{"doi":"10.5014/ajot.2023.050095","title":"Design and Use of a 3D-Printed Dynamic Upper Extremity Orthosis for Children With Cerebral Palsy and Severe Upper Extremity Involvement: A Pilot Study","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Importance: Children with cerebral palsy (CP) and severe hand impairment have limited options for upper extremity (UE) orthoses.</jats:p>\n                  <jats:p>Objective: To (1) design and fabricate a customized low-cost, functional, three-dimensional (3D) printed dynamic upper extremity orthosis (DUEO) and (2) examine, using a comprehensive evaluation, the effect of the orthosis on the UE function of children with unilateral UE CP, Manual Ability Classification System (MACS) Levels III to V.</jats:p>\n                  <jats:p>Design: Pilot study. Assessments were performed pretreatment and immediately posttreatment.</jats:p>\n                  <jats:p>Setting: Hospital-based outpatient occupational therapy department.</jats:p>\n                  <jats:p>Participants: Five patients, ages 13 to 17 yr, with CP and unilateral UE involvement MACS Levels III to V.</jats:p>\n                  <jats:p>Intervention: Custom forearm thumb opponens orthosis and the DUEO were designed and fabricated by a multidisciplinary team for use during eight 1-hr occupational therapy sessions targeting bimanual UE training.</jats:p>\n                  <jats:p>Outcomes and Measures: Pretreatment and posttreatment assessments included the Assisting Hand Assessment (AHA), Melbourne Assessment 2 (MA–2), Pediatric Motor Activity Log–Revised (PMAL–R), and the Pediatric Quality of Life Inventory: CP Module (PedsQL:CP).</jats:p>\n                  <jats:p>Results: All participants had higher posttreatment scores on at least one measure. Four had minimal clinically important differences (MCID) on the AHA. Three met MCID criteria on MA-2 subtests (one negative change). Four demonstrated improvement on the PMAL–R (one participant achieved an MCID score), and three reported improvements in more than one PedsQL:CP domain.</jats:p>\n                  <jats:p>Conclusions and Relevance: This novel 3D-printed device, in combination with occupational therapy, shows promising evidence that children who score in lower MACS levels can show gains in UE function.</jats:p>\n                  <jats:p>What This Article Adds: This study demonstrates that a customized, 3D-printed dynamic orthosis, in combination with occupational therapy intervention, can facilitate UE function in children with severe hand impairment.</jats:p>","journal":"The American Journal of Occupational Therapy","year":2023,"id":671500,"datarank":0.341911394792805,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.07314747440859677,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.07314747440859677,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":5,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1754313,"name":"Stacy Kirsch Dlugacz","orcid":null,"position":1,"is_corresponding":false},{"id":1754314,"name":"Cali Sadowsky","orcid":null,"position":2,"is_corresponding":false},{"id":350241,"name":"Gabriella Cammarata","orcid":"0000-0002-0271-2277","position":3,"is_corresponding":false},{"id":1754315,"name":"Debra A. Sala","orcid":null,"position":4,"is_corresponding":false},{"id":1754316,"name":"Victoria Bill","orcid":null,"position":5,"is_corresponding":false},{"id":1754317,"name":"Renat Sukhov","orcid":null,"position":6,"is_corresponding":false},{"id":476486,"name":"Alice Chu","orcid":"0000-0003-4099-580X","position":7,"is_corresponding":false},{"id":1754312,"name":"Lori B. Ragni","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Design and Use of a 3D-Printed Dynamic Upper Extremity Orthosis for Children With Cerebral Palsy and Severe Upper Extremity Involvement: A Pilot Study","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Importance: Children with cerebral palsy (CP) and severe hand impairment have limited options for upper extremity (UE) orthoses.</jats:p>\n                  <jats:p>Objective: To (1) design and fabricate a customized low-cost, functional, three-dimensional (3D) printed dynamic upper extremity orthosis (DUEO) and (2) examine, using a comprehensive evaluation, the effect of the orthosis on the UE function of children with unilateral UE CP, Manual Ability Classification System (MACS) Levels III to V.</jats:p>\n                  <jats:p>Design: Pilot study. Assessments were performed pretreatment and immediately posttreatment.</jats:p>\n                  <jats:p>Setting: Hospital-based outpatient occupational therapy department.</jats:p>\n                  <jats:p>Participants: Five patients, ages 13 to 17 yr, with CP and unilateral UE involvement MACS Levels III to V.</jats:p>\n                  <jats:p>Intervention: Custom forearm thumb opponens orthosis and the DUEO were designed and fabricated by a multidisciplinary team for use during eight 1-hr occupational therapy sessions targeting bimanual UE training.</jats:p>\n                  <jats:p>Outcomes and Measures: Pretreatment and posttreatment assessments included the Assisting Hand Assessment (AHA), Melbourne Assessment 2 (MA–2), Pediatric Motor Activity Log–Revised (PMAL–R), and the Pediatric Quality of Life Inventory: CP Module (PedsQL:CP).</jats:p>\n                  <jats:p>Results: All participants had higher posttreatment scores on at least one measure. Four had minimal clinically important differences (MCID) on the AHA. Three met MCID criteria on MA-2 subtests (one negative change). Four demonstrated improvement on the PMAL–R (one participant achieved an MCID score), and three reported improvements in more than one PedsQL:CP domain.</jats:p>\n                  <jats:p>Conclusions and Relevance: This novel 3D-printed device, in combination with occupational therapy, shows promising evidence that children who score in lower MACS levels can show gains in UE function.</jats:p>\n                  <jats:p>What This Article Adds: This study demonstrates that a customized, 3D-printed dynamic orthosis, in combination with occupational therapy intervention, can facilitate UE function in children with severe hand impairment.</jats:p>","is_dataset_classified":null,"base_score":1.791759469228055,"endowment":1.791759469228055,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"37611318","pmcid":null,"openalex_id":"https://openalex.org/W4386087738","authors":[],"funders":[],"total_grants":0,"fwci":0.8918,"citation_percentile":0.72552551,"influential_citations":0,"citation_trend":[{"year":2023,"count":1},{"year":2024,"count":1},{"year":2025,"count":1},{"year":2026,"count":2}],"oa_status":"closed","license":null,"oa_locations":[{"url":"https://research.aota.org/ajot/article-pdf/doi/10.5014/ajot.2023.050095/82585/7704205060.pdf","host_type":"publisher"},{"url":"https://doi.org/10.5014/ajot.2023.050095","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/37611318","host_type":"repository"}],"fields_of_study":["Cerebral Palsy and Movement Disorders","Stroke Rehabilitation and Recovery","Assistive Technology in Communication and Mobility","Humans","Child","Pilot Projects","Cerebral Palsy","Quality of Life","Orthotic Devices","Upper Extremity","Printing, Three-Dimensional","Phthalic Anhydrides"],"mesh_terms":["Cerebral Palsy","Child","Humans","Orthotic Devices","Phthalic Anhydrides","Pilot Projects","Quality of Life","Upper Extremity","Printing, Three-Dimensional"],"keywords":["Minimal clinically important difference","Cerebral palsy","Medicine","Physical therapy","Physical medicine and rehabilitation","Gross Motor Function Classification System","Occupational therapy","Randomized controlled trial","Surgery"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-16T03:04:14.445960Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}