This study clarified the characteristics of using chopsticks among children with autistic spectrum disorder (ASD). The subjects consisted of 18 children with ASD and 16 normally developing children. We evaluated and compared “how to hold chopsticks”, “how to move chopsticks”, and “movement of fingers when using chopsticks”. As a result, the characteristics of how to use chopsticks with a child with ASD included “difficulty in holding chopsticks with thumbs when opening”, “immaturity of separating movements on the radial and ulnar sides”, and “movement of unstable fingers”. Results indicate that relevant factors are the immaturity of separation movement of fingers, vision-based information processing, and executive function disorders.
This study aimed at establishing practice methods for pulling up trousers during toileting among patients with hemiparesis, as pulling up trousers has been reported to be the most difficult process in toileting, requiring the patients to perform simultaneous tasks such as maintaining standing postural stability and pulling up trousers. This study measured center-of-pressure (COP) of this process and compared the independent group and the surveillance group. There were a total of 15 patients (11 men and 4 women) in the independent group, and the mean age was 59 years old. There were 7 patients (5 men and 2 women) in the surveillance group, and the mean age was 65 years old. COP indexes were locus length per unit time (total, Antero-posterior, Medial-lateral), root mean square area, and root mean square (Antero-posterior, Medial-lateral). This study identified significant differences between the groups in Medial-lateral root mean square, indicating a larger value in the surveillance group. The results may indicate that the patients in the surveillance group barely maintained their stability, especially in the Medial-lateral direction. Obtaining ability to maintain postural control in this direction was considered to be necessary for the surveillance group. In conclusion, this study proposes balanced exercise to control the center of gravity in the Medial-lateral direction during pulling up trousers and standing simultaneously in the surveillance group.
This study aimed to investigate the actual conditions of occupational therapy evaluation for school adaptation of children with neurodevelopmental disorders in Japan. The study took place from April 1st, 2017 to March 31st, 2018, and selected children were enrolled in a regular elementary school class and received special needs support. An original questionnaire was mailed to 1,594 Japanese occupational therapists specializing in “Clinical” and “Neurodevelopmental Disorders” who were registered with the Japanese Association of Occupational Therapists. There were 324 respondents (response rate, 20.3%). Occupational therapy was performed for children with neurodevelopmental disorders in both medical institutions and day-care facilities including medical and welfare types. Preschool- and school-age children were frequently evaluated based on sensory integration theory;these occupational therapy evaluations involved a developmental test of visual perception. Furthermore, such evaluations were mostly used for clinical observation. The use of standardized assessment was limited.
This study explored the occupational experiences influencing the daily satisfaction of community-dwelling older adults. Twenty older adults living in the community agreed to participate in this study. The data were collected through dairies and semi-structured interviews and were analyzed using thematic analysis. Nine themes were identified as the aspects of occupational experiences that influenced the daily satisfaction of the participants:connection/estrangement, affirmation/negation, contribution/annoyance, effort/laziness, enjoyment/boredom, progress/regress, success/disappointment, acquisition/forfeiture, and recovery/decline. The themes included both positive and negative experiences, which shows the complexity of occupational experiences. These results promote the understanding of older people's occupational experiences and can be used to assist them with increasing positive experiences in their daily lives.
This study aimed to investigate the factors related to the usage of the paralytic arm during daily activities among acute stroke patients. Particularly, we focused on the patient characteristics, physical functions, and the degree of understanding of how to use the affected arm in daily activities. Participants were 56 acute stroke patients within 1 week of onset. Multivariate logistics regression analysis revealed that the amount of hemiplegic arm use was affected by the arm function (FMA score) and the degree of understanding. These results indicate that acute stage occupational therapy intervention should focus on both improving the function of the paralyzed arm, and evaluating and encouraging the patients to better understand how to use the paralyzed arm in the daily activities.
A patient with multiple cerebral infarctions along with vertebrobasilar artery occlusion involving the thalamus, hypothalamus, midbrain, and cerebellum on both sides and the parietal and occipital lobes on the right side received occupational therapy. The patient exhibited various symptoms, such as conscious disturbance, ataxia, and rapid body movements with strong muscle contractions in the sitting position at rest. Ten days after onset, the patient's alertness rapidly improved and spontaneous movements were gradually observed. However, 21 days after onset, the patient became apathetic. Occupational therapy interventions struggled to cope with changes in the patient's various symptoms mentioned above. Among the occupational therapy interventions, an activity related to the patient's hobby as an intervention for apathy was the only activity that the patient voluntarily performed.
