US20050113652A1 - Remote psychological evaluation - Google Patents
Remote psychological evaluation Download PDFInfo
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- US20050113652A1 US20050113652A1 US10/997,737 US99773704A US2005113652A1 US 20050113652 A1 US20050113652 A1 US 20050113652A1 US 99773704 A US99773704 A US 99773704A US 2005113652 A1 US2005113652 A1 US 2005113652A1
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/70—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mental therapies, e.g. psychological therapy or autogenous training
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1071—Measuring physical dimensions, e.g. size of the entire body or parts thereof measuring angles, e.g. using goniometers
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- A61B5/16—Devices for psychotechnics; Testing reaction times ; Devices for evaluating the psychological state
- A61B5/165—Evaluating the state of mind, e.g. depression, anxiety
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- A—HUMAN NECESSITIES
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- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F5/0123—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the knees
- A61F5/0125—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the knees the device articulating around a single pivot-point
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
- A63B24/0003—Analysing the course of a movement or motion sequences during an exercise or trainings sequence, e.g. swing for golf or tennis
- A63B24/0006—Computerised comparison for qualitative assessment of motion sequences or the course of a movement
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/20—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for electronic clinical trials or questionnaires
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- G—PHYSICS
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
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- G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
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- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
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- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
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- A61F2005/0134—Additional features of the articulation with two orthogonal pivots
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- A—HUMAN NECESSITIES
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- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F2005/0132—Additional features of the articulation
- A61F2005/0158—Additional features of the articulation with locking means
- A61F2005/016—Additional features of the articulation with locking means in standing position
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- A—HUMAN NECESSITIES
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- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F2005/0132—Additional features of the articulation
- A61F2005/0165—Additional features of the articulation with limits of movement
- A61F2005/0167—Additional features of the articulation with limits of movement adjustable
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S128/00—Surgery
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S482/00—Exercise devices
- Y10S482/90—Ergometer with feedback to load or with feedback comparison
Abstract
Instrumented orthoses with more sophisticated structures provide for coordinated support and rehabilitation of complex joints and multiple injured joints. Improved instrumented orthoses can include hinges that can rotate in multiple different planes. Particularly preferred embodiments include a shoulder brace with a hand hold and a lower extremities brace. Preferably, a control unit monitors the output of transducers used to instrument the brace. A patient can be prompted by the control unit for the performance of a variety of different monitored exercises.
Description
- CROSS REFERNECE TO RELATED APPLICATIONS
- This application is a continuation of copending U.S. patent application Ser. No. 09/339,071 to Stark et al., entitled “Rehabilitative Orthoses,” incorporated herein by reference.
- The invention relates to orthoses useful for the rehabilitation of patients with injured joints, weakened joints, and/or neurological deficits degrading motor control or operation of joints. More particularly, the invention relates to instrumented orthoses for the performance of monitored rehabilitative exercises.
- Both muscles and bones should be exercised to maintain strength. Also, bone fractures that are exposed to permissible weight bearing stress often heal more predictably and more rapidly than fractures that are not stressed at all. Improved healing based on application of appropriate stress is also believed to be true for connective tissue, such as ligaments and cartilage.
- In the case of neurological injury or degradation, the nerve impulse pathways that control skeletal motor functions and joints are interrupted due to loss of brain cells or nerve conducting structures. Such neurological injuries can result from cerebrovascular accidents such as ischemic or hemorrhagic strokes or certain types of head trauma. Recovery mechanisms involve creation of new neurological pathways by retraining the motor functions with different surviving brain cells as receptors. This requires physical therapy and joint exercise very similar to exercise that is advantageous for rehabilitation of joints following orthopedic injury. Additionally, joint disuse following such neurological injury similarly requires orthopedic rehabilitation and stress to effect useful recovery, given the secondary orthopedic damage resulting from the disuse.
- Suitable stress can be applied to the tissue by the performance of selected exercises. For example, isometric exercises generally involves the exertion of force against a relatively immovable object. To perform isometric exercises, a restraining device can be used that has a substantially unchanging position for the duration of a particular exercise routine. Isotonic exercises involve exertion against the same weight or resistance through a range of motion. Isokinetic exercise is designed to mimic exertions that take place on a playing field or the like. When performing isokinetic exercises in a simulated environment, a machine is used to provide resistance in direct proportion to the exertion of the exerciser.
- Isometric exercises are particularly usefull with painful injuries to lower the risk of further injury. If performed in a controlled manner, isometric exercises can be performed earlier in the recuperation period to speed recovery. As the patient's recovery progresses, isotonic exercises or other exercises can be used to reestablish a desired range of motion about a joint. With continuing recovery, eventually the patient is able to perform a full range of exercises.
- A difficulty with the application of stress to an injured joint is that the application of excessive stress can further injure the joint rather than assist with the healing. Thus, the exercises need to be carefully planned to provide appropriate amounts of stress. Also, the performance of the exercises should be monitored closely by a physician, physical therapist or other appropriate health care professional to optimize the treatment and to reduce the risk of injury. The need to carefully plan and closely monitor the exercises provides a cost and motivation barrier to accessing desirable amounts of exercise.
- In a first aspect, the invention pertains to an instrumented orthosis comprising:
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- a support that fits around the joint of a patient, the support comprising a hinge that can rotate in different planes;
- a position sensor operably connected to the hinge such that motion can be measured with respect to different rotational motions about the joint; and
- a control unit operably connected to the position sensor to receive signals related to the position of the hinge.
- In another aspect, the invention pertains to method of rehabilitating a joint that has a range of motion in a plurality of planes. The method involves exercising with an orthosis having a hinge that can rotate in different planes. The hinge preferably includes a position sensor that can provide measurement of the orientation of the hinge in the different planes. The orthosis includes a control unit connected to one or more position sensors.
- In a further aspect, the invention pertains to an orthosis comprising:
-
- a support that fits around a plurality of joints of a patient, the support comprising a plurality of hinges such that motions about separate hinges correspond to motions about different joints;
- position sensors operably connected with the hinges such that motion can be measured about different joints; and
- a control unit operably connected to the position sensors to receive signals related to the position of the hinges.
- Moreover, the invention pertains to a method of upper body rehabilitation comprising exercising two or more adjacent joints using an ambulatory orthosis supporting the two or more adjacent joints. The orthosis preferably is connected to a control unit that provides a target exercise routine and immediate feedback on patient performance relative to the target exercise routine with respect to motion about either of the adjacent joints.
- In additional aspects, the invention pertains to a leg orthosis including:
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- an ambulatory support structure including:
- a waist support;
- an upper leg support;
- a lower leg support;
- a hinge connecting the waist support with the upper leg support;
- a hinge connecting the upper leg support and the lower leg support;
- sensors operably connected to the support structure to measure forces applied to the support structure; and
- a control unit connected to the sensors to receive measurements related to the applied forces.
- In another aspect, the invention pertains to a method of rehabilitating a stroke victim including performing a set of exercises using an ambulatory orthosis supporting the hip and knee. The orthosis preferably is connected to a control unit that provides a target exercise routine directing the application of forces by the patient at the hip and knee and provides immediate feedback on patient performance relative to the target routine.
- In a further aspect, the invention pertains to a shoulder orthosis including:
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- an ambulatory shoulder support;
- a hand hold extending from the shoulder support;
- a transducer operably connected to the hand hold such that forces applied to the hand hold result in an altered signal from the transducer; and
- a control unit connected to the transducer to receive measurements of forces applied to the hand hold.
- The ambulatory shoulder support preferably includes a trunk support and an under arm support directly or indirectly connected to the trunk support by a hinge, preferably a multi-dimensional hinge.
- In addition, the invention pertains to a method of evaluating a patient's mental condition comprising:
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- collecting answers to a set of questions regarding the patient's mental condition using a remote controller programmed to pose the questions and receive the answers; and
- evaluation of the answers by a health care professional.
-
FIG. 1 is a schematic perspective view of an orthosis for supporting two joints. -
FIG. 2 is a schematic perspective view of an orthosis with a hinge capable of rotating in multiple planes. -
FIG. 3 is a schematic perspective view of an embodiment of a support portion. -
FIG. 4 is a schematic perspective view of an alternative embodiment of a support portion. -
FIG. 5 is a sectional top view of a hinge with a mechanical locking feature and a position sensor, where the section is taken through the central axis of the hinge. -
FIG. 6 is a side view of a portion of the hinge ofFIG. 5 with another portion removed. -
FIG. 7 is a top view of an electromechanical hinge, where a portion of the casing and other structures are removed to expose internal structure. -
FIG. 8 is a sectional, side view of the electromechanical hinge ofFIG. 7 taken along line 8-8. -
FIG. 9 is an exploded, perspective view of an embodiment of a mechanical hinge with an easy to use locking mechanism. -
FIG. 10 is a sectional front view of a manual resistance unit that can be used with the mechanical hinge ofFIG. 9 . -
FIG. 11 is a side view of an orthosis with an articulating hinge connecting two support portions. -
FIG. 12 is a side view of a mechanical, biaxial hinge. -
FIG. 13 is a fragmentary, perspective view of one embodiment of a hinge that provides for motion in two planes. -
FIG. 14 is an exploded, perspective view of the principle components of the hinge ofFIG. 13 . -
FIG. 15 is a fragmentary, perspective view of an alternative embodiment of a hinge that provides for rotation in two planes. -
FIG. 16 is a fragmentary, perspective view of an orthosis with a squeeze ball for the patient's hand. -
FIG. 17 is a fragmentary, perspective view of an orthosis with a squeeze ball ofFIG. 16 and a wrist hinge. -
FIG. 18 is a fragmentary, perspective view of an orthosis with a hand grip. -
FIG. 19 is a front view of a shoulder orthosis. -
FIG. 20 is a perspective, front view of a lower extremity orthosis. - Sophisticated instrumented orthoses/braces provide for more complex and coordinated rehabilitation exercises than previously possible. In particular, certain embodiments are suitable for the rehabilitation of complex joints that enable motion in multiple, different planes. These complex joints can be rehabilitated much more efficiently and appropriately using the more sophisticated orthoses described herein. Furthermore, other embodiments of the improved orthoses are particularly suitable for the rehabilitation of stroke victims. These stroke braces provide suitable rehabilitation for patients that have lost motor function on one side or both sides of their body. Thus, the rehabilitation can involve muscle building as well as neuro-reflex retraining. Using these sophisticated orthoses, many serious injuries/illnesses can be treated more effectively than was possible previously and, potentially, at a lower cost.
- Certain embodiments of the improved orthoses are suitable for the rehabilitation of joints that move in multiple planes of motion. Joints that move in multiple planes of motion include, for example, shoulder, spine, hip, wrist and ankle/foot. These orthoses include a support structure that fits around the joint and supports the body portions connecting at the joint. The support structure includes one or more hinges that provide for motion of the joint in multiple planes of motion. Position sensors preferably provide for measurements of the position of the hinge in the multiple planes of motion. The hinge or hinges preferably provide for the measurement of the motion about two or more planes of motion. The orthoses can include additional types of transducers, such as strain gauges. Preferred embodiments include instrumented shoulder braces that provide for the multiple planes of motion of the shoulder. Preferred shoulder braces can further include instrumented supports for the arm, elbow and/or hand.
- Certain embodiments of the improved orthoses are particularly suitable for use as a stroke brace. Stroke victims can lose a significant portion of their motor control on one or both sides of their body. These victims need a particularly high level of support and can benefit tremendously from appropriate type of rehabilitative exercises. Because stroke victims generally have injuries that involve multiple joints, a stroke brace includes a support structure that provides support for multiple joints. Preferred stroke orthoses include an upper extremity brace along with a long leg brace, although other embodiments can be used. In preferred embodiments, the support structures include hinges providing for motion of multiple joints.
- The hinges preferably include position sensors for measuring the motion about the hinge. The orthoses can include additional types of transducers, such as strain gauges. The orthosis can provide for multiple planes motion about one or more of the joints. The instrumentation of the orthosis generally involves a control unit that is operably connected to transducers on the orthosis. The control unit can be used to provide feedback and instructions to the patient to assist with the retraining of neurological pathways. Instrumentation of the orthosis reduces the need for professional intervention.
- Hand injuries may not be adequately treated by standard types of orthoses with hinges. Furthermore, hand muscles can atrophy due to inactivity following an arm injury. An improved hand orthosis includes an instrumented squeeze device, such as an air-bulb or a foam grip. Generally, the instrumented squeeze ball is supported by a support that extends, at least, to the patient's wrist. In certain embodiments, the instrumentation measures the total force exerted by the hand onto the squeeze ball. In other embodiment, the instrumentation provides for measurements of forces applied by individual fingers. The capability to measure the force exerted by individual fingers is particularly suitable for a stroke brace where redevelopment of neuromuscular control of the movement of individual fingers is a significant consideration.
- As noted above, preferred embodiments of the improved orthoses include a control unit operably connected to transducers placed on the orthosis for position, strain or other measurements. The control unit preferably includes a microprocessor to assist with the monitoring of the rehabilitative exercises. Information regarding the compliance and performance of the patient can be downloaded from the control unit for evaluation by a health care professional. Microprocessor based control units can provide instruction to and prompting of the patient for the performance of the selected exercises. The selection of suitable exercises preferably is performed by a health care professional following an examination of the condition of the patient. The control unit is programmed accordingly.
- 1. Orthosis Structure
- Previous instrumented orthoses are designed for placement around a single joint. Support portions support the respective body portions that meet at the joint. A selectively flexible connection/hinge connects the support portions at or near the joint such that rotation of the hinge provides for motion around the joint. Hinges used in these orthoses provide for rotation in a single plane. Transducers can provide for measurements of strain within the support and/or the position of the hinge. A microprocessor based control unit provides for monitoring of the measurements of the transducers. To the extent that previous instrumented orthoses have extended to multiple joints such as a knee brace extending to the foot, the measurements at the second joint have not involved rotation of the second joint. In other words, a force detector at the foot measures the force applied against the leg as a whole and not the force due to torque at the ankle. Further description of previous instrumented orthoses is found in U.S. Pat. No. 5,484,389 to Stark et al, entitled “Instrumented Orthopedic Restraining Device and Method of Use,” incorporated herein by reference.
- Various features of instrumented rehabilitation orthoses have been refined generally to provide for improved performance of the orthosis. Many of these features can be adapted for use in the improved orthoses described herein. These features are described in detail in copending and commonly assigned U.S. Provisional Application Ser. No. 60/098,779 to Stark et al., entitled “ORTHOSES FOR JOINT REHABILITATION,” incorporated herein by reference, hereinafter “application 60/098,779”. Certain of these features are described with particularity below, as appropriate. While application 60/098,779 is incorporated herein in its entirety, it is referred to for particular features in additional citations below.
- Improved orthoses described herein provide for more sophisticated rehabilitation procedures than previous instrumented orthoses. Referring to
FIG. 1 , certain embodiments of animproved orthosis 100 include afirst support portion 102, asecond support portion 104, and athird support portion 106 such that multiple joints can be supported byorthosis 100.First support portion 102 preferably is connected tosecond support portion 104 by flexible connection/hinge 108. Similarly,second support portion 104 preferably is connected tothird support portion 106 by flexible connection/hinge 110. Control unit/controller 112 can be connected to position sensors, described further below withinhinges gauges 114, 116. Alternative embodiments can include only one hinge or more than two hinges, with a correspondingly appropriate number of support portions. -
Support portions hinges linkers linker 118 links supportportion 102 withhinge 108,linker 120 links supportportion 104 withhinge 108,linker 122 links supportportion 104 withhinge 110 andlinker 124 links supportportion 106 withhinge 110.Linkers -
Other embodiments 130 of the improved orthoses include hinges that provide for the motion of a joint in multiple planes. Referring toFIG. 2 ,first support portion 132 andsecond support portion 134 are connected tomultidimensional hinge 136. As described further below,multidimensional hinge 136 can include a plurality of single plane hinges or more complex structures.Support portions multidimensional hinge 136 or by way oflinkers Orthosis 130 preferably includes, at least, onestrain gauge 142 to measure forces applied athinge 136. - A variety of constructions can be used for the
support portions FIGS. 1 and 2 ) such that a support portion properly supports the respective body portion. Referring toFIG. 3 , afirst embodiment 150 of a support portion hasframe members Straps 156 extend from oneframe member support portion 150 in place around the corresponding body portion.Straps 156 can be replaced with fabric sheets or other flexible or rigid connectors.Straps 156 can be secured to framemembers straps 156 can be adjusted using conventional designs. A rope and pulley system can be used for tightening and looseningsupport structure 150, as described further in application 60/098,779.Frame members elements - Referring to
FIG. 4 , analternative embodiment 166 of a support structure that surrounds the corresponding body portion.Support portion 166 generally is somewhat rigid and can be constructed from a variety of materials. Preferred materials for the construction ofsupport portion 166 include, for example, molded plastic shells, plaster, water-activated fiberglass, heat moldable thermoplastics, heat shrink plastic, and other cast forming materials.Support portion 166 can be premolded in various sizes such that a particular size is selected “off-the-shelf'based on measurements of the patient. Alternatively,support portion 166 can be constructed to provide a custom fit for a particular patient. These custom molded support portions are molded to fit the body portions of the particular patient by a trained physician or technician. - Whether or not a linker is used to connect a particular support portion and a hinge, a hinge can involve just one or a plurality of distinct hinge elements, as appropriate. As used herein, a hinge element is a physically distinct structure that has two or more lever arms that rotate relative to each other. A hinge includes one hinge element if a support portion has a single lever arm connecting it by way of the hinge to the other support portion and more than one hinge element if a support portion has multiple lever arms at distinct locations of attachment to the support portion.
- For example, as shown in
FIG. 2 , hinge 136 has a single hinge element, which corresponds to the hinge itself. In contrast, inFIG. 3 the hinge includes twohinge elements FIG. 1 eachhinge Support structure 166 inFIG. 4 can be attached to one hinge element or two hinge elements by direct attachment or using appropriate linkers. The hinge elements are placed such that the joint can rotate when the orthosis is properly placed around the joint and the hinge elements are not in a locked position. - When forces are applied by the patient against the orthosis, the orthosis tends to change position relative to the patient's joint. This shifting reduces the effectiveness of any exercises being performed with the orthosis and may necessitate realignment of the orthosis for proper fit. The orthosis can be designed to reduce or eliminate this shifting.
- A first approach to prevent a knee orthosis from slipping during exercise is to construct the orthosis with indentations in the femur supracondylar area just above the knee. An alternative solution involves the use of additional securing cuffs. Securing cuffs are designed to be tightened more during exercise routines to help secure the orthosis relative to the joint. Securing cuffs include a gripping element and, for example, can be placed against the leg above the knee such that when tightened, the gripping element applies pressure above the kneecap and pushes on the knee without pushing on the vasculature and lymphatic drainage posteriorly. In other embodiments, the securing cuff can be appropriately placed.
Cuffs - Another approach to securing the orthosis involves securing the orthosis to a belt by way of one or more straps. Still another approach involves reducing the friction of the surface contacting the orthosis or part of the orthosis, for example, using a high friction, polymer sleeve. Still another approach to securing the orthosis involves the placement of crossed straps behind the joint. The straps apply forces that tend to maintain the straps in the fold of the joint. Furthermore, for a knee orthosis, the orthosis can end with a heel cup or other support placed along the bottom of the foot. Such a foot support preferably includes a strap or the like around the foot to hold the bottom of the orthosis at the bottom of the foot and, thus, to fix the hinge roughly at the knee.
- With any of these approaches for inhibiting orthosis motion during use, the method preferably distributes the restraining forces sufficiently such that no portion of the skin is subject to excessive pressures that could bruise the skin as well as damage or interfere with neural or circulatory functions. Most of these approaches for preventing movement of the support portions are described further in the 60/098,779 application.
