WO2017039553A1

WO2017039553A1 - A personalized rehabilitation system

Info

Publication number: WO2017039553A1
Application number: PCT/TR2016/000115
Authority: WO
Inventors: Ozgur UNVER; Muhammed KILINC
Original assignee: AKSU YLDIRIM, Sibel
Priority date: 2015-09-01
Filing date: 2016-08-17
Publication date: 2017-03-09

Abstract

The present invention relates to a rehabilitation system (1) which is used in personalized physiotherapy and rehabilitation treatment of patients with insufficiency of upper extremity functions. Disability status and level are automatically detected, a personalized progress speed is created by creating a difficulty map of a patient and exercises such as game, etc. specific to a patient are provided by rating disabled areas of a patient by means of the inventive system (1).

Description

DESCRIPTION

A PERSONALIZED REHABILITATION SYSTEM Technical Field

The present invention relates to a rehabilitation system which is used in personalized physiotherapy and rehabilitation treatment of patients with insufficiency of upper extremity functions.

Background of the Invention

In rehabilitation systems being used today, it is expected to fasten recovery period of patients by providing electronic games to patients. However, these games provided to patients are not particular to these patients and they also have the same beginning and progress levels for patients who have different disability levels. Moreover, games played usually by non-patient people are used for patients for the purpose of exercise. Using the same game, levels of progress and difficulty for every patient causes rehabilitation to be inefficient in patients at different functional levels. Providing a difficult game to a patient with a low functional level reduces motivation and rehabilitation success of the patient. In the event of providing an easy game to a patient with a high functional level, progress cannot be ensured in the patient.

The United States patent document no. US20140188009 discloses an individually adjustable training and rehabilitation system which has a calibration module that carries out calibration transaction in accordance with limits of people's limb and trunk movements. In the said invention, the customization module may customize pre-determined performance criteria based on the determined limits. In addition to this, an activity task presentation module presents an activity task to a human subject and an activity assessment module assesses the activity performed by the human subject. Thereby, a game scenario which is neither too difficult nor too easy for a human subject using the said invention and system is provided. A level whereby the human subject can use the game under proper circumstances is determined by the calibration module.

The United States patent document no. US20150133206 discloses an exercise gaming system having a motion-detect device which includes a plurality of sensors configured to transfer the movements detected by the motion-detect device during a user motion, and a first processor which is configured to receive input data from the plurality of sensors and transfer necessary information to the first wireless communication interface. In the said patent document, game scenarios are controlled for providing appropriate movements in accordance with game requirements such as sequences, types and numbers of required or acceptable movements that should be included in the game. Game requirements may include performance metrics and evaluations. For example, game requirements are used for adjustment of the game level in accordance with requirements such as accuracy, delay, weakness and fatigue. For example, game level is reduced if fatigue is recognized.

The United States patent document no. US8419661 discloses an upper limb measurement and rehabilitation method and system for measuring an upper limb reaching capability of a person with an impaired upper limb. Preferences and times of the upper limb for reaching the targets determined on the display are recorded in the said invention. Besides, processor provides new targets depending on the performances of the user preferences.

The United States patent document no. US7452336 discloses a device and method for rehabilitating patients and assessing tactile skills in response to visual stimuli given from a neural training device. The device provides images are to the patient in order to measure hand movement responses of the patients in the said patent document. The device can automatically adjust the difficulty of a programme applied the patient by considering correct responses given by the patient, speed, and accuracy of responses. The device obtains information of the patient by analysing the responses received.

Summary of the Invention

An objective of the present invention is to realize a rehabilitation system which automatically detects disability status and level of patients who are in need of physiotherapy and rehabilitation, creates a personalized progress speed by creating a difficulty map of a patient and provides exercises such as game, etc. specific to a patient by grading disabled areas of a patient.

Another objective of the present invention is to realize a rehabilitation system whereby patient-specific games which can be used on devices having display are developed in treatment of patients with insufficiency of upper extremity functions.

Another objective of the present invention is to realize a personalized rehabilitation system which ensures that rehabilitation can achieve its real objectives and increases success of rehabilitation. Another objective of the present invention is to realize a rehabilitation system which provides exercises such as game, etc. that can adapt itself depending on criteria such as disabilities, fatigue, disease type, etc. of a patient by assessing upper extremity and hand functions of the patient in each treatment session. Another objective of the present invention is to realize a personalized rehabilitation system whereby a treatment suitable for each patient type is provided.

