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Design Alternatives. Patient Positioning Aid E. Vargas, E. Kordeih, M. Britan December 2, 2005. Outline. Brief Background Patient Specifications MRI Machine Dimensions Applications Design Alternatives Our Design Decision Future Direction References / Acknowledgements.

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design alternatives

Design Alternatives

Patient Positioning Aid

E. Vargas, E. Kordeih, M. Britan

December 2, 2005

outline
Outline
  • Brief Background
    • Patient Specifications
    • MRI Machine
      • Dimensions
      • Applications
  • Design Alternatives
  • Our Design Decision
  • Future Direction
  • References / Acknowledgements
patient specifications
Patient Specifications
  • Bruce
    • Renal failure, manual wheelchair
  • Joan
    • Heart failure, old, weak, hard of hearing
  • Lloyd
    • Type II Diabetes, overweight
  • Sophia
    • On heparin, limited right arm function, uses a cane
  • Arnold
    • Parkinson’s, Diabetes, suffers from slight to moderate tremors
  • Dave
    • Limited use to right arm and leg, may use a scooter.
imaging mri machine
Imaging: MRI Machine
  • Phillips Achieva 3.0T
    • Sets the standard in comfort and image quality
    • Provides strength through partnership with other coil manufacturers
    • Complements SENSE™ functionality for super-fast imaging and exceptional resolution
  • Dimensions:
    • Bed: 8’ L x 4’ W x 2” H
    • Current pad: 2” thick (all around)
    • Contour: 1.5” dip in center in ‘bed-frame’
design alternatives1
Design Alternatives
  • #1 - Bead filled mattress (original idea)
  • #2 - Star / ROHO Cushion
  • #3 – Otto Bach Cloud
  • #4 – Varilite ‘Pro-Form’ Concept
design alternative 1
Design Alternative #1

Protocol for Bead Filled Mattress:

  • Initially filled with air
  • Patient lays down
  • Beads contour body
  • Deflation occurs
  • Contour stays as a solid entity
  • Clinician allows air back into the system
  • Ready for the next patient
bead filled mattress
Bead Filled Mattress
  • What kind of beads?
    • (material, size)
  • Covering?
    • (Softness, elongation, tension, strength)
  • Encapsulation?
    • (Grid blocking the inlet/out let of air)
purpose of beads
Purpose of beads
  • Vibrations damper
    • Dissipate excess energy
    • Rapid response
  • Provide rigid support
    • High surface friction
    • High resilience characteristics
purpose of covering
Purpose of Covering
  • Create tension
    • Squeeze beads together
    • High surface friction
  • Provide system/patient barrier
    • Externally pleasant to touch
    • Impermeable to fluids
cover
Cover
  • Naugahyde
  • Darlex
  • Knit
    • Water resistant
    • Impermeable to air
  • Polar Fleece
  • Rubatex – ‘Scuba Gear’
  • Vinyl
    • Assortment of Colors
encapsulation
Encapsulation
  • Purpose
    • Prevent the beads from entering the tubes
  • Cylindrical cap at end of the inlet/out tube
    • High surface area
    • Plastic or strong polymer
pros and cons
Pros and Cons
  • Pros:
    • Not extremely expensive.
    • Imaging compatible.
    • Retains shape and fixed positioning of any patient.
    • Can absorb minimal amount of unavoidable movement
  • Cons:
    • Encapsulation of beads
    • Method of suction
    • Long tubing
    • Extra stress on frightened patients
design alternative 2
Design Alternative #2
  • Star / ROHO Cushion Concept

Synthesis of Floatation Technology (SOFT)

    • Robert H. Graebe, the inventor of the ROHO cushions
    • Uses the principle of Flotation
      • Archimedes' Principle
        • The surface forces it to behave the way seawater envelops and supports a sea mammal
    • Floatation is designed on the concept that blood flow is primarily compromised as a function of deformation of the vascular bed. In total immersion, i.e., scuba divers.
principles of floatation
Principles of Floatation
  • F    =    hdg . A            [where A = base area]      =    (Ah). d . g      =    V . d . g            [where V is the immersed volume]      =    m/g[where m' is the mass of the displaced liquid]
  • The upthrust is thus the weight of the displaced liquid..
  • Archimedes' Principle states that any body partly or wholly immersed in a liquid experiences an upthrust which is equal to the weight of the liquid displaced.

