Method and apparatus for angular position and velocity based determination of body sway for the diagnosis and rehabilitation of balance and gait disorders

• US 5,919,149 A
• Filed: 03/14/1997
• Issued: 07/06/1999
• Est. Priority Date: 03/19/1996
• Status: Expired due to Term

• Current Assignee: Balance International Innovations GmbH
• Original Assignee: John H. Allum
• Inventors: Allum, John H.
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US08/818,319
• Time in Patent Office: 844 Days
• Field of Search: 600/587, 600/595, 73/862.042, 73/865.4
• US Class Current: 600/595
• CPC Class Codes: A61B 2505/09 Rehabilitation or training
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1117 Fall detection
• CPC Class Codes: A61B 5/1121 Determining geometric values, e.g. centre of rotation or angular range of movement
• CPC Class Codes: A61B 5/4023 Evaluating sense of balance
• CPC Class Codes: A61B 5/6823 Trunk, e.g., chest, back, abdomen, hip

Abstract

A method and apparatus for the diagnosis and rehabilitation of abnormal postural sway of a subject during standing or the performance of movement tasks is provided. Body sway sensors, such as angular velocity transducers, are attached to the body, such as the upper torso, of the subject. Output signals from the body sway sensors are transformed into detailed body sway angular displacement and velocity information by a system processor. The body sway angular displacement and velocity information may be displayed to an operator for diagnosis of the subject'"'"'s balance or gait disorders. The angular displacement and velocity information may also be provided as feedback to the subject, to augment the signals normally used by the subject'"'"'s brain to help stabilize body sway and improve balance. Rehabilitory feedback may be in visual, auditory, and/or tactile form, and/or in the form of electrical stimulation of the vestibular nerve. For visual feedback, a lightweight imaging system mounted on a pair of eyewear may be used to project a body sway angle and angular velocity feedback display into an eye of the subject. An angular position and velocity based body sway diagnosis system in accordance with the present invention may be used to monitor simultaneously the body sway of multiple subjects, and to provide rehabilitory feedback to such subjects, without interfering with or restricting the normal movement activities of the subjects.

Claims

1. A body sway monitoring system, comprising:

(a) a body sway sensor adapted to be attached to the body of a subject and providing continuous body sway signals indicative of the sway of the body;

(b) a system processor means for deriving continuous body sway information from the body sway signals and for generating an operator display of the body sway information; and

(c) an operator display means for displaying the operator display to an operator of the system.

2. The body sway monitoring system of claim 1 wherein the body sway sensor is adapted to be attached to the torso of the subject'"'"'s body.

3. The body sway monitoring system of claim 1 including a body sway sensor adapted to be attached to the body of the subject to provide body sway signals indicative of the sway of the body in a pitch direction and a body sway sensor adapted to be attached to the body of the subject to provide body sway signals indicative of the sway of the body in a roll direction.

4. The body sway monitoring system of claim 1 wherein the body sway sensor includes an angular velocity transducer providing body sway signals indicative of the angular velocity of the body.

5. The body sway monitoring system of claim 1 wherein the body sway sensor includes acceleration transducers providing body sway signals indicative of the angular acceleration of the body.

6. The body sway monitoring system of claim 1 wherein the body sway sensor includes a position transducer providing body sway signals indicative of the angular displacement of the body.

7. The body sway monitoring system of claim 1 wherein the system processor means includes means for deriving body sway angle and body sway angular velocity information from the body sway signals and means for generating an operator display of the body sway angle and body sway angular velocity information.

8. The body sway monitoring system of claim 7 wherein the system processor means includes means for generating an operator display including a time history of the subject'"'"'s body sway angle and body sway angular velocity over a trial period.

9. The body sway monitoring system of claim 1 wherein the system processor means further includes means for comparing the body sway information with a set of safety rules defining a cone of stability of the subject to obtain a measure of the subject'"'"'s balance control and for incorporating the measure of the subject'"'"'s balance control in the operator display.

10. The body sway monitoring system of claim 1 wherein the system processor means includes means for generating body sway feedback from the body sway information and further including a subject body sway feedback means for providing the body sway feedback to the subject.

11. The body sway monitoring system of claim 10 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject visually.

12. The body sway monitoring system of claim 11 wherein the means for providing the body sway feedback visually includes a head mountable subject display means for displaying a subject feedback display to the subject.

13. The body sway monitoring system of claim 10 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject aurally.

14. The body sway monitoring system of claim 10 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject through tactile stimulation of the subject'"'"'s body.

15. The body sway monitoring system of claim 10 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject through electrical stimulation of the subject'"'"'s vestibular nerve.

16. The body sway monitoring system of claim 10 wherein the system processor means includes means for comparing the body sway information with a set of safety rules defining an angular cone of stability of the subject and for incorporating a fall warning indication into the body sway feedback when the subject'"'"'s body sway exceeds an angle greater than a selected fraction of the angular cone of stability, and wherein the subject body sway feedback means includes means for providing the fall warning indication to the subject.

