Development of a e-textile rheumotoid arthritis glove for rehabilitation

Along with the developments in technology, the usage area of the electronics has been developed and electronic systems has begun to be integrated into fields such as textiles. Textile has become an interactive design space where the body must be close and the wearable alternatives of the products that need comfort are blended with technology. Electronics based intelligent clothing possesses has the potential to meet at a common point of science such as industrial design, fashion, textile engineering, electronics engineering, computer and software engineering, medical engineering, medicine, and ergonomics. Electronic textile-based wearable products have become an issue of work that makes interactive group work compulsory as they require design entry from many areas. Wearable technologies have become to an important point in health field applications. Electronics based measuring devices allow patients to follow their own health status at home, where patients can be monitored continuously. The comfort of the users is gaining importance in electronic applications which are close to the body and; should be worn continuously or frequently in daily life. In electronic based wearable health products, studies on systems such as electromyography (EMG), electrocardiography (ECG), pulse, body temperature measurement, and systems for treatment, which must be directly related to the skin, joints, and muscles, are close to the field of rehabilitation, biomedical and textile. In this study, it was aimed to design a rehabilitation product for Rheumatoid Arthritis (RA) disease, an autoimmune disease whose cause still not precisely determined, but is affected by genetic characteristics, living conditions, environmental conditions and patients' morale level. RA is a disease that causes deformations in the fingers, resulting in tissue loss, especially in the small joints of patients, with pain in the joints. The joint deformations caused by RA reduce the life standard of patients by decreasing mobility at hand, loss of function and severe pain. In daily life, patients need solutions that they can use without affecting their living comfort in the negative direction. This thesis focuses on three objectives in the study. The first objective is the development of electronic textile (e-textile) based glove technology that implements electrical stimulation for the rehabilitation of RA disease; the second objective is the optimization of computer-aided embroidery production technology in the production of electronic textile lines for electrical stimulation; The third objective is the development of an integrated textile-based splint with glove for the prevention of hand deformities caused by RA disease. In this study, the integration of the TENS application to the glove was achieved by embroidery of textile glove conductive yarns rather than using Ag / AgCl based conventional electrodes. Although there are e-textile electrode studies produced by the embroidery method in the literature, there is no example of a manufactured work that does TENS application. In the conventional methods, the splint has been used as an independent apparatus. In this study, a textile-based splint application was performed by lamination on the glove using TPU membrane. In the case of the conventional methods the TENS device is connected to the electrodes via long cables; in this thesis, the TENS device is designed to be integrated with the glove and removable-attachable to the e-textile line integrated with the embroidery method. This usage provides a high comfort during daily activities. Therefore, to clean the glove, the electronic circuit can be removed away from the glove. This thesis study was conducted to investigate the effects of the RA glove on the effectiveness of the product in use and the user experience of wear and tear, along with literature reviews and field surveys conducted during the design process and applied textile and electrical tests, results, concept and concept development, concept decision process, prototyping process the results are related to. In the process of creating a new product for RA disease, literature is researched including RA disease and effects on hand physiology; physical therapy methods and alternative treatment methods applied in rheumatology clinics; wearable electronic devices improved for medical use; e-textile product studies in medical field; and methods about integration of e-textile structure to textile fabrics using the embroidery method has been investigated. The process of creating a new product was followed step by step and observation and a field survey including the target group. Field research is driven in a hospital with specialists and patients who include 1 RA doctor, 1 physiotherapy specialists and 1 technician; and 14 patients. To identify needs of RA patients, personal interviews with physicians and RA patients were conducted and recorded by video recorder voice recorder and phograph machine. Field study completed using techniques like voice and video recording during interviews. Information gathered from patients and specialists has been brought together by means of design criteria. Using the results of the field survey, design criteria for new product concepts were formed. In order to select the suitable fabric alternative to develop the prototype, physical tests were applied to the fabric samples to determine physical properties such as thickness, density, unit weight and physical characterization at first. Afterwards, tests such as air permeability, water vapor permeability and thermal comfort were applied to the fabrics with the aim of comparing the fabric samples in terms of comfort characteristics. Each test result being compared comparatively using shemas. A suitable fabric was selected according to the test results and used in the prototype development process. Paralel to the comfort tests of fabrics, electronic tests have been applied to the conductive yarn samples; in order to determine which conductive yarn can be used by the purpose of integration of the TENS system with RA glove. The e-textile structure samples were produced with an embroidery machine. Electrical conductivity is measured by using multimeter and signal-to-noise ratio is measured with a oscilloscope and fuction generator system. Because of yarn characteristics affect the embroidering process production efficiency; also producibility of conductive yarn by the embroidery method is observed and recorded during the sample production process. The prototype design process was continued with the most suitable yarn in consideration of the electrical test results and parameters related to the suitability of the yarn during the embroidery process. After selection of suitable conductive yarn and fabric, to produce low-fidelity prototypes; first, gloves patterns are designed by using 2 dimentional computer program, and fabrics cut by lasercut machine. Electrodes of various shapes, patterns and sizes are designe in computer aided embroidery design program. Drawings are transferred to the embroidery machine and e-textile patterns are embroidered using the conductive yarn on to gloves fabric cut before. The parts of e-textile structure which should not come into contact with the skin were laminated from the inside; and outside of glove, which inverse of embroidered conductive yarn stitches, laminated by using TPU membrane. After laminating, the signal-to-noise ratios of the e-textile structure on gloves are measured. The transmission line and the embroidery pattern which exhibited the optimum characteristics according to the feedback from the users and tests were selected and improvements were made. The RA glove prototypes are formed on glove shape draped textile fabric combining the embroidered e-textile structure which includes electrodes, conductive snap fastener, the electronic circuit that provides the TENS current, and the battery. Eventually, user experience tests have been performed with gloves produced as low-fit prototypes. The user experience test using the Think Aloud protocol was tested on both healthy and RA patients and their interactions with the interface and TENS stimulation effect were investigated. As a result of this thesis study, e-textile RA glove is designed for home rehabilitation, in order to stop the aches that RA disease had caused. In the design of this glove, the TENS circuit is integrated into the e-textile structure using embroidery method and the textile-based splint is applied to the glove to prevent RA deformations.