥱ➽
ຊࡸ㊊㊑㛤᤼ 㐠ື ࡀ⭸ 㛵⠇࡟ཬࡰࡍ ᙳ㡪࡟ࡘ ࠸࡚ ⤖ㄽ࡙ࡅ ࡿ࡟ࡣ㸪 ࡑࢀࡽࡢ࣓
࢝ࢽࢬ࣒ࢆヲ ⣽࡟᳨ド ࡍࡿᚲせࡀ࠶ ࡾ㸪௒ᚋ ࡢ◊✲ㄢ㢟 ࡜ ࡉࢀࡿ 㸬 ᭱ࡶയᐖⓎ
⏕⋡ࡢῶᑡࡀ ࡳࡽࢀࡓ ㊊㒊/ࡘࡲඛ࡟ࡘ࠸࡚㸪ྠയᐖ㒊఩ࡢ ௓ධ๓ࡢ യᐖࡢ ✀㢮
ࡢከࡃࡀ⭝⅖ ࡛࠶ࡗࡓ 㸬 ⭝⅖ࡣ៏ᛶ 㞀ᐖࡢ୍ ࡘ࡛࠶ࡿࡀ㸪 ㊊㊑ࢺࣞ ࣮ࢽࣥࢢ࡟
ࡼࡿ㊊㒊ࡢ࢔ ࣮ࢳ๛ᛶ ࡀ㧗ࡲࡿࡇ࡜ ࡛ ㊊㒊ࡢ Ᏻᐃᛶࢆྥୖ ࡉࡏ㸪 ࡉ ࡽ࡟ࡣ㊊㒊
࢔ࣛ࢖࣓ࣥࢺ ࡢ▹ṇ࡟ ࡘ࡞ࡀࡗࡓࡇ ࡜ ࡛៏ᛶ 㞀ᐖࡢῶᑡ࡟ ᐤ୚ࡉࡏ ࡓ ࡶࡢ࡜᥎
ࡍࡿ㸬
യᐖࡢ✀㢮࡟ ࡘ࠸࡚㸪 ௓ධᚋࡢയᐖ Ⓨ⏕ᩘ࠾ ࡼࡧയᐖⓎ⏕ ⋡ ࢆ᭱ࡶ పୗࡉࡏ
ࡓࡢ ࡣ㸪 ⭝⅖ /⭝ ࿘ᅖ ⅖ 㸪 ḟ࡟ ᡴ᧞/⾑ ⭘/᣸ യ㸪 ᤬᣸ ࡢ㡰 ࡛࠶ ࡗࡓ 㸬 ≉ ࡟㛵 ⠇ യ
ᐖ࡟ཬࡰࡍᙳ 㡪࡟ࡘ࠸ ࡚⪃ᐹࡍࡿ࡜ 㸪᤬᣸ ࡟ ࡼࡿയᐖࡢῶ ᑡࡀ㢧ⴭ ࡛࠶ࡗࡓ㸬
ୗ⫥㛵⠇യᐖ ண㜵࡟ᅛ ᭷ឤぬჾ ࡜⚄ ⤒➽༠ㄪ ᛶࡢྥୖ ࢆ≺ ࠸࡜ࡋࡓ ࢺ࣮ࣞࢽࣥ
ࢢࡀከᩘ⾜ࢃ ࢀ࡚࠸ࡿ ࡀ 㸪ඛ㏙ࡋࡓ ㊊㊑ࢺࣞ ࣮ࢽࣥࢢࡀ ࣓ ࢝ࣀࣞࢭ ࣉࢱ࣮ ࢆ㈿
άࡉࡏ㸪⚄⤒ 㐠ືჾᙉ ㄪࢆᨵၿࡉࡏ ࡿ [஭ཎ, 1996]࡜࠸ࡗࡓሗ࿌ ࠿ ࡽࡶ㸪㊊㊑㛤
᤼࠾ࡼࡧ㊊㊑ ᢕᣢືస ࡀ⚄⤒➽༠ㄪ ᛶࢆྥୖ ࡉࡏࡓࡇ࡜ࡀ ᤬᣸യᐖ ࡢῶᑡ࡟ ᐤ
୚ࡉࡏࡓࡢ࡛ ࡣ࡞࠸࠿ ࡜⪃࠼ ࡓ㸬ࡲ ࡓ㸪ඛ⾜ ◊✲㸦 ◊✲ 5㸪7㸧࡛ ࡢ᳨ド࡛㸪㊊
㊑ᢕᥱຊ࡜ୗ ⫥ࣂࣛࣥ ࢫಖᣢ⬟ຊ࡜ ࡟᭷ព࡞ 㛵㐃ᛶࢆ♧ࡋ ࡓࡇ࡜㸪 ㊊㊑ᢕᥱຊ
ࡢඃࢀࡿ⪅ࡣ ࡑ࠺࡛࡞ ࠸⪅࡜ẚ࡭࡚ 㸪๓᪉ࡢ ࡳ࡛ࡣ࠶ࡗࡓ ࡀືⓗࣂ ࣛࣥࢫಖᣢ
⬟ຊ࡟ඃࢀ࡚ ࠸ࡓࡇ࡜ 㸪 ㊊㊑ෆᅾ➽ ࠾ࡼࡧ㊊ 㒊እᅾ➽ࡢ➽ ⥭ᙇࡀ࢔ ࣮ࢳ๛ᛶࢆ
㧗ࡵ㸪㊊㒊Ᏻ ᐃᛶ࡟ᐤ ୚ࡉࡏࡿ࡜࠸ ࡗࡓ⪃ᐹ ࠿ࡽࡶ㸪ࡑࢀ ࡽࡀ ᤬᣸ യᐖࡢῶᑡ
171
࡟ᐤ୚ࡉࡏࡓ ࡜᥎ ࡍ ࡿ 㸬
യᐖࡢཎᅉู ࡟ࡼࡿ ௓ ධᚋࡢയᐖⓎ ⏕ᩘ࠾ࡼ ࡧയᐖⓎ⏕⋡ ࡢኚ໬࡟ ࡘ࠸࡚ࡣ 㸪
᭱ࡶపୗࡉࡏ ࡓയᐖࡢ ཎᅉࡣ᥋ゐᆺ യᐖ㸦௚ ࡢ㑅ᡭ㸧㸪ḟ ࡟㠀᥋ゐ ᆺ യᐖ㸪౑
࠸ࡍࡂ࡛࠶ࡗ ࡓ㸬 ࡇࢀ ࡟ࡘ࠸࡚ࡶ◊ ✲ 2㸪5㸪7 ᳨࡛ドࡉࢀ ࡓ㊊㊑ 㛤᤼⬟ ࡸ㊊㊑
ᢕᥱຊࡀୗ⫥ ࢔ࣛ࢖࣓ ࣥࢺ▹ṇࡸ㟼 ⓗ ࠾ࡼࡧ ືⓗࣂࣛࣥࢫ ⬟ຊ ྥୖ ࡟ᐤ୚ࡉࡏ 㸪
യᐖⓎ⏕⋡ῶ ᑡ࡟ࡘ࡞ ࡀࡗࡓྍ⬟ᛶ ࡀ⪃࠼ࡽ ࢀࡿࡀ㸪᥋ゐ ᆺ യᐖࡣ ୺࡟እⓗせ
ᅉ࡟ࡼࡗ࡚Ⓨ ⏕ࡍ ࡿയ ᐖ࡛࠶ࡾ㸪ᮏ ◊✲࡛ᚓ ࡽࢀࡓ⤖ᯝ࠿ ࡽ⪃ᐹࡍ ࡿࡢࡣᅔ㞴
࡛࠶ࡿ࡜⪃࠼ ࡓ㸬
യᐖࡢᅇᩘ࠾ ࡼࡧയᐖ Ⓨ⏕⋡ ࡟ࡘ࠸ ࡚㸪 ≉࡟ യᐖⓎ⏕⋡ࡀ పୗࡋࡓ ࡢࡣึᅇ
ཷയ࡛࠶ࡗࡓ ࡀ㸪 ◊ ✲ 1 ࠾ࡼࡧඛ⾜ㄽ ᩥ [బ㔝ᮧࡽ㸪2012]ࡢ⤖ ᯝ࡛ ♧ࡉࢀࡓ 2
ᅇ┠௨ୖࡢ෌ യᐖࡢ๭ ྜࡀ඲യᐖࡢ 1/4 ࢆ༨ࡵࡿࡇ࡜ࡀ኱ ᏛዪᏊࣛ ࢡࣟࢫയᐖ
ࡢ≉ᚩ࡛࠶ࡾ 㸪ึᅇཷ യࡢῶᑡࡣ㸪 ࡑࢀ௨ᚋ ࡟Ⓨ⑕ࡍࡿྠ 㒊఩ࡢയ ᐖ ࡢῶᑡ࡟
ᐤ୚ࡉࡏࡿ࡜ ⪃࠼ࡿ㸬
௓ධ๓ᚋࡢ➇ ᢏ᚟ᖐࡲ ࡛ࡢᮇ㛫࡜യ ᐖⓎ⏕ᩘ ࠾ࡼࡧയᐖⓎ ⏕⋡ ࡟ࡘ ࠸࡚㸪᭱
ࡶῶࡌࡉࡏࡓ ᚟ᖐࡲ࡛ ࡢᮇ㛫 ࡢⓎ⏕ ⋡ࡣ 1㹼 2 ᪥࡛࠶ࡾ 㸪ḟ࡟ 3㹼 7 ᪥㸪4 㐌㹼6
ࣨ᭶࡛࠶ࡗࡓ 㸬ࡇ ࢀࡽ ࡢ⤖ᯝ࠿ࡽ㸪7 ᪥௨ෆ ࡢẚ㍑ⓗ▷ᮇ 㛫࡛ࡢ➇ ᢏ᚟ᖐ ྍ⬟
࡞യᐖࡢῶᑡ ࡜㸪4 㐌 㹼6 ࣨ᭶࡜࠸࠺ ୰࣭㛗 ᮇ 㛫࡛ࡢ➇ᢏ ᚟ᖐྍ⬟ ࡞ യᐖࡢῶᑡ
ࡀࡳࡽࢀࡓ㸬ࡇࢀࡣ㸪യᐖࡢ✀㢮ࡢ ୰ ࡛യᐖ Ⓨ⏕⋡ ࡢపୗ ࡀ㢧ⴭ࡛ ࠶ࡗࡓ ᡴ᧞/
⾑ ⭘ /᣸ യ ࠾ ࡼ ࡧ ➽ ⫗ ③ /ࢫ ࣃ ࢬ ࣒ ࡜ ࠸ ࡗ ࡓ ẚ ㍑ ⓗ ▷ ᮇ 㛫 ࡛ ࡢ ᚟ ᖐ ࡀ ண ࡉ ࢀ ࡿ
യᐖࡢῶᑡࡀ ᙳ㡪ࡋࡓ ࡢ࡛ࡣ࡞࠸࠿ ࡜ ⪃࠼ࡓ 㸬ࡲࡓ㸪୰࣭ 㛗ᮇ ࡢ➇ ᢏ᚟ᖐᮇ㛫
ࡢῶᑡ࡟ࡘ࠸ ࡚ࡣ㸪៏ ᛶയᐖࡢ୍ࡘ ࡛࠶ࡿ ⭝ ⅖/⭝࿘ᅖ⅖ࡢ㢧ⴭ࡞ ῶᑡࡀ㸪യᐖ
Ⓨ⏕⋡ࡢῶᑡ ࡟ ᐤ୚ࡋ ࡓࡢ࡛ࡣ࡞࠸ ࠿࡜ ⪃࠼ ࡓ㸬
ᮏ◊✲࡛⾜ࡗ ࡓ ୗ⫥യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢࡣ 㸪௓ධᮇ 㛫⣙ 43 㐌㛫㸦304 ᪥㛫㸧㸪
ࢺ࣮ࣞࢽࣥࢢ 㢖ᗘࡣ㐌 ࠶ࡓࡾ ⣙ 4 ᅇ 㸪1 ᅇ ࡟ ⾜ࡗࡓ᫬㛫 ࡣ 20 ศ⛬ ᗘ࡛࠶ ࡿ 㸬ከ
ᩘࡢඛ⾜ㄽᩥ ࠿ࡽࡳࡽ ࢀࡿண㜵ࢺࣞ ࣮ࢽࣥࢢ ࡣ㸪 ௓ධᮇ㛫 ⣙ 6 㐌࠿ ࡽ 12 㐌㛫㸪
㢖ᗘࡣ㐌 2㹼3 ᅇ㸪᫬ 㛫ࡣ 1 ᅇ࡟ࡘ ࡁ 10 ศ ࠿ࡽ 30 ศ⛬ᗘ࡛ ࠶ࡗ ࡓ㸬ᮏ◊✲࡜ඛ
⾜ㄽᩥ࡜ࡶ࡟ 㸪௓ධࡢ ࢱ࢖࣑ࣥࢢ࡟ ࡘ࠸࡚ࡣ 㸪⦎⩦๓࡟⾜ ࢃࢀ ࡚࠸ ࡿ࢛࣮࣑࢘
ࣥࢢ࢔ࢵࣉࡢ ୰࡛ᐇ᪋ ࡉࢀ࡚࠸ࡿ 㸬 ඛ⾜ㄽᩥ ࡜ࡢ㐪࠸ࡣ㸪 ᮏ◊✲ࡣ ௓ධᮇ㛫ࡀ
㛗࠸Ⅼ࡜㸪㐌 ࠶ࡓࡾࡢ ࢺ࣮ࣞࢽࣥࢢ ᅇᩘ ࡀከ ࠸Ⅼ࡛࠶ࡿ㸬 ࢺ࣮ࣞࢽ ࣥࢢෆᐜ࡟
172
ࡘ࠸࡚ࡣ㸪ඛ ⾜◊✲࡛ ࡣ ࣉࣛ࢖࣓ࢺ ࣜࢵࢡせ ⣲ ࢆྲྀࡾධࢀ ࡓࢺ࣮ࣞ ࢽࣥࢢࡀከ
ࡃࢆ༨ࡵ㸪ࣂ ࣛࣥࢫ⬟ ຊྥୖࢆ≺࠸ ࡜ࡋࡓ ࢺ ࣮ࣞࢽࣥࢢࡶ 」ᩘࡳࡽ ࢀࡿ㸬ࢪࣕ
ࣥࣉࢺ࣮ࣞࢽ ࣥࢢࡸ ࣂ ࣛࣥࢫࢺ࣮ࣞ ࢽࣥࢢࡣ 㸪 ⚄⤒➽ࢥࣥ ࢺ࣮ࣟࣝ ࡸᅛ᭷ឤぬ
ჾࡢྥୖ࡟↔ Ⅼࢆᙜ࡚ ࡓ ࢺ࣮ࣞࢽࣥ ࢢ࡛࠶ࡿ 㸬ᮏ◊✲ ࡛⾜ࡗࡓ ࢺࣞ ࣮ࢽࣥࢢࡣ 㸪
ࢪࣕࣥࣉࢺࣞ ࣮ࢽࣥࢢ ࡸࣂࣛࣥࢫࢺ ࣮ࣞࢽࣥ ࢢ ࡛ࡣ࡞ࡃ㸪 ㏻ᖖ⾜ࢃ ࢀ࡚࠸ࡿ ࢘
࢛࣮࣑ࣥࢢ࢔ ࢵࣉ ࡢ✀ ┠࡜ࡋ࡚⾜ࢃ ࢀ࡚࠸ࡿ ࣛࣥࢪ㸪᪉ྥ ㌿᥮㉮㸪 ษࡾ࠿࠼ࡋ
ືస㸪ࢧ࢖ࢻ ࢫࢸࢵࣉ 㸪ࢲࢵࢩࣗ࠿ ࡽࡢ ࢫࢺ ࢵࣉ➼ࡢືస ᫬࡟͆㊊ ㊑ࢆ㛤࠸࡚
ᗋࢆᥗࡴ͇ື సࢆ⾜ࢃ ࡏ ࡿ࡜࠸ࡗࡓ ᣦᑟἲࢆ ⏝࠸ࡓⅬ࡟኱ ࡁ࡞≉ᚩ ࢆᣢࡘࡀ㸪
ᮏㄽᩥ◊ ✲ 2 ࡛㸪㊊㊑ 㛤᤼ᣦ♧ࡀ㸪≉࡟ࣛࣥ ࢹ࢕ࣥࢢືస ᫬ࡢ ͆ knee-in͇➼ࡢ
ືⓗୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࢆไᚚࡏࡿ࡜ ࠸࠺⤖ㄽ ࠿ࡽ㸪ࡲࡓ㸪 ◊✲ 5 ࡛ ㊊㊑ᢕᥱຊ
ࡢඃࢀࡿ⪅ࡣ ㊊㒊࢔࣮ ࢳ๛ᛶࡀ㧗ࡲ ࡿࡇ࡜࡛ ㊊㒊ࢆᏳᐃࡉ ࡏ㸪 㟼ⓗ ୗ⫥ࣂࣛࣥ
ࢫಖᣢ⬟ຊྥ ୖ࡟ᐤ୚ ࡉࡏࡿࡇ࡜㸪 ㊊㊑ᢕᥱ ຊࡢඃࢀࡿ⪅ ࡣ๓᪉࡬ ࡢືⓗࣂࣛ
ࣥࢫಖᣢ⬟ຊ ࡀඃࢀ㸪 ∦⬮࠾ࡼࡧ୧ ⬮╔ᆅື స᫬ࡢ㊊㊑ᢕ ᣢືసᣦ ♧ࡀ ㊊㛵⠇
ࡸ⭸㛵⠇യᐖ ࡢῶᑡ࡟ ᐤ୚ࡉࡏࡿྍ ⬟ᛶࢆ♧ ၀ ࡋࡓࡇ࡜㸪 ◊✲ 7 ࡛ 㸪㊊㊑㛤᤼
ືసࡸ㊊㊑ᢕ ᣢືస ᣦ ♧ࡣ㸪ᑠ㊑እ ㌿➽ࡸẕ ㊑እ㌿➽ࡢ ㊊ 㒊ෆᅾ➽ ࡸ㊊㒊እᅾ
➽ࡢ➽⥭ᙇ࡟ ࡼࡾ㸪 ㊊ 㒊࢔࣮ࢳࡢ๛ ᛶ ࡀ㧗ࡲ ࡿࡇ࡜࡛㸪㊊ 㒊ࡢᏳᐃ ᛶ࡟ᐤ୚ࡉ
ࡏࡓࡇ࡜㸪ࡑ ࡋ࡚㊊㊑ ࢺ࣮ࣞࢽࣥࢢ ࡀ ㊊㊑ࡢ ࣓࢝ࣀࣞࢭࣉ ࢱ࣮ࢆά ᛶ໬ࡉࡏ㸪
እຊ࡟ᑐࡍࡿ ࣇ࢕࣮ࢻ ࣂࢵࢡไᚚ࡟ ࡼࡾ㊊㒊 ࡢᶵ⬟ⓗᏳᐃ ᛶ࡟ᐤ୚ ࡉࡏࡿ࡜࠸
࠺ඛ⾜ㄽᩥ࠿ ࡽࡢሗ࿌ ࢆྵࡵ࡚ 㸪㊊ 㛵⠇യᐖ ࢆྵࡵࡓୗ⫥ ඲యࡢയ ᐖⓎ⏕⋡ࡢ
ῶᑡ࡟ᐤ୚ࡉ ࡏࡓྍ⬟ ᛶࡀ♧၀ࡉࢀ ࡓ㸬
ᮏ◊✲ࡢၥ㢟 Ⅼ࡜ࡋ࡚ 㸪 ◊✲ 7 ྠᵝ 㸪ࢥࣥࢺ ࣮ࣟࣝ⩌ࢆタ ᐃࡋ࡚࠾ ࡽࡎ㸪௓
ධ⩌࡜ࢥࣥࢺ ࣮ࣟࣝ⩌ ࡢẚ㍑᳨ドࡀ ᚲせ࡛࠶ ࡿ࡜⪃࠼ࡿ㸬 ࡲࡓ㸪ᑐ ㇟⪅ᩘ࡜ࢺ
࣮ࣞࢽࣥࢢ௓ ධᮇ㛫࡟ ࡘ࠸࡚㸪 ࢺࣞ ࣮ࢽࣥࢢ ௓ධຠᯝ᳨ド ࡟ࡣ 㸪ᩘ ⓒே௨ୖࢆ
ᑐ㇟࡜ࡋࡓ◊ ✲ࡀ㸪ࡉ ࡽ࡟ࡣࡼࡾ㛗 ࠸௓ධᮇ 㛫ࡀᚲせ࡛࠶ ࡿ࡜⪃࠼ 㸪 ᮏ◊✲࡛
⾜ࡗࡓᑐ㇟⪅ ᩘ࡜௓ධ ᮇ㛫࡟ࡼࡾ ᚓ ࡽࢀࡓ⤖ ᯝ ࠿ࡽ⤖ㄽࢆ ฟࡍࡢࡣ 㝈⏺ࡀ࠶ࡿ
࡜⪃࠼ࡿ㸬
173
6-8-5. ⤖ㄒ
኱ᏛዪᏊࣛࢡ ࣟࢫ➇ᢏ ࢆᑐ㇟࡜ࡋ ࡓ 㸪ୗ⫥യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢ ௓ ධࡀୗ⫥
യᐖⓎ⏕⋡➼ ࡬ཬࡰࡍ ᙳ㡪࡟ ࡘ࠸࡚ ẚ㍑᳨ド ࡍࡿࡇ࡜ࢆ┠ ⓗ࡜ࡋ㸪 ㏻ᖖ⾜ࢃࢀ
࡚࠸ࡿ࢛࣮࢘ ࣑ࣥࢢ࢔ ࢵࣉ࣓ࢽ࣮ࣗ ࡢ ୰ࡢࣛ ࣥࢪࡸࢪࣕࣥ ࣉ࠿ࡽࡢ ╔ᆅ ືస㸪
ࢧ࢖ࢻࢫࢸࢵ ࣉ➼ࡢ ື స᫬࡟͆㊊㊑ ࢆ㛤࠸࡚ ᗋࢆᥗࡴ ͇ࢆ ᣦ♧ࡍࡿ ືసᣦᑟἲ
ࡢ௓ධ࡟ࡼࡾ ᚓࡽࢀࡓ ⤖ᯝࡣ 㸪௓ධ ᚋࡣ௓ධ ๓࡜ẚ㍑ࡋ࡚ 㸪
1) ⥲യᐖⓎ⏕ᩘ ࠾ࡼࡧ ⥲ യᐖⓎ⏕⋡ࢆ ῶᑡࡉࡏ ࡓ㸬
2) യ ᐖ ࡢ 㒊 ఩ ࡟ࡘ ࠸ ࡚ ࡣ 㸪 ୺ ࡟ ㊊ 㒊/ࡘ ࡲ ඛ 㸪 ୗ ⭣ 㸪 ⫤ 㛵 ⠇യ ᐖ Ⓨ ⏕ ⋡ ࢆ ῶ ᑡ
ࡉࡏࡓ㸬ࡲࡓ㸪ࢃ ࡎ࠿ ࡛ࡣ࠶ࡿࡀ㊊ 㛵⠇യᐖ Ⓨ⏕⋡ࢆῶᑡ ࡉࡏࡓ㸬ୗ⫥඲య
ࡢ യ ᐖ Ⓨ ⏕ ⋡ࡢ ῶ ᑡ ࡀ 㢧 ⴭ ࡛ ࠶ ࡗ ࡓ㸬 യ ᐖ ࡢ ✀ 㢮 ࡟ ࡘ ࠸ ࡚ࡣ 㸪 ⭝ ⅖ /೺ ࿘ ᅖ
⅖㸪ᡴ᧞/⾑⭘/᣸യ㸪᤬᣸യᐖⓎ⏕⋡ ࢆῶᑡࡉ ࡏࡓ㸬യᐖࡢཎ ᅉ ࡟ࡘ ࠸࡚ࡣ㸪
᥋ゐᆺയᐖ㸦 ௚ࡢ㑅ᡭ 㸧㸪㠀᥋ゐᆺയ ᐖ㸪౑ ࠸ࡍࡂ㸦ᚎࠎ ࡟㸧࡟ࡼ ࡿയᐖⓎ
⏕⋡ࢆῶᑡࡉ ࡏ ࡓ㸬
3) യᐖࡢᅇᩘ࡟ ࡘ࠸࡚ ࡣ 㸪≉࡟ึᅇཷയ Ⓨ⏕⋡ ࢆῶᑡࡉࡏ 㸪➇ ᢏ᚟ᖐ ࡲ࡛ࡢᮇ
㛫࡟ࡘ࠸࡚ࡣ㸪1㹼2 ᪥ ࡜ 3㹼7 ᪥࡛➇ᢏ ᚟ᖐ ྍ⬟࡛࠶ࡗࡓ യᐖ Ⓨ⏕ ⋡ࢆῶᑡ
ࡉࡏࡓ㸬
4) ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ࣓ ࢽ࣮ࣗ ࡛⾜ࢃ ࢀ࡚࠸ࡿ ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪ࢧ࢖
