JP2015047449A - Massage evaluation method - Google Patents
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Abstract
Description
本発明は、マッサージ法の評価法に関し、詳細にはマッサージ被施術者の脳血流変動量を測定し、該測定値に基づき、マッサージ法の効果を客観的に評価する方法に関する。 The present invention relates to a massage method evaluation method, and more particularly, to a method of measuring a cerebral blood flow fluctuation amount of a massage recipient and objectively evaluating the effect of the massage method based on the measured value.
認知、記憶、判断などの高次脳機能は加齢により低下する傾向にあることが知られている。これは、前頭前野（PFC: prefrontal cortex）における脳血流変動の低下が影響しているといわれ、加齢による脳機能低下を予防し改善するためには、日常的に脳血流変動を伴う活動を行うことが有効であると考えられている（J.M. Jennifer, S. Hayasaka and P.J. Laurienti, Frontiers in human neuroscience, 4, 16, 2010、
H. Yanagisawa, I. Dan, D. Tsuzuki, M. Kato, M. Okamoto, Y. Kyutoku and H. Soya, Neuroimage, 50, 1702-10, 2010）。
It is known that higher brain functions such as cognition, memory, and judgment tend to decrease with aging. This is said to be due to the decrease in cerebral blood flow fluctuations in the prefrontal cortex (PFC). In order to prevent and improve brain function deterioration due to aging, cerebral blood flow fluctuations are routinely involved. It is considered effective to carry out activities (JM Jennifer, S. Hayasaka and PJ Laurienti, Frontiers in human neuroscience, 4, 16, 2010,
H. Yanagisawa, I. Dan, D. Tsuzuki, M. Kato, M. Okamoto, Y. Kyutoku and H. Soya, Neuroimage, 50, 1702-10, 2010).
脳血流変動をマッサージによりもたらすことが知られている（特許文献１）。また、本発明者らは、高い心理的効果を有する、リンパ腺を刺激するフェイシャルマッサージによってPFCにおける脳血流が大きく変動し、この変動が加齢により減弱すること（非特許文献１）、及び、女性が日常的に行う化粧品を用いたスキンケア行為や単に頬をさするといった行為時においても、類似した変動が認められることを報告している（非特許文献２）。 It is known that cerebral blood flow fluctuation is brought about by massage (Patent Document 1). In addition, the present inventors greatly change cerebral blood flow in PFC by facial massage that stimulates lymphatic glands having a high psychological effect, and this fluctuation is attenuated by aging (Non-patent Document 1), and It has been reported that similar fluctuations are observed even when a woman performs daily skin care using cosmetics or simply cheeks (Non-Patent Document 2).
しかし、これまでに為されてきた研究はマッサージ手技を所定のものに固定して行われており、複数の手技を用いるのが通常である実際のマッサージ法を反映したものとはなっていない。また、脳血流変動データの解析方法も確立されているとはいえない。そこで、本発明は、複数のマッサージ手技を用いたマッサージ法における脳血流を変動させる効果を客観的に評価する方法を提供することを目的とする。 However, researches that have been conducted so far have been carried out with fixed massage procedures, and do not reflect the actual massage methods that usually use multiple procedures. Also, it cannot be said that a method for analyzing cerebral blood flow fluctuation data has been established. Accordingly, an object of the present invention is to provide a method for objectively evaluating the effect of changing cerebral blood flow in a massage method using a plurality of massage techniques.
即ち、本発明は、以下のものである。
［１］少なくとも２種のマッサージ手技を含むマッサージ法を評価する方法であって、
（１）該マッサージ手技の各々について、被施術者の所定部位に所定時間マッサージを施術する間、被施術者の脳血流変動を測定するステップ、
（２）（１）で得られた脳血流変動データを手技間で比較し、手技間での脳血流変動特性の差異の有無を判断するステップ、
（３）差異が有ると判断された手技のうちの少なくとも２つを、少なくとも一の順番で、被施術者の所定部位に所定時間施術する間、被施術者の脳血流変動を測定するステップ、
（４）（３）で得られた脳血流変動データを、（１）で得られた脳血流変動データと比較し、脳血流変動がより大きいか否かを判断するステップ、
を含む方法。
［２］ステップ（２）及び（４）が、該脳血流変動データの平均値、及び該脳血流変動データのうちの最大値と最小値の差を比較するステップを含む、上記［１］記載の方法。
［３］ステップ（２）及び（４）が、該脳血流変動データの所定時間当たりの差分、及び該差分の絶対値の平均値を比較するステップを含む、上記［１］又は［２］記載の方法。
［４］ステップ（３）の少なくとも一の順番が、前記平均値、前記最大値と最小値の差、及び／又は前記差分の絶対値の平均値がより大きい手技をより後で施術する順番である、上記［３］記載の方法。
［５］ステップ（２）及び（４）が、脳血流変動の測定値を平滑化するステップをさらに含み、前記平均値、前記最大値と最小値の差、及び、前記差分が、平滑化された測定値から求められる、上記［３］又は［４］記載の方法。
［６］脳血流変動が、機能的近赤外分光分析法により血液中の酸素化ヘモグロビンの量の変動によって測定される、上記［１］〜［５］のいずれか１つに記載の方法。
［７］マッサージを施術する所定部位が、顔面部である、上記［１］〜［６］のいずれか１つに記載の方法。
［８］少なくとも２種のマッサージ手技が、顔面部の異なる部位を刺激する手技である、上記［７］記載の方法。
［９］該異なる部位が、筋肉とリンパ腺である、上記［８］記載の方法。
That is, the present invention is as follows.
