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CHAPTER 1
INTRODUCTION
1.1
INTRODUCTION
In medicine, a coma [1] is a state of unconsciousness lasting more than six hours,
in which a person cannot be awakened; fails to respond normally to painful stimuli, light,
or sound; lacks a normal sleep-wake cycle and does not initiate voluntary actions. A
person in a state of coma is described as being comatose.
For a patient to maintain consciousness, two important neurological components
must function. The first is the cerebral cortexthe grey matter that covers the outer layer
of the brain. The other is a structure located in the brainstem, called reticular activating
system (RAS). Injury to either or both of these components is sufficient to cause a patient
to experience a coma.
Traumatic brain injury [2] can cause a variety of complications, health effects that
are not TBI themselves but that result from it. The risk of complications increases with
the severity of the trauma; however even mild traumatic brain injury can result in
disabilities that interfere with social interactions, employment, and everyday living.
Coma may result from a variety of conditions like
1. Intoxication (such as drug abuse, overdose or misuse of over the counter
medications, prescribed medication, or controlled substances).
2. Metabolic abnormalities
3. Central nervous system diseases
4. Strokes , Head trauma caused by vehicle injuries
5. Deliberately induced by pharmaceutical agents during major neurosurgery, to
preserve higher brain functions following brain trauma, or to save the patient from
extreme pain during healing of injuries or diseases.
6.
may
cause
emotional
or
personality. Emotional
symptoms
that
behavioural
can
problems
follow
TBI
and
include
changes
in
emotional
instability, depression, anxiety, hypomania, mania, apathy, irritability, and anger. TBI
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memory loss
communication problems
sensory deficits
During coma a patient may suffer from pressure sores, pneumonia, progressive
multiple organ failure, muscular degradation and reduced rate of blood flow.
1.2 MOTIVATION
At the present different medications are used to decrease brain swelling, treat
infections, and prevent seizures. If a persons intracranial pressure is very high or difficult
to control, medication may be used to put the person into a medication induced coma to
prevent more swelling.
Some preventive rehabilitation may be initiated in the Intensive Care Unit such as
body positioning, splinting, and range of motion (a therapist moves the persons body
limbs). Sometimes surgery may be necessary to remove blood clots and pressure.
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1.5 CONTRIBUTIONS
This project aims to concentrate on the comatose and the bedridden patients. It
provides a solution to two major problems that are
Muscular degeneration
It keeps the muscles active by externally exercising the calf muscles and also aids
for the venous shoot of the blood back to the heart. When used in physiotherapy, it
provides energy to weakened muscles thus helping in rehabilitation of the patient. This
device along with the feature of web control provides an immense contribution in the
medical field with a major advantage being that the cost is less than 150 USD.
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CHAPTER 2
LITERATURE SURVEY
2.1 RELATED WORKS
This section gives an overview about the works that run in parallel with the
proposed work. Each of these below mentioned works have different strategies but are not
designed for the coma patients or the bed ridden. The advantages and drawbacks are also
mentioned below. The new devise called cybernetic assistive leg exoskeleton is built
keeping in mind the drawbacks of the related work.
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LOPES provide unhindered walking in the device and that any torques/forces
needed to impose a gait pattern can be achieved. Also, limb orientations of the robot and
the walking subject agree well, sufficient for stable implementation of training and lower
level control.
The BLEEX method does not concentrate on any kind of patients and the LOPES
concentrate on the patients recovered from the bed ridden state. The hardware required
invisibly very large and the cost of implementation is very high.
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CHAPTER 3
The inputs to the control unit are the angle at which the foot should move and also
the number of times it should move. The angle input is converted to appropriate pulse
width to get the required angle movement of the foot board while the number of iterations
are directly mapped to the number of times the foot board should move .The resulting
PWM signal from the module is given to the servo motor through the buffer circuit. The
servo when powered using a power module or an adapter providing the necessary current
requirement moves at the angle provided by the user.
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512 MB RAM
It provides 2 USB ports via the built in integrated 3-port USB hub
10/100 Mbits/s Ethernet USB adapter on third port of the USB hub
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in the iPhone 3G and the Kindle 2, so the capabilities of the Raspberry Pi as comparable
to those powerful little devices. This chip is a 32 bit, 700 MHz System on a Chip, which
is built on the ARM11 [7] architecture. ARM chips come in a variety of architectures
with different cores configured to provide different capabilities at different price points.
