Influence of Prosthodontic Intervention on the Effect of Rehabilitation for Elderly Patients with Bone Fractures Caused by Falls
Depression of the equilibrium function is one of the causes of falls of the elderly. In dentistry, there are some reports that the occlusal supporting depletion influences the depression of the equilibrium function. The purpose of this study was to investigate the influence of prosthetic treatment o...
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| Published in | Ronen Shika Igaku Vol. 27; no. 3; pp. 304 - 310 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Gerodontology
2013
一般社団法人 日本老年歯科医学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-3866 1884-7323 |
| DOI | 10.11259/jsg.27.304 |
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| Abstract | Depression of the equilibrium function is one of the causes of falls of the elderly. In dentistry, there are some reports that the occlusal supporting depletion influences the depression of the equilibrium function. The purpose of this study was to investigate the influence of prosthetic treatment on the rehabilitation of patients admitted to a convalescent rehabilitation hospital after bone fractures caused by falls. Twenty eight non-dementia elderly patients (5 males, 23 females, mean age of 81.6±9.47 years old) who had bone fractures by falls and were in the convalescent rehabilitation hospital were selected as subjects. They were divided into two groups. One group consisted of 18 patients who received prosthodontic treatment after the intraoral examination on admission, due to loss of a tooth or poor prosthesis (intervention group), and the another group consisted of 10 patients (non-intervention group) who did not receive any prosthodontic treatment. BMI and sera albumin value were used to indicate the nutritional improvement. The motor subtotal score, cognitive subtotal score and “walk” score in the Functional Independence Measure (FIM) were used to indicate the efficacy of the rehabilitation. Both groups data on admission and at discharge were compared and examined. While nutritional improvement showed no significant difference in the intervention group, there was a significant difference in the total FIM score. The non-intervention group showed significant difference in sera albumin value, but not in cognitive subtotal score and “walk” score. It was suggested that the intervention of prosthodontic treatment in a convalescent rehabilitation hospital had an important rehabilitation effect after bone fracture by fall. |
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| AbstractList | Depression of the equilibrium function is one of the causes of falls of the elderly. In dentistry, there are some reports that the occlusal supporting depletion influences the depression of the equilibrium function. The purpose of this study was to investigate the influence of prosthetic treatment on the rehabilitation of patients admitted to a convalescent rehabilitation hospital after bone fractures caused by falls. Twenty eight non-dementia elderly patients (5 males, 23 females, mean age of 81.6±9.47 years old) who had bone fractures by falls and were in the convalescent rehabilitation hospital were selected as subjects. They were divided into two groups. One group consisted of 18 patients who received prosthodontic treatment after the intraoral examination on admission, due to loss of a tooth or poor prosthesis (intervention group), and the another group consisted of 10 patients (non-intervention group) who did not receive any prosthodontic treatment. BMI and sera albumin value were used to indicate the nutritional improvement. The motor subtotal score, cognitive subtotal score and “walk” score in the Functional Independence Measure (FIM) were used to indicate the efficacy of