Axis

AXIS James Higson JAHigson@icloud.com

PROBLEM SPACE AND RATIONALE FRAMING THE PROBLEM When recovering from surgery or an injury, it can take a long time for muscles to regenerate and heal. Patients not performing exercises correctly and giving up on physiotherapy prolong this and this can possibly lead to a chronic illness. This is an unnecessary waste of, a physiotherapist’s valuable time and the patient’s time and suffering.

THE DESIGN BRIEF

Surgery cannot achieve total TISSUE REGENERATION

“Improving the recovery process through compliance to progressive exercise therapy” Increasing number of ROBOTIC DEVICES used in physiotherapy PROGRESSIVE THERAPY provides significant improvements in function Physiotherapy improves patients QUALITY of LIFE

UNIVERSITY OF LEEDS 33 PRODUCT DESIGN

PROBLEM SPACE AND RATIONALE

Shoulder pain leads to a higher absence from WORK

James Higson

Design and develop a device or system that will help speed up recovery for a patient who has had an operation or injury with soft tissue shoulder damage. The device will promote muscle regeneration, improve flexibility and reach for the patient. The device should give visual cues the help complete physio recommended exercises and provide feedback to the patient. It must provide the user with confidence to complete prescribed exercises and give feedback about how well they are doing. The device will be sold through multiple outlets to physiotherapists in the UK and eventually internationally.

PROBLEM & CHALLENGE ANALYSIS

45 % HER INJURIES OT

c

%

32 MILLION b muscoloskeletal injuries each year a

S

D E R TE N D O N UL S HO

THE FACTS The shoulder is one of the most sophisticated and complicated joints in the body. It has the greatest range of motion of any joint in the body with complete global movement allowing you to position the hand anywhere in space.

• The coordinated activity of numerous muscles working together in set patterns is required to produce this motion.

• It is made up of FOUR joints and FIVE linked bone groups which are related and work together.

• To allow so much movement the joints need to be ‘free’ to move, therefore the shoulder should be ‘unstable’ compared to other joints of the body.

• However a series of complex ligaments and muscle keep it in joint.

55

DISCOVERY PHASE

DISCOVERY PHASE

James Higson

(N/A. Shoulder Anatomy)

“Shoulder pain has a 1 in 3 lifetime prevalence”

“Sufferers are effected by restless sleep and difficulty getting dressed”

UNIVERSITY OF LEEDS 34 PRODUCT DESIGN

MARKET & COMPETITOR ANALYSIS Worldwide there are more than 300,000 physiotherapists. In the UK there are 49,573 registered physiotherapists. In the US there were 198,600 physiotherapists in 2010 with “39% growth in employment projected by the year 2020” “Major factors fueling growth of this market are, a rapidly aging population, increasing inclination towards active lifestyles, and government support in the form of incentives”

“Physiotherapy cost the NHS £335,046,852 in 2014”

(Physiotherapy Equipment Market: Global Forecast to 2019)

Currently the physiotherapy device market only contains expensive monitoring equipment such as isokinetic machines. There is a clear opportunity to exploit a less expensive alternative.

I calculated that the total number of people receiving shoulder treatment in the UK in 2014 is approximately 3.5 million.

8% Private - 4,000

Other nations ~ 50,000

AMERICA ~ 200,000

Number of registered physiotherapists Worldwide

James Higson

“The physiotherapy equipment market will be worth $20 billion by 2020”

UK 49,573

REDUCE COST

PROVIDE FEEDBACK

c SHOULDER PROTECTION

b 92% a NHS - 46,000

DECREASE RECOVERY TIME

Number of registered physiotherapists in UK UNIVERSITY OF LEEDS 35 PRODUCT DESIGN

DISCOVERY PHASE

ENCOURAGE USERS COMPLIANCE

USER INSIGHT

USER INSIGHT

PRIMARY RESEARCH WITH USERS USER MONITORING TECHNIQUES I looked at several pieces of technology in order to monitor movement of the shoulder and its muscles. This will then hopefully encourage compliance by setting achievable goals. The technology I’ve investigated includes: Electromyography Accelerometers Flexibility sensors

James Higson

Strain gauges I conducted two formal focus groups and multiple informal ones. These included discussing potential problems that I might come across down the line, product function and purpose. One prominent point raised was the need to have disposable arm bands for maintaining patient hygiene. I also conducted user tests frequently and I broke these down into four areas: • Testing of prototypes • Device attachment methods • Arm band materials and perceived value • Finally device shape

UNIVERSITY OF LEEDS 36 PRODUCT DESIGN

DESIGN PHASE

PROTOTYPING PROCESS

ACCELEROMETER This is the most promising device as it is easy to wear. The device would provide feedback and monitor the patients activity through an accelerometer

COST ~ £60+

COST ~ £50

SIZE ++

SIZE +

FEEDBACK - INTERMEDIATE

FEEDBACK - ADVANCED ACCELEROMETER - USER ASSESSMENT • Too Tight • Include an adjustable strap.

