急性期脳梗塞患者の日常生活活動と麻痺側運動機能，バランス能力，注意機能の関連─意識障害および認知機能障害軽症例を対象とした検討─

Relationship between the activities of daily living and hemiplegia, balance, and attention deficit in patients with acute cerebral infarction: Research targeting patients with slight consciousness disorder and cognitive impairment

要旨：意識障害や認知機能障害が軽症な24例の脳梗塞患者を対象に，発症1週目のADL自立度と麻痺側運動機能，バランス能力，注意機能の関連を検討した．評価はBrunnstrom Recovery Stage（BRS），Berg Balance Scale（BBS），Clinical Assessment for Attention（CAT），Barthel Index（BI）を用いSpearmanの順位相関係数検定で分析した．BIとBRS上肢，BRS手指，BRS下肢，BBSの間に有意な相関を認めた．全症例に注意障害を認めたが，BIとCATとの間に有意な相関はみられなかった．軽症脳梗塞患者に対し，注意障害を改善させADL自立度の改善を図る練習を発症1週目で行う重要度は低いが今後は2週目以降のADLやIADLとの関連を調査する必要がある．

　We explored the relationship between activities of daily living (ADL) and motor function, balance ability, and attention in 24 patients with slight consciousness disorder and cognitive impairment during the first week following the onset of cerebral infarction. Main outcome measures were Brunnstrom Recovery Stage (BRS), Berg Balance Scale (BBS), Clinical Assessment for Attention (CAT), and the Barthel Index (BI). We used Spearman's rank correlational analysis. Our analysis showed significant correlations between BI and BRS for shoulder and elbow (r=0.752，p<0.001), BI and BRS for hand (r=0.532, p=0.007), BI and BRS for trunk and lower limbs (r=0.703, p<0.001), and BI and BBS (r=0.898, p<0.001). Although all patients had attention deficit, the results showed an insignificant correlation between BI and CAT. These findings suggest that the relationship between ADL and programs for attention deficit is of low importance when the patients lack obvious consciousness disorder and cognitive impairment during the first week following the onset of cerebral infarction. It is necessary for us to investigate the relationship between ADL, IADL and attention deficit after the second week.