Functional Reachを用いた回復期脳卒中患者の退院時トイレ移乗・屋内歩行の自立度予測

Prediction of toilet transfer and walking ability using Functional Reach for stroke patients

要旨：自宅退院の重要な条件となるトイレ移乗・屋内歩行自立の予測指標として，Functional Reach（以下，FR）の臨床的有用性を報告する．対象者は，回復期リハビリテーション病院に入院した脳卒中患者21名とした．入院時，入院時から1ヵ月経過，2ヵ月経過時点でFRテストを実施した．退院時ADLを屋内歩行自立群，トイレ移乗自立群，トイレ移乗非自立群の3群に分類し，FR値との関連性を検討した．さらに，受信者動作特性（ROC）曲線を用いて，カットオフ値の検討を行った．入院から1ヵ月経過時点のFR値が5cm以上の場合に退院時ADLがトイレ移乗修正自立以上，15cm以上で屋内歩行修正自立以上に至ることが明らかとなった．

　The purpose of this study is to determine the clinical usefulness of Functional Reach (FR) to predict toilet transfer and walking ability, both being important factors for hospital-to-home discharge. The study population comprised 21 stroke patients admitted to the rehabilitation ward of our hospital. We evaluated the patients using FR at the time of admission, one month after the first evaluation, and two months later. According to ADL at discharge to home, the patients were divided into three groups; walking independence group, toilet transfer independence group and toilet transfer non-independence group. We also examined the cutoff value of FR to indicate toilet transfer ability and walking ability, using a Receiver Operating Characteristic (ROC) curve. In conclusion, FR=5cm or more at one month after the first evaluation is useful to predict independence in toilet transfer, and FR=15cm or more is useful to predict independence in walking.