EP4212140A1 - Adaptive rolling walking apparatus with sensor data acquisition - Google Patents

Abstract

The present disclosure relates to a rolling walker for therapy and diagnosis of a person with a motor impairment. The walker comprises at least one axis and a plurality of rollers, a support device for the person, which is arranged such that the person sits on the support device during use of the walker and at the same time with a front of their upper body, and optionally the head, at least partially resting on the support device, and one or more sensors configured to generate sensor data associated with a therapeutic interaction of the person with the walking device.

Description

1. Technical field

The present invention relates to an adaptive rolling walker for patients with a motor impairment. particularly for use in therapy and diagnosis of such a person.

2. Technical background

Walking aids are used to support and treat patients with congenital, disease, accident and/or age-related disorders of the human walking system. These can be used by users with primarily chronic disorders of the musculoskeletal system, as well as for users with acute and secondary chronic motor impairments. Classic walking devices support the patient passively. However, walking aids are already known from the prior art, which can actively support a person with motor disabilities with the help of sensor data.

In this context, for example, from the prior art EP 3 197 414 A1 discloses a power wheelchair operated by sensor based control pads which incorporate force transducers to produce a variable output signal proportional to varying force. A directional pad provides an analog output that provides a variable speed signal to a controller to operate the wheelchair at a variable speed in both forward/backward and right or left turn directions.

Furthermore, from the EP3 678 821 A1 an exoskeleton system is known which has a first exoskeleton unit and a second exoskeleton unit for supporting a body part and a control device, the control device being designed to control the exoskeleton units based on a control model, the control model being based on a multi-body system which has the exoskeleton units and modeling a body part and wherein the exoskeleton units are mechanically decoupled from each other.

Furthermore, walking sticks in particular are known from the prior art, which actively support people with restricted mental/motor skills with the help of sensor data. Walking sticks are equipped with an integrated GMS modem and a GPS antenna, so that people suffering from dementia or disorientation can be located at any time via the position of the walking stick. Furthermore, to support Parkinson's patients, walking sticks can be equipped with sensors and a laser system which, based on an output from the sensor that the walking stick is in contact with the ground, triggers a laser signal which is intended to stimulate a Parkinson's patient to walk.

However, the walking aids described above have the disadvantage that these aids only compensate for mobility deficits that occur in isolation. In addition, simple walking aids in particular, such as walking sticks, do not offer any direct weight relief in the event of an acute disturbance of the gait pattern, such as exhaustion, shooting spasms and absences.

More complex walking aids, such as exoskeletons, have the disadvantage that the technology is very complex to use and adapt, and therefore cannot be used realistically in everyday life. The use of such aids is usually only possible under optimal conditions for the user and the patient, and movement patterns are usually only displayed or assessed for a short period of time. When using exoskeletons, there are also limiting factors, mostly in the areas of muscular tone, contractures, and trunk and head instability, which exclude or at least significantly limit their use.

Furthermore, cognitive limitations in the operation of walking aids by the user must also be taken into account. Known walking aids provide only insufficient support, especially for people who are both motorically and cognitively restricted.

The present invention is therefore based on the object of providing a walking aid that can be highly individually, easily adapted and adjusted for users with complex problems, which in particular simplifies everyday use and the targeted adjustment of the individual therapy parameters, while overcoming the disadvantages of the prior art discussed above overcome technology at least in part.

3. Summary of the Invention

This object is solved by the subject matter of the independent claims of the present invention. Exemplary embodiments are described in the dependent claims.

In one embodiment, the present invention provides a walking device for the therapy and diagnosis of a person with a motor impairment, the walking device comprising: at least one axis and a plurality of rollers, a support device for the person, which is set up so that the person during use of the walking device can sit on the support device and at the same time rest at least partially with a front of their upper body on the support device, and one or more sensors that are configured to generate sensor data associated with a therapeutic interaction of the person with the walking device .

In particular, it has been shown that the therapy of patients with active-training, rolling walking devices such as those in WO 2020/020872 A1 are disclosed and which, thanks to their innovative mechanical design, not only support the patient in moving, but also treat or train their muscles and nervous system, significantly improved by integrating such sensors that allow the therapeutic interaction with such a training walking device to be characterized can be.

In the WO 2020/020872 A1 disclosed invention also goes back to the inventors of the present application. Therefore, its content is incorporated herein in its entirety as if reproduced in its entirety below.

In particular, such an arrangement allows a person with a motor impairment to be able to use the rolling walking device as a walking aid and/or therapy device, while at the same time sensor data are recorded that characterize the patient's therapeutic interaction with the walking device. As explained in detail below, in particular closed -loop therapy approaches can be implemented in which the patient can be given therapeutic feedback in real time and/or the mechanical and/or dynamic properties of the walking device and thus the therapeutic interaction of the patient with the walker can be adjusted in real time. Furthermore, the generated sensor data can also be used for software- and in particular for machine-learning-supported diagnosis, in order, among other things, to adapt long-term therapy plans optimally to the respective motor impairment of the patient. It has been shown that the success of the therapy can be significantly improved in this way, even in the case of severe disease progression, and at the same time the acceptance of the therapy and the joy of using the walking device, especially in children, can be increased even further.

In particular, the muscles involved in walking and their coordination can be trained by the walking device designed in this way, even in patients who are only partially able to maintain an upright posture. Patients with a hip extensor muscle strength value according to Janda greater than or equal to 3 can usually even use the walking device according to the invention independently. As a result, the walking device can be used regularly in everyday life, as a result of which the permanent acquisition of sensor data can map the actual limitations of the person in detail and it is easier to adapt the therapy and/or the walking device to the real physical limitations of the person.

For example, the invention makes it possible to support and/or treat patients who have one or more of the following motor impairments: decreased pelvic, trunk and head control, lesion of the first motor neuron (spasticity); second motor neuron lesion (paralysis); Fixed contractures on the extremities; Simultaneous functional limitations of the upper and lower extremities.

