This is a study project of the Design & Engineering programme, the joint International programme of Tallinn University of Technology and Estonian Academy of Arts.

1. CURA
2011
www.design-engineering.ee

2. Janno Nõu - product designer, Estonia
Alan Guillemot - Engineer, exchange student, France
Larissa Frosch - product manager, Estonia
Madheswaran Chidambaram - structural engineer, India
2

3. Contents
Introduction 4
Subject research 4
Innovation context 10
Global solution 11
Monitoring
Devices
Pre-concepts
Usability 14
Bracelet
Tablet
Storyboard
Everyday life
Working-out
Technical working 24
Patches 25
Motion sensor
Wireless connection
Autonomy calculation
Bracelet 26
Wireless connection
Microcontroller
Memory
Vibration alarm
Visual alarm
Sound alarm
Activity display
Tablet 28
Wireless connection
Memory
Microcontroller
LCD display
Speaker
Service 29
Further developments 31
Conclusion 31
References 31
Appendixes 33
3

4. Introduction This report is a conclusion of our teamwork on concep-
tual design studies.
The aim of this assignment is to develop a concept for
personal training device. All though we started the de-
sign process with the classical gym equipment we real-
ised only after several backfirings that our project had
a different angle for the theme. It took an independent
workshop that was comfortably joined with the project
to really get a firm foundation to get going.
Subject We started the project with a superficial overall re-
search which lasted one day and after what we nar-
Research rowed our project scope down. We chose the theme of
motivation which had to be narrowed down further as it
was still way too wide. We introduced three sub-themes:
seniors, equilibrium and interaction which were narrow
enough to get usable results out of the research. Output
of the research was a giga-scale map (more than 300 en-
tities) that brought out the problem and illustrated the
overall situation quite well (the map itself can be seen
here: dl.dropbox.com/u/20271965/Map.pdf ).
We discovered that quite many problems among older
people are accident related. Accidents are the only
domain in health care that will increase as population
is getting healthier and with aging population accident
related injuries and results are demanding more and
more money.
The population percentage that is over 65 will skyrocket
in the beginning of the 2nd decade of 21st century be-
cause of the post WW2 baby boom. In 2030, the propor-
tion of those over 65 will be 33% in Australia, or 50% in
Germany. A really important factor is also the amount
of healthy years to live for people 65 years old which
shows that poorer countries who don’t have enough
money to spend on personal healthcare have problems
with many ill people who haven’t received full deten-
tion, this in turn will demand even more money. After
retiring your physical activity decreases, increasing the
chance of accident with serious consequenses.
4

5. It has been stated in many papers that bone fracture
among older people is a serious concern as it will lead to
a decrease in life quality in about half of the cases. Two
thirds from among the people who will even recover
won’t get back the same movement level as they had
before the accident. The hip fracture is usually stated
to be one of the most serious that will lead to immobil-
ity, decrease in life quality, fear and quite often to next
fracture or another illness. Amazingly there hasn't been
any serious research to find out how many deaths that
are caused by other factors can be traced back to hip
fracture. Swedish health care report thinks it to be up to
three times as much as there are deaths caused directly
by hip fracture.
Accident and bone fracture that will decrease your
moving capacity can be described as a self feeding circle.
Quite often people who have had bone fracture in the
older age and even completely healthy people who are
in the older age will develop fear of falling. This in turn
will lead to moving less that will decrease the equilib-
rium and muscle fitness and this increases the likelihood
of falling and fracturing a bone. Once fallen the fear of
fall will increase and the circle starts again.
BREAKDOWN FOR MEN
Life expectancy/healthy
years after age 50
UK: 79.5/19.7
Sweden: 80.3/20.2
France: 79.6/18.0
Spain: 79.5/19.2
Austria: 79.1/14.5
Germany: 79.0/13.6
Finland: 78.5/12.9
Denmark: 78.3/23.6
Estonia: 72.4/9.0
Latvia: 71.3/11.0
Population is ageing,
BREAKDOWN FOR WOMEN that means there are
Life expectancy/healthy years more and more people
after age 50 who won’t work.
UK: 82.7/20.8
France: 85.4/19.7
Spain: 85.0/18.6
Finland: 84.1/13.9
Sweden: 84.0/20.3 After retiring your
Old-Age Dependency Ratio
2020 forecast %
Austria: 83.7/15.7 physical activity 30–50 10–19.9
Germany: 83.0/13.5 decreases. 20–29.9 0–9.9
Denmark: 81.9/24.1
Not Illustrated
Estonia: 80.5/10.4
Latvia: 79.3/12.7
WESTERN EUROPE IN DETAIL
In 2030, the
proportion of those
over 65 will be 33%
Population
in Australia, or 50%
in Germany.
Population percentage who
is over 65 will skyrocket in
nd
the beginning of the 2
st
decade of 21 century
because of the post WW2
baby boom.
5

