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Waldburger, et al.
a. How do you clean the splint? Assessment 2 (by investigator)
Patient ID:
K. Have skin changes occurred under the splint? A. Satisfied with fit? yes / no
O Yes O No
a. If no, why not? ______________________
a. If yes: How? O Rash
B. Adjustments made? yes / no
O Pressure point
a. If yes, which? ______________________
O Open wound
C. Any adverse events? yes / no
O ______________________
a. If yes, which?
Where? ___________________________________ ______________________
When? ____________________________________ D. Any change of procedure? yes / no

Did you have to change the splint? O Yes O No a. If yes, which? ______________________

L. Are there mechanical or material issues of the E. Next appointment:______________________ at
splint? O Yes O No Occupational therapy / Consultation with doctor

a. If yes: What? O Splint broke _____________________________________________
O Cracks _________________________________________

O The splint was deformed Place and date: Investigator signature:

O ______________________ Questionnaire 3 for patients
Patient ID:
Where? ___________________________________ The following questionnaire will ask various questions.
Please answer these truthfully and completely. Please judge
When? ____________________________________ the proprieties of the splints on a scale 1-10 (1=minimum,

Did you therefore have to take the splint off ? 10= maximum) and explain more specifically where
needed. Please relate your answers to the time interval
O Yes O No from the last questionnaire. Feel free to contact us if you
have any questions or problems. Thank you very much!
M. How many times was your splint adjusted? O not
once A. How do you rate the general fit of your new splint?

O ___ times
B. How much pain do you have with the splint?
a. If yes: Why? __________________________
N. How many times was your splint replaced? O
never C. How heavy is the splint?
O ___ times

a. If yes: Why? __________________________ a. Did you have neck pain due to splint wearing? O
__________________________________________ never O sometimes O often O always
__________________________________________
_______________________________ D. How easy do you find putting the splint on and off?
Place and date: Patient signature:
E. Is the splint aesthetically pleasing?
_____________________________________________
_________________________________________

International Journal of Bioprinting (2022)–Volume 8, Issue 1 137