Asian Journal of Occupational Therapy
Online ISSN : 1347-3484
Print ISSN : 1347-3476
ISSN-L : 1347-3476
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Showing 1-13 articles out of 13 articles from the selected issue
ORIGINAL ARTICLE
  • Yuji Nakamura, Shingo Umeda, Yuta Nakaya, Sonomi Nakajima, Yasuhito Se ...
    2021 Volume 17 Issue 1 Pages 1-8
    Published: 2021
    Released: March 18, 2021
    JOURNAL FREE ACCESS

    Objective: To examine the effects of a movable seat surface with forward tilting and forward locomotion mechanisms from muscle activation time and anticipatory postural adjustment of the trunk and lower limbs in the forward reach task.

    Methods: There were 15 healthy adults, and the muscles to be examined were the deltoid muscles, which are the main muscles for reach movement, as well as the left and right external oblique muscles, the left and right erector spinae muscles, and the left and right rectus femoris muscles. The subjects performed a forward reach task using a fixed and a movable seat surface, that was created, and the examiner analyzed the reach time and the start time of each muscle activity.

    Results: The reach time did not differ between the two conditions, but the start time of the erector spinae muscle was later than that of the other muscles in the movable condition. Anticipatory postural adjustment associated with reach task was not confirmed.

    Conclusion: It was suggested that the movable seat surface enhances the stability of the trunk movement at the beginning of the reach movement and contributes to the reach movement with less sway of the center of gravity.

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  • Kohei Kusuda, Rumi Tanemura
    2021 Volume 17 Issue 1 Pages 9-16
    Published: 2021
    Released: March 18, 2021
    JOURNAL FREE ACCESS

    Background: While many studies research factors that affect Instrumental Activities of Daily Living after stroke, few studies research factors that affect domestic chores after stroke. This study aims to investigate factors that affect domestic chores after stroke.

    Methods: In this cohort study, 29 stroke patients were followed from the time they entered the rehabilitation ward to one month after discharge. Participants were included if they had been independently doing domestic chores before stroke onset and were independently walking inside the hospital after stroke onset. Variables were selected from demographics, physical function, cognitive function, psychological function, and functioning. The Spearman correlation between the domestic chores score of the Frenchay Activities Index (FAI) after stroke and variables was calculated.

    Results: The Timed Up and Go test (r = 0.41, p = 0.03), the Stroke Self-Efficacy Questionnaire (r = 0.54, p < 0.01) and the Functional Independence Measure motor domain (r = 0.57, p < 0.01) were significantly associated with the domestic chores domain of the FAI. Unlike previous studies, cognitive function and depression also didn't show a statistical relationship with domestic chores after stroke.

    Conclusion: Our results show that stroke patients should improve their self-efficacy to resume domestic chores after stroke, in addition to physical and cognitive functions. The results are also consistent with previous studies about the research relationship between self-efficacy and functioning.

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  • Sho Maruyama, Satoshi Sasada, Yohei Jinbo, Peter Bontje
    2021 Volume 17 Issue 1 Pages 17-25
    Published: 2021
    Released: March 18, 2021
    JOURNAL FREE ACCESS

    Introduction: Acquiring competence in clinical reasoning is regarded as key to meet the challenges of integrating knowledge into one's practice. Learners and educators need a shared understanding of what is clinical reasoning because they need appropriate means for reflection and feedback. However, the clinical reasoning concept needs revisiting in the current context, which is becoming increasingly diverse and complex. The purpose of this study was to analyse the clinical reasoning concept and develop a common framework.

    Methods: Rodgers' concept analysis was selected for this theoretical study. Accordingly, a systematically search of multiple databases yielded 903 articles and 135 articles that met the inclusion criteria were extracted, and of these 30 articles randomly sampled for analysis. Data analysis was done following Rodgers' method of thematic analysis.

    Results: The attributes were four ‘therapeutic thinking processes’ and two ‘professional thinking skills.’ The application contexts were ‘clinical and non-clinical practice settings,’ and ‘professional education.’ Moreover, the antecedents were ‘professional factors’ and ‘practice factors,’ and the consequences were ‘professional developments’ and ‘professional attitudes and behaviours.’

    Conclusion: The resulting framework of clinical reasoning can be the basis for developing pedagogies and assessment of clinical reasoning competence acquisition.

