AUTOMATIC DYNAMIC SPLINT

By

JOSEPH ANGELA

OYE FLORENTINA

GEEYAM ERIC

AKANDE SEYI

A PROJECT REPORT

Submitted to the

SCHOOL OF BIOMEDICAL ENGINEERING

In partial fulfillment of the requirements for the award of the degree

Of

BACHELOR OF ENGINEERING

In

(BIOMEDICAL ENGINERING)

ALL NATIONS UNIVERISITY COLLEGE

KOFORIDUA, GHANA

JUNE 19TH, 2020.

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 BONA FIDE CERTIFICATE

We certify that this project “AUTOMATIC TENDON DYNAMIC SPLINT’’ is a bona fide
work of “MISS JOSEPH ANGELA, MISS OYE FLORENTINA, MR GEEYAM ERIC, and
MR AKANDE SEYI” who carried out this project under the supervision of “DR ARCHIBALD
DARQUAH-AMOAH”.

Certified further, this work reported does not form part of any other project report or dissertation
on the basis of which a degree of which a degree or award was conferred on an earlier occasion
on this or any other candidate.

………………………………………….. ……………………………………

DR MERCY ADUSIE DR ARCHIBALD DARQUAH- AMOAH

HEAD OF DEPARTMENT SUPERVISOR

Biomedical Engineering Biomedical Engineering

All Nations University College All Nations University College

Koforidua Koforidua

…………………………………… …………………………………….

DR ARCHIBALD DARQUAH-AMOAH EXTERNAL EXAMINER

DEAN OF BIOMEDIAL ENGINEERING AND

SCHOOL OF ALLIED HEALTH AND SCIENCES

Biomedical Engineering

All Nations University College

Koforidua

2
 DECLARATION

This project report titled “MUSCLE STRAIN DYNAMIC SPRINT” was prepared and
submitted by “Joseph Angela, Oye Florentina Cindy, Geeyam Eric, and Akande Seyi” and has
been found satisfactory in terms of scope, quality and presentation in partial fulfillment of the
requirement for the Bachelor of Engineering (Biomedical Engineering) in All Nations University
College, Koforidua, Ghana.

...................... ...................... ….……………… .………………….

Joseph Angela Oye Florentina Geeyam Eric Akande Seyi

ANU16280034 ANU16280110 ANU15270273 ANU13230617

3
 ABSTRACT

A splint could be defined as a rigid or flexible device that aids in maintaining position a displaced
or moveable part. They are used to keep in place and protect an injured part. The materials which
were used to construct the device were selected based on the following factors: easy to integrate,
bio-compatibility. These were the materials used leather, wood and thread. This device was
designed to help individuals relieve their pains without adding undue stress on the affected body
part. Its operation was done through the electronics with inbuilt circuits.

4
 ACKNOWLEDGEMENT

After a successful completion of the above project, we wish to use this opportunity to thank God
for his infinite mercies, understanding and wisdom which enabled us to see that this project was
a success.

And also, with our hearts full of gratitude, we also show our deepest appreciation to the
management of All Nations University College.

We also appreciate our beloved supervisor and Dean of Biomedical Engineering and Allied
health and Sciences for his tremendous help and assistant to see we achieved our stated aim for
the project.

We also appreciate our colleagues who assisted during the construction and programming.

5
 TABLE OF CONTENTS

BONAFIDE CERTIFICATE i

DECLARATION ii

ACKNOWLEDGEMENT iii

ABSTRACT iv

1. INTRODUCTION

1.1 Back ground of study 12

1.2 Problem statement 13

1.3 Justification 14

1.4 Aim 15

1.5 Objectives 15

2. LITERATURE REVIEW

2.1 History of the dynamic splint 14

2.2 Reviewed Papers 15

6
3. MATERIALS, METHODOLOGY, SYSTEMS DESIGNS AND IMPLEMENTATION.

3.1 Introduction 23

3.2 Materials 23

3.3 Methodology 33

3.4 System Design 3

4. RESULTS AND DISCUSSION

4.1 Device Set Up 43

4.2 Result 44

4.3 Discussion 45

5. CONCLUSION AND RECOMMENDATIONS

5.1 Conclusion 46

5.2 Recommendation 47

5.3 Finding 48

5.4 Limitation 49

Referencing 50

Appendix 52

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 LIST OF FIGURES

Fig 2.2.1 Elbow Splint 20

Fig 2.2.2 Ulna Splint 20

Fig 2.2.3 Cock up Splint 21

Fig 2.2.4 Mallet Splint 21

Fig 2.2.5 Silver ring splint 22

Fig 3.2.1: 9v Adapter 26

Fig 3.2.2: Light Emitting Diode 27

FIG 3.2.3: A Stepper Motor 28

FIG 3.2.4: Internal structure of a stepper motor 28

Fig 3.2.5: Capacitor 29

Fig 3.2.6: On/Off switch 30

Fig 3.2.7: Microcontroller 31

Fig 3.2.8: Stepper driver 32

Fig 3.4.1 Flow chart 34

Fig 3.4.2 Block Diagram 35

Fig 3.4.3 Circuit Diagram 37

Fig 4.1.1: Complete set up of the device 40

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Fig 4.1.2: Complete set up of the device 41

