Future Directions
Realizing that neoprene and aluminum wire materials do not take away from thermoplastics and are not substitutes, but can be quite powerful in combination, I plan to explore developing guidelines for the process of selecting orthoses and materials. I also plan to explore how the use of various gauges of aluminum wire may offer new opportunities, such as the thicker yet still malleable 9 inch gauge wire, for use in individuals who have stronger tone in one digit versus other digits. I also plan to explore uses of neoprene for other joints such as those in the lower extremities and for people with fragile skin, as the material may be more gentle than traditional orthosis materials.
Limitations
There are a few limitations that immediately stand out. Firstly, neoprene edges need to be sealed so that moisture does not enter the material causing it to erode. The sealing process is time consuming and not efficient in a busy outpatient clinic. Like sealing the edges of neoprene, sewing the materials is time consuming and often requires extended time for fabrication which will delay the provision of the orthosis. Another disadvantage is that the neoprene material can be too warm to wear as it is similar to scuba diving material. The scuba diving material limits air circulation, inhibiting the skin’s ability to cool. The disadvantage to using aluminum wire is that it can bend out of shape if the hand grips an object with enough force. Another limitation is that the color of the aluminum wire wears off with longer term wear such as two months.
Improvements
Since 2020, I have been using double sided strap to attach two neoprene pieces together which saves time and allows me to issue the orthosis on the same day. I have added more colors to the aluminum gauge wire to offer more cosmetic choices. The use of one inch pre-cut Neoprene strapping has proven to be useful as a supination strap for pronated Erb’s palsy patients.