ES2272137B1 - DYNAMIC ORTHESICAL DEVICE FOR MONITORING, DIAGNOSIS AND SUPPRESSION OF PATHOLOGICAL TEMBLOR. - Google Patents

Abstract

The invention relates to an ambulatory orthotic platform which is used to monitor and diagnose tremors and to validate both active and passive control strategies in order to suppress a pathological tremor while preserving natural movement. The inventive device is based on an articulated structure which is used to support a group of sensors and actuators that are required to perform the monitoring and diagnosis tasks and to apply the control strategies.

Description

Dynamic orthotic device for monitoring, diagnosis and suppression of pathological tremor.

Technical sector

The present invention relates to devices biomechanical or biomedical for monitoring, diagnosis and validation of control strategies, both active and passive, to suppress pathological tremor, specifically in the limb higher. As such, they are applicable in the industry orthoprosthetic and in rehabilitation and medical treatment.

State of the art

Pathological tremor is a symptom strongly disabling characterized by rhythmic contractions and Involuntary muscles of the human body. Tremor can affect different parts of the body. These oscillations Rhythms are superimposed on the patient's voluntary movement. The amplitude and frequency characteristics of the oscillations trembling depend on the type of tremor, be it resting, Postural or kinetic. In addition, for the same patient you are characteristics may be altered depending on the activity or conditions that you develop or that you are subject to.

The frequency of these oscillations varies in function of tremor type and pathology. The range commonly accepted ranges from 2 Hz to 12 Hz.

The classic treatment of tremor is the medication and thalamic or subthalamic electrical stimulation. Some papers show that medical treatment by medication it fails in 85 percent of cases and treatments for stimulation are effective in a greater number of cases but involve a delicate surgical intervention that is not indicated for a good number of potential patients (E. Rocon, J.M. Belda-Lois, J.J. Sanchez-Lacuesta, J.L. Pons, Pathological Tremor management: modeling, compensatory technology and evaluation, Technology and Disability, 16, pp. 3-18, 2004). These facts have promoted the development of devices for the alternative treatment of pathological tremor

There are currently several systems that have achieved significant results in the reduction of tremor or their efects. There are two basic approaches to this treatment:

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Isolation of the task of trembling movement,

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Amplitude reduction tremor.

The concept of isolation of the trembling movement task is based on the insertion of a serial device between the human body and the task. This approach can be done electronically or in a way
mechanics.

A clinically established procedure for reduce the amplitude of the tremor is the application of loads biomechanics to the affected member and is based on devices orthotics or orthotics (E. Rocon, J.M. Belda-Lois, J.J.  Sanchez-Lacuesta, J.L. Pons, Pathological Tremor management: modeling, compensatory technology and evaluation, Technology and Disability, 16, pp. 3-18, 2004). The application of biomechanical loads can be implemented both in active systems as in passive systems.

In active systems, the actuators generate a movement in the limb of equal amplitude but in the sense contrary to the trembling movement, thus subtracting the tremor of global movement of the member. In passive systems, actuators apply resistive mechanical loads, be these dissipative or inertial.

These braces can be portable or not laptops Non-portable braces are subject to the member affection and to a platform fastens the ground (which can be one's own floor, wheelchair, table, etc). Portable braces they are attached only to the patient's arm. The way in which both approaches exert the loads on the arm for the Tremor suppression is radically opposite. Orthoses laptops eliminate the tremor between consecutive elements of the Kinematic chain of the arm. Non-portable braces eliminate the tremor applying loads from the ground to the arm.

Among non-portable systems anymore representative we can highlight the Neater commercial device Eater, the MIT cushioned joystick, the controlled orthosis of CEDO energy dissipation and the dissipation modulated arm of MED energy

There are fewer portable solutions for the suppression of tremor. Among them stands out the "Viscous Beam ", a passive orthosis for the suppression of tremor of wrist flexo-extension that works by applying a viscous friction system parallel to the wrist. But nevertheless, its mechanical design restricts the movements of prono-supination and deviation radial-ulnar wrist.

The ideal solution is to apply loads Biomechanics only to trembling movement. However, in all the embodiments described in the state of the art these devices apply a dissipative biomechanical load so independent of the type of tremor that affects the patient. This load it is also independent of the type of movement on which it apply, either voluntary, shaky or a combination of both. As a consequence the patient also feels a resistive load before Your intentional movement.

