CH703611B1 - Interactive training system for rehabilitation of physiologically compromised patients - Google Patents

Abstract

The invention relates to an interactive training system (1) for the rehabilitation of physiologically impaired patients, (2) comprising a receiving means (3) for a body part to be trained, a base unit (4), at least one sensor (7) mounted in or on the receiving means (3) ) and optionally at least one in or on the receiving means (3) attached actuator (9), which sensors and actuators are connected to the base unit (4). It is essential that to the base unit (4) further data input and data output means are connected, so that a therapist (37) to define a training program and the patient (2) to complete the training program on these other data input and data output means with the interactive training system (1) can interact.

Description

The invention relates to an interactive training system for the rehabilitation of physiologically impaired patients and a method for performing a rehabilitation of physiologically impaired patients with an interactive training system, as indicated in the claims 1 and 21.

From US 5,466,213 a generic device and a generic method for interacting with a patient to train his motor skills is known. According to this known system, an interactive robotic therapist is provided, which interacts with the patient by means of a movable robot arm and guides the body part to be trained through the physiotherapeutic exercises of the training program. During an exercise, by applying force to the robotic arm guiding it, the patient can change the movement path of the exercise movement. According to the invention, the physiotherapeutic exercises can be determined by moving the robot arm, which movements are stored in the memory of a controller of the interactive robotic therapist and later called by the patient. Further, it is shown that with such a system, a therapist can care for multiple patients simultaneously without having to be physically present at each of them, and a patient can also independently perform the physiotherapeutic exercises of the assigned exercise program with the disclosed robotic interactive therapist. The versatility in the training exercises achievable with this system or with this procedure is severely restricted by the fundamental fixation on the movable robotic arm as the main means of interaction, and the available options for assisting therapists and patients are thus only partially satisfactory.

Furthermore, WO 2008/124 025 A1 describes a device and a method for guided movement execution of body parts to be trained by means of a driven orthosis. The equipped with actuators driven orthosis is mounted on the body part to be trained and supports or directs the patient by synchronously driving the actuators in the movement of the body part to be trained along the desired movement path according to the tolerances allowed. The forces applied thereby by the driven orthosis on the body part to be trained can be selected in their strength proportional to the deviation from the desired movement path. Further, a method is disclosed in which the user of the driven orthosis is given visual feedback about the deviation between the desired and actual motion path. This embodiment is also unsatisfactory in terms of diversity of the physiotherapeutic training exercises and the support of the therapist and the patient in the determination or completion of the training exercises by only one main, less flexible interaction means, namely the driven orthosis.

The present invention has for its object to provide a training system for the rehabilitation of physiologically impaired patients, especially of patients with movement impairment of the extremities, which increases the efficiency of planning, setting, completion and evaluation of a physiotherapeutic exercise program and an additional Relief of the therapist and support of the patient contributes.

The above object of the invention is achieved by an interactive training system according to the features in claim 1.

According to the invention, the training system comprises a base unit to which a variety of data input means, such as the sensors of a receiving means for the body part to be trained, a touch screen or a video camera, and a variety of data output means, such as the actuators of the receiving means for the body part to be trained, a screen or a speaker, connected and / or installed so that on the one hand a therapist can interact with the training system to set up or configure a patient training program and on the other hand the patients can interact with the training system to provide the therapist with and / or interactive physiotherapy training program chosen by the patient himself. The interactive training system supports the therapist in the creation of a training program and relieves him in the care of his patients. Likewise, the interactive training system supports the patient in completing the training program, and thus increases the efficiency of physiotherapeutic care for both the therapist and the patient.

Concretely, the therapist has the following advantages. The interactive training system allows the therapist a simple, interactive definition of the training program and supports him in the intensive care of several patients. The extensive data entry and data output options enable the definition of individually tailored to the respective patient and varied training programs and provide the therapist versatile evaluation options. This results in an improved tracking and recording of the course of therapy and success.

The advantages for the patients include the following: They are offered an increased quality of treatment, since a tailor-made training program can be set very well on them. Likewise, the varied data entry and data output options make it possible to have a varied training program, which, above all, increases the motivation of the patients to complete or achieve their respective training program or training schedule on a regular basis and in a timely manner.

An advantage of the interactive training system is also that this versatile system can also be used for targeted training of healthy people, resulting in, for example, increased utilization of the interactive training system.

Also advantageous are the measures according to claim 2, since a mobile, interactive training system is created, the position of which can be changed in the treatment room in a simple manner. It is also possible to use this mobile, interactive training system in several rehabilitation centers or at home, since the system is easy to transport.

Another advantage is also an embodiment according to claim 3, as this information can be issued acoustically and in particular instructions can be given to the patient regarding the training exercise to be completed. It is also possible to increase the motivation of the patient, for example by the output of music or inspiring tones or sounds or bars during the exercise. An output of acoustic information via a headphone is on the one hand suitable for assisting patients with a hearing impairment, on the other hand this results in the advantage, for example in a rehabilitation center, that any further persons in the same room are not disturbed.

Advantageous further are the measures according to claim 4, as this rich visual information can be given to the user of the interactive training system and a patient in the execution of a training exercise can be given precise instructions. Likewise, an increase in the motivation of the patient is made possible visually by the output of appealing graphics, images, animations or video films.

The advantageous measures according to claim 5 allow on the one hand, that the external screen for displaying visual information can be positioned at a suitable location, for example, at eye level a short distance in front of the patient, and thus a good readability for the patient is ensured. On the other hand, the use of an already existing on the patient screen, for example, the patient's television, that the base unit of the interactive training system has very compact dimensions, so that the mobility or transportability of the training system is improved.

Also advantageous are the measures according to claim 6, as this visual information in the training room can be flexibly projected, so they can be positioned well visible by the user of the interactive training system. Furthermore, the projection of an image allows a very large and easy-to-read representation of visual information, which is particularly advantageous for users with visual impairments.

Also advantageous are the measures according to claim 7, since thereby the quality and clarity of the visual representations is greatly improved and thus, for example, the clarity of instructions for exercise performance for the patient is greatly increased. Furthermore, in exercises such as games of skill and the spatial perception is trained, which, for example, benefit patients with neurological impairments after surgery or a stroke.

