15．地域理学療法 診療ガイドライン

1 15 1 1083 2 1084 3 1085 4 1104 5 1128 1129 1135 1083 1 Community Based Rehabilitation.

2 CBR WHO 1084 2 1 1) Physical activity in the prevention, treatment and rehabilitation of diseases.

3 : +AND+activity 2) Evidence-based practice guideline. Exercise promotion: walking in elders.: +AND+elders 2 1) PubMED 2) PEDro 3) The Cochran Library 4) 5) 1085 3 1 actibities daily living: ADL 1 bedside mobility scale BMS B 163 ICC ICC Barthel index BI r rs 1) 49 49 BI BMS Zarit 2) 78 78 Zarit < 10 10 BI BMS p p 3) BMS 2 Barthel index BI A 1 20 stroke rehabilitation assessment of movement BI 4)

4 95 BI minimum data set-home care MDS-HC R square p < 5) BI 75 126 BI 85 20 15 75 BI 6) 3 Katz index A Katz ADL index 4 instrumental actibities of daily living: IADL 659 coefficient of reproducibility coefficient of scalability 7) 177 1086 2 3 2 Katz ADL index 8) Katz ADL index 134 9) 81 10) 4 functional independence measure FIM A 80 49 80 104 ICC ICC 11)

5 FIM 5 28 intraclass correlation coefficient ICC 95 CI: 95 CI: 12) FIM 52 52 13) 22 14) 5 Nottingham extended activities of daily living scale NEADLS A 67 60 Cronbach's ICC Barthel index r p < 15) 153 2 4 Guttman coefficient of reproducibility > coefficient of scalability > Barthel index rs 16) 303 3 Guttman 17)

6 NEADLS BI EuroQol carer strain index 18) 6 older americans resources and services scale-instrumental activities of daily living OARS-IADL B 1087 72 OARS-IADL Cronbach's Katz ADL physical performance test PPT SF-36 19) 872 OARS-IADL 20) OARS-IADL 114 4 21) 194 1 22) 7 minimum data set MDS B MDS 23) 47 MDS 1427 sensitivity specificity 24) MDS home care MDS-HC 6 925 1 MDS-HC 1 734 13 2 MDS-HC 25) 8 A 65 6,776 3,636 26)

7 6,776 27) 28) IADL timed up & go test TUG 12 life-space assessment LSA 56 29) 1088 1) Bedside Mobility Scale 35 81-88 2008 2) 45 59-67 2008 3) Makizako H, Abe T, Shimada H, et al.: Combined effect of factors associated with burdens on primary caregiver. Geriatr Gerontol Int 9: 183-189, 2009.

8 4) Lin JH, Hsieh CL, Lo SK, et al.: Preliminary study of the effect of low-intensity home-based physical therapy in chronic stroke patients. Kaohsiung J Med Sci 20: 18-23, 2004. 5) Landi F, Tua E, Onder G, et al: Minimum data set for home care: a valid instrument to assess frail older people living in the community. Med Care 38: 1184-1190, 2000. 6) Sinoff G, Ore L: The Barthel activities of daily living index: self-reporting versus actual performance in the old-old ( > or = 75 years). J Am Geriatr Soc 45: 832-826, 1997. 7) Sonn U, Asberg KH: Assessment of activities of daily living in the elderly. A study of a population of 76-year-olds in Gothenburg, Sweden.

9 Scand J Rehabil Med 23: 193-202, 1991. 8) Pitkala K: The effectiveness of day hospital care on home care patients. J Am Geriatr Soc 46: 1086-1090, 1998. 9) Rolland Y, Pillard F, Klapouszczak A, et al.: Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial. J Am Geriatr Soc 55: 158-165, 2007. 10) Holmqvist LW, Koch L, Kostulas V, et al.: A randomized controlled trial of rehabilitation at home after stroke in southwest stockholm. Stroke 29: 591-597, 1998. 11) Pollak N, Rheault W, Stoecker JL: Reliability ans validity of the FIM for persons aged 80 years and above from a multilevel continuing care retirement community.

10 Arch Phys Med Rehabil 77: 1056-1061, 1996. 12) Young Y, Fan MY, Hebel JR, et al.: Concurrent validity of administering the functional independence measure (FIM) instrument by interview. Am J Phys Med Rehabil 88: 766-770, 2009. 13) Mann WC, Ottenbacher KJ, Fraas L, et al.: Effectiveness of assistive technology and environmental interventions in maintaining independence and reducing home 1089 care costs for the frail elderly. A randomized controlled Fam Med 8: 210-217, 1999. 14) Sato D, Kaneda K, Wakabayashi H, et al.: Comparison two-year effects of once-weekly and twice-weekly water exercise on health-related quality of life of community-dwelling frail elderly people at a day-service facility.