Effects of Assistive Device on ADL Function in Patients With Nerve Injury

Study Overview
=================
Brief Summary
-----------------
Our study is aimed to evaluate the effect of 3D printing assistive device on hand function for patients with neural injury.

Detailed Description
-----------------
Background: Injury to the central or peripheral nerves can lead to limited hand function and further affect the ability of daily life. The use of assistive devices can assist functional activities and reduce the phenomenon of non-use. 3D printing technology was used to construct personalized, complicated orthosis, and one piece to reduce assembly time. But the evidence most are product development, but few of study investigate the effectiveness and it cannot be widely used for hand injuries. Aim: To evaluate the effect of 3D printing assistive device on hand function for patients with neural injury. Methods: Thirty neural injury patients were recruited and randomized into experimental (3D printing assistive device) or control (universal cuff) groups for 4 weeks of treatment (thirty minutes a time, twice a week). The performance was assessed by a blinded assessor included Active Range of motion (AROM), Box and block test, Grip dynamometer, upper extremity task, Disability of the arm, shoulder and hand questionnaire(DASH), General Health Questionnaire(GHQ-12) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST). The practice performance and adverse effect were recorded. Collected data will be analyzed with nonparametric tests by SPSS version 20.0, and alpha level was set at .05. Keywords: Neural injury, 3D printing, assistive device, hand function.

Official Title
-----------------
Effects of 3D Printing Assistive Device on ADL Function in Patients With Nerve Injury

Conditions
-----------------
Nerve Injury

Intervention / Treatment
-----------------
* Behavioral: Wear 3D printing assistive device
* Behavioral: Wear universal cuff device


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: The medical record shows the diagnosis of central or peripheral nerve injury, and the onset is more than three months Able to understand wearing operation instructions and have the ability to give informed consent Able to control shoulder lifting and bending elbows, but difficult to grasp tools Exclusion Criteria: Older than 75 years old and younger than 20 years old Severe visual or hearing impairment Suffering from other neurological, cardiopulmonary, or musculoskeletal diseases that affect the subject to perform the actions required by this test.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 3D printing assistive device group<br>experimental (3D printing assistive device) groups for 4 weeks of treatment (thirty minutes a time, twice a week). | Behavioral: Wear 3D printing assistive device<br>* Wear 3D printing aids and engage in functional tasks, including eating, typing, and writing. At home: use daily, 30 minutes each time; Treatment room: 30 minutes twice a week<br>|
| Active Comparator: universal cuff groups<br>control (universal cuff) groups for 4 weeks of treatment (thirty minutes a time, twice a week). | Behavioral: Wear universal cuff device<br>* Wear universal cuff aids and engage in functional tasks, including eating, typing, and writing. At home: use daily, 30 minutes each time; Treatment room: 30 minutes twice a week<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Active joint range of motion of shoulder and elbow | use a goniometer to measure the active joint movements of the shoulder and elbow, including shoulder flexion, abduction, external rotation , internal rotation, and elbow flexion angle. | Change from Baseline at 2 weeks and 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Box and block test (BBT) | Assess grasping, transporting, and releasing small blocks, and count the number of blocks the individual moves 1 inch to the opposite side of the box in one minute. | Change from Baseline at 2 weeks and 4 weeks | 
| Grip power | use the Jamar Dynamometer (Asimow Engineering Co., CA, USA) grip strength device to test, ask the individual to bend the elbow and shoulder adduct, and hold the grip strength device firmly, and measure the average 3 times in total | Change from Baseline at 2 weeks and 4 weeks | 
| Hand function tasks | Complete the tasks of writing, spoon, and typing. The writing task is based on the writing sub-item of the Basic Literacy Test, and the individual is asked to write a short sentence, the content is 25 words, count the number of words in two minute; spoon task, ask the client to use a spoon to scoop five kidney beans into a can, and count the seconds it takes; one-minute typing test (https://typing.tw/), to see the number of words typed in one minute with the correct rate. | Change from Baseline at 2 weeks and 4 weeks | 
| Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) | The first and second subscales are used. To evaluate the ability of a patient to perform certain upper extremity activities. This questionnaire is a self-report questionnaire that patients can rate difficulty and interference with daily life on a 5 point Likert scale., which are converted into 100 points. The higher the score, the higher the severity. | Change from Baseline at 4 weeks | 
| General Health Questionnaire (GHQ-12) | Self-rating scale used to measure mental health status. Respondents rated the frequency of occurrence of each item in the past month on a scale of 0 (not at all) to 3 (often). The total score can be up to 36 points, and a score of 15 or more can be defined as mental distress. The higher the score, the more serious the distress. | Change from Baseline at 4 weeks | 
| Daily wearing activity record sheet | To record the daily wearing and practice time, the number of side effects, such as soreness, pain, injury, etc. | Every training session during 8 sessions, total sessions continued to 4 weeks | 
| Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) | The questionnaire is a subjective self-administered scale for the use of assistive devices, with a 5-point scale (strongly agree to strongly disagree), including beauty, complexity, weight , resistance, comfort, easy to wear, etc. | The end of the study at 4 weeks |