I'm Aoi Hashima , an occupational therapist working in Saga Sumai and Fukuoka.
One of the high-level brain dysfunctions that occurs after a stroke is "executive dysfunction."
Executive functions are a set of functions that plan their own actions and execute them as planned, or come up with new ways to solve problems and reformulate action plans when things don't go as planned.
Executive dysfunction can occur when the frontal lobes in the front of the brain (specifically the prefrontal cortex) are damaged by a stroke or traffic accident.
When you see symptoms such as "difficulty moving independently" or "easy panic", executive dysfunction may be noticed by those around you.
So far, I've written various things about advanced brain dysfunction, but this time I'd like to summarize "Executive Dysfunction".
What is an executive function?
Executive functions are competencies necessary for activities of daily living and social life, and are required in a variety of situations.
Lezak (1995) divided executive function into four stages:
① Goal setting
③ Actual implementation of the plan towards the target
④ Effective action
For example, you want to go to the toilet, you want to go to the toilet, if someone is already on the toilet, what will you do?
✔ If there is another toilet, go to another toilet
✔ If you can stand up to the toilet, wait for the toilet user to come out first.
✔ When you feel the urgency to go to the toilet, knock on the door to let the person in the bathroom know that someone is waiting to go to the toilet
As the behavior of wanting to go to the toilet, there are times when you can go to the toilet right away, and there are times when you can't.
Once the action plan (going to the bathroom) has been successfully executed, it is recommended to proceed as planned.
But if you can't follow your plan (someone is in the bathroom), then you need to make another action plan (eg go to another bathroom) and you need to execute another action. I have.
When making an action plan, make a plan based on your current situation and the situation around you (the situation and environment of the people around you).
When this executive function is impaired due to brain damage, symptoms can appear as "executive dysfunction."
On barriers to execution
Symptoms of executive dysfunction include:
✔ Inability to adopt new behaviors appropriate to achieve goals
✔ You cannot monitor what you are doing
✔ Inability to modify own behavior
✔ Can't choose what to do
✔ Can't change behavior
✔ Risky not following the rules
These symptoms can interfere with daily life and social life.
For example, we can see that people can no longer use the smartphones they used to be able to use, or walk alone without being able to manage the risk when there is a possibility of a fall.
At the end
This time, I'm writing about "executive dysfunction," which is one of the higher-order brain dysfunctions.
Next time, I'd like to summarize executive dysfunction recovery.
1) Jun Tanemura: Clinical Executive Function: Advanced Brain Function Research Volume 28 Issue 3
2) Hiromi Hara: Executive dysfunction and its cognitive rehabilitation therapy. Jpn J Rehabil Med 2020;57:629-637
☆*:.｡. Thank you for reading to the end.｡.:*☆
This article was reprinted on September 28 , 2022 on Aoi Hashima's blog " Stroke Rehabilitation Longevity Consultation Center " .