Convalescent hospital prosthetic rehabilitation plays an important role in determining whether prosthetic walking becomes practical in the future life of amputees. While specialty hospitals have a high success rate, the lack of knowledge and experience of medical personnel in the field of prosthetic limbs (amputation) is an issue. Clinical pathways are used to eliminate variability in medical care, but lower limb amputations are rare and standardization has not progressed. In this paper, we visualize the problems of prosthetic leg rehabilitation, and describe the overall flow of prosthetic leg creation, and rehabilitation before and after prosthetic leg installation.

The purposes of this study were to measure behaviors associated with scratching via an artificial nail apparatus and to objectively evaluate itch severity. Four healthy volunteers (three men and one woman) were recruited and wore an artificial nail apparatus on each fingertip, excluding the thumb. The participants scratched four parts of their body (forearm, thigh, upper arm, and head) in a usual manner, and signals generated by the sensors in the apparatus were recorded. The amplitude, frequency, and integrated values over 10-s durations from each scratching waveform were validated. Each parameter was statistically analyzed using one-way analysis of variance multiple comparison tests and the Mann-Whitney U test for comparisons among fingers, scratch strength, scratch areas, and between bare and clothed skin. Among the four fingers, the amplitude and integrated values were higher for the index and middle fingers than for the ring and little fingers. The scratching frequency was higher, and the total amplitude tended to be lower in the head area compared to other parts of the body. The scratch strength was well correlated with the amplitude. All values for scratching clothed skin were higher than those for scratching bare skin (p<0.05). Our artificial nail apparatus is useful for objectively evaluating scratching action and itch severity.

The early use of a knee-ankle-foot-orthosis in stroke patients is effective in improving physical function and activities of daily living. The length of stay for differs between secondary and tertiary emergency hospitals, so the decision to provide a knee-ankle-foot-orthosis should be made according to hospital function. Regardless of whether knee-ankle-foot-orthoses are made or not, it is important for acute phase hospitals to fill prescriptions for an orthosis and to collaborate with rehabilitation hospitals on methods of gait reconstruction. In this report, as a secondary emergency hospital, we have established in-hospital and out-of-hospital cooperation for the fabrication of knee-ankle-foot-orthoses.

There have been increasing reports of the use of a knee-ankle-foot orthosis (KAFO) from the early stage of stroke, but KAFO used as hospital equipment (equipment KAFO) cannot be used due to the large circumference of the patient’s lower limb and the weight limit of equipment KAFO. In this study, we retrospectively examined the medical records of 45 stroke patients who had KAFOs made for them at our hospital from 2017 to January 2021, and examined the factors that prevented the use of equipment KAFOs. The results showed that 30 of the 45 patients were men, and the mean weight of the men was 69.6±15.7 kg. Of these, 12 (about 40%) were above the weight limit of the equipment KAFO. If a KAFO is needed in a stroke patient who is above the weight limit of the equipment KAFO, it is suggested that a KAFO for the patient should be made early.

The study was conducted on three unilateral transfemoral amputees, with two participants using NU-FlexSIV sockets (NU), while the third participant was instructed to continuously use an ischial-ramal containment socket (IRC) for six months. Before and after this period, the participants’ gait, balance, and socket comfort were evaluated; bone mineral density was measured; and the soft tissue surrounding the hip joint was analyzed using MRI. One of the participants who wore an NU socket stopped wearing it due to pain, choosing instead an IRC socket for the remainder of the study period. As a result, only socket comfort and bone mineral density could be measured at six months in addition to MRI analysis. Findings showed that gait and balance were comparable in individuals wearing NUs and those wearing IRCs, with a superior socket comfort in those wearing NUs. Moreover, the NU-wearing participant showed increased femoral neck bone mineral density on the side of the amputated limb, whereas the other two participants showed decreased bone mineral density. MRI findings further showed that the cross-sectional area of the muscle mass around the hip joint of the amputated limb had increased in the NU-wearing participant, but this was decreased in the other two. Therefore, these results may imply that NU sockets exerted mechanical stimuli on the femur and residual muscles of the stump, which were different from those exerted by conventional IRCs, thereby affecting the amputated side’s bone mineral density as well as soft tissue composition.

To clarify the relationship between using status and trouble occurrence of ankle-foot orthosis in community-based stroke patients, a questionnaire was given to hemiplegic stroke patients who used an ankle-orthosis during hospitalization. One hundred twenty-five surveys were distributed, collected and analyzed. We asked participants to report: frequency of use per week of the orthosis, damage to the orthosis and system-specific problems related to the orthosis, as well as physical changes and hygiene changes of the patient. It was clarified that the stroke patients in the living period had issues/problems/difficulties in each item. The problem of continuous use in people with community-based stroke is that the troubles increase due to the increased use of the ankle-foot orthosis.