CN111387990B - Cerebral apoplexy hemiplegia patient is with early warning system that leaves bed - Google Patents
Cerebral apoplexy hemiplegia patient is with early warning system that leaves bed Download PDFInfo
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Abstract
The invention relates to a bed-leaving early warning system for a stroke hemiplegia patient, which comprises: the monitoring system comprises an acquisition module, a monitoring module and a monitoring module, wherein the acquisition module is used for acquiring behavior data acquired by wearable equipment which is only worn on the upper and lower limbs of the affected side of a monitored object; the wind control grading module, wherein the monitored object especially refers to the crowd who has motor dysfunction on the upper and lower limbs of the same side and who has the upper and lower limbs of the affected side and the upper and lower limbs of the healthy side differently, and the system further comprises: the early warning information processor is configured to judge whether the behavior data of the monitored object triggers early warning at least based on a stage attribute association rule and a preset wind control level, wherein the stage attribute association rule corresponds to a motor dysfunction evaluation result determined by at least one mobile digital device operated by a monitoring person, and the stage attribute association rule is between at least one motion characteristic value extracted by the acquisition module from the behavior data acquired by at least one wearable device worn on the upper and lower limbs of the monitored object.
Description
Technical Field
The invention relates to the technical field of intelligent nursing, in particular to a bed leaving early warning system for a stroke hemiplegia patient.
Background
Cerebral apoplexy is also called cerebrovascular Accident (CVA), which is a kind of vasospasm, occlusion or rupture caused by the pathological changes of Cerebral artery system, resulting in the acute development of Cerebral local circulatory disturbance and hemiplegic limb dysfunction, including Ischemic Stroke (Ischemical Stroke) and Hemorrhagic Stroke (Hemorrhagic Stroke). Stroke, as a common nervous system disease, has become a serious disease seriously threatening the life health and life quality of residents due to high morbidity, mortality, recurrence rate and disability rate. Diabetes is an independent risk factor of ischemic stroke, the stroke risk is increased due to long-term hyperglycemia, the stroke incidence of a diabetic patient is four times that of a normal person, hyperglycemia damages cerebral vessels through various ways to cause atherosclerosis, influences the elasticity and hardness of vessel walls, and causes pathological changes such as vascular intimal plaque formation, stenosis and occlusion, and the heart, brain and whole body tissues are damaged due to complications such as dyslipidemia, hypertension, atherosclerosis, blood viscosity increase, and the like, so that ischemic or hemorrhagic symptoms occur.
Stroke causes damage to upper motor neurons, often leading to central paralysis, and dysfunction of the extremities, both positive and negative. The negative symptoms include the following aspects: decline of muscle strength, decline of exercise control ability, decline of limb coordination, and the like; and positive symptoms include hyperreflexia, increased spasticity, and the like. There are also some special motor coordination impairment modes: such as co-contraction, abnormal coordinated movement, etc. Abnormal coordinated movement patterns after cerebral apoplexy and hemiplegia become typical characteristics of upper limb movement dysfunction, and the abnormal movement patterns obstruct the completion of normal movement patterns and cause serious influence on the daily life activity performance of patients. According to investigation and statistics of the national cause of death for the third time in China, the first leading cause of death in China is cerebral apoplexy, more than 75% of survivors have sequelae with different degrees, wherein 40% of survivors have severe disabilities including disorders in limbs, language, cognition and the like, and motor dysfunction is common and has the greatest influence on patients, particularly hemiplegia is common. More than 70% of patients lose life and work ability to different degrees, and the Activity of Daily Life (ADL) of the patients is seriously affected. According to related researches, the falling rates of stroke patients in an acute treatment period, a rehabilitation treatment period and a community returning life are 14-64.5%, 24-47% and 37.5-73%, and the falling is a main complication with extremely high incidence rate for the stroke patients.
A fall is a sudden, involuntary, unintended change in posture that falls on the ground or a lower level. The falling can cause injuries such as brain injury, soft tissue injury, fracture, dislocation and even death, especially for stroke patients, the falling and the consequences can cause huge physical and mental injuries to patients and family members, the life quality of the patients and the family members is seriously influenced, the fear of falling causes the reduction of activities of part of patients or the limitation of the family members to the activities of the patients, and as a result, the self-care ability of the patients is reduced. Meanwhile, the patient falls down, the hospitalization cost and the hospitalization time of the patient are increased, and huge burden is brought to families and society. In order to effectively prevent the stroke patients from falling, the currently common method is to adopt a scale to evaluate the patients, screen high-risk groups easy to fall, adopt uniform measures such as ensuring the living environmental safety of the patients, strengthening the falling prevention knowledge health promotion of the patients and family members, hanging a warning board on a bed head and the like to prevent the patients from falling, but the measures are lack of pertinence, and no nursing device for preventing and intervening the risk of falling out of bed for the stroke hemiplegia patients in the prior art is provided. Thus, up to now, the risk of falling out of bed, especially for stroke hemiplegia patients, remains one of the main problems troubling medical staff.
A nursing system proposed in patent document No. CN208876548U, which is granted publication No. CN208876548U, whose publication date is 2019, 5, month and 21, includes: the sleep monitor is connected with the signal repeater, the signal repeater is connected with the server, and the server is connected with the terminal equipment; the sleep monitor collects a micro-motion signal of a user and sends the micro-motion signal to the signal repeater; the signal repeater transmits the micro-motion signal to a server; the server receives the micro-motion signal, obtains a physiological characteristic signal according to the micro-motion signal, obtains the sleep information and the activity information of the user according to the physiological characteristic signal, and sends the sleep information and the activity information to the terminal equipment, wherein the activity information comprises: the user is in bed or out of bed, and the sleep information comprises: the sleep state of the user and the sleep quality of the user. The nursing system obtains the sleep information and the activity information of the user according to the physiological characteristic signals of the user, thereby realizing the intellectualization of nursing and effectively increasing the nursing force.
As another example, a child falling prevention and bed leaving detection alarm device provided by patent document with publication number CN110853299A, whose publication number is 2020, 2, 28, is that a bed fence (1) is arranged on one side of a bed, and further includes a photoelectric emission tube LED1 (2) installed on one side of the bed head, and a photoelectric receiving tube V1 (3) installed on the other side of the bed head, the photoelectric receiving tube V1 is used to receive emission signals of the photoelectric emission tube LED1, a wireless transmitter (4) is installed on the other side of the bed head, a wireless receiver corresponding to the wireless transmitter is installed on a child, an infrared sensor IRX (5) is installed under the bed, and further includes a peripheral circuit connected with the photoelectric emission tube LED1, the photoelectric receiving tube V1, the wireless transmitter, and the infrared sensor IRX; the alarm device can monitor the sleeping state of the child at any time, and can give an alarm when the child falls off the bed or leaves the bed carelessly.
In view of the problem of poor early warning performance in the above patent documents, the following technical solutions with good early warning performance are proposed in the prior art:
for example, patent document No. CN103824418B with the publication number of 2016, 8, 31 and the publication number of CN103824418B proposes an alarm system for monitoring leaving bed, which comprises two piezoelectric film sensors, a processor and an alarm. The two piezoelectric film sensors are sequentially laid on the bed along the extension direction of the long edge of the bed and synchronously and continuously acquire pressure signals from the bed. The processor respectively forms two periodic physiological characteristic signals of a human body on the bed according to the two pressure signals, judges that the human body falls off the bed when the two periodic physiological characteristic signals are synchronously interrupted, and judges that the human body is firstly sitting up and then self-leaves the bed when the two periodic physiological characteristic signals are interrupted back and forth. The alarm gives an alarm prompt when falling off the bed. The alarm system can find the falling and leaving of the human body in time, and is convenient for making quick remedial measures. The patent document also relates to a bed equipped with the bed leaving monitoring alarm system, a bed leaving monitoring alarm device used in cooperation with the bed leaving monitoring alarm system, and an alarm method thereof.
