Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
  • A61B5/4538—Evaluating a particular part of the muscoloskeletal system or a particular medical condition
  • A61B5/4566—Evaluating the spine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
  • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
  • A61B5/1121—Determining geometric values, e.g. centre of rotation or angular range of movement
  • A61B5/1122—Determining geometric values, e.g. centre of rotation or angular range of movement of movement trajectories
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
  • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
  • A61B5/683—Means for maintaining contact with the body
  • A61B5/6832—Means for maintaining contact with the body using adhesives
  • A61B5/6833—Adhesive patches
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
  • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
  • A61B5/684—Indicating the position of the sensor on the body
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
  • A61B5/7235—Details of waveform analysis
  • A61B5/725—Details of waveform analysis using specific filters therefor, e.g. Kalman or adaptive filters
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/74—Details of notification to user or communication with user or patient; User input means
  • A61B5/742—Details of notification to user or communication with user or patient; User input means using visual displays
  • A61B5/7435—Displaying user selection data, e.g. icons in a graphical user interface
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/74—Details of notification to user or communication with user or patient; User input means
  • A61B5/742—Details of notification to user or communication with user or patient; User input means using visual displays
  • A61B5/744—Displaying an avatar, e.g. an animated cartoon character
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/74—Details of notification to user or communication with user or patient; User input means
  • A61B5/7475—User input or interface means, e.g. keyboard, pointing device, joystick
  • A61B5/749—Voice-controlled interfaces
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T13/00—Animation
  • G06T13/20—Three-dimensional [3D] animation
  • G06T13/40—Three-dimensional [3D] animation of characters, e.g. humans, animals or virtual beings
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
  • G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H30/00—ICT specially adapted for the handling or processing of medical images
  • G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
  • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
  • A61B2562/0219—Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
  • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
  • A61B2562/028—Microscale sensors, e.g. electromechanical sensors [MEMS]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
  • A61B2562/04—Arrangements of multiple sensors of the same type
  • A61B2562/043—Arrangements of multiple sensors of the same type in a linear array
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T2207/00—Indexing scheme for image analysis or image enhancement
  • G06T2207/30—Subject of image; Context of image processing
  • G06T2207/30004—Biomedical image processing
  • G06T2207/30008—Bone
  • G06T2207/30012—Spine; Backbone
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T2215/00—Indexing scheme for image rendering
  • G06T2215/16—Using real world measurements to influence rendering

