wearable hand technology - james connolly
TRANSCRIPT
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Wearable Hand Technology For Stiffness And
Movement Measurements In Rheumatoid
Arthritic Patients
Digit-Ease
James Connolly*, Joan Condell*, Kevin Curran*, Philip Gardiner#
*Faculty of Computing and Engineering, Magee College, University of Ulster, Londonderry, N. Ireland.# Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, N. Ireland.
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Background
[1] J. Y. Reginster: The prevalence and burden of arthritis. Rheumatology 2002, 41 (suppl. I):3-6, British
Society for Rheumatology.
• Rheumatoid Arthritis (RA) is a disease that attacks the joints of the
human skeleton.
• In 2010, RA affected up to 500,000 of the UK population and
starts between the ages of 40-50 [1].
• RA is currently diagnosed by clinicians and therapists using
manual evaluation methods.
• Manual methods are open to observer bias.
• This project focuses on an accurate hand measurement tool to
detect hand Range of Motion (ROM) and joint stiffness.
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• Stiffness, swelling and deformity are common
symptoms.
• Distal interphalangeal (DIP)
• Proximal interphalangeal (PIP)
• Hand joints affected are:
Joint Pain
• Swollen joints may cause clicking sounds
during movement and „trigger finger‟.
• RA affects the synovial tissue that lubricates
the joints.
• Metacarpaphalangeal (MCP)
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Current detection
techniques
• Occupational Therapists (OT) quantify joint range and determine
hand function using the following instrumentation and
techniques.
• Measures flexion, extension, abduction and adduction of all
finger joints.
Goniometer
• Goniometer is placed resting on the top of each
finger. Measures flexion in degrees for each
digit
• Goniometric techniques have changed very
little over the past 80 years. Average results
within 7° in 62%-72% of trials [2].
[2] ] E. Fess, C. Moran, “Clinical Assessment and Recommendations American Society of Hand Therapists,”
St . Louis : American Society of Hand Therapists, 1981 .
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• A Health Assessment Questionnaire (HAQ) determines a
patients ability to perform daily tasks.
• Tape measure – measures thumb-index finger web space and
distal phalanx-palm distance in centimetres.
• Kapandji Score – grades the range of movement of
the patients thumb against each finger tip.
Current detection
techniques
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Problems….
• Outcomes are easily influenced by clinicians training and
experience.
• Current process is time consuming – average initial
consultation can take up to 3 hours.
• Joint stiffness is currently unmeasured.
• All measurements are recorded in handwritten form.
Current detection
techniques
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Digit-Ease
Project
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Digit-Ease
Project
This project builds upon the development of earlier work to
provide the clinician with a ROM tool measuring:
• The degree of deformity of the hand and stiffness of the moving
finger joints.
• A shift in the position of the fingers in relation to the direction
of the thumb by measuring web space.
• Recording the minimum, maximum and average values of a
number of tests.
• Minimum and maximum flexion and extension angles of each
digit.
• Real-time display of the angular movement for each digit.
• Live movement of the hand displayed as a 3D model.
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Digit-Ease
Project
• Recording, storage and analysis of patient data.
• Bespoke reports show statistical results recorded from exercise
routine
• Comparison of historical data showing changes in ROM over
time.
• Customised exercise routines determine the ROM for specified
joints within a time period.
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Digit-Ease
Project
The Digit-Ease project consists of a wearable glove and a 3D
software system
This project has initially been developed using the X-IST[1] and
5DT[4] data gloves to measure joint ROM.
[3]
[3] Inition.http://www.inition.co.uk/3D-Technologies/x-ist-data-glove.
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Digit-Ease
Project
The data gloves contain sensors strategically placed over each
finger joint to accurately measure finger movement.
• X-IST glove uses piezo-resistive bend sensors.
• 5DT glove uses fibre-optic sensors.
• One end of fibre loop is connected to a
LED and the other is connected to a
phototransistor.
• Light emitted by the LED is measured by the phototransistor.
Light intensity indirectly measures finger movement.
[2]
[4] 5DT http://www.5DT.com.
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Velocity
readings
(degrees per 100
milliseconds)
closely follow
movement
readings
Angular readings
switch from 0º
To maximum
range very
quickly
Exercise Report for
Undamaged Hand
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Angular
readings
gradually
move from 0º
to maximum
range in a
“stepped”
appearance
Velocity values
remain close to
the X axis.
Exercise report for
Damaged Hand
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Comparison
Report
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Future
Developments
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Future
Developments
A new glove is currently under design with added functionality.
• Additional bend sensors will measure abduction and adduction
between each digit and the thumb.
• Mote will write sensor data
onto a flash card and will
include wireless connectivity.
An accelerometer will measure
forearm supination and
pronation.
• Accelerometers on each digit will measure initial angular values for
each finger joint, removing the need for initial calibration.
Bend sensor
Abduction sensor
Accelerometer
WIMU
Battery
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• Pressure sensors will measure Kapandji index.
• Kapandji score increases as each
point is touched.
• The patient attempts to touch their
thumb against various points on the
hand.
Future
Developments
• Wrist and thumb sensors will measure ulnar / radial deviation.
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Detailed measurements for the glove in development
Future
Developments
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• Examining glove materials to improve comfort levels, fit and
durability.
• Working in conjunction
with Shirley Coyle from
DCU to create a new glove
with sensors sewn into the
glove structure. Improves
readings since the glove is
less bulky than current
gloves.(top) CE sensor coated onto stretch knit fabric,
(bottom) commercial bend sensor
Future
Developments
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Additions to the software system:
• Adduction and abduction range for each digit.
• Thumb-index finger web space.
• Amount of joint stiffness for each digit.
• Automatic calibration system to quantify arthritic hand ROM
• Wireless connectivity to the data glove
Future
Developments
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• The new system will be a data collection and playback tool.
• First ambulatory system to record joint stiffness at home
• System will simultaneously record angles from multiple
fingers and detect previously unidentifiable movement
patterns.
• Record data offline for future analysis and playback.
Future
Developments
• Measurement of joint movement at home.
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Conclusion
• A new e-textile glove will provide a glove with low-weight,
comfort, and high flexibility.
• To date, Clinicians use manual, time consuming techniques to
quantify hand limitations.
• Current methods have the capability to detect hand ROM, with
some issues.
• The current system provides an automatic hand ROM measuring
tool capable of measuring joint movement, joint stiffness and
comparison analysis of historical movement data.
• Future work will provide additional joint movement for each
finger and offline recording of movement at home.
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Questions?
Thank you for your attention.
Email address : [email protected]