ISSN 2434-0758
J.Asia.Reha.Sci.

Vol.5 (Suppl.1) March 2022aAbstract of the 13th International Meeting of
Asian Rehabilitation Science in Japan

13th International Meeting of Asian Rehabilitation Science in Japan
March 19th, 2022
International University of Health and Welfare Otawara Campus, Japan
Chair: Professor Takamichi Taniguchi (Japan)
Contents
13:00 Opening Ceremony

Opening Speech by Professor Hitoshi Maruyama

Ⅰ. Special Lecture
Chair: Daisuke Hirano, International University of Health and Welfare
Theme: Current Status and Prospects of Occupational Therapy in Asia
13:10 Special Lecture‐1「Current Educational Situation of Occupational Therapy Relationship between Asia and IUHW」
Takamichi Taniguchi, International University of Health and Welfare… 1
13:40 Special Lecture‐2「Current Status and Prospects of Occupational Therapy in Vietnam」
Do Ngoc Tung, Vietnam Assistance for the Handicapped… 2
14:10 Special Lecture‐3「Current Status and Prospects of Occupational Therapy in China」
Huang Fubiao，China Rehabilitation Research Center… 3
14:40 Discussions and questions
Ⅱ. Presentation 15:00-16:00 Oral Presentation
Chair: Masafumi Itokazu, International University of Health and Welfare
O- 1 Blood frailty markers related to cognition and walking ability
Masahiro Kameda, Kyoto University Hospital (Japan) … 4
O- 2 Timed Up and Go test with an obstacle: Proposal for measurement of anticipatory locomotor adjustments
in older adults focused on the selection of route suitability
Juntaro Sakazaki, Tokyo Metropolitan University (Japan)… 5
O- 3 Developing a virtual reality system to improve the collision-avoidance behavior when walking

through an aperture for older adults
Yuki Suda, Tokyo Metropolitan University (Japan) … 6
O- 4 Muscle activity of the hip adductor during bicycle ergometer

Atsushi Iwashita，Yamato University (Japan) … 7
O- 5 Relationship between the chest and abdominal expansion and anterior-posterior motion of the chest andabdominal wall during inspiration.
Yoshihiro Miyata，International University of Health and Welfare (Japan) … 8
O- 6 Effect of Online Rehabilitation Training for Patients with Stroke During COVID-19： A Pilot From Vietnam Assistance for The Handicapped

Nguyen Linh Lan, Vietnam Assistance for the Handicapped (Vietnam) … 9i

Special Lecture‐1

Current Educational Situation of Occupational Therapy Relationship between Asia and IUHWTakamichi TaniguchiInternational University of Health and Welfare
The International University of Health and Welfare (IUHW) was founded in 1995 with the objective of
nurturing health and welfare specialists and raising their status. Since then, our highly specialized education
has produced about 26,000 graduates. At the time of its establishment IUHW had one school and fivedepartments, and since then we have expanded to 10 schools and 25 faculty and departments, in addition
to a graduate school, spread over six campuses.
The founding principle of IUHW that we have followed since our establishment is “building a society withmutual respect and support,” which was advocated by our first President, Fujio Ohtani, who strove toprotect human rights throughout his life. In accordance with that principle we have developed theeducational environment so that our campuses also include health and welfare facilities for the elderly anddisabled, giving students the opportunity to have direct contact with people who have special needs andthus nurture loving-kindness in their everyday experiences naturally.
Fundamental Principles of IUHW
1.University focused on well-balanced individuals with a solid sense of humanity
2.University strongly connected to and fully open to the community
3.University directed towards the attainment of global standard
The IUHW Scholarship System is one of the programs that achieves this Fundamental Principle No.3.
The Occupational Therapy Department has been accepting international students since 2000.
Since then, we have started accepting international students not only in undergraduate education but also
in graduate school, and we are accepting international students from Vietnam and Myanmar.
Some have obtained national qualifications for occupational therapists in Japan. One of the Chinese
students got a Ph.D. I am very proud of this. We are also developing an educational program for Vietnamese
physical therapists in collaboration with Vietnamese graduates.
This society reports on the international cooperation of the Department of Occupational Therapy,
International University of Health and Welfare.