Advantageous further measures according to claim 8, since instructions to the user of the receiving means for the body part to be trained can also be transmitted via the haptic information channel. This makes it possible, for example, to give patients even more precise and detailed instructions during the exercise. For example, it is possible to give a haptic indication to the patient at a too large deviation of the exercise movement of the predetermined target movement with a vibration actuator in the receiving means for the body part to be trained, which is approximately comparable to a gentle guidance by the hand of a therapist , Thus, an additional information channel is available in the interactive training system.

Another advantage is the measures according to claim 9, as created by the use of a touch screen as a data input means on the base unit, a very versatile user interface, which can be operated in a simple and intuitive manner by the therapist and / or the patient to to control or use the training system interactively.

Also advantageous are the measures according to claim 10, as this acoustic information can be recorded and processed by the base unit. Thus, it is possible, for example, to realize a simple control of the interactive training system by means of voice commands. Furthermore, it is possible to record the voice of the user of the training system or other ambient noise, analyze and, if necessary, for example, at the request of the user to forward to a recipient. In addition, the acoustic information, in particular in conjunction with additional and other information obtained, also evidence of the condition and condition of a patient and especially on the presence of unusual or dangerous conditions can be obtained, so that in case of problems can respond immediately. This increases the safety of the patient when using the interactive training system.

If a plurality of microphones spaced apart from each other are used, their signals can also be linked together and thus a fixed or even adjustable directional characteristic can be achieved in order to detect acoustic signals from the user's direction, while filtering out or at least attenuating other environmental noises. This serves to improve the quality of the acoustic information recorded by the microphones. Likewise, the signals of multiple microphones can be linked in order to achieve an at least limited location of the acoustic source, in particular the user, so that the interactive training system at least the approximate position of the acoustic source is known.

Also of advantage are the measures according to claim 11, since the inclusion of a video image is a very versatile and comprehensive source of information regarding the activities of the user of the interactive training system is available. In addition to the basic recognition of whether a user of the training system is present, a variety of different data can be recorded by a user, for example his position, his current movement, his gestures, his facial expressions or his direction of view. In particular, the performed movement of a patient with the receiving means for the body part to be trained can be recorded very accurately, so that control over the correct execution of the exercise is easily possible. The detection of the viewing direction of the patient can also be used for simple operations, which significantly improves the operability of the interactive training system for patients with significant impairment of the motor skills of the arms or with a movement restriction of the applied receiving means.

Also advantageous are the measures according to claim 12, as this allows even more accurate detection of the position, movement and behavior of users and objects in the interactive training system.

Another advantage are the measures according to claim 13, since on the one hand an increased ease of use for the users of the interactive training system is achieved because a user is more flexible in its position, are issued from the operating commands. On the other hand, the mobile hand-held unit also provides a uniform user interface with which control commands can be given to the interactive training system in an intuitive manner. Wireless transmission of the commands from the mobile hand-held unit to the base unit further increases the mobility of the hand-held unit and improves ergonomics and operational reliability by eliminating the cable connection.

Also of advantage are the measures according to claim 14, since thereby the care of a patient by a physiotherapist over long distances is possible. Thus, the efficiency of the therapy is increased, because despite intensive care of a patient, for example, strenuous and time-consuming patient transports are eliminated and the travel time for the therapist remains low, resulting in less care costs. Similarly, it is possible for a therapist to care for multiple patients from a central location so that the efficiency of the therapy is also increased.

Also advantageous are the measures according to claim 15, since this no longer in each case patient and therapist must come together to practice the exercise at the same geographical location. On the one hand, the travel and working time for the therapist is reduced, on the other hand, frequent patient transports, which can sometimes be very stressful for the patient avoided, while at the same time the accuracy of the therapeutic exercises carried out or the frequency and regularity of the exercise procedures continue to be encompassed by the therapist and can be controlled exactly. This control can be carried out by the therapist on the basis of the stored data at a time suitable for the therapist, ie very flexibly, or the transmitted data can be viewed and analyzed directly by the therapist, so that immediately hints and corrections can be made to the exercise ,

Another advantage is the measures according to claim 16, since thereby the protection of the privacy of users of the interactive training system, in particular of patients who train with the training system is improved because video image or activity information only after a conscious release by the User is transmitted from the base unit to the central control unit and further in the case of transmission of a video image, the transmitted information is necessarily on the base unit, in particular in a reduced form, is displayed. Examples of typical data output means for this purpose are the internal or external flat screen, the internal or external touch screen, the internal or external loudspeaker or the at least one internal or external projector.

Also advantageous are the measures according to claim 17, since for example patients can communicate with each other via their respective base devices and exchange information, whereby the motivation of the patients to use the interactive training system is increased. The measures offer a further increase in the motivation of the patients to perform the exercises, since training activities of patients can be carried out together, that is playfully with each other or against each other.

Also advantageous are the measures according to claim 18, since it allows storage of the individual settings of the interactive training system for the respective user on a suitable storage medium, such as a hard disk or a memory card with non-volatile memory in the base unit and / or in the central control unit and these individual settings can later be recalled by the patient or therapist and can also be evaluated as well. When the profile data records are stored in a central control unit, these data are also available centrally for the various base units used by the patient.

Also advantageous are the measures according to claim 19, since the unauthorized access to the, in some cases also used by several people, base unit of the interactive training system or stored data, such as profile data or activity information of a user, to simple and secure Way is prevented. Especially in the use of existing chip cards from the health sector for such identification or authentication, advantageous synergy effects arise because the patient must submit such a health chip card in many cases in a treatment by the physiotherapist anyway.

Another advantage is also an embodiment according to claim 20, as this unauthorized, abusive and manipulative access to the transmitted information or control commands is prevented and thus the security of the interactive training system is increased.

For a better understanding of the invention, this will be explained in more detail with reference to the following figures.

In each case in a highly simplified, schematic representation: <Tb> FIG. 1 <SEP> an interactive training system for the rehabilitation of physiologically impaired patients, consisting of a basic device, the body part to be trained and various data input and output means for interacting with the training system by patients and therapists; <Tb> FIG. 2 <SEP> an interactive training system in which a base device operated by the patient also via a mobile hand-held unit and a central control unit operated by the therapist exchange data via the Internet; <Tb> FIG. 3 <SEP> an interactive training system comprising a plurality of base-communicating devices equipped with various data input and output devices and a central control device; <Tb> FIG. 4 <SEP> An interactive training system that visualizes the discrepancy between the therapist's intended training movement and the patient's actual exercise movement on a screen.

