Balance testing and training system and method

• US 10,376,739 B2
• Filed: 01/09/2017
• Issued: 08/13/2019
• Est. Priority Date: 01/08/2016
• Status: Active Grant

• Current Assignee: Nymbl Science
• Original Assignee: Balance4Good, Ltd.
• Inventors: Cook, James Bingham, Farcy, Jean Pierre Claude
• Primary Examiner(s): Thai, Xuan M
• Assistant Examiner(s): Blaise, Malina D.
• Application Number:
  US15/402,078
• Publication Number:
  US 20170197115A1
• Time in Patent Office: 946 Days
• CPC Class Codes: A63B 2071/0625 Emitting sound, noise or music
• CPC Class Codes: A63B 2220/22 Stride length
• CPC Class Codes: A63B 2220/30 Speed
• CPC Class Codes: A63B 2220/836 Sensors arranged on the body of the user
• CPC Class Codes: A63B 2225/20 with means for remote communication, e.g. internet or the like
• CPC Class Codes: A63B 24/0003 Analysing the course of a movement or motion sequences during an exercise or trainings sequence, e.g. swing for golf or tennis
• CPC Class Codes: A63B 24/0062 Monitoring athletic performances, e.g. for determining the work of a user on an exercise apparatus, the completed jogging or cycling distance
• CPC Class Codes: A63B 24/0075 Means for generating exercise programs or schemes, e.g. computerized virtual trainer, e.g. using expert databases
• CPC Class Codes: A63B 26/003 for improving balance or equilibrium balance beams A63B4/00; apparatus for rope dancing A63B7/08; balancing drums, balancing boards or the like A63B22/16
• CPC Class Codes: A63B 71/0622 Visual, audio or audio-visual systems for entertaining, instructing or motivating the user
• CPC Class Codes: G09B 19/003 Repetitive work cycles; Sequence of movements
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising

Abstract

A human balance testing and training system may comprise: a mobile communication device comprising: (1) sensors; (2) a display unit; (3) an input unit; (4) an evaluation subsystem for evaluating balance capabilities of a human subject utilizing data collected when the human subject is performing one or more balance evaluation exercises, the data including data received from the sensors; (5) an expert subsystem for prescribing an exercise plan; and (6) a training subsystem for maintaining an exercise plan including one or more balance training exercises for the human subject; wherein the exercise plan is determined by at least one of a balance evaluation by the evaluation subsystem, performance data provided by the training subsystem, and input from a health professional; and wherein the sensors are configured to measure movement of the human subject during performance of one or more of an evaluation exercise and a training exercise.

Claims

1. A human balance testing and training system comprising:

a mobile communication device comprising;

a computer processor;

a system memory;

a network interface comprising one or more communication modules adapted to communicate over a wide area network;

a combination of sensors for measuring movement and rotation of the mobile communication device, the combination of sensors including (i) a 3-axis gyroscope adapted for measuring orientation and angular velocity and (ii) a 3-axis accelerometer adapted for measuring acceleration, the combination of sensors configured to measure sensor data characterizing movement of a human subject, the sensor data comprising one or more of gyroscope data and accelerometer data;

a display unit;

a mobile application operating on the mobile communication device, the mobile application including a balance evaluation subsystem for evaluating balance capabilities of the human subject utilizing data collected when said human subject is performing one or more balance evaluation exercises, said data including data received from one or more of the human subject'"'"'s interaction with the mobile communication device and said combination of sensors, the balance evaluation subsystem configured to evaluate the data and to provide a balance evaluation for the human subject;

the mobile application further including an expert subsystem for prescribing an exercise plan for the human subject based on the balance evaluation provided by the balance evaluation subsystem, the exercise plan comprising one or more balance training exercises specifically tailored for improving balance of the human subject; and

the mobile application further including a training subsystem for administering the prescribed exercise plan received from the expert subsystem to the human subject, the prescribed exercise plan administered as an interactive exercise plan including one or more balance training exercises for said human subject, wherein the training subsystem is configured to collect performance data for the human subject while the human subject is performing the one or more balance training exercises;

