US20070087901A1 - Therapy system - Google Patents
Therapy system Download PDFInfo
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- US20070087901A1 US20070087901A1 US11/639,998 US63999806A US2007087901A1 US 20070087901 A1 US20070087901 A1 US 20070087901A1 US 63999806 A US63999806 A US 63999806A US 2007087901 A1 US2007087901 A1 US 2007087901A1
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- therapy
- compressible substance
- pressure
- compressor
- fabric
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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
- A63B23/00—Exercising apparatus specially adapted for particular parts of the body
- A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
- A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
- A63B23/16—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles for hands or fingers
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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
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/40—Interfaces with the user related to strength training; Details thereof
- A63B21/4023—Interfaces with the user related to strength training; Details thereof the user operating the resistance directly, without additional interface
- A63B21/4025—Resistance devices worn on the user's body
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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
- G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
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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
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/008—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using hydraulic or pneumatic force-resisters
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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
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/02—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resilient force-resisters
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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
- A63B2220/00—Measuring of physical parameters relating to sporting activity
- A63B2220/50—Force related parameters
- A63B2220/54—Torque
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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
- A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
- A63B2225/20—Miscellaneous features of sport apparatus, devices or equipment with means for remote communication, e.g. internet or the like
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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
- 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
- G16H40/67—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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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Physical Education & Sports Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biophysics (AREA)
- Engineering & Computer Science (AREA)
- Epidemiology (AREA)
- Medical Informatics (AREA)
- Primary Health Care (AREA)
- Public Health (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
A therapy system providing exercise, massage, and medication. The system includes a portable, wearable exercise device with provisions for resistance during range of motion exercises. The system also offers metrics, diagnostics, remote monitoring, massage therapy, and controlled delivery of medication. The therapy system automatically provides information that is useful for determining recommendations for enhancing therapy.
Description
- This is a Continuation-in-Part of U.S. patent application Ser. No. 10/212,485, entitled HAND REHABILITATION GLOVE, of Brassil, et al., filed Aug. 8, 2002 (which is currently pending and will be abandoned), which is a Divisional of U.S. patent application Ser. No. 09/475,793, entitled HAND REHABILITATION GLOVE, of Brassil, et al., filed Dec. 30, 1999, (which issued as U.S. Pat. No. 6,454,681) which is a Continuation-in-Part of U.S. patent application Ser. No. 09/197,035, entitled HAND REHABILITATION GLOVE, of Brassil, filed Nov. 29, 1998, which claims priority from U.S. Provisional Application 60/070,380, entitled HAND REHABILITATION GLOVE, of Brassil, filed Jan. 5, 1998, all of which are incorporated, in their entireties, herein by reference.
- The present invention relates to therapy systems. As the baby boomers age, healthcare providers and financing providers, such as Medicare and private insurers, will be stressed by high demand, relative to supply. Insurance is well known in the art, with managed care strategies that include insurers in medical decisions, but healthcare costs have grown to 16% of GDP, with projections for 20% by 2015. Nationalized solutions result in rationing, waiting lines, and overcrowding. Supply-centered solutions would offer more doctors, nurses, and clinics, but a massive expansion could impact the quality of care, disrupt established providers, and discourage investors. Taxes can be raised to cover spending, but estimates show Medicare's total unfunded liability to be over $70 trillion. There is an unmet need for systems that will help the Medicare trustees grow and preserve the fund. Post-process audits and investigations for misbehaving members, are well known in the art. But, there is an unmet need for feedback early in the process to help the trustees find members of the Medicare system who promote safety and savings; to calculate and offer them early incentives. This system automatically generates feedback useful for determining early incentives.
- Arthritis is the nation's leading cause of disability, with estimates showing that one in five adults in the nation are affected by arthritis. The limited supply of providers helping arthritis patients will be stressed by increasing demand as the baby boomers age. This system offers savings, balanced neuromuscular development, massage, controlled delivery of medication, and feedback, from the comfort of the patient's home.
- Disclosed is an exercise and therapy system. It provides resistance exercise, massage, and medication. It provides means for monitoring, delivering, and controlling therapy. It generates therapy information that is useful for patients and providers.
- The above and other aspects, features and advantages of the present invention will be more apparent from the following more particular description, along with the following drawings wherein:
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FIG. 1 is a view of an exercise and therapy device in accordance with one embodiment of the present invention; -
FIG. 2 is a view of an embodiment delivering medication; -
FIG. 3 is a view of an embodiment delivering pressurized medication; -
FIG. 4 is a view of an embodiment with an encapsulant or pocket; -
FIG. 5 is a view of an embodiment with an array of electrodes; -
FIG. 6 is a view of an embodiment which includes monitoring means; -
FIG. 7A is a view of another embodiment of the device ofFIG. 6 including multiple chambers within the compressible substance; -
FIG. 7B is a view of another embodiment of the device ofFIG. 7A wherein the multiple chambers of the compressible substance are separated by walls; -
FIG. 8 is a view of the embodiment of the device ofFIG. 7A and including a displacement transducer module of the embodiment ofFIG. 6 ; -
FIGS. 9A and 9B are views of the device ofFIG. 6 illustrating the displacement transducer module and line configurations; -
FIG. 10 is a block diagram of one embodiment of the therapy system. -
FIG. 11 is a functional block diagram of an embodiment of a therapy system. -
FIG. 12 a view of an embodiment of the compressor/pressure transducer module. -
FIG. 13 is a flow chart illustrating the steps for generating information for facilitating therapy. -
FIG. 14 is a view an embodiment of means for monitoring the therapy. -
FIG. 15 is a view of an embodiment of a display for monitoring the therapy. -
FIG. 16 is a view of an embodiment of a display for monitoring the therapy. - Corresponding reference characters indicate corresponding components throughout the several views of the drawings.
- The following description of the presently contemplated best mode of practicing the invention is not to be read in a limiting sense, but is made merely for the purpose of describing the general principles of the invention.
- Referring now in detail to the drawings, in which like numerals indicate corresponding parts throughout the several views,
FIG. 1 illustrates a therapy device embodied preferably as aglove 1. Included are acompressible substance 3, a proximate (to the compressible substance)portion 4,finger portions 5, a distal (to the compressible substance)portion 6, andelastic members 2. Eachelastic member 2 spans or extends fromglove 1 to thecompressible substance 3. Thecompressible substance 3 provides resistance during flexion, and theelastic members 2 provide resistance during extension. Eachelastic member 2 is coupled to thecompressible substance 3 and then spans to, and attaches to, theglove 1. In another embodiment, the elastic members may be attached to theproximate portion 4, through “slits” 13 formed in thecompressible substance 3 which theelastic members 2 pass through and then span to and attach to thedistal portion 6.Such slits 13 run through thecompressible substance 3. InFIG. 1 , thedashed line 14 represents anelastic member 2 extended through thecompressible substance 3 and attached to theproximate portion 4 directly. Note that only one of theslits 13 is shown, although multipleelastic members 2 could extend through slits in thecompressible substance 3. Theelastic members 2 may be attached along anedge 8 of theglove 1, between theproximate portion 4 and thedistal portion 6. Additionally, the subject matter described herein is related to Canadien Patent Application Serial No. 2,282,072, entitled HAND REHABILITATION GLOVE, of Brassil, filed Sep. 10, 1999, which is incorporated herein by reference. It is to be appreciated that a skilled artist could easily alter or modify a preferred embodiment without departing from the spirit of the invention. - Referring next to