6. While population is
getting healthier, the
amount of accident
injuries is increasing
Accident injuries
Opthalmic – Eye problem is very
common in old people.
Osteoporosis
Hearing – loss of hearing and
hard- hearing are the major
hearing problems of old age.
Cardiovascular –
hypertension, heart
about half of the attack, rupture of blood
population over vessels etc. are common
65 disorders in old age.
Sight impairments Major health
Diabeties problems among
seniors
Musculoskeletal –
osteoporosis, spasm, drooping
shoulder are invariably found in
aged people.
Avoid falling down
• Regular physical activity Musculoskeletal pain
• Equilibrium exercises (weight
shift, knee flexion, toe raise, etc.) Endocrinological –
• Good shoes diabetes is major disease.
• Grab bars / handrails
• Avoid domicile dangers (carpets
tacked down, stable chairs, etc.) Psychological Problems and
• Tai Chi Emotional problems
Cancer – the danger of
cancer is multiplied with
Reduce the fall effect the advancement of age.
• Healthy diet (stronger bones)
• Hip protector
Rehabilitation
• Immobilisation (Cast, lay in bed,
etc)
• Surgery
• Training (continued after reha-
bilitation)
*Physiotherapist
*Rehabilitation centre
*In-home assisted care
• Healthy diet
6

7. The circle that describes falling is linked with another
one that describes social isolation. People who are recov-
ering from fracture are in bigger risk to be left in social
isolation. Right now there are two solutions for people
recovering to help them get back their confidence and
mobility. One of them includes staying at rehabilita-
tion center where professionals have the know-how and
equipment to help, but staying outside home will de-
crease motivation and about half of the people wont go
back home. Second of them lets people to stay at home
and is a device (protective padding) that you wear on
your hip, it doesn’t do much more than give you reassur-
ance that when you fall then there is bigger possibility
that you won’t fracture anything. This will obviously
work only when you wear it. Rehabilitation while living
at home will give older people much more motivation
as they can see the possibility of getting along by them-
selves. It has been noted that people staying at home
have still problems with motivation - for some reason
they won’t do enough exercises. They have the goal
in sight but they don’t exercise enough, when they do
though they have better results than people who stay at
a rehabilitation centre. When people fail to recover they
face really serious consequences. A staggering eighty
per cent of women who have survived a hip fracture
would rather be dead than experience the loss of inde-
pendence and quality of life that results from a bad hip
fracture and subsequent admission to a nursing home.
Here are four cases that describe the situation of hip
fracture:
Full health—Anne She lives in her own home and
cares for herself. Anne is active in her local commu-
nity and is out and about with friends quite a bit. She
swims regularly and enjoys visiting her children each
weekend. Anne walks without any aids and can manage
her 12 steps at home without any problems. She enjoys
shopping and cooking for herself. Anne does not need
any help with the housework and derives pleasure and
relaxation from gardening.
Fear of falling—Mary She lives alone in her own home
and cares for herself. Mary is involved in community
fundraising and enjoys playing bridge. Mary recently
had a fall. She did not break any bones but was badly
cut and bruised. She is scared of falling. Mary continues
to walk without aids. She still looks after herself and
does her own housework. Mary has been a bit depressed
since her fall. She has returned to her bridge group but
is anxious when she is outside the home because she is
scared of falling again.
Good hip fracture—Jean She lives in her own home
and cares for herself. Before her fall Jean was out and
about quite a bit with her church group. She swam on
a regular basis and occasionally looked after her grand-
children. Jean broke her hip when she fell. She is finding
it difficult to do everything at home now that she walks
with a stick. She needs help in shopping as she no longer
drives or feels confident to shop alone. She can prepare 7

8. only simple meals and is missing being able to bake for
her friends. Jean can no longer manage the housework
by herself. She misses her church activities but finds
it too painful and tiring to be out for long periods. Jean
experiences feelings of frustration and anger. Jean gets
tearful thinking about all the things she can’t do.
Bad hip fracture—Elizabeth Until her recent fall, she
lived in her own home and managed to care for herself.
She was active in her local community.
Elizabeth broke her hip when she fell. She is now unable
to live alone as she requires a great deal of help to do
most things. Elizabeth now lives in a nursing home near
to her family but away from her friends. She is limited
in where she can walk because of the frame and is un-
able to walk for long distances. She is unable to shower
or dress without help from the nurse. She is unable
to pursue her gardening or community work. Her leg
impact
(FoF) bad experience
equilibrium is controlled
by deep muscles
immobility
Back problems no sucsess
+ group activities are possible
lack of training
stay at home Lack of
8

9. aches sometimes at night. She has become anxious and
is easily upset.
We decided to concentrate on the circle that will de-
velop after the fall and put our efforts towards easing
the problem and helping along with rehabilitation after
hip fracture. We went to Viimsi hospital to speak with
physiotherapists working there. When mapping the
situation in real life, we learned that the problem is not
in the hospital but at home. Rehabilitation hospitals are
quite well equipped. The equipment is simple, elegant,
professional and easy to use but with the help of a thera-
pist. Furthermore, it turns out that most of the older
people, at least in Estonia, don’t have enough money to
buy necessary equipment for themselves, which means
going to therapy regularly. But most people will start
going to therapy far too late.
- poor respect
- poor respect
+ no more relationship with the
partner
+ emotional support
- don’t meet people
-
+ practical support - contact with store keepers
+ emotional support, Hobbies,
solidarity - di culties to meet people
+ afraid to go out
- no more buisness asociates
- less involved in the society
possible + less money
- di cult to go to activity places
- decrease the walk and drive avility
9