ࢻࢫࢸࢵࣉ 㸪ࣛࣥࢪ ➼ ࡢືస᫬࡟㊊ ㊑㛤᤼ ࠾ ࡼࡧ㊊㊑ᢕᣢ ࢆ ᣦ♧ࡍ ࡿᣦᑟἲ
ࡣ㸪㊊㊑ᢕᥱຊ ࡸ㊊㊑ 㛤᤼⬟ ࢆྥୖ ࡉࡏ 㸪㟼 ⓗ࠾ࡼࡧືⓗ ୗ⫥ࣂࣛ ࣥࢫ⬟ຊ
ࢆྥୖࡉࡏࡿ ࡜࠸࠺ ඛ ⾜⤖ᯝࢆ㏻ࡋ ࡚㸪ୗ ⫥ യᐖⓎ⏕⋡ࡢ ῶᑡ ࡀ㢧 ⴭ࡟♧ࡉ
ࢀࡓࡇ࡜࠿ࡽ 㸪ୗ⫥ യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢࡢ ᣦᑟἲࡢ୍ࡘ ࡟࡞ࡿྍ ⬟ᛶࡀ♧
၀ࡉࢀࡓ㸬
174
➨7❶
⥲ྜ⪃ᐹ
175
⥲ ྜ ⪃ᐹ ᮏ◊✲ࡣ㸪ࢫ ࣏࣮ࢶയ ᐖ ண㜵ࡢྲྀࡾ ⤌ࡳ࡜ࡋ ࡚㸪 van Mechelen ࡽ ࡀ♧ࡋࡓ 4
ẁ㝵ࣔࢹࣝࢆ ౛࡟኱Ꮫ ዪᏊࣛࢡࣟࢫ ➇ᢏࢆᑐ ㇟ ࡟㸪ࢫ࣏࣮ ࢶയᐖࡢ ᐇែࡢᢕᥱ
࡜യᐖண㜵ࡢ ᐇ㊶ ࢆࢸ ࣮࣐࡟㸪㊊㛵 ⠇࡜⭸๓ ༑Ꮠ㠌ᖏയᐖ ࡟↔Ⅼࢆ ᙜ࡚࡚ ◊✲
࠾ࡼࡧ᳨ドࢆ ⾜ࡗࡓ㸬 ᮏ◊✲࡛ᚓࡽ ࢀࡓ ⤖ᯝ ࡜⤖ㄽࢆ௨ୗ ࡟♧ࡍ㸬
Ϩ㸬኱ᏛዪᏊ ࣛࢡࣟࢫ ➇ᢏࢆᑐ㇟࡟ 㸪യᐖࡢ 㒊఩࣭✀㢮࣭ ཎᅉ➼ࡢ യᐖࡢ≉ᚩ
ࢆ᫂ࡽ࠿࡟ࡍ ࡿࡇ࡜ࢆ ┠ⓗ࡟㸪 2 ᖺ㛫ࡢയᐖ ㄪᰝࢆ⾜࠸㸪 ᚓࡽࢀࡓ ୺࡞⤖ᯝ
ࢆ௨ୗ࡟♧ࡍ 㸦◊ ✲ 1㸧㸬
1)
඲യᐖࡢ 9 ๭௨ୖࡀ ⦎ ⩦᫬࡟Ⓨ⏕ࡋ 㸪ヨྜ ᫬ ࡟Ⓨ⏕ࡋࡓയ ᐖࡣ 1 ๭ ⛬ᗘ
࡛࠶ࡗࡓ㸬
2)
᭱ࡶ ከࡃ Ⓨ⏕ ࡋࡓ യᐖ 㒊఩ ࡣ ͂ ㊊㛵 ⠇̓ 㸪ḟ ࡟͂ ⭸㛵 ⠇̓ ࡛㸪 ୗ⫥ ࡢയ
ᐖ࡟ࡘ࠸࡚ࡣ ඲യᐖ ࡢ 7 ๭⛬ ᗘࢆ༨ࡵ ࡚࠸ ࡓ㸬യᐖࡢ✀ 㢮 ࡛᭱ࡶ ከ࠸ࡢ
ࡣ͂ ᤬᣸ ࡛̓ 㸪യ ᐖࡢ ཎᅉ ࡟ࡘ ࠸࡚ ࡣ ͂ ౑࠸ ࡍࡂ ̓࡟ ࡼࡿ ࡶࡢ ࡀ ᭱ ከ࡛
࠶ࡗࡓ㸬
3)
኱Ꮫ ዪᏊ ࣛࢡ ࣟࢫ ࡢ୺ ࡓࡿ യᐖ ࡢ≉ ᚩࡣ ͂㠀 ᥋ゐ ᆺࡢ ㊊㛵 ⠇᤬ ᣸ ̓ ࡛࠶
ࡗࡓ㸬
4)
඲യᐖࡢ 3 ๭ ⛬ᗘࡀ㸪 ྠ㒊఩ࡢ෌ཷ യࢆ㈇ࡗ ࡚࠸ࡓ 㸬
5)
ᏛᖺูയᐖⓎ ⏕⋡࡟ࡘ ࠸࡚ ࡣ㸪4 ᖺ⏕ ࡢയᐖ Ⓨ⏕⋡ࡀ᭱ࡶ 㧗ࡃ㸪1 ᖺ⏕࡜
ẚ࡭࡚࠾࠾ࡼ ࡑ 2 ಸ㧗 ࠸Ⓨ⏕⋡ࢆ♧ ࡋࡓ 㸬
6)
࣏ࢪࢩูࣙࣥ ࡟ࡳࡓയ ᐖ Ⓨ⏕ᩘࡣ㸪 ࣑ࢵࢻࣇ ࢕ࣝࢲ࣮ࡀ᭱ ࡶ ከ࠿ࡗ ࡓ㸬
7)
኱Ꮫ࠿ࡽࣛࢡ ࣟࢫ➇ᢏ ࢆ㛤ጞ ࡋࡓࡶ ࡢࡀ඲య ࡢ 95㸣⛬ᗘࡳࡽࢀ ࡓ 㸬
ϩ㸬◊✲ 2 ࡛ࡣ㸪ୗ⫥ യᐖண㜵ࢺࣞ ࣮ࢽࣥࢢ ௓ධ᳨ウࡢࡓ ࡵࡢᇶ♏ ⓗ◊✲࡜ࡋ
࡚㸪㊊㊑ᶵ⬟ ࡜ືⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ ࡜ࡢ㛵 㐃ᛶࡸ㊊㊑ᶵ ⬟ࡀືⓗ ୗ⫥࢔ࣛ
࢖࣓ࣥࢺ࡟ཬ ࡰࡍᙳ㡪 ࡟ࡘ࠸᳨࡚ウ ࡍࡿࡇ࡜ ࢆ┠ⓗ࡜ࡋ㸪 ∦⬮ࢫࢡ ࣡ࢵࢺ㸪
∦⬮ࢻࣟࢵࣉ ࣛࣥࢹ ࢕ ࣥࢢ㸪࢝ࢵࢸ ࢕ࣥࢢ ࢆ ㄢ㢟ືస࡟タ ᐃࡋ ࡚⾜ ࠸㸪௨ୗ
ࡢ⤖ㄽࢆᚓࡓ 㸬
1)
∦⬮ ࢫࢡ ࣡ࢵ ࢺ᫬ ࡜∦ ⬮ࢻ ࣟࢵ ࣉࣛ ࣥࢹ ࢕ࣥ ࢢ᫬ ࡢ ㊊ ㊑㛤 ᤼⬟ ࡜⭸ ෆ᪉
೫఩ ⋡㸪 ⭸እ ཯⋡ 㸪⫤ 㛵⠇ ෆ㌿ ゅࡢ ࢫࢱ ࣥࢹ ࢕ࣥ ࢢ࣏ ࢪࢩ ࣙࣥ ࠿ࡽ ࢫࢡ
࣡ࢵࢺ࣏ࢪࢩ ࣙࣥࡲ࡛ ࡢኚ໬㔞 ࡜ࡢ 㛫࡟᭷ព ࡞㈇ࡢ┦㛵ࡀ ㄆࡵࡽࢀ ࡓ㸬
176
2 ) ㊊ᣦ 㛤᤼ ⬟ࡢ ᑠ࣭ ୰࣭ ኱⩌ ࡢẚ ㍑࡟ ࠾࠸ ࡚㸪 ∦⬮ ࢻࣟ ࢵࣉ ࣛࣥ ࢹ࢕ ࣥࢢ
࡛ࡣ 㸪㊊ ㊑㛤 ᤼⬟ ࡟ඃ ࢀ࡚ ࠸ࡿ ࡶࡢ ࡣ୰ ➼ᗘ ࡟㊊ ㊑㛤 ᤼ࡢ ࡛ࡁ ࡿࡶ ࡢ࡟
ẚ࡭ ࡚᭱ ኱ࡋ ࡷࡀ ࡳࡇ ࡳ᫬ ࡢ⭸ ෆ᪉ ೫఩ ⋡ࡀ ࡼࡾ ᑠ࡛ ࠶ࡗ ࡓ㸬 ㊊㊑ 㛤᤼
⬟࡟ ඃࢀ ࡚࠸ ࡿࡶ ࡢࡣ ୰➼ ᗘ࡟ ㊊㊑ 㛤᤼ ࡢ࡛ ࡁࡿ ࡶࡢ ࠾ࡼ ࡧ㊊ ㊑㛤 ᤼⬟
࡟ஈ ࡋ࠸ ࡶࡢ ࡟ẚ ࡭᭱ ኱ࡋ ࡷࡀ ࡳࡇ ࡳ᫬ ࡢ⭸ እ཯ ⋡ࡀ ࡼࡾ ᑠ࡛ 㸪╔ ᆅ᫬
࠿ࡽ ᭱኱ ࡋࡷ ࡀࡳ ࡇࡳ ᫬ࡲ ࡛ࡢ ⭸ෆ ᪉೫ ఩⋡ ࡢኚ ໬㔞 ࡀࡼ ࡾᑠ ࡛࠶ ࡗࡓ 㸬
㊊㊑ 㛤᤼ ⬟࡟ ඃࢀ ࡚࠸ ࡿࡶ ࡢࡣ ୰➼ ᗘ࡟ ㊊㊑ 㛤᤼ ࡢ࡛ ࡁࡿ ࡶࡢ ࡟ẚ ࡭╔
ᆅ᫬ ࠿ࡽ ᭱኱ ࡋࡷ ࡀࡳ ࡇࡳ ᫬ࡲ ࡛ࡢ ⭸እ ཯⋡ ࡢኚ ໬㔞 ࡶࡼ ࡾᑠ ࡛࠶ ࡗࡓ 㸬
╔ᆅ ᫬ࡢ ⫤㛵 ⠇ෆ ㌿ゅ 㸪╔ ᆅ᫬ ࠿ࡽ ᭱኱ ࡋࡷ ࡀࡳ ࡇࡳ ᫬ࡲ ࡛ࡢ ⫤㛵 ⠇ෆ
㌿ゅ ࡢኚ ໬㔞 ࠸ࡎ ࢀࡶ ࡀ㸪 ㊊㊑ 㛤᤼ ⬟࡟ ඃࢀ ࡚࠸ ࡿࡶ ࡢࡣ ୰➼ ᗘ࡟ ㊊㊑
㛤᤼ ࡢ࡛ ࡁࡿ ࡶࡢ ࠾ࡼ ࡧ ㊊ ㊑㛤 ᤼⬟ ࡟ஈ ࡋ࠸ ࡶࡢ ࡟ẚ ࡭㸪 ࡼࡾ ᑠ࡛ ࠶ࡗ
ࡓ㸬
3)
㊊㊑ 㛤᤼ ᣦ♧ ࡢ᭷ ↓ࡢ ẚ㍑ ࡛ࡣ 㸪 ∦ ⬮ࢻ ࣟࢵ ࣉࣛ ࣥࢹ ࢕ࣥ ࢢ࡟ ࠾࠸ ࡚㸪
࢖ࢽ ࢩࣕ ࣝࢥ ࣥࢱ ࢡࢺ ࡢ⭸ ෆ᪉ ೫఩ ⋡࠾ ࡼࡧ ⭸እ ཯⋡ ࢆ᭷ ព࡟ ቑຍ ࡉࡏ 㸪
ࣛࣥ ࢹ࢕ ࣥࢢ ࣏ࢪ ࢩࣙ ࣥࡢ ⫤㛵 ⠇ෆ ㌿ゅ ࢆ᭷ ព࡟ ῶᑡ ࡉࡏ ࡓ㸬 ࡋ࠿ ࡋ࢖
ࢽࢩ ࣕࣝ ࢥࣥ ࢱࢡ ࢺ࠿ ࡽࣛ ࣥࢹ ࢕ࣥ ࢢ࣏ ࢪࢩ ࣙࣥ ࡲ࡛ ࡢ⭸ እ཯ ⋡ࡢ ኚ໬
㔞ࡣ᭷ព࡟ῶ ᑡࡋࡓ㸬
4)
㊊㊑㛤᤼ࡀඃ ࢀࡿࡶࡢ ࡣ㸪㊊ ㊑㛤᤼࠾ ࡼࡧ㊊ ㊑ᢕᣢ ືసࡢ ᣦ♧࡜࡜ ࡶ࡟㸪
≉࡟ ∦⬮ ࢻࣟ ࢵࣉ ࣛࣥ ࢹ࢕ ࣥࢢ ࡟࠾ ࠸࡚ ⭸㛵 ⠇እ ཯ࢆ ࡼࡾ ไᚚ ࡋࡓ 㸬㊊
㊑㛤 ᤼⬟ ࢆ㧗 ࡵࡿ ࢚ࢡ ࢧࢧ ࢖ࢬ ࡜ࠕ ㊊㊑ ࢆ㛤 ࠸࡚ ᗋࢆ ᥗࡴ ࠖ࡜ ࠸࠺ ືస
ᣦ♧ ࡣ㸪 ࢪࣕ ࣥࣉ ࠿ࡽ ࡢ╔ ᆅື స࡟ ࡚ከ Ⓨࡍ ࡿ⭸ ๓༑ Ꮠ㠌 ᖏയ ᐖࢆ ྵࡵ
ࡓୗ ⫥യ ᐖண 㜵࡟ ࡘ࡞ ࡀࡿ ྍ⬟ ᛶࡢ ࠶ࡿ 㐠ື ᣦᑟ ἲࡢ ୍ࡘ ࡜ࡋ ࡚ࡑ ࡢ᭷
⏝ᛶࡀ♧၀ࡉ ࢀࡓ㸬
Ϫ㸬ዪᏊࣛࢡ ࣟࢫ യᐖ Ⓨ⏕ࡢཎᅉ㸪 യᐖ࣓࢝ ࢽࢬ࣒ࢆ᫂ࡽ ࠿࡟ࡍࡿ ࡇ࡜ ࢆ┠ⓗ
࡜ࡋ㸪≉࡟യ ᐖ㔜⑕ᗘ ࡢ 㧗࠸⭸๓༑ 㠌ᖏ യᐖ Ⓨ⏕࣓࢝ࢽࢬ ࣒ ࡟╔┠ ࡋ࡚ືసศ
ᯒࢆ⾜ࡗࡓ㸬 ㄢ㢟ືస ࡣࢻࣟࢵࣉ ࣂ ࣮ࢸ࢕࢝ ࣝ ࢪࣕࣥࣉ࡜ ࢝ࢵࢸ࢕ ࣥࢢືస ࡛
177
࠶ࡾ㸪ࣛࢡࣟ ࢫࢫࢸ࢕ ࢵࢡࡢಖᣢ ࠶ ࡾ࣭࡞ࡋ ࡛⾜ࢃࡏࡓ࡜ ࡁࡢ ືⓗ ୗ⫥࢔ࣛ࢖
࣓ࣥࢺࡢኚ໬ ࢆẚ㍑᳨ ドࡋ 㸦◊ ✲ 3㸪4㸧㸪 ᚓࡽࢀࡓ⤖ᯝ ࡣ㸪
1)
ࣛࢡ ࣟࢫ ࢫࢸ ࢕ࢵ ࢡ ࢆ ಖᣢ ࡉࡏ ࡚⾜ ࢃࡏ ࡓ ࢻ ࣟࢵ ࣉࣂ ࣮ࢸ ࢕࢝ ࣝ ࢪ ࣕࣥ
ࣉືసࡣ㸪ಖ ᣢ࡞ࡋࡢ ᫬࡜ẚ࡭࡚㸪 ⭸㛵⠇ᒅ ᭤ゅᗘ ࡀ᭷ព ࡟ ῶᑡࡋ ࡓ㸬
2)
ࣛࢡ ࣟࢫ ࢫࢸ ࢕ࢵ ࢡ ࢆ ಖᣢ ࡉࡏ ࡚⾜ ࢃࡏ ࡓ࢝ ࢵࢸ ࢕ࣥ ࢢື సࡣ 㸪ಖ ᣢ࡞
ࡋࡢ᫬࡜ẚ࡭ ࡚㸪⫤㛵 ⠇ෆ㌿ゅᗘ ࡀ ᭷ព࡟ቑ ຍࡋࡓ㸬
3)
ࣛࢡ ࣟࢫ ➇ᢏ ≉Ṧ ᛶࡢ ୍ࡘ ࡛࠶ ࡿࢫ ࢸ࢕ ࢵࢡ ࢆಖ ᣢࡋ ࡓ≧ ែ࡛ ࡢࢪ ࣕࣥ
ࣉ࠿ࡽࡢ╔ᆅ ࡸ࢝ࢵࢸ ࢕ࣥࢢືసࡣ㸪⭸๓༑ 㠌ᖏയᐖせᅉ ࡢ୍ࡘ࡛ ࠶ࡿ㸪
⭸㛵 ⠇ᒅ ᭤ゅ ᗘࡢ ῶᑡ ࠾ࡼ ࡧ⫤ 㛵⠇ ෆ㌿ ゅᗘ ࡢ ቑ ຍࢆ ⏕ࡌ ࡉࡏ 㸪ዪ Ꮚࣛ
ࢡࣟ ࢫ࡛ Ⓨ⏕ ࡍࡿ ⭸๓ ༑㠌 ᖏയ ᐖ࣓ ࢝ࢽ ࢬ࣒ ࡢ୍ ࡘ࡜ ࡋ࡚ ᪂ࡓ ࡞▱ ぢ࡜
࡞ࡿྍ⬟ᛶࡀ ♧၀ࡉࢀ ࡓ㸬
ϫ㸬◊✲ 5㸪◊✲ 6 ࡛ࡣ⭸๓༑㠌ᖏ യᐖࢆྵ ࡵࡓୗ⫥യᐖ ண㜵ࡢࡓ ࡵࡢࢫࢡࣜ
࣮ࢽࣥࢢࢸࢫ ࢺࡢ୍⪃ ᐹ࡜ࡋ࡚ ⾜࠸㸪◊✲ 5 ㊊㊑ᢕᥱຊ࡜ 㟼ⓗ࠾ࡼ ࡧືⓗࣂ
ࣛࣥࢫ⬟ຊ࡜ ࡢ㛵㐃ᛶ 㸪࠾ࡼࡧ㊊㊑ ᢕᥱຊࡢ ኱ᑠࡀ 㟼ⓗ࠾ ࡼࡧືⓗ ࣂࣛࣥࢫ
⬟ຊ࡟ཬࡰࡍ ᙳ㡪࡟ ࡘ ࠸࡚௨ୗࡢ⤖ ㄽࢆᚓࡓ 㸬
1)
ྑ㊊ ㊑ᢕ ᥱຊ ࡜㔜 ᚰື ᦂᛶ ࡢ 㔜 ᚰ⥲ ㌶㊧ 㛗㸪 㔜ᚰ ༢఩ ㌶㊧ 㛗 ࡜ ࡢ㛫 ࡟᭷
ព࡞㈇ࡢ┦㛵 㛵ಀࢆ♧ ࡋࡓ㸬
2)
ྑ㊊ ㊑ᢕ ᥱຊ ࡢ኱ ࡁ࠸ ⩌ࡣ ᑠࡉ ࠸⩌ ࡜ẚ ㍑ࡋ 㸪㔜 ᚰື ᦂᛶ ࡢ 㔜 ᚰ⥲ ㌶㊧
㛗࡜㔜ᚰ༢఩ ㌶㊧㛗 ࡟ ࠾࠸࡚㸪᭷ព ࡟㌶㊧㛗 ࡀ ▷࠿ࡗࡓ㸬
3)
ᕥ㊊㊑ᢕᥱຊ ࡢ ኱ࡁ࠸ ⩌ࡣᑠࡉ࠸⩌ ࡜ẚ㍑ࡋ 㸪Star Excursion Balance Test
ࡢ๓᪉࣮ࣜࢳ 㛗 ࡟࠾࠸ ࡚㸪᭷ព࡟ࣜ ࣮ࢳ㛗ࡀ 㛗࠿ࡗࡓ㸬
4)
㊊㊑ ᢕᥱ ຊ ࡣ 㸪㟼 ⓗࣂ ࣛࣥ ࢫಖ ᣢ⬟ ຊ࡟ 㛵㐃 ᛶࢆ ♧ࡋ ࡓࡇ ࡜㸪 ࡲࡓ 㸪㊊
㊑ᢕ ᥱຊ ࡢ኱ ᑠࡀ 㟼ⓗ ࠾ࡼ ࡧື ⓗࣂ ࣛࣥ ࢫಖ ᣢ⬟ ຊࡢ ୍㒊 ࡟ᙳ 㡪ࢆ ཬࡰ
ࡋ㸪 ㊊㊑ ᢕᥱ ືస ࠾ࡼ ࡧ㊊ ㊑ᢕ ᥱຊ ྥୖ ࢚ࢡ ࢧࢧ ࢖ࢬ ࡀ㸪 㟼ⓗ ࠾ࡼ ࡧື
ⓗࣂࣛࣥࢫ⬟ ຊྥୖ࡟ ࡘ࡞ࡀࡿྍ⬟ ᛶࡀ♧၀ ࡉࢀࡓ㸬
㟼ⓗୗ⫥࢔ࣛ ࢖࣓ࣥࢺ ࡸୗ⫥㛵⠇ྍ ືᇦ㸪඲ ㌟㛵⠇ᘱ⦆ᛶ 㸪⫤㛵⠇ እ㌿➽
ຊ࡜ࢻࣟࢵࣉ ࣂ࣮ࢸ࢕ ࢝ࣝ ࢪࣕࣥࣉ ືస᫬ࡢ ୗ⫥࢟ࢿ࣐ࢸ ࢕ࢡࢫ࣭࢟ࢿࢸ࢕
ࢡࢫ࡜ࡢ㛵㐃 ᛶ 㸦◊ ✲ 6㸧࡟ࡘ࠸࡚ ࡣ㸪௨ ୗࡢ⤖ㄽࢆᚓ ࡓ㸬
178
1)
Q-angle㸪Femoral anteversion angle ࡢ኱ᑠ࡜ 㸪᭱኱⭸㛵 ⠇እ㌿ゅ ᗘ ࠾ࡼࡧ
⭸㛵 ⠇እ ㌿ゅ ᗘ೫ ఩㔞 ࡢ኱ ᑠ ࡜ ࡢ㛵 㐃ᛶ ࡀㄆ ࡵࡽ ࢀ㸪 ⫤㛵 ⠇እ ㌿➽ ຊࡢ
኱ᑠ ࡜㸪 ᭱኱ ⭸㛵 ⠇እ ㌿ゅ ᗘ࠾ ࡼࡧ ⭸ 㛵 ⠇እ ㌿ゅ ᗘ೫ ఩㔞 ࡢᑠ ኱ ࡜ ࡢ㛵
㐃ᛶࡀㄆࡵࡽ ࢀࡓ 㸬
2)
࢔࣮ ࢳ㧗 ⋡࠾ ࡼࡧ ㊊㛵 ⠇⫼ ᒅゅ ᗘ࡜ ᗋ཯ ຊ࡜ ࡢ㛵 ಀ࡟ ࠾࠸ ࡚㸪 ࢔࣮ ࢳ㧗
⋡ࡢ 㧗ప ࡜㸪 ᗋ཯ ຊࡢ ኱ᑠ ࡜ࡢ 㛵㐃 ᛶࡀ ㄆࡵ ࡽࢀ 㸪 ㊊ 㛵⠇ ⫼ᒅ ゅᗘ ࡢ኱
ᑠ࡜㸪ᗋ཯ຊ ࡢᑠ኱࡜ ࡢ㛵㐃ᛶࡀㄆ ࡵࡽࢀ ࡓ 㸬
3)
⭸๓ ༑㠌 ᖏയ ᐖ ࢆ ྵࡵ ࡓୗ ⫥യ ᐖண 㜵ࡢ ࡓࡵ ࡢࢫ ࢡࣜ ࣮ࢽ ࣥࢢ ࢆ┠ ⓗ࡜