FIG. 2 , a medication delivery device, preferably a disposable glove, is shown with a cutaway window view. Themedication delivery device 202 includes aninner surface 210 and anouter surface 208. Theinterior surface 210 of themedication delivery device 202 is coated withmedication 212. The system provides a massaging effect that will enhancemedication 212 absorption into the skin. During extension, theelastic members 2, pull themedication delivery device 202 closer to the wearer's skin, whereby massaging themedication 212 pressed between themedication delivery device 202, and the wearer's skin. During flexion, thecompressible substance 3, pushes themedication delivery device 202 closer to the wearer's skin, whereby massaging themedication 212 pressed between themedication delivery device 202, and the wearer's skin. Medications or supplements with transdermal or transcellular carriers may be used to synergistically enhance therapy. Examples of such medications or supplements are glucosomine and chrondroitin sulfate, which have been found to be helpful in treating osteoarthritis, and are described in pages 29-52 of “The Arthritis Cure” by Theodosakis, Adderly and Fox, 1997, which is incorporated herein by reference. Research studies have shown that glucosomine and chrondroitin are safe and effective, but only a limited percentage is delivered to the target site when ingested orally. Thesemedications 212 may also include carriers or penetration enhancing agents, such as those shown in U.S. Pat. No. 4,362,737, issued Dec. 7, 1982 to Schafer, and U.S. Pat. No. 4,405,616 issued Sep. 20, 1983 to Rajadhyaksha, both of which are incorporated herein by reference. Thus, the system provides exercise, massage, and controlled delivery ofmedication 212 to the target site, which can be controlled for example, by the number of extension and flexion repetitions. Since the system delivers medication directly to the target site, the patient doesn't need to purchase as much medication as would be required for an oral medication to reach the same concentration at the target site. The system can help patients and providers avoid the safety risks of uncontrollable oral medications, which travel through the digestive system, mix with foods, drinks, and other medications; filter into the circulatory system, and affect many other off-target sites throughout the body. The safety hazards to off-target body sites are well known in the art, and are often admitted to within or on the medication package, so the foreknown safety risks and resulting costs (including the costs of legal service providers) must be calculated by malpractice, business, and health financing provider underwriters, if the financing provider entity is going to attract and retain investors, which leads to a multiplier effect increasing the cost of care. If uncontrollable oral medication must be used, the system may still be able to help draw medication to the target site, because resistance exercise, tissue massage, and leeching (seeFIG. 5 ) can enhance circulation at the target site. The system also offers advantages in the way thatmedication 212 is dispensed. For examnple, medication dispensed as a bottle of 100 uncontrollable pills, allows many more unsafe permutations than a singledisposable device 202, coated with site-specific medication 212.Medication 214 may also be formed within the body of themedication delivery device 202, especially if themedication delivery device 202 is formed with a sponge-like material. Theinner surface 210 and body of themedication delivery device 202 could be formed with a sponge-like material, while theouter surface 214 could be formed with a less porous material. Advantageously, themedication delivery device 202 operating under repetitious compression from thecompressible substance 3 and tension from theelastic members 2, dispenses and deliversmedication 214, to the target site. - Referring next to
FIG. 3 , a medication delivery device, preferably a glove, is shown with a cutaway window view. Themedication delivery device 302 includes aninner surface 310 and anouter surface 308. In one embodiment, theinner surface 310 may contain amedication 312. In another embodiment, acanister 314 provides medication under pressure, through a connectingtube 316. Thecanister 314 may be pressurized, or may be connected to a compressor/pressure transducer module (seeFIG. 12 ). These techniques and equipment for accomplishing the techniques are described, for example, in U.S. Pat. No. 5,688,233, issued Nov. 18, 1997 to Hofmann, et al. entitled “ELECTROINCORPORATION ENHANCED TRANSDERMAL DELIVERY OF MOLECULES”; which is incorporated herein by reference. Advantageously, the system delivers pressurized medication directly to the target site. For example, the known safety risks of ear or lung damage from a whole-body hyperbaric oxygen chamber could be avoided by pumping concentrated oxygen directly to the target site. By reversing the pressure, a leeching effect can be useful for removing waste, enhancing circulation, or reducing swelling. The vacuumed effluent can be retained in acanister 314, and analyzed by researchers. Such research and equipment for conducting the research are commercially available from Finnegan Corporation of San Jose, Calif. which provides mass spectrometer technology capable of identifying the exact molecular or particulate breakdown of the contents of thecanister 314. So, one group of patients could ingest an oral medication, and another group could use themedication delivery device 302 to deliver a similar medication directly to the target site. After a predetermined time period, a freshdisposable device 302, operating in vacuum mode, provides effluent from the target site which can be retained in acanister 314, providing researchers with evidence useful for comparing concentration levels of medications or other markers at the target site. Such feedback can be useful for advising patients and providers who need to compare the safety, cost, control, and effectiveness of medications and their delivery systems. Such information is especially useful for financing providers, as input into automated risk scoring and underwriting systems, for determining early incentives. - Referring next to
FIG. 4 , a sectional view of aglove embodiment 402 is shown. This embodiment provides an encapsulant 404 or pocket, within which thecompressible substance 3 is positioned. Additionally, theencapsulant 404 could have acover flap 406 that folds or seals over thecompressible substance 3. Thecompressible substance 3 under pressure from flexion exercise, may force thecover flap 406 to become separated or unsealed from theglove 402, thus dispensing and deliveringmedication 408 under pressure emanating from the deflatingcompressible substance 3. - Referring next to
FIG. 5 , an exploded view of aglove embodiment 502 with an array ofelectrodes 506 is shown.Electrodes 506 for providing a low level pulsed electric field, are coupled to theinterior surface 504 of theglove 502. The pulsed electric field delivers materials, such asmedication 508 and supplements, through the skin; to the target site. Theelectrodes 506 are connected to the signal generator 515 (seeFIG. 10 ) by acable 512. A fluid medium carrying molecules or medication may be supplied from the fluidmedium source 514, which is coupled to theglove 502 by atube 510 which may include a pump (seeFIGS. 10 and 12 ). Such techniques are known in the art and are referred to as “electroporation” or “electroincorporation”. These techniques and equipment for accomplishing the techniques are described in U.S. Pat. No. 5,688,233, issued Nov. 18, 1997 to Hofmann, et al. entitled “ELECTROINCORPORATION ENHANCED TRANSDERMAL DELIVERY OF MOLECULES”; which is incorporated herein by reference. The pneumatics/fluidics, sensors, and controller modules provide monitoring and control of the pressure and electrical pulses (explained below). Thus, the system provides means for delivering medication, including means for monitoring and controlling its delivery. Operating in reverse or vacuum mode, the system provides means for controlling the reduction of swelling or removing medication, with electroporation and transdermal or transcellular carrier means. -
FIG. 6 illustrates an embodiment providing means for monitoring therapy. Shown is a monitoredtherapy system device 600, embodied as aglove 602, with aproximate portion 604,finger portions 606,distal portion 608,fingernail portion 610,wrist portion 612, acompressible substance 614 that has achamber 616 located within thecompressible substance 614, adisplacement transducer module 618, a compressor/pressure transducer module 620, athermal transducer 622,lines 624, line guides 626,anchor 628, filltube 630, output means 632, and acomputer interface 634. This embodiment offers transducers to determine estimates of performance, such as force exerted on the compressible substance 614 (using the compressor/pressure transducer module 620), range of motion (using the displacement transducer module 618), heat generated (using the thermal transducer 622), number of repetitions, or velocity. It features atransducer module 618, withlines 624 extending therefrom. The lines are guided through line guides 626 and are anchored at theanchor 628, which is located distally at thefingernail portion 610. Force is monitored by a compressor/pressure transducer module 620 affixed at theinside wrist portion 612. Thefill tube 630 extends from the compressor/pressure transducer module 620 and into thecompressible substance 614 to thechamber 616 within thecompressible substance 614. In other embodiments, modules may be swapped out or relocated. For example, the fill tube may be coupled directly to the glove 602 (seeFIGS. 3 and 5 ). The elastic members (not shown) are also present. Furthermore, thedisplacement transducer module 618 and the compressor/pressure transducer module 620 link to a computer. This embodiment illustrates an output means 632 connected to acomputer interface 634 as means for linking to a computer or controller, as part of a monitored therapy system. - In operation, the monitored therapy system, quantifies motion, force, work done, as well as the number and speed of repetitions performed. In this embodiment, the
compressible substance 614 has achamber 616 inside which is used to for measuring pressure resulting from the force as applied onto thecompressible substance 614. Thechamber 616 is filled with air, a gas, a fluid or a gel through thefill tube 630 that extends from the compressor/pressure transducer module 620 into thecompressible substance 614. The compressor/pressure transducer module 620 is typically controlled by a separate controller. Thus, when pressure is applied to thecompressible substance 614, a portion of the content within thechamber 616 is forced out through thefill tube 630 into the compressor/pressure transducer module 620. The pressure transducer portion of the compressor/transducer module 620 translates this push of gas, fluid, or gel into a signal proportional to or representing the pressure or force applied against thecompressible substance 614. This signal is output using output means 632. Valves may be used at the entry of thefill tube 630 into thechamber 616 to help establish the required pressure level within thechamber 616. - The compressor portion of the compressor/
