Clinical reasoning system based on physical therapy diagnostics in adults with knee osteoarthritis

Research Project

Project/Area Number	18K17738
Research Category	Grant-in-Aid for Early-Career Scientists
Allocation Type	Multi-year Fund
Review Section	Basic Section 59010:Rehabilitation science-related
Research Institution	Tokoha University
Principal Investigator	Amano Tetsuya 常葉大学, 保健医療学部, 准教授 (10617070)
Project Period (FY)	2018-04-01 – 2022-03-31
Project Status	Completed (Fiscal Year 2021)
Budget Amount *help	¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000) Fiscal Year 2021: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000) Fiscal Year 2020: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000) Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Keywords	変形性関節症 / 予後予測 / 効果判定 / 転倒 / 筋力 / 多施設共同研究 / 変形性膝関節症 / 臨床予測式 / 理学療法診断学 / 理学療法診断 / 診断特性
Outline of Final Research Achievements	The purpose of this study was to construct an objective clinical reasoning system for physical therapy in community-dwelling older adults with knee osteoarthritis. Specifically, we examined indexes that are useful to predict the prognosis of patients and to determine the effects on physical therapy. From the results of our study, a screening tool consisting of three items (previous history of falls, one-leg standing test, five times sit-to-stand test) possesses potential clinical utility for identifying patients with knee osteoarthritis at high risk of falls in the future. Clarifying the minimal detectable change of the muscle strength test using hand-held dynamometer brought the useful index for the interpretation of the changes of muscle strengths by the resistance training exercises over time in the patients with knee osteoarthritis in this study.
Academic Significance and Societal Importance of the Research Achievements	高齢者の転倒は寝たきりに繋がる可能性が高く、変形性膝関節症は転倒の危険因子である。本研究で導出したスクリーニングツールは転倒リスクの高い症例を特定できるため、適切かつ効果的な転倒予防対策に役立つ指標となる可能性がある。変形性膝関節症患者に対する理学療法として大腿四頭筋を中心とした筋力増強運動が指導・実施されている。対象者の筋力の経時的変化を的確に把握するためには筋力テストの測定誤差を明らかにする必要がある。本研究で得られた膝関節の筋力テストの測定誤差を明らかにすることができたため、筋力増強運動の効果判定に役立つ指標となる可能性がある。