People with mid-cervical spinal cord injury (SCI) often have difficulty in performing activities of daily living due to weakness or paralysis in the flexor muscles. The inability to perform activities requiring fine motor control, such as eating, brushing, writing, unlocking doors, etc., affects overall quality of life negatively. To perform such tasks, appropriate movement of the hands, specifically at the wrist, is essential. For SCI patients, wrist orthotics are considered a viable option with which to perform general tasks. Wrist orthotics, used for rehabilitating people with SCI, help to maintain proper wrist and hand positioning; however, patients must frequently change these orthotic devices as per separate activity requirements. This becomes difficult and cumbersome for such patients. In this work, a passive 3D-printed upper-extremity dynamic orthosis was developed to assist SCI patients in their activities of daily living. The orthosis works on the principle of a worm-gear-based mechanism to produce pronation/supination motions at the wrist. To test the developed multipurpose customized orthosis, ten patients with cervical SCI were recruited and prescribed the 3D-printed splint for a period of four weeks. It was assessed through the QUEST questionnaire and a task completion assessment for its performance. The developed multipurpose customized orthotic device was found to provide an appropriate range of motion, ease in performing tasks, and took less time to complete tasks compared to previous works. The results indicated satisfactory performance, thereby improving quality of life. The multipurpose customized orthotic device successfully assisted the subjects with their daily activities, thus making them more independent in their rehabilitative period.

Foot-related problems are prevalent across the globe, and this issue is aggravated by the presence of diabetes mellitus. Diabetic-foot-related issues include extreme foot pain, plantar corns, and diabetic foot ulcers. To assess these conditions, accurate characterization of plantar pressure is required. In this work, an in-shoe, low-cost, and multi-material pressure measuring insole, based on a piezoresistive material, was developed. The device has a high number of sensors, and was tested on 25 healthy volunteers and 25 patients with different degrees of diabetes. The working range of the device was observed to be 5 kPa to 900 kPa, with an average hysteresis error of 3.25%. Plantar pressure was found to increase from healthy to diabetic volunteers, in terms of both standing and walking. In the case of the diabetic group, the-high pressure contact area was found to strongly and positively correlate (R² = 0.78) with the peak plantar pressure. During the heel strike phase, the diabetic volunteers showed high plantar pressure on the medial heel region. In regard to the toe-off phase, the central forefoot was found to be a prevalent site for high plantar pressure across the diabetic volunteers. The developed device is expected not only to assist in the prediction of diabetic ulceration or re-ulceration, but also to provide strategies and suggestions for foot pressure alleviation and pain mitigation.

Plantar foot pain is one of the most common musculoskeletal conditions affecting the foot. It is regularly experienced by the population with occupations that require prolonged standing hours, especially in nurses. The etiology of plantar foot pain remains unclear, but it is likely to be multi-factorial, with many associated risk factors including increased hours of standing. Orthoses and insoles are often recommended to plantar foot pain patients, however with minimal scientific advancements and limited customizations. In this study, a novel 3D-printed multi-material customized foot orthosis was developed, and its effectiveness on plantar foot pain reduction and functional ability improvement was studied in the nursing population. A total of thirty-six subjects were recruited and were randomized into two groups. The experimental group received the novel 3D-printed multi-material customized foot orthosis, whereas the control group received the standard-of-care (or traditional) intervention. Pre-test and the post-test scores of pains, functional ability and plantar pressure were observed using SPSS software. Improvements were observed in both of the groups; however, better improvements were seen in the experimental group. Overall, the novel 3D printing-based customized foot orthosis showed significant efficacy in reducing plantar foot pain and pressure, and also in increasing functional ability in the nursing population as compared to the traditional method.

Rheumatoid arthritis has become one of the most common inflammatory diseases and plays a major role in the disability of the population affected by it. The prevalence of finger deformities in the upper extremity caused by rheumatoid arthritis is increasing day by day, especially in low and middle-income countries such as India. For the management of these finger deformities, the splinting options are either customized or prefabricated. The performance and success of finger splinting depend on several factors, including precision, aesthetics, patient acceptance, comfort, the convenience of usage, effects, price, and side effects. However, to date, customized splints are high-cost and usually fabricated by conventional production techniques, which dominantly work on approximation. This study focused on the development of a novel finger splint through computational optimization and 3D printing for the management of boutonniere and swan neck deformity caused by rheumatoid arthritis. Twenty subjects with finger deformities were recruited, and the performance of the 3D-printed splint was characterized. The results were assessed using the nine-hole peg test and QUEST 2.0, which showed positive effects of the splint, including achievement of corrected joint positions, finger dexterity, and comfort. Such a low-cost and effective splint, with further acceptability testing, is anticipated to be a better line of conservative management for patients affected by rheumatoid arthritis.

A variety of 3D volumetric scanners and smart-device applications are currently being used in podiatry for recording virtual foot data. The accuracy and reliability of these devices vary, resulting in a large variation in the quality of foot scans used for orthotic design. While it is widely believed that a higher quality scanner yields a better scan and thus is expected to produce a more accurate orthotic design, the direct impact of scanning quality on orthotic design has not yet been tested. Therefore, in this study, three commonly used industrial 3D scanners with varying output qualities were used to obtain foot scans of three participants in two weight-bearing conditions. A total of 54 foot scans were obtained, out of which 18 were used to design orthotic insoles using commercial software (FitFoot360). We found variation in the quality of foot scans produced by the different scanners (61.75 ± 2.23% similarity of the foot scans showing a deviation of less than ±1 mm). However, there were no significant differences in the designed foot orthoses within the same weight-bearing condition (83.59 ± 1.97% similarity of the orthotic designs showing a deviation of less than ±1 mm). The medial arch height and heel width differed significantly only when the weight-bearing condition was changed. The findings from this study suggest that the industrial design and production of an orthotic insole using current methods does not depend on the scanning quality of the scanner used but is dependent on the extent of weight bearing.