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A Smart Spinal Orthopedic Bed for General Purpose Rehabilitation

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Abstract and Figures

Critical spinal cord injuries and paralyzation are amongst the leading medical concerns. Lack of movement associ- ated with post-operative phases and paralization complicates the lives of patients from one side, and subject the nurses and families to an excessive load from the other side. Despite the presence of Stryker and one function orthopedic beds for rehabilitation purposes, they were either expensive or non-automated. Thereby, it was not prevailing to see these beds in hospitals and/or houses as assistive tools. The aim of our innovative and exploratory study is to design a smart orthopedic bed for patients, starting with children, in order to facilitate their movement while maintaining their posture. Rotation was considered laterally from one side to another while maintaining their body fixed. The smart bed was automatically controlled by sound recognition, and manually controlled through a touchscreen for safety. Simulation results showed the best fit and architecture of the building up parts of the smart bed. Experimental results revealed the compact design, the touchscreen with its facilities, and various immobility functions to provide feasibility while performing daily activities. The feasibility of triggering the smart system reduced the time deducted from nurses and family members. Statistical Evaluation showed that the smart design was 95% efficient in performing the movement as opposed to the Stryker (55%) and one function orthopedic beds (45%). The net cost of the system was low ($775) as opposed to alternatives ($1000-1300). The time of rotation of the smart bed was in seconds. As a future prospect more complicated movements could be considered to provide specific types of rehabilitation for the spinal cord.
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A Smart Spinal Orthopedic Bed for General Purpose
Rehabilitation
Hanin Elsayed, Nadine Ghannam, Amira Zaylaa
To cite this version:
Hanin Elsayed, Nadine Ghannam, Amira Zaylaa. A Smart Spinal Orthopedic Bed for General Purpose
Rehabilitation. The 5th International Conference on Advances in Biomedical Engineering, IEEE-
EMBS, Oct 2019, Tripoli, Lebanon. �inserm-02320946�
A Smart Spinal Orthopedic Bed for General
Purpose Rehabilitation
Hanin ElSayed, Nadine Ghannam, Amira J. Zaylaa
Department of Biomedical Engineering,
Lebanese International University, Bekaa, Lebanon,
Email: 21730439/21630914@students.liu.edu.lb,
amira.zaylaa@liu.edu.lb
Amira J. Zaylaa
Neoroscience Research Center,
Faculty of Medical Sciences, Lebanese University,
Faculty of Public Health-V, Lebanese University,
Lebanon,
Email: amira.zaylaa@ul.edu.lb
Abstract—Critical spinal cord injuries and paralyzation are
amongst the leading medical concerns. Lack of movement associ-
ated with post-operative phases and paralization complicates the
lives of patients from one side, and subject the nurses and families
to an excessive load from the other side. Despite the presence
of Stryker and one function orthopedic beds for rehabilitation
purposes, they were either expensive or non-automated. Thereby,
it was not prevailing to see these beds in hospitals and/or houses
as assistive tools. The aim of our innovative and exploratory study
is to design a smart orthopedic bed for patients, starting with
children, in order to facilitate their movement while maintaining
their posture. Rotation was considered laterally from one side
to another while maintaining their body fixed. The smart bed
was automatically controlled by sound recognition, and manually
controlled through a touchscreen for safety. Simulation results
showed the best fit and architecture of the building up parts
of the smart bed. Experimental results revealed the compact
design, the touchscreen with its facilities, and various immobility
functions to provide feasibility while performing daily activities.
The feasibility of triggering the smart system reduced the time
deducted from nurses and family members. Statistical Evaluation
showed that the smart design was 95% efficient in performing
the movement as opposed to the Stryker (55%) and one function
orthopedic beds (45%). The net cost of the system was low ($775)
as opposed to alternatives ($1000-1300). The time of rotation
of the smart bed was in seconds. As a future prospect more
complicated movements could be considered to provide specific
types of rehabilitation for the spinal cord.
Index Terms—Smart Orthopedic Bed; Spinal Cord Injuries;
Rehabilitation; Biomedical Instrument; Statistical Evaluation.
I. INTRODUCTION
Critical spinal cord damage is the harm to any part of the
spinal cord or nerves at the end of the spinal canal, it fre-
quently causes permanent modifications in strength, sensation
and different body features. The ability to control the limbs
after a spinal cord injury depends on two factors: the place of
the injury along the spinal cord and the severity of injury in the
spinal cord. Spinal cord injuries may result from the damage of
the vertebrae or disks of the spinal column, accidents, falling,
violence, diseases etc. [1], [2]. Spinal cord injuries may result
in various symptoms such as, loss of movement and difficulty
in stability and walking, lower back ache, loss of bladder
control, exaggerated reflex activities and others [1].
