Questionnaire on EMG hand provided Government expense No.2

Questionnaire on EMG hand provided Government expense No.2

Jiro Kawamura

2/25/2000

Colleagues and friends,

 $B!! (JI asked about financial support system of EMG prosthesis by government in
 each country by the mail of September 1999. Unfortunately, I could get
only few answers to my question.
  Now I am again going to ask to answering the new questionnaire which is
more specific and minute.
  Please send me your answer by the end of February. I am going to
compile your answers and we (Japanese Society of Prosthetics and Orthotics)
will request the Japanese Goverment to improve supporting system of
upper-limb amputees with the world-wide information. We do not use use
your name in it. We also do not intend to use those as official
information of each country because we welcome your answer even if it is
based on your daily experience or includdes some guess.

Jiro Kawamura, M.D.:
Board member of Japanese Society of Prosthetics and Orthotics.

Medical Director of Kusaka Hospital
680 Ageki, Hokusei-cho, Inabe-gun, Mie-prefecture, 511-0428, Japan
FAX: +81-594-72-4075, PHONE: +81-594-72-2511

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Introduction of Questionnaire
In Japan, the charge of prostheses for an amputees is covered by public
expense such as the law for the welfare of physically disabled persons
(LWPDP), child welfare law, employees' welfare pension insurance (EWPI),
workmen's accident compensation insurance(WACI), and the others. Though
almost all types of lower-limb prostheses have been covered by public
expense, financial support of electric or myoelectric hand (EMG hand) for
the upper-limb prosthesis is strictly restricted. For example, EMG hand is
supported as an exceptional application in the case of LWPDP in which
procedure of application is very much complicated and time-consuming. It
takes 6 months or more from application to its permission. In the case of
WACI, the EMG hand is supported for only one-side of a bi-lateral amputee
and the upper limit of price is USD 6,000. Even in this case, only seven
big hospitals or facilities are allowed to engage in this delivery. As a
result of this system, only about 25 EMG hands have been distributed in
these ten years. EWPI does not support EMG hands.
To improve miserable situation like this for the upper limb amputees in
Japan, we think that we need to gather information on financial support
system of powered hands by government, funds, and the others in the other
countries. We need your supports in this matter.
We also welcome your suggestion on this matter.
Thank you very much in advance.

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Questionnaire (We welcome your answer even if it is a part of the following
questions.)
 1) Which country are you in?

 2) Is the charge of an EMG hand covered by government, insurance or other
  funds?

 3) If it is supported, is there any limitation about the amputation level,
 such as bi-lateral? Is there any limitation about the use of it for a
unilateral amputees? $B!! (J

 $B!! (J4) In Japan, there are several funds as mentioned above.
     What kind of funds can you use for the EMG hands?

5) About the types of hand and elbow.
5-1) Which type of terminal devise of EMG hands can you use?
 $B!! (J* natural shaped hand (yes or no)
 $B!! (J* hook for heavy duty such as Otto Bock electric Greifer (yes or no)
 $B!! (J* others: example:
  5-2) Which type of elbow joint can you use?
  * NY-Hosmer electric elbow (yes or no)
 $B!! (J* Boston elbow (yes or no)
  * Utah arm (yes or no)
 $B!! (J* others: example:

 $B!! (J6) Do you have any limitation of the cost which is covered by the funds?
    If so, how much is it?

 Is it possible for the amputee to use more expensive ones by paying the
difference of the cost for him/herself?

  7) Where do the amputees have to visit to ask for getting the EMG hand
using public expense?
  * hospital
 $B!! (J* government office
 $B!! (J* insurance office
 $B!! (J* others places:

 8) How long does it take to get the allowance to use the EMG hand?

 9) Do the hospitals, prosthetic fabrication companies, or prosthetists
need to have any certification or qualification to prescribe or fabricate
EMG hands?

 10) How often amputees can ask to make the EMG hand for the fund, as a
regulation? To say in the other expression, how long is the durability of
the hand?


 Can they get only one hand during the time of durability?

 11) Does the fund cover the repairing charge when the hand is broken?

 12) How many EMG hands were delivered in your country, last year? If you
do not know exact number, your guess based on your experience is welcome.


 13) I would like to ask you the ratio of cosmetic hand, hook, body powered
hand and EMG hand against the amputation level? We also welcome your guess.
    Ratio of :cosmetic hand : hook : body powered hand : EMG hand
a) Unilateral above elbow: : : :
b) Bi-lateral above elbow: : : :
c) Unilateral below elbow: : : :
d) Bi-lateral below elbow: : : :
e) Above elbow + below elbow
f) other combination

 14) Do you think the myoelectric hand is useful from functional,
psychological or other point of view?


  Do you think it is limiting the possibilities of the amputees if the
government does not allow to use the fund for the EMG hand?


  We would like to ask your personal advice about the use of EMG hands
using those funds.