wherein said expert subsystem is adapted to modify the interactive exercise plan as the human subject progresses in accordance with a level of performance of the human subject based on evaluating the performance data for the human subject provided by the training subsystem, wherein updates to the interactive exercise plan are determined based on at least one of the balance evaluation provided by said balance evaluation subsystem, the performance data provided by said training subsystem, and input from the human subject,

wherein the mobile application is further configured to provide one or more cognitive challenges for dual tasking to actively engage the human subject'"'"'s mind during performance of one or more balance evaluation exercises and balance training exercises, including (i) communicating the one or more cognitive challenges to the human subject during performance of one or more balance evaluation exercises and balance training exercises and receiving performance data while the human subject is under the cognitive challenge, (ii) determining differences in the performance data for the human subject under the cognitive challenge with performance data under conditions without the cognitive challenge, and (iii) evaluating the determined differences in the performance data to ascertain an amount of variability in the human subject'"'"'s performance during times when the human subject'"'"'s attention is focused away from performing the balance evaluation or training exercises by the cognitive challenge, and

wherein the human balance testing and training system enables the human subject using a mobile communication device to evaluate balance and to receive one or more exercise plans tailored for improving balance of the human subject to reduce risk of falls.

2. The system of claim 1, wherein the combination of sensors is configured to measure movement of the human subject during performance of one or more of the balance evaluation exercises and balance training exercises, the balance evaluation subsystem configured to perform operations comprising:

loading and validating the sensor data comprising the gyroscope data and the accelerometer data;

correcting for orientation of the sensors;

determining cadence of the human subject'"'"'s gait, including (i) calculating a motion signal based on the accelerometer data and the gyroscope data (ii) detecting stationary time periods wherein the motion signal falls below a threshold value (iii) selecting a midpoint in each stationary time period and (iv) calculating cadence of each step between midpoints in each stationary time period;

determining gait parameters for the human subject based on computing stride length and step height for each step in the human subject'"'"'s gait based on the sensor data, including performing integration operations on the accelerometer data to acquire position data and calculating the human subject'"'"'s stride length and step height based on the position data;

calculating one or more of variability and asymmetry in the human subject'"'"'s gait based on the stride length, step height and the cadence for each step between midpoints in each stationary time period; and

storing the gait parameters and variability and asymmetry thereof in the system memory.

3. The system of claim 1, wherein said mobile communication device is adapted to be hand held by the human subject or adapted to be attached to said human subject during performance of one or more of the balance evaluation exercises and the balance training exercises.

4. The system of claim 2, wherein said mobile device is configured to provide at least one of an auditory stimulus, a visual stimulus and a tactile stimulus to said human subject for providing feedback in real time to the human subject during performance of one or more of said balance evaluation exercises and said balance training exercises, the feedback including one or more of the gait parameters.

5. The system of claim 1, further comprising a remote subsystem on a remote server in communication with the mobile communication device via a wide area network, said remote subsystem being configured to receive data from said mobile communication device and send software updates to said mobile communication device for at least one of said evaluation subsystem, said expert subsystem and said training subsystem.

6. The system of claim 5, wherein said software updates are sent daily and wherein said software updates include updates to said exercise plan.

7. The system of claim 5, wherein said combination of sensors and at least one of said evaluation subsystem, said training subsystem and said remote subsystem, are configured to measure the gait of said human subject based on the gait parameters.

8. The system of claim 1, further comprising a remote interface in communication with the mobile communication device via a wide area network, said remote interface being configured to permit one or more of monitoring the performance of said human subject and controlling evaluation and training of said human subject.

9. The system of claim 1, wherein said mobile communication device further comprises an incentive subsystem for providing motivational messages to said human subject on said display unit of said mobile device.

10. The system of claim 1, wherein said combination of sensors and at least one of said evaluation subsystem and said training subsystem are configured to measure the gait of said human subject.

