乗車者および介助者を考慮したスロープ勾配と車いす昇降介助操作方法に関する検討

• Published in: 日本看護技術学会誌 Vol. 9; no. 2; pp. 55 - 66
• Main Authors: 能登 裕子, 村木 里志
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Nursing Art and Science 2010; 日本看護技術学会
• Subjects: physical strain; riding comfort; slope; transportation; wheelchair; スロープ; 乗り心地; 介助負担; 移送; 車いす
• ISSN: 1349-5429; 2423-8511
• DOI: 10.18892/jsnas.9.2_55

The present study examined the influences of slope gradients and the direction of wheelchair travel on the user’s riding comfort and the helper’s physical strain during wheelchair attendant-controlled locomotion on a longitudinal slope. Fifteen pairs of young helpers and users and 17 pairs of elderly helpers and users participated in this study. The helper-subjects pushed the wheelchair during three operations : going up a slope, going down frontward and down backward at seven different slope gradients ranging from 1/25 to 1/6. During wheelchair locomotion, the speed and variations in wheelchair locomotion were monitored. After locomotion, the helpers and users subjectively evaluated their physical strain and riding comfort, respectively. On both uphill and downhill slopes, one eighth and 1/6 slope gradients were considered unsafe for elderly helpers because the helper’s subjective evaluation of “physical strain” markedly increased, and some elderly helpers could not control the wheelchair properly. In addition, steeper gradients of the slope increased the user’s subjective evaluations of “sense of insecurity” and “scary feeling” and decreased helpers “easiness of technique.” Variations in speed also increased especially when elderly helpers were managing locomotion. On steeper downhill gradients, going down the slope backward showed lower variation of the speed, compared with that going down frontward. These findings suggest that steeper gradients enhance the physical strain on the helper, especially elderly helpers, and promote the user’s riding discomfort, irrespective of whether the direction of movement is up- or downhill. On a downhill slope with a steep gradient, going down backward would be a useful technique to help steady the speed during wheelchair locomotion. 本研究は介助者および乗車者を考慮したスロープ昇降介助操作方法を提案することを目的とし，勾配の大きさをふまえた昇降操作方法と，介助負担および乗り心地との関係を検討した．被験者は，若年者群15組と高齢者群17組の2群を設けた．操作条件は①昇り，②降り前向き，③降り後ろ向きの3種類とし，勾配条件は1/25から1/6の7条件に設定した．測定項目は車いすの走行動態，乗車者の乗り心地および介助者の介助負担についての主観評価とした．介助者が高齢の場合，昇り ・降りとも1/8および1/6勾配は介助者の負担が大きく，操作不可や停止困難な場合があり危険であることが示された．また，両群とも勾配が大きくなると介助者の操作の容易性は低下し，乗車者の恐怖不安感は増大，総合的な乗り心地は低下した．車いすの速度変動は，いずれの操作においても若年者に比べ高齢者のほうが大きい傾向がみられた．一方，高齢介助者の降り操作では，前向きに比べ後ろ向きのほうが速度変動が小さかった．以上のことより，介助者がスロープ勾配を昇降する場合，勾配の大きさと介助者の年齢および操作方法により走行動態や介助負担および主観的乗り心地に違いが生じることが示唆された．