重度脳卒中患者における入院1 ヵ月時のMotor Assessment Scale と退院時FIM との関連

• Published in: 理学療法学 Vol. 43; no. 3; pp. 236 - 240
• Main Authors: 佐藤 惇史, 藤田 貴昭, 小沼 亮, 奥田 裕, 山本 優一, 潮見 泰藏
• Format: Journal Article
• Language: Japanese
• Published: 日本理学療法士学会 2016; Japanese Society of Physical Therapy
• Subjects: Activities of daily living; Basic movements; Partial correlation analysis; Severe stroke; 偏相関分析; 日常生活活動; 起居動作; 重度脳卒中
• ISSN: 0289-3770; 2189-602X
• DOI: 10.15063/rigaku.11137

Purpose: The aim of this study was to clarify the relationship between the skill for basic movements such as rolling and sit-to-stand at one month after admission and activities of daily living (ADL) independence at discharge in severe stroke patients.Methods: This retrospective study included 25 patients with first stroke who had a score of less than 40 points on the Functional Independent Measure (FIM) scale at admission. ADL was assessed by using the FIM at admission and discharge, and basic movements were assessed by using the Motor Assessment Scale at admission and at one month. Partial correlation analyses were conducted between each basic movement at one month after admission and the FIM at discharge (dFIM) or the functional gain of FIM (gFIM) during the hospital stay.Results: There were significant positive correlations between the dFIM and “Supine to sitting over side of bed”, “Balanced sitting”, and “Sit to stand”. There were significant positive correlations between the gFIM and “Supine to sidelying”, “Spine to sitting over side of bed”, “Balanced sitting”, and “Sit to stand”. In particular, “Balanced sitting” and “Sit to stand” indicated a high correlation coefficient with the dFIM and gFIM.Conclusion: These findings suggest that the relationships between the dFIM or the gFIM and basic movements at one month after admission, and “Balanced sitting” and “Sit to stand” are particularly important. 【目的】重度脳卒中患者において入院1 ヵ月時のどの起居動作が，ADL 自立度と関連するのかを明らかにすること。【方法】入院時Functional Independent Measure（以下，FIM）が40 点未満の初発脳卒中患者25 名の入退院時FIM，入院時と1 ヵ月時のMotor Assessment Scale（以下，MAS）を評価した。偏順位相関にて，退院時FIM，FIM 利得と1 ヵ月時のMAS 各項目との相関係数を算出した。【結果】退院時FIM と「起き上がり」「座位バランス」「座位から立位」，FIM 利得と「寝返り」「起き上がり」「座位バランス」「座位から立位」との間にそれぞれ有意な相関が認められた。両者とも相関係数は「座位バランス」「座位から立位」が特に高かった。【結論】退院時ADL やADL の改善には，入院1 ヵ月時点での起居動作が関連し，特に「座位バランス」と「座位から立位」が重要であることが示唆された。