61. The system of claim 1 wherein the balance evaluation comprises a balancing index configured to provide a numerical measure of the human subject'"'"'s balance capabilities, the balancing index including one or more of a static balancing factor, a dynamic balancing factor, a strength factor and a cognitive balancing factor.

62. The system of claim 61 wherein the dynamic balancing factor is measured by the variance in the human subject'"'"'s gait parameters while the human subject is performing one or more of the balance evaluation exercises and the balance training exercises.

11. A human balance testing and training system comprising:

a mobile communication device comprising;

a computer processor;

a system memory;

a display unit; and

a network interface comprising one or more communication modules adapted to communicate over a wide area network;

a combination of sensors, the combination of sensors including (i) a 3-axis gyroscope adapted for measuring orientation and angular velocity and (ii) a 3-axis accelerometer adapted for measuring acceleration, the combination of sensors configured to measure sensor data characterizing movement of a human subject, the sensor data comprising one or more of gyroscope data and the accelerometer data; and

a mobile application operating on the mobile communication device in communication with the combination of sensors and configured to receive data from one or more of the human subject'"'"'s interaction with the mobile communication device and said combination of sensors, the mobile application including a balance evaluation subsystem for evaluating balance capabilities of the human subject utilizing data collected when said human subject is performing one or more balance evaluation exercises, said data including data received from one or more of the human subject'"'"'s interaction with the mobile communication device and said combination of sensors;

the balance evaluation subsystem configured to evaluate the collected data and to provide a balance evaluation for the human subject, wherein the mobile application operating on the mobile communication device further comprises;

an expert subsystem for prescribing an exercise plan for the human subject based on the balance evaluation provided by the balance evaluation subsystem, the exercise plan comprising one or more balance training exercises tailored for improving balance of the human subject; and

a training subsystem for administering the prescribed exercise plan received from the expert subsystem to the human subject, the prescribed exercise plan administered as an interactive exercise plan including one or more balance training exercises for the human subject, wherein the training subsystem is configured to collect performance data for the human subject during performance of the one or more balance training exercises,

wherein the expert subsystem is adapted to modify the interactive exercise plan as the human subject progresses in accordance with a level of performance of the human subject based on evaluating the performance data for the human subject provided by the training subsystem,

wherein the mobile application is further configured to provide one or more cognitive challenges for dual tasking to actively engage the human subject'"'"'s mind during performance of one or more balance evaluation exercises and balance training exercises, including (i) communicating the one or more cognitive challenges to the human subject during performance of one or more balance evaluation exercises and balance training exercises and receiving performance data while the human subject is under the cognitive challenge, (ii) determining differences in the performance data for the human subject under the cognitive challenge with performance data under conditions without the cognitive challenge, and (iii) evaluating the determined differences in the performance data to ascertain an amount of variability in the human subject'"'"'s performance during times when the human subject'"'"'s attention is focused away from performing the balance evaluation or training exercises by the cognitive challenge, and

wherein the human balance testing and training system enables the human subject using a mobile communication device to evaluate balance and to receive one or more exercise plans tailored for improving balance of the human subject to reduce risk of falls.

12. The system of claim 11, wherein the mobile communication device is configured to perform operations comprising:

loading and validating the sensor data comprising the gyroscope data and the accelerometer data;

correcting for orientation of the sensors;

determining cadence of the human subject'"'"'s gait, including (i) calculating a motion signal based on the accelerometer data and the gyroscope data (ii) detecting stationary time periods wherein the motion signal falls below a threshold value (iii) selecting a midpoint in each stationary time period and (iv) calculating cadence of each step between midpoints in each stationary time period;

determining gait parameters for the human subject based on computing stride length and step height for each step in the human subject'"'"'s gait based on the sensor data, including performing integration operations on the accelerometer data to acquire position data and calculating the human subject'"'"'s stride length and step height based on the position data;

calculating one or more of variability and asymmetry in the human subject'"'"'s gait based on the stride length, step height and cadence for each step between midpoints in each stationary time period; and

storing the gait parameters and variability and asymmetry thereof in the system memory.