The upper member has as its main function allow the hand to perform its functions and can reach any point of space, especially any point of the individual's body surface, so that it is possible approach, manipulate and move objects, from the body and / or to the same. Therefore, the kinematic chain formed by the shoulder, the elbow,  the forearm, wrist and hand, has a high degree of mobility, as well as distal capacity for grip with infinity number of positions and functions. The upper limb is one of the more complex body parts anatomically and physiologically.

In addition, the upper limb is very important. It is capable of developing cognitive activities, of expression and manipulation, and intervenes in the functions exploratory of the environment and in all the motor acts reflexes.

Thus, any alteration or pathology that affect the range of motion of the upper limbs, their strength muscle, sensitivity and / or the integrity of your skin, will alter the operation of them. Therefore, the objectives of the upper limb orthoses should be:

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Keep alignment articulate,

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Assist the movement deficit,

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Increase coordination and function in several tasks,

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Maintenance of the hand functionality, and

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Prevention of restrictions

An orthotic or orthotic platform is defined as a medical device that acts outside a segment of the human body in order to establish some kind of functional compensation Postural or passive orthoses they represent the common way of acting of the orthoses of the member superior, whose main objective is to preserve the position Functional hand (E. Viosca and others, Guide to use and prescription of custom orthopedic products, IBV Publications, 1999).

When an orthosis applies some kind of force about the human body in order to improve functionality of any member, this orthosis is classified as an orthosis dynamic. A dynamic brace can be defined as a group of articulated splints that, by using various dynamic devices, get to improve the functionality of some member. Dynamic braces have independent sections in the segments of the forearm, wrist, hand and fingers, to which adds several joint components to get the movement and functionality of the member.

For dynamic functional braces can develop the functions outlined above is needed get a good fixing effect as a prerequisite. Regarding this fixing effect, two aspects can be considered different:

one.

The fixation of the brace on the body segment to which it is directed, Y

2.

The fixation necessary for dynamic elements to act.

Fixing the brace on the limb upper is achieved using a series of fastening straps, that allow to apply distributed forces along the Different body segments involved. On the other hand, so that dynamic elements develop their action, it is necessary to arrange of a base, or rigid structure (the orthotic itself), that serves as a point of application of those external forces that cause the dynamic effect

In the state of the art there are some patents whose objective is the development of dynamic orthoses to the upper limb Such is the case of US4180870 (Universal-orthese, Radulovic R., Karisik M., Wolfer K.R.) which focuses on the development of a universal brace for the upper member whose function is to assist the movements of the shoulder and elbow in patients with some type of weakness in the superior member. This is also the purpose of the patent. US6179799 (Orthosis for supination and pronation of the wrist, Doran  R.E.), with the difference that the assisted movement is the prone-supination movement of the forearm. The main disadvantage of these devices is the inability to apply externally controllable forces in each of the joints in which they act. In addition, they are not equipped with sensors to evaluate or measure the behavior of the upper limb. The measure of the movements of the upper limb is the goal of Other patents An example is US6334852B1 (Joint movement monitoring system, Seyl V.C.), which focuses on the development of an upper limb orthosis for the measurement of several movements of the joint in the wrist of his Username.

In the state of the art there are also some devices whose objective is the damping of trembling movement through weights, US6458089 patents (Methods and devices for reducing trembling, Ziv-Av A.), US5058571 (Hand-held gyroscopic device, Hall; W.D.) and US6695794B2 (Active tremor control system, Kaiser; K.W., Hall; G.E.). This type of devices is characterized by having a mass that oscillates in contrast to the trembling movement, canceling the tremor in this way. This mechanical load is independent of the type of movement performed by the patient (voluntary, shaky or a combination of both). How consequently the patient feels a resistive load before his Intentional movement and therefore a lack of comfort. Others drawbacks are that these types of devices must be adjusted to the characteristics of each patient and they are also able to control the tremor only in one direction previously defined.

In short, it does not exist in the state of the art orthotic devices that:

- allow the specific application of loads in function of the specific characteristics of the type of tremor (variable frequencies and amplitudes) or characteristics particular at a particular moment of the tremor in a patient, which will usually be different from any other instant.

