Asian Journal of Occupational Therapy
Online ISSN : 1347-3484
Print ISSN : 1347-3476
ISSN-L : 1347-3476
19 巻, 1 号
選択された号の論文の34件中1~34を表示しています
RAPID COMMUNICATIONS
  • Yusuke Masuda, Jun Yaeda, Tamami Aida
    2023 年 19 巻 1 号 p. 1-7
    発行日: 2023年
    公開日: 2023/01/31
    ジャーナル フリー

    In recent years, the concepts of value-based practice (VBP) and shared decision-making (SDM) have become popular as methods of clinical decision-making and consensus-building. Moreover, the underlying decision-making is commonly known as evidence-based practice (EBP). EBP is the necessary knowledge and skills for clinical practice of occupational therapy, but at the same time, the difficulties of EBP have been reported.

    Purpose: The purpose of this study was to explore the structure of EBP-promoting factors, including clinical, educational, and research experiences, among occupational therapists.

    Methods: A questionnaire survey using a postal method was conducted among 30 occupational therapists working in Japanese convalescent rehabilitation wards.

    Results: Factors associated with the implementation of EBP and self-efficacy regarding EBP included the following: (1) experience of learning in graduate school, (2) experience of receiving education on research methods, (3) positive experience with research, (4) experience of working in professional teams, (5) experience as a clinical practice supervisor for students, (6) frequency of database use, (7) outcome expectancy, (8) work environment, (9) intrinsic motivation, and (10) barriers. The number of years of clinical experience of occupational therapists was not associated with the implementation of EBP and self-efficacy regarding EBP.

    Conclusions: Research experience, working in professional teams, and being clinical practice supervisors for students and others were more important factors than years of clinical experience to promote the implementation of EBP and self-efficacy regarding EBP among occupational therapists. The structures of these factors interacted with each other.

ORIGINAL ARTICLE
  • Shan Yun, Risa Takashima, Mari Sakaue, Daisuke Sawamura, Takao Inoue, ...
    2023 年 19 巻 1 号 p. 8-15
    発行日: 2023年
    公開日: 2023/02/17
    ジャーナル フリー

    Background: Occupational dysfunction (OD) can become a major health problem for community-dwelling older adults. OD can be experienced by older adults despite the absence of an apparent medical diagnosis or disability. Therefore, OD may be a new health indicator in the field of preventive medicine.

    Objectives: This study investigated possible predictors of OD in community-dwelling older adults.

    Methods: Fifty-four participants (aged 63-94) in Japan completed a demographic questionnaire, the Classification and Assessment of Occupational Dysfunction Scale (CAOD), assessments of functional health (Five Times Sit-to-Stand Test, Timed Up & Go, Automatic Thoughts Questionnaire-Revised, and Japan Science and Technology Agency Index of Competence), and responded about their subjective health (self-rated health). Only seven participants were men; therefore, male data were excluded from the analysis. Independent t-test and analysis of multiple regression model was performed to identify the predictors of OD.

    Results: The results of the independent samples t-test shows that the OD group correlated to a significant younger age, more negative automatic thoughts, and better social engagement in older women. The results of the multiple regression analysis showed that negative automatic thoughts was a significant predictor of OD among older women.

    Conclusion: Negatively evaluating stressful events related to occupational engagement may be associated with OD. It may be useful to assess, maintain, and improve negative automatic thoughts to prevent OD. The results of this study can provide an assessment perspective and intervention strategy focusing on occupations to occupational therapists active in the field of preventive occupational therapy.

RAPID COMMUNICATIONS
  • Miho Yoshioka, Zen Kobayashi, Kaori Kato, Keisuke Inoue, Masaki Hakomo ...
    2023 年 19 巻 1 号 p. 16-21
    発行日: 2023年
    公開日: 2023/02/17
    ジャーナル フリー

    Background: The Trail Making Test (TMT) is widely used as a measure of attention and executive functions. The time needed to complete TMT (TMT score) is prolonged in the presence of attention and executive dysfunction in patients with brain diseases. Thus far, there have been few reports examining the TMT score in the early stages of mild ischemic stroke.

    Methods: We evaluated the TMT-Japanese edition (TMT-J) score 8-14 days after onset in patients with mild ischemic stroke. When the TMT-J Part A or Part B score was high, re-evaluation was performed 29-35 days after onset.

    Results: In a total of 54 patients, 1 and 4 patients could not complete TMT-J Part A and Part B, respectively. The average Part A and Part B scores were 65 and 119 seconds, respectively. Part A and Part B scores were higher than one standard deviation above the age-specific average scores in 51 and 47% of patients, respectively. In these patients, Part A and Part B scores improved in 81 and 69% of the patients on re-evaluation, respectively.

    Conclusions: This study demonstrated that a significant proportion of mild ischemic stroke patients exhibited a high TMT-J score 8-14 days after onset, and scores improved over time in the majority of patients.

ORIGINAL ARTICLE
  • Yuki Nakagawa, Kazue Noda, Hiroaki Naritomi, Hiroshi Nakata, Tomoki Ni ...
    2023 年 19 巻 1 号 p. 22-29
    発行日: 2023年
    公開日: 2023/02/23
    ジャーナル フリー

    Background: Patients in rehabilitation facility have enormously long free time and often fall asleep during daytime. Excessive daytime sleep (DS) was reported to decrease rehabilitation efficiency resulting in poor functional recovery. In general population, insomnia, obesity, depression, dementia and the use of sleeping pills are known to be important risk factors of excessive DS. However, the causes of excessive daytime sleep in patients undergoing inpatient rehabilitation have not been clearly identified. Therefore, the current preliminary study aimed to explore factors underlying excessive DS in elderly patients undergoing inpatient rehabilitation following acute stroke.

    Methods: Subjects were 17 patients without dementia with more than 65 years of age who were admitted to our rehabilitation wards following acute stroke. In all the patients, daytime and nighttime sleep states were monitored with wrist actigraphy consecutively for five days. Relationships of DS duration with insomnia, obesity, depression, apathy, hypnotic administration, motor functional ability, recreational activities and self-exercise were investigated.

