2001 Conference Proceedings

Go to previous article 
Go to next article 
Return to 2001 Table of Contents


The study of the motivative exercise and the Takizawa program by the 21st Century Rehabilitation Study Meeting in Japan

Takizawa, Shigeo BA, Secretary General of the study
Rehabiliaid Company
Fujisawa-shi 251-0871 Japan
takizawa@civilnet.org

Hideo Kijima, M. D. Ph. D
Kijima orthopaedics doctor's office
Fujisawa-shi 251-0054 Japan.

Tetsuhiko Kimura, M. D. Ph. D
Department of health services administration
Nippon Medical School
Tokyo 113-8602.

Mitsuyo Makita, RPT
Akishima City at-home care support center
Tokyo 196-0014.

Satoshi Endo, RPT
Department of rehabilitation
Keio University Hospital
Tokyo 160-0016.

Akira Iemoto, Ph.D
Kanagawa Industry Technology Research Institute
Ebina-shi 243-0405.

Hiroshi Nagasawa, RPT. Ph. D
School of Allied Health Sciences
Kitasato university
Sagamihara-shi 228-8555.

Yoshiko Morita, M.D
Department of rehabilitation
Kawasaki Medical hospital
Okayama 700-0821.

Noriko Yoshiike, MA
Graduate School of Media and Governance
Keio university 252-8520.

Kyoko. Takizawa, RPT
Roujinhokensisetu Shonannooka
Chigasaki-shi 253-0001 Japan.

Abstract

This study is a review the new rehabilitation process in order to realize the desired goal, from care reliance to independence. We reported on the many devices developed, which were utilized to present the Takizawa method of rehabilitation at this academic meeting in March 2000.

This paper describes the Takizawa method of rehabilitation. The 4th general meeting of the 21st Century Rehabilitation Study was held in Japan. The Takizawa program and the motivative exercise were defined at this meeting. The following discussion points help to define the findings of our research:

The 4th 21st Century Rehabilitation Study

The meeting was called, from care reliance to independence and was attended by 37 medical and engineering personnel in the 1st Nippon Medical School Auditorium on August 5, 2000. The research is done since last years meeting, enabling aged and disabled persons to reclaim one's life, even if they are bedridden due to hemiplegia from cerebrovascular disease or by lower extremity fracture.

Kijima H2, the president of the meeting, expressed thanks to all of the members for their participation, effort, and determination in making the goal of aged and disabled persons fall to 10 percent or less than its hypothesized projection of 16 percent in 2025 and outlined heretofore:

Training for the aged and disabled Person from Impairment to Independence

Kimura S3, vice president of the meeting, and also the former president of the Japanese National Rehabilitation Center Hospital, is presently leading the medical research. He expressed the concept of overcoming impairments in the aged and disabled persons daily life, which was spoken of at the RESNA 2000 conference this year.

He stressed the importance of having a community rehabilitation network based on the existing research. He announced that the speakers would report on the means and actual rehabilitation process as "regarding to the research of the motivative exercise and the advancement of the program centering around it.

He then announced the name for the motivative exercise in the CSUN 2000 paper as “SOUDOU UNDOU,” which was rendered by popular vote.

Achievement Evaluation and Training in the Specialized Bed-Ridden Elderly-Disabled Patients' Hospital

Makita M4 reported how to carry out the motivative exercise based on the Takizawa program, and its result in rehabilitating 193 people of 225 hospitalized persons in a specialized bed-ridden elderly-disabled patients' hospital. As a result of this rehabilitation, 59 persons were able to walk again, where none were capable before. This situation was reported in anothers viewpoint in the CSUN report last year.

Comparison of Knee and Ankle Exercises by Hands of a Physical Therapist and Two Simple Devices

Endo S5 reported that he had conducted verification tests of the lower extremities training devices, by using a three-dimensional action analysis device that further supported the report of Makita. The comparison of the exercise angle according to three-dimensional analysis, using the Locus VDMa6250 for motivative exercise of the easy ankle dorsiflexion device and the easy knee flexion and extension device and for passive exercise by a physical therapist for six normal healthy persons.

It was through this application, that range of movement in the extremities by the easy ankle dorsiflexion device was been approximately 0 to 37 degrees, while the physical therapists was approximately minus-12 to 37 degrees. Applying the easy knee flexion and extension device rendered approximately 10 to 118 degrees, while the physical therapists produced a range of movement of 0 to 140 degrees.

