脳卒中片麻痺患者を対象とした加速度計（ActiGraph Link GT9X）による上肢活動量計測と活動量可視化の試み—3点計測法の妥当性の検討
要旨：脳卒中片麻痺患者を対象に加速度計（ActiGraph Link GT9X）を用いた上肢活動量計測を行い，本邦においてもこの評価が妥当であるか否か，および2点計測法と3点計測法のどちらが，より妥当な手法であるかを検証した．本研究は単一施設の横断研究で，37名を対象とした．3点計測法は，各手の測定値を体幹部の測定値で減じた上で，左右手の活動量比や活動時間比を算出した．その結果，2点計測法と3点計測法のどちらであっても，麻痺側上肢の活動量と上肢機能評価の間に中程度から強い相関関係が示された．3点計測法の優位性は示されなかった．脳卒中患者の上肢活動量評価において，どのような計測方法や分析方法がよ...
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| Published in | 作業療法 Vol. 38; no. 5; pp. 550 - 558 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本作業療法士協会
15.10.2019
一般社団法人 日本作業療法士協会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0289-4920 2434-4419 |
| DOI | 10.32178/jotr.38.5_550 |
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| Abstract | 要旨：脳卒中片麻痺患者を対象に加速度計（ActiGraph Link GT9X）を用いた上肢活動量計測を行い，本邦においてもこの評価が妥当であるか否か，および2点計測法と3点計測法のどちらが，より妥当な手法であるかを検証した．本研究は単一施設の横断研究で，37名を対象とした．3点計測法は，各手の測定値を体幹部の測定値で減じた上で，左右手の活動量比や活動時間比を算出した．その結果，2点計測法と3点計測法のどちらであっても，麻痺側上肢の活動量と上肢機能評価の間に中程度から強い相関関係が示された．3点計測法の優位性は示されなかった．脳卒中患者の上肢活動量評価において，どのような計測方法や分析方法がより適切であるかは，引き続き検討を重ねる必要がある． |
|---|---|
| AbstractList | 要旨：脳卒中片麻痺患者を対象に加速度計（ActiGraph Link GT9X）を用いた上肢活動量計測を行い，本邦においてもこの評価が妥当であるか否か，および2点計測法と3点計測法のどちらが，より妥当な手法であるかを検証した．本研究は単一施設の横断研究で，37名を対象とした．3点計測法は，各手の測定値を体幹部の測定値で減じた上で，左右手の活動量比や活動時間比を算出した．その結果，2点計測法と3点計測法のどちらであっても，麻痺側上肢の活動量と上肢機能評価の間に中程度から強い相関関係が示された．3点計測法の優位性は示されなかった．脳卒中患者の上肢活動量評価において，どのような計測方法や分析方法がより適切であるかは，引き続き検討を重ねる必要がある． 脳卒中片麻痺患者を対象に加速度計（ActiGraph Link GT9X）を用いた上肢活動量計測を行い，本邦においてもこの評価が妥当であるか否か，および2点計測法と3点計測法のどちらが，より妥当な手法であるかを検証した．本研究は単一施設の横断研究で，37名を対象とした．3点計測法は，各手の測定値を体幹部の測定値で減じた上で，左右手の活動量比や活動時間比を算出した．その結果，2点計測法と3点計測法のどちらであっても，麻痺側上肢の活動量と上肢機能評価の間に中程度から強い相関関係が示された．3点計測法の優位性は示されなかった．脳卒中患者の上肢活動量評価において，どのような計測方法や分析方法がより適切であるかは，引き続き検討を重ねる必要がある． |
| Author | 市村 幸盛 花田 恵介 竹林 崇 河野 正志 平山 和美 |
| AuthorAffiliation | 大阪府立大学地域保健学域総合リハビリテーション学類作業療法学専攻 山形県立保健医療大学作業療法学科 穂翔会村田病院リハビリテーション部 山形県立保健医療大学大学院保健医療学研究科博士後期課程 |
| AuthorAffiliation_xml | – name: 穂翔会村田病院リハビリテーション部 – name: 山形県立保健医療大学作業療法学科 – name: 大阪府立大学地域保健学域総合リハビリテーション学類作業療法学専攻 – name: 山形県立保健医療大学大学院保健医療学研究科博士後期課程 |
| Author_xml | – sequence: 1 fullname: 花田 恵介 – sequence: 2 fullname: 竹林 崇 – sequence: 3 fullname: 河野 正志 – sequence: 4 fullname: 市村 幸盛 – sequence: 5 fullname: 平山 和美 |
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| References | 26) The R Project for Statistical:Getting Started. http://www.r-project.org (accessed 2018-10-30). 15) Bailey RR, Klaesner JW, Lang CE:Quantifying real-world upper-limb activity in nondisabled adults and adults with chronic stroke. Neurorehabil Neural Repair 29(10):969-978, 2015. 19) Waddell KJ, Birkenmeier RL, Bland MD, Lang CE:An exploratory analysis of the self-reported goals of individuals with chronic upper-extremity paresis following stroke. Disabil Rehabil 38(9):853-857, 2015. 24) Lyle RC:A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res 4(4):483-492, 1981. 16) 竹林 崇，天野 暁，花田恵介，内山侑紀，道免和久：慢性期の脳卒中後上肢麻痺を呈した患者の麻痺手の使用頻度を定量化する試み─事例報告─．作業療法 36 (1) ：74-80，2017 9) Adams SA, Matthews CE, Ebbeling CB, Moore CG, Cunningham JE, et al:The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol 161(4):389-398, 2005. 25) Van der Lee JH, De Groot V, Beckerman H, Wagenaar RC, Lankhorst GJ, et al:The intra- and interrater reliability of the action research arm test:A practical test of upper extremity function in patients with stroke. Arch Phys Med Rehabil 82(1):14-19, 2001. 