    Results: All the patients had more or less DS, the duration of which widely ranged from 43 to 550 min/day with mean value 210 ± 122 min/day. This DS duration was 3 - 4 times longer than that in general elderly population. The majority of patients had sufficiently long nighttime sleep (NS). There was no correlation between DS duration and NS duration. DS duration had no relationship with obesity, depression, apathy, hypnotic administrations, or motor functional ability. DS duration was, however, significantly shorter in patients performing self-exercise (n = 10, 157 ± 82 min) than in those without self-exercise (n = 7, 285 ± 135 min) (p = 0.03). Recreational activities did not shorten DS duration.

    Conclusion: Patients in rehabilitation facility tend to have long DS because of enormously long free time and consequent idleness. Taking up the free time with self-exercise appears to be useful for preventing excessive DS.

  • Yasuhiro Higashi, Shinichi Takabatake, Asako Matsubara, Koji Nishikawa ...
    2023 年 19 巻 1 号 p. 30-37
    発行日: 2023年
    公開日: 2023/02/23
    ジャーナル フリー

    Background: The ADL-focused Occupation-based Neurobehavioral Evaluation (A-ONE) is used to evaluate both performance of ADL tasks and neurobehavioral impairments (NBIs) that interfere with ADL performance of clients with neurological disorders. Its Japanese translation is referred to as A-ONE J. This study examined the psychometric properties of the Neurobehavioral Impairment (NB) Scale of A-ONE J for persons with cerebral vascular accident (CVA).

    Methods: Rasch analysis was performed on NB scale data from 185 participants with CVA, as well as from right CVA (RCVA) and left CVA (LCVA) data separately. The values of the obtained Rasch indicators were compared with results from previous A-ONE studies.

    Results: Unidimensionality was obtained for 55 item CVA scale for the entire group as well as for 55 item RCVA scale and 53 item LCVA scale. Separation reliability for item and person calibrations was high for all three scales. Most comparisons of Rasch indicators concurrently met set criteria.

    Conclusion: The psychometric properties of the NB scale of A-ONE J were determined. The obtained unidimensionality of the NB scale items for Japanese people with CVA provides an opportunity for quantitative measurement of a wide range of NBIs interfering with their ADL performance.

  • Fumio Sakimoto, Mizuho Fujiwara
    2023 年 19 巻 1 号 p. 38-45
    発行日: 2023年
    公開日: 2023/04/05
    ジャーナル フリー

    Background: Stroke survivors face various problems after discharge from rehabilitation hospitals. This study aimed to clarify the post-discharge experiences of male stroke survivors with attention deficits, a form of higher brain dysfunction.

    Methods: The subjects of this study were three male stroke survivors who were discharged from a convalescent rehabilitation ward and their spouses. Semi-structured interviews were conducted 1, 3, and 6 months after discharge. Data were qualitatively analyzed using Trajectory Equifinality Modeling to depict the post-discharge pathways experienced by stroke survivors.

    Results: The Obligatory Passage Points of post-discharge pathways experienced by stroke survivors were as follows: feeling “difference” in daily life, becoming aware of higher brain dysfunction through interaction with others, and becoming able to “organize my thoughts” through an occupation and interacting with others. In addition, the Bifurcation Points were “increased occupation away from the wife” and “occupation with the wife continues,” and the Equifinality Point was “select occupation autonomously.”

    Conclusion: Although the stroke patients were suspected of being attention deficit during the evaluation that performed during their hospitalization, they were unaware of it during their hospitalization and immediately after discharge. However, the stroke survivors became aware of their higher brain dysfunction through interactions with others other than their wives, and their insight into their disability increased as they participated in occupations. These results suggest the importance of including occupations that challenge stroke survivors and in which others, besides the wife, participate in the occupational therapy program.

  • Takuya Noguchi, Makoto Kyougoku, Mutsumi Teraoka
    2023 年 19 巻 1 号 p. 46-54
    発行日: 2023年
    公開日: 2023/04/05
    ジャーナル フリー

    Aims: This study aimed to validate the Assessment of Positive Occupation 15 (APO-15) by differential item functioning (DIF) and differential test functioning (DTF).

    Method: Participants were to obtain research cooperation from individual clinics, community healthcare institutions, and home-visit rehabilitation services. The inclusion criteria for participants were people between the ages of 20 and 90 years who were diagnosed with mental illness, physical illness, or geriatric illness and agreed to participate in the study. In this study, the face sheet and APO-15 were distributed to the participants, and they were asked to respond.

    Results: A total of 3003 participants were included in this study. The mean age was 67.41 (±16.63) years (≥ 75; 1168 and ≤ 74; 1835). Regarding the gender of participants, 1565 were males and 1438 were females. Considering illness, 1184 participants had a mental illness, 897 had a physical illness, and 922 had a geriatric illness. The results of the DIF and DTF suggested that the APO-15 did not differ in the response pattern of the scale due to the influence of subgroups (illness, gender, and age).

    Conclusion: The APO-15 suggests the potential to provide measurement results with a good level of scale validity and robustness.

  • Akira Masuo, Takuto Sakuma, Shohei Kato
    2023 年 19 巻 1 号 p. 55-62
    発行日: 2023年
    公開日: 2023/04/05
    ジャーナル フリー

    Introduction: Maintaining means of communication is an extremely important issue in occupational therapy for patients with intractable neurological disease. A brain-computer interface (BCI) is a device control technology for utilizing physiological signals, and is eagerly awaited for application in occupational therapy as a communication aid for patients with severe motor dysfunction. As an exploratory study for the development of BCI, we examined the accuracy of discriminating brain activation state using near-infrared spectroscopy (NIRS) signals and the effects of cognitive tasks on subjective burden through case study.

    Methods: One 21-year-old male with Duchenne muscular dystrophy participated in the experiment. We measured NIRS signals with16 channels in the prefrontal cortex during three cognitive tasks: mental arithmetic (MA), figure rotation imagery (FRI), and Japanese word chain (JWC). Using support vector machine, a supervised machine learning, we constructed a classification model that discriminate type of cognitive task from features in the NIRS signals. In addition, the state-trait anxiety inventory and visual analogue scale were conducted to assess subjective burden associated with performing cognitive tasks.

