Fugl-Meyer运动功能评分的敏感性及实用性

The Practicality and Sensitivity in Fugl-Meyer Motor Function Assessment

目的本文旨在通过对偏瘫患者康复前后运动能力与 Fugl- Meyer运动积分 (FMA)相关性研究判断其对治疗效果评定的敏感性及实用价值。方法选择住院的偏瘫患者 2 1例 ,于入院前后分别进行 FMA下肢运动积分、实际运动能力 Rivermead运动指数 (RMI)和功能独立性评定 (FIM,选用转移与行进积分 )。康复方法以下肢物理治疗、步行和日常生活活动训练为中心。统计采用配对 t检验与相关分析。结果住院治疗前后比较 FMA,P>0 .0 5 ;RMI与 FIM,均 P<0 .0 5。三者治疗前后均存在显著相关关系 (P <0 .0 0 1)。治疗前后差值相关性分别为 FMA -RMIr=0 .48(P<0 .0 5 ) ;FMA - FIM r=0 .0 8(P>0 .0 5 ) ;RMI- FIM r=0 .5 8(P<0 .0 1)。结论 FMA可反映下肢运动能力 ,但对治疗前后评定敏感性差 ,与 RMI和 FIM比较不能直观反映患者实际移动能力 ,其实用性较低。

Objective To study the relationship between the motor ability before and after hemiplegic rehabilitation and Fugl Meyer motor function assessment (FMZ) and to evaluate the practicality and sensitivity of FMA in the patients with hemiplegia. Methods Twenty one in patients with heimplegia were selected and accepted FMA (lower limbers), Rivermead motor index (RMI) and functional independence measure (FIM, transfer and mobility) before and after admission. The rehabilitation was emphasized on physical therapy in lower extremities, gait training and daily living activities. Pair test and correlation analysis was used in statistics (significance level: P <0 05). Results There was significant difference in RMI and FIM before and after treatment (P <0 05) except Fma ( P >0.05). There was significant correlation ( P <0 001) among FMA, RMI and FIM before and after treatment. The different correlation before and after treatment was FMA RMI r =0 48 ( P <0 05), FMA FIM r =0 08 ( P >0 05) and RMI FIM r =0 58 ( P <0 01), respectively. Conclusion FMA could reflect the ability of lower extremities, but the sensitivity was lower. Meanwhile, the practicality was poor as compared with BMI and FIM in mobility for the patients with hemiplegia.