KR20130101861A - Vision cue projection system using laser beam and the method thereof - Google Patents

Abstract

PURPOSE: A visual cue projection system using a laser beam and a method thereof are provided to project a proper visual cueing of the walking condition of the patients with severe central nerve injury. CONSTITUTION: A visual cue projection system using a laser beam includes a laser diode and a cylindrical lens. The visual cue projection system improves the walking of a FOG patient by forming a line shaped phase when walking. The visual cue projection system outputs a line inducing or controlling the walking, the thickness of the line, a symbol display, and a character display through the laser diode and the cylindrical lens.

Description

Vision cue projection system using laser beam and the method

The present invention relates to a system for visual cue presentation using a laser beam and a method thereof, and more particularly, to an optical cue presentation system comprising a laser diode and a cylindrical lens. The present invention relates to a visual cue presentation system using a laser beam and a method for improving walking of FOG patients.

High-level gait disorder is a gait disorder caused by abnormalities in the cortex or subcortical structures. Representative examples include freezing of gait (FOG) and festination. FOG refers to an unpredictable pedestrian interruption during walking, with the patient's feet sticking to the ground for 1-10 seconds. Festination refers to a condition in which the stride length is shortened and the cadence is accelerated regardless of the will during walking. Because FOG and accelerated walking are major causes of falls, this greatly reduces the quality of life.

The cause of Parkinson's gait disorder is not clear, and it is reported that the dysfunction of the basal ganglia and motor cortex and psychological and environmental factors work.

Treatment of high-level gait disorders is divided into medication and deep brain stimulation (DBS) treatment. The effects of medication on FOG and accelerated walking are very limited. The typical drug, levodopa, is effective for FOG in the off phase of the drug, but is either none or poor for FOG in the on phase. Is being reported. In addition, FOG occurs most frequently in patients with long medications. Both therapeutic drugs and surgery have very limited effects on FOG and accelerated walking, requiring different therapeutic or training methods.

The effects of medication (levodopa) and surgery are very small in the case of high walking disorders, but the effects of cueing have been found to be effective. Cueing suggests a signal that suggests gait through sensory stimulation to enhance the onset or continuous walking of the patient.

In general, domestic and existing researches have problems. Despite the importance of high-level gait disorders, the following problems occur.

High-level gait disorders, for example, are gait disorders caused by abnormalities in the cortex or subcortical structures, also known as parkinsoinian gait disorders. freezing of gait (FOG) and festination.

Among these, FOG refers to an unpredictable (episodic) walking interruption during walking, which is as if the patient's feet stick to the ground for 1-10 seconds. (Giladi, 1992). These FOGs occur frequently in the beginning of walking, turning, narrow pathways, shortly before arrival at destinations, and worsen in cognitive overloads (Nieuwboer 2008).

In addition, the festination refers to a state in which the stride length is shortened and the cadence is increased regardless of the will while walking, and is also known as a sequence effect or motor instability. have.

The above-described FOG and accelerated walking are a major cause of falls (Bloem 2004), which prevents the patient from living normally.

Therefore, it is common for patients with high walking disorder to be disconnected from society and to live only in the home, which causes a problem of very low quality of life (QOL).

The diseases that cause such high walking disorders are degenerative brain diseases such as Parkinson's disease, Progressive supranuclear palsy, Corticobasal degeneration, and secondary Parkinson's with hydrocephalus. Also included are syndromes and Vascular Parkinsonism.

Parkinson's syndrome is similarly referred to as Parkinsonism (Parkinsonism) or Parkinson's syndrome (Parkinson's syndrome).

In terms of prevalence and mechanism, the prevalence is 780 prevalence in 100,000 people with Parkinson's disease, which is the representative disease of high-level walking disorder, and the prevalence is 1.47% in population over 60 years (Seo WK et al. 2007). .

The FOG occurs in about one half of Parkinson's patients and increases with disease progression, reaching 60% in the more advanced stage.

However, the cause of Parkinson's gait disorder is not clear, and the gradual delay of motor cue from hypokinesia and GPi (internal globus pallidus) from the basal ganglia and motor cortex is associated with FOG and accelerated walking. It is believed to be involved, in addition to psychological and environmental factors (Morris 2008).

In other words, it is estimated that episodic deterioration of the amplitude generation function and the rhythm generation function of the exercise is involved (Nieuwboer 2008, Morris 2008).

