A must-see for those who want to undergo rehabilitation in Hokkaido! Explaining how to choose assistive devices and training tools | column | 日常で気軽に実践できる片麻痺のリハビリ方法や機能を低下させない生活習慣などを解説

Hokkaido is one of the regions in Japan where the aging of the population is particularly rapid, and the importance of rehabilitation in the field of local medical and welfare services is increasing year by year. As the population is widely dispersed, it is difficult to go to the hospital and there is a large disparity in services between regions, so care must be taken when choosing an environment for rehabilitation. There is a discrepancy in the medical and nursing care services provided between urban and rural areas in the prefecture, and travel restrictions are often imposed, especially in winter. Against this background, flexible options are required, including not only facility-based rehabilitation by medical institutions, but also self-training at home and home visit rehabilitation.

In Hokkaido, uneven distribution of specialists such as physical therapists and occupational therapists is also an issue, and while hospitals in urban areas have a good training environment, clinics in rural areas have a serious shortage of personnel. In addition, in areas where there are many single-person households of elderly people, assistance from family members is not available, and there is an urgent need to develop home rehabilitation and comprehensive community care. In response to this, there has been an increase in online rehabilitation support and the introduction of functional recovery equipment that can be used at home in recent years.

The demand for rehabilitation in Hokkaido is not limited to mere medical treatment, but is essential as a foundation for the elderly to continue living independently in the local community. The role of medical institutions is of course important, but at the same time, there will be an increasing need to build a comprehensive support system in collaboration with local governments, welfare services, specialists, and families. It can be said that the standardization of the quality of rehabilitation throughout Hokkaido will be achieved only when effective services rooted in the local community are provided.

Rehabilitation is not simply a medical procedure to restore motor skills, but a series of processes to support the independent performance of activities in daily life. In Japan, the word is shortened to "rehab," but the English word "rehabilitation," which is the origin of the word, means to make (re) suitable (habilitation), and has a very comprehensive meaning.

Rehabilitation can be broadly divided into three types: medical, social, and vocational. Medical rehabilitation aims to restore the physical function of patients whose physical functions have been impaired due to illness or injury, such as after a stroke or fracture, through physical therapy, occupational therapy, and speech-language-hearing therapy. Social rehabilitation refers to support for returning to the home and local community, including measures such as preventing the need for nursing care and encouraging participation in community activities. Vocational rehabilitation aims to help patients return to work or find new employment, and includes employment support and workplace adaptation training.

Furthermore, rehabilitation is not limited to the elderly and disabled. It is applicable to a wide range of people, including those recovering from accidents, those with incurable diseases, and those with mental illnesses. For example, in convalescent rehabilitation, full-scale support for walking training and independent daily activities begins once the patient's condition has stabilized. Typical examples of rehabilitation in the convalescent phase include functional recovery after a cerebral infarction and retraining after artificial joint replacement. Furthermore, in recent years, the targets and methods have evolved to include rehabilitation for cancer patients and exercise therapy as part of dementia prevention.

The purpose of rehabilitation is not simply to improve motor function, but to improve the quality of life (QOL) of the patient and help them regain their independence. For this reason, training often consists of content that is directly related to daily life, and often includes movements such as getting up from bed, using the toilet, cooking, and cleaning. In addition, professionals such as physical therapists and occupational therapists create and instruct the most effective training plan according to the individual's abilities and living environment.

There are various rehabilitation methods, including training using walkers and parallel bars, mat exercises, muscle strengthening using balance balls and rubber tubes, and lower limb strengthening training by climbing up and down steps. All of these are carried out in stages according to the patient's condition, age, and physical strength. In addition, speech therapy includes voice training, breathing training, and reading and writing training with the aim of improving aphasia and speech disorders.

In this way, rehabilitation is a comprehensive process that combines medical care, welfare, and lifestyle support, and is not just exercise or treatment. In order to help patients achieve their goals and rebuild their lives, it is necessary for professionals from various fields to form a team and maintain continuous contact. In a wide area with large regional differences, such as Hokkaido, a flexible and careful rehabilitation strategy tailored to the characteristics of each region is essential.

Hokkaido has one of the highest rates of aging in the country, and the demand for rehabilitation is rapidly increasing. In areas with a high proportion of elderly people, rehabilitation is essential to treat declines in physical function due to aging and to recover from illness. However, due to the vast geographical location and dispersed population, there are regional disparities in the placement of medical resources and rehabilitation facilities, and the environment is not one in which everyone can receive equal access to high-quality rehabilitation.

