[in Japanese]

View full abstract

Many patients develop oculomotor disorders due to brain injury. However, methods for rehabilitation to improve the oculomotor disorder have not been established thus far. This paper outlines the neural mechanism, brain imaging findings, prognosis, general evaluation, and treatment of oculomotor disorders. In addition, it summarizes previous domestic and international research on oculomotor rehabilitation for patients with brain injury. Finally, it discusses the clinical utility of oculomotor rehabilitation. Previous studies have reported that training to pursuit, fixation, saccade, and vergence improve oculomotor function. The training duration and frequency were within the scope of normal medical care. Oculomotor disorders greatly impact QOL, and occupational therapists need to actively evaluate oculomotor disorders, intervene, and evaluate the effectiveness of oculomotor rehabilitation.

View full abstract

In our hospital, we are taking a new psychiatric occupational therapy approach for admitted patients with liaison team intervention (liaison OT). The purpose of this study is to examine the efficacy of liaison OT in patients with delirium. Status changes of the intervention group and the non-intervention group were compared retrospectively one week after using the Global Assessment of Functioning (GAF) and Memorial Delirium Assessment Scale (MDAS). The results showed that GAF/MDAS total score, and the MDAS sub-items of ‘reduced ability to maintain and shift attention’, ‘decreased or increased psychomotor activity’, and ‘sleep/wake cycle disturbance’ improved significantly in the intervention group. In conclusion, liaison OT may contribute to the improvement of delirium.

View full abstract

This study retrospectively examined the association between post-discharge instrumental activities of daily living (IADL) and sarcopenia among post-stroke patients. The subjects were 69 stroke patients discharged from our hospital from 2015 to 2019, and all patients were surveyed by home visits 1 to 1.5 months after discharge. The IADL was evaluated using the Frenchay Activities Index (FAI), and sarcopenia was evaluated using the Asian Working Group for Sarcopenia. The FAI after discharge was significantly lower among the patients with sarcopenia at discharge than those without. Multivariate analysis adjusting for confounders showed that sarcopenia was independently associated with FAI among stroke patients discharged to home. In order to improve FAI in stroke patients, occupational therapy aimed at preventing or improving sarcopenia should be implemented.

View full abstract

The purpose of this study was to substantiate the relationship between locomotive syndrome (Locomo) and occupational performance. A total of 58 elderly living in the community participated in this study. Measurement items were comprised of the 25-question Geriatric Locomotive Function Scale, standing test, Self-completed Occupational Performance Index (SOPI), and a number of important activities. The subjects were divided two groups:the Locomo group and the non-Locomo group, and the locomotive syndrome and occupational performance were compared. As a result, age was higher in the Locomo group than in the non-Locomo group, and SOPI leisure and the number of important activities were lower in the Locomo group than in the non-Locomo group. Analyzing the relationship between the 25-question Geriatric Locomotive Function Scale and occupational performance indicated a moderate negative correlation between the 25-question Geriatric Locomotive Function Scale and SOPI satisfaction, and the 25-question Geriatric Locomotive Function Scale and SOPI leisure. Furthermore, there were poor negative correlations between the 25-question Geriatric Locomotive Function Scale and SOPI self-care，and the 25-question Geriatric Locomotive Function Scale and SOPI total score. This study reveals Locomo’s occupational performance.

View full abstract

To examine the characteristics of non-motor symptoms in patients with Parkinson’s disease (PD) during the perioperative period of deep brain stimulation (DBS), we investigated cognitive functions and behavioral symptoms in five PD patients who underwent DBS to determine the target site via experimental stimulation of the subthalamic nucleus (STN) and the globus pallidus internus (GPi). The results showed a significant decrease in the phonemic verbal fluency task performance involving inhibition of habitual responses only during stimulation of the STN compared to before surgery, and delirium-like behavioral symptoms were observed in 4 of 5 patients after surgery. These results suggest the need for occupational therapy for perioperative PD patients with DBS that considers motor symptoms and non-motor symptoms, including behavior management in the ward.

View full abstract

【aims】We analyzed changes in brain activity during a short period of non-dominant chopstick use learning. 【Methods】The 49 channels fNIRS measurement were assessed, and we analyzed the relative value of oxyhemoglobin in FP, DLPFC, FEF, PMC, and M1 in both hemispheres during practice. We also evaluated the motor skills before and after practice. 【Results】The motor skills of left and right hands improved after practice. Brain activity during left-hand practice showed activation of FP, DLPFC, FEF, and PMC in the left and right hemispheres, and a significant decrease in activity in FP in the left and right hemispheres, and DLPFC in the left hemisphere. 【Discussion】The results suggest that motor control using sensory information and cognitive activity were performed in the trial and error stage in the early stage of motor learning.

