JP2020508722A - System and method with user interface for monitoring physiotherapy and rehabilitation - Google Patents

Abstract

An object of the present invention is to provide a system including a user interface for monitoring a physiotherapy or rehabilitation of a patient. A system for monitoring a joint of a patient includes a plurality of sensors disposed near the joint for measuring or observing a motion or a physical quantity related to the joint, and an external system coupled to the sensor for receiving data from the sensor and receiving data from the sensor. At least one communication module for transmitting sensor information to the device. The system monitors and displays information obtained from sensors, for example, determines range of motion measurements from sensor data, indicates the progress of physiotherapy, takes pictures or videos of the patient's site, and obtains pain scores However, it also includes patient and clinician devices that can be used to include encouraging friends during physical therapy. [Selection diagram] FIG.

Description

[Cross-reference with related application]
This application claims priority to US Patent Application No. 15 / 422,320, filed February 1, 2017, which is hereby incorporated by reference in its entirety.

  The present invention relates to the field of methods, systems and devices that include a user interface for monitoring physiotherapy or rehabilitation. The present invention also relates to systems and methods that include a user interface for monitoring physiotherapy or rehabilitation after surgery or after implantation of an orthopedic device.

  Artificial joint replacement is a common orthopedic surgery of joints such as the shoulder, hip, knee, ankle and wrist. In situations where the patient suffers from joint wear or damage, the joint can be replaced with an implant that can assimilate into a skeletal structure to restore painless movement and function. Generally, prior to implanting the prosthetic element in a patient's joint, the surgeon resects at least a portion of the patient's autologous bone to form a platform, recess or cavity for receiving at least a portion of the implanted prosthetic element. In the process of implanting the prosthetic element, the muscles and tendons need to be put back in place and reattached.

US Patent Application Publication No. 15/077809 US Patent Application Publication No. 15/077793 US Provisional Patent Application No. 62/136892 US Provisional Patent Application No. 62/136925 U.S. Patent Application Publication No. 15 / 422,312 US Patent Application Publication No. 15/422299

  Patients must undergo physical therapy to recover from this major surgery. Patients must exercise regularly and strive for flexibility and balance of the displaced muscles. The purpose of this is to allow the patient to extend his range of motion, but there may also be a high risk of overturning or overextension leading to implant damage and patient injury. If the patient does not achieve the required range of motion without rehabilitation, the joints will become rigid and additional surgery (MUA-anaesthesia) to achieve sufficient range of motion to maintain an active lifestyle Lower manipulation) may be required. It is difficult to measure or monitor the progress of physiotherapy, but it is very useful for keeping the patient engaged.

  One embodiment is a system for monitoring a patient. The system includes a patient device configured and arranged to communicate with a sensor unit located on or within the patient, the patient device including a display, a camera, a memory, and a display, a camera, and a memory. Coupled to the processor, the processor instructing a user on the display to take a picture or video of the patient's site, and receiving the photo or video upon receiving user input to take the picture or video. It is arranged and prepared to perform operations including taking a video and storing a photo or video in a memory.

  In at least some embodiments, the operation further comprises performing a dye analysis using the photograph or video to assess the health of the patient's site. In at least some embodiments, the operation further comprises generating a visual or audible alert to the patient when the dye analysis indicates a potential infection of the patient's site. In at least some embodiments, the operation further comprises transmitting a message to the clinician device including an indication of a potential infection when the dye analysis indicates a potential infection at the site of the patient.

  In at least some embodiments, the operation further comprises transmitting a photo or video to the clinician device so that the health of the patient's site can be assessed. In at least some embodiments, the photo or video is a video, and the action further includes using the video to evaluate athletic performance. In at least some embodiments, the operation further comprises overlaying one or more lines or angles on the photo or video to represent the position or movement of the patient's limb in the photo or video.

  Another embodiment is a system for monitoring a patient. The system includes a patient device configured and arranged to communicate with a sensor unit located on or within the patient, the patient device comprising a display, a memory, and a processor coupled to the display and the memory. Wherein the processor is configured and arranged to perform an operation comprising: instructing a user to enter a pain score on a display; and transmitting the pain score to a clinician device.

  In at least some embodiments, the act displays on the display a step of receiving an exercise selection by the user, a graphical representation of the exercise, and user controls indicating that the user is performing the exercise when activated by the user. And monitoring the sensor data from the sensor unit to monitor the exercise result when the user control is activated. In at least some embodiments, the operation further comprises, during the performance of the exercise, displaying a number of repetitions of the exercise being performed. In at least some embodiments, the operation further comprises displaying, during the performance of the exercise, either a current range of motion measurement or a maximum achieved range of motion measurement associated with the exercise determined from the sensor data. .

  In at least some embodiments, the act of receiving a request for an exercise summary from a user; displaying a plurality of exercise summary on a display indicating a number of repetitions performed for each exercise over a period of time; Further included. In at least some embodiments, the act of receiving a request for a range of motion measurement progress report from a user and displaying a graph of a plurality of values of the range of motion obtained over a period of time on a display. , Is further included. In at least some embodiments, the operation further comprises displaying, on a display, a representation of a path to a goal indicative of the patient's current progress toward the range of motion measurement goal.

  Another embodiment is a system for monitoring physiotherapy of a patient. The system includes a patient device configured and arranged to communicate with a sensor unit located on or within the patient, the patient device comprising a display, a memory, and a processor coupled to the display and the memory. The processor instructing the user to enter one or more friends on a display, sending a connection message to each of the one or more friends, Or receiving a message from at least one of the two or more friends prompting the patient to continue the physiotherapy.

  In at least some embodiments, the act further comprises sending a message to at least one of the one or more friends in response to the user input. In at least some embodiments, the operation further comprises transmitting a challenge to at least one of the one or more friends in response to the user input. In at least some embodiments, the act of transmitting a progress report to at least one of the one or more friends including an indication of progress toward at least one physiotherapy goal by the patient. In addition. In at least some embodiments, the operation further comprises transmitting to at least one of the one or more friends a progress report including an indication of patient outcome of the at least one physiotherapy exercise. In at least some embodiments, the progress report further includes an indication of the performance of at least one physiotherapy exercise by at least one of the one or more friends.

  Yet another embodiment is a method of performing the operations described for any of the systems described above. A further embodiment is a non-transitory computer-readable medium containing instructions for performing the operations described for any of the systems described above.

  Non-limiting and non-exhaustive embodiments of the present invention will be described with reference to the following drawings. In the drawings, the same parts are designated by the same reference numerals throughout the various figures unless otherwise specified.

  For a better understanding of the present invention, reference is made to the following detailed description taken in conjunction with the accompanying drawings.

