2019 Fiscal Year Final Research Report
Elucidation of factors associated with worsening severity of peripheral arterial disease by focusing on physical activity intensity
| Project/Area Number |
17K01478
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Rehabilitation science/Welfare engineering
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| Research Institution | Juntendo University (2018-2019)
Tokyo University of Technology (2017) |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Keywords | 末梢動脈疾患 / 重症虚血肢 / 身体活動 / 重症化予防 |
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| Outline of Final Research Achievements |
Physical activity after revascularization for peripheral arterial disease was more likely to increase in duration of activity of moderate or greater exercise intensity than in average daily steps, especially after surgical revascularization. Physical function at discharge was also associated with physical activity at 3 months after revascularization.
Patients with severe ischemic limb had a higher recurrence rate of 38% with re-wounding at the site of healed wound, and the associated factors were ankle dorsiflexion restriction, decreased blood flow, perceptual impairment, muscle weakness, and decreased physical activity. On the other hand, walking speed was generally slower due to ischemic pain and wound care, and there was no relationship between sole pressure during walking and wound recurrence.
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| Free Research Field |
心臓血管病のリハビリテーション
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| Academic Significance and Societal Importance of the Research Achievements |
末梢動脈疾患は血行再建術により身体活動量は改善する。特に明らかな症状の改善により、退院後1カ月後から3.0Mets以上の中～高強度の身体活動を増加させることができる。退院時の身体機能が退院後の身体活動量の回復に関係するので、退院時の身体機能評価や生活指導が重要である。
一方、末梢動脈疾患が進行し、ひとたび重症下肢虚血を呈すると予後は不良で、運動療法によってその活動範囲を維持ししたり、創部の血流を維持すること難しく、虚血痛や創傷への不安から歩行速度は総じて遅く、歩行時の創部のストレスは決して高くないが、創傷再発が高率で認められる。重症虚血肢では身体活動強度に依らない厳重な創部保護が必要である。
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