01 円背姿勢を呈した腰部変形性脊椎症に対し大腰筋の筋力増 …

1 01 1 2) 1) 1) 1) 1) 1) 3) 1) 2) 3) 70 DEXA(dual energy X-ray absorptiometry) 74% 20 150cm ( / ) 4/4 wall-occiput distance test( WOD) 5cm 45 1 20 2 8 16 ( / ) 5/5 WOD 3cm 0 15 15 45 45 02 1 1 1 1 1 1 2 3 1 2 3 [ ] [ ] 70 1 4 [ / ]

2 20 / -5 -5 /-10 -5 /-10 2 Wall occiput distance WOD 7cm [ ] 30 3 1 20 2 5 10 [ ] [ / ] 25 / 0 0 /-5 0 /-5 WOD [ ] White 03 1) 1)2) 1) 1) 1) 2) [ ] ( :LLB) [ ] 80 Th12-L2 [ ] MMT (2/2) (3/3) (2/2) (2/2) (2) III L2 [ ] 1 LLB [ ] MMT (3/3) (4/4) (3/3) (3/3)

3 II 10m [ ] LLB LLB LLB [ ] LLB 04 1) 1) 1) 2) 1) 2) 70 MRI 2 3 3 4 2 1 NRS 8/10 10 25 2 T 5 30 1 2 3 4

4 05 III 06 NPPV ADL NPPV CO2 NPPV ADL

5 92 2016 11 11/13 SPO2 70% 10L CO2 BiPAP 11/15 ( ) 10-20 30 400ml CO2 high PEEP FiO2 PCO2 11/18 BiPAP 11/24 CO2 400 600ml Ex PCO2 11/30 BiPAP ADL CO NPPV CO2 NPPV ADL 07 1) 1,2) 1)

6 1 2 90 CTR 72 EF 52 MR AR Stridor BP 120/60 130/70 mmHg HR 80 120 bpm SpO2 98 98 % 2 5m FIM 60 BUN NT-ProBNP 3050pg/ml HR 30 40bpm HR Tilt-up40 1 1 4 42 5 m 20m 2 78 104 Stridor 10m 3 BP HR 30m 5 171 BP 110/60 130/70 mmHg HR 80 110 bpm SpO2 98 98 % 3 Stridor 40m FIM 75 BUN NT-ProBNP 2411 pg/ml 08 PBSCT PT 48 7 PBSCT PT 24 PT 1 20 5

7 3 pre 21 post 30 CS-30 10 10 MWT 6 6 MWD InBody770 InBody IsoforceGT330 Nm/kg 2 PBSCT 19 28 PT 13 100% , , , , , CS-30 pre17 -post23 , 10 MWT , 6 MWD pre558m-post516m, PBSCT GVHD 100 PT PT CS-30 10 MWT 09 1) 1) 1) 1) 1) 1) 1) 1) 1) 2) 1) 2)

8 [ ] [ ] 40 ADL S TLC 288 L T-cho42mg/dl CONUT 12 2 CO2 ADL 4 [ ] NST PPN 2 TPN 500 1200kcal JCSI-3 ADL 2 ex 3 T- ADLex 1700kcal 3 TLC860 L T-cho195mg/dl COUNT 8 TPN 1 4 5 3 Ns 1200kcal TPN420kcal 1711kcal 7 3 ADL 8 TLC838 L T-cho199mg/dl CONUT 6 MMT4 ADL [ ]

9 NST 10 1) 2) 2) 1,3 1) 2) 3) [ ] [ ] 20 ( :VO2) ( :CO2) ( :RR) ( :VE) ( :VE/VO2) ( :VE/VCO2) ( :HR) ( :VO2/HR) (UPPER BODY CYCLE BIODEX ) (AEROBIKE 75 XLIII COMBI ) AE-310s( ) (DS-7520 ) Breath by Breath 10 50 60 /min 1 5 (IBM )

10 [ ] VO2/HR HR VE RR VE/VO2 VE/VCO2 [ ] 11 1) 1) 1) 1) KAFO ADL 70 6 MRA t-PA GCS(E3V1M6) BRS I MAS0 SCP 3 ADL FIM 18 2 5 KAFO