Dysphagia improvement support system and dysphagia improvement support method

Abstract

To provide a dysphagia improvement support system and a dysphagia improvement support method capable of supporting the improvement of dysphagia.SOLUTION: A dysphagia improvement support system receives deglutition function evaluation information for evaluating a deglutition function, receives aspiration pneumonia risk evaluation information for evaluating an aspiration pneumonia risk, receives sarcopenia evaluation information for evaluating sarcopenia, determines whether deglutition exists on the basis of the deglutition function evaluation information, determines whether the aspiration pneumonia risk exists on the basis of the aspiration pneumonia risk evaluation information, determines whether there is the possibility of the sarcopenia on the basis of the sarcopenia evaluation information, and derives correspondence for improving deglutition on the basis of the determination result of whether the deglutition exists, the determination result of whether the aspiration pneumonia exists and the determination result of whether there is the possibility of the sarcopenia.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present invention relates to a system for assisting in improving dysphagia during eating and swallowing and a method for assisting in improving dysphagia during eating and swallowing.

Background Art

[0002] Regarding dysphagia during eating and swallowing in the elderly, comprehensive treatment is carried out in acute care hospitals and convalescent rehabilitation hospitals, and intensive rehabilitation involving speech therapists' training of eating functions and multiple professions is performed. In addition, home-based cardiac rehabilitation using information and communication technology is also being carried out (see, for example, Non-Patent Document 1).

Prior Art Documents

Non-Patent Documents

[0003]

Non-Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] In the home life after treatment during the acute or recovery phase, due to reasons such as staff shortages and lack of skills, sufficient swallowing rehabilitation and appropriate diet forms are not provided, and repeated aspiration pneumonia and nutritional disorders due to the progression of functional decline often lead to conditions that affect the prognosis of life. In addition, in patients infected with the coronavirus, since the staff available for intervention is limited, sufficient rehabilitation is not provided, and there is a risk of causing further functional decline.

[0005] An object of the present invention is to provide a dysphagia improvement support system and a dysphagia improvement support method capable of assisting in the improvement of dysphagia.

Means for Solving the Problems

[0006] In order to solve the above problems, the present invention provides the following means. (1) The dysphagia improvement support system according to the first aspect includes a dysphagia function evaluation information reception unit that receives dysphagia function evaluation information for evaluating the swallowing function, an aspiration pneumonia risk evaluation information reception unit that receives aspiration pneumonia risk evaluation information for evaluating the risk of aspiration pneumonia, a sarcopenia evaluation information reception unit that receives sarcopenia evaluation information for evaluating sarcopenia, a dysphagia disorder determination unit that determines whether there is a dysphagia disorder based on the dysphagia function evaluation information, an aspiration pneumonia risk determination unit that determines whether there is a risk of aspiration pneumonia based on the aspiration pneumonia risk evaluation information, a sarcopenia possibility determination unit that determines whether there is a possibility of sarcopenia based on the sarcopenia evaluation information, and a derivation unit that derives a response for improving dysphagia based on the determination result of whether there is a dysphagia disorder by the dysphagia disorder determination unit, the determination result of whether there is a risk of aspiration pneumonia by the aspiration pneumonia risk determination unit, and the determination result of whether there is a possibility of sarcopenia by the sarcopenia possibility determination unit. (2) In the dysphagia improvement support system according to the above aspect, the derivation unit may derive a rehabilitation menu. (3) In the dysphagia improvement support system according to the above aspect, a selection unit that selects dietary guidance may be further provided based on the determination result of whether or not there is dysphagia by the dysphagia determination unit and the determination result of whether or not there is a risk of aspiration pneumonia by the aspiration pneumonia risk determination unit. (4) In the dysphagia improvement support system according to the above aspect, the dysphagia determination unit may determine whether or not there is dysphagia based on the level of phios included in the dysphagia function evaluation information, the result of the repeated saliva swallowing test, and the result of the revised water drinking test. (5) In the dysphagia improvement support system according to the above aspect, the aspiration pneumonia risk determination unit may determine whether or not there is a risk of aspiration pneumonia based on the local findings, general findings, result of the repeated saliva swallowing test, and result of the revised water drinking test included in the aspiration pneumonia risk evaluation form. (6) In the dysphagia improvement support system according to the above aspect, the sarcopenia possibility determination unit may determine whether or not there is a possibility of sarcopenia based on the information indicating the circumference of the lower leg and the information indicating muscle strength.

[0007] (7) The method for supporting the improvement of dysphagia according to the first aspect includes a step of receiving dysphagia function evaluation information for evaluating dysphagia function, a step of receiving aspiration pneumonia risk evaluation information for evaluating the risk of aspiration pneumonia, a step of receiving sarcopenia evaluation information for evaluating sarcopenia, a step of determining whether or not there is dysphagia based on the dysphagia function evaluation information, a step of determining whether or not there is a risk of aspiration pneumonia based on the aspiration pneumonia risk evaluation information, a step of determining whether or not there is a possibility of sarcopenia based on the sarcopenia evaluation information, and a step of deriving a measure for improving dysphagia based on the determination result of whether or not there is dysphagia, the determination result of whether or not there is a risk of aspiration pneumonia, and the determination result of whether or not there is a possibility of sarcopenia. It is a method for supporting the improvement of dysphagia executed by a computer.

Advantages of the Invention

[0008] According to an embodiment of the present invention, it is possible to provide a dysphagia improvement support system and a dysphagia improvement support method that can assist in improving dysphagia.

Brief Description of the Drawings

[0009]

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Mode for Carrying Out the Invention

[0010] Next, the eating and swallowing disorder improvement support system and the eating and swallowing disorder improvement support method of the present embodiment will be described with reference to the drawings. The embodiments described below are merely examples, and the embodiments to which the present invention is applied are not limited to the following embodiments. In all the drawings for explaining the embodiments, those having the same function are denoted by the same reference numerals, and repeated explanations are omitted. Hereinafter, the present embodiment will be described in detail with appropriate reference to the drawings.

[0011] (Embodiment) FIG. 1 is a diagram showing an example of an eating and swallowing disorder improvement support system 1 according to the present embodiment. The eating and swallowing disorder improvement support system 1 includes an eating and swallowing disorder improvement support device 100. In FIG. 1, in addition to the eating and swallowing disorder improvement support device 100, a terminal device 10 for accessing the eating and swallowing disorder improvement support device 100 is shown. The terminal device 10 and the eating and swallowing disorder improvement support device 100 can communicate with each other via a communication network NW. The communication network NW includes the Internet, WAN (Wide Area Network), LAN (Local Area Network), public line, provider device, dedicated line, wireless base station, and the like.

[0012] The swallowing disorder improvement support device 100 provides a swallowing disorder improvement support service. The swallowing disorder improvement support device 100 receives swallowing function evaluation information for evaluating the swallowing function, aspiration pneumonia risk evaluation information for evaluating the aspiration pneumonia risk, and sarcopenia evaluation information for evaluating sarcopenia. The swallowing disorder improvement support device 100 determines whether there is a swallowing disorder based on the received swallowing function evaluation information, determines whether there is an aspiration pneumonia risk based on the received aspiration pneumonia risk evaluation information, and determines whether there is a possibility of sarcopenia based on the received sarcopenia evaluation information. The swallowing disorder improvement support device 100 derives a measure for improving the swallowing disorder based on the determination results of whether there is a swallowing disorder, whether there is an aspiration pneumonia risk, and whether there is a possibility of sarcopenia.

[0013] FIG. 2 is a block diagram showing an example of the swallowing disorder improvement support device 100 and the terminal device 10 according to the present embodiment. (Swallowing disorder improvement support device 100) The swallowing disorder improvement support device 100 includes a communication unit 101, a swallowing function evaluation information reception unit 102-1, an aspiration pneumonia risk evaluation information reception unit 102-2, a sarcopenia evaluation information reception unit 102-3, a swallowing disorder determination unit 103-1, an aspiration pneumonia risk determination unit 103-2, a sarcopenia possibility determination unit 103-3, a creation unit 104, a derivation unit 105, a connection processing unit 106, a selection unit 107, and a storage unit 110.

[0014] The communication unit 101 is realized by a communication module. The communication unit 101 communicates with an external communication device via the network NW. The communication unit 101 communicates by a communication method such as a wired LAN, for example. Also, the communication unit 101 may communicate by a wireless communication method such as a wireless LAN, Bluetooth (registered trademark), or LTE (Long Term Evolution) (registered trademark). The communication unit 101 holds communication information necessary for communicating with the terminal device 10 via the network NW.

[0015] The storage unit 110 is implemented by a HDD (Hard Disk Drive), flash memory, RAM (Random Access Memory), ROM (Read Only Memory), etc., and stores information. The storage unit 110 stores user information associating one or more login IDs with passwords for each of the one or more login IDs for a user corresponding to the login ID to log in to the site of the dysphagia improvement support service.

[0016] The communication unit 101 receives an access request transmitted by the terminal device 10. When the communication unit 101 receives the access request transmitted by the terminal device 10, a login process is performed. The login process will be described. The creation unit 104 acquires the access request from the communication unit 101, and creates an access response for causing the terminal device 10 to display an initial screen based on the acquired access request. The creation unit 104 transmits the created access response from the communication unit 101 to the terminal device 10. FIG. 3A is a diagram showing an example of an initial screen. An authentication button ABU to be pressed during authentication is displayed in an example of the initial screen. Returning to FIG. 2, the description will continue.

[0017] The communication unit 101 receives an authentication request transmitted by the terminal device 10. The connection processing unit 106 acquires the authentication request from the communication unit 101, and creates login authentication screen information for causing the terminal device 10 to display a login authentication screen based on the acquired authentication request. The creation unit 104 transmits the created login authentication screen information from the communication unit 101 to the terminal device 10. FIG. 3B is a diagram showing an example of a login authentication screen. A login ID input box IDBO for inputting a login ID, a password input box PWBO for inputting a password, and a login button LOBO to be pressed when logging in are displayed in an example of the login authentication screen. Returning to FIG. 2, the description will continue.

[0018] The communication unit 101 receives the login request sent by the terminal device 10. The connection processing unit 106 acquires the login request from the communication unit 101, and acquires the login ID and password included in the acquired login request. The connection processing unit 106 determines whether the combination of the acquired login ID and password is included in the user information of the storage unit 110. The description of the login process ends.

[0019] When the connection processing unit 106 determines that the combination of the login ID and password is included in the user information of the storage unit 110, the creation unit 104 creates login screen information for causing the terminal device 10 to display a login screen. The creation unit 104 transmits the created login screen information from the communication unit 101 to the terminal device 10.

[0020] FIG. 3C is a diagram showing an example of a login screen. In an example of the login screen, there are displayed an evaluation / diagnosis button EDBU that is pressed when the user receives evaluation / diagnosis, a rehabilitation guidance button RGBU that is pressed when the user receives rehabilitation guidance, and a diet guidance button MGBU that is pressed when the user receives diet guidance. Returning to FIG. 2, the description continues.

[0021] When the connection processing unit 106 determines that the combination of the login ID and password is not included in the user information of the storage unit 110, the creation unit 104 creates login failure screen information for causing the terminal device 10 to display a login failure screen (not shown) for notifying that the user cannot log in to the dysphagia improvement support service. The creation unit 104 transmits the created login failure screen information from the communication unit 101 to the terminal device 10.

[0022] The communication unit 101 receives the evaluation / diagnosis information sent by the terminal device 10. The creation unit 104 acquires the evaluation / diagnosis information from the communication unit 101, and creates evaluation / diagnosis screen information for causing the terminal device 10 to display an evaluation / diagnosis screen based on the acquired evaluation / diagnosis information. The creation unit 104 transmits the created evaluation / diagnosis screen information from the communication unit 101 to the terminal device 10.