- be able to apply biomechanical loads, active or passive, to the trembling movement on the same level in which is produced, that is, in the limb joint.

Description of the invention Brief Description of the Invention

The patent presented refers to a ambulatory orthotic platform for monitoring, diagnosis of tremor and validation of control strategies, both active as passive, for the suppression of pathological tremor at the time It preserves the natural movement. The device is developed in around an articulated structure that allows to support a set of sensors and actuators necessary for the realization of tasks of monitoring, diagnosis and application of strategies of control.

The platform architecture is formed by a computer program for management, configuration and presentation of information from the diagnostic support system and cancellation of the tremor, a programmable device for execution of the signal acquisition algorithms of the sensors and control of the orthosis, the algorithms for the acquisition, interpretation of the sensor signal and activation of the actuators, electronic circuits for the interface between sensors and actuators with the programmable device, the structure of the orthosis and power supplies for the actuators, in addition of the actuators themselves.

Detailed description of the invention

The present invention faces the problem of provide new orthotic devices or dynamic braces for evaluation, diagnosis and treatment of human patients with pathological tremor in limbs or upper limbs.

The present patent refers to a device Dynamic orthotic with rigid or elastic structure for fixation of actuators and sensors that enable the application of different control strategies for tremor suppression over three joints of the human upper limb (the shoulder, elbow and wrist) Optionally, the structure of the device Orthotic can be flexible (textiles or elastic materials) when It is used as a tool for objectification, monitoring and / or tremor diagnosis, in which case it does not include the actuators although the rest of the elements. The application of a force external (through an external actuator) provides the brace a corrective effect Secondary collaborates in the maintenance of a correct alignment of the different segments involved

This orthosis is based on the application of internal forces, that is, the force is applied between segments consecutive of the member to suppress the tremor of three joints Efforts can be resistive, dissipative, inertial or those resulting from active control strategies.

This device also allows to implement various control strategies, both active and passive, to the suppression of tremor in the joints responsible for the flexo / wrist extension, flexo elbow extension, in addition to the prono-supination of the forearm, so that can apply independent control strategies in each of these joints through, for example, the use of method protected in Spanish patent P200302927 (method and pathological tremor cancellation biomechanical device) that protects a control strategy for active cancellation of pathological tremor This method could be programmed in the orthosis controller object of this patent. The sensors are they would use to capture the user's movement. An algorithm would allow the determination of the main frequency of the tremor. This information would be used to generate the movement in contraphase that cancels the tremor.

The use of this orthotic device dynamic is related, on the one hand, with a tool objectification, evaluation and diagnosis of patients with tremor pathological under normal conditions or to which they are applied any tremor suppression strategy and, on the other hand, with a tool for the treatment of such patients with tremors The pathological tremor to which the object can be applied of the present invention (both in its objectification aspect, evaluation and diagnosis, as in its cancellation aspect) is the resting tremor (characteristic of Parkinson's disease), the postural tremor (characteristic of the essential tremor) and the kinetic or intentional tremor (of multiple etiology).

The main advantages of this device Dynamic orthotic object of this patent can be summarized how:

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It is a portable device, not invasive and ambulatory (can work without the need for external references),

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Biomechanical data are obtained at from a multiplicity of kinematic and / or kinetic sensors relative or absolute,

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Offers direct information from torque and / or tremor power of each limb joint superior, which allows us to estimate the contribution of each articulation on the total tremor movement throughout the upper limb kinematic chain,

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Offers direct information from the contribution of each joint on the trembling movement total, and

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It does not limit rank and freedom of the upper limb movement.

The scheme of this group of passive orthoses it serves as a basic module on which new ones can be added components. The orthosis facilitates the interface between the system of tremor suppression without external reference and upper limb. This approach has the following advantages:

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The orthosis facilitates the interface with the member,

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It provides alignment between the joint and brace,

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It provides a rigid structure that It allows the application of torque to cancel the tremor, Y

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 The limits of range of motion result in safety additional.

Thus, an object of the present invention is constitutes a dynamic orthotic device useful for monitoring, diagnosis and suppression of pathological tremor in any of its variants of the human upper limb, in hereinafter orthotic device or orthosis of the present invention, consisting basically of the following components (Figure one):

a) An orthotic structure with joints (1) for elbow flexion extension, prone-supination of the forearm and flexo-extension of the wrist that allows the coupling of a set of actuators for the application of forces (4) and sensors (2, 3), responsible for the interface between the actuators (4) of the orthosis and the upper limb of the patient, consisting of:

i.