In urban areas such as Sapporo and Asahikawa, there are many large hospitals with rehabilitation wards and specialized rehabilitation clinics. On the other hand, in rural areas such as eastern and northern Hokkaido, there is a shortage of specialists such as physical therapists and occupational therapists, and with limited medical facilities, a limited number of staff are caring for many patients. As a result, there are concerns that the frequency and time of training is insufficient, which may affect the effectiveness of rehabilitation.

Furthermore, residential environments in Hokkaido are widely dispersed, and travel times to medical institutions tend to be long. For elderly people in particular, long-distance medical visits are a major physical and psychological burden, and many people give up on going to the hospital. Family members must also transport patients to and from the hospital, which places a significant burden on the entire household. Due to these circumstances, in some areas it is difficult to continue rehabilitation, and there are cases where opportunities for functional recovery are missed.

According to statistics from the Ministry of Health, Labor and Welfare, the number of rehabilitation beds in Hokkaido tends to be slightly lower than the national average. In addition, home medical care and visiting rehabilitation providers are concentrated in urban areas, and opportunities to receive these services are limited in rural areas. This uneven distribution of medical care and welfare has a direct impact on the quality and results of rehabilitation, and there is a need to restructure the comprehensive community care system in the future.

Furthermore, in order to establish rehabilitation professionals such as physical therapists and occupational therapists in local areas, it is necessary to strengthen cooperation with local medical institutions, improve the work environment and training system. It is also essential to provide career support and lifestyle support systems that allow young professionals to continue working in local areas. Unless the shortage of medical and welfare personnel in local areas is fundamentally resolved, the medical disparity will not be rectified.

Considering the characteristics of Hokkaido, it is important that medical institutions, local governments, and local residents work together to build a sustainable rehabilitation system. Multifaceted efforts, such as remote rehabilitation using ICT, training of local support staff, and strengthening cooperation with public transportation, are required to solve future issues.

Hokkaido's winters are long and bitterly cold, with heavy snowfall, making it difficult to continue outpatient rehabilitation. For elderly people, walking on snowy roads or going outside in cold weather can pose a risk of falling or worsening their physical condition, so many patients refrain from going to the hospital due to safety concerns. In fact, there are reports that rehabilitation is often interrupted or canceled during the winter, which has a serious impact on the maintenance and recovery of patients' physical functions.

In this situation, visiting and in-home rehabilitation services are gaining attention. In visiting rehabilitation, professionals such as physical therapists and occupational therapists visit the user's home directly to provide individually optimized training. This allows the user to receive rehabilitation in the comfort of their own home, without having to worry about the cold or transportation issues. In particular, for elderly people living alone or those who require care and have difficulty going to the hospital, in-home rehabilitation is a promising option that combines safety and continuity.

One of the benefits of home rehabilitation is that it allows training to be tailored to the actual living environment. For example, the content is centered on what is directly related to daily life, such as practicing how to climb steps at the entrance, how to move in the bathroom, and how to maintain a standing position while cooking, so more practical functional improvements can be expected. In addition, advice and guidance on how to assist family members and caregivers can be given at the same time, which also strengthens the support system for the entire household.

Some local governments in Hokkaido are working with local comprehensive support centers to promote comprehensive life support services, including in-home rehabilitation. Nursing care insurance is generally used to provide home rehabilitation services, which has the economic benefit of reducing the burden on users. However, there are only a limited number of businesses offering home visit services in some areas, and differences in the quality of services and the areas they are available remain an issue.

Securing visiting staff and transportation is a particularly important issue in Hokkaido. Depending on snowfall and road conditions in winter, visits may be canceled, so flexibility in scheduling and a rotation system for multiple staff members are essential. In addition, the introduction of online rehabilitation using ICT is becoming more widely used as an alternative when physical visits are difficult.

Selecting the right assistive devices for rehabilitation directly leads to the recovery of functions and improvement of the patient's quality of life. Since different types of rehabilitation devices are effective for different types of disabilities, such as hemiplegia, contracture, and swallowing disorders, it is important to select the device according to the purpose of introduction and the condition of the patient.

First, for those with hemiplegia, electrical stimulation devices and automated movement training machines that support functional training of the paralyzed upper and lower limbs are effective. Even if it is difficult to move on one's own, it is possible to promote motor function through repetitive movements and achieve neural re-education. In addition, robotic suits for walking training and balance training devices have also been introduced to supplement mobility in daily life.

