Design and Calibration of Pinch Force Measurement Using Strain Gauge for Post-Stroke Patients

Two fingers strength is an indicative measurement of pinch impairment. Conventionally, Fugl Meyer Upper Extremity Assessment (FMA-UE) is the primary standard to measure pinch strength of post-stroke survivors. In literature, the evaluation method performed by the therapist is subjective and exposed to inter-rater and intra-rater reliabilities. Recently, force-sensing resistors were implemented to measure two fingers force, but these sensors are subjected to nonlinearity, high hysteresis, and voltage drift. This paper presents a design of pinch force measurement based on the strain gauge. The pinch sensor was calibrated within a range of between 0 N to 50 N over a pinching length of 20 mm with a linearity error of 0.0123% and hysteresis of 0.513% during the loading and unloading process. The voltage drift has an average of 0.24% over 20 minutes. The pinch force measurement system reveals an objective pinch force measurements in evaluating the rehabilitation progress of post-stroke patients

Designing an Egocentric Video-Based Dashboard to Report Hand Performance Measures for Outpatient Rehabilitation of Cervical Spinal Cord Injury

Background: Functional use of the upper extremities (UEs) is a top recovery priority for individuals with cervical spinal cord injury (cSCI), but the inability to monitor recovery at home and limitations in hand function outcome measures impede optimal recovery. Objectives: We developed a framework using wearable cameras to monitor hand use at home and aimed to identify the best way to report information to clinicians. Methods: A dashboard was iteratively developed with clinician (n = 7) input through focus groups and interviews, creating low-fidelity prototypes based on recurring feedback until no new information emerged. Affinity diagramming was used to identify themes and subthemes from interview data. User stories were developed and mapped to specific features to create a high-fidelity prototype. Results: Useful elements identified for a dashboard reporting hand performance included summaries to interpret graphs, a breakdown of hand posture and activity to provide context, video snippets to qualitatively view hand use at home, patient notes to understand patient satisfaction or struggles, and time series graphing of metrics to measure trends over time. Conclusion: Involving end-users in the design process and breaking down user requirements into user stories helped identify necessary interface elements for reporting hand performance metrics to clinicians. Clinicians recognized the dashboard's potential to monitor rehabilitation progress, provide feedback on hand use, and track progress over time. Concerns were raised about the implementation into clinical practice, therefore further inquiry is needed to determine the tool's feasibility and usefulness in clinical practice for individuals with UE impairments

Angle assessment for upper limb rehabilitation: a novel light detection and ranging (LiDAR)-based approach

The accurate measurement of joint angles during patient rehabilitation is crucial for informed decision making by physiotherapists. Presently, visual inspection stands as one of the prevalent methods for angle assessment. Although it could appear the most straightforward way to assess the angles, it presents a problem related to the high susceptibility to error in the angle estimation. In light of this, this study investigates the possibility of using a new approach to angle calculation: a hybrid approach leveraging both a camera and LiDAR technology, merging image data with point cloud information. This method employs AI-driven techniques to identify the individual and their joints, utilizing the cloud-point data for angle computation. The tests, considering different exercises with different perspectives and distances, showed a slight improvement compared to using YOLO v7 for angle calculation. However, the improvement comes with higher system costs when compared with other image-based approaches due to the necessity of equipment such as LiDAR and a loss of fluidity during the exercise performance. Therefore, the cost-benefit of the proposed approach could be questionable. Nonetheless, the results hint at a promising field for further exploration and the potential viability of using the proposed methodology.This work has been supported by SmartHealth—Inteligência Artificial para Cuidados de Saúde Personalizados ao Longo da Vida, under the project number NORTE-01-0145-FEDER- 000045. The authors are grateful to the Foundation for Science and Technology (FCT, Portugal) for financial support through national funds FCT/MCTES (PIDDAC) to CeDRI (UIDB/05757/2020 and UIDP/05757/2020) and SusTEC (LA/P/0007/2021). Arezki A. Chellal is grateful to the FCT Foundation for its support through the FCT PhD scholarship with reference UI/BD/154484/2022. João Braun is grateful to the FCT Foundation for its support through the FCT PhD scholarship with reference 2023.04536.BD.info:eu-repo/semantics/publishedVersio