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CASE REPORT
  • Masahiro Tanaka
    2021 Volume 17 Issue 1 Pages 27-30
    Published: 2021
    Released: April 09, 2021
    JOURNAL FREE ACCESS

    Visual agnosia is a rare symptom in which the patient cannot recognize objects by visual perception. We report a case of integrative visual agnosia and memory disorder. A 70-year-old, right-handed man was diagnosed with cardioembolic stroke affecting the proximal left posterior cerebral artery. He had a short-term memory disorder. He could not name and explain how to use objects, or read characters, but could discriminate between objects to some extent and draw copies of simple figures. His recognition by tactile sense was comparatively preserved. He needed complete assistance with his life in the hospital ward. We provided him with training using preserved tactile sensation by errorless learning. We arranged the environment around him to promote his memory of the position of objects and to avoid misuse of daily objects. Improvement in the visual agnosia and memory disorder was slight. He became independent with his life in the hospital ward. However, he needed assistance in a new environment, such as an unfamiliar lavatory. The results suggest that a patient with visual agnosia may become independent early by appropriate training, despite insufficient visual perception and memory function. In our patient, the intervention period was too short to generalize the effects of training. Additionally, the memory disorder might have become an obstacle for generalization. Further improvement in visual perception, independence in daily activities, and quality of life, will need continuous support.

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  • Kazuo Saito, Maki Koyama, Atsuko Ishida, Toshiko Futaki
    2021 Volume 17 Issue 1 Pages 31-35
    Published: 2021
    Released: April 23, 2021
    JOURNAL FREE ACCESS

    Purpose: The objectives of this study were to quantitatively analyze the reaction patterns of ataxia and Parkinson's disease cases that are cognitively harmless and to examine the characteristics of pathological reactions, such as ataxia, rigidity, and motor control, compared to the patterns of a healthy subject.

    Methods: An eye–hand coordination pointing with pencil test (EHCPPT) app was developed that requires patients to tap a bullseye target with a pencil for screening testing. This app is intended to be used during regular check-ups of the elderly to help them maintain their home lifestyle through self-management of health. The EHCPPT consists of two tasks, both of which require the patient to tap a bullseye target as a test of eye–hand coordination in response to a stimulus sound. In one task, the sound is repeated rhythmically; in the other, it is generated irregularly and infrequently. The EHCPPT app is based on the “oddball paradigm” experimental design and can be administered in just a few minutes to measure the time lag between the sounds and taps as well as the distance between the target and tapped locations automatically.

    Results: The data generated when the app was used by a healthy subject, an ataxia patient, and a patient with Parkinson's disease were analyzed. In each case, the data exhibited a distinctive pattern.

    Conclusion: The EHCPPT app is simple and fast and shows potential as a screening test.

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ORIGINAL ARTICLE
  • Kimiko Shibata, Hirokazu Nishikata, Sayoko Kawabata, Hiroko Miyadera, ...
    2021 Volume 17 Issue 1 Pages 37-44
    Published: 2021
    Released: April 19, 2021
    JOURNAL FREE ACCESS

    Purpose: This study explored the effectiveness of a new parent-child social skills training program addressing social skills and parenting stress among children with developmental disabilities and their parents.

    Methods: Participants were 15 children (14 boys, 1 girl; 7-9 years old) with diagnoses related to developmental disability and a Full Scale IQ ≥ 70 and 17 parents (2 fathers, 15 mothers; 34-51 years old). Each session of this program lasted 110 minutes and occurred every 1-3 weeks for about 2 months. Social skills were measured by self-evaluation (Social Skills Scale for Elementary School Children, Social Skills Self-Rating Scale for Adults: SS-A), information provider's evaluation (Vineland Adaptive Behavior Scales, Second Edition, Japanese version: VABS-II), and practitioner's evaluation (Role-Play Test for Children and Parents: RPT-CP), and parenting stress was measured with the Parenting Stress Index (PSI) before, immediately after, and at a 3-month follow-up after intervention.

    Results: VABS-II scores were significantly lower after the intervention (z = −2.58, p = .011, r = −.65). Children's RPT-CP scores also improved (z = 1.705, p = .08). The scores on SS-A, parents' RPT-CP, and PSI improved significantly at follow-up (z = 2.832, p = .005, r = .71; z = 2.91, p = .004, r = .71; z = −2.34, p = .019, r = −.57), and parents' RPT-CP scores were significantly higher at follow-up than post-intervention (z = 2.333, p = .02, r = .58).

    Conclusions: This program effectively improved parents' social skills after the intervention, and parenting stress decreased at follow-up.

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  • Kyohei Fujii, Masayoshi Kobayashi, Koji Funasaka, Suguru Kurokawa, Koj ...
    2021 Volume 17 Issue 1 Pages 45-52
    Published: 2021
    Released: April 19, 2021
    JOURNAL FREE ACCESS

    Objective: This study aimed to explore the efficacy of metacognitive training (MCT) with long-term hospitalized patients with schizophrenia.

    Methods: Patients admitted to a hospital's long-term care ward were randomly allocated to Groups A or B, and a crossover trial was performed. As intervention, 16 weekly MCT sessions were performed for 4 months as part of standard occupational therapy, and the participants' cognitive functioning, psychiatric symptoms, overall functioning, and cognitive bias were assessed at baseline, 4 months later, and 8 months later.