As for the treatment of high-level walking disorders, medication has very limited effects on FOG and accelerated walking.

The typical drug, levodopa, is effective for FOG in the off phase of the drug, but is either none or poor for FOG in the on phase. Is being reported.

On-phase FOG has been reported to be associated with pure akinesia, while off-phase FOG has been reported to be closely associated with disease progression (Bartels 2006).

In addition, FOG occurs most frequently in patients with long medication (Giladi 2001). Although deep brain stimulation (DBS) has been proposed for deep brain stimulation (DBS) of the subthalamic nucleus (STN) and pedunculopontine (PPN), STN-DBS responds to levodopa. It is effective only in FOG and its effect is lower than levodopa (Ferraye 2008), and PPN-DBS is only effective in some patients (Ferraye 2009).

Therefore, both drugs and surgery have very limited effects on FOC and accelerated walking, requiring different treatment or training methods.

In addition, the effects of pharmacotherapy (levodopa) and surgery are very small in the case of high-level walking disorders, but the effect of cueing has been found to be effective (Bloem 2004, Nieuwboer 2008).

The cueing suggests a signal suggesting gait through sensory stimulation, and is intended to enhance the onset or continuous gait of the patient. As a modality of the cueing, visual, auditory and somatic senses have been proposed (Kracking). 2003, Nieuwboer 2007).

For visual queuing, parallel lines perpendicular to the walkway (Dietz 1990), inverted sticks (Dietz 1990), laser beam sticks (Bryant 2010), simple flash (Nieuwboer 2007), tile pattern virtual reality (Baram 2010), etc. have been proposed. .

Of these modalities, parallel lines are the only ones that have been proven to improve FOG. 1990, Jiang 2006, Nieuwboer 2008).

Visual cueing with large amounts of information, such as virtual reality, is likely to cause cognitive overload of patients, and in fact, the immediate effect of using virtual reality worsens walking speed and stride length (Baram 2010).

The effect of visual queuing also improves the amplitude generation primarily at the start of walking (Jiang 2006, Nieuwboer 2008).

In auditory and somatosensory queuing, metronome and beep were used for auditory stimulation, and there was a slight improvement in step time variability (Willems 2007).

There was no immediate effect on substantial FOG improvement (Cubo 2004), and the improvement in FOG was negligible through training (Nieuwboer 2007). In other words, auditory queuing mainly aids in rhythm generation, but it is important to be carried out simultaneously with an attentional strategy that intentionally takes a big step (Baker 2008).

Somatosensory is mainly used as a vibrational stimulus, and stimulation only once at the beginning of exercise shows only the effect of levodopa in the off-phase (Burleigh-Jacobs 1997). Somatosensory assists in generating amplitude of motion (Burleigh-Jacobs 1997).

On the other hand, when looking at the problem of queuing for walking disorder, the problem of open-loop queuing is that the problem of FOG improvement is weak, and the open-loop method of presenting queuing such as vision, hearing, and touch in accordance with a predetermined beat. Queuing contributed to increased walking speed and stride length, but did not substantially improve the frequency and severity of FOG (Lim 2005, Niuwuwer 2007: FOG score: 4.2%; FOG-Q: 3.6%, Nieuwboer 2008) .FOG deteriorates in some cases, and in open loop queuing, the actual walking pattern of the patient and the timing of the queuing do not match, and it is difficult to adapt to the queue due to the deterioration of the cognitive function of the patient. Overloading can cause confusion. Indeed, in some patients, open-loop queuing worsens FOG and accelerated walking (Nieuwboer 2006). In addition, beat discrepancies increased gait volatility and instability (McIntosh 1997).

Spatial queuing mainly affects the control and amplitude generation of motion, and is only suitable for the start of motion (Nieuwboer 2008). Temporal queuing is effective only during walking, assisting in the rhythm of walking and symmetry in turning by acting on the timing of walking and the coordination of limb movements (Thaut 2001, Nieuwboer 2008).

As the mode of operation applied according to the modality is different, it is difficult to improve the function across the gait disorder with one modality (Morris 2006, Nieuwboer 2008). In addition, in terms of cosmetics, the patient is very psychologically reluctant to distinguish from the normal person, causing the patient's desire to use when the queuing device has a shape that is largely distinguished from the normal person (virtual glasses, inverted sticks, etc.). It is hard to do, and even when used, the psychological satisfaction is low, which lowers the quality of life.

