hello there I WOULD LIKE a help writing a Conclusion for a lab report , please go over the report read it then type for me a good Conclusion.IT is a biomedical project drift report.
Assistive Device for Stretching Exercise in Patients with Frozen
Adhesive capsulitis, or frozen shoulder syndrome, is a disabling and painful condition of the
glenohumeral joint characterized by increased stiffness and compromised mobility, which has a
significant socioeconomic impact. The condition is primarily treated with physical therapy, wherein
different types of stretching exercises are prescribed to regain the range of motion. Many of these
stretching exercises require human intervention for support, multiple times in a day. The aim of
this project is to develop an affordable and portable assistive device that allows patients to perform
stretching exercises independently, without any human intervention.
Table of Contents
Senior Projects Coordinator
List of Figures
List of Tables
Alternative Designs Based on Design Criteria
Final Design Selected and Rationale
Impact on Schedule and Budget
Revised Scope of Work
List of Tables
List of Figures
Introduction Frozen shoulder syndrome, also known as adhesive capsulitis, is a condition
where the shoulder joint has a compromised range of motion that results in extreme pain
and discomfort to patients. The condition is caused by inflammatory changes in the
connective tissues around the shoulder capsule area. Over time, the tissue thickens and
becomes tight, allowing stiff bands called adhesions to develop. These adhesions make
the movement of the joint very painful and can limit the shoulder joint’s range of motion.
Frozen shoulder syndrome affects various populations of people, especially, those with
diabetes, hormonal imbalances, and thyroid disorders. Typically, patients of between the
ages of 40 to 60 years old are most likely to develop this syndrome. Additionally, it has
been seen that women are at an increased risk for frozen shoulder. . The primary
treatment for frozen shoulder syndrome includes a variety of strengthening and stretching
exercises which are usually performed multiple times a day to improve shoulder flexibility.
Some of these exercises, such as the upward arm stretch, requires assistance from
another person, thereby causing dependency .
Therefore, the objective of this design is to make a portable assistive medical
device that will allow patients to practice the upward arm stretch on their own, thereby
eliminating the dependency on another person to perform this exercise.
Analysis and Design Describe the method of analysis used. Provide details of the design criteria, alternative
designs, final design and the rationale for the selection.
The assistive device to perform the upward arm stretch in patients with frozen
shoulder syndrome should include the following features:
● Patients should be able to raise their arm to perform upward arm stretch
without human intervention.
● Patients should be able to operate the device either in the standing mode
or in the sitting mode (to address elderly patients or patients in
● To account for a range of patient heights the device should provide
assistance from 2’ (if operating in the sitting position) to 6’8’’ (if operating
in the standing position).
● The device should be able to support the weight of the patient’s arm,
which is typically less than 5% of the total body weight (maximum body
weight to support 600 lbs).
● The device should provide a smooth actuation without any jerk.
● The control for the range of motion should be user optimized.
● The device must be portable.
● The device must be safe and secure for patient use.
The first design considered by the group was based around a pneumatic
actuator. Initial design considerations produced a concept utilizing user-controlled
pneumatic actuation to raise the affected limb at an appropriate rate. Essentially, the
design was a pole comprised of two distinct parts: a button-lock section to raise the
actuator to a comfortable starting level, and the pneumatic section raises the arm past
where the patient can already comfortably position their arms. Figure 1 shows an
illustration of the pneumatic design.
The button-lock section would be used to elevate the actuator of the device to a
fixed starting height in accordance with the height and preference of the user. Once set,
the button-lock setting would be constant throughout the duration of the exercise. The
pneumatic section would be built in-house to reduce the overall cost. An air compressor
controlled by a switch would be used to raise the arm of the patient, whose elbow would
be constrained on a 3D-printed saddle designed by the group. This design was the
favored approach for the initial planning of the project, however further analysis of the
concept revealed several drawbacks and impediments that proved to be problematic in
accordance with our design criteria. The inner pneumatic tube needed to be coated in
grease in order to reduce friction, which would have been messy and unpleasant for the
end-user. Additionally, the seal between the two sections of the pneumatic section
would be insecure and constantly bleed air during operation. Furthermore, due to the
incomplete seal and inability to properly secure the actuator rod, the rod had the
potential to rapidly jettison from the device, which could be hazardous for the patient.
Thus the pneumatic design was simply infeasible given the safety and reliability
specified by the group in our project outline. In light of this, other designs were created
to address the problems encountered.
