回復期片麻痺患者の上衣更衣自立到達期間に影響を及ぼす因子

Factors affecting the duration to achieve independence of upper-body dressing in post-acute stroke patients

要旨：回復期リハビリテーション病棟において，上衣更衣が自立した初発脳卒中患者56例を対象に，自立到達期間の影響因子を検討した．自立到達期間が1ヵ月以内，1ヵ月以降2ヵ月以内，2ヵ月以降の3群に分類し，年齢などの基本的属性，脳卒中機能評価法（以下，SIAS），神経心理学的検査，Functional Independence Measure（以下，FIM）を初回評価値で比較した．1ヵ月以内群はFIM上衣更衣・問題解決・記憶，SIAS下肢運動機能・感覚機能が高値であった．1ヵ月以降2ヵ月以内群の特徴は明確でなく，2ヵ月以降群はFIM社会的交流，SIAS視空間認知が低値だった．自立到達期間の影響因子は，認知機能や麻痺側下肢機能が主である．

　The purpose of this study is to identify factors affecting the duration to achieve independence of upper-body dressing in 56 first stroke patients who had become independent during hospitalization in a convalescent rehabilitation ward. Patients were divided into three groups according to the duration to achieve independence: group A within one month, group B more than one month and less than two months, and group C over two months. Basic characteristics, stroke impairment assessment set (SIAS), and functional independence measure (FIM) were compared from the beginning of training the among groups. In group A, the score of FIM upper-body dressing, problem solving, memory, and SIAS lower limb motor function and sensory function were higher than those of the other groups. Characteristics of Group B were unclear. In group C, the score of FIM social interaction and SIAS visuospatial recognition were lower than in other two groups. Factors affecting the duration to independence are mainly cognitive functions and lower limb function of the affected side.