Effectiveness of 3D-printed orthoses for traumatic and chronic hand conditions: A scoping review

Abstract

Background In the field of orthotics, the use of three-dimensional (3D) technology as an alternative to the conventional production process of orthoses is growing. Purpose This scoping review aimed to systematically map and summarize studies assessing the effectiveness of 3D-printed orthoses for traumatic and chronic hand conditions, and to identify knowledge gaps. Methods The Cochrane Library, PubMed, EMBASE, CINAHL, Web of Science, IEEE, and PEDro were searched for studies of any type of 3D-printed orthoses for traumatic and chronic hand conditions. Any outcome related to the effectiveness of 3D-printed orthoses was considered. Two reviewers selected eligible studies, charted data on study characteristics by impairment type, and critically appraised the studies, except for case reports/series. Results Seventeen studies were included: four randomized controlled trials, four uncontrolled trials, four case series and five case reports. Only three studies had a sample size >20. Impairments described were forearm fractures (n = 5), spasticity (n = 5), muscle weakness (n = 4), joint contractures (n = 2) and pain (n = 1). Four poor to fair quality studies on forearm fractures supported the effectiveness of 3D-printed orthoses on hand function, functionality, and satisfaction. One good quality study on spasticity demonstrated the effectiveness of 3D-printed orthoses on hand function. One poor quality pain study reported limited positive effects on satisfaction. Studies on muscle weakness and joint contractures showed no benefits. Conclusion Current literature addressing the effectiveness of 3D-printed orthoses for traumatic and chronic hand conditions consists primarily of small and poor methodological quality studies. There is a need for well-designed controlled trials including patient-related outcomes, production time and cost analyses.

Preliminary effectiveness of 3D-printed orthoses in chronic hand conditions: study protocol for a non-randomised interventional feasibility study

“…Additive manufacturing, otherwise known as three-dimensional (3D) printing, is becoming increasingly popular in the field of orthotics, not only in manufacturing lower extremity orthoses, 1 but more recently also in 3D-printing of upper extremity orthoses for chronic disabling conditions. 2 In the Netherlands alone, 27 000 persons are provided with upper extremity orthoses each year, 3 of which a large part includes hand orthoses.…”

“…Our recent scoping review on this topic identified only 12 studies on chronic hand conditions. 2 These were mostly case reports/case series (n=8), and of the four clinical trials, only one was of high methodological quality. 15 Furthermore, it was noticed that only one clinical trial reported on the performance of activities of daily living (ADL), 16 while the main goal for prescribing a hand orthosis is to support the hand during ADL.…”

“…Yet, although 3D-printing has several promising advantages and 3D-printed hand orthoses are increasingly applied within routine care, evidence for the effectiveness, and production time and costs of 3D-printed orthoses in chronic hand conditions is scarce. Our recent scoping review on this topic identified only 12 studies on chronic hand conditions 2. These were mostly case reports/case series (n=8), and of the four clinical trials, only one was of high methodological quality 15.…”

3D-Printed Polycaprolactone Mechanical Characterization and Suitability Assessment for Producing Wrist–Hand Orthoses

“…Depending on the diagnosis (arthritis, fracture, strains, etc. [ 17 ]), splints, braces, or casts [ 18 ] are used for different periods of time, and functionality and comfort (to enhance compliance to wear the WHO) are the main criteria used in their development [ 19 , 20 ]. An attractive design, customization based on the patient’s forearm anatomy (usually acquired by 3D scanning [ 21 , 22 ]), and a lightweight design in comparison to traditional casts or splints are the frequently mentioned advantages of 3D-printed WHOs (3DP-WHOs) [ 23 , 24 ].…”

Personalized 3D-printed forearm braces as an alternative for a traditional plaster cast or splint; A systematic review

“…The authors also concluded that the printing technology in hand therapy settings remains challenging in part due to the resources required. Another recent systematic review reported that current literature addressing the effectiveness of 3Dprinted orthoses for traumatic and chronic hand conditions con- sists primarily of small and poor methodological quality studies [ 9 ]. Both reviews appreciate there is a need for well-designed controlled trials including patient-reported outcomes, production time and cost analyses.…”