dr justin magee careful design: pain relief for unmet ...€¦ · skeletal joe: static model • 43...

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Research Director : Art & Design Senior Lecturer in Product Design OREC NI 2017-2019 R&D T&RRRG 2002-2012 Dr Justin Magee Careful Design: Pain Relief for Unmet Needs in Healthcare NI Pain Society 12 th April 2019

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Page 1: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Research Director : Art & Design

Senior Lecturer in Product Design

OREC NI 2017-2019

R&D T&RRRG 2002-2012

Dr Justin MageeCareful Design: Pain Relief for Unmet Needs in Healthcare

NI Pain Society

12th April 2019

Page 2: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Dr Justin MageeCareful Design: Contents

NI Pain Society

12th April 2019

Art & Design Research at Ulster

Role of Design Thinking in Healthcare

Case Studies:

Pain Relief #1: Digital Anatomy

Pain Relief #2: PUPI

Pain Relief #3: Bow Easy

Page 3: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

• 3rd for World leading 4* Research

• 70% of world leading Impact

• 7th for GPA (3.24) from 25 FTE’s

Page 4: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

“There is nothing more frustrating than coming up with the right answer to the wrong question.”

(Tim Brown)

Page 5: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Design Thinking Methodologies

Magee, McGilloway (2007) Better Design for Better Wellbeing

Page 6: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 7: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Magee, Quigley (2017) Children’s Stroke Support Unit

Page 8: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

“I wish I could see inside your spine without needing to take an X-Ray”

Pain Relief #1

Page 9: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

RQ: To what extent is it possible to serial monitor intervertebral rotations, using photography of human posture mapped to a digital model of the spine?

Pain Relief #1

Page 10: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

DCAL (2002-2003) Creatively Seed Fund, ‘Orthoped-X’ £43,933 (Magee)

EPSRC (2006-2012) Academic Fellowships x 2, The Digital Human Project, EP/E500676/1 £250,000 (Magee)

Innovate UK (2017-2019) KTP axial3D £147,840 (Wilson, Magee, Donnelly)

Magee, J (2003) Designing a prototype with elements of virtual behaviour for interactive biomechanics applications, in M McNeill (ed.), vol. 2, pp. 43-52, Eurographics Ireland Chapter, Workshop proceedings 2003, 30/04/03.

Magee, J (2010) 3D digital modelling of spinal posture, PhD Thesis

Magee, J., McClelland, B., & Winder, J. (2012). Current issues with standards in the measurement and documentation of human skeletal anatomy. Journal of Anatomy, 2211(3), 240-251.

Magee, J (2015), 'Three Dimensional Digital Modelling of Human Spine Anthropometrics and Kinematics from Meta-analysis. How Relevant is Existing Anatomical Research?' Journal of Spine vol 4, no. 1, pp. 1-7.

Digital Modelling of Spinal PostureDigital Human Project

Page 11: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 12: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Skeletal Joe: Static model

• 43 selected studies were normalised to correspond to 2004

stature averages for white UK males.

• 590 different dimensions were used in the model

construction

• Construction precision limited to 0.1mm or 0.1°

• As far as we know it is the most complete and precise 3D

model of the human skeletal structure informed by clinical

research studies.

• Skeletal Joe measured 1758.2mm in height.

• The average age of subject data for each of the spinal

regions was

• 32.7 years: Cervical spine

• 31.6 years : Thoracic spine

• 27.9 years: Lumbar spine

Page 13: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

ModelJournal of Anatomy

Current issues with standards in the measurement and documentation of human skeletal anatomy,J. Anat. (2012) 221, pp240–251

Magee, JDM, McClelland, B., Winder, RJ., (2012)

Magee, Justin (2012) JANAT

Page 14: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Vertebrae Body centre location [Y,Z] Vertebrae Body centre location [Y,Z]

C0 [-4.0, 1602.0] T6 [32.2, 1365.9]

C1 [-0.9, 1591.2] T7 [32.4, 1342.6]

C2 [-12.4, 1579.8] T8 [31.2, 1317.5]

C3 [-18.3, 1561.1] T9 [27.1, 1291.7]

C4 [-19.7, 1542.3] T10 [20.7, 1265.9]

C5 [-18.1, 1524.6] T11 [11.9, 1238.2]

C6 [-15.0, 1507.0] T12 [0.0, 1208.9]

C7 [-8.5, 1489.1] L1 [-11.7, 1176.7]

T1 [0.0, 1470.1] L2 [-22.2, 1142.6]

T2 [10.3, 1451.9] L3 [ -29.6, 1106.8]

T3 [19.0, 1432.0] L4 [-32.2, 1069.7]

T4 [27.5, 1411.5] L5 [ -23.6, 1031.4]

T5 [29.9, 1389.3] S1 [ -4.6, 1003.1]

Page 15: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Region C0-C2 C3-T1 C0-T1 T1-T12 T12-S1

Flexion (Rx)

30.15 63.3 93.45 62.1 38.5

Extension(-Rx)

-32.15 -67.4 -99.55 -29.9 -98.1

Lateral bending(±Ry)

±16.1 ±46.1 ±62.2 ±82.0 ±63.8

Axial rotation (±Rz)

±55.6 ±42.6 ±98.2 ±99.0 ±58.35

Magee, J (2015), 'Three Dimensional Digital Modelling of Human Spine Anthropometrics and Kinematics from Meta-analysis. How Relevant is Existing Anatomical Research?'Journal of Spine vol 4, no. 1, pp. 1-7.

