Abstract:
A finger orthosis for moving a joint of a finger is provided. The finger orthosis includes a first cuff configured to couple to a first finger portion, a second cuff configured to couple to a second finger portion, and an actuator member coupled to said first and second cuffs, said actuator member configured to provide relative rotation between said first and second cuffs when a force is applied to said actuator member.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 12/181,520, filed Jul. 29, 2008, now U.S. Pat. No. 8,038,637 which is a continuation of U.S. patent application Ser. No. 11/181,238, filed Jul. 14, 2005, now U.S. Pat. No. 7,404,804 which is a continuation of U.S. patent application Ser. No. 10/329,895, filed Dec. 26, 2002 (now U.S. Pat. No. 6,921,377), which is a continuation of U.S. patent application Ser. No. 09/664,922, filed Sep. 18, 2000 now U.S. Pat. No. 6,502,577, the entire content of these applications is expressly incorporated herein by reference thereto. 
    
    
     BACKGROUND OF THE INVENTION 
     The present invention relates to new and improved method for moving joints of fingers. 
     A known splint for supporting and injuring hand is disclosed in U.S. Pat. No. 4,765,320. The splint disclosed in this patent allows movement of the fingers of the hand and urges the fingers toward an extended condition under the influence of elastic bands. 
     A known joint extension splint is disclosed in U.S. Pat. No. 5,681,269. The splint disclosed in this patent has an adjustable finger support for a joint of the finger. Support sections of the support are connected to portions of the finger on opposite sides of the joint. A screw jack operates with hinged attachments to the undersides of the support sections to provide controlled extension of the finger. 
     SUMMARY OF THE INVENTION 
     The present invention provides a new and improved method for using an orthosis to sequentially move different fingers of a hand. The method includes mounting a hand cuff of the orthosis on the hand. Mechanisms operable to move joints of the fingers are connected to the hand cuff at locations aligned with the fingers. The mechanisms are connected with the fingers. The joints of the fingers are moved by operating the mechanisms. 
     The joints and first and second portions of the fingers define, on one side of the joints, outer sectors which decrease in angle as the joints are extended. Force is applied to the first and second portions of the fingers to move the joints by providing relative rotation between internally and externally threaded members disposed in the outer sectors. Actuator members connected with the internally or externally threaded members are moved along paths that extend through the joints. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The foregoing and other features of the invention will become more apparent upon consideration of the following description taken in connection with the accompanying drawings, wherein: 
         FIG. 1  is an illustration of an orthosis constructed in accordance with the present invention and mounted on a hand with a mechanism which can be operated to move a finger of the hand; 
         FIG. 2  is a schematic side view of the orthosis of  FIG. 1  depicting the manner in which the orthosis of  FIG. 1  is operated to bend the finger in flexion; 
         FIG. 3  is a schematic side view, generally similar to  FIG. 2 , of the orthosis depicting the manner in which the orthosis of  FIG. 1  is operated to bend the finger in extension; 
         FIG. 4  is an enlarged sectional view of a portion of the orthosis of  FIG. 1  depicting the manner in which the orthosis is operated to move the finger in flexion; 
         FIG. 5  is an enlarged sectional view of the portion of the orthosis, generally similar to  FIG. 4 , depicting the manner in which the orthosis is operated to move the finger in extension. 
     
    
    
     DESCRIPTION OF THE INVENTION 
     Orthosis 
     General Description 
     An orthosis  10  ( FIG. 1 ) can be used to sequentially move different fingers of the same hand. The orthosis  10  includes a hand cuff  12  which is connected with a hand  14  of a person. A bending mechanism  16 , operable to move a joint of a finger, can be connected to an index finger  18 , a middle finger  20 , a ring finger  22 , or a little finger  24  of the hand  14 . The bending mechanism  16  is shown connected to the index finger  18  in  FIG. 1 . Furthermore, more than one bending mechanism  16  may be connected to more than one of the fingers  18 - 24 . 