-
Hinges FIGS. 1 and 2 ) are intended to be interpreted broadly as any flexible connection that provides for angular motion of one support portion relative to another support portion.Hinges Hinges controller 112. For example, U.S. Pat. No. 5,052,375, to Stark et al. entitled “Instrumented Orthopedic Restraining Device and Method of Use,” incorporated herein by reference, discloses the use of a potentiometer-like mechanism used as a position sensor. Other suitable position sensors can be used, such as magnetic or optical sensors that are either digital or analog devices. Position sensing is useful for the evaluation of range-of-motion exercises and a variety of other exercises, as described further in the 60/098,779 application. - An embodiment of a suitable mechanical hinge capable of locking and unlocking is shown in
FIG. 5 .Hinge 180 includes a first engagingmember 182 and a second engagingmember 184.Members teeth hinge 180 is in a locked position.Knob 190 is used to rotatebolt 192. Second engagingmember 184 includes a threadedscrew hole 194 that is mated withbolt 192 such that rotation ofknob 190 movesknob 190 relative tomember 184.Spring 196 tends to separatemembers bolt 192 within threadedhole 194.Clip 198 withinrecess 200 prevents separation ofbolt 192 frommember 184. Referring toFIG. 6 ,strain gauges 202 are located onframe 204.Frame 204 can be a linker betweenhinge 180 and a support portion or a component of a support portion. - Referring to
FIGS. 5 and 6 , hinge 180 includes a position sensing device in the form of a variable resister. In particular,member 184 includes twoflexible wiper arms Wiper arms Flexible wiper arm 210contacts resistance element 214, whileflexible wiper arm 212contacts conducting element 216.Resistance element 214 and conductingelement 216 have an electrical potential difference between them.Resistance element 214 has anelectrical connection 218 at one end such that the electrical resistance resulting from current flow throughresistance element 214 depends on the position ofwiper arm 212 as determined by the relative angular orientation ofmember 184 relative tomember 182.Wires 220 provide for electrical connection ofresistance element 214 and conductingelement 216 directly or indirectly tocontroller 112. - Referring to
FIG. 7 , anelectromechanical hinge 240 is shown.Hinge 240 includes afirst element 242, which connects to afirst support portion 244, and asecond element 246, which connect to asecond support portion 248.Second element 246 connects withaxle 250, which rotates withinshaft 252 such thatsecond element 246 can rotate relative tofirst element 242.Axle 250 is secured withnut 254.Shaft 252 passes througharmature 256.Armature 256 is held withincase 258.Case 258 is secured tofirst element 242. - Lead 270 electrically connects
stator coil 272 withinstator housing 274 with a current source.Stator coil 272 is designed to attractarmature 256 when sufficient magnetic field is generated by electric current flowing throughstator coil 272. The current can be supplied fromcontroller 112. Whenarmature 256 is attracted tostator coil 272, a pair offree riding discs 276, 278 are gripped betweenarmature 256 andstator housing 274. Outer disc 276 is made preferably from a suitable metal, andinner disc 278 is made preferably from a suitable polymeric material to provide for a smooth grip between the surfaces and to prevent wear between the surfaces. Aspring 280 biases armature 256 away fromstator housing 274 when the magnetic attraction betweencoil 272 andarmature 256 is insufficient to overcome the forces ofspring 280. Sufficient attraction betweencoil 272 andarmature 256 locksfirst element 242 relative tosecond element 246. - In preferred embodiments, a hinge provides selectable resistance to rotation for the performance of isotonic exercises. For example in the embodiment of
FIG. 7 , lesser amounts of attraction betweencoil 272 andarmature 256 can result in selectable amounts of resistance/friction in the rotation offirst element 242 relative tosecond element 246. The selectable resistance can be adjusted withcontroller 102 by varying the current supplied bycontroller 102 tostator coil 272. - Referring to
FIGS. 7 and 8 , a position sensor/variable resistor includes aresistance element 290 andwirer arm 292.Resistance element 290 is connected tocase 258.Wiper arm 292 is keyed to rotate withaxle 250 such that rotation ofsecond element 246 relative tofirst element 242 rotateswiper arm 292 to different angular positions alongresistance element 290.Conductor arm 294 provides current to wiperarm 292. Conductor arm is electrically insulated relative tocase 258 while providing electrical connection by way ofconnection 296.Resistance element 290 is connected toelectrical connection 298. Resistance measurements can be made by way ofconnectors support portion 244 relative tosecond support portion 248. - Mechanical and electromechanical hinges are described further in U.S. Pat. No. 5,484,389 to Stark et al., incorporated herein by reference. In particular, a suitable electromechanical hinge with variable resistance controllable by way of
controller 112 is described further in published PCT application WO 96/36278, entitled “An Orthopedic Device Supporting Two or More Treatment Systems and Associated Methods,” incorporated herein by reference. - A preferred embodiment of a left,
mechanical hinge 300 is shown inFIG. 9 . This hinge has a construction that provides for particularly easy release of the lock by a patient with one hand. The orientation of the hinge is measured by a position sensor to assist the patient in resetting the lock at a desired orientation. A right hinge would be the mirror image of the hinge inFIG. 9 . -
Hinge 300 includes aouter plate 302,washer 304, lockingunit 306,ring lever 308,electrical resistance disc 310 andinner plate 312.Outer plate 302 is connected to aframe member 318.Strain gauge 319 can be attached toframe member 318.Outer plate 302 andinner plate 312 include concentric stop holes 320, bolt holes 322, connection holes 324 andslot 326. The corresponding holes are aligned between leftouter plate 302 andinner plate 312. - One or two stop pins can be placed through two aligned stop holes 320 in
outer plate 302 andinner plate 312 to define limits of hinge rotation. Bolts or other fasteners are secured throughbolt holes 322 to holdhinge 300 together.Electrical resistance disc 310 rests within a hollow 338 withininner plate 312.Electrical resistance disc 310 makes electrical contact withwire 340. - Locking
unit 306 includescontrol disc 346,slider 348,slider spring 350 and lock-out latch 352.Control disc 346 includes bolt holes 322 and aslit 354 in whichslider 348 slides.Slider 348 has agroove 356 and anindentation 358 with acatch 360. Lock-out latch 352 has a knob 362 and abar 364. Bar 364 slides withinslots 326 and can fit withingroove 356 to holdslider 348 in a depressed, unlocked, position. -
Ring lever 308 is connected with aframe member 370.Ring lever 308 has anopening 372 with a diameter slightly larger than the diameter ofcontrol disc 346 such thatcontrol disc 346 can fit withinopening 372.Control disc 346 preferably has a thickness slightly larger thanring lever 308. A set of concentric, notches 374 are located around the edge of opening 372 ofring lever 308. Catch 360 ofslider 348 fits within the notches 374 to lock the hinge at a particular orientation whenslider 348 is in an extended position.Depressing slider 348 against the force ofspring 350 disengages catch 360 from one of the notches 374 such thathinge 300 is free to rotate within the bounds establishes by any stop pins.Ring lever 308 includes anelectrical contact 376 set within ahole 378 that contactselectrical resistance disc 310. Electrical contact 476 is connected bywire 380 tocontroller 112 or alternative resistance meter. -
Outer plate 302,inner plate 312,ring lever 308,control ring 346, lock-out latch 352 andslider 348 preferably are made from rigid, durable materials. In particular,outer plate 302 andinner plate 312 are preferably made from an aluminum alloy, andring lever 308,control ring 346, lock-outslide 352 andslider 348 preferably are made from stainless steel.Spring 350 generally would be made from resilient steel or the like.Washer 304 and stop pin 330 generally are made from polytetrafluoroethylene or the like.Electrical resistance disc 310 can be made from circuit board material with a resistance element screen-printed on its surface. -
Frame members hinge 300 such that movement offrame member 318 relative to framemember 370 involves rotation ofhinge 300. Whenhinge 300 rotates,outer ring 302 andinner ring 312 rotate relative to ringlever 308.Outer ring 302,inner ring 312 andcontrol disc 346 are held fixed with respect to each other by way of bolts passing through bolt holes 322. The orientation ofhinge 300 is locked unlessslider 348 is depressed such thatcatch 360 is withdrawn fromnotches 372. Lock-outslide 352 can holdslider 348 in the depressed, unlocked position. The position ofring lever 308 relative toinner ring 312 can be measured by way of the position ofelectrical contact 376 alongelectrical resistance disc 310. The relative position ofelectrical contact 376 alongelectrical resistance disc 310 provides a variable electrical resistance useful for position/orientation sensing. - It may be convenient to provide for release of a hinge with a remote control. The release of an electromechanical hinge using a command from the controller is described above. It may be desirable to have a simple mechanical remote release. A simple photographic shutter release can be adapted for this purpose with the hinge of
FIG. 9 . The shutter release can be screwed at its threaded tip intohinge 300 at threadedhole 394 incontrol ring 346. Pressing the plunger of the cable release advances a cable, which in turn depressesslider 348 thereby unlockinghinge 300. Alternative designs for mounting of a manual hinge release involve pulling a plunger that in turn pullsslider 348 such that the lock is disengaged and such that releasing the plunger reestablishes the hinge lock. - While electronic control of the resistance in a flexible connection/hinge has advantages, cost and design simplicity favors a purely mechanical hinge. Referring to
FIG. 10 , With a purely mechanical hinge, such as shown inFIG. 5 , strain gauge readings can be accurately calibrated to reflect the forces applied to move the hinge against a setting on a mechanical resistance applicator. Thus,control unit 112 can be used to monitor the isotonic exercises even though the resistance is not electronically controlled. A mechanical resistance applicator can be made integral with the hinge, but in preferred embodiments the resistance unit can be separated from the hinge such that no resistance is applied to the hinge when resistance is not desired. A resistance applicator can designed to amplify small changes in the resistance that correlate with easily made changes in the position of a knob. - Referring to
FIG. 10 , a cross section through the center of an embodiment ofresistance applicator 400 is shown.Resistance applicator 400 includeshousing 404, acrank 406, acompression structure 408,knob 410, bearingunit 412,washer 414 andspacers 416. -
Housing 404 includes lock pins 428. A second lock pin is not shown in the sectional drawing. Lock pins 328 provide releasable connection for attachment ofresistance applicator 400 to a hinge, such ashinge 300 ofFIG. 9 . In particular, lock pins 428 ofresistance applicator 400 can be secured throughconnection holes 324 to releasablysecure resistance applicator 400 in an operable position with respect to hinge 300. Alternative locking approaches can be used for the attachment of the friction applicator to the hinge.Housing 404 includes threadedhole 432 for engagingknob 410.Housing 404 further includescylindrical protrusion 438 for engagingcompression structure 408. -
Crank 406 includescylindrical extension 454 for engagingcompression structure 408 andpads 458, which engage a support portion, such that rotation of the hinge of the orthosis rotates crank 406 relative tohousing 404. -
Compression structure 408 provides for small changes in the resistance due to changes in the distance betweenwasher 414 andhousing 404 asknob 410 is rotated, thus amplifying resistance changes by way of the knob.Compression structure 408 generally produces friction as a result of shear forces withincompression structure 408 due to relative motion ofhousing 404 and crank 406. In one embodiment,compression structure 408 includes alternating crank discs and housing discs to form a multiple clutch plate. Crank discs engage crank 406, such that the crank discs rotate withcrank 406. Housing discs have a central hole shaped to engageprotrusion 438 inhousing 404, such that housing discs rotate withhousing 404. -
Knob 310 includes a threadedshaft 482 with threads and diameter suitable for engaging the threads of threadedhole 432 inhousing 404.Bearing unit 412 preferably includes a ring of ball bearings in a bearing case.Bearing unit 412 can be replaced with other bearing structures or other friction reducing approaches such as hydro bearings. -
Washer 414 has a suitable inner diameter such that threadedshaft 482 can pass through the inner diameter but bearingunit 412 cannot pass.Washer 414 has an outer diameter such thatwasher 414 rests onextension 454 ofcrank 406 covering the opening tocompression unit 408 betweenhousing 404 and crank 406. Two optional spacers preferably are located with one on each side ofcompression unit 408. The spacers have the shape of a washer but with a suitably larger inner diameter and smaller outer diameter thanwasher 414 such that the spacers fit within the cavity between crank 406 andhousing 404. - The primary components of the
resistance applicator 400 preferably are made from metals and/or alloys. Aluminum alloys and stainless steel are suitable metals for the construction of housing and crank components. Rigid polymers can be used in place of metals for the housing and crank elements. The spacers preferably are made of brass. The housing disc preferably is made from spring steel, and the crank disc preferably is made from spring tempered phosphor bronze. The bearing case can be made from Nylon®. -
Resistance applicator 400 is designed to attach to a hinge such thathousing 404 moves with a frame member attached to one side of the hinge while crank 406 moves with a frame member attached to the other side of the hinge. Thus, rotation of the hinge results in rotation ofhousing 404 relative to crank 406. Tightening ofknob 410 presseswasher 414 down ontocompression unit 408. Housing rings and crank rings rotate relative to each other whenhousing 404 moves relative to crank 406. Increasing the pressure oncompression unit 408 results in increased resistance in the rotation ofhousing 404 relative to crank 406 because of friction between housing rings and crank rings. This design provides for sensitive adjustment rotational resistance by rotation ofknob 410. Theimproved hinge 300 shown inFIG. 9 combined with theimproved resistance applicator 400 is described further in the 60/098,779 application. - In alternative embodiments, a hinge takes the form of an articulating
hinge 490, as shown inFIG. 11 . Articulatinghinge 490 can be made with resilient collapsible materials such as a bendable straw, sliding sections that can slide past each other to articulate, or other similar constructions. Sliding sections can be locked relative to one another by way ofclamps 492 attached toslots 494 defining a range of motion, where the clamps are tightened manually with wing nuts or the like, or electronically with solenoids or the like. As shown inFIG. 11 , articulatinghinge 490 is connected to twosupport portions 166 that surround the corresponding body portions. Alternatively, one or bothsupport portions 166 can be replaced with other types of support portions or by linkers that connect the support portions to hinge 490. - Certain joints such as the knee are cams that do not involve rotation about a single axis. A biaxial hinge can be used to more closely approximate the motion of the joint cam. A
biaxial hinge 500 generalizing on the structure ofhinge 300 is shown inFIG. 11 .Biaxial hinge 500 includes aproximal arm 502 and adistal arm 504.Proximal arm 502 includes teeth, which engage teeth ondistal arm 504.Proximal arm 502 further includes lock notches and an electrical contact for position (orientation) sensing. A control ring operates similarly to controlring 346 inhinge 300 to control the locking/unlocking of the hinge. Further details onbiaxial hinge 500 can be found in the 60/098,779 application. -
Orthosis 130 shown inFIG. 2 includeshinge 136 capable of rotation in multiple planes to provide for multiple ranges of motion about a single joint. A first embodiment of a hinge capable of motion in multiple planes is shown inFIG. 13 and an exploded view inFIG. 14 .Hinge 510 includesrod 512 that moves withinsleeve 514.Sleeve 514 has fourresilient sections 516 that form a truncated conical shape.Sleeve 514 further hasthreads 518.Cap 520 fits over and screws ontosleeve 514.Cap 520 includesworm gear threads 522.Lever 524 has matedworm gear threads 526 to complete the worm gear withlever 524adjacent cap 520. -
Cap 520 can be screwed to varying degrees to increase or decrease the tension atresilient sections 516. Tension atresilient sections 516grips rod 512 to a corresponding degree. The wormgear comprising threads cap 520 on to or off fromsleeve 514. The worm gear is advanced by the rotation oflever 524. - Hinge 510 moves in two degrees of freedom, with one degree of freedom corresponding to the
rod 512 moving into or out fromsleeve 514. The rotation ofrod 512 provides motion in the second degree of freedom. Screwingcap 520 sufficiently locks both degrees of freedom. Hinge 510 can be incorporated into a shoulder orthosis such that motion of therod 512 into and out fromsleeve 514 provides for movement of the patient's elbow toward or away from the torso while rotation ofrod 514 provides for movement of the arm toward the front or toward the rear. - In preferred embodiments, hinge 510 includes position sensors such that the orientation in each degree of freedom can be measured. In one embodiment,
rod 512 includes aresistive element 530 that can be used to contact a conductive brush withinsleeve 514.Resistive element 530 can be used to measure the position ofrod 512 as it projects to varying degrees withinshaft 512. Slimily,rod 512 can further include aconductive brush 532 that contacts a resistive element. Brush 512 can be used to measure the orientation ofrod 512 depending on the rotation ofrod 512 withinsleeve 514. - A second
multidimensional hinge 540 is displayed inFIG. 15 .Hinge 540 includes afirst hinge 542 attached to afirst lever arm 544. Asecond lever arm 546 linksfirst hinge 542 withsecond hinge 548. Rotation about the first hinge involves relative rotational motion offirst lever arm 544 relative tosecond lever arm 546 andsecond hinge 548.Third lever arm 550 is attached tosecond hinge 548, such that rotation aboutsecond hinge 548 rotatessecond lever arm 546 relative tothird lever arm 550. - Preferably,
first hinge 542 andsecond hinge 548 are separately lockable, and, optionally, have adjustable resistance. Designs for single plane hinges described above can be used forfirst hinge 542 andsecond hinge 548. These hinges have position sensors, such that the orientation of each hinge can be measured.Multidimensional hinge 540 can be used advantageously in orthoses for joints that move in multiple planes. For example, hinge 540 can be used in a shoulder brace where one oflever arms - Strain gauges 114, 116, 142 can be useful for the performance of both isometric and isotonic exercises. Strain gauges can be placed at any suitable location such that the strain in the underlying material reflects the torque applied between two respective flexibly connected body portions surrounding the joint of interest. Suitable locations for the strain gauges involve placement of the strain gauges on a structure that is attached to the corresponding hinge. The strain gauges generally are located on a rigid element near the hinge that is under stress when torque is applied to the hinge. Since different structures have different relationships between the support portions and the hinge, the preferred locations for the strain gauges depend on the particular construction of the orthosis.
- Whether monitoring isometric exercises or isotonic exercises, strain measurements obtained by way of a strain gauge can be correlated with the corresponding forces applied by the patient. Strain gauges 114, 116 are connected to
controller 112, which evaluates the strain based on the electrical properties of the strain gauge. Suitable strain gauges are available from Vishay Micromeasurements Group (Raleigh, N.C.) (e.g., type 125AD, part number EK-XX-125AD-350 with dual copper pads), or JP Technologies (San Bernardino, Calif.). Evaluation of the strain is discussed further below in the context ofcontroller 112. - As noted above, for a variety of treatments, it is useful to incorporate an instrumented hand hold. Referring to
FIG. 16 , a hand hold 600 is mounted on top of asupport 602.Support 602 projects from aarm rest 604.Support 602 should have a height for comfortable gripping of hand hold 600. In preferred embodiments,arm rest 604 forms part of an instrumented orthosis that, at least, extends past a patient's elbow.Arm rest 604 can be part of a shoulder brace, as described further below. Hand hold 600 can have any comfortable shape for gripping, such as spherical or cylindrical. - As shown in
FIG. 17 ,arm rest 604 can include awrist hinge 606.Wrist hinge 606 preferably includes a position sensor, a position lock and adjustable friction, as described above with respect to preferred embodiments of various hinge designs. Hand hold 600 rests on a hand support 608 that connects to armrest 604 throughwrist hinge 606. As shown inFIG. 17 , hand hold 600 rests on hand support 608 without elevation with asupport 602. - Hand hold 600 can be a bladder filled with a fluid, such as a gas, liquid or a pseudo-liquid formed by a granular material or the like. Alternatively, hand hold 600 can be formed from a compressible material, such as a foam or the like. The degree of compressibility can be selected to obtain a suitable amount of exercise from hand hold 600. If hand hold 600 is filled with a fluid, hand hold 600 can include one or
more valves 610.Valve 610 can be used to add or remove fluid from hand hold 600 to vary the nominal pressure in ball 600. - Hand hold 600 preferably includes a
pressure sensor 612 or a strain gauge.Pressure sensor 612 can be used to measure the amount of force applied by a patient when squeezing hand hold 600. When hand hold 600 is squeezed, the pressure increases in hand hold 600, if hand hold 600 contains a fluid. A strain gauge measures forces applied to squeeze ball 600 according to the increased strain along the surface of ball 600.Pressure sensor 612 and/or a strain gauge generally are connected tocontroller 112 bywire 614. - Suitable strain gauges were described above.
Pressure sensor 612 can be any reasonable type. A variety of suitable pressure sensors are commercially available. Preferred pressure sensors include the MPX series of pressure sensors manufactured by Motorola because of their linear output and small size, and NPP 301A from Lucas Novasensor, Fremont Calif., which are small and inexpensive. Other suitable pressure sensors use silver oxide ink surfaces separated by a dielectric material or piezoelectric materials that produce a voltage when stressed. - In an alternative embodiment, the orthosis includes a
hand grip 630, as shown inFIG. 18 .Hand grip 630 can be mounted in the same way with respect to anarm support 604 as squeeze ball 600.Hand grip 630 includes finger rests 632. Finger rests 632 are indentations that provide a specific location for resting each finger. In preferred embodiments,hand grip 630 includes pressure sensors/strain gauges 634 in the vicinity of eachfinger rest 632. Pressure sensors/strain gauges 634 can be used to measure the force approximately corresponding to the force applied by a particular finger. Pressure sensors/strain gauges 634 are connected tocontroller 112 by way ofwires 636. -
Hand grip 630 generally includes some compartmentatization such that forces applied by one finger are approximately segregated in effect within a corresponding compartment. Thus, ifhand grip 630 includes a fluid or fluids, the fluids can be placed within separate compartments for each finger, preferably separated by a relatively rigid barrier. Similarly, a compressible material, e.g., a foam, supporting each finger can be similarly separated by a relatively rigid barrier. - An instrumented orthosis can be configured to delivery one or more monitored, therapeutic energy treatments along with the capability of performing monitored exercise. The therapeutic energy is delivered by way of an energy transducer. Suitable types of energy transducers include, for example, ultrasonic transducers, pulsed electromagnetic field transducers, implantable electrical current transducers, surface electrical current transducers, and electrical muscle contraction stimulator. The transducers are located at an appropriate position to provide treatment for the injured area. The transducers preferably are controlled and monitored by
controller 112. Further discussion of combined treatment approaches using exercise and/or energy propagating transducers are described in published PCT application WO 96/36278, entitled “An Orthopedic Device Supporting Two or More Treatment Systems and Associated Methods,” incorporated herein by reference. - In simplified embodiments,
controller 112 may just include analog circuits and a suitable display. In preferred embodiments,controller 112 includes a digital processor to provide a more sophisticated interface with the patient and/or with a health care professional and to perform more involved monitoring functions. The digital processor preferably is a microprocessor. The digital processor can be programmed in any of a variety of computer languages including, for example, basic, assembler, C, C++ and the like. Preferably, controller 232 is portable, which in this context means that the controller is small enough to be ambulatory with the patient. More preferably,controller 112 is small enough to be held in the hand of a patient, and even more preferably to be placed in a standard shirt pocket. - A preferred microprocessor based
controller 112 has several subsystems including a power supply such as a battery, a transducer bias circuit such as described below, A/D converters, a microprocessor, real time clock, RAM and non-volatile storage such as FLASH, SRAM or EEPROM, a graphic display such as a 64×128 pixel LCD display with a corresponding driver, keypad, audible or tactile feedback device, data link to transducer, and an integral modem or RS232 standard output for serial connection or modem access. - In one particular embodiment, the microprocessor is a Motorola MC68HC11A1FN 8-bit microcontroller with built-in deep sleep shutdown mode for power conservation between active events, a programmable serial interface and an 8-channel, 8-bit A/D converter. In this embodiment, controller 232 can provide analog multiplexing and A/D conversion for up to 8 analog input signals over a voltage range from 0.0 to +5.0 volts. For example, three of the channels can be devoted to provide signal conditioning for up to three strain gauges, and three of the channels can be devoted to providing signal conditioning for up to three position (angle) sensors. The remaining two input channels then can be used for additional treatment devices. If desired, added sensors can be handled by multiplexing and duty-cycling.
- In this preferred embodiment, the controller module memory includes SRAM, FLASH and EEPROM, where each section is independently addressable. Each section can support, at least, 32K words with 8-bits (1 byte) per word. The EEPROM supports in-circuit reprogramming by way of the microcontroller serial channel for code updates. The FLASH memory provides non-volatile storage of recorded data. The real time clock is battery powered to allow time keeping to continue when the microcontroller circuitry is off The real time clock is capable of generating periodic interrupts at a programmable rate to power switching circuitry to activate the microcontroller during an alert mode of operation.