5) Taub E, Miller NE, Novack TA, Fleming WC, Nepomuceno CS, et al:Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil 74(4):347-354, 1993. 8) Tatemichi TK, Desmond DW, Stern Y, Paik M, Sano M, et al:Cognitive impairment after stroke:Frequency, patterns, and relationship to functional abilities. J Neurol Neurosurg Psychiatr 57(2):202-207, 1994. 13) de Niet M, Bussmann JB, Ribbers GM, Stam HJ:The stroke upper-limb activity monitor:Its sensitivity to measure hemiplegic upper-limb activity during daily life. Arch Phys Med Rehabil 88(9):1121-1126, 2007. 20) Bailey RR, Lang CE:Upper-extremity activity in adults:Referent values using accelerometry. J Rehabil Res Dev 50(9):1213-1222, 2014. 27) Guiraud T, Granger R, Gremeaux V, Bousquet M, Richard L, et al:Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program. Arch Phys Med Rehabil 93(12):2141-2147, 2012. 14) Hayward KS, Eng JJ, Boyd LA, Lakhani B, Bernhardt J, et al:Exploring the role of accelerometers in the measurement of real world upper-limb use after stroke. Brain Impairment 17(1):16-33, 2015. 17) Narai E, Hagino H, Komatsu T, Togo F:Accelerometer-based monitoring of upper limb movement in older adults with acute and subacute stroke. J Geriatr Phys Ther 39(4):171-177, 2016. 22) Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S:The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med 7(1):13-31, 1975. 3) Nichols-Larsen DS, Clark PC, Zeringue A, Greenspan A, Blanton S:Factors influencing stroke survivors’ quality of life during subacute recovery. Stroke 36(7):1480-1484, 2005. 12) Uswatte G, Giuliani C, Winstein C, Zeringue A, Hobbs L, et al:Validity of accelerometry for monitoring real-world arm activity in patients with subacute stroke:Evidence from the extremity constraint-induced therapy evaluation trial. Arch Phys Med Rehabil 87(10):1340-1345, 2006. 2) Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, et al:Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke:The EXCITE randomized clinical trial. JAMA 296(17):2095-2104, 2006. 28) Izawa KP, Watanabe S, Omiya K, Hirano Y, Oka K, et al:Effect of the self-monitoring approach on exercise maintenance during cardiac rehabilitation:A randomized, controlled trial. Am J Phys Med Rehabil 84(5):313-321, 2005. 23) Amano S, Umeji A, Uchita A, Hashimoto Y, Takebayashi T, et al:Clinimetric properties of the Fugl-Meyer assessment with adapted guidelines for the assessment of arm function in hemiparetic patients after stroke. Top Stroke Rehabil 25(7):500-508, 2018. 7) Bradburn NM, Rips LJ, Shevell SK:Answering autobiographical questions:The impact of memory and inference on surveys. Science 236(4798):157-161, 1987. 6) 高橋香代子，道免和久，佐野恭子，竹林 崇，蜂須賀研二，他：新しい上肢運動機能評価法・日本語版Motor Activity Logの信頼性と妥当性の検討．作業療法 28 (6) ：628-636，2009 21) アクチ・ジャパン：アクティビティ (活動量) 測定方法．http://actigraphcorp.jp/activitycount/index.html (参照2018-10-30 1) 厚生労働省：介護の状況．平成25年国民生活基礎調査の概況，https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa13/dl/05.pdf (参照 2018-09-10 10) Prince SA, Adamo KB, Hamel ME, Hardt J, Gorber SC, et al:A comparison of direct versus self-report measures for assessing physical activity in adults:A systematic review. Int J Behav Nutr Phys Act 5:56, 2008. 