November 28, 2013

The Future of Occupational Therapy

I went to the WESTEC conference a few weeks ago, which showcased the latest innovations in manufacturing technology and engineering. I strolled through booths displaying electric welding systems, optical communication encoders, expansion clamps, CNC machines, and all things redefining the future of manufacturing. What's this got to do with Occupational Therapy? Well, after strolling through a lane offering free candy, I came across the Additive Manufacturing, or commonly known as 3-D printing, booth. Recently, there have been a lot of advances made in the field of medicine such as targeted cancer therapies, the first full face transplant, bionic hands that position using an iPad app, bluetooth devices that coordinate motor movement, and 3-D computer models that customize eye socket design. But what really blew my mind was in a glass showcase - a 3D printed "magic arm," also known as WREX (Wilmington Robotic Exoskeleton) and a 3D printed arm cast, aka, Cortex Cast.  I had heard of 3D printed replicas of monuments, jewelry and even printed shoes! The custom made, light weight, waterproof arm cast/splint caught my interest, especially as an Occupational Therapist. The Cortex exoskeletal cast is "...fully ventilated, super light, shower friendly, hygienic, recyclable and stylish," says Jake Evill the creator and founder of Cortex Cast Systems. The system allows you to create an x-ray of the upper extremity, identifying the exact position of the fracture, then the extremity is 3D scanned to generate its exact dimensions, and finally all this information is fed into the computer and the 3D printer creates a cast molded to fit snug on the extremity. What's even better is that it is printed with support around the bony prominences and built-in fasteners to snap close (so long velcro!).

To think, that Occupational Therapists will no longer have to run around with the splint cart ricocheting around the clinic/hospital hallways, turning corners ever so carefully as not to spill the hot hot water on anyone warranting a law suit, then to manually fabricate a hand splint in a span of 30 minutes which includes: drawing a silhouette of the extremity on a napkin paper (that's what I had to use when I was working at a hospital), cutting out the figure, tracing it on the one type of splint material we were provided, cutting the splint figure, throwing it in the hot water to make it malleable, then forming a base splint shape on your own hand, heating up the splint again and manipulating the corners making sure no sharp edges are left behind, followed by structuring the splint around the patient's own hand, molding it to the approximately correct angle of the extremity, reheating once again to fine tune, re-fitting once again to ensure proper fit, re-re-heating and round out corners and edges, cutting velcro strips, attaching them on strategic spots on the splint, fitting the splint on the patients hand, and FINALLY velcro-ing them in. Oops, I forgot to write the patient's name on the splint. Oh, and still have to document it all - do I still have time?!

Granted, it took Jake Evill 3 months to make the first prototype, but with the most recent 3D printer heading to space (true story, see link at bottom of post), OTs worldwide will be churning out splints in the blink of an eye...or two. Just think, the allotted 30-40 minutes for a screen and splint would be greatly reduced to mere minutes, granting us an even bigger caseload for the day. Yes, I know, not many of you jumped out of your seat for that comment, but remember, we're doing it for the patients! The more patients we can heal and make happy, the closer we are to being better human beings, agree? I do wonder, however, will the increasing supply of 3D printers on the market and the creation of printed splints and prosthetics eventually eliminate the need for therapists? What happens to the face-to-face interactions we're taught to create client-centered interventions? We interact with our patients to learn about their life, their hobbies, their abilities and disabilities and goals to get better, but with a 3D printer in our clinics, will we need to do that anymore? Or should we just read the chart, identify the fracture and bam, here's your splint Mr. Bane.  There's probably an app for that already, though.

Disclaimer: I am neither employed or promoting any of the products or companies mentioned in this post. This writing is voluntary and not in exchange for any type of credit. This post is solely for blog purposes as I sit atop my soapbox.

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