WO2021078721A1 - Prévention et traitement de lésions de pression à l'aide d'une redirection dans un environnement de réalité virtuelle, de réalité augmentée ou de réalité mixte - Google Patents

Prévention et traitement de lésions de pression à l'aide d'une redirection dans un environnement de réalité virtuelle, de réalité augmentée ou de réalité mixte Download PDF

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Publication number
WO2021078721A1
WO2021078721A1 PCT/EP2020/079467 EP2020079467W WO2021078721A1 WO 2021078721 A1 WO2021078721 A1 WO 2021078721A1 EP 2020079467 W EP2020079467 W EP 2020079467W WO 2021078721 A1 WO2021078721 A1 WO 2021078721A1
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Prior art keywords
environment
user
change
visual content
orientation
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PCT/EP2020/079467
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English (en)
Inventor
Johannes DAGEVOS VAN RIJ
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T.J.Smith And Nephew,Limited
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Publication of WO2021078721A1 publication Critical patent/WO2021078721A1/fr

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Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F3/00—Input arrangements for transferring data to be processed into a form capable of being handled by the computer; Output arrangements for transferring data from processing unit to output unit, e.g. interface arrangements
    • G06F3/01—Input arrangements or combined input and output arrangements for interaction between user and computer
    • G06F3/011—Arrangements for interaction with the human body, e.g. for user immersion in virtual reality
    • 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
    • A61B5/1116—Determining posture transitions
    • 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
    • A61B5/1122—Determining geometric values, e.g. centre of rotation or angular range of movement of movement trajectories
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/44—Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441—Skin evaluation, e.g. for skin disorder diagnosis
    • A61B5/447—Skin evaluation, e.g. for skin disorder diagnosis specially adapted for aiding the prevention of ulcer or pressure sore development, i.e. before the ulcer or sore has developed
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/486—Bio-feedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6802—Sensor mounted on worn items
    • A61B5/6803—Head-worn items, e.g. helmets, masks, headphones or goggles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient ; user input means
    • A61B5/742—Details of notification to user or communication with user or patient ; user input means using visual displays
    • A61B5/743—Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient ; user input means
    • A61B5/746—Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2505/00—Evaluating, monitoring or diagnosing in the context of a particular type of medical care
    • A61B2505/07—Home care

Definitions

  • Embodiments of the present disclosure relate to apparatuses, systems, and methods for the prevention and treatment of pressure injuries.
  • Pressure injuries are injuries to skin and underlying tissue resulting from prolonged pressure on the skin, soft tissue, muscle, or bone above capillary filling pressure (approximately 32 mmHg). Pressure injuries may typically develop on skin that covers bony areas, such as heels, ankles, hips, shoulder blades, spine, elbows, back of the head, and tailbone as illustrated in Figure 1. Persons whose mobility is limited due to age or medical conditions are at an increased risk of developing pressure injuries because of their inability to change positions while sitting or lying down.
  • Prevention, management, and treatment of pressure injuries include repositioning of the injured limb or body part and using support surfaces, such as a mattress, cushion, or the like.
  • support surfaces such as a mattress, cushion, or the like.
  • prior art approaches and systems are unable to ensure that a patient or caregiver follows these approaches for the prevention, management, and treatment of pressure injuries. Because of these limitations, prevention and healing of patients’ pressure injuries using prior art approaches and systems may be delayed or, worse yet, the condition could worsen leading to prolonged discomfort, hospitalization, or even surgery.
  • An apparatus for prevention and/or treatment of pressure injuries can include a head mounted display (HMD) with a processor and a display.
  • the HMD can be configured to be worn by a user.
  • the processor can be configured to present a virtual, augmented, or mixed reality environment to the user on the display.
  • Environment can include visual content with a position in the environment configured to move over a time period to cause the user to shift a body weight of the user according to a change in the position of the visual content in order to facilitate prevention and/or treatment of one or more pressure injuries of the user.
