[in Japanese]

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The ankle-foot orthosis (AFO) prescribed for patients with stroke are often casted with the patient in a sitting position in a chair. However, during actual usage, the AFO is often used in a weight-bearing or standing position. Therefore there may be an issue of AFO compatibility. In the present study, we investigated the differences between AFO casted in a standing position (standing-AFO) and that casted in a sitting position in a chair (sitting-AFO) in healthy adult females, by examining the balance, lower limb alignment and foot pain while in a standing position. The results showed that the standing balance was stabilized and the arch height ratio was reduced when wearing a standing-AFO compared to wearing a sitting-AFO. Furthermore, foot pain tended to be reduced when wearing a standing-AFO. These results suggest the importance of considering the casting position during fabrication of AFO.

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In an occupational therapy class at the university of rehabilitation, we have introduced experience-based learning, the production of modular-type temporary prostheses, for third-year students from 2013. The purpose of this study was to examine the significance of this experienced-based learning for education about upper limb prosthesis. In the present research, following completion of this learning program, a questionnaire-based survey was administered. The Spearman rank correlation was used to assess the correlation between the data (p=0.05). As a result, a statistically significant correlation coefficient was observed between experience of producing modular-type temporary prostheses, and artificial hands (r=0.53), harnessing (r=0.44), soft dressing (r=0.55), and rigid dressing (r=0.54). The results showed that the introduction of production of modular-type temporary prostheses was effective for learning about artificial limbs.

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Most of the patients who undergo major limb amputation are old, and in many cases the cause of amputation is infection or ischemia. In the case of amputation caused by ischemia patients have lower ADL before amputation, so even if the prosthesis fits the patient, it is uncertain whether patients can achieve a natural gait or not. In addition, major amputation is a high risk factor which influences life expectancy and the survival rate after major amputation is poor. Therefore recently researchers have been paying attention to the limb salvage as the ideal medical treatment which is practiced by a multidisciplinary team, to avoid major amputation and restore the gait. In this case the patient was affected by spina bifida, so the patient was supposed to undergo major amputation. The patient, however, avoided major amputation by multidisciplinary treatment and gained a normal gait with a Knee-Ankle- Foot-Orthosis. Now the patient lives daily life without recurrence of ulcer. In my opinion, prosthetists play an important role in the area of limb salvage.

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The Robotic Stride Assistance System (SAS), developed by Honda R&D, is a wearable machine which can be expected to aid in the acquirement of a better gait for lower limb amputees through an improving walking cycle. In order to investigate the effect of SAS on improving the abnormal gait in amputees, SAS was applied to a trans-femoral amputee with an apparent abnormal gait. In this research, reduction of energy expenditure was obtained. Improvement of the abnormal gait was also achieved through an increase of the range of hip motion.

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Following the decision of holding the 2020 Olympic and Paralympic Games in Tokyo, prosthetic limbs have increasingly become a topic of discussion. In both the Summer and Winter Olympic Games, athletes with prosthetic limbs and young persons who conquer their disabilities compete in all kinds of sports, inspiring so many people worldwide through their courage and determination. At the same time, the advances in prosthetic limbs have been highly commended. From the viewpoint of manufacturers and distributors of prosthetic limbs, this is a gratifying development. As a manufacturer of prosthetic limbs for nearly 50 years, the author describes in this article the width and depth of the appeal in creating prosthetic limbs, together with the spirit of challenge learnt directly or indirectly from many pioneers and leaders in this field, and also attempts to anticipate the outlook and the approaches to be taken in the future.

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