2/7 徳永誠 他 :FIM 利得 退院時 FIM の予測式 表 1. 全国調査と比較した対象患者 1,118 例の基本属性データ,, FIM. FIM.. FIM.. FIM FIM.. FIM.. FIM FIM.. FIM.. FIM Functional Independenc
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1 1/7 Japanese Journal of Comprehensive Rehabilitation Science (2015) Original Article FIM 利得および退院時 FIM の予測式 入院時 FIM, 年齢, 認知機能および転院時期で層別化した場合の FIM 利得中央値を使った手法 徳永誠, 1 三宮克彦, 1 中島雪彦, 1 野尻晋一, 1 時里香, 1 桂賢一, 1 渡邊進, 1 中西亮二, 1 1 山永裕明 1 熊本機能病院総合リハビリテーション部 要旨 Tokunaga M, Sannomiya K, Nakashima Y, Nojiri S, Tokisato K, Katsura K, Watanabe S, Nakanishi R, Yamanaga H. Formula for Predicting FIM Gain and Discharge FIM Methods using Median Values of FIM Gain Stratified by Admission FIM, Age, Cognitive Function, and Transfer Interval. Jpn J Compr Rehabil Sci 2015; 6: FIM FIM A, FIM mfim mfim mfim mfim mfim mfim. mfim. mfim mfim mfim mfim キーワード Functional Independence Measure FIM はじめに Functional Independence Measure FIM tokunaga@juryo.or.jp FIM FIM FIM y ax bx cx y X X a c FIM FIM FIM FIM FIM, FIM FIM FIM FIM FIM FIM FIM FIM FIM 対象と方法 A FIM FIM,
2 2/7 徳永誠 他 :FIM 利得 退院時 FIM の予測式 表 1. 全国調査と比較した対象患者 1,118 例の基本属性データ,, FIM. FIM.. FIM.. FIM FIM.. FIM.. FIM FIM.. FIM.. FIM Functional Independence Measure 検討 1 入院時運動 FIM に応じた運動 FIM 利得 退院時運動 FIM の標準値 FIM FIM FIM FIM FIM FIM Spearman 検討 2 標準値を年齢で補正する FIM FIM P FIM FIM Q P Q FIM FIM FIM FIM 検討 3 認知 FIM で補正する FIM FIM FIM FIM 検討 4 発症から入院までの日数で補正する FIM / FIM FIM 結果 FIM FIM. FIM FIM FIM a FIM FIM.. FIM FIM FIM FIM a FIM
3 徳永誠 他 :FIM 利得 退院時 FIM の予測式 3/7 a FIM b FIM FIM. FIM FIM FIM. FIM. a FIM FIM b FIM a FIM b FIM FIM FIM.... FIM. p. FIM d FIM.. FIM.. d 考察 図 1. 入院時運動 FIM と運動 FIM 利得との関係 ( 標準値 ) FIM FIM FIM FIM FIM FIM. FIM. FIM FIM 表 2. 相関係数と残差 a FIM FIM FIM FIM b FIM FIM FIM FIM c FIM FIM FIM FIM FIM FIM FIM d FIM FIM FIM FIM FIM FIM FIM B
4 4/7 徳永誠 他 :FIM 利得 退院時 FIM の予測式 図 2. 年齢の影響係数 FIM FIM FIM 図 3. 認知機能の影響係数 FIM FIM FIM 図 4. 転院時期の影響係数 FIM FIM FIM FIM... a FIM b b b FIM a, d FIM...