Since the interaction of the respective patient with the walking device can be very different with such and similar restrictions and varies greatly over time, the claimed invention allows the therapy and / or the therapeutic function of the walking device to be individually adapted to the current interaction profile of the patient with the walking device . Furthermore, such an arrangement allows movement data of the patient to be generated simultaneously in real time and under real conditions, which can otherwise only be generated under laboratory conditions and with considerable effort. The sensor data can include information that allows the therapeutic and/or diagnostic benefit of the person's interaction with the walking device to be assessed.

Such information can include information about the individual activity profile and the individual loading of the walking device. The detection of such Information usually requires laborious laboratory conditions. The use of the walking device according to the invention reduces the effort, in particular the personnel effort, significantly.

The data on the user's individual activity profile or the interaction with the walking device recorded by the arrangement described above enable, for example, an evaluation with regard to the user's behavior in relation to obstacles such as objects or other people. For example, the data of the individual activity profile can provide information about specific, recurring difficulties, such as obstacles, especially in a frequently frequented environment. This information can be used to circumvent or eliminate such difficulties in a targeted manner. Furthermore, data on the individual load on the walking aid, which is generated by using the described walking device in everyday life, can be used in order to optimally adjust the walking device individually to the user.

In addition, the walking device may comprise one or more feedback means set up to provide the person with therapeutic and/or diagnostic feedback, which is preferably multi-sensory, or to stimulate the person's nervous system and/or musculature; and/or include one or more actuators to affect the mechanical properties, state of motion, and/or interaction of the person with the walking device.

The person can be given therapeutic and/or diagnostic feedback by the feedback means. Such feedback can be either mechanical-haptic or audio-visual. For example, the person can be stimulated or motivated by a mechanical-haptic and audio-visual signal to perform certain movements more or at least to receive diagnostic information on movement sequences. Furthermore, the movement of the walking device can be at least supported by one or more actuators, whereby the person can be motivated to move, since moving is simplified. Such reward mechanisms are particularly suitable for motivating people with cognitive disabilities or children to exercise.

The feedback, the stimulation and/or the influencing of the walking device and/or the interaction of the person with the walking device can also be at least partially based on the generated sensor data and/or the feedback means, haptic and/or gives mechanical feedback and/or wherein the feedback means is set up for electrical stimulation of the person's muscles.

The feedback device can cause the walking device to give the person feedback based on the sensor data, which supports the person in the therapy and/or diagnosis. For example, if it has been determined from the sensor data that the person is exhausted, an actuator can move the walking device independently or at least support the person in moving the walking device. Such support can also be audio-visual and/or through electrical stimulation of the muscles. The latter can be particularly helpful for people with severe cognitive impairments. Overall, a person can be motivated or instructed to move according to the situation by the arrangements/embodiments described here.

Alternatively or additionally, the walking device can also include a communication interface in order to transmit the sensor data to a data processing device that is set up to generate therapy data, therapeutic instructions and/or instructions for avoiding obstacles from the sensor data, and/or to provide therapeutic instructions and/or or to receive instructions on how to avoid obstacles. This arrangement makes it possible to transmit the sensor data recorded/generated in real time to a data processing device. The data can then be used, for example, to generate / receive information about the course of therapy, to send therapeutic instructions, such as updated therapy plans, which are communicated to the person via the feedback device, to the walking device, or to generate instructions that are sent in real time help avoid obstacles.

In some embodiments, the one or more sensors may include at least one of a speed sensor, an incline sensor, a pressure sensor, an acceleration sensor, a sensor to measure the position of the person's legs in relation to the walker, a weight sensor, or a sensor to detect obstacles .

Such sensors enable a comprehensive detection of the activity profile of the person, as well as the load on the walking device by the person. For example, the speed sensor, inclination sensor and acceleration sensor Movement of the walking device can be detected. The sitting position or posture of the person can be detected by the pressure sensor, weight sensor and sensor for measuring the position of the person's legs in relation to the walking device. Together with the sensor for detecting obstacles, it is thus possible to generate comprehensive information about the device, the person and the person's surroundings. The fact that one or more of these sensors are permanently integrated into the walking device makes it possible to record such data even during normal use of the walking device in everyday life. This data could be transmitted to a data processing device and evaluated immediately or at a later point in time.

The sensor for detecting obstacles may include at least one of a camera, an infrared sensor, a laser sensor, a radar sensor, or an ultrasonic sensor. Such sensors enable reliable visual detection of various complexities. Thus, these sensors can be used individually or in combination. Combining individual sensors increases reliability, but also complexity. The advantages of infrared, laser, radar and ultrasonic sensors are that they can also be used in poor lighting conditions. Camera sensors, on the other hand, are usually less technically complex than alternatives and easier/cheaper to implement.

In some embodiments, the walking device is further configured to raise and/or lower at least a portion of at least one axis, preferably using electromechanical, hydraulic, or pneumatic elements. Adjusting the height of sections of an axis allows precise adjustment of the tilt and/or elevation position of the walker. In addition, tipping over of the person, if this was detected by the sensor data, can be actively prevented/prevented by influencing the electromechanical, hydraulic or pneumatic elements. For example, at least one of the elements can change the inclination of the walking device in such a way that the body position/centre of gravity of the person is changed so that the person is moved to a stable position, or that a damaging position detected by sensors is changed.

Also can the in WO 2020/020872 A1 tilting mechanism with restoring force described in detail can be adapted to the therapy requirements in real time via such actuators.

In some embodiments, the walking device can include a data processing device that is set up to generate therapy data for therapy of the person with a motor impairment from the sensor data and/or to control actuators and/or feedback means, at least in part based on the sensor data and/or the therapy data .

