U.S. patent application number 11/639998 was filed with the patent office on 2007-04-19 for therapy system.
Invention is credited to John Michael Brassil, Thomas William Brassil.
Application Number | 20070087901 11/639998 |
Document ID | / |
Family ID | 37948844 |
Filed Date | 2007-04-19 |
United States Patent
Application |
20070087901 |
Kind Code |
A1 |
Brassil; Thomas William ; et
al. |
April 19, 2007 |
Therapy system
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.
Inventors: |
Brassil; Thomas William;
(San Diego, CA) ; Brassil; John Michael;
(Northbrook, IL) |
Correspondence
Address: |
Thomas Brassil
15855 Avenida Venusto #723
San Diego
CA
92128
US
|
Family ID: |
37948844 |
Appl. No.: |
11/639998 |
Filed: |
December 16, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10212485 |
Aug 5, 2002 |
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11639998 |
Dec 16, 2006 |
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09475793 |
Dec 30, 1999 |
6454681 |
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10212485 |
Aug 5, 2002 |
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09197035 |
Nov 21, 1998 |
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09475793 |
Dec 30, 1999 |
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60070380 |
Jan 5, 1998 |
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Current U.S.
Class: |
482/44 ;
482/49 |
Current CPC
Class: |
A63B 21/008 20130101;
A63B 21/02 20130101; A63B 2225/20 20130101; A63B 2220/54 20130101;
G16H 40/67 20180101; A63B 23/16 20130101; G16H 20/30 20180101; A63B
21/4025 20151001 |
Class at
Publication: |
482/044 ;
482/049 |
International
Class: |
A63B 23/16 20060101
A63B023/16; A63B 23/14 20060101 A63B023/14 |
Foreign Application Data
Date |
Code |
Application Number |
Sep 10, 1999 |
CA |
2,282,072 |
Claims
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.
Description
[0001] 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.
BACKGROUND OF THE INVENTION
[0002] 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.
[0003] 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.
SUMMARY
[0004] 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.
BRIEF DESCRIPTION OF THE DRAWINGS
[0005] 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:
[0006] FIG. 1 is a view of an exercise and therapy device in
accordance with one embodiment of the present invention;
[0007] FIG. 2 is a view of an embodiment delivering medication;
[0008] FIG. 3 is a view of an embodiment delivering pressurized
medication;
[0009] FIG. 4 is a view of an embodiment with an encapsulant or
pocket;
[0010] FIG. 5 is a view of an embodiment with an array of
electrodes;
[0011] FIG. 6 is a view of an embodiment which includes monitoring
means;
[0012] FIG. 7A is a view of another embodiment of the device of
FIG. 6 including multiple chambers within the compressible
substance;
[0013] FIG. 7B is a view of another embodiment of the device of
FIG. 7A wherein the multiple chambers of the compressible substance
are separated by walls;
[0014] FIG. 8 is a view of the embodiment of the device of FIG. 7A
and including a displacement transducer module of the embodiment of
FIG. 6;
[0015] FIGS. 9A and 9B are views of the device of FIG. 6
illustrating the displacement transducer module and line
configurations;
[0016] FIG. 10 is a block diagram of one embodiment of the therapy
system.
[0017] FIG. 11 is a functional block diagram of an embodiment of a
therapy system.
[0018] FIG. 12 a view of an embodiment of the compressor/pressure
transducer module.
[0019] FIG. 13 is a flow chart illustrating the steps for
generating information for facilitating therapy.
[0020] FIG. 14 is a view an embodiment of means for monitoring the
therapy.
[0021] FIG. 15 is a view of an embodiment of a display for
monitoring the therapy.
[0022] FIG. 16 is a view of an embodiment of a display for
monitoring the therapy.
[0023] Corresponding reference characters indicate corresponding
components throughout the several views of the drawings.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0024] 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.