The existing bed leaving alarm device proposed by the above patent documents needs to realize the bed leaving alarm function on the basis of excellent mobility of the monitored object, because the device judges whether the human body leaves the bed by itself, so as to judge whether the human body stands up or not, the process of directly converting from the supine posture to the sitting posture has great requirements on the abdominal strength of the monitored object, and the action is the action which cannot be completed by the people with inconvenient mobility, such as hemiplegic patients with cerebral apoplexy, therefore, the device can not be applied to the bed leaving alarm of the people with inconvenient mobility, such as hemiplegic patients with cerebral apoplexy, and only the false alarm rate can be increased.
For another example, the anti-falling intelligent crib proposed by patent document No. CN109757928A with publication number of 2019, 5, month and 17 comprises at least a crib body and a crib frame fixedly connected with the crib body, and further comprises a baby crossing detection module, a plurality of hand behavior detection modules and a plurality of foot behavior detection modules. When at least one specific event occurs, pressure change information of the anti-falling intelligent crib is obtained and recorded through at least one of the foot behavior detection modules and at least one of the hand behavior detection modules, infant crossing estimation analysis is carried out based on the received pressure change information, and an infant crossing estimation result and/or an infant crossing risk grade matched with the infant crossing estimation result and/or the infant crossing estimation grade are/is output to the central processing module, and the central processing module sends out an early warning prompt to an intelligent terminal operated by a guardian based on the received infant crossing estimation result and/or the infant crossing risk grade and/or sends out first acousto-optic information through the acousto-optic prompt module.
The above-mentioned patent documents disclose a bed leaving alarm device, which can provide a better warning effect by using the interaction process between the hands and feet of the user and the pressure sensors of the different regions arranged on the bed body, but the facing objects are only limited to the infants who need to cross over the bed frame before leaving the bed, and are also not suitable for the patients who are implanted into the elderly patients and have knee joint or hip joint replacement, and patients who have anemia or weak patients or patients with cerebral hemiplegia after surgery, and the bed leaving alarm device does not advise medical staff, is not accompanied by family members, and causes the occurrence of accidental bed leaving or falling down.
In order to solve the problem that the above prior art documents have good early warning performance but have too large limitation in application range, the prior art proposes to abandon a non-contact monitoring device (such as the mattress with multiple sensors listed above) with a limited behavior monitoring range, and instead adopt a wearable monitoring device with better behavior monitoring capability, for example:
the clinical early warning system provided by patent document CN109966088A with publication number of 7/5/2019 comprises an electronic tag, a tag reading module, a ward routing terminal, a cloud platform, a monitoring terminal and a nurse station terminal; the electronic tag comprises a foot ring arranged on the foot of the patient, and an RFID electronic tag is arranged in the foot ring; the label reading module is arranged below the bed body and comprises a shielding cover, an opening facing the side of the bed is formed in the shielding cover, and a reading unit used for wirelessly reading the RFID electronic label is arranged in the shielding cover. Compared with the prior art, when reading electronic tags at the tag reading module below the sickbed in the clinical early warning system, the clinical early warning system indicates that a patient gets off the bed, transmits information to the cloud platform through the ward routing terminal, processes the information through the cloud platform, and transmits the information to the accompanying terminal and the nurse station terminal respectively, so that the distance between the foot ring and the bed is monitored in real time, the risk is fallen through real-time early warning, and early warning information is sent out to accompanying personnel and a nurse station in time.
When the technical scheme does not consider the practical application, the monitored object can only extend the feet out of the outer edge of the bed to cause the alarm of the device, but actually the monitored object has no tendency to get out of the bed at all and has no tendency to get out of the bed by itself.
Furthermore, on the one hand, due to the differences in understanding to the person skilled in the art; on the other hand, since the inventor has studied a lot of documents and patents when making the present invention, but the space is not limited to the details and contents listed in the above, however, the present invention is by no means free of the features of the prior art, but the present invention has been provided with all the features of the prior art, and the applicant reserves the right to increase the related prior art in the background.
Disclosure of Invention
The invention provides a bed-leaving early warning system for stroke hemiplegia patients, in particular to a bed-leaving early warning system which is suitable for monitored objects with dyskinesia existing in the upper and lower limbs on the same side and capable of distinguishing the upper and lower limbs on the affected side from the upper and lower limbs on the healthy side.
The bed leaving early warning system of the invention is provided aiming at the defects of the bed leaving warning device provided for realizing the bed leaving warning function in the prior art, and the defects of the prior art are as follows: in order to solve the problem of falling with high incidence and high hazard, especially the problem of self-walking bed-leaving falling of stroke unilateral hemiplegia patients, the bed-leaving alarm device proposed in the prior art for realizing the bed-leaving alarm function can be roughly divided into a solution based on non-contact monitoring equipment or wearable monitoring equipment. First, in the prior art, as for the solution proposed by the patent document with publication number CN103824418B based on the non-contact monitoring device such as the intelligent mattress, the judgment of whether the human body is getting out of the bed by itself is equivalent to the judgment of whether the human body is sitting up upright, and actually, the action of sitting up upright needs to be directly converted from the lying posture to the sitting posture, which requires a great force on the abdomen of the monitored subject. Therefore, the implementation of the bed exit warning function in such solutions is based on the very good mobility of the monitored subject, and the movement is very difficult or even impossible for people with inconvenient mobility, such as stroke hemiplegia patients. Such solutions are therefore not suitable for bed exit alarms for persons with mobility impairments, such as stroke hemiplegia patients, but only increase the false alarm rate. Secondly, for the solution based on the foot ring with an RFID electronic tag provided therein as proposed in patent document CN109966088A based on wearable monitoring equipment, the implementation of the bed leaving alarm function in such a solution is realized by monitoring whether the foot ring moves out of the area outside the bed body, and determining that the patient is leaving the bed and giving an alarm if the foot ring moves out of the bed body, however, when the actual application is not considered in this type of solution, the monitored object may only extend the feet out of the outer edge of the bed body, and does not have the tendency to leave the bed or leave the bed by oneself, but the alarm of the device is still caused in this situation, so that the false alarm rate is high, and the workload of the nursing staff is increased. Especially for the monitored object such as the unilateral hemiplegia patient of cerebral apoplexy, the upper and lower limbs of the affected side of the monitored object have dyskinesia and seriously impaired sensation of the limbs, the patient often needs to use the supporting function of the healthy side to move the affected side, and the degree of dependence on artificial assistant nursing and the degree of motion limitation are very high.
Therefore, aiming at the defects of the bed leaving alarm device in the prior art, the invention provides a bed leaving early warning system for stroke hemiplegia patients, which comprises: the monitoring system comprises an acquisition module, a monitoring module and a monitoring module, wherein the acquisition module is used for acquiring behavior data acquired by wearable equipment only worn on upper and lower limbs of an affected side of a monitored object; the system comprises a wind control grade dividing module, a monitoring module and a control module, wherein the wind control grade dividing module is used for determining a wind control grade corresponding to a monitored object according to historical wind control data of the monitored object, the monitored object particularly refers to a crowd who has motor dysfunction on the upper and lower limbs on the same side and has different upper and lower limbs on an affected side from upper and lower limbs on a healthy side, and the system further comprises: the early warning information processor is configured to judge whether the behavior data of the monitored object triggers early warning at least based on a stage attribute association rule and a preset wind control level, wherein the stage attribute association rule corresponds to a motor dysfunction evaluation result determined by at least one mobile digital device operated by a monitoring person, and the stage attribute association rule is between at least one motion characteristic value extracted by the acquisition module from the behavior data acquired by at least one wearable device worn on the upper and lower limbs of the monitored object. Preferably, the early warning information is transmitted to at least one mobile digital device carried by the guardian in the periphery when the early warning is triggered.