17. A system for providing augmenting prosthetic body sway feedback to improve a subject'"'"'s balance and movement control, comprising:

(a) a body sway sensor adapted to be attached to the body of a subject and providing continuous body sway signals indicative of the sway of the body;

(b) a system processor means for deriving continuous body sway information from the body sway signals and for generating body sway feedback from the body sway information; and

(c) a subject body sway feedback means for providing the body sway feedback to the subject.

18. The system of claim 17 wherein the body sway sensor is adapted to be attached to the torso of the subject'"'"'s body.

19. The system of claim 17 including a body sway sensor adapted to be attached to the body of the subject to provide body sway signals indicative of the sway of the body in a pitch direction and a body sway sensor adapted to be attached to the body of the subject to provide body sway signals indicative of the sway of the body in a roll direction.

20. The system of claim 17 wherein the body sway sensor includes an angular velocity transducer providing body sway signals indicative of the angular velocity of the body.

21. The system of claim 17 wherein the body sway sensor includes acceleration transducers providing body sway signals indicative of the angular acceleration of the body.

22. The system of claim 17 wherein the body sway sensor includes a position transducer providing body sway signals indicative of the angular displacement of the body.

23. The system of claim 17 wherein the system processor means includes means for deriving body sway angle and body sway angular velocity information from the body sway signals and means for generating the body sway feedback from the body sway angle and body sway angular velocity information.

24. The system of claim 17 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject visually.

25. The system of claim 24 wherein the means for providing the body sway feedback visually includes a head mountable subject display means for displaying a subject feedback display to the subject.

26. The system of claim 24 wherein the system processor means includes means for generating a subject feedback display including a central frame display and a bar that divides the central frame display into top and bottom fields and wherein the bar moves upward and downward in the central frame display when the subject'"'"'s body sways forward and backward and wherein an angle of the bar in the central frame display is varied in response to left and right sway of the subject'"'"'s body.

27. The system of claim 17 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject aurally.

28. The system of claim 17 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject both visually and aurally.

29. The system of claim 17 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject through tactile stimulation of the subject'"'"'s body.

30. The system of claim 17 wherein the subject body sway feedback means includes means for providing the body sway feedback to the subject through electrical stimulation of the subject'"'"'s vestibular nerve.

31. The system of claim 17 wherein the body sway feedback is related to the body sway information by feedback gain parameters, and comprising additionally means for adjusting the feedback gain parameters.

32. The system of claim 17 wherein the system processor means includes means for comparing the body sway information with a set of safety rules defining an angular cone of stability of the subject and for incorporating a fall warning indication into the body sway feedback when the subject'"'"'s body sway exceeds an angle greater than a selected fraction of the angular cone of stability, and wherein the subject body sway feedback means includes means for providing the fall warning indication to the subject.

33. A central monitoring system for monitoring the body sway of one or more subjects, comprising:

(a) a body sway sensor adapted to be attached to the body of each subject, each body sway sensor providing continuous body sway signals indicative of the sway of the subject'"'"'s body;

(b) a system processor means for deriving continuous body sway information for each subject from the body sway signals, for comparing the body sway information for each subject with a set of safety rules defining an angular cone of stability of the subject, and for generating a fall warning indication when a subject'"'"'s body sway exceeds an angle greater than a selected fraction of the angular cone of stability; and

(c) an operator display means for displaying the fall warning indication to an operator of the system.

34. The central monitoring system of claim 33 wherein the system processor means includes means for deriving body sway angle and body sway angular velocity information for each subject from the body sway signals and for generating an operator display of the body sway angle and body sway angular velocity information for each subject, and wherein the operator display means includes means for displaying the operator display.

35. The central monitoring system of claim 33 wherein the system processor means includes means for generating body sway feedback for each subject from the body sway information for each subject and further including a subject body sway feedback means for each subject for providing the body sway feedback to the subject.

36. The central monitoring system of claim 35 wherein the system processor means includes means for incorporating the fall warning indication into the body sway feedback, and wherein the subject body sway feedback means includes means for providing the fall warning indication to the subject.

37. The central monitoring system of claim 33 wherein the system processor means is remotely located from the subjects and further comprising wireless transmission means for transmitting the body sway signals from the body sway sensors to the system processor means.

38. A method for monitoring the body sway of a subject, comprising the steps of:

(a) attaching a body sway sensor to the body of a subject, the body sway sensor providing continuous body sway signals indicative of the sway of the body;

(b) deriving continuous body sway angle and body sway angular velocity information from the body sway signals and generating an operator display of the body sway angle and body sway angular velocity information; and

(c) displaying the operator display to an operator of the system.

