Innovation in Ulnar Deviation Orthosis using Parametric Design and Additive Manufacturing New orthosis concept

Main Article Content

Valéria Meirelles Carril Elui Daniela Nakandakari Goia Felipe Saconi Marisa de Cassia Registro Fonseca Fausto Orsi Medola Carlos Alberto Fortulan

Abstract

Background: Technologies of additive manufacturing (AM) enable the creation of parts with suitable finish and resistance, including those with complex geometries, which allows custom design and rapid manufacturing solutions at reliable cost, thus making possible its application to orthotic and therapeutic devices in rehabilitation practice.


Objective: To introduce the development of computer-designed orthotic tools through parametrization for manufacturing of custom dynamic orthoses for ulnar deviation.


Methods: The methodology consisted of two stages, with the first involving the development of parametric design methodology and the second involving the project evolution from the evaluation with 23 participants.


Results: The final design had six components with 10 reference measurements from the hand to the arm, whose data were entered into an electronic spreadsheet (MS Excel) so that the CAD software could automatically redraw the parts in a few seconds.  The parts were manufactured by using FDM (Fused Deposition Modeling) in about 10 hours, including 15 minutes for assembly and adjustments.


Discussion: The choice of this new methodology came from the need to have a tool that could be easy to handle by therapists in any clinic setting, and also enable the therapist to use her/his skills to evaluate and provide functional training of the kinetic orthosis, without the need to have specific skills or materials to manufacture the device.


Conclusion: The parametric orthosis project was successful at different levels of deformity, providing ulnar deviation correction and enabling full wrist and finger flexion/extension without causing any disturbance during daily activities. Although the initial project was costly in relation to the reference version due to the high demand for therapists and the industrial designer, the parametric versions become economic as the cost impact is focused only on the digital manufacturing.

Keywords: Rehabilitation, Orthotic devices, Rheumatoid arthritis, Self-help device, 3D Printing

Article Details

How to Cite
ELUI, Valéria Meirelles Carril et al. Innovation in Ulnar Deviation Orthosis using Parametric Design and Additive Manufacturing. Medical Research Archives, [S.l.], v. 12, n. 3, mar. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5101>. Date accessed: 30 apr. 2024. doi: https://doi.org/10.18103/mra.v12i3.5101.
Section
Research Articles

References

1. Beasley J. Osteoarthritis and Rheumatoid Arthritis: Conservative Therapeutic Management. J Hand Ther. 2012;25(2):22326361. doi:10.10 16/j.jht.2011.11.001

2. Formsma SA, van der Sluis CK, Dijkstra PU. Effectiveness of a MP-blocking Splint and Therapy in Rheumatoid Arthritis: A Descriptive Pilot Study. J Hand Ther. 2008;21(4):347-353. doi:10.1197/j.jht.2008.06.001

3. Goia DN, Fortulan CA, Purquerio BM, Elui VM. A new concept of orthosis for correcting fingers ulnar deviation. Res Biomed Eng. 2017 ;33(1):50-57. doi:10.1590/2446-4740.02516

4. Lipsky PE. Rheumatoid arthritis. In: Harrison’s rheumatology. 2a ed. Mcgraw Hill; 2010:82-99.

5. Pitzalis C, Kelly S, Humby F. New learnings on the pathophysiology of RA from synovial biopsies. Curr Opin Rheumatol. 2013;25(3):3 34-344. doi:10.1097/bor.0b013e32835fd8eb

6. Carmona L, Cross M, Williams B, Lassere M, March L. Rheumatoid arthritis. Best Pract Amp Res Clin Rheumatol. 2010;24(6):733-745. doi:10.1016/j.berh.2010.10.001

7. Rennie HJ. Evaluation of the Effectiveness of a Metacarpophalangeal Ulnar Deviation Orthosis. J Hand Ther. 1996;9(4):371-377. doi :10.1016/s0894-1130(96)80044-5

8. Luzo MC, Mello MAF, Capanema VM. Recursos tecnológicos em terapia ocupacional: órteses e tecnologia assistiva. In: Terapia ocupacional: reabilitação física e contextos hospitalares. São Paulo: Roca, 2004. p. 99-126. Rocca; 2004:99-126.

9. Massa LD, Silva TS. A utilização de órteses de membro superior em pacientes com artrite reumatoide: uma revisão de literatura no campo da terapia ocupacional. Cad Ter Ocupacional UFSCar. 2015;23(3):647-659. doi :10.4322/0104-4931.ctoar0522

10. Lede PV, Veldhoven Gv. Mechanical and biomechanical considerations. In: Therapeutic hand splints : a rational approach. Provan; 2002:96-108.

