fMRI plus rTMS and Occupational Therapy for Post-stroke Patients with Upper Limb Hemiparesis…Masahiro ABO, Wataru KAKUDA 152

Hemiplegia Rehabilitation in Stroke Patients : Transcranial Magnetic Stimulation, Intensive Facilitation Exercise Repetition, Vibration…Seiji ETOH, Shuji MATSUMOTO, Kazumi KAWAHIRA, Tomokazu NOMA 156

Cortical Modulation of Spinal Plasticity induced with Electrical Stimulation and Transcranial Direct Current Stimulation…Toshiyuki FUJIWARA 159

Effects of Motor Imagery on Motor Cortical Activation during Robot-aided Gait Training…Futoshi WADA 161

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Objective: To develop a weighted disuse risk score rating. Design : Based on specified selection criteria, items of the disuse risk factor were chosen. Then, a conjoint questionnaire for physicians was created using orthogonal cards with ordinal disuse risk grade. Conjoint analysis (SPSS 15.0) was performed, weighting each item and making a formula for calculating the disuse risk score. Setting : The Rehabilitation Department of a University Hospital. Participants : Forty-one physician respondents and 129 consecutive inpatients referred to the rehabilitation department. Main outcome measures : Agreement of the rated disuse risk grade with the calculated disuse risk score, and the reliability of the calculated disuse risk score of the 129 inpatients. Results : Eleven disuse risk factor items were selected ; age, malignant tumor, heart impairment, respiratory impairment, kidney impairment, pain, gait disorder, psychiatric impairment, intellectual disability, dementia, and body mass index. Forty-one physicians completed and returned a postal questionnaire. Cronbach's a of the rated disuse risk grade was 0.948. The correlation coefficient of the average rated disuse risk grade to the calculated disuse risk score was 0.985 (p=0.000). Items of high overall importance (%) were gait disorder (14.0%), malignant tumor (11.5%), and respiratory impairment (11.0%). Those of low overall importance (%) were body mass index (6.8%), kidney impairment (6.6%), and psychiatric impairment (6.1%). For the 129 patients, the calculated disuse risk score of the 11-item was correlated to that of the 9-item weighted disuse risk factor (R=0.930, p=0.000). Conclusions : Both the 11-item disuse risk factor and the weighted disuse risk score rating were considered reliable and useful.

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The aim of this study is to clarify which educational style, self-directed learning (SDL) or the traditional style of listening to lectures, is more effective in physiatry education for residents under the Japanese new residency program. Participants were 15 residents. Eight residents from the lecture group completed 7 lectures on the basics of physiatry (total 420 minutes). Seven residents from the SDL group chose their learning objective by themselves and we then facilitated their learning with 3 sessions (total 160 minutes). Outcomes, including their subjective understanding of physiatry and interest in it, were measured by a brief questionnaire. The SDL group showed more favorable development in understanding and more interest in physiatry than the lecture group. This result demonstrates that the individuality, flexibility and mutuality provided by SDL may encourage residents to learn physiatry more effectively.

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