     A first finger cuff  26  of the bending mechanism  16  is connected with a first portion  28  of the index finger  18  connected to a joint  30  of the index finger. A second finger cuff  32  of the bending mechanism  16  is connected to a second portion  34  of the finger  18  connected to the joint  30 . The cuffs  12 ,  26 , and  32  may have any desired construction as long as they are effective to engage the hand  14  and the first and second portions  28  and  34  of the finger  18 . 
     A first cuff arm  36  is connected with the first finger cuff  26 . A second cuff arm  38  is connected with the second finger cuff  32 . A connecting portion  40  of the bending mechanism  16  is connected with the hand cuff  12 . The connecting portion  40  is pivotally connected to the second cuff arm  38 . The connecting portion  40  connects the bending mechanism  16  to the hand cuff  12  in alignment with the finger  18 . 
     End portions  42  and  44  ( FIGS. 1-3 ) of the cuff arms  36  and  38  are spaced apart and interconnected by a base link or actuator member  46 . The first cuff arm  38  is pivotally connected to the actuator member  46  at a pivot connection  48 . The pivot connection  48  is offset from the joint  30  on a side of the joint toward a tip of the finger  18 . The second cuff arm  38  is pivotally connected to the actuator member  46  at a pivot connection  50 . The pivot connection  50  is offset from the joint  30  on a side of the joint away from the tip of the finger  18 . The cuff arms  36  and  38  are pivotal about spaced apart parallel axes at the pivot connections  48  and  50 . 
     An actuator mechanism  54  transmits force to simultaneously pivot the cuff arms  36  and  38  about the pivot connections  48  and  50  and to move the finger cuffs  26  and  32  along the cuff arms. The actuator mechanism  54  transmits force from an input member which, in the illustrated embodiment of the orthosis  10 , is a manually rotatable knob  56 . Force is transmitted from the knob  56  through the actuator mechanism  54  to the actuator member  46 . Force is transmitted from the actuator member  46  to pivot the cuff arms  36  and  38  about the pivot connections  48  and  50 . In addition, force is transmitted from the knob  56  to move the finger cuffs  26  and  32  along the cuff arms  36  and  38  as the cuff arms are pivoted about the pivot connections  48  and  50 . 
     The actuator mechanism  54  is operable to move the cuff arms  36  and  38  from an initial position, such as the one shown in  FIG. 1 , to actuated positions, such as those shown in  FIGS. 2 and 3 . Operation of the actuator mechanism  54  moves the actuator member  46  along a path extending through the joint  30  of the finger  18 . As this occurs, the cuff arms  36  and  38  are pivoted about parallel spaced apart axes which extend through the pivot connections  48  and  50  and are perpendicular to the longitudinal central axes of the cuff arms  36  and  38 . 
     As the inner end portions  42  and  44  of the cuff arms  36  and  38  are moved, the finger cuffs  26  and  32  move along the cuff arms. The movement of the finger cuffs  26  and  32  reduces the amount of distraction applied to the finger  18 . This enables the finger  18  to be moved without being distracted or compressed. Although it is advantageous to move the finger  18  without either compressing or distracting the soft tissue in the finger, there is a slight controlled distraction of the soft tissue in order to be certain that compression of the finger is avoided. 
     When the finger cuffs  26  and  32  ( FIGS. 2 and 3 ) are connected with the finger  18 , the cuff arms  36  and  38  are disposed at a back side of the finger  18  opposite the palm of the hand  14 . Thus, the cuff arms  36  and  38  are disposed in an outer sector having a center at the finger joint  30  and radians which are coincident with longitudinal central axes of the portions  28  and  34  of the finger  18 . The longitudinal central axis of the portion  28  of the finger  18  has been indicated at  60  and the longitudinal central axis of the portion  34  of the finger has been indicated at  62 . The axes  60  and  62  intersect at a center  64  of the joint  30 . The outer sector includes the are indicated by arrows  66  and  68  indicated in  FIGS. 2 and 3 . The outer sector decreases in angle as the joint  30  is moved in extension from either of the positions in  FIGS. 1 and 2  to the position shown in  FIG. 3 . The inner sector includes the are indicated by the arrows  70  and  72  in  FIGS. 2 and 3 . The inner sector decreases in angle as the joint  30  is moved in flexion from either of the positions shown in  FIGS. 1 and 3  to the position shown in  FIG. 2 . 
