Dong Yi, Zhang Chang-Jie, Shi Jie, Deng Jinggui, Lan Chun-Na
Mawangdui Hospital of Hunan Province Department of Rehabilitation, The Second Xiangya Hospital of Central South University, Changsha, China.
Medicine (Baltimore). 2016 Sep;95(38):e4479. doi: 10.1097/MD.0000000000004479.
This study was aimed to identify and evaluate the International Classification of Functioning (ICF) key codes for dysphagia in stroke patients. Thirty patients with dysphagia after stroke were enrolled in our study. To evaluate the ICF dysphagia scale, 6 scales were used as comparisons, namely the Barthel Index (BI), Repetitive Saliva Swallowing Test (RSST), Kubota Water Swallowing Test (KWST), Frenchay Dysarthria Assessment, Mini-Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). Multiple regression analysis was performed to quantitate the relationship between the ICF scale and the other 7 scales. In addition, 60 ICF scales were analyzed by the least absolute shrinkage and selection operator (LASSO) method. A total of 21 ICF codes were identified, which were closely related with the other scales. These included 13 codes from Body Function, 1 from Body Structure, 3 from Activities and Participation, and 4 from Environmental Factors. A topographic network map with 30 ICF key codes was also generated to visualize their relationships. The number of ICF codes identified is in line with other well-established evaluation methods. The network topographic map generated here could be used as an instruction tool in future evaluations. We also found that attention functions and biting were critical codes of these scales, and could be used as treatment targets.
本研究旨在识别和评估国际功能、残疾和健康分类（ICF）中中风患者吞咽困难的关键编码。30例中风后吞咽困难患者纳入本研究。为评估ICF吞咽困难量表，使用了6个量表作为对照，即巴氏指数（BI）、反复唾液吞咽试验（RSST）、久保田饮水试验（KWST）、Frenchay构音障碍评定法、简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）。进行多元回归分析以量化ICF量表与其他7个量表之间的关系。此外，采用最小绝对收缩和选择算子（LASSO）方法对60个ICF量表进行分析。共识别出21个与其他量表密切相关的ICF编码。其中包括来自身体功能的13个编码、来自身体结构的1个编码、来自活动与参与的3个编码以及来自环境因素的4个编码。还生成了一张包含30个ICF关键编码的地形图以直观显示它们之间的关系。识别出的ICF编码数量与其他成熟的评估方法一致。此处生成的网络地形图可作为未来评估的指导工具。我们还发现注意力功能和咬合是这些量表的关键编码，可作为治疗靶点。
