Introduction / Objectives:
We experienced occupational therapy for a patient with diffuse axonal injury who was enrolled in high school. At the beginning of the intervention, the patient refused it due to decreased motivation, but rehabilitation became a habit through hobby activities, leading to improvement in ADL.
Methods / Approach:
Initial assessment showed a lack of spontaneous behavior and a tendency to stay in bed during the day. FIM score was 29, and the patient exhibited signs of higher brain dysfunction, such as disinhibition, executive dysfunction, and attention deficits. In the MOHOST, nearly all items were "work-limiting," and the Volitional Questionnaire (VQ) score was 19/56.Initially, the patient resisted leaving the bed, making intervention difficult. To overcome this, we used the patient’s hobby of watching idol videos to encourage participation. This led to regular attendance in the rehabilitation room, where ADL training and interventions for higher brain dysfunction were incorporated.As the patient began to recognize the need for rehabilitation, spontaneous behaviors increased, leading to improved motivation for social reintegration.
Results / Practice Implications:
At the final evaluation, FIM score increased to 93, and ADL functioning in the hospital reached a modified independent level. The MOHOST showed improvements in work motivation and patterns, and the VQ score increased to 48. Additionally, the patient began interacting with others.
Conclusion / Contribution to the occupational therapy profession:
For a patient who initially resisted leaving the bed, hobby activities played a key role in improving ADL independence. Using hobbies as an introduction to therapy is an effective approach for patients with low motivation.