ࡋ࡚ 㸪ࢻ ࣟࢵ ࣉ ࣂ ࣮ࢸ ࢕࢝ ࣝࢪ ࣕࣥ ࣉࢆ ⾜ࢃ ࡏࡓ ࡜ࡁ ࡢ⭸ 㛵⠇ እ㌿ ືస
࠾ࡼࡧ⫤㛵⠇ෆ㌿ືసࡸ㛵⠇࣮࣓ࣔࣥࢺ࡟╔┠ࡋ࡚ホ౯ࡍࡿሙྜ㸪
Q-angle㸪Femoral antevertion angle㸪⫤㛵⠇ እ㌿➽ຊࡢ ᐃ㡯┠ࢆ ྵࡵࡓ
ホ౯ࡢ᭷⏝ᛶ ࡀ♧ࡉࢀ ࡓ㸬ࡲࡓ㸪╔ᆅ᫬ࡢ ⾪ᧁ ⦆⾪⬟ࡢホ౯ 㡯┠࡜ࡋ ࡚ 㸪
࢔࣮ࢳ㧗⋡࡜ ㊊㛵⠇⫼ ᒅゅᗘ ࢆྵࡵ ࡓホ౯ ࡢ ᭷⏝ᛶࡀ♧ࡉ ࢀࡓ㸬
Ϭ㸬㏻ᖖ⾜ࢃ ࢀ࡚࠸ࡿ ࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ࣓ ࢽ࣮ࣗ ࡢ୰࡛ ᐇ᪋ࡉࢀ ࡚࠸ࡿ ࣛࣥ
ࢪࡸࢪࣕࣥࣉ ࠿ࡽࡢ╔ ᆅືస㸪ࢧ࢖ ࢻࢫࢸࢵ ࣉࡸษࡾ㏉ࡋ ືస᫬࡟ ͆㊊㊑ࢆ
㛤࠸࡚ᗋࢆᥗ ࡴ ͇ࡢື సᣦᑟἲࢆ ୗ ⫥യᐖண 㜵ࢺ࣮ࣞࢽࣥ ࢢ ࡜ࡋ࡚ ௓ධࡉࡏ 㸪
◊✲ 7 ࡟࠾࠸ ࡚ࡣ ㊊㊑ ᢕᥱຊ㸪㊊㒊 ᙧែ㸪 㟼 ⓗ࠾ࡼࡧືⓗ ࣂࣛࣥࢫ ⬟ຊ ࡟ཬ
ࡰࡍᙳ㡪ࢆ㸪 ◊✲ 8 ࡟ ࠾࠸࡚ࡣയᐖ Ⓨ⏕⋡➼ ࡟ཬࡰࡍᙳ㡪 ࡟ࡘ࠸࡚ ௓ධຠᯝ
᳨ドࢆ⾜ࡗࡓ 㸬 ⤖ㄽࡣ ௨ୗࡢ㏻ࡾ࡛ ࠶ࡿ 㸬
1)
㊊㊑㛤᤼⬟㸪 ㊊㊑ᢕᥱ ຊ㸪࢔࣮ࢳ㧗 ⋡࡟ࡘ࠸ ࡚㸪 ௓ධᚋࡣ ௓ධ๓࡜ ẚ㍑
ࡋ࡚㸪ᕥྑ㊊ ࠸ࡎࢀ ࡟ ࠾࠸࡚ࡶ᭷ព ࡟ቑຍ ࡋ ࡓ㸬
2)
Star excursion balance test ࡟ࡘ࠸࡚ࡣ㸪ᚋෆ ᪉࠾ࡼࡧᚋእ ᪉࡟ ࡘ࠸ ࡚㸪ᕥ
ྑ⬮࠸ࡎࢀࡶ ௓ධᚋ࡟ ᭷ព࡟ྥୖࡋ ࡓ㸬
3)
ࣛࣥࢪࡸࢪࣕ ࣥࣉ࠿ࡽ ࡢ╔ᆅືస㸪 ࢧ࢖ࢻࢫ ࢸࢵࣉࡸษࡾ ㏉ࡋືస ᫬࡟
͆㊊㊑ࢆ㛤࠸ ࡚ᗋࢆᥗ ࡴ ͇ືసࢆᣦ ♧ࡍࡿᣦ ᑟἲࡣ㸪㊊㊑ ᶵ⬟࠾ࡼ ࡧື
ⓗࣂࣛࣥࢫ⬟ ຊࢆྥୖ ࡉࡏࡿ࡜࠸࠺ ⤖ᯝ࠿ࡽ 㸪ୗ⫥ യᐖண 㜵ࢆ┠ⓗ ࡜ࡋ
ࡓᣦᑟ᪉ἲ࡟ ࡞ ࡿྍ⬟ ᛶࡀ♧၀ࡉࢀ ࡓ㸬
4)
യᐖⓎ⏕⋡࡟ ࡘ࠸࡚ࡣ 㸪 ⥲യᐖⓎ⏕ ⋡ ࢆῶᑡ ࡉࡏࡓ㸬യᐖ ࡢ㒊఩ ࡟ ࡘ࠸
࡚ࡣ㸪≉ ࡟ ㊊ 㒊 /ࡘ ࡲ ඛ 㸪 ୗ ⭣ 㸪 ⫤ 㛵 ⠇ യ ᐖ Ⓨ ⏕ ⋡ ࢆ ῶ ᑡ ࡉ ࡏ ࡓ 㸬 ࡲ ࡓ 㸪
179
ࢃࡍ࠿࡛ࡣ࠶ ࡿࡀ㊊㛵 ⠇യᐖⓎ⏕⋡ ࢆῶᑡࡉ ࡏࡓ㸬
5)
യᐖࡢ✀㢮࡟ ࡘ࠸࡚ࡣ 㸪⭝⅖/೺࿘ᅖ⅖㸪ᡴ ᧞/⾑⭘/᣸യ㸪᤬᣸ ࡢ യᐖⓎ
⏕⋡ࢆῶᑡࡉ ࡏ 㸪യᐖ ࡢཎᅉ࡟ࡘ࠸ ࡚ࡣ㸪 ᥋ ゐᆺയᐖ㸦௚ ࡢ㑅ᡭ㸧 㸪㠀
᥋ゐᆺയᐖ㸪 ౑࠸ࡍࡂ 㸦ᚎࠎ࡟㸧 ࡟ ࡼࡿയᐖ Ⓨ⏕⋡ࢆῶᑡ ࡉࡏ ࡓ㸬
6)
യᐖࡢᅇᩘ࡟ ࡘ࠸࡚ࡣ 㸪≉࡟ ึᅇཷ യ࡜࡞ࡿ യᐖⓎ⏕⋡ࢆ ῶᑡࡉࡏ ࡓ㸬
7)
➇ᢏ᚟ᖐࡲ࡛ ࡢᮇ㛫 ࡟ ࡘ࠸࡚ࡣ㸪 1㹼2 ᪥ ࡜ 3㹼7 ᪥࡛➇ᢏ᚟ ᖐྍ⬟ ࡛࠶
ࡿẚ㍑ⓗ▷ᮇ 㛫࡛᚟ᖐ ྍ⬟࡞ യᐖⓎ ⏕⋡ࢆప ୗࡉࡏࡓ㸬
8)
࢛࣮࣑࢘ࣥࢢ ࢔ࢵࣉ࣓ ࢽ࣮࡛ࣗ⾜ࢃ ࢀ࡚࠸ࡿ ࢪࣕࣥࣉ࠿ࡽ ࡢ╔ᆅ ື స㸪
ࢧ࢖ࢻࢫࢸࢵ ࣉ㸪ࣛࣥ ࢪ➼ࡢ ືస᫬ ࡟㊊㊑㛤 ᤼࠾ࡼࡧ㊊㊑ ᢕᣢࢆᣦ ♧ࡍ
ࡿᣦᑟἲࡣ㸪 ◊✲ 7 ࡛ ᚓࡽࢀࡓ㊊㊑ ᢕᥱຊࡸ ㊊㊑㛤᤼⬟㸪 ືⓗୗ⫥ ࣂࣛ
ࣥࢫ⬟ຊࢆྥ ୖࡉࡏࡿ ࡜࠸࠺⤖ᯝ ࢆ ㏻ࡋ࡚㸪 ≉࡟ୗ⫥യᐖ Ⓨ⏕⋡ࢆ ῶࡌ
ࡉࡏ㸪ୗ⫥യ ᐖண㜵ࢺ ࣮ࣞࢽࣥࢢࡢ ᣦᑟἲࡢ ୍ࡘ ࡜࡞ࡿྍ ⬟ᛶࡀ♧ ၀ࡉ
ࢀࡓ㸬
ᮏ◊✲ࡣ㸪ዪ Ꮚࣛࢡࣟ ࢫ➇ᢏࢆᑐ㇟ ࡜ࡋ࡚㸪 യᐖࡢᐇែㄪ ᰝ㸪ୗ⫥ യᐖࡢ୰
࡛㔜⑕ᗘࡢ㧗 ࠸⭸๓༑ Ꮠ㠌ᖏയᐖ࣓ ࢝ࢽࢬ࣒ ࡢゎ᫂㸪 ୗ⫥ യᐖண㜵 ࢺ࣮ࣞࢽࣥ
ࢢࡢ௓ධ㸪ୗ ⫥യᐖண 㜵ࡢࡓࡵࡢࢫ ࢡ࣮ࣜࢽ ࣥࢢ ࢸࢫࢺࡢ ᭷⏝ᛶ࡟ ࡘ࠸࡚㸪㊊
㛵⠇യᐖ࡜⭸ ๓༑Ꮠ㠌 ᖏയᐖ࡟╔┠ ࡋ᳨࡚ウ ᳨࣭ドࢆ⾜ࡗ ࡓ 㸬 ㊊㊑ 㛤᤼࠾ࡼࡧ
㊊㊑ᢕᣢືస ࢆᣦ♧ࡍ ࡿᣦᑟἲ࡟ࡼ ࡿ ୗ⫥യ ᐖண㜵ࢺ࣮ࣞ ࢽࣥࢢ ௓ ධࡣ㸪⥲യ
ᐖⓎ⏕⋡ࢆῶ ᑡࡉࡏ㸪 ≉࡟ୗ⫥യᐖ Ⓨ⏕⋡ ࢆ ῶᑡࡉࡏࡓ㸬 ⭸㛵⠇യ ᐖⓎ⏕⋡ ࡢ
ῶᑡࡣࡳࡽࢀ ࡞࠿ࡗࡓ ࡀ 㸪㊊㛵⠇യ ᐖⓎ⏕⋡ ࢆࢃࡎ࠿࡛ࡣ ࠶ࡿࡀ ῶ ᑡࡉࡏࡓ㸬
ࡲࡓ㸪᤬᣸࡟ ࡼࡿയᐖ Ⓨ⏕⋡ ࡀῶᑡ ࡋࡓ㸬ࡇ ࢀࡣ㸪╔ᆅື స᫬࡟㊊ ㊑㛤᤼࡜㊊
㊑ᢕᣢࢆᣦ♧ ࡋࡓ ᣦᑟ ࡟ࡼࡾ㸪㊊㊑ 㛤᤼⬟࡜ ㊊㊑ᢕᥱຊ ࡀ ྥୖࡋ㸪 ㊊㒊࢔࣮ࢳ
๛ᛶࡀ㧗ࡲࡿ ࡇ࡜࡛㊊ 㒊Ᏻᐃᛶ࡟ᐤ ୚ࡉࡏ㸪 㟼ⓗ࠾ࡼࡧື ⓗୗ⫥ࣂ ࣛࣥࢫಖᣢ
⬟ຊࢆྥୖࡉ ࡏࡿࡇ࡜ 㸪ࡲࡓ㸪㊊㊑ ࢺ࣮ࣞࢽ ࣥࢢࡀ ⚄⤒➽ ༠ㄪᛶࢆ ྥୖࡉࡏࡿ
ࡇ࡜࡛㸪≉࡟ ㊊㒊ࡢᶵ ⬟ⓗᏳᐃᛶ ྥ ୖ࡟ᐤ୚ ࡉࡏ ࡓࡇ࡜ࡀ ㊊㛵⠇യ ᐖࡢῶᑡࡸ
ୗ⫥യᐖⓎ⏕ ⋡ࡢῶᑡ ࡟ࡘ࡞ࡀࡗࡓ ྍ⬟ᛶࢆ ♧၀ࡋࡓ 㸬
180
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181
ࡲ࡜ࡵ
ᮏㄽᩥࡣ㸪ࢫ ࣏࣮ࢶയ ᐖண㜵࡟ྥࡅ ࡓྲྀࡾ⤌ ࡳ࡟㛵ࡋ࡚ከ ᩘࡢㄽᩥ ࡛ᘬ⏝ࡉ
ࢀ࡚࠸ࡿ van Mechelen ࡢ 4 ẁ㝵ࣔࢹ ࣝࢆཧ ⪃࡟ 㸪ࠕዪᏊࣛࢡࣟ ࢫ ࢆࣔࢹࣝ࡜ࡋ
࡚ࡢࢫ࣏࣮ࢶ യᐖࡢᐇ ែ࡜ண㜵ࡢᐇ ㊶ ࠖ࡜ࡋ ࡚㸪㊊㛵⠇࡜ ⭸๓༑Ꮠ 㠌ᖏ യᐖ࡟
↔Ⅼࢆᙜ࡚㸪 ኱ᏛዪᏊ ࣛࢡࣟࢫࢆᑐ ㇟࡟◊✲ ࡜᳨ドࢆ⾜ࡗ ࡓ㸬ᮏ◊ ✲࡟ࡼࡾ㸪
ዪᏊࣛࢡࣟࢫ യᐖࡢᐇ ែࡢᢕᥱ㸪യ ᐖ࣓࢝ࢽ ࢬ࣒ࡢ⌮ゎ㸪 യᐖண㜵 ࢺ࣮ࣞࢽࣥ
ࢢࡢ௓ධ࠾ࡼ ࡧയᐖண 㜵ࢺ࣮ࣞࢽࣥ ࢢ ࡢ௓ධ ຠᯝ᳨ド㸪ࡲ ࡓ㸪 ୗ⫥ യᐖண㜵ࡢ
ࡓࡵࡢࢫࢡࣜ ࣮ࢽࣥࢢ ࢸࢫࢺἲ ࡀ᳨ ドࡉࢀࡓ ࡇ࡜ࡣ 㸪ࡇࡢ ୍㐃ࡢࣔ ࢹࣝࡀ௚ࡢ
ࢫ࣏࣮ࢶࡢയ ᐖண㜵 ࡜ ᐇ㊶࡟ྥࡅࡓ ྲྀࡾ⤌ࡳ ࢆ⾜࠺㝿ࡢ୍ ຓ࡜࡞ ࡾ 㸪௒᪥ࢫ࣏
࣮ࢶ་Ꮫ఍ࡀ ᥎ዡࡋ࡚ ࠸ࡿࢫ࣏࣮ࢶ യᐖண㜵 ࡢ☜❧࡟ྥࡅ ࡓ ◊✲ࡢ ࡉࡽ࡞ࡿⓎ
ᒎ࡟ᐤ୚ࡍࡿ ࡶࡢ࡜⪃ ࠼ࡿ㸬
182
ᘬ ⏝ ᩥ⊩
Abstracts from the IOC World Conference on Prevention of Injury & Illness in
Sport. Br. J. Sports Med 45: 310-384, 2011.
Agel, J. et al.: Anterior cruciate ligament injury in national collegiate athletic
association basketball and soccer: a 13-year review. Am. J. Sports Med 33: 524-530,
2005.
Agel, J. et al.: Descriptive epidemiology of collegiate women's basketball inj uries:
National Collegiate Athletic Association Injury Surveillance System, 1988 -1989
through 2003-2004. J. Athl. Train 42: 202-210, 2007.
Alentorn-Geli, E. et al.: Prevention of non-contact anterior cruciate ligament injuries
in soccer players. Part 2: a review of prevention programs aimed to modify risk
factors and to reduce injury rates. Knee. Surg. Sports Traumatol Arthrosc 17: 859-79,
2009.
Allen, M.K., Glasoe, W.M.: Metrecom measurement of navicular drop in subjects
with anterior cruciate ligament injury. J. Athl. Train 35: 403-406, 2000.
Alonso, J.M. et al.: Sports injuries surveillance during the 2007 IAAF World
Athletics Championships. Clin. J. Sport Med 19: 26-32, 2009.
Andresen, B.L. et al.: High school football injuries: field conditions and other
factors. Wis. Med. J 88: 28-31, 1989.
Anderson, M.K. et al.: Foundation of athletic training. Prevention, assessment, and
management. Lippincott Williams & Wilkins, Philadelphia, Fourth ed, 638-697, 2009.
Andriacchi, T.P. et al.: A point cluster method for in vivo motion analysis: applied to
a study of knee kinematics. J. Biomech. Eng 120: 743-749, 1998.
