ランダム化比較試験によるデュシェンヌ型筋ジストロフィー患者の作業療法効果 The occupational therapy effect for Duchenne Muscular Dystrophy patients by the randomized clinical trial

長期臥床状態へ移行する過程にあるデュシェンヌ型筋ジストロフィー患者に対しランダム化比較試験を行い,ニーズに基づくOTを実施し,介入群と経過観察対照群のQOLの変化を比較した。評価は,SEIQoL-DW及びMDQoL-60を用いて,3ヶ月間にわたるOT介入前後の変化を測定した。その結果,介入群では,心理的安定,環境,人間関係の項目でQOLの向上が認められた。対照群では,心理的安定,環境,希望,活動の項目で有意に低下が認められた。変化量を比較した結果,心理的安定,ADL環境,希望,活動,人間関係,性の項目で介入群の方が高かった。よって,DMD患者に対するニーズに基づくOTはQOLの向上に繋がる有効な援助の1つであり,効果があることが示唆された。

For the Duchenne Muscular Dystrophy (DMD) patients in the process that shifted from in a wheelchair-ridden to bed-ridden, I performed a random ed clinical trail and carried out occupational therapy and compared the change of the QOL of intervented group and the follow-up control group. The participants in the sutudy were made of 20 people in an intervention group and 20 in an control group. There are stages were VII and VIII in Functional Classification. We examined the change at the begining and three months later by using the Schedule of Individual Quality of life-Direct Weighting (SEIQoL-DW) and the MDQoL-60. As a result, the scores of SEIQoL-index and in MDQoL-60 items of psychological stability, environment and the human relations increased in the interventioned group. The scores of SEIQoL-index and in MDQoL-60 items of psychological stability, environment, hope and activity declined in the control group. As a result of having compared the amount of change between two groups,the score's of SEIQoL-index and in MDQoL-60 items of psychological stability, ADL, environment, hope, activity, human relations and nature in the intervention group surpassed those scores in the control group. Therefore, it was suggested that the occupational therapy based on the needs of the DMD patients is one of the effective support to lead to QOL and it effects on them.