「The Effectiveness of Occupational Therapy focusing on sitting posture in wheelchair」          Hiroko Karitani(OTR)    Ayumi Noguti(OTR)    Takako Yamada(PhD,OTR)

学会名 第4回アジア作業療法学会
会 場 香港コンベンションセンター
開催地 香港

<Background>
The sitting posture in wheelchair aged are became difficulty for various factors for example the main disease, disuse atrophy. We utilized OT focusing on sitting posture in wheelchair and the stretch to treat the aged. We report on the case study as described below.

<Methods>
The patient was a female who aged were 79 years old. she was diagnosed head injury aftereffects, cervical myelopathy (C5/6) and dementia. She was bedridden, and she was with round back. We offer device of wheelchair for example head-support, back-support, arm-support and manual. And we offered OT doing stretch to her trunk chiefly. Rating of wheelchair sitting time, questionnaire to care workers, observation by an OT were taken before and after intervention to investigate effects.

<Results>
Durability time of wheelchair sitting: The mean before intervention was 4.12miniutes, after was 8.61miniutes and there were significant differences. (p<0.05) Questionnaire: 〔difficulty setting〕care workers answered easy became 29% from 6%.〔time to need 〕it was so necessary 24% from 59%.〔manual〕it was so convenience 70% from 23%.Observation of OT: When she eats, the number of times to support her trunk decreased. When driving of wheelchair, most of supporting her trunk became needless. In addition, it became often that she moved a hand to scratched face.

<Conclusion>
After the intervention accepted extension of wheelchair sitting time, and it suggested that it was effective by questionnaire and observation of OT and flexibility of musculus rectus abdominis by palpation. We approached that she eats all by tableware to assist in the time that she can sit easily. As a result, we accepted improvement of BMI and functional proof was considered by videofluoroscopic examination of swallowing. Finally, we reached a conclusion that this wheelchair posture was adequately for her.