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要旨:在宅脳損傷者における日常生活活動(以下,ADL)の作業療法アプローチに関する障害特性を明らかにするため,72人の脳損傷者を対象に,従来ADL関連要因としてあげられている麻痺,拘縮,痴呆などの因子と高次脳機能障害について横断的調査を行った.その結果,ADL障害は互いに重複しながらも基本的ADLと手段的ADL,拡大ADLにおいて二層構造を持ち,関連要因は多重線形構造を示すと考えられた.各ADLごとのロジスティック回帰分析の結果から,高次脳機能障害は手段的ADLに強く影響を及ぼすことが示唆された.各ADL障害における関連要因のオッズが明らかになったことは,在宅脳損傷者の評価の基礎的資料として有用と考えられる.
We examined 72 patients with brain damage, using physical and mental function tests and measurements, to clarify the characteristics of their ADL disturbance at home.
We investigated the relationship between the factors affecting their ADL disturbance and odds of each factor, by logistic regression analysis.
Correlation coefficients of basic ADL, instrumental ADL, and advanced ADL scores were 0.647〜0.803 and the BADL independence level was lower than those of others (BADL<IADL, AADL, p<0.05. High-risk factors were found in BADL that were physical, in IADL that were social and mental, in AADL that were due to disused syndrome. Higher brain functional disorder mostly affected IADL. Our result would be useful in the evaluation of ADL disturbance.
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