脳卒中片麻痺患者におけるSHAP日本語版の妥当性の検討

Validity of the Japanese Version of the Southampton Hand Assessment Procedure in Stroke Patients

要旨

目的：The Southampton Hand Assessment Procedure（SHAP）は12項目の物品移動検査と14項目のADL検査で構成された上肢機能検査である．今回，脳卒中の上肢機能麻痺の評価としての有用性を検討した．

方法：脳卒中患者143名を対象とし，SHAP日本語版と既存の上肢機能評価との併存的妥当性を検証した．また，麻痺手が利き手か非利き手かの違いについても検討した．

結果：SHAP日本語版と既存の上肢機能評価法との間に併存的妥当性が示された．麻痺手の違いでは，利き手麻痺群で主観的評価スケールにおいて強い相関が得られた．

考察：SHAP日本語版は義手のみでなく脳卒中の上肢機能評価としても有用である可能性が示唆された．特に，軽度の上肢機能麻痺評価に適していることが示された．さらに，日常生活での麻痺手の使用に関しては，利き手麻痺のほうがより使用状況を反映することが示唆された．

Purpose：The Southampton Hand Assessment Procedure (SHAP) is a test of upper extremity function composed of 12 movement tasks and 14 activities of daily living tasks, and is used as an assessment battery for upper extremity prostheses. The purpose of this study is to examine its validity in clinical practice.

Methods：The study included 143 patients with hemiparesis. The validity of SHAP and an existing assessment battery were compared in this study. Factors influencing the validity of differences between dominant and non-dominant hands were examined.

Results：Concomitant validity was shown between the SHAP Japanese version and an existing upper extremity function evaluation method. A strong correlation with the subjective evaluation scale was obtained in cases of dominant hand paralysis.

Discussion：These results suggested that SHAP is able to accurately evaluate upper extremity hemiparesis, because the difficulty level in evaluation of upper extremity function is higher than that of the Action Research Arm Test, and a ceiling effect is unlikely. Therefore, SHAP is useful in clinical practice not only for assessment of an artificial hand but also for hemiparesis with stroke. Further study to clarify the characteristics of SHAP as well as verification of reliability and standard values is warranted.