One advantage of such an arrangement is that sensor data for generating therapy data does not first have to be sent to an external data processing device, but can be generated and processed directly on the walking device. In this way, the generation of therapy data can be accelerated, which means that real-time support through updated therapy data is better possible. In addition, it is also possible to generate updated therapy data for the therapy of the person at remote locations. As a result, the person can be optimally treated and/or supported at any time.

In some embodiments, the one or more actuators are set up, an inclination angle of the walking device, a position of the at least one axis of the device, a movement speed of the device, a tiltability of the support device relative to a surface on which the walking device rolls, a restoring force for the tiltability, a Adjust saddle height, propulsion force and/or the shape of the support device.

Such actuators allow the walking device to be adapted to the situation. For example, the walking device can be stabilized by adjusting the angle of inclination, which can prevent tilting, especially in the case of people with severe physical disabilities. The inclination angle can be adjusted statically, through prior configuration of the actuators, but also dynamically, in response to sensor data.

Changing the position of the at least one axis also makes it possible, among other things, to adjust the angle of inclination. In addition, the direction of the walking device can be controlled if, for example, a person with cognitive impairments is unable or only partially able to do so. In addition, if, for example, an obstacle has been detected, adjusting the at least one axle can enable evasive action. On the other hand, if, for example, an inclined position is detected, this can be counteracted by changing the position of the axles, for example by lowering a roller on one side by changing the position of the axle. This makes it possible to overcome smaller obstacles and bypass larger obstacles. In addition, by adjusting the propulsion force, gradients that are particularly difficult to overcome for people with severe motor impairments can be overcome. Changing the speed of movement enables the walking device to slow down or accelerate independently, i.e. without any action on the part of the person. With simultaneous adjustment of the position of the axles, avoiding and/or driving over obstacles can be improved.

Adjusting the tiltability of the support surface can also contribute to improving the stability of the person on the walking device. In addition to these advantages that were mentioned in relation to the angle of inclination of the walking device, this can also prevent the person from slipping off the at least one support surface. Changing the saddle height can have safety-relevant advantages in addition to orthopedic reasons, ie in addition to optimal adjustment of the walking device to the physique of the person. For example, if tilting of the walker is detected, the saddle height can be reduced so that the center of gravity of the walker is lowered and tilting is prevented.

Further orthopedic adjustment options result from adjusting the at least one support device to the physique of the person. For example, if the at least one support device is in the form of a seat, the leg width of the seat can be changed. In addition, individual sections of the supporting device can be raised or lowered so that the person can be optimally seated or supported. In some embodiments, the support device has a seat and at least one upper body support that can be adjusted relative to one another.

This allows the walking device to be adapted to the body size and/or posture and/or deformity of the skeletal muscles of a patient. In particular, such an adjustability of the at least one support device makes it possible to adapt the walking device over a longer period of time to the patient's posture, which is constantly improving as the success of the therapy progresses.

Furthermore, this means that most patients do not have to be fixed to the walking device and can get into the walking device independently or only need minor help from an untrained person to do so. In some embodiments, the walking device includes means for creating a virtual therapy environment that can be presented to the person.

One advantage of a virtual therapy environment is that it can motivate children and/or people with cognitive impairments in particular to train/for therapy with the walking device and/or to encourage specific movement sequences. Additionally, a virtual therapy environment can include a video game character with a reward system that can motivate the person to engage in therapy exercises over a period of time.

In some embodiments, the means for creating the virtual therapy environment is set up, based on the sensor data, to change the virtual therapy environment, to insert one or more virtual objects into the virtual therapy environment and/or to adjust a position of a virtual object in the therapy environment.

By adapting the virtual therapy environment to the sensor data, the person's therapy can be further improved. For example, a reward can be customized in the virtual therapy environment for correctly performing therapy exercises. In addition, the virtual therapy environment can be customized to give the person feedback on how to perform exercises correctly. In one example, the person can be presented with a virtual therapy environment in which obstacles are placed that form a course that the person must avoid using steering movements. In another example, by performing motion sequences, the person may affect objects in the virtual therapy environment that are part of a virtual scenario. In this way, the person can be playfully motivated to carry out therapy exercises.

In some embodiments, the virtual objects correspond to obstacles that are detected using the sensor data. By placing and changing objects in the virtual world based on the sensor information, the person's real environment can be included in the virtual therapy environment. This can prevent the person from colliding with real obstacles, when interacting with the virtual therapy environment. Furthermore, this can increase immersion in the virtual therapy environment, which can also motivate people. Overall, this makes the virtual therapy environment more realistic. In some embodiments, the walking device further comprises a preferably multi-sensory display device for the virtual therapy environment.

A multi-sensory display can enable people with different cognitive abilities to display the virtual therapy environment. For example, an audio-visual representation of the virtual therapy environment can be ideal for a person with no or mild cognitive impairment. A purely audio-visual representation may not be sufficient for a person with severe cognitive impairment. In this case, a mechanical-haptic signal or electrical stimulation can also help. The walking device can also be equipped with a residual power assistance device (e.g. a pulse-controlled electric motor in the rear wheel) and/or a controllable brake system.

