Purpose: Patients who can only use one of their upper limbs experience difficulties in opening the lids of full-open-end cans. Thus, we developed a self-help device consisting of a cord and J-shaped hook. This device allows the user to pull a tab fixed to the end of the can with the body, enabling the lid to be opened with one hand. This study aimed to demonstrate the effectiveness of the device by comparing it with a spoon for opening the lids of cans.

Methods: The study participants were 28 hemiplegic individuals. They were taught to use a device that involves leaning their body backward instead of pulling a tab with their fingers as well as using a spoon to open a lid. They were then asked to open the lid using only one hand. Next, we judged whether the participants could perform the movements, and measured the time taken to open the can using video recording.

Results: All the participants successfully opened the can with the device and its use greatly reduced the opening time.

Conclusions: Our results suggest that this device is effective in helping hemiplegic individuals open cans. They also demonstrate that this self-help device created from cheap, everyday components enables hemiplegic individuals to open can lids without difficulty.

Introduction: The number of Japanese children who refuse to attend school is increasing every year. However, it is uncommon for occupational therapists (OTs) to visit to the homes and rooms of these students. We examined the effects of visiting occupational therapy on a junior high school student with an addiction to Internet games.

Methods: The case (Case) involved a home visit by an OT to a 13-year-old boy with attention deficit/hyperactivity disorder. Case told the OT that he was addicted to competitive Internet games and went to bed around 5 a.m.

Result: OT spoke with Case concerning his daily rhythm, and he promised to be in bed by midnight. However, this promise was frequently broken, and no improvement was seen in his life rhythm or his relationship with his family. Therefore, the OT increased the frequency of visits from once to twice a week. Six months into the visit, the OT took advantage of plastic model making, which Case had shown interest in, to break the vicious cycle caused by Internet games. Case's reliance on Internet gaming was eliminated, thanks to plastic model building, and his life rhythm significantly improved. Case's Vineland-2 Adaptive Behavior Scale scores also improved, and his Maladaptive Behavior Scale score was zero.

Conclusion: The OT's encouragement to build plastic models occurred at the right time to assist Case to break free from his addiction. These findings suggest that home-visit occupational therapy is effective for students who refuse to attend school.

Purpose: Patients forced to use only one hand find wearing a knit cap without a brim difficult. Therefore, we developed a self-help device using a string and clothespin. The device can immobilize the knit cap, making it easy to put on the cap with one hand. This study aimed to demonstrate the device's effectiveness by comparing the action of putting on the cap with the device (usage motion) and without the device (non-usage motion) in hemiplegic patients.

Methods: Twenty-eight hemiplegic patients were recruited as participants. After receiving explanations about the procedures for both the usage and non-usage motions, the participants were asked to put on the knit cap with one hand. Next, the success of the action was evaluated before hearing the feedback provided by participants regarding the ease of wearing. Finally, the time taken to put on the cap was measured from the video footage.

Results: The usage motion made it easier to wear the cap and had a higher success rate than the non-usage motion.

Conclusion: The experimental results suggest that the motion of putting on the cap using the device is an efficient method for hemiplegic patients. Furthermore, it was demonstrated that hemiplegic patients can comfortably wear a knit cap without difficulty using a self-help device combining inexpensive daily items.

Purpose: Individuals with limited use of one hand, such as those with hemiplegia, often struggle with handling umbrella. While automatic umbrellas can be opened and closed with one hand, storing them in their covers requires both hands. To address this issue, we developed a self-help device that stores the umbrella without rolling up the fabric. This study aims to assess user satisfaction with the device for practical use.

Methods: Thirty-two stroke participants with hemiplegia due to cerebrovascular disease were instructed to perform a task using their non-paralyzed hand: removing a folding umbrella from the self-help device, opening, and placing it back into the device. Once familiar with the task, their actions were recorded using a digital video camera. Participants then evaluated their satisfaction using the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0). The average score for each item was calculated.

Results: The motion images showed that most participants performed the task without difficulty, and all successfully used the device. However, only a few tried again when closing the self-help device. The lowest mean score was 3.8 ± 0.9. Some participants provided encouraging feedback for improvement.

