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Integration of Behavioral, Physical and Engineering Technologies for Advancing Cutting Edge of Preventative Rehabilitation and Health Promotion |
Sunday, May 26, 2024 |
8:00 AM–9:50 AM |
Marriott Downtown, Level 4, Franklin Hall 9-10 |
Area: CBM/CSS; Domain: Applied Research |
Chair: Yoshitsugu Omori (Faculty of Medical Sciences, Shonan University of Medical Sciences; Faculty of Systems Design, Tokyo Metropolitan University) |
Discussant: Yusuke Hayashi (Division of Social Sciences and Education,Pennsylvania State University, Hazleton) |
Abstract: This symposium will present intervention technologies from behavior analysis, rehabilitation science, and virtual reality to promote physical function, activity, social participation, and quality of life in older adults. As decline in physical function would be associated with frailty, activity limitation and social participation, health promotion and disease prevention is very important. Daily exercise of physical activity is one of the ways to promote health, prevent disease and disability, and improve quality of life. To increase the sustainability of exercise implementation, it is important that exercise interventions are simple and can be implemented at home every day. In this symposium, we clarify the effectiveness of home-based training on body movement, muscle strength, cardiopulmonary function and activities of daily living for older adults using both behavioral and rehabilitation and Virtual Reality technology. The presenters are working on a bridge study of behavior analysis, physical therapy, occupational therapy, and psychology. The presentations are as follows: Upper limb rehabilitation using virtual reality, Fine motor skills using Behavioral Skills Training with self-recording for activities of daily living, Home-based physical training for incontinence and leg muscle strength in older adults with lower urinary tract dysfunction, Home-based step training on the leg to promote cardiopulmonary function. |
Instruction Level: Intermediate |
Keyword(s): health promotion, home-based intervention, older adults, rehabilitation |
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Upper Limb Rehabilitation Using Virtual Reality System: The Effect of Behavioral Intervention |
NAOKI ISO (Faculty of Health Sciences, Tokyo Kasei University; Faculty of Systems Design, Tokyo Metropolitan University ), Makoto Suzuki (Faculty of Health Sciences, Tokyo Kasei University; Faculty of Systems Design, Tokyo Metropolitan University), Jun'ichi Yamamoto (Tokyo Metropolitan University, Faculty of Systems Design) |
Abstract: Virtual Reality(VR) technology and integrating behavior analysis and rehabilitation techniques can maximize the effectiveness of intervention. The fading technique that gradually reduces physical guides is necessary to promote spontaneous upper limb movement. The prompt fading methods based on quantitative indices have not been implemented. We developed VR-based upper limb rehabilitation system that automatically measures the participant's arm movements, reduces prompt stimuli according to the degree of movement mastery, and generates spontaneous reaching movements. When Head Mount Display was worn, a model avatar arm appears on the virtual screen and reaches out at a specified direction, speed, and rhythm. The participant's actual arm movements also appear on the screen. The participant is asked to match the movements of avatar arm, and when the movements overlap, the parts of avatar arm gradually disappear. This feedback is repeated to promote the acquisition of appropriate arm movements. The result showed that fading with VR produced more accurate reaching responses when the distance between the movements of avatar and actual arms was shorter and fading was more immediate. This is a first study of modeling and fading in rehabilitation using VR, and it will contribute to research integrating behavior analysis and rehabilitation. |
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Establishing Fine Motor Skills of Non-Dominant Hand by Behavioral Skills Training and Self-Recording in Older Adults: Perspectives for Behavioral Rehabilitation |
JUN'ICHI YAMAMOTO (Tokyo Metropolitan University, Faculty of Systems Design), Yoshitsugu Omori (Faculty of Medical Sciences, Shonan University of Medical Sciences; Faculty of Systems Design, Tokyo Metropolitan University) |