By way of introduction, it should be noted that in the differently described embodiments, the same parts are provided with the same reference numerals or the same component names, wherein the disclosures contained in the entire description can be transferred to the same parts with the same reference numerals or the same component names. Also, the location information chosen in the description, such as top, bottom, side, etc. related to the immediately described and illustrated figure and these position information in a change in position should be transferred analogously to the new situation. Furthermore, individual features or combinations of features from the illustrated and described different embodiments may also represent separate, inventive or inventive solutions.

In Fig. 1, an interactive training system 1 is illustrated schematically and by way of example, with which the rehabilitation of physiologically impaired patients 2, in particular of patients 2 with movement impairment of the extremities, is made possible.

According to the illustrated embodiment, a patient 2 sits with a receiving means 3 for the body part to be trained, in this case the left arm or shoulder area, a base unit 4 opposite, which is equipped with a data processing device 5 and a data storage device 6. The data processing device 5 controls the entire interactive training system 1 and accesses information stored in the data storage device 6 or stores information there itself.

According to the embodiment shown, the receiving means 3 is equipped for the body part to be trained with a sensor 7 in the upper arm of the receiving means, which information about the type of movement of the receiving means 3 and thus the arm of the patient 2 via a sensor line 8 to the base unit 4 and its data processing device 5 transmits. Likewise, the receiving means 3 for the body part to be trained is equipped with an actuator 9, with which a support or movement of the left arm to be trained of the patient 2 is performed depending on the training program just completed, the corresponding control commands for the actuator 9 from the data processing device 5 is transmitted in the base unit 4 via an actuator line 10 to the actuator 9.

In an advantageous embodiment, not shown, the sensor information and the actuator control commands are transmitted via wireless connections, for example via radio links, between the base unit 4 and the sensor 7 or actuator 9.

Preferably, the base unit 4 is equipped with further data input and data output means for interacting with the users of the interactive training system 1. In the illustrated embodiment, the base unit is equipped inter alia with a touch screen 11 for the visual display of information and for the touch-controlled recording of user inputs and an integrated loudspeaker 14 for the acoustic output of information such as sounds, music or speech. Also connected to the base 4 of the interactive training system 1 are the video cameras 12, 12 for receiving visual information and the external display 13 for the visual output of information.

In an advantageous embodiment, not shown, the integrated touchscreen 11 can also be designed as an external touchscreen and at least one of the external video cameras 12, 12 can also be integrated in the base unit 4 of the interactive training system.

An expedient embodiment with multiple video cameras 12, 12 allows the three-dimensional detection of the environment, so that about the position, movement, gestures, sight or facial expression of the therapist 37 or the patient 2 can be taken even more accurate. The detection accuracy of the movements of the receiving means 3 for the body part to be trained on a video image can be further increased by, for example, one or more special, optically detectable markings are attached to the receiving means 3.

In an expedient embodiment, not shown, the further external data input and data output means are connected via wireless connections to the base unit 4 of the interactive training system 1, so complicated wiring work or impairments by the existing wiring, in particular impairments of the mobility of the interactive training system. 1 or the freedom of movement of the patient 2 are excluded.

It is now practical that a therapist 37 first uses the interactive training system 1 and interacts with the various data input and output means of the base unit 4 to define or configure at least part of the training program for the patient 2. The training program thus created is stored in the data storage device 6 and can then be carried out by the patient 2 in accordance with the therapist's specifications or according to the physical and temporal capabilities of the patient 2, for the most part independently of the availability or presence of the therapist 37. The patient 2 interacts in a similar manner as the therapist previously with the data input and data output means of the base unit 4 to interactively complete the predetermined physiotherapy training program or to perform any self-selected, additional physiotherapy training programs. The exact training procedure is thereby monitored by the data input means, and on the data output means corresponding instructions for the patient 2 concerning the correct execution of the exercise are displayed and information about exercise deviations and exercise progress is output. Optionally, by means of the at least one actuator 9 in the receiving means 3 for the body part to be trained, a support or movement of the body part to be trained made. The interactive training system 1 therefore supports and relieves, therefore, on the one hand the therapist 37 in the exercise preparation and care and on the other hand also supports the patient 2 in the exercise execution.

It is useful if the base unit 4 of the interactive training system 1 is equipped with a stand device 15, the bottom element 16 is not fixed on the underlying base surface, such as a floor 17. This makes it possible in a simple manner to move the base unit 4 of the interactive training system 1 in a room or the interactive training system 1 with its base unit 4 and the connected data input and data output means to another location, for example, from the ordination of the therapist 37 to the patient's apartment 2, to transport. It is expedient, furthermore, to equip the bottom element 16 of the stand device 15 of the base device 4 with rolling elements 18 on its underside, in order to further increase the mobility of the base device 4.

In special circumstances, for example when the patient 2 suffers from a hearing impairment, it is expedient to connect an external loudspeaker 19 or a headphone 20 to the base unit 4, so that acoustic information such as sounds and noises for one in such a way impaired patients 2 can be audibly issued.

For example, for cost reasons, it may also be appropriate to perform the integrated touch screen 11 in the base unit 4 as a simple, integrated flat screen without touch sensitivity to output visual information such as graphics, animations or videos. Another way to reduce the manufacturing cost of the base unit 4 or to reduce the dimensions of the base unit 4 is the procedure to dispense with the installation of a touch screen 11 in the base unit and the visual information on an external screen 13, which also already in the patient 2 TV can be present.

According to a particularly advantageous embodiment, the base unit 4 of the interactive training system 1 is equipped with at least one externally arranged or, as shown, an integrated projector 21 to display visual information about on a projector screen 22.

It is also expedient to display the visual information on the corresponding data output means, for example the integrated touch screen 11, the external screen 13 or the integrated projector 21, in a three-dimensional representation in order to achieve an increased clarity of the visually displayed information.

According to a particularly advantageous embodiment, the at least one actuator 9 is provided on the receiving means 3 for the body part to be trained with a vibration and / or pressure function, so that information can be transmitted to the user of the interactive training system 1 also haptic way. Such haptic information transmission provides a very immediate and intuitive feedback to the user of the interactive training system 1 and, for example, does not require the user to pay much attention to the corresponding data output means.

