To increase the femoral prosthesis socket fitting, it is necessary to fix the residual limb soft tissue moderately. The hardness of the residual limb soft tissue is one of factors for the fabrication of a transfemoral prosthetic socket, but there is no quantitative evidence of the factor working. In this study, we tried to quantify the hardness of the soft tissue on the thighs of six non-amputee subjects and on the residual limb of fourteen transfemoral (TF) amputee subjects. An indentation test was carried out on the soft tissue of both subject groups. There are four measurement points (A proximal and distal point on each thigh and residual or sound limb). The elasticity model coefficient (index of the hardness) and its average were calculated on each point. As result, there was no significant difference in the index of the hardness of the soft tissue of the thigh in the dominant leg and the non-dominant leg on the non-amputee subjects. However, the index of the hardness on the residual limb of TF amputee subjects was significantly smaller than that of the non-amputee subjects and sound leg of amputee subjects. In addition, the index of the proximal points of the residual limb tended to have a different hardness from the distal points.

We have developed a new-concept hip abduction orthotic device, Coilen, for people with severe physical and mental disabilities (hereinafter referred to as severely handicapped children). Coilen is a simple and lightweight specification that can be used continuously by severely ill children (persons) without stress. It is also an orthotic device that can be easily worn by caregivers. It is a well-known fact that surgical treatment is considered the best method for hip dislocation of severely ill children (persons) who do not apply a load. However, many families choose conservative therapy. We would like to support that choice so that the use of orthotics can lead to a comfortable daily life.

We experienced a case of a mature male patient with bilateral above-knee amputation, right hemiplegia, and higher brain dysfunction, and reported that he became independent in his activities of daily living except for bathing and was able to walk with prosthetic legs with assistance. We selected a tilt-recline electric wheelchair that can be operated by the non-paralyzed hand and can accommodate the limited range of motion of the hip joint, backward transfer in the direction of the paralyzed side, and placement of the changing table behind the portable toilet. As a result, the patient was able to move and transfer, expand his range of living, and become independent in defecation. The bilateral femoral prostheses were suspended in quadrilateral sockets, silicone liners and Velcro, with fixed knees and carbon feet. While the patient’s dignity was enhanced by conducting ADL training and gait training in parallel, frequent guidance to family members was important for improving physical and mental functions, ADL, and walking ability.

There are few reports about prosthetic rehabilitation for children with congenital trans-humeral upper limb deficiency. This report presents a case study of a 3-year-old girl with a congenital trans-humeral upper limb deficiency and the process of acquisition of her prosthetic use. At the beginning of the training, she refused to use her upper limb prosthesis due to her lack of needs, but riding a bicycle inspired her to start using it. Rehabilitation training for 3 years resulted in skillful use of two upper limb prostheses, a body-powered prosthesis and a prosthesis for gymnastics. The successful key points were exploring her needs, repeated practices of control of the elbow joint, and her family support. The limited choice of pediatric components still remained a problem. Prosthetic rehabilitation for children with congenital trans-humeral upper limb deficiency is considered important to promote physical development and to learn activities of daily living with a prosthesis as well as for children with congenital trans-radial deficiency.

We report a case of severe right hemiplegia with congenital bilateral foot deformities and severe obesity. On day 19 of onset, a 38-year-old man was admitted to our hospital after left putaminal hemorrhage. We prescribed right knee-ankle-foot orthosis and left foot orthosis each with high quarter shoes, which had modification for pes equinocavovarus deformity. The use of an orthosis contributed to standing stability, foot pain reduction and reduction in the amount of assistance. As a result, the patient was able to repeat task-oriented training in anti-gravity position such as standing, stepping, and walking, which were difficult to perform without orthosis. On day 154, the patient was able to independently walk indoors with a bilateral lower limb orthosis and one side crutch, and became independent in basic activities of daily living except for bathing and stairs. On day 198, the patient was admitted to a support facility for persons with disabilities to train him to live alone. In recent years, there has been increasing demand for rehabilitation of patients with multiple disabilities. We need to provide the best orthotic therapy for each individual case to improve their prognosis.

We report a case of a femoral prosthesis patient whose gait improved using a simple motion analysis device. A forty-seven-year-old male came to the office to repair his prosthesis after 3 years using the prosthesis. The range of motion of the hip joint was restricted, and the center of gravity was displaced backward, making it difficult to move the center of gravity forward. When the movement of the center of gravity was confirmed using a simple motion analysis device (Waltwin^®), the center of gravity moved only to the midfoot after the prosthesis side heel touched down. The standing time with the prosthesis was 29.9%. We practiced walking using this device. One month after the start of the practice, the standing time on the prosthesis improved to 39.4%, and the center of gravity could be moved to the forefoot. Since the simple motion analysis device can evaluate walking easily and objectively and give guidance to the patient while confirming the position of the center of gravity in real time, it may be a useful tool for improving walking even in patients with artificial legs.