Nursing undergrad helps develop ARMAS robotic suit to relieve nurses’ back pain

Year 3 Nursing student Lin Jing Wen with Dr Rainier Natividad, the suit’s inventor.

The suit is made up of fabric motors that are wrapped around its wearer’s muscles and limbs. When the motors are inflated, they help to supplement muscle function by reducing muscle strain by about 65 per cent.

“I knew back pain is a problem in the industry but I didn’t know it is such an extensive and serious problem,” says Ms Lin, a Year 3 Nursing undergraduate at the Alice Lee Centre for Nursing Studies, part of the Yong Loo Lin School of Medicine at the National University of Singapore (NUS).

“Almost all nurses have some form of pain, it just depends on the severity. Some use pain medication or braces to cope with it, but others need surgery.”

Back pain is a common occupational health problem among nurses in Singapore, with the Ministry of Manpower’s Workplace Safety and Health Report 2019 ranking healthcare among the top three industries for work-related musculoskeletal disorders.

Qualitative input from nurses

Ms Lin, 21, first became aware of the physical stress involved in nursing during her freshman attachment at a community hospital. While shadowing a nurse in her late 20s on her rounds, Ms Lin noticed that the nurse wore not only a back brace but also hand and wrist guards. She later learnt in conversation that the nurse had a slipped disc that was likely caused by certain motions, such as frequent twisting and turning while lifting bedbound patients.

When she heard about a prototype suit for nurses, she joined Dr Rainier Natividad and team ARMAS in May to help in its development.

Dr Natividad conceptualised the soft fabric-based exoskeletal suit for his PhD thesis with the aim of helping ease the physical demands on nurses. An engineer, Dr Natividad said that the involvement of the four students in team ARMAS, and Ms Lin in particular, proved essential.

“Jing Wen is a nurse so she interacts more with nurses on the ground and she is aware of the practical issues they face. Her experience provides valuable inputs in the designing of the suit,” says Dr Natividad, 29.

In carrying out a qualitative survey of nine nurses, Ms Lin found out that while they were enthusiastic about having a new tool to help them with their jobs, there were also a few reservations voiced about the suit’s convenience, comfort, safety and whether it would look professional.

Armed with the feedback, the team were able to improve to the existing prototype. For example, an airy, breathable material may be used to better suit nurses who have to work in non-airconditioned wards, while shortened sleeves and additional front buckles should allow nurses to put on or take off the suit in less than a minute.

The suit, completely unlike a metallic contraption, also promises great flexibility which will allow nurses to carry out their regular duties while wearing the suit.

Future improvements to robotic suit

Dr Natividad and team ARMAS, which also includes two medical students and a pharmacy undergraduate, impressed the audience at this year’s MGC, which brings cross-disciplinary teams together to solve healthcare dilemmas.

The team easily won the Open Category as well as the People’s Choice Award, which brought with them a total of S$24,000 in prize money.

“We were overwhelmed by the double wins,” says Ms Lin. “I think the suit was popular because many healthcare innovations today are made for patients, but ours seeks to support and empower healthcare professionals, who also need technological aids to serve their patients better.”

Their success is even more impressive given that the students have not even touched the suit since their involvement began in May, due to safe distancing measures enacted to combat the COVID-19 pandemic. Ms Lin and her fellow team members conducted all their meetings virtually, while plans for pilot testing of the suit with nurses had to be postponed.

Dr Natividad conceptualised the suit as part of his PhD thesis under the guidance of A/Prof Raye Yeow from the Department of Biomedical Engineering.

Right now, Dr Natividad and the team also have to navigate other challenges. They need to think of how to power the suit (whether via portable batteries or by connecting to a power source) as well as how to clean it to meet infection control standards, depending on the needs of the nurses.

The plan now is to bring the suit to the commercial market within two years. It is expected to cost approximately $2,000.

Ms Lin hopes to take her experience with this innovation further by understanding the issue of chronic back pain in greater depth for her upcoming Honours thesis. She also hopes that nurses would gain more exposure to healthcare innovation by having an internship module on it included in the nursing curriculum.

“I’ve observed that nurses in Singapore face heavy workloads and as a result, the initiation of technological innovation or change often takes a back seat,” says Ms Lin.

“Yet no one knows the needs and gaps of patients more than us as we spend the most time with them. I hope that in future, nurses will be able to use their ground knowledge to innovate and harness the potential of technology to better meet the vast needs out there.”