METHOD AND APPARATUS FOR VIBROTACTILE MOTIONAL TRAINING EMPLOYING COGNITIVE SPATIAL ACTIVITY
A method and apparatus is disclosed for providing motional training, such as treatment of disequilibrium and movement and balance disorders, using cognitive spatial activity and by providing a subject with vibrotactile feedback in response to an attempt to perform the spatial activity.
This application is a continuation-in-part of U.S. application Ser. No. 12/201,778 filed Aug. 29, 2008 which claimed the benefit of U.S. Provisional Patent Application Ser. No. 60/966,997 filed Sep. 1, 2007 under 35 U.S.C. §119(e) for all commonly disclosed subject matter. U.S. application Ser. No. 12/201,778 and U.S. Application Ser. No. 60/966,997 are expressly incorporated herein by reference in their entirety to form a part of the present disclosure.
FIELD OF THE INVENTIONThe present invention relates generally to systems and methods for providing a subject with motional training and, more particularly, to a system and method for providing motional training, such as treatment of disequilibrium and movement and balance disorders, using cognitive spatial activity and by providing a subject with vibrotactile feedback in response to an attempt by the subject to perform the spatial activity.
BACKGROUND OF THE INVENTIONBalance, or a state of equilibrium, may be described as the ability to maintain the body's position over its base of support. In particular, the optimal posture for controlling balance typically requires maintaining the body's center of gravity (COG) within the base of support, such as the support frames defined by the soles. Balance may be divided into static balance and dynamic balance, depending on whether the base is stationary or moving.
Disequilibrium and movement and balance disorders can be debilitating and increase the potential for fall occurrences. A movement disorder is a condition that prevents normal movement. Some movement disorders are characterized by lack of movement, while others are characterized by excessive movement. A balance control disorder is typically the result of sensory and/or motor disorders which impair equilibrium control by a subject. Balance control disorders may be bilateral, i.e., affect a subject on both left and right sides, or may only be manifested on one side. Movement and balance disorders may be caused by disorders in the vestibular, somatosensory, visual or central or peripheral nervous systems.
The vestibular system carries sensory information related to body equilibrium, specifically roll, pitch, and yaw motion oriented relative to the direction of gravity. Information is generated by the semicircular canals and maculae in the inner ear, relayed by the vestibular nerve to the brainstem vestibular nuclei, and processed by the vestibular nuclei and mid brain with corresponding muscular contraction and relaxation known as motor output.
Aspects of the somatosensory system include: 1) perception of pressure, vibration, and texture, i.e., discriminative touch, 2) perception of pain and temperature, and 3) proprioceptive sensation. Proprioception, which is often referred to more generally as the somatosensory system, involves awareness of movement derived from muscular, tendon, and joint articular surfaces provided by the peripheral nervous system and processed in the parietal lobe of the brain. These interoception senses provide internal feedback on the status of the body, indicating whether the body is moving with required effort and indicating where various parts of the body are located in relation to each other. Thus, proprioception involves the essential stimuli provided to, or received by, skin, joints, and/or muscles to maintain equilibrium or balance control.
Damage to any part of the central or peripheral nervous systems may interfere with postural control of sway necessary for control of balance. Central nervous system processing includes the brain primary motor cortex responsible for generating the neural network impulses controlling execution of movement, the posterior parietal cortex responsible for transforming visual information into motor commands, the premotor cortex responsible for sensory guidance of movement and control of proximal and trunk muscles of the body, and the supplementary motor area responsible for planning and coordination of complex movements such as coordinated activity using two hands.
In particular, vision plays a significant role in balance. Indeed, up to twenty percent of the nerve fibers from the eyes interact with the vestibular system. A variety of visual dysfunctions can cause disequilibrium. These dysfunctions may be caused directly by problems in the eyes, or may be caused indirectly by disorders related to stroke, head injury, vestibular dysfunction, deconditioning, decompensation, or the like.
