JP2007522838A - Rehabilitation of fine motor control - Google Patents

Abstract

  An elongated object adapted to be held in the hand, handled with a finger and used in a task, and adapted to exert a force on the object that is coupled to the object and at least sufficient to move the object A rehabilitation device comprising:

Description

Related applications

  This application is based on U.S. provisional application 119 (e) based on US provisional application filed February 5, 2004, application number 60 / 542,022, and US provisional application filed April 29, 2004, application number 60 / 566,079. The disclosures of both applications are incorporated herein by reference. In addition, this application was filed by the same applicant on the same day as this application, and “Gait Rehabilitation Methods and Apparatuses”, “Rehabilitation with Music”, “Neuromuscular Stimulation”. (Neuromuscular stimulation), "Methods and Apparatuses for Rehabilitation Exercise and Training", "Methods and Apparatus for Rehabilitation and Training" , Entitled "Methods and Apparatus for Rehabilitation and Training", "Methods and Apparatus for Rehabilitation and Training" Relevant for PCT applications with reference numbers 414/04391, 414/04396, 414/04400, 414/04388, 414/04213, 414/04404, and 414/04405, respectively. The disclosures of all these applications are incorporated herein by reference.

  The present invention relates to a method and apparatus for rehabilitation, behavior support, and exercise, for example, rehabilitation, evaluation, support, and exercise for eating and writing.

  Seizures, accidents, and other medical conditions can deprive a person of the ability to control fine-motion movements, which are necessary, for example, to write things by hand and to eat with a fork or spoon It is what is done. During the long rehabilitation process, the patient is again taught to control the limbs.

  Many rehabilitation methods have been developed, but for a variety of reasons, patients do not follow the method and / or cannot restore a reasonable level of control for other reasons.

  A broad aspect of some embodiments of the invention relates to rehabilitation of fine motion control, for example, using a finger-treated object. In an exemplary embodiment of the invention, the position and / or direction and / or force with respect to the object is recorded and / or set in the controller. Optionally, the object is used in a setting corresponding to the real world. Optionally, the movement of one or more gross movements of the patient is restricted or rehabilitated simultaneously with fine movement control.

  A broad aspect of some embodiments of the present invention relates to rehabilitation that provides simultaneous coarse and fine rehabilitation using a single integrated device. Optionally, the device provides position feedback or position control to the controller and / or patient.

  One aspect of some embodiments of the present invention relates to a fine movement control rehabilitation device, for example, while the rehabilitation device applies force to a patient's hand (or other source of fine movement control). A pen used to mimic and / or as part of a real-world action, such as a writing action. Optionally, the applied force can be applied to guide the pen in a desired manner or to constrain its movement. Optionally, the device can be repositioned to correspond to a real-world action location, such as a table. Optionally, the coarse movement of the patient's limb is suppressed, controlled and / or monitored by suitable means attached to the user's arm.

  One aspect of some embodiments of the invention relates to using a system for behavior support. For example, the system is selectively used to help people write. In such an embodiment, a person can write letters and words in response to writing cues supplied on a writing surface.

  Optionally, the system is used to evaluate the person's condition while the person is about to perform a predetermined action. For example, if a person performs an eating operation while using the system, defects in the operation are recorded and / or analyzed. Defects are analyzed and targeted for exercise and / or rehabilitation based on direct observations of medical professionals who are the attending physicians and / or observations detected through the system.

  In an exemplary embodiment of the invention, such a pen (or other rehabilitation device) is movable in several degrees of freedom, such as direction and planar position. Optionally, movement along the pen axis is supported as well. In some cases, for example, the operation is intentionally limited to the type of operation required for the rehabilitation work.

  Optionally, the rehabilitation system can set or constrain the movement of the pen. Alternatively or additionally, such movement is measured or supported by a rehabilitation system. Optionally, the pen is equipped with one or more pressure sensors to determine the particular grip of the pen. Optionally, the pen includes one or more feedback points, for example it is a small vibrator that can provide feedback to the user in a rehabilitation system.

  In an exemplary embodiment of the invention, the pen moves on a table plane. Optionally, the pen is attached to a table, for example, held from directly under the table. Alternatively, the pen is held from the top against the table. Optionally, the pen is incorporated into a positioning system that can be moved and attached to various positions relative to a particular table or other tables.

  In an exemplary embodiment of the invention, the table is a means for sensing pen usage, such as a pressure sensor, a tablet computer, or other pen detection means known in the art, such as a position sensor and a direction sensor. , Including. Optionally, one or more images are projected onto the table, for example from below (eg a transparent table) or from above, and displayed using the table as an active display.

  In an exemplary embodiment of the invention, the pen is mounted on a ball joint that allows spherical movement of the pen. Optionally, the pen has an axial linear joint for moving radially. Optionally, the ball joint is provided on an XY table.

  One aspect of some embodiments of the invention relates to a system for rehabilitation of eating behavior. Optionally, the rehabilitation system includes fine motor control rehabilitation, which involves handling the utensil successfully, and coarse motion control rehabilitation, which involves moving the tool (eg, from dish to mouth). including. Optionally, mouth rehabilitation and / or mouth-hand coordination rehabilitation is also provided. In an exemplary embodiment of the invention, the system can hold the eating utensil in the air and move the path from the food container to the user's mouth. Optionally, the rehabilitation system or user can move the food container to achieve various rehabilitation situations during the session.

  Optionally, the rehabilitation system can automatically feed the user and / or complete an unfinished user action. In an exemplary embodiment of the invention, the patient is rehabilitated during daily activities such as eating. Optionally, the rehabilitation system can detect the condition of the mouth, for example whether it is open or closed. Optionally, the rehabilitation system can detect food drops, for example from tools or from the mouth. Optionally, the system comprises a camera and appropriate image processing to detect food fall and / or various motion elements.

