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DESIGN OF AN AUTOMATIC LIMB THERAPY
REHABILITATION DEVICE
Benjamín Alejandro Rosas Revilla
Universidad Privada del Norte, (Peru).
E-mail: n00138860@upn.pe
ORCID: https://orcid.org/0000-0003-2672-574X
Ricardo Manolo Cruz Evangelista
Universidad Privada del Norte, (Peru).
E-mail: n00071527@upn.pe
ORCID: https://orcid.org/0000-0002-7587-2546
Sebastian Sanchez Diaz
Universidad Privada del Norte, (Peru).
E-mail: sebastian.sanchez@upn.pe
ORCID: https://orcid.org/0000-0002-0099-7694
Edward Flores
Universidad Nacional Federico Villarreal Grupo de Investigación GISI – EUPG, (Peru).
E-mail: eores@unfv.edu.pe
ORCID: https://orcid.org/0000-0001-8972-5494
Recepción: 07/09/2021 Aceptación: 01/11/2021 Publicación: 14/02/2022
Citación sugerida:
Rosas, B. A., Cruz, R. M., Sanchez, S., y Flores, E. (2022). Design of an automatic limb therapy
rehabilitation device. 3C Tecnología. Glosas de innovación aplicadas a la pyme, Edición Especial, (febrero 2022),
113-135. https://doi.org/10.17993/3ctecno.2022.specialissue9.113-135
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ABSTRACT
The objective of this research work is to design an automatic rehabilitation device in
charge of limb therapy in specialized rehabilitation centers. Within the methodology, the
quantitative approach was followed, presenting a type of prospective research with a non-
experimental design, for this the design of the device was elaborated in its dierent stages,
which were segmented into electronic design, Adaptive structure and Control interface. For
this, dierent matrices were elaborated to obtain the most important characteristics of the
adaptive design. In addition, torque and weight calculations were carried out so that the
device can work in optimal conditions. It was concluded in the realization of the design
of the control and programming system, the adaptive structure of the same device, the
power and control circuits for the electronic part, all this making use of the engineering
programs Autodesk Inventor, Proteus, Pic C Compiler. Likewise, the simulation was carried
out to ensure the correct functioning of the device. Finally, a stress analysis was performed,
obtaining a fairly high safety factor.
KEYWORDS
Mechatronics, Device, Systems, Rehabilitation, Physiotherapists.
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1. INTRODUCTION
At present there are various types of treatments for physical rehabilitation, each one of
them has its benets and harms, some authors made comparisons between Conventional
Physiotherapy and Wiitherapy (Wibelinger et al., 2013), on the other hand, Vibrotherapy is
applied (Rodríguez et al., 2006), and “Electro shock, electromagnetic waves, acupuncture,
suction cups, among others” (Colegio profesional de Fisioterapeutas de Andalucía, 2012).
On the mechatronic side, dierent equipment has been developed for the treatment such as
a mechatronic rehabilitator for ankle sprain (Guzmán & Matías, 2017).
All these devices focus on rehabilitation of tendons, joints, mobility aid, muscle relaxation
aid. Therefore, “worldwide it is much easier to treat an injury or have more eective
rehabilitation therapies” (Alburqueque & Rondón, 2019; Araujo & Chirinos, 2017;
Cortés, Vergaray, & Torrejón, 2017). “In the same way, in Peru several assistive devices
in physiotherapy are also being developed, in many cases they are still in the preliminary
or development phase” (Camacho, 2018). In the eld of Rehabilitation, the most used is
Conventional Therapy, aided by magnetic waves, TENS and suction cups.
By not having so much technological development applied in this area, “physiotherapists
suer from ergonomic risk, leading to injury” (Montoya, 2016). “In our country there is no
applied technology to carry out therapies, this reduces productivity in treatments, due to
the fact that several patients cannot be attended at the same time and it generates saturation
in the attention, for this reason the specialized centers of integral rehabilitation are not
alien to this problem, many of the physiotherapists suer injuries in upper extremities,
backs produced by the ergonomic risk and work stress generated in their work routine”
(Montoya, 2016; Leyva et al., 2011; Morales & Goiriz, 2020). In the following graph the
authors Carrera and Morales (2020) shows us the most frequent injuries in physiotherapists.
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Note: Results obtained from Evaluación del riesgo ergonómico por posturas forzadas en el área de sioterapia
del Hospital de Especialidades Carlos Andrade Marín.
Figure 1. Frequent injuries in physiotherapists in their work routine.
Source: (Carrera & Morales, 2020).
