@article{oai:air.repo.nii.ac.jp:00004765,
 author = {佐々木, 誠 and SASAKI, Makoto},
 issue = {2},
 journal = {秋田大学大学院医学系研究科保健学専攻紀要, Health Sciences Bulletin Akita University},
 month = {Oct},
 note = {慢性閉塞性肺疾患（chronic obstructive pulmonary disease : COPD）患者は，進行する呼吸困難や運動耐容能の低下，骨格筋の機能障害を経験し，これにより日常生活活動（activities of daily living : ADL）を遂行するための能力が制限される．疲労や ADL を含む身体活動の低下はさらなる身体能力の低下をもたらし悪循環を招く．COPD 患者にとって ADL 制限は疾病の重症度が増すにつれ顕在化する重要な障害の１つである．本稿の目的は，COPD 患者における ADL 制限の概要と機能的背景，評価方法，介入の方法と効果に言及することである．COPD 患者は，消費エネルギーの高い動作で ADL が制限されやすいが，身体的負荷が小さい動作でも上肢の使用に伴って ADL 制限が生じる．身体能力の低下が ADL の遂行に伴って努力や疲労を引き起こし，また，気流制限や動的肺過膨張が ADL 中の呼吸困難を生じさせるものと考えられる．COPD 患者の ADL を評価する方法は多数開発されており，目的に応じて，様々な場面で評価することが可能である．ADL 制限に対する介入方法には各種トレーニングと動作指導および環境整備がある．これらの介入の ADL 制限に対する効果は不明なままであり，さらなる検討が必要と考えられる．
Chronic obstructive pulmonary disease (COPD) patients experience progressive dyspnea, a decline of exercise tolerance, and skeletal muscle dysfunction. As a result, their ability to perform activities of daily living (ADLs) is limited. Fatigue and decreased physical activity, including the performance of ADLs, produce a further decline in physical capacity, causing a vicious spiral. For COPD patients, ADL limitation is one of the important problems that occurs as the severity of the disease increases. The aim of this review is to outline and discuss the functional background, methods of evaluation, methods of intervention, and the effects of intervention for ADL limitation in the COPD patients. The ADLs of the COPD patients are limited by their high energy expenditure. However, even when the physical load is low, ADL limitation occur with the use of the upper limbs. With a decline of physical capacity it is considered that the performance of ADLs requires greater effort and produces fatigue, and airflow limitation and dynamic lung hyperinflation is presumed to cause dyspnea during ADLs. Methods of evaluating ADLs in COPD patients have been developed, and evaluation can be performed in various settings, according to the purpose. There are several training and energy conservation techniques that can be used as methods of intervention for patients with ADL limitation. The effects of these interventions on ADL limitation remain unclear, and further examination is considered necessary.},
 pages = {31--44},
 title = {慢性閉塞性肺疾患患者における日常生活活動とこれに対する介入効果},
 volume = {27},
 year = {2019}
}