We sought to determine the effects of the Comprehensive Life Goal Setting Technique method of Preventive Care Management (C-LGST-PCM), which supports achievement of life goals regarding Activity and Participation Level (APL) using a multidisciplinary team for preventive care outcomes in a preventive care program for frail community-dwelling elderly. Methods:This was a cluster-nonrandomized controlled trial. Participants were frail older people living in Izumi, Osaka, Japan, all of whom attended weekly 120-min preventive care exercise classes over 3 months. We compared the C-LGST group, which introduced the C-LGST-PCM, and a control group. We introduced the C-LGST-PCM from the assessment stage at a community center and assessed outcomes by comparing baselines and follow up at 3, 6, and 9 months. The primary outcome measure was preventive care outcomes according to the Kihon Checklist for assessment of frailty, which was analyzed by chi-square test. Results:No significant differences were found between the two groups for any variables. Improvement as per the Kihon Checklist for the C-LGST group was approximately 60% from baseline to the 9-month follow up;the control group improved by approximately 40%. The difference between groups was significant both at 3 and 6 months (p=0.039), but not at the 9-month follow up. Conclusion:This study shows that C-LGST-PCM, which supports achievement of life goals for APL by a multidisciplinary team, benefited preventive care outcomes in a preventive care program for frail community-dwelling elderly. Furthermore, the effect of preventive care was maintained after 6 months.
This study aimed at clarifying the practical circumstance of professionals and the role of Occupational Therapists (OT) in preventing disuse syndrome through multidisciplinary teamwork among acute elderly inpatients. The subjects were OT, Physical Therapists (PT) and Nurses. We analyzed the results of a questionnaire on the practicality of preventing disuse syndrome and recognizing the roles of the subjects. The findings revealed the main roles of each professional in preventing disuse syndrome in the acute phase. The main roles of the subjects were as follows:OTs were responsible for intervention in life function, PTs intervened in physical function, and Nurses cared for patients in the hospital ward. In addition, the results revealed that there are partial differences among professionals in recognizing the role of OTs. In order for OTs to work effectively in a team, they should acknowledge subjective and objective perceptions of their roles, and expand of opportunities to highlight their expertise through cultivating specific jargon.
This study examined the validity and reliability of the ‘Questionnaire for measuring mealtime behavior for children with Autism Spectrum Disorder (ASD).' A survey was conducted on 384 subjects (301 males, 82 females and 1 unknown) with ASD aged 3 to 18 years old. The average age of the children with ASD was 9.8 ± 4.2 years, and the ratio of males to females was approximately 4:1. Factor analysis revealed 5 factors of 42 items “Selective eating”, “Clumsy/Manner”, “Concentrate/Interest in eating”, “Oral function”, and “Overeating”, and the Cronbach' alpha coefficient was 0.930 overall and 0.781 to 0.923 among the 5 factors. Our results indicate that ‘Questionnaire for measuring mealtime behavior for children with ASD' has high validity and reliability.
This study investigated joint angles and whole-body angle changes required for realistic eating with chopsticks. We assessed the eating movements of 45 healthy, right-handed subjects using a three-dimensional motion capture system and observed the upper and lower limb, neck, and trunk angulations. Among these angles, the maximal and minimal flexion angles of the right elbow joints were approximately 133 and 99 degrees, respectively, and the dorsal flexion angles of the right wrist joints were approximately 30 and 10 degrees, respectively. Internal rotation of the shoulder joints was largest when picking up food with the chopsticks, while putting food into the mouth resulted in the largest flexion and abduction of the shoulder joints. Putting food in the mouth also led to extension, right lateral bending, and right rotation angles of the neck. We assume that these results will add to our basic understanding of positional assessments and interventions in patients.
It is well known that TV viewing time in the daily life of the elderly is high, and TV viewing over an extended period of time has a bad influence on health. However, the relationship between TV viewing times and the health is unclear. This study investigated the relationship of these two factors among the elderly. A questionnaire examining TV viewing times and the Kihon Checklist among 407 community-dwelling elderly was carried out. The results show that the viewer rating of older people who were judged as frail in the items of “locomotion” and “depression” and the comprehensive standards of Kihon Checklist were higher from 4pm to 6pm.
This study examined the effectiveness of an “activity diary” for occupational therapy practice among pain, psychological factors and activity levels after total knee arthroplasty (TKA) in non-randomized trials. TKA patients were classified into a control group (15) and a diary group (15). The outcome indices were measured using the Canadian Occupational Performance Measure (COPM) for pain, pain catastrophizing, anxiety and depression, and activity levels and were analyzed post hoc. Comments on activity diaries were analyzed by the KJ method. Results from the COPM indicate a significant improvement in anxiety and activity levels, while the KJ method similarly revealed a shift from OT “pain” to OT “accomplishment” at the end. The results demonstrate the effectiveness of the “activities diary” for occupational therapy practice after TKA.