  • the apparatus of any of the preceding paragraphs and/or any of the apparatuses disclosed herein can include one or more of the following features.
  • the position of the visual content can be configured to move in a path over the time period.
  • the path can be an arc.
  • Visual content can include one or more of a film, show, or interactive content.
  • Position of the one or more of the film, show, or interactive content in the environment can be configured to move in path, such as an arc, over the time period.
  • the apparatus can include at least one sensor that can be configured to monitor at least one of a positon or orientation of the user.
  • the processor can be configured to adjust the change in the position of the visual content in the environment responsive to the monitored at least one of the position or orientation of the user at first time.
  • the processor can be configured to, responsive to the monitored at least one of the position or orientation of the user at a second time subsequent to the first time, determine that the adjustment of the change in the position of the visual content in the environment has caused an expected change in the at least one of the position of orientation of the user and cease the adjustment of the change in the position of the visual content in the environment.
  • the expected change can correspond to a predetermined change in the at least one of the position or orientation of the user.
  • the processor can be configured to generate an alarm in response to a determination that the adjustment of the change in the position or orientation of the visual content in the environment has not caused the expected change in the at least one of the position of orientation of the user.
  • Adjustment of the change in the position of the visual content in the environment can include adjusting a rate of the change.
  • the apparatus of any of the preceding paragraphs and/or any of the apparatuses disclosed herein can include one or more of the following features.
  • Environment can include interactive content configured to cause the user to at least one of shift the body weight of the user according to a change in the position of the interactive content in the environment in order to facilitate prevention and/or treatment of pressure injuries or perform physical activity that facilitates prevention and/or treatment of pressure injuries.
  • a method of operating an apparatus for prevention and/or treatment of pressure injuries can include presenting a virtual, augmented, or mixed reality environment to a user on a display of a head mounted display (HMD) worn by a user.
  • Environment can include visual content.
  • the method can include moving a position of the visual content in the environment over a time period to cause the user to shift a body weight of the user according to a change in the position of the visual content in order to facilitate prevention and/or treatment of one or more pressure injuries of the user.
  • the method can be performed under control of a processor.
  • the method of any of the preceding paragraphs and/or any of the methods disclosed herein can include one or more of the following features.
  • the method can include moving the position of the visual content in a path over the time period.
  • the path can be an arc.
  • Visual content can include one or more of a film, show, or interactive content.
  • the method can include moving a position of the one or more of the film, show, or interactive content in the environment in a path, such as an arc, over the time period. Change in the position of the visual content in the environment over the time period can cause the user laying on a first side to make a turn and lay on a second side opposite the first side.
  • Rate of change in the position of the visual content in the environment can be selected to cause the user to make a full turn from laying on the first side to laying on the second side over the time period.
  • the method of any of the preceding paragraphs and/or any of the methods disclosed herein can include one or more of the following features.
  • the method can include adjusting the change in the position of the visual content in the environment responsive to a monitored at least one of the position or orientation of the user at first time.
  • the method can include, responsive to a monitored at least one of the position or orientation of the user at a second time subsequent to the first time, determining that the adjustment of the change in the position of the visual content in the environment has caused an expected change in the at least one of the position of orientation of the user and ceasing the adjustment of the change in the position of the visual content in the environment.
  • the expected change can correspond to a predetermined change in the at least one of the position or orientation of the user.
  • the method can include generating an alarm in response to determining that the adjustment of the change in the position or orientation of the visual content in the environment has not caused the expected change in the at least one of the position of orientation of the user.
  • Adjustment of the change in the position of the visual content in the environment can include adjusting a rate of the change.
  • Environment can include interactive content configured to cause the user to at least one of shift the body weight of the user according to a change in the position of the interactive content in the environment in order to facilitate prevention and/or treatment of pressure injuries or perform physical activity that facilitates prevention and/or treatment of pressure injuries.
  • Figure 1 illustrates pressure injuries including diabetic foot ulcers
  • Figures 2A-2C and 3 illustrate rotation of a patient in bed for preventing pressure injuries
  • Figure 4 a block diagram of a system for preventing and/or treating pressure injuries.
