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New dimension
Monday October 1, 2012
Sheri Dawson, PT, and Emma

(Courtesy of Nemours/Alfred I. duPont Hospital)


Imagine a world in which the term "printing" no longer conjures up images of a machine spitting out sheets of paper with text or pictures. In this new world, healthcare professionals, aerospace engineers and consumers use printers to create everything from customized hip replacements to airplane parts to jewelry.

The reality is that 3D printing technology — also known as additive manufacturing — already is allowing people to make all of these things. According to an article in The Economist published in April, 3D printing will amount to a third industrial revolution in this country.

According to experts in the 3D printing industry, this technology has tremendous potential for physical therapists. Although it currently is used at larger hospitals, the technology is evolving so quickly that it is likely to become more affordable and user-friendly within the next few years, said Scott Summit, founder of Bespoke Innovations Inc. in San Francisco, a company that specializes in 3D printing related to coverings for prosthetic legs.

"The technology tool of 3D printing is incredibly versatile, so almost anything we design we can 3D print," Summit said. "It stands to become a profoundly powerful new tool for physical therapists because it offers them the ability to create products for specific patients, based on their unique needs and individual morphology."

Customizing for young children

The first 3D printers in the mid-1980s cost more than $500,000 and were primarily used by large companies such as General Motors, Ford and Boeing to make prototypes.

"Basically they work by putting a layer of materials down and then putting another layer on top of that," said Graham Bennett, technical director at CRDM Ltd., one of the largest 3D printing companies in England. "It is like building a house and putting down layers of bricks, but the layers are made of very small particles that may be one-tenth of a millimeter."

The printers are driven by information from a 3D computer-aided design file created by engineers, Bennett said.

"In the beginning of the 3D printing revolution, no one would have even dreamed of producing actual parts because the initial value was in using the technology for rapid prototyping," said Cathy Lewis, vice president of global marketing at 3D Systems Corporation, based in Rock Hill, S.C. "About 10 years ago, we started to realize that 3D printing could be used for end-use products."

Now 3D printing is used to make customized Invisalign teeth aligners, hearing aids, doorknobs, fuel injection systems for airplanes and more. Some hospitals, such as Nemours/Alfred I. duPont Hospital for Children in Delaware, are pioneering new ways to use 3D printing to create devices for physical therapy. A patient named Emma, for example, was born with arthrogryposis multiplex congenita, a condition that affects her joints and muscles and makes her arms extremely weak. Historically, there have been devices that enable movement in older children with this condition, but the equipment is too heavy and restrictive for younger children.

In 2010, Nemours purchased a Stratays 3D printer for approximately $35,000. The design engineers at the hospital started experimenting with using the printer to make light, plastic parts for a device customized to fit Emma.

"It’s been absolutely amazing to hear her talk about the things she can do," said Sheri Dawson, MPT, a physical therapist in outpatient therapy services at Nemours. "When these children can enjoy uninhibited play and explore on their own, it opens their world of learning and expression."

3D printing is particularly beneficial in the pediatric population because children frequently need new parts as they grow and test the limits of their devices. "When Emma’s mother calls in the morning to tell me that something on her device broke, I can simply print another part and have it ready when she comes in that afternoon," said Whitney Sample, a research design engineer at Nemours.

Making 3D printing accessible

Summit’s company, which was recently acquired by 3D Systems, is close to releasing a product that will be user-friendly to healthcare providers. "A physical therapist should never have to learn CAD," Summit said. "PTs should have tools that enable them to use their existing skills. In the not-too-distant future, a physical therapist will be able to access tools to 3D scan a person and simply modify a template on the screen for any type of exoskeletal bracing and then send it to a printer." Printing services could be at a separate location.

Summit also said he believes that PTs can expect to see more compliance from their patients with 3D printed orthoses. "There will no longer be a need for padding and cushioning to make something fit because these customized orthoses will wrap perfectly around the body," he said. Based on patients’ interests, they will be able to select from a variety of patterns.

"Children who need bracing face not just a medical issue, but a psychological issue," Summit said. "They are developing their outlook on the world and are sensitive to their physicality. I feel that if you are going to create something for the body, you really have an obligation to treat that person with the most respect and individuality possible. I think 3D printing allows us to do that." •

Heather Stringer is a freelance writer.

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Monday October 1, 2012
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