WO2020174255A1 - Injury risk assessment - Google Patents

Abstract

A computer implemented method of generating an expected injury risk of an individual is disclosed. In an embodiment, said method comprises the steps of: undertaking a health assessment of the individual's current health, based on responses to one or more health questions to determine loads on the individual; undertaking a lifestyle assessment of the individual's current lifestyle, based on responses to one or more lifestyle questions to determine usages of the individual; undertaking a body foundation assessment by a medical professional, to determine foundations of the user; determine a series of screening markers, based on the difference between the body foundation assessment and the health and lifestyle assessments, wherein each screening marker provides a visual indicator of the risk of injury to the user of a body part or during a body movement; and presenting the visual indicator to the user.

Description

INJURY RISK ASSESSMENT

The present invention relates to a method of determining an injury risk of a user. In particular it relates to comparing usages and loads with foundations and providing a risk assessment in a visual manner.

Musculoskeletal injury is having a detrimental effect on the global economy. As an example, lower back injury of NHS staff is costing the NHS £400 million per year. In 2015 it cost UK businesses 31 million in lost working days a year and cost the UK economy £14 Billion a year, with the NHS alone assumed to be effected by £5 - £6 Billion per year.

This affects 1 in 4 Adults of working age which is around 9.6 million people per year in the UK. Globally, musculoskeletal disease and injury costs the global economy 796.3 Billion Dollars.

There are around 160,000 knee and hip replacement surgery’s performed each year in the UK. In the USA 600,000 people opted for spine and back surgery. Much of these issues could be avoided if at least foreseen if medical screening was routinely undertaken.

The current medical screenings that exist are as follow:

1. Performance Matrix TPM

This looks at Functional Movement that observes your movement and assessors your quality of movement and weak areas as well as areas of restriction causing compensations.

The screening performs 10 - 15 movement tests and the results are produced on a traffic light system. The practitioner then gives an exercise program based on these outcomes. The scores do not interlink Health, Lifestyle and Body measures and do not educate the patient on the findings. The results are therefore linear.

2. Nuffield Health MOT

This is a very basic screening that looks at your blood pressure and blood glucose and asks a user to fill out a lifestyle questionnaire with a 1 hr session.

Nuffield provides a basic score and advises what classes are needed to be done, or services to undertake, in order to improve on those scores. This however does not educate the user on what the scores mean, why they are measured and how the score impacts on them. They also don’t know why the classes are important and how they can prevent potential or further injury.

3. Nuffield Health 360 +

This is an overly detailed expensive screen that fails to educate the client on the meaning of the measures. Why is this measured and what does it mean for that patient? The cost to each client is £749 and looks at the following factors:

Personal medical history and lifestyle questionnaire; Height and weight measurements; Body Mass Index (BMI) calculation; Body fat percentage; Waist circumference; Nuffield Body Composition Index; Hydration levels; Urine analysis; Full biochemistry profile including liver and kidney function; Blood glucose (diabetes); Cholesterol test and full lipid breakdown; Analysis of nutritional status; Computerised spinal assessment; Lung function test; Measurement of physiological resilience to stressors; Blood pressure; Resting ECG; Cardiovascular risk score; Chest x-ray (if clinically indicated); Bowel cancer test (45+); Dynamic cardiovascular test using ECG or Aerobic Fitness test; Analysis of metabolic syndrome risk. The lack of feedback to the client or user of how the collected data interacts to influence health is a key problem of this system.

The present invention aims to at least ameliorate the above mentioned deficiencies.

Summary

According to a first aspect of the present invention there is provided a computer implemented method of determining an injury risk of an individual or user, said method comprising the steps of: undertaking a health assessment of the users current health, based on responses to one or more health questions to determine loads on the user; undertaking a lifestyle assessment of the users current lifestyle, based on responses to one or more lifestyle questions to determine usages of the user; undertaking a body foundation assessment by a medical professional, to determine foundations of the user; determine a series of screening markers, based on the difference between the body foundation assessment and the health and lifestyle assessments, wherein each screening marker provides a visual indicator of the risk of injury to the user of a body part; and presenting the visual indicator to the user.

With the present invention it is possible to identify issues long before they become a problem and advise patients on how best to prevent the injury occurring by educating the patient whilst using the interlinks and body measures combined with the visual indication, such as a traffic light system, so that the client can determine and identify which areas they need to address to reduce the loads and usages causing risk of injury and also the things they can do to improve their foundations to also minimise risk of injury. This can be easily determined using the visual indicators.

The present invention aims to feedback to the user why it is bad for that patient or user to have, for example, poor functional movement, (l.e. poor foundations) and highlights lifestyle and health factors and other body measures that would expose the user to an increased chance of injury. It also looks at multiple other body measures as well as functional movement such as balance, flexibility and stability.

The present invention strives to educate the user on how best to achieve their full physical health by looking at Health, Lifestyle and Body measures. It advises on gym class suitability and appropriate services taking 1000’s of combinations with and between these categories into consideration.

The visual indicators may give scores that are provided clearly and the reasoning and understanding of why the user has these scores are made available. This allows the user to track their own progress as well as compare their body score on each level of the screening with other users across the country and even globally if taken on that scale.

With the method of the present invention it is possible to identify issues long before they become a problem and advise users on how best to prevent injury occurring by educating the user, whilst using interlinks and body measures combined with a traffic light system, so the user can pick up on which areas they need to address and the things they are doing wrong.

The present invention could not only help the individual but could save businesses and the economy billions a year if taken seriously on a national scale.

In an embodiment, the Assessment may be split into two; A Health and Lifestyle Questionnaire to be filled out by the client on the website/application and a Health and Body Assessment performed by an accredited Screener at an approved Screening Centre.

The Health and Lifestyle Questionnaire: The client or user may be provided with a username via email and they may be required to choose a password to login to their profile where they are asked to book an appointment with a practitioner. A link to the practitioners booking page is provided for this purpose.