  In an exemplary embodiment of the invention, a rehabilitation system is provided that assists in other tasks with fine movement, such as sorting and assembly. Optionally, in such applications, the device is held on the patient's own finger, for example using a short rubber sleeve or ring that fits the finger.

  One aspect of the present invention relates to allowing a patient who has lost finger control to learn fine motor control. An instrument, such as a pen, can be attached to the end of the patient's forearm and can be taught to the patient to write using the system described herein.

  In an exemplary embodiment of the invention, a patient using an artificial limb is taught fine motor control over the entire limb to perform actions such as eating and writing.

  In an exemplary embodiment of the invention, the system is adapted to be portable. Optionally, communication between the various components of the system is performed wirelessly. Optionally, the system is powered by a battery.

  One aspect of the present invention relates to analyzing a patient's behavior while using the system against the patient's emotional state. Optionally, handwriting actions performed while using the system are analyzed to determine the patient's emotional state. The patient is selectively trained, rehabilitated and / or assisted based on their emotional state. For example, the system can provide healing music to the patient or simplify the operating routine based on the sensed emotional state.

Thus, according to an exemplary embodiment of the present invention, an apparatus for rehabilitation comprising:
Tools adapted for hand-held, handled with fingers and used for real-world work;
And a fine motion mechanism coupled to the tool and adapted to apply force to the tool sufficiently to move the tool.

Also, according to an exemplary embodiment of the present invention, an apparatus for rehabilitation comprising:
Tools,
A fine motion mechanism adapted to move the tool with at least 3 degrees of freedom; and
There is provided an apparatus comprising a coarse operating mechanism having at least two degrees of freedom and adapted to operate the fine operating mechanism.

According to an exemplary embodiment of the present invention, a pen rehabilitation device comprising:
Surface,
A pen extending from the surface; and
An apparatus is provided that includes an operating mechanism adapted to change the orientation of the pen below the surface.

Thus, according to an exemplary embodiment of the present invention, an apparatus for rehabilitation comprising:
Objects that are adapted to be held by a person and handled with a finger to perform tasks; and
And a fine motion mechanism coupled to the object and adapted to apply sufficient force to move the object. Optionally, the weight of the device is less than 30 kg.

  In an exemplary embodiment of the invention, the object is adapted to move along a predetermined surface.

  In an exemplary embodiment of the invention, the operating range of the mechanism is less than 20 cm.

  In an exemplary embodiment of the invention, the apparatus includes a controller that analyzes the motion of the object to determine at least one characteristic of the person.

  In an exemplary embodiment of the invention, the controller analyzes the force applied to the object to determine at least one characteristic of the person.

  In an exemplary embodiment of the invention, the characteristic includes a human emotional state.

  In an exemplary embodiment of the invention, the controller stores an operation pattern therein. Optionally, the pattern includes a pattern of actions to write.

  In an exemplary embodiment of the invention, the fine motion mechanism resists movement of the object by a person.

  In an exemplary embodiment of the invention, the fine motion mechanism applies a resistance to the movement of the object.

  In an exemplary embodiment of the invention, the fine motion mechanism assists the movement of the object.

  In an exemplary embodiment of the invention, the object comprises at least one feedback source that provides a stimulus to the user of the device.

  In an exemplary embodiment of the invention, the device further comprises at least one sensor for tracking the movement of the object.

  In an exemplary embodiment of the invention, the device further comprises at least one sensor for tracking the force applied to the object.

  In an exemplary embodiment of the invention, a mechanism blunts the movement of the object.

  In an exemplary embodiment of the invention, the apparatus further comprises a coarse operating mechanism adapted to move the fine operating mechanism with at least two degrees of freedom. Optionally, the coarse motion mechanism is adapted to move the object from the table to the patient's mouth. Optionally, the object includes chopsticks.

  In an exemplary embodiment of the invention, the device further includes a separate coarse motion mechanism adapted to be attached to a person with the finger, the motion coordinating with the motion of the object.

  In an exemplary embodiment of the invention, the device further includes a surface that is touched by the object, which surface also functions as a display. Optionally, the surface comprises a tablet computer.

An exemplary embodiment of the present invention is an apparatus for rehabilitating a motion control function related to writing,
Surface,
A stylus extending upward from the surface; and
And an operating mechanism adapted to change the orientation of the pen relative to the surface and disposed below the surface. Optionally, the operating mechanism is adapted to move the stylus over the surface. Alternatively or additionally, the operating mechanism is adapted to be moved by a person holding a stylus.

  In an exemplary embodiment of the invention, the device is adapted to measure the force applied to the stylus.

  In an exemplary embodiment of the invention, the device includes a controller having stored therein at least one operational pattern. Optionally, the controller controls the operating mechanism according to the pattern. Alternatively or additionally, the controller measures a patient's psychological state in response to operation of the operating mechanism.

In an exemplary embodiment of the present invention, a rehabilitation method for fine motion control,
Providing an object to be handled with the patient's finger; and
Controlling an actuator coupled to the object to provide assistance for movement of the object, wherein the actuator is limited to less than 30 cm and has a freedom of movement of at least 3 A method of providing a range of movement for the object is provided. Optionally, the supported action includes a writing action. Alternatively or additionally, the assisted operation includes an eating operation.

Also, in an exemplary embodiment of the present invention, a method for assisting a person in daily work involving control of arm and finger movements, comprising:
Determining at least one characteristic of the operation; and
Using a robot actuator to assist in arm and / or finger movement is provided. Optionally, the method includes assisting only if the task cannot be completed. Alternatively or additionally, the method includes assisting as a safety measure. Alternatively or additionally, the method includes periodically assisting as part of the rehabilitation process.

  Non-limiting embodiments of the present invention will be described with reference to the following description of exemplary embodiments in conjunction with the drawings. The drawings are generally not drawn to scale and any size is only intended to be exemplary and is not necessarily limited. In the drawings, identical structures, elements or portions that appear in more than one drawing are preferably numbered the same or similar in all the drawings in which they appear.