Figure 1: Drawing of the Pneumatic Design
Mechanical Gear-Based Devices: Two gear-based designs, a hand-crank
driven device and a pedal-motor driven device were developed as possible solutions.
Hand-Crank Driven Device: The hand-crank driven rack design is shown in Figure 2.
This design functioned by having the patient manually turn a hand crank which would
rotate the gear directly intertwined with the rack. This hand cranking action would
translationally move the rack-saddle assembly upwards in order to raise the patient’s
arm mounted on the saddle. Although the design would safely provide the required lift,
the hand cranking action would be strenuous for the patients, especially since the
exercise requires multiple repetitions in the same sitting. Furthermore, since most
patients have the syndrome on both the shoulders, the other arm may not be viable to
provide the required cranking action.
Figure 2: Hand Crank Driven Device
Pedal-Motor Driven Device: The motor-driven rack design is shown in Figure 3.
This design contains a pedal at the base of the device, which when activated would
send an electric signal to a motor-gearbox assembly. This gear, intertwined with a rack
would drive the rack similarly to the hand-crank design. The motor design was more
user friendly and easy to operate, however, it had several drawbacks. The first
drawback found was the device would require a programmed controller for operation, in
turn increasing the device complexity. The second encountered problem encountered
was the motor has a wind up time with a non-constant speed, and would not stop
immediately upon release of the pedal, thereby compromising on device safety. The
third problem is that the motor could potentially create a loud noise during operation
which may be inconvenient for the patients. The last discovered problem is that the
design is overly expensive, which directly violates the design criteria.
Figure 3: Pedal Motor Drive Device
Linear Actuator-Based Design: Another potential design that was considered
was similarly driven by a linear actuator with a step motor as shown in Figure 4. The
design consisted of two parts, a button-lock section (similar to the pneumatic design) in
the base and a linear actuator mounted onto the top of the button-lock. A linear actuator
induces motion in one dimension. Linear actuators already have extensive applications
within the medical field, such as in hospital beds, dentistry devices, prosthetic limbs and
others. In this design, it is coupled with a stepper motor to provide controlled vertical
actuation in the upward direction. The patient is to rest his/her elbow on the 3D printed
saddle attached to the top of the actuator. The primary drawback of this design is the
restricted range of motion which limits height that a linear actuator within our anticipated
budget would provide.
Figure 4: Linear Actuator Based Device
In conclusion, the above mentioned designs could not be used as they did not
satisfy one or more of our design criteria as shown in Figure 5.
Since the designs discussed in the previous section did not satisfy one or more
of the design criteria, the team pursued a fifth design that used cable actuation.
As shown in Figure 6, the design consists of a frame (consisting of 80/20
aluminum) on which a remote controlled electric winch (Hiltex 11302 12V) is mounted.
The included remote used to raise and lower the winch is joined to one of the support
columns at a height that allows easy user accessibility independent of the user’s height.
A blood pressure cuff was attached to the winch hook by paracord. The cuff will be
fastened around the elbow of the patient, and as the winch is raised it will allow the
patient to lift their arm and perform the upward arm stretch. The frame has an outer
dimension of 15.5 inches x 21.3 inches . The height of the frame will accommodate a
maximum patient height of 6’8’’, which is the 99.99 percentile of US adult male height.
Since there is no constraint on lowering down the cable the device can not only
accommodate shorter patient height but also support patients with disabilities confined
to wheelchairs. The rectangular geometry of the frame will prevent the device from
toppling in any direction during use when a load is applied perpendicular to the top face
of the structure. Additionally, lockable wheels are included inferior to the bottom face of
the frame allowing for device portability.
Figure 6: Overhead Cable Design
Comparing the considering the selected design amongst the disqualified ideas, it
has been deemed advantageous. Most importantly is the superior draw range provided
by the cable. As was mentioned previously, the frame sets the upper limit of the draw
range. Unique to the cable design, the minimum lower limit is defined by the floor.
Therefore, the potential draw range is set by the adjustable frame and is much greater
than that provided by any of the other designs. This is especially useful not only for
shorter patients, but for those with disabilities such as users confined to a wheelchair.
The design also allows easy user interface through a two-buttoned remote control as
opposed to alternative approaches requiring greater input work from the user. The
device satisfies all the design criteria, as well as some additional features. These
additional features allow for the device to be used for a variety exercises such as a
behind the back stretch, as well a lateral arm raise stretch. It allows for an extended
range as the cable as a great draw range. This allows for those whom are handicapped
and bound to a wheelchair to use the device. The extended range allows or this device
to be used whether the patient is sitting or standing. The cable designed was picked for
meeting all of the design criteria that were put forth, as well as additional features.