11. Palousek D, Rosicky J, Koutny D, Stoklásek P, Navrat T. Pilot study of the wrist orthosis design process. Rapid Prototyp J. 2014;20(1):27-32. doi:10.1108/rpj-03-2012-0027.

12. Paterson AM, Bibb R, Campbell RI, Bingham G. Comparing additive manufacturing technologies for customised wrist splints. Rapid Prototyp J. 2015;21 (3):230-243. doi:10.1108/rpj-10-2013-0099

13. Assad DA, Elui VM, Wong V, Fortulan CA. Órtese com impressão 3D para ombro: relato de caso. Acta Fisiatr. 2018;24(3). doi:10.5935/ 0104-7795.20170029

14. Moylan SP, Cooke AL, Jurrens KK, Slotwinski JA, Donmez MA. A Review of Test Artifacts for Additive Manufacturing. Published online May 24, 2012. doi: https://doi.org/10.6028/nist.ir.7858

15. Hieu LC, Sloten JV, Hung LT, Khanh L, Soe S, Zlatov N, et al. Medical Reverse Engineering Applications and Methods. 2nd International Conference on Innovations, Recent Trends and Challenges in Mechatronics, Mechanical Engineering and New High-Tech Products Development (Mecahitech '10). 2010:186-96. Doi: 10.1016/j .procir.2016.02.315

16. Krznar N, Pilipović A, Šercer M. Additive Manufacturing of Fixture for Automated 3D Scanning – Case Study. Procedia Eng. 2016;1 49:197-202. doi:10.1016/j.proeng.2016.06.656

17. Camba J, Contero M, Johnson M, Company P. Extended 3D annotations as a new mechanism to explicitly communicate geometric design intent and increase CAD model reusability. Computer-Aided Design. 2014;57:61-73. doi:https://doi.org/10.1016/j.cad.2014.07.001

18. Baronio G, Harran S, Signoroni A. A Critical Analysis of a Hand Orthosis Reverse Engineering and 3D Printing Process. Appl Bionics Biomech. 2016;2016:1-7. doi:10.1155 /2016/8347478Paterson AMJ, Bibb RJ, Campbell RI. A review of existing anatomical data capture methods to support the mass customisation of wrist splints. Virtual and Physical Prototyping. 2010;5(4):201-207. doi: https://doi.org/10.1080/17452759.2010.528183

19. Paterson AM, Bibb RJ, Campbell RI. A review of existing anatomical data capture methods to support the mass customisation of wrist splints. Virtual Phys Prototyp. 2010;5(4):2 01-207. doi:10.1080/17452759.2010.528183

20. Anderl R, Mendgen R. Parametric design and its impact on solid modeling applications. Proceedings of the third ACM symposium on Solid modeling and applications - SMA ’95. Published online 1995. doi: https://doi.org/10.1145/218013.218018

21. Purquerio B, Fortulan CA, Goia D, Elui V. Órtese autoarticulada para correção do desvio ulnar dos dedos e da articulação metacarpofalangeana e uso. University of Sao Paulo, ed. 2013:13(BR102013019730).

22. Camba JD, Contero M, Company P. Parametric CAD modeling: An analysis of strategies for design reusability. Computer-Aided Design. 2016;74:18-31. doi:https://doi.org/10.1016/j.cad.2016.01.003

23. Paterson AM, Donnison E, Bibb RJ, Ian Campbell R. Computer-aided design to support fabrication of wrist splints using 3D printing: A feasibility study. Hand Therapy. 2014;19(4):102-113. doi:https://doi.org/10.1177/1758998314544802

24. Fantini, M., De Crescenzio, F., Brognara, L., Baldini, N. (2017). Design and Rapid Manufacturing of a customized foot orthosis: a first methodological study. In: Eynard, B., Nigrelli, V., Oliveri, S., Peris-Fajarnes, G., Rizzuti, S. (eds) Advances on Mechanics, Design Engineering and Manufacturing. Lecture Notes in Mechanical Engineering. Springer, Cham. https://doi.org/10.1007/978-3-319-45781-9_46

25. Abrilahij A, Boll T. A Qualitative Metasynthesis of Reasons for the Use or Nonuse of Assistive Technologies in the Aging Population. GeroPsych. 2019;32(2):79-92. doi: https://doi.org/10.1024/1662-9647/a000203

26. Sugawara AT, Ramos VD, Alfieri FM, Battistella LR. Abandonment of assistive products: assessing abandonment levels and factors that impact on it. Disability and Rehabilitation: Assistive Technology. 2018;13( 7):716-723. doi:https://doi.org/10.1080/17483107.2018.1425748

27. Osterwalder A, Pigneur Y. Business Model Generation a Handbook for Visionaries, Game Changers, and Challengers. (Clark T, ed.). John Wiley & Sons, Inc.; 2010.