DE102018004685A1 - Vibrotactile stimulation system - Google Patents

Abstract

An apparatus for applying vibrotactile stimulation to at least one user's hand is provided. The device comprises: a hand rest formed to support the at least one hand; at least one tactile stimulator configured to stimulate at least a portion of the at least one hand; an activation module configured to activate the at least one tactile stimulator.

Description

Field of the invention

Here, various embodiments of systems, devices, and components adapted for applying vibrotactile stimulation to a user's hands, and methods for doing so, are described and disclosed. Likewise, various embodiments of systems, devices, and components designed to determine, particularly measure, symptoms associated with jitter, and methods for doing so are described and disclosed. Vibrotactile stimulation and the measurement of symptoms associated with tremor may occur together or independently in the context of therapeutic or non-therapeutic treatments of neurological disorders, such as neurological disorders. Parkinson's disease or epilepsy, as well as for the treatment of movement impairments, e.g. as a result of stroke or spinal cord injury.

background

Various neurological disorders indicate hyperactive neuronal areas or pathologically synchronized neuronal activity as characteristic features. Epilepsy and Parkinson's disease are examples of such diseases. It has been shown clinically that local electrical stimulation may assist in normalizing such synchronized activity, thereby resulting in a beneficial reduction in symptoms (see, eg Tass et al., 2012, Annals in Neurology, Adamchic et al., 2014, Movement Disorders ).

As a non-invasive approach, structured vibrotactile stimulation applied according to the coordinated reset structure has shown positive results in several individuals and the ability to improve pathological neurological activity (Syrkin-Nikolau et al., 2018, Movement Disorders).

Induced desynchronization can not only improve symptoms while stimulation continues. Neuroplasticity induces long lasting beneficial effects in brain activity leading to symptom improvements ( Syrkin-Nikolau et al., 2018, Adamchic et al., 2014, Tass et al., 2012 ).

Therefore, the use of structured non-invasive vibrotactile stimulation is a very promising method of treatment for enabling the early treatment of diseases, e.g. Parkinson's disease and epilepsy.

Accordingly, it is a problem to efficiently and conveniently provide vibrotactile stimulation that can be used in the treatment of neurological disorders and / or movement impairments. In particular, the currently available prototypes, which have also been used in said clinical trial, lack the convenience of use that would be required for a widely used product. In particular, when an early treatment of diseases, e.g. Parkinson's disease and epilepsy, provided that the treatment stimulation devices must be easily integrated into the daily lives of patients. Therefore, a new design and functions are required, which are described below.

Summary

In one embodiment, an apparatus for applying vibrotactile stimulation to at least one user's hand is provided.

The device is designed to provide vibrotactile stimulation to the user, e.g. Parkinson's disease, where the vibrotactile stimulation causes the user to perceive tactile stimulation (such as vibration) by a touch, that is, by means of physical contact between the user and the device. In particular, the contact with the device takes place by at least one hand of the user. In other words, the user can touch the device with one hand or with both hands. In a specific example, the device for providing vibrotactile stimulation is designed for both hands of the user. Accordingly, the device may generate a mechanical vibration that is sensed by the user's body due to a contact between the user's hand or hands and the device. In particular, at least a portion of one or more fingers (e.g., at least a portion of the respective fingertips) and / or the palm of the hand or hands may be in contact with the device.

The device comprises a hand rest, which is designed to support the at least one hand of the user. The hand rest provides a location on which the user's hand or hands can be placed to receive vibrotactile stimulation. In other words, the hand rest is the component of the device that allows positioning of the hand or hands such that vibrotactile stimulation thereon can be applied. Accordingly, the size of the hand rest may be sufficient for the placement of one hand or two hands. Further, the shape of the hand rest may be ergonomic to match the shape of the hand or hands. The compliance of the palm rest may be such that the at least one hand is substantially firmly positioned on the hand rest, ie, the at least one hand may be in a stable position with respect to the device and in particular to the source (s) of vibration (ie maintain the tactile stimulator (s) described below. The use of a hand rest instead of eg gloves simplifies the application of the vibrotactile stimulation, as the user can easily remove his / her hands from the pad and possibly replace them.

In some examples, the hand rest may include a fixation strip configured to fix the hand or hands to the hand rest to make it easier for a user (eg, an impaired or disabled user) to keep the hand in the correct one for a long time To stay in place and allow the user to be physically more relaxed. The fixing strip can be made of a flexible textile material and can be provided with an adjustment mechanism such as Velcro ^® -Einsätzen. As an example, the fixation strip may extend over the palm rest in a direction perpendicular to the direction of the fingers of the hand or hands. The fixation strip can be attached to the surface of the palm rest where the hands rest in at least two places, eg at their ends. In some examples, the fixation strip may be fixed to the surface at more than two locations so that it follows the anatomy of the hand, eg, it may be attached to locations between the spaces provided for the fingers. By way of example, the fixation strips may be fastened by means of buckles so that a given portion of the fixation strip is not permanently attached to the surface but can slide so as to follow the adjustment mechanism.

The hand rest may be made, at least in part, of biocompatible materials in view of repeated and prolonged contact with human skin. In some examples, the hand rest may be at least partially made of a latex-free material. The biocompatible materials may be present only on the surface of the palm rest that is in direct contact with the hands, whereas a back surface and / or a base structure may or may be made of other materials.

The hand rest may have a plurality of different configurations that serve the purpose in the same manner. In one example, the palm rest may be a substantially flat layer of material superimposed on the source (s) of vibration. In another example, the palm rest may have a substantially convex shape that allows the hand or hands to rest in a curved position rather than flat. In particular, the substantially convex palm rest may allow the user's two hands to be at a certain angle to each other, which may result in a more relaxed position of the user during the treatment.

