著者
濱嶋 真弘 村川 雄一朗 大門 恭平 北村 哲久 石川 秀雄
出版者
公益社団法人 日本リハビリテーション医学会
雑誌
The Japanese Journal of Rehabilitation Medicine (ISSN:18813526)
巻号頁・発行日
pp.20007, (Released:2020-12-17)
参考文献数
12

Objective:It is often difficult to provide effective functional training in patients with severe attention deficit caused by organic damage to the brain. Herein, we report a case of attention deficit in a patient with subarachnoid hemorrhage, which was successfully treated by virtual reality (VR)-guided rehabilitation.Methods:A 71-year-old woman was transferred to our hospital for rehabilitation after a subarachnoid hemorrhage. The patient suffered from severe attention deficit. She was unable to follow instructions from therapists and was unable to concentrate on rehabilitation tasks. We attempted VR-guided rehabilitation using mediVR KAGURA (mediVR, Toyonaka, Japan) in order to improve her attention deficit. The training was performed approximately 20 min every weekday, for 4 months in a 360-degree VR environment, with no background image initially. The difficulties in physical and cognitive tasks were adjusted by focusing on the size, range of appearance, and falling speed of each task object, so that even patients with severe attention deficit could respond to these tasks appropriately.Results:After the above-mentioned VR-guided training, the trail making test A, behavioral inattention test, and moss attention rating scale were improved from 300 s (could not complete the test) to 100 s, 119 to 133, and 55 to 98, respectively. In addition, in the clinical assessment for attention, the time required for visual obliteration tests was significantly shortened, and clinical symptoms associated with attention deficit were also improved clinically.Conclusion:VR-guided rehabilitation has the potential to be used as a new therapeutic approach to improve attention deficit.
著者
片山 祐介 北村 哲久 清原 康介 酒井 智彦 溝端 康光 嶋津 岳士
出版者
一般社団法人 日本臨床救急医学会
雑誌
日本臨床救急医学会雑誌 (ISSN:13450581)
巻号頁・発行日
vol.21, no.6, pp.697-703, 2018-12-31 (Released:2018-12-31)
参考文献数
12

患者が病院を受診すべきか否かを自身で判断できないことは救急車要請の一因である。その一方で,電話相談で「緊急度が低い」と判定されたにもかかわらず救急車出動した事例の実態については明らかにされていない。方法:対象者は2013〜2015年に大阪市内から救急電話相談に電話をし,「緊急度が低い」と判定された症例で,救急車が出動した症例のうち救急活動記録とひもづけできた救急搬送患者である。5歳年齢階層ごとの判定例1,000人当たりの救急車出動数を算出し,年齢階層別の動向をJoinpoint分析で評価した。結果:緊急度が低いにもかかわらず救急車が出動したのは185件で,もっとも多かった年齢階層は0〜4歳群で23件であった。一方でJoinpoint分析結果では,35〜39歳以降大きく増加していた。考察:とくに高齢者では緊急度が低いにもかかわらず救急車が出動する傾向にあり,救急車に代わる病院受診手段の確立が求められる。