    Results: The classification accuracy of the MA versus FRI tasks was 73.1% (p = .03). The subjective evaluation scores showed the JWC had the lowest burden, and the MA and FRI were also rated as low anxiety tasks.

    Conclusion: In this participant, we could identify whether the MA or FRI was being performed with 73.1% accuracy. These results suggest that brain activation state may be applicable as a means of communicating intentions.

CASE REPORTS
  • Kaori Inoue, Miyako Takada, Yuka Oyama, Kana Takahashi, Hayato Shibuma ...
    2023 年 19 巻 1 号 p. 63-67
    発行日: 2023年
    公開日: 2023/04/05
    ジャーナル フリー

    Introduction: Focal brain damage can cause difficulties in counting similar items. It has been hypothesized that this visual counting disorder (VCD) is caused by an inability to recall places seen in the immediate past. However, this has not been directly tested. There also have been no studies on the impacts of VCD on patients' daily lives.

    Methods: A 60-year-old, right-handed man visited our hospital complaining of difficulty counting multiple similar objects placed next to each other; for example, accounting errors caused by an inability to read multiple zeros in numbers in sales receipts. This patient had the problem for 25 years, since an infarction in the right temporoparietal region after a subarachnoid hemorrhage. To test the recall hypothesis, we performed a visual counting test on the patient and healthy control subjects. Circles were presented under two conditions: static (rows of circles presented vertically, centered on the screen) and dynamic (rows of circles presented by scrolling vertically). Subjects were asked to count and report numbers of circles as soon as each row appeared.

    Results: Under the static condition, the patient showed a significantly longer reaction time and more frequent gaze retentions than did the control subjects; however, no differences were observed under the dynamic condition.

    Conclusion: These findings directly support the hypothesis. Our patient's compensatory methods might be useful to other patients.

ORIGINAL ARTICLE
  • Masato Ikegami, Hitoshi Mutai, Rika Karasawa, Yoshie Yuzawa, Nobuko Sa ...
    2023 年 19 巻 1 号 p. 68-76
    発行日: 2023年
    公開日: 2023/04/05
    ジャーナル フリー

    Background and Purpose: We introduced an intervention that aimed to improve upper limb use in daily life using Aid for Decision-making in Occupation Choice for Hand (ADOC-H), a monitoring and problem-solving technique, in addition to conventional occupational therapy for hospitalized patients with acute stroke. This pilot study examined the effectiveness of this intervention to improve paralyzed upper limb use in daily life and their motor function.

    Methods: This comparative study included 28 patients with acute stroke who underwent an intervention based on the ADOC-H process (ADOC-H group) and 155 participants from a previous study (control group). The paralytic arm participation measure (PPM; scores for eating and toileting items) was used to evaluate upper limb use in daily life, and the Stroke Impairment Assessment Set (SIAS; knee mouth [K-M] and finger flexion [F-F] tests) was used to evaluate upper limb motor function. The amount of change in these evaluations was compared between the two groups.

    Results: Using propensity score matching, 21 participants were allocated to each group. Comparing the two groups, significant improvements were observed in the ADOC-H group for all items, as shown by the scores for PPM total (P = 0.005, r = 0.43), eating (P = 0.035, r = 0.32), toileting (P = 0.004, r = 0.44), upper limb motor function (P = 0.001, r = 0.52), K-M (P = 0.014, r = 0.38), and F-F (P = 0.002, r = 0.48).

    Conclusion: This intervention process may be effective for improving the frequency of paralyzed upper limb use and upper limb motor function of the paralyzed upper limbs in patients with acute stroke.

  • Yue Zhao, Kyosuke Yorozuya, Hideaki Hanaoka
    2023 年 19 巻 1 号 p. 77-86
    発行日: 2023年
    公開日: 2023/04/26
    ジャーナル フリー

    Objective: It is well known that reminiscence therapy improves mental health by encouraging the elderly to recall past life events; however, the content and how it can contribute to the intervention is still not fully understood. This study examined the relationship between reminiscence content and the quality of reminiscence and determined whether the latter was associated with depression, life satisfaction, and self-esteem.

    Methods: A total of seventy-one community-dwelling older adults participated in this study. We chose 15 topics to determine whether they could recall the reminiscence contents. Data were collected on mental health using the Japanese versions of the Geriatric Depression Scale-5, Life Satisfaction Index-Koyano Scale, and Rosenberg Self-esteem Scale. Multiple imputations were performed to compensate for missing values.

    Results: A single regression showed that 10 reminiscence content items were associated with positive reminiscence, while three predicted lower negative reminiscences. Positive reminiscence was significantly correlated with negative reminiscence (r = −0.456, p < 0.001), depression (r = −0.299, p = 0.012), life satisfaction (r = 0.315, p < 0.010), and self-esteem (r = 0.400, p < 0.001). Negative reminiscence significantly correlated with depression (r = 0.435, p < 0.001), life satisfaction (r = −0.423, p < 0.001), and self-esteem (r = −0,345, p = 0.003).

    Conclusion: Reminiscence content was associated with positive and negative recalling experiences, which are possible factors affecting mental health. Understanding the influence of reminiscence content and quality on mental health can inform strategies to improve mental health.

  • Yoshihiko Morikawa, Megumi Taniguti, Mika Yasui, Sayaka Hirabayashi, M ...
    2023 年 19 巻 1 号 p. 87-95
    発行日: 2023年
    公開日: 2023/04/26
    ジャーナル フリー

     The purpose of this study was to determine the effects of SIT on developmentally disabled children with sensory integration disorder.

