Wearable Hand Technology - James Connolly

http://isrc.ulster.ac.uk

Magee Campus

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]

Wearable Hand Technology - James Connolly

Health & Medicine

finger joints

hand function

hand range of motion

joint range

joint stiffness

joint painswollen joints

symptoms of ra

accurate hand measurement