脳卒中リハビリテーション患者の早期自立度予測 EARLY PREDICTION OF THE OUTCOME OF STROKE REHABILITATION

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脳卒中患者のリハビリテーション後の最終自立度が, (1)患者の年齢, (2)各時期の自立度, (3)臨床的諸因子の組み合わせにより, 早期にどの程度予測可能かを検討した.対象は発症後第30病日以内に入院した脳卒中患者406人で, 平均年齢は67.0歳である.自立度は, 屋外歩行, 屋内歩行, ベッド上生活自立, 全介助の4段階に分類し, 臨床的諸因子としては, 運動障害の他に, 意識障害, 痴呆, 夜間せん妄等12因子を選んだ.これら諸因子を組み合わせて作製した予測基準により, 入院時自立歩行不能患者のうち, 7割は入院時に, 8割は入院後2週時に, 9割は同1月時に, 最終自立度が予測可能であった.

The purpose of this study is to predict the outcome (final independence level) in stroke rehabilitation early with a simple clinical method.Our subjects consisted of 406 acute stroke patients who were admitted to a community hospital within one month after the onset. There average age was 67.0 years.We used a combination of three factors to predict the final independence level of each patient. These factors were (1) ptient's age, (2) independence levels on admission, two weeks after admission, one monthe after that and (3) clinical signs. We classified independence level into three : ambulant (AMB), independent in sitting (SIT), totally dependent (DEP). We divided clinical signs into motor disturbance and other 12 signs such as consciousness disturbance, dementia, night delirium, aphasia, left hemispatial agnosia.Main results were as follows : (1) Patients who were SIT on admission finally became AMB.(2) Patients who were DEP on admission but ahd mild hemiparesis of Brunnstrom's recovery stage IV to VI finally became AMB.(3) Patients who were DEP on admission but became SIT within one monthe after that finally became AMB.(4) Among the patients who remained DEP one month after admission, certain patients continued to be DEP, who were 60 years or order and had delayed consciousness disturbance, dementia, bilateral hemiplegia or severe heart disease.Based on these results, we composed a set of criteria for the early prediction, which could denfinitely predict the final independence level in 70% of the stroke cases on admission, in 80% two weeks after admission and in 90% one month after admission.

収録刊行物

  • リハビリテーション医学 : 日本リハビリテーション医学会誌

    リハビリテーション医学 : 日本リハビリテーション医学会誌 19(4), 201-223, 1982-07-18

    社団法人日本リハビリテーション医学会

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各種コード

  • NII論文ID(NAID)
    110001857252
  • NII書誌ID(NCID)
    AN00250275
  • 本文言語コード
    JPN
  • 資料種別
    雑誌論文
  • ISSN
    0034351X
  • データ提供元
    CJP引用  NII-ELS 
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