-1-Special Lecture‐2

Current Status and Prospects of Occupational Therapy in Vietnam
Do Ngoc Tung
Viet Nam Assistance for the Handicapped (VNAH)
The Rehabilitation has been established and operated in Vietnam for more than 40 years. However,education and training activities, and service provision only focus on Physiotherapy. The need for
Occupational Therapy (OT) of people in health facilities and in the community is very enormous while
Vietnam does not have official/formal and methodical training of OT human resources although somerehabilitation departments in large cities already provide basic OT services in hospitals. Before 2017,training in OT was integrated into the Bachelor of Physiotherapy program at a number of universities suchas University of Medicine and Pharmacy Ho Chi Minh (UMP HCMC) and Hai Duong Medical Technical
University (HMTU). This reduces the effectiveness of the patient's rehabilitation treatment and affects thepatient's ability to independently perform ADLs and IADLs. Since 2017, Medical Committee NetherlandsVietnam (MCNV) has cooperated with UMP HCMC and HMTU with professional support from Manipal
University - India to organize the first full-time OT bachelor's degree program (full) -time and work-study).
At the same time, Vietnam Assistance for the Handicapped (VNAH) also cooperated with Curtin University- Australia to organize 10-12 month training courses specializing in OT for doctors and technicians. Up tonow, Vietnam has 57 OT graduates and 188 OT students attending medium-term courses of 10-12 months.
In the coming time, not only schools/university in the public sector but also the private sector will begin to
deploy OT bachelor's training and gradually move towards autonomy in training.
Keywords: rehabilitation, occupational therapy, Vietnam-2-

Special Lecture‐3

Current Status and Prospects of Occupational Therapy in China
Huang Fubiao
Department of Occupational Therapy, China Rehabilitation Research Center, China
Faculty of Rehabilitation, Capital Medical University, China
Along with social progress and economic development, occupational therapy has made great advances in
China in the past three decades. It is mainly reflected in the following aspects: fast development ofoccupational therapy and more and more attention it receives; constantly enriched and improved
professional connotation; continuous breakthroughs of occupational therapy education from scratch; rapid
expansion of the team. There are currently over several thousand occupational therapy practitioners as well
as 440 individual members of WFOT. The academic atmosphere of occupational therapy remains active.
The occupational Therapy Professional Committee of The Chinese Rehabilitation Association held its 2019
Annual Conference before COVID-19, with 883 officially registered representatives and more than 1,000
actual participants. However, there are still challenges and shortcomings: the lack of occupational therapy
norms and guidelines; the needs of improved concept of occupational therapy and clinical thinking; theobstacles faced in training occupational therapy talents; the far-reaching yet impeditive influences of
traditional thinking and practice. The Occupational Therapy Committee of the Chinese Rehabilitation
Association, an organization of occupational therapists in China, has done some work, including: revising
the definition of occupational therapy; redefining the scope of occupational therapy; revising theoccupational therapy process; drawing up new standards and norms related to occupational therapy;
carrying out personnel training base construction, personnel training, education and guidance. The author
believes that occupational therapy in China will develop in the following directions in the future (outlook):
The urgent demand for occupational therapy will increase rapidly; the field of occupational therapy will
expand and the direction will become clearer; the technological contents of occupational therapy will beenriched; the process of standardization and internationalization will be accelerated. This paper describes
the development status, challenges and shortcomings of occupational therapy in China, analyzes the future
development direction of occupational therapy in China, and puts forward corresponding suggestions forthe development of occupational therapy in China.
Key words: Occupational Therapy, Current Status; prospective-3-

