亜急性期脳卒中症例の訓練室と病棟での活動評価

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  • Evaluation of Patient Activity Level in the Ward and Training Room in Patients with Subacute Stroke
  • アキュウセイキ ノウソッチュウ ショウレイ ノ クンレンシツ ト ビョウトウ デ ノ カツドウ ヒョウカ

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The activity level of 77 patients admitted within 7 days of stroke was evaluated on 17.0±4.2 and 43.1±7.9 days after onset. Nurses scored each patient's functional independent measure (FIM) in the ward as a measure of performance and therapists scored their (FIMR) without sphincter control in the training room as their capacity. FIMR patients had higher scores in self-care, transfer and locomotion, but no significant differences in cognitive scores were found between the two groups. The gap (Δ) between FIMR and FIM patients was significantly correlated to the FIM gain for 4 weeks in self-care, transfer, locomotion and social cognition. However, the correlation coefficients were not very high (r=0.27-0.35). For further examination, the patients were divided into three groups according to the difference (FIM gain-Δ) in FIM motor item scores without sphincter control. (G1, the difference≤-3, 15 cases; G2, 14≥the difference≥-2, 43 cases; G3, the difference≥15, 19 cases). To investigate the factors influencing the correlation, six factors (stroke type, age, both sides Motricity index (MI), trunk control test, FIM cognitive item scores) were analyzed among the groups. There was only one G1 patient out of a total of 19 cases with intracerebral hematoma. The G1 patient had higher scores in the affected side MI. The G3 patients were younger and had higher scores in the non-affected side MI. For subacute stroke patients, FIMR will be helpful in predicting FIM gain for 4 weeks. However, other multiple factors should also be considered to affect the prognosis.

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