WO2002076293A1 - Systeme de monitorage physiologique combine - Google Patents

Systeme de monitorage physiologique combine Download PDF

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Publication number
WO2002076293A1
WO2002076293A1 PCT/US2001/009418 US0109418W WO02076293A1 WO 2002076293 A1 WO2002076293 A1 WO 2002076293A1 US 0109418 W US0109418 W US 0109418W WO 02076293 A1 WO02076293 A1 WO 02076293A1
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WIPO (PCT)
Prior art keywords
circuit
signal
cpms
person
specified
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PCT/US2001/009418
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English (en)
Inventor
Maryrose Cusimano
Scott J. Zeff
Original Assignee
Maryrose Cusimano
Zeff Scott J
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Application filed by Maryrose Cusimano, Zeff Scott J filed Critical Maryrose Cusimano
Priority to PCT/US2001/009418 priority Critical patent/WO2002076293A1/fr
Priority to US10/002,942 priority patent/US6678549B2/en
Publication of WO2002076293A1 publication Critical patent/WO2002076293A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1121—Determining geometric values, e.g. centre of rotation or angular range of movement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
    • A61B5/224—Measuring muscular strength
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/389—Electromyography [EMG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
    • A61B5/4041—Evaluating nerves condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/024—Detecting, measuring or recording pulse rate or heart rate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/276—Protection against electrode failure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]