It is useful if at least one external microphone 55 is connected to the base unit 4 of the interactive training system 1, with which the patient 2 or the therapist 37 can make voice input for the transmission or control of the interactive training system 1 or other acoustic information, such as ambient noise, can be recorded and processed by the base unit 4. When using a plurality of external microphones 55 and / or a plurality of internal microphones 56 - Fig. 4 - also a microphone can be realized with directivity and / or an efficient compensation of environmental noise can be performed.

In an embodiment not shown, the microphones 55, 56 are used in conjunction with controllable sound generators, in particular ultrasound transmitters, which are attached to one or more points of the receiving means 3 of the body part to be trained, so that also a position, positional and / or movement determination of the receiving means 3 can be carried out.

A method implementable with the interactive training system 1 according to the invention for carrying out a rehabilitation of physically impaired patients 2, in particular patients 2 with limb movement impairments, comprises the following steps: First, the training program is initiated by the therapist 37 by interaction with at least a part of built into the base unit 4 and / or the data input and data output means connected to the base unit 4 set or configured. Subsequently, the receiving means 3 for the body part to be trained is applied or positioned on the body part of the patient 2 to be trained, and the exercise program 37 previously interactively defined or configured by the patient 2 is now interacting with the base unit 4 interactively completed data entry and data output means or the patient 2 completes a self-selected physiotherapeutic training program with the support of the interactive training system 1.

According to an advantageous measure, it is provided that at least one therapist 37 and optionally further persons are filmed when issuing training instructions or when explaining or presenting the training exercises to be performed by means of a video camera 12 and / or acoustic information is recorded by means of a microphone 55. The instructions or explanations can be given in different languages or according to different character characteristics. It is also possible to record various useful variations of the training target 50 - Fig. 4 - for the patient 2 or to record the training target 50 from different angles. Furthermore, these records can be made several times in varying degrees of detail. After processing the recordings thus obtained and assigning them to specific training situations or sequences, these explanations and / or representations of the training target movement 50 for instructing and supporting a patient 2 during the execution of a training unit via loudspeakers 14, 19, headphones 20, touchscreen 11 , Screen 13 and / or projector 21, which are connected to the base unit 4 of the interactive training system 1 reproduced. This reproduction of the edited real shots takes place in quasi-random sequences or variations or depending on the current training situation, the intended exercise procedure, the condition and / or the response of the patient 2. It is particularly expedient, the recorded training instructions and / or movement presentations alternately or simultaneously with live recordings of the patient 2 during the completion of the training exercise.

2 shows a highly schematic representation of an embodiment of an interactive training system 1, which comprises a base unit 4 operated by a patient 2 with attached receiving means 3 for the body part to be trained, a mobile hand control means 25 and a central control unit 28 operated by the therapist 37 includes.

[0053] The terms "hand-operated means" and "hand-held control unit" are understood to mean the same subject matter here, and the same reference numeral 25 is assigned to the two terms.

In the illustrated expedient embodiment, the data processing device 5 of the base unit 4 has a data interface 23, which establishes a radio link with the aid of the radio antennas 27 and 27 with a corresponding data interface 24 on the mobile hand-held means 25. The patient 2 can now manually guide the mobile hand control means 25 and transmit operating commands wirelessly via the radio link to the base unit 4 by means of the operating elements 26, 26 on the mobile hand control means in order to control the interactive training system 1. Conveniently, the mobile hand control means 25 may also be equipped with a display means 57. In one embodiment, not shown, the connection of the data interfaces 23 and 24 of the base unit 4 and the mobile hand-held means 25 is made wired with a cable connection.

According to a particularly advantageous embodiment, the interactive training system 1 in addition to the base unit 4, a central control unit 28, wherein the data processing device 29 of the central control unit 28 has a data interface 30 and the data processing device 5 of the base unit 4 has a corresponding data interface 31 via which a connection between the two devices for exchanging data in both directions. Such a connection between the base unit 4 and the central control unit 28 can be made for example via the Internet 32 or via the mobile radio network, not shown.

On the one hand, this embodiment enables the therapist 37 to interactively operate the base unit 4 via the central control unit 28 and to provide the exercising patient 2 with information, for example a message 33 displayed on the touch screen 11 of the base unit 4, or the training program of the patient 2 to update or expand. On the other hand, it is possible to transfer data from the base unit 4 to the central control unit 28 and thus to the therapist 37. Such data may be, for example, a video image of the exercising patient 2 or activity information obtained from sensors in the recording means 3 of the body part to be trained. The transmitted data may be stored in the central controller 28 and later analyzed by the therapist 37, or the transmitted data will be viewed and analyzed live by the therapist 37 at the central control unit 28, prompting the therapist 37 immediately to provide any feedback, cues or comments to the patient 2 on the base unit 4 can transmit to influence the execution of the training program.

According to an advantageous embodiment, data, such as a video image, from the base unit 4 to the central control unit 28 only after the user of the base unit 4 has an electronic or programmatic lock by pressing a release means, for example, a button 11 shown on the touchscreen 11 has lifted , When transmitting a video image from the base unit 4 to the central control unit 28, it is furthermore expedient to display the video image 35 on the touchscreen 11 in possibly reduced form 36 on the touchscreen 11 of the base unit 4, so that the user of the base unit 4, whose activities are recorded by a video camera 12 is always informed about which video image 35 the therapist 37 can see on the central control unit 28.

As best seen in FIG. 3, an interactive training system 1 may also comprise at least one central control unit 28 for the therapist 37 and several base units 4, 4 for the patients 2, 2 with their respective receiving means 3, 3 consist of the body part to be trained.

According to an advantageous embodiment, it is provided that the patients 2, 2 communicate via the data interfaces 31, 31 of the data processing devices 5, 5 in their respective base units 4, 4 and, for example, exchange information or perform training activities together. Basically, such communication is not limited to two basic devices 4, 4, but can be extended to any number of basic devices.

It is advantageous if the data processing devices 5, 5 are equipped in the base units 4, 4 with data storage devices 6, 6 and the data processing device 29 in the central control unit 28 also has a data storage device 38, so that profile records from the patient 2, 2 in the base units 4, 4 or after transmission via the data interface 30 of the data processing device 29 in the central control unit 28 can be stored in these storage media. The data connection between the base units 4, 4 with each other and also each to the central control unit 28 can be accomplished, for example, again via the Internet 32.