  • Embodiments disclosed herein relate to apparatuses, systems, and methods for the monitoring of body loading and body position for prevention and treatment of pressure injuries.
  • Loading can refer to transferring or placing at least a threshold amount of force on a body part. Placing such threshold amount of force on the body part causes the body part to support weight.
  • loading of a foot can refer to transferring or placing at least a portion of the body weight (or body weight in combination with external weight) on the foot such that the foot is supporting at least such portion of the body weight. At least such portion of the body weight can serve as a threshold for determining that the foot has been loaded.
  • Some of the disclosed implementations may utilize a dressing (also sometimes referred to as wound dressing) alone or in combination with negative or reduced pressure.
  • a dressing also sometimes referred to as wound dressing
  • the apparatuses and components including an overlay and packing materials or internal layers, if any, are sometimes collectively referred to herein as dressings.
  • any reference to a wound herein can refer to a wound on a human or animal body, and any reference to a body herein can refer to a human or animal body.
  • the disclosed technology embodiments may relate to preventing or minimizing damage to physiological tissue or living tissue, or to the treatment of damaged tissue (for example, a wound as described herein).
  • wound may include an injury to living tissue may be caused by a cut, blow, or other impact, typically one in which the skin is cut or broken.
  • a wound may be a chronic or acute injury. Acute wounds occur as a result of surgery or trauma. They move through the stages of healing within a predicted timeframe. Chronic wounds typically begin as acute wounds. The acute wound can become a chronic wound when it does not follow the healing stages resulting in a lengthened recovery. It is believed that the transition from acute to chronic wound can be due to a patient being immuno-compromised.
  • Chronic wounds may include for example: venous ulcers (such as those that occur in the legs), which account for the majority of chronic wounds and mostly affect the elderly, diabetic ulcers (for example, foot or ankle ulcers), peripheral arterial disease, pressure ulcers, or epidermolysis bullosa (EB).
  • venous ulcers such as those that occur in the legs
  • diabetic ulcers for example, foot or ankle ulcers
  • peripheral arterial disease for example, pressure ulcers, or epidermolysis bullosa (EB).
  • EB epidermolysis bullosa
  • wounds include, but are not limited to, abdominal wounds or other large or incisional wounds, either as a result of surgery, trauma, sterniotomies, fasciotomies, or other conditions, dehisced wounds, acute wounds, chronic wounds, subacute and dehisced wounds, traumatic wounds, flaps and skin grafts, lacerations, abrasions, contusions, bums, diabetic ulcers, pressure ulcers, stoma, surgical wounds, trauma and venous ulcers or the like.
  • Wounds may also include a deep tissue injury.
  • Deep tissue injury is a term proposed by the National Pressure Ulcer Advisory Panel (NPUAP) to describe a unique form of pressure ulcers. These pressure ulcers have been described by clinicians for many years with terms such as purple pressure ulcers, ulcers that are likely to deteriorate and bruises on bony prominences.
  • NPUAP National Pressure Ulcer Advisory Panel
  • Wound may also include tissue at risk of becoming a wound as discussed herein.
  • tissue at risk may include tissue over a bony protuberance (at risk of deep tissue injury /insult) or pre-surgical tissue (for example, knee tissue) that may have the potential to be cut (for example, for joint replacement/surgical alteration/reconstruction).
  • Some embodiments relate to methods of preventing, monitoring, or treating a wound with the technology disclosed herein in conjunction with one or more of the following: advanced footwear, turning a patient, offloading (such as, offloading diabetic foot ulcers), treatment of infection, systemix, antimicrobial, antibiotics, surgery, removal of tissue, affecting blood flow, physiotherapy, exercise, bathing, nutrition, hydration, nerve stimulation, ultrasound, electrostimulation, oxygen therapy, microwave therapy, active agents ozone, antibiotics, antimicrobials, or the like.