Definitions

  • the invention pertains to the general field of electro-diagnostic systems and more particularly to a system which monitors muscles in various ranges of motion such as lifting, pulling, pushing, gripping and inching while simultaneously monitoring physiological functions such as temperature, heart rate and skin response.
  • Range of motion testing is often relied upon to determine the cause, yet measuring the muscle activity during range of motion testing is difficult.
  • the extent to which a patient exerts him or herself also presents a subjective bias. If muscle activity could be recorded during range of motion testing, the extent to which the muscles or muscle groups are activated and to what degree would provide helpful information about the nature of the soft tissue injury.
  • the Mayo clinic confirmed in their studies on sagittal gait patterns and knee joint functions that static measurements do not correlate well with true functional assessment of movement. As part of their conclusions, they recommended the use of functional assessments as a routine diagnostic tool in a similar manner as an electrocardiogram (EKG). In this setting, the use of tests like magnetic resonance imaging (MRI) or X-rays are of little use, since they are static tests and not specifically designed to evaluate soft tissue damage and the subsequent change in function. Therefore, there is a growing need within the medical, insurance and industrial communities for an objective analysis of biomechanics on a functional level. Myofacial injuries represent a significant medical problem, with back pain accounting for a large number of medical visits.
  • MRI magnetic resonance imaging
  • X-rays X-rays
  • GTS carpal tunnel syndrome
  • RSI repetitive stress injuries
  • the inventive combined physiological monitoring system solves many of the above problems on data gathering by combining up to 32 channels of proprietary surface EMG, UP to 12 range of motion channels, two FOE sensors and a grip strength. There is also room for at least two cables of electromyography (EMG).
  • EMG electromyography
  • the CPMS also combines two channels of nerve conduction velocity ( NGN ) to apply a current to monitor ⁇ CV with temperature control and pre-set electrodes.
  • NGN nerve conduction velocity
  • the CPMS can also be designed to operate with utility power or to be battery operated to allow an individual to be monitored anywhere, including the worksite.
  • the 5,513,651 and 5,462,065 patents disclose an integrated movement analyzing system that utilizes surface electromyography in combination with range of motion and functional capacity testing to monitor muscle groups in the human body.
  • the system consists of an integrated movement analyzer (IMA) that receives inputs from surface EMG electrodes, a range of motion arm (ROMA), and a functional capacity sensor.
  • IMA integrated movement analyzer
  • ROMA range of motion arm
  • the ROMA is connected between the patient's upper back and lower back by a shoulder harness and a waist belt.
  • the ROMA is connected between the patient's head and upper back by a cervical cap and the shoulder harness.
  • the output of the IMA is provided via an analog to digital converter to a computer.
  • the computer in combination with a software program produces an output consisting of comparative analytical data.
  • the 5,042,505 patent discloses an electronic device for measuring relative angular positional displacement and angular range of motion for body segments and articulating joints of the human skeleton.
  • the device has a hand-held interface unit which is placed against the body segment or joint to be tested.
  • Mounted within the housing of the interface unit is a shaft with a pendulum at one end and an optical encoder at the other.
  • the pendulum swings in the direction of gravity, causing the shaft to rotate.
  • the optical encoder generates an electrical signal representative of the amount of rotation of the shaft.
  • the generated signal is fed to a microprocessor which processes the information and can produce on a display the change in angular position relative to initial angular position or the angular range of motion of the body segment or articulating joint.
  • the 4,688,581 patent discloses an apparatus and a method for non-invasive in vivo determination of muscle fiber composition. The method includes the steps of electrically stimulating a chosen muscle; determining the stimulation current; measuring the electrical potential of the muscle; the contraction time, and the force produced by the " - contraction; and by intercorrelating the data by multiple regression, determining the type, percentage and size of muscle fibers within the muscle stimulated.
  • Apparatus for determining the muscle composition includes a muscle stimulator of controlled voltage electromyogram equipment, and a force transducer providing a tension curve as well as force measurements.
  • the 4,667,513 patent discloses an apparatus and a method for estimating the degree of the fatigue and pain of muscles.
  • the apparatus composes subjects of different weights on the same basis by deriving the variation in the muscular strength such as dorsal muscular strength, shoulder muscular strength, grasping power and the like.
  • An analogous electric signal integrates the muscular output on one hand, and provides an integrated value of the electromyogrammatic amplitude by processing the voltage induced from the muscle to be tested through an electromyogram amplitude and a waveform processor. The ratio between these integrated values, after correcting the ratio with a weight/muscular strength coefficient is digitally displayed.
  • the combined physiological monitoring system consist of a portable, non-loading electronic unit that simultaneously monitors muscle activity with standard electrodes.
  • the muscle groups in the human body including cervical, midback, low back and upper and lower extremities, are monitored.
  • the CPMS also uses the gold standard in combination with a load cell and strain gauge to determine a person's lifting, gripping and range- ⁇ f-motion capability.
  • the CPMS functions with a dedicated computer and a proprietary software program, entitled Patient Data Acquisition system (PDAS), which correlates muscle activity with a force produced by a person.
