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
草場 正彦 櫻井 卓郎 角田 明子 梅崎 成子 村川 雄一朗
出版者
日本緩和医療学会
雑誌
Palliative Care Research (ISSN:18805302)
巻号頁・発行日
vol.15, no.4, pp.277-284, 2020 (Released:2020-10-08)
参考文献数
30

近年,悪性脳腫瘍患者に対する終末期ケアの重要性が報告されている.終末期脳腫瘍患者と関わるうえで,患者の呈する症状を知ることは重要である.本研究の目的は,終末期脳腫瘍患者のデータ収集方法や評価時期,症状を調査することである.抽出された論文は7本であり,データ収集方法は診療録からの情報収集(4本),質問表(2本),電話での調査(1本)であった.評価時期は,死亡までの期間が46日から1週間前であった.患者の呈する症状は疾患特異的な症状と,終末期のがん患者が呈する一般的な症状に分類することができた.疾患特異的な症状である意識障害(4本),痙攣発作(7本),嚥下障害(6本),頭痛(6本)を報告した論文が多かった.終末期に近づくほど,嚥下障害の出現率は高くなった.以上より,データ収集方法や評価時期は先行研究ごとで異なり,終末期脳腫瘍患者は疾患特異的な症状を呈する可能性が高いことが示唆された.