[0025] 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 a glove
1. Included are a compressible substance 3, a proximate (to the
compressible substance) portion 4, finger portions 5, a distal (to
the compressible substance) portion 6, and elastic members 2. Each
elastic member 2 spans or extends from glove 1 to the compressible
substance 3. The compressible substance 3 provides resistance
during flexion, and the elastic members 2 provide resistance during
extension. Each elastic member 2 is coupled to the compressible
substance 3 and then spans to, and attaches to, the glove 1. In
another embodiment, the elastic members may be attached to the
proximate portion 4, through "slits" 13 formed in the compressible
substance 3 which the elastic members 2 pass through and then span
to and attach to the distal portion 6. Such slits 13 run through
the compressible substance 3. In FIG. 1, the dashed line 14
represents an elastic member 2 extended through the compressible
substance 3 and attached to the proximate portion 4 directly. Note
that only one of the slits 13 is shown, although multiple elastic
members 2 could extend through slits in the compressible substance
3. The elastic members 2 may be attached along an edge 8 of the
glove 1, between the proximate portion 4 and the distal 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.
[0026] Referring next to FIG. 2, a medication delivery device,
preferably a disposable glove, is shown with a cutaway window view.
The medication delivery device 202 includes an inner surface 210
and an outer surface 208. The interior surface 210 of the
medication delivery device 202 is coated with medication 212. The
system provides a massaging effect that will enhance medication 212
absorption into the skin. During extension, the elastic members 2,
pull the medication delivery device 202 closer to the wearer's
skin, whereby massaging the medication 212 pressed between the
medication delivery device 202, and the wearer's skin. During
flexion, the compressible substance 3, pushes the medication
delivery device 202 closer to the wearer's skin, whereby massaging
the medication 212 pressed between the medication 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. These medications 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 of medication 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 (see FIG.
5) can enhance circulation at the target site. The system also
offers advantages in the way that medication 212 is dispensed. For
examnple, medication dispensed as a bottle of 100 uncontrollable
pills, allows many more unsafe permutations than a single
disposable device 202, coated with site-specific medication 212.
Medication 214 may also be formed within the body of the medication
delivery device 202, especially if the medication delivery device
202 is formed with a sponge-like material. The inner surface 210
and body of the medication delivery device 202 could be formed with
a sponge-like material, while the outer surface 214 could be formed
with a less porous material. Advantageously, the medication
delivery device 202 operating under repetitious compression from
the compressible substance 3 and tension from the elastic members
2, dispenses and delivers medication 214, to the target site.
[0027] Referring next to FIG. 3, a medication delivery device,
preferably a glove, is shown with a cutaway window view. The
medication delivery device 302 includes an inner surface 310 and an
outer surface 308. In one embodiment, the inner surface 310 may
contain a medication 312. In another embodiment, a canister 314
provides medication under pressure, through a connecting tube 316.
The canister 314 may be pressurized, or may be connected to a
compressor/pressure transducer module (see FIG. 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 a
canister 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 the canister 314. So,
one group of patients could ingest an oral medication, and another
group could use the medication delivery device 302 to deliver a
similar medication directly to the target site. After a
predetermined time period, a fresh disposable device 302, operating
in vacuum mode, provides effluent from the target site which can be
retained in a canister 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.
[0028] Referring next to FIG. 4, a sectional view of a glove
embodiment 402 is shown. This embodiment provides an encapsulant
404 or pocket, within which the compressible substance 3 is
positioned. Additionally, the encapsulant 404 could have a cover
flap 406 that folds or seals over the compressible substance 3. The
compressible substance 3 under pressure from flexion exercise, may
force the cover flap 406 to become separated or unsealed from the
glove 402, thus dispensing and delivering medication 408 under
pressure emanating from the deflating compressible substance 3.
[0029] Referring next to FIG. 5, an exploded view of a glove
embodiment 502 with an array of electrodes 506 is shown. Electrodes
506 for providing a low level pulsed electric field, are coupled to
the interior surface 504 of the glove 502. The pulsed electric
field delivers materials, such as medication 508 and supplements,
through the skin; to the target site. The electrodes 506 are
connected to the signal generator 515 (see FIG. 10) by a cable 512.
A fluid medium carrying molecules or medication may be supplied
from the fluid medium source 514, which is coupled to the glove 502
by a tube 510 which may include a pump (see FIGS. 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.