Conclusion: All participants were able to complete the task. An average QUEST 2.0 score close to 4 indicates a high level of satisfaction. These results suggest that the self-help device has a high satisfaction rate. While suggestions were made for enhancements, the device shows promise for practical use, especially with proper instruction on closing the clasp.

Background: Individuals with severe mental disorders are increasingly using social media platforms to discuss their illnesses, seek advice, and support each other. This phenomenon is known as online peer-to-peer support.

Objective: This study aimed to identify the characteristics of online peer-to-peer support in Japan.

Methodology: Data were collected through semi-structured interviews and blog posts.

Results: Inductive thematic analysis revealed three themes: (1) expanding online networks of mutual support as self-organization progresses; (2) cultivating a positive self-identity for individuals with schizophrenia; and (3) taking steps toward social participation and inclusion.

Conclusion: Despite concerns regarding the risks of online communities, self-organized online peer-to-peer support groups promote social participation rather than isolation. However, this result cannot be generalized to all online communities because its quality is influenced by peer support structures and environments. Self-organized online peer-to-peer support groups with a flexible and receptive organizational culture effectively promote social participation. Our results suggest that online interactions that foster positive self-identity may be a prelude to offline social affiliations. In this study, individuals living with schizophrenia who communicated online were provided with a foundation that enabled them to take steps toward engaging in offline social participation. However, a sustainable management system is required. Hence, peer partnership services, in which the service is provided by peers, but its operation is conducted in collaboration with professionals, should be considered.

Objective: The Risk Assessment Scale for Incident Functional Disability (RFD) is used to predict the risk of future certification for incident long-term care and support. In this study, we used the RFD to clarify the effect of remote exercise on the functional decline risk of community-dwelling older adults.

Methods: The study population comprised 36 older adults who participated in an exercise class held at a local community center. After written informed consent was obtained, body composition and physical function were measured before the exercise intervention. Participants with a high- and low-risk of certified need for care and support were identified based on the RFD cutoff value (16/17 points). Interim and final follow-up assessments were conducted after the exercise intervention to compare the pre- and post-intervention changes in each measure.

Results: After the intervention, significant improvements were observed in the phase angle between the entire body and both arms (p = 0.001 and p = 0.016, respectively), handgrip strength (p < 0.001), walking speed (p < 0.008), and chair standing (p < 0.001). In the RFD, although age, a risk factor for needing care and support, increased significantly after the intervention (p < 0.001), the number of high-risk individuals did not increase (p = 0.48).

Conclusion: Remote exercise interventions for community-dwelling older individuals improves muscle quality and physical function and limits the functional decline risk as measured using the RFD.

This study aimed to clarify the effects of different cognitive-motor exercise teaching methods using the limbs on prefrontal oxyhemoglobin, number of errors, and subjective difficulty. We also aimed to elucidate relationships between prefrontal oxyhemoglobin and the number of errors and subjective difficulty in 77 healthy adults. Oxyhemoglobin levels in the group taught in third-person perspective (3PP) were higher than those in the group taught in first-person perspective (1PP), as ascertained by a comparison of cerebral blood flow in the anterior halves. The median number of errors was significantly higher in the 3PP group (3.5) than in the 1PP group (3.0), but the subjective difficulty did not differ significantly between these conditions. A significant positive correlation was observed between oxyhemoglobin and the number of errors, whereas no significant correlation was observed between oxyhemoglobin and subjective difficulty. The 3PP group exhibited more errors and higher prefrontal cortex activity than that of the 1PP group. Consequently, occupational therapists and caregivers should consider these indicators when performing cognitive motor exercises involving the limbs in clinical settings to ensure higher efficacy. Future research should target older adults, and use near-infrared spectroscopy probes to cover the activated parietal and occipital lobes associated with mental rotation tasks.

Objective: To investigate the variability in agitated behaviour due to different contexts in a patient with dementia.

Methods: We describe the case of an 80-year-old male with dementia who scored 0 on the Mini-Mental State Examination. AwareCare was used to assess his agitated behaviour across 14 response categories, including eyes and facial expressions. One occupational therapist observed his behaviour in a context where activity was not provided in the hospital ward (Phase A) and while he was drinking tea in a quiet room (Phase B) for 10 minutes. The Tau-U A vs B coefficient of the Tau-U test was used for analysis.