LIST OF TABLES

Table 3.2.1 Components 24

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 CHAPTER ONE

1.1 Background of study

Extensor is a muscle whose contraction extends or straightens a limb or other part of the body.
Tendon is a tough band of fibrous connective tissues that connects muscles to bones and it is
capable of withstanding tension. Tendons are made of collagen. When a tendon is only stretched,
it should heal in four to six weeks if a splint is worn. And if in the case whereby the tendon is
torn, the splint will be worn for about six to eight weeks before adequate healing can occur. A
dynamic splint can reduce recovery time and maximize the overall range of motion for a joint by
Eric (2008). The manual tendon extensor dynamic splint is an orthotic device that is used for
upper hand extremities in order aid mobility after incident or accidents. The dynamic splint, aids
in reducing pain and swelling by providing local rest to the joints of the hand and the hand. It
also helps to ensure that there is proper positioning of the hand when asleep. It also immobilizes
and protects joints and tendons that are inflamed. They stretch joints that are lacking range of
motion. When one is injured, undergoes a surgery, has a disease or even immobilized, we know
what joint stiffness feels like and how it restrains you. Range of motion limitations, or
contractures, can result from a variety of orthopedic conditions. A dynamic splint is defined by
Dyna Splint Systems Inc (2015) as a two-sided non-circumferential spring-loaded tensioning
apparatus that helps to increase joint range of motion. Dynamic splinting has been applied in so
many areas of rehabilitation. Research shows that an extensor tendon surgery has been
recognized as a difficult problem in hand surgeries such as muscle atrophy, joint stiffness,
infection, accident, stroke etc. Where loss of active motion in the digits results in significant
morbidity. Muscle strain injuries are traditionally splinted with no motion for three to four weeks
after repair, but in order to prevent this we implore the dynamic splint program. The tendons are
said to lie just under the skin, they lie next to the bones on the back of the hand and fingers and
they function by straightening the wrist, fingers and thumb. As a result, they can be injured by a
minor cut or jamming a finger which may cause the thin tendons to rip from their attachment to
bone and the inability to independently bend or straighten a joint or finger. The extensor tendon
can be divided into intrinsic and extrinsic groups. The intrinsic muscles are located within the
hand itself and they allow delicate fingers motions and contraction. Whereas the extrinsic

10
muscles are located proximally in the forearm and insert onto the hand by tendons. They are like
ropes attached to the muscle bellies of the forearm. When the muscles contract they pull on the
rope and movement is induced in the fingers. The base of the dynamic splint extends from the
metacarpal’s heads to two thirds of the forearm for the adequate support of the outrigger.
Dynamic hand splints like the SaeboStrech, stated by Henry (2017) aids to improve the range of
joint motion and as well prevent pain resulting from contracture. This type of dynamic splint
allows for more mobility recovery while providing an overall support and stability for the
affected area. It helps the fingers relax, and this gradually causes the finger to return to their
original or initial position. Another dynamic splint designed is the R.I.C plastic tenodesis splints,
which is used after hand surgery. It provides maximum strength for the functioning muscles
groups and likewise prevents contracture of the web space of the thumb and contractures or
deformities of the index and long fingers. An automatic dynamic splint is not so different from
the manual or the normal dynamic splinting that we know about. It is just that for the automatic
splint, there is an introduction of electrical or electronic components. This type of dynamic splint
is home-based, in the sense that it is used only at home or working places. This is due to the
electronic devices such as the stepper motors, which is quite a heavy device and also due to the
fact that it uses power supply. It will also have a battery which is used as a means of back up in
case of power light out. This review focuses on the design of a dynamic splint (Automatic), its
functionality, cases where it can be applied. This spring-loaded dynamic splint is worn at rest for
six to eight hours at a time, and employs adjustable low load prolonged duration stretch
technology (LLPS) to achieve a permanent change in shortened connective tissues. Conversely,
when a joint is stretched quickly by high intensity short duration (HISD) some range of motion
may be gained but rebounding will occur. According to Elaine (2002), Splints are removable
external devices used to support a weak or ineffective joint or muscle, prevent or correct joint
deformities, improve functional use of the upper limb, and improve position for hygiene and/or
outward appearance. Although there is little published evidence to support the use of hand splints
in children with neurologic conditions, splints continue to be widely prescribed for all MACS
levels in an effort to improve upper limb skills and functional activities. Job (2015) stated that
dynamic splinting could be applied to patients with limited range of motion due to orthopedic or
neurological conditions such as trauma or surgery, post-surgery joint stiffness, ligament or
tendon repairs, joint replacement, post fractures, long-term immobilization.

11
1.2 Problem Statement

The world is evolving digitally everyday as it is. All existing splints to be precised dynamic
splint are all manual. All these manual splints, therefore requires that the patient has to wear it
almost every day everywhere and every time. This could be said to help stimulate spontaneous
healing but the after effects should be likely considered. Although the materials used in
designing the dynamic splint are said to be biocompatible to the body. But when they are used
externally always could lead to adverse effect to the affected area or even cause more damage to
the patient such as, irritations at the affected area. Using the manual splint requires that everyone
know that you are facing a difficulty. But the automatic splint will be designed. Since it is more
of home or hospital based, it would be more of an exercising than an everyday burden. It will
likewise reduce the inferior feeling they feel in public. And also making it more fun to use. All
existing dynamic splints are manual; therefore, the need for automatic dynamic splint and this
research will be embarking on it.

12
1.3 Justification

This device will aid in reducing the after effects that arises as a result of a prolonged use of the
dynamic splint. Irritations of the skin which results from insufficient air on the affected area,
stiffness, as well as blood clothing as a result of blood flow obstruction could be avoided if the
automatic splint is introduced into the health system. It could be employed in homes and hospital
wards and even at therapeutic centers, since it will reduce the stress of attending to only on
patient at a time.

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1.4 Aim

To design a comfortable and wearable automatic device for Extensor Tendon splint using
Stepper motor and Arduino timer.

1.5 Objectives

To design an automatic dynamic splint device for muscle strains without placing undue stress
across the repair site.

To incorporate an appropriate circuit and a stepper motor for motor control.

