回復期脳卒中患者に対するアームサポート「MOMO」を活用した介入が自己効力感の向上に繋がった症例—意味のある作業への参加と精神的賦活

Improving participation in meaningful work, mental activation, and self-efficacy through an intervention using the arm support "MOMO" for convalescent stroke patients: A case study

要旨：MOMOは主に神経難病や高位脊髄損傷患者の上肢機能支援として活用されるアームサポートである．本研究は，脳卒中後にうつ病やアパシーを呈し，リハ拒否や意欲低下が見られた症例に対し，MOMOを活用した介入を実施した．その結果，自身の身体状態を悲観的に捉える症例の自己効力感の向上を促すことに成功し，Apathy Rating Scale（ARS）やMotor Activity Log（MAL）のスコア改善へと繋がった．これらより，MOMOを活用して意味のある作業への参加を援助することで，対象者の自己効力感が向上し，生活全般に対して意欲的となるといった精神的賦活効果の一助となる可能性が示唆された．

　MOMO is an arm support for upper extremity function in patients with intractable neurological diseases and high-level spinal cord injuries. In this study, we performed an intervention using MOMO for a patient who presented with depression and apathy after stroke, refused rehabilitation, and had decreased motivation for activities. As a result, we succeeded in promoting the improvement of self-efficacy in patients who had a pessimistic view of their own physical condition, leading to improvements in ARS and MAL scores. These results suggest that using MOMO to help participants participate in meaningful tasks, may improve self-efficacy, and the subjects may become more motivated about life in general.