     The bending mechanism  16  is connected with the back of the finger  18 . Accordingly, the actuator mechanism  54  and the pivot connections  48  and  50  are disposed adjacent to the back of the finger  18 . Thus, the bending mechanism  16 , the actuator mechanism  54  and the pivot connections  48  and  50  are disposed in the outer sector indicated by the arrows  66  and  68 . 
     Moving Finger in Flexion 
     When the input knob  56  is manually rotated in the direction of arrow  80  in  FIG. 1 , the actuator mechanism  54  is operated. Operation of the actuator mechanism  54  transmits force from the knob  56  to the actuator member  46 . The actuator member  46  pivots the cuff arms  36  and  38  from the orientation shown in  FIG. 1  toward the orientation shown in  FIG. 2  to move the joint  30  in flexion. 
     Operation of the actuator mechanism  54  moves the inner end portions  42  and  44  of the cuff arms  36  and  38  away from the finger  18 . This pivots the first cuff arm  38  in a counterclockwise direction (as viewed in  FIG. 2 ) about the pivot connection  48 . Simultaneously therewith, the second cuff arm  38  pivots in a clockwise direction (as viewed in  FIG. 2 ) about the pivot connection  50 . As the cuff arms  36  and  38  are pivoted in opposite directions about the pivot connections  48  and  50  toward the orientation shown in  FIG. 2 , the joint  30  of the finger  18  is moved in flexion. 
     During pivotal movement of the cuff arms  36  and  38  and movement of the finger  18  in flexion, the actuator mechanism  54  transmits force to the finger cuffs  26  and  32 . The cuffs  26  and  32  move along the cuff arms  36  and  38  away from the joint  30  and the pivot connections  48  and  50 . Moving the finger cuffs  26  and  32  away from the joint  30  and the pivot connections  48  and  50  as the joint is moved in flexion greatly reduces the distractive forces applied to the soft tissue in the finger  18 . 
     In the illustrated embodiment of the invention, the cuff arms  36  and  38  are moved by the actuator mechanism  54  through a range of movement from positions in which the cuff arms are positioned relative to each other as shown in  FIG. 1  to a condition of maximum flexion in which the longitudinal axes of the cuff arms are disposed at an angle of approximately 70° C. relative to each other, as shown in  FIG. 2 . As the orthosis  10  is operated to move the finger  18  in flexion, the size of the inner sector, indicated by the arrows  70  and  72  is decreased and the size of the outer sector, indicated by the arrows  66  and  68  is increased. It should be understood that the foregoing specific range of movement of the orthosis  10  has been set forth herein for purposes of clarity of description and that it is contemplated that specific embodiments of the orthosis  10  will have finger cuffs  26  and  32  which move through different distances relative to each other and are movable to different angular orientations relative to each other. 
     It is contemplated that the specific procedure which is followed to move the finger  18  in flexion will vary depending upon the conditions of the finger and the desires of a surgeon or therapist supervising the use of the orthosis  10 . However, it is believed that it may be preferred to use a static progressive stretch procedure during movement of the finger  18 . This procedure is implemented by operating the actuator mechanism  54  to move the finger  18  in flexion to a limit of tolerance of the finger without severe pain. This position of the finger  18  is held for a period of time, for example, five minutes, to allow the tissue in the finger to relax. As the tissue relaxes, stress decreases. After the period of time has elapsed, the input member  56  is manually rotated to again stretch the soft tissue in the finger  18  to the limit of tolerance. This condition is again held for a period of time, for example, five minutes, to allow the tissue in the finger  18  to again relax. The process is repeated for the duration of a therapy session which, may be approximately 30 minutes long. 
     The input knob  56  may be manually rotated by either the patient, that is, the person having the hand  14  on which the orthosis  10  is mounted, or by a supervisory personnel, such as the therapist. However, it is believed that it will be desired to have the patient actuate the orthosis  10  to affect movement of the finger  18 . The patient can feel when the tissue has tightened and the finger  18  has been moved to the limit of its tolerance, without severe pain. The patient can also feel when the tissue has relaxed and further actuation of the orthosis  10  to further move the finger  18  in flexion can be undertaken. 
