The purpose of this study is to investigate whether cognitive dysfunction, especially frontal lobe dysfunction, is a predictive factor of falls in patients with Parkinson’s disease（PD）. We recruited 81 PD hospitalized patients. The severity of patients was evaluated by Hoehn-Yahr（H-Y）staging. All patients were ranked into stages 2 to 4, and all patients could walk without aids. One month prior to hospitalization, the patients were categorized according to their fall history: Group 1 consisted of patients without falls, Group 2 consisted of patients with one or two falls, and Group 3 consisted of patients with more than two falls. Spearman’s rank correlation analyses were used to compare the severity of H-Y with total scores of MMSE, and with total scores of FAB among three groups. We also analyzed the correlation between falls and total scores of MMSE, and total scores of FAB using multiplex logistic-regression analyses. The results of which demonstrated that total scores of FAB were useful for predicting falls, and PD patients with total scores of FAB below 13 out of 18 may have more tendency to fall. In conclusion, frontal lobe dysfunction may be the riskiest predictive factor for tendency of falls.

This study aimed to examine whether driving performance in simplified driving simulator assessments could be related to fitness-to-drive in evaluating driving by post-stroke patients. The study was conducted on 149 stroke patients whose fitness-to-drive had been evaluated by on-road assessment. Principal component analyses were performed for driving simulator assessment items and compressed into five principal components. For the relationship with fitness-to-drive, multiple logistic regression analysis was performed with fitness-to-drive as the dependent variable, PC scores of driving simulator assessment as the independent variable, and age, FIM-M, MMSE, KDBT, SDMT, ROCF, and SIAS-U/E as covariates. The results pointed to three driving simulator assessment characteristics related to fitness-to-drive: distributive attention, lane driving ability, and left-right attention distribution.

The usefulness of assessments was investigated by measuring the work performance skills, adaptive behavior levels, and intellectual ability of children with Autism Spectrum Disorder （ASD） simultaneously, and by investigating the characteristics and relationships among these assessments. The results indicated that more children with ASD had work performance skills and adaptive behavior levels of －1 to －2SD or less than those of children with typical development, indicating the need for support based on each assessment. Work performance skills were found to be related to the level of adaptive behavior in ‘Personal’ and ‘Domestic’, but the relationship with intellectual ability was limited, necessitating further investigation. This study indicates the usefulness of using the AMPS and the Vineland-Ⅱ adaptive behavior scale to focus on the needs of the target children and their parents.

This study aimed to determine the movement characteristics of COPD patients at home using AMPS and its association with critical COPD-specific outcomes. The subjects were 13 patients who had not yet received home oxygen therapy, and for whom AMPS could be measured at home. Respiratory function tests, mMRC, CAT, NRADL, PFSDQ-m, and AMPS were measured and correlated with AMPS measurements. Results showed that both AMPS motor and process skills correlated with CAT, NRADL, and PFSDQ-m. AMPS motor skills also correlated with respiratory function and mMRC, and AMPS correlated with existing disease-specific ADL scales, suggesting that AMPS reflects the ADL abilities of COPD patients.

The aim of this prospective cohort study was to substantiate the impact of a state of emergency to prevent COVID-19 infection on occupational participation of the elderly living in the community. This study investigated 26 elderly over 65 years old living in the community: 11 before the state of emergency and 14 during the state of emergency. The 25-question Geriatric Locomotive Function Scale and Self-completed Occupational Performance Index (SOPI) were compared before and after in each group. The results indicate that SOPI control, balance, satisfaction, leisure activities, productive activities, and total scores were significantly lower before than after the state of emergency only in the state of emergency group, suggesting the substantial impact of a month-long state of emergency on occupation performance of elderly living in the community.

Recently, many schools for children with special needs in Japan are collaborating with PTs, OTs, and STs to brush up teachers’ expertise and to meet the needs of each child. Though many OTs are working in schools for children with special needs, there is a lack of standardization, and specifics of employment and the contents of their business depend on local government policies. This study aimed to discover the actual state of OT in schools for children with special needs in Japan. 34 OTs working in schools for children with special needs （18 of them were full-time staffs and 16 of them were external resources） were approached and interviewed about their in-school activities. Interviews were transcribed and analyzed thematically. The interview data suggest that OTs working in schools for children with special needs are maximizing their specialization and collaborating with teachers to support the children’s school life. The interview data also indicate that there is a difference between the full-time workers and the external resources. Full-time workers are working both as an OT and as a teacher, and external workers are working as OTs in each school.

The purpose of this study was to clarify the differences between occupational therapists’ (OTR) and occupational therapy students’ (OTS) eye movements on movement observations and changes due to advice. The method was to wear a gaze analysis device and watch a video of a hemiplegic eating movement. The gaze data of 5 OTRs and 28 OTSs (13 with advice, 15 without advice) were obtained and compared in 5 areas. The results showed that OTRs and OTSs had similar rates of gaze fixation with and without advice and gazed more at specific areas when specific viewpoints were presented through verbal instructions. However, there were fewer significant changes in the gazes of OTSs when instructions were given using clinical reasoning, suggesting that later observations may be more appropriately implemented by adjusting the amount and content of advice to match the comprehension abilities of OTSs in clinical practice.

