The purpose of this study was to examine the effect of the Adjusting the Challenge-skill balance (ACS) process, which applies flow theory (flow model), on the subjective quality of life of elderly people who use home-visit rehabilitation. The research method was a crossover study, and 10 home-visit rehabilitation users were included in the study. In the experimental phase, ACS was implemented to meet the lifestyle and activity goals related to the care plan being used, and in the control phase, normal in-home rehabilitation services were provided. The primary outcome was subjective quality of life (Ikigai-9), and a generalized linear mixed model (Bayesian estimation method) was used for analysis. Results showed no significant difference between the experimental and control periods (difference: 0.87±0.48, 95% CI; -0.01-1.81). As a result, it can be difficult to balance challenges and skills when implementing ACS for real home life problems. In other words, it was suggested that it would be difficult to share goals and carry out the goal achievement process according to the CL situation, and that it might not have a positive impact on subjective QOL.

The purpose of this study was to explore the effects of interactional “Hureai play” in early childhood between mother and child on attachment. Participants comprised 36 children between the ages of 2 and 2 years and 11 months, and their respective mothers. Ten minutes of free play between mother and child were filmed, and the analysis was conducted for the five minutes in which there was a lot of “Hureai play.” A questionnaire was used to evaluate attachment, and “Hureai play” was examined quantitatively through total time of positive touch with the child as well as items related to mother-child interactions. The relationship between attachment and “Hureai play” was examined using a binomial logistic regression analysis. The results showed that quantitative items were not involved in attachment stability. However, a mother's ability to respect the child's intentions before “Hureai play,” the child's moderate emotional expressions during “Hureai play,” and the mother's emotional responsiveness after “Hureai play” were related. Therefore, it was suggested that interactional “Hureai play” between mother and child with this sequence of events is important for attachment formation.

We investigated the effects of sensory information from the contralateral upper limb on motor control during grasping movements of the upper limb. In the first experiment, movements of 20 healthy subjects were compared in three conditions based on the presence or absence of object grasping and vision in the contralateral upper limb. The results showed that the hand opening width was decreased in the condition of the combination of vision and contralateral upper limb grasping. In the second experiment, the movements of 20 healthy subjects were compared under the condition that the distance and size of the object were individually provided by the grasping of the contralateral upper limb. The results showed that the distance information contributed to the decrease in hand opening width, but the time required to open and close the hand tended to increase when the distance and size information were not aligned. Thus, the contribution to the control of grasping motion may depend on the spatial clarity of the integration of object vision and the somatosensory integration of the contralateral upper extremity.

The purpose of this study was to elucidate the current conditions and factors influencing the practice of IADL in a recovery rehabilitation unit. The subjects were 900 occupational therapy department managers from member wards of the Kaifukuki Rehabilitation Ward Association, and a total of 251 responses were received. The study observed significant correlations between the degree of IADL practice implementation and factors such as perceived value of IADL practice, required budget, required time, and understanding of surrounding staff. Remarkably, around half of the participants did not conduct objective evaluations. Among the group that did conduct evaluations, there was a significantly greater perceived need for IADL practice and a better physical environment. Thus, while the study provided suggestions for facilitating the practice of IADL, it also highlighted the need to implement IADL evaluation and develop a simple evaluation method.

This study investigated the performance of daily activities and changes in time-use before and after a psychiatric outreach service using a management tool for daily life performance (MTDLP). A total of 25 people with schizophrenia and related disorders (F2) or affective disorders (F3)(ICD-10)living in the community participated in the study; the occupational questionnaire was administered before and after the intervention. Before the intervention, about 50% of the day was used for “sleeping” and “watching TV.” After the four-month intervention, time-use of “daily activities with low value” decreased. These results suggest that the people with psychiatric disorders may come to spend the meaningful time through the “psychiatric outreach service using MTDLP.”

The objective of this report is to present a case-based, investigative examination of clinical education aimed at bolstering occupation-centered evidence-based practice (EBP). The participant was an occupational therapist employed at a convalescent hospital. The clinical education program, which lasted approximately six months, was based on occupation-centered EBP competencies. Alongside providing guidance and advice regarding the clinical scenario of the assigned case, individual lectures were administered according to the intervention's progress. Pre-and post-education, there was a marked improvement in participants' attitudes and perceptions regarding EBP, as well as a boost in their professional identities. These developments suggest the clinical education program's utility in supporting occupation-centered EBP.

We experienced a case with Parkinson's disease who complained of difficulty reading letters. The cause of the reading difficulty was considered to be a reduction in contrast sensitivity. By changing the color tone, width, and size of the letters, the readability of the cases was improved. We considered that the contrast-enhancing operation, i.e., facilitating the detection of the boundary between the background and the visual object, was effective in solving the problem. The case was able to acquire a solution to the reading difficulty. It is important to understand the pathophysiology characteristic of the disease. In addition, understanding and verifying the life situation in which the problem occurs helps determine the cause and respond to it.

