USER MANUAL version 13.3.
THE FUTURE OF REHAB Welcome to the future and thank you for choosing SHoW Motion. SHoW Motion is the most innovative product for the functional evaluation of both Upper and Lower Body. SHoW Motion incorporates wearable technology, novel measurement protocols and easy reporting of human body kinematic and muscle activity through an end-user software interface that guide the user throughout the entire process. SHoW Motion brings functional evaluation of upper extremities to a new level in rehabilitation.
SHoW Motion – USER MANUAL v 13.2.2 DISCLAIMER This manual is intended to be informative document and not as lonely source of training for the product usage. For proper training, please contact our support and assistance team at the following: info@ncs-company.com Technical assistance is provided by our team. Each detected problem should be reported to the address previously provided.
INTRODUCTION Visual observation in rehabilitation is the current technique for the identification of signs of alterations in patients due to an injury, muscolo-skeletal deficiency or impairment, rather than results of surgical treatment.
SHoW Motion – USER MANUAL v 13.2.2 INTENDED USE The product is intended to be used as instrumentation for the kinematic analysis of the movement using inertial sensors. Product provides comparison capabilities of data collected that makes use of novel interpretation methods. However, the product does not implement decision-making algorithms.
Location The product is intended to be used in physiotherapic settings, including small physiotherapic offices where no surgical equipment or other electrical medical devices are provided During training of personnel and system configuration by the manufacturer, location will be chosen together with the customer according to his needs. In the event where the location needs to be changed by the customer, please contact our support and assistance.
SHoW Motion – USER MANUAL v 13.2.2 SYSTEM CONFIGURATION The picture below illustrates the 3 different main configurations available in SHoW Motion. CONFIGURATION 1: SHoW Motion software SHoW Motion software can be used as stand-alone system when opening patient database, playing back previously recorded analyses, generating specific reports or comparisons.
Fixomull skin tape FUNDAMENTAL for motion recording Surface EMG electrodes FUNDAMENTAL for muscle activity recording Depending on the package of the product purchased, the kit supplied differs for the number of movement sensors and for the elastic strips (in terms of number, color and size) necessary to perform the analyzes as specified in the table below. Each kit contains 1 GTWY for receiving the data wireless transmitted from WISE sensors.
SHoW Motion – USER MANUAL v 13.2.2 PRODUCT CONTENT PLEASE READ CAREFULLY - A User Manual is provided with the product, serving as the main reference both for hardware and software usage. It is essential that the user and all personnel involved in the use of the product fully understand the content of the manual and follows instructions provided during all the steps of the implemented protocol.
USAGE REQUIREMENTS User requirements The right user of SHoW Motion must belong to one of the following areas: o Practitioner in physiotherapy o Practitioner in kinesiotherapy o Practitioner in surgery o Practitioner in motion analysis of human body o Biomedical engineer Each user must have received the proper training by or by means of education personnel belonging to the manufacturing Company The user/operator and the subject himself/herself must be able to collaborate during the proced
SHoW Motion – USER MANUAL v 13.2.
ENVIRONMENT REQUIREMENTS Environment where product is used must fulfill the following requirements: Never go out of the level of temperature and moisture suggested by hardware manufacturer. It is best to avoid moisture/wet surroundings. Please refer to the related User Manuals from NCS Lab and Cometa Systems for further information. No ferromagnetic materials (iron, heating machines, hard drivers, engines, hi-fi) should get closer to the hardware sensors, during usage or afterwards.
SHoW Motion – USER MANUAL v 13.2.2 The sensors WISE should be installed and operated with minimum distance of 0.006m between the radiator and your body. The case of the device guarantees the fulfillment of this requirement and therefore allows its direct application on the body by means of elastic bands and/or double-sided tape. The receiver GTWY should be installed and operated with minimum distance of 0.009m between the radiator and your body.
SOFTWARE INSTALLATION Preliminary notes Before every usage user must accept the following declaration: o “I declare that I have the proper qualification and I have received the proper training for using such product” PC Minimum requirements and compatible software: o Laptop/Desktop PC with at least quad core processor (Intel, AMD, Atom) o Intel Graphics HD or superior4 o At least 2 USB (>2.
