Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
Qual Life Res. 2014 Aug;23(6):1823-31. doi: 10.1007/s11136-014-0624-9. Epub 2014 Jan 14.
To explore the environmental effects on the disabilities of people post stroke and to search for the best probabilistic cut-off value of the WHO Disability Assessment Schedule second edition (WHODAS 2.0) scores to predict people post stroke experiencing an access barrier to the International Classification of Functioning, Disability and Health category e120 products and technology for personal indoor and outdoor mobility and transportation (PMT).
We analyzed data of 162 younger (aged 18-64 years) and 202 older (aged ≥65 years) people post stroke from the databank of persons with disability between June 1, 2011 and February 29, 2012. All participants rated each WHODAS 2.0 item with environmental intervention (performance score) and without any intervention (capacity score). We used the paired capacity-performance score difference to assess the whole environmental effects on the participants' disability, evaluated each participant's access barrier to PMT (negative PMT), and used a receiver-operating characteristic curve to predict patients having a negative PMT.
The whole environment acted as a barrier on mobility and self-care in >10 % of older people post stroke. Older patients having a summary index performance score of ≥78.8 points and younger patients having an index of ≥56.0 points were likely to experience a negative PMT. Older patients who have an access to PMT were possible to improve their daily activities performance, and younger patients could report less disability.
An environmental support to improve the PMT accessibility is important for people post stroke to reduce their disability.
探索环境对脑卒中后患者残疾的影响，并寻找世界卫生组织残疾评定量表第二版（WHODAS 2.0）评分的最佳概率截断值，以预测脑卒中后患者在使用个人室内和室外移动和交通（PMT）的国际功能、残疾和健康分类 e120 产品和技术方面存在使用障碍。
我们分析了 2011 年 6 月 1 日至 2012 年 2 月 29 日期间残疾人士数据库中 162 名年轻（年龄 18-64 岁）和 202 名老年（年龄≥65 岁）脑卒中后患者的数据。所有参与者均对 WHODAS 2.0 的每个项目进行了环境干预（表现评分）和无任何干预（能力评分）的评分。我们使用配对的能力-表现评分差值来评估环境对参与者残疾的整体影响，评估每个参与者对 PMT 的使用障碍（负 PMT），并使用受试者工作特征曲线预测有负 PMT 的患者。
在≥10%的老年脑卒中后患者中，整个环境对移动和自理能力构成障碍。总指数表现评分为≥78.8 分的老年患者和指数为≥56.0 分的年轻患者可能会出现负 PMT。有机会获得 PMT 的老年患者可能会改善他们的日常活动表现，而年轻患者可能会报告较少的残疾。
为改善 PMT 的可及性，为脑卒中后患者提供环境支持对于减轻其残疾至关重要。