pressure transducer module 620 is a pneumatic or fluidic component, which uses a compressor or pump. This compressor is a miniature mechanical compressor, such as those commercially available from Gast located in Benton Harbor, Mich. or Medo USA of Hanover Park, Ill. or Sensidyne of Clearwater, Fla., and are used to inflate the compressible substance to a therapeutic pressure. The compressor may be a part of the compressor/pressure transducer module 620 as shown or may be a separate unit that is worn on the body of the patient (e.g. on the patient's belt) or placed nearby the patient and attached to thecompressible substance 614 via a tube. The timing and rate at which the compressor inflates or pressurizes thechamber 616 within thecompressible substance 614 maybe set by a separate controller. Alternatively, a squeezable ball, such as used in blood pressure cuffs, may be used to for inflation, or a miniature tank of compressed gas. Furthermore, valves may be used in addition to the compressor. For example, micro solenoid valves like those used in inkjet printers or pinch valves like those used in pneumatic systems can be used to control the air or fluid flowing in and out of thechamber 616 of thecompressible substance 614. Such valves could be open or shut, or pulsed, working in concert with the compressor or pump to control the pressure in the chamber 616 (or chambers) and the rate at which they are inflated or filled. These valves are readily available, such as commercially available from Lee Company of Westbrook, Conn. or SMC, located in Indianapolis, Ind. - The pressure transducer portion of the compressor/
pressure transducer module 620 is a transducer that produces a signal proportional to the pressure applied to its port, which is proportional to or represents the pressure or force applied by the patient. Typically, the port of the pressure transducer is positioned at the end of thefill tube 630 within the compressor/pressure transducer module 620 so that the gas or fluid that is forced from thechamber 616 of thecompressible substance 614. In response to the pressure against the port of the pressure transducer, the pressure transducer outputs a signal that is proportional to or represents the pressure inside thechamber 616. Such pressure transducers are well known in the art and are commercially available from Honeywell located in Minnesota. In this embodiment, the compressor/pressure transducer module 620 uses output means 632 that is linked to thecomputer interface 634, which in turn may be linked to a controller of a therapy system. Medication (not shown) may be contained in various locations throughout the system. - The
displacement transducer module 618 provides the means for measuring motion or the distance traveled during extension and flexion. One embodiment of adisplacement transducer module 618 is a rotary encoder system. Within thedisplacement transducer module 618, a shaft of the rotary encoder is coupled to a spool or roller carrying theline 624. Ideally, the spool or roller is spring loaded so that theline 624 is pulled tight from theanchor 628 to the spool of thedisplacement transducer module 618. The distal end of thelines 624 are attached to ananchor 628. Thelines 624 pass through respective line guides 626. Alternatively, thelines 624 may pass through a flexible protective tubing so as to protect the lines during use. - In use, during flexion, the
lines 624 are drawn from the spool causing the rotary encoder to transmit electrical pulses whose number is in proportion to the flexing and movement. The stiffness of theline 624 returning through the line guides 626, or a light-force spring return mechanism in the spool or roller would return theline 624 back onto the spool or across the roller during extension, providing extension and flexion displacement data. Thus, the rotary encoder can determine the magnitude of the movement, so that a complete range of movement while opening and closing the hand may be modeled. Thedisplacement transducer module 618 will output a signal over output means 632 to thecomputer interface 634 that is proportional to or represents the displacement. - Alternative means for monitoring displacement include the use of strain gauge transducers. These sensors produce an electrical signal in proportion to motion. They work on a variety principles: piezo electric, electro mechanical (like a condenser microphone), accelerometer, goniometer, and variable resistance strain gauge. These transducers, and their detector circuits, are readily available in scientific materials catalogs like Cole Parmer, located in Vernon Hills, Ill. Other examples of monitoring means and wearing means, are shown in U.S. Pat. No. 5,280,265 issued Jan. 18, 1994 to Kramer, et al., entitled “STRAIN SENSING GONIOMETERS, SYSTEMS AND RECOGNITION ALGORITHMS”; in U.S. Pat. No. 4,414,537, issued Nov. 8, 1983 to Grimes entitled “DIGITAL DATA ENTRY GLOVE INTERFACE DEVICE”; and in U.S. Pat. No. 4,542,291, issued Sep. 17, 1995 to Zimmerman entitled “OPTICAL FLEX SENSOR”, all of which are incorporated herein by reference. The preferred means for monitoring motion are not meant to be limiting, as those skilled in the art can modify a preferred embodiment without departing from the scope or spirit of the invention.
- Additionally, a
thermal transducer 622 is positioned within the monitoredtherapy system device 600. The thermal sensor, measures the temperature change during exercise, providing a calorimetric estimate of work. This feedback can be used as simple and expensive way to measure the progress, and enhance a patient's therapy. - Thus, monitoring means can provide outputs that represent force, temperature, and motion during exercise. These output signals may also be used to determine the number and speed of repetitions. Additionally, the system includes means for linking to a computer system that may be used to display and store the measurements and/or control the pressure within the
chamber 616 of thecompressible substance 614. A therapy provider can monitor the results of therapy sessions, and use the performance feedback to make recommendations for enhancing the therapy. - Referring next to
FIG. 7A , another glove embodiment is shown including multiple chambers within the compressible substance. Shown are a monitored therapy system device 700 aproximate portion 702,wrist portion 708,finger portions 704 anddistal portion 706, the compressor/pressure transducer module 710, thecompressible substance 712 includingchambers 714 and filltubes 716 extending through amain fill tube 718. Also shown are theelastic members 720. This embodiment provides a chamber within thecompressible substance 712 that is divided intoseparate chambers 714. Similarly, instead of one fill tube, there is aseparate fill tube 716 for each of thechambers 714. Eachfill tube 716 extends through thecompressible substance 712 into the compressor/pressure transducer module 710 via amain fill tube 718. Furthermore, the compressor/pressure transducer module 710 actually contains separate pressure transducers one for eachchamber 714. The patient or therapist may adjust the pressure within each of therespective chambers 714. By adjusting the pressure, the delivery of medication (not shown), and extraction of waste, can be controlled. - Referring next to
FIG. 7B , is a view of another embodiment wherein multiple chambers of the compressible substance are separated bywalls 715. This embodiment includeswalls 715 that separate thechambers 714 within thecompressible substance 712. As can be seen,walls 715 are molded in between theindividual chambers 714 of thecompressible substance 712.Such walls 715 are slightly more rigid than the remaining material of thecompressible substance 712 so that pressure applied to onechamber 714 will not in effect apply pressure to an adjacent chamber. Therefore, the majority of the pressure will be channeled such that the fluids within theindividual chambers 714 will be forced out of thechamber 714 into thefill tubes 716, and not expand sideways into adjacent chambers. Thewalls 715 should not be so rigid that they do not allow the compressible substance to adequately be compressed or squeezed. Thesewalls 715 may be molded as described above while thecompressible substance 712 is being formed. Alternatively, thewalls 715 could be made to be rigid; thus, these rigid walls would almost completely eliminate pressure from an adjacent chamber from having an effect on a given chamber's pressure reading. As another alternative, the walls themselves may be theelastic members 720 that extend through slits in thecompressible substance 712. These slits and elastic members are described with reference toFIG. 1 . Thus, theelastic members 720 would extend through thecompressible substance 712 and attach to the proximate portion of the glove, while at the same time forming walls betweenchambers 714 of thecompressible substance 712. - Referring next to
FIG. 8 , is a monitored therapy system device including a displacement transducer module. Shown is a monitoredtherapy system device 800 embodied as a glove having aback portion 802, a proximate portion,distal portion 804,fingernail area 806, andwrist area 808. Also shown are thecompressible substance 810 includingmultiple chambers 812, and filltubes 814 within amain fill tube 816, the compressor/pressure transducer module 820,displacement transducer module 822,lines 824, line guides 826,anchor 828, and theelastic members 830. Theindividual chambers 812 within the compressible substance are better illustrated including their positioning within the compressible substance inFIG. 8 . The fluid within eachchamber 812 is forced through arespective fill tube 814 to a respective pressure transducer within the compressor/pressure transducer module 820 via themain fill tube 816. It is also noted that the compressor may not be within the compressor/pressure transducer module 820, but may be located elsewhere on the body of the patient or located proximate to the patient. Also, the entire compressorpressure transducer module 820 could be located separately and attached by thefill tube 816. Thus, the compressor is coupled to thefill tubes 814 through the pressure transducer. For example, the compressor and the pressure transducer are both coupled to the fill tubes, but a valve or similar functioning device can cut off the compressor from the fill tube when desired. Furthermore, there are multiple pressure transducers as a part of the compressor/pressure transducer module 820. Medication (not shown) may be positioned in various locations within the system. Medication could be contained and pressurized in onechamber 812, while waste or effluent could be vacuumed into and captured in another chamber. - Referring next to
