Portfolio | Miriam Zisook

8/9/2019 Portfolio | Miriam Zisook

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Portolio Miriam Zisook2 College St. #2261 I Providence, RI 02903(847) 828-6710 [email protected]


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Introduction PIP Splin

Distal PhalanxMiddle PhalanxProximal Phalanx

Healthy PIP Joint Contracted PIP

Dorsal Side

Ventral Side

As an intern at the University o Pittsburgh Department o Rehabilitation Science and

Technology and VA Pittsburgh Medical System I designed a splint or PIP Contracture, a

common and dicult to treat hand problem. The VA has fled a patent or this splint, or which I

am co-inventor. The project was a collaboration between the Human Engineering Research Lab

and the Department o Veterans Aairs Competitive Pilot Project Fund.

The Proximal Interphalangeal (PIP) Joint is the second knuckle on each digit. Shortening o

the fexor tendons can be caused by many conditions and eventually lead to contracture.

Contractures can cause pain, u nctional limitation and problems with hygeine.

Contractures are usually treated by surgery ollowed by splinting.

Splinting is rarely eective because the splints available have majorunctional problems.

My job was to explore the shortcomings o current treatments and

design a splint that would improve the outcomes or patients by:

researching current methods

developing design criteria based on research

generating concepts

presenting in design reviews with surgeon and therapists

creating prototypes

developing procedure or abrication

1.

2.

3.

4.

5.

6.


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Research Methods PIP Splin

Gutter Splint Dicultto t, rolls, putspressure on specicpoints

Bunnell Splint Doesnot apply enough orce

R. Knuckle Benderso bulky it causesunctional limitations

Oval 8 Splint lowprole, but puts highpressure on smallareas

Literature search

Method Results

Observation o clinic/

Experiential Research

Market review

I read scholarly research papers and books on surgery and splinting. Scholarly work primarily concerned with straightening

the nger, not usability or patient comort. Emphasize

problems with patient adherence.

Available splints are high prole, have ew options or

and are not easily customizable.Outdated use o mater

No fexible plastics or abrics presented.

Clinicians admit do not straighten well because o mat

limitations, improper t, and lack o patient adherence

I ound making custom splints challenging and time

consuming and available splints uncomortable.

Patient Interview Patients admit to not wearing their splints, complaininimproper t, pain and discomort, diculty donning, an

embarrassment.

I had many conversations andinterviews with patients in

the occupational therapy and

surgery clinics.


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Design Criteria PIP Splin

Adherence I the splint isuncomortable or dicult to put onthen it will not be worn

Straightening Splint needs to applyenough corrective orce to straightenthe contracture

Fit Custom splints are dicult toabricate and o the shel splints aredicult to t

Comort/ Health Splints cause painand discomort because pressure isuneven

1. Flexible Material combined w/ eective extension moment Straightening

2. Low prole, not interere with activities o daily living Adherence

3. Comortable, held in place by circumerential tension Adherence, Comort

4. Form tting or variety o nger sizes and still easy to don Adherence, Fit

5. Pressure diused over the whole nger Adherence,Comort

6. Permit visual monitoring o skin health and circulation Adherence, Comort

Problems discovered in research


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Initial Exploration PIP SplinBased on the design criteria I developed a series o sketchesand models to test the concepts. The fexible material wasused to secure the splint and distribute the orce o the rigid

stay. I considered dierent ways to put the stay on and adjust

the size and straightening orce.

Adjust width by placing the

stay in dierent pockets.

Use tensioned bands instead

o stay to relieve pressure


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Concept Development PIP Splin

Using a series o models and sketches I explored possible

arrangements o the stays and explored dierent materials and ways o

making the prototypes. Biradial stays allow fexing between them and

permit the material to hammock. Multiple radial cavities worked very

well but made the device dicult to put on. Using 4 radial cavities was

very eective at stabilizing the joint. At the discretion o the doctor the

stays can be adjusted and customized and reinserted into the cavities

ater the sleeve is donned.