- The RS-232 interface consists of three conductor (T×D, R×D and GND) jack type connector with a mechanical switch to automatically switch power on to all on-board electronics when the plug is inserted. The baud rate of the interface is programmable with standard rates such as 9600 and 19200. A suitable display is a Densitron™ LE3328 LCD with Hitachi HD61202 and HD61203 LCD controller chip sets. The display can be run with a five volt supply that can be separate or not from the power supply for the rest of controller 232. In this embodiment, a three key keypad is interfaced with the microcontroller.
- All of the components of
controller 112 can be placed on the orthosis or in a separate case. The components ofcontroller 112 can be integrated into a single package or physically partitioned into portions mounted on the orthosis frame and/or portions placed into one or more small cases. -
Controller 112 preferably stores a software program that manages the use of the device for patient rehabilitation. The software can provide for alerting the patient to scheduled times for the performance of exercises using audible and/or vibratory signals.Controller 112 preferably provides instructions on the exercises as well as feedback and reinforcement messages to the patient. The software preferably is custom programmed for the patient by a health care professional based on an evaluation of the patient's condition. Approaches for programming the control unit is described further in the 60/098,779 application. - Stored information relating to the patient's performance of exercises generally is downloaded to the supervising health care professional at specified intervals. The download of the information can be performed in a variety of ways. If the patient goes to the office of the health care professional,
controller 112 can be directly connected to the monitor station/computer using the RS232 port or other port using suitable protocols including standard protocols. Alternatively,controller 112 can be attached to a modem by way of the RS232 port or other suitable port. Since with certain embodiments the file sizes are relatively small, a single chip, 9 volt supply Rockwell® 2400 baud or 9600 baud modem can be used.Controller 112 can be in radio communication with a monitor station.Controller 112 then would include a radio transmitter and, optionally, a receiver. Radio communication with a monitor station is described further and U.S. Pat. No. 5,823,975 entitled “Local Monitoring System For an Instrumented Orthopedic Restraining Device and Methods Therefore,” incorporated herein by reference. The display or a television set similarly can be in communication withcontroller 112 by way of radio transmissions or infrared communication such that a wire attachment is not necessary. Additional features of the controller are describe in the 60/098,779 application. - In order for the value of electrical resistance associated with a strain gauge to be useable as a measure of applied stress during isometric exercises, the values must be referenced to a “null” valve approximately corresponding to a value when no strain is applied to the orthosis. The null value can be set by a manual adjustment performed by the health care professional or by the patient. The “null” value, however, is preferably established automatically without the need for calibration by the user. Furthermore, the variations in the resistance due the strain gauge preferably are converted into a voltage value that is amplified to make efficient use of an analog-to-digital (A/D) converter with a specified number of binary digits. A preferred summing amplifier circuit for calibrated strain gauge measurement is described in detail in the 60/098,779 application.
- Further aspects of the improved orthoses are illustrated by reference to three particular preferred embodiments.
- A. Shoulder Brace
- Referring to
FIG. 19 , a preferred embodiment of ashoulder brace 700 includestrunk support 702, underarm support 704, upright support 706,shoulder hinge 708,arm support 710,elbow hinge 712,fore arm extension 714 andcontroller 716.Trunk support 702 includes a paddedhip rest 730 contoured to rest comfortably against a patient's hip and distribute any downward forces over a reasonable area.Padded hip rest 730 can include a relatively rigid shell, made from fiber glass, polytetrafluorethylene other suitable polymers, metal or the like. Padding, such as cloth covered foam padding, can be placed adjacent the rigid shell.Trunk support 702 generally further includes astrap 732, which can wrap around a patient's waist to securetrunk support 702.Strap 732 preferably has an adjustable length,optional padding 734 and afastener component 736, such as a portion of a hook-and-loop fastener, a buckle or any other suitable fastener component. Asecond fastener component 738 is attached to a strap or directly to paddedhip rest 730, as desired.Second fastener component 738 is the complement tofastener component 736, such thatfastener components - Under
arm support 704 includes a paddedsupport portion 740, which can include a relatively rigid shell with padding located along the inner and/or upper surface. Underarm support 704 further includes astrap 742, which can wrap around a patient's chest to secure underarm support 704.Strap 742 has anoptional pad 744, and preferably has an adjustable length and a fastener component 746. Asecond fastener component 748 can be attached to another strap or directly to paddedsupport portion 748.Fastener components 746, 748 can be complementary components of a buckle fastener, a look-and-loop fastener, or any other suitable fastener. Underarm support 704 further includes ashoulder strap 750.Shoulder strap 750 can includepadding 752, and preferably has an adjustable length. In this embodiment,shoulder strap 750 extends fromstrap 742 to paddedsupport portion 740, although other configurations are possible.Shoulder strap 750 is designed to extend over the opposite shoulder of the patient relative to the shoulder supported by underarm support 704. - Upright support 706 connects padded
hip rest 730, paddedsupport portion 740, andshoulder hinge 708. Upright support can be constructed from any rigid material such as metal, fiber glass or other rigid material or materials. Upright support 706 can be bolted to paddedhip rest 730 and paddedsupport portion 740, molded into a rigid shell of paddedhip rest 730 and paddedsupport portion 740, or secured to paddedhip rest 730 and paddedsupport portion 740 in any other reasonable fashion. Upright support 706 can attach directly to a lever arm ofshoulder hinge 708 or through a linking element connecting upright support 706 to a lever arm ofshoulder hinge 708. Upright support 706 holds paddedhip rest 730, paddedsupport portion 740 andshoulder hinge 708 at constant relative positions. -
Shoulder hinge 708 preferably is a hinge capable of motion in multiple planes. Suitable designs for hinges with releasable motion in multiple planes for use asshoulder hinge 708 are described above. As noted above, upright support 706 is attached to one lever arm ofshoulder hinge 708. A second lever arm ofshoulder hinge 708 is attached toarm support 710. -
Arm support 710 preferably includes asupport brace 760 and paddedarm support 762.Support brace 760 is attached to a lever arm of should hinge 708 and to a lever arm ofelbow hinge 712, either directly or through a linker.Padded arm support 762 is connected to supportbrace 760. Padded arm support helps the patient hold their arm in a proper position alongsupport brace 760. - One lever arm of
elbow hinge 712 is connected to supportbrace 760 and a second lever arm ofelbow hinge 712 is connected tofore arm extension 714.Elbow hinge 712 is oriented such that rotation at the patient's elbow results in rotation of the hinge, ifhinge 712 is in an unlocked setting and the patient's arm is properly located alongarm support 710 andfore arm extension 714 with their handgripping hand hold 774.Elbow pad 764 is attached to elbowhinge 712 orsupport brace 760. If desired, the lengths ofarm support 710 and/orfore arm extension 714 can be adjustable. -
Fore arm extension 714 includesextension shaft 770,bend 772 and hand hold 774.Shaft 770 can be made adjustable, such that the distance from the elbow to the hand can be set to an appropriate value.Bend 772 connectsshaft 770 withhand hold 774. Hand hold 774 preferably is a padded grip. Bend 772 preferably is connected toshaft 770 by way of awrist hinge 776.Fore arm extension 714 preferably includestraps 778 to secure the patient's arm. The hinge shown inFIG. 9 can be adapted for use aselbow hinge 712 andwrist hinge 776. -
Shoulder brace 700 preferably includes a plurality of transducers. As depicted inFIG. 19 ,strain gauges support brace 760, respectively. Strain gauges 780, 782 can supply measurements related to forces applied against a locked hinge or forces applied for rotation ofshoulder hinge 708 and/orelbow hinge 712.Shoulder hinge 708 preferably includes amultidimensional position sensor 784, as described above.Elbow hinge 712 preferably includes a position sensor, 786. Furthermore, hand hold 774 can include one or more pressure/stress transducers 788, to provide measurements related to forces applied by the patient's hand. - The transducers are preferably connected to
controller 716, generally by wires, although transmitter based approaches can be used. Suitable designs forcontroller 716 were described above with respect tocontroller 112 ofFIG. 1 . Straightforward modifications can be made to accommodate all of the transducers desired forshoulder brace 700. - To use
shoulder orthosis 700, a patient can slipshoulder strap 750 over their arm and head. With the weight of shoulder brace supported onshoulder strap 750,straps shoulder brace 700 over the various support segments. Withbrace 700 secured to the patient's torso, the patient can position their arm alongarm support 710 with their appropriate handgripping hand hold 774.Shoulder brace 700 can serve as a support for the patient's back, shoulder, elbow, wrist and/or hand. Furthermore, shoulder brace provides for a variety of exercises to assist with the recovery of an upper body injury, and/or to prevent the deterioration from lack of use of joints near an injury. Potential exercise programs are described further below. - B. Lower Extremity Full Leg Brace
- Referring to
FIG. 20 , a particular embodiment of afull leg brace 800 includeswaist support 802,hip hinge 804,thigh support 806,knee hinge 808,shin support 810,ankle hinge 812, ankle/foot support 814,foot rest 816 andcontroller 818.Waist support 802 preferably secures at the patient's waist to support the upper portion offull leg brace 800.Waist support 802 can have a similar design astrunk support 702, described above.Waist support 802 generally includessupport section 820 and hingelink 822.Support section 820 can be formed from one or more segments of rigid shell with inner padding to cushion contact with the patient. Multiple rigid shell segments can be connected with flexible segments for easier fastening around the patient's waist. Waist support includesstraps 824 or the like to provide for easy fastening and unfastening ofwaist support 802.Hinge link 822 provides for rigid connection ofsupport section 820 withhip hinge 804. -
Hip hinge 804 preferably is a hinge capable of motion in multiple planes. Suitable instrumented hinges with motion in multiple planes were described above. Preferred hip hinges 804 provide for motion of the leg forward-to-back as well as side-to-side, when the hinge is unlocked. -
Thigh support 806 includes ahinge link 830, asupport segment 832 andframe members Hinge link 830 provides rigid support betweenhip hinge 804 andsupport segment 832.Support segment 832 preferably encircles the patient's thigh, to securethigh support 806.Support segment 832 generally includes rigid shell segments with padding. In preferred embodiments,support segment 832 includes flexible segments connecting rigid shell segments. One or more flexible segments preferably include areleasable fastener 838, such as a hook-and-loop fastener to provide for easy fastening and unfastening ofsupport segment 832.Frame members support segment 832 andknee hinge 808.Frame members - In this embodiment,
knee hinge 808 includeshinge elements members hinge elements Hinge elements shin support 810, such thatshin support 810 andthigh support 806 connect to different lever arms of eachhinge element -
Shin support 810 includesframe elements straps element 850.Frame elements hinge elements frame elements Straps straps Straps Straps fastener element fastener elements element 852 directly or with straps.Fastener elements Fastener elements - In this embodiment,
ankle hinge 812 includeshinge elements 880, 882, connected respectively to frameelements hinge elements 880, 882 are described above.Hinge elements 880, 882 connect to ankle/foot support 814, such that ankle/foot support 814 andshin support 810 connect to different lever arms of eachhinge element 880, 882. - Ankle/
foot support 814 includesframe segments Frame segments hinge elements 880, 882, respectively.Frame segments foot rest 816. Frame segments can be made adjustable such that the distance fromhinge elements 880, 882 tofoot rest 816 can be adjusted to the proper length for the patient. -
Foot rest 816 includes aheel support 890 andfoot strap 892.Heel support 890 is contoured to the fit the rear portion of a patient's foot.Foot strap 892 wraps around the patient's foot to secure the patient's foot againstheel support 890.Strap 892 preferably has an adjustable length to obtain a proper fit.Foot strap 892 includes afastener portion 894 that connects with matedfastener portion 896.Fastener portion 896 generally is connected toheel support 890 on the opposite side relative to the connecting point offoot strap 892.Fastener portions -
Full leg brace 800 preferably includes a plurality of transducers. As depicted inFIG. 20 ,strain gauge 900 is associated withhinge link 822.Strain gauge 902 is associated withframe member 834.Strain gauge 904 is associated withframe segment 884. Strain gauges 900, 902 and 904 can supply measurements related to forces applied against a locked hinge or related to rotation ofhip hinge 804,knee hinge 808, and/orankle hinge 812.Hip hinge 804 preferably includes a multidimensional position sensor 906, as described above.Hinge element 840 ofknee hinge 808 preferably includes a position sensor, 908, to measure the orientation ofknee hinge 808. Similarly, hinge element 880 ofankle hinge 812 preferably includes a position sensor, 910. Furthermore,heel support 890 can include one or more pressure/stress transducers 898, to provide measurements related to forces applied by the patient on their heel. - The transducers are preferably connected to
controller 818, generally by wires, although transmitter based approaches can be used. Suitable designs forcontroller 818 were described above with respect tocontroller 112 ofFIG. 1 . Straightforward modifications can be made to accommodate all of the transducers desired forfull leg brace 800. - The brace shown in
FIG. 20 is intended to be worn on the patient's left leg. A corresponding brace can be constructed for the patient's right leg based on this design by connecting the leg portion of the brace to the other side ofwaste support section 820. The leg portion can be identical in construction to the left leg version shown inFIG. 20 , or the leg portion can involve reversal of the left and right hand elements on the leg portion, such that the resulting right leg portion corresponds to the left leg portion reflected through a symmetry plane going through the center of the leg portion. Furthermore, a lower extremity brace that supports both of the patient's legs can be constructed with a singlewaste support section 820 connected through two hip hinges 804 to appropriate supports for both legs. - For use, fill
leg brace 800 is placed around the patient's leg with the foot supported byfoot support 816, withwaist support 802 secured at the patient's waist, andsupport segment 832 secured around the patient's thigh.Straps fill leg brace 800.Full leg brace 800 can be used to provide valuable support for the patient as well as for the performance of a variety of monitored, programmed exercises, as described further below. - C. Stroke Brace
- Preferred embodiments of a stroke brace have upper body and lower extremity support. For the most common stroke debilitation, i.e., hemiparesis affecting one whole side of the body, the shoulder brace and fill leg brace described above can be combined.
Shoulder orthosis 700 ofFIG. 19 can be used along with lower extremities orthosis 800 ofFIG. 20 . In these embodiments, a common trunk support is substituted fortrunk support 702 andwaist support 802. The common trunk support is straightforward to design by incorporating the features oftrunk support 702 andwaist support 802. - With respect to instrumentation, transducers from
orthoses separate controllers Shoulder orthosis 700 can be physically connected to lower extremities orthosis 800 for stability, ororthoses - 2. Rehabilitation Using Orthoses
- The controllers described above preferably are programmed under the supervision of an appropriate health care professional. In one preferred embodiment, the controller has four modes of operation: OFF, STANDBY, ALERT and FULL ON. In the OFF mode, primary and backup battery power are removed, and no operations are taking place in the controller. In the STANDBY mode, no primary battery power is online, and backup battery power is used to maintain the real time clock and SRAM. Back-up power can be supplied by a coin cell or the like. STANDBY mode is generally used while the primary battery is being replaced or recharged.
- In ALERT mode, the real time clock produces a signal at programmed, periodic intervals to activate all on-board electronic components. ALERT-ACTIVE submode has all circuits active. Exercises are generally performed during the ALERT-ACTIVE mode. In ALERT-SLEEP submode, only the real time clock and SRAM memory remain active. ALERT-SLEEP mode is the standard mode of operation between exercise prompts. To allow switching between submodes, primary and backup battery power should be available during the ALERT mode. A beeper function can be used to prompt the patient that an exercise time has been reached.
- FULL-ON mode primarily is used during programming and data transfer operations. All on-board electronics and the display are active. FULL-ON mode can be activated automatically when an interface cable is connected.
- In a preferred embodiment, the controller can prompt and monitor the performance of isometric exercises, range of motion exercises, isotonic exercises and/or neurosensory, reflex, proprioception and neuromotor exercises. When the patient has suffered a stroke, preferably the exercises involve more than simple proprioception. The stroke generally destroys neurological pathways involving brain cells controlling reflexes, movements, and the like. Thus, the patient must relearn new neurological pathways connected to different memory locations. A variety of reflex exercises can be used to relearn these neurological pathways.
- When the health care professional programs the controller, the desired exercises from this group of possible exercises are selected along with the associated parameters and timing conditions for the selected exercises. Also, the controller preferably can store two or more sets of exercise routine parameters that can be used in different time intervals relative to the start of rehabilitation. In other words, after a first set of exercise routines have been used for a certain period of time, the controller selects a second, generally more difficult, set of exercises for the patient to perform. These exercises can be performed for any selected joint or group of joints.
- Similarly, the control unit can be programmed to prompt the patient to perform different exercises at different time of the day. These can be designed in a variety of ways by the health care professional based on the particular circumstances of the patient. For example, the control unit can prompt the patent to perform range-of-motion exercises every three hours, finger squeeze exercises every hour and longer exercise sessions for neurological rehabilitation every evening.
- Preferably, the controller prompts the patient at the time for performance of the selected exercises. In some embodiments, the patient presses a key when they are ready to proceed. The display on the monitor can graphically show the patient's motions with suitable coordinates for the particular exercise and compare them with a target performance, if suitable. The controller can store all of the data points or averages over a set of exercises performed over a period of time.
- To perform the isometric exercises of a particular joint, the corresponding hinge is adjusted to a particular angle. If a manual hinge is used, the hinge is manually adjusted. The controller may instruct the patient if the hinge is set at the desired angle. At the correct angle, the patient applies stress against the fixed hinge in one direction or the other. The controller instructs the patient if the applied stresses are within tolerance values of a target value. The controller preferably prompts the patient regarding the timing of the exercises, including the repetition rate and the amount of time to hold an applied stress. After the selected number of repetitions are performed the exercises are terminated or a new angle of the hinge is selected. The process is repeated until exercises are performed at all of the desired angles for the particular joint. For hinges that rotate in multiple planes, the joint can be exercised with forces applied along any plane of motion appropriate for the joint. The motion can be in a single plane at a particular time or within multiple planes simultaneously, such as moving a hand in a circle with an outstretched arm.
- Improvement in joint function can be advanced with attention to achieving a desirable range-of-motion (ROM). The ROM can be monitored using the orthosis with a suitable position sensing hinge or hinges, as described above. The particular hinge is set to allow rotation, at least over a portion of the possible rotation range. For hinges that rotate in multiple planes of motion, the range-of-motion exercises can be performed in the different planes.
- Proprioception in this context refers to the patient's sense of position in space, such as the bend of a particular joint. This seeming innate knowledge is a learned phenomenon involving a complex interaction of nerve sensations from sensors that are processed and combined with feedback and correction. A joint has dozens of single-celled measurement sensors: Paninian-like receptors, Ruffini corpuscles and the like. The brain and spinal cord process the information from these cellular sensors. When a joint is damaged, dozens of sensors may be permanently lost. For example, the anterior cruciate ligament of a knee has over 60 sensor/receptor cells some of which may be lost when the ligament tears. The body makes up for lost receptors by recruiting new sensor information from adjacent places. A new pathway and analysis must be relearned by the nervous system. With a properly designed orthosis this process should be accelerated and enhanced.
- In one embodiment, the controller display prompts an action through a graphic display, for example, to get a ball back into a circle, and the patient must react quickly, reflexively with the rehabilitating joint in the orthosis to move the ball on the screen. The position of the ball on the screen is correlated with the position of the joint by way of the position sensor in the orthosis operably connected to the controller. By changing the position of the joint, e.g. knee, the patient can move the ball back into the circle or to another target of some kind. These exercises improve cooperation and coordination. A similar game format can be used to perform isometric exercises where the amount of strain measured by the strain gauge is used to move the cursor. For hinges/joints that rotate in multiple planes, the full range of motion can be explored in a proprioception exercise.
- Isotonic exercises are similar to the range-of-motion exercises except that selected resistance is provided in the selected hinge. Resistance is provided by a manual unit, such as
resistance unit 400 above, or by an electrical resistance hinge actuated by a controller, such aselectromechanical hinge 240 above. In any case, a desired amount of resistance is set manually or automatically. The joint is then flexed over a prescribed range-of-motion. A controller can monitor the degree of flexing of the joint using a position sensor in the hinge and the amount of forces applied during the flexing using a strain gauge. The strain gauge can be calibrated such that a strain reading can be matched with a corresponding torque applied to the hinge. - Some preferred embodiments include an additional component to provide for closed chain exercises when used with the joint supporting component. Closed chain exercises involve muscular motion against resistance to mimic natural motions against gravity or to provide balanced stresses to the joint. Closed chain exercises can be contrasted with open chain exercises where a limb or trunk is moved or stressed in space without any resistance against the motion other than perhaps the weight of the limb itself. Closed chain exercise may provide more balanced exercise of the various muscle groups within a patient's limb or trunk. The closed chain component may or may not be physically connected with the joint supporting orthosis components.
- For the performance of closed chain exercises, a body portion pushes against an essentially immovable surface. The surface can be a floor, a wall, a table top or the like. In order to monitor the forces being applied, a sensor is used that is placed between the body part and the surface, for example, the
stress sensor 898 ofheel support 890. If closed chain exercises are to be performed with joints other than the knee, a suitable force sensor can be used. For example, a elbow can be exercised pushing with a hand against a pad sensor on a table or against a wall. These sensors can be connected to the controller. Additional information on the performance of the exercises described above and the corresponding programming of the controller is found in the 60/098,779 application. - As noted above, the controller can be attached to a variety of additional devices, such as closed chain exercise units, energy propagating transducers and the like, to assist with treatment. Generally, the monitoring of the operation of these additional units can be performed with the controller in a straightforward manner.
- The controller can be programmed to accept other input from the patient. In particular, inquiries can be directed to the patient at the start of an exercise routine, at the end of an exercise routine or at other times. The answers are stored for downloading to a health care professional along with suitable information regarding the performance of programmed exercises.
- As part of the monitoring operation, the controller preferably, continuously monitors the performance of an exercise to prevent difficulties. For example, after exercises have been started, the transducer parameters are evaluated to determine if the exercises are being performed within specified parameters. If the exercises are not being performed within tolerance values, a sound warning can be given. Additional description on the performance of exercises with an instrumented orthosis are described in the 60/098,779 application.
