Competence Project – Neoprene Glove product adapted as per client feedback
This section demonstrates how the occupational adaptation frame of reference influenced decision-making to increase the comfort and cosmetic appearance of the orthosis with the purpose of increasing the compliance wear. Each stage of the process of designing and adapting the custom neoprene glove product for the client is described below. The main takeaways that changed my practice during this experiential learning process were that, unless otherwise indicated, I will now use duct tape instead of surgical tape for the mold of the hand. I found the surgical tape was too soft to offer the correct circumferential measurements of the digits. Also, unless otherwise indicated, I will likely choose orficast for weight-bearing on small joints, instead of thermoplastics. I found that orficast was less likely to create pressure points around the PIP joints, where the client had increased tone. Also, because the orficast is thin, an extra piece can be easily added around the joint without impacting comfort or function while the orthosis is in place. I will also use Crazy Glue or Gorilla Glue instead of cement glue to avoid ‘bleed through’ the material. Finally, I now realize that moving forward, any type of functional use of neoprene with respect to the hand will require traction for grip or weightbearing. Since neoprene is a smooth material, the use of Puffy paint will be used to provide this traction.
I needed to make a 3D mold somehow of the pt’s hand because she could only come to therapy 1x/wk and I needed her exact measurements while I designed the glove. If I used a hospital glove and wrapped something strong around it, a 3D mold should occur with the patient’s exact measurements. I did not have duct tape, so I used surgical tape insteadNext time I would use duct tape because the surgical tape was flimsy and didn’t give me a strong enough 3D shapeOrficast inserts custom fabricated around digits 2 to 5. Thermoplastic was used initially, however, it was not comfortable for the patient when weight-bearing. Therefore, Orficast was chosen instead of thermoplastic for rigidity and comfort of material. Less likely to create pressure points around the PIP joints due to increased tone. Also, an extra piece can be easily added around it if needed. The 3D mold was cut in half to make a pattern for the neopreneDraw a pattern on paper towelCut the neoprene material from the pattern on the paper towel. The neoprene color was chosen by the patient. Cement Glue the orficasts to the inside of the gloveSide view of the orficast insertsHand sew the glove. Here the cement glue has bled through the neoprene material. Next time, I would use a different type of glue, maybe CrazyGlue or Gorilla Glue? The thumb was not included because the patient determined that the thumb did not interfere with the plank position in weight-bearing. The ulnar aspect of the glove was purposely left open for the pt to have ease of access while donning the glove, as can be seen in the next picture. J.F. donning the glove. This confirmed that leaving the ulnar aspect open was a good ideaDonning the glove completelyPractice with the glove before it is sealed with seam tape on the edges. Here, it is realized that a D-ring strap is needed to prevent the weight of the orficasts from slipping off the handD-ring strap allows the base of the glove to tighten, one-handed. A velcro attachment would not give the glove a stable base around the carpal bones. The wrist has to remain free to achieve the plank position and to minimize the look of the glove.“The neoprene material is a little slippery”Solution: I had to learn about puffy paint for fabrics. I also learned about permanent fabric paint for clothing. I used puffy paint to add tread to the volar aspect of the glove for the weight-bearing radial and ulnar aspects of the hand. Also, the patient practiced with fabric paint to color the glove, as the patient is an artist who enjoys drawing. This also makes the glove her own which was very important for compliance according to all the pediatric courses I have taken. Seam tape ironed onto the edges to prevent frayingPersonalize the glove with permanent fabric paintFinal Design