The Model B has 512MB of RAM and the Model A has 256 MB. (The first batch of
Model Bs had only 256MB of RAM.). The Secure Digital (SD) Card slot is used in Pi
and has no hard drive; everything is stored on an SD Card. There is a need for some sort
of protective case since the solder joints on the SD socket may fail if the SD card is
accidentally bent. On the Model B there are two USB 2.0 ports, but only one on the
Model A. Some of the early Raspberry Pi boards were limited in the amount of current
that they could provide. Some USB devices can draw up 500mA.
The original Pi board supported 100mA or so, but the newer revisions are up to
the full USB 2.0 specifications. The model B has a standard RJ45 Ethernet port. The
Model A does not, but can be connected to a wired network by a USB Ethernet adapter
(the port on the Model B is actually an on board USB to Ethernet adapter). WiFi
connectivity via a USB dongle is another option. The HDMI port provides digital video
and audio output.14 different video resolutions are supported, and the HDMI signal can
be converted to DVI (used by many monitors), composite (analog video signal usually
carried over a yellow RCA connector), or SCART (a European standard for connecting
audio-visual equipment) with external adapters.
Status LEDs: The Pi has five indicator LEDs that provide visual feedback.
Table 3.1 Status LEDs of RPi
ACT
Green
PWR
Red
Hooked up to 3.3V
FDX
Green
LNX
Green
100
Yellow
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When we need to control a servo motor with hard real-time response requirements
then we need to use the Hardware PWM. Even then, there may be problems ensuring a
real-time response for the servo loop which ties encoder input to PWM output. A
stable servo loop needs to read encoders at a regular rate (low jitter), write out revised
PWM output values at a regular rate and the latency between these should be fixed (low
jitter overall) or you will have to under-tune your motor to prevent it becoming unstable
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INPUT
INPUT/OUTPUT
OE
DIR
An
Bn
A=B
Input
Input
B=A
3.4 ACTUATOR
The actuator part is the mechanical designed part of the project. It helps mimic the
natural action of the foot and keeps the muscles alive. The design is based on the Scotch
Yoke mechanism.
Weight: 51g
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Voltage: 4.8v~6v
Plug: JR style
Features:
Metal Gears
Dual Ball-race
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3.5.1. FEATURES
Output Current up to 1A
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CHAPTER 4
4.1 NOOBS
NOOBS stands for New out of the Box Software installer which is an image file
you have to download and copy onto the newly formatted 8 GB SD card. This software
helps to start the Raspberry Pi and gives you list of operating systems to choose from
during installation. This also contains several other software packages which help in the
functioning of the Raspberry Pi.
4.2 RASPBIAN
Raspbian is a Debian-based free operating system optimized for the Raspberry Pi
hardware. Debian uses the Linux kernel (the kernel is the core of an OS) and contains a
wide range of application software and some pre-compiled software bundles.
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content
from
document
presentation,
including
elements
such
as
the layout, colours, and fonts. This separation can improve content accessibility, provide
more flexibility and control in the specification of presentation characteristics, enable
multiple pages to share formatting, and reduce complexity and repetition in the structural
content.
4.4 PYTHON
Python is a widely used general-purpose, high-level programming language. The
language provides constructs intended to enable clear programs on both a small and large
scale.
Python
supports
multiple programming
paradigms,
including object-
features a dynamic type system and automatic memory management and has a large and
comprehensive standard library Like other dynamic languages, Python is often used as
a scripting language.
best-known
application
of
the
protocol
is
for
access
to shell
accounts on Unix-like operating systems, but it can also be used in a similar fashion for
accounts
on
Windows.
It
was
designed
as
replacement
other insecure remote shell protocols such as the Berkeley rsh and rexec protocols, which
send information, notably passwords, in plaintext, rendering them susceptible to
interception and disclosure using packet analysis. The encryption used by SSH is
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4.5.1 NETSCANNER
It helps in Network scanning which is a procedure for identifying active hosts on a
network. Scanning procedures, such as ping sweeps and port scans, return information
about which IP addresses map to live hosts that are active on the Internet.
Desktop
Protocol (RDP)
is
a proprietary
protocol developed
4.6 Bonjour
Bonjour is Apple's implementation of Zero-configuration networking (Zeroconf),
a
group
of
technologies
that
includes service
discovery, address
assignment,
and hostname resolution. Bonjour locates devices such as printers, other computers, and
the services that those devices offer on a local network using multicast Domain Name
System (mDNS) service records.
Bonjour provides a general method to discover services on a local area network.