[0023] FIG. 3D is a diagram showing an example of an evaluation diagnosis screen. An example of the evaluation diagnosis screen includes a table-form information associating one or more examinee numbers, the name, gender, date of birth, disease name of each of the one or more examinee numbers, buttons for selecting evaluation contents, buttons for selecting guidance contents, a button to be pressed when viewing evaluation results, and check boxes to be selected when deleting. The buttons for selecting evaluation contents include a button for selecting evaluation contents regarding swallowing / oral cavity and a button for selecting evaluation contents regarding diet guidance. The buttons for selecting guidance contents include a button for selecting rehabilitation guidance and a button for selecting diet guidance. Further, an example of the evaluation diagnosis screen includes a new addition button NABU for newly adding an examinee. Return to FIG. 2 and continue the explanation.

[0024] The communication unit 101 receives a swallowing function evaluation request transmitted by the terminal device 10. The swallowing function evaluation information reception unit 102-1 acquires the swallowing function evaluation request from the communication unit 101 and registers it in the storage unit 110.

[0025] The creation unit 104 acquires a swallowing function evaluation request from the communication unit 101 and creates swallowing function evaluation screen information based on the acquired swallowing function evaluation request. The creation unit 104 transmits the created swallowing function evaluation screen information from the communication unit 101 to the terminal device 10. FIG. 3E is a diagram showing an example of a swallowing function evaluation screen. An example of the swallowing function evaluation screen includes, for the examinee selected by the user, as evaluation results of the swallowing function, a plurality of buttons FSBU for selecting FOIS (Functional Oral Intake Scale), a box RSBO for inputting the results of the repeated saliva swallowing test, and a plurality of buttons MSBU for selecting the results of the revised water drinking test. Further, an example of the swallowing function evaluation screen includes a registration button REBU to be pressed when the input of the evaluation results of the swallowing function is completed and registration is to be performed.

[0026] FOIS is a method for evaluating the oral intake status, consisting of seven levels from level 1 "no oral intake" to level 7 "normal (able to have a normal diet without restrictions)". Each of the multiple buttons FSBU corresponds to one of the levels from level 1 to level 7. The repetitive saliva swallowing test is a screening test for the presence or absence of aspiration. In the box RSBO, the number of times that can be swallowed in 30 seconds is input while touching the thyroid cartilage with the index finger and middle finger. The revised water drinking test involves pouring 3 ml of cold water into the bottom of the oral cavity and instructing swallowing, and then performing repetitive swallowing twice after swallowing, with the evaluation criteria having a maximum of 4 points. For the button MSBU, when performed twice repeatedly, the worst score is selected. Return to Figure 2 and continue the explanation.

[0027] The communication unit 101 receives the swallowing function registration request transmitted by the terminal device 10. The swallowing function evaluation information reception unit 102-1 acquires the swallowing function registration request from the communication unit 101 and registers it in the storage unit 110. The creation unit 104 creates the aspiration pneumonia risk assessment screen information. The creation unit 104 transmits the created aspiration pneumonia risk assessment screen information from the communication unit 101 to the terminal device 10.

[0028] Figure 3F is a diagram showing an example of the aspiration pneumonia risk assessment screen. In an example of the aspiration pneumonia risk assessment screen, for the examiner selected by the user, as the aspiration pneumonia risk assessment result, i-EALD (Aspiration Pneumonia Risk Assessment Form) is shown. i-EALD includes, as local findings, a plurality of buttons OSBU for selecting the amount of saliva in the oral cavity, a plurality of buttons ORSBU for selecting oral residue, and a plurality of buttons BBSBU for selecting bad breath. i-EALD includes, as overall findings, a plurality of buttons CCSBU for selecting conversation clarity, a plurality of buttons NSSBU for selecting nutritional status, a plurality of buttons ADSBU for selecting ADL (Activities of Daily Living), a plurality of buttons MESBU for selecting the maximum expiratory flow rate, and a plurality of buttons CCSBU for selecting choking or coughing during meals. Further, an example of the aspiration pneumonia risk assessment screen includes a registration button REBU that is pressed when the input of the evaluation result of the aspiration pneumonia risk is completed and registered.

[0029] The amount of saliva in the oral cavity consists of four grades from Grade 0 "moist" to Grade 3 "the surface is dry". Each of the plurality of buttons OSBU corresponds to one of Grade 0 to Grade 3. Oral residue consists of four grades from Grade 0 "no residue" to Grade 3 "residue on both sides". Each of the plurality of buttons ORSBU corresponds to one of Grade 0 to Grade 3. Bad breath consists of four grades from Grade 0 "odorless" to Grade 3 "turning the face away at 30 cm from the mouth". Each of the plurality of buttons BBSBU corresponds to one of Grade 0 to Grade 3.

[0030] The conversation clarity consists of four grades from Grade 0 "well understood" to Grade 3 "completely incomprehensible". Each of the plurality of buttons CCSBU corresponds to one of Grade 0 to Grade 3. The nutritional status consists of two grades, Grade 0 "BMI (Body Mass Index) ≥ 19" or Grade 1 "BMI < 19". Each of the plurality of buttons NSSBU corresponds to Grade 0 or Grade 1. ADL consists of two grades, Grade 0 "able to sit during meal time" or Grade 1 "unable to sit". Each of the plurality of buttons ADSBU corresponds to Grade 0 or Grade 1.

[0031] The maximum expiratory flow rate consists of two grades, Grade 0 "clearly feel forced exhalation 40 cm from the mouth" or Grade 1 "not felt". Each of the plurality of buttons MESBU corresponds to Grade 0 or Grade 1. Coughing and choking during meals consist of two grades, Grade 0 "no coughing and choking" or Grade 1 "repeatedly having obvious coughing and choking". Each of the plurality of buttons CCSBU corresponds to Grade 0 or Grade 1. Return to Figure 2 and continue the explanation.

[0032] The communication unit 101 receives the aspiration pneumonia risk registration request sent by the terminal device 10. The aspiration pneumonia risk assessment information reception unit 102-2 acquires and registers the aspiration pneumonia risk registration request from the communication unit 101. The creation unit 104 creates sarcopenia evaluation screen information. The creation unit 104 transmits the created sarcopenia evaluation screen information from the communication unit 101 to the terminal device 10.

[0033] FIG. 3G is a diagram showing an example of a sarcopenia evaluation screen. An example of the sarcopenia evaluation screen includes a box LLCBO for inputting the lower leg circumference (numerical value) as an evaluation result of sarcopenia for the examinee selected by the user, a box MSBO for inputting the muscle strength weight (numerical value), and a box NRBO for inputting the time required for standing up five times (numerical value). Further, an example of the sarcopenia evaluation screen includes a radio button CDSBO for selecting the presence or absence of a disease complicated by dysphagia as an evaluation result of sarcopenia. Further, an example of the sarcopenia evaluation screen includes a registration button REBU that is pressed when the input of the evaluation result of sarcopenia is completed and registration is to be performed. Returning to FIG. 2, the description will continue.

[0034] The communication unit 101 receives a sarcopenia registration request transmitted by the terminal device 10. The sarcopenia evaluation information reception unit 102-3 acquires the sarcopenia registration request from the communication unit 101 and registers it in the storage unit 110. The dysphagia determination unit 103-1 acquires the evaluation result of the swallowing function included in the swallowing function registration request for the subject from the storage unit 110 and determines the possibility of dysphagia. The aspiration pneumonia risk determination unit 103-2 acquires the evaluation result of the aspiration pneumonia risk included in the aspiration pneumonia risk registration request for the subject from the storage unit 110 and determines the possibility of the aspiration pneumonia risk. The sarcopenia possibility determination unit 103-3 acquires the evaluation result of sarcopenia included in the sarcopenia registration request for the subject from the storage unit 110 and determines the possibility of sarcopenia.

[0035] The derivation unit 105 acquires the determination result of the possibility of dysphagia from the dysphagia determination unit 103-1, acquires the determination result of the possibility of aspiration pneumonia risk from the aspiration pneumonia risk determination unit 103-2, and acquires the determination result of the possibility of sarcopenia from the sarcopenia possibility determination unit 103-3. The derivation unit 105 derives a countermeasure for improving feeding and swallowing disorders based on the acquired determination results of the possibility of dysphagia, the possibility of aspiration pneumonia risk, and the possibility of sarcopenia.

[0036] Specifically, the derivation unit 105 derives a rehabilitation menu based on the determination result of the possibility of dysphagia, the determination result of the possibility of aspiration pneumonia risk, and the determination result of the possibility of sarcopenia. When there is a possibility of dysphagia, no possibility of aspiration pneumonia risk, and no possibility of sarcopenia, the derivation unit 105 derives swallowing training as a rehabilitation menu. When there is a possibility of dysphagia, no possibility of aspiration pneumonia risk, a possibility of sarcopenia, and an obvious swallowing function decline disease, the derivation unit 105 derives swallowing training and sarcopenia rehabilitation as a rehabilitation menu. When there is a possibility of dysphagia, no possibility of aspiration pneumonia risk, a possibility of sarcopenia, and no obvious swallowing function decline disease, the derivation unit 105 derives swallowing training and sarcopenia rehabilitation as a rehabilitation menu.

[0037] When there is a possibility of dysphagia, a risk of aspiration pneumonia, and no possibility of sarcopenia, the derivation unit 105 derives swallowing training and respiratory rehabilitation as a rehabilitation menu. When there is a possibility of dysphagia, a risk of aspiration pneumonia, a possibility of sarcopenia, and an obvious swallowing function decline disease, the derivation unit 105 derives swallowing training, respiratory rehabilitation, and sarcopenia rehabilitation as a rehabilitation menu. When there is a possibility of dysphagia, a risk of aspiration pneumonia, a possibility of sarcopenia, and no obvious swallowing function decline disease, the derivation unit 105 derives swallowing training, respiratory rehabilitation, and sarcopenia rehabilitation as a rehabilitation menu.

[0038] When there is no possibility of dysphagia, the repeated saliva swallowing test is 2 times or less, or the rating of the revised water drinking test is 3 or less, and there is a risk of aspiration pneumonia and no possibility of sarcopenia, the derivation unit 105 derives swallowing training and respiratory rehabilitation as a rehabilitation menu. When there is no possibility of dysphagia, the repeated saliva swallowing test is 2 times or less, or the rating of the revised water drinking test is 3 or less, and there is a risk of aspiration pneumonia and a possibility of sarcopenia, the derivation unit 105 derives swallowing training, respiratory rehabilitation, and sarcopenia rehabilitation as a rehabilitation menu. When there is no possibility of dysphagia, the repeated saliva swallowing test is 2 times or less, or the rating of the revised water drinking test is 3 or less, and there is no risk of aspiration pneumonia and no possibility of sarcopenia, the derivation unit 105 derives swallowing training and preventive rehabilitation as a rehabilitation menu. When there is no possibility of dysphagia, the repeated saliva swallowing test is 2 times or less, or the rating of the revised water drinking test is 3 or less, and there is no risk of aspiration pneumonia and a possibility of sarcopenia, the derivation unit 105 derives swallowing training and sarcopenia rehabilitation as a rehabilitation menu.

[0039] When there is no possibility of dysphagia, the repetitive saliva swallowing test is less than or equal to 2 times, the evaluation of the revised water drinking test is not less than 3, there is a possibility of aspiration pneumonia risk, and there is no possibility of sarcopenia, the derivation unit 105 derives respiratory rehabilitation as a rehabilitation menu. When there is no possibility of dysphagia, the repetitive saliva swallowing test is less than or equal to 2 times, the evaluation of the revised water drinking test is not less than 3, there is a possibility of aspiration pneumonia risk, and there is a possibility of sarcopenia, the derivation unit 105 derives respiratory rehabilitation and sarcopenia rehabilitation as a rehabilitation menu.

