Stretch-a-Gen: MCU Based Goniometric Tool
for Knee Improvement
Faith D. Baisa1, Jonard G. Climaco2, Earvin John E. Fabro3, Atty. Alfredo U. Ganggangan4
Electronics Engineering Department
Adamson University
900, San Marcelino Street, Ermita, Manila
1baisa.faith@gmail.com, 2jonard.climaco@yahoo.com, 3earvinjohnfabro@gmail.com
Abstract - Joint Flexibility is defined as the range of
motion (ROM) allowed at a joint. A joints ROM is
usually measured by the number of degrees from the
starting position of a segment to its position at the end
if its full range of the movement. However, most of the
people fails to achieve normal range of motion in the
joint especially in their knee due to muscle tightness
and back pain. The purpose of this design project is to
develop a device that can measure the range of motion
of the knee joint accurately, provide an exercise
protocol for improvement, and monitor the
individuals progress at the same time.
The system is implemented with a
microprocessor which processes all the protocol
embedded in the device thus maintaining the program
flow of therapeutic exercise. The process starts by
encoding the patient number of the user and setting of
the threshold in the force sensing resistor depending
on the users own capacity to push the sensor that will
serve as a queue which will trigger the microprocessor
to send a pulse to the relay to command the motor to
move according to the direction of the pressure. After
setting the threshold in each FSR, the user will
undergo pre testing and post testing that will serve as
the initial and final extension of the knee before and
after the therapeutic exercise respectively. The said
angle measurements correspond to a certain voltage
that is controlled by the potentiometer located at the
fulcrum will be recorded in SD card installed in the leg
brace. The SD card can be departed in the device to be
able to transmit data in its dedicated software that
provides the database and its capability to forecast the
recovery of the user.
The result of the validation shows the
accuracy of knee angle measurement is above 95%.
Also, the recovery forecast will tell when the user will
be able to reach full 180angle of range of motion with
the aid of a database where all data will be observed
and monitored.
Keywords: Range of Motion, Knee Joint, Muscle
Tightness, Back Pain, Goniometric, Joint Angle, Force
Sensing Resistor, Potentiometer, Arduino
I. INTRODUCTION
Musculoskeletal trauma is a very common
problem in rehabilitation caused by daily activities
such as walking and running. 40% of this trauma
occurs during sports activities. One of the most
injured body part during this extra-curricular is the
knee. Anatomically, the knee is the most complex
and most difficult joint to rehabilitate. To treat this
problem, one of the tools used by a physical
therapist is the goniometer. A goniometer measures
the angle of the joint that can have a lapse of 2.9.
It is composed by two legs connected by a pivot with
angle labelling. However, the traditional goniometer
only helps in angle reading. Take note that
exercising is also part of rehabilitation, and is not
offered by a traditional goniometer. Rehabilitation is
also commonly done inside a medical facility.
Considering the patients condition having an
injured knee, it is best to have his therapy done at
home. Therefore, a homebased apparatus combining
angle measurements and exerciser can partake a
great role in the field of rehabilitation. Since the
goniometer can have an error of 2.9, the accuracy
can be increased with the use of electronics. In
addition, in can be enhanced to be both an angle
measurement and exercising apparatus in the form
of a leg brace. With the existing device, it will be a
great innovation for the current technology.
II. OVERVIEW OF THE DESIGN PROJECT
The aim of the design project is to develop
a clinic and/or home based mechanical goniometric
leg brace device for people undergoing therapy for
knee extension measuring Range of Motion using
Biofeedback with Database as progress recorder.
This focuses on the progress monitoring of the
patient with a recovery forecast.
The research is divided into three systems,
the angle measurement system, the exerciser system
and the relational database. The measurement and
exerciser systems are incorporated within the leg
brace itself. These are composed of a Arduino,
motor relays, force sensing resistor, potentiometer,
and motor actuators. The potentiometer located in
the fulcrum of the brace serves as an angle indicator.
Each rotation serves a corresponding degree of
revolution. The exerciser system is for the
rehabilitation process. By entering number of
repetitions, the patient is now able to reeducate his
leg muscles and increase his range of motion. The
relational database is composed of a receiving
software using Visual Basic and a database using
Microsoft access. This is where all data are kept for
further monitoring.