Evidence for a top-down approach utilizing Goal-Directed Training in pediatric occupational therapy is presented. The purpose of this report is to assess the efficacy of a home program for the goals of child with attention-deficit/hyperactivity disorder and her mother. In the present report, child with attention-deficit/hyperactivity disorder and her mother engaged in collaborative goal setting with mother and child, a home program adapted to the home context, and timely coaching, which resulted in improved Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) scores and changes in targeted activities. This study demonstrates that a home program focused on meaningful work with child and mother has the potential to facilitate goal achievement through the provision of supportive parenting within the context of parenting.

In the present study, patients in the acute phase of stroke with unilateral neglect were given a wearable device that provides sensory stimulation to the paralyzed hand, and practiced repetitive task-oriented exercises of the upper limb and paralyzed hand use in ADL, one of the Transfer Package. The wearable device stimulated self-monitoring of the paralyzed upper limb, and the repetitive upper limb use practice improved upper limb function, frequency of paralyzed hand use in ADL, awareness of neglect behaviors and paralyzed hand use situations, and improvement of hemiparesis symptoms. These findings suggest the usefulness of combining these exercises as an intervention for patients with hemiparesis neglect.

This case report aims to add additional knowledge to existing reports on the effect of visual cognitive dysfunction on mobility, and support for mobility through case reports and literature review. In the first case, the patient experienced visual inattention, which led the patient to miss landmarks, get lost, and experience delayed judgment when crossing roads. The other patient had metamorphopsia and abnormalities in distance judgment and optic flow, which resulted in abnormalities in distance perception during movement and climbing stairs and in landscape vision. Neither patient showed improvement in mobility with compensatory strategies using conventional visual information, such as maps and landmarks. These findings underscore the importance of considering a range of visual cognitive dysfunctions when assessing and supporting mobility after brain injury.

The effect of Graded Repetitive Arm Supplementary Program (GRASP) combined with Functional Electrical Stimulation (FES) on stroke patients with severe upper limb paralysis was investigated in an ABA single case design. The method was the usual occupational therapy in phase A and the GRASP combined with FES in phase B, which was performed for 1 hour per day. Each period was set for 4 weeks. FES was applied to the proximal part of the upper limb where the paralysis was more severe. The results showed that the changes in upper limb function and real-world arm use exceeded the minimum clinical important difference in phase B. The patient was able to use the paralyzed hand as a support in daily life. The results suggest that the combination of GRASP and FES for severe upper limb paralysis may improve upper limb function and real-world arm use.

An interview-based occupational therapy intervention using the Classification and Assessment of Occupational Dysfunction (CAOD) was conducted on an inpatient with avoidant personality disorder characterized by extreme inhibition of social interactions. The effectiveness of the intervention was investigated based on a single-case experimental design, examining the following: number of times the inpatient participated in occupational therapy programs, changes in his narratives, and changes in his behavior before and after the intervention. The results showed a significant increase in the number of occupational therapy participation, changes in the narrative of meaningfulness in daily activities, and an influence on the expansion of proactive behavior in daily life. These results suggest that occupational therapy intervention based on interviews, focusing on occupational dysfunction is effective for participation in occupational activities in inpatients with avoidant personality disorder.

[Introduction] We report the results of interventions in which a family-participatory Transfer package (TP) and voluntary practice were used in addition to CI therapy for stroke patients with left hemiplegia. [Intervention] CI therapy with orthoses and electrical stimulators was performed for 1 hour a day with the family present. A 30-minute day was carried out for 11 weeks. [Results] Psychological changes were observed, such as improvement in upper limb function evaluation and positive remarks regarding returning to school. [Discussion] For child who were mentally unstable, family-participatory TP and voluntary practice lead to maintenance of motivation and improvement of monitoring, and not only paralyzed hands but also psychological changes. The possibility of exerting it was considered.

[Introduction] We report a case of flaccid hemiplegia in which the patient had difficulty using his dominant hand for Activities of Daily Living (ADLs). [Subject] A man in his 50s who had two cerebral infarctions (left cerebellum and left corona radiata) in a short period of time. Initially, he had difficulty using his dominant hand for ADL due to flaccid hemiplegia. [Methods] Mental practice, video observation task, task-oriented training, and praise from others were performed for 3 months. [Result] The affected hand can be used as the dominant hand in ADL due to functional improvement of the affected hand. [Discussion] The patient had difficulty using his affected hand due to damage to the pyramidal tract and cerebellum. Although interhemispheric inhibition and learned non-use of the affected hand were also assumed to have affected the patient's recovery, it is possible that combined interventions contributed to the patient's recovery.

We investigated whether passive stimulation using a game application in Virtual Reality (VR) with an immersive head-mounted display device was effective in improving left hemispatial neglect (USN) in two convalescent patients with left hemispatial neglect, compared with an intervention using active stimulation. The results showed that USN symptoms were improved in both patients after the intervention using the VR game application compared to the intervention using active stimuli. We believe that VR training has potential as an approach to USN that requires a variety of interventions.