  • a wound may be treated using topical negative pressure or traditional advanced wound care, which is not aided by the using of applied negative pressure (may also be referred to as non-negative pressure therapy).
  • Advanced wound care may include use of an absorbent dressing, an occlusive dressing, use of an antimicrobial or debriding agents in a wound dressing or adjunct, a pad (for example, a cushioning or compressive therapy, such as stockings or bandages), or the like.
  • a pad for example, a cushioning or compressive therapy, such as stockings or bandages
  • treatment of such wounds can be performed using traditional wound care, wherein a dressing can be applied to the wound to facilitate and promote healing of the wound.
  • Some embodiments relate to methods of manufacturing a wound dressing including providing a wound dressing as disclosed herein.
  • wound dressings that may be utilized in conjunction with the disclosed technology include any known dressing in the art.
  • the technology is applicable to negative pressure therapy treatment as well as non-negative pressure therapy treatment.
  • a wound dressing includes one or more absorbent layer(s).
  • the absorbent layer may be a foam or a superabsorbent.
  • wound dressings may include a dressing layer including a polysaccharide or modified polysaccharide, a polyvinylpyrrolidone, a polyvinyl alcohol, a polyvinyl ether, a polyurethane, a polyacrylate, a polyacrylamide, collagen, or gelatin or mixtures thereof.
  • dressing layers including the polymers listed are known in the art as being useful for forming a wound dressing layer for either negative pressure therapy or non-negative pressure therapy.
  • the polymer matrix may be a polysaccharide or modified polysaccharide.
  • the polymer matrix may be a cellulose.
  • Cellulose material may include hydrophilically modified cellulose such as methyl cellulose, carboxymethyl cellulose (CMC), carboxymethyl cellulose (CEC), ethyl cellulose, propyl cellulose, hydroxyethyl cellulose, hydroxypropyl cellulose, hydroxypropylmethyl cellulose, carboxyethyl sulphonate cellulose, cellulose alkyl sulphonate, or mixtures thereof.
  • hydrophilically modified cellulose such as methyl cellulose, carboxymethyl cellulose (CMC), carboxymethyl cellulose (CEC), ethyl cellulose, propyl cellulose, hydroxyethyl cellulose, hydroxypropyl cellulose, hydroxypropylmethyl cellulose, carboxyethyl sulphonate cellulose, cellulose alkyl sulphonate, or mixtures thereof.
  • cellulose material may be cellulose alkyl sulphonate.
  • the alkyl moiety of the alkyl sulphonate substituent group may have an alkyl group having 1 to 6 carbon atoms, such as methyl, ethyl, propyl, or butyl.
  • the alkyl moiety may be branched or unbranched, and hence suitable propyl sulphonate substituents may be 1- or 2-methyl-ethylsulphonate.
  • Butyl sulphonate substituents may be 2- ethyl-ethylsulphonate, 2,2-dimethyl-ethylsulphonate, or 1 ,2-dimethyl- ethylsulphonate.
  • the alkyl sulphonate substituent group may be ethyl sulphonate.
  • the cellulose alkyl sulphonate is described in W010061225, US2016/114074, US2006/0142560, or US 5,703,225, the disclosures of which are hereby incorporated by reference in their entirety.
  • Cellulose alkyl sulfonates may have varying degrees of substitution, the chain length of the cellulose backbone structure, and the structure of the alkyl sulfonate substituent. Solubility and absorbency are largely dependent on the degree of substitution: as the degree of substitution is increased, the cellulose alkyl sulfonate becomes increasingly soluble. It follows that, as solubility increases, absorbency increases.
  • a wound dressing also includes a top or cover layer.
  • the thickness of any of the wound dressings disclosed herein may be between 1 to 20, or 2 to 10, or 3 to 7 mm.
  • Pressure injury prevention and treatment can include redistributing pressure by regularly repositioning the patient and offloading of one or more regions of tissue. For example, a laying patient can be turned every two hours. In addition to the turning, the tissue can be decompressed for at least 15 minutes.
