WO2018161896A1

WO2018161896A1 - Remote rehabilitation system

Info

Publication number: WO2018161896A1
Application number: PCT/CN2018/078152
Authority: WO
Inventors: 朱振中; 张长青; 李小锋; 盛加根
Original assignee: 上海市第六人民医院
Priority date: 2017-03-06
Filing date: 2018-03-06
Publication date: 2018-09-13
Also published as: CN108523841A

Abstract

Provided is a remote rehabilitation system. The remote rehabilitation system comprises: a server, a user terminal and a sensing device, wherein the server can be used for issuing an action instruction to the user terminal, with the action instruction being used for indicating a user action; the user terminal can be used for displaying the action instruction so as to instruct a user to carry out the user action, receiving a sensing signal, which responds to the action instruction, from the sensing device, and transmitting at least part of the information contained in the sensing signal back to the server; and the sensing device can be used for detecting the user so as to generate the sensing signal which responds to the user action. The remote rehabilitation system in the present invention has a better effect.

Description

Remote rehabilitation system

Technical field

The present invention relates to the field of network technologies, and in particular, to a remote rehabilitation system.

Background technique

Rehabilitation medicine is an important field of medicine. Rehabilitation can be a process of promoting bone healing and limb function recovery after repairing or replacing bones or joints of the limbs. It can be a process of muscle recovery or other organs or systems of the human body. For example, the heart, lungs, brain, nervous system, and blood circulation system undergo a healing process after treatment.

Rehabilitation medicine is an indispensable part of recovery treatment, and remote rehabilitation systems are also being used more and more. However, the rehabilitation effect of the existing remote rehabilitation system needs to be improved.

Summary of the invention

The technical problem solved by the present invention is to improve the rehabilitation effect of the remote rehabilitation system.

In order to solve the above technical problem, an embodiment of the present invention provides a remote rehabilitation system, including: a server, a user terminal, and a sensing device, wherein: the server is configured to send an action indication to the user terminal, where the action indication For indicating a user action; the user terminal is adapted to display the action indication to instruct the user to perform the user action, receive a sensing signal in response to the action indication from the sensing device, and The server returns at least a portion of the information contained in the sensing signal; the sensing device is adapted to detect the user to generate the sensing signal responsive to the user action.

Optionally, the user terminal is adapted to display the action indications in at least one of the following: voice, image, animation, video, and text.

Optionally, the sensing signal carries one or more sensing parameters, and the user terminal is adapted to display at least part of the sensing parameters.

Optionally, the sensing signal carries one or more sensing parameters, where the motion indication includes a standard range of the sensing parameter, and the user terminal is adapted to compare the standard range with the sensing The signal generates a prompt message based on the result of the comparison.

Optionally, the sensing signal carries one or more sensing parameters, where the motion indication includes a standard range of the sensing parameter, and the user terminal is adapted to compare the standard range with the sensing And signaling back to the server at least a portion of the information contained in the sensing signal based on the result of the comparison.

Optionally, the action indication includes a plurality of action instructions, each action instruction indicating a split action; and the user terminal displays the action instruction at a preset time interval included in the action indication.

Optionally, the action indication includes a plurality of motion instructions, each motion instruction indicating a decomposition action; the sensing signal carries one or more sensing parameters, and the motion indication includes the sensing parameter The standard range; after the sensing signal in response to the current motion instruction falls within the standard range, the user terminal displays the next motion instruction.

Optionally, the action indication includes a plurality of action instructions, each action instruction indicating a split action; the user terminal is further adapted to receive a user indication, and after receiving the user instruction, display the next action instruction.

Optionally, the user terminal is adapted to prompt the user to input user feedback data, and return the user feedback data to the server; the user feedback data includes at least one of the following: subjective data and objective data, where: The subjective data is used to describe the subjective perception of the user, and the objective data is used to describe the objective physical condition of the user.

Optionally, the server is further configured to receive a doctor indication, and deliver the doctor indication to the user terminal; the user feedback data further includes doctor demand data; the user terminal is adapted to display the doctor instruction to prompt The customer enters the doctor's request data.

Optionally, the remote rehabilitation system further includes a doctor terminal, the server is adapted to send the user feedback data and/or the information returned by the user terminal to the doctor terminal, based on the received from the doctor The information of the terminal updates the action indication.