1 is a schematic diagram of one embodiment of a system for monitoring patient rehabilitation after implant surgery, in accordance with the present invention. FIG. 2 is a schematic diagram of one embodiment of a computing device used in the system of FIG. 1 according to the present invention. FIG. 4 is a side perspective view of one embodiment of the sensor unit and base detached from each other according to the present invention. FIG. 3B is a side view of the sensor unit and base of FIG. 3A engaged with each other, in accordance with the present invention. FIG. 3B is a top view of the sensor unit and base of FIG. 3A engaged with each other according to the present invention. FIG. 3B is a top view of one embodiment of the sensor unit of FIG. 3A, according to the present invention. FIG. 4B is a side view of the sensor unit of FIG. 4A according to the present invention. FIG. 4B is an exploded view of the sensor unit of FIG. 4A according to the present invention. FIG. 4B is an exploded view of one embodiment of the housing of the sensor unit of FIG. 4A, according to the present invention. FIG. 3 is an illustration of one embodiment of a mobile device user interface displaying a patient or clinician profile in accordance with the present invention. FIG. 4 is a diagram of one embodiment of a user interface of a mobile device displaying information obtained from a sensor unit according to the present invention. FIG. 4 is a diagram of another embodiment of a user interface of a mobile device displaying information obtained from a sensor unit according to the present invention. FIG. 3 is an illustration of one embodiment of a mobile device user interface displaying range of motion measurements in accordance with the present invention. FIG. 3 is an illustration of one embodiment of a mobile device user interface displaying a summary of an athletic repetition according to the present invention. FIG. 4 is a diagram of one embodiment of a user interface of a mobile device displaying information obtained from a sensor unit according to the present invention. FIG. 3 is an illustration of one embodiment of a user interface of a mobile device displaying a selectable video describing exercise in accordance with the present invention. FIG. 4 is an illustration of one embodiment of a mobile device user interface for setting an exercise reminder according to the present invention. FIG. 3 is an embodiment of a user interface of a mobile device displaying information obtained from a sensor unit and a path toward a physiotherapy goal according to the present invention. FIG. 11 is a diagram of yet another embodiment of a user interface of a mobile device displaying information obtained from a sensor unit according to the present invention. FIG. 5 is an illustration of one embodiment of a user interface of a mobile device for setting patient-specific settings of a sensor unit according to the present invention. FIG. 4 is an illustration of one embodiment of a user interface for taking a photo or video according to the present invention. FIG. 7 is a diagram of another embodiment of a user interface for displaying information obtained from a sensor unit according to the present invention. FIG. 4 is a diagram of a further embodiment of a user interface for displaying information obtained from a sensor unit according to the present invention. FIG. 11 is a diagram of yet another embodiment of a user interface for displaying information obtained from a sensor unit according to the present invention. 1 is a flowchart of one embodiment of a method for taking a picture or video of a patient's site according to the present invention. 4 is a flowchart of an embodiment of a pain score input method according to the present invention. 5 is a flowchart of one embodiment of a method for displaying information requested by a patient according to the present invention. 4 is a flowchart of one embodiment of a method for including a friend in physical therapy according to the present invention.

  The present invention relates to the field of methods, systems and devices that include a user interface for monitoring physiotherapy or rehabilitation. The present invention also relates to systems and methods that include a user interface for monitoring physiotherapy or rehabilitation after surgery or after implantation of an orthopedic device.

  The systems described herein can be used to monitor a patient's physiotherapy or healing process or rehabilitation after surgery, as well as to monitor or confirm a patient's range of activity. The system includes one or more sensors that can communicate with the processor, the processor including the patient or another user, such as a clinician, physician, physiotherapist, nurse, care coordinator, or other appropriate person. Information can be generated based on the sensor readings and sensor data that allows the activity of the patient, the condition of the orthopedic implant or surrounding tissue, or the effect of rehabilitation or other therapy to be easily monitored. However, it will be appreciated that the systems, devices and methods described herein may also be used in connection with other surgery or rehabilitation or physiotherapy without surgical intervention. The sensors described below are located near a physiotherapy or rehabilitation site, such as a surgical site or a body part to be rehabilitated.

  The system may also provide an alert if the patient's tissue becomes inflamed or if the physical therapy or rehabilitation therapy is less effective or compatible with these therapies. The system includes a wearable device with one or more sensors. For example, one or more sensors applied to the patient's skin may be provided on the wearable device.

  In at least some embodiments, one or more sensors are in communication with a sensor processor on a device that includes the sensors. In at least some embodiments, the sensor processor, or alternatively or additionally, the sensor is a processor of a patient device such as a mobile phone, tablet or computer, or a clinician device such as a mobile phone, tablet or computer. Communicate with the processor.

  FIG. 1 illustrates one embodiment of a system 100 for monitoring an orthopedic implant and rehabilitation after an orthopedic replacement procedure. System 100 includes one or more sensors 102, an optional sensor processor 104, a patient device 106 (such as a mobile phone, tablet or computer), a clinician device 108, and a network 60. In at least some embodiments, an apparatus in which one or more sensors 102 and preferably a sensor processor 104 (or one or more of a plurality of sensor processors) are applied, for example, to the skin of a patient. Or in a wearable device 112 external to the patient, such as a device worn in a brace or other article or textile worn by the patient. Alternatively, one or more of the sensors 102 and, optionally, a sensor processor can be implanted in the patient. In some embodiments, one or more of the sensors 102 are embedded, and a sensor processor and, optionally, one or more additional sensors are provided in the wearable device.

  Although other embodiments of the system may include fewer or more components than those shown in FIG. 1, typically, the system includes the sensor (s) 102 and the sensor (s) in communication with the sensor (s). A processor (such as sensor processor 104, patient device 106 or clinician device 108) that provides information based on the data. In the illustrated embodiment, wearable device 112 includes sensor 102 and sensor processor 104, but it will be understood that other sensors that are not part of wearable device 112 may be included. For example, one or more additional sensors may be combined in another wearable device, which may also include a sensor processor. Also, in some embodiments, the wearable device 102 may not include the sensor processor 104, or the capability of the sensor processor 104 (eg, without analyzing the sensor readings (or with limited analysis)). It will be appreciated that the sensor readings can also be restricted).

  In FIG. 1, communication between components in at least some embodiments of the system is indicated by solid lines. The dashed line indicates another or further mode of communication between the components. In addition to the communication shown in FIG. 1, in at least some embodiments, the sensor processor 104 or the sensor 102 can also communicate directly with the clinician device. The communication may include, but is not limited to, wireless communication, wired communication, optical communication, ultrasonic communication, or a combination thereof. Non-limiting examples of wireless communications that can be used for communications include satellite communications, cellular communications, Bluetooth, Near Field Communication (NFC), Infrared Data Association Standard (IrDA), Wireless Fidelity (WiFi), and There is Worldwide Interoperability for Microwave Access (WiMAX). Non-limiting examples of wired communications that can be used for communications include Ethernet, Digital Subscriber Line (DSL), Fiber to the Home (FTTH), and Basic Telephone Service (POTS).

  Network 60 may include, but is not limited to, a personal area network (PAN), a local area network (LAN), a metropolitan area network (MAN), a wide area network (WAN), the Internet, or any combination thereof. It can be any suitable type of network, including. In at least some embodiments, a direct connection between components may be bypassed by the network 60. It will be appreciated that the patient device 106 or the clinician device 108 may be connected to other devices, such as a server or server farm, or memory storage device, via the network 60 or directly. For example, the patient device 106 or clinician device 108 may be coupled to a server that stores patient or other medical information, applications, user interfaces or web interfaces, etc. so that the patient device 106 or clinician device 108 can access it. Can be

  The patient device 106 and the clinician device 108 may be a computer (eg, a notebook computer, a mobile medical station or computer, a server, a mainframe computer, or a desktop computer), a mobile device (eg, a mobile phone or smartphone, a personal digital assistant, Or a tablet), or any other suitable device. In at least some embodiments, the clinician device 108 can be incorporated into a medical station or system.

  FIG. 2 illustrates one embodiment of a computer device 201 used as a patient device 106 or a clinician device 108. The computer device 201 includes a processor 214, a memory 216, a display 218, and an input device 220. Computing device 201 may be local to the user, or may include components that are not local to the computer, including one or both of processor 214 or memory 216 (or a portion thereof). For example, in some embodiments, a user can operate a terminal connected to a non-local processor or memory.

