脳卒中患者における麻痺側下肢荷重率と日常生活活動との関係

Relationship between Weight Bearing Rate on the affected limb and activities of daily living ability in a stroke patient

要旨：本研究では，脳卒中患者を対象に日常生活活動（以下，ADL）能力に対する麻痺側下肢荷重率のカットオフ値の提示を目的とした．ADLの自立度を目的変数，麻痺側下肢荷重率を説明変数とした単回帰分析を行い，決定係数が0.4以上のADL項目についてReceiver Operating Characteristic曲線を用い，当該ADL項目の自立判定のための麻痺側下肢荷重率のカットオフ値を算出した．その結果，麻痺側下肢荷重率はトイレ動作，階段昇降と因果関係が認められ，自立判定のための麻痺側下肢荷重率のカットオフ値はそれぞれ58.1％，76.9％であった．臨床において麻痺側下肢荷重率の計測により，安全かつ簡便にトイレ動作および階段昇降能力の推測が可能と考えられる．

　We investigated cut-off values of the paralyzed-side weight bearing rate (WBR) in stroke patients as indexes of the degree of independence in activities of daily living (ADL). We used a simple regression analysis to select the ADL abilities associated with the paralyzed-side WBR. Cut-off values for independence in ADL ability in relation to the paralyzed-side WBR were calculated by using a receiver operating characteristic curve. The study participants were 36 stroke patients. The paralyzed-side WBR was associated with toileting ability (r²= 0.45, OR= 1.13) and stair-climbing ability (r² = 0.45, OR= 1.16). The WBR cut-off value for toileting ability was 58.1%, whereas that for stair-climbing ability was 76.9%. In assessments of toileting and stair-climbing abilities, patients whose paralyzed-side WBRs are less than the cut-off values can be considered to be at decreased risk for fear of falling in an appropriate surrounding environment. In addition, patients who have not sufficiently accepted their disabilities can be given occupational therapy to help them reach the cutoff values needed for independence at a later date.