[1] A method of evaluating a massage method including at least two types of massage techniques,
(1) measuring each subject's cerebral blood flow fluctuation while performing massage for a predetermined time on a predetermined site of the patient for each of the massage techniques;
(2) A step of comparing the cerebral blood flow fluctuation data obtained in (1) between procedures and determining the presence or absence of a difference in cerebral blood flow fluctuation characteristics between the procedures;
(3) A step of measuring cerebral blood flow fluctuations of a patient while performing at least two of the procedures determined to have a difference on a predetermined part of the patient for a predetermined time in at least one order. ,
(4) comparing the cerebral blood flow fluctuation data obtained in (3) with the cerebral blood flow fluctuation data obtained in (1) to determine whether or not the cerebral blood flow fluctuation is larger;
Including methods.
[2] The steps [2] and (4) include the step of comparing the average value of the cerebral blood flow fluctuation data and the difference between the maximum value and the minimum value of the cerebral blood flow fluctuation data. ] The method of description.
[3] The above [1] or [2], wherein steps (2) and (4) include a step of comparing a difference per predetermined time of the cerebral blood flow fluctuation data and an average value of absolute values of the difference. The method described.
[4] The order in which at least one of the steps (3) is performed later is a procedure in which the average value, the difference between the maximum value and the minimum value, and / or the average value of the absolute value of the difference is larger. The method according to [3] above.
[5] Steps (2) and (4) further include a step of smoothing a measured value of cerebral blood flow fluctuation, wherein the average value, the difference between the maximum value and the minimum value, and the difference are smoothed. The method of the above-mentioned [3] or [4], which is determined from the measured values obtained.
[6] The method according to any one of [1] to [5] above, wherein the cerebral blood flow fluctuation is measured by a fluctuation in the amount of oxygenated hemoglobin in the blood by functional near infrared spectroscopy. .
[7] The method according to any one of [1] to [6] above, wherein the predetermined site for performing the massage is a face portion.
[8] The method according to [7] above, wherein the at least two types of massage techniques are techniques for stimulating different parts of the face.
[9] The method according to [8] above, wherein the different sites are muscle and lymph gland.
上記本発明の方法によれば、脳血流変動データに基づく客観的な判断によって、マッサージ法の効果を評価することができ、より効果的なマッサージ処方の開発につなげることができる。 According to the method of the present invention, the effect of the massage method can be evaluated by objective judgment based on the cerebral blood flow fluctuation data, which can lead to the development of a more effective massage prescription.
本発明においてマッサージ手技としては、例えば軽擦法、強擦法、揉捏法、圧迫法、叩打法、振戦法等の施術技法が異なる手技、血液・リンパ循環促進、筋肉の柔軟性向上、リラックス等のマッサージの目的及び効果が異なる手技等、種々のカテゴリのものが包含される。 In the present invention, massage techniques include, for example, a light rub method, a strong rub method, acupuncture method, compression method, tapping method, tremor method, and other procedures, blood / lymph circulation promotion, muscle flexibility improvement, relaxation Various categories such as procedures with different purposes and effects of massage are included.
マッサージを施術する部位は、人体の部位、例えば顔面部、頸部、肩、腕部、手、胸部、腹部、腰部、及び脚部等のいずれの箇所でもよい。これらのうち、頭部に近い部位、なかでも顔面部が好ましく、例えば図１に示すような、顔筋を刺激するマッサージやリンパ腺を刺激するマッサージを施術することができる。 The part to be massaged may be any part of the human body, such as the face, neck, shoulder, arm, hand, chest, abdomen, waist, and leg. Of these, a part close to the head, particularly the face part, is preferable. For example, as shown in FIG. 1, massage that stimulates facial muscles or massage that stimulates lymph glands can be performed.
