Low cost portable sensor for real-time monitoring of lower back

bending
Wern Kam a, Kieran O’Sullivan b, Waleed S. Mohammed c, Elfed Lewis *a
a
Optical Fibre Sensors Research Centre(OFSRC) , Dept. of Electronic and Computer Engineering,
University of Limerick, Ireland; bDept. of Clinical Therapies, University of Limerick, Ireland;
c
Center of Research in Optoelectronics, Communication and Control Systems(BU-CROCCS),
School of Engineering, Bangkok University, Thailand.

ABSTRACT
A mechanically robust and compact optical fibre sensor system is described to monitor the bending of the lower back
bone in both sagittal and frontal plane. Both bending modes are monitored through the change of the coupled optical
intensity ratio between three output fibers aligned to one input fiber. This provides real time feedback when different
postures are sustained. The output ratio is calibrated to bending angles using an optical setup that utilized a precise
rotational stage. An operation range between -12o to 12o is demonstrated. It is also demonstrated that sensor is suitable
for use in a clinical diagnosis system with the additional benefits of being non-invasive, robust, straightforward to use
and low cost.
Keywords: Plastic optical fiber sensor, bending sensor, lower back bending

1. INTRODUCTION
Low back pain is one of the most common health problems that influences an individual’s life quality and is a leading
cause of disability1. The cost of medical care for treating and monitoring back pain and the related loss of time from the
workplace etc. is estimated to be at least $50 billion a year2. These statistics highlight the need for lumbar spine
monitoring among patients in a low cost and effective manner so that the cause of back pain can be accurately identified
and treated accordingly. There are currently several methodologies available to measure the bending angle of the spine in
the clinical assessment of lumbar spine conditions. Apart from the use of imaging through radiography3 to visualize the
structural movement of the lumbar spine, there exist numerous alternative methods for externally measuring the motion
and bending curve of lumbar spine which remove the need for exposure to ionizing radiation and hence reduce the risk to
the patient from radiation exposure. Devices for dynamic spine assessment include wearable and skin mounted types for
example the goniometer4, inertia sensor modules5 and accelerometers6. Non-contact type sensors involving image
capture form a significant part of the diagnostic methods that are currently available. This sensor generally uses a motion
capture or other imaging system such as the Vicon optoelectronic system7, MRI scanning8 and rasterstereography9. These
systems are very accurate, but are generally large devices and are expensive in terms of their capital and running costs.

To date, an intensity-based optical fiber device for spine bending monitoring has been developed by Zawawi et al10. A
wearable optical sensor for monitoring seated spinal posture has also been developed by Dunne et al11, where a plastic
optical fiber (POF) is abraded on one side with one end of fiber connect to light source and light sensor at the other end.
The sensor was stitched to a wearable garment using a loose zig-zag stitch to allow the POF sensor to move vertically
along the garment surface.

The sensor developed in the investigation of this work utilizes plastic optical fiber (POF) for which bending results in a
change in optical intensity coupled between a feed fiber to three receiving fibers grouped together. The bend causes an
alignment mismatch between the input and output fibers and hence the optical power is redistributed between the
receiving fibers. By measuring the output signal from the three fibers, it is possible to accurately and separately
determine the angle of bending for both the sagittal (forwards and backwards) and frontal (left and right) directions. A
simple, low cost and portable sensor has been fabricated using 3-D printing which allows initial clinical diagnosis of

25th International Conference on Optical Fiber Sensors, edited by Youngjoo Chung, Wei Jin,
Byoungho Lee, John Canning, Kentaro Nakamura, Libo Yuan, Proc. of SPIE Vol. 10323,
1032373 · © 2017 SPIE · CCC code: 0277-786X/17/$18 · doi: 10.1117/12.2264787

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 back bone bending problems and tracking of curvature progression. The sensor is able to provide a real-time signal
change for different posture for interpretation by clinicians.

2. METHODOLOGY
This POF sensor works based on an intensity interrogation technique which was initially proposed by some authors of
this article which involved three optical fibers at the output and one input fiber connected to a light source10. This
configuration consists of an input fiber which is accurately aligned to the center of three connected output fibers so that
in the rest position (no bending in any direction) the optical power transmitted in each of receiving fibers is ideally equal
as shown in figure 1(a). During the lateral bending to the left (left bending in frontal plane), the input fiber shifts,
increasing the light coupled to I1 and decreases that of I2. This process is reversed for the case of lateral bending to the
right (right bending in frontal plane). The lateral bending magnitude is estimated from the following output ratio R(θx).

I1 ( x, y, z ) − I 2 ( x, y, z )
R(θx) = (1)
I1 ( x, y, z ) + I 2 ( x, y, z )
During sagittal forwards bending (flexion), the input fiber shifts upward, increases the coupling to fiber I3 and decreases
the coupling to fiber I1 and I2. This is reversed for sagittal backward bending (extension). Sagittal bending response is
calculated from the ratio R(θy) formed between all three output fibre readings as follows :-

1 1
I ( x, y , z ) + I 2 ( x, y , z ) − I 3 ( x, y , z )
R(θy) = 2 1 2 (2)
1 1
I 1 ( x, y , z ) + I 2 ( x , y , z ) + I 3 ( x, y , z )
2 2
A specially designed sensor element has been fabricated to house the fibers and to measure the bending angle of the
lower spine. The design was 3D printed and was suitable for easy attachment onto the skin of the patient’s back. The
cross-section of the fabricated sensor is depicted schematically in figure 1(b). The device consists of two tubes for
hosting the optical fibers which were fabricated separately but could be accurately aligned using minimal mechanical
adjustment. Both tubes were subsequently centered (aligned) and then locked together using a flexible silicon mold that
allows the sensor to be flexible during bending. The bases of two tubes, which form the attachment point to the skin are
mounted at a distance 30mm apart via two pods which are integral to the housing. The pods are to be attached on the
lower back using adhesive tape.