Results: Tea consumption was associated with a significant reduction in agitated behaviours, e.g. eye flickering, head movements, and shouting or moaning. There was a notable increase in positive behaviours, including more frequent smiling.

Conclusions: The level of agitated behaviour in an individual with severe dementia may vary depending on the context.

Background: The decision-making process underlying shared decision-making is evidence-based practice (EBP). However, in Asia, EBP has widely become only a concept, and empirical research on measures to promote its implementation is lacking. Therefore, we first developed the EBP self-assessment (EBPSA) for occupational therapists.

Purpose: To examine the characteristics of occupational therapists and their clinical, educational, and research experiences related to the EBPSA scores.

Methods: The participants were 1216 occupational therapists working in Japanese convalescent rehabilitation wards, who were surveyed by mail using the questionnaire. Data analysis was conducted using a categorical multiple regression analysis with EBPSA scores as the dependent variable, years of clinical experience and sex as adjustment variables, and the characteristics of occupational therapists and their clinical, teaching, and research experiences as independent variables.

Results: In total, 531 occupational therapists (44% response rate) responded to the questionnaire. Of these, 465 who answered all questions were considered valid respondents. As a result, the following five items related to “work environment,” “intrinsic motivation,” and “self-efficacy” subscale scores in the EBPSA were extracted: final educational background; experience in education on EBP methodology; positive experiences resulting from the implementation of EBP; experience in presenting at academic conferences as the first author; experience in education on high-level evidence-based intervention and assistance methods.

Conclusions: It was discussed the important issues of enhancing EBP education, encouraging academic and research activities, and increasing positive experience resulting from the implementation of EBP for improving the “workplace environment,” “intrinsic motivation,” and “self-efficacy.”

Objective: This study examines how care robot use, spatial constraints, and caregiver proficiency affect torso and pelvic posture during toileting assistance, focusing on lower garment manipulation - a physically demanding task in excretion care.

Methods: Twenty-four participants (12 experts and 12 nonexperts) performed toileting assistance tasks using an excretion assistance device across three bathroom layouts: a 1.34 m² residential layout (1.34 plan), a 2.11 m² care facility layout (2.11 plan), and a modified 1.34 m² residential layout with a widened entrance (1.34 W plan). The IMU-based motion capture system measured the torso and pelvic angles during robot positioning and garment lowering.

Results: Significant differences were observed between experts and nonexperts across all movement types (flexion, lateral flexion, and rotation), with nonexperts exhibiting consistently higher angles, suggesting increased biomechanical loading. Spatial design significantly influenced rotational movements, with the modified residential layout (1.34 W plan) reducing angles compared to the standard residential layout (1.34 plan). However, no significant interaction effect was found between skill level and spatial conditions.

Conclusion: When implementing care robots, caregiver proficiency and environmental factors should be considered separately. The findings indicate that optimizing only the spatial design or training alone may not be sufficient, but addressing both factors can enhance caregiving efficiency and reduce physical burden. Specifically, appropriate spatial design alleviates movement strain, while skilled caregivers demonstrate more efficient motion patterns, even in constrained spaces. These insights contribute to optimizing caregiving environments in home and small-scale facilities, facilitating the effective utilization and adoption of excretion care robots.

Background: Autism spectrum disorder (ASD), a neurodevelopmental condition, is defined by deficits in social communication interaction. Social skills in ASD have been associated with executive functions (EFs), which include working memory (WM).

Objective: This preliminary study investigated the effect of computerized training in logical thinking as an EFs (specifically WM) and social skills intervention via RehaCom on autistic children.

Methods: Participants were eight children diagnosed with ASD (mean age: 7.6 ± 0.6 years) who attended rehabilitation. Intervention effects were measured via Raven's Coloured Progressive Matrices as an intelligence test, questionnaires on ASD characteristics, which included social skills, the Autism Spectrum Quotient (AQ) for children, and a visuo-spatial memory task and digit span memory test (to assess visuo-spatial and verbal WM, respectively) as EFs abilities. The intervention was conducted twice a week for six weeks in two sets of 10 min. Effects were measured pre- and post-intervention and at the six-week follow-up.