Definitions

• such a device may include one or more of the following characteristics.
• the second processing unit is configured so as to, for each inertial unit, which indicates a direction assumed to be terrestrial magnetic North, calculate a divergence correction rotation, the so-called divergence correction rotation. divergence transforming a reference direction common to the inertial units into the direction indicated by the inertial unit; when the orientation of the inertial unit is updated, returning the orientation of the inertial unit to an orientation relative to the reference direction by dialing it to the right by the respective divergence correction rotation
• the device of the invention makes it possible to carry out a sort of calibration of the inertial units according to a common standard.
• the invention provides a device for generating a sequence of images, configured to represent in the three dimensions of space a moving spine belonging to a subject, the device comprising:
• each inertial unit is configured to cyclically measure rotation speeds around three axes linked to the inertial unit, thus forming measurement data, intended to be arranged, facing selected vertebrae of the column vertebrae, at the rate of one inertial unit per vertebra, the said vertebrae thus forming a plurality of vertebrae, to order at least a first processing unit, configured to receive the measurement data from the inertial unit(s) respectively, upon receipt of new measurement data, updating from said measurement data, an orientation of each of the inertial units of the plurality of inertial units,
• a second processing unit configured to receive the orientations of inertial units from the at least one first processing unit, upon receipt of new orientations of inertial units, for each vertebra of the plurality of vertebrae, update an orientation of vertebra from the orientations of inertial units received; except for the first vertebra, a position, from the vertebra orientation of the updated previous vertebra and a table of distances between the vertebrae of the spine, the position of the first vertebra being determined from 'an axis of rotation from the continuous sequence of bony elements, thus forming a position of the plurality of vertebrae; interpolate again, for each pair of successive vertebrae of the plurality of vertebrae, between the vertebrae of said pair, a curve segment; form a curve again by joining the curve segments.
• the device of the invention has a chart which contains, for each pair of vertebrae of the subject's spine, a ratio of the distance of said vertebrae to the length of the spine from subject ; and where for each pair of vertebrae of the subject's spine, the distance separating the vertebrae of said pair is calculated by multiplying the corresponding ratio of the chart by the length of the subject's spine; and where, for each pair of vertebrae of the subject's spine, the distance separating the vertebrae of said pair is calculated by multiplying the corresponding ratio of the chart by the length of the subject's spine; and where said distance is automatically entered into the table of distances between the vertebrae.
• the second processing unit is configured to allow a user to modify the distance table.
• the second processing unit is configured for: for each vertebra of the plurality of vertebrae and/or for the head, when an inertial unit with an inertial unit orientation is arranged on the respective vertebra or the head, which have a vertebra orientation, calculate a correction rotation, the correction rotation transforming the orientation of the inertial unit into vertebra orientation of the respective vertebra or of the head; upon receipt of new measurement data, for each vertebra of the plurality of vertebrae and/or for the head, before updating the orientations of the vertebrae and/or the head, correct the orientation of the respective inertial unit by application of the calculated correction rotation.
• orientation errors of the inertial unit resulting from a difficulty in placing it precisely where it is needed on the spine or from an instability of the signal electronics rendered by the inertial units can be corrected.
• an inertial unit intended for the skull can be placed anywhere on the skull.
• the second processing unit is configured to allow a user to modify the correction rotations of the vertebrae.
• the device of the invention comprises a database.
• the device of the invention comprises a display unit.
• the device of the invention further comprises a database and/or a display unit and where the second processing unit is configured to allow a user to trigger at each cycle of measures a record of the position of the plurality of generalized vertebrae then formed in the database; and/or a display of the curve then formed on the display unit.
• the measurement frequency is adjustable by a user.
• the second processing unit is provided with a first pedal for recording the positions of the plurality of vertebrae and a second pedal for ending the recording of the positions of the plurality of vertebrae ; and/or a voice command combining the functions of the first and second pedal.
• the device according to the invention is configured such that: a pairing of the positions of the sensors is carried out, the sensors being positioned freely on the patient according to the user's choice and facing 'bone elements identified, these positions being informed, the calculation of the distances between two sensors, essential for correct modeling, is carried out according to a previously completed table collecting the relative distances between each neighboring bone element, the modeling calculations integrate the location of the sensors and the distance between them, and in the event of a positioning level error, the latter is corrected by modifying this pairing.