To use a C programming language to program the pull and releasing movements of the device.

14
 CHAPTER TWO

LITERATURE REVIEW

2.1 History of dynamic splint

It has long been known that the hand is used to perform a lot of tasks, but when it is overstressed
or gets involved in a massive contact from an opposing force, there arises a lot of medical
complications. Therefore, as a result, wearable devices used for healing have been put in place to
aid victims in such situations. Different Patent has come up with different inventions to help
reduce the rate of immobility or effect of stroke or accidents on the upper limbs. Dynamic splint
was founded by physical therapist, George. (1981), and is the pioneer and recognized market
leader in dynamic splinting. The need was recognized for longer periods of stretching to
keep range of motion (ROM) gains made in therapy and to make further gains to resolve joint
stiffness. In 1981, the Dynamic splint was conceived to continue the work of the physical
therapy at home. Gerald et al. (2017) came about whit the Dorsal Wrist Cock-up splint, it’s a
type of wrist hand orthosis which may be used to treat a wide range of conditions localized at or
near the wrist and hand. Traction splints are used for reducing and immobilizing long bone
fractures of the femur. In the early 1900s, femur fractures were often fatal. The Thomas Traction
Splint, also commonly called the Thomas Half-Ring, was the first traction splint. It was invented
by Dr. Hugh (1916), a Welsh surgeon. When Sir Robert Jones applied this splint during World
War I, it reduced mortality of compound fractures of the femur from 80 percent to less than 8
percent over a two-year period.

15
Clark L et al. (1965) conducted a research on the tenodesis dynamic splint. Where it was used
as a functional brace for a paralyzed hand with effective wrist extensors.

Werntz JR et al. (1989) worked on a dynamic splint used to lessen the resistance to finger
extension and increases the arc of motion through full passive flexion of the injured fingers. A
rubber band is used to run from the tips of the injured fingers under a spring-loaded roller bar at
the metacarpophalangeal joint level to a coiled lever at the distal flexor surface of the forearm.

Silva et al. (2005) likewise, investigated the amount of force/ tension that would be required by
designing a dynamic splint that would be connected to a dynamometer in order to allow forces
measurement. After which the spring tension concluded that the spring tension increases at the
beginning of PIP finger flexion and decreases when the flexion angle increases. The research
went further to explain that the longer the finger; the greater the spring tension exerted on the
tendon of the finger.

Cynthia et al. (2015) it’s made of sterling silver and have a double loop design whit elliptically-
shape rings that fit comfortable to the finger. It holds the finger in extension whit the splint in
place and gently push one side of the splint against the finger, check for space between the ring
and the finger on the opposite side. Normally there should be minimal or no space, however, if
the joint is enlarged or has a contracture, there may be some space.

Gerald et al. (2017) came about the Dorsal Wrist Cockup splint; it’s a type of wrist hand
orthosis which may be used to treat a wide range of conditions localized at or near the wrist and
hand. This type of splint is made of turbocast is a unique low temperature thermoplastic material
white thin foam coating on both sides, the foam allows for air transfer between the patent’s skin
and the thermoplastic, which reduces the risk of the skin crafting, and it’s also uses an elastic

16
band which holds the writs and that of the thermoplastic after its been place on the patient’s
hand.

Bianca C et al. (2018), did a study on how to use a dynamic splint for the treatment of hand
spasticity after stroke. Spasticity of the upper limbs is said to be a major outcome after stroke. It
was observed that one of the major factors to consider when designing a splint is understanding
the anatomical structures of the forearm, wrist and hand. The knowledge of normal joint
functions and some of the kinematics movements of the upper limbs such as the rolling, gliding,
and spinning is said to be another factor to consider when designing a dynamic splint. Based on
their prior studies, dynamic splints have been shown to enhance the capacity of post-stroke
patient with plasticity of upper limbs in order to engage in task-specific training activities that
involves grasp and release action.

Alexandre et al. (2018) worked on a dynamic splint used to lessen the resistance to finger
extension. The chance of getting finger injuries is high in every individual. The device is made
up of plastic-coated malleable aluminium, which keeps the inter phalangeal joints in required
position, polyfoam padding for comfort. Apply the product on the finger in such a way that the
finger comes in between the foam pads, the long part must come in palmar region.

Judy et al. (2019) conducted a research on Dynamic Ulnar Nerve Splint. Mould strap from the
ulnar aspect of the hand over the palm around the metacarpals, overlap in the palm of the hand
but do not press to avoid permanent bonding, adjust the metacarpal ring, so that the palmar
section reaches the wrist, loosen the overlapping portion on the ulnar side, a u shape the spring
arm and melt it into the plastic.

17
Hsu H et al. (2019) conducted a research on the forearm splinting. The forearm is comprising of
the ulna and radius, and this brings about the ulna and radial gutter splints respectively. The
main goal of the forearm splinting is to prevent rotation about the entire forearm. It decreases
pain and debility, and as well prevents further injury and facilitates the healing process.
Stockinet, cast padding, plaster or fabricated splinting material, elastic bandages were the
possible materials used when designing this dynamic splint.

Gluck et al. (2019) likewise, investigated the Padded Elbow splint, the elbow splint immobilizes
or restricts the movement of your elbow. It reduces elbow pain resulting from muscle tension,
the splint can also prevent elbow injury. Slide support over elbow, position pressure pads so that
they rest on top and underside (radial and ulna sides) of forearm, just below elbow, wrap strap
around forearm and tighten until fit is firm, yet comfortable.

18
Fig 2.2.1 Elbow Splint (https://backontrackproducts.com/wp-content/uploads/2018/07/1207-
Physio-elbow-brace-II.jpg. Accessed January 2020.)