[0040] When there is no possibility of dysphagia, the repetitive saliva swallowing test is less than or equal to 2 times, the evaluation of the revised water drinking test is not less than 3, there is no possibility of aspiration pneumonia risk, and there is no possibility of sarcopenia, the derivation unit 105 derives preventive rehabilitation as a rehabilitation menu. When there is no possibility of dysphagia, the repetitive saliva swallowing test is less than or equal to 2 times, the evaluation of the revised water drinking test is not less than 3, there is no possibility of aspiration pneumonia risk, and there is a possibility of sarcopenia, the derivation unit 105 derives sarcopenia rehabilitation as a rehabilitation menu.

[0041] The selection unit 107 obtains the determination result of the possibility of dysphagia from the dysphagia determination unit 103-1, obtains the determination result of the possibility of aspiration pneumonia risk from the aspiration pneumonia risk determination unit 103-2, and obtains the determination result of the possibility of sarcopenia from the sarcopenia possibility determination unit 103-3. The selection unit 107 selects diet guidance based on the obtained determination results of the possibility of dysphagia, the possibility of aspiration pneumonia risk, and the possibility of sarcopenia. For example, the selection unit 107 stores information associating the combination of the determination results of the possibility of dysphagia, the possibility of aspiration pneumonia risk, and the possibility of sarcopenia with information indicating diet guidance, and selects diet guidance from the information. The creation unit 104 acquires the determination result of the possibility of dysphagia from the dysphagia determination unit 103-1, acquires the determination result of the possibility of aspiration pneumonia risk from the aspiration pneumonia risk determination unit 103-2, and acquires the determination result of the possibility of sarcopenia from the sarcopenia possibility determination unit 103-3. Further, the creation unit 104 acquires information indicating a rehabilitation menu from the derivation unit 105 and acquires information indicating dietary guidance from the selection unit 107. The creation unit 104 creates evaluation result screen information for causing the terminal device 10 to display an evaluation result screen based on the acquired determination result of the possibility of dysphagia, the determination result of the possibility of aspiration pneumonia risk, the determination result of the possibility of sarcopenia, the information indicating the rehabilitation menu, and the information indicating dietary guidance. The creation unit 104 transmits the created evaluation result screen information from the communication unit 101 to the terminal device 10.

[0042] FIG. 3H is a diagram showing an example of an evaluation result screen. In an example of the evaluation result screen, for the examinee selected by the user, as evaluation results, information indicating the evaluation execution date, the determination result of the possibility of dysphagia, the determination result of the possibility of aspiration pneumonia risk, the determination result of the possibility of sarcopenia, and information indicating sarcopenia swallowing dysphagia are included. In FIG. 3H, as the information indicating the evaluation execution date, "2022.4.30" is displayed, as the determination result of the possibility of dysphagia, "Yes" is displayed, as the determination result of the possibility of aspiration pneumonia risk, "Possible" is displayed, and as the determination result of the possibility of sarcopenia and the information indicating sarcopenia swallowing dysphagia, "Possible" is displayed.

[0043] Furthermore, in an example of the evaluation result screen, for the examinee selected by the user, as evaluation results, information indicating the evaluation execution date and dietary guidance information are included. In FIG. 3H, as the information indicating the evaluation execution date, "2022.5.6" is displayed, and as the dietary guidance information, "Indirect swallowing training, direct swallowing training by a speech therapist" is displayed. Furthermore, an example of the evaluation result screen includes, for the examiner selected by the user, a plurality of buttons RMSBU for selecting the target rehabilitation menu (rehabilitation menu (eating form)) and a button PCG for graphically displaying the changes in the individual's evaluation results. The plurality of buttons RMSBU for selecting the target rehabilitation menu (eating form) include a button for selecting swallowing training, a button for selecting respiratory rehabilitation, a button for selecting sarcopenia rehabilitation, a button for selecting preventive rehabilitation, and a button for selecting dietary guidance.

[0044] The communication unit 101 receives the individual change graph request transmitted by the terminal device 10. The creation unit 104 acquires the individual change graph evaluation request from the communication unit 101, and creates individual change graph image information for causing the terminal device 10 to display an individual change graph based on the acquired individual change graph request. The creation unit 104 transmits the created individual change graph screen information from the communication unit 101 to the terminal device 10.

[0045] FIG. 3I is a diagram showing an example of the individual change graph screen. An example of the individual change graph screen includes, for the examiner selected by the user, as an individual change graph, a history FH of the evaluation results of FOIS, a history RH of the test results of repeated swallowing, a history MH of the test results of the revised water only, a history iEH of the aspiration pneumonia risk evaluation results, a history SH of the sarcopenia evaluation results, and a history MGH of the dietary guidance. The history FH of the evaluation results of FOIS includes a graph representing the history of the test date, level, and FOIS level. The history RH of the test results of repeated swallowing includes a graph representing the history of the test date, evaluation, and number of swallows. The history MH of the test results of the revised water only includes a graph representing the history of the test date, evaluation, and score. The history iEH of the aspiration pneumonia risk evaluation results includes a graph representing the history of the test date, risk, total score, and i-EALD.

[0046] The history SH of sarcopenia evaluation results includes sarcopenia evaluation, sarcopenia swallowing disorder evaluation, and rehabilitation menu. The sarcopenia evaluation includes the examination date, lower leg circumference, muscle strength weight, time required for 5 - time stand - up, and determination result. The sarcopenia swallowing disorder evaluation includes the determination result. The rehabilitation menu includes the menu. The history MGH of diet guidance includes the examination date and determination result. Return to Figure 2 and continue the explanation.

[0047] The communication unit 101 receives the rehabilitation information (rehab information) transmitted by the terminal device 10. The creation unit 104 acquires the rehab information from the communication unit 101 and creates rehabilitation screen information for causing the terminal device 10 to display a rehabilitation screen based on the acquired rehab information. The creation unit 104 transmits the created rehabilitation screen information from the communication unit 101 to the terminal device 10.

[0048] Figure 4A is a diagram showing an example of a rehabilitation screen. An example of the rehabilitation screen includes a button STBU for selecting swallowing training, a button RRBU for selecting respiratory rehabilitation, a button SRBU for selecting sarcopenia rehabilitation, and a button PRBU for selecting preventive rehabilitation. Return to Figure 2 and continue the explanation.

[0049] The communication unit 101 receives the swallowing training request transmitted by the terminal device 10. The creation unit 104 acquires the swallowing training request from the communication unit 101 and creates swallowing training screen information for causing the terminal device 10 to display a swallowing training screen based on the acquired swallowing training request. The creation unit 104 transmits the created swallowing training screen information from the communication unit 101 to the terminal device 10.

[0050] FIG. 4B is a diagram showing an example of a swallowing training screen. An example of the swallowing training screen includes a plurality of buttons SSBU for selecting typical symptoms. An example of the plurality of buttons SSBU includes a button to be pressed when selecting symptoms such as the lips not closing, saliva flowing from the mouth, a button to be pressed when selecting warm-up exercises, a button to be pressed when selecting symptoms of poor lip and tongue movement, a button to be pressed when selecting symptoms of inability to perform the swallowing action, a button to be pressed when selecting symptoms such as air leaking through the nose and food coming out of the nose, a button to be pressed when selecting symptoms of the esophagus not opening, and a button to be pressed when selecting symptoms such as a hoarse voice, a very soft voice, and a short voice production period. Returning to FIG. 2, the description will continue.

[0051] The communication unit 101 receives a swallowing training selection request transmitted by the terminal device 10. The creation unit 104 acquires the swallowing training selection request from the communication unit 101 and creates swallowing training selection screen information for causing the terminal device 10 to display a swallowing training selection screen based on the acquired swallowing training selection request. The creation unit 104 transmits the created swallowing training selection screen information from the communication unit 101 to the terminal device 10.

[0052] FIGS. 4C to 4G are diagrams showing an example of a swallowing training selection screen. As shown in FIG. 4C, an example of the swallowing training selection screen created by the creation unit 104 includes a plurality of buttons ITBU-1 for selecting indirect training. An example of the plurality of buttons ITBU-1 includes a button to be pressed when selecting lip and cheek progression massage, a button to be pressed when selecting warm-up exercises, a button to be pressed when selecting tongue and oral cavity surrounding movement area training, a button to be pressed when selecting blowing, and a button to be pressed when selecting tongue and oral cavity surrounding muscle strength load training.

[0053] Also, as shown in FIG. 4D, an example of the swallowing training selection screen created by the creation unit 104 includes a button ITBU-2 for selecting indirect training. An example of the button ITBU-2 is a button to be pressed when selecting Pushing exercise.

[0054] Also, as shown in FIG. 4E, an example of the swallowing training selection screen created by the creation unit 104 includes a plurality of buttons ITBU-3 for selecting indirect training. An example of the plurality of buttons ITBU-3 includes a button to be pressed when selecting Thermal stimulation and a button to be pressed when selecting the K-point stimulation method.

[0055] Also, as shown in FIG. 4F, an example of the swallowing training selection screen created by the creation unit 104 includes a button ITBU-4 for selecting indirect training. An example of the button ITBU-4 is a button to be pressed when selecting Shaker exercise.

[0056] Also, as shown in FIG. 4G, an example of the swallowing training selection screen created by the creation unit 104 includes a button ITBU-5 for selecting indirect training. An example of the button ITBU-5 is a button to be pressed when selecting relaxation.

[0057] The communication unit 101 receives the swallowing training information request transmitted by the terminal device 10. The creation unit 104 acquires the swallowing training information request from the communication unit 101, and creates swallowing training information screen information for causing the terminal device 10 to display a swallowing training information screen based on the swallowing training type information included in the acquired swallowing training information request. The creation unit 104 transmits the created swallowing training information screen information from the communication unit 101 to the terminal device 10.

[0058] FIGS. 5A to 5M are diagrams showing an example of the swallowing training information screen. An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates lip and cheek stretching massage is lip massage and "a", "i", "u" gymnastics. FIG. 5A shows an image representing lip massage, and FIG. 5B shows an image representing "a", "i", "u" gymnastics. An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates tongue and oral cavity surrounding movement range training is tongue movement. FIG. 5C shows an image representing tongue movement.

[0059] An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates tongue and oral cavity muscle strength loading training is tongue spoon resistance training and cheek puffing training. Figure 5D shows an image representing tongue spoon resistance training, and Figure 5E shows an image representing cheek puffing training. An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates articulation training is patakara oral gymnastics and "a", "i", "u" gymnastics. Figure 5F shows an image representing patakara oral gymnastics, and Figure 5G shows an image representing "a", "i", "u" gymnastics.

[0060] An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates blowing is blowing. Figure 5H shows an image representing blowing. An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates Pushing exercise is Pushing exercise. Figure 5I shows an image representing Pushing exercise.

[0061] An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates Thermal stimulation is Thermal stimulation. Figure 5J shows an image representing Thermal stimulation. An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates K-point stimulation method is K-point stimulation method. Figure 5K shows an image representing K-point stimulation method.

[0062] An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates Shaker exercise is Shaker exercise. Figure 5L shows an image representing the Shaker exercise. An example of the swallowing training information screen created by the creation unit 104 when the swallowing training type information indicates preparatory swallowing exercises is salivary gland massage. FIG. 5M shows an image representing salivary gland massage.

[0063] The communication unit 101 receives the respiratory rehabilitation request transmitted by the terminal device 10. The creation unit 104 acquires the respiratory rehabilitation request from the communication unit 101 and creates respiratory rehabilitation screen information for causing the terminal device 10 to display a respiratory rehabilitation screen based on the acquired respiratory rehabilitation request. The creation unit 104 transmits the created respiratory rehabilitation screen information from the communication unit 101 to the terminal device 10.

