"Revolution of Hope on Re-acquirement of Ability by Rehab. Medicine Innovation"

10-11 Oct. 2017

In Riga, Latvia

Hosted by;

International Biophilia Rehabilitation Academy

Riga Stradins University

Biophilia Rehabilitation Academy of Japan

Supported by:

Embassy of Japan in Latvia

Japanese Society for Rehabilitation of Persons with Disabilities

Japanese National Foundation, Association for Technical Aids

Chairperson of the workshop BIOPHILIA 2017 in Riga

Prof. Gunta Ancane

Head of the Department of Psychosomatics and Psychotherapy, Riga Stradins University

President Anda Nulle

President of Latvian Association of Rehabilitation Physicians

Chair of the Board National Rehabilitation center “Vaivari”, Latvia

Dean, Signe Tomsone

Dean and Associated professor of the Faculty of Rehabilitation, Riga Stradins University

Prof. (Taki) TAKIZAWA, Shigeo, (Founder / Inventor) Biophilia Institute, The Designated and Registered Institute by the Japanese Ministry of Education, Culture, Sports, Science and Technology President, International Biophilia Rehabilitation Academy

Workshop BIOPHILIA 2017 in Riga at glance

The 14th International Biophilia Rehabilitation Conference - IBRC

Workshop BIOPHILIA 2017 in Riga

Tuesday (10.10.2017)

Place: Riga Stradins University, Kristapa Iela 30

Press Conference

11.00– 11.20 Prof. TAKIZAWA. Shigeo Welcome speech

11.20 - 11.40 Prof. Gunta Ancāne

Wednesday (11.10.2017)

The 14th International Biophilia Rehabilitation Conference - IBRC

Workshop BIOPHILIA 2017 in Riga

9.00 – 9.15 Registration and reception

9.15 – 10.00 Welcome

· Prof. Gunta Ancane - Head of the Department of Psychosomatics and Psychotherapy, RSU

· Prof. Shigeo Takizawa - Biophilia Institute, Japan

· Dr.Anda Nulle - Chair of the Board National Rehabilitation center “Vaivari”, Latvia

President of Latvian Assotiation of Rehabilitation Physicians

· Dean and Assoc. prof. Signe Tomsone - Faculty of Rehabilitation, RSU

· Representative of the Embassy of Japan in Latvia

10.00 – 10.20 (Taki) Shigeo Takizawa - Biophilia Institute

To Shape the New Civilization, which does not make the Increase in Elderly a Negative Factor

10.20 – 10.40 Toshiyuki Tanaka - Keio University

Prospective Rehabilitation System in the Declining Birth Rate and the Aging Society

10.40- 11.00 Yoshiko Morita - Department of the rehabilitation Medicine, Okayama rehabilitation hospital

Explanation of the Takizawa Method and Motivative Exercise

11.00 – 11.20 Rika Wada - Tachibana orthopedic Hospital Rehabilitation Canter

The Reality of my Facility to Introduce Takizawa Method and Motivative Exercise

11.20 – 11.40 Discussion

11.40– 11.55 Coffee break

11.55 – 12.15 Kiyoshi Morita - ex-President of the Okayama University

Practice of Advanced Medical Research of the Okayama University (National)

12.15 – 12.45 Hiroshi Nagasawa - Shonan Iryo University

Physical therapy strategies to prevent sarcopenia and frailty for Japanese elderly people

12.45 – 13.05 Mieczyslaw Pokorski. Memory function: A clinical perspective

13.05 – 13.35 Discussion group about the future collaboration

I am happy and honored to welcome prof. Takizawa and his colleagues from Japan and the colleagues from Poland in Latvia, in Riga Stradins University. We here in the Department of Psychosomatics and psychotherapy are very interested in the issue of healthy aging. We are convinced that older people must be able to access fully the services they are entitled to, and everything they need should be available to them. To help older people lead more independent lives, which in turn helps maintain good health, is highly important. The maintenance of optimal mental and physical well-being and function in older adults is most likely to be achieved when physicians have good knowledge and skills to help. Especially we would like to stress the importance of mental health in the healthy aging process. As we know from WHO statements, that mental health is crucial for maintaining somatic health.