The questions in the questionnaire are typically research based and easy to fill in online and may include questions such as demographics, diet, health, approach to exercise and the type of exercise they partake in.

In an embodiment, the step of presenting may comprise a step of combining screening markers to provide a screening map of injury risk for the user. This allows a user to easily identify and prioritise which body part requires attention.

The risk of injury may be shown by the screening marker as determined from a comparison between the loads and usages associated with a body part and the foundations associated with said body part.

The method may further determine one or more physical exercises or movements to improve foundations of the user.

The body foundation assessment may be based, at least in part, on the outcome of the health and lifestyle assessments.

The health and/or lifestyle assessment may be a questionnaire asking the user questions such as demographics, diet, health, approach to exercise and the type of exercise they partake in. The loads, lifestyles and foundations may each comprise a score or rating.

The screening marker may comprise a number of parameters chosen from the loads, lifestyles and foundations, said screening marker comprising a foundation score based on the scores or ratings of the number of parameters. The foundation score may comprise a ranking of risk of injury to the user for a body part. Additionally the number and selection of parameters may differ for each body part of the user. Also, the foundation score may be determined by the score or ranking of the lowest ranked parameter.

In an embodiment, each screening marker may provide a breakdown of the loads, usages and parameters that determine the risk of injury.

The method may further comprise a step of generating exercise recommendations for one or more body part to improve foundations. It may also comprise the step of transmitting the exercise recommendations to the individual or a healthcare practitioner.

The method step of generating exercise recommendations may further comprise the steps of characterising risk factors based on the visual indicators; and generating recommendations based on the risk factors.

It can be appreciated that in embodiments the method may use visual indications to highlight risk of injury to an individual. By providing recommendations to the individual or the healthcare practitioner, the method may adapt the visual indications showing risk of injury based on which recommendations are accepted by the individual. This may allow the individual to visually identify which recommendation provides the highest benefit in a visual manner.

The recommendations may also be ranked by the method to prioritise recommendations based on clinical need and/or the goals of the individuals.

In summary embodiments provide for the following potential advantages:

Tailored - Screening looking at Health, Lifestyle and Body Measures together. Interlinks between the measures. Example: High BMI (Health) will increase the injury risk if the patient does impactful exercise (Lifestyle) and it will be worse if they have poor core stability (BODY).

Educational - For every interlink the patient receives an information snippet on an information sheet explaining why and how it has affected their scores.

Affordable - The screening only costs between £40-£50

Accessible - Screening Centres will be set up all around the country within existing infrastructures Time Efficient- The exercises are automatically produced by the algorithms so don’t need to be produced separately. The Health and Lifestyle questionnaire is done online beforehand and not in session. These and other aspects of the invention will be apparent from, and elucidated with reference to, the embodiments described hereinafter.

Brief description of Drawings

Embodiments will be described, by way of example only, with reference to the drawings, in which figure 1 illustrates parameters determined by an embodiment of the present invention;

figure 2 illustrates a method for obtaining data on the parameters of figure 1 ;

figure 3 illustrates how the parameters are weighted to determine risk;

figure 4 illustrates some of the parameters shown in figure 1 ;

figure 5 is a schematic representation of how the parameters of figure 4 interact to determine risk; figure 6 shows a visual representation of a likelihood of risk to the user, by body part;

figure 7 shows how the parameters are ranked or scored and also shows an exemplary exercise regime suggested by the method of figure 3; and

figure 8 shows an overall foundation score for a user.

It should be noted that the Figures are diagrammatic and not drawn to scale. Relative dimensions and proportions of parts of these Figures have been shown exaggerated or reduced in size, for the sake of clarity and convenience in the drawings. The same reference signs are generally used to refer to corresponding or similar feature in modified and different embodiments.

Detailed description of embodiments

Figure 1 shows an overview of the present invention. In particular, the invention describes a method 100 of analysing a user’s health and activity levels and determining a likelihood of risk of injury. This likelihood is presented to the user in a visual manner and allows the user to determine what influences their risk.

In brief, method 100 comprises the steps of a user booking an appointment 110 with an accredited healthcare professional such as a physio. The system may automatically sync to available accredited healthcare professionals - The user then follows a link in order to book an appointment with that practitioner separately.

Broadly, the method of assessment is split in to two. Firstly a Health and Lifestyle Questionnaire is available for free once the user has created an account. This is to be filled out prior to the Health and Body Screening sent to a user to be filled out by the client via a link to a website 120. This is shown in figures 1 and 2. Additionally, once completed, a Health and Body Assessment is performed by an accredited Physio Screener at an approved Screening Centre 130. As shown in figures 1 and 2, the Health and Lifestyle Questionnaire is sent to the user 120. In an embodiment the client or user is provided with a username via email and they can choose a password to login to their profile where they are also asked to book an appointment with a practitioner. The user then follows a link in order to book an appointment with that practitioner separately.

The questions in the questionnaire are research based and easy to fill in online and include questions such as demographics, diet, health, approach to exercise and the type of exercise they partake in.

This questionnaire takes into consideration multiple factors that categorise the client in to an appropriate level of Health and Body Screening that they will partake in; Beginner/Intermediate. This ensures that the client’s Body Assessment is at an achievable level and safe. Clients start on either beginner or intermediate working up through intermediate level 2 and 3 to advanced level 1 ,2,3 and elite to icon levels by getting 70%+ in their overall score. Factors that determine level of Health and Body Screening include Age, Body fat risk and blood pressure. If any two of these factors are high (e.g. Age over 60 and a high Body Fat Risk), then client is categorised into beginning assessment. Otherwise, the client would be categorised into intermediate assessment.

