BA thesis project. 

This dynamic orthosis was designed as a physical support during rehabilitation sessions for people with Cerebral Palsy, and ready for being mass produced specifically in the local context of Cordoba, Argentina.

Research study was mainly based on a case study in the Hospital "Misericordia" and in collaboration with the Director of rehabilitation, Dr. Jorge Gonzalez, and the medical devices company '"DTA bioingenieria'".

2 prototypes remain at the hospital and are being used in the specific area of rehabilitation.

CP ORTHOSIS

80% of the people with Cerebral Palsy suffers of atrophy (Spasticity) in their muscles, so a daily stretching is needed. 

CONTEXT. .The main research fields were the limitations a public hospital in Cordoba, Argentina presents, as in personnel like monetarily; basic rehabilitation to a person with Cerebral Palsy and the effort the person doing the rehabilitation suffers, and last the physical and social problems a person with Spastic Cerebral palsy suffers and they caretakers  (family)

Public

Hospitals

Rehabilitation

Cerebral

Palsy

Activity

Market

Family

Therapist

Doctor

Family

Spastic

Cerebral Palsy

Muscular stress

Back efforts

Muscular tension

REHABILITATION. Every type of muscle rehabilitations starts by stretching arms and legs muscles. This stretching must to be done in a gradual way or the muscle could be broken, so is the physiotherapist or the doctor the one setting the openness limits.

The muscle must to remain stretched for 1 minute.

Stretching becomes difficult to be done by a single person due the muscle strength presented by the patient. Public Hospitals in Cordoba do not have enough personel to conduct rehabilitation sessions every day, for what families are forced to keep these stretching sessions home

ARGENTINAN MARKET. Several factors make orthosis inaccessible to most of the Argentinians. In 2008 Argentina closed its borders to most of the imported products from Europe and USA ; Raised border duties; The official exchange rate for the United States dollar climbed from 3:1 to 10:1 between 2008 to 2015; Argentina suffers an average of 50% of annual inflation.

Most of the companies producing orthosis manufacture them individually,  and work specifically on clients customization. For all this an orthosis in the local market is too expensive for an avg. salary of an Argentinian worker.

Ministry of

Health

Government

Healthcare

institutions

Administration

Department

Suppliers

Program

Department

CP

family

Administrative

projects

Factory

Project

(orthosis)

Hospital

Supplies

and deliveries 

Distribution

Rehabilitation

Service

Retail

Ministry of

Health

Physiotherapy

Person 

with CP

Occupational

Therapy

STAKEHOLDERS. The stakeholders map is complex due mainly an involvement of different sectors of the government, public health, production and the central activity that is rehabilitation. 

This project centers in the importance of the doctor to keep a track of the muscles evolution and the person with Cerebral Palsy's family to follow the doctor's instructions.

FAMILY AND TRANSPORT. Low income families are unable to bring the person with CP to hospital every week due the public transport that the city of Cordoba presents. Cordoba is 2 times bigger than Copenhagen for example, but just counts with buses. Moving a person with spasticity becomes really difficult, for what it has to be moved by taxi and many families can't afford it.  

How to design a dynamic arm orthosis for people with Spastic Cerebral Palsy easy enough to being used by their families in order to keep a daily rehabilitation and muscle stretching making use of local technologies ? 

SKETCHING. It was a back and forth process together with prototyping and 3d modeling, focusing mainly in simplifying an automatic adjustment system.

PROTOTYPING. Prototypes were used to try out different mechanism, some quick ideas in cardboard and laser cutting. And to try out the resistant and measures of different arm adjustments. 

TEST AND MEDICAL VALIDATION. The orthosis was tried out in the Hospital Misericordia  during an intense use during 30 days on an 18 years old man with Cerebral Palsy. This person presented an increment of his arm muscles opening of 40 degrees, 15 degrees more than the previous month without the orthosis. That is a 40% more almost. 

Some changes were made afterwards mostly related to the arm adjustments, and padded. 

Tabla de costos

MANUFACTURING. This orthosis was designed for being mass produced. For this was necessary to think in a market were 1200- 3500 orthosis would be produced in total, having a final individual cost of production of 211 Pesos (46,4 USD at that time). 

Grades measurements. To keep track of the process.

Single hand unlocking. so the other therapist's arm can keep holding the person with PC arm 

Length adjustment, for different arms sizes.

Automatic opening. To low down physical efforts done by the person doing the rehabilitation. 

Velcro adjustment around arm circumference. 

Padded components due the sensitive body tissues that people with PC has. 

Automatic lock to the rehabilitation activity. 

CONCLUSION. 2 models were done to leave in the Hospital Misericordia and they remain being used for rehabilitation. So it was a project that went from a case study, to a full product design process, focusing mainly in the importance of realize something for a local market, considering local technologies and not losing focus on the importance the stakeholders have in all this.