Oral Presentation-1
Blood frailty markers related to cognition and walking ability
Masahiro Kameda, Hiroshi Kondoh
Kyoto University Hospital, Geriatric Unit
[Background and Purpose]
As human society ages globally, age-related disorders are becoming common. Due to decreasing physiologicalreserves and increasing organ system dysfunction associated with age, frailty affects many elderly people,
compromising their ability to cope with acute stressors. Frail elderly people commonly manifest complex clinicalsymptoms, including cognitive dysfunction, hypomobility, and impaired daily activity, the metabolic basis of which
has been little understood.
[Methods]
We applied untargeted, comprehensive, LC-MS metabolomic analysis to human blood from 19 frail and non-frail
elderly patients, who were clinically evaluated using the Edmonton Frail Scale, the MoCA-J for cognition, and the
TUG for mobility.
[Results]
Among 131 metabolites assayed, we identified 22 markers for frailty, cognition, and hypomobility, most of whichwere abundant in blood. Frailty markers included 5 of 6 markers specifically related to cognition and 6 of 12
associated with hypomobility. These overlapping sets of markers include metabolites related to antioxidation, muscle
or nitrogen metabolism, and amino acids, most of which decrease in frail elderly people. Five frailty-related
metabolites that decreased have been previously reported as markers of aging, providing a metabolic link between
human aging and frailty.
[Discussion]
Our findings clearly indicated that metabolite profiles would efficiently dissect the frailty from the others. Oxidative
stress, resulting from diminished antioxidant levels, would be a key vulnerability for pathogenesis among frail elderly
people, exacerbating illnesses related to human aging.

-4-Oral Presentation-2
Timed Up and Go test with an obstacle: Proposal for measurement of anticipatory locomotor adjustments inolder adults focused on the selection of route suitability
Juntaro Sakazaki1), Takahito Nakamura1,2), Kentaro Kodama3), Takahiro Higuchi.1)
1) Department of Health Promotion Science, Tokyo Metropolitan University, Tokyo, Japan.
2) Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan.
3) University Education Center, Tokyo Metropolitan University, Tokyo, Japan[Background and Purpose] Timed Up and Go test (TUG) is a clinical tool widely used to evaluate balance andmobility. Given that planning a reasonable walking path outbound is critical to efficiently turning around a cone,leading to the quick completion of the task, performing the TUG test inherently involves anticipatory locomotor
adjustments. To strengthen this nature of the TUG, we created a modified version of the TUG, called “Obs.TUG,” in which an additional pole obstacle was located beside the cone. With this task, participants arerequested to decide which of two possible routes—passing through an aperture between the obstacles or taking
a detour—is better for quickly completing the task. We investigated whether older adults would be able tochoose a suitable route in response to the width of an aperture (i.e., the wider an aperture is, the quicker
individuals can complete the task when choosing to pass through an aperture).
[Methods] Thirty-eight older adults (75.0 ± 6.4 years) and twenty-five younger adults (25.2 ± 4.8 years)

participated. Two poles 1 m tall were used to create an aperture (i.e., a cone was replaced with the pole). There
were four aperture widths: 0.9, 1.05, 1.2, and 1.35 times the participant’s shoulder width. Participants performed
the Obs.-TUG test under two conditions: free choice and forced choice. For the free-choice condition,
participants were requested to choose the route that they believed would enable them to most quickly complete
the task. For the forced-choice condition, they were instructed which route they were to select. When completing
the Obs.-TUG task under the forced-choice condition, participants’ times when passing through an aperture andwhen taking a detour were compared to determine which route was most suitable for meeting the task goal foreach aperture-width condition. Three-dimensional motion analyses were also conducted to compare gait speed
and step length between older and younger participants.
[Results and Discussion] Older participants chose taking a detour significantly more frequently than younger

participants in the free-choice condition. Comparisons of the time taken to complete the Obs.-TUG task under
the forced-choice condition showed that, for wider apertures (1.2, 1.35 times), the time to complete the task wassignificantly faster when passing through an aperture than when taking a detour. These results suggest that older
adults preferred choosing to take a detour to passing through an aperture, even when it would not makecompleting the task faster. Three-dimensional motion analyses showed that (a) the magnitude of the decrease in
movement speed before taking a turn is significantly lower in older participants and (b) the number of steps
with which the shortened step length for taking a turn was recovered to the normal step length was greater inolder participants. These findings suggest that older participants are likely to select the route with the lower
demand for locomotor adaptability, rather than the more suitable route in terms of the task goal.

