[in Japanese]

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[in Japanese]

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This scoping review aimed to map existing literature on goal setting for people with visceral disabilities in rehabilitation. Of the 1,114 articles, the following 46 were included:cancer (19), heart disease (16), lung disease (6), kidney disease (0), and multiple (5). Except for the articles on cancer, there were few studies focusing on individualized occupational therapy, activities of daily living or participation-based goal setting. However, the research investigating occupation and COPM was reported for patients with heart and lung disease. Thus, Japan would benefit from similar research.

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The purpose of this study was to investigate the status of bathtub bathing and related factors 1 month after surgery among osteoarthritis patients who had undergone total hip arthroplasty. Eighty-nine patients (74 women, mean age 67.2 ± 9.8 years) were followed up until 1 month after surgery, and 47 patients (52.8%) took a bath in the bathtub. Compared to those who did not bathe, those who bathed in the bathtub 1 month after surgery had significantly higher fall-related self-efficacy 2 weeks after surgery and a significantly higher rate of using the chair in the bathtub 1 month after surgery. The results of this study suggest that the implementation of bathing in the bathtub 1 month after surgery requires occupational therapy intervention to increase self-efficacy during hospitalization.

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Families and patients of acquired brain injury have difficulty participating in society when driving is interrupted due to an insufficient support system. The purpose of this Meta-study was to develop an intervention framework by organizing the experiences of the patients and their families after cessation of driving. The research included in the meta-study were qualitative studies published up to 2020, and nine foreign papers were selected. We then coded the quotes from the target studies and organized them into three categories:Person, Environment, and Occupation. The results were classified into 39 subcategories. The person category was organized into five themes for clients, three themes for family members, three themes for the environment, and four themes for Occupation. The results can be utilized for the intervention of acquired brain injury persons who experienced driving interruption. Since the selected papers were published abroad, further research is desirable for their use in Japan.

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The geriatric nutritional risk index (GNRI) is a well-established tool to assess nutritional risk. We assessed the association between GNRI, ADL, and the rates of returning home for hospitalized patients with proximal femur fractures. Results indicated that patients with high-GNRI scores significantly improved Grooming, Walking/Wheelchair, and Stairs on the Functional Independence Measure. However, there was no correlation between GNRI and the rate of returning home on the Logistic Regression Analysis. GNRI scores can predict the improvement of ADL for geriatric patients with proximal femur fractures.

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This research aimed to clarify the competencies of occupation-centered EBP. We used the Structure-Constructive Qualitative Research Method for qualitative research designs, and Steps for Coding and Theorization for qualitative data analysis. The participants were four occupational therapists. As a result, we identified four competencies:understanding EBP knowledge and skills, adoption of occupation-centered problems and outcomes, integration of diverse evidence from occupational therapy expertise, and practical references to occupational therapy theory. Findings from this study suggest that understanding EBP knowledge and skills and integrating diverse evidence are important for EBP practice based on occupational therapy expertise. These findings contribute to the development of EBP based on occupational therapy expertise.

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In Japan, there are no long-term follow-up studies of CI therapy of stroke patients in the acute phase. This study conducted a long-term follow-up study of several subjects in the acute phase who received modified CI therapy for 2 hours or less per day up to 1 year after the intervention and observed the progress of recovery of the paralyzed upper limb. Results showed significant differences in both FMA and MAL in the fixed effects at post-intervention and 1-year post-intervention. MAL showed changes that exceeded MCID in both the short- and long-term. Furthermore, long-term improvement in FMA was strongly associated with MAL. This study suggests that even in the acute phase, modified CI therapy may have favorable long-term changes in upper limb function and paralytic hand use behavior in some patients.