Desenvolvimento de goniômetro digital para mensuração de amplitude articular

Goniometry refers to the technique used for angular measures. In the health system area such technique is applied in the assessment of the joint mobility through measuring the range of motion (ROM). In clinical practice, there are several instruments that are used for this purpose, such as: visual estimation, fleximeter, computerized photogrammetry, among others. However, the universal goniometer has been considered the first-choice instrument in the verification of ROM for decades because of its advantages such as reliability, low cost, durability and simplicity in handling. Despite this, it also has limitations, since the accuracy of measurements depends on standardized techniques, in addition to being directly proportional to the examiner's skill and experience. For this reason, it is common for inexperienced examiners to find difficulty performing the procedure, which may interfere with the reliability of the measurements. In this context, this research aimed to build a prototype of a digital goniometer using low-cost electronic components in order to make the goniometry process easier and more accurate. This study comprises an applied research of literature review and experimental character, focusing on the search for low-cost electromechanical components that would enable the construction of the prototype and the programming for the operation of the prototype and performance evaluation in order to compare the prototype results to those of the UG. During the performance evaluation, the equipment presented very different results from the UG, with poor intra-rater reliability (ICC = 0,282) when comparing the two devices, pointing out the need for improvements in the programming and revision of the physical structure of the circuit, in order to make the measurement results equivalent to the UG results.A goniometria se refere à técnica usada para mensurações angulares. Na saúde essa técnica é aplicada na avaliação da mobilidade articular através da mensuração da amplitude do movimento. Na prática clínica existem diversos instrumentos que são utilizados para esse fim, como por exemplo: estimativa visual, flexímetro, fotogrametria computadorizada, entre outros. Porém, o goniômetro universal há décadas tem sido considerado o instrumento de primeira escolha na verificação da amplitude de movimento por apresentar vantagens como confiabilidade, baixo custo, durabilidade e simplicidade no manuseio. Apesar disso, também apresenta limitações, uma vez que a precisão das medidas depende de técnicas padronizadas, além de ser diretamente proporcional à habilidade e experiência do examinador. Por esta razão, é comum que examinadores inexperientes tenham dificuldade em realizar o procedimento, podendo interferir na confiabilidade das medidas. Neste contexto, esta pesquisa teve como objetivo construir um protótipo de goniômetro digital utilizando componentes eletrônicos de baixo custo com o intuito de tornar o processo de goniometria mais fácil e mais preciso. Este estudo trata de uma pesquisa aplicada de caráter bibliográfico e experimental, com foco na busca de componentes eletromecânicos de baixo custo que viabilizassem a construção e programação do protótipo e avaliação de desempenho de modo a comparar os resultados do protótipo aos do goniômetro universal. O protótipo foi construído utilizando a plataforma de prototipagem arduíno, um módulo GY-521 integrado com o sensor MPU-6050 o qual é composto por um acelerômetro e um giroscópio, ambos triaxiais, capaz de realizar medidas angulares a partir de cálculos de aceleração e/ou velocidade angular. Além disso, foram utilizados outros dispositivos como display OLED, push button, jumpers, protoboards a fim de dar robustez ao equipamento e aumentar a autonomia do mesmo. Durante a avaliação de desempenho o equipamento apresentou resultados muito discrepantes do goniômetro universal, com confiabilidade intraexaminador fraca (CCI = -0,282) ao comparar os dois equipamentos, indicando necessidade de melhorias na programação e revisão da estrutura física do circuito, a fim de tornar os resultados das medidas equivalentes aos resultados do goniômetro universal

Development of a mobile technology system to measure shoulder range of motion

In patients with shoulder movement impairment, assessing and monitoring shoulder range of motion is important for determining the severity of impairments due to disease or injury and evaluating the effects of interventions. Current clinical methods of goniometry and visual estimation require an experienced user and suffer from low inter-rater reliability. More sophisticated techniques such as optical or electromagnetic motion capture exist but are expensive and restricted to a specialised laboratory environment.;Inertial measurement units (IMU), such as those within smartphones and smartwatches, show promise as tools bridge the gap between laboratory and clinical techniques and accurately measure shoulder range of motion during both clinic assessments and in daily life.;This study aims to develop an Android mobile application for both a smartphone and a smartwatch to assess shoulder range of motion. Initial performance characterisation of the inertial sensing capabilities of both a smartwatch and smartphone running the application was conducted against an industrial inclinometer, free-swinging pendulum and custom-built servo-powered gimbal.;An initial validation study comparing the smartwatch application with a universal goniometer for shoulder ROM assessment was conducted with twenty healthy participants. An impaired condition was simulated by applying kinesiology tape across the participants shoulder girdle. Agreement, intra and inter-day reliability were assessed in both the healthy and impaired states.;Both the phone and watch performed with acceptable accuracy and repeatability during static (within ±1.1°) and dynamic conditions where it was strongly correlated to the pendulum and gimbal data (ICC > 0.9). Both devices could perform accurately within optimal responsiveness range of angular velocities compliant with humerus movement during activities of daily living (frequency response of 377°/s and 358°/s for the phone and watch respectively).;The concurrent agreement between the watch and the goniometer was high in both healthy and impaired states (ICC > 0.8) and between measurement days (ICC > 0.8). The mean absolute difference between the watch and the goniometer were within the accepted minimal clinically important difference for shoulder movement (5.11° to 10.58°).;The results show promise for the use of the developed Android application to be used as a goniometry tool for assessment of shoulder ROM. However, the limits of agreement across all the tests fell out with the acceptable margin and further investigation is required to determine validity. Evaluation of validity in clinical impairment patients is also required to assess the feasibility of the use of the application in clinical practice.In patients with shoulder movement impairment, assessing and monitoring shoulder range of motion is important for determining the severity of impairments due to disease or injury and evaluating the effects of interventions. Current clinical methods of goniometry and visual estimation require an experienced user and suffer from low inter-rater reliability. More sophisticated techniques such as optical or electromagnetic motion capture exist but are expensive and restricted to a specialised laboratory environment.;Inertial measurement units (IMU), such as those within smartphones and smartwatches, show promise as tools bridge the gap between laboratory and clinical techniques and accurately measure shoulder range of motion during both clinic assessments and in daily life.;This study aims to develop an Android mobile application for both a smartphone and a smartwatch to assess shoulder range of motion. Initial performance characterisation of the inertial sensing capabilities of both a smartwatch and smartphone running the application was conducted against an industrial inclinometer, free-swinging pendulum and custom-built servo-powered gimbal.;An initial validation study comparing the smartwatch application with a universal goniometer for shoulder ROM assessment was conducted with twenty healthy participants. An impaired condition was simulated by applying kinesiology tape across the participants shoulder girdle. Agreement, intra and inter-day reliability were assessed in both the healthy and impaired states.;Both the phone and watch performed with acceptable accuracy and repeatability during static (within ±1.1°) and dynamic conditions where it was strongly correlated to the pendulum and gimbal data (ICC > 0.9). Both devices could perform accurately within optimal responsiveness range of angular velocities compliant with humerus movement during activities of daily living (frequency response of 377°/s and 358°/s for the phone and watch respectively).;The concurrent agreement between the watch and the goniometer was high in both healthy and impaired states (ICC > 0.8) and between measurement days (ICC > 0.8). The mean absolute difference between the watch and the goniometer were within the accepted minimal clinically important difference for shoulder movement (5.11° to 10.58°).;The results show promise for the use of the developed Android application to be used as a goniometry tool for assessment of shoulder ROM. However, the limits of agreement across all the tests fell out with the acceptable margin and further investigation is required to determine validity. Evaluation of validity in clinical impairment patients is also required to assess the feasibility of the use of the application in clinical practice