In a particular example, regardless of the specific configuration, the hand rest may include a surface that includes at least one cavity configured to receive at least a portion of the at least one hand. The at least one cavity may beneficially hold the hand or hands in a substantially fixed position during application of the vibrotactile stimulation.

The outer surface of the hand rest may have various curvatures, as discussed above, using e.g. may be generally flat or generally convex, however, it may include one or more regions of a different local curvature forming depressions in the surface. The hand rest may include at least one cavity or depression shaped to mate with at least a portion of the at least one hand such that one or more portions of the hand at least partially fit into the one or more cavities. sink in or slide into it. In other words, the hand or hands may or may be at least partially in the one or more cavities.

In one example, the hand rest may comprise a continuous cavity corresponding to the shape of the entire hand. When vibrotactile stimulation is applied to both hands, the hand rest may comprise two cavities, each corresponding to one hand. In another example, only one or more specific portions of the hand or hands may or may be received in the at least one cavity, where, for example, a cavity may be shaped to hold only one finger or fingertip or picking up the base of the thumb (thumb pad) or the small finger bale or another section. Thus, the hand rest may comprise a cavity corresponding to only a portion of a hand, or may comprise a plurality of cavities which correspond to a plurality of sections in one hand or two hands.

Accordingly, in one particular example, the hand rest may include a plurality of cavities for receiving various portions of the at least one hand, wherein the plurality of cavities are separated from each other by other portions of the surface of the wrist rest following the general curvature. In other words, if the palm of the hand is placed on the palm rest, only some areas of the hand may fit into the cavities, while the rest of the palm may be supported by the remainder of the surface.

When the device is designed to stimulate both hands, the hand rest may comprise a plurality of cavities comprising two sets of cavities, one for the left hand and the other for the right hand. Each set may have a cavity, e.g. the entire hand or a section of the hand, or comprise multiple cavities. The sets may comprise the same cavities arranged in a mirrored manner in the hand rest or different portions may be stimulated in one hand with respect to the other.

In a specific example, the plurality of cavities may be configured to receive a plurality of fingertips of the at least one hand. As an example, the hand rest may include five cavities for receiving five fingertips of one hand or ten cavities for receiving five fingertips of each hand. The cavities may have a substantially circular cross-section and a depth in a range between about 3 mm and about 12 mm, in particular about 8 mm.

The size of an adult's hand can vary from person to person. In one example, the position and / or shape of the at least one cavity in the surface of the hand rest may be determined and shaped based on an average size of a human adult hand. In another example, the hand rest may be adapted to the specific size of the hand or hands of a given user, such as a user. by providing a plurality of sets of cavities for different hand sizes.

In a specific example, the hand rest may include a replaceable pad configured to adjust the size of the at least one hand. The pillow may be replaceable in a sense that it is possible to remove a pillow from the device and replace it with another pillow. In particular, the replaceable cushion may include a coupling mechanism for temporarily securing it to the device.

In one example, the hand rest may cover the surface with the cavities, e.g. for the fingertips, with the surface fixedly mounted to the device, and the replaceable pad may be releasably secured to the portion of the palm rest on which the center of the palm substantially rests. The various replaceable pads may have different thicknesses to adjust the distance of the hand or hands to the fingertip cavities, so that the device can be easily modified for different hand sizes. In other words, the releasably secured replaceable pad may present a protrusion with a variable thickness on the wrist rest. By way of example, such a protrusion may have a cross-section (in thickness direction) of a few square centimeters in size and a thickness (or height relative to the surface of the wrist-rest), e.g. may vary between about 1 cm and 5 cm. The thickness of the replaceable pad to be used may be varied based on the length of the user's fingers, e.g. a larger thickness may be needed for longer fingers.

In another example, the replaceable pad may include the at least one cavity. The pad may be made up of a plurality of pre-existing pads corresponding to different sizes of the hand, e.g. standardized for gloves are selected. Alternatively, the cushion may be molded on the basis of a cast of the hand and thus customized for a specific user. In some examples, the hand rest may be the replaceable cushion and may be attached directly to other components of the device, such as a device. the tactile stimulator (s) described below. In other examples, the hand rest may further include a fixed (non-replaceable) base structure upon which the replaceable pad is mounted.

In another example of a customizable hand rest, the hand rest may be made of a deformable material that can be formed into a predetermined shape, such as a wrist rest. by pressing the hand, which is also elastic, that is, returning to its original amorphous state. An example of such a material is a shape memory foam.

Alternatively, or in addition to the at least one cavity, the palm rest may be a visual indication of where the hand or hands are to be placed, e.g. a contour of the hand.

Furthermore, the device comprises at least one tactile stimulator, which is designed to stimulate at least a part of the at least one hand. As an example, the at least one tactile stimulator may stimulate only a portion of one hand or multiple portions of a hand or portions associated with both hands of the user.

The at least one tactile stimulator may be configured to generate a mechanical vibration for the vibrotactile stimulation. In particular, the tactile stimulator may comprise a vibration motor, such as a motor. an electric motor connected to a moving mass, wherein the moving mass may be eccentric and mounted on the shaft, or connected to a spring. Examples of a vibration motor are linear resonance actuators (LRAs) or eccentric rotating mass (ERM) vibration motors or piezoelectric actuators.

Although it is contemplated that only one tactile stimulator will be used, e.g. for very targeted stimulation, a majority of tactile stimulators are used in most cases. Thus, the device may include a plurality of tactile stimulators configured to stimulate a plurality of parts of the at least one hand. Accordingly, further details will be given below with respect to a plurality of tactile stimulators, it being understood from the context which features may be applied to a single tactile stimulator.

