Ninety-two patients (92 hands) with distal radius fractures after volar locking plating (VLP) were divided into two groups: those with a low degree and those with a high degree of fear of movement (FOM) using the cutoff values of the Japanese version of the Tampa Scale for Kinesiophobia in the early postoperative period; the short-term outcomes between the two groups were compared. Pain during activity, wrist ulnar deviation angle and Disability of the Arm, Shoulder and Hand (DASH) scores at 1 month and 3 months postoperatively were significantly worse in the patients in the high FOM group than in those in the low FOM group. A high FOM in the early postoperative period after VLP for distal radius fracture may affect short-term objectives and subjective symptoms, as well as functional recovery.

We attempted to introduce the Aid for Decision-making in Occupational Choice (ADOC) and ADOC for schools (ADOC-S) to clients receiving home-based occupational therapy. Our study examined the acceptance rate, characteristics of clients where acceptance was possible or not possible, the content of longitudinal intervention, and subjective and objective outcome changes. Out of the 30 clients included in the study, 11 clients (36.7%) successfully accepted ADOC/ADOC-S. The focus of the goals shifted towards activities and participation. However, even after implementing ADOC, further specification using the SMART framework was found to be necessary. Various adjustments and goal re-evaluations were required to achieve the desired outcomes. Following the intervention, positive changes were observed not only in the degree of goal attainment and satisfaction, but also in terms of health-related quality of life and outcomes based on occupational performance.

Dementia with Lewy bodies (DLB) occurs through the same mechanisms as Parkinson's disease (PD）, leading to similar symptoms. While PD occupational therapy guidelines recommend several assessment indicators, there have been few reports on DLB, and the status of assessments is unclear. Therefore, to elucidate the assessment indicators in occupational therapy interventions for DLB, we conducted a literature review of occupational therapy intervention studies targeting DLB and examined the assessment indicators used. As a result, 14 papers were included, revealing that assessments of cognitive function, tasks, and activities of daily living are being conducted. However, compared to PD, assessments of physical function, mental function, and disease-specific evaluations are insufficient. Using assessment indicators may allow for a multifaceted understanding of disabilities and strengths.

The purpose of this study was to develop an assessment of occupational engagement (AOE). Procedure 1 created a construct of connection of occupational engagement, examined its face validity with 6 elderly people, examined its content validity with 6 occupational therapist researchers, and developed a prototype version of AOE. Procedure 2 examined the validity and reliability of the prototype AOE for 204 elderly people hospitalized in a medical institution for physical disabilities. Analyses included calculation of descriptive statistics, item analysis, structural validity, hypothesis testing, concurrent validity, and internal consistency. The results were generally good, and a final AOE with both validity and reliability was created. This study suggests that AOE can be used for the elderly who are hospitalized in medical institutions.

To gain insight into the role of occupational therapists (OTs) in Japanese social prescribing (SP), which is currently being introduced to Japan, we explore how Japanese OTs implement interventions, including the concept of SP in medical institutions. Japanese OTs identify the health and social needs of inpatients and outpatients with health and social problems using multifaceted evaluations of physical and mental functions, activities, participation, and occupation, without using the term “social prescribing.” They support participation and retention in non-medical resources that meet identified needs. Japanese OTs have already been providing similar support related to social prescribing, and they could play a role in eliciting the needs associated with social issues in Japanese social prescribing and serve as link workers.

The measurement characteristics of the prototype version of the “Communication and Intervention Skills Assessment to build better partnerships with clients in clinical rehabilitation settings (CISA）” were examined and the CISA was developed. A web-based questionnaire consisting of 54 items and a five-item method was administered to 437 physical therapists, occupational therapists, and speech-language-hearing therapists. The validity and reliability of the CISA were examined based on the results of the item analysis, exploratory factor analysis, both Rasch analysis and principal component analysis of residuals, confirmatory factor analysis, and reliability analysis. The CISA had a three-factor structure, Eigenvalues of Principal Component Analysis of Residuals=2.83, a Comparative Fit Index of. 921, a Root Mean Square Error of Approximation of .065, and an overall Cronbach's alpha of .961. A 27-item CISA was developed and validity and reliability were confirmed.

The aim of this study was to unveil the work reality of therapists in the field of physical disabilities within hospital settings, calculate reference values for the number of units that can be feasibly completed within working hours, and contribute to the enhancement of labor management. A total of 349 participants comprising physical therapists (RPT）, occupational therapists (OTR）, and speech-language therapists (ST) were involved in this study. The results showed that the average number of units executed per day was 17.5±2.9 units. In terms of professional comparisons, PTs had significantly more units than STs, while OTs had significantly more paperwork tasks than PTs. Moreover, OTs exceeded STs in maintenance and inspection tasks, with STs having the highest significance for overtime work (p＜0.05）. Significant predictive equations for each profession were obtained through multiple regression analysis, where education and paperwork tasks were found to influence the number of units. This suggests that innovative management approaches are essential to enhance the acquisition of units. In conclusion, this study provides valuable insights into the daily work experiences of therapists specializing in physical disabilities. It presents a foundation for assessing the number of units that can be reasonably accomplished within designated working hours, and offers guidance for more effective labor management.

