慢性関節リウマチにおける改訂class分類の有用性についての一考察

Study on usefulness of revised functional status classification in occupational therapy of rheumatoid arthritis

要旨：慢性関節リウマチ患者の機能状態の分類(class分類)は1991年に改訂され，アメリカリウマチ学会の分類(ACRの分類)として発表された．従来用いられてきたSteinbrockerの分類は患者の関節炎症状，機能障害，能力障害の程度によって機能状態の程度を分類するようになっていた．これに対し，ACRの分類は能力障害の程度や患者の希望する余暇・仕事の遂行状況によって機能状態の程度を分類するという特徴を持っている．ACRの分類は慢性関節リウマチ患者に対し作業療法を行う上で，患者のQOL改善に貢献できる有用な分類基準であると考える．

　Criteria for the classification of functional status in rheumatoid arthritis was revised in 1991 and was released as criteria of the American College of Rheumatology (ACR). The original Steinbrocker criteria, which had been used previously, classifies the level of functional status; classification was based on the presence or absence and the level of (1) arthritis, (2) impairment, and (3) disability. On the other hand, the ACR revised criteria classifies the level of functional status based on (1) the level of independence of self-care and (2) the level in which the patients can engaged in avocational and vocational activities. At present, in Japanese clinical studies on occupational therapy, the ACR revised criteria is hardly used. However, the ACR revised criteria is a useful classification which takes into account the quality of life of rheumatoid arthritis patients. The authors recommend that occupational therapists in performing occupational therapy of rheumatoid arthritis patients use the ACR revised criteria.