初級 肘神経損傷リハビリテーション

Pain level ≤3/10 at rest with ulnar nerve distribution symptom reporting,No worsening of medial epicondyle or cubital tunnel tenderness,Protected elbow range of motion limited to 30-90° flexion avoiding full flexion positions,Wrist and hand splinting as needed for ulnar nerve glide protection,No increase in paresthesia or numbness in ring and little finger,Assessment of medial collateral ligament stability to rule out concomitant injury

→ 次の段階へ： Early Mobilization

Continued pain control with numeric rating scale ≤3/10 during light ADL,Tolerance of passive elbow range of motion from 20° extension to 100° flexion without nerve provocation,No reproduction of cubital tunnel symptoms with ulnar nerve palpation,Minimal to no flexor carpi ulnaris spasm on palpation,Sleep quality improved with elbow positioning modifications,Tolerance of short-duration wrist splinting (2-3 hours)

→ 次の段階へ： Early Mobilization

Pain ≤2/10 with activities of daily living involving elbow,Passive elbow ROM tolerance increased to 15° extension to 110° flexion,No exacerbation of ulnar nerve symptoms with valgus stress testing,Improved tolerance to prone elbow flexion position (nerve gliding),Near-normal sleep patterns without night-time paresthesia,Demonstrated understanding of activity modification principles

→ 次の段階へ： Early Mobilization

Full passive elbow extension within 10° of contralateral side,Active elbow flexion to 120° with minimal compensation,Ulnar nerve gliding exercises tolerated 3x daily without symptom flare,Isometric wrist flexor and grip exercises at 30% maximum voluntary contraction,No reproduction of medial epicondyle tenderness with resisted forearm pronation,Tolerance of 15-minute functional activity without increased numbness

→ 次の段階へ： Progressive Strengthening

Active elbow ROM 0° extension to 130° flexion achieved,Pronation and supination within 15° of contralateral side,Ulnar nerve slider exercises progressing to 10 repetitions, 3 sets,Isometric elbow flexion at 40% MVC without increased flexor group spasm,Functional reach activities to 80% arm length without cubital tunnel compression,Subjective improvement in hand intrinsic muscle coordination

→ 次の段階へ： Progressive Strengthening

Full active elbow ROM equal to contralateral side (±5°),Ulnar nerve tension test negative at neutral elbow position,Isometric wrist extension added at 40% MVC intensity,Light functional activities (computer work, light lifting under 2 lbs) tolerated,No overnight paresthesia in ulnar nerve distribution,Grip strength within 80% of contralateral side (dynamometer)

→ 次の段階へ： Progressive Strengthening

Resistance band exercises for wrist flexors (yellow-red grade) tolerated,Elbow flexion and extension against gravity without compensation,Ulnar nerve glides performed 5x daily with 15-20 repetitions,Flexor carpi ulnaris strengthening at 50% MVC intensity,No provocation of medial epicondyle pain with resisted pronation,Tolerance of 30-minute continuous activity without rest breaks

→ 次の段階へ： Advanced Strengthening

Wrist curl and reverse wrist curl exercises at 1-2 lbs tolerated,Pronation and supination against resistance (theraband),Ulnar nerve neural mobilization with elbow in full flexion and wrist extended,Grip strength progressing to 85% of contralateral side,Decreased resting parasthesia in ring and little finger,Functional reach to full arm length without symptoms

→ 次の段階へ： Advanced Strengthening

Bicep curl and tricep extension with 2-3 lbs weight,Full ulnar nerve slider pattern completed without symptom provocation,Improved fine motor coordination of intrinsic hand muscles,Tolerance of light resisted sports-specific movements,No recurrence of cubital tunnel symptoms with overhead activities,Subjective functional index improvement of 20 points

→ 次の段階へ： Advanced Strengthening

Resistance training progressing to 3-4 lbs for upper extremity,Eccentric elbow flexor strengthening at modified angle,Ulnar nerve tension test negative in all positions,Grip strength ≥90% of contralateral side,Return to light recreational activities (golf putt, short tennis),No limitations in sustained elbow flexion (overhead reaching)

→ 次の段階へ： Return to Function

Sport-specific or occupation-specific movement patterns introduced,Isokinetic elbow flexion/extension at 60°/second velocity tolerated,Tolerance of valgus stress in late elbow extension (throwing mechanics),No residual ulnar nerve symptoms with maximum grip exertion,Near-normal proprioception testing on elbow position sense,Patient-reported outcome measure score improvement ≥30%

→ 次の段階へ： Return to Function

Full resistance training program equivalent to pre-injury level,Ulnar nerve conduction studies showing improvement if previously abnormal,Complete return to work or sport-specific training without restrictions,No medial or lateral epicondyle tenderness on palpation,Full endurance capacity for repetitive elbow activities,Subjective satisfaction score ≥8/10 with rehabilitation outcome

→ 次の段階へ： Return to Function

Tolerance of high-intensity functional simulation (30+ minutes),No symptom recurrence with provocative positions (telephone holding, leaning on elbow),Full return to activities of daily living without modification,Ulnar nerve gliding maintenance program independently performed,Grip and pinch strength within 95% of contralateral side,Confidence in elbow use during unexpected loading scenarios

→ 次の段階へ： Return to Function

Final outcome measures documenting ≥90% function restoration,No restrictions for return to full occupational or athletic activities,Patient education completed on maintenance exercises and symptom monitoring,Understanding of warning signs requiring follow-up (numbness, weakness),Discharge criteria met with individualized home program prescription,Plan established for gradual discharge with 30-day follow-up

→ 次の段階へ： Discharge