临床研究

运用ICF核心分类组合脑卒中(综合版)评价脑卒中患者功能状况的多中心研究

展开
  • 1.十二五”国家科技支撑计划课题组
    2.中国康复研究中心北京博爱医院,北京市 100068
    3.首都医科大学康复医学院,北京市 100068
    4.神经损伤与康复北京市重点实验室,北京市 100068
刘丽旭(1972-),女,汉族,湖南邵阳市人,博士,副主任医师、副教授,主要研究方向:神经系统疾病诊治、神经康复。

收稿日期: 2019-05-20

  修回日期: 2019-07-04

  网络出版日期: 2019-07-23

基金资助

“十二五”国家科技支撑计划课题(No. 2011BAI08B11)

Application of Comprehensive ICF Core Set for Stroke for Evaluation for Stroke Patients: A Multi-center Study

Expand
  • 1. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China;
    2. Capital Medical University School of Rehabilitation, Beijing 100068, China;
    3. Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing 100068, China

Received date: 2019-05-20

  Revised date: 2019-07-04

  Online published: 2019-07-23

Supported by

Supported by “Twelfth Five-Year” National Plan for Science & Technology Support Program of China (No. 2011BAI08B11)

摘要

目的 运用ICF核心分类组合脑卒中(综合版)评价脑卒中康复患者的功能、结构、活动和参与、环境因素,并探讨其相互关系。 方法 2012年7月至2014年6月,来自全国57个医疗中心的首发脑卒中住院患者2822例,采用ICF核心分类组合脑卒中(综合版)进行评定。对各类目以及不同类目之间的关系进行分析。 结果 步态、肌肉力量、随意运动控制、驾驶、做家务、就业是患者困难较大的前几位类目;环境因素中,建筑物相关的用品和技术、个人室内外移动和运输用的用品和技术、劳动和就业的服务、体制和政策等是影响患者的前几位障碍因素。功能与活动和参与正相关(r = 0.712, r = 0.694, P < 0.001);活动和参与的活动表现与能力表现高度正相关(r = 0.877, P < 0.001);环境因素中的障碍因素与活动和参与的活动表现正相关(r = 0.308, P < 0.001)。 结论 ICF核心分类组合脑卒中(综合版)可以作为一个新的康复评价体系应用于脑卒中患者,有助于开展更实用、更有效的康复。

本文引用格式

刘丽旭, 张通, 何静杰 . 运用ICF核心分类组合脑卒中(综合版)评价脑卒中患者功能状况的多中心研究[J]. 中国康复理论与实践, 2019 , 25(7) : 816 -821 . DOI: 10.3969/j.issn.1006-9771.2019.07.015

Abstract

Objective To evaluate the body function, structure, activities and participation, and environmental factors of stroke patients using the Comprehensive ICF Core Set for Stroke, and explore the correlation among them. Methods From July, 2012 to June, 2014, 2822 stroke inpatients from 57 health service centres were assessed with Comprehensive ICF Core Set for Stroke. The ICF categories and the relationship among them were analyzed. Results The most serious barriers for the stroke patients involved in gait pattern, muscle power, control of voluntary movement, driving, doing housework, and remunerative employment in the domains of body functions and activities and participation; and products and technology of design, building and construction of buildings, products and technology for personal indoor and outdoor mobility and transportation, labor and employment services and policies in the domains of environmental factors. There was positive correlation between the categories of body functions and activities and participation (r = 0.712, r = 0.694, P < 0.001), activities and participation-performance and activities and participation-capacity (r = 0.877, P < 0.001), and environmental factors-barrier and activities and participation-performance (r = 0.308, P < 0.001). Conclusion Comprehensive ICF Core Set for Stroke may be used as a standard tool for evaluation for stroke patients, which benefit for rehabilitation practice.

