Biomedical Engineering Reference
In-Depth Information
are able to provide maximum, average and standard deviation of the force, but with-
out any temporal analysis within a series except for the systems exploiting additional
electromyographic signals [13]. In [5], a grip measurement device is presented, able to
perform also some time measurements but only on a single 4.4s grip exercise for the
performance assessment in rheumatic patients. A similar work has been presented in [1]
for the parkinsonian patients. In both cases the aim is a one-shot functional assessment
rather than the evaluation of a series of exercises. An interesting device for rehabili-
tation mixing torque and grip force has been presented in [7], but is not intended for
performance assessment.
The hand agility (severely affected by rheumatoid arthritis and scleroderma) can be in
principle evaluated by means of finger tapping tests, originally conceived to assess both
motor speed and control in neuropsychology. From the first mechanical devices, other
approaches for the monitoring of this kind of exercise have arisen. Approaches including
a passive marker-based motion analyzer [6] present a very complex setup not suited for
a fast evaluation. Other approaches, based on sensorized gloves [3], are uncomfortable
for patients with hand deformities caused by arthritis. In [9], a touch system based on a
4-finger active sensor (injecting on the hand a small sinusoidal current at 1.5 kHz) has
been presented along with its support software. An App (Digital Finger Tapping Test
1.0) with limited functionalities is also available for IPhone users. An approach based
on the detection of the exerted force in the tapping activity is presented in [8].
To the best of our knowledge, the realization of a low cost device for the quantita-
tive monitoring of both agility and strength exercises for hand functional evaluation
on rheumatic patients during real rehabilitation exercises has not been presented in
literature until now.
3
The Hand Functional Assessment Device
The proposed device is conveniently packaged in a lightweight metal briefcase, as
shown in Fig. 1. The patient can perform 4 exercises with a single hand at a time,
with as many sensorized devices. By using a GUI installed on his PC, the physician
can choose which exercise to execute, evaluating in real-time how the patient executes
it not only in terms of correct position but also looking at barely perceptible execution
parameters that the digital device is able to reveal. For instance, a real-time updated plot
discloses sensors wave shape while numerical data such as peak and running-average
values are displayed on the GUI, allowing a finer monitoring compared to a traditional
visual inspection. From this point of view the device can be conveniently used as a ki-
nesitherapic monitoring system. The physician can stop the execution at any time but
an upper bound is imposed by the predefined number of repetitions of the same exercise
hard coded in the device firmware. During the exercise execution, the device automat-
ically extracts the relevant measures from the signals and updates their statistics (min,
max, avg, std, etc.) in order to provide at every time the parameters needed for the
quantitative hand functionality assessment.
From the patient viewpoint, the interaction with the device is very simple. The hand
to use is indicated by a led and the movements to be performed exploiting the sensorized
embedded aids are well defined by the rehabilitation protocol, as follows.
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