     The subjects were children with developmental disabilities diagnosed as autism spectrum disorder, attention deficit hyperactivity disorder, and motor retardation. There were eight children in a SIT group, and seven children in a non-SIT group. The SIT group received individualized SIT at a hospital, and the non-SIT group received social skills training at a welfare facility. The training period for both groups was about 10 months. In a non-randomized controlled trial, the effectiveness of SIT was examined by comparing the differences in SSP, DAM, and S-JPAN scores before and after therapy. No significant differences in changes of these scores were found between the non-SIT and SIT groups before and after the intervention. However, the SIT group showed a significant difference in the subdomains of hyporesponsiveness and sensory seeking (p < .05). A marginal difference was also observed in visual and auditory hypersensitivity (p < .1). The DAM showed a marginal difference in pre- and post-intervention differences between the two groups (p < .1). The S-JPAN showed a significant difference between the two groups (p < .05). In the present study, SIT was found to improve the sensory processing function, body schemas, and some praxes of children with sensory integration disorder. In the future, we would like to consider homogenizing the target children's disorders, expanding the sample size, and conducting a randomized controlled trial.

REVIEWS
ORIGINAL ARTICLE
  • Takayuki Watabe, Hisayoshi Suzuki, Kunio Kabe, Taiki Sano, Asumi Oki, ...
    2023 年 19 巻 1 号 p. 102-107
    発行日: 2023年
    公開日: 2023/04/26
    ジャーナル フリー

    Background: We prospectively investigated the capability of the dual-task stepping test in predicting falls and the ability to perform activities of daily living in older patients receiving acute care.

    Methods: We recruited 92 participants aged ≥ 65 years who were admitted to our hospital for treatment of an acute disease from January to December 2021. They performed the dual-task stepping test, wherein they recalled their previous meal while stepping in place in the seated position for 30 s. Data regarding their falls and ability to use the toilet, change underwear, bathe, walk, and use stairs while in the hospital were recorded. We assessed the accuracy with which we could predict these measures at discharge using the dual-task stepping test results.

    Results: A significant association was noted between the dual-task stepping test results and falls (p = 0.014). The area under the curve was 0.70, sensitivity was 100%, and specificity was 38.8%. The dual-task stepping test results were associated with all activities of daily living items examined (p < 0.001), with areas under the curve of 0.92, 0.83, 0.84, 0.87, and 0.87 for the ability to use the toilet, change underwear, bathe, walk, and use stairs, respectively. Sensitivity was the highest for the ability to use the toilet at 96.2%, and specificity exceeded 90% for changing underwear, bathing, walking, and using the stairs.

    Conclusions: The dual-task stepping test is highly sensitive for predicting falls in the hospital and accurately predicts the need for assistance with activities of daily living in older patients.

  • Aki Watanabe, Takayuki Kawaguchi, Koshi Matsuoka, Harumi Kotaki, Makot ...
    2023 年 19 巻 1 号 p. 108-116
    発行日: 2023年
    公開日: 2023/06/02
    ジャーナル フリー

    Objectives: It is difficult to predict behavioral disturbances in patients with Alzheimer's dementia because the order of appearance of behaviors is not clear. This study aimed to clarify the difficulty of the Dementia Behavior Disturbance Scale (DBDS) sub-items in patients with Alzheimer's disease and to compare changes in behavioral disorders after 6 months.

    Methods: The participants were inpatients with Alzheimer-type dementia hospitalized in participating hospitals for more than a year. They were assessed with the DBDS, the Mini-Mental State Examination (MMSE), and the Functional Independence Measure (FIM) twice: at the initial assessment and after 6 months. Rasch analysis for the sub-items of the DBDS determined the difficulty of behavioral disturbances.

    Results: The participants were 44 inpatients. There was no significant difference in the DBDS, MMSE, and FIM between the initial assessment and that after 6 months. Even though many participants increased or decreased for each assessment scale, there was no major change in the order of item difficulty of DBDS between the initial assessment and after 6 months.

    Conclusions: The systematic indication of the difficulty of behavioral disturbances in the DBDS is a new finding. It is possible to rank the difficulty of sub-items of the DBDS and infer behavioral disturbances that are likely to appear in the future. This is useful for clinical decision-making in dementia rehabilitation and care because it indicates the predictability of signs of dementia and behavioral disturbances that suggest the need for dementia intervention.

  • Toshiki Takeuchi, Hidekazu Saito, Hisaaki Ota
    2023 年 19 巻 1 号 p. 117-123
    発行日: 2023年
    公開日: 2023/06/09
    ジャーナル フリー

    Introduction: Prism adaptation (PA) is a promising treatment to improve unilateral spatial neglect (USN). Egocentric neglect and allocentric neglect are the two types of USN in terms of spatial reference frames, but no study was reported the PA affects allocentric frame selectively. This study therefore aimed to investigate whether the PA effect could be observed only on allocentric frame in healthy participants.

    Method: Thirty right-handed participants (12 females and 18 males, mean age 22.6 years), wore the right wedged prismatic glasses that created an optical shift of 5.7° to the left. They were asked to reach two visual targets with the right index finger 100 times alternately. Outcomes were measured through the line bisection task where lines of two different lengths (200 mm and 50 mm) were presented one by one in front of or on the left or right side of the participants.

    Results: The subjective midpoint on the 200-mm line shifted significantly to the right after the PA, but not on the 50-mm line. Additionally, the degree of rightward deviation was not affected by the position of the presented line regardless of its length.

    Discussion: These results indicate that the PA task induced allocentric neglect-like behavior. Hence, PA affected only the allocentric frame among healthy participants. The results of this study may contribute to the evaluation and treatment of allocentric neglect.

  • Yoshiro Nakagawa, Haruka Kumoi, Hironori Sasaki, Sumie Yamada
    2023 年 19 巻 1 号 p. 124-131
    発行日: 2023年
    公開日: 2023/06/09
    ジャーナル フリー

    Background: Patients with schizophrenia have difficulty performing activities of daily living (ADLs) that require fine motor skills. This study investigated the hand instability of 24 patients with schizophrenia and 20 healthy controls during a finger opposition task.

    Methods: We evaluated the path length of the hand position during the finger task from a motion capture system. Subjective difficulties in ADLs were assessed using a visual analog scale.

    Results: The path lengths of both hands were significantly greater for patients with schizophrenia than for healthy controls. Significant associations were found between the path length of the non-dominant hand and subjective difficulties encountered by patients with schizophrenia while performing ADLs.

    Conclusion: The findings suggest that instability in the non-dominant hand is a potential marker of daily functioning in schizophrenia.