参考文献

1 WinsteinC J, SteinJ, ArenaR, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association [J]. Stroke, 2016, 7(6): e98-e169.
2 中华医学会神经病学分会神经康复学组,中华医学会神经病学分会脑血管病学组,卫生部脑卒中筛查与防治工程委员会办公室. 中国脑卒中康复治疗指南(2011完全版)[J]. 中国康复理论与实践, 2012, 18(4): 301-318.
3 中华医学会神经病学分会,中华医学会神经病学分会神经康复学组,中华医学会神经病学分会脑血管病学组. 中国脑卒中早期康复治疗指南[J]. 中华神经科杂志, 2017, 50(6): 405-412.
4 PowersW J, RabinsteinA A, AckersonT, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association [J]. Stroke, 2018, 49(3): e46-e110.
5 世界卫生组织. 国际功能、残疾和健康分类(国际中文增补版)[M]. 邱卓英,译. 日内瓦:世界卫生组织, 2015.
6 TempestS, JeffersonR. Engaging with clinicians to implement and evaluate the ICF in neurorehabilitation practice [J]. NeuroRehabilitation, 2015, 36(1): 11-15.
7 KinoshitaS, AboM, MiyamuraK, et al. Validation of the "Activity and participation" component of ICF Core Sets for stroke patients in Japanese rehabilitation wards [J]. J Rehabil Med, 2016, 48(9): 764-768.
8 WongA W K, LauS C L, FongM W M, et al. Conceptual underpinnings of the Quality of Life in Neurological Disorders (Neuro-QoL): Comparisons of Core Sets for Stroke, Multiple Sclerosis, Spinal Cord Injury, and Traumatic Brain Injury [J]. Arch Phys Med Rehabil, 2018, 99(9): 1763-1775.
9 PaanalahtiM, BerzinaG, ?Lundgren-Nilsson, et al. Examination of the relevance of the ICF cores set for stroke by comparing with the Stroke Impact Scale [J]. Disabil Rehabil, 2019, 41(5): 508-513.
10 ZhangT, LiuL, XieR, et al. Value of using the International Classification of Functioning, Disability, and Health for stroke rehabilitation assessment: a multicenter clinical study [J]. Medicine (Baltimore), 2018, 97(42): e12802-e12808.
11 GeyhS, CiezaA, SchoutenJ, et al. ICF Core Sets for stroke [J]. J Rehabil Med, 2004, 44(Suppl): 135-141.
12 GeyhS, CiezaA, SchoutenJ, et al. 针对脑卒中的ICF核心分类模板[J]. 张君梅,蔡飞鸣,王朴,等,译. 中国康复理论与实践, 2008, 14(12): 1124-1127.
13 BeninatoM, ParikhV, PlummerL. Use of the International Classification of Functioning, Disability and Health as a framework for analyzing the Stroke Impact Scale-16 relative to falls [J]. Physiother Theory Pract, 2014, 30(3): 149-156.
14 Bunketorp-K?llL, ReinholdtC, FridénJ, et al. Essential gains and health after upper-limb tetraplegia surgery identified by the International Classification of Functioning, Disability and Health (ICF) [J]. Spinal Cord, 2017, 55(9): 857-863.
15 LiaoH F, HwangA W, SchiaritiV, et al. Validating the ICF core set for cerebral palsy using a national disability sample in Taiwan [J]. Disabil Rehabil, 2018, 18(11): 1-9.
16 SobergH L, EngebretsenK B, JuelN G, et al. Associations between shoulder pain and functioning on the ICF checklist and the disabilities of the arm, shoulder, and hand scale-a cross-sectional study [J]. Disabil Rehabil, 2019, 23(3): 1-8.
17 HeinemannA W, MagasiS, HammelJ, et al. Environmental factors item development for persons with stroke, traumatic brain injury, and spinal cord injury [J]. Arch Phys Med Rehabil, 2015, 96(4): 589-595.
18 ChangK H, LinY N, LiaoH F, et al. Environmental effects on WHODAS 2.0 among patients with stroke with a focus on ICF category e120 [J]. Qual Life Res, 2014, 23(6): 1823-1831.
19 张静,邱卓英. 脑卒中ICF核心分类量表综合版的效标关联效度研究[J]. 中国康复理论与实践, 2013, 19(1):4-7.
20 SaltychevM, Tarvonen-Schr?derS, B?rlundE, et al. Differences between rehabilitation team, rehabilitants, and significant others in opinions on functioning of subacute stroke survivors: Turku ICF study [J]. Int J Rehabil Res, 2014, 37(3): 229-235.
21 HanK Y, KimH J, BangH J. Feasibility of applying the extended ICF Core Set for Stroke to clinical settings in rehabilitation: a preliminary study [J]. Ann Rehabil Med, 2015, 39(1): 56-65.
22 KinoshitaS, AboM, OkamotoT, et al. Responsiveness of the functioning and disability parts of the International Classification of Functioning, Disability, and Health core sets in postacute stroke patients [J]. Int J Rehabil Res, 2017, 40(3): 246-253.
23 郝又国,陆伟伟,施海燕,等. 中国版脑卒中简明ICF核心要素量表在康复中的应用[J]. 中国康复理论与实践, 2014, 20(3): 279-281.
24 邱卓英,陈迪,李沁燚,等. 运用ICF脑卒中核心分类量表(综合版)对脑卒中患者康复效果和成本效益分析[J]. 中国康复理论与实践, 2014, 20(1): 15-19.
25 StuckiG, ZampoliniM, JuoceviciusA, et al. Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in physical and rehabilitation medicine [J]. Eur J Phys Rehabil Med, 2017, 53(2):299-307.
26 MaddenR H, BundyA. The ICF has made a difference to functioning and disability measurement and statistics [J]. Disabil Rehabil, 2019, 41(12): 1450-1462.
文章导航

/