2001 Conference Proceedings
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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
Fujisawa-shi 251-0871 Japan
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
Mitsuyo Makita, RPT
Akishima City at-home care support center
Satoshi Endo, RPT
Department of rehabilitation
Keio University Hospital
Akira Iemoto, Ph.D
Kanagawa Industry Technology Research Institute
Hiroshi Nagasawa, RPT. Ph. D
School of Allied Health Sciences
Yoshiko Morita, M.D
Department of rehabilitation
Kawasaki Medical hospital
Noriko Yoshiike, MA
Graduate School of Media and Governance
Keio university 252-8520.
Kyoko. Takizawa, RPT
Chigasaki-shi 253-0001 Japan.
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
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
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
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
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
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
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
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
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
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
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
Yoshiike N9 announced a plan for development of the Kyoko
Takizawafs knowledge analysis system and rehabilitation support
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
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
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,
The web homepage, Questions on participation can be received by
e-mail or faxing #81-466-81-8815 (Rehabiliaid limited company)
(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
(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
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Reprinted with author(s) permission. Author(s) retain copyright.