COPD患者の呼吸リハビリテーションにおける加圧筋力トレーニングの応用

• 研究課題/領域番号: 21500465
• 研究種目: 基盤研究(C)
• 配分区分: 補助金
• 応募区分: 一般
• 研究分野: リハビリテーション科学・福祉工学
• 研究機関: 国際医療福祉大学
• 研究代表者: 永田 泰自 国際医療福祉大学, 臨床医学研究センター, 教授 (20272552)
• 研究分担者: 中島 敏明 東京大学, 医学部附属病院, 特任准教授 (50227790)
• 研究期間 (年度): 2009 – 2011
• 研究課題ステータス: 完了 (2011年度)
• 配分額: 4,420千円 (直接経費: 3,400千円、間接経費: 1,020千円); 2011年度: 1,040千円 (直接経費: 800千円、間接経費: 240千円); 2010年度: 1,560千円 (直接経費: 1,200千円、間接経費: 360千円); 2009年度: 1,820千円 (直接経費: 1,400千円、間接経費: 420千円)
• キーワード: 呼吸リハビリテーション / 慢性閉塞性肺疾患(COPD) / 加圧筋力トレーニング / COPD / サルコペニア / 高齢者 / 酸化ストレス / 加齢 / 炎症 / C反応性タンパク / 筋萎縮 / 静脈コンプライアンス

研究概要

はじめに、血流制限(加圧)の凝固系への急性の影響を検討した。健常人のレッグプレスでは、加圧はprothrombin fragment 1+2(PTF)、thrombin-antithrombin III complex(TAT)、D-dimer、fibrin degradation product(FDP)といった凝固系の指標に影響せず、加圧トレーニングの安全性が示された。次に、セラバンド(elastic band)を用いた加圧トレーニングの筋活動への影響を検討した。健常人のアームカールでは、加圧により上腕二頭筋は筋電図上筋活動が著明に亢進し、血中乳酸濃度、Borgスケールも増加した。加圧はセラバンドによる比較的軽い負荷でも著明に筋線維を動員し筋活動を亢進させると考えられた。さらに、COPD患者において、フリーウェイトでのアームカール運動の筋活動への影響を検討した。加圧により筋電図上の筋活動が亢進し、血中乳酸濃度、Borgスケールも増加したが、SpO_2の低下はきたさなかった。加圧トレーニングはCOPD患者において、フリーウェイト、ゴムバンド使用などの低強度で手軽な運動様式でも安全かつ効果的に筋活動を亢進させると考えられた。最後に、加圧トレーニングの慢性効果をCOPD患者で検討した。加圧下のレッグエクステンションにより、QOLの改善、筋力と筋量の増加が確認され、軽度ながら最大吸気圧(PImax)および最大呼気圧(PEmax)も改善した。なお、COPD患者がサルコペニアをきたす原因として、COPDだけでなく高齢も重要である。そこで高齢者において加圧ウォーク(加圧下の歩行)が、QOL、筋力などに及ぼす効果を検討した。加圧により筋力は有意に増加し、timed Up & goおよびchair stand testの機能向上も見られた。サルコペニアを有するCOPD患者では、加圧ウォークも、安全で効果的な筋力トレーニングとなる可能性が示唆された。今後、症例を増やして研究を継続する予定である。

研究成果

• [雑誌論文] Blood Flow restrcited exercise in a ballet dancer with Churg-Strauss syndrome (2011)
  • 著者名/発表者名: Madarame H, Takano H, Iida H, Hashida H, Morita T and Nakajima T.
  • 雑誌名: Gazzetta Medica Italiana 巻: 170 ページ: 63-67
• [雑誌論文] Effects of 10-Weeks Walk Training With Leg Blood Flow Reduction on Carotid Arterial Compliance and Muscle Size in the Elderly Adults (2011)
  • 著者名/発表者名: Ozaki H, Miyachi M, Nakajima T, Abe T.