The Health and Body Assessment is shown in figure 2. The Body Screening includes a series of clinically researched health tests and body outcome measures using medical and physiotherapy equipment that are performed alongside an accredited screener at an appropriate level for the client’s current level of health and lifestyle choices. This is a full body assessment including all the following criteria which is then inputted in to the database, where complex algorithms create advice and triage the client appropriately to a healthcare professional or personal trainer to help reduce their risk of injury.

Broadly, the method is looking for information on 3 subsets of parameters: undertaking a health assessment of the users current health, based on responses to one or more health questions to determine loads on the user; undertaking a lifestyle assessment of the users current lifestyle, based on responses to one or more lifestyle questions to determine usages of the user; and undertaking a body foundation assessment by a medical professional, to determine foundations of the user. Loads include tangible parameters such as resting heart rate, bmi, diet, fat, cholesterol or the like. Data on these loads may be obtained from measurements, health questions, health devices or the like.

An example for determining loads focus on balance and core stability; functional movement; health; and body measurements. The user’s level is assessed by the accredited healthcare professional and the user is assigned a score having a value between -2 and +2 depending on how and in what way the performance is likely to affect the measured metric.

Examples of performance balance board and core stability measurements include: Standing posture (left to right), Amber. This has an effect on the Lower back, knees, quads, hamstrings, calfs, hip, pelvis of the user. Standing posture (front), this has an effect on the Lower back, hamstrings, calfs, hip, pelvis of the user; and Standing Posture (back). This also has an effect on the Lower back, quads, knees, hip flexors, pelvis of a user. Further measurements include Single Leg Balance, lunges, Deep Breathing and Side Plank Press up. It can be appreciated that these performance gradings also effect an overall score of metrics of the user in a similar manner to the posture measurements.

Similar measurements are also undertaken to assess functional movements, health and body - Lunges; Press up/Side Plank; Shoulder Mobility; Squat; BMI; Spirometry; Cholesterol; ISIS/PSIS angle (posterior/anterior).

A second area is lifestyle parameters to determine likely usages on body parts of a user. These include exercise habits, medical history, gym habits etc. Again, data may be obtained by questionnaire or by direct measurement using one or more sensors or a smart device.

Example questions include questions on health, lifestyle, history and miscellaneous relevant questions. Questions relate to metrics of the user, such as heart health, neck and thoracic health, cardio/recovery speed, blood pressure, or other strength or proprioception of individual limbs or muscle groups.

The answer to each question is ranked and assigned a value between -2 and +2 depending on how and in what way the response is likely to affect the measured metric. Colour coding is generally used to indicate to the user the effect of their answer on the metric - so a negative response having a negative effect on the metric would be shown in red, followed by amber and beneficial answers shown in green.

Example health questions include How Stressful is your life in general?; A Diet questionnaire; smoking status; alcohol consumption, and the like. Lifestyle questions include determining the amount, type and impact level of exercise undertaken, sedentary level, hours spent doing repetitive activity, hours spent doing physical labour, approach to exercise, consistency of exercise, exercise metrics etc. A list of the Health/Lifestyle Questionnaire questions includes questions on health, diet (fat/sugar/water intake), sleep, caffeine, smoking status, alcohol consumption, exercise, impactful/intensive exercise intensity and duration, body fat, BMI, An example of such questions is given in Appendix 1 .

As an example, the amount of water intake by an individual is assessed by questionnaire. Based on the result

Example miscellaneous questions include injuries, current pain, gravidity/parity status etc. It can be appreciated that the responses to questions may have positive effect on one metric and a negative effect on a second metric. For example, a high level of physical labour may improve shoulder strength, but may generate a risk of lower back injury.

The third aspect is determining a user’s existing foundations. These include muscles stability, strength, flexibility, posture and the like. This is typically obtained during a physical assessment with an accredited medical practitioner such as a physiotherapist. Appendix 2 shows the scoring system used and the colours associated with the scores in the Body Assessment.

So, as figure 3 demonstrates, measures to do with your Health are considered‘Load’, measures to do with your Lifestyle are considered‘Usage’ and measures to do with your Body are considered your ‘Foundations.’

Figure 3 shows how the loads and usages stack against the foundations in order to prevent injury the loads and usages should be offset by existing foundations. If the foundations do not counterbalance the loads and usages then the risk of injury increases

Figure 4 shows the parameters in greater detail, with a description provided for the user of what the parameters measure and how it relates to mitigating against injury. Broadly, each parameter is sub divided into a description of the situation covered by the parameter, an impact that the parameter has, and an advice section for maximising or minimising the parameter to aid the user to achieve their target.

It can be appreciated that these parameters interact, potentially in differing ways for each body part, to add or minimising risk of injury for each body part. An example of the interactions is shown in figure 5. It can be seen that each parameter broadly relates to either another parameter or to the health, lifestyle or body of the user (which correspond with the loads usages and foundations described earlier).

Once these interactions are accounted for, a visual representation of the risk for a body part may be generated as shown in figure 6. In this figure, body parts are highlighted in a traffic light system. This allows a user to easily identify areas of weakness. Selecting in a body part allows further detail to be shown, with an overall impact of relevant parameters shown and fed back to the user. These visual markers provide invaluable quick guidance to the user.

As noted above, the algorithms are based on a simple concept. If your load and usage outweigh the strength of your foundations, then this increases your chance of injury. The solution therefore is to strengthen your foundations to meet your load and usage. This is demonstrated by the diagram below: Each of these measures is evidence based and involves the inputting of data which is then given a score between 1 and 10. The score is then rated on a traffic light system 1-3 = RED 4-7= AMBER 8- 10 = GREEN

On completion of the Health and Lifestyle Questionnaire and Health and Body Assessment, the patient receives a Summary Sheet, Information Sheet, Exercise Sheet and a Risk Assessment.

The Summary Sheet provides for each measure, a score between 1-10. This is rated on a traffic light system and then shown to the client. The Information Sheet is produced from the answers of the Health/ Lifestyle Questionnaire and Health and Body Assessment. These are designed to explain what has impacted on their final scores in the Risk Assessment (see later). These are either in Red, Amber or Green boxes depending on the answers they selected in the questionnaire or scored in the assessment.