FIGS. 9A and 9B , two different embodiments are shown for the displacement transducer modules and the structures used to measure the displacement. Shown is a monitoredtherapy system device 900 embodied as a glove including theback portion 902,finger portion 904,fingernail portion 906,lines 908, line guides 910, anchors 912, anddisplacement transducer modules lines 908 are a low stretch, monofilament or wound thread that extends from thedisplacement transducer module 914 to theanchor 912 at thedistal portion 906. Thelines 908 are threaded or fed through line guides 910 that have holes therein or a channel formed at the exterior surface (alternatively, the line guides 910 may be flexible hollow tubes). Thelines 908 are wound onto a spring loaded spool or a spring tensioned roller such that thelines 908 are held relatively tightly from theanchor 912 at the distal end of the displacement measuring system and the displacement transducer. Thedisplacement transducer module 914 shown inFIG. 9A contains multiple displacement transducers and asingle output 916 which includes a computer interface (not shown). The displacement transducer module shown inFIG. 9B is broken into two separate modules, firstdisplacement transducer module 914′ and seconddisplacement transducer module 915. Again, output means 916 is shown, which is linked to a computer interface. - Referring next to
FIG. 10 , is a block diagram of the monitoredtherapy system 1000. This embodiment of the monitoredtherapy system 1000 includes thetherapy device 1010,patient 1020, sensing/communicating/controlling equipment (“SCCE”) 1030,service provider 1040,product provider 1050,financing provider 1060, andcommunications provider 1070. Thefinancing provider 1060 includesMedicare 1062 but other embodiments could includevarious financing providers 1060 such as banks, lenders, or insurance entities such as health, malpractice, business, medicaid, disability, workers compensation, long term care, etc., which are well known in the art. Thefinancing provider 1060 provides capital for the purchase of products or services that a member, usually apatient 1020,service provider 1040, orproduct provider 1050, cannot afford to, chooses no to, or is otherwise unable to, afford outright. Occasionally,financing providers 1060 such as malpractice or business insurance firms, provide capital to settle disputes between members. Thefinancing provider 1060 has the functions of attracting members, protecting and growing their fund, determining and minimizing waste, safety risks, and health risks (which will deplete the fund), and providing capital. The sensing/communicating/controlling equipment (“SCCE”) 1030 include acontrol panel 1037,feedback controller 1036, andtransducers 1031. Thecontrol panel 1037 includes akeyboard 1038 anddisplay 1039. The transducers includemotion 1032,force 1033,sound 1034, andtemperature 1035. Thetherapy device 1010 includes anencapsulant 1011,compressible substance 1012, pneumatics/fluidics 1014,elastic members 1016,medication 1017,electrodes 1018, and preferably, aglove 1019. Theservice provider 1040 includesdiagnostics 1041,therapy 1042, andadvice 1043.Advice providers 1043 includestraining 1044,research 1045, andadvertising 1046. Theproduct provider 1050 includes pharmaceutical 1052 andequipment 1054. Thecommunications provider 1070 includes well known means for computing and communicating throughout the system, allowing data processing and storage to occur at various points. The monitoredtherapy system 1000 automatically provides information that is useful for determining members' needs, helping providers meet members' needs in a targeted manner. For example, theadvertising provider 1046 can provide targeted ads (not shown) promotingproduct providers 1050, orservice providers 1040 to specific patients 1020 (or other provider members) based on automatically generated target-specific information, such as a diagnosis code, thereby avoiding the cost of expensive off-target broadcast ads. Lower advertising costs can generate a multiplier effect; decreasing prices throughout thesystem 1000; not just for thepatients 1020, but also for providers. Advertising expenditure information is readily available from SEC filing, prospectus, annual report, and investor relations documents. Thus, thesystem 1000, offerspatients 1020 andfinancing providers 1060 such asMedicare 1062, information that is useful for limiting spending on unsafe or unrelated items, for example for passthroughs that aren't healthcare, such as broadcast advertising. Furthermore, targetedadvice 1043, such as needs basedtraining 1044,related research 1045, andpersonalized advertising 1046, based on information provided by thesystem 1000, is a reasonable way to spendMedicare 1062 funds on passthroughs, if thatadvice 1043 meets specific healthcare needs. Thesystem 1000 includes incentives (not shown) thatfinancing providers 1060 can award toservice providers 1040,product providers 1050, andpatients 1020 who, for example, promote safety, or minimize unnecessary passthrough spending. - The
patient 1020 interacts with atherapy device 1010, that provides flexion resistance exercise, extension resistance, exercise, massage, medication, and medication delivery control. Theelectrodes 1018 receive signals from theSCCE 1030 that control the transdermal delivery ofmedication 1017. The pneumatics/fluidics module 1014 may also receive signals from theSCCE 1030 that control pressure to inflate or deflate thecompressible substance 1012, or deliver or removemedication 1017. In operation, the monitoredtherapy system 1000 provides means for measuring the motion, force and work done by the patient. Furthermore, it provides a means for controlling, the pressure resistance of thecompressible substance 1012, and the delivery ofmedication 1017 automatically, so that therapy parameters can be set, monitored, and maintained automatically by the patient's 1020 or therapy provider's 1042 interaction with theSCCE 1030. - In this embodiment, both the
patient 1020 and thetherapy provider 1042 are operators of theSCCE 1030. In other embodiments, it may be advantageous for atraining provider 1044,equipment provider 1054, orpharmaceutical provider 1052 to interact directly or remotely with theSCCE 1030 to help novice users. Both thepatient 1020 and thetherapy provider 1042 can set the therapy parameters such as resistance pressure, or range of motion goals, and will review the therapy outcomes such as joint movement, pressure or force applied, or work done. Over time, thetherapy provider 1042 will adjust the therapy parameters to reflect the best plan of treatment. Thetherapy provider 1042 may interact remotely through theSCCE 1030 to control thetherapy device 1010, or by making recommendations to thepatient 1020 regarding adjustments. - A computer (not shown) could be physically integrated with the
SCCE 1030, located in its vicinity, or connected via a network link. It provides a way for thetherapy provider 1042 to adjust parameters and review treatment, locally and remotely. It stores and organizes therapy parameters and outcomes in a database for archival and ready access. It also converts outcomes data into a graphical charts displayable on a computer terminal and printable on paper that ease the interpretation of the outcomes data and help the providers make better recommendations. TheSCCE 1030 might be a standalone unit, located near thepatient 1020, or it might be a miniature battery operated controller that is integrated, for example as an attachment to thetherapy device 1010. TheSCCE 1030 receives and generates signals to and from various sources throughout thesystem 1000, and contains the algorithms necessary to translate the signals from thevarious transducers 1031 into the respective estimations of actual displacement, temperature and force or pressure applied. Such algorithms for translating these conventional signals supplied by conventional transducers are well known in the art; thus, no further explanation is required. TheSCCE 1030 is also able to determine the number of repetitions and speed of repetitions, for example, by comparing the direction of the displacement signals received and when the signals “change direction” (indicating a change from extension to flexion, for example) to a timer or clock. TheSCCE 1030 also sends control signals to the compressor to set the resistance. TheSCCE 1030 translates the signals from thetransducers 1031, and maintains communications between thetherapy device 1010, and its users. It could contain a custom computer, such as a microcomputer or personal digital assistant, or a common personal computer running commercially available software, such as National Instruments' Labview. Thecontrol panel 1037 consists of knobs, buttons anddisplays 1039 that allow the user to set therapy parameters and review therapy outcomes. These knobs, buttons and displays are electronically connected to the SCCE's 1030 embedded computer. Thecontrol panel 1037 may be configured so that thepatient 1020 ortherapy provider 1042 can: set the initial and final pressure resistance level of thecompressible substance 1012; set a repetitions counter or therapy timer; set limits and alarms for excess pressure or other abnormal conditions; set control parameters such as PID (proportional, integral, derivative) constants; store parameters for future use; and control the power for theSCCE 1030. Additionally, thecontrol panel 1037 may provide adisplay 1039 indicating real time indications of pressure, displacement, and work, as well as graphical displays of such measurements. Additionally, the therapy settings may be shown. Such displays may be displayed on a corresponding computer or on a screen ordisplay 1039 of theSCCE 1030 itself depending on the embodiment. The knobs, buttons and displays comprising thecontrol panel 1037 are commercially available from many sources as discrete components or integrated into control panel assemblies. Displays are widely available in the following forms: LED alphanumeric displays, LCD alphanumeric and graphic displays, electro luminescent and plasma displays, and cathode ray tubes. - The