The tactile stimulators stimulate at least a portion of the hand by generating a vibration perceived by the hand due to contact with the palm rest. For example, there may be a one-to-one correspondence between the tactile stimulators and the areas to be stimulated, e.g. a tactile stimulator for every finger. In another example, a plurality of tactile stimulators may be arranged in close proximity to each other and configured to have the same area as, for example, one of a plurality of tactile stimulators. a finger, stimulates. The distribution of tactile stimulators may depend on the size of the tactile stimulators and the characteristics of the stimulation to be provided.

When both hands of the user are stimulated, the device may include at least two tactile stimulators configured to stimulate both hands, each tactile stimulator configured to stimulate a respective hand. In other words, a tactile stimulator can stimulate either (part of) the left hand or (part of) the right hand. Alternatively, a tactile stimulator may be designed to stimulate both hands. By way of example, the device includes a first set of tactile stimulators for stimulating the left hand and a second set of tactile stimulators for stimulating the right hand, which may or may not overlap the two sets.

The plurality of tactile stimulators are positioned below the surface of the palm rest on which the user's hand or hands may or may rest to transmit the generated vibration to the hand or hands supported by the hand rest , In one example, the tactile stimulators may be uniformly beneath the contact surface of the palm rest, wherein the activation of a given tactile stimulator is dependent upon detecting the presence of the hand above it, e.g. by means of detecting a pressure and / or heat. In another example, the position of the hand may be determined in a predetermined manner, e.g. visual indications and / or cavities, and the tactile stimulators may be located only below the areas of the surface of the palm rest where the hand is to contact the device.

In some examples, the surface of the hand rest may include holes, particularly corresponding to the position of the tactile stimulators, to allow for direct contact of the tactile stimulators with the skin of the hand or hands. By way of example, the holes may have a characteristic dimension (e.g., a diameter for a substantially circular hole or a size of a substantially square hole) in a range between about 3 mm and about 15 mm, in particular 6 mm.

In the particular example where the hand rest comprises at least one cavity, the tactile stimulators may be positioned at least corresponding to the at least one cavity. In other words, the tactile stimulators can be located in particular below the at least one cavity. In particular, as already mentioned, there may be a tactile stimulator for a cavity or a plurality of tactile stimulators for a cavity. In some examples, the tactile stimulators may be located only below the at least one cavity and not below other areas of the surface of the palm rest. In other examples, the tactile stimulators may be located below both the at least one cavity and other areas of the surface of the wrist rest. As discussed above, the at least one cavity may include one or more holes at the position of the tactile stimulators.

If the tactile stimulators are below the area where the hand or hands are to be placed, it can be detected whether the hand or hands are correctly placed on the hand rest to effectively use the vibrotactile stimulation, as it continues to do is explained below.

Depending on the configuration of the palm rest, the tactile stimulators may be in contact with the palm rest on only one side, e.g. when the hand rest has a sheet-like structure superimposed on the tactile stimulators. In another specific example, the tactile stimulators may be embedded in the palm rest, e.g. when the palm rest has two layers and the tactile stimulators are disposed between the layers or the palm rest has an outer layer for arranging the hands and a base pad on which the outer layer is disposed with the tactile stimulators in the base pad.

When both hands of the user are stimulated, the tactile stimulators can apply the vibrotactile stimulation to each hand in a mirror-image manner or they can apply it in an asymmetrical manner.

The device further comprises an activation module configured to activate the at least one tactile stimulator. In other words, the activation module may control the tactile stimulators to initiate and stop the generation of vibrations by the tactile stimulators. In particular, the activation module may be adapted to tactile stimulators, such as e.g. the vibrating motors, supplying electricity. The activation module may include a power source, such as a power source. a battery, or control the connection between an external (i.e., not part of the activation module) power source and the tactile stimulators. The activation module may be an electronic module comprising a processor and / or a memory.

In a specific example, the activation module is configured to activate the tactile stimulators according to an activation sequence according to a predetermined pattern. In fact, the vibrotactile stimulation may have certain properties based on the type of treatment to be used, e.g. a structured desynchronizing stimulation or a structured synchronizing stimulation. As an example, the predetermined pattern for the activation sequence, which may be determined based on neurological considerations, may be characterized by a set of stimulation parameters. This set of pacing parameters may include, among other things, the frequency of the vibration, the amplitude of the vibration, the duration, and the repetition rate of the vibration stimulus.

The vibration frequency is proportional to the engine speed, which in turn depends on the applied voltage. The vibration amplitude may indicate the magnitude of the vibration and may be related to both the speed of the motor and the mass of motion. For LRAs indicated by an alternating current and comprising an oscillating mass, the frequency and the amplitude can be modified independently, with the frequency being kept substantially identical to the resonant frequency of the LRA.

The repetition rate is not a characteristic of the vibration itself, but rather the pattern according to which the vibration stimulus is applied. The pattern may include non-repetitive stimuli (non-periodic pattern) or repeated stimuli (periodic pattern), the latter being determined by the repetition rate, i.e., the number of times a given stimulus is repeated. The duration of each vibration stimulus can be another parameter.

The activation sequence may be determined by the set of pacing parameters for all tactile stimulators. In other words, the activation module can reduce the generation of vibration stimuli by the tactile stimulators in accordance with e.g. controlling the vibration frequency and amplitude, as well as controlling the application of such vibration stimuli according to a temporal scheme, optionally determined by start times, duration and repetition rates.

The predetermined pattern of the activation sequence may be stored in the activation module or the activation module may receive it from an external device. In the former case, the activation module may include a user interface that allows a user to operate the device by means of the activation module, in particular to start / stop the stimulation.

