A Feasibility Study of an Individualized Voiding Program in Japan to Improve the Sense of Control in Older People with Functional Urinary Incontinence

Purpose: This study intended to assess the feasibility of an individualized voiding program in Japan aimed at improving the sense of micturition control in older people with functional urinary incontinence. Method: Following the interview guide, FGIs were conducted in two groups (4 - 6 participants) consisting of nurses and care workers with more than 5 years of experience as practitioners of urination care. Data were analyzed using a qualitative descriptive approach. Results: We determined that the program purpose is to “enable caregivers to work as a well-coordinated team to humanely facilitate excretion independence in older people, which is essential for living with dignity”, as this confirmed the importance of maintaining the sense of micturition control in older people for their well-being. In the program outline, we extracted the following five categories: 1) setting selection criteria for recipients considering the status of micturition induction, 2) careful collection of information and assessment of lower urinary tract symptoms in older people in case of environmental changes, 3) examination of methods used for assessing lower urinary tract symptoms according to the facility environment, 4) confirmation of the recipient’s micturition habits and request for assistance, and 5) conducting necessary examination for setting the intervention period and evaluation period according to the target condition. The feedback on the program guide was summarized in the statement—specific successful cases help frame and implement the micturition induction plan. Conclusion: We confirmed the feasibility of the micturition induction plan for improving the sense of control in older people with functional urinary incontinence. Upon evaluating the program guide, we deemed that referring to specific successful cases helps frame and implement the micturition induction plan. It is extremely important to verify the effectiveness of the program going forward.

Spinal Manipulation and Dynamic Neuromuscular Stabilization Care for a 4-Year-Old Patient with Agenesis of the Corpus Callosum

The purpose of this case study is to describe the chiropractic care of a 4-year-old male patient with agenesis of the corpus callosum. Methods: Chiropractic care plan consisted of weekly appointments with the inclusion of at-home exercises coupled with academic intervention of physical and occupational therapies and assistive gait devices. Functional changes were monitored via objective clinic findings, independent clinical examination, and parental observation. Results: Agitated flexion contracted non-weight bearing child with gastrointestinal dysfunction and developmentally shunted growth responds to co-managed chiropractic care. Focus on aiding structural balance helped improve the weight bearing movement and mobility, physical calmness and contentment, emotional and verbal communication, as well as gastointestinal function. Discussion: This therapeutic approach decreased aberrant posture and enhanced quality of life. Conclusion: Chiropractic care in combination with academic intervention improved this child’s postural abnormalities, attitude, and cognitive development warranting consideration in subsequent care investigation.