Although it is widely recognized that a multidisciplinary/interdisciplinary team approach is important in prosthetic rehabilitation and support, it is not easy to put it into practice appropriately. We present a case of young traumatic trans-radial amputee who underwent body-powered and myoelectric upper limb prosthetic rehabilitation at Hyogo Rehabilitation Center. In this paper, we focused on the practical multidisciplinary/interdisciplinary team approach in rehabilitation and long-term follow-up of upper limb prostheses at our hospital, with particular emphasis on the myoelectric prosthesis approach. The purpose of a multidisciplinary/interdisciplinary team approach for upper limb amputees is that amputees fully learn to operate prostheses by rehabilitation, return to work and acquire social participation as a member of the local community by means of prostheses usage.

Body-powered prostheses support at Kawasaki Medical School Hospital is based on the needs of the user, aiming for a useful prosthesis. In this paper, we introduce the multidisciplinary team approach in body-powered prostheses after shoulder disarticulation. By providing support while each profession shared the same goals, we were able to smoothly solve a wide variety of problems that occurred from the acute phase to the daily life phase. As a result, it led to the useful prosthesis sought by the patient.

A previous study, reported a spillover effect of foot alignment correction on scapular function. However, there are no reports on the effect of foot alignment correction on shoulder joint muscle strength. Therefore this study aimed to confirm whether the correction of foot alignment with plantar plates can increase shoulder joint muscle strength in patients with external flat feet. The participants were 18 male patients diagnosed with bilateral flat feet. Foot alignment and shoulder joint muscle strength (shoulder joint abduction, external rotation, and internal rotation) were measured with and without employing plantar plates. Foot alignment was significantly corrected, and shoulder joint muscle strength increased in abduction, external rotation, and internal rotation when wearing the plantar plates compared to when not wearing the plantar plates. In patients with external flat feet, it was assumed that the foot’s alignment was corrected by wearing the plantar plate, making it more stable and easier to obtain floor reaction force. Secondarily, the alignment of the lower limb, pelvis, spine, thorax, and scapula changed, and posture was corrected, making it easier to perform the upper limb functions.

The purpose of this study was to examine factors associated with ankle plantar flexion moments during the loading response of assisted walking using a knee-ankle-foot orthosis (KAFO) with Gait Solution (GS). One hemiplegic stroke patient and 20 physical therapists (PTs) (14 male, 6 female) at our hospital were subjects. Each PT performed assisted walking for the patient wearing KAFO with GS, and the relationship between ankle plantar flexion moment and various data was analyzed using Spearman’s correlation coefficient. Correlation analysis showed that the maximum plantar flexion moment during the loading response correlated with walking speed, number of steps, and ankle dorsiflexion angle at the end of the stance phase (p<0.01). A correlation was also found between the maximum plantar flexion moment during the loading response and the maximum plantar flexion moment during the anterior stance phase (p<0.05). In assisted walking using KAFO with GS, it is suggested that caregivers can elicit the heel rocker function by adjusting walking speed and stride length and guiding the body so that the maximum plantar flexion moment of the paralyzed leg becomes larger during the loading response.

We conducted surveys of assistive device manufacturers on the follow-up with assistive device users. The questionnaire survey revealed that the follow-up system differs among manufacturers, that about one fourth of the manufacturers perform follow-up, that a minority of the manufacturers actively confirms the conditions of the prostheses/orthoses, that how to deal with users who report trouble is inconsistent, and that most manufacturers recognize the necessity of a follow-up. Individual interviews with six manufacturers led to collection of detailed information on the follow-up system, and suggested that the system differs according to the scale of manufacturers.