Optionally, the server is further adapted to update the action indication according to the user feedback data and/or the information returned by the user terminal.

Optionally, the server is further adapted to update the action indication according to the information returned by the user terminal.

Optionally, the updated action indication includes aborting the user action.

Optionally, the sensing device comprises at least one of the following sensors: a pressure sensor, a position sensor, an acceleration sensor, an angle sensor, an electromyography detecting sensor, an EEG detecting sensor, a respiratory detecting sensor, a heart rate detecting sensor, and a blood oxygen detecting sensor. , camera equipment.

Optionally, the sensing device is worn by the user.

Compared with the prior art, the technical solution of the embodiment of the present invention has the following beneficial effects:

In the embodiment of the present invention, the user sends an action indication to the user, and the user terminal displays the action indication to the user to indicate the user action required in the action indication; the user wears the sensing device, which can be generated when the user performs the user action. The corresponding sensing signal, the user terminal can also accept the sensing signal and transmit at least part of the information contained in the sensing signal to the server. Therefore, the server can issue a user indication, and can obtain information included in the sensing signal when the user indicates the instruction, and can further analyze the information and the action indication included in the subsequent combined sensing signal, and determine the execution of the action indication. The effect can further adjust the action indications adaptively, so that a better rehabilitation effect can be obtained.

Further, the user terminal is adapted to compare the standard range with the sensing signal, and generate prompt information according to the comparison result, thereby indicating that the user can better complete the user action and obtain a better rehabilitation effect; or prompting the user to suspend execution to avoid When it is not suitable to continue, the user continues to perform user actions and is hurt.

Further, the user terminal can compare the standard range and the sensing signal, and determine whether to return the information to the server according to the comparison result, so that all or part of the information contained in the sensing signal can be returned to the server, and the sensing sensor can be returned to the server. The judgment result obtained by the signal can further reduce the amount of data returned to the server and reduce the resource occupation.

In addition, in the embodiment of the present invention, the action indication can be updated according to the information from the user terminal, so the action indication can be more suitable for the current physical condition of the user, and thus a better rehabilitation effect can be achieved.

DRAWINGS

1 is a schematic structural view of a remote rehabilitation system in an embodiment of the present invention.

detailed description

Hereinafter, embodiments of the present disclosure will be described with reference to the drawings. It should be understood, however, that the description is only illustrative, and is not intended to limit the scope of the disclosure. In addition, descriptions of well-known structures and techniques are omitted in the following description in order to avoid unnecessarily obscuring the concept of the present disclosure.

The terminology used herein is for the purpose of describing the particular embodiments, The use of the features "comprises", "comprising", and the like, as used herein, is intended to mean the presence of the features, steps, operations and/or components, but does not exclude the presence or addition of one or more other features, steps, operations or components.

All terms (including technical and scientific terms) used herein have the meaning commonly understood by one of ordinary skill in the art, unless otherwise defined. It should be noted that the terms used herein are to be interpreted as having a meaning consistent with the context of the present specification and should not be interpreted in an ideal or too rigid manner.

Where an expression similar to "at least one of A, B, and C, etc." is used, it should generally be interpreted in accordance with the meaning of the expression as commonly understood by those skilled in the art (for example, "having A, B, and C" "Systems of at least one of" shall include, but are not limited to, systems having A alone, B alone, C alone, A and B, A and C, B and C, and/or A, B, C, etc. ). Where an expression similar to "at least one of A, B or C, etc." is used, it should generally be interpreted according to the meaning of the expression as commonly understood by those skilled in the art (for example, "having A, B or C" "Systems of at least one of" shall include, but are not limited to, systems having A alone, B alone, C alone, A and B, A and C, B and C, and/or A, B, C, etc. ). Those skilled in the art will also appreciate that transitional conjunctions and/or phrases that are arbitrarily arbitrarily representing two or more optional items, whether in the specification, claims, or drawings, are to be construed as The possibility of one of the projects, either or both of these projects. For example, the phrase "A or B" should be understood to include the possibility of "A" or "B", or "A and B."

Some block diagrams and/or flowcharts are shown in the drawings. It will be understood that some blocks or combinations of the block diagrams and/or flowcharts can be implemented by computer program instructions. These computer program instructions may be provided to a general purpose computer, a special purpose computer or a processor of other programmable data processing apparatus such that when executed by the processor, the instructions may be used to implement the functions illustrated in the block diagrams and/or flowcharts. / operating device.