Detailed Description of the Invention "A personalized rehabilitation system¹' realized to fulfil the objectives of the present invention is shown in the figure attached, in which: Figure 1 is a schematic view of the inventive personalized rehabilitation system.

The components illustrated in the figure are individually numbered, where the numbers refer to the following:

1. System

2. Display module

3. Coordinate detection module

4. Patient identification module

5. Measuring unit

6. Disability determination unit

7. Grading unit

8. Analysis unit

9. Feedback unit

The inventive rehabilitation system (1) essentially comprises:

- at least one display module (2) whereby exercises such as game, etc. are provided to a patient;

- at least one coordinate detection module (3) whereby a patient can make choices by taking his/her limb to a desired coordinate and the coordinates of the said area is determined after the related choice;

at least one patient identification module (4) which requests a patient to reach the easiest point where s/he can reach on the display module (2) before the exercise and then receives the coordinates of the point from the coordinate detection module (3) in order to determine the condition and level of the patient, and afterwards creates mobile and/or fixed objects in order to calculate access times of the patient on the display module (2);

at least one measuring unit (5) which calculates elapsed times such as the patient reaches, reacts to the objects created on the display module (2);

- at least one disability determination unit (6) which creates a disability map of a patient by using the times calculated by the measuring unit (5); at least one grading unit (7) which classifies exercises such as game, etc. in different difficulty degrees by using disability map;

- at least one analysis unit (8) which provides exercises such as game, etc. over the display module (2) and enables to reduce level and/or stop exercise by enabling to skip level and/or determine fatigue status for a patient by comparing the times measured in the measuring unit (5) with the times determined in the disability determination unit (6);

at least one feedback unit (9) which provides feedbacks to a patient by guidance of the analysis unit (8).

In the rehabilitation system (1), the display module (2) is an image member whereby stimuli required to be reached by the patients are displayed. The coordinate detection module (3) is a member which comprises at least one detector detecting coordinates of a limb - desired to be followed - of a patient who is guided by the display module (2) and can also detect other objects apart from human limbs. It is ensured via the inventive rehabilitation system (1) that games with objects are supported and played and for example, paralyzed patients with high disability amount are enabled to take part in games by holding rubber hammer, ball, cloth and similar objects instead of opening their fingers. It is ensured that a patient's movement, thought and synchronization (sensory integration) takes place more naturally and it is encouraged by means of the fact that moving objects are used together with the display module (2).

In another preferred embodiment, the display module (2) may be three-dimensional glasses, a device providing three-dimensional virtual reality, a computer screen, a television, a projector device or similar devices.

In the inventive rehabilitation system (1), the coordinate detection module (3) which can also be used for recognizing a patient's posture and to find out limb coordinates in addition to the display module (2) interaction may comprise: IMU (inertial measurement units) wherein accelerometer, gyroscope and magnometers are used; touch screen, touch kit, Kinect sensors, cameras with image processing feature, load cells sensors for measuring balance, sensors used for detection many motions in the daily life. The display module (2) also comprises sensors for different uses optionally. In the system (1), data received from the said components are used as data for determining flow of exercises such as game, etc. and triggering the feedback unit (9) upon being transmitted to the analysis unit (8). Also, in the event that a patient reaches an undesired position, a patient is enabled to reach the right position by triggering the analysis unit (8) and the feedback unit (9) upon detecting the body position via the said components. In a preferred embodiment, the display module (2) may be situated on a column which is reflected to the wall or located on an electrically or manually moving or fixed table, or mounted to the wall or from the floor to the ceiling.

In one preferred embodiment of the invention, the coordinate detection module (3) determines coordinates of the point that is accessed in the most comfortable way and accepted as reference by requesting the patient to reach the point that s/he can reach in an easiest way on the display module (2).

In the inventive rehabilitation system (1), the patient identification module (4) receives the coordinate information obtained from the coordinate detection module (3). The patient identification module (4) calculates the coordinates of the said points by using the information of the reached points received from the coordinate detection module (3). The patient identification module (4) can also find out coordinates of each limb by means of interfaces of kinect and similar devices.

