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208 HOUSTON-HICKS ET AL.

INTRODUCTION attempt to bite and traumatize the fingers, leading to
Annually in the U.S., approximately 10,000 infants pain, wounds, and difficulties with subsequent self-
are born with cerebral palsy (CP) (1). The worldwide care tasks and play. The reinforcing material will be
incidence of CP is 1.6 to 2.5/1,000 live births, placing non-toxic but durable to minimize the risk of ingest-
CP as the leading cause of childhood motor disabil- ing harmful materials. The gloves would ideally appeal
ity (1,2). Approximately 23% of children with CP to children by being adorned with popular cartoon
are dependent upon assistive technologies (3). Use characters, pending licensing agreements. The gloves
of these assistive technologies includes functional will facilitate higher quality of life for patients and
uses such as walking aids and orthoses but may also caregivers by mitigating complications associated
include protective roles. Protective roles may be aimed with finger biting. An additional benefit of PLAY
at limiting injury during function but may also be Hands is that many people affected by CP and other
necessary in the case of self-injury caused by behav- neurologic disorders may have contractures of the
iors such as finger biting. Currently, technologies to joints of the hands and fingers. The act of donning/
facilitate the dual role of therapeutics and protection doffing PLAY Hands will require a range of motion
of the hand and finger in populations such as these activity for the hands, offering a therapeutic effect in
are limited. The purpose of this technical note is to addition to protection. Finally, wearing a glove offers
describe potential needs and design considerations a sensory experience from both tactile and thermal
for a protective glove and/or finger covering that perspectives that may be beneficial for some users.
maintains dexterity of the finger for children with The wearable finger protection design is dependent
diagnoses such as cerebral palsy, Lesch-Nyhan syn- upon the desired device utilization. A solution is pre-
drome, and dermatophagia who exhibit finger/hand sented that is either an entire glove or independent for
chewing, require therapeutic range of motion, and each finger, allowing either targeted intervention on
may benefit from sensory stimulation from constant digits that are more prone to chewing or protection for
contact. the entire hand when used in combination. For this
construction, use of high molecular weight poly(lactic
acid) PLA or high to ultra-high molecular weight
CONCEPT polyethylene (UHMWPE) should be considered in
Protecting Little and Adolescent Hands (PLAY) the design of a bite protection device. Both materials
Hands Gloves are protective gloves for children with are commonly used in food packaging materials, are
developmental disorders such as CP who injure them- non-toxic, and can be used in implantable devices
selves by biting their hands due to pain or sensory with proper processing.
issues. At times, these self-mutilating behaviors result “PLA is a thermoplastic, high-strength, high-mod-
in wounds, pain, loss of function, and increased ulus polymer that can be made from annually
dependence or self-care. PLAY Hands are conceived renewable resources to yield articles for use in …
to be cosmetically appealing gloves that provide biocompatible/bioabsorbable medical device market”
therapeutic warmth, tactile sensory feedback, range according to Garlotta (4). PLA is a thermoplastic
of motion for donning/doffing, and protection to material with a melting point of approximately 180
maximize function and quality of life for families of °C, a tensile strength typically in the range of 50
children with developmental disorders. MPa (depending upon processing and origin), and
an elastic modulus of 3500 MPa. PLA also has a glass
DESIGN transition temperature of 60 to 65 °C, which allows
PLAY Hands are gloves with protective finger pad for easy at-home thermofitting around the patient’s
material reinforcement to prevent young persons with finger to ensure a tight yet comfortable fit. Figure 1
CP, or other diagnoses contributing to self-mutilating presents a sample prototype showing fitting of a basic
behaviors, from biting and traumatizing their fingers. protective frame using 3D-printed PLA.
The gloves will be reinforced with protective materi- The second thermoplastic under consideration
als to cover the finger pads where these individuals for the proposed design is UHMWPE. Although it