  • 雑誌名: Angiology 巻: 62 ページ: 81-86
• [雑誌論文] Increases in thigh muscle volume and strength by walk training with leg blood flow reduction in older participants (2011)
  • 著者名/発表者名: Ozaki H, Sakamaki M, Yasuda T, Fujita S, Ogasawara R, Sugaya M, Nakajima T, Abe T.
  • 雑誌名: J Gerontol A Biol Sci Med Sci 巻: 66 ページ: 257-263
• [雑誌論文] Effects of walking with blood flow restriction on limb venous compliance in elderly subjects (2011)
  • 著者名/発表者名: Iida H, Nakajima T, Kurano M, Yasuda T, Sakamaki M, Sato Y, Yamasoba T, Abe T.
  • 雑誌名: Clin Physiol Funct Imaging 巻: 31 ページ: 472-476
• [雑誌論文] Cardiac rehabilitation decreases plasma pentraxin 3 in patients with cardiovascular diseases (2011)
  • 著者名/発表者名: Fukuda T, Kurano M, Iida H, Takano H, Tanaka T, Yamamoto Y, Ikeda K, Nagasaki M, Monzen K, Uno K, Kato M, Shiga T, Maemura K, Matsuda N, Yamashita Y, Hirata Y, Nagai R, Nakajima T.
  • 雑誌名: Eur J Cardiovasc Prev Rehabil
  • URL: http://cpr.sagepub.com/content/early/2011/09/09/1741826711422990.full.pdf
• [雑誌論文] Effects of Exercise and Anti-Aging (2011)
  • 著者名/発表者名: Nakajima T, Yasuda T, Sato Y, Morita T, Yamasoba T.
  • 雑誌名: Anti-Aging Medicine 巻: 8 ページ: 92-102
  • NAID: 130002116544
• [雑誌論文] Key considerations when conducting KAATSU training (2011)
  • 著者名/発表者名: Nakajima T, Morita T, Sato Y.
  • 雑誌名: Int J KAATSU Training Res 巻: 7 ページ: 1-6
• [雑誌論文] A case of dementia presenting remarkable improvement in activities of daily living through KAATSU training (2011)
  • 著者名/発表者名: Fukuda T, Fukumura K, Uchida Y, Ootsuka T, Yasuda T, Iida H, Morita T, Nagata T, Sato Y, Nakajima T.
  • 雑誌名: Int J KAATSU Training Res 巻: 7 ページ: 13-17
• [雑誌論文] Effects of serum amyloid A and lysophosphatidylchoilne on intracellular calcium concentration in human coronary smooth muscle cells (2011)
  • 著者名/発表者名: Tanaka T, Ikeda K, Yamamoto Y, Iida H, Kikuchi H, Morita T, Yamasoba T, Nagai R, Nakajima T.
  • 雑誌名: Int Heart J 巻: 52 ページ: 185-193
• [雑誌論文] High frequency powers hidden within QRS complex as an additional predictor of lethal ventricular arrhythmias to ventricular late potential in post-myocardial infarction patients (2011)
  • 著者名/発表者名: Tsutsumi T, Takano N, Matsuyama N, Higashi Y, Iwasawa K, Nakajima T.
  • 雑誌名: Heart Rhythm 巻: 8 ページ: 1509-1515
• [雑誌論文] Developmental changes in the expression of Kv1 potassium channels in rat vestibular ganglion cells (2011)
  • 著者名/発表者名: Iwasaki S, Nakajima T, Chihara Y, Inoue A, Fujimoto C, Yamasoba T.
  • 雑誌名: Brain Research 巻: 1429 ページ: 29-35
• [雑誌論文] Time frequency power profile of QRS complex obtained with wavelet transform in spontaneously hypertensive rats (2011)
  • 著者名/発表者名: Takano NK, Tsutsumi T, Suzuki H, Okamoto Y, Nakajima T.
