The Status of Prescriptions for Lower Limb Prosthesis in Yamanashi Prefecture: Progress and Problems in the Past Ten Years

In Yamanashi Prefecture, the quality of lower limb prosthesis prescribed under the Law for the Welfare of Physically Disabled (Welfare Law) was poor, due to a lack of checking on private prostheses manufacturers by the doctors and administration. The evaluation system was improved with the enforcement of the Artificial Limb Fitter's Law in 1988. Under the new system, doctors conduct strict checking on the the prescriptions, finished products, and cost estimates subjected by the municipal artificial limb fitters. Lectures are conducted for welfare workers concerning the assessment of prosthesis, so that they may find persons in the community who are using misfit prostheses, and refer them for home visits and subsequent repair or restoraction of the prostheses. Guidance is given to private manufacturers regarding new technology of prostheses such as intelligent prosthesis and ischial-ramal-containment socket. Annual seminars are conducted for medical doctors for deeper understanding of the technology of prostheses and related laws. After ten years of such activities, the level of technology and knowledge about lower limb prostheses has improved in Yamanashi Prefecture. Under the new system, it has become possible to supply good-quality lower limb prostheses to physically disabled persons living in mountain villages where there are few doctors. Through application of new technology to construct lower limb prosthesis suitable for sports, there is an increase in number of persons participating in athletic competitions using prosthesis.