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Spinal Cord Independence MeasureⅡ와 Modified Barthel Index를 이용한 척수 손상 환자의 기능 평가 비교 KCI 등재

The Comparison of Functional Assessment for Spinal Cord LesionThrough the Spinal Cord Independence MeasureⅡ and the ModifiedBarthel Index

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대한작업치료학회지 (Korean Journal of Occupational Therapy)
대한작업치료학회 (Korean Society Of Occupational Therapy)
초록

Objective : The purpose of the present study was to compare the Spinal Cord Independence MeasureⅡ (SCIMⅡ) and the Modified Barthel Index (MBI) to determine the evaluation tool in order to use the tool as an effective index for following these patients for functional changes and determining treatment and rehabilitation outcomes.Method : The present study was conducted with 20 patients who underwent there first time rehabilitation care at A hospital from December 2002 to April 2003. The patients were evaluated at a 2-week interval using the SCIMⅡ and the MBI.Collected data analysis were completed by using Total agreement and Kappa coefficient of agreement, McNemar test, t-test, Correlation analysis, and Wilcoxon rank sum test.
Results : The following results were obtained from this study.1.A high correlation was seen in the results of evaluation made by two raters in the SCIMⅡ, showing high interrater reliability(r=0.99, p<0.01).2.When functional changes were compared, more changes in the common items including management in bladder sphincter muscle(p<0.01), toileting(p<0.05), and bathing(p<0.05) were seen in the SCIMⅡ compared with the MBI. Furthermore, among the non-common items in the SCIMⅡ, significant changes were estimated in breathing, prevention of bed sores and bed mobility, and outdoor movement, the SCIMⅡ well reflecting major func-tional changes in patients with spinal cord lesion.3.When the scores of the SCIMⅡ and the MBI were compared at the time of admission and discharge, significant correlation was revealed between the two evaluation tools. However, the SCIMⅡ admission scores were significantly higher than the MBI admission scores in patients with quadriplegia (p<0.05), due to the effects of non-common items such as breathing, prevention of bed sores, and bed mobility.4.When these tools were compared according to muscle strength change, the SCIMⅡ com-pared with the MBI well reflected upper extremity motor score and the ASIA motor score in patients with complete and incomplete quadriplegia(p<0.05), and lower extremity motor score in patients with incomplete spinal cord lesion(p<0.05).Conclusions : These results indicated that the SCIMⅡ is more sensitive compared with the MBI as a tool for functional evaluation in patients with spinal cord lesion, suggesting that the SCIMⅡ would be used to examine functional changes in patients with spinal cord lesion and to effectively follow-up patients for rehabilitation treatment outcome.

목차
Abstract
 Ⅰ. 서 론
 Ⅱ. 연구 방법
  1. 연구 대상
  2. 평가 도구
  3. 연구 절차
  4. 분석 방법
 Ⅲ. 연구 결과
  1. 환자의 일반적 특성
  2. SCIM Ⅱ의 검사자간 신뢰도
  3. 기능 변화 측정률
  4. 입퇴원시 SCIMⅡ와 MBI의 점수 비교
  5. 근력변화에 따른 SCIMⅡ와, MBI의 점수변화 비교
 Ⅳ. 고 찰
 Ⅴ. 결 론
 참 고 문 헌
 부 록
저자
  • 송영진 | Song Young-Jin
  • 박창일 | Park Chang-Ill
  • 신지철 | Shin Ji-Choel
  • 배하석 | 배하석