39. The method of claim 38 wherein the body sway sensor is attached to the torso of the subject'"'"'s body.

40. The method of claim 38 wherein the step of attaching a body sway sensor to the body of a subject includes the steps of attaching a first body sway sensor to the body of the subject to provide body sway signals indicative of the sway of the body in a pitch direction and attaching a second body sway sensor to the body of the subject to provide body sway signals indicative of the sway of the body in a roll direction.

41. The method of claim 38 wherein the body sway sensor includes an angular velocity transducer providing body sway signals indicative of the angular velocity of the body.

42. The method of claim 38 wherein the body sway sensor includes acceleration transducers providing body sway signals indicative of the angular acceleration of the body.

43. The method of claim 38 wherein the body sway sensor includes a position transducer providing body sway signals indicative of the angular displacement of the body.

44. The method of claim 38 wherein the step of generating an operator display includes the step of generating a time history of the subject'"'"'s body sway angle and body sway angular velocity over a trial period.

45. The method of claim 38 comprising additionally the steps of comparing the body sway angle information with a set of safety rules defining a cone of stability of the subject to obtain a measure of the subject'"'"'s balance control and for incorporating the measure of the subject'"'"'s balance control in the operator display.

46. The method of claim 38 comprising additionally the step of comparing the body sway angle and angular velocity information to normal body sway information.

47. The method of claim 38 comprising additionally the step of comparing the body sway angle and angular velocity information to body sway information of the subject obtained during past performance of a particular task.

48. The method of claim 38 comprising the additional steps of generating body sway feedback from the body sway angle and angular velocity information and providing the body sway feedback to the subject.

49. The method of claim 48 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject visually.

50. The method of claim 48 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject aurally.

51. The method of claim 48 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject through tactile stimulation of the subject'"'"'s body.

52. The method of claim 48 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject through electrical stimulation of the subject'"'"'s vestibular nerve.

53. The method of claim 48 comprising additionally the steps of comparing the body sway angle information with a set of safety rules defining an angular cone of stability of the subject, generating a fall warning indication when the subject'"'"'s body sway exceeds an angle greater than a selected fraction of the angular cone of stability, and providing the fall warning indication to the subject.

54. A method for providing augmenting prosthetic body sway feedback to improve a subject'"'"'s balance and movement control, comprising the steps of:

(a) attaching a body sway sensor to the body of a subject, the body sway sensor providing continuous body sway signals indicative of the sway of the body;

(b) deriving continuous body sway angle and body sway angular velocity information from the body sway signals and generating body sway feedback from the body sway angle and angular velocity information; and

(c) providing the body sway feedback to the subject.

55. The method of claim 54 wherein the step of attaching a body sway sensor to the body of a subject includes the step of attaching a body sway sensor to the torso of the subject'"'"'s body.

56. The method of claim 54 wherein the step of attaching a body sway sensor to the body of a subject includes the steps of attaching a first body sway sensor to the body of the subject to provide body sway signals indicative of the sway of the body in a pitch direction and attaching a second body sway sensor to the body of the subject to provide body sway signals indicative of the sway of the body in a roll direction.

57. The method of claim 54 wherein the body sway sensor includes an angular velocity transducer providing body sway signals indicative of the angular velocity of the body.

58. The method of claim 54 wherein the body sway sensor includes acceleration transducers providing body sway signals indicative of the angular acceleration of the body.

59. The method of claim 54 wherein the body sway sensor includes a position transducer providing body sway signals indicative of the angular displacement of the body.

60. The method of claim 54 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject visually.

61. The method of claim 54 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject aurally.

62. The method of claim 54 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject through tactile stimulation of the subject'"'"'s body.

63. The method of claim 54 wherein the step of providing the body sway feedback to the subject includes the step of providing the body sway feedback to the subject through electrical stimulation of the subject'"'"'s vestibular nerve.

64. The method of claim 54 comprising additionally the steps of comparing the body sway information with a set of safety rules defining an angular cone of stability of the subject, generating a fall warning indication when the subject'"'"'s body sway exceeds an angle greater than a selected fraction of the angular cone of stability, and providing the fall warning indication to the subject.

65. A method for monitoring the body sway of one or more subjects, comprising the steps of:

(a) attaching a body sway sensor to the body of each subject, each body sway sensor providing continuous body sway signals indicative of the sway of the subject'"'"'s body;

(b) deriving continuous body sway information for each subject from the body sway signals, comparing the body sway information for each subject with a set of safety rules defining an angular cone of stability of the subject, and generating a fall warning indication when a subject'"'"'s body sway exceeds an angle greater than a selected fraction to the angular cone of stability; and

(c) displaying the fall warning indication to an operator of the system.

66. The method of claim 65 comprising additionally the steps of generating body sway feedback for each subject from the body sway information for each subject and providing the body sway feedback to the subject.

67. The method of claim 65 comprising additionally the step of providing the fall warning indication to the subject.