It is unrealistic for us to expect that elderly people will not have diseases. We can however strive for that they enjoy a high quality of life. Therefore we are excited that prof. Takizawa is here in Riga presenting his "Takizawa's method".

It is my honor to extend a heartfelt greeting in holding the workshop BIOPHILIA 2017 in Riga named the pearl of the Baltic Sea, the city of famous Hanseatic League as a president of IBRA.

I express my profound gratitude to Professor Gunta Ancane who agreed this workshop holding readily.

I express my heartfelt greeting to Dr.Anda Nulle, Chair of the Board National Rehabilitation center "Vaivari" and Latvia and President of Latvian Assotiation of Rehabilitation Physicians and Dr. Signe Tomsone, Dean and Assoc. Professor of the Faculty of Rehabilitation, RSU who welcome our visit.

Aging proceeds globally. And the elderly with disabilities are increasing more and more in the world. The problem of mental health has also expanded. Then their life is threatened.

The World Health Organization (WHO) and the International Society of Physical and Rehabilitation Medicine (ISPRM) established the research organization for the disabilities with a shared sense of crisis. The head of the woman and health committee of the ISPRM took the lead to hold the workshop 2016 in Tokyo under such a situation, and it was held. And it is also true that it led to IBRC2016 holding with the WHO participation with the help of the Japanese Health, Labour and Welfare Ministry.

Our research is in the middle of a way, and this shows that it is necessary to advance further research with new researchers. I am expecting holding of this the workshop BIOPHILIA 2017 in Riga leads to the expansion of development of research, and also the improvement in the welfare of the human beings who enabled longevity attained.

Now, I explain why I wanted to hold BIOPHILIA workshop here in Riga. The philosophy of free and equality were borne by the French Revolution in the 18th century. This concept spread with Napoleon's victory. Napoleon's wave reached to Lisbon in the south and reached here Riga in the north. The Napoleon Imperial Government was pushed down by defeat in Lisbon and Riga. However, by having been pushed down, the philosophy of free and equality became a norm in the world. I visited Torres Vedras, Lisbon at the time of the IBRC 2014 in Sevilla holding. And now, I visit here Riga in Latvia called the pearl of the Baltic Sea in the city of famous Hanseatic League.

Today the world civilization has reached the era of demographic transition. And the era has become the time when human beings' happiness is not enough only with the concept of freedom, equality, and friendship.

The Takizawa method rehabilitation centering on a motivative exercise a core implement shows the high efficiency of the functional recovery. The supplementary examination, RCT, and a mechanism elucidation are called for, in order to make it the useful intervention technique to human beings. I would like to study such research with you at this opportunity. It shows that our joint study affects the paradigm shift in the rehabilitation medicine which is “acceptance of disability" to "overcome disability."

We hold the BIOPHILIA workshop in Riga. Now as I expressed, it gives the human beings a chance to establish the new civilization enabling to develop the sustainable super-aged society, which is configured the philosophy of free and equalityand the overcome disability.

In closing, I expect that the significant Riga workshop will be a fruitful meeting for all of the participants.

Good morning,Dear professor Takizawa, dear professor Ancane, dear guests from Japan, dear colleagues, ladies and gentlemen!

It's a great pleasure for me to be here in the opening ceremony of the international conference of Biophilia. It is wonderful to open the mind to new knowledge and experience.

I bring greetings and good wishes from Jurmala, from National rehabilitation center “Vaivari” and from all rehabilitation physicians of Latvia.

As a President of Latvian association of rehabilitation physicians, I would like to note the importance of the healthy aging concept in rehabilitation medicine.

The short version of the definition of Rehabilitation medicine: ”

The use of all means aimed at reducing the impact of disabling conditions to achieve optimal social integration and quality of life.”

And it means we have to work all together with different methods to achieve better results and better functioning and better quality of life.

I wish you interesting, fruitful day during Conference and nice time in our beautiful country.