マッサージの時間は任意であってよく、数十秒から数時間、好ましくは数十秒から数十分行う。また、手技毎に異なる時間であってもよい。 The massage time may be arbitrary, and is performed for several tens of seconds to several hours, preferably several tens of seconds to several tens of minutes. Further, the time may be different for each procedure.
脳血流変動を測定する方法としては、測定が比較的簡便である点で、機能的近赤外分光分析法（ｆＮＩＲＳ）が好ましい。該方法は、近赤外光（波長700〜900nm）を頭皮上から被施術者の脳内に照射して、照射点から数ｃｍ程度離れたところで、大脳皮質で乱反射されて戻ってきた光を検出する。検出された光から、大脳皮質内の血液中の酸素化ヘモグロビン（Oxy-Hb）、還元ヘモグロビン（Deoxy-Hb）、及びこれらの合計である総ヘモグロビン（Total-Hb）の量を推定して、脳血流変動の解析に使用する。マッサージによる刺激をより反映し易いことから、酸素化ヘモグロビン（Oxy-Hb）の量を用いて解析することが好ましい。 As a method for measuring cerebral blood flow fluctuation, functional near-infrared spectroscopy (fNIRS) is preferable in that the measurement is relatively simple. The method irradiates near infrared light (wavelength 700 to 900 nm) from the scalp into the subject's brain, and returns the light that is diffusely reflected by the cerebral cortex at a distance of about several centimeters from the irradiation point. To detect. From the detected light, the amount of oxygenated hemoglobin (Oxy-Hb), deoxyhemoglobin (Deoxy-Hb), and their total total hemoglobin (Total-Hb) in the blood in the cerebral cortex is estimated, Used for analysis of cerebral blood flow fluctuations. Since it is easier to reflect stimulation by massage, it is preferable to analyze using the amount of oxygenated hemoglobin (Oxy-Hb).
ｆＮＩＲＳの計測では、通常、近赤外光照射用ファイバと検出用ファイバを交互に正方格子状に並べる。ファイバの設定位置、設定数は任意であるが、データの再現性を確保する点から脳波測定で用いられる国際１０−２０法に従い標準点を設定し、標準点間の間隔を均一にすることにより、個人差による測定位置の誤差を軽減することが好ましい。後述する実施例においては、脳波測定で用いられる国際１０−２０法に従い、まず鼻根と後頭結節とを、頭頂を通るように結ぶ線の中央と、左右の耳介前点を頭頂を通るように結ぶ線の中央が交差する部位（Cz）を決定した。次いで鼻根と後頭結節を結ぶ線の長さを100％として鼻根から10％Cz方向に移動した部位（Fpz）を決定した。そして、マッサージによる顔面の変動（皮膚及び筋肉の変化）の影響を受けずに正確な血流変動を測定するために、図２に示すとおり、部位FpzからCz方向へ3 cm移動した位置をAとし、FpzとAをそれぞれ右耳方向に3 cm移動させた位置、及び左耳方向に3 cm移動させた位置に照射用ファイバと検出用ファイバを夫々配置し、ファイバ間の脳血流変動を計測した。 In fNIRS measurement, normally, near-infrared light irradiation fibers and detection fibers are alternately arranged in a square lattice pattern. The setting position and number of fibers are arbitrary, but from the point of ensuring data reproducibility, standard points are set according to the international 10-20 method used in electroencephalogram measurement, and the intervals between the standard points are made uniform. It is preferable to reduce the error of the measurement position due to individual differences. In the examples described later, according to the International 10-20 method used in electroencephalogram measurement, first, the center of the line connecting the nasal root and the occipital nodule so as to pass through the parietal, and the left and right anterior pinna points passing through the parietal. The portion (Cz) where the center of the line connecting to crosses was determined. Then, the length of the line connecting the nasal root and the occipital nodule was defined as 100%, and the site (Fpz) moved from the nasal root in the 10% Cz direction was determined. Then, in order to measure accurate blood flow fluctuations without being affected by facial changes (skin and muscle changes) due to massage, as shown in FIG. 2, the position moved 3 cm in the Cz direction from the site Fpz Fpz and A are each placed 3 cm in the direction of the right ear and 3 cm in the direction of the left ear. Measured.