The Information sheet also gives advice to personal trainers, physiotherapists, nutritionist as well as gives advice on appropriate gym classes for that client based on the findings.

Any important information from the Health Check (BMI, blood pressure), Lifestyle (regular exercise, intensive exercise, past medical history) or body screen (weak core stability), due to a red or amber score will automatically generate a bullet point for the attention of personal trainers.

For example, if the Body fat Risk Score is shown to be high (i.e. Red or amber), then this generates a bullet point for the attention of personal trainers to inform the client to focus on closed chain exercises for now, and gradually build to impactful exercise once your Body Fat Risk Score has reduced. A full list of the advice generated to personal trainers is given in appendix 3. Information about gym classes, advice to physiotherapists, nutritional advice, as well as other information produced by the information sheet is also shown in appendix 3.

The Exercise sheet is produced from the answers in the Body Assessment. The level of intensity and frequency is determined by the Red or Amber score in the assessment. The difficulty is determined by the level of the screening example Beginner, Intermediate and Advanced etc (see key features).

Once all the scores have been inputted, the method, using software, aims to predict the injury risk for each area of the body by combining multiple combinations within and between each category. As can be seen in figure 6 each measure that has impacted on that area of the body is displayed under ‘Impact On Score.’ A snippet on the Information sheet is given for each one of these impacts.

Again as shown in figure 6, each area of the body is coloured with the Red, Amber or Green shading that was reached once all the values were combined. The way this works is each area of the body is first rated using the‘Foundation Score’. The Foundation Score is taken from a specific Body Score and placed on the‘Risk Margin’ as a percentage. For example, if someone scored 6/10 on their knee stability test, then this will be placed on the‘Risk Margin’ as 18/30. The Health, Lifestyle and Body Measures are then placed on top (similar to the injury risk scale). If the client hits a Red then this - 2 points, if the client hits Amber then this - 1 point. If the client hits Green then this + 2 points on the scale.

Each Risk Margin the Foundational Score is placed on, differs depending on the stability of the structure. For example, the knees are more subject to injury than the hips so the margin for error is greater for the knee than the hip. The margin for the knees is therefore less than the hips, for example /30 instead of /35. This means measurement of effects of different measures upon different structures depending on the stability of the structure.

The client also gets a total score for their Health Lifestyle Body and Overall (from the risk assessment) as shown in figure 8. These scores are worked out from the total scores and given as a percentage. These scores can than be tracked by the client but also compared to other people of a similar age gender etc. There are even capabilities for sharing this information on social media.

As an example, the scores are correlated as follows:

Load and Usage Interlinks Maximum +ve and -ve effect on Risk Margins

Spirometry - Worst 6 Best 6

Grip - Worst 6 Best 1

Shoulder prop- Worst 10 Best 5

Shoulder strength - Worst 4 Best 3

Lats - Worst 10 Best 5

Neck Stability - Worst 10 Best 6

Core stability - Worst 12(14) Best 6

BP - Worst 18 Best 15

Cardio - Worst 12 Best - 12

Recovery- Worst 14 Best 10

IRQ - Worst 8 Best 4

Quads - Worst 10 Best 4

Hamstrings - Worst -12 Best 6

Calfs Worst -12 Best 6

Hip - Worst -12 Best 6

Pelvis - Worst 12(14) Best 6

Scapulothoracic - Worst 14 Best 8

Body Interlinks Maximum +ve and -ve effect on Risk Margins Spirometry - Worst 2 Best 0

Grip - Worst 6 Best 1

Shoulder prop- Worst 6 Best 0

Shoulder strength - Worst 6 Best 0

Lats - Worst 8 Best 0

Neck Stability - Worst 6 Best 0

Core stability - Worst 20 Best 0

BP - Worst 4 Best 0

Cardio - Worst 4 Best - 0

Recovery- Worst 2 Best -0

IRQ - Worst 16 Best 0

Quads - Worst 16 Best 0

Hamstrings - Worst -18 Best 0

Calfs - Worst -18 Best 0

Hip - Worst -18 Best 0

Pelvis - Worst 16 Best 0

Scapulothoracic - Worst 8 Best 0

Total Scores from Health/Lifestyle and Body Maximum +ve and -ve effect on Risk Margins

Spirometry - Worst 8 Best 6

Grip - Worst 6 Best 1

Shoulder prop- Worst 16 Best 5

Shoulder strength - Worst 10 Best 3

Lats - Worst 18 Best 5

Neck Stability - Worst 16 Best 6

Core stability - Worst 32(34) Best 6

BP - Worst 22 Best 15

Cardio - Worst 16 Best - 12

Recovery- Worst 16 Best 10

IRQ - Worst 26 Best 4

Quads - Worst 28 Best 4

Hamstrings - Worst -30 Best 6

Calfs - Worst -28 Best 6

Hip - Worst -30 Best 6

Pelvis - Worst 28(30) Best 6

Scapulothoracic - Worst 22 Best 8 With the risk margins determined, foundation scores can then be determined for the‘Risk Margin’ in the risk assessment. These scores are taken from the body screen and then converted on the risk margin on the risk assessment. The other scores above are then applied on top.