Figure 1. Overall block diagram of the whole
design project
Figure 1 shows the complete yet
momentary description of operation of each
components and operations. Lets discuss briefly the
functions of each components.
For the whole system, the Arduino Mega
serves as the brain of the device. It runs through all
of the commands garnered within the system. It
processes the input from the keypad, and force
sensing resistor. After measuring, the Arduino reads
the voltage that had been yielded by the
potentiometer and converts it to a corresponding
angle. The I2C module just shrinks the pins to be
used for the LCD display. The keypad were used for
the input settings (eg. Patient Number, Yes/No). The
potentiometer served as the angle indicator wherein
each rotation outputs voltages that correspond to a
certain angle. The force sensing resistor senses the
maximum force that the user has exerted. It will be
used as the threshold pressure for the exerciser. The
card reader module enables the device to read and
store data in the SD card. Lastly, the dual relay
driver serves as the switch of the two DC Geared
motor.
Figure 2 shows how does the measurement
system run throughout the process of using the
device. It starts after the patient has entered his
patient number. The device will ask the user to input
the pressure threshold of the device using the force
sensing resistor. After inputting on the two sensor,
the device will now request the user to measure his
initial angle. The motor will move until the threshold
pressure is not reached. The motor locks and the
MCU processes the voltage reading of the
potentiometer and converts it to angle. The data
garnered has to be confirmed before storing in the
SD card. Notice that there are block connectors
labeled as 1 and 2. These will be used for further
processes in the device.
Figure 2. System Flowchart of the Measurement
System
Figure 3 below shows the process within
the device while using the leg brace as an exerciser.
The exerciser initiates when the measured quantity
is not the final angle, as indicated by connector 2. It
starts of by inputting the desired number of
repetitions of exercise. After doing so, the user has
to exert effort onto the FSR until the threshold
pressure is reached.
Upon reaching the threshold pressure, the
Arduino will now send a pulse to the relay to turn on
the motor. The user has to reach the initial and final
angle measured during the angle measurement to
complete one cycle. The protocol repeats until the
set number of repetitions is finished.
The process then goes back to the
measurement system wherein the final angle is
currently being measured. The device repeats the
algorithm until the two angle measurements had
been recorded and stored in the SD card.
 Figure 4 shows that the device has to be
worn while sitting which creates a 90 angle for the
knee. This is because the initial position of the brace
is set to 90.

B. Software Implementation

The following explanation shows the step

by step procedure of the program flow embedded to
the project design. The patient has to enter his
patient number. This enables the database in a
separate computer to identify the patients profile.

After entering, the patient has to exert

effort on the two force sensing resistors located just
above the front and back of the ankle to set the
threshold pressure that will be used to control the
device all throughout the process.

The initial angle measurement process of

the brace occurs. The user has to exert the same or
more pressure on the FSR to activate the motor. If
not, then the motor locks and displays the measured
angle from the brace.

After measuring the initial angle, the

patient has to set the number of exercise repetitions.
It corresponds the number of cycles that has to be
done to finish the exercise. The patient has to
Figure 3 System Flowchart of the Exerciser System
complete the whole set of cycle.
After storing, the SD card will be extracted
After exercising, the process goes back to
from the brace so it can be connected to the
goniometric, measuring the final angle. The final
computer. A receiving software is needed to read the
angle tells if the patient has improved while using
data garnered from the device. The software will just
the brace. Less angle than the initial angle means
simply display the outcomes of the patient, and the
knee range of motion improvement.
database that had stored all of the previous session,
measurements, physical therapists and recovery
forecasts that had been taken from the users data
and results.

A. Hardware Implementation

This covers the actual processes of using

the leg brace for its designated operation.

Figure 5. Graphic Interface of the Database

Figure 5 shows the receiving software

created from Microsoft Visual Basic that displays all
the data inside the database. This will only display if
a memory card with data will be put into the
computer.