As mentioned above, the correct placement of the hand or hands on the hand rest may be tested before and / or while the vibrotactile stimulation is being applied.

In a specific example, the at least one tactile stimulator may comprise a linear resonant actuator and the activation module may be used to determine a resonant frequency of the linear resonant actuator when the at least one hand is placed on the palm rest. The activation module may also for comparing the determined resonant frequency of the linear resonant actuator with a resonant frequency of the linear resonant actuator when no hand is placed on the hand rest, adapted to detect whether the at least one hand is correctly positioned on the wrist rest. LRAs are characterized by a resonant frequency due to harmonic oscillator behavior caused by the mass-spring system. The presence of the hand on the palm rest exerts a load on a LRA, thereby modifying its resonant frequency. In particular, only if the hand is correctly arranged on the hand rest, for example in the corresponding cavity, this can cause a change in the resonant frequency. If the hand is displaced, it may not be in contact with the LRA, so no load will affect the mass-spring system.

Accordingly, by comparing the resonance frequency of a LRA without any load (hereinafter also referred to as "nominal frequency") with the resonance frequency of the LRA, once the hand has been placed on the device (hereinafter also referred to as "loading frequency"), it can be detected whether the at least one hand is correctly placed on the palm rest. In particular, the comparison between the nominal frequency and the stress frequency of a quantitative estimate can be made using various mathematical procedures, such as e.g. Difference, ratio, relative ratio, etc., correspond. A threshold may be set so that if the quantity is below the threshold, it is assumed that the hand is not correctly positioned, and if that quantity is above the threshold, it is considered that the hand is correctly located. In particular, such a comparison may be performed for each LRA or only for a subset of the plurality of LRAs that may be representative of the position of the entire hand on the wrist rest. Consequently, the correct position of the hand or hands can be checked by viewing the LRAs themselves, without the need for additional components.

In another specific example, the hand rest may comprise a piezoelectric material, and the activating module may be configured to measure a piezoelectric effect on the piezoelectric materials when the at least one hand is disposed on the hand rest to detect whether the at least one hand is properly seated the hand rest is arranged. The hand rest may comprise a piezoelectric material in the areas adapted to receive the hand or hands, e.g. the cavities. Additionally or alternatively, the tactile stimulators may be piezoelectric activators.

The piezoelectric material generates an electrical charge in response to an applied mechanical stress, such as a mechanical stress. the pressure exerted by the hand or hands on the palmrest. Accordingly, the activation module may measure the presence and / or amount of electrical charge in the piezoelectric material of the wrist rest to deduce that the hand is properly placed on the hand rest.

The LRA or piezoelectric tactile stimulators may be provided with a component (e.g., by incorporating a gage or strain gauge) that may enable the activation module to measure the position of a moving part of the tactile stimulator. Prior to the beginning of the pacing sequence or during pacing sequence interruptions, the resting position of the moving portions of the tactile stimulators may be used to detect the correct hand arrangement on the tactile stimulators.

In other examples, temperature sensors may be used to check the position of the hands.

In general, if the activation module checks to see if the hand is correctly located, the activation module may provide an indication of the results to the user so that the user can adjust the position of the hand or hands if necessary. For example, the activation module may provide a visual indication (e.g., a red / green light source) and / or an audible indication.

In a specific example, the device may further include a connection module configured to allow the device to connect to an external mobile device such that the actuation module is controlled by the external mobile device.

The connection module may be a component of the device that provides a connection to an external mobile device, which connection may facilitate an exchange of power and / or data with the activation module. In other words, a connection between the activation module and the external mobile device may take place via the connection module. In particular, the connection may be wireless, e.g. based on Bluetooth, WLAN, optics or any near field communication technology.

The connection module may also be configured to allow stable positioning of the external mobile device with respect to the device, eg by providing a slot into which a part of the external mobile device may be inserted. Further, the connection module may be configured to provide the user with visual access to a screen of the external mobile device. In other words, the interconnection module may provide a data and / or power connection between the devices and may also provide a physical support for the external mobile device.

The external mobile device may include a display unit, a processing unit, a storage unit, and a communication unit. As an example, the external mobile device may be an intelligent mobile device, eg an iPod Touch from ^Apple® , or a smartphone, eg an iPhone from ^Apple® . In particular, the connection module of the device for vibrotactile stimulation may cooperate with the communication unit of the external mobile device to establish communication between the two devices.

The external mobile device may send instructions to the activation module to control the beginning and end of the vibrotactile stimulation as well as the stimulation pattern. As an example, the storage unit may store stimulation parameters, which may be data transmitted to the vibrotactile stimulation device by means of the external mobile device communication unit and the vibrotactile stimulation connection module. Alternatively, the stimulation parameters may be e.g. based on user data obtained from the external mobile device, as explained below, and stored in the memory of the activation module. In some examples, the external mobile device may allow the user to set one or more pacing parameters, such as pacing parameters. to adjust the intensity of the vibrotactile stimulation.

As an example, the external mobile device may allow the user to start / stop the stimulation. Accordingly, the external mobile device can receive control data, e.g. a trigger signal for starting / stopping the stimulation, to the activation module e.g. in response to a user input, such as touching a touchscreen. Even if the external mobile device controls the activation module, the activation module can maintain at least partial autonomy, e.g. under certain circumstances. For example, the activation module may stop the stimulation if it determines that the positioning of the hands is not optimal / proper for effective vibrotactile stimulation.

Further, the external mobile device may track data concerning the application of the treatment, such as e.g. the total stimulation time to help the user to follow the treatment recommendations, such as the daily stimulation time to comply.

