Dispositivo EMG

BME 200/300 Final Design Report 12-10-03

Abstract
The following report outlines a design of an electromyogram (EMG) controlled massaging pad intended for use by a child with lissensephaly. The device was designed using criteria and constraints suggested by a client familiar with lissensephaly. The final design consists of an electrode attachment device, an analog circuit to amplify and process the patients EMG signal and a massaging pad to provide positive tactile stimulation to the patient. A prototype circuit was built and tested and the design functions properly. The circuit was constructed on a printed circuit board to consolidate the circuitry, however future work is needed to complete the final printed circuit board design.

Problem Statement
The purpose of this project is to design a device that will serve as an EMG biofeedback device to activate a vibrating pad. A child with Lissencephaly will use this device to activate the pad by flexing a muscle in his thigh. The vibrations will provide a

pleasurable tactile sensation at his command, providing him some control over his life which he currently lacks. An EMG signal of a chosen magnitude will activate the pad and the pad will deactivate after a chosen time period.

Motivation
The child with Lissencephaly currently has no control over his life. This device will give him a way to take some control. By allowing him to activate the pad on his own the child will be given freedom that he currently lacks. Our device will also allow us to observe whether the child is capable of simple operant conditioning; should the child associate flexing his muscle with activating the massage pad it will demonstrate a capacity for cognitive activity. We would observe this association through a deliberate increase in the flexing of the targeted muscle. This could provide a basis for further learning. The device could be modified to give more options to the child. For example, a component of the circuit could be added so that the child could also turn the device off with a second flex. This process of learning would serve to improve the quality of the patients life

Lissencephaly
Lissencephaly is a brain disorder exhibited when the brain fails to correctly develop. Lissencephaly is also referred to as smooth grey matter due to the smooth appearance of the brain in patients with this condition (Figure 1). During development, nerve cells are not able to reach the outer cortex of the brain, which in turn prevents cells from making necessary connections. The deficiency in development also accounts for the lack of ridges normally present [1].

Symptoms of Lissencephaly can vary from case to case. Some of the common problems experienced are difficulties eating, loss of bodily control, severe mental retardation, regular seizures and reoccurring pneumonia. The severity of these symptoms varies greatly. The lifespan of a person with Lissencephaly is projected at around two years, but since the disorder is quite rare and provides few recorded cases the lifespan is difficult to gauge [1].
Figure 1: (above) A normally developed brain. (below) A brain from a patient with Lissencephaly. Notice the smooth appearance of thisbrain[2]

Design Problem
The EMG biofeedback device needs to detect a proper EMG signal and then activate the massage pad for a predetermined amount of time. There are three major components to the EMG biofeedback device; the EMG electrodes, the EMG amplifier circuit and the massage pad. Either needle or surface electrodes can measure EMG signals. We will be using the less invasive surface electrode. Surface electrodes are often composed of a Ag+/AgCl disk and an adhesive attached to the skin [3]. However, the client has specified that the EMG electrodes need to be reusable. Reusable EMG electrodes are already in use with the child for his apnea monitor. The EMG pads need to be easily attached to the childs body, reusable, and require minimal training for application. A total of three EMG electrodes will need to be attached to the patients body.

Figure 2: Schematic of chair

Figure 3: Patients actual chair

The EMG circuit needs to detect a proper EMG signal and respond by activating the massage pad. A proper EMG signal is defined as a voluntary muscle contraction. This patient will occasionally have seizures which result in involuntary muscle contractions. Therefore, the device will need to distinguish between voluntary and involuntary muscle contractions. Once a proper EMG signal is detected the massage pad will be activated by a timer for a predetermined amount of time. The final component in the EMG biofeedback device is a massaging pad. The pad is the device that will deliver the pleasurable stimulus to the patient. There is a wealth of small vibrating devices available through retail, ranging in function from full back massage devices that fit inside a chair to simple massage pad motors. The massage pad used in our biofeedback device must fit the unique shape and size of the patients chair. Figure 2 is a schematic of the chair with its dimensions and figure 3 is an actual picture of the chair. More detailed discussion of each component in the EMG biofeedback device is found in the latter parts of this report. Overall, the entire device must be safe and reliable for years of use by the child and his caretakers. The controls on the device also need to be easy to learn and operate. Finally, throughout the design process the patients confidentiality must be maintained. At no time can the patients name, personal information, and/or pictures of the patient be released to the public.

