The rehabilitation team approach is a way of performance that is easier said than done. Certainly it possesses a great contribution for both improvement of functional outcome and increase of QOL. Upper-limb amputees obtain the rehabilitation goal by means of prosthetic usage. However, facilities that come up to the standard level regarding management of prosthetic rehabilitation for upper-limb amputees are scarce. Among several factors, the lack of experienced human resources who are responsible for the rehabilitation team approach is one of the major reasons for not making preparation for it.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The purpose of this study was to investigate the sprinting motion of unilateral trans-femoral amputee sprinters to determine a direction for training. A unilateral trans-femoral amputee high level male sprinter (100 meter record : 12.73 s) was filmed while sprinting at maximal velocity. In addition, the ground reaction force and strain detected on a double clamp adapter connected to a socket in the knee joint of his prosthetic leg were recorded during the trial. Three-dimensional coordinate data were obtained by the DLT method. The kinematics and kinetics of the hip, knee and ankle joints were calculated from these data. The maximal sprint velocity was greater for the prosthetic leg (7.86 m/s) than for the normal leg (7.67 m/s). In the swing phase, hip joint torque was similar for both legs. For the hip joint in both legs, flexion torque was exerted during the first half of the phase, whereas extension torque was exerted during last half of the phase. On the other hand, the hip joint torque in each leg was different in the contact phase. For the prosthetic leg, extension torque was exerted throughout the contact phase. However, for the normal leg, the joint torque changed from extension torque to flexion torque during the contact phase. These results reveal that the motion of the normal and prosthetic legs was not symmetric. In addition, they suggest that the sprinter should be trained in a way based on consideration of the difference between the two legs.

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A new style of harness for BWSTT (Body Weight Support Treadmill Training) for a patient with weakness in the trunk was developed. The harness had the useful effect of reducing the sway of the body, and that of increasing the extension of the trunk on three-dimensional motion analysis. The patient with the new style of harness maintained good posture while gait training. By using the new style of harness, the therapist can utilize the difficulty regulating function and reproducibility of BWSTT. Therefore, it can be used for gait training and judging of exercise effect. This time the subject was less reliable because of just one person’s verification. By increasing the number of diseases and the number of patients to validate, we can continue to work towards the practical application of the new style of harness.

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While an ankle-foot orthosis with the GaitSolution ankle joint improves the heel locker function of recovery-phase patients with hemiplegia, effects of a knee-ankle-foot orthosis with the GaitSolution on the symmetry of the gait stance phase has not been reported. The aim of the study was to determine the influence of the knee-ankle-foot orthosis with GaitSolution on the gait pattern of patients with hemiplegia. Seven patients with recovery-phase hemiplegia (mean age : 64.1±7.3 years) were enrolled. Their gait patterns assisted by a physical therapist with or without the GaitSolution were analyzed two-dimensionally using commercial video cameras. None of the parameters in the gait pattern were altered by the use of the GaitSolution. Limitations of the present study include the choice of gait distance as well as variations of a supporting technique and adjustment of the hinge settings. To conclude, the use of the GaitSolution joint may not be effective in improving gait patterns in patients who need knee-ankle-foot orthosis.

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A purpose of this thesis is to introduce a functional below-elbow prosthesis which does not use a harness. The problem with this functional arm in our examination process was the control of the terminal device and suspension of the functional arm. The control of the terminal device was improved by four phases of lever-type locking mechanisms. The suspension of the functional arm was improved by using a silicone liner. The improved functional arm was used in activities of daily living by a patient for 21 months and led to the improvement of a damaged part. Finally, the functional arm that we made was approved as an exceptional prosthesis in Okayama and was a candidate for the public funding.

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The results of annual health examinations at workplaces revealed an increase in the incidence of lifestyle-related diseases such as obesity, hypertension, and dyslipidemia in Japan. As the workforce ages, this incidence is expected to increase further. The risk factors for these diseases can be modified through lifestyle changes. Recently, the Active Guide 2013 has been implemented to increase physical activity, even if only slightly. Collaboration between community health and occupational health services should be recommended, especially in small- and medium-scale enterprises. These services should implement health promotion activities, improve the environment to promote occupational health, and aim to increase individuals’ physical activity such as walking to work and using the stairs. Promoting health in the workplaces should be an important company initiative with regard to work-related outcomes such as job satisfaction, absenteeism, and economic assessment as well as lifestyle-related diseases.

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