Pacing障害における着衣動作訓練の有効性—トークンシステムによるアプローチ

Effect of the training on disability of dressing activity owing to pacing disorder: An approach based on the token system

要旨：pacing障害を呈す患者は言語指示や動作反復による訓練効果が乏しく，長期間の介助や監視が必要になってしまう可能性が指摘されている．今回pacing障害によって着衣動作に介助を要した症例に対し，トークンシステムに基づくアプローチの有効性を明らかにするため，シングルケースデザインにて検討した．トークンを用いた強化刺激は，着衣動作ステップの省略を改善させる上で有効であった．またその効果はpacing障害や半側無視の改善とは独立して生じた．

　It is said that patients with pacing disorder may need assists or observation for a long time, because rehabilitation training by verbal instructions or repeated movements don't have much effect. We investigated the effect of the training based on the token system for a patient who needed assists in dressing owing to pacing disorder. As a result, we found that the training based on the token system was effective for the patient in remedying omission of some motions. We guess the training made the dressing disorder improve. The pacing disorder itself didn't improve very much.