Engineering a next generation physiological wrist simulator for innovation of rehabilitation protocols and surgical interventions

如果你不能有效地使用你的双手，你的生活会发生怎样的变化？据估计，英国有270万人因手部灵巧性下降而衰弱，这对他们的生活质量产生了巨大影响。腕部是人体最常见的创伤部位，但尽管如此，手部和腕部损伤的治疗仍然是手外科医生和治疗师的一个挑战。治疗方法往往因临床医生而异，其结果的成功很难评估。原因之一是手腕的复杂性——它由8块相对于前臂和手部的骨头组成。确定治疗效果的一种方法是研究肌肉中的力量和由此产生的运动。这可以用计算机模型来完成。然而，为了创建一个准确代表复杂解剖结构的计算机模型，需要许多参数。另一种方法，我们可以评估手和手腕的许多关节之间的相互作用，是通过使用关节运动模拟器。这些模拟器通过对肌腱施加力来复制人体标本中的关节运动，使我们能够测量肌肉和关节中的力。这使我们能够比较不同手术和治疗过程的效果，而这在病人志愿者身上是不可能实现的。通过这种方式，我们可以客观地评估治疗方案，在将其应用于患者之前测试生物力学结果。我的研究小组已经开发并测试了一个腕部关节运动模拟器，它包括六块主要肌肉。然而，众所周知，控制手指的肌肉功能与控制手腕的肌肉功能密切相关。因此，这个项目的目的是利用我们的专业知识，为手腕创造一个新的定制关节运动模拟器，也包括手指肌肉。这项工作将创造一种独特而创新的设备，通过使我们能够复制手指和手腕的运动，它具有更高的真实感和功能。马达将被用来产生肌肉的效果。专门的摄像机将用于实时监测和控制关节的运动。测试将与外科同事合作进行，他们也将确保这项工作的临床影响。这项研究的结果将产生一种设备，可用于植入物和其他矫形设备的设计和测试，肌肉骨骼系统计算模型的验证，假肢的设计和临床医生的培训。

How would your life change if you could not use your hands effectively? An estimated 2.7 million people in the UK suffer from a debilitating loss of manual dexterity, which has a dramatic effect on their quality of life. The wrist is the most common site of traumatic injury in the human body, but despite this, treating hand and wrist injuries remains a challenge for the hand surgeon and therapist. Methods of treatment often vary from clinician to clinician and the success of their outcomes is difficult to assess. A reason for this is the complexity of the wrist - it is comprised of eight bones that move relative to those in the forearm and the hand.One method for determining the effects of treatment is to study the forces in the muscles and the motions that result. This can be done using computer models. However, many parameters are needed in order to create a computer model that accurately represents the complex anatomy. An alternative way in which we can evaluate the interactions between the many joints in the hand and wrist, is through the use of joint motion simulators. These simulators replicate joint movement in human specimens by applying forces to the tendons, enabling us to measure the forces in the muscles and joints. This allows us to compare the effects of different surgical and therapeutic procedures in a way that is simply not possible with patient volunteers. In this way we can objectively assess treatment regimens, testing the biomechanical outcomes, before applying them to patients.My research group has developed and tested a joint motion simulator for the wrist that includes six major muscles. However, it is well known that the function of the muscles that control the fingers is highly linked to those that control the wrist. Therefore, the aim of this project is to use our expertise to create a new custom-made joint motion simulator for the wrist that also includes the finger muscles. This work will create a unique and innovative device that possesses greater realism and functionality by enabling us to replicate the motions of the fingers in addition to the wrist. Motors will be used to create the effects of the muscles. Specialised cameras will be used to monitor and control the motion of the joints in real-time. Testing will be performed in collaboration with colleagues in surgery, who will also ensure the clinical impact of the work.The result of this research will produce a device that can be used in the design and testing of implants and other orthopaedic devices, the validation of computational models of the musculoskeletal system, the design of prosthetics, and the training of clinicians.