SCCE 1030 allows the pressure resistance to be adjusted automatically in dynamic response to predetermined pressure profiles and sequences, existing pressure in the chamber/s of thecompressible substance 1012, motion, and the work being done. Thefeedback control 1036 is a function performed by the SCCE's embedded computer. It receives the real-time pressure, displacement, and work measurements, then uses readily available algorithms, such as PID (proportional, integral, derivative) control to send the proper signals to adjust the valve settings and the compressor (within the pneumatics/fluidics module 1014), to maintain the pressure resistance within the chamber/s of thetherapy device 1010 according to the therapy provider's 1042 or patient's 1020 settings. Thefeedback controller 1036 contains therapy data storage circuits, parameter storage circuits, and a real time clock that permit it to operate autonomously. - The
SCCE 1030 communicates with thetherapy device 1010. It outputs signals to the pneumatic/fluidic module 1014, to control the amount of pressure that the chambers are inflated to, and to theelectrodes 1018, to control the delivery ofmedication 1017. These output signals might be pulsed waveforms intended to switch the compressor and valves on and off, or to induce electroporation, or they may be analog voltage signals intended to set the compressor speed. TheSCCE 1030 also receives signals from thetransducers 1031, e.g. pressure transducer, displacement transducers and thermal transducer. These received signals might be pulsed waveforms, or analog voltage levels as output from the respective types oftransducers 1031. - Additionally, the
SCCE 1030 may perform communications via thecommunications provider 1070, typically with atherapy provider 1042. Thus, thetherapy provider 1042 may be located at another location than thepatient 1020. Advantageously, thepatient 1020 may operate the monitoredtherapy system 1000 at home and be simultaneously monitored by thetherapy provider 1042. Thus, aservice provider 1040 can send signals to theSCCE 1030 via thecommunications provider 1070 to control or set the parameters of the patient's 1020 session in accordance with a therapy plan, or in response to the measurements. Advantageously, the providers can see the results of the session and provide diagnostics, advice, or make therapeutic changes to further enhance the therapy, from a remote location. Furthermore, a provider computer (in addition to or instead of the SCCE 1030) may also be capable of translating the signals output from the transducers into the appropriate measurements of displacement, work, pressure or force, and the number and speed of repetitions. Advantageously, the monitored therapy system provides a system that other members, such asadvice providers 1043 orfinancing providers 1060 could connect to and interact with. Thus, afinancing provider 1060 can monitor, or verify that therapy session data was stored (and can be later retrieved), to facilitate the immediate transfer of funds to the service provider's 1040 account (not shown). Monitoring and storage and systems are well known and commercially available from Nice Systems, Motorola, Diebold, or Logitech. Storage, search, and retrieval systems for complex databases are commercially available from Teradata or TRW. Knowing that the therapy session has been electronically stored, afinancing provider 1060 can recommend immediate incentives (not shown) such as discounts to encourage members who reduce facility and transportation costs by participating in remotely monitored therapy. Such stored session information is also useful as unambiguous evidence that can help reduce costs for legal services, and help amicably settle disputes. - The
SCCE 1030 will comprise many different circuits including: pulse width modulation circuits that will generate a pulsatile waveform to control medication delivery and pressure, digital to analog circuits to create a variable voltage level to adjust the compressor speed; driver circuits to convert the outputs from the pulse width modulator and the digital to analog circuit into the proper voltage and current to supply the valves and the compressor; transceiver circuits to convert the pulsed waveform from the displacement transducers into a computer readable form; analog to digital circuits to convert the signals from the displacement transducers, temperature sensors, and pressure transducers into computer readable form; and also data communication circuits such as a modem, Ethernet transceiver, USB transceiver, infrared or RF transceivers, or a simple serial interface to allow connection to the computer (e.g. the therapist's computer if it is located nearby). These circuits are commercially available as add-on-boards for personal computers through companies like National Instruments located in Austin, Tex. They are also readily constructed from available components from electronics components made by manufacturers like Texas Instruments (located in Dallas, Tex.) and National Semiconductor (located in Santa Clara, Calif.), available through distributors and catalog sources like DigiKey and Newark Electronics. The circuits themselves are well-understood and are described in readily available reference books. - The pneumatics/
fluidics module 1014 receives signals from theSCCE 1030, either generated by thetherapy provider 1042 or thepatient 1020, to regulate the air or fluids going into and out of thecompressible substance 1012. Thus, theSCCE 1030 sends the appropriate signals to make sure the pressure within the compressible substance is as desired. Again, as described above, the pneumatics/fluidics module may comprise an electronically controlled compressor (or pump) and/or valves. Thecompressible substance 1012 is also as described above and includes a flexible enclosure containing one or more chambers within thecompressible substance 1012. The compressor and/or valves (of the pneumatics/fluidics module 1036) would be connected to the fill tubes leading to each chamber, to establish air or fluid pressure in each chamber and to regulate the flow in and out of each chamber. Thetransducers 1031, provide the measurements in the form of signals so that determinations of motion, force while squeezing the compressible substance, a calorimetric estimate of the work done can be obtained by theSCCE 1030, along with the number and speed of repetitions. - The
patient 1020 wears thetherapy device 1010 and interacts with thecompressible substance 1012 andelastic members 1016. The system may includemedication 1017 andelectrodes 1018 on the interior surface of theglove 1019. Theelectrodes 1018 are linked to theSCCE 1030 to monitor and control the transdermal delivery of themedication 1017. Precise estimates of drug absorption can be transmitted and displayed for thepatient 1020 on thedisplay 1039, or for a provider. If analysis of variables such as duration, number of repetitions, medication concentration, electrode activity, temperature or other measurements indicate an anomaly, then alarms can be displayed and the therapy parameters appropriately adjusted. A skilled artist could easily alter this embodiment by swapping or positioning sensors, or transducer modules, in various locations without departing from the spirit of the invention. - Referring next to
FIG. 11 , a functional block diagram is shown oftherapy system 1100 that uses a glove embodiment, as described above with reference toFIGS. 6 through 9 B. Thetherapy system 1100 includes the therapist/patient 1102,computer 1104,computer link 1106,controller 1108,glove 1110, and thehand 1112. Thecontroller 1108 includes acontrol panel 1114,feedback controller 1116, and input/output 1118 (also referred to as IO 1118). Theglove 1110 includes a pneumatics/fluidics module 1120, thecompressible substance 1122, andtransducers 1124. The therapist/patient block 1102 is coupled to thecomputer 1104 andcontrol panel 1114 of thecontroller 1108. Thecontrol panel 1108 is coupled to thefeedback controller 1116 of thecontroller 1108 which is coupled to the input/output 1118 (IO) of thecontroller 1108. Thecomputer 1104 is coupled to theIO 1118 of thecontroller 1108 via thecomputer link 1106. Furthermore, theIO 1118 of thecontroller 1108 is coupled to the pneumatics/fluidics module 1120 of theglove 1110, which is coupled to thecompressible substance 1122 of the glove. Thetransducers 1124 are coupled back to theIO 1118 of thecontroller 1108. Thehand 1112 of the patient interacts withcompressible substance 1122 and thetransducers 1124 of theglove 1110. - In operation, the hand therapy system works 1100 with the
glove 1110 to provide a means for measuring the motion, force and work done by thepatient 1110. Furthermore, it provides a means for controlling the pressure resistance of thecompressible substance 1122 of theglove 1110 automatically, so that therapy parameters can be set and maintained automatically by the patient's or therapist's interaction with thecontroller 1108. - The therapist/
patient block 1102 represents both the patient and the therapist. As shown in this embodiment, both the patient and the therapist have access to the measurements obtained using theglove 1110 in addition to being the operators of thehand therapy system 1100. Both the patient and the therapist can set the therapy parameters such as resistance pressure (of the compressible substance 1122), and will review the therapy outcomes such as joint movement, pressure or force applied, and work done. Over time, the therapist will adjust the therapy parameters to reflect the best plan of treatment. The therapist may interact with thehand therapy system 1100 directly through thecomputer 1104 or remotely over a computer network via thecomputer link 1106, such as the Internet link. Thecomputer 1104 is either physically integrated with thecontroller 1108 in a monolithic enclosure, located in the vicinity of thecontroller 1108, or connected to thecontroller 1108 via a computer network (e.g. the internet) through the computer link 1106 (e.g. an internet link). It provides a readily accessible way for the therapist to adjust parameters and review treatment, locally and remotely. Thecomputer 1104 stores and organizes therapy parameters and outcomes in a database for archival and ready access. It also converts outcomes data into a graphical charts displayable on a computer terminal and printable on paper that ease the interpretation of the outcomes data and help the therapist make better decisions. - The
