回復期片麻痺患者の上衣更衣能力に影響を及ぼす因子―機能的側面からの検討─

Factors affecting upper-body dressing ability in post-acute stroke patients: A functional assessment

要旨：回復期片麻痺患者151名を対象に上衣更衣の自立を阻害する因子を検証した．対象を退院時上衣更衣自立群と非自立群に分類し，年齢，発症から入院までの日数，在棟日数，初回評価時（発症後61.1±18.3日）のFIM上衣更衣項目の値および脳卒中機能評価法（SIAS)を両群間で比較し，ロジスティック回帰式を用いて分析した．自立群は有意に若く，初回評価時の上衣更衣FIM値も有意に高値であった．機能評価では上下肢運動麻痺，体幹機能，非麻痺側下肢筋力，半側空間無視で自立群が有意に良好であった．自立に強く影響する因子は年齢，体幹機能，半側空間無視となり，自立を図るにはこれらの項目を考慮することが重要である．

　Post-acute stroke patients were examined, and the factors which obstructed independence in upper-body dressing were extracted. Patients were classified into two groups: an acquired independence group and a non-independence group. Five factors were compared between the two groups: age, days elapsed from the onset of the condition to hospitalization, days of hospitalization, the value of the Functional Independence Measure (FIM) upper-body dressing item at the initial evaluation and each item of the Stroke Impairment Assessment Set (SIAS). Logistic regression analysis indicated that the independent group was younger and had higher FIM scores. Furthermore, motor function, the trunk function and unilateral spatial neglect were significantly better in the independence group.