  • HCP healthcare provider
  • Other existing approaches involve the use of devices that physically move the patient (such as, a motorized bed) or monitoring systems that provide an indication of the need to reposition the patient.
  • Existing approaches can be burdensome, inefficient, expensive, and unreliable. For example, patients suffering from neuropathy can be particularly susceptible to pressure injuries as they lack the natural urge to shift their weight or turn.
  • a system or apparatus for repositioning the patient can generate undetectable changes in one or more of real or virtual stimulus to generate a physical response by a patient.
  • the physical response can include shifting the weight of the patient, turning in bed, offloading weight from a limb, sitting up, standing up, walking, or the like.
  • the system can monitor the patient’s response and adjust the one or more of real or virtual stimulus in response to detecting that the patient’s response deviates from a desired response. Unlike the existing approaches, the system can reliably and efficiently facilitate prevention or treatment of pressure injuries.
  • the system (which can be referred to as repositioning system) can include a virtual reality device, augmented reality device, mixed reality device, or the like (sometimes referred to as a head mounted display (HMD)) worn by the patient.
  • HMD can display a virtual reality environment, augmented reality environment, mixed reality environment, or the like to the patient (which can be referred to individually or collectively as environment).
  • Presentation of the virtual environment can immerse the patient in an artificial (or virtual) environment.
  • Presentation of augmented reality (AR) environment can immerse the patient in a real-world environment with virtual objects or elements.
  • Presentation of mixed reality (MR) environment can immerse the patient in a real-world environment with virtual objects or elements anchored to real-world objects or elements.
  • Presentation of the environment can cause generation of the physical response by the patient.
  • the physical response can include the patient shifting the patient’s weight in order to allow tissue to decompress.
  • a patient 200 laying in bed can wear an HMD 220 of the system.
  • Presentation of the environment by the HMD 220 can cause the patient 200 to turn from one side (for example, the right side as illustrated in Figure 2A) to the back (as illustrated in Figure 2B), and from the back to the other side (for example the left side, as illustrated in Figure 2C).
  • the system can cause the patient 200 to make a full turn in bed, which results in decompression of the tissue and prevention or treatment of pressure injuries.
  • the environment can include visual content, such as a movie, film, show, a virtual scene, or the like.
  • the system can adjust or move one or more elements of the environment (for instance, the visual content) over a period of time. For example, orientation or position of the one or more elements of the environment, such as position of the visual content, can be moved or adjusted. This can cause the patient to shift the patient’s body weight in response to the movement. The patient can be caused to shift the patient’s body weight in the same direction as the movement.
  • one or more elements of the environment for instance, the visual content
  • the visual content can include interactive content.
  • interactive content can cause the patient to participate or actively engage with the one or more elements of the environment.
  • Rate of movement of the one or more elements of the environment can be below a rate that the patient is able to detect.
  • Humans can rely primarily on vestibular, visual, and auditory senses for balance and orientation. Humans may rely on these senses to determine if surrounding objects are moving. If the rate of movement of the one or more elements of the environment (or augmented reality environment, mixed reality environment, or the like as described herein) is selected to below the threshold of human perception of movement of surrounding objects, the patient will not be aware of the movement in the environment, but will produce the physical response as a result of the movement. This can result in optimal experience without causing any undesirable symptoms, such as stimulator sickness, motion sickness, or the like.
  • the environment can include a film or show (or another type of static content).
  • the film or show can be displayed on a virtual screen in the environment.
  • Position of the film or show such as position of the virtual screen within the environment, can be adjusted or moved over the period of time, such as moved in a path.
  • position of the film or show (or any other environment element) can be moved in an arc 320 (or another path).
  • the patient 200 can physically move, such as rotate in bed as illustrated by the arc 310.
  • the patient 200 can make the rotation in order to view the film or show correctly as the position of the virtual screen changes.
  • the patient 200 can make a full rotation from one side to the other as shown in Figures 2A-2C.
  • the patient 200 can make a partial rotation.