  • 雑誌名: Comput Biol Med 巻: 42 ページ: 205-212
• [雑誌論文] Cardiac rehabilitation decreases plasma pentraxin 3 in patients with cardiovascular diseases (2011)
  • 著者名/発表者名: Fukuda T, Kurano M, Iida H, Takano H, Tanaka T, Yamamoto Y, Ikeda K, Nagasaki M, Monzen K, Uno K, Kato M, Shiga T, Maemura K, Matsuda N, Yamashita Y, Hirata Y, Nagai R, Nakajima T
  • 雑誌名: Eur J Cardiovasc Prev Rehabil 巻: Epub Sep 13
  • 査読あり
• [雑誌論文] Effects of exercise and anti-aging (2011)
  • 著者名/発表者名: Nakajima T, Yasuda T, Sato Y, Morita T, Yamasoba T
  • 雑誌名: Anti-Aging Medicine 巻: 8 ページ: 92-102
  • NAID: 130002116544
  • 査読あり
• [雑誌論文] Effects of 10- Weeks Walk Training With Leg Blood Flow Reduction on Carotid Arterial Compliance and Muscle Size in the Elderly Adults. (2011)
  • 著者名/発表者名: Ozaki H, Miyachi M, Nakajima T, Abe T
  • 雑誌名: Angiology 巻: 62 ページ: 81-86
  • 査読あり
• [雑誌論文] Increases in thigh muscle volume and strength by walk training with leg blood flow reduction in older participants. (2011)
  • 著者名/発表者名: Ozaki H, Sakamaki M, Yasuda T, Fujita S, Ogasawara R, Sugaya M, Nakajima T, Abe T
  • 雑誌名: J Gerontol A Biol Sci Med Sci 巻: 66 ページ: 257-263
  • 査読あり
• [雑誌論文] Blood Flow restricted exercise in a ballet dancer with Churg-Strauss syndrome. (2011)
  • 著者名/発表者名: Madarame H, Kurano M, Takano H, Iida H, Morita T, Nakajima T
  • 雑誌名: Gazzetta Medica Italiana 巻: 170 ページ: 63-67
  • 査読あり
• [雑誌論文] Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in elderly subjects (2010)
  • 著者名/発表者名: Abe T, Sakamaki M, Fujita S, Ozaki H, Sugaya M, Sato Y, Nakajima T.
  • 雑誌名: J Geriatr Phy Ther 巻: 33 ページ: 34-40
• [雑誌論文] Effects of low-intensity resistance exercise with blood flow restriction on coagulation system in healthy subjects (2010)
  • 著者名/発表者名: Madarame H, Kurano M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T and Nakajima T.
  • 雑誌名: Clinical Physiology and Functional Imaging 巻: 30 ページ: 210-3
• [雑誌論文] Effects of Acute Hypoxia at Moderate Altitude on Stroke Volume and Cardiac Output During Exercise (2010)
  • 著者名/発表者名: Fukuda T, Maegawa T, Matsumoto A, Komatsu Y, Nakajima T, Nagai R, Kawahara T.
  • 雑誌名: Int Heart J 巻: 51 ページ: 170-5
  • NAID: 130000250213
• [雑誌論文] Venous blood gas and metabolite response to low-intensity muscle contractions with external limb compression (2010)
  • 著者名/発表者名: Yasuda T, Abe T, Brechue WF, Iida H, Takano H, Meguro K, Kurano M, Fujita S, Nakajima T.
  • 雑誌名: Metabolism 巻: 59 ページ: 1510-1519
• [雑誌論文] Effects of low-intensity KAATSU resistance training on skeletal muscle size/strength and endurance capacity in patients with ischemic heart disease (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Sakagami F, Iida H, Fukumura K, Fukuda T, Takano H, Madarame H, Yasuda T, Nagata T, Sato Y, Yamasoba T, Morita T.
  • 雑誌名: Int J KAATSU Training Res 巻: 6 ページ: 1-7
• [雑誌論文] Muscle volume and strength and arterial compliance after walk training with blood flow restriction in elederly women (2010)
  • 著者名/発表者名: Ozaki H, Miyauchi M, Nakajima T, Abe T.