The software is widely used throughout OS X, and allows users to set up a network
without any configuration. As of 2010 it is used to find printers and file-sharing servers.
iTunes uses Bonjour to find shared music, iPhoto to find shared photos, iChat,
Adobe Creative
Suite
Vine
Server,
and Elgato EyeTV to share local recordings with multiple clients, the Gizmo5 to find
other users on the local network, TiVo Desktop to find digital video recorders and sharedmedia libraries, SubEthaEdit and e to find document collaborators, Contactizer to find
and share contacts, tasks, and events information, and Things & OmniFocus to
synchronize projects and tasks across the Mac desktop and the iPad, iPhone or iPod
touch. It is used by Safari to find local web servers and configuration pages for local
devices, and by Asterisk to advertise telephone services along with configuration
parameters to VoIP phones and dialers. Software such as Bonjour Browser or iStumbler,
both for Mac OS X, or Zeroconf Neighbourhood Explorer for Windows, can be used to
view all services declared by these applications. Apple's "1Remote" application for
iPhone and iPod Touch also uses Bonjour to establish connection to iTunes libraries via
Wi-Fi.
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Zeroconf,
including Adobe
Systems Creative
Suite
3,
iTunes,
Cerulean
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CHAPTER 5
The total angular motion of the feet must be in the range of 40 to 50 degrees.
The foot should only have one degree of freedom for its motion.
Durability.
The torque while pushing or pulling the foot must not exceed the permissible
limit.
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-------- Eq 5.1
We can calculate the crank length. On calculating the term r (length of the foot
from malleolus joint and the tip of the foot) of many individuals, it is found that the
average value is around 14cm. The angle is to be in the range of 40o to 50o as
specified by the doctor. We have chosen a total angle movement of 45o. In radians, 45o is
equal to 0.785rad. Having these values,
S= (14cm) x (0.785)
= 10.99cm (11cm approximately)
Hence, S should be of 11cm to provide a total angular motion of 45 o. While
calculating for the term r, the length of the foot from malleolus to the tip is considered.
The malleolus joint is made the origin as the ankle rotates over that joint and the tip of the
foot is considered as the force required in moving the foot (i.e. push and pull) is less as
the distance increases, from the equation
T=F X L
---------- Eq 5.2
Fig 5.2 Scotch yoke side view: 1- clamp, 2- crank, 3 - pin, 4 - shaft and 5 - slider
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25
2.3
0.6
20
1.9
0.95
15
1.75
1.125
10
1.65
1.25
1.55
1.35
It is observed that for every 1.2cm displacement, 5o movement of the foot plate is
obtained. The offset point is 0.6cm away from the centre of the disc. The displacements
considered are taken from this point only. 1.2cm displacement in both the directions
together gives 10o motion, which is labelled as 5o representing that it moves 5o in one
direction. The corresponding pulse width is as mentioned in the table.
The angle of the motor is decided by taking the inverse cosine function on the
linear displacement and the radius of the disc which acts as hypotenuse when a triangle is
drawn using the linear displacement, radius of the disc and the altitude of the point under
consideration as the sides. Based on the angle obtained, pulse width to be sent is decided.
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Light weight
Corrosion resistance
Ductility
In addition to these, it is harmless to the skin even though it is kept in contact for a long
time.
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Use short and concise phrases (come to the point as quickly as possible),
Use simplified layout (categorize the content, use multiple heading levels, use visual
elements and bulleted lists which break the flow of uniform text blocks), Such that
any new user can also quickly understand and access the webpage without difficulty.
To setup the Raspberry Pi as a server, we need to setup bonjour services and then
configure the board to host the webpage by accessing the pico.conf file. There are two
ways of performing the next step, you can either install an apache based framework or
use various web framework platforms for python such as flask, pylon, django and
cherrypy. We have used the Flask framework as it provides easier accessibility, and can
connect the HTML frontend with the python script in the backend.
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CHAPTER 6
The patient is in the Intensive care unit and the status of the patient is known and
updated to the doctor.
The nurse can strap on the exoskeleton and power-on the system without any
technical know-how.
After the conclusion of the iterations, the doctor may or may not instruct the nurse
to remove the exoskeleton after the operation.
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6.4
of control in the main program when the system is accessed through the web interface are
as follows:
Step 1: Initialize and call various python and Raspberry Pi libraries such as RPi.
GPIO, Wiring Pi, Time and sys.
Step 2: Initialize GPIO pins and various modules associated with it. Configure the
board programmatically to follow a particular pin configuration for the Raspberry
Pi i.e. BCM mode or BOARD mode.
Step 3: Run the host webpage function. It is the empty webpage setup by the host.