-5-Oral Presentation-3
Developing a virtual reality system to improve the collision-avoidance behavior
when walking through an aperture for older adults.
Yuki Suda, Kazunobu Fukuhara, Kazuyuki Sato, Takahiro Higuchi.
Department of Health Promotion Science, Tokyo Metropolitan University, Tokyo, Japan[Background and Purpose] Virtual reality (VR) could be used to set up a training protocol to improve one’s
collision-avoidance behavior. Kondo et al. (2021) developed a VR system for training older individuals to walkthrough an aperture in a manner that is both safe (i.e., no collision) and efficient (i.e., no exaggerated behavior toensure collision avoidance). In the present study, we made several modifications to the VR system in terms ofenriched feedback (vibratory stimulation for virtual collisions and the addition of positive feedback for successful
trials) and gradual increase in task difficulty during training to strengthen the skill transfer.
[Methods] Nineteen older adults (74.4 ± 5.3 years of age) participated. They were randomly assigned to one of two
training groups: the intervention group (n = 10) or the control group (n = 11). The experiment consisted of pre- andpost-training tests in a real environment and training in a VR environment. During training, participants held ahorizontal bar while stepping in place as if a VR image on the screen were moving in response to their stepping.
[Results and Discussion] Participants in the intervention group tried to pass a narrow aperture without collision
while attempting to minimize their body rotation to avoid collision as much as possible. The criterion upon which
the collision-avoidance behavior was regarded as successful became incrementally more demanding as participants
successfully met the previous criterion. Participants in the control group passed through a very wide aperture, so thatcollision-avoidance behavior was unnecessary. A comparison between pre- and post-training test performances
showed that, for older adults in the intervention group, the spatial margins became significantly smaller, while thesuccess rate remained unchanged. For those in the control group, neither the spatial margin nor the success rate was
improved. These results suggest that the three modifications made for the VR system contributed to improvement of
the system and helped participants transfer the behavior learned from the VR environment to real walking.

-6-Oral Presentation-4

Muscle activity of the hip adductor during bicycle ergometer
Atsushi Iwashita1), Yuto K2), Masaki Y3), Iori A4)
Takeshi F1), Yoshiyuki K1), Tomoya A1), Keisuke I1)
1) Faculty of Health Sciences, Yamato University.
2) Faculty of Health Sciences, Butsuryo College of Osaka.
3) Faculty of Biomedical Engineering, Osaka Electro-Communication University.
4) Faculty of Allied Health, Kansai University of Welfare Sciences.
[Background and Purpose] Previous studies on muscle activity in bicycle ergometer exercise have mainly

investigated hip extensor muscle groups such as the gluteus maximus and hamstrings, and knee extensor muscle
groups such as the quadriceps. Only a few studies have focused on the hip adductor muscle group. Therefore,
we focused on the muscle activity of the hip adductor muscle group during bicycle ergometer exercise. The hip
adductor muscles, the greater adductor and longus adductor, extend the hip joint at deeper hip flexion angles.
On the other hand, those muscles flex the hip joint when the hip joint is extended. Therefore, we performed
bicycle ergometer exercise while varying two parameters and measured the muscle activity of the hip adductor
muscles. The two parameters were hip angle and pedaling position.
[Methods] The hip angle was adjusted by the height of the saddle. In the high saddle position, the hip angle is

90 degrees at the lower dead center. In the low saddle position, the hip angle is 110 degrees at the bottom deadcenter. Two pedaling positions were used. One is anterior, which places the second metatarsal head on the pedal
axle. The other was posterior, 10 cm behind the anterior. The work rate of the bicycle ergometer exercise was
100 W and the rotational speed was 60 rpm. There were 14 subjects in this study. The study was approved by
the Yamato university ethical committee (approval nr: 2021-3), and informed consent was obtained from allparticipants. We measured electromyograms of the hip adductor muscle, vastus medialis, semitendinosus,
medial head of gastrocnemius, and tibialis anterior muscles during bicycle ergometer exercise. Active electrodes
were used for the measurements. The joint angles of the hip, knee, and ankle joints were calculated by a motion
analyzer. Based on the motion analysis results, the bicycle ergometer exercise was divided into flexion andextension phases. RMS values were calculated as the average muscle activity and normalized to the muscle
activity during the maximum voluntary contraction. A three-way analysis of variance was performed for phaseseparation, hip angle, and pedaling position.
[Results and Discussion] Muscle activity of the hip adductor muscle group was 18.6% to 22.7%. The range of

its activity was not significantly different between the flexion and extension phases, which suggested that it was
active in a wide range of bicycle ergometer exercises.
This study has been made possible thanks to the contribution of the JKA (2021M-137).

