記述言語：日本語   出版者・発行元：Frontiers in Neurology  

Introduction: Whereas repetitive facilitative exercise (RFE) affects primarily recovery of motor impairment after stroke, task-oriented training (TOT) focuses on facilitating daily use of the affected upper extremity. However, feasibility of combined RFE and TOT has not been reported. We originated “task-oriented RFE,” as a new combination therapy for patients with hemiplegic upper extremity after subacute stroke, to examine its feasibility in convalescent rehabilitation wards. Methods: This is a before-and-after pilot study. Eight patients with hemiplegic upper extremity after subacute stroke received the task-oriented RFE program for 6 weeks at 80 min per day (20–60 min of TOT applied after 60–20 min of RFE under continuous neuromuscular electrical stimulation) in a convalescent rehabilitation ward. In the current program, we introduced the Aid for Decision-making in Occupation Choice (ADOC) iPad application as a goal-setting method for determining tasks. Feasibility was assessed with adherence to the protocol, adverse events in response to the intervention, and preliminary efficacy. Motor functions, amount of use and quality of movement in the hemiparetic upper extremity, and satisfaction of the patients were evaluated with Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), the motor activity log (MAL) for the amount of use (AOU) and quality of movement (QOM) of the paralyzed hand, and ADOC. Results: All participants accomplished the program, which was implemented as originally planned; neither nonattendance nor an adverse event occurred during the study. Favorable outcomes were obtained with all measures; mean changes in FMA, ARAT in the dominant hand, MAL-AOU, and MAL-QOM were greater than minimal clinically important differences. Mean changes in ADOC were greater than the minimal detectable change. Discussion: The task-oriented RFE program was safe, well-tolerated, beneficial, and feasible within 80 min a day of occupational therapy, which means also within the procedural constraints of the Japanese health insurance system during the convalescent phase. Future studies are warranted to examine whether combined RFE and TOT enhances the efficacies of each program alone.

DOI： 10.3389/fneur.2024.1356732

Scopus

PubMed

記述言語：英語   出版者・発行元：公益社団法人 日本リハビリテーション医学会  

DOI： 10.2490/prm.20230019

PubMed

CiNii Research

出版者・発行元：医歯薬出版(株)  

DOI： 10.32118/j02606.2022227464

CiNii Research

記述言語：日本語   出版者・発行元：医歯薬出版(株)  

目的◆本学リハビリテーション科初期研修後に他科の専攻医となった医師は、どのような動機で初期研修にて当科を選択したか、そして現在の診療の現場で当科研修がもたらす意義について検討する。対象◆2018年度および2019年度に初期臨床研修で当科を研修した他科専攻医。方法◆Googleフォームを用いた匿名のアンケート調査を実施した。結果◆対象者17名のうち、14名からアンケートの回答を得た。研修で学んだことは「リハビリテーション診断」に関する項目が多かった一方で、「リハビリテーション治療」に関する項目は「もっと学びたい」と答えた割合が高かった。また、「社会福祉制度の利用(リハビリテーションマネジメント)」は専攻医らが現在の診療現場で直面している問題であった。結語◆当科研修を経て、患者の障害に目を向け、退院後の生活にまで関心が向くようになっていることが初期研修における当科選択の意義と考えられる。今後、対象者を増やすとともに複数施設での検討が望まれる。(著者抄録)

記述言語：日本語  

記述言語：日本語  

記述言語：日本語