  • PDAS Patient Data Acquisition system
  • the design of the CPMS allows electromyography (EMG), range-of-mot ion, grip assessment and functional assessment to be conducted during a single testing session.
  • the OPMS is comprised of the following elements, which are shown in FIGURE 1 and described in the Best Mode for carrying out the Invention: a) a plurality of EMG sensors, b) a range-of-motion (ROM) arms p c) a plurality of functional capacity- evaluation (FCE) sensors, d) a grip sensor, e) a pinch sensor, f) a power supply g) a computer, h) software, and i) a CPMS control circuit.
  • the primary object of the CPMS is to monitor selective muscle activity in a human body, which includes, cervical, thoraic,. upper and lower extremities and lumbosacral .
  • the CPMS can simultaneously correlate the muscle activity with EMG, range-of-motion, grip assessment and a functional assessment.
  • a CPMS in addition to the primary object of the invention, it is also an object of the invention to produce a CPMS that: o identifies malingering persons, workers who may be magnifying symptoms, and most importantly, in diagnosing real injuries and allows the acquire data to be reviewed to determine appropriate treatment, o assesses the actual extent of myofascial injuries that might be job or accident related, o allows muscle pathology to be assessed above and below the area of the reported injury which then allows the total extent of an injury to be established to determine future treatment, the probability of permanent disability and the need for potential vocational rehabilitation, o provides a real time diagnosis of muscle activity, o provides a powerful tool for establishing an evaluation and treatment program, o can assess chronic versus acute injuries by- evaluating muscle compensation, o can assist physicians who care for professional or high level college athletes, in determining 5 the extend of sports-related musculoskeletal injuries, and provide accurate data that can be used in designing site-specific treatment protocols, thus allowing a more rapid, predicable and safe return to competition.
  • the CPMS identifies the severity of injuries allows future diagnostic and treatment programs to be established that take into account both the needs of the injured person and the need to contain the runaway costs of potential long term or 2o unsubstantiated cases.
  • FIGURE 1 is a block diagram showing the basic elements that comprise the combined hysiological monitoring system (CPMS).
  • FIGURE 2 is a detailed block diagram of the overall combined physiological monitoring system (CPMS).
  • FIGURE 3 is a detailed block diagram of the CPMS control circuit which is integral element. of the CPMS.
  • FIGURE 4 is a side elevational view of an electromyograph (EMG) cable assembly.
  • EMG electromyograph
  • FIGURE 5 is an elevational view of the mult i-pin connector of the. EMG cable assembly.
  • FIGURE .6 is a sectional view of the EMG cable assembly taken along the lines 5-5 of FIGURE 3.
  • FIGURE 7 is a module flow diagram of the CPMS spatent Data Acquisition system (PDAS) software program.
  • PDAS CPMS spatent Data Acquisition system
  • the best mode for carrying out the invention is presented in terms of a preferred embodiment for a combined physiological monitoring system (CPMS) 10.
  • the CPMS performs an electrodiagnostic functional assessment (EFA) by analyzing muscle activity by means of electroymography (EMG).
  • EMG electroymography
  • EMG electroymography
  • EMG electroymography
  • the muscle groups monitored by the CPMS 10 are: cervical, thoraic, upper extremity, lower extremity and lumbosacral. Data pertaining to each muscle group is typically taken in the following five steps, while the monitored muscle or muscle group is:
  • the above test allow the CPMS 10 to determine muscle tone (contracture amplitude), muscle spasms (frequency), blood flow to muscles (vasoconstrive states), muscle activity (frequency and recruitment patterns), and muscle response (fatigue).
  • the CPMS can assess the condition and the dynamic functions of any particular muscle or muscle group.
  • the CPMS 10 is comprised of: a) UP to 32 channels of surface electromyography (EMG), wherein each channel can be designed to incorporate an analog-to-digital converter
  • ADC nerve conductive velocity
  • NCV nerve conductive velocity
  • ROM range-of-mot ion
  • FOE functional capacity evaluation
  • the electrodiagnostic functional assessment • can be conducted one test at a time or can be combined with EMG, ROM, FOE and the grip and pinch strengths to
  • the OPMS 10 can also be configured to function as an electrocardiagram (EKG) and to allow additional physiological functions to be added such as temperature, heart rate and skin
  • the CPMS is modified by using only eight channel(s).
  • the EKG provided by the CPMS is better because there is no movement artifact and can simultaneously monitor blood flow.
  • a CPMS control circuit 14 is comprised of the following major elements: a CPMS control circuit 14, a leads-off circuit 50, an EMG sensor 52, a range of motion (ROM) arm 54, functional capacity evaluation (FCE) sensors 56, a grip and a pinch sensor 58, a power supply
  • the CPMS control circuit 1 has means for processing the digital and analog signals which operate the OFMS 10.
  • the analog section 16 is comprised of an electromyography (EMG) leads connection circuit 18, an EMG front end circuit 20, a leads-off detection circuit 22, a leads-off display circuit 24, a range of motion (ROM) /functional capacity evaluation (FCE)/grip and pinch interface circuit 26, a ROM front end circuit 28, an FCE/grip " and pinch front end circuit 30, and a data acquisition circuit 34.
  • EMG electromyography
  • ROM range of motion
  • FCE functional capacity evaluation
  • the EMG leads connection circuit 18 has means for determining the structural integrity of the leads from the EMG sensors 52, and can accommodate from one to nineteen leads.
  • the circuit 18 is connected to a first signal, a second signal and a third signal.
  • the first signal is connected to the EMG sensor 52 and the second signal is connected to the EMG front end circuit 20 which has means for assessing the muscle activity sensed by the EMG sensors 52.
  • the circuit 20 produces a fourth signal that is applied to the data acquisition circuit 34 for further processing.