Abstract: Fine motor skills of the fingers and hands and their coordination are the basis for movements such as picking, grasping and holding, and for Activities of Daily Living such as eating and dressing. Difficulties of fine motor skills are often caused by diseases such as hemiplegia, frailty and brain dysfunction. Occupational therapy and physical therapy have provided rehabilitation interventions for such diseases. Not enough research has been examined what kind of practice in the home could have a clinical effectiveness after intensive rehabilitation. The target behavior in the present study was an appropriate chopstick manipulation with the non-dominant hand. Older adults aged 80 years and older participated. Dependent measures were the number of plastic chips transferred to the left and right bowls per minute, actual eating movements, a standardized fine motor score, grip strength and social validity, which were measured at baseline, after 2 weeks and after 4 weeks of intervention. The intervention consisted of Behavioral Skills Training and self-recording of plastic chip transfer and actual eating with the non-dominant hand was administered. Results showed the effectiveness of home practice. The integration of applied behavior analysis and rehabilitation studies would lead to a new field of behavioral rehabilitation. |
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Effectiveness of Home-Based Step Training on Lower Extremity Function and Cardiopulmonary Function in Community-Dwelling Older Adults: Health Promotion With Behavior Analysis and Physical Therapy |
YUJI MORIO (Faculty of Medical Sciences, Shonan University of Medical Sciences; Faculty of Systems Design, Tokyo Metropolitan University), Yoshitsugu Omori (Faculty of Medical Sciences, Shonan University of Medical Sciences/ Tokyo Metropolitan University), Yoshimi Sakurai (Faculty of Medical Sciences, Shonan University of Medical Sciences; Faculty of Systems Design, Tokyo Metropolitan University), Jun'ichi Yamamoto (Tokyo Metropolitan University, Faculty of Systems Design) |
Abstract: It is important for older people to continue walking to maintain their physical function. Therefore, we developed a step training program that can be performed continuously in the home and evaluated its effectiveness on lower limb and cardiopulmonary function in older adults. The training consisted of a 2.5 cm high obstacle to step over, and the participants were instructed to step forward and backward for 2 minutes and left and right for 2 minutes continuously every day at home. For each participant, we first counted the rhythm of the steps in which each participant could comfortably walk, and determined the target criteria as 120% of pre-determined step rhythm for the practice at the home. After 4 weeks of training, older adults showed increases in knee extensor muscle strength, the number of steps participants could step over an obstacle per 30 seconds, and the 6-minute walk distance as a measure of cardiopulmonary function. Home-based step training for older adults advances health promotion through the use of physical therapy and applied behavior analysis, even when the instructor is not present during the training. |
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The Intervention of Lower Urinary Tract Dysfunction in Older Adults With Frailty: Improvement of Physical Function and Quality of Life |
YOSHIMI SAKURAI (Faculty of Medical Sciences, Shonan University of Medical Sciences; Faculty of Systems Design, Tokyo Metropolitan University), Jun'ichi Yamamoto (Tokyo Metropolitan University, Faculty of Systems Design) |
Abstract: Lower urinary tract dysfunction (LUTD) and incontinence due to this dysfunction impair a person's life, participation, and activities and is associated with the frailty in older adults. For prevention and care of LUTD in older adults, physical therapy, pharmacotherapy, and behavioral interventions are needed. We presented the effects of home-based training instruction by a physical therapist on urinary-related behavior and improvement of lower limb function in frailty older adults with lower urinary tract dysfunction. A physical therapist visited the patient's home approximately once every two weeks to provide home-bases lower limb strength training and feedback on the records. The results showed a decrease in incontinence frequency and an increase in calf circumference, an improvement in the patient's ability to sit to stand in a chair, and an improved quality of life using the King's Health Questionnaire. These results indicate that home-based training is effective not only in improving physical function but also in improving activity, participation, and quality of life in older adults. Combining behavior modification with physical therapy using applied behavior analysis may be more effective in improving health promotion among the older adults. |
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