Alternatively or additionally, the external mobile device may assist the user in correctly positioning the hand or hands on the wrist rest and / or in exercising the correct amount of pressure / contact of the hand or hands or part of the hand or hands (on or off) several fingers) on the palm rest. By way of example, the external mobile device on the display unit may show an outline of the user's hand or hands when they are on the palm rest with color coding for alignment with the optimal positioning on the palm rest, e.g. with the cavities, and / or the optimal pressure / contact between the hand or the hands / the finger (s) and the palm rest. Red or yellow areas may indicate suboptimal alignment and / or suboptimal pressure / contact, whereas green areas may indicate good hand rest orientation. The optimal orientation and / or pressure and / or contact may be determined overall and given for a complete hand, and / or may be determined and indicated locally for individual areas (eg, fingers) of the user's hand or hands become. In some examples, pacing may be applied only when a certain degree of alignment / pressure / contact is achieved, and may stop when the alignment / pressure / contact falls below a pre-established threshold. This would allow a very comfortable, simple, intuitive use of the vibrotactile stimulation device. It should be noted that this functionality of determining and indicating the optimal orientation / pressure / contact is not limited to the use of an external (mobile) device. Alternatively or additionally, this functionality can be integrated into the claimed device, e.g. by directly implementing a respective determination unit (e.g., the activation module as explained above) and a display unit in the claimed device.

In one aspect of the invention, a method of applying vibrotactile stimulation to at least one user's hand may include using the external mobile device Assessing symptoms of the user and determining one or more parameters of the vibrotactile stimulation based on the evaluation of the symptoms.

To optimize the effectiveness of vibrotactile stimulation, the user's symptoms can be detected and quantified. In particular, the external mobile device may detect symptoms associated with tremors and derive parameters for optimal therapeutic or non-therapeutic stimulation.

In a specific example, evaluating symptoms of the user includes measuring a frequency of at least one hand trembling and including or comprising a repetition rate of the vibrotactile stimulation that is determined based on the frequency of the jitter. Examples of repetition rate values may be 2 Hz or 5 Hz.

For example, the external mobile device may include a built-in gyroscope, and may detect the frequency of jitter using the gyroscope and inquiring that the user is performing various tasks (e.g., drawing circles on a touch screen or a touch experiment). The results of these experiments, along with information from questionnaires, can be used to identify the most prevalent frequency of jitter that can be used to individualize the stimulation pattern. For example, the repetition rate may be set to the frequency of jitter or to a multiple or fraction of the frequency of jitter or to more complex functions of the frequency of jitter.

The best-established tool for evaluating symptoms associated with tremors and symptoms associated with disorders associated with motor impairment is the Unified Parkinson Disease Rating Scale (UPDRS) (https://www.support.edu/). movementdisorders.org/MDS-Filesl/PDFs/Rating-Scales/MDS-UPDRS_English_FINAL.pdf). The third part (motor assessment) is of particular interest for establishing a ranking of symptoms associated with tremors. The external mobile device can be used to evaluate the UPDRS rating in a simple and intuitive manner, which in particular allows self-assessment by the user at home.

A questionnaire may be created covering the sections of the UPDRS classification that can be covered by simple questions. If necessary, the responses can be collected by the nearest family members to assess the validity of the self-assessment. Other UPDRS-based ratings require a more complex analysis, which may be supported by the capabilities of the external mobile device.

• - Sprachbewertung: der Nutzer wird durch die mobile Vorrichtung aufgefordert, einen vorgegebenen Text zu lesen, der bezüglich der Artikulation und des Verständnisses aufgezeichnet wird. Dies kann z.B. unter Verwendung von eingebauten Spracherfassungsalgorithmen und durch Vergleichen des resultierenden Texts mit dem vorgegebenen Text durchgeführt werden.
• - Gesichtsausdruck: die mobile Vorrichtung kann ein Foto aufnehmen und/oder ein Video aufzeichnen, während der Nutzer gebeten wird, verschiedene Gesichtsausdrücke zu zeigen. Gesichtsausdruckalgorithmen können verwendet werden, um das Vermögen der Person, Gesichtsausdrücke zu modulieren, in eine Rangfolge zu bringen.
• - Steifigkeit: der Nutzer kann die mobile Vorrichtung mit dessen eingebautem Gyroskop in dessen/deren Hände halten, während der Unterarm nach oben und unten bewegt wird. Der Verlauf der erfassten Bewegung kann bezüglich gleichmäßiger oder steifer Bewegungen analysiert werden.
• - Finger- und Zehenklopfen: der Nutzer kann gebeten werden, auf den Berührungsbildschirm der mobilen Vorrichtung zu klopfen. Die Vorrichtung kann einfach die Frequenz und die Stärke des Klopfens messen, was zu einer Rangfolge für diese Teileinstufung führt.
• - Hand- und Beinbewegungen: die mobile Vorrichtung kann auf der Oberseite der Hand/des Fußes angebracht werden, während der Nutzer die Aufgabe ausführt. Die Gyroskopinformationen können zum Bewerten der Qualität der durchgeführten Bewegung verwendet werden.
• - Aufstehen von einem Stuhl: der Nutzer wird gebeten, von einem Stuhl aufzustehen, während er/sie die mobile Vorrichtung in dessen/deren Händen hält. Unter Verwendung des eingebauten Gyroskops kann die Gleichmäßigkeit und die Vollständigkeit der Bewegung erfasst werden.
• - Gangart: der Nutzer wird gebeten, sich zu bewegen, während er/sie die mobile Vorrichtung in dessen/deren Hand oder in einer Tasche hält. Dies ermöglicht die Bewertung der Geschwindigkeit, der Gleichmäßigkeit und von potenziellen Beeinträchtigungen der Gangart.
• - Haltungsstabilität: der Nutzer wird gebeten, für eine Minute stillzustehen. Abweichungen und Bewegungen, die durch das Gyroskop der mobilen Vorrichtung erfasst werden, können angeben, ob Stabilitätsprobleme vorliegen.
• - Gesamtspontanität der Bewegung: die mobile Vorrichtung gibt Anweisungen und das Startkommando für eine Bewegung (z.B. eine Vibration oder ein Ton). Die mobile Vorrichtung kann messen, wie schnell der Nutzer nach einem vorgegebenen Auslöser mit der Bewegung beginnt. Ferner kann ein anderer Auslöser zum Stoppen der Bewegung angegeben werden (z.B. eine Vibration oder ein Ton), und die Vorrichtung kann die Reaktion des Nutzers erfassen.
• - Zittermessungen: der Nutzer erhält Anweisungen von der mobilen Vorrichtung. Während die mobile Vorrichtung in der Hand gehalten wird (oder während die mobile Vorrichtung an der Rückseite der Hand fixiert ist), führt der Nutzer die Anweisungen durch und das Zittern wird durch das eingebaute Gyroskop gemessen.

