This application claims priority from U.S. Provisional Patent Application No. 62/537,777 filed Jul. 27, 2017. It is also related to applications Ser. No. 15/284,157, Ser. No. 14/149,158 and 61/750,390. Applications 62/537,777, Ser. No. 15/284,157, Ser. No. 14/149,158 and 61/750,390 are hereby incorporated by reference in their entireties.
The present invention relates to systems that allows a caregiver to monitor a patient and more particularly to a range of motion tracking system.
In the care of the elderly, it is difficult to accurately access a person's condition. It would be very advantageous to have an automated system that could accurately access and record a person's condition and range of motion.
A “subject” is any person using the application of the present invention. A subject could be a patient, a customer, or client who is seeking an exercise program.
A “caregiver” is any person in authority who is enlisted by the subject to create, manage and control an exercise program. A caregiver could be a doctor, or nurse, or physical therapist, a trainer or a coach.
Embodiments of the present invention include a method for range of motion (ROM) tracking, that determines with a ROM tracking system, an exercise identified by a caregiver to be performed by a subject by positioning a sensor of the ROM tracking system to allow the sensor to detect at least one movement by the subject during a performance of the exercise, and then detecting, through the sensor, at least one movement of the subject. The system further analyzes the movement by the subject to determine a range of motion of the at least one movement; recording through a user interface an indication by the subject of an experiential narrative; and finally, providing a report to the caregiver, where the report contains the results of at least one movement in conjunction with at least a portion of the experiential narrative.
A range of motion tracking system is described. In one example embodiment, the range of motion tracking system is implemented with an application running on a smartphone. However, an actual smartphone is not strictly required, as would be apparent to one skilled in the art: In the alternative, a device comprising sufficient communication and processing capabilities able to execute methods for conveying instructions for an exercise to the user (e.g., by display or audio output), detecting and analyzing a subject's movements in the context of the exercise, and recording indication of pain level of the subject in conjunction with recording the range of motion, and communicating those records of range of motion and pain level to the caregiver.
The invention provides an evaluation system that engages subjects, e.g., the elderly and those requiring physical therapy, and encourages them to make specific movements or a series of movements, with the movements being measured by motion sensors. Said sensors will either be internal to the smartphone or external sensors in wired and/or wireless communication with the smartphone. The present invention builds a 3D “range of motion” map for specific portions of the subject's body, e.g., for movement of limbs where their joints that are under evaluation for various reasons, including surgery, trauma, old age, etc. The phone, or a sensor in communication with the phone, is held or else attached to a measurement zone, allowing the sensor to measure motions of the target portion of the subject's body, e.g., the target limb. The amount of pain during movement is also recorded based on indication by the subject, whether by voice or other user interface such as typing a value or description, or by control on a touchscreen or other graphic user interface to accept the pain level entry from the subject, or through a caregiver.
The invention is not limited to the injured and elderly and can be used by healthy, younger persons in order to track specific movements, or series of movements, for example ones that are suggested by a trainer or coach.
Further, a goal of the present improvement is to create both an educational and an evaluation system that can be easily employed and used by a single person at home without the aid of another person. Note that a subject might be alone at the time of exercise and evaluation.
In some embodiments, the system instructs and guides the subject through specific movements or exercises, and, at the same time uses the microphone internal to the smartphone, to record the subject's voice, use a voice recognition tool to recognize the subject's words, thereby “listening” to and record the subject as the subject describes the level of pain felt in conjunction with the measured movement.
The aim of most exercise therapy is to regain, or at least maintain, a range of motion that is perceived to be normal for the subject, for example, that which existed prior to an accident or surgery.
It is a goal of the present invention to improve the results of the training and therapy by combining a 3D range of motion map with the subject's verbal monologue, describing the level of pain, but not limited to pain, at any given point along the path of movement of the target limb. This is termed an “experiential narrative” and can include various sensations such as tingling, numbness, weakness, cold, warmth, tremors, etc.
