## 3 Hand Orthosis Development
### Orthosis Manufacturing  
Beyond functional classification, orthoses can also be distinguished by their method of production: off-the-shelf orthoses and custom-made orthoses. Off-the-shelf orthoses are prefabricated splints available in various sizes, designed for general use. However, these industrially manufactured models do not account for the unique characteristics and specific needs of each patient's hand. In contrast, customized orthoses are tailored to meet the individual anatomical characteristics and specific requirements of each patient. In the past, creating customized orthoses often required using cast molds, due to the high temperatures of the materials during the process, which made direct application to the patient's hand impossible [24]. Therefore, this process was labor-intensive and imprecise. The introduction of new thermoplastic materials, such as polypropylene, polyethylene, and Kydex, has significantly improved the customization process. These materials are low-thermoplastic materials that can be processed at temperatures between 50\({}^{\circ}\) and 70\({}^{\circ}\) Celsius, and therefore can be molded directly onto the patient's hand at lower temperatures, resulting in a more accurate and comfortable fit [24]. Thermoplastic materials have diverse properties that impact various aspects of orthosis design, including patient comfort, meeting the functional requirements of the splint, and accommodating the therapist's processing preferences [19]. These advancements have revolutionized orthosis manufacturing, enabling faster production times, greater precision, and improved patient outcomes. The whole process is not limited to material shaping but also involves the incorporation of various mechanical elements, such as joints, elastic components, and padding. Despite these advancements, the process remains largely dependent on manual craftsmanship, which can lead to variability in the final product's quality. Consequently, there is a pressing need for the development of more advanced solutions to streamline and improve these processes. The range of materials used in hand splinting extends far beyond thermoplastics. Neoprene provides soft, flexible support for dynamic splints, while aluminum adds strength and durability [17]. Silicone, along with EVA and Plastazote, is commonly used for padding in pressure-sensitive areas, enhancing comfort [25; 26]. Although less common today, leather is a sturdy and breathable option [17]. Carbon fiber composites, though more expensive, offer advantages for lightweight and strong dynamic or sports orthoses [27]. Material selection depends on the patient's needs, balancing between stability, flexibility, and comfort. Many modern splints combine materials to optimize therapeutic outcomes. According to [PERSON] and [PERSON] [28], to ensure the optimal fit of a splint, it is crucial to make careful considerations before creating it. This process should involve answering a set of questions to understand the context in which the splint will be used. * Which anatomical structures are impacted, and how will the splint address them? * What therapeutic objectives should the splint achieve? * What is the recommended duration and schedule for wearing the splint? * When and under what conditions should the splint be adjusted? * What key factors must be considered during the fitting process to ensure optimal function and comfort? * What is the correct positioning of the splint to achieve the desired therapeutic outcome? * Are there any contraindications or potential risks associated with this splint that need to be addressed? * What monitoring and maintenance protocols are required for the splint, including who is responsible and the frequency of checks? During the workshops, it was identified that the context of use should be further explored by understanding the habits and preferences of the individuals. By providing solutions that fit their expectations and involve their favorite activities, higher involvement in the rehabilitation process can be achieved.