[0064] FIG. 6A is a diagram showing an example of a respiratory rehabilitation screen. As shown in FIG. 6A, an example of the respiratory rehabilitation screen created by the creation unit 104 includes a plurality of buttons BREXBU for selecting exercises. An example of the plurality of buttons BREXBU includes a button to be pressed when selecting elbow rotation exercises, a button to be pressed when selecting trunk rotation exercises, and a button to be pressed when selecting walking. An example of the plurality of buttons BREXBU includes a button to be pressed when selecting trunk side bending exercises, a button to be pressed when selecting drawing in, a button to be pressed when selecting abdominal breathing, and a button to be pressed when selecting back stretching exercises. An example of the plurality of buttons BREXBU includes a button to be pressed when selecting a bicycle ergometer, a button to be pressed when selecting pursed-lip breathing, a button to be pressed when selecting knee hugging exercises, a button to be pressed when selecting stair climbing and descending exercises, and a button to be pressed when selecting postural expectoration.

[0065] The communication unit 101 receives a respiratory rehabilitation information request transmitted by the terminal device 10. The creation unit 104 acquires the respiratory rehabilitation information request from the communication unit 101, and creates respiratory rehabilitation exercise screen information for causing the terminal device 10 to display a respiratory rehabilitation exercise screen based on the exercise type information included in the acquired respiratory rehabilitation information request. The creation unit 104 transmits the created respiratory rehabilitation exercise screen information from the communication unit 101 to the terminal device 10.

[0066] Figures 6B to 6N are diagrams showing an example of a respiratory rehabilitation exercise screen. As shown in Figure 6B, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is elbow rotation exercise, an image representing the elbow rotation exercise is displayed. As shown in Figure 6C, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is trunk lateral flexion exercise, an image representing the trunk lateral flexion exercise is displayed.

[0067] As shown in Figure 6D, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is back extension exercise, an image representing the back extension exercise is displayed. As shown in Figure 6E, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is knee hugging exercise, an image representing the knee hugging exercise is displayed. As shown in Figures 6F and 6G, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is trunk rotation exercise, an image representing the trunk rotation exercise is displayed.

[0068] As shown in FIG. 6H, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is drawing, an image representing drawing is displayed. As shown in FIG. 6I, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is a bicycle ergometer, an image representing a bicycle ergometer is displayed. As shown in FIG. 6J, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is stair climbing and descending exercise, an image representing stair climbing and descending exercise is displayed.

[0069] As shown in FIG. 6K, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is walking, an image representing walking is displayed. As shown in FIG. 6L, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is abdominal breathing, an image representing abdominal breathing is displayed. As shown in FIG. 6M, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is pursed-lip breathing, an image representing pursed-lip breathing is displayed. As shown in FIG. 6N, in an example of a respiratory rehabilitation exercise screen created by the creation unit 104 when the exercise type information is expectoration method, an image representing the expectoration method is displayed.

[0070] The communication unit 101 receives the sarcopenia rehabilitation request transmitted by the terminal device 10. The creation unit 104 acquires the sarcopenia rehabilitation request from the communication unit 101 and creates sarcopenia rehabilitation screen information for causing the terminal device 10 to display a sarcopenia rehabilitation screen based on the acquired sarcopenia rehabilitation request. The creation unit 104 transmits the created sarcopenia rehabilitation screen information from the communication unit 101 to the terminal device 10.

[0071] FIG. 7A is a diagram showing an example of a sarcopenia rehabilitation screen. As shown in FIG. 7A, an example of the sarcopenia rehabilitation screen created by the creation unit 104 includes a plurality of buttons SREXBU for selecting an exercise. An example of the plurality of buttons SREXBU includes a button to be pressed when selecting a pelvic tilt exercise, a button to be pressed when selecting a knee closing and buttocks lifting exercise, and a button to be pressed when selecting a half squat exercise. An example of the plurality of buttons SREXBU includes a button to be pressed when selecting a trunk training exercise, a button to be pressed when selecting a wall-facing squat exercise, a button to be pressed when selecting a stepping exercise, and a button to be pressed when selecting a patella setting exercise. An example of the plurality of buttons SREXBU includes a button to be pressed when selecting a horizontal abduction exercise of the shoulder joint, a button to be pressed when selecting a stair climbing and descending exercise, a button to be pressed when selecting a standing-up exercise from a chair, and a button to be pressed when selecting an abduction exercise of the shoulder joint.

[0072] The communication unit 101 receives the sarcopenia rehabilitation information request transmitted by the terminal device 10. The creation unit 104 acquires the sarcopenia rehabilitation information request from the communication unit 101, and creates sarcopenia rehabilitation exercise screen information for causing the terminal device 10 to display a sarcopenia rehabilitation exercise screen based on the exercise type information included in the acquired sarcopenia rehabilitation information request. The creation unit 104 transmits the created sarcopenia rehabilitation exercise screen information from the communication unit 101 to the terminal device 10.

[0073] FIGS. 7B to 7L are diagrams showing an example of a sarcopenia rehabilitation exercise screen. As shown in FIG. 7B, an example of the sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is a pelvic tilt exercise includes an image representing the pelvic tilt exercise. As shown in FIG. 7C, an example of the sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is a trunk training exercise includes an image representing the trunk training exercise.

[0074] As shown in FIG. 7D, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is patella setting includes an image representing patella setting. As shown in FIG. 7E, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is the rising motion from a chair includes an image representing the rising motion from a chair.

[0075] As shown in FIG. 7F, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is knee closing and hip lifting includes an image representing knee closing and hip lifting. As shown in FIG. 7G, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is a wall-facing squat includes an image representing a wall-facing squat. As shown in FIG. 7H, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is the horizontal abduction motion of the shoulder joint includes an image representing the horizontal abduction motion of the shoulder joint. As shown in FIG. 7I, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is the abduction motion of the shoulder joint includes an image representing the abduction motion of the shoulder joint.

[0076] As shown in FIG. 7J, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is a half squat includes an image representing a half squat. As shown in FIG. 7K, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is a stepping motion includes an image representing a stepping motion. As shown in FIG. 7L, an example of a sarcopenia rehabilitation exercise screen created by the creation unit 104 when the exercise type information is a stair ascending and descending motion includes an image representing a stair ascending and descending motion.

[0077] The communication unit 101 receives a preventive rehabilitation request transmitted by the terminal device 10. The creation unit 104 acquires the preventive rehabilitation request from the communication unit 101, and creates preventive rehabilitation screen information for causing the terminal device 10 to display a preventive rehabilitation screen based on the acquired preventive rehabilitation request. The creation unit 104 transmits the created preventive rehabilitation screen information from the communication unit 101 to the terminal device 10.

[0078] FIG. 8A is a diagram showing an example of a preventive rehabilitation screen. As shown in FIG. 8A, an example of the preventive rehabilitation screen created by the creation unit 104 includes a plurality of buttons PRBU for selecting a category to be prevented. An example of the plurality of buttons PRBU includes a button to be pressed when selecting frailty prevention, a button to be pressed when selecting low back pain prevention, a button to be pressed when selecting round back prevention, a button to be pressed when selecting fall prevention, and a button to be pressed when selecting shoulder stiffness prevention.

[0079] The communication unit 101 receives a preventive rehabilitation information request transmitted by the terminal device 10. The creation unit 104 acquires the preventive rehabilitation information request from the communication unit 101, and creates preventive rehabilitation exercise screen information for causing the terminal device 10 to display a preventive rehabilitation exercise screen based on the category information included in the acquired preventive rehabilitation information request. The creation unit 104 transmits the created preventive rehabilitation exercise screen information from the communication unit 101 to the terminal device 10.

[0080] FIGS. 8B to 8F are diagrams showing an example of a preventive rehabilitation exercise screen. As shown in FIG. 8B, an example of the preventive rehabilitation exercise screen created by the creation unit 104 when the category information indicates frailty prevention includes an image representing finger and head gymnastics. As shown in FIG. 8C, an example of the preventive rehabilitation exercise screen created by the creation unit 104 when the category information is round back prevention includes an image representing back stretching gymnastics.

[0081] As shown in FIG. 8D, an example of a preventive rehabilitation exercise screen created by the creation unit 104 when the category information is shoulder stiffness prevention includes an image representing elbow rotation exercises. As shown in FIG. 8E, an example of a preventive rehabilitation exercise screen created by the creation unit 104 when the category information is low back pain prevention includes an image representing knee hugging exercises. As shown in FIG. 8F, an example of a preventive rehabilitation exercise screen created by the creation unit 104 when the category information is fall prevention includes an image representing hip joint abduction exercises.

[0082] The communication unit 101 receives a meal guidance information request transmitted by the terminal device 10. The creation unit 104 acquires the meal guidance information request from the communication unit 101 and creates meal guidance information screen information for causing the terminal device 10 to display a meal guidance information screen based on the acquired meal guidance information request. The creation unit 104 transmits the created meal guidance information screen information from the communication unit 101 to the terminal device 10.

[0083] FIG. 9A is a diagram showing an example of a meal guidance information screen. As shown in FIG. 9A, an example of a meal guidance screen created by the creation unit 104 includes a button RMBU for selecting a rehabilitation menu and a plurality of buttons FMBU for selecting a meal form. An example of the plurality of buttons FMBU includes a button pressed when selecting enjoyable eating (jelly food), a button pressed when selecting starting food (mousse food), a button pressed when selecting nursing care food, and a button pressed when selecting normal food.

[0084] Figs. 9B to 9D are diagrams showing an example of a food form screen. As shown in Fig. 9B, an example of a meal form screen created by the creation unit 104 when the category information is enjoyable eating (jelly eating) includes an image representing enjoyable eating (jelly eating). As shown in Fig. 9C, an example of a meal form screen created by the creation unit 104 when the category information is starting eating includes an image representing starting eating. As shown in Fig. 9D, an example of an exercise screen created by the creation unit 104 when the category rehabilitation type information is nursing food and normal food includes images representing nursing food and normal food. Returning to Fig. 2, the description will continue.

[0085] The swallowing function evaluation information reception unit 102-1, the aspiration pneumonia risk evaluation information reception unit 102-2, the sarcopenia evaluation information reception unit 102-3, the swallowing disorder determination unit 103-1, the aspiration pneumonia risk determination unit 103-2, the sarcopenia possibility determination unit 103-3, the creation unit 104, the derivation unit 105, the connection processing unit 106, and the selection unit 107 are realized, for example, by a hardware processor such as a CPU executing a computer program (software) stored in the storage unit 110. Also, some or all of these functional units may be realized by hardware (including a circuit unit; circuitry) such as LSI (Large Scale Integration), ASIC (Application Specific Integrated Circuit), FPGA (Field-Programmable Gate Array), GPU (Graphics Processing Unit), or may be realized by the cooperation of software and hardware. The computer program may be stored in advance in a storage device such as an HDD (Hard Disk Drive) or a flash memory, or may be stored in a removable storage medium such as a DVD or a CD-ROM, and may be installed by mounting the storage medium on a drive device.

[0086] (Terminal device 10) The terminal device 10 includes a communication unit 12, a creation unit 14, a processing unit 16, an operation unit 18, a storage unit 15, and a display unit 19. The communication unit 12 is realized by a communication module. The communication unit 12 communicates with an external communication device via a network NW. The communication unit 101 communicates using a communication method such as a wired LAN. Also, the communication unit 12 may communicate using a wireless communication method such as a wireless LAN, Bluetooth (registered trademark), or LTE (Long Term Evolution) (registered trademark). The communication unit 12 holds communication information necessary to communicate with the dysphagia improvement support device 100 via the network NW.