Design Constraints
Designing our device specifically for this patient introduced a number of design constraints. The first constraint was that our device must not interfere with any of the pre-

existing equipment already in use with the patient. This includes his apnea monitor, feeding tube, and oxygen tank. The EMG amplifier designed for this project also needs to be designed for the patients limited musculature. Most EMG amplifiers are designed assuming that the subject has normal muscle tone; however for this project that assumption is not valid. To further complicate matters, the teams access to the patient for testing and EMG measurements is very limited. For privacy reasons, the mother of the child has not given the team permission to work directly with him. Instead all matters involving the child must first go through our client, Arleigh Birchler. Additional design specifications and constraints can be found in appendix A.

Proposed Solutions
All of our proposed design solutions include the same circuitry and electrodes, components that provide little area for variation. As mentioned previously, reusable carbon rubber electrodes will be used and placed on the childs thigh per the request of our client. The quadriceps is the best option for electrode placement because it is a large muscle that the child can easily isolate and signal. Also, the thigh is not highly prone to involuntary muscle contractions. Our design proposals vary in size, shape and application of the vibrating pad. We will describe our best design solution in detail later in the report. The first alternative design is to use a portable, prefabricated massage cushion for the vibrating pad. The model of the massage cushion is the Homedics BK-150 Back Master and measures 19 x 16 x 3.25. Even though the BK-150 is smaller then many of the other massage pads on the market, it is still too wide to fit perfectly in the childs

chair. Also, this solution leaves little opportunity to modify the padding or change the location of the vibrating motors. A second alternative design is a pad that wraps around the child. It is assembled from different parts including a small vibrating motor, and padding. It will be built into a pad that can be wrapped around the childs waist as opposed to attached to his chair. The form of this design is similar to a wide belt. A Velcro piece attaches the two ends of the pad in front of the child. A drawback to this design comes from the additional equipment already in use. The apnea monitor and feeding tube would most likely experience some interference from the front portion of the pad.
Table 1: Design Matrix

Cost

Homedics BK-150 3
$25.00

Modified/Customized 1
$25.00 plus costs to modify and cost in time

Wraparound 2
similar to Modified pad plus fastening pieces

Simplicity

3
requires only the modification to connect to EMG circuit

1
requires disassembly and reassembly of pad and modification to connect to EMG circuit

1
requires disassembly and reassembly of pad and modification to connect to EMG circuit

Durability

2
durability assured without testing

1
would have to test for durability of pad components

1
would have to test for durability of pad components

Ergonomics (x3)

3
no chance for modification

9
can be very specifically designed for child

6
marginal opportunity for specification

Total

11

12

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In order to decide which massage pad design alternative would be best we ranked the solutions on the criteria of cost, simplicity of production, durability and ergonomics/comfort (Table 1). The child will be sitting with the pad behind him at all

times, so we deemed ergonomics the most important criteria weighing it three times higher than the others. Each design option was ranked with a 1, 2, or 3; 3 being the best, depending on how well it fit each criterion in relation to the other alternatives. Modification of the ConAIR HP08 to create a custom fit for the child received the largest total points making it our best design option.

EMG Circuit Design

The final circuit design contains seven main components. A functional block diagram outlining the basic circuit design is shown below.