The objective of this project is to design a device that allows limb muscles to be relaxed
for patients undergoing physical rehabilitation thanks to the fact that our design allows the
device to carry out the therapies in an automated and personalized way for each patient. In
addition, it provides the ability to perform therapies in parallel to alleviate the high demand
for patients. To achieve compliance with the proposed objectives, a non-invasive or harmful
prototype for the patient will be designed to establish corrective observations in favor of
health. Its result will allow nding alternative solutions according to the needs of patients
and Physiotherapists.
2. MATERIALS AND METHODS
As objectives of our Project, we have the following:
• Design an adaptable structure for various muscles and limb sizes of rehabilitation
patients.
• The hardware and software must be interactive and user-friendly with the user
and/or physiotherapist.
• Electronic design segmented into dierent stages, both analog and digital.
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To comply with the aforementioned, we propose a ow chart in which we determine the
operating process of this device, in this way we can identify the factors that inuence when
performing a decontraction therapy.
Figure 2. Flowchart proposed of the processes when performing a decontraction therapy.
Source: own elaboration.
For the design of the automatic rehabilitation device, the black box diagram specied in
Figure 3, where the inputs of the system are taken into consideration in order to obtain an
automated and personalized therapy for each patient.
Figure 3. Black box diagram of the device needs.
Source: own elaboration.
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After making the black box diagram, the functions that it will perform for the operation of
the device were specied. As a result, the function diagram Figure 4 in which the subsystems
that belong to the control stage are determined considering the inputs mentioned above
and the output to be obtained.
Figure 4. Function diagram of the device design.
Source: own elaboration.
To carry out the design of all the hardware and software we take into account certain criteria
determined by the needs of the physiotherapist for their correct use in rehabilitation. This
was done using the pair comparison matrix (Figure 5) with the following criteria:
• Impact resistence.
• Adaptability of the device.
• Manufacturing material.
• Ease of manufacture.
• Easy use of the physiotherapist.
• Maintenance.
• Aesthetic.
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Figure 5. Pair comparison matrix for optimal device design.
Source: own elaboration.
By doing this analysis for the design criteria, we were able to get the most important points
to take into account when designing the entire rehabilitator. As a result, we had that the
device must present a structure adaptable to the dierent extremities of each patient to be
treated in the specialized center. At the same time, the criteria of resistance to impact and
ease of manufacture are equally important. In addition, the easy use of it occupies the third
place on this list since it is a very necessary point for the development of this design. Finally,
it was determined that aesthetics, maintenance and manufacturing material are the criteria
with the lowest value obtained in the table, but they are still important within the needs of
the device.
2.1. CONTROL INTERFACE
We elaborated the control interface design in the MIT App Inventor software “due to its
possibility of creating applications for IOS and Android in a simple way with bluetooth
communication, which is the communication protocol used in our rehabilitation device”
(Gutsens, 2020; Ven, 2017).
For the design of the application, we took into account the following parameters to enter, in
the same way it is shown in the block diagram of Figure 6.
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• The Bluetooth connection with the automatic rehabilitation device.
• The therapy time established by the physiotherapist.
• The intensity of the therapy regulated by the eector.
• The position of the eector on the X axis depending on the type of muscle.
• The therapy start signal.
• An emergency stop controlled from the app.
Figure 6. Block diagram of the device’s bluetooth user control interface.
Source: own elaboration.
2.2. PROGRAMMING
In the programming design stage, we dene two stages, “the rst is the data reception stage
commissioned by the 16F628A microcontroller and the second stage which controls the
actuators and receives the data from the sensors for the correct operation of the device”
(Delgado, 2020), “this last stage is designed for the 16F877 microcontroller” (E-Marmolejo,
2017).
The block diagram followed to carry out the programming is shown in Figure 7.
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Figure 7. Block diagram of the microcontroller functions for actuator control and therapy customization.
Source: own elaboration.
As mentioned above, the programming of the rst microcontroller will be focused on the
time management established by the physiotherapists and all the additional congurations
for the customization of each therapy, for this, the data is received from the bluetooth
interface, for this particular case all they will be characters, then, depending on whether
they are data of time, intensity, movement, etc. It will load the necessary value into the
microcontroller and then execute the start order to the other microcontroller in charge of
actuator control. This is seen in the following gure (Figure 8).
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Figure 8. Flow diagram of the logic to follow for the elaboration of the code.
Source: own elaboration.
After elaborating the logic, we proceeded to write the programming code, which carries
interruptions of the timer 0 located inside the microcontroller to count the time.
The second microcontroller is focused on receiving data from the sensor, stepper motor
control (PAP) through A4988 modules and DC motor control through Pulse Width
Modulation (PWM). Because this microcontroller will always be in operation, it will be
disabled, until it receives the start data from microcontroller 1 where it can nally perform
the analysis of the sensors in IF conditionals and then execute one action or another. The
logic for the elaboration of this code is seen in the following ow diagram (Figure 9).
