Towards Implementing Upper Limb Spasticity Simulator(ULSS) in Medical Education; An Integrative Literature Review and Methodology

Simulation is widely used in Medical Education as a teaching and learning method. The purpose of this paper is to discover the implication of the simulator into clinical trainee behaviour, medical education, and patient safety. At the other hand, a methodology of quantitative research design towards implementing Upper Limb Spasticity Simulator (ULSS) named BITA1.0 is discussed. The Descriptive Quantitative Research design is focused on formative clinical assessment with students of Master in Rehabilitation, Universiti Teknologi MARA as subjects with pre and post-response test. With the intention of implementing BITA1.0 into medical education, the result from The Descriptive Quantitative Research is essential. Keywords: simulation; spasticity; upper limb; medical education eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5iSI3.255

Design of a passive hydraulic simulator for abnormal muscle behavior replication

Spasticity and rigidity are two abnormal hypertonic muscle behaviors commonly observed in passive joint flexion and extension evaluation. Clinical evaluation for spasticity and rigidity is done through in-person assessment using qualitative scales. Due to the subjective nature of this evaluation method, diagnostic results produced from these clinical assessments can have poor reliability and inconsistency. Incorrect diagnosis and treatment often result in worsening of the abnormal muscle behaviors, reducing the quality of life and leading to an increased cost of healthcare. Several programmable, robotic simulators had been developed to improve the accuracy of clinical evaluation by providing clinician practical training opportunities; however none of these training devices are commercially available due to technical and manufacturing limitations. For this reason, a novel, purely mechanical, hydraulic-based simulator design was proposed as an alternative approach to abnormal muscle behavior simulation. The original goal of the project presented in this thesis was to address both spasticity and rigidity in the elbow joint during flexion; however due to time constraints, the initial prototype can only mimic spasticity. The hydraulic-based simulator utilized a novel damper design using viscous fluid in combination with creative flow channel configurations to replicate different levels of spasticity behaviors depicted on a qualitative scale. The simulator was capable of generating a wide range of speed-dependent force feedbacks without need for any computational controls. Preliminary results obtained from evaluating the simulator suggested the possibility of using this novel design in replicating the speed-dependent characteristics of spasticity. The framework and method implemented in the current simulator prototype could be further developed and expanded to replicate spasticity or other types of abnormal behaviors, such as rigidity, in various human joints (not limiting the design to just the elbow joint)

A Design Methodology for Development of Clinically Compliant Upper Limb Spasticity Part-Task Trainer

芝浦工業大学201