13. The system of claim 11, wherein said gait parameters include any selection of stride length, stride width, foot height, step cadence, walking speed, and measures of variabilities or asymmetries of stride length, stride width, foot height, step cadence and walking speed, wherein said variabilities or asymmetries are a measure of one or more of stride-to-stride variabilities or asymmetries and left-leg-to-right-leg variabilities or asymmetries.

14. The system of claim 11, wherein said mobile communication device is configured to provide at least one of an auditory stimulus, a visual stimulus and a tactile stimulus to said human subject for providing feedback in real time to the human subject during performance of one or more of said balance evaluation exercises and said balance training exercises, the feedback including one or more of the gait parameters.

15. The system of claim 12, further comprising a remote subsystem on a remote server in communication with the mobile communication device via a wide area network, said remote subsystem being configured to receive data from said mobile communication device and send software updates to said mobile communication device for at least one of said evaluation subsystem, said expert subsystem and said training subsystem.

16. The system of claim 15, wherein said software updates are sent daily and wherein said software updates include updates to said exercise plan.

17. The system of claim 15, wherein said remote subsystem is further configured to calculate gait parameters of said human subject from data collected from said combination of sensors.

18. The system of claim 11, further comprising a remote interface in communication with the mobile communication device via a wide area network, said remote interface being configured to permit one or more of monitoring the performance of said human subject and controlling the evaluation and training of said human subject.

19. The system of claim 11, wherein said mobile communication device comprises device sensors configured to measure movement of said human subject during performance of one or more of an evaluation exercise and a training exercise.

20. The system of claim 19, wherein said mobile communication device is adapted to be hand held by said human subject during performance of one or more of an evaluation exercise and a training exercise.

21. The system of claim 19, wherein said mobile communication device is adapted to be attached to said human subject during performance of one or more of an evaluation exercise and a training exercise.

22. The system of claim 19, wherein said sensors include one or more of said device sensors.

23. The system of claim 11, wherein said mobile communication device further comprises an incentive subsystem for providing motivational messages to said human subject on said display unit of said mobile communication device.

63. The system of claim 11 wherein additional analysis is performed on the gait parameters to determine regularity, unpredictability, and self-similarity of time series data relating to the human subject'"'"'s gait.

64. The system of claim 63 wherein the additional analysis comprises detrended fluctuation analysis (DFA) or entropy analysis (ApEn) performed on the gait parameters.

65. The system of claim 11 wherein the sensor data is processed by the mobile application or a remote computer server to determine the human subject'"'"'s overall average speed of walking.

66. The system of claim 11 wherein gait speed of the human subject is measured at intervals to identify changes in gait speed as an indicator of increased risk of falling.

67. The system of claim 11 wherein the gait parameters are communicated over the wide area network to one or more external individuals, including the human subject'"'"'s caregiver, family, trainer or doctor.

24. A method of evaluating and training human balance, comprising:

at a mobile communication device comprising a computer processor, a system memory, a display unit, a network interface comprising one or more communication modules adapted to communicate over a wide area network, and a combination of sensors for measuring movement and rotation of the mobile communication device, the combination of sensors including (i) a 3-axis gyroscope adapted for measuring orientation and angular velocity and (ii) a 3-axis accelerometer adapted for measuring acceleration, the combination of sensors configured to measure sensor data characterizing movement of a human subject, the sensor data comprising one or more of gyroscope data and accelerometer data;

receiving, at a balance evaluation subsystem operating on the mobile communication device for evaluating balance capabilities of a human subject, data collected when said human subject is performing one or more balance evaluation exercises, said data including data received from one or more of the human subject'"'"'s interactions with the mobile communication device and data received from said combination of sensors, the balance evaluation subsystem configured to evaluate the data and to provide a balance evaluation for the human subject;

prescribing an exercise plan for the human subject, at an expert subsystem, based on the balance evaluation provided by the balance evaluation subsystem, the exercise plan comprising one or more balance training exercises specifically tailored for improving balance of the human subject; and

administering, using a training subsystem, the prescribed exercise plan received from the expert subsystem to the human subject, the prescribed exercise plan administered as an interactive exercise plan including one or more balance training exercises for said human subject,

