A novel detection method for determining a surgeon's fatigue and hand tremor

The thesis presents new methodology and algorithms that can be used to analyse and measure the hand tremor and fatigue of surgeons while performing surgery. This will assist them in deriving useful information about their fatigue levels, and make them aware of the changes in their tool point accuracies. This thesis proposes that muscular changes of surgeons, which occur through a day of operating, can be monitored using Electromyography (EMG) signals. The multi-channel EMG signals are measured at different muscles in the upper arm of surgeons. The dependence of EMG signals has been examined to test the hypothesis that EMG signals are coupled with and dependent on each other. The results demonstrated that EMG signals collected from different channels while mimicking an operating posture are independent. Consequently, single channel fatigue analysis has been performed. In measuring hand tremor, a new method for determining the maximum tremor amplitude using Principal Component Analysis (PCA) and a new technique to detrend acceleration signals using Empirical Mode Decomposition algorithm were introduced. This tremor determination method is more representative for surgeons and it is suggested as an alternative fatigue measure. This was combined with the complexity analysis method, and applied to surgically captured data to determine if operating has an effect on a surgeon’s fatigue and tremor levels. It was found that surgical tremor and fatigue are developed throughout a day of operating and that this could be determined based solely on their initial values. Finally, several Nonlinear AutoRegressive with eXogenous inputs (NARX) neural networks were evaluated. The results suggest that it is possible to monitor surgeon tremor variations during surgery from their EMG fatigue measurements.

The effect of supporting a surgeon's wrist on their hand tremor

Background. Operative tremor can greatly influence the outcome of certain, precise, microsurgical operations. Reducing a surgeons tremor may not only improve the operative results but decrease the operative time. Previous studies have only measured uni or bi directional tremor and therefore have been unable to calculate both the overall tremor amplitude and the tremor reduction by resting the wrists. Materials and methods. We measured the tremor of 21 neurologically normal volunteers while performing a micromanipulation task, with and without wrist support. Measurements were acquired in three dimensions using three accelerometers attached to the hand, allowing an overall tremor amplitude to be calculated. Results. Resting the wrist on a gelled surface decreases an individuals tremor by a factor of 2.67 (P = 0). Conclusions. Supporting the wrists significantly decreases the amplitude of the tremor. Surgeons should consider using wrist supports when performing parts of operations which necessitate a high degree of accuracy. © 2010 Wiley-Liss, Inc.

Investigation and modelling of tremor reducer with the technology of targeted energy transfer

This thesis presents the study of a two-degree-of-freedom (2 DOF) nonlinear system consisting of two grounded linear oscillators coupled to two separate light weight nonlinear energy sinks of an essentially nonlinear stiffness. In this thesis, Targeted Energy Transfer (TET) and NES concept are introduced. Previous studies and research of Energy pumping and NES are presented. The characters in nonlinear energy pumping have been introduced at the start of the thesis. For the aim to design the application of a tremor reduction assessment device, the knowledge of tremor reduction has also been mentioned. Two main parties have been presented in the research: dynamical theoretic method of nonlinear energy pumping study and experiments of nonlinear vibration reduction model. In this thesis, nonlinear energy sink (NES) has been studied and used as a core attachment for the research. A new theoretic method of nonlinear vibration reduction which with two NESs has been attached to a primary system has been designed and tested with the technology of targeted energy transfer. Series connection and parallel connection structure systems have been designed to run the tests. Genetic algorithm has been used and presented in the thesis for searching the fit components. One more experiment has been tested with the final components. The results have been compared to find out most efficiency structure and components for the theoretic model. A tremor reduction experiment has been designed and presented in the thesis. The experiment is for designing an application for reducing human body tremor. By using the theoretic method earlier, the experiment has been designed and tested with a tremor reduction model. The experiment includes several tests, one single NES attached system and two NESs attached systems with different structures. The results of theoretic models and experiment models have been compared. The discussion has been made in the end. At the end of the thesis, some further work has been considered to designing the device of the tremor reduction.