  • the third signal from the circuit 18 is connected to the leads-off detection circuit 22, which has means for determining if the EMG sensor leads are properly attached by measuring the impedance of the muscle and the surrounding skin area.
  • the circuit 22 is also connected to a fifth, sixth and seventh signal.
  • the fifth signal is applied to the data acquisition circuit 34 for further processing
  • the seventh signal is connected to the EMG sensors 52
  • the sixth signal is applied to the leads-off display circuit 24 which has means for producing a display when an electrode attached to a muscle or the surrounding skin area is not properly attached. This determination is made by measuring the impedance of each electrode. If the impedance is not at a correct level, a corresponding LED illuminates.
  • the circuit 24 allows UP to 32 electrodes to be utilized, wherein each electrode pertains to a specific muscle placement.
  • the circuit 24, which functions in combination with the circuit 22, is connected to the circuit 22 via the sixth signal.
  • the range of motion (ROM) /functional capacity evaluation FCE/grip and pinch interface circuit 26 is shown as a single element for purposes of explanantion.
  • the circuit 26 is connected, to an eighth, ninth and tenth signal which are connected respectively to a ROM sensor 54, a plurlaity of FCE sensors 56 and a grip and. pinch sensor 58, which are further described infra.
  • the circuit 26 also produces an eleventh signal which is applied to the ROM front end circuit 28 and a twelfth signal applied to the FCE/grip and pinch front end circuit 30.
  • the ROM front end circuit 28 has means for receiving and processing the data applied from the circuit 26 via the eleventh signal. The received data is amplified and filtered prior to producing a thirteenth digital signal that is applied to the data acquisition circuit 34 for further processing.
  • the FCE/grip and pinch front end circuit 30 has means for receiving and processing the data applied from the circuit 26 via the twelfth signal.
  • the received data is amplified and filtered prior to producing a fourteenth, digital signal that is applied to the data acquisition ' circuit 34 for further processing.
  • the data acquisition circuit 34 is designed to include a first DAQ module 34A and a second DAQ module 34B.
  • the DAQ modules function in combination to receive the fourth signal from the circuit 20, the fifth signal from the circuit 22, the thirteenth signal from the circuit 28 and the fourteenth signal from the circuit 30.
  • the input signals are processed by the circuit 34 to produce a fifteenth digital signal that is applied to the digital section 40 for further processing as shown in FIGURE 3.
  • the digital section 40 of the CPMS control circuit 14 is comprised of an optical isolation circuit 42, a data processing circuit 44 and a computer interface circuit 46.
  • the optical isolation circuit 42 has means for isolating a person from external electrical power sources which may harm a person and can cause erroneous test readings.
  • the circuit 42 is connected to the data acquisition circuit 34 via the fifteenth signal, to the data processing circuit 44 via a seventeenth signal, and to the computer interface circuit 46 via an eighteenth signal.
  • the circuit 42 also has connected a sixteenth digital power signal.
  • the data processing circuit 44 which is designed to process, transfer and store data, is also connected to the computer interface circuit 46 via a nineteenth signal.
  • the computer interface circuit 46 is also connected to a twenty-sixth signal, as shown in FIGURES 2 and 3, that is applied from the computer/system interface circuit 84 which interfaces with the computer 82 via a twenty-fifth signal.
  • the circuit 46 can be designed to operate with a universal Serial Bus (USB), a Firewire (IEEE 1394) bus or a parallel port.
  • the circuit 46 is designed to interface with the software 80 via the computer 82.
  • the final element of the CPMS control circuit 14 is the power distribution circuit 48, which is applied a twenty-second analog power signal and a twenty-fourth digital power signal as shown in FIGURE 2.
  • the circuit 48 has means for regulating and distributing digital power to the digital circuits in the CPMS control circuit 14 via the optical isolation circuit 42, which is applied the sixteenth signal from the circuit 48.
  • the circuit 48 also applies analog power to the analog section 16 of the OPMS control circuit 14 via a twentieth signal.
  • the preferred embodiment, of the overall combined physiological monitoring system (CPMS) 10 is shown in FIGURE 2, which includes the signal inputs applied to the CPMS control circuit 14 as described above.
  • the first signal applied to the circuit 14 is from the
  • ⁇ 0 leads-off circuit 50 which includes a means for determining if an electrode "is not properly attached to a muscle.
  • the first signal is sent sequentially to the circuit 18 and 22, and to the leads-off display circuit 24 where an improperly-attached lead is displayed and a
  • the 15 signal is sent to the software 80 to shut off the CPMS 10.
  • the EMG sensors 52 produce the seventh signal which is applied to the leads-off detection circuit 22 in the CPMS circuit 14.
  • the EMG sensors 52 sense the amplitude and frequency of various muscles or muscle
  • This data is used to monitor muscle, EKG or blood flow activity.
  • the range of motion (ROM) arm 54 includes a means for measuring the range of motion in the cervical, thoracic, lumbosacral, upper extremity, lower extremity
  • the ROM arm 54 measures a person's lateral movement, flexion, extension and rotation, each having six degrees of freedom.
  • the ROM arm 54 incorporates two triaxial, silicon, micromatched accelerometer systems, wherein each system includes three 0 hermetically-sealed ADXL05 accelerometers.
  • the device 54 has a bandwidth of 1 KHz to 4 KHz and, if required, can be a-c coupled, optimally, the ROM arm 54 can be designed with precision potentiometers having three joints for monitoring seg ⁇ ntal changes plus range of 5 motion. All the analog data collected is converted to a d-c signal that is applied via an eighth signal to the ROM interface circuit 26 located in the OPMS control circuit 14.