In terms of convenience, sticks, laser pointers, walkers, etc. are inconvenient to carry and are separated from the body, and thus, patients with weakened cognitive function forget to carry them.

In the case of cognitive overload, if the use of a queuing device deviates from daily operation (sticks, walkers, etc.), or if the presented queue is too complex (virtual reality glasses, etc.), cognitive overload Rather than FOG (Nieuwboer 2008).

The effect of this queuing is significant after long-term training (eg 3 weeks), but the effect is not retained and returns to its original state (Lim 2010, Nieuwboer 2007). It is unreasonable.

In order to solve the above problems, an object of the present invention is to provide a system and method for visual cue presentation using a laser beam for presenting an appropriate cue according to a gait impairment condition in order to improve gait impairment in patients with high-level central gait disorder. There is this.

In addition, an apparatus according to the present invention is composed of a laser diode and a cylindrical lens, it is an object of the present invention to provide a visual cue presentation system and method using a laser beam to project various types of information when walking.

The present invention is composed of a laser diode (cylindrical diode), a cylindrical lens (cylindrical lens), and when walking to form a line (line) phase, to improve the walking of FOG patients.

The laser diode outputs a line, a thickness of a line, a symbol display, and a character display for inducing or suppressing gait through the cylindrical lens.

The laser diode and a cylindrical lens are mounted on a shoe so as to not give a patient a cognitive overload.

When the patient has freezing of gait (FOG), the laser diode and an green cue (encouraging cue) inducing walking through the cylindrical lens are presented.

Often, when festination is performed, a red line (discouraging cue) is provided as a stop signal to prevent walking through the laser diode and the cylindrical lens to prevent a fall.

In the case of the red line (Discouraging cue), the thickness of the line, symbol display, and character display are output through the laser diode and the cylindrical lens.

The line output through the cylindrical lens is thickened and a 'STOP' message indicating a plurality of X marks or stops is output.

In a method using a visual cue presentation system using a laser diode composed of a laser diode and a cylindrical lens, a step of receiving a walking start signal and forming a line-shaped image during walking It is configured to include.

Outputting the laser diode, a line for inducing walking through the cylindrical lens, the thickness of the line, the symbol display, and the character display, and outputting the line, the thickness of the line, the symbol display, and the character display refraining from the walking. It is configured to include.

And mounting the laser diode and a cylindrical lens to the shoe.

And presenting an encouraging cue to induce walking when the patient has freezing of gait (FOG).

Often, the festination includes a step of preventing falling by presenting a red line (discouraging cue) as a stop signal to prevent walking.

The red line includes a step of outputting a thickness, a symbol display, and a character display of the line through the laser diode and the cylindrical lens.

And thickening a line output through the cylindrical lens and outputting a 'STOP' message indicating a plurality of X marks or stops.

According to the present invention, it is possible to present convenient visual cuing according to the walking state of the patients with high-level central injury so that they can enjoy convenient daily life.

1 is a view showing the overall configuration of a system according to an embodiment of the present invention.
2 is a real-time walking state classification algorithm according to the present invention.
3 illustrates a visual cue system in accordance with the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, the present invention will be described in detail with reference to the drawings.

The present invention is preferably composed of a laser diode and a cylindrical lens.

Therefore, it is possible to improve the walking of FOG patients by forming a line-shaped image when walking according to the present invention.

The present invention outputs a line, a thickness of a line, a symbol display, and a character display for inducing or refraining from walking through the laser diode, a cylindrical lens, or the laser diode and a cylindrical lens. It is desirable to apply it so that it does not give the patient a cognitive overload.

The present invention provides a device or system that operates when a patient has freezing of gait (FOG), suggesting a laser diode, an green cue that guides walking through a cylindrical lens, and the like.

In addition, when festination is often performed, a red line (discouraging cue) is prevented from falling by stopping the walking signal through the laser diode and the cylindrical lens.

In addition, in the case of the red line (Discouraging cue), the thickness of the line, the symbol display, and the character display through the laser diode and the cylindrical lens output.

The line output through the cylindrical lens is thickened and a 'STOP' message indicating a plurality of X marks or stops is output.

Hereinafter, a method for practicing the present invention will be described in detail.

