F-4-03-01
OUR METHODS FOR PSYCHOLOGICAL REHABILITATION OF HEMIPARETICS WITH FEAR OF FALLING AT THE BEGINNING FOR WALKING
GUEORGUI V. ARNAUDOV (I CITY HOSPITAL, SOFIA, BULGARIA)
The problem for Fear of Falling at Hemiparetics (after Stroke, trauma, etc.) concerns every 4th or 5th person of our planet. We developed Methods for its overcoming - Individual approach, The speech and behaviour of rehabilitator, Method of drawing away the attention at the beginning of walking, Method of active directing of attention, Method of willing relaxation of tension at beginning of walking, Purposefulness of rehabilitative measures according to the leading factor for disturbed balance reactions, Following the didactic principles of cosequtiveness at training of walking. Our clinical experience shows that with these Methods can overcome the Fear of Falling in many patients.
F-4-03-02
COMPARISON OF THE RESPONSES TO A MEMORY TRAINING PROGRAM BETWEEN PSYCHOGENIC AND ORGANIC AMNESIAS
Shin-ichi Izumi-a, Mitsuaki Yasueda-a, Nobuhiko Hihara-a, Tetsumi Honda-b, Minoru Toyokura-a, Keiichi Murakami-a, Akira Ishida-a, Jungo Yanagisawa-c
a-Department of Rehabilitation Medicine, Tokai University School of Medicine, Isehara, Japan
b-Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
c-Department of Psychiatry, Tokai University School of Medicine, Isehara, Japan
Psychogenic amnesia, classified as dissociative amnesia in DSM-IV, has been little studied in the literature. It is said that failure in early diagnosis makes this disorder resistant to treatment. The present study compares neuropsychological and behavioral findings between patients with psychogenic and organic amnesias from their earlier stages. T.Y., 52 y/o male, showed antegrade and retrograde amnesia and short4erm memory disturbance two months after the operation of esophageal carcinoma without a loss of personal identity and information. No apparent organic causes were identified. H.S., 46 y/o male, with antegrade amnesia, was diagnosed as limbic system encephalitis based o n t he findings of MRI and SPECT showing lesions at the bilateral medial temporal lobes. Since neuropsychological features of T.Y. were suggestive of organic amnesia, a "memory note" training was administered to both patients. T.Y.'s behavioral responses to this training contrasted with H.S.' s, and w ere indicative of psychogenic amnesia. Confrontation with cancer would have been a precipitating stress. We emphasize the importance of behavioral responses to the memory training in differentiating psychogenic amnesia from organic amnesia.
