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Wrist orthoses are used by occupational therapists to decrease pain, support weak muscles and protect tissues during healing. However, use of wrist orthoses has been observed to produce compensatory movements in other upper extremity joints. This paper aims to determine whether wearing wrist orthoses produced compensatory movements of the elbow in addition to the shoulder when performing drinking and hammering tasks.

Two twin-axis electrogoniometers were positioned on the elbow and shoulder to track joint movement. The four conditions were drink with orthosis, hammer with orthosis, drink without orthosis and hammer without orthosis. Joint movement was defined as total angular excursion of the joint throughout the performance of the task. Separate 2 × 2 (joint × orthosis) repeated measures analyzes of variance (ANOVA) were used to evaluate differences in joint excursion of the elbow and shoulder joints between orthosis conditions for each task.

Wearing a wrist orthosis did not change the amount of joint excursion compared to not wearing an orthosis during the drinking and hammering tasks.

Findings suggest that wrist orthoses do not result in statistically significant changes in elbow and shoulder joint movements during simulated drinking and hammering tasks.

The purpose of this paper is to describe a manufacturing methodology for a wrist orthosis. The case study aims to offer new approaches in the area of human orthoses.

The article describes the utilization of rapid prototyping (RP), passive stereo photogrammetry and software tools for the orthosis design process. This study shows the key points of the design and manufacturing methodology. The approach uses specific technologies, such as 3D digitizing, reverse engineering and polygonal-surface software, FDM RP and 3D printing.

The results show that the used technologies reflect the patient's requirements and also they could be an alternative solution to the standard method of orthosis design.

The methodology provides a good position for further development issues.

The methodology could be usable for clinical practice and allows the manufacturing of the perfect orthosis of the upper limb. The usage of this methodology depends on the RP system and type of material.

The article describes a particular topical problem and it is following previous publications in the field of human orthoses. The paper presents the methodology of wrist orthosis design and manufacturing. The paper presents an alternative approach applicable in clinical practice.

Pediatric disorders, such as cerebral palsy and stroke, can result in thumb-in-palm deformity greatly limiting hand function. This not only limits children's ability to perform activities of daily living but also limits important motor skill development. Specifically, the isolated orthosis for thumb actuation (IOTA) is 2 degrees of freedom (DOF) thumb exoskeleton that can actuate the carpometacarpal (CMC) and metacarpophalangeal (MCP) joints through ranges of motion required for activities of daily living. The paper aims to discuss these issues.

IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual wearers. The mechanism is actuated via flexible cables that connect to a portable control box. Embedded encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist. A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was measured.

Using this platform, a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor control. Linear force and torque studies showed a maximum efficiency of 44 percent, resulting in a torque of 2.39±1.06 in.-lbf and 0.69±0.31 in.-lbf at the CMC and MCP joints, respectively.

The authors envision this at-home device augmenting the current in-clinic and at-home therapy, enabling telerehabilitation protocols.

This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning.

The purpose of this study is to validate a novel model of resting hand splint manufactured by additive manufacturing (AM) and compare it with the traditional model manufactured by high temperature thermoplastic in terms of cost, weight, volume and thermal comfort.

A novel resting hand splint model was created from the topology optimization (TO) and analyzed, by finite-element analysis, manufacturing cost and weight, with a traditional resting hand splint. A pilot clinical study was carried out to verify heat diffusion during the use of the two splints.

The results showed that compared with the traditional model, the novel model reduced the volume of material used by 35.48%, the weight of the orthosis by 17.56% and the maximum surface deformation by 171.17% when subjected to actuation forces. It was also verified that, when manufactured with Nylon by AM, the new model is 1.5 times cheaper than the traditional model made of Polypropylene. The result of the thermographic analysis showed greater temperature variation in the use of the traditional splint (+4.6°C) compared to the temperature variation observed in the nylon splint (2.1°C).

These results have as clinical relevance the demonstration of the feasibility of manufacturing functional orthoses that are more comfortable, cheaper and lighter than traditional ones.

This study describes the use of TO to manufacture a novel resting hand splint, which was compared with the commonly used traditional splint in terms of mechanical resistance, weight, cost and thermal comfort.

The purpose of this paper is to describe a novel design workflow for the digital fabrication of custom-made orthoses (CMIO). It is intended to provide an easier process for clinical practitioners and orthotic technicians alike. It further functions to reduce the dependency of the operators’ abilities and skills.

The technical assessment covers low-cost three-dimensional (3D) scanning, free computer-aided design (CAD) software, and desktop 3D printing and acetone vapour finishing. To analyse its viability, a cost comparison was carried out between the proposed workflow and the traditional CMIO manufacture method.

The results show that the proposed workflow is a technically feasible and cost-effective solution to improve upon the traditional process of design and manufacture of custom-made static trapeziometacarpal (TMC) orthoses. Further studies are needed for ensuring a clinically feasible approach and for estimating the efficacy of the method for the recovery process in patients.

The feasibility of the process increases the impact of the study, as the great accessibility to this type of 3D printers makes the digital fabrication method easier to be adopted by operators.

Although some research has been conducted on digital fabrication of CMIO, few studies have investigated the use of desktop 3D printing in any systematic way. This study provides a first step in the exploration of a new design workflow using low-cost digital fabrication tools combined with non-manual finishing.

The purpose of this paper is to introduce a new design for a finger and wrist rehabilitation robot. Furthermore, a fuzzy sliding mode controller has been designed to control the system.

