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5.精神および行動の障害 （F03
㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)㧗㱋⪅ᢚ࠺ࡘ㸧 ᩥ⊩ Shahidi M, et al. Laughter Yoga versus group exercise program in elderly depressed women: a randomized controlled trial International Journal of Geriatric Psychiatry.2011, 26: 322-27.Pubmed ID:20848578 ┠ⓗ 㧗㱋ዪᛶ࠾ࡅࡿ࢝ࢱࣜᘧ➗࠸ࣚ࢞ࡢᢚ࠺ࡘపῶຠᯝே⏕‶㊊ᗘྥୖຠᯝࢆࠊࢢ࣮ࣝ ࣉ࣭࢚ࢡࢧࢧࢬ⒪ἲẚ㍑ࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࢸ࣊ࣛࣥᕷ➨ 13 ༊ෆᡤᅾࡍࡿᩥࢥ࣑ࣗࢽࢸࢭࣥࢱ࣮ ཧຍ⪅ ྠᩥࢥ࣑ࣗࢽࢸࢭࣥࢱ࣮ᡤᒓࡍࡿࠊ࠺ࡘഴྥࢆᣢࡘዪᛶ 70 ྡ(60-80 ṓ) ධ ࢝ࢱࣜᘧ➗࠸ࣚ࢞ ᅇࡢࡳ $UP➗࠸ࣚ࢞⩌ ྡ ࢭࢵࢩࣙࣥࡼࡾᵓᡂ $UP࢚ࢡࢧࢧࢬ⩌ ྡ ศࡢ᭷㓟⣲㐠ື ศࡢఇ᠁ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ఱࡶࡋ࡞࠸⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ Yesavage Geriatric depression scale (Yesavage ⪁ᖺ࠺ࡘᑻᗘ) Diener life satisfaction scale (Diener ே⏕‶㊊ࢫࢣ࣮ࣝࠊLSS) ධ๓ᚋࡢ㸰ᅇࠊ ᐃࠋ ࡞⤖ᯝ ⪁ᖺ࠺ࡘᑻᗘᚓⅬ㸸➗࠸ࣚ࢞⩌ࠊ࢚ࢡࢧࢧࢬ⩌ࡣࠊࢥࣥࢺ࣮ࣟࣝẚ࡚᭷ព࡞ᨵၿ ࡀぢࡽࢀࡓ㸦➗࠸ࣚ࢞⩌(P<0.01)ࠊ࢚ࢡࢧࢧࢬ⩌(P<0.1)㸧ࡀࠊ➗࠸ࣚ࢞⩌࢚ࢡࢧࢧ ࢬ⩌ࡢ㛫࡛ࡣᨵၿᗘྜ࠸᭷ព࡞ᕪࡣ࡞ࡗࡓ ே⏕‶㊊ࢫࢣ࣮ࣝ㸸➗࠸ࣚ࢞⩌ࡢࡳࢥࣥࢺ࣮ࣟࣝẚ࡚᭷ព࡞ᨵၿࡀぢࡽࢀࡓ(P<.0.01) ࡇࢀࡽࡢ㡯┠࡛ࠊࣚ࢞⩌࢚ࢡࢧࢧࢬ⩌ࡢ㛫ࡣᕪࡣ࡞ࡗࡓࠋ ⤖ㄽ ➗࠸ࣚ࢞ࡣࠊᢚ࠺ࡘഴྥࡢ㧗㱋ዪᛶࡗ࡚ࠊᑡ࡞ࡃࡶࢢ࣮ࣝࣉ㐠ືࣉࣟࢢ࣒ࣛྠᵝ 㨚ࡸே⏕ࡢ‶㊊ឤࡢᨵၿຠᯝࡀ࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ⩌࠾࠸࡚ ྡࡀࢻࣟࢵࣉ࢘ࢺ ⌮⏤ࡣ᫂ ࣚ࢞ࡢヲ⣽ ᴦࡋ࠸ฟ᮶㸦ᅜࡢ⾜ࡸ᐀ᩍⓗᘧ࡞㸧ࡘ࠸࡚▷ࡃヰࡍ 2.యࢆືࡍ ᡭ ࢆࡓࡓࡁࠊྠ⡆༢࡞ࢳࣕࣥࢶ(㸸࣍ࠊ࣍ࠊࣁࣁࣁ)ࢆຍ࠼ࡿ 4. ᚰ㌟ࡶࣜࣛࢵࢡ ࢫࢆࡶࡓࡽࡍ῝྾ࢆ࠼ࠕ⚾ࡣୡ⏺୍࡛␒ᖾࡏ⪅ࡔࠖྉࡧࠊᡭࢆ྇ࡁ௰㛫ࢆぢ࡚➗࠺ࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ᢚ࠺ࡘࠊே⏕‶㊊ᗘࡢᨵၿࡣࠊձࠕ➗࠺ࠖ࠸࠺⾜Ⅽࡀࠊ➽⫗ࡢ⦆ࠊචࠊ࣍ࣝࣔࣥࠊ ᚰ⌮㠃ࡽᚰ㌟≧ࢆᨵၿࡍࡿຠᯝ㸦➗࠸ࣚ࢞ጞ⪅࢝ࢱࣜࡣࠕ➗࠺ࠖ⌮⏤ࡢ᭷↓ ࢃࡽࡎᨵၿຠᯝࡀ࠶ࡿࡇࢆᙉㄪ㸧ࠊղ➗࠸ࣚ࢞࠾ࡅࡿࣚ࢞ㅖᢏἲ㸦య᧯ࠊ྾ἲ㸧 ࡢຠᯝࡼࡾ⏕ࡌࡓ⪃࠼ࡽࢀࡿࠋࠕ➗࠺ࠖ࠸࠺⾜Ⅽࡣࠊேࠎᖾ⚟ឤࡸᎰࡋ࠸ឤࢆ ࡶࡓࡽࡍ⪃࠼ࡿࠋࡑࡋ࡚ࠊ࢝ࢱࣜࡀᣦࡍࡿࡼ࠺ࠊࣜࢬ࣒ࡼࡃኌࢆฟࡋ࡚➗࠺ࡇ ࡛ࡲࡓࠊ⫵ࡸ⬚➽ࠊ⭡➽ാࡁࡅ࡞ࡀࡽ྾ࡀฟ᮶ࡿ⪃࠼ࡽࢀࡿࠋࡇࡢࡓࡵ➗࠸ࣚ࢞ ࢚ࢡࢧࢧࢬࢆ⾜࠺ࡇࡼࡾࠊ⫯ᐃⓗ࡞ᚰ⌮స⏝ࡀ⏕ࡌࠊࡲࡓ㌟య㠃ࡶຠᯝࡀ࠶ࡿ ⪃࠼ࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ 㧗㱋ዪᛶᑐࡍࡿࠊᢚ࠺ࡘపῶຠᯝே⏕‶㊊ᗘྥୖຠᯝࡢࡓࡵࠊࣚ࢞ࢆ່ࡵࡿ $EVWUDFWRUDQG'DWH ᐑᓮ ┿ᘪ ᒸ Ꮥ 2013.11.1 − 86 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)㧗㱋⪅ᢚ࠺ࡘࠊ╀㸧 ᩥ⊩ Chen KM, Chen MH, Chao HC, Hung HM, Lin HS, Li CH: Sleep quality, depression state, and health status of older adults after silver yoga exercises: Cluster randomized trial. Int J Nurs Stud 2009;46:154-163. Pubmed ID:18947826 ┠ⓗ 㧗㱋ᡂேᑐࡍࡿ㸴࢝᭶ࡢࢩࣝࣂ࣮ࣚ࢞㐠ືࡢຠᯝࠊ≉╧╀ࡢ㉁ࠊᢚ࠺ࡘࠊᗣ≧ែ ᑐࡍࡿ⮬ᕫㄆ㆑ࠊࢆㄪࡿ ◊✲ࢹࢨࣥ &OXVWHUUDQGRPL]HGWULDO ࢭࢵࢸࣥࢢ ࢝ᡤࡢࢩࢽࢡࢸࣈࢸࢭࣥࢱ࣮ ཧຍ⪅ 㻢㻜 ṓ௨ୖ䛾䝁䝭䝳䝙䝔䜱䞊ᒃఫ⪅䛷䝉䝹䝣䜿䜰䛜⊂❧䚸䜒䛧䛟䛿㍍ᗘ౫Ꮡ䛾㧗㱋⪅㻔ᖹᆒ 㻢㻥 ṓ㻕㻌 ධ ࢩࣝࣂ࣮ࣚ࢞ࣉࣟࢢ࣒ࣛ ᅇ ศ㐌 ᅇ ࣨ᭶㛫 $UPධ⩌ ࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ᚅᶵ⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ Pittsburgh Sleep Quality Index (PSQIࠊ╧╀)ࠊTaiwanese Depression Questionnaire (TDQࠊ࠺ࡘ)ࠊ SF-12 Healthy Survey㸦ᗣ≧ែ㛵ࡍࡿ⮬ᕫㄆ㆑㸧ࢆධ๓ࠊධ㛤ጞ3ࣨ᭶ᚋࠊ6ࣨ᭶ᚋ ホ౯ࠋ ࡞⤖ᯝ ⩌㛫ẚ㍑࡛ࡣࠊ3ࣨ᭶ᚋࠊධ⩌ࡢ᪉ࡀࢥࣥࢺ࣮ࣟࣝ⩌ࡼࡾࠊPSQIࡼࡿ⮬ぬⓗ࡞╧╀ࡢ ㉁ࡀࡍࡄࢀࠊ᪥୰ࡢᶵ⬟ࡀపࡗࡓࠋ㌟యⓗࠊ⢭⚄ⓗᗣㄆ▱ᚓⅬࡀ㧗ࡃࠊ࠺ࡘᚓⅬ ࡀపࡗࡓࡀࠊ╧╀₯ࡣධ⩌ࠊࢥࣥࢺ࣮ࣟࣝ⩌࡛ᕪࡣ࡞ࡗࡓࠋ6ࣨ᭶ᚋࡣࠊୖグࡣ ࡍ࡚ධ⩌࡛ࡍࡄࢀ࡚࠸ࡓ㸦╧╀₯ࡶࢥࣥࢺ࣮ࣟࣝ⩌ࡼࡾ▷ࡃ࡞ࡗࡓ㸧 ࠋ 㸦࠸ࡎࢀࡶ p<0.05㸧 ⤖ㄽ 㸴࢝᭶ࢩࣝࣂ࣮ࣚ࢞ࢆ⾜࡞ࡗࡓ⩌࡛ࡣࠊ㧗㱋⪅ࡢ࣓ࣥࢱࣝ࣊ࣝࢫᣦᶆࡢࢇࡀࢥࣥࢺ ࣮ࣟࣝ⩌ࡼࡾୖᅇࡗࡓࠋ㧗㱋⪅ࡢ࣓ࣥࢱࣝ࣊ࣝࢫྥୖຠᯝࡢࢇࡣࠊ㸱ࣨ᭶ᚋ࡛ᚓࡽ ࢀࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ᭷ᐖ㇟࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ୧⩌࡛ 㸣 ⌮⏤ࡣ࣮࢜ࢺࣂᨾࡸ㌿ᒃ ࣚ࢞ࡢヲ⣽ ࢩࣝࣂ࣮ࣚ࢞㐠ືࣉࣟࢢ࣒ࣛࡣ&KHQࡼࡗ࡚㧗㱋⪅ࠊᰂ㌾ᛶࡀపୗࡋࡓࡶࡢ࠶ ࢃࡏࠊ㛤Ⓨࡉࢀࡓࣉࣟࢢ࣒ࣛࠋ㸲ࡘࡢࣇ࢙࣮ࢬࡽ࡞ࡾࠊ࣮࣒࢘࢜ࢵࣉ㸦ศࠊ㌟ యࢆࡸࢃࡽࡆࡿ㸶ࡘࡢ࣏࣮ࢬ㸧 ࠊࣁࢱ࣮ࣚ࢞㸦ศࠊ㧗㱋⪅ࡢ㌟య⬟ຊࠊ⪏ᛶࢆ≉⪃ ៖ࡋࡓࠊྍືᇦ㐍ⓗ➽ᘱ⦆ࢆࡲࡍࡓࡵࡢࠊࢆ㸵ࡘࡢࡺࡿࡸ࡞ࢫࢺࣞࢵࢳࡍࡿ࣏࣮ ࢬ㸧 ࠊࣜࣛࢡࢮ࣮ࢩࣙࣥ㸦ศࠊ㌟యࢆࡸࡍࡵࡿ㸱ࡘࡢάືࠊㄏᑟࡉࢀࡓ࣓࣮ࢪ ▂ࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࢩࣝࣂ࣮ࣚ࢞ࡣ㧗㱋⪅⏝㛤Ⓨࡉࢀࡓࡶࡢࡢࡼ࠺࡛࠶ࡿࡀࠊᐇ࠶ࡓࡾࠊࣚ࢞ࣥࢫࢺ ࣛࢡࢱ࣮ࡣࠊࡑࢀࡒࢀࡢ࣏࣮ࢬࡣ✜ࡸࠊ㐺ᗘ⾜࡞࠺ᵝᙉㄪࡋࠊ࣏࣮ࢬ୰ࡣࡽࡔࢆ ᐖࡍࡿࡣᘬࡁᘏࡤࡉ࡞࠸ࡼ࠺ࠊᖖὀពࡋ࡚⾜࡞ࡗࡓࠊグ㍕ࡉࢀ࡚࠾ࡾࠊࡑࢀ ࡀ㧗㱋⪅ࡀᑐ㇟࡛࠶ࡿࡶࢃࡽࡎࠊ᭷ᐖ㇟ࡀࡃッ࠼ࡽࢀ࡞ࡗࡓ⌮⏤࡛࠶ࢁ࠺ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ 㧗㱋⪅ࡢ࣓ࣥࢱࣝ࣊ࣝࢫྥୖࡢࡓࡵࢩࣝࣂ࣮ࣚ࢞ࢆ່ࡵࡿ $EVWUDFWRUDQG'DWH ᒸᏕ − 87 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)㧗㱋⪅ᢚ࠺ࡘ㸧 ᩥ⊩ Krishnamurthy MN et al. Assessing Depression Following Two Ancient Indian Interventions: Effects of Yoga and Ayurveda on Older Adults in a Residential Home. Journal of Gerontological Nursing; 2007; 17-23. Pubmed ID:17310659 ┠ⓗ タධᡤ㧗㱋⪅࠾࠸࡚ࠊ ࣨ᭶㛫ࡢ࣭ࣚ࢞ࣉࣟࢢ࣒࣮ࣦ࢙࣮ࣛࣘࣝࢲ⏕⸆〇ࡢᢚ ࠺ࡘᨵၿຠᯝࢆ᳨ウࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࣥࢻࠊ%DQJDORUH ࠾ࡅࡿ㧗㱋⪅ධᡤタ ཧຍ⪅ タ࣮࣒࣍ࡢ ṓ௨ୖ ྡ ධ $UPධ⩌ ࣚ࢞⩌ ྡ 69<$6$ ࠺ࡘࣉࣟࢢ࣒ࣛ ᅇ ศ㐌 ᪥ 㐌㛫 $UPධ⩌ ࣮ࣦ࢙࣮ࣘࣝࢲ⩌ ྡ ⏕⸆ࣛࢧࣖࢼ࢝ࣝࣃࢆ ᪥ ᅇᦤྲྀࠋ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ᚅᶵ⩌ ྡ ධᚋ࣮ࣦ࢙࣮ࣚ࢞ࣘࣝࢲᐇྍ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1. The 15-item Geriatric Depression Scale (GDS, 15 㡯┠ࡢ⪁ᖺᮇ࠺ࡘᑻᗘ) ධ๓ࠊ㸱ࣨ᭶ᚋࠊ㸴ࣨ᭶ᚋࡢ㸱ᅇࠊ ᐃࠋ ࡞⤖ᯝ ࣚ࢞⩌ࡣࠊ࣮࣋ࢫࣛࣥẚ㍑ࡋ࡚ 3 ࣨ᭶(p <0 .001)ࠊ࠾ࡼࡧ 6 ࣨ᭶ (p <0 .001)࠺ࡘ ≧ᚓⅬ(GDS)ࡀ᭷ពῶᑡࡋࡓࡀࠊ࣮ࣦ࢙࣮ࣘࣝࢲ⩌ᚅᶵ⩌࡛ࡣ᭷ព࡞ኚࡣㄆࡵࡽ ࢀ࡞ࡗࡓࠋ ⤖ㄽ ㌟యⓗカ⦎ࠊ⢭⚄ⓗࠊဴᏛⓗ࡞ほⅬࢆྵࡵࡓࣚ࢞ࡢ⤫ྜⓗࣉ࣮ࣟࢳࡣࠊタ࠸ࡿ㧗 㱋⪅ࡗ࡚᭷⏝࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࣚ࢞⩌㸣 ࣮ࣦ࢙࣮ࣘࣝࢲ⩌㸣 ⌮⏤⏕⸆〇 PO ࢆẖ᪥ ᅇᦤྲྀ ࡍࡿࡽ‶⭡࡞ࡾࠊ㣧ࡳࡓ࠸ࢥ࣮ࣄ࣮ࢆᴦࡋࡵ࡞ࡃ࡞ࡿ ࢥࣥࢺ࣮ࣟࣝ⩌㸣 ࣚ࢞ࡢヲ⣽ ࣈ࣮ࣜࢪࣥࢢ㺃࢚ࢡࢧࢧࢬศࠊ࣮ࣝࢬࢽࣥࢢ㺃࢚ࢡࢧࢧࢬศࠊయἲ㸦❧ࠊ ௮⮩ࠊ⭡⮩ࠊᗙࢆศ㸧ࠊ྾ἲศࠊࣚ࢞ᇶ࡙ࡁㄏᑟࡍࡿࣜࣛࢡࢭ࣮ࢩࣙࣥ ศࠊ⪷ḷศ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ 㧗㱋⪅ࢆᑐ㇟ࡋࡓᙜ◊✲࡛ࡣࠊྛ✀⾜ἲࡢ࠺ࡕࠊ⪷ḷࡀ᭱ࡶᴦࡋ࠸ࣉࣟࢢ࣒ࣛࡋ࡚ዲ ࡲࢀ࡚࠸ࡓࠋᵝࠎ࡞య㦂ࢆ⤒࡚ࠊே⏕ࡢ⤊ᮎᮇ࠶ࡓࡿேࠎࡗ࡚ࠊ⢭⚄ᛶࢆ῝ࡵࡿࣉ ࣟࢢ࣒ࣛࡣᚲせ࡛࠶ࢁ࠺ࡋࠊᐇ㝿ዲࡲࢀ࡚࠸ࡓࠋࡋࡋࠊᩥࡢ㐪࠸ࡼࡗ࡚ࡣࠊࣉࣟ ࢢ࣒ࣛࢆᕤኵࡍࡿࡇࡀồࡵࡽࢀࡼ࠺ $EVWUDFWRU ࡢ᥎ዡᗘ ᐙ᪘ࡢὶࡀᑡ࡞ࡃே⏕ࡢ⤊ᮎᮇྥ࠺㧗㱋⪅ᑐࡋࠊᢚ㨚ឤࢆ㍍ῶࡉࡏࡿࡶࡢࡋ ࡚ࠊ㌟యⓗ࢚ࢡࢧࢧࢬࡸࣜࣛࢡࢭ࣮ࢩࣙࣥࠊ྾ἲࠊ⢭⚄ⓗ࣭ဴᏛⓗ࡞ほⅬࢆྵࡵࡓࣚ ࢞ࡢ⤫ྜⓗࣉ࣮ࣟࢳࢆ᥎ዡࡍࡿ $EVWUDFWRUDQG'DWH 㔝ᆏぢᬛ௦ ᒸᏕ − 88 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)⤫ྜኻㄪ㸧 ᩥ⊩ Ikai S, et al. Effects of yoga therapy on postural stability in patients with schizophrenia-spectrum disorders : A single-blind randomized controlled trial. Journal of Psychiatric Research, 2013,Vol. 47, pp1744-1750 Pubmed ID:23932244 ┠ⓗ ⤫ྜኻㄪ࡛ࡣ㌟యⓗᏳᐃࡀ㌿ಽࡢࣜࢫࢡࢆቑࡍࡓࡵ㔜せ࡞ၥ㢟࡛࠶ࡿࠋ⤫ྜኻㄪᝈ ⪅ࡢጼໃᏳᐃᰂ㌾ᛶᑐࡍࡿࣚ࢞⒪ἲࡢຠᯝࢆ᳨ウࡍࡿࠋ ◊✲ࢹࢨࣥ ▷┣᳨ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦VLQJOHEOLQG5&7㸧 ࢭࢵࢸࣥࢢ ᒣ┴ᒣ┴❧㝔⚄⤒⢭⚄⛉ 1 タ ཧຍ⪅ ⤫ྜኻㄪ࠶ࡿ࠸ࡣ⢭⚄ᛶ㞀ᐖデ᩿ࡉࢀࡓ ṓ௨ୖࡢእ᮶ᝈ⪅ ධ ࣚ࢞⒪ἲ ᅇ ศ㐌 ᅇ ᅇ㸦㸶㐌㸧 ࡑࡢᚋ ࠥ 㐌ࡣࢹࢣཧຍ $UPධ⩌ ⥅⥆୰ࡢ⒪㸩ࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ⥅⥆⒪㸩ࢹࢣࣉࣟࢢ࣒ࣛ⩌ ྡ 667ᚰ⌮ᩍ⫱ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1. 㔜ᚰືᦂ᳨ᰝ㸦ࣟࣥ࣋ࣝࢢ⋡࡞㸧 2.❧ࡼࡿ๓ᒅࡢ ᐃ 3.㏣㊧ㄪᰝ࠾࠸࡚ ձPositive and Negative Syndrome Scale 㸦PANSS, 㝧ᛶࠊ㝜ᛶ≧㸧 ղ Drug-Induced Extrapyramidal Symptoms Scale 㸦㗹యእ㊰≧㸧ճFACT-Sz 㸦≧ࡼࡿၥ㢟♫ᶵ ⬟ホ౯㸧մ EroQol 5 dimensions㸦QoL㸧 յ CVR-R㸦ᚰ㟁ᅗ R-R 㛫㝸㸧 ධᮇ㛫๓ᚋ㸦8 㐌ࠊࡉࡽ 16 㐌ࡢ㡯┠ࡶ࠶ࡾ㸧 ࠋ ࡞⤖ᯝ ධᚋࠊࣚ࢞⩌ࡣࢥࣥࢺ࣮ࣟࣝ⩌ẚ࡚㔜ᚰືᦂィ࡛ࡢయᖿ㐠ື㊥㞳ࡢ㛗ࡉ(P=0.008) ࣟࣥ࣋ࣝࢢ⋡(P=0.009)ࠊ❧ࡼࡿ๓ᒅ(P=0.014)ࡀᨵၿࡋࡓࠋ⮫ᗋⓗᣦᶆ࡛୧⩌㛫࡛ᕪ ࡀࡳࡽࢀࡓࡶࡢࡣ PANSS ࡢ㝜ᛶ≧(P=0.014ࠊࣚ࢞⩌࡛ᚓⅬపୗ) FACT-Sz(P-=0.003ࠊ ࣚ࢞⩌࡛ቑຍ)ࡢࡳ࡛ࠊࡢ⤫ྜኻㄪࡢ⮫ᗋ≧㛵㐃ࡍࡿᣦᶆ࡛ࡣ୧⩌࡛ᕪࡣ࡞ࡗ ࡓࠋࣚ࢞⒪ἲ⩌࠾࠸࡚ 8 㐌┠♧ࡉࢀࡓຠᯝࡣࠊ16 㐌┠ࡰ࣮࣋ࢫࣛࣥᡠࡗࡓࠋ ⤖ㄽ ⤫ྜኻㄪࢫ࣌ࢡࢺ࣒ࣛᝈ⪅ࡢጼໃᏳᐃᰂ㌾ᛶ㛵ࡍࡿࣚ࢞⒪ἲࡢຠᯝࡀึࡵ࡚ホ౯ ࡉࢀࡓࠋ8 㐌㛫ࡢࣚ࢞⒪ἲ࡛ጼໃືᦂࡣ᭷ពῶᑡࡋࡓࠋࣚ࢞ࡣ⤫ྜኻㄪࢫ࣌ࢡࢺ࣒ࣛ ᝈ⪅ࡢጼໃᏳᐃࢆ㧗ࡵࠊ㌿ಽࡸ㦵ᢡࡢࣜࢫࢡῶᑡ᭷ຠ࡛࠶ࡿࡇࡀ♧၀ࡉࢀࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌ 8㸣 ⌮⏤ࡣ୧⩌ඹྠពࡢ᧔ᅇࠊධ๓ࡢ≧ࡢ⇞ࠊྜేࡼࡿධ㝔 ࢥࣥࢺ࣮ࣟࣝ⩌ 㸣 ࣚ࢞ࡢヲ⣽ ࢛࣮࣒࢘ࢵࣉࡋ࡚➽⫗ࢆࡄࡍ㐠ືࡢ࠶ࠊ࣮ࢧࢼࡋ࡚ࠊࡡࡌࡾࡢ࣏࣮ࢬࠊ ❧ࡼࡿ࣏࣮ࢬࠊኴ㝧♩ᣏࠊᒈࡢ࣏࣮ࢬࠊ྾ἲࢆ⾜ࡗࡓࠋ 㸦྾ἲࡢヲ⣽ࡘ࠸࡚ ࡣ 