Lessons from the Medical World: Osteopathic Medicine and Human-Centered Design

Lessons from the Medical World: Osteopathic Medicine and Human-Centered Design  

Meaghan Hudak  | Reading time: 4 minutes

Humans have 204 bones and 360 joints that work together following two basic methods of movement. Understanding how and why the body moves is critical to creating effective tools. The connections between the nervous system, the musculoskeletal system, and our world can be used to effectively introduce new tools that make life easier and more comfortable for the community.

During this session, we discussed how a holistic approach to patient care led to the evolution of a tool to monitor joint motion and how data acquisition impacts our ability to move comfortably. 

Attendees learned: 

• Learn about the DO's preventive, "whole person" approach to illness and how mind-body-spirit considerations are important considerations during treatment.
• Discover how normal humans work from a biomechanical perspective, and 
• Understanding how the connection between human behavior, the nervous system, and the musculoskeletal system led to an innovative health care solution. 

What's Wrong with People? 

Dr. Cymet opened the discussion explaining a few flaws of the human body. The design flaws include: 

1. The spine of a quadriped - arched to support organs and bipeds develop LS pain.

2. Inflexible knee with parts that are not easily replaced - flex, extend, and improved joint needed.

3. Poorly packaged brain - access is hard and introducing medicines to the brain is complicated. 

4. Exposed Genitals (male) - What was the designer thinking? 

5. Trachea and esophagus open into the same space - Asking for trouble!

6. Allergies - Should we be able to reject ourselves?

7. Eyes need ability to be modified

As someone who has poor vision and suffers with life threatening allergies, I resonated with this discussion. We have all suffered with a human body design flaw a time or two. 

Mechanical Rules for the Body

Dr. Cymet reviewed with the audience the laws of motion. Specifically, Newton's Laws of Motion and Fryette's Law of Motion.

NEWTON’S LAWS OF MOTION

• A body remains at rest, or in
  motion at a constant speed in a
  straight line, unless acted upon by
  a force.
• When a body is acted upon by a
  force, the time rate of change of
  its momentum equals the force.
• If two bodies exert forces on each
  other, these forces have the same
  magnitude but opposite directions.

FRYETTES LAWS OF MOTION
Law #1 = Neutral Mechanics

• When the spine is operating in neutral
  mechanics, side-bending to one side
  will be accompanied by horizontal
  rotation to the opposite side.
• Needs to be observed for more than one vertebrae.
• Can be different for one pair (two) vertebrae, or a bunch of vertebrae.

FRYETTES LAWS OF MOTION
Law #2 = Non-Neutral Mechanics

• When the spine is in a flexed or extended
  position (non-neutral), side-bending to
  one side will be accompanied by rotation
  to the same side.

FRYETTES LAWS OF MOTION
Law #3 = Motion in One Plane

• Limits Motion in Other Two Planes
• When motion is introduced in one
  plane it will modify (reduce) motion in
  the other two planes.

The third principle sums up the other two laws by stating dysfunction in one plane will negatively affect all other planes of motion. For example, if you have problems with your hip, you may over compensate or rely on your other hip when getting in and out of a seat. If you observe runners in a marathon, based on their gait, who is comfortable and who is not?  Dr. Cymet explains that as the bones break down, the person will experience pain and become unhappy. 

Within the nervous system, we have a sixth sense (and no it's not seeing dead people). It is called Proprioception. Proprioception is knowing your body's orientation, structure, how it can move and how your brain tells it to move. This is controlled by your nervous system alpha motor neurons and gamma motor neurons. This provides us with awareness of what's going on with the body. 

Awareness: How to Design Things Better

Dr. Cymet concludes with reviewing the most common workplace injuries. These include overexertion, trips and falls, and chemical burns. Injuries like these could be a result of poor design or poor placement. Dr. Cymet explains the injuries he see's in the Emergency Room the most: cuts from eyeglasses and hands from work. Eyeglasses pose a risk for the elderly when they fall. The design of the eyeglass is done poorly. One solution could include breakaway glass that prevents injury to the eye. Cutting hands with equipment at work in factories and kitchens are also seen frequently in the Emergency Room. Below includes an image for a design solution for those who experience nosebleeds:

Nasaclip, designed by partner Elizabeth Clayborne, provides a safe, effective, hands-free nosebleed rescue for anyone.

Data Driven Joint Surgeries
Joint Monitoring Data: The Time Has Come

Dr. Ward starts his presentation explaining that hip and knee replacements are on a rapid rise. Osteoarthritis causes the loss of joint space and will affect all people to some degree during their lifetime. 
Expectations: • Just fix me doctor: Will break the bank • Growing risk factors: Age, obesity,
déconditioning, diabetes
• Rising number of doctors who can perform
knee / hip replacements
• Growing access to imaging = greater diagnosis • Growing number of outpatient rehabilitation
facilities
• Growing number of physician owned ASC • Growing cost of healthcare

Determining who is a good candidate 

Pain is an imprecise measure
▪ X-ray / Mri is imprecise measure
▪ Function is subjective
▪ Validated surveys as instruments
Future:
Compliance in pre-habilitation
Food choices / weight management
Aerobic, mind-body exercise,
strengthening, flexibility
Force coupling optimization & gait

JOINT MONITOR ▪ Takes the guessing out of pre
-surgical
function over time.
▪ Evaluates movement dynamics ▪ Provides patient feedback during post
op period
▪ Improves goal setting ▪ Identifies risk before they become a
problem
▪ Quantifiable data with ability to
interface machine learning AI

Optimizing Outcomes

DISRUPTIVE TECHNOLOGY
21
BREAKING THE MOLD ▪ A tool to define the pre-existing baseline ▪ A means to define failure of conservative
measures by quantifying compliance
▪ To improve expectations regarding post surgery
function
▪ Improve post operative safety and reduce need
for revisions
▪ Optimize rehabilitation intervention strategies:
data driven multimodal co
-ordination
▪ Quantify goal progression during rehabilitation ▪ Determine end point of rehabilitation, Maximal
Medical Improvement
▪ Cost containment through data
-driven,
evidenced
-based care

If you missed Dr. Cymet and Dr. Ward's presentation, check out the transcript and recording on the CCSQ World Usability Day page. This page also includes an archive of transcripts and recordings of speaker presentations, session materials, and event photos. For more information about the Human-Centered Design Center of Excellence, refer to the HCD CoE Confluence page.