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糖尿病が併存する人工膝関節全置換術後患者の長期経過と最適な介入方法の効果検証

糖尿病患者全膝关节置换术后远期病程及最佳干预方法效果的验证

基本信息

批准号：
19K19749
负责人：
藤田玲美
金额：
$ 2.33万
依托单位：
Seijoh University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Early-Career Scientists
财政年份：
2019
资助国家：
日本
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

项目摘要

変形性膝関節症（膝OA）と糖尿病は互いの疾患のリスクを高める．末期膝OA患者において，症状が軽減しない場合には人工膝関節全置換術 (TKA) 等の手術の適応となる．TKAは，膝痛の改善や身体機能・身体活動量の向上に有効であるといわれているが，糖尿病が併存するTKA患者を対象にTKA前後で糖尿病指標を比較した研究では，膝機能や身体機能，質問紙で評価した身体活動レベルは向上したが糖尿病指標は変化しなかったと報告されている．その理由として，身体活動量増加に焦点を当てた介入をしておらず，糖尿病指標改善が見込まれる強度の活動をしていないことが考えられる．本研究の目的は糖尿病が併存するTKA後患者に対する効果的な介入を検討するために，TKA後の膝機能・身体機能・QOL・身体活動量・糖尿病指標・姿勢・運動セルフエフィカシーを長期にわたって調査し，糖尿病の改善に関連する項目を検討すること（研究①），申請者が提案する運動介入方法の効果検証を行うこと（研究②）である．2022年度は，研究②の申請者が提案する運動介入方法（Draw-in歩行）の効果検証を行った．コロナウイルス感染拡大により，研究対象者の確保が難しく，9名の生活習慣病が併存する整形外科疾患患者を対象とし，3ヶ月間Draw-in歩行を行った．1日合計20分，毎日実施するよう指導し，歩行実施時間を運動記録表に記載して，運動実施率を算出した．また，介入前と3ヶ月終了した時点でアウトカム指標（健康関連QOL，体重，筋量，腹囲，血液検査データ）を測定した．その結果，運動実施率は97.4%であった．介入3ヶ月後に改善がみられた項目は，健康関連QOLの身体的側面スコア，体重，体幹筋量，腹囲，HDLコレステロール，ヘモグロビンA1cであった．

Deformable knee syndrome (knee OA) is associated with diabetes mellitus and mutual disease. Patients with end-stage knee OA are suffering from atypical dyspnea, and the symptoms are complicated with surgery such as total knee surgery (TKA). TKA is used to improve knee pain, and the amount of physical activity can be improved. In patients with diabetes mellitus, patients with diabetes mellitus were enrolled in the study of diabetes mellitus index comparison study before and after TKA, the knee machine was able to perform physical function, and the knee machine was able to detect physical activity and increase the level of physical activity in patients with diabetes mellitus. The reason is poor, the amount of physical activity increases the focus when the device is involved. Diabetes refers to the improvement of exercise activity. The purpose of this study is to investigate the effects of diabetes on the outcome of diabetes patients after TKA. The purpose of this study is to investigate the effects of diabetes on the outcome of diabetes patients after TKA. The purpose of this study is to investigate the physical function of QOL after TKA. The Diabetes improvement Program (study 1), the applicant proposed the intervention method (study 2), and the applicant proposed the intervention method (study 2). In the year 2022, the applicant proposed the exercise intervention method (Draw-in line). The results of the study show that the patients are not infected with the disease, and the researchers are sure to ensure that they are infected. In 9 patients with orthopedic diseases, 9 patients with orthopedic diseases had abnormal symptoms, and the total score of Draw-in training was 20 points in 3 months. The daily exercise instruction was performed, the exercise time was recorded, and the exercise rate was calculated. The exercise rate was calculated 3 months before the intervention, and the health index (QOL, body weight, muscle weight, abdominal pain) was recorded at different times 3 months before the intervention. The results showed that the exercise rate was 97.4%. After 3 months of intervention, we improved the health care program, QOL the face, weight, muscle mass, abdomen, HDL, weight, and A1c test.