  • the functional capacity evaluation (FCE) sensors 56 include a means for measuring a person's lift, pull and push capability.
  • the FCE sensor function by utilizing load cells which convert an analog signal produced by the sensors to a corresponding digital signal that is applied via a ninth signal to the FOE interface circuit 26 located in the CPMS control circuit 14.
  • the grip/ pinch sensors 58 include a means for measuring a person's hand, grip strength and pinch strength.
  • the hand grip strength is measured by a load sensor that produces an analog signal proportional to the grip force.
  • the analog grip force signal is converted by ah ADC to a . corresponding digital signal that is applied via a tenth signal to a grip interface circuit 26 located in the CPMS control circuit 14.
  • the pinch strength is comprised of a load button-load cell.
  • the load button- load cell which has a range of 0 to 50 lbs, is placed between the thumb and index finger and squeezed to produce an analog signal which is likewise converted to a digital signal that is applied, via the tenth signal, a pinch, interface circuit 26, also located in the CPMS control circuit 14.
  • the power input to the CPMS 10 is provided by an external power source that is applied to a power supply interface circuit 62.
  • the circuit 62 has means for receiving and processing a power input ranging from 120-250 volts at a frequency of so or 60 Hz.
  • the circuit 62 which incorporates circuit protection in the form of a circuit breaker or fuse, produces a twenty-first analog power signal and a twenty-third digital power signal.
  • the analog power supply 64 which is connected to the twenty-first signal, produces a twenty-second output signal consisting of a regulated 5-volts d-c which powers the analog circuits in the CPMS control circuit 14.
  • the digital power supply 66 r which is isolated from the analog power ' supply 64, is connected to the twenty-third signal and produces a twenty-fourth output signal consisting of a regulated 5-volt d-c which powers the CPMS 10.
  • the EMG cable assembly 70 is designed to connect the EMG sensors to the muscle or muscle group of a person being tested.
  • the cable 70 includes a multi-pin connector 72, as shown in FIGURES 4. and 5, ten shielded wire pairs 74, as shown in FIGURE ⁇ , and three EMG electrodes 76, 77 and 78, as shown in FIGURE 4.
  • the first electrode 76 is active and is common with the second electrode 77 which is also active.
  • the third electrode 78 attaches to circuit ground.
  • the EMG cable assembly 70 incorporates a separation bar 79, as shown in FIGURE 4, which can be locked, at a distance between 3 to 5 inches.
  • the separation bar 79 allows the two active electrodes 76,77 to remain isolated from each other.
  • the EMG cable assembly 70 can be designed to include a temperature sensor (not shown) which allows temperature readings to be taken in combination with other EMG sensor readings.
  • the Patient Data Acquisition System (PDAS) software program 80 is designed to provide control and data collection for the combined Physiological Monitoring System (CPMS) 10.
  • the software 80 provides error detection, interactive computer interface and resides in a dedicated PC computer 82, which preferably consists of a laptop computer 82 which operates at least 400 MHz and has 64 to 256 megabytes of RAM. Additionally, the computer 82 incorporates at least a ' 10-gigabyte hard drive, a 14-inch active matrix LCD, an enhanced parallel port (EPP), a universal serial Bus (USB), a V.90 modem and lObaseT network cards.
  • the operating system preferably consists of MS windows or Linux, and the overall design methodology is Booch's object oriented design (OOD).
  • the computer 82 is connected via a twenty-fifth signal to a computer/system interface circuit 84 which allows the computer 82 to communicate with the CPMS 10 via the CPMS control circuit 14 as shown in FIGURE 1.
  • the software 80 is comprised of nine major modules: a) PDAS start - provides start up routines and initialization routines for the CPMS 10. Upon startup a main window is displayed and user commands are concurrently sent to selected elements of the OPMS 10. b) Location - provides routiness to verify the location of the selected CPMS element, c) Password - provides access control over specialized routiness for demonstration purposes, d) select Patient - provides, services to add a new patient, selects a previous patient for retest and selects a patient for demonstration. This module also calls Patient Info (described below) to collect patent information. e) Patient info - provides interactive forms for the collection of patient information.
  • select protocol provides control and message passing for eight specialized protocols and one custom protocol. Each protocol provides instructions to the patient and instructions on the lacement of the EMG sensors. This module also provides support for the muscle groups: cervical, Thoraic, Upper Extremity, Lower Extremity, Lu bosacral, and chest.
  • Acquire - provide data capture routines based on messages from the select Protocol module via the PDAS Start module. Data is collected and monitored via the CPMS.
  • the Acquire module cancels the -data capture and sends a warning to the SelectProtocol module via the PDAS start module.
  • a successful data capture results in a data file being saved to a disk. h) scanEMG ' - provides testing of the EMG channels.
  • TestPlot - provides a strip chart for testing all channels and their functions, operation
  • EFA functional assessment
  • the muscle groups are classified as follows: a) the cervical muscle group comprises: sternocleidomastoid, scalene, paracervical , and upper trapzii, b) the thoraic muscle group comprises: mid trapezii, lower trapezii, paraspinal muscles T5-T8, T8-T12, terses, and seratus, c) the lu b ⁇ sacral muscle group comprises: paraspinal muscles L1-L3, L5-L51, quaratus lumborum, gluteal muscles, abdominal, and hamstrings, d) the lower extremities muscle group comprises: all muscles in pelvis, legs and feet, e) the foot muscle group comprises: all muscles in feet, f) the upper extremities muscle group comprises: bilateral SOM, scalene, deltoid, biceps, triceps, and wrist flexors/extensors, g) the hand muscle group comprises: all muscles in the hand, h) the face muscle group comprises