the rehabilitation. Both groups data on admission and at discharge were compared and examined. While nutritional improvement showed no significant difference in the intervention group, there was a significant difference in the total FIM score. The non-intervention group showed significant difference in sera albumin value, but not in cognitive subtotal score and “walk” score. It was suggested that the intervention of prosthodontic treatment in a convalescent rehabilitation hospital had an important rehabilitation effect after bone fracture by fall. Depression of the equilibrium function is one of the causes of falls of the elderly. In dentistry, there are some reports that the occlusal supporting depletion influences the depression of the equilibrium function. The purpose of this study was to investigate the influence of prosthetic treatment on the rehabilitation of patients admitted to a convalescent rehabilitation hospital after bone fractures caused by falls. Twenty eight non-dementia elderly patients (5 males, 23 females, mean age of 81.6±9.47 years old) who had bone fractures by falls and were in the convalescent rehabilitation hospital were selected as subjects. They were divided into two groups. One group consisted of 18 patients who received prosthodontic treatment after the intraoral examination on admission, due to loss of a tooth or poor prosthesis (intervention group), and the another group consisted of 10 patients (non-intervention group) who did not receive any prosthodontic treatment. BMI and sera albumin value were used to indicate the nutritional improvement. The motor subtotal score, cognitive subtotal score and “walk” score in the Functional Independence Measure (FIM) were used to indicate the efficacy of the rehabilitation. Both groups data on admission and at discharge were compared and examined. While nutritional improvement showed no significant difference in the intervention group, there was a significant difference in the total FIM score. The non-intervention group showed significant difference in sera albumin value, but not in cognitive subtotal score and “walk” score. It was suggested that the intervention of prosthodontic treatment in a convalescent rehabilitation hospital had an important rehabilitation effect after bone fracture by fall. 高齢者の転倒の原因の一つに身体平衡機能の低下が挙げられる。歯科領域において，身体平衡機能の低下は，咬合支持の喪失が影響しているとの報告が散見している。そこで，転倒により骨折し，回復期リハビリテーション病院へ入院した高齢者患者に対して，リハビリテーション効果に補綴的介入が及ぼす影響を検証した。被検者として，転倒により骨折し，回復期リハビリテーション病院に入院した非認知症高齢者 28 名（男性 5 名，女性 23 名，平均年齢 81.6±9.47 歳）を選択した。入院時の口腔内診査により被検者を，補綴処置を行った群 18 名（以下，介入群）と，補綴処置を行わなかった群 10 名（以下，非介入群）に分類した。評価項目として栄養改善指標には，BMI および血清アルブミン値を，リハビリテーション効果の指標には，機能的自立度評価表（Functional Independence Measure，以下 FIM）の運動と認知項目の総合点数および歩行点数の 3 項目の評価点数をそれぞれ用いた。得られた各データを，各群の入退院時についてそれぞれ比較・検討した。介入群では有意な栄養改善は認められなかったが，FIM の 3 項目すべてに有意な改善を認めた。しかし，非介入群では血清アルブミン値に有意な改善を認めたが，認知および歩行項目に改善が認められなかった。以上のことから，補綴的介入がリハビリテーション効果に影響を及ぼすことが示された。 |
| Author | Tanaka, Muto Tanioka, Tadasuke Tanaka, Masahiro Hayashi, Akiko Tanaka, Junko |
| Author_FL | 田中 睦都 田中 昌博 田中 順子 林 亜紀子 谷岡 款相 |
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| References | 3）鈴木隆雄：転倒の疫学，日老医誌，40：85〜94，2003 8）萩原 淳，守屋信吾，村田あゆみ，原田江里子，小林國彦，野谷健治，柏崎晴彦，黒江敏史，井上農夫男：臼歯部咬合支持を喪失した症例における義歯の治療が身体平衡機能に及ぼす影響，北海道歯誌，30：80〜86，2009 9）加藤伸司，下垣 光，小野寺敦志，植田宏樹，老川賢三，池田一彦，小坂敦二，今井幸充，長谷川和夫：改訂版長谷川式簡易知能評価スケール（HDSR）の作成，老年精医, 2：1339〜1347, 1991 2）日本老年医学会編：健康長寿診療ハンドブック―実地医家のための老年医学のエッセンス，p. 30〜36，日本老年医学会，東京，2011 20）Itoda, M., Sakaguchi, H., Kusumoto, T., Sakane, K.,Matsushita, K., Yamazaki, Y., Tanaka, M. and Kawazoe, T. ：Relationship between occlusal supports and training grade in physical therapy in elderly，J. Jpn. Assoc. Craniomandib. Orthoped., 20：41〜45，2007 1）厚生労働省：要介護度別にみた介護が必要となった主な原因の構成割合，平成 22 年国民生活基礎調査 13）厚生労働省：「寝たきりゼロへの 10 か条」，1991 17)千葉まさこ：FIM（Functional Independence Measure；機能的自立度評価表）による ADL 評価の実用性の検討，Bull. Sch. Allied. Med. Sci., Nagasaki Univ.,12：115〜120，1998 6）森川英彦：高齢者における咬合の維持・回復が身体のバランス能に及ぼす影響に関する疫学的研究, 広大歯誌，39：24〜36，2007. 