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A Smart Tendon Hammer System for Remote Neurological Examination.

Waiman Meinhold1, Yoshinori Yamakawa2, Hiroshi Honda2

  • 1Biorobotics and Human Modeling Laboratory, Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States.

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Summary

Novices can now perform deep tendon reflex exams remotely using a smart hammer that guides tapping and provides feedback. This innovation enables accurate reflex elicitation and grading by laypeople, improving neurological care access.

Keywords:
COVID-19 pandemicIoTneurologyreflexremote diagnosis

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Area of Science:

  • Neurology
  • Biomedical Engineering
  • Digital Health

Background:

  • The deep tendon reflex (DTR) exam is crucial for neurological assessment but traditionally requires in-person clinician expertise.
  • The COVID-19 pandemic accelerated the need for remote healthcare solutions, including telemedicine.
  • Novice performance of the DTR exam is limited by the need for trained professionals.

Purpose of the Study:

  • To enable novices to perform the deep tendon reflex exam remotely.
  • To develop a smart tendon hammer system for assisting in reflex elicitation and grading.
  • To bridge the gap in neurological care delivery exacerbated by the pandemic.

Main Methods:

  • Development of a smart tendon hammer transmitting wireless acceleration measurements.
  • Implementation of a feedback application to guide novice users on tapping location and appropriateness.
  • Evaluation of novice ability to elicit and grade reflexes using the smart hammer system.

Main Results:

  • The smart hammer accurately differentiated correct and incorrect tapping locations with 91.5% accuracy.
  • Novices demonstrated reasonable ability in grading reflex responses, with a mean error of 0.2 points on a five-point scale.
  • The system successfully enabled novices to perform the reflex elicitation component.

Conclusions:

  • A smart hammer with a feedback application can assist novices in performing the reflex elicitation component of the DTR exam.
  • Novices can adequately grade reflex responses, making remote DTR exams feasible.
  • This technology addresses a critical need for remote neurological assessment, particularly in public health crises.