［Purpose］ We implemented dysesthesia-matched transcutaneous electrical nerve stimulation (dysesthesia-matched TENS) in conjunction with occupational therapy in a female patient in her 60s with cervical spondylotic myelopathy (CSM) exhibiting dysesthesia in both hands after surgery. ［Methods］ Starting from postoperative day 8 and continuing for 5 days, dysesthesia-matched TENS was applied in addition to conventional intervention targeting both hands. ［Results］ Dysesthesia in both hands gradually decreased (Right hand: Tau=−0.65, Left hand: Tau=−0.69）, and upper limb performance improved. Consequently, independence in activities such as eating, bathing, and grooming was achieved, and generalization to activities of daily living was observed. ［Conclusion］ Dysesthesia-matched TENS for CSM has shown potential utility in early postoperative patients, and it suggests the potential contribution to the improvement of dysesthesia, upper limb performance, and activities of daily living.

People with multiple disabilities, including hearing and mental health, may not receive appropriate support due to communication problems, and may have difficulty living as a member of society. In this study, the author, an Occupational Therapist (OT）, provided support for a client with Schizophrenia and Hearing Impairment, who had been in and out of a psychiatric hospital repeatedly and had been considered by her family and support personnel to have limited capacity for living as a member of society. The OT explored her capability from the perspective of occupational therapy as a community life support worker. As a result, the client's built-in ability to live as a member of society was brought out, so the client was able to live as she wished while receiving support from multiple institutions. Thus, occupational therapy may support individuals with co-occurring Schizophrenia and Hearing Impairment to live as a member of society.

Occupation-centered individualized rehabilitation based on the Occupational Therapy Intervention Process Model (OTIPM) was performed for a schizophrenic patient with sequelae of cerebral hemorrhage. As physical function declined and pain worsened, the focus of intervention shifted from “performance” to “engagement.” The intervention resulted in an improvement of satisfaction from 3.3 to 6.7 in the Canadian Occupational Performance Measure（COPM）, a self-efficacy deviation from 34 to 37, and a mean subjective increase of the World Health Organization Quality of Life assessment (WHOQOL) from 2.27 to 2.31. This suggests that proving engagement-focused interventions to patients who have difficulty in occupational performance is one effective approach that contributes to a healthy life with a sense of oneself.

Apathy after stroke can be classified into three types based on thought-behavior processes. We studied the neural circuits of three types of apathy using near infrared spectroscopy (NIRS) and analyzed the cerebral blood flow in the regions of interest (DLPFC, FP, and OFC) by cluster analysis. We confirmed the expected neural circuits for the three types of apathy by comparing which regions of interest showed reduced cerebral blood flow in each cluster. The results showed that apathy was categorized into some clusters: DLPFC and FP, with low cerebral blood flow and impaired cognitive-behavioral processing; OFC, with low cerebral blood flow, impaired affective processing, and emotional disturbance; and other types which did not fall into either of these categories. These analyses indicated that apathy following stroke can be categorized into some types from a neuropsychological perspective.

A man in his 40s who developed a left capsular hemorrhage 10 months earlier and presented with severe right hemiplegia and higher brain dysfunction was provided with employment support in a daycare rehabilitation center far from his workplace. In order to return to work, he needed to bathe, do housework, use public transportation for commuting, and learn the job of “construction estimation” in order to live independently outside of the prefecture. Through a step-by-step intervention managed in collaboration with multiple professions, family members, and companies, the subject returned to work after 42 months of intervention. In employment support, it was important for the subject and the company to understand the characteristics of the disability, and evaluation and practice in an actual environment were essential for this. The occupational therapist's role in setting up the situation and managing the collaboration with supporters is significant, and we believe that there is a high need for employment support in daycare rehabilitation as well.

［Purpose］ This study investigated “tataki dyeing” in a woman in her 70s who was a long-term hospitalized patient with schizophrenia in remission. By comparing the before and after results, we physiologically verified the stress relief effect. ［Methods］ Salivary amylase levels, blood pressure, and pulse rate were used as physiological indicators. Each index was measured three times before and after the activity, and the average value was calculated. Subjective mood was evaluated using the visual analog scale once before and after each activity. Additionally, three “tataki dyeing” sessions were conducted with an interval of approximately 2 weeks. ［Results］ Salivary amylase levels decreased in all three sessions, and subjective mood improved. Furthermore, no significant changes were observed in blood pressure and pulse. ［Conclusion］ Physiological indicators suggest that “tataki dyeing” relieves psychological stress without being affected by physical stress. Furthermore, it improves subjective mood.

The case is a seventy-year-old woman with left lower quarter hemianopia due to right occipital subcortical hemorrhage. Over a period of 4 months, occupational therapists collaborated with her husband to help the woman acquire bicycle riding skills. As a result, we were able to achieve our goals despite the time and route constraints. We found that occupational therapy in collaboration with doctors and caregivers to resume riding a bicycle for patients with hemianopia through establishment of safe methods through actual vehicle practice is important.

Family education and information provision are important in supporting persons with higher brain dysfunction. This case is a woman in her 60s who developed capsular hemorrhage with attention disorder. Because the family did not understand the symptoms and the patient suffered from occupational dysfunctions, outpatient care was conducted utilizing Cognitive-related Behavioral Assessment (CBA) between the occupational therapist and the family. The results showed that the family became more supportive, and their occupational dysfunction improved after the assessment and intervention using the CBA, as they gained an understanding of the patient's symptoms. The intervention process in this case suggests the clinical usefulness of CBA for the purpose of helping patients' families understand the symptoms and learn how to relate to the patient appropriately.

Patient education and self-management using a self-management sheet were implemented on elderly heart failure patients. Patient education included ADL interventions based on goal-setting using COPM. As a result, early discharge and prevention of exacerbation of heart failure were achieved. This report suggests that patient education and completion of self-management sheets for heart failure patients may contribute to early discharge and prevent heart failure. Additionally, motivation is essential for patients to practice self-management from the time of hospitalization, and we believe that COPM is an effective intervention for heart failure patients as a means of goal-setting.