Fig 2.2.2 Ulna Splint (https://en.wikipedia.org/wiki/Ulna_fracture. Accessed January (Anon.,

n.d.)22nd 2020.)

19
Fig 2.2.3 Cock up Splint (https://www.orfit.com/blog/the-volar-wrist-cock-up-orthosis/.
Accessed January 22nd 2020.)

Fig 2.2.4 Mallet Splint

(https://www.google.com/imgres?imgurl=https://cdn11.bigcommerce.com/sqjdz8xa4i2/image
s/stencil/1280x1280/products/131/1013/frog_finger_splint_2___80906.1562706334.jpg?c%3D
2%26imbypass%3Don&imgrefurl=https://supportsdirect.com/mallet-finger-splint. Accessed
January 22nd 2020.)

20
Fig 2.2.5 Silver ring splint (https://www.google.com/imgres?imgurl=https://images-na.ssl-
images-
amazon.com/images/I/817rUeFMIJL._SL1500_.jpg&imgrefurl=https://www.amazon.com/Thum
b-Swan-Silver-Splint. Accessed on January 22nd 2020.)

21
 CHAPTER THREE

MATERIALS AND METHODS

3.1

This chapter explains the various materials and components that are to be used in the project, as
well as their respective descriptions and functions.

3.2 Materials

The materials which were used for this project was selected based on the following factors: cost,
easy to integrate, bio-compatibility. The main idea is to minimize cost as well as ensuring that
the functionality of the device is not compromised.

Below is the various list of components used;

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TABLE 3.2.1 Components

COMPONENTS TYPE QUANTITY

Resistors 1kΩ As required

Capacitors 100uf 1

Power supply 9volts Ac 1

Switch ----------------- 1

Microcontroller Arduino Nano 1

Adapter Dc adapter 1

LED ----------------- 2

Stepper motor Hybrid Stepper motors 1 each

Stepper Driver A4988 Stepper driver 1

Leather -------------------- As required

Thread -------------------- As required

The components specified in the table above were chosen to give a desired output by the circuit
for the device.

23
POWER SUPPY
A power supply is simply an electrical device that supplies electric power to an electrical load.
The main function of a power supply is to convert electric current from a source to the correct
voltage, current, and frequency to power the load. As a result, power supplies are sometimes
referred to as electric power converters. Some power supplies are separate standalone pieces of
equipment, while others are built into the load appliances that they power. Examples of the latter
include power supplies found in desktop computers and consumer electronics devices. Other
functions that power supplies may perform include limiting the current drawn by the load to safe
levels, shutting off the current in the event of an electrical fault, power conditioning to prevent
electronic noise or voltage surges on the input from reaching the load, power-factor correction,
and storing energy so it can continue to power the load in the event of a temporary interruption in
the source power. DC power supplies use AC mains electricity as an energy source. Such power
supplies will employ a transformer to convert the input voltage to a higher or lower AC voltage
but in this case an adapter was employed to step down the voltage to any level we want to step it
down. A rectifier is used to convert the transformer output voltage to a varying DC voltage,
which in turn is passed through an electronic filter to convert it to an unregulated DC voltage.
But in this case we need not the rectifier.

24
9V ADAPTER

FIG 3.2.1: A 9V ADAPTER (https://www.aliexpress.com/item/32802927503.html.)

Likewise referred to as a power adaptor, an AC adaptor plugs into a standard electrical outlet
and converts the AC electrical current from the wall outlet to the specifications needed by the
electrical device that's plugged in. The AC adaptor is a box attached to the power cord, either at
the end of the cord where the device plugs into the wall outlet, or in the middle of the power
cord. Inside the AC adaptor are two wire windings that wrap around a single iron core. The first
of the windings receives the 120-volt alternating current delivered to the electrical outlet, and
creates an electric field in the iron core. The second wire winding turns the newly created electric
field into a smaller alternating electric current. The measure of the resulting alternating current is
dependent upon the number of coils in the second wire winding in relation to the number in the
first winding. If the second winding is half of the first winding, the alternating current will
measure half of what it did when it entered the AC adaptor. Therefore, if there were 100 coils on
the first winding, the second winding will have only 50 coils.

25
FIG 3.2.2: LIGHT EMITTING DIODE (https://www.alibaba.com/product-detail/5mm-LED-
Diodes-Flashing-RED-Diffused_60675248590.html.)

A light Emitting Diode is simply a light source that emits light when current flows through it.
The light emitting diode emits its light when it is forward biased. When a voltage is applied
across the junction to make it forward biased, current flows as in the case of any PN junction.
Holes from the p-type region and electrons from the n-type region enter the junction and
recombine like a normal diode to enable the current to flow. When this occurs energy is released,
some of which is in the form of light photons.

Majority of the light which is produced from the area of the junction are said to be nearer to the
P-type region. As a result, the design of the diodes is made such that this area is kept as close to
the surface of the device as possible to ensure that the minimum amount of light is absorbed in
the structure. When the device is connected to a power source, the LED (Light Emitting Diode)
lights up indicating that there is power. The longer side of the LED is the anode, while the
shorter side is the cathode.

26
STEPPER MOTOR

COILS

ROTOR STATOR

FIG 3.2.3: A STEPPER MOTOR FIG 3.2.4: INTERNAL STRUCTURE OF A STEPPER MOTOR

(https://www.distrelec.biz/en/stepper-motor-5nm-nema-23-motionking-
23h2a7442/p/30097251.)