計測は施術前後に安静期間を置いたブロックデザインと呼ばれる手法で行うことが好ましい。例えば、施術前安静期間（レスト）、マッサージ施術期間（タスク）、及び施術後安静期間（レスト）を１単位とし、マッサージ開始時からのOxy-Hb変動量を、少なくとも１単位の間、測定する。好ましくは２又は３単位行い、その平均値を解析に用いる。後述する実施例では、図３に示すように、施術前安静期間３０秒、施術期間６０秒、施術後安静期間６０秒を用い、マッサージ手技が２種以上の場合には施術期間６０秒を等分に分割して行った。 The measurement is preferably performed by a technique called block design with a rest period before and after the treatment. For example, pre-treatment rest period (rest), massage treatment period (task), and post-treatment rest period (rest) are taken as one unit, and the amount of Oxy-Hb variation from the start of massage is measured for at least one unit. . Preferably, 2 or 3 units are used, and the average value is used for analysis. In the examples described later, as shown in FIG. 3, the rest period before treatment is 30 seconds, the treatment period is 60 seconds, and the rest period after treatment is 60 seconds. If there are two or more massage techniques, the treatment period is 60 seconds, etc. Divided into minutes.
本発明の方法では、少なくとも２種のマッサージ手技の各々について、上記のように脳血流変動データを測定し、得られたデータを手技間で比較し、手技間での脳血流変動特性の差異の有無を判断する。該判断手法としては、脳血流変動データを統計的に処理して有意差検定を行うことが好ましい。他の判断方法、例えばアンケート調査による方法、唾液中のアミラーゼ量やアミラーゼ活性を測定する方法等に比べて、本発明の方法はより客観的かつ直接的である点で優れている。但し、アンケート調査による方法等を本発明の方法と組み合わせて行うことを妨げるものではない。 In the method of the present invention, the cerebral blood flow fluctuation data is measured as described above for each of at least two types of massage procedures, and the obtained data is compared between the techniques. Determine if there is a difference. As the determination method, it is preferable to statistically process cerebral blood flow fluctuation data and perform a significant difference test. The method of the present invention is superior to other judgment methods, for example, a questionnaire survey method, a method for measuring the amount of amylase in saliva and amylase activity, and the like in that it is more objective and direct. However, this does not preclude performing a questionnaire survey method or the like in combination with the method of the present invention.
統計的な処理としては、脳血流変動データの（１）平均値、（２）最大変動幅、さらに（３）血流量変化値を求めることによって行うことが好ましい。特に、（３）血流量変化値は、所定時間当たりの脳血流変動量の差分であり、脳血流変動カーブの傾きの大きさを表す。（１）及び（２）が、比較的長い時間で均した変動の大きさを示すのに対して、（３）はより短時間での変動の大きさを示すため、脳血流変動のより細かい違いを捉えることができる。また、後述する実施例で示すように、該血流量変化値を時間に対してプロットすると、脳血流変動の態様の違いを視覚的に捉えることができる。 The statistical processing is preferably performed by obtaining (1) average value, (2) maximum fluctuation range, and (3) blood flow change value of the cerebral blood flow fluctuation data. In particular, (3) the blood flow rate change value is a difference in the cerebral blood flow fluctuation amount per predetermined time, and represents the magnitude of the slope of the cerebral blood flow fluctuation curve. (1) and (2) show the magnitude of fluctuation averaged over a relatively long time, whereas (3) shows the magnitude of fluctuation in a shorter time. Can capture small differences. Moreover, as shown in the Example mentioned later, when this blood flow rate change value is plotted with respect to time, the difference in the mode of cerebral blood flow fluctuation | variation can be caught visually.
より好ましくは、得られる脳血流変動の測定値を平滑化して、平滑化されたデータについて、上記（１）〜（３）を求める。平滑化の方法は特に限定されず、例えば所定の時間ごとにデータの平均値を求めることによって行うことができる。後述する実施例では、０．１秒毎に採取した血流量データ（ｘｉ、ｉ＝１〜Ｎ、Ｎは総データ数）について、０．５秒毎の平均値（Ｘｋ、ｋ＝１〜ｎ、ｎ＝（Ｎ−１）／５）を取った。 More preferably, the obtained measured values of cerebral blood flow fluctuations are smoothed, and the above (1) to (3) are obtained for the smoothed data. The smoothing method is not particularly limited, and can be performed, for example, by obtaining an average value of data every predetermined time. In the examples described later, the average value (X k , k = 1) every 0.5 seconds for blood flow data (x i , i = 1 to N, N is the total number of data) collected every 0.1 seconds. ˜n, n = (N−1) / 5).