The peripheral nervous system generally relates to the conduction of sensory information, or messages, from the peripheral nerves to the brain and spinal cord. For example, such sensory information may indicate that there is a pressure on the sole of a foot or that a toe is flexed. Sensory information may also indicate that the feet are cold or that a finger is burned. Peripheral neuropathy relates to defects in the peripheral nervous system. In general, damage to the peripheral nervous system interferes with the communication of messages to the brain and spinal cord.
Accordingly, the body relies on the interaction of several systems to control movement, balance, and posture. For example, the vestibular system in the ears orient upright stance, especially when the eyes are closed. The cutaneous, proprioceptive sensory system feels pressure under the feet. In addition, the joint and muscle spindles are sensitive to joint position and movement. Moreover, cognition or brain processing estimates the motor response magnitude. In sum, balance disorders are predominantly multi-causal with imbalance occurring due to deficits in more than one sensory, motor, neuro or cortical pathway.
The cause and extent of any deficits in a subject's movement and balance control may be determined by assessing the subject's ability to control movement and balance while performing a number of standard functional motor tasks, such as standing still, moving from a sitting position to a standing position, walking, walking on steps and uneven surfaces, or the like. This assessment may be achieved by manipulating sensory input and monitoring motor response. Quantified sensory assessment, for example, may examine touch-pressure, two-point discrimination, inner ear response to warm and cold, or visual acuity by reading the print on an eye chart. Diagnosis may also be determined qualitatively according to the observations by an examining physician or a physical therapist.
After a balance deficit has been diagnosed and quantified, a physician may prescribe remedial measures to try and bring the subject's balance control near or within normal limits. In certain instances, the physician may prescribe medication that reduces the action of peripheral senses on the brain or enhance neural network function. Alternatively, the physician may prescribe a course of physical therapy, which will typically last at least several months, with the object of training the subject's brain to deal with a reduced sense of balance when trying to maintain the body upright and prevent a fall. Normally, neither of these techniques will have an immediate effect on the subject's balance deficit. Moreover, medication can have side effects, and can also reduce the capability of the brain to process balance information from the peripheral senses. A traditional course of physical therapy requires a long training period which may extend over more than two months. These difficulties and limitations associated with conventional remedial measures for dealing with balance deficits are most problematic when the subject is older and likely to have a falling tendency.
SUMMARY OF THE INVENTIONIn view of the foregoing, there is a need for a system and a method for rehabilitating disequilibrium and movement and balance disorders. One or more embodiments of the present invention are directed to systems and methods for motional training, such as for the treatment of balance disorders, in which vibrotactile feedback is provided to the subject in response to an attempt by the subject to perform predetermined motions. In an alternative embodiment, motional training is provided using one or more cognitive spatial activities with or without vibrotactile stimulation as feedback indicative of the effectiveness of the subject in performing the spatial activity.
One embodiment provides a method for providing motional training to a subject, comprising: providing one or more force plates each having at least one sensor; positioning a subject on the force plate(s); identifying a predetermined task for the subject to perform while positioned on the force plate(s) wherein the predetermined task is defined by one or more parameters; receiving signals produced by the at least one sensor in response to an attempt by the subject to perform the predetermined task; and, providing vibrotactile stimulation to the subject in the event of a variance between the signals and the parameters defining the predetermined task in which the vibrotactile stimulation is applied at one or more locations on the subject to induce one or more movements on the part of the subject in one or more directions in order to counteract the variance.
Another embodiment provides a system for providing motional training to a subject, comprising: one or more force plates that support a subject and provides force-plate-sensor signals while the subject performs at least one predetermined motion, the force-plate-sensor signals indicating the results of the attempt by the subject to perform the at least one predetermined motion; and one or more actuators that are configured to be coupled to the subject and that provide vibrotactile feedback to the subject indicating a variance, with respect to one or more directions, between the at least one predetermined motion and the results of the attempt by the subject to perform the at least one predetermined motion, the one or more actuators being spatially oriented with respect to the subject to indicate the one or more directions. The embodiment may further comprise one or more inertial sensors that are configured to be coupled to the subject and provide inertial-sensor signals while the subject performs the at least one predetermined motion, the inertial-sensor signals further indicating the results of the attempt by the subject to perform the at least one predetermined motion.