A multiplicity of sensors that allow obtaining information kinematics of the human arm,

ii.

A multiplicity of sensors that allow obtaining the information kinetics about the interaction force between the arm and the structure described in a), and

iii.

A multiplicity of rotary actuators that allow acting on the affected organ;

b) A programmable electronic device responsible for the execution of different control strategies for the suppression of tremor based on the readings of sensors described in points a.i) and a.ii), of the generation of control signals for the actuator government described in a.iii) and communication with an external device (8).

c) Electric power module (5) connected to the electronic device described in b) and capable of converting the command signal from b) on a power signal for the actuator government, and

d) An external device connected to the electronic device described in b) capable of providing a interface to access all platform functionalities orthotics that allow:

i.

He adjustment of control strategy parameters,

ii.

The definition of orthosis mode of operation,

iii.

The presentation of the variables measured by the orthosis,

iv.

He shaking motion analysis,

v.

The presentation of diagnoses,

saw.

Storage of acquired data by orthosis,

vii.

Report generation, and

viii

the Communication with the brace.

A particular object of the invention is constitutes the orthotic device of the invention in which the sensors used to measure kinematic variables (position, angular velocity and acceleration) of a.i) are inertial sensors capable of operating in a minimum frequency range between 0 and 30 Hz, and among others, by way of illustration and without limiting the scope of the invention, belonging to the following group: goniometers, gyroscopes and accelerometers and force. Tremors have been described up to a maximum frequency of 17-20 Hz, so the range up to 30 Hz is conservative and includes all possible tremors In the example, a sensor that goes beyond is used.

Another particular object of the invention is constitutes the orthotic device of the invention in which the sensors used to measure the kinetic variables described in a.ii) are force sensors capable of operating in a range minimum frequencies between 0 and 30 Hz, and among others, by title illustrative and without limiting the scope of the invention, belonging to the following group: gauge set extensometers mounted on the Bridge configuration Wheatstone

Another particular object of the invention is constitutes the orthotic device of the invention in which the rotary actuators of a.iii) are engines to produce the action canceling of the tremor, and among others, by way of illustration and without that limits the scope of the invention, belonging to the following group: ultrasonic motors and a current motor assembly continuous and reducing. As a concrete embodiment of the invention a flat DC motor has been used as an example of a motor direct current and reducer.

Another particular object of the invention is the orthotic device of the invention in which the programmable electronic device of b) is capable of acquiring signals from the sensors, processing them, analyzing them and generating a control signal from the actuators and implementing strategies for tremor monitoring and identification based on an algorithm in the frequency or time domain, among others, by way of illustration and without limiting the scope of the invention, belonging to the following group: IEEE-1057 standard, Kalman filter and the Benedict-Bordner filter (JM Belda-Lois, J. Sanchez-Lacuesta, MJ Vivas-Broseta, E. Rocon, L. Bueno, JL Pons, Tremor movement analysis techniques: an approach towards ambulatory systems, Asistive Technology - Shaping the future , pp. 827-831,
2003).

A particular embodiment of the device The orthotic of the invention is one in which the device b) programmable electronic belongs to the following group: a microcontroller, microprocessor, DSP or computer running some real time operating system.

The orthotic device of the present invention can be coupled or adapted by one skilled in the art to others existing market realizations, such as for example the method protected by the Spanish patent P200301767 be used as the tremor cancellation algorithm executed by the programmable electronic device described in point 1.b).

Another particular object of the invention is constitutes the orthotic device of the invention in which the d) external device is able to communicate with the b) programmable electronic device functioning as a configuration tool capable of:

a) adjust the parameters of the strategies of control executed by the electronic device of b), and

b) define the mode of operation of the orthosis

Another particular object of the invention is constitutes the orthotic device of the invention in which the d) external device works as an interface tool between the orthotic device and the observer capable of:

a) present the variables measured by the orthosis,

b) analyze the trembling movement,

c) present diagnoses based on the values measured,

d) store the data acquired by the orthosis, and

e) generate reports on the experiments made.