[0030] FIG. 6 illustrates an embodiment providing means for
monitoring therapy. Shown is a monitored therapy system device 600,
embodied as a glove 602, with a proximate portion 604, finger
portions 606, distal portion 608, fingernail portion 610, wrist
portion 612, a compressible substance 614 that has a chamber 616
located within the compressible substance 614, a displacement
transducer module 618, a compressor/pressure transducer module 620,
a thermal transducer 622, lines 624, line guides 626, anchor 628,
fill tube 630, output means 632, and a computer 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 a transducer module 618, with
lines 624 extending therefrom. The lines are guided through line
guides 626 and are anchored at the anchor 628, which is located
distally at the fingernail portion 610. Force is monitored by a
compressor/pressure transducer module 620 affixed at the inside
wrist portion 612. The fill tube 630 extends from the
compressor/pressure transducer module 620 and into the compressible
substance 614 to the chamber 616 within the compressible 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
(see FIGS. 3 and 5). The elastic members (not shown) are also
present. Furthermore, the displacement transducer module 618 and
the compressor/pressure transducer module 620 link to a computer.
This embodiment illustrates an output means 632 connected to a
computer interface 634 as means for linking to a computer or
controller, as part of a monitored therapy system.
[0031] 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 a chamber 616 inside which is used to for
measuring pressure resulting from the force as applied onto the
compressible substance 614. The chamber 616 is filled with air, a
gas, a fluid or a gel through the fill tube 630 that extends from
the compressor/pressure transducer module 620 into the compressible
substance 614. The compressor/pressure transducer module 620 is
typically controlled by a separate controller. Thus, when pressure
is applied to the compressible substance 614, a portion of the
content within the chamber 616 is forced out through the fill 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 the compressible substance 614. This signal is output using
output means 632. Valves may be used at the entry of the fill tube
630 into the chamber 616 to help establish the required pressure
level within the chamber 616.
[0032] 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 the compressible substance 614 via a tube. The
timing and rate at which the compressor inflates or pressurizes the
chamber 616 within the compressible 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 the chamber 616 of the compressible 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.
[0033] 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 the fill tube 630 within the
compressor/pressure transducer module 620 so that the gas or fluid
that is forced from the chamber 616 of the compressible 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 the chamber 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 the computer 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.
[0034] The displacement transducer module 618 provides the means
for measuring motion or the distance traveled during extension and
flexion. One embodiment of a displacement transducer module 618 is
a rotary encoder system. Within the displacement transducer module
618, a shaft of the rotary encoder is coupled to a spool or roller
carrying the line 624. Ideally, the spool or roller is spring
loaded so that the line 624 is pulled tight from the anchor 628 to
the spool of the displacement transducer module 618. The distal end
of the lines 624 are attached to an anchor 628. The lines 624 pass
through respective line guides 626. Alternatively, the lines 624
may pass through a flexible protective tubing so as to protect the
lines during use.
[0035] 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 the line 624 returning through the line guides 626, or
a light-force spring return mechanism in the spool or roller would
return the line 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. The displacement transducer module 618 will
output a signal over output means 632 to the computer interface 634
that is proportional to or represents the displacement.
[0036] 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.
[0037] Additionally, a thermal transducer 622 is positioned within
the monitored therapy 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.
[0038] 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
the compressible substance 614. A therapy provider can monitor the
results of therapy sessions, and use the performance feedback to
make recommendations for enhancing the therapy.
[0039] 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 a proximate portion
702, wrist portion 708, finger portions 704 and distal portion 706,
the compressor/pressure transducer module 710, the compressible
substance 712 including chambers 714 and fill tubes 716 extending
through a main fill tube 718. Also shown are the elastic members
720. This embodiment provides a chamber within the compressible
substance 712 that is divided into separate chambers 714.
Similarly, instead of one fill tube, there is a separate fill tube
716 for each of the chambers 714. Each fill tube 716 extends
through the compressible substance 712 into the compressor/pressure
transducer module 710 via a main fill tube 718. Furthermore, the
compressor/pressure transducer module 710 actually contains
separate pressure transducers one for each chamber 714. The patient
or therapist may adjust the pressure within each of the respective
chambers 714. By adjusting the pressure, the delivery of medication
(not shown), and extraction of waste, can be controlled.
