Design Principles for FES Concept Development

© Cranfield University 2013. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright owner.A variety of pathologies can cause injury to the spinal cord and hinder movement. A range of equipment is available to help spinal injury sufferers move their affected limbs. One method of rehabilitation is functional electrical stimulation (FES). FES is a technique where small electrical currents are applied to the surface of the user’s legs to stimulate the muscles. Studies have demonstrated the benefits of using this method and it has also been incorporated into a number of devices. The aim of the project was to produce a number of designs for a new device that uses FES technology. The project was completed in conjunction with an industrial partner. A review of the literature and consultation with industrial experts suggested a number of ways current devices could be improved. These included encouraging the user to lean forwards while walking and powering the device using a more ergonomic method. A group of designers were used to produce designs that allowed the user to walk with a more natural gait and avoided cumbersome power packs. The most effective of these designs were combined to form one design that solved both problems. A 3-dimensional model of this design was simulated using computer-aided design software. Groups of engineers, scientists and consumers were also invited to provide input on how a new device should function. Each of these groups provided a design that reflected their specific needs, depending on their experience with similar technology. Low level prototypes were produced of these designs. A group of designers were also used to design concepts for a functional electrical stimulation device based on an introduction given by industry experts. Each of the designs was presented to experienced professionals to obtain feedback. A set of guidelines were also produced during the project that instructed how to create the designs

L’efficacia degli smart walkers nella mobilità di anziani e disabili: una review sistematica della letteratura

L’invecchiamento della popolazione sta aumentando rapidamente in tutto il mondo e la robotica sta offrendo soluzioni sempre più innovative per migliorare la vita degli anziani. Allo stesso modo, si stanno compiendo progressi significativi nella creazione di dispositivi che consentono alle persone disabili di vivere in modo indipendente. Gli smart walker, dotati di sensori e ruote motorizzate, sono una tecnologia emergente che assiste le persone con difficoltà motorie, offrendo loro maggiore autonomia nella mobilità. Questa tesi si propone di esaminare lo stato dell’arte nel campo degli smart walker attraverso una revisione sistematica della letteratura. Le domande chiave affrontate sono: (1) Quali sono attualmente i diversi approcci utilizzati per garantire la sicurezza agli utenti in fase di assistenza e riabilitazione? (2) Quali sono le tecnologie utilizzate per implementare tali approcci? (3) Quali sono i problemi che limitano lo sviluppo dei dispositivi analizzati? Il processo di selezione e valutazione degli studi in questa ricerca è stato fatto seguendo le linee guida del protocollo Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). La camminata assistita e la raccolta di parametri sono alcuni tra i metodi più rilevanti individuati, insieme all’uso esteso di sensori di forza e telecamere RGB. Vengono poi discusse le criticità legate a queste tecnologie, che possono essere utilizzate come punto di partenza sul quale lavorare per ulteriori sviluppi nel merito dell’assistenza motoria

Development of a standing disruptive concept for the mobility of individuals with motor disability

Dissertação de mestrado integrado em Biomedical EngineeringThe present project intends to explore the idea of creating a new and better kind of mobility device, capable of transporting individuals who suffer of mobility impairments. The developments of the dissertation culminated in an explanatory prototype based of a set of requirements and of withdrawn conclusions of the state of the art of mobility devices. It is proposed a novel concept of vertical transport for the mobility impaired. The present idea allows the user greater agility than most mobility devices, improved self-autonomy and operating while in a vertical stance, reducing health risks which the mobility disabled are prone to, both mental and physical. Firstly, it is presented a literature review of the mobility devices targeted for the mobility impaired developed thus far. The analysis of the development throughout history and of the devices currently presented in the market allowed to understand which necessities of the mobility disabled are yet to be answered. Said knowledge is the foundation of a project intended to further improve the quality of life of whoever has such special needs. To counter the list of requirements and specifications, the complex engineering problem was divided in smaller subfunctions that could be more easily answered to. After presenting several solutions to each subfunction, the ones considered best were selected and developed. For designing the device, several steps were taken. For a broader triage of concepts, it was used sketching. Later, the best notions were recreated on the CAD software SolidWorks, which allowed for virtual testing of the wouldbe prototype. Once a design was deemed worthy, the pieces of the mechanism were 3D printed, creating a physical model of the final goal of the project. Thus, it was created the basis of a mobility device for the individuals who suffer from mobility impairments that can be used in the outdoors, reach running speeds and assists in maintaining a vertical stance, diminishing the risks of developing health problems triggered from prolonged times in a seated position.O presente projeto pretende explorar a ideia de criar um novo e melhor dispositivo de mobilidade, capaz de transportar indivíduos que sofrem de deficiências de mobilidade. A evolução da dissertação culminou num protótipo elucidativo baseado num conjunto de requisitos e conclusões retiradas do estado da arte de dispositivos de mobilidade. Propõe-se um novo conceito de transporte vertical para quem sofre de problemas de mobilidade. A ideia permite ao usuário uma maior agilidade do que a maioria dos dispositivos de mobilidade, auto autonomia aprimorada e ser operável em posição vertical, reduzindo os riscos de saúde a que os deficientes de mobilidade são propensos, tanto a nível mental como físico. Em primeiro lugar, é apresentada a revisão da literatura sobre os dispositivos de mobilidade desenvolvidos até agora para quem sofre de problemas de mobilidade. A análise do desenvolvimento ao longo da história e dos dispositivos atualmente apresentados no mercado permitiu entender quais as necessidades dos deficientes que ainda necessitam de ser respondidas. O referido conhecimento é o fundamento de um projeto destinado a melhorar ainda mais a qualidade de vida de quem tem tais necessidades especiais. Para a lista de requisitos e especificações, o complexo problema de engenharia foi dividido em subfunções menores que poderiam ser mais facilmente respondidas. Depois de apresentar várias soluções para cada subfunção, os considerados melhores foram selecionados e desenvolvidos. Para projetar o dispositivo, foram tomadas várias etapas. Para uma triagem mais ampla de conceitos, foram utilizados esboços. Mais tarde, as melhores noções foram recriadas no software CAD SolidWorks, o que permitiu testes virtuais do potencial protótipo. Uma vez que um design foi considerado digno, as peças do mecanismo foram impressas em 3D, criando um modelo físico do objetivo final do projeto. Assim, foi criada a base de um dispositivo de mobilidade para os indivíduos que sofrem de deficiências de mobilidade que pode ser usado no exterior, alcança velocidades de corrida e ajudam a manter uma posição vertical, diminuindo os riscos de desenvolver problemas de saúde desencadeados por períodos prolongados na posição sentada

