筋電義手普及の現状と課題，高位切断者に対する戦略，そして今後の展望

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Rehabilitation using myoelectric prosthesis for trans-radial amputees has become wide spread and well established in several developed countries. However, the clinical use of myoelectric prostheses for trans-radial amputees has not yet spread in Japan. It is well known that once amputees become accustomed to using their prosthesis efficiently through adequate rehabilitation, that various activities which the amputees had given up so far will become possible through enhanced bimanual activities. Although myoelectric prostheses have proved to be useful, the majority of amputees have not been satisfied with their function. As an amputee becomes a better user, they request not only simple tasks but also complicated ones. As a consequence, the amputee comes to know the limits of their myoelectric prosthesis, thus expectations for superior prostheses will arise. The recent remarkable development of engineering technology has enabled the progress of prosthetic limb technology, leading to the production of far superior functional prostheses which meet the user's expectations. However, there is a paradox in developing such superior prostheses. The more advanced the prosthesis we produce, the higher the cost. To achieve this end, it is absolutely imperative to secure the cooperation of both clinicians and engineers. Furthermore, a rehabilitation strategy for patients with a higher level of amputation(trans-humeral amputation, shoulder disarticulation)remains unsolved. In this paper, we propose a “Hybrid Myoelectric Prosthesis”, which consists of a myoelectric hand as a terminal device and a body-powered active elbow joint, as a realistic solution for higher level amputees. In addition, we introduce Targeted Reinnervation (TR) as a future strategy for reference.

筋電義手普及の現状と課題，高位切断者に対する戦略，そして今後の展望

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