Woo Sob Sim

The current study aimed to assess the effects of a customized three-dimensional (3D) printed writing and typing assistive device in patients with cervical spinal cord injury who presented with severe hand dysfunction. Three patients with cervical spinal cord injury who presented with severe hand dysfunction were included in the analysis. The patients’ writing and typing abilities were evaluated after using the silicon assistive device made from a 3D-printed frame for 4 weeks. Patient discomfort and issues were evaluated. Customized 3D-printed writing and typing assistive devices were developed. The Korean Western Aphasia Battery (K-WAB), particularly the writing part, and the word practice program of Hangeul were utilized to assess device effects. All patients with cervical spinal cord injuries (SCIs) performed writing or typing using a customized assistive device. Patients 2 and 3 had better typing and writing accuracies based on the word practice program of Hangeul and the K-WAB, respectively. However, patient 3 had increased time, which was associated with the process of adapting to the use of the customized device. Nevertheless, he was highly satisfied with the device. The patient’s typing and writing speed and accuracy improve with the customized 3D-printed device, which can lead to a better performance in the activities of daily living.

Bilateral amputees are disadvantaged as they lack healthy leg support. We present the rare case of a bilateral transtibial amputee (BTA), in which we compared the first South Korean-made microprocessor-controlled prosthesis (MPA) to a conventional prosthetic ankle (CPA) with gait analysis and a patient questionnaire for long-term outcomes. A 70-year-old man presented with bilateral transtibial amputations from injury. Assessments were performed after wearing an MPA for 1 month and 1 year with three-dimensional gait analysis. Satisfaction, mobility, and pain were evaluated using the Korean version of the Prostheses Evaluation Questionnaire (K-PEQ). The spatiotemporal parameters of both sides showed increased stability from the CPA to 1 month (mMPA) and 1 year (yMPA). We observed an increased single support time, decreased step width, and almost normal stance-swing time ratio. In kinematic parameters, the ankle range of motion (ROM) was bilaterally increased at mMPA and yMPA. Unfortunately, the MPA gait showed insufficient ankle plantarflexion during the terminal stance that failed to generate push-up power. As the MPA adaptation time increased, the symmetry ratio improved to a balanced value. The questionnaire-based investigations of satisfaction, mobility, and pain revealed excellent results. The MPA proved helpful for ankle mobility in the BTA, and the questionnaire showed good satisfaction and mobility in varied terrain.

Background: Power wheelchair joysticks are often available as standardized ready-made products for patients with severe hand dysfunction. However, standardized joysticks have limitations in accommodating the individualized features of hand dysfunctions. Three-dimensional (3D) printing technology has facilitated active research on the development of joysticks that can overcome such limitations. Methods: Four subjects participated in the study to evaluate driving abilities and satisfaction after using the customized joystick for two weeks. Modified power-mobility indoor driving assessment (PIDA), National Aeronautics and Space Administration task load index (NASA-TLX), and psychosocial impact of assistive devices scale (PIADS; Korean version) were employed for evaluation. Results: In patients 1–3, the modified PIDA scores had the highest values in the pre-test and post-test. In patient 4, the modified PIDA score had a higher value in the post-test (mean value = 4) compared to the pre-test (mean value = 3.33). In all patients, the modified PIDA time was lower in the post-test compared to the pre-test. The NASA-TLX and PIADS values indicate that greater satisfaction was achieved through the usage of customized joysticks in the post-test. Conclusions: All patients can improve their power wheelchair driving abilities and achieve greater satisfaction. Clinical Relevance: Three-dimensional printed customized power wheelchair joysticks can offer enhanced driving abilities and satisfaction to patients with limited hand function owing to severe spinal cord injury.