Seamless and Long-term Rehabilitation for Supporting Self-management and Return to College Life in a Young Case of Hypertrophic Cardiomyopathy with Post-resuscitation Encephalopathy：A Case Study

Marina WATANABE-ABE; Ryo MIYAZAWA; Takayuki WATABE; Misaki MAKINO; Naonori TASHIRO; Yoshitaka ISO

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Seamless and Long-term Rehabilitation for Supporting Self-management and Return to College Life in a Young Case of Hypertrophic Cardiomyopathy with Post-resuscitation Encephalopathy：A Case Study

VernacularTitle:蘇生後脳症を合併した若年肥大型心筋症症例の大学復帰に向けたシームレスかつ長期的な自己管理支援
Author: Marina WATANABE-ABE ¹ ; Ryo MIYAZAWA ² ; Takayuki WATABE ³ ; Misaki MAKINO ⁴ ; Naonori TASHIRO ² ; Yoshitaka ISO ³
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1. Rehabilitation Center, Showa University Koto Toyosu Hospital
2. Department of Rehabilitation, Major of Occupational Therapy, Showa University, School of Nursing and Rehabilitation Sciences
3. Rehabilitation Center, Showa University Fujigaoka Rehabilitation Hospital
4. Department of Rehabilitation, Major of Physical Therapy, Showa University, School of Nursing and Rehabilitation Sciences
Keywords: post-resuscitation encephalopathy; higher brain dysfunction; occupational therapy; cardiac rehabilitation
From:The Japanese Journal of Rehabilitation Medicine 2024;():22041-
CountryJapan
Language:Japanese
Abstract: We report the case of a 20-year-old woman with hypertrophic cardiomyopathy and severe brain dysfunction caused by post-resuscitation encephalopathy. Transferred to our hospital's convalescent rehabilitation ward, she aimed to regain independence in daily living and return to college. Upon admission, she was diagnosed with moderate attention impairment and intellectual disability. She underwent a 4-month intensive inpatient rehabilitation program, including occupational therapy (OT). Despite modest improvements in day-to-day activities and brain function by discharge, these were insufficient for her to resume university childcare classes. Further improvement in behavioral control, physical activity management, and exercise tolerance was necessary post-discharge.OT is pivotal in supporting patient self-management of day-to-day activities, is included within the cardiac rehabilitation (CR) program covered by health insurance. Thus, we introduced her to the CR program for aerobic exercise training and OT. Counseling for physical activity based on the aerobic threshold was performed at each visit, using a chart to record daily activities and heart rate to prevent overactivity, which could lead to fatal arrhythmia.Eventually, she resumed her classes and engaged in childcare training. For patients with brain and heart conditions, a combination of rehabilitation in the convalescent ward and outpatient CR seems to be beneficial for secondary prevention and long-term self-management.