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(a) (b)
Figure 1. (a) Fiber configuration (alignment) for device and (b) cross-section diagram of sensor prototype for printing.

The sensor was fixed on an optical setup to obtain a calibration between rotation angle and output ratio of the sensor.
Figure 2 depicts the schematic diagram of the experimental setup and the working mechanism for both lateral and
sagittal bending. The sensor was fixed on an optical setup which consists of two translational stages, two optical posts,
two holders with clips and a rotational stage. For the frontal and sagittal axis measurement, the output fiber’s intensity
was recorded and the ratios in Equations 1 and 2 calculated (in the LabVIEW TM software) in near real time while
rotating the stage. The stage was rotated with an angle of 2o increment every 30 seconds starting from 0o. The rotation
continued until reaching the output ratio saturation value at which no changes in the output ratio in response to the angle

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 change could be observed. At this point the rotation angle was slowly decreased with a 2o interval until it returned to the
original 0 degrees position. A finer calibration was also performed by decreasing the angle step size to 0.5o using a fine
tuning adjustment on the stage in a range up to 4o. The whole process was repeated for each lateral and sagittal bending.

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(a) (b)
Figure 2. Schematic diagram of experiment setup for sensor characterization on (a) lateral bending (frontal plane) and (b) sagittal
bending.

3. RESULTS AND DISCUSSIONS

Figure 3 shows the bending test results obtained for both sagittal and frontal plane. The results show that the device has a
non-linear response where saturation is reached at bending angles of around ±12o for both lateral and sagittal bending.
The non-linearity observed in the bending data can be attributed to the large angle values causing increased misalignment.
This in turn results in an increase in departure from linearity of the received signal arising from exacerbated loss in
coupling between the transmission and receiving fibers of the sensor. In figure 3(a), the sensor’s response for lateral
bending between -12o and 12o has been fitted to a third order polynomial and is shown as the solid line in this figure. For
the sagittal bending in figure 3(b), the polynomial fit is not as accurate for angles lower than -6o. This is due to the
asymmetrical response of the sensor during the sagittal bending as the higher intensity of light coupled to two fibers
during bending in the positive direction and a higher intensity of light coupled to the one fiber when bending was in
negative direction. These polynomials have subsequently been used during the actual measurements to interpret the
sensor output as bending angles. This was performed within an in-house developed LabVIEW ™ programme written
specifically for this investigation. Initial results of these tests are shown in figure 4 for a limited bending range of about +
or - 1 to 2 degrees for a sensor mounted on a volunteer performing lateral and sagittal bending exercises.

4. CONCLUSION
The feasibility of fabricated sensor was demonstrated to detect bending posture in both sagittal (flexion and extension)
and lateral (left and right) axis movement cases. The bending angle of the sensor was calibrated using a fixed rotation
stage in the lab. The calibration illustrated a non-linear response with saturation at angles of 12o in both directions. The
experimental calibration data were fitted to a third order polynomial. This polynomial will be used in future
measurements to be conducted on human patients’ back to acquire the bending angle from sensor’s output and compared
to other imaging equipment installed in the clinic.

ACKNOWLEDGEMENTS
This work is supported by the LEADERS project, funded by the European Union as part of the Erasmus Mundus
scholarship Programme (20140031). The authors would also like to acknowledge and thank the staff of the Department
of Clinical Therapies for all their support during the testing of this sensor.

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 Bending Assessment in Frontal Plane Bending Assessment In Sagittal Plane
1.5 1.5

1
y = -0.0003x3 + 9E-05x2 + 0.1143x + 0.0637
1
0.5
Output Ratio

Output Ratio
0.5
0
0
-0.5

-1
-0.5
y = -0.0004x3 + 0.0009x2 + 0.1392x - 0.0835
-1.5 -1
-15 -10 -5 0 5 10 15 -15 -10 -5 0 5 10 15
Bending Angle (0) Bending Angle (o)

Figure 3. Intensity output ratio of sensor versus bending for both (a) frontal plane and (b) sagittal plane and the polynomial fit for
interpreting the angle value from the ratio measurement.
Lateral Ratio Chart Flexion Ratio Chart
-0.2 Bending 0.25
to Right Extension Extension
Right 0.2
-0.3
0.15 Middle
Middle Middle
-0.4 0.1 Position Middle
Output Ratio
Output Ratio

Middle Slight Slight Bending

Middle Position 0.05 Bending
-0.5 Position Middle Middle to front
0 to front

-0.6 -0.05
-0.1
-0.7
Bending -0.15
to Left Further Flexion to
Further Flexion to
-0.8 -0.2 Front
Front
0:00:00 0:00:17 0:00:35 0:00:52 0:01:09 0:01:26 0:01:44 0:02:01 0:02:18 0:02:36 0:00:00 0:00:43 0:01:26 0:02:10 0:02:53 0:03:36 0:04:19
Time Time

Figure 4. Sensor's response for lateral and sagittal bending as tested on the back of a participants.

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