It is useful if a base unit 4 as a data input means a keyboard 39, a contact-type or contactless transponder reader 40 and / or a contactless or contact smart card reader 41, so that an identification of a user of the base unit 4, for example, a patient 2, means a user name entered on the keyboard 39 or a transponder 42 placed in the vicinity of the contactless transponder reader 40 is feasible. Likewise, with these devices, a secure authentication of a user of the base unit 4 by means of an entered via the keyboard 39 user name-password combination, brought by a brought into the vicinity of the contactless transponder reader 40 cryptographic transponder 42 or by means of a contact-type chip card reader 41 smart card 43 possible. In a particularly advantageous embodiment, the chip card 43 used is an already existing chip card from the healthcare sector, which the patient 2 carries with him anyway.

It is useful, if the previously described, communicating devices, namely the central control unit 28 and its data storage device 38, the base units 4, 4 and their respective data storage devices 6, 6, the keyboard 39, the contactless transponder reader 40 or the contact Chip card reader 41, equipped with data encryption means, so that the transmitted information is encrypted transferable or storable and / or only for the authorized therapist 37 and the authorized patient 2, 2 are available. Among these already mentioned, communicating devices, which may be equipped with data encryption devices, also includes a mobile handheld 25, which is equipped with controls 26, 26 and a display means 57, and which via a data interface 24 and a radio antenna 27 a radio link to provided with a radio antenna 27 equipped data interface 23 in the data processing device 5 of the base unit 4. Thus, the exchanged between the base unit 4 and the mobile hand-held 25 data can be transmitted encrypted and are thus deprived of access by third parties.

For safety-related considerations, it may further be expedient to use not only data encryption but also a data integrity check and / or a data authenticity check in order to likewise prevent manipulation of the data streams between the various communicating devices.

According to a particularly advantageous embodiment of the interactive training system 1, a patient 2 is assisted in performing the exercise with the receiving means 3 for the body part to be trained by a virtual trainer or avatar, for example, visually on the touch screen 11 of the base unit 4 is represented and represents the therapist 37. It is expedient for the patient 2 to be able to select the properties of the avatar, for example its appearance 44 or 44, in order to receive the training instructions by this virtual trainer or avatar via the data output means of the interactive training system 1. Likewise, it is expedient to make the voice of the virtual trainer or avatar and / or his character, for example soft-gentle or hard-demanding, selectable for the patient 2. It may also be up to the therapist to parameterize at least some of the properties of the virtual trainer or avatar.

This increases patient acceptance and patient motivation when using the interactive training system 1. The representation of a virtual trainer or avatar 44, 44 with a suitable data output means of the interactive training system 1, for example a screen 13 or a projector 21, allows the creation of a therapy or exercise situation for the patient 2, which is comparable to that, in which the therapist 37 is physically present at the patient 2, so that both can interact immediately during the exercise. The virtual trainer or avatar 44, which represents the physiotherapist 37, which is tunable to the special wishes of the patient 2, subsequently motivates the patient 2 during his training and if desired presents the rehabilitation exercises to be carried out, for example by playing a video sequence of the exercise or by playing an animation of the exercise. Thus, regardless of the presence of the therapist 37, the patient 2 can be instructed in the respective training exercises or perform these training exercises and is assisted by a virtual trainer or avatar 44, 44 with as humanoid behavior or design as possible. The use of an avatar 44, 44 also creates in long-term therapies a constant and familiar reference personality for the patient 2, even if the therapist 37, who accompanies the therapy remotely, actually changes, as occurs for example due to vacation or especially in the clinic ,

It is also expedient to adapt the vocabulary of the virtual trainer or avatar depending on the comprehension ability of the patient 2 and / or adaptively according to the training course and the reactions to given voice instructions in the speech output. The voice output can also be multilingual.

In an advantageous embodiment for the training patient 2 only offline or online available entertainment media such as music, movies or games unlocked on the base unit when the intended training performance has been provided. This serves in particular for the motivation of the patient 2 to provide the intended training performance or even to exercise more often than required.

A particularly advantageous measure is to record the training movement of the patient 2 with the receiving means 3 for the body part to be trained by means of a video camera 12 and this training movement or an animation calculated therefrom by means of a projector 21 integrated in the base unit 4 visualize on a projector screen 22 and embed the illustrated training scenario 45 in the most realistic possible environment by mapping a real environment or animated as realistically as possible. It is particularly advantageous or motivating for the patient 2 if known, real environments are used for this imaging or animation for the patient 2.

In this way, the motivation of the patients is increased to fulfill the intended training schedule, since very realistic training scenarios or exercise presentations are provided. Likewise, such a method enables a compilation of very varied training and exercise scenarios for the therapist. In the mapping or animation of the patient 2 already known environments whose motivation is further increased because a training exercise could then be as follows: By performing the exercise movement, which is registered by the receiving means 3 for the body part to be trained, the patient 2 with his virtual training figure representing him travel a known route from a known building A to a building B known to him. The virtual training figure is displayed by the interactive training system 1 in the mapping or animation of the known real environment according to the current training progress and displayed by a suitable data output means, such as the projector 21, the training system 1.

It is expedient if an interactive reminder or reminder is transmitted, for example as a message 46 to the base unit 4 of the patient 2 as a measure to catch up a training backlog. In a further advantageous embodiment, not shown, this reminder message 46 is also sent as a short message to the mobile phone of the patient 2, as an e-mail to his e-mail address and / or as a message to his user account in a social network. As a result, the patient 2 is reminded or motivated to reliably participate in the agreed training appointments and online voting appointments with the therapist 37 and to catch up with this backlog in the event of a training backlog.

According to another advantageous measure, the therapist 37 uses a sensor suit 47 which comprises the body part to be trained in order to define a training target movement by active movement. This training target movement is stored and converted to the body part of the patient 2 to be trained or the properties of the receiving means 3 used by the patient for the body part to be trained or integrated and integrated as a target movement in the training program to be carried out independently by the patient 2. In the independent implementation of the training target movement by the patient 2, this is optionally supported by at least one actuator 9 in or on the receiving means 3 for the body part to be trained. As a result, a simple and efficient procedure is provided for the therapist 37 in order to define or configure the desired movement of the patient 2 with the body part to be trained in the training program. By directly transferring the movement pattern from the therapist 37 to the patient 2, a very precise match of the target movement performed by the therapist 37 and the actual movement performed by the patient 2 is ensured, whereby an increased therapeutic effect is achieved.

