4種類の簡単な認知的作業を順番におこなう作業提示の影響 : 認知機能検査と唾液アミラーゼモニターによる検討

作業療法の治療的介入として、一部の工程の反復練習も作業提示方法として治療的に意味があるが、作業活動の全体を通しておこなうことも作業の遂行目標に対する行動の形成から、運動機能や認知機能の改善に働く. 対象者に4種類の簡単におこなえる認知的な作業を提示し、作業提示の切り替えから認知機能面の効果を検討した. 作業提示の切り替えの効果を比較するために、PASAT・1秒・2秒とSDMTを、作業実施後と作業未実施日に期間をあけておこなった. 作業実施の前後に、酵素分析装置唾液アミラーゼモニターを使用して唾液アミラーゼ活性値を測定した. PASAT・1秒・2秒と、SDMTにおいて、作業後に正答率や達成率が有意な向上につながった. 作業提示の切り替えから作業記憶に関与する機能の影響が推察された. 各作業活動に目的性も生ずることから、AMY値において快適な刺激の反応になる対象者がいたが、逆に意味を見いだせない作業提示も推察された.As therapeutic intervention of occupational therapy, repeated practice of some processes is also therapeutically meaningful as the work presentation method. However, from formation of the action to the execution target of work, carrying out through the whole work activity also works to an improvement of a motor function and a cognitive function. Four kinds of cognitive work which can be performed easily were shown to the candidate, and the effect of the cognitive functional side was examined from the change of work presentation. In order to compare the effect of a change of work presentation, the period was opened in the work performance back and a work sheep enforcing date, and PASAT, 1 second and 2 seconds, and SDMT were performed on them. Before and after the work performance, the salivary amylase activity value was measured using the enzyme analysis equipment salivary amylase monitor. In PASAT, 1 second and 2 seconds, and SDMT, the percentage of correct answers and the achievement ratio led to significant improvement after work. The influence of a function which participates in working memory from the change of work presentation was guessed. Since finality also arose in each work activity, there was a candidate who becomes a reaction of a comfortable stimulus in an AMY value, but the work presentation which cannot find out a meaning conversely was also guessed

作業教示が作業遂行時のワーキングメモリに及ぼす影響

注意の制御能力の低下の一因に、ワーキングメモリを要する機能の不活発が関与しているのではないかと推察した。注意障害に関する認知リハビリテーションにおいて、繰り返して練習した作業の処理スピードは速くなるといった効果が報告されている。繰り返しおこなう作業遂行で、教示方法の違いがワーキングメモリの活性に影響すると推察した。本研究では、2種類の教示方法を用いて箱つくりをおこなった。教示方法によるワーキングメモリの活性化について酸素モニタ装置NIRSと認知機能検査を用いて比較検討した。視覚教示は、同寸法の箱を作製するため効率よく自身のペースで箱を作製でき、繰り返しおこなう事でワーキングメモリよりも短期記憶の要素が強くなったと考えた。箱つくりがDLPFCの脳血流量の変化に影響を与えたと推察したが、ワーキングメモリの活性化には、対象者のワーキングメモリの容量や作業課題の選択、認知負荷の容量などを考慮する必要がある。Contribute to the reduction of the control capability of attention, inactivity of functions that require working memory I have assumed or not you\u27re involved.In cognitive rehabilitation on attention disorders, the treatment speed of the work has been practiced repeatedly effect have been reported, such as faster.In the work performed to repeated, the difference of the teaching methods were presumed to affect the activity of the working memory.In this study, it was subjected to a box made by using the two methods of instruction.And were compared using the oxygen monitoring device NIRS cognitive function testing for the activation of the working memory by instruction method.Visual instruction, it can be produced a box at a rate of efficiency itself for producing a box of the same dimensions, thought of short-term storage than the working memory by repeating became strongly.Boxes make it was presumed to have influenced the change in cerebral blood flow in DLPFC, but the activation of the working memory, the selection of capacity and working issues working memory of the subject, it is necessary to consider such as capacitance cognitive load is there

