上級 足関節・足部 慢性疾患 リハビリテーション

Pain at rest ≤2/10 on VAS scale,ATFL and CFL ligamentous laxity stability tests show no further worsening,Weight-bearing tolerance achieves ≥50% body weight with assistive device,Plantar fascia tenderness reduces by ≥30% with ice and manual therapy,Peroneal tendon irritation responds to offloading and compression,Achilles tendon resting angle improves with heel lift accommodation

→ 次の段階へ： Early Mobilization

Full weight-bearing achieved without antalgic gait pattern,Active ankle dorsiflexion ≥5° beyond neutral with knee extended,Single-leg stance time ≥10 seconds on affected side,Plantar fascia night splinting reduces morning pain by ≥50%,Peroneal tendon resisted eversion strength ≥3/5,Cervical calcaneal bursa and Achilles insertion tolerance improves

→ 次の段階へ： Early Strengthening

Calf raise repetitions ≥10 with controlled tempo on affected leg,Y-balance anterior reach ≥80% of contralateral side,Proprioceptive training achieves 3 of 5 successful single-leg perturbations,Peroneal tendon strength ≥4/5 with resisted eversion in neutral,Gastrocnemius-soleus complex flexibility permits ankle dorsiflexion ≥10°,Functional hop testing achieves ≥50% distance of contralateral side

→ 次の段階へ： Progressive Loading

Heel-rise test completes ≥15 repetitions with full range,Achilles tendon load tolerance progresses to 70% body weight in eccentric loading,Single-leg balance eyes closed achieves ≥8 seconds,PTFL and posterior ankle stability confirmed on stress testing,Plantar fascia loading tolerance for daily walking ≥30 minutes without flare,Return to modified work activities if applicable

→ 次の段階へ： Advanced Conditioning

Eccentric Achilles loading achieves 100% body weight without pain,Running progression at 70% intensity without symptom recurrence,Y-balance posterolateral reach ≥85% of contralateral side,Peroneal tendon power testing shows 85% of contralateral side,Plantar fascia-specific stretching routine independent for home program,Cutaneous sensation and proprioception within normal limits

→ 次の段階へ： Return to Activity

Full sport-specific or occupation-specific activity simulation completed,Single-leg hop for distance ≥90% of contralateral side,Isokinetic dynamometry ankle strength within 10% of contralateral side,Functional Movement Screen ankle mobility scoring ≥3,Patient-reported outcome measures achieve minimal clinically important difference,No Achilles tendon crepitus or thickening on palpation

→ 次の段階へ： Maintenance/Discharge

FAAM score ≥90% of normative values,Ankle-Hindfoot Scale score ≥85 points,Return to full athletic or occupational demands,Independent home exercise program compliance confirmed,No bracing or orthotic requirement for basic activities,Patient discharged with education on prevention of recurrence