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Oral Presentation-5

Relationship between the chest and abdominal expansion and anterior-posterior motion of the chest
and abdominal wall during inspiration
Yoshihiro Miyata, Masafumi Itokazu
Graduate school of International University of Health and Welfare[Background and Purpose]
In Japan, there are many people with respiratory diseases who have not been examined; due in part to the
COVID-19 epidemic, telemedicine using the Internet and camera sensors is considered important because it
allows patients to be examined under non-contact conditions. The purpose of this study was to examine thevalidity of chest and abdominal wall motion measured with an infrared camera sensor (RGB-D camera) basedon measurement of the chest and abdominal expansion and to observe temporal changes in chest and abdominal
wall motion with respiration.
[Participants]
Participants in this study were 22 healthy adult males (age: 22.0 ± 2.2, height: 173.5 ± 5.3 cm, weight: 68.9 ±12.2 kg). The study has been approved by the Ethics Committee of the International University of Health andWelfare (approved no. 20-Io-141-2).
[Method]
Participants inhaled continuously up to 3000 ml with a syringe of 500 ml of air every 5 seconds from the
maximal expiratory position in the supine position, 6 times with no spontaneous inhalation, and in a relaxedstate. The anterior-posterior motion of the chest and abdominal wall were measured using Kinect v1 (Microsoft).
The chest and abdominal expansion were monitored using a T.K.K. 3345 (Takei Scientific Instruments Co.,
Ltd.). The chest was measured simultaneously at the xiphoid process and the abdomen at the umbilicus. Data
collection was performed six times between 500 ml and 3000 ml, and the average of the three seconds of eachtime was calculated. Spearman's rank correlation coefficient was calculated for the relationship between theanterior-posterior motion of the chest and abdominal wall and chest and abdominal expansion. One-way
ANOVA and the Holm method or Friedman test and the Steel-Dwass method were used to test for differencesin each measured interval. The significance level was set at 5%.
[Results]
The correlation coefficient between the chest wall motion and expansion was 0.61, and that between theabdominal wall motion and expansion was 0.66, both have accordingly shown a significant association.
Abdominal wall motion showed a continuous significant increase with a stepwise increase in inspiratory volume.
[Conclusion]
This study suggests that it is possible to measure the chest and abdominal wall motion during inspiration withan RGB-D camera, and that motion were significantly related to the expansion motion. In term of themeasurement of chest wall motion, it is considered necessary to measure and study the lateral movement of thethorax with changes in inspiratory volume.

-8-Oral Presentation-6
Effect of Online Rehabilitation Training for Patients with Stroke During COVID-19： A Pilot From Vietnam Assistance for The Handicapped
Nguyen Linh Lan, Do Ngoc Tung, Nong Thi Ngoc Lan
Vietnam Assistance for the Handicapped (VNAH)[Background and Purpose]
From mid-2021, the complicated situation of the COVID-19 epidemic caused hospitals and health centers in
Vietnam to have to convert part or all of their functions to COVID-19 prevention and treatment. Therefore, theprovision of Rehabilitation services for patients at the hospital or people with disabilities in the community isalmost suspended. This difficulty leads to an interrupted recovery process as well as an additional burden on thefamily and society. Stemming from these concerns, VNAH's rehabilitation technician group conducted a surveyof the actual needs of patients and piloted "Online rehabilitation training for patients with stroke" via the ZAVI
app.
[Method]This training form was piloted in August and September of 2021, starting with 5 patients and officially deployedfrom October 2021 until now. The implementation process consists of 3 steps: contacting the patient, assessing
the condition and determining the need; instructing the patient in need how to install and use ZAVI and the rulesin the training session; introducing the purpose of the session and showing the patient an example of a session.
The session usually lasts 45-60 minutes (twice a week), revised from the FAME program's documentation, andincludes 3 steps of warming up, main exercises, stretching and cooling down.
[Results and Discussion]

Evaluations are done every 2 months including the 10MWT, ABILHAND, Barthel index. The most recent
evaluation in January 2022 showed that 100% of patients improved on all indicators. In the future, it isrecommended to combine many forms of training to create the best conditions for patients during the recovery
process when the epidemic situation still has many unpredictable developments.
Keywords: stroke, online training, rehabilitation-9-