If more than one portion of the body is to be evaluated (e.g., different limbs), the subject may describe to the audio input, or indicate using another user interface (e.g., typing or entry with a touchscreen control), which portions are being exercised or which exercise or motion is to be or has been performed. For some movements, the expected motions may produce measurements that are automatically recognizable, whereby providing a description from the subject is not needed. For an example of such technology, see U.S. Pat. No. 8,109,858. Similarly, if the particular body portion is identified, or the specific motion is prescribed by the invention, then it is not necessary for the subject to indicate the particular exercise.
The exercises or motions undertaken by the subject may be in compliance with instructions from the caregiver. Such instructions may be dispensed by the present invention, e.g., a smartphone application that announces the next exercise to be undertaken, which may include the instructions for how the subject is to hold the smartphone or how to attach the smartphone to the subject's body. The detection and recording of movement of the limb through space and the recording on the smartphone of the words, description and experiential narrative provided by the subject, are date and timestamped. The key concept is to build a connection in time between the subject's experience, which includes pain, and the 3D spatial map of movement of the limb. In one instance, this will be the subject's running monologue describing a level of pain based on common physical pain assessment descriptions from 1 to 10, ten being the most painful.
The spatial map is shown in one summary diagram, either animated or still, of the subject's movement with a color scheme from red to blue, with red as the highest pain level. Also, a series of summary diagrams are shown to the caregiver showing the subject's progress over time. This allows the caregiver to quickly and easily assess the subject's status.
Another attribute that will be described beside pain is “strength”. The subject might not have pain, but might lose strength at a certain point along the path of movement, or perhaps the joint makes a concerning sound at a certain point and that sound will also be recorded for later analysis. This may all be described, keeping in mind that the level of pain during movement is the primary focus for most elderly and injured subjects.
The subject's voice will be recorded and time stamped so that the subject's words regarding pain, or other attributes as mentioned above, can be correlated with the subject's own movements; however, the voice recognition process does not need to be in real time, and may be processed locally or remotely (e.g., “in the cloud”) at some reasonable time during, or after, the evaluation period. Remote voice recognition processing allows the application to take up less memory and processor power, compared with that processing taking place on the smartphone.
Another important attribute of the present invention is that the caregiver can review a session, once captured, to monitor the subject's recorded movements, range of motion, the number of repetitions, and the speed of each movement, as part of the prescribed exercise program. In some embodiments, during review, the system will record a caregiver comment in conjunction with the particular exercise or session being reviewed, for example to make recommendations, as needed, about the subject's exercise performance or progress.
The range of motion tracking system of the present invention performs the following steps:
Authenticating the identity of the subject. Authentication can be by account and password, but is preferably biometrically based, for example an image of the user's face, taken by a camera of the system, where the image is recorded in conjunction with the exercise, or is submitted for facial recognition to determine whether the image of the user's face is recognized as being the subject. If the authentication or any other data being recorded is categorized as patient data to be afforded privacy protections, then standard HIPAA precautions of encrypting sensitive data and confidentiality shall be followed.
Positioning at least a sensor of the system on the subject. At least a sensor of the system is held by or attached to the subject, in accordance with an instruction for an exercise. For example, the subject may attach the whole smartphone onto a particular (target) limb at a prescribed location. In some cases, multiple limbs can be tested and exercised at the same time, which may or may not require additional sensors; however, in general, a single limb, or a single joint, will be targeted, and the exercise and evaluation will be for just the one body portion.
A flexible band with velcro fastening, or other mounting, can be used to attach the sensor or smartphone to a limb. Instruction for attaching the sensor or smartphone to the limb or body portion indicates a consistent positioning and orientation on the limb or body portion. Consistency will provide the best results over a series of sessions. In the preferred embodiment a small motion sensor, rather than a phone, will be inserted into or contained in the band that is attached to the limb. Preferably, the velcro fastening allows the band to be to be secured in position, or released, with only one hand.