Figure 4: Block diagram of circuit design

Power is supplied to the integrated circuit (IC) components by two nine volt batteries. Due to certain specifications of the IC components, two voltage regulators were necessary to drop the power supply voltage from 9V to 7V. Attached in appendix B is the precise circuit schematic. All components are named and all their values are shown. 8

Two carbon patch input electrodes measure the potential difference created when the patient contracts his/her muscle group. A third electrode is attached to ground to and serves as a reference voltage. The potential difference created by the patients EMG signal is then input into an instrumentation amplifier. The instrumentation amplifier has high input impedance so it does not draw any current from the patient. A differential amplifier then amplifies the potential difference across the two electrodes and has a gain of 13. This value is determined by one external resistor, R1 on the circuit schematic. The signal is then passed through a passive high pass filter with a low corner frequency of 1.6 Hz. This filter blocks any DC offset present in the signal. The final stage of the instrumentation amplifier is an active low pass filter that has a gain of 158 and a 2027 Hz corner frequency. Overall, the gain of the entire circuit is about 2050. The next stage of the circuit is a precision full wave rectifier [4]. The rectifier takes the absolute value of the amplified signal. After the rectifier is a passive low pass filter. The low pass filter serves to effectively average the signal. At this point in the circuit the EMG input signal has been processed from a signal similar to high frequency noise, to essentially a DC signal with amplitude proportional to the strength of the patients muscle contraction. This signal now can be easily compared to a set threshold voltage. The next stage in the circuit, a comparator, performs the threshold operation. The threshold voltage, or reference voltage, can be manually controlled via a potentiometer that feeds the positive input of the comparator. The reference voltage set on the

comparator stage of the circuit determines the strength of muscle contraction needed to trigger the timer device. If the signal is strong enough, the comparator outputs positive saturation (+7V) to the timer stage of the circuit. However, if the amplitude of the input signal is not greater than the set reference voltage then the output of the comparator will stay at negative saturation (-7V). A 555 timer IC component was used to establish a specific time to trigger the massage pad. The input to the timer determines whether the output is either high or low. A high output passes the signal to the next stage of the circuit and triggers a timed countdown, while a low output gives no input to the next circuit stage. If the timer receives a positive signal from the comparator the output will be high for about two and half minutes. The time constant of the timer stage is determined by the product of the values of R9 and C10 on the circuit schematic. After the duration of one time constant, the output of the timer will return to low. The high output of the timer is about 7 volts and is sent to the next stage of the circuit, a solid state relay device. The relay serves as a switch that safely activates the massage pad unit upon receiving a high input from the timer. The relay is optically isolated so that there is no opportunity for the high voltage and current supplied by a wall outlet to reach the patient. The final stage is the massage pad unit. The pad contains a transformer that steps down the 120 volt wall voltage to 12 volts for pad operation. One of the massage pad cord wires was severed and the two output wires of the relay device were attached across

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the severed lead to complete the design. See appendix B for an exact schematic of the circuit design.

Circuit Board
A circuit board was drawn to match specifications laid out in the circuit schematic. Guidelines for drawing a circuit board were used [5]; thicker traces for power supply and ground, no closed-loop ground trace, and sufficient spacing for traces and pads. PCB Express was the program used to draw and order the circuit boards used in the final design. Most of the components for the schematic were ordered as SMT (surface mount) components through Digi-Key. Custom footprints were drawn for components that were unavailable in SMT, requiring common push-through parts such as diodes, wire terminals, potentiometers and capacitors used with the voltage regulators. Components were attached to the circuit board in the final design using a simple soldering procedure. The design of the circuit board condensed the circuitry in to as little space as possible. The remainder of the board was used as space for the battery casing. These batteries were used to power the circuitry components independent of the wall source, which powered the vibrating pad. See appendix C for printed circuit board design.

Consolidated Circuitry
A black plastic box was selected to house the various electrical components separate from the pad. This protects the components from damage, and protects a user from accidental electrical exposure. The physical dimensions of the box were approximately 3 3 6. The limited volume was used to contain the circuitry,

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batteries, and SSR in a protected compartment. The three components needed to be as compact as possible, and this was mostly accomplished through condensing the circuitboard design. The circuit board was mounted inside the black box using four bolts attached to the corners. The SSR was attached alongside the circuit board. Openings in the black box would have been drilled for the electrode leads, and the massage pad wire fed in series through the SSR. These holes were not completed in the prototype due to the unfunctional operation of the circuitry upon assembly.

Figure 5: Printed circuit board mounted in black box.