  FIG. 1 is a schematic block diagram of a fine motion control rehabilitation system 100 in an exemplary embodiment of the invention. The system 100 is also selectively used for action support, exercise, and evaluation.

  The patient 128 to be rehabilitated holds the tool 101, for example a pen or fork. The rehabilitation behavior generally includes a fine motion movement of the tool 101 associated with a reference 103 (eg, a table) and one or more targets 105 (eg, a table, a dish, a mouth) that serve as the reference 103. A support structure 107 is optionally provided so that the system 100 can move the tool 101 or resist the movement. The rehabilitation process is managed by the controller 102 according to the situation, and the controller 102 receives inputs from various sensors and / or generates motion commands. In a particular class of rehabilitation, the system 100 allows the device 101 to move only within a predetermined range of position and / or orientation. Beyond these ranges, it can be detected by a sensor, for example, increasing resistance to movement or generating audio or visual feedback.

  A micromotion mechanism 110 is provided for micromotion rehabilitation, for example, moving the tool 101, applying force thereto, and / or measuring the force applied thereto. More complex controls can be applied in the same way, for example, sensing motion can be included in assisting the motion of the patient 128, and then a force is applied in the direction of the motion.

  A coarse motion mechanism 108 is provided for combined fine and coarse motion rehabilitation, which enables / supports / detects the coarse motion of the device.

  Optionally, one or more target sensors 106 are provided, which may include target status (eg mouth open, pressure level from the tool) and / or tool proximity to the target (eg absolute or relative). A signal indicating (using the correct measured value).

  Optionally, one or more fumble sensors 104 are provided that generate a signal indicating that the device 101 could not be used correctly. In one example, a camera detects food falling from a fork. In another example, the camera detects ink stains caused by using the pen incorrectly.

  Optionally, one or more grip sensors 112 are provided that generate signals relating to the quality or other characteristics of the patient 128 holding the device 101. In one example, a pen includes a pressure sensor that is a point along the pen where pressure is being applied by hand and / or indicates the pressure level.

  Optionally, the work is constructed using a display provided to a user using display 114. In one example, an image is projected onto reference 103 (and optionally the image serves as a target). In another example, one or more targets are display objects.

  Optionally, one or more tool sensors 116 are provided to generate feedback regarding the position and / or orientation of the tool. In some cases, such as in a pen, the fine motion mechanism does not need to control all the degrees of freedom, and the tool sensor 116 provides data regarding one or more additional degrees of freedom.

  Optionally, one or more feedback providing means 118 are provided on the device 101. In one example, the device 101 includes a vibration or force application element to suggest feedback to the patient 128 for correct and / or incorrect movement.

  In an exemplary embodiment of the invention, the system 100 focuses on the control and detection of the tool 101. In other embodiments, additional reference points in the patient are controlled and / or measured. In one example, a mechanism (eg, another limb control unit 120) that fixes and operates the elbow is used to monitor and / or control hand movements while providing rehabilitation of eating behavior. To do.

  In an exemplary embodiment of the invention, tool 101 is attached to system 100 such that it cannot be removed. However, optionally, the system 100 includes means for quickly installing and removing the tool 101. In one example, the means includes a rubber film pincer. In another example, the means includes a hollow tube that conforms to the hand-held portion of the tool. In another example, a bayonet connection is used to quickly change tools. In another example, a ring or sleeve attached to the finger is used to control the patient's finger like a tool.

  Optionally, the controller 102 is designed for interaction with a user (eg, patient 128 or physical therapist) using, for example, the user input device 122 and / or the display 126. Optionally, link 124 is provided to a remotely located computer, rehabilitation device, database, and / or physical therapist. The controller 102 optionally includes storage for storing results and / or a program for one or more patients.

  Of course, the rehabilitation system in an exemplary embodiment of the present invention need not include all elements shown in the drawings. In particular, it should be noted that rehabilitation can be applied to a wide range of actions. As an example, for writing operations, most (or even all) of the tip movement of the pen is made in a single plane, and rotation about the pen axis is usually ignored. In another example, the eating motion requires both fine and coarse motion control, and fine motion control is required over the full range of spatial locations (typically at least dishes and Mouth area).

In an exemplary embodiment of the invention, system 100 is used to control the movement of patient 128 as part of the rehabilitation process. Since system 100 includes both sensors and actuators, a variety of operating options can be provided. For example, one or more of the operation control options described below can be provided.
(a) The system 100 can prevent unnecessary operations.
(b) The system 100 can increase the patient's freedom to achieve motion as the rehabilitation process progresses.
(c) The user can set a free level. For example, the level of freedom can be one of “automatic motion”, “automatic motion initiated by the user”, “resistance to user motion”, “free motion”.
(d) The safety and effectiveness of operation is, for example, that it will not operate unless the patient is holding the device correctly (or at all).

  In some embodiments of the invention, the system assists the patient in writing. Optionally, the system uses patient cues to assist the patient in action. Optionally, the system has a handwritten optical character reader (OCR) function.

  In an exemplary embodiment of the invention, the system analyzes patient behavior while using the system against the patient's emotional state. Through the use of sensors such as grip sensors, motion sensors, and position sensors, the system can determine the patient's emotions that differ essentially as frustration and relaxation depending on the situation. Optionally, handwriting actions made during use of the system are analyzed to determine a patient's emotional state. The patient is selectively trained, rehabilitated and / or assisted based on the detected emotional state. For example, the system can provide healing music to the patient, or can simplify or complicate the operating routine based on the sensed emotional state.

  Of course, based on the description herein, the system is optionally used for patient assessment, rehabilitation, behavioral support, and / or exercise. Actions optionally include eating, writing, and / or other actions that require fine motor control. In some embodiments of the present invention, a rehabilitation device such as a pen is attached to the end of the patient's forearm to teach fine motor control (eg, for a patient who has lost the ability to control a finger). . Optionally, patients with artificial limbs are taught fine motion control using the system. Additional possibilities (but not limited) are described below.