  Computing device 201 utilizes any suitable processor 214, including one or more hardware processors, which may be local to the user or non-local to the user or other components of the computer device. be able to. Processor 214 is configured to execute a given instruction. Such instructions can include any of the method or process steps described herein.

  Any suitable memory 216 may be used for computing device 214. Memory 216 represents one type of computer-readable medium, a computer-readable storage medium. A computer-readable storage medium is non-volatile, non-transitory, implemented in any way or technology that stores information, such as, but not limited to, computer-readable instructions, data structures, program modules or other data. It may include target, removable and non-removable computer readable media. Examples of computer readable storage media include RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disk ("DVD") or other optical storage device, magnetic cassette, magnetic tape, magnetic Disk storage or other magnetic storage, or any other medium that can be used to store desired information and that can be accessed by a computer device.

  The communication method provides another type of computer readable medium, a communication medium. Generally, communication media embodies computer readable instructions, data structures, program modules or other data in a modulated data signal such as a carrier wave, data signal or other transport mechanism, and includes any information delivery media. The terms "modulated data signal" and "carrier signal" include signals that have one or more of their characteristics set or changed in such a manner as to encode information, instructions and data in the signal. By way of example, communication media includes wired media such as twisted pair, coaxial cable, fiber optics, waveguides and other wired media, and acoustic, RF, infrared, Bluetooth, near field communication and other wireless media. And wireless media.

  Display 218 may be any suitable display device, such as a monitor, screen, or display, and may include a printer. Input device 220 may be, for example, a keyboard, mouse, touch screen, trackball, joystick, voice recognition system, camera, microphone, or any combination thereof.

  Referring again to FIG. 1, the sensor processor 104 can be any suitable processor, including one or more hardware processors. The sensor processor 104 is configured to execute the given instruction. Sensor processor 104 is configured to receive sensor data from the sensor (s) and communicate with patient device 106, network 60, clinician device 108, or any combination thereof. Optionally, the sensor processor 104 can also process or analyze the sensor data and instructions for performing such processing or analysis, for example, performing any of the processing or analyzing steps described herein. Can be stored. In at least some embodiments, each of the one or more sensors 102 can include a processor that performs some or all of the functions of the sensor processor 104.

  The one or more sensors 102 monitor the orthopedic implant and surrounding tissue, or monitor rehabilitation after orthopedic surgery, whether or not the implant was needed, or provide pre-treatment pre-treatment, Alternatively, it is provided to perform any combination of these. The present disclosure uses an orthopedic knee implant as an example, but other joint implants, such as implants for the shoulder, hip, ankle, wrist or any other joint, or joint replacement, face replacement It will be appreciated that the present invention is applicable to other orthopedic devices such as orthopedic spinal implants, whether surgery, soft tissue reconstruction, debridement, limb correction, ligament replacement, and the like.

  Sensors 102 include, but are not limited to, accelerometers, magnetometers, gyroscopes, proximity sensors, infrared sensors, ultrasonic sensors, thermistors or other temperature sensors, cameras, piezoelectric sensors or other pressure sensors, sonar sensors Any suitable type may be used, including external fluid sensors, skin discoloration sensors, pH sensors or microphones, or any combination thereof. In at least some embodiments, system 100 includes at least one, two, three, four, five, six, or more sensors 102 of different types. The system can include at least one, two, three, four, five, six, eight, ten, or more sensors 102. Further examples of suitable sensors, and their placement and use, can be found in U.S. Patent Application Nos. 15/077809 and 15/077993, and in U.S. Provisional Patent Applications Nos. 62/136892 and 62/136925. , All of which are incorporated herein by reference.

  Using one or more of these sensors 102, one or more aspects, such as an orthopedic device, surrounding tissue, or patient activity, can be measured, monitored, or otherwise observed. Examples of observations or measurements that can be performed or interpreted using one or more of these sensors include steps, repetition of movement, repetition of joint movement (eg, pivoting of a joint), movement being performed. Type or other movement, stability or lack of stability, flexion angle or range of motion, exercise speed, skin temperature, pulse or pulse profile or heart recovery time after activity, ultrasound imaging, flow measurement or Doppler measurement, sonar Imaging, flow or Doppler measurement, pressure or load bearing measurement, detection of lame or body direction (eg, subluxation, posture, scoliosis) or body direction change, monitoring of impact or impact on joints, Such as sleep profile or rest time, gait analysis, or body / limb / joint alignment. The system 100 may observe or measure one or more of these items, or any combination of these items.

  The following provides further details regarding some of these measurements or observations. One or more sensors (eg, accelerometers, gyroscopes, magnetometers or proximity sensors, etc.) count the number of steps or repetitions of movement, or the number of joint movements or other movements felt by the sensors, and It can be used to identify if a type of exercise or movement is taking place. This can be used, for example, to monitor patient activity, monitor compliance with exercise therapy, or monitor for possible signs of pain or other conditions that may hinder or assist rehabilitation. These sensor data can also be used to monitor changes in activity or trends in activity.

  One or more sensors (eg, accelerometers, gyroscopes, magnetometers or proximity sensors, etc.) sense, detect or calculate the range of motion of the sensors, joints or other body parts of the patient, or flexion of the joints. Can also. This can be used, for example, to monitor patient rehabilitation, patient activity, monitor exercise therapy compliance, or monitor for possible signs of pain or other conditions that may hinder or assist rehabilitation. . These or other sensors can be used to monitor the impact or impact on the orthopedic device or on tissue surrounding the orthopedic device. These sensor data can also be used to monitor changes in range of motion or flexion, or trends in range of motion or flexion.

  As another illustrative example, one or more accelerometers can measure acceleration from joint motion. Using the ratio of the measured acceleration between the accelerometers at known distances, the joint motion and range of motion or flexion can be evaluated by calculating the center of rotation around which the device is rotating. This information can be used for the same purpose as described in the above example.

  In another illustrative example, range of motion, operating speed or number of repetitions, etc. can be measured using 1) an accelerometer and 2) a gyroscope or a magnetometer (indicating direction to magnetic north). This information can be used for the same purpose as described in the two examples above.

  In another illustrative example, a single sensor such as an accelerometer, gyroscope or magnetometer may be used to measure or otherwise observe a range of motion, operating speed or number of repetitions. In at least some embodiments, these measurements or other observations may be related to the sensor data and the sensor or sensor data based on, for example, recognition of a pattern of sensor data, or upper and lower bounds of the collected data range. Alternatively, it is obtained using two or more assumptions. Such information can also be used in a manner similar to the three examples above.

  One or more sensors (eg, thermistors or infrared sensors) can sense, detect, or calculate temperature, temperature changes, or temperature trends. This temperature can be skin temperature or ambient temperature. These temperature measurements can be used to indicate, for example, the possibility of inflammation, pain, or another condition that could interfere with rehabilitation or the patient's health. These temperature measurements can also be used to monitor the effectiveness of icing, for example, to help reduce inflammation and promote healing. Additionally or alternatively, these sensors may be used to measure pulse, pulse change, patient pulse propensity, pulse profile, or heart rate recovery after patient activity (such as exercise or other work). Can also be sensed, detected or measured.

  One or more sensors (eg, ultrasonic sensors, sonar sensors, or cameras, etc.) can also sense, detect, or calculate particles, particle densities or particle density trends. These sensors can be used to sense tissue surrounding the orthopedic device or to detect wear or dimensional changes in the orthopedic device or surrounding tissue. Ultrasonic and sonar sensors can also be used to determine how close other parts of the knee (or other joints) are to the implant.