Arendt, E.A., Dick, R.: Knee injury patterns among men and women in collegiate
basketball and soccer. NCAA data and review of literature. Am. J. Sports Med 23:
694-701, 1995.
Arendt, E.A. et al.: Anterior cruciate ligament injury patterns among collegiate men
and women. J. Athl. Train 34: 86-92, 1999.
183
Arnason, A. et al.: Soccer injuries in Iceland. Scand. J. Med. Sci. Sports 6:
40-45, 1996.
Backous, D.D. et al.: Soccer injuries and their relation to physical maturity. Am. J.
Dis. Child 142: 839-842, 1988.
Bahr, R. et al.: A twofold reduction in the incidence of acute ankle sprains in
volleyball after the introduction of an injury prevention program: a prospective
cohort study. Scand. J. Med. Sci. Sports 7: 172-177, 1997.
Bahr, R., Krosshaug, T.: Understanding injury mechanism: a key component of
preventing injuries in sport. Br. J. Sports Med 39: 324-329, 2005.
Baker, M.M.: Anterior cruciate ligament injuries in the female athlete. J. Women's
Health (Larchmt) 7: 343-349, 1998.
Barrett, J., Bilisko, T.: The role of shoes in the prevention of ankle sprains. Sports
Med 20: 277-280, 1995.
Baumhauer, J.F. et al.: A prospective study of ankle injury risk factors. Am. J. Sports
Med 23: 564-570, 1995.
Beckett, M.E. et al.: Incidence of hyperpronation in the ACL injured knee: a clinical
perspective. J. Athl. Train 27: 58-62, 1992.
Bernier, J.N., Perrin, D.H.: Effect of coordination training on proprioception of the
functionally unstable ankle. J. Orthop. Sports Phys. Ther 27: 264-275, 1998.
Beynnon, B.D. et al.: Ankle ligament injury risk factors: a prospective study of
college athletes. J. Orthop. Res 19: 213-220, 2001.
Beynnon, B.D et al.: First-time inversion ankle ligament trauma: the effects of sex,
level of competition, and sport on the incidence of inj ury. Am. J. Sports Med 10:
1485-1491, 2005.
Beynnon, B.D. et al.: Predictive factors for lateral ankle sprains: a literature review.
J. Athl. Train 37: 376-380, 2002.
Bing, Yu., Garrett, W.E.: Mechanism of non-contact ACL injuries. Br. J. Sports Med
41: 47-51, 2007.
Boden, B.P. et al.: Mechanisms of anterior cruciate ligament injury. Orthopedics 23:
184
573-578, 2000.
Boden, B.P. et al.: Video analysis of anterior cruciate ligament injury: abnormalities
in hip and ankle kinematics. Am. J. Sports Med 37: 252-259, 2009.
Bonci, C.M.: Assessment and evaluation of predisposing factors to anterior cruciate
ligament injury. J. Athl. Train 34: 155-164, 1999.
Bere, T. et al.: Kinematics of anterior cruciate ligament ruptures in World Cup alpine
skiing: 2 case reports of the slip-catch mechanism. Am. J. Sports Med 41: 1067-1073,
2013.
Borotikar, B.S. et al.: Combined effects of fatigue and decision making on female
lower limb landing postures: central and peripheral contributions to ACL injury risk.
Clin. Biomech (Bristol, Avon) 23: 81-92, 2008.
Borowski, L.A. et al.: Yard EE, Fields SK, Comstock RD. The epidemiology of US
high school basketball injuries, 2005 -2007. Am. J. Sports Med 36: 2328-2335, 2008.
Bressel, E. et al.: Comparison of static and dynamic balance in female collegiate
soccer, basketball, and gymnastics athletes. J. Athl. Train 42: 42-46, 2007.
Brody, D.M.: Techniques in the evaluation and treatment of the injured runner.
Orthop. Clin. North. Am 13: 541-58, 1982.
Brynhildsen, J. et al.: Previous injuries and persisting symptoms in female soccer
players. Int. J. Sports Med 11: 489-492, 1990.
Burton A.W., Miller, D.E.: Movement skill assessment, Human Kinetics, 41-60,
1988.
Caraffa, A. et al.: Prevention of anterior cruciate ligament injuries in soccer. A
prospective controlled study of proprioceptive training. Knee Surg. Sports Traumatol.
Arthrosc 4: 19-21, 1996.
Carlson, R.E. et al.: The biomechanical relationship between the tendoachilles,
plantar fascia and metatarsophalangeal joint dorsiflexion angle. Foot Ankle Int 21:
18-25, 2000.
Carter, E.A. et al.: Common game injury scenarios in men's and women's lacrosse .
185
Int. J. Inj. Contr. Saf. Promot 17: 111-118, 2010.