The purpose of this study was to examine trends in the highest level of mobility of patients admitted to a palliative care unit at the time of a fall and the motives for the behavior leading to the fall in order to consider the balance between patient safety and patient dignity. The subjects were 392 patients admitted to a palliative care unit. The mobility of the non-fall group and the fall group was evaluated with the Johns Hopkins Highest Level of Mobility Scale （JH-HLM）. The highest level of mobility at the time of the fall in the fall group was the level at which the patient could transfer to a chair. Defecation was the most common behavior leading to falls. By providing opportunities for discussion between medical care providers and patients with a view to eventually narrow the range of activities and decline in ADL, it is possible to support patients’ autonomous medical treatment life.

We conducted an occupational therapy intervention for a patient with paralysis of the dominant hand due to cerebral infarction, utilizing not only functional interventions but also OSA-Ⅱ and GATB, in order to bring about an interaction. After approximately 5 months of intervention, the patient’s paralyzed hand function and use behavior in real life changed beyond MCID, and the patient eventually returned to work. In this case, comprehensive intervention using OSA-Ⅱ and GATB with a view to return to work was effective and led to behavioral change.

This practical study aimed to improve the social outcomes in a client with schizophrenia who hoped to gain employment. The client was assessed for occupational dysfunction, life skills and environment, internal motivation, and cognitive impairment. After interpreting the relationship between each factor, the interventions based on cognitive rehabilitation techniques, life skills training, and environmental support were applied to improve the cognitive impairment that was assumed to cause the occupational dysfunction. As a result, the client’s occupational dysfunction improved, and he was able to meet his goal and obtain an employment contract for continuous employment type A (paid employment). Conducting an occupational therapy practice based on the assessment of occupational dysfunction while interpreting factors, such as life skills, environment, internal motivation, and cognitive impairment, is useful to improve social outcomes in community-living clients with schizophrenia presented with cognitive dysfunction.

The case was a male patient in his 50s using outpatient rehabilitation with long-term care insurance who sought competitive employment. He suffered from lower back pain, poor physical fitness, and autonomic imbalance and had been treated with antipsychotic drugs. He was initially reluctant to work in the disability quota. Several interventions were started from the point of being old, which the patient had accepted as a disincentive to employment. In addition, the occupational therapist implemented a plan to increase outings to improve real life physical fitness based on self-determination and reviewed the results. As a result, the client started to work under welfare employment with subjective satisfaction as a passage to competitive employment. This case identifies three important aspects for a patient with low feasibility employment goals to be convinced and to change their goals: a focus on accepting the state of disability, respect for self-determination, and the opportunity to experience and reflect on real-life.

We had the opportunity to be involved with a client with schizophrenia in the ward within the Medical Treatment and Supervision Act. This intervention focused on the client’s desire to “improve conversation with others” and achieved it through the Occupational Therapy Intervention Process Model and Evaluation of Social Interaction. As a result, the client’s interpersonal skills improved, and the difficulty in communication was reduced. In medical care of the Medical Treatment and Supervision Act preceded by a crisis intervention model, the practice of forensic psychiatric occupational therapy based on the occupational therapy intervention process model may protect the clients and promote medical care of Medical Treatment and Supervision Act based on the social reintegration model.

Multimodal supportive intervention is essential to ameliorate perioperative complications for patients with severe heart disease. However, little is known on the clinical efficacy of occupational therapy for neonates with severe congenital heart disease. In recent years, post-intensive care syndrome may lead to decreased quality of life （QOL） after leaving the pediatric intensive care unit. Herein, we report our clinical experience of early occupational therapy following extensive cardiovascular surgery for a neonate with Epstein’s disease. Occupational therapy intervention from the acute phase of the disease contributed to patients’ early discharge and improvement of QOL. This study highlights the importance of the early introduction of a rehabilitation program to promote patient recovery, thereby improving the quality of life of neonates with cardiopulmonary failure.

In recent years, universities and other institutions have been training occupational and physical therapists using early exposure. However, since 2020, the coronavirus has made it impossible to conduct early exposure training in Japan. In order to clarify the advantages and challenges of using virtual reality as an alternative to early exposure, a virtual reality facility tour using teaching materials and a questionnaire were conducted. The results showed that virtual reality is an effective method that allows students to feel the facility’s atmosphere, has a high level of student satisfaction, and is not easily affected by time constraints. On the other hand, eye fatigue and motion sickness were observed in some students, which is an issue to be addressed in the future.

We examined the effect of Transfer Package （TP） using the single case design （BAB method） for a stroke patient with motor paralysis and aphasia of the right upper and lower limbs. Standard occupational therapy （range of motion exercises, task-oriented training, activities of daily living exercises, and housework exercises） was performed in stage A, and standard occupational therapy and TP were performed in stages B1 and B2. As a result, in the B1 and B2 stages, compared with the A stage, improvements were observed in the Fugl-Meyer Assessment upper extremity items, the frequency of use of the paralyzed hand, and the quality of movement. Therefore, TP may be a useful approach for patients with aphasia.

The aim of this study was to evaluate occupational therapy interventions in a dementia support team in an acute hospital. Postoperative elderly patients with musculoskeletal disease with impaired cognitive function were assessed. The results show an improvement in cognitive function was found in the Functional Independence Measure （FIM）, but not the Japanese Mini Mental State Examination. Moreover, the FIM motor improved, and behavioral and psychological symptoms of dementia, delirium, psychotropic drug use, disposable diaper use, and physical restraint use decreased. These observations imply that dementia support teams involving occupational therapists could be useful for elderly care in acute hospital care settings.