목적 : 본 연구에서 뇌졸중 환자의 체간 조절(PASS, TCT)과 균형(BBS, FM-B) 및 일상생활동작(MBI)과의 관련성과 각 변수들과의 영향력을 알아보고자 하였다. 연구방법 : 본 연구는 뇌졸중으로 인한 편마비 진단을 받은 환자 43명을 대상으로 체간 조절 평가(Postural Assessment Scale for Stroke : PASS, Trunk Control Test : TCT), 균형 평가(Berg Balance Test : BBS, Fugl-Meyer Assessment - Balance : FM-B), 일상생활동작 평가(Modified Barthel Index : MBI)등을 이용하였고, 자료 분석은 피어슨 상관 분석(pearson correlation coefficient)과 단계적 다중 회귀분석(stepwise multiple regression)을 이용하였다. 결과 : PASS 자세 유지, 자세 변환, 총합은 TCT와 r=.78～.96(p<.01)으로 체간 조절 평가 도구간에 매우 유의한 상관관계가 있는 것으로 나타났다. PASS, TCT는 BBS, FM-B(r=.65～.82), MBI(r=.75～.79)에서 유의한 상관관계가 있었으며(p<.01), BBS, FM-B는 MBI(r=.77～.78)와 유의한 상관관계가 있었다(p<.01). FM-B와 BBS는 r=.84(p<.01)로 유의한 상관관계가 있는 것으로 나타났다. MBI의 보행 항목이 PASS 자세유지, 자세변환, 총합, FM-B(p<.001), TCT, BBS에 가장 영향력을 주는 것으로 나타났으며(p<.01), PASS의 지지없이 서기 항목이 MBI, FM-B, TCT, BBS에 가장 영향력을 주는 것으로 나타났다(p<.001). PASS 총합은 MBI에 가장 영향력을 주는 것으로 나타났다(p<.01). PASS 세부 항목 중 개인 위생, 목욕하기, 화장실 사용, 계단 오르기, 보행, 의자․침상 이동은 지지 없이 서기가 가장 영향을 주는 것으로 나타났으며(p<.001), 식사하기는 누운자세에서 테이블 가장자리에 앉기(p<.001), 옷입기는 환측으로 돌아눕기(p<.01)가 가장 영향력을 주는 것으로 나타났다. 결론 : PASS, TCT, BBS, FM-B, MBI간에 유의한 관련성을 보였으며 변수들과의 인과관계 분석을 통하여 예측 가능한 변수들을 제시 하였다. 또한 환자의 기능적 회복과 재활 치료 후 결과를 예측하거나 영향을 줄 수 있는 변수를 찾아내어 그에 대한 집중적인 치료의 병행이 환자의 성공적인 재활 치료를 위한 전략이 될 수 있을 것이다. 추후 임상적인 평가도구로서 적극적인 활용과 그 유용성에 대한 연구가 필요하다.

The purpose of this preliminary study was to develop a measurement for assessing risk factors for falling in community-dwelling elderly persons. Rasch analysis and principal component analysis were performed to examine whether items on the Activities-Specific Balance Confidence (ABC), assessing self-efficacy, and items on the Berg Balance Scale (BBS), assessing balance function, contribute jointly to a unidimensional construct in the elderly. A total of 35 elderly persons (4 men, 31 women) participated. In this study, each item of ABC (16 items) and BBS (14 items) was scored on a 5-point ordinal rating scale from 0 to 4. The initial Rasch and principal component analysis indicated that 3 of the ABC items and 2 of the BBS items were misfit for this study. These 5 items were excluded from further study. After combining ABC and BBS, Rasch and principal component analyses were examined and finally 23 items selected; 12 items from ABC, 11 items from BBS. The 23 combined ABC-BBC items were arranged in order of difficulty. The hardest item was 'walk outside on icy sidewalks' and the easiest item was 'pivot transfer'. Although structural calibration of each 5 rating scale categories was not ordered, the other three essential criteria of Linacre's optimal rating scale were satisfied. Overall, the ABC-BBS showed sound item psychometric properties. Each of the 5 rating scale categories appeared to distinctly identify subjects at different ability levels. The findings of this study support that the new ABC-BBS scale measure balance function and self-efficacy. It will be a clinically useful assessment of risk factors for falling in the elderly. However, the number of subjects was too small to generalize our results. Further study is needed to develop a new assessment considering more risk factors of falling in elderly.

The purposes of this study were to determine correlations between the Berg Balance Test (BBS), Timed -UP & Go Test, Fugl Meyer-L/E, Balance, Sensory (FM-L/E, B, S), Motor Assessment Scale-Gait (MAS-G), Comfortable maximal Gait Speed (C MGS), and the Modified Barthel Index (MBI). The subjects were 40 stroke patients of the Korea National Rehabilitation Center in Seoul. Main outcome measures were Balance control (BBS, FM-B), Gait (TUG, C MGS, MAS-G), ADL (MBI) and Motor Function of Lower Extremities (FM-L/E, S). The data were analyzed using Pearson product correlation. FM scales between other clinical and instrumental indexes and multiple stepwise regression analyses were performed to identify prognostic factors for Balance, Gait and ADL Motor Function of Lower Extremity inclinations. The results of this study were as follows: The BBS, FM-L/E, balance, sensory and MBI showed positive correlation relations, but TUG and C MGS showed negative correlations. The sensory factor of the FM-scale showed the strongest variance in predicting BBS. However the FM-balance showed the strongest variance in predicting TUG, MAS-G and C MGS. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general clinical performance of the patients.