This application only dresses the wearable equipment in there being movement dysfunction's one side upper and lower limbs through the setting, because the impaired serious of sick side limb body sensation, the perception ability is low, and is better to the acceptance of wearable equipment to remain the unrestricted good mobility of healthy side, sick side limb activity degree is lower simultaneously, has reduced the data volume that needs the processing widely. Based on the situation, the early warning information processor limits a plurality of monitoring modes which are used for indicating the early warning danger degree and have different early warning danger degrees mutually on the basis of different risk control grades which are different from different patients and the movement dysfunction degrees of different hemiplegic single sides, so that the early warning information processor can be compared with the preset monitoring modes based on the current behavior data of the patients, and judges whether early warning is needed or not based on the comparison result and the preset stage attribute association rule between the upper and lower limbs on the affected side, thereby improving the early warning timeliness of informing a guardian to provide timely nursing or assistance for the monitored object before danger occurs.
According to a preferred embodiment, the motion characteristic values at least include a first motion characteristic value in the behavior data collected by a first wearable device worn on the affected upper limb of the monitored subject and a second motion characteristic value in the behavior data collected by a second wearable device worn on the affected lower limb of the monitored subject, wherein the phase attribute association rule between the first motion characteristic value and the second motion characteristic value for indicating the motion characteristic variation trend corresponding to the first motion characteristic value and the second motion characteristic value respectively is prestored in the collection module.
The off-bed early warning system is based on behavior data of upper and lower limbs of a patient side acquired by wearable equipment and a placing posture and/or posture change trend analyzed and determined by a placing posture detection module, compares the placing posture and/or posture change trend with a motion characteristic change trend preset in a behavior rule module, enables the system to adapt to the special requirement of placing of a bed body of a patient suffering from stroke hemiplegia to monitor the bed behavior of the patient, judges whether early warning is needed or not by an early warning information processor based on a comparison result and a preset stage attribute association rule between the upper and lower limbs of the patient side, and improves early warning timeliness of informing a guardian to provide timely nursing or assisting for a monitored object before danger occurs.
The multiple modules included in the bed leaving early warning system of the invention are listed in a unified way as follows: the system comprises a collection module for collecting behavior data of a monitored object, a wind control grade division module for determining a wind control grade, an early warning information processor for judging and triggering early warning, a placing posture detection module for determining a current placing posture, a behavior rule module for presetting a change trend of motion characteristics, wearable equipment worn on the affected side of the monitored object, mobile digital equipment carried by a guardian, and a mattress internally provided with a processor and a sensor. Furthermore, a pressure sensor array for detecting pressure changes of the patient and a processor connected to the pressure sensor array are arranged on the mattress. The above mentioned devices referred to in the present invention may all be computer processors, and fig. 1 shows a simplified logic flow diagram of a bed exit warning system for stroke hemiplegia patients, the operations of which represent a series of operations that can be implemented in hardware, computer instructions or a combination thereof. In the context of computer instructions, the operations represent computer-executable instructions stored on one or more computer-readable storage media that, when executed by one or more computer processors, perform the recited operations. Generally, computer-executable instructions include routines, programs, objects, components, data structures, and so forth that perform particular functions or implement particular data types. The order in which the operations are described is not intended to be construed as a limitation, and any number of the described operations can be combined in any order and/or in parallel to implement the described processes. Additionally, the data transfer process between modules may be performed under the control of one or more computer systems configured with executable instructions and may be implemented as code (e.g., executable instructions, one or more computer programs, or one or more applications) executing uniformly on one or more computer processors, or implemented in hardware, or implemented by a combination of both. The code may be stored on a computer-readable storage medium, for example in the form of a computer program comprising a plurality of instructions executable by one or more processors. The computer readable storage medium may be non-transitory. In some embodiments, the data transfer process between the modules of FIG. 1 may be stored in a memory of a computer processor and executed by the computer processor.
The features described may be implemented in digital electronic circuitry, or in computer hardware, firmware, software, or in combinations of them. The apparatus may be implemented in a computer program product for execution by a programmable processor, the computer program product being tangibly embodied in an information carrier, e.g., in a machine-readable storage device; and method steps can be performed by a programmable processor executing a program of instructions to perform functions of the described implementations by operating on input data and generating output. The described features may advantageously be implemented in one or more computer programs that are executable on a programmable system including: at least one programmable processor connected to receive data and instructions from, and to transmit data and instructions to, a data storage system; at least one input device; and at least one output device. A computer program is a set of instructions that can be used, directly or indirectly, in a computer to perform a certain activity or bring about a certain result. A computer program can be written in any form of programming language, including compiled or interpreted languages, and it can be deployed in any form, including as a stand-alone program or as a module, component, subroutine, or other unit suitable for use in a computing environment.
Examples of suitable processors for the execution of a program of instructions include both general and special purpose microprocessors, and the sole processor or one of multiple processors of any kind of computer. Generally, a processor will receive instructions and data from a read-only memory or a random access memory or both. The essential elements of a computer are a processor for executing instructions and one or more memories for storing instructions and data. Generally, a computer will also include, or be operatively connected to communicate with, one or more mass storage devices for storing data files; such devices include magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and an optical disc. Storage devices suitable for tangibly embodying computer program instructions and data include all forms of non-volatile memory, including by way of example: semiconductor memory devices such as EPROM, EEPROM, and flash memory devices; magnetic disks such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks. The processor and the memory may be supplemented by, or incorporated in, ASICs (application-specific integrated circuits).
According to a preferred embodiment, the system further comprises a behavior rule module, which is respectively connected with the pose detection module and the air control grading module, and is used for presetting a motion characteristic change trend which respectively corresponds to at least one pose and is used for indicating the motion characteristic change trend which is likely to occur in the pose. The action rule module in the application can be distinguished from dangerous actions or actions which may occur under each putting posture aiming at the fact that the plurality of putting postures determined by the putting posture detection module respectively correspond to preset different motion characteristic change trends, whether the actions or the actions have potential risks or not can be judged by directly comparing the preset motion characteristic change trends, and the problem that data processing feedback time is long due to the fact that analysis processing and re-judgment are carried out on a large amount of data in the prior art is solved.
According to a preferred embodiment, the movement characteristic trend comprises at least a movement characteristic trend for a monitored subject who has been instructed by posture change and a movement characteristic trend for a monitored subject who has not been instructed by posture change. The posture change guidance referred to herein is primarily directed to teaching the subject the proper and proper roll-over or rise posture through the subject after the subject has been in a hospital for a period of time. In contrast, the fact that the subject does not receive the posture change guidance mainly means that the subject is just in hospital or is not in hospital for a long time and does not have the posture guidance of turning over or getting up. The two different movement characteristic change trends can distinguish the action or behavior of the monitored object which is more likely to appear under the condition of being separated from monitoring, the speed of data comparison processing can be effectively improved, and the monitoring accuracy and effectiveness of the monitored object are further improved.
