Nakao Shigetaka, Takata Shinjiro, Uemura Hirokazu, Kashihara Michiharu, Osawa Toshifumi, Komatsu Koji, Masuda Yuki, Okahisa Tetsuya, Nishikawa Koji, Kondo Shin, Yamada Megumi, Takahara Risa, Ogata Yoshimi, Nakamura Yuka, Nagahiro Shinji, Kaji Ryuji, Yasui Natsuo
Department of Orthopedic Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
J Med Invest. 2010 Feb;57(1-2):81-8. doi: 10.2152/jmi.57.81.
The Barthel Index (BI) cannot be used to measure initial stroke severity or by extension, to stratify patients by severity in acute stroke trials because most patients are bedbound in the first few hours after stroke, either by their deficit or by medical directive. Our objectives were to clarify the threshold of acute BI for use in the prediction of subsequent independence in activities of daily living (ADL) and to assist in the definition of acute stroke rehabilitation goals. Subjects comprised 78 patients out of 191 inpatients admitted with acute stroke at our hospital during 2006-2007. The BI ADL score was divided into 2 ranges (BI> or =60 and < or =40), in a process similar to previous studies. During the acute period (from onset to approximately 3 weeks), all patients with a BI> or =40 could improve their ADL in 6 months. Patients with a BI< or =40 exhibited two ADL recovery outcomes (improved and no change) at 6 months. We also found that the skill level of basic activities related to standing was significant indicator of BI improvement (P<0.001). BI scores determined at approximately 3 weeks were reliable predictors of ADL disabilities at 6 months.
巴氏指数（BI）不能用于衡量初始卒中严重程度，或者由此延伸，在急性卒中试验中按严重程度对患者进行分层，因为大多数患者在卒中后的最初几个小时内，要么因功能缺损，要么因医嘱而卧床不起。我们的目标是明确急性BI用于预测后续日常生活活动（ADL）独立性的阈值，并协助定义急性卒中康复目标。研究对象包括2006年至2007年期间我院收治的191例急性卒中住院患者中的78例。与以往研究类似，将BI ADL评分分为2个范围（BI≥60和≤40）。在急性期（从发病至约3周），所有BI≥40的患者在6个月内其ADL都能得到改善。BI≤40的患者在6个月时表现出两种ADL恢复结果（改善和无变化）。我们还发现，与站立相关的基本活动技能水平是BI改善的显著指标（P<0.001）。约3周时测定的BI评分是6个月时ADL残疾情况的可靠预测指标。
