Effect of personalized wrist orthosis for wrist pain with three-dimensional scanning and printing technique

Kim, Sang Jun; Kim, Sung Jae; Ho, Yong; Lee, Keun Ho; Kwon, Jeong-Yi

doi:10.1177/0309364618785725

Cited by 53 publications

(79 citation statements)

References 21 publications

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“…3D printing enables design freedom by facilitating deviation from traditional design paradigms and hence allows the development of patient-specific orthosis. [ 4 , 32 ] In our case, the 3D-printed wrist orthosis was personalized by using CT-scanned 3D images and was printed out using thermoplastic polyurethane filament by a 3D printer. An AFO manufactured by 3D printing had a unique design considering a progress direction of foot center of pressure during gait cycle.…”

Section: Discussionmentioning

confidence: 99%

The functional effect of 3D-printing individualized orthosis for patients with peripheral nerve injuries

Chae¹,

Kim

Kang³

et al. 2020

Medicine

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Rationale: In the medical field, the use of 3-dimensional (3D) printing is increasing explosively and it is especially widespread in the clinical application of fabricating orthosis. Advantages of 3D-printed orthosis compared to conventional ones include its lower cost, easier modification, and faster fabrication. The 3D-printing technique makes it possible for physicians to easily create individual-tailored products. Recently, many kinds of orthosis through 3D printing have been studied and used. The knee orthosis, ankle-foot orthosis, wrist orthosis, hand orthosis, and foot orthotics are examples used in the rehabilitation fields of orthotics. We reported 3 cases of 3D-printed orthoses in patients with peripheral nerve injuries. Patients concerns: In spite of the rapid development of the clinical use of 3D printing, to our knowledge, its application to patients with peripheral nerve injuries has not yet been reported. Two patients suffered from upper limb problems and 1 patient had a foot drop associated with peripheral nerve injury. Diagnosis: Three patients diagnosed with median neuropathy, ulnar neuropathy, and right lower lumbar radiculopathy, respectively, by electromyography. Interventions: Herein we present 3 case reports of patients with peripheral nerve injuries whose orthotic needs were fulfilled with the application of 3D-printed wrist orthosis and ankle-foot orthosis. Outcomes: For hand function evaluation, we assessed the Jebsen–Taylor hand function test. Grasp and pinch powers were assessed by a hand dynamometer before and after orthosis application. For lower limb functional evaluation, we used a 6-minute walking test and modified Emory Functional Ambulation Profile for ambulatory function. Lessons: The 3D-printed orthosis could help functional improvement in patients with peripheral nerve injuries.

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Section: Discussionmentioning

confidence: 99%

The functional effect of 3D-printing individualized orthosis for patients with peripheral nerve injuries

Chae¹,

Kim

Kang³

et al. 2020

Medicine

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“…Optical scanning has recently been proposed as a less costly alternative. 25,44 Having an HEO with an adjustable carrying angle to replicate the variable carrying angle of the native elbow may also be useful in improving the effectiveness of these devices.…”

Section: Discussionmentioning

confidence: 99%

“…However, investigations of a variety of knee and ankle orthoses in ligamentous injuries have shown conflicting results, with some studies indicating enhanced proprioception with orthoses 59 and others suggesting no effect. 5,7 Orthoses have also been reported to increase confidence, 6,61 enhance neuromuscular control, 31,49,60 and modulate pain 25 in other clinical settings. Again, there is some conflicting evidence on these effects and their magnitude.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of a Hinged Elbow Orthosis in Medial Collateral Ligament Injuries: An In Vitro Biomechanical Study

2019

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Background: Medial collateral ligament (MCL) injuries are common after elbow trauma and in overhead throwing athletes. A hinged elbow orthosis (HEO) is often used to protect the elbow from valgus stress early after injury and during early return to play. However, there is minimal evidence regarding the efficacy of these orthoses in controlling instability and their influence on long-term clinical outcomes. Purpose: (1) To quantify the effect of an HEO on elbow stability after simulated MCL injury. (2) To determine whether arm position, forearm rotation, and muscle activation influence the effectiveness of an HEO. Study Design: Controlled laboratory study. Methods: Seven cadaveric upper extremity specimens were tested in a custom simulator that enabled elbow motion via computer-controlled actuators and motors attached to relevant tendons. Specimens were examined in 2 arm positions (dependent, valgus) and 2 forearm positions (pronation, supination) during passive and simulated active elbow flexion while unbraced and then while braced with an HEO. Testing was performed in intact elbows and repeated after simulated MCL injury. An electromagnetic tracking device measured valgus angulation as an indicator of elbow stability. Results: When the arm was dependent, the HEO increased valgus angle with the forearm in pronation (+1.0°± 0.2°, P = .003) and supination (+1.5°± 0.0°, P = .006) during active motion. It had no significant effect on elbow stability during passive motion. In the valgus position, the HEO had no effect on elbow stability during passive or active motion in pronation and supination. With the arm in the valgus position with the HEO, muscle activation reduced instability during pronation (–10.3°± 2.5°, P = .006) but not supination ( P = .61). Conclusion: In this in vitro study, this HEO did not enhance mechanical stability when the arm was in the valgus and dependent positions after MCL injury. Clinical Relevance: After MCL injury, an HEO likely does not provide mechanical elbow stability during rehabilitative exercises or when the elbow is subjected to valgus stress such as occurs during throwing.

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“…Kim et al 35 found no significant difference between wearing 3D-printed orthosis and readymade orthosis regarding the effect on relieving Table 3. Results of primary outcome measures (MAS scores of wrist flexor muscle).…”

Section: Mas Scoresmentioning

confidence: 99%

Effects of a 3D-printed orthosis compared to a low-temperature thermoplastic plate orthosis on wrist flexor spasticity in chronic hemiparetic stroke patients: a randomized controlled trial

et al. 2019

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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.

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Effect of personalized wrist orthosis for wrist pain with three-dimensional scanning and printing technique

Abstract: A three-dimensional-printed wrist orthosis can be a substitute for a conventional ready-made wrist orthosis for patients with wrist pain with more satisfaction.

Cited by 53 publications

References 21 publications

The functional effect of 3D-printing individualized orthosis for patients with peripheral nerve injuries

The functional effect of 3D-printing individualized orthosis for patients with peripheral nerve injuries

The Effectiveness of a Hinged Elbow Orthosis in Medial Collateral Ligament Injuries: An In Vitro Biomechanical Study

Effects of a 3D-printed orthosis compared to a low-temperature thermoplastic plate orthosis on wrist flexor spasticity in chronic hemiparetic stroke patients: a randomized controlled trial

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