Thus, the techniques of this disclosure may be implemented in the form of hardware and/or software (including firmware, microcode, etc.). Additionally, the techniques of this disclosure may take the form of a computer program product on a computer readable medium storing instructions for use by or in connection with an instruction execution system. In the context of the present disclosure, a computer readable medium can be any medium that can contain, store, communicate, propagate or transport the instructions. For example, a computer readable medium can include, but is not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, device, or propagation medium. Specific examples of the computer readable medium include: a magnetic storage device such as a magnetic tape or a hard disk (HDD); an optical storage device such as a compact disk (CD-ROM); a memory such as a random access memory (RAM) or a flash memory; and/or a wired /Wireless communication link.

As described in the background art, rehabilitation medicine is an indispensable part of the recovery period, and the remote rehabilitation system is also being used more and more. However, the rehabilitation effect of the existing remote rehabilitation system needs to be improved.

In the embodiment of the present invention, the user sends an action indication to the user, and the user terminal displays the action indication to the user to indicate the user action required in the action indication; the user wears the sensing device, which can be generated when the user performs the user action. The corresponding sensing signal, the user terminal can also accept the sensing signal and transmit at least part of the information contained in the sensing signal to the server.

Therefore, the server can issue a user indication and obtain feedback when the user indication is executed, and then can lay out a basis for analyzing and determining the execution effect of the action indication in combination with the feedback and the action indication, and further adaptively adjusting the action indication. Thereby a better healing effect can be obtained.

The above described objects, features, and advantages of the present invention will become more apparent from the detailed description of the embodiments.

1 is a schematic structural diagram of a remote rehabilitation system according to an embodiment of the present invention, which may include: a server 11, a user terminal 12, and a sensing device 13.

The server 11 may be a single server or a server cluster, and is configured to send an action indication to the user terminal, and the action indication may be used to indicate the user action. The action indication may directly indicate the user action, or may also instruct the terminal to select the user action related information in the terminal database according to the agreement with the terminal, and indirectly indicate the user action through the terminal. The user action may be a sequence of actions that the user needs to complete during the rehabilitation process, and the action indication may include information such as the doctor's advice and the action points of the user action. The server can send an action indication to the user terminal through a wired or wireless network.

Specifically, the server 11 may send an action indication that matches the identity of the user to the corresponding user terminal 12 after confirming the identity of the user. The action indication may be selected among a plurality of preset action sets, or may also be a set of actions customized by the doctor according to the user's situation. The server 11 may directly accept the doctor's input to obtain a customized set of actions, or may also obtain a customized set of actions through the doctor terminal 14.

The action indication may be that the server 11 generates a customized action indication according to the situation of the user, such as the case information of the user, the medical detection result, or the like; or the server 11 may generate one or more sets of customized action instructions according to the information. The doctor makes modifications or selections to get the final action instructions; or, the doctor can directly customize the action instructions according to the user's situation.

The user terminal 12 may be a user equipment dedicated to the remote rehabilitation system in the present invention, or may be a smart device such as a mobile phone or a tablet computer, loaded with application software adapted to the server 11 and the sensing device 13. . The user terminal 12 can establish a connection with the sensing device 13 for data transmission. Specifically, a wireless connection, such as a Bluetooth connection or a WIFI-direct connection, can be established.

The user terminal 12 can present the action indication and the user terminal 12 can be configured with a corresponding display component. For example, the user terminal 12 may be configured with a speaker component and/or a display component to perform an action indication display in any one or more of voice, image, animation, video, and text messages, thereby helping the user know that the user should know that the action should be completed. User action.

The user can wear the sensing device 13, from which point the sensing device 13 is also a wearable device. Sensing device 13 may also include sensors that are not in direct contact with the user, such as cameras, infrared sensors, and the like. The sensing device 13 can detect the user to obtain a sensing signal responsive to the user's motion. Specifically, the user action may be a lower limb motion, an arm motion, a finger motion, a head motion, etc., and the sensing signal may include pressure distribution, acceleration, position signal, myoelectric signal, etc.; for more comprehensive monitoring of user state, sensing The signals may also include respiratory signals, heart rate signals, blood oxygen signals, brain electrical signals, video signals, and the like.