得られた平滑化データ（Ｘｋ、ｋ＝１〜ｎ）から、（１）平均値（ΣＸｋ／ｎ、ｋ＝１〜ｎ）、及び（２）最大変動幅（Ｘmax - Ｘmin ）を算出する。（３）血流量変化値は、隣接する平滑化データの差（Ｘｋ＋１−Ｘｋ）として求める。さらに、該差分の絶対値の平均値（Σ｜Ｘｋ＋１−Ｘｋ｜／（ｎ−１）、ｋ＝１〜（ｎ−１））を算出して、比較する。このようにしてブロック毎に求めた値を、ブロック間で平均した後、被施術者間の平均値を求めて、手技毎の平均値、最大変動幅、血流量変化値とする。 From the obtained smoothed data (X k , k = 1 to n), (1) average value (ΣX k / n, k = 1 to n) and (2) maximum fluctuation range (Xmax−Xmin) are calculated. To do. (3) The blood flow rate change value is obtained as a difference (X k + 1 −X k ) between adjacent smoothed data. Further, an average value (Σ | X k + 1 −X k | / (n−1), k = 1 to (n−1)) of absolute values of the differences is calculated and compared. The values obtained for each block in this way are averaged between the blocks, and then the average value between the patients is obtained to obtain the average value, maximum fluctuation range, and blood flow rate change value for each procedure.
手技間での脳血流変動特性に差異があると判断されたもののうちの少なくとも２つを、少なくとも一の順番で、被施術者の所定部位に所定時間施術して、上記と同様の方法で、被施術者の脳血流変動を測定する。そして、手技毎のデータと比較して、該異なる手技を組み合わせることによる相乗効果の有無を判定し、より効果的な施術の開発へとつなげる。脳血流変動特性が異なる手技のいずれを組み合わせるか、及び、どのような順番で施術するかについては限定されず、任意のプログラムで行ってよい。好ましくは、平均値、最大変動幅及び／又は脳血流変化値がより大きいものを、より後の順番で施術する。これは、異なる手技を組み合わせた場合、より後に施術した手技により脳血流変動が大きく影響されることが見出されたからである。 At least two of those determined to have a difference in cerebral blood flow fluctuation characteristics between the procedures are applied to a predetermined part of the patient for a predetermined time in at least one order, and in the same manner as described above. Measure cerebral blood flow fluctuations of the subject. Then, compared with the data for each procedure, the presence or absence of a synergistic effect by combining the different procedures is determined, leading to the development of a more effective treatment. It is not limited as to which of the procedures having different cerebral blood flow fluctuation characteristics are combined and in which order the procedure is performed, and any program may be used. Preferably, those having a larger average value, maximum fluctuation range and / or cerebral blood flow change value are performed in a later order. This is because it was found that when different procedures are combined, cerebral blood flow fluctuations are greatly influenced by procedures performed later.
組み合わせた場合の脳血流変動が、単独の場合に比べて大きいか否かを判断し、大きいと判断された場合には、組合せにより相乗的な効果があると考えることができ、これによって、老化防止等により効果的な処方の開発につなげることができる。 It is determined whether or not the cerebral blood flow fluctuation when combined is larger than that of a single case, and if it is determined to be large, it can be considered that the combination has a synergistic effect, It can lead to the development of effective prescriptions by preventing aging.
既に述べたように、脳血流変動による評価法に加えて、従来行われているアンケート調査による心理的評価を行ってもよい。アンケートの方法は特に限定されず、例えば図８ａ，ｂに示すようなリラックス感やリフレッシュ感を９段階で評価して、平均値を求める方法とすることができる。 As already described, in addition to the evaluation method based on cerebral blood flow fluctuation, a psychological evaluation based on a conventional questionnaire survey may be performed. The method of the questionnaire is not particularly limited, and for example, a relaxed feeling or a refreshing feeling as shown in FIGS.
以下、本発明を実施例により説明するが、本発明はこれらに限定されるものではない。
［実施例］
２７歳から３２歳の右利きの健常な女性６名（平均２８．８歳）を被施術者とし、外光を遮断した部屋で、複数のマッサージ手技各々及びその組合せを評価した。
EXAMPLES Hereinafter, although an Example demonstrates this invention, this invention is not limited to these.
[Example]
Six right-handed healthy women (average 28.8 years old) aged 27 to 32 years were treated, and each of a plurality of massage techniques and their combinations were evaluated in a room where external light was blocked.