  • One or more of the trajectory of the arc 320 or the rate of movement can be selected to ensure that the patient moves from one side to the other causing a consistent spread of load across the whole area of tissue and preventing pressure injuries.
  • Period of time for the movement can be, for example, 30 minutes or less or more, 1 hour of less or more, two hours or less or more, or the like.
  • rate of movement in a semi-circular arc 320 illustrated in Figure 3 can be 1.5 degrees/minute, which may be well below the threshold of human perception of object movement.
  • the environment can include visual content of the patient laying in a virtual bed. Such environment can mimic the real-world environment in which the patient is positioned.
  • the environment can additionally or alternatively include a film or show (or another type of static content).
  • viewing angle from which the patient sees the environment (or visual content) can be adjusted or moved over the period of time. For example, the viewing angle can be rotated, as described herein. Such movement can cause physical movement of the patient to physically and shifting of the patient’s weight.
  • the environment can include interactive content.
  • interactive content can include one or more gamified elements or content (sometimes referred to as gamelike elements or content).
  • One or more gamified elements can include one or more virtual objectives (or objects) positioned in or within the patient’s virtual field of view.
  • targets can be positioned within the patient’s virtual field of view.
  • position(s) of the one or more gamified elements can be moved or adjusted to cause positioning of the one or more gamified elements outside the patient’s virtual field of view.
  • the one or more gamified elements can be rotated, as described herein.
  • the patient can be caused to physically move and shift the patient’s weight, as described herein.
  • Level of engagement of the patient with the game can be proportional to the speed or rate of redirecting the patient to cause the patient to move. The more engaged the patient might be, the less the patient may detect the rate of movement of the one or more gamified elements.
  • Any environment (or visual content), including user-selected content, configured to move or adjust the patient’s direction of view can be used to cause the patient to physically move and shift the patient’s weight, as described herein.
  • augmented reality environment or mixed reality environment can be used.
  • presentation of augmented reality environment can immerse the patient in a real-world environment with virtual objects or elements.
  • presentation of mixed reality environment can immerse the patient in a real-world environment with virtual objects or elements anchored to real-world objects or elements.
  • objects or elements can be placed or moved (for example, dynamically) to positions relative to the position of orientation of the patient. Such placement or movement of the objects can to cause the patient to physically move and shift the patient’s weight.
  • Such approaches can reduce the sensory impact as the patient may perceive less of removal from the real-world environment than with the use of a virtual reality environment.
  • FIG. 4 illustrates a repositioning system 400.
  • the system 400 can include an HMD 410.
  • the HMD 410 can include at least one controller or processor 412 and a display 414.
  • the processor 412 may not be part of the HMD 410 or the system 400 can include another processor (or processors) that are not part of the HMD 410.
  • the processor 412 can present or cause presentation of the environment on the display.
  • the system can include one or more sensors 420 configured to monitor position or orientation of one or more of the patient or virtual, augmented reality or mixed reality environment.
  • a sensor 420 can include one or more accelerometers (which can be configured to measure acceleration, pitch, roll, or the like), magnetometers (which can be configured to measure yaw), gyroscopes (which can be configured to measure orientation), or the like.
  • the sensor 420 can be an inertial measuring unit (IMU) sensor.
  • the IMU sensor can include one or more accelerometers, gyroscopes, or magnetometers.
  • the IMU sensor can determine rotation in a number of degrees of freedom, such as in pitch (which can be associated with tilting backward and forward), yaw (which can be associated with left and right movement while remaining level), or roll (which can be associated with clockwise or counterclockwise movement).
  • Position or orientation of the environment can be determined based on the position or orientation of the patient’s head.
  • the system 400 can adjust the movement in the environment in response to the monitored position (which can be indicative of a location) or orientation (which can be indicative of a relative position, such as up, down, sideways, etc.) of one or more of the patient or the environment.
  • the system 400 can adjust the rate of the movement (such as, speed up or slow down the movement) in response to determining that the patient’s position or orientation is not in accordance with an expected position or orientation.