The following is a non-exhaustive list of tasks that can be performed with the external mobile device to evaluate the symptoms of a user:

• - Language rating: the user is prompted by the mobile device to read a given text that is recorded in terms of articulation and comprehension. This can be done, for example, by using built-in speech detection algorithms and comparing the resulting text with the given text.
• Facial expression: the mobile device can take a picture and / or record a video while the user is asked to show different facial expressions. Facial expression algorithms can be used to rank the person's ability to modulate facial expressions.
• Stiffness: the user can hold the mobile device with its built-in gyroscope in his / her hands while moving the forearm up and down. The course of the detected movement can be analyzed for even or stiff movements.
• Finger and Toe Tap: The user may be asked to tap the touch screen of the mobile device. The device can simply measure the frequency and severity of the knock, resulting in a ranking for this partial rating.
• Hand and leg movements: the mobile device can be mounted on top of the hand / foot while the user is performing the task. The gyroscope information can be used to rate the quality of the movement being performed.
• Getting up from a chair: the user is asked to get up from a chair while he / she holds the mobile device in his / her hands. By using the built-in gyroscope, the uniformity and completeness of the movement can be detected.
• Gait: the user is asked to move while holding the mobile device in his / her hand or in a bag. This allows the evaluation of Speed, uniformity and potential impairment of gait.
• - Posture stability: the user is asked to rest for a minute. Deviations and movements detected by the gyroscope of the mobile device can indicate whether stability problems exist.
• - Total spontaneity of movement: the mobile device gives instructions and the start command for a movement (eg a vibration or a sound). The mobile device can measure how fast the user starts to move after a given trigger. Further, another trigger for stopping the movement may be indicated (eg, a vibration or a sound), and the device may detect the user's response.
• - Shake measurements: the user receives instructions from the mobile device. While the mobile device is held in the hand (or while the mobile device is fixed to the back of the hand), the user performs the instructions and the jitter is measured by the built-in gyroscope.

Another established test for quantifying parkinsonian symptoms is the so-called "Distinguishing Different Stages of Parkinson's Disease Using Composite Index of Speed and Pen-Pressure of Sketching a Spiral," Zham et al. (2017), Frontiers in Neurology 8th : 435). The user may be asked to draw a circle or a spiral. The accuracy, speed and pen pressure used can be used to extract measures to quantify the extent of Parkinson's symptoms. Such a circle test can be implemented in the mobile device. The user may be asked to draw circles or spirals on the touch screen. Speed, accuracy and fingertip pressure can be recorded and analyzed.

The results of these experiments, along with information from questionnaires, can be used to identify the highest frequency of jitter and other relevant disease parameters that can be used to individualize the stimulation pattern.

The user data collected by the external mobile device may be stored in its storage unit. As an example, the external mobile device may determine the collected user data for determining stimulation parameters of vibrotactile stimulation for the specific user. Additional data, e.g. may be used in the determination, if appropriate, from the literature in this field. Then, the external mobile device may send the stimulation parameters, optionally together with the user data, to the device for vibrotactile stimulation via the communication unit and the connection module. Accordingly, the external mobile device may control the activation module by means of the control data associated with the activation / deactivation of the stimulation as well as by the stimulation parameters which dictate how the activation module controls the tactile stimulators.

Alternatively, the external mobile device may send the user data to the activation module of the device for vibrotactile stimulation, and the activation module may determine stimulation parameters of vibrotactile stimulation based thereon. In this case too, additional data (for example from the literature) can be used.

Furthermore, an iterative method can be used to determine the stimulation parameters, in which the user data are collected at different times and the stimulation parameters are set, if appropriate, on the basis of the last set of user data.

The communication between the external mobile device and the vibrotactile stimulation device is bidirectional, and any type of data may be transmitted from the external mobile device to the vibrotactile stimulation device, as well as from the vibrotactile stimulation device to the external mobile device. The control data, the user data, and the pacing parameter data discussed above are merely examples thereof. For example, if the activation module determines the orientation / pressure / contact of the hands, the activation module may send feedback data to the external mobile device. In particular, if the hand positioning is not optimal according to the predetermined criteria, the feedback data may prevent any attempt by the user to start the stimulation to actually cause the "start" control data to be sent to the activation module.