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Figure 9. Flow diagram of the microcontroller in charge of the power stage and sensor reading.
Source: own elaboration.
With the dened diagram, we proceeded to read the data from the sensors and with them
dene whether the motor was moving in one direction or another, in addition, we made
use of timer 2 and its interruptions of the microcontroller to control the PWM of the DC
motor.
2.3. STRUCTURE
Information was collected by analyzing the work area of the physiotherapists taking into
account how the therapies are carried out in the extremities, with this, several design ideas
and corresponding measures of the structure were raised to perform the therapies, once this
was obtained, the 3D design in Autodesk Inventor software with appropriate measurements.
The rst design proposed for the device is seen in the following gure.
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Figure 10. First structural design of the rehabilitation device.
Source: own elaboration.
With the designed structure, we proceeded to calculate the necessary torque of the motors
to carry out the movement of the “X”, “Y” and “Z” axes. To begin, we collect the mass data
that the inventor software oers us, obtaining the following results shown in the following
table.
Table 1. Torque calculation as a function of mass and its type of movement.
KIND OF MOVEMENT MASS TORQUE
Axis Y 3.4 Kg 2.677 Kgf.cm
Axis X 1.87 Kg 0.887 Kgf.cm
Axis Z 1.1 Kg 0.514 Kgf.cm
Source: own elaboration.
With the calculation of the torque of the motors we make the necessary selection of them,
for each of them we determine as a quality criterion the use of PAP motors, since they
oer more precision when executing their movement, and for use in rehabilitation is an
important criterion for design. We prepare a table shown in Table 2 with the specications
of the stepper motors to be used, and with this we make the selection according to their
optimal torque and needs.
Table 2. PAP motors and their various characteristics to meet design criteria and proper selection.
Motor Voltage
(V)
Current
(A)
Par
kg * cm
Inertia
g * cm2
Length
(mm)
N# of
conections
Temp
min
Temp
max
Step
Angle
Weight
Kg
NEMA 8
SY20STH42-
0804A
4.32 0.8 0.33 3.6 42 4 -20 50 1.8 0.08
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NEMA 11
SY28STH32-
0956A
2.66 0.95 0.43 9 31 6 -20 50 1.8 0.12
NEMA 17
SY42STH33-
1334A
2.8 1.68 3.6 54 38 4 -20 50 1.8 0.285
NEMA 23
SY57STH76-
2804A
3.2 2.8 18.9 480 76 4 -20 50 1.8 1.03
NEMA 34
SY85STH156-
4208A
5.25 4.2 122 4000 156 8 -20 50 1.8 5.35
Source: own elaboration.
With the selection criteria carried out, we obtained that the engines to be used will be the
following:
• PAP Nema 14 motor for “X” movement.
• PAP Nema 17 motor for “Y” movement.
• PAP Nema 14 motor for “Z” movement.
Having the structure in the software, we proceeded to carry out the “analysis and simulation
tests that allow us to ensure its correct operation” (Torres, Camarillo, & Orozco, 2013).
Figure 11. Stress analysis of the structure to obtain the safety factor and determine the safety of the device.
Source: own elaboration.
As can be seen in the graph, the safety coecient is quite high, which ensures optimal
support so as not to put the patient or the physiotherapist at risk with a structural failure.
In addition, the design also has an adaptability depending on the lengths of each muscle.
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Figure 12. Final structural design of the automatic rehabilitation device.
Source: own elaboration.
This was achieved by implementing a pair of mobile sensors on the sides and millimeter
rails so that the personnel in charge of therapy can regulate it depending on the therapy
area.
With all the analysis carried out in the structural part, we made the corrections and obtained
a nal design of the automatic rehabilitation device which is shown in the following gure.
2.4 ELECTRONICS
We contemplate the needs of the equipment previously established as sensor inputs, and
microprocessors, this helped us to carry out the data collection in parallel, in this way we
could dene the inputs, outputs and power stages of the system for the software stage and
the electronic development in Proteus software 8.12 (Hubor-Proteus, 2015).
To obtain an electronic design we begin to order and classify it in stages, the power stage
(actuators) would be the most important and an order and manufacturer specications must
be obtained to avoid temperature problems and short circuit.
Figure 13. Classication of stages.
Source: own elaboration.
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We collect information on the connections of electronic devices that your data sheet oers
us from each manufacturer.