作業教示が作業遂行時のワーキングメモリに及ぼす影響(第2報) 高齢者に対する検討

高齢者に対する作業療法で,日常生活活動の遂行を目的とした作業活動が,様々な原因が伴い持続困難な場合もある.その一因と考えられる注意の制御能力の低下は,ワーキングメモリ機能の不活発な影響が関与していると推察した.本研究では健常な高齢者7名に,作業課題を複数の工程に分けて,順番に各工程を達成しながら作品を完成する作業を設定した.その課題を複数回実施することで各工程の内容を創意工夫する作業遂行となり,ワーキングメモリに影響をおよぼすと推察した.そこで,ワーキングメモリの構成要素の音韻メモ,視空間メモの2つの補助システムに着目し,課題に対して言語と視覚を介する教示方法の違いがワーキングメモリに及ぼす影響を,酸素モニタ装置NIRSと認知機能検査を用いて比較検討をした.言語を介する教示による課題の作業遂行は左右のDLPFC領域の酸素化ヘモグロビン濃度が有意に賦活し,認知機能検査では視覚を介する教示と比較してPASAT2秒が有意に向上した.今回の高齢者の箱つくりにおいて言語を介する教示は, 視覚を介する教示と比較して内言語を方略としたワーキングメモリの関与を推察し,目標志向性が明確化しやすくワーキングメモリの活性に適度な負荷につながる教示方法になったと考えた.Elderly people undergoing occupational therapy sometimes have difficulty continuing tasks assigned to them to improve their daily activities for several reasons. We developed a hypothesis that aggravated attention deficit of the elderly, a probable cause of the above-mentioned difficulty, is influenced by their inactive working memory functions. In the present study, seven healthy elderly people were asked to complete a task consisting of multiple processes. We asked them to perform the task repeatedly because we expected them to use their inventiveness while completing each process, which would influence their working memory functions. We focused on two systems - phonological loop and visuospatial sketchpad, as components of the working memory, and conducted a comparative study to examine the effects of differences in two methods based on verbal and visual instructions provided to implement the task on the working memory, using an oxygen monitoring device (NIRS) and a cognitive function test. When the task was completed by the elderly after receiving verbal instructions, deoxygenated hemoglobin concentrations in the left and right DLPFC (dorsolateral prefrontal cortexes) significantly increased, and there were significant improvements in their performance in “PASAT2” compared with when visual instructions were provided, as suggested by the results of the cognitive function test. The elderly were asked to complete a task of creating boxes after receiving verbal and visual instructions. Verbal instructions promoted the deeper involvement of the working memory through endophasia, helped the elderly to become more goal-oriented, and appropriately increased loads to activate the working memory more, compared with visual instructions

リハビリテーション医療系大学1年生の状態不安状況について : 入学から前期定期試験1週前までの縦断的研究

2014 年の文科省の調査では，高校から大学への“円滑な移行”ができていないことを理由に退学した者の割合は，18.9％に上った．現在，入学後のまもない時期が適応への重要な移行の時期であるとされている．本研究では，大学への円滑な移行，適応という観点から，リハビリテーション医療系大学１年生の『不安』に焦点をあてた．本研究の目的は，大学入学直後から定期試験1 週間前までの４期における，『不安』点数の変化の特徴を縦断的に捉えることである．結果，性別により状態不安点数の変化に大きな差異が見られた．男性は，入学１ヵ月目に状態不安点数が最も低くなり，定期試験１週前に最も高くなる特徴があった．一方女性は，3期まで状態不安は上がり続け，試験1週前で，最も低くなる特徴が見られた．これらは，性別による大学生活に求める志向の違いが反映されていると推察された．現段階ではデータからの推察が中心となっており，今後各期に行った不安対象についてのアンケート内容の整理，分析を補完的に行うことが必要と考えられた．The survey by Ministry of Education, Culture, Sports, Science and Technology of 2014, the ratio of student who quitted school for reasons of "the smooth transition" from the high school to the university not being done was 18.9%. It is reported that it begins after a university admission at the time when it is important to the　adaptation to the university. In this study, we focused on "the anxiety" of the first grader of the rehabilitation medical care university from the viewpoint of smooth transition and adaptation to the university. A purpose of this study is to clarify the characteristic of the change of "the anxiety" mark between the fourth until one week before the regular examination for running from the university admission. As a result, a difference was considerably seen in the change of the state-anxiety mark between genders. Men, state anxiety mark for admission 1 months is the lowest, also it was the highest in a regular test 1 week before. On the other hand women, state anxiety continues to rise up to three terms, was the lowest in a week before the test. These differences may reflect the difference in orientation to seek the adaptation of university life by gender. At this stage, since it is inferred from the data, it is necessary to organize and analyze the questionnaire contents of anxiety interest