(Typical embodiment)
FIG. 2 is a perspective view of a portable pen-type rehabilitation system 200 according to an exemplary embodiment of the present invention. Although the system 200 can be integrally attached to the table 202 in an exemplary embodiment of the invention, the coupling 204 is used to selectively attach the system 200 to the table 202. Optionally, this may include mounting the system 200 on the location where the patient is used to perform the action and / or the location where the patient desires to perform the action, eg, on a favorite desk or replica thereof. enable. Optionally, communication between the various elements of the system is performed wirelessly. Optionally, the system is powered by a battery. In an exemplary embodiment of the invention, the system 200 is extendable that can be used to position the system 200 such that the action area (eg, where the rehabilitation action is performed) is in a convenient position. The arm 206 is provided. Thereafter, the arm 206 is selectively locked. In other embodiments of the present invention, the arm 206 can apply motion, position sensing, and / or force in any desired manner.

  At the end of the arm 206 is optionally supporting a pen operating mechanism 208 for operating the pen 210, for applying a force to the pen 210, and / or for measuring the operation of the pen 210. . The mechanism 208 is shown in more detail in FIG. A writing target 212 is also shown for use with the pen 210. The optional sensor 214 can be used, for example, to measure the relative position of the pen 210, the movement of the pen 210, and / or to image the rehabilitation action area.

  Of course, not all of the elements of FIG. 1 are required or provided. Optionally, additional elements that are beneficial to rehabilitation, support, and / or exercise, such as cameras, projectors, and other elements described herein and / or known in the art, Is provided.

(Writing surface)
The writing target 212 has various types. In an exemplary embodiment of the invention, target 212 is a simple piece of paper. This has potential benefits in terms of cost, convenience, and naturalness. Optionally, a pattern, such as a geometric pattern or written pattern, is provided on the paper and the patient follows it. Optionally, the system 200 forces (or prompts) the patient 128 to follow its pattern. Alternatively, the system monitors free attempts to follow the pattern. Alternatively, the patient is forced or prompted to follow an invisible pattern, or attempts to follow such a pattern (eg, a verbal pattern).

  Optionally, the source of the image in mechanism 208 is provided to project the image onto the sheet, for example, projection from under the table or projection from pen motion mechanism 208.

  Optionally, pen 210 can elute ink. Alternatively, the pen 210 is inert. In some embodiments of the invention, an erasable laminate sheet is used. In some embodiments of the invention, the writing operation is performed in the air and not on the surface. Optionally, a hand rest is provided to make the work more realistic, for example, the hand rest extends downward from the pen operating mechanism 208.

  In alternative embodiments of the present invention, tablet devices such as those known for tablet PCs, PDAs, and stand-alone tablets are used. Many types of pen sensing mechanisms are known and can sense, for example, position, pressure, contact, and / or hand pressure on a writing target.

  Optionally, the writing target includes a display for providing work, feedback and / or instructions. A selective advantage of using the writing target as a display is that because the patient 128 is careful, it is usually already paying attention to the surface. Optionally, such a tablet device serves as the controller 102, optionally using a wireless connection.

  Optionally, the writing target records what was actually written by the patient 128. If the movement of the patient's hand is limited, the writing target can compensate for this effect in real time so that the patient 128 can selectively see the results of the effort at work.

  Optionally, the writing target (or other part of system 200, such as mechanism 208) includes a position and / or orientation sensing mechanism. For example, optical, image-based, ultrasonic, and high-frequency sensing techniques are known in the art. Optionally, not only the position of the pen tip is detected, but also the direction in space is detected, for example, using a direction sensor or by detecting the position of the other end of the pen. Optionally, when one end is detected by the tablet-like mechanism, the other end is detected from the setting of the mechanism 208. In some embodiments of the invention, the writing target moves. Optionally, it can be moved by placing the writing target on the XY motion table or by integrating the writing target and the XY motion table.

  In an exemplary embodiment of the invention, the tablet displays a shape and a person is required to track the shape. The mechanism then measures the person's ability. The tablet communicates the correct action to the robot, and the mechanism can nudge, move, or resist the patient's action to help ensure that the correct action is achieved.

(pen)
Various types of pens can be used, for example, a simple pen, pencil, or marker that is held by mechanism 208. Alternatively, other instruments that can be held in the hand, such as chopsticks, can be used for the pen position. When using a tablet mechanism, an appropriate pen is selectively used. Optionally, the pen includes a sensor for detecting contact pressure. Alternatively or additionally, the pen includes a grip sensor, for example, it can be arranged on the pen or on a special contact point (eg between three fingers and between the thumb and forefinger) with the pressure sensor aligned. Is deployed in the area). Optionally, the sensor is provided in a sleeve that can be mounted on an existing pen (or other device). Optionally, the pen is designed for a particular patient, for example, a patient who needs compensation for hand deformities or limited ability to control the hand. Optionally, the pen is replaced or modified as the rehabilitation progresses over time. Optionally, the pen includes one or more straps or straps for attaching the pen to the patient's 128 hand (or artificial prosthesis).

  In an exemplary embodiment of the invention, sensor readings recorded during rehabilitation, behavioral support, and / or exercise may include hard copies of results, plans, progress reports, and / or other data, for example. Stored, logged, and / or analyzed.

(Pen movement mechanism)
Various types of mechanisms are used to operate the pen 210. For example, one of the mechanisms described in US Provisional Patent Application 60 / 542,022, whose disclosure is incorporated herein by reference, can be used. Alternatively, the robot arm can be used (selectively upside down).