As a variant of the measure last described, it is also appropriate that the therapist 37 is present at the patient 2 and by moving the applied to the patient 2 receiving means 3 for the body part to be trained and thus by moving the body part to be trained itself the training target movement pretends that it is stored and is then integrated as a target movement in the independently carried out by the patient 2 training program, with the independent implementation of the target movement by the patient 2 is optionally supported by at least one actuator 9 in or on the receiving means 3. This ensures that the patient 2 performs the training exercise as correctly as possible and according to the instructions of the therapist 37 accordingly. Equally, the training exercises can also be carried out by physically weakened patients, since on the one hand the therapist 37 and, on the other hand, the optional actuators 9 in or on the receiving means 3 for the body part to be trained support the movements of the body part of the patient 2 to be trained. In an embodiment not shown, the present therapist 37 alternatively performs the exercise movement with the corresponding healthy body part of the patient, and this training target movement is received by the interactive training system, stored and converted to the body part of the patient 2 to be trained. Thus, in turn, a training target movement is available for integration into the training program of the patient 2 to be carried out independently.

It is particularly expedient if the trainingist movement of the patient 2 is recorded with suitable data input means, for example with a video camera 12, and displayed directly on the projector screen 22 with the integrated projector 21. This representation as an immediate illustration or animation serves as a "training mirror", with which the training movement just completed by the patient 2 itself or by the therapist 37 can be observed directly and from different perspectives and thus errors or deviations can be detected more easily. This especially increases the exercise accuracy and thus improves the treatment effect.

FIG. 4 shows exemplary advantageous measures for an interactive training system 1 in order to ensure the correct execution of a training movement by a patient 2.

It is expedient here if the training set movement carried out by a therapist 37 is recorded in the base unit 4, for example with sensors 48, 48 on the receiving means 49 for the body part to be trained, which receiving means is worn by the therapist 37 for this purpose then with the trainingist movement of the patient 2, which carries a receiving means 3 for the body part to be trained, is compared. The training movement of the patient 2 is recorded by a video camera 12 and processed by the base unit 4. For easy and clear comparison, the training target movement 50 and the training movement 51 are superimposed on the screen 13 connected to the base unit 4 and any deviations 52 between the training target movement 50 and the training movement 51 are specifically marked or highlighted, for example by a color and graphic highlighting of the deviation 52 by red arrows. It is expedient, if entertainment media are used or played via a loudspeaker 14 during the execution of the exercise, to interrupt the reproduction of these entertainment media when too great a deviation 52 occurs between the training target movement 50 and the training movement 51 in order to make the patient 2 aware of it and in order subsequently to avoid any physical damage.

It is also advantageous to adapt the training program currently carried out by the patient 2 to the condition and / or according to the feedback of the patient 2 in an adaptive or situation-dependent manner. In order to determine the behavior or the physiological state of the patient 2 during the execution of the training program, various data input means such as a video camera 12, a temperature sensor 52, a pulse sensor 54 or a microphone 56 integrated in the base unit 4 can be used, and a comparison of training target movement 50 can be used and exercise movement 51. Likewise, a determination of the physiological and psychological condition of the patient 2 via simple question / answer dialogues is expedient. As a result, a training program which is even better adapted to the patient 2, his body part to be trained and his physical and mental state is carried out, since the training exercises are adapted directly and continuously to the current training situation. This significantly improves the therapeutic effect and avoids over or under-demanding the patient 2.

It is also advantageous to determine any problem or emergency situations of the patient 2 during the implementation of the training program based on an analysis or evaluation of the information from the data input means and bring a regulated shutdown or in neutral position when a problem or emergency situation occurs of the training system 1 and its receiving means 3 for the body part to be trained to perform. Essential, for example, is the automatic recognition and controlled resolution of spastic paralysis phenomena during the passive movement of a patient, which are a frequent accompanying symptom after damage to the central nervous system. The passive movement of the patient should be stopped immediately, the paralysis by a slow counter-movement to dissolve and then continue the exercise, especially at a reduced rate. It is also expedient, if entertainment media are displayed or played during the execution of the training program, to interrupt the reproduction of these entertainment media in the event of a problem or emergency situation of the patient 2. These measures improve the safety of the patient 2 when using the interactive training system 1, since problems or emergency situations are reliably and quickly recognized by the system and, when such a situation occurs, a regulated shutdown or in-neutralization of the training system 1 and in particular the receiving means 3 for the body part to be trained is caused, so that injuries and further stress on the patient 2 are reliably avoided. The monitoring takes place both with regard to exercise deviations and with respect to medical problems of the patient 2.

A further, particularly advantageous measure is to start a occasion-related image recording with the video camera 12 and / or an occasion-related audio recording with the built-in base unit 4 microphone 56 in the presence of a problem or emergency situation of the patient 2 and this image or Sound information to a central control unit 28 - Fig. 3 - on which a therapist 37 sits to transfer. This therapist 37 is immediately aware of the problem or emergency situation of the patient 2 and can initiate appropriate auxiliary measures.

In an expedient embodiment, not shown, the therapist 37 is equipped with a special data input and output means, which as a wireless, mobile alarm device in a problem or emergency situation of the patient 2, the data emitted in such a case by the base unit 4 data, for example, receives or displays image or sound information. The therapist 37 is thereby made aware of the problem or emergency situation of the patient 2 regardless of his presence at the central control unit 28 and can initiate appropriate auxiliary measures. The transmission of the data to and from the mobile alarm device also takes place via a radio network, in particular a mobile radio network. The data for or from the mobile alarm device are either sent or received directly from the base unit 4, or the central control unit 28 acts as an intermediate station in the communication of base unit 4 and mobile alarm device. In this case, in an expedient embodiment, the central control unit 28 only transmits the data if no therapist 37 is present at the central control unit 28.

It is also particularly expedient to use the image taken by a video camera 12 of a patient 2 or therapist 37 to analyze the gestures, facial expressions and / or viewing direction of the patient 2 or therapists 37 and with this information the interactive training system 1 to control. This allows a very simple and intuitive control of the interactive training system 1, in which a user is also flexible in its positioning, since operator inputs do not have to be made directly on the base unit 4. In particular, an operation of the interactive training system 1 is also possible if a patient 2 due to his physical impairment or due to the momentary impairment of his freedom of movement by the receiving means 3 for the body part to be trained an operation in a conventional manner on the base unit 4 is not possible. Likewise, the user of the interactive training system 1 can be identified on the basis of the present image information by the application of facial recognition methods, so that, for example, the corresponding profile data set can be loaded automatically or a personal greeting message can be output.