To prevent the progression of contracture (stiffness of joints), range of motion training devices, stretchers, and continuous passive motion devices (CPM) are useful. By using these devices continuously under the supervision of a physical therapist, you can maintain the flexibility of muscles and joints and prevent the occurrence of secondary disorders.

For swallowing disorders, balloon-equipped tubes for swallowing training and pharyngeal training devices with suction are used. These are expected to improve the swallowing reflex and reduce the risk of aspiration, promoting independence in oral intake. Training using appropriate equipment is particularly important for elderly patients and those with sequelae from strokes.

The table below summarizes representative rehabilitation equipment that is considered effective by function and the purpose of its introduction.

When introducing rehabilitation support equipment according to symptoms, it is essential to consider not only improving function but also resolving issues in daily life. For example, for a person who has difficulty getting dressed due to hemiplegia, a simple upper limb support device that assists arm movement is recommended. Such equipment also has an aspect of social rehabilitation, supporting the patient's participation in daily life while maintaining their own functional ability.

In addition, when introducing assistive devices, assessment by specialists such as physical therapists and occupational therapists is essential, and cooperation with doctors is also required. Assistive devices are merely supplementary measures, and the key is to select and use them according to the individual's condition and wishes.

Rehabilitation in Hokkaido faces challenges unique to the region, such as its vast geographical location, harsh winter climate, and an aging population. Given the reality of the difficulty of commuting to hospitals and the uneven distribution of specialists, it is important to expand rehabilitation options, and there is a demand for not only facility-based rehabilitation, but also home and visiting rehabilitation, as well as the use of online support.

In addition, the introduction of appropriate assistive devices and training tools according to symptoms such as hemiplegia, contracture, and swallowing disorders will directly lead to improved quality of life and support for independence. To increase the effectiveness of training, careful evaluation and guidance by specialists such as physical therapists and occupational therapists is essential, as is the creation of a comprehensive system in which medical care, welfare, and family members work together.

In areas like Hokkaido, it is even more important to create an environment where people can continue their rehabilitation safely in the places they are familiar with, while making use of local resources.

We hope this article will help those seeking rehabilitation in Hokkaido and families considering providing support to make the best choice.

Q. What kind of assistive equipment is available for home rehabilitation in Hokkaido?
A. Representative devices include power-assisted legs for lower limb support, electrical stimulation devices for swallowing disorders, rehabilitation stools for maintaining the range of motion of the ankle joint, etc. These are often selected by physical therapists or occupational therapists according to the type of physical function or disability, and are introduced through systems for providing prosthetic devices or welfare equipment loans.

Q.In which areas of Hokkaido are rehabilitation facilities concentrated?
A. Rehabilitation hospitals and specialized facilities are concentrated in urban areas such as Sapporo, Asahikawa, and Hakodate, and many of these facilities have full-time physical therapists and occupational therapists. On the other hand, there is a high demand for home rehabilitation and in-home support in the northern and eastern parts of Hokkaido, and the type of support varies by region. It is possible to check the distribution of facilities and the number of specialists on staff from statistics from the Ministry of Health, Labor, and Welfare and the Hokkaido Prefectural Government.

Customer 1: We appreciate your help in renting the power assist.
Thanks to you, my husband's fingers, which used to be clenched, can now be straightened. It will take some time before he can move them freely, but we will keep trying. The same goes for his ankles, and he can walk a lot better now. thank you very much.

User 2: About two years ago, I was in a traffic accident and suffered brain damage that left me paralyzed in both hands.
It has been eight months since I started using the Power Assist Hand in April, and now I can make rock-paper-scissors.

User 3: Continues rehabilitation every day using the power-assisted hand. Maybe it's because the blood circulation in my right hand has improved, but I feel like the nails on my right hand are growing faster than before. It's a big change. The cold weather is about to get even more severe, so I would like to continue with rehabilitation and care.

Customer 4: I would like to thank you on behalf of my son. It has been over eight years since I suffered a subarachnoid hemorrhage, and I spend most of my daily life undergoing ST and PT training. However, I was worried because the treatment wasn't working for my hands.
I discovered your Power Assist Hand and have been using it every day. I was surprised at first because my fingers were stretched for a while after using it, but before I knew it, they were back to their original state.
I hope to be able to report good results, but I will continue to work hard and take my time.

