在宅脳卒中者のIADL（手段的日常生活動作）に影響する要因—脳卒中発症前後の家事動作実施頻度の変化から見た検討

The predictor of IADL abilities of stroke patients living at home: Frequency change of household activities after stroke

要旨：脳卒中の発症前後でIADLの変化について報告した研究や，IADL低下に影響する要因について検討した研究は少ない．本研究では脳卒中者のIADL実施頻度の変化について脳卒中発症前後で項目ごとに調査し，IADL項目の1つである「家事」低下の要因を検討した．その結果，脳卒中発症後，家事は交通手段の利用や外出などの屋外活動に比べて実施されやすく，家事の中では，食事の後片付けや洗濯などが行われやすいことがわかった．また脳卒中後の家事動作維持群と低下群の2群間では，FIM，FIM-M，BBS，TMT-B，COPM遂行度で有意差を認め，脳卒中後の家事の自立には，ADL能力，立位バランス，注意機能（分配性，容量）が影響していることが示唆された．

　There are many studies on instrumental activities of daily living (IADL), but few studies report on changes of IADL before and after the onset of stroke, nor on the associated factors contributing to the deterioration of IADL. We compared all IADL items before and after the onset of stroke, and investigated the factors leading to the deterioration of household activities. As a result, the subjects carried out household activities more frequently than those outdoor activities which involved leaving the house and using public transportation. Furthermore, they easily did household activities, including clearing the table and washing clothes. We found significant statistical differences in scores of FIM, FIM-M, BBS, TMT-B and COPM-performance between the subjects who continued household activities and those who did not. The study shows that ADL, standing balance, divided attention and attentional capacity influences independence in household activities.