  One or more sensors (eg, piezo, strain gauge, or other pressure or load bearing sensors) may also sense, detect, or calculate the pressure or load on or around the sensor or orthopedic device. These sensor data can be used to monitor changes in pressure or load bearing ranges, or trends in pressure or load bearing. These and other sensors can be used to monitor the impact or impact on the orthopedic device or tissue surrounding the orthopedic device. Pressure or load bearing sensors can also be used to detect swelling of the tissue surrounding the orthopedic implant. Multiple pressure sensors or load bearing sensors can also be used to detect flexion (which can be indicated by uniaxial stretching of tissue) and swelling (which can be indicated by biaxial stretching of tissue).

  U.S. Patent Application Nos. 15/077809 and 15/077993 and U.S. Provisional Patent Applications Nos. 62/136892 and 62/136925 provide sensors for monitoring rehabilitation (including placement of implanted sensors). , Systems, apparatus and methods are described, all of which are incorporated herein by reference. Further examples of sensors and their use are described in Systems and Methods for Monitoring Orthopedic Implants and Rehabilitation Using Wearable Devices, both filed on February 1, 2017 (Systems and Methods using a Wearable Device for). U.S. Patent Application No. 15 / 422,312, entitled "Monitoring an Orthopedic Implant and Rehabilitation", and "Systems and Methods for Monitoring Physical Assistance and Promotion of Monitoring and Rehabilitation". Rice named No. 15 / 422,299, which are also incorporated herein by reference.

  The sensor 102 and any sensor processor 104 may include any suitable power source, including, but not limited to, a primary battery, a rechargeable battery, a storage capacitor or other storage device, or any combination thereof. Can be used to supply power. In some embodiments, movement of the patient's body can be used to generate power for the component or be powered by a kinetic energy source that charges a battery, storage capacitor, or power storage device coupled to the component. . In some embodiments, a wireless power source can be used instead of (or in addition to) a battery, storage capacitor, or other storage device.

  Further, a charging port for charging a battery, a storage capacitor, or another power storage device from a power source such as a wall outlet can be provided. Alternatively or additionally, wireless charging systems and methods may be used. It will be appreciated that in some embodiments, there may be more than one way to power a component or a power storage device associated with the component. The sensors and any sensor processors may all be connected to the same power supply, or some (or all sensors) and the sensor processors may have separate power supplies.

  In at least some embodiments, the sensors and any sensor processors can be active at all times to make measurements, monitor, or otherwise make observations. In other embodiments, one or more sensors and an optional sensor processor may be used to measure, monitor, or otherwise make observations (eg, 15 or 30 seconds, or 1 minute, 5 minutes, 10 minutes, It can operate periodically or randomly (on a cycle of 15 minutes or 30 minutes, or 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, 7 hours or 24 hours). Optionally, this period can be programmable. This cycle can be arbitrarily changed based on data from one or more sensors. In still other embodiments, a sensor module, patient device, clinician device, or other device may manually or automatically activate one or more sensors and any sensor processors. In at least some embodiments, the sensors and any sensor processors may have different (continuous, periodic, random or manual) activation schedules. For example, a sensor that measures temperature is activated periodically, a sensor that measures the number of steps or joint movements is activated continuously, and a sensor that measures the range of motion is a wearable device when the patient performs rehabilitation exercise. It can be activated manually by the device or a clinician device.

  The system and method are described herein with reference to an orthopedic knee implant or other knee surgery. Similar systems and methods can be used for other joints, including but not limited to finger joints, wrist joints, elbow joints, shoulder joints, hip joints, ankle joints or toe joints. These systems and methods can be used to monitor physiotherapy for any reason, including, but not limited to, rehabilitation associated with ligaments or other treatments, including treatments for fracture surgery.

  3A to 3C show an embodiment of the wearable device 312 including the sensor unit 322 and the base 324. As shown in FIG. 3A, the sensor unit 322 can be removed from the base 324. As shown in FIGS. 3B and 3C, wearable device 312 is placed on the patient's skin and base 324 adheres to the skin.

  The base 324 includes a flexible housing shell 326, a magnet 328, an optional opening 330 for a temperature sensor, an optional tab 332, an adhesive disposed on a bottom surface 334 of the shell, and disposed on the shell. And an optional magnet holder 336. When the sensor unit 322 is attached to the base 324, the magnet 328 of the base 324 magnetically attaches to a similar magnet 354 (FIG. 3C) in the sensor unit 322. The magnets 328, 354 are intended to maintain the attachment of the sensor unit to the base 324 during normal activity, exercise and other physiotherapy unless a patient or other person detaches the sensor unit from the base. Optionally, magnet holder 336 houses magnet 328 (entire or peripheral only) and secures magnet to shell 326.

  In at least some embodiments, the shell 326 of the base 324 is sufficiently flexible to adhere to the patient's skin when the patient moves during normal activity or during physiotherapeutic exercise. The shell can be formed of any suitable material, including, but not limited to, a flexible plastic such as silicone or polyurethane.

  The shell 326 can also removably grip the sensor unit 322 to further maintain the attachment of the sensor unit to the base 324. In the illustrated embodiment, shell 326 defines a receiving cavity 338 and has a sidewall 340 around the receiving cavity 338 and a rim 342 around the sidewall. In operation, shell 326 receives a portion of sensor unit 322, as shown in FIGS. 3B and 3C. In some embodiments, the sidewalls 340 or rims 342 are resilient so as to expand when a portion of the sensor unit 322 is received within the cavity 338 and then squeeze the periphery of the received portion of the sensor unit 322. It can be made flexible. Preferably, at least the rim 342 and / or side wall 340 of the base 324 is formed of a material that grips the sensor unit 322, such as by adhesion or compression, or any combination thereof. In at least some embodiments, the sensor unit 322 can have a groove 390 that can receive the rim 342, which further facilitates maintaining the attachment of the sensor unit to the base 324. In at least some embodiments, sidewalls 340 slope outward and downward from rim 342 to form an undercut region below the rim. Similarly, the sensor unit 322 can be formed with a sloped housing that fits within an undercut below the rim 342 of the base 324, which further facilitates maintaining engagement between the sensor unit and the base. Fixing the sensor unit 322 to the base 322 using any other suitable type of mechanical fastener in addition to or instead of these magnets (or magnets and magnetically attracted materials) It will be recognized that it is possible.

  The adhesive can be applied to the base 324 or can be an adhesive that is disposed on both sides of the substrate and attaches one side of the substrate to the base 324. The adhesive is preferably selected so that it is water resistant and does not lose its adhesion on contact with sweat. In at least some embodiments, the base 324, or the adhesive on the base, can be used for at least one day, two days, three days, five days, seven days, under normal use conditions, before changing or reapplying the adhesive. It is intended to be used for 10 days, or 2 weeks, 3 weeks, 4 weeks or more. In at least some embodiments, the adhesive is selected to maintain adherence to the skin when the user takes a shower. In at least some embodiments, the adhesive is selected to maintain adhesion to the skin when the user takes a bath, swims in a pool, or sits in a jacuzzi, hot tub, or rehabilitation pool.

  Optionally, base 324 includes a tab 332 located at any suitable location relative to shell 326. The tab 332 can facilitate removal of the sensor unit 322 from the base 324 by pinching and pushing the tab 332 to deform the shell 326 and release the sensor unit. The operation of the tab 332 for detaching the sensor unit 322 can preferably be performed while maintaining the adhesion of the base 324 to the patient's skin. In some embodiments, manipulation of the tab 332 may also facilitate engagement of the sensor unit 322 with the base 324.