5 徳永誠 他 :FIM 利得 退院時 FIM の予測式 5/7... a, d FIM Jeong Sonoda Jeong FIM FIM FIM Glasgow Coma Scale modified Rankin Scale mrs R. FIM. FIM FIM FIM FIM FIM. Jeong. Jeong R. R, R Sonoda FIM FIM FIM FIM. FIM FIM FIM... Sonoda FIM. FIM, FIM Jeong Sonoda FIM. FIM. Sonoda Jeong.. Sonoda FIM FIM FIM / /. FIM / /. FIM 表 3. 本邦のリハビリテーション病院における重回帰分析を用いた退院時 FIM と FIM 利得の予測 R FIM FIM Jeong et al.. FIM Sonoda et al..... FIM Liu et al. FIM Iwai et al. FIM Tokunaga et al. FIM Jeong et al... FIM Tsuji et al. FIM Inouye.. FIM... FIM Mutai et al FIM., FIM FIM Tokunaga et al.. FIM Imada et al.., FIM.. FIM. FIM. FIM., FIM R FIM Functional Independence Measure FIM
6 6/7 徳永誠 他 :FIM 利得 退院時 FIM の予測式 FIM FIM FIM FIM FIM. Jeong mrs Sonoda. FIM. FIM FIM FIM, FIM FIM, FIM FIM FIM FIM FIM FIM FIM, R FIM R, FIM FIM FIM FIM FIM FIM 文献 1. Data management service of the Uniform Data System for Medical Rehabilitation and the Center for Functional Assessment Research (1990) Guide for use of the uniform data set for medical rehabilitation. version 3.0, State University of New York at Buffalo, Buffalo. 2. Jeong S, Inoue Y, Kondo K, Matsumoto D, Shiraishi N. Formula for predicting FIM for stroke patients at discharge from an acute ward or convalescent rehabilitation ward. Jpn J Compr Rehabil Sci 2014; 5: Sonoda S, Saitoh E, Nagai S, Okuyama Y, Suzuki T, Suzuki M. Stroke outcome prediction using reciprocal number of initial activities of daily living status. J Stroke Cerebrovasc Diseas 2005; 14: Liu M, Domen K, Chino N. Comorbidity measures for stroke outcome research. Arch Phys Med Rehabil 1997; 78: Iwai N, Aoyagi Y. Discharge index and prediction for stroke patients in the post-acute stage. Jpn J Compr Rehabil Sci 2012; 3: Tokunaga M, Fukunaga K, Sannomiya K, Imada Y, Hamasaki H, Noguchi D, et al. The difference between measured Nichijo-seikatsu-kino-hyokahyo (NSKH) score and predicted NSKH score derived from ADL is related to FIM gain. Jpn J Compr Rehabil Sci 2013; 4: Jeong S, Kondo K, Shiraishi N, Inoue Y. An evaluation of post-stroke rehabilitation in Japan. Clinical Audit 2010; 2: Tsuji T, Liu M, Sonoda S, Domen K, Chino N. The stroke impairment assessment set. Arch Phys Med Rehabil 2000; 81: Inouye M. Predicting models of outcome stratified by age after first stroke rehabilitation in Japan. Am J Phys Med Rehabil 2001; 80: Hirano Y, Okura Y, Takeuchi M. The influence of ADL severity at admission on ADL at discharge in convalescent stroke rehabilitation. Tohoku Rigaku-ryoho Kagaku 2011; 23: Japanese. 11. Mutai H, Furukawa T, Araki K, Misawa K, Hanihara T. Factors associated with functional recovery and home discharge in stroke patients admitted to a convalescent rehabilitation ward. Geriatr Gerontol Int 2012; 12: Imada Y, Tokunaga M, Fukunaga K, Sannomiya K, Inoue R, Hamasaki H, et al. Relationship between cognitive FIM score and motor FIM gain in patients with stroke in a Kaifukuki rehabilitation ward. Jpn J Compr Rehabil Sci 2014; 5: Tokunaga M, Kondo K. Training time and FIM gain in patients with stroke in Kaifukuki rehabilitation hospitals. Sogo Rehabil 2014; 42: Japanese. 14. Shiraishi N, Matsubayashi Y, Tanaka N, Iwamoto H. Changes in ADL of stroke patients in a convalescent
7 徳永誠 他 :FIM 利得 退院時 FIM の予測式 7/7 rehabilitation ward. Rigakuryoho Kagaku 2005; 32: Japanese. 15. Shiraishi N, Mizutani M, Menjho A, Deguchi K, Takase H, Hamaguchi Y, et al. Comparison of activities of daily living for a convalescent rehabilitation ward and general ward for strke patients. Jpn J Geriat 2004; 41: Japanese. 16. Sonoda S, Nagai S, Saitoh E. A viewpoint and problem of the convalescent rehabilitation wards. Jpn J Rehabil Med 2005; 42: Japanese. 17. Tokunaga M, Nakanishi R, Eguchi G, Kihara K, Tokisato K, Katsura K, et al. The influence of age on corrected motor FIM effectiveness. Jpn J Compr Rehabil Sci 2014; 5: Tokunaga M, Honda S, Uyama E, Mita S, Terasaki T, Hirata Y, et al. Difference of FIM improvement between subtypes of brain infarction. J Clin Rehabil 2014; 23: Japanese Annual Report from the Annual Survey Committee of Kaifukuki Rehabilitation Ward Association. February pp Japanese. 20. Black-Schaffer RM, Winston C. Age and functional outcome after stroke. Top Stroke Rehabil 2004; 11: Tokunaga M, Yonemura M, Inoue R, Sannomiya K, Nakashima Y, Watanabe S, et al. Effects of age on functional independence measure score gain in stroke patients in Kaifukuki rehabilitation ward. Jpn J Compr Rehabil Sci 2012; 3: 32 6.
1/8 Japanese Journal of Comprehensive Rehabilitation Science (2017) Original Article 運動 FIM と認知 FIM を層別化して 4 つの予測式を作ることで運動 FIM 利得を目的変数とした重回帰分析の予測精度が高ま
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