    Results: Twenty-two patients participated. Those who were discharged midway through the course, and those who withdrew their consent were excluded, and 17 individuals (Group A: n = 9; Group B, n = 8) completed their assessments 8 months later. No significant differences were seen in inter-group comparisons of the scores of various scales at the baseline. Four months and eight months later, a comparison between before and after MCT showed improvement tendencies for both groups in the participants' cognitive function and psychiatric symptoms. A comparison of scores before and after the MCT intervention period, from all participants, showed significant improvement tendencies in their verbal memory and attention.

    Conclusion: MCT can be used for long-term hospitalization in patients with chronic-stage schizophrenia, and this study showed its potential to improve neurocognitive function. Going forward, there is a need to increase the sample size and examine the efficacy of MCT in more detail.

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RAPID COMMUNICATIONS
  • Kazuki Yokoyama, Shigeya Yabe, Takafumi Morimoto, Nozomu Ikeda
    2021 Volume 17 Issue 1 Pages 53-56
    Published: 2021
    Released: June 04, 2021
    JOURNAL FREE ACCESS

    Purpose: This study determined the relationship between having an emotional peer support network (i.e. people experiencing similar mental health difficulties) and aspects of subjective recovery in people with mental illness.

    Methods: In total, 37 participants with mental illness living in the community were divided into high/low emotional peer support groups using the Emotional Support Network Scale. Subjective recovery was evaluated using the Recovery Assessment Scale (RAS). Total and individual factor scores of subjective recovery between the two groups were compared with an unpaired t-test, and effect size were calculated.

    Results: Participants were categorized into high (n = 18) and low (n = 19) emotional support (ES) network groups. For demographic and clinical characteristics and the total score of RAS, the groups had no significant differences. However, high ES was significantly higher in “no domination by symptoms” and “willingness to ask for help”, showed medium effect size.

    Discussion: People with high levels of emotional peer support felt less affected by symptoms and were more willing to ask for help, which affected their recovery. This result reflects elements of peer support, like using experiential knowledge and recovery role models. In occupational therapy, emotional support among clients through group therapy and environmental adjustment is critical for recovery.

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ORIGINAL ARTICLE
  • Ivan Neil Benitez Gomez, Pauline Grace G. Morato-Espino, Cynthia YY La ...
    2021 Volume 17 Issue 1 Pages 57-63
    Published: 2021
    Released: July 10, 2021
    JOURNAL FREE ACCESS

    Children's ability to adequately process sensory information from their environments contribute to the development of self-regulation. The increasing prevalence of sensory processing difficulties in both clinical and normative childhood population underscores the need for assessment. However, in the Philippine context, there is no cross-culturally validated tool that measures sensory processing and self-regulation among children. Both language equivalency and cultural-relevance should be addressed when translating health-related outcomes. In this study, the accuracy of linguistic equivalency and cultural relevance of the Tagalog version of the Sensory Processing and Self-Regulation Checklist (SPSRC) was validated. Using a multi-step process of forward translation, equivalence of translation testing, backward translation, face, and content validation, and cross-cultural adaptation inquiry, the SPSRC-Tagalog was examined. Adaptation of colloquial English terms was incorporated, and several items whose examples were deemed not culturally relevant were modified to reflect the language and culture it is intended for. The findings in this study support the linguistic equivalency and cultural-relevance of the SPSRC-Tagalog as a single measure of sensory processing and self-regulation abilities of Tagalog-speaking Filipino children that can be used by Filipino occupational therapists. Future studies should further examine its psychometric properties in the target population.

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CASE REPORT
  • Masato Sato, Yukio Mikami, Yoji Asakura, Kiya Katayama, Fumihiro Tajim ...
    2021 Volume 17 Issue 1 Pages 65-68
    Published: 2021
    Released: July 30, 2021
    JOURNAL FREE ACCESS

    Introduction: Patients with autism spectrum disorder (ASD) may present with problems related to eating behaviors, including unbalanced diet, attention disruption, and poor tool manipulation. These problems are attributed to the widespread sensory processing abnormalities associated with ASD. Therefore, it is important to consider interventions and support for eating behaviors in patients with ASD that address these sensory processing problems. However, to date, no studies have investigated interventions to aid eating behaviors in this population. Here, we describe an action-based intervention to promote food ingestion in a young adult with ASD.

    Methods: An A-B method with a single-system research design was implemented, with three main outcome measures: goal attainment scaling (GAS), time required to eat, and functional independence measure (FIM). Following baseline measures, the intervention was based on changes in eating actions and consisted of two phases. In Phase I, the eating environment was adjusted. Phase II supported the manipulation of eating tools in addition to environmental adjustments.

    Results: The eating action changed from needing complete assistance with eating to her own manipulation of eating tools and the ability to ingest food orally. The time needed for eating was reduced, while the GAS and FIM scores both improved.