• the senor To be able to represent the correct orientation of a bone element, the sensor must advantageously be positioned respecting the axis defined and included in the modeling of this bone element. However, this positioning can be uncertain, so it may be necessary to compensate for poor positioning. [0070] According to one embodiment, the device according to the invention is configured such that an angular correction is applied to the angular data generated by the sensors, this correction being memorized and taken into account in the calculations leading to the modeling .
• a set of cursors can separately apply an angular correction to the data coming from each sensor in the three planes.
• the fix can be immediately viewed on the modeling form.
• a first assistance function is proposed using positional data defined beforehand.
• the correct positioning of a sensor at the level of the head is not simple.
• Biomechanics defines the horizontality of the head when the patient's line of vision is horizontal.
• An automatic angular correction can be made to the data from the sensor which can then be positioned indifferently on the head.
• Anatomical or positional data can be provided before an examination. These angular data can come from the user but are mainly given by radiological examinations (conventional radiology, EOS, etc.).
• the device according to the invention is configured to make angular adjustments automatically to conform to these so-called anatomical or positional data and informed beforehand.
• the data recorded can be: Sacral slope, Lumbar lordosis, Dorsal kyphosis, or any other angle that can be used for angular correction.
• the device according to the invention is configured to carry out the following steps:
• anatomical and positional data are provided from radiological examinations, such as conventional radiology, EOS among others, in particular data from radiology such as: in the sagittal plane, the sacral slope then a continuity of adjacent angles, i.e. usual, L5 Ll lordosis, T12 Tl kyphosis, C7 Cl lordosis.. in the frontal plane, if necessary, so-called Cobb angles, of lateral inclination, limiting a set of vertebrae, for example Cobb angle between T4 and T12, and in the coronal plane.
• radiological examinations such as conventional radiology, EOS among others, in particular data from radiology such as: in the sagittal plane, the sacral slope then a continuity of adjacent angles, i.e. usual, L5 Ll lordosis, T12 Tl kyphosis, C7 Cl lordosis.. in the frontal plane, if necessary, so-called Cobb angles, of lateral inclination,
• an automatic angular adjustment of the patient modeling in real time is carried out according to the data of said theoretical model.
• the sensors being initialized then placed on the patient and the patient taking a posture identical to the radiological examination, an angular correction of each representation of the bony elements can be applied to conform the real-time modeling of the patient to theoretical modeling recorded.
• pelvic incidence pelvic incidence
• pelvic thickness these parameters enter into the biomechanics of the sacrolumbar pelvic complex
• positional pelvic parameters sacral slope and pelvic version.
• pelvic incidence, sacral slope and pelvic version are linked by an equation. These parameters vary with the patient's posture.
• the sacred slope corresponds to the angle formed between the sacred plateau and the horizontal. By conditioning the inclination of the last lumbar vertebra, it conditions the entire overlying spinal posture. It is therefore essential to know this angle of sacred slope as best as possible. This angle could be deduced from the angular data delivered by a sensor placed opposite its posterior face and more particularly the second sacral vertebra, the theoretical point of rotation of the sacrum, but, the sacrum having a variable anatomy, the angular information will not make it possible to deduced the angle itself of sacred slope reliably.
• the device according to the invention is configured to: enter the pelvic parameters from radiology, model the pelvis by integration into the calculations with a view to reliable modeling of the pelvis according to the anatomical parameters, determine the instantaneous center of rotation of the sacrum; real-time modeling can integrate the rotation of the sacrum according to the radius between the center of rotation and the second sacral, as well as the movement deduced from the entire overlying column according to the data from the sensors placed on the vertebrae, and determine a reliable sacral slope angle in the erect position using an angular adjustment as seen previously of the sensor placed on the sacrum according to the sacral slope calculated during a radiological examination in the same posture.
• the modeling of the spine extended to the head considered as a continuous series of moving bone elements is acquired, as well as the integration of the pelvis and the biomechanics of the lumbosacral pelvic complex.
• the pelvis including the coxofemoral joints can be modeled, the anatomy of the pelvis and its parameters such as the pelvic incidence, the thickness and the distance between the coxofemoral joints being modelable according to parameters derived from the radiological data.
• the entire column overlying the sacrum, including the sacrum, has as its axis of rotation during movements the instantaneous center of rotation of the sacrum. This is confused with the middle of the line joining the coxofemoral joints.
