P-2-01-13
CLASSIFICATION OF ACCIDENTAL FALLS IN THE STROKE PATIENTS:
A Practical Use of International Classification of Disease Codes.
Hiromasa Suzuki, Fumio Eto, Teruhito Furuichi, Kenichiro Shibuya, Genichiro lna, Ikuko Saotome (Department of Rehabilitation Medicine, Dokkyo University School of Medicine, Tochigi, Japan)
Objective: To investigate the utility of falls classification codes in the 10th International Classification of Disease (ICD-10). Method and subjects: Description of accidental falls according to the ICD-10 was encouraged to every medical staffs of the rehabilitation ward of the Dokkyo University Hospital for more than three months before the census day. Episodes of accidental falls were examined in 22 post-stroke patients stayed there on the 16th of December, 1996.
Results: 28 accidents were experienced by 11 patients after the admission. Those were classified into only three codes: 12 cases with the code W051.4, 11 with W061.4 and 6 with W181.4. Among them only three complications were required medical or surgical treatment. Most of accidents would have been overlooked and not recorded under ordinary description circumstances. The last figure of code was additional to describe the activity of engaging in. All of them were code 4, where most of fallers were going to transfer between the bed and the wheelchair. However their situations were varied in intending further activities such as going back to the bed, going to a exercise place, a toilet and a meeting.
Conclusions: At present the activity code is described supplementarily. Further detailed classification system on activity of faller at the accident should be developed to improve the accidental injury management and prevention.
P-2-01-14
GAIT OF HEMIPLEGIC INPATIENTS AND PEDESTRIAN REFUSAL DISTANCE
Kimiaki Ikegawa (Asakura Hp.,Kohchi,Japan) Akihiro Kawamura (Kubokawa Hp., Kohchi, Japan) Etsusi Okumura (Kohchi Gakuen Jun. College and Rehabilitation Institute, Kohchi, Japan)
Abstract:
Purpose: The study was investigated in order to detect factors of pedestrian refusal distance (PRD)on hemiplegic inpatient who could go on foot with cane and free hand.
Material: The material was 20 cases and average of 78.0±7.4 years old who were above in rank of Stroke Impairment Assessment Set (SIAS) 61.1±9.0.The criterion variable of multiple regression analysis utilized actual PRD (aPRD) and explanatory variable made use of age, maximum PRD (mPRD), Satisfaction with Daily Life(SDL), SIAS, Quality of Life(QOL), Cornell Medical Index (CMI), Manifest Anxiety Scale(MAS) and gait-speed. And the discriminant analysis was statistically dealt with criterion variable of the group which walked well outdoor or well indoor.
Result and Conclusion: Most of hemiplegic inpatient has preferred beauty alley way of soil and they have acquired the longest distance of PRD. The regression equation was showed, aPRD=O.13mPRD -1.24MAS +19.56CMI -1.58age +226.79. And PRD come under the influence of QOL, SDL, gait-speed as for discriminant analysis. Therefore, taking away their anxieties, taking much more outdoor gait-training, uplifting and encouragement are very significant countermeasure in the rehabilitation.