  • 雑誌名: J Am Geriatr Soc 巻: 58 ページ: 1597-1598
• [雑誌論文] Pentraxin3 and hsCRP are independent inflammatory markers released during high-intensity exercise (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Hasegawa T, Takano H, Iida H, Yasuda T, Fukuda T, Madarame H, Uno K, Meguro K, Shiga T, Sagara M, Nagata T, Maemura K, Hirata Y, Yamasoba T, Nagai R.
  • 雑誌名: Eur J Appl Physiol 巻: 110 ページ: 905-913
• [雑誌論文] Effects of low-intensity cycle training with restricted leg blood flow on thigh muscle volume and VO_<2max> in young men (2010)
  • 著者名/発表者名: Abe T, Fujita S, Nakajima T, Sakamaki M, Ozaki H, Ogasawara R, Sugaya M, Kudo M, Kurano M, Yasuda T, Sato Y, Ohshima H, Mukai C, Ishii N.
  • 雑誌名: Journal of Sports Science and Medicine 巻: 9 ページ: 452-458
• [雑誌論文] Pentraxin3 and hsCRP are independent inflammatory markers released during high-intensity exercise. (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Hasegawa T, Takano H, Iida H, Yasuda T, Fukuda T, Madarame H, Uno K, Meguro K, Shiga T, Sagara M, Nagata T, MaemuraK, Hirata Y, Yamasoba T, Nagai R
  • 雑誌名: Eur J Appl Physiol 巻: 110 ページ: 905-913
  • 査読あり
• [雑誌論文] Effects of low-intensity resistance exercise with blood flow restriction on coagulation system in healthy subjects. (2010)
  • 著者名/発表者名: Madarame H, Kurano M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T, Nakajima T
  • 雑誌名: Clinical Physiology and Functional Imaging 巻: 30 ページ: 210-213
  • 査読あり
• [雑誌論文] Effects of acute hypoxia at moderate altitude on stroke volume and cardiac output during exercise. (2010)
  • 著者名/発表者名: Fukuda T, Maegawa T, Matsumoto A, Komatsu Y, Nakajima T, Nagai R, Kawahara T
  • 雑誌名: Int Heart J 巻: 51 ページ: 170-175
  • NAID: 130000250213
  • 査読あり
• [雑誌論文] Venous blood gas and metabolite response to low-intensity muscle contractions with external limb compression. (2010)
  • 著者名/発表者名: Yasuda T, Abe T, Brechue WF, Iida H, Takano H, Meguro K, Kurano M, Fujita S, Nakajima T
  • 雑誌名: Metabolism 巻: 59 ページ: 1510-1519
  • 査読あり
• [雑誌論文] Muscle volume and strength and arterial compliance after walk training with blood flow restriction in elederly women. (2010)
  • 著者名/発表者名: Ozaki H, Miyauchi M, Nakajima T, Abe T
  • 雑誌名: J Am Geriatr Soc 巻: 58 ページ: 1597-1598
  • 査読あり
• [雑誌論文] Effects of low-intensity KAATSU resistance training on skeletal muscle size/strength and endurance capacity in patients with ischemic heart disease. (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Sakagami F, Iida H, Fukumura K, Fukuda T, Takano H, Madarame H, Yasuda T, Nagata T, Sato Y, Yamasoba T, Morita T
  • 雑誌名: Int J KAATSU Training Res 巻: 6 ページ: 1-7
  • 査読あり
• [雑誌論文] 最大負荷運動と持続運動による血管内皮前駆細胞およびサイトカインに及ぼす急性効果の違い (2010)
  • 著者名/発表者名: 目黒健太郎、目黒美葉、安田智洋、高橋昇子、高橋政夫、高野治人、森田敏宏、佐田政隆、平田恭信、永井良三、中島敏明
  • 雑誌名: 日本心臓リハビリテーション(JJCR) 巻: 15 ページ: 160-164
  • 査読あり
• [雑誌論文] Venous blood gas and metabolite response to low-intensity muscle contractions with external limb compression (2010)
  • 著者名/発表者名: Yasuda T, Abe T, Brechue WF, Iida H, Takano H, Meguro K, Kurano M, Fujita S, Nakajima T.
