THE EFFECT OF A MODIFIED TENODESIS WRIST-HAND ORTHOSIS ON HAND FUNCTION IN PATIENTS WITH TETRAPLEGIA
Bibliographic record
Abstract
BACKGROUND: An individual experiencing tetraplegia faces functional limitations due to impaired hand function. The use of an affordable tenodesis wrist-hand orthosis (WHO) can enable finger flexion with active wrist extension, thereby enhancing the three-jaw chuck grasp and overall hand functionality. OBJECTIVES: To assess hand function and satisfaction in patients with tetraplegia using a modified tenodesis wrist-hand orthosis (WHO), utilizing the Duruöz Hand Index (DHI) and the Orthotics and Prosthetics User Survey (OPUS) satisfaction with device and services subscales. METHODOLOGY: The study was conducted at a tertiary care center in central India, enrolling patients with tetraplegia admitted to the Department of Physical Medicine and Rehabilitation. A modified tenodesis wrist-hand orthosis (WHO) was designed using low-temperature thermoplastic components. Twenty-two individuals with a minimum wrist extensor power of grade 3/5 were included in the study. These patients were provided with the modified tenodesis WHO and underwent daily training sessions for a period of 2 weeks. Duruöz Hand Index (DHI) scores were assessed at baseline, 6 weeks, and 12 weeks post-enrolment. Patient satisfaction was evaluated using the Orthotics and Prosthetics User’s Survey (OPUS) satisfaction with device and services subscales. FINDINGS: The analysis of the DHI scores indicated a significant enhancement in functional abilities at both 6-week and 12-week follow-ups compared to the baseline assessment. Notably, the most substantial progress at 6 weeks follow-up was observed in tasks such as buttoning a shirt, while significant improvement at the 12-week mark was noted in activities like turning a key in a lock. The median OPUS device satisfaction score was 50, corresponding to a Rasch score of 68.8. Additionally, the median OPUS satisfaction score for services stood at 46, with a Rasch score of 72.7. Patients expressed the highest satisfaction levels with the courteous demeanor of the staff, prompt scheduling of appointments, and accurate fitting of the orthosis. CONCLUSION: The study findings indicate that the modified tenodesis WHO is an effective and satisfactory therapeutic device for improving hand function in patients with tetraplegia. The findings encourage further investigation and application of the modified tenodesis WHO in clinical practice. Layman's Abstract Individuals who are affected due to spinal cord injury (SCI) are often unable to perform the basic daily activities of life due to weakness. The hands are one of the most specialized parts of the human body and loss of its function can be incapacitating. Certain wrist hand orthoses (WHO) can aid such individuals by assisting the weak hand muscles. One such WHO is a tenodesis wrist hand orthosis. Modifications to the previously available tenodesis wrist hand orthosis were made to make it cheaper, lighter, and easier to manufacture. The effectiveness of this modified tenodesis WHO on improving hand activity and satisfaction in the individuals using it was assessed in this study which was conducted in a tertiary care center in central India. Twenty-two individuals with cervical SCI, who had some ability to extend their wrists against gravity, were admitted to the Physical Medicine and Rehabilitation department and enrolled in this study. Notable improvements were observed in functional tasks such as buttoning a shirt, opening a lock, eating with a fork, brushing teeth, and writing, with considerable satisfaction in those trained with the modified tenodesis WHO. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/42879/33253 How To Cite: Sonune S.P, Saha A, Joshi N.G, Pathak S, Bhadra P, Goel G. The effect of a modified tenodesis wrist-hand orthosis on hand function in patients with tetraplegia. Canadian Prosthetics & Orthotics Journal. 2024; Volume 7, Issue 1, No.8. https://doi.org/10.33137/cpoj.v7i1.42879 Corresponding Author: Dr. Anyesha Saha,Affiliation: Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Saket Nagar, Bhopal (M.P.), India.E-Mails: saha.anyesha@gmail.com; anyesha.sr2023@aiimsbhopal.edu.inORCID ID: https://orcid.org/0009-0004-1574-0519
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".