Clubfoot
Research Project I Correct Appliance of Brace
Collaboration: Maxima Medisch Centrum (Veldhoven) I Target group: Children with Clubfoot
Collaboration: Maxima Medisch Centrum (Veldhoven) I Target group: Children with Clubfoot
Group work I Size: 5 students
1/3 of time of 16 weeks, Spring 2018 I Eindhoven University of Technology
1/3 of time of 16 weeks, Spring 2018 I Eindhoven University of Technology
WHAT IS CLUBFOOT?
Clubfoot is a birth defect where one foot or both feet are
rotated inwards and downwards
TREATMENT
Most effective treatment for clubfoot is the Ponseti Method.
The method consists of two phases: The treatment phase and the maintenance phase.
> Treatment phase: Children undergo a series of casting, an achilles tenotomy followed by the last cast
> Maintenance phase: Wearing of the Ponseti brace 3-4 months for 23 hours a day then for 2-5 years during the night and naps.
(A picture of the Ponseti brace is displayed in the header of this project)
The method consists of two phases: The treatment phase and the maintenance phase.
> Treatment phase: Children undergo a series of casting, an achilles tenotomy followed by the last cast
> Maintenance phase: Wearing of the Ponseti brace 3-4 months for 23 hours a day then for 2-5 years during the night and naps.
(A picture of the Ponseti brace is displayed in the header of this project)
OUTCOMES INTERVIEWS STAKEHOLDERS
Board of the
Dutch Clubfoot Association:
Parents see the brace
as something negative. They think it hurts their child and
are insecure about applying the brace. They might assume the brace
is causing the child pain and when their child cries it often
leads to removal of the brace. Frequent
brace removal increases the risk of the recurrence of clubfoot. In addition to that, parents often do not know how
to apply the brace correctly. Braces that are too loose can
cause the feet to be able to move up and down causing
redness and skin irritations.
Researcher MMC Veldhoven (hospital):
For the Ponseti
method to be successful the brace has to be worn frequently
and in the correct way. If the brace is not worn correctly the
chance of relapse is bigger and this means that the treatment
phase of the Ponseti method has to be done again.
Parents:
They are often insecure about how they
have applied the brace. They fear that they are hurting their
child when tightening the straps of the brace, or that they
have applied the brace too loosely. Sometimes others have
to apply the brace as well, like caretakers at a daycare for
example. They do not have as much experience as the
parents with the brace, and never got explanation from a
professional on how to apply the brace.
MAIN PROBLEM
There is no feedback for the person
who is putting the brace on, so knowing whether the brace
is applied correctly is difficult
RESEARCH QUESTIONS
Main question:
How can pressure sensors be used to indicate correct
appliance of a clubfoot brace?
Subquestions:
> Where and how should the sensors be placed in the
clubfoot brace?
> Can a range be computed from the obtained data which indicates correct appliance of the brace?
> Can a range be computed from the obtained data which indicates correct appliance of the brace?
SENSORS AND PLACING
Novel Pressure Sensors
Placing of sensors - Orthopedic surgeon from
MMC Veldhoven verified these places
METHODOLOGY
Step 1: Turn on the 4 sensors simultaneously, and place them in the brace.
Step 2: Let the parent apply the brace correctly according to them, while the child is laying on its back.
As soon as the brace is applied, the time starts.
Step 3: Measure with the sensors for 2 minutes, while the child is laying on its back and lays as still as possible.
Step 4: After 2 minutes, let the parents loosen the brace. The straps should be 3 holes looser.
Step 5: Measure with the sensors for 2 minutes, while the child is laying on its back and lays as still as possible.
Step 6: After 2 minutes, let the parents take off the brace.
Step 7: Remove the sensors from the brace, and disconnect the sensors.
Step 2: Let the parent apply the brace correctly according to them, while the child is laying on its back.
As soon as the brace is applied, the time starts.
Step 3: Measure with the sensors for 2 minutes, while the child is laying on its back and lays as still as possible.
Step 4: After 2 minutes, let the parents loosen the brace. The straps should be 3 holes looser.
Step 5: Measure with the sensors for 2 minutes, while the child is laying on its back and lays as still as possible.
Step 6: After 2 minutes, let the parents take off the brace.
Step 7: Remove the sensors from the brace, and disconnect the sensors.
TESTING
Left: Placing of sensors in the Ponseti brace
Top: Test with child with Clubfoot
CONCLUSION
> The sensors can be used for measurements in a clubfoot brace. They are sensitive
enough and you see a difference when the child moves in the brace or not and if the
straps are looser or more tight. However the data doesn’t have a unit. Therefore it is very
difficult to convert it into newton.
> It is not possible to calculate a range of data in which the brace is worn correctly for age categories. We have to use an individual range instead of this. Every foot is different and the children also have different weights. In addition to that is not every clubfoot deformity the same which could cause the foot to have more pressure at the different sensor locations.
> It is not possible to calculate a range of data in which the brace is worn correctly for age categories. We have to use an individual range instead of this. Every foot is different and the children also have different weights. In addition to that is not every clubfoot deformity the same which could cause the foot to have more pressure at the different sensor locations.
FINAL RESULT
Select some other work