     Although the foregoing description of moving a finger  18  in flexion with the orthosis  10  has been in conjunction with the movement of the index finger, it should be understood that the orthosis can be equally as well used to move any finger  18 - 24  of the hand  14  in flexion. Thus, the finger cuffs  26  and  32  are designed to enable them to be used to connect any of the fingers  18 - 24  of the hand  14  with the cuff arms  36  and  38 . The hand cuff  14  is designed to enable the bending mechanism  16  to be connected with the hand cuff in alignment with any of the fingers  18 - 24 . Furthermore, it is contemplated that bending mechanisms  16  can be connected with more than one of the fingers  18 - 24  at the same time to be used to sequentially move the fingers. 
     Moving Finger in Extension 
     When the finger  18  is to be moved in extension, the input knob  56  is manually rotated, in the direction of arrow  84  in  FIG. 1 , to operate the actuator mechanism  54 . Operation of the actuator mechanism  54  transmits force from the input knob  56  to the actuator member  46 . As the input knob  56  is manually rotated, the actuator mechanism  54  moves the actuator member  46  toward the finger  18 . Thus, the end portions  42  and  44  of the cuff arms  36  and  38  are moved from the position shown in  FIG. 1  toward the position shown in  FIG. 3  as the input knob  56  is manually rotated. 
     As the end portions  42  and  44  of the cuff arms  36  and  38  are moved toward the finger  18 , the cuff arms are pivoted in opposite directions about axes extending through the pivot connections  48  and  50 . Thus, the cuff arm  38  is pivoted in a clockwise direction (as viewed in  FIG. 3 ) about the pivot connection  48 . The cuff arm  38  is pivoted in a counterclockwise direction about the pivot connection  50 . 
     As the cuff arms  36  and  38  are pivoted about the pivot connections  48  and  50 , the finger  18  is moved in extension from the initial condition shown in  FIG. 1  toward the condition shown in  FIG. 3 . As this occurs, the outer sector, indicated by the arrows  66  and  68 , decreases in size, and the inner sector, indicated by the arrows  70  and  72 , increases in size. The cuff arms  36  and  38  are pivoted toward the actuator mechanism  54  in the outer sector. 
     As the cuff arms  36  and  38  ( FIG. 3 ) are pivoted under the influence of force transmitted from the actuator mechanism  54  through the actuator member  46 , the finger cuffs  26  and  32  are moved along the cuff arms  36  and  38 . Thus, force is transmitted from the actuator mechanism  54  to the finger cuffs  26  and  32  to move the finger cuff along the cuff arms  36  and  38  toward the joint  30  and the pivot connections  48  and  50 . The finger cuff  26  is moved along the cuff arm  38  toward the joint  30  and the pivot connection  48  as the cuff arm  38  is pivoted in a clockwise direction about the pivot connection  48 . Similarly, the finger cuff  32  is moved along the cuff arm  38  toward the joint  30  and the pivot connection  50  as the cuff arm  38  is pivoted in a counterclockwise direction about the pivot connection  50 . Moving the finger cuffs  26  and  32  toward the joint  30  and the pivot connections  48  and  50  minimizes the extent of distraction of the joint while ensuring that there is no compression of the finger  18 . 
     It is believed that a static progressive stretch procedure may be preferred for moving the finger  18  in extension. Thus, the input knob or member  56  is manually rotated to operate the actuator mechanism  54  and effect pivoting of the cuff arms  36  and  38  to move the finger  18  in extension until the patient feels tissue tightness, but not severe pain. The orthosis  10  is maintained in that position for a period of time, which may be five minutes. When the tissue relaxes, the input member or knob  56  is again rotated to stretch the tissue. The steps of operating the orthosis  10  to stretch the tissue, interrupting operation of the orthosis to allow the tissue to relax and then again operating the orthosis to again stretch the tissue is repeated for the duration of a therapy session. 
