NAME : SUFI DARWISYAH BINTI MOHAMMAD HATTA

MATRIC NUMBER : 074717

LECTURER’S NAME : DR. AMIRUL FAHMI BIN RAZALI

CREATIVE RESEARCH
(DPI 31803)

LITERATURE REVIEW

ARTIFICIAL INTELLIGENCE IN USER-CENTERED DESIGN :

“DESIGNING THE HANG STOOL AS A PRACTICAL FURNITURE
SOLUTION FOR MULTIFUNCTIONAL ENVIROMENTS”

FACULTY OF INNOVATIVE DESIGN AND TECHNOLOGY

 TABLE OF CONTENTS

INTRODUCTION
1.0 BACKGROUND
1.1 RESEARCH STATEMENT
1.2 RESEARCH QUESTION
1.3 RESEARCH OBJECTIVE

LITERATURE REVIEW
2.3 Age and Gender of Headache Sufferers………………………………..
2.4 Interventions to Reduce Headache Burden………………………………….
1.5 Postural control………………………………………………………………
1.6 Support for communication …………………………………………………
1.7 Assistive technologies for student with down syndrome………………….
1.7.1 Assistive technology impact for educational…………………….
1.7.2 Text to speech to text software……………………….……………
1.7.3 Motor skills technologies for down syndrome……………………
1.7.4 Adaptive writing tools……………………………………………..
 CHAPTER ONE

INTRODUCTION
1.0 BACKGROUND

1.1 RESEARCH STATEMENT

Furniture plays a crucial role in shaping the functionality and aesthetic appeal of modern
living and working spaces. Today, there is an increasing demand for furniture that combines
practicality, style, and space-saving solutions to cater to the needs of dynamic
environments. Traditional furniture designs often fall short of meeting these requirements,
especially in settings where multifunctionality and portability are essential. This has led to a
growing interest in innovative furniture concepts that offer flexibility and adaptability to
evolving lifestyles.

In contemporary times, multifunctional furniture has gained significant attention due to the
constraints of urban living and the emphasis on maximizing utility within limited spaces.
Consumers are seeking products that serve multiple purposes, such as foldable, modular, or
convertible furniture, to optimize room organization and enhance efficiency. Despite the
availability of some multifunctional options, many designs fail to balance durability,
portability, and aesthetic appeal, highlighting a gap in the market for well-rounded
solutions.

This research explores the potential of multifunctional furniture, focusing on its ability to
address modern challenges such as space limitations, mobility, and workflow optimization.
By examining existing trends and consumer needs, this study aims to contribute to the
development of innovative furniture designs that align with contemporary demands,
offering practicality, efficiency, and visual harmony in both residential and professional
settings.
1.2 RESEARCH QUESTION

In this analysis gives some questions for each furniture user that is how to make
people comfortable in the studio of photography.

1.3 RESEARCH OBJECTIVE

 To design a multifunctional furniture solution that combines the functionality of

a stool and a hanger, addressing space-saving needs in studio photography
environments.
 To enhance the portability and ease of use of tools and clothing storage within
studio settings, ensuring efficient workflow management.
 To utilize durable, lightweight, and aesthetically pleasing materials to create a
product that supports frequent use in professional photography studios.
 CHAPTER TWO

LITERATURE REVIEW
 REVIEW OF LITERATURE

2.0 OVERVIEW OF HEADACHE

Headaches are a commonly reported problem in today’s society. When people

experience headaches, there is a tendency for them to feel upset and irritable, especially
when the pain becomes unbearable. (Hj & Cl, 2008) A headache is a pain or discomfort
in the head, scalp, or neck area. It can vary in intensity, location, and duration, ranging
from a dull ache to a sharp, throbbing pain. Headaches may be a standalone issue which
is primary headache or a symptom of another health condition which is secondary
headache. They are often classified into types based on their causes and characteristics,
such as tension headaches, migraines, and cluster headaches. Common triggers include
stress, dehydration, fatigue, and changes in sleep or diet. Headache is a common health
issue, but in some cases, it has the potential to become a chronic or recurring problem,
classified as a headache disorder or headache disease.

2.2 Types of Headache Disease

Headaches can be divided into many types. Firstly, migraine is a headache

experienced usually on one side of the head. The symptoms are throbbing pain,
sensitivity to light, sound or smell nausea and can lead to vomiting. It also causes
disturbances in vision or senses. The duration of a migraine can last from a few hours to
a few days. The exact cause is unknown but may involve genetic, environmental and
neurological factors. Migraine triggers include the type of food consumed, stress,
hormonal changes, and sleep disturbances.

Next is tension type headache or TTH. The symptoms are mild to moderate pain,
often described as a band-like tightness around the head. Usually TTH lasts 30 minutes
to several hours but can be chronic. The cause of this headache can be linked to muscle
tension, stress and posture problems, however the exact cause is still unclear. Cluster
headaches involve symptoms of severe, stabbing pain on one side of the head, often
around one eye. It may include redness, tearing or nasal congestion. The duration of
these headaches usually lasts from 15 minutes to 3 hours but occurs in clusters that are
attacks over several weeks or months. The cause is not fully understood but may involve
the hypothalamus and certain blood vessels.

Surveys indicate that between 50% and 70% of adults experience headaches, 40% of
which are tension headaches. (Hj & Cl, 2008) This community study on headache in
Malaysia is based on the IHS diagnostic criteria and shows that the prevalence of
migraine last year was 9.0%. Migraine with aura accounts for only 10.6% of the migraine
population. The prevalence of tension headache last year was 26.5% (94.4% episodic,
5.6% chronic) and 28.2% for other types of headache. No cases of cluster headache were
found. Nearly two-thirds of the migraine subjects graded their headache as severe, while
nearly 60% of the tension headache subjects and nearly 70% of the other headache
subjects graded their headache as mild.

Overall, there was a higher prevalence in women for migraine and tension-type
headache, and in men for other types of headache. The prevalence of headache is lower
among those under 15 years of age and older than 65 years. No significant differences
were found in the prevalence of headache among different racial groups nor among
urban versus rural populations.