He summarized, “It can be safely assumed, that the same end results were revealed by both the motivative exercise devices and the passive exercises by a physical therapist, in terms of a pattern, because there was no significant difference in the range of movement of the extremities and little difference in the mean value”.

The Development of Devices for the Quantitative Evaluation of the Motivative Exercise

Iemoto A6 announced the development of support by the furtherance system of the Kanagawa Prefecture government for these last two years. The purpose is to develop the recovery degree measurement station of lower extremities function recovery (or RDMSE) by the motivative exercise, quantitative to the function recovery degree available. It is also to develop the possibility of achieving quantitative measurement of function recovery degrees, by exercise of the lower extremities in the rehabilitation process and analysis of collection database information. The development of RDMSE was realized from the wheelchair lifter, lower extremities round trip exercise measuring device (or LERMD), and the foot joint flexible degree-measuring device (or FFDMD).

The LERMD imitates the easy knee flexion and extension device, and then the round trip exercise measurement becomes possible through this device. The LERMD measures front-back movement as its guideline. It considers the flexibility of the knee and ankle, the smoothness of movement, and the balance of advance and retraction of both the left and right foot, due to detection of the mobile range of the lower extremities and movement in the left and right direction. As a result, LERMD measured the load degree of the patient in the training, in order for quantitative analysis of the speed, acceleration and volume of energy consumption.

FFDMD is the device for automatically measuring the angle of movement for the foot joint. In summary, Iemoto’s report provides analysis and quantity of function recovery degree for the lower extremities by the motivative exercise, and proposes the addition of vital reaction data collection devices, the construction of a patient database, and the sharing of patient data on the Internet.

Improvement of Walking Ability by Using the Walker Inside of a House

Nagasawa H7 suggested there were other factor to femoral neck facture besides bone density due to incidence comparison and its occurrence in terms of the age class between Japan and European countries and its classification to each environmental factor (i.e. tripped, slipped, staggered).

He reported about introduction of the rake-walker with sleds for the people with problems moving about at home, in order to improve their transiting ability and in preventing dangerous falls, because 9.3 percent of all falls result in a bone fracture.

As the result, the raku-walker was introduced to the patients (four people with post-operative femoral neck fracture, two with post-operative osteoarthritis, two with hemiplegia due to brain infarction, one with Parkinsonism, one with spinocerebellar degeneration, one with a compressed fracture of a joint of the lumbar vertebra, and lastly, one with cephalomeningitis quadriplegia), who were care-dependent in ability of movement in their daily life, showed significant improvement in only one month’s time, with a Functional Independence Measure (FIM) for moving and whole point total of (P<0.05) in the clinical trial plan finished at Tokyo University’s Medical School Hospital.

In the case of a change in the ability of movement on a particular level of impairment, the improvement of physical function was possible. Also, there was no change in performance levels after a month to three months later. If the patient has limited movement ability, the body function level improved by the introduction of the suitable walking device and can expand the level of activity in one’s daily life, the clinical study shows. Furthermore, it is conceivable that some parts of the role of caregivers could be reduced, personal injuries from falls inside the home could be avoided and prevented, and a decrease in bed-ridden people. The new empirical research on daily life independence of the raku-walker user is supported through grants of the Ministry of Health and Welfare (TEKUNO-AID foundation).

The Medical Inspection of the Takizawa Program and the Motivative Exercise

Morita Y8 summed up characteristics of both the Takizawa program and the motivative exercise, based upon a presentation by the Japanese Rehabilitation Medicine Academy in June 2000 with Kijima, Kimura and members in Rehabiliaid limited company who led the research, in order to advance medical study in the health improvement of humankind

1) Motivative Exercise.

The Motivative Exercise was performed with the movement of the patient’s functional extremity to act in tandem with the movement of the impaired extremity, while using the devices. It is possible to conclude that the motivative exercise appears to be mixed training, both in the sense of self-training and the assisted-training. The motivative exercise is made up of the self-training and the assisted-training methods. The motivative exercise is performed in a sitting position.

It is possible for the patient to alternate from part of the passive exercise to the motivative exercise.

2) Takizawa Program.

It is a patient-aggressive program that centers on the motivative exercise for impairment level patients.

It is performed in the sitting position. The range of motion exercise for both the trunk and the impaired extremities, caused by hemiparesis is performed in the sitting position. The patients do not feel any pain. This program is standardized. Training for this program can be performed by a care-giver, with guidance from the physical or occupational therapist.

