若年健常者におけるWeb版打点検査と認知検査との関係

若年健常者を対象として,協調性検査の上田による東大リハビリテーションセンター方式の協調性検査（OG版）のコンピューター版（WA版）の検査結果と認知検査（MMSE：Mini mental state examination,TMT：Trail making test, ADT： Audio detection test の正答率）との相関関係を調査した.加えて,打点時の手指の加速度を計測し,そのパワースペクトルのピーク周波数と認知検査との相関関係を調査した.比較対照として,OG版もWA版と同様に相関を調査した.結果,左手の打点得点,左手と右手の打点得点の合計がOG版,WA版の両方でMMSEと負の相関を示した.左手の打点得点はWA版,OG版ともにTMT-Bと正の相関を示した.パワースペクトルのピーク周波数との関連はみられなかった.以上から,WA版の成績は若年健常者の全般的な認知機能および注意機能と関連があることが示唆された.We examined correlations between the computer version of coordination test of the University of Tokyo Rehabilitation Center method by Ueda（WA version） and cognitive examinations（ MMSE： Mini mental state examination, TMT： Trail making test, ADT： Audio detection test）. In addition, we analyzed the peak of the power spectrum of the index fingers acceleration. As a control, the Original paper version（ Ueda, 1971： OG version） was done as well as the WA version. The results demonstrated, that in both the WA version and OG version, the score of the left hand hit point, the total score（ left hand score + right hand score） showed negative correlation with MMSE, and that in both the WA version and the OG version, the score of the left hand showed a positive correlation with TMT - B. There was no relation with the peak frequency of the power spectrum of the index fingers acceleration. It is suggested that the results of the WA version test are related to general cognitive function and attention of young healthy subjects

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

地域高齢者を対象としたiPad版点打ち課題と注意機能検査との関連

高齢者の認知機能の低下を検出する一次スクリーニングツールとして,運動機能が有用な可能性がある.本研究はタッチペンによるタッピング課題のどんな指標が認知検査と関連するのかを調査した.本研究は地域在住の7人の高齢者（年齢73.1±5.4歳,Barthel Index合計98.0±0.2点）が参加した.参加者には1000Hzのビープ音に合わせてタッチペンで的の中心をタップするように求めた.測定にはタブレットPC（iPad Pro）とタッチペン（Apple Pencil）を使用した.さらにMMSE, TMT,かなひろい検査を実施した.打点成績と認知検査得点の関係を調べた結果,TMTのスコアとかなひろい検査の正解数は2つの指標と高い相関を示した.1つ目は右手によりタッチペンでタップした点が的の中心からずれた度合いの指標であり,もう1つは左手で操作したタッチペンがタップ時にiPadの画面に接触していた時間であった.タッチペンを用いたタッピング課題は注意機能のスクリーニングに役立つ可能性があることが示唆された.As a first screening tool to detect cognitive decline in the elderly, such as mild cognitive impairment and dementia, motor function test may be useful. In this study, we researched which index of tapping with touch pen are correlate with cognitive test.7 elderly people in community-dwelling (age:73.1±5.4, Barthel Index total score: 98.0±0.2 ) were participate in this study. Participations were ask to tap toward the center of the target with touch pen according to the 1000Hz beep sound. A tablet PC (iPad Pro) and a touch pen (Apple Pencil) were used as the measuring devices.Participations were also examined mini mental states examination, trail making test (TMT), “KANA-HIROI” test (dual attention task). Then, the relations between the performances of tapped points and the scores of the cognitive tests were explored. As a result, the two index showed a high correlation with the score of TMT and the number of correct answers of the “KANA-HIROI” test. One was the degree of deviation of the 50 dots with right hand from the center of target , and the other was the contact time between the touch pen and the screen with left hand.Our results suggested that tapping task with pen in elderly people with self-independent could be useful to screening attention function

