脳出血急性期の意識障害者に対する作業療法実施時間増加の効果に関する傾向スコアマッチングを用いた検討

Effectiveness of increased occupational therapy using propensity score matching for patients with impaired consciousness in the acute stage of cerebral hemorrhage

要旨：【目的】脳出血意識障害者に対し，作業療法（OT）時間増加の効果を検証することを目的とした．【方法】研究デザインは非ランダム化比較試験とし，実験群ではコントロール群よりもOTを20分増やした．対象はJCS II桁の脳出血患者86名（各群43名）とした．調査項目は，JCS I桁への改善率との関連が推測されるベースライン特性17項目とした．統計解析は，傾向スコアマッチング後，ログランク検定を用いた．【結果】累積意識障害残存率は，実験群でより低下している様子が観察されたが有意差は無かった．【結論】OTを20分増やすことによる意識障害改善効果は有意差が無かったが，サンプルサイズ不足の可能性が考えられた．

　[Objective] The purpose of this study was to evaluate the effect of increasing the duration of occupational therapy (OT) for patients with cerebral hemorrhage and impaired consciousness. [Methods] The study design was a non-randomized controlled trial, and the experimental group received 20 minutes more OT than the control group. The subjects were 86 patients with JCS II-digit cerebral hemorrhage (43 patients in each group). The survey items were 17 baseline characteristics that were presumed to be associated with the rate of improvement to JCS I digits. Statistical analysis was performed by log-rank test after propensity score matching. [Results] The cumulative residual rate of impaired consciousness was observed to be lower in the experimental group, but the difference was not significant. [Conclusion] There was no significant difference in the effect of 20 minutes of additional OT on the improvement of disorientation, but this may be due to insufficient sample size.