     As was previously mentioned, the knob or input member  56  may be manually rotated by a therapist or surgeon. However, it is believed that it will be preferred to have the patient manually rotate the knob  56 . Thus, the person having the hand  14  and finger  18  will rotate the knob  56  until he or she feels the tissue tighten and will further rotate the knob to further move the finger when he or she feels the tissue relax. 
     Although the foregoing description has been in conjunction with the moving of an index finger  18  in extension, it should be understood that the orthosis  10  may be used to move any of the fingers  18 - 24  of the hand  14  in extension. In the example of moving the finger  18  in extension illustrated in  FIGS. 1 and 3 , the finger is moved from an initial condition illustrated in  FIG. 1 . However, it is believed that, under certain circumstances, the finger  18  may initially be in the flex condition shown in  FIG. 2  and moved in extension from the flex condition to the condition shown in  FIG. 1 . When this is to be done, the orthosis  10  is operated to move the finger  18  in extension toward the condition illustrated in  FIG. 1 . 
     Actuator Mechanism 
     The actuator mechanism  54  ( FIGS. 2-5 ) is supported on the actuator member  46 . The actuator mechanism  54  includes an externally threaded member or screw  100  which is rotatably supported within a frame  102 . A central axis of the screw  100  extends through the center of the actuator member or base link  46  and through the center of the joint  30  with which the bending mechanism  16  is connected. A central axis of the screw  100  extends midway between and is perpendicular to parallel axes extending through the pivot connections  48  and  50 . 
     The manually rotatable knob  56  is fixedly connected to the upper (as viewed in  FIG. 1 ) end of screw  100 . The frame  102  ( FIGS. 2-5 ) has internal thread convolutions which engage with external thread convolutions on the screw  100 . In the illustrated embodiment of the invention, the screw  100  is movable relative to the frame  102 . However, the frame  102  could be movable relative to the screw  100 . If this was done, the base link  46  would be connected with the frame  102 . 
     Upon rotation of the input member or knob  56 , the screw  100  is moved relative to the frame  102 . As this occurs, the base link  46  pivots the cuff arms  36  and  38  about the pivot connections  48  and  50 . Of course, pivotal movement of the cuff arms  36  and  38  moves the joint  30  of the finger  18  with which the orthosis  10  is connected. Movement of the screw  100  toward the joint  30  moves the joint in extension. Movement of the screw  100  away from the finger  18  moves the joint  30  in flexion. 
     The screw  100  and the base link  46  are moved from the initial condition shown in  FIG. 1  to one of the actuated conditions shown in  FIGS. 2 and 3 . The screw  100  and base link  46  move along a linear path which extends perpendicular to the parallel axes through the pivot connections  48  and  50 . The path along which the screw  100  and actuator member  46  move has a longitudinal central axis which is coincident to the central axis of the screw  100  and extends between the end portions  42  and  44  of the cuff arms  36  and  38 . 
     In the illustrated embodiment of the invention, the screw  100  has a right-hand thread so that the knob  56  is manually rotated in a clockwise direction, as indicated by arrow  84  in  FIG. 1 , to move the screw  100  and base link  46  toward the finger  18 . When the knob  56  is manually rotated in a counterclockwise direction, the screw  100  and the actuator member  46  move away from the finger  18 . It should be understood that an input member other than the knob  56  could be used to operate the actuator mechanism  54  if desired. 
     The frame  102  ( FIGS. 2-5 ) has a first end  110  pivotally connected with the cuff arm  38  at a pivot connection  112 . The end  110  of the frame  102  is also pivotally connected to the finger cuff  26  and the cuff arm  38  at a pivot connection  114 . The end  110  of the frame  102  extends between side walls  116  ( FIGS. 4 and 5 ) of the cuff arm  38 . The frame  102  has a second end  118  pivotally connected with the cuff arm  38  and the finger cuff  32  at a pivot connection  120 . The end  118  of the frame  102  extends between side walls  122  of the cuff arm  38 . 
     The cuff arm  36  has slots  124  ( FIGS. 4 and 5 ) in the side walls  116 . A pin  126  extends through the slots  124  and the end  110  of the frame  102 . The pin  126  connects the end  110  of the frame  102  with the cuff arm  38  at the pivot connection  112 . The pin  126  is movable relative to the cuff arm  36  along the slot  124 . 
