In January 2004, a panel of experts (chairman : Satoshi Ueda) commissioned by the Health and Welfare Bureau for the Elderly, the Ministry of Health, Labor and Welfare, came up with an idea suggesting a direction the nation’s rehabilitation project for the aged should take in the future. This has rekindled the debate over the way the rehabilitation work for the old people should be carried out the inevitable subject of discussion that had been taken place on and off since the nursing care insurance system came into being.We have been involved in the rehabilitation of those people mainly with the after-effects of strokes since the early 1960’s when the Japanese government embarked on the rehabilitation project for the elderly.In this paper, we examined our ways of grappling with the task of rehabilitation for the aged people in retrospect. At the same time, from the standpoint of the philosophy that the rehabilitation work for the aged should be aimed at recovering their mental and physical functions to improve their quality of life, we envisioned the future of the rehabilitation project for the old people with stress placed on the following two points :(1) the working on a rehabilitation program for the aged after the model of the international classification of functioning, disability and health ; and(2) the building up of a community-based rehabilitation system interlocked with an overall program for the promotion of health care, welfare and security in the local community.
Rehabilitation aspects ; Work ; Future ; Elderly ; Rehabilitation therapy

With the rapid development of modern science and technology, various kinds of new therapy and technology have widely been used in rehabilitation medicine. This review summarizes those new therapies and principles in rehabilitation and their application during treatment of burn injury, in order to provide more ways and methods to improve the rehabilitation of mentation, motor function, and the quality of life of burn patients.
Burns ; rehabilitation ; therapy ; Humans ; Rehabilitation ; methods

Treatment of schizophrenia is one of the most challenging areas in the field of psychiatry. There has been much improvement in psycho-pharmacotherapy, and at present, psycho-pharmacotherapy along with milieu therapy and social rehabilitation is the standard first-line treatment for schizophrenia. Healing environment, a concept which has arisen from the architectural field, has similarities in meaning to milieu therapy in psychiatry. In other words, healing environment may be an encountering point between psychiatry and architecture. In this encountering, each field can understand each other and expand its concept to aid the treatment of schizophrenia and to plan the build-up of the entire environment considering its social and psychological effects. In this paper, we aim to establish the basic concept of healing environment to alleviate the psychopathologies in schizophrenic patients. We worked under the premise that physical setting affects human behavior and mind, and that physical setting should play a role as a medium with therapeutic potential for patients with medical problems. The aims of this paper are as follows. First, theoretical discussion of the concept and the constructs of healing environment : second, understanding of the schizophrenic symptoms that may be affected by supporting environment : and third, discussion of supporting environment that may alleviate the symptoms of schizophrenia.
Humans ; Milieu Therapy ; Rehabilitation ; Schizophrenia*

After over 50 years' development, the modern burn care system of China has made remarkable progress, however, we still lack ample attention to functional rehabilitation and quality of life of burn patients recovering from burn injury. The burn rehabilitation in China is still in juvenile stage, but it is really encouraging that more and more burn care facilities are paying attention to it. To further promote the development of burn rehabilitation in China, more emphasis must be stressed on the formation of multidisciplinary team in our burn care system, the concept of early and integral rehabilitation should be promoted, and therapeutic regimens and research work on function and aesthetics related body parts like hand and face should be emphasized. Moreover, we should also carry out rehabilitation on pediatric burn patients and promulgate the idea of burn rehabilitation in the society at large with the purpose of seeking supports for burn rehabilitation from all sectors of the society.
Burns ; rehabilitation ; therapy ; China ; Humans

OBJECTIVE

To determine the effects of guitar lessons (intervention group) in comparison to conventional occupational therapy (OT) sessions (control group) on hand function of chronic stroke patients with unilateral hand impairment.

METHODS

This randomized controlled trial enrolled 34 chronic stroke patients with unilateral hand impairment. Participants were grouped randomly into intervention (guitar lessons) and control (conventional occupational therapy) groups. Each group participant underwent a total of eight consecutive therapy sessions, twice weekly for an hour each session, at the designated treatment rooms in the Department of Rehabilitation Medicine of the Philippine General Hospital. Pre- and post-treatment evaluations were done to assess range of motion, grip and pinch strength, and hand functions. Satisfaction surveys were answered at the end of the 8-therapy session.

RESULTS

Improvements in hand function were assessed through measurement of range of motion (ROM), grip and pinch strength, and with the use of Beery-Buktenica Developmental Test of Visual-Motor Integration, Jebsen-Taylor Hand Function test, and Purdue Pegboard Test of Manual Dexterity. In this study, the comparison of actual change of passive range of motion (ROM) of the impaired hand from pre- to post-treatment between control and intervention groups showed no statistically significant difference. No statistically significant difference between groups were also observed for the active ROM of the impaired hand. Comparison of function of the impaired hand pre- and posttreatment between control and intervention groups showed no statistically significant difference except for an observed greater improvement with the control group in motor coordination (median [IQR] 0 [-1 to 0] vs 1 [1 to 5], p = 0.004), tip (median [IQR] 0.33 [0 to 0.75] vs 1 [0.58 to 1.5], p = 0.006), and 3-jaw (median [IQR] 0.5 [0 to 0.92] vs 1.08 [0.41 to 2], p = 0.043) pinch strength.

