TALUS: PROTOTYPE OF A PORTABLE CONTINUOUS PASSIVE MOTION PHYSICAL THERAPY DEVICE FOR ANKLE TRAUMA

Abstract

Excessive stretching or rotation during daily movements can cause joint traumas that impair quality of life. These traumas are common in ankle joints, which bear the weight of the body, and can present as sprains, dislocations or fractures, causing pain and limited movement. Physiotherapy methods and technologies are used to restore optimum neuromusculoskeletal function. Continuous passive motion is a method used to prevent joint stiffness and calcification in joint surgery cases by providing repetitive movement of the joint. Physical therapy devices utilizing this technology allow for controlled repetition, speed, power, and angle. In this study, a prototype called Talus was developed that can deliver continuous passive motion physiotherapy at an adjustable angle, in real time or autonomously, after ankle joint trauma or surgery, and record application and patient information. Nextion was utilised to input patient information, determine movement angles, select the operating mode, and display recorded patient and treatment data. The information was recorded and the servo motors on the relevant axes were controlled using Arduino Mega. Talus allows for personalised treatment to be administered at home.

Keywords

• Ankle joint
• Continuous passive movement
• Range of motion
• Rehabilitation device

Thanks

I would like to express my gratitude to TUBITAK BİDEB for their support through the 2209-A University Students Research Projects Support Programme during the 2021/2 application period, with the application number 1919B012105903

TALUS: AYAK BİLEĞİ TRAVMALARI İÇİN TAŞINABİLİR SÜREKLİ PASİF HAREKET FİZİK TEDAVİSİ CİHAZI PROTOTİPİ

Abstract

Günlük hareketler sırasında aşırı gerilme veya dönme sonucu oluşan eklem travmaları yaşam kalitesini bozabilmektedir. Vücudun ağırlığını taşıyan ayak bileği eklemlerinde sık görülen bu travmalar burkulma, çıkık veya kırık şeklinde ortaya çıkarak ağrıya ve hareket kısıtlılığına neden olabilmektedir. Çeşitli fizyoterapi yöntemleri ve teknolojilerini kullanımı ile bu semptomlar geriletilerek optimum nöromüsküloskeletal fonksiyonun geri kazanılması kolaylaştırılmaktadır. Bu yöntemlerden biri, eklemin tekrarlayan hareketini sağlayarak eklem sertliğini ve kireçlenmeyi önlemek için eklem cerrahisi vakalarında da uygulanan sürekli pasif harekettir. Sürekli pasif hareket fizik tedavi cihazlarının teknolojisi kontrollü tekrar, hız, güç ve açıya izin vermektedir. Bu çalışmada ayak bileği eklemi travması veya cerrahisi sonrasında sürekli pasif hareket fizik tedavisini ayarlanabilir açıda, gerçek zamanlı veya otonom olarak uygulayabilen ve uygulama ve hasta bilgilerini kaydedebilen Talus adlı bir prototip geliştirilmiştir. Hasta bilgilerinin girilmesi, hareket açıların belirlenmesi, çalışma modunun seçilmesi ve kaydedilen hasta ve tedavi verilerinin görüntülenmesi için Nextion kullanılmıştır. Bilgileri kaydetmek ve ilgili eksenlerdeki servo motorları kontrol etmek için Arduino Mega kullanılmıştır. Talus, hasta için özelleştirilmiş tedavinin evde de uygulanabilmesini sağlamaktadır.

Keywords

• Ayak bileği eklemi
• Sürekli pasif hareket
• Eklem hareket açıklığı
• Rehabilitasyon cihazı

References

1. Ofluoğlu, D., “Exercise and Rehabilitation Principles in Painful Foot and Ankle Problems”, Turkish Journal of Physical Medicine and Rehabilitation, 60(2), 65-70, 2014.
2. Salter, R. B., “Textbook of disorders and injuries of the musculoskeletal system: An introduction to orthopaedics, fractures, and joint injuries, rheumatology, metabolic bone disease, and rehabilitation”, Lippincott Williams & Wilkins, 111, 1999.
3. O'Driscoll, S. W. and Giori, N. J., “Continuous passive motion (CPM): theory and principles of clinical application”, J Rehabil Res Dev, 37(2), 179-88, 2000.
4. Viveen, J., Doornberg, J. N., Kodde, I. F., Goossens, P., Koenraadt, K. L., The, B., and Eygendaal, D., “Continuous passive motion and physical therapy (CPM) versus physical therapy (PT) versus delayed physical therapy (DPT) after surgical release for elbow contractures; a study protocol for a prospective randomized controlled trial”, BMC Musculoskelet Disord, 8, 484, 2017.
5. Arjmandi, Z., Nejad, F. B., and Pajouh, M. A. A. “Design, fabrication and verification of continuous passive motion equipment for the index finger”, 25th National and 3rd International Iranian Conference on Biomedical Engineering (ICBME), IEEE, 1-5, 2018.
6. Zúñiga, H. S. G., Rangel, L. D., Escamirosa, F. P., Gnecchi, J. A. G., Osnaya, J. R. H., and Espinoza, D. L., “Device, Continuous Passive Motion-CPM, for the rehabilitation of motor skills of the forearm and wrist using a mobile application and Arduino” 19th International Conference on Electrical Engineering, Computing Science and Automatic Control (CCE), IEEE, 1-4, 2022.
7. Daothong, P., Sukpramote, T., Chanmanacharoen, I. R., and Senavongse, W., “Development of the program for the Continuous Passive Motion device for knee”, 13th Biomedical Engineering International Conference (BMEiCON), IEEE, 1-4, 2021.
8. Hamdan, W. K., Ali, S. M., Saleh, Z. H., Awad, D. M., Tareq, F. Z., and Radi, T. M., “Design and fabricating of continuous passive motion (CPM) machine for physical knee pain therapy”, In AIP Conference Proceedings (Vol. 2977, No. 1). AIP Publishing., 2023.