NIRSを用いた前頭葉機能検査遂行時の脳活動の検討 : PASATの2秒条件と1秒条件の比較

健常大学生15名を対象に、ワーキングメモリ検査の一つである定速聴覚的連続加算テスト(PASAT)の2秒条件と1秒条件遂行時の前頭葉活動について、近赤外分光法(NIRS)を用いて検討を行った。 PASAT施工中は、前頭葉野背外側部(DLPFC)の酸化型ヘモグロビン(Oxy-Hb)が有意に増加を認め、特に正答率の高いPASATの2秒条件においてのDLPFCのOxy-Hb増加が強い傾向を示し、難易度の程度によってDLPFCの賦活が変化することが考えられた.Frontal lobe activity when university students of 15 people, has been conducting the PASAT is one of the working memory test, we have examined using NIRS. As a result, Oxy-Hb in DLPFC recognized increased significantly, tended to increase in Oxy-Hb in the DLPFC of in terms of two seconds PASAT high percentage of correct answers is particularly strong, when you are performing the PASAT, the difficulty was thought to be due to a change in the degree of activation of the DLPFC degrees

リハビリテーション医療系大学生における学業および大学生活適応尺度の作成

現在、高等学校卒業者のおよそ50%が大学へ進学している一方、休学・中退者の数は増え続けており、社会問題化している。文科省は休学・退学の要因として、高校と大学教育のギャップが生む『学業不振』を挙げている。必ずしも学業に重きをおかない、多様な価値観を持った学生のグローバル化が背景にある中、リハビリテーション医療系大学生は、一方で明確に学業をクリアすることを求められるという特徴がある。本研究の目的は、リハビリテーション医療系大学生を対象にした、学業および大学生活適応尺度を作成することである。作業療法学教員2名によって精選された35項目に対して、学生122名に反応を求めた。探索的因子分析の結果、感情・心理因子(6項目)、積極性因子(6項目)、適合感因子(4項目)、他者性因子(3項目)、自己対処因子(3項目)の5因子構造が得られた。信頼性に関しては,Cronbach α係数は高値を示し、因子間相関ではすべての因子間に有意な正の相関が見られ、一定の内的整合性、信頼性は保たれていた。Recently about 50 percent of the new graduates from high school enroll to university. However, the number of temporary absent or drop out students from university continue to grow up, and it becomes a social issue now. Ministry of Education, Culture, Sports, Science and Technology states that one of the factor of long term absence and dropping out from the university is poor academic performance that occurs from educational gap between high school and university . While the students with various senses of values are increasing, it\u27s important to give fixed academic performance for the student who try to be a rehabilitation related occupation. The purpose of this study is to develop the scale of relationship between academic performance and adaptation skill in university life for the OT students of Shijonawate—gakuen University.122 OT students were involved to answer the 35 questions which were selected by 2 OT teachers of the university. As a result of searching factor analysis, 5 factors which are consisted by feeling and psychological factor(6 items),initiative factor (6 items),feeling of conformity factor(4 items), other related factor(3 items) and self-cooping factors(3 items).The reliability by the Cronbach of coefficient shows high score and meaningful equilateral correlation among the factors also shows significantly high

