FR2974006A1 - Device for monitoring and displacement assistance of mobility disabled patient moving in wheel chair at inside of e.g. dwelling, has sensors for measuring physiological data of person and physical data of wheelchair - Google Patents

Abstract

The device has a data acquisition unit i.e. geolocator, including a sensor carried by a person for measuring physiological data of the person. The acquisition unit includes another sensor positioned on a wheelchair for measuring physical data of the wheelchair, where the data are used to estimate information relative to comfort, a fatigue level and/or gesture efficiency of the person. The former sensor is formed of electromyographic type sensors (7) to measure muscular activity of the person, and a heart rate and respiratory frequency measuring sensor (8).

Description

FIELD OF THE INVENTION The present invention relates to the field of monitoring and assisting the movement of persons using a wheelchair.

PRESENTATION OF THE PRIOR ART The invention relates to a method and a device for monitoring a person moving with the aid of a manual wheelchair

A wheelchair conventionally comprises a frame mounted on an axis receiving two large wheels manually operated by the user, and two small self-directional wheels. The chair also includes a seat consisting of a seat and a backrest on the frame.

Each wheelchair comprises adaptable adjustment means depending in particular on the morphology of the patient and the type of use envisaged.

At present, wheelchair adjustment is carried out using an empirical approach based on anthropometric measurements and on the know-how of clinicians (mainly physiotherapists and physiotherapists) type of service.

Thus, there is no solution for determining the appropriate settings of a wheelchair based on physiological parameters relating to the person using the wheelchair.

In addition, the urban environment is not always adapted to the movement of people moving on a wheelchair, so that some places remain inaccessible or difficult to access for these people.

At present, there is no way for communities to collect information centrally on the accessibility of the places that make up the urban environment, so that the adaptation of the urban environment to wheelchair users rolling stock remains difficult to implement. It is an object of the present invention to provide a device and method for increasing the range, comfort and safety of wheelchair users.

SUMMARY OF THE INVENTION

For this purpose, the invention proposes a device for monitoring and assisting a person moving in a wheelchair, the device comprising acquisition means comprising: at least one sensor carried by the person to measure a given piece of data physiological person, - at least one sensor positioned on the chair to measure a physical data of the chair, said data being used to estimate information relating to comfort, a level of fatigue and / or the gestural efficiency of the chair; nobody.

The representative information of the comfort of the person can be of different types. This comfort information may relate to the accessibility quality of a given location or to the wheelchair settings, or to the physical condition of the person. This information can take the form of a score whose values extend on a scale of 1 to 10 for example. In all cases, this comfort information allows: - communities to collect data to improve the accessibility of a place to people in wheelchairs; 25 - clinicians and wheelchair users to monitor their state of health and possibly to adapt the propulsion technique of the person to reduce the risk of occurrence of musculoskeletal disorders, - the clinician adjusting the wheelchairs evaluate settings made. 30 - designers to develop wheelchairs adapted to their users and contexts of use

Advantageously, the information representative of the comfort of the person is determined from physiological data acquired on the person and physical data acquired on the wheelchair. Thus, the determination of a comfort information is no longer solely related to a user's feeling, but to more objective parameters such as the speed of movement of the chair, the force applied by the person on the chair for propel, the heart and respiratory rates of the person, etc.