10. Innovation
Context
Hospital Home
external passive Everyday
fixation or active training life
training
Internal with
(low-stress Active training
fixation physiotherapist
workouts) alone
(surgery)
simplified
scenario of
recovery after
a serious joint
fracture
In case of a serious joint fracture, the recovery period is
divided in 4 parts.
For instance after a hip fracture surgery with prosthe-
sis in Estonia:
• The patient will stay maximum 14 days in the hospi-
tal.
• A medical visit is planned 2,5 month after surgery.
If the joint can move at 90 degrees, the operation is
considered as a success.
• If after 6 month, the joint is still not recovered, the
patient will go to therapy.
This system has many problems:
• Some people don’t exercise at home (lack of motiva-
tion, lack of confidence, don’t remember the exer-
cises, don’t think about it, etc.)
• Some people work out too much and risk to hurt
themselves (over-motivation, body limits unaware-
ness, etc.)
• If a movement is done in a wrong way or with too
much amplitude, the joint can dislocate or break
again.
• If physiotherapy is done too late after the surgery,
its efficiency is very low.
Globally, the existing system minimizes the direct costs
(equipment, medical visits and physiotherapy). How-
ever, because it’s efficiency is quite low, it has many
additional costs like additional physiotherapy sessions,
personal assistance for non-self-contained people, etc.
10

11. Monitoring Our solution is to imitate some aspects
of the therapist to give patient reassurance that he is Global
being looked after, knowledge what to do when he is
exercising, motivation to do the exercises thoroughly Solution
and all of that in home environment. We achieve it with
sensors that are placed on the body.
Devices Sensors can’t do anything reasonable by
themselves - they need some interpretation. So our
solution consists of three different parts. Firstly, as
mentioned there are sensors, secondly there is a device
that is with you all the time (even when you are sleep-
ing) to monitor your physical activity and warn you
when needed. Thirdly there is a device that will assist
you when you are working out - it has more specific
capabilities to help you along the way.
Pre-Concepts Nb: “Doctor” can designate a physi-
otherapist or a nurse
Concept 1: Plasters and frequent visits
Sensors are placed on the body with a kind of plaster,
this is done by a doctor to ensure the right placement.
The doctor will set up the devices and teach patient to
use them. Plasters are thereafter changed every 1 to 2
weeks during visits to the doctor. Sensors and bracelet
are replaced with new ones that have charged battery.
Data stored in the bracelet is transferred over blue-
tooth to the doctor’s computer where it is analysed by
a computer program which is in turn overviewed by
the doctor. Doctor receives information about patients’
activity between the visits, wrong movements made by
patients and joints’ movement amplitude and can give
suggestions and new workouts directly face to face.
Concept 2: Strap/pants and distance monitoring
Sensors are placed on the body with several straps or
pants-like things, by the patient him/herself. Device
is removed every night and re-applied every morning.
Sensors are big enough to be feeled and put in a good
position (more space for electronics). Data is sent auto-
matically to the doctor via phone system. Doctor analy-
ses the data from his/her office, then can call or meet
the patient if needed. Doctor can be alarmed in case of
emergency (fall etc). Device is set up first time by the
doctor and thereafter by the patient him/herself. Feed-
back about current situation is received over phone or
in case of a very serious problem the patient is called to
the hospital for an emergency visit.
11

12. Legend:
Good
Bad
Neutral
Possible solution Concept 1: Plasters Concept 2: Strap/pants
and frequent visits and distance monitoring
Wash the device Don’t need to be Washable waterproof
washed and temperature resistant
Not usable during
washing
sensors must be
removable from straps
Possible to not wash it
often?
Take a shower/bath Possible Has to be removed
Need to be waterproof
which is expensive if
bathing should be
included
Go to toilets No changes Straps: no changes
Pants: Need to be
removed
Comfort Sweat Straps: need to be tight
Need to be flexible Pants: ok
Painful when removed
can be removed with
solvaint
Battery all components must be Seems ok, especially with
really power efficient pants (1 battery and 1
transmitter)
Extra power to send
energy
Accuracy Good because applyed Straps: Difficult to put
by the doctor/nurse accurately
Can move if skin is Can move afterwards
flabby Pants: ok for the position
placed in non flabby Good stability
places
Aesthetics ok more visible
Price and time for Medium Depends of the needs
doctors Can be combined with Doctor needs to file a
distance monitoring if report even if monitoring
no battery problem from distance
Efficiency Long time before Doctor receives the data
feedback of doctor quickly
Can be combined with Don’t see the patient
distance monitoring if directly
no battery problem
Direct contact with
doctor immediate
feedback
Communication Good and predictable Few direct meetings
less confidence
Amount of work and None Every morning and
12 difficulty for patient evening