Still another embodiment of this invention comprises providing a force plate having at least one sensor; providing a controller coupled to the force plate which is operative to receive input signals from the at least one sensor and to transmit control signals to a moveable device such as a radio-controlled vehicle or other object capable of movement; positioning a subject having a center of pressure on the force plate; shifting the center of pressure of the subject on the force plate in one or more of forward, rearward and side-to-side directions and combinations thereof; receiving input signals produced by the at least one force sensor in response to shifting of the subject's center of pressure; and, transmitting a control signal in response to the input signals causing the moveable device to move in the same direction as the shift of the subject's center of pressure. Vibrotactile actuators may be located at different positions on the subject, each corresponding to one of the forward, rearward or side-to-side directions, or combinations thereof, which may be activated by the controller in the event the input signals vary from predetermined parameters of the subject's shifting of his or her center of pressure.
These and other aspects of the present invention will become more apparent from the following detailed description of the preferred embodiments of the present invention when viewed in conjunction with the accompanying drawings.
It is understood that although aspects of the present invention may be described with respect to the treatment of balance disorders, embodiments may be applied more generally to any type of motional training. It should also be evident that the systems and methods described herein may be used for non-medical activities such as sports, dance, or specific work task training.
Embodiments according to aspects of the present invention provide systems and methods for providing a subject with motional training. In particular, embodiments provide motional training by providing a subject with vibrotactile feedback in response to an attempt by the subject to perform predetermined motions.
The set of predetermined motions may correspond to a functional task, while each predetermined motion corresponds to a sub-task. The act of moving from a sitting position to a standing position is a known and well documented functional task. Other examples include standing, reaching for an object, getting out of bed, and tasks related to gait.
The embodiments provide spatial orientation and/or timing feedback cues via a vibrotactile mechanism to guide postural and mobility decisions. Real time vibrotactile feedback may be provided to cue appropriate motions by the subject. In addition, such feedback may also be used to correct abnormal movement that can occur during functional tasks. Unlike the prior art, the embodiments recognize that sensory feedback requirements are context sensitive, and thus employ vibrotactile stimulation that may vary by type, location, duration, etc. to provide information that relates closely to each stage of a the functional activity. Thus, in some embodiments, the vibrotactile feedback is provided according to specific, and often well-understood, sub-tasks, thereby restricting the context and simplifying the control intelligence.
For example, the approaches to motional training described herein may be employed to treat balance disorders. Subjects with balance disorders may be trained to perform basic functional tasks and sub-tasks, so that the subjects learn balance strategies and retain the skills needed to prevent falls. In general, aspects of the present invention take advantage of the brain's ability to re-organize and re-learn the functional tasks and sub-tasks. Thus, embodiments provide a tool by which a subject and a therapist may determine the limits of stability and understand how the subject can learn/relearn functional tasks and sub-tasks.
In addition, embodiments allow such tasks to be scripted from a set of defined sub-tasks tailored to a subject. In other words, embodiments provide for the design of new tasks or the concatenation of different sub-tasks together to define more complex tasks. Of particular interest are functional activities that involve transitional motion, i.e., the change from one motional condition to another. For example, the sit-to-stand task includes several sub-tasks: sit, upper body lean, transition to upright stance, and steady upright stance. The sequence from one stage to the next is transitional and thus requires well bounded temporal (timing) and spatial (kinematical) conditions to be achieved.
Moreover, because the object of clinical treatment is the transfer of knowledge and experience to the subject during the treatment, and the retention of transferred knowledge, embodiments facilitate dynamic modifications to accommodate the special needs of each subject and to adapt dynamically to challenge the subject to achieve new skill levels when the subject has mastered a certain tasks. This dynamic process is believed to be related to brain plasticity. Thus functional activities, after a training and evaluation period, may be repetitively practiced in a clinical setting using an environment that adaptively changes task difficulty as well as the number of tasks. Some embodiments also contemplate a take-home system that is programmed with the characteristics and requirements tailored to specific subjects, at a specific stage in their training or treatment, allowing subjects to continue balance training therapy in the home environment.