It can be seen that the sensing signal may include a signal for indicating the completion of the user's action, and may also include a signal for indicating the physical condition of the user to monitor the physical condition of the user and perform subsequent indications to prevent the user from occurring when performing the user action. Danger.

Accordingly, in order to obtain one or more of the above signals, the sensing device 13 may be configured with any one or more of the following sensors: pressure sensor, position sensor, acceleration sensor, angle sensor, myoelectric detection sensor, brain electricity Detection sensor, respiratory detection sensor, heart rate detection sensor, blood oxygen detection sensor, and imaging equipment.

The sensing signal can be identified by a sensing parameter, for example, by a parameter such as a pressure value, a position coordinate, an acceleration value, a respiratory frequency, a heartbeat frequency, etc., and the specific parameter can be related to the type of the sensor to which the sensing device 13 is specifically applied. The signals that need to be obtained correspond.

The user terminal 12 can display one or more parameters of the sensing signal and corresponding values to the user to help the user to more intuitively learn the user's motion completion degree, or the direction of the action adjustment to be performed, or to see the user more intuitively. The parameters of the physical condition to avoid the occurrence of danger.

In a specific implementation of the present invention, the action indication sent by the server 11 may include a standard range of sensing parameters, so that the user terminal 12 can compare the sensing signal with the standard range, and prompt the user according to the comparison result. .

The action indication may include a plurality of decomposition actions, and the standard range may be multiple, respectively indicating a numerical range of parameters corresponding to each decomposition action.

The user terminal 12 can compare each parameter value and each standard range included in the sensing signal, prompt the user to operate the method, or give the user encouragement. Or when it is determined that it is necessary for the user to stop training, the user may be prompted to suspend the current action to avoid danger and damage.

The server 11 delivers the standard range of the sensing parameters, and the user terminal 12 compares the standard range and the sensing signal to generate different prompt information and prompt the user, which can make the indication to the user more precise and intelligent, and further improve the rehabilitation training. effect.

The user terminal 12 can also compare the standard range with the sensing signal and return at least a portion of the information contained in the sensing signal to the server 11 based on the result of the comparison.

The information contained in the sensing signal may be a value of the sensing parameter, or may be a judgment information obtained after determining the sensing signal, such as "normal" or "abnormal" information. The information contained in the sensing signal may also be information generated after analysis and calculation based on the sensing signal and the standard range, or may be information obtained by statistically analyzing and analyzing the sensing signal, for example, may be a statistical result, a peak value. And other information.

After comparing the standard range and the sensing signal, the user terminal 12 may not return the information when the value of the parameter included in the sensing signal is within the standard range, or only return "normal"; when sensing the signal When the value of the included parameter is not within the standard range, the value of the parameter contained in the sensing signal is returned, or "abnormal" is returned.

The user terminal 12 can also determine the content of the returned information in other manners and whether to return the information to the server 11.

It can be understood by those skilled in the art that the foregoing manner is merely an example, and is not limiting, and the content of the returned information may be determined in other manners, and whether the information is returned to the server 11. For example, all or part of the parameter values included in the sensing signal may be returned, or all or part of the information calculated by the sensing data may be returned.

In another specific implementation of the present invention, the user terminal 12 may also transmit all the sensor signals, and the server 11 sends an updated action indication to the user terminal 12, and performs the next user action on the user through the updated action indication. .

Since the server 11 can be connected to the doctor terminal 12 and has more computing power, more complicated calculations can be performed according to more data, so that the user's next user action can be indicated by means of the service update action indication, which can be more accurate and Meet the user's rehabilitation needs. However, in this manner, the amount of data interaction between the server 11 and the user terminal 12 is large, and the system resources occupied are large, and the requirements on the server 11 are high.

If the standard range of the sensing parameters is sent by the server 11, the user terminal 12 compares the standard range and the sensing signal, generates different prompt information, and prompts the user, thereby reducing the amount of data interaction.

The selection can be made in the different manners described above according to the needs of the actual application.

In the embodiment of the present invention, the action indication may include multiple action instructions, and each action instruction may indicate a decomposition action. The decomposition action can be determined according to the needs of rehabilitation, and can be continuous multiple movements or one movement.