4. Short description of the drawings

Fig. 1

eine Seitenansicht eines Gehgeräts gemäß einer Ausführungsform der Erfindung;

Fig. 2

eine Seitenansicht eines Gehgeräts gemäß einer Ausführungsform der Erfindung einschließlich möglicher Sensorpositionen;

Fig. 3

eine Auflagevorrichtung mit beispielhaften Sensorpositionen gemäß einer Ausführungsform der vorliegenden Erfindung;

Fig. 4

eine Seitenansicht eines Gehgeräts gemäß einer Ausführungsform der Erfindung einschließlich möglicher Aktuatorpositionen;

Fig. 5

eine beispielhafte Ausführungsform einer Datenverarbeitungsvorrichtung der vorliegenden Erfindung;

Fig. 6

eine Frontansicht eines Gehgeräts gemäß einer Ausführungsform der vorliegenden Erfindung während der Benutzung;

Fig. 7

eine einstellbare, sattelartige Auflagevorrichtung gemäß einer Ausführungsform der vorliegenden Erfindung;

Fig. 8

eine anpassbare Achsenanordnung gemäß einer Ausführungsform der vorliegenden Erfindung;

Fig. 9

ein Anwendungsbeispiel des Gehgeräts gemäß einer Ausführungsform der vorliegenden Erfindung unter Verwendung eines Mittels zum Erfassen von Hindernissen sowie Aktuatoren;

Certain aspects of the present invention are described below with reference to the attached drawings. The drawings show:

1

a side view of a walker according to an embodiment of the invention;

2

a side view of a walking device according to an embodiment of the invention including possible sensor positions;

3

a pad with exemplary sensor positions according to an embodiment of the present invention;

4

a side view of a walking device according to an embodiment of the invention including possible actuator positions;

figure 5

an exemplary embodiment of a data processing apparatus of the present invention;

6

a front view of a walker according to an embodiment of the present invention during use;

7

an adjustable saddle type support device according to an embodiment of the present invention;

8

an adjustable axle assembly according to an embodiment of the present invention;

9

an application example of the walking device according to an embodiment of the present invention using means for detecting obstacles and actuators;

5. Detailed description of some exemplary embodiments

Some exemplary embodiments of the present invention are described below. Various combinations of features are described here with reference to some exemplary embodiments of the present invention. By way of example, a three-wheeled rolling walking device with a large rear wheel and two smaller front wheels as well as a frame, a hand support, a seat and an upper body support is described below. However, the claimed walking devices are not limited to such embodiments. Rather, it is to be understood that other combinations of features can also fall within the scope of protection of the invention. In other words, not all features of the described embodiments have to be present in order to implement the present invention. Furthermore, embodiments may be modified by combining certain features of one embodiment with one or more features of another embodiment - where technically reasonable - without departing from the disclosure and scope of the present invention. The invention is defined by the claims.

In particular, the present invention is not limited to three-wheel walking devices with a rear wheel, but can be used for a variety of different rolling walking devices for a person with a motor or cognitive impairment. The terms roller and wheel are used equivalently in the context of the present invention. Furthermore, the term "essentially" is to be understood within the scope of the present invention as "within typical design, construction, manufacturing and/or measurement tolerances".

The 1 Fig. 12 shows a side view of a three-wheel rolling walker according to an embodiment of the present invention. The walking device has a seat 111 and an upper body support 112, which in the embodiment shown are independently detachably connected to the front part 140-V of a frame. In other embodiments, however, the seat 111 and the upper body support 112 can also be integrated in a common support device and/or further support elements (not shown) for the upper body and/or other body parts of the patient can also be attached to the frame 140.

Furthermore, both the seat 111 and the upper body support 112 are in 1 embodiment shown adjustable in height and / or position to each other. It is also possible to change the position of the respective fastening point of the seat 111 and the upper body support 112 on the frame 140 of the walking device. In some embodiments, the upper body support can also be attached essentially vertically. As below with reference to Figures 2 to 4 is described in detail, the walking device is provided according to the present invention with sensors that allow it to generate sensor data associated with a therapeutic interaction of a patient with the walking device and allow this interaction to be characterized for therapeutic and diagnostic purposes and the Use sensor data for diagnostic purposes and to improve neurological or motor therapy.

For this purpose, the walking device can comprise a data processing device 120, which can be set up to process sensor data from one or more sensors that are attached to the walking device (in 1 not shown, see eg 2 ) to process and/or transmit to an external data device. For example, the data processing device 120 can include a communication interface and transmit sensor data to an external device. Alternatively or additionally, the individual sensors can also be provided with a data processing device and/or a communication interface. For example, the data processing device 120 may include a processor and/or a general purpose signal and data processing device that performs calculations and/or initiates actions based on the sensor data. In some embodiments, the computing device of the walking device could also be implemented substantially in software, eg, executing on a general purpose computing device (eg, a single board computer or a smartphone) that may be, eg, removably attached to the walking device. A precise description of an example to that Walker mountable sensors are set forth below with reference to FIG Figure 2, Figure 3 and 4 . An exemplary computing device 120 is provided with reference to FIG figure 5 described.

The rolling walker from 1 comprises two eccentrically arranged front wheels 160 and a substantially centrically arranged rear wheel 150, which can include an electric motor for residual power assistance and/or a brake. The eccentrically located front wheels 160 are pivotally connected to a wheel suspension 192 via pivots 190 (and to the frame 140 via the connecting rod) and stabilize the walker against tipping over of the walker. The pivot joints 190 thereby improve the steerability of the walker thereby reducing the minimum turning radius that the walker can roll. In a preferred embodiment, the wheels 160 are connected to the wheel suspension 192 in a pivotable and detachable manner via swivel joints 190, so that the track width of the axle can be individually adjusted, for example with the aid of a plug-in system. More details of the in 1 walking device shown are in WO 2020/020872 A1 described in detail.

2 shows the exemplary walking device from 1 as well as a variety of possible sensors that, in some embodiments, may be attached to the walking device. Sensor data can be generated with the aid of the sensors, which are associated with an interaction of the person with the walking device and can therefore be used to improve the therapy and to diagnose the person. Exemplary sensors that may be attached to the walker include one or more pressure sensors 211, weight sensors 212, speed sensors 213, acceleration sensors 214, incline sensors 215, obstacle detection sensors 216, and collision sensors 217.