The assistive device that was ultimately developed best conforms to the design
criteria as defined relative to considered alternatives. A two-dimensional schematic is
given in Figure 6. Once set in place, the device allows the patient to perform the upward
arm stretch without required aid from another individual. It allows for the user to be
either sitting or standing due to the generous draw range the winch provides. The base
plate allows for both standing and a sitting users to passively support stabilization of the
device through body weight. Additionally, the range of motion accommodates across a
wide range of user heights. External configuration of the cable allows free space for the
user’s arm. By consequence of the implemented winch’s integrity, the device can bear
the weight of a patient’s arm with ease as the winch can operate under loads of up to
1000 lbs. The assistive device has manageable jerks. Portability is provided by wheels
located on the lower back portion of the frame. Nevertheless, the device itself is
relatively heavy, especially for those afflicted with adhesive capsulitis. As such, a patient
with adhesive capsulitis may require assistance in the initial placement of the device.
The base plate works to prevent toppling and increase the safety and security
experienced by the user.
Procedure – Andrew
Describe in detail how the team implemented the design such that an
engineer who was not associated with the project could duplicate your work. Describe equipment
installations, using drawings when applicable. Describe software development and verification,
if applicable. Describe analytical and/or experimental work completed – successes and failures.
k. Schedule: Show a schedule describing initial and actual plans. (using MS Project
software; you have the option of using the “export” command to an Excel file; limited to 1 page).
Results – maria and Becky
Provide an objective discussion of the principal results of your project and
important observations. This is the most important section of the report. Discuss what you have
accomplished in a positive manner. Do not dwell on minor factors or attempt to “lay blame” for
Between phases, modifications were made to the designs. After phase 2 modifications included
mounting the controller to the device. The noise cancelation was improved upon as well as the
box holding the winch was wrapped in more noise cancelling foam to improve the noise levels.
A paracord was used to replace the attachment between the arm cuff and winch hook.
For phase 2, the average smoothness of actuation improved slightly, going from 3.33/5 to 3.5/5.
The ease of use improved from 4 / 5 to 4.17/5. The safety improved from 4.33 to 4.67. Painless
operation remained 5/5. Noise improved from 1.5/5 to 2.17/5. Arm strap comfort improved from
4.5/5 to to 4.83/5. Controller comfort improved from 3 / 5 to 3.5/5.
Safety increased due to the addition of a base plate and housing the winch in a noise cancelling
box. The base plate increased the safety of the device because the weight of the subject on the
base plate attached to the device would keep the device from falling over. The winch also being
housed in the box puts the patient more at ease because they can’t see the machinery. The
improved controller comfort is due to mounting the controller on the device so that the patient
didn’t have to hold the controller while testing. This improved comfort as their arm didn’t get as
sore and tired. The device never caused anyone any pain, so that result stayed consistent. Ease of
use improved due to the controller being mounted on the device as well. The device became
quieter between phase 1 and phase 2 due to the addition of a noise cancelling box lined with
acoustic foam placed over the winch. Arm strap comfort increased due to the improved point of
attachment between the strap and the cable. Smoothness of actuation stayed the same as no
modifications were made to the device that would have affected this parameter.
Clearly state the conclusions reached based on the Results described in the previous section.
Your conclusions must be clearly justified. This section documents the knowledge acquired
during the project.
First the winch that was used in the final design was found to be too fast at a
speed of 10ft/minute. The speed needs to be slowed down to increase safety and
comfortability for patients. In addition to the winch speed, the noise from the winch is too
loud for commercial use. This is due to the winch being designed to work with loads up
to 1000 lbs whereas realistically it only needs to be capable of lifting a much lesser load.
Furthermore, the controller exhibits lag in relation to the winch which is a potential
safety concern in the event of an overstretching of the user’s arm. The next main
problem is the frame used for this project was costly given the use of materials obtained
from third-party manufacturers. Additionally, due to being unstable, a base plate had to
be added to the design as it was too top heavy. A heavier, more cosmetically pleasing
base plate and/or sturdier frame is recommended for greater stability. Lastly, the cuff for
the arm needs to better accommodate patients as it currently slides too much if it is too
loose and cuts off circulation if its too tight.
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