- Periodically, the information stored by the processor is downloaded to a health care professional. Various methods for downloading the information were described above. In principle, the controller can store all of the information about the performance of particular sets of exercise routines and download all of this information for analysis. Alternatively, the controller can perform some initial data analysis to reduce the amount of data that must be stored and transferred. The preliminary analysis, if any, performed by the controller can include grouping and/or averaging of groups of exercises over certain periods of time and/or performed at particular times of the day. Thus, raw or analyzed data can be transferred. This analysis can involve an evaluation of variation with the progress of time to assist the health care professional evaluate whether the patient is making sufficient improvement and to evaluate whether the exercise routine programmed into the controller is appropriate.
- To reduce the chance of the patient injuring themselves using the orthoses described herein, the patient preferably is examined by a trained health care professional prior to using the orthosis. Upon evaluating the condition of the patient, the controller is programmed for suitable exercises. In preferred embodiments, a monitor station assists the health care professional with the programming process. Once the controller is connected to the monitor station by way of an RS 232 connection, a modem connection, a radio connection, a IR connection or other suitable connection using an appropriate protocol the program is downloaded into the controller.
- At prescribed periods of time, information stored in the controller regarding the performance of the exercises by the patient can be downloaded into the monitor station. The time interval can be determined based on the storage capacity of the controller, the suitable length for evaluation of progress by health care professional or other similar issues. The download of information from the controller to the monitor station can be performed at the health care facility where the monitor station is located or from a remote location. If performed at the health care facility, the information can be downloaded by direct hook up of the controller with the monitor station or through a modem, radio connection, infrared connection or the like. Remote hook up can be performed with a modem connection, internet connection, radio communication or other longer range connection. A combination of the downloading of performance parameters with telecommunications capability is described further in copending and commonly assigned U.S. patent application Ser. No. 09/226,866, entitled “REMOTE MONITORING OF AN INSTRUMENTED ORTHOSIS,” incorporated herein by reference.
- Suitable analysis is performed of the data for example, the downloaded data on the exercises can be plotted in raw form or following some form of data averaging or selection. Based on an evaluation of the downloaded data, the health care professional can maintain the exercise program in its initially programmed form or modify the exercise program to account for unexpected developments. In preferred embodiments, the health care professional can reprogram the controller remotely such that any desired changes in the routine can be made without the patient needing to visit the health care facility. Further information on performance data analysis is found in the 60/098,779 application.
- One of several important functions of a microprocessor controlled orthosis is to monitor compliance with performance of exercises. A useful adjunct to the compliance monitoring function can be achieved by performing a psychological evaluation of the patient. The psychological test can be used to evaluate the suitability of the programmed exercises as well as indicate other potential problems with the healing process not directly linked to the exercises.
- Specifically, patients undergoing treatment for an injury are under stress. Pain, immobility, lack of understanding, fear contribute to the stress resulting from the injury. The stress complicates recovery because the stress interacts with other emotional or physical complaints. In particular, patients under stress undergo changes in their psychology. This psychological change commonly manifests itself as depression, fear, anxiety, anger or other types of decompensation.
- The stress and associated changes in psychology complicates the recovery by impairing the patient's ability to understand the problem and to cooperate filly in their own recovery. For example, depressed patients experience more pain, as measured by increased need for pain medication. Also, depressed patients exert less force during physical testing and, therefore, are measurably weaker. Thus, stress and associated complications can result in an objective, measurable decrease in physical ability.
- In the past, such factors generally have been accommodated or accepted as unavoidable because there has been no way to follow easily or to evaluate reasonably the changes in the patient's mental state. The ability to monitor the patient's mental emotional state can lead to important advances in the treatment of orthopedic injuries. To make effective use of the information on the patient's emotional state, the information preferably is coordinated with other aspects of the orthopedic and neurological recovery.
- As a result of their injury, patients likely will undergo a predictable series of changes as they first adapt to the pain of their injury, the inconvenience, the expense and the change in their function. The patient's emotional changes likely will include aspects of denial anger, bargaining, acceptance, etc., which have also been associated with death and dying, as described by Elisabeth Kübler-Ross. For a more complete description of these emotional changes see “On Death and Dying,” Elisabeth Kübler-Ross, Simon & Schuster (1969), incorporated herein by reference. These changes can be correlated with predictable or identifiable factors, such as age, gender, mechanism and socio-economic status.
- The emotional changes are a form of psychological pain. Since it is known that patients will undergo these emotional changes, a more complete treatment of the patient includes the management of the emotional changes accompanying the physical trauma. Effective management and/or treatment of the emotional changes preferably would involve 1) education, 2) monitoring, 3) accurate characterization, 4) cooperation-based contingent intervention, and 5) communication.
- In analogy with Kübler-Ross models, patients can benefit from the simple knowledge that emotional changes are common and predictable. Reassuring information can be passed along to the patient at regular intervals, consistent with identifiable patient demographic parameters. Patient suffering is reduced by mental preparation. The educational data can only be presented with optimum timing if the patient's ability to absorb the information is known. Thus, individual specific and time specific psychological quantification can be used to considerable advantage. Psychological quantification can be accomplished efficiently through portable psychological testing coordinated with the patient's physical therapy or exercise prescription. In particular, appropriate educational information can be presented by the controller.
- As part of the monitoring function, the treating professional preferably knows what the patient is experiencing and when they are experiencing it. These experiences will be based on the patient's specific stresses, demands, events and individual psychology. The experiences also will parallel progress or relapse in the orthopedic treatment regime. While qualitative features of the patient's emotional responses may be predictable, it is difficult to know when the psychological treatment can be effectively provided. By analogy, with physical discomfort the specific timing of effective administration of pain medication, assistance with physical activities and nursing assistance is highly variable and patient specific. The treatment is more effective when the patient is able to say when they require pain medication or other forms of help.
- Monitoring is an important component to effective treatment. Effective monitoring is not possible without ongoing, systematic and injury appropriate querying of the patient. To perform this in a cost effective way, the monitoring function must be portable with the patient. This portable monitoring can be accomplished by incorporating psychological monitoring on an orthopedic management system, such as those described herein. In particular, the monitoring function can be coordinated by the controller, which is programmed to pose questions and to receive answers from the patient. The psychological monitoring can be used to modify parameters in the orthopedic management, such as device comfort, exertion levels and pain control, when the monitoring function detects deviations from an expected emotional or psychological condition.
- To obtain an accurate characterization of the patient's emotional state, the treating professional and the patient need to work together to determine the stage of the patient's emotional recovery, the depth and type of the patient's distress, and changes in the patient's emotional condition as the problem either resolves or worsens. There are a number of literature based instruments available that have been used to characterize patients on a one-time basis to quantify an emotional state. These instruments can be adapted to an ongoing monitoring of a constantly evolving medical-surgical state, such as associated with an orthopedic or neurological injury.
- A first instrument for emotional evaluation involves the formation of a pain diagram. The patient is asked if the pain occurs at the expected location. Pain away from the expected location may indicate a complication or missed injury. See the discussion in Mayer et al., “A Prospective Short-Term Study of Chronic Low Back Pain Patients Utilizing Novel Objective Functional Measurement, Pain 25:53-68 (1986), incorporated herein by reference.
- An alternative approach is known as the Million analog scale. The patient is asked to characterize their discomfort based on a range of possible limitations. For example, they may be asked to state on an arbitrary scale their perceived functional restriction from “no pain” to “worst possible pain.” In addition, they may be asked whether they are easily able to work, unable to work or some gradation between these limits. The responses generally change based on the patient's recovery process and their perception of their recovery process. Thus, this is a straightforward tool to regularly administer during high risk periods as a significant tool to report changes in the patient's condition. For further discussion of this approach see, for example, R. Million et al., “Assessment of the Progress of the Back-Pain Patient,” Spine, 7(3):204-212 (1982), incorporated herein by reference.
- Patient's often find it difficult to describe their symptoms. In addition, patients in a certain high risk category for back injury are likely to have a range of educational limitations. This is a paradox that the patients who are most likely to sustain a certain type of injury are also least likely to be able to adequately characterize it as needing and deserving treatment. The McGill Pain Questionnaire provides a tool to overcome these difficulties. The McGill Pain Questionnaire uses words that the patient can understand and appropriately choose, but words that the patient would not likely use without suggestion. The words are provided in a format and grouping that tells more about the patient's situation and emotional state than just their pain level. A further description of the McGill Pain Questionnaire is described in R. Melzack, “The McGill Pain Questionnaire: Major Properties and Scoring Methods,” Pain 1:277-299 (1975), incorporated herein by reference. The questionnaire can be updated and modified as appropriate.
- Another potential instrument is the Beck Depression Inventory (BDI). Depression often follows injury and states of pain. A method of polling the patient for signs of depression would be another usefull method of controlling and improving the recovery process, as the patient progresses through their disease process.
- The BDI is a series of questions whose answers reflect the patient's mental state with respect to indications of depression. The BDI provides a standardized, objective measure that approximates clinical judgments of the intensity of depression without variability due to an evaluator's idiosyncrasies or theoretical orientation. The BDI's ease of administration and low cost provide for its economical use, for example, with a patient suffering from an orthopedic injury. Furthermore, statistical analysis can be performed with the quantitative data generated by the BDI.
- In its standard form, the BDI consists of 21 items that are scored to assess the patient's state of depression. Each of the 21 items can be rated on a scale of 0-3 such that the total score ranges from 0-63. The patient selects the number next to a statement that reflects the way that he/she has felt over a selected time period. The degree of depression is evaluated by the sum of the individual numbers with totals indicating as follows: 0-9 no depression, 10-16 mild depression, 17-29 moderate depression and 30-63 severe depression. In the standard test, the 21 items are: 1) sadness, 2) pessimism, 3) failure, 4) dissatisfaction, 5) guilt, 6) punishment, 7) self-dislike, 8) self-accusations, 9) suicidal thought, 10) crying, 11) irritability, 12) withdrawal, 13) indecision, 14) self-image, 15) work inhibition, 16) insomnia, 17) fatigue, 18) anorexia, 19) weight loss, 20) hypochondria, 21) libido loss.
- In summary, these instruments can be used 1) to demonstrate the location of pain as typical or atypical (the pain diagram), 2) to evaluate the patient's own perceived level of disability (the million analog scale), 3) to describe the specific nature of the pain as stinging, burning, torturing, or the like (the McGill Pain Questionnaire), or to reflect the effect of the difficulties on the patient's mental state (Beck Depression Inventory). Suitable tests are described further in the 60/098,779 application. Thus, standardized instruments for emotional evaluation can be integrated into an orthopedic treatments regime organized around an instrumented orthosis.
- In particular, the questions can be posed and the answers received through the controller. These questions can be posed at regular intervals. The questions can be interspersed throughout the day and coordinated with the timing of exercise routines. In particular, different subset of questions can be asked at different times. For example, a subset of questions on pain levels can be asked in the morning while a subset of questions on depression can be asked in the afternoon. To assist with these tests, the controller can be attached to a television set to provide a larger display, if desired. If administered in an appropriate and timely manner, the subjective aspects of the patient's suffering can be identified and quantified for appropriate intervention.
- The psychological test can be integrated with the physical evaluation of the patient to form a more complete overall evaluation. Using this evaluation, the exercise routine can be modified in response partly to the to mental attitude of the patient to help assure further compliance with the exercises and to increase the comfort level of the patient. The balance of all of these factors can lead to faster rehabilitation of the patient.
- The patient's ability to cooperate with their treatment is determined by their emotional state. Like physical pain, the patient's emotional state changes in a highly individualized manner. If the patient's emotional state can be more scientifically evaluated, characterized and bracketed with identifiable ranges and types, the modification to a more effective or more pleasurable reinforcement scheme can be assisted through cooperation-based contingent intervention. In particular, the information received from the patient is used to improve the cooperation of the patient in their own recovery. Thus, the relationship between the patient and the treating professional is augmented in a way that strengthens the relationship without adding unreasonable cost to treatment.
- With respect to implementing the cooperation-based contingent intervention, the controller first evaluates the immediacy of the patient's state. If there are serious concerns, such as if the patient indicates that the pain is unbearable or tortuous or if the patient is seriously depressed, the controller can either instruct the patient to immediately call the doctor or directly interface with the health professional's computer to down load the information, with the patient's help, if needed. Alternatively, the controller can modify the exercise level by decreasing the exertion if the pain is higher than desired or increase the level if the pain is low and the patient is frustrated by the slow pace.
- Thus, the patient's physical and mental condition, as communicated in the psychological evaluation, can provide useful information regarding the modifications to the treatment program in response to the patient's evolving physical condition and the mental state of the patient. Cooperation-based contingent intervention involves integrating the result of the psychological evaluation to the patient's evolving physical abilities to provide for improved adjustment of the treatment program. For example, a variety of different formats for presenting a particular exercise can be tried to evaluate whether the patient is more receptive to the particular formats. The formats can be put in the form of a game or in the form of detailed instructions with continuous positive reinforcement.
- Communication with the health care professional is an important aspect of the process. The controller can be used to intervene in the communication process to ensure that important information is communicated in a timely way. Regardless of any immediate concerns, the outcome of the patient's responses are reported to the treating professional for confirmation, data analysis and other types of support. Prior to evaluation by the health care professional, the patient's responses are characterized and identified. This can be done by the controller or by a remote processor. A scientific and quantifiable method of evaluating emotional change is an important component of the evaluation process.
- As a supplement to or as an alternative to, the questioning of the patient regarding their emotional state, physiological measurements can be made regarding conditions correlated with stress. For example, pulse rate can be measured with, for example, a laser Doppler sensor or a pulse oximeter. A pulse oximeter is an apparatus that the patient inserts their finger into to measure pulse rate and blood oxygenation. Similarly, galvanic skin response can be measured using electrodes placed on the skin. The electric resistance of skin is measured with the electrodes. In addition, blood pressure can be measured with a blood pressure cuff. These physiological measurements can be controlled and monitored with the controller. The physiological measurements can then be downloaded to the health care provider.
- The embodiments described above are intended to be illustrative and not limiting. Additional embodiments are within the claims. Although the present invention has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.
Claims (40)
1. An ambulatory medical device comprising a display, an input device, a microprocessor, memory, a download channel with an output portal and software wherein the software executes on the microprocessor to present questions on the psychological state of the patient with answers being input through the input device for storage for subsequent downloading from the output portal.
2. The ambulatory medical device of claim 1 wherein the display comprises an LCD display.
3. The ambulatory medical device of claim 1 wherein the input device comprises a keypad.
4. The ambulatory medical device of claim 1 wherein the microprocessor has a deep sleep mode.
5. The ambulatory medical device of claim 1 wherein the microprocessor has analog to digital multiplexing capability.
6. The ambulatory medical device of claim 1 wherein the memory is non-volatile memory.
7. The ambulatory medical device of claim 1 wherein the output comprises an RS-232 port.
8. The ambulatory medical device of claim 1 wherein the output comprises an internal modem.
9. The ambulatory medical device of claim 1 wherein the output comprises a radio transmitter.
10. The ambulatory medical device of claim 1 wherein the questions relate to pain levels.
11. The ambulatory medical device of claim 1 wherein the questions relate to the formation of a pain diagram.
12. The ambulatory medical device of claim 1 wherein the questions relate to depression.
13. The ambulatory medical device of claim 12 wherein a statistical analysis is performed on the depression questions to obtain an objective quantitative measure of depression.
14. The ambulatory medical device of claim 1 wherein the device is further connected to an orthosis.
15. The ambulatory medical device of claim 1 wherein the device is further connected to a pulse rate sensor, galvanic skin response or a blood pressure sensor.
16. A method for remote evaluation of the psychological state of a patient, the method comprises posing questions to a patient using an ambulatory device comprising a display, an input device, a microprocessor, memory, an output portal and software wherein the software executes on the microprocessor to present questions on the psychological state of the patient with answers being input through the input device for storage for subsequent downloading from the output portal.
17. The method of claim 16 wherein the questions relate to pain levels.
18. The method of claim 16 wherein the questions relate to the formation of a pain diagram.
19. The method of claim 16 wherein the questions relate to depression.
20. The method of claim 19 wherein a statistical analysis is performed on the depression questions to obtain an objective quantitative measure of depression.
21. The method of claim 16 wherein the psychological evaluation is coupled with a physiological evaluation.
22. The method of claim 21 wherein the physiological evaluation comprises evaluation of the performance of target exercises.
23. The method of claim 21 wherein the physiological evaluation comprises pulse measurements.
24. The method of claim 21 wherein the physiological evaluation comprises blood pressure measurements.
25. The method of claim 21 wherein the physiological evaluation comprises galvanic skin response measurements.
26. The method of claim 16 further comprising modifying a treatment program in response to the psychological evaluation.
27. The method of claim 16 wherein the downloading of important information is performed in a timely way.
28. The method of claim 16 further comprising characterizing the patient's answers prior to review by a health care professional.
29. The method of claim 28 wherein the characterization is performed on the ambulatory medical device.
30. The method of claim 28 wherein the characterization is performed on a central processor.
31. The method of claim 16 wherein detection of specific responses from the patient prompts an instruction to the patient to immediately contact a treatment professional.
32. A method of evaluating a patient's mental condition comprising:
collecting answers to a set of questions regarding the patient's mental condition using a remote controller programmed to pose the questions and receive the answers; and
evaluation of the answers by a health care professional.
33. The method of claim 32 further comprising performing initial analysis of the answers using a computer processor.
34. The method of claim 32 wherein the remote controller is operably connected to transducers associated with an orthosis.
35. The method of claim 34 wherein the transducers are selected from the group consisting of strain gauges, position sensors, and combinations thereof.
36. The method of claim 34 wherein the orthosis comprises a hinge that can rotate in several different planes and a position sensor operably connected to the hinge such that motion can be measured with respect to different rotational motions around the joint, the controller being operably connected to the position sensor to receive signals related to the position of the hinge.
37. The method of claim 34 wherein the orthosis comprises a plurality of hinges such that motions about separate hinges correspond to motions about different joints.
38. The method of claim 32 wherein the controller further processes a signal related to a physiological condition in the patient correlated with stress.