  • the system 400 can speed up the rate of movement in response to a determination that the user is turning too slowly. Subsequent to the adjustment of the rate of movement, the system 400 can determine whether the patient’s position or orientation has changed as expected.
  • the system 400 can discontinue adjustment of the movement. If not, the system 400 can perform one or more of continue adjustment of the movement, alter the adjustment (for example, speed up the rate of movement even more), or generate an indication or alarm.
  • the indication can be visual, audible, tactile, or the like.
  • the indication can be transmitted to a remote computing device, such as HCP’s or caregiver’s computing device.
  • the rate of movement can be adjusted based on elapsed time relative to the period of time. For example, if the elapsed time is within one or more thresholds of the period of time, the rate of movement can be increased by a corresponding threshold rate. As the elapsed time approaches the total period of time, the rate of movement can be increased by a greater amount. The increase in the rate of movement can be limited to ensure that the resulting rate of movement stays remains the threshold of human perception of object movement. In some instances, the rate of movement can be static or fixed.
  • the one or more sensors 420 can be positioned on or in the HMD 410, such as on or within a housing of the HMD.
  • the one or more sensors 420 can communicate data to the processor 412 (or to another processor or controller). Data can be communicated wirelessly or via a wired connection.
  • the one or more sensors 420 can be part of a tracking system separate from the HMD 410.
  • one or more sensors 420 can be positioned on the patient, in the bed, in the room, or the like.
  • the tracking system can include one or more controllers or processors. Data of the one or more sensors 420 of the tracking system can be communicated to the processor 412 wirelessly or via a wired connection.
  • a first sensor 420 can be positioned on or in the HMD 410 and a second sensor 420 can be positioned on the patient’s body.
  • the first and second sensors 420 can be IMU sensors.
  • the first sensor 420 can be used for determining the position or orientation of the environment (for instance, based on the position or orientation of the patient’s head).
  • the second sensor 420 can be used for determining the position or orientation of the patient.
  • one or more additional sensors can be used to determine how long the patient has compressed one or more of a region of tissue of interest or adjacent region(s) of tissue. For example, such one or more sensors can monitor a period of time during which one or more regions of tissue have been loaded by determining that force or pressure satisfy a loading threshold.
  • Such one or more sensors can be pressure sensors, force sensors, or the like.
  • the one or more sensors can be placed on the patient’s torso, foot, or the like.
  • the system 400 can utilize information from such one or more sensors to adjust the rate (or direction) of movement of the one or more elements in the environment.
  • the system 400 can cause movement of the one or more elements in the environment to the left. This can cause the patient to shift the patient’s weight to the left (or toward the side of the least compressed tissue).
  • the first compression threshold can be indicative of greater level of compression than the second compression threshold.
  • the second compression threshold can be indicative of greater level of compression than the third compression threshold.
  • the environment can additionally or alternatively include interactive content configured to cause the patent to engage in physical activity, which can result in decompression of the tissue.
  • Physical activity can include sitting up, standing up, walking in place, walking, moving arms, moving the head, or the like.
  • real or non-virtual stimulus can be provided by the system to cause the physical response by the patient.
  • Such stimulus can include one or more of visual stimulus, auditory stimulus (such as, a prompt or announcement to turn), or the like.
  • Non-virtual stimulus can include increasing the light levels on one side of the room, changing the light levels from one side of the room to the other (such as, from left to right), or the like.
  • a physical screen can be moved similarly to the movement of the virtual screen described herein.
  • Any of the systems disclosed herein can include one or more of headphones or other devices for providing audio playback, haptic feedback devices, or the like.
  • the audio playback can be directional.
  • any value of a threshold, limit, duration, etc. provided herein is not intended to be absolute and, thereby, can be approximate.
  • any threshold, limit, duration, etc. provided herein can be fixed or varied either automatically or by a user.