• the modeling of this set advantageously has a so-called initial main point around which all the modeling moves.
• the modeling of the two lower limbs advantageously follows the same process.
• Each is, like the column, a continuous series of moving bone elements.
• the femur, the tibia and the foot are considered as non-deformable bony elements responding to this continuous series of elements.
• a sensor placed next to bony landmarks at each level can generate angular information relating to bony elements of the lower limbs.
• Each modeling advantageously has a main, initial point, around which the modeling of the lower member moves. It may correspond to the head of the femur.
• Each head of the femur advantageously merges with the coxofemoral joint of the modeling of the head-spine-pelvis assembly. [0099] Thus, these three continuous sequences of moving bone elements are connected and form a whole whose overall initial center is the instantaneous center of rotation of the sacrum.
• the device according to the invention is then configured to: define one or more angles such that the side(s) of an angle are defined relatively with one or more bone elements entering into the modeling, with :
• angles ⁇ in the case where one side relates to a bony element can be vertical or horizontal; if it is the representation of a vertebra, these angles advantageously correspond to the so-called angles of slope, where one of the sides is horizontal, and of heel, one of the sides is vertical,
• the definition of this angle advantageously induces the monitoring of a modification of curvature of the set of bone elements included in this corner ; it can thus involve monitoring the modification of curvature of a set of vertebrae, Y1 for example angle of kyphosis, lordosis, scoliosis, the sides then corresponding to the tangents of the upper plate of the selected upper vertebra and the lower plate of the lowest vertebra selected, for a defined angle, calculate this angle in the three planes and visualize it in real time during the movement, and collect the data collected relating to the angles.
• Figure 1 represents a subject being examined by the device of the invention in a certain embodiment.
• Figure 2a represents a spine seen from the left in the sagittal plane.
• Figure 2b represents an extended spine seen from the left in the sagittal plane.
• Figure 3a represents a typical vertebra, on the left in the sagittal plane.
• Figure 3b represents the vertebra of Figure 3a from above in the transverse plane.
• Figure 4a represents anatomical plans.
• Figure 4b represents anatomical axes suitably oriented for the calculation of Euler angles.
• Figure 5 represents an approximation of the curve of the spine by a broken line and a curve.
• Figure 6 shows a spinal position being examined and spinal positions recorded.
• Figure 7 represents a box containing an inertial unit, placed on a vertebra through the skin and held by a bracket.
• Figure 8 represents an inertial unit placed sideways on the spinous process compared to the desired position.
• Figure 9 represents distances between vertebrae.
• Figure 10 represents a man-machine interface allowing the entry of the subject's anatomical data.
• Figure 11 shows a typical vertebra having rotated relative to a neighboring vertebra.
• Figure 12 illustrates an example of angular adjustment.
• Figure 13 illustrates an example of the constitution of a theoretical modeling resulting from anatomical or positional data previously entered and the automatic angular adjustment according to this so-called theoretical posture.
• the device 14 of the invention applies to any continuous sequence of aligned bony elements of the skeleton 9.
• the device 14 is mainly used but not exclusively for the arms, lower limbs and spine.
• the device 14 is also adapted to the pair of arms, the pair of lower limbs, with the spine if the user wishes, etc. This application develops the case of the extended spine 9.
• Figure 2a represents a vertebral column in the strict sense (or spine) 6 of a human being seen from the left. It has thirty-three vertebrae classically distributed into sub-groups: the seven cervical vertebrae 5, the twelve thoracic or dorsal vertebrae 4, the five lumbar vertebrae 3, the five fused sacral vertebrae (or sacrum) 2 and the four fused coccygeal vertebrae ( or coccyx) 1. It is customary to number the vertebrae of a subset from top to bottom, assuming that being considered human is standing; for example, C7 designates the 7th cervical vertebra from the top.
• Figure 2b represents a spinal column extended 9 to the head 8.
• One of the contributions of the invention is to take the head into account in the diagnosis of spinal pathologies.
• the head is also considered as a vertebra by renowned specialists and called the “cephalic vertebra”.
• Figures 3a and 3b represent a type vertebra 10, seen from the left and from above respectively, that is to say any vertebra of the spinal column 6. All the vertebrae of the spinal column 6 are made of the same way, except for a few details of shape or dimension, which justifies the notion of a typical vertebra.
• a type 10 vertebra has at the rear a spinous process 11, a pointed part which extends towards the rear as it descends. It also includes an upper plate 12 and a lower plate 12a, approximately flat parts in contact with the neighboring vertebrae.
• Figure 1 represents a subject 15 of observation being examined by a device 14 according to the invention.
• the subject 15 represented is a human being but it could be any vertebrate being.
• a plurality of inertial units 16 are arranged opposite the vertebrae of the subject's 6/9 spinal column, shown schematically by a dotted line in Figure 1.
