We conduct a wide variety of rehabilitation programs for patients with cognitive disorders. Patients have often presented decreased levels of awareness, associated with decreased levels of motivation, while participating in rehabilitation activities. To define the goal of a horticultural rehabilitation program, we developed two tables associating cognitive functions, contents, and difficulty levels of the rehabilitation tasks performed by the patients. Table 1 demonstrates a task construction combining specific body and cognitive functions needed to perform the specified task. Table 2 classifies a task according to the difficulty level of each process involved. The processes listed in Table 2 are hierarchically divided into four functions: (1) attention and information processing, (2) memory and executive function, (3) upper limb and finger function, (4) lower limb and balance function. After applying these tables to a rehabilitation program, the level of awareness of one individual gradually increased. Using this program, a new goal was set for this patient, ultimately allowing him to rehabilitate himself into the community. These findings showed that these tables, which aim to help visualize cognitive and motor information, were useful in creating opportunities for self-feedback. This method was effective in improving self-awareness and determining the patientʼs personal limitations, and helped understanding of the purpose of the rehabilitation.
We administered a semantic association judgment test to patients with aphasia, and investigated their semantic processing. The subjects were 35 aphasics and 10 healthy individuals (control group). Each participant was instructed to select one item that was the most related to the target item from five choices. We controlled the semantic relationship between the choices and the target item. For example, when the target was “dog,” one item related to both situation and category (SC: “cat”), one related only to situation (S: “house”), one related only to category (C: “elephant”), and the others did not relate to either situation or category (N1 and N2: “bream” and “eraser”). The results showed that the responses by the patients with aphasia were more varied than those by the controls. The number of N1 and N2 responses was significantly larger in the patients with aphasia than those by the controls. The proportion of related items in the subgroup of mild aphasia (good auditory comprehension group) was significantly higher than that in the subgroup of severe aphasia (poor comprehension group). These results suggest that there are functional associations between non-verbal semantic processing, and severity and auditory comprehension in patients with aphasia.
In this report we presented a case of semantic category-specific deficits accompanied by alexia and agraphia of kanji after herpes simplex encephalitis. We found that the subject tended to make numerous errors that share the same category and same number of moras, especially for living items. Learning names of tools improved rapidly, but corresponding progress was not seen in naming of living items. We attempted to improve naming of living items using materials that present the character indicating the initial sound of each target word together with their picture as the phonetic cue. The results revealed improved in performance on all naming tasks, and improvement was sustained even after improved removing the phonetic cues. Based on the result of rehabilitation for confrontation naming with phonetic cues and assessment of the subjectʼs errors, we concluded that his problems were caused by weak interaction between the semantic level and phonetic level in lexical access, with differentiation in semantic systems according to category.