TLSO with Graphene Sensors—An Application to Measurements of Corrective Forces in the Prototype of Intelligent Brace

Round 1

Reviewer 1 Report

The presented results of authors research work dealt with a prototype brace that enabled data acquisition using 253 thin-film pressure sensors. The first trials were done in laboratory and later on patients allowed to test the Intelligent Brace in real conditions and to verify the operation of the data acquisition system. Approximately 2 months of data were collected and interpreted.  I agree that the described thin-layer pressure sensor has a  potential to improve the efficiency of the treatment of idiopathic scoliosis  Further work will be oriented on the system optimization and enlarging group of tested patients. They plan to devote a special interest to improvement of the patients acceptance for long-term wearing of uncomfortable orthosis and arbitrary shortening of therapy time.
The paper has a good structure and provides authors with a valuable experience. Authors used 15 references dated since 2002 till 2021, just one was dated 1974, but it was related to a basic electronic principle.

Author Response

Thank you for your review. We appreciate it very much. Other reviewers have made comments and suggestions to the manuscript, which we are analysing and will make amendments.  We will send the revised article to the editor.

Reviewer 2 Report

Judging from the title, the authors want to introduce the application of graphene sensors in the prototype of intelligent brace, but in the manuscript the authors describe the measurement method, and the description of graphene sensors only has very little content, so I don't understand what the authors want to highlight. Also, if the authors want to highlight the advantages of graphene sensors, that requires comparative experiments with other materials. In addition, the authors introduced a large number of relevant research, but without in-depth analytical discussion, and the authors did not highlight the advantages of their own research in the manuscript. Although there are logical problems with the manuscript, given the more systematic research, I recommend a major revision.

 

Author Response

Judging from the title, the authors want to introduce the application of graphene sensors in the prototype of intelligent brace, but in the manuscript the authors describe the measurement method, and the description of graphene sensors only has very little content, so I don't understand what the authors want to highlight. Also, if the authors want to highlight the advantages of graphene sensors, that requires comparative experiments with other materials. In addition, the authors introduced a large number of relevant research, but without in-depth analytical discussion, and the authors did not highlight the advantages of their own research in the manuscript. Although there are logical problems with the manuscript, given the more systematic research, I recommend a major revision.

 

Thank you for your review. We appreciate all comments and suggestions, they will contribute to the enhancement of the article.

We would like to emphasize that we use sensors that have already been tested (item 13 in the References). In the manuscript, we study their characteristics and show how we process the data.

After investigating the use of various thin-film sensors, it was decided to use graphene due to the fact that they are printed, their structure is easily obtained, and, above all, they are thin so that they can be applied inside the orthosis without subjecting the patient to discomfort.

We present a complex system for the collaboration of single sensors on a brace with a data acquisition, processing, and visualization environment ready for interpretation and evaluation by a physician.

We will make corrections and send the revised article to the editor.

Reviewer 3 Report

I recommend revising this article overall. See the attachment.

Comments for author File: Comments.pdf

Author Response

Thank you for your review. We appreciate all comments and suggestions, they will contribute to the enhancement of the article.

We will make corrections and send the revised article to the editor.

In response to your review:

First of all, this article has many unclearcontents to be explained in detail. Therefore, the aim of the research and the novelty areso incomprehensiblethat the article may indicate just procedure or performance of the rehabilitation brace.

The purpose of this article is to demonstrate the possibility of improving the treatment process for idiopathic scoliosis by placing a data collection and acquisition system with thin-film grapheme sensors in a rigid brace. The measurement of forces and the determination of their adequate range will contribute to the improvement of therapy and shorten its time.

1. The rig of brace as shown in Figs.6 and 7 lacks the significance of using each instrument: for example, what are the rolesof rigid braceandpump?

Ref 1. Figures 6 and 7 show a schematic view of the system described in the manuscript. The components and their roles are described in the text below these figures. The rigid orthosis is the main component of the therapeutic solution for idiopathic scoliosis - it exerts pressure on the patient's body. A pump is used to control the inflation of the derotation airpads, which increase the pressure of the brace. This element is mentioned because it is a component of the whole system, but it is not relevant to the analysis of the measurements.

 

2. In especial, how does the microcontroller work?Perhaps, the program of the microcontrolleris importantfor the achievement by the present researchprocedure. The managing algorithmis to be enunciated so that the cause of using the microcontroller might beclear.

Ref. 2. The microcontroller collects data from sensors. It makes one measurement from each sensor every second and stores the result in memory. It measures resistance using analog ports. The ADC module of the microcontroller converts the analog signal from the sensors into a digital signal, which is then converted into voltage and force. The whole program is quite elaborate and insignificant for the scope of this article.

3. It is unclear how the sensingresults ofthe sensor as shown in Fig. 1can be obtained.For example, the schematic diagram of the sensing principle is needed.

Ref. 3. A schematic diagram will be added to the article. The principle of the operation of measuring sensors is a Wheatstone bridge. The sensor in the brace depending on pressure changes its resistance, and the resistance is measured by the microcontroller.

4. The explanation howthe impedance results as shown in Figs. 2 and 3 bring about to the sensingresults of the rehabilitation braceis needed.

Ref. 4. Brace force measurements do not affect the idiopathic scoliosis therapy, but only study the impact of the orthosis on the body in order to improve the effects later when more studies are made. The research presented in manuscript is a fragment of a study to develop a whole view of the influence of a brace on a patient's body. This will allow us to build a decision-making system which will control the pressure in the future.

5. Figure 5 is hackneyed so that it is not needed to be delineatedin the text.

Ref. 5. We are aware of that, but it shows the principle of acquiring data from sensors.

6. Figures 9 and10 are unnecessary information to be understood the cause of using the controlling program.

Ref. 6. Those figures show the potential for our system in everyday use for patients, their parent and doctors to control the overall discipline of the therapy.

7. Figures 12, 14 and 16 havediminutive captions enough to be incomprehensible.

Ref. 7. The figures will be changed.

8. Figures 2 and 3 areto be replaced each other according tothe ordered explanation in the textual body.

Ref. 8. Those figures will be replaced.

9. The word “÷”, for example, in lines 37,74, etc. is incomprehensible.

Ref. 9. The word “÷” will be replaced with “up to”.

Round 2

Reviewer 2 Report

The authors carefully answered all questions and the manuscript is of the current quality to be accepted

Reviewer 3 Report

Maybe I wonder if the present style is right.

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

I consider the paper good for publication, I have just some very minor suggestions to enhance the organization of the text, as follows: 

1) I recommend the authors extract the related works discussion from the introduction and create a separate section specifically for them after the introduction; 

2) I recomment the authors integrate the current discussion section in the previous section about the results;

3) Create a new final section with a conclusion, summarizing the discussion, but also bringing the general aspects of an ordinary conclusion. 

   Doing this reorganization, I think the paper can be published. 

Reviewer 2 Report

This manuscript is unfortunately a classical example of how a paper should not be written.

1) a thorough literature review is missing; the authors did not even make any effort to verify whether similar papers were published in the very journal they submitted their manuscript to; in fact, a similar if not identical paper was indeed published in 'Sensors' earlier this year

2) the methods section is described superficially, without specific details on the sensors

3) the authors conducted tests with participants, and even claimed that data were collected during an alleged clinical trial; yet, there is no evidence that this study was approved by an university ethics committee, let alone by a clinical trial committee under a registered clinical trial approval number.

Under these circumstances, I cannot recommend publishing this manuscript.