Another particular object of the invention is constitutes the orthotic device of the invention in which the external device d) can operate in both modes, that is, as a configuration and interface tool. Another realization particular of the orthotic device of the invention is that in the that the external device d) belongs to the following group: a computer, a PDA and a Pocket PC.

Another particular object of the invention is constitutes the orthotic device of the invention in which the communication between the programmable electronic device of b) and the external device of d) is performed, among other means, to illustrative title and without limiting the scope of the invention, belonging to the following group: through cables using TCP / IP or serial communication protocols, wirelessly using Bluetooth technology, Homer technology, the Wifi technology and IrDA infrared technology.

Another particular object of the present invention it is the dynamic orthotic device of the invention in which the Its structure is not rigid but is flexible (textiles or elastic materials). This device alternative is would use as a tool for objectification, monitoring and / or tremor diagnosis, in which case it also does not include actuators although the rest of the elements.

On the other hand, the platform object of this Patent has three different practical operating modes:

1.- Monitoring - the platform acts as a system of measurement and characterization of both qualitative tremor as quantitatively. This way it doesn't offer any kind of opposition to the patient's movement, be this movement voluntary or shaky. In this mode of operation the platform works in real time, allowing to read, process the data and record the tremor for different specific tasks to perform by the patient That way it behaves like a tool for acquisition and analysis of tremor signals and can be used as an aid for medical diagnosis (the type and degree of tremor that a patient suffers) and to observe the progress of a treatment.

2.- Passive Intervention - the platform acts as a device capable of mechanically damping the effects caused by the tremor, applying forces on the limb superior to compensate for vibrations caused by tremor and stabilize the user's voluntary movement. It is important highlight that in this mode the platform allows the evaluation of the operation of the control strategy through the reading of The signals of the sensors. That way you can appreciate the reduction, or not, of the effects of tremor on the limb higher.

3.- Active Intervention - the platform suppresses the tremor as a dynamic system, generating dissipative signals proportional to the intensity of the tremor. As in mode Passive Intervention, in this mode the platform also allows the evaluation of the operation of the control strategy through of reading the sensor signals, thus allowing appreciate the reduction, or not, of the effects of tremor on the superior member. This type of intervention is based on the method described in patent P200301767.

Thus, another object of the present invention is constitutes the use of the orthotic device of the present invention, hereinafter use of the orthotic device, in the monitoring and diagnosis of human patients with tremors pathological under normal conditions or to which they are applied any tremor suppression strategy and also in the Treatment of human patients with tremors. The earthquake pathological to which the object of the present can be applied invention (both in terms of objectification, evaluation and diagnosis, as in its aspect of cancellation-treatment) belongs, among others, to illustrative title and without limiting the scope of this invention, to the following group: resting tremor (characteristic of Parkinson's disease), postural tremor (characteristic of the essential tremor) and the kinetic or intentional tremor (of multiple etiology).

Detailed explanation of the drawings

Figure 1.- The figure schematically represents the architecture of the proposed orthotic device . Block 1 represents the rigid structure with joints for the elbow, prono-supination of the forearm and flexo-extension. Blocks 2 and 3, respectively, represent the kinematic and kinetic sensors coupled to this rigid structure. Block 4 represents the rotary actuators coupled to the rigid structure that allow acting on the affected organ. Block 5 represents an electric power module connected to the programmable electronic device characterized by converting the command signal into a power signal for actuator control. Block 6 represents a programmable electronic device characterized by executing different control strategies for tremor suppression and capable of generating control signals for actuator governance and communicating with an external device. Block 7 represents an external device connected to the electronic device capable of providing an interface to access all the functionalities of the orthotic platform and present the data in an appropriate way to clinicians. Block 8 represents the communication between block 6 and block 7 that can be implemented both wirelessly (Bluetooth, Homer, Wifi or IrDA) and through cables (TCP / IP, serial cable).

Figure 2.- Orthosis for cancellation of tremor at the elbow level . The figure schematically illustrates the rigid structure for the elbow joint. Coupled to this rigid structure are a set of kinematic and kinetic sensors in addition to a rotary actuator that allow acting on the elbow joint.

