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Essay / A Simulator Design for Cervical Spine Manipulation Training their skills on treatment methods for cervical musculoskeletal deficiencies. The most important reasons for the long training period are the presence of vital organs in the region and the widespread use of manual therapy (MT) techniques in the cervical spine. TM interventions include externally applied passive movements for facet joint alignment and soft tissue mobilization. The goal of these interventions is to achieve a clinically significant decrease in neck pain and an increase in neck mobility. Passive movements at slow speed are called mobilization techniques. Generally, mobilization techniques are easier to learn and do not pose a significant risk of complications. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an original essay Interventions applied to adjust the involved cervical segment, with a single high-velocity, low-amplitude thrust, are known as manipulative techniques. Cervical spine manipulation (MCS) has advantages over conventional physical therapy modalities in immediately increasing range of motion and decreasing symptoms (headaches, stiffness) despite the risk of complications in a wide spectrum from simple spasms to arterial dissection (can cause quadriplegia or death). The presence of serious risks increases the duration of the course of manipulation techniques compared to other techniques. During the long training period, physiotherapy students study each safety element (extrinsic factor) of their handling skills; the appropriate pre-manipulative position of the patient's head and cervical spine, the angular displacement of the head and each cervical segment during manipulation, and the appropriate thrust speed. If there is a mismatch between extrinsic factors and the patient's condition, MCS may lead to adverse effects or complications instead of the desired results. In traditional MT training, students can only have subjective feedback; manual or verbal instructions from an expert practitioner regarding their practices. The numerical magnitude of the extrinsic parameters is unknown. This is the main limitation of the classical training model and there is a need to measure, demonstrate and verify extrinsic parameters in an objective manner. Physiotherapist students also develop their skills in handling each other before having a real patient experience. Even if they are healthy and classmates, the first handling experience on humans may exaggerate students' unreal perceptions of risk factors; Unfounded negative comments from classmates can sometimes contribute to self-distrust. This way of thinking can cause physical therapy students to avoid developing their manual skills on each other. Patient simulators are commonly used in medicine and nursing to demonstrate normal physiological functions, pathological conditions, and skills training prior to an actual patient experience. However,there are only experimental simulator models for MT training in the literature. There is a need for fully functional systems for classrooms that can help physical therapy students gain experience before applying techniques on healthy volunteers, simulations, or real patients. In Turkish physiotherapy practice, Orthopedic Manual Medicine is the most common and conventional TM method which was first introduced by Dr. James Cyriax in 1954. All MCS techniques of Dr. Cyriax can be reduced to different variations of two skill components that can be measured by transducers. These two parameters are the traction force and the angular displacement of the head and neck which must remain within the physiological limits of the patient.safety. Excessive tensile force or excessive angular displacement of the spinal segments in one or more directions can lead to complications. Analyzing raw data to determine whether or not limits are exceeded can provide objective feedback on the safety of handling. The aim of this study is to design and manufacture an objective skills assessment simulator for training cervical spine manipulation skills according to Cyriax. Methods Traction force and angular displacement feedback system A traction force and angular displacement feedback system suitable for Dr. Cyriax's manipulation method is configured as a classical biophysical signal acquisition and processing system consisting of a traction force transducer; a traction force amplifier; an angular displacement transducer, a data acquisition device and a data processing device. Dr. Cyriax had classified the magnitude of spinal traction force subjectively (Grade A, B, C) and there is insufficient data in the literature for magnitude equivalence. Mechanical traction systems are alternative methods of manual traction and 10-15% of the patient's body weight or traction forces between 2.27 and 8.14 Kgf (5-40lb) are used in clinical practice. Type S load cells are suitable for mounting on a rotating surface and can measure tensile force. A 500N HC-C3 type S load cell (Zemic, Etten-Leur/Netherlands) is used as force transducer. The transducer range is selected over the clinical range (200 N) for simulations of excessive traction forces. A bar graph threshold option is included in the software for normal traction range guidance. The load cell signal is amplified by an instrumentation amplifier (LT1167) with 500x adjusted gain. The calibration of the load cells is carried out by a set of class M2 reference masses. Dr. Cyriax described the range of angular displacement per physiological barrier which is a subjective range between the anatomical barrier and joint dislocation. In an electrogoniometric measurement study, the physiological range of cervical rotation is reported to be between 70° and 90°. This range was to be further validated using a motion capture system on real patients for an alternative manual manipulation technique. A 5 V/360° single-turn analog encoder, Opkon MRV-50 (Opkon Electronics Istanbul/Türkiye) is used to measure the angular displacement. The transducer range is selected over the clinical range for simulation of excessive rotational displacement. Guidance to physiological limits is also provided by adjustment screws which can limit rotation within the indicated range on both sides. The USB-1608FS DAQ card(Measurement Computing (MCC), Norton/USA) is used for the acquisition of tensile force and angular displacement data. The device was built using separate elements of a CNC machine (ball bearing, bearing housing, connector shell and shafts), a head model (Enas CPR Prompt, Wisconsin/USA) and vertebra models cervical (3B Scientific A72, Budapest/Hungary). All elements are mounted on a stainless steel base. Two adjustment screws with rubber pads were placed on the proximal side of the base to limit rotation as within the physiological range. SoftwareThe software is developed in C# using the MCC universal library for users who are not familiar with technical computing. The A/D input channels are read by the AIn function and the returned 16-bit integer values are converted to a single precision equivalent voltage value by the ToEngUnits function. The sampling rate was set to 1KS/sec. Raw tension measurements are converted to force and angular position data by calibration equations. The final data is presented as an xy line plot or bar graph. The XY line chart format is suggested for demonstration and analysis of soft skills. The bar graph format is specifically designed for workouts at physiological limits. Graph, data logging and reporting functions are included for storage. The software is tested with Tracer DAQ 2. 3. 0 (MCC USA) reference software for reference weights and angular positions until the same results are obtained.AssessmentSoftware supports industry-leading measurement results , generates a report with graphical and maximum values for the assessment of fundamental skills. Additionally, maximum traction zone, rotation zone, and intersection zone markers are used for brief visual definition of skill deficits. The maximum traction zone is a horizontal rectangle at the level where the traction force reaches its maximum and remains constant. The rotation area is a vertical rectangle that represents the rotation duration. The intersection of the two areas identifies the critical area where any error can lead to complications. ResultsForce calibration was carried out between 0 and 50 Kgf using a set of class M2 reference masses. All data were analyzed using linear regression. The linearity of the force transducer is R=0. 995 and SEE=0. 910 is in the range. The angular position sensor is factory calibrated. It has a resolution of 10 bits, 5 V/360°. Working PrinciplesThe pulling force on the main part triggers the load cell, the output signal increases according to the pulling force. Then a bad output signal is amplified 500 times and acquired by the DAQ card. The center of mass places the head in a natural 90° position (1.25 V). The baseline can be adjusted by software. At the end of traction, the rotation of the head triggers the rotary encoder. The output voltage increases for the right side and decreases for the left side. The output signal has adequate amplitude and is directly acquired by the DAQ card. Software interface The software interface consists of two group areas and a graphics area. DAQ card, acquisition, and evaluation operations can be performed using commands in group boxes. Maximum and current values are indicated by legends. The values of the desired points can be accessed by mouse clicks. Skills reporting, data export, and charting features are included. Controls and.
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