39. The method of claim 38 wherein the physiological condition is pulse rate.
40. The method of claim 38 wherein the physiological condition is the galvanic skin response.
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Cited By (70)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050074732A1 (en) * | 2003-10-02 | 2005-04-07 | Morris Gary Jay | Blood pressure simulation apparatus with tactile interface |
WO2007064711A2 (en) * | 2005-11-30 | 2007-06-07 | The Regents Of The University Of California | Method and apparatus for measurement of psychological pain as a construct for diagnosis, treatment, and drug development |
US20070283966A1 (en) * | 2006-06-09 | 2007-12-13 | Maples Paul D | Contamination avoiding device |
US20080161731A1 (en) * | 2006-12-27 | 2008-07-03 | Woods Sherrod A | Apparatus, system, and method for monitoring the range of motion of a patient's joint |
US20080319272A1 (en) * | 2007-06-19 | 2008-12-25 | Abhilash Patangay | System and method for remotely evaluating patient compliance status |
JP2009543230A (en) * | 2006-07-06 | 2009-12-03 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | Remote patient management platform with entertainment components |
US20100113979A1 (en) * | 2007-03-09 | 2010-05-06 | The Regents Of The University Of California | Method and apparatus for quantitative assessment of neuromotor disorders |
US20100125229A1 (en) * | 2008-07-11 | 2010-05-20 | University Of Delaware | Controllable Joint Brace |
US20100292592A1 (en) * | 2009-05-12 | 2010-11-18 | Angiologix Inc. | System and method of measuring changes in arterial volume of a limb segment |
US20100311022A1 (en) * | 2009-06-05 | 2010-12-09 | Jeffrey Asper | Runner's Arm Position Training Device |
US20100312149A1 (en) * | 2007-11-26 | 2010-12-09 | Nicola Hagemeister | Harness system for kinematic analysis of the knee |
US20110071002A1 (en) * | 2009-09-18 | 2011-03-24 | Gravel Martin | Rehabilitation system and method using muscle feedback |
US20120157859A1 (en) * | 2009-07-09 | 2012-06-21 | Societe De Ressources Et De Developpement Pour Les Entreprise Et Les Particuliers Srdep | Device to assist in the practice of a physical activity session, and physical activity apparatus provided with such a device |
US20120277891A1 (en) * | 2010-11-05 | 2012-11-01 | Nike, Inc. | Method and System for Automated Personal Training that Includes Training Programs |
US8308794B2 (en) | 2004-11-15 | 2012-11-13 | IZEK Technologies, Inc. | Instrumented implantable stents, vascular grafts and other medical devices |
US8491572B2 (en) | 2004-11-15 | 2013-07-23 | Izex Technologies, Inc. | Instrumented orthopedic and other medical implants |
US20130297022A1 (en) * | 2011-09-30 | 2013-11-07 | Anupam Pathak | Stabilizing unintentional muscle movements |
US8678979B2 (en) * | 1998-09-01 | 2014-03-25 | Izex Technologies, Inc. | Remote monitoring of a patient |
US8790258B2 (en) | 1999-06-23 | 2014-07-29 | Izex Technologies, Inc. | Remote psychological evaluation |
US20140213415A1 (en) * | 2010-01-08 | 2014-07-31 | Kermit Patrick Parker | Digital professional training instructor (The DPT instructor) |
US8808377B2 (en) | 2010-01-13 | 2014-08-19 | Jcbd, Llc | Sacroiliac joint fixation system |
US20150125839A1 (en) * | 2012-07-27 | 2015-05-07 | Tillges Technologies Llc | Wireless communication for pressure sensor readings |
WO2015164814A3 (en) * | 2014-04-25 | 2016-02-04 | The Trustees Of Columbia University In The City Of New York | Spinal treatment devices, methods, and systems |
US9333090B2 (en) | 2010-01-13 | 2016-05-10 | Jcbd, Llc | Systems for and methods of fusing a sacroiliac joint |
US20160174630A1 (en) * | 2013-07-15 | 2016-06-23 | SoftArmour LLC | Variable Modulus Body Brace And Body Brace System |
US9381045B2 (en) | 2010-01-13 | 2016-07-05 | Jcbd, Llc | Sacroiliac joint implant and sacroiliac joint instrument for fusing a sacroiliac joint |
US9421109B2 (en) | 2010-01-13 | 2016-08-23 | Jcbd, Llc | Systems and methods of fusing a sacroiliac joint |
US20160270996A1 (en) * | 2013-05-31 | 2016-09-22 | Sichuan Xukang Medical Electrical Equipment Co., Ltd. | Joint Rehabilitation Training System Based on the Remote Control, its Implementation Method and Evaluation Method of Joint Range of Motion |
US20170010636A1 (en) * | 2014-03-28 | 2017-01-12 | Intel Corporation | Rotation sensor device |
US9554909B2 (en) | 2012-07-20 | 2017-01-31 | Jcbd, Llc | Orthopedic anchoring system and methods |
US9700356B2 (en) | 2013-07-30 | 2017-07-11 | Jcbd, Llc | Systems for and methods of fusing a sacroiliac joint |
US9717539B2 (en) | 2013-07-30 | 2017-08-01 | Jcbd, Llc | Implants, systems, and methods for fusing a sacroiliac joint |
US9744428B2 (en) | 2012-06-04 | 2017-08-29 | Nike, Inc. | Combinatory score having a fitness sub-score and an athleticism sub-score |
US9788961B2 (en) | 2010-01-13 | 2017-10-17 | Jcbd, Llc | Sacroiliac joint implant system |
US9801546B2 (en) | 2014-05-27 | 2017-10-31 | Jcbd, Llc | Systems for and methods of diagnosing and treating a sacroiliac joint disorder |
US9811639B2 (en) | 2011-11-07 | 2017-11-07 | Nike, Inc. | User interface and fitness meters for remote joint workout session |
US9826986B2 (en) | 2013-07-30 | 2017-11-28 | Jcbd, Llc | Systems for and methods of preparing a sacroiliac joint for fusion |
US20170361217A1 (en) * | 2012-09-21 | 2017-12-21 | Bright Cloud International Corp. | Bimanual integrative virtual rehabilitation system and methods |
US9852271B2 (en) | 2010-12-13 | 2017-12-26 | Nike, Inc. | Processing data of a user performing an athletic activity to estimate energy expenditure |
US9919186B2 (en) | 2010-11-05 | 2018-03-20 | Nike, Inc. | Method and system for automated personal training |
US9943430B2 (en) | 2015-03-25 | 2018-04-17 | Verily Life Sciences Llc | Handheld tool for leveling uncoordinated motion |
US9977874B2 (en) | 2011-11-07 | 2018-05-22 | Nike, Inc. | User interface for remote joint workout session |
US10188890B2 (en) | 2013-12-26 | 2019-01-29 | Icon Health & Fitness, Inc. | Magnetic resistance mechanism in a cable machine |
US10220259B2 (en) | 2012-01-05 | 2019-03-05 | Icon Health & Fitness, Inc. | System and method for controlling an exercise device |
US10226396B2 (en) | 2014-06-20 | 2019-03-12 | Icon Health & Fitness, Inc. | Post workout massage device |
US10238306B2 (en) | 2006-02-20 | 2019-03-26 | Everist Genomics, Inc. | Method for non-evasively determining an endothelial function and a device for carrying out said method |
US10245087B2 (en) | 2013-03-15 | 2019-04-02 | Jcbd, Llc | Systems and methods for fusing a sacroiliac joint and anchoring an orthopedic appliance |
US10272317B2 (en) | 2016-03-18 | 2019-04-30 | Icon Health & Fitness, Inc. | Lighted pace feature in a treadmill |
US10271770B2 (en) | 2015-02-20 | 2019-04-30 | Verily Life Sciences Llc | Measurement and collection of human tremors through a handheld tool |
US10279212B2 (en) | 2013-03-14 | 2019-05-07 | Icon Health & Fitness, Inc. | Strength training apparatus with flywheel and related methods |
WO2019094096A1 (en) * | 2017-11-07 | 2019-05-16 | Djo, Llc | Brace having integrated remote patient monitoring technology and method of using same |
US10368669B2 (en) | 2011-09-30 | 2019-08-06 | Verily Life Sciences Llc | System and method for stabilizing unintentional muscle movements |
US10391361B2 (en) | 2015-02-27 | 2019-08-27 | Icon Health & Fitness, Inc. | Simulating real-world terrain on an exercise device |
US10420663B2 (en) | 2017-05-01 | 2019-09-24 | Verily Life Sciences Llc | Handheld articulated user-assistive device with behavior control modes |
US10426989B2 (en) | 2014-06-09 | 2019-10-01 | Icon Health & Fitness, Inc. | Cable system incorporated into a treadmill |
US10433612B2 (en) | 2014-03-10 | 2019-10-08 | Icon Health & Fitness, Inc. | Pressure sensor to quantify work |
US10493349B2 (en) | 2016-03-18 | 2019-12-03 | Icon Health & Fitness, Inc. | Display on exercise device |
WO2020046142A1 (en) * | 2018-08-28 | 2020-03-05 | Opum Technologies Limited | Orthosis or exoskeleton system |
US10583328B2 (en) | 2010-11-05 | 2020-03-10 | Nike, Inc. | Method and system for automated personal training |
US10600596B2 (en) | 2014-04-21 | 2020-03-24 | Verily Life Sciences Llc | Adapter to attach implements to an actively controlled human tremor cancellation platform |
US10603055B2 (en) | 2017-09-15 | 2020-03-31 | Jcbd, Llc | Systems for and methods of preparing and fusing a sacroiliac joint |
US10625137B2 (en) | 2016-03-18 | 2020-04-21 | Icon Health & Fitness, Inc. | Coordinated displays in an exercise device |
US10671705B2 (en) | 2016-09-28 | 2020-06-02 | Icon Health & Fitness, Inc. | Customizing recipe recommendations |
WO2020110656A1 (en) * | 2018-11-29 | 2020-06-04 | 株式会社村田製作所 | Muscle activity observation device and muscle activity observation method |
US20200315514A1 (en) * | 2017-12-21 | 2020-10-08 | Hoffmann-La Roche Inc. | Digital biomarkers for muscular disabilities |
US11042219B2 (en) * | 2017-11-16 | 2021-06-22 | Zhaosheng Chen | Smart wearable apparatus, smart wearable equipment and control method of smart wearable equipment |
KR20210108294A (en) * | 2020-02-25 | 2021-09-02 | 에이치로보틱스 주식회사 | Rehabilitation exercise apparatus for upper limb and lower limb |
US11136234B2 (en) | 2007-08-15 | 2021-10-05 | Bright Cloud International Corporation | Rehabilitation systems and methods |
US11304829B2 (en) * | 2017-02-01 | 2022-04-19 | Ottobock Se & Co Kgaa | Electromagnetic locking element for a joint orthosis or a joint prosthesis |
US11547587B2 (en) | 2017-01-06 | 2023-01-10 | Djo, Llc | Orthosis, related components and methods of use |
Families Citing this family (93)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6730047B2 (en) * | 1997-10-24 | 2004-05-04 | Creative Sports Technologies, Inc. | Head gear including a data augmentation unit for detecting head motion and providing feedback relating to the head motion |
US6827670B1 (en) * | 1999-10-11 | 2004-12-07 | Izex Technologies, Inc. | System for medical protocol management |
US20130158367A1 (en) * | 2000-06-16 | 2013-06-20 | Bodymedia, Inc. | System for monitoring and managing body weight and other physiological conditions including iterative and personalized planning, intervention and reporting capability |
US6966882B2 (en) | 2002-11-25 | 2005-11-22 | Tibion Corporation | Active muscle assistance device and method |
DE10311189B4 (en) * | 2003-03-12 | 2007-02-22 | Otto Bock Healthcare Gmbh | Orthopedic technical aid with a locking device |
DE10311187B4 (en) * | 2003-03-12 | 2006-08-10 | Otto Bock Healthcare Gmbh | Orthopedic technical aid with a locking device |
US7182738B2 (en) * | 2003-04-23 | 2007-02-27 | Marctec, Llc | Patient monitoring apparatus and method for orthosis and other devices |
US20130268296A1 (en) * | 2003-05-06 | 2013-10-10 | M-3 Information Llc | Method and apparatus for identifying, monitoring and treating medical signs and symptoms |
US8075633B2 (en) * | 2003-09-25 | 2011-12-13 | Massachusetts Institute Of Technology | Active ankle foot orthosis |
GB0422223D0 (en) * | 2004-10-07 | 2004-11-03 | Browne Wilkinson Oliver | Orthopaedic demonstration aid |
GB2425960A (en) * | 2005-05-12 | 2006-11-15 | Ali Bajwa | Adjustable splint |
US8834169B2 (en) * | 2005-08-31 | 2014-09-16 | The Regents Of The University Of California | Method and apparatus for automating arm and grasping movement training for rehabilitation of patients with motor impairment |
US8209022B2 (en) | 2005-11-16 | 2012-06-26 | Bioness Neuromodulation Ltd. | Gait modulation system and method |
US7899556B2 (en) | 2005-11-16 | 2011-03-01 | Bioness Neuromodulation Ltd. | Orthosis for a gait modulation system |
US7632239B2 (en) * | 2005-11-16 | 2009-12-15 | Bioness Neuromodulation Ltd. | Sensor device for gait enhancement |
US8972017B2 (en) | 2005-11-16 | 2015-03-03 | Bioness Neuromodulation Ltd. | Gait modulation system and method |
DE102005059342A1 (en) * | 2005-12-09 | 2007-06-14 | Eberhard P. Prof. Dr. Hofer | Mechanism, device and method for generating physiologically relevant force signals for stimulation of the lower extremities |
KR101040631B1 (en) * | 2006-06-29 | 2011-06-10 | 혼다 기켄 고교 가부시키가이샤 | Walk assistance device |
DE102007003515A1 (en) * | 2007-01-19 | 2008-07-31 | Bort Gmbh | Orthopedic supporting unit e.g. wrist bandage, has evaluation unit connected with sensors and provided for processing measured values at part of body, where sensors are formed for determining pressure in pad of guiding device |
US8353854B2 (en) | 2007-02-14 | 2013-01-15 | Tibion Corporation | Method and devices for moving a body joint |
US8095994B2 (en) * | 2007-03-15 | 2012-01-17 | Hilary Mass | Garment-integrated proprioceptive feedback system |
JP5427343B2 (en) | 2007-04-20 | 2014-02-26 | 任天堂株式会社 | Game controller |
US8657772B2 (en) * | 2007-07-20 | 2014-02-25 | össur hf. | Wearable device having feedback characteristics |
JP5427346B2 (en) | 2007-10-05 | 2014-02-26 | 任天堂株式会社 | Load detection program, load detection device, load detection system, and load detection method |
JP5080196B2 (en) | 2007-10-09 | 2012-11-21 | 任天堂株式会社 | Program, information processing apparatus, information processing system, and information processing method |
JP4382844B2 (en) | 2007-10-31 | 2009-12-16 | 任天堂株式会社 | Weighting machine for adjustment and weighting method for adjustment |
US8475339B2 (en) * | 2008-02-04 | 2013-07-02 | Xiusolution Co., Ltd. | Apparatus and method for correcting life patterns in real time |
WO2009099671A2 (en) | 2008-02-08 | 2009-08-13 | Tibion Corporation | Multi-fit orthotic and mobility assistance apparatus |
DE102008024750A1 (en) * | 2008-05-20 | 2009-12-03 | Otto Bock Healthcare Gmbh | connecting element |
DE102008024747A1 (en) * | 2008-05-20 | 2009-12-03 | Otto Bock Healthcare Products Gmbh | Orthopedic device with a joint and method for controlling an orthopedic device |
US20090306548A1 (en) | 2008-06-05 | 2009-12-10 | Bhugra Kern S | Therapeutic method and device for rehabilitation |
US20100022927A1 (en) * | 2008-07-23 | 2010-01-28 | Linares Medical Devices, Llc | Body limb cast with key adjustable outer cage and inner foam support members for maintaining breathe-ability |
US8274244B2 (en) | 2008-08-14 | 2012-09-25 | Tibion Corporation | Actuator system and method for extending a joint |
JP5361349B2 (en) | 2008-11-28 | 2013-12-04 | 任天堂株式会社 | Information processing apparatus, computer program, information processing system, and information processing method |
JP5806443B2 (en) | 2008-12-26 | 2015-11-10 | 任天堂株式会社 | Biological information management system |
US20100198124A1 (en) * | 2009-01-30 | 2010-08-05 | Kern Bhugra | System and method for controlling the joint motion of a user based on a measured physiological property |
US8639455B2 (en) | 2009-02-09 | 2014-01-28 | Alterg, Inc. | Foot pad device and method of obtaining weight data |
GB2467940A (en) | 2009-02-20 | 2010-08-25 | Cambfix | Fixator |
US7931567B2 (en) * | 2009-03-06 | 2011-04-26 | Leon Rosenberg | Apparatus for isolating an injured ankle or foot during aerobic exercise |
JP5271121B2 (en) | 2009-03-09 | 2013-08-21 | 任天堂株式会社 | Information processing program, information processing apparatus, information processing system, and information processing method |
JP5436909B2 (en) | 2009-03-30 | 2014-03-05 | 任天堂株式会社 | Information processing program, information processing apparatus, information processing system, and information processing method |
US8939924B1 (en) * | 2009-05-18 | 2015-01-27 | The Lonnie and Shannon Paulos Trust | Magnet assisted orthotic brace |
EP2453850A2 (en) * | 2009-07-15 | 2012-05-23 | President and Fellows of Harvard College | Actively controlled orthotic devices |
JP5161182B2 (en) | 2009-09-28 | 2013-03-13 | 任天堂株式会社 | Information processing program and information processing apparatus |
JP5610735B2 (en) | 2009-09-29 | 2014-10-22 | 任天堂株式会社 | Information processing program, information processing apparatus, information processing method, and information processing system |
JP5496591B2 (en) | 2009-09-30 | 2014-05-21 | 任天堂株式会社 | Information processing program and information processing apparatus |
EP2572639B1 (en) * | 2010-05-17 | 2016-09-14 | Osaka University | Muscle tone measuring apparatus |
US9095417B2 (en) * | 2011-02-07 | 2015-08-04 | Bioness Neuromodulation Ltd. | Adjustable orthosis for electrical stimulation of a limb |
US9114255B1 (en) | 2011-06-17 | 2015-08-25 | Customkynetics, Inc. | Exercise device for use with electrical stimulation and related methods |
US8868217B2 (en) | 2011-06-27 | 2014-10-21 | Bioness Neuromodulation Ltd. | Electrode for muscle stimulation |
US9168418B2 (en) | 2011-12-30 | 2015-10-27 | Lawrence G. Adamchick | Portable physical therapy/rehabilitation/exercise device, system and method |
US8845566B2 (en) | 2012-08-02 | 2014-09-30 | The Regents Of The University Of Michigan | Active exoskeletal spinal orthosis and method of orthotic treatment |
US9345609B2 (en) | 2013-01-11 | 2016-05-24 | Elwha Llc | Position sensing active torso support |
US10314733B2 (en) * | 2012-12-20 | 2019-06-11 | Elwha Llc | Sensor-based control of active wearable system |
US9889058B2 (en) | 2013-03-15 | 2018-02-13 | Alterg, Inc. | Orthotic device drive system and method |
US9867985B2 (en) | 2014-03-24 | 2018-01-16 | Bioness Inc. | Systems and apparatus for gait modulation and methods of use |
EP3334394B1 (en) | 2015-08-14 | 2021-05-26 | Pavini, Marie | Medical protective and exercise restraint systems and methods |
EP3402404B1 (en) | 2016-01-11 | 2021-07-21 | Bioness Inc. | Apparatus for gait modulation |
WO2018204280A1 (en) | 2017-05-01 | 2018-11-08 | Arizona Board Of Regents On Behalf Of The University Of Arizona | Active assist orthotic |
GB201716123D0 (en) * | 2017-10-03 | 2017-11-15 | Virtualclinic Direct Ltd | Data capture device |
US11185735B2 (en) | 2019-03-11 | 2021-11-30 | Rom Technologies, Inc. | System, method and apparatus for adjustable pedal crank |
US11471729B2 (en) | 2019-03-11 | 2022-10-18 | Rom Technologies, Inc. | System, method and apparatus for a rehabilitation machine with a simulated flywheel |
US20200289889A1 (en) | 2019-03-11 | 2020-09-17 | Rom Technologies, Inc. | Bendable sensor device for monitoring joint extension and flexion |
US11957960B2 (en) | 2019-05-10 | 2024-04-16 | Rehab2Fit Technologies Inc. | Method and system for using artificial intelligence to adjust pedal resistance |
US11801423B2 (en) | 2019-05-10 | 2023-10-31 | Rehab2Fit Technologies, Inc. | Method and system for using artificial intelligence to interact with a user of an exercise device during an exercise session |
US11904207B2 (en) | 2019-05-10 | 2024-02-20 | Rehab2Fit Technologies, Inc. | Method and system for using artificial intelligence to present a user interface representing a user's progress in various domains |
US11957956B2 (en) | 2019-05-10 | 2024-04-16 | Rehab2Fit Technologies, Inc. | System, method and apparatus for rehabilitation and exercise |
US11433276B2 (en) | 2019-05-10 | 2022-09-06 | Rehab2Fit Technologies, Inc. | Method and system for using artificial intelligence to independently adjust resistance of pedals based on leg strength |
US11896540B2 (en) | 2019-06-24 | 2024-02-13 | Rehab2Fit Technologies, Inc. | Method and system for implementing an exercise protocol for osteogenesis and/or muscular hypertrophy |
US11701548B2 (en) | 2019-10-07 | 2023-07-18 | Rom Technologies, Inc. | Computer-implemented questionnaire for orthopedic treatment |
US11071597B2 (en) | 2019-10-03 | 2021-07-27 | Rom Technologies, Inc. | Telemedicine for orthopedic treatment |
US11955223B2 (en) | 2019-10-03 | 2024-04-09 | Rom Technologies, Inc. | System and method for using artificial intelligence and machine learning to provide an enhanced user interface presenting data pertaining to cardiac health, bariatric health, pulmonary health, and/or cardio-oncologic health for the purpose of performing preventative actions |
US11915815B2 (en) | 2019-10-03 | 2024-02-27 | Rom Technologies, Inc. | System and method for using artificial intelligence and machine learning and generic risk factors to improve cardiovascular health such that the need for additional cardiac interventions is mitigated |
US11955222B2 (en) | 2019-10-03 | 2024-04-09 | Rom Technologies, Inc. | System and method for determining, based on advanced metrics of actual performance of an electromechanical machine, medical procedure eligibility in order to ascertain survivability rates and measures of quality-of-life criteria |
US11830601B2 (en) | 2019-10-03 | 2023-11-28 | Rom Technologies, Inc. | System and method for facilitating cardiac rehabilitation among eligible users |
US11756666B2 (en) | 2019-10-03 | 2023-09-12 | Rom Technologies, Inc. | Systems and methods to enable communication detection between devices and performance of a preventative action |