The present invention relates to a visual cue presentation system using a laser diode and a laser beam composed of a cylindrical lens, the method comprising receiving a walking disability state signal and a line shape when walking. It includes the step of making a costume.

In addition, the present invention includes the steps of outputting the line, the thickness of the line, the symbol display, and the character display to guide the walk through the laser diode and the cylindrical lens, and the line, the thickness of the line, symbol display, and Encouraging cue that outputs a text display, mounts the laser diode and cylindrical lens on a shoe, or induces walking when a patient has a freezing of gait (FOG) ) Or the red line (discouraging cue) as a stop signal to restrain walking when often festination, or in the case of the red line (Discouraging cue), the line through the laser diode, the cylindrical lens Outputs thickness, symbol display, and character display, or thickens the line output through the cylindrical lens, and indicates a plurality of X marks or stops. It comprises a step of outputting a 'STOP' message.

Example 1

A walking signal measuring system for a senior central gait patient developed by a visual cue presentation system using a laser beam according to an embodiment of the present invention will be described.

In order to measure the walking pattern, a sensor module integrating an accelerometer and a force sensing resistor (FSR) sensor has been developed.

That is, the Acceleromete (1) is a device for measuring the acceleration of the heel and toe using a three-axis acceleration sensor, the FSR sensor (2) is a device for detecting a heel-strike event.

That is, in order to implement a filtering and amplifying circuit according to the present invention, a walking signal measuring system as shown in FIG. 1 was developed.

For example, the information through the Acceleromete 1 and the FSR sensor 2 is filtered and amplified by a filter / amplifier 3, etc., and then passed to the microprocessor 4 to present a visual cue for a walking signal. do.

In other words, such a system is a wearable, unobstructive real-time measurement system that improves the cognitive overload and practicality of the patient. Since the carryover effect of queuing does not exist, the system can be easily applied to daily life without being constrained when worn.

Example 2

In accordance with another embodiment of the present invention, a gait classification recognition algorithm for mounting an intelligent biofeedback queuing system has been developed.

As shown in FIG. 2, the gait variability test of the patient induces natural gait in daily life, and the gait variability of the patient is expected to be high through synchronization with the video camera system for analyzing the gait pattern of the patient. The pattern of the patient walking signal measured through the analysis was analyzed.

The measured pattern of the patient walking signal is an attempt to analyze various walking states such as stable state, normal walking, freezing of walking and acceleration walking in the frequency domain as well as the time domain.

In addition, it is preferable to calculate various parameter values such as time domain (RMS, peak acceleration, peak angular rate) and frequency domain (peak power, total power) according to each walking state.

Specifically, as shown in FIG. 2, through (1) data acquisition and processing (S1, 2, 3), (2) determination of gait status classification threshold (S4, 5), and (3) implementation of FOG and festination classification algorithm Realized.

The data acquisition and processing consists of determining the optimal sampling frequency and the cutoff frequency of the digital filter through residual analysis, and determining the optimum window length and FFT length.

The determination of the gait status classification threshold is expected to determine various thresholds using the analysis parameters of the time domain as well as the frequency domain parameter to recognize each gait state, and there is almost no energy in the resting state. Power spectrum density (PSD) analysis is used to determine the energy threshold to distinguish between resting and walking states, and normal gait is expected to occupy a lower frequency range compared to abnormal gait. The normal gait threshold is determined and when it is lower than that, the normal gait is determined.

Example 3

In the development of a visual cue presentation system using a laser beam according to another embodiment of the present invention, a visual cue is essential for improving amplitude generation when FOG is generated, and a visual effect such as parallel lines is used for effective walking improvement, rather than a flash-like effect. It is necessary to not give cognitive overload to patients absolutely, and to develop a fallback prevention during the occurrence of estination, various cues such as discouraging cues as well as encoding cues are required.

For example, the design of a new concept visual cue presentation system considering cognitive overload has studied the basic design of a system that can effectively improve the FOG. The laser diode and the cylindrical lens form a line-like image when walking. In addition, the system was developed to improve the walking of FOG patients. Therefore, it is expected to be applied conveniently in everyday life without giving the patient cognitive overload when it is attached to shoes, and it was possible to present visual cues using various types of cylindrical lenses.

As shown in FIG. 3, the laser beam passing through the cylindrical lens forms an image in the form of a line.