  4A to 4C show an embodiment of the sensor unit 322. FIG. The illustrated sensor unit 322 includes an upper housing 350, a lower housing 352, a magnet 354, an electronics assembly 356, a power supply 358, a light emitting device 360, and an adhesive 362, 364. Also, in some embodiments, as shown in FIG. 4D, the upper housing 350 can include a main housing 366 and a gripping element 368. In some embodiments, the sensor unit 322 can include more or less components than those shown in FIGS. 4A-4D.

  Upper housing 350 and lower housing 352 form a cavity in which at least electronics assembly 356 and power supply 358 reside. Upper housing 350 and lower housing 352 may be formed of any suitable material, such as a metal or plastic material (preferably, a rigid plastic material), or any combination thereof. In at least some embodiments, the upper housing 350 and the lower housing 352, and the junction of the upper and lower housings, prevent water, sweat, rain, and other fluids from entering the housing. It is water resistant. In at least some embodiments, the sensor unit 322 has sufficient water resistance to allow a patient to take a shower without covering the sensor unit. In at least some embodiments, the sensor unit 322 is sufficiently water resistant to allow a patient to bathe or swim without covering the sensor unit.

  Optional gripping element 368 can have a roughened or otherwise non-smooth surface on at least a portion of the gripping element. This non-smooth surface facilitates gripping of the sensor unit 322, particularly for engaging / disengaging the sensor unit with the base 324. In the illustrated embodiment, the gripping element 368 is a separate element that is overmolded, glued, or otherwise attached to the main housing 366. The gripping element 368 can be formed of a different material, such as silicone or polyurethane, which is more flexible than the main housing 366. In other embodiments, the gripping element 368 is formed as part of the main housing 366 by roughening or otherwise roughening at least a portion of the surface of the main housing.

  Magnet 354 is arranged to be magnetically coupled to magnet 328 of base 324. In some embodiments, replacing one of the magnets 354, 328 with a magnetically attractable material that couples to the other magnet 354, 328 and magnetically couples the base 324 to the sensor unit 322. Can be. In the illustrated embodiment, the magnet 354 is attached to the lower housing by an adhesive layer 364, which can be an adhesive layer or adhesive located on both sides of the substrate. In other embodiments, the magnet 354 can be attached to the lower housing 352 by any other suitable method, or can be located in a cavity formed by the upper housing 350 and the lower housing 352. .

  Power supply 358 can be any suitable power supply. For example, power supply 358 can have an expected life of at least 7, 10, 20, 30, 60, 90, 100, 70, 180, or more days under normal use conditions. It can be a primary battery (for example, a battery). In some embodiments, the primary battery can be replaceable. In some embodiments, the power source 358 is connected to the power source 358 using, for example, a recharging port or an inductive recharging device (such as an inductive mat or sleeve), or WiFi, ultrasonic charging, or any other suitable recharging method. Can be recharged. In some embodiments, the primary battery (eg, a battery) can be a magnetically attractive material to which the magnet 328 of the base 324 can be magnetically coupled.

  Electronics assembly 356 may include any components suitable for operation of sensor unit 322. In the illustrated embodiment, electronics assembly 356 includes a circuit board 368, a sensor processor 304, a temperature sensor 370, an accelerometer 372, at least one LED 374, a communication device 376, and a magnetic switch 378. The circuit board 368 can be bonded to the lower housing 352 by an adhesive 362. Circuit boards or other components may be coupled to the upper housing 350 by other adhesives (not shown).

  The sensor processor 304 can be similar to the sensor processor 104 described above and can have more or less capabilities than the sensor processor 104. In some embodiments, the sensor processor 304 can include an analysis algorithm for performing an analysis or partial analysis of the sensor data. In other embodiments, the sensor processor 304 can be designed primarily to receive, store, and transmit sensor data.

  Although the illustrated sensor unit 322 includes a temperature sensor 370 and an accelerometer 372, as described above, other embodiments can include more or different sensors in any suitable combination. In the illustrated embodiment, the temperature sensor 370 is a thermistor extending away from the circuit board 368 through an opening 366 in the lower housing 352. When the sensor unit 322 is engaged with the base 324, a portion of the temperature sensor 370 extends through the opening 330 in the base 324 so that the temperature sensor 370 can be exposed to and contact the patient's skin.

  As described above, communication device 376 operates with sensor processor 304 to communicate with a patient or clinician device or other device. Any suitable communication method or protocol may be used, including, but not limited to, WiFi, Bluetooth, short-range wireless communication, infrared, radio frequency, acoustic, optical, and the like.

  In some embodiments, a reed switch (reed) coupled to the sensor processor 304 to activate the electronics assembly 356 when placed near the magnet 328 of the base 324 to put the sensor unit 322 into an operating mode. switch). In at least some embodiments, removing the sensor unit 322 from the base 324 activates a magnetic switch to place the sensor in a non-active mode or a standby mode. Alternatively or additionally, the sensor unit 322 may be used to put the sensor into an active mode, or a non-active mode or a standby mode, or to switch modes, or to turn the sensor unit on or off. Buttons, mechanical switches or other mechanisms. Alternatively, or in addition, the sensor unit 322 may be configured to enter one of these modes using signals from a patient or clinician device or other device in communication with the sensor unit 322. It can also be set (or the mode is switched). In at least some embodiments, sensor unit 322 can continue to receive signals from an external source (such as a patient device or clinician device) in a non-active mode or a standby mode. In at least some embodiments, sensor unit 322 also maintains an internal clock in a non-active mode or a standby mode.

  At least one LED 374 is coupled to the light emitting device 360 to provide light to the light emitting device. In at least some embodiments, light emitting device 360 includes light emitter 380 and light guide 382 that directs light from the LED (s) to the light emitter. Light emitting device 360 provides a user or patient with operating indicators of the device. For example, when the sensor unit 322 is operating or is in an operation mode, the light emitting device 360 can be turned on. In some embodiments, the color of the light emitted by the light emitting device is the mode in which the sensor unit is currently active (active or inactive / standby), or the action the sensor unit is performing (e.g., transmitting, sensing, Non-sensing, or synchronized with a patient or clinician device). In some embodiments, instead of or in addition to color, flashing light or brightness of light may be used to indicate the mode or operation. As an example, a blinking blue light may indicate synchronization with a patient or clinician device, a green light may indicate an active mode, and when not lit may indicate a non-active / standby mode.

  U.S. Patent Applications Nos. 15/077809 and 15/077993 and U.S. Provisional Application Nos. 62/136892 and 62/136925 can be incorporated into wearable devices and sensor units described herein. Additional features and devices have been described, all of which are hereby incorporated by reference. These patent applications also describe other wearable or embedded devices that can be used in the methods and systems described herein.

  In some embodiments, a second sensor unit can be used. For example, the second sensor unit can be located on the same leg or on the other side of the joint in the leg. As another example, the second sensor unit may be located on the other leg for use in detecting or observing lameness or other gait disturbance, or may be located on the torso so that body orientation can be detected or observed. You can also. Also, using a second sensor unit (or additional sensor units) when two or more replacements, including, for example, multiple joint or vertebral replacements, are implanted in the body, for example, subluxation, postural changes Or, deficiencies, or scoliosis, etc. can be detected or observed.

