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Design Problem

Design Problem. Knee related injuries: Most common sports-career ending injury Post-ACL Surgery: Pain, scar tissue, muscle atrophy, decreased proprioception Physical therapy: Important for full recovery. Problem Difficult and expensive to restore injured knee to pre-injury functionality.

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Design Problem

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  1. DesignProblem Knee related injuries: • Most common sports-career ending injury Post-ACL Surgery: • Pain, scar tissue, muscle atrophy, decreased proprioception Physical therapy: • Important for full recovery Problem Difficult and expensive to restore injured knee to pre-injury functionality. http://www.leefalin.com/wp-images/acl.jpg

  2. Background & Demographics Rice's 2nd Knee Injury Ends a Lost Season The New York Times • Background • The average cost of ACL reconstruction ~$11,500 • Total cost of recovery ~ $30,000 • Recovery time can be up to 6 months • Out-patient physical therapy 1-2 visits/week • Check progress, review and modify program • Patient Overexertion/Non-Compliance • Poor results • Re-injury Jerry Rice http://tinyurl.com/3dzgqt

  3. DesignBrief Method Provide an suitable exercise regimen coupled with sensors to: • Display physiological measurements for real-time biofeedback • Record these signals for later evaluation by health care providers Solution Develop an integrated exercise device for a more autonomous rehabilitation.

  4. Several months • Full R.O.M. • Normal muscle strength, no swelling • Continue stability, balance and • strength training • 6-8 weeks • Control swelling • Regain R.O.M., muscle strength • PT visits few times per week • Exercise 30-60 minutes per day • 2-4 months • Stability and balance training • Less frequent PT sessions • Weight machines, exercise • bicycles or treadmills Basic Principles General Rehab Process Phase 1 Phase 2 Phase 3 Rehabilitation Metrics Target Muscle Groups • Qualitative assessment • Cincinnati Knee Rating System • QOL Questionnaire for ACL Deficiency • Manual manipulation • Quantitative assessment • Surface/Needle EMG • Range of Motion • Volume of exercise http://www.orthoassociates.com/ACL_Rehab_protocol.htm http://tinyurl.com/2gxw2l

  5. Competing Products Delsys Myomonitor® Biodex System 4®

  6. Constraints & Specifications Reliability & Accuracy • Must collect EMG data reliably and accurately enough to distinguish between a functioning knee and a sub-functioning knee Usability • Must be intuitive, accessible, and attractive to use Simple User Interface • User interface/data output must be easy to understand and analyze by both the user and the professional Cost • Must not be prohibitively expensive - $5000 or less to build / $10,000 or less to purchase (to be subsidized by insurance company) Business Model • Initially sold to physical therapy facilities or doctor’s offices, possibly rented out for home use • Potential for partnership with an exercise equipment company • Disposables - Electrodes

  7. Components Bike Leg press Elliptical Exercise equipment Surface EMG Goniometer Knee cuff Sensors Exercise data Muscle firing (EMG) Display Bluetooth Waist pack Data transfer

  8. Idea 1 ORTHOMETRICS Smart Elliptical Trainer 2007® Components • Elliptical trainer • Surface EMG • Bluetooth Targeted Muscles • Calves • Gluteal • Hamstrings • Quadriceps Partial-weight bearing • Lower joint loading Drawbacks • Less common

  9. Idea 2 ORTHOMETRICS Leg Press Trainer 2007® Components • Leg press • Surface EMG • Goniometry • Bluetooth/Wifi Targeted Muscles • Quadriceps • Gluteus Maximus • Hamstrings Physical Therapy • Phase II and later • Drawbacks* *Serrão F, et al. “Effect of tibia rotation on the electromyographical activity of the vastus medialis oblique and vastus lateralis longus muscles during isometric leg press.” Physical Therapy in Sport. 6(1) 15-23 (2005).

  10. Idea 3 ORTHOMETRICS Bike Trainer 2007®

  11. bluetooth/wifiantenna surface EMG electrode userinterface Idea 3 ORTHOMETRICS Bike Trainer 2007®

  12. Summary Exercise equipment User friendly efficient guided rehab program Biosensors Data processing

  13. Thank You Dr. Clark Hung Associate Professor of Biomedical Engineering Dr. Elizabeth Hillman Assistant Professor of Biomedical Engineering Keith Yeager Senior Staff Associate, Laboratory Manager Dr. William Macaulay Orthopedic Surgeon, Columbia University Medical Center Director of Center for Hip and Knee Replacement Dr. Ranjan Gupta Department Chair of Orthopaedic Surgery, UC Irvine Professor of Orthopaedics, Anatomy & Neurobiology, and BME James Gossett Associate Athletic Director, Columbia University Dr. Evan Johnson Director of Physical Therapy at the Spine Center Administrative Director of the Spine Center Julianne Costa Occupational Therapist Registered Physical Therapist Dr. Tim Wright Orthopaedic Biomechanics and Biomaterials Hospital of Special Surgery

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