[0087] The storage unit 15 is realized by an HDD, flash memory, RAM, ROM, etc., and stores information. The display unit 19 is, for example, a display and includes a touch panel. The operation unit 18 is an input device that receives user operations, for example, a touch panel. When the user U performs an operation to access the site of the dysphagia improvement support service, the operation unit 18 receives the operation. When the operation unit 18 receives an operation to access the site of the dysphagia improvement support service, the login process is started. The login process will be described. The creation unit 14 creates an access request to the site of the financing service based on the operation received by the operation unit 18, and transmits the created access request from the communication unit 12 to the dysphagia improvement support device 100.

[0088] The access response transmitted by the dysphagia improvement support device 100 in response to the access request is received by the communication unit 12. The processing unit 16 acquires the access response from the communication unit 12, and based on the acquired access response, causes the display unit 19 to display the initial screen (FIG. 3A) of the dysphagia improvement support service site. When the user performs an operation of pressing the authentication button ABU on the initial screen, the operation unit 18 receives the operation. The creation unit 14 creates an authentication request based on the operation received by the operation unit 18, and transmits the created authentication request from the communication unit 12 to the dysphagia improvement support device 100.

[0089] The login authentication screen information sent by the dysphagia improvement support device 100 in response to the authentication request is received by the communication unit 12. The processing unit 16 acquires the login authentication screen information from the communication unit 12, and based on the acquired login authentication screen information, causes the display unit 19 to display a login authentication screen (FIG. 3B). When the operation unit 18 receives an operation in which the user inputs a login ID and a password into the login ID input box IDBO and the password input box PWBO, respectively, and presses the login button LOBO on the login authentication screen (FIG. 3B), the operation unit 18 accepts the operation. The creation unit 14 creates a login request including the login ID and the password based on the operation accepted by the operation unit 18, and transmits the created login request from the communication unit 12 to the dysphagia improvement support device 100. The explanation for the case where the login is successful will be continued.

[0090] The login screen information sent by the dysphagia improvement support device 100 in response to the login request is received by the communication unit 12. When the login screen information is received by the communication unit 12, the login process ends. The processing unit 16 acquires the login screen information from the communication unit 12. The processing unit 16 causes the display unit 19 to display a login screen (FIG. 3C) based on the acquired login screen information.

[0091] When the operation unit 18 receives an operation in which the user presses the evaluation / diagnosis button EDBU on the login screen (FIG. 3C), the operation unit 18 accepts the operation. The creation unit 14 creates evaluation / diagnosis information including the login ID and information indicating the evaluation / diagnosis based on the operation accepted by the operation unit 18, and transmits the created evaluation / diagnosis information from the communication unit 12 to the dysphagia improvement support device 100.

[0092] The evaluation / diagnosis screen information sent by the dysphagia improvement support device 100 in response to the evaluation / diagnosis information is received by the communication unit 12. The processing unit 16 acquires the evaluation / diagnosis screen information from the communication unit 12. The processing unit 16 causes the display unit 19 to display an evaluation / diagnosis screen (FIG. 3D) based on the acquired evaluation / diagnosis screen information.

[0093] When the operation unit 18 receives an operation where the user presses a button to select the evaluation content regarding swallowing / oral cavity associated with the examinee on the evaluation diagnosis screen (Fig. 3D), the operation unit 18 accepts the operation. The creation unit 14 creates a swallowing function evaluation request including information indicating the examinee No. and the evaluation regarding swallowing / oral cavity based on the operation accepted by the operation unit 18, and transmits the created swallowing function evaluation request from the communication unit 12 to the eating / swallowing disorder improvement support device 100.

[0094] The swallowing function evaluation screen information transmitted by the eating / swallowing disorder improvement support device 100 in response to the swallowing function evaluation request is received by the communication unit 12. The processing unit 16 acquires the swallowing function evaluation screen information from the communication unit 12. Based on the acquired swallowing function evaluation screen information, the processing unit 16 causes the display unit 19 to display the swallowing function evaluation screen (Fig. 3E).

[0095] When the operation unit 18 receives an operation where the user presses any one of a plurality of buttons FSBU for selecting FOIS on the swallowing function evaluation screen (Fig. 3E), an operation of inputting the result of the repeated saliva swallowing test into the box RSBO, an operation of pressing any one of a plurality of buttons MSBU for selecting the revised water drinking test result, and an operation of pressing the registration button REBU, the operation unit 18 accepts the operation. The creation unit 14 creates a swallowing function registration request including information indicating the selection result of the examinee No. FOIS, information indicating the result of the repeated saliva swallowing test, and information indicating the revised water drinking test result based on the operation accepted by the operation unit 18, and transmits the created swallowing function registration request from the communication unit 12 to the eating / swallowing disorder improvement support device 100.

[0096] The aspiration pneumonia risk evaluation screen information transmitted by the eating / swallowing disorder improvement support device 100 in response to the swallowing function registration request is received by the communication unit 12. The processing unit 16 acquires the aspiration pneumonia risk evaluation screen information from the communication unit 12. Based on the acquired aspiration pneumonia risk evaluation screen information, the processing unit 16 causes the display unit 19 to display the aspiration pneumonia risk evaluation screen (Fig. 3F).

[0097] When the operation unit 18 performs an operation of pressing any one of a plurality of buttons OSBU for selecting the amount of saliva in the oral cavity, an operation of pressing any one of a plurality of buttons ORSBU for selecting oral residue, an operation of pressing any one of a plurality of buttons BBSBU for selecting bad breath, an operation of pressing any one of a plurality of buttons CCSBU for selecting conversation clarity, an operation of pressing any one of a plurality of buttons NSSBU for selecting nutritional status, an operation of pressing any one of a plurality of buttons ADSBU for selecting ADL, an operation of pressing any one of a plurality of buttons MESBU for selecting maximum expiratory flow rate, an operation of pressing any one of a plurality of buttons CCSBU for selecting choking or coughing during meals, and an operation of pressing a registration button REBU, it accepts the operation.

[0098] Based on the operation received by the operation unit 18, the creation unit 14 creates a dysphagia pneumonia risk registration request including information indicating the amount of saliva in the oral cavity of the examiner No., information indicating oral residue, information indicating bad breath, information indicating conversation clarity, information indicating nutritional status, information indicating ADL, information indicating maximum expiratory flow rate, and information indicating choking or coughing during meals, and transmits the created dysphagia pneumonia risk registration request from the communication unit 12 to the dysphagia improvement support device 100.

[0099] The sarcopenia evaluation screen information transmitted by the dysphagia improvement support device 100 in response to the dysphagia pneumonia risk registration request is received by the communication unit 12. The processing unit 16 acquires the sarcopenia evaluation screen information from the communication unit 12. Based on the acquired sarcopenia evaluation screen information, the processing unit 16 causes the display unit 19 to display a sarcopenia evaluation screen (FIG. 3G).

[0100] When the operation unit 18 performs an operation of inputting the lower leg circumference into the box LLCBO, an operation of inputting the muscle strength weight into the box MSBO, an operation of inputting the time required for standing up five times into the box NRBO, an operation of selecting a radio button CDSBO for selecting the presence or absence of a disease complicated with dysphagia, and an operation of pressing a registration button REBU on the sarcopenia evaluation screen (FIG. 3G), it accepts the operation.

[0101] Based on the operations received by the operation unit 18, the creation unit 14 creates a sarcopenia registration request including information indicating the lower leg circumference length of the examinee No., information indicating the weight of muscle strength, information indicating the time required for standing up five times, and information indicating the presence or absence of diseases complicated by swallowing disorders, and transmits the created sarcopenia registration request from the communication unit 12 to the eating and swallowing disorder improvement support device 100. The evaluation result screen information transmitted by the eating and swallowing disorder improvement support device 100 in response to the sarcopenia registration request is received by the communication unit 12. The processing unit 16 acquires the evaluation result screen information from the communication unit 12. Based on the acquired evaluation result screen information, the processing unit 16 causes the display unit 19 to display the evaluation result screen (Fig. 3H). When the user performs an operation of pressing the button PCG on the evaluation result screen (Fig. 3H), the operation unit 18 receives the operation.

[0102] Based on the operations received by the operation unit 18, the creation unit 14 creates an individual change graph request including information for graphically displaying the changes in the individual evaluation results of the examinee No., and transmits the created individual change graph request from the communication unit 12 to the eating and swallowing disorder improvement support device 100. The individual change graph screen information transmitted by the eating and swallowing disorder improvement support device 100 in response to the individual change graph request is received by the communication unit 12. The processing unit 16 acquires the individual change graph screen information from the communication unit 12. Based on the acquired individual change graph screen information, the processing unit 16 causes the display unit 19 to display the individual change graph screen (Fig. 3I).

[0103] When the user performs an operation of pressing the rehabilitation guidance button RGBU on the login screen (Fig. 3C), the operation unit 18 receives the operation. Based on the operations received by the operation unit 18, the creation unit 14 creates rehabilitation information including the login ID and information indicating rehabilitation guidance, and transmits the created rehabilitation information from the communication unit 12 to the eating and swallowing disorder improvement support device 100.

[0104] The rehabilitation screen information sent by the dysphagia disorder improvement support device 100 for the rehabilitation information is received by the communication unit 12. The processing unit 16 acquires the rehabilitation screen information from the communication unit 12. Based on the acquired rehabilitation screen information, the processing unit 16 causes the display unit 19 to display a rehabilitation screen (FIG. 4A).

[0105] When the user operates to press the button STBU on the rehabilitation screen (FIG. 4A), the operation unit 18 accepts the operation. The creation unit 14 creates a dysphagia training request including information indicating the login ID and the dysphagia training based on the operation accepted by the operation unit 18, and transmits the created dysphagia training request from the communication unit 12 to the dysphagia disorder improvement support device 100. The dysphagia training screen information sent by the dysphagia disorder improvement support device 100 for the dysphagia training request is received by the communication unit 12. The processing unit 16 acquires the dysphagia training screen information from the communication unit 12. Based on the acquired dysphagia training screen information, the processing unit 16 causes the display unit 19 to display a dysphagia training screen (FIG. 4B).

[0106] When the user operates to press any one of the plurality of buttons SSBU on the dysphagia training screen (FIG. 4B), the operation unit 18 accepts the operation. The creation unit 14 creates a dysphagia training selection request including information indicating the login ID and the symptom selected by pressing the button based on the operation accepted by the operation unit 18, and transmits the created dysphagia training selection request from the communication unit 12 to the dysphagia disorder improvement support device 100. The dysphagia training selection screen information sent by the dysphagia disorder improvement support device 100 for the dysphagia training selection request is received by the communication unit 12. The processing unit 16 acquires the dysphagia training selection screen information from the communication unit 12. Based on the acquired dysphagia training selection screen information, the processing unit 16 causes the display unit 19 to display a dysphagia training selection screen (FIGS. 4C to 4G).

[0107] The operation unit 18 accepts an operation when the user presses any one of a plurality of buttons ITBU-1, button ITBU-2, a plurality of buttons ITBU-3, button ITBU-4, and button ITBU-5 on the swallowing training selection screen (Figs. 4C to 4G). The creation unit 14 creates a swallowing training information request including information indicating the login ID and the swallowing training selected by pressing the button based on the operation accepted by the operation unit 18, and transmits the created swallowing training information request from the communication unit 12 to the dysphagia improvement support device 100. The swallowing training information screen information transmitted by the dysphagia improvement support device 100 in response to the swallowing training information request is received by the communication unit 12. The processing unit 16 acquires the swallowing training information screen information from the communication unit 12. The processing unit 16 causes the display unit 19 to display a swallowing training information screen (Figs. 5A to 5M) based on the acquired swallowing training information screen information.