C. Forecasting Equations

Although potentiometer is a very popular

Figure 4. Device framework and wearing the leg angular measurer among different applications,
brace in a 90 knee angle position
there is no significant standard on how to relate the
resistance to angular position. For the capstone
project, the researchers used a linear potentiometer
to measure the angle. By calling it as linear
potentiometer, the division ratio of the
potentiometer is proportional to the angle of shaft
rotator. The readings of linear potentiometers can be
extracted using linear regression using the formula y
= mx+b. The proponents have chosen to use a 1M
resistor. This have a wide working resistance to
measure angle from. The total rotational range of the
potentiometer is from -45 to 225. The students
have assigned the -45 rotation of the potentiometer
as the 0V output. The students have then divided the
input 5V to 12 angle equivalences. Since the
potentiometer is linear, it can be assumed that the
voltage and the angle are directly proportional. The
students put in an input of 5V and have linearly
calculated for the expected value of the angle
measured from rotating the shaft of the
potentiometer.
The students have gathered the data for the
potentiometer calibration and have managed to
derive a formula using linear regression technique:
y = -45 + 54x
Where: x = voltage reading
y = angle reading
The formula for the forecasting has been
derived from the raw data taken from the results. The
students however used two regression techniques to
come up with the most suitable formula for the
forecast. The students have used linear least square
regression and quadratic least square regression. It
showed in the data and results that the quadratic
formula had fitted the forecasted graph more
accurately than the linear formula.
For the linear least square regression:
y = 3.28 + 0.41x
Where: x = angle takes
y = remaining number of therapy
Table 1 Summary of Recorded Range of Motion
Data Progress in the Database
Table 1 shows Stretch-a-Gen versus
Goniometric Measurements wherein the accuracy
was validated using T-test while the inter-testing and
intra-testing reliability was validated using ANOVA
and Cronbachs Alpha. The initial angle measured is
converted into its supplementary angle by
subtracting the measured angle to 180 degrees
because physical therapists prefer to read knee angle
in this format.
Using T-test, the p-value equivalent to 0.97
which is greater than 0.05 indicates that the two
compared parameters has accepted the null
hypothesis which means that there are no significant
difference between the measurements of the Stretch-
a-Gen and the Goniometer. This means that the
values measured by the Stretch-a-Gen and
Goniometer were statistically accurate.
To validate the inter-testing and intra-
testing reliability, the data was analyzed using the
ANOVA and Cronbachs Alpha technique.
Resulting to 0.98 as the Cronbachs Alpha for both
initial and final angle, indicates that the data
gathered has an excellent internal consistency and
reliability. Also, a p-value of 0.00 using ANOVA
was resulted which means that the data has no
significant difference.

For the quadratic least square regression:

y = 1.50x2 + 0.74x 0.01
Where: x = angle takes
y = remaining number of therapy
Table 2 Summary of Recorded Range of Motion of Stretch-a-
Gen

