![Background
Magee Campus
• 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.
[1] J. Y. Reginster: The prevalence and burden of arthritis. Rheumatology 2002, 41 (suppl. I):3-6, British
http://isrc.ulster.ac.uk Society for Rheumatology.](https://image.slidesharecdn.com/wearablehandtechnologyjamesconnolly-111128054315-phpapp01/85/Wearable-Hand-Technology-James-Connolly-2-320.jpg)
![Current detection
Magee Campus techniques
• Occupational Therapists (OT) quantify joint range and determine
hand function using the following instrumentation and
techniques.
Goniometer
• Measures flexion, extension, abduction and adduction of all
finger joints.
• 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,”
http://isrc.ulster.ac.uk St . Louis : American Society of Hand Therapists, 1981 .](https://image.slidesharecdn.com/wearablehandtechnologyjamesconnolly-111128054315-phpapp01/85/Wearable-Hand-Technology-James-Connolly-4-320.jpg)
![Digit-Ease
Project
Magee Campus
The Digit-Ease project consists of a wearable glove and a 3D
software system
[3]
This project has initially been developed using the X-IST[1] and
5DT[4] data gloves to measure joint ROM.
10
[3] Inition.http://www.inition.co.uk/3D-Technologies/x-ist-data-glove.
http://isrc.ulster.ac.uk](https://image.slidesharecdn.com/wearablehandtechnologyjamesconnolly-111128054315-phpapp01/85/Wearable-Hand-Technology-James-Connolly-10-320.jpg)
![Digit-Ease
Magee Campus
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 [2]
phototransistor.
• Light emitted by the LED is measured by the phototransistor.
Light intensity indirectly measures finger movement.
[4] 5DT http://www.5DT.com.
http://isrc.ulster.ac.uk](https://image.slidesharecdn.com/wearablehandtechnologyjamesconnolly-111128054315-phpapp01/85/Wearable-Hand-Technology-James-Connolly-11-320.jpg)
Wearable Hand Technology - James Connolly
- 1. Digit-Ease Magee Campus Wearable Hand Technology For Stiffness And Movement Measurements In Rheumatoid Arthritic Patients 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. http://isrc.ulster.ac.uk
- 2. Background Magee Campus • 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. [1] J. Y. Reginster: The prevalence and burden of arthritis. Rheumatology 2002, 41 (suppl. I):3-6, British http://isrc.ulster.ac.uk Society for Rheumatology.
- 3. Magee Campus Joint Pain • RA affects the synovial tissue that lubricates the joints. • Stiffness, swelling and deformity are common symptoms. • Hand joints affected are: • Distal interphalangeal (DIP) • Proximal interphalangeal (PIP) • Metacarpaphalangeal (MCP) • Swollen joints may cause clicking sounds during movement and „trigger finger‟. http://isrc.ulster.ac.uk
- 4. Current detection Magee Campus techniques • Occupational Therapists (OT) quantify joint range and determine hand function using the following instrumentation and techniques. Goniometer • Measures flexion, extension, abduction and adduction of all finger joints. • 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,” http://isrc.ulster.ac.uk St . Louis : American Society of Hand Therapists, 1981 .
- 5. Current detection Magee Campus techniques • 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. http://isrc.ulster.ac.uk
- 6. Current detection Magee Campus techniques 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. 6 http://isrc.ulster.ac.uk
- 7. Magee Campus Digit-Ease Project 7 http://isrc.ulster.ac.uk
- 8. Digit-Ease Project Magee Campus 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. • Minimum and maximum flexion and extension angles of each digit. • Live movement of the hand displayed as a 3D model. • Recording the minimum, maximum and average values of a number of tests. • Real-time display of the angular movement for each digit. http://isrc.ulster.ac.uk
- 9. Digit-Ease Project Magee Campus • Comparison of historical data showing changes in ROM over time. • Customised exercise routines determine the ROM for specified joints within a time period. • Bespoke reports show statistical results recorded from exercise routine • Recording, storage and analysis of patient data. 9 http://isrc.ulster.ac.uk
- 10. Digit-Ease Project Magee Campus The Digit-Ease project consists of a wearable glove and a 3D software system [3] This project has initially been developed using the X-IST[1] and 5DT[4] data gloves to measure joint ROM. 10 [3] Inition.http://www.inition.co.uk/3D-Technologies/x-ist-data-glove. http://isrc.ulster.ac.uk
- 11. Digit-Ease Magee Campus 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 [2] phototransistor. • Light emitted by the LED is measured by the phototransistor. Light intensity indirectly measures finger movement. [4] 5DT http://www.5DT.com. http://isrc.ulster.ac.uk
- 12. Exercise Report for Magee Campus Undamaged Hand Velocity readings (degrees per 100 milliseconds) closely follow movement readings Angular readings switch from 0º To maximum range very quickly 12 http://isrc.ulster.ac.uk
- 13. Exercise report for Magee Campus Damaged Hand Velocity values remain close to the X axis. Angular readings gradually move from 0º to maximum range in a “stepped” appearance 13 http://isrc.ulster.ac.uk
- 14. Comparison Magee Campus Report 14 http://isrc.ulster.ac.uk
- 15. Magee Campus Future Developments 15 http://isrc.ulster.ac.uk
- 16. Future Magee Campus 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. Bend sensor An accelerometer will measure Abduction sensor Accelerometer forearm supination and WIMU pronation. Battery • Accelerometers on each digit will measure initial angular values for each finger joint, removing the need for initial calibration. http://isrc.ulster.ac.uk
- 17. Future Magee Campus Developments • Wrist and thumb sensors will measure ulnar / radial deviation. • 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. http://isrc.ulster.ac.uk
- 18. Future Magee Campus Developments Detailed measurements for the glove in development 18 http://isrc.ulster.ac.uk
- 19. Future Magee Campus Developments • 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 19 http://isrc.ulster.ac.uk
- 20. Future Magee Campus Developments Additions to the software system: • Automatic calibration system to quantify arthritic hand ROM • Wireless connectivity to the data glove • Adduction and abduction range for each digit. • Thumb-index finger web space. • Amount of joint stiffness for each digit. http://isrc.ulster.ac.uk
- 21. Future Magee Campus Developments • 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. • Measurement of joint movement at home. • Record data offline for future analysis and playback. http://isrc.ulster.ac.uk
- 22. Conclusion Magee Campus • 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. • A new e-textile glove will provide a glove with low-weight, comfort, and high flexibility. http://isrc.ulster.ac.uk
- 23. Magee Campus Thank you for your attention. Questions? Email address : connolly-j3@email.ulster.ac.uk http://isrc.ulster.ac.uk