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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.

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 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.

Carpal tunnel syndrome (CTS) is a hand disease caused by the pressing of the median nerve present in the palmar side of the wrist. It causes severe pain in the wrist, triggering disturbance during sleep. Different products like splints, braces and gloves are available in the market to alleviate this disease but there was still a need to improve the wearability, comfort and cost of the product. This study was about designing a comfortable and cost-effective wearable system for mild-to-moderate CTS. Transcutaneous electrical nerve stimulation (TENS) therapy has been used to reduce the pain in the wrist.

After simulation by using Proteus software (which allowed the researchers to draw and simulate electrical circuits using ISIS, ARES and PCB design tools virtually), the circuit with optimum frequency, i.e. 33 Hz was selected, and the circuit was developed on a printed circuit board (PCB). The developed circuit was integrated successfully into the half glove structure.

The developed product had good thermophysiological comfort and hand properties as compared to the commercially available product of the same kind. In vivo testing (It involves the testing with living subjects like animals, plants or human beings) was performed which resulted in 85% confirmed viability of the product against CTS. A glove with an integrated circuit was developed successfully to accommodate various sizes without any sex specifications in a cost-effective way to mitigate the issue of CTS.

Industrial workers, individuals frequently using their hands or those diagnosed with CTS may wish to use this product as therapy. The attention could not be paid to the aesthetic or visual appeal of the developed product.

A very comfortable glove with integrated TENS electrodes was developed successfully to accommodate various sizes without any sex specifications in a cost-effective way to mitigate the issues of CTS.

The post-operative management of flexor tendon injuries has been the focus of considerable exploration and there continues to be variation in approaches and methods of mobilisation. The purpose of this paper is to explore therapy management following repair to flexor tendons at zone II and flexor pollicis longus (FPL) (all zones) in Ireland.

A descriptive survey questionnaire design through an online format was used. Therapists were recruited through the Irish Association of Hand Therapists, the national bodies for occupational therapy and physiotherapy, and therapy managers in acute hospitals, with 29 therapists participating in the study. Descriptive statistics were used to analyse the survey data.

Patients were generally seen three to five days following surgery. Early active mobilisation approaches were favoured by all but one therapist, with 62% using the Belfast protocol and 34% the Manchester Short Splint (MSS) protocol. Each early active protocol exercise session commences with passive motion followed by graded active flexion. Tenodesis is incorporated by the majority of respondents within the first four weeks. Therapy programme and splints are modified based on patient presentation. Resistance exercises are commenced from week seven. Patient compliance was identified as the most influential factor in the post-operative intervention approach taken.

This study provides the first Irish profile of current practice in the post-operative management of flexor tendon repairs at zone II and FPL which has not previously been reported. Further research should explore the reasoning behind the interventions chosen and also the implications for practice of changes to surgical techniques.

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 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 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.

The paper seeks to examine the health risks faced when using computer‐based systems by library staff in Nigerian libraries.

The paper uses a survey research approach to carry out this investigation.

The investigation reveals that the perceived health risk does not predict perceived ease of use of computer‐based libraries. Even though a wide range of health hazards were identified in the libraries, the level of availability of ergonomic programmes to tackle them was low.

In general, librarians, university authorities, IT policy formulators and systems administrators should find this paper useful, as it educates them about the fact that perceived health risk does not significantly deter people from using information systems. This is due to the enormous benefits arising from the use of IT when compared with the manual systems.

The study offers new insights in the area of IT use by librarians in Nigerian universities. That the study found that prevailing health risks do not significantly deter people from using information systems means that it differs from other studies.

This case study describes a community-based urgent care clinic in a general practitioner (GP) super clinic in South East Queensland.

This retrospective chart audit describes patient demographic characteristics, types of presentations and management for Sundays in 2015.

The majority of patients (97%) did not require admission to hospital or office investigations (95%) and presented with one condition (94%). Of the presentations, 66.5% were represented by 30 conditions. Most patients received a prescription (57%), some were referred to the pathology laboratory (15%) and some were referred to radiology (12%). A majority (54%) of patients presented in the first three hours. Approximately half (51%) of patients presenting were aged under 25. More females (53%) presented than males. A majority (53%) lived in the same postcode as the clinic. The three most common office tests ordered were urinalysis, electrocardiogram (ECG) and urine pregnancy test. Some patients (19%) needed procedures, and only 3% were referred to hospital.

The study offers analysis of the client group that can be served by an urgent care clinic in a GP super clinic on a Sunday. The study provides an option for emergency department avoidance.

Despite calls for more research into community-based urgent care clinics, little is known in Australia about what constitutes an urgent care clinic. The study proposes a classification system for walk-in presentations to an urgent care clinic, which is comparable to emergency department presentations.