13. Possibility to Can´t change difficult if it is under
correct the position immediately dressing
when it is disturbed Painful to take off
Physical conditions good, because I can’t Pants: difficult to put on,
of patient: memory, feel it all the time/ to correct them( balance
vision, balance, possible to forget that and possibility to turn the
movements you have it on body, stomach aloud not);
fingers will not move well;
forget to put on
Straps: difficult to feet
down the leg ( balance,
fingers will not move well,
stomach aloud not),
difficult to worship; forget
to put on, cant see the
connection marking
How it feet with Very well- possible to Pants: impossible to
dressing put on as pants , so as compose with other
tights (women) dressing(type, colour,
boots- stout body)
Straps: difficult to put on
with tights; connections
remain in the fabrics
How it fit with the Doesn’t disturb body Pants: uncomfortable -
body movements; can’t change the pants if
its too warm. It is needed
to put on and off mornings
and evenings- I don’t want
to do it again , because it
is painful and difficult;
should be right size; it
supports body- helps to
move
Straps: scale of sizes; if it
is not well placed it can
slip down or move to the
wrong position; disturbing
to lie down or took of for
resting time- squeezes and
disturbs because of the
thickness of the fabric);
Conclusion We decided to go with the plaster concept, mainly so because
of the benefits when wearing it and the fact that it’s less demanding for the
patient. The plaster concept got even stronger when feedback from our fam-
ily doctor came back saying that even when they monitor from the distance
they still must file the report, so there is no time benefit for doctors with
distance monitoring, if anything then the time will be increased because of
the denser monitoring cycle. 13

14. Usability Patches Patient is wearing patches all the time, these
are applied and changed during medical visit that hap-
pens roughly once every month. The patches are invis-
ible under clothes, they withstand showering but bath-
ing and swimming is not allowed during recovery period
(this will exclude water therapy). Patches are made
from fabric that lets skin breathe but makes the patch
more durable. When a patch has been applied on skin for
a month it could be stuck quite toughly so solvent can be
applied to remove it.
Bracelet & Tablet Usability qualities of the bracelet
(device that is always with you and is meant to monitor
your overall activity) and tablet (specialized for exer-
cising) are made to meet the possible physical changes
of aging. Typically these are diminished vision, vary-
ing degrees of hearing loss, hand eye coordination and
psychosomatic impairments including difficulty with
small motor coordination. Important factor to follow is
the emotional and physical stage after surgery or injury
rehabilitation in hospital.
Emotional qualities of bracelets and tablets usability:
safety
motivation
assurance
independence
self-confidence
Usability milestones of bracelet:
• uniformly understandable display data
• easily manipulative grasp of the bracelet, so it is
easy to put it on and take it off (see image on the
facing page)
• antibacterial material
• good contrast of display colors
• visual, sound and vibration alarms provide efficiency
in the different physical conditions of the elderly
users
• is applicable with one hand
Benefits of bracelet:
• black-white and two warning colors
• uses 3 different possibilities of alarm: visual, sound
and vibration - they all work simultaneously and
complement each other to give clear understanding
of the situation
• it has also low battery indicator (emergency only,
normally battery is replaced in hospital)
• easy to put on and take off because of material of the
strap and system of the clasp what is broaded on the
end so that it is impossible to pull it out of the buckle
14

15. Characteristics of tablet:
• has two working positions: standing and lying for
various using patterns
• doesn’t have a battery and only needs to be plugged
in to operate
• display orientation will change according to the posi-
tion of the device
• two buttons to use: on/off and pause/play
• exercises are displayed as video, these are the same
videos that are already in use at the rehabilitation
centres
• speaker and warning signs let the person know
about too fast and wrong movements, also voice
command is played when proceeding to the next
exercise
The bracelet uses Velcro to open and close easily. The end of the strap is bigger than the buckle
so the bracelet never completely opens, and is therefore easy to slip on the wrist.
15

16. 16

17. 17

18. 18

19. 19

20. Storyboard
The clock is ringing Ants opens his eyes, he puts one leg
over the bedside to stand up. Something on his night-
stand goes BEEP-BEEP-BEEEP... he hears it almost
every morning, it is an alarm saying he bends his leg
to a dangerous position. As the sound isn’t violent he
knows that he is in the safe zone and that this is just
a reminder. He raises to sitting position, picks up the
bracelet that doctor gave him after his hip surgery and
fastens it on his hand.
Over last couple of weeks Ants has developed a habit of
going to the market place with his wife. Doctor suggest-
ed him to walk daily and going to marketplace is a nice
and pleasing outcome of trying to fulfill that command.
As the weather is nice and their house isn’t far they de-
cide to walk back. In front of the house Ants is looking
at the bracelet that doctor gave him and he smiles. The
watch shows that he has already done half of the daily
physical activity required.
20