Spirometry = Lungs

Grip Strengths Wrist

Shoulder External Rotation on biofeedback (mmhg) =Shoulder Strength

Shoulder proprioception test = Shoulder Proprioception

Lats Length Test- Lats

Neck stability on biofeedback (mmhg) Neck

Core Stability on biofeedback (mmhg)Lower Back

Blood pressure monitor - BP

1 mile Run Walk Test- Cardio

Time it takes to recover back to same HR -Recovery

Knee stability on biofeedback (mmhg)- Knee

Thomas Test -Quad

Hamstring 90/90 -Hamstring

Gastrosoleus Test- Calf

Gastrosoleus Test Calf

Thomas Test hip flexor -Hip

Pelvis Angle- Pelvis

Scapulothoracic - Thoracic

Finally, the overall risk margins determined in the risk assessment can be summarised, to provide a score for each body part of the user. As an example, the scores can correlate as below:

Lungs -Out of 12

Wrist - Out of 9

Shoulder- Out of 25

Shoulder Strength- Out of 15

Lats L- Out of 30

Lats R-Out of 30

Neck - Out of 22 (adjusted to structure)

Lower Back - Out of 54

BP - Out of 35

Cardio - Out of 25

Recovery - Out of 25

Knee L - Out of 30 (adjusted to structure)

Knee R - Out of 30 (adjusted to structure)

Quad L - Out of 36 Quad R - Out of 36

Hamstring L -Out of 48

Hamstring R - Out of 48

Calf L - Out of 42(adjusted to structure)

Calf R - Out of 42 (adjusted to structure)

Hip L - Out of 48

Hip R - Out of 48

Pelvis L- Out of 37 (adjusted to structure)

Pelvis R- Out of 37 (adjusted to structure)

Thoracic - Out of 34

Key Features of the present method include Score/ Margin Adjustment Based on Stability of Joint/ Structure; Algorithms to pick the appropriate level of assessment for the patient - the intensity of the testing will grow with the intensity of usage; the ability to consider how multiple factors influence other factors between and even within categories with 1000's of score combinations to ensures a tailored screening; and use of the software to work out suitable classes and other services like physiotherapy, nutritional advice for the patients which allows for upsell for a business.

The patient is able to compare their scores in the Overall, Health, Lifestyle and Body category to other people all around the country/ world based on their age and gender. This can also be shared on social media.

The overall scores can also be used by the accredited healthcare provider to give tailored advice to the user - for example, for every red or amber score of the user advice can be given to the healthcare provider of how the user can address this weakness. This can help to guide the user to decide whether they would benefit from physiotherapy, nutritional advice, psychological support, sports massage or what gym classes would benefit them.

As the software produces a risk assessment, information sheet and exercises the patient knows exactly what is at risk, why it is at risk and how to help. This will revolutionise the way people will view their health and wellbeing.

It is also possible to objectify the Health and Lifestyle measures using existing technology. This can be done by integrating Apple Health, Samsung Health and Google Health. Merging more Health measures like a Diabetic Screen, Mental Health is also a possibly to provide more data and improve the risk assessment.

Further options include the integration of a neural network to integrate Al, where the algorithms track body scores and tailor your exercises even more around you. Competitions based on level of screening within gyms and between gyms may also be implemented. Furthermore, uploading Scores to Insurance Companies to help with premiums, incentivised advertising based on‘Staying in the Green’ and developing more screens for specific activities are examples of further uses for the risk assessment.

It can be appreciated that the scoring can be continuously updated, with the assessment repeated to see the evolution of the user’s health over time. In embodiments, the system may pull data relating to one or more of the metrics directly from health devices, such as an Apple Watch™, Fitbit™ or the like.

From reading the present disclosure, other variations and modifications will be apparent to the skilled person. Such variations and modifications may involve equivalent and other features which are already known in the art of helmet mould making and which may be used instead of, or in addition to, features already described herein.

Although the appended claims are directed to particular combinations of features, it should be understood that the scope of the disclosure of the present invention also includes any novel feature or any novel combination of features disclosed herein either explicitly or implicitly or any generalisation thereof, whether or not it relates to the same invention as presently claimed in any claim and whether or not it mitigates any or all of the same technical problems as does the present invention.

Features which are described in the context of separate embodiments may also be provided in combination in a single embodiment. Conversely, various features which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable subcombination. The applicant hereby gives notice that new claims may be formulated to such features and/or combinations of such features during the prosecution of the present application or of any further application derived therefrom.

Features which are described in the context of separate embodiments may also be provided in combination in a single embodiment. Conversely, various features which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable sub combination. The applicant hereby gives notice that new claims may be formulated to such features and/or combinations of such features during the prosecution of the present application or of any further application derived therefrom.

Throughout the description the terms user” and“individual” have been used interchangeably to refer to the subject of the method. It will be appreciated that where the term“user” is used, this does not imply that the subject of the method for whom the optimised workout recommendations is generated is the person who necessarily interacts with any software of hardware operated as described herein. The direct user of the software or hardware may be a personal trainer, physio, doctor, or other healthcare practitioner, generating an optimised workout recommendations for a patient, who is the ultimate“user” as described herein.

The methods described above may be implemented as a computer program, which when run on a computer, causes the computer to configure any apparatus, including a circuit, controller, sensor, filter, or device disclosed herein or perform any method disclosed herein. The computer program may be a software implementation, and the computer may be considered as any appropriate hardware, including an analyser, a microprocessor, and an implementation in read only memory (ROM), erasable programmable read only memory (EPROM) or electronically erasable programmable read only memory (EEPROM), as non-limiting examples. The software implementation may be an assembly program. A user interface may be provided to allow for the inputting of information by the user - such interface may be a webpage, application or hardware based interface. The computer program may be provided on a computer readable medium, which may be a physical computer readable medium, such as a disc or a memory device, or may be embodied as a transient signal. Such a transient signal may be a network download, including an internet download.

For the sake of completeness it is also stated that the term "comprising" does not exclude other elements or steps, the term "a" or "an" does not exclude a plurality, and reference signs in the claims shall not be construed as limiting the scope of the claims.

