Development of Transcutaneous Electrical Nerve Stimulator (TENS)

Chair with Microcontroller Based Application

Engr. Ronnie M. Dysangcoa; Dr. Jesusa N. Padillab
Assistant Professor Technological Institute of the Philippines-Quezon Citya; Dean College of Engineering and
Architecture, Technological Institute of the Philippines,
[email protected]; doctor_jesusa_padilla @yahoo.com :

RATIONALE
Transcutaneous Electrical Nerve Stimulator (TENS) is an advance pain reducing and rehabilitation technology
used in the field of medicine. Over the years electronic experts and medical professionals are joining their
hands in order to develop the said technology. However, for some reasons, the mentioned technology had its
own limitations especially in terms of cost.

OBJECTIVES
The main objective of this project was to design a microcontroller based stimulator device that produce
required electrical charge for body stimulation.

METHODOLOGY
The researcher conducts a series of experiment procedures to come up with a functional prototype. The
prototype electronic design and its software application were evaluated through different series of trials.

RESULTS
The developed prototype is mainly a composition of different electronic circuits. This circuit was embedded
with a microcontroller application that could control the stimulator pad movement. The power window motor
utilization controlled the stimulator pad movement into up and down direction. The researcher developed a
software program for the microcontroller functionality. The accuracy test was based on the set range by the
researcher following the study of Karla Peavy Simmons about the average length of the human body.

CONCLUSIONS
The developed prototype offers an alternative way of controlling the movement of the stimulator circuits
installed in a chair together with electro pulse vibration output. This prototype shows a 90% functionality based
on the series of tests and trials. A 5mA current output supplies the back portion of the body for stimulation. The
system algorithm was designed using window based software. The prototype was embedded with electro signal
transmission. In which, 90% accuracy was measured after the 5 series of trials.

KEYWORDS
Analog Digital Conversion (ADC)
Embedded System
Microcontroller
Stimulator
Transcutaneous Electrical Nerve Stimulator (TENS)
1. INTRODUCTION with code of engineering and standards with
constraints and trade-offs considerations.
Transcutaneous Electrical Nerve Stimulator
(TENS) is a non-invasive analgesic technique that The research came up with an idea of designing a
is used to relieve nociceptive, neuropathic, and Transcutaneous Electrical Nerve Stimulator
musculoskeletal pain. [1] TENS is used extensively (TENS) Chair controlled by a microcontroller. To
in health care because it is inexpensive, safe, and make it easier to utilize, the researcher developed a
can be administered by patient themselves. Success system application that was applicable to the
depends on appropriate application. Systematic prototype full functionalities.
reviews have been compromised by poor quality
randomized controlled trials (RCT). Better quality
trials are needed to determine differences in the Requirements
effectiveness of different types of TENS. [2]

TENS (Transcutaneous Electrical Nerve Analysis

Stimulator) is a therapeutic device used to deliver
electric current through one’s skin. As a device is
used on human body, safety concern becomes a Design
matter that needs special attention. The test is done
in the interval of the simulator pulse. This option is
used to protect users by electrical shock that can be
caused from this device. [3] Coding

This research presented on how to improve the

performance of Transcutaneous Electrical Nerve
Stimulator (TENS) through PIC16F877A Testing
microcontroller. In which the embedded
microcontroller code would do its full functionality
as therapeutic chair.
Acceptance
2. OBJECTIVES

