Overall, I have enjoyed my experience with the program so far. I find that this project is very challenging, but I am thankful for the experience because it is pushing me to be out of my comfort zone and think like an engineer. The campus is very nice and Menomonie is a cute little town. It is a little small for my liking, but I think I can easily call this place my home away from home for the next six weeks. For my project, I am working on developing an assistive robot that will help reduce tremors and allow someone with tremors insert a catheter more comfortably in their own home.
A tremor is defined as an unintentional, rhythmic muscle movement involving to-and-fro movements of one or more parts of the body and most of these movements are involuntary and affect the hands, arms, head, face, voice, trunk and legs. [i] Tremors are not only a result of aging, but can also be present in those who have multiple sclerosis, suffered from a stroke or traumatic brain injury, or have neurodegenerative diseases that damages or destroys parts of the brainstem or cerebellum. Though tremors cannot be completely cured, this disability is treated using drug therapy, physical therapy, or with surgery. The form of treatment depends on the type of tremor present in the patient. However, 1) about 25% of the patients treated cannot manage their tremors effectively, 2) the drugs offered have side effects that could present health risks to the user, 3) surgery presents a risk in itself and may cause hemorrhaging and could leave the patient with psychiatric issues. [ii] As a result, many who suffer from tremors still have to live and cope with them daily even with the current treatment options provided.
The most common tremor is an essential tremor (ET). Hands are most commonly affected in patients who suffer from ET.[iii] ET is an action tremor[iv] meaning the tremor is most present when an action is being done. These actions include basic daily living actions such as eating, writing, and brushing teeth. These tremors also occur when the limb is outstretched away from the body. The severity of the tremor can vary and the tremor can increase depending on the type of activity being performed and how much stress the person is under while performing the activity. It is estimated that ET affects up to 10 million people in the US alone and affects men and women equally.[v]
Urinary catheters are defined as a thin, flexible rubber tube placed in your body to drain urine from your bladder. [vi] The catheter is inserted through the urethra to reach the bladder, and the urine is expelled either into a bag or into a toilet. In aging patients, catheters may be used if the patient is bed confined and is too weak to make it to the bathroom. For those affected by spina bifida, cerebral palsy, or multiple sclerosis, the muscles needed to contract to release the bladder cannot be controlled and a catheter must be used.
As seen, those who suffer from tremors may be faced with the need to insert a catheter, such as elderly people or people who have multiple sclerosis. Catheter insertion can cause stress to the patient and could cause an ET to worsen as the affect person attempts the insertion. Thus, tremors can make the insertion of a catheter difficult or painful. Currently, there is no solution to steady the hand of someone who suffers from tremors to aid them in inserting a catheter. Ideas have been proposed to reduce the effect of tremors in patients. Most ideas proposed offer an exoskeleton solution in which the user has a wearable device that would counteract the tremor motion. However, the exoskeletons can be bulky and would inhibit catheter insertions and often focus on upper limb control rather than hand control. Sleeve like or glove like designs have been proposed where electrodes are sewn into the material and monitor and respond to the tremor, however, these cloth like materials cannot be cleaned easily and could result in the spread of bacteria and infection if used when inserting a catheter.
I have formulated two ideas to help alleviate the need to assist those who have tremor when a catheter is inserted independently. The first design is an exoskeleton design for the hand in which an exoskeleton would attach to the hand in a glove like design and counteract the motion of the tremor by either providing damping or an equal and opposite reaction. The second proposed idea is a device that the patient holds in their hand. On the end of the tool is a set of tongs or tweezers. The device in hand would sense the tremor and counteract the motion by moving tweezers in and equal and opposite direction. A button would be used to clamp the tweezers onto the catheter tube and then the patient could guide the catheter accordingly. Either designed is hoped to help both men and woman, would be constructed of a material that can easily be cleaned and sanitized, and uses sensors and actuators to counteract the vibrational motion of the tremor.
For my next steps, I hope to look further into motion sensors and determine which is best for tremors. Based on which sensors are best, I can then decide which design is best for this problem. From there I hope to build and test my design, and hopefully test my design on patients who suffer from tremors to see if the device can actively cancel the motion.