[0108] The operation unit 18 accepts an operation when the user presses the button RRBU on the rehabilitation screen (Fig. 4A). The creation unit 14 creates a respiration rehabilitation request including information indicating the login ID and respiration rehabilitation based on the operation accepted by the operation unit 18, and transmits the created respiration rehabilitation request from the communication unit 12 to the dysphagia improvement support device 100. The respiration rehabilitation screen information transmitted by the dysphagia improvement support device 100 in response to the respiration rehabilitation request is received by the communication unit 12. The processing unit 16 acquires the respiration rehabilitation screen information from the communication unit 12. The processing unit 16 causes the display unit 19 to display a respiration rehabilitation screen (Fig. 6A) based on the acquired respiration rehabilitation screen information.

[0109] When the operation unit 18 receives an operation where the user presses any one of a plurality of buttons BREXBU on the respiratory rehabilitation screen, the creation unit 14 creates a respiratory rehabilitation information request including the login ID and the type-of-exercise information selected by the button being pressed based on the operation received by the operation unit 18, and transmits the created respiratory rehabilitation information request from the communication unit 12 to the dysphagia improvement support device 100. The respiratory rehabilitation exercise screen information transmitted by the dysphagia improvement support device 100 in response to the respiratory rehabilitation exercise information request is received by the communication unit 12. The processing unit 16 acquires the respiratory rehabilitation exercise screen information from the communication unit 12. Based on the acquired respiratory rehabilitation exercise screen information, the processing unit 16 causes the display unit 19 to display the respiratory rehabilitation exercise screen (Figs. 6B to 6N).

[0110] When the operation unit 18 receives an operation where the user presses the button SRBU on the rehabilitation screen (Fig. 4A), the creation unit 14 creates a sarcopenia rehabilitation request including the login ID and information indicating sarcopenia based on the operation received by the operation unit 18, and transmits the created sarcopenia rehabilitation request from the communication unit 12 to the dysphagia improvement support device 100. The sarcopenia rehabilitation screen information transmitted by the dysphagia improvement support device 100 in response to the sarcopenia rehabilitation request is received by the communication unit 12. The processing unit 16 acquires the sarcopenia rehabilitation screen information from the communication unit 12. Based on the acquired sarcopenia rehabilitation screen information, the processing unit 16 causes the display unit 19 to display the sarcopenia rehabilitation screen (Fig. 7A).

[0111] When the operation unit 18 receives an operation where the user presses any one of a plurality of buttons SREXBU on the sarcopenia rehabilitation screen, the creation unit 14 creates a sarcopenia rehabilitation information request including the login ID and the exercise type information selected by pressing the button based on the operation received by the operation unit 18, and transmits the created sarcopenia rehabilitation information request from the communication unit 12 to the dysphagia improvement support device 100. The sarcopenia rehabilitation exercise screen information transmitted by the dysphagia improvement support device 100 in response to the sarcopenia rehabilitation information request is received by the communication unit 12. The processing unit 16 acquires the sarcopenia rehabilitation exercise screen information from the communication unit 12. Based on the acquired sarcopenia rehabilitation exercise screen information, the processing unit 16 causes the display unit 19 to display the sarcopenia rehabilitation exercise screen (Figs. 7B to 7L).

[0112] When the operation unit 18 receives an operation where the user presses the button PRBU on the rehabilitation screen (Fig. 4A), the creation unit 14 creates a preventive rehabilitation request including the login ID and information indicating preventive rehabilitation based on the operation received by the operation unit 18, and transmits the created preventive rehabilitation request from the communication unit 12 to the dysphagia improvement support device 100. The preventive rehabilitation screen information transmitted by the dysphagia improvement support device 100 in response to the preventive rehabilitation request is received by the communication unit 12. The processing unit 16 acquires the preventive rehabilitation screen information from the communication unit 12. Based on the acquired preventive rehabilitation screen information, the processing unit 16 causes the display unit 19 to display the preventive rehabilitation screen (Fig. 8A).

[0113] When the operation unit 18 receives an operation where the user presses any one of the plurality of buttons PRBU on the preventive rehabilitation screen (Fig. 8A), the creation unit 14 creates a preventive rehabilitation information request including the login ID and the category information selected by pressing the button based on the operation received by the operation unit 18, and transmits the created preventive rehabilitation information request from the communication unit 12 to the dysphagia improvement support device 100. The preventive rehabilitation exercise screen information transmitted by the dysphagia improvement support device 100 in response to the preventive rehabilitation information request is received by the communication unit 12. The processing unit 16 acquires the preventive rehabilitation exercise screen information from the communication unit 12. Based on the acquired preventive rehabilitation exercise screen information, the processing unit 16 causes the display unit 19 to display the preventive rehabilitation exercise screen (Figs. 8B to 8F).

[0114] When the operation unit 18 receives an operation where the user presses the meal guidance button MGBU on the login screen (Fig. 3C), the creation unit 14 creates meal guidance information including the login ID and information indicating meal guidance based on the operation received by the operation unit 18, and transmits the created meal guidance information from the communication unit 12 to the dysphagia improvement support device 100. The meal guidance screen information transmitted by the dysphagia improvement support device 100 in response to the meal guidance information is received by the communication unit 12. The processing unit 16 acquires the meal guidance screen information from the communication unit 12. Based on the acquired meal guidance screen information, the processing unit 16 causes the display unit 19 to display the meal guidance screen (Fig. 9A).

[0115] When the operation unit 18 receives an operation where the user presses any one of the plurality of buttons FMBU on the meal guidance screen (Fig. 9A), the creation unit 14 creates a meal guidance information request including the login ID and the category information selected by pressing the button based on the operation received by the operation unit 18, and transmits the created meal guidance information request from the communication unit 12 to the dysphagia improvement support device 100. The dietary guidance exercise screen information transmitted by the swallowing disorder improvement support device 100 in response to the dietary guidance information request is received by the communication unit 12. The processing unit 16 acquires the dietary guidance exercise screen information from the communication unit 12. Based on the acquired dietary guidance exercise screen information, the processing unit 16 causes the display unit 19 to display a dietary guidance exercise screen (Figs. 9B to 9D).

[0116] The creation unit 14, the processing unit 14, and the operation unit 18 are realized, for example, by a hardware processor such as a CPU executing a computer program (software) stored in the storage unit 110. Also, some or all of these functional units may be realized by hardware (including circuitry such as LSI, ASIC, FPGA, GPU), or may be realized by cooperation between software and hardware. The computer program may be stored in advance in a storage device such as an HDD or a flash memory, or may be stored in a removable storage medium such as a DVD or a CD-ROM, and may be installed by mounting the storage medium on a drive device.

[0117] (Operation of the Swallowing Disorder Improvement Support System 1) Figs. 10 to 12 are diagrams showing an example of the operation of the swallowing disorder improvement support system 1 according to the present embodiment. (Step S1-1) A login process is performed between the terminal device 10 and the swallowing disorder improvement support device 100. The explanation continues for the case where the login process is successful. (Step S2-1) The swallowing disorder improvement support device 100 creates login screen information. (Step S3-1) The swallowing disorder improvement support device 100 transmits the login screen information to the terminal device 10. (Step S4-1) The terminal device 10 displays the login screen. (Step S5-1) The terminal device 10 creates evaluation diagnosis information.

[0118] (Step S6-1) The terminal device 10 transmits the evaluation diagnosis information to the dysphagia improvement support device 100. (Step S7-1) The dysphagia improvement support device 100 creates evaluation diagnosis screen information. (Step S8-1) The dysphagia improvement support device 100 transmits the evaluation diagnosis screen information to the terminal device 10. (Step S9-1) The terminal device 10 displays the evaluation diagnosis screen. (Step S10-1) The terminal device 10 creates a dysphagia function evaluation request. (Step S11-1) The terminal device 10 transmits the dysphagia function evaluation request to the dysphagia improvement support device 100. The description will continue with reference to FIG. 11.

[0119] (Step S1-2) The dysphagia improvement support device 100 creates dysphagia function evaluation screen information. (Step S2-2) The dysphagia improvement support device 100 transmits the dysphagia function evaluation screen information to the terminal device 10. (Step S3-2) The terminal device 10 displays the dysphagia function evaluation screen. (Step S4-2) The terminal device 10 creates a dysphagia function registration request. (Step S5-2) The terminal device 10 transmits the dysphagia function registration request to the dysphagia improvement support device 100. (Step S6-2) The dysphagia improvement support device 100 registers the dysphagia function.

[0120] (Step S7-2) The dysphagia improvement support device 100 creates aspiration pneumonia risk assessment screen information. (Step S8-2) The dysphagia improvement support device 100 transmits the aspiration pneumonia risk assessment screen information to the terminal device 10. (Step S9-2) The terminal device 10 displays the aspiration pneumonia risk assessment screen. (Step S10-2) The terminal device 10 creates an aspiration pneumonia risk registration request. (Step S11-2) The terminal device 10 transmits a request for registering the risk of aspiration pneumonia to the dysphagia improvement support device 100. (Step S12-2) The dysphagia improvement support device 100 registers the risk of aspiration pneumonia. This will be further described with reference to FIG. 12.

[0121] (Step S1-3) The dysphagia improvement support device 100 creates sarcopenia evaluation screen information. (Step S2-3) The dysphagia improvement support device 100 transmits the sarcopenia evaluation screen information to the terminal device 10. (Step S3-3) The terminal device 10 displays the sarcopenia evaluation screen. (Step S4-3) The terminal device 10 creates a sarcopenia registration request. (Step S5-3) The terminal device 10 transmits the sarcopenia registration request to the dysphagia improvement support device 100. (Step S6-3) The dysphagia improvement support device 100 registers sarcopenia. (Step S7-3) The dysphagia improvement support device 100 determines the possibility of dysphagia, the risk of aspiration pneumonia, and the possibility of sarcopenia, and derives a countermeasure for improving dysphagia.

[0122] (Step S8-3) The dysphagia improvement support device 100 creates evaluation result screen information. (Step S9-3) The dysphagia improvement support device 100 transmits the evaluation result screen information to the terminal device 10. (Step S10-3) The terminal device 10 displays the evaluation result screen. (Step S11-3) The terminal device 10 creates a personal change graph request. (Step S12-3) The terminal device 10 transmits the personal change graph request to the dysphagia improvement support device 100. (Step S13-3) The dysphagia improvement support device 100 creates personal change graph screen information. (Step S14-3) The dysphagia improvement support device 100 transmits the personal change graph screen information to the terminal device 10. (Step S15-3) The terminal device 10 displays the personal change graph screen.

[0123] Figs. 13A to 13B are diagrams showing an example of the operation of the dysphagia improvement support system 1 according to the present embodiment. With reference to Figs. 13A to 13B, the details of the process for deriving the measures for improving dysphagia in step S7-3 of Fig. 12 will be described. (Step S1-4) The derivation unit 105 acquires the determination result (evaluation result) of the possibility of dysphagia, acquires the determination result (evaluation result) of the possibility of aspiration pneumonia risk, and acquires the determination result (evaluation result) of the possibility of sarcopenia. (Step S2-4) The derivation unit 105 determines whether there is a possibility of dysphagia based on the evaluation result of the possibility of dysphagia. For example, the derivation unit 105 determines that there is a possibility of dysphagia when the FOIS level is 1 to 4. (Step S3-4) When there is a possibility of dysphagia, the derivation unit 105 determines whether there is no risk of aspiration pneumonia. For example, the derivation unit 105 determines that there is no possibility of aspiration pneumonia risk when the total of iEALD is 2 or less. (Step S4-4) When there is no possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is no possibility of sarcopenia. (Step S5-4) When there is no possibility of sarcopenia, the derivation unit 105 derives swallowing training as a measure for improving dysphagia.