wherein said expert subsystem is adapted to modify the interactive exercise plan as the human subject progresses in accordance with a level of performance of the human subject based on evaluating the performance data for the human subject provided by the training subsystem, wherein updates to the interactive exercise plan are determined based on at least one of the balance evaluation provided by said balance evaluation subsystem, the performance data provided by said training subsystem, and input from the human subject;

providing one or more cognitive challenges for dual tasking to actively engage the human subject'"'"'s mind during performance of one or more balance evaluation exercises and balance training exercises, including (i) communicating the one or more cognitive challenges to the human subject during performance of one or more balance evaluation exercises and balance training exercises and receiving performance data while the human subject is under the cognitive challenge, (ii) determining differences in the performance data for the human subject under the cognitive challenge with performance data under conditions without the cognitive challenge, and (iii) evaluating the determined differences in the performance data to ascertain an amount of variability in the human subject'"'"'s performance during times when the human subject'"'"'s attention is focused away from performing the balance evaluation or training exercises by the cognitive challenge,

wherein the human balance testing and training system enables the human subject using the mobile communication device to evaluate balance and receive interactive exercise plans tailored for improving balance of the human subject to reduce risk of falls.

25. The method of claim 24, wherein the combination of sensors is configured to measure movement of the human subject during performance of one or more of the balance evaluation exercises and balance training exercises, the balance evaluation subsystem configured to perform operations comprising:

loading and validating the sensor data comprising the gyroscope data and the accelerometer data;

correcting for orientation of the sensors;

determining cadence of the human subject'"'"'s gait, including (i) calculating a motion signal based on the accelerometer data and the gyroscope data (ii) detecting stationary time periods wherein the motion signal falls below a threshold value (iii) selecting a midpoint in each stationary time period and (iv) calculating cadence of each step between midpoints in each stationary time period;

determining gait parameters for the human subject based on computing stride length and step height for each step in the human subject'"'"'s gait based on the sensor data, including performing integration operations on the accelerometer data to acquire position data and calculating the human subject'"'"'s stride length and step height based on the position data;

calculating one or more of variability and asymmetry in the human subject'"'"'s gait based on the stride length and the cadence for each step between midpoints in each stationary time period; and

storing the gait parameters and variability and asymmetry thereof in the system memory.

26. The method of claim 24, wherein said mobile communication device is adapted to be hand held by the human subject or attached to said human subject during performance of one or more of an evaluation exercise and a training exercise.

27. The method of claim 25, further comprising providing by said mobile device at least one of an auditory stimulus, a visual stimulus and a tactile stimulus to said human subject for providing feedback in real time to the human subject during performance of one or more of said evaluation exercises and said training exercises, the feedback including one or more of the gait parameters.

28. The method of claim 24, further comprising receiving software updates by said mobile communication device for at least one of said balance evaluation subsystem, said expert subsystem and said training subsystem, said software updates being sent by said remote subsystem.

29. The method of claim 28, wherein said software updates are sent daily and wherein said software updates include updates to said exercise plan.

30. The method of claim 24, further comprising coupling a remote interface to one or more of said mobile communication device and said remote server via a wide area network, said remote interface being configured to permit one or more of monitoring the performance of said human subject and controlling the evaluation and training of said human subject.

31. The method of claim 30, further comprising sending from one or more of said mobile communication device and said remote server to said remote interface a message identifying a risk of falling of said human subject.

32. The method of claim 31, wherein said risk of falling is determined by one or more of said balance evaluation subsystem, said training subsystem and said remote subsystem from said balance capabilities of said human subject.

33. The method of claim 24, further comprising providing motivational messages to said human subject on said display unit of said mobile communication device wherein said mobile communication device further comprises an incentive subsystem for generating said motivational messages.

34. The method of claim 24, further comprising, before evaluating balance capabilities, collecting information from said human subject regarding self-reported age, physical activity level and level of confidence regarding ability to maintain balance during physical activity, assessing using said information by said balance evaluation subsystem a risk of falling of said human subject during balance evaluation exercises, and wherein when said risk is above a threshold, providing a warning by said mobile communication device to said human subject to have a human companion available to provide for the safety of said human subject.