controller 1108 is the electronic brain of thehand therapy system 1100. It might be a standalone unit, located near the patient, or it might be a miniature battery operated controller that is integrated onto the glove (e.g. as an attachment to the compressor/pressure transducer module or the displacement transducer module). Thecontroller 1108 receives signals from thetransducers 1124 of the glove representing finger displacement (from the displacement transducers), force applied (from the pressure transducers) and work (measured as a calorimetric estimate from the thermal transducer) and contains the algorithms necessary to translate the signals from the various transducers into the respective estimations of the finger displacement, temperature and force or pressure applied. The controller also sends control signals to the compressor (within the pneumatic/fluidics module 1120) of the glove to set the glove's resistance (e.g. the compressor and valve settings). Thecontroller 1108 contains an embedded computer that manages the activities of the controller, translates the signals from the transducers, and maintains communications between thecontroller 1108, theglove 1110, and its users. It could be a custom computer, or be a common personal computer running commercially available software, such as National Instruments' Labview. - The
controller 1108 is comprised of the subsystems of thefeedback controller 1116,control panel 1114 and theIO 1118. Thecontrol panel 1114 consists of knobs, buttons and displays that allow the user to set therapy parameters and review therapy outcomes. - Theses knobs, buttons and displays are electronically connected to the controller's 1108 embedded computer. The
control panel 1114 may be configured so that the user can: set the initial and final pressure resistance level of thecompressible substance 1122 within the glove; set a repetitions counter or therapy timer; set limits and alarms for excess pressure or other abnormal conditions; set control parameters for thefeedback controller 1116, such as PID (proportional, integral, derivative) constants; store parameters for future use; and control the power to thecontroller 1108. - Additionally, the
control panel 1114 may provide a display indicating real time indications of pressure, displacement, and work in aggregate or on a finger by finger basis, as well as graphical displays of such measurements. Additionally, the glove settings may be shown. Such displays may be displayed on a corresponding computer or on a screen or display of the controller itself depending on the embodiment. - The
feedback controller 1116 allows the pressure resistance of thecompressible substance 1122 to be adjusted automatically in dynamic response to predetermined pressure profiles and sequences, existing pressure in the chamber/s of thecompressible substance 1122, finger motion, and the work being done. Thefeedback controller 1116 is a function performed by the controller's embedded computer. It receives the real-time pressure, displacement, and work measurements, then uses readily available algorithms, such as PID (proportional, integral, derivative) control to send the proper signals to adjust the valve settings and the compressor (within the pneumatics/fluidics module 1120), to maintain the pressure resistance within the chamber/s of theglove 1110 according to the user's settings. Thefeedback controller 1116 contains therapy data storage circuits, parameter storage circuits, and a real time clock that permit it to operate autonomously. - The
IO 1118 allows thecontroller 1108 to communicate with theglove 1110 and thecomputer 1104. TheIO 1118 outputs signals to the pneumatic/fluidic module 1120, which contains the compressor and the valves, to control the amount of pressure that the chambers are inflated or filled up to in order to provide the appropriate resistance when the patient squeezes thecompressible substance 1122. These output signals might be pulsed waveforms intended to switch the compressor and valves on and off, or they may be analog voltage signals intended to set the compressor speed. TheIO 1118 also receives signals from thetransducers 1124, e.g. pressure transducer, displacement transducers and thermal transducer. These received signals might be pulsed waveforms, or analog voltage levels as output from the respective types oftransducers 1124. - Additionally, the
IO 1118 may perform data communications with thecomputer 1104 via thecomputer link 1106. Thecomputer 1104 is typically the therapist's computer, which may be physically attached to thecontroller 1108 through serial interfaces or may be linked via acomputer link 1106 to the controller. Thecomputer 1104 may be part of a local area network or wide area network or other computer network. Thus, the therapist may be located at another location than the patient. Advantageously, the patient may operate thehand therapy system 1100 at home and be simultaneously monitored by the therapist online with thecontroller 1108. Thus, the therapist can send signals from thetherapists computer 1104 to thecontroller 1108 via the computer link 1106 (such as an internet link) to control or set the parameters of the patient's session in response to the measurements of theglove 1110. Advantageously, the therapist can see the results of the session (i.e. the estimations of finger displacement, work, force or pressure, and the number and speed of repetitions) and recommend desired changes to further facilitate improve in a patient's condition without having to be physically present at the session. Furthermore, the computer 1104 (in addition to or instead of the controller 1108) may also be capable of translating the signals output from the transducers into the appropriate measurements of displacement, work, pressure or force, and the number and speed of repetitions. - The
IO 1118 will comprise many different circuits including: pulse width modulation circuits that will generate a pulsatile waveform to control the compressor and valves of the pneumatics/fluidics module 1120; digital to analog circuits to create a variable voltage level to adjust the compressor speed; driver circuits to convert the outputs from the pulse width modulator and the digital to analog circuit into the proper voltage and current to supply the valves and the compressor; transceiver circuits to convert the pulsed waveform from the displacement transducers into a computer readable form; analog to digital circuits to convert the signals from the displacement transducers, temperature sensors, and pressure transducers into computer readable form; and also data communication circuits such as a modem, Ethernet transceiver, USB transceiver, infrared or RF transceivers, or a simple serial interface to allow connection to the computer (e.g. the therapist's computer if it is located near the IO 1118). - The
glove 1110 comprises the pneumatics/fluidics module 1120, thecompressible substance 1122, and thetransducers 1124. The pneumatics/fluidics module 1120 contains the compressor and appropriate valves of the compressor/pressure transducer module described earlier. The pneumatics/fluidics module 1120 receives signals from thecontroller 1108, either generated by the therapist or the patient, to regulate the air or fluids going into and out of thecompressible substance 1122. Thus, thecontroller 1108 sends the appropriate signals to make sure the pressure within the compressible substance is as desired. Again, as described above, the pneumatics/fluidics module may comprise an electronically controlled compressor (or pump) and/or valves. - The
compressible substance 1122 is also as described above and includes a flexible enclosure containing one or more chambers within thecompressible substance 1122. The multi-chamber compressible substance as shown inFIGS. 7A through 8 would permit resistance pressure regulation on a finger-by-finger basis, whereas a single chamber, such as shown inFIG. 6 , would be a simpler way to regulate the pressure resistance of all the fingers together. The compressor and/or valves (of the pneumatics/fluidics module 1120) would be connected to the fill tubes leading to each chamber, to establish air or fluid pressure in each chamber and to regulate the flow in and out of each chamber. - The
transducers 1124, as described above as the pressure transducer, the displacement transducer, and the thermal transducer, provide the measurements in the form of signals back to thecontroller 1108 so that determinations of finger motion, force exerted by each finger or the hand total while squeezing the compressible substance, a calorimetric estimate of the work done can be obtained by thecontroller 1108, and the number and speed of repetitions. - The patient's
hand 1112 fits within theglove 1110 and interacts with thecompressible substance 1122. Theglove 1110 is designed to snugly fit the patient'shand 1112 and contains thetransducers 1124 required to obtain the measurements. Additionally, the glove may be embodied as described above, including the addition of medication on the interior surface of theglove 1110. Theglove 1110 will fit properly to the patient'shand 1112 and will provide resistance to motion that is therapeutically appropriate. Furthermore, theglove 1110 will position and anchor thetransducers 1124 andcompressible substance 1122 so that the measurements are sufficiently accurate and precise. - Referring next to