Massage Pad
The massage pad is the second major component of the biofeedback device, which provides a stimulating and pleasurable feedback. We chose the ConAIR HP08, an off-the-shelf massage pad to modify for the project. This particular pad was chosen because its dimensions (11 x 24) match the childs unique chair. In addition, the pad is less than one inch thick so it should not disturb the comfortable fit of the chair that the

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child is accustomed to. The ConAIR HP08 offers two massage intensities and a heat option that can be adjusted to create the most pleasurable sensation for the child. To improve the quality and functionality of the pad we created a fabric cover similar to a pillow case to put over the pad (Figure 6). The cover serves many functions. Made with a fabric with a child friendly pattern, it appears less like a medical device than the plain massage pad would and new covers can be made as the childs interests change. More importantly, the cover is removable and washable to increase sanitation since the child will be sitting on it twenty-four hours a day, seven days a week. Finally, the cover will reduce the amount of wear on the pad increasing its useful life.

Figure 6: Modified massage pad with protective cover.

Electrodes
Electrodes and means of attaching them are the final component of the full design. We chose to use carbon-rubber electrodes to fulfill the request of our client that they be reusable and inexpensive. The child is already using carbon-rubber electrodes on other devices so he and his caretakers are already familiar with them. Moreover, the carbon13

rubber electrodes are an excellent choice because they are non-invasive. They simply rest on the skin rather than penetrate it or adhere to it. With the addition of a thin layer of conductive gel they work nearly as well as an adhesive electrode. The electrodes will be attached to the child with a soft, felt strap that will Velcro around the childs thigh and can be adjusted for a perfect fit as the child grows (Figure 7). The strap is washable for the same reason as the massage pad cover. The electrodes can also be removed from the strap for washing. The electrodes attach to the strap with Velcro to assure simple replacement in the correct position after they have been removed. This is important because the electrodes must be in approximately the same place each time in order to obtain consistent results.

Figure 7: Electrode attachment device.

Ethics
Our project has presented us with some important ethical considerations. These considerations stem from the fact that our device is designed for a specific patient rather than the general public. Of utmost importance was honoring the clients request that all sensitive patient information be kept confidential. All operating components of our design must be safe for use within specific design parameters for this patient. Additional 14

technical support could be necessary, but is possible with such exclusive patient use. All possible emphasis was placed on meeting these ethical requirements.

Conclusion
The EMG biofeedback project has been very successful in proving that an EMG signal can be obtained, amplified, and used to control the activation of a massage pad. Our large degree of accomplishment shows that a project of this sort can be completed to the given specifications. There are, however, a number of steps that need to be taken before this prototype can be implemented with the child. The first step towards completion is an accurate measurement of the childs EMG. This measurement needs to include measurements in multiple locations to find an ideal position on the body. From these measurements the EMG amplifier can be calibrated to properly amplify his biological signal to proper amplitude to activate the massage pad. Voluntary and involuntary EMG signals will also need to be measured. These measurements could allow the design of an IC to distinguish between a conscious versus involuntary muscle contraction, such as during a seizure. The patient will finally need to be monitored to see if he is adapting to the device. This will be the ultimate test of this projects success. If clients predictions are correct, the patient will eventually condition himself to understand that a particular muscle contraction will elicit a pleasurable stimulus.

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References
[1] Dobyns, William. Lissencephaly: Information for Parents. 1991. Online: http://www.Lissencephaly.org/about/lissen.htm [2] Lissencephaly Newsgroup. Acessed: Oct 2003. http://groups.yahoo.com/group/Lissencephaly/ [3] Webster, John. Bioinstumemtation. New York: John Wiley and Sons, 2004. Chapter 2 [4] Medical Instrumentation Application and Design. 3rd Ed. John G. Webster Editor. John Wiley and Sons Inc. NY 1998. [5] Victorey, Paul. Personal consultation. Oct-Dec 2003.

