Osaka Kawasaki Rehabilitation University Repository
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Changes in Motor and Cognitive Functions after Self-training during a Post-intervention Period
Get PDF【目的】地域在住者を対象に運動教室終了後の自主活動の成果を反復測定し、運動及び認知機能の改善について調査することを目的とした。
【対象および方法】対象は3 回の反復測定が可能であった60 歳以上の地域在住者25 名( 男性3 名、女性22名) とした。効果判定の指標は歩行速度、2 ステップテスト、四肢骨格筋量指数、握力、Mini-Mental state Examination、Trailmaking test–A、基本属性とした。測定は事前検査を行い、3 ヵ月の運動教室を実施したのちに、事後検査を行い、それぞれの参加者による3 ヵ月の自主活動を継続実施したのち、追加検査を実施した。
【結果】歩行速度及び握力について事前検査と比較して事後検査では有意な改善が見られた(p<0.05)。事後から追加の自主活動期間で改善した項目はなかった。
【結論】専門職による介入教室は運動機能の改善効果が示唆されたが、自主的な活動における持続した運動機能改善は見られなかった。articl
Keys to Life-fulfillment in Severe Chronic Upper Extremity Hemiplegia: A Qualitative Study
Get PDF【序文】脳卒中の慢性重度片麻痺上肢は、日常の失敗体験の積み重ねにより、麻痺側上肢は益々使われない手として学習される。これは、麻痺側上肢を生活場面で使用する機会を阻害されるだけでなく、生きがいや幸福感にも影響を及される。しかしながら、彼らの生きがいをどのように感じているかを捉える構造はいまだ明らかにされていない。
【目的】本研究は、慢性重度片麻痺側上肢の人に対して生きがいに対する構造を明確に示すことである。
【方法】先行研究の蓄積から起こっている事象がはっきりと変数として捉えられない段階なので、質的研究の採用が妥当と考えた。
【結果】カテゴリーは、作業失意サイクル、楽観的作業の捉え方、生活の強みを知る充足感、人の役に立ちたい、作業療法士の支援、の５つが抽出された。
【考察】作業参加ができない現状が継続されると、生きがいが喪失され、慢性的に日々の生産的活動が脅かされ≪作業失意サイクル≫に陥る。これらを打開するには、本人の生きがいを捉えた上で、自己効力感を高める作業に参加する支援が重要であると示唆された。
【結語】本研究は、作業療法士の支援によって、≪作業失意サイクル≫から他者を気遣う契機に至ったと考えられる。articl
Association between cognitive decline and decreased serum osteocalcin levels in community-dwelling older people
Get PDFMany reports show that low bone mineral density and osteoporosis are associated with cognitive impairment and Alzheimer's disease in older women. In addition, bone-related substances such as osteocalcin (OC) and insulin-like growth factor 1 (IGF-1) affect cognitive function. In this study, the aim was to clarify the relationship between changes in cognitive function and changes in serum OC, IGF-1, and albumin levels in community-dwelling older people. The participants were 76 healthy older people living in Japan. They participated in a weekly, local government-supported exercise class for 13 weeks. The Mini-Mental State Examination (MMSE) was used to evaluate cognitive function. Twenty-two participants (28.9%) had decreased MMSE scores at the 13th week. Correlation analysis showed that ΔOC correlated with ΔMMSE score. On analysis of covariance adjusted for baseline values, the cognitive decline group had a significantly greater decrease in OC levels than the no cognitive decline group. The participants with increased ΔOC had lower odds of cognitive decline at the 13th week on logistic regression analysis. These results suggest that there may be a relationship between decreases in serum OC levels and cognitive decline in community-dwelling older people.Original Articleothe
Effect of purposeful activity-based electrical stimulation on auditory event-related potential in a stroke survivor with a severely paretic upper limb
Get PDFThe objective of this case study was to determine the effect of purposeful activity-based electrical stimulation therapy (PA-EST) on cognitive function using auditory event-related potentials (ERPs) in chronic stroke survivors. [Methods:] The participant was a female patient in her late 60s who presented with left-sided paresis. She had a subarachnoid haemorrhage about 20 years prior and a right thalamic haemorrhage five years prior. The participant received four phases of the PA-EST program (three months for each phase). Auditory ERPs, Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), Goal Attainment Scaling-Light (GAS-L), and Mini-Mental State Examination (MMSE) were used for evaluation before administration of the PA-EST intervention and following phases II and IV. [Results:] The P300 latency component of auditory ERPs (Fz, Cz, and Pz) shortened after phase II compared to the initial evaluation and did not change remarkably afterwards. FMA for the upper extremity, MAL amount of use, quality of movement, and GAS-L demonstrated improvements following phases II and IV. FMA for the upper extremity showed drastic improvement until phase II with minimal differences observed after this phase. There was a minimal difference in the MMSE scores during the observation period. [Conclusion:] The PA-EST program for survivors of chronic stroke with severe upper limb paresis may contribute to improvements in cognitive function.Original Articleothe
The effect of illusory kinesthesia by vibratory tendon stimulation on musculoskeletal pain disorders
