地域包括ケアシステムに向けた継続可能な自主運動グループの構築

Development of peer-instructed, sustainable community-based exercise groups targeting the fulfillment of integrated community care system in old age

要旨：地域包括ケアシステムでは，フレイル高齢者も含めた地域在住高齢者を対象とした一般介護予防事業が開始され，その継続した活動が求められている．本報告では，従来の一次予防事業において実施した運動教室が自主グループ活動につながり，市内全域に広がった経過と作業療法士の関わりをまとめた．我々が過去11年にわたり，18地区で11週間の運動教室を実施した結果，21会場で自主グループ活動が継続し，年間の参加延べ人数は2万人を超えるまでになった．この経過から，作業療法士が自主グループ活動への移行と継続を支援しながら展開した本事業は，新たな一般介護予防事業を構築する際のモデルになりうると思われた．

　An “Integrated Community Care System (ICCS)” has been introduced in Japan under the long-term care insurance system to address “ageing in place”. Promoting ‘mutual aid' is a vital element of ICCS. The aim of the present study was to develop peer-instructed, sustainable community-based exercise groups (PSCEG) by promoting mutual aid to fulfill the target of ICCS in old age. Over the past 11 years, we have instructed 11-week long community-based exercise programs in 18 separate districts of Tokai city in different periods. The programs then continued until the present by the participants themselves where they took turns as instructors for each exercise session. Hence the training became a peer-instructed one. Later on, three more PSCEG were formed and currently there is a total of twenty-one PSCEG in Tokai city. The number of participants is increasing each year, and currently more than 20 thousand participants are working out under the PSCEG umbrella in Tokai city. These results indicate that enhancing mutual aid based on a peer-instructed mode of training could be useful in organizing a PSCEG.