  • 雑誌名: Metabolism (In press, 未定)
  • 査読あり
• [雑誌論文] Effects of acute hypoxia at moderate altitude on stroke volume and cardiac output during exercise (2010)
  • 著者名/発表者名: Fukuda T, Maegawa T, Matsumoto A, Komatsu Y, Nakajima T, Nagai R, Kawahara T.
  • 雑誌名: International Heart Journal (In press, 未定)
  • NAID: 130000250213
  • 査読あり
• [雑誌論文] Effects of low-intensity resistance exercise with blood flow restriction on coagulation system in healthy subjects (2010)
  • 著者名/発表者名: Madarame H, Kurano M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T, Nakajima T.
  • 雑誌名: Clinical Physiology and Functional Imaging (In press, 未定)
  • 査読あり
• [雑誌論文] Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in elderly subjects (2010)
  • 著者名/発表者名: Abe T, Sakamaki M, Fujita S, Ozaki H, Sugaya M, Sato Y, Nakajima T.
  • 雑誌名: J Geriatr Phy Ther (In press, 未定)
  • 査読あり
• [学会発表] Effects of low-intensity resistance exercise with restricting muscle blood flow(KAATSU) on intracellular PTX3 and MPO in neutrophils (2011)
  • 著者名/発表者名: Nakajima T, Kurano M, Hasegawa T, Takano H, Iida H, Fukuda T, Madarame H, Fukumura K, Sato Y, Morita T.
  • 学会等名: The 58^<th> American College of Sports Medicine
  • 発表場所: Denver, Colorado, USA
• [学会発表] Effects of low-intensity resistance exercise with restricting muscle blood flow (KAATSU) on intracellular PTX3 and MPO in neutrophils (2011)
  • 著者名/発表者名: Nakajima T, Kurano M, Hasegawa T, Takano H, Iida H, Fukuda T, Madarame H, Fukumura K, Sato Y, Morita T
  • 学会等名: The 58^<th> American College of Sports Medicine
  • 発表場所: Denver, Colorado, USA
• [学会発表] Acute high-intensity exercise releases myeloperoxidase and pentraxin3 from peripheral neutrophils in healthy subjects (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Takano H, Iida H, Fukuda T, Meguro K, Shiga T, Sagara M, Maemura K, Hirata Y, Yamasoba T, Nagai R.
  • 学会等名: The Scientific Sessions, American Heart Association 2010
  • 発表場所: Chicago, Ilinois
• [学会発表] Low-intensity resistance exercise with blood flow restriction does not activate coagulation system in young men (2010)
  • 著者名/発表者名: Madarame H, Kurano M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T, Nakajima T.
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Low-intensity walk training with blood-flow reduction concurrently improved VO2_<peak> and muscular function in elderly women (2010)
  • 著者名/発表者名: Ozaki H, Sakamaki M, Ogasawara R, Suguya M, Yasuda T, Sato Y, Nakajima T, Abe T.
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Concurrent improvement in muscle vlolume and VO_<2max> in respsonse to blood flow restricted cycle training (2010)
  • 著者名/発表者名: Abe T, Fujita S, Nakajima T, Sakamaki M, Ozaki H, Ogasawara R, Sugiya M, Kudo M, Kurano M, Yasuda T, Sato Y, Ohshima H, Mukai C, Ishii N.
