Orthotic Design and Fabrication for the Upper Extremity: A Practical Guide

251 Pages·2019·17.024 MB·English

by  Katherine A. Schofield, Deborah Schwartz

OOrrtthhoottiicc DDeessiiggnn aanndd FFaabbrriiccaattiioonn
ffoorr tthhee UUppppeerr EExxttrreemmiittyy
AA PPRRAACCTTIICCAALL GGUUIIDDEE
Longitudinal transverse arch
Proximal transverse arch
Distal transverse arch
KKaatthheerriinnee SScchhooffiieelldd •• DDeebboorraahh SScchhwwaarrttzz
SSLLAACCKK IInnccoorrppoorraatteedd

Katherine Schofield, DHS, OTR/L, CHT
Assistant Program Director and Associate Professor
Department of Occupational Therapy
Midwestern University
Glendale, Arizona
Deborah Schwartz, OTD, OTR/L, CHT
Product and Educational Specialist
Physical Rehabilitation
Orfit Industries
Antwerp, Belgium
Adjunct Professor
Department of Occupational Therapy
Touro University
New York, New York
Senior Vice President: Stephanie Arasim Portnoy
Vice President, Editorial: Jennifer Kilpatrick
Vice President, Marketing: Michelle Gatt
Acquisitions Editor: Tony Schiavo
SLACK Incorporated
Managing Editor: Allegra Tiver
6900 Grove Road
Thorofare, NJ 08086 USA Creative Director: Thomas Cavallaro
856-848-1000 Fax: [phone] Cover Artist: Katherine Christie
www.Healio.com/books Project Editor: Dani Malady
© 2019 by SLACK Incorporated
Dr. Katherine Schofield has no financial or proprietary interest in the materials presented herein.
Dr. Deborah Schwartz is a full-time employee of Orfit Industries America, a manufacturer of thermoplastic materials.
All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording or otherwise, without written permission from the publisher, except for
brief quotations embodied in critical articles and reviews.
The procedures and practices described in this publication should be implemented in a manner consistent with the professional
standards set for the circumstances that apply in each specific situation. Every effort has been made to confirm the accuracy of
the information presented and to correctly relate generally accepted practices. The authors, editors, and publisher cannot accept
responsibility for errors or exclusions or for the outcome of the material presented herein. There is no expressed or implied
warranty of this book or information imparted by it. Care has been taken to ensure that drug selection and dosages are in accor-
dance with currently accepted/recommended practice. Off-label uses of drugs may be discussed. Due to continuing research,
changes in government policy and regulations, and various effects of drug reactions and interactions, it is recommended that
the reader carefully review all materials and literature provided for each drug, especially those that are new or not frequently
used. Some drugs or devices in this publication have clearance for use in a restricted research setting by the Food and Drug and
Administration or FDA. Each professional should determine the FDA status of any drug or device prior to use in their practice.
Any review or mention of specific companies or products is not intended as an endorsement by the author or publisher.
SLACK Incorporated uses a review process to evaluate submitted material. Prior to publication, educators or clinicians provide
important feedback on the content that we publish. We welcome feedback on this work.
Library of Congress Cataloging-in-Publication Data
Names: Schofield, Katherine (Katherine A.), author. | Schwartz, Deborah
(Deborah A.), author.
Title: Orthotic design and fabrication for the upper extremity : a practical
guide / Katherine Schofield, Deborah Schwartz.
Description: Thorofare, NJ : Slack Incorporated, 2019. | Includes
bibliographical references and index.
Identifiers: LCCN 2019008424 (ebook) | ISBN
9781630915919 (epub) | ISBN 9781630915926 (web)
Subjects: | MESH: Orthotic Devices | Upper Extremity | Equipment Design
Classification: LCC RD557 (ebook) | LCC RD557 (print) | NLM WE 26 | DDC
617.5/7--dc23
LC record available at https://lccn.loc.gov/2019007687
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Dedication
I dedicate this book to those in my life who encouraged me along the way. This includes my husband, Dale; my sons,
Austin and Andrew; my mom, Gretchen; and my sister, Lisa. Thank you for having faith in me.
—Katherine Schofield
I inherited my love of writing from my father, Bernard Shuman. My brother, Ellis, shares this passion as does my hus-
band, Barry. I dedicate this book to Barry, who encourages and inspires me everyday, and to my children, Nadav, Talia,
and Noam, who have offered me multiple opportunities to practice orthotic fabrication.
—Deborah Schwartz

Contents
Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Part One Foundations of Orthotic Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 1 Orthotic Fabrication: Principles and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Chapter 2 Anatomical and Biomechanical Principles of Orthotic Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Chapter 3 The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Part Two Orthoses as Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Chapter 4 Wrist Immobilization Orthoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Chapter 5 Wrist and Hand Immobilization Orthoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Chapter 6 Forearm- and Hand-Based Thumb Orthoses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Chapter 7 Elbow, Wrist, and Hand Immobilization Orthoses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Chapter 8 Hand-Based Orthoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Chapter 9 Digit-Based Orthoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Part Three Advanced Orthotic Concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Chapter 10 Orthoses for Tendon Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Chapter 11 Orthoses for Mobilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .227
Prefabricated Immobilization Orthoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235

Acknowledgments
I am so grateful that Deb agreed to work with me on this endeavor. I found a knowledgeable, passionate individual
who loves teaching and making orthoses as much as I do! Thank you, Deb, for all of your support, perseverance, tenacity,
friendship, encouragement, constructive feedback, and hard work. This would not have been possible without you!
Thank you Brien Cummings and the wonderful staff at SLACK Incorporated for supporting us through to the end of
this long journey.
Thank you to my colleagues and mentors at Midwestern University in Glendale, Arizona, for their unending encour-
agement. I am blessed to have the opportunity to teach and inspire my occupational therapy students on a regular basis,
and I am eternally grateful for their ongoing support and excitement about this project as it progressed. A special thank
you to Jack Mullins and Jason Tinsley for their expertise and patience with video production; Dr. Chris Merchant for her
support and encouragement; and Dr. Tana Brown for her suggestion that I needed a “project” to work on.
I also wish to express my gratitude and appreciation for my occupational therapy students: Allie Cammarata for her
hard work and tireless attitude drawing all of our custom illustrations; Callie Surridge for having her camera ready for our
photos; Carson Lund for his suggestions and help during our video shoot; and Brianne Van Buren and Cassie Durfee for
their time and willingness to assist with our videos and photos.
—Katherine Schofield
Thank you to my wonderful writing partner and colleague, Katherine, for inviting me to join you on this creative
journey.
Thank you to SLACK Incorporated and Brien Cummings for picking up the ball with this project.
Thank you to Orfit Industries for donating thermoplastic materials for our orthotic fabrication videos and for use of
photos.
—Deborah Schwartz