21. It is time for everyday workout. Well, it isn’t so much an
exercise as it is just bending practice, he thinks. At the
last meeting the doctor showed him some exercises that
would be best performed next to table. As always he
turns on the device that shows him exercises the doctor
described. The display on the device starts to glow and
plays a video clip of the exercise. Ants is already famil-
iar with the exercises so he isn’t looking at the screen so
much because he knows the movements and the device
tells him with nice voice when he is doing something
wrong. After some repetitions device says: “That’s
enough it will do. Lets move on to the next exercise”
and the video showing next exercise starts. Right then
telephone rings! Without hesitation he pushes one of
the two buttons on device, which pauses and answers
the phone, it was his daughter checking his progress on
recovery. After call ends he walks back to the table and
turns on the device, screen starts to glow and it starts to
play the same video it was prior to shutting off.
In the evening Ants decides to take a shower. As he
undresses he puts the bracelet on top of the washing
machine. As in their apartment shower and bathtub is
joined, getting under shower is hard work for someone
who is recovering from hip surgery. The bracelet seems
to agree as it starts vibrating and beeping vigourosly a
few times during his “mountain climbing”. This might
be the most extreme point of the day regarding to his
recovering limb. Ants thinks that he might avoid show-
ering altogether when there weren’t this little helper.
21

22. Everyday life
bracelet’s interface
Situations Vibration alarm Sound alarm Visual alarm Screen
morning, wake up,
beginning of the day
wrong movement,
too large amplitude
of movement
or too fast
starts with low starts with low
interval impulse, alarm light alarm light
interval impulse,
grows more vigorous outside the screen. outside the screen
as the limit gets grows more
closer. vigorous as the
limit gets closer.
amount of activity
is too close
to the limit
Limit is achieved
2x beep 2x vibration impulse
Amount of activity
is to less
2x beep 2x vibration impulse
Baracelet is not on
the hand
steady alarm light
steady signal steady alarm light
outside the screen
outside the screen
Stay a long in
wrong position or
fall down
stop after a while stop after a while
stop after a while stop after a while
22

23. Working-out
bracelet’s and tablet’s interface
bracelet’s interface tablet’s interface
situations Sound alarm vibration Visual screen Voice on Screen
alarm tablet
start
exercising
wrong
movement,
too large
amplitude
alarm light
of starts with starts with alarm light
movement low interval low interval outside the outside the screen
impulse, screen.
grows more impulse,
vigorous as grows more
the limit gets vigorous as
closer the limit gets
closer
too fast
movement
the end of
exercises
depends on how
much is done
too much
is done off off
2x beep 2x vibration
impulse
too little
is done off off
2x beep 2x vibration
impulse
stay long
in a wrong
position or
stop after a stop after a stop after a
fall down while
while while stop after a while
23

24. Technical The figure below describes the interactions between the
patches, bracelet and tablet electronic components.
working The patches capture the body movements with the mo-
tion sensors (1) and send it to the bracelet via bluetooth
(2).
The collected data are then processed by the bracelet
microcontroller (3), to calculate the joint angles. These
angles are saved in the bracelet memory (4). The brace-
let display changes according to the quantity of move-
ment registered (5). If a problem is detected by the
microcontroller, the alarms will work (6).
When the user is working out, the LCD screen displays
a video of the exercise, which is stored in the tablet
memory (7-8). The exercise is chosen according to the
settings of the bracelet (4-3-7-9). The data processed by
the bracelet are used by the tablet microcontroller to
command the speaker (3-7-9-10).
Patches Bracelet Interface
Vibration
alarm
4 6
1
Visual
6
alarm
6
3 Sound
alarm
2 5
7
Tablet
9 8
Movement
7
Wired 10
Wireless
24

25. Motion sensor To measure movements, several kind Patches
of electronic components can be used:
• Accelerometer and gyroscope
They measure respectively the linear and rotational ac-
celeration.
To measure a position, it should be calibrated (refer-
ence position and sensibility). Also, they have a limited
measure speed; if this speed is exceeded, the reference
position has to be set again.
• Infrared DEL and camera
This solution uses special camera to follow the move-
ment of infrared DEL (For instance in the Nitendo
Wii™). Because the camera is external and should
always point at the DEL, it’s not suitable for our appli-
cation.
• Incremental encoder
It measures the angular position or motion of an axle.
Because it measures the position only around an axle,
it’s not suitable for complex joints like the hip, which can
rotate in every direction.
• Electronic compass
An electronic compass uses the magnetic fields to know
its orientation. By calculating the difference between
the angular position of the two compass, it’s easy to
measure an angle.
In this way, the reference is always the same for every
sensor, so the measures are reliable.
These components are cheap (~2€), small (~15mm3) and
consume little energy (~100µA in normal mode, 1µA in
sleeping mode).
An electronic compass in each patch will be used to
measure the joints’ angles.
For instance, the STMicroelectronics LSM303DLHC
could be used (see Appendix VI)
Wireless connection Because the bracelet is always
close to the patches, and people work-out near the tab-
let, the distance range is approximately 5m (plus secu-
rity margin).
The amount of data is very low (few kbit/s).
The Bluetooth v4.0 with low energy technology suits
very well.
Bluetooth low energy chip
Bluetooth v4.0 low energy characteristics:
Distance range 10 to 60m
Bit rate ~200 kbit/s
Current consumption 15.8 mA (0.001mA in sleeping mode)
Size 6mm x 6mm x 0.85mm
Price ~2€
25