FIG. 12 , a view is shown of the details of the compressor/pressure transducer module described above. Shown are aglove 1200,compressible substance 1202,first tube 1204, and the compressor/pressure transducer module 1206. The compressor/pressure transducer module 1206 includes afirst tee 1208,second tee 1210, vent solenoid 1212 (also referred to as the vent valve), pump solenoid 1214 (also referred to as the pump or compressor valve),pressure transducer 1216,compressor 1218,filters tubes wires interface port 1244, and the interface means 1246. Thefirst tube 1204 enters the compressor/transducer module 1206 and is coupled to thefirst tee 1208. Thevent solenoid 1212 is coupled to thefirst tee 1208 viatube 1222 and is also coupled to filter 1220 via tube 1224.Tube 1226 couples thefirst tee 1208 to thesecond tee 1210. The second tee is coupled to thepressure transducer 1216 viatube 1228 and thepump solenoid 1214 viatube 1230. Thepump solenoid 1214 is coupled to thecompressor 1218 viatube 1232. Thecompressor 1218 is coupled to thefilter 1221 viatube 1234.Wire 1236 is coupled from thevent solenoid 1212 to theinterface port 1244,wire 1238 is coupled from thepressure transducer 1216 to theinterface port 1244,wire 1240 is coupled from the pump solenoid to theinterface port 1244, andwire 1242 is coupled from thecompressor 1218 to theinterface port 1244. The interface means 1246 links to theinterface port 1244 and is the input to a computer system, e.g. the SCCE ofFIG. 10 . - In practice, the compressor/
transducer module 1206 pumps materials, such as gas, air, fluids, or gels into the chamber or chambers (not shown) of thecompressible substance 1202 and provides the means for measuring the force exerted by the fingers (i.e. fingers and thumb) of the patient's hand upon squeezing thecompressible substance 1202. The embodiment shown inFIG. 12 inflates the chamber/s of the compressible substance, 1202 with air or another similar gas. - In order to inflate the chamber/s within the
compressible substance 1202, thecompressor 1218 pulls air through thefilter 1221 viatube 1234 and forces the air out throughtube 1232. The compressor, which is a miniature mechanical compressor as described above with reference toFIG. 6 , e.g. rotary vane pump, is controlled or activated by control signals sent throughwire 1242. Furthermore, thecompressor 1218 may be reversible, such that it may assist in the deflation of thecompressible substance 1202. Thepump solenoid 1214 acts as a valve and controls the flow of air into the rest of the system. Typically, the pump solenoid 1214 (controlled by signal sent via wire 1240) works in concert with thecompressor 1218, such that when the compressor is “pumping” to inflate the chambers within thecompressible substance 1202, thepump solenoid 1214 is open to allow thecompressor 1218 to force the air therethrough. Alternatively, pinch valves may be used instead of the solenoids as described above with reference toFIG. 6 . The air is pumped throughtube 1230 and through thesecond tee 1210 intotube 1226 and thefirst tee 1208. The air continues through thefirst tee 1208 and into thefirst tube 1204 which is fed into the chambers of thecompressible substance 1202 in order to inflate the chambers to a desired pressure level. - Air is also pumped into
tube 1222 from thefirst tee 1208 to thevent solenoid 1212, which acts as a valve; however, during the “pumping” of thecompressor 1218, thevent solenoid 1212 is closed such that the air will not be allowed to flow through thevent solenoid 1212. Thevent solenoid 1212 is controlled via signals sent throughwire 1236. - Furthermore, air is forced against the port of the
pressure transducer 1216 throughtube 1228 of the second tee. Thepressure transducer 1216 of the compressor/pressure transducer module 1206 is a transducer that produces a signal, such as a voltage proportional to the pressure applied to its port. Thepressure transducer 1216 is used during inflation to determine when the desired pressure (e.g. desired psi) within thecompressible substance 1202 has been reached.Wire 1238 of thepressure transducer 1216 transmits the voltage signals proportional to the pressure withintube 1228 to the controlling computer (to translate the signals into estimation of pressure) through theinterface port 1244 and the interface means 1246. Such information is used to control the switching on and off of thecompressor 1218. Thecompressor 1218 is well known in the art as described with reference toFIG. 6 . - Once the pressure within the chambers of the
compressible substance 1202 is at the desired level, i.e. the pressure at thepressure transducer 1216 is at the desired level, thepump solenoid 1210 is closed and the patient squeezes thecompressible substance 1202, which forces air back into thefirst tube 1204 and causes more pressure to be placed upon thepressure transducer 1216. Thus, thepressure transducer 1216 sends voltage signals which are proportional to the additional pressure within the system, which can be translated, by the controller ofFIG. 10 for example, into the pressure or force exerted by the digits of the hand (e.g. by taking the difference between the initial pressure and the additional pressure), either collectively, or individually, depending on the embodiment. There is typically a direct proportionality between the force or pressure applied by the fingers and the measurements of the pressure transducer; however, this proportionality may be altered by different configurations and different material selection. - Additionally, the
vent solenoid 1212 may be employed to vent the system; thus, allowing rapid deflation of thecompressible substance 1202 upon completion of the therapy. In this case, thevent solenoid 1212 is opened, while thepump solenoid 1214 is closed. Thus, the air contained within thecompressible substance 1202 and the system will be pushed out throughtube 1222, through thevent solenoid 1212, through tube 1224, and out of the compressor/transducer module 1206 throughfilter 1220. - The compressor/
pressure transducer module 1206 may be as shown, i.e. as a separate unit not physically located on the body of the glove. Thus, the compressor/pressure transducer module 1206 may be worn on the body of the patient (e.g. on the patient's belt) or placed nearby the patient and attached to thecompressible substance 1202 via thefirst tube 1204. Alternatively, the compressor/pressure transducer module 1206 may be integrated onto the body of the glove, as described above with reference toFIG. 6 . The components of such a module are well known in the art; thus, no further explanation is required. Furthermore, the compressor/pressure transducer module 1206 may be easily modified to pump fluids or other gases into thecompressible substance 1202 by attaching gas canisters or fluid reservoirs at the locations of thefilters FIG. 3 ). - Furthermore, for a
compressible substance 1202 including more than one chamber, e.g. one chamber for each finger, there are fiveseparate pressure transducers 1216 within five separate compressor/pressure transducer modules 1206. Thus, there is one compressor/pressure transducer module 1206 for each respective chamber of thecompressible substance 1202. Alternatively, there may be one compressor/pressure transducer module, including 5 pressure transducers all sharing the same compressor and/or sharing common vent solenoids. - Referring next to
FIG. 13 is a flowchart showing the steps for providing information useful to offer targeted incentives. The system provides diagnostic information (step 1302); which is useful for generating therapy plan information (step 1304); which is useful for gaining patient approval information (step 1306); all of which information is useful for obtaining financing provider approval and incentive information (steps 1308, 1310). The product and advice providers access the therapy plan information (step 1312) which is useful for advertising, promoting, proposing, or bidding (step 1314). Advertising provides product knowledge and substantial revenue. This step provides targeted information to members based on estimates of their needs. This competitive bidding process is useful for providing savings. The patient and provider accept offers (step 1316) and this information is useful for transferring funds (step 1318) from the financing provider to the product and service providers. The funds transfer information is useful for prompting the delivery of products and services (step 1320). The therapy session (step 1322) information is useful for monitoring and controlling the therapy (step 1324). This information is stored (also step 1324) and is useful for updating diagnostics (step 1302). - Referring back to
step 1310, when the financing provider offers incentives: there is an unmet need for incentives for protecting funds managed by healthcare financing providers, such as Medicare. For example, Medicare funds might be readily available for limosine or air travel for non-emergency therapy sessions, without any incentive to save by choosing remotely monitored home therapy. Other questionable factors that providers employ include items such as broadcast advertising, or legal expenses for unsafe pills. For example, recent broadcast television ads promote motorized scooters that can be financed by Medicare; with company sales reps ready to assist with Medicare processing. Thus, questionable items, such as broadcast advertising and sales commissions, are passed through to the Medicare members in higher scooter prices. Restated with reference toFIG. 