According to a preferred embodiment, the monitored subject with the highest wind control level determined by the wind control level dividing module does not have the movement dysfunction degree completely lower than the monitored subjects with other wind control levels. Aiming at a part of monitored objects with better independence, the degree of movement dysfunction at the hemiplegic side of the monitored objects is smaller, the turning difficulty or the rising difficulty is not large, but the monitored objects are often considered to be capable of getting out of the bed independently or turning over randomly too high, so that the risk of falling off the bed of the people is higher than that of the people with poorer independence.
According to a preferred embodiment, the system further comprises a pose detection module, connected to the acquisition module, for determining a relative position relationship between the affected side of the monitored subject and the mattress and generating a current pose of the monitored subject based on the relative position relationship and at least part of the motion characteristic values. Due to the particularity of the posture of the hemiplegic patient, the hemiplegic patient usually needs to be assisted to keep good limb position by a plurality of pillows as shown in fig. 2 when lying in bed, but because part of limbs are indirectly pressed onto the mattress through the pillows, the problem that the pressure distribution corresponding to two postures is extremely high and different postures cannot be distinguished exists. According to the invention, the placing posture detection module is arranged, and the module can predict and determine the pressure distribution data of the good limb position of the patient on the mattress based on the predetermined relative position relation between the side of the affected limb of the patient and the mattress, so that the current placing posture or posture change can be accurately analyzed and obtained by comparing the current pressure distribution data with the predicted pressure distribution data.
According to a preferred embodiment, the mattress is divided into a hip region and a shoulder region, which are arranged at a distance from each other and each of which is provided with at least one sensor, the bed body corresponding to the hip region having a higher resilience relative to the bed body corresponding to the shoulder region. Because the bed body corresponding to the hip bone area has better resilience and deformability, the pressure born by the hip bone, the sacrum and other limbs of the patient suffering from stroke hemiplegia when lying on side or lying can be reduced, and the improvement of blood circulation and the reduction of the injury of the side lying extrusion to the affected side or the healthy side are facilitated.
According to a preferred embodiment, the sensor distribution density provided at the shoulder and elbow region is greater at least in relation to the sensor distribution density provided at the hip region. Be applicable to in this application all having the mattress that is applicable to by the guardianship object of movement dysfunction with one side upper and lower limbs, but at least from sensor distribution and the bed body resilience deformability two aspects, come when guaranteeing by the guardianship object's travelling comfort, still improved data acquisition's validity and sensitivity.
This system that this application provided is not only the above-mentioned early warning effect of leaving bed of performance, can also be through carrying out simple adjustment with the above-mentioned parameter in the early warning system of leaving bed, can regard as a recovered system who is applicable to cerebral apoplexy hemiplegia patient, and this recovered system includes first treater (collection module), second treater (wind control rating divides the module), third treater (early warning information processor), fourth treater, fifth treater, wearable equipment and mobile digital device at least. The rehabilitation system is provided with a fourth processor for entering a rehabilitation guidance mode when information of rehabilitation training of a patient determined by medical personnel is collected, the fourth processor indicates a fifth processor (a behavior rule module) used for presetting a movement characteristic variation trend in the system to increase a trigger threshold value of the fifth processor, a plurality of rehabilitation guidance grades correspond to at least one trigger threshold value, and a rehabilitation guidance grade corresponding to the degree of motor dysfunction of the upper and lower limbs on an affected side is selected correspondingly, so that the system is changed into the rehabilitation guidance mode which can send a notice when the action of the patient reaches the standard, the patient can clearly determine a rehabilitation training target and further achieve a better rehabilitation effect, meanwhile, due to the realization of the rehabilitation auxiliary effect, the subjective intention of the patient wearing wearable equipment is enhanced, the wearable equipment is willing to be worn for a long time and cannot be taken down due to the objection, and therefore, the bed-leaving early warning monitoring effect of the system in a non-rehabilitation training time period can be better achieved.
A rehabilitation system for a stroke hemiplegia patient, the rehabilitation system comprising: a memory; and at least one processor coupled with the memory, the at least one processor comprising: the first processor is used for acquiring behavior data acquired by wearable equipment which is only worn on the upper and lower limbs of the affected side of the monitored object; the second processor is used for determining a rehabilitation guidance level corresponding to the historical rehabilitation data of the monitored object; and the third processor is configured to judge whether the behavior data meets rehabilitation requirements or not based on a stage attribute association rule between at least one motion characteristic value extracted from the behavior data by the first processor and a preset rehabilitation guidance level in a manner of adjusting the preset rehabilitation guidance level when the current mode is determined to be the rehabilitation guidance mode, and transmit the action standard information to at least one peripheral mobile digital device carried by the guardian when the rehabilitation requirements are met, wherein the first processor, the second processor and the third processor are all arranged in the wearable device. According to a preferred embodiment, the at least one processor is further configured to preset a trend corresponding to at least one specific gesture respectively for indicating a change in the motion characteristic that is likely to occur in the specific gesture. Preferably, the fourth processor determines whether the current mode is converted into the rehabilitation guidance mode and instructs the fifth processor (behavior rule module) for presetting the movement characteristic variation trend in the system to increase the trigger threshold when the current mode is converted into the rehabilitation guidance mode, or instructs the fifth processor (behavior rule module) for presetting the movement characteristic variation trend in the system to decrease the trigger threshold when the current mode is converted into the bed leaving early warning mode.
Drawings
Fig. 1 is a schematic diagram of a simplified structural connection relationship of a bed-leaving early warning system for stroke hemiplegia patients according to the present invention;
FIG. 2 is a simplified diagram of the posture of the monitored subject according to the present invention; and
fig. 3 is a simplified side view schematic diagram of a mattress in the bed exit warning system according to the present invention.
List of reference numerals
1: wearable device 2: acquisition module
3: and a wind control grading module 4: early warning information processor
5: the behavior rule module 6: put posture detection module
7: the mobile digital device 8: mattress
9: hip bone region 10: shoulder and elbow region
1a: first wearable device 1b: second wearable device
Detailed Description
The present invention will be described in detail with reference to the accompanying drawings.
The invention relates to terms and explanations thereof:
wearable device 1: the wearable device 1 is a portable accessory having a part of a computing function and being connectable to a mobile phone and various terminals, and may include watch-type products such as a watch and a wrist strap supported by a wrist, shoes-type products such as shoes, socks or other leg-wearing products supported by a foot, and Glass-type products such as glasses, a helmet, a headband supported by a head. The wearable device 1 according to the present invention is mainly in the form of a watch-like product supported by a wrist. Preferably, the wearable device 1 of the present invention may also be in the form of a watch-like product supported by the wrist and ankle. Wherein, the wearing side is mainly the affected side of the monitored object.
Affected side of the monitored subject: the affected side of the monitored subject refers to the upper and lower limbs of the monitored subject on which the motor dysfunction occurs. Motor dysfunction is the most prominent problem after stroke, and various kinds of disorders are caused by different focuses, and hemiplegia is the most typical of motor dysfunction. The paralyzed limbs of the serious patient can not move autonomously and lose the sensation, the muscle strength is not available, the paralyzed side muscle strength is reduced and the patient is inconvenient to move.
Behavior data: the behavioural data comprises pose or pose change information determined with respect to the subject based on pressure data acquired by sensors arranged on the mattress 8. The behavior data also comprises determined posture or posture change information of the monitored object based on the motion data collected by the wearable device 1 worn by the monitored person. The behavior data also comprises the side of the monitored object where the affected limb is located, which is determined by the historical case data of the monitored object, so that the relative position relationship between the affected side of the monitored object and the mattress 8 can be determined.