26. Autonomy calculation Because the patches will be
changed every 3-4 weeks only, they should have this
autonomy at least. The patches are worn all the time, so
their electronic part (including the battery) should be as
small and lightweight as possible. For this reason, it is
important to optimize the energy consumption.
• Bluetooth consumption:
Single connection event of BLE: 2.3 ms
@10Hz active time: ~2%
The average current consumption during a single con-
nection event: ~10.655 mA
Sleep current: 0.001 mA
=>Average consumption: [ (1000 ms – 2.348 ms)*(0.001
mA) + (2.348 ms)*(10.655 mA) ] / (1000 ms) = 0.026 mA
(Sleeping mode / Normal mode)
• Compass consumption
Compass average current consumption: 0.11 mA
• Global autonomy
Coin cell battery* nominal capacity: 550mAh
550mAh /(0.026mA + 0.11mA)= 4044h
4044h/24h = 168,5 days = 24 weeks
=> A patch can have a long enough autonomy with a
very small and lightweight battery.
*A coin cell battery is used for calculations as an ex-
ample. The final device could use any kind of battery
(disposable or rechargeable). The example battery has
following characteristics: 3V, 13mA, 24.5 x 5.0 mm, 6.2g,
0.08 - 0.16 € / Piece.
Bracelet Wireless connection See “Technical working/
Patches/Wireless connection” page 25
Microcontroller The bracelet microcontroller is used
44 to:
• Calculate the joint angle from the sensors data
• Control the bracelet alarms
• Control the bracelet display
• Store the data in the bracelet memory
Because the required speed is very low comparing to
existing microcontrollers, the bluetooth embedded mi-
54
crocontroller could maybe be used.
Memory The bracelet memory should store:
• The bracelet firmware
• All movement data between two medical visits
• The reference of the exercises gave by the doctor
• The limit angle settings
In this way, during a medical visit the physiotherapist
14
can download the movement data and set up the system
via bluetooth.
Activity display The display should be easily readable
in all conditions. A liquid crystal display (LCD) is not
readable if the light level is too high. Also, the back-light
of an LCD screen consumes a lot.
For these reasons, an electronic paper (E-ink) will be
26 used.

27. The main advantages are:
• Electronic paper uses natural light. So it is visible
even in difficult condition (except dark), just like
usual paper.
• The energy consumption is very low (and null when
the display remains the same).
• Cheap (a few euros)
The E-ink is usually only black and white (color screens
exist but are expensive). Because the displayed colors
are constant (orange and red), some color filters will be
placed above the display. It will color the white parts of
the display, but will remain almost invisible on the black
parts.
Visual alarm For the visual alarm, a LED light is
more suitable than the E-ink, because it is more «ag- Bracelet display
gressive». To include the led light in the E-ink display,
there are several possibilities:
• Because the electronic paper can be translucent, a
backlight can be placed behind (the display back-
ground would become white for a better visibility).
• A light can be placed around the display (the display
background would also become white for a better
visibility).
• A hole can be drilled in the center of the display to
insert a light (the E-ink would still work). Filters can give
color to electronic
paper
Visual alarm with
backlight
Visual alarm with
light around the
display
Visual alarm with
light in the center
27
of the display

28. Vibration alarm The same kind of vibration motor
as used in cellphones is suitable. They are cheap, small,
lightweight, etc.
An example is the “Precision Microdrives 310-103”
Sound alarm The alarm should be loud enough to
be heard in a noisy environment. A powerful enough
speaker would be big, heavy and power consuming.
The alarm will then be a simple polyphonic “beep”.
In order to not be too loud in more quiet environment,
Precision Microdrives 310-103 a small and cheap microphone will be used to measure
the environment noise level, and then adjust the alarm
level.
Wireless connection (Bluetooth low energy) See
Tablet “Technical working/Patches/Wireless connection”
page 25
Memory The tablet memory will store every exercise
demonstration. Each exercise has a reference, so the
bracelet can control which exercises will be displayed.
It also stores the vocal records used by the speaker.
Microcontroller The tablet microcontroller controls
the screen and the speaker. It also counts the exercise
movements with the measured joint angles.
LCD display The tablet will be used indoor, and will be
mains-operated (plugged). A color LCD screen will be
used to display the exercise demonstration. Indeed, the
light and consumption are not problematic in this case.
Speaker To give clear information, the tablet will use
a recorded voice. Normal speakers used in multimedia
equipments are suitable.
270
201
76
28

29. SERVICE FLOW MAP
PATIENT DEVICE (KIT)
AT HOME PRODUCER/SUPPLIER
Admit to
hospital
HOSPITAL
2.Surgery, Sensor fixing
and Rehabilitation
training
START
3.Patient back to home
4.Patient Visits every 3-4 weeks
5.Check the sensor and
battery, change plasters
LEGEND LOCAL SERVICE
6. Technical service and COMPANY
Support
material information financial labour
flows flows flows performances
Service
29

30. Service blueprint
Device Medical Patient
producer staff
Bone fracture
Device
Surgery Surgery
production
Beginning of
Intensive care
Device supply rehabilitation
Normal
logistics
Put the sensors on Get the sensors
Teach how to use Learn how to use
the device the device
Technical support
Working- Everyday
Time
out life
• Remove sensors
• Download and Medical visit
analyse data
• Gives feedback
• Put new plaster
• Learn new
• Physical check
• Change watch exercises and
practise
battery
• Set-up (Angle
limits, exercises
and speed)
• Teach new
exercises
Working- Everyday
out life
Send discharged
sensors
• Receive sensors
• Remove sensors
• Test battery Final medical
• Download and
• Recharge visit
analyse data
battery
• Physical check
• Pack sensors in Give back the
• Recovery
new plasters watch and external
validation
• Ship back device
• Advices
sensors
30

