Use of McKibben muscle in a haptic interface

One of the most relevant issues in the development of a haptic interface is the choice of the actuators that are devoted to generating the reflection forces. This work has been particularly focused on the employment of the McKibben muscle to this aim. A prototype of one finger has been realized that is intended to be part of a haptic glove, and is based on an articulated mechanism driven by a McKibben muscle. A dynamic model of the finger has been created and validated; then, it has been used to define the control algorithm of the device. Experimental tests highlighted the static and dynamic effectiveness of the device and proved that a McKibben muscle can be appropriately used in such an application

Usporedbeno istraživanje metoda prikupljanja podataka u procesu sestrinske njege: otkrivanje nuspojava kemoterapije pomoću upitnika za samoprocjenu

Toxicity of chemotherapy is a factor that most negatively affects the quality of life of cancer patients. Monitoring of side effects and adverse effects may be subject to errors due to various factors such as the lack of privacy during data collection, shame on the part of the patient to talk about some issues, lack of recognition of symptoms and/or unawareness of side effects of treatments, and/or inappropriate reference model of data collection. In order to assist caregivers in proper data collection, a ‘self-reporting questionnaire’ was designed. The questionnaire was developed using validated scales such as the Common Terminology Criteria for Adverse Event, Edmonton Symptom Assessment Scale and Douleur Neuropathique en 4 Questions. The survey involved the population of patients scheduled for chemotherapy in Day Hospital at the Campus Bio-Medico University Hospital, Rome, between June and July 2015. During the period of observation, 367 patients were admitted to Day Hospital, 57.5% of women and 38.4% of men, average age 64 years, for a total of 622 accesses; of these, only 173 were interviewed by the nursing staff in relation to side effects and toxicity. During the trial, 381 patients were involved, of which 60.1% of women (p=0.8) and 38.3% of men (p=0.9), average age 63 years (p=0.9), for a total of 611 accesses and 498 self-reporting questionnaires administered. At the end of the trial period, in order to evaluate usability, an evaluation questionnaire was given to medical personnel, including five doctors and six nurses, to consider possible amendments to the instrument and its perceived effectiveness. Comparative analysis of data collected during the observation period and the trial showed how the use of the self-reporting questionnaire allowed for detection of side effects of chemotherapy earlier and in a more detailed way than relying only on medical examination and unstructured interview by nursing staff. It also enabled reaching a larger number of users. In conclusion, the use of self-reporting systems, together with the work and clinical judgment of the expert, can contribute to improvement in the patient quality of life, corroborating nurse interviews through a precise and systematic data collection process that reduces the amount of interpretation of symptoms by the patient and the caregiver, while providing them with precise instructions on what to report and how to report it. The significant and rapid spread of computers, tablets and smartphones allows for speculating on further use and implementation of this system through its computerized application.Toksičnost kemoterapije je čimbenik koji ima najteži učinak na kvalitetu života u bolesnka s karcinomom. Praćenje nuspojava i štetnih učinaka može biti podložno greškama zbog raznih čimbenika kao što je nedostatna zaštita povjerljivosti ­tijekom prikupljanja podataka, nevoljkosti bolesnika da govori o nekim problemima, neprepoznavanje simptoma i/ili ­nepoznavanje nuspojava liječenja i/ili neodgovarajući referentni model prikupljanja podataka. Zato smo izradili upitnik za samoprocjenu kako bismo pomogli u ispravnom prikupljanju podataka onima koji pružaju skrb ovim bolesnicima. Upitnik je izrađen uz pomoć provjerenih ljestvica kao što su Common Terminology Criteria for Adverse Event, Edmonton Symptom ­Assessment Scale i Douleur Neuropathique en 4 Questions. Istraživanje je obuhvatilo bolesnike naručene za kemoterapiju u Dnevnoj bolnici Sveučilišne bolnice Campus Bio-Medico u Rimu u lipnju i srpnju 2015. godine. U tom razdoblju u Dnevnu bolnicu je primljeno 367 bolesnika, 57,5% žena i 38,4% muškaraca prosječne dobi od 64 godine, za ukupno 622 pristupa. Od svih tih bolesnika sestrinsko osoblje je samo njih 173 ispitalo o nuspojavama i toksičnosti. Za vrijeme istraživanja bio je uključen 381 bolesnik, od toga 60,1% žena (p=0,8) i 38,3% muškaraca (p=0,9) prosječne dobi od 63 godine (p=0,9), za ­ukupno 611 pristupa i 498 izdanih upitnika za samoprocjenu. Kako bismo procijenili primjenjivost ovoga upitnika, na kraju istraživanja upitnik za njegovu procjenu je podijeljen medicinskom osoblju uključujući pet liječnika i šest medicinskih sestara kako bi razmotrili moguće potrebne dopune ovoga instrumenta te njegovu učinkovitost. Usporedbena analiza podataka prikupljenih tijekom istraživanja pokazala je da je primjena upitnika za samoprocjenu omogućila otkrivanje nuspojava kemoterapije ranije i podrobnije nego kad se to oslanjalo samo na medicinski pregled i nestrukturirani razgovor sestrinskog osoblja s bolesnicima. Uz to, ovom metodom je obuhvaćen veći broj korisnika. U zaključku, primjena sustava za samoprocjenu zajedno sa stručnim radom i kliničkom prosudbom može doprinijeti poboljšanju bolesnikove kvalitete života, pružiti potporu razgovoru sestrinskog osoblja s bolesnikom kroz proces preciznog i sustavnog prikupljanja podataka, čime se znatno smanjuje tumačenje simptoma od strane bolesnika i osoba koje ih njeguju, ali im pruža točne upute o čemu trebaju izvijestiti i kako. Zahvaljujući značajnom i brzom širenju računala, tableta i ‘pametnih telefona’ može se promišljati o daljnjoj primjeni ovoga sustava kroz njegovu računalnu aplikaciju