Further, the external mobile device and / or the device for vibrotactile pacing may communicate with a cloud server, eg, via secure encrypted internet communication. In particular, user data and / or feedback data relating to the positioning of the hand may be sent to the cloud server. In some examples, the cloud server may determine the stimulation parameters based on the user data and, optionally, additional information. The cloud server can do that Send stimulation parameters and, if necessary, additional data to the activation module and / or the external mobile device.

Accordingly, the present invention provides a computer program product, e.g. a storage medium or signal stream, or preferably digital signals, comprising computer readable code that, when loaded and executed by a computer system, causes the computer system to perform operations in accordance with one or more of the examples described herein. For example, the computer program product may be an app for a smartphone or a tablet.

The external mobile device may be used alone (or in combination with devices other than the vibrotactile stimulation device) to detect and quantify the symptoms of the user, as shown above.

Here further embodiments are disclosed or will become apparent to those skilled in the art after reading and understanding the specification and drawings thereof.

list of figures

• 1 zeigt eine Seitenansicht einer beispielhaften Vorrichtung zum Anwenden einer vibrotaktilen Stimulation auf die Hände eines Nutzers.
• 2 zeigt eine Vorderansicht einer beispielhaften Vorrichtung zum Anwenden einer vibrotaktilen Stimulation auf die Hände eines Nutzers, wobei Hände gezeigt sind, die auf der Vorrichtung angeordnet sind.

Details of exemplary embodiments are given below with reference to the exemplary drawings. Further features emerge from the description, the drawings and from the claims. It should be noted, however, that while embodiments are described separately, individual features of various embodiments may be combined into other embodiments.

• 1 FIG. 11 is a side view of an exemplary apparatus for applying vibrotactile stimulation to a user's hands. FIG.
• 2 FIG. 12 is a front view of an exemplary apparatus for applying vibrotactile stimulation to a user's hands, showing hands placed on the device. FIG.

Detailed description

Hereinafter, a detailed description of examples will be given with reference to the drawings. It should be noted that the drawings can be variously modified. Unless otherwise stated, elements of one example may be combined and used in other examples to form new examples.

The 1 shows a side view of an exemplary device 100 to apply vibrotactile stimulation to the hands of a user.

The device 100 includes a palm rest 110 which is designed to support the user's hands. In this particular example, as it is in the 2 shown is the hand rest 110 designed to support both hands. The side view of 1 shows the right side of the device 100 and accordingly the right side of the palm rest 110 in more detail, where the right hand of the user can be placed to receive the vibrotactile stimulation. The configuration of the left side of the hand rest 110 is a mirror image of the configuration of the right side.

The hand rest 110 It has an ergonomic shape that adapts to the shape of the hands and allows the hands to lie comfortably and stably on them for the duration of the treatment. The hand rest 110 has a substantially convex shape, which allows the hands to rest in a curved position and be at a certain angle to each other, as shown in FIG 2 shown, resulting in a more relaxed attitude of the user during the treatment.

To guide the hands to the optimal position for the treatment, ie, the position where the vibrations can be effectively sensed, and to assist the user to maintain the hands in substantially the same optimal position during the application of the vibrotactile stimulation , includes the palm rest 110 wells 115 ,

The cavities 115 are formed for receiving the fingertips of the right hand and symmetrical cavities that are not in the 1 are shown are adapted to receive the fingertips of the left hand. The cavities 115 are depressions in the surface of the palm rest 110 that are shaped to hold the fingertips. The cavity for the thumb can be placed further away from the others and follow the shape of the human hand.

For taking into account different hand sizes and for more comfortable support of the hand, the hand rest 110 further comprising a replaceable pad (not shown) located in the central area 120 is arranged. A corresponding replaceable pillow may be on the left side of the hand rest 110 be arranged.

For some hand sizes, no cushion may be required. For other sizes of hands, a pillow that is made up of a plurality of Cushion is selected with different thicknesses, removably attached to the portion of the palmrest on which the center of the palm substantially rests, such as by means of a screw. The various replaceable pads may have different thicknesses to adjust the distance of the hand or hands to the fingertip cavities so that the device can be easily modified for different hand sizes. For example, the replaceable pads may have a substantially hemispherical shape.

The device 100 includes a plurality of tactile stimulators (not shown) configured to stimulate the fingertips by means of a vibration. Optionally, additional tactile stimulators are placed below the finger elements (eg between the angles) and below the palm of the hand. The tactile stimulators are located below the surface of the palm rest 110 on which your hands rest.

For example, vibration motors, such as e.g. LRAs, used as tactile stimulators. The tactile stimulators deliver short pulses of vibration to the various parts of the hand, with the duration of the pulses on the order of several hundred milliseconds.

The LRAs or vibration motors in general are driven at frequencies that result in optimal response of the cutaneous nerves and the neural system, e.g. from about 100 Hz to 400 Hz, especially between about 250 Hz and 300 Hz. Therefore, LRAs are selected which have their resonant frequency in this range of optimal stimulation frequency. Typically, the LRAs are operated at their resonant frequencies, resulting in the highest efficiency. For this, methods of auto-resonance tracking (e.g., Texas Instruments, "Application Report SLOA188", October 2013) may be used, which are also implemented in available chipsets (e.g., Texas Instruments, "Application Report SLOS854C" - May 2014).

These methods and devices for auto-resonance tracking may be used in the device 100 be used for another important functionality, namely the detection of a sufficient alignment of the user's hand with the palm rest. When the fingers exert some load on the vibration motor (eg the LRAs), the resonant frequency of the vibration motor is affected. Therefore, the detected resonant frequency of the vibration motor can be used at a load by the user's hand as compared with the resonant frequency of the free vibration motor for detecting good alignment of the user's hand with the palm rest. This can be done for each of the numerous vibrating motors of the wrist-rest, resulting in a map of good or bad hand-rest position of the hand without the need for additional mechanical components.