Referring now to
In general, the motional training system 10 may be operated with a controller 20, which may be any processing device, such as an intelligent controller, a conventional desktop computer or the like, that can execute programmed instructions provided on media, such as computer-readable memory. A visual display monitor 30 and a keyboard interface 31 may be connected to the controller 20 to provide a user interface. The therapist 40 may also operate aspects of the motional training system 10 via a remote interface 41 as shown in
The force plates 11a and 11b provide a technique for measuring body sway in terms of displacement of the center of pressure (COP), generated by the inherent instability of the subject 15 standing on the fixed support surface of the force plates 11a and 11b. The COP is computed from the signals provided by force transducers which are typically embedded in the corners the force plates 11a and 11b. The force transducer outputs are processed to obtain a projection of the resultant forces acting at the subject's center of gravity (COG) via the force plates 11a and 11b.
In general, a force plate is a sensor that measures the load at discrete points mounted beneath a relatively rigid plate. The load is usually measured using load-cell type sensors, converted into an electronic voltage signal and sampled using an analog to digital converter to be in a form suitable for computer or microcontroller processing. The response from one or multiple force plates can be combined using known analog to digital and mathematical algorithms implemented in computer software. The load cells and measurement conversion electronics in the embodiment of
Although the embodiment of
Although the sensors used in some embodiments may be limited to the use of force plates 11a and 11b, the embodiment of
Commercially available inertial sensors are typically provided with on-board intelligent processing, real-time signal filtering, and digital interfacing. In particular, each inertial sensor 12 or 13 may be a three-axis device that employs accelerometers and magnetometers. In some embodiments, the three-axis device may combine three-axis accelerometers with a magnetometer to provide a tilt sensor. In other embodiments, the three-axis device may employ gyroscopes to provide higher resolution than the tilt sensors, which are angular rate limited due to filtering and may be prone to drift.
The choice of sensor is based on the resolution and costs constraints. For example, the measurement of spine angle during a sit-to stand transition will require less resolution in clinical systems where the primary body orientation is measured using a force plate sensor. In this example, an accelerometer or low cost inertial device will provide sufficient accuracy for this task. However, for a stand-alone inertial sensor, a precision sensor (i.e. one that includes three axis accelerometers, gyroscopes and magnetometers) is preferably used.
There are some advantages in using multiple inertial sensors, particularly one mounted at the base of the spine and one just above the shoulder blades as shown in
There are advantages to combining inertial sensors (or multiple inertial sensors) with a force plate as shown in
In general, the motional training system includes one or more sensors that measure appropriate subject body orientation and approximate the location of the center of gravity. As described in detail below, sensor information is used together with knowledge of various functional activities to predict and compare the actual body response and posture during various stages of each particular functional task.
The selection of sensors may depend on whether the system is a clinical system or a more portable take-home system. In the clinical environment, a force plate or multiple force plate sensors is feasible.
Referring still to
The sense of touch is processed via the somatosensory (SI) cortex in the brain. Various cutaneous sensory regions are mapped to different areas of the SI cortex, making the sense of touch both intuitive and implicitly linked to motion. In other words, the sense of touch is intrinsically linked with the neuro-motor channel, both at the reflex and higher cognitive regions, and is thus uniquely tied to orientation and localization.
Accordingly, the actuators of the vibrotactile feedback mechanism 16 are arranged and coupled to the subject 15, so that the actuators provide body-referenced, spatial information to the subject 15. In particular, a direction or motion is mapped to a specific vibrotactile actuator, so that activation of the specific vibrotactile actuator and its associated location provide information with respect to that particular direction or motion. Motion may be also conveyed with a vibrotactile feedback mechanism 16 by the sequential and timed activation of a series of vibrotactile actuators, two or more actuators being spatially oriented with respect to the subject, so that the associated location and movement of vibrotactile stimulus provide information with respect to that particular rate and movement direction.