• the inertial units 16 are five in number, but in variants not shown, a larger or smaller number of inertial units 16 can be provided according to needs.
• the number of inertial units 16 on the spine 6/9 is limited, and in any case less than the number of vertebrae.
• the practitioner Prior to using the device, the practitioner must set an order in the inertial units 16: the first inertial unit 16, the second inertial unit 16, etc. This allows us to talk about the next or previous inertial unit, or a pair of successive inertial units, etc.
• the order of inertial units 16 must follow the natural order of the vertebrae, from sacrum 2 to head 8 or vice versa. The order in the inertial units will subsequently allow the measurement points to be ordered.
• each inertial unit 16 is included, as shown in Figure 7, in a small housing 80.
• the housing 80 is held against a vertebra by a flexible adhesive insert 81 which adheres to the housing and to the skin 13 around the housing.
• the practitioner can advantageously choose a point of the anatomy as a fixed point called “main center of rotation” 7 as indicated in Figure 2b.
• the kinematics of the spine 6 will then be corrected according to known mathematical methods.
• it is particularly advantageous to choose as the main center of rotation the middle of the axis joining the coxofemoral joints. This corresponds to common postures of a person bending or squatting, which are of great clinical interest to observe.
• the device 14 also comprises a plurality 20 of first processing units, one per inertial unit 16. In a variant not shown, there is a single first processing unit 20 common to the plurality of inertial units 16.
• the device 14 further comprises a second processing unit 30 connected, in the embodiment shown, to a database 40 and to one or more display units 50.
• the second processing unit 30 is physically located at a distance from the subject 7.
• the second processing unit 30 could be a personal computer.
• Communication between the hardware elements placed on the back of the subject 15 and the second processing unit 30 is done by wired link or by radio link (for example Bluetooth®, preferably low consumption, in English Bluetooth Low Energy registered under the brand Bluetooth Smart®, or Wi-Fi®).
• radio link for example Bluetooth®, preferably low consumption, in English Bluetooth Low Energy registered under the brand Bluetooth Smart®, or Wi-Fi®.
• distances This involves, prior to using the device 14, obtaining the curvilinear distances (abbreviated as “distances” in the rest of the application) between the inertial units 16 and entering them into the second unit of treatment 30.
• the distance between the inertial units 16 is none other than the distance between the facing vertebrae.
• the device 14 also makes it possible, in an advantageous variant, to help the practitioner calculate distances based on a general principle of anatomy.
• the vertebral columns in the strict sense 6 of human beings are almost all similar except for a factor of homothety (that is to say that only the size changes). Therefore the distance separating a pair of type 10 vertebrae relative to the total length of the vertebral column 6 of subject 15 is constant in the human population (it does not depend on subject 15).
• the distance between the C2 vertebra and the T3 vertebra is 1 and the total length of the vertebral column in the strict sense 6, L.
• the ratio 1/L does not depend on the subject considered.
• the anatomical method however, has its limits. It is not suitable, for example, for the pathological case of vertebrae collapse. It also does not allow the distance between head 8 and typical vertebrae 10 to be calculated. It is therefore important that the practitioner can modify the distance between the vertebrae, including head 8, so that it corresponds to the reality that he observes.
• the distances thus calculated or measured are recorded in a distance table.
• the distance table is recorded in the memory of the second processing unit 30.
• the device 14 is configured to allow the practitioner to enter the length of the spinal column 6, to modify the distance table, to take into account radiographic documents, etc. [0142] It is also a matter, prior to using the device 14, of correcting the orientation of the inertial units 16.
• Figure 8 illustrates the case of an inertial unit 16 placed sideways on the spinous process 11 of a type 10 vertebra (the skin 13 between the inertial unit and the type 10 vertebra is not shown).
• the central 16, the type 10 vertebra and the spinous process 11 are seen in section in a transverse plane, from above.
• the edge of the inertial unit 16 makes an angle (-a) with the position 16a that it is supposed to have.
• it must be corrected by applying a rotation of angle a around the axis perpendicular to the plane of the figure.
• the present application makes the approximation that a type 10 vertebra is a non-deformable solid and therefore the correction rotation R is constant during a sequence of measurements. Therefore, during any measurement interval, we can accurately deduce the orientation of a typical vertebra 10 from the orientation of the respective inertial unit 16 by multiplying it by R.
• the correction function is also useful for the placement of an inertial unit 16 on the head 8 of the extended spine 9. In fact this function allows the inertial unit 16 to be placed anywhere on the head 8. As the head 8 is an undeformable solid, the reasoning held for the typical vertebrae 10 applies and we can deduce during any measurement interval the position of the head 8 from the position of the inertial unit 16 in applying to it the correction rotation R calculated initially.