Preferred but non-limiting aspects of the present invention are as follows: the sensor carried by the person may comprise an electromyographic type sensor for measuring the muscular activity of the person, and a heart rate and respiratory sensor for measuring the frequency cardiac and respiratory person - the sensor positioned on the chair can include an accelerometer to measure the acceleration of said chair. - The acquisition means may further comprise at least one position sensor disposed on the person for measuring a plurality of successive positions of the person during a wheelchair travel; this allows on the one hand to estimate if the movement carried out by the person to propel himself is correct, and on the other hand to propose to the person an alternative propulsion technique according to this estimate; the acquisition means may comprise at least one geolocator; this helps determine the path taken by the wheelchair user; this also makes it possible to determine the geographical position of an obstacle encountered by the person during a displacement thereof; the acquisition means may comprise at least one vibration sensor; this makes it possible to determine information (i.e. rough surface, smooth, etc.) relative to the surface on which the person in a wheelchair is moving; in addition, the combination of a geolocator and a vibration sensor can determine the type of surface (pavement, gravel, sand, etc.) on which the chair moves; the acquisition means may comprise at least one distance measuring sensor for measuring the distance between the ground and a front wheel of the wheelchair; some wheelchair users tilt backward down a slope, so that only the rear carrier wheels are in contact with the ground and the chair is substantially horizontal during movement of the chair in the slope; for persons using this descent technique, a downward slope can not be obtained from a single tilt measurement obtained from an inclinometer, which is why the device may comprise a sensor for measuring the distance between the wheelchair front wheels and the ground: this sensor makes it possible to detect a slope even when the wheelchair remains substantially horizontal in a slope; as a variant, the combination of a speed measurement and a measurement of the position of the arms may make it possible to detect a downward slope: indeed, if for a given non-zero speed, the position of the arms of the person does not vary then it can be deduced that the person moves in his chair on a downward slope; the acquisition means may comprise at least one sensor for measuring the force applied to the chair, such as a dynamometric load-bearing rear wheel; the acquisition means may furthermore comprise at least one gyroscope and / or one magnetometer and / or one inclinometer and / or one angular encoder and / or one altimeter, said gyroscope and / or magnetometer and / or inclinometer and / or encoder angular and / or altimeter being disposed on the wheelchair; - The acquisition means may further comprise at least one gyroscope and / or accelerometer, said accelerometer and / or gyroscope being disposed on the person.

BRIEF DESCRIPTION OF THE DRAWINGS

Other advantages and features will become more apparent from the following description of several alternative embodiments, given by way of non-limiting examples, from the appended drawings in which: FIG. 1 schematically illustrates a wheelchair; FIGS. 2 and 3 schematically illustrate various embodiments of the device according to the invention.

DETAILED DESCRIPTION OF THE INVENTION An embodiment of the tracking and assist device of a person moving in a wheelchair according to the invention will now be described in more detail.

This tracking device allows individuals with severe mobility restrictions resulting from spinal cord injury, congenital or acquired neurological or muscular disease, lower limb trauma, or aging, to preserve their independence and quality of life related to the use of the wheelchair by: - promoting the choice and appropriate adjustment of the chair to their characteristics and their needs, - reducing the risk of developing musculoskeletal disorders, - optimizing their care therapeutic functional, - providing relevant information to local communities for the design and assessment of accessibility to persons with reduced mobility in the context of daily activities (housing, public facility, facilities open to the public, building of dwelling, collective means of transport, etc.) or information corresponding to the movement and use of a public place by a person in a wheelchair.

Referring to Figure 1, there is illustrated an example of a wheelchair. This chair comprises a frame 1 on which are mounted footrests 2 and a seat 3 composed of a seat 31, a backrest 32 and armrests 33 disposed on either side of the seat 31.

The chair comprises orientable front wheels 4 for directing the wheelchair and carrying rear wheels 5 on which are fixed handrails (not referenced).

The tracking device according to the invention comprises acquisition means for acquiring data of a physiological or physical nature. The acquisition means comprise a plurality of sensors that can be worn by the person or integrated into the wheelchair used by the person.

Sensors carried by the person The acquisition means may comprise one or more sensors carried by the person to measure one or more physiological variable (s) relative to the person traveling in a wheelchair.

This makes it possible to follow the physical activity of the person according to the path taken by the person. This also makes it possible to determine the state of fatigue of the person in his wheelchair.30 The number and type of sensors worn by the person may vary according to the characteristics of the wheelchair user and the intended application ( ie determination of accessibility in the living areas of the person, determination of optimum chair settings, etc.).

The acquisition means may comprise one or more sensors of the inertial central type comprising one or more accelerometers, one or more gyroscopes and possibly one or more magnetometers. ). This makes it possible to measure the postural state of the person.

The acquisition means may comprise one (or more) sensor (s) of the cardio-frequency meter type or inductive wound plethysmography type vest. This makes it possible to measure the person's heart rate and breathing rate during wheelchair movement. The acquisition means may comprise one (or more) electromyograph type sensor (s) for measuring the muscular activity of the person. This makes it possible to determine the gestural efficiency of the person by quantifying the co-contractions and / or by quantifying the energy expenditure of the person 20 during a displacement thereof.