This study investigated the effects of a collective cooking intervention focusing on mission planning on the cognitive function and frequency of cooking at home among community-dwelling elderly females. This study involved 39 elderly female residents living in the community. The residents were divided into a mission planning-cooking group (20 participants) and a cooking group (19 participants). Each program was held once a week for 6 months, and the cognitive function, psychological function, and social behavior of the participants were evaluated before and after the intervention. Results revealed that although the main effect was recognized in the cognitive functions, no interaction and no difference resulting from changing the frequency of cooking were observed between the two groups. These results suggest that although cooking intervention can improve cognitive function, its effect on cognitive function and cooking frequency is not clear. Therefore, this intervention strategy is in need of further consideration.
For five patients in the acute phase after stroke onset, we did not constrain the non-paralyzed arm in the real world, but employed intensive upper-extremity training combined with supplementary methods for two hours per day for about three weeks. This study investigated the efficacy and safety of combined intervention including the intensive training in acute phase from stroke onset for improving affected upper-extremity function and use in activities of daily living. Results indicate significant improvements in the affected upper-extremity function and the amount and quality of arm use in real world. In addition, no adverse events were observed during the intervention period. Therefore, these results suggest that shortened intensive training in the acute phase from the onset of stroke might be a meaningful method to improve the affected upper-extremity function and use in activities of daily living. However, to completely demonstrate the effect of this intervention protocol in the acute phase from stroke onset, we will have to investigate using randomized controlled trials with control groups in the future.
Somatoparaphrenia (SP) is a syndrome involving both a lack of awareness of ownership of a body part and delusional misidentification and confabulation. SP patients usually have large fronto-parietal lesions in the right hemisphere, and SP resulting from left hemisphere lesions is relatively rare. A 50-year-old woman with left thalamic hematoma suffered from feelings of disownership of the right upper and lower extremities. In addition to these feelings of disownership, she complained of a sense of nonbelonging, autoheterosyncisis, and personification of her right upper extremity. Brain magnetic resonance imaging demonstrated a left thalamic hematoma (2cm), and an eazy Z score Imaging System (eZIS) analysis of the single photon emission computed tomography (SPECT) images showed widespread hypoperfusion in the left hemisphere. We performed combination therapy using vibratory stimulation and mirror therapy for the SP of her right upper and lower extremities. She eventually came to recognize the right extremity as her own. Combination therapy using direct sensory input and visual optical illusion of the right limb aid in the reconstruction of the body image resulting in successful treatment of cases of SP.
This research examined the effectiveness of psychiatric occupational therapy in improving the social anxiety in patients with schizophrenia. A series case study was conducted at the psychiatric rehabilitation center of a university hospital. Data from 3 patients were collected at the baseline, and after 3 and 6 months, indicating an improvement in social anxiety, psychological symptoms, and interpersonal exchange scores. Those symptoms in the patients with moderate social anxiety improved more than the severely impaired patients. This study suggests that occupational therapy intervention may improve not only the symptoms, but also social anxiety in patients with schizophrenia, especially among patients with less severe social anxiety.
We investigated the long-term effects of constraint-induced movement therapy (CIMT) among stroke patients in the acute phase, and combined it with electrical stimulation therapy for the patient with moderate upper-extremity paresis. After discharge from our hospital, we investigate upper-extremity function for one year and found an improvement in upper-extremity function and the amount and quality of arm use in real world activities both immediately and one year after intervention. The results indicate that using the CIMT in the acute phase after stroke onset might have long-term effectiveness. Since our findings represent only one case, it is necessary to expand the sample size and define similar problems in the future.
We used constraint-induced movement therapy (CI therapy) combined with the improved version of capener splint to facilitate real-world use for stroke patients with no voluntary finger extension. Method:Although we used CI therapy using the spider splint, the stroke patients refused to use the spider splint in the real-world, resulting in the development and use of the improved version of capener splint. Results:The Fugl-Meyer Assessment, Wolf Motor Function Test, and Motor Activity Log improved significantly, and the improved version of capener splint resulted in higher scores than the spider splint in evaluation of the degree of welfare equipment satisfaction. Conclusion:The improved version of capener splint might be a useful orthosis in CI therapy training.
This research analyzed relationship of the characteristics of concrete driving behaviors to the comprehensive evaluation results of on road assessment using neuropsychological examination analysis, and clarified salient driving behaviors during on road assessment. Comparisons among groups revealed no significant differences in the neuropsychological test results in driving suitability. The total number of driving behaviors that were evaluated as dangerous was the only significant difference, and the numbers in the unfit to drive group were significantly more than in the fit to drive group (p=0.007). Regarding specific driving behaviors and driving suitability, it was clear that the driving position at the time of turning, the existence of the signal at the time of course change, and the course direction at the time of backward movement affected the comprehensive evaluation results. There was no association between neuropsychological tests and driving behavior. This study suggests that driving behavior is a complicated activity which is difficult to judge from neuropsychological tests.