The relative position relationship is as follows: the relative positional relationship between the affected side of the subject to be monitored and the mattress 8 means that the left side and the right side of the mattress 8 where the affected side of the subject to be monitored is located when the subject to be monitored lies on the mattress 8 are previously set as the left side and the right side, respectively, of the two sides of the mattress 8 for the subject to be monitored to go up and down the bed.
Historical wind control data of the monitored object: the history data referred to herein refers to basic information of the subject to be monitored, medical information, and the like stored in the hospital information system. The historical data mentioned in the invention also comprises the scale evaluation result and historical behavior data (such as historical self-leaving-bed times and historical leaving-bed falling times) about the monitored object, which are input by a monitoring person.
Wind control grade: the wind control level refers to the bed leaving risk control level corresponding to the monitored object, which is determined according to the historical wind control data of the monitored object, and comprises a level I (basically independent but overestimated activity capacity), a level II (conditional independent or extremely light dependence), a level III (moderate or severe dependence), and a level IV (extreme or complete dependence). The wind control level is used to provide different degrees of restricted motion risk control for different degrees of independence of the subject. The single level of wind control includes the degree of limitation of movement of the unilateral limb in a certain stance.
Movement dysfunction exists in the upper and lower limbs on the same side: the monitored object in the invention is mainly a crowd with dyskinesia of the upper and lower limbs on the same side, namely dyskinesia of the upper and lower limbs on the same side which is difficult to move. Most of the time, patients spend on the bed, usually in order to avoid the disease symptoms such as high muscle tension and incapability of moving, the guardian needs to assist the monitored object to adjust to the proper lying position posture, and the position posture will directly relate to the quality of the rehabilitation prognosis.
The motion characteristic value is as follows: the motion characteristic value refers to the posture of the monitored object on the bed, the pressure distribution and the limb motion data (parameters such as the motion amplitude of the upper limb or lower limb motion) determined by the behavior data. Specifically, the motion feature values include a first motion feature value extracted by the warning information processor from behavior data collected by the first wearable device 1a worn on the affected upper limb of the subject, and a second motion feature value extracted by the warning information processor from behavior data collected by the second wearable device 1b worn on the affected lower limb of the subject. The first motion characteristic value and the second motion characteristic value mentioned here mainly refer to contents included in a block of limb motion data in the motion characteristic values, that is, the motion characteristic values may further include a third motion characteristic value and a fourth motion characteristic value corresponding to a pose.
The mobile digital device 7: the mobile digital device 7 refers to a battery-powered handheld device or the like such as a mobile phone, a computer, a portable media player, a remote control device, a personal digital assistant, a paging device, a GPS positioning device, a PDA, a calculator, a portable medical device, and the like. The mobile digital device 7 of the invention is mainly carried and operated by a guardian. The method mainly plays a role in enabling the guardian to acquire the early warning information in a visual mode, an auditory mode, a tactile mode and the like, and can display at least one scale on an operation interface of the guardian to interact with the guardian, acquire input information input by the guardian and generate a scale evaluation result according to the input information.
The scale is as follows: the scale or the function comprehensive rating scale is a prerequisite for evaluating the dysfunction of a patient by an objective, effective and accurate method, and is used for a guardian to know the functional condition of a monitored object, make a rehabilitation treatment scheme and evaluate the curative effect. It may include: a Functional Comprehensive Assessment (FCA) scale for evaluating the comprehensive functions of the patient; a simple mental state examination (MMSE) adopts a modified MMSE translation of a table compiled by Folstein and the like in 1975, and the implementation and scoring method is that each question and answer pair is given 1 point, and the total score range is 0-30 points, so as to be used for evaluating the cognitive function of a patient; barthel Index (BI), which is a scale compiled in 1965 by Barthel et al, for evaluating the patient's ability to live in Daily life (ADL); the Quality of Life Index (QLI) evaluates 5 items of activities, daily life, health, support and prospect of the patient, and the implementation and scoring method comprises that the highest score of each item is 2 points, the lowest score is 0 point, and the total score range is 0-10 points, and is used for evaluating the quality of life of the patient; the Function Independent Measure (FIM) scale is a valid detection tool in the assessment of the ability of disabled patients to perform activities in daily life. The assessment of motor dysfunction determined by the at least one mobile digital device 7 operated by the guardian may include class i (essentially independent but overestimated self-activity), class ii (conditionally independent or extremely lightly dependent), class iii (moderate or severe dependent), class iv (extremely severe or complete dependent). The outcome of a motor dysfunction assessment may be represented by one of two results, better or worse, of the independence of the subject (primarily referring to the degree of assistance required by the patient to perform a prescribed action or item). The independence of the subject may be the degree of assistance required by the patient to complete the semi-rise or out-of-bed activities. The subject independence preferably includes class i (substantially independent but overestimated self-activity) and class ii (conditionally independent or extremely lightly dependent), and less independent subjects include class iii (moderate or severe dependent), class iv (extremely severe or complete dependent).
The placing posture is as follows: also called posture or orthostatic posture, refers to a therapeutic posture designed to prevent or counter the occurrence of spastic postures, maintain the shoulder joints and induce early distraction. The special requirement of the bed position arrangement of the stroke hemiplegia patient is the point. Typical postures of stroke hemiplegia patients are characterized in that the shoulders of the upper limbs are sunken and retracted, the elbow joint is bent, the forearms are rotated forwards, the wrist joint is bent in the palm, and the fingers are bent; outward rotation of the lower limbs, extension of the hip and knee joints, and inward inversion of the foot drop. Early attention and maintenance of proper position in the bed helps prevent or reduce the occurrence and aggravation of the spastic posture described above. As shown in fig. 2, the following positions are typically selected: lateral decubitus, lateral decubitus and supine positions. The "lateral lying position" means the affected side is on the lower side and the healthy side is on the upper side. The head is supported comfortably by the pillow, the upper limb on the affected side extends forwards to make the shoulder part move forwards, and the inner edge of the scapula is ensured to be flatly leaned against the chest wall. The upper arm is extended forward to avoid compression and retraction of the shoulder joint. The elbow joint is extended, the forearm is supinated, the fingers are opened, and the palm is upward. The healthy upper limbs can not be placed in front of the body, and the whole trunk is driven forwards to cause the scapula to retract. The affected lower limb is in the back, the affected hip joint is slightly stretched backwards, the knee joint is slightly bent, and the foot bottom pedals the support. The "lying position on the healthy side" means that the healthy side is on the lower side and the affected side is on the upper side, and the pillow on the head should not be too high. The pillow is arranged below the upper limb of the affected side, the shoulder is bent forwards by 90-130 degrees, the elbow and the wrist are extended, the forearm is rotated forwards, the wrist joint is extended back, the pelvis of the affected side is rotated forwards, and the hip and the knee joint are in natural half-bending positions and are arranged on the pillow; the affected foot and the lower leg keep vertical positions as much as possible, and the foot cannot be overturned and suspended at the edge of the pillow; the pillow can be placed behind the body for supporting, which is good for relaxing the body. Keep the healthy lower limbs on the bed, slightly extend the hip and slightly bend the knees. The supine position is a position with a pillow under the head, but should not be too high, and the face faces the affected side; the affected side shoulder pad is a pillow slightly higher than the trunk, and the extended upper limb is placed on the pillow to prevent the scapula from retracting; the forearm is rotated backwards, the palm center is upward, and the fingers are stretched and opened; pillows are placed under the affected hip and thigh to prevent the affected pelvis from retracting.