For example, weight and pressure sensors can be installed in one of the support devices 111, 112 or the hand rest 130 (cf. 1 ) may be appropriate to detect whether a person is sitting on the walker. In particular, a large number of attached weight and/or pressure sensors 211, 212 can be used to achieve an accurate determination of the seat position by detecting the weight distribution over the support devices 111, 112 or the hand rest 130.

An example arrangement of four weight and/or pressure sensors in an example upper body support 112 is shown in FIG 3 shown. Through the even Distribution of the weight and/or pressure sensors, information/data on the exact pressure distribution or the load on the support devices 111, 112 and/or the hand rest 130 can be determined. For example, it can be detected which of the support devices is mainly loaded and/or whether the load is evenly distributed.

In addition, the walker may include incline sensors 215 . These can be used to detect an inclination angle of the walking device. The data from the inclination sensors, together with the information/data from the weight and/or pressure sensors, form data on the individual load and on the static or dynamic configuration and/or the state of motion of the walking device. Such inclination sensors can be attached, for example, to a universal joint between the axle and the frame, in order to collect data which allows the patient's hip instability to be characterized indirectly by measuring lateral tilting. The inclination of the front wheels could also be measured, e.g. to characterize straight running.

Such data can be used to detect a change in the person's disability. Furthermore, data on the individual load on the walking device can be used in order to optimally adjust the walking device individually to the person. For example, the data on the individual loading of the walker can be used to adjust the seat height of the walker, or to configure the axes of the walker to make it difficult to incline in either direction.

Referring again to 2 , the walking device can further comprise speed sensors 213, acceleration sensors 214 and/or sensors for detecting the axis position. The speed and/or acceleration sensors 213, 214 can be used to detect a movement speed and/or an acceleration of the walking device. Together with data from the sensors for detecting the axis position and/or the data from the inclination sensors 215, the data from the speed and/or acceleration sensors can be used to generate movement data and/or a dynamic movement profile of the walking device. The movement data of the walker can provide information about the speed and acceleration of the walker, but also about the direction of movement of the walker. In addition, the movement data of the walking device can provide information about the incline (with a negative or positive slope) of the ground on which the walking device is moving. The The incline of the ground can be used together with data from pressure sensors in the push rod, for example, in order to determine from the movement data of the walking device how large the person's own contribution to the movement of the walking device is. The movement data of the walking device can thus be used to generate comprehensive information about the current movement of the walking device and the person's own contribution to the movement.

The sensors mounted on the walker can be used not only to detect the sitting position of the user on the walker or to detect the movement of the walker, but also to detect obstacles in the vicinity of the walker.

For example, collision sensors 217 and obstacle detection sensors 216 may be attached to the walker to detect obstacles around the walker. Example sensors for detecting obstacles are a camera, an infrared sensor, a laser sensor or an ultrasonic sensor. The sensors for detecting obstacles 216 can be arranged in such a way that they produce a full-circumference image of the environment around the walker. The sensors are preferably arranged at least in such a way that obstacles that are detected in front of the walking device are detected.

In some embodiments, capturing the complete environment of the walking device is only possible to a limited extent. In particular, this can be the case when the computing and/or storage capacities of the data processing device 120 are limited. In order to optimize the data processing, the data processing device 120 can determine a prognosis about a probable future movement path of the walking device based on the movement data of the walking device. Based on the prognosis, the sensors for detecting obstacles 216 can be adjusted in such a way that only data in the probable future path of movement is recorded and evaluated. In this way, only obstacles that have to be avoided, for example to avoid a collision, are detected, as a result of which the required computing power and the required memory requirement can be reduced.

4 shows an exemplary arrangement of actuators and feedback means on/on a possible embodiment of the walking device. For example, the walking device can comprise means for adjusting the speed of movement 420 . Such means can be, for example, an electric motor such as a hub motor. If, for example, it was determined based on the sensor data that a person did not contribute enough of their own accord to move the walking device, an electric motor can be controlled in such a way, for example, that the walker moves forward. Furthermore, if it is determined by the movement data of the walking device that the person's own contribution decreases over time, as a result of which exhaustion of the person is determined, the electric motor can be controlled in such a way that the person is supported. In addition, the person can be constantly supported in the movement, so that the person is prevented from becoming too exhausted. Further, when it is determined by the data processing device 120 that a collision with an obstacle is imminent, the data processing device 120 may cause the moving motor 420 to decrease the moving speed or to accelerate in the opposite direction, ie, to brake.

The walker may further comprise means/actuators for adjusting an axis position 430 (see also below 7 ). The means for adjusting an axis position 430 is set up to change the position of at least one axis and/or to change an angle of an axis or a part of the axis. For example, if it was determined in the previous example that a collision can be avoided by a steering maneuver, the means for adjusting the axle position 430 can be controlled to change the axle position in such a way that the obstacle is avoided.

Additionally or alternatively, in further embodiments, the walking device can comprise a means for adjusting an inclination of the walking device. If, for example, it is determined based on the data on the individual loading of the walking device that the person is sitting on the walking device in an inclined position, the means for adjusting an inclination of the walking device can be activated in such a way that the person is moved in an opposite direction, thereby reducing the inclined position is canceled or reduced. Additionally or alternatively, the inclination can be adjusted based on the data on the individual loading of the walking device in such a way that the person can be prevented from slipping off the walking device.

In further embodiments, the walking device can additionally or alternatively comprise haptic feedback means 450 . Haptic feedback means can be a means for triggering an electrical stimulation and/or an actuator for triggering a vibration, such as a vibration motor. Such haptic feedback means are preferably mounted in the hand rest and/or the support devices 111, 112. Through the haptic feedback means, the person can receive information from the walking device and the success of the therapy can thereby be improved.

In addition to the haptic feedback means, the walking device can additionally or alternatively comprise visual feedback means. Exemplary visual feedback means may be a display device 461 or a lighting means. The Display device 461 may be mounted on data processing device 120 as part of data processing device 120 and/or may be a separate screen, such as in FIG 4 shown to be. Through the visual feedback means 461, the person can receive cues from the walker. For example, detected obstacles or the probable future movement path can be illuminated and/or displayed by the visual feedback means.