＜測定法＞
測定にはｆＮＩＲＳシステム（島津製作所製）を用い、左右前頭前野（ＰＦＣ）の酸素化ヘモグロビン（Oxy-Hb）、脱酸素化ヘモグロビン（Deoxy-Hb）、総ヘモグロビン（Total-Hb）の変化を測定した。図２に示す位置にプローブを置いた。同図において、Ｃｚ及びＦｐｚは、脳波測定に関する国際１０−２０法に従う部位であり、Ｃｚは頭頂を通って鼻根と後頭結節を結ぶ線の中央と、頭頂を通って左右の耳介を結ぶ線の中央が交差する部位であり、Ｆｐｚは頭頂を通って鼻根と後頭結節を結ぶ線の長さを１００％としたときに鼻根から１０％Ｃｚ方向に移動した部位である。さらに、部位ＦｐｚからCz方向へ3 cm移動した位置をＡとし、ＦｐｚとＡを、それぞれ右耳方向に３ｃｍ移動した位置に右ＰＦＣ測定用の照射用ファイバと検出用ファイバを夫々配置し、及び左耳方向に３ｃｍ移動させた位置に、左ＰＦＣ測定用の照射用ファイバと検出用ファイバを配置し、マッサージ開始時の値（ｔ＝０の値）を０として、該値からの脳血流変化値を０．１秒毎に計測した。
<Measurement method>
The fNIRS system (manufactured by Shimadzu Corporation) is used for measurement, and changes in oxygenated hemoglobin (Oxy-Hb), deoxygenated hemoglobin (Deoxy-Hb), and total hemoglobin (Total-Hb) in the left and right prefrontal cortex (PFC) are measured. did. The probe was placed at the position shown in FIG. In the figure, Cz and Fpz are parts according to the International 10-20 Method for EEG measurement, and Cz connects the center of the line connecting the nasal root and the occipital nodule through the parietal and the left and right auricles through the parietal. The center of the line intersects the region, and Fpz is a region moved in the 10% Cz direction from the nasal root when the length of the line connecting the nasal root and the occipital nodule through the parietal is 100%. Further, a position moved 3 cm in the Cz direction from the part Fpz is set as A, and an irradiation fiber and a detection fiber for measuring the right PFC are respectively arranged at positions Fpz and A moved 3 cm in the right ear direction, and An irradiation fiber and a detection fiber for left PFC measurement are arranged at a position moved 3 cm in the direction of the left ear, and the value at the start of massage (value of t = 0) is set to 0, and the cerebral blood flow from the value is set. Change values were measured every 0.1 seconds.
＜手技毎の評価＞
図３に示すような、「レスト−タスク−レスト」のブロックデザインに従い、測定を２回繰り返した。被施術者は、簡易ベッド上で閉眼仰臥状態を維持し、マッサージ施術者は前レスト時に被施術者の頬に手をあてた状態で待機し（３０秒間）、タスク時に被施術者の頬部位にマッサージを行い（３０秒間×２）、後レスト時には前レスト時と同様に被施術者の頬に手をあてた状態で待機し（６０秒間）、これを１ブロックとして、２回繰り返した。各施術後に、図８ａ，ｂに示すアンケートを行った。
<Evaluation for each procedure>
The measurement was repeated twice according to the “rest-task-rest” block design as shown in FIG. The patient maintains a supine position on the cot and the massage practitioner waits for 30 seconds with his hand on the cheek's cheek at the front rest, and the patient's cheek area during the task Was massaged (30 seconds × 2), and the patient rested on the cheek of the person to be treated (60 seconds) at the time of the rear rest, and this was repeated twice as one block. After each treatment, the questionnaire shown in FIGS. 8a and 8b was performed.
マッサージの手技としては、図１上段に示す、比較的浅い層にあるリンパ循環を刺激するマッサージ（ＬＭ：Lymphatic drainage massage）と、図１下段に示す、皮膚の下にある顔筋である咬筋を刺激するマッサージ（ＭＭ：Face muscle massage）を用いた。 As the massage technique, there is a massage that stimulates lymph circulation in a relatively shallow layer (LM: Lymphatic drainage massage) shown in the upper part of FIG. 1 and a masseter that is a facial muscle under the skin shown in the lower part of FIG. A stimulating massage (MM: Face muscle massage) was used.
＜データ解析＞
各手技の各ブロックにおける、右側ＰＦＣ及び左側ＰＦＣのデータを、夫々、以下の手順で解析し、ブロック間での平均値を求めた。
ステップ１：得られた０．１秒毎の血流量データ（ｘｉ）５個ずつの平均値を取り平滑化データ（Ｘｋ、ｋ＝１〜ｎ）を得た。
ステップ２：平滑化データの平均値（ΣＸｋ／ｎ）、及び標準偏差を算出した。
ステップ３：平滑化データのうちの最大値から最小値を差し引いて、最大変動幅（Ｘmax - Ｘmin ）を算出した。
ステップ４：隣接する平滑化データの差分（Ｘｋ＋１−Ｘｋ）を求め、次いで、その絶対値の平均値（Σ｜Ｘｋ＋１−Ｘｋ｜／（ｎ−１）、ｋ＝１〜（ｎ−１））を算出した。
<Data analysis>
The right PFC data and left PFC data in each block of each procedure were analyzed by the following procedure, and the average value between the blocks was obtained.