[0040] Referring next to FIG. 7B, is a view of another embodiment
wherein multiple chambers of the compressible substance are
separated by walls 715. This embodiment includes walls 715 that
separate the chambers 714 within the compressible substance 712. As
can be seen, walls 715 are molded in between the individual
chambers 714 of the compressible substance 712. Such walls 715 are
slightly more rigid than the remaining material of the compressible
substance 712 so that pressure applied to one chamber 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 the individual chambers 714 will be forced out of the
chamber 714 into the fill tubes 716, and not expand sideways into
adjacent chambers. The walls 715 should not be so rigid that they
do not allow the compressible substance to adequately be compressed
or squeezed. These walls 715 may be molded as described above while
the compressible substance 712 is being formed. Alternatively, the
walls 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 the elastic members 720
that extend through slits in the compressible substance 712. These
slits and elastic members are described with reference to FIG. 1.
Thus, the elastic members 720 would extend through the compressible
substance 712 and attach to the proximate portion of the glove,
while at the same time forming walls between chambers 714 of the
compressible substance 712.
[0041] Referring next to FIG. 8, is a monitored therapy system
device including a displacement transducer module. Shown is a
monitored therapy system device 800 embodied as a glove having a
back portion 802, a proximate portion, distal portion 804,
fingernail area 806, and wrist area 808. Also shown are the
compressible substance 810 including multiple chambers 812, and
fill tubes 814 within a main fill tube 816, the compressor/pressure
transducer module 820, displacement transducer module 822, lines
824, line guides 826, anchor 828, and the elastic members 830. The
individual chambers 812 within the compressible substance are
better illustrated including their positioning within the
compressible substance in FIG. 8. The fluid within each chamber 812
is forced through a respective fill tube 814 to a respective
pressure transducer within the compressor/pressure transducer
module 820 via the main 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 compressor
pressure transducer module 820 could be located separately and
attached by the fill tube 816. Thus, the compressor is coupled to
the fill 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 one chamber 812,
while waste or effluent could be vacuumed into and captured in
another chamber.
[0042] 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 monitored
therapy system device 900 embodied as a glove including the back
portion 902, finger portion 904, fingernail portion 906, lines 908,
line guides 910, anchors 912, and displacement transducer modules
914, 914' and 915 are output means 916. As shown and also as
described above, the lines 908 are a low stretch, monofilament or
wound thread that extends from the displacement transducer module
914 to the anchor 912 at the distal portion 906. The lines 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). The lines 908 are wound
onto a spring loaded spool or a spring tensioned roller such that
the lines 908 are held relatively tightly from the anchor 912 at
the distal end of the displacement measuring system and the
displacement transducer. The displacement transducer module 914
shown in FIG. 9A contains multiple displacement transducers and a
single output 916 which includes a computer interface (not shown).
The displacement transducer module shown in FIG. 9B is broken into
two separate modules, first displacement transducer module 914' and
second displacement transducer module 915. Again, output means 916
is shown, which is linked to a computer interface.
[0043] Referring next to FIG. 10, is a block diagram of the
monitored therapy system 1000. This embodiment of the monitored
therapy system 1000 includes the therapy device 1010, patient 1020,
sensing/communicating/controlling equipment ("SCCE") 1030, service
provider 1040, product provider 1050, financing provider 1060, and
communications provider 1070. The financing provider 1060 includes
Medicare 1062 but other embodiments could include various 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. The financing provider 1060 provides capital for the purchase
of products or services that a member, usually a patient 1020,
service provider 1040, or product 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. The financing 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 a
control panel 1037, feedback controller 1036, and transducers 1031.
The control panel 1037 includes a keyboard 1038 and display 1039.
The transducers include motion 1032, force 1033, sound 1034, and
temperature 1035. The therapy device 1010 includes an encapsulant
1011, compressible substance 1012, pneumatics/fluidics 1014,
elastic members 1016, medication 1017, electrodes 1018, and
preferably, a glove 1019. The service provider 1040 includes
diagnostics 1041, therapy 1042, and advice 1043. Advice providers
1043 includes training 1044, research 1045, and advertising 1046.