Get PDF"Vibratory stimulation" is a form of physical therapy in which a vibratory stimulus is applied to muscles, tendons, or the whole body to reduce muscle tension and pain. This therapeutic approach is mainly used in a clinical practice setting. Notably, vibratory stimulation of tendons can produce an illusory sensation of limb movement (illusory kinesthesia). In a previous study, my research group revealed that the illusory kinesthesia induced by vibratory tendon stimulation can reduce pain in postoperative patients. This review summarizes the present knowledge regarding the illusory kinesthesia arising from vibratory tendon stimulation, and then describes the indications for the use of vibratory tendon stimulation in patients with orthopedic diseases, with a focus on my own clinical research.Review Articleothe
A report on the footsteps of 10 years and challenges in Hanwa community-based rehabilitation research group
Get PDFAfter opening of Osaka Kawasaki Rehabilitation University (OKRU) in 2006, Professor and physical therapist Kazuyoshi Yamamoto organized Senshu (later Hanwa) community-based rehabilitation research group in 2007, aiming at the community contribution to Senshu (Hanwa) area and also the development of rehabilitation professionals and others. This report presents these 10 years activities of the rehabilitation research group and challenges to the future.Review Articleothe
Elections in the Era of Social Networking Service and Role of Psychiatrists
Get PDFThe 25th Election of the Upper House (21 Jun 2019) was the first national election of Japan in which social networking services (SNS) were effectively incorporated, bringing unexpected results which may affect the existing political party structure. This trend will change the qualification of politicians to be successful in any type of elections including president, prime minister, and other important persons related with national politics. American Psychiatric Association has approved the ethical code, so-called Goldwater Rule, to avoid publicizing professional opinions by psychiatrists on a public personality, but it may be the time to reconsider the credibility of this rule in the SNS era.Review Articledepartmental bulletin pape
Program for rehabilitation of the chronic severe hemiparesis upper extremity of cerebral stroke survivors: application of purposeful activities and an electrical stimulation therapy program
Get PDFObjective: We studied the effect of the purposeful activities and the electrical stimulation therapy program (PA-EST), based on the patient's interests and preferences as a purposeful electrical stimulation therapy in patients with chronic severe hemiparesis in the upper extremity. The aim of the therapy was to prevent the disuse of upper extremity switching to supportive upper extremity. The therapy is designed to conform to the intent, practice, subjective experience and self-efficacy of the theory of occupational therapy. Methods: The purposeful movements of disused upper extremity of two severe chronic hemiplegia patients were studied for the effect of PA-EST, aiming for the lifestyle improvement management. In the first phase, muscle contraction force and blood flow to the muscles were promoted based on purposeful movements using supportive-type electrical stimulators. In the second phase, after voluntary contraction was confirmed, purposeful activities were conducted using volition control electrical stimulators. This regimen was performed as one cycle every seven months, with a rest period of one month between each cycle to confirm voluntary activities. Results: After clarifying the purposeful activities within activities of daily living (ADL), electrical stimulation therapy was administrated. The amount of the use of the upper extremity on the severely paralysed side was significantly increased in these ADL. Discussions: The study demonstrated the totally disused upper extremity of the patients with chronic severe hemiparesis can be transformed to functional restoration of purposeful activities, allowing improvements in ADL of the patient. We hypothesise the transition of the paralysed limb to a useful hand can be attained through the application of PA-EST to promote ADL of the patients with chronic severe hemiparesis.Original Articleothe
