Okamura T, Nakagawa Y, Ishikawa Y, Kitamura A, Kiyama M, Sato S, Naito Y, Iida M, Iso H, Shimamoto T
Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Center for Adult Diseases Osaka.
Nihon Koshu Eisei Zasshi. 1995 Oct;42(10):878-87.
To clarify characteristics of participants in community-based rehabilitation programs provided by local municipalities (cities, towns, and villages) and effect of the program on their levels of independence in activities of daily living (ADL), a cross-sectional study was performed on 422 participants in 49 municipalities in Kochi Prefecture. 1. Mean age of participants was 68.3 +/- 9.0, and 77.7% of them were stroke patients. 2. The mean interval between disease onset and program participation was 40.4 months, and the mean duration of program participation was 54.5 months. 3. At the start of rehabilitation programs and at the time of the investigation (December 1993), about 90% of the participants had good levels of independence in ADL (Rank A and over according to the standard of the Ministry of Health and Welfare). 4. The frequency of rehabilitation programs and the presence of occupational therapists were positively associated with the improvement of levels of independence in ADL. In particular, the frequency of rehabilitation programs was associated with improvement of quality of life in self-supporting participants (Rank J2), and the presence of occupational therapists was associated with the improvement of ADL in semi-bed-ridden participants (Rank A). 5. After adjusting for age and sex, using multiple logistic regression analysis, type of diseases (non-stroke), hospital rehabilitation immediately after onset, higher levels of independence in ADL at the start of rehabilitation programs, and higher frequency of rehabilitation programs were significantly associated with improvements in levels of independence in ADL. Shorter interval between disease onset and program participation, and the presence of occupational therapists were also associated with improvements in levels of independence in ADL, although the relation did not reach statistical significance.
为阐明由当地自治市（市、镇和村）提供的社区康复项目参与者的特征，以及该项目对他们日常生活活动（ADL）独立水平的影响，对高知县49个自治市的422名参与者进行了一项横断面研究。1. 参与者的平均年龄为68.3±9.0岁，其中77.7%为中风患者。2. 疾病发作与参与项目之间的平均间隔为40.4个月，参与项目的平均时长为54.5个月。3. 在康复项目开始时以及调查时（1993年12月），约90%的参与者在ADL方面具有良好的独立水平（根据厚生省标准为A级及以上）。4. 康复项目的频率和职业治疗师的配备与ADL独立水平的提高呈正相关。特别是，康复项目的频率与自理参与者（J2级）生活质量的改善相关，职业治疗师的配备与半卧床参与者（A级）ADL的改善相关。5. 在对年龄和性别进行调整后，使用多元逻辑回归分析，疾病类型（非中风）、发病后立即进行的医院康复、康复项目开始时较高的ADL独立水平以及较高的康复项目频率与ADL独立水平的改善显著相关。疾病发作与参与项目之间较短的间隔以及职业治疗师的配备也与ADL独立水平的改善相关，尽管这种关系未达到统计学意义。
