I'm Aoi Hashima , an occupational therapist who works in Saga Sumai and Fukuoka .
Yesterday, I put together the outline of "Executive Dysfunction."
"Advanced Brain Dysfunction: On Executive Dysfunction"
I'm Aoi Hashima , an occupational therapist who works in Saga Sumai and Fukuoka . Higher Brain Dysfunction After Stroke...
This time I want to write about the rehabilitation of executive dysfunction.
Rehabilitation of executive dysfunction
A survey of past papers from 2003 to 2008 reported that strategy training for patients with traumatic brain injury was the highest recommended level of cognitive rehabilitation for executive dysfunction.
Subsequent follow-up studies have also shown that strategy training is highly recommended as a form of rehabilitation for executive dysfunction.
There are also reports of applied training and group training on everyday life and behavior.
There are two types of training for executive dysfunction, "problem-solving training" and "goal management training", both of which have established procedures and methods.
problem solving training
Problem-solving training trains how to break down complex problems (problems) into easier-to-understand methods and solve them.
Problem-solving training is a combination of cognitive training and behavioral therapy.
In this training, the problem-solving process is divided into the following three parts.
1) The first stage: problem analysis
2) Phase 2: Find and subdivide the solution to the problem
3) Stage 3: Evaluation and Judgment (Error Detection and Correction)
For example, if schedule management is difficult, and problem-solving training for people who are often late for work, do the following.
①Problem analysis・Difficulty remembering the schedule・I lost the piece of paper I wrote down the schedule.
・You will panic when you are late
②Problem solutions and breakdowns ・Be sure to write your appointments on the calendar ・Put a sheet of paper with a schedule on the side of the refrigerator.
・Post your phone number near the phone so you can call the office immediately if you are late
③Evaluation and Judgment ・Evaluate whether the method considered in ② is a realistic solution
management by objectives training
Source: Executive Dysfunction and Its Cognitive Rehabilitation Treatment
The goal management training is to activate the attention and working memory in the action towards the goal, grasp the path to the goal hierarchically, and adjust the action so as not to deviate from the path to the goal.
Management by objectives training includes the following five processes.
1) Miscarriage: The Process of Task Orientation and Awareness
2) Define the main problem: the goal setting process
3) Step Listing: The process of dividing the target into sub-items
4) Staged learning: the process of coding and maintaining sub-goals
5) Confirmation: Monitoring Process
At the end
This time, I summarize it as an approach to executive dysfunction.
Some procedures and methods for the rehabilitation of executive dysfunction have been established, but others have not yet been established.
I want to deepen my understanding so that I can provide better support.
1) Hiromi Hara: Cognitive Rehabilitation for Executive Dysfunction. Higher Brain Function Research Vol. 32, No. 2
2) Tetsuzo Honda et al.: Rehabilitation of Executive Dysfunction. Aphasia Research Vol.18 No.2
3) 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 29 , 2022 on Aoi Hashima's blog " Stroke Rehabilitation Longevity Consultation Center " .