探討腦中風病人軀幹損傷與疾病嚴重度對其生活品質的影響

背景：腦中風為國人主要死亡與失能原因之一，除神經功能缺損外，軀幹控制能力受損亦常影響病人姿勢穩定、日常活動與生活品質。軀幹穩定被視為功能恢復與復健成效的重要基礎，然而國內針對腦中風病人之疾病嚴重度、軀幹功能與生活品質三者關聯性之實證研究仍相對有限，臨床照護決策缺乏具體量化依據。目的：探討腦中風病人之疾病嚴重度、軀幹功能與生活品質之相關性，並進一步檢驗疾病嚴重度與軀幹功能對生活品質之預測效力。研究方法：本研究採用描述性、預測性之橫斷式研究設計，於中部某醫學中心神經內科病房進行方便取樣，納入處於急性期（發病後兩週內）且可配合評估之腦中風住院病人，共45人，研究工具包括美國國家衛生研究院腦中風評量表（National Institutes of Health Stroke Scale, NIHSS）、軀幹損傷量表（Trunk Impairment Scale, TIS）及簡短版腦中風衝擊量表（Stroke Impact Scale-16, SIS-16），資料以 IBM® SPSS® 22 版進行分析，採用描述性統計、皮爾森相關分析與多元線性迴歸分析（強迫進入法，Enter method）檢驗變項間之關係與預測效力。研究結果：研究結果顯示，疾病嚴重度（NIHSS）與軀幹功能（TIS）呈顯著負相關（r = -.56，p < .001），與生活品質（SIS-16）亦呈顯著負相關（r = -.56，p < .001），而軀幹功能與生活品質呈高度正相關（r = .92，p < .001）。進一步分析 SIS-16 三個面向結果顯示，軀幹功能與日常生活活動、移動能力及手部功能皆呈顯著正相關，多元線性迴歸分析顯示，在同時納入疾病嚴重度與軀幹功能後，軀幹功能為生活品質之顯著正向預測因子（β = 0.883，p < .001），而疾病嚴重度未達統計顯著，整體模型可解釋約 84.1% 的生活品質變異量（R² = .841）。結論：腦中風病人之軀幹功能與生活品質具有高度關聯，且在控制疾病嚴重度後，軀幹功能仍為生活品質之主要預測因子，結果顯示，早期評估與介入軀幹控制能力，對於提升腦中風病人功能表現與生活品質具有重要臨床意義。

Background: Stroke is a leading cause of mortality and disability. In addition to neurological deficits, impaired trunk control often affects postural stability, activities of daily living, and the quality of life. Trunk stability is a fundamental component of functional recovery and rehabilitation outcomes. However, empirical evidence examining the relationships between disease severity, trunk function, and quality of life in patients with stroke remains limited in the domestic literature, resulting in a lack of quantitative evidence to inform clinical care decision-making.Objective: This study aimed to examine the relationships among disease severity, trunk function, and quality of life in patients with stroke and to investigate the predictive effects of disease severity and trunk function on quality of life.Methods: A descriptive, predictive, cross-sectional study design was used. Convenience sampling was conducted in the neurology wards of a medical center in central Taiwan. A total of 45 hospitalized patients with acute stroke (within 2 weeks of stroke onset) who were able to participate in the assessments were recruited. The research instruments included the National Institutes of Health Stroke Scale (NIHSS), Trunk Impairment Scale (TIS), and Stroke Impact Scale-16 (SIS-16). Data were analyzed using IBM SPSS version 22. Descriptive statistics, Pearson’s correlation analysis, and multiple linear regression analysis (Enter method) were performed to examine the relationships among the variables and their predictive effects.Results: Disease severity (NIHSS) was significantly negatively correlated with trunk function (TIS) (r = −.56, p < .001) and quality of life (SIS-16) (r = −.56, p < .001), whereas trunk function was highly positively correlated with quality of life (r = .92, p < .001). Further analysis of the three SIS-16 domains indicated that trunk function was significantly and positively correlated with activities of daily living, mobility, and hand function. Multiple linear regression analysis demonstrated that, after simultaneously entering disease severity and trunk function into the model, trunk function remained a significant positive predictor of quality of life (β = 0.883, p < .001), whereas disease severity was no longer statistically significant. The overall model explained approximately 84.1% of the variance in quality of life (R² = .841).Conclusion: Trunk function is highly associated with the quality of life in patients with stroke and remains the primary predictor after controlling for disease severity. These findings highlight the clinical importance of early assessment and intervention targeting trunk control to improve the functional performance and quality of life in patients with stroke.