  These two sensor units can optionally communicate or synchronize with each other. In at least some embodiments, the two sensor units can be synchronized with each other to know where they are in space and their positions in terms of distance and orientation. As an example, the two sensor units can triangulate their position using a patient device or a clinician device. In at least some embodiments, a notification is provided to the patient device or the other sensor unit when one sensor unit is replaced or removed from its base. When the sensor unit is reattached to the base or a new sensor unit is attached to the base, the system can determine the position or distance of the new sensor unit relative to the other sensor unit.

  The sensors in the two sensor units can be used to measure bending angles, range of motion, calculate vectors, angles, rays, planes or distances, and the like. Temperature sensors on the two sensor units can be used to determine the temperature difference between two parts of the body. The sensors of the two sensor units are used to calculate angles or other information that can be used to send a signal to the patient during physiotherapy or rehabilitation if the patient has exceeded the limits of range of motion. be able to.

  As described above, the sensor processor or sensor can communicate with the patient or clinician device to provide sensor data or information derived from the sensor data. The patient device can be a dedicated device or an application on a smartphone, tablet, laptop or desktop computer, a web or cloud application, or any other suitable configuration. Communication between the implantable or wearable sensor unit and the patient or clinician device can occur at predetermined times (eg, every 30 minutes, every hour, or once a day). In this way, the sensor unit can be synchronized with the patient device or the clinician device. Similarly, the patient device may periodically synchronize with the clinician device. In some embodiments, if the sensor unit or patient device detects a situation that requires an alert (such as a decrease or increase in temperature), the sensor unit or patient device may respond to the patient device or the Each may communicate (or attempt to communicate) with a medical device.

  Alternatively or additionally, communication between the sensor unit and the patient or clinician device may be periodic or nearly periodic (eg, every 1 second, 5 seconds, 10 seconds, 30 seconds). Every once or every 60 seconds). For example, if the sensor unit determines that the patient is exercising, or indicates that the patient intends to begin exercising, or otherwise desires communication or synchronization between the sensor unit and the patient device. If the patient manually activates the controls on the indicated patient device or sensor unit, periodic or near-periodic communication can be established.

  5-16 are screen shots of one embodiment of a patient device or clinician device application or user interface. The illustrated application or user interface is particularly useful for mobile devices such as smartphones or tablets, but can also be used with other devices such as desktop or laptop computers. FIG. 5 illustrates one embodiment of a patient or clinician profile of an application or user interface. Elements on this page include, but are not limited to, patient or clinician information, the wearable device identification number or other identification so that the wearable device can be synchronized or otherwise connected to the patient or clinician device. Controls for entering information, entering or changing a password, or entering or accessing application settings, accessing a calibration program to calibrate a wearable device, or one or more. Other features or controls for accessing the page, and the like. Other information that can be presented on this or another page includes, but is not limited to, controls for account creation or account login, or instructions on the status of the wearable device, or help information, FAQs, It can include controls to access photos, videos or text to give instructions on how to apply the wearable device, how to care for surgical wounds, how to perform certain exercises, or how to program or operate the wearable device. .

  FIG. 6 shows another page of a user interface or application that provides information such as steps per day (or number of exercise repetitions) and temperature readings as shown in section 592. As shown in FIG. 6, the user interface 590 can also include a portion 594 showing a graph of data such as steps per hour. In the illustrated user interface, the user may also select from other charts such as exercise history (represented as "ROM"), temperature or temperature trend, and impact or number of impacts on the sensor module. It will be appreciated that other measurements or observations from the sensors described above may be graphed. In at least some embodiments, the user may also select a data display period for the graph, such as, for example, minutes, hours, days, or weeks.

  This user interface can be useful in monitoring patient activity and progress. The graph in section 594 may be useful to show the patient's exercise history and progress. In some embodiments, the user can use the user interface to, for example, repeat steps or exercise over a specific period of time (eg, 1 hour, 2 hours, 4 hours, 6 hours or 7 hours, or 1 day or 1 week). A goal such as the number of times can be set. The user interface may also display the current status of achieving these goals. The user interface can also highlight important events such as, for example, maximum steps or maximum number of exercise repetitions, increased temperature readings, impact or increased impact. The user interface may also highlight achievement of the goal.

  FIG. 7 illustrates another page of a user interface or application that displays information related to a particular patient measurement that can be tracked to monitor rehabilitation or physiotherapy. In the illustrated page, the patient measurements are flexion and extension with respect to the patient's knee. These patient measurements can include, but are not limited to, range of motion measurements such as flexion and extension. This page also shows a chart 596 that tracks the progress of these measurements. Progress can be tracked hourly, daily, weekly, or over any other time period. In some embodiments, a user can select or change the time period shown in the chart via a user interface or application. The page of FIG. 7 also provides information about other measurements, such as percentage of exercise completed, skin temperature or steps.

  FIG. 8 shows another page where a user interface or application can be instructed to calculate or otherwise determine a particular measurement. In the illustrated example, the measured value is the femoral angle.

  FIG. 9 shows another page where the user interface or application tracks daily exercise programs. In the illustrated embodiment, the exercises are sitting lift, heel slide (hip and knee flexion), lower limb extension fist up and neat chest. Other exercises include, but are not limited to, standing lift, ankle pump, ankle circle, thigh squeeze (quadriceps set), supine kick (short arc quadriceps), knee bending (seated knee) Flexion), prolonged knee stretching, sitting kick (long quads), knee extension stretching, knee dangling / swinging, hamstring set (heel dig), buttocks squeeze (buttock set), walking, etc. it can. These exercises are intended for knee rehabilitation. Of course, rehabilitation or physiotherapy of other joints or body regions may involve different sets of exercise. The page also shows the percentage complete for each iteration set (3 in this case) that the patient should perform.

  FIG. 10 shows yet another page containing one exercise. This page shows current measurements related to exercise (flexion and extension in this example). This page also indicates how to perform the exercise, and may include controls for the patient to indicate that exercise is to begin. In some embodiments, this page may also indicate the number of repetitions (or additional repetitions needed to achieve the repetition goal) when the patient exercises. The page may also show exercise-based patient measurements (eg, the current measurement of the last iteration, the average measurement of the current iteration set, or the maximum measurement of the iteration set), and measurement goals. The page may also include a meter that includes a bar or the like that indicates which portion of the exercise goal has been met. The indication (such as a bar) may also indicate which portion of the range of motion or other treatment goal has been met. In some embodiments, the page may also display the average patient time to range of motion goal, etc. to motivate the patient.

  FIG. 11 shows a page that includes controls for accessing a video that can show the patient how to perform the exercise. FIG. 12 shows a page on which the patient can set a reminder to exercise. The patient can set a reminder time and also set a visual or audible alarm that reminds the patient to exercise at the specified time.

  FIG. 13 shows a page that displays how much the physiotherapy or rehabilitation of the patient has progressed. The distances and milestones included in this display may be the time of rehabilitation (eg, days or weeks), anthropometric measurements (eg, flexion or extension) towards the final anthropometric goal, the number of completed repetitions, or the athletic goal. May be based on completion of one or more exercises towards As shown in FIG. 13, the page may also include a graph of measurements (similar to FIG. 7) or number of repetitions, or any other relevant information.

  FIG. 14 shows a clinician device that displays information about a group of patients, such as the number or percentage of patients who have completed exercise or other goals, the number or percentage of patients who have reached a particular range of motion or other measurement goal. Page.