Appendix 1

Example Health Questionnaire:

HOW STRESSFUL IS YOUR LIFE IN GENERAL? (link to Blood Pressure and Cholestrol)

1. Low level stress, I get regular sleep, exercise and eat well - 10

2. I have some stressful times but generally I feel OK - 8

3. I get a moderate amount of stress that occasionally disturbs my sleep - 6

4. I get moderate to high stress levels, quite often that disturbs my sleep and diet - 4

5. I have a high degree of stress a lot of the time - 2

Amber 4-7 - is_stress_amber

Red 3-1 - is_stress_red

Example wellbeing and diet questions

How much water do you drink in a day? - 1 cup = 250ml -

Amber (-1) Red (-2) Green (+2) effect heart, neck and lower back scores

2 litres-·- - 10

1.8 litres - 9

1.5 litres - 8

1 litre - 7

800 ml - 6

575 ml - 5

500 ml - 4

375 ml - 3

250 ml - 2

200 ml or less - 1

Amber 4-7 - is_water_amber

Red 3-1 - is_water_red

Green 8-10 - is_water_green

How many hours sleep do you get per day on average? (Total Sleep during day and night) Amber (-1) Red (-2) Green (+2) - Heart, neck, lower back, hip and knee scores

18- 64 years old 10hrs+ - 10

9hrs - 10

8hrs - 9

7hrs - 8

6hrs - 7

5hrs - 6

4hrs - 5

3hrs - 4

2hrs - 3

1 hrs - 2

Amber 4-7 - is_sleep_18-64_amber Red 3-1 - is_sleep_18-64_red Green 8-10 - is_sleep_18-64_green

64 years old+

10hrs+ - 10

9hrs - 10

8hrs - 9

7hrs - 8

6hrs - 7

5hrs - 6

4hrs - 5

3hrs - 4

2hrs - 3

1 hrs - 2

Amber 4-7 - is_sleep_64+_amber Red 3-1 - is_sleep_64+_red Green 8-10 - is_sleep_64+_green

Appendix 2

AGE

60 + - Beginner

Age 16-40 Intermediate

35-50 - Minus 1 on all changeable scores

51-65- Minus 2 on all changeable scores (Information Sheets per age category) 66- 80- Minus 3 on all changeable scores

81+ - Minus 4 on all changeable scores

BMI

Reds - 40 plus and 12-14 - 123’s = Beginner

Amber - 15-18, 30-39 - 4,5,6 = Intermediate

Green - 19-24 - 7,8,9,10 = Intermediate

Blood Pressure

70-90 - Red (low) - 70-80 - 1 , 80- 892 - Beginner

140 -190- Red (high) - 170- 190 - 1 , 150- 169-2, 140 - 159 - 3 - Beginner 120-140 -Amber- 120- 125 - 4, 125 - 135 - 5, 135 - 140- 6 - Intermediate 90-120 -Green -90-99-7, 99- 109- 8, 110 - 115 - 9, 115-120 - 10 - Intermediate

Appendix 3

Every red or amber score from the answers of the Health/ Lifestyle Questionnaire and Health and Body Assessment will automatically generate a bullet point for the attention of personal trainers. For example:

1. Body Fat Risk Score - High (Red/Amber) - Allow your client to focus on closed chain

exercises for now and gradually build to impactful exercise once your Body Fat Risk Score has reduced.

2. Body Fat Risk Score - Low (Red/Amber) - Gradually increase your clients impactful exercise to encourage strengthening of bones and joints

3. Regular Exercise (Red/Amber) Increase the amount of regular exercise your client does on a weekly basis. Try to incorporate at least 20 mins of regular exercise a day (on average).

4. Intensive Exercise (Red/Amber) Increase the amount of intensive exercise your client does.

Try to incorporate at least 1 hr a week of intensive exercise into their regime.

5. How Much Do You Bench (Amber) Your client is lifting close to their body weight which can damage their muscles and joints. Check your clients lifting posture. Is their lower back supported with contact on bench? Is their neck in a neutral position and not protracted? Is there equal weight going through the legs when lifting? Are there any compensation to one side when lifting? Is their core engaged when lifting? Are they breathing when lifting?

6. How Much Do You Bench (Red) Your client is lifting to their body weight which can damage their muscles and joints. Check your clients lifting posture. Is their lower back supported with contact on bench? Is their neck in a neutral position and not protracted? Is there equal weight going through the legs when lifting? Are there any compensation to one side when lifting? Is their core engaged when lifting? Are they breathing when lifting?

7. Water intake (Amber/ Red) - Your client does not drink enough water during the day. Take the time for regular breaks to allow them to rehydrate.

8. Repetitive Activity (Red) Your client does a lot of repetitive activity during the day so focus on low reps and increased load.

9. Prolonged Sitting (Red) Your client lives a sedentary lifestyle so consider loading them

gradually as their body is not used day to day loading.

10. Heavy lifting (Red) Your client does a lot of heavy lifting during the day so focus on high reps and decreased load.

11. Exercise after a month off (Amber) - Your client tends to progress quickly to the same level as before after taking a month off. To avoid injury, encourage a programme that progress them gradually

12. Exercise after a month off (Red) - Your client tends to return to the same frequency, level and intensity of exercise after taking a month off. To avoid injury, encourage a programme that gradually increases the frequency, level and intensity. 13. Consistency of exercise (Amber) - Your client tends to have long breaks between exercise routines. These can last up to three months at a time. Find out the reasons for reduced exercise adherence and address these issues in their exercise programme.

14. Consistency of exercise (Red) - Your client tends to always stop and start with their exercise routines. Find out the reasons for reduced exercise adherence and address these issues in their exercise programme.

