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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">近年の医療や安全装置の発展により，完全麻痺よりも不全麻痺の患者の比率が高くなった．それに伴い，定型的な練習メニューだけでなく，回復のためのプログラムを組み合わせる必要が出てくるなど，理学療法士には柔軟な対応が求められている．本改訂では，臨床の第一線で活躍する執筆陣が，より今日の臨床に即した内容へと修正・加筆を行っている．確立された練習メニューがない中，手探りで臨床に向き合う理学療法士にとって，バイブルとなるべき一冊．</section><section class="preface">第3版に寄せて<br><br>　第2版でも冒頭に述べさせていただきましたが，多くの方々からいろいろな御意見，御質問を頂戴いたしました．この場を借りて御礼を申し上げます．<br>　神経再生の話題はテレビ，新聞，週刊誌，インターネットでよくみられます．特にテレビでは特集があり，患者様，障害をお持ちの方，関係者，さらに国民の皆様が興味津々でいらっしゃることでしょう．中枢神経は回復しないという定説が昔話となり，この時代を迎えました．京都大学，慶應義塾大学のiPS，大阪大学の嗅粘膜移植術，特に札幌医科大学とニプロが共同開発し，2018年12月に世界初の脊髄損傷用の再生医療製品として承認された間葉系幹細胞の「ステミラック注」があり，当事者の方々は自分の番が早く回ってくるようにと願っています．年間5,000人の脊髄損傷者，そして受傷から数年経過している方々のすべてが適応ではないとしても，他人事ではないでしょう．治療は無料ではありませんので，それなりの金額は必要であり，ニュースから高額な治療であるとはご存じでしょう．今，医療保険は様々な病気に対して保険適用を増やしている状況です．これにより多くの患者様の生命が救われ，また機能が回復し，いろいろなかたちで社会に戻られるでしょう．本当に素晴らしいことと考えます．以上は光の部分ですが，影の部分も当然あります．それは予算です．そして，日本の経済状況です．本書では語ることはありませんが，予算は無尽蔵ではありません，必ず，どこかに皺寄せが来ると考えております．<br>　近年，完全麻痺ではなく，不全麻痺の比率が高くなり，完全麻痺のような定型的な練習メニューではなく，回復のためのメニューも組み合わされ，担当するPTも試行錯誤を繰り返していることでしょう．いまだ正式なメニューがないので，個人の能力が試されているのではないかと考えています．<br>　第3版は第2版から項目と内容に変化を付け，それに伴い執筆者に考え方の違いを述べていただきました．原稿量としては少ないのですが，内容は十分に吟味されていると考えています．<br>　最後に，本書が脊髄損傷者の方，アプローチをするPTのお役に立てれば幸いです．<br><br>2020年1月<br>岩﨑　洋</section><section class="indexes">第1章　病　態<br>　1．総説<br>　2．脊髄解剖・神経症状・レベル<br>　3．排尿障害<br>　4．排便障害<br>　5．合併症<br><br>第2章　理学療法<br>　1．理学療法の評価<br>　（1）評価の進め方<br>　（2）外傷性脊髄損傷受傷後の機能変化<br>　2．クリニカルパス<br>　3．呼吸理学療法<br>　4．理学療法<br>　（1）急性期<br>　（2）回復期<br>　　　①スタートアップエクササイズ<br>　　　②座位バランス<br>　　　③プッシュアップ<br>　（3）基本動作<br>　　　①寝返り・起きあがり<br>　　　②四つ這い・膝立ち<br>　（4）移乗動作<br>　　　①ベッド⇔車椅子<br>　　　②トイレ⇔車椅子<br>　　　③自動車⇔車椅子<br>　　　④床⇔車椅子<br>　5．立位・歩行<br>　（1）歩行の意義・効果<br>　（2）練習1　長・短下肢装具<br>　（3）練習2　継手付き装具での歩行<br>　（4）練習3　杖・歩行器での歩行<br>　（5）練習4　ロボットによる歩行支援<br>　6．日常生活動作<br>　（1）食事<br>　（2）更衣<br>　（3）排泄<br>　（4）入浴・洗身<br>　（5）自動車改造と運転<br>　（6）コミュニケーション<br>　7．不全麻痺の運動療法<br>　（1）体幹・下肢への運動感覚入力<br>　（2）四肢・体幹の交互性運動<br>　（3）座位練習<br>　（4）四つ這い練習<br>　（5）立位練習<br>　（6）歩行練習<br>　（7）体重免荷式トレッドミルトレーニング<br>　8．住宅整備<br>　9．車椅子<br>　（1）シーティング<br>　（2）操作練習<br>　10．トランスファー<br>　（1）全介助<br>　（2）リフト<br><br>第3章　社会生活<br>　1．脊髄損傷者に役立つ制度と法律<br>　2．高齢化への対応<br>　3．復学・復職への対応<br><br>第4章　トピックス<br>　1．高位頚髄損傷者に対する基本的アプローチ<br>　2．高位頚髄損傷者に対する非侵襲的陽圧換気療法<br>　3．環境制御装置<br>　4．重複障害<br>　5．二分脊椎<br>　6．脊髄損傷とセクシュアリティ<br>　7．脊髄再生<br>　8．褥瘡<br>　9．スポーツ<br>　10．痙縮治療<br>　11．在宅リハビリテーション<br>　12．新人・研修生指導マニュアル<br><br>あとがき<br>索引</section></article>
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