All types of headaches share the same trigger factors indicating that different
physiological characteristics are responsible for the type of pain experienced. In this
community location with a tropical climate, headache was associated with sun exposure
in 51.9% of migraine subjects, 55.7% of tension headache subjects, and 36.6% of the
group with other headaches.

METHODOLOGY
Data Source and Study Population

2.2.1 Trigeminal Autonomic Cephalalgias

TAC is characterized by unilateral pain in the distribution of the first part of the
trigeminal nerve, accompanied by ipsilateral cranial parasympathetic activation,
including tearing, conjunctival injection, miosis, ptosis, and rhinorrhea. There are 4 types
of TAC: cluster headache, paroxysmal hemicrania, short-term unilateral neuralgiform
headache attacks, and hemicrania continua. Each TAC has a different pattern of
headache attack frequency, duration and treatment response. Most TAC has episodic
and chronic subtypes, distinguished by the presence of remission periods of 3 months or
more each year. (Review, 2024).

Cluster headache is characterized by severe pain and restlessness. Cluster headache

attacks are more common at night. Cluster headache has an estimated lifetime
prevalence of 0.1%, has a 3:1 male to female ratio, and approximately 10% of patients
have chronic cluster headache, which is particularly severe and more resistant to
treatment.85 Nonoral triptans (subcutaneous or intranasal sumatriptan; intranasal
zolmitriptan) and high-flow oxygen are recommended for acute treatment. The calcium
channel blocker verapamil (with an initial target dose of 240 mg per day), lithium up to
900 mg per day, and galcanezumab, 300 mg, injected monthly are preventive therapies
recommended by expert opinion.86,87 Chronic therapies require at least 1 week after
initiation to prevent cluster headache. Bridge treatments, defined as short-term
preventive therapies used to reduce attacks while waiting for preventive treatment to
become effective, consist of a short course of oral steroid for around 2 weeks or a
greater occipital nerve injection with steroid ipsilateral to the pain.86 External vagus
nerve stimulation is a tolerable adjunctive acute and preventive treatment. Although not
readily available, implanted sphenopalatine ganglion stimulation is one of a few
therapies effective for patients with chronic cluster headache. (Review, 2024).

2.2.2 Secondary Headache

Secondary headache disorders are due to an underlying symptomatic cause and

have numerous etiologies. In addition to the possible causes previously noted,
intracranial pressure disorders should be considered such as idiopathic intracranial
hypertension (IIH) and spontaneous intracranial hypotension (SIH). Pseudotumor cerebri
syndrome is defined as intracranial hypertension without a structural or vascular cause.
A diagnosis of IIH requires excluding drug-induced, metabolic, or hormonal causes of
intracranial hypertension.3,89 IIH has an annual incidence of 1 to 2 per 100 000 and is
more common in individuals with obesity.90 Headache is the most common IIH
symptom, though visual symptoms, including persistent blurred vision, transient visual
obscurations, and horizontal diplopia, as well as pulsatile tinnitus are frequent, and if
untreated can lead to irreversible visual loss. The syndrome is most common in women
aged 20 to 40 years who are overweight. (Review, 2024)

Patients should undergo fundoscopy to evaluate for optic disc edema. Testing with
brain MRI and magnetic resonance venography can exclude other causes of intracranial
hypertension, such as neoplasm and cerebral venous thrombosis. Additional diagnostic
testing includes lumbar puncture to confirm an elevated opening pressure (typically
>250 mm of cerebrospinal fluid [CSF]) and ensure CSF constituents are normal and
neuro-ophthalmological evaluation. Treatment goals include vision preservation, which
can be attained with weight loss and prescription of acetazolamide to reduce CSF
production. Patients with more severe visual loss may require surgery to lower
intracranial pressure.91 Headache improvement may not accompany visual
improvement and may require treatment with migraine therapies. (Review, 2024)

Headache is an important symptom of low intracranial pressure (intracranial

hypotension) and may be precipitated by a spinal CSF leak, leading to lower intracranial
pressure or volume, downward brain sagging with traction on intracranial structures,
and compensatory venous engorgement. Headache due to intracranial hypotension can
be secondary to postdural puncture headache after a diagnostic lumbar puncture,
lumbar anesthesia, another spine procedure, or SIH.3 SIH has an estimated annual
incidence of 2 to 5 per 100 000,93 and onset of SIH is often associated with an inciting
event such as a Valsalva maneuver. SIH can be caused by 3 types of CSF leaks: focally
weakened dura often in a nerve root sleeve, osteophytic or discogenic ventral tears, or
CSF-venous fistulas. (Review, 2024).

The classic presentation of postdural puncture headache or SIH is an orthostatic

headache, developing within minutes of standing and disappearing within minutes of
becoming supine, though other headache characteristics (exertional, “second-half-of-
the-day headache”) and nonheadache symptoms, including muffled hearing, may be
reported. Treatment includes hydration, nonspecific analgesics, and caffeine; however,
the underlying cause may require more definitive therapy if no improvement, including
lumbar or targeted autologous epidural blood patches and potentially surgical repair of
the leak or fistula site. (Review, 2024).

2.3 Age and Gender of Headache Sufferers

Globally, approximately 50% of adults experience at least one headache each year.
Of those, 30% or more reported having migraines, while 4% had headaches for 15 days
or more each month (chronic headaches). In Malaysia, research has shown that the
prevalence of headaches is comparable to the global average. A study in Malaysia
reported a migraine prevalence of around 9-12% among adults. Tension-type headache
(TTH), which is the most common type, can affect an estimated 20-40% of adults at
some point. Chronic headaches, including chronic migraines and chronic tension-type
headaches, can affect about 3-4% of Malaysians. Headaches are also common among
young people in Malaysia, with reports showing that nearly half of Malaysian
schoolchildren and teenagers experience some form of headache, often linked to stress,
lack of sleep, or screen time. As in other parts of the world, headaches more often attack
women than men in Malaysia, especially migraine.

Data for consecutive eligible adult patients were included prospectively list of
headaches. Patients were divided into two age groups group that is elderly people 55
years old and above and younger less than 55 years. Of the 175 patients screened, 165
was included in the study. 70 in the old age group and 95 in the younger group. Tension-
type headache is the most common subtype (45.7%) among the elderly while Migraine
without aura (54.7%) was more common in young adults. More elderly patients had
chronic daily headache than younger patients (47.1 vs. 28.4 %; p = 0.015). Expectedly,
the higher prevalence rate is reported in a young population with a female
predominance of 66% female and 55% male in aged patients 55–74 years. 92% of
women and 74% of men are younger adults aged 21–34 years) Although, headaches
start at a younger age, the appearance in the elderly is possible observed in 5.4% of
patients aged 65 years and above. Furthermore, all headache subtypes were observed
among elderly However, migraine occurs less frequently (4.6%) compared to tension-
type headache (16-27%). (M. S. Tai et al., 2012).

Regarding gender differences, there are conflicting reports literature on sleep

deprivation. Female patients with migraine experience more sleep deprivation than
males migraine in previous studies. However, another study showed that men's migraine
had a higher rate lack of sleep compared to migraine women. Stress was reported by
65.4 and 63.1% of women and male migraineurs, respectively, in previous studies.
Sunlight has been described in the literature as common trigger factors among female
patients with migraine. However, there are conflicting reports as to whether there is
there are gender variations in other triggers such as weather
change and smell. In some studies, climate change and odors are more common triggers
in women's migraines from migraine men. However, in another study, odor frequency,
weather and other triggering factors do not different between men and women with
migraine. (M. S. Tai et al., 2019).

2.4 Interventions to Reduce Headache Burden

TENS therapy, which employs low-level electrical impulses to reduce pain, helps
some patients. Additionally, migraine sufferers can lessen their migraine symptoms by
using the FDA-approved Cefaly Device, a headband-like device that stimulates the
trigeminal nerve. The clinic is also in charge of implementing a number of therapies,
including Cognitive Behavioral Therapy (CBT), which assists people in managing stress
associated to headaches and changing cognitive patterns that could exacerbate the pain.
In order to lessen the frequency of headaches, biofeedback therapy trains patients to
regulate their body's reactions to stress, such as heart rate and muscle tension.
Alternative Medicine for some people, the ancient practice of acupuncture can help
lessen the frequency of chronic headaches.

Although the burden of headache is undeniable worldwide, healthcare provision for

headache, quality of care delivered and rates of utilization are consistently poor across
regions, countries, cultures and settings. Structured headache services are best placed to
provide efficient, cost-effective and equitable headache care across the country, and are
central to any national healthcare solution for headache. (Saylor & Steiner, 2018).

First and foremost, for Level 1 Providers, with the clinical skills expected in primary
care plus basic training, are fully capable of diagnosing and managing common primary
headache disorders while recognizing secondary headaches that require management.
Level 2 providers, that is, physicians with an interest in headache and additional
theoretical and practical training in headache medicine should manage another 8 to
10%, including more complex primary headache disorders as well as some secondary
headaches. Next, a level 3 provider, that is, a fully trained physician in an academic
medical center, should manage the 1 to 2% with very complex or rare primary
headaches and multiple secondary headache disorders. (Saylor & Steiner, 2018).

Analysis of Dyspepsia and Headache

Across-sectional study was conducted in a tertiary institution, the University Malaya

Medical Centre, from February 2012 until September 2012. The study was approved by
the Institutional Ethics Committee of University Malaya Medical Centre. Cases consisted
of subjects, aged 18 years, with headache at least once per month for more than three
months attending the specialist neurology outpatient clinic. Patients with headache
secondary to intracranial mass lesions and secondary headache were excluded. Patients
with headache on aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), a
known history of gastroesophageal reflux or peptic ulcer disease were also excluded. (M.
L. S. Tai et al., 2015)
During the study period, 93 subjects with headache and 187 control subjects were
recruited at the specialist neurology clinic of Universiti Malaya Medical Center. Table 1
highlights demographic and clinical comparisons between subjects with headaches
(cases) and those without headaches (controls). Patients with headache and controls
were matched for eating (45.0 17.3 years of headache vs 42.1 15.4 years of controls, p =
0.15), gender (57% of headache women vs 66.3% of control women, p = 0.15) and
ethnicity (Table 1). There were more smokers among cases (10.8% vs 7.0%) and a
greater amount of alcohol consumption among controls (2.7% vs 0%) (Table 1).
Headache cases also have more comorbidities in terms of cardiovascular (22.6% vs
11.2%) and metabolic (17.2% vs 11.2%) diseases. (M. L. S. Tai et al., 2015)

The headache characteristics of the study subjects are shown in Table 2. Most
patients experience headaches at any time of the day. About one-third of patients
experience headaches for 15 days in a month. In terms of headache lateralization, most
patients complain of unilateral and intermittent headaches. The most frequently
affected area is the temporal area and about half experience throbbing headaches.
Headache subtypes were as follows: tension-type headache (TTH) n = 53 (57.0%) and
migraine n = 40 (43.0%). Among migraine subtypes, 26 (65.0%) patients had migraine
without aura and 26 (65.0%) had migraine without aura. The TTH subtype group had the
following characteristics: frequent TTH n = 31 (58.5%), rare TTH n = 6 (11.3%) and
chronic TTH n = 16 (30.2%). The mean visual analogue scale (VAS) score for headache
was 54.4 24.2 mm. The VAS for headache intensity was used for current headache
symptoms. More than half of the patients took paracetamol for headache, but a large
number of patients (37.6%) also used traditional medicinal oils for analgesia. (M. L. S. Tai
et al., 2015)

Dyspepsia was more prevalent in subjects with headache compared to non-

headache controls (25.8% vs 12.8%, p = 0.011). However, dyspepsia prevalence did not
differ among the major headache types (27.5% migraine vs 24.5% TTH, p = 0.81). Six
patients who had migraine with aura and five patients who had migraine without aura
complained of dyspepsia. (p = 0.15) There were no statistically significant differences
between various types of headache and dyspepsia (p = 0.84). Similarly, dyspepsia sub-
types (according to the Rome II criteria) were not different between headache
categories as follows: ulcer-like (18.2% migraine vs 23.1% TTH), motility-like (36.4%
migraine vs 46.1% TTH) and reflux-like (45.4% migraine vs 30.8% TTH). The association of
dyspepsia with headache was explored further in a multivariate regression model with
various recognised variables (Table 3). Predictive factors for dyspepsia in our subjects
were found to include headache (OR 2.75) and anxiety (OR 3.52) only, indicating a strong
link between headache and dyspepsia. (M. L. S. Tai et al., 2015)
 Headaches Lead to Suicide

Chronic headaches such as migraines or cluster headaches, are not only physically
debilitating but also mentally exhausting. Constant pain can cause feelings of hopelessness
and depression. In addition,Chronic headaches can alter brain chemistry, sometimes
reducing serotonin levels, which are important for mood regulation and even severe
headaches often interfere with daily life leading to isolation, missing work, or strained
relationships. These factors can exacerbate feelings of hopelessness. Conditions such as
anxiety and depression are commonly associated with chronic headache disorders that will
increase the risk of suicide. If sufferers feel their pain cannot be treated or dismissed by
healthcare providers, this can reinforce feelings of frustration and hopelessness.
In the largest study examining suicide attempts (SA) among veterans with different
chronic pain disorders, we found that patients with chronic headache had a higher risk of SA
than those with other chronic pain conditions. In particular, women with chronic headaches
have a higher risk than men. This is consistent with existing literature that women tend to
attempt suicide more often than men, but men are more likely to die by suicide than
women. Men tend to use more lethal means, such as firearms when attempting suicide,
while women tend to use methods, such as drug overdoses. It should be noted that overall
veterans are more likely to use firearms in SA than the general population, and
approximately 90% of SAs with firearms result in death. (Androulakis et al., 2021)
In addition, we found that chronic headache concurrent with TBI increased the risk
of SA in both men and women, but the increased risk was more pronounced in men. In this
cohort, men with chronic headache and TBI were nearly three times more likely to attempt
suicide, while women were more than twice as likely to attempt suicide. It is possible that
the higher risk of suicide attempts in men with chronic headache and TBI is associated with
TBI severity and pain, and/or poorer executive function associated with TBI, while the higher
risk of suicide in women with chronic headache only associated with excruciating pain.
(Androulakis et al., 2021)
 Our study examined the annual incidence of physician-diagnosed SA in headache, neck,
back and other chronic pain over a decade. Each year, the incidence of SA is consistently the
highest for those with chronic headache compared to any other non-headache chronic pain
condition. A transient increase in SA was observed in all types of chronic pain conditions in
2005. The cause of this spike is unclear and may require further investigation, but given that
this spike was consistent across all chronic pain conditions, it is most likely a historical
artifact unrelated to our research question (eg, it is possible that changes in veteran use
patterns or resources may have contributed to this spike). Because this study only looked at
medically confirmed SA in EHR data rather than broader community survey reports, it is
possible that the rate of SA represented in this study is lower than previously reported.
(Androulakis et al., 2021)
Chronic headache is characterized by unique neurobiological and psychological factors
that may contribute to suicide risk in veterans with TBI. Chronic headache tends to be highly
debilitating even outside of the general experience of chronic pain, as it is uniquely
characterized by severe limitations of self-efficacy due to the associated sense of subjective
helplessness. fMRI findings in patients with chronic migraine showed that a higher
frequency of Headache was associated with aberrant connectivity in the Salience and
Executive networks as well as intranet network connectivity. Chronic headache associated
with TBI likely impairs executive function and increases feelings of helplessness, while
reducing top-down behavioral inhibition. (Androulakis et al., 2021)

2.0 HEAD MASSAGER

3.1 Definition of Head Massager

A scalp massager is a device designed to stimulate the scalp and promote relaxation,
increase blood circulation, and reduce stress. Head massagers come in various forms
such as Manual Head Massager which are metal or plastic prongs that are pressed gently
on the scalp, moving in a circular motion or up and down. They are usually shaped like a
spider with flexible prongs to massage the head with hands. Next, Electric Head
Massagers are battery-powered or rechargeable devices that often have vibrating or
rotating features, providing a more intense massage. They can include multiple
attachments for different massage sensations. The Scalp Brush is used with or without
shampoo, this scalp brush helps to exfoliate and massage the scalp.

Numerous emotional and physical advantages of using a head massager enhance

general wellbeing. First of all, it can ease tension and stress. The scalp massager's mild
pressure and stimulation lower stress hormones and have a relaxing impact that can
elevate mood and lessen anxiety. By relaxing the muscles surrounding the scalp, neck,
and shoulders, a head massager can also lessen the frequency and intensity of tension
headaches. In addition, it may improve mental clarity and concentration. A head
massage can help you focus and think more clearly by reducing stress and boosting
blood flow, which will leave your mind feeling renewed and invigorated.

Another advantage is that it promotes healthy hair. Hair follicles are stimulated by
increased blood flow to the scalp, which over time may result in stronger and more
abundant hair. Additionally, it enhances scalp health by preventing dandruff, dryness,
and clogged hair follicles by exfoliating and removing dead skin cells with the use of a
scalp massager. By promoting blood flow to particular locations that nourish hair
follicles, head massagers can help enhance blood circulation, which may support
healthier hair development and contribute to the health of the scalp. Lastly, it
encourages rest and improved sleep. A head massage's calming effects can aid in body
and mind relaxation, facilitating falling asleep and enhancing the quality of sleep.

3.2 Human Massages or Robot Massages

At the basis of human-robot interaction is tactile interaction. The difference between

human-robot and human-virtual relationships is the physical presence of the robot. The
study looked at whether receiving a massage from another person was more fun than
providing one yourself, and whether administering a massage using a basic robot was
worse. It also explored whether participants' sentiments regarding robots were changed
by their direct interaction with the robot. The findings show how much more enjoyable
it is to get a massage from a human masseur than from a robot or yourself. In contrast,
under the robot condition, subjects showed happier facial expressions. Participants
experience with robots did not materially change their opinions about robotics. (Science,
n.d.).

This research shows that the field of robotic massage therapy has great potential to
facilitate the human-robot connection. The study made it possible to directly compare
the pleasure when the head is massaged by a robot and by a human massage. This offers
insight into how humans perceive tactile stimuli during human-robot interactions.
Through the analysis of the participants' facial expressions, pleasure by providing
comprehensive knowledge of their emotional responses to various massage situations.
This research works on the Robot's lack of visual or tactile feedback loops and lack of
adaptation to each person's characteristics. Focus only on the head massage and not on
the muscle massage that is usually associated with tension relief. (Science, n.d.)

