A study to detect the determinants of divergence between the walking ability and the activities of daily walking of stroke patients in a convalescent ward.

本研究の目的は, (1)脳卒中患者の退院時歩行能力と歩行の実行状況の乖離の実態を明らかにし, (2)乖離に寄与する因子を検討することである. 対象は, 回復期病棟に入院する215例の脳卒中患者である. 退院時点で歩行能力と実行状況の乖離の有無により２群に分け, 単純集計を行った. 診療記録から, 身体機能障害, 高次脳機能障害, 動作能力, 日常生活活動の情報を収集し, 乖離の大きさを従属変数としてこれらから回帰式を求めた. その結果, 99例(46％) は歩行能力と実行状況の乖離が解消しないまま退院していた. 乖離の大きさの決定因子として抽出された項目は, Motor of age, 社会的認知FIM であった. このことから, Motor of age や社会的認知FIM が低い患者は, 歩行能力と実行状況に乖離が生じやすいことが示唆された.The purpose of this study is (1) to reveal any divergences between the walking ability and the activities of daily walking and (2) examine any determinants of the divergence at the time of their discharge. The subjects consisted of 215 stroke patients who had been admitted to the convalescent ward. The patients were divided into two groups consisting of those with or without any divergence in their walking ability and the activities of daily living. Clinical data, such as the physical functions, brain functions, the abilities to perform tasks and the activities of daily living were all obtained from their medical records. Based on these identified factors, we performed a regression analysis to determine any dependent variables in the degree of divergence. A total of 99 patients (46％) were discharged with some divergence in the walking ability and the activities of daily living. Social cognition in FIM and “motor of age” were extracted as determinate s in the degree of divergence. The patients with a dysfunction of social cognition and “motor of age” were often found to demonstrate some divergence between the walking ability and the activities of daily living