9. 이제우., “Development and Evaluation of a Sliding Type Continuous Passive Motion Automation Device for Diagnosis and Rehabilitation of Frozen Shoulder”, (Doctoral dissertation, 서울대학교 대학원), 2023.
10. Trochimczuk, R., Zdobytskyi, A., and Borkowski, P., “The Use of Generative Design Methods to Reduce the Parameters of an Actuator Used in the Positioning System of a Continuous Passive Motion (CPM) Device” Applied Sciences, 14(8), 3477., 2024.
11. Sepehri, A., Ward, S., Tolley, M. T., and Morimoto, T. K., “A Soft Robotic Wrist Orthosis Using Textile Pneumatic Actuators For Passive Rehabilitation” In 2024 IEEE 7th International Conference on Soft Robotics (RoboSoft) (pp. 284-290), IEEE, 2024.
12. Noviyanto, A. H., Nugraha, F. K. A., and Anurogo, B. L., “Rotary speed control on Continuous Passive Motion (CPM) Therapy Machine Device with PI Control”, Jurnal Polimesin, 22(1), 2024.
13. Kersten, S., Prill, R., Hakam, H. T., Hofmann, H., Kayaalp, M. E., Reichmann, J., and Becker, R., “Postoperative Activity and Knee Function of Patients after Total Knee Arthroplasty: A Sensor-Based Monitoring Study”, Journal of Personalized Medicine, 13(12), 1628, 2023.
14. Kim, J. J., Seo, J. Y., Noh, Y. H., Jung, S. J., and Jeong, D. U., “Development of IMU Sensor-Based XGBoost Model for Patients with Elbow Joint Damage”, In International Conference on Intelligent Human Computer Interaction (pp. 188-193), Cham: Springer Nature Switzerland, 2023.
15. Subramaniam, K., Rani, A. M. A., Zainuddin, A. A., Kurappa, L. G., and Appannah, Y., “Investigation of force analysis Stewart platform actuated by Shape Memory Alloy (SMA)”, In AIP Conference Proceedings (Vol. 2579, No. 1), AIP Publishing, 2023
16. Schäfer, H., Schäfer, R., and Platen, P., “A novel motorized office chair causes low-amplitude spinal movements and activates trunk muscles: A cross-over trial”, Plos one, 18(12), e0294778, 2023.
17. Foot and Ankle Structure and Function, Physiopedia, Retrieved April 25, 2024, from https://www.physio-pedia.com/Foot_and_Ankle_Structure_and_Function
18. Ankle and Foot Bone Fractures, Fizyoo, Retrieved April 20, 2024, from https://fizyoo.com/ayak-bilegi-kiriklari-ayak-kemigi-kiriklari
19. Golanó, P., Vega, J., De Leeuw, P. A., Malagelada, F., Manzanares, M. C., Götzens, V., and Van Dijk, C. N., “Anatomy of the ankle ligaments: a pictorial essay”, Knee Surgery, Sports Traumatology, Arthroscopy, 18, 557-569, 2010.
20. Genç, S., Çatal, Y., Şen, M., Oğuz, A. B., Koca, A., Eneyli, M. G., and Polat, O., “Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department” Journal of Ankara University Faculty Medicine, 75(3), 433-440, 2022.
21. Yonezawa, T., Onodera, T., Ding, M., Mizoguchi, H., Takemura, H., and Ogitsu, T., “Development of three-dimensional motion measuring device for the human ankle joint by using parallel link mechanism”, In 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), IEEE, 4358-4361., 2014.
22. Brockett, C. L., and Chapman, G. J., “Biomechanics of the ankle”, Orthopaedics and trauma, 30(3), 232-238, 2016.
23. Terzi, R., Gültekin, A., and Atlıhan, D., “The Effect of Continuous Passive Motion Implementation After Anterior Cruciate Ligament Reconstruction” Turkish Journal Of Physical Medicine & Rehabilitation, 59(4), 2013.
24. Fidan, U., Yılmaz, E., and Zığarlı, H. K., “Design and Implementation of CPM Device Compatible with Mobile Devices”, Afyon Kocatepe University Journal of Science and Engineering, 17(1), 124-130, 2017.
25. Callegaro, A. M., t Caten, C. S., Jung, C. F., Fogliatto, F. S., and Tonetto, L. M., “Design of a module for continuous passive motion to be used in equipment for the rehabilitation of elbow and forearm” In DS 84: Proceedings of the DESIGN 2016 14th International Design Conference, 801-810, 2016.
26. Pang, Z., Wang, T., Wang, Z., Yu, J., Sun, Z., and Liu, S., “Design and analysis of a wearable upper limb rehabilitation robot with characteristics of tension mechanism”, Applied Sciences, 10(6), 2101, 2020.
27. Şahin, Ö., “Isokinetic assessments in rehabilitation”, Cumhuriyet Medical Journal, 32, 386-396, 2010.
28. Therapeutic Ultrasound, Electrotherapy, Retrieved September 29, 2023, form https://www.electrotherapy.org/therapeutic-ultrasound