• Another advantage of being able to correct the orientation of an inertial unit 16 is that this frees the practitioner from having to do very precise work to reposition the inertial units 16 in the same place, from a session of exercise from topic 15 to the next.
• the device 14 is configured to allow the practitioner to modify the correction rotations R according to his observations.
• an inertial unit 16 is supposed to indicate an absolute direction which is the terrestrial magnetic North, using a magnetometer.
• the inertial unit 16 diverges in the sense that it does not accurately indicate the terrestrial magnetic North. It is therefore important to correct this discrepancy.
• the divergence is not corrected in relation to the terrestrial magnetic North but in relation to a reference direction common to all inertial units, set by the user. We therefore measure, for each inertial unit 16, a divergence correction rotation, which is recorded in the second processing unit.
• the divergence correction rotation transforms the reference direction into North as indicated by the inertial unit.
• the second processing unit 30 corrects the orientation by composition to the right by the respective divergence correction rotation and an orientation of the unit is thus obtained inertial 16 relative to the reference direction.
• each inertial unit 16 measures the rotation speeds around a system of axes specific to it and quantifies the measurements. Then the measurements are processed by the first processing unit 20 associated with the inertial unit 16. According to a conventional method, the rotation speeds are integrated over the time interval where they were measured to give angles of rotation around the axes of the inertial unit 16. We deduce the roll, pitch and yaw angles and therefore the rotation carried out by the inertial unit 16 during the time interval and therefore its orientation at the end of the time interval.
• the inertial units 16 are connected to a “mother” electronic card, worn on the belt by the subject.
• the second processing unit 30 interpolates a curve segment 32 between two successive inertial units 16 based on the orientation of the first of the two units and the distance which separates them.
• a first approximation interpolation method illustrated in Figure 5, consists of projecting the orientation of the inertial units 16 concerned in the frontal and sagittal planes and considering each vector 31 thus obtained as a directing vector of the tangent to the extended spine 9 (in Figure 5, only the spine 6 is shown) in the plane considered, at the level of the vertebra facing the inertial unit 16 considered.
• the tangents intersect and thus form a broken line 33.
• a more realistic representation of the extended spine 9 can be obtained by using curve construction methods such as the Euler method or the Runge-Kutta method.
• the curve 34 represents the extended spine 9.
• the second processing unit 30 checks whether the curve 34 respects the biomechanical limits of the extended spine 9. For example, it checks that the angular difference between two successive type vertebrae 10a and 10b, illustrated in Figure 11, do not exceed a certain limit. If it exceeds this limit, the practitioner is warned by a report from the device which can for example take the form of a window appearing on the display unit 50 and containing an error message. It is up to the practitioner to analyze this anomaly. In practice, it is very often due to measurement inaccuracies of the inertial units 16 or to incorrectly entered data. It is then appropriate, depending on the case, to “reset” the inertial units 16 or to correct the data entered.
• Images of the spine formed from sets of geometric points are then displayed on the display unit(s) 50.
• a representation in the form of a broken line connecting the sensors is also interesting for the practitioner (this is the “geometric mode”). If a whole sequence of measurements has been taken, you can also scroll through the sequence of images to see the movement carried out. These images are significant for the practitioner and help them assess the state and behavior of the subject's back 15 during a movement.
• the practitioner can “play back” a recorded sequence.
• the second processing unit will again form curves from the positions of pluralities of vertebrae.
• the practitioner can delete certain positions of the plurality of vertebrae if he considers them unnecessary.
• the interface display unit 60 is for example in the form of a touch screen with an integrated keyboard, that is to say displayed on the interface display unit 60.
• the touch screen prevents the practitioner from being cluttered with peripherals such as a keyboard and mouse.
• a display unit of the man-machine interface 60 can be integrated into a fixed terminal intended to be installed near an exercise station of the subject 15.
• the man-machine interface comprises a “hands-free” control unit in the form of a double pedal or a voice-controlled system.
• the first pedal is used to record the positions of the plurality of vertebrae, the second pedal is used to end the recording.
• Voice control offers the same functions; each function corresponds to an agreed word or short sequence of words.
• the practitioner launches the exercise session through the man-machine interface.
• a so-called “sensor installation” window appears.
• a new selection of measurement points can be created among the vertebrae 10 including the head 8.
• the practitioner installs the brackets.
• the inertial units 16 one after the other at the locations he has selected and indicates opposite which bone element he has arranged them. It measures the distance between each sensor and records it in the second processing unit 30.