35. The method of claim 24, further comprising communicating from said mobile communication device to said human subject a message identifying that said human subject is at risk of falling.

36. The method of claim 35, wherein said risk of falling is determined by one or more of said balance evaluation subsystem, said training subsystem and said remote subsystem from said balance capabilities of said human subject.

37. The method of claim 24, further comprising calculating gait parameters of said human subject from data collected from said sensors during performance of said one or more balance evaluation exercises and balance training exercises by said human subject, said calculating being performed by one or more of said evaluation subsystem, said training subsystem and a remote subsystem on a remote server coupled to said mobile communication device by a wide area network.

38. The method of claim 37, further comprising providing feedback to said human subject regarding the gait of said human subject during performance of said one or more balance evaluation exercises and balance training exercises, wherein said feedback is provided during said performance of said one or more balance evaluation exercises and balance training exercises.

39. The method of claim 37, wherein said gait parameters include any selection of stride length, stride width, foot height, step cadence, walking speed, and measures of variabilities or asymmetries of stride length, stride width, foot height, step cadence and walking speed, wherein said variabilities or asymmetries include a measure of one or more of stride-to-stride variabilities or asymmetries and left-leg-to-right-leg variabilities or asymmetries.

40. A method of evaluating and training human balance, comprising:

at a mobile communication device comprising a computer processor, a system memory, a display unit, a network interface comprising one or more communication modules adapted to communicate over a wide area network, and a combination of sensors for measuring movement and rotation of the mobile communication device, the combination of sensors including (i) a 3-axis gyroscope adapted for measuring orientation and angular velocity and (ii) a 3-axis accelerometer adapted for measuring acceleration, the combination of sensors configured to measure sensor data characterizing movement of a human subject, the sensor data comprising one or more of gyroscope data and accelerometer data;

receiving data collected when said human subject is performing one or more balance evaluation exercises at a balance evaluation subsystem on the mobile communication device adapted for evaluating balance capabilities of the human subject, the data including data received from one or more of the combination of sensors and the human subject'"'"'s interactions with the mobile communication device, the balance evaluation subsystem configured to evaluate the collected data and to provide a balance evaluation for the human subject based thereon,

prescribing an exercise plan for the human subject at an expert subsystem based on the balance evaluation provided by the balance evaluation subsystem, the exercise plan comprising one or more balance training exercises tailored for improving balance of the human subject;

administering to the human subject the prescribed exercise plan received from the expert subsystem, using a training subsystem, the prescribed exercise plan administered as an interactive exercise plan including one or more balance training exercises for said human subject; and

providing one or more cognitive challenges for dual tasking to actively engage the human subject'"'"'s mind during performance of one or more balance evaluation exercises and balance training exercises, including (i) communicating a cognitive challenge to the human subject during performance of one or more balance evaluation exercises and balance training exercises and receiving performance data while the human subject is under the cognitive challenge, (ii) determining differences in the performance data for the human subject under the cognitive challenge with performance data under conditions without the cognitive challenge, and (iii) evaluating the determined differences in the performance data to ascertain an amount of variability in the human subject'"'"'s performance during times when the human subject'"'"'s attention is focused away from performing the balance evaluation or training exercises by the cognitive challenge,

wherein the human balance testing and training system enables the human subject using the mobile communication device to evaluate balance and to receive one or more exercise plans tailored for improving balance of the human subject to reduce risk of falls.