REVIEW
  • Masahiro Ogawa, Kouya Oshita, Kouta Matsumoto, Sousuke Nakatsuka, Haji ...
    2023 年 19 巻 1 号 p. 132-139
    発行日: 2023年
    公開日: 2023/06/09
    ジャーナル フリー

    Background: The number of studies on cognitive impairment in patients with chronic obstructive pulmonary disease (COPD) has been increasing in recent years. However, no study has comprehensively examined the relationship between cognitive impairment and occupation. Thus, the relationship between cognitive impairment and occupation in patients with COPD remains unclear.

    Objectives: This study aimed to conduct a scoping review and summarize the findings on the relationship between occupation and cognitive impairments in patients with COPD.

    Methods: A scoping review of articles published in English from 2001 to 2020 was conducted in MEDLINE, PsychINFO, and OTseeker. A key search term was employed using “COPD,” “occupation,” and “cognitive impairment.” Two investigators independently screened article titles and abstracts (primary screening) and then conducted full text review (secondary screening).

    Results: After screening, 22 articles were included in the analysis. The results of the analysis of the relationship between cognitive impairment and occupations in patients with COPD revealed that many studies have examined inhaler use and medication management in patients with COPD, whereas only a few studies were conducted in areas such as activities of daily living (ADL) and driving.

    Conclusion: Since occupations such as ADL and driving are critical for patients with COPD, further studies on these occupations are warranted.

ORIGINAL ARTICLE
  • Tsutomu Sasaki, Kyohei Yamada, Tomoki Ikeda, Hatsune Obuchi, Tomoaki Y ...
    2023 年 19 巻 1 号 p. 140-145
    発行日: 2023年
    公開日: 2023/06/09
    ジャーナル フリー

    Driving simulators (DS) have been used in medical institutions to evaluate a participant's driving abilities. Despite the empirical fact that the learning effects of multiple DS runs have been observed in clinical practice, few studies have examined the learning effects. The learning effects of multiple DS runs were examined among 25 older adults and 27 young participants. The participants drove the same course thrice without receiving any advice on the operation. The older adults had significantly more accidents than the young (p < 0.05) in all the trials. The number of accidents was significantly higher (p < 0.05) among older adults in the first trial than in the second. No significant difference was observed in the number of accidents between the second and third trials (p = 0.94). No significant difference in the number of accidents was found among all trials in the younger age groups. Among the different types of accidents noted, “Rear-end collisions due to inadequate deceleration” were observed more frequently among the older adults. “Collisions with a wall or vehicle due to improper maneuvering when turning right or left” were observed more frequently among young drivers. The results suggest that, the older adults may reveal their true driving abilities after at least three trials in the course used in this study. Furthermore, the results suggest that the quality of accidents differ between the older adults and the young.

  • Takayuki Watabe, Hisayoshi Suzuki, Marina Abe, Kengo Uchibori
    2023 年 19 巻 1 号 p. 146-152
    発行日: 2023年
    公開日: 2023/06/09
    ジャーナル フリー

    Objective: This study identifies differences in the motor performance immediately after and 15 s after cognitive task loading during the dual task stepping test in patients who experienced a stroke.

    Methods: Twenty-seven patients who experienced a stroke were included in the study. The paralyzed lower limb elevation was measured during the dual task stepping test. The task was performed for 30 s, with measurement time periods of 5 s immediately after starting the single task, 5 s immediately after cognitive task loading, and 5 s beginning 10 s after cognitive task loading. The mean lower limb elevation during each time period was determined. The amount of paralyzed lower limb elevation during each time period was compared, and correlations between the amount of change in each time period and assessment scores were examined. The relationships between the patients' walking abilities and the amounts of change during each time period were also analyzed.

    Results: The amount of lower limb elevation decreased after cognitive task loading (p < 0.01). The change in lower limb elevation from the motor task to after cognitive task loading was negatively correlated with the attention rating scale score (rs = −0.40, p = 0.04). Patients who could walk independently had a significantly lower change in lower limb elevation immediately after cognitive task loading than patients who required walking supervision (p < 0.01).

    Conclusion: Additional specific dual training assessments and their applications to dual task training must be investigated in future studies.

  • Shun Harada, Kiyomi Tateyama, Shigeki Kurasawa, Hiroyuki Tanba, Kazuyo ...
    2023 年 19 巻 1 号 p. 153-160
    発行日: 2023年
    公開日: 2023/07/27
    ジャーナル フリー

    Introduction: This study examined consultations by occupational therapists (OTs) regarding problem behaviors in a school for special needs education (Intellectual Disabilities) to clarify (1) the kind of advice provided, (2) the extent to which advice is put into practice in the classroom, and (3) the characteristics of the advice most frequently put into practice.

    Methodology: In total, reports on 78 school consultations conducted in 2015 and 2016 were examined; advice provided by the OTs was analyzed using Berelson's content analysis method. The OTs gave advice on the following: introducing and changing activities, adjusting the environment, ways of interacting to increase desirable behaviors, responding directly to problem behaviors, methods of talking with and instructing students, methods of visual support, and introducing alternatives to satisfy sensory needs.

    Results: Advice on methods of visual support and advice on introducing alternative ways to satisfy sensory needs were especially linked to practice.

    Conclusion: The results also indicated that the kind of advice frequently implemented in practice was that in which “who, what, when, and how” were clearly stated. Furthermore, it was found that discussing classroom feasibility with teachers based on specific advice improved the efficiency of consultations.

