The Japanese Journal of Rehabilitation Medicine
Online ISSN : 1881-8560
Print ISSN : 1881-3526
ISSN-L : 1881-3526
48 巻, 10 号
選択された号の論文の4件中1~4を表示しています
原著
  • 山里 道彦, 大賀 優
    2011 年 48 巻 10 号 p. 659-665
    発行日: 2011/10/18
    公開日: 2011/11/10
    ジャーナル フリー
    外傷性脳損傷 (TBI) 者の社会的孤立を防ぐために,集団で行う心理療法が注目され,さまざまな形態でのグループ訓練が試みられてきた.本報告ではTBI者に対して,デイケアの形態で行うグループ訓練の有効性を認知面と心理行動面に分けて検証した.過去3 年間にデイケアに参加したTBI 20 例を対象とし,訓練6 カ月後に家族に対して行った質問票の結果で,心理面 (抑うつ気分・興奮) と,行動面 (他者情動の理解・身だしなみ) に有意な改善がみられた.これは,我々のとったグループ訓練の体制によりTBI者の発動性やコミュニケーション能力が改善したためであると考察された.TBI者の心理行動面の改善に,デイケアの形態をとったグループ訓練は有効であった.
症例報告
  • 青木 昌弘, 佐々木 梨嘉, 森泉 茂宏, 土岐 めぐみ, 村上 孝徳, 石合 純夫
    2011 年 48 巻 10 号 p. 666-670
    発行日: 2011/10/18
    公開日: 2011/11/10
    ジャーナル フリー
    Bilateral lesions damaging the primary auditory cortex or the auditory radiation may cause auditory agnosia. We describe a 67-year-old woman with auditory agnosia after bilateral thalamic hemorrhage. Initially, she showed subcortical deafness for words and environmental sounds. Pure tone audiometry showed a moderate-to-severe hearing loss (mean hearing level, right 56 dB ; left 57 dB), while the recording of auditory brainstem response was normal. Brain CT demonstrated a hematoma in the left thalamus and a narrow low density area suggesting a sequel of the right thalamic hemorrhage. Hearing training was begun using sound sources that were easily recognizable for the patient. Her recognition was better for words than for individual Japanese vowel or consonant-vowel sounds, and the use of lip reading contributed to her better recognition of words. After 2 months, she was able to communicate with medical staff and family members in daily conversation.
総説
  • 牧田 茂
    2011 年 48 巻 10 号 p. 671-679
    発行日: 2011/10/18
    公開日: 2011/11/10
    ジャーナル フリー
    Cardiac rehabilitation (CR) offers a highly effective causative treatment of atherosclerotic coronary and peripheral disease. The life style and risk factor modifications achieved by CR have been shown to halt disease progression, and to reduce cardiovascular mortality and the rate of non-fatal myocardial infarction in patients with coronary artery disease. CR programs consist of exercise training, medical counseling, cardiovascular disease education, and psychosocial support. This comprehensive approach has significant benefits on exercise capacity, coronary risk factors, and health-related quality of life. In addition, CR reduces all-cause mortality as well as cardiovascular events. In general, CR programs consist of 3 stages : acute stage (phase I), convalescent stage (phase II), and chronic stage (phase III). In addition to this preventive approach, exercise-based intervention programs are also effectively used for chronic heart failure (CHF). Since exercise intolerance in CHF is primarily related to the degree of peripheral changes (such as muscle atrophy, reduced peripheral perfusion due to endothelial dysfunction, abnormalities in ventilation), regular aerobic training in CHF has been shown to improve peak oxygen uptake, to reduce peripheral vascular resistance, to retard or reverse muscle wasting, and to reduce morbidity. Despite its documented clinical effectiveness, rehabilitation and a preventive approach are still widely underutilized in Japan. However, it becomes increasingly clear that the use of interventional and surgical procedures is suboptimal therapy in the absence of simultaneous lifestyle modifications, including regular physical exercise and controlling cardiovascular risk factors.
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