6XSSOHPHQWDU\WDEOH ࢆཧ↷グ㍕࠶ࡿࡢࡳ㸧 ࠋ▂ࡘ࠸࡚ࡣグ㍕࡞ࡋࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ⤫ྜኻㄪᝈ⪅ࡢጼໃᏳᐃᰂ㌾ᛶ࠾ࡅࡿࠊࣚ࢞⒪ἲࡢຠᯝࡢ◊✲ࡣ㐣ཤ࡞ࡃࠊ౯್ ࡀ࠶ࡿࠋࣚ࢞ࡢࢭࢵࢩࣙࣥࢆ⤫ྜኻㄪᝈ⪅ྥࡅᕤኵࡋࠊࢻࣟࢵࣉ࢘ࢺ⋡ࢆῶᑡࡉࡏ ࡓⅬࡀ⯆῝࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ⤫ྜኻㄪᝈ⪅ࡢጼໃᏳᐃᰂ㌾ᛶࢆ㧗ࡵࡿࡓࡵࠊࣚ࢞ࢆ່ࡵࡿ $EVWUDFWRUDQG'DWH ᖹ⃝ᫀᏊ ᒸᏕ − 89 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)&⤫ྜኻㄪ㸧 ᩥ⊩ Varambally S, et al. Therapeutic efficacy of add-on yogasana intervention in stabilized outpatient schizophrenia: Randomized controlled comparison with exercise and waitlist. Indian Journal of Psychiatry . 2012 ; 54(3): 227–232. Pubmed ID: 23226845 ┠ⓗ ⤫ྜኻㄪእ᮶ᝈ⪅ᑐࡋ࡚ࣚ࢞ࢧࢼ㏣ຍධࡢ⒪ⓗ᭷⏝ᛶࢆ᳨ウࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ WKH1DWLRQDO,QVWLWXWHRI0HQWDO+HDOWKDQG1HXURVFLHQFHV タࣥࢻ ཧຍ⪅ ⤫ྜኻㄪデ᩿ࡉࢀࡓእ᮶ᝈ⪅ ྡࠋᖹᆒᖺ㱋ࡣࣚ࢞⩌ ṓࠊ㐠ື⩌ ṓࠊᚅ ᶵ⩌ ṓࠋṔࡢᖹᆒ᭶ᩘࡣࠊࣚ࢞⩌ ࣧ᭶ࠊ㐠ື⩌ ࣧ᭶ࠊᚅᶵ⩌ ࣧ᭶ࠋ ධ ࣏࣮ࢬ྾ἲࡢࡳࡢࣚ࢞ ᅇ ศ᭱ึࡢ ᭶㛫 ᅇࠋධᚋࡶ⮬Ꮿ࡛ࡢᐇ⩦ࢆ ᥎ዡࠋධᚋࡢ ᭶㛫ẖ᭶ࣇ࢛࣮ࣟࢵࣉࢆ⾜ࡗࡓࠋ $UPࣚ࢞⩌ ྡࠋ㏻ᖖ⒪ຍ࠼ࠊࣚ࢞ࢆධࠋ $UP㐠ື⩌ ྡࠋ㏻ᖖ⒪ຍ࠼ࠊᶆ‽ⓗ࡞㐠ືࠋ $UPᚅᶵ⩌ ྡࠋ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1.PANSS ⤫ྜኻㄪࡢ㝧ᛶ࣭㝜ᛶ≧ホ౯ᑻᗘࠊ2.SOFS ♫ⓗ⫋ᴗⓗᶵ⬟ࢫࢣ࣮ࣝࠊ3. Extra Pyramidal Symptoms 㗹యእ㊰≧ࠋධ๓ 4 ᭶ᚋࡢ 2 ᅇ ᐃࠋ ࡞⤖ᯝ ධࡢ๓ 4 ᭶ᚋࡢ ᐃ࡛ࠊࣚ࢞⩌࡛ PANSS㸦㝜ᛶ㸦P<0.001㸧⥲ྜ㸦P<0.001㸧 㸧 SOFS㸦P<0.001㸧ࡢⴭࡋ࠸ῶᑡࡀ㉳ࡇࡗࡓࠋ㐠ື⩌࡛ࡣ SOFS㸦P=0.004㸧࡛ῶᑡࡀ࠶ࡗࡓ ࡶࡢࡢࠊࡑࡢࡢ ᐃ࡛ࡣ㐠ື⩌ࡶᚅᶵ⩌ࡶⴭࡋ࠸ኚࡣ࡞ࡗࡓࠋࣚ࢞⩌ࡣ㐠ື⩌㸦࢜ ࢵࢬẚ=5.000㸧 ࠊᚅᶵ⩌㸦࢜ࢵࢬẚ=5.167㸧ࡢࡕࡽẚ㍑ࡋ࡚ࡶ PANSS 㝜ᛶᚓⅬࡢᨵၿ ࢆᚓࡿྍ⬟ᛶࡣ 5 ಸࡢቑຍࢆࡶࡓࡽࡍࡇࢆ♧ࡋࡓࠋPANSS ⥲ྜᚓⅬࡢほⅬࡽࣚ࢞⩌ ࠾ࡅࡿᨵၿࡢྍ⬟ᛶࡣᚅᶵ⩌㸦࢜ࢵࢬẚ= 6.576㸧ࡼࡾࡶ⣙ 6 ಸ࡛࠶ࡗࡓࠋධࡣࠊ⸆ ᛶ㗹యእ㊰≧ࡢホ౯ࡣᙳ㡪ࢆཬࡰࡉ࡞ࡗࡓࠋ ⤖ㄽ ᩘᖺ㛫Ᏻᐃࡋࡓᢞ⸆⒪ࢆཷࡅ࡚࠸ࡿ⤫ྜኻㄪᝈ⪅ࠊࣚ࢞ࡢ 1 ࣨ᭶ࡢᐇ⩦ࡑࡢᚋࡢ 3 ࣨ᭶ࡢ⮬Ꮿᐇ⩦ࢆ⾜࠺㏣ຍࡢ⒪ࡣࠊ㐠ືࢆ㏣ຍࡍࡿ⒪ࡸ㏻ᖖ⒪ࡼࡾࡶ㔜せ࡞ຠᯝ ࢆᥦ౪ࡋࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ゝཬ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࣚ࢞⩌ ྡࠊ㐠ື⩌ ྡࠊᚅᶵ⩌ ྡࠊィ ྡࡢ ࡀ᭱⤊ⓗࢻࣟࢵࣉ࢘ࢺࡋࡓࠋ ࣚ࢞ࡢヲ⣽ ≉ᐃࡢ࣏࣮ࢬ྾ἲ࡛ᵓᡂࡉࢀࡿࣚ࢞ࠋ▂ࡣࠊ⢭⚄ࢆᝏࡍࡿ༴㝤ᛶࡀ࠶ࡿࡓࡵࠊ ▂ࡢᵓᡂせ⣲ࡣྵࡲ࡞࠸ࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ⤫ྜኻㄪᑐࡋ࡚㏻ᖖ⒪ຍ࠼ࡓࣚ࢞ࡢຠᯝࡘ࠸࡚᭷ព⩏࡞⤖ᯝࢆᚓࡽࢀࡓࠋཧຍ ⪅ࡢṔࡀᖹᆒ࡛ ᖺ࠶ࡾࠊᝈ⪅ᮏேࡸᝈ⪅ࡢ㏆ࡃ࡛ᬽࡽࡍேࠎࡢࡇࢆ⪃࠼ࡿ ࡶࡗ᪩ࡃࡇࡢ᭷ຠ࡞⒪ࢆ▱ࡾࡓࡗࡓ࡛࠶ࢁ࠺ࠋᚋࡣࠊṔࡢ㛗ࡉࣚ࢞ࡢຠᯝࡢ 㛵ಀࡘ࠸࡚ࡢ◊✲ࡀࡉࢀࡿࡇࢆᮇᚅࡋࡓ࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ⤫ྜኻㄪࡢᝈ⪅ᑐࡋ࡚ࠊ㏻ᖖ⒪ຍ࠼ࣚ࢞ࢆᐇ⩦ࡍࡿࡇࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ᯇ⏣༓㔛 ᒸᏕ − 90 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)⤫ྜኻㄪ㸧 