Both physical and emotional relaxation can be obtained from regular head care
practices including shampooing and scalp massage. This head care robot is being
developed based on robot hand technology. Using accelerated plethysmography
biosignals (SDNN, HF/TP, LF/HF), heart rate (HR), blood pressure, salivary amylase (SAA),
and peripheral skin temperature (PST), quantitatively evaluated the effects of relaxation
in this work. It specifically confirmed significant differences between the planned robot
technique and the proposed head care robot in five indices: HF/TP, LF/HF, HR, SAA and
PST. Sympathetic nervous system index values of LF/HF, HR, and SAA decreased
significantly, indicating a decrease in sympathetic nervous system activity. (Science,
n.d.).

However, an increase in the value of the HF/TP index and PST of the
parasympathetic nervous system is accompanied by an increase in the activity of the
parasympathetic nervous system. After only five minutes of operation, this designed
head care robot offers a good level of relaxation. The author states that currently there
are many massage therapy tools available in the market, but none of them are really
worth the cost, thus they cannot provide the immediate relief needed. It will showcase
the entire production, control and design process for the product through a series of
simulations that include vibration/modal frequency response to analyze stability during
operation. Fatigue testing to determine the maximum stress the design can withstand
for a good life Besides, thermal analysis to evaluate heat dissipation from the electronics
and finally, linear static stress analysis to determine the strength of the design that can
produce the right amount of force. SOLID WORKS software will be used to generate
computer-aided design, and ANSYS will be used to optimize finite element simulations.
(Science, n.d.).

4.1 Analysis of The 3D Head Model

Realizing the importance of head anthropometric data, many researchers have

begun to investigate and collect head models for design purposes. In China, over the
past decade, two-dimensional head measurement data has been obtained using
conventional hand-made size measuring instruments. To create standards, measuring
points were defined, and 41 dimensions of head and face measurements were collected
to describe the morphological structure of the head among the adult population.
Meanwhile, Ball et al. combines traditional anthropometric methods and three-
dimensional scanning to collect data on head shape. In the study, a total of 270
participants from seven different regions in China were recruited to scan, to obtain the
three-dimensional coordinates of the head point cloud, creating a high-resolution 3D
scanning database of Chinese head shapes. In the GB/T 23461-2009 project, computed
tomography (CT) and magnetic resonance imaging (MRI) were used to collect 3D
scanning data from 1261 Chinese adult male heads to create a hierarchical description
3D model. The results show that male head shape is divided into seven standard
categories based on head width, height and length. (Li et al., 2022).

Seven types of head shapes have been widely used in the design of headwear
products. Yan et al. proposed a method of building digital models based on 3D scanning
data of Chinese heads, with the aim of designing various products that fit the human
body. They select head feature points, connect them two by two, and build a head mesh
model based on triangles. However, a limitation of the study is that the final head model
framework cannot fully express the complex surface features of the head and face. On
the other hand, Wang et al. collected 3D scan data from 2200 people from seven
representative cities in China, while Kuo et al. established a 3D head anthropometric
database of Taiwanese residents and obtained several head shapes using a two-step
clustering method and two-level self-organizing mapping (SOM) with a coverage rate of
80%. Compared to traditional two-dimensional measurements, high-resolution 3D
scanning data shows more detailed head geometry information. (Li et al., 2022).

The database was developed in 1997. The CAESAR project developed a 3D model
database management system, which users can query for 3D shapes, and
anthropometric and demographic data. For better use of anthropometric data, Lee et al.
manually repaired 2299 head models from the CAESAR database by marking 26
measurement points in the 3D head to collect 30 head dimensions relevant to headwear
product design. The results of the study show that there are various main human head
sizes for several target products, populations and size categories. After that, a grading
system was produced to identify representative head models. Lee et al. collect 3D scan
data of the head, face and ears, and produce hierarchical systems and representational
models using statistical analysis methods, such as factor and principal component
analysis. Elena et al. obtained measurement data from 222 adolescent cyclists in
Melbourne, Australia, and differentiated heads based on three standards (minimum,
average, and maximum) according to head shape and size. Wood et al. proposed a
method of developing a head model based on in vivo imaging data obtained using
magnetic resonance imaging. After that, the detail and anatomical accuracy of the
model is analyzed. The developed model accounts for the thickness of human soft
tissue, allowing its use in experimental simulations of human anatomy. (Li et al., 2022).

Meanwhile, the Netherlands recently obtained descriptive statistics based on

detailed measurements of the heads and faces of Dutch children. To develop an
ergonomic head and face suitable for children, they conducted an anthropometric
survey using traditional anthropometry and 3D imaging-derived measurement
technology to obtain measurements from children between the ages of 6 months and 7
years. Different data sets were organized according to the gender and age of the child to
provide a reference for future product design for children. In contrast, the US Army
conducts an army-wide anthropometric survey, the ANSUR II, which includes 94
traditional manual measurements and 3D scanning data. Studies show that there is a
significant difference in quantitative size between male and female staff. Furthermore,
gender differences are shown not only in absolute size (male > female) but also in
proportion, which affects the potential design of head protection devices. (Li et al.,
2022).

4.2 Head Massager Suitability

Head acupoint massage products imitate human massage techniques, and act on
acupuncture points on the head by means of inflating, squeezing, vibrating, and heating
to promote bloodcirculation in the head, relieve fatigue and prevent diseases.
Furthermore, long-term use of products that do not match the shape of the head will
not only fail to achieve the effect of massage and relaxation, but also lead to chronic
physical damage. Based on research, module gap analysis is used to confirm whether
this product fits the head. By operating the cutting slider, users can continuously cut
headwear products and head models on multiple datum planes. Next, it helps users
discover structural design problems in products that come into contact with the head. At
the same time, the outline of the head shape and the product line can be drawn through
the distance button, and the distance between the head shape line and the product line
can be calculated. (Li et al., 2023).

The front end, left and right side of the product is an airbag device, the top is an
airbag and a vibration device, and the back is a dual vibration device, which is used to
squeeze and massage the acupuncture points on the head. (Figure 1).