In addition, by using a variety of existing cylindrical lenses can be obtained an effective image by adjusting the size and width of the line to be presented when walking FOG patients.

In addition, the present invention will propose a visual cue that can improve the FOG using this.

In addition, the present invention proposes two suitable visual cues according to the walking state using the green and red laser diode.

In the case of green (encouraging cue) guidelines are given to provide a starting signal to continuously induce walking in a typical FOG patient, and in the case of red (discouraging cue) a stop signal is often used to suppress walking in the presence of signs of walking. Suggest guidelines to prevent falls.

Therefore, considering the cognitive function of the individual, various types of laser diode, cylindrical lens, and light source combination can present an effective visual cue.

In general, high walking disorders include Parkinson's disease, advanced nuclear palsy, and cerebral cortical degeneration, and secondary Parkinson's syndrome and vascular Parkinson's disease with hydrocephalus. Parkinson's disease, the leading disease of high-level walking disorders, has a prevalence of 780 people per 100,000 people, and the prevalence of people over 60 is 1.47%.

These high-level walking disorders occur in about half of Parkinson's patients and increase with disease progression, accounting for 60% of the more advanced stages. It is expected to increase rapidly with the aging of the population.

Currently, there is a cue presentation system to improve the walking status of patients with high-level central injury, but most of them have a weak or worsening effect on improving walking disorder. The estimated system price of intelligent biofeedback system considering cognitive overload is about 1 million won, so it is thought that it can be purchased without any burden for personal use.

1: Acceleromete
2: FSR sensor
3: filter, amplifier
4: microprocessor

Claims (14)

With laser diode
It is composed of a cylindrical lens (cylindrical lens), a visual cue presentation system using a laser beam characterized in that to form a line-shaped image when walking, for improving the walking of FOG patients. The method of claim 1,
And a line for inducing or restraining walking through the laser diode and a cylindrical lens, a line thickness, a symbol display, and a character display. The method of claim 1,
And a laser diode and a cylindrical lens mounted on a shoe so that the laser diode and a cylindrical lens are applied to the shoe so as not to give a cognitive overload to the patient. The method of claim 3,
And a laser cue (encouraging cue) for instructing walking through the laser diode and a cylindrical lens when the patient has freezing of gait (FOG). The method of claim 3,
When the festination is often performed, the laser diode and the visual cue presentation system using a laser beam to prevent falling by presenting a red line (discouraging cue) as a stop signal to refrain from walking through the cylindrical lens. The method of claim 5,
In the case of the red line (Discouraging cue), the visual cue presentation system using a laser beam, characterized in that for outputting the thickness, symbol display, and character display of the line through the laser diode and the cylindrical lens. The method according to claim 6,
A line for visual cue presentation using a laser beam, characterized by thickening a line output through the cylindrical lens and outputting a 'STOP' message indicating a plurality of X marks or stops. In the method using a visual cue presentation system using a laser diode consisting of a laser diode and a cylindrical lens,
Receiving a walking disability status signal
Steps to form a line-shaped image when walking
Visual cue presentation method using a laser beam, characterized in that comprises a. 9. The method of claim 8,
Outputting the laser diode, a line for inducing walking through the cylindrical lens, the thickness of the line, the symbol display, and the character display;
Outputting a line, a line thickness, a symbol display, and a character display that refrain from walking
Visual cue presentation method using a laser beam, characterized in that comprises a. 9. The method of claim 8,
Mounting the laser diode and a cylindrical lens on a shoe
Visual cue presentation method using a laser beam, characterized in that comprises a. 9. The method of claim 8,
Presenting an encouraging cue to induce walking when the patient has freezing of gait (FOG)
Visual cue presentation method using a laser beam, characterized in that comprises a. 9. The method of claim 8,
When festination is often performed, a red line (discouraging cue) is presented as a stop signal that prevents walking, thereby preventing falls.
Visual cue presentation method using a laser beam, characterized in that comprises a. The method of claim 12,
In the case of the red line (Discouraging cue), outputting the thickness of the line, symbol display, and character display through the laser diode and the cylindrical lens
Visual cue presentation method using a laser beam, characterized in that comprises a. 9. The method of claim 8,
Thickening a line output through the cylindrical lens and outputting a 'STOP' message indicating a plurality of X marks or stops
Visual cue presentation method using a laser beam, characterized in that comprises a.

Images