10 ,financing providers 1060, such asMedicare 1062, are paying for factors employed byproduct providers 1050, such asequipment providers 1054, who employbroadcast advertising 1046, andMedicare processing advice 1044, which increases theprices Medicare 1062 andpatients 1020 pay for equipment. Thus, Medicare trustees need improved processing systems, and incentives to encourage members to protect the fund. In the above example, an equipment provider could simply access the system (step 1312) to target patients with diagnostic data that indicate potential need for their equipment, and use the system to send advertising information (step 1314) directly to those patients. Instead of paying Medicare processing commissions, the patient can simply use the system to efficiently update or fill in the appropriate Medicare data fields online. If targeted advertising and automatic processing reduce costs, then Medicare can offer incentives to patients and providers who choose (step 1316) methods that effect those savings. Thus performance can be tracked and rewarded based on individual transactions, or perhaps by tiered or certification programs, whereby providers can be rewarded. Incentive systems are known in the art, such as U.S. Pat. No. 6,434,534, issued Aug. 13, 2002 to Walker, et al. entitled “METHOD AND SYSTEM FOR PROCESSING CUSTOMIZED REWARD OFFERS”, and U.S. Pat. No. 5,689,100 issued Nov. 18, 1997 to Carrithers, et al. entitled “DEBIT CARD SYSTEM AND METHOD FOR IMPLEMENTING INCENTIVE AWARD PROGRAM” (both of which are incorporated herein by reference). The U.S. Pat. No. 5,689,100 patent is assigned to Maritz, Inc. of Fenton, Mo. whose methods and systems for managing incentive programs are commercially available, so Medicare would not need to manage the incentive program directly. Furthermore, Medicare members may lobby for macroincentives, such as tax exemptions; research grants; tiered levels of antitrust exemptions; investment trusts; securities; interstate licensing; targeted advertising lists; or access to foreign membership. Thus, providers who implement systems that protect (or grow) the Medicare fund can be rewarded with strategic incentives. Most conventional theories would object to early incentives, such as using diagnostic information from a therapy system to generate targeted advertising. It is obvious that this is a violation of privacy laws. Thus, conventional theory would reject proposals to use a therapy system to provide targeted advertising that generates a profit, or at least reduces broadcast advertising passthrough cost. But, U.S. Pat. No. 6,285,983 issued Sep. 4, 2001 to Jenkins entitled “MARKETING SYSTEMS AND METHODS THAT PRESERVE CONSUMER PRIVACY” (which is incorporated herein by reference) teaches a targeted advertising system that can protect privacy through a third party repository. And U.S. Pat. No. 6,334,110 issued Dec. 25, 2001 to Walter, et al. entitled “SYSTEM AND METHOD FOR ANALYZING CUSTOMER TRANSACTIONS AND INTERACTIONS” (which is incorporated herein by reference) teaches how to extract targeted information from the therapy system in a timely manner, so incentives or rewards can be offered early in the process. - Referring to
FIG. 14 is a view an embodiment of means for monitoring the therapy system. Thescreen display 1400 receives and displays information from thecontroller 1402. Thecontroller 1402 receives information from the patient. In this instance, the patient positions amember incentive card 1404 so as to be readable by thecontroller 1402. Information from the card is transmitted, received, and displayed for members of the system who can help meet the patient's needs, such as (referring back toFIG. 10 ) thefinancing provider 1060,service provider 1040, orproduct provider 1050. In this embodiment, theincentive card 1404, provides markings that verify that the patient is a member of a remote monitoring plan. Thus the identification, authorization, pricing, therapy session, and payment processes are remote and automatic, so the therapy session can commence in a timely manner. If problems arise, the stored session records can be retrieved, and reviewed; providing evidence useful for legal expense savings. U.S. Pat. No. 6,442,532 issued Aug. 27, 2002 to Kawan entitled “WIRELESS TRANSACTION AND INFORMATION SYSTEM”, U.S. Pat. No. 7,040,533 issued May 9, 2006 to Ramachandran entitled “CASH WITHDRAWAL FROM ATM VIA VIEDOPHONE”, and U.S. Pat. No. 6,385,595 issued May 7, 2002 to Kolling et al. (all of which are incorporated herein by reference) teach related methods and systems. - Referring next to
FIG. 15 is a screen display view of remote therapy in operation. Aside window 1502 displays therapy related information; in this view the therapist is speaking to the patient. Content topics ormenus 1504 provide means for choosing therapy related information. Buttons let the patient start asnew session 1506; save asession 1508; send a stored session as anemail attachment 1510; review aprevious session 1512; or reviewtherapy progress 1514. Themain window 1516 displays content such as a therapy session in progress. U.S. Pat. No. 6,813,372 issued Nov. 2, 2004 to Standridge et al, entitled “MOTION AND AUDIO DETECTION BASED WEBCAMMING AND BANDWIDTH CONTROL” (which is incorporated herein by reference) teaches a system for transmitting and receiving signals to generate such a display under low bandwidth or low memory conditions. U.S. Pat. No. 6,173,317 issued Jan. 9, 2001 to Chadda, et al. entitled “STREAMING AND DISPLAYING A VIDEO STREAM WITH SYNCHRONIZED ANNOTATIONS OVER A COMPUTER NETWORK” (which is incorporated herein by reference) teaches a system for providing such a display under higher bandwidth and higher memory conditions. Alternatively, themain window 1516 could display training or research information; and previously stored therapy sessions could be used for research studies, or licensed as content for such training sessions. -
FIG. 16 is another embodiment of a screen display of a remote therapy session in operation. Aside window 1602 displays performance metrics. Theinternet address 1604 shows a link whereby the patient, therapist, and other providers can obtain access to help meet the patient's needs, depending on levels of permission. The mainwindow title bar 1606 displays information about the patient and the therapy session, along with information about the incentive level. Themain window 1608, displays a therapy session in progress, preferably, in real time. U.S. Pat. No. 7,130,618 issued Oct. 31, 2006 to Hirotugu, entitled “METHODS, APPARATUS, AND SYSTEM FOR TRANSMITTING MOVING IMAGE DATA” (which is incorporated herein by reference) teaches modern means for monitoring therapy. Information from the therapy is transmitted, received, and displayed for members of the system who can then make customized recommendations, based on the collected therapy information, to help meet that patient's specific needs. - While the invention herein disclosed has been described by means of specific embodiments and applications thereof, numerous modifications and variations could be made thereto by those skilled in the art without departing from the scope of the invention set forth in the claims.
Claims (21)
1. An therapy system comprising:
a product worn by a person, said product including a compressible substance affixed thereto, said compressible substance being located proximate to a joint of said person, said compressible substance providing resistance against flexion of said joint, during the active flexion movements of said person, wherein said compressible substance may be squeezed between bones brought together during the flexion of said joint, wherein massaging the body tissues between said compressible substance and the converging bones; and
stretchable fabric, said fabric having elastic properties, wherein said fabric is attached to the product, and extending outwardly therefrom, and spanning to the compressible substance, and coupled thereto, said fabric providing resistance against extension of said joint, during the active extension movements of said person, wherein said fabric, when stretched between bones brought farther apart during the extension of said joint, may urge said product to press against said person, wherein massaging the body tissues under the pressure; and
attachment means, whereby said compressible substance and said fabric may be affixed to said product.
2. The system of claim 1 further comprising means for monitoring said therapy.
3. The system of claim 1 further comprising means for controlling said therapy.
4. The system of claim 1 wherein said product further comprises means for regulating pressure, wherein a therapeutic gas, fluid, gel, or ingredient may enter, exit, be retained, be extracted, be flow-regulated, or be flow-restricted.
5. The system of claim 1 wherein said product contains one or more therapeutic ingredients, such as a medication, supplement, gene, transdermal or transcellular carrier agent.
6. The system of claim 5 further comprising means for monitoring said therapy.
7. The system of claim 5 further comprising means for controlling the delivery of said therapy.
8. A therapy system comprising:
an exercise device worn on an extremity of a person comprising:
a resilient compressible substance positioned in close proximity to a joint of said extremity, said compressible substance providing resistance against flexion of said joint, wherein said compressible substance is squeezed between the extremity portions that converge during the active flexion movements of said person; and
at least one base fabric portion for engaging one or more portions of said extremity; and
one or more elastic fabric portions, said elastic fabric coupled to said compressible substance and extending outwardly therefrom, and spanning to one or more of said base fabric portions, and attached thereto, said elastic fabric providing resistance against the extension of said joint, during the active extension movements of said person; and
attachment means, whereby the base fabric may be affixed to the elastic fabric.
9. The system of claim 8 further comprising a circuitry module linked thereto, said circuitry module including means for providing a signal proportional to a performance parameter.
10. The system of claim 8 further comprising display means, for displaying performance information, whereby facilitating the communication of performance information to a person monitoring the performance.
11. The system of claim 8 further comprising means for communicating with a processing system, whereby said processing system may determine performance information.
12. The system of claim 11 further comprising networking means, wherein said performance information adapted to being communicated, processed, stored, or displayed over a network.
13. The device of claim 8 further comprising a gas, fluid, gel, or therapeutic ingredient contained therein.
14. The system of claim 13 further comprising pressure regulating means connected thereto.
15. The system of claim 13 further comprising means for monitoring said therapy.
16. The system of claim 15 further comprising means for controlling said therapy.
17. The device of claim 15 further comprising means for storing therapy information.
18. The device of claim 15 further comprising means for communicating therapy information.
19. A monitoring system for monitoring one or more therapy systems, said monitoring system comprising:
means for collecting therapy information from said therapy system; and
means for determining performance information from said therapy system information, wherein a provider determines a customized recommendation based on said performance information.
20. The monitoring system of claim 20 wherein said customized recommendation further comprises a therapy product recommendation.
21. The monitoring system of claim 20 wherein said customized recommendation further comprises a customized incentive recommendation.
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