ᩥ⊩ Visceglia E, et al: Yoga Therapy as an adjunctive Treatment for Schizophrenia: A Randomized, Controlled Pilot Study. The Journal of Alternative and Complementary Medicine (2011) 17(7), 601-607. PubMed ID:21711202 ┠ⓗ ⢭⚄タධ㝔୰ࡢᡂே⤫ྜኻㄪᝈ⪅ࡢ≧ 42/ ᑐࡍࡿࣚ࢞⒪ἲࣉࣟࢢ࣒ࣛࡢ ຠᯝࢆ᳨ウࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ⡿ᅜࢽ࣮࣮ࣗࣚࢡࡢ⢭⚄タ㸦%URQ[3V\FKLDWULF&HQWHU%URQ[1<㸧 ཧຍ⪅ ྡ'60ϫࡢ➨ ㍈デ᩿࡛⤫ྜኻㄪデ᩿ࡉࢀࡓ⮫ᗋⓗᏳᐃࡋࡓධ㝔ᝈ⪅ࠋᩘྡ ࡣ⤫ྜኻㄪᛶឤ㞀ᐖࡲࡓࡣ 376' ేࡏ࡚デ᩿ࡉࢀ࡚࠸ࡿࠋࣚ࢞⩌ࡢ࠺ࡕ ྡࠊᚅᶵ⩌ ࡢ࠺ࡕ ྡࡣ➨ ㍈࡛ࡶ㞀ᐖ࠶ࡾデ᩿ࡉࢀ࡚࠸ࡿࠋ ධ ࣚ࢞ࢭࣛࣆ࣮ ᅇ ศ㐌 ᅇ 㐌㛫 $UPධ⩌ࣚ࢞⩌㸦 ྡ㸧 $UPࢥࣥࢺ࣮ࣟࣝ⩌ᚅᶵ⩌㸦 ྡ㸧ධヨ㦂ࢆ 㐌㛫⾜࡞ࡗࡓࠋ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ PANSS(⯡ⓗ࡞⤫ྜኻㄪࡢ⢭⚄≧ែ)ࠊ WHOQOL-BREF (WHO QOL ㉁ၥ⣬) ࢆධ ๓ࠊධᚋ࡛ẚ㍑ࠋ ࡞⤖ᯝ ࣚ࢞⩌ࡣࢥࣥࢺ࣮ࣟࣝ⩌ẚ㍑ࡋ࡚ࠊ PANSS ࡢ᭷ព࡞ᨵၿ[Total(㹮<.00), ୗᑻᗘ positive syndrome(p=.02), negative syndrome(p<.01), general psychopathology(p<.00), activation(p=.04), paranoia(p<.01), depression(p=.02)ࡀぢࡽࢀࡓࠋWHOQOL-BREF ࡣ Physical Health Domain 㸦p=.04)ࠊPsychological Domain(p<.01)ࡀ᭷ពᨵၿࡋ࡚࠸ࡓࠋ ⤖ㄽ ⢭⚄タ࡛⒪ࢆཷࡅ࡚࠸ࡿᡂே⤫ྜኻㄪᝈ⪅ᑐࡋ࡚ࠊ㸶㐌㛫ࡢࣚ࢞⒪ἲࣉࣟࢢࣛ ࣒ࡣࠊࢥࣥࢺ࣮ࣟࣝ⩌ࡼࡾ⢭⚄⌮ QoL ࢆᨵၿࡋࡓࠋࡼࡾつᶍࡢࡁ࠸ࠊࢡࢸࣈ ࢥࣥࢺ࣮ࣟࣝࢆ⏝࠸ࡓ◊✲ࢆᐇࡍࡿࡁ࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ グ㍕࡞ࡋࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࢻࣟࢵࣉ࢘ࢺ࡞ࡋࠋ ࣚ࢞ࡢヲ⣽ ࣚ࢞ࢭࣛࣆ࣮㸸㍍㈇ᢸࡢࣚ࢞ࢫࢺࣞࢵࢳࠊ྾㐃ືࡉࡏࡿ༢⣧࡞య᧯ࠊ༢⣧࡞྾ἲྤ ࡃᜥࢆ㛗ࡃࡍࡿࡇࢆᙉㄪࠊ࣮ࢧࢼࠊࡼࡾᵓᡂࠋ᭱ᚋᣦᑟ⪅ࡢ࢞ࢻࡼࡿᘱ⦆ ἲࢆᐇࠋయ᧯ࡢ✀㢮࡞ࡣࢡࣛࢫ࣭ࢡࣛࣥࢺࡢ≧ἣࡼࡾ⤌ࡳ᭰࠼࡚ᐇࡍࡿࡁ ࡢ⪃࠼᪉ࡽࠊྛᅇࡼࡾኚ᭦ࡋࡓࠋ▂ࡣᐇࡋ࡞ࡗࡓࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ⤫ྜኻㄪᑐࡍࡿࣚ࢞⒪ἲࡢຠᯝࢆ᳨ウࡋࡓࣃࣟࢵࢺࢫࢱࢹࡋ࡚ព⩏࠶ࡾࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ⤫ྜኻㄪᝈ⪅ᑐࡋ࡚᮲௳ࡁ່࡛ࡵࡿࠋ 㸦ᑐ㇟⪅ࡢᑡ࡞࠸ࣃࣟࢵࢺࢫࢱࢹࡢࡓࡵ㸧 $EVWUDFWRUDQG'DWH ᮧୖ┿ ᒸᏕ − 91 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)⤫ྜኻㄪ㸧 ᩥ⊩ Behere RV, et al. Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia. Acta Psychiatr Scand 2011;123:147–53.Pubmed ID:20846271 ┠ⓗ ⤫ྜኻㄪ࡛ࡣ㢦ືㄆ▱㞀ᐖIDFLDOHPRWLRQUHFRJQLWLRQGHILFLW)(5'ࡀࡳࡽࢀࠊ ♫⫋ᴗⓗᶵ⬟ࢆᦆࡡࡿཎᅉ࡞ࡗ࡚࠸ࡿࠋࡑࡇ࡛ᢠ⢭⚄⸆࡛Ᏻᐃࡋ࡚࠸ࡿ⤫ྜኻㄪ ᝈ⪅ࡢ㢦ືㄆ▱㞀ᐖᑐࡍࡿࣚ࢞ࡢຠᯝࢆ᫂ࡽࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࣥࢻ࣭ࣂ࣮ࣥ࢞ࣟࣝᕷࡢ 1DWLRQDO,QVWLWXWHRI0HQWDO+HDOWKDQG1HXUR6FLHQFHV ཧຍ⪅ '60ϫ࡛⤫ྜኻㄪデ᩿ࡉࢀࡓ ṓࡢᝈ⪅ ྡ ධ 69<$6$ ࡢ⤫ྜኻㄪᝈ⪅⏝ࣉࣟࢢ࣒ࣛ ศ㸯ࣨ᭶㛫ẖ᪥⥆ࡃ ࣨ᭶㛫ࡣ⮬Ꮿᐇ⩦ $UPධ⩌ ࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ࢚ࢡࢧࢧࢬ⩌ ྡ ศ㸯ࣨ᭶㛫ẖ᪥ ࣨ᭶⮬Ꮿᐇ⩦ $UPࢥࣥࢺ࣮ࣟࣝ⩌ᚅᶵ⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1. Positive and Negative Syndrome Scale 㸦PANSS,㝧ᛶࠊ㝜ᛶ≧㸧2. Socio-Occupational Functioning Scale 㸦SOFC,♫⫋ᴗⓗᶵ⬟㸧3. Tool for Recognition of Emotions in Neuropsychiatric Disorders (TRENDS)ࠊTRENDS Accuracy Score (TRACSࠊືⓗ⾲ࢆṇ☜ ㄆ㆑)ࠋධ๓ࠊ2 ࣨ᭶ᚋࠊ4 ࣨ᭶ᚋࡢ 3 ᅇࠊ ᐃࠋ ࡞⤖ᯝ ධ๓ࠊࣚ࢞ᐇ⩦⩌ࡣࡢ㸰⩌ᑐࡋ࡚ࠊPANSS࣭Negative Symptoms Scale ࡀ᭷ព㧗ࡃࠊ TRACS ࡀ᭷ពపࡗࡓࠋධࡢຠᯝ㸸ࣚ࢞⩌ࡢࡳ PANSS࣭Positive and Negative Symptom Scale (㸰ࣨ᭶ᚋࠊp=0.002, p<0.001), TRACS(㸰ࣨ᭶ᚋࠊp=0.003), SOFC(㸰ࣨ᭶ᚋࠊp<0.001) ࡀ᭷ពᨵၿࡋࡓࠋࡇࡢᨵၿຠᯝࡣ㸰࢝᭶ᚋ࡛᭱ࡶࡁࡗࡓࡀࠊ4 ࣨ᭶ᚋࡢᨵၿࡶ᭷ព ࡛࠶ࡗࡓࠋ୍᪉ࠊࡢ㸰⩌࡛ࡣࠊࡇࢀࡽࡢᣦᶆኚࡣ࡞ࡗࡓࠋ ⤖ㄽ ࣚ࢞⒪ἲࡣᢠ⢭⚄⸆ࡼࡾ≧ࡀᏳᐃࡋ࡚࠸ࡿ⤫ྜኻㄪᝈ⪅ࡢ)(5'♫⫋ᴗⓗᶵ ⬟ࢆᨵၿࡍࡿຍⓗ⒪ἲࡋ࡚᭷⏝࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࣚ࢞⩌㸵ྡ ࢚ࢡࢧࢧࢬ⩌ ྡ ᚅᶵ⩌ ྡ ࣚ࢞ࡢヲ⣽ ࣦࣦ࢙࣮࢝ࢼࣥࢲ࣭࣮ࣚ࢞◊✲㈈ᅋ㸦69<$6$㸧ࡀ㛤Ⓨࡋࡓࣉࣟࢢ࣒ࣛࢆᣦᑟࠋ࣮ࣝࢬࢽ ࣥࢢ࢚ࢡࢧࢧࢬࠊ࣮ࢧࢼࠊ྾ἲࠊࣜࣛࢡࢮ࣮ࢩࣙࣥࡽᵓᡂࡉࢀయ࡛㸯㛫ࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ඛ⾜◊✲ࡀஈࡋ࠸)(5'ᑐࡍࡿࣚ࢞⒪ἲࡢຠᯝࢆ᳨ドࡋࡓࡇࠊ≉ࣨ᭶ᚋⅬ࡛ࡶຠ ᯝࡀ⥅⥆ࡋ࡚࠸ࡿⅬ࡛ព⩏ࡢ࠶ࡿᡂᯝ⪃࠼ࡽࢀࡿࠋࡓࡔࠊᶆᮏศᕸࡢṇつᛶࡘ࠸࡚ゝ ཬࡣ࡞࠸ࡀࠊᶆᮏᩘ㚷ࡳࢀࡤࣃ࣓ࣛࢺࣜࢵࢡศᯒࡼࡿ᳨ᐃࡣ↓⌮ࡀ࠶ࡿᛮࢃࢀ ࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ⤫ྜኻㄪᝈ⪅ᑐࡋ࡚ᢞ⸆୪⾜ࡋ࡚ࣚ࢞⒪ἲࢆᐇ⩦ࡍࡿࡇࢆ᮲௳ࡁ່࡛ࡵࡿ $EVWUDFWRUDQG'DWH ᮧୖ┿ ᒸᏕ − 92 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)⤫ྜኻㄪ㸧 ᩥ⊩ Vancampfort D, et al. State anxiety, psychological stress and positive well-being responses to yoga and aerobic exercise in people with schizophrenia: a pilot study: a randomized controlled trial. Disability and Rehabilitation.2011;33(8):684-689 Pubmed ID: 20718623 ┠ⓗ ⤫ྜኻㄪᝈ⪅ࠊࣚ࢞࠶ࡿ࠸ࡣ࢚ࣟࣅࢡࢫࡢࢩࣥࢢࣝࢭࢵࢩࣙࣥᑐ↷᮲௳࡛Ᏻࠊ ⢭⚄ⓗࢫࢺࣞࢫࠊほⓗᖾ⚟ឤࡢኚࡘ࠸࡚ẚ㍑᳨ウࢆ⾜ࡗࡓࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ .RUWHQEHUJ Ꮫᛴᛶᮇ⢭⚄⛉㸯タ࣮ࣦ࢙ࣝࣥ࣋ࣝࢠ࣮ ཧຍ⪅ .RUWHQEHUJ Ꮫᛴᛶᮇ⢭⚄⛉Ჷධ㝔ࡋ࡚࠸ࡿ⤫ྜኻㄪࡶࡋࡃࡣ⤫ྜኻㄪᵝ㞀ᐖ デ᩿ࡉࢀࡓ⏨ᛶ ྡ㸦ᖹᆒᖺ㱋 s ṓ㸧 ࠊዪᛶ ྡ㸦s ṓ㸧ィ ྡࠋ ධ ࣁࢱࣚ࢞ ᅇ ศ ྡࡢཧຍ⪅ࡣࣛࣥࢲ࣒࡞㡰␒࡛ࣚ࢞ࠊ࢚ࣟࣅࢡࢫࠊ㐠ືࡣࡋ ࡞࠸ᑐ↷᮲௳ࡢ ࡘࡢࢭࢵࢩࣙࣥࢆ୍ᗘ⾜ࡗࡓࠋ $UPࣚ࢞ $UP࢚ࣟࣅࢡࢫ ศ㛫⮬ศࡢዲࡁ࡞ᙉᗘ࡛࢚ࣝࢦ࣓࣮ࢱ࣮ࢆ₈ࡄࠋ $UPᑐ↷᮲௳ ศᏳ㟼ᗙࢆಖᣢ㸦࠼ࡽࢀࡓࡶࡢࢆㄞ᭩ࡍࡿࡇࡣྍ⬟㸧 ࠋ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1.State Anxiety Inventory (SAI) Ᏻ 2. Subjective Exercise Experiences Scale (SEES) ⢭⚄ⓗ ࢫࢺࣞࢫほⓗᖾ⚟ឤࠋධ๓ᚋࡢ 2 ᅇ ᐃࠋ ࡞⤖ᯝ Ᏻࡣࠊࣚ࢞ᚋ㸦P<0.0001㸧࢚ࣟࣅࢡࢫᚋ㸦P<0.0001㸧࡛㐠ື࡞ࡋᚋẚ㍑ࡋ᭷ព ῶᑡࡋࡓࠋࣚ࢞ᚋ࢚ࣟࣅࢡࢫᚋ࡛ࡣ᭷ពᕪࡣぢࡽࢀ࡞ࡗࡓࠋ ⢭⚄ⓗࢫࢺࣞࢫࡣࠊࣚ࢞ᚋ㸦P<0.0001㸧࢚ࣟࣅࢡࢫᚋ㸦P<0.0001㸧࡛ධᚋࡢ್ࡀ㐠 ື࡞ࡋᚋẚ㍑ࡋ࡚᭷ពపୗࡋࡓࠋࣚ࢞ᚋ࢚ࣟࣅࢡࢫᚋ࡛ࡣ᭷ពᕪࡣぢࡽࢀ࡞ࡗ ࡓࠋ ほⓗᖾ⚟ឤࡣࠊࣚ࢞ᚋ㸦P<0.0001㸧࢚ࣟࣅࢡࢫᚋ㸦P<0.0001㸧࡛ධᚋࡢ್ࡀ㐠ື ࡞ࡋᚋẚ㍑ࡋ࡚᭷ពୖ᪼ࡋࡓࠋࣚ࢞ᚋ࢚ࣟࣅࢡࢫᚋ࡛ࡣ᭷ពᕪࡣぢࡽࢀ࡞ࡗ ࡓࠋ ⤖ㄽ ࣚ࢞᭷㓟⣲㐠ືࡣ≧ែᏳࢫࢺࣞࢫࢆῶᑡࡉࡏࠊほⓗᖾ⚟ឤࢆቑຍࡉࡏࡿ⤖ᯝ࡞ ࡗࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ グ㍕࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࢻࣟࢵࣉ࢘ࢺ࡞ࡋࠋ ࣚ࢞ࡢヲ⣽ ᪂ᚠ⎔⣔ࡢ࢛࣮࣑࢘ࣥࢢࢵࣉ ศ⭡ᘧ྾カ⦎ ศ࣮ࢧࢼ ศ㸦D ᒣࡢ࣏࣮ࢬ Eᮌࡢ࣏࣮ࢬ F⊧ࡢ࣏࣮ࢬ Gࢥࣈࣛࡢ࣏࣮ࢬ H⭸⬚ࡢ࣏࣮ࢬ㸧 ࣜࣛࢡࢮ࣮ࢩࣙࣥ㸦6KDYDVDQD ྵࡴ㸧 ศ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ⤫ྜኻㄪᝈ⪅ࡀ♫⏕άࢆ㏦ࡿ୰࡛ឤࡌࡿᏳࡸ⢭⚄ⓗࢫࢺࣞࢫࢆᑐฎࡍࡿ᪉ἲࢆ㌟ ࡘࡅࡿࡇࡀࠊࡑࡢ᪉ࡢ 42/ ࢆ㧗ࡵࡿ㝿࡚ࡶ㔜せ࡞ࡇ࡞ࡗ࡚ࡃࡿࠋࡑࡢᑐฎ᪉ ἲࡢ୍ᡭẁࡋ࡚ࣚ࢞ࢆ⨨࡙ࡅࡿࡇࡀฟ᮶ࡿࡇࡣ࡚ࡶ⯆῝ࡃࠊᡭ㍍ཧຍ࡛ࡁ ࡿࣚ࢞ࡢሙࢆቑࡸࡍࡇࡸࠊሗࢆᥦ౪ࡍࡿࡇࡀฟ᮶ࢀࡤឤࡌࡓࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ⤫ྜኻㄪ⪅ࡢᏳ࣭ࢫࢺࣞࢫ㍍ῶࠊほⓗᖾ⚟ឤྥୖ㛵ࡋ࡚ࠊࣚ࢞ࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ୍⏫ᑠⓒྜ ᒸᏕ − 93 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ 㸦)&⤫ྜኻㄪ㸧 ᩥ⊩ Jayaram N, et al. Effect of yoga therapy on plasma oxytocin and facial emotion recognition deficits in patients of schizophrenia. Indian Journal of Psychiatry. 2010 ; 112, 597-601. Pubmed ID:24049210 ┠ⓗ ᢠ⢭⚄⸆ࢆ᭹⏝୰ࡢ⤫ྜኻㄪᝈ⪅࠾࠸࡚ࠊࣚ࢞⒪ἲࡢ≧ࠊ♫⫋ᴗⓗ࡞ᶵ⬟ࠊ㢦 ⾲ㄆ▱㞀ᐖࠊ⾑₢࢜࢟ࢩࢺࢩࣥࣞ࣋ࣝཬࡰࡍຠᯝࢆ᳨ウࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ 1DWLRQDO,QVWLWXWHRI0HQWDO+HDOWKDQG1HXUR6FLHQFHV タࣂ࣮ࣥ࢞ࣟࣝࣥࢻ ཧຍ⪅ ⤫ྜኻㄪデ᩿ࡉࢀࠊᑡ࡞ࡃࡶ 㐌㛫ࡢᢠ⢭⚄⸆ࢆᏳᐃࡋ࡚ᢞࡉࢀ࡚࠸ࡿ ṓ 㹼 ṓࡢ ྡࠋ ධ ⤫ྜኻㄪࡢࡓࡵࡢࣚ࢞ ࣨ᭶ࠋ୧⩌ࡢᝈ⪅ࡣᢠ⢭⚄⸆ࡼࡗ࡚Ᏻᐃࡋࡓᝈ⪅ࠋ $UPࣚ࢞⩌ ྡ $UPᚅᶵ⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1.SAPS ⤫ྜኻㄪࡢ㝧ᛶ≧ホ౯ᑻᗘࠊ2.SANS ⤫ྜኻㄪࡢ㝜ᛶ≧ホ౯ᑻᗘࠊ3.SOFS ♫ⓗ⫋ᴗⓗᶵ⬟ࢫࢣ࣮ࣝࠊ4.TRENDS ⢭⚄⚄⤒ᝈ࠾ࡅࡿឤㄆ㆑㸦4-1.TRENDS accuracy score ⢭ᗘࢫࢥ㸦TRACS㸧 ࠊ4-2.TRENDS over identification score ㆑ูࢫࢥ (TOI)㸧 ࠋධ๓ᚋࡢ 2 ᅇ ᐃࠋ ࡞⤖ᯝ ධᮇ㛫ᚋࠊ୧⩌ࡶ SAPSࠊSANS ᚓⅬࡣ᭷ពᨵၿࡋࡓࡀࠊࣚ࢞⩌ࡢࡳ SOFS ♫ ⓗ⫋ᴗⓗᶵ⬟ࢫࢣ࣮ࣝ㸦P<0.001㸧 ࠊTRACS ឤㄆ㆑⢭ᗘ㸦P<0.001㸧 ࠊTOI ឤㄆ㆑㆑ู 㸦P=0.03㸧ࡀᨵၿࡋࠊ⾑₢࢜࢟ࢩࢺࢩࣥࣞ࣋ࣝ㸦P=0.01㸧ࡀቑຍࡋࡓࠋ ⤖ㄽ ࡇࡢ◊✲ࡣࠊᢠ⢭⚄⸆ࢆ᭹⏝ࡍࡿ⤫ྜኻㄪᝈ⪅ᑐࡋ࡚㏣ຍࡋ࡚⾜ࢃࢀࡿࣚ࢞⒪ἲࡀ ≧ࠊ♫⫋ᴗⓗ࡞ᶵ⬟㢦⾲ㄆ▱ࢆᨵၿࡍࡿࡢ᭷┈࡞ᙺࡀ࠶ࡿࡇࢆ♧ࡋࡓࠋ㔜 せ࡞Ⅼࡣࣚ࢞⩌࡛⾑₢࢜࢟ࢩࢺࢩࣥࣞ࣋ࣝࡀቑຍࡋࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ゝཬ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࣚ࢞⩌ࡢࢻࣟࢵࣉ࢘ࢺࡣ࡞ࡗࡓࡀࠊᚅᶵ⩌࡛ ேࡀࢻࣟࢵࣉ࢘ࢺࡋࡓࠋ ࣚ࢞ࡢヲ⣽ ࣥࢻ࣭ࣂ࣮ࣥ࢞ࣟࣝࡢࣚ࢞ࡢᏛ 69<$6$ ࡼࡗ࡚㛤Ⓨࡉࢀࡓ⤫ྜኻㄪࡢࡓࡵࡢ≉ᐃ ࡢࣚ࢞⒪ἲࣉࣟࢢ࣒ࣛࠋᘱ⦆ࡍࡿࡓࡵࡢືࡁࠊ྾ἲࠊ6XU\DQDPDVNDUD ኴ㝧♩ᣏࠊᗙ࣭ ௮ྥࡁ࣭࠺ࡘఅࡏ࡛ࡢ࣏࣮ࢬࢆ྾ἲࡸࣜࣛࢡࢮ࣮ࢩࣙࣥࢸࢡࢽࢵࢡࢆ⏝࠸࡚⾜࠺ࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ⤫ྜኻㄪᝈ⪅ࡢ≧࡞ࣚ࢞⒪ἲࡀ᭷ព࡛࠶ࡿࡇࡀࢃࡗࡓࡢ࡛࠶ࡿࡀࠊࡇࢀࡣ ࣥࢻ࡛ࡶ⌋ࡋ࠸ࣚ࢞ࡢᏛ࡛࠶ࡿ 69<$6$ ࡢ㛤Ⓨࣉࣟࢢ࣒࡛ࣛ࠶ࡿࡇࡶᛀࢀ࡚ࡣ࡞ࡽ ࡎࠊ≉⤫ྜኻㄪᝈ⪅ᑐࡍࡿࣚ࢞ࡢෆᐜࡸᣦᑟࡢ᪉ὀពࡀᚲせ࡛࠶ࡿࡇࡀ❚ࢃ ࢀࡿࠋ⾑₢࢜࢟ࢩࢺࢩࣥ㛵ࡋ࡚ࡣࠊ⤫ྜኻㄪᝈ⪅ࡔࡅ࡛࡞ࡃྠࡌࣚ࢞ࣉࣟࢢ࣒ࣛࢆ ≧ࡢ࡞࠸ᗣ࡞ேධࡋࡓሙྜࡢ◊✲ࡘ࠸࡚ࡶᐇࡉࢀࡿࡇࢆᮇᚅࡍࡿࠋ 㸦࢜࢟ࢩࢺࢩࣥࡣ⤫ྜኻㄪ≧ࢆᨵၿࡍࡿゝ࠺ሗ࿌ࡶ࠶ࡿ㸧 $EVWUDFWRU ࡢ᥎ዡᗘ ⤫ྜኻㄪࡢ⸆≀⒪ἲࢆ⾜ࡗ࡚࠸ࡿᝈ⪅㏣ຍࡋ࡚ࣚ࢞ࢆධࡍࡿࡇࢆ່ࡵࡿࠋ⌮⏤ࡣ ≧ࠊ♫ⓗᶵ⬟ࠊ⾲ㄆ▱ࡢᨵၿࡔࡅ࡛࡞ࡃࠊ࢜࢟ࢩࢺࢩࣥࡢࣞ࣋ࣝࡶቑຍࡍࡿࡇࡀ ࢃࡗࡓࡓࡵࠋ $EVWUDFWRUDQG'DWH ᯇ⏣༓㔛 ᒸᏕ − 94 − 㸳⢭⚄࠾ࡼࡧ⾜ືࡢ㞀ᐖ )⤫ྜኻㄪ ᩥ⊩ Duraiswamy G, et al. Yoga therapy as an add-on treatment in the management of patients with schizophrenia –a randomized controlled trial. Acta Psychia Scand 2007sep;116(3): 226-32. Pubmed ID:17655565 ┠ⓗ ⤫ྜኻㄪ࡛᭹⸆⒪୰ࡢᝈ⪅ᑐࡍࡿࣚ࢞ࡢධࡀࡢࡼ࠺࡞ຠᯝࢆࡶࡓࡽࡍࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ National Institute of Mental Health and Neuro Sciences, Bangalore, India ཧຍ⪅ ⤫ྜኻㄪࡢ ྡ ධ 6ZDPL9LYHNDQDQGD<RJD$QXVDQGKDQD6DPVWKDQD69<$6$ࡼࡿࠕ⤫ྜࣚ࢞⒪ἲࠖ ▂ࡣྵࡲ࡞࠸ࠋ 㛫㐌 ᅇ 㐌㛫ࠋࡑࡢᚋ⮬Ꮿᐇ⩦ࢆ 㛫㐌 ᅇ ࢝᭶㛫 $UPධ⩌ᢠ⢭⚄⸆㸩ࣚ࢞⩌ Q $UPࢥࣥࢺ࣮ࣟࣝ⩌ᢠ⢭⚄⸆㸩࢚ࢡࢧࢧࢬ⩌Q ࣚ࢞ྠ㢖ᗘࡢධ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ せホ౯㡯┠㸸ձPANSS(⤫ྜኻㄪࡢ㝧ᛶ≧ࠊ㝜ᛶ≧ࠊᢚ࠺ࡘࠊAnergia score)ࠊղSocial and Occupational Functioning Scale (SOFSࠊ♫⫋ᴗⓗᶵ⬟) ḟホ౯㡯┠㸸WHOQOL-BREF (QOL, ㌟యⓗࠊ ⢭⚄ⓗࠊ ♫ⓗࠊ ⎔ቃⓗ)ࠊ స⏝㸸Abnormal Involuntary Movement Scale (AIMS) Simpson Angus Scale for Extrapyramidal Symptoms(SOFS)ࢆධ๓ࠊ4 ࣨ᭶ࡢ 2 ᅇ ᐃࠋ ࡞⤖ᯝ ձධᮇ㛫ᚋࠊPANSS ⥲ᚓⅬࢧࣈࢫࢣ࣮ࣝᚓⅬ SOFS ⥲ᚓⅬࡣࠊ୧⩌࡛పୗࡋࡓࠋ ୧⩌㛫ࡢẚ㍑࡛ࡣࠊPANSS 㝧ᛶ≧ࢆ㝖ࡁࠊࣚ࢞⩌ࡢ᪉ࡀ᭷ពᨵၿࡋࡓࠋ ղQoL ࡢࢫࢥࡣࠊࣚ࢞⩌࡛ࡢࡳ᭷ពᨵၿࡋࡓࠋࣚ࢞⩌ࡣࠊࢥࣥࢺ࣮ࣟࣝ⩌ࡼࡾ᭷ព 㧗࠸ࢫࢥࢆ♧ࡋࡓࠋ ճస⏝ࡣ୧᪉ࡢᣦᶆ࡛ࠊ୧⩌㛫࡛ᕪࡣࡳࡽࢀ࡞ࡗࡓࠋ ⤖ㄽ ࣚ࢞ࡶ㌟యⓗ㐠ືࡶ⤫ྜኻㄪࡢ≧ᑐࡋ࡚ྠ➼ࡢຠᯝࢆ♧ࡋࡓࡀࠊࣚ࢞⩌ࡢ᪉ࡀࡼࡾ ຠᯝⓗ࡛࠶ࡗࡓࠋᢠ⢭⚄⸆࡛⒪୰ࡢ⤫ྜኻㄪᝈ⪅ࡀࢻ࢜ࣥ⒪ἲࡋ࡚ࣚ࢞ࢆ⾜࡞ ࠺⢭⚄⌮ⓗഃ㠃ࡸከࡃࡢ⤖ᯝ࡛᭷ຠᛶࡀ♧၀ࡉࢀࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ 㔜⠜࡞᭷ᐖ㇟㸦ᗁぬࠊΰࠊ⮬ẅ࡞㸧ࡣ࡞ࡗࡓࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌Q ࢥࣥࢺ࣮ࣟࣝ⩌Q ࣚ࢞ࡢヲ⣽ ࣚ࢞ࢭࣛࣆ࣮㸸D6LWKLOLNDUDQD9\D\DPDࠊEVXU\DQDPDVNDUࢆྵࡴ࣮ࢧࢼࠊF ྾ἲࠊGࣜࣛࢡࢮ࣮ࢩࣙࣥࢸࢡࢽࢵࢡ࡛ᵓᡂࡉࢀࠊࡑࢀࡒࢀࡢ㛫㓄ศࡣDEF 㸯㸸㸯㸸㸯࡛࠶ࡗࡓࠋ▂ࡣᐇࡏࡎࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣚ࢞ࡢධࡣ⒪୰ࡢ⤫ྜኻㄪᝈ⪅ࡢ≧ࡸ♫⫋ᴗⓗᶵ⬟ࢆᨵၿࡋࠊ42/ ࢆᨵၿࡍࡿ ࡇࡀ♧၀ࡉࢀࡿࠋᚋࡣࣚ࢞ࡀ⚄⤒⣔ලయⓗࡢࡼ࠺࡞ᶵᗎ࡛స⏝ࡍࡿࡢ◊✲ࡀ ᮇᚅࡉࢀࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ⤫ྜኻㄪᝈ⪅ᑐࡋ࡚ࣚ࢞㸦▂ࢆྵࡲ࡞࠸㸧ࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ᒸభ Ώ㎶࠶ࡸ ᒸᏕ − 95 −