In another preferred embodiment, the patient identification module (4) accepts coordinates of the said points as reference by requesting a patient to reach any point desired by the physiotherapist. In preferred embodiment of the invention, the patient identification module (4) indicates a new object in the easily reached point and enables the patient to return the reference point after the easily reachable point is defined and then object is selected in a different area. The patient identification module (4) calculates reaching or access time of the patient by creating a random object on the display module (2) again after the patient returns the reference point. The patient identification module (4) ensures that a patient's reaching times from a reference point are calculated by the measuring unit (5) by creating random objects on the display module (2). The patient identification module (4) ensures that the reaching or access time calculated by the measuring unit (5) is based on the reference point by enabling the patient to return the reference point after each object creation on the display module (2). In a preferred embodiment, the patient identification module (4) assigns objects on the display module (2) randomly such that they will be located inside the areas divided into 5x8 sub-segments. The patient identification module (4) enables the patient to reach all sub-segments of the display module (2) after about forty questions. The patient identification module (4) realizes the working area of the patient on the display module (2) within the limits to be determined by the patient and/or the rehabilitation specialist.

The measuring unit (5) is a unit which calculates the time for a patient to reach the objects emerging on the display module (2). The measuring unit (5) also measures the reaction time required for the object to be sensed by the patient. This time defines the time wherein the patient does not move physically but which passes as detection of the newly emerged object. Although the reaction time varies by patient, it is usually a value in the range of 0-1 second. The measuring unit (5) calculates the net flying time passing for reaching the object by subtracting the reaction time from the reaching time. Net flying time is a direct measurement of the difficulty experienced by the patient while going from the reference point to another point on the display module (2).

In a preferred embodiment, the measuring unit (5) measures how much it is approached to the center of the object desired to be reached from the patient (accuracy) in order to determine the movement quality. The measuring unit (5) can stop the game in the event that the patient has difficulty excessively preferably by using pulse sensors.

In the inventive system (1), the disability determination unit (6) determines disability by using net flying times and positional sensitivities of patients from reference point to the random objects determined by the patient identification module (4) preferably. The disability determination unit (6) draws map depending on net flying times received from the segment in determined number and indicates the obtained graphic such that it will include the working range of the display module (2) by curve fitting devices.

The grading unit (7) grades exercises such as game, etc. by dividing the map created by the disability determination unit (6) into a desired number of difficulty level. Exercises such as game, etc. are started by asking the patient questions from the first grade depending on the grading unit (7). The grading unit (7) enables to determine different difficulty levels depending on the feedbacks received from the patient identification module (4). In preferred embodiment, the grading unit (7) determines ten different difficulty levels. Difficulty level forms a basis during doing exercises such as game, etc. and patient's performance is determined according to the difficulty level map.

The analysis unit (8) carries out level skipping in the event that the times such as reaching, reaction, etc. given by the patient for exercises such as game, etc. provided by the display module (2) are under pre-determined times by measuring them continuously. The analysis unit (8) senses that the patient starts to get tired upon the times measured after the patient reaches to a certain level start moving away from the determined times. The analysis unit (8) senses that the patient gets tired upon s/he moves away from the period of time measured for equal level in the measuring unit (5) in a deviation ratio. The analysis unit (8) does not allow the patient to upgrade upon detecting that s/he gets tired by means of the fact that flying time decreases and sensitivity reduces or enables the patient to go down to a lower level depending on his/her performance and carries out interpretation of measurements at lower level again.

In another preferred embodiment, the analysis unit (8) uses cardiac rhythm as sign of fatigue and/or resting decision criteria by monitoring also maximum heart rate of the patient by means of heart sensors.

In one preferred embodiment, the analysis unit (8) stops exercises such as game, etc. in pre-determined times and/or when the patient decreases grade upon getting tired after certain level/levels and it enables the patient to rest. For example, the analysis unit (8) enables the patient to get rest in 5 minutes periods of times or after the patient decreases three grades.

The analysis unit (8) reports performance and progress of the patient retrospectively after s/he starts the treatment. The analysis unit (8) enables to monitor a patient's progress more easily by adding up the disability maps - which are created before the patient starts exercise - on a single display.