Figure 1
 Product Redesign with the help of additional design module analysis, it was found
that there are two main problems with this head massager. With the change in head
size, the massager's pressure points are not accurate. The massager has a low level of
compatibility with the head, it is prone to pressure concentrations or an unreliable fit,
resulting in uncomfortable wear. (Figure 1).

The results show that the optimized massager is more suitable for the shape of the
head, and when the massager adjusts the size, it can always maintain the fit with the
head in the left and right direction, and there is no interference between the massager
and the head. The adaptability of headwear products affects the comfort and safety of
wearing, and how to improve the adaptability of products has become the focus of
research. (Figure 2).

Figure 2

The difference between electronic and manual head massagers

First of all, both manual and electronic have their own advantages and
disadvantages. One of them is for electronic head massager more efficient to reach areas of
the head that are difficult to reach with manual techniques. The sequence is more uniform
and consistent. Manual efficiency depends on the user's skill in using the tool. Next,
electronic ones are heavy and less portable, especially if a cable or access to power is
needed but manual ones are lighter, portable and suitable for travel. As for the price factor,
electronics usually more expensive due to the use of advanced technology and additional
features while the manual provides a lower price and affordability to the user. Electronics
require extra care to ensure that electronic components last longer and are at risk of
damage if dropped or exposed to water. As for the manual, it is more durable and less
prone to damage due to its simple design.
In addition, electronics usually have various modes such as vibration, heating or
automatic massage. It is equipped more complex functions and designed to provide a more
comprehensive and immersive massage experience. Manual too designed for easy and
simple use, such as finger pressure or movements that need to be controlled by the user.
Manual head massagers do not have additional functions such as heating or vibration. As for
the ease of use factor, electronics easier to use because most functions are activated
automatically by pressing a button and do not require much physical effort. Manual requires
manual control and strong energy to produce a good massage effect. But manual is more
suitable for mobile use without relying on electric power.

4.3 Types of Exist Head Massagers

The manual scalp massager is one type of head massager. Massage the spider's long,
pliable prongs give it a spider-like appearance. It provides a calming and tingling sensation
when applied to the scalp and massaged carefully. In the meanwhile, this massager features
a hand-held rubber or silicone brush with soft bristles that gently exfoliate the scalp,
encourage circulation, and may be used in the shower with shampoo. It is designed like a
brush or comb. For a mild massage, you can roll or press the Finger Massager's numerous
circular nodes or fingers, against your scalp. It's a compact and portable gadget.
The next electric head massager is for a more intense massage, a vibrating head
massager that uses a rechargeable or battery-powered motor. They help relieve tension
headaches and often have several intensity settings. The rotating head on certain electric
massagers mimics the circular action of a massage therapist's hands, creating a soothing
kneading sensation that helps relax the muscles in the scalp. To increase blood flow and
relax tense muscles, a pulse or percussion massager uses a tapping or percussion motion.
While some types may be multifunctional for use on the body, others are made only for the
head.
Additionally, there are helmet massagers that fit over the head like a helmet and
apply uniform pressure to the entire scalp. To give a thorough massage of the head and
scalp, they frequently mix vibration, heat, and even air compression. Compared to helmet
massagers, portable hat massagers are more compact and lightweight. Hat-style massagers
are designed to be worn like a hat and concentrate on warmth and vibration features.
Compression massagers apply pressure to the scalp and temples using either heat or air
pressure. They can provide feelings akin to a therapeutic head massage and are frequently
used to treat tension headaches.
Thermal head massager with heating. Some scalp massagers incorporate a heating
element that provides warmth to the scalp during use. Heat therapy helps improve blood
circulation and relax muscles, offering additional relief from tension and headaches. Lastly is
the multi-purpose massager with a versatile head attachment that comes with a variety of
attachments, including a device for the head. They often have a variety of massage options
such as percussion and vibration and can be used on different parts of the body.

4.3.1 Example of IoT Head Massager Products

 In this work the author has listed some advantages and disadvantages of each, A
perfect massage anywhere without annoying wires for two hours when fully recharged, it
only focuses on two points on the head, it cannot maintain rpm and some noise knurling is
listening from the device, heavy to use. (Science, n.d.).

Figure 3 is light and portable, easy to use, and can be used for exercise, walking and
simple home. It only takes 15 minutes every day to enjoy a comfortable sleep and adjust the
clock stably. Ergonomic body, curved head, and comfortable to wear. In addition, Sleep
Mode with low-frequency pulses helps relieve tension and stress and helps improve sleep
quality. Migraines help the brain produce endorphins, which relieve headaches and
discomfort. let you enjoy a 15 minute massage and give you a baby. The advantages are
relieving headaches and discomfort and reducing migraines. The downside is the difference
in size and is not safe for children. (Science, n.d.).

Figure 3
Figure 4 shows the head of the acupoint massager electric soul extractor
rechargeable battery. Scalp that is shaped like a massage claw vibration reduces fatigue and
promotes blood circulation of the tool. Onekey adjustment, multi-gear mode, free force,
easy mode change. Smart pseudo frequency vibration, hands free and scalp relaxed.
Furthermore, the advantage of this head massager is pseudo-intelligent frequency vibration,
also hands-free, relaxing the skin and head nerves. The downside is the limited battery
capacity, not suitable for everyone and not being able to be controlled by an external unit.
(Science, n.d.).
 Figure 4
This scalp massager is lightweight and stylish at only 120 grams (4.3 ounces). Receive
a deep, relaxing therapeutic massage and use the Magic 11 Fingers Electric Massager to
relieve stress, anxiety, headaches and migraines. Plus, it's perfect for relaxing at home or at
work. The relief of 11 fingers of a professional massage therapist and vibrations up to
12,000 hertz. Furthermore, the advantage of this product is that it helps relieve pain
including in the head, neck and scalp. It is compact and easy to use. For the weakness, the
massage is only in a limited area and cannot be stretched. Not suitable for children. (Figure
5).

