{"created":"2023-05-15T09:03:21.435878+00:00","id":4280,"links":{},"metadata":{"_buckets":{"deposit":"9eb8e863-a2c9-4f71-94c7-e5efe6eb232f"},"_deposit":{"created_by":3,"id":"4280","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"4280"},"status":"published"},"_oai":{"id":"oai:hirosaki.repo.nii.ac.jp:00004280","sets":["557:677:678"]},"author_link":["14140","14142","14138"],"item_7_biblio_info_8":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-03-20","bibliographicIssueDateType":"Issued"},"bibliographic_titles":[{}]}]},"item_7_date_granted_66":{"attribute_name":"学位授与年月日","attribute_value_mlt":[{"subitem_dategranted":"2014-03-20"}]},"item_7_degree_grantor_64":{"attribute_name":"学位授与機関","attribute_value_mlt":[{"subitem_degreegrantor":[{"subitem_degreegrantor_name":"弘前大学"}],"subitem_degreegrantor_identifier":[{"subitem_degreegrantor_identifier_name":"11101","subitem_degreegrantor_identifier_scheme":"kakenhi"}]}]},"item_7_degree_name_63":{"attribute_name":"学位名","attribute_value_mlt":[{"subitem_degreename":"博士（保健学）"}]},"item_7_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【Introduction】\nThe aim of the present study is to assess effective physical therapy interventions on\nhome-care patients with Parkinson’s disease through the following: understanding how\nthey practice therapeutic exercises; clarifying the characteristics of their physical\nfunctions and situation of physical activity; and elucidating the effects of therapeutic\nexercises on their physical functions and situation of physical activity.\nThe study procedures were following:\n(1) To conduct a visit survey on how home care patients with Parkinson’s disease use\nnursing care insurance and practice therapeutic exercises (Chapter 1: Step1).\n(2) To investigate the relationship between problems in daily living and the practice of\nself-exercise in patients with Parkinson’s disease (Chapter 2: Step2).\n(3) To demonstrate the characteristics of physical function and 24-h activity in home-care\npatients with Parkinson’s disease compared with healthy elderly people (Chapter 3:\nStep3).\n(4) To understand what kind of impacts two-month interventions on home-care patients\nwith Parkinson’s disease through self-exercise and individual therapeutic exercises\nhave on their physical functions and situation of physical activity (Chapter 4: Step4).\n【Step1】 Research on exercise therapy in home-care patients with Parkinson’s\ndisease: Results of home-visit survey on the use of domiciliary service and\nthe implementation of self-practice\nObjective: This study aimed to obtain insight for the investigation of future intervention\nand measures by disclosing the conditions of understanding exercise therapy, including\nself-exercise, and securing the opportunities as well as practical problems at home in\nhome-care patients with Parkinson’s disease.\nMethod: Home-visit survey was conducted by an interview method in which an\ninvestigator visited the home of the subjects and interviewed them directly. The major\nitems for the visit survey were the chief complaints in activity of daily living, application\nto long-term care insurance and self-practice was conducted in 15 home-care patients\nwith Parkinson’s disease.\nResults: The results revealed that the answers for chief complaints related to sit-to-stand\nand gait performance such as “slow movement,” “difficulty in prompt action,” “easy to\nfall,” “leaning body,” and “walking in small steps” ranked high. When divided into two\ngroups based on the presence or absence of the certification of long-term care need, a\nstatistically significant difference was observed in the number of answers of “easy to fall”\nas determined by χ2 test and in the fear of a fall as determined by t-test. As a result of χ2\ntest with respect to the presence or absence of a habit of exercise therapy as self-practice,\na significant difference was observed in the number of answers of “easy to fall” and\n“difficulty in toilet activities.” A significant difference was also observed by t-test in the\nduration from onset, score on fear of a fall, and the Tokyo Metropolitan Institute of\nGerontology Index of Competence.\nConclusion: This result suggests that it is difficult to accustom exercise therapy as\nself-discipline in severe patients with difficulty in maintaining standing position, turning\naround, and visiting the hospital, prolonged duration from onset, increase in the score on\nfear of a fall, and reduction in activities such as those represented by the Tokyo\nMetropolitan Institute of Gerontology Index of Competence.