先天性上肢欠損児に対する早期の義手装着の利点として，義手の機能や外観を受け入れやすくなり，両手動作 による成長の促進に寄与する。しかし上肢欠損児の場合は，義手を使用せず残存機能を利用する。一方で，小学 校では 1 学年から両手を使う跳び箱動作や縄跳びおよび鉄棒動作が学習指導に盛り込まれている。併せて，保護 者と児からは，自転車操作の希望も寄せられた。 　本研究では，先天性左前腕欠損児の就学前から現在（小学 3 年生）までの就学環境に必要となる両手動作のう ち，自転車操作，縄跳び，跳び箱および鉄棒に着目して，個々の動作に対応した自助具（義手）の作製および提 供を行った。それらを使用した際の動作解析などによる効果検証を行い自助具（義手）の有効性を認めた。 小児期の身体活動は健全な成長に必要不可欠であるため，今後も自助具（義手）の修理など児の成長に対応した フォローアップを継続することが重要であると考える。

The early use of prosthetic hands is benefi cial for children with congenital absence or amputation of upper limbs, as they become familiar with such devices’ functions and appearances more smoothly than those who begin use later in life. This facilitates their bilateral hand movements, consequently promoting their growth. However, in these children, importance tends to be attached to the harnessing of their remaining functions, rather than the use of prosthetic hands. On the other hand, it is necessary to consider that activities requiring bilateral hand movements, such as box jump, jump rope, and horizontal bar, are incorporated into educational programs from the fi rst grade of elementary school. In the present case, a child with congenital absence of the left forearm and her parents desired support for these activities, as well as support to be able to ride a bicycle. Among the bilateral hand movements needed for elementary school activities from the preschool period to the third grade (present), we focused on those needed for bicycle riding, jump rope, box jump, and horizontal bar to create and offer self-help devices (prosthetic hands) corresponding to individual activities. Their usefulness was mainly confi rmed through motion analysis. As physical activities during childhood are indispensable for healthy growth, it may be important to continue following up with the child through approaches, such as repairing her self-help devices, in consideration of her growth stage.

特別寄稿