  FIG. 15 shows a page of a patient device or a clinician device in which settings for a patient can be input or changed. Such settings can include, for example, which exercises to perform, the number of repetitions for each exercise, the number of repetition sets for each exercise per day, and the number of steps per day. This page can include controls to allow changing these settings. These settings can also be associated with a particular rehabilitation or physiotherapy stage, as shown in FIG. On this page, you can switch between the different stages and check, enter, or change the settings for that stage. Another page on the patient device or clinician device may display the actual results achieved by the patient and compare it to the patient's entered settings or goals.

  FIG. 22 illustrates one embodiment of a method for displaying information requested by a patient. At step 2202, the patient device receives input from the patient for displaying exercise or other information. In step 2204, the patient device displays the requested information. For example, the information requested may be a graphical representation of the exercise and user controls indicating that the user is performing the exercise when actuated by the user. FIG. 10 shows an example of such required information. The required information can be a summary of multiple exercises indicating the number of repetitions of the exercise being performed or the number of repetitions of each exercise performed over a period of time. FIGS. 7, 9, 13 and 14 show examples of such required information. The required information may be a progress report of the range of motion measurement or a graph of range of motion measurements obtained over a period of time. FIGS. 7, 13 and 14 show examples of such required information. The required information may also be a representation of the path to the goal, for example, as shown in FIG. 13, indicating the patient's current progress toward the goal of range of motion measurements.

  FIG. 16 shows another page instructing the patient to take a photo or video of the patient's knee or other wound site or physiotherapy site using the camera of the patient device or other device. This page can instruct the user on how to compose the photo or video. In at least some embodiments, these photos or videos may be transmitted to a clinician or other device over a network (see FIG. 1) or by other methods. The clinician can use these photos or videos to evaluate the wound site or physiotherapy site. In some embodiments, the patient device may request to take a video of the patient performing the exercise. This video can be provided to a patient or clinician device to evaluate or observe athletic performance. For example, a clinician can assess whether a patient is exercising correctly, or assess the progress of physiotherapy or rehabilitation by observing the exercise.

  In some embodiments, a patient device is configured and arranged to perform a knee pigmentation or other wound analysis using photographs or videos. For example, the patient device may compare skin pigment at the wound site with skin pigment near the wound site to identify an infection (eg, superficial or deep wound infection), rash, discoloration or other problem. it can. In at least some embodiments, dye analysis or other wound analysis may be combined with skin temperature information to assess infection (eg, superficial or deep wound infection), rash, discoloration, or other problems. it can. If the analysis indicates a potential or practical problem, the patient device may also provide a visual or audible alert to the patient and send an alert to the clinician device. In other embodiments, instead of (or in addition to) the patient device, the clinician device or other device (with or without skin temperature information) may perform the pigment analysis or other wound analysis. it can. The patient or clinician device may include a white balance or light correction algorithm to evaluate the photo or video. The patient device may also include a calibration tool that facilitates calibration of photographic or video light and other aspects.

  In some embodiments, instead of, or in addition to, taking a picture or video, the patient device may display an area where the patient is pointing the camera for viewing. This display area, or photograph or video, can be modified to overlay lines or figures corresponding to the patient's anatomy. These lines or figures may move as the patient's legs or other body parts move. In some embodiments, patient measurements, such as flexion or extension, or other range of motion measurements, during movement can be calculated and displayed on the patient device and changed as the patient's limbs move.

  FIG. 20 illustrates one embodiment of a method for taking a picture or video of a patient's site. In step 2002, the patient device (or clinician device, other device or person) instructs the patient to take a picture or video of the site (such as a physiotherapy site, a surgical site or a wound site). In step 2004, the patient captures and saves a photo or video using the patient device's camera (or another device's camera). In some embodiments, at an optional step 2006, the photos or videos are transmitted to a clinician or other device. At step 2008, a photo or video analysis may be performed. The analysis may be performed by a patient device, a clinician device, or any other suitable device. For example, a dye analysis or an analysis relating to motion or range of motion measurements can be performed. In some embodiments, a graphical representation, such as a line or angle, can be superimposed on the photo or video based on the analysis.

  The patient device, user interface or application may also include other features. For example, a patient device, user interface or application may describe how a patient associates his or her hospital experience, rehabilitation experience, patient fee during the rehabilitation process, or wearable device or other treatment aspect to a family member or friend. Controls for entering information or ratings about whether to recommend or not. The patient device, user interface or application may also include controls for entering an assessment regarding pain or other clinical aspects. For example, the patient can enter a pain score based on a scale provided on the device. Other scores that can be entered by the patient, clinician or other person include Knee Society score, New Knee Science score, other academic scores, KOSS or PROM (patient reported outcome measures), Oxford knee score Or a score such as Womack, or any other suitable score or rating.

  FIG. 21 illustrates one embodiment of a method for entering a pain score. At step 2102, the patient device instructs the user to enter a pain score and receives the pain score. At step 2104, the pain score is sent to a clinician or other device.

  The patient device, user interface or application may include controls for adding friends, forming a friend network, sending messages to friends, updating progress or sending other athletic information to friends or other people, etc. Can be. Some of the friends may be other patients, and the patient device, user interface, or application displays a comparison of progress with the friend, allows the issuance of a challenge to the friend, and sends encouragement to the friend Controls, or other social controls or interaction features. Other applications may also be made available to the patient's family, friends, and colleagues. The application may allow the user to send encouragement or messages to the patient, and may also display progress updates or other athletic information permitted by the patient. These applications and features can help encourage patients to continue their efforts toward physical therapy or rehabilitation goals and objectives.

  FIG. 23 illustrates one embodiment of a method for including a friend in physical therapy. At step 2302, the patient is instructed to enter one or more friends into the patient device. At step 2304, a connect message is sent to one or more friends to connect those friends to the patient's friend network. At step 2306, the patient receives an encouragement message from at least one of one or more friends. In optional step 2308, the patient sends a message, challenge or progress report to at least one of the one or more friends. The progress report may be, for example, an indicator of progress toward at least one physiotherapy goal by the patient, an indicator of the outcome of at least one physiotherapy exercise by the patient, or at least one of at least one of one or more friends. It may include an indicator of the performance of one physiotherapy exercise, or the like, or any combination thereof.

  FIG. 17 illustrates a user interface 1390 that may be suitable for a computer or web interface. The illustrated user interface includes an area 692 that displays the results of temperature measurements 692a, step measurements 692b, range of motion tests 692c, specific exercises and tests 692d, and adverse events 692e. These results can include numerical and graphical information. These results may indicate graphically or numerically the success of the exercise execution (see, for example, region 692d), as well as the degree of adherence to rehabilitation activities (such as the number of exercise repetitions performed). Such an arrangement of information may facilitate monitoring patient progress, identifying progress or under-progress, identifying concerns (such as increased temperature, or increased number of shocks or impacts), and the like.

  Other information that can be displayed on one or more pages of the user interface can include any suitable patient rehabilitation progress data, including baseline and progress over time. For example, this information can include baseline range of motion information for exercises such as sitting leg lift, heel slide, standing lift, prone lift, and the like. This information may also include current range of motion information for these exercises. This information should include, but is not limited to, gait analysis information including, but not limited to, pre- and post-operative mean gait, maximal gait, stride angle, and time spent walking, biking, running or sitting. Can also. Additional information can include skin temperature, environmental temperature and temperature trends. The user interface may also provide information about the number or frequency of falls of the patient, or other important events. The user interface may also provide information from GPS readings on the wearable or patient device to assess baseline activity, current activity, general activity after surgery or physical therapy, and the like.

  The in-hospital range of motion test can also be performed using the user interface of the clinician device. A clinician or patient device can also be used to create a video of range of motion.