[0124] (Step S6-4) When there is no possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is a possibility of sarcopenia. (Step S7-4) When there is a possibility of sarcopenia and there is an obvious swallowing function decline disease, the derivation unit 105 derives swallowing training and sarcopenia rehabilitation as measures for improving dysphagia. (Step S8-4) When there is a possibility of sarcopenia and no obvious swallowing function decline disease, the derivation unit 105 derives swallowing training and sarcopenia rehabilitation as countermeasures to improve dysphagia.

[0125] (Step S9-4) When there is a possibility of dysphagia, the derivation unit 105 determines whether there is a risk of aspiration pneumonia. For example, when the total of iEALD is 3 or more, the derivation unit 105 determines that there is a possibility of aspiration pneumonia risk. (Step S10-4) When there is a possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is no possibility of sarcopenia. (Step S11-4) When there is no possibility of sarcopenia, the derivation unit 105 derives swallowing training and respiratory rehabilitation as countermeasures to improve dysphagia.

[0126] (Step S12-4) When there is a possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is a possibility of sarcopenia. (Step S13-4) When there is a possibility of sarcopenia and there is an obvious swallowing function decline disease, the derivation unit 105 derives swallowing training, respiratory rehabilitation and sarcopenia rehabilitation as countermeasures to improve dysphagia. (Step S14-4) When there is a possibility of sarcopenia and no obvious swallowing function decline disease, the derivation unit 105 derives swallowing training, respiratory rehabilitation and sarcopenia rehabilitation as countermeasures to improve dysphagia. Continue the explanation with reference to FIG. 13B.

[0127] (Step S1-5) The derivation unit 105 obtains the determination result (evaluation result) of the possibility of dysphagia, obtains the determination result (evaluation result) of the possibility of aspiration pneumonia risk, and obtains the determination result (evaluation result) of the possibility of sarcopenia. (Step S2-5) The derivation unit 105 determines whether there is no possibility of dysphagia based on the evaluation result of the possibility of dysphagia. For example, when the FOIS level is 5 to 7, the derivation unit 105 determines that there is no possibility of dysphagia. (Step S3-5) When it is determined that there is no possibility of dysphagia, the derivation unit 105 determines whether the repeated saliva swallowing test is 2 or less or the revised water drinking test is rated 3 or less. (Step S4-5) When the repeated saliva swallowing test is 2 or less or the revised water drinking test is rated 3 or less, the derivation unit 105 determines whether there is a risk of aspiration pneumonia. For example, when the total of iEALD is 3 or more, the derivation unit 105 determines that there is a possibility of aspiration pneumonia risk. (Step S5-5) When there is a possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is no possibility of sarcopenia. (Step S6-5) When there is no possibility of sarcopenia, the derivation unit 105 derives swallowing training and respiratory rehabilitation as measures to improve feeding dysphagia.

[0128] (Step S7-5) When there is a possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is a possibility of sarcopenia. (Step S8-5) When there is a possibility of sarcopenia, the derivation unit 105 derives swallowing training, respiratory rehabilitation, and sarcopenia rehabilitation as measures to improve feeding dysphagia. (Step S9-5) When the repeated saliva swallowing test is 2 or less or the revised water drinking test is rated 3 or less, the derivation unit 105 determines whether there is no risk of aspiration pneumonia. For example, when the total of iEALD is 2 or less, the derivation unit 105 determines that there is no possibility of aspiration pneumonia risk. (Step S10-5) When there is no possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is no possibility of sarcopenia. (Step S11-5) When there is no possibility of sarcopenia, the derivation unit 105 derives swallowing training and respiratory rehabilitation as measures to improve feeding dysphagia. (Step S12-5) The derivation unit 105 determines whether there is a possibility of sarcopenia when there is no possibility of aspiration pneumonia. (Step S13-5) When there is a possibility of sarcopenia, the derivation unit 105 derives swallowing training and sarcopenia rehabilitation as countermeasures for improving dysphagia.

[0129] (Step S14-5) When neither the repetitive saliva swallowing test is 2 or less nor the revised water drinking test is rated 3 or less, the derivation unit 105 determines whether there is a risk of aspiration pneumonia. For example, when the total of iEALD is 3 or more, the derivation unit 105 determines that there is a possibility of aspiration pneumonia risk. (Step S15-5) When there is a possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is no possibility of sarcopenia. (Step S16-5) When there is no possibility of sarcopenia, the derivation unit 105 derives respiratory rehabilitation as a countermeasure for improving dysphagia. (Step S17-5) When there is a possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is a possibility of sarcopenia. (Step S18-5) When there is a possibility of sarcopenia, the derivation unit 105 derives respiratory rehabilitation and sarcopenia rehabilitation as countermeasures for improving dysphagia.

[0130] (Step S19-5) When neither the repetitive saliva swallowing test is 2 or less nor the revised water drinking test is rated 3 or less, the derivation unit 105 determines whether there is no risk of aspiration pneumonia. For example, when the total of iEALD is 2 or less, the derivation unit 105 determines that there is no possibility of aspiration pneumonia risk. (Step S20-5) When there is no possibility of aspiration pneumonia risk, the derivation unit 105 determines whether there is no possibility of sarcopenia. (Step S21-5) When there is no possibility of sarcopenia, the derivation unit 105 derives preventive rehabilitation as a countermeasure for improving dysphagia. (Step S22-5) The derivation unit 105 determines whether there is a possibility of sarcopenia when there is no possibility of aspiration pneumonia risk. (Step S23-5) When there is a possibility of sarcopenia, the derivation unit 105 derives sarcopenia rehabilitation as a measure to improve swallowing disorders related to eating.

[0131] In the above-described embodiment, the case where the swallowing disorder improvement support system 1 includes one terminal device 10 has been described, but the present invention is not limited to this example. For example, the swallowing disorder improvement support system 1 may include a plurality of terminal devices 10. In the above-described embodiment, the case where the swallowing disorder improvement support system 1 includes one swallowing disorder improvement support device 100 has been described, but the present invention is not limited to this example. For example, the functions of the swallowing disorder improvement support device 100 may be realized by a plurality of devices. In the above-described embodiment, as an example, the case where the swallowing disorder improvement support device 100 registers the evaluation results of the swallowing function, the evaluation results of the aspiration pneumonia risk, and the evaluation results of sarcopenia in this order has been described. However, the present invention is not limited to this example, and registration may be performed in any order.

[0132] In the above-described embodiment, the case where an examiner is registered has been described. Here, the process of registering an examiner will be described. When the user presses the newly added button NABU for newly adding an examiner on the evaluation diagnosis screen (FIG. 3D), the operation unit 18 accepts the operation. The creation unit 14 creates a new examiner addition request including information for newly adding an examiner based on the operation accepted by the operation unit 18, and transmits the created new examiner addition request from the communication unit 12 to the swallowing disorder improvement support device 100.

[0133] The communication unit 101 receives a new addition request for an examinee sent by the terminal device 10. The creation unit 104 acquires the new addition request for an examinee from the communication unit 101, and creates examinee registration screen information for causing the terminal device 10 to display an examinee registration screen based on information for newly adding the examinee included in the acquired new addition request for an examinee. The creation unit 104 transmits the created examinee registration screen information from the communication unit 101 to the terminal device 10.

[0134] FIG. 14 is a diagram showing an example of an examinee registration screen. The examinee registration screen includes a box MENBO for inputting an examinee number, a box NBO for inputting a name, a box FBO for inputting furigana, a gender selection column, a pull-down menu for inputting a date of birth, a box DNBO for inputting a disease name, a selection column for inpatient or outpatient, and a registration button REBU.

[0135] When the operation unit 18 receives an operation in which a user inputs examinee information such as an examinee number, name, furigana, gender, date of birth, disease name, inpatient or outpatient on the examinee registration screen and an operation of pressing the registration button REBU, the operation unit 18 accepts the operation. The creation unit 14 creates an examinee registration request including a login ID and examinee information based on the operation accepted by the operation unit 18, and transmits the created examinee registration request from the communication unit 12 to the dysphagia improvement support device 100. The dysphagia improvement support device 100 receives the examinee registration request sent by the terminal device 10 and registers it in the storage unit 110.

[0136] In the above-described embodiment, the process of displaying a list of user information will be described. When the operation unit 18 receives an operation in which a user performs a predetermined operation for displaying a list of user information, the operation unit 18 accepts the operation. The creation unit 14 creates a user information list request including information for displaying a list of user information based on the operation accepted by the operation unit 18, and transmits the created user information list request from the communication unit 12 to the dysphagia improvement support device 100.

[0137] The communication unit 101 receives the user information list request transmitted by the terminal device 10. The creation unit 104 acquires the user information list request from the communication unit 101, and creates user information list screen information for causing the terminal device 10 to display a user information list screen based on the acquired user information list request. The creation unit 104 transmits the created user information list screen information from the communication unit 101 to the terminal device 10.

[0138] FIG. 15 is a diagram showing an example of a user information list screen. The user information list screen includes the names of one or more persons in charge, and for each of the names of the one or more persons in charge, an ID, a classification, a registration date, a date of the last login, a button to be pressed when editing, and a box to be checked when deleting. Further, the user information list screen includes a button SUBU to be pressed when newly registering a user. When the user performs an operation of pressing the button SUBU on the user information list screen, the operation unit 18 receives the operation. The creation unit 14 creates a user new registration request including information for newly registering a user based on the operation received by the operation unit 18, and transmits the created user new registration request from the communication unit 12 to the dysphagia improvement support device 100.

[0139] The communication unit 101 receives the user new registration request transmitted by the terminal device 10. The creation unit 104 acquires the user new registration request from the communication unit 101, and creates user registration screen information for causing the terminal device 10 to display a user registration screen based on the acquired user new registration request. The creation unit 104 transmits the created user registration screen information from the communication unit 101 to the terminal device 10.

[0140] FIG. 16 is a diagram showing an example of a user registration screen. The user registration screen includes a box NBO for entering a name, a box FBO for entering a furigana, a box IDBO for entering an ID, a box PWBO for entering a password, a selection column for classification, a button REDBU to be pressed when registering and moving to an evaluation diagnosis screen, and a registration button REBU.

[0141] When the operation unit 18 receives an operation where the user inputs user information such as name, kana, ID, password, and category, and presses the registration button REBU on the user registration screen, the operation unit 18 accepts the operation. The creation unit 14 creates a user registration request including the login ID and user information based on the operation accepted by the operation unit 18, and transmits the created user registration request from the communication unit 12 to the dysphagia improvement support device 100. The dysphagia improvement support device 100 receives the user registration request transmitted by the terminal device 10 and registers it in the storage unit 110.

[0142] In the above-described embodiment, a meal evaluation may be performed. FIG. 17 is a diagram showing an example of a meal content setting screen. An example of the meal content setting screen may be included in the swallowing function evaluation screen (FIG. 3E) or may be displayed individually. The meal content setting screen includes a selection column for selecting whether or not a meal has been taken.

[0143] When the operation unit 18 receives an operation where the user inputs into the selection column for selecting whether or not a meal has been taken on the meal content setting screen, the operation unit 18 accepts the operation. The creation unit 14 creates a meal intake registration request including the login ID and information indicating whether or not a meal has been taken based on the operation accepted by the operation unit 18, and transmits the created meal intake registration request from the communication unit 12 to the dysphagia improvement support device 100.

[0144] FIG. 18 is a diagram showing an example of a meal content setting screen. An example of the meal content setting screen may be included in the swallowing function evaluation screen (FIG. 3E) or may be displayed individually. The meal content setting screen includes a selection column for selecting whether the chewing situation is such that the food can be chewed and ground with the teeth or the food cannot be bitten and ground.