One of the physical or occupational therapist can perform it to many patients at the same time. Including the motivative exercise, this program is planned to make the patient raise their desire for training. It cannot be seen in any example in the world.

Morita stated, that future research need not make Rehabiliaid Corporation’s leadership, but the membership study understand and support the systematization of the study meeting, the prospects for the future of research organization (the organization and the influence to the national life), and in new research fields.

The research fields were on international research, contrasting both the motivative exercise to passive exercise and their terminology (the program, enforcement, evaluation standard, evaluation expression), the actual condition analysis for the institution of disabled elderly that raised their daily life’s activities without leading to Kyoko Takizawa, the training standardization and the training method of trainer.

The joint research agreement with the professors of WINDSOR University, Canada included the fusion of nursing, human kinematics and rehabilitation medicine.

Rehabilitation Support System Development that Used Image Recognition Technology

Yoshiike N9 announced a plan for development of the Kyoko Takizawafs knowledge analysis system and rehabilitation support system.

The system would contribute to the independence of disabled elderly and reduce the requirement for physical therapists, due to application of the non-contact gesture recognition system to rehabilitation and through the spread of advanced technology. Demonstration of the non-contact gesture recognition system was performed using an artificial retina camera.

From the Order Maid Rehabilitation to the Ready Maid Rehabilitation, Influence to the Society.

The researcher’s investigative synopsis is summarized below:

It is considered that the TAKIZAWA Method of Rehabilitation for Geriatric Persons prevents or improves contracture by the central nervous system, due to environmental hazards from both the study and from experiences over the past 30 years. The in-depth research and hypothesis conducted in analyzing the mechanism has been a topic of discussion for several years.

It might prove necessary to vitalize the extension and flexion motor neuronal circuits in order to prevent contracture as a result of the exercise. In order to prevent or improve contracture, the paralyzed part of the nervous system was re-activated as a result of the revival of prevention and/or improvement of contracture. It is important for it to be accepted by the participating members.

The present condition of the caregiver and disabled elderly in the home and the decline in efficient care is a serious social problem. It is important to solve the difficult problem of disabled elderly achieving care-independence. However, nowadays the disabled elderly tend to resign themselves to accepting their fate.

The members of 21st Century Rehabilitation Study sought to allow disabled elderly achieve care-independence through research. We are presently aiming toward improvement to the quality of life for those living into a healthy old age.

There was a question.

One asked, “Is this adaptable to anyone? " Kyoko Takizawa10 answered, “You need to consider body situation. But, anyone who can reach a sitting position can perform this!”.

On the basis of the medical research, the influence to the national economy makes this a critical subject for the research from here on out. Recruiting new members is the worldwide aim. So realistically, the organization of the study is constantly changing. We are waiting your participation.

The study meeting 2001, provides a personal interpretation, will be at the Nippon Medical School at 2 o'clock p.m. on Saturday, August 4.

The web homepage, Questions on participation can be received by e-mail or faxing #81-466-81-8815 (Rehabiliaid limited company) for admission.

REFERENCES

(1). Takizawa S, Kimura T, Kijima H, Okamoto Y, Nagaoka K, Takizawa K. The development of devices for the MOTIVATIVE exercise of impaired extremities. CSUN's Fifteenth Annual International Conference "Technology and Persons with Disabilities". Los Angeles. March 22. 2000: Session 166.

(2) Morita Y, Kimura T, Kijima H, et al. The enforcement of the MOTIVATIVE exercise with TAKIZAWA program. Paper presented at: The 37th Annual Meeting of Japanese Association of Rehabilitation medicine, Tokyo. June 24. 2000: 413

(3) Takizawa S, Kimura T.CKijima H, et al. THE CASE REPORT OF THE ACQUISITION OF WALKING FROM BEDRIDDEN BY RAKU WALKER. Paper presented at RESNA, Orlando, Florida - July 1, 2000: Session 1P1.2, D

(4) Takizawa S. From Care reliance to independence. Journal of Kouseihukusi (Welfare). Jiji press. August 26, 2000: 4-7.

Special thanks to Mr. Steven L. Worrell for helping to check the English


Go to previous article 
Go to next article 
Return to 2001 Table of Contents 
Return to Table of Proceedings


Reprinted with author(s) permission. Author(s) retain copyright.