間質性肺炎におけるIADLトレーニングの検討—〜掃除課題における前後比較から〜

IADL training in interstitial pneumonia : A before and after comparison of the cleaning tasks

要旨：間質性肺炎患者25名に，AMPSを用いた掃除活動の評価を行い，抽出した問題技能に対して，動作速度を遅めに調整，適宜休憩，腹部圧迫や息こらえを避けるなどの指導を3日間（40分／日）実施した．運動技能は初回2.25±0.68Logits（以下，LG），最終2.78±0.75LG，処理技能は初回1.80±0.50LG，最終2.33±0.46LGとなり，介入の有用性を示す0.5LG以上の向上を示した．また，課題時のSpO₂は，開始時88.6±3.0％から終了時91.3±2.6％と改善を認め，Borg Scaleは，開始時3.0±1.6から終了時1.5±0.9に改善を認めた（p＜0.001）．間質性肺炎に対するIADLトレーニングは，作業遂行能力の改善や呼吸困難の軽減に有用である．

　Cleaning training was provided for 25 subjects (14 males, 11 females : mean age, 67.9±11.9 years : Medical research council score grade 3, n=10 and grade 4, n=15) with interstitial pneumonia in efforts to alleviate their labored breathing. Using the Assessment of Motor and Process Skills (AMPS), we assessed effectiveness of the motor and process skills. We then performed interventions for the problematic skills identified by the assessment, such as ‘regulating movement', ‘taking appropriate breaks', ‘avoiding abdominal compression', and ‘stopping breathing', for three days (40 min/day) before conducting a post-intervention assessment. The pre and post intervention results for motor skills were 2.25±0.68 Logits (LG) and 2.78±0.75 LG, respectively, while those for process skills were 1.80±0.50 LG and 2.33±0.46 LG, respectively, thereby demonstrating an improvement of 0.5 LG or greater, indicating effective interventions. We also observed an improvement in average SpO₂ at completion of the cleaning activities from 88.6±3.0% upon commencement to 91.3±2.6% upon completion, and an improvement in labored breathing determined by the Borg Scale from an average of 3.0±1.6 upon commencement to 1.5±0.9 upon completion (p＜0.001). IADL training is effective for improving task completion and alleviating breathing difficulties in individuals suffering from interstitial pneumonia.