For example, when the user needs lower limb rehabilitation, each action instruction may indicate the following decomposition actions: "lifting the left foot to 5 cm from the ground", "moving the left foot forward 10 cm from the ground 5 cm", "falling the left foot" "," raise your right foot to 5cm from the ground and keep it for 3s", "5cm forward with your right foot 5cm away from the ground."

Alternatively, each action command may correspond to the following decomposition action: “left foot moves forward by 10 cm” and right foot moves forward by 8 cm”.

The above example emphasizes that those skilled in the art will appreciate that the decomposition action does not have a physiological absolute distinction, but can be determined based on the need for rehabilitation.

When the action instruction includes multiple action instructions, the user terminal 12 may sequentially display the action instruction to the user. Specifically, the action may be performed as follows:

In an embodiment of the present invention, the action indication sent by the server 11 may include a plurality of action instructions, and a time interval for implementing the decomposition action corresponding to the action instructions, and the user terminal 12 may use the preset included in the action instruction. The time interval displays the action instruction to prompt the user for the user action that needs to be performed.

In another embodiment of the present invention, the sensing signal may carry one or more sensing parameters, and the motion indication may include a standard range of the sensing parameter, when the sensing signal is in the standard range In the meantime, the user can be considered to have completed the current decomposition action, and the next action instruction can be presented to the user to instruct the user to perform the next decomposition action.

In still another embodiment of the present invention, the user terminal 12 may receive a user indication, and the user terminal 12 may display the next action instruction to the user after receiving the user indication.

In a specific implementation, the priority may also be set. For example, the next action command may be set when the sensing signal is within the standard range, and the priority indicated by the setting user is higher, and after receiving the user indication, although sensing The signal is outside the standard range, but still shows the user the next action command.

The user terminal 12 in the embodiment of the present invention may also prompt the user to input user feedback data, and return the user feedback data to the server 11.

The user feedback data includes at least one of the following: subjective data and objective data. The subjective data may be used to describe the subjective feelings of the user, such as a user's pain, psychological feeling, etc., and may provide an optional level for the user to select; the objective data reflects the objective physical condition of the user, specifically It may be data obtained by testing by medical instruments or medical methods, such as X-ray film, CT film, electroencephalogram, blood routine results, etc., and may also be other data reflecting objective physical conditions, such as photos of the affected area.

The server 11 can also receive a doctor's instruction, for example, can directly receive the doctor's input, or can also receive the doctor's instruction through the doctor's terminal 14, and deliver the doctor's instruction to the user terminal 12.

The doctor's instructions may include data required by the doctor, and the user terminal 12 may display a doctor's instruction to prompt the user to respond to the doctor's needs and enter the doctor's request data. The user feedback data may include doctor demand data, and the user terminal 12 may return the doctor demand data to the server 11 for subsequent analysis and judgment.

The doctor's demand data is data that is feedback from the user's instructions to the doctor according to the doctor's instructions. The doctor's instruction may be a doctor's inquiry about the user's condition, and accordingly, the doctor's demand data may be the user's answer to the doctor's inquiry.

The doctor can ask the user for the last time of taking the medicine, the amount of the medication, the feeling of the user after taking the medicine, or the like, or the doctor may instruct the user to feel the feeling after the activity. Alternatively, the doctor may also make further inquiries based on subjective data provided by the user. For example, if the doctor finds that the user feels painful, he may ask "How much pain do you eat today, how much medicine you have eaten".

The server 11 may have the capability of data analysis, and based on the big data, update the action indication based on the user feedback data and/or the information returned by the user terminal 12.

The server 11 may also send feedback data and/or information returned by the user terminal 12 to the doctor terminal 14, updating the action indication based on the received information from the doctor terminal 14.

The doctor can also confirm, select or improve the analysis result of the server 11 directly on the server 11 or through the doctor terminal 14 based on the analysis of the server 11.

The updated action indication may include an instruction to instruct the user to suspend the user action, may also include other action instructions, or may include information such as a doctor's order.

In the embodiment of the present invention, the action indication can be updated according to the information from the user terminal, so the action indication can be more suitable for the user's condition, and thus a better rehabilitation effect can be obtained.

The user terminal is adapted to compare the standard range with the sensing signal, and generate prompt information according to the comparison result, thereby indicating that the user can better complete the user action and obtain a better rehabilitation effect; or prompting the user to suspend execution to avoid discomfort As the proceeding continues, the user continues to perform user actions and is hurt.