Stepper motors are DC motors that move in discrete steps. They have multiple coils that are
organized in groups called "phases". By energizing each phase in sequence, the motor will
rotate, one step at a time. It is a brushless DC electric motor that divides a full rotation into
number of equal steps. They convert digital pulses into mechanical shaft rotation.
Advantages of step motors are low cost, torque at low speeds and a simple, rugged and
simplicity of construction. Step motors are said to work in any environment and they can
operate in open loop control system. When a train of pulses is applied, it gets turned through
a certain angle. The angle through which the stepper motor shaft turns for each pulse is
referred to as the step angle. It is generally expressed in degree.

27
CAPACITOR

FIG 3.2.5: A CAPACITOR (https://en.wikipedia.org/wiki/Capacitor.)

A capacitor is simply a device that stores electrical energy or charge in an electrical field. The
capacitor is a passive component with two terminals. The effect of capacitor is referred to as
capacitance. It consists of two conductors that are separated by a non-conductive region. The
noon-conductive region can either be a vacuum or an electric insulator material known as a
dielectric. In order to indicate the polarity of a capacitor some of the following tests can be used.
Electrolytic capacitors are often marked with a stripe, and that strip usually indicate the negative
part. Sometimes, the length of the leads acts as an indicator of polarity. The positive lead is
usually longer, while the shorter lead indicates the negative polarity.

28
SWITCH

FIG 3.2.6: AN ON/OFF SWITCH

(https://www.google.com/search?q=switch+button&tbm=isch&safe=active&chips=q:switch+
button,g_1:red:8oZfhMUuOi8%3D&client=safari&safe=active&hl=en&ved=2ahUKEwie1Zaok
MrpAhUR8xoKHeyIBX0Q4lYoBHoECAEQHA&biw=1039&bih=739#imgrc=AXlg1DeADKZbiM.)

A switch is simply an electrical component that can connect and disconnect the conducting path
in an electrical circuit, thereby interrupting the electric current or diverting it from one conductor
to other. A switch may be operated manually, for example, a light switch, or may function as a
sensing element. In this project, the switch was used as an on/off switch.

29
FIG 3.2.7: A MICROCONTROLLER
(https://www.google.com/search?q=microcontroller+atmega328p&tbm=isch&ved=2ahUKEw
ie1ZaokMrpAhUR8xoKHeyIBX0Q2cCegQIABAA&oq=microcontroller+At&gs_lcp=CgNpbWcQA
RgBMgIIADICCAAyAggAMgIIADICCAAyAggAMgIIADICCAAyAggAMgIIADoECCMQJzoECAAQQz
oGCAAQChAYUI8ZWKZLYJ1baAFwAHgAgAG4AogB2yKSAQYyLTE4LjGYAQCgAQGqAQtnd3Mtd
2l6LWltZw&sclient=img&ei=_inJXp7eFpHmayRlugH&bih=539&biw=559&client=safari&safe=a
ctive#imgrc=nfy7Kin7cRR_OM.)

The ATMEGA 328p is an 8-bit microcontroller that is based on ABR RISC architecture. It is
known as the most popular of all AVR controllers as it is used in ARDINO boards. It is a 28-pin
chip, of which most of the pins perform or carry out more than one function. The ATMEGA
328p is used in a similar way other controller are used. In order to get the controller working,
programs need to be assigned to the ATMEGA328P FLASH memory. After this is done, the
controller is then able to execute the code or information after which it provides appropriate
responses. In order to use the ATMEGA 328P when using Arduino, you need to install an
Arduino bootloader into the chip.

30
STEPPER DRIVER

FIG 3.2.8: A STEPPER DRIVER (https://www.alibaba.com/product-detail/3D-printer-A4988-

Stepper-motor-driver_60790832571.html.)

The driver of a stepper motor converts the indexer command signals into the power necessary to
energize the motor windings. We have many types of drivers, which are said to have different
voltage and current ratings. It is important to note that not all the drivers are possible to be used
to run a motor. So, when designing a motor control system, it is necessary to properly select an
accurate driver.

31
3.3 METHODOLOGY

The flow diagram below simply illustrates how the requirements and specifications of the
components were obtained. Starting from the selection, testing, designing, building and finally,
its implementation. After the appropriate components and materials were obtained, they were
tested based on the function each was to perform in obtaining a full device. The power supply
was checked constantly to ensure that it will be able to carry and supply enough electrical energy
to the circuit. The stepper motor was also checked to see if it will respond to the imputed
oscillation. When any component is checked and comes out error free, it is then included to the
design.

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3.4 SYSTEM DESIGN

Fig 3.4.1 FLOW CHART

REQUIREMENTS AND
SPECIFICATION

SELECTION OF MATERIALS AND

COMPONENTS

GOOD AND
COMPLETE

PROGRAMMING /SYSTEM DESIGN

BUILDING OF DEVICE

TESTING

WORKING
WELL?