Figure 5
A thorough history and physical examination, focusing on neurological signs and
symptoms, are essential for an accurate headache diagnosis. The history is important
because most patients evaluated for headache have a normal physical examination and
diagnostic tests. The history should consist of a chronological description of the headache
since onset including frequency, duration (usually ≥4 hours for migraine), location (usually
unilateral with migraine. and TAC), and character (usually pulsating in migraine). Migraines
are characterized by nausea, vomiting, photophobia, phonophobia, and osmophobia.
Movement usually makes migraines worse. Migraine attacks during menstruation (either
before or after menstruation) are common among women. TAC is characterized by
unilateral headache with autonomic symptoms and signs (tearing, conjunctival injection,
eyelid ptosis, miosis, nasal congestion).

4.3.2 Aroma Head Massager

The head massager was pre-programmed to run 5 minutes in order to provide the
best massaging experience as well as to avoid overstimulation the neck region. Besides that,
it also can be stopped if the user deemed that the massaging was enough within the 5
minutes. The second stage of the device development involves in studying and selecting
herbs that has aromatic properties and known for its anti-anxiety effects. The herbs that
were used are Country Borage, Edible Camphor, Sweet Basil, Chaste Tree and Indian
Fragrant Rose. Each of the herbs are carefully selected for its natural properties. For
example, the sweet basil in study by (Bina and Rahimi, 2017) is shown to be an excellent
anxiety and stress reducer. These herbs are able to reduce the anxiety levels and boost
hormones such as serotonin, dopamine, endorphin and oxytocin.

The herbs were selected and dried. In order to for the scent to suitable for all user, dried
leaves were used instead of diffusing essential oil as it can be irritating the airways thus
causing allergic reactions. The dried herbs do not contain any addictive that essential oils
may contain to prolong its shelf-life. The dried leaves were packed in a sachet bag and was
placed within the pillow in the Ayur Flex Aroma Head Massager. The diagram below depicts
the work process of selecting the herbs until its end process. The final product was
assembled and developed into a functioning device. The speed and time of the motor
spinning were calibrated to ensure the best experience when the users use the Ayur Flex
Aroma Head Massager. The sealed sachet was placed within the pillow to ensure the users
are able to smell the scent of the herbs.

3.0 TARGET MARKET

According to my research, sedentary folks and office workers are among the groups
of people who use head massagers frequently. Adults between the ages of 25 and 45,
particularly those in high-stress or desk-based occupations. They require quick and
simple equipment, particularly items that they may utilize after work or during breaks.
The reason for this is that they spend a lot of time in front of the computer, which can
lead to shoulder, neck, and head strain. To unwind during or after the workday, a lot of
office workers utilize head massagers. Also, head massages are used to improve
relaxation routines by health and wellness enthusiasts those who invest in health
 activities, such as mindfulness and meditation, and who are concerned about both
internal and exterior health. Consumers of scalp and hair care are mainly women aged
18-40 where they are interested in beauty and personal care. They care about scalp
health, hair growth and skin care. Head massager products that support scalp
circulation, reduce dandruff, and promote healthy hair growth attract their attention to
buy it. They are also often interested in scalp massagers that can be used with shampoos
or treatments.

Those who suffer from stress or worry are the ones who purchase it most frequently.
The one who experience high levels of stress or anxiety frequently search for ways to.
People aged 25-65, especially those with high-stress lifestyles or chronic conditions
unwind. A head massager can make you feel more relaxed, less stressed, and happier.
Individuals who suffer from sleep problems are also observed to use head massagers a
lot. People who struggle with insomnia or have difficulty relaxing before bed can use a
head massage as part of their relaxation routine to induce sleep. Elderly individuals
which is older adults sometimes use scalp massagers to manage tension, relieve pain
and increase scalp circulation, as the sensation can be gentle and non-invasive.
Meanwhile, massage and therapy enthusiasts such as individuals who enjoy massage or
regular customers of massage therapy can purchase a scalp massager to recreate the
sensation of a professional scalp massage at home. Adults aged 18-50, generally health
conscious and interested in holistic health and stress management such as engaging in
Yoga, meditation, aromatherapy and other self-care routines.

The target market also includes gift shoppers, who are often in the 25–50 age range
and seek out clever and distinctive presents. Award-winning personal care products that
are connected to health and technological devices. This head massager is a wonderful
present for friends, family, and coworkers because it is stylish, well-made, and simple to
use. Then, sports and fitness enthusiasts which is adults aged 18-50 who regularly do
physical activities such as weight lifting, running or sports. They use a lot of recovery
tools that can help relieve post-workout tension and increase flexibility. As such, a
portable and durable massager that aids recovery after exercise, helps release tension in
the head, neck and shoulders. The mental health support market is adults aged 18-50
who may be experiencing stress, anxiety or mental health challenges. They need
products that help with relaxation, mindfulness and reduce tension as part of a mental
health routine. Besides, head massager as an alternative medicine and holistic health
practitioner. It includes adults of all ages who are interested in natural healing,
acupuncture and alternative therapies. A non-invasive head massager that can be used
for natural pain management, energy stimulation and increased relaxation.
4.0 CREATING AN ELECTRONIC HEAD MASSAGER PRODUCTS
 From basic conception to final production, there are multiple phases involved in
making an electric head massager. Finding the target audience through concept
development and market research comes first. To learn about the demands of future
users, conduct market research. This can include personal choices for elements like heat
therapy, size, comfort, and the type of massage (vibration, kneading, or tapping). After
that, examine the competition by looking at current head massagers to see what works
and what needs to be improved. Identify key elements of the device, such as battery life,
massage mode, vibration strength, and thermal function. Take into account additional
variables including simplicity of use, noise level, and ergonomic design.

Product Design and Engineering is producing a 3D model of the head massager using
CAD software. Put an emphasis on ergonomic design to accommodate a range of head
sizes and shapes. Electronic components such as control circuits, motor types,
rechargeable batteries, and heat-generating devices (if included) are developed by
electrical engineering. The next stage is prototype development, which involves building
prototypes with breadboards for the electronic components and 3D printing for the
physical elements. This makes testing and modifications possible. Create firmware and
app capabilities to change settings if the device supports Bluetooth/Wi-Fi connectivity or
numerous modes. Choose materials and components plastic and silicone is the next
step. Use skin-safe, durable plastic for the housing and silicone for the massage nodes to
provide comfort and ensure longevity. Choose a low-noise, high-torque motor and a
high-capacity rechargeable lithium-ion battery for optimal performance and long battery
life. For circuit components, buy microcontrollers, resistors, capacitors and transistors as
needed. For the heat function, choose a safe heating element with adjustable
temperature control.