The user terminal can compare the standard range and the sensing signal, and determine whether to return the information to the server according to the comparison result, so that all or part of the information contained in the sensing signal can be returned to the server, and the sensing signal can be returned to the server. The result of the judgment can further reduce the amount of data returned to the server and reduce resource usage.

Although the present invention has been disclosed above, the present invention is not limited thereto. Any changes and modifications may be made by those skilled in the art without departing from the spirit and scope of the invention, and the scope of the invention should be determined by the scope defined by the appended claims.

Claims

A remote rehabilitation system, comprising: a server, a user terminal, and a sensing device, wherein:

The server is configured to send an action indication to the user terminal, where the action indication is used to indicate a user action;

The user terminal is adapted to display the action indication to instruct the user to perform the user action, receive a sensing signal in response to the action indication from the sensing device, and return the transmission to the server At least a portion of the information contained in the sense signal;

The sensing device is adapted to detect the user to generate the sensing signal responsive to the user action.
The remote rehabilitation system of claim 1, wherein the user terminal is adapted to present the action indications in at least one of: voice, image, animation, video, and text.
The remote rehabilitation system of claim 1 wherein said sensing signal carries one or more sensing parameters and said user terminal is adapted to exhibit at least a portion of said sensing parameters.
The remote rehabilitation system according to claim 1, wherein the sensing signal carries one or more sensing parameters, and the action indication includes a standard range of the sensing parameters, and the user terminal is adapted to In contrast to the standard range and the sensing signal, prompt information is generated based on the result of the comparison.
The remote rehabilitation system according to claim 1, wherein the sensing signal carries one or more sensing parameters, and the action indication includes a standard range of the sensing parameters, and the user terminal is adapted to Comparing the standard range with the sensing signal, returning at least part of the information contained in the sensing signal to the server according to the result of the comparison.
The remote rehabilitation system according to claim 1, wherein the action indication includes a plurality of action commands, each action command indicating a split action; and the user terminal uses the preset time included in the action indication The action instructions are displayed at intervals.
The remote rehabilitation system according to claim 1, wherein the action indication includes a plurality of motion commands, each motion command indicating a decomposition action; and the sensing signal carries one or more sensing parameters. The action indication includes a standard range of the sensing parameter; after the sensing signal in response to the current motion instruction falls within the standard range, the user terminal displays a next motion instruction.
The remote rehabilitation system according to claim 1, wherein the action indication includes a plurality of action commands, each action command indicating a split action; and the user terminal is further adapted to receive a user indication, upon receiving the After the user indicates, the next action instruction is displayed.
The remote rehabilitation system according to claim 1, wherein the user terminal is adapted to prompt the user to input user feedback data, and return the user feedback data to the server;

The user feedback data includes at least one of subjective data and objective data, wherein: the subjective data is used to describe a subjective feeling of the user, and the objective data is used to describe an objective physical condition of the user.
The remote rehabilitation system according to claim 9, wherein the server is further adapted to receive a doctor's instruction and deliver the doctor's instruction to the user terminal; the user feedback data further includes doctor demand data;

The user terminal is adapted to present the physician indication to prompt the client to enter physician demand data.
The remote rehabilitation system according to claim 9, wherein said remote rehabilitation system further comprises a doctor terminal, said server being adapted to transmit said user feedback data and/or information returned by said user terminal to said The doctor terminal updates the action indication based on the received information from the doctor terminal.
The remote rehabilitation system according to claim 9, wherein said server is further adapted to update said action indication based on said user feedback data and/or information returned by said user terminal.
The remote rehabilitation system of claim 1 wherein said server is further adapted to update said action indication based on information returned by said user terminal.
A remote rehabilitation system according to claim 12 or claim 13 wherein said updated action indication comprises aborting said user action.
The remote rehabilitation system according to claim 1, wherein said sensing device comprises at least one of: a pressure sensor, a position sensor, an acceleration sensor, an angle sensor, a myoelectric detecting sensor, an EEG detecting sensor, and a breathing Detection sensor, heart rate detection sensor, blood oxygen detection sensor, and imaging equipment.
The remote rehabilitation system of claim 1 wherein said sensing device is worn by said user.