Depending on the rehabilitation procedure desired, the requirements from mechanism 208 will vary. The requirements include, for example, a sufficiently short response time, ability to apply force (and level), spatial stability, accuracy, and / or accuracy. For example, one or more of the rehabilitation related actions described below are provided by mechanism 208.
(a) Move the hand in the desired way as part of the complex motion or all of the complex motion (eg, to compensate for non-reactive hands or non-reactive sites only). Optionally, the system operates and otherwise activates the device when a hand is detected there or in response to other commands.
(b) To move the tool in the opposite direction to the resistance from the patient. The reverse is also true: the patient moves the device against the resistance of the system.
(c) Move your hand little by little in the desired direction, and if it is considered necessary, it is a signal that a change in motion is required. As mentioned above, a vibration source or other feedback mechanism can be provided on the pen itself. The vibration source may be a point source, and becomes active when the hand touches the pen contact point, for example. Alternatively or additionally, the entire pen vibrates to indicate, for example, that the operation is incorrect or that the operation is complete and a new operation is expected.
(d) Tracking actions and / or forces, for example, for diagnosis or to determine what the patient is doing for what is expected or required. Optionally, when correct behavior is detected.
(e) Support patients. As an aid, the pen movement mechanism can move the hand in a desired direction.
(f) Attenuation. The pen 210 can function to damp vibrations of the patient's hand, for example, by actively applying resistance.
(g) Be able to integrate with real-world actions, such as writing a letter in the way that patient 128 used to do. Optionally, detecting characters and shapes and preventing movements out of shape can be used to learn handwriting actions even for people without handicap. However, the system 200 is advantageously used to prevent children with handicaps from falling behind in studying.
(h) Correct wrong hand movement, for example after a delay, for example by retracting the wrong movement or by returning the tool to various points on the correct trajectory.

  FIG. 3 is an enlarged view of mechanism 208 and pen 210 in an exemplary embodiment of the invention. This operating mechanism includes three functional units, which are a pen holder 306, a rotary joint 304, and an XY table 302. Other design and / or rehabilitation processes can be provided as well, for example, as described in the above-referenced US provisional application.

  Optionally, a camera 344 is provided to monitor user activity. Optionally, multiple cameras are used to monitor user activity. Multiple cameras are used to overcome field obstructions, for example, by hands and / or other parts of the body. Optionally, a plurality of cameras are used to construct a three-dimensional image. In some embodiments of the invention, the image captured by camera 344 is used for subsequent analysis. Alternatively or additionally, the camera is used to track and record pen movements instead of or in addition to other sensors. In other examples, the camera 344 is used to track and record the position of the pen relative to the “dumb” writing target 212 or to calibrate their relative position. Various suitable image processing techniques are known in the art. Optionally, the hand, pen, pen holder, and / or writing target are marked for easy and automatic identification. In some embodiments of the invention, the progress of rehabilitation and / or exercise and / or behavior support is monitored remotely with at least one camera.

(Pen and pen holder)
In an exemplary embodiment of the invention, a simple pen holder 306 is provided, for example it is a hollow tube with a narrow rubber insert inside. Optionally, special pens with various interfaces (eg, sensors) are used and these interfaces are electrically supported by the pen holder 306.

  Optionally, the holder 306 is a spring loaded to maintain the tip of the pen 210 in contact with the writing target 212. Optionally, the holder 306 includes a sensor that detects pen contact pressure, for example to track and record pen lift and press by the patient 128. It should be noted that this pressure can be measured as a change based on the pressure caused by the spring. In general, the spring pressure is not constant but can vary and / or be calculated in a known manner and / or can be calibrated against a slowly varying value or a slowly varying value Can be treated as In other embodiments, the pen is attached to the surface using, for example, magnetic force.

  Optionally, the holder 306 includes a linear actuator that moves the pen 210 toward and / or away from the writing target 212. Many suitable linear actuators are known in the art and may be used.

  As described above, the pen 210 optionally includes one or more vibration sources 342 that can be localized (vibrating only the pen or part of the hand holding the pen) or global (pen Vibrate the whole).

  As described above, the pen 210 includes a pressure sensor for measuring the shape and / or pressure of the grip, for example, one or more sensors 340 arranged in a straight line.

(Rotating joint)
In an exemplary embodiment of the invention, the orientation of the pen 210 is achieved using a joint that can rotate in the air without selectively twisting about the pen axis. Optionally, a twist is provided by the pen holder 306, for example, the twist is a free twist, a controlled twist (eg, using the motor of the holder 306), and / or a measurement of twist.

  In an exemplary embodiment of the invention, the joint includes a ball 346 mounted on a ring 348 from which a pen holder 306 extends. A short nub (but hidden) extends from the ball 346 and optionally extends in the opposite direction of the holder 306. The nub rides on two slit arc members 332 and 334, which are selectively substantially orthogonal to each other. The pair of motors 324 and 326 are coupled to the arc member by coupling portions 328 and 330, respectively. For example, the coupling is coupling by a worm gear.

  As will be described later, the ring 348 is provided on the XY table 302 by using, for example, a support member (brace) 336 and a finger member 322 that are coupled to an operation mechanism of the XY table 302.

  Motors 324 and 326 may include an encoder or another encoder, or other position sensors may be provided (not shown).

  In setting the pen direction, the controller 102 determines the desired angle setting for the ball 346. Motors 324 and 326 rotate arc members 332 and 334, which cause ball 346 to rotate relative to ring 348 by engaging a short nub at the intersection of those grooves (ring 348 cannot rotate).

  Optionally, the ball 346 is balanced, for example, a short nub is weighted to act against the torque produced by the pen 210 and holder 306 or by an appropriate weight inside the ball 346. .

  Optionally, when a non-resistive state is desired (eg, while monitoring), motors 324 and 326 are neutral or possibly positive so that the user of pen 210 feels little or no resistance. Add feedback.

  Instead of the mechanism described above, a universal joint can be provided.

(XY table)
As described above, the joint 304 is selectively provided in the XY table 302. In an exemplary embodiment of the invention, the XY table 302 includes two orthogonal groove members 318 and 320 that are operated by a set of motors 310 and 312 and optionally a set of belts 314. And 316 are coupled to motors 310 and 312. In the exemplary embodiment of the present invention, the finger member 322 is inserted into the intersection of the grooves of the groove members 318 and 320.