The main objective of this project is to develop a Figure 1 Project Development

Transcutaneous Electrical Stimulator Chair with
microcontroller based application in accordance 3.1 Project Development
with engineering standards, and consideration of
trade-offs based on economic, functionality, and Also in this study, the researcher used experimental
manufacturability constraints. method in the development of the whole prototype.
The researcher has conducted series of accuracy
2.1 Specific Objectives testing. The researcher used a model development
a. To design a stimulator chair that would as shown in Figure 1.
produce electro pulse to stimulate the
back portion of the body. 3.1.1 Requirements
b. To develop an embedded code for the
prototype full functionality.
c. To test and evaluate the prototype In this phase researcher conducted research about
based on the 50% accuracy (User TENS application in the country. This type of
Evaluation and Prototype) and device is available in the local market but it is very
reliability. expensive. This scenario inspired the researcher to
develop an engineering solution. The researcher
also considered the following:
3. MATERIALS AND METHODS
 Pulse Amplitued: 0 to 80 mA each
channel, adjustable, (500 ohm load)
There has been mixed methodologies used in this
 Pulse Rate: 1 to 200 hz, adjustable
research to further results evaluation. These include
 Pulse Width: 40 to 260 microseconds,
hardware and software design methodologies.
adjustable
Together with resource management in accordance
3.1.2 Analysis price of the major components to show practicality
without effect in/or the functionality of each on its
The designers researched and studied the main expected output. There were different types of
problem about TENS device. Along in this phase major components used in each circuit design and
researcher consulted a physician who also studied the designers considered the most advisable TENS
the same problem. pad and other components in order to achieve the
objectives of the project.
3.1.3 Design
3.2.2 Functionality Constraint
The researcher made a strategic plan about the
problem. Brainstorming was one of the best plans The functionality of the Transcutaneous Electrical
that the researcher did with the problems in the Nerve Stimulator (TENS) was considered through
prototype. The researcher listed down all the the operating properties of the sensors used in the
possible solutions to the problems and studied how design. The voltage sensitivity greatly affects the
to handle each problem and how each problem will function of the design because the higher voltage
be solved sensitivity has, the higher the changes in input
voltage to output voltage of the TENS Pads.
3.1.4 Coding
3.2.3 Manufacturability Constraint
Final design of circuit and plan was established and
the next step was the construction of those ideas to Manufacturability is critical because some
finish the project. The researcher worked on the components might be unavailable locally and needs
prototype using TENS technology and develop shipping from other countries. This might affect the
application that serves as the microcontroller I/O development of the prototype since the project is
interface. time bounded.

3.1.5 Testing 3.3 Design Standards Inputs

The researcher tested the prototype to know if the The design of this project conforms to the
design was working accurately based from the following studies, codes, and standards:
standards and constraints. Evaluation form was
given to ten respondents to evaluate the prototype 3.3.1 Fundamentals and requirements of
based on its accuracy, and reliability. peripheral electric nerve stimulation. A
contribution to the improvement of safety
3.1.6 Acceptance standards in regional anaesthesia

When the project met the objectives stated in the The use of a nerve stimulator allows an injection
first phase, it was then ready and prepared for the cannula to be located without the cooperation of
implementation. The development of the project the patient. Regional anaesthesia thus becomes
was advised by the evaluator in accordance to the safer because the basic condition "no paraesthesia,
specifications. no anaesthesia" becomes irrelevant. In accordance
with the basic electrophysiological conditions, a
3.2 Design Constraint Inputs stimulator should have the following properties: (1)
adjustable constant current at resistances of 0.5-10
The consideration of multiple constraints was kOhm; (2) monophasic square-wave initial
applied in the process designing the project. These impulse; (3) impulse duration selectable (0.1 ms +
constraints served as the aspects that determined 1 ms, and exactly adjustable; (4) impulse amplitude
the feasibility of the design. There were different (0-5 mA) exactly adjusted, unequivocal scale
types of constraints applicable for the design, but graduation or current indicator, in particular in the
the designers have selected only those that greatly range of 0.05-1.0 mA; (5) impulse frequency 1-2 (-
affect the entire development process. 3) Hz; (6) alarm at high impedance and check on
electrical circuit; (7) battery test (indication of
3.2.1 Economic Constraint battery voltage); (8) unequivocal assignment of
load end; (9) high-quality connecting cable and
The total cost of the designs of the project was plug; and availability of (10) instructions for use
affected by the price of the major components used with relevant parameters (tolerated variations,
in each circuit design. The designers considered the steady-state characteristic curves, etc.). [4]
3.3.2 The function of peripheral nerve
stimulators in the implementation of nerve
and plexus blocks

A selection of nine instruments supplied by eight

different manufacturers for carrying out peripheral
nerve stimulation were checked for their suitability,
safety and ease of operation, and were compared
and contrasted with reference to a spectrum of
characteristics that appear desirable in theoretical
and practical terms. Measurements at Ohm's
resistance showed that in the clinically relevant
range of impulse amplitudes (0.1-1.0 mA) the
quality of adjustment of the instruments varied
widely. The actual electrical impulse delivered by
some of the instruments deviated so widely from
the adjusted theoretical value that they must be
regarded as unsuitable. The duration of the impulse
corresponded to the manufacturer's specifications
for only two instruments. Four instruments did not
generate a monophasic square-wave signal despite
assertions to the contrary in the instructions for use,
and one instrument did generate such a signal
although a "special biphasic asymmetrical" impulse
is described by the manufacturer. Impulse-like
overshooting at the beginning of the signal,
oscillations into the positive range at the end of the Figure 2 Illustrative Diagram
signal and fall in current during the course of the
signal were the form variants indicating technically 3.5 Voltage Sensitivity Formula
inadequate design in the other instruments.
Resistance to the square-wave current impulse The researcher determined the voltage sensitivity
engendered by the complex body resistance of the TENS pad stated in the datasheets. The
(impedance), a good approximation to the voltage sensitivity as shown in Eq. (1) was
mathematical e-function to be expected, could be considered in the functionality constraint of the
demonstrated for the rising signal flank, whereas design and used for trade-offs. With deep research,
the signal curve in the lower part of the descending the researcher found a related study and the
flank was flatter than expected owing to following computation was for the voltage
polarization effects in the body tissue. [5] sensitivity of the TENS pads:

3.4 Illustrative Diagram (1)

The designers used three different sensors that
detect vibrations from the construction materials. Wherein:
These sensors were categorized in three hardware 𝑆𝑣 - Voltage sensitivity
design of the project. As shown in Figure 3.3, the 𝐺33 - Material voltage constant for PZT
illustrative diagram shows the components of the ℎ - height of the PZT material
design project. These components is conforming 𝑀 - Mass of the prototype (Kg)
the engineering studies, codes, and standards that 𝑎 - Acceleration constant (9.8𝑚/𝑠2)
govern it. As shown in Figure 2. 𝐴 - Area of the PZT material

3.6. Trade-Offs

This research used three different design categories

in obtaining the final prototype design. The three
designs were compared and evaluated based on the
different constraints criterions such as economic,
functionality, and manufacturability. Figure 3 shows the procedures as well as the
requirements that were processed upon the purpose
Using Otto and Antonsons' model on trade-off of the research. The input, process and output
strategies in engineering design, each criterion was consist of the several requirements of this research
given a value of 0 to 5, depending on its and constraints consideration used to determine the
importance. The designers calculated the ability to best Transcutaneous Electrical Nerve Stimulator
satisfy each criterion based on certain properties of (TENS) prototype.
the device, using the equations:
4. RESULTS AND DISCUSSION
Computation of ranking for the ability to satisfy
criterion of each mechanism:[6] as shown in Eq. 4.1 Design Raw Ranking
(2) and (3).
The Table 1 shows the indicated constraints which
(2) are the economic, functionality, and
manufacturability and the ranking based Eq. (2).
The researcher ranked the criterion’s importance
from zero (0) to five (5) and the ability to satisfy
the criterion is rated from negative five (-5) to
(3) positive five (5). It also shows the summary results
Wherein: of the Designers’ raw ranking based on economic,
SR- Subordinate Rank functionality, and manufacturability constraints.
GR – Governing Rank

3.7. Conceptual Framework Table 1.Design Raw Ranking

The conceptual framework shown in Figure 3 is the Ability to satisfy the

researcher conceptualization based on engineering Decision criterion
standards and different constraints consideration. Criteria (on scale from -5 to 5)
The microcontroller was embedded with a program Design Design Design
that controlled the prototype functionality. It also
1 2 3
compromises other electronic component that
affects the prototype functionalities. Cost 5 4 1
Functionality 3 5 4
INPUT PROCESS OUTPUT Availability 3 2 5
Knowledge Data Rank 47 46 45
Requirements Gathering Transcutaneous
Electrical Nerve
 Circuit  Componen Stimulator The Researchers gave a rank of 5 for the
Design ts Canvas (TENS) Chair importance of the functionality constraint since the
 Digital and voltage sensitivity of sensor was considered
Signal purchase
Processing
4.2 Prototype Functionality Testing
 Electronics Design
 Embedded  Circuits
Systems The results from the testing proved that either of
 Embedded
 Software Systems the two orientation of the device is acceptable with
Design  Hardware respect to the Electro node stimulator standard
Hardware and vibration level for human body. Table 2 below
Requirements Software presents the data gathered from the testing of
 Microcontrol- Integration device.
ler
 Power Supply Design
 Circuits Testing
Multiple and
Constraints Evaluation
Engineering
Standards

Figure 3 Conceptual Frameworks (IPO)

 Researcher had three sets of trials per orientation of
Table 2 Functionality Test Results device to have a basis whether the results are
acceptable or not. The standard Pulse (pulse s-1)
TENS Trial Pulse Measured ranges 1 to 200 (pulse s-1). As the result from the
Pads Frequency Values testing, 3 out of 3 trials for rows have acceptable
(pulse s-1) (pulse s-1) results, and 3 out 3 trials for columns. All trials
1 1 – 200 155.62 were within the range of standard pulse frequency
Rows 2 122.92 based on Iain study which means the results were
1 – 200 respectively acceptable.
3 123.08
1 – 200
4.4 Prototype Accuracy Testing
1 111.21
1 – 200
Columns The researcher had decided the possible direct
2 113.15
1 – 200 users of the system which would be the
3 214.11 respondents for the evaluation procedure. The
1 – 200
questions stated in the evaluation form were based
in the specific objectives. The Figure 4 shows the
Researcher had three sets of trials per orientation of signal status of the evaluation conducted by the
device to have a basis whether the results are respondents. The accuracy was based on question
number 1 from the questionnaires.
acceptable or not. The standard Pulse (pulse s-1)
ranges 1 to 200 (pulse s-1). As the result from the The result for the accuracy was shown in Figure 4
testing, 3 out of 3 trials for rows have acceptable out of 10 respondents selected Excellent as their
results, and 3 out 3 trials for columns. All trials evaluation for the device in terms of accuracy. The
were within the range of standard pulse frequency remaining 4 respondents answered Moderate as an
based on Iain study which means the results were evaluation for accuracy.
acceptable.