SHoW Motion – USER MANUAL v 13.2.2 4. At this point of installation, hardware drivers are installed. Windows might ask for confirmation on drivers signature 5. Launch SHoW Motion software for the first time. The proper link can be found in the start menu 6. At first launch of the software, software license needs to be activated. In order to do this, copy the Activation License ID as shown in the picture and send it to your sales contact. 7.
FOLLOWING INSTALLATIONS 1. Launch SHoWMotion_setup.exe and follow the instructions on the screen: 2. Select the components to be installed. Full installation is recommended: 3.
SHoW Motion – USER MANUAL v 13.2.2 INSTRUCTIONS OF USE PRELIMINARY VERIFICATIONS Make sure that all sensors batteries are fully charged before each session of analysis. Verify to have enough free space available (at least 200 MB) on your hard drive where the software has been installed to allow correct data and error log saving after each session. It is convenient to start connecting wireless receivers through the USB cables before launching the software.
Picture 1 BASIC INSTRUCTIONS 1. At the beginning of each session, open the suitcase, pick up the wireless receivers for motion sensors and EMG and position them on a flat surface so that they are at least 2 meters far each other. For best communication, it is suggested to place them at different heights with respect to each other5. Always use suitcase provided with the product to store sensors and accessories when these are not used. 2.
SHoW Motion – USER MANUAL v 13.2.2 4. Turn on the EMG wireless receiver by pushing the toggle on its back. After a few seconds, LED indicators on the front will show the EMG sensors connected to the receiver. Note that only when the EMG sensors are removed from the suitcase, the connection can be established. 5. Prepare EMG sensors for the analysis by first placing skin adhesive stickers on the back of each probe. Secondly, connect 2 EMG electrodes to the extremities.
ANALYSIS FLOW-CHART Start a new analysis Open new analysis Analysis configuration Compare data Connection Add notes Positioning Real-time window Warm-up Calibration The above picture illustrates the framework used within the SHoW Motion software. During the analysis, it is always possible to go back to the previous step and repeat it.
SHoW Motion – USER MANUAL v 13.2.2 ANALYSIS PROCEDURE Start a new analysis To start a new session of analysis, click on the top left button to open the menu, then click on “new analysis”. Right panel will change showing one list menu for each configurable parameter of the analysis (Picture 3): Analysis type: each analysis type selected automatically correspond to a subset of possible configurations, for example regarding the number of sensors to be used.
Picture 4 Depending on the number of EMG sensors received with the package, the user can select the corresponding muscle upon which the EMG sensors will be placed on the subject. WARNING: at this stage make sure that the EMG wireless receiver is connected via USB and already turned on. Click on the blue arrow to proceed to the next step. Initialization During initialization part, if the gateway is already inserted in the computer, extract the gateway and plug it into the USB port.
SHoW Motion – USER MANUAL v 13.2.2 Picture 5 Positioning of sensors A button called “video” is available for the user. When pressed the button, a dedicated movie is shown explaining the primary actions to take in order to position the motion sensors on the body of the subject. In the following pictures, stepwise procedure is described. Each sensor is provided with a colored sticker on the side, corresponding to a specific body segment.
3) Now keeping the scapula sensor in your right hand, place the sensor as shown in the Picture 6. Picture 6 The correct positioning is made when the longer side of the motion sensor is aligned and almost parallel to the middle part of the scapula spina. If this is done properly, the sensor will not be perpendicular to the vertebral spine and the part of the sensor opposite to the side aligned will lay on the supraspinatus muscle area.
SHoW Motion – USER MANUAL v 13.2.2 Positioning of shank sensor (lower limb analysis) Position “Shank” sensor by first placing the shank strap provided in the kit, around the shank, so that the sensor is positioned within the distal third, close to the lateral malleolus, with the X axis aligned with the long axis of the fibula and with the Z axis pointing laterally in the body’s frontal plane.