The walking device can further comprise acoustic feedback means 470 . Exemplary acoustic feedback means are means for triggering a vibration and/or loudspeakers. As already described for the haptic feedback means and the visual feedback means, the acoustic feedback means can convey cues to the person. Together with the visual feedback means, the acoustic feedback means produce audio-visual feedback.

A therapy arrangement according to an embodiment of the present invention comprising the walking device and an external data processing device is described below with reference to the exemplary embodiments described above. Data can be transmitted via a communication interface via a communication device in the data processing device 120 of the walking device. The data received in this way can be retrieved and/or evaluated and/or processed and/or used at the external data processing device.

For example, a therapist can read out sensor data on the external data processing device and use it for therapy purposes, which was recorded at a point in time, possibly preprocessed and stored on the walking device at which the person used the walking device in everyday life. In a further example, a therapist can read out the collected sensor data on an external data processing device and, based on this data, optimally adapt the walking device to the requirements of the person using the walking device. In a further example, diagnostic data can be evaluated in order to read out the status of the walking device. The data generated by the walking device can be transmitted to and stored on a storage device such as a server or other suitable storage medium.

In addition, data can also be transmitted from the external data processing device to the data processing device 120 of the walking device. such data may include therapy plans, therapy instructions, virtual scenarios and/or software updates, such as firmware updates.

In another example, a therapist can create a therapy plan based on sensor data that was previously transmitted to the external data processing device and transmit it to the data processing device 120 of the walking device. This therapy plan can, for example, include instructions for feedback means to reconfigure the feedback means(s). For example, if it was detected based on the sensor data that the person reacts better to a first feedback than to a second feedback, the first feedback can be given more frequently and/or the second feedback less frequently. If it has been detected based on the sensor data that the person does not respond well to either the first feedback or the second feedback, a third feedback and/or a fourth feedback can be given more frequently and the first and second feedback less frequently. If, for example, based on the sensor data it was detected that a first exercise/therapy exercise causes a targeted effect, the first exercise can be triggered more frequently by the walking device than a second exercise, which less achieves the desired effect.

On the other hand, if it is detected based on the sensor data that the first exercise does not achieve the effect achieved, the second exercise or a third exercise may be triggered more frequently than the first exercise. Exercises with the walking device can be varied. An exemplary exercise can be transmitted to the subject through audio-visual or mechanical-haptic feedback, which motivates/prompts the subject to perform a specific movement. For example, instructions to the person can be presented on a display device. Mechanical haptic signals and/or electrical impulses can also be used to trigger or announce certain exercises.

In particular, exercises can also be carried out unnoticed by the person. Thus, during normal use, the walking device can trigger a targeted incline of the walking device, or reduce a power assistance, whereby the person is unconsciously encouraged to compensate independently. This can be particularly beneficial for children or people with cognitive impairments, who are often unable to concentrate over a longer period of time or are unmotivated to carry out targeted therapeutic exercises. In addition, if one or more sensors of the walking device has detected that a configuration of one or more actuators leads to an undesired action, an updated configuration of the one or more actuators can be transmitted to the data processing device 120 of the walking device via the external data processing device. For example, it can be detected, based on the configuration of one or more of the actuators, that the walking device is tilted too much/too weakly or too slowly/jerkily or quickly, for example, such that the person using the walking device is adversely affected. In addition, it can be detected that, for example, the residual power assistance or the acceleration is too strong/too weak, which can also have a negative effect on the person using the walking device. In particular, an incorrect configuration/calibration of the actuators can cause dizziness in the person.

Furthermore, software or firmware updates for the actuators or other electronic components, such as the data processing device 120 of the walking device, can be updated and/or changed via the external data processing device. As a result, additional functions of the walking device can be implemented and/or optimized afterwards.

In another embodiment, all of the steps described in the example use cases above with reference to the Fig. 1 - Fig. 4 have been described can also be performed locally on the data processing device 120 of the walking device. These can be carried out independently of or in addition to being carried out on the external data processing device.

One advantage of processing the data on the data processing device 120 of the walking device is that this allows you to spontaneously react to environmental effects or user inputs at any time and the instructions described above can also be generated independently of therapists or other people at any location / at any time and the person that uses the walker can be provided.

figure 5 12 shows an exemplary data processing device 120 of the walking device. The data processing device comprises at least one processor 510. This can be used to process sensor data locally on the data processing device 120. In particular, the processor can be used to perform the processing steps described above locally on the walking device. For example the processor can execute firmware used to control the walking device through sensors/actuators/feedback means, as well as to collect the sensor data. Furthermore, the processor can receive sensor data from the sensors and transmit this to an external data processing device using a communication interface, such as an LTE, a 5G and/or a Bluetooth interface. Alternatively or additionally, the processor can process the sensor data itself and generate therapy and/or diagnostic data based thereon and/or read out or control sensors/actuators/feedback means. The data processing device also includes at least one memory 520 in which, for example, the firmware or other software components can be stored. Some of the above with reference to. 4 Display means / devices and / or actuators and feedback means described can in some embodiments in the

Be integrated data processing device and / or be functionally connected to this, for example via a wireless communication interface such as Bluetooth.

In particular, a walking device such as from the WO 2020/020872 A1 known to be provided with the necessary sensors by means of universally applicable recordings of the hand rest, chest rest and saddle. The present invention is therefore based on sustainability and cost reduction in healthcare as a central design idea. Especially in the area of outpatient use, this concept involves a significant cost reduction. Adapters fitted as standard enable the attachment of inclination and/or acceleration sensors and/or distance measurement (e.g. for simple tracking).