A further advantageous measure is the activity or movement information of a patient 2 during the execution of the training program in the data storage device 6 of the data processing device 5 of the base device 4 and / or, as best seen in Fig. 3, in the data storage device 38 of the data processing device 29 of the central control unit 28 to store, then anonymize this data, so that no longer on the patient 2 or its therapist 37 can be deduced and provide this anonymized data other therapists or medical research groups for scientific evaluation available to the physiotherapeutic To improve therapies. This makes it possible to compile a central knowledgebase on defined and performed exercise movements and other information about the training and physiological condition of the patients, which data are available for other therapists or for scientific evaluations, for example, and at the same time the privacy of the patients and therapists is sufficient is protected. The anonymization of the data thus creates a balance between the data analysis for the improvement of therapies and the data protection for patient data.

In an embodiment of an interactive training system 1, not shown, the central control unit 28 consists of two separate components: a control and access device and a data supply device. In particular, the data delivery device is implemented as a central, highly reliable and available database server that stores a variety of information such as, for example, ready-made training programs, multimedia files, therapy history data and patient data or profiles. The data delivery device also includes, in addition to the means for data storage, all the resources necessary for a highly reliable and available state-of-the-art data management, such as data protection, access protection and uninterruptible power supplies. Likewise, the data delivery device optionally offers central services, such as a short-range call generation and transmission service, as is common in mobile networks. The data providing device is housed, for example, in a large data center, in which a plurality of similar servers are operated for completely different purposes. A personal presence of staff is not provided except for service purposes. The control and access device is designed in particular as a commercially available PC or laptop with appropriate control software and is available to the therapist 37, for example via the Internet to the base units 4, 4 for performing control and communication tasks or to the data providing device for storing and retrieve information or use centralized services. In particular, the therapist 37 deposits information such as training programs for the patients 2, 2 by means of the control and access device in the data delivery device and can also retrieve information such as therapy history data or activity data from patients 2, 2 from there, which data from the base devices 4, 4 of the patients 2, 2 were stored there or stored. The base units 4, 4 in turn access the deposited for them or the patient 2, 2 and enabled information such as the aforementioned training programs. The base devices 4, 4 may also access at least a portion of the central services offered by the data delivery device, according to their authorization. Through this system, information can be exchanged between the therapist's control and access device 37 and the base devices 4, 4 without having to operate both simultaneously. At the same time, the data storage and service provisioning takes place centrally and in accordance with the high security and availability standards of modern data centers, which would not be possible with a data storage or service provision directly to the therapist 37.

Thus, for example, granting training instructions or explanations optionally in different languages or according to different character characteristics and / or representing training target movements in particular in different variations by at least one therapist and optionally other persons possible. Likewise, a recording of these explanations and / or representations may optionally also be useful multiple times in different degrees of detail or from different angles, in particular visually by means of a video camera and / or on an acoustic path by means of a microphone, as well as editing or cutting these records. Subsequently, assigning the thus obtained scenes or recordings to different languages, training situations or sequences or characters of the virtual trainers or avatars and the reproduction of these explanations and / or representations, in particular with a speaker and / or on a screen of the Base device depending on the current training situation, the intended exercise procedure, the condition and / or the reaction of the patient or the playback of the processed real shots in quasi-random sequences or variations are performed. Finally, it may be appropriate to perform a replay of the recorded training instructions and / or motion images alternately or simultaneously with live recordings of a patient during the completion of a training exercise.

The embodiments show possible embodiments of the interactive training system, it being noted at this point that the invention is not limited to the specifically illustrated embodiments thereof.

For the sake of order, it should finally be pointed out that, for a better understanding of the construction of the interactive training system, this or its components have been shown partly without dimensions and / or enlarged and / or reduced in size.

REFERENCE NUMBERS

[0086] <Tb> 1 <September> Training System <tb> 2, 2 <SEP> Patient <tb> 3, 3 <SEP> Receptacle <tb> 4, 4 <SEP> Base device <tb> 5, 5 <SEP> Data processing device <tb> 6, 6 <SEP> data storage device <tb> 7, 7 <SEP> Sensor <tb> 8, 8 <SEP> Sensor cable <Tb> 9 <September> actuator <Tb> 10 <September> actuator cable <tb> 11,11, 11 <SEP> touchscreen <tb> 12, 12 <SEP> video camera <Tb> 13 <September> Screen <Tb> 14 <September> Speakers <Tb> 15 <September> fixture <Tb> 16 <September> floor element <Tb> 17 <September> Floor <Tb> 18 <September> rollers <Tb> 19 <September> Speakers <Tb> 20 <September> Headphones <tb> 21, 21 <SEP> Projector <Tb> 22 <September> projector screen <Tb> 23 <September> Data Interface <Tb> 24 <September> Data Interface <tb> 25 <SEP> Mobile handheld <tb> 26, 26 <SEP> Control <tb> 27, 27 <SEP> Radio antenna <Tb> 28 <September> central control unit <Tb> 29 <September> Data Processing Device <Tb> 30 <September> Data Interface <tb> 31, 31 <SEP> Data Interface <Tb> 32 <September> Internet <Tb> 33 <September> Message <Tb> 34 <September> confirmation button <Tb> 35 <September> video <Tb> 36 <September> video <Tb> 37 <September> therapist <Tb> 38 <September> data storage device <Tb> 39 <September> Keyboard <tb> 40 <SEP> Contactless transponder reader <tb> 41 <SEP> Contact Smart Card Reader <tb> 42 <SEP> Contactless transponder <tb> 42 <SEP> Contactless cryptographic transponder <tb> 43 <SEP> Contact Smart Card <tb> 44, 44 <SEP> Avatar <Tb> 45 <September> training scenario <Tb> 46 <September> reminder <Tb> 47 <September> Sensor Suit <tb> 48, 48 <SEP> Sensor <Tb> 49 <September> receiving means <Tb> 50 <September> Training theoretical movement <Tb> 51 <September> Trainingsistbewegung <Tb> 52 <September> deviation <Tb> 53 <September> Temperature Sensor <Tb> 54 <September> pulse sensor <Tb> 55 <September> Microphone <Tb> 56 <September> Microphone <Tb> 57 <September> display means

Claims (20)

