Abstract
As healthcare technologies advance rapidly, the greatest challenge is no longer just innovation, but ensuring that all stakeholders are benefitted equitably. My capstone project focuses on designing a wearable 4 degree-of-freedom (DOF) upper-limb soft-robotic device to support the rehabilitation of those suffering from neuromuscular conditions at a low cost outside of clinical settings. In parallel, my STS research examines how healthcare technologies within the UVA Health system shape disparities in access across Virginia. These two studies are connected by their shared focus on accessibility in healthcare, where my capstone project designs a physical rehabilitation technology designed to expand access, my STS research evaluates how such technologies may unintentionally reinforce inequalities if they do not explicitly address digital, financial, and geographic barriers.
My capstone project addresses the problem of limited access to neuromuscular rehabilitation for patients who cannot consistently travel to healthcare facilities. The solution proposed by the project is a lightweight, low-cost, at-home, wearable soft robotic exoskeleton for the upper arm capable of assisting in movements in four DOF. The system is designed to perform slow, controlled movements of the elbow or wrist to enable safe rehabilitation exercises to promote neuromuscular regeneration. The design utilizes an cable system to allow for all motors to be housed in a compact and lightweight backpack, and linear actuators of small size minimize weight on the wrist without losing functionality. This design prioritizes portability, user comfort, and cost to make at-home rehabilitation more realistic for a broad patient population.
This project concludes that a cable-driven, soft exoskeleton design can successfully balance function and accessibility with 4 DOF. Previous designs relied on bulky and loud pneumatic systems which had limited portability and ranges of motion, while this approach reduces noise and weight and promotes at-home care. The integration of IMU sensor data allowed for precise motor control and distinct movements for exercise. Although the elbow DOF relied on assistance from the muscle strength of the user, the wrist DOF could be used without. Overall, this proposed design demonstrates that it is possible to create an accessible, at-home, and low-cost rehabilitation device without sacrificing range of motion.
My STS research investigates the question: how can health technologies within the UVA Health system be designed and implemented to promote accessibility and equity rather than reinforce existing divides? This question is significant because it focuses on who is actually able to benefit from innovations, not the technology itself. The UVA Health system serves a diverse population with ranges in digital literacy, broadband access, and financial resources. To analyze this question, I used the Actor Network Theory (ANT) as a STS framework. ANT serves as a basis to analyze the relationships between human and nonhuman actors to identify where inequities may emerge.
The evidence in this research includes UVA Health online resources, existing literature, and actor experiences. This research has found that UVA Health addresses digital divides with digital literacy services, geographic divides with E-Visits and telehealth, broadband divides with loaner devices, and financial divides with remote clinics. Healthcare systems such as UVA Health cannot rely solely on innovation, they must actively address financial, geographic, and digital divides throughout a technological lifecycle. Overall, this research concludes that healthcare technologies must be designed with stakeholders in mind to ensure equitable outcomes.
Notes
School of Engineering and Applied Science
Bachelor of Science in Mechanical Engineering
Technical Advisor: Sarah Sun
STS Advisor: Pedro Francisco
Technical Team Members: Aidan Mermagen, Andrew Wittman, Hannah Tse, Juan Gomez, Madelyn Tubbs, Ryan Murray, Sam Moran, Sean Pawlowski, Zoe Benton