There are many options for using sensors, e.g. on the base frame, on the measurement components (saddle, chest, handle) and/or directly on the user. Initial tests by the inventors have shown that the following sensors in particular can significantly improve the success of the therapy: an inclination sensor in the pendulum axis, a 4-fold pressure sensor on the chest pad, a saddle pressure sensor, a speed sensor and/or a sensor for distance measurement. Through direct feedback, the sensor technology offers the user control over the pressure/load conditions on the walking device and communicates online and in real time directly with a server.

As in figure 6 shown, a hand support 130 on the walking device can be dispensed with if the torso and head are well controlled. Without hand rest 130, however, it may be difficult for the person to steer the device, particularly when using both hands to carry objects or when performing bimanual activities. The walking device enables manual activities in particular thanks to the support in the chest and saddle area. Especially in such cases.

In such cases in particular, it is helpful to support the movement of the person by actuators, such as in particular by means for adjusting the movement speed 420, means for adjusting the axis position 430 or means for adjusting an inclination of the walking device.

The variable and expandable sensor system, as described above, offers many possibilities for data collection and for controlling both the walking device and other components, such as a display device for augmented reality or virtual reality-based training scenarios. For example, the pressure load in the gait cycle can be graphically displayed and thus used for the following purposes: the adjustment of the device, for personal feedback and for training purposes under controlled conditions such as a specific unloading of a limb without support from the upper limbs

Furthermore, the data can be saved and training successes can be documented. Gait analysis data can be recorded under real conditions without a gait laboratory. By standardizing the data, comparable collectives can be formed and compared between and within individuals. Furthermore, almost all degrees of severity of movement restrictions can be measured, even those that do not meet the demands of a gait laboratory. There is no spatial or temporal limitation of measurement intervals. Application data can be recorded over a longer period of time and movement and activity profiles can be created in everyday life.

Structural changes (e.g. due to spasticity) can possibly be detected early by changing the stress parameters through long-term observation. Furthermore, the walking device can be controlled by recording voluntary/unconscious user parameters, such as slowing down the walking device if the user is tired, for example, or environmental control by the walking device, e.g. if the light is switched on when entering a room, etc.

The integration of environment sensors enables crossing or avoiding obstacles, an inclination measurement, an inclination compensation, which enables anti-tipping in the terrain and / or a lane adjustment when crossing doors and / or a warning of danger. Furthermore, as described in detail in section 3. above, the data obtained can be used, for example in real time, for control in the field of augmented reality or virtual reality for motivation and for training purposes are used. Self-learning systems that adapt to the respective user can also be implemented.

Feedback from the patient's vital parameters (e.g. cardiovascular activity via hand rests or a separate sensor such as a smartwatch) is also possible. This makes it possible to adapt the training program, both in real terms and in the area of virtual / augmented reality.

It is possible to control medical devices such as electrical muscle stimulators. A worldwide collection of data opens up new possibilities for the development of therapy concepts (big data) in the field of research. Through networking, consultations can take place online by evaluating the telemetry data. In the context of early rehabilitation in the field of intensive care, communication and adjustment with life-sustaining devices (e.g. a ventilator) is possible and thus offers the earliest possible rehabilitation.

7 shows part of an optional embodiment in which, instead of a seat device as described above, a saddle that can be adapted to the muscle tone of the person and has a diagnostic option, for example the pressure load, is used. The new type of saddle includes a height-adjustable seat post 710 that can be individually adjusted to the patient under load. A clamping device 715 in the longitudinal direction of the saddle regulates the hardness of the seat surface 720, but also the width of the seat pad by changing the buckling capacity of the seat surface.

Tensionable chains 730 that run transversely to the back make it possible to increase the abduction in the parts of the saddle flaps 740 that are far from the seat surface. These chains can be moved forwards and backwards via two parallel suspension rods. Thus, the abduction in the gait cycle, especially at the beginning of step initiation, can be individually adapted to the user / patient. In the rear part of the saddle there is a contact or contact surface 750 which additionally stabilizes the patient's pelvis dorsally and prevents slipping backwards over the saddle.

In some embodiments, the saddle exemplified above may include various sensors. For example, pressure sensors can be installed in several places, in order to record the following parameters in particular to allow: the total load on the saddle, the pressure on the abduction blades in the front or rear section and/or, the pressure on the rear attachment. The recording of these parameters is important, among other things, for assessing the load transfer to the lower extremities and for assessing the active stabilization of the pelvis.

Such a saddle can, for example, prevent a reduction in the crossing of the legs of the hip-adducting muscles at the point of origin (e.g. in the case of spasticity). Furthermore, such a saddle allows the measurability of therapeutic measures or interventions such as therapy with botulinum toxin, oral tone-regulating medication, surgical interventions, etc.

8 shows another optional embodiment or further development in which a flexible front axle is used to improve off-road mobility and the tipping moment in combination with environment sensor technology. The sensors can detect the ground slope and/or obstacles (see 9 ). In response to this, the front axis of the walker can be adjusted, for example by electromechanical, hydraulic and/or pneumatic actuators 810, which can be attached to different positions on the walker, in order to compensate for the ground slope and/or to overcome obstacles 820. Alternatively or additionally, the residual power support (see 4 ) be adjusted. In some embodiments, the rotary joints of the front axle wheels can also be stabilized if necessary by a suitable actuator 830, such as a ferrofluid chamber with adjustable viscosity and/or the restoring force of the tilting mechanism can be adjusted via another actuator 840, also to adjust the therapy parameters.