15. Past Medical History Lower back/Lower Limb Left (Amber) - Your client has had previous injuries to their lower back/ lower limb on the left side. Please consider that there might be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

16. Past Medical History Lower back/Lower Limb Left (Red) - Your client has had multiple

injuries or permanent changes to their lower back / lower limb on the left side. Please consider that there is likely to be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

17. Past Medical History Lower back/Lower Limb Right (Amber) - Your client has had previous injuries to their lower back/ lower limb on the right side. Please consider that there might be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

18. Past Medical History Lower back/Lower Limb Right (Red) - Your client has had multiple injuries or permanent changes to their lower back / lower limb on the right side. Please consider that there is likely to be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

19. Past Medical History Neck/Shoulder Left (Amber) - Your client has had previous injuries to their neck/shoulder on the left side. Please consider that there might be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

20. Past Medical History Neck/Shoulder Left (Red) - Your client has had multiple injuries or permanent changes to their neck/shoulder on the left side. Please consider that there is likely to be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

21 . Past Medical History Neck/Shoulder Right (Amber) - Your client has had previous injuries to their neck/shoulder on the right side. Please consider that there might be muscle weakening in this area as a result. Consider loading this area gradually and watch out for

compensations.

22. Past Medical History Neck/Shoulder Right (Red) - Your client has had multiple injuries or permanent changes to their neck/shoulder on the right side. Please consider that there is likely to be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

23. Past Medical History Wrist/ Forearm Left (Amber) - Your client has had previous injuries to their wrist/forearm on the left side. Please consider that there might be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations. 24. Past Medical History Wrist/ Forearm Left (Red) - Your client has had multiple injuries or permanent changes to their wrist/forearm on the left side. Please consider that there is likely to be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

25. Past Medical History Wrist/ Forearm Right (Amber) - Your client has had previous injuries to their wrist/forearm on the right side. Please consider that there might be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

26. Past Medical History Wrist/ Forearm Right (Red) - Your client has had multiple injuries or permanent changes to their wrist/forearm on the right side. Please consider that there is likely to be muscle weakening in this area as a result. Consider loading this area gradually and watch out for compensations.

WHAT GYM CLASSES WOULD I BENEFIT FROM? (Taken from risk assessment)

Classes will also be recommended and generated from the scores:

Red In lungs or heart - Circuit training/ Cardio Class - Low Intensity (if amber in another - red overrides)

Amber In lungs or heart - Circuit training/ Cardio Class - High Intensity

Green in lungs or heart - High Intensity Interval Training (HUT) Classes, Spin Class

Red in Lower back / Neck - Pilates, Thai Chi, Cross Training, Spin Class, Aqua Fitness Classes (red overrides amber)

Amber in Lower back/Neck - Pilates, Spinning, Rowing

Amber in shoulders/ thoracic- Low Weights on Cables/Machine, Strength and Toning Classes Red in Hips, Knee’s, Hamstrings, Quads- Legs, Bums and Turns (low intensity) Yoga x 2 a week (red overrides amber)

Amber in Hips, Knee’s, Hamstrings, Quads- Legs, Bums and Turns (high intensity), Zumba, Yoga x 1 a week

Green in shoulder, neck, thoracic, knees, lower back- Kettlebells, Bootcamp, Cross Fit, Body Combat, Martial Arts, Free Weights (20kg+), Military Fitness

WOULD I BENEFIT FROM A SPORTS MASSAGE?

Sports massage can relieve tightness in muscles as well as break down scar tissue which is limiting the contraction of the muscle.

For example, the client may benefit from a sports massage in the following areas: (the following list is depending on getting amber or red in the body screening):

Hamstrings on the left side Hamstrings on the right side

Hip flexors on the left side

Hip flexors on the right side

Quadriceps on the left side

Quadriceps on the right side

Gastrosoleus on the left side

Gastrosoleus on the right side

llliotibial band on the left side

lilliotibial band on the right side

Lats on the left side

Lats on the right side

WOULD I BENEFIT FROM PHYSIOTHERAPY?

If client has past medical history, then advice generate could include:

As you have past medical history in your lower back and/or lower limb then physiotherapy can help improve the function of your joints, muscles and nerves. It can also help strengthen the muscles that have become weak over time and restore function.

As you have past medical history in your neck and/or shoulder then physiotherapy can help improve the function of your joints, muscles and nerves. It can also help strengthen the muscles that have become weak over time and restore function.

As you have past medical history in your wrist and/or wrist then physiotherapy can help improve the function of your joints, muscles and nerves. It can also help strengthen the muscles that have become weak over time and restore function.

If client is currently in pain, the advice generated could include:

As you are currently experiencing pain in your lower back and/or lower limb physiotherapy can help diagnose the cause of your symptoms as well as treating your symptoms in order to help you become pain free once again.

As you are currently experiencing pain in your neck and/or shoulder physiotherapy can help diagnose the cause of your symptoms as well as treating your symptoms in order to help you become pain free once again. As you are currently experiencing pain in your wrist and/or forearm physiotherapy can help diagnose the cause of your symptoms as well as treating your symptoms in order to help you become pain free once again.

If scores red or amber on any Functional Movement, then advice generated could include:

As you have scored red in your functional movement, physiotherapy can help address the weak areas or overactive areas that are causing you to make the compensations. This results in improved function and more efficient movement which can therefore improve performance.

As you have scored amber in your functional movement, physiotherapy can help address the weak areas or overactive areas that are causing you to make the compensations. This results in improved function and more efficient movement which can therefore improve performance.

WOULD I BENEFIT FROM NUTRITIONAL ADVICE?

As your score is red in the fruit and veg category then you would benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. Vitamin supplements could also help if there is found to be a deficiency. This can help improve the overall cardiovascular system and bodily functions. By improving your health this can significantly reduce your chances of injury in the future.

As your score is amber in the fruit and veg category then you may benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. Vitamin supplements could also help if there is found to be a deficiency. This can help improve the overall cardiovascular system and bodily functions. By improving your health this can significantly reduce your chances of injury in the future.

As your score is red in the fatty food category then you would benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. This can help reduce your BMI, Body Fat Risk Score as well as potentially improving your cholesterol levels. By improving your health this can significantly reduce your chances of injury in the future.

As your score is amber in the fatty food category then you may benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. This can help reduce your BMI, Body Fat Risk Score as well as potentially improving your cholesterol levels. By improving your health this can significantly reduce your chances of injury in the future.