  FIG. 18 shows a user interface 790 for a clinician to monitor multiple patients. Area 792 includes information such as patient name, date of surgery, sensor data and test results 792a, number of adverse events, and location of the orthopedic implant. The clinician may determine the number of surgeries 794, rehabilitation success rate 796, and total number of surgeries (eg, total knee replacements), average time to reach a particular rehabilitation outcome (eg, average time to reach a specified range of motion). Other suitable information can also be tracked.

  FIG. 19 illustrates another user interface for a clinician to monitor a patient. Area 892 includes information such as the patient's name, gender, date of surgery, number of days after surgery, measured temperature or trend, range of motion measurements, activity, steps, important events, implantation sites, and wearable device status. The clinician can also track the number of successful rehabilitations 894, range of motion 896 achieved over time for a group of patients, and other suitable information. Controls may be provided for access to individual patient records 898, access to patient alerts 899.

  In at least some embodiments, the application or user interface described herein can be a web or application interface that a patient device or clinician device can access when accessing a content provider's server. In at least some embodiments, a server or other server or memory storage stores information for the web interface and patient identification data, sensor data, or information derived from sensor data, patient or clinical information. Patient-specific information may also be stored, including physician comments, or any other suitable data. In at least some embodiments, patient-specific information can be accessed from a patient device, a clinician device, or other device, and in some embodiments, authentication information (eg, user Name or password, or both).

  Additional user interfaces and methods for calculating or otherwise determining information regarding physiotherapy, rehabilitation, or the condition of a patient are described in “Applications for Orthopedic Implants and Wearable Devices Using a Wearable Device,” filed February 1, 2017. A system and method for monitoring rehabilitation (Systems and Methods using a Wearable Device for Monitoring an Orthopedic Implant and Rehabilitation) and a system for monitoring rehabilitation. And Methods (Systems and Methods for Monitoring Physical) herapy and Rehabilitation of Joints) "is described in U.S. Patent Application No. 15/422299 entitled, these references are incorporated herein by reference.

  The methods and systems described herein may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Accordingly, the methods and systems described herein may take the form of an entirely hardware embodiment, an entirely software embodiment or an embodiment combining software and hardware aspects. The systems referred to herein typically include memory and typically include methods for communicating with other devices, including mobile devices. Communication methods can include both wired and wireless (eg, RF, optical, or infrared) communication methods, which provide another type of computer readable medium, ie, a communication medium. Wired communications may include communications over twisted pairs, coaxial cables, optical fibers or waveguides, etc., or any combination thereof. The wireless communication may include RF, infrared, acoustic, short-range wireless communication or Bluetooth®, etc., or any combination thereof.

  It will be understood that each block of the flowchart illustrations disclosed herein, and combinations of blocks in the flowchart illustrations and methods, can be implemented by computer program instructions. Providing these program instructions to a processor to produce a machine causes the instructions executed on the processor to create a means for performing the operations depicted in one or more of the flowchart blocks of the flow diagrams disclosed herein. Can be made. These computer program instructions may be executed by a processor such that the sequence of operating steps performed by the processor creates a computer-executed process. These computer program instructions may also cause at least some of the operating steps to be performed simultaneously. Further, some of the steps may be performed across multiple processors, such as is done in a multi-processor computer system. Also, one or more processes may be performed simultaneously with other processes or in an order different from that shown, without departing from the scope or spirit of the invention.

  Computer program instructions include, but are not limited to, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disk ("DVD") or other optical storage device, magnetic cassette Storing on any suitable computer readable storage medium, including magnetic tape, magnetic disk storage or other magnetic storage, or any other medium that can be used to store the desired information and accessible by the computer device be able to.

  The above specification illustrates the manufacture and use of the invention. Many embodiments of the invention can be made without departing from the spirit and scope of the invention, and the invention is thus subject to the appended claims.

Claims (20)

A system for monitoring a patient,
A display, a camera, a memory, and a processor coupled to the display, the camera, and the memory, wherein the processor is configured and configured to communicate with a sensor unit disposed on or within the patient. Having a patient device,
The processor comprises:
Instructing a user on the display to take a picture or video of the patient's site;
Taking the picture or video upon receiving user input for taking the picture or video;
Storing the photo or video in a memory;
A system configured and arranged to perform an operation comprising:   The system of claim 1, wherein the operation further comprises performing a dye analysis using the photograph or video to assess the health of the site of the patient.   3. The system of claim 2, wherein the action further comprises generating a visual or audible alert to the patient when the dye analysis indicates a potential infection of the site of the patient.   The system of claim 2, wherein the action further comprises sending a message to the clinician device including an indication of the potential infection when the dye analysis indicates a potential infection of the site of the patient. .   The system of claim 1, wherein the action further comprises transmitting the photo or video to a clinician device so that a health status of the site of the patient can be assessed.   The system of claim 1, wherein the photo or video is a video, and the action further comprises using the video to evaluate athletic performance.   The method of claim 1, wherein the action further comprises overlaying one or more lines or angles on the photo or video to represent the position or movement of the patient's limb in the photo or video. The described system. A system for monitoring a patient,
A patient device comprising a display, a memory, and a processor coupled to the display and the memory, the patient device configured and arranged to communicate with a sensor unit disposed on or within the patient;
The processor comprises:
Instructing the user to enter a pain score on the display;
Transmitting the pain score to a clinician device;
A system configured and arranged to perform an operation comprising: The operation is
Receiving an exercise selection by the user;
Displaying, on the display, a graphical representation of the exercise and a user control indicating that the user is performing the exercise when activated by the user;
Monitoring the sensor data from the sensor unit to monitor the outcome of the exercise when the user control is activated;
The system of claim 8, further comprising:   The system of claim 9, wherein the action further comprises, during the performance of the exercise, displaying a number of repetitions of the active exercise.   The operation may further include displaying either a current range of motion measurement or a maximum achieved range of motion measurement associated with the exercise determined from the sensor data during the performance of the exercise. 10. The system according to 9. The operation is
Receiving a request for an exercise summary from the user;
Displaying on the display a summary of a plurality of exercises indicating the number of repetitions performed for each exercise over a period of time;
The system of claim 9, further comprising: The operation is
Receiving a request for a range of motion measurement progress report from the user;
Displaying a graph of the plurality of values of the range of motion measurement obtained over a period of time on the display;
The system of claim 9, further comprising:   14. The system of claim 13, wherein the operation further comprises displaying on the display a representation of a path to the goal indicative of the patient's current progress toward the range of motion goal. A system for monitoring physiotherapy of a patient,
A patient device comprising a display, a memory, and a processor coupled to the display and the memory, the patient device configured and arranged to communicate with a sensor unit disposed on or within the patient;
The processor comprises:
Instructing a user to enter one or more friends on the display;
Sending a connection message to each of the one or more friends;
Receiving from at least one of the one or more friends a message prompting the patient to continue the physical therapy;
A system configured and arranged to perform an operation comprising:   The system of claim 15, wherein the action further comprises sending a message to at least one of the one or more friends in response to user input.   The system of claim 15, wherein the action further comprises transmitting a challenge to at least one of the one or more friends in response to user input.   The operation may further include transmitting, to at least one of the one or more friends, a progress report including an indication of progress toward at least one physiotherapy goal by the patient. The system according to item 15,   16. The method of claim 15, wherein the operation further comprises transmitting to at least one of the one or more friends a progress report including an indication of at least one physiotherapy exercise patient outcome. system.   20. The system of claim 19, wherein the progress report further comprises an indication of the outcome of the at least one physiotherapy exercise by at least one of the one or more friends.

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