上肢機能の変化に伴い3Dプリンタで作製した自助具の変更が日常生活における麻痺手の習慣的使用を促した回復期脳梗塞患者の一例—症例報告

How self-help devices made by a 3D printer due to changes in upper limb function promoted the habitual use in daily life of the paralyzed hand of a cerebral infarction patient in the convalescent stage: A case study

要旨：日常生活において麻痺手の使用頻度が乏しい回復期脳梗塞患者に対し，3Dプリンタで作製した筆記自助具を麻痺手機能の改善状況に合わせ段階的に変更を加え提供した．同患者へは，日記をつける際に自助具を用いた麻痺手で行うことを促した．結果，上肢機能評価において臨床上意義のある最小変化量を超えた改善が得られた．また，福祉用具満足度評価では，症例の上肢機能改善に応じて，修正を加えた3Dプリンタの自助具に対して高い満足度が示された．以上の結果は，上肢機能の変化に応じて自助具の形状を変更する方略が上肢機能訓練において有用な手段であることを示唆した．

　A 3D printer-fabricated writing aid was provided to a stroke patient who infrequently used his paralyzed hand in daily life. Gradual modifications were made according to the improvement of paralyzed hand function. The patient was encouraged to keep a diary with his paralyzed hand using a self-help device. As a result, improvement beyond the minimum clinically meaningful change in upper extremity function assessment was achieved. In addition, the satisfaction evaluation of the welfare equipment showed high satisfaction with the 3D printer self-help device with modifications according to the improvement of the upper-limb function of the case. These results suggest that the strategy of changing the shape of self-help devices in response to changes in upper-limb function is a useful tool in upper-limb function training.