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Prototype Process PIP Splin

Make positive model o splint in CAD

Several Iterations to establish the best ways

to design the mold eatures

Pour rubber Prototypes o sleeves

Create mold cavities and add air holes,

reerence pins, and a unnel or the liquid

Build the molds in the Stereolighography (SLA)

rapid prototyper

Cast urethane rubber was the chosen material. In order to go through iterations quickly and

accurately I used SolidWorks to create molds to pour the rubber into.


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Final Design Review PIP Splin

1 2 3

4 5 6

Future Work

It may be possible to replace the stays with a thicker/ stier band o material over the dorsal side o the joint.It would be much easier to put the splint on i it were lined with a material that did not stick such as abric.


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Introduction Inclusion ChaProblem A special education school district provided a grant to

design a chair or Garrett, an eight-year-old with a physical and

cognitive disability. The seat enables him to sit at the caeteria

lunch table with his peers. I worked with Garretts therapy and

education team to develop the chair and test prototypes with the

goal that it be universal enough to work or many children with

diverse needs.

Beore Garrett currently uses these chairs or dierent tasks but none

have the correct amount o support or his body or can be used at the

caeteria table

Ater Garrett can sit independently in the caeteria at lunchtime

in the community

Caeteria tables Nowhere or Garrett to sit in his wheelchaiGarrett Enjoys being with his riends but has physical needs

that require special seating


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Research Methods Inclusion ChaThe overarching research problems were:

From video o Garrett using many dierent available alternatives Ilearned that his body is rarely calm enough or him to sit saely without

his eet, lap and upper bo dy secure. Initially, it was very important to

his therapists not to secure his upper body. Opening their minds took

creative approaches to research..

To learn how to tell i Garrett was comortable I explored Garretts

behavior in other settings, and I interviewed his amily, therapists,

teachers and peers.

To change his therapists perspectives on his sensory needs I

researched methods or therapy in other areas, especially sensory

integration disorders

To open my mind to new approaches and aesthetic styles I looked or

inspiration in seemingly disparate areas o design

I also did a morphological ordering o existing products, observed

other students, interviewed people with less experience with special

needs about their prejudices, and researched childrens products and

trends.

How can I ask Garrett what he wants, when Garrett

does not use words to say what he wants?

How can research challenge existing perceptions o

what is right?

1.

2.


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Initial Thoughts Inclusion Cha

Because Garretts needs or support varied widely rom trial to trial, it was

necessary or all elements to adjustable and modular. The prototypes

themselves became tools to research Garretts needs urther.


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Studies Inclusion Cha

In this concept the seat, trunk support and oot rest would slide up and

down along a rame while the trunk support and armrest rotate to tighten

and to allow access rom the side

Here the chair would consist o panels with slots that could be put togethe

like a puzzle to t each child. It would be collapsible or transportation

Small scale sketch models helped nd ways to simpliy the mechanisms. I chose

to uniy the booster or height with a mechanism or sliding orward because we

observed that Garrett couldnt reach the table.

During research I observed that Garrett moves his body less when he hassensory

stimulation around his trunk. I experimented with a fexible wrap instead o rigid

sides to oer him sensory input and calm his body movement.


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Concept Based on my research and stu

built the chair with a fexible chest suppor

hip support which would give Garrett se

input and reassurance o his boundaries w

using the traditional hard supports ound in

products.

Trial When Garrett tested the chair he did not extend

and throw himsel orward as much as in his currentchair and he was able to eed himsel.

Initial Prototype Inclusion Cha


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Final Prototype Inclusion Cha


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Functions Inclusion ChaSeat Position Seat moves up and down along rame when buckle is tightened t

adjust booster height|Chair slides orward and back to bring child closer to ta

Trunk Support There are two sets o chest supports

that can be adjusted or width and height. One is rigid

and stuck at 90 degrees to maintain posture. The

other is fexible and is secured with a velcro wrap or

better upper body security and sensory input. Both can

be adjusted or height and width.