Results: No differences were observed in participants' intelligence. Participants' visuo-spatial WM ability improved immediately after training. However, the intervention had no significant effect on verbal WM or ASD characteristics, especially social skills.

Conclusion: Despite the limited participants owing to the preliminary nature of this study, our results suggest that logical thinking training via a computer program is effective for temporarily improving EFs, including visuo-spatial WM, in autistic children.

Background: Since the 1980s, illness memoirs have been recognized for their therapeutic and educational value. Recently, young adults have increasingly utilized video platforms for self-expression, social support, and meaning-making. AYA cancer survivors often face socioeconomic challenges, particularly regarding employment, even after treatment. Therefore, long-term career support and reintegration are crucial. Sharing cancer experiences on platforms like YouTube may serve as “meaningful work,” enabling selfexpression, social connection, and potential income. This study presents two AYA cancer survivors who used YouTube post-treatment, highlighting aspects of recovery, reintegration, and employment.

Case 1: A patient with peripheral T-cell lymphoma (PTCL) underwent hematopoietic stem cell transplantation. An occupational therapist (OT) supported physical activity during hospitalization and introduced video creation post-discharge. At 1,828 days posttransplant, the patient achieved full ADL independence (SPPB 12/12, A-QOA probit 3.55 ± 0.27). The videos showed natural engagement but reflected uncertainty in collaborating with healthcare professionals to improve information quality.

Case 2: A patient with a left forearm bone/soft tissue tumor adapted to one-handed ADLs and produced videos on adaptive techniques and social interaction. One year post-surgery, the patient was ADL-independent (TESS 97.2%, A-QOA probit 4.47 ± 0.28). While socially reintegrated, the patient struggled to articulate the concept of “disability.”

Conclusion: Post-treatment video creation functioned as meaningful occupational engagement with therapeutic and social benefits. OTs played a vital role in support. Further research should explore candidate selection and integration into rehab and employment programs.

Objective: This scoping review identifies and synthesises the factors—child, task, environment, and intervention-related—that are associated with improved handwriting performance in children with handwriting difficulties.

Materials and Methods: Using Arksey and O'Malley's five-step framework and reported in line with PRISMA-ScR, we searched PubMed, CINAHL, MEDLINE, Web of Science and ERIC in May 2023. Articles were evaluated by three reviewers based on the inclusion criteria: (1) children under 18 years of age with handwriting difficulties, (2) studies involving interventions, assessments, and/or observations, and (3) studies conducted in diverse geographical contexts.

Results: The review included 29 studies, of which six were conducted in the United States. Occupational therapists served as the principal investigators in 21 studies, while the remaining studies were led by speech-language pathologists, physical therapists, psychologists, special educators, or system designers. A qualitative thematic analysis of the selected studies identified two key themes: (1) the rationale for designing handwriting programs and (2) additional programs to support handwriting programs.

Conclusion: This study highlights that integrating multiple interventions, including alphabetic tasks, cognitive strategies, and ergonomic exercises, can significantly enhance handwriting performance. Additionally, incorporating home and classroom exercises as supplementary programs can enrich handwriting curricula by leveraging the involvement of parents and instructors, which plays a critical role in motivating and improving children's handwriting abilities. Future research should test these combined approaches in large, controlled trials and explore under-represented regions to strengthen the evidence base.

Objective: The purpose of this study was to identify the prevalence of and need for occupational therapist interventions in intensive care units in Japan, as well as the need for postgraduate learning and education in the practice of occupational therapy.

Method: Occupational therapists were invited to respond to questionnaire that was distributed to 359 facilities with intensive care units.

Result: A total of 139 responses were received from the 359 facilities contacted, representing a response rate of 38.7%. The frequency of intervention by occupational therapists in intensive care units was 74.3%, and 93.5% of occupational therapists felt that the interventions were justified. Self-learning was the most common method of post-graduate learning (95.1%), followed by instruction from other professions (85.3%). The vast majority of occupational therapists (98.0%) indicated that postgraduate education was a necessary component of their professional development.