  Other XY table designs are known and may be used in the art.

  It should be noted that in this described embodiment of the present invention, many “normal” pen movements will require a coupling between the movement of the ball joint 304 and the movement of the XY table 302. It is. In an exemplary embodiment of the invention, such coupling and coordinated operation between individual operating elements is provided by the controller 102.

(Calibration and programming)
In an exemplary embodiment of the invention, the system 200 is calibrated to determine the writing target, for example, the relative position of the pen 210 and the resting position. In an exemplary embodiment of the invention, an image of the writing target and pen is obtained when the pen is placed in the rest position. Optionally, the writing target is a display-style writing target, which can correct its position based on calibration.

  Optionally, system 200 is programmed using, for example, input device 122 and display 126. Optionally, programming is done by handling the tool 101 in “learn” mode. In an exemplary embodiment of the invention, a remote connection is provided for remote training and / or control of the system.

(Embodiment at the bottom of the table)
FIG. 4 illustrates a system 400 that is an alternative embodiment of the present invention that holds, moves, and / or monitors the pen 402 from the bottom of the table rather than the top. .

  In an exemplary embodiment of the invention, pen 402 is provided at point 406 on surface 404. A ball joint 412 (eg, like the joint 304 of FIG. 3) is coupled to the pen 402 via a rod 408, which is continuous with the pen 402, for example. Optionally, a spring-loaded base 410 is provided for the rod 408 to provide enough space to accept the change in distance between point 406 and all 412. Optionally, to mimic the lifting action of the pen, the pen 402 is telescopic at least from the rod 408 for a short distance. The tension of the pen 402 can be used to indicate the lifting force. An actuator can be provided to provide such lifting control.

  In an exemplary embodiment of the invention, the surface 404 is provided on a structure 420 that is operable by an XY table 422 described below.

  In an exemplary embodiment of the invention, the ball 412 is a ball 412 whose change in direction of the rod 408 (eg, due to a set of motors 413 and 415) is constrained by two orthogonal groove members 416 and 418. It is passively provided in the XY table 414 so as to be converted into an XY operation. Alternatively, table 422 can compensate for the relative movement of point 406.

  In an exemplary embodiment of the invention, the XY table 422 includes a set of motors 424 and 430 that operate a set of orthogonal groove members 426 and 428 using, for example, a worm drive.

  In an exemplary embodiment of the invention, XY table 422 operates both structure 420 and surface 404. Optionally, patient 128 wears a glove that slides well so that this action is not bothered. Alternatively or additionally, the XY table provides an operation to compensate for the writing operation so that it appears to be a more natural operation.

  In an alternative embodiment of the present invention, the size of the surface 404 is reduced (so that the hand can rest on the table) and / or provide a resting area for the hand when not in operation. In some embodiments, no table is provided. Optionally, surface 404 is affixed inside the table surface.

  Optionally, an operational or stationary image is projected onto the surface 404.

(Eating behavior rehabilitation system)
FIG. 5 is a perspective view of an eating rehabilitation system 500 in an exemplary embodiment of the invention. System 500 includes a table 502 (or system 500 is configured to mount on a standard table including, for example, a suitable frame 516). The target 504 of the eating operation, for example, a dish, may be fixed to the table 502 or may be allowed to move. A tool 506, such as a spoon, is held by a tool holder 510 having a fine motion control mechanism 508 associated therewith. The mechanism 508 is the same as the mechanism 208 described above. Optionally, additional rotational and / or translational degrees of freedom are provided. For example, the holder 510 includes extension and / or rotation. Optionally, only some degrees of freedom are detected. For example, the direction of tool 506 relative to the horizon is determined by an accelerometer.

  In an exemplary embodiment of the present invention, the system 500 can be used to rehabilitate coarse operations as well as fine operations with respect to eating operations. To achieve this goal, a coarse operating mechanism 514 is selectively provided to add three degrees of freedom of translation to mechanism 508 by moving support arms 512 that interconnect them.

  Optionally, the combination of mechanisms 508 and 514 can lay the foundation for many everyday tasks, such as eating, which requires fine control in the dish, mouth, and to some extent in the trajectory of the spoon. In addition, fine motion control can be rehabilitated over a plurality of spatial positions.

  Optionally, motion control of other points in the body, such as the arms, is provided. In an exemplary embodiment of the invention, a robotic arm or other position controller 518 is used, which includes an armrest 520. For example, the controller 518 includes a groove member mechanism as described above. As another example, the controller 518 includes a ball 522 and an extendable arm 524, each of which is powered by one or more motors and / or by one or more sensors. Detected.

  In an exemplary embodiment of the invention, the mechanism 514 is as follows. Ball 526 is held between two aperture plates 528 and 530. One or more motors 532 operate the ball 526. Optional brake 534 is activated by bringing plates 528 and 530 closer together, thereby increasing the friction on ball 526. An extension arm can be provided as well.

  In an exemplary embodiment of the invention, mechanism 508 includes a camera or other sensor for detecting proximity to the mouth and / or its mouth condition. This can be used to assist patient training to coordinate mouth and hand. Optionally, by providing markers at the upper and lower portions of the mouth, the camera detects the mouth open state and detects the distance between the markers. Alternatively, an image processing technique that does not use markers may be used.

  In an exemplary embodiment of the invention, system 500 can be used during a meal or to provide food to a patient. Optionally, any step of the feeding behavior can be temporarily taken over by the patient. Optionally, a pause is interpreted as an opportunity to remind the patient of the next action, for example, by using verbal feedback or by moving the tool in the correct direction.

  Optionally, at least one camera 536 is provided to track the tool 506, to make a mistake in the dish 504 (or bowl, not shown), or to drop food, eg, in the dish 504, in the mouth, and / or Detects falling on the patient.