Caswell, S.V. et al.: Video incident analysis of head injuries in high school girls'
lacrosse. Am. J. Sports Med 40: 756-762, 2012.
Chaiwanichsiri, D. et al.: Star excursion balance training: effects on ankle functional
stability after ankle sprain. J. Med. Assoc. Thai 88: 90-94, 2005.
Chappell, J.D., Limpisvasti, O.: Effect of a neuromuscular training program on the
kinetics and kinematics of jumping tasks. Am. J. Sports Med 36: 1081-1086, 2008.
Chaudhari, A.M.: Sport-dependent variations in arm position during single-limb
landing influence knee loading: implications for anterior cruciate ligament injury. Am.
J. Sports Med 33: 824-830, 2005.
Chomiak, J. et al.: Severe injuries in football players. Influencing factors. Am. J.
Sports Med 28(5 Suppl): S58-68, 2000.
Cibulka, M.T.: Determination and significance of femoral neck anteversion. Phys.
Ther 84: 550-558. 2004.
ⴭ ); ஭ ཎ ⚽ಇ ,୰ ᒣᙲ ୍ (ヂ ): ⭸࣭㊊㛵⠇࣭ ㊊㒊ࡢ᪂
Hervéou, C, Messéan, L (ⴭ
ࡋ࠸ ⚄⤒㸫㐠 ືჾ༠ㄪカ⦎ , Proprioceptive exercise ࡢ ᐇ㝿 , ་ ṑ⸆ฟ∧ , ᮾ ி ,
➨ 4 ∧ , 2-29, 1995.
Coplan, J.A.: Rotational motion of the knee: a comparison of normal and pronating
subjects. J. Orthop. Sports Phys. Ther 10: 366-369, 1989.
Cowan, D.N. et al.: Lower limb morphology and risk of overuse injury among male
infantry trainees. Med. Sci. Sports Exerc 28: 945-52, 1996.
Cranel, L.: Femoral torsion and its relation to toeing -in and toeing-out. J. Bone Joint
Surg. Am 41: 421-428, 1959.
Decker, M.J. et al.: Gender differences in lower extremity kinematics, kinetics and
energy absorption during landing. Clin. Biomech (Bristol, Avon) 21: 297-305, 2006.
Decoster, L.C. et al.: Generalized joint hypermobility and its relationship to injury
patterns among NCAA lacrosse players. J. Athl. Train 34: 99-105, 1999.
de Loës, M. et al.: A 7-year study on risks and costs of knee injuries in male and
186
female youth participants in 12 sports. Scand. J. Med. Sci. Sports 10: 90-97, 2000.
de Noronha, M. et al.: Intrinsic predictive factors for ankle sprain in active
university students: a prospective study. Scand. J. Med. Sci. Sports 10: 1-7, 2012.
Devita, P., Skelly, W.A.: Effect of landing stiffness on joint kinetics and energetics in
the lower extremity. Med. Sci. Sports Exerc 24: 108-115, 1992.
Diamond, P.T., Gale, S.D.: Head injuries in men's and women's lacrosse: a 10-year
analysis of the NEISS database. Brain Inj 15: 537-544, 2001.
Dick, R. et al.: Descriptive epidemiology of collegiate women’s lacrosse injuries:
National collegiate athletic association injury surveillance system, 1988-1989
through 2003-2004. J. Athl. Train 42: 262-269, 2007.
Dvorak, J. et al.: D: Medical report from the 2006 FIFA World Cup Germany. Br. J.
Sports Med 41: 578-581, 2007.
Dvorak, J. et al.: Injuries and illnesses of football players during the 2010 FIFA
World Cup. Br. J. Sports Med 45: 626-630, 2011.
Earl, J.E., Hertel, J.: Lower-extremity muscle activation during the star excursion
balance tests. J. Sport Rehabil 10: 93-104, 2001.
Emami, M.J. et al.: Q-angle: an invaluable parameter for evaluation of anterior knee
pain. Arch. Iran. Med 10: 24-26, 2007.
Emery, C.A. et al.: Effectiveness of a home-based balance-training program in
reducing sports-related injuries among healthy adolescents: a cluster randomized
controlled trial. CMAJ 172: 749-754, 2005.
Engström, B. et al.: Soccer injuries among elite female players. Am. J. Sports Med
19: 372-375, 1991.
Ettlinger, C.F. et al.: A method to help reduce the risk of serious knee sprains
incurred in alpine skiing. Am. J. Sports Med 23: 531-537, 1995.
Ekstrand, J. et al.: Prevention of soccer injuries. Supervision by doctor and
physiotherapist. Am. J. Sports Med 11: 116-120, 1983.
Ekstrand, J., Gillquist, J.: Soccer injuries and their mechanisms: a prospective study.
187
Med. Sci. Sports Exerc 15: 267-270, 1983.
Fagenbaum, R., Darling, W.G.: Jump landing strategies in male and female college
athletes and the implications of such strategies for anterior cruciate lig ament injury.
Am. J. Sports Med 31: 233-240, 2003.
Faude, O. et al.: Injuries in female soccer players: a prospective study in the German
national league. Am. J. Sports Med 33: 1694-1700, 2005.
Faude, O. et al.: Risk factors for injuries in elite female soccer players. Br. J. Sports
Med 40: 785-790, 2006.
Faunø, P., Wulff Jakobsen, B.: Mechanism of anterior cruciate ligament injuries in
soccer. Int. J. Sports Med 27: 75-79, 2006.
Ferber, R. et al.: Gender differences in lower extremity mechanics during runn ing.
Clin. Biomech 18: 350-357, 2003.
Fiolkowski, P. et al.: Intrinsic pedal musculature support of the medial longitudinal
arch: an electromyography study. J. Foot Ankle Surg 42: 327-333, 2003.
Filipa, A. et al.: Neuromuscular training improves performanc e on the star excursion
balance test in young female athletes. J. Orthop. Sports Phys. Ther 40: 551-558,
2010.
Flynn, R.K. et al.: The familial predisposition toward tearing the anterior cruciate
ligament. A case control study. Am. J. Sports Med 33: 23-28, 2005.
Ford, K.R. et al.: A comparison of dynamic coronal plane excursion between
matched male and female athletes when performing single leg landings. Clin.
Biomech 21: 33-40, 2006.
Ford, K.R. et al.: Valgus knee motion during landing in high school femal e and male
basketball players. Med. Sci. Sports Exerc 35: 1745-1750, 2003.
Franco, A.H.: Pes cavus and pes planus. Analyses and treatment. Phys Ther 67:
688-694, 1987.
Gilchrist, J. et al.: A randomized controlled trial to prevent noncontact anterior
cruciate ligament injury in female collegiate soccer players. Am. J. Sports Med 36:
188
1476-1483, 2008.
Goldenberg, M.S., Hossler, P.H.: Head and facial injuries in interscholastic women's
lacrosse. J. Athl. Train 30: 37-39, 1995.
Gomez, E. et al.: Incidence of injury in Texas girls' high school basketball. Am. J.
Sports Med 24: 684-687, 1996.
Gray, J. et al.: A survey of injuries to the anterior cruciate ligament of the knee in
female basketball players. Int. J. Sports Med 6: 314-316, 1985.
Gribble, P.A. et al.: Chronic ankle instability and fatigue create proximal joint
alterations during performance of the star excursion balance test. Int. J. Sports Med
28: 236-242, 2007.
Gribble, P.A. et al.: The Effects of fatigue and chronic ankle instability on dynamic
postural control. J. Athl. Train 39: 321-329, 2004.
Gribble, P.A., Hertel, J.: Considerations for normalizing measures of the star
excursion balance test. Meas. Phys. Educ. Exerc. Sci 7: 89-100, 2003.
Griffin, L.Y. et al.: Noncontact anterior cruciate ligament i njuries: risk factors and
prevention strategies. J. Am. Acad. Orthop. Surg 8: 141-150, 2000.
Griffin, L.Y. et al.: Understanding and preventing noncontact anterior cruciate
ligament injuries: a review of the Hunt Valley II meeting, January 2005. Am. J. Sports
Med 34: 1512-1532, 2006.
Grindstaff, T.L. et al.: Neuromuscular control training programs and noncontact
anterior cruciate ligament injury rates in female athletes: a numbers -needed-to-treat
analysis. J. Athl. Train 41: 450-456, 2006.
Grood, E.S., Suntay, W.J.: A joint coordinate system for the clinical description of
three-dimensional motions: application to the knee. J. Biomech. Eng 105: 136-144,
1983.
Guskiewicz, K.M., Perrin, D.H.: Research and Clinical Applications of Assessing
Balance. J. Sport Rehabil 5: 45-63, 1996.
Güven, M. et al.: A new radiographic measurement method for evaluation of tibial
189
torsion: a pilot study in adults. Clin. Orthop. Relat. Res 467: 1807-1812, 2009.
Haight, H.J. et al.: Measuring standing hindfoot alignment: reliability
of
goniometric and visual measurements. Arch. Phys. Med. Rehabil 86: 571-575, 2005.
Hale, S.A. et al.: The effect of a 4-week comprehensive rehabilitation program on
postural control and lower extremity function in individuals with chronic ankle
instability. J. Orthop. Sports Phys. Ther 37: 303-311, 2007.
᭹ 㒊 ᜏ᫂ : ࣄ ࢺࡢ࠿ࡓࡕ ࡜㐠ື . ኱ ಟ㤋᭩ᗑ , ᮾ ி , ึ∧ , 109-111, 1996.
Headlee, D.L. et al.: Fatigue of the plantar intrinsic foot muscles increases navicular
drop. J. Electromyogr. Kinesiol 18: 420-425, 2008.
Heidt, R.S. Jr. et al.: Avoidance of soccer injuries with preseason conditioning. Am.
J. Sports Med 28: 659-662, 2000.
Heidt, R.S. Jr. et al.: Differences in friction and torsional resistance in at hletic
shoe-turf surface interfaces. Am. J. Sports Med 24: 834-842, 1996.
Herrington, L. et al.: A comparison of star excursion balance test reach distances
between ACL deficient patients and asymptomatic controls. Knee 16: 149-152, 2009.
Hertel, J. et al.: Differences in postural control during single leg stance among
healthy individuals with different foot types. J. Athl. Train 37: 129-132, 2002.
Hertel, J. et al.: Intratester and intertester reliability during the star excursion
balance tests. J. Sport Rehabil 9: 104-116, 2000.
Hertel, J. et al.: Lower extremity malalignments and anterior cruciate ligament
injury history. J. Sports Sci. Med 3: 220-225, 2004.
Hertel, J. et al.: Simplifying the star excursion balance test: analyses of subjects with
and without chronic ankle instability. J. Orthop. Sports Phys. Ther 36: 131-137, 2006.
Hertel, J.: Sensorimotor deficits with ankle sprains and chronic ankle instability.
Clin. Sports Med 27: 353–370, 2008.
Hewett, T.E. et al.: Anterior cruciate ligament injuries in female athletes: part 1,
mechanisms and risk factors. Am. J. Sports Med 34: 299-311, 2006.
Hewett, T.E. et al.: Anterior cruciate ligament injuries in female athletes: part 2, a
190
meta-analysis of neuromuscular interventions aimed at injury prevention. Am. J.
Sports Med 34: 490-498, 2006.
Hewett, T.E. et al.: Biomechanical measures of neuromuscular control and valgus
loading of the knee predict anterior cruciate ligament injury risk in female athletes.
Am. J. Sports Med 33: 492-501, 2005.
Hewett, T.E. et al.: Gender differences in hip adduction motion and torque during a
single-leg agility maneuver. J. Orthop. Res 24: 416-421, 2006㸬
Hewett, T.E. et al.: Plyometric training in female athletes. Decreased impact forces
and increased hamstring torques. Am. J. Sports Med 24: 765-573, 1996.
Hewett, T.E. et al.: Preparticipation physical examination using a box drop vertic al
jump test in young athletes: the effects of puberty and sex. Clin. J. Sport Med 16:
298-304, 2006.
Hewett, T.E. et al.: Prevention of anterior cruciate ligament injuries. Curr. Womens
Health Rep 1: 218-224, 2001.
Hewett, T.E. et al.: Strategies for enhancing proprioception and neuromuscular
control of the knee. Clin. Orthop. Relat. Res 402: 76-94, 2002.
Hewett, T.E. et al.: The effect of neuromuscular training on the incidence of knee
injury in female athletes. A prospective study. Am. J. Sports Med 27: 699-706, 1999.
Hewett, T.E. et al.: Understanding and preventing noncontact ACL injuries . 1st ed.,
ACL injury prevention program, Human kinetics, Champaign, 57-129, 2007.
Hewett, T.E. et al.: Video analysis of trunk and knee motion during non -contact
anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction
motion are combined components of the injury mechanism. Br. J. Sports. Med 43:
417-422, 2009.
Hewett, T.E., Myer, G.D.: The mechanistic connection between the trunk, hip, knee,
and anterior cruciate ligament injury. Exerc. Sport Sci. Rev 39: 161-166, 2011.
Hinton, R.Y. et al.: Epidemiology of lacrosse injuries in high school -aged girls and
boys: a 3-year prospective study. Am. J. Sports Med 33: 1305-1314, 2005.
191
Hirth, C.J.: Rehabilitation techniques for sports medicine and athletic training,
Prentice, W.E., The McGraw-Hill companies, New York, Fourth ed, 579-607, 2004.
Hoch, M.C. et al.: Dorsiflexion range of motion significantly influences dynamic
balance. J. Sci. Med. Sport 14: 90-92, 2011.
Hootman, J.M. et al.: Epidemiology of collegiate injuries for 15 sports: summary
and recommendations for injury prevention initiatives . J. Athl. Train 42: 311-319,
2007.
Hopper, D.M. et al.: Do selected kinanthropometric and performance var iables
predict injuries in female netball players? J. Sports Sci 13: 213-222, 1995.
Horton, M.G., Hall, T.L.: Quadriceps femoris muscle angle: normal values and
relationships with gender and selected skeletal measures. Physical Therapy 69:
897-901, 1989.
Hosea, T.M. et al.: The gender issue: Epidemiology of ankle injuries in athletes who
participate in basketball. Clin. Orthop. Relat. Res 372: 45-49, 2000.
Hughesa, G. et al.: Differences between the sexes in knee kinetics during landing
from volleyball block jumps. Eur. J. Sport Sci 30: 1-11, 2009.
Hupperets, M.D.W. et al.: Effect of unsupervised home based proprioceptive
training on recurrences of ankle sprain: randomised controlled trial. BMJ 339: b2684,
2009.
Hutchinson, M.R., Ireland, M.L.: Knee injuries in female athletes. Sports Med 19:
288-302, 1995.
஭ ཎ ⚽ಇ : 㛵 ⠇ࢺ࣮ࣞࢽ ࣥࢢ , ⚄⤒ 㐠ືჾ༠ㄪ カ⦎㸪༠ྠ ་᭩ฟ∧ , ᮾ ி , ᨵ
ゞ ➨ 2 ∧ , 89-107, 1996.
Inklaar, H.: Soccer injuries. II: Aetiology and prevention. Sports Med 18: 81-93,
1994.
IOC World Conference on Prevention of Injury & Illness in Sport , Available at :
http://www.ioc-preventionconference.org/files/CIOFINAL72.pdf , accessed May 5,
2012.
192
Ireland, M.L. et al.: ACL injuries in the female athlete. J. Sport Rehabil 6: 97-110,
1997.
Ireland, M.L.: Anterior cruciate ligament injury in female athletes: epidemiology. J.
Athl. Train 34: 150-154, 1999.
Ireland, M.L., Nattiv, A.: The female athlete. 1st ed., Knee injuries, Saunders,
Philadelphia, 387-419, 2002.
Ireland, M.L., Ott, S.M.: Special concerns of the female athlete. Clin. Sports Med
23: 281-298, 2004.
Jacobs, C.A. et al.: Hip abductor function and lower extremity landing kinematics:
sex differences. J. Athl. Train 42: 76–83, 2007.
Jørgensen, U.: Epidemiology of injuries in typical Scandinavian team sports. Br. J.
Sports Med 18: 59-63, 1984.
Joy, E.A. et al.: Health-related concerns of the female athlete a lifespan approach.
Am. Fam. Physician 79: 489-495, 2009.
Jung, D.Y. et al.: A comparison in the muscle activity of the abductor hallucis and
the medial longitudinal arch angle during toe curl and short foot exercises. Phys Ther
Sport 12: 30-35, 2012.
Junge, A., Dvorak J.: Injuries in female football players in top -level international
tournaments. Br. J. Sports Med 41: 3-7, 2007.
Junge, A. et al.: Football injuries during the World Cup 2002. Am. J. Sports Med 32(1
Suppl): S23-27, 2004-1.
Junge, A. et al.: Football injuries during FIFA tournaments and the Olympic Games,
1998-2001: development and implementation of an injury-reporting system. Am. J.
Sports Med 32(1 Suppl): S80-99, 2004-2.
Junge, A. et al.: Injury surveillance in multi-sport events: the International Olympic
Committee approach. Br. J. Sports Med 42: 413-421, 2008.
Junge, A. et al.: Injuries in team sport tournaments during the 2004 Olympic Games.
Am. J. Sports Med 34: 565-576, 2006.
Junge, A. et al.: Sports injuries during the Summer Olympic Games 2008. Am. J.
193
Sports Med 37: 2165-2172, 2009.
ຍ㎶᠇ேࡽ : ㊊㊑ࡀືⓗጼໃไᚚ࡟ᯝࡓࡍᙺ๭࡟㛵ࡍࡿ◊✲. ⌮Ꮫ⒪ἲ⛉Ꮫ
17: 199-204, 2002.
㛵 ⠇ ྍ ື ᇦ ᐃ ἲ . ࣜࣁ ࣅ ࣜ ࢸ ࣮ࢩ ࣙࣥ ་Ꮫ఍ . 㛵 ⠇ྍ ືᇦ ࡢ ⾲♧࡞ ࡽ ࡧ࡟ ᐃἲ . ࣜ ࣁ་Ꮫ 32: 207-217. 1995.