Conclusion: The current postgraduate education system for occupational therapists working in intensive care units needs to be revised to improve its effectiveness. The development of a dedicated postgraduate education system for occupational therapists, particularly in the intensive care setting, would be a valuable addition to the existing training framework.

Background: The Canadian Occupational Performance Measure (COPM) is widely used to assess client-centered outcomes in occupational therapy. However, its psychometric properties, particularly responsiveness and minimal important change (MIC), require further validation in specific populations.

Objective: This study aimed to determine the MIC values for COPM performance (COPM-P) and satisfaction (COPM-S) scores using MICpredict and MICadjust methods in a Japanese home rehabilitation context, and to evaluate the responsiveness of the COPM compared to the EQ-5D-5L.

Methods: A multicenter prospective cohort study was conducted with 45 participants who received home-based rehabilitation services. MIC values were calculated using predictive modeling methods, whereas responsiveness was assessed using standardized response means (SRM) and Spearman's correlation coefficients with EQ-5D-5L scores.

Results: MICpredict values were 1.35 (95% CI: 0.88-1.80) for COPM-P and 1.37 (95% CI: 0.81-1.88) for COPM-S, with adjusted values (MIC_adjust) accounting for unequal group proportions at 1.23 (95% CI: 0.73-1.72) and 1.24 (95% CI: 0.60-1.77), respectively. The COPM demonstrated high responsiveness (SRM: 1.09 COPM-P and 1.01 for COPM-S), whereas no significant correlations were found between COPM change scores and EQ-5D-5L scores. These findings reflect the individualized nature of COPM and its sensitivity to client-specific outcomes.

Conclusions: This study underscores the utility of MICpredict and MICadjust in establishing MIC values tailored to the Japanese home-based rehabilitation population. The results highlight strong responsiveness of the COPM and the complementary use of individualized and comprehensive patient-reported outcomes for a holistic evaluation of rehabilitation outcomes.

Introduction: Interventions using meaningful activities based on a client's interests and roles improve the behavioral and psychological symptoms of dementia (BPSD). However, as dementia progresses, it becomes increasingly difficult to identify meaningful activities. In this study, we report the effectiveness of activity-based practices using the Assessment of Quality of Activities (A-QOA) in a client with severe dementia.

Case Presentation: A woman in her 80s (Mrs. A) with Alzheimer's disease was diagnosed with severe dementia. After being admitted to the hospital, she spent a lot of time doing nothing and showed BPSD such as aggression and resistance to care, which made it difficult for the ward staff (the staff) to care for her. Therefore, we used the A-QOA to identify meaningful activities and appropriate care for her. We found two activities that could be engaged in as “roles” and five “care innovations”. Over the course of a week, Mrs. A performed her “role”, and the staff could implement care. Consequently, she became more active in her “role”, her interactions with others increased, and her BPSD improved.

Conclusions: Mrs. A's situation improved as a result of the provision of personalised activities and care tailored to her needs. Mrs. A's case showed that the A-QOA is useful for identifying meaningful activities for clients with severe dementia and implementing care accordingly. This case also highlights the importance of identifying meaningful activities and strengthening connections to support clients with severe dementia.

Objectives: The aim of this study was to determine the hierarchy of neuropsychological tests and behavioral observational scale of attention function, using levels of consciousness.

Methods: This single-center, cross-sectional study was conducted at St. Marianna University Yokohama Seibu Hospital (Yokohama, Japan). The study included 54 patients who were admitted to an acute hospital for stroke between September 2022 and February 2023 and consented to participate. The primary outcome was the Wessex Head Injury Matrix (WHIM). The secondary outcomes were tests related to attentional function: Mini-Mental State Examination (MMSE), Digit Span (DS), Trail Making Test (TMT), Frontal Assessment Battery, Symbol Digit Modalities Test (SDMT), and Moss Attention Rating Scale (MARS). We investigated the difficulty levels of five neuropsychological tests, according to levels of consciousness impairment identified by the WHIM.