31. The project has a lot to be developed, for instance we
left aside the doctor’s side of the information flow. Further
We included some information but the area is lack-
ing deeper research and development. Similarly we developments
didn’t go into further details with the electronics
partly because our team lacks the competence and
partly because the project will be taken further by
Peeter Lump - a master student from the depart-
ment of mechatronics who will prototype the neces-
sary components as his master thesis. Also rehabili-
tation nurses in Viimsi hospital offered their help
with finding patients for testing if the project reaches
prototype stadium.
Further development should also take place on
graphical interface part - there are already many
changes that could improve the performance on the
interface level that didn’t fit to the report.
It seems that the project timing was very good, as a
few key components that were crucial for project’s
Conclusion
success were released after the start of this project.
For that reason high activity can be expected in that
part of the field this year. We believe that in a few
years personal monitoring will become highly acces-
sible. It is possible today and will be more effective
tomorrow. Technical development is definitely head-
ing that way.
Technical
References
Bluetooth low energy (05/12/2011)
http://www.bluetooth.com/Pages/Low-Energy.aspx
Electronic Paper Displays (27/12/2011)
http://www.eink.com/
Vibration Motors - Precision Microdrives (24/11/2011)
https://catalog.precisionmicrodrives.com/order-parts/product/310-103-10mm-vibration-motor-
2-7mm-type
Existing
Movea - Joint Assessment (18/11/2011)
http://www.movea.com/applications/e-health-and-wellness/joint-assessment
Motion trackers and motion capture systems for biomechanics research - Xsens (18/11/2011)
http://www.xsens.com/en/movement-science/mtw
Up by Jawbone | Band + App Inspires Healthy Living (09/12/2011)
http://jawbone.com/up/product
Medical
Quality of life related to fear of falling and hip fracture in older women: a time trade off study ; G
Salkeld, I D Cameron, R G Cumming, S Easter, J Seymour, S E Kurrle, S Quine (BMJ VOLUME
320 5 FEBRUARY 2000)
“Forget-me-not: Long-term Post-
operative Care in Hip Fracture Patient” presentation by: Jay Magaziner, PhD, MSHyg 31

32. Home-Based Multicomponent Rehabilitation Program for Older. Persons After Hip Fracture: A
Randomized Trial (Arch Phys Med Rehabil Vol 80, August 1999 )
A SOCIAL PORTRAIT OF OLDER PEOPLE IN IRELAND (Government of Ireland 2007)
A healthier elderly population in Sweden! Göran Berleen (ational institute of public health – swe-
den 2004)
PREVENTION OF HIP FRACTURE IN ELDERLY PEOPLE WITH USE OF A HIP PROTEC-
TOR (The New England Journal of Medicine VOLUME 343 NOVEMBER 23, 2000)
Randomised factorial trial of falls prevention among older people living in their own home (BMJ
2002)Lesley Day, Brian Fildes, Ian Gordon, Michael Fitzharris, Harold Flamer, Stephen Lord
Fear of Falling After Hip Fracture: A Systematic Review of Measurement Instruments, Prevalence,
Interventions, and Related Factors (2010, The American Geriatrics Society)
Older adults’ perspectives on home exercise after falls rehabilitation: Understanding the impor-
tance of promoting healthy, active ageing Helen Hawley (Health Education
Journal September 2009 vol. 68)
SOCIAL AND HEALTH PROBLEMS OF THE ELDERLY Ljiljana Pesic (Acta Medica Medianae
2007)
Joint fracture treatment (04/01/2012)
http://bonesfracture.com/joint-fracture-treatment-joint-bone-fracture-surgery-fractured-joint-
healing-time-symptoms-and-recovery/
Tools
Workshop attended on 26.09.2011 and venue Tallinn University of Technology, room V 215
Title of workshop: System design for sustainability and service
http://www.lens.polimi.it/index.php?P=lr_upload_course.php&ID=MLYUUXUFON2009070820
2156&DWNL=Y#
Tests and interviews
dropbox/ report/ appendixes/tests results
dropbox/ report/ appendixes/elders view
32