As a rehabilitation and support, Kinetic therapy was used to
mobilize severely disabled humans by means of placing them
on a distinctive rotating bed (orthopedic beds). This remedy
has the unique capability of anatomically immobilizing acutely
ill patients, while developing a state of relative physiological
mobility. Kinetic therapy provided preliminary proof for its
efficiency as a rehabilitation method [2]. Consequently, the
revolution in beds started for this therapy, when first the ”one
function” orthopedic bed was designed, which was mainly
used for hips surgeries especially for babies and children.
However, the one function orthopedic bed was not capable
of tackling adults and elder patients. Later, many bed designs
were published under the marketing name ”orthopedic”, how-
ever, these mattresses where either too soft or too firm, thus no
support for pressure points where supplied, also they affected
directly the comfort of the body curvature and the spine when
they are bent for a period of time. Recently, Stryker frame
bed was the final method invented to assist patients, this bed
allows the movement of body without disrupting the traction
but it requires a lot of time to be rotated and it employs two
or more nurses to apply rotation.
To this purpose, the aim of our innovative and exploratory
study is to design an automated Smart spinal orthopedic bed
that facilitates the movement of the patient, starting with the
children, in order to reduce their pain, supply them with the
optimal balanced mattresses, and reduce the time of nurses
and family members [3], [4].
The paper is organized as follows. Section I provides a
summary of the therapeutic and rehabilitation methods and the
aim of our innovative and research work. Section II presents
the materials and the Smart Orthopedic Bed design. Sec-
tion III showcases the simulated, experimental and statistical
evaluation results of the smart design. Section IV provides
the discussion of the Smart Orthopedic Bed as opposed to
alternatives and the conclusion, and section V provides the
future work.
II. SM ART ORTHOPED IC BE D MATER IA LS
The major parts of the smart orthopedic bed design are
summarized in the block diagram shown in Fig. 1. The servo-
motors, relays, Arduino Mega, voice recognition module, load
cell, touchscreen, leds, Plexiglas, and an Adapter (12 V, 3A)
Fig. 1: The Block Diagram of the Smart Orthopedic Bed.
were used. The servomotors were used as they form closed-
loop servomechanism that uses position feedback to control
both the motion and position. The relay was used as an
automatic switch, it transforms 5Vto 12 Vto light up the
leds. The Arduino was used to control all the other modules.
The Arduino takes the order from the screen and sends the
signal to the motor to rotate. It also takes data from the load
cell and sends it to the screen. The voice recognition module
was used, as it takes the order from the sound through the
microphone that amplifies and processes the sound. Some
words were saved by the code so that the module recognizes
them. The load cell was chosen to work on the variation of
the resistance when a body is placed on the bed. The weight
can be measured according to a built in equation in the library
of load cell. The touchscreen, was used to control the system
and reads the data, such as the torque and the weight. The
leds were used on all the bed sides as they lighten up in the
direction ordered when the relay supply them with 12 V. The
Plexiglas was used to design the bed structure. An Adapter
(12 V, 3A) was used to supply leds and servomotors with
voltage. Finally, a 7806 voltage regulator was used to regulate
the voltage to 6Vafter a 12 Vwas taken from the adapter,
and to supply the servomotor with the regulated voltage [5].
III. SMA RT ORTH OPEDIC BED METHODOLOGY
The method followed along with the requirements including
the (i) touchscreen methodology and (ii) interactions were
provided. In the (i) touchscreen methodology, the system
works based on the screen connected to it. When the system is
turned on, the Log-in page appears. After entering the correct
Username and password, the nurse can enter the patient’s
name, ID, and room number. The menu page appears then the
bed settings which can control the bed directions. The weight,
torque and angle of each motor was designed to appear on
the screen. The nurse can control each motor and the angle of
motion. Voice recognition settings can be enabled or disabled
through the screen. In the (ii) interactions:
Fig. 2: The Simulated Form and Dimensions of the Smart
Spinal Orthopedic Bed.
Screen-Motor interaction: the screen is connected to the
Arduino by the receiver RX and transmitter TX wires,
respectively. When the order is replaced, it is sent through
TX wire of the screen, and received by the RX wire of
the Arduino. After taking the order from the screen, it
gives a signal to one of the digital PINS of the motors;
the motor that receives the signal applies the order.
Load cell-Arduino-Screen interaction: the load cell sends
the mass of the patient by its TX wire which is received
by RX wire of the Arduino.