Results. Improvements in hand function were assessed through measurement of range of motion (ROM), grip and pinch strength, and with the use of Beery-Buktenica Developmental Test of Visual-Motor Integration, Jebsen-Taylor Hand Function test, and Purdue Pegboard Test of Manual Dexterity. In this study, the comparison of actual change of passive range of motion (ROM) of the impaired hand from pre- to post-treatment between control and intervention groups showed no statistically significant difference. No statistically significant difference between groups were also observed for the active ROM of the impaired hand. Comparison of function of the impaired hand pre- and posttreatment between control and intervention groups showed no statistically significant difference except for an observed greater improvement with the control group in motor coordination (median [IQR] 0 [-1 to 0] vs 1 [1 to 5], p = 0.004), tip (median [IQR] 0.33 [0 to 0.75] vs 1 [0.58 to 1.5], p = 0.006), and 3-jaw (median [IQR] 0.5 [0 to 0.92] vs 1.08 [0.41 to 2], p = 0.043) pinch strength.

All participants in both groups displayed 100% compliance in attending onsite treatments. Despite not showing statistically significant difference between groups (p = 0.721), an 11.8% tendency for better compliance is found in the intervention group.

CONCLUSION

The specific guitar lesson created and performed in this study as used by 17 participants of the intervention group have brought about improvement in hand function that is comparable with those who underwent traditional occupational therapy. This may be most helpful in areas with limited access to rehabilitation facilities and occupational therapy services. This may also be used as a continuing activity of chronic stroke patients at home to help improve hand function.

Music Therapy ; Stroke Rehabilitation ; Occupational Therapy

Introduction : Every day, patients undergo rehabilitation training under the guidance of a physical therapist person-to-person, but it ends in a short time. A patient who are taking walking exercises in the rehab center is confined to a wheelchair when that patient returns to the hospital ward. Such being the situation, we introduced part of the rehabilitation program into daily routine in the ward life. All the staff of the convalescent ward joined forces to help the patients restore their ability to perform the basic activities if daily living (ADLs) and motivate them to return to normal. The results of our efforts shall be reported here.Subjects and Methods : A total of 10 patients who were undergoing training in the rehab center were the subjects for this study. The progression of rehabilitation was observed and documented. The target of rehabilitation at the hospital ward was set. Their ability to perform ADLs were assessed.Results : Eight of the 10 subjects achieved the objective. Two persons failed because they got out shape. Two of the eight subjects who could attain the objective became eager to do daily routine.Discussion : Before this study, we only drove the patients to and from the rehab center, but when the study got started, we came to observe the patients from various angles because we had opportunities to grasp the situation about rehabilitation, to asked physical therapists questions about care and exercises and exchange views with them. We thought that the introduction of part of the program implemented in the rehab center into daily routine in the ward life and the setting of the target of rehabilitation contributed to the enhancement of the levels of the patient’s ability to perform the ADLs. The old people exhibit a peculiar state of mind due to physical inactivity and aging. When they are hindered from performing daily activities, they feel frustrated and plunge into helplessness. We thought that it is important to make them take an interest in what they can do instead of what they cannot do, if we are to uplift their ability to perform ADLs and improve the quality of their life.Conclusion : Giving the patients rehabilitation training in concert with physical therapists results in the improvement of their ability to do the activities of daily living.
Patients' Rooms ; Rehabilitation aspects ; Hospitals ; Training ; Rehabilitation therapy

Humans ; Lung ; Lung Diseases ; rehabilitation ; Pneumoconiosis ; rehabilitation ; Respiratory Therapy

OBJECTIVEOn the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.

METHODSA total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.

RESULTSThe MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).

CONCLUSIONPNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.

Acupuncture Therapy ; Brain Ischemia ; complications ; rehabilitation ; Combined Modality Therapy ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Scalp ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome

Among 954 outpatients there are 75.5% patient aged 50-79 was bone-joints pathology, following by the disease of spinal column (33.4%). Especially in 91.6% of patients, there was pain, in 39.1% there was a history of gastroduodenal diseases. 45.9% of patients visited to the clinic 3 months after detecting the symptoms, therefore the treatment had not satisfied result. In the whole, 49.9% got best result, 37.4% got and 12.6% bad
Physical Therapy (Specialty) ; Outpatients ; Patients ; Therapeutics ; Rehabilitation

Cognitive rehabilitation refers to the cognition-based approaches that aim to induce people with cognitive impairment to achieve or maintain an optimal level of psychological and social functioning. Many models and definitions of cognitive rehabilitation exist. In this review, cognitive rehabilitation would be briefly reviewed as three categories; cognitive stimulation, cognitive training and cognitive rehabilitation. Cognitive stimulation is a range of group activities and discussions targeting general enhancement of cognitive and social functioning. Cognitive training is guided practice of standardized cognitive task-sets according to the individual levels. Cognitive rehabilitation is an individual approach using rehabilitation strategy for cognitively disabled person. Goal-setting is essential and emphasis is on improving performance in everyday life.
Cognitive Therapy ; Dementia* ; Disabled Persons ; Humans ; Rehabilitation*