WO2017171660A1 - Système de diagnostic de santé d'articulation de pied - Google Patents

Système de diagnostic de santé d'articulation de pied Download PDF

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Publication number
WO2017171660A1
WO2017171660A1 PCT/SG2017/050189 SG2017050189W WO2017171660A1 WO 2017171660 A1 WO2017171660 A1 WO 2017171660A1 SG 2017050189 W SG2017050189 W SG 2017050189W WO 2017171660 A1 WO2017171660 A1 WO 2017171660A1
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WO
WIPO (PCT)
Prior art keywords
foot
force
patient
diagnosis system
load cell
Prior art date
Application number
PCT/SG2017/050189
Other languages
English (en)
Inventor
Chi Chiu Chan
Li Han Chen
Niu LUO
Pui Wah KONG
Original Assignee
Nanyang Technological University
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Nanyang Technological University filed Critical Nanyang Technological University
Publication of WO2017171660A1 publication Critical patent/WO2017171660A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1121—Determining geometric values, e.g. centre of rotation or angular range of movement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6829—Foot or ankle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02—Operational features
    • A61B2560/0223—Operational features of calibration, e.g. protocols for calibrating sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0233—Special features of optical sensors or probes classified in A61B5/00
    • A61B2562/0238—Optical sensor arrangements for performing transmission measurements on body tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0247—Pressure sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal

Definitions

  • This invention relates to a foot joint health diagnosis system.
  • foot joint mobility is an important foot health condition evaluation index, including first metatarsophalangeal joint (MPJ) mobility and first ray (big toe) mobility.
  • MPJ metatarsophalangeal joint
  • big toe first ray
  • First ray hypermobility has been linked to many abnormal conditions in the foot. Increased first ray mobility has been seen in patients with hallux valgus. Patients with diabetes mellitus are characterized by higher joint stiffness in the first ray than non-diabetic controls. In addition, hypermobility of the first ray may also contribute to laxity in the arch and the development of posterior tibialis tendon dysfunction.
  • First metatarsal vertical displacement is proportional to the measurement of first ray dorsitlexion.
  • the common practice is to subjectively 'feel' how stiff a joint is and this type of clinical assessment is unreliable.
  • clinical testing of first ray mobility is performed with one hand stabilizing the lateral fourth metatarsals while the other hand applies a displacement force to the first metatarsal head.
  • this method is widely used, it allows considerable interobserver error and its reliability and validity are questionable because the direction and the amount of the force applied to the first metatarsal are not controlled.
  • a foot joint health diagnosis system comprising: a force provider to apply a force onto an application point on a part of a patient's foot, the force provider comprising a load cell to detect the magnitude of the force; and a sensor device comprising a number of fiber Bragg gratings to be attached to the patient's foot in alignment with a corresponding number of toes, wherein movement of the part of the patient's foot consequent to application of the force gives rise to axial strain in the fiber Bragg gratings to determine extent of mobility of the part of the patient's foot consequent to application of the force.
  • the force provider may comprise a platform to rest the patient's foot thereon, the load cell provided under the platform to exert an upward force on the part of the patient's foot on the platform.
  • the load cell may be provided on a moving platform adjustable in orthogonal directions on a horizontal plane.
  • the force provider may alternatively comprise a hand-held instrument, the hand-held instrument comprising a handle, a connector attached to the handle, the load cell attached to the connector, and a force transmitter attached to the load cell, the force transmitter having a distal end, wherein when the distal end of the force transmitter is in contact with the application point, a force exerted by a user holding the handle is transmitted through the connector and the load cell and applied by the force transmitter onto the application point.
  • the force transmitter may comprise a transmission rod having a proximal end attached to the load cell.
  • the force transmitter may further comprise a stabiliser comprising an L-shaped bar, a long arm of the L-shaped bar orthogonally attachable to a central portion of the transmission rod, a short arm of the L-shaped bar having a distal end to contact a reference part of the patient's foot.
  • the fiber Bragg gratings may be embedded in an elastic polymer, the elastic polymer and fiber Bragg gratings provided in a sock to be worn over the foot.
  • the fiber Bragg gratings may be provided on the sole of the foot when the sock is worn.
  • the sensor device may comprise one fibre Bragg grating to be adhered to the sole of the patient's foot and along an underside of a toe to be investigated.
  • the sensor device may comprise a coupler, the fibre Bragg gratings connected to the coupler, an input fiber cable connected to the coupler to connect a light source to the coupler, and an output fiber cable to the coupler to connect the coupler to a data processing module.
  • Fig. 1 is a schematic illustration of a sensor device of a first embodiment of a foot joint monitoring system.
  • Fig. 2 is a block diagram of component connections of the sensor device of Fig. 1.
  • Fig. 3(a) is a schematic illustration of different force application points when using the foot joint monitoring system.
  • Fig. 3(b) is a schematic illustration of downward pressure applied to immobilize toes that are not being investigated when using the system.
  • Fig. 3(c) is a schematic illustration of the first embodiment of the foot joint monitoring system.
  • Fig. 3(d) is a perspective view of a force provider of the first embodiment of the foot joint monitoring system.
  • Fig. 4 is an illustration of force resolution when a vertical force is applied to measure rotational stiffness of MPJ.
  • Fig. 5 is a side view illustration of a force provider of the second embodiment of the foot joint monitoring system.
  • Fig. 6 is a photograph of the force provider of Fig. 5.
  • Fig. 7 is a photograph of a close-up of a connector of the force provider of Fig. 6.
  • Fig. 8 is a photograph of a perspective view of the force provider of Fig. 6.
  • Fig. 9 is a photograph of the second embodiment of the foot monitoring system in use to measure first ray mobility.
  • Fig. 10 is a photograph of a sensor device of the second embodiment of the foot monitoring system applied on a patient and indicating displacement when measuring first ray mobility.
  • Fig. 1 1 is a photograph of the second embodiment of the foot monitoring system in use to measure rotational stiffness of the MPJ.
  • Fig. 12 is a photograph of a sensor device of the second embodiment of the foot monitoring system applied on a patient and indicating rotational angle when measuring rotational stiffness of the MPJ.
  • Fig. 13 is a graph showing Bragg wavelength shift with increase in rotational angle and first ray displacement.
  • Fig. 14 is a graph showing relationship between rotational angle and FBG wavelength shift.
  • Fig. 15 is a graph showing relationship between displacement and FBG wavelength shift.
  • the system 10 comprises a force provider 100 that exerts a force on a part of a foot such as at the joint of the toes and on the first ray.
  • the force provider 100 may comprise a hand-held instrument 110 or a platform 120 and the force may be exerted manually or automatically with an actuator 122.
