Tutorial for making the Composite Cerebellar Functional Score (CCFS) board

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Introduction

The Composite Cerebellar Functional Severity Score is a quantitative tool to measure cerebellar severity independently from age. It is an assessment in addition to a clinical examination and has demonstrated its usefulness in epidemiological studies, clinical trials, and patient follow-up. It was validated in adults and children. The CCFS is a combination of the time to perform 2 tasks, a 9-hole pegboard and a click test. Both tasks include a series of alternative movements: placing pegs and finger-pointing cycles, adjusted on age. A score is calculated and used as a follow-up measure of cerebellar signs. Pr Alexandra Durr and Dr Sophie Tezenas du Montcel have the pleasure to give you access to this online version that has been developed to facilitate administration and increase reliability and reproducibility. You can find all information, technical explanations and blueprints to build your own CCFS Board. Laser cutter machine is the only technical machine you would need to build your CCFS Board. You can find this kind of machine in your university or city’s FabLab.

Production stages

CASE PRINTING

Download the STL file to print it on a 3D Printer (Zortrax M300 like).

PLATE CUTTING

Dowload the DXF File to cut it on a laser cutting machine.

PROGRAM

Download the Arduino IDE and the file to transfer it into the Arduino MEGA board.

ELECTRONIC

OptoswitchesBoard

Weld the resistors and the optoswitches according to the picture.

Weld the 11 pins male header to the Board and connect it according to the diagram

Screw it at its location in the case.

Power supply circuit

1. Place the interruptor on the case

2. Weld 2 wires to the interruptor

3. Complete the power supply circuit by welding wires between the battery case, the interruptor and the arduino board, according to the diagram.

LCD screen

Weld the wires and connect them to the arduino card according to the diagram

Glue it with the glue gun at its location acording to the photo bellow :

Rotary Button

Weld on a PCB plate the rotary button and the resistor and connect it according to the table

CLK Pin 2
DT Pin 3
SWITCH Pin 20
GND GND
VCC 5V

Screw it on the case according to the photo below

SD card Reader

Glue it with the glue gun at its location acording to the photo below :

Connect it to the arduino board according to the table :

MOSI Pin 51
MISO Pin 50
SCK Pin 52
SS Pin 4
GND GND
VCC 5V

Arduino Card

Screw the arduino card at its location on the left inside the case.

Buttons

Weld two wires on each button according to the photo below :

Place them on the plexiglass plate.

Connect them to the pins (40 ;42) and (44 ;46)

Plate

Screw the plate to the case

Inventory

QUANTITY REFERENCES
1 Arduino MEGA 2560
1 Platine SD Card Shield V4.0 for Arduino
1 Screen 2 x 16 characters
10 opto-switches
1 resistors 200 & 300
1 SD card reader
1 battery case
1 slide switch ON/OFF
2 buttons (30mm)
QUANTITY REFERENCES
 1 Multiple colored wires
1 Sheet of pmma 3mm 600x600mm
1 Rotary encoder

Optoswitches board
Order the Optoswitches board from a PCB manufacturer with these files . In case you want to make the board by yourself download Kicad and open these files to see the wiring.

Instructions for CCFS Board use

First of all, be sure that the batteries are full and the SD card is available with free space.

–    Start the CCFS
Use the ON/OFF button on the side

–    File name
Name the file .csv which will be created to store the CCFS score. You can only use numbers from 0 to 9 to name the file. Use the « + » and « – » buttons to choose the set of numbers and press OK to implement the file’s name. When the name is correct, choose « V » on the screen to valid the name.
Press ok to continue.

–    Age
Enter the age of your participant. Use the « + » and « – » buttons to choose the correct age and press OK.

–    Nine-hole pegboard test (9hls)
The screen indicates the « nine-hole test », press OK when you and the participant are ready to start the test.
You should be seated face to face with the participant and the screen should be on your side.
The participant is seated and holds nine pegs  in the non dominant hand and places them randomly, one by one, as fast as possible, with the other hand (the dominant one) in the board with nine holes. If the participant drops a peg, he/she has to repeat the test.
To repeat the test, you need to place the pegs in the remaining empty holes. Then, remove all the pegs from the board before renewing the test. Press OK. The screen indicates “repeat the test ?”; you can choose yes or no with the “+” and “-“ buttons. Validate your choice, by pressing OK. The participant can then perform this test again. If the participant drops the peg again during the repeat test, you should consider that he/she is not able to perform the nine-hole peg test.
An intermediate score appears on the screen at the end of this test. Press OK to continue and remove the pegs.

–    Click test
To perform this test, you have to telescope the two arms supporting the buttons.
The screen indicates the « click test », press OK when you and the participant are ready to start the test.
The participant uses a dominant hand finger of his/her choice to press one button, alternately 10 times on each button, as fast as possible and strong enough in the middle of the buttons. The number of goes is indicated on the screen and you can stop the participant after 10 goes. PRESS OK.
The screen indicates “repeat the test ?” but you are not supposed to repeat this one except if the participant misunderstood the instructions.
To repeat the test, you can choose yes or no with the “+” and “-“ buttons. Validate your choice, by pressing OK.

NB:
•    After each test, you get the score of the performed one
•    During both tests, make sure the participant doesn’t take support on the table with his/her “working” arm.

–    Save the CCFS score
When both tests are passed, the screen displays the CCFS score. Press OK to save the score on the SD Card. The screen indicates”Exam successfully saved.

–    Repeat the tests with another participant or switch off the CCFS with the on/off button on the side.

Contact

Pierre Tissier – Email