The product provider 1050 includes pharmaceutical 1052 and
equipment 1054. The communications provider 1070 includes well
known means for computing and communicating throughout the system,
allowing data processing and storage to occur at various points.
The monitored therapy system 1000 automatically provides
information that is useful for determining members' needs, helping
providers meet members' needs in a targeted manner. For example,
the advertising provider 1046 can provide targeted ads (not shown)
promoting product providers 1050, or service 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 the system 1000; not just for
the patients 1020, but also for providers. Advertising expenditure
information is readily available from SEC filing, prospectus,
annual report, and investor relations documents. Thus, the system
1000, offers patients 1020 and financing providers 1060 such as
Medicare 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, targeted
advice 1043, such as needs based training 1044, related research
1045, and personalized advertising 1046, based on information
provided by the system 1000, is a reasonable way to spend Medicare
1062 funds on passthroughs, if that advice 1043 meets specific
healthcare needs. The system 1000 includes incentives (not shown)
that financing providers 1060 can award to service providers 1040,
product providers 1050, and patients 1020 who, for example, promote
safety, or minimize unnecessary passthrough spending.
[0044] The patient 1020 interacts with a therapy device 1010, that
provides flexion resistance exercise, extension resistance,
exercise, massage, medication, and medication delivery control. The
electrodes 1018 receive signals from the SCCE 1030 that control the
transdermal delivery of medication 1017. The pneumatics/fluidics
module 1014 may also receive signals from the SCCE 1030 that
control pressure to inflate or deflate the compressible substance
1012, or deliver or remove medication 1017. In operation, the
monitored therapy 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 the
compressible substance 1012, and the delivery of medication 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 the SCCE 1030.
[0045] In this embodiment, both the patient 1020 and the therapy
provider 1042 are operators of the SCCE 1030. In other embodiments,
it may be advantageous for a training provider 1044, equipment
provider 1054, or pharmaceutical provider 1052 to interact directly
or remotely with the SCCE 1030 to help novice users. Both the
patient 1020 and the therapy 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, the therapy
provider 1042 will adjust the therapy parameters to reflect the
best plan of treatment. The therapy provider 1042 may interact
remotely through the SCCE 1030 to control the therapy device 1010,
or by making recommendations to the patient 1020 regarding
adjustments.
[0046] 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 the therapy 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. The SCCE 1030 might be a
standalone unit, located near the patient 1020, or it might be a
miniature battery operated controller that is integrated, for
example as an attachment to the therapy device 1010. The SCCE 1030
receives and generates signals to and from various sources
throughout the system 1000, and contains the algorithms necessary
to translate the signals from the various 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. The
SCCE 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. The SCCE 1030 also sends control
signals to the compressor to set the resistance. The SCCE 1030
translates the signals from the transducers 1031, and maintains
communications between the therapy 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. The control panel 1037 consists of knobs, buttons and
displays 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. The
control panel 1037 may be configured so that the patient 1020 or
therapy provider 1042 can: set the initial and final pressure
resistance level of the compressible 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 the SCCE 1030. Additionally, the control panel 1037 may provide
a display 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 or display 1039 of the SCCE 1030 itself depending on the
embodiment. The knobs, buttons and displays comprising the control
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.
[0047] 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 the
compressible substance 1012, motion, and the work being done. The
feedback 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 the
therapy device 1010 according to the therapy provider's 1042 or
patient's 1020 settings. The feedback controller 1036 contains
therapy data storage circuits, parameter storage circuits, and a
real time clock that permit it to operate autonomously.
[0048] The SCCE 1030 communicates with the therapy 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
the electrodes 1018, to control the delivery of medication 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. The SCCE 1030 also receives signals from the
transducers 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 of transducers 1031.
[0049] Additionally, the SCCE 1030 may perform communications via
the communications provider 1070, typically with a therapy provider
1042. Thus, the therapy provider 1042 may be located at another
location than the patient 1020. Advantageously, the patient 1020
may operate the monitored therapy system 1000 at home and be
simultaneously monitored by the therapy provider 1042. Thus, a
service provider 1040 can send signals to the SCCE 1030 via the
communications 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 as advice
providers 1043 or financing providers 1060 could connect to and
interact with. Thus, a financing 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, a financing 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.