Let volume of body = VBLet volume of displaced liquid = VLLet density of body = rhoBLet density of liquid = rhoL – in our case air

stability of floatation
Stability of Floatation

Buoyant force acts on the object at the center of gravity of displaced liquid

technology explained cont d
Technology Explained (cont’d)

Features and benefits

material properties
Material Properties
  • Neoprene Rubber

Physical Properties

NEOPRENE is a synthetic rubber material designed to act flexibly, durably, and to resist breakdown by water. It is form fitting and resilient. Because air and water become isolated in its unique molecular structure, Neoprene is temperately stable. The many uses of Neoprene include: wet suits, waders, insulated can holders, sports gloves, mouse pads, pet collars, elbow and knee pads, orthopedic braces, tack gear.

pros and cons1
Pros and Cons
  • Cons
    • Leakage
    • Needs proper inflation
  • Pros
    • Easy of use
    • Uses Air instead of water
    • Custom contour all times
      • Normal body or abnormal body shape
    • Equal pressure throughout the contact area
    • No power pump need
    • Allows blood flow
prices of neoprene rubber
Prices of Neoprene Rubber

Full Neoprene Sheets (51" x 83")

design alternative 3
Design Alternative #3

Otto Bock – The Cloud

  • The design / concept
the cloud
The Cloud
  • Benefits:
    • Produces clinically acceptable levels of pressure distribution.
    • Eliminates the risk of bottoming out and the potential for catastrophic failures due to punctures or leak.
    • Easy to use. No need to frequently check air fill levels or fluid position.
    • Easily modifies to individual's requirements for a customized fit.
    • Highly stable.
disadvantages the cloud
Disadvantages – The CLOUD
  • Self corrects to automatically and quickly adjust to the dynamic conditions
    • Thus, does not have fixed posture positioning.
  • Requires a knowledgeable technician, clinician, and/or therapist.
design alternative 4
Design Alternative #4

Varilite ProForm NX

  • An easy-to-customize, off-the-shelf product.
  • Original concept: Seating Cushion
  • Expand it to a larger size: mattress
air foam flotation cushion
Air-Foam Flotation Cushion
  • Designed for pelvic obliquities and other asymmetrical conditions.
  • Air-Foam Flotation cushion contains two self-inlfating, independently-adjustable chambers (patent pending).
  • Adjustments are made using two-way air valves that release air to immerse the user in the foam.
  • The foam contours to the user and the user’s weight is distributed over the surface of the cushion.
  • ProForm NX is also available in a single chamber configuration.
anaylsis proform nx
Pros

Fixed posture

Comfortable

Easy-to-use

Patient specific

No pump necessary

Inexpensive

MRI Safe

Cons

For efficient positioning may require 6-10 air valves.

Anaylsis – ProForm NX
which one is best
Which One is Best?
  • RERC 2005-2006
    • Aim:Versatile, low-cost, easy-to-adjust patient positioning aid that works with a range of examination table…and meets the customer needs.
which one is best1
Which One is Best?

Customer Needs

  • Bruce
    • Renal failure, manual wheelchair
  • Joan
    • Heart failure, old, weak, hard of hearing
  • Lloyd
    • Type II Diabetes, overweight
  • Sophia
    • On heparin, limited right arm function, uses a cane
  • Arnold
    • Parkinson’s, Diabetes, suffers from slight to moderate tremors
  • Dave
    • Limited use to right arm and leg, may use a scooter.
our decision proformnx
Our Decision: ProFormNX
  • Integrates both air and foam.
  • Requires no true expertise in air quantity.
  • Will never bottom out
  • Durable (up to 5 years)

Meets our RERC 2005-2006 aim!!!

our design envisioned
Contoured platform

Eliminate contour via a solid wedge.

Mattress topper will lay flat.

Thus can go on most, if not all imaging tables.

Abide by the conditions set by the MRI machine

Our Design - Envisioned
future direction
Future Direction
  • Decisions must be made:
    • Foam
    • Coverings
    • Type of air valves
    • Sizes of wedges using the same technology.
references
References
  • www.varilite.com
  • www.ottobockus.com
  • www.plus2physics.com
  • www.roho.com
  • www.starcushion.com
  • www.systam.com
  • www.columbianchemicals.com
  • JPO – Journal of Prosthetics and Orthotics
  • Medical Design New – Sept/Oct 2001
  • Vibrating powder beds: a comparison of experimental and DistinctElement Method simulated data. A.J. Matchett. Powder Technology, 1999.
  • Efficient Computation of Particle Motions in Discrete Element Modelingof Particle Damping, Michael Yu Wang.
acknowledgements
Acknowledgements
  • Dr. Strey – our advisor
  • Dr. Wagshul – Radiology Department
  • Rabson Rehab Sales
    • David Rabbiner
    • Tom Sonntag
  • BioDynamics Ltd
    • Raul Vargas
thank you
Thank You.

Any questions?