Yeh Pei-Chun, Chen Ching-Hsuan, Chen Chen-Sheng
IEEE Trans Neural Syst Rehabil Eng. 2023;31:2552-2559. doi: 10.1109/TNSRE.2023.3273300. Epub 2023 Jun 9.
Individuals with cervical spinal cord injury (C-SCI) often use a tenodesis grip to compensate for their hand function deficits. Although clinical evidence confirms that assistive devices can help achieve hand function improvements, the currently available devices have some limitations in terms of their price and accessibility and the difference in the user's muscle strength. Therefore, in this study, we developed a 3D-printed wrist-driven orthosis to improve the gripping effect and tested the feasibility of this device by assessing its functional outcomes. A total of eight participants with hand function impairment due to a C-SCI were enrolled, and a wrist-driven orthosis with a triple four-bar linkage was designed. The hand function of the participants was assessed before and after they wore the orthosis, and the outcomes were assessed using a pinch force test, a dexterity test (Box and block test, BBT), and a Spinal Cord Independence Measure Version III questionnaire. In the results, before the participants wore the device, the pinch force was 0.26 lb. However, after they wore the device, it increased by 1.45 lb. The hand dexterity also increased by 37%. After 2 weeks, the pinch force increased by 1.6 lb and the hand dexterity increased by 78%. However, no significant difference was observed in the self-care ability. The results showed that this 3D-printed device with a triple four-bar linkage for individual with C-SCI improved pinch strength and hand dexterity in these patients, but did not improve their self-care ability. It may help patient in the early stages of C-SCI to learn and use the tenodesis grip easily. However, the usability of the device in daily life needs further research.
颈椎脊髓损伤（C-SCI）患者常采用肌腱固定握法来代偿手部功能缺陷。尽管临床证据证实辅助器械有助于改善手部功能，但目前可用的器械在价格、可及性以及使用者肌肉力量差异方面存在一些局限性。因此，在本研究中，我们开发了一种3D打印的腕驱动矫形器以改善抓握效果，并通过评估其功能结果来测试该器械的可行性。总共招募了8名因C-SCI导致手部功能受损的参与者，并设计了一种具有三重四杆联动机构的腕驱动矫形器。在参与者佩戴矫形器前后对其手部功能进行评估，并使用捏力测试、灵巧性测试（箱块测试，BBT）和脊髓独立性测量第三版问卷来评估结果。结果显示，在参与者佩戴该器械之前，捏力为0.26磅。然而，佩戴后捏力增加了1.45磅。手部灵巧性也提高了37%。2周后，捏力增加了1.6磅，手部灵巧性提高了78%。然而，在自我护理能力方面未观察到显著差异。结果表明，这种为C-SCI患者设计的具有三重四杆联动机构的3D打印器械改善了这些患者的捏力强度和手部灵巧性，但未改善其自我护理能力。它可能有助于C-SCI早期阶段的患者轻松学习和使用肌腱固定握法。然而，该器械在日常生活中的可用性需要进一步研究。
