Effectiveness of 3D-printed orthoses in persons with chronic hand conditions

Hand orthoses are often prescribed to people with chronic hand conditions to reduce impairments (e.g. pain, loss of grip strength, spasticity and joint and/or muscle contractures), which in turn helps to improve the performance of activities of daily living (ADL). Because hand orthoses for chronic conditions are often worn on a daily basis, they need to fit well and be durable. Therefore, orthoses for chronic hand conditions are usually custom-fabricated, which is labor-intensive and time-consuming. In the past decade, three-dimensional (3D) printing has emerged in the field of orthotics as a promising and less labor-intensive alternative to the manufacture of hand orthoses. This thesis indicates that 3D-printed hand orthoses are similar to conventional custom-fabricated orthoses in terms of ADL performance, hand function, and quality of life in persons with chronic hand conditions, while orthosis satisfaction is higher for 3D-printed orthoses. Additionally, the 3D-printing process is twice as fast and half the cost of custom-fabricated hand orthoses. These preliminary results and a review of the literature, which consists mainly of small and poorly designed studies, indicate that there is a strong need for well-designed randomized controlled trials in this population. These should evaluate the effects of 3D-printed orthoses on ADL performance and orthosis satisfaction using the investigated valid and reliable DF-PROMIS-UE custom short form and the D-CSD respectively, with an economic evaluation alongside.