It has a static local address when accessed through LAN but if accessed through
WAN, every time the Raspberry Pi is booted, it is assigned a dynamic IP address
thats linked to the static local address.
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The various steps and the flow of control when the Homepage is called
Step 1: As soon as the Homepage is called, it loads the source code. This acts as
the primary user interface. The doctor is asked to input various parameters.
Step 2: The parameters such as the angular control range and the number of
iterations for the action are taken as input. These inputs are passed on to the
python script.
Step 3: Returns control to the main program.
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6.5 RESULTS
The major objective of this chapter is to verify the design of the exoskeleton and
examine the results produced by it. It is important to note that the following results
represent that the concept and design is working. Various screen shots of the web
interface and images of the different positions of the footplate are presented. Actual
implementation of the exoskeleton on the comatose requires testing and approval by
various medical bodies and the Government of India. It involves various procedures and
license grants which we are yet to obtain. But, rest assured, the concept and the study of
the effects on the human body and muscles show great promise that the main objective is
achievable, as soon as permission for testing on the target demographic is granted. The
following sets of images i.e. Figures 6.6 6.10 represent the web interface and the
various stages during input, operation and end of operation and Figure 6.11 shows the
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CHAPTER 7
CONCLUSIONS AND FUTURE WORK
This new idea of bringing out an electromechanical assistive structure helps solve
the medical field problems in a simpler way. The results obtained by this method are
consistent and efficient. The design has been successful in mimicking the natural action
of the foot externally. This method improves the blood circulation in bedridden patients
without resorting to invasive procedures and drugs which may be harmful. By exercising
the calf muscles thoroughly the exoskeleton decreases the chances of muscular atrophy
and the improvement of the rate of circulation also prevents embolism formation. The
manufacture of the prototype along with the required components is very economical and
the design is found to be applicable to variable foot sizes and patients of different ages
from 15 years old and up.
This project shows immense promise and can be further extended to new stages. A
few of the possible enhancements are discussed below:
Implementation and testing on comatose would be the first step out of many. The
next goal of the project is to provide a feedback from the leg using sensors to
communicate vital information and also know the condition of the patient. This is
the higher stage of the project and will provide an easier method to monitor the
patient regularly.
By developing and implementing the right sensors, signals can also be tapped
from nerve endings in the leg to track the body status. This can also be used to
study the human brain when a person is in coma. Hence, it can help in
understanding the human brain but this would be very difficult and require a
dedicated amount of time to be implemented.
The same concept can be further implemented on Wide Area Network by buying
domain name. This provides a greater area through which the device can be operated. The
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REFERENCES
[1] Coma and its related problems, Wikipedia,
Link: http://en.wikipedia.org/wiki/Coma
[2] Traumatic brain Injury, Wikipedia,
Link: http://en.wikipedia.org/wiki/Traumatic_brain_injury
[3] Jan F. Veneman, Rik Kruidhof ; Design and Evaluation of the LOPES Exoskeleton
Robot for Interactive Gait ;IEEE transactions on neural system and rehabilitation
engineering Sept. 2007 (Volume:15 , Issue: 3 ); Page number 379 - 386
[4] Zoss.A , H. Kazerooni, Andre chu ; On the Mechanical Design of the Berkeley
Lower Extremity Exoskeleton (BLEEX); IEEE/RSJ International conference on
Intelligent robots and systems, 2005. Page number 3465 3472. ISBN - 0-78038912-3
[5] GPIO on RPi , Google sites,
Link: https://groups.google.com/forum/#!topic/freedom-domotics/NJH9squrYAM
[6] Matt Richarson and Shawn Wallace Quick Start Guide .The Raspberry Pi Single
Board Computer source Raspberry Pi and wiki ,OReilly publications, Revised
edition 2013,ISBN-978-1-449-34421-4.
[7] Raspberry Pi ,www.raspberrypi.org/
[8] Pulse width modulation ,Wikipedia
Link: http://en.wikipedia.org/wiki/Pulse-width_modulation
[9] Scotch yoke mechanism, YouTube,
Link: https://www.youtube.com/watch?v=hsaoTo1vuY4
[10] Servo motor control ,Wikipedia,
Link: http://en.wikipedia.org/wiki/Servo_control
[11] Aluminium and its properties , Wikipedia,
Link: http://en.wikipedia.org/wiki/Aluminium
[12] 74HC245 Buffer , nxp.com,
Link: http://www.nxp.com/documents/data_sheet/74HC_HCT245.pdf
[13] S.D Doty , Python basics,
[14] Python , www.codeacademy.com
[15] HTML coding , www.stackoverflow.com
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