Example of embodiment of the invention Example 1  Development of an orthotic solution for cancellation of tremor at elbow level

As a particular embodiment of the present invention describes an orthosis for cancellation of tremor to elbow level. The orthotic is formed by a rigid structure articulated that allows to support a set of sensors and actuators to implement control strategies for tremor cancellation (Figure 2).

In this example they are used as sensors Kinematic two gyros located on the rigid structure a both sides of each joint and that offer information on the absolute angular velocity of the segments (arm and forearm) in the plane of movement of the joint. The frequency range of measurement is between 0 and 50 Hz, thus covering all the frequency range of possible tremors.

The kinetic sensors used in this example for measuring the interaction force between the orthosis and the member are strain gauges. The gauges are responsible for the measure of the cancellation torque applied by the motors on the orthotic platform structure, therefore, are mounted on the structure so that they measure only the force perpendicular to the motor shaft, so its measurements are not influenced by forces originating in unwanted directions. The strain gauges are connected in a bridge circuit  Wheatstone in a combination of four active gauges (bridge full).

As an actuator a DC motor assembly is used plane and reducer to generate the earthquake cancellation torque in The articulation of interest. The total torque that can be generated by the gearmotor assembly is 8 N.m but is limited through the energy delivered by the power module to the engine at 3 N.m, enough to counteract the average torque of the tremor at this level without the possibility of causing damage to the user.

All the algorithms used for the tremor cancellation were implemented using the Matlab and RealTime Workshop programming environments. Algorithms they are executed by a personal computer on the Kernell of time real xPCTarget. This computer incorporates acquisition cards for sufficient capture speed and resolution, in this case 200 Khz and 12 bits respectively, in addition to a network card with TCP / IP communication port.

An identification strategy is implemented and tremor monitoring according to the method described in the Spanish patent P200301767. The selected sample rate for the identification loop it is 1 KHz. Every time the selected strategy grants the estimate with a delay of one single sample, the estimate delay is reduced to 1 ms, negligible compared to the intrinsic frequency of the tremor that is between 2 and 12 Hz.

In addition, a dynamic model of the upper limb capable of estimating torque values in real time and tremor power in each joint. With this model it is possible to evaluate the contribution of each arm joint about the tremor in the limb of the arm. The method for obtaining arm kinematics is the method of the matrices of  homogeneous transformation (Fu, K. S .; Gonzalez, R. C .; Lee, C. S. G; Robotics: control, sensing, vision, and intelligence. McGraw-Hill, Inc. New York, NY, USA, 1997). He developed model is based on the Denavit- parameterization Hartenberg To model the dynamics of the human arm was used a combination between the kinematic model, developed by the technique of transformation matrices and parameters human antoprométricos extracted from the tables of Cam (P. de Cam, Adjustments to Zatsioorsky-Seluyanov's segment inertia parameters, Journal of Biomechanics, 29, 9, pp. 1223-1230, 1996). The parameters related to the member dynamics (center of mass, member mass, matrix of inertia) have been obtained through the corrections of Cam to the biomechanical tables of Zatsiorsky and Selyyanoy (V.M. Zatsiorsky and V.N. Seluyanov and L.G. Chugunova, Methods of determining mass-inertial characteristics of human body segments, in Contemporary problems of biomechanics, CRC Press, pp. 272-291, 1990). For the implementation of developed model the recursive algorithm of Newton so that the implementation of the algorithms is allowed of estimation in a modular way.

As an external device responsible for the user interface implementation is used a personal computer. The user interface is programmed in the object-oriented programming language Visual C ++. The communication between the control computer and the computer interface is made through cables using the protocol TCP / IP communication

Claims (25)

1. Dynamic orthotic device useful for monitoring, diagnosis and suppression of pathological tremor in any of its variants characterized in that it comprises: a) A structure with rigid joints for the elbow, prono-supination of the forearm and flexo-extension of the wrist that allows the coupling of a set of composite actuators and sensors by:

i.-

A multiplicity of sensors of electrical signals corresponding to trembling movements that allow obtaining the kinematic information of the human arm,

ii.-

A multiplicity of sensors of electrical signals corresponding to trembling movements that allow obtaining the kinetic information about the interaction force between the arm and the structure described in point a), and

iii.