4.3 Prototype Reliability Testing

The researcher set three (3) distances to test the

reliability of the electro node stimulator readings.
The result from the testing proved that in any
distance from the testing table the readings are
acceptable with respect to the electro node
stimulator standard for human body.

Table 3 Reliability Test Results

Distance Trial Pulse Measured

(m) Frequency Values
(pulse s-1) (pulse s-1)
1 1 – 200 121.74
1 2 1 – 200 156.38
3 1 – 200 165.67
1 1 – 200 134.59
1.5 2 1 – 200 132.21
3 1 – 200 124.51
1 1 – 200 111.71
2 2 1 – 200 120.79
Figure 4 Device Accuracy
3 1 – 200 122.80
5. CONCLUSIONS Exploration of different microcontroller is also
applicable for improving this study.
The researcher developed a stimulator circuit that
will produce an electro pulse and installed at the The researcher would also like to recommend an
front portion of the chair with 8 stimulator pad that alternative configuration of the stimulator circuit
is used for stimulation. The 5mA to 1mA is the which does not make use of a different supply for
amount of current that the stimulator pad produced lessen the wiring connection of each component.
that is installed at the front portion of the chair that
controlled by the microcontroller. REFERENCES
[1] Johnson M. Transcutaneous electrical nerve
The researcher designed a system algorithm that is stimulation. In: Watson T, ed. Electrotherapy: Evidence-
transmitted to the different circuitry that the based Practice. Edinburgh: Churchill Livingstone, 2008;
prototype is providing. Through the use of a 253–96
window based programming software of the PIC16
Microcontroller the full functionality of the [2] Iain Jones and Mark I Johnson, “Transcutaneous
electrical nerve stimulation, 2009.
stimulator chair is depending on the signal that the
said microcontroller produced each time the user [3] Joel J.P.C. Rodriguez (2012). “Emerging
pressed the buttons at the numerical key pad. Communication Technologies for E-Health and
Medicine”, USA
The prototype is 60% accurate based on the results
gathered by the researcher on the series users [4] Kaiser H, Niesel HC, Hans V. (1990)” Reg Anaesth.
evaluation on determining the required range of the Sep;13(7):143-7. “Review. German. PMID:2236709
stimulator circuit functionality. For the timing
accuracy the stimulator functionality was divided
[5] Kaiser H, Niesel HC, Hans V, Klimpel L. (1990)
into 6 minutes functional time (1 minute to 6
minute of stimulation). ” Reg Anaesth. Sep;13(7):143-7. “Review. German.
PMID:2236715 
This prototype shows a 90% functionality based on [6] Otto, K. N. (1991). “Trade-off strategies in
the series of tests and trials. A 5mA current output
supplies the back portion of the body for engineering design. In K. N. Otto, Research in
stimulation. The system algorithm was designed Engineering Design” (pp. volume 3, number 2, pages
using window based software. The prototype was
embedded with electro signal transmission. In 87-104.).
which, 90% accuracy was measured after the 5
series of trials. Acknowledgements

The designer would like to extent their gratitude

6. RECOMMENDATIONS with the Technological Institute of the Philippines
Quezon City, Computer Engineering Department
for the opportunity to present this paper. To Dr.
The researcher recommends that instead of using a Jesusa N. Padilla (Dean of College of Engineering
power window motor, use a step up motor for it and Architecture). Prof. Edgardo S. Dajao, Prof.
could have exact direction but base on the Manuel I. Ocampo, and Dr. Neil Balba,
limitation of its supply necessity the future (Pamantasan ng Lungsod ng Maynila). Mrs.
researcher is to advice to maximize the capability Alejandra Rivera-Mendoza Dysangco (+) my mom.
of the step-up motor. In order to enhance the
performance of the system, additional motor should
be applied for it to be able to move left and right
directions.

Installation of a solar panel is also recommended

for power saving purposes.

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