System design and performance analysis of wireless body area networks

One key solution to provide affordable and proactive healthcare facilities to overcome the fast world population growth and a shortage of medical professionals is through health monitoring systems capable of early disease detection and real-time data transmission leading to considerable improvements in the quality of human life. Wireless body area networks (WBANs) are proposed as promising approaches to providing better mobility and flexibility experience than traditional wired medical systems by using low-power, miniaturised sensors inside, around, or off the human body and are employed to monitor physiological signals. However, the design of reliable and energy efficient in-body communication systems is still a major research challenge since implant devices are characterised by strict requirements on size, energy consumption and safety. Moreover, there is still no agreement regarding QoS support in WBANs. The first part of this work concentrates on the design and performance evaluation of WBAN communication systems involving the ‘in-body to in-body’ and ‘in-body to on-body’ scenarios. The essential step is to derive the statistical WBAN path loss (PL) models, which characterise the signal propagation energy loss transmitting via intra-body region. Moreover, from the point of view of human body safety evaluation, the obtained specific absorption rate (SAR) values are compared with the latest Institute of Electrical and Electronics Engineers (IEEE) 802.15.6 Task Group technical standard and the International Commission on Non-Ionizing Radiation Protection (ICNIRP) safety guidelines. Link budget analysis is then presented using a range of energy-efficient modulation schemes, and the results are given including the transmission distance, data rate and transmitting power in individual sections. On the other hand, major quality of service (QoS) support challenges in WBANs are discussed and investigated. To achieve higher lifetime and lower network energy consumption, different data routing protocol methods, including incremental relaying and the two-relay based routing technique are taken into account. A set of key QoS metrics for linear mathematical models is given along with the related subjective functions. The incremental relaying routing protocol promises significant enhancements in in-body WBAN network lifetime by minimising the overall communication distance while the two-relay based routing method achieves better performance in terms of emergency data transmission and high traffic condition, QoS-aware WBANs design. Moreover, to handle real-time high data transmission applications such as capsule endoscope image transmission, a flexible QoS-aware wireless body area sensor networks (WBASNs) model is proposed and evaluated that can bring novel solutions for a realistic multi-user hospital environment regarding information packet collision probability, manageable numbers of sensor nodes and a wide range of data rates

Human Health Engineering Volume II

In this Special Issue on “Human Health Engineering Volume II”, we invited submissions exploring recent contributions to the field of human health engineering, i.e., technology for monitoring the physical or mental health status of individuals in a variety of applications. Contributions could focus on sensors, wearable hardware, algorithms, or integrated monitoring systems. We organized the different papers according to their contributions to the main parts of the monitoring and control engineering scheme applied to human health applications, namely papers focusing on measuring/sensing physiological variables, papers highlighting health-monitoring applications, and examples of control and process management applications for human health. In comparison to biomedical engineering, we envision that the field of human health engineering will also cover applications for healthy humans (e.g., sports, sleep, and stress), and thus not only contribute to the development of technology for curing patients or supporting chronically ill people, but also to more general disease prevention and optimization of human well-being