[0050] 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.
[0051] The pneumatics/fluidics module 1014 receives signals from
the SCCE 1030, either generated by the therapy provider 1042 or the
patient 1020, to regulate the air or fluids going into and out of
the compressible substance 1012. Thus, the SCCE 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. The compressible
substance 1012 is also as described above and includes a flexible
enclosure containing one or more chambers within the compressible
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. The transducers 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 the SCCE 1030, along with the number and
speed of repetitions.
[0052] The patient 1020 wears the therapy device 1010 and interacts
with the compressible substance 1012 and elastic members 1016. The
system may include medication 1017 and electrodes 1018 on the
interior surface of the glove 1019. The electrodes 1018 are linked
to the SCCE 1030 to monitor and control the transdermal delivery of
the medication 1017. Precise estimates of drug absorption can be
transmitted and displayed for the patient 1020 on the display 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.
[0053] Referring next to FIG. 11, a functional block diagram is
shown of therapy system 1100 that uses a glove embodiment, as
described above with reference to FIGS. 6 through 9B. The therapy
system 1100 includes the therapist/patient 1102, computer 1104,
computer link 1106, controller 1108, glove 1110, and the hand 1112.
The controller 1108 includes a control panel 1114, feedback
controller 1116, and input/output 1118 (also referred to as IO
1118). The glove 1110 includes a pneumatics/fluidics module 1120,
the compressible substance 1122, and transducers 1124. The
therapist/patient block 1102 is coupled to the computer 1104 and
control panel 1114 of the controller 1108. The control panel 1108
is coupled to the feedback controller 1116 of the controller 1108
which is coupled to the input/output 1118 (IO) of the controller
1108. The computer 1104 is coupled to the IO 1118 of the controller
1108 via the computer link 1106. Furthermore, the IO 1118 of the
controller 1108 is coupled to the pneumatics/fluidics module 1120
of the glove 1110, which is coupled to the compressible substance
1122 of the glove. The transducers 1124 are coupled back to the IO
1118 of the controller 1108. The hand 1112 of the patient interacts
with compressible substance 1122 and the transducers 1124 of the
glove 1110.
[0054] 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 the patient 1110. Furthermore, it provides a means for
controlling the pressure resistance of the compressible substance
1122 of the glove 1110 automatically, so that therapy parameters
can be set and maintained automatically by the patient's or
therapist's interaction with the controller 1108.
[0055] 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
the glove 1110 in addition to being the operators of the hand
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 the hand therapy
system 1100 directly through the computer 1104 or remotely over a
computer network via the computer link 1106, such as the Internet
link. The computer 1104 is either physically integrated with the
controller 1108 in a monolithic enclosure, located in the vicinity
of the controller 1108, or connected to the controller 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. The computer 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.
[0056] The controller 1108 is the electronic brain of the hand
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). The controller 1108 receives signals from the
transducers 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). The controller 1108 contains an
embedded computer that manages the activities of the controller,
translates the signals from the transducers, and maintains
communications between the controller 1108, the glove 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.
[0057] The controller 1108 is comprised of the subsystems of the
feedback controller 1116, control panel 1114 and the IO 1118. The
control panel 1114 consists of knobs, buttons and displays that
allow the user to set therapy parameters and review therapy
outcomes.
[0058] 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 the compressible 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 the feedback controller
1116, such as PID (proportional, integral, derivative) constants;
store parameters for future use; and control the power to the
controller 1108.
[0059] 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.
[0060] The feedback controller 1116 allows the pressure resistance
of the compressible substance 1122 to be adjusted automatically in
dynamic response to predetermined pressure profiles and sequences,
existing pressure in the chamber/s of the compressible substance
1122, finger motion, and the work being done. The feedback
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 the glove
1110 according to the user's settings. The feedback controller 1116
contains therapy data storage circuits, parameter storage circuits,
and a real time clock that permit it to operate autonomously.
[0061] The IO 1118 allows the controller 1108 to communicate with
the glove 1110 and the computer 1104. The IO 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 the compressible 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. The IO 1118
also receives signals from the transducers 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 of transducers 1124.