III. DATA AND RESULTS

It is also shown in Table 2, that the highest
frequency of angle measured ranges from 171 to 180
degrees. This validates the recovery of the patients
The following data and results were
that they attain their desired full range of motion
obtained by the researchers using the therapeutic
using the Stretch-a-Gen.
exercise that is embedded in the project design.
 In Table 2, the ranges of motion (ROM) degrees, it means that the expected number of
were determined using the data gathered in the therapy needed is approximately 16 days.
patients during the Pre-test and Post-test. For both Using Linear Least-squares Regression and
pre-test and post-test, the highest frequency was Quadratic Least-Squares Regression with the aid of
found in the range of 171 to 177 degrees. the add-in data analysis of the Microsoft Office
Excel, the relation between the projected angle and
The mean angle for the pre-test is 171 projected number of therapy needed was
degrees and 173 degrees for the post-test. While the determined.
standard deviation values 7.42 and 6.5 for pre-test For Figure 5.5, it shows that the
and post-test respectively shows that the data supplementary angle of the angle measured is
gathered are close to the mean of the data set. inversely proportional to the number of therapy
It is observed that in Table 2, we would see needed to achieve full range of motion. For the
that for the range of motion 171 to 177 degrees, pre- forecasting tool of the device, the Quadratic Least-
test gives a higher frequency than the post-test, but squares Regression gives a more accurate relation
for the last range of motion, the frequency for post- between the two parameters as shown in the line
test was higher than the pre-test, which means that graph.
more patients successfully achieves their desired
recovery of angle of range of motion with the aid of
the Stretch-a-Gen as an exerciser which is also
shown in Figure 16.
Lastly, the p-value for the t-test was
determined as 0.00 which indicates that the null Table 4 Results of Stretch-a-Gen measurement in an injured
hypothesis was accepted. This means that there is a patient
significant difference between the pre-test and post-
test measurements. This validates that patients In Table 4, the ranges of motion (ROM)
achieved full ROM after several testing for the pre- were determined using the data gathered in a
test and post-test reliability validation. specific patient with injury during the Pre-test and
Post-test for about three consecutive therapies
Angle Measured Supplementary Angle No. of Days together with the number of sessions remaining
38 142 17.5 based on the forecasting tool formulated. Figure 16
32 148 16
shows the graph representation of Pre-test and Post-
27 153 15.5
test of the injured subject with respect to the number
22 158 13
16.5 163 11.5
of forecasted remaining days. The graph also
11.6 168 9 visually shows how the patient improves every
8.7 171 7.5 session for about 2 to 3 degrees every therapy.
5.207 174 6
3.226 176 3.5 Having a measured post-test value of
1.46 178 2 97.50, 100.76, 103.31, it had been computed to
have an approximately 38, 36.50 and 35 number of
Table 3 Projected Number of Therapy for Projected Angle
Measured sessions. Which can be concluded that, the patient
will be having a total of 5.43 weeks to recover.

Figure 7 Line Graph Representation of Table 4

Figure 6 Line Graph Representation of the Linear and Quadratic
Relation between the Angle measured and the Number of
Therapy Needed
In Table 3, the data shown are the projected
number of therapy needed for every projected angles
measured during the pre-test and post-test. For
example, it is said that if the measured angle is 148
The forecasted recovery days provides a
notion that the patient can recuperate to a specific
number of sessions regardless if the total timeline of
the whole recovery period is not yet finished. With
this, it boosts the optimism of the patient to finish all
of his remaining sessions. It sets the mind of the
patient that whenever a session is finished using the
device, the patient is within reach to his full
recovery.
The patient had a hard time doing the
therapy than those subject who is at normal state
caused by his injury but significant improvement
can still be observed since the range of motion and
pain tolerance of the patient increases gradually
every therapy. The patient had said no complaints
that she is having a hard time using the device, but
she had noted about the bulkiness and weight of the
device.
IV. SUMMARY OF FINDINGS
After using different statistical tool and
techniques for data analysis, the summary of
findings are the following:
1. For the accuracy, the p-value determined
using T-test that was equivalent to 0.97
which is greater than 0.05 indicates that the
two compared parameters has accepted the
null hypothesis which means that there are
no significant difference between the
measurements of the Stretch-a-Gen and the
Goniometer.
2. Using the recorded Range of Motion data
progress, the number of therapy needed for
every measured angle can be forecasted
accurately with their relationship
determined using quadratic least-squares
regression.
3. For the data tabulated according to pre-test
and post-test results, the p-value for the t-
test was determined as 0.00 which indicates
that the null hypothesis was accepted. This
means that there is a significant difference
between the pre-test and post-test
measurements. This validates that patients
achieved full ROM after several testing.
4. For the validation of inter-testing and intra-
testing reliability, the Cronbachs alpha
resulted to 0.98 for both initial and final
angle indicates that the data gathered has an
excellent internal consistency and
reliability. Also, the p-value determined
using ANOVA was determined to be
equivalent to 0.00.
V. CONCLUSIONS
The researchers were able to develop a
clinic and home based mechanical goniometric leg
brace that is capable of measuring the knee range of
motion, execute protocols based on the physical
therapists recommendations and forecast knee
recovery. The researchers were also able to:
1. Design a goniometric leg brace that has
accuracy based on established standard for
medical equipment as confirmed by paired T-
test. The potentiometer has been able to
output the desired angle reading for each
measurement using varying voltages.
2. Build a receiving software using Visual Basic
6.0 composing the parameters assessed by the
physical therapist:
a. The researchers were able to construct a
relational database using Microsoft Access
that records the initial, final and mean
angle of the patient.
b. The proponents were successful in
formulating a quadratic formula predicting
the recovery of a patient under normal
physiological, psychological and internal
health conditions. The formula can forecast
up to three weeks of recovery.
3. The researchers were able to validate the results
using different methods of reliability testing:
a. The device was validated by itself using T-
test and exhibited to have more than 95%
accuracy with T-test value less than 0.05 as
reference.
b. The prototype was facilitated by the three
proponents and confirmed the validation of
each data taken using T-test.
c. The protocol of the physical therapist was
done repeatedly for five (5) days in a week
for three (3) weeks using the leg brace.
VI. RECOMMENDATIONS
Based on the success of the project design, the
researchers offer the following recommendation of
enhancement, innovation and corrections that can be
apply for the sake of the researchers want to
continue this study.
1. The future proponents can design a
goniometric leg brace with the use of
optical encoders instead of a potentiometer
that provides electrical signals in the form
of pulse trains which can be translated into
motion, direction or position to get a
desired output more than 95% accuracy.
2. Add different types of therapeutic
protocols which can be configured
according to the state or condition of the
subject and create a visual representation of
the progress of the subject that is
automatically generated by the software
once data is saved from the database.
 3. The researchers must be able to test the VII. RESEARCHERS PROFILE
project design to different subjects like
elderly, athletes, has knee injury or patients
undergone post surgeries to scrutinize the Faith D. Baisa, 20
effectivity of the device according to BS Electronics Engineering
different situation might the subject Adamson University
experiencing. 32A, Malta St., Pinagbuklod, Purok 1-A,
Brgy. New Lower Bicutan, Taguig City
baisa.faith@gmail.com