  • Christopher Jeffrey Bernaldo Streegan, Ivan Neil Benitez Gomez
    2023 年 19 巻 1 号 p. 161-168
    発行日: 2023年
    公開日: 2023/07/27
    ジャーナル フリー

    The Coronavirus disease (COVID-19) pandemic has affected the practice of hospital-based occupational therapists (OTs) and this may have influenced their occupational balance (OB) and quality of life (QOL). There is limited literature exploring OTs' OB, QOL, and the relationship between these. This study aimed to measure OB and QOL and their relationship among hospital-based OTs during the pandemic. Using a descriptive-correlational and cross-sectional design, n = 64 participants answered electronic versions of the Occupational Balance Questionnaire-11 (OBQ11) and World Health Organization Quality of Life-BREF (WHOQOL-BREF). Friedman test with a post-hoc pairwise Wilcoxon signed-rank test was used to compare QOL domain scores within-group. Independent t-test and Mann-Whitney Test were used to compare the subgroups' OB and QOL, respectively. 54.69% were classified to have low OB. Mean overall QOL score was 3.59 ± 0.68. QoL domain scores were relatively moderate: 66.67 ± 11.41 (physical); 55.58 ± 15.60 (psychological); 64.48 ± 21.81 (social); and 62.42 ± 14.74 (environmental). OB was significantly correlated with overall QOL (p < 0.001), physical health domain (p < 0.001), psychological domain (p < 0.001), social domain (p = 0.022), and environmental domains (p = 0.005). Low OB and moderate QoL, regardless of sex, work schedule, and hospital funding type, validates the need for improved personal strategies and enhanced organizational support. The positive correlation between OB and QoL contributes to occupational science providing extant evidence on how occupations support health and well-being. Our findings have implications for developing programs that support hospital-based OTs during the pandemic period and beyond.

  • Sayaka Iwakami, Wataru Tominaga
    2023 年 19 巻 1 号 p. 169-175
    発行日: 2023年
    公開日: 2023/07/27
    ジャーナル フリー

    Discharge support currently focuses on the independence of activities of daily living (ADL) in the convalescent rehabilitation ward. However, understanding the psychological aspects is important for suitable discharge interventions. The objective of this study was to clarify the relationship between ADL independence level and psychological aspects when patients' discharge from convalescent wards was confirmed. A cross-sectional survey was conducted with 80 patients in convalescent wards to examine the relationship between ADL independence level using functional independence measure (FIM) values and responses to eight questions about psychological aspects. The results revealed that the ADL independence level is correlated with “mental preparation for discharge” and “consultation during hospitalization.” The details correlated with “mental preparation for discharge” differed depending on the disease. “Awareness of ADL independence” was correlated in cerebrovascular diseases and “awareness of physical recovery” in motor diseases. The results suggest the importance of comprehending patients' concerns during hospitalization and changing the perspective to providing psychological support according to disease.

  • Junichiro Muranaka, Satoshi Sasada
    2023 年 19 巻 1 号 p. 176-186
    発行日: 2023年
    公開日: 2023/09/13
    ジャーナル フリー

    Background: Occupational therapists' perceptions of the ‘quality of life’ of stroke clients are not uniform, and therefore appropriate quality of life support is not always provided. The purpose of this study was to clarify occupational therapists' perceptions of quality of life of stroke clients and to help develop a new disease-specific quality of life scale and corresponding occupational therapy practice.

    Method: The research design used was qualitative descriptive study. Inductive content analysis was used for the descriptive data obtained from the semi-structured interviews. The 12 participants included nine authorized by the Japan Association of Occupational Therapists with experience in working with stroke clients and three quality of life expert researchers.

    Results: The qualitative analysis revealed that occupational therapists' perceptions of stroke clients' quality of life were based on the concepts of ‘Adaptation to meaningful occupation’, ‘Good personal causation’, and ‘Family happiness and good relationships’.

    Conclusion: Occupational therapy researchers and clinicians can use the three concepts identified in this study to develop new quality of life measures and to develop occupational therapy practice to improve the quality of life of stroke clients.

  • Kensuke Tochio, Daisuke Kimura, Hiroshi Kinoshita, Ryuhei Okuno, Takes ...
    2023 年 19 巻 1 号 p. 187-194
    発行日: 2023年
    公開日: 2023/09/13
    ジャーナル フリー

    Objective: The aim of this study was to develop a personal computer (PC)-coupled nine-hole peg test (NHPT) incorporating an engineering device that could accurately measure the travel time of individual pegs and use it to provide standard data in healthy young women for future reference.

    Methods: We produced a nine-hole pegboard consisting of a container with an accelerometer, a small photo reflector, and an amplifier. Four temporal variables were calculated using software developed by the researcher. NHPTs were performed by 37 healthy right-handed young women with dominant and non-dominant hands. The hand used, the distance from the container to the peg hole (index of difficulty; ID), task (container to the board and board to the container), and phase (peg movement time, reaching time) were used as independent variables.

    Results: The developed pegboard was found to accurately measure the time in each of the assumed phases. The total performance time with the dominant hand was significantly shorter than that of the non-dominant hand (P < 0.001). Time to move the peg from the container to the board accounted for approximately 54% of the total performance time for both the left and right hands. The peg movement time increased performance time as the task difficulty increased (P < 0.001).

    Conclusions: Our pegboard accurately measures movement times with individual pegs and the time to reach pegs without stopwatch assessments in young women. Baseline data on the right- and left-hand peg travel times and reach times for healthy young women were provided for future reference.

  • Aiko Hoshino, Ichiro Kutsuna, Ami Usui, Yukari Mori, Mami Suwa
    2023 年 19 巻 1 号 p. 195-204
    発行日: 2023年
    公開日: 2023/10/03
    ジャーナル フリー

    Background: Mental health problems in the workplace are an important issue globally, and return-to-work (RTW) programs for people on sick leave because of mental health problems are being developed. However, participants' situations and states are various and there are few assessment tools.

    Objectives: We aimed to reveal the clinical picture of participants of an RTW program according to depressive state with mixed method research to help occupational therapists plan client-centered rehabilitation programs.

    Methods: We used a conversion mixed methods research design. We collected basic information and administered the Beck Depression Inventory (BDI) in the quantitative arm, and used written rehabilitation plans based on interviews conducted in the initial stage assessments of participants in an RTW program as the qualitative arm. Data from the quantitative arm were divided into three groups according to severity of depressive symptoms based on BDI cut-off points. Qualitative data were analyzed by creating codes and categories following the grounded theory approach. Both types of data were merged by calculating the frequencies of occurrence of codes for each depression severity group.

    Results: Our results showed that participants' clinical pictures were different depending on their depressive state. Participants with a severe state had difficulty waking up early, disordered eating habits and appetite, and difficulty with selfdisclosure. Participants with a lighter depressive state had a stable lifestyle and were able to perform high-level cognitive activities like studying or exercise.