  • the force provider 100 incorporates a load cell 102 to detect the magnitude of the exerted force.
  • the system 10 also comprises a sensor device 200 for measuring ray displacement and angle of bending of the toe.
  • the sensor device 200 comprises a number of FBG sensors 20 arranged in alignment with one or more toes.
  • the three measurements are obtained and computed to provide a gauge of the toe mobility issues.
  • the measurements may be obtained by wired connections or transmitted wirelessly to a processor.
  • the number of FBG sensors 201 may be incorporated into a wearable device 210 in the form of toe socks or individually attached to the foot.
  • the sensor device 200 comprises a wearable device 210 comprising a five-toe sock 21 1 .
  • the wearable device 210 comprises custom-made FBGs 201-1 to 201-5 for each of the first to fifth rays respectively, and an optical coupler 213 embedded in the five-toe sock 21 1.
  • the sensor device 200 also comprises a light source 202, an input fiber cable 204, an output fiber cable 205, and a data processing module 206. As shown in Fig. 2, the input fiber cable 204 is connected to the light source 202 through or at an input end or terminal 213-1 of the coupler 213.
  • the output fiber cable 205 is connected to data processing module 206 through or at an output end or terminal 213-2 of the coupler 213.
  • a third end or terminal 213-3 of the coupler 213-3 is connected to the optical fiber sensors 201 , transmitting the input light to optical fiber sensors 201 as well as re-transmitting the output light to the data processing module 6.
  • the data processing module 206 comprises a display platform.
  • the optical fiber sensors 201 comprise five fiber Bragg gratings (FBGs) 201.
  • the FBGs 201 and the coupler 213 are embedded in an elastic polymer 215 such as polydimethylsiloxane (PDMS) which is molded into a five-toe shape and packaged with a reusable five-toe sock 21 1 as the wearable device 210.
  • PDMS polydimethylsiloxane
  • the sensing sock 210 is made entirely of fabric 21 1 with the PDMS embedded, this makes the wearable device 210 soft without complicated mechanical setups, providing a comfort for patients.
  • the dimensions of the FBG sensors 202 and sock 210 can be made based on conventional sizes of socks for different age groups and gender.
  • Velcro straps may be introduced at the location of each toe and at the sock cuff 216 to cater to abnormal shapes of foot/toe and ensure better fixation of the wearable device 210 for effective signal transduction.
  • the fiber sensor 202 is made of silica and no electric current is involved for the transduction, the fiber FBG embedded five-toe sock 210 is washable and sterilizable for hygienic purposes.
  • FBG is formed by photo induced periodic refractive index modulation within the fibre core, which results in a series of grating planes along the fibre axis. If the Bragg condition is achieved, light propagating in the core will be reflected at each of the grating planes to form a back reflected signal with a center wavelength commonly known as the Bragg wavelength, A B .
  • a variation of axial strain on the FBG has impact on A and n eff , inducing a shift of A B . By demodulating the shift of A B , the applied axial strain can be determined.
  • Foot joint mobility includes two measurement aspects, which are the rotational stiffness of the metatarsophalangeal joint (MPJ) as well as the stiffness of the first ray (big toe).
  • Fig. 3 shows the first embodiment of the device or system 10 for measuring foot joint mobility in which the force provider 100 comprises a platform 120.
  • the force provider 100 preferably includes a customized immobilizer boot 121 (as shown in Fig. 3(c)) on the platform 120 upon which the patient's foot rests for the patient to maintain a 90° ankle-joint flexion and prevents transverse rotation of the leg.
  • an upward force F from a programmable load cell 102 provided under the platform 120 of the force provider 100 (as shown in Fig.
  • Fig. 4 shows a rotational force analysis when a vertical force F is applied to determine rotational stiffness of the first MPJ.
  • the rotational stiffness of the first MPJ mobility (Nmm/rad) is computed by ⁇ / ⁇ .
  • the load cell 102 is designed and equipped with a mechanical moving platform 123 that is adjustable in the X and Y directions (i.e. in orthogonal directions on a horizontal plane) to allow a clinician to apply the load in the Z direction (i.e. vertically) at the desired location on the patient's foot, as shown in Fig 3(d).
  • the mechanical moving platform 123 may be mounted to an X-axis linear block 124 and Y-axis linear block 125 that are in turn provided on a base plate to allow for X and Y axis movements.
  • An actuator 122 comprising a motor 126 and up/down slider attachment 127 is provided to exert the force automatically.
  • the slider attachment 127 is connected to the motor 126 via a coupler 131 provided on the moving platform 123.
  • the motor 126 moves the load cell 102 up and down as the load cell 102 is mounted on the up/down slider attachment 127 that is in turn mounted on the moving platform 123.
  • a stopper 128 may be used to prevent movement of the moving platform 123 along each of the X and Y axis once the moving platform 123 is at its desired location.
  • the force provider 120 preferably also includes a load display 109 and a control panel 129.
  • the thickness of the PDMS 215 is adjusted to be 2 mm which offers a maximum bending sensitivity.
  • the maximum angular range supplied by the load cell 102 is capped at 120° for safety.
  • the applied force F by the load cell 102 should be from 3 to 4.5N.
  • the maximum load force that can be provided by the load cell 102 in the present example of the first embodiment was designed to be 100N.
  • Determining first ray mobility is the same as determining rotational stiffness of the MPJ except that the predefined vertical force F is applied to the first ray at the MPJ (as indicated by arrow F2 in Fig. 3(a)) through the load cell 102.
  • the displacement of the first ray can be computed by interpolating strain/displacement coefficient of the FBG.
  • the stiffness (N/mm) of the first ray is determined.