Moving On:Measuring Movement Remotely after Stroke

Most persons with stroke suffer from motor impairment, which restricts mobility on one side, and affects their independence in daily life activities. Measuring recovery is needed to develop individualized therapies. However, commonly used clinical outcomes suffer from low resolution and subjectivity. Therefore, objective biomechanical metrics should be identified to measure movement quality. However, non-portable laboratory setups are required in order to measure these metrics accurately. Alternatively, minimal wearable systems can be developed to simplify measurements performed at clinic or home to monitor recovery. Thus, the goal of the thesis was ‘To identify metrics that reflect movement quality of upper and lower extremities after stroke and develop wearable minimal systems for tracking the proposed metrics’. Section Upper Extremity First, we systematically reviewed literature ( Chapter II ) to identify metrics used to measure reaching recovery longitudinally post-stroke. Although several metrics were found, it was not clear how they differentiated recovery from compensation strategies. Future studies must address this gap in order to optimize stroke therapy. Next, we assessed a ‘valid’ measure for smoothness of upper paretic limb reaching ( Chapter III ), as this was commonly used to measure movement quality. After a systematic review and simulation analyses, we found that reaching smoothness is best measured using spectral arc length. The studies in this section offer us a better understanding of movement recovery in the upper extremity post-stroke. Section Lower Extremity Although metrics that reflect gait recovery are yet to be identified, in this section we focused on developing minimal solutions to measure gait quality. First, we showed the feasibility of 1D pressure insoles as a lightweight alternative for measuring 3D Ground Reaction Forces (GRF) ( Chapter IV ). In the following chapters, we developed a minimal system; the Portable Gait Lab (PGL) using only three Inertial Measurement Units (IMUs) (one per foot and one on the pelvis). We explored the Centroidal Moment Pivot (CMP) point ( Chapter V ) as a biomechanical constraint that can help with the reduction in sensors. Then, we showed the feasibility of the PGL to track 3D GRF ( Chapters VI-VII ) and relative foot and CoM kinematics ( Chapter VIII-IX ) during variable overground walking by healthy participants. Finally, we performed a limited validation study in persons with chronic stroke ( Chapter X ). This thesis offers knowledge and tools which can help clinicians and researchers understand movement quality and thereby develop individualized therapies post-stroke

Machine Medical Ethics

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. This collection is the first book to address these 21st-century concerns

Proceedings of the 2018 Canadian Society for Mechanical Engineering (CSME) International Congress

Published proceedings of the 2018 Canadian Society for Mechanical Engineering (CSME) International Congress, hosted by York University, 27-30 May 2018

Medical-Data-Models.org:A collection of freely available forms (September 2016)

MDM-Portal (Medical Data-Models) is a meta-data repository for creating, analysing, sharing and reusing medical forms, developed by the Institute of Medical Informatics, University of Muenster in Germany. Electronic forms for documentation of patient data are an integral part within the workflow of physicians. A huge amount of data is collected either through routine documentation forms (EHRs) for electronic health records or as case report forms (CRFs) for clinical trials. This raises major scientific challenges for health care, since different health information systems are not necessarily compatible with each other and thus information exchange of structured data is hampered. Software vendors provide a variety of individual documentation forms according to their standard contracts, which function as isolated applications. Furthermore, free availability of those forms is rarely the case. Currently less than 5 % of medical forms are freely accessible. Based on this lack of transparency harmonization of data models in health care is extremely cumbersome, thus work and know-how of completed clinical trials and routine documentation in hospitals are hard to be re-used. The MDM-Portal serves as an infrastructure for academic (non-commercial) medical research to contribute a solution to this problem. It already contains more than 4,000 system-independent forms (CDISC ODM Format, www.cdisc.org, Operational Data Model) with more than 380,000 dataelements. This enables researchers to view, discuss, download and export forms in most common technical formats such as PDF, CSV, Excel, SQL, SPSS, R, etc. A growing user community will lead to a growing database of medical forms. In this matter, we would like to encourage all medical researchers to register and add forms and discuss existing forms