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Most evidence-based approaches to upper extremity paralysis after stroke are based on patients in the living phase. Although studies with a high level of evidence are desirable in the acute phase, it is not easy to conduct comparative studies in the acute phase. Therefore, this study used a data pool of previous studies to establish a control group, which was considered a challenge, and compared it with the intervention group by propensity score matching in order to estimate the effect of modified CI therapy in the acute phase. The results suggest that the implementation of modified CI therapy in the acute phase may be effective for cases discharged home with a relatively good prognosis, while it may not be sufficiently effective in a short period of time for cases transferred to the convalescent phase. Future studies will also compare the effects on the behavior of using the paralyzed hand.

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Recently, the effectiveness of telerehabilitation has been demonstrated. Teleconstraint-induced movement therapy (CI therapy) for stroke patients has a long history in the United States. A patient with right hemiplegia after stroke was discharged from a rehabilitation ward and considered visiting our hospital as an outpatient, but due to difficulty in traveling to the hospital, we performed tele-CI therapy for 40 minutes twice a week for a total of 8 sessions. As a result, the Fugl-Meyer Assessment and Motor Activity Log showed improvement beyond the minimum clinically meaningful change after discharge from the rehabilitation ward. This report describes the progress of remote CI therapy.

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We report a case of acute brainstem infarction in a male in his 70s with diplopia who practiced a therapeutic intervention in the integrated mechanism of vision and somatosensory resulting in no paralyzed eyes. The case presented with adduction disorder in the right eye (paralyzed eye) and diplopia in the left eye. The patient lived with one-eye blockage such as using an eye patch for paralyzed eyes, experienced inconvenienced in walking. Treatment intervention using upper limb motor sensation and visual integration was performed up to 5 times a week, 20 minutes per day for a period of 9 days. As a result, it became possible to live with both eyes, and the degree of inconvenience in life was reduced. We believe that the use of both eyes prevented secondary changes such as shortening and atrophy of the extraocular muscles (paralyzed eye), which led to good results.

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Upper limb function exercises were performed for subjects who presented with shoulder joint pain in the paralyzed upper limb after stroke according to the shoulder joint pain and psychological condition. In particular, in the Transfer Package, we requested that the degree of pain caused by the activity of the paralyzed hand and the feeling of use be recorded, and provided guidance including how to deal with the pain and environmental adjustment. As a result, the pain in the shoulder on the paralyzed side was reduced, and the frequency of use of the paralyzed hand in daily life increased. The Transfer Package appears useful among patients with upper limb paralysis with shoulder joint pain.

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Purpose:We investigated non-pharmacological interventions such as sleep management and dietary adjustment for a patient with Parkinson’s disease (PD) who experienced excessive daytime sleepiness (EDS), which limited his ADL. Case:A 60-year-old male patient with H&Y severity class 3 PD developed EDS during daytime rehabilitation, which limited his ADL. Methods:The patient and his family were instructed on nighttime and daytime sleep management, dietary adjustment, and step-by-step exercise therapy. Results:The UPDRS Part 3 score improved from 50 to 41, and the PDSS 2 score improved from 43 to 21. Conclusion:The patient’s lifestyle was corrected with the cooperation of her family, and exercise therapy was conducted at a daytime rehabilitation center, which reduced EDS and improved activities of daily living.

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We examined the factors associated with HRQOL of CVD patients and their primary caregiver three months after being discharged from the rehabilitation ward and provided ergotherapy intervention and discharge support in the convalescent rehabilitation ward. The subjects were 36 patients who were discharged from the convalescent rehabilitation ward and met the eligibility criteria. Each aspect of the patients’ and main caregiver’s QOL at the time of discharge and 3 months after discharge were compared using statistical analysis. The QOL of the patients 3 months after discharge showed degree of pain, cleaning and rearranging, shopping of FAI, and a correlation of the IADL of the patient. The QOL of the main caregiver showed degree of pain, health of the caregiver of HCS, the degree of independence in bathing the patient, traveling, and reading of FAI. Important intervention in the convalescent rehabilitation ward requires consideration of intervention to reduce the quantity of ADL assistance and examination of factors that burden a caregiver. The care power of the patient caregiver can improve patient QOL after the discharge of the patients.

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