33. Appendixes
Appendix I: Findings among older people
Opinion of 3.elderly person ( women ) in 65, 76 and 90 years about equipment, comparing
plasters and pants, wearing and use :
• All worried about how to remember exercises they should to do: what exercises, how
much and how often
• Liked idea of plasters more, because it is simply to wear, possible to compose with
other dresses
• Plasters, because it is not needed to put on and take off
• 2. of them (90 and 76 ) was worried about how carefully they should wear plasters for
not making wet or not to take off accidentally
• Liked watch idea very much, because it is like a milestone of remembering, possibility
to see how much exercises have been done
• But worried about when the watch let them know about wrong movement , how they
will get know what position exactly was done with wrong angle or direction
• Worried about watch to put on and off because fingers don´t move so good ( 76, 90 )
• About the display of watch to be clear to view and to understand, because they afraid
to do something wrong with electronic equipments
• Liked alarm and vibration of watch, because it seems better when both signals works
at one time
But:
All of them thought that this is a good idea to be controlled by equipment and
Plasters- simple to wear, possible to compose System-how to remember exercises
with other dresses
Plasters- it is not needed to put on and take off how carefully they should wear plasters
Watch- like a milestone of remembering, when the watch let them know about wrong
possibility to see how much exercises have movement , how they will get know what
been done position exactly was done with wrong angle or
direction
Alarm and vibration of watch- better when watch to put on and off because fingers don´t
both signals works at one time move so good ( 76, 90 )
System-it is a good to be controlled by watch to be clear to view and to understand,
equipment and interaction with a doctor or a because they afraid to do something wrong
specialist with electronic equipments
interaction with a doctor or a specialist
33

34. Appendix II
Bracelets interface test results:
what is important for user
Visual Sound Vibration
alarm alarm alarm
Limit set by Wrong Wrong
doctor movement movement
control control
Limit set by Wrong Wrong
doctor, battery movement movement
control, control
Over limit
Limit set by Over limit Wrong
doctor, battery movement
control
Appendix III
Bracelets interface test results
question answer
Should I wear a bracelet all the Yes, it is the main idea
time ?
Will it possible to remain me I It is possible, but it will be
should do exercises ? complicated to compare all alarms
When I should check my results: It is possible to check during the
during the day or on the end of the day or in the end
day ?
What I`ll see on the bracelet Visual alarm as a light outside the
screen after I do the wrong screen. It is not needed to push
movement? What I should do the any button (not exist), the
next, push some button ? signal will stop if the position will
change
Will I see next day yesterday Start with a new one
achievement or start with new?
34

35. Appendix IV
Tablet interface test results
question solution
How can I start the exercise Just push the on/off button
video ?
How can I stop and Push the pause/play button
continue ?
If I do wrong movement will I Yes, a red triangle and a voice
see info on the screen? declaring it
Will I see the certain place on No, it will be just video of
the screen I did wrong exercises, not animation of
movement? real movements
Does the video stop after I do Video stops with voice alarm
wrong movement that I may and red triangle and continue
then continue? itself after position is changed
Appendix V
Usability of bracelet and external
device
Functional qualities “ Soft “ qualities
Sound and vibration alarm Safety: wrong movement
control
Exercises menu- Independence:`”I may do it
introductory video, reminder by myself without asking “
Activity results will be Assurance: results will be
collected independently analysed by specialist
Alarm when the limit is Encouragement: allowed
exceeded limit set by the doctor
Activity screen Self-confidence: “ I can
move and see results “
35

36. Appendix VI
LSM303DLHC
Ultra compact high performance e-compass
3D accelerometer and 3D magnetometer module
Preliminary data
Features
■ 3 magnetic field channels and 3 acceleration
channels
■ From ±1.3 to ±8.1 gauss magnetic field full-
scale
■ ±2g/±4g/±8g/±16g selectable full-scale
LGA-14 (3x5x1mm)
■ 16 bit data output
■ I2C serial interface
■ Analog supply voltage 2.16 V to 3.6 V Description
■ Power-down mode/ low-power mode
The LSM303DLHC is a system-in-package
■ 2 independent programmable interrupt featuring a 3D digital linear acceleration sensor
generators for free-fall and motion detection and a 3D digital magnetic sensor.
■ Embedded temperature sensor LSM303DLHC has linear acceleration full-scales
■ Embedded FIFO of ±2g / ±4g / ±8g / ±16g and a magnetic field full-
■ 6D/4D orientation detection scale of ±1.3 / ±1.9 / ±2.5 / ±4.0 / ±4.7 / ±5.6 /
±8.1 gauss. All full-scales available are fully
■ ECOPACK® RoHS and “Green” compliant selectable by the user.
LSM303DLHC includes an I2C serial bus interface
Applications that supports standard and fast mode 100 kHz
■ Compensated compass and 400kHz. The system can be configured to
generate interrupt signals by inertial wake-
■ Map rotation up/free-fall events as well as by the position of the
■ Position detection device itself. Thresholds and timing of interrupt
■ Motion-activated functions generators are programmable by the end user on
the fly. Magnetic and accelerometer parts can be
■ Free-fall detection enabled or put into power-down mode separately.
■ Click/double click recognition
The LSM303DLHC is available in a plastic land
■ Pedometer grid array package (LGA) and is guaranteed to
■ Intelligent power-saving for handheld devices operate over an extended temperature range from
-40 °C to +85 °C.
■ Display orientation
■ Gaming and virtual reality input devices
■ Impact recognition and logging
■ Vibration monitoring and compensation
Table 1. Device summary
Part number Temperature range [°C] Package Packing
LSM303DLHC -40 to +85 LGA-14 Tray
LSM303DLHCTR -40 to +85 LGA-14 Tape and reel
April 2011 Doc ID 018771 Rev 1 1/42
This is preliminary information on a new product now in development or undergoing evaluation. Details are subject to www.st.com 42
36 change without notice.