I am sure that we can use together with our minds for the best solution in our everyday work with patients.With that, I wish you an excellent Conference ahead.

Thank you.

Dear participants of the 14th International Biophilia Rehabilitation Conference of BIOPHILIA 2017!It is well-known tendency that people around the world live longer. Besides the positive aspects of longer life, older age also can be related to functional decline, need of assistance and social isolation. The aim of rehabilitation is to enable people with disabilities to reach and maintain their capacity and it means that principles of rehabilitation could be applicable for older people. It is a challenge for society to find the optimal ways to support healthy aging and facilitate the sense of good life among older people. I think it is very important to search for good practices and learn from experiences around the world. Therefore, today I am very excited to welcome prof. Takizawa and his colleagues from Japan and the colleagues from Poland, to learn more about their research and practice in the field of rehabilitation for older people.I wish an interesting and inspiring day for everyone!

It is my pleasure to say “Hello” to Riga people because to visit Riga have been my long dream.

The foundation of current civilization is composed by the philosophy of free equality. It was established by the Code civil, called Code Napoleon.

This concept is diffused with together the wave of Napoleon in Europe. And it became the universal Value by stopping it at the Riga front and Lines of Torres Vedras in Portugal.

It is the reason that I have dreamed visiting Riga for a long time. And the Latvian history has said “The modernization that began after the defeat of Napoleon benefited the whole Europe” about it.

Human beings gain longevity all over the world and have faced the new situation as the super-aged society which cannot be maintained in the current civilization.

I have appealed the necessity of changing the concept of “acceptance of disability” of the Rehabilitation medicine.

I explain systematization of the previous research and contents for this realization in my keynote address. Our systematic research started in 1998 as the 21st-century rehabilitation study group to realize it. Preparation had begun in 1996.

We advanced research with estimating the mechanism of the high treatment effect from the beginning.

We reported the study of the effect first and verified the effect with using the developed device to measure by the national grant respectively.

We changed the name of the study group into the Biophilia Rehabilitation Academy. We organized the international organization.

We announced the article that the previous rehabilitation intervention is not helpful for the disabled elderly.

We measured the cerebral function about the mechanism of the effect by fNIRS and fMRI. It seemed the mechanism elucidation was done in part.

The time of demographic transition has come globally and who agree with our enforcement are increasing.

I present a keynote lecture about the above-mentioned matter and am praying for that it is accepted by participants and start the co-study for it.

I feel strongly necessity and possibility to do the RCT of Passive exercise versus Motivative exercise, which is the indispensable matter and to realize it.

I am wishing that this workshop will be an opportunity for it and will lead to the creation of the new civilization which is constituted by the Freedom, Equality, Fraternity, and “overcome the disability”, in order to make the current civilization adapt to the super-aged society.

I would like to talk to you using the slides in the presentation. Firstly, I will introduce our university, and then I would like to explain to you the vision I proposed when I was inaugurated as the president of the university. I will then explain our motivation and objective for coming to this place at this time, and finally present our university as a global university proposal that we would like to make to you.

Our research has a long history. Research began by the lawmaker of the local governing having recognized the result of the community rehabilitation in 1987. Then, the Takizawa method rehabilitation was performed at the inpatient of the hospital for the bedridden elderly ¹⁾²⁾. We verified the fact that the elderly inpatients of the terminal stage who had been admitted to a hospital in the state of bedridden re-gained the 1/3 walk as a result of an investigation of a medical chart and factual survey³⁾⁴⁾⁵⁾. And the orthopedists of Fujisawa-Shi described the first fact paper with Takizawa, and it was published⁶⁾. We introduce you the research done on the Geriatric Health Services Facility Shonan-no-oka as a supplementary examination of this fact today. The doctors and the physiotherapists did this research for one year. The number of those who regained the walk was 35 as the result⁷⁾. And the number of those who could walk was seven at the beginning. Moreover, we admitted the significant effect to the item of a walk and a toilet about an FIM score in the statistical evaluation⁸⁾. According to video televising, we explain the actual condition of the Takizawa method, technique of having explained this fact, and introduce it.

