Yuji Osada, RPT, MS, Masashi Simabukuro, RPT, Yoshinori Iwasaki, RPT, Kaori Kaneko, OTR, Masako Fuchi, OTR, MS, Setsuro Ibayashi, MD, PhD
Jpn J Compr Rehabil Sci 6: 143-150, 2015
Objective: This study aimed to identify subjective
and objective assessment items to rate independent
ambulation in hemiplegic patients, and to develop an
effective independent ambulation rating chart.
Methods: Logistic regression analyses were conducted
on subjective assessment items extracted from a
questionnaire survey of 25 physical therapists and on
objective assessment items using the Fugl-Meyer
Assessment (FMA) to identify factors that influence
independent ambulation in hemiplegic patients. The
factors identified were used to construct an independent
ambulation rating chart. Forty-five hemiplegic patients
were assessed using the chart, and the concordance with
the actual independence status was analyzed.
Results: Unsteadiness, distribution of attention,
associated reaction, and balance subscale of FMA
were identified as factors influencing independent
ambulation. The results obtained from the rating chart
constructed using the above factors showed high
concordance with the actual independence status.
Conclusion: We developed a rating chart from
analyzing independent ambulation factors. Since the
rating chart assesses higher level brain functions and
clinical context including self-management, good
concordance with the actual independence status
was obtained. The chart is useful for the rating of
independence.
Key words: hemiplegic patients, gait, independent ambulation rating, kaifukuki rehabilitation ward