[0062] Additionally, the IO 1118 may perform data communications
with the computer 1104 via the computer link 1106. The computer
1104 is typically the therapist's computer, which may be physically
attached to the controller 1108 through serial interfaces or may be
linked via a computer link 1106 to the controller. The computer
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 the hand therapy system 1100 at home and be simultaneously
monitored by the therapist online with the controller 1108. Thus,
the therapist can send signals from the therapists computer 1104 to
the controller 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 the glove 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.
[0063] 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).
[0064] The glove 1110 comprises the pneumatics/fluidics module
1120, the compressible substance 1122, and the transducers 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 the controller 1108, either generated by the therapist
or the patient, to regulate the air or fluids going into and out of
the compressible substance 1122. Thus, the controller 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.
[0065] The compressible substance 1122 is also as described above
and includes a flexible enclosure containing one or more chambers
within the compressible substance 1122. The multi-chamber
compressible substance as shown in FIGS. 7A through 8 would permit
resistance pressure regulation on a finger-by-finger basis, whereas
a single chamber, such as shown in FIG. 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.
[0066] 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
the controller 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 the controller 1108, and the number and speed of
repetitions.
[0067] The patient's hand 1112 fits within the glove 1110 and
interacts with the compressible substance 1122. The glove 1110 is
designed to snugly fit the patient's hand 1112 and contains the
transducers 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 the glove 1110.
The glove 1110 will fit properly to the patient's hand 1112 and
will provide resistance to motion that is therapeutically
appropriate. Furthermore, the glove 1110 will position and anchor
the transducers 1124 and compressible substance 1122 so that the
measurements are sufficiently accurate and precise.
[0068] Referring next to FIG. 12, a view is shown of the details of
the compressor/pressure transducer module described above. Shown
are a glove 1200, compressible substance 1202, first tube 1204, and
the compressor/pressure transducer module 1206. The
compressor/pressure transducer module 1206 includes a first 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 1220 and 1221, tubes 1222, 1224, 1226, 1228, 1230, 1232,
and 1234, wires 1236, 1238, 1240 and 1242, the interface port 1244,
and the interface means 1246. The first tube 1204 enters the
compressor/transducer module 1206 and is coupled to the first tee
1208. The vent solenoid 1212 is coupled to the first tee 1208 via
tube 1222 and is also coupled to filter 1220 via tube 1224. Tube
1226 couples the first tee 1208 to the second tee 1210. The second
tee is coupled to the pressure transducer 1216 via tube 1228 and
the pump solenoid 1214 via tube 1230. The pump solenoid 1214 is
coupled to the compressor 1218 via tube 1232. The compressor 1218
is coupled to the filter 1221 via tube 1234. Wire 1236 is coupled
from the vent solenoid 1212 to the interface port 1244, wire 1238
is coupled from the pressure transducer 1216 to the interface port
1244, wire 1240 is coupled from the pump solenoid to the interface
port 1244, and wire 1242 is coupled from the compressor 1218 to the
interface port 1244. The interface means 1246 links to the
interface port 1244 and is the input to a computer system, e.g. the
SCCE of FIG. 10.
[0069] In practice, the compressor/transducer module 1206 pumps
materials, such as gas, air, fluids, or gels into the chamber or
chambers (not shown) of the compressible 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 the
compressible substance 1202. The embodiment shown in FIG. 12
inflates the chamber/s of the compressible substance, 1202 with air
or another similar gas.
[0070] In order to inflate the chamber/s within the compressible
substance 1202, the compressor 1218 pulls air through the filter
1221 via tube 1234 and forces the air out through tube 1232. The
compressor, which is a miniature mechanical compressor as described
above with reference to FIG. 6, e.g. rotary vane pump, is
controlled or activated by control signals sent through wire 1242.
Furthermore, the compressor 1218 may be reversible, such that it
may assist in the deflation of the compressible substance 1202. The
pump 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 the
compressor 1218, such that when the compressor is "pumping" to
inflate the chambers within the compressible substance 1202, the
pump solenoid 1214 is open to allow the compressor 1218 to force
the air therethrough. Alternatively, pinch valves may be used
instead of the solenoids as described above with reference to FIG.