Motion characteristic variation trend: the trend of the motion characteristic change which may occur in the posture refers to a behavior of the monitored object which may occur without monitoring after the guardian adjusts the posture of the monitored object to a proper posture. The monitoring system comprises a first mode which is used for changing the posture of a monitored object such as small-amplitude lifting and overturning of limbs with extremely low risk coefficients and the like, a second mode which is used for trying to turn over or trying to get up with medium risk coefficients and has poor independence of the monitored object, a third mode which is used for trying to turn over or trying to get up with high risk coefficients and has good independence of the monitored object, and a fourth mode which is used for changing the posture of the monitored object such as small-amplitude lifting and overturning of limbs with high risk coefficients and the like. Different from different body position placing postures, each body position placing posture corresponds to a predefined first mode, a predefined second mode, a predefined third mode and a predefined fourth mode.
Phase attribute association rule: the phase attribute association rule corresponds to a result of the assessment of motor dysfunction determined by at least one mobile digital device 7 operated by the guardian. The phase attribute association rule mentioned here refers to a motion characteristic change trend corresponding to the first motion characteristic value and a motion characteristic change trend corresponding to the second motion characteristic value, which are determined according to the degree of motion dysfunction determined by the current motion dysfunction evaluation result of the user and are different from the degree of motion dysfunction accompanied by the patient in the current phase. The trend of the motion characteristic mentioned here mainly refers to the behavior of the monitored object kept in a certain posture without monitoring, which is mainly used for distinguishing the boundary/trigger threshold between the first mode, the second mode, the third mode and the fourth mode. Further preferably, in the "early warning information processor 4 determines whether the behavior data triggers the early warning based on the preset wind control level and the phase attribute association rule between the first motion characteristic value and the second motion characteristic value and corresponding to the assessment result of the dyskinesia determined by the at least one mobile digital device 7 operated by the guardian", the phase attribute association rule and the wind control level are only part of the to-be-processed data used by the early warning information processor 4 to determine whether the behavior data triggers the early warning.
The association rules are illustrated below for the phase attributes: when the result of the assessment of the motor dysfunction, determined by the at least one mobile digital device 7 operated by the guardian, is that the independence of the monitored subject is poor, the upper limb preset motion amplitude (upper limb motion amplitude trigger threshold), the upper limb preset panning amplitude (upper limb panning amplitude trigger threshold), the lower limb preset motion amplitude (lower limb motion amplitude trigger threshold) and the lower limb preset panning amplitude (lower limb panning amplitude trigger threshold) corresponding to the situation are determined, and based on the determined amplitude/trigger threshold, the boundaries between the first mode, the second mode, the third mode and the fourth mode can be distinguished, and the system can be switched between the bed exit early warning mode and the rehabilitation guidance mode by integrally raising or lowering the amplitude/trigger thresholds of the four modes. Different from the corresponding reminding modes in the bed leaving early warning mode and the rehabilitation guidance mode, the bed leaving early warning mode can be a telephone ring type to continuously ring and can be turned off manually by medical personnel, and the rehabilitation guidance mode can be a short message type to briefly prompt the sound and only plays a role in prompting the medical personnel and the monitored object.
To clarify the correlation between the movement characteristic variation trend and the posture setting posture, the movement characteristic variation trend is further exemplified: when medical personnel assist the patient to adjust to be the position posture of healthy side position (being the last schematic diagram in fig. 2, the patient lies on one's side and its affected side is located healthy side top in this schematic diagram), because the right side of mattress 8 is provided with the pillow and the affected side is located mattress 8 right side this moment, under the condition of not guardianship promptly, the patient wants to get off the bed, need utilize healthy side to support, earlier affected side towards the left side upset of mattress 8, overturn to the posture of lying on the back and continue to use healthy side to get up. The patient cannot turn towards the right side of the mattress by himself without monitoring. In the process, the patient needs to withdraw the upper limb of the affected side placed on the pillow to the position near the waist of the affected side, and simultaneously utilizes the force of the healthy side to gradually turn the lower limb of the affected side to the left side of the mattress. In this process, because the patient is in the position of lying on the side of being good for, its side of being good for is comparatively close to the left side border of mattress 8, if the patient turns over towards the left side of mattress 8, is probably directly turned down mattress 8 or out on the dangerous position very close to the edge of the bed. In the process, the patient may only adjust the position of the affected limb in the lateral recumbent position to relieve the blood circulation disorder caused by long-time compression, namely, the patient may move the affected upper limb up and down by using the healthy side or move the affected lower limb in a small range.
Through the analysis of the behaviors of the patient in the posture setting posture of the healthy lateral recumbent position, which may appear under the condition of no monitoring, the following first mode, second mode, third mode and fourth mode corresponding to the posture setting posture are respectively preset: if the wearable device 1 worn on the upper limb of the patient side has collected the behavior data meeting the preset motion amplitude of the upper limb, when the behavior data collected by the wearable device 1 monitoring the lower limb of the patient side meets the preset motion amplitude of the lower limb and the patient is monitored to be converted from lying on the side to lying on the back or from lying on the back to lying on the side, it is determined that the current patient condition is a fourth mode with a large risk coefficient, such as overturning the patient's limb in a small-amplitude lifting manner and changing the placing posture of the monitored object.
If the wearable device 1 worn on the upper limb of the affected side has collected the behavior data meeting the preset motion amplitude of the upper limb and the monitored object has a good independence, when the behavior data collected by the wearable device 1 on the lower limb of the affected side meets the preset motion amplitude of the lower limb or when the pressure distribution on the right side of the mattress 8 is gradually reduced and the pressure distribution on the left side is gradually increased, the risk coefficient is large because the monitored object has a good independence and the turning difficulty or the getting-up difficulty is small, and the monitored object is determined to be in the third mode.
If the wearable device 1 worn on the affected upper limb has collected the behavior data meeting the preset motion range of the upper limb and the monitored object has poor independence, when the behavior data collected by the wearable device 1 on the affected lower limb is monitored to meet the preset motion range of the lower limb, or when the pressure distribution on the right side of the mattress 8 is monitored to be gradually reduced and the pressure distribution on the left side is monitored to be gradually increased, the patient usually tries to turn over or starts up, but because the monitored object has poor independence and high turning difficulty, the risk coefficient is medium, and the monitored object is determined to be in the second mode.
When the wearable device 1 worn on the upper limb of the affected side acquires the behavior data meeting the preset moving range of the upper limb or monitors that the behavior data acquired by the wearable device 1 on the lower limb of the affected side meets the preset moving range of the lower limb, and the posture of the patient is not changed, the patient may only need to adjust the current posture by a small margin and the risk coefficient is low, and the patient is determined to be in the first mode.
For "trend of motion characteristic change of the monitored subject that has been instructed by posture change and trend of motion characteristic change of the monitored subject that has not been instructed by posture change": the posture change guidance referred to herein is primarily to teach the subject the proper turn-over or rise posture via the subject after the subject has been in a hospital for a period of time. In contrast, the fact that the subject does not receive the posture change guidance mainly means that the subject is just in hospital or is not in hospital for a long time, and does not have the posture guidance of turning over or getting up. The two different movement characteristic change trends can distinguish the action or behavior of the monitored object which is more likely to appear under the condition of being separated from monitoring, the speed of data comparison processing can be effectively improved, and the monitoring accuracy and effectiveness of the monitored object are further improved.
