【はじめに，目的】立位姿勢制御において視覚は重要であり，視覚が遮断されると立位姿勢制御に影響を与える。理学療法において視覚を遮断する際，閉眼を用いることが多いが日常生活において閉眼立位をとることは少ない。閉眼と開眼した状態の暗所とは立位姿勢制御が異なる可能性がある。両者ともに重心の前後方向の最大動揺が増加し，前者より後者が認知課題の処理能力が落ちることが報告されている（Raymond K, 2012）。しかし，先行研究では重心の前後の最大動揺を評価しているのみである。そこで，今回は前後だけでなく総軌跡長と矩形面積を評価した。また，臨床場面において完全暗室を用いて評価することは難しいため，開眼した状態でを装着することにより暗室と類似した立位姿勢制御を評価した。本研究の目的は，高齢者と若年者において，閉眼および開眼した状態でを装着するという二つの視覚遮断条件が姿勢動揺に与える差異を明らかにすることとした。【方法】対象は健常大学生20名（男性10名，女性10名，年齢21.7±0.6歳）と健常高齢者20名（男性10名，女性10名，年齢72.7±4.0歳）とした。対象者はForce platform（WIN FDM, Zebris, Germany）上で開眼，閉眼，の3つの視覚条件にて立位を各々30秒間測定した。評価項目は総軌跡長と矩形面積とした。内で開眼するよう指示した。統計解析は年齢（若年者，高齢者），視覚条件（開眼，閉眼，）による測定項目の平均値の差を反復測定二元配置分散分析を用いて検討した。交互作用があれば単純主効果検定を行ない，交互作用がなければ主効果判定を行なった。有意水準は5％未満とした。【結果】総軌跡長において，若年者ではが開眼と比較して総軌跡長の値が有意に大きかった。高齢者では全ての視覚条件の間で有意差が認められ，開眼，閉眼，の順に大きくなる傾向が示された。年齢と視覚条件の有意な交互作用が認められた。矩形面積においては，若年者と高齢者ともに開眼と閉眼に対してで矩形面積の値が有意に大きかった。年齢と視覚条件の有意な交互作用が認めらなかった。【考察】本研究の結果，若年者では，閉眼の間で総軌跡長に有意な差はないが，高齢者では閉眼よりもにおける総軌跡長が有意に大きいことが示された。この結果は，加齢の影響により開眼した状態で視覚情報が得られない場合，自ら閉眼するときよりも姿勢動揺が大きくなることを示唆している。姿勢制御能力が低下した高齢者にとって，夜間の暗所でのトイレ移動のように開眼しているが見えないという状況において姿勢動揺が増加する危険性が高くなると考えられる。また，矩形面積においては年齢と視覚条件の主効果のみ認め，それらの交互作用は認められなかった。このことから，では閉眼と比較して姿勢動揺が増加し，また不意の大きな動揺の出現や動揺の方向の変化が生じると考えられる。高齢者や患者においては特に，閉眼立位に加えて，などを利用して開眼した状態で視覚を遮断した立位時の姿勢動揺も合わせて評価する必要があると考える。閉眼とによる視覚遮断において姿勢動揺に差異が生じたメカニズムについて考察する。健常成人は開眼立位時と比較して，閉眼立位時に前頭眼野，前頭前野背外側部の活動が増大する（Ouchi, 1999）。前頭前野は姿勢制御における感覚の重みづけに関わっている可能性がある（Bolton, 2012）。開眼した状態で視覚情報が得られない際の脳活動に関する先行研究はない。閉眼による視覚遮断時は開眼した状態でのによる視覚遮断時と比較して，前頭前野による足底感覚など姿勢制御に必要な視覚以外の感覚への再重みづけが有効に行われる。その結果，姿勢動揺が減少した可能性があると考える。視覚遮断の方法によって立位時動揺に差異が生じる機序について今後明らかにする必要があると考える。【理学療法学研究としての意義】本研究の結果，自ら閉眼して見えない状況と開眼しながら見えない状況では姿勢動揺の傾向に違いがあることがはじめて示された，その差異を考慮することにより，理学療法において視覚遮断時の姿勢制御の評価・治療を実際の日常生活環境に近い状況で実施可能になるのではないかと考える。

