Objective: The aim of this study was to compare the effects of two kinds of wrist-hand orthosis on wrist flexor spasticity in chronic stroke patients. Design: This is a randomized controlled trial. Setting: The study was conducted in a rehabilitation center. Participants: A total of 40 chronic hemiparetic stroke patients with wrist flexor spasticity were involved in the study. Interventions: Patients were randomly assigned to either an experimental group (conventional rehabilitation therapy + 3D-printed orthosis, 20 patients) or a control group (conventional rehabilitation therapy + low-temperature thermoplastic plate orthosis, 20 patients). The time of wearing orthosis was about 4–8 hours per day for six weeks. Main measures: Primary outcome measure: Modified Ashworth Scale was assessed three times (at baseline, three weeks, and six weeks). Secondary outcome measures: passive range of motion, Fugl-Meyer Assessment score, visual analogue scale score, and the swelling score were assessed twice (at baseline and six weeks). The subjective feeling score was assessed at six weeks. Results: No significant difference was found between the two groups in the change of Modified Ashworth Scale scores at three weeks (15% versus 25%, P = 0.496). At six weeks, the Modified Ashworth Scale scores (65% versus 30%, P = 0.02), passive range of wrist extension ( P < 0.001), ulnar deviation ( P = 0.028), Fugl-Meyer Assessment scores ( P < 0.001), and swelling scores ( P < 0.001) showed significant changes between the experimental group and the control group. No significant difference was found between the two groups in the change of visual analogue scale scores ( P = 0.637) and the subjective feeling scores ( P = 0.243). Conclusion: 3D-printed orthosis showed greater changes than low-temperature thermoplastic plate orthosis in reducing spasticity and swelling, improving motor function of the wrist and passive range of wrist extension for stroke patients.

This numerical study predicted wear of lubricated total knee replacements with the existing of textured surface and the possibility of surface designs to reduce wear. In the first part, a wear model of metal-on-polyethylene total knee replacement was developed. The medial and lateral knee compartments was accounted for separately, with the contact force and motion during walking cycles applied. An adapted Archard wear formula was employed where the wear factor was an exponential function of the 'Lambda ratio' (film thickness to the average roughness). Wear of the soft bearing surface (polyethylene insert) was simulated with regularly geometry update until a steady-state wear observed. In the second part, the effect of surface topography of the knee replacements was investigated. The surface texturing techniques have shown promising benefit to machine components in many areas of engineering practice. The texture parameters were designed using the Taguchi method for the geometry, size, and distribution of the micro dimples. It was observed that the lateral compartment may benefit from surface texturing if dimples were properly designed, while the texturing showed hardly advantageous effect on the medial surface in terms of lubrication enhancement and wear reduction. Some results were presented in the 6th World Tribology Conference.

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A Biotribo-POD apparatus has been developed, which provides an efficient and reliable methodology for the wear evaluation of orthopaedic biomaterials.