What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

Hand injuries and elective hand surgery is an ever increasing entity, with increasing burden on the NHS for monitoring of progress of these patient groups. Delays in access to specialist hand therapy services, the inconvenience and difficulty in travelling to specialist centres, as well as the associated costs are significant barriers to patient care. Virtual appointments do not suffice, as clinical assessment for accurate measurement of range of movement is required to assess progress.
SMART splints have been developed for use in the foot, knee, shoulder and ankle with data using inertial measurement units collected using an app, and shown to be feasible and highly accurate when compared with standard goniometers recordings. However use in hand surgery has been limited as the neoprene splints are restrictive and are difficult to use in post operative period and acutely injured hands.

What does your project aim to achieve?

We aim to develop technology for a custom-made splint to allow remote monitoring using battery powered sensors on the splint, that will track non-battery powered sensors on the patient’s finger to record finger range of movement (ROM), allowing highly accurate measurements for clinical analysis in a remote setting.
By facilitating collation of this data remotely, the splint will enable accurate clinical assessment without the need to travel to appointments, especially benefiting those who struggle to attend appointments due to cost implications, physical limitations and other health issues, reducing the social and economic cost associated with hand conditions.
It will also provide insight into finger ROM over a longer period than a single clinic appointment. This will give a more accurate representation of progress to guide the frequency and duration of follow up required, allowing for resources to be prioritised to those in need of the most input.

How will the project be delivered?

Two trauma and orthopaedic hand surgeons, Gemma Smith and Subodh Deshmukh will work alongside mechanical &/or Computer engineering students and academics at the University of Birmingham (UoB). Allowing for a combined approach of clinical and engineering expertise, with access to the world-leading human movement analysis laboratory at the School of Engineering, UoB, which is equipped with advanced mechanical and optical motion capture systems.
1.   Recruit post-graduate research student
2.   Design splint using appropriate materials and sensors
3.   Make splint with assistance from a trained hand therapist
4.   Test splint accuracy: assess whether measurements can accurately record finger ROM using additional mechanical and motion sensors available at the UoB
5.   Refine splint in accordance with initial results
6.    Feasibility assessment on healthy volunteers with a range of hand sizes and shapes
7.   Process results from testing with a view to take onto next stage

How is your project going to share learning?

The project will be disseminated both nationally and internationally, via orthopaedic surgery and physiotherapy conferences and journal publications. Proof of concept as a finger splint may also demonstrate the benefits of the technology, and therefore prompt consideration of use in other joints, increasing the population of patients that may be able to benefit from this project.