Skeletal Joe: Articulated model

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Magee, Justin (2010) Skeletal Joe

Page 17: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Magee, Justin (2010) Skeletal Joe

Accumulative Flexion (Max): +193.7°Accumulative Extension (Max): -225.6 °

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Accumulative Lateral Bending (Max): ±184.8°Accumulative Axial Rotation (Max): ±255.7 °

Page 19: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Magee, J., Woods, A., Prickett, S. (2012) Arranged Motion

Page 20: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

• IAR centres vary significantly and have

not been precisely measured

• IAR migration during rotations have not

been integrated

• Vertebral translations have not been

modelled

• Intervertebral coupling motions is complex

and not fully understood or published

• Helical elevations have not been well

documented or quantified

• Disc Degeneration (Age, damage etc) has

not been factored and remains a variable

• Sacroiliac motions was excluded due to

absence of data

• The lack of research quantifying anatomy

of the thoracic spine

• The use of different bony landmark

reference anatomy within existing

literature, introducing errors. A standard

measurement protocol is

• required.

• The inaccuracies indicative of physical

measurement of anatomy or from distortion

in medical imaging methods.

• Barriers exist to the development of an

entirely single gender model because

investigators often combine male and

female data together for many pelvic

measurements, spinal profiles and

vertebrae morphology.

Limitations of the study

Page 21: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

KTPKnowledge Transfer Partnership

Current KTP developing realistic 3D visuals and interfaces as WebApp application for Surgeons, planning operations using 3D printed anatomy.

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Page 23: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

+

Page 24: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

PUPIPressure Ulcer Prevention Innovation

Dr Justin Magee, Dr Mark Porter (Ulster University)Roisin McSwiggan (NHSCT)

Pain Relief #2

Page 25: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 26: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 27: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 28: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 29: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Co-creative workshops: Leg Ulcer Forum x3 (2016/ 2017/ 2018)

Page 30: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

October 2017

Page 31: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

October 2016

Service improvement testing

Page 32: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Best not talk about it….…it could affect my career

Case Study #3

Page 33: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

BowEasy

• Porter, M., Wilson, I. M., Doherty, L., & Magee, J. (2018). The extent of playing-related musculoskeletal problems (PRMDs) in the Irish traditional music community. A Survey. Medical Problems of Performing Artists, 33(1), 49-57.

• Porter, M., Magee, J., Doherty, L., & Wilson, IM. (2018). IPC No. G10D 3/16 (2006.01). Hand Support for a Bow. (Patent No. WO 2018/091399 A1).

• Porter, M, Wilson, IM, Doherty, L & Magee, J 2016, Playing-related Musculoskeletal Disorders (PRMDs) in Irish traditional fiddle players. in Irish Society of Chartered Physiotherapy, 26/07/16.

Page 34: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 35: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 36: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 37: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Adapted Standardised questionnaire79 questionnaires returnedLargest survey of its typeResponse rate of 77.5%. 58% (n = 46) female and 42% (n = 33) male35 years old (SD 12.5, min = 18, max =65).

Page 38: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Design brief

Page 39: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

0

5

10

15

20

25

30

Hea

d

Jaw

Nec

k fr

on

t

Nec

k b

ack

Sho

uld

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ron

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sho

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Ch

est

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Mid

Bac

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Up

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Low

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Thu

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Fin

gers

Bu

tto

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Up

per

leg

Foo

t

Num

be

r o

f re

sp

on

de

nts

0 10 20 30 40 50 60 70

Pain

Tingling

Stiffness

Weakness

Numbness

Loss of control

Hypersensitivity

Pressure sores

Other

Rarely Occasionally Always

0

10

20

30

40

50

60

Pai

n

Tin

glin

g

Stif

fnes

s

Wea

knes

s

Nu

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Loss

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Pre

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Oth

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Num

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f fidd

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laye

rs

Common PRI symptoms experienced

Body parts affected by pain

Symptom Prevalence

Page 40: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 41: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 42: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

TestingEOU Ease of use Positive

Ease of use Negative

EOL Ease of learning Positive

Ease of learning Negative

PPRO Perceived productivity Positive

Perceived productivity Negative

PCOM Perceived Comfort Positive

Perceived Comfort Negative

P2Thumb

(g)

P2 Finger(g)

P3Thumb

(g)

P3 Finger(g)

P4Thumb

(g)

P4 Finger(g)

P5Thumb

(g)

P5 Finger(g)

Config 1 98 21 285 0 121 19 73 26

Config 2 23 30 29 226 29 114 129 258

Config 3 26 83 119 152 0 189 67 74

Config 4 74 119 30 478 116 199 107 130

0

50

100

150

200

250

300

350

400

450

500

Me

an f

orc

e in

gra

ms

Mean force comparison between test configuations

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Page 44: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white
Page 45: Dr Justin Magee Careful Design: Pain Relief for Unmet ...€¦ · Skeletal Joe: Static model • 43 selected studies were normalised to correspond to 2004 stature averages for white

Empathy | Collaboration | Iteration

Pain Relief for Unmet Needs in Healthcare

@Justin_D_Magee

[email protected] + 44 2890 367015

+44 772 007 3925