Hokkaido is a vast region located in the northernmost part of Japan, accounting for approximately 22 percent of the country's total area. Characterized by a cool climate and rich natural environment, the region is highly popular with both domestic and international tourists, as it offers a variety of seasonal scenery and activities. Primary industries such as agriculture and fishing are thriving, and the region is particularly known for its top-class production of dairy farming, wheat, potatoes, and corn in Japan. In recent years, the region has also been focusing on developing new industries such as IT and renewable energy.

Major cities include Sapporo, Asahikawa, Hakodate, and Obihiro, each of which plays a central role in the economy and culture of the region. Sapporo is home to Hokkaido University and many medical and research institutions, and plays an important academic role. Hokkaido is also dotted with numerous hot springs and ski resorts, with Niseko, Noboribetsu, and Yunokawa Onsen being particularly popular areas. In addition, the region is actively working to preserve and pass on Ainu culture, and visitors can deepen their understanding of it through facilities such as Upopoy, the Symbolic Space for Ethnic Coexistence.

Hokkaido's appeal lies in its diverse natural environment. It is home to landscapes that cannot be experienced anywhere else, such as vast national parks, untouched virgin forests, and the Sea of Okhotsk where drift ice can be seen. It also has a well-developed transportation network, with good access via air routes including New Chitose Airport, as well as railways and expressways that connect various parts of the prefecture. In winter, events such as the Snow Festival are held, which also help revitalize the region.

Below is a table summarizing Hokkaido's most representative landmarks.

We at LAP Co., Ltd. provide high-quality rehabilitation services that support the lives of each individual.

In addition to a reliable support system in cooperation with medical institutions, the detailed care provided by professionals such as physical therapists and occupational therapists is the reason why this service is chosen by many users.

We serve not only Sapporo city but also the surrounding areas, and we flexibly respond to home rehabilitation needs. We understand the unique living environment and regional characteristics of Hokkaido, and propose the most suitable training and lifestyle support for each person, fully supporting them in their first steps towards independent daily life.

With warm human relationships and services backed by solid technology, we will continue to be a trusted rehabilitation partner.

Rehabilitation refers to a series of medical and social processes to help people who have impaired physical or mental functions due to accidents, illness, aging, etc. to live an independent life again. In Japanese, it is sometimes called "functional recovery training," but in reality it is not just exercise therapy or training, but also includes a wide range of efforts aimed at rebuilding one's life. The scope of rehabilitation is very broad, and includes not only physical functional disorders after strokes or fractures, but also symptoms such as dementia, developmental disorders, and frailty in the elderly.

Rehabilitation can be broadly divided into three types: medical rehabilitation, vocational rehabilitation, and social rehabilitation. Medical rehabilitation is mainly provided by professionals such as physical therapists, occupational therapists, and speech-language-hearing therapists, and is carried out in hospitals, clinics, and home medical care settings. Physical therapists specialize in restoring motor functions, occupational therapists in improving movements necessary for daily life, and speech-language-hearing therapists in improving speech and swallowing functions. These medical approaches support patients' return to daily life.

Vocational rehabilitation is an effort to provide training, job introductions, and improve the work environment so that people with disabilities can return to work, with Hello Work and employment transition support centers playing a central role. Social rehabilitation aims to improve the overall living environment, including community activities, relationships with family, and use of welfare systems, so that people can rejoin society as members.

Rehabilitation is also classified according to the timing, with stages including acute rehabilitation immediately after onset, mid-term recovery rehabilitation, and maintenance rehabilitation, which provides long-term support. In the acute phase, early intervention is emphasized to prevent functional decline, while in the recovery phase, intensive training is used to support independence. In the maintenance phase, support is continued with the aim of preventing recurrence in daily life and maintaining physical function.

In today's Japan, the population is aging and the demand for rehabilitation is increasing year by year. In particular, in the field of home medical care and nursing care, the importance of services such as home visit rehabilitation and outpatient rehabilitation is increasing, and the roles of physical therapists and occupational therapists are becoming increasingly diverse. Furthermore, as cooperation between medical care and welfare is required, the establishment of a comprehensive support system using a team approach is also progressing.

For rehabilitation to be successful, it is important not only to restore physical functions, but also to emphasize psychological and social aspects such as the patient's wishes, cooperation with family, and connections with the local community. Motivating the patient, setting appropriate goals, and sharing information between medical institutions and the home are major factors that determine the outcome. Understanding that rehabilitation is not a one-off treatment but a continuing process in daily life, and finding a method that suits you, is the first step to recovery.

Company name: LAP Co., Ltd.
Location: 2-1-40 Oikawa, Atsugi City, Kanagawa Prefecture, 243-0212
Telephone number: 046-204-9343

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