US11101028B2 (en) | 2019-10-03 | 2021-08-24 | Rom Technologies, Inc. | Method and system using artificial intelligence to monitor user characteristics during a telemedicine session |
US11915816B2 (en) | 2019-10-03 | 2024-02-27 | Rom Technologies, Inc. | Systems and methods of using artificial intelligence and machine learning in a telemedical environment to predict user disease states |
US11923065B2 (en) | 2019-10-03 | 2024-03-05 | Rom Technologies, Inc. | Systems and methods for using artificial intelligence and machine learning to detect abnormal heart rhythms of a user performing a treatment plan with an electromechanical machine |
US11961603B2 (en) | 2019-10-03 | 2024-04-16 | Rom Technologies, Inc. | System and method for using AI ML and telemedicine to perform bariatric rehabilitation via an electromechanical machine |
US11515021B2 (en) | 2019-10-03 | 2022-11-29 | Rom Technologies, Inc. | Method and system to analytically optimize telehealth practice-based billing processes and revenue while enabling regulatory compliance |
US11069436B2 (en) | 2019-10-03 | 2021-07-20 | Rom Technologies, Inc. | System and method for use of telemedicine-enabled rehabilitative hardware and for encouraging rehabilitative compliance through patient-based virtual shared sessions with patient-enabled mutual encouragement across simulated social networks |
US11955221B2 (en) | 2019-10-03 | 2024-04-09 | Rom Technologies, Inc. | System and method for using AI/ML to generate treatment plans to stimulate preferred angiogenesis |
US11075000B2 (en) | 2019-10-03 | 2021-07-27 | Rom Technologies, Inc. | Method and system for using virtual avatars associated with medical professionals during exercise sessions |
US11955220B2 (en) | 2019-10-03 | 2024-04-09 | Rom Technologies, Inc. | System and method for using AI/ML and telemedicine for invasive surgical treatment to determine a cardiac treatment plan that uses an electromechanical machine |
US11515028B2 (en) | 2019-10-03 | 2022-11-29 | Rom Technologies, Inc. | Method and system for using artificial intelligence and machine learning to create optimal treatment plans based on monetary value amount generated and/or patient outcome |
US11887717B2 (en) | 2019-10-03 | 2024-01-30 | Rom Technologies, Inc. | System and method for using AI, machine learning and telemedicine to perform pulmonary rehabilitation via an electromechanical machine |
US20210134463A1 (en) | 2019-10-03 | 2021-05-06 | Rom Technologies, Inc. | Systems and methods for remotely-enabled identification of a user infection |
US11826613B2 (en) | 2019-10-21 | 2023-11-28 | Rom Technologies, Inc. | Persuasive motivation for orthopedic treatment |
WO2021216881A1 (en) * | 2020-04-23 | 2021-10-28 | Rom Technologies, Inc. | Method and system for using sensor data from rehabilitation or exercise equipment to treat patients via telemedicine |
KR20230006641A (en) * | 2020-04-23 | 2023-01-10 | 롬 테크놀로지스, 인크. | Method and system for using sensor data from rehabilitation or exercise equipment to treat patients via telemedicine |
CN113223690B (en) * | 2020-07-06 | 2022-10-11 | 罗姆科技股份有限公司 | Method and system for rehabilitating a subject via telemedicine |
WO2022076039A1 (en) * | 2020-10-09 | 2022-04-14 | Vispalexo Inc. | Orthopedic system and method of controlling the same |
Citations (45)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4586495A (en) * | 1984-07-02 | 1986-05-06 | Wright State University | Therapy system for acute patient care |
US4621620A (en) * | 1984-04-16 | 1986-11-11 | Gene Anderson | Human limb manipulation device |
US4645199A (en) * | 1985-01-25 | 1987-02-24 | Bio-Dynamic Innovations, Inc. | Exercise device |
US4653479A (en) * | 1985-01-17 | 1987-03-31 | Empi, Inc. | Interrupted drive limb motion apparatus |
US4801138A (en) * | 1987-12-01 | 1989-01-31 | Soma Dynamics Corporation | Wearable apparatus for exercising body joints |
US4825852A (en) * | 1986-10-31 | 1989-05-02 | Sutter Biomedical, Inc. | Continuous passive motion device |
US4828257A (en) * | 1986-05-20 | 1989-05-09 | Powercise International Corporation | Electronically controlled exercise system |
US4863157A (en) * | 1988-04-29 | 1989-09-05 | State University Of New York | Method and apparatus for exercising a paralyzed limb |
US4934694A (en) * | 1985-12-06 | 1990-06-19 | Mcintosh James L | Computer controlled exercise system |
US4958632A (en) * | 1978-07-20 | 1990-09-25 | Medtronic, Inc. | Adaptable, digital computer controlled cardiac pacemaker |
US5003965A (en) * | 1988-09-14 | 1991-04-02 | Meditron Corporation | Medical device for ultrasonic treatment of living tissue and/or cells |
US5012820A (en) * | 1985-11-12 | 1991-05-07 | Niels Meyer | Device for investigation of muscular contraction |
US5052379A (en) * | 1989-04-27 | 1991-10-01 | Soma Dynamics Corporation | Combination brace and wearable exercise apparatus for body joints |
US5052375A (en) * | 1990-02-21 | 1991-10-01 | John G. Stark | Instrumented orthopedic restraining device and method of use |
US5181902A (en) * | 1990-09-21 | 1993-01-26 | American Medical Electronics, Inc. | Double-transducer system for PEMF Therapy |
US5195941A (en) * | 1991-01-07 | 1993-03-23 | American Medical Electronics, Inc. | Contoured triangular transducer system for PEMF therapy |
US5239987A (en) * | 1991-12-06 | 1993-08-31 | Jace Systems | Anatomically correct continuous passive motion device for a limb |
US5255188A (en) * | 1991-09-16 | 1993-10-19 | Jace Systems, Inc. | Universal controller for continuous passive motion devices |
US5474090A (en) * | 1989-01-13 | 1995-12-12 | The Scott Fetzer Company | Exercise monitoring system capable of simultaneous transmission of voice and physiological data |
US5569120A (en) * | 1994-06-24 | 1996-10-29 | University Of Maryland-Baltimore County | Method of using and apparatus for use with exercise machines to achieve programmable variable resistance |
US5579378A (en) * | 1993-08-25 | 1996-11-26 | Arlinghaus, Jr.; Frank H. | Medical monitoring system |
US5625882A (en) * | 1994-03-01 | 1997-04-29 | Motorola, Inc. | Power management technique for determining a device mode of operation |
US5671733A (en) * | 1994-04-21 | 1997-09-30 | Snap Laboratories, L.L.C. | Method of analyzing sleep disorders |
US5704364A (en) * | 1995-11-08 | 1998-01-06 | Instromedix, Inc. | Concurrent medical patient data and voice communication method and apparatus |
US5722418A (en) * | 1993-08-30 | 1998-03-03 | Bro; L. William | Method for mediating social and behavioral processes in medicine and business through an interactive telecommunications guidance system |
US5751959A (en) * | 1995-04-20 | 1998-05-12 | Canon Kabushiki Kaisha | Communication terminal, supervisory system and communication method |
US5801756A (en) * | 1994-11-25 | 1998-09-01 | Nec Corporation | Multipoint video conference system |
US5823975A (en) * | 1990-02-21 | 1998-10-20 | Stark; John G. | Local monitoring system for an instrumented orthopedic restraining device and method therefor |
US5913310A (en) * | 1994-05-23 | 1999-06-22 | Health Hero Network, Inc. | Method for diagnosis and treatment of psychological and emotional disorders using a microprocessor-based video game |
US5929782A (en) * | 1990-02-21 | 1999-07-27 | Stark; John G. | Communication system for an instrumented orthopedic restraining device and method therefor |
US5940801A (en) * | 1994-04-26 | 1999-08-17 | Health Hero Network, Inc. | Modular microprocessor-based diagnostic measurement apparatus and method for psychological conditions |
US5980447A (en) * | 1996-11-27 | 1999-11-09 | Phase Ii R & D -Dependency & Codependency Recovery Program Inc. | System for implementing dependency recovery process |
US5997476A (en) * | 1997-03-28 | 1999-12-07 | Health Hero Network, Inc. | Networked system for interactive communication and remote monitoring of individuals |
US6007459A (en) * | 1998-04-14 | 1999-12-28 | Burgess; Barry | Method and system for providing physical therapy services |
US6012926A (en) * | 1996-03-27 | 2000-01-11 | Emory University | Virtual reality system for treating patients with anxiety disorders |
US6014432A (en) * | 1998-05-19 | 2000-01-11 | Eastman Kodak Company | Home health care system |
US6059692A (en) * | 1996-12-13 | 2000-05-09 | Hickman; Paul L. | Apparatus for remote interactive exercise and health equipment |
US6231344B1 (en) * | 1998-08-14 | 2001-05-15 | Scientific Learning Corporation | Prophylactic reduction and remediation of schizophrenic impairments through interactive behavioral training |
US6249809B1 (en) * | 1993-08-30 | 2001-06-19 | William L. Bro | Automated and interactive telecommunications system |
US6248065B1 (en) * | 1997-04-30 | 2001-06-19 | Health Hero Network, Inc. | Monitoring system for remotely querying individuals |
US6302844B1 (en) * | 1999-03-31 | 2001-10-16 | Walker Digital, Llc | Patient care delivery system |
US6322502B1 (en) * | 1996-12-30 | 2001-11-27 | Imd Soft Ltd. | Medical information system |
US6371123B1 (en) * | 1999-06-11 | 2002-04-16 | Izex Technology, Inc. | System for orthopedic treatment protocol and method of use thereof |
US6827670B1 (en) * | 1999-10-11 | 2004-12-07 | Izex Technologies, Inc. | System for medical protocol management |
US6872187B1 (en) * | 1998-09-01 | 2005-03-29 | Izex Technologies, Inc. | Orthoses for joint rehabilitation |
Family Cites Families (249)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5338157B1 (en) | 1992-09-09 | 1999-11-02 | Sims Deltec Inc | Systems and methods for communicating with ambulat |
US2693796A (en) | 1953-04-24 | 1954-11-09 | Wendell S Warner | Spinal traction table |
US2777439A (en) * | 1954-10-11 | 1957-01-15 | Eugene F Tuttle | Manipulator |
US2832334A (en) * | 1956-05-23 | 1958-04-29 | Stephen H Whitelaw | Therapeutic device for use in manipulative treatment of joints of the human body |
US3253588A (en) * | 1962-02-01 | 1966-05-31 | Lear Siegler Inc | Bio-instrumentation apparatus |
US3374675A (en) * | 1965-01-04 | 1968-03-26 | Keropian Michael | Isometric muscle testing apparatus |
US3521623A (en) | 1965-02-12 | 1970-07-28 | Wayne Nichols | Back brace |
FR90727E (en) * | 1966-01-12 | 1968-02-02 | Apparatus for physical culture, more particularly for muscle rehabilitation or physiotherapy | |
GB1249791A (en) | 1969-01-23 | 1971-10-13 | Medico Ortopedica Dott Giovann | Orthopaedic apparatus for traction of the spinal column |
US3734087A (en) * | 1971-11-11 | 1973-05-22 | Medical Innovations Inc | External pressure circulatory assist |
DE2249208A1 (en) | 1972-10-07 | 1974-04-11 | Max Planck Gesellschaft | PROCEDURES AND EQUIPMENT FOR Aptitude Assessment |
US3866604A (en) * | 1973-09-28 | 1975-02-18 | Avco Everett Res Lab Inc | External cardiac assistance |
US3976057A (en) | 1974-12-23 | 1976-08-24 | Clarence F. Bates | Joint flexing apparatus |
US3929335A (en) * | 1975-02-10 | 1975-12-30 | Franklin S Malick | Electronic exercise aid |
US3986498A (en) | 1975-09-08 | 1976-10-19 | Videodetics Corporation | Remote ECG monitoring system |
US4135503A (en) | 1977-01-05 | 1979-01-23 | Romano Nicholas A | Orthopedic device |
US4178923A (en) | 1977-09-23 | 1979-12-18 | Curlee James D | Therapeutic corset |
NL7806327A (en) | 1978-06-12 | 1979-12-14 | Stijnen Hubertus J M | Orthopaedic back corset - has air cushions at loins, which are pressure adjustable while being worn |
US4235437A (en) | 1978-07-03 | 1980-11-25 | Book Wayne J | Robotic exercise machine and method |
US4436303A (en) * | 1978-08-28 | 1984-03-13 | Mckillip James B | Physical therapy apparatus |
US4544154A (en) | 1978-10-13 | 1985-10-01 | Pepsico, Inc. | Passive programmable resistance device |
US4354676A (en) | 1978-10-13 | 1982-10-19 | Pepsico, Inc. | Exerciser |
US4256094A (en) * | 1979-06-18 | 1981-03-17 | Kapp John P | Arterial pressure control system |
US4306571A (en) * | 1980-03-31 | 1981-12-22 | Orthopaedic Research Institute, Inc. | Dynamic joint motion analysis technique |
US4375217A (en) * | 1980-06-04 | 1983-03-01 | The Kendall Company | Compression device with pressure determination |
US4323080A (en) * | 1980-06-23 | 1982-04-06 | Melhart Albert H | Ankle stress machine |
US4331133A (en) * | 1980-06-30 | 1982-05-25 | The Kendall Company | Pressure measurement apparatus |
US4396010A (en) | 1980-06-30 | 1983-08-02 | The Kendall Company | Sequential compression device |
US4422634A (en) | 1981-06-08 | 1983-12-27 | Hopkins Harry C | Swimming simulator |
US4397308A (en) | 1981-07-23 | 1983-08-09 | Therapeutic Appliances, Inc. | Adjustable splint |
US4508111A (en) * | 1981-07-23 | 1985-04-02 | Dynasplint Systems, Inc. | Adjustable splint |
US4485808A (en) | 1982-04-12 | 1984-12-04 | Dynasplint Systems, Inc. | Adjustable splint |
US4419988A (en) | 1981-08-03 | 1983-12-13 | Jobst Institute, Inc. | Electronic circuit for a dynamic pressure wave pneumatic control system |
US4408599A (en) | 1981-08-03 | 1983-10-11 | Jobst Institute, Inc. | Apparatus for pneumatically controlling a dynamic pressure wave device |
US4520804A (en) | 1981-08-04 | 1985-06-04 | Digeorge Michael A | Double-locking ratchet for orthopedic brace |
US4436099A (en) * | 1981-08-14 | 1984-03-13 | The University Of Toledo | Instrument for measuring the range of motion associated with a human body joint |
CA1181306A (en) * | 1981-10-23 | 1985-01-22 | Toronto Medical Corp. | Device for imparting continuous passive motion to human joints |
US4407496A (en) | 1981-12-14 | 1983-10-04 | Johnson David E | Limb exercise device |
US4501148A (en) * | 1982-01-05 | 1985-02-26 | Nicholas James A | Manual muscle tester |
US4426884A (en) * | 1982-02-01 | 1984-01-24 | The Langer Biomechanics Group, Inc. | Flexible force sensor |
NL8303271A (en) | 1983-01-25 | 1984-08-16 | Draegerwerk Ag | MONITORING DEVICE FOR MEDICAL APPARATUS. |
BE895728A (en) * | 1983-01-28 | 1983-05-16 | Region Wallonne Represente Par | METHOD FOR CONTROLLING THE STABILITY OF AN ORTHOPEDIC ASSEMBLY CONSISTING OF AN EXTERNAL FIXING BAR USED FOR REDUCING FRACTURES |
US4512567A (en) * | 1983-03-28 | 1985-04-23 | Phillips Robert V | Exercise bicycle apparatus particularly adapted for controlling video games |
US4556216A (en) | 1983-08-15 | 1985-12-03 | Pitkanen Alan R | Computer directed exercising apparatus |
US4590925A (en) * | 1983-08-24 | 1986-05-27 | Dillon Richard S | System for promoting the circulation of blood |
US4553124A (en) | 1983-09-16 | 1985-11-12 | Carron & Company | Strain gauge transducer assembly |
US4620532A (en) | 1983-09-26 | 1986-11-04 | Lenox Hill Brace Shop, Inc. | Adjustment device for an articulated joint brace |
US4538600A (en) | 1983-10-27 | 1985-09-03 | Dynasplint Systems, Inc. | Adjustable splint |
US4538595A (en) | 1984-02-21 | 1985-09-03 | Hajianpour Muhamad A | Passive exercising device |
US4836218A (en) | 1984-04-09 | 1989-06-06 | Arthrotek, Inc. | Method and apparatus for the acoustic detection and analysis of joint disorders |
US4548208A (en) | 1984-06-27 | 1985-10-22 | Medtronic, Inc. | Automatic adjusting induction coil treatment device |
US4604098A (en) | 1984-07-17 | 1986-08-05 | The Johns Hopkins University | Prosthetic elbow with a motor-driven release mechanism |
US4651719A (en) * | 1985-01-22 | 1987-03-24 | Danninger Medical Technology, Inc. | Continuous passive motion shoulder unit |
US4654010A (en) * | 1985-03-04 | 1987-03-31 | Rod Havriluk | Method and apparatus of measuring swimming technique |
GB8509968D0 (en) | 1985-04-18 | 1985-05-30 | Rawcliffe J | Physiotherapy apparatus |
US4697808A (en) | 1985-05-16 | 1987-10-06 | Wright State University | Walking assistance system |
US4763901A (en) | 1985-06-14 | 1988-08-16 | Richter Howard S | Tennis elbow brace |
US5078152A (en) * | 1985-06-23 | 1992-01-07 | Loredan Biomedical, Inc. | Method for diagnosis and/or training of proprioceptor feedback capabilities in a muscle and joint system of a human patient |
GB2177603B (en) | 1985-07-09 | 1989-07-19 | David Ernest Young | Modular lower limb bracing system |
US4624246A (en) | 1985-11-01 | 1986-11-25 | Krikor Ajemian | Knee-supporting brace |
GB2186191B (en) | 1985-11-06 | 1990-01-10 | Univ Strathclyde | Hybrid orthosis |
US4681097A (en) | 1986-01-23 | 1987-07-21 | Pansiera Timothy T | Orthopedic brace |
US4711242A (en) * | 1986-02-18 | 1987-12-08 | Wright State University | Control system for knee joint |
US4858620A (en) | 1986-02-28 | 1989-08-22 | Walgen Corporation | Warning system for excessive orthopedic pressures |
US4757453A (en) | 1986-03-25 | 1988-07-12 | Nasiff Roger E | Body activity monitor using piezoelectric transducers on arms and legs |
ATE56133T1 (en) * | 1986-03-27 | 1990-09-15 | Gregory James Roger | MEASUREMENT OF MOBILITY OF THE ANTERIOR CRUCIAL LEGIONS. |
SU1380747A1 (en) | 1986-04-03 | 1988-03-15 | А.Г.Гриценко | Orthopedic jacket |
US4718665A (en) * | 1986-07-15 | 1988-01-12 | Soma Dynamics Corporation | Exercise device |
US4762134A (en) | 1986-08-01 | 1988-08-09 | Jeffery Gala | Vertebrae diagnostic and treatment apparatus |
US5474083A (en) | 1986-12-08 | 1995-12-12 | Empi, Inc. | Lifting monitoring and exercise training system |
US5090421A (en) * | 1986-12-09 | 1992-02-25 | Hoggan Health Industries, Inc. | Apparatus for testing muscle strength |
US4785674A (en) | 1987-01-20 | 1988-11-22 | Orman Gary M | Torque sensor |
US4988981B1 (en) * | 1987-03-17 | 1999-05-18 | Vpl Newco Inc | Computer data entry and manipulation apparatus and method |
DE3714218A1 (en) | 1987-04-29 | 1988-12-01 | Huberti Helmut Dr Med | THERAPEUTIC PROTECTIVE DEVICE AGAINST OVERLOAD OF THE HUMAN MOTORIZED APPARATUS, SOCIAL FOOT SCALE |
EP0290683A3 (en) | 1987-05-01 | 1988-12-14 | Diva Medical Systems B.V. | Diabetes management system and apparatus |
US4848152A (en) | 1987-05-04 | 1989-07-18 | Pratt Jr G Andrew | Biofeedback lifting monitor |
US4912638A (en) * | 1987-05-04 | 1990-03-27 | Pratt Jr G Andrew | Biofeedback lifting monitor |
US4817588A (en) * | 1987-07-01 | 1989-04-04 | Medical Technology, Inc. | Motion restraining knee brace |
US4796641A (en) * | 1987-07-06 | 1989-01-10 | Data Sciences, Inc. | Device and method for chronic in-vivo measurement of internal body pressure |
US4839822A (en) | 1987-08-13 | 1989-06-13 | 501 Synthes (U.S.A.) | Computer system and method for suggesting treatments for physical trauma |
CA1297952C (en) * | 1987-10-05 | 1992-03-24 | Diagnospine Research Inc. | Method and equipment for evaluating the flexibility of a human spine |
US4815469A (en) * | 1987-10-08 | 1989-03-28 | Siemens-Pacesetter, Inc. | Implantable blood oxygen sensor and method of use |
GB8726933D0 (en) | 1987-11-18 | 1987-12-23 | Cadell T E | Telemetry system |
US4905560A (en) * | 1987-12-24 | 1990-03-06 | Yamaha Corporation | Musical tone control apparatus mounted on a performer's body |
US4922925A (en) | 1988-02-29 | 1990-05-08 | Washington University | Computer based upper extremity evaluation system |
US4822336A (en) * | 1988-03-04 | 1989-04-18 | Ditraglia John | Blood glucose level sensing |
US4875469A (en) | 1988-06-13 | 1989-10-24 | Innovative Medical Engineering, Inc. | Continuous passive motion devices and methods |
US4830021A (en) | 1988-08-29 | 1989-05-16 | Thornton William E | Monitoring system for locomotor activity |
US4952928A (en) | 1988-08-29 | 1990-08-28 | B. I. Incorporated | Adaptable electronic monitoring and identification system |
US5047952A (en) * | 1988-10-14 | 1991-09-10 | The Board Of Trustee Of The Leland Stanford Junior University | Communication system for deaf, deaf-blind, or non-vocal individuals using instrumented glove |
US4928674A (en) | 1988-11-21 | 1990-05-29 | The Johns Hopkins University | Cardiopulmonary resuscitation and assisted circulation system |
US4928959A (en) | 1988-12-16 | 1990-05-29 | Osteo-Dyne, Inc. | Method and device for providing active exercise treatment for a patient suffering from a bone disorder |
US4930497A (en) | 1989-01-23 | 1990-06-05 | Toronto Medical Corp. | Apparatus for imparting continuous passive motion to a lower limb |
US5252102A (en) | 1989-01-24 | 1993-10-12 | Electrobionics Corporation | Electronic range of motion apparatus, for orthosis, prosthesis, and CPM machine |
US4909262A (en) * | 1989-01-31 | 1990-03-20 | Orthopedic Systems, Inc. | Apparatus for obtaining a body limb torque signal |
US5410472A (en) * | 1989-03-06 | 1995-04-25 | Ergometrx Corporation | Method for conditioning or rehabilitating using a prescribed exercise program |
US5031604A (en) | 1989-04-12 | 1991-07-16 | The Kendall Company | Device for applying compressive pressures to a patient's limb |
US5153584A (en) | 1989-03-17 | 1992-10-06 | Cardiac Evaluation Center, Inc. | Miniature multilead biotelemetry and patient location system |
US5020795A (en) | 1989-06-07 | 1991-06-04 | Soma Dynamics Corporation | Physical therapy and exercise apparatus for body limbs |
US5054771A (en) | 1989-07-17 | 1991-10-08 | Outer Sports, Inc. | Computer-interactive game machine with swing-action |