V. ACKNOWLEDGEMENT Jonard G. Climaco, 21

BS Electronics Engineering
This research would not have been possible Adamson University
without the guidance, supervision and help of the B-31 L-54, Carissa 2-A, Palmera Homes,
following individuals who have contributed and City of San Jose del Monte Bulacan
assisted in the preparation and the completion of this jonard.climaco@yahoo.com
paper.

First, to Engr. Evelyn Q. Raguindin, Dean Earvin John E. Fabro, 21

of College of Engineering, for her encouragement BS Electronics Engineering
and her support from the start until the end of this Adamson University
study; Big thanks are given to Engr. Mark Angelo #100 A. Bonifacio St. Villarica Subd.
C. Purio, Engr. Melannie B. Mendoza and Engr. Poblacion, Sta. Maria, Bulacan
Joan P. del Espiritu, panel members, for their earvinjohnfabro@gmail.com
concerns and valuable suggestions for the
betterment of this study; To Campus Research &
Development (CRD), for providing the researchers
the financial aid and guidance in choosing for the
right resources;

Special thanks to Atty. Alfredo U.

Ganggangan, adviser, for his suggestions, his words
of encouragement and for giving the researchers
deep appreciation of the detail of the study;

Huge gratitude to Innovation Technology

Support Office (ITSO) and Ms. Anna A. Ramos,
adviser, for her untiring lectures, revisions, huge
support and assistance in order to complete this
study;

Finally, to God, the omnipotent Father, for

giving the researchers strength despite of all the
hardships and failures the researchers have
experienced in conducting this study.

V. REFERENCES

[1] IAC Publishing, LLC, What is the largest joint in the

human body?, 2017. [Online]. Available:
https://www.reference.com/science/largest-joint-
humanbody-2337632c8dd4f0ab# [Accessed: 14-Mar-
2017].
[2] R.T. Loder et al., Angular Measurement Error Due To
Different Measuring Devices, PubMed, vol. 27(3), pp.
338-46., Apr. 2007. [Online]. Available:
https://www.ncbi.nlm. nih.gov/pubmed/17414022.
[Accessed: 12-Oct- 2016].