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The purpose of research is to clarify the behavioral characteristics of the visually impaired in model courses. Experimental courses were a straight course without any obstructions, and 6 kinds of bent course. Subjects were 5 totally blind pedestrians, 5 eye-masked pedestrians and 5 normal sighted pedestrians. The results were that, in bent course, walking time of the totally blind was twice as much as that of the normal sighted, while that of the eye-masked, 5 times as much as that of the normal sighted. The totally blind walked at a speed of 62% of the normal sighted in bent course, while the eye-masked, at a speed of 25% of the normal sighted. The number of stops of the eye-masked was 2.4 times as many as that of the totally blind in the bent course. The time of stops of the eye-masked was 2.5 times as much as that of the totally blind in the bent course.

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 Walking environment for visually handicapped people has improved. However, the present condition of pedestrian spaces still causes difficulty for them. A good sample is a spiral ramp. In this study, we put yellow-colored braille blocks on a spiral ramp, and surveyed the spatial cognition of visually handicapped people to improve the ramp. To clarify the characteristics of spatial cognition and search behavior, experiments were performed using 32 different courses. Subjects were visually handicapped people and eye-masked people with ordinary vision. The search behavior of the two groups was compared and analyzed by walking locus and observation; and the spatial cognition, by interview and observation.

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Spatial cognition of visually handicapped people has clarified and walking environment for them has been improved. However, the pedestrian spaces of present condition are still highly constrained for them. A spiral ramp is one of them. Therefore, we surveyed the spatial cognition of visually handicapped people on a spiral ramp. In this study, in order to clarify the characteristics of their spatial cognition and search behavior, experiments were carried out in 14 kinds of courses on a spiral ramp. Subjects were visually handicapped people and eye-masked people with ordinary vision. The search behavior of the two is compared and analyzed by walking locus and observation; and the spatial cognition, by interview and bservation.

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It is hard for the visually handicapped to attain their objects by walking alone. Improving the walking environment is important for them. The behavior to recognize the spaces must be clarified for the improvements. In this study, the experiments ware carried out in nine model laboratories which are five square models and four corridor models, and the behavior of the visually handicapped was analyzed. As a results, the characteristics of the behavior ware clarified in each model laboratory. Especially in square models which had two axis, the behavior was influenced by the length of wall without a break, the degree of restriction in a corner and the complication of factors in spaces.

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It is difficult for visually handicapped people to recognize spaces and their position when they walk on curved paths. They often have accidents or lose their way in such paths. In this study, in order to clarify the spatial cognition of the visually handicapped and their characteristics of the search behavior, experiments were carried out by producing 7 kinds of model paths. I made it clear whether the visually handicapped could recognize the direction of the paths, whether they could keep the direction, and how to know the direction and the clues for their spatial cognition.

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我が国で初めて系統的な歩行訓練指導員（歩行訓練士）の養成がおこなわれたのは1970年、米国人のMr. Jaekleによってである．当時の資料1</sup)と受講体験^（注1）を参考に白杖歩行訓練草創期のモビリティ技術について概要を述べる．