11) Kim SY, Jeon EY, Sok SR, Oh HK, Kim KB:Quality of life of Korean and Korean American older adults:A comparison. J Gerontol Nurs 35(6):28-34, 2009. 29) Kanai M, Izawa KP, Kobayashi M, Onishi A, Kubo H:Effect of accelerometer-based feedback on physical activity in hospitalized patients with ischemic stroke:A randomized controlled trial. Clin Rehabil 32(8):1047-1056, 2018. 18) Rand D, Eng JJ:Predicting daily use of the affected upper extremity 1 year after stroke. J Stroke Cerebrovasc Dis 24(2):274-283, 2015. 4) Kelly KM, Borstad AL, Kline D, Gauthier LV:Improved quality of life following constraint-induced movement therapy is associated with gains in arm use, but not motor improvement. Top Stroke Rehabil 25(7):467-474, 2018. |
| References_xml | – reference: 12) Uswatte G, Giuliani C, Winstein C, Zeringue A, Hobbs L, et al:Validity of accelerometry for monitoring real-world arm activity in patients with subacute stroke:Evidence from the extremity constraint-induced therapy evaluation trial. Arch Phys Med Rehabil 87(10):1340-1345, 2006. – reference: 26) The R Project for Statistical:Getting Started. http://www.r-project.org (accessed 2018-10-30). – reference: 17) Narai E, Hagino H, Komatsu T, Togo F:Accelerometer-based monitoring of upper limb movement in older adults with acute and subacute stroke. J Geriatr Phys Ther 39(4):171-177, 2016. – reference: 21) アクチ・ジャパン：アクティビティ (活動量) 測定方法．http://actigraphcorp.jp/activitycount/index.html (参照2018-10-30) ． – reference: 28) Izawa KP, Watanabe S, Omiya K, Hirano Y, Oka K, et al:Effect of the self-monitoring approach on exercise maintenance during cardiac rehabilitation:A randomized, controlled trial. Am J Phys Med Rehabil 84(5):313-321, 2005. – reference: 11) Kim SY, Jeon EY, Sok SR, Oh HK, Kim KB:Quality of life of Korean and Korean American older adults:A comparison. J Gerontol Nurs 35(6):28-34, 2009. – reference: 18) Rand D, Eng JJ:Predicting daily use of the affected upper extremity 1 year after stroke. J Stroke Cerebrovasc Dis 24(2):274-283, 2015. – reference: 20) Bailey RR, Lang CE:Upper-extremity activity in adults:Referent values using accelerometry. J Rehabil Res Dev 50(9):1213-1222, 2014. – reference: 10) Prince SA, Adamo KB, Hamel ME, Hardt J, Gorber SC, et al:A comparison of direct versus self-report measures for assessing physical activity in adults:A systematic review. Int J Behav Nutr Phys Act 5:56, 2008. – reference: 13) de Niet M, Bussmann JB, Ribbers GM, Stam HJ:The stroke upper-limb activity monitor:Its sensitivity to measure hemiplegic upper-limb activity during daily life. Arch Phys Med Rehabil 88(9):1121-1126, 2007. – reference: 23) Amano S, Umeji A, Uchita A, Hashimoto Y, Takebayashi T, et al:Clinimetric properties of the Fugl-Meyer assessment with adapted guidelines for the assessment of arm function in hemiparetic patients after stroke. Top Stroke Rehabil 25(7):500-508, 2018. – reference: 4) Kelly KM, Borstad AL, Kline D, Gauthier LV:Improved quality of life following constraint-induced movement therapy is associated with gains in arm use, but not motor improvement. Top Stroke Rehabil 25(7):467-474, 2018. – reference: 5) Taub E, Miller NE, Novack TA, Fleming WC, Nepomuceno CS, et al:Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil 74(4):347-354, 1993. – reference: 6) 高橋香代子，道免和久，佐野恭子，竹林 崇，蜂須賀研二，他：新しい上肢運動機能評価法・日本語版Motor Activity Logの信頼性と妥当性の検討．