Post-injury rotation contractures of the forearm significantly interfere with various activities of daily living, such as washing the face, receiving change, or wiping a desk, and cause distress to patients. The Colello-Abraham dynamic pronation-supination splint is useful for rotation contractures of the forearm；however, the device includes several small parts and a complicated structure, and assembling the appliance requires technical expertise. Here, we report a case of rotation contracture of the forearm that improved following the use of a simple dynamic splint.

This report describes a case of an amputee with a lumber spinal cord injury who successfully recovered ambulation with the use of prosthesis.

A 30-year-old man with schizophrenia underwent amputation of the lower legs and concurrently developed lumbar spinal cord injury from of a suicide attempt. After the treatment of stump plasty and posterior fusion, the patient was transferred to our facility. Lower-extremity prostheses for both legs were fitted, and orthostatic training was commenced following admission. During the initial evaluation, the patient could not maintain a stable standing position because of weakness in the hip extensor muscle. An inflexion angle of the prosthesis was set to 0° to extend the knee joint and achieve standing stability. Appropriate adjustments of the prosthesis were made as required, specifically addressing the paraplegia caused by his lumbar spinal cord injury. Thus, the patient successfully regained ambulation with the treatment.

Recovering walking independence after bilateral lower leg amputations or paraplegia caused by lumber spinal cord injury is not uncommon. However, this case is unique in that the muscle weakness caused by lumbar spinal cord injury presented unforeseen difficulties for the patient to achieve ambulation, which is not ordinarily observed in amputation rehabilitation cases. No similar cases have been reported in which patients concurrently suffered from both these conditions in Japan；therefore, this case is extremely rare.

Welwalk WW-1000^® (WW-1000^®) is a gait exercise-assisted robot. Suitable assistance was provided to the patients with hemiplegic legs in both stance and swing phases. In addition，this robot offers various forms of feedback to patients during exercise. We present the case of a patient with multiple sclerosis and left hemiplegia who underwent WW-1000^® gait exercise.

The 73-year-old patient required maximum assistance with metal ankle foot orthotics (AFO) and a quadruped cane prior to robot-based rehabilitation. The aims of gait exercise with the WW-1000^® were as follows；① maintain the verticality of the trunk during the entire gait cycle；②shifting the center of gravity during stance phase on the nonparalytic limb；③stabilizing the swing phase on the paralytic limb, and enhancing support during the stance phase on the paralytic limb. Each aim was modified depending on level of achievement. Assistance with the WW-1000^® activated the trunk and Nonparalytic limb (visual feedback was utilized in exercises). On day 9, the patient could walk using a plastic AFO and T-cane supervised by a therapist.

The multifunctional WW-1000^® is useful for subdividing gait goals, exercise and set stepwise aims consistent with the patient's abilities. Gait exercises using the WW-1000^® may efficiently improve gait and helps adapt to changes in conditions in the subacute phase.

目的：高齢者において，浴槽をまたぐ動作は，転倒を伴いやすく注意が必要な動作である．歩行分析では両脚支持時間の割合が大きいと転倒リスクが高い関係が示唆され，浴槽側方またぎ動作においても同様の関係が予想される．本研究では，機能的バランス能力および移動・歩行能力の回復が不十分なTHA術後患者において，術側下肢を先行脚とした場合と非術側下肢を先行脚とした場合の浴槽側方またぎ動作の違いを両脚支持時間の割合の観点から解析することを目的とした．

方法：対象は，初回片側THAを後方アプローチにて施行した変形性股関節症患者11例とした．測定時期は当院退院時期とした．ポータブル3次元動作解析装置を使用し，手すりを把持しながら浴槽に入る，浴槽を出る動作を行い，それぞれにおいて，先行脚の違いによる両脚支持時間の割合を算出し，両脚支持時間割合と関連する項目について検討した．

結果：浴槽を出る際の両脚支持時間の割合は，非術側から出る場合のほうが術側から出る場合に比べて有意に小さかった．浴槽を出る際の両脚支持時間割合と手すり荷重値割合に負の相関関係を認めた．

結論：THA術後2～3週の下肢機能に左右差がある患者において，浴槽を出る動作は，非術側下肢を先行脚とすることで転倒リスクが小さくなる可能性がある．また，手すりの使用は術側下肢支持時の転倒リスク軽減に寄与する．

Spinal muscular atrophy is a neuromuscular disease characterized by muscle atrophy and progressive muscle weakness due to the degeneration of motor neurons in the anterior horn of the spinal cord. We report a case of an adult patient with spinal muscular atrophy type II and difficulty holding a sitting position. The patient was evaluated before and after Nusinersen treatment and thereafter periodically for up to 3 months for motor and daily living functions. At 3 months post-treatment, the Expanded version of the Hammersmith Functional Motor Scale and the Revised Upper Limb Module, which are motor function assessment tools for evaluating spinal muscular atrophy, showed an increase of 2 points. Evaluation of daily functioning using the Canadian occupational performance measure demonstrated improvements in eating and computer finger manipulation, and these improvements were considered important in daily lives by the patient. This report shows that the Nusinersen treatment improved motor and daily life functions in a patient with spinal muscular atrophy and low motor function. The report also concludes that rehabilitation evaluation for spinal muscular atrophy should include a disease-specific assessment of motor function, combined with an assessment focusing on physical symptoms and daily life functions to capture clinical changes that are responsive to individual patients with spinal muscular atrophy.