  • the dorsal mobility of the first ray was about 4.2-7.6mm when the corresponding applied force was less than 55N.
  • the displacement range in the present example of the first embodiment of the system 10 is kept from 0 to 10 mm, and the applied maximum force is up to 100N.
  • the sensor device 200 comprises one FBG sensor 20 arranged in alignment with a toe that is being investigated (shown as the big toe in the present application).
  • the FBG sensor 20 is adhered to the sole of the patient's foot and along the underside of the toe being investigated, as shown in Figs. 9 to 12.
  • the force provider 100 in the second embodiment comprises a hand-held instrument 110, as shown in Figs. 5 to 8 and Fig. 10.
  • the instrument 110 is configured to be small and light. Data from the instrument 110 may be output via a USB connection or a wireless connection, e.g. Bluetooth.
  • the instrument 1 10 comprises a handle 1 11 that may be cylindrical or any other appropriate shape.
  • the handle 11 1 is preferably made of a plastics material to reduce weight.
  • the instrument 1 10 also comprises a multidirectional load cell connector 112 that is connected to the handle 11 1 between the handle 11 1 and the load cell 102 of the instrument 1 10.
  • the connector 112 allows the load cell 102 to be attached orthogonally to the handle 11 1 as shown in Figs. 5, 6, 8 and 1 1 , or co-axially with the as shown in Fig. 9.
  • the connector 1 12 preferably comprises a generally square block having a threaded hole
  • the end 1 11-1 of the handle 11 1 (if mainly plastic) may be provided with a steel insert 1 15 to strengthen connection of the handle 1 11 with the connector 112.
  • the instrument 110 further comprises a force transmitter 140 attached to a distal side of the load cell 10.
  • the force transmitter 140 is configured to contact the patient's foot and to transmit the force F exerted by a person holding the handle 1 11 to the patient's foot, as shown in Fig. 9.
  • the transmitted force F can be determined by the load cell 102.
  • the force transmitter 140 preferably comprises a transmission rod 141 having a first end 141-1 attached to the load cell 102.
  • the first end 141-1 of the transmission rod 141 may be threaded and a nut 144 may be used to adjust and lock the connection of the load cell 102 with the force transmitter 140.
  • the force transmitter preferably further comprises a contact bar 142 connected transversely to a second end 141-2 of the transmission rod 141.
  • the contact bar 142 comes into contact with the patient's foot and serves to apply the load evenly at the desired application point of the load on the foot.
  • Fig. 9 shows the instrument 1 10 being used to determine stiffness of the first ray by applying the force F onto the MPJ, as indicated by the large single-ended arrow.
  • the displacement (as indicated by the double headed arrow) of the first ray (from the dotted line to the solid line) in Fig. 10 can be computed by measuring the Bragg wavelength shift of the FBG 20, as described above with reference to the arrow F2 in Fig. 3(a).
  • the force provider 1 10 preferably further comprises a stabiliser 143 provided as an accessory to the force transmitter 140, as shown in Figs. 5, 6, 8 and 11.
  • the stabiliser 143 comprises an L-shaped bar having its long arm 143-1 configured to be orthogonally attached to a central portion of the transmission rod 141 so that a distal end of the short arm of the L-shaped bar contacts a reference part of the patient's foot when the distal end of the transmission rod is in contact with the patient's foot.
  • the short arm 143-2 preferably comprises a reference bar 145 at its distal end that contacts the patient's foot when in use. A distance between the reference bar 145 and the contact bar 142 (i.e.
  • a screw connection 146 may be used to attach the stabiliser 143 to the transmission rod 141 to allow the length L to be easily adjusted.
  • the distance between the reference bar 145 and the contact bar 142 defines the length L used to determine rotational stiffness of the MPJ.
  • the length L is measured by clinicians before testing from the first MPJ (contacted by the reference bar 145) to the force application point on the toe (contacted by the contact bar 142).
  • the force provider 100 in the form of the portable hand-held instrument 110 ensures that the applied force is kept perpendicular to the plane of the sole of the foot. It also allows the mobility of the first ray and the first MPJ to be measured separately according to specific needs of each patient. Components of the hand-held force provider 1 10 may be manually removed and assembled.
  • the displacement of the first ray (Figs. 9 and 10) or the rotation of the big toe (Figs. 1 1 and 12) due to the applied force F will induce length extension of the fiber sensor, inducing a strain variation on the FBG 20, due to the sensor 200 being provided at the sole of the foot.
  • the displacement and/or rotational angle can be computed by interpolating strain coefficient of the FBG.
  • the Bragg wavelength will shift to a longer wavelength, as shown in Fig. 13.
  • the linear relationship between rotational angle and displacement and FBG wavelength shift is good, as can be seen in Figs. 14 and 15 respectively.
  • All data collected from the load cell and the FBG sensor can be input directly into a computer for a programmed software to process automatically, which is easy to operate for the clinicians.
  • the system 10 described above is able to accurately measure foot joint mobility which is an important parameter in the evaluation of foot function and disorders.
  • the system can accomplish real-time detection within a simple structure, is easy to produce, has a fast response, is stable, is anti-electromagnetic interference, is corrosion resistant, and can be applied to academic research, medical treatment and industrial products.
  • Figs. 1 , 3(a) and 3(c) show the FBGs 201 embedded in the elastic polymer 215 being provided at the top of the foot
  • the FBGs 201 embedded in the elastic polymer 215 may be provide at the sole of the foot.
  • the sensor device of the first embodiment may be used with the force provider of the second embodiment and the sensor device of the second embodiment may also be used with the force provider of the first embodiment.

