Soft tissue injuries (STIs) refer to the damage of muscle fibres, tendons and ligaments that connect the skeletal bones and account annually for $200billion in lost work hours across the US. This is by no means an insignificant sized sum nor is the fact that 34% or $68 billion dollars of all work related injuries in the US are defined as Soft tissue injuries (STIs).
The main reason for the cost of STIs is the failure of current diagnostic tools to provide soft-tissue-specific diagnosis. In relation to STI in back pain for example, x-ray machines only reveal significant results in 1 in 10,000 cases.
Litigious environments and stand offs between embellished STI cases or legitimate work injuries create the need for a ready solution to this troublesome issue.
A recent IEEE pulse article deals with this very challenge, it begins at the root of the problem, how it has been approached thus far, and how future solutions can ensure that these kinds of injuries are treated in a cost effective manner to improve clinical outcomes.
The IEEE article reports on Insight Diagnostics Inc. (iDi) a Nevada based Diagnostics Company; outlining how they have developed state-of-the-art evaluation and diagnostic equipment for STIs. They combine the existing Electro-diagnostic Functional Assessment (EFA) with five medically accepted tests – Electromyography (EMG), Range of Motion (ROM), functional capacity evaluation (FCE), grip test and pinch test.
This method opens a comprehensive list of results to the clinician to determine the nature, extent, acuity, location and source of the referred pain, capturing information not only when a patient is static but also while the muscle is functioning dynamically (ROM). The EFA Assessment is nonloading, meaning there is no weight or resistance placed on the both the patient and the ROM apparatus whilst capturing full freedom of movement (flexion, extension, rotation, and lateral movements).
Currently iDi’s solution is a wired unit, with the patient tethered to a signal acquisition system using a complex wire harness. This provides less flexibility when performing tests within different work place environments and activities, resulting in the need for a more portable, and adaptable solution.
The relationship between iDi and Shimmer Research IEEE maintains is just the tonic for the advancement of this kind of technology, “Maximising potential gains while mitigating drawbacks led to a system that was validated for further commercial development.”
Shimmer Research, a leader in body worn sensor manufacture sought to deliver a wireless solution to the EFA wired offering. The Shimmer sensors configured for EMG, ROM (accelerometers), FCE pinch, and grip were chosen to develop the wireless EFA system based on features, commercial availability, and extensibility to include all the sensors in an EFA measurement suite.
Working in partnership the companies were able to address challenges of operating time, RF communication, network architecture, and device configuration to develop a reliable sensor based Personal Area Network (PAN) for the wireless EFA system.
The development of a wireless system resulted in a ‘significant enhancement in system capability’ over the wired solution. Improved data quality, form factor, portability, number of channels, costs, and field maintenance were gained in the development of the wireless system.
One of the most notable outcomes was in relation to lead failure. Lead Failure is the primary failure mode of the wired EFA solution and can lead to a test being postponed. The wireless solution allows for the detection of the fault by a Shimmer device with an indicator illuminated at the failure location. The lead in question can be changed or, as the system is modular, the Shimmer in question can be easily swapped out. This results in a more robust solution, reduced complexity, lower initial system costs, elimination of custom components, and an increase in uptime.
The wireless EFA system will allow iDi to make a more significant impact in occupational and sports medicine, with greater ease of use, flexibility and portability, whilst offering a clear economic advantage.
Read the Full IEEE Pulse Article on pages 20-26.