IMPLEMENTATION OF WORK

Fig 3.4.1 illustrates the system development flow chart

33
Fig 3.4.2 System Block Diagram

POWER SUPPLY

STEPPER DRIVER STEPPER DRIVER

ARDUINO NANO

STEPPER STEPPER
MOTOR MOTOR

Fig 3.4.2 System Block Diagram of the device

34
The automatic muscle strain dynamic splint consists of a stepper motor, stepper drivers,
Atmega 328p and a power supply. Just as every microcontroller or computer is the heart
of every system. The Atmega 328p microcontroller serves as the central processing unit
of the system. Specifically, in this project the microcontroller instructs the Stepper motor
to control the pulling and releasing movement of the wrist by programming. The Arduino
is a very important tool used for this project. It is used to test and program the Atmega
328p microcontroller. The Arduino Nano is a small, complete, and breadboard-friendly
board based on the ATmega328 (Arduino Nano 3.x). It has more or less the same
functionality of the Arduino Duemilanove, but in a different package. It lacks only a DC
power jack, and works with a Mini-B USB cable instead of a standard one. A Stepper
Motor or a step motor is a brushless, synchronous motor, which divides a full rotation
into a number of steps. Unlike a brushless DC motor, which rotates continuously when a
fixed DC voltage is applied to it, a step motor rotates in discrete step angles. The circuit
also has a stepper driver. A stepper drive is the driver circuit that controls how the stepper
motor operates. Stepper drives work by sending current through various phases in pulses
to the stepper motor. The circuit also has a stepper driver. A stepper drive is the driver
circuit that controls how the stepper motor operates. Stepper drives work by sending
current through various phases in pulses to the stepper motor. There are four types: wave
drives (also called one-phase-on drives), two-phase on, one-two phase-on drives and
micro stepping drives. The primary considerations to consider when choosing the stepper
motor driver are the required torque and accuracy. Torque is a factor of the stepper motor
size. Here, the driver must have the capacity to produce the step current required by the
motor. Accuracy requires either small steps or a convoluted gear train.

All the components are connected to the power supply unit.

35
3.4.3 System Circuit Diagram of the device

36
After the appropriate components and materials were obtained, they were tested based on the
function each was to perform in obtaining a full device. The power supply was checked
constantly to ensure that it will be able to carry and supply enough electrical energy to the
circuit. The stepper motor was also checked to see if it will respond to the imputed oscillation.
When any component is checked and comes out error free, it is then included to the design. And
ones that showed traces of faults or where faulty were replaced with good ones. After the checks,
the components are considered in the system design, and this comprises of the block and circuit
diagram and the general building of the device. The building of the device of the software system
and the integration of the components of which some of the components were left to stand alone
for safety purposes. After the software has been programmed to move in correlation with the
hybrid stepper motors and driver, the oscillation is monitored from the stepper motors which are
supposed to move or oscillate in opposite directions. Errors are bound to happen, so they were
checked. Especially errors arising from the motors where there is a delay in oscillation or
irregular oscillations. So, during construction, proper precautions and attention was involved in
order to detect these faults when they surface. System testing is done until the device exhibits no
form of fault and function of device is obtained. After the selection of the components, the
connection of the components to each other was carried out. The microcontroller being the
primary component was connected to the other components. The microcontroller was connected
to the two steppers drivers which were placed at both sides. These stepper drivers were then
connected to the stepper motors. The microcontroller at one end was connected to the power
supply which played a vital role in achieving our desired goal. The ground pins of the two
stepper drivers were connected to the pin 12 of the microcontroller which is the ground pin. This
was done in order to avoid short-circuiting or leakage current. The positive and negatives of the
stepper motors were connected to the Black, Green, Red, and Blue pins of the stepper drivers.
The three diodes that were used along with the resistors were connected to the A0, A1, A2 pins
of the microcontroller. We used the method of pulling and releasing which were achieved with
the help of the two stepper motors, strategically placed above and below the patient’s hand
respectively. Both motors pull in a synchronous manner. After one pull, the other follows.
However, in order to achieve the goal of pulling the hands up and down, when one motor is
pulling the other motor is made to releasing mode. Therefore, by the pulling and releasing forces

37
made by the two 5-35volts stepper motors, the patient’s hand will be adequately exercised, and
the healing process stimulated.

38
 CHAPTER FOUR
RESULTS AND DISCUSSION

ON/OFF
SWITCH
CAPACITOR
(100UF)

STEPPER MOTOR

Fig 4.1.a shows the complete set up of the device

39
 FINGER
SUSPENDERS

RESISTORS

LED
ARDUINO NANO
(Atmega 328p)

Fig 4.1.b shows the complete set up of the device

40
These figures show a complete physical system of the finished device. The automatic muscle
strain dynamic splint consists of a microcontroller, stepper motors, stepper drivers, finger
suspender, LED (Light Emitting Diode), capacitors, resistors, on/off switch. As part of our
requirement is to have a voltage between 5v to 35v. So, we made use of an adapter (240v Dc to
12v Ac). The function of the resistors in this project is that it limits the transmission of current in
LED. Resistors are responsible for ensuring that the LED’s don’t blow up when power is
applied. The resistors are connected in series with the LED in other to limit the flow of current
between the two components to a safe value. The capacitors are there to act as a filter. They filter
out noise and cancels out ripples. In this project, the LED act as a power indicator and a system
active indicator. It also indicates which of the motor is operating at each moment. Just as a
microcontroller is the heart of every system, the Atmega 328p serves as the Central Processing
unit. Specifically, in this project the microcontroller instructs the Stepper motor to control the
pulling and releasing movement of the wrist by programming. Just as a microcontroller is the
heart of every system, the Atmega 328p serves as the Central Processing unit. Specifically, in
this project the microcontroller instructs the Stepper motor to control the pulling and releasing
movement of the wrist by programming. The drivers provide five different step resolutions: full
step, half step, quarter-step, eight-step, and sixteenth-step. It also has a potentiometer for
adjusting the current output, over-temperature thermal shutdown and crossover-current
protection. The ground pins of the two stepper drivers were connected to the pin 12 of the
microcontroller which is the ground pin. This was done in order to avoid short-circuiting or
leakage current. The VIN pin is used for powering the driver. The following four pins are for
connecting the motor. The black and blue pins will be connected to one coil of the motor, and
blue and red pins to the other coil of the motor. For powering the motor, the GND and VMOT
pins are connected to the power supply. Also, a decoupling capacitor with at least 47uf, but in
this case a 100uf was used. It is used for protecting the driver board from voltage spikes. The
next two pins, Step and Direction are used for controlling the movements of the motors. The
Direction pin controls the rotation direction of the motor. Whilst the Step pin is used to control
the micro-steps of the motor and with each pulse sent to the pin, the motor moves one step. The
next is the SLEEP and RST pin. The SLEEP pin is used for minimizing power consumption
when the motor is not in use. The RST pin is a floating pin, so if we have no intention of

