使用简短身体性能电池对脑卒中偏瘫患者进行步态评估。

Gait evaluation in stroke hemiplegic patients using short physical performance battery.

机构信息

Department of Rehabilitation, Fujita Health University Nanakuri Memorial Hospital, 424-1, Oodoricho, Tsu, Mie 514-1295, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2022 Oct;31(10):106704. doi: 10.1016/j.jstrokecerebrovasdis.2022.106704. Epub 2022 Aug 27.

DOI:10.1016/j.jstrokecerebrovasdis.2022.106704

PMID:36037677

Abstract

OBJECTIVES

Falls can occur daily in stroke patients and appropriate independence assessments for fall prevention are required. Although previous studies evaluated the short physical performance battery (SPPB) in stroke patients, the relationship between SPPB and fall prediction and walking independence remains unclear. Therefore, we aimed to verify whether SPPB is a predictor of walking independence.

MATERIALS AND METHODS

The present study included 105 hemiplegic stroke patients who were admitted to the rehabilitation ward and gave consent to participate. Cross-sectional physical function and functional independence measure cognitive (FIM-C) evaluation were conducted in hemiplegic stroke patients. Logistic regression analysis using the increasing variable method (likelihood ratio) was performed to extract factors for walking independence. Cutoff values were calculated for the extracted items using the receiver operating-characteristic (ROC) curve.

RESULTS

Among 86 participants included in the final analysis, 36 were independent walkers and 50 were dependent walkers. In the logistic regression analysis, SPPB and FIM-C were extracted as factors for walking independence. The cutoff value was 7 [area under the curve (AUC), 0.94; sensitivity, 0.83; specificity, 0.73)] for SPPB and 32 (AUC, 0.83; sensitivity, 0.69; specificity, 0.57) for FIM-C in ROC analysis CONCLUSIONS: SPPB and FIM-C were extracted as factors for walking independence. Although SPPB alone cannot determine independent walking, combined assessment of SPPB with cognitive function may enable more accurate determination of walking independence.

摘要

目的

脑卒中患者可能每天都会发生跌倒，因此需要进行适当的独立性评估以预防跌倒。虽然先前的研究评估了脑卒中患者的短体适能测试（SPPB），但 SPPB 与跌倒预测和行走独立性的关系仍不清楚。因此，我们旨在验证 SPPB 是否是行走独立性的预测指标。

材料和方法

本研究纳入了 105 名偏瘫脑卒中患者，这些患者均入住康复病房并同意参与研究。对偏瘫脑卒中患者进行了横断面的身体功能和功能性独立测量认知（FIM-C）评估。使用递增变量方法（似然比）进行逻辑回归分析，以提取行走独立性的预测因素。使用受试者工作特征（ROC）曲线计算提取项目的截断值。

结果

在最终纳入的 86 名参与者中，36 名是独立行走者，50 名是依赖行走者。在逻辑回归分析中，SPPB 和 FIM-C 被提取为行走独立性的预测因素。SPPB 的截断值为 7 [曲线下面积（AUC），0.94；敏感性，0.83；特异性，0.73]，FIM-C 的截断值为 32（AUC，0.83；敏感性，0.69；特异性，0.57），ROC 分析。