41. The method of claim 40, further comprising:

loading and validating the sensor data comprising the gyroscope data and the accelerometer data;

correcting for orientation of the sensors;

determining cadence of the human subject'"'"'s gait, including (i) calculating a motion signal based on the accelerometer data and the gyroscope data (ii) detecting stationary time periods wherein the motion signal falls below a threshold value (iii) selecting a midpoint in each stationary time period and (iv) calculating cadence of each step between midpoints in each stationary time period;

determining gait parameters for the human subject based on computing stride length and step height for each step in the human subject'"'"'s gait based on the sensor data, including performing integration operations on the accelerometer data to acquire position data and calculating the human subject'"'"'s stride length and step height based on the position data;

calculating one or more of variability and asymmetry in the human subject'"'"'s gait based on the stride length, step height and the cadence for each step between midpoints in each stationary time period; and

storing the gait parameters and variability and asymmetry thereof in the system memory.

42. The method of claim 41, wherein said gait parameters include any selection of stride length, stride width, foot height, step cadence, walking speed, and measures of variabilities or asymmetries of stride length, stride width, foot height, step cadence and walking speed, wherein said variabilities or asymmetries include a measure of one or more of stride-to-stride variabilities or asymmetries and left-leg-to-right-leg variabilities or asymmetries.

43. The method of claim 41, wherein said determining one of said initial training program or said modified training program uses as data input at least said gait parameters of said human subject.

44. The method of claim 41, further comprising providing feedback to said human subject regarding the gait of said human subject during performance of said one or more balance evaluation exercises and balance training exercises, wherein said feedback is provided during said performance of said one or more balance evaluation exercises and balance training exercises.

45. The method of claim 40, wherein one or more sensors of said combination of sensors are configured to be attached to said human subject at one or more of ankles and upper body.

46. The method of claim 40, further comprising providing by said mobile device at least one of an auditory stimulus, a visual stimulus and a tactile stimulus to said human subject for providing feedback in real time to the human subject during performance of one or more of said balance evaluation exercises and said balance training exercises, the feedback including one or more of the gait parameters.

47. The method of claim 41, further comprising receiving software updates by said mobile communication device for at least one of said evaluation subsystem, said expert subsystem and said training subsystem, said software updates being sent by said remote subsystem.

48. The method of claim 47, wherein said software updates are sent daily and wherein said software updates include updates to said exercise plan.

49. The system of claim 47, wherein said remote subsystem is further configured to calculate gait parameters of said human subject from data collected from said sensors.

50. The method of claim 41, further comprising coupling a remote interface to one or more of said mobile communication device and said remote server via a wide area network, said remote interface being configured to permit one or more of monitoring the performance of said human subject and controlling the evaluation and training of said human subject.

51. The method of claim 50, further comprising sending from one or more of said mobile communication device and said remote server to said remote interface a message identifying a risk of falling of said human subject.

52. The method of claim 51, wherein said risk of falling is determined by one or more of said evaluation subsystem, said training subsystem and said remote subsystem from said balance capabilities of said human subject.

53. The method of claim 41, further comprising providing motivational messages to said human subject on said display unit of said mobile communication device wherein said mobile communication device further comprises an incentive subsystem for generating said motivational messages.

54. The method of claim 41, further comprising measuring movement of said human subject by device sensors during performance of one or more of an evaluation exercise and a training exercise, wherein said mobile communication device comprises the device sensors.

55. The method of claim 54, wherein said mobile communication device is adapted to be hand held by said human subject during performance of one or more of an evaluation exercise and a training exercise.

56. The method of claim 54, wherein said mobile communication device is adapted to be attached to said human subject during performance of one or more of an evaluation exercise and a training exercise.

57. The system of claim 54, wherein said sensors include one or more of said device sensors.

58. The method of claim 41, further comprising, before evaluating balance capabilities, collecting information from said human subject regarding self-reported age, physical activity level and level of confidence regarding ability to maintain balance during physical activity, assessing using said information by said evaluation subsystem a risk of falling of said human subject during balance evaluation exercises, and wherein when said risk is above a threshold, providing a warning by said mobile communication device to said human subject to have a human companion available to provide for the safety of said human subject.

59. The method of claim 41, further comprising communicating from said mobile communication device to said human subject a message identifying that said human subject is at risk of falling.

60. The method of claim 59, wherein said risk of falling is determined by one or more of said evaluation subsystem, said training subsystem and said remote subsystem from said balance capabilities of said human subject.