    Conclusion: The organization of the environment promoted eating, while the manipulation of eating tools promoted the flow of actions. When a person with ASD has eating difficulties, it is suggested that manipulating the eating tools may be useful to promote oral ingestion in addition to environmental adjustments.

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ORIGINAL ARTICLE
  • Akira Sagari, Takayuki Tabira, Michio Maruta, Hironori Miyata, Takashi ...
    2021 Volume 17 Issue 1 Pages 69-77
    Published: 2021
    Released: September 15, 2021
    JOURNAL FREE ACCESS

    Background: Japan has become a super-aged society, resulting in an increased number of insurance certifications for long-term care needs. This study aimed to identify the effects of daily living activities on changes in certification among older persons with support needs classified by cognitive function.

    Methods: The sample, sourced from the 2014 and 2016 Japanese long-term care insurance certification surveys, consisted of 6,219 individuals with support needs. Logistic regression analysis was performed to identify activities of daily living (ADL) associated with certification changes. Separate logistic regressions were performed to predict certification changes based on participants' cognitive functioning.

    Results: Regarding levels of cognitive functioning, ADL associated with certification change among the highest functioning individuals were bathing, nail trimming, mobility, managing money, and decision-making ability. At the next level of functioning, the activities included bathing, toilet hygiene (urinary), taking prescribed medications, managing money, decision-making ability, and preparing meals. At the lowest level of functioning, only managing money was associated with a certification change.

    Conclusion: ADL affecting certification change varies with the level of cognitive functioning. Thus, managing money was considered to be the most important activity as it influences change in certification in all cognitive categories. When occupational therapists create interventions for older persons with support needs, they should use IADL abilities such as managing money, which requires complex cognitive functions, from an early stage. This may lead to the reduction of the need for care in older persons with support needs.

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CASE REPORT
  • Masato Sato, Atsuko Shiosaki, Yoshiki Samoto, Ryo Yoshimura
    2021 Volume 17 Issue 1 Pages 79-82
    Published: 2021
    Released: September 15, 2021
    JOURNAL FREE ACCESS

    Introduction: Diplopia due to restricted eye movements makes it difficult to locomote. There are no reported therapies that overcome the locomotion difficulties of patients with oculomotor nerve palsy after a stroke. We outline a therapy process conducted by an occupational therapist (OT) that combines ptosis therapy and the treatment of impaired eye movements with exploratory activities for locomotion that enabled the patient, a Japanese woman in her 70s, to improve her engagement in daily activities.

    Methods: The OT therapy consisted of two phases. Phase I: Ptosis and eye movement interventions were performed. Phase II: Interventions supported locomotion that linked visual exploration and the somatosensory system, and the experienced locomotion was adapted to the environmental structure. The outcomes for the intervention effects were the degree of ptosis, eye movement and diplopia, gait functions, and a functional independence measure for activities of daily living.

    Results: The patient's ptosis and eye movement disorder improved, and the difficulty of locomotion due to diplopia was overcome. She was thus able to become independent in all daily activities.

    Conclusion: Therapy that combines interventions for ptosis and eye movement with exploratory activities supporting locomotion have overcome locomotion difficulties and improved the outcomes of patients with oculomotor nerve palsy. Current interventions may improve locomotion in post-stroke patients with oculomotor nerve palsy. Our findings led us to hypothesize that locomotion difficulties in patients with diplopia due to oculomotor nerve palsy can be overcome by combined therapy for ptosis and eye movements with support for exploratory action in locomotion.

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ORIGINAL ARTICLE
  • Akira Teramura, Kosuke Hamada, Seiji Yamamoto
    2021 Volume 17 Issue 1 Pages 83-89
    Published: 2021
    Released: December 16, 2021
    JOURNAL FREE ACCESS

    The purpose of this study was to analyze the current status and challenges related to social participation faced by people with intellectual disabilities living in rural areas in the Philippines. Semi-structured interviews were conducted with 10 professionals, including nurses of public health center, social workers of nonprofit facility for persons with disabilities, and teachers of public and private special needs schools. The study was approved by the Graduate School of Human Sciences, Osaka University. The results indicated five categories and 21 subcategories. The five categories are: Current status of social participation of people with intellectual disabilities in rural areas; Interventions performed by rural professionals for people with intellectual disabilities; Improved activities of people with intellectual disabilities owing to study participants' interventions; Recognition of hindrances to promote social participation; Recognition of the ideal social participation for people with intellectual disabilities. Based on the current conditions, there were challenges in leisure activities and employment, especially for adults with intellectual disabilities. Our findings suggest it is important for Philippine occupational therapists and those working in international organizations to conduct occupation analysis for understanding the backgrounds, strengths, limitations, concerns, and goals for their leisure activities and employment. In addition, occupational therapists can contribute not only to providing individual support but also to the development of community supporters.

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