Suzuki Makoto, Yamada Sumio, Omori Mikayo, Hatakeyama Mayumi, Sugimura Yuko, Matsushita Kazuhiko, Tagawa Yoshikatsu
Department of Rehabilitation Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Japan.
Am J Phys Med Rehabil. 2008 Sep;87(9):740-9. doi: 10.1097/PHM.0b013e31818378b0.
A patient with poststroke hemiparesis learns to use the nonparetic arm to compensate for the weakness of the paretic arm to achieve independence in dressing. This is the learning process of new component actions on dressing. The purpose of this study was to develop the Upper-Body Dressing Scale (UBDS) for buttoned shirt dressing, which evaluates the component actions of upper-body dressing, and to provide preliminary data on internal consistency of the UBDS, as well as its reproducibility, validity, and sensitivity to clinical change.
Correlational study of concurrent validity and reliability in which 63 consecutive stroke patients were enrolled in the study and were assessed repeatedly by the UBDS and the dressing item of Functional Independent Measure (FIM).
Fifty-one patients completed the 3-wk study. The Cronbach's coefficient alpha of UBDS was 0.88. The principal component analysis extracted two components, which explained 62.3% of total variance. All items of the scale had high loading on the first component (0.65-0.83). Actions on the paralytic side were the positive loadings and actions on the healthy side were the negative loadings on the second component. Intraclass correlation coefficient was 0.87. The level of correlation between UBDS score and FIM dressing item scores was -0.72. Logistic regression analysis showed that only the score of UBDS on the first day of evaluation was a significant independent predictor of dressing ability (odds ratio, 0.82; 95% confidence interval, 0.71-0.95). The UBDS scores for paralytic hand passed into the sleeve, sleeve pulled up beyond the elbow joint, and sleeve pulled up beyond the shoulder joint were worse than the score for the other components of the task. These component actions had positive loading on the second component, which was identified by the principal component analysis.
The UBDS has good internal consistency, reproducibility, validity, and sensitivity to clinical changes of patients with poststroke hemiparesis. This detailed UBDS assessment enables us to document the most difficult stages in dressing and to assess motor and process skills for independence of dressing.
中风后偏瘫患者学习使用非瘫痪侧手臂来补偿瘫痪侧手臂的无力，以实现独立穿衣。这是在穿衣方面新的组成动作的学习过程。本研究的目的是开发用于扣钮衬衫穿衣的上身穿衣量表（UBDS），该量表可评估上身穿衣的组成动作，并提供有关UBDS内部一致性、再现性、有效性以及对临床变化敏感性的初步数据。
同时效度和信度的相关性研究，63例连续中风患者纳入研究，并通过UBDS和功能独立性测量（FIM）的穿衣项目进行反复评估。
51例患者完成了为期3周的研究。UBDS的Cronbach's系数α为0.88。主成分分析提取了两个成分，解释了总方差的62.3%。量表的所有项目在第一个成分上具有高载荷（0.65 - 0.83）。瘫痪侧的动作在第一个成分上为正载荷，健康侧的动作在第二个成分上为负载荷。组内相关系数为0.87。UBDS得分与FIM穿衣项目得分之间的相关水平为 - 0.72。逻辑回归分析表明，仅评估第一天的UBDS得分是穿衣能力的显著独立预测因子（优势比，0.82；95%置信区间，0.71 - 0.95）。瘫痪手穿入袖子、袖子拉到肘关节以上以及袖子拉到肩关节以上的UBDS得分比任务的其他组成部分得分差。这些组成动作在主成分分析确定的第二个成分上具有正载荷。
UBDS对中风后偏瘫患者具有良好的内部一致性、再现性、有效性和对临床变化的敏感性。这种详细的UBDS评估使我们能够记录穿衣中最困难的阶段，并评估穿衣独立性的运动和过程技能。
