When the survey focused on specific orthoses related tasks, a clear pattern emerged:

Orthotic fabrication and design skills

Items that were of highest critical importance include custom fabrication of basic (thumb spica, wrist, finger) and complex static orthoses (Muenster, long arm elbow/ wrist), static progressive orthoses, dynamic orthoses, and related patient education, plus adjusting/modifying custom orthoses.
These same tasks have relatively high frequency scores (between monthly/weekly and daily use).
For these core tasks, roughly 84–98% of respondents expect CHTs to have the knowledge and skills to perform them.

Education – as important as the thermoplastic material we use

Providing patient education for both custom and prefabricated orthoses (don/doff, wear schedule, precautions) ranks near the top for criticality, frequency and expected competency.

Pre-fabricated splints - still critical, slightly less frequent

Custom fitting prefabricated soft and static orthoses (e.g., Neoprene thumb, buddy straps, Stax) and using prefabricated dynamic and static progressive devices show high criticality but slightly lower frequency. These tasks were performed somewhat less frequently than custom fabrication, but they still represent important tools in our orthotic toolbox—especially in fast paced or resource limited settings.

3D printing - emerging, not yet expected

At the time of the survey, utilizing 3D printing to fabricate orthoses or prostheses ranked low in criticality, frequency, and performance expectation for newly certified hand therapists. Given the rapid evolution of 3D printed devices since 2019, this is an area to watch. Many clinics are beginning to experiment with 3D printed components, and future practice analyses may show a shift toward higher utilization and expectation of competence.

Why orthotic fabrication and hand therapy are so tightly connected

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