Step 1: Smoothed data (X k , k = 1 to n) was obtained by taking an average value of 5 blood flow rate data (x i ) obtained every 0.1 seconds.
Step 2: The average value (ΣX k / n) and standard deviation of the smoothed data were calculated.
Step 3: The maximum fluctuation range (Xmax−Xmin) was calculated by subtracting the minimum value from the maximum value of the smoothed data.
Step 4: A difference (X k + 1 −X k ) between adjacent smoothed data is obtained, and then an average value of the absolute values (Σ | X k + 1 −X k | / (n−1), k = 1 to (n -1)) was calculated.
上記各データの、被施術者間の平均値を求めて、手技毎の平均値、最大変動幅、血流量変化値の平均値とした。なお、ステップ２〜４はこの順序で行う必要はなく、いずれのものから行っても、並列で行ってもよい。
また、アンケートの結果を集計して、平均値及び標準誤差を求めた。
The average value of the above-mentioned respective data among the subjects was obtained, and the average value for each procedure, the maximum fluctuation range, and the average value of the blood flow rate change value were obtained. Steps 2 to 4 do not have to be performed in this order, and may be performed from either one or in parallel.
In addition, the questionnaire results were aggregated to obtain the average value and standard error.
図４はステップ２で求めた平均値を、手技ごとにプロットしたグラフである。ここで、「両側ＰＦＣ」は、右側ＰＦＣと左側ＰＦＣの平均値である。同図におけるＬＭとＭＭとを比較すると分かるように、ＰＦＣにおけるＯｘｙ−Ｈｂをより強く低下させる傾向が認められた。 FIG. 4 is a graph in which the average value obtained in step 2 is plotted for each procedure. Here, “both sides PFC” is an average value of the right PFC and the left PFC. As can be seen from a comparison between LM and MM in the figure, a tendency to more strongly reduce Oxy-Hb in PFC was observed.
図５はステップ３で求めた最大変動幅を手技ごとにプロットしたグラフである。同図におけるＬＭとＭＭとを比較すると分かるように、ＭＭにはＬＭと比較してＰＦＣにおけるＯｘｙ−Ｈｂの最大変動幅をより強く増大させる傾向が認められた。 FIG. 5 is a graph in which the maximum fluctuation range obtained in step 3 is plotted for each procedure. As can be seen by comparing LM and MM in the figure, MM showed a tendency to increase the maximum fluctuation range of Oxy-Hb in PFC more strongly than LM.
図６は、血流量変化値を時間に対してプロットしたグラフである。同図におけるＬＭとＭＭとを比較すると分かるように、ＬＭによってＰＦＣにおけるＯｘｙ−Ｈｂが顕著に低下し、ＭＭによってはＯｘｙ−Ｈｂの上下動が認められ、両者の手技の違いを視覚的に捉えることができた。 FIG. 6 is a graph in which blood flow change values are plotted against time. As can be seen by comparing LM and MM in the figure, Oxy-Hb in the PFC is significantly reduced by LM, and Oxy-Hb moves up and down depending on MM, and the difference between the two techniques can be visually grasped. I was able to.
図７は脳血流変化値の絶対値の平均値を示すグラフである。図６では差が認められたが、平均的にみるとＬＭとＭＭとでの脳血流の変動はほぼ同程度であることが認められた。 FIG. 7 is a graph showing an average of absolute values of cerebral blood flow change values. Although a difference was observed in FIG. 6, it was recognized that, on average, the fluctuations in cerebral blood flow between LM and MM were almost the same.
以上、図４〜７の結果から、ＬＭとＭＭとで、ＰＦＣにおけるＯｘｙ−Ｈｂの変化が異なると判断された。 As described above, from the results of FIGS. 4 to 7, it was determined that the change in Oxy-Hb in the PFC is different between the LM and the MM.
＜手技の組合せの評価＞
次に、ＬＭとＭＭを組み合わせることによる脳血流の変化を検討した。タスクを２分割してＬＭ（３０秒間）→ＭＭ（３０秒間）、ＭＭ（３０秒間）→ＬＭ（３０秒間）の順序で組み合わせた際のＯｘｙ−Ｈｂ変化を解析し、ＬＭ、ＭＭとの比較を行った。
<Evaluation of combination of procedures>
Next, changes in cerebral blood flow by combining LM and MM were examined. Analyze the Oxy-Hb change when the task is divided into two parts and combined in the order of LM (30 seconds) → MM (30 seconds), MM (30 seconds) → LM (30 seconds), and compared with LM and MM Went.
