上級 腹部 捻挫・挫傷 リハビリテーション

Pain level at rest <3/10 on VAS scale,Able to perform diaphragmatic breathing without exacerbation,Transverse abdominis can be activated on command with palpation,Pelvic floor muscle awareness present (able to contract/relax on cue),No increase in symptoms with activities of daily living,Linea alba tension acceptable (no diastasis >2cm)

→ 次の段階へ： Early Mobilization

Pain with movement <3/10,Diaphragm excursion functional (2-4cm chest wall movement),TA contraction sustained for 5 seconds with palpation,Pelvic floor contraction reproducible for 3-5 seconds,Rectus abdominis tolerance to gentle isometric contraction,No provocative symptoms with coughing/sneezing

→ 次の段階へ： Early Mobilization

Pain-free range of motion for trunk flexion/extension/rotation,TA contraction sustained for 10 seconds with proper timing,Pelvic floor hold time improved to 8-10 seconds,External oblique and internal oblique activation without compensation,Ability to maintain neutral spine during upper extremity movements,Diaphragm breathing synchronized with pelvic floor (co-contraction)

→ 次の段階へ： Early Strengthening

Full pain-free range of motion in all planes,Transverse abdominis endurance >20 seconds sustained contraction,Pelvic floor functional endurance (10+ second hold),No visible diastasis recti with loaded activities,Coughing/sneezing without abdominal bracing pain,Upper body exercises tolerated without core compensation

→ 次の段階へ： Early Strengthening

Dead-bug exercise performed with proper core control (no lumbar hyperextension),Bird-dog position held 20 seconds each side without compensation,Pelvic floor quick contractions (10 fast flickers) without fatigue,Diaphragmatic breathing maintained under light load,External oblique strength allowing resisted trunk rotation,Pain-free with activities of daily living and light exercise

→ 次の段階へ： Progressive Strengthening

Dead-bug holds 30 seconds with opposite arm/leg extension,Bird-dog with arm/leg reach (alternating) 10 repetitions each side,Transverse abdominis recruited automatically during loading tasks,Pelvic floor functional strength for cough/sneeze support,Loaded flexion exercises tolerated (partial curl-up with resistance),Core endurance: plank hold >30 seconds modified

→ 次の段階へ： Progressive Strengthening

Full dead-bug protocol (alternating arm/leg) 3x10 without lumbar compensation,Pallof press (anti-rotation) 3x15 seconds each side,Loaded trunk rotations with resistance tolerated,Pelvic floor able to coordinate with Valsalva maneuver (modified),Diaphragm function optimized during exertion,Modified plank progression (elbows to hands) 3x45 seconds

→ 次の段階へ： Advanced Strengthening

Anti-rotation holds 30+ seconds with band resistance,McGill Big Three exercises initiated (curl-up, side bridge, bird-dog),Transverse abdominis hypertrophy tolerance to direct training,Pelvic floor strength grades improved (Oxford scale progression),Loaded carries (farmers walk) 2x30 seconds with core control,Rotational power development (medicine ball throws) 3x10 each side

→ 次の段階へ： Advanced Strengthening

Heavy loaded movements (squat, deadlift) with neutral spine maintained,Pelvic floor fully integrated with explosive movements,Diaphragm breathing under high-intensity exertion,Chamber holds (anti-extension/rotation/lateral flexion) 30+ seconds each,Rotational power progressions (cable chops/lifts) 3x12,Trunk endurance tests: Biering-Sorensen >90 seconds

→ 次の段階へ： Sport-Specific Training

Sport-specific core movements without compensation,Olympic lifting progressions with core stability,Pelvic floor response time adequate for athletic demands,Advanced rotational exercises (windshield wipers, landmine rotations),Core-hip-thoulder coordination drills,Isokinetic trunk strength testing >80% contralateral side

→ 次の段階へ： Sport-Specific Training

Plyometric core exercises (medicine ball slams, jump twists) tolerated,Integrated kinetic chain exercises (clean pulls, snatches),Pelvic floor coordination during high-velocity movements,Diaphragm efficiency during repeated sprints,Advanced loaded carries (overhead, unilateral),Sport-specific rotational power testing

→ 次の段階へ： Sport-Specific Training

Full training volume without post-exercise soreness increase,Athletic movement patterns without core compensation,Pelvic floor stability during directional changes,Diaphragm recovery time normal between bouts,Functional movement screen core score >15,Return-to-sport testing: single leg stance >30 seconds with core engagement

→ 次の段階へ： Return to Sport Prep

High-intensity interval training without symptoms,Sport-specific skill execution with core stability,Pelvic floor control during landing/jumping tasks,Trunk muscle endurance sufficient for competition duration,Proprioceptive drills: unstable surface single-leg work 30 seconds,Full contact training tolerated

→ 次の段階へ： Return to Sport Prep

Complete practice sessions without modification,Explosive movements at 100% intensity without compensation,Pelvic floor response adequate for sport demands,Diaphragm fatigue threshold met (normal recovery),Core stability tests: Y-balance >95% limb length,Subjective outcome measures at pre-injury levels

→ 次の段階へ： Return to Sport Prep

Full return to practice/competition (100% volume),No pain or dysfunction during or after activity,Pelvic floor symptoms fully resolved,Diaphragm function normal in all positions,Objective strength measures >90% contralateral side,Functional testing equal to pre-injury baseline

→ 次の段階へ： Return to Sport

Two consecutive weeks of full competition without setback,Recovery metrics within normal limits,Pelvic floor stress test negative (cough, jump, heavy lift),Sport-specific performance metrics met,No fear-avoidance behaviors with core engagement,Patient-reported outcome measures at optimal levels

→ 次の段階へ： Return to Sport

Return to competition at full intensity,Post-competition assessment: no increased symptoms,Pelvic floor functional index at pre-injury level,Diaphragm breathing pattern normal at rest and exertion,Core endurance maintained throughout season demands,No recurrence of injury at 17-week mark

→ 次の段階へ： Maintenance

Progressive increase in training load without issues,Sport-specific power output at pre-injury levels,Pelvic floor and diaphragm coordination seamless,Trunk muscle strength maintained with season demands,Psychological readiness for full return confirmed,Injury recurrence prevention protocols established

→ 次の段階へ： Maintenance

Three consecutive weeks of full sport participation,No abdominal wall laxity with maximal exertion,Pelvic floor stress test negative under competition conditions,Core performance metrics stable,Injury-specific prevention exercises mastered,Self-management strategies effective

→ 次の段階へ： Maintenance

Peak performance metrics achieved,Core stability under fatigue conditions verified,Pelvic floor endurance sufficient for extended activity,Diaphragm efficiency at maximum exertion,Maintenance exercise compliance verified,Quarterly outcome measures documented

→ 次の段階へ： Discharge

Injury-free training block completed,Return-to-performance benchmarks met,Pelvic floor and diaphragm holistically functional,Core strength and endurance at athletic standards,Injury prevention protocol integration complete,Patient discharge criteria met

→ 次の段階へ： Discharge

Full return to performance level achieved,Long-term core health status optimized,All outcome measures at pre-injury or improved levels,Independence in self-management confirmed,Discharge planning initiated,Follow-up schedule established

→ 次の段階へ： Discharge

Complete return to prior level of function/sport,No activity limitations or modifications required,Core stability tests equal to contralateral side,Pelvic floor and diaphragm function normalized,Patient satisfaction and outcome measures at goal levels,Discharge with home maintenance program

→ 次の段階へ： Complete