Providing instructions for an exercise to the subject. The subject will listen to directions from the smartphone in order to initiate an exercise and evaluation session and carry the session to its close. Instructions standardized for specific injuries and/or specific joints and limbs, may be selected by the caregiver, or customized instructions may be provided by the caregiver. For example, instructions for a shoulder, or knee, or hip, will be similar, but all different. In some embodiments, a video can be provided to the subject. In some embodiments, a record is made that the subject has seen the video, and may further record a signature of the subject to that effect. The instructions may be taken from a standard checklist of instructions for each limb.
A sample script: “Extend your arm and let it rest at your side. As you slowly raise your arm from waist level to shoulder height, tell us if you have any pain. If yes, at what point does the pain begin? Using a range of 1 to 10, describe the pain as you move through the prescribed motion.” In addition to the quantity of pain, there can also be descriptors for the quality of pain, such as dull, shooting or sharp, constant or only at a certain limit of movement. These qualifiers will all be noted as part of the subject's statement during the course of the session.
This detailed information will be part of the subject's education during the course of therapy, overlapping personal session data with data from a larger population of the same age and gender with the same or similar movement issues and with similar root causes, such as trauma, arthritis, etc. The technology will provide prognosis based on type of joint problem, age, gender, rehabilitation progress as sensed and recorded during recent sessions. In future embodiments, a dialogue will take place in which the smartphone becomes a virtual personal trainer/robot. The sessions will become a source of personalized learning and tracking progress. We must assume that the subject is in therapy because he or she values the full range of movement of their limbs and will be motivated to listen, to learn and to follow instructions.
Sessions will be tied in through and managed by systems such as Alexa. In another embodiment, this system will be used by a healthy person who wants to be certain that he or she is performing their exercises correctly. The movement information and data captured by the system will be sent to a the caregiver for evaluation.
In another embodiment in which an external sensor is used to track the motion of the limb(s), the smartphone's camera will be positioned to “watch” the subject using a pattern recognition technique and will combine this added optical information to the 3D map database and the subject's spoken words in order to give a more complete picture of the subject and the session. For an example of such technology, see VivoVR marketed by 3DiVi Inc., and described in international patent publication WO2017061890.
On the caregiver's, coach and physical therapist's side:
The caregiver advises his/her subject to download the application to their phone or tablet. They advise how to register and gain secure access to the application and the data that is kept with the application. Alternatively, a pre-loaded phone and sensor will be loaned to the subject.
In another embodiment, the caregiver, perhaps a nurse or doctor, can choose from a series of options for their patient(s), based on which joint(s) are under evaluation and/or therapy. Of course, all instructions and patient data will also be made available to a physical therapist chosen by the doctor.
A phone app or a browser on a computer connected to the Internet can be utilized for registering the subject into the database.
The patient can be confirmed and registered into the caregiver's system. After the subject is registered, he or she can follow instructions from the mobile device in order to set the baseline for the movement, reps, speed of movement, and range of motion of the target limb(s).
As described above, the 3D mapping data of the limb's movement and the subject's voice, or a written text of the subject's words, are correlated in time and a detailed report on range of motion and perceived pain is displayed as a 3D map for the caregiver on a device that is connected to the caregiver's system.
In one embodiment, the subject's avatar appears to move the target limb through a prescribed movement path as indicated by the caregiver. This will help the caregiver understand the path and the pain points along the path. In another embodiment, the inventors envision large data and predictive algorithms helping to coach the subject based on the real time measurements of range of motion and the pain description and historical data about similar subjects and similar injuries. Again, this technology will also pertain to healthy individuals who are trying to maintain or improve their strength and balance and endurance.
During a session, it is important that the subject carefully stretches the envelope of movement, but does not go too far. In this manner, an interactive program can be created in which the program itself monitors the range of motion and the perceived pain level, monitoring and instructing the subject regarding repetitions and range of motion.
A history of these reports is created in order to determine changes, a patient's improvement or degradation, or lack of cooperation can be noted in the file.
Using the envisioned technology and system the caregiver will gain improved data about their subjects that will help improve the overall process, and help the caregiver or trainer make the most informed treatment and exercise decisions optimized for their subjects.