Engineering a Clinical Force Measuring Walker for Patients Recovering from Median Sternotomy

Background: Patients often need the use of their arms to assist with functional activities, but after median sternotomy, pushing is frequently limited to less than 4.5 kg. No method exists to objectively measure arm weight bearing in clinical settings. This project aimed to design, construct, and test a walker for patients recovering from median sternotomy to prevent excessive bone stress during ossification. Methods: First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) Walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. Results: The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. Conclusions: The innovative CFM Walker will help patients with restricted upper extremity weight bearing, especially elderly adults, recover safer and faster in the future.

RADIATION DIAGNOSTICS OF STRESS BONE RESTRUCTURING

В данной статье представлены результаты клинических проявлений и рентгенологических исследований, перестройки костной ткани. Результаты наших исследований показали, что обычная рентгенография не решает всей проблемы диагностики стрессовых переломов напряжения. Мы в данной публикации выделяем те случаи, когда обычная рентгенография не в силах решить проблему диагностики и требует использования дополнительных методов лучевой диагностики. Исследование проведено на базе ЦГКБ г. Алматы. Под нашим наблюдением находились 11 (100%) больных, у которых заподозрено наличие перестройки костей. У 6 (54.5%) больных данные рентгенологического исследования указывали, на наличие стрессовой перестройки кости у 5 (45,5%) больных признаки были сомнительными. Применение компьютерной томографии (КТ) и динамическое рентгенологическое исследование позволило установить диагноз стрессовой перегрузки костей. This article presents the results of clinical manifestations and X-ray studies of the bone remodeling. The results of our research have shown that conventional radiography does not solve the entire problem of diagnosing stress fractures of tension. In this publication, we highlight those cases when conventional radiography is unable to solve the diagnostic problem and requires the use of additional methods of radiation diagnostics. The research was carried out on the basis of the Central City Clinical Hospital of Almaty. We observed 11 (100%) patients in whom the presence of bone remodeling was suspected. In 6 (54.5%) patients, X-ray examination data indicated that the presence of stress bone remodeling in 5 (45.5%) patients were dubious. The use of computed tomography analysis (CT) and dynamic X-ray examination made it possible to establish the diagnosis of bone stress overload.

Engineering a Clinical Force Measuring Walker for Patients Recovering from Median Sternotomy

Patients often need the use of their arms to assist with functional activities, but after bone disruption, pushing is frequently limited to less than 4.5 kg. No method exists to measure arm weight bearing objectively in clinical settings. This project aimed to design, construct, and test a walker for patients who need to limit arm force to prevent excessive bone stress during post-fracture (iatrogenic or traumatic) ossification. First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. The innovative CFM Walker will help patients with restricted arm weight bearing, especially elderly adults, recover safer and faster in the future.