OUCH: Objective, Uniform, Controlled Haptic Stimulation for Automated Neurological Assessment
Sherry Choi, Sitao Sunny Li, Joseph Romero, Lillian Chin, Ashwin G. Ramayya, Allison M. Okamura, Ava Chen
Motor responses evoked by noxious stimulation are used to assess neurological function in hospitalized patients with disorders of consciousness. In standard bedside assessments, these stimuli are applied manually, resulting in substantial variation in force, duration, frequency, and location. Here, we present OUCH (Objective, Uniform, Controlled Haptic stimulation), a wrist-worn device that uses pneumatic actuation to deliver noxious mechanical stimuli. OUCH combines stacked pneumatic pouch actuators, a rigid indenter, and a compliant spacer designed to buckle at a set load, so that the indenter contacts the skin only during actuation. We characterize the device using blocked force tests, clinician evaluation, finite element analysis, and a deformable pressure testbed, and benchmark it against a commercially available handheld pressure algometer. At 200 kPa pouch inflation pressure, our indenter concentrated its load into an estimated contact pressure of 18,500 kPa, over 25 times that of the algometer tip, while requiring less total force. On the deformable testbed, it localized deformation near the surface, while deformation at depth remained comparable to the algometer. As a result, in preliminary perceptual testing, our indenter elicited discomfort at approximately 89% lower applied force than the algometer, demonstrating the feasibility of evoking discomfort with a compact, wearable soft actuator. These results show that combining pneumatic actuation with designed contact geometry enables controlled, repeatable noxious stimulation at the wrist, providing a foundation for objective neurological assessment.
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