In one preferred embodiment, the analysis unit (8) addresses questions such that they will run the components of the system (1) over the display module (2) synchronously. Thus, feedback to patient in the event of success or failure is realized over the feedback unit (9) such that it will appeal to senses related to the whole movement. In one preferred embodiment, the analysis unit (8) also provides exercises such as game, etc. to a patient such that they are bi-manual (both hands are used). Thus, it is ensured that healthy part and disabled part operate synchronously. For example, such as trying to pop a red balloon with left hand while popping a blue balloon with right hand. In addition, the analysis unit (8) also realizes an exercise set-up wherein reaching and touching transactions are mostly at the forefront for stroke patients in the said system (1). The analysis unit (8) sets up the game set-up in ataxia patients such that it will be associated to the time to be spent in a fixed point. Besides, the analysis unit (8) can shape the objects provided in exercises as moving or fixed optionally.

In the inventive system (1), the feedback unit (9) is configured such that it give feedback to the patient such as vibration, tactile sensation, audio warning, application of physical force to a limb/limbs of a patient by processing data collected in the analysis unit (8). The feedback unit (9) is preferably one or several of members such as vibration motor, actuator, LED, spring, etc. The inventive system (1) can be used for upper extremity and also other limbs of the body.

In the inventive rehabilitation system (1), firstly a patient is asked to reach the easiest coordinate on the display module (2). Then, it is enabled to create disability map of the patient upon moving or fixed objects are determined in different places on a table and the patient reaches these objects and thereby this map is graded. By this way, a personalized exercise plan will be created by calculating the difficulty level of the patient in access areas. Thus, upper extremity and hand functions of the patient will be assessed in each treatment session and an exercise will be enabled to adapt itself in accordance with disease type by considering the disability instantly and also fatigue level.

With the inventive personalized rehabilitation system (1), condition and level of a patient is detected automatically and level of exercises such as game, etc. provided to patients and operating area of the patient are determined in a personalized way. It is tried to treat every patient personally and instantly through the system (1) by means of detecting fatigue status. Standard approaches will be avoided in patients, approaches used even in the same session will not be standard by considering learning effect of patients due to the fact that patients' functional levels, needs and responses to treatments vary. Besides, a personalized rehabilitation is ensured by generating different exercises according to different types of patients. Forming exercises depending on these criteria by determining patient disabilities increases recovery period of patients and also patients will not have difficulty excessively by means of detection of fatigue level.

The inventive rehabilitation device (1) can be used in neurological rehabilitation, orthopedic rehabilitation, sports medicine, pediatric rehabilitation, cardiopulmonary rehabilitation, prosthesis-orthesis rehabilitation, occupational therapy, ergotherapy, physiotherapy in women's health, oncological rehabilitation, geriatric rehabilitation, rheumatology rehabilitation, low-vision rehabilitation, hand rehabilitation, vestibular rehabilitation, and similar applications.

Within these basic concepts, it is possible to develop a great variety of embodiments of the inventive "Personalized Rehabilitation System (1)" and transfer it to different fields of rehabilitation; it cannot be limited to the examples disclosed herein and it is essentially according to the claims.

Claims

1. A personalized rehabilitation system (1) essentially comprising:

at least one display module (2) whereby exercises such as game, etc. are provided to a patient;

characterized by:

at least one patient identification module (4) which requests a patient to reach the easiest point where s/he can reach on the display module (2) before the exercise and then receives the coordinates of the point from the coordinate detection module (3) in order to determine the condition and level of the patient, and afterwards creates mobile and or fixed objects in order to calculate access times of the patient on the display module (2);

- at least one measuring unit (5) which calculates elapsed times such as the patient reaches, reacts to the objects created on the display module (2);

at least one disability determination unit (6) which creates a disability map of a patient by using the times calculated by the measuring unit (5);

at least one grading unit (7) which classifies exercises such as game, etc. in different difficulty degrees by using disability map;

at least one analysis unit (8) which provides exercises such as game, etc. over the display module (2) and enables to reduce level and/or stop exercise by enabling to skip level and/or determine fatigue status for a patient by comparing the times measured in the measuring unit (5) with the times determined in the disability determination unit (6);

2. A personalized rehabilitation system (1) according to Claim 1 , characterized by the display module (2) which is an image member whereby stimuli required to be reached by the patients are displayed.

3. A personalized rehabilitation system (1) according to Claim 1 or 2, characterized by the coordinate detection module (3) which is a member comprising at least one detector detecting coordinates of a limb - desired to be followed - of a patient who is guided by the display module (2) and can also detect other objects apart from human limbs.

4. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the coordinate detection module (3) which is used for recognizing a patient's posture and to find out limb coordinates and has IMU (inertial measurement units) wherein accelerometer, gyroscope and magnometers are used; touch screen, touch kit, Kinect sensors, cameras with image processing feature and/or load cells sensors for measuring balance, sensors used for detection many motions in the daily life.

5. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the display module (2) which is situated on a column that is reflected to the wall or located on an electrically or manually moving or fixed table, or mounted to the wall or from the floor to the ceiling.

6. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the patient identification module (4) which accepts coordinates of the said points as reference by requesting a patient to reach any point desired by the physiotherapist.

7. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the patient identification module (4) which enables the patient to return the reference point by indicating a new object in the easily accessed point after the easily accessible point is defined and then object is selected in a different area.

8. A personalized rehabilitation system (1) according to Claim 7, characterized by the patient identification module (4) which calculates reaching and access time of a patient by creating a random object on the display module (2) again after the patient returns the reference point.

9. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the patient identification module (4) which ensures that a patient's reaching times from a reference point are calculated by the measuring unit (5) by creating random objects on the display module (2).

10. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the patient identification module (4) which ensures that the reaching or access time calculated by the measuring unit (5) is based on reference point by enabling the patient to return the reference point after each object creation on the display module (2).

1 1. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the patient identification module (4) which assigns objects on the display module (2) randomly such that they will be located inside the areas divided into 5x8 sub-segments.

12. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the measuring unit (5) which calculates the time for a patient to reach the objects emerging on the display module (2).

13. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the measuring unit (5) which is the time required for the objects to be sensed by a patient, wherein the patient does not move physically but which passes as detection of the newly emerged object.

14. A personalized rehabilitation system (1) according to Claim 13, characterized by the measuring unit (5) which calculates the net flying time passing for reaching the object by subtracting the reaction time from the reaching time.

15. A personalized rehabilitation system (1) according to any of Claim 2 to 14, characterized by the measuring unit (5) which measures how much it is approached to the center of the object desired to be reached from the patient (accuracy) in order to determine the movement quality.

16. A personalized rehabilitation system (1) according to Claim 14, characterized by the disability determination unit (6) which determines disability maps by using net flying times and positional sensitivities of patients from reference point to the random objects determined by the patient identification module (4).

17 A personalized rehabilitation system (1) according to Claim 16, characterized by the disability determination unit (6) which draws map depending on net flying times received from the segment in determined number and indicates the obtained graphic such that it will include the working range of the display module (2) by curve fitting devices.

18. A personalized rehabilitation system (1) according to Claim 16, characterized by the grading unit (7) which grades exercises such as game, etc. by dividing the map created by the disability determination unit (6) into a desired number of difficulty level.

19. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the analysis unit (8) which carries out level skipping in the event that the times such as reaching, reaction, etc. given by the patient for exercises such as game, etc. provided by the display module (2) are under pre-determined times by measuring them continuously.

20. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the analysis unit (8) which senses that the patient starts to get tired upon the times measured after the patient reaches to a certain level start moving away from the determined times.

21. A personalized rehabilitation system (1) according to Claim 20, characterized by the analysis unit (8) which senses that the patient gets tired by means of the fact that flying time decreases and sensitivity reduces, and enables the patient to go down to a lower level by not allowing him/her to upgrade or depending on the patient's performance, and carries out interpretation of measurements at lower level again.

22. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the analysis unit (8) which uses cardiac rhythm as sign of fatigue and/or resting decision criteria by monitoring also maximum heart rate of the patient by means of heart sensors.

23. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the analysis unit (8) which stops exercises such as game, etc. in pre-determined times and/or when the patient decreases grade upon getting tired after certain level/levels and it enables the patient to rest.

24. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the analysis unit (8) which enables to report performance and progress of the patient retrospectively after s/he starts the treatment.

25. A personalized rehabilitation system (1) according to Claim 24, characterized by the analysis unit (8) which enables to monitor a patient's progress more easily by adding up the disability maps - that are created before the patient starts exercise - on a single display.

26. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the analysis unit (8) which provides exercises such as game, etc. to a patient such that they are bi-manual (both hands are used).

27. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the feedback unit (9) which is configured such that it gives feedback to a patient such as vibration, tactile sensation, audio warning, application of physical force to a limb/limbs of the patient by processing data collected in the analysis unit (8).

28. A personalized rehabilitation system (1) according to any of the preceding claims, characterized by the feedback unit (9) which is one or several of members such as vibration motor, actuator, LED, spring, etc.