6. The air is pumped through tube 1230 and through the second tee
1210 into tube 1226 and the first tee 1208. The air continues
through the first tee 1208 and into the first tube 1204 which is
fed into the chambers of the compressible substance 1202 in order
to inflate the chambers to a desired pressure level.
[0071] Air is also pumped into tube 1222 from the first tee 1208 to
the vent solenoid 1212, which acts as a valve; however, during the
"pumping" of the compressor 1218, the vent solenoid 1212 is closed
such that the air will not be allowed to flow through the vent
solenoid 1212. The vent solenoid 1212 is controlled via signals
sent through wire 1236.
[0072] Furthermore, air is forced against the port of the pressure
transducer 1216 through tube 1228 of the second tee. The pressure
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. The pressure
transducer 1216 is used during inflation to determine when the
desired pressure (e.g. desired psi) within the compressible
substance 1202 has been reached. Wire 1238 of the pressure
transducer 1216 transmits the voltage signals proportional to the
pressure within tube 1228 to the controlling computer (to translate
the signals into estimation of pressure) through the interface port
1244 and the interface means 1246. Such information is used to
control the switching on and off of the compressor 1218. The
compressor 1218 is well known in the art as described with
reference to FIG. 6.
[0073] Once the pressure within the chambers of the compressible
substance 1202 is at the desired level, i.e. the pressure at the
pressure transducer 1216 is at the desired level, the pump solenoid
1210 is closed and the patient squeezes the compressible substance
1202, which forces air back into the first tube 1204 and causes
more pressure to be placed upon the pressure transducer 1216. Thus,
the pressure transducer 1216 sends voltage signals which are
proportional to the additional pressure within the system, which
can be translated, by the controller of FIG. 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.
[0074] Additionally, the vent solenoid 1212 may be employed to vent
the system; thus, allowing rapid deflation of the compressible
substance 1202 upon completion of the therapy. In this case, the
vent solenoid 1212 is opened, while the pump solenoid 1214 is
closed. Thus, the air contained within the compressible substance
1202 and the system will be pushed out through tube 1222, through
the vent solenoid 1212, through tube 1224, and out of the
compressor/transducer module 1206 through filter 1220.
[0075] 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 the compressible
substance 1202 via the first tube 1204. Alternatively, the
compressor/pressure transducer module 1206 may be integrated onto
the body of the glove, as described above with reference to FIG. 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 the compressible substance 1202
by attaching gas canisters or fluid reservoirs at the locations of
the filters 1220 and 1221, for example (see FIG. 3).
[0076] Furthermore, for a compressible substance 1202 including
more than one chamber, e.g. one chamber for each finger, there are
five separate 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 the compressible 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.
[0077] 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).
[0078] 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 to FIG. 10, financing
providers 1060, such as Medicare 1062, are paying for factors
employed by product providers 1050, such as equipment providers
1054, who employ broadcast advertising 1046, and Medicare
processing advice 1044, which increases the prices Medicare 1062
and patients 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.
[0079] Referring to FIG. 14 is a view an embodiment of means for
monitoring the therapy system. The screen display 1400 receives and
displays information from the controller 1402. The controller 1402
receives information from the patient. In this instance, the
patient positions a member incentive card 1404 so as to be readable
by the controller 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 to FIG. 10) the
financing provider 1060, service provider 1040, or product provider
1050. In this embodiment, the incentive 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.
[0080] Referring next to FIG. 15 is a screen display view of remote
therapy in operation. A side window 1502 displays therapy related
information; in this view the therapist is speaking to the patient.
Content topics or menus 1504 provide means for choosing therapy
related information. Buttons let the patient start as new session
1506; save a session 1508; send a stored session as an email
attachment 1510; review a previous session 1512; or review therapy
progress 1514. The main 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, the main 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.
[0081] FIG. 16 is another embodiment of a screen display of a
remote therapy session in operation. A side window 1602 displays
performance metrics. The internet 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 main window title bar 1606 displays information about the
patient and the therapy session, along with information about the
incentive level. The main 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.
[0082] 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.
* * * * *