The FCC ID of the sensors is 2ATZJ-WISE and it is affixed in the lower part of WISE sensors, as show in the figures. TROUBLESHOOTING”)7 Humerus/Thigh/Shank/Foot sensor: after positioning, keep the entire sensor strap with one hand and try to rotate it internally towards the center of the body. If the strap will not move or fall down along the limb, the positioning is stable.
SHoW Motion – USER MANUAL v 13.2.2 around the floor. It is also important that subject is not sitting above metal objects during this phase or walking closely to active motors or metal objects. When the subject is ready, click on the red circle at the right to start (Picture 7). Warm-up phase of the system can easily be used in order to double-check correct positioning of motion and EMG sensors. If something is discovered during this phase, it is not necessary to restart warm-up phase.
It is strictly important that during this phase the subject does not perform any movement. If the subject is not autonomously able to keep the posture, the operator can help in keeping the position. If the subject is not capable of performing the movements actively, passive mobility by the operator can also be accepted. When completed, it is possible to proceed to the next step by pressing the blue right arrow.
SHoW Motion – USER MANUAL v 13.2.2 During this calibration step, the subject is asked to perform a sequence of pure flexions and extensions of the left knee according to Outwalk protocol as described in “ABOUT MEASUREMENT PROTOCOLS”. In order to accomplish this, the subject under investigation has to stand in the upright posture and to flex-extend the knee about five times up to 70°. For best results, the subject should not perform full flexions or full extension and speed should be comfortable speed.
Picture 8 Controls in the left panel Left panel contains a dedicated window incorporating a 3D environment where full skeleton can visualize in real-time. When the user presses the play button, 3D animation of the skeleton will follow subject motion, depending on the number of sensors/segments available in the configuration selected at the beginning. Left panel also contains stop and record controls. Record is a radio button that needs to be active in order to apply recording.
SHoW Motion – USER MANUAL v 13.2.2 Provide the subject with a direct feedback regarding the type of measurement, how motion is performed and concept behind the analysis, enhancing therefore subject involvement Verifying correctness of measurement By the 3D animation is always possible to verify that skeleton shows reasonable representation of bones. If this does not happen: please check that sensors positioning was correct.
Inter-joint coordination plot In the Picture 10, an example of data visualized in the right panel is shown. The graph was selected among the available list of titles by clicking on the corresponding toggle button. Each title refers to a couple of joint degree of freedom which will be visualized in the abscissa and ordinate axes of the graph. For example, the graph selected in the picture 11 is called “Up-Do Vs Fl-Ex”.
SHoW Motion – USER MANUAL v 13.2.2 As shown in the Picture 11 above, EMG muscle activity is plot against time. Muscle activity is provided as µV, according to the amplification method of the EMG manufacturer. During real-time, the plot against time will scroll to the left showing data frame by frame. 3D animation using EMG Direct information regarding muscle activity is also available in the 3D animation window when an EMG system is associated with motion sensors.
Picture 13 This will open a new window called “Load Analysis” containing the list of subjects trials available in the database. Clicking on a subject allows to visualize and change Patient Note, while clicking on a trial allows to visualize and change the Analysis Note. The buttons at the bottom of the window serve as commands to interact with the database, as shown in the Picture 14.
SHoW Motion – USER MANUAL v 13.2.2 Report creation Selecting a trial from the database and clicking on button will automatically generate a PDF format report of the entire trial containing: Patient information and related notes Graphs available with kinematics information (including inter-joint coordination) Graphs with EMG information for all the muscles analyzed An example of report is shown in Picture 15.
Picture 16 Alarms generated by the software The problems detected by the software are signaled to the user with alarm messages. The generated alarms are not exclusively visual but include text. The text clearly illustrates the problems encountered and how to solve them. The user of the system must be aware of the alarms that may be generated by the software and how to manage them. If it is impossible to proceed with the analysis, contact our support team.
SHoW Motion – USER MANUAL v 13.2.2 This message appears when the quality of the data received by the sensors during the functional calibration phase is not optimal. This could be caused by: i) incorrect positioning of the sensors ii) sensors have transmitted inconsistent iii) the calibration movement was not performed correctly.
