Download Aalborg University, Aalborg, Denmark 26/06/2015

Aalborg University, Aalborg, Denmark
26/06/2015
ARM SUPPORTS TO WEAR OR NOT TO WEAR?
Brachial Plexus Injuries (BPI) caused by trauma,
mainly motorcycle accidents, result in paralysis
Design of a Subject-specific Orthosis
for Upper Extremity Assistance
• Motorcycle accidents involving
male subjects (age < 30)
Miguel N. Castro*, John Rasmussen*, Shaoping Bai*, Michael
S. Andersen*
• Injured nerve pathways
*Biomechanics Research Group, Department of Mechanical
and Manufacturing Engineering, Aalborg University, Aalborg,
Denmark (email: mnc,jr,shb,[email protected])
• Compromised muscle function
(Moran et al. 2005; Faglioni et al. 2014)
Motivation
Assistance of patients with Brachial
Plexus Injuries using an arm orthosis
• Understanding patient’s level of impairment to assess whether
or not a patient can be assisted with a passive orthosis
• Optimizing the orthosis design through human-orthosis
simulation to achieve a design with essential components only
3D-Printing
Patient model
• Finding new approaches to aim at a wearable, lightweight
and inconspicuous custom-fit orthosis
Arm
Orthosis
• Enabling independent and mobile patients at home
Kinect™ Scanning
Assistance of patients with Brachial
Plexus Injuries using an arm orthosis
Specific Orthosis Model
Musculoskeletal system indeterminacy is solved
according to a muscle recruitment criteria
• AnyBody Modeling System (AMS)
(AnyBody Technology A/S, Aalborg, DK)
Human bones
Human joints
3D-Printing
Patient model
Arm
Orthosis
Kinect™ Scanning
• Right arm model (10 joints; 134 muscles)
• Full inverse dynamics analysis
• Motion
Internal Forces
Specific Orthosis Model
where
Miguel Nobre Castro
rigid bodies/segments
joints linking segments
, f(M) and f(R) are muscle forces and joint reactions
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Aalborg University, Aalborg, Denmark
26/06/2015
Musculoskeletal model is scaled to the patient’s
anatomy fitting the motion captured data
How accurate can BPI diagnosis techniques be
for predicting muscle atrophy?
?
(Andersen et al. 2010)
“Golden Standard” for biomechanical modeling
of patients with BPI: Electromyography!
sEMG
nEMG
Assistance of patients with Brachial
Plexus Injuries using an arm orthosis

3D-Printing
Patient model
Arm
Orthosis
Kinect™ Scanning
Orthosis design choice: a passive device
Overall
Muscle
Capability
BPI
Overall
Muscle
Capability
NMD
Specific Orthosis Model
Acquiring physiognomy data using Microsoft
Kinect® 1.0 for a custom-fit orthosis
onset
diagnosis
1
passive
active
onset
diagnosis
1
Time
passive
active
Time
•
No mechanical joint misalignment
•
No control algorithms
•
Anatomical joints still functional
•
Inconspicuous/reduced volume
•
No battery dependence
•
Reduced manufacturing costs
Miguel Nobre Castro
2
Aalborg University, Aalborg, Denmark
26/06/2015
New orthosis design concept CAD model for cosimulation : custom-fitted braces + bungee cords
Assistance of patients with Brachial
Plexus Injuries using an arm orthosis
• Covers five degrees-of-freedom
– Shoulder+Acromioclav. joints, 3+1-DOF
– Elbow flexion, 1-DOF
• Parts:
3D-Printing
Patient model
– Trunk armor
– Upper-arm brace
– Lower-arm brace
• No mechanical joints
Arm
Orthosis
• Six bungee cords provide
• support (elastic potential energy)
Kinect™ Scanning
Design case for optimization: motion data of
pick and drink from a cup drives the model
Specific Orthosis Model
A set of known postures was chosen
as new design case for co-simulation
BASE
(Zhou et al. 2012)
Reducing the maximal force required by
residual functional muscles over all postures
• Pre-defined 12 mm resting length per each cord
• Mixed-integer nonlinear optimization for number of parallel
cords per connection
• 6 design variables: Num. Parallel Cords, NC1-6
• Hand payload of 1 kg (purple ball)
Assistance of patients with Brachial
Plexus Injuries using an arm orthosis
3D-Printing
Patient model
Arm
Orthosis
Kinect™ Scanning
Miguel Nobre Castro
Specific Orthosis Model
3
Aalborg University, Aalborg, Denmark
26/06/2015
Manufacturing the new orthosis design in ABS
New orthosis design concept using custom-fitted
braces and bungee-cords (“plug&use”)
Discussion & future developments
References
•
• Theoretically, a patient-specific model can simulate the
biomechanics of the upper limb with paralysed muscles
•
• When the level of muscular impairment is complex and
individual, the model needs strength scaling and validation
•
• According to the simulations, an optimised orthosis design
assist the patient in some common daily activities
• Design optimization is essential for experimentation and
design maturation before the manufacturing stage
•
Faglioni, W. et al., 2014. The epidemiology •
of adult traumatic brachial plexus lesions in
a large metropolis. Acta neurochirurgica,
156(5), pp.1025–8.
Moran, S.L., Steinmann, S.P. & Shin, A.Y.,
2005. Adult brachial plexus injuries:
mechanism, patterns of injury, and physical •
diagnosis. Hand clinics, 21(1), pp.13–24.
Rahman, T. et al., 1996. Task priorities and
design for an arm orthosis. Technology and
Disability, 5(2), pp.197–203.
Rasmussen, J., Damsgaard, M. & Voigt, M.,
2001. Muscle recruitment by the min/max
criterion — a comparative numerical study.
Journal of Biomechanics, 34(3), pp.409–415.
Sakellariou, V.I., Badilas, N.K., Mazis, G. a,
Stavropoulos, N. a, Kotoulas, H.K.,
Kyriakopoulos, S., Tagkalegkas, I., Sofianos,
I.P., 2014. Brachial plexus injuries in adults:
evaluation and diagnostic approach. ISRN
Orthop. 2014, 726103.
Zhou, L. et al., 2012. Design and
Optimization of a Spring-loaded Cabledriven Robotic Exoskeleton. 25th Nordic
Seminar on Computational Mechanics.
Lund, Sweden: Deparment of Construction
Sciences, Structural Mechanics, Lund
University, pp. 205–208.
• Emerging 3d-printing technologies can enable manufacturing
a compact, wearable, affordable inconspicuous orthosis
• Clinical validation of a prototype is mandatory to assess the
function of the orthosis under operating conditions
Acknowledgements
•
Patient@Home Project /
Danish Agency for Science Technology and Innovation
ARM SUPPORTS TO WEAR OR NOT TO WEAR?
Design of a Subject-specific Orthosis
for Upper Extremity Assistance
Miguel N. Castro*, John Rasmussen*, Shaoping Bai*, Michael
S. Andersen*
•
Workshop Assistants at the Dept. Mechanical and Manufacturing
Engineering, AAU:
– Henrik Wiberg, Engineering Assistant
– Klaus Kjær, Engineering Assistant
– Søren Erik Bruun, Engineering Assistant
•
*Biomechanics Research Group, Department of Mechanical
and Manufacturing Engineering, Aalborg University, Aalborg,
Denmark (email: mnc,jr,shb,[email protected])
To my supervisors:
– Michael Skipper Andersen, PhD
– Shaoping Bai, PhD
– John Rasmussen, PhD
Miguel Nobre Castro
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