図４及び５から分かるように、ＭＭ→ＬＭの組み合わせにより、左側ＰＦＣにおけるＯｘｙ−ＨｂがＬＭ→ＭＭと比較して有意（Ｐ＜0.05：Paired t-test）に低下し、両側ＰＦＣにおける最大変動幅がＬＭと比較して有意に増加した。
図６から分かるように、ＬＭ→ＭＭはＭＭと、ＭＭ→ＬＭはＬＭと類似した波形を示し、手技の組み合わせを行った場合には後半のマッサージに影響されやすいことが示された。
図７からわかるように、ＭＭ→ＬＭは脳血流量の絶対値の変化量が有意に大きく、ＭＭ→ＬＭと組み合わせて行うことにより、より大きな脳血流量の変化が認められた。
As can be seen from FIGS. 4 and 5, Oxy-Hb in the left PFC significantly decreases (P <0.05: Paired t-test) compared to LM → MM and the maximum fluctuation in the two-sided PFC due to the combination of MM → LM. The width increased significantly compared to LM.
As can be seen from FIG. 6, LM → MM shows a waveform similar to MM, and MM → LM shows a waveform similar to LM, indicating that it is easily influenced by the latter massage when a combination of procedures is performed.
As can be seen from FIG. 7, the change in the absolute value of the cerebral blood flow was significantly large in MM → LM, and a larger change in cerebral blood flow was observed when performed in combination with MM → LM.
これらの結果から、異なるマッサージ手技であるＭＭとＬＭを組み合わせると、単独の場合よりも最大変動幅が大きくなり、より効果的であることが分かった。さらに、ＭＭ−ＬＭの順序で行うことにより、ＰＦＣにおけるＯｘｙ−Ｈｂの変動量と最大変動幅の双方が増加することが分かり、さらに効果的であることが分かった。このことは、アンケート結果（図９）によっても支持された。即ち、ＭＭ→ＬＭはＬＭと同等レベルの高いリラックス効果と、ＭＭと同等レベルの高いリフレッシュ効果を有することが示された。 From these results, it was found that the combination of MM and LM, which are different massage techniques, has a larger maximum fluctuation range than that of a single case, and is more effective. Furthermore, it was found that by performing in the order of MM-LM, both the amount of fluctuation of Oxy-Hb in the PFC and the maximum fluctuation range are increased, which is more effective. This was also supported by the questionnaire results (FIG. 9). That is, it was shown that MM → LM has a high relaxing effect equivalent to that of LM and a high refreshing effect equivalent to that of MM.
本発明の評価方法によれば、脳血流の変動を効果的に誘導することによって老化防止等に有効なマッサージ法を開発することができる。 According to the evaluation method of the present invention, it is possible to develop an effective massage method for preventing aging and the like by effectively inducing fluctuations in cerebral blood flow.
Claims (9)
（１）該マッサージ手技の各々について、被施術者の所定部位に所定時間マッサージを施術する間、被施術者の脳血流変動を測定するステップ、
（２）（１）で得られた脳血流変動データを手技間で比較し、手技間での脳血流変動特性の差異の有無を判断するステップ、
（３）差異が有ると判断された手技のうちの少なくとも２つを、少なくとも一の順番で、被施術者の所定部位に所定時間施術する間、被施術者の脳血流変動を測定するステップ、
（４）（３）で得られた脳血流変動データを、（１）で得られた脳血流変動データと比較し、脳血流変動がより大きいか否かを判断するステップ、
を含む方法。 A method of evaluating a massage method including at least two types of massage techniques,
(1) measuring each subject's cerebral blood flow fluctuation while performing massage for a predetermined time on a predetermined site of the patient for each of the massage techniques;
(2) A step of comparing the cerebral blood flow fluctuation data obtained in (1) between procedures and determining the presence or absence of a difference in cerebral blood flow fluctuation characteristics between the procedures;
(3) A step of measuring cerebral blood flow fluctuations of a patient while performing at least two of the procedures determined to have a difference on a predetermined part of the patient for a predetermined time in at least one order. ,
(4) comparing the cerebral blood flow fluctuation data obtained in (3) with the cerebral blood flow fluctuation data obtained in (1) to determine whether or not the cerebral blood flow fluctuation is larger;
Including methods.
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| WO2012165602A1 (en) * | 2011-05-31 | 2012-12-06 | 国立大学法人名古屋工業大学 | Cognitive dysfunction-determining equipment, cognitive dysfunction-determining system, and program |
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