  Optionally, other tools may be attached, or a set of tools may be controlled simultaneously, eg, using multiple fine and / or coarse motion mechanisms. In one example, the cup is controlled. In another example, the fork and knife are controlled simultaneously. As another example, two chopsticks are controlled simultaneously. Optionally, two separate micro-motion mechanisms are provided, one for each chopstick. Both fine motion mechanisms are optionally attached to the same coarse motion mechanism.

  Exemplary embodiments of the present invention support machine replacement of tools. In an exemplary embodiment of the invention, the tool holder includes a plurality of tool cartridges that are replaced by machine commands. In one example, a number of different crayons are provided for children.

  Although the armrest 520 is selectively operable, in some embodiments of the invention, the rest 520 is used to limit movement of other points of the body. It should be noted that such other point fixing and / or control can be used for other tasks such as writing operations.

  A particular feature of some embodiments of the present invention is that fine motion rehabilitation can require high resolution feedback and / or multiple degrees of freedom in a small space. In an exemplary embodiment of the invention, one or both of these requirements are provided by a fine motion mechanism that is located near the work volume. Also, optionally, such a mechanism can be illuminated with light, presented with a smaller resistance, and / or delayed in operation.

  Optionally, the fine motion mechanism is stabilized, for example by a relatively fixed support. Optionally, dynamic stabilization is provided. In one example, feedback from the camera is used to apply corrective fine motion (eg, via an XY table). In another example, the tool, tool holder, and / or micromotion mechanism includes an accelerometer or other suitable sensor. The input from such a sensor is used to close a feedback loop that stabilizes the tool in the air as desired.

(Additions you can choose freely)
The systems 100, 200, 500 can be modified in various ways, for example using additional elements. In an exemplary embodiment of the invention, patient 128 wears a glove that provides hand EMG measurements. Alternatively or additionally, such a glove electrically stimulates the hand.

  Optionally, voice input is provided, for example, patient 128 can control the operation of the system by voice control. Optionally, the patient can tell a desired coded word or language word, which defines the pattern (eg, the word itself) used in the rehabilitation task.

  Optionally, various wearing bands are used. For example, for chopsticks, one chopstick is controlled by the system and the other chopstick is attached to a hand using a wearing band (eg, an appropriate glove, as the case may be).

  Optionally, a finger wear band is provided so that the rehabilitation system can treat a part of the finger or hand as if it were a tool.

  It should be noted that the system 200 generally controls only the end points of operation (eg, tools). In order to control the movement in more detail, more points on the limb (for example using a positioning system as shown in FIG. 5) or movement limiting means are selectively used.

(Typical size)
In an exemplary embodiment of the invention, the micro-motion mechanism covers a volume (in which, for example, a side is smaller than 30 cm, a side is smaller than 20 cm, or a side is smaller than 10 cm). You can move the tool). Optionally, the smallest range of the space is less than 2 cm.

  In an exemplary embodiment of the invention, the coarse motion mechanism covers, for example, a space between 20 cm and 100 cm on a side. Optionally, the space is cylindrical, for example with a diameter of 40 cm or less. The axis may be a curve.

  Optionally, the fine motion mechanism applies a force of 1 Kg or less. In other embodiments, a greater force is applied. Optionally, the accuracy of the applied force is 100 g, 10 g, 1 g, or less, which is at one or more degrees of freedom of the system.

  Optionally, the accuracy of the placement of the tool tip is in the range of 5 mm, 3 mm, 2 mm, 1 mm or less. The accuracy of the angle is, for example, in the range of 10 degrees, 5 degrees, 1 degree, 0.5 degrees, or less.

(Usage)
Various uses of the rehabilitation system are described in the above-mentioned application. In particular, it is noted that the system described in this specification can be used by being attached to an everyday work table such as a table or a counter at home, for example. Optionally, the rehabilitation system stores logs, results, actions, plans, progress reports, and / or other data locally. Alternatively or additionally, some or all of such data is stored remotely.

  In an exemplary embodiment of the invention, the system embodiments described herein are used for behavioral support. For example, the system is used to support writing or eating. Optionally, the system embodiments described herein are used for exercise.

  In an exemplary embodiment of the invention, a network of rehabilitation systems is used for collaborative or competitive activities, such as racing.

  Optionally, the rehabilitation system is connected to a television set or virtual reality (VR) set (eg, goggles) to support patient intensive training during rehabilitation.

  In some exemplary embodiments of the invention, the tracked tool is a free tool that is used to provide feedback but not force.

  In an exemplary embodiment of the invention, the rehabilitation system is used for evaluation. Optionally, the assessment includes an assessment to test progress and / or an assessment to measure the ability to perform a given daily action. Optionally, the results of a test with various handicaps (eg, tool design, force field, task, target, and / or time limitations) can be used by the patient to determine what type of tool and / or daily task. Used selectively to evaluate.

  Optionally, the assessment is performed periodically, for example, assessing progress and / or determining whether a stable period of improvement has been reached. For example, various evaluation methods such as attaching bolts, assembling objects, using scissors, sorting, and building a tower can be used. Optionally, using a rehabilitation system, for example, assisting a patient during a test (eg, determining what error control the patient has), applying restrictions, guiding, monitoring, and Remind the patient.

  In an exemplary embodiment of the present invention, filed on December 7, 2004 and filed as a PCT application by the same applicant on the same day as the present application, entitled “Rehabilitation Using Music”, As described in US Provisional Application No. 60 / 633,429, which has a docket number 414/04396, the disclosure of which is incorporated herein by reference, its operation is related to music. For example, correct operation can generate correct notes. As another example, the spatial position is related to the notes to be played in a predetermined sequence. In an exemplary embodiment of the invention, using music helps the physiotherapist in tracking the patient's behavior because it does not approach the patient and does not stare at the fingers.

  Various designs of robots and positioning devices (eg 6 legs) are known in the art. Of course, according to exemplary embodiments of the present invention, each one of the various descriptions described herein may be adapted for such robots and / or positioning devices. Is possible. Alternatively or additionally, in accordance with all exemplary embodiments of the present invention, software is provided for such robots and devices to perform the various methods described herein. Can be provided.