[0145] When the operation unit 18 receives an operation where the user presses a selection bar for selecting whether the chewing situation can chew and crush food with teeth or cannot chew and crush food on the meal content setting screen, the operation unit 18 accepts the operation. The creation unit 14 creates a meal intake registration request including information indicating the login ID and the chewing situation based on the operation accepted by the operation unit 18, and transmits the created meal intake registration request from the communication unit 12 to the dysphagia improvement support device 100.

[0146] In the dysphagia improvement support device 100, the creation unit 104 creates meal evaluation screen information for causing the terminal device 10 to display a meal evaluation screen based on the information indicating the presence or absence of meal intake included in the meal intake registration request and the information indicating the chewing situation included in the meal intake registration request. The creation unit 104 transmits the created meal evaluation screen information to the terminal device 10. The terminal device 10 receives the meal evaluation screen information transmitted by the dysphagia improvement support device 100 and displays a meal evaluation screen (not shown). In addition to the information indicating the presence or absence of meal intake and the information indicating the chewing situation, the creation unit 104 may create meal evaluation screen information for causing the terminal device 10 to display a meal evaluation screen based on the revised water drinking test result, the repeated saliva swallowing test result, and the aspiration pneumonia risk evaluation result.

[0147] According to the dysphagia improvement support system 1 according to the present embodiment, the dysphagia improvement support device 1 includes a dysphagia function evaluation information reception unit 102-1 that receives dysphagia function evaluation information for evaluating the swallowing function, a mis-swallowing pneumonia risk evaluation information reception unit 102-2 that receives mis-swallowing pneumonia risk evaluation information for evaluating the risk of mis-swallowing pneumonia, a sarcopenia evaluation information reception unit 102-3 that receives sarcopenia evaluation information for evaluating sarcopenia, a dysphagia disorder determination unit 103-1 that determines whether there is a dysphagia disorder based on the dysphagia function evaluation information, a mis-swallowing pneumonia risk determination unit 103-2 that determines whether there is a risk of mis-swallowing pneumonia based on the mis-swallowing pneumonia risk evaluation information, a sarcopenia possibility determination unit 103-3 that determines whether there is a possibility of sarcopenia based on the sarcopenia evaluation information, and a derivation unit 105 that derives a countermeasure for improving the dysphagia based on the determination result of whether there is a dysphagia disorder by the dysphagia disorder determination unit 103-1, the determination result of whether there is a risk of mis-swallowing pneumonia by the mis-swallowing pneumonia risk determination unit 103-2, and the determination result of whether there is a possibility of sarcopenia by the sarcopenia possibility determination unit 103-3.

[0148] Also, in the dysphagia improvement support device 1, the derivation unit 105 derives a rehabilitation menu. Also, in the dysphagia improvement support device 1, a selection unit 107 that selects dietary guidance is further provided based on the determination result of whether there is a dysphagia disorder by the dysphagia disorder determination unit 103-1 and the determination result of whether there is a risk of mis-swallowing pneumonia by the mis-swallowing pneumonia risk determination unit 103-2. Also, in the dysphagia improvement support device 1, the dysphagia disorder determination unit 103-1 determines whether there is a dysphagia disorder based on the level of phios, the result of the repetitive saliva swallowing test, and the result of the revised water drinking test included in the dysphagia function evaluation information. Also, in the dysphagia improvement support device 1, the mis-swallowing pneumonia risk determination unit 103-2 determines whether there is a risk of mis-swallowing pneumonia based on the local findings, general findings, result of the repetitive saliva swallowing test, and result of the revised water drinking test included in the mis-swallowing pneumonia risk evaluation form. In addition, in the feeding and swallowing disorder improvement support device 1, the sarcopenia possibility determination unit 103-3 determines whether there is a possibility of sarcopenia based on information indicating the circumference of the lower leg and information indicating muscle strength.

[0149] By configuring it in this way, with a system that has been ICT (Information and Communication Technology) enabled, anyone other than professionals can implement appropriate evaluation and rehabilitation menus for feeding and swallowing disorders and sarcopenia. The feeding and swallowing disorder improvement support system 1 can implement appropriate rehabilitation even in situations where rehabilitation interveners are restricted due to home visit medical care without professionals or infectious diseases such as COVID-19. In addition, since the feeding and swallowing disorder improvement support system 1 can be easily evaluated, it can be used for purposes such as swallowing disorder risk assessment, rehabilitation consultation, and diet consultation in health consultations held in the community.

[0150] In addition, in order to enable seamless rehabilitation from the acute phase to the recovery phase and home life, rehabilitation using ICT was developed. The algorithm of the rehabilitation system was configured based on three points: (1) evaluation and diagnosis, (2) rehabilitation guidance, and (3) diet guidance. (1) Evaluation and diagnosis performed three evaluations: swallowing function evaluation, sarcopenia diagnosis, and aspiration pneumonia risk assessment. (2) For rehabilitation guidance, a rehabilitation program was created based on existing programs according to symptoms. The content of the rehabilitation program was a comprehensive respiration and swallowing rehabilitation program based on the evaluation in (1). (3) For setting the diet content, a program was created in which an appropriate diet form can be selected from the algorithm based on i-EALD performed in the aspiration pneumonia evaluation. It becomes possible to perform rehabilitation by using this system by anyone other than rehabilitation technical staff (speech therapists). It is possible for the patient himself / herself to perform rehabilitation according to the symptoms. Since it is possible to accumulate evaluation data, it is possible to objectively grasp the changes in the state.

[0151] With the swallowing disorder improvement support system 1, it has become possible to provide appropriate rehabilitation for patients with swallowing disorders in hospitals where there are no rehabilitation technicians. It has become possible to propose the provision of an appropriate diet form based on a functional evaluation, and to propose an appropriate diet form at an early stage. Since it is also possible to evaluate sarcopenia, it has become possible to evaluate sarcopenia before surgery and to evaluate the risk of postoperative aspiration pneumonia due to sarcopenia at an early stage, enabling the proposal of proactive respiratory rehabilitation from before surgery and the prevention of postoperative pneumonia. There has been no developed swallowing disorder prevention program utilizing ICT, and there is no research verifying its effectiveness and safety. This system can be applied to hospitals without rehabilitation specialists and to a wide range of diseases such as frail patients and sarcopenia patients at risk of recurrent pneumonia, and a high dissemination effect is expected.

[0152] Although the embodiments of the present invention have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the gist of the invention. The embodiments are included in the scope and gist of the invention, and are also included in the invention described in the claims and its equivalent scope.

[0153] Note that the above-described swallowing disorder improvement support device 100 may be realized by a computer. In that case, a program for realizing the functions of each functional block is recorded on a computer-readable recording medium. The program recorded on this recording medium may be read into a computer system and realized by the CPU (arithmetic processing unit) executing it. Here, the "computer system" shall include hardware such as an OS (Operating System) and peripheral devices. Also, the "computer-readable recording medium" refers to a portable medium such as a flexible disk, a magneto-optical disk, a ROM, a CD-ROM, etc. Also, the "computer-readable recording medium" includes a storage device such as a hard disk built into the computer system.

[0154] Here, a computer-readable recording medium refers to a magnetic disk, magneto-optical disk, CD-ROM, DVD-ROM, semiconductor memory, etc. Also, this computer program may be distributed to a computer via a communication line, and the computer that has received this distribution may execute the program. Further, the computer-readable recording medium may include those that hold a program dynamically for a short period of time. Those that hold a program dynamically for a short period of time are, for example, communication lines when transmitting a program via a network such as the Internet or a communication line such as a telephone line.

[0155] Also, the "computer-readable recording medium" may include those that hold a program for a certain period of time, such as volatile memory inside a computer system serving as a server or a client. Also, the above program may be for realizing a part of the functions described above. Also, the above program may be one that can be realized in combination with a program already recorded in the computer system for the functions described above. Also, the above program may be realized using a programmable logic device. A programmable logic device is, for example, an FPGA. Also, the above program may be for realizing a part of the functions described above. Furthermore, it may be a so-called difference file (difference program) that can be realized in combination with a program already recorded in the computer system for the functions described above.

Explanation of Signs

[0156] 1... Feeding and swallowing disorder improvement support system, 10... Terminal device, 12... Communication unit, 14... Creation unit, 15... Memory unit, 16... Processing unit, 18... Operation unit, 19... Display unit, 100... Feeding and swallowing disorder improvement support device, 101... Communication unit, 102-1... Swallowing function evaluation information reception unit, 102-2... Aspiration pneumonia risk evaluation information reception unit, 102-3... Sarcopenia evaluation information reception unit, 103-1... Swallowing disorder determination unit, 103-2... Aspiration pneumonia risk determination unit, 103-3... Sarcopenia possibility determination unit, 104... Creation unit, 105... Derivation unit, 106... Connection processing unit, 107... Selection unit, 110... Memory unit

Claims

1. A dysphagia function evaluation information receiving unit that receives dysphagia function evaluation information for evaluating a swallowing function; A risk of aspiration pneumonia risk evaluation information receiving unit that receives risk of aspiration pneumonia risk evaluation information for evaluating a risk of aspiration pneumonia; A sarcopenia evaluation information receiving unit that receives sarcopenia evaluation information for evaluating sarcopenia; A dysphagia disorder determination unit that determines whether there is a dysphagia disorder based on the dysphagia function evaluation information; An aspiration pneumonia risk determination unit that determines whether there is a risk of aspiration pneumonia based on the aspiration pneumonia risk evaluation information; A sarcopenia possibility determination unit that determines whether there is a possibility of sarcopenia based on the sarcopenia evaluation information; A derivation unit that derives a measure for improving dysphagia based on the determination result of whether there is a dysphagia disorder by the dysphagia disorder determination unit, the determination result of whether there is a risk of aspiration pneumonia by the aspiration pneumonia risk determination unit, and the determination result of whether there is a possibility of sarcopenia by the sarcopenia possibility determination unit A dysphagia improvement support system comprising:

2. The system according to claim 1, wherein the derivation unit derives a rehabilitation menu.

3. The dysphagia improvement support system according to claim 1, further comprising a selection unit that selects dietary guidance based on the determination result of whether there is a dysphagia disorder by the dysphagia disorder determination unit and the determination result of whether there is a risk of aspiration pneumonia by the aspiration pneumonia risk determination unit

4. The dysphagia improvement support system according to claim 1, wherein the dysphagia disorder determination unit determines whether there is a dysphagia disorder based on the level of phios, the result of the repetitive saliva swallowing test, and the result of the revised water drinking test included in the dysphagia function evaluation information.

5. The dysphagia improvement support system according to claim 1, wherein the aspiration pneumonia risk determination unit determines whether there is a risk of aspiration pneumonia based on local findings, general findings, the result of the repetitive saliva swallowing test, and the result of the revised water drinking test included in the aspiration pneumonia risk evaluation form.

6. The dysphagia improvement support system according to claim 1, wherein the sarcopenia possibility determination unit determines whether there is a possibility of sarcopenia based on information indicating the circumference of the lower leg and information indicating muscle strength.

7. A step of receiving dysphagia function evaluation information for evaluating a swallowing function; A step of receiving aspiration pneumonia risk evaluation information for evaluating a risk of aspiration pneumonia; ​ A step of receiving sarcopenia evaluation information for evaluating sarcopenia; A step of determining whether there is a swallowing disorder based on the swallowing function evaluation information; A step of determining whether there is a risk of aspiration pneumonia based on the aspiration pneumonia risk evaluation information; A step of determining whether there is a possibility of sarcopenia based on the sarcopenia evaluation information; A step of deriving a measure for improving dysphagia based on the determination result of whether there is a swallowing disorder, the determination result of whether there is a risk of aspiration pneumonia, and the determination result of whether there is a possibility of sarcopenia; A method for assisting in improving dysphagia, which is executed by a computer and includes the above steps.

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