急性期脳卒中患者における上肢機能評価を用いた麻痺した利き手で箸操作が自立できる予測因子の検討

Factors predicting independent manipulation of chopsticks in acute stroke patients with dominant hand paralysis using upper extremity evaluations

要旨：急性期脳卒中患者に上肢機能評価を用いて，麻痺した利き手で箸操作自立を予測する因子を調べた．初期評価は発症から6.4±1.4日に握力，ピンチ力，10秒テスト，Fugl-Meyer Assessment for Upper Extremity，簡易上肢機能検査（以下，STEF），Motor Activity Log を実施した．退院前（発症から17.3±4.6日）に箸操作の自立度を評価し，予測因子を求めた．予測因子にSTEFが抽出され，カットオフ値は50点であった．STEFが箸操作自立の予測因子に抽出されたことで，箸操作が自立するためには物品操作の速度が必要であることが示唆された．

　We evaluated factors which predict independent manipulation of chopsticks in acute stroke patients with dominant hand paralysis in the upper extremities. Upper extremity function was measured within one week after the stroke (6.4 days). Grip strength, pinch strength, ten-second grip, and release were measured using Fugl-Meyer Assessment for Upper Extremity, Simple Test for Evaluating Hand Function (STEF), and Motor Activity Log. Independence in using chopsticks was also assessed before discharge (17.3 days). Results indicate that the STEF could significantly contribute to the use of chopsticks, and the STEF cut-off point was 50. These findings imply that the efficient ability to manipulate tools is needed to obtain independent chopsticks agility.