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髋部骨折患者个体运动相关功能独立性测量项目的独立性水平与其总分之间的关系:一项有序逻辑建模研究。

Relationship between the independence level of individual motor-related functional independence measure items and its total score in patients after hip fracture: an ordinal logistic modelling study.

作者信息

Uchiyama Yuki, Domen Kazuhisa, Katsutani Masashi, Koyama Tetsuo

机构信息

Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan.

Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Rehabilitation Hospital, Japan.

出版信息

J Phys Ther Sci. 2022 May;34(5):404-409. doi: 10.1589/jpts.34.404. Epub 2022 May 1.

DOI:10.1589/jpts.34.404
PMID:35527845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9057680/
Abstract

[Purpose] The independence level of activities of daily living during the recovery period should be predicted to plan a rehabilitation program. This study aimed to assess the relationship between the independence levels of individual motor-related Functional Independence Measure (FIM-motor) items and total FIM-motor score in patients after hip fracture. [Participants and Methods] This study retrospectively analyzed 40 patients who had stayed in a convalescent rehabilitation hospital after hip fracture. The FIM-motor score was assessed for each patient on admission, after 2 and 4 weeks of hospitalization, and at discharge. [Results] The median FIM-motor scores were 52.5 on admission and 83.0 at discharge. The results of ordinal logistic modeling were statistically significant for all 13 FIM-motor items. The independence levels for transfer to toilet and bed/chair/wheelchair were proportionally distributed across the entire range of total FIM-motor scores. However, a weak relationship was observed between the scores for bladder and bowel management and total FIM-motor scores. Although eating and grooming were relatively easy items, stair-climbing and locomotion were difficult. [Conclusion] The relationship between the independence level of individual FIM-motor items and the total FIM-motor score varied widely. This knowledge might be useful while scheduling rehabilitative treatments for patients after hip fracture.

摘要

[目的] 为制定康复计划,需预测恢复期日常生活活动的独立水平。本研究旨在评估髋部骨折患者个体运动相关功能独立性测量(FIM-运动)项目的独立水平与FIM-运动总分之间的关系。[参与者与方法] 本研究回顾性分析了40例髋部骨折后入住康复疗养医院的患者。在入院时、住院2周和4周后以及出院时对每位患者进行FIM-运动评分评估。[结果] 入院时FIM-运动评分中位数为52.5,出院时为83.0。对所有13个FIM-运动项目进行的有序逻辑回归建模结果具有统计学意义。转移至厕所和床/椅/轮椅的独立水平在FIM-运动总分的整个范围内呈比例分布。然而,膀胱和肠道管理评分与FIM-运动总分之间的关系较弱。尽管进食和修饰相对容易,但爬楼梯和移动困难。[结论] 个体FIM-运动项目的独立水平与FIM-运动总分之间的关系差异很大。这一认识在为髋部骨折患者安排康复治疗时可能有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b74/9057680/268bae56d295/jpts-34-404-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b74/9057680/268bae56d295/jpts-34-404-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b74/9057680/268bae56d295/jpts-34-404-g001.jpg

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本文引用的文献

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Item Difficulties of the FIM-Motor Subscale in Patients with Ischemic Stroke during Acute Care: An Ordinal Logistic Modeling Study.急性护理期间缺血性中风患者FIM运动分量表的项目难度:一项有序逻辑建模研究。
Prog Rehabil Med. 2020 Sep 29;5:20200022. doi: 10.2490/prm.20200022. eCollection 2020.
2
Epidemiology of fragility fractures and fall prevention in the elderly: a systematic review of the literature.老年人脆性骨折的流行病学与跌倒预防:文献系统综述
Curr Orthop Pract. 2017 Nov;28(6):580-585. doi: 10.1097/BCO.0000000000000563. Epub 2017 Oct 27.
3
Establishing score equivalence of the Functional Independence Measure motor scale and the Barthel Index, utilising the International Classification of Functioning, Disability and Health and Rasch measurement theory.
利用国际功能、残疾和健康分类以及 Rasch 测量理论,确立功能独立性测量运动量表和巴氏指数的评分等效性。
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Cognitive Status at Hospital Admission: Postoperative Trajectory of Functional Recovery for Hip Fracture.入院时的认知状态:髋部骨折功能恢复的术后轨迹
J Gerontol A Biol Sci Med Sci. 2017 Jan;72(1):61-67. doi: 10.1093/gerona/glv138. Epub 2015 Aug 21.
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Determinants of outcome in hip fracture: role of daily living activities.髋部骨折预后的决定因素:日常生活活动的作用。
Eur J Phys Rehabil Med. 2015 Jun;51(3):253-60. Epub 2014 Nov 27.
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Effect of comorbidity on functional recovery after hip fracture in the elderly.老年髋部骨折后合并症对功能恢复的影响。
Am J Phys Med Rehabil. 2013 Aug;92(8):686-96. doi: 10.1097/PHM.0b013e318282bc67.
7
Past and present issues in Rasch analysis: the functional independence measure (FIM™) revisited.Rasch 分析的过去和现在的问题:重新审视功能独立性测量(FIM™)。
J Rehabil Med. 2011 Oct;43(10):884-91. doi: 10.2340/16501977-0871.
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The burden of osteoporotic fractures beyond acute care: the Canadian Multicentre Osteoporosis Study (CaMos).骨质疏松性骨折的负担超出急性护理范围:加拿大多中心骨质疏松症研究(CaMos)。
Age Ageing. 2011 Sep;40(5):602-7. doi: 10.1093/ageing/afr085. Epub 2011 Jul 20.
9
Relationships between independence level of single motor-FIM items and FIM-motor scores in patients with hemiplegia after stroke: an ordinal logistic modelling study.脑卒中偏瘫患者单个运动FIM项目的独立水平与FIM运动评分之间的关系:一项有序逻辑回归建模研究。
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Development of a short version of the motor FIM for use in long-term care settings.
J Rehabil Med. 2006 Jan;38(1):50-6. doi: 10.1080/16501970510044034.