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  • Oral & Maxillofacial Surgery (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
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  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

L'invention concerne un système de diagnostic de santé d'articulation de pied, qui comprend : un fournisseur de force pour appliquer une force sur un point d'application sur une partie du pied d'un patient, le fournisseur de force comprenant une cellule de charge pour détecter l'amplitude de la force ; et un dispositif de capteur comprenant un certain nombre de fibres à réseau de Bragg à fixer au pied du patient en alignement avec un nombre correspondant d'orteils, un mouvement de la partie du pied du patient suite à l'application de la force entraînant une élévation de contrainte axiale dans les fibres à réseau de Bragg pour déterminer l'étendue de la mobilité de la partie du pied du patient suite à l'application de la force. De préférence, les fibres à réseau de Bragg sont intégrées dans un polymère élastique qui peut être disposé dans une chaussette à porter sur le pied.
PCT/SG2017/050189 2016-04-01 2017-04-03 Système de diagnostic de santé d'articulation de pied WO2017171660A1 (fr)

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Cited By (6)

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CN108852361A (zh) * 2018-03-23 2018-11-23 狮丹努集团股份有限公司 基于fbg传感技术的人体姿态监测方法和服装
US11024195B2 (en) 2018-04-10 2021-06-01 Imam Abdulrahman Bin Faisal University Diagnostic and therapeutic system for manual therapy
WO2021188693A1 (fr) * 2020-03-17 2021-09-23 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery Structure de pied et dispositif d'évaluation de fonction et procédés d'utilisation associés
CN114767090A (zh) * 2022-03-09 2022-07-22 上海工程技术大学 一种可穿戴光纤传感袖套及其手腕扭转运动识别方法
EP4272640A1 (fr) * 2022-05-06 2023-11-08 Haute Ecole du Paysage, d'Ingénierie et d'Architecture de Genève (Hépia) Évaluation de la mobilité relative de l'avant-pied
WO2024077956A1 (fr) * 2022-10-14 2024-04-18 复旦大学 Dispositif de mesure multidimensionnelle in-vivo de la contrainte et de la déformation de tissus mous plantaires

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108852361A (zh) * 2018-03-23 2018-11-23 狮丹努集团股份有限公司 基于fbg传感技术的人体姿态监测方法和服装
US11024195B2 (en) 2018-04-10 2021-06-01 Imam Abdulrahman Bin Faisal University Diagnostic and therapeutic system for manual therapy
WO2021188693A1 (fr) * 2020-03-17 2021-09-23 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery Structure de pied et dispositif d'évaluation de fonction et procédés d'utilisation associés
CN114767090A (zh) * 2022-03-09 2022-07-22 上海工程技术大学 一种可穿戴光纤传感袖套及其手腕扭转运动识别方法
EP4272640A1 (fr) * 2022-05-06 2023-11-08 Haute Ecole du Paysage, d'Ingénierie et d'Architecture de Genève (Hépia) Évaluation de la mobilité relative de l'avant-pied
WO2023214061A1 (fr) 2022-05-06 2023-11-09 Haute Ecole Du Paysage, D'ingénierie Et D'architecture De Genève (Hépia) Évaluation de la mobilité relative de l'avant-pied
WO2024077956A1 (fr) * 2022-10-14 2024-04-18 复旦大学 Dispositif de mesure multidimensionnelle in-vivo de la contrainte et de la déformation de tissus mous plantaires

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