1. Objective for

2. System of Quality of

3. Measure Life

4. Team Members Maja Middleton – Team Leader Kayla Ericson – Communicator Kristin Riching – BSAC Katherine Davis - BWIG

5. Client Dr. Erwin B. Montgomery M.D. Department of Neurology Advisor Prof. Justin Williams BME Department

6. Problem Statement Design a system or tool to measure the quality of life for a patient suffering from movement disorders. The system/device must provide evidence that the quality of life has improved post surgery so that insurance companies will continue to fund deep- brain stimulus rehabilitation.

7. Quality of Life Definition: Quality of life is a measure of the means that people live within their own environments in ways that are best for them Applicable Definition: The ultimate goal of deep brain stimulation surgery is to enable people to live quality lives -- lives that are both meaningful and enjoyed, but are also functional mentally, physically and socially.

8. Three Aspects of Quality of Life Mental – Patient’s feelings and attitudes about themselves and their abilities as related to their disease and quality of life –Cognitive assessment (PADLS or MSQOL54) Physical – Patient’s ability to perform daily tasks –Bluetooth accelerometer Social – Patient’s daily interactions with society and personal relationships –GPS  All three aspects will be measured pre- and post-surgery

9. Product Design Specifications Performance RequirementsRepeated use, all types of patients, non- invasive, easy to operate SafetySafe for patient and operator Accuracy and ReliabilityDependable, durable, precise, fulfill companies requirements for objective measure Life in Service7 days of operation and battery life, record tri-axial motion, 20 cycles per seconds (accelerometer) QuantityFive (5) accelerometers Bluetooth enabled, one (1) PDA Bluetooth enabled, one (1) GPS CompactFlash card – one unit can be used for many repeated patients Target Production CostApproximately $1600 ErgonomicsLight, non-invasive SizeMinimal, fitting watch or PDA (GPS) WeightNot more than 750 grams (accelerometer) MaterialsHypo-allergenic for all types of patients

10. Background Material and Research Movement Disorder Symptoms Rigidity Postural Instability Tremor Bradykinesia / akinesia –Slowness –Absence of movement Dyskinesia –Abnormal, involuntary movement –Side effect of drug therapy

11. Previous Methods No previous devices for objective measure of movement disorders found besides written questionnaires and doctor judgment. Doctor observation is becoming less accepted as insurance companies lean toward evidence based medicine

12. Background Material and Research Insurance companies only pay for necessary rehabilitation treatments that bring the patient to a normal functioning level for their environment –They continue to fund treatments so long as progress continues –All progress is marked on a scale that relates to daily functions of life Reaching, lifting, standing, walking, dressing, etc…

13. Deep Brain Stimulation For neurologically based movement disorders Two electrodes implanted in the brain are fed to a pulse generator implanted in the chest The generator delivers high-frequency electrical stimulation that shuts down nerve cells to allow cells to regain self-control Figure 1: http://www.clevelandclinic.org/neuroscience/techniques/dbs.htm

14. Physical Design Specifications Accelerometers –5 subunits One for each wrist (2 total) One for each ankle (2 total) One on the trunk as a reference –Bluetooth enabled Allows for wireless messaging of data to the central PDA Figure 2: Top picture - front view; bottom picture – back view http://www.gvu.gatech.edu/ccg/resources/btacc/index.html 35 mm Depth: 5mm

15. Physical Technical Aspects All accelerometers need to communicate together – done via the PDA and Bluetooth technology Each signal must be recognized individually by the PDA (X, Y, Z data in ASCII format – number for a character) Will sample at 20 Hz (Nyquis’ Theorem) Battery life (Lithium ion) is about 60 hours (840 mAh – 3.7V) Has A-D conversion

16. Central Integration Unit Hewlett Packard - Personal Desktop Assistant (PDA) –Bluetooth enabled PDA –CompactFlash slot –Expansion slot in PDA for memory capabilities –USB port for easy PC interfacing HP iPAQ2215 Figure 3: http://www.circuitcity.com/detail.jsp?c=1&b=g&u=c&qp=0&bo okmark=bookmark_0&oid=74016&catoid=-8028&m=0

17. Central Unit Technical Aspects PDA –64 MB internal RAM –Up to 512 MB of add-on memory –900 mAh lithium rechargeable battery –Software must be programmed for PDA to record and store GPS data (every half hour) –Software must also be programmed to receive, store, and manipulate accelerometer data –All programming will be done using the software development kit (SDK) from Microsoft

18. Social Design Specifications Laipac Global Positioning System (GPS) –Tracking GPS compact flash card (to log distance and location) –Low power consumption –Windows compatible Figure 4: http://www.laipac.com/gps_tf30cf_eng.htm

19. Social Technical Aspects GPS –Record readings every half hour –Accurate to 25 m –3.3 V –.2 W power consumption –PDA driver is downloadable from the website

20. Thank you! We just want to extend our thanks to: Dr. Montgomery Prof. Justin Williams Dr. Jim Abbs Daryn Belden Gary Diny, PT

21. Future Work The plan for the device is thoroughly mapped out. The next steps include: –Purchasing the PDA and CompactFlash card –Writing the software with the SDK for the GPS –Purchasing the pieces for the accelerometer –Purchasing the circuit board and assembling the system –Design and build casing for the accelerometers –Write software using the SDK for the accelerometer –Test the integrated system

22. Overall schematic Accelerometer Integrated PDA and GPS Reference Accelerometer Upload data to PC Figure 5: www.circuitcity.com

23. References Davis, William R. Personal Interview. 14 Feb. 2004. Department of Neurology. (2001). What are Movement Disorders and How are they Treated? Retrieved March 8, 2004, from Baylor College of Medicine Web site: http://www.bcm.tmc.edu/neurol/struct/park/park6.html http://www.bcm.tmc.edu/neurol/struct/park/park6.html Diny, Gary. Personal Interview. 27 Feb. 2004. Hobson, J.P., et al., eds. “The Parkinson’s Disease Activities of Daily Living Scale: a new simple and brief subjective measure of disability in Parkinson’s disease.” Clinical Rehabilitation 15:1 (2001): 241-246. Meyers, Allan R., et al., eds. “Health-Related Quality of Life in Neurology.” Neurology and Public Health 57:1 (2000): 1224- 1227. Montgomery, Erwin B. Personal Interview. 27 Jan. 2004. Deep Brain Stimulation surgery. Retrieved April 25, 2004. http://www.clevelandclinic.org/neuroscience/techniques/dbs.ht m http://www.clevelandclinic.org/neuroscience/techniques/dbs.ht m Deep Brain Stimulation Surgery. Retrieved April 25, 2004. www.wemove.org www.wemove.org