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Functions Inclusion Cha

Additional Adjustments The seatbelt is passed thro

a clip on the side o the seat to squeeze the seat sn

around the hips | Pelvic Support rom a crotch stra

ootrest height adjustable | Seat depth can be adju

by adding padding | Washable cover is removable

In the community Garrett will be able to enjoy more experiences with his riends and

amily in a chair that is colorul, riendly and playul in appearance


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Garrett Inclusion Cha

Since Garrett began using this chair he has grown socially. Through the

research and trials Garretts therapy program has been reinvented to inc

sensory considerations. Another child has also begun to use the chair.


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Initial Concepts Watering CaProcess I observed the use o a watering can and identied diculties with weight

bearing and pouring rom the wrist and balance I developed and tested sketch models and

prototypes. These sketches are examples rom my exploration o how a watericang can

could be reinvented to alleviate these problems or universal use.

1.

2.

3.

4.

Watering sling. Carry weight with whole bod

Use nozzle to pour. Dicult to don and do

Reverse spout allows user raise whole arm

instead o bending wrist.

Alleviate problems o weight bearing by pla

the ground on wheels. No need to bend d

bend wrist to pour.

Angle nozzle to the side to create a second

to distribute weight and help with balance.

1. 2.

3. 4.


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Balance Exploration Watering CaConcept By making the watering can shallower and broader

it would require less tilt in the wrist to pour rom it which

would alleviate the increased strain o bearing weight with a

bent wrist.

ObservationsWater splashed around easily and it was awkward to carry. It was

also dicult to maintain balance because weight bearing was on one side othe body.


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Unolding Exploration Watering CaConcept Separate the weight bearing and pouring demands by either pivoting the

basin or lowering the spout without changing the position o the weight bearing hand.

Result It was very comortable to use but required a mechanism to prevent the spout

rom deploying accidentally. Not the most simple or elegant solution. Also posed a

risk that that mechanism could be dicult to use, especially or someone with limited

dexterity.


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Selected Concept, Basin Watering Ca

Concept Inspired by a statue o a goddess pouring a basin o

water, the watering basin is evocative o an oering. It helpsthe user connect with their garden, and enables the user to

center the weight at their core.


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NightlightThis light or a childs room can be manuactured with

one die and sold in a fat envelope to consumers or creative

assembly. It ts a Grundton table lamp rom IKEA. The user can

control the brightness or day or night by peeling away layers to

release more light.

Paper Lampshade Nursery Nightligh

+


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Problem Hand Sanitizer For Hospital UsEvery year 2 million patients get preventable antibiotic resista

inections in the hospital and 90 thousand die as a result.

Doctors and nurses wash their hands one-third to

one-hal as oten as they are supposed to.

Even i you get the whole process down to a minute

per patient, thats still a third o sta time spent just

washing hands.

With alcohol nally in wide use the compliance rates

or proper hand hygeine improved substantially, rom

40% to 70%. But the ho spital inection rates did not

drop one iota. Our 70% compliance just wasnt good

enough.

-Dr. Atul Gawande

Author o Better: A Surgeons Notes on Perormance

Convenience I Device must be portable,wearable, ast, used with one hand

Memory I Device must be bold, prominent,

not hidden in pocket

Accountability I How much gel the doctor

has used must be visible

Aesthetic I Device must be patient-riendly,

t into hospital setting

Dr. Gawandes Barriers I Design Opportunities


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Concepts Hand Sanitizer For Hospital Us

Form study and idea generating based on 4 design criteria. Focused on orcing the user

to wear the device in a certain way to create a standard and encourage mindulness. Each

eatures a way to view how ull it is and can be used with o ne hand. From let: Wristband,

clip to pager, wear on stethoscope, armband.

Ater conducting interviews with design and medical students determined fexibility is use

would be better or compliance. Additional ideas to develop aesthetic, mechanism o use

and ease o use.

P d d S l


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Final Design Hand sanitizer can clip to clothing, charts, stethoscope, etc. but is

not easy to use rom a p ocket, keeping it always in sight. It has a playul shape

the user wont mind showing. It can be used easily with one hand by cupping

hand over object and squeezing the gel into the palm. Additionally, the dispenser

is clear so the user is accountable or how much hand sanitizer they have used.

A ull gel packet at the end o a day means sick patients.

Product Hand Sanitizer For Hospital Us

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