     The cuff arm  36  also has slots  132  in the side walls  116  which extend at angles to the slots  124 . The finger cuff  26  has slots  134  in side walls  136  that extend perpendicular to the slots  124  and at an angle to the slots  132 . A pin  138  extends through the slots  132  and  134  and the end  110  of the frame  102 . The pin  138  connects the end  110  of the frame  102  with the cuff arm  38  and the cuff  26  at the pivot connection  114 . The pin  138  is movable relative to the slots  132  in the cuff arm  38  and the slots  134  in the finger cuff  26 . 
     The finger cuff  26  has slots  140  in the side walls  136  extending perpendicular to the slots  134  and parallel to the slots  124 . A pin  142  extends through the cuff arm  38  and the slots  140  to guide movement of the cuff  26  relative to the cuff arm  36 . The pin  142  is movable along the slots  140  relative to the finger cuff  26 . 
     The cuff arm  36  ( FIGS. 4 and 5 ) extends between the side walls  136  of the cuff  26 . The side walls  136  of the cuff  26  engage the side, walls  116  of the cuff arm  36 . The side walls  116  of the cuff arm  36  guide movement of the cuff  26  relative to the cuff arm  36 . 
     The cuff arm  38  ( FIGS. 4 and 5 ) has slots  146  in the side walls  122 . A pin  148  extends through the slots  146 , the cuff  32  and the end  118  of the frame  102 . The pin  148  connects the finger cuff  32  with the cuff arm  38  and the frame  102  at the pivot connection  120 . The pin  148  extends through side walls  150  of the cuff  32 . The pin  148  is movable along the slots  146  to guide movement of the cuff  32  relative to the cuff arm  38 . 
     The side walls  150  of the cuff  32  have openings  152  and  154  on opposite sides of the pin  148 . The pin  148  could extend through the openings  152  or  154  instead of extending through the cuff  32  at the location between the openings. Accordingly, the pin  148  can connect the finger cuff  32  to the cuff arm  38  and the end  118  of the frame  102  at any of three locations. 
     The cuff arm  38  extends between the side walls  150  of the cuff  32 . The side walls  150  of the cuff  32  engage the side walls  122  of the cuff arm  38 . The side walls  122  of the cuff arm  38  guide movement of the cuff  32  relative to the cuff arm  38 . 
     Upon manual rotation of the input member or knob  56  in a clockwise direction, the screw  100  is rotated to move the base link  46  toward the finger  18  ( FIG. 3 ). As this occurs, the cuff arm  38  is pivoted in a clockwise direction about the pivot connection  48  and transmits force to the pivot connections  112  and  114 . The force transmitted from the base link  46  to the pivot connections  112  and  114  pivots the cuff arm  38  and cuff  26  in a clockwise direction about axes extending through the pivot connections  112  and  114 . This results in the cuff arm  38  pivoting from the initial position shown in  FIG. 1  to the actuated position shown in  FIG. 3  as the screw  100  moves relative to the frame  102 . 
     As the cuff arm  38  ( FIG. 5 ) pivots about the pivot connections  112  and  114 , the pin  126  moves along the slots  124  toward the right, as viewed in  FIG. 5 . The pin  138  moves toward the right as viewed in  FIG. 5 , along the slots  132 . The pin  138  also moves downward, as viewed in  FIG. 5 , along the slots  134 . This results in the finger cuff  26  moving relative to the cuff arm  38  toward the joint  30 . 
     As the screw  100  and base link  46  move toward the finger  18 , the cuff arm  38  is pivoted in a counterclockwise direction relative to the base link  46  and force is transmitted to the pivot connection  120 . The force transmitted to the pivot connection  120  pivots the cuff arm  38  relative to the second end  118  of the frame  102 . As the cuff arm  38  pivots about the pivot connection  120  relative to the second end  118  of the frame  102 , the pin  148  moves toward the left, as viewed in  FIG. 5 , along the slots  146  and the finger cuff  32  moves relative to the cuff arm  38 . 