歯磨きに対する利き手交換訓練 : 訓練効果を得るための実施期間

本研究の目的は、歯磨きにおいて利き手交換訓練により歯垢除去効果がどの程度有効か否かを検討することである. 対象は健常者44名(男性14名、女性30名)とし、利き手交換訓練実施の有無および非利き手か否かを組み合わせ、各11名4群とした. 歯磨きの実施期間は3週間42回とし、1週間ごとに計4回の判定を行った. 判定は歯科衛生士によるO\u27Learyのプラークコントロールレコードの実施により、口腔内の磨き残しを算出し、3週間の訓練経過を追った. その結果、利き手交換訓練として実施した群で、訓練期間中70%以上の実施者において歯垢除去効果を得ることができた. つまり、歯磨きにおける利き手交換訓練は有効であることが示唆された.It is for a purpose of this study to consider how effective a plaque on a tooth removal effect is by changing hand dominance training in toothpaste. A subject assumes it 44 physically unimpaired people (14 men, woman 30), we put it together whether it is in presence of changing hand dominance training enforcement and non-handedness, we assumed it for each 11 people 4. Duration of toothpaste assumes it 42 rounds of three weeks, we judged four times in total to be it every one week. A judgment; by enforcement of plaque control record of O\u27Leary by dental hygienist, we leave polishing in the oral cavity and calculate, we chased the training course of three weeks. As a result, in the group that we carried out as changing hand dominance training, we were able to get a plaque on a tooth removal effect in a person of enforcement more than 70% during a training period. In other words it was suggested that changing hand dominance training in toothpaste was effective

作業療法士が行う歯磨き訓練の効果 : 両側性片麻痺を呈した一症例を通して

著者は先行研究にて、歯磨きの専門家でない作業療法士が歯磨き訓練を実施する際の具体的な訓練方法を提案した. その方法は1.歯磨き訓練マニュアルによる個別指導、2.手鏡を用いた視覚的フィードバックによる個別指導の2点であった. 今回、もともと左利きで69歳時に左片麻痺、71歳時に右片麻痺を呈した症例を対象に歯磨き訓練を実施した. 症例は69歳時の左片麻痺発症時に右手への利き手交換にてADLは自立していたが、71歳時の発症にて右片麻痺の方が重度であったために、再度機能低下した左手でのADL獲得をもとめられている. 歯磨き訓練内容については前回の報告とほぼ同様の方法を用いた. ただし、実施期間は3ヶ月としOTRが直接指導するのは週5回とした. 判定は歯科衛生士によるO\u27Learyのプラークコントロールレコードにより口腔内の磨き残しを算出した. その結果、口腔内の磨き残しが顕著に減少し、口腔機能も改善したので考察を含め報告する.In a previous study, we presented a detailed training method to be used in tooth-brushing training for occupational therapists, who have no expertise in tooth brushing. That method is comprised of two main points:(1)individual instruction according to a tooth-brushing training manual, and (2)individual instruction with visual feedback using a mirror. In the present study, we conducted tooth-brushing training in an originally left-handed patient who developed left hemiplegia at 69 years old and right hemiplegia at 71 years old. With the development of left hemiplegia at 69 years old, the patient switched to using the right hand predominantly and was independent in ADL. With the onset of right paralysis at 71 years old, however, the right paralysis was more severe and ADL demands were placed on the left hand, which had undergone functional decline for a second time. The method used for tooth-brushing training was nearly the same as in the previous report. However, the implementation period was three months and direct OTR training was performed five times per week. Unbrushed parts of the oral cavity were calculated by a dental hygienist using O\u27Leary\u27s plaque control record. As a result, unbrushed portions of the oral cavity decreased markedly and oral funxction improved