A multiplicity of rotary actuators that allow to act on the affected organ;

b) A programmable electronic device responsible for the execution of different control strategies for the suppression of tremor based on the readings of sensors described in points a.i) and a.ii), of the generation of control signals for the governance of the actuators described in a.iii) and of communication with an external device of d); c) Electric power module connected to the electronic device described in b) capable of converting the signal command from b) on a power signal for the actuator government; Y d) An external device connected to the electronic device described in b) capable of providing a interface to access all platform functionalities orthotics and presenting the data in an appropriate way. 2. Orthotic device according to claim 1 characterized in that the sensors used to measure the kinematic variables of ai) are inertial sensors capable of operating in a minimum frequency range between 0 and 30 Hz. 3. Orthotic device according to claim 2 characterized in that the inertial sensors belong to the following group: gyroscopes, goniometers, accelerometers and force. 4. Orthotic device according to claim 1 characterized in that the sensors used to measure the kinetic variables described in a.ii) are force sensors capable of operating in a minimum frequency range between 0 and 30 Hz. 5. Orthotic device according to claim 4 characterized in that the force sensors are a set of strain gauges mounted in the Wheatstone Bridge configuration. 6. Orthotic device according to claim 1 characterized in that the rotary actuators of a.iii) are ultrasonic motors. 7. Orthotic device according to claim 1 characterized in that the rotary actuators of a.iii) are a direct current motor and reducer assembly. 8. Orthotic device according to claim 7, characterized in that the direct current motor is a flat DC motor. 9. Orthotic device according to claim 7 characterized in that the reducer coupled to the DC motor is a flat reducer. 10. Orthotic device according to claim 1 characterized in that the programmable electronic device of b) is capable of acquiring signals from the sensors, processing them, analyzing them and generating a control signal of the actuators and of implementing tremor monitoring and identification strategies. 11. Orthotic device according to claim 9 characterized in that the strategies are based on an algorithm in the frequency or time domain. 12. Orthotic device according to claim 10 characterized in that the algorithm belongs to the following group: IEEE-1057 standard, Kalman filter and Benedict-Bordner filter. 13. Orthotic device according to claims 9 to 11, characterized in that the programmable electronic device belongs to the following group: a microcontroller, a microprocessor, a DSP and a computer running some real-time operating system. 14. Orthotic device according to claim 1 characterized in that the external device of d) is capable of communicating with the programmable electronic device of b) functioning as a configuration tool capable of: a) adjust the parameters of the strategies of control executed by the electronic device of b), and b) define the mode of operation of the orthosis 15. Orthotic device according to claim 1 characterized in that the external device of d) functions as an interface tool between the orthotic device and the observer capable of: f) present the variables measured by the orthosis, g) analyze the trembling movement, h) present diagnoses based on the values measured, i) store the data acquired by the orthosis, and j) generate reports on the experiments made. 16. Orthotic device according to claim 1 characterized in that the external device d) can operate in both modes according to claims 13 and 14. 17. Orthotic device according to claim 1 characterized in that the external device d) belongs to the following group: a computer, a PDA or a Pocket PC. 18. Orthotic device according to claim 1 characterized in that the communication between the programmable electronic device of b) and the external device of d) is carried out via cables using TCP / IP or serial communication protocols. 19. Orthotic device according to claim 1 characterized in that the communication between the programmable electronic device of b) and the external device of d) is carried out wirelessly using Bluetooth technology. 20. Orthotic device according to claim 1 characterized in that the communication between the programmable electronic device of b) and the external device of d) is carried out wirelessly using Wifi technology. 21. Orthotic device according to claim 1 characterized in that the communication between the programmable electronic device of b) and the external device of d) is carried out wirelessly using IrDA infrared technology. 22. Orthotic device according to claims 1 to 21, characterized in that the structure thereof is flexible, preferably of textile materials or elastic materials and does not include the actuators. 23. Use of the orthotic device according to claims 1 to 22 in monitoring and diagnosis of tremor of human patients or for the evaluation of the effect of Medications about tremor. 24. Use of the orthotic device according to claims 1 to 22 in the treatment of tremor of Human sick 25. Use according to claim 23 and 24 characterized in that the pathological tremor belongs to the following group: resting tremor (characteristic of Parkinson's disease), postural tremor (characteristic of essential tremor) and kinetic or intentional tremor (multiple etiology).