    Conclusions: Our results will help occupational therapists assess participants in the initial stage RTW programs, and contribute to effective interventions.

  • Yuri Matsuzaki, Hidetoshi Omiya, Takayuki Hisakura, Hiroki Tanii, Maki ...
    2023 年 19 巻 1 号 p. 205-212
    発行日: 2023年
    公開日: 2023/10/03
    ジャーナル フリー

    Background: Mild Cognitive Impairment (MCI) are known to revert to normal cognition, so early intervention during the MCI stage is required. MCI is reported to be associated with a reduction in frontal lobe volume, blood flow, and metabolism; dysfunction of the frontal lobes has also been reported to increase the risk of progressing to dementia. This study verifies the effects of cognitive rehabilitation targeting frontal lobe executive function in MCI.

    Method: MCI patients aged over 65 were divided into a group taking part in the Frontal/Executive Program (FEP Group), and the Control Group. Ten FEP Group patients took part in the FEP, and nine Control Group patients took part in the Group Exercise Program, 22 times each. Cognitive function was evaluated with MoCA-J, BACS-J, and WCST.

    Results: The FEP Group showed significant improvements over the Control Group in verbal memory, working memory, executive function, conversion of sets, and persistent wrong answers. A dramatic effect was also seen in the FEP Group before and after intervention in verbal memory, working memory, verbal fluency, executive function, conversion of sets, and persistent wrong answers. These effects on verbal memory, verbal fluency, and conversion of sets were maintained for a period of three months. In addition, 60.0% of the patients in the FEP Group reverted to and maintained normal cognition for three months.

    Conclusion: Improvements were seen in the target function due to cognitive rehabilitation targeting frontal lobe executive function. A high rate of reversion was also seen from MCI to normal cognition.

  • Nao Yoshihiro, Kazu Amimoto, Shinpei Osaki, Junpei Tanabe
    2023 年 19 巻 1 号 p. 213-222
    発行日: 2023年
    公開日: 2023/10/20
    ジャーナル フリー

    Background: Functional electrical stimulation (FES) improves unilateral spatial neglect (USN). However, only few studies have reported on the relationship between FES and cognitive function. Therefore, this study aimed to investigate the effects of FES on attentional function in healthy participants using the Posner task, which is generally used to assess patients with USN.

    Methods: In this interventional study, we conducted experiments on healthy participants to obtain fundamental knowledge before investigating effective ways of adapting FES to patients with USN as our final purpose. A total of 28 right-handed healthy young participants were assigned to the online-effect group or after-effect group and underwent FES simultaneously with or immediately before the Posner task, respectively. FES was applied to the extensor muscles of the left forearm to induce involuntary movement.

    Results: A significant difference was observed in the effects of FES in the Posner task between the online-effect group or after-effect group in the left-valid conditions (online-effect, 26.7 ms delay; after-effect, -0.4 ms [reduction]; p = 0.01). No interaction was noted between the groups and the type of target of the Posner task presentation condition. The effects of FES differed between the online- and after-effect condition groups.

    Conclusion: Performing the attention task after FES may enhance attention compared with performing the task with FES simultaneously.

  • Kazuo Saito, Daichi Narita, Mikayo Omori
    2023 年 19 巻 1 号 p. 223-229
    発行日: 2023年
    公開日: 2023/10/20
    ジャーナル フリー

    Objective: For splints/orthoses fabricated by therapists during hand therapy to be recognized as a novel specialized medical technology, we demonstrated their ease of dissemination, ethics, safety, and effectiveness. We also investigated the technical difficulty and dissemination of splints/orthoses in a first study on the current situation of splint/orthoses fabrication using thermoplastic splinting sheets, and evaluated the effectiveness, safety, and ethics of splinting sheets in a second study.

    Methodology: In the first study, we investigated the name of the target diagnosis, purpose of fabrication, time of fabrication, joints involved, presence or absence of component connections, and fabrication time. In the second study, we investigated basic attributes, explanations and consent, prescriptions, difficulties, and efficacy indicators. The participants were 49 therapists from 46 institutions who completed the academic society-approved seminars in the first and second studies.

    Results: The subjects were 31 out of the 49 therapists (response rate: 67.4%), and the target splints were 547. The splints/orthoses were used in daily clinical practice after surgery or immediately after injury, and various splints/orthoses were fabrication according to a specific purpose, even during treatment. Moreover, regarding the difficulty level, the splints/orthoses could be fabrication in a relatively short time by a advanced hand therapist. For instance, 260 (48%) were produced within 20 minutes.

    Conclusion: The safety and ethics of the splint/orthoses showed high values, but further objective indicators and subjective data indexing of efficacy are required.

RAPID COMMUNICATIONS
  • Daisuke Sakagawa, Daisuke Konda, Miyu Kawato, Kyoko Chiba, Kazuki Waka ...
    2023 年 19 巻 1 号 p. 230-235
    発行日: 2023年
    公開日: 2023/10/20
    ジャーナル フリー

    Purpose: For patients forced to use only one hand, closing a zipper is challenging. Therefore, we developed a self-help device that uses a string and clothespins; the device stretches the zipper, allowing the individual to close it easily with one hand. We aimed to 1) demonstrate the effectiveness of this device by comparing the zipper closing motion when the device is used (“usage motion”) with that when it is not used (“non-usage motion”) and 2) determine whether difficulty level changes when using either the left or right hand.

    Methods: This study included 38 patients with hemiplegia. Participants were asked to close the zipper with one hand after being instructed on how to perform the usage and non-usage motions. Next, we judged whether the participants could perform the movements, and measured the time taken to close the zipper using video.

    Results: All participants could close the zipper using the usage motion; however, time taken to close the zipper was significantly shorter when the device was used than when it was not. On comparing the zipper closing time between the left and right hand for the usage motion, no significant differences were noted.

    Conclusion: Experimental results suggest that device-based zipper closure is an efficient method for patients with hemiplegia. Furthermore, we demonstrated that a self-help device, combining inexpensive everyday items, could enable patients with hemiplegia to successfully dress themselves without difficulty.

