Multifaceted orthotic to facilitate communication in a medically complex patient: A case report.

Abstract

Background: A multidisciplinary team effort to promote functional communication in a medically complex case involving custom orthotic creation and implementation.

Purpose: To explore the clinical reasoning, design process, and implementation of a custom orthotic developed for a patient with history of a spinal cord injury and complex comorbidities to use an electrolarynx communication device. Emphasis is placed on the iterative process of clinical decision-making, material selection, and adaptive strategies to ensure the orthosis was both functional and user-friendly.

Study design: A retrospective, singular case report.

Methods: An evaluation of the patient's upper extremity function was conducted. Findings from this assessment informed the design of a custom, hand-based orthosis, which featured a stable base structure with an integrated attachment mechanism to securely accommodate an electrolarynx. Therapeutic intervention centered on use of the orthosis to support functional communication, leading to expanded use in self-care tasks.

Results: When donned, the custom orthotic was successful in allowing the patient to use an electrolarynx for communication.

Conclusions: The outlined treatment and orthosis mechanics can be generalized for use in comparable cases across settings to promote occupational therapy's unique ability to create orthotics to meet individualized patient needs.