Contact force regulation in physical human-machine interaction based on model predictive control

With increasing attention to physical human-machine interaction (pHMI), new control methods involving contact force regulation in collaborative and coexistence scenarios have spread in recent years. Thanks to its internal robustness, high dynamic performance, and capabilities to avoid constraint violations, a Model Predictive Control (MPC) action can pose a viable solution to manage the uncertainties involved in those applications. This paper uses an MPC-driven control method that aims to apply a well-defined and tunable force impulse on a human subject. After describing a general control design suitable to achieve this goal, a practical implementation of such a logic, based on an MPC controller, is shown. In particular, the physical interaction considered is the one occurring between the body of a patient and an external perturbation device in a dynamic posturography trial. The device prototype is presented in both its hardware architecture and software design. The MPC-based main control parameters are thus tuned inside hardware-in-the-loop and human-in-the-loop environments to get optimal behaviors. Finally, the device performance is analyzed to assess the MPC algorithm’s accuracy, repeatability, flexibility, and robustness concerning the several uncertainties due to the specific pHMI environment considered

Customization of 3D-Printed Hinged Ankle-Foot Orthosis Based on Kinematic Evaluation from Motion Capture

Commercial hinged foot-ankle orthoses (HAFO) generally do not ensure the alignment between the mechanical and the anatomical joints, causing discomfort and unnatural walking. This paper presents a method to design a customized HAFO modeled on geometrical and kinematic data collected from a healthy 24-year-old woman. The geometry of the shank and foot was acquired through a 3D scanner. The physiological articular rotation axis (AoR) was estimated through helical axis and SARA algorithms. The identified AoR was then used to properly design the orthosis by making particular attention to the hinge position. Finally, the prototype was manufactured with fused deposition modeling technique, and its functionality was validated through gait analysis trials

A novel pneutronic device for the investigation of compression-induced physiological phenomena: Modeling and experimental testing