Built-in sensors on the chair

The acquisition means may also include one or more sensors integrated on the chair to measure one or more physical variable (s) of the wheelchair, such as, for example, the orientation of the wheelchair. of the chair, the inclination of the chair, the deceleration of the chair, the speed of the chair, the vibration of the chair, the movements of the chair, etc.

The combination of these physical variables with the physiological data acquired by the sensors carried by the person makes it possible to determine information representative of the comfort of the person. This information representative of the comfort can be: - either a score of accessibility to a place of life, 35 - or information on the quality of the adjustments made on the wheelchair. Preferably, the sensors are integrated into the chair in areas that do not interfere with the ergonomics and / or comfort of the chair. For example, the sensors are positioned under the armrests 33, under the footrests 2, under the seat 31 or behind the backrest 32 of the wheelchair. The acquisition means may comprise one or more accelerometer type sensors for measuring the acceleration and deceleration of the wheelchair during a journey.

The acquisition means may also comprise one (or more) gyrosocope type sensor (s) for measuring different information on the angles of the rear wheels (speed and / or angular position of the wheels, etc.).

The acquisition means may comprise one (or more) sensor (s) of the magnetometer type. A magnetometer is a sensor providing information on the chair position relative to magnetic north. The use of a magnetometer-type sensor makes it possible to detect whether the chair is moving in a straight line or whether the person is turning with his chair.

The acquisition means may comprise one (or more) sensor (s) of the type: - inclinometer for measuring the inclination of the chair; this makes it possible in particular to detect a fall of the person in a wheelchair, - altimeter for measuring the altitude at which the wheelchair is located; 25 This altitude may affect the heart rate or breathing of the person, - angular encoder for measuring the angular velocity of the wheel loader wheelchair; in combination with data relating to the muscular activity of the person, 30 - vibrometer for measuring the vibrations of the chair, - geolocator for determining the position of the chair; in combination with the vibrometer, this data can make it possible to determine the nature of the soil (gravel, pavement, etc.) which has caused an increase in the vibrations of the wheelchair during the displacement of the person; furthermore, knowledge of the position of the chair can make it possible to provide the person in wheelchair with information on the most accessible route to reach his final destination, for example according to his state of fatigue determined by the The acquisition means may comprise one or more instrumented dynamometer type sensors for measuring and / or calculating various kinematic or dynamic parameters of the wheelchair propulsion cycle, such as: the distance traveled, the instantaneous speed, the displacement, the acceleration and the deceleration of each wheel, or the distribution of the mechanical forces.

For example, the instrumented dynamometer wheel can detect a plurality of movements back and forth in front of the chair over a short period, which is representative of a difficulty encountered by the wheelchair user (ie maneuvers performed by the person to pass a door, or to circumvent an obstacle, etc.), and thus influences the accessibility of a place along a given course.

Sensors distributed in the living area

The acquisition means may also include one (or more) sensor (s) distributed at different positions of the place of life of the person traveling in a wheelchair. This makes it possible to measure, to qualify and to quantify the activity of the person in his place of life. This information can make it possible to improve the choice and / or the settings of the chair according to the activity of the person in his place of life.

The acquisition means may comprise one or more sensor (s) of presence detector type, indoor GPS, pressure pad, door switch, etc.

Means of treatment The device may comprise a memory for storing the data measured by the acquisition means. This memory can be integrated into the wheelchair. Alternatively, the memory may be remote from the chair.

The device also comprises processing means for processing the data measured by the acquisition means.

The processing means are adapted to determine the information representative of the comfort of the person in his wheelchair.

The treatment means can be integrated into the wheelchair.

The treatment means may also be remote from the wheelchair.

In this case, the chair comprises wired or wireless communication means for transmitting the data measured by the acquisition means to the processing means.

The processing means may be a personal computer, a mobile phone, an electronic tablet (such as an IPAD®), or any other type of terminal known to those skilled in the art for the processing of the data measured by the data transmission means. acquisition.

