Raggi Alberto, Leonardi Matilde, Ajovalasit Daniela, D'amico Domenico, Bussone Gennaro
Neurology, Public Health and Disability Unit - Scientific Directorate bHeadache Centre, Neurological Institute C. Besta IRCCS Foundation, Milano, Italy.
Int J Rehabil Res. 2010 Sep;33(3):225-31. doi: 10.1097/MRR.0b013e3283375e53.
To describe the functional profiles of patients with migraine, and the relationships between symptoms, activities and environmental factors, using WHO's International Classification of Functioning (ICF). Patients were consecutively enrolled at the Besta Institute of Milan. The ICF checklist was administered and two count-based indexes developed: 'extension', containing ICF categories rated with qualifiers 1-4, and 'severity', containing ICF categories rated with qualifiers 3-4. Categories rated with qualifiers 1-4 in at least 50% of patients are described separately. Spearman's correlation was performed to identify the relationships between symptoms, activities and environmental factors; linear regressions were performed to identify the best predictors of performance indexes in activities and participation domain. One hundred and two patients joined this study. Twenty-eight categories rated with qualifiers 1-4 in at least 50% of patients are reported: they include difficulties in daily activities, in mobility and in labor activities. Capacity and performance indexes are significantly different. Low correlations are reported between body functions impairments and limitations in activities and participation, slightly higher with capacity indexes. Environmental factors are mildly correlated with capacity indexes. Environmental factors play a relevant role in improving functioning of patients with migraine. Nevertheless, difficulties in activities and participation are explained more by functional impairments than by the effect of environmental factors: in particular, no facilitators target difficulties in work activities or mobility. To plan appropriate interventions that meet patients' needs, especially in the labor sector, methodologies and tools are needed to couple information on symptoms, on the difficulties in executing activities and on environment's features.
使用世界卫生组织的《国际功能、残疾和健康分类》(ICF)来描述偏头痛患者的功能概况,以及症状、活动和环境因素之间的关系。患者在米兰的贝斯塔研究所连续入组。采用ICF清单并制定了两个基于计数的指标:“扩展度”,包含用1-4级限定词评定的ICF类别;“严重程度”,包含用3-4级限定词评定的ICF类别。对至少50%患者用1-4级限定词评定的类别进行单独描述。采用斯皮尔曼相关性分析来确定症状、活动和环境因素之间的关系;进行线性回归以确定活动和参与领域表现指标的最佳预测因素。102名患者参与了本研究。报告了至少50%患者用1-4级限定词评定的28个类别:包括日常活动、移动性和劳动活动方面的困难。能力和表现指标有显著差异。身体功能损害与活动和参与受限之间的相关性较低,与能力指标的相关性略高。环境因素与能力指标轻度相关。环境因素在改善偏头痛患者的功能方面发挥着重要作用。然而,活动和参与方面的困难更多是由功能损害而非环境因素的影响所解释:特别是,没有促进因素针对工作活动或移动性方面的困难。为了规划满足患者需求的适当干预措施,尤其是在劳动领域,需要方法和工具来整合关于症状、执行活动的困难以及环境特征的信息。