1. Interactive training system (1) for the rehabilitation of physiologically impaired patients (2, 2), in particular of patients (2, 2) with movement impairments of the extremities, comprising - A receiving means (3) for a body part to be trained; - A base unit (4) with means for data processing (5) and storage (6); - At least one in or on the receiving means (3) for the body part to be trained mounted sensor (7) which is connected to the base unit (4) and to this information about the patient (2), for example, about attitude or temperature of the body part to be trained , transmitted; and Optionally at least one actuator (9) mounted in or on the receiving means (3) for the body part to be trained, connected to the base unit (4) and corresponding control commands for supporting and / or moving the body part of the patient to be trained (2 ), characterized in that to the base unit (4) data input means, such as a touch screen (11) or a video camera (12), and data output means, such as a screen (13) or a speaker (14) are connected or built into the base unit (4) and at least a portion of said data input and output means are adapted to interact with a therapist (37) such that at least a portion of a patient training program (2, 2) is determinable and configurable by the therapist (37), and at least a part of these data input and output means for interacting with patients (2, 2) is designed so that the physiotherapeutic training program predetermined by the therapist (37) and / or chosen by the patient (2) can be completed interactively. 2. Interactive training system according to claim 1, characterized in that the base unit (4) with a stand device (15) is equipped, which has a bottom element (16) with rolling bodies (18) on the underside. 3. Interactive training system according to claim 1 or 2, characterized in that the base unit (4) has at least one integrated loudspeaker (14) as data output means and / or with at least one externally arranged loudspeaker (19) or headphones (20) is connected, so Information on acoustic way, for example, as sounds, sounds, music, sounds, speech, can be output. 4. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) is equipped with at least one integrated flat screen (11) as a data output means, so that information by visual means, such as graphics, images, animations, videos, can be output , 5. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) with at least one external screen (13) is connected as a data output means, so that information can be output visually. 6. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) is connected to at least one externally arranged projector as a data output means or equipped with an integrated projector (21) as a data output means, so that information can be output visually. 7. Interactive training system according to one of claims 4 to 6, characterized in that at least one visual data output means (11, 13, 21) is designed such that a three-dimensional representation of objects to be displayed can be output. 8. Interactive training system according to one of the preceding claims, characterized in that the basic device (4) connected to receiving means (3) for the body part to be trained with at least one actuator (9) is equipped with at least one vibration and / or pressure means, so that information can be output by haptic means. 9. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) has at least one externally arranged or integrated touch screen (11) as data input means, so that the training system (1) by the therapist (37) and / or the patient ( 2, 2) is interactively operable. 10. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) is equipped with at least one externally arranged microphone (55) and / or integrated microphone (56) as data input means, so that with this data input means acoustic information from the base unit ( 4) is receivable, for example, the ambient noise or the voice of the therapist (37) or the patient (2) for voice input or for voice control of the training system (1). 11. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) as data input means at least one integrated and / or at least one externally arranged video camera (12), so that visual information from the base unit (4) is receivable, for example a Image of the environment or the position, movement, gestures, gaze or facial expression of the therapist (37) or the patient (2). 12. Interactive training system according to claim 11, characterized in that the base unit (4) at least two video cameras (12, 12) are formed, so that the environment is detected three-dimensionally. 13. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) is equipped with a data interface (23) and comprises a mobile hand control unit (25) having a corresponding data interface (24) and via a connection of the two Data interfaces (23, 24) operating commands, which at least one control element (26, 26) on the mobile hand control unit (25) by the therapist (37) or patient (2) can be entered, to the base unit (4) can be transmitted and the connection of Data interfaces (23, 24) is designed wirelessly as a radio link or wired as a cable connection. 14. Interactive training system according to one of the preceding claims, characterized in that a central control unit (28) is formed, which has a data interface (30) for transmitting data and the base unit (4) has a corresponding interface (31) for receiving the data such that the basic device (4) for a therapist (37), for example via the Internet (32), is interactively operable and / or can be supplied with information, for example with a message (33) to the patient (2), with feedback and / or instructions for the patient (2) or with updated and / or expanded patient training programs (2). 15. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) has a data interface (31) for transmitting data, for example a video image (35) or activity information from the recording means (3) for the body part of the patient to be trained ( 2), and a central control unit (28) has a corresponding data interface (30) for receiving this data so that the received data can be stored in the central control unit (28) and / or the received data can be viewed directly and live by a therapist (37) Real-time analyzable. 16. Interactive training system according to claim 15, characterized in that the base unit (4) has an electronic or programmable locking mechanism and further a release means (34), so that it can be ensured that the video image (35) or the activity information only after a confirmation means of the release means (34) is transmitted to the central control unit (28) and the transmitted video picture (35) is necessarily displayed on the base unit (4) by a corresponding data output means (11) as a copy (36). 17. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) has a data interface (31) for transmitting and receiving data, and the interactive training system at least one further base unit (4) with a corresponding data interface (31 ) For sending and receiving data, so that a communication between users of the base units (4, 4), in particular between patients (2, 2), is carried out in order, for example, to exchange information or, for example, training activities, in particular of a playful nature, of widely distanced patients (2, 2) can be carried out jointly. 18. Interactive training system according to one of claims 14 to 16, characterized in that the base unit (4, 4) and / or the central control unit (28) is equipped with a storage medium (6, 6, 38), so that one or more Profile records of one or more patients (2, 2) are stored. 19. Interactive training system according to one of the preceding claims, characterized in that the base unit (4) has as data input means a keyboard (39), a contact-type or contactless transponder reader (40) and / or a contactless or contact-type chip card reader (41), so that a Identification of a user (2) of the base device (4), in particular when selecting a user profile data set, by means of a user name and / or a transponder (42), such as an RFID tag, is feasible and / or secure authentication, especially when dialing a user profile data record, by means of a user name-password combination, a cryptographic transponder (42), for example, a cryptographic RFID tag and / or a contactless or contact smart card (43), in particular a smart card from the health sector, is feasible. 20. Interactive training system according to one of claims 13 to 19, characterized in that the respectively communicating and / or data-providing devices, for example, the central control unit (28), the base unit (4, 4), the storage medium (6, 6, 38), and data input means such as the keyboard (39), the transponder reader (40) or the smart card reader (41) are provided with data encryption means, so that the transmitted information such as the video image (35), the activity information, the user profile records, the Identification data sets or the authentication records, encrypted transferable and are stored, are not manipulated and / or only for the authorized therapist (37) or patients (2, 2) are retrievable.