Kapandji, I.A.: The physiology of the joints. vol.2, lower limb, Churchill
Livingstone, Edinburgh, Fifth ed, 216-241, 1987.
Kaufman, K.R. et al.: The effect of foot structure and range of motion on
musculoskeletal overuse injuries. Am. J. Sports Med 27: 585-593, 1999.
Kelly, A.K.: Anterior cruciate ligament injury prevention. Curr. Sports Med. Rep 7:
255-262, 2008.
Kendall, F.P. et al.: Muscles: testing and function with posture and pain. Lippincott
Williams and Williams, Fifth ed, 359-464, 2005.
Kernozak, T.W. et al.: Gender differences in frontal and sagittal plane biomechanics
during drop landings. Med. Sci. Sports Exerc 37: 1003-1012, 2005.
Kiani, A. et al.: Prevention of soccer-related knee injuries in teenaged girls. Arch
Intern Med 170: 43-49, 2010.
Kinzey, S.J., Armstrong, C.W.: The reliability of the star-excursion test in assessing
dynamic balance, J. Orthop. Sports Phys. Ther 27: 356-360, 1998.
Kiriyama, S. et al.: Gender differences in rotation of the shank during single -legged
drop landing and its relation to rotational muscle strength of the knee. Am. J. Sports
Med 37: 168-174, 2009.
ᮌ⸨ఙᏹࡽ : 㧗㱋⪅ࡢ㌿ಽண㜵࡜ࡋ࡚ࡢ㊊ᣦࢺ࣮ࣞࢽࣥࢢࡢຠᯝ. ⌮Ꮫ⒪ἲ
Ꮫ 28: 313-319, 2001.
Klingenstein, G.G., Martin, R.R.: Hip injuries in the overhead athlete. Clin. Orthop.
Relat. Res 470: 1579-1585, 2012.
ᑠᯘ㝯ྖࡽ : 㧗㱋⪅ࡢ㊊㊑ᢕᥱカ⦎ࡀ㟼ⓗ㔜ᚰືᦂ࡟ཬࡰࡍᙳ㡪. ᪥⅏་఍
ㄅ 47: 633-636, 1999.
194
Koga, H. et al.: Mechanisms for noncontact anterior cruciate ligament injuries: knee
joint kinematics in 10 injury situations from female team handball and basketball. Am.
J. Sports Med 38: 2218-2225, 2010.
Krause, D.A. et al.: Influence of lever arm and stabilization on measures of hip
abduction and adduction torque obtained by hand -held dynamometry. Arch. Phys.
Med. Rehabil 88: 37-42, 2007.
Krosshaug, T. et al.: Biomechanical analysis of anterior cruciate ligament injury
mechanism: three-dimensional motion reconstruction from video sequences. Scand. J.
Med. Sci. Sports 17: 508-519, 2007.
Krosshaug, T. et al.: Mechanisms of anterior cruciate ligament injury in basketball :
video analysis of 39 cases. Am. J. Sports Med 35: 359-367, 2007.
Langevoort, G. et al.: Handball injuries during major international tournaments.
Scand. J. Med. Sci. Sports 17: 400-407, 2007.
LaPrade, R.F., Burnett, Q.M. 2nd.: Femoral intercondylar notch stenosis and
correlation to anterior cruciate ligament injuries: a prospective study. Am. J. Sports
Med 22: 198-203, 1994.
Leanderson, J. et al.: Ankle injuries in basketball players. Knee Surg. Sports
Traumatol. Arthrosc 1: 200-202, 1993.
Le Gall, F. et al.: Injuries in young elite female soccer players: an 8 -season
prospective study. Am. J. Sports Med 36: 276-284, 2008.
Lephart, S.M. et al.: Gender differences in strength and lower extremity kinematics
during landing. Clin. Orthop. Relat. Res 401: 162-169, 2002.
Levangie, P.K., Norkin, C.C.: Joint structure and function. A comprehensive
analysis. F. A. Davis Company, 3rd Ed, 437-477, 2001.
Liederbach, M. et al.: Incidence of anterior cruciate ligament injuries among elite
ballet and modern dancers: a 5-year prospective study. Am. J. Sports Med 36,
1779-1788, 2008.
Livingston, L.A.: The quadriceps angle: a review of the literature. J. Orthop. Sports
195
Phys. Ther 28: 105-109, 1998.
Lincoln, A.E. et al.: Head, face, and eye injuries in scholastic and collegiate
lacrosse: a 4-year prospective study. Am. J. Sports Med 35: 207-215, 2007.
Lindblad, B.E. et al.: Handball injuries. An epidemiologic and socioeconomic study.
Am. J. Sports Med 20: 441-444, 1992.
Lindblom, H. et al. : No effect on performance tests from a neuromuscular warm-up
programme in youth female football: a randomised controlled trial. Knee Surg. Sports
Traumatol. Arthrosc 20: 2112-2119, 2012.
Lindenfeld, T.N. et al.: Incidence of injury in indoor soccer. Am. J. Sports Med 22:
364-371, 1994.
Loudon, J.K. et al.: Relationship between static posture and ACL injury in female
athlete. J. Orthop. Sports Phys. Ther 24: 91-97, 1996.
Malinzak, R.A. et al.: A comparison of knee Joint motion patterns between men and
women in select athletic tasks. Clin. Biomech 16: 438-445, 2001.
Mann, R., Inman, V.T.: Phasic activity of intrinsic muscles of the foot . J. Bone Joint
Surg. Am 46: 469-481, 1964.
Mandelbaum, B.R. et al.: Effectiveness of a neuromuscular and proprioceptive
training program in preventing anterior cruciate ligament injuries in female athletes.
2-year follow-up. Am. J. Sports Med 33: 1003-1010, 2005.
Marar, M. et al.: Epidemiology of concussions among United States high school
athletes in 20 sports. Am. J. Sports Med 40: 747-755, 2012.
ቑᮏ㡯, ᑠᒣளᕼᏊ : ኱ᏛዪᏊࣛࢡࣟࢫ➇ᢏ࡟࠾ࡅࡿയᐖㄪᰝ, ⮫ᗋࢫ࣏࣮
ࢶ་ Ꮫ 16: 1089-1092, 1999.
Mattacola, C.G., Dwyer, M.K.: Rehabilitation of the ankle after acute sprain or
chronic instability. J. Athl. Train 37: 413-429, 2002.
Matz, S.O., Nibbelink, G.: Injuries in intercollegiate women's lacrosse. Am. J. Sports
Med 32: 608-611, 2004.
McCrory, J.L. et al.: Arch index as a predictor of arch height. The Foot 7: 79-81.
196
1997.
McGuine, T.A., Keene, J.S. : The effect of a balance training program on the risk of
ankle sprains in high school athletes. Am. J. Sports Med 34: 1103-1111, 2006.
McHugh, M.P. et al.: The effectiveness of a balance training intervention in reducing
the incidence of noncontact ankle sprains in high school football players. Am. J.
Sports Med 35: 1289-1294, 2007.
McKay, G.D. et al.: Ankle injuries in basketball: injury rate and risk factors. Br. J.
Sports Med 35: 103-108, 2001.
McKeon, P.O. et al.: Balance training improves function and postural control in
those with chronic ankle instability. Med. Sci. Sports Exerc 40: 1810-1819, 2008.
McMullen, K.L. et al.: Lower extremity neuromuscular control immediately after
fatiguing hip-abduction exercise. J. Athl. Train 46: 607-614, 2011.
McLean, S.G. et al.: Association between lower extremity posture at contact and
peak knee valgus moment during sidestepping: implications for ACL injury. Clin.
biomech 20: 863-870, 2005.
McLean, S.G. et al.: Effect of gender and defensive opponent on the biomechanics of
sidestep cutting. Med. Sci. Sports Exerc 36: 1008-1016, 2004.
McLean, S.G. et al.: Evaluation of a two dimensional analysis method as a screening
and evaluation tool for anterior cruciate ligament injury. Br. J. Sports Med 39:
355-362, 2005.
McNair, P.J., Marshall, R.N.: Landing characteristics in subjects with normal and
anterior cruciate ligament deficient knee joints. Arch. Phys. Med. Rehabil 75:
584-589, 1994.
Medina McKeon, J.M., Hertel, J.: Sex differences and representative values for 6
lower extremity alignment measures. J. Athl. Train 44: 249-255, 2009.
Meeuwisse, W.H.: Assessing causation in sports injury: a multifactorial model. Clin.
J. Spotrs Med 4: 166-170, 1994.
Meeuwisse, W.H. et al.: Rates and risks of injury during intercollegiate basketball.
Am. J. Sports Med 31: 379-385, 2003.
197
Messina, D.F. et al.: The incidence of injury in Texas high school basketball. A
prospective study among male and female athletes. Am. J. Sports Med 27: 294-299,
1994.
Mihata, L.C. et al.: Comparing the incidence of anterior cruciate ligament injury in
collegiate lacrosse, soccer, and basketball players. Am. J. Sports Med 34: 899-904,
2006.
୕ᮌⱥஅ, ⵦ⏣࿴ⰾ : ࢫ࣏࣮ࢶእയ࣭㞀ᐖࡢ⌮Ꮫデ᩿࣭⌮Ꮫ⒪ἲ࢞࢖ࢻ. ⮫
ᗋࢫ ࣏࣮ࢶ་ Ꮫ⦅㞟ጤ ဨ఍ , ᩥ ගᇽ , ᮾ ி , ➨ 1 ∧ , 353-365, 2003.
Ỉ⃝୍ᶞ, ᑐ㤿ᰤ㍤ : 㟼ⓗጼໃಖᣢ࡟ඹ㏻ࡍࡿ㊊ᅽ୰ᚰືᦂࣃ࣓࣮ࣛࢱ࣮࡟
ࡘ࠸ ࡚ . ⌮Ꮫ⒪ ἲ⛉Ꮫ 24: 1-5, 2009.
ᐑᓥᜨᶞࡽ : ࣔࣀࣇ࢕࣓ࣛࣥࢺᅽ③ィ࡟ࡼࡿⱝᖺ⪅㊊ᗏឤぬ ᐃࡢᛶ࡜㒊఩
࡟ࡼ ࡿᕪࡢ᳨ ウ . ⌮Ꮫ⒪ἲ ⛉Ꮫ 27: 161-164: 2012.
Miyasaka, K.C. et al.: The incidence of knee ligament injuries in the general
population. Am. J. Knee Surg 4: 3-8, 1991.
Moul, J.L.: Differences in selected predictors of anterior cruciate ligament tears
between male and female NCAA division I collegiate basketball players. J. Athl.
Train 33: 118–121, 1998.
Mountjoy, M. et al.: Sports injuries and illnesses in the 2009 FINA World
Championships (Aquatics). Br. J. Sports Med 44: 522-527, 2010.
Murphy, D.F. et al.: Risk factors for lower extremity injury: a review of the literature.
Br. J. Sports Med 37: 13-29, 2003.
ᮃ᭶ஂ, ᓠᓥᏕ㞝 : 㔜ᚰືᦂィࢆ⏝࠸ࡓጼໃᏳᐃᗘホ౯ᣦᶆࡢಙ㢗ᛶ࠾ࡼࡧ
ጇᙜ ᛶ , ⌮Ꮫ⒪ ἲᏛ 29: 199-203, 2000.
ᮧ⏣ఙ : 㛤║∦㊊❧ࡕ఩࡛ࡢ㔜ᚰືᦂ࡜㊊㒊ᶵ⬟࡜ࡢ㛵㐃 㸫೺ᖖዪᛶࢆᑐ
㇟࡜ ࡋࡓ᳨ウ ―. ⌮Ꮫ⒪ἲ ⛉Ꮫ 19: 245-249: 2004.
ᮧ ⏣ ఙ , ᛛ 㑣 㱟 㞝 : ㊊ ᢕ ᣢ ຊ ᐃ ࡢ ヨ ࡳ ― ᐃ ჾ ࡢ స ᡂ ࡜ ᐃ ್ ࡢ ෌ ⌧ ᛶ
ࡢ᳨ ウ ―. ⌮ Ꮫ⒪ἲ⛉Ꮫ 17: 243-247, 2002.
Myklebust, G. et al.: A prospective cohort study of anterior cruciate ligament injuries
198
in elite Norwegian team handball. Scand. J. Med. Sci. Sports 8: 49-153, 1998.
Myklebust, G. et al.: Prevention of anterior cruciate ligament injuries in female te am
handball players: a prospective intervention study over three seasons. Clin. J. Sport
Med 13: 71-78, 2003.
Nagano, Y. et al.: Gender differences in knee kinematics and muscle activity during
single limb drop landing. Knee 14: 218-223, 2007.
୰Ụᚨᙪ, ఀబᆅᘯᇶ : ୗ⫥ࢫ࣏࣮ࢶእയࡢࣜࣁࣅࣜࢸ࣮ࢩࣙࣥ࡜ࣜࢥࣥࢹ
࢕ ࢩ ࣙࢽ ࣥ ࢢ 㸫 ࣜࢫࢡ ࣐ ࢿ࣮ ࢪ ࣓ࣥ ࢺ ࡟ᇶ࡙ ࠸ ࡓ࢔ ࣉ ࣮ࣟ ࢳ 㸫 . ᩥ ග ᇽ , ᮾ
ி , ➨ 1 ∧ , 188-204, 2011.
୰ ᔱ ᐶ அ ࡽ : ዪ Ꮚ య ᧯ 㑅 ᡭ ࡟ ࠾ ࡅ ࡿ ๓ ༑ Ꮠ 㠌 ᖏ ᦆ യ . ᩚ ᙧ ࣭ ⅏ ᐖ እ ⛉ 27:
609-613, 1984.
National Collegiate Athletic Association , Men's Lacrosse Rules of the Game,
Available
at:
http://www.ncaa.org/wps/wcm/connect/public/NCAA/Playing+Rules+Administration/
NCAA+Rules+Sports/Lacrosse/Mens/Playing+Rules/Mens+Lacrosse+Index, accessed
February 3, 2013.
NCAA
women’s
lacrosse,
Rankings,
Available
at:
http://www.ncaa.com/sports/lacrosse -women/d1, accessed January 12, 2013.
Neumann, D.A.: Kinesiology of the muscleskeletal system. Foundations for physical
rehabilitation. Mosby, 477-521, 2002.
Nguyen, A.D., Shultz, S.J.: Sex difference in clinical measures of lower extremity
alignment. J. Orthop. Sports Phys. Ther 37: 389-98, 2007.
Nielsen, A.B., Yde, J.: Epidemiology and traumatology of injuries in soccer. Am. J.
Sports Med 17: 803-807. 1989.
᪥ ᮏ ᖹ⾮ ⚄ ⤒⛉ Ꮫ఍ : 㔜 ᚰືᦂ ᳨ᰝࡢᇶ‽ . Equilibrium Res 42: 367-369, 1983.
Noyes, F.R. et al.: Drop-jump screening test: difference in lower limb control by
gender and effect of neuromuscular training in female athletes. Am. J. Sports Med 33:
197-207, 2005.
199
Nunley, R.M. et al.: Gender comparison of patellar tendon tibial shaft angle with
weight bearing. Res. in Sports Med 11: 173-185, 2003.
Oatis, C.A.: Kinesiology. The mechanism & pathomechanics of human movement ,
2nd, Ed., Knee unit, Lippincott Williams & Wilkins, Baltimore, 807-837, 2009.
O'Driscoll, J. et al.: Effect of a 6-week dynamic neuromuscular training programme
on ankle joint function: a Case report. Sports Med. Arthrosc. Rehabil. Ther. Technol 3,
13, 2011.
Olmsted, L.C. et al.: Efficacy of the star excursion balance tests in detecting rearch
deficits in subjects with chronic ankle instability. J. Athl. Train 37: 501-506, 2002.
Olsen, O.E. et al.: Exercises to prevent lower limb injuries in youth sports: cluster
randomised controlled trial. BMJ 330: 449-452, 2005.
Olsen, O.E. et al.: Injury mechanisms for anterior cruciate ligament injuries in team
handball: a systematic video analysis. Am. J. Sports Med 32: 1002-1012, 2004.
Olsen, O.E. et al.: Relationship between floor type and risk of ACL injury in team
handball. Scand. J. Med. Sci. Sports 13: 299-304, 2003.
Orchard, J.: Is there a relationship between ground and climatic cond itions and
injuries in football? Sports Med 32: 419-432, 2002.
Orchard, J.W.: Intrinsic and extrinsic risk factors for muscle strains in Australian
football. Am. J. Sports Med 29: 300-3003, 2001.
Orchard, J.W, Powell, J.W.: Risk of knee and ankle sprains under various weather
conditions in American football. Med. Sci. Sports. Exerc 35: 1118-1123, 2003.
Ortiz, A. et al.: Landing mechanics between noninjured women and women with
anterior cruciate ligament reconstruction during 2 jump tasks. Am. J. Sports Med 36:
149-157, 2008.
Osborne, M.D., Rizzo, T.D. Jr.: Prevention and treatment of ankle sprain in athletes.
Sports Med 33: 1145-1150, 2003.
Ostenberg, A., Roos, H.: Injury risk factors in female European football. A
prospective study of 123 players during one season. Scand. J. Med. Sci. Sports 10:
200
279-285, 2000.
Otago, L. et al.: The epidemiology of head, face and eye injuries to female lacrosse
players in Australia. Int. J. Inj. Contr. Saf. Promot 14: 259-261, 2007.
Pappas, E. et al.: Biomechanical differences between unilateral and bilateral
landings from a jump: gender differences. Clin. J. Sport Med 17: 263-268, 2007.
Petersen, W. et al.: A controlled prospective case control study of a prevention
training program in female team handball players : the German experience. Arch.
Orthop. Trauma Surg 125: 614-621, 2005.
Peterson, L. et al.: Incidence of football injuries and complaints in different age
groups and skill-level groups. Am. J. Sports Med 28(5 Suppl): S51-57, 2000.