9 illustrated, like those above with reference to FIG 8 described functions can be used to be able to use the walking device in difficult environments for therapy and/or diagnosis. Environment sensors 910 allow obstacles and/or changes in the subsoil 920 to be recognized and suitable countermeasures or support measures to be carried out, such as an increase/decrease in the feed force 930, an increase/decrease in the rotation stabilization 940 and/or an increase/decrease in the axis tilt or The axis position and/or the restoring force of the tilting mechanism 950. In this way, the walking device described above can not only be used indoors or in similar environments for therapy and diagnosis, but also, with the same degree of safety, in normal and especially therapy-supporting environments such as playgrounds or forest paths. In other embodiments, this arrangement can also be combined with the other sensors and/or feedback means described above, in order, for example, to also inform the patient about changes in the environment and/or possible dangers.

The invention described above offers physicians and therapists for the first time the possibility of analyzing the patient through the use of such walking devices. The invention can be used for a short time in a therapeutic setting, but can also provide data as part of a long-term application. Obtaining data on movement and activity patterns in everyday life is difficult and almost impossible at the moment, especially for severely affected users. The present invention thus provides completely new data on mobility and on the success of rehabilitative measures in everyday life. The user can be given immediate feedback, but also objective feedback over the course of the process. Training plans can be customized and monitored. Changes in movement dynamics can be detected early. An environment adjustment / - control can be planned specifically according to the activity pattern. The user does not have to wear any sensors on their body. The collection of large amounts of data through publicly accessible platforms and the subsequent evaluation of the data in longitudinal and cross-section shows enormous potential in mobility research, in environmental adaptation and in mobility prophylaxis. In particular, the users of the present invention will experience a high level of disadvantage compensation from a direct or indirect environment control or environment adaptation.

Reference List

111

Seat

112

upper body support

120

data processing device

130

hand rest

140

Frame

140V

front part

140-H

posterior

150

rear wheel

160

front wheels

170

deflection pulleys

190

swivel joints

192

suspension

211

pressure sensor

212

weight sensor

213

speed sensor

214

accelerometer

215

tilt sensor

216

Sensor for detecting obstacles

217

collision sensor

420

Means for adjusting movement speed

430

Means for adjusting an axis position

450

haptic feedback tool

460

visual feedback tool

461

display device

470

acoustic feedback device

510

processor

520

Storage

530

communication interface

540

Power Source / Battery

710

seat post

715

clamping device

720

seat

730

rigid chains

740

saddle flaps

750

system or contact area

810, 840

Actuators to change the axle configuration

820

obstacle

830

Actuator for changing joint rotation

910

environmental sensors

920

obstacle

930

feed actuator

940

joint rotation actuator

950

axle actuator

Claims (15)

Walking device for therapy and diagnosis of a person with a motor impairment comprising: at least one axle (192) and a plurality of rollers (150, 160); a support device (111, 112) for the person, which is set up in such a way that the person can sit on the support device while using the walking device and at the same time can rest at least partially with a front of their upper body, and optionally their head, on the support device; and one or more sensors (211-217) configured to generate sensor data associated with an interaction of the person with the walking device. The walking device according to claim 1, wherein the sensor data comprises information that allows the therapeutic and/or diagnostic benefit of the person's interaction with the walking device to be assessed. The walker of claim 1 or 2, further comprising: one or more feedback means (450,460,470) set up to give the person therapeutic and/or diagnostic feedback, which is preferably multi-sensory, or to stimulate the nervous system and/or the musculature of the person; and or one or more actuators (420, 430) to affect the mechanical properties, the state of motion and/or the interaction of the person with the walking device. Walking device according to the preceding claim 3, wherein the feedback, the stimulation and/or the influencing of the walking device and/or the person's interaction with the walking device is based at least in part on the generated sensor data; and or wherein the feedback means gives haptic and/or mechanical feedback; and or wherein the feedback means is set up for electrostimulating the muscles of the person. A walker according to any one of the preceding claims, further comprising
a communication interface (120, 530) in order to transmit the sensor data to a data processing device which is set up to generate therapy data, therapeutic instructions and/or instructions for avoiding obstacles from the sensor data; and/or to receive therapeutic instructions and/or instructions on how to avoid obstacles. The walking device according to any one of the preceding claims, wherein the one or more sensors is at least one of a speed sensor, an inclination sensor, a pressure sensor, an acceleration sensor, a sensor for measuring the position of the person's legs in relation to the walking device, a weight sensor or a sensor for Include obstacle detection. 7. The walker of claim 6, wherein the sensor for detecting obstacles comprises at least one of a camera, an infrared sensor, a laser sensor, a radar sensor, or an ultrasonic sensor. Walking device according to one of the preceding claims, further set up to raise and/or lower at least a section of at least one axis, preferably using electromechanical, hydraulic and/or pneumatic elements. Walking device according to one of the preceding claims, further comprising a data processing device (120), which is set up to generate therapy data for therapy of the person with a motor impairment from the sensor data and/or to provide actuators and/or feedback means, at least partially based on the sensor data and/or or the therapy data. Walking device according to one of the preceding claims in conjunction with claim 3, wherein the one or more actuators are configured, a tilt angle of the walking device, a position of the at least one axis of the device, a speed of movement of the device; a tiltability of support device opposite a surface on which the walker rolls; a restoring force for tiltability; a saddle height; adjust a propulsion force and / or the shape of the support device. Walking device according to one of the preceding claims, wherein the supporting device has a seat and at least one upper body support which can be adjusted relative to one another, preferably via controllable actuators. The walking device according to any one of the preceding claims, further comprising means for creating a virtual therapy environment which can be presented to the person via a display means of the walking device or a separate display means. Walking device according to claim 12, wherein the means for creating the virtual therapy environment is set up, based on the sensor data, to change the virtual therapy environment, to insert one or more virtual objects into the virtual therapy environment and/or to adjust a position of a virtual object in the therapy environment. The walker of claim 13, wherein the virtual objects correspond to obstacles detected using the sensor data. Walking device according to one of Claims 12 - 14, further comprising a preferably multi-sensory display device for the virtual therapy environment.

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