An automatic pneumatic system designed to investigate the physiological effects induced by limb compressions, able to apply customizable pressure patterns in the physiologic range (0–200 mmHg), is here presented. A mathematical model, simulating the whole pneutronic system and its interaction with the limb is described. The model is validated by means of experimental tests. An on-going study aiming to investigate the role of different factors in the development of post compression hyperemia is presented

Portable low-cost smart brace for elbow rehabilitation

This article deals with the development and experimentation of an elbow static progressive brace equipped with special sensors, aimed at objective evaluation of the physiological response of the articulation during treatments for recovery of the functional range of motion. The device is able to acquire and record the moment which is applied to the joint and the flexion angle of the latter. The first part of the article describes the general design of the brace, which takes into account the several specifications of such a device. The design considers both the mechanical and electronic requirements of the application. The device, after acceptance tests, was employed in an experimental phase where two different patients were analyzed. Ultimately, the device proved to be an useful instrument for the classification of the patients and the definition of the treatment protocol; further experience may allow to define criteria for an objective monitoring during the rehabilitation treatment

Applications of Intermittent Pneumatic Compression for Diagnostic and Therapeutic Purposes

Intermittent Pneumatic Compression (IPC) technique is prescribed for several treatments, as the management of venous leg ulcers or the prevention of deep vein thrombosis. Commercial devices do not enable the full customization of the compressive patterns due to design specifications and low dynamics. However, IPC can be implemented in a wide scenario of clinical protocols, and not only as a therapeutic tool. In this paper, the results of the research on IPC devices conducted at the Politecnico di Torino (Turin, Italy) are presented. In particular, applications regarding the treatment of the end-diastolic volume (EDV) reduction, the investigation of vascular phenomena as hyperemia, and the assessment of venous pulse wave velocity (vPWV) are discussed. The outcomes of the research demonstrate that IPC technology can lead to the creation of widely used diagnostic, therapeutic and rehabilitative devices

Patient experience e adolescenti: uno studio qualitativo sul punto di vista di adolescenti, genitori e professionisti

BACKGROUND: L'esperienza del paziente (patient experience) nell'assistenza sanitaria e nell'erogazione delle cure sta emergendo come un'area importante di conoscenza e sviluppo dei servizi sanitari in un ottica paziente-centrica. Tuttavia, non è presente in letteratura nessun contributo che analizzi il punto di vista di adolescenti, genitori, infermieri e medici circa la loro percezione della definizione di patient experience. Obiettivo: Esplorare il punto di vista di adolescenti, genitori, infermieri e medici in merito alla definizione di patient experience nell’ospedalizzazione degli adolescenti per patologia acuta. METODI: Sono state realizzate delle interviste semistrutturate in un campione di convenienza di partecipanti composto da medici, infermieri, adolescenti e genitori. E’ stata effettuata una analisi qualitativa delle risposte secondo i tre livelli identificati da Ricoeur: lettura preliminare, analisi strutturale e analisi critica. RISULTATI: Sono state intervistate un totale di 16 persone: quattro medici, quattro infermieri, quattro genitori e quattro adolescenti. Dall’analisi delle risposte sono emersi 5 principali temi: ricordo dell’ospedalizzazione, competenze messe in campo, soddisfazione ed esperienza, relazione umana, ambiente ospedaliero e facility. CONCLUSIONI: Esplorare il concetto di patient experience in differenti popolazioni non solo in funzione delle diverse patologie, ma anche in funzione delle diverse categorie di età, permette una conoscenza più approfondita degli aspetti multidimensionali di questo concetto e dei fattori da considerare per orientare i servizi sanitari verso i reali bisogni dei pazienti. In particolare, quando il paziente è un adolescente, comprenderne il suo punto di vista e le interazioni che avvengono con il servizio, può essere la leva per migliorarne l’esperienza del percorso di cura, oltre che la sola soddisfazione