\n【Step2】 Problems with Daily Living and Performing Home Exercise in Japanese\nHome-care Patients with Parkinson’s Disease\nObjective: We investigated the relationship between problems in daily living such as\nfalls and the practice of self-exercise in patients with Parkinson’s disease in Japan, to\nshow the requirements for their effective and sustainable home exercises.\nMethods: An anonymous questionnaire was sent by mail to 159 Parkinson’s disease\npatients who were members of the Miyagi Prefecture Branch of the Japan Parkinson’s\nDisease Association. The questionnaire included questions on Parkinson’s disease\nsymptoms, chief complaints, history of falls, use of the nursing care insurance program,\nand performance of exercise therapy.\nResults: The questionnaire response rate was 62.3%. Falls had been experienced by 38\nsubjects (44.2%) during the month before the survey and by 52 (60.5%) during the 6\nmonths before the survey. More than half (52.3%) of subjects had never undergone\nexercise therapy at a medical institution, and those who continued to undergo exercise\ntherapy accounted for only 12.8% of all subjects. Thirty-three subjects (38.4%) did not\nundergo exercise therapy on a regular basis in any setting.\nConclusion: To prevent a decrease in activity due to disuse muscular atrophy, it is\nimportant to establish more effective self-exercise for home-care Parkinson’s disease\npatients so that they can do these exercises on a regular basis.\n【Step3】 Comparison of Physical Function and Activity in Home-care Patients with\nParkinson’s Disease and Healthy Elderly People\nObjective: To compare physical function and 24-h activity in home-care patients with\nParkinson’s disease with those in healthy elderly people.\nMethods: Physical function (range of motion, muscle strength, activities of daily living,\ngait, and balance) was measured in 10 home-care patients with Parkinson’s disease (PD\ngroup) and 10 healthy elderly subjects (healthy group). As an indicator of the amount of\nphysical activity per day, a triaxial accelerometer was used to measure the 24-h total\nimpulse value; simultaneously, behavior recorders were used to measure 24-h posture.\nResults: The healthy group scored significantly higher in activities of daily living,\nwalking speed, and balance. No significant difference was observed between groups in\nterms of range of motion, muscle strength, cadence, amount of physical activity per day,\nand number of postural changes. However, the PD group spent significantly more time\nper day standing and in a supine position.\nConclusion: In the PD group, the amount of physical activity per day was comparable to\nthat in the healthy elderly group, despite the decreased levels of activity caused by their\nimpaired performance in activities of daily living. Range of motion and muscle strength\nmay have been maintained by these patients’ self-exercise and by training at day-care\ncenters. Our results suggest the importance of practicing postural transfers from the\nstanding and supine positions and of intervention and guidance that aim to improve\nimpaired performance in daily living.\n【Step4】 Effects of Therapeutic Exercises by Home-care Patients with Parkinson’s\nDisease on Their Physical Functions and Situation of Physical Activity.\nObjective: The aim was to clarify how two-month interventions on home care patients\nwith Parkinson’s disease through self-exercise and individual therapeutic exercises affect\ntheir physical functions, daily amount of activity and posture dynamics.\nMethods: With 10 home-care patients with Parkinson’s disease as a target, we conducted\nphysical therapy intervention that consisted of 2-months self-exercise and individual\ntherapeutic exercise. Before and after the intervention status of implementation of\nself-exercise, state of fall, and fear of falling were heard from the patients. In addition,\nphysical functions (range of motion, muscle strength, activities of daily living, gait, and\nbalance) of the patients were also evaluated. As an indicator of the amount of physical\nactivity per day, a triaxial accelerometer was used to measure the 24-h total impulse\nvalue; simultaneously, behavior recorders were used to measure 24-h posture.