Methods and Apparatus for Rehabilitation and Training

• US 20070282228A1
• Filed: 02/04/2005
• Published: 12/06/2007
• Est. Priority Date: 02/05/2004
• Status: Active Grant

• Current Assignee: Motorola, Inc. (Motorola Solutions, Inc.)
• Original Assignee: Motorola, Inc. (Motorola Solutions, Inc.)
• Inventors: Einav, Omer, Einav, Haim, Rousso, Benny, Shabanov, Doron, Katzir, Eran, Binyamini, Gad
• Granted Patent: US 8,012,107 B2
• Time in Patent Office: Days
• US Class Current: 601/33
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• CPC Class Codes: A61B 5/224 Measuring muscular strength
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61H 1/0237 for the lower limbs
• CPC Class Codes: A61H 1/0262 Walking movement; Appliances for aiding disabled persons to walk A61H3/00 takes precedence
• CPC Class Codes: A61H 1/0274 for the upper limbs
• CPC Class Codes: A61H 1/0296 Neck
• CPC Class Codes: A61H 2201/0184 by raising an alarm
• CPC Class Codes: A61H 2201/1215 Rotary drive
• CPC Class Codes: A61H 2201/1238 with hydraulic or pneumatic drive
• CPC Class Codes: A61H 2201/1607 Holding means therefor
• CPC Class Codes: A61H 2201/1611 Holding means therefor
• CPC Class Codes: A61H 2201/1635 Hand or arm, e.g. handle hand-held, A61H2201/0153; fore-arm support, A61H2003/006
• CPC Class Codes: A61H 2201/1638 Holding means therefor
• CPC Class Codes: A61H 2201/1642 Holding means therefor
• CPC Class Codes: A61H 2201/1659 Free spatial automatic movement of interface within a working area, e.g. Robot
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/501 : connected to external computer devices or networks
• CPC Class Codes: A61H 2201/5023 : Interfaces to the user
• CPC Class Codes: A61H 2201/5038 : freely programmable by the user
• CPC Class Codes: A61H 2201/5043 : Displays
• CPC Class Codes: A61H 2201/5048 : Audio interfaces, e.g. voice or music controlled
• CPC Class Codes: A61H 2201/5058 : Sensors or detectors
• CPC Class Codes: A61H 2201/5061 : Force sensors
• CPC Class Codes: A61H 2201/5064 : Position sensors
• CPC Class Codes: A61H 2201/5069 : Angle sensors
• CPC Class Codes: A61H 2201/5092 : Optical sensor
• CPC Class Codes: A61H 2230/065 : used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/085 : used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/425 : used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/505 : used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/655 : used as a control parameter for the apparatus
• CPC Class Codes: A63B 2022/0094 : for active rehabilitation, e.g. slow motion devices
• CPC Class Codes: A63B 2024/0078 : Exercise efforts programmed as a function of time
• CPC Class Codes: A63B 2071/065 : Visualisation of specific exercise parameters
• CPC Class Codes: A63B 21/00178 : for active exercising, the apparatus being also usable for passive exercising
• CPC Class Codes: A63B 21/00181 : comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
• CPC Class Codes: A63B 21/0058 : using motors
• CPC Class Codes: A63B 21/4021 : to the wrist
• CPC Class Codes: A63B 21/4043 : Free movement, i.e. the only restriction coming from the resistance A63B21/00043, A63B21/072 take precedence
• CPC Class Codes: A63B 21/4047 : Pivoting movement weight pivoting A63B21/0615
• CPC Class Codes: A63B 2220/13 : Relative positions
• CPC Class Codes: A63B 2220/16 : Angular positions
• CPC Class Codes: A63B 2220/50 : Force related parameters
• CPC Class Codes: A63B 2225/50 : Wireless data transmission, e.g. by radio transmitters or telemetry
• CPC Class Codes: A63B 23/03508 : For a single arm or leg, A63B21/0726 takes precedence
• CPC Class Codes: A63B 23/1209 : Involving a bending of elbow and shoulder joints simultaneously
• CPC Class Codes: A63B 71/0009 : for handicapped persons
• CPC Class Codes: G09B 23/28 : for medicine
• CPC Class Codes: G09B 23/32 : with moving parts
• CPC Class Codes: G16H 20/30 : relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising

Abstract

Apparatus for rehabilitating a patient who has a paretic body part, the apparatus comprising: a) at least one electromyography (EMG) sensor adapted to being applied to a voluntary muscle of a healthy body part of the same type as the paretic body part which at least one sensor produces at least one EMG signal; b) a neuromuscular electrical stimulation (NMES) device adapted to stimulating at least one voluntary muscle of the paretic body part; and c) a controller which controls the NMES device, making the amplitude of stimulation of the paretic body part at least partly dependent on the EMG signal from the healthy body part.

Claims

1. A method of rehabilitation comprising:

providing an actuator that includes a movement mechanism capable of applying a force that interacts with a motion of a patient'"'"'s limb in a volume of at least 30 cm in diameter, in at least three degrees of freedom of motion of the actuator and capable of preventing substantial motion in any point in any direction in said volume;

coupling said actuator to a point on a human body;

applying a force vector to said point by said actuator, said force including a rotation.

