Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
PO TF(1), Kaur R(1), Wong MF(1), Hui N(1)
Affiliation :
Occupational Therapy Department, United Christian Hospital
Introduction :
Static Progressive Stretch (SPS) is a functional splint for gradual passive mobilization for joint stiffness and contracture that are unresolved by standard therapy. It combines plastic deformation and stress relaxation principles causing tissue re-modeling for permanent elongation. Previously, patients received SPS using commercial devices when attending our out-patient classes. These devices are expensive and vulnerable, making them infeasible as a loan device for patient use at home. Occupational Therapists of UCH designed their own wrist and elbow SPS using 3D printing technology for patient loan service.
Objectives :
To design a new turnbuckle SPS using 3D printing technology and study its effectiveness in improving joint stiffness as home program
Methodology :
Our SPS prototype was finalized using commercial turnbuckle parts from skiing boots adapted with 3D printing materials on a hinge brace. There are two designs with one targeting wrist or elbow flexion and extension, while the other one works for forearm pronation and supination. The advantages of these new turnbuckle SPS include: (1) It works better on finer or more extreme range of motion (ROM); (2) It allows daily home-based treatment with increased total end range time; (3) It provides strong enough tension over time; (4) It is safer, more durable and at far lower cost than commercial device.
Result & Outcome :
Six patients with post-traumatic elbow stiffness have loaned our new SPS devices for home program since July 2023. Two patients have completed SPS treatment with excellent outcomes as illustrated below: Case 1: Mr. Chen was a 44-year old male patient with left elbow fracture dislocation. New elbow SPS for flexion and extension was prescribed seven weeks after the operation. Following a wearing protocol of 15 minutes for 3 sessions daily for two months, the total range of motion was increased from 80 to 120 degrees, the elbow flexion contracture was decreased from 30 to 5 degrees Case 2: Mr. Chu was a 24-year old male patient with right triquetrum fracture with triangular fibro-cartilage complex injury. New SPS for pronation and supination was prescribed three months after operation. Following a wearing protocol of 15 minutes for 1-2 sessions daily for four months, the arc of rotation was increased from 120 to 170 degrees. The new design turnbuckle SPS with 3D technology adapted parts, patients easily comply to home program with loan service and can achieve finer ROM. It has become one of the effective interventions in improving joints stiffness. Further studies will be needed with a larger sample size.