Voice-recognition module-Arduino-Motor: the module is
connected to the Arduino, RX of module is connected to
TX1 of Arduino and TX of the module is connected to
the RX1 of the Arduino, i.e. when the patient talks, the
module sends a signal from its RX to the TX of Arduino
which then sends the order to either move the motors or
request the nurse.
In the testing process, we first started by testing each
component alone to make sure it was functioning well. Then
we connected all the components to form the required system
(a) (b) (c)
Fig. 3: The Preliminary Design of the Smart Orthopedic Bed. (a) The Arduino Connections. (b) The Attached Servomotors.
(c) The Architecture of the Smart Orthopedic Bed.
while testing was in progress. We coded each component, and
finally we combined all the codes side by side to get the
final system working. The Arduino was tested for controlling
and giving orders from the components connected to it. The
link between the screen and Arduino is both ways, i.e. the
screen gives and takes the order to and from the Arduino.
For instance, the nurse gives order to rotate the bed through
the Arduino and servomotors. On the other hand, the Arduino
takes the mass of the patient from the load cell and sends it
to the screen. The screen is the only component that takes
and gives orders, while the other components only take orders
from the Arduino.
IV. SMA RT ORTH OP ED IC BED RESULTS
Herein, the smart orthopedic bed results are divided into
simulation, experimental and evaluation results.
A. Simulation Results
The AutoCAD simulation was used to draw the planned ge-
ometrical aspects of the smart orthopedic bed. The simulation
shows the architecture contribution illustrated in Fig. 2. The
system was made up of three main parts: the base, body, and
top. The base was made up of Plexiglas containing the circuit,
which connects some of the electronic parts of the system. The
body comprised three 3-D printed servomotors. And the top
was made up of Plexiglas, containing the load cell leds and
voice recognition module. The top also comprised supporting
parts that hold the belts supporting the patient.
B. Experimental Results
In order to get the bed to rotate and achieve all the tasks
required, a system of circuits connected to the Arduino was
made as shown in Fig. 3 (a). The orthopedic bed rotates 360
degrees by using three servomotors to ensure the rotation and
movement. The first servomotor rotates the bed on X-Y plane
(left and right), while the second rotates the bed on Y-Z plane
and the third motor on X-Z plane. A real picture was taken
as shown in Fig. 3 (b) of the 3 motors fixed on 3-D printed
parts, and the body in as shown in Fig. 3 (c).
C. Experimental Evaluation
In order to make sure that the smart orthopedic bed was the
best seller in the market, a comparison bar graph was made
and reported in Fig. 4. We compared the smart orthopedic bed
to the Stryker frame bed and the one function orthopedic bed
according to the efficiency as shown in Fig. 4 (a), the time
the bed takes to rotate 5 degrees as shown in Fig. 4 (b), the
number of features that each bed has as shown in Fig. 4 (c),
and the cost of the smart bed as opposed to the alternatives
as shown in Fig. 4 (d). Noteworthy that the efficiency was
calculated as the power of the motor divided by total power
of the motor. The servomotors used in this prototype were high
torque servomotors placed above each other to give the bed
a uniform movement in all the directions; also this technique
decreases the distance between the motor and the bed so that
the torque decreases. The efficiency of the bed was evaluated
by placing a mass on different positions on the bed and testing
the torque of each motor, this was repeated 15 times. The smart
orthopedic bed achieved the best results with a minimal cost
unlike other designs. The net cost is low and affordable as
illustrated in Fig. 4 (b).
According to statistical evaluation, the efficiency of moving
the angle of the bed is equal to the efficiency of the servomotor,
i.e. 90 degrees = 95 % according to Fig. 4 (a). In addition,
the bed’s electronic and mechanical safety was considered.
Our system was powered by 5V,6Vand 12 VDC and
was categorized as a class 2 safety. The servomotors had high
torque that limits the moving angle of the servo. Our system
was mostly made up of plastic and Plexiglas to avoid the
conduction of electricity, thus it is safer for the patient. To
increase the safety and secure the information of the patient,
a screen was implemented with a login page that required a
username and a password to ensure a professional control of
the bed.
V. D ISCUSSION AND CONCLUSION
The smart orthopedic bed was successfully developed and
was functioning in a way that can fulfill the patient’s needs.
0
10
20
30
40
50
60
70
80
90
100
Smart Ortho pedic Bed "One Function"
Orthopedic B ed
Stryker Frame Bed
Efficiency ( %)
The Percentage of Efficiency Versus the Type of Beds
0
1
2
3
4
5
6
7
8
9
10
Smart Ortho pedic Bed "One Function"
Orthopedic B ed
Stryker Frame Bed
Time to Rotate 5 Degrees (Sec)
The Time to Rotate Versus the Type of Beds
0
200
400
600
800
1000
1200
1400
Sma rt-Pe dic Bed "One Function" Orthopedic
Bed
Str yker Fram e Be d
Cost in U.S. Dollars
The Cost Versus the Type of Beds
(a) (b)
(c) (d)
Fig. 4: The Variation of Features Relative to the Three Beds Discussed. (a) The Percentage of Performance Versus the Type
of Beds. (b) The Cost Versus the Type of Beds.