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はじめに 13歳男児は、日常生活援助や声かけなどの刺激、療育活動、授業中も眠っていることが多い。このような状況の中、どのように生活リズムを整えたらいいのか戸惑いながら関わってきた。そのため、サーカディアンリズムを調査したところ、日内変動が認められた。男児は、9時〜12時の間は入眠していることが多く、睡眠・覚醒リズムが乱れていた。そこで、看護介入をすることでサーカディアンリズムが整えられたため、ここに報告する。 目的 急性脳症後遺症児のサーカディアンリズムを明らかにし、看護介入の効果をみる。 対象 13歳男児　診断名　急性脳症後遺症　大島の分類1 方法 1．看護介入前後の体温、脈拍、酸素飽和度、睡眠・覚醒状況、環境温度を1時間ごとに測定する。 2．看護介入として、（1）朝食前に冷タオルで顔面清拭　（2）車椅子乗車・声かけ　（3）夜間の装着を行う。 結果および考察 看護介入の結果、9時〜12時までの覚醒時間の延長を認めた。冷タオルの洗面刺激では、パッと開眼し驚いた表情と四肢の屈伸がみられた。これは、一定の時間に起床を促し刺激をすることで生活のめりはりとなったのではないかと考える。日中の車椅子乗車では、声かけやスキンシップを通して、周りをキョロキョロする反応がみられ、活動量の上昇は、日中の覚醒とほどよい疲労として夜間睡眠を促したのではないかと考える。装着は、昼夜の環境面を整える一環として大切であると考える。 結論　 1．体温、脈拍、睡眠・覚醒リズムから、サーカディアンリズムを確認できた。 2．冷タオル刺激、車椅子乗車・声かけ、装着による看護介入は、睡眠・覚醒リズムを整える効果があった。

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This study is based on the study "Recognition of spaces in model laboratory: A study on walking environments for visually-handicapped people". In this study, the experiments in previous study were analyzed in new aspect and in detail. The behavior of the visually-handicapped was analyzed by walking locus, and the recognition of spaces was analyzed by using sketch map and interview. As results, in the behavior, characteristics were clarified in each model laboratory. Especially they could be seen at the area of corner, around the walls, inside of the area surrounded with the walls, outside of the area surrounded with the walls; the blind subjects tend to stop and think at the area of corner, the low vision subjects, inside of the area, and the eye-masked subjects, out side of the area. In the recognition of spaces, correct answer rate was specific according to the attributes of subjects. The relation between the behavior and the recognition were clarified.

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 It is difficult for visually handicapped people to recognize spaces and their position in circular structures. They often have accidents or lose their way in such situations. In my previous studies, I found that they not only lost their way but also were not safe around circular structures. Therefore, I surveyed the spatial cognition of visually handicapped people walking outside circular structures. In this study, in order to clarify the spatial cognition of the visually handicapped and the characteristics of their search behavior, experiments were carried out by producing 4 kinds of model structures of circular plan. I chose 12 totally blind people ages 22 to 39 and 12 sleep mask wearers ages 18 to 24. I will call the sleep mask wearers s.m.w.

 The results are as follows.

 

 1. Walking speed of both the visually handicapped and the s.m.w. were 0.45m/s regardless of the radius when walking 1 lap, and this speed were 1.3 times of 1/4 laps. The rate of lap difference of the visually handicapped were 20-30 % and that of the s.m.w. were 30-45 %, regardless of the radius. Understanding of laps of the visually handicapped were 70-80 % and that of the s.m.w. were 50-70%. It appeared that the s.m.w. had difficulty understanding 3/4 laps. The larger the radius was, the smaller both the visually handicapped and the s.m.w. could sense the radius. They sensed the radius as 60-70% of the real radius in the 5m radius. The visually handicapped sensed the radius as 1.2 times of it in the 2m radius, while the s.m.w. sensed it correctly.

 2. For the two, the difference of laps was correlated with the difference of the radius. The larger the difference of laps was, the larger the difference of the radius was, or the larger the difference of the radius was, the larger the difference of laps was. The regression line of the visually handicapped was similar to that of the s.m.w., so the relationship between the difference of laps and the difference of the radius had similar characteristics for the two.

