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Title せん妄の早期発見・予防と理学療法の重要性
Subtitle 総説
Authors 鈴木康介1)2), 有薗信一1), 佐久間俊輔1)3), 金原一宏1)
Authors (kana)
Organization 1)聖隷クリストファー大学大学院, 2)地方独立行政法人静岡市立静岡病院, 3)寺田痛みのクリニック
Journal 聖隷クリストファー大学リハビリテーション学部紀要「リハビリテーション科学ジャーナル」
Volume 16
Number
Page 39-54
Year/Month 2020 /
Article 報告
Publisher 聖隷学園
Abstract 「要旨」せん妄は急性期病院だけでなく医療現場全体に渡る問題である. せん妄の発症はADLやQOLの低下に関連するだけでなく, 生命予後の独立不良因子である. せん妄は早期発見と予防が重要であるが, 現状では正確にせん妄を評価することができておらず見逃されることが多い. せん妄と評価される手前の閾値下せん妄は, 症状の出現が分かりづらく, 発見が遅れるといった問題がある. せん妄の発症メカニズムは脳内ネットワークの障害があり, 理学療法評価・治療によりせん妄の早期発見・予防ができる可能性がある. せん妄を症状のみから捉えるのではなく, 発症メカニズムに基づいて脳の反応から捉えることが必要である. 本稿では, せん妄発症による問題点と, 発症メカニズムの仮説から理学療法がせん妄の早期発見・予防にとって重要であることを, 早期発見ツール・発症予防プログラムの開発の観点から論じる.
Practice 医療技術
Keywords せん妄, 理学療法, 脳内ネットワーク, Delirium, Physical Therapy, Brain Network

English

Title The importance of physical therapy in early diagnosis and prevention of delirium
Subtitle Review articles
Authors Kosuke Suzuki1)2), Shinichi Arizono1), Shunsuke Sakuma1)3), Kazuhiro Kimpara1)
Authors (kana)
Organization 1)Graduated School of Rehabilitation Sciences, Seirei Christopher University, 2)Shizuoka City Shizuoka Hospital, 3)Terada pain clinic
Journal Journal of Rehabilitation Sciences Seirei Christopher University
Volume 16
Number
Page 39-54
Year/Month 2020 /
Article Report
Publisher SEIREI GAKUEN EDUCATIONAL ORGANIZATION
Abstract [Abstract] Delirium, a common clinical problem in hospitalized individuals, has been found to be a strong independent prognostic factor in critically ill patients, with a large effect on the impairment of their activities of daily living and quality of life. Early diagnosis and prevention are important strategies for delirium; however, it is often not diagnosed accurately. Subsyndromal delirium is difficult to evaluate clinically. Evaluating the dysfunction and restriction of the brain network, which is thought to be the cause of delirium, may provide new strategies for its prevention. We discuss the properties of a tool for the screening and early diagnosis of delirium based on the discontinuation and restriction of the brain network. Furthermore, we focus on the importance of physiotherapy as a new treatment strategy for delirium.
Practice Medical technology
Keywords Delirium, Physical Therapy, Brain Network
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