PMID- 37611318
OWN - NLM
STAT- MEDLINE
DCOM- 20230825
LR  - 20230825
IS  - 0272-9490 (Print)
IS  - 0272-9490 (Linking)
VI  - 77
IP  - 4
DP  - 2023 Jul 1
TI  - Design and Use of a 3D-Printed Dynamic Upper Extremity Orthosis for Children With 
      Cerebral Palsy and Severe Upper Extremity Involvement: A Pilot Study.
LID - 7704205060 [pii]
LID - 10.5014/ajot.2023.050095 [doi]
AB  - IMPORTANCE: Children with cerebral palsy (CP) and severe hand impairment have 
      limited options for upper extremity (UE) orthoses. OBJECTIVE: To (1) design and 
      fabricate a customized low-cost, functional, three-dimensional (3D) printed 
      dynamic upper extremity orthosis (DUEO) and (2) examine, using a comprehensive 
      evaluation, the effect of the orthosis on the UE function of children with 
      unilateral UE CP, Manual Ability Classification System (MACS) Levels III to V. 
      DESIGN: Pilot study. Assessments were performed pretreatment and immediately 
      posttreatment. SETTING: Hospital-based outpatient occupational therapy 
      department. PARTICIPANTS: Five patients, ages 13 to 17 yr, with CP and unilateral 
      UE involvement MACS Levels III to V. INTERVENTION: Custom forearm thumb opponens 
      orthosis and the DUEO were designed and fabricated by a multidisciplinary team 
      for use during eight 1-hr occupational therapy sessions targeting bimanual UE 
      training. OUTCOMES AND MEASURES: Pretreatment and posttreatment assessments 
      included the Assisting Hand Assessment (AHA), Melbourne Assessment 2 (MA-2), 
      Pediatric Motor Activity Log-Revised (PMAL-R), and the Pediatric Quality of Life 
      Inventory: CP Module (PedsQL:CP). RESULTS: All participants had higher 
      posttreatment scores on at least one measure. Four had minimal clinically 
      important differences (MCID) on the AHA. Three met MCID criteria on MA-2 subtests 
      (one negative change). Four demonstrated improvement on the PMAL-R (one 
      participant achieved an MCID score), and three reported improvements in more than 
      one PedsQL:CP domain. CONCLUSIONS AND RELEVANCE: This novel 3D-printed device, in 
      combination with occupational therapy, shows promising evidence that children who 
      score in lower MACS levels can show gains in UE function. What This Article Adds: 
      This study demonstrates that a customized, 3D-printed dynamic orthosis, in 
      combination with occupational therapy intervention, can facilitate UE function in 
      children with severe hand impairment.
CI  - Copyright (c) 2023 by the American Occupational Therapy Association, Inc.
FAU - Ragni, Lori B
AU  - Ragni LB
AD  - Lori B. Ragni, MS, OTR/L, BCP, is Supervisor, Pediatric Occupational Therapy, 
      Rusk Rehabilitation, NYU Langone Health, NYU Langone Orthopedic Hospital, New 
      York, NY.
FAU - Dlugacz, Stacy Kirsch
AU  - Dlugacz SK
AD  - Stacy Kirsch Dlugacz, MS, OTR/L, C/NDT, is Clinical Specialist, Pediatric 
      Occupational Therapy, Rusk Rehabilitation, NYU Langone Health, NYU Langone 
      Orthopedic Hospital, New York, NY.
FAU - Sadowsky, Cali
AU  - Sadowsky C
AD  - Cali Sadowsky, MS, OTR/L, is Senior Occupational Therapist, Pediatric 
      Occupational Therapy, Rusk Rehabilitation, NYU Langone Health, NYU Langone 
      Orthopedic Hospital, New York, NY.
FAU - Cammarata, Gabriella
AU  - Cammarata G
AD  - Gabriella Cammarata, MS, is Studio Research Coordinator, Tandon School of 
      Engineering, New York University, Brooklyn, NY.
FAU - Sala, Debra A
AU  - Sala DA
AD  - Debra A. Sala, MS, PT, is Research Coordinator, Division of Pediatric 
      Orthopedics, Hassenfeld Children's Hospital, NYU Langone Health, New York, NY.
FAU - Bill, Victoria
AU  - Bill V
AD  - Victoria Bill, MS, is Director, MakerSpace, and Adjunct Professor, Tandon School 
      of Engineering, New York University, Brooklyn, NY.
FAU - Sukhov, Renat
AU  - Sukhov R
AD  - Renat Sukhov, MD, is Clinical Research Associate Professor of Rehabilitation 
      Medicine, NYU Langone Health, New York, NY.
FAU - Chu, Alice
AU  - Chu A
AD  - Alice Chu, MD, is Associate Professor of Orthopedic Surgery and Chief, Division 
      of Pediatric Orthopedics, Rutgers New Jersey Medical School, Newark, NJ; 
      Chual@njms.rutgers.edu.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Occup Ther
JT  - The American journal of occupational therapy : official publication of the 
      American Occupational Therapy Association
JID - 7705978
RN  - 78213-30-6 (6-hydroxy-7-methoxyphthalide)
SB  - IM
MH  - Humans
MH  - Child
MH  - Pilot Projects
MH  - *Cerebral Palsy
MH  - Quality of Life
MH  - Orthotic Devices
MH  - Upper Extremity
MH  - Printing, Three-Dimensional
EDAT- 2023/08/23 18:42
MHDA- 2023/08/25 06:42
CRDT- 2023/08/23 17:24
PHST- 2023/08/25 06:42 [medline]
PHST- 2023/08/23 18:42 [pubmed]
PHST- 2023/08/23 17:24 [entrez]
AID - 24923 [pii]
AID - 10.5014/ajot.2023.050095 [doi]
PST - ppublish
SO  - Am J Occup Ther. 2023 Jul 1;77(4):7704205060. doi: 10.5014/ajot.2023.050095.