Dear colleagues,
It is my honor to hold the workshop “Biophilia 2016” to enforce the RCT of the Passive exercise vs the Motivative exercise. And we hold the Workshop “BIOPHILIA 2016” as an opportunity to acquire the newest knowledge of the rehabilitation medicine by ISPRM and to prepare the clinical test, the randomized control trial (RCT).
Although Prof. Newton discovered universal gravitation from the apple drop, we, as me a leader have continued research to sublime Ms. Kyoko Takizawa's experience which I had found to a science. We have used expression called Proposition from Experience until now. I held IBRC 2015 as a chair entitled “Experience to A Science” for the first time last year. This is an expression used by the research of a cerebral function including plasticity progressed and the RCT of Motivative exercise versus Passive ROM Exercise which was a subject since the year before becomes possible.
We are glad to hold the meeting showing as the result of our previous endeavor. The RCT is indispensable, in order to restructure the rehabilitation medicine to the medicine which diversifies the intervention technique and can realize "Overcome disabilities” from "acceptance of disabilities ", and in order to sublime experience to a science. I have received some questions from the doctor who expressed enforcement. About RCT, I perform adjustment with each country and Professor Suputtitada who is a Chairperson of Women and Health Task Force of International Society of Physical and Rehabilitation Medicine (ISPRM) and International Exchange Committee of ISPRM and I adjust enforcement at the workshop this time. I hope it will be a science committee for the RCT study.
We perform the arrangement related to the research of following matters besides lectures in the Workshop;
1.How many days to do the Motivative exercise at one week?
2.How much time one session?
3.Concerning the age of the patient, how many patient can work with one physiotherapist?
4.How many devices can IBRA provide?
5.The matter of the clinical study registration.

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Falls are a common problem in the elderly. A common error in their management is that injury from the fall is treated, without finding its cause. Thus a proactive approach is important to screen for the likelihood of fall in the elderly. Fall assessment usually includes a focused history and a targeted examination. The healthcare costs of falls (hospitalization, surgery, rehabilitation, equipment, home health services, and institutionalization) are really costly. The emotional, physical, and personal costs to the individual are even higher. Most falls could be prevented by a vigilant physician anticipating, assessing, and correcting fall risks, which may be medical, mechanical, or environmental. The impact of chronic disease and medication, balance and gait, and home risks should be assessed routinely. Balance and gait should be evaluated in clinical practice with the Timed Up and Go test. Balance only can be evaluated in clinical practice with One Leg Stance Test, Functional Reach Test, Rhomberg Test and Tandem Walk Test. Balance and gait should be comprehensive evaluated in research with Berg Balance Scale, Tinetti Balance and Gait test. The test results will indicate areas of further investigation. Fall prevention through proper assessment and intervention will not only decrease morbidity and mortality, but will also help maintain patient independence and quality of life. There are several balance and gait tests in researches as Berg Balance Scale, Tinetti Balance and Gait test with highly specificity to fall. The proper selection of balance test will enhance the objective of the research. Optimization of balance test both in clinical practice and in research will increase efficacy of walking, promote fall prevention and improve quality of life.

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I show some of the previous researches on the effect of the introduction. It is my honor to become data of the debate about RCT. I introduce the Takizawa method rehabilitation first. We evaluated the change of the degree of independent living which was officially defined in Japan which evaluates the grade of the life independence by Takizawa method introduction and showed clearly that the introduction was significantly effective. Moreover, we clarified improvement in the capability of the walk and toilet by the introduction. Furthermore, we carried out the RCT of the existing rehabilitation method between the Takizawa method rehabilitation at the nursing home for the elderly once. I will introduce all for the RCT of the Motivative exercise versus Passive ROM Exercise.

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One physical therapist (PT) gives exercise at rehabilitation. We call the exercise “passive exercise”. Since most of stroke patients become hemiplegia patients, they can perform the exercise operating devices by the healthy side. We call this system “motivative exercise”. In this report, the difference of effectiveness between passive exercise and motivative exercise are shown by brain function measurement. Activating sites in brain are measured by fNIRS through both exercises.

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In the chronic stages of aging or illness, less staffs are employed in both medical and care faculties in Japan than acute stages. This situation might have the unexpected risk of many patients returning to bedridden states easily. We have recognized "The Motivative Exercise" very useful to solve this problem. In this Exercise, we use simple tools instead of therapists' hands to exercise their legs by themselves. We project to prove the effectiveness of this rehabilitation method by f MRI to observe brain activities during Motivative exercise.

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It is a great pleasure and an honor to host the workshop of International Biophilia Rehabilitation Academy (IBRA) in Keio University, on April 28, 2016. I am Toshiyuki Tanaka, with the Faculty of Science and Technology at Keio University, which is a long-established private institution founded in Japan in 1858 by Yukichi Fukuzawa. Keio University is well known to researchers worldwide for the students and professors who produce high-quality research. Keio University has a School of Medicine and University hospital, which provides the highest quality specialized medical treatment in Japan. Moreover, School of Medicine in Keio University has the rehabilitation unit with the highest level in Japan. School of Medicine is a great partner of School of Science and Technology, and the collaboration of both schools makes a worldwide remarkable accomplishment in researches. And many students and researchers in Keio University are interested in the study and medical treatment of rehabilitation.
My research field is pattern measurement, including medical image processing and computer-aided diagnosis. In recent years, hospitals have seen increases in the number of patients, in step with the aging of the population. Following advances in medical devices using techniques such as fMRI, fNIRS, and X-ray CT to support the work of doctors, the precision of diagnosis has risen markedly. However, it seems that the burdens on doctors have not lessened. To reduce these burdens, we are developing a diagnosis support system using medical image processing.
In this workshop, IBRA invites Professor Areerat Suputtitada from Chulalongkorn University, Thailand. She is a chairperson of neurorehabilitation research unit at Chulalogkorn University, chairperson of excellent center for gait and motion at King Chulalongkorn Memorial Hospital, Bangkok, Chair of ISPRM Women and Health, and ISPRM international exchange committee. We are greatly pleased that professor Areerat Suputtiada to deliver lecture of her study in Keio University. Through a workshop and research exchange, we hope that the workshop will provide the opportunity to introduce important innovations in the field of the rehabilitation.

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