Following an introduction regarding the hand rehabilitation, this paper discusses the conceptual and detailed design of a novel wrist and finger rehabilitation robot. The robot provides the possibility of rehabilitating each phalanx individually which is very important in the finger rehabilitation process. Moreover, due to the model uncertainties, disturbances and chattering in the system, a fuzzy sliding mode controller design method is proposed for the robot.

With the novel design for moving the DOFs of the system, the rehabilitation for the wrist and all phalanges of fingers is done with only two actuators which are combined in one device. These features make the system a good choice for home rehabilitation. To control the robot, a fuzzy sliding mode controller has been designed for the system. The fuzzy controller does not affect the coefficient of the sliding mode controller and uses the overall error of the system to make a control signal. Thus, the dependence of the controller to the model decreases and the system is more robust. The stability of the system is proved by the Lyapunov theorem.

The paper provides a novel design of a hand rehabilitation robot and a controller which is used to compensate the effects of the uncertain parameters and chattering phenomenon.

This paper aims to propose a new solution for producing customized three-dimensional (3D)-printed flat-shaped splints, which are then thermoformed to fit the patient’s hand. The splint design process is automated and is available to clinicians through an online application.

Patient anthropometric data measured by clinicians are associated with variables of parametric 3D splint models. Once these variables are input by clinicians in the online app, customized stereo lithography (STL) files for both splint and half mold, in the case of the bi-material splint, are automatically generated and become available for download. Bi-materials splints are produced by a hybrid manufacturing process involving 3D printing and overmolding.

This approach eliminates the need for 3D CAD-proficient clinicians, allows fast generation of customized splints, generates two-dimensional (2D) drawings of splints for verifying shape and dimensions before 3D printing and generates the STL files. Automation reduces splint design time and cost, while manufacturing time is diminished by 3D printing the splint in a flat position.

The app could be used in clinical practice. It meets the demands of mass customization using 3D printing in a field where individualization is mandatory. The solution is scalable – it can be extended to other splint designs or to other limbs. 3D-printed tailored splints can offer improved wearing comfort and aesthetic appearance, while maintaining hand immobilization, allowing visually controlled follow-up for edema and rapidly observing the need for revision if necessary.

An online application was developed for uploading patient measurements and downloading 2D drawings and STL files of customized splints. Different models of splints can be designed and included in the database as alternative variants. A method for producing bi-materials flat splints combining soft and rigid polymers represents another novelty of the research.

The purpose of this paper is to compare four different additive manufacturing (AM) processes to assess their suitability in the context of upper extremity splinting.

This paper describes the design characteristics and subsequent fabrication of six different wrist splints using four different AM processes: laser sintering (LS), fused deposition modelling (FDM), stereolithography (SLA) and polyjet material jetting via Objet Connex. The suitability of each process was then compared against competing designs and processes from traditional splinting. The splints were created using a digital design workflow that combined recognised clinical best practice with design for AM principles.

Research concluded that, based on currently available technology, FDM was considered the least suitable AM process for upper extremity splinting. LS, SLA and material jetting show promise for future applications, but further research and development into AM processes, materials and splint design optimisation is required if the full potential is to be realised.

Unlike previous work that has applied AM processes to replicate traditional splint designs, the splints described are based on a digital design for AM workflow, incorporating novel features and physical properties not previously possible in clinical splinting. The benefits of AM for customised splint fabrication have been summarised. A range of AM processes have also been evaluated for splinting, exposing the limitations of existing technology, demonstrating novel and advantageous design features and opportunities for future research.

The present field of prosthetics/orthotics is an erratic agglomerate of vague guidelines, skills and knowledge. The author conceived prosthotology to clarify, expand and enlighten prosthetics/orthotics into a science with a solid foundation and clear framework. This paper seeks to present itself as an introduction to the field and its relationship with cybernetics and systems.

Prosthotology achieves this by disregarding the established barriers between the human body, mind and environment. This traditional scheme is replaced by focusing on goals and goal systems instead. A goal system consists of a goal former and a goal achiever. When a goal achiever cannot achieve a goal, it can be amended. If a goal achiever cannot initialise, a prosthesis may provide amendment. If a goal achiever cannot propagate, an orthosis may provide amendment.

This perspective enables one to focus on a person's needs, what exactly is inhibiting these needs, and how best to permit the needs to be granted. It does not assume that, in order to achieve a goal, only the human body can be used.

Prosthotology provides direction and advancement for prosthetics and orthotics. It also enhances integration of prosthetics and orthotics with other engineering disciplines.

So far one has only scratched the surface of the potential of prosthetics and orthotics, using prosthotology, this potential is obvious and a step closer.

The purpose of this paper is to implement a new process aimed at the design and production of orthopaedic devices fully manufacturable by additive manufacturing (AM). In this context, the use of generative algorithms for parametric modelling of additively manufactured textiles (AMTs) also has been investigated, and new modelling solutions have been proposed.

A new method for the design of customised elbow orthoses has been implemented. In particular, to better customise the elbow orthosis, a generative algorithm for parametric modelling and creation of a flexible structure, typical of an AMT, has been developed.

To test the developed modelling algorithm, a case study based on the design and production of an elbow orthosis made by selective laser sintering was investigated. The obtained results have demonstrated that the implemented algorithm overcomes many drawbacks typical of the traditional computer aided design (CAD) modelling approaches. The parametric CAD model of the orthosis obtained through the new approach is characterised by a flexible structure with no deformations or mismatches and has been effectively used to produce the prototype through AM technologies.

The obtained results present innovative elements of originality in the CAD modelling sector, which can contribute to solving problems related to modelling for AM in different application fields.