Verify the prototype's comfort, massage efficacy, heat level, vibration intensity, and
noise level through testing. After that, hold focus groups or user trials to get input on
usability, comfort, and functionality. Modify the massage node position, motor speed,
and general ergonomics as needed in light of test findings. Electronic components are
mass produced using a manufacturing technique that uses injection molding for plastic
components. Establish an assembly procedure to ensure effective production. The
motor, wiring, control board, battery, and outer housing must all be installed. In the
meanwhile, test functioning, durability, and safety standards by conducting quality
control inspections. Every gadget needs to be inspected for problems like loose
connections, broken motors, or overheating. Ensure compliance with regional safety
standards, such as CE for Europe, FCC for the United States and RoHS to restrict
hazardous substances and test materials for hypoallergenic properties and skin safety
certification. Finally, is environmentally friendly designed packaging, durable packaging
that protects the device during shipping.

4.1 Effectiveness of Head Massager Products

 Head massage products are generally considered good because of their effectiveness
in providing relaxation, relieving tension and promoting scalp health. Improvement in
Scalp Circulation head massagers are designed to stimulate scalp circulation through
their kneading and tapping functions. This increased blood flow to the scalp can improve
hair and scalp health by delivering more nutrients and oxygen to hair follicles, which
may be beneficial for hair growth over time. Next, convenience and customization head
massagers are usually easy to use and often include a remote control or app integration,
allowing users to customize their massage settings based on personal preferences.
Adjustable intensity and pressure settings make it accessible to different users, from
those who prefer gentle pressure to those who want a stronger massage. Portability and
ease of use make the head massager easy to use at home, in the office, or while
traveling.

This product's efficacy makes it possible to relax and relieve tension more effectively.
To promote relaxation, certain head massagers combine heat therapy with intensity
levels that may be adjusted. Similar to a professional head massage, the warmth and
massaging pressure assist calm the scalp and neck, lower stress levels, and produce a
calming effect. The calming impact, which provides instantaneous and noticeable
relaxation, can be a beneficial addition to a self-care regimen for people who are
struggling with anxiety or excessive levels of stress. It leaves a positive impression with
its user-focused features. Numerous items are made with comfort and ergonomics in
mind, guaranteeing that they fit snugly around the head without being uncomfortable to
use. Rechargeable or battery-operated models offer more versatility and make
integrating massagers into daily schedules simple. The latter's effectiveness involves
quality and durability. Head massage products are known for their high build quality,
durability and advanced technology, ensuring a long-lasting product that works
effectively over time. Many consumers find electronic products worth the investment
because of their durability and advanced features. Some of the famous head massagers
in Malaysia are Ogawa, Gintell, Snowfit, 8D Zero and Amway. This is the best and most
effective product for users in the market.
Across-sectional study was conducted in a tertiary institution, the University Malaya
Medical Centre, from February 2012 until September 2012. The study was approved by
the Institutional Ethics Committee of University Malaya Medical Centre. Cases consisted
of subjects, aged 18 years, with headache at least once per month for more than three
months attending the specialist neurology outpatient clinic. Patients with headache
secondary to intracranial mass lesions and secondary headache were excluded. Patients
with headache on aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), a
known history of gastroesophageal reflux or peptic ulcer disease were also excluded.
During the study period, 93 subjects with headache and 187 control subjects were
recruited at the specialist neurology clinic of Universiti Malaya Medical Center. Table 1
highlights demographic and clinical comparisons between subjects with headaches
(cases) and those without headaches (controls). Patients with headache and controls
were matched for eating (45.0 17.3 years of headache vs 42.1 15.4 years of controls, p =
0.15), gender (57% of headache women vs 66.3% of control women, p = 0.15) and
ethnicity (Table 1). There were more smokers among cases (10.8% vs 7.0%) and a
greater amount of alcohol consumption among controls (2.7% vs 0%) (Table 1).
Headache cases also have more comorbidities in terms of cardiovascular (22.6% vs
11.2%) and metabolic (17.2% vs 11.2%) diseases.
The headache characteristics of the study subjects are shown in Table 2. Most
patients experience headaches at any time of the day. About one-third of patients
experience headaches for 15 days in a month. In terms of headache lateralization, most
patients complain of unilateral and intermittent headaches. The most frequently
affected area is the temporal area and about half experience throbbing headaches.
Headache subtypes were as follows: tension-type headache (TTH) n = 53 (57.0%) and
migraine n = 40 (43.0%). Among migraine subtypes, 26 (65.0%) patients had migraine
without aura and 26 (65.0%) had migraine without aura. The TTH subtype group had the
following characteristics: frequent TTH n = 31 (58.5%), rare TTH n = 6 (11.3%) and
chronic TTH n = 16 (30.2%). The mean visual analogue scale (VAS) score for headache
was 54.4 24.2 mm. The VAS for headache intensity was used for current headache
symptoms. More than half of the patients took paracetamol for headache, but a large
number of patients (37.6%) also used traditional medicinal oils for analgesia.
Dyspepsia was more prevalent in subjects with headache compared to non-
headache controls (25.8% vs 12.8%, p = 0.011). However, dyspepsia prevalence did not
differ among the major headache types (27.5% migraine vs 24.5% TTH, p = 0.81). Six
patients who had migraine with aura and five patients who had migraine without aura
complained of dyspepsia. (p = 0.15) There were no statistically significant differences
between various types of headache and dyspepsia (p = 0.84). Similarly, dyspepsia sub-
types (according to the Rome II criteria) were not different between headache
categories as follows: ulcer-like (18.2% migraine vs 23.1% TTH), motility-like (36.4%
migraine vs 46.1% TTH) and reflux-like (45.4% migraine vs 30.8% TTH). The association of
dyspepsia with headache was explored further in a multivariate regression model with
various recognised variables (Table 3). Predictive factors for dyspepsia in our subjects
were found to include headache (OR 2.75) and anxiety (OR 3.52) only, indicating a strong
link between headache and dyspepsia.