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Effects of low-intensity KAATSU resistance training on skeletal muscle size and muscle strength/endurance capacity in patients with ischemic heart diseases (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Iida H, Takano H, Madarame H, Yasuda T, Sato Y, Morita T
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Low-intensity resistance exercise with blood flow restriction does not activate coagulation system in young men. (2010)
  • 著者名/発表者名: Madarame H Kurano M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T, Nakajima T
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Low-intensity walk training with blood-flow reduction concurrently improved VO2peak and musclular function in elderly women. (2010)
  • 著者名/発表者名: Ozaki H, Sakamaki M, OgasawaraR, Suguya M, Yasuda T, Sato Y, Nakajima T, Abe T
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Concurrent improvement in muscle volume and VO2max in response to blood flow restricted cycle training. (2010)
  • 著者名/発表者名: Abe T, Fujita S, Nakajima T, Sakamaki M, Ozaki H, OgasawaraR, Sugiya M, Kudo M, Kurano M, Yasuda T, Sato Y, Ohshima H, Mukai C, Ishii N
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Effects of low-intensity KAATSU resistance training on skeletal muscle size and muscle strength/endurance capacity in patients with ischemic heart diseases. (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Iida H, Takano H, Madarame H, Yasuda T, Sato Y, Morita T
  • 学会等名: The 57^<th> American College of Sports Medicine
  • 発表場所: Baltimore, Maryland, USA
• [学会発表] Acute high-intensity exercise releases myeloperoxidase and pentraxin3 from peripheral neutrophils in healthy subjects. (2010)
  • 著者名/発表者名: Nakajima T, Kurano M, Takano H, Iida H, Fukuda T, Meguro K, Shiga T, Sagara M, Maemura K, Hirata Y, Yamasoba T, Nagai R
  • 学会等名: The Scientific Sessions, American Heart Association
  • 発表場所: Chicago, Illinois, USA
• [学会発表] Six-week blood flow restricted walking training improves limb venous compliance in elderly subjects (2009)
  • 著者名/発表者名: Nakajima T, Iida H, Kurano M, Takano H, Yasuda T, Fujita S, Morita T, Sato Y, Yamasoba T, Abe T.
  • 学会等名: American Heart Association
  • 発表場所: Florida, U.S.A.
  • 年月日: 2009-11-17
• [学会発表] Effects of 42 weeks walk training with blood flow reduction on muscle size and strength in the elderly (2009)
  • 著者名/発表者名: Abe T, Ozaki H, Sugaya M, Fujita S, Sakamaki M, Sato Y, Bemben MG, Nakajima T.
  • 学会等名: The 1^<st> International Conference on Sports and Exercise Science
  • 発表場所: Bangkok, Thailand
• [学会発表] Cardiovascular and metabolic responses to walking with and without leg blood flow reduction (2009)
  • 著者名/発表者名: Ozaki H, Kusuhara K, Sato Y, Brechue WF, Ogita F, Nakajima T, Abe T.
  • 学会等名: The 1^<st> International Conference on Sports and Exercise Science
  • 発表場所: Bangkok, Thailand
• [学会発表] Six-week blood flow restricted walking training improves limb venous compliance in elderly subjects (2009)
  • 著者名/発表者名: Nakajima T, Iida H, Kurano M, Takano H, Yasuda T, Fujita S, Morita T, Sato Y, Yamasoba T, Abe T.
  • 学会等名: The Scientific Sessions, American Heart Association 2009
  • 発表場所: Orlando, Florida, USA
• [学会発表] Effects of 6-week Kaatsu walking on limb venous compliance in elderly subject (2009)
  • 著者名/発表者名: Nakajima T, Kurano M, Iida H, Takano H, Yasuda T, Fujita S, Morita T, Sato Y, Yamasoba T, Abe T.
  • 学会等名: The 56^<th> American College of Sports Medicine
  • 発表場所: Seattle, Washington, USA
• [学会発表] Effecst of Kaatsu training on haemostasis in healthy subjects (2009)
  • 著者名/発表者名: Takano H, Nakajima T, Kurano M, Kubota N, Iida H, Yasuda T, Sato Y, Ohshima H, Abe T, Ishii N, Morita T.
  • 学会等名: The 56^<th> American College of Sports Medicine
  • 発表場所: Seattle, Washington, USA
• [図書] リハ医とコメディカルのための最新リハビリテーション医学(編集主幹 上月正博、芳賀信彦、生駒一憲)(先端医療シリーズ40) (2010)
  • 著者名/発表者名: 中島敏明
  • 出版者: 先端医療技術研究所