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Abstract

L'invention concerne un système de monitorage physiologique combiné (CPMS) (10), qui effectue une évaluation fonctionnelle d'électrodiagnostic (EFA) destinée à déterminer l'âge relatif et la gravité d'une lésion myofaciale. L'EFA met en oeuvre des données fournies par des capteurs d'électromyographie (EMG) qui mesurent l'amplitude et la fréquence d'un groupe musculaire; des capteurs d'évaluation de la capacité fonctionnelle (FCE) qui mesurent les capacités de levage, de traction et de poussée; des capteurs d'amplitude des mouvements (ROM) qui mesurent l'amplitude articulaire dans les régions cervicale, thoracique, lombo-sacrée et dans les membres supérieurs et inférieurs; et un capteur de préhension et de pincée qui mesure la force de préhension et de pincée d'une personne. Le CPMS (10) permet d'effectuer les mesures séparément, ou de façon intégrée et simultanément à l'activité de l'ECG, au débit sanguin, et à la vitesse de conduction nerveuse. Le CPMS (10), qui peut être un appareil portatif, fonctionne en association avec un logiciel (80) tournant dans un ordinateur portatif spécialisé (82).
PCT/US2001/009418 2001-03-26 2001-03-26 Systeme de monitorage physiologique combine WO2002076293A1 (fr)