The processing means are adapted to synchronize, merge and correlate the signals measured by the acquisition means so as to allow automatically and autonomously: recognition and monitoring of the activities and state of health of the person, by example: o the person sits in his / her chair, where the person is traveling, o the wheelchair's moving speed is "X", where the person is at home, where the person is outside their home home, where the person is tired, where the person applies a force equal to "Y", etc. the quantification of the wheelchair propulsion efficiency, for example from the heart and / or respiratory rate of the person, the speed of the wheelchair, the slope (ie resistance to advancement), the muscular activity, the variability of the propulsion cycles defined via instrumented dynamometric wheels, etc. - Early detection of physiological and behavioral changes in the person and critical situations that may reflect a high risk of occurrence of musculoskeletal disorder in the person.

The data processed by the treatment means can be transmitted directly to the person to inform him of the risks involved in terms of the occurrence of musculoskeletal disorders, postural changes and / or the activity that should reduce these risks.

As a variant or in combination, the data processed by the treatment means can be transmitted to an equipment center, a medical team, a remote monitoring center, the entourage, the family or the caregivers of the person moving in. Wheelchair. This allows the recipient (s) of these processed data to remotely monitor the person, but also to intervene if necessary, for example by changing the choice or settings of the chair or by optimizing their support by a clinician, etc.

The processed data can also be transmitted to local authorities for the design or evaluation of accessibility to wheelchair users of a given place related to their living environment (ie housing, public establishment, public transportation, etc.).

Use of Sensors to Identify Poor Chair Use Due to Improper Chair Adjustment or Misuse Technique Referring to Fig. 2, an embodiment is illustrated in which the device acquisition means comprises a accelerometer 6, an electromyographic type sensor 7, a respiratory frequency sensor 8.

The accelerometer 6 is positioned on the wheelchair. The accelerometer 6 makes it possible to measure and quantify the acceleration and deceleration of the chair.

The electromyographic type sensor 7 is positioned on the person.

The electromyograph 7 makes it possible to measure the muscular activity of the person. In the case of a manual wheelchair, muscle activity is primarily related to wheelchair propulsion. To propel his manual wheelchair, the person applies a propulsive force on the rear wheel loader 5 of the chair according to the following principle. The person grasps the carrying rear wheels 5 and starts a propulsion movement. The triceps of the person contracts and his biceps relaxes so that the person's hands move towards the front of the chair. At the end of the propulsion movement, the person's biceps contracts and the triceps relaxes. The person then initiates a return movement so that the person's hands move backwards. The biceps contracts and the triceps relaxes to return the person's arm to an initial position to begin a new propulsion cycle. Advantageously, the electromyographic type sensor 7 can be arranged to measure the contraction of the biceps, and the contraction of the triceps.

The respiratory rate sensor 8 is positioned on the person. The respiratory rate sensor 8 makes it possible to measure the respiratory rate of the person.

The study of these independently measured data can make it possible to determine various parameters relating to the settings of the chair. By way of nonlimiting examples, these different measured data can make it possible to determine the following parameters.

The measurement of the respiratory rate can be used to determine the fatigue state of the wheelchair user. For example, the calculation of the duration 81 between two successive inspirations and the comparison of this calculated duration with a threshold makes it possible to determine whether the person is tired or not.

Measurement of the muscular activity of the person can make it possible to detect an abnormality in the chair settings, in particular by comparing the durations 82, 83 and / or amplitudes 84, 85 of contraction of the agonist / antagonist muscles at predetermined thresholds.

For example, if the contraction time of an agonist muscle (such as the triceps) is less than a threshold, then the magnitude of the propulsion movement performed by the person is too small. This allows to detect one (or more) anomaly (s) in the chair settings (such as the fact that the height of the seat 31 of the chair is too large compared to the height of the rear wheels carrier). For example, if the user travels a great distance each day and his percentage of co-contraction is much higher on one arm than the other, then there is a risk that a chair not appropriate. The acceleration / deceleration measurement is used to quantify the rolling quality of the wheelchair. In the examples described above, the measured data are analyzed independently. However, this data can also be mapped to determine chair adjustment information. For example, matching the muscular activity with the fatigue state of the patient allows to refine the calculated information concerning the adjustment of the chair. For example, it is known that muscular activity increases when the fatigue of the wheelchair user increases. Similarly, the matching of the deceleration and muscle activity data makes it possible to determine whether certain chair settings are optimal. For example, if the duration 86 between the start of the application of the propulsion force and the start of the acceleration is above a threshold, so there may be a problem of inflation of the rear wheels tires carrier.