We take as a reference these connections from a PIC16F88X family microcontroller with
similar characteristics, in this case we will use the internal oscillator conguration and an
external source that will power the entire control stage. and the recommended connections
of a PIC16F887 microcontroller, in this case we will use the internal oscillator conguration
and an external source that will power the entire control stage. For the power supply of
the microcontrollers, we use a circuit based on the LM2596 DC-DC module. 7-segment
displays are devices used to display information. On this occasion we can display digits from
0 to 9. We use a 7447 decoder; it is an integrated circuit that converts the input binary code
in BCD format to logic levels that allow activating a 7-segment common anode display
where the position of each bar forms the decoded number. For the design of a PWM
module we use an IRFZ44N transistor of MOS-FET technology.
Table 3. Driver selection for stepper motors.
CONTROLLER VOLTAGE (V) OUTPUT CURRENT (A) MICRO STEPS
Driver TB 6600 20 a 42 0.2 a 5 1, 1/2, 1/4, 1/8, 1/16
Driver TB6560 12 a 36 0.5 a 3.5 1, 1/2, 1/4, 1/8, 1/16
Driver Pap A4988 8 a 35 1 a 2 1, 1/2, 1/4, 1/8, 1/16
CNC shield 12 a 36 1 a 2 1, 1/2, 1/4, 1/8, 1/16, 1/32
Source: own elaboration.
This time we use the Driver PAP A4988 module because its technical specications are
adequate for the correct operation of the motors. Specically, “this stepper motor controller
allows you to control a bipolar stepper motor with an output current of up to 2 A per coil”
(García, 2020).
3. RESULTS
As a rst result, we obtained the nal design of the user-friendly interface for the
physiotherapist, which is shown in Figures 14 and 15.
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por favor escoja el tiempo de funcionamiento
Bluethoot
Introduzca el tiempo en minutos de la terapia
Intensidad del efector
Posición del efector
¡Empezar! ¡PARO!
Figure 14. Final design of the interface seen from the MIT APP Inventor program.
Source: own elaboration.
Figure 15. User interface application seen from an IOS device.
Source: own elaboration.
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When good results were obtained from the components that match the manufacturer’s
specications, the plan for each electronic card was designed separately, specifying the
inputs and outputs. 5V is considered for digital circuits.
Figure 16. Design of the supply stage based on the LM2596 DC-DC module.
Source: own elaboration.
Additionally, a PWM module was designed for the eector. Next, the PCB board is designed,
the measurements of the dierent stages were taken into account, track size according to
the manufacturer, current, voltage.
Figure 17. General schematic diagram of the electronic subsystem.
Source: own elaboration.
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A 3D design was obtained through the 3D visualizer option oered by the Proteus 8.12
software, which helped us in the implementation of a nal design of the entire system.
Figure 18. Design of Control 3D PCB in Proteus 8.12.
Source: own elaboration.
The main problems that arose, not having a consideration in the tolerances of the
components and not isolating some stages that generated static current. An adjustment
had to be made by modifying the size of the tracks and the order of some components for
functionality and aesthetics. Additionally, some 3D components had to be designed in the
Inventor software, since the Proteus software does not have all the necessary libraries.
Regarding the development of time programming and microcontrollers to personalize the
therapy of patients, the corresponding tests were carried out on the oscilloscope of the
Proteus 8.12 program and a wave of approximately 1 second was obtained as a result, with
which it is performed the programming of the variable time of the therapy.
Figure 19. Calculation of the estimated time using the oscilloscope.
Source: own elaboration.
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4. CONCLUSIONS
An automatic rehabilitation device in charge of limb therapy was designed, it was possible
in all its parts that make it up, obtaining the ability to execute parallel therapies and
conguration through the mobile phone.
The design of the control stage was carried out in two parts, rst the control interface for
mobile phones in the MIT APP INVENTOR software where all the necessary parameters
for rehabilitation therapy can be congured, in addition, the programming of the system
of control based on two microcontrollers, one for receiving Bluetooth data and the other
for controlling the device’s power stage, thereby ensuring the optimal functioning of these
subsystems.
The design of the PCB boards was carried out in dierent sections of control, power,
feeding and decoding. This was achieved by using the Proteus 8.9 software where the
schematic diagram of the circuit was made and then the PCB design with the respective
simulation tests where we can check the correct operation of the electronic system.
The structural design was developed complying with all the requirements established by
the physiotherapists, which should be adaptable and cover dierent work areas in the
extremities, for this the design was elaborated in the Autodesk Inventor software, in addition,
the parameters were studied of the mass and in this way the necessary calculations were
carried out for the touches of the motors, which are: 2.677 Kgf.cm, 0.887 Kgf.cm and
0.514 Kgf.cm. The tension analysis was also carried out in the same software to obtain the
safety coecient that ensures the correct functioning of the device.
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