Fig. 1 shows a simplified connection relationship diagram of a bed leaving early warning system for stroke hemiplegia patients according to the present invention.
The system comprises a wearable device 1, and the wearable device 1 mainly refers to a device in the form of a watch product with a wrist and an ankle as supports. The acquisition module 2 proposed in patent document No. CN104524760B with publication date of 2017, 8, and 29, which is published as 29, is an intelligent bracelet worn by a monitored subject during exercise, in which a three-axis gyroscope sensor capable of acquiring three directional accelerations is built, so as to capture real-time acceleration values and vibration amplitudes of the intelligent bracelet/affected limb in real time. The built-in sensor in the wearable device 1 is not limited to a triaxial gyroscope sensor, and any sensor capable of detecting the upward acceleration, the forward acceleration and the vibration amplitude of the basketball action may be used, for example, the gravitational acceleration and the like. The three-axis gyroscope sensor can simultaneously measure the position, the movement track and the acceleration in six directions. The wearable device 1 is internally provided with a setting module for presetting the position, the movement track and the acceleration range/amplitude captured by the sensor corresponding to the body actions such as lifting, overturning, putting down and the like.
The system comprises an acquisition module 2 for acquiring behavior data of a monitored object, a wind control grade division module 3 for determining a wind control grade, an early warning information processor 4 for judging and triggering early warning, a placing posture detection module 6 for determining a current placing posture, a behavior rule module 5 for presetting a change trend of motion characteristics, wearable equipment 1 worn on the affected side of the monitored object, mobile digital equipment 7 carried by a guardian, and a mattress 8 internally provided with a processor and a sensor. Furthermore, a pressure sensor array for detecting changes in the pressure of the patient and a processor connected to the pressure sensor array are arranged on the mattress 8. The above mentioned devices mentioned in the present invention may all be computer processors, and fig. 1 shows a simplified logic flow diagram of a bed exit warning system for stroke hemiplegia patients, and the operations of the logic flow diagram may represent a series of operations implemented by hardware, computer instructions or a combination thereof. In the context of computer instructions, the operations represent computer-executable instructions stored on one or more computer-readable storage media that, when executed by one or more computer processors, perform the recited operations.
The monitor enters the monitored object to a certain pose through a mobile digital device 7 operated by the monitor or determines the adjusted pose by a pose detection module 6 under the condition that the monitor adjusts the monitored object to a certain pose, pressure change data collected by a plurality of sensors is acquired by a processor arranged on the mattress 8 when the monitored object moves on the body of the mattress 8 or adjusts the pose by self, and pressure distribution data and pressure change data about the monitored object are generated based on the pressure change data, and the processor transmits pressure change related information (including the pressure distribution data and the pressure change data) on the mattress 8 for analyzing the behavior trend, the pose or the pose change trend of the monitored object to the collection module 2.
The wearable device 1 acquires behavior data of the monitored object, particularly behavior data corresponding to the upper limb and the lower limb of the affected side respectively and used for extracting the first motion characteristic variation trend and the second motion characteristic variation trend when the monitored object moves the limbs on the mattress 8 or adjusts the placing posture by itself, and the wearable device 1 transmits the acquired behavior data to the acquisition module 2 at a preset time interval (which may be 1min or 30m in) for monitoring the behavior condition of the patient in real time.
The acquisition module 2 transmits the acquired pressure-related information and behavior data of the mattress 8 to the placing posture detection module 6, and the acquisition module 2 generates motion characteristic values corresponding to each behavior data and including at least an upper limb preset motion amplitude, an upper limb preset moving amplitude, a lower limb preset motion amplitude and a lower limb preset moving amplitude based on the behavior data when acquiring the behavior data of the monitored object determined by the wearable device 1, and transmits the generated motion characteristic values to the behavior rule module 5.
The placing posture detection module 6 processes the received data (the pressure related information and/or the behavior data of the mattress 8) and judges whether the pressure distribution on the mattress 8 obtained by processing appears an upper and lower obvious fault and/or whether the pressure distribution on one side is in a dispersion state relative to the other side, so as to judge and obtain the current placing posture information of the monitored object, and the placing posture detection module 6 transmits the placing posture information to the behavior rule module 5 and the wind control grade division module 3. As a preferred embodiment, the determination of the posing information is here mainly determined on the basis of pressure-related information provided on the mattress 8 or manually entered by the nursing staff after the posing has been adjusted.
Further exemplified for pose detection module 6: because mattress 8 is provided with pressure sensor, through processing the data that pressure sensor gathered, can obtain the pressure distribution condition on current mattress 8. As shown in fig. 2, when no obvious fault appears in the upper and lower directions in the obtained pressure distribution and the pressure distribution on one side is dispersed with respect to the other side, the pose detection module 6 generates pose information of the posture of the patient currently in the supine position based on the known relative positional relationship between the affected side of the patient and the mattress 8 (i.e., the positional relationship between the affected side of the patient who lies on the back and the left or right side of the mattress 8). For another example, as shown in fig. 2, when a significant fault appears in the top and bottom of the obtained pressure distribution and the pressure distribution on one side is dispersed with respect to the other side, the pose detection module 6 generates pose information of the pose of the patient in the healthy lateral decubitus position or the affected lateral decubitus position based on the known relative positional relationship between the affected side of the patient and the mattress 8. Wherein, the expression that the upper and lower obvious faults appear in the pressure distribution condition refers to that: because the patient needs to put the upper limb and the lower limb on one side on the pillow respectively when lying on side, especially the upper limb on the affected side of the patient needs to be put on the pillow completely, and different from the normal people, the upper limbs on two sides can be randomly placed at a position close to the head/body of the patient, so that the mattress 8 put between the upper limb and the lower limb on one side of the upper side and the lower limb on one side of the mattress 8 is not stressed, and an obvious fault that the stress action is not monitored exists between the upper side and the lower side observed from the stress distribution diagram appears. And the obvious fault is only present in a healthy lateral decubitus position or a diseased lateral decubitus position. The phrase "the pressure distribution on one side is dispersed with respect to the other side" means that the side having a relatively high degree of dispersion is obtained as viewed from the pressure distribution diagram, and as shown in fig. 2, the relatively high degree of dispersion is caused by the upper and lower limbs on the side where the patient is stretched being placed on the pillow, and therefore the side having a relatively high degree of dispersion can be determined as the side on the mattress 8 on which the upper and lower limbs on the side where the patient is stretched are placed. For example, when it is determined that the degree of relative diffusion on the left side of mattress 8 is higher and the patient is known to be paralyzed of the upper and lower extremities on the right side, pose detection module 6 generates pose information for a posture pose in which the patient is currently in the affected lateral decubitus position. For example, when it is determined that the degree of relative diffusion on the right side of mattress 8 is higher and the patient is known to be paralyzed of the upper and lower extremities of the right side, pose detection module 6 generates pose information for a posture pose at which the patient is currently in a strong lateral decubitus position.
The behavior rule module 5 processes the pose information determined by the pose detection module 6 and the plurality of motion feature values determined by the acquisition module 2 and including at least the first motion feature value and the second motion feature value, generates the affected limb motion data including at least the motion feature value and indicating the behavior of the affected upper limb or the affected lower limb, and transmits the affected limb motion data to the warning information processor 4 based on the preset motion feature change trend for predicting the behavior of the monitored object under a certain pose without monitoring.
