The important points while assessing the apparatus and orthoses in children with cerebral palsy are as follows ; ①Based on the proper perspective concerning each child’s future gross motor function using the Gross Motor Function Classification System, we have to make an actual intervention plan. ②The objective of the intervention for children with cerebral palsy is not to facilitate their normal development. We have to assess them in order to make their compensatory movements more effective. ③We have to always think of each child’s intention. ④Using the apparatus and orthoses, we don’t have to secure children in a fixed position, but we have to provide them with a stable surface/point which promotes their movements. ⑤We have to take the influence of the primitive reflexes into account during the interventions for cerebral palsy children with severe disabilities. ⑥We have to always explore new ways of applying the existing apparatus and orthoses, ⑦Based on the framework of the six F-words, we have to make efforts to know the life of children with disabilities and their family and to produce the apparatus and orthoses which truly contribute to their life.

Evaluation of the hind foot part is regarded as important for insole therapy. Movement chain occurs from the lower leg to the thigh by inducing the pronation and supination of the hind foot, and the pain is alleviated. If dynamic alignment is simply compared in an easy-to-understand manner, it is the same as a bicycle chain. In a state where the chain of the bicycle is disengaged, even if you pedal hard, you will not go forward efficiently. When the bicycle is used for a long time in this state, a strain is applied to the muscles and joints, and pain develops. The patient whose alignment is broken is the same as this condition. It is important to arrange the dynamic alignment in this way, and the effect can be obtained by guiding it in the correct direction. In this issue, we will also present research reports on sensomotoric insoles, as well as evaluation and 2 example cases.

To identify the occasions in activities of daily living (ADL) that require ankle foot orthosis and the desirable roles of the orthosis, this study sought to clarify the differences in recognition between post-stroke orthosis users and physiotherapists. From the results of a questionnaire survey, orthosis users recognized that ankle foot orthosis was required in activities accompanying motions in the sitting position, while physiotherapists recognized that the orthosis is required at a high frequency in activities accompanying ambulation. In terms of ambulation conditions, differences in recognition were found in 9 of the 25 items in the indoor independent walking group. In the indoor independent walking group and the assisted walking or wheelchair ambulation group in which differences in recognition regarding the degree of necessity of ankle foot orthosis were observed, evaluation considering the use of ankle foot orthosis in various ADL occasions including sitting activities may be necessary, in order to reflect the wishes of the parties involved and develop more meaningful orthosis for daily living.

Myoelectric prosthesis is a useful tool for congenital upper limb deficiency children in terms of expanding their activity and participation. However, very few children use myoelectric prosthesis in Japan. Hyogo Rehabilitation Center have introduced a framework in 2002 to allow children to undergo training and the fitting of a myoelectric prosthesis at any time. We have trained more than 70 children with upper limb deficiency. We report the results of 15 years’ experience of myoelectric prosthesis training for children and elucidate the current problem and future perspective.

More than about 80% of activities of daily living can be performed on the unaffected side with partial hand amputation, so the patient often receives only a cosmetic hand. However, bimanual action is certainly necessary among patients, and the work arm becomes the adaptation in this case. We prescribed the work arm for a partial hand amputation patient. In addition, we enabled the installation of various kitchen utensils by request to manufacture a joint using a three-dimensional (3D) printer which can prescribe the shape that we want to arrange and prescribe the shape freely. Moreover, it was possible to improve durability and strength, and it became possible to perform bimanual action and to work more than 30 minutes, and thus to return to employment, particularly in the case of cooking procedures. We can expect to expand the possibility for a “utilizable work arm” that the patient hopes for in the future by using the 3D printer sequentially.

Many partial hand amputees choose cosmetic arms. At present, temporary hand prosthesis training is not common, and specific approaches to partial hand amputation have not been established. In this report, we conducted temporary hand prosthesis training sessions for a partial hand amputees from an early stage, and examined their effectiveness. We made temporary hand prosthesis with material for making hand splints, and performed functional training. As a result, it was possible to reacquire the pinch function and improve the appearance. Partial hand prosthesis with both appearance and functionality was completed. The subject was able to grasp objects by wearing a partial hand prosthesis from the time she received it. From this process, it was suggested that training for partial hand amputation is effective.

Asia Seating Assist Project (ASAP) was established by seating engineers, medical doctors and physical therapists in Japan for transferring the seating technologies to physical therapists and occupational therapists in Thailand in 2011. In 2016, ASAP planned and performed several lectures and workshops in which seating engineers and physical therapists of ASAP introduced the manufacturing process for seating systems and adapting it for children with severe physical disabilities by using reinforced cardboard and polyurethane foam. ASAP will continue these activities in Thailand and neighboring countries in the future.