2. A method according to claim 1, wherein said force vector includes at least two rotations directions relative to the force vector.

3. A method according to claim 1, comprising applying a second force to at least a second point on said body, simultaneously with said force.

4. A method of rehabilitation comprising:

providing a first actuator that includes a movement mechanism capable of applying a force that interacts with a motion of a patient'"'"'s limb in a volume of at least 30 cm in diameter, in at least three degrees of freedom of motion of the actuator and capable of preventing substantial motion in any point in any direction in said volume;

coupling said first actuator to a first point on a human body;

providing a second actuator that includes a movement mechanism capable of applying a force that interacts with a motion of a patient'"'"'s limb in a volume of at least 30 cm in diameter, in at least three degrees of freedom of motion of the actuator and capable of preventing substantial motion in any point in any direction in said volume;

coupling said second actuator to a second point on a human body; and

applying different forces to said points using said actuators.

5. A method according to claim 4, wherein said first actuator applies a rotation.

6. A method according to claim 4, wherein said different points are on a same limb.

7. A method according to claim 4, wherein said different points are on different limbs.

8. A method according to claim 7, comprising exercising the two limbs in concert.

9. A method according to claim 7, comprising copying motion from one limb to the other limb.

10. A method of reverse kinematics, comprising:

controlling motion of at least one point on an organ using an actuator that includes a movement mechanism capable of applying a force that interacts with a motion of a patient'"'"'s limb in a volume of at least 30 cm in diameter, in at least three degrees of freedom of motion of the actuator and capable of preventing substantial motion in any point in any direction in said volume;

controlling a position of at least a second point on the organ; and

reconstructing by a computer of a value of a bending of at least one joint of said organ from said motion and said position.

11. A rehabilitation device, comprising:

an actuator that includes a movement mechanism capable of applying a force that interacts with a motion of a patient'"'"'s limb in a volume of at least 30 cm in diameter and capable of preventing substantial motion in any point in any direction in said volume;

a support for a patient; and

a controller adapted to adjust a rehabilitation exercise according to the relative positions of said actuator and at least one of said patient and said support.

12. A device according to claim 11, comprising a distance sensor for determining said relative positions.

13. A device according to claim 11, comprising an imaging sensor for determining said relative positions.

14. A device according to claim 11, wherein said controller relates to the relative placement of said patient and said actuator.

15. A device according to claim 11, wherein said controller assumes the relative positions differ only in two dimensions.

16. A device according to claim 11, comprising a pointer which indicates a desired patient placement.

17. A device according to claim 11, wherein said controller is configured to use said actuator to determine said relative placement.

18. A device according to claim 11, wherein said controller is configured to use said actuator to indicate a desired relative placement.

19. A device according to claim 11, wherein said controller is configured to adjust said exercise on the fly, during an exercise session and in response to patient movement.

20. A rehabilitation device, comprising:

a memory storing therein a correspondence between exercises and payment codes;

a controller adapted to control a rehabilitating exercise and generate a report including a code from said memory corresponding to said exercise.

21. A rehabilitation device, comprising:

at least one actuator adapted to support motion of a body part;

at lest one sensor associated with the actuator and measuring said motion; and

a controller which analyses said measured motion and generates a measure of quality of motion and which modifies a rehabilitation plan responsive to said quality of motion measure.

22. A device according to claim 21, wherein the controller modifies a selection of future exercises according to a measured quality of motion.

23. A device according to claim 21, wherein the controller modifies a selection of parameters for future exercises according to a measured quality of motion.

24. A device according to claim 21, wherein the quality of motion measure used is defined as the degree of matching to a 2/3 power law.

25. A method of rehabilitation, comprising:

causing a person to carry out at least one exercise;

estimating a mental state of said person from a result of said at least one exercise; and

automatically selecting at least one second exercise according to said estimation.

26. A method according to claim 25, wherein estimating a mental step comprises comparing performance between two exercises, one or which is expected to elicit a higher compliance.

27. A method according to claim 25, wherein estimating a mental step comprises comparing performance within an exercise, using the maximum ability of the patient as a base line against which variation can be determined.

28. A method according to claim 25, wherein said estimating is automatic.

29. A method of rehabilitation, comprising:

determining a patient'"'"'s ability to perform a motor task;

determining a patient'"'"'s ability to perform a non-motor task; and

automatically selecting an exercise or parameters of an exercise for the patient according to said determinations.

30. A method according to claim 29, wherein said selecting comprises matching an instruction or feedback modality to a perceptive ability.

31. A method according to claim 29, wherein said selecting comprises matching an instruction or feedback modality to a cognitive ability.

32. A method according to claim 29, wherein said selecting comprises an exercise or series of exercises designed to rehabilitate both of said motor and said non-motor abilities.

33. A method according to claim 29, wherein said exercise rehabilitates visual-motor coordination.

34. A method of rehabilitation comprising;

moving a motorized actuator having a tip to a spatial position within a volume having a diameter of at least 30 cm, wherein said actuator is capable of preventing substantial motion in any point in any direction in said volume; and

instructing a patient to apply force against said tip, wherein said actuator provides a compliant resistance to said force.

35. A method according to claim 34, comprising selecting the resistance according to the spatial location.