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

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

リハビリテーション医療系学生の抑うつ状況について : 学習性無気力の観点から

リハビリテーション医療系学生は、授業の多さとそれに伴う課題の多さ、長期にわたる実習、国家試験などストレッサーとなる出来事が数多く長期に継続する特徴がある. 長期にわたるストレッサーの中、学生は「学習性無気力」の状況にあるのではないかと考え、学生の抑うつ傾向をはじめ自尊感情・ストレス反応など心理的状況を調査した. 結果として、抑うつ傾向・ストレス反応が高くまた自尊感情は低い状況が明らかになった. また家庭内に相談できる人物が多いこと、また睡眠・休養・食事のいわゆる生活リズムが確立していることが、抑うつ傾向を抑えることが示された. 学生生活や精神状態について家族と情報を共有すること、また生活リズムの確立に向けた援助が、教員として必要であると考えられた.Rehabilitation Medical student, there is a feature event to be a large number of stressors and challenges of multi-class, training for a long period of time, such as the national examination to continue in the long-term number. Under the influence of the stressor long-lasting, and is in a situation of "learned helplessness"to students, I guess. And I investigated the psychological conditions such as stress response and self-esteem and depression of students. That as a result, stress response and depression is high, self-esteem is low have been revealed. Which of the following influence to suppress the tendency of depression, it was that there is more than one person you can talk to family. Further, it may life including diet and rest and sleep is stable affects the suppression of depression was shown. I was considered the assistance for the establishment of life rhythm, is necessary as a teacher and that, to share information with the family about the mental state and student life

運動方向の違いが到達把持運動時の指先距離に与える影響

本研究は、運動方向の違いが到達把持運動時の指先距離に与える影響を検討する事を目的とした。対象は、健常成人12名である。大球・中球・小球の3種類の物品を、正面(以下;F)、右45°(以下;R)、左45°(以下;L)に設置し、各物品に対する"F"・"R"・"L"の運動方向へ到達把持運動を実施し、動作解析法を用いて、動作開始から物品接触までの指先距離を抽出し,3群間で比較検討した。結果、大球の比較では、60～90%の時点において、"F"が、"L"より、指間距離は有意に広く、さらに"L"が"R"においても指先距離は有意に広かった。中球比較では、70～90%の時点で、"F"が"L"より、有意に指先距離が広く、さらに"R"が"L"より有意に広かった。小球では、60～95%の時点で、"L"が"F"より有意に指先距離が広く、さらに"L"が"R"より有意に広かった。これらのことから、"L"への到達把持運動では"F"・"L"と異なったパターンを示し、これらの要因として、肩関節・手関節における関節の自由度に対する方向調整と適応調整による動作パターンの違いが考えられ、運動方向の違いでの手指の形成パターンは異なることが明らかとなった。This study was intended to examine whether the difference in the movement direction affects the distance of the fingertip at the time of reaching the gripping movement. The subject is a healthy adult 12 people. Target is the large ball, medium ball and small ball, which is the three types. Placed of the target is a Front("F") and Right45°("R"), left 45 °("L") . Between three groups by extracting the distance of the fingertip with reach and grasping motion is compared motion analysis to each target. Result, In the comparison of large ball, "L" is significantly wider distance of the fingertip at time of 65-90% than the "F". "L" was more significantly wider than "R". In the comparison of medium ball, "F" is significantly wider distance of the fingertip at the time of 20-40% than the "L", "L" was significantly wider than "R". In the comparison of small ball, "L" is significantly wider distance of the fingertip at the time of 60-95% than the "F". "L" was significantly wider than "R". From these things, this study showed that the difference in the movement direction affects the fingers forming the pattern

臨床実習における理学療法実践体験量と理学療法技術水準の関係

理学療法臨床実習における見学、検査測定体験、治療体験の量が、実習終了時の自覚的な検査測定技術、治療技術の水準に及ぼす影響を検証するために、臨床実習を終了した本学理学療法学専攻4年次学生36名を対象にアンケートを行った. 質問内容は、一日あたりに見学した患者数とその時間、検査測定した患者数とその時間、指導を受けたセラピスト数とした. 理学療法技術水準は、実習終了時の自己の検査測定技術、治療技術水準が考えうる最高の水準であれば100点、最低の水準であれば0点として自己採点させた. 検査測定技術点、治療技術点は治療時間と有意な正の相関関係、見学人数と有意な負の相関関係にあった. 以上より、実習中の治療体験量の増大は、実習終了時の自覚的な理学療法技術水準を増大させるが、見学では増大しない可能性が示唆された.Purpose of this study was to investigate the effect of the volume of observation of physical therapy,experiment of measurement and therapy on skill of measurement and therapy by self-evaluation. The thirty six student of physical therapy after clinical internship of physical therapy were asked about the internship by questionnaire distributed after the internship. The items in the questionnaire were the number of patient and time in observation per day, the number of the patient and time in evaluation and therapy, and number of therapist who teach the student of physiotherapy per day. The ability of evaluation and therapy were scored by self-estimation after the internship. There were significantly positive correlation between the score of ability of evaluation and therapy and the time of therapy. In the other, there was significantly negative correlation between the score and number of patient in observation. These finding indicate that increasing of the volume of experiment of physical therapy can increase the ability of evaluation and therapy but increasing of observation cannot increase the ability