• Put a fabric backing on the plastic so it’s softer on the skin.

• Good quality and feel

PROTECTIVE This device contains a non-utonian material to protect the user during the early stages of recovery COST ~ £30

FEEDBACK - NONE

COMFORT

70%

SKIN-IRRITATION

50%

FIT

61%

QUALITY

83%

WARMTH

UNIVERSITY OF LEEDS 37 PRODUCT DESIGN

DESIGN PHASE

SIZE ++

61%

James Higson

FLEXIBILITY SENSOR The flexibility sensor has proven to be extremely accurate at monitoring the shoulders elevation. However it would require multiple sensors as they only work in one plane

DESIGN PHASE James Higson

PROTOTYPING I used my prototypes above to test functionality during focus groups. This helped to generate constructive feedback about the design direction.

SYSTEM The device interfaces with either a computer or a TV screen through the base station, if they have a HDMI port. Right we can see the user performing the exercise in front of the screen.

The screen is now displaying a line for the user to reach also the target angle in red and the current angle in white. Once the exercise is complete the device vibrates and will light up green. The green LEDs can be seen lit up in the image to the right.

UNIVERSITY OF LEEDS 38 PRODUCT DESIGN

SOLUTION SPACE Torx Screw

10mm magnet

PRODUCT COSTS Each device costs ÂŁ37.64 in direct costs from the Bill Of Materials and packaging including delivery packaging.

AAA Battery Green LEDs ADXL 335 XbeeS1

3mm

Blue Power switch Hole for LEDS

INFERRED COSTS Other costs included in bringing Axis to market include the indirect costs. The largest of these are the wages for 4 employees their bonuses and pensions, Rent, IP setup and insurance, Advertising, Business insurance. Details of which can all be seen in the financial profit and loss spread sheet.

SOLUTION SPACE

UNIVERSITY OF LEEDS 39 PRODUCT DESIGN

James Higson

COMPONENTS Axis uses an accelerometer (ADXL 335) to measure its position relative to gravity. Using a wireless transmitter (XBee S1) the data is transferred from the armband device to a receiver in its base station. The base stations software transfers this data into an animated figure whose position mimics the patients. This is then output to a display through a HDMI cable.

SOLUTION SPACE James Higson

REQUIREMENT WEIGHT TEST METHOD

EVIDENCE

Easily attached to shoulder/arm

5

User group score

After working with a user group the attachment method was rated as highly successful

Inspire confidence to complete exercises

5

Speak with my primary user.

Portray the idea with the use of a final working prototype.

Qualitative feedback.

The device is highly interesting, however only with actually usage of a real product and software would it be fairly judgeable.

Competitively priced

3

Question my physiotherapists on perceived value of the device. Then compare to my RRP of ÂŁ226.

The device was under valued in comparison to the selling price on both accounts but by no more than ÂŁ80. I consider this to be relatively successful.

Demonstrate value to the physiotherapist

3

Test device with physiotherapists, to assess if the device would be practical and useful.

Qualitative feedback is positive. Imagining the data received from the device. Both physiotherapists expect the device would be successful if priced correctly.

Give feedback to the physiotherapist

2

Test device with physiotherapists about levels of feedback provided

Qualitative feedback is positive/ negative

Promote muscle regeneration through technology

2

Does the device encourage compliance to a progressive physiotherapy program? YES/NO

Yes the device uses targets and goals for the patients to achieve, encouraging them to complete their physiotherapy exercises.

EVALUATION

The device meets the requirements with the highest weightings successfully. This suggests the design would be successful at achieving improvements in shoulder rehabilitation. However there are areas for further development in the lower weighted requirements UNIVERSITY OF LEEDS 40 PRODUCT DESIGN

FINAL SCORE