1.Effects of Our Locomotive Syndrome Prevention Program
Ryokichi GOTO ; Yuki SASAKI ; Takahiro TODOROKI ; Misako HANAI ; Tomohiro NAKAI
Journal of the Japanese Association of Rural Medicine 2015;64(1):1-7
[Purpose] This study was carried out to examine the effects of the locomotive syndrome prevention program implemented by our hospital. [Subjects] Thirty-four individuals (3 males and 31 females; mean age, 72.2±6.9 years) who participated in the exercise class held under the program from 2010 to 2011 were enrolled in the study. [Methods] We examined their bodily functions and the self-assessment checklists for locomotion and exercise habit at the beginning of, at the end of, and six months after the class, and made a comparison between the results obtained on the three occasions. The bodily function examinations included tests of grip strength, 10-m fast-paced walk, tandem gait, 30-sec chair-stand (CS-30), timed “up and go” and one-leg stance with their eyes open. The lower limb length to height ratio was calculated in percentage. [Results] A good deal of improvement was observed in all of the bodily functions tested except for the grip strength. The follow-up survey which was taken six years after the class ended showed a significant improvement in the 10-m fastest walk, lower limb length ratio, and CS-30. The average number of locomotion-syndrome-positive items on the locomotion checklist decreased from 2.5 at the beginning of the exercise class to 1.7 at the end of the exercise class, though the difference was not so significant. The number further decreased six months after the class ended. It was also shown that an increasing number of subjects took exercise more frequently. [Conclusion] The abovementioned results suggested that our program was effective in preventing locomotive syndrome.
2.Assessment of Cognitive Function in the Elderly Using the Soundcell Method
Yoshihiko SANO ; Yuki SASAKI ; Misako HANAI ; Nobuyuki SUZUMOT ; Takahiro TODOROKI ; Tomihiro HAYAKAWA ; Makoto MIYAJI ; Katsumi MITA
Journal of the Japanese Association of Rural Medicine 2014;62(5):715-725
A soundcell is defined as a musical unit of meaning with short period of phrase. The soundcell method (SCM) is a musical procedure that decomposes a musical piece into several soundcells and subsequently recomposes the original music with the soundcells arbitrarily scattered. The present investigation aimed to assess cognitive function in the elderly using the SCM. An electronic system realizing the concept and methodology of the SCM was developed, and SCM examination with the school song “Furusato” as the musical piece was performed on18aged females. Four clinical tests were also carried out before or after the SCM examination to screen cognitive function: Mini-Mental State Examination (MMSE), Kana Pick-out Test, and Trail Making Tests A and B. The performance in the SCM examination was compared with the score in the clinical tests. The scores in all four clinical tests were significantly different between subjects who passed and failed the SCM examination. The individuals who passed the SCM examination were not suspected of dementia on the basis of the MMSE and seemed to execute successfully the Kana Pick-out Test. The number of acts and mean act time in the SCM examination were strongly correlated not only with the total score in the MMSE but also with the scores of the two sub-items: attention/calculation and memory recall. The results suggest that the SCM reflects a subject's short-term and recent memory and provides useful supplementary information for early diagnosis of mild cognitive impairment and Alzheimer’s disease since impairment of memory is frequently observed in the early stage of the diseases. In addition, most subjects enjoyed the SCM examination incorporating the element of musical amusement. The SCM is thus expected to allow repetitive and participatory assessment of cognitive function without imposing a large psychological burden on the subject.
3.Proposal of Functional Scoring (FS) Method From the Viewpoint of Target Setting
Tomohiro NAKAI ; Toshitaka MITUHASHI ; Yoshiyuki SUZUMOTO ; Hiroki FUNAHASHI ; Ryokichi GOTO ; Shunsuke GOTO ; Yuki SUZUKI ; Kenji SUGIMOTO ; Naoko HOSHIDA ; Takahiro TODOROKI ; Fumiko MATSUI ; Junko SAKAI ; Fumiko SUZUKI ; Emiko KAWAI ; Tomihiro HAYAKAWA
Journal of the Japanese Association of Rural Medicine 2009;58(1):4-12
This paper proposes a method for evaluating and scoring the activities of rehabilitation service users in order to pinpoint the problems with the health service of this kind and set the adequate targets for each user. Sincs the Nursing Care Insurance System was introduced in Japan in 2000, it has been argued that home-visit rehabilitation services should be excluded from home-nursing care services. However, the methods of certifing that nursing care is required are not fully established yet for setting the rehabilitation targets for service users. As things stand, it is recommended that such a method as the Functional Independence Measure (FIM) or the Barthel Index (BI) should be utilized. However, these methods only evaluate “performing activities” (the activities that a user usually performs). In order to set the users' targets, we thought it necessary to establish a method for evaluating “possible activities” (the activities that a user is able to perform at his/her full capacity). We have established a method called Functional Scoring (FS) which evaluates and scores the both performing and possible activities based on the same evaluation items. We conducted experimental evaluations on the home-visit rehabilitation users for one year from October 2005 to September 2006. When the first evaluations in 2005 were compared with the second evaluations in 2006, the total score of the performing activities significantly increased from 44.1±13.7 to 47.8±14.2 (P<0.05). Although the total score of the possible activities did not significantly increase, it demonstrated an upward trend from 49.6±13.2 to 51.6±13.5. The result suggests that our method is useful for distinguishing between the performing and possible activities. The proposed method enables us to adequately recognize the problems each user has, and to set the rehabilitation target for each user, which can be shared between the user, care personnel, and care service provider.
Rehabilitation aspects
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Functional
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FS
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Care given by nurses
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