Effectiveness of a New 3D-Printed Dynamic Hand–Wrist Splint on Hand Motor Function and Spasticity in Chronic Stroke Patients

Spasticity, a common stroke complication, can result in impairments and limitations in the performance of activities and participation. In this study, we investigated the effectiveness of a new dynamic splint on wrist and finger flexor muscle spasticity in chronic stroke survivors, using a randomized controlled trial. Thirty chronic stroke survivors were recruited and randomly allocated to either an experimental or control group; 25 completed the 6-week intervention program. The participants in the experimental group were asked to wear the dynamic splint at least 6 h/day at home, for the entire intervention. The participants in the control group did not wear any splint. All the participants were evaluated 1 week before, immediately, and after 3 and 6 weeks of splint use, with the modified Ashworth scale and the Fugl−Meyer assessment for upper extremity. User experience was evaluated by a self-reported questionnaire after the 6-week intervention. The timed within-group assessments showed a significant reduction in spasticity and improvements in functional movements in the experimental group. We found differences, in favor of the experimental group, between the groups after the intervention. The splint users indicated a very good satisfaction rating for muscle tone reduction, comfort, and ease of use. Therefore, this new splint can be used for at-home rehabilitation in chronic stroke patients with hemiparesis.

Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review

Background: Developmental dysplasia of the hip (DDH) is one of the most common pediatric conditions. The current gold-standard treatment for children under six months of age with a reducible hip is bracing, but the orthopedic literature features several splint options, and each one has many advantages and disadvantages. The aim of this review is to analyze the available literature to document the up-to-date evidence on DDH conservative treatment. Methods: A systematic review of PubMed and Science Direct databases was performed by two independent authors (C.d.C. and A.V.) using the keywords “developmental dysplasia hip”, “brace”, “harness”, “splint”, “abduction brace” to evaluate studies of any level of evidence that reported clinical or preclinical results and dealt with conservative DDH treatment. The result of every stage was reviewed and approved by the senior investigators (V.P. and G.T.). Results: A total of 1411 articles were found. After the exclusion of duplicates, 367 articles were selected. At the end of the first screening, following the previously described selection criteria, we selected 29 articles eligible for full text reading. The included articles mainly focus on the Pavlik harness, Frejka, and Tubingen among the dynamic splint applications as well as the rhino-style brace, Ilfeld and generic abduction brace among the static splint applications. The main findings of the included articles were summarized. Conclusions: Dynamic splinting for DDH represents a valid therapeutic option in cases of instability and dislocation, especially if applied within 4–5 months of life. Dynamic splinting has a low contraindication. Static bracing is an effective option too, but only for stable hips or residual acetabular dysplasia.

Design and Analysis of a Dynamic Splint Based on Pulley Rotation for Post-Stroke Finger Extension Rehabilitation Device

The presence of rehabilitation tools is essential to more rapidly cure hand muscle disorders of people affected by stroke. One of the tools is a dynamic splint that is fit-sized, lightweight, comfortable to wear, and easy to operate. The paper proposes the design and analysis of new dynamic splints based on pulley rotation as a rehabilitation device for finger extension after stroke. This device consists of the main splint, the pulley, the locker, the finger handles, the ball bearing, and the fishing line. To lock and stop pulley turning, the locking system is designed to complement it which is also the most important mechanical segment. The shear stress of the pulley was 0.026 N/mm2. The deformation, stress, and strain energy of the locking system section were analyzed by the finite element method. The results showed that the deformation distribution around the locker section was at 0.1-0.15 mm intervals. The maximum stress 25.0786 MPa, which is still inferior to the yield strength of ABS Material (28.5 MPa). The safety factor of the structure is about n = 1.14. The largest strain energy was 0.2856 mJ at the same place as with the maximum stress which was close to the conical end of the locker. The correlation between stress-strain energy and moment was linear as well. In future work, a prototype will be fabricated using 3D printers, and it will be applied to the stroke patient. In addition, the therapies will be involved to assess the improvement of the finger extension of stroke patients.

Newly developed dynamic splint vs. dynamic outrigger splint for postoperative treatment of extensor tendon rupture in patients with rheumatoid wrists - a preliminary study

Aim and object of the study: Extensor tendon rupture in patients with rheumatoid wrists causes dysfunction of the hand and necessitates tendon reconstruction and surgical treatment of the wrist joint. Dynamic outrigger splints using rubber bands have been used for early postoperative mobilization of the fingers. However, these splints are bulky and cause discomfort. We developed a new dynamic splint, which is compact and uses torsion springs instead of the rubber bands used in conventional outrigger splints. The splint extends the metacarpophalangeal joints using a volar finger bar. The objective of this study was to compare the clinical outcomes and subjective assessments between patients treated with the two types of splint. Methodology: Fourteen wrists (14 patients) were included. Clinical outcomes (range of active motion of the metacarpophalangeal joint) and subjective assessments were investigated in patients treated with either an outrigger splint or our new dynamic splint. Results: There were no differences in clinical outcomes between patients treated with the two kinds of splint. The new splint performed better in terms of the subjective assessment of changing clothes and bulkiness. Conclusions: The new splint yielded equivalent clinical outcomes and better subjective assessments compared to conventional outrigger splints due to its reduced size.