In the device 100 from 1 are the tactile stimulators within the palm rest 110 embedded. Furthermore, the device comprises 100 an activation module (not shown) configured to activate the tactile stimulators also within the palm rest 110 is embedded.

Specifically, the activation module is an electronic module that powers the vibration motors, controls the activation sequence according to a predetermined pattern, analyzes the resonance frequency of each vibration motor (as described above), and connects to an external mobile device described below. manufactures.

The activation module or generally the device 100 may include a power source, such as a battery, for powering the tactile stimulators.

The activation module may provide structured, desynchronizing stimulation, such as e.g. the coordinated reset neuromodulation (see US 2013/0041296, eg for the treatment of neurological disorders characterized by a pathological synchronization, such as Parkinson's disease or epilepsy), or a structured, synchronizing stimulation control (eg for the treatment a motor impairment after a stroke where the coordinated brain activity is absent or diminished).

The device 100 of the 1 and 2 further comprises a connection module 130 to facilitate connection of the device 100 with an external mobile device 200 is formed, so that the activation module by the external mobile device 200 is controlled.

The connection module 130 includes a slot in which the external mobile device 200 , such as a smartphone, can be placed in an upright position where there is visual access to the screen of the external mobile device 200 for the user during the application of the vibrotactile stimulation. The user can also simply use the external mobile device 200 Touch, eg to start / stop the vibrotactile stimulation or to modify some parameters of it.

The external mobile device 200 can be used to control the beginning and end of the stimulation can track the total pacing time, thereby assisting the user in meeting the daily recommended pacing time, and can track the correct alignment of the user's hand with the palm rest. For example, the mobile device 200 show a sketch of the hand when the user starts to put his hand on the palm rest 110 red or yellow areas may indicate sub-optimal alignment and green areas good alignment with the tactile stimulators in the palm rest 110 can specify. In some examples, pacing may only begin when a certain degree of alignment is reached, such as 80%, and may stop when the alignment becomes worse (eg below 50%).

Furthermore, the mobile device may 200 for detecting and measuring the symptoms of the user by providing the user with various tasks, and in some cases using a built-in gyroscope, speech detection algorithms and / or face recognition techniques. The results of the task tests may be used in conjunction with information from questionnaires, eg to identify a frequency of jitter that may be used to individualize a repetition rate of the stimulation pattern.

Accordingly, the external mobile device 200 after collecting and quantifying the symptoms of the user, deriving the parameters for optimal therapeutic or non-therapeutic stimulation based on relationships eg from the literature on neurological disorders. Such stimulation parameters are used when the tactile stimulators are controlled by the activation module, effectively treating the disease.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited non-patent literature

• Tass et al., 2012, Annals in Neurology, Adamchic et al., 2014, Movement Disorders [0002]
• Syrkin-Nikolau et al., 2018, Adamchic et al., 2014, Tass et al., 2012 [0004]

Claims (13)

Apparatus for applying vibrotactile stimulation to at least one user's hand, the apparatus comprising: a palm rest formed to support the at least one hand; at least one tactile stimulator configured to stimulate at least a portion of the at least one hand; an activation module configured to activate the at least one tactile stimulator. Device after Claim 1 in that the hand rest comprises a surface comprising at least one cavity adapted to receive at least a portion of the at least one hand, optionally wherein the surface comprises a plurality of cavities for receiving different parts of the at least one hand, and optionally also A plurality of cavities for receiving a plurality of fingertips of the at least one hand is formed. Device after Claim 2 in that the hand rest comprises a replaceable pad configured to adapt the device to the size of the at least one hand. Device after Claim 2 or 3 in which the at least one tactile stimulator is positioned corresponding to the at least one cavity. Device according to one of Claims 1 to 4 in which the at least one tactile stimulator is embedded in the palm rest. Device according to one of Claims 1 to 5 in which the activation module is designed to activate the at least one tactile stimulator according to an activation sequence according to a predetermined pattern. Device according to one of Claims 1 to 6 in which: the at least one tactile stimulator comprises a linear resonant actuator; the activation module is adapted to determine a resonant frequency of the linear resonant actuator when the at least one hand is disposed on the hand rest; and the activation module for comparing the determined resonant frequency of the linear resonant actuator with a resonant frequency of the linear resonant actuator, when no hand is placed on the hand rest, is adapted to detect whether the at least one hand is correctly positioned on the wrist rest. Device according to one of Claims 1 to 6 in which: the hand rest comprises a piezoelectric material; and the activation module is configured to measure a piezoelectric effect on the piezoelectric material when the at least one hand is disposed on the hand rest to detect whether the at least one hand is correctly positioned on the hand rest. Device according to one of Claims 1 to 8th wherein the device comprises a plurality of tactile stimulators configured to stimulate a plurality of parts of the at least one hand. Device according to one of Claims 1 to 9 wherein the device comprises at least two tactile stimulators configured to stimulate both hands of the user, each tactile stimulator configured to stimulate a respective hand. Device according to one of Claims 1 to 10 further comprising a connection module configured to allow the device to be connected to an external mobile device such that the actuation module is controlled by the external mobile device. A method of applying vibrotactile stimulation to at least one user's hand, the method comprising: providing a device Claim 11 ; Using the external mobile device to score symptoms of the user; and determining one or more parameters of the vibrotactile stimulation based on the evaluation of the symptoms. Method according to Claim 12 wherein evaluating symptoms of the user comprises measuring a frequency of jitter of the at least one hand, and the one or more parameters comprises or include a repetition rate of the vibrotactile stimulation determined based on the frequency of the jitter.

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