作業療法 28 (6) ：628-636，2009． – reference: 14) Hayward KS, Eng JJ, Boyd LA, Lakhani B, Bernhardt J, et al:Exploring the role of accelerometers in the measurement of real world upper-limb use after stroke. Brain Impairment 17(1):16-33, 2015. – reference: 24) Lyle RC:A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res 4(4):483-492, 1981. – reference: 15) Bailey RR, Klaesner JW, Lang CE:Quantifying real-world upper-limb activity in nondisabled adults and adults with chronic stroke. Neurorehabil Neural Repair 29(10):969-978, 2015. – reference: 22) Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S:The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med 7(1):13-31, 1975. – reference: 29) Kanai M, Izawa KP, Kobayashi M, Onishi A, Kubo H:Effect of accelerometer-based feedback on physical activity in hospitalized patients with ischemic stroke:A randomized controlled trial. Clin Rehabil 32(8):1047-1056, 2018. – reference: 16) 竹林 崇，天野 暁，花田恵介，内山侑紀，道免和久：慢性期の脳卒中後上肢麻痺を呈した患者の麻痺手の使用頻度を定量化する試み─事例報告─．作業療法 36 (1) ：74-80，2017． – reference: 9) Adams SA, Matthews CE, Ebbeling CB, Moore CG, Cunningham JE, et al:The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol 161(4):389-398, 2005. – reference: 3) Nichols-Larsen DS, Clark PC, Zeringue A, Greenspan A, Blanton S:Factors influencing stroke survivors’ quality of life during subacute recovery. Stroke 36(7):1480-1484, 2005. – reference: 7) Bradburn NM, Rips LJ, Shevell SK:Answering autobiographical questions:The impact of memory and inference on surveys. Science 236(4798):157-161, 1987. – reference: 27) Guiraud T, Granger R, Gremeaux V, Bousquet M, Richard L, et al:Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program. Arch Phys Med Rehabil 93(12):2141-2147, 2012. – reference: 1) 厚生労働省：介護の状況．平成25年国民生活基礎調査の概況，https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa13/dl/05.pdf (参照 2018-09-10) ． – reference: 2) Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, et al:Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke:The EXCITE randomized clinical trial. JAMA 296(17):2095-2104, 2006. – reference: 25) Van der Lee JH, De Groot V, Beckerman H, Wagenaar RC, Lankhorst GJ, et al:The intra- and interrater reliability of the action research arm test:A practical test of upper extremity function in patients with stroke. Arch Phys Med Rehabil 82(1):14-19, 2001. – reference: 8) Tatemichi TK, Desmond DW, Stern Y, Paik M, Sano M, et al:Cognitive impairment after stroke:Frequency, patterns, and relationship to functional abilities. J Neurol Neurosurg Psychiatr 57(2):202-207, 1994. – reference: 19) Waddell KJ, Birkenmeier RL, Bland MD, Lang CE:An exploratory analysis of the self-reported goals of individuals with chronic upper-extremity paresis following stroke. Disabil Rehabil 38(9):853-857, 2015. |
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| SubjectTerms | Behavioral assessment Cerebral vascular disease Daily living Health-related quality of life Monitoring モニタリング 健康関連QOL 日常生活 脳血管障害 行動評価 |
| Title | 脳卒中片麻痺患者を対象とした加速度計（ActiGraph Link GT9X）による上肢活動量計測と活動量可視化の試み—3点計測法の妥当性の検討 |
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| ispartofPNX | 作業療法, 2019/10/15, Vol.38(5), pp.550-558 |
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