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要旨:Aid for Decision-making in Occupation Choice for Hand(以下,ADOC-H)は麻痺手の使用場面の意思決定を促すiPadアプリケーションとして開発された.今回,麻痺手が不使用状態に陥っていた上肢運動麻痺と軽度失語症を呈した事例に対し,運動機能に応じた課題指向型訓練と併行して,ADOC-Hを使用して実生活における麻痺手の使用行動の変容を図った.介入開始時,麻痺手の日常使用について消極的な反応を示していたが,退院時には麻痺手の使用行動に関する主体的なセルフモニタリング,問題解決技能を修得した.文字とイラストを同時に示すADOC-Hが,麻痺手の使用に関する行動変容戦略を補完するためのツールとして有用であることが示唆された.
Aid for Decision-making in Occupation Choice for Hand (ADOC-H) is a decision-aid to promote the use of the affected hand in the real life;however, only a few studies have used the ADOC-H in clinical settings. This case study investigated the clinical utility of the ADOC-H in a male patient with upper limb palsy and mild aphasia. In this study, we provided him task-oriented training according to motor function, and promoted behavioral change using his affected hand in daily activities by ADOC-H. As a result, the function of his affected hand improved, and he could increase the frequency of the use of his affected hand in daily life. We speculate that the ADOC-H may help to facilitate communication regarding using the affected hand in real life.
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