1. Digit-Ease
Magee Campus
Wearable Hand Technology For Stiffness And
Movement Measurements In Rheumatoid
Arthritic Patients
James Connolly*, Joan Condell*, Kevin Curran*, Philip Gardiner#
*Faculty of Computing and Engineering, Magee College, University of Ulster, Londonderry, N. Ireland.
# Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, N. Ireland.
http://isrc.ulster.ac.uk

2. Background
Magee Campus
• Rheumatoid Arthritis (RA) is a disease that attacks the joints of the
human skeleton.
• In 2010, RA affected up to 500,000 of the UK population and
starts between the ages of 40-50 [1].
• RA is currently diagnosed by clinicians and therapists using
manual evaluation methods.
• Manual methods are open to observer bias.
• This project focuses on an accurate hand measurement tool to
detect hand Range of Motion (ROM) and joint stiffness.
[1] J. Y. Reginster: The prevalence and burden of arthritis. Rheumatology 2002, 41 (suppl. I):3-6, British
http://isrc.ulster.ac.uk Society for Rheumatology.

3. Magee Campus
Joint Pain
• RA affects the synovial tissue that lubricates
the joints.
• Stiffness, swelling and deformity are common
symptoms.
• Hand joints affected are:
• Distal interphalangeal (DIP)
• Proximal interphalangeal (PIP)
• Metacarpaphalangeal (MCP)
• Swollen joints may cause clicking sounds
during movement and „trigger finger‟.
http://isrc.ulster.ac.uk

4. Current detection
Magee Campus techniques
• Occupational Therapists (OT) quantify joint range and determine
hand function using the following instrumentation and
techniques.
Goniometer
• Measures flexion, extension, abduction and adduction of all
finger joints.
• Goniometer is placed resting on the top of each
finger. Measures flexion in degrees for each
digit
• Goniometric techniques have changed very
little over the past 80 years. Average results
within 7° in 62%-72% of trials [2].
[2] ] E. Fess, C. Moran, “Clinical Assessment and Recommendations American Society of Hand Therapists,”
http://isrc.ulster.ac.uk St . Louis : American Society of Hand Therapists, 1981 .

5. Current detection
Magee Campus techniques
• A Health Assessment Questionnaire (HAQ) determines a
patients ability to perform daily tasks.
• Tape measure – measures thumb-index finger web space and
distal phalanx-palm distance in centimetres.
• Kapandji Score – grades the range of movement of
the patients thumb against each finger tip.
http://isrc.ulster.ac.uk

6. Current detection
Magee Campus techniques
Problems….
• Outcomes are easily influenced by clinicians training and
experience.
• Current process is time consuming – average initial
consultation can take up to 3 hours.
• Joint stiffness is currently unmeasured.
• All measurements are recorded in handwritten form.
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7. Magee Campus
Digit-Ease
Project
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8. Digit-Ease
Project
Magee Campus
This project builds upon the development of earlier work to
provide the clinician with a ROM tool measuring:
• The degree of deformity of the hand and stiffness of the moving
finger joints.
• A shift in the position of the fingers in relation to the direction
of the thumb by measuring web space.
• Minimum and maximum flexion and extension angles of each
digit.
• Live movement of the hand displayed as a 3D model.
• Recording the minimum, maximum and average values of a
number of tests.
• Real-time display of the angular movement for each digit.
http://isrc.ulster.ac.uk

9. Digit-Ease
Project
Magee Campus
• Comparison of historical data showing changes in ROM over
time.
• Customised exercise routines determine the ROM for specified
joints within a time period.
• Bespoke reports show statistical results recorded from exercise
routine
• Recording, storage and analysis of patient data.
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10. Digit-Ease
Project
Magee Campus
The Digit-Ease project consists of a wearable glove and a 3D
software system
[3]
This project has initially been developed using the X-IST[1] and
5DT[4] data gloves to measure joint ROM.
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[3] Inition.http://www.inition.co.uk/3D-Technologies/x-ist-data-glove.
http://isrc.ulster.ac.uk

11. Digit-Ease
Magee Campus
Project
The data gloves contain sensors strategically placed over each
finger joint to accurately measure finger movement.
• X-IST glove uses piezo-resistive bend sensors.
• 5DT glove uses fibre-optic sensors.
• One end of fibre loop is connected to a
LED and the other is connected to a [2]
phototransistor.
• Light emitted by the LED is measured by the phototransistor.
Light intensity indirectly measures finger movement.
[4] 5DT http://www.5DT.com.
http://isrc.ulster.ac.uk

12. Exercise Report for
Magee Campus
Undamaged Hand
Velocity
readings
(degrees per 100
milliseconds)
closely follow
movement
readings
Angular readings
switch from 0º
To maximum
range very
quickly
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13. Exercise report for
Magee Campus
Damaged Hand
Velocity values
remain close to
the X axis.
Angular
readings
gradually
move from 0º
to maximum
range in a
“stepped”
appearance
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14. Comparison
Magee Campus
Report
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15. Magee Campus
Future
Developments
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16. Future
Magee Campus
Developments
A new glove is currently under design with added functionality.
• Additional bend sensors will measure abduction and adduction
between each digit and the thumb.
• Mote will write sensor data
onto a flash card and will
include wireless connectivity. Bend sensor
An accelerometer will measure Abduction sensor
Accelerometer
forearm supination and WIMU
pronation.
Battery
• Accelerometers on each digit will measure initial angular values for
each finger joint, removing the need for initial calibration.
http://isrc.ulster.ac.uk

17. Future
Magee Campus
Developments
• Wrist and thumb sensors will measure ulnar / radial deviation.
• Pressure sensors will measure Kapandji index.
• Kapandji score increases as each
point is touched.
• The patient attempts to touch their
thumb against various points on the
hand.
http://isrc.ulster.ac.uk

18. Future
Magee Campus
Developments
Detailed measurements for the glove in development
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19. Future
Magee Campus
Developments
• Examining glove materials to improve comfort levels, fit and
durability.
• Working in conjunction
with Shirley Coyle from
DCU to create a new glove
with sensors sewn into the
glove structure. Improves
readings since the glove is
less bulky than current
gloves. (top) CE sensor coated onto stretch knit fabric,
(bottom) commercial bend sensor
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20. Future
Magee Campus
Developments
Additions to the software system:
• Automatic calibration system to quantify arthritic hand ROM
• Wireless connectivity to the data glove
• Adduction and abduction range for each digit.
• Thumb-index finger web space.
• Amount of joint stiffness for each digit.
http://isrc.ulster.ac.uk

21. Future
Magee Campus
Developments
• The new system will be a data collection and playback tool.
• First ambulatory system to record joint stiffness at home
• System will simultaneously record angles from multiple
fingers and detect previously unidentifiable movement
patterns.
• Measurement of joint movement at home.
• Record data offline for future analysis and playback.
http://isrc.ulster.ac.uk

22. Conclusion
Magee Campus
• To date, Clinicians use manual, time consuming techniques to
quantify hand limitations.
• Current methods have the capability to detect hand ROM, with
some issues.
• The current system provides an automatic hand ROM measuring
tool capable of measuring joint movement, joint stiffness and
comparison analysis of historical movement data.
• Future work will provide additional joint movement for each
finger and offline recording of movement at home.
• A new e-textile glove will provide a glove with low-weight,
comfort, and high flexibility.
http://isrc.ulster.ac.uk

23. Magee Campus
Thank you for your attention.
Questions?
Email address : connolly-j3@email.ulster.ac.uk
http://isrc.ulster.ac.uk