Pfeiffer, R.P. et al.: Lack of effect of a knee ligament injury prevention program on
the incidence of noncontact anterior cruciate ligament injury. J. Bone Joint Surg. Am
88: 1769-1774, 2006.
Plisky, P.J. et al.: Star Excursion Balance Test as a predictor of lower extremity
injury in high school basketball players. J. Orthop. Sports Phys. Ther 36: 911-919,
2006.
Pollard, C.D. et al.: Influence of gender on hip and knee mechanics during a
randomly cued cutting maneuver. Clin. Biomech (Bristol, Avon) 19: 1022-1031, 2004.
Powers, C.M.: The influence of altered lower-extremity kinematics on patellofemoral
joint dysfunction: a theoretical perspective㸬J. Orthop. Sports Phys. Ther 33: 639-646,
2003.
Powell, J.W.: A multivariate risk analysis of selected playing surfaces in the National
Football League: 1980 to 1989. An epidemiologic study of knee injuries. Am. J.
Sports Med 20: 686-694, 1992.
Quatman, C.E. et al.: The Effects of Gender and Maturational Status on Generalized
Joint Laxity in Young Athletes. J. Sci. Med. Sport 11: 257–263, 2008.
Quatman, C.E., Hewett, T.E.: The anterior cruciate ligament injury controversy: is
"valgus collapse" a sex-specific mechanism? Br. J. Sports Med 43: 328-335, 2009.
201
Ramesh, R. et al.: The risk of anterior cruciate ligament rupture with generalized
joint laxity. J. Bone Joint Surg. Br 87: 800-803, 2005.
Renstrom, R. et al.: Non-contact ACL injuries in female athletes: an International
Olympic Committee current concepts statement. Br. J. Sports Med 42: 394-412, 2008.
Robinson, R.H., Gribble, P.A.: Support for a reduction in the number of trials
needed for the star excursion balance test. Arch. Phys. Med. Rehabil 89: 364-370,
2008.
Russell, K.A. et al.: Sex differences in valgus knee angle during a single-leg drop
jump. J. Athl. Train 41: 166-171, 2006.
Sanomura, M., Irie, K.: Relationship between leg and foot alignment and dynamic
knee valgus during single-leg squat, single-leg drop landing and cutting tasks, IOC
World Conference on Prevention of Injury & Illness in Sport (abstract), Br. J. Sports
Med 45: 371, 2011.
బ㔝ᮧᏛ, ධỤ୍᠇ : ㊊㊑㛤᤼ᣦ♧ୗ࡟࠾࠸࡚ࡢືⓗୗ⫥࢔ࣛ࢖࣓ࣥࢺࡢኚ
໬ 㸫∦⬮ࢫࢡ࣡ࢵࢺ࣭∦⬮ࢻࣟࢵࣉࣛࣥࢹ࢕ࣥࢢ࣭࢝ࢵࢸ࢕ࣥࢢືసࢆㄢ㢟
࡜ࡋ ࡚㸫 , ➨ 64 ᅇ ᪥ᮏయ ຊ་Ꮫ఍ ኱఍ᢒ㘓㞟 , 322, 2009.
బ㔝ᮧᏛ, ධỤ୍᠇ : ㊊㊑㛤᤼⬟ࡀືⓗୗ⫥࢔ࣛ࢖࣓ࣥࢺ࡟ཬࡰࡍᙳ㡪 㸫
㊊ ㊑ 㛤᤼ ᣦ ♧ୗ ࡢ ∦⬮ࢫ ࢡ ࣡ࢵ ࢺ , ∦ ⬮ ࢻ ࣟࢵ ࣉ ࣛࣥ ࢹ ࢕ࣥ ࢢ , ࢝ ࢵ ࢸ ࢕ࣥ ࢢ
ືస ࡢศᯒ㸫 . ᪥ ᮏ⮫ᗋࢫ ࣏࣮ࢶ་ Ꮫ఍ㄅ 20: 112-121, 2012.
బ㔝ᮧᏛ , ධỤ୍᠇ : ㊊㊑㛤᤼ᣦ♧ࡀືⓗୗ⫥࢔ࣛ࢖࣓ࣥࢺ࡟ཬࡰࡍᙳ㡪
㸫∦ ⬮ࢫࢡ࣡ ࢵࢺ㸪∦⬮ࢻ ࣟࢵࣉࣛ ࣥࢹ࢕ࣥࢢ㸪࢝ ࢵࢸ࢕ࣥࢢ ືసࡢศ ᯒ㸫 , ᪥
ᮏ⮫ ᗋࢫ࣏࣮ ࢶ་Ꮫ ఍ㄅ 21: 157-164, 2013.
బ㔝ᮧᏛ : ᅜ㝿࢜ࣜࣥࣆࢵࢡጤဨ఍࡟ࡼࡿࢫ࣏࣮ࢶയᐖ࡟ྥࡅ ࡓྲྀࡾ⤌ࡳ.
໭ி ࢜ࣜࣥࣆ ࢵࢡ➇ᢏ኱఍ ࡢയᐖㄪ ᰝሗ࿌ . JATI EXPRESS 30: 20-21, 2012.
బ 㔝 ᮧᏛ : ୗ ⫥യᐖ ண㜵 ࣉࣟࢢࣛ ࣒ࡢᐇ㝿࡜ࡑ ࡢຠᯝ . ➨ 1 ᅇ ⭸๓ ༑Ꮠ㠌ᖏ
ᦆയ ண㜵ࣉࣟ ࢢࣛ ࣒ 1. JATI EXPRESS 34: 22-23, 2013-1.
బ 㔝 ᮧᏛ : ୗ ⫥യᐖ ண㜵 ࣉࣟࢢࣛ ࣒ࡢᐇ㝿࡜ࡑ ࡢຠᯝ . ➨ 2 ᅇ ⭸๓ ༑Ꮠ㠌ᖏ
ᦆയ ண㜵ࣉࣟ ࢢࣛ ࣒ 2. JATI EXPRESS 35: 16-18, 2013-2.
202
బ㔝ᮧᏛࡽ : ኱ᏛዪᏊࣛࢡࣟࢫ࡟࠾ࡅࡿ๓ྥࡁയᐖㄪᰝ. ᪥ᮏ⮫ᗋࢫ࣏࣮ࢶ
་Ꮫ ఍ㄅ 20: 460-468, 2012-1.
బ㔝ᮧᏛࡽ : ࢻࣟࢵࣉࢪࣕࣥࣉ᫬࡟࠾ࡅࡿࣛࢡࣟࢫࢫࢸ࢕ࢵࢡࡢಖᣢࡸ᧯స
ࡀୗ⫥࢟ࢿ࣐ࢸ࢕ࢡࢫ࣭࢟ࢿࢸ࢕ࢡࢫ࡟ཬࡰࡍᙳ㡪 . ⮫ᗋࣂ࢖࣓࢜࢝ࢽࢡࢫ
33, 383-388, 2012-2.
బ㔝ᮧᏛࡽ : ኱ᏛዪᏊࣛࢡࣟࢫയᐖ ̿2 ᖺ㛫ࡢ๓ྥࡁയᐖㄪᰝ̿, యຊ⛉
Ꮫ 62: 2013.㸦 accepted㸧
Salci, Y. et al.: Comparison of landing maneuvers between male and female c ollege
volleyball players. Clin. Biomech (Bristol, Avon) 19: 622-628, 2004.
బ ࠎ ᮌ⌮ ᜨ Ꮚ , ᾆ ㎶ ᖾ ኵ : Star excursion balance test ࢆ⏝࠸ ࡓ୰㧗㱋⪅ ࡢࣂࣛ
ࣥࢫ ⬟ຊホ౯ , ⌮ Ꮫ⒪ἲ⛉ Ꮫ 24: 827-831, 2009.
Shambaugh, J.P. et al.: Structural measures as predictors of injury basketball players.
Med. Sci. Sports Exerc 23: 522-527, 1991.
Schamberger, W.: The malalignment syndrome. Implications for medicine and sports,
Churchill livingstone, 87-195, 2002.
Schmidt-Olsen, S. et al.: Injuries among young soccer players. Am. J. Sports Med 19:
273-275, 1991.
Schmitz, R.J. et al.: Dynamic valgus alignment and functional strength in male and
females maturation. J. Athl. Train 44: 26-32, 2009.
Schmitz, R.J. et al.: Sex differences in lower extremity biomechanics during single
leg landings. Clin. Biomech (Bristol, Avon) 22: 681-688, 2007.
Schot, P.K. et al.: Bilateral performance symmetry during drop landing: a kinetic
analysis. Med. Sci. Sports Exerc 26: 1153-1159, 1994.
Sefton, J.M. et al.: Sensorimotor function as a predictor of chronic ankle instability.
Clin. Biomech (Bristol, Avon) 24: 451-458, 2009.
Seil, R. et al.: Sports injuries in team handball. A one-year prospective study of
sixteen men's senior teams of a superior nonprofessional level. Am. J. Sports Med 26:
203
681-687, 1998.
Shambaugh, J.P. et al.: Structural measures as predictors of injury basketball players.
Med. Sci. Sports Exerc 23: 522-527, 1991.
Shelbourne, K.D. et al.: The relationship between intercondylar notch width of the
femur and the incidence of anterior cruciate ligament tears. A prospective study. Am.
J. Sports Med 26: 402-408, 1998.
ᓥ ⃝ ┿୍ : ࢔ ࢫࣞࢸ࢕ࢵ ࢡࣜࣁࣅ ࣜࢸ࣮ࢩࣙࣥ ࢞࢖ࢻ ➇ᢏ᚟ᖐ࣭෌ Ⓨண㜵ࡢ
ࡓࡵ ࡢᐇ㊶ⓗ ࢔ࣉ࣮ࣟࢳ , ⚟ ᯘᚭ . ᩥග ᇽ , ᮾி , ➨ 1 ∧ , 136-148, 2008.
Shimokochi, Y., Shultz, S.J.: Mechanisms of noncontact anterior cruciate ligament
injury. J. Athl. Train 43: 396-408, 2008.
᪁⍆ࡽ : ❧఩ጼໃ᫬ࡢ㌟యືᦂไᚚ࠾ࡼࡧどぬࡢᙳ㡪࡟ࡘ࠸࡚ . యຊ⛉Ꮫ
55: 469-476, 2006.
Smith, J. et al.: Role of hyperpronation as a possible risk factor for anterior cruciate
ligament injuries. J. Athl. Train 32: 25-28, 1997.
Smith, T.O. et al.: The reliability and validity of the Q-angle: a systematic review.
Knee Surg. Sports Traumatol. Arthrosc 16: 1068–1079, 2008.
Söderman, K. et al.: Balance board training: prevention of traumatic injuries of the
lower extremities in female soccer players? A prospective randomized intervention
study. Knee Surg. Sports Traumatol Arthrosc 8: 356-363, 2000.
Souryal, T.O., Freeman, T.R.: Intercondylar notch size and anterior cruciate
ligament injuries in athletes. A prospective study. Am. J. Sports Med 21: 535-539,
1993.
Souza, R.B., Powers, C.M.: Predictors of hip internal rotation during running. An
evaluation of hip strength and femoral structure in women with and without
patellofemoral pain. Am. J. Sports Med 37: 579-587, 2009.
Sports
medicine,
Lacrosse
injuries,
Available
at
:
http://www.sportsmed.org/uploadedFiles/Content/Medical_Professionals/P rofessional
_Educational_Resources/Publications_and_Resources/Sports_Medicine_Update/SMU
204
_2009/SMU%20Mar%20Apr%2009.pdf, accessed June 17, 2012.
Staheli, L.T. et al.: Lower-extremity rotational problems in children. Normal values
to guide management. J. Bone. Joint Surg. Am 67: 39-47, 1985.
Stasinopoulos, D.: Comparison of three preventive methods in order to reduce the
incidence of ankle inversion sprains among female volleyball players. Br. J. Sports
Med 38: 182-185, 2004.
Steffen, K. et al.: Preventing injuries in female youth football. A cluster-randomized
controlled trial. Scand. J. Med. Sci. Sports 18: 605-614, 2008.
Stevenson, H. et al.: Gender differences in knee injury epidemiology among
competitive alpine ski racers. Iowa Orthop. J 18: 64-66, 1998.
Stuart, M.J., Smith, A.: Injuries in Junior A ice hockey. A three-year prospective
study. Am. J. Sports Med 23: 458-461, 1995.
Stuberg, W. et al.: Measurement of tibial torsion and thigh-foot angle using
goniometry and computed tomography. Clin. Orthop. Relat. Res 272: 208-212, 1991.
Subotnick, S.T.: Sports medicine of the lower extremiry. Churchill livingstone,
129-158, 1989.
Surve, I. et al.: A fivefold reduction in the incidence of recurrent ankle sprains in
soccer players using the Sport-Stirrup orthosis. Am. J. Sports Med 22: 601-606, 1994.
㕥 ᮌ ဴ ࡽ : ∦ ⬮ ❧ ఩ ᫬ ࡢ య ᖿ ➽ ά ື ࡜ 㔜 ᚰ ື ᦂ ࡜ ࡢ 㛵 ಀ . ⌮ Ꮫ ⒪ ἲ ⛉ Ꮫ 24:
103-107, 2009.
Swanik, C.B. et al.: The relationship between neurocognitive function and
noncontact ACL injuries. Am. J. Sports Med 35: 943-948, 2007.
Swenson, D.M. et al.: Epidemiology of United States high school s ports-related
fractures, 2008-09 to 2010-11. Am. J. Sports Med 40: 2078-2084, 2012.
Tamari, K. et al.: Ethnic-, gender-, and age-related differences in femorotibial angle,
femoral antetorsion, and tibiofibular torsion: cross-sectional study among healthy
Japanese and Australian caucasians. Clin. Anat 19: 59-67, 2006.
Thacker, S.B. et al.: The prevention of ankle sprains in sports. A systematic review
205
of the literature. Am. J. Sports Med 27: 753-760, 1999.
Thordarson, D.B. et al.: Effect of partial versus complete plantar fasciotomy on the
windlass mechanism. Foot Ankle Int 18: 16-20, 1997.
Tiberio, D.: The Effect of excessive subtalar joint pronation on patellofemoral
mechanics: a theoretical model. J. Orthop. Sports Phys. Ther 9: 160-165, 1987.
᫬⏣ႛ
: 㔜ᚰືᦂ᳨ᰝ
― ⑓ ᕢ デ ᩿ ࢆ ┠ ᶆ ࡜ ࡋ ࡚ ―. Equilibrium Res 54:
172-179, 1995.
Trimble, M.H. et al.: The relationship between clinical measurements of lower
extremity posture and tibial translation. Clin. Biomech (Bristol, Avon) 17: 286-290,
2002.
Tropp, H. et al.: Prevention of ankle sprains. Am. J. Sports Med 13: 259-262, 1985.
㎷ 㔝 ⥤ Ꮚ , ⏣ ୰ ๎ Ꮚ : ㊊ ㊑ ᅽ ㏕ ຊ࡜ ๓ ᪉࣮ࣜ ࢳ ືస ᫬ ࡢ㊊ ᅽ ୰ᚰ఩ ⨨ ࡢ㛵 ಀ .
⌮Ꮫ ⒪ἲᏛ 22: 245-248, 2007.
ὠ ⏣ Ύ⨾ , Ύ Ỉ ⤖ : ண㜵 ࡜ࡋ࡚ࡢ ࢫ࣏࣮ࢶ་Ꮫ ࢫ࣏ ࣮ࢶእയ࣭㞀ᐖ ࡜ࡑࡢண
㜵࣭෌Ⓨ ண㜵 . ⮫ᗋ ࢫ࣏࣮ ࢶ་Ꮫ⦅ 㞟ጤ ဨ఍, ᩥග ᇽ , ᮾி , 25㸦⮫᫬ ቑหྕ㸧:
120-126, 2008.
Uhorchak, J.M. et al.: Risk factors associated with noncontact injury of the anterior
cruciate ligament: a prospective four-year evaluation of 859 West Point cadets. Am. J.
Sports Med 31: 831-842, 2003.
US
Lacrosse,
2011
US
lacrosse
participation
survey,
Available
at:
http://www.uslacrosse.org/LinkClick.aspx?fileticket=tIqhe4P9DsM%3d&tabid=1464
5, accessed January 10, 2013.
van Mechelen, W. et al.: Incidence, severity, aetiology and prevention of sports
injuries. A review of concepts. Sports Med 14: 82-99, 1992.
Verhagen, E. et al.: An economic evaluation of a proprioceptive balance board
training programme for the prevention of ankle sprains in volleyball. Br. J. Sports
Med 39: 111-115, 2005.
Waicus, K.M. et al.: Eye injuries in women's lacrosse players. Clin. J. Sport Med 12:
206
24-29, 2002.
Waldén M. et al.: Prevention of acute knee injuries in adolescent female football
players: cluster randomised controlled trial. BMJ 344: e3042, 2012.
Webster, D.A. et al.: Head and face injuries in scholastic women's lacrosse with and
without eyewear. Med. Sci. Sports Exerc 31: 938-941, 1999.
Wedderkopp, N. et al.: Prevention of injuries in young female players in European
team handball. A prospective intervention study. Scand. J. Med. Sci. Sports 9: 41-47,
1999.
Wen, D.Y. et al.: Injuries in runners: a prospective study of alignment. Clin. J. Sport
Med 8: 187-194, 1998.
Wiesler, E.R. et al.: Ankle flexibility and injury patterns in dancers. Am. J. Sports
Med 24: 754-757, 1996.
Wikstrom, E.A. et al.: Measurement and evaluation of dynamic joint stability of the
knee and ankle after injury. Sports Med 36: 393-410, 2006.
Wolfe, M.W. et al.: Management of ankle sprains. Am. Fam. Physician 63:
93-104, 2001.