41
controlling it with our program we just need to connect it to the SLEEP pin in order to bring it
high and enable the board. Before connecting the motor, we need to ensure that the current
limiting is adjusted so that we are sure that the current is within the current limits of the motor.
That can be achieved by maybe adjusting the voltage (reference) using a potentiometer on the
board. The loop section is assigned in order to enable the motor to move in a particular direction.
Using this loop section, we could make a one full cycle rotation. In order to make one full cycle
rotation, we need to send 200 pulses into the Step pin. In order to make pulses, we need to add a
high and low state. And likewise add a delay, and this will determine the speed of the motor. The
positive and negatives of the stepper motors were connected to the Black, Green, Red, and Blue
pins of the stepper drivers. The three LED (Light Emitting diodes) that were used along with the
resistors were connected to the A0, A1, A2 pins of the microcontroller. When the device is
connected to a power source, the LED (Light Emitting Diode) lights up indicating that there is
power. Then the on/off switch is switched on so that the patient could make use of the device.
The patient suspends his/fingers in the finger suspenders. The patient’s fingers could be
positioned in the suspenders before switching on/off switch. When the switch is on, the hybrid
stepper motors begin to undergo the pulling and releasing process. The stepper motors, with the
help of the individual stepper motors for each stepper motor has been programmed with the help
of the arduino. They are controlled in the forward and backward movement in small “steps”.
Integers are used to indicate which of the control pins are connected to the motor controller.

42
4.2 RESEULT

At the end of the project we were able design an alternative dynamic device for extensor
tendon without placing undue stress on the repair site. We were able to design a
comfortable device that would be worn easily by the patient. Also, we were able to
incorporate an appropriate circuit and a stepper motor for motor control. In conclusion,
the splint was effective, as it was able to carry out the task for which it was built. It could
also serve as a massager. The device is designed and built based on the need and
expectation of the patient, position and area to be supported. The individual should have
ease of application and removal of splint. Using the dynamic hand splint as a
supplementary training program in addition to other hospital-based rehabilitation can
effectively increase the muscle strength of hemiplegic hands.

43
4.3 DISCUSSION
This type of splint for muscle strains is meant to replace the manual type of splint
by providing the automatic components such as the microcontroller along with the
stepper motors and drivers. This type of splint is used to reduce or heal muscle
strains likewise referred to as the muscle pull. This system can also be used for
patients with immobility of the hands and fingers. It could also be used to heal the
fingers after an accident or cramps. This system is specifically made for the upper
extremities and to be specific the wrist and fingers. The system has five circular
finger suspenders. The fingers are relaxed in the suspender, with the arm kept at
rest. This is done in order to ensure fast healing. Under normal circumstances,
when the device is connected to the power source, the LED (Light Emitting
Diode) is expected to light on. In a case when the device is connected to a power
source and there is no light indication from the LED, then it’s either the power
house of the device is malfunctioning or the current from the power source is too
low to carry the device. So, in a case when there is full voltage from the power
source, the power house is also in tact then the LED should be checked. There
might be a case of the LED getting burnt when the voltage is too high.
We observed that if the load that is applied on the stepper driver is too much it
could cause it to burn. Also we observed that if the load also is low, the driver is
unable to function thereby the stepper motor would not be able to carry out
assigned task. It was observed that stepper motors don't rotate continuously but
they rotate in steps. Also, it was observed that if the time assigned for an
oscillation is small the step intervals will not be noticed. And otherwise goes for
when the allocated time is high.

44
 CHAPTER FIVE

5.0 CONCLUSION AND RECOMMENDATION

5.1 CONCLUSION

Due to the diverse symptoms of hemiplegia, including weakness, orthopedic considerations,

spasticity variations and cognitive and also accident, it is unlikely that one type of splint will be
appropriate for all. Appropriate splint choice and functional outcome is enhanced by a team
approach to manage complex cases. This is a type of orthotics which provides greater pain
reduction, faster recovery of muscle strains and grip strength, and was better tolerated. It would
likewise, reduce the risk of aftereffects that occurs as a result of prolonged use of the dynamic
splint. There was an electronic circuit which was incorporated which made the device automatic.
And this way, the device is only used with the help of power supply. This dynamic splinting it
normally function as a massager in a way that after the patient insert his or her hand into the
device it performs a movement of pulling the hand up and down with the help of the stepper
motor.

45
5.2 RECOMMENDATION

This dynamic splint has been recommended for any age facing challenges of not been able to
move his or her hands due to spasticity, accident, weakness, and stroke. It could be designed with
personal specification or general hospital specification such as age. That is to say, a particular
age will be mapped out for a particular kind and size of wrist splint.

46
5.3 LIMITATION

It cannot be worn outside as it requires the use of power supply.

Without power supply it can’t function

47
REFERENCES

Barbara Hall, Hoe C, Helen Fitgerald, Andy H, Annette B (2014). Investigation of the
effectiveness of full-time wrist splinting and education in the treatment of carpel tunnel
syndrome. American Journal of Occupation Therapy, 67, pp 448-459.

Boyd S, Benjamin H, Asplund C. (2009) Principle of Casting and Splinting: dynamic splint.
Farnham.

Boyes J H. (2016). Bunnel’s surgery of the hand. 5th ed., Philadelphia, PA: JB Lippincott.

