Advertisement

A rehabilitation protocol for the use of a 3D-printed prosthetic hand in pediatrics: A case report

Published:November 16, 2022DOI:https://doi.org/10.1016/j.jht.2022.10.010

      Highlights

      • A home exercise program using a 3D printed hand can improve functional outcomes.
      • Improvements in patient outcomes in functional mobility and sensory integration.
      • 3D printed prosthetic hand usage to help improve activities of daily living.

      Abstract

      Introduction and Purpose

      The purpose of this study was to evaluate the outcomes of utilizing a 3D prosthetic device with a home exercise program. This case study was intended to see if the application of a home exercise program utilizing a 3D printed prosthetic hand resulted in increased range of motion, strength, coordination, sensory integration, and perceived function of the upper extremity.

      Study Design

      Case Study

      Methods

      This study outlines one rehabilitation protocol for a 6-year-old boy with right congenital upper limb deficiency. A 4-week home rehabilitation protocol was utilized with a 3D printed prosthetic hand. Pre-assessment measurements were taken of range of motion, strength testing, BOT-2 coordination, and a sensory questionnaire. The home program included ROM exercises, body-powered use of the 3D printed device, strengthening without the device and sensory integration exercises. The frequency of the protocol was 3 times per week for 30 minutes with adult supervision.

      Results

      Improvements were seen in range of motion, strength, coordination, and sensory integration. Results demonstrated improved right upper extremity strength with all movements except radial deviation. Range of motion improved with passive and active wrist flexion, extension, and forearm pronation. Sensory integration questionnaires showed decreased sensory sensitivities. A structured home exercise program with and without a 3D printed hand improved upper extremity function in this population.

      Discussion

      Evaluating the outcomes of a home rehabilitation protocol for a child using a 3D printed hand was successful. The studies evidence will help guide treatment and clinical decision making for future studies.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Therapy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Agrawal A
        • Sakale H
        • Kumar S.
        Transverse terminal upper limb deficiency through the arm: the problem and management.
        J Orthop Traumatol Rehab. 2018; 10: 145
        • Laurien M
        • Marij E
        • Josemiek M
        • Pesch-Batenburg W
        • Janssen-Henk J.
        Assessment of arm/hand functioning in children with a congenital transverse or longitudinal reduction deficiency of the upper limb.
        Disabil Rehab. 2006; 28: 85-95
        • Farr S
        • Catena N
        • Martinez-Alvarez S
        • Soldado F.
        Peromelia—congenital transverse deficiency of the upper limb: a literature review and current prosthetic treatment.
        J Child Orthop. 2018; 12: 558-565
        • Quinn M.
        Congenital upper limb deficiency: a case report.
        J Contemp PEDS. 2019; 36: 3
        • Zuniga J
        • Peck L, J
        • Srivastava R
        • et al.
        Functional changes through the usage of 3D-printed transitional prostheses in children.
        Disabil Rehab Assist Technol. 2019; 14: 68-74
        • Jelle K
        • Gerwin S
        • Paul B.
        3D-printed upper limb prostheses: a review.
        Disabil Rehab Assist Technol. 2017; 12: 300-314
        • Zuniga J
        • Dimitrios K
        • Peck J
        • et al.
        Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist driven 3D printed partial hand prosthesis.
        J Neuroeng Rehab. 2018; 15: 45
        • Arnould C
        • Penta M
        • Renders A
        • Thonnard J.
        ABILHAND-Kids: a measure of manual ability in children with cerebral palsy.
        Neurology. 2004; 63: 1045-1052
        • Anderson B
        • Schanandore JV.
        Using a 3D-printed prosthetic to improve participation in a young gymnast.
        Pediatr Phys Ther. 2021; 33: 1-6
        • Cuthbert S
        • Goodheart G
        On the reliability and validity of manual muscle testing: a literature review.
        Chiropr Man Therap. 2007; 15 (–4): 4https://doi.org/10.1186/1746-1340-15-4
        • Zuniga J
        • Peck J
        • Srivastava R
        • Katsavelis D
        • Carson A
        An open source 3D-printed transitional hand prosthesis for children.
        J Prosthet Orthot. 2016; 28: 103-108https://doi.org/10.1097/JPO.0000000000000097
        • Hanson H
        • Harrington A
        • Nixon-Cave K
        Implementing treatment frequency and duration guidelines in a hospital-based pediatric outpatient setting: administrative case report.
        Phys Ther. 2015; 95: 678-684https://doi.org/10.2522/ptj.20130360