訪問リハビリテーションにおける生活行為向上マネジメントを活用した介入効果—転倒恐怖感と生活活動の変化に着目して

Efficacy of the Management Tool for Daily Life Performance on home-visit rehabilitation services: Focusing on fear of falling and life activities

要旨：生活行為向上マネジメント（以下，MTDLP）を活用した訪問リハビリテーションが，転倒恐怖感と生活活動に与える効果検証のために，訪問リハビリテーション利用者36名を介入群と対照群の2群に分け検討した．介入群はMTDLPによる介入，対照群は従来の訪問リハビリテーションを実施した．結果，介入群では活動・参加の改善を目指す具体的な目標が立案され，実際場面での活動練習，家族や関連職種との連携，環境支援などがバランスよく行われた．介入から3ヵ月後，介入群のみで有意な改善を認め，MTDLPの活用は自己効力感の改善により転倒恐怖感を軽減し，生活活動を改善させることが示され，活動・参加の促進と自立支援としての有用性を示せた．

　To examine the effects of home-visit rehabilitation with the Management Tool for Daily Life Performance (MTDLP) on the fear of falling and life activities, 36 home-visit rehabilitation users were divided into intervention and control groups. Both groups underwent MTDLP and routine home-visit rehabilitation interventions, respectively. As a result, specific goals to improve activities and participation were set in the intervention group: facilitating exercise practices in real situations, cooperating with family members and related businesses, and supporting the environment in a well-balanced manner. Three months later, significant improvement was achieved in the intervention group. Thus, the MTDLP reduced the fear of falling by improving the feeling of self-efficacy, and enhanced life activities, suggesting the usefulness of the MTDLP in promoting activities and participation and supporting independence.