[Purpose] To clarify the relationships between nurses’ and therapists’ clinical competence levels and attitudes toward interprofessional collaboration, we examined the 2 types of professionals using the Japanese-version Assessment of Interprofessional Team Collaboration Scale II (AITCS-II-J), a scale to measure the status of such collaboration, and compared their scores, focusing on these relationships. [Participants and Methods] A total of 115 nurses and therapists working in hospitals specializing in rehabilitation were analyzed. [Results] There were no significant differences in the total AITCS-II-J score among the ladders. On the other hand, the score for each statement varied between nurses and therapists based on the ladder. [Conclusion] The results suggest that the perspective on interprofessional collaboration varies according to the profession and career ladder level. Based on this, the timing of intervention and interventional approaches to promote positive attitudes toward interprofessional collaboration should be carefully examined.

Measuring physiological responses using Arduino microcomputers has become increasingly popular in recent years. This technical note describes making circuits on a breadboard to measure three major psychophysiological research indicators: electrocardiogram, electromyogram, and skin conductance. This note also explains how to program and measure these indices using the Arduino development environment. An advanced example of wireless measurement utilizing a microcomputer that supports Bluetooth and Wi-Fi communication is also presented. The measurement of physiological indices using handmade circuits makes the system more affordable and offers additional advantages, including a more precise understanding of the indices and flexible experimental designs. These methods are expected to develop new possibilities for psychophysiological measurements.

[Purpose] Visual assessment of the quality of movement is a common and important component of physiotherapy. The purpose of this study is to quantify the level of proficiency of therapists and to obtain a new index of proficiency by measuring the coordinates of the gaze tracking trajectories of therapists with years of experience. [Participants and Methods] Eighteen voluntary physiotherapists (1st year (n=4), 7th year (n=1), 9th year (n=4), 10th year (n=3), 11th year (n=4), 13th year (n=1), and 21st year (n=1)) were recruited for this study. [Results] Discriminant analysis according to the size of the deviation between the X-axis and Y-axis of the range of gaze tracking during movement analysis measured from each therapist showed that the percentage of classification accuracy in the 10th year or less was 72.2%. Cluster analysis showed that two clusters were formed. Thirteen therapists in Cluster 2 were in their 9th year or more. Eye tracking trajectories can be classified by the 10th year of experience as a therapist. [Conclusion] It was shown that full-fledged therapists with 10 years of experience also expanded the range of eye tracking. The trajectory in the Y-axis direction tends to be extended with their 9th year or more of experience. In this point, quantitative judgments of eye-tracking results can serve as indicators of proficiency. The eye movements are important as a tool to objectively measure skills from experience.

[Purpose] Integrated volitional control electrical stimulation (IVES) is a type of electrical stimulation therapy that promotes agonist muscle contraction in limbs with motion paralysis. This case study describes the improvement in the paretic hand with stroke hemiplegia, eight years after the onset, with IVES for one month in the extrinsic and intrinsic muscles, including change of mode of stimulation based on the degree of improvement. [Participant and Methods] A 76 year-old male with hemiplegia for eight years. The patient was evaluated for two weeks and performed IVES in the right flexor pollicis brevis, abductor pollicis brevis, and extensor carpi ulnaris with the change of mode of IVES. [Results] The upper limb function improved in a short period of time. The hemiplegia test showed Brunnstrom stages II-III and II-IV for the right upper limb and right hand and fingers, respectively, 28 days after IVES initiation. [Conclusion] After one month of undergoing IVES, the patient showed improvement in hand and finger motor function, which was maintained even after IVES was completed. In this case, there was improvement with a short-term intervention using appropriately combined IVES modes.

[Purpose] To examine longitudinal changes after starting to use day service facilities specializing in rehabilitation through measurement of users’ fitness levels. [Subjects and Methods] In 12 users (4 and 8 requiring assistance and care, respectively), the following items were measured: the hand grip strength, functional reach (FR), duration of standing on one leg with the eyes open, Timed Up and Go (TUG) score, time needed to walk 5 m, weight-bearing index (WBI), mean rhythm error, and rate of such errors. Changes over a 6-month period were retrospectively analyzed. [Results] During the 6-month rehabilitation period, the FR, WBI, and rhythm error rate markedly improved. On comparing the initial measurement values between those requiring assistance and care, there were significant differences in the FR and TUG score. [Conclusion] Six-month rehabilitation improved the balance and lower-limb muscle strength while alleviating rhythm abnormalities, suggesting such an approach as an important factor to reduce the level of care dependency.

[Purpose] Electromyography biofeedback therapy is applied to various diseases during physical therapy for motor learning. Our aim was to develop a low-cost electromyography biofeedback device kit that students could build by themselves in class and to evaluate whether this kit was an adequate educational tool for physical therapy students. [Subjects and Methods] This study included 34 volunteers from a 3 year physical therapy vocational school and a 4 year university course. All students were tasked with: 1) completing a pre-questionnaire
2) attending basic lectures on electromyography biofeedback therapy and how to build the device
3) building the device
and 4) completing a post-questionnaire. [Results] Mean time required to build the device was 50.8 ± 34.1 minutes for the vocational course students and 27.4 ± 8.8 minutes for university students. For both groups, there was a significant increase in the number of students stating “have an interest in,” “be involved with,” and “have knowledge of electromyography biofeedback” when pre- and post-questionnaires were compared. In the post questionnaire, the frequency of the “knowledge increased” response was higher. [Conclusion] Physical therapy students can easily build our new device in a classroom, and this kit is a useful educational tool to motivate learning in electromyography biofeedback.