As your score is red in the sugary food category then you would benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. This can help reduce your BMI, Body Fat Risk Score as well as potentially improving your cholesterol levels. By improving your health this can significantly reduce your chances of injury in the future.

As your score is amber in the sugary food category then you may benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. This can help reduce your BMI, Body Fat Risk Score as well as potentially improving your cholesterol levels. By improving your health this can significantly reduce your chances of injury in the future.

As your score is red in the balanced diet category then you would benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. Vitamin supplements could also help if there is found to be a deficiency. This can help improve the overall cardiovascular system and bodily functions. By improving your health this can significantly reduce your chances of injury in the future.

As your score is amber in the balanced diet category then you may benefit from some nutritional advice. This can be straight forward and be adapted to your everyday routine. Vitamin supplements could also help if there is found to be a deficiency. This can help improve the overall cardiovascular system and bodily functions. By improving your health this can significantly reduce your chances of injury in the future.

WOULD I BENEFIT FROM PSYCHOLOGICAL SUPPORT?

As you scored Red for in the stress category, then psychological support can help. A healthy body and a healthy mind are very important. Evidence suggests a significant link between the two. This means if you are feeling stressed or depressed your body will soon decondition to keep in line with your mind. By reducing your stress this will improve your health and help keep your body injury free.

As you scored Amber for in the stress category, then psychological support can help. A healthy body and a healthy mind are very important. Evidence suggests a significant link between the two. This means if you are feeling stressed or depressed your body will soon decondition to keep in line with your mind. By reducing your stress this will improve your health and help keep your body injury free.

Red Sleep Red Stress:

It seems you are getting nowhere near enough sleep for your age and you have a lot of stress in your life on a day to day basis. If you are stressed, then this might be affecting your sleep and if you don’t sleep this affects the ability to organise thoughts in your head to help with stress. Psychological support can help you better organise your thoughts which can aid your sleep and further improve your mental health. Red Sleep Amber Stress:

It seems you are getting nowhere near enough sleep for your age and you have moderate levels of stress in your life. If you are stressed, then this might be affecting your sleep and if you don’t sleep this affects the ability to organise thoughts in your head to help with stress. Psychological support can help you better organise your thoughts which can aid your sleep and further improve your mental health.

Amber Sleep Red Stress

It seems you are not getting the recommended amount of sleep for your age and you have a lot of stress in your life on a day to day basis. If you are stressed, then this might be affecting your sleep and if you don’t sleep this affects the ability to organise thoughts in your head to help with stress. Psychological support can help you better organise your thoughts which can aid your sleep and further improve your mental health.

Amber Sleep Amber Stress:

It seems you are not getting the recommended amount of sleep for your age and you have a moderate amount of stress in your life. If you are stressed, then this might be affecting your sleep and if you don’t sleep this affects the ability to organise thoughts in your head to help with stress. Psychological support can help you better organise your thoughts which can aid your sleep and further improve your mental health.

Claims

1 . A computer implemented method of generating an expected injury risk of an individual, said method comprising the steps of:

undertaking a health assessment of the individual’s current health, based on responses to one or more health questions to determine loads on the individual;

undertaking a lifestyle assessment of the individual’s current lifestyle, based on responses to one or more lifestyle questions to determine usages of the individual;

undertaking a body foundation assessment by a medical professional, to determine foundations of the user;

determine a series of screening markers, based on the difference between the body foundation assessment and the health and lifestyle assessments, wherein each screening marker provides a visual indicator of the risk of injury to the user of a body part; and

presenting the visual indicator to the user.

2. The method of claim 1 , wherein the step of presenting comprises combining screening markers to provide a screening map of injury risk for the user.

3. The method of claim 1 or claim 2, wherein the risk of injury shown by the screening marker is determined from a comparison between the loads and usages associated with a body part or movement of the body and the foundations associated with said body part.

4. The method of claim 1 or claim 2 or claim 3, further comprising the step of determining one or more physical exercises or movements to improve foundations of the user.

5. The method of any preceding claim wherein the body foundation assessment is based, at least in part, on the outcome of the health and lifestyle assessments.

6. The method of any preceding claim wherein the health and/or lifestyle assessment is a questionnaire asking the user questions such as demographics, diet, health, approach to exercise and the type of exercise they partake in.

7. The method of any preceding claim wherein the loads, lifestyles and foundations each comprise a score or rating.

8. The method of claim 7 wherein the screening marker comprises a number of parameters chosen from the loads, lifestyles and foundations, said screening marker comprising a foundation score based on the scores or ratings of the number of parameters.

9. The method of claim 8 wherein the foundation score comprises a ranking of risk of injury to the user for a body part.

10. The method of claim 8 or claim 9 wherein the number and selection of parameters differs for each body part of the user.

1 1 . The method of any one of claims 8 to 10 wherein the foundation score is determined by the score or ranking of the lowest ranked parameter.

12. The method of any one of claims 8 to 1 1 , wherein the foundation score is automatically updated as scores of the number of parameters is altered.

13. The method of claim 12, wherein scores of one or more of the loads, lifestyles and foundations are automatically updated based on information collected from one or more monitoring devices associated with the user, and wherein the scores of the number of parameters are automatically updated to also update the foundation score.

14. The method of any preceding claim wherein each screening marker provides a breakdown of the loads, usages and parameters that determine the risk of injury.

15. The method of any preceding claim, further comprising the steps of:

generating exercise recommendations for one or more body part to improve foundations; and transmitting the exercise recommendations to the individual or a healthcare practitioner.

16. The method of claim 15, wherein the step of generating exercise recommendations are by: characterising risk factors based on the visual indicators; and

generating recommendations based on the risk factors.

17. The method of claim 16, further comprising the step of adapting the visual indications based on which recommendations are accepted.