3D Printing Hand Hand Therapy

3D Printing in Hand Therapy

Woman using wrist immobiliser after hand's injury

3D printing technology is on the rise, and there is increased use by professionals and laypersons. Someday soon, this amazing technology will give hand therapists a remarkable tool to make “in-house” assistive devices, hand exercise equipment, therapy tools, orthotic components and orthoses (formerly termed “splints”), and more.

What are 3D printers and how do they work?

There are different types of 3D printers that use various processes to create objects. The most common type of 3D printer in the consumer market uses plastic filament with a price range of about $500 to $4,000 (Figure 1). Think of it as a highly sophisticated hot glue gun, which melts plastic filament and deposits it in layers from the bottom up to form an object (like building a brick wall). A digital file provides the “virtual blueprint” for instructing a 3D printer where to lay the plastic to form an object. These digital files are created by persons with skill in using computer design/modeling software or from scans of objects (using scanning technologies and even data from MRI or CT scans).

3d printerFigure 1: A filament-based desktop 3D printer used by the author

How is a 3D Printed Wrist Orthosis (Splint) Made?

Briefly, the process of making a custom 3D printed wrist orthosis requires scanning technology to obtain a digital copy of a person’s hand and arm. Next, using special software, a digital wrist orthosis is created on the digital hand and arm, and then the digital hand and arm is removed, leaving a digital wrist orthosis ready for 3D printing. Printing of the orthosis takes some time. For example, one prototype of a wrist orthosis took more than seven hours to print using a filament-based 3D printer. As this technology evolves, the process will become more user-friendly and faster for use in hand therapy practice. The current method of making wrist orthoses in a hand therapy clinic consists of heating a thin sheet of low temperature thermoplastic and skillfully molding it directly upon the client. This process takes about 15 minutes.

A nice feature of 3D printing is that many of the digital 3D models (for a wide variety of objects) are available for free download from the Internet for anyone to print! These models are created and shared by laypersons and professionals with various levels of skill in 3D design. Included among these are assistive devices (Figure 2), simple hand orthoses and mechanical hands/digits. It is important to be aware that the majority of these models are not created by healthcare professionals, and there is no requirement/regulation to ensure functionality and safety of these devices.

assistive device

Figure 2: An example of a 3D printable assistive device

When finger pain, weakness or limited range of motion make it difficult to twist open lids on plastic containers, a 3D printed assistive device such as a “Plastic Cap Wrench” can do the job with much less effort! The Plastic Cap Wrench (remix) Rounded was created by GiovaGio and is available for free download from http://www.thingiverse.com/thing:711671. It takes about 20-30 minutes to print, and the material cost is less than 50 cents. The tricky part is resizing, or scaling, the object prior to printing in order to fit a specific cap size.

3d illustration

In the near future, as 3D printing technology improves (and it is doing so at a very rapid pace), hand therapists will be able to use this technology to make custom assistive devices, equipment, therapeutic tools, orthoses and more within the clinic setting. The advanced technology will help clients return to the occupations and daily living skills that are important to them!

Robin Janson, MS, OTR, CHT is an occupational therapist, Certified Hand Therapist and is a member of the American Society of Hand Therapists (ASHT).

All of the photos provided were taken by Robin Janson.

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  • Aimee Lawrence
    January 19, 2018 at 3:27 AM

    Hello Robin,
    I am a 4th year OT student at the University of Pretoria, South Africa. We are busy doing research on 3D printing and Forearm based wist extention splints. We are busy doing a trial where we printed 3D patterns of splints that can be modified with a heat gun. I read your reply to Emily Boulton and was wondering if you have any data or research that we can reference with regards to why we didn’t follow the route of specific 3D splints individualized for each participant.

    Thank you in advance,

    Aimee Lawrence

  • Sandra Salinas
    February 18, 2017 at 6:07 PM

    The advantage to 3D printing for the hand therapist is it’s use in small orthosis fabrication, such as for the PIP joint. The process takes about 45 to 55 minutes of actual printing, about 10 additional minutes for set up and refinement. The advantages are that the cost is minimal and the fit can be precise versus trying one that most closely fits. We should be thinking of designing for fingers, or for parts that can be incorporated into our orthoses.

  • October 20, 2016 at 6:54 PM

    I was looking to know more about hand therapy. It is interesting to learn that 3D printers can be used to make hand exercise equipment, therapy tools, and more to assist hand therapists. Something to consider would be to buy quality materials for the printer to make sure that it function properly.

  • Emily Boulton
    September 20, 2016 at 9:39 PM

    Hi Robin,
    I am a fourth year Occupational Therapy student at the University of Queensland. I am currently working on a project determining whether 3D printing to make hand and wrist splints would be feasible in a public hospital. I have sent you an email and would be keen to discuss this topic with you in more detail!
    Kind Regards,

    • Robin Janson, OTD, OTR, CHT
      October 14, 2016 at 10:08 AM

      Hello Emily, I wanted to share a brief version of my response to your question that I emailed to you. Currently the technology required to scan a hand/arm, process the scan to create a digital orthosis and then 3D print it requires a high level of technological expertise. In addition, the process takes many hours which isn’t feasible in a busy clinic setting. As the technology evolves in the future and becomes more user-friendly and faster, we will likely see implementation within clinical settings.

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