作業選択意思決定支援ソフト（ADOC）を用いたクライエントにとっての意味のある作業に焦点を当てた上肢機能アプローチの経験

Effects of a task-oriented upper extremity function approach using Aid for Decision-making in Occupation Choice (ADOC): A case report

要旨：Constraint-induced movement therapy（CI療法）の要素を含む上肢機能訓練において，目標設定のために作業選択意思決定支援ソフト（以下，ADOC）を使用した．対象者は脳卒中後，回復期の50歳代の右片麻痺の男性で，職業はエンジニアであった．ADOCを使い，「職業活動：工具の操作，パソコンの操作」と「日常生活動作（ADL）：箸の操作」を目標に設定した．目標設定後，クライエントは1日1〜2時間の上肢機能訓練を受けた．結果，上肢機能の改善度や，上肢の使用頻度と動作の質，目標に設定した作業の満足度は，臨床上意味のある最小変化量または最小可検量を超える改善を認めた．

　In order to set goals in the OT practice for stroke patients with upper extremity paresis including components of the constraint-induce movement therapy, we used the Aid for Decision-making in Occupation Choice (ADOC). The client was a male engineer in his early fifties with right hemiparesis due to sub-acute stroke. We used the ADOC to set the following OT goals: activities of working (manipulation of a personal computer and industrial tools), and activities of daily living (using chopsticks). The client received 1-2 hours of intervention per day for the affected upper extremities. The intervention resulted in the following areas improving slightly above the minimum required for meaningful change according to the goals set by the client: upper extremity function, frequency of upper torso use, quality of movement and degree of satisfaction of the occupational goal.