Introduction: D4E1: Fixatiehulp

Our client was a 7-year-old
enthusiastic girl. Since childhood she has a hemiplegia on the left-hand side. A few hours a week she goes to the rehabilitation center. Now that the girl is in the first grade, she’s learning to write. Writing has evolved well.

The occupational therapist is experiencing problems with her posture and the acceptance of her left hemiplegia. These are the problems identified:

- faillure to focus on using her left hand and arm when she’s concentrating on something else (writing for example)

- whilst highly concentrated, the left upper extremity goes to spastic pattern

- she slides forward with her torso, causing her stretched upper arm and body to lay on the table.

- when not paying attention to it, the spastic pattern causes the left hand to grasp the sheet of paper, causing it to wrinkle

- the sheet of paper is shifting because she can’t apply pressure on it.

We were instructed to find a solution for her problems.

Step 1: Materials and Tools

Time to start the
assignment. We used the toolbox INNOWIZ to start our creative process. By using templates we collected ideas in a creative way. After thinking and puzzling, we started looking for the following items:

Materials:

- clipboard

- thermoplastic sheets.

- clay

- velcro

- tubular rivets

- anti-skid material

- magnets

- metal plate

- silicone

- ballpoint pen

- stickers

Tools:

- hot water bath

- heat blower

- a file

- scissors

- sandpaper

- a small drill

- adhesive tape

- grinding machine

- double-sided tape

Materials are available in the hardware stores.

You can find non-slip material on the internet.

The orthosis plate was sponsored by Orfit. With much gratitude we thank Orfit for supplying us with the Thermoplastic sheets.

Step 2: The Clipboard

Take the clipboard, anti-slip material and double-sided tape.

1. Take the anti-skid material.

2. Cut out 2 A4 sheets and one strip of 10 cm wide and with the same height of a A4 sheet.

3. Open the clipboard.

4. Stick the double-sided tape on the back of the clipboard.

5. Place the anti-skid on the clipboard.

6. The inside: stick a metal plate on the right side with silicone. Place the 10 cm strip on the middle of the right flap (on the magnet strip).

7. Take a hole punch. Place it on the left flap. About 5 cm from the top.

8. Punch 2 holes.

Step 3: Hand Shell

There are two options for making the shell.

Method 1: the client's handprint is in the hand shell.

Method 2: a universal hand shell without fingers.

Method 1:

1. Take a piece of clay and make a handprint of the affected hand. Press firmly so that all fingers are visible, including the thumb. Make sure the fingers are extended.

2. Let the clay harden.

3. Cut a piece from the orthosis plate. The size depends on the client's hand. Take the size of the hand and calculate a few centimeters as a reserve.

4. Then heat the hot water bath. Recommended degrees: +60 °C.

5. Lower the cut-out piece of orthosis plate into the wake and leave it submerged until the plate becomes transparent. Get it out of the water and put it on the clay print. Leave the plate until it is no longer transparent. When the plate returns to its original color, it will be hard again. the shape will retain.

6. Place silicone in the shell, place the magnets in it and let it dry.

7. Grind the edges from the plate with the grinding machine. File the edges as a last finish.

8. Drill in the top left, top right and in the center right a hole.

9. Take the velcro, cut into 4 pieces of approximately 10 cm.

10. Drill one hole at the end of the velcro.

11. Place a piece of velcro above the hole of the plate and push the tubular rivets together.

Hint: when extra adjustments are needed, use a heat blower. Heat the part of the plate where the adjustment is needed. Wait until the transparency is clear and adjust where necessary. Let it harden again.

Hint: it’s recommended to work with 2 people while operating the heat blower.

Method 2:

Follow the same instructions as method one. But now you place a piece of cloth over the clay so that the fingers are no longer visible. Place the heated plate on the towel to obtain a general hand shell.

Step 4: Pen Holder

1. Cut 2 fine strips from the orthosis
plate (approximately 2 mm white and 3,5cm long).

2. Keep them in front of the heat blower until they are transparent.

3. Place the strips through the perforated holes and connect the end of the strips (forming a circle).

4. Hold them together until the material has cooled down (the material returns to its original color).

5. Do the same with the second strip.