This facility is the only one which is the institution introduced the Takizawa method rehabilitation service in Japan as the integrative one now¹⁾. A functional sustentation is the most important problem for the chronic phase patients living at home who are using the nursing-care-insurance ²⁾ when continuing a home life. According to aging and house environment of a person requiring care or a care giver, a pejoration of the degree of care of the insurance will be a shift factor to institution use service irrespective of their intention. It would appear that the program ³⁾ easily implements would be indispensable in order to maintain activity and home life and to prevent a pejoration of the degree of care.

In charge of rehabilitation service implementation especially for a short time, it would appear that the Takizawa method is useful because it can be equivalent to various utilizes at a low risk even little arrangement staff. And it is easy to introduce into the chronic phase patients, whose active tends to fall. As a result, their activities sustained.

There have been 74 outpatients total number in 2010 since 2003 opening, who used and continued for one year or more, and got evaluation one year after were 43 persons, and who did for 2 years or more, and evaluated annually were 20 persons, for 3 years were 7 persons and for 4 years was 1 person. We assayed change of 67 persons' degree of care, and change of 414 persons' the degree of care of a University bulletin.

Hypothetical: -- the method and improvement factor of the rehabilitation medical treatment and improvement factor are independent (there is no difference in an improvement factor during two methods) The result of the chi-square test; The hypothesis was rejected by 1% of the significance level as a result of official approval.

We authorized there is no difference in an "improvement" by the numerical value, and there is the difference in "maintain the degree of care" and "pejoration” ^4）.

It is effective that the method introduction maintains the degree of care and stops a pejoration. We reported the fact to the Japanese Health, Labour and Welfare Ministry^5）.

In this lecture, we introduce the daily activities of this institution by the video televising ⁶⁾.

The number of stroke patients has increased year by year in many countries, as the population ages and fewer babies are born. Most of stroke patients require a rehabilitation after the onset of stroke. Many researchers and companies in most of countries have been studying new rehabilitation systems. The systems include the approach of Brain Machine Interface (BMI), rehabilitation supported robot and so on. It seems that those systems target at higher socioeconomic group in wealthy countries. Since the stroke patients are not necessarily wealthy, it is necessary to make other solution for the non-wealthy groups. Biophilia Rehabilitation Academy (BRA) in Japan have been constructing the new rehabilitation system with easy and cheap devices, which is so-called “Takizawa method”. The proposed method enable that the burden of PT will decrease by contrast of the traditional method, since one physical therapist (PT) treats several rehabilitation patient. In the future rehabilitation, each patient will select a favorite solution among many rehabilitation systems.

Aging well has been declared a global health priority by the World Health Organization. The age-related loss of muscle mass and/or strength and performance, sarcopenia, has been associated with geriatric syndromes, morbidity, and mortality. Frailty is the decline in an individual’s homeostatic function, strength and physiologic reserves leading to increased vulnerability. The sarcopenia and frailty lead to the fall and fracture and becomes the cause of bedridden.

The proportion of the Japanese population aged over 65 years was 26.7% in 2015, but it will be predicted to be 30.3 %, at 2025. So, it is a national problem to prevent sarcopenia and frailty of elderly people.

Sarcopenia defined as combined low muscle mass, strength and physical performance. Using commonly used cut-off points to define sarcopenia, including solely muscle mass and combined definitions, on a community-dwelling elderly Japanese population. Muscle mass measured by dual-energy X-ray absorptiometry and measured by bioelectrical impedance analysis. Body mass index was the most prominent related factor for sarcopenia across the definitions in this Japanese sample. Physical performance is measured by One leg standing time, walking speed, timed up and go test, and time required to stand-up five times form a chair.

Physical therapy strategies for sarcopenia and frailty are as follows;

1) At first, it is important to educate correct knowledge concerning sarcopenia and frailty.

2) There are some methods of maintaining and improving muscular strength.

3) The balance training is necessary to improve physical function and ADL.

4) Physical therapy combined nutritional intervention, there is scope for early intervention to prevent disability since both sarcopenia and frailty.