@article{oai:ir.kagoshima-u.ac.jp:00014227,
 author = {瀬戸山, 弘貴 and SETOYAMA, Hiroki and 窪田, 正大 and KUBOTA, Masatomo and 八反丸, 健二 and HATTANMARU, Kenji},
 issue = {1},
 journal = {鹿児島大学医学部保健学科紀要, Bulletin of the School of Health Sciences, Faculty of Medicine, Kagoshima University},
 month = {Mar},
 note = {反復性低頻度経頭蓋磁気刺激と集中的リハビリテーション併用療法（併用療法）に関して，これまで数多くの臨床成績が報告されている。しかし，併用療法後の麻痺側上肢運動機能が改善を認めたにもかかわらず，患者の主観的評価が改善しないことをしばしば経験する。そこで今回，主観的評価であるJASMIDの結果を改善群と非改善群の２群に分類し，上肢運動機能の改善について検討した。その結果，改善群と非改善群とも介入後にすべての上肢運動機能の改善を認めた。このことは，上肢運動機能改善が主観的評価に十分に反映されていない可能性を示唆するものである。よって，患者の機能，能力に応じた目標設定および丁寧な説明が必要であると考えられる。また，変化量の比較では，改善群のARAT，WMFTに変化を認めた。これらの評価内容の特徴は，ADL，物品操作などに関連した評価である。よって，訓練期間中に麻痺側上肢の適切な使用方法を具体的に指導し，それを繰り返しADLの中で習慣化する必要がある。, Numerous studies have reported positive clinical outcomes from the combination treatment of repetitive transcranial magnetic stimulation and intensive occupational therapy. However, although improvements following combination treatment for hemiplegic upper limb motor function have been confirmed, we have often experienced cases in which the patient’s subjective evaluation does not improve. Against that backdrop, we divided subjects into two groups (Improved and Not Improved) according to results of JASMID, a subjective evaluation tool, and examined improvement in upper limb motor function. We found that both groups showed improvement following intervention in all upper limb motor functions, demonstrating the possibility that subjective evaluations may not sufficiently reflect improvements in upper limb motor function. Therefore, it may be necessary to establish goals that fit the patient’s function and abilily, and to provide a careful explanation. Comparison of changes in upper limb motor function also revealed changes in ARAT and WMFT scores in the Improved group. Characteristics of these evaluation items are associated with ADL and integrative functional movements as evaluated by the WMFT. Therefore, specific instructions should be given during treatment on the appropriate use of the paralyzed upper limb, and this should be practiced repeatedly in the context of ADL until it becomes habit.},
 pages = {101--108},
 title = {反復性低頻度経頭蓋磁気刺激と集中的リハビリテーション併用療法後の主観的評価（JASMID）からみた上肢運動機能の検討},
 volume = {28},
 year = {2018}
}