Design Brief Presentation

Design Brief:

CPM Machine Alternative

https://commons.wikimedia.org/wiki/File:Runners-knee_SAG.jpg

Team 5: Divya Chandula, Sydney Keer, Thomas Li, Julie Yan

BMED 2310 A01

2/15/2023

01. Problem Statement

Post-operative TKA patients need a self-use, active-motion device to recover the full range of motion and function of their knee.

03. Interview: Primary User

Primary User: Patient

• 67 years of age
• Female
• TKA and CPM prescribed: November 2021

User Needs

• Assembled and operated by user independently
• Maintain proper position of leg throughout
• Allow user to immediately stop device for any reason
• Motivated user by providing sense of progress

Continuous Passive Motion Machine

https://commons.wikimedia.org/wiki/File:Continuous_Passive_Motion_Machine.jpg

04. Interview: Secondary User

Secondary User: Physical Therapist

• Outpatient Physical Therapist at Orthopedic Clinic
• Rehabilitates TKA patients
• Experience with CPM machines within hospital

User Needs

• Provide aggressive home exercise regimen

• Limit patient compensation to get accurate range of motion
• Target quadriceps, hamstrings, and gastrocnemius
• Initiate treatment that is easy to use and short in duration

02. User Story

Meet Cassie!

Cassie, an active 65-year old woman, used a CPM machine for pain relief and function recovery after a TKA. After 8 weeks, she complained that it:

1. Caused her to neglect PT exercises
2. Did not increase her knee range of motion
3. Allowed muscular atrophy of knee flexors and extensors

https://pixnio.com/free-images/people/female-women/older-woman-walking-850x565.jpg

05. User Needs

Increase muscular strength

Assembled and operated by primary user

Especially need early activation of quadriceps and hamstring

Ensure comfort while using machine

Fit and move properly throughout treatment

Initiate treatment that is short in duration

Increase range of motion

Problems with compliance can stem from longer set-up or treatment times.

Flexion and Extension

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06. Objectives

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Secure Fit

Self-set up

Increase muscular strength

Primary user can set up device independently

Reduce compensation caused by extra movement

Increase quadriceps, hamstrings, gastrocnemius strength

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07. Constraints

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Secure Fit:

Increase muscular strength:

Increase muscular strength:

Secure Fit:

Self-set up:

Self-set up:

Have no more than 2° of deviation from reading to measured RoM

All components that need user manipulation must be within hand's reach at upright posture

Presence of contraction of quadriceps, hamstring, gastrocnemius

07. Constraints and Users

Users:

• Primary: Patient
• Secondary: Caretaker, Sales Rep, Physical Therapist
• Tertiary: Physician

Concept Prompts

08.

1. Same patient peace of mind as CPM, but same strength improvement as PT exercises2. Ensure patient flexes/extends knee to limit of their pain tolerance 3. Active-assisted motion device for knee

Thanksfor your attention

Any questions?

10.

References

The Effect of Continuous Passive Motion in Patients Treated With Total Knee Arthroplasty for Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Essentials of physical medicine and rehabilitation

• Essentials of physical medicine and rehabilitation. Medicine & Science in Sports & Exercise. 2017;49(1):221. doi:10.1249/mss.0000000000001175.

• Yang Y, Wang J, Zhang XY, Dong L, Liu AF, Li CY. The Effect of Continuous Passive Motion in Patients Treated With Total Knee Arthroplasty for Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Phys Med Rehabil. Dec 1 2021;100(12):1160-1169. doi:10.1097/PHM.0000000000001718

Clinical evaluation of usefulness and effectiveness of sitting type continuous passive motion machines in patients with total knee arthroplasty: a study protocol for a single-blinded randomized controlled trial.

Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty

• Lee BC, Moon CW, Choi WS, et al. Clinical evaluation of usefulness and effectiveness of sitting type continuous passive motion machines in patients with total knee arthroplasty: a study protocol for a single-blinded randomized controlled trial. BMC Musculoskeletal Disorders. 2022;23(1)doi:10.1186/s12891-022-05507-2

• Lenssen TA, Van Steyn MJ, Crijns YH, et al. Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty. BMC Musculoskeletal Disorders. 2008;9(1):60. doi:10.1186/1471-2474-9-60

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Additional Slides

<-----Flexion mobilization

^ Extension mobilization

----->Patella mobilization