  • relative terminology such as exceeds, greater than, less than, etc. in relation to a reference value is intended to also encompass being equal to the reference value. For example, exceeding a reference value that is positive can encompass being equal to or greater than the reference value.
  • relative terminology such as exceeds, greater than, less than, etc. in relation to a reference value is intended to also encompass an inverse of the disclosed relationship, such as below, less than, greater than, etc. in relations to the reference value.
  • blocks of the various processes may be described in terms of determining whether a value meets or does not meet a particular threshold, the blocks can be similarly understood, for example, in terms of a value (i) being below or above a threshold or (ii) satisfying or not satisfying a threshold.
  • the various components illustrated in the figures may be implemented as software or firmware on a processor, controller, ASIC, FPGA, or dedicated hardware.
  • Hardware components such as controllers, processors, ASICs, FPGAs, and the like, can include logic circuitry.
  • the features and attributes of the specific embodiments disclosed above may be combined in different ways to form additional embodiments, all of which fall within the scope of the present disclosure.
  • the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list.
  • the term “each,” as used herein, in addition to having its ordinary meaning, can mean any subset of a set of elements to which the term “each” is applied.
  • the terms “generally parallel” and “substantially parallel” refer to a value, amount, or characteristic that departs from exactly parallel by less than or equal to 15 degrees, 10 degrees, 5 degrees, 3 degrees, 1 degree, or 0.1 degree.

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Abstract

L'invention concerne un appareil pour la prévention et/ou le traitement de lésions de pression, pouvant comprendre un visiocasque (HMD) doté d'un processeur et d'un dispositif d'affichage. Le visiocasque peut être conçu pour être porté par un utilisateur. Le processeur peut être configuré pour présenter un environnement de réalité virtuelle, augmentée ou mixte à l'utilisateur sur l'affichage. L'environnement peut comprendre un contenu visuel avec une position dans l'environnement configurée pour se déplacer sur une période de temps pour amener l'utilisateur à décaler son poids corporel en fonction d'un changement de la position du contenu visuel afin de faciliter la prévention et/ou le traitement de lésions de pression de l'utilisateur. En résumé, l'invention concerne un système d'apprentissage et d'assistance basé sur un visiocasque pour encourager un patient à se déplacer pour éviter un décubitus/ulcère.
PCT/EP2020/079467 2019-10-22 2020-10-20 Prévention et traitement de lésions de pression à l'aide d'une redirection dans un environnement de réalité virtuelle, de réalité augmentée ou de réalité mixte WO2021078721A1 (fr)

Applications Claiming Priority (2)

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GB1915248.7 2019-10-22
GB201915248A GB201915248D0 (en) 2019-10-22 2019-10-22 Pressure injury prevention and treatment using redirection in a virtual reality, augmented reality, or mixed reality environment

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WO2021078721A1 true WO2021078721A1 (fr) 2021-04-29

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5703225A (en) 1995-12-13 1997-12-30 Kimberly-Clark Worldwide, Inc. Sulfonated cellulose having improved absorbent properties
US20060142560A1 (en) 2004-12-29 2006-06-29 Glasser Wolfgang G Sulfoalkylated cellulose
WO2010061225A2 (fr) 2008-11-27 2010-06-03 Speciality Fibres And Materials Limited Matériaux absorbants
US20180151258A1 (en) * 2015-07-31 2018-05-31 Universitat De Barcelona Motor Training

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5703225A (en) 1995-12-13 1997-12-30 Kimberly-Clark Worldwide, Inc. Sulfonated cellulose having improved absorbent properties
US20060142560A1 (en) 2004-12-29 2006-06-29 Glasser Wolfgang G Sulfoalkylated cellulose
WO2010061225A2 (fr) 2008-11-27 2010-06-03 Speciality Fibres And Materials Limited Matériaux absorbants
US20160114074A1 (en) 2008-11-27 2016-04-28 Speciality Fibres And Materials Ltd. Absorbent material
US20180151258A1 (en) * 2015-07-31 2018-05-31 Universitat De Barcelona Motor Training

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