\nResults: The interventions made statistically significant improvements in the following:\nincrease in both the number and duration of self-exercise, decrease in chief complaints,\nand mitigation of the fear of falling down. As for physical functions, significant increases\nwere noted with respect to the following: angle of shoulder joint flexion and trunk\nextension, hip flexor muscle strength, and knee extensor muscle strength. However, no\nsignificant changes were recognized in the following indicators: Functional\nIndependence Measure, walking speed and cadence, Timed Up and Go test, Functional\nReach Test and Functional Balance Scale. Whereas indicators for the amount of physical\nactivity, such as total impulse and the number of posture change did not change\nsignificantly, the amount of activity significantly increased due to decrease in the duration\nof recumbent position per day and increase in the ratio of sitting position.\nConclusion: The interventions made as part of the study seemingly had the following\neffects: habituation of self-exercise; improvements in the joint range of motion, lower\nlimb muscle strength, and balance in upright position; and reduction in the duration of\nrecumbent position.\n【Summary】\nThe results of the study suggest the importance of further rehabilitation measures for\nhome-care patients with Parkinson’s disease. As one example of such measures, it is\nconsidered necessary to increase the opportunities for home-care patients with\nParkinson’s disease to receive direct coaching from medical professionals and practice\ntherapeutic exercises, thus making the following possible: provision of therapeutic\nexercises through individual nursing care insurance depending on the symptoms and\nseverity of each patient; and interventions that help patients to conduct self-exercise on a\nregular basis. Also, the study suggests that interventions including individual therapeutic\nexercises and coaching on self-exercise have the following effects: habituation of\ntherapeutic exercises, increase in flexibility and lower limb muscle strength, and decrease\nin the duration of incumbent position. However, the effects of the interventions were not\nsignificant enough with respect to increase in the amount of activity and the number of\nposture change, and decrease in the duration of uptight position. Also, while the duration\nof incumbent position decreased, that of sitting position was prolonged. It is necessary to\nconsider effective intervention methods for these phenomena from now on.","subitem_description_type":"Abstract"}]},"item_7_dissertation_number_67":{"attribute_name":"学位授与番号","attribute_value_mlt":[{"subitem_dissertationnumber":"甲41"}]},"item_7_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"14140","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ナカエ, ヒデユキ"}]}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"14138","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Nakae, Hideyuki"}]}]},"item_7_radio_18":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_radio_item":"ETD"}]},"item_7_radio_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_radio_item":"Thesis"}]},"item_7_text_4":{"attribute_name":"著者所属","attribute_value_mlt":[{"subitem_text_value":"弘前大学大学院保健学研究科"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"中江, 秀幸"}],"nameIdentifiers":[{"nameIdentifier":"14142","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-03-13"}],"displaytype":"detail","filename":"tdh_41_nakae.pdf","filesize":[{"value":"5.9 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"本文","url":"https://hirosaki.repo.nii.ac.jp/record/4280/files/tdh_41_nakae.pdf"},"version_id":"bbbba36e-32f8-45b3-9e60-ccdfdce0e074"},{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-03-13"}],"displaytype":"detail","filename":"tdh_41_nakae_a2.pdf","filesize":[{"value":"541.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"審査結果要旨","url":"https://hirosaki.repo.nii.ac.jp/record/4280/files/tdh_41_nakae_a2.pdf"},"version_id":"c7a458b2-616e-4730-9d5a-15202ff00538"},{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-03-13"}],"displaytype":"detail","filename":"tdh_41_nakae_a1.pdf","filesize":[{"value":"121.7 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"内容要旨","url":"https://hirosaki.repo.nii.ac.jp/record/4280/files/tdh_41_nakae_a1.pdf"},"version_id":"d525b2b8-0ea3-4189-859d-07e225334284"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"doctoral thesis","resourceuri":"http://purl.org/coar/resource_type/c_db06"}]},"item_title":"在宅パーキンソン病患者における活動量および姿勢動態への 効果的理学療法介入の検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"在宅パーキンソン病患者における活動量および姿勢動態への 効果的理学療法介入の検討"}]},"item_type_id":"7","owner":"3","path":["678"],"pubdate":{"attribute_name":"公開日","attribute_value":"2014-06-20"},"publish_date":"2014-06-20","publish_status":"0","recid":"4280","relation_version_is_last":true,"title":["在宅パーキンソン病患者における活動量および姿勢動態への 効果的理学療法介入の検討"],"weko_creator_id":"3","weko_shared_id":3},"updated":"2023-05-15T10:18:21.945219+00:00"}