Our design was suitable for extension to serve adults and
infants as opposed to the orthopedic bed that was invented
in 1741. Moreover, our design surpassed the design invented
in 1950 tackling mattresses, which was neither a firm mattress
providing comfort for pressure points nor a soft surface
provided support. We supported our design with a mattress
that has the optimal balance of softness and support.
Last but not least, Stryker frame bed invented by H. Stryker
was based on joining two disks around each other to help
rotate the bed manually which wastes time, requires energy
and requires the nurse’s strength [6]. However, our smart spinal
orthopedic bed allowed the movement of the body without any
disruption of traction; and since our design was controlled by
a screen connected to the Arduino and a voice recognition
module, the time of rotation was reduced without the need of
others. Besides, our design was considered as a vast option
for injured patients, because of its flexible and comfortable
structure and affordable cost.
Our multi-function orthopedic bed is a design which meant
to provide several features and movement which was not taken
in consideration in other beds. The smart orthopedic bed was
designed to function with a touchscreen connected to the bed
to make it feasible for the nurse to deal with. As well as the
bed comprised a voice recognition system to allow the patient
to control it. This bed offers 360 degrees’ rotation; it flips
sideways to maintain a normal blood flow, and it stands in a
steady position to decrease stress and strain on the patient’s
back pressure points. The bed was of low cost and surpassed
alternatives in the number of features it provides, the efficiency
and the time of rotation.
VI. FUTURE WORK
As a future prospect we could include in our smart orthope-
dic bed the idea of flipping the bed upside down, and making
the mattress separated from the patient, in case the patient
needs some physical therapy or needs to change his cast. We
could also evolve the mattress to aid in wounds caused while
lying in the bed for a long time by adding moisturizer and
temperature sensors. Moreover, the extension of the size of the
bed will be considered to make it usable not only by children
but also by adults. REFERENCES
[1] D. K. Zhao, “Spinal cord injury, mayo foundation for
medical education and research,” [online], May 2019,
https://www.mayo.edu/research/centers-programs/spinal-cord-injury-
research-program.
[2] T. N. Byrne, C. E. Benzel, and G. S. Waxman, Diseases of the Spine and
Spinal Cord. Oxford University Press, 2000, vol. 58.
[3] J. Auer, “Mechanics of orthopedic mattresses and how its largely used as
marketing term,” Matress Clarity, 2015.
[4] H. H. Stryker, “Stryker frame,” [Online], 2009, farlex and Partners,
https://medical-dictionary.thefreedictionary.com/Stryker+frame.
[5] B. A. Green, K. L. Green, and K. J. Klose, “Kinetic therapy for spinal
cord injury,Spine, vol. 8, no. 7, pp. 722–728, 1983.
[6] T. Thinnes, “Homer stryker and his revolutionary bed,” Museography,
vol. 2, no. 1, pp. 15–24, 2002.
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Kinetic therapy, also referred to as kinetic nursing, is the process of mobilizing severely disabled individuals by placing them on a special rotating bed. This therapy has the unique capability of anatomically immobilizing acutely ill patients while simultaneously creating a state of relative physiological mobility. A series of 162 patients suffering acute spinal cord injuries were treated with kinetic therapy during a 60-month period. A retrospective review of this patient population was performed with regard to the effectiveness of kinetic therapy in reducing commonly occurring sequelae in major organ systems. Results of the study provide preliminary evidence for the efficacy of kinetic therapy, yet point to the need to assess benefits relative to those achieved with standard therapy within a prospective randomized trial.
Spinal cord injury, mayo foundation for medical education and research
  • D K Zhao
D. K. Zhao, "Spinal cord injury, mayo foundation for medical education and research," [online], May 2019, https://www.mayo.edu/research/centers-programs/spinal-cord-injuryresearch-program.
Mechanics of orthopedic mattresses and how its largely used as marketing term
  • J Auer
J. Auer, "Mechanics of orthopedic mattresses and how its largely used as marketing term," Matress Clarity, 2015.
Homer stryker and his revolutionary bed
  • T Thinnes
T. Thinnes, "Homer stryker and his revolutionary bed," Museography, vol. 2, no. 1, pp. 15-24, 2002.