脳卒中により言語障害を呈したクライエントへのCognitive Orientation to daily Occupational Performance（CO-OP）を基盤とした訪問作業療法実践

Home-visit occupational therapy using the CO-OP approach for a client with stroke and speech impairments: A case study

要旨：本報告の目的は言語障害を呈したCLへのCO-OPの可能性を示すことである．方法は1事例の事例報告で，言語障害を呈した脳卒中者に対して，CO-OPを基盤とした訪問OTを実施した．結果は目標であった調理技能の獲得に加えて，調理で習得した問題解決技能を活用して，言語による家族交流といった作業への転移まで導くことができた．言語機能では，SLTAで「呼称」と「書字命令に従う」で平均値±1標準偏差範囲内へと改善を示した．結論として，CO-OPは，言語障害を呈した脳卒中者の技能習得および転移に有用である可能性が示された．さらに，認知戦略に言語機能を有効活用することで言語機能の向上にも繋がる可能性が示された．

　[Objectives] To examine the effects of intervention using the CO-OP for a stroke client with speech impairments. [Method] We used the CO-OP approach to intervene in a client with stroke and speech impairments. [Results] The CO-OP approach helped the client acquire cooking skills and achieve her goals. In addition the client could transfer the skills to other occupations. The language function has been significantly improved in “confrontation naming” and “follow writing instructions.” [Conclusion] The CO-OP approach may be helpful for goal attainment skill acquisition, and transfer in stroke patients with speech impairments. In addition the client effectively used the cognitive skills to acquire and improve language function.