Of course, other parameters representative of the comfort of the person in his wheelchair can be estimated from the three measured data using the device illustrated in Figure 2. Referring to Figure 3, there is illustrated another mode of embodiment in which the acquisition means comprise an accelerometer 9, an electromyographic type sensor 10, and a position sensor 11.

The accelerometer 9 is positioned on the wheelchair, at the backrest 32 thereof. The accelerometer 9 measures the deceleration of the chair. The deceleration of the wheelchair can vary according to two criteria: the wheelchair ride quality which is a function of the wheelchair settings (orientation of the load wheels, inflation of the tires of the carrier wheels, coefficient of friction of the load wheels on a shaft of the wheelchair). chair frame, etc.), and / or - the quality of the floor; by dint of equal propulsion, the deceleration of the chair is greater on granular soil (such as gravel) than on a smooth floor (such as tiling). Thus, for a given floor, the deceleration measurement can be used to define whether there is an incorrect use of the chair or a poor adjustment thereof. The position sensor 11 is disposed on the person, for example at his forearms. The position sensor 11 makes it possible to measure a succession of positions of each forearm of the patient during a propulsion cycle. This measurement of a plurality of positions of the forearms of the person makes it possible to quantify the propulsion movement of the person.

Comparing this movement of propulsion for example: - to a standard, or - to the movement of propulsion of the person on another chair, one can define if there is a bad use of the chair.

For example, if a propulsion cycle is defined as the period separating two propulsive motions, then the propulsion movement generally represents 33% of the cycle time. This ratio of about 33% may vary depending on the propulsion technique used by the person, the propulsion frequency, the speed of movement of the chair or the gradient of the support.

For the prevention of musculoskeletal disorders, it is preferable: to avoid the rate of increase of the force applied on the carrying wheels during the first hand contact on the hoop, to avoid the increase of the frequency (ie cadence) of the propulsion movements, and to favor the increase of the contact time of the person's hands on the carrying wheels (increase of the thrust angle).

Thus, the use of a measurement of the movement of the person's arms in combination with measures of acceleration / deceleration and the respiratory or cardiac rate can make it possible to determine information relating to the comfort of the person. This allows to deduce if the person uses his chair correctly, if the choice and / or the chair settings are optimal for the person, etc.

Of course, the acquisition means may comprise other types of sensors. For example, the acquisition means may also comprise a vibrometer for measuring the vibrations of the chair. This makes it possible to detect an incorrect use of the chair when the nature of the floor on which the wheelchair is rolling is not known. For example, if the deceleration of the chair is important for a short time and the vibrations of the chair are low, then it is possible to deduce a poor use of the chair.

First example of the use of sensors to determine the accessibility of a place by a person moving in a wheelchair In another embodiment, the acquisition means of the device comprise two dynamometric wheels, an inclinometer disposed on the chair, an accelerometer placed on the chair, an electromyograph worn by the person, The person leaves home to go to a given urban place. This person is falling downhill. The inclinometer detects and measures the slope. The electromyograph detects and measures the co-contraction of the agonist / antagonist muscles.

The data measured by the inclinometer and the electromyograph are for example: - sent to the mobile phone of the person to provide information on his muscular condition (tired state, or not by comparing measured data with corresponding data stored in memory and relating to the same path), - saved in a chair memory and / or sent to a database. They can then be used by the clinician, who will eventually see that the person contracts, gets too tense when he encounters the "downhill" difficulty. This person may not use the best practices recommended in this situation such as getting on two wheels, or has difficulties just to get on two wheels in these situations.

The instrumented dynamometric wheels measure the distance traveled by the person before the meeting of the downward slope. This distance traveled can be used to estimate the state of fatigue of the person at the time of meeting a "downward slope". This allows to weight the difficulty related to the presence of this downward slope.