SU1750681A1 (en) | 1990-01-09 | 1992-07-30 | Ярославское Производственное Объединение "Ярославрезинотехника" | Device for fixing the lumbar region of the vertebral column |
US5000169A (en) * | 1990-01-16 | 1991-03-19 | Clinitex Corporation | Adjustable flexion-extension hinge for hinged limb immobilizer |
US5631861A (en) | 1990-02-02 | 1997-05-20 | Virtual Technologies, Inc. | Force feedback and texture simulating interface device |
US5050618A (en) | 1990-04-17 | 1991-09-24 | Larsen Lawrence E | Method and apparatus for measurement of joint stiffness |
US5265010A (en) | 1990-05-15 | 1993-11-23 | Hewlett-Packard Company | Method and apparatus for performing patient documentation |
US5125412A (en) | 1990-07-23 | 1992-06-30 | Thornton William E | Musculoskeletal activity monitor |
US5285773A (en) | 1990-07-30 | 1994-02-15 | Peter M. Bonutti | Orthosis with distraction through range of motion |
US5013037A (en) | 1990-10-30 | 1991-05-07 | Todd Stermer | Physical therapy device |
US5284131A (en) | 1990-11-26 | 1994-02-08 | Errol Gray | Therapeutic exercise device for legs |
US5337758A (en) | 1991-01-11 | 1994-08-16 | Orthopedic Systems, Inc. | Spine motion analyzer and method |
US5211161A (en) | 1991-01-22 | 1993-05-18 | Compagnie Generale De Materiel Orthopedique | Three axis passive motion exerciser |
US5287546A (en) * | 1992-09-14 | 1994-02-15 | Lunar Corporation | Patient positioning apparatus for bone scanning |
US5354162A (en) | 1991-02-26 | 1994-10-11 | Rutgers University | Actuator system for providing force feedback to portable master support |
US5558627A (en) | 1991-03-01 | 1996-09-24 | Singer; Samuel | Orthopaedic brace with an inflatable air bag |
US5116296A (en) | 1991-04-26 | 1992-05-26 | Medmetric Corporation | Isometric leg muscle ergometer |
US5396896A (en) * | 1991-05-15 | 1995-03-14 | Chrono Dynamics, Ltd. | Medical pumping apparatus |
JP3017569B2 (en) | 1991-05-30 | 2000-03-13 | 松下電工株式会社 | Air massage control method |
US5209712A (en) | 1991-06-24 | 1993-05-11 | Frederic Ferri | Proprioceptive exercise, training and therapy apparatus |
US5178160A (en) * | 1991-07-08 | 1993-01-12 | Diagnospine Research Inc. | Apparatus for the rehabilitation and measurement of musculoskeletal performances |
US5228454A (en) * | 1991-08-01 | 1993-07-20 | Drexel University | Apparatus and method for determining load-displacement and flexibility characteristics of a joint |
US5597373A (en) | 1991-11-08 | 1997-01-28 | Cedaron Medical, Inc. | Physiological evaluation and exercise system |
US5186163A (en) * | 1991-11-25 | 1993-02-16 | The Kendall Company | Compression device |
US5282460A (en) * | 1992-01-06 | 1994-02-01 | Joyce Ann Boldt | Three axis mechanical joint for a power assist device |
US5830162A (en) | 1992-01-23 | 1998-11-03 | Giovannetti; Giovanni Battista | Apparatus for the antigravity modification of the myotensions adapting the human posture in all of the planes of space |
US5297540A (en) * | 1992-01-29 | 1994-03-29 | Jace Systems, Inc. | Continuous passive motion orthosis device for a toe |
FI92139C (en) | 1992-02-28 | 1994-10-10 | Matti Myllymaeki | Monitoring device for the health condition, which is attached to the wrist |
US5263491A (en) | 1992-05-12 | 1993-11-23 | William Thornton | Ambulatory metabolic monitor |
US5336245A (en) | 1992-05-20 | 1994-08-09 | Angeion Corporation | Storage interrogation apparatus for cardiac data |
WO1994000817A1 (en) | 1992-06-22 | 1994-01-06 | Health Risk Management, Inc. | Health care management system |
US5449002A (en) | 1992-07-01 | 1995-09-12 | Goldman; Robert J. | Capacitive biofeedback sensor with resilient polyurethane dielectric for rehabilitation |
US5520622A (en) | 1992-07-01 | 1996-05-28 | Smith & Nephew Donjoy Inc. | Orthopedic brace having a pneumatic pad and associated pump |
US5218954A (en) | 1992-07-09 | 1993-06-15 | Bemmelen Paul S Van | Arterial assist device and method |
US6283761B1 (en) | 1992-09-08 | 2001-09-04 | Raymond Anthony Joao | Apparatus and method for processing and/or for providing healthcare information and/or healthcare-related information |
US5280783A (en) * | 1992-09-29 | 1994-01-25 | Sutter Corporation | Continuous passive motion device for full extension of leg |
US5346461A (en) | 1992-10-23 | 1994-09-13 | Bio-Cybernetics International | Electromechanical back brace apparatus |
US5391141A (en) * | 1992-11-10 | 1995-02-21 | Hamilton; Josef N. | Adjustable size and variable pressure regulated medical binder used by a patient after her or his body surgery |
US5918603A (en) | 1994-05-23 | 1999-07-06 | Health Hero Network, Inc. | Method for treating medical conditions using a microprocessor-based video game |
US6168563B1 (en) * | 1992-11-17 | 2001-01-02 | Health Hero Network, Inc. | Remote health monitoring and maintenance system |
US5713841A (en) | 1993-02-12 | 1998-02-03 | Graham; Richard A. | Inflatable cervical cervico-thoracic thoraco-lumbar and lumbar exercising device |
US5360392A (en) | 1993-05-14 | 1994-11-01 | Northeast Orthotics & Prosthetics, Inc. | Method of forming a scoliosis brace |
US5443440A (en) | 1993-06-11 | 1995-08-22 | Ndm Acquisition Corp. | Medical pumping apparatus |
US5431171A (en) | 1993-06-25 | 1995-07-11 | The Regents Of The University Of California | Monitoring fetal characteristics by radiotelemetric transmission |
US5373852A (en) | 1993-06-25 | 1994-12-20 | The Regents Of The University Of California | Monitoring uterine contractions by radiotelemetric transmission |
US5466213A (en) * | 1993-07-06 | 1995-11-14 | Massachusetts Institute Of Technology | Interactive robotic therapist |
DE69434390T2 (en) | 1993-07-09 | 2006-04-27 | Kinetecs, Inc. | EXERCISE DEVICE AND TECHNOLOGY |
US5954621A (en) | 1993-07-09 | 1999-09-21 | Kinetecs, Inc. | Exercise apparatus and technique |
US5788618A (en) | 1993-07-09 | 1998-08-04 | Kinetecs, Inc. | Exercise apparatus and technique |
US5425750A (en) | 1993-07-14 | 1995-06-20 | Pacesetter, Inc. | Accelerometer-based multi-axis physical activity sensor for a rate-responsive pacemaker and method of fabrication |
AU690910B2 (en) * | 1993-08-10 | 1998-05-07 | Katayama, Midori | Method for teaching the body gesture |
US5476441A (en) | 1993-09-30 | 1995-12-19 | Massachusetts Institute Of Technology | Controlled-brake orthosis |
US5417643A (en) | 1993-10-27 | 1995-05-23 | Danninger Medical Technology, Inc. | Continuous passive motion exercise device |
US5474088A (en) * | 1993-12-09 | 1995-12-12 | The Research Foundation Of State University Of New York | Device for measuring motion characteristics of a human joint |
US5435321A (en) | 1993-12-10 | 1995-07-25 | E.V.C. | Joint displacement measurement apparatus |
US6206829B1 (en) * | 1996-07-12 | 2001-03-27 | First Opinion Corporation | Computerized medical diagnostic and treatment advice system including network access |
US5437610A (en) | 1994-01-10 | 1995-08-01 | Spinal Cord Society | Extremity pump apparatus |
US5462504A (en) | 1994-02-04 | 1995-10-31 | True Fitness Technology Inc. | Fitness apparatus with heart rate control system and method of operation |
US5586067A (en) | 1994-07-19 | 1996-12-17 | Bcam International, Inc. | Support enhancing device and associated method |
US5890997A (en) * | 1994-08-03 | 1999-04-06 | Roth; Eric S. | Computerized system for the design, execution, and tracking of exercise programs |
FI100851B (en) | 1994-08-15 | 1998-03-13 | Polar Electro Oy | Method and apparatus for ambulatory recording and storage of a body part's movement in an individual and for simultaneous observation of movements of different body parts |
US5827209A (en) | 1994-09-23 | 1998-10-27 | Bcam International, Inc. | Intelligent body support |
US5683351A (en) | 1994-09-27 | 1997-11-04 | Jace Systems, Inc. | Continuous passive motion device for a hand |
GB9422007D0 (en) | 1994-11-01 | 1994-12-21 | Beacon Jonathan P | An orthopaedic measurement and display system |
JP2002514939A (en) | 1994-12-29 | 2002-05-21 | バーガン ピニー | Systems and methods for detecting and quantifying Parkinson's disease |
US5890906A (en) * | 1995-01-20 | 1999-04-06 | Vincent J. Macri | Method and apparatus for tutorial, self and assisted instruction directed to simulated preparation, training and competitive play and entertainment |
US5553609A (en) | 1995-02-09 | 1996-09-10 | Visiting Nurse Service, Inc. | Intelligent remote visual monitoring system for home health care service |
US6515593B1 (en) * | 1995-02-15 | 2003-02-04 | Izex Technologies, Inc. | Communication system for an instrumented orthopedic restraining device and method therefor |
US5556421A (en) | 1995-02-22 | 1996-09-17 | Intermedics, Inc. | Implantable medical device with enclosed physiological parameter sensors or telemetry link |
US5842175A (en) | 1995-04-28 | 1998-11-24 | Therassist Software, Inc. | Therapy system |
JP3023228U (en) | 1995-05-15 | 1996-04-16 | ヤーマン株式会社 | Lower limb skeleton correction device |
EP0957762A4 (en) | 1995-05-17 | 2003-04-02 | John G Stark | An orthopedic device supporting two or more treatment systems and associated methods |
JPH08316411A (en) | 1995-05-18 | 1996-11-29 | Hitachi Ltd | Semiconductor device |
US5882203A (en) * | 1995-05-31 | 1999-03-16 | Correa; Elsa I. | Method of detecting depression |
US5662693A (en) * | 1995-06-05 | 1997-09-02 | The United States Of America As Represented By The Secretary Of The Air Force | Mobility assist for the paralyzed, amputeed and spastic person |
US5779549A (en) | 1996-04-22 | 1998-07-14 | Walker Assest Management Limited Parnership | Database driven online distributed tournament system |
US5888173A (en) * | 1995-08-10 | 1999-03-30 | Singhal; Tara Chand | Health saver computer break |
EP0861552A4 (en) | 1995-08-21 | 1999-03-31 | Frederick J Kellinger | Computer system for cognitive rehabilitation |
US6177940B1 (en) * | 1995-09-20 | 2001-01-23 | Cedaron Medical, Inc. | Outcomes profile management system for evaluating treatment effectiveness |
US5961446A (en) * | 1995-10-06 | 1999-10-05 | Tevital Incorporated | Patient terminal for home health care system |
US5785666A (en) | 1995-10-31 | 1998-07-28 | Ergonomic Technologies Corporation | Portable electronic data collection apparatus for monitoring musculoskeletal stresses |
US6272481B1 (en) | 1996-05-31 | 2001-08-07 | Lucent Technologies Inc. | Hospital-based integrated medical computer system for processing medical and patient information using specialized functional modules |
US5792085A (en) | 1996-06-11 | 1998-08-11 | Walters; David J. | Pressure application unit for positioning vertebra |
US6132384A (en) | 1996-06-26 | 2000-10-17 | Medtronic, Inc. | Sensor, method of sensor implant and system for treatment of respiratory disorders |
US5797898A (en) | 1996-07-02 | 1998-08-25 | Massachusetts Institute Of Technology | Microchip drug delivery devices |
US5989157A (en) | 1996-08-06 | 1999-11-23 | Walton; Charles A. | Exercising system with electronic inertial game playing |
US5754121A (en) | 1996-09-03 | 1998-05-19 | Ward; Francisco A. | Joint monitor |
US6246975B1 (en) | 1996-10-30 | 2001-06-12 | American Board Of Family Practice, Inc. | Computer architecture and process of patient generation, evolution, and simulation for computer based testing system |
US6039688A (en) * | 1996-11-01 | 2000-03-21 | Salus Media Inc. | Therapeutic behavior modification program, compliance monitoring and feedback system |
ES2208963T3 (en) * | 1997-01-03 | 2004-06-16 | Biosense, Inc. | PRESSURE SENSITIVE VASCULAR ENDOPROTESIS. |
US6781284B1 (en) | 1997-02-07 | 2004-08-24 | Sri International | Electroactive polymer transducers and actuators |
BR9807260A (en) * | 1997-02-21 | 2000-05-02 | Rolf Eckmiller | Adaptive sensorimotor encoder for neuroprostheses |
US5980429A (en) * | 1997-03-12 | 1999-11-09 | Neurocom International, Inc. | System and method for monitoring training programs |
IL131873A0 (en) | 1997-03-13 | 2001-03-19 | First Opinion Corp | Disease management system |
IL120507A (en) | 1997-03-24 | 2001-06-14 | Keytron Electronics & Technolo | Exercise monitoring system |
US6540707B1 (en) * | 1997-03-24 | 2003-04-01 | Izex Technologies, Inc. | Orthoses |
US5792077A (en) * | 1997-03-31 | 1998-08-11 | Bel-Art Products, Inc. | Feedback goniometer for measuring flexibility of member movement |
US6050924A (en) * | 1997-04-28 | 2000-04-18 | Shea; Michael J. | Exercise system |
US6119516A (en) | 1997-05-23 | 2000-09-19 | Advantedge Systems, Inc. | Biofeedback system for monitoring the motion of body joint |
US5915240A (en) | 1997-06-12 | 1999-06-22 | Karpf; Ronald S. | Computer system and method for accessing medical information over a network |
US5868647A (en) * | 1997-07-14 | 1999-02-09 | Belsole; Robert J. | Apparatus and method for reducing repetitive strain injuries |
US6029138A (en) * | 1997-08-15 | 2000-02-22 | Brigham And Women's Hospital | Computer system for decision support in the selection of diagnostic and therapeutic tests and interventions for patients |
US5908383A (en) | 1997-09-17 | 1999-06-01 | Brynjestad; Ulf | Knowledge-based expert interactive system for pain |
US6915265B1 (en) | 1997-10-29 | 2005-07-05 | Janice Johnson | Method and system for consolidating and distributing information |
US6171237B1 (en) * | 1998-03-30 | 2001-01-09 | Boaz Avitall | Remote health monitoring system |
US6014631A (en) * | 1998-04-02 | 2000-01-11 | Merck-Medco Managed Care, Llc | Computer implemented patient medication review system and process for the managed care, health care and/or pharmacy industry |
US6283923B1 (en) | 1998-05-28 | 2001-09-04 | The Trustees Of Columbia University In The City Of New York | System and method for remotely monitoring asthma severity |
US6161095A (en) | 1998-12-16 | 2000-12-12 | Health Hero Network, Inc. | Treatment regimen compliance and efficacy with feedback |
US6551266B1 (en) * | 1998-12-29 | 2003-04-22 | Occulogix Corporation | Rheological treatment methods and related apheresis systems |
US6542720B1 (en) * | 1999-03-01 | 2003-04-01 | Micron Technology, Inc. | Microelectronic devices, methods of operating microelectronic devices, and methods of providing microelectronic devices |
US6285897B1 (en) * | 1999-04-07 | 2001-09-04 | Endonetics, Inc. | Remote physiological monitoring system |
DE19915846C1 (en) * | 1999-04-08 | 2000-08-31 | Implex Hear Tech Ag | Partially implantable system for rehabilitating hearing trouble includes a cordless telemetry device to transfer data between an implantable part, an external unit and an energy supply. |
US6166518A (en) | 1999-04-26 | 2000-12-26 | Exonix Corporation | Implantable power management system |
US7251609B1 (en) | 1999-04-29 | 2007-07-31 | The Trustees Of Boston University | Method for conducting clinical trials over the internet |
US6129663A (en) * | 1999-05-17 | 2000-10-10 | Mini-Mitter Co., Inc. | Monitor for input of subjective rating scores |
US6162189A (en) | 1999-05-26 | 2000-12-19 | Rutgers, The State University Of New Jersey | Ankle rehabilitation system |
US6270457B1 (en) | 1999-06-03 | 2001-08-07 | Cardiac Intelligence Corp. | System and method for automated collection and analysis of regularly retrieved patient information for remote patient care |
US6312378B1 (en) | 1999-06-03 | 2001-11-06 | Cardiac Intelligence Corporation | System and method for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care |
US7416537B1 (en) | 1999-06-23 | 2008-08-26 | Izex Technologies, Inc. | Rehabilitative orthoses |
US6413190B1 (en) | 1999-07-27 | 2002-07-02 | Enhanced Mobility Technologies | Rehabilitation apparatus and method |
US6440066B1 (en) | 1999-11-16 | 2002-08-27 | Cardiac Intelligence Corporation | Automated collection and analysis patient care system and method for ordering and prioritizing multiple health disorders to identify an index disorder |
EP2308522A3 (en) | 1999-11-17 | 2012-02-29 | Boston Scientific Limited | Microfabricated devices for the delivery of molecules into a carrier fluid |
US6442413B1 (en) | 2000-05-15 | 2002-08-27 | James H. Silver | Implantable sensor |
US7181261B2 (en) | 2000-05-15 | 2007-02-20 | Silver James H | Implantable, retrievable, thrombus minimizing sensors |
US20020017834A1 (en) * | 2000-07-06 | 2002-02-14 | Macdonald Robert I. | Acoustically actuated mems devices |
AU2001288417B2 (en) * | 2000-08-25 | 2004-07-22 | The Cleveland Clinic Foundation | Apparatus and method for assessing loads on adjacent bones |
DE60116520T2 (en) | 2000-10-10 | 2006-08-31 | Microchips, Inc., Bedford | MICROCHIP RESERVOIR DEVICES WITH WIRELESS TRANSMISSION OF ENERGY AND DATA |
US7283874B2 (en) | 2000-10-16 | 2007-10-16 | Remon Medical Technologies Ltd. | Acoustically powered implantable stimulating device |
US7273457B2 (en) | 2000-10-16 | 2007-09-25 | Remon Medical Technologies, Ltd. | Barometric pressure correction based on remote sources of information |
US6783499B2 (en) | 2000-12-18 | 2004-08-31 | Biosense, Inc. | Anchoring mechanism for implantable telemetric medical sensor |
US6638231B2 (en) | 2000-12-18 | 2003-10-28 | Biosense, Inc. | Implantable telemetric medical sensor and method |
US7232460B2 (en) * | 2001-04-25 | 2007-06-19 | Xillus, Inc. | Nanodevices, microdevices and sensors on in-vivo structures and method for the same |
WO2002099457A1 (en) * | 2001-05-31 | 2002-12-12 | Massachusetts Inst Technology | Microchip devices with improved reservoir opening |
WO2003015469A1 (en) | 2001-08-06 | 2003-02-20 | Measurement Specialties, Inc. | Acoustic sensor using cured piezoelectric film |
US6894456B2 (en) | 2001-11-07 | 2005-05-17 | Quallion Llc | Implantable medical power module |
US7051120B2 (en) | 2001-12-28 | 2006-05-23 | International Business Machines Corporation | Healthcare personal area identification network method and system |
US20040073175A1 (en) * | 2002-01-07 | 2004-04-15 | Jacobson James D. | Infusion system |
US6850804B2 (en) * | 2002-01-18 | 2005-02-01 | Calfacior Corporation | System method and apparatus for localized heating of tissue |
US6821299B2 (en) | 2002-07-24 | 2004-11-23 | Zimmer Technology, Inc. | Implantable prosthesis for measuring six force components |
EP1581287A1 (en) | 2002-12-23 | 2005-10-05 | Medtronic, Inc. | Multiple infusion section catheters, systems, and methods |
US20040143221A1 (en) | 2002-12-27 | 2004-07-22 | Shadduck John H. | Biomedical implant for sustained agent release |
US20040267234A1 (en) | 2003-04-16 | 2004-12-30 | Gill Heart | Implantable ultrasound systems and methods for enhancing localized delivery of therapeutic substances |
WO2005007223A2 (en) | 2003-07-16 | 2005-01-27 | Sasha John | Programmable medical drug delivery systems and methods for delivery of multiple fluids and concentrations |
US7367968B2 (en) * | 2003-09-05 | 2008-05-06 | Codman & Shurtleff, Inc. | Implantable pump with adjustable flow rate |
US7001393B2 (en) | 2003-11-10 | 2006-02-21 | Rush University Medical Center | Servo-controlled impacting device for orthopedic implants |
CA2592999C (en) | 2004-02-26 | 2017-11-07 | Linguaflex Llc | A method and device for the treatment of obstructive sleep apnea and snoring |
US20050197554A1 (en) | 2004-02-26 | 2005-09-08 | Michael Polcha | Composite thin-film glucose sensor |
US7794499B2 (en) | 2004-06-08 | 2010-09-14 | Theken Disc, L.L.C. | Prosthetic intervertebral spinal disc with integral microprocessor |
US7121998B1 (en) * | 2004-06-08 | 2006-10-17 | Eurica Califorrniaa | Vented microcradle for prenidial incubator |
WO2006055547A2 (en) | 2004-11-15 | 2006-05-26 | Izex Technologies, Inc. | Instrumented orthopedic and other medical implants |
US8308794B2 (en) | 2004-11-15 | 2012-11-13 | IZEK Technologies, Inc. | Instrumented implantable stents, vascular grafts and other medical devices |
-
1999
- 1999-06-23 US US09/339,071 patent/US7416537B1/en not_active Expired - Fee Related
-
2000
- 2000-06-20 AU AU57493/00A patent/AU5749300A/en not_active Abandoned
- 2000-06-20 WO PCT/US2000/016859 patent/WO2000078263A2/en active Application Filing
-
2004
- 2004-11-24 US US10/997,737 patent/US20050113652A1/en not_active Abandoned
-
2010
- 2010-01-19 US US12/689,568 patent/US8790258B2/en not_active Expired - Fee Related
Patent Citations (47)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4958632A (en) * | 1978-07-20 | 1990-09-25 | Medtronic, Inc. | Adaptable, digital computer controlled cardiac pacemaker |
US4621620A (en) * | 1984-04-16 | 1986-11-11 | Gene Anderson | Human limb manipulation device |
US4586495A (en) * | 1984-07-02 | 1986-05-06 | Wright State University | Therapy system for acute patient care |
US4653479A (en) * | 1985-01-17 | 1987-03-31 | Empi, Inc. | Interrupted drive limb motion apparatus |
US4645199A (en) * | 1985-01-25 | 1987-02-24 | Bio-Dynamic Innovations, Inc. | Exercise device |
US5012820A (en) * | 1985-11-12 | 1991-05-07 | Niels Meyer | Device for investigation of muscular contraction |