     Upon manual rotation of the input member or knob  56  in a counterclockwise direction, the screw  100  is rotated to move away from the finger  18  ( FIGS. 2 and 4 ). As this occurs, the cuff arm  36  is pivoted in a counterclockwise direction about the pivot connection  48  and force is transmitted to the pivot connections  112  and  114  between the cuff arm  36  and the first end  110  of the frame  102 . The force transmitted to the pivot connections  112  and  114  pivots the cuff arm  36  in a counterclockwise direction about the pivot connections  112  and  114 . This results in the pin  126  moving downward, as viewed in  FIG. 4 , along the slots  124 . The pin  138  moves downward as viewed in  FIG. 4 , along the slots  132 . The pin  138  also moves toward the left, as viewed in  FIG. 4 , along the slots  134 . The pin  142  moves upward along the slots  140  as the finger cuff  26  moves away from the joint  30 . 
     As the input member or knob  56  is rotated in the counterclockwise direction, the cuff arm  38  is pivoted in a clockwise direction about the pivot connection so and force is transmitted to the pivot connection  120  between the first end  118  of the frame  102  and the cuff arm  38 . The force transmitted to the pivot connection  120  pivots the cuff arm  38  in a clockwise direction about the pivot connection  120 . This results in the pin  148  moving toward the right, as viewed in  FIG. 4 , along the slots  146  and the finger cuff  32  moving away from the joint  30 . 
     Cuff Adaptors 
     The finger cuff  26  ( FIGS. 4 and 5 ) includes a channel-shaped portion  160  for receiving the cuff arm  36 . The channel-shaped portion  160  is defined by the parallel side walls  136  extending perpendicular to a base  164 . The base  164  can be placed in engagement with a back of the portion  28  of the finger  18 . Suitable straps  168  and  170  extend through retainers  172  extending from the base  164  to secure the finger cuff  26  with the finger  18 , as seen in  FIG. 1 . 
     The finger cuff  32  ( FIGS. 4 and 5 ) has a channel-shaped portion  180  which receives the cuff arm  38 . The channel-shaped portion  180  is defined by the side walls  150  extending perpendicular to a base  184 . The base  184  is placed in engagement with a back of the portion  34  of the finger  18 . A suitable strap  186  extends through a retainer portion  190  extending from the base  184  to secure the finger cuff  32  with the finger  18 , as seen in  FIG. 1 . 
     The hand cuff  12  has a first plate  200  ( FIGS. 1-3 ) with padding  202  which is mounted on a palm of the hand  14 . A second plate  204  with padding  206  is mounted on the back of the hand  14  opposite from the palm. Four cylindrical members  210  are fixedly connected with the second plate  204 . Each of the cylindrical members  210  is aligned with one of the fingers  18 - 24  of the hand  14 . The cylindrical members  210  have axially extending openings  212  for receiving the connecting portion  40  of the bending mechanism  16 . Threaded openings  214  in the cylindrical members  210  extend transverse to the axis of the cylindrical members. A set screw  216  threadably engages the opening  214  in the cylindrical member  210  to clamp the connecting portion  40  to the cylindrical member. 
     A suitable strap  222  is fixedly connected to the plate  204  by rivets  224 . Another strap  226  extends around the plates  200  and  204  adjacent the heel of the hand  14 . The straps  222  and  226  secure the plates  200  and  204  to the hand  14  using hook and loop connectors. 
     CONCLUSION 
     The present invention provides a new and improved method for using an orthosis  10  to sequentially move different fingers of a hand. When the orthosis  10  is to be used to move a finger of the hand, a bending mechanism  16  is connected with a back of the finger. The bending mechanism  16  is operated to move a joint of the finger. An actuator member  46  of the bending mechanism  16  is moved along a path extending through the joint to move the joint. The bending mechanism  16  can be connected with another finger of the hand to move the other finger or a second bending mechanism can be connected with the other finger to move the other finger. 
     From the above description of the invention, those skilled in the art will perceive improvements, changes and modifications. Such improvements, changes and modifications within the skill of the art are intended to be covered by the appended claims.