  In some embodiments of the present invention, the systems described herein are used for applications other than rehabilitation, such as work training, testing, and / or robot operation.

  Of course, the above-described method of rehabilitation can be modified in many ways, including omission or addition of steps, order of steps and changing the type of device used. Furthermore, a great many different features have been described both in the method and in the apparatus. In some embodiments, a method is primarily described, but an apparatus adapted to implement the method is also considered to be within the scope of the present invention. Of course, different features can be combined in different ways. In particular, not all features illustrated above in a particular embodiment are required for each similar embodiment of the invention. Moreover, combinations of the above features are also considered to be within the scope of some embodiments of the invention. Also within the scope of the present invention, a kit includes a set of devices, one or more tearing pins, one or more accessories, and / or software. Also, hardware, software, and computer readable media (including providing such software used to perform and / or guide the steps described herein, such as arm position and feedback) Is within that range. Section headings are provided to aid navigation and should not necessarily be considered as limiting the content of the section. The terms “comprises”, “includes”, “have” and their conjugations, as used in the claims, include “but but not limited to”. ) ". Also, although male pronouns are used for convenience, it should be noted that the device is appropriate for both men and women.

  Of course, for those skilled in the art, the present invention is not limited by what has been described. Rather, the scope of the present invention is limited only by the claims.

FIG. 1 is a schematic block diagram of a fine motion control rehabilitation system in an exemplary embodiment of the present invention. FIG. 2 is a perspective view of a portable pen-type rehabilitation system in an exemplary embodiment of the invention. FIG. 3 is a detailed view of the fine motion mechanism for the pen of FIG. 2 in an exemplary embodiment of the invention. FIG. 4 is a detailed view of the pen operating mechanism below the table in an exemplary embodiment of the invention. FIG. 5 is a perspective view of an eating rehabilitation system in an exemplary embodiment of the invention.

Claims (36)

A device for rehabilitation,
Objects that are adapted to be held by a person and handled with a finger to perform tasks; and
A micro-motion mechanism coupled to the object and adapted to apply sufficient force to move the object.   The apparatus of claim 1, wherein the apparatus weighs less than 30 kg.   Device according to claim 1 or 2, characterized in that the object is adapted to move along a predetermined surface.   Device according to claims 1 to 3, characterized in that the operating range of the mechanism is less than 20 cm.   5. An apparatus according to any preceding claim, comprising a controller that analyzes the motion of the object to determine at least one characteristic of the person.   6. A device according to any one of the preceding claims, characterized in that the controller analyzes the force applied to the object in order to determine at least one characteristic of the person.   Device according to claim 5 or 6, characterized in that the characteristic comprises a state of human emotion.   8. A device according to any one of claims 5 to 7, characterized in that the controller stores an operation pattern therein.   The apparatus of claim 8, wherein the pattern comprises a pattern of writing actions.   The apparatus according to claim 1, wherein the fine movement mechanism resists movement of the object by a person.   The apparatus according to claim 1, wherein the fine movement mechanism applies a resistance force to the movement of the object.   The apparatus according to claim 1, wherein the fine movement mechanism supports movement of the object.   Device according to any of the preceding claims, characterized in that the object comprises at least one feedback source for stimulating the user of the device.   The apparatus according to any of claims 1 to 13, further comprising at least one sensor for tracking movement of the object.   15. An apparatus according to any preceding claim, further comprising at least one sensor for tracking a force applied to the object.   Device according to any of the preceding claims, characterized in that a mechanism blunts the movement of the object.   17. An apparatus according to any of claims 1 to 16, comprising a coarse motion mechanism adapted to move the fine motion mechanism with at least two degrees of freedom.   The apparatus of claim 17, wherein the coarse motion mechanism is adapted to move the object from a table to a patient's mouth.   The apparatus of claim 18, wherein the object includes chopsticks.   20. A device according to any preceding claim, comprising a separate coarse motion mechanism adapted to be attached to a person with the finger, the motion coordinating with the motion of the object. .   21. Device according to any of the preceding claims, characterized in that it comprises a surface that is touched by the object, which surface also functions as a display.   The apparatus of claim 21, wherein the surface comprises a tablet computer. A device for rehabilitating the motion control function related to writing,
Surface,
A stylus extending upward from the surface; and
An operating mechanism adapted to change the orientation of the pen relative to the surface and disposed below the surface.   24. The apparatus of claim 23, wherein the motion mechanism is adapted to move the stylus over the surface.   24. The apparatus of claim 23, wherein the motion mechanism is adapted to be moved by a person holding a stylus.   26. A device according to any of claims 23 to 25, characterized in that the device is adapted to measure the force applied to the stylus.   27. Apparatus according to any of claims 23 to 26, characterized in that the apparatus comprises a controller having stored therein at least one operational pattern.   The apparatus according to claim 27, wherein the controller controls the operation mechanism according to the pattern.   28. The apparatus of claim 27, wherein the controller measures a patient's psychological state in response to operation of the operating mechanism. A method for rehabilitation of fine motor control,
Providing an object to be handled with the patient's finger; and
Controlling an actuator coupled to the object to provide assistance for the operation of the object;
A method wherein the actuator provides a range of motion for the object that is limited to less than 30 cm and has a freedom of motion of at least 3.   The method of claim 30, wherein the assisted operation comprises a writing operation.   32. The method of claim 30, wherein the assisted action includes an eating action. A method for assisting a person in daily work including control of movement of arms and fingers,
Determining at least one characteristic of the operation; and
Using a robotic actuator to assist arm and / or finger movement.   34. The method of claim 33, comprising assisting only if the work is not completed.   34. The method of claim 33, comprising assisting as a safety measure.   34. The method of claim 33, comprising periodically assisting as part of the rehabilitation process.

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