US4934694A (en) * | 1985-12-06 | 1990-06-19 | Mcintosh James L | Computer controlled exercise system |
US4828257A (en) * | 1986-05-20 | 1989-05-09 | Powercise International Corporation | Electronically controlled exercise system |
US4825852A (en) * | 1986-10-31 | 1989-05-02 | Sutter Biomedical, Inc. | Continuous passive motion device |
US4801138A (en) * | 1987-12-01 | 1989-01-31 | Soma Dynamics Corporation | Wearable apparatus for exercising body joints |
US4863157A (en) * | 1988-04-29 | 1989-09-05 | State University Of New York | Method and apparatus for exercising a paralyzed limb |
US5003965A (en) * | 1988-09-14 | 1991-04-02 | Meditron Corporation | Medical device for ultrasonic treatment of living tissue and/or cells |
US5474090A (en) * | 1989-01-13 | 1995-12-12 | The Scott Fetzer Company | Exercise monitoring system capable of simultaneous transmission of voice and physiological data |
US5052379A (en) * | 1989-04-27 | 1991-10-01 | Soma Dynamics Corporation | Combination brace and wearable exercise apparatus for body joints |
US5052375A (en) * | 1990-02-21 | 1991-10-01 | John G. Stark | Instrumented orthopedic restraining device and method of use |
US5368546A (en) * | 1990-02-21 | 1994-11-29 | John G. Stark | Instrumented orthopedic restraining device and method of use |
US5484389A (en) * | 1990-02-21 | 1996-01-16 | John G. Stark | Instrumented orthopedic restraining device and method of use |
US5929782A (en) * | 1990-02-21 | 1999-07-27 | Stark; John G. | Communication system for an instrumented orthopedic restraining device and method therefor |
US5823975A (en) * | 1990-02-21 | 1998-10-20 | Stark; John G. | Local monitoring system for an instrumented orthopedic restraining device and method therefor |
US5181902A (en) * | 1990-09-21 | 1993-01-26 | American Medical Electronics, Inc. | Double-transducer system for PEMF Therapy |
US5195941A (en) * | 1991-01-07 | 1993-03-23 | American Medical Electronics, Inc. | Contoured triangular transducer system for PEMF therapy |
US5255188A (en) * | 1991-09-16 | 1993-10-19 | Jace Systems, Inc. | Universal controller for continuous passive motion devices |
US5239987A (en) * | 1991-12-06 | 1993-08-31 | Jace Systems | Anatomically correct continuous passive motion device for a limb |
US5579378A (en) * | 1993-08-25 | 1996-11-26 | Arlinghaus, Jr.; Frank H. | Medical monitoring system |
US6249809B1 (en) * | 1993-08-30 | 2001-06-19 | William L. Bro | Automated and interactive telecommunications system |
US5722418A (en) * | 1993-08-30 | 1998-03-03 | Bro; L. William | Method for mediating social and behavioral processes in medicine and business through an interactive telecommunications guidance system |
US5625882A (en) * | 1994-03-01 | 1997-04-29 | Motorola, Inc. | Power management technique for determining a device mode of operation |
US5671733A (en) * | 1994-04-21 | 1997-09-30 | Snap Laboratories, L.L.C. | Method of analyzing sleep disorders |
US5940801A (en) * | 1994-04-26 | 1999-08-17 | Health Hero Network, Inc. | Modular microprocessor-based diagnostic measurement apparatus and method for psychological conditions |
US5913310A (en) * | 1994-05-23 | 1999-06-22 | Health Hero Network, Inc. | Method for diagnosis and treatment of psychological and emotional disorders using a microprocessor-based video game |
US5569120A (en) * | 1994-06-24 | 1996-10-29 | University Of Maryland-Baltimore County | Method of using and apparatus for use with exercise machines to achieve programmable variable resistance |
US5801756A (en) * | 1994-11-25 | 1998-09-01 | Nec Corporation | Multipoint video conference system |
US5751959A (en) * | 1995-04-20 | 1998-05-12 | Canon Kabushiki Kaisha | Communication terminal, supervisory system and communication method |
US5704364A (en) * | 1995-11-08 | 1998-01-06 | Instromedix, Inc. | Concurrent medical patient data and voice communication method and apparatus |
US6012926A (en) * | 1996-03-27 | 2000-01-11 | Emory University | Virtual reality system for treating patients with anxiety disorders |
US5980447A (en) * | 1996-11-27 | 1999-11-09 | Phase Ii R & D -Dependency & Codependency Recovery Program Inc. | System for implementing dependency recovery process |
US6059692A (en) * | 1996-12-13 | 2000-05-09 | Hickman; Paul L. | Apparatus for remote interactive exercise and health equipment |
US6322502B1 (en) * | 1996-12-30 | 2001-11-27 | Imd Soft Ltd. | Medical information system |
US5997476A (en) * | 1997-03-28 | 1999-12-07 | Health Hero Network, Inc. | Networked system for interactive communication and remote monitoring of individuals |
US6248065B1 (en) * | 1997-04-30 | 2001-06-19 | Health Hero Network, Inc. | Monitoring system for remotely querying individuals |
US6007459A (en) * | 1998-04-14 | 1999-12-28 | Burgess; Barry | Method and system for providing physical therapy services |
US6014432A (en) * | 1998-05-19 | 2000-01-11 | Eastman Kodak Company | Home health care system |
US6231344B1 (en) * | 1998-08-14 | 2001-05-15 | Scientific Learning Corporation | Prophylactic reduction and remediation of schizophrenic impairments through interactive behavioral training |
US6872187B1 (en) * | 1998-09-01 | 2005-03-29 | Izex Technologies, Inc. | Orthoses for joint rehabilitation |
US6302844B1 (en) * | 1999-03-31 | 2001-10-16 | Walker Digital, Llc | Patient care delivery system |
US6371123B1 (en) * | 1999-06-11 | 2002-04-16 | Izex Technology, Inc. | System for orthopedic treatment protocol and method of use thereof |
US6827670B1 (en) * | 1999-10-11 | 2004-12-07 | Izex Technologies, Inc. | System for medical protocol management |
Cited By (112)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8678979B2 (en) * | 1998-09-01 | 2014-03-25 | Izex Technologies, Inc. | Remote monitoring of a patient |
US9230057B2 (en) | 1998-09-01 | 2016-01-05 | Izex Technologies, Inc. | Remote monitoring of a patient |
US8790258B2 (en) | 1999-06-23 | 2014-07-29 | Izex Technologies, Inc. | Remote psychological evaluation |
US7972141B2 (en) | 2003-10-02 | 2011-07-05 | Gary Jay Morris | Blood pressure simulation apparatus with tactile feedback |
US7320599B2 (en) * | 2003-10-02 | 2008-01-22 | Gary Jay Morris | Blood pressure simulation apparatus with tactile interface |
US20080118901A1 (en) * | 2003-10-02 | 2008-05-22 | Morris Gary J | Blood pressure simulation apparatus with tactile feedback |
US20050074732A1 (en) * | 2003-10-02 | 2005-04-07 | Morris Gary Jay | Blood pressure simulation apparatus with tactile interface |
US8784475B2 (en) | 2004-11-15 | 2014-07-22 | Izex Technologies, Inc. | Instrumented implantable stents, vascular grafts and other medical devices |
US8740879B2 (en) | 2004-11-15 | 2014-06-03 | Izex Technologies, Inc. | Instrumented orthopedic and other medical implants |
US8491572B2 (en) | 2004-11-15 | 2013-07-23 | Izex Technologies, Inc. | Instrumented orthopedic and other medical implants |
US8308794B2 (en) | 2004-11-15 | 2012-11-13 | IZEK Technologies, Inc. | Instrumented implantable stents, vascular grafts and other medical devices |
WO2007064711A3 (en) * | 2005-11-30 | 2009-04-30 | Univ California | Method and apparatus for measurement of psychological pain as a construct for diagnosis, treatment, and drug development |
WO2007064711A2 (en) * | 2005-11-30 | 2007-06-07 | The Regents Of The University Of California | Method and apparatus for measurement of psychological pain as a construct for diagnosis, treatment, and drug development |
US10238306B2 (en) | 2006-02-20 | 2019-03-26 | Everist Genomics, Inc. | Method for non-evasively determining an endothelial function and a device for carrying out said method |
US20070283966A1 (en) * | 2006-06-09 | 2007-12-13 | Maples Paul D | Contamination avoiding device |
US20090125083A1 (en) * | 2006-06-09 | 2009-05-14 | Maples Paul D | Contamination avoiding device |
US7476102B2 (en) * | 2006-06-09 | 2009-01-13 | Maples Paul D | Contamination avoiding device |
US20100235177A1 (en) * | 2006-07-06 | 2010-09-16 | Koninklijke Philips Electronics, N.V. | Remote patient management platform with entertainment component |
JP2009543230A (en) * | 2006-07-06 | 2009-12-03 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | Remote patient management platform with entertainment components |
US20080161731A1 (en) * | 2006-12-27 | 2008-07-03 | Woods Sherrod A | Apparatus, system, and method for monitoring the range of motion of a patient's joint |
US20100113979A1 (en) * | 2007-03-09 | 2010-05-06 | The Regents Of The University Of California | Method and apparatus for quantitative assessment of neuromotor disorders |
US8845554B2 (en) * | 2007-03-09 | 2014-09-30 | The Regents Of The University Of California | Method and apparatus for quantitative assessment of neuromotor disorders |
US20080319272A1 (en) * | 2007-06-19 | 2008-12-25 | Abhilash Patangay | System and method for remotely evaluating patient compliance status |
US9597029B2 (en) * | 2007-06-19 | 2017-03-21 | Cardiac Pacemakers, Inc. | System and method for remotely evaluating patient compliance status |
US11136234B2 (en) | 2007-08-15 | 2021-10-05 | Bright Cloud International Corporation | Rehabilitation systems and methods |
US20100312149A1 (en) * | 2007-11-26 | 2010-12-09 | Nicola Hagemeister | Harness system for kinematic analysis of the knee |
US20100125229A1 (en) * | 2008-07-11 | 2010-05-20 | University Of Delaware | Controllable Joint Brace |
US8657755B2 (en) | 2009-05-12 | 2014-02-25 | Angiologix, Inc. | System and method of measuring changes in arterial volume of a limb segment |
US8057400B2 (en) | 2009-05-12 | 2011-11-15 | Angiologix, Inc. | System and method of measuring changes in arterial volume of a limb segment |
US20100292592A1 (en) * | 2009-05-12 | 2010-11-18 | Angiologix Inc. | System and method of measuring changes in arterial volume of a limb segment |
US20100311022A1 (en) * | 2009-06-05 | 2010-12-09 | Jeffrey Asper | Runner's Arm Position Training Device |
US20120157859A1 (en) * | 2009-07-09 | 2012-06-21 | Societe De Ressources Et De Developpement Pour Les Entreprise Et Les Particuliers Srdep | Device to assist in the practice of a physical activity session, and physical activity apparatus provided with such a device |
US20110071002A1 (en) * | 2009-09-18 | 2011-03-24 | Gravel Martin | Rehabilitation system and method using muscle feedback |
US8262541B2 (en) | 2009-09-18 | 2012-09-11 | Consultant En Ergonomie Et En Mieux-Etre Du Saguenay Inc. | Rehabilitation/exercise machine and system using muscle feedback |
US8187152B2 (en) | 2009-09-18 | 2012-05-29 | Consultant En Ergonomie Et En Mieux-Etre Du Saguenay Inc. | Rehabilitation system and method using muscle feedback |
US20140213415A1 (en) * | 2010-01-08 | 2014-07-31 | Kermit Patrick Parker | Digital professional training instructor (The DPT instructor) |
US10159431B2 (en) * | 2010-01-08 | 2018-12-25 | Kermit Patrick Parker | Digital professional training instructor (the DPT instructor) |
US8808377B2 (en) | 2010-01-13 | 2014-08-19 | Jcbd, Llc | Sacroiliac joint fixation system |
US9017407B2 (en) | 2010-01-13 | 2015-04-28 | Jcbd, Llc | Systems for and methods of fusing a sacroiliac joint |
US8979928B2 (en) | 2010-01-13 | 2015-03-17 | Jcbd, Llc | Sacroiliac joint fixation fusion system |
US9333090B2 (en) | 2010-01-13 | 2016-05-10 | Jcbd, Llc | Systems for and methods of fusing a sacroiliac joint |
US10034676B2 (en) | 2010-01-13 | 2018-07-31 | Jcbd, Llc | Systems for and methods of fusing a sacroiliac joint |
US9381045B2 (en) | 2010-01-13 | 2016-07-05 | Jcbd, Llc | Sacroiliac joint implant and sacroiliac joint instrument for fusing a sacroiliac joint |
US9421109B2 (en) | 2010-01-13 | 2016-08-23 | Jcbd, Llc | Systems and methods of fusing a sacroiliac joint |
US9788961B2 (en) | 2010-01-13 | 2017-10-17 | Jcbd, Llc | Sacroiliac joint implant system |
US11710549B2 (en) | 2010-11-05 | 2023-07-25 | Nike, Inc. | User interface for remote joint workout session |
US9457256B2 (en) * | 2010-11-05 | 2016-10-04 | Nike, Inc. | Method and system for automated personal training that includes training programs |
US11915814B2 (en) | 2010-11-05 | 2024-02-27 | Nike, Inc. | Method and system for automated personal training |
US9919186B2 (en) | 2010-11-05 | 2018-03-20 | Nike, Inc. | Method and system for automated personal training |
US11094410B2 (en) | 2010-11-05 | 2021-08-17 | Nike, Inc. | Method and system for automated personal training |
US20120277891A1 (en) * | 2010-11-05 | 2012-11-01 | Nike, Inc. | Method and System for Automated Personal Training that Includes Training Programs |
US10583328B2 (en) | 2010-11-05 | 2020-03-10 | Nike, Inc. | Method and system for automated personal training |
US9852271B2 (en) | 2010-12-13 | 2017-12-26 | Nike, Inc. | Processing data of a user performing an athletic activity to estimate energy expenditure |
US9925034B2 (en) * | 2011-09-30 | 2018-03-27 | Verily Life Sciences Llc | Stabilizing unintentional muscle movements |
US10455963B2 (en) | 2011-09-30 | 2019-10-29 | Verily Life Sciences, LLC | System and method for stabilizing unintentional muscle movements |
US20130297022A1 (en) * | 2011-09-30 | 2013-11-07 | Anupam Pathak | Stabilizing unintentional muscle movements |
US10368669B2 (en) | 2011-09-30 | 2019-08-06 | Verily Life Sciences Llc | System and method for stabilizing unintentional muscle movements |
US11944216B2 (en) | 2011-09-30 | 2024-04-02 | Verily Life Sciences Llc | System and method for stabilizing unintentional muscle movements |
US9811639B2 (en) | 2011-11-07 | 2017-11-07 | Nike, Inc. | User interface and fitness meters for remote joint workout session |
US10825561B2 (en) | 2011-11-07 | 2020-11-03 | Nike, Inc. | User interface for remote joint workout session |
US9977874B2 (en) | 2011-11-07 | 2018-05-22 | Nike, Inc. | User interface for remote joint workout session |
US10220259B2 (en) | 2012-01-05 | 2019-03-05 | Icon Health & Fitness, Inc. | System and method for controlling an exercise device |
US9744428B2 (en) | 2012-06-04 | 2017-08-29 | Nike, Inc. | Combinatory score having a fitness sub-score and an athleticism sub-score |
US10188930B2 (en) | 2012-06-04 | 2019-01-29 | Nike, Inc. | Combinatory score having a fitness sub-score and an athleticism sub-score |
US9554909B2 (en) | 2012-07-20 | 2017-01-31 | Jcbd, Llc | Orthopedic anchoring system and methods |
US20150125839A1 (en) * | 2012-07-27 | 2015-05-07 | Tillges Technologies Llc | Wireless communication for pressure sensor readings |
US20170361217A1 (en) * | 2012-09-21 | 2017-12-21 | Bright Cloud International Corp. | Bimanual integrative virtual rehabilitation system and methods |
US10722784B2 (en) * | 2012-09-21 | 2020-07-28 | Bright Cloud International Corporation | Bimanual integrative virtual rehabilitation system and methods |
US10279212B2 (en) | 2013-03-14 | 2019-05-07 | Icon Health & Fitness, Inc. | Strength training apparatus with flywheel and related methods |
US10245087B2 (en) | 2013-03-15 | 2019-04-02 | Jcbd, Llc | Systems and methods for fusing a sacroiliac joint and anchoring an orthopedic appliance |
US20160270996A1 (en) * | 2013-05-31 | 2016-09-22 | Sichuan Xukang Medical Electrical Equipment Co., Ltd. | Joint Rehabilitation Training System Based on the Remote Control, its Implementation Method and Evaluation Method of Joint Range of Motion |
US20160174630A1 (en) * | 2013-07-15 | 2016-06-23 | SoftArmour LLC | Variable Modulus Body Brace And Body Brace System |
US11259577B2 (en) * | 2013-07-15 | 2022-03-01 | SoftArmour LLC | Variable modulus body brace and body brace system |
US9700356B2 (en) | 2013-07-30 | 2017-07-11 | Jcbd, Llc | Systems for and methods of fusing a sacroiliac joint |
US9717539B2 (en) | 2013-07-30 | 2017-08-01 | Jcbd, Llc | Implants, systems, and methods for fusing a sacroiliac joint |
US9826986B2 (en) | 2013-07-30 | 2017-11-28 | Jcbd, Llc | Systems for and methods of preparing a sacroiliac joint for fusion |
US10188890B2 (en) | 2013-12-26 | 2019-01-29 | Icon Health & Fitness, Inc. | Magnetic resistance mechanism in a cable machine |
US10433612B2 (en) | 2014-03-10 | 2019-10-08 | Icon Health & Fitness, Inc. | Pressure sensor to quantify work |
US20170010636A1 (en) * | 2014-03-28 | 2017-01-12 | Intel Corporation | Rotation sensor device |
US10571972B2 (en) * | 2014-03-28 | 2020-02-25 | Intel Corporation | Rotation sensor device |
US10600596B2 (en) | 2014-04-21 | 2020-03-24 | Verily Life Sciences Llc | Adapter to attach implements to an actively controlled human tremor cancellation platform |
US10639185B2 (en) | 2014-04-25 | 2020-05-05 | The Trustees Of Columbia University In The City Of New York | Spinal treatment devices, methods, and systems |
WO2015164814A3 (en) * | 2014-04-25 | 2016-02-04 | The Trustees Of Columbia University In The City Of New York | Spinal treatment devices, methods, and systems |
US9801546B2 (en) | 2014-05-27 | 2017-10-31 | Jcbd, Llc | Systems for and methods of diagnosing and treating a sacroiliac joint disorder |
US10426989B2 (en) | 2014-06-09 | 2019-10-01 | Icon Health & Fitness, Inc. | Cable system incorporated into a treadmill |
US10226396B2 (en) | 2014-06-20 | 2019-03-12 | Icon Health & Fitness, Inc. | Post workout massage device |
US10271770B2 (en) | 2015-02-20 | 2019-04-30 | Verily Life Sciences Llc | Measurement and collection of human tremors through a handheld tool |
US10391361B2 (en) | 2015-02-27 | 2019-08-27 | Icon Health & Fitness, Inc. | Simulating real-world terrain on an exercise device |
US10532465B2 (en) | 2015-03-25 | 2020-01-14 | Verily Life Sciences Llc | Handheld tool for leveling uncoordinated motion |
US9943430B2 (en) | 2015-03-25 | 2018-04-17 | Verily Life Sciences Llc | Handheld tool for leveling uncoordinated motion |
US10493349B2 (en) | 2016-03-18 | 2019-12-03 | Icon Health & Fitness, Inc. | Display on exercise device |
US10625137B2 (en) | 2016-03-18 | 2020-04-21 | Icon Health & Fitness, Inc. | Coordinated displays in an exercise device |
US10272317B2 (en) | 2016-03-18 | 2019-04-30 | Icon Health & Fitness, Inc. | Lighted pace feature in a treadmill |
US10671705B2 (en) | 2016-09-28 | 2020-06-02 | Icon Health & Fitness, Inc. | Customizing recipe recommendations |
US11547587B2 (en) | 2017-01-06 | 2023-01-10 | Djo, Llc | Orthosis, related components and methods of use |
US11304829B2 (en) * | 2017-02-01 | 2022-04-19 | Ottobock Se & Co Kgaa | Electromagnetic locking element for a joint orthosis or a joint prosthesis |
US10420663B2 (en) | 2017-05-01 | 2019-09-24 | Verily Life Sciences Llc | Handheld articulated user-assistive device with behavior control modes |
US11369500B2 (en) | 2017-05-01 | 2022-06-28 | Verily Life Sciences Llc | Handheld articulated user-assistive device with behavior control modes |
US10603055B2 (en) | 2017-09-15 | 2020-03-31 | Jcbd, Llc | Systems for and methods of preparing and fusing a sacroiliac joint |
WO2019094096A1 (en) * | 2017-11-07 | 2019-05-16 | Djo, Llc | Brace having integrated remote patient monitoring technology and method of using same |
JP2021501651A (en) * | 2017-11-07 | 2021-01-21 | ディージェーオー,エルエルシー | Equipment with built-in remote patient monitoring technology and how to use it |
US11583210B2 (en) | 2017-11-07 | 2023-02-21 | Djo, Llc | Brace having integrated remote patient monitoring technology and method of using same |
CN111386092A (en) * | 2017-11-07 | 2020-07-07 | Djo有限责任公司 | Stent with integrated remote patient monitoring technology and method of use thereof |
US11042219B2 (en) * | 2017-11-16 | 2021-06-22 | Zhaosheng Chen | Smart wearable apparatus, smart wearable equipment and control method of smart wearable equipment |
EP3690608B1 (en) * | 2017-11-16 | 2022-04-06 | Zhaosheng Chen | Smart wearable apparatus, smart wearable device, and control method |
US20200315514A1 (en) * | 2017-12-21 | 2020-10-08 | Hoffmann-La Roche Inc. | Digital biomarkers for muscular disabilities |
WO2020046142A1 (en) * | 2018-08-28 | 2020-03-05 | Opum Technologies Limited | Orthosis or exoskeleton system |
CN113164099A (en) * | 2018-11-29 | 2021-07-23 | 株式会社村田制作所 | Muscle activity observation device and muscle activity observation method |
WO2020110656A1 (en) * | 2018-11-29 | 2020-06-04 | 株式会社村田製作所 | Muscle activity observation device and muscle activity observation method |
JP6750768B1 (en) * | 2018-11-29 | 2020-09-02 | 株式会社村田製作所 | Muscle activity observation device and muscle activity observation method |
KR102471990B1 (en) * | 2020-02-25 | 2022-11-29 | 에이치로보틱스 주식회사 | Rehabilitation exercise apparatus for upper limb and lower limb |
KR20210108294A (en) * | 2020-02-25 | 2021-09-02 | 에이치로보틱스 주식회사 | Rehabilitation exercise apparatus for upper limb and lower limb |
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US7416537B1 (en) | 2008-08-26 |
US20100121160A1 (en) | 2010-05-13 |
WO2000078263A3 (en) | 2008-05-15 |
WO2000078263A9 (en) | 2002-05-02 |
WO2000078263A2 (en) | 2000-12-28 |
US8790258B2 (en) | 2014-07-29 |
AU5749300A (en) | 2001-01-09 |
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