The wind control level dividing module 3 is configured to output preset wind control level data corresponding to the placing posture and indicating the motion limitation degree of the limb of the affected side based on the placing posture information when the placing posture information after the placing posture of the monitored object is adjusted by the monitor through the mobile digital device 7 operated by the monitor or the adjusted placing posture information is determined by the placing posture detection module 6 based on the monitor entering the placing posture information by the monitor through the mobile digital device 7 operated by the monitor and/or when the placing posture information after the placing posture detection module 6 determines the self-adjusted placing posture information based on the moving limb of the monitored object on the mattress 8 in the non-monitoring state or the placing posture is adjusted by the monitor, and transmit the data to the early warning information processor 4. The single wind control level includes the degree of limitation of motion of the unilateral limb in a certain pose. The wind control classes include class i (essentially independent but overestimated self-activity), class ii (conditionally independent or extremely lightly dependent), class iii (moderately or heavily dependent), and class iv (extremely heavily or completely dependent). Further, at least two of the wind control levels are divided into evaluations of the independence of the monitored subject. The grades I (basically independent but overestimated self-activity) and II (conditional independent or extremely light dependence) are divided into the evaluation with better independence of the monitored object, and the grades III (moderate or heavy dependence) and IV (extremely heavy or complete dependence) are divided into the evaluation with lower independence of the monitored object.
The early warning information processor 4 judges whether an early warning is needed for the monitored object which is currently moving on the mattress 8 or automatically adjusts the placing posture based on the received affected limb action data determined by the behavior rule module 5, the wind control grade data determined by the wind control grade dividing module 3 and/or the independence evaluation of the monitored object, meets an early warning condition when judging that the affected limb action data meets at least one mode in at least one motion characteristic change trend, and sends the bed number, the name, the early warning content and the like of the monitored object to surrounding monitoring personnel when triggering the condition.
Preferably, as shown in fig. 3, the present application proposes a mattress suitable for a monitored subject with dyskinesia in the upper and lower limbs of the same side, which at least has two aspects of sensor distribution and rebound deformability of the bed body, so as to ensure comfort of the monitored subject and improve effectiveness and sensitivity of data acquisition. According to the invention, a hip region 9 and a shoulder and elbow region 10 are delimited on the mattress 8 at a distance from one another and are each provided with at least one sensor. The hip bone region 9 corresponds to a region where the buttocks of the subject lie, and the region extends in a radial direction perpendicular to the height direction of the body and is in a long strip shape. The shoulder-elbow region 10 corresponds to a region between the shoulder and the elbow of the subject, and extends in a radial direction perpendicular to the height direction of the body, and has an elongated shape. The bed at the hip region 9 is resiliently deformable at least to a greater extent than the bed at the shoulder and elbow regions 10.
Because the bed body corresponding to the hip bone region 9 has better resilience and deformability, the bed body can relieve the pressure born by the hip bone, the sacrum and other limbs of a patient with stroke hemiplegia when lying on the side or lying on the back, and is beneficial to the improvement of blood circulation and the reduction of the injury of the side lying extrusion to the affected side or the healthy side. The sensor adopted by the invention is a flexible film grid-shaped touch pressure sensor, the thickness of the sensor is only 0.1mm, the flexibility is good, and the detection precision and speed can be better improved.
It is further preferred that the sensor distribution density provided on the shoulder elbow region 10 is greater at least in relation to the sensor distribution density provided on the hip region 9. Since the possible contact area between the monitored object and the shoulder-elbow region 10 is much smaller than the possible contact area between the monitored object and the hip bone region 9, the sensor distribution density is relatively increased, which is beneficial to improving the detection accuracy. The sensor used in the invention and arranged on the mattress 8 is preferably Tekscan touch and pressure distribution sensor produced by Beijing GmbH with Babert technology, the hardware of the sensor comprises an A/D conversion circuit based on a PC and a reusable sensor, the pressure display and analysis software based on MS Windows is combined to form a pressure monitoring system, the system can carry out static and dynamic measurement on the pressure distribution of any contact surface, the pressure profile and various data are displayed in real time by two-dimensional and three-dimensional color images which are visual and vivid, the whole measurement process is recorded and/or stored, and a guardian can check and analyze the measurement record at any time.
It should be noted that the above-mentioned embodiments are exemplary, and that those skilled in the art, having benefit of this disclosure, may devise various solutions which are within the scope of this disclosure and are within the scope of the invention. It should be understood by those skilled in the art that the present specification and figures are illustrative only and are not limiting upon the claims. The scope of the invention is defined by the claims and their equivalents.
Claims (7)
1. A stroke hemiplegia patient is with early warning system of leaving bed, the system includes:
an acquisition module (2) for acquiring behavior data acquired by a wearable device (1) worn only on the affected upper and lower limbs of a subject;
a wind control grade dividing module (3) for determining the wind control grade corresponding to the historical wind control data of the monitored object according to the historical wind control data,
wherein the monitored object refers to a crowd with dyskinesia on the upper and lower limbs on the same side and with difference between the upper and lower limbs on the affected side and the upper and lower limbs on the healthy side,
characterized in that, the system further comprises:
an early warning information processor (4) configured to determine whether behavior data of the monitored subject triggers an early warning based on a preset pneumatic control level and a phase attribute association rule between motion characteristic values extracted by the acquisition module (2) from the behavior data acquired by at least one wearable device (1) worn on the upper and lower limbs of the monitored subject, the phase attribute association rule corresponding to a dyskinesia assessment result determined by at least one mobile digital device (7) operated by a monitoring person;
the historical wind control data refers to basic information and clinic information of the monitored object stored in a hospital information system;
the phase attribute association rule refers to a degree of dyskinesia determined from a current dyskinesia assessment result of the user;
the movement characteristic change trend refers to the behavior of the monitored object kept in a certain placing posture under the condition of no monitoring;
the motion characteristic values at least comprise a first motion characteristic value in the behavior data acquired by a first wearable device (1 a) worn on the affected upper limb of the monitored object and a second motion characteristic value in the behavior data acquired by a second wearable device (1 b) worn on the affected lower limb of the monitored object, wherein a phase attribute association rule between the first motion characteristic value and the second motion characteristic value and used for indicating motion characteristic variation trends respectively corresponding to the first motion characteristic value and the second motion characteristic value is prestored in the acquisition module (2).
2. The system according to claim 1, characterized in that the system further comprises a behavior rule module (5), wherein the behavior rule module (5) is respectively connected with the pose detection module (6) and the pneumatic classification module (3) and is used for presetting a trend corresponding to at least one pose respectively for indicating the motion characteristic change which is likely to occur in the pose.
3. The system of claim 2, wherein the movement characteristic trend comprises at least a movement characteristic trend for a subject who has received posture change guidance and a movement characteristic trend for a subject who has not received posture change guidance.
4. The system according to claim 3, wherein the degree of motor dysfunction of the monitored subject with the highest wind control level determined by the wind control level dividing module (3) is not completely lower than that of the monitored subjects with other wind control levels.
5. The system according to claim 4, further comprising a pose detection module (6), wherein the pose detection module (6) is connected to the acquisition module (2) and is configured to determine a relative position relationship between the affected side of the monitored subject and the mattress (8) and generate a current pose of the monitored subject based on the relative position relationship and at least some of the motion characteristics.
6. System according to claim 5, characterized in that the mattress (8) is divided into a hip region (9) and a shoulder region (10) which are arranged at a distance from one another and each of which is provided with at least one sensor, the hip region (9) corresponding to a bed body having a higher resiliently deformability than at least the bed body corresponding to the shoulder region (10).
7. System according to claim 6, characterized in that the sensor distribution density provided on the shoulder elbow region (10) is at least greater than the sensor distribution density provided on the hip bone region (9).
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