If in normal times, the person has no difficulty to approach a downward slope regardless of his state of fatigue, and that for a given downward slope, the person encounters a difficulty related for example to the fact that the slope is too steep, then the presence of this difficulty along a given route can be sent to the local authorities (with the GPS coordinates of the obstacle) so that they take the necessary measures to remove this difficulty from the urban environment (by example by reducing the stiffness of this slope or by proposing an alternative route to people moving in wheelchairs, etc.).

Users can also warn communities of a difficulty along a given route using communication devices such as a telephone. This one will allow him via an application to "denounce" the obstacle by "writing" or "visually" by a photo. Thanks to GPS positioning, the obstacle is directly added to a map. This map can then be consulted by planners or communities to improve accessibility. This card can also be viewed by other people using a wheelchair to avoid this passage.

Second example of the use of sensors to determine the accessibility of a place by a person traveling in a wheelchair

In another embodiment, the acquisition means of the device comprise an electromyograph type sensor, an inclinometer type sensor, a Hall effect sensor on the carrying wheels of the chair.

During a trip, the EMG sensor detects a high rate of co-contraction of the agonist / antagonist muscles (such as triceps and biceps).

In order to interpret the cause of this rate, it must be related to the inclinometer data.

If they do not return anything abnormal, one wonders what type of soil was the user? Did he denounce an obstacle in that period of time or was he in a place already denounced? If this is irrelevant, then perhaps the user's gesture during the push is bad.

We must then ask the question of why and then how to re-educate / rework this gesture. Perhaps this is due to the fatigue state of the user. What was the number of kilometers traveled? The Hall effect sensor of the wheels can inform us about this data.

When crossing a sidewalk or high obstacle, the inclinometer will detect a sudden change in slope, the electromyograph will detect a possible strong co-contraction and the four magnets on each wheel will allow us to know that at this time moment, the person made small wheel movements. If the user has difficulty crossing this obstacle, the clinician will see it because these data, which can be described as specific to an obstacle, will be spread over time.

This may be due to a poor adjustment of the chair such as a folder not enough straightened, footpegs too low, or tires not inflated enough etc. During his daily journey, the person may be faced with exceptional work on the roadway. The person can then use a mobile terminal (such as a telephone) to, at first, denounce that this road is not practicable to this day, and look on the map what can be the most practicable.

Claims (9)

REVENDICATIONS1. Device for monitoring and assisting a person moving in a wheelchair, the device comprising acquisition means comprising: - at least one sensor carried by the person to measure a physiological data of the person, - at least one sensor positioned on the chair for measuring a physical data of the chair, said data being used to estimate information relating to the comfort, to a level of fatigue and / or the gestural efficiency of the person. 2. Device according to claim 1, wherein: - said and at least one sensor carried by the person comprises an electromyographic type sensor (7, 10) for measuring the muscular activity of the person, and a heart rate sensor and respiratory system (8) for measuring the heart and respiratory rate of the person, - said and at least one sensor positioned on the chair comprises an accelerometer (8, 9) for measuring the acceleration of said chair. 3. Device according to any one of claims 1 or 2, wherein the acquisition means further comprises at least one position sensor (11) arranged on the person to measure a plurality of successive positions of the person when a wheelchair trip. 4. Device according to any one of claims 1 to 3, wherein the acquisition means comprise at least one geolocator. 5. Device according to any one of the preceding claims, wherein the acquisition means comprise at least one vibration sensor. 6. Device according to any one of the preceding claims, wherein the acquisition means comprise at least one distance measuring sensor for measuring the distance between the ground and a front wheel of the wheelchair. 7. Device according to one of the preceding claims, wherein the acquisition means comprise at least one load measuring sensor applied to the chair such as a load bearing rear wheel. 35 8. Device according to one of the preceding claims, wherein the acquisition means further comprises at least one gyroscope and / or a magnetometer and / or an inclinometer and / or an angular encoder and / or an altimeter, said gyroscope and and / or magnetometer and / or inclinometer and / or angular encoder and / or altimeter being placed on the wheelchair. 9. Device according to one of the preceding claims, wherein the acquisition means further comprises at least one gyroscope and / or accelerometer, said accelerometer and / or gyroscope being disposed on the person.