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PCT/US2001/009418 WO2002076293A1 (fr) 2001-03-26 2001-03-26 Systeme de monitorage physiologique combine
US10/002,942 US6678549B2 (en) 2001-03-26 2001-11-15 Combined physiological monitoring system

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PCT/US2001/009418 WO2002076293A1 (fr) 2001-03-26 2001-03-26 Systeme de monitorage physiologique combine

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004098406A1 (fr) * 2003-05-02 2004-11-18 The Johns Hopkins University Systeme et procede de mesure d'une force electromyographique
WO2005006956A2 (fr) 2003-07-09 2005-01-27 Medical Technologies Unlimited, Inc. Profileur neuromusculaire complet
WO2005115228A1 (fr) * 2004-05-25 2005-12-08 Andrew J Ronchi Appareil et procede de surveillance des contraintes et/ou charges appliquees a un mammifere
US7383728B2 (en) 2005-07-13 2008-06-10 Ultimate Balance, Inc. Orientation and motion sensing in athletic training systems, physical rehabilitation and evaluation systems, and hand-held devices
AU2005247045B2 (en) * 2004-05-25 2011-01-27 Andrew J Ronchi Apparatus and method for monitoring strain and/or load applied to a mammal
US11446191B2 (en) 2019-04-19 2022-09-20 Hill-Rom Services, Inc. Patient bed having exercise therapy apparatus
US12005012B2 (en) 2022-08-16 2024-06-11 Hill-Rom Services, Inc. Patient bed having exercise therapy apparatus

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US5513651A (en) * 1994-08-17 1996-05-07 Cusimano; Maryrose Integrated movement analyzing system
US5885231A (en) * 1997-01-07 1999-03-23 The General Hospital Corporation Digital motor event recording system
US6152855A (en) * 1999-02-03 2000-11-28 Synergy Innovations, Inc. In-bed exercise machine and method of use

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5513651A (en) * 1994-08-17 1996-05-07 Cusimano; Maryrose Integrated movement analyzing system
US5885231A (en) * 1997-01-07 1999-03-23 The General Hospital Corporation Digital motor event recording system
US6152855A (en) * 1999-02-03 2000-11-28 Synergy Innovations, Inc. In-bed exercise machine and method of use

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004098406A1 (fr) * 2003-05-02 2004-11-18 The Johns Hopkins University Systeme et procede de mesure d'une force electromyographique
WO2005006956A2 (fr) 2003-07-09 2005-01-27 Medical Technologies Unlimited, Inc. Profileur neuromusculaire complet
EP1651106A2 (fr) * 2003-07-09 2006-05-03 Medical Technologies Unlimited Inc. Profileur neuromusculaire complet
EP1651106A4 (fr) * 2003-07-09 2009-05-27 Medical Technologies Unltd Inc Profileur neuromusculaire complet
WO2005115228A1 (fr) * 2004-05-25 2005-12-08 Andrew J Ronchi Appareil et procede de surveillance des contraintes et/ou charges appliquees a un mammifere
AU2005247045B2 (en) * 2004-05-25 2011-01-27 Andrew J Ronchi Apparatus and method for monitoring strain and/or load applied to a mammal
US8167799B2 (en) 2004-05-25 2012-05-01 Andrew J Ronchi Apparatus and method for monitoring strain and/or load applied to a mammal
US7383728B2 (en) 2005-07-13 2008-06-10 Ultimate Balance, Inc. Orientation and motion sensing in athletic training systems, physical rehabilitation and evaluation systems, and hand-held devices
US11446191B2 (en) 2019-04-19 2022-09-20 Hill-Rom Services, Inc. Patient bed having exercise therapy apparatus
US12005012B2 (en) 2022-08-16 2024-06-11 Hill-Rom Services, Inc. Patient bed having exercise therapy apparatus

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