In Japan, which is prone to many disasters, in addition to earthquake disasters such as the Great East Japan Earthquake and the Kumamoto Earthquake, tremendous flood damage occurs in many parts of the country every year. As a result, some prosthetic users are feeling anxious. In addition, there are many victims who suffer from physical and cognitive decline due to inactivity caused by living in shelters. In response to this situation, the Japan Disaster Rehabilitation Assistance Team (JRAT) was established, and disaster rehabilitation support activities are being carried out. This paper describes the response to prosthetics and orthotics during the Great East Japan Earthquake and the Kumamoto Earthquake, and an outline of the JRAT.

Before wearing an orthosis, conducting objective fit assessment followed by adjustment of the foot orthosis is considered to be able to prevent insufficient function of the orthosis due to inadequate arch ratio or pain and potential injury due to excessively large arch ratio. We conducted a study on 30 patients (60 feet) who visited a general orthopedic outpatient clinic. With each subject in a resting standing position, we measured the differences in foot length and MP width of each foot between when the subject was in bare foot and when wearing a foot orthosis. When wearing the foot orthosis, the foot length was shortened by 2.9±1.7 mm on the right and by 3.1±1.8 mm on the left. When wearing the orthosis, the MP width was shortened by 2.6±2.7 mm on the right and 3.5±3.1 mm on the left. The MP width was measured in 29 subjects (58 feet). These results suggested that wearing the foot orthosis prevented the arch from falling, resulting in shortening of the foot length and MP width. The amounts of changes in foot length and MP width before and after wearing a foot orthosis were positioned as reference values for fitting assessment. We report an objective assessment method that can be performed in the clinical setting in a short time using inexpensive measuring instruments.

Knee-ankle-foot orthoses (KAFOs) are prescribed for stroke hemiplegic patients with unstable lower limbs. To date, however, no research has compared and verified the effect of the differences in ankle joint function on kinematics and muscle activity during gait in post-stroke patients using KAFOs. To determine the effect of KAFOs with different ankle joint settings—plantar flexion stop (KAFO-PS), and plantar flexion resistance (KAFO-PR)—on the gait of stroke patients in the subacute phase, the gait of 7 stroke patients using KAFOs with ankle joint settings—KAFO-PS and KAFO-PR—was assessed using surface electromyography (EMG) and an electrogoniometer, a three-axis gyro sensor. The ankle plantar flexion angle during loading response and the muscle activity ratio of the tibialis anterior in loading response, hip extension angle change during anterior swing were significantly larger with KAFO-PR compared with KAFO-PS. It was suggested that the difference in plantar flexion function of the ankle joint of KAFOs affects the kinematics and muscle activity of the ankle and hip joints during gait.

We report a case in which a myoelectric prosthetic hand was effective for an adult with congenital left forearm deficiency whose job is a physical therapist. The case was a 25-year-old woman with a congenital left forearm deficiency. She learned how to operate a myoelectric prosthetic hand and we rented her a myoelectric prosthetic hand. After clarifying what could and could not be done at work, the myoelectric prosthetic hand was used for the patient, and it was possible to use it safely and effectively. In her work, she always put the myoelectric prosthetic hand on during the training time and maintenance of the training room, and the work was done safely and efficiently, the physical burden was reduced, and the cases and training content that could be handled were expanded. Even in the work of a physical therapist, where safety is important, it is possible to use myoelectric prosthetic hands safely and effectively by clarifying what can and cannot be done.

Previous reports have described prosthetic treatment offered to patients in convalescent rehabilitation wards and chronic phases ; however, no report has discussed prosthetic treatment rendered in community-based care wards (care wards). In this study, we retrospectively investigated patients who were admitted to our care wards and received prosthetic treatment between 2018 and 2020. We analyzed patients’ medical records for their baseline data and recorded detailed information regarding prosthetic treatment received by these patients. Approximately 11% (107 patients) of the patients who were admitted to the care wards received prosthetic treatment, and many of these patients had received botulinum treatment or had been diagnosed with stroke or orthopedic disorders. Many of the prosthetic treatments administered involved the fabrication and repair of ankle foot orthoses and foot correction, which required effective collaboration among a multidisciplinary team comprising physicians, therapists, prosthetists and orthotists.

We report the experience of walking exercises using Trunk-Hip-bilateral Knee-Ankle-Foot Orthosis (THbKAFO) for 15 patients with severe stroke. The evaluation was of arousal, lower limb motor paralysis, muscle tone of knee flexors and ankle plantar flexors, sitting/trunk function, and activities of daily living. We examined changes over time from admission through one, two, and three months after admission. Our results show that arousal was significantly higher 2 to 3 months after admission than at admission, and significantly higher 2 months after admission than 1 month after admission (p<0.05). Muscle tone was significantly higher in both knee flexors and ankle plantar flexors 1 to 3 months after admission than at admission (p<0.05). Interventions centered on walking exercises using THbKAFO may have a positive effect on arousal.