Wong, Y.S.: Influence of the abductor hallucis muscle on the medial arch of the foot:
a kinematic and anatomical cadaver study. Foot Ankle Int 28: 617-620, 2007.
Woodford-Rogers, B. et al.: Risk factors for anterior cruciate ligament injury in high
school and college athletes. J. Athl. Train 29: 343-346, 1994.
ᒣ ཱྀ ගᅜ ࡽ : ∦ ⬮㉳❧᫬ ࡛ࡢ㊊㊑ ᒅ➽⩌ࡢᙺ๭ ࡟ࡘ࠸࡚ . 㐠 ື⏕⌮ 4: 65 -69,
1989.
Yard, E.E. et al.: The epidemiology of United States high school soc cer injuries,
2005-2007. Am. J. Sports Med 36: 1930-1937, 2008.
Yeung, M.S. et al.: An epidemiological survey on ankle sprain. Br. J. Sports Med 28:
112-116, 1994.
Yoo, J.H. et al.: A meta-analysis of the effect of neuromuscular training on the
prevention of the anterior cruciate ligament injury in female athletes. Knee Surg.
Sports Traumatol Arthrosc 18: 824-830, 2010.
207
Yoon, Y.S. et al.: Football injuries at Asian tournaments. Am. J. Sports Med 32(1
Suppl): S36-42, 2004.
Yu, B. et al.: Age and gender effects on lower extremity kinematics of youth soccer
players in a stop-jump task. Am. J. Sports Med 33: 1356-1364, 2005.
Yu, B. et al.: Lower extremity biomechanics during the landing of a stop-jump task.
Clin. Biomech 21: 297-305, 2005.
Yu, B., Garrett, W.E.: Mechanism of non-contact ACL injuries. Br. J. Sports Med
41: 47-51, 2007.
Zazulak, B.T. et al.: Gender comparison of hip muscle activity during single -leg
landing. J. Orthop. Sports Phys. Ther 35: 292-299, 2005.
Zech, A. et al.: Balance training for neuromuscular control and performance
enhancement: a systematic review. J. Athl. Train 45: 392-403, 2010.
Zelisko, J.A. et al.: A comparison of men's and women's professional baske tball
injuries. Am. J. Sports Med 10: 297-299, 1982.
Zeller, B.L. et al.: Differences in kinematics and electromyographic activity between
men and women during the single -legged squat. Am. J. Sports Med 31: 449-456, 2003.
Zhang, S.N. et al.: Contributions of lower extremity joints to energy dissipation
during landings. Med. Sci. Sports Exerc 32: 812-819, 2000.
208
ᴗ ⦼ ୍ぴ ᮏㄽᩥࡢෆᐜ ࡢ୍㒊ࡣ ࠊ௨ୗࡢㄽᩥ ࡟ᥖ㍕ࡉ ࢀ࡚࠸ࡿࠋ
1.
బ㔝ᮧᏛ㸪ධỤ୍᠇㸸㊊㊑㛤᤼⬟ࡀືⓗୗ⫥࢔ࣛ࢖࣓ࣥࢺ࡟ཬࡰࡍᙳ㡪
̿㊊㊑㛤᤼ᣦ ♧ୗࡢ∦ ⬮ࢫࢡ࣡ࢵࢺ 㸪∦⬮ ࢻ ࣟࢵࣉࣛࣥࢹ ࢕ࣥࢢ 㸪࢝ࢵࢸ
࢕ࣥࢢືసࡢ ศᯒ ̿㸬᪥ᮏ⮫ᗋࢫ࣏ ࣮ࢶ་Ꮫ ఍ㄅ㸬20(1)㸬112-121㸬2012㸬
2.
బ㔝ᮧᏛ㸪⣽ᕝ ⏤᲍㸪୰ᮧ༓⛅㸪⚟ᯘ ᚭ㸸኱ ᏛዪᏊࣛࢡࣟ ࢫ࡟࠾ࡅ ࡿ๓ྥ
ࡁയᐖㄪᰝ㸬 ᪥ᮏ⮫ᗋ ࢫ࣏࣮ࢶ་Ꮫ ఍ㄅ㸬20(3)㸬460-468㸬2012㸬
3.
బ㔝ᮧᏛ㸪㜰ཱྀ ṇᚊ㸪బಖὈ᫂㸪⚟ᯘ ᚭ㸸ࢻ ࣟࢵࣉࢪࣕࣥ ࣉ᫬࡟࠾ ࡅࡿࣛ
ࢡࣟࢫࢫࢸ࢕ ࢵࢡࡢಖ ᣢࡸ᧯సࡀୗ ⫥࢟ࢿ࣐ ࢸ࢕ࢡࢫ࣭࢟ࢿࢸ࢕ ࢡ ࢫ࡟ཬ
ࡰࡍᙳ㡪㸬⮫ ᗋࣂ࢖࢜ ࣓࢝ࢽࢡࢫ㸬 33㸬383-388㸬2012㸬
4.
బ㔝ᮧᏛ㸪ධỤ୍᠇㸸㊊㊑㛤᤼ᣦ♧ ࡀືⓗୗ ⫥࢔ࣛ࢖࣓ࣥ ࢺ࡟ཬࡰ ࡍᙳ㡪 ̿∦⬮ࢫࢡ࣡ ࢵࢺ㸪∦ ⬮ࢻࣟࢵࣉࣛ ࣥࢹ࢕ࣥ ࢢ㸪࢝ࢵࢸ ࢕ࣥࢢື స ࡢศᯒ
̿㸬᪥ᮏ⮫ᗋ ࢫ࣏࣮ࢶ ་Ꮫ ఍ㄅ㸬21(1)㸬157-164㸬2013㸬21(1)㸬2013㸬
5.
బ㔝ᮧᏛ㸪⣽ ᕝ⏤᲍㸪୰ᮧ༓⛅㸪⚟ ᯘᚭ㸸 ኱ ᏛዪᏊࣛࢡࣟ ࢫയᐖ ̿2 ᖺ
㛫ࡢ๓ྥࡁയ ᐖㄪᰝ̿ 㸬యຊ⛉Ꮫ㸬62(5)㸬2013㸬㸦accepted㸧
ᮏㄽᩥࡢෆᐜ ࡢ୍㒊ࡣ ࠊ௨ୗࡢᏛ఍ ࡟࠾࠸࡚ Ⓨ⾲ࡉࢀ࡚࠸ ࡿ 1.
బ㔝ᮧᏛ㸪ධỤ୍᠇㸸㊊㊑㛤᤼ᣦ♧ ࡟࠾࠸࡚ ࡢୗ⫥ືⓗ࢔ ࣛ࢖࣓ࣥ ࢺࡢኚ
໬㸬➨ 64 ᅇ ᪥ᮏయຊ ་Ꮫ఍኱఍ 㸪2009㸬
2.
బ㔝ᮧᏛ㸪ධ Ụ୍᠇㸸 ㊊㊑㛤᤼ࡀື ⓗୗ⫥࢔ ࣛ࢖࣓ࣥࢺ࡟ ཬࡰࡍᙳ 㡪
㸫㊊㊑㛤᤼⬟ ࡜⭸እ཯ ⋡ࡢẚ㍑㸫 㸬➨ 20 ᅇ ᪥ᮏ⮫ᗋࢫ࣏ ࣮ࢶ་Ꮫ ఍Ꮫ⾡
㞟఍㸪2009㸬
3.
Manabu, Sanomura. Toru, Fukubayashi. : Lacrosse injuries in female collegiate
athletes: A prospective study. The 3rd International Sport Sciences Symposium
on “Active Life”. Global COE Program “Sport Sciences for the Promotion of
Active Life”, Tokyo, Japan, 2010.
4.
Manabu, Sanomura. Toru, Fukubayashi. : Effect of the dominant leg and pivot
leg and foot posture on the star excursion balance test . The 4th International
209
Sport Sciences Symposium on “Active Life”. Global COE Program “Sport Sciences for the Promotion of Active Life”, Tokyo, Japan, 2010.
5.
Manabu, Sanomura. Kazunori, Irie. : Relationship between leg and foot alignment and dynamic knee valgus during single -leg squat, single-leg drop landing
and cutting tasks. The 3rd IOC World Conference on Prevention of Injury and
Illness in Sport, Monaco, 2011.
6.
Manabu, Sanomura. Masanori, Sakaguchi, Yasuaki, Saho, Toru, Fukubayashi. :
Difference in knee joint mechanics during cutting with and without a lacrosse
stick. The 5th International Sport Sciences Symposium on “Active Life”. Global
COE Program “Sport Sciences for the Promotion of Active Life” , Tokyo, Japan,
2011.
7.
బ㔝ᮧᏛ㸪⣽ᕝ ⏤᲍㸪୰ᮧ༓⛅㸪⚟ᯘ ᚭ㸸኱ ᏛዪᏊࣛࢡࣟ ࢫ➇ᢏ࡟ ࠾ࡅࡿ
๓ྥࡁയᐖㄪ ᰝ㸬 ➨ 22 ᅇ ᪥ᮏ⮫ᗋࢫ࣏ ࣮ ࢶ་ᏛᏛ⾡㞟 ఍ 㸪2011㸬
8.
బ㔝ᮧᏛ㸪㜰ཱྀ ṇᚊ㸪బಖὈ᫂㸪⚟ᯘ ᚭ㸸ࣛ ࢡࣟࢫࢫࢸ࢕ ࢵࢡಖᣢ ࡢ᭷↓
ࡀ࢝ࢵࢸ࢕ࣥ ࢢືస᫬ ࡢ⭸࢟ࢿ࣐ࢸ ࢕ࢡࢫ࡟ ཬࡰࡍᙳ㡪㸬 ➨ 38 ᅇ ᪥ᮏ⮫
ᗋࣂ࢖࣓࢜࢝ ࢽࢡࢫᏛ ఍ 㸪2011㸬
9.
Manabu, Sanomura. Masanori, Sakaguchi. Yasuaki, Saho. Toru, Fukubayashi. :
Lower extremity joint kinematics and kinetics during a drop jump task with and
without a lacrosse stick. The 6th International Sport Sciences Symposium on
“Active Life”. Global COE Program “Sport Sciences for the Promotion of A ctive Life”, Tokyo, Japan, 2012.
10. Manabu, Sanomura. Masanori, Sakaguchi. Yasuaki, Saho. Toru, Fukubayashi. :
Hip and knee joint mechanics during cutting maneuver with and without a lacrosse stick. The 59th ACSM Annual Meeting and 3rd World Congress on E xercise is Medicine, San Francisco, California, 2012.
11. Manabu, Sanomura. Masanori, Sakaguchi. Yasuaki, Saho. Toru, Fukubayashi. :
Differences in lower extremity joint kinematics and kinetics during drop vertical jumps with and without a lacrosse stick. The 17th Annual congress of the
ECSS, Bruges, Belgium, 2012.
210
Manabu, Sanomura. Yuri, Hosokawa. Takuma, Hoshiba. Yasuaki, Saho. Tsukasa,
Miyamura. Chiaki, Nakamura. Toru, Fukubayashi shi. : Prospective injury surveillance of women’s lacrosse: a 2-year study. The 18th Annual congress of the
ECSS, Barcelona, Spain, 2013.
ᮏㄽᩥࡢෆᐜ ࡢ୍㒊ࡣ ࠊ௨ୗࡢⴭ᭩ ࡟࠾࠸࡚ Ⓨ⾲ࡉࢀ࡚࠸ ࡿ 1.
బ㔝ᮧᏛ㸸ᅜ㝿࢜ࣜ ࣥ ࣆࢵࢡጤဨ఍ ࡟ࡼࡿࢫ ࣏࣮ࢶയᐖ࡟ ྥࡅࡓྲྀ ࡾ⤌ࡳ㸬
໭ி࢜ࣜࣥࣆ ࢵࢡ➇ᢏ ኱఍ࡢയᐖㄪ ᰝሗ࿌ 㸬 JATI EXPRESS㸦᪥ᮏ ࢺ࣮ࣞ
ࢽࣥࢢᣦᑟ⪅ ༠఍ᶵ㛵 ㄅ㸧 30㸪20-21㸪2012㸬
2.
బ 㔝ᮧ Ꮫ 㸸 ୗ⫥ യ ᐖ ண 㜵 ࣉࣟ ࢢ ࣛ ࣒ࡢ ᐇ 㝿 ࡜ ࡑ ࡢຠ ᯝ ➨ 1ᅇ ⭸๓ ༑ Ꮠ 㠌
ᖏᦆയண㜵ࣉ ࣟࢢ࣒ࣛ 1㸬JATI EXPRESS㸦᪥ ᮏࢺ࣮ࣞࢽࣥ ࢢᣦᑟ⪅ ༠఍ᶵ
㛵ㄅ㸧34㸪22-23㸪2013㸬
3.
బ 㔝ᮧ Ꮫ 㸸 ୗ⫥ യ ᐖ ண 㜵 ࣉࣟ ࢢ ࣛ ࣒ࡢ ᐇ 㝿 ࡜ ࡑ ࡢຠ ᯝ ➨ 2ᅇ ⭸๓ ༑ Ꮠ 㠌
ᖏᦆയண㜵ࣉ ࣟࢢ࣒ࣛ 2㸬JATI EXPRESS㸦᪥ ᮏࢺ࣮ࣞࢽࣥ ࢢᣦᑟ⪅ ༠఍ᶵ
㛵ㄅ㸧35㸪16-18㸪2013㸬
211
ㅰ㎡
ᮏㄽᩥࡣ᪩✄⏣኱Ꮫࢫ࣏࣮ࢶ⛉ᏛᏛ⾡㝔 ⚟ᯘᚭᩍᤵࡢᣦᑟࡢࡶ࡜࡟⾜ࢃࢀ
ࡓࡶࡢ࡛࠶ࡾ 㸪✏ࢆ⤊ ࠼ࡿ࡟࠶ࡓࡾ 㸪㐺᫬ຓ ゝ㸪ᣦᑟࡋ࡚ ࠸ࡓࡔ࠸ ࡓ ඛ⏕࡟῝
ࡃឤㅰࡢពࢆ ⾲ࡍࡿ㸬ࡉࡽ࡟᪩✄⏣ ኱Ꮫࢫ࣏ ࣮ࢶ⛉ᏛᏛ⾡ 㝔 㔠ᒸ ᜏ἞ᩍᤵ 㸪ᗈ
℩⤫୍෸ᩍᤵ ࡟ࡣࡈከ ᛁࡢ୰㸪ᑂᰝ ဨ࡜ࡋ࡚ ぶ㌟࡞ࡈᣦᑟ 㸪ࡈᣦ᦬ ࢆ㈷ࡾᚰࡼ
ࡾឤㅰࡍࡿ 㸬᪥ᮏ య⫱ ኱Ꮫ኱Ꮫ㝔 ධỤ ୍᠇ ᩍᤵ࡟ࡣ ኱Ꮫ 㝔༤ኈ๓ ᮇㄢ⛬࡟⥆ࡁ
ࡈከᛁࡢ୰㸪 ࡈᣦᑟࢆ ㈷ࡾᚰ࠿ࡽឤ ㅰ ࡍࡿ㸬 ᪩✄⏣኱Ꮫ኱ Ꮫ㝔ࢫ࣏ ࣮ࢶ⛉Ꮫ◊
✲⛉⏕యࢲ࢖ ࢼ࣑ࢡࢫ ◊✲ᐊ 㜰ཱྀṇᚊ ࡉࢇ ࡟ ࡣືసᐇ㦂 ࡸືసゎ ᯒ㸪ࡲࡓ 㸪Ꮫ
఍Ⓨ⾲➼࡟࠾ ࠸࡚࡟ከ ኱࡞ࡿ ࠾ຊῧ ࠼ࢆ㈷ࡾ ῝ࡃឤㅰࡍࡿ 㸬ࡑࡋ࡚ බ⚾ඹ࡟ᨭ
࠼࡚㡬࠸ࡓ᪩ ✄⏣኱Ꮫ ኱Ꮫ㝔ࢫ࣏࣮ ࢶ⛉Ꮫ◊ ✲⛉ࢫ࣏࣮ࢶ እ⛉Ꮫ◊ ✲ᐊ࡟ᡤᒓ
ࡍࡿⓙᵝ㸪⿕ 㦂⪅ࢆᛌ ㅙࡋ࡚࠸ࡓࡔ ࠸ࡓ ᪩✄ ⏣኱ᏛዪᏊࣛ ࢡࣟࢫ㒊 ဨ࠾ࡼࡧ㛵
ಀ⪅ࡢⓙᵝ࡟ ᚰ࠿ࡽឤ ㅰࡍࡿ㸬ࡇࢀ ࡲ࡛ࡢ㛗 ࠸ ே⏕⏕ά࠾ ࡼࡧ኱Ꮫ 㝔⏕ά ࢆᨭ
࠼࡚࠸ࡓࡔ࠸ ࡓ୧ぶ ࡟ ῝ࡃឤㅰࡍࡿ 㸬᭱ᚋ࡟ 㸪኱Ꮫ㝔༤ኈ ๓ᮇㄢ⛬ ࡟⥆ࡁ᪩✄
⏣኱Ꮫ኱Ꮫ㝔 ༤ኈᚋᮇ ㄢ⛬࡬ࡢ㐍Ꮫ ࡬ࡢ⌮ゎ 㸪ࡑࡋ࡚◊✲ ࠾ࡼࡧㄽ ᩥᇳ➹࡟ᑐ
ࡍࡿ⃭ບ➼㸪 ඲࡚࡟࠾ ࠸࡚ ᭱ᚋࡲ࡛ ࠿ࡃぢ Ᏺࡗ࡚࠸ࡓࡔ ࠸ࡓ⚾ࡢ ጔ࡟ᚰࡼࡾ
ឤㅰ⮴ࡋࡲࡍ 㸬
212

公益社団法人宇都宮青年会議所 2015年度理事長所信

Broschure 1

2015 年度 札幌記録会 第 6 戦 開催要項

KINECT を使用した立ち上がり/関節モーメント/座り込み