ORIGINAL ARTICLE
  • Takayuki Miyauchi, Shotaro Sasaki, Yoko Sasaki, Takuma Mogamiya, Rumi ...
    2023 年 19 巻 1 号 p. 236-242
    発行日: 2023年
    公開日: 2023/10/20
    ジャーナル フリー

    Introduction: Stroke rehabilitation that considers attention deficits and effectively improves activities of daily living (ADL) requires sufficient evaluation of attention functions. Attention function evaluations are generally performed using neuropsychological tests in patients with stroke. However, such tests become unviable for patients with acute stroke due to fatigue-related unstable general conditions and cannot determine how attention deficits affect ADL. Hence, developing an appropriate observational rating scale is crucial. Therefore, we investigated the factors related to independence in ADL in patients with acute stroke and the usefulness of the Moss Attention Rating Scale (MARS) score in predicting independence in ADL.

    Methods: In this cross-sectional single-center study, we included 154 patients admitted to Acute Hospital, Japan for stroke treatment between April 2016 and April 2020 who consented to participate. The primary outcome was the motor functional independence measure (m-FIM) score. The secondary outcome measures were the Glasgow Coma Scale score, Brunnstrom recovery stage, grip strength, one-leg standing time (1LST), Mini-Mental State Examination-Japanese score, Visual Cancellation Task score, Symbol Digit Modalities Test score, and MARS score.

    Results: The 1LST and MARS scores were associated with independence in ADL. The cutoff values were 2.99 seconds for 1LST (average), 89 points for MARS total score, and 58.87 points for MARS logit score.

    Discussion: The MARS score and 1LST might be useful indices for predicting independence in ADL. Thus, behavioral assessments might be appropriately performed by implementing these indices to determine the degree of ADL independence in patients with stroke, and thereby establishing targeted rehabilitation strategies.

  • Manabu Sasaki
    2023 年 19 巻 1 号 p. 243-249
    発行日: 2023年
    公開日: 2023/11/18
    ジャーナル フリー

    Background: A simple method for measuring arm mass in clinical practice would be useful for medical records and experimental approaches; however, which but there is no popular measurement method.

    Objective: To develop a simple, accurate, and reliable method for approximating arm masses.

    Methods: A theoretical model for estimating the mass of the lower and upper arms was proposed. The validity of the model was confirmed via 34 measurements on a steel model in each of the nine upper arm abduction positions using one-sample t-tests. The reproducibility of the method was investigated by performing repeat measurements for 29 participants and was confirmed using paired t-tests.

    Results: One-sample t-tests showed no significant differences (p < 0.05) in the mean of the nine upper arm abduction positions investigated during the model validation. Regarding reproducibility, the paired t-tests showed no significant differences (p < 0.05), and the 95% confidence intervals were corroborated by previous reports. Interpretation of intraclass correlation (ICC) was difficult because of inappropriate application.

    Limitations: The reproducibility of the suggested method should be verified using an appropriate statistical method.

    Conclusions: Because of insufficient reproducibility, supplemental method is required, such as the adjusted backrest fitting better for all subject, and assessor must try to achieve reproducibility when the therapists use this method in clinical practice.

  • Shintaro Kawano, Shinnosuke Hatabe, Shinsuke Imaoka
    2023 年 19 巻 1 号 p. 250-255
    発行日: 2023年
    公開日: 2023/11/18
    ジャーナル フリー

    Background: Several guidelines recommend robotic therapy for upper extremity motor paralysis after stroke, but the number of eligible patients is unknown. This study aimed to examine predictors of functional outcomes after robotic therapy in patients with moderate or severe upper extremity paralysis.

    Methods: This retrospective observational study included 53 patients with subacute stroke. Patients received daily occupational therapy (OT) for 4 weeks and robotic therapy 3 to 4 times per week for 20 min per session. Binomial logistic regression analysis was performed to estimate predictors of participants with a minimal clinically important difference (MCID) of 9 points or greater in the Fugl-Meyer Assessment of Upper Extremity (FMA-UE) after 4 weeks based on FMA-UE shoulder and elbow forearm scores, days since onset, and amount of OT training. Cutoff values were calculated using receiver operating characteristic curves.

    Results: Only the FMA-UE shoulder and elbow forearm score (odds ratio = 0.913, p = 0.014) was a predictor of FMA-UE improvement in MCID after 4 weeks. The cutoff value was calculated to be 12.5 points.

    Conclusion: The FMA-UE shoulder and elbow forearm score at the start of interventions may be a useful predictor of functional outcomes after robotic therapy in patients with moderate or severe upper limb motor paralysis after stroke. Furthermore, an FMA shoulder and elbow forearm score of 12.5 might be necessary to show improvement over MCID in the short term.

  • Kei Ito, Shota Suzumura, Yoshikiyo Kanada, Yoko Nagakawa, Rie Narukawa ...
    2023 年 19 巻 1 号 p. 256-259
    発行日: 2023年
    公開日: 2023/12/27
    ジャーナル フリー

    Purpose: There are no reported cases of reacquisition of cooking ability in patients with severe hemiplegia of the dominant hand due to stroke. Thus, this study reports a case in which a patient with severe hemiplegia on the dominant hand side due to stroke reacquired practical cooking ability after being trained on cooking using the non-dominant hand.

    Methods: The patient was a right-handed woman with severe right hemiplegia due to left capsular hemorrhage who needed to be able to cook by herself. The patient had difficulty cooking with her right upper limb because of severe right hemiplegia; therefore, we examined cooking methods suited to the patient using various tools so that she could manage to cook using only her left upper limb. In addition, we asked her family members to help her repeat and practice what we had trained her to do.

    Results: The mean performance score and satisfaction, obtained using the Canadian Occupational Performance Measure, improved by 3 points after the intervention. The patient was able to cook independently.

    Conclusions: Our results suggest that patients with severe hemiplegia on the dominant hand side may be able to reacquire cooking ability using the non-dominant hand through repeated practice of cooking-related tasks adjusted to an appropriate level of difficulty while using cooking apparatus.

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