中風患者功能性平衡量表之因素分析

Functional Balance Measures in Stroke Patients

平衡能力的評估與訓練是中風病患復健治療的重要課題。然而，「平衡」的定義，以及平衡的測量應包含哪些向度，迄成仍未有定論。本研究的目的在探討三種常用之功能性平衡量表所有項目的因素組成，包含Fugl-Meyer Motor Assessment中的Balance Subscale、Performance-Oriented Mobility Assessment 其中的Balance portion 及Berg Balance Scale，並籍以了解中風病人平衡量表之組成架構。研究對象為自民國86年7月至87年7月間所有轉介至台大醫院及新光醫院復健科的第一次中風病患，符合條件者共120位。資料分析利用因素分析法之最大變異轉軸法(varimax rotation)，來檢測三項功能性平衡量表中21項測驗之共同因素。研究結果發現所有項目的共同性高，均測量了中風患者之平衡功能，且其中包含了三個因素。因素一與不改變腳底面積之站姿平衡項目相關；因素二與需改變腳底面積之站姿平衡項目相關；因素三主要與坐姿平衡項目相關。因此，本研究驗證了功能性平衡量表測量了中風病患平衡能力的三個不同向度，也說明了中風患者的平衡功能屬於多向度(multiple dimensions)組成，平衡能力的測量應包含至少上述三個向度，此結果可以作為臨床評估及治療平衡能力的參考。

Patients with hemiplegia following a stroke exhibit a variety of balance deficits. Balance assessment and training are curcial elements of stroke rehabilitation programs. However,the definition of balance and what dimensions should be included to measure balance remain controversial. The purpose of this study was to investigate the constructs of three commonly used functional balance measures: the Balance Subscale of the Fugl-Meyer Motor Assessment, the Performance-Oriented Mobility Assessment, and the Berg Balance Scale. One hundred and twenty consecutive patients from two hospitals, who had suffered their first stroke within the preceding three months, participated in this study. The results of factor analysis indicated that all items measured a common underlying construct – balance, which comprised three major factors: 1) postural adjustment without altering the base of support by moving either foot; 2) postural adjustment with altering the base of support by moving either foot, and 3) sitting balance. The results suggest that functional balance measures might assess three different dimensions 'of balance in stroke patients, and that balance measurement and training should incorporate different dimensions.