Results: One hundred and sixty-three measurements were included in the analysis. The WHIM phases showed nearly the same hierarchy as that of the original version. The neuropsychological tests, ranked in decreasing order of difficulty, were TMT-Part B, SDMT, TMT-Part A, DS backward, MMSE, and MARS.

Conclusion: The findings underscore the importance of carefully selecting tests and interpreting results. Certain assessments may be feasible, even in patients with impaired consciousness, whereas other tests may pose challenges, even in patients with relatively good levels of consciousness.

Introduction: This case report aims to elucidate the potential of occupational therapy (OT) for patients with severe COVID-19 by highlighting the prolonged recovery of a survivor, with a focus on mental health and social participation.

Case Presentation and Progress: A man in his 50s with diabetes required prolonged hospitalization and mechanical ventilation for severe COVID-19. OT started early and continued for 9 months. The overall rehabilitation team's goals were to restore independent activities of daily living (ADL) and facilitate social participation. OT progressed from basic to complex tasks, including strength training, cognitive rehabilitation, ADL training, and work simulations. At the initial evaluation, the patient demonstrated severe muscle weakness, cognitive impairment, delirium, and elevated anxiety and depression, significantly reducing quality of life (QOL). Following rehabilitation, muscle strength and cognitive function improved and delirium resolved. QOL gradually improved, reaching pre-hospital levels at 7 months. The patient was able to return to work after 8 months. Mental health also improved, corresponding with enhanced social participation, as indicated by the community integration questionnaire.

Conclusion: This case highlights the importance of early and sustained OT in addressing recovery challenges of severe COVID-19 survivors. OT, including vocational assessment and individualized support, facilitated social participation and improved QOL. Although generalizability is limited, this report underscores the potential of OT in optimizing long-term outcomes for severe COVID-19 survivors.

Objective: This study investigated the effect of the timing of occupational therapy initiation during the acute phase of stroke on patient recovery.

Methods: This retrospective study with a 2-week observation period included 216 patients who experienced stroke and underwent rehabilitation during hospitalization at our institution. Patients were classified as the early group (began occupational therapy 1 day after stroke onset) or the late group (began therapy 2 days or later after stroke onset). This classification was based on the limited number of occupational therapists at our institution, where therapy is initiated 1 day after stroke onset if that day is a weekday (Monday through Friday); however, therapy for new patients is suspended on weekends (Saturday and Sunday) and holidays. As a result, the classification of patients into early and late groups was influenced by the patients' admission dates, resulting in some degree of randomization. Baseline characteristics were balanced using propensity score matching, and outcomes were compared at 2 weeks using the Mann-Whitney U test. The primary outcome was the change in the activities of daily living (ADLs) performance. The secondary outcome was the ADLs performance at 2 weeks.

Results: The early group exhibited a significantly greater change in the ADLs performance compared to that of the late group (p = 0.036). Additionally, compared to the late group, the early group exhibited significantly better ADLs performance at 2 weeks (p = 0.049).

Conclusion: Earlier initiation of occupational therapy during the acute phase of stroke may positively influence patient recovery.

Introduction: Illness Management and Recovery (IMR) is expected to be an effective strategy to support the recovery of clients with personality disorders, but its effective implementation for clients with avoidant personality disorder (AvPD) is unknown. In this study, we outlined the IMR modules combined with interviews focused on occupational dysfunction to facilitate recovery.

Methods: The study consisted of two courses of IMR with a client with AvPD who was reluctant to participate in treatment. The recovery process was assessed using the Recovery Assessment Scale (RAS), and interviews were conducted to share difficulties in daily life using the Classification and Assessment of Occupational Dysfunction (CAOD). In this study, only two IMR modules were performed on the following themes: “Recovery Strategies” and “Coping with Stress.”

Results: RAS scores increased throughout the study, indicating his recovery process was facilitated. The CAOD scores increased during the interview before the overnight stay. However, they improved at the end of the occupational therapy intervention, when the patient was anxious but hopeful toward discharge and maintained a recovery orientation.

Conclusion: The IMR modules combined with interviews focused on occupational dysfunction for the client with AvPD led to increased recovery orientation and hope for life after discharge. The IMR module support for this client provided basic information for considering support strategies for recovery and improving occupational dysfunction in clients with AvPD.