 3. When the visually handicapped sensed that they could understand the laps or they walked anticlockwise, the rate of the lap difference was lower and the difference of the radius was larger. When the s.m.w. sensed that they could understand the laps, the rate of the lap difference was higher and the difference of the radius was smaller, however the rate of the lap difference and the difference of the radius was not influenced by the direction they were walking. Depending on their understanding of laps and the walking direction, their consciousness turned to one side, and the understanding of laps and the cognition of the radius were not compatible.

 4. As clues for the cognition of the laps, subjects sensed acoustic echo, imaging spaces, bending degrees of the wall and sense of rotation of their body useful, however degrees of panel seam, the number of panels and the number of steps not helpful. Moreover, the feeling of the panels was useful and also not helpful as a clue. When the subjects were walking around the circler structures, some of them were conscious of the center of the circle or the starting point constantly.

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A real-time speech synthesizer enables users to control pitch, loudness, and phonemic information of the output speech using their body motions in real time. To investigate optimal motions for the synthesizer, pitch control experiments were carried out. A subject controls hand height, shoulder angle, or elbow angle to determine pitch of the matching tone, and is required to match with the pitch of the presented target tone. The pitch errors were evaluated in two sensory feedback conditions. One is a full-feedback conditions in which auditory, kinesthetic, and visual feedbacks are available. The other is a limited feedback condition where visual feedback is unavailable. The results indicated that subjects could control hand height with 4.2 mm accuracy, shoulder angle with 0.85- degree accuracy, and elbow angle with 1.8-degree accuracy in the full-feedback condition. The visual feedback was found to be very effective which could reduce 42.1 to 64.1 % pitch errors on the average. In the limited feedback condition, the mean pitch errors were 0.465, 0.546, and 0.410 semitone for hand, shoulder, and elbow controls, respectively. The elbow angle was thus concluded to be the most effective motion to control pitch for the speech synthesizer.

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We evaluated the effects of eye-masks containing heat- and steam-generating (HSG) sheets application to the eyes during sleep on sleep quality. The former 3 days were used as a control period (control condition). On the latter 3 days, the subjects used eye-masks containing HSG sheets during sleep (HSG sheets condition). An actigraph was worn on the non-dominant wrist during sleep under each condition. As a result, the sleep latency slightly decreased under HSG sheets condition than under control condition, and the total awake period during sleep in the former half of sleep significantly decreased under HSG sheets condition. In addition, the self-evaluated sleep quality on waking up significantly improved. The application of HSG sheets at bedtime was useful for inducing sleep.

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加齢や服薬に伴う唾液分泌能の低下は摂食・嚥下障害や誤嚥性肺炎につながる深刻な問題であり，有効な対策が求められている。本研究では，柑橘系のにおい刺激と顎顔面周囲への温熱刺激の併用によって唾液分泌を改善する方法を試みた。今回の試験では，スダチのにおいを実際の患者の食事に応用するにあたって，量産可能な代替香料の有効性(実験1)，および作用の持続(実験2)について検討した。対象者は，健常成人94 名(実験1：68 名，男性37 名，女性31 名，平均年齢24.3±2.1 歳，実験2：31 名，男性23名，女性8名，平均年齢25.5±3.9歳)とした。 におい刺激剤としてスダチ果皮より抽出したスダチ精油と，スダチの香気成分資料をもとに精製したスダチ風人工香料を用いた。温熱刺激には，使い捨て温熱(めぐリズム蒸気で®無香料，花王株式会社)を用いた。におい刺激の有無と温熱刺激部位別に8 条件を設定し，1 時間の唾液分泌量の変化を比較した。唾液分泌量の測定にはワッテ法を用いた。 安静時を基準とした唾液の増加率において，スダチ精油とスダチ風人工香料間で有意な差は認められなかった。刺激後1 時間の唾液分泌量の変化より，におい刺激は刺激当初に，温熱刺激は徐々に唾液量の増加を促すことが示された。食事時のリハビリテーションへの応用には，食事のタイミングや食事時間を考慮した刺激の組み合わせが有効であることが示唆された。

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