Brand P, Honner R. (2017). Mechanics of individual muscle at individual joints. Clinical

mechanic of the hand. St Luis.

Browne E Z Jr, Ribik CA. (1989) early dynamic splinting for extensor tendon injuries. The
Cleveland clinic. Ohio.

Celeste G, Leigh T, Jenny F (2008). Dynamic verse static progressive splinting to mobilize stiff
joints in the hand. The British Journal of Hand Therapy, 13(4), 104-110.

Chien Liu, Shih-Chen (2014). Ergonomic design of a computer mouse for clients with wrist
splints. American Journal of Occupational Therapy, 68(2), pp 317-324.

Evans R B, Burkhalter WE. (1986) A study of the dynamic anatomy of extensor tendons and
implication for treatment. India.

Glasgow C, Fleming J, and Tooth LR. (2012). The long-term relationship between duration of
treatment and contracture using dynamic orthotic devices for the stiff proximal interphalangeal
joint, 7th ed., Sydney: McGraw Hill.

Gunther G, Bettina W (2007). Introduction to microcontroller. Vienna University of technology

Institute of computer Engineering Embedded Computing Systems Group. Pg 320-329.

Ibrahim M, Saleem A. (2007) Flexor Tendon Injuries of hand: Experience at Pakistan Institute
of Medical Sciences. Islambad.

48
Jongs R, Harvey L, Gwinn T, and Lucas B (2012). Dynamic splints on contracture following
distal radial fracture: a randomized controlled. Journal of Physiotherapy, 58(3), 170-180.

Journal of Hand Therapy. America. Elsevier, vol.24, no.4, Feb 2013.

Judy C (2014). Low profile Dynamic Splinting of the injured hand. American Journal of
occupational Therapy, 63(1), pp 334-345.

Kenneth J, Daniel Tabak (1992). Microcontroller: architecture, implementation, and

programming. McGraw-Hills Proffessional, 89-104.

Mackay J., Osemwengie B., Swinford N., and Mckee D. (2019). Soft Tissue Membrane on
nerve after traumatic injury of the upper extremity. American. American association for hand
surgery.

Merrel G, and Slade J (2011). Dislocations and ligament injuries in the digits, 6th ed.,
Philadelphia: Elsevier Churchill Livingstone.

Publie par A. (2019). Information Technology in Geo-engineering: Proceedings of the 3rd

edition. 33(4), 145-160.

Rebecca M Duncan (1989). Basic principles of splinting the hand. Journal of Physical Therapy,
69(12), 1104-16.

Renton R, Marosszeky JE, Gracies JM, Gandevia SC, Burke D, Sandanam J (2000). Short-term
effects of dynamic lycra splints on upper limb in hemiplegic patients. Archives of Physical
Medicine and Rehabilitation, 81(12), 1544-1555.

Rockwell W, Butler P, Byrne B. (2011) Extensor tendon: Anatomy, injury, and reconstruction.
California.

Sadura-Sieklucka T, Sokolowska B (2013). Benefits of wrist splinting in patients with

rheumatoid arthritis.

49
APPENDIX

Source code

/* Simple Stepper Motor Control Example Code

* by Dejan Nedelkovski, www.HowToMechatronics.com

*/

// defines pins numbers

const int stepPin = 2; //motor 1 step 2, dir 3

const int dirPin = 3; //

const int stepPin1 = 5; //motor 1 step 5, dir 6

const int dirPin1 = 6; //

int powerLed = 13;

int dragup = 10;

int dragdown = 12;

void setup() {

// Sets the two pins as Outputs

pinMode(stepPin,OUTPUT);

pinMode(dirPin,OUTPUT);

50
 pinMode(stepPin1,OUTPUT);

pinMode(dirPin1,OUTPUT);

pinMode(powerLed,OUTPUT);

pinMode(dragdown,OUTPUT);

pinMode(dragup,OUTPUT);

delay(1000);

void loop() {

digitalWrite(powerLed,HIGH);

for(int x = 0; x < 120 ; x++) {

digitalWrite(dragdown,HIGH);

digitalWrite(dragup,LOW);

digitalWrite(dirPin,HIGH); //Changes the rotations direction

delay(10);

// Makes 200 pulses for making one full cycle rotation

for(int x = 0; x < 2; x++) {

digitalWrite(stepPin,HIGH);

delayMicroseconds(200);

digitalWrite(stepPin,LOW);

delayMicroseconds(200);

digitalWrite(dirPin1,LOW); //Changes the rotations direction

delay(10);

51
 // Makes 400 pulses for making two full cycle rotation

for(int x = 0; x < 2; x++) {

digitalWrite(stepPin1,HIGH);

delayMicroseconds(200);

digitalWrite(stepPin1,LOW);

delayMicroseconds(200);

delay(500);

for(int x = 0; x < 120 ; x++) {

digitalWrite(dragdown,LOW);

digitalWrite(dragup,HIGH);

digitalWrite(dirPin,LOW); //Changes the rotations direction

digitalWrite(dirPin,LOW); //Changes the rotations direction

delay(10);

// Makes 200 pulses for making one full cycle rotation

for(int x = 0; x < 2; x++) {

digitalWrite(stepPin,HIGH);

delayMicroseconds(200);

digitalWrite(stepPin,LOW);

delayMicroseconds(200);

52
 digitalWrite(dirPin1,HIGH); //Changes the rotations direction

digitalWrite(dirPin1,HIGH); //Changes the rotations direction

delay(10);

// Makes 400 pulses for making two full cycle rotation

for(int x = 0; x < 2; x++) {

digitalWrite(stepPin1,HIGH);

delayMicroseconds(200);

digitalWrite(stepPin1,LOW);

delayMicroseconds(200);

delay(500);

53
54