12）慶應義塾大学医学部リハビリテーション医学教室：FIM 医学的リハビリテーションのための統一データセット利用の手引き，第 3 版，p.16〜36，慶應義塾大学医学部リハビリテーション医学教室，東京，1991 16）厚生労働省：介護予防マニュアル改訂版，2012 14）青木芳和：血漿蛋白による栄養アセスメント，臨病理レビュー，特集 127：12〜16，2003 15）河野真紀子，佐藤裕二，北川 昇，椎名美和子，原 聰：総義歯新製治療における装着前後のアウトカム評価，補綴誌，51：260〜269，2007 10）日本肥満学会編集委員会編：肥満・肥満症の指導マニュアル，第 2 版，p.14〜24，医歯薬出版，東京，2001 18）Sato, Y., Minagi, S., Akagawa, Y. and Nagasawa, T. ：An evaluation of chewing function of complete denture wearers, J. Prosthet. Dent., 62：50〜53，1989 5）永井晴美，柴田 博，芳賀 博，上野満雄，須山靖男，安村誠司，松崎俊久，崎原盛造，平良一彦：地域老人における咀嚼能力の健康状態への影響，日老医誌，27：63〜68，1990 4）American Geriatrics Society, British Geriatrics Society and American Academy of Orthopaedic Surgeons Panel on Falls Prevention：Guideline for the prevention of falls in older persons, J. Am. Geriatr. Soc., 49：664〜672，2001 19）今井智子，北川 昇，佐藤裕二，山口麻子，桑澤実希：補綴治療が無歯顎者の咀嚼能力に与える影響，Dent. Med. Res., 31：143〜150，2011 11）鈴木隆雄：低栄養状態の高齢者の転倒予防，ナーシング・トゥデイ，22：99〜104，2007 7）Yoshida, M., Morikawa, H. Kanehira, Y. Taji, T.,Tsuga, K. and Akagawa, Y. ：Functional dental occlusion may prevent falls in elderly individuals with dementia, J. Am. Geriatr. Soc., 53：1631〜1632, 2005 |
| References_xml | – reference: 9）加藤伸司，下垣 光，小野寺敦志，植田宏樹，老川賢三，池田一彦，小坂敦二，今井幸充，長谷川和夫：改訂版長谷川式簡易知能評価スケール（HDSR）の作成，老年精医, 2：1339〜1347, 1991． – reference: 14）青木芳和：血漿蛋白による栄養アセスメント，臨病理レビュー，特集 127：12〜16，2003． – reference: 18）Sato, Y., Minagi, S., Akagawa, Y. and Nagasawa, T. ：An evaluation of chewing function of complete denture wearers, J. Prosthet. Dent., 62：50〜53，1989． – reference: 1）厚生労働省：要介護度別にみた介護が必要となった主な原因の構成割合，平成 22 年国民生活基礎調査． – reference: 3）鈴木隆雄：転倒の疫学，日老医誌，40：85〜94，2003． – reference: 4）American Geriatrics Society, British Geriatrics Society and American Academy of Orthopaedic Surgeons Panel on Falls Prevention：Guideline for the prevention of falls in older persons, J. Am. Geriatr. Soc., 49：664〜672，2001． – reference: 10）日本肥満学会編集委員会編：肥満・肥満症の指導マニュアル，第 2 版，p.14〜24，医歯薬出版，東京，2001． – reference: 11）鈴木隆雄：低栄養状態の高齢者の転倒予防，ナーシング・トゥデイ，22：99〜104，2007． – reference: 20）Itoda, M., Sakaguchi, H., Kusumoto, T., Sakane, K.,Matsushita, K., Yamazaki, Y., Tanaka, M. and Kawazoe, T. ：Relationship between occlusal supports and training grade in physical therapy in elderly，J. Jpn. Assoc. Craniomandib. Orthoped., 20：41〜45，2007． – reference: 17)千葉まさこ：FIM（Functional Independence Measure；機能的自立度評価表）による ADL 評価の実用性の検討，Bull. Sch. Allied. Med. Sci., Nagasaki Univ.,12：115〜120，1998． – reference: 15）河野真紀子，佐藤裕二，北川 昇，椎名美和子，原 聰：総義歯新製治療における装着前後のアウトカム評価，補綴誌，51：260〜269，2007． – reference: 16）厚生労働省：介護予防マニュアル改訂版，2012． – reference: 19）今井智子，北川 昇，佐藤裕二，山口麻子，桑澤実希：補綴治療が無歯顎者の咀嚼能力に与える影響，Dent. Med. Res., 31：143〜150，2011． – reference: 13）厚生労働省：「寝たきりゼロへの 10 か条」，1991． – reference: 2）日本老年医学会編：健康長寿診療ハンドブック―実地医家のための老年医学のエッセンス，p. 30〜36，日本老年医学会，東京，2011． – reference: 5）永井晴美，柴田 博，芳賀 博，上野満雄，須山靖男，安村誠司，松崎俊久，崎原盛造，平良一彦：地域老人における咀嚼能力の健康状態への影響，日老医誌，27：63〜68，1990． – reference: 8）萩原 淳，守屋信吾，村田あゆみ，原田江里子，小林國彦，野谷健治，柏崎晴彦，黒江敏史，井上農夫男：臼歯部咬合支持を喪失した症例における義歯の治療が身体平衡機能に及ぼす影響，北海道歯誌，30：80〜86，2009． – reference: 12）慶應義塾大学医学部リハビリテーション医学教室：FIM 医学的リハビリテーションのための統一データセット利用の手引き，第 3 版，p.16〜36，慶應義塾大学医学部リハビリテーション医学教室，東京，1991． – reference: 7）Yoshida, M., Morikawa, H. Kanehira, Y. Taji, T.,Tsuga, K. and Akagawa, Y. ：Functional dental occlusion may prevent falls in elderly individuals with dementia, J. Am. Geriatr. Soc., 53：1631〜1632, 2005． – reference: 6）森川英彦：高齢者における咬合の維持・回復が身体のバランス能に及ぼす影響に関する疫学的研究, 広大歯誌，39：24〜36，2007. |
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| SubjectTerms | fall FIM prosthodontic treatment 補綴的介入 転倒 |
| Title | Influence of Prosthodontic Intervention on the Effect of Rehabilitation for Elderly Patients with Bone Fractures Caused by Falls |
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