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

Dong-Sik Chae, Da-Ham Kim, Kyung-Yil Kang, Doo-Young Kim, Si-Woon Park, Sung-Jun Park, Jae-Hyung Kim, Dong-Sik Chae, Da-Ham Kim, Kyung-Yil Kang, Doo-Young Kim, Si-Woon Park, Sung-Jun Park, Jae-Hyung Kim

Abstract

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.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Wrist orthosis for carpal tunnel syndrome: (A) palmar view, (B) dorsal view. Ulnar wrist orthosis: (C) palmar view, (D) dorsal view. Ankle-foot orthosis: (E) anterior view, (F) lateral oblique view.
Figure 2
Figure 2
The score of Quebec User Evaluation of Satisfaction with Assistive Technology.

References

    1. Lebovits AH. Psychological interventions with pain patients: evidence for their effectiveness. Semin Pain Med 2003;2:43.
    1. Dombroski CE, Balsdon ME, Froats A. The use of a low cost 3D scanning and printing tool in the manufacture of custom-made foot orthoses: a preliminary study. BMC Res Notes 2014;7:443.
    1. Dessery Y, Pallari J. Measurements agreement between low-cost and high-level handheld 3D scanners to scan the knee for designing a 3D printed knee brace. PLoS One 2018;13:e0190585.
    1. Kim SJ, Kim SJ, Cha YH, et al. Effect of personalized wrist orthosis for wrist pain with three-dimensional scanning and printing technique: a preliminary, randomized, controlled, open-label study. Prosthet Orthot Int 2018;42:636–43.
    1. Nam HS, Seo CH, Joo SY, et al. The application of three-dimensional printed finger splints for post hand burn patients: a case series investigation. Ann Rehabil Med 2018;42:634–8.
    1. Xu R, Wang Z, Ma T, et al. Effect of 3D printing individualized ankle-foot orthosis on plantar biomechanics and pain in patients with plantar fasciitis: a randomized controlled trial. Med Sci Monit 2019;25:1392–400.
    1. Poole JL. Measures of hand function: Arthritis Hand Function Test (AHFT), Australian Canadian Osteoarthritis Hand Index (AUSCAN), Cochin Hand Function Scale, Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability Test (GAT), Jebsen Hand Function Test (JHFT), and Michigan Hand Outcomes Questionnaire (MHQ). Arthritis Care Res (Hoboken) 2011;63: Suppl 11: S189–99.
    1. Fulk GD, Echternach JL, Nof L, et al. Clinometric properties of the six-minute walk test in individuals undergoing rehabilitation poststroke. Physiother Theory Pract 2008;24:195–204.
    1. Wolf SL, Catlin PA, Gage K, et al. Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile. Phys Ther 1999;79:1122–33.
    1. Bethoux F, Rogers HL, Nolan KJ, et al. Long-term follow-up to a randomized controlled trial comparing peroneal nerve functional electrical stimulation to an ankle foot orthosis for patients with chronic stroke. Neurorehabil Neural Repair 2015;29:911–22.
    1. Hong JY, Cho JH. Effects of combined exercise on the skeletal muscle mass index and balance scale of elderly women with sarcopenia. Asian J Kinesiol 2015;17:17–24.
    1. Lee SH, Jung BK, Park SY. Korean translation and psychometric properties of Quebec user evaluation of satisfaction assistive technology 2.0. Journal of Korea Academia-Industrial cooperation Society 2013;14:3284–92.
    1. Padua L, LoMonaco M, Gregori B, et al. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol Scand 1997;96:211–7.
    1. Werner RA, Franzblau A, Gell N. Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome. Arch Phys Med Rehabil 2005;86:1–7.
    1. Chan L, Turner JA, Comstock BA, et al. The relationship between electrodiagnostic findings and patient symptoms and function in carpal tunnel syndrome. Arch Phys Med Rehabil 2007;88:19–24.
    1. Walker WC, Metzler M, Cifu DX, et al. Neutral wrist splinting in carpal tunnel syndrome: a comparison of night-only versus full-time wear instructions. Arch Phys Med Rehabil 2000;81:424–9.
    1. Page MJ, Massy-Westropp N, O’Connor D, et al. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev 2012;7:CD010003.
    1. Huisstede BM, Hoogvliet P, Randsdorp MS, et al. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments–a systematic review. Arch Phys Med Rehabil 2010;91:981–1004.
    1. Huisstede BM, Randsdorp MS, Coert JH, et al. Carpal tunnel syndrome. Part II: effectiveness of surgical treatments—a systematic review. Arch Phys Med Rehabil 2010;91:1005–24.
    1. Wang B, Zhao Y, Lu A, et al. Ulnar nerve deep branch compression by a ganglion: a review of nine cases. Injury 2014;45:1126–30.
    1. Murata K, Shih JT, Tsai TM. Causes of ulnar tunnel syndrome: a retrospective study of 31 subjects. J Hand Surg Am 2003;28:647–51.
    1. Depukat P, Mizia E, Kuniewicz M, et al. Syndrome of canal of Guyon - definition, diagnosis, treatment and complication. Folia Med Cracov 2015;55:17–23.
    1. Aleksenko D, Varacallo M. Guyon Canal Syndrome. StatPearls. Treasure Island (FL): StatPearls Publishing LLC; 2019.
    1. Dy CJ, Mackinnon SE. Ulnar neuropathy: evaluation and management. Curr Rev Musculoskelet Med 2016;9:178–84.
    1. Hoogvliet P, Coert JH, Friden J, et al. How to treat Guyon's canal syndrome? Results from the European HANDGUIDE study: a multidisciplinary treatment guideline. Br J Sports Med 2013;47:1063–70.
    1. Blaya JA, Herr H. Adaptive control of a variable-impedance ankle-foot orthosis to assist drop-foot gait. IEEE Trans Neural Syst Rehabil Eng 2004;12:24–31.
    1. Bishop D, Moore A, Chandrashekar N. A new ankle foot orthosis for running. Prosthet Orthot Int 2009;33:192–7.
    1. Sackley C, Disler PB, Turner-Stokes L, et al. Rehabilitation interventions for foot drop in neuromuscular disease. Cochrane Database Syst Rev 2007. CD003908.
    1. Nagaya M. Shoehorn-type ankle-foot orthoses: prediction of flexibility. Arch Phys Med Rehabil 1997;78:82–4.
    1. Middleton EA, Hurley GR, McIlwain JS. The role of rigid and hinged polypropylene ankle-foot-orthoses in the management of cerebral palsy: a case study. Prosthet Orthot Int 1988;12:129–35.
    1. Velasco I, Vahdani S, Ramos H. Low-cost method for obtaining medical rapid prototyping using desktop 3D printing: a novel technique for mandibular reconstruction planning. J Clin Exp Dent 2017;9:e1103–8.
    1. Wojciechowski E, Chang AY, Balassone D, et al. Feasibility of designing, manufacturing and delivering 3D printed ankle-foot orthoses: a systematic review. J Foot Ankle Res 2019;12:11.

Source: PubMed

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