• a new window appears at the interface display unit 60.
• the representation of the extended spine 9 in movement, in real time and in 3 D, is visible. Laterally, 3 small windows allow me to to have vision in the 3 anatomical planes PS, PF, PT.
• the main center of rotation 9 is external to the sacrum 2.
• the practitioner can improve the realism of the curve to get closer to what he considers to be reality, by correcting the angles given by the inertial units 16. He opens an “angular adjustment” function and can modify in each plane , the angulation by inertial unit 16. This is a simplified case of application of a correction rotation illustrated in Figure 11.
• the device 14 also offers to help him. For example, for head 8, it is proposed to ask subject 15 to look straight and to validate that head 8 is considered straight. According to another example, for the sacrum 2 and the pelvis in general, it is proposed that the device of the invention takes into account the anatomical data already recorded, in particular sacral slope and lateral inclination. The result can be checked and corrected.
• the practitioner can also act on the distance between the inertial units 16 by returning to the “sensor installation” window. It can also improve the representation of the pelvis by correcting the distances and angulations between the sacrum and the coxofemoral bones, or even validate the use of pre-recorded anatomical data. Once he is satisfied with the representation of the extended spine 9, he can make the subject 15 take a pose that is easy to reproduce and record the shape of the corresponding representation.
• a light warns him of the good quality of the data used.
• it can, depending on the case, return to the “sensor status” window or the “sensor installation” window. It can thus either, for example, re-inspect lost inertial units 16, or reset them in a recorded position, or exchange an inertial unit 16 with a reserve inertial unit 16. He can return to the “installation of sensors” window at any time and modify their locations and number, with a view to a broader or more precise examination.
• the practitioner can use the device to make an “assessment”.
• the practitioner orders subject 15 to perform a movement.
• the movement records the positions of the plurality of vertebrae that it considers relevant and crucial. It uses a double foot pedal or a voice command to free his hands and also allow him to move around the patient.
• the practitioner Before launching a comparison, the practitioner displays the subject sheet 15 on the display unit of the man-machine interface 60. He then chooses the examination to be repeated from the sheet. The selection of measuring points is mentioned there. It arranges the wall lights 81 and the inertial units 16 as indicated on the selection of measurement points.
• a specific window displays the positions of a second plurality of vertebrae 71, 72, 75, 76 extracted from the database and performing an animation of the movement carried out during the last examination, and highlights the positions of the first plurality of vertebrae corresponding to the movement that the subject 15 is currently performing.
• the practitioner also launches the recording and the second processing unit 30 automatically records the positions of the first plurality of vertebrae when they enter a vicinity of the positions of the second plurality of vertebrae.
• the notion of neighborhood depends on the application made of the device 14 (spine, lower limb, upper limb, etc.). It also depends on the selected measurement points, for example, in the case of the spine, assuming that the sacrum 2 is one of the selected measurement points, the neighborhood can designate an interval of values of the anatomical parameter “sacral slope”.
• the interface display unit 60 opens a window with the superposition of the first and the positions of the second plurality of vertebrae 71, 72, 75, 76 recorded.
• This function allows the practitioner to analyze the differences between the positions of the first and second plurality of vertebrae. It can analyze the difference by changing the viewing angle or by selecting the thumbnails of the anatomical planes PS, PF, PT. Using a software tool, he can measure the angles he deems useful. He can prepare a report necessary for medical practice, in the form of a computer file.
• the device 14 allows the practitioner to choose straight away the continuous sequence of bony elements 9 which interests him, for example one of the lower limbs.
• the practitioner can also modify the distances and angulations between the sacrum 2 and the coxofemoral joint 7, possibly relying on pre-recorded anatomical data such as an x-ray, to improve the representation of the pelvis in his eyes.
• first processing unit 20 and the second processing unit 30 can independently be produced in different forms, in a unitary or distributed manner, by means of hardware and/or software components.
• Usable hardware components are specific ASIC integrated circuits, FPGA programmable logic networks or microprocessors.
• Software components can be written in different programming languages, for example C, C++, Java or VHDL. This list is not exhaustive.
• Figure 12 illustrates an example of an angular correction applied to the angular data generated by the sensors, this correction being stored and taken into account in the calculations leading to the modeling, as described previously.
• Figure 13 illustrates an example of an angular correction based on a previously established theoretical model of posture, as described previously.

