[in Japanese]

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[in Japanese]

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This study clarified the process leading to the use of powered wheelchair (PWC) by long-term care insurance recipients. Four subjects were interviewed, and the Trajectory Equifinality Approach was used to analyze the results which indicate that after going through the Bifurcation Point, they reached the Equifinality Point where they continued to use PWC as a means to connect with their families and society. Through this process, the belief that “PWC makes it impossible for me to walk” has evolved to “PWC is a convenient tool.” Information from other PWC users encouraged the subject’s use of PWC at various times. The results of this study showed the importance of providing timely support, such as information from other PWC users.

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This study aims to clarify the process of strengthening occupational therapists’ professional identity. Four occupational therapists who scored high on the Occupational Identity Self-Assessment Scale were interviewed for 60 minutes in a semi-structured interview using a voice recorder. A written verbatim record was obtained, and a Trajectory Equifinality Model (TEM) was performed. Occupational therapists with a high professional identity experienced anxiety and a gap between ideals and reality at the start of their careers, but their interest in occupational therapy and occupation increased during their efforts to respond to the needs of their organizations. Subsequently, the process of enriching their knowledge of the occupation strengthened their professional identity.

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The latent association test was used to examine the implicit cognition of occupational therapy students for patients with dementia. The results indicate that although occupational therapy students had both implicit and explicit negative cognition for dementia patients, there was no correlation between the two. In addition, specialized education such as lectures and clinical education further enhances students’ implicit negative perceptions, suggesting that BPSD due to dementia is the cause. Therefore, it is necessary to begin education on the premise that students already have negative cognition for dementia patients, and it is necessary for them to learn how to interact with people with dementia and how to deal with their symptoms before clinical education.

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This study clarified the process of client support in collaboration with caregivers at a geriatric health care facility from the perspective of occupational therapists. Twelve occupational therapists were interviewed, and their responses were analyzed using a modified grounded theory approach. As a result, 16 concepts and 7 subcategories were generated, and three categories were identified:[building a foundation for collaboration], [sharing knowledge and skills], and [occupational therapists and caregivers supporting clients with a common understanding]. The process of supporting clients in collaboration with caregivers, which is not a one-way process, but a process that moves back and forth between categories, subcategories, and concepts, was clarified.

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This study used a modified grounded theory approach (M-GTA) to clarify the change in feelings that clients in the ward of Medical Treatment and Supervision Act have for their hospitalization treatment. As a result of analyzing the contents of the semi-structured interview with 12 people in the ward of Medical Treatment and Supervision Act, clients who had complex feelings about hospitalization accepted inpatient treatment through relationships with other patients and multidisciplinary teams, and at the time of discharge, they longed for new and normal life. In addition, experiencing stress relief and self-efficacy in forensic psychiatric occupational therapy led to the clients’ independent participation in treatment.

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The study examines the effectiveness of intensive occupational therapy (OT) in improving upper limb and cognitive function in patients with spinocerebellar degeneration (SCD) with and without multiple-site symptoms. In this retrospective before-after clinical study, we included patients with pure cerebellar ataxia (eight with cortical cerebellar ataxia and two with suspected spinocerebellar ataxia type-6) and polyphyletic disorder (twelve with multiple system atrophy-cerebellar and two with Machado-Joseph disease). The following were evaluated at the time of admission and discharge:(1) upper-limb ataxia based on the Scale for the Assessment and Rating of Ataxia (SARA) and (2) the Trail Making Test (TMT) to evaluate cognitive functions such as attention. The data were analyzed using the Wilcoxon signed-rank test with Holm’s method. At the time of discharge, significant improvements in SARA and TMT scores were observed in both groups, indicating that OT improves upper limb ataxia and cognitive function in patients with SCD with or without multiple-site symptoms.

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The GRASSP (Graded Redefined Assessment of Strength, Sensation and Prehension) is an evaluation tool for upper limb and finger function primarily for people with cervical spinal cord injury (CSCI). Except for Japan, it is often used worldwide to evaluate upper limb function. We evaluated the upper limb function of patients with CSCI by GRASSP and we verified its reliability, validity, and predictability. As a result, we obtained almost the same results as those in the previous reports. In addition, we examined the relationship between the GRASSP scores and the ADL status of the subjects, confirming that a significant relationship was shown between GRASSP and the utilization of chopsticks.

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The case was a 60-year-old man with cucullaris muscle paralysis after head and neck cancer lymph node dissection. Rehabilitation commenced after the Modified Eden-Lange Procedure. The patient had limited upper limb elevation and difficulty with activities of daily living requiring upward reaching. Rehabilitation began from the early postoperative period, and the patient acquired 150-degree active elevation range of motion at five months after surgery, and was able to smoothly change a light bulb, indicating improvement in arm elevation. The active elevation improved to 170 degrees two and a half years after surgery. Exercise of the transition muscle promoted reconstruction of the shoulder upper arm rhythm that linked to residual muscle and improved arm function and ADL.

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This study examined the clinical usefulness of the level of engagement estimation system in the Assessment of Positive Occupation 15 (APO-15) through a case study. We assessed the client’s status using the APO-15 for the intervention. Then, based on the client’s condition as determined by the assessment results, intervention strategies to further increase occupational experience to promote well-being were considered. As a result, we were able to contribute to the promotion of the client’s well-being and social participation. This suggests that the APO-15 estimation system has the potential to contribute to well-being in occupational therapy practice because it can promote opportunities for clients experiencing mental illness to participate in positive occupations according to their level of engagement.

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A man in his 70s with isolated thumb palsy was treated with repetitive facilitative exercise under continuous neuromuscular electrical stimulation (RFE under cNMES). The RFE under cNMES was performed on the 6th day from the onset of stroke. The RFE under cNMES patterns for this program was thumb opposition/palmar abduction/radial abduction. The surface electrodes were placed on the flexor pollicis brevis muscle, abductor pollicis brevis muscle, and extensor pollicis longus muscle. The 1-week intervention improved the ability to manipulate objects (9 points by the Action Research Arm Test, 175.62 seconds by the Nine Hole Peg Test), suggesting that selective RFE under cNMES on the thumb may promote recovery from isolated thumb palsy.

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The case is a female in her 60s with chronic schizophrenia presenting severe positive symptoms, impeding realistic communication and attention to work activities. Occupational therapy intervention included the following horticultural activities:daily watering activities and creation of a weekly plant growth record poster for 6 months. As a result, the case was able to accumulate opportunities for realistic communication with occupational therapists and engage in occupational activities, indicating that sharing and engaging in plant growth promoted realistic communication. Furthermore, it was thought that incorporating creative activities related to horticulture and setting them to increase motivation activated attention to work.

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We examined the effectiveness of introducing an upper limb rehabilitation support system, which consists of a new small mobile robot and a personal computer, to a patient with severe upper limb paralysis after stroke, in addition to conventional occupational therapy. We intervened for 40 minutes a day for two 14-day periods, resulting in the subject preparing the equipment by himself and using it voluntarily for 27 days. However, the effectiveness of this system was not apparent. Future studies should reconsider the research design, collect cases, verify the effects of this system, and consider application settings that match upper limb functions.

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