Sources Consulted
Webster, John. Personal consultation. Oct-Dec 2003 Birchler, Arleigh. Personal consultaion. 12 Sept. 2003

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Appendix A

Product Design Specification: EMG Biofeedback Device

Team Members:
Brent Geiger Leader Jason Ethington Communications Tom Chia BSAC Kim Treml BSAC Tim Rand BWIG Advisor: John G. Webster Revision date December 7, 2003 Function: An EMG biofeedback device will allow a child with Lissencephaly to exhibit some control over his life. Client Requirements: Client would like the device to serve as a learning tool for the child. The device will consist of four components: electrodes, amplifier, information processor, and massage pad. Electrodes Two/three carbon patch electrode placed on skin on childs thigh muscle. The electrodes must not be intrusive or irritating to the child. They must require little skill to attach and remove. Amplifier A basic EMG amplification circuit will be used. Information Processor This stage must distinguish between voluntary and involuntary muscle contractions by establishing a baseline. The amplified EMG signal will trigger the massage pad. This stage will control the duration of vibrations, and record how many voluntary contractions occur in a certain time period. The processor will terminate the massage after a specified time period. It should regulate massage pad to eliminate over stimulation by child. Massage Pad The massage pad must fit in the childs chair. The pad should be comfortable for the child and not change the environment to which he has became accustomed to. The massage must not be too strong and must not cause the child any discomfort.

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Design Requirements:
Physical and Operational Characteristics
a. Performance requirements Must be able to perform at any given time 24/7. Massage mechanism will be activated 5-6 times a day. Must be easy to operate and have minimal learning curve for operator. b. Safety Must not harm patient in any way. Device will not have any sharp areas, exposed wires, or abrasive material. EMG pads will not draw current from the patients body. Massage pad vibration will be noticeable, but not cause pain. Entire device must not interfere and be compatible with current devices he is hooked up to. c. Accuracy and Reliability Massage feedback must trigger every time an intentional muscle contraction is performed. Device must accurately distinguish between involuntary (C-posturing) and voluntary muscle contractions. Vibrational feedback must only be turned on for 5 minutes each time a voluntary muscle contraction is detected. d. Life in Service Must be in service for as long as patient is able to utilize the device. Proper operation should be checked for each week. Major calibration checked for every 6 months. e. Shelf Life The shelf life of our product will be five years stored at room temperature in a dry location. f. Operating Environment This device will be used in a home environment. It will be subjected to constant pressure caused by the patient sitting on top of the vibrating pad. The device may be subjected to fluids and dust caused by everyday use. This device will be handled by a nurse or caretaker for the patient. g. Ergonomics The patient will be sitting on this device for most of the day so it is important that the device does not change the current environment as to annoy or agitate the patient. The device must as comfortable as the chair that the patient currently uses. A washable, protective pad will cover the massage pad to minimize wear and increase sanitation. h. Size The device must fit in the current chair of the patient. The bottom of the chair is 11.5x11.5. The device must fit between two side guards that are 9.5 apart and 8 above the bottom on the back of the chair. The back of the chair is 15 tall. i. Weight The information processor should be no more than 5 pounds so that it is easy to transport with the child. The electrodes and device used to hold them in place should be just a few ounces so that they do not inhibit or encumber the child. There are no weight specifications for the massage pad because we will assume whichever model we use is already at a suitable weight. 18

j. Materials There are no restrictions on materials. k. Aesthetics, Appearance, and Finish The massage pad must be soft and comfortable. The apparatus for applying the electrodes must also be comfortable so that it does not bother the child in any way. The massage pad cover has been designed with a colorful pattern that is child orientated.

Production Characteristics
a. Quantity One. Childs guardian gets to keep prototype if she wishes. b. Target Production Cost $100-$200. More if digital microcomputer processors are incorporated into design.

Miscellaneous
a. b. c. Standards and Specifications Human subjects testing approval may be required. Approval from childs doctors and mother also required. Customer Confidentiality is of utmost importance for both the child and the childs mother. No information whatsoever regarding their whereabouts can be disclosed. Patient-related concerns Childs EMG signal may be somewhat irregular, amplifier must be able to properly amplify signal. Device must fit into childs chair. Device must be able to be cleaned periodically due to constant contact with child. Child could possibly find device uncomfortable and irritable. Again, all patient information must be held in confidence. Competition Lissencephaly is an extremely rare. There are no devices designed for this purpose.

d.

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