Insole (Foot orthosis) is an important treatment for various type of sports injuries and disabilities. I have the experience of making insoles for over 1000 feet and conducting scientific research about insoles. In this article, I will explain previous research and my insole design method in relation to sports injuries.

This study aimed to compare the effects of the wrist joint cuff material and shape of the artificial muscle type dynamic splints on fingertip blood flow and muscular activity. Eight hands from 4 male subjects with an average age of 26.2 years were analyzed. A semiconductor laser tissue blood flow meter was used for pulse group measurements. The electromyography was measured using TRIAS at the weak position and at 60° in both the wrist flexion and dorsiflexion directions with the splint attached. The mesh type and polyurethane type significantly decreased in the dorsal flexion direction after 5 minutes (p<0.05). In the palmar flexion direction, the mesh type cuff decreased significantly 3 or 5 minutes after the start of correction (p<0.05). With respect to EMG, significantly higher muscle activity was associated with dorsal flexion movement and the mesh type cuff (p<0.05). Considering the material and shape of the wrist cuff, it is recommended to use a polyurethane type with a double structure when installing an artificial muscle type splint. However, it is necessary to pay attention to the DTSaM structure, which tends to decrease the blood flow in the dorsiflexion direction even for the polyurethane type.

We completed the development of the specialized wheelchair PS1 for Elderly Welfare Facilities in 2015. After clinical interventions using the PS1 at multiple Elderly Welfare Facilities, we have achieved a lifestyle improvement for the ADL and others by using the PS1. However, from the beginning of the development, PS1 has been a wheelchair that is unsuitable for mass production including the height alterations. Structurally, it needs a significant readjustment. The aim of this paper is to organize the issues that we have found from the clinical intervention with PS1, and to develop modified models of PS1 that can be mass produced. As a result, the issues of modified models of PS1 were resolved. However, improvement of the design will remain as the focus of our future studies.

Bilateral hip disarticulation is extremely rare, and there are very few reports on rehabilitation, including adaptation of prostheses. The case is a 24-year-old man with bilateral hip disarticulation caused by a traffic accident. After acquiring a prosthetic swing gait, we tried alternate prosthetic reciprocating gait training. The commercially available hip joints with stride control (The-Lin, TH-01C) were improved and the knee joint with yielding function (Otto Bock, 3R31) was introduced into the bilateral hip prostheses. The prosthetic limb could be swung by moving the center of gravity to the left and right. The gait training method for paraplegic spinal cord injured persons was applied. In addition, a joint release mechanism has been devised. The subject could independently don and doff the prosthesis, rise from a bed to a standing position, achieve reciprocal gait and return to a seated position without any assistance.

To date, it has been pointed out that there are regional disparities in the provision of prosthetic devices through the public funding system ; however, the details have not been sufficiently clarified. In order to conduct a full-scale analysis in the future, we first analyzed welfare administrative reports for fiscal 2017 from the viewpoints of administrative districts (State), regional classifications, size of local governments, and financial conditions, and clarified their trends and problems. As a result, it was suggested that there were differences in the provision of these prosthetic devices depending on the size of the area or municipality, among other issues. On the other hand, the limitations of methods to eliminate the influence of population and analysis of factors were identified as issues to be addressed. In the future, it will be confirmed whether this tendency exists regardless of the fiscal year, and if there is a constant difference, we will investigate the factors and develop a more even distribution of assistive devices.

The use of Knee-Ankle-Foot-Orthosis (KAFO) is increasing from the early stage of stroke, but there are no reports of adverse events associated with the use or production of KAFO. Therefore, we retrospectively investigated the adverse events associated with the use and preparation of KAFO in patients with early stroke onset in our acute hospital and applied countermeasures. Adverse event data reported from August 2017 to July 2019 was included. There were 376 adverse events during the survey period, of which 25 (6.6%) were related to KAFO. Most of the adverse events occurred with equipment KAFO, and the most frequent content was 6 cases of Medical Device Related Pressure Ulcer (MDRPU). In order to use equipment KAFO in acute hospitals, it is important to take measures to prevent the occurrence of MDRPU and acquire knowledge about wounds.

In order to extend healthy life expectancy, it is necessary to protect one’s healthy feet. Foot care is an effort to prevent aggravation of foot disease by proper assessment and detecting the abnormality at an early stage. Currently, an amputation is performed every 30 seconds in the world, and most of them are in diabetic patients. Most diabetic patients have some kind of foot problem, and about 25% of them develop foot ulcers, which will eventually lead to amputation of the lower limbs when all treatment modalities are exhausted. By practicing appropriate foot care, limb amputation can be prevented. In this section, we will introduce the appropriate foot care for diabetic foot lesions, and their diagnosis to treatment.