ABOUT MEASUREMENT PROTOCOLS SHoW Motion modus operandi was designed in order to fully implement: ISEO (INAIL Shoulder and Elbow Outpatient) protocol for tracking shoulder and elbow kinematics of upper body Outwalk protocol for tracking lower limb Description of ISEO is publicly available in: Cutti, Andrea Giovanni, Andrea Giovanardi, Laura Rocchi, Angelo Davalli, e Rinaldo Sacchetti. «Ambulatory measurement of shoulder and elbow kinematics through inertial and magnetic sensors».
SHoW Motion – USER MANUAL v 13.2.2 Description of Outwalk is publicly available in: A. Ferrari et al; Outwalk: A new protocol to measure the 3D kinematics of gait in real-life environment using an inertial & magnetic measurement system; Gait & Posture; v 30 pp S52-S53; 2009 A.
PRODUCT MAINTENANCE Hardware Maintenance of hardware components is necessary to guarantee characteristics and performance of hardware and related measurements. In this section, a list of items to be periodically verified by the user is provided: Batteries: duration of batteries during measurement is guarantee for the entire analysis if a full charge has been accomplished. Before every use, please verify sensors where charged. The WISE is equipped with LiPo batteries, with a capacity of 240mAh.
SHoW Motion – USER MANUAL v 13.2.2 Software Maintenance of software and computer where software is installed are necessary to guarantee the best experience with SHoW Motion. Your trainer and Company support team will make sure that after first installation computer is optimally configured to operate with SHoW Motion. However, it is highly recommended that: Laptop PC: your computer needs to be always connected to the power in order to avoid any data loss in database.
TECHNICAL INFORMATION SYSTEM COMMUNICATION Risk of communicating within the same Wi-Fi channel At first usage we set-up the proper channel of communication setup When changing environment, we recommend to ask assistance in case of you would like to switch channel of communication HARDWARE SPECIFICATIONS For specifications on inertial sensors, please refer to the WISE Technical Information (NCS Lab, Carpi, Italy).
SHoW Motion – USER MANUAL v 13.2.2 The FCC ID of the receiver is 2ATZJ-GTWY and it is affixed in the back side of GTWY receiver as show in the figures. The FCC ID of the sensors is 2ATZJ-WISE and it is affixed in the lower part of WISE sensors, as show in the figures.
>> Hardware cannot be connected anymore after an unexpected reset Unplug the wireless receivers from the USB port. Plug them again and restart the analysis >> Technical assistance Technical assistance is provided by our team. Any problem encountered should be reported to the following email: info@ncs-company.com Our team will provide technical assistance regarding all aspects of the supplied device and will also take care of replacing any damaged parts of the device.
SHoW Motion – USER MANUAL v 13.2.2 INFORMATION TO THE USER 1. For devices approved under Part 15, the user’s manual or instruction manual for an intentional or unintentional radiator shall caution the user about changes or modifications to the device (Section 15.21). 2. For Class A and Class B digital devices, information to the user is required to include the following statements (Section 15.
WARRANTY ON PRODUCT WARNING: Non modification of this device is allowed Please refer to your sales contact for information regarding warranty contract on the product.
SHoW Motion – USER MANUAL v 13.2.2 SOFTWARE LICENSE AND MAINTENANCE AGREEMENT (SLAMA) IMPORTANT - READ CAREFULLY BEFORE INSTALLING OR OTHERWISE USING SDK SOFTWARE PROVIDED UNDER THIS AGREEMENT ARTICLE 1 – MAIN TERMS SHoW Motion (SHOW) is an end-user software incorporating high-level methods for the quantification of motor control coordination. SHOW is provided as it is and is only intended for clinical use and applied research in clinics but not as measurement system software.
NCS Lab disclaims unintended use of the SHOW functionality regarding kinematics of human motion, such as for the creation of measurement systems based on it or diagnostic tools of human/animal body parts or human/animal joints. SHOW is intended to be used only for the quantification of the motor coordination.
SHoW Motion – USER MANUAL v 13.2.2 ACKNOWLEDGMENTS Wave Plus (Cometa Systems), WISE (NCS Lab) and GTWY (NCS Lab) are trademarks from the respective owners.
