Commercial Versus Custom-Made Cock-Up Orthoses: A Randomized Cross-Over Analysis of Dexterity and Satisfaction in Female Office Employees.

Background/Objectives: Wrist cock-up orthoses are standard for work-related muscu-
loskeletal disorders, yet consensus is lacking on whether commercial orthoses (COs) or
custom-made thermoplastic orthoses (THs) better preserve function. While COs offer
availability, THs provide a superior anatomical fit. This study evaluated dexterity and
satisfaction in healthy female employees to establish a functional baseline for preventive
strategies. Methods: Healthy female office workers with no prior musculoskeletal or neuro-
logical conditions participated in this randomized cross-over study. Manual dexterity was
assessed at baseline and after each of two consecutive workdays, during which participants
wore, in a randomized order, either a CO or a TH made by an expert physiotherapist.
Outcome measures included the Functional Dexterity Test (FDT), recording time and errors,
and the Client Satisfaction with Device (CSD-It) scale. Results: Twenty right-handed
women (mean age 45.6 ± 11 years) participated. A significant difference in FDT completion
times across conditions (χ2 = 12.6, p = 0.002) was found. While both orthoses slowed
performance compared to baseline (p < 0.01), the CO allowed for faster dexterity than the
TH (p < 0.01). No differences were found in error rates. Regarding satisfaction, the CO
achieved significantly better CSD-It scores than the TH (p = 0.0047), despite 60% of users
reporting increased skin temperature with the CO. Final preferences were nearly evenly
split (55% CO vs. 45% TH). Conclusions: Both orthoses impact manual dexterity without
compromising precision. While the CO offered better execution speed and overall satis-
faction, the TH version was preferred for prolonged skin tolerability. Selection should be
individualized, balancing mechanical efficiency with the superior fit of custom-fabricated
solutions in office environments.