神経系疾患の病態を捉えるのは難しく、身体と脳で何が生じ、理学療法の効果がどのように現れているのかということは分かり難い。しかしながら、理学療法の過程や効果を対象者ご本人や家族、そして社会に対して目に視える形で提供していくことは非常に重要なことである。今回、回復段階の運動再学習に不可欠となるフィードバックや効果の可視化を実現するために重要となる運動学習理論の再確認とリハビリテーションに関連する脳科学の知見を提示した。脳卒中後のリハビリテーションは、運動は脳の運動野再構成、再組織化を促進すること、運動の再学習にはKR(結果の知識)、KP(動作の手際の知識)が必要である。また、運動学習には、意図、目的をもった行為を伴う随意運動が必要であり、随意運動の発現が困難な場合でも、1人称運動イメージを持つことで運動学習の準備段階となる可能性が高い。さらに、理学療法におけるフィードバックの利用の具体例として、言語を用いたフィードバック(知覚評価、トレーニング)、聴覚フィードバックを併用したロボット機器、電気刺激装置に筋電フィードバックを付加した研究、タイミングフィードバック、BCI(Brain Computer Interface)についても紹介し、理学療法の新しい方法論を考案・実践するための手がかりとした。(著者抄録)

【はじめに】本研究の目的は、言語の一つの手段として擬態語を用い、これが運動記憶にどのような影響を与えるかを検証することである。【実験方法】被験者は運動器疾患の既往のない健康な18〜25歳の男性で説明と同意を得た45名(平均年齢20.48±1.86歳)である。実験手順は、被験者を15名ずつ、A群:運動:練習・角度測定ともに擬態語を発声するグループ、B群:運動練習のみ擬態語を発声するグループ、C群:練習・測定ともに擬態語の発声のないグループに分類した。開始肢位は、閉眼にて肩幅開脚立位。非利き手(鉛筆を持たない側)の肩峰・上腕骨外側上顆にランドマークとした。練習方法は、被験者に、設定装置の板角度(150°設定)まで回内外中間位にて肩関節屈曲をまで実施させ、その後肩関節伸展0°に戻す運動を20回繰り返し運動練習とした。擬態語は、肩関節屈曲運動を表す音韻として、「すー」を選択し使用した。測定は、装置を除去し、再び「板があったと思う高位」まで肩屈曲運動を1回のみ実施し、これを再生時角度とした。分析は再生時角度と装置角度150°との誤差の絶対値の平均値をA群、B群、C群で比較検討し、1元配置分散分析を実施した。【結果】再生時角度の誤差は、A群6.64±1.05°(n=11)、B群10.64±1.06°(n=11)、C群7.00±1.38°(n=10)(平均±SEM)であった。分散分析で有意差が認められ(F(2、29)=3.72、p=0.037)、Tukey-Kramer法による多重比較の結果、A群とB群の間に有意差(p<0.05)が認められた。従って、練習のみ擬態語を使用した場合は、運動練習と測定時に擬態語を使用すると統一した場合よりも誤差が大きくなることが見出された。【考察】今回の結果から、運動記憶学習過程では、言語使用に解離がある場合はその効果は期待できないことが示唆された。臨床的には、リハ実施時と生活場面で方法を統一して実行する必要があると考えられる。(著者抄録)

A power-assisted electrical stimulator was developed for motor function improvement of stroke patients, and was clinically evaluated. The present stimulator can change its stimulation intensity in proportion to the amplitude of voluntary EMG, and give an electrical stimulation of subthreshold intensity during no voluntary contraction. A pair of electrodes were used for both EMG detection and electrical stimulation. Thus, the stimulator can facilitate and amplify weak muscle voluntary contractions of stroke patients. It was expected that the stroke patients might relearn the motor control through the repetitive contraction with the stimulator. The stimulator was applied to the clinical training for 15 minutes, and its treatment effect was evaluated in comparison with the conventional therapeutic electrical stimulation (TES). The effects were examined in the active range of motion, the muscle strength, and the coordination of the ankle joints. Ten hemiplegic patients (Age: 25-76 years old, SIAS-M foot pat score 2) participated in this study, and were randomly divided into two groups for treating different TES programs. The treatment improvements were observed in both methods. The power-assisted stimulator group showed greater improvements in dorsiflexion strength, compared with the conventional TES group. There were no significant differences in the active range of motion and coordination between the groups. The power-assisted stimulator was more effective to facilitate voluntary contraction than the conventional TES in enhancing isometric strength, and was able to assist the patients in the correct recognition and motor learning of the target muscle.