Landscapes

• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Engineering & Computer Science (AREA)
• Physics & Mathematics (AREA)
• Medical Informatics (AREA)
• Public Health (AREA)
• General Health & Medical Sciences (AREA)
• Biophysics (AREA)
• Veterinary Medicine (AREA)
• Biomedical Technology (AREA)
• Molecular Biology (AREA)
• Surgery (AREA)
• Animal Behavior & Ethology (AREA)
• Pathology (AREA)
• Heart & Thoracic Surgery (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Dentistry (AREA)
• Physiology (AREA)
• Physical Education & Sports Medicine (AREA)
• Orthopedic Medicine & Surgery (AREA)
• General Physics & Mathematics (AREA)
• Rheumatology (AREA)
• Theoretical Computer Science (AREA)
• Geometry (AREA)
• Human Computer Interaction (AREA)
• Epidemiology (AREA)
• Primary Health Care (AREA)
• Artificial Intelligence (AREA)
• Computer Vision & Pattern Recognition (AREA)
• Signal Processing (AREA)
• Psychiatry (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Radiology & Medical Imaging (AREA)
• Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
• Apparatus For Radiation Diagnosis (AREA)

Applications Claiming Priority (2)

Publications (1)

Family

ID=83506008

Family Applications (1)

Country Status (4)

Families Citing this family (1)

Family Cites Families (5)

• 2022
  • 2022-06-20 FR FR2206056A patent/FR3136645A1/fr active Pending
• 2023
  • 2023-06-19 WO PCT/EP2023/066487 patent/WO2023247453A1/fr not_active Ceased
  • 2023-06-19 US US18/876,442 patent/US20250380901A1/en active Pending
  • 2023-06-19 EP EP23733942.9A patent/EP4539740A1/de active Pending

Also Published As

Similar Documents

Legal Events