We performed occupational therapy to restore the work ability of a barber with malignant lymphoma with abnormal sensations in the distal parts of both fingers due to chemotherapy-induced peripheral neuropathy. The patient experienced numbness and pain in the distal part of both fingers, facing difficulty with fine motor skills, such as writing and using chopsticks. Occupational therapy gradually introduced the practice of fine movements, such as writing, using chopsticks, and utilizing scissors. A slight improvement was observed in the sensations in both fingers, leading to increased finger mobility and resumption of work as a barber. To promote the use of hands with abnormal sensations, it seems effective to perform systematic article manipulation with reference to desensitization therapy and use tactile sensations in the healthy sense area of the hands for task execution. Furthermore, it is essential to set occupational therapy goals based on the professional role of the patient.
The life support comprehensive service C including visited-type service C (hereinafter referred to as visit C) is a long-term care prevention and living support service project for nursing care prevention and living support comprehensive projects. Its focus is to improve ADL/IADL through comprehensive preventative care and daily living support over a period of 3 months. Mr. A, who was certified as Support 2, was struggling to hang up the laundry because of the large number of occupational processes and the laundry basket's carrying distance. We advised Mr. A to move the clothes hanger to more comfortably hang the laundry. We focused on the occupational performance and conducted environmental setting and practice exercises. As a result, three months after the initial assessment, he was able to dry the laundry comfortably, indicating a significant increase in motor and process skills of the AMPS and in Health Related Quality of Life. Thus, occupational therapy may be able to improve ADL/IADL in a short period of time by taking care of visit C.
After developing a cerebral hemorrhage, the client and her mother have lived in isolation for about 50 years, constantly refusing various welfare services, which lead to difficulty introducing home-based occupational therapy. For about 8 months, the occupational therapist repeatedly intervened with suggestions while listening to and sympathizing with the client and her mother. As a result, their values and preferences gradually became clear, and the occupational therapist discovered the client's preferred activities. The client shared her broad sphere of activities and living space as her mother began watching over the client. This study reviews efficacy of home-based occupational therapy, analyzes the client's new activities along with the client's and her mother's verbal behaviors, and discusses why the behavior of the two people changed.
This study examined whether a posture of comfort of a person with SMID (severe motor and intellectual disabilities) can be accurately evaluated. An evaluation method based on an ABAB research design was utilized for a single case. We alternately video recorded the person being spoken to and then watched the recording, calculating the average time and the blinking rate as an indicator of comfort. We subsequently compared a supine position on a bed with a seated position on a seating system. The seated position on the seating system resulted in shorter reactions times and lower blinking rates compared to the supine position on a bed. Thus, a posture of comfort can be evaluated with use of behavioral indicators, even for a person with SMID.
This paper will report on visual search training for an aphasic patient with left brain damage, which resulted in an improvement in communication abilities. The subject's gaze was analyzed while she was looking at the screen, which was then examined to evaluate communication skills. Three months after the onset of aphasia, a lack of movement in the subject's gaze indicated a lack of understanding of the situation during communication settings, leading to a decrease in the understanding of nonverbal information. The gaze analysis revealed poor gaze movement, with the gaze point tending to stay in one location. The gaze search training resulted in an increase of gaze movement, and an improvement in the understanding and expression of non-verbal information through gaze analysis and communication settings. As a result of this visual task training, visual attention involved in the input process of non-verbal information improved, showing that there was an improvement in communication skills.
Virtual reality (VR) was utilized for understanding the housing environment, including the position of the handrail, without conducting home visits. VR video has the advantage over assessing using conventional photography in that a simulated experience is possible from a remote location. This case did not exhibit visually induced motion sickness due to using a tablet PC instead of a head mounted display when watching VR videos. Safety of the use of the VR video was confirmed and did not induce motion sickness. However, disadvantages of VR video included not being able to accurately display the heights of the shelves and stairs. The results show the possibility of using VR for occupational therapy, at discharge, in nursing facilities, and to grasp the situation remotely.
After devising how to use ADOC, a client with higher brain dysfunction and an occupational therapist could share meaningful occupations. By sharing the meaningful occupations revealed in the interview using ADOC, the team was able to share the role that focused on the meaningful occupations. By devising methods in how to use ADOC in accordance with the client's symptoms, ADOC may be effective for clients who have difficulty communicating, such as those with aphasia, dementia, and attention disorder. Further it may also be effective for Inter-Professional Work that focuses on client's meaningful occupations.