View full abstract

The purpose of this study was to evaluate the effectiveness of a health promotion program using tablets among the community-dwelling elderly. Participants were 34 healthy adults 65 years of age or older, and the program consisted of 8 sessions. In lectures we elicited discussion among them on the importance of good life balance. In practice, they reviewed their lives, and then learned how to use tablets and search for a meaningful task. Quality of life (QOL), living function, and occupational competence were assessed before and after the task using the WHOQOL-BREF, and Franchay Activity Index (FAI). The analysis was a within-group comparison, and all of the evaluation indexes were calculated using the Wilcoxon signed-rank test. The follow-up rate for the research was 81.0%. Participants were 34 community-dwelling healthy elderly, 65 years of age or older (mean age±SD, 75.1±5.67 years). Mean change of the following items after the task was significantly greater than before the task:mental and environment areas of WHOQOL-BREF, and total points of FAI. The findings provided evidence that the program using tablets can improve QOL. The results indicated a fair possibility of using tablets as a health promotion agent among the elderly.

View full abstract

The purpose of this study is to clarify the key pinch strength and II to V fingers palmar pinch strength, the reliability of pinch strength measurement, the prediction method of pinch strength, and the clinical interpretation of the measured value. Measurements were performed 3 times over 2 days on 15 healthy young male and female adults. The correlation between dominant and non-dominant hand strength, grip strength, pinch strength, presence or absence of systematic error, and Minimal Detectable Change (MDC) were examined using the average value of three measurements. The Day-to-day Reliability was greater than 0.8 for all the pinch strength measurements, which was highly reproducible. When predicting the pinch strength, the predicting the dominant and non-dominant hands is the most reliable, while the dominant hand is 105～110% more predictable than the non-dominant hand. It is useful to use a key pinch strength of 13% and palmar pinch strength of 25% of the measured value as the true changes.

View full abstract

The purpose of this study was to develop the assessment scale of clinical reasoning for occupational therapy education. We conducted the following procedures for scale development:1) item generation, 2) content validity of items, and 3) content validity of scales, referring to the recommended stages of scale development by Boateng et al. and the COSMIN guidelines. The study participants included occupational therapy educators and students. The result is a scale with confirmed content validity that consists of 40 items based on the four thinking processes of clinical reasoning and five grading stages. We are planning the necessary examination of the reliability and validity of this scale.

View full abstract

Self-awareness is important for successful intervention for higher brain dysfunction. This study utilized the Japanese edition of the “Self-Regulation Skills Interview (SRSI)” to support the social rehabilitation of patients with higher brain dysfunction. From the results of the SRSI, we determined the degree of self-awareness and developed intervention guidelines. Each strategy can be established and contribute to the social rehabilitation if the effective compensation means based on the degree of self-awareness of the patients matches the compensation means that is actually used. We suggest that the SRSI Japanese edition may assist in evaluating the degree of self-awareness and its changes and composing a proper intervention guideline for supporting patients with higher brain dysfunction.

View full abstract

The task-oriented approach is an evidence-based intervention for children with developmental coordination disorder. In this study, occupational therapy intervened with jumping rope for children with developmental coordination disorder, and attention deficit hyperactivity disorder. Jumping rope is one of the most difficult activities for children with developmental coordination disorder in Japan. The task-oriented approach improved appropriate staging and difficulty adjustment, intrinsic motivation, independent efforts, and the number of consecutive jumps of the jumping rope. The task-oriented approach may be a useful intervention for children with developmental coordination disorder, depending on their individual condition.

View full abstract

It is important to utilize day care facilities to support the return to work. The case involves supporting a 50-year-old man recovering from a stroke to return to work. Based on rehabilitation management, a basic intervention policy was shared with doctors, families, care managers, and companies at the rehabilitation meeting, and the interventions were carried out in an appropriate environment to support the smooth return to work. In day care facilities, it is possible to share information regularly and intervene in an environment suitable for the subject. The study suggests that it is effective in supporting the return to work, where cooperation with companies is important.

View full abstract

The case involves a client with depression and avoidant personality disorder in a forensic psychiatric ward in Japan who attempted extended suicide with her father. The intervention introduced leather work, which the client showed a strong interest in, and under specific rules triggered rehabilitation by a multidisciplinary team (MDT). Occupational therapy for clients suffering from both depression and personality disorder in a forensic psychiatric ward could find occupations that values the clients, manifests the clients’ personalities in the specific occupational experience, and safely promotes behavioral changes.

View full abstract

A right frontal lobe stroke patient with mild motor and sensory deficits, left hemisphere neglect, decreased use of the affected upper extremity, and self-awareness disorder received constraint-induced movement therapy combined with the transfer package (TP) for the upper extremity. Consequently, the Amount of Use and Quality of Movement Scales in the motor activity log were improved beyond the minimal important difference, and the Awareness Questionnaire, which assesses a client’s self-awareness disorder of one’s situation, showed improvement as well. The results of this case study indicate that the TP might improve self-awareness functioning and awareness of affected upper extremity use in the real-world.

View full abstract

Occupational therapy was carried out on a patient in a forensic psychiatric ward in Japan who suffered from schizophrenia and ADHD who had attempted murder. Intervention was difficult due to the client’s poor self-awareness of his condition, difficulty reflecting on the case, and lack of motivation for inpatient treatment. However, by gaining successful experiences through leather work and being a member of the executive committee of the ward events, he began to voluntarily participate in the subsequent treatment. Occupational therapy could be responsible for the introduction of treatment by a multi-disciplinary team for clients who lack motivation to be hospitalized in forensic psychiatric wards, and occupational therapy may assist in establishing relationships with the clients, enhance their self-efficacy, and increase participation in independent treatment through occupation.

View full abstract