1. Device for Acute Rehabilitation of the Paretic Hand After Stroke
Team: Carly Brown, Sasha Cai Lesher-Perez, Justin Lundell, Mike Socie, Karissa Thoma
BME 300/200
20 Oct 2006

2. Medical College of Wisconsin – Milwaukee
Client:
Dr. Michelle Johnson
Medical College of Wisconsin – Milwaukee
Advisor:
Professor Mitch Tyler
Dept of Biomedical Engineering UW-Madison

3. Introduction Motivation An intermediate rehabilitative device
Universal design
Engagement level for patients

4. Introduction Background Current Products Stroke Rehabilitation EMS7500
Demographics
Paralysis
Rehabilitation
Current Products
EMS7500
Bioness
-background info
-Stroke- 3rd leading cause of death amongst adults. more prevelant in males than females
72% of stroke victums over 65 yrs
-rehabilitation-focus on upper limb function include neurodevelopment techniques, motor relearning, biofeedback, splinting, constraint-induced movement therapy and robot-induced therapy; Functional Electrical Stimulation (FES), Transcutaneous Electro-Nerve Stimulator (TENS unit)
-current products-EMS=in-home system to facilitate movement, not necessarily used to regain function
bioness-expensive robotic system
Above: Bioness H200
Left: EMS7500

5. Methods Objective Recover range of motion PT
Supination/pronation
Flexion/extension of hand grip PT
Ability to connect to computer interface

6. Methods Project Statement
Design a portable, simple, universal, and comfortable attachment for impaired arm rehabilitation following stroke.
Design a portable, simple, universal, and comfortable attachment for impaired arm rehabilitation following stroke.

7. Methods PDS Summary Portable device Universal use Allow for TENS use
24” x 20” x 18”
$750
Supination and pronation movement of wrist
Flexion and extension of the hand

8. Results Preliminary design Wrist Cylinder Computer monitor -allows for
supination and
pronation of
the wrist
-has plates to
secure hand
Computer monitor
-patient engagement
a video game
Wheelchair tray
-building block
on an existing
wheelchair tray
Our preliminary design focused on the movement of supination pronation. for that movement, we designed the cylinder that a hand would be placed in and it would rotate. the arm rest would be adjustable to accommodate for different arm lengths. the system would then but connected with a computer that would have a game/slideshow for the patient to play with during PT
Armrest
-restricts
movement
in lateral
directions

9. Results Our Design Picture
idk if we should talk about this here or just talk about it as we step through our device-(Our design incorporates an active system and a system that is functioned by electro-stimulation. This design also has the abilities to be universal and be connected to a game interface)

10. Results Active System Cylinder Motor Switch
(Our design has two parts to it, an active system and a electro-stimulation system) The active system invovles the supination/pronation of the wrist. Given the range of abilities that patients are going to have, this active system will provide the means for the patient to work on movements even if they aren't able to do it physically. This system consists of a cylinder where the patient places their wrist in the cuff and velcros themselves in. A motor underneath the system will accuate when the patient pushes the switch. The motor will rotate in one direction until the fingers placed on the cuff hit the toggle underneath that switches the direction of the motor. When the patient has done enough of that movement, the patient pushes the switch to turn off the motor.

11. Results Electro-Stimulation Radial Nerve -extension of hand
The electro-stimulation system is fostered by a TENS unit. the pads will be placed on the arms (show) to help the extension of the hand since most patients have the ability to grip their hands. the patient will then grasp the handle of the controller. grasping depresses the trigger on the joystick, which will allow for incorporation of a game into the system for patient involvement. another aspect of the controller is the ability to incorporate other motions of the hand such as distal movements.

12. Results Ability to be Universal
Connectivity to CPU for patient engagement
As you can see, these systems are connected as one piece. the system is connected to a pre-existing wheelchair tray. To make the system universal, we put pegs into the bottom of the system that will allow for adjustment for different sized arms. also if holes were added to the other side. the system would then be able to be used by either arm. Also, since we used an existing joystick controller with USB connection, the system will be simple to connect to a computer in PT and a game could then be accessed to stimulate interest for PT.

13. Results Budget Item Cost Tray $36.99 Joystick $22.98 Foam $18.00 Board
$12.68
Tube
$3.59
Rollers and Dowels
$8.82
Hardware
$13.20
TOTAL
$116.26

14. Conclusion Future work Plastic/Aluminum-easy to clean Motor
Microprocessor
Game incorporation
Pong, Driving, Skiing
PT Testing

15. References
Bastings, Greenberg, Good Hand motor recovery after stroke: a transcranial magnetic stimulation mapping study of motor output areas and their relation to functional status. The American Society of Neurorehabilation 16:
Drabycz, S Stroke. The University of Calgary. Retrieved from on 15 Oct 2006.
Elhendy, A. Health Center Online. Stroke Symptoms. Retrieved from on 7 Oct
Hluštík, Petr, Mayer, Michal Paretic hand in stroke: from motor
cortical plasticity research to rehabilitation. Neuropsychiatry, Neuropyschology, and Behavioral Neurobiology 19:
Nathan, Dominic: Marquette University
O’Neal, Burke: UW-Madsion
Tompkins, Willis, PhD: UW-Madison