It has been demonstrated that tactile cueing is significantly faster and more accurate than comparable spatial auditory cues and is stable across a variety of body orientations, even when spatial translation is required. The vibrotactile feedback mechanism 16 is therefore an intuitive, non-intrusive feedback mechanism that may be more preferable to visual and audio cueing. In addition, temporal information can also be conveyed through the actuators in the vibrotactile feedback mechanism 16.
The controller 20 can be operated to drive the vibrotactile feedback mechanism 16 to provide feedback to the subject 15 during motional training. This feedback may include spatially oriented and body-referenced information, temporal information, information based on sequences or patterns of pulses, as well as information based on vibration frequency. As described previously, the spatially oriented and body-referenced information may include directional information based on the location of the vibrotactile stimulus. The temporal information may be provided according to pulse timing, where more rapid pulses indicate a greater urgency. Information based on vibration frequency may be provided according to high and low frequencies which can be discerned by the subject 15, where frequencies of approximately 250 Hz may, for example, indicate a greater urgency and frequencies less than 120 Hz may indicate less urgency.
The therapist 40 may interface with the controller 20 via the screen display 30 and the keyboard 31. However, to make it easier for the therapist 40 to monitor and assist the subject 15 during the motional training, the therapist 40 may alternatively use the remote interface 41 to control aspects of the motional training system 10 as described further below.
In addition, because the vibrotactile feedback mechanism 16 provides information directly to the subject 15 undergoing motional training, the motional training system 10 may provide the therapist 40 with a similar vibrotactile feedback mechanism 42 as shown in
An embodiment of a vibrotactile feedback mechanism 16 is illustrated in
The vibrotactile belt 55, for example, may be formed with a band 53 of stretch fabric with a fastener 50, which may include a hook-and-loop fastener, button, zipper, clip, or the like. A wire 52 extends between each pair of actuators 51 and is of sufficient of length to allow the band 53 to stretch when worn by the subject 15. In particular, the wire 52 may be looped or coiled and mounted to the belt 55. The actuators 51 are connected to control electronics 56 via a wire harness 54. The control electronics 56 may include a microcontroller with analog to digital converters, circuitry for interfacing with sensors, digital-to-analog converters, and a series of amplifiers. The actuators 51 are optimized for exciting the tactile response at the skin. In some embodiments, the actuators 51 are linear actuators.
This vibrotactile belt 55 may also employ additional sensors, such as direction sensors (not shown), which operate with the control electronics 56 and interface with the system controller 20, for example via the wireless data connection 21. Additional directional sensors may be used to determine the orientation of the subject 15 with respect to the force plates 11a and 11b to be used by the intelligent controller in motional tasks described hereinafter for the determination of vibrotactile feedback 16. Further, additional directional sensors may be used to determine the orientation of the subject with respect to the therapist 40 and to allow the vibrotactile feedback mechanism 42 on the therapist 40 to indicate the position of the vibrotactile feedback mechanism 16 on the subject. The position of the vibrotactile feedback mechanism 16 may be indicated to the therapist 40 in a format that is independent of or dependent on the orientation of the therapist 40.
As
It is noted that movement of the COP 63 can be caused when the subject sways, and movement by foot or other significant movement is not required. As such, the example embodiment illustrated by
During an example operation of the motional training system 10, the subject 15 attempts to move according to one or more motions defined as a part of the motional training, e.g., moving from a sitting position to a standing position to test static balance. These predetermined motions may make up all or part of a functional activity. The force plates 11a and 11b react to the attempt by the subject 15 to move according to the predetermined motions. In particular, the force plates 11a and 11b determine corresponding movement of the COP 63 and communicate this information to the controller 20. As discussed previously, thresholds may be visually defined on the display monitor 30 via the controller 20 in terms of segments 61 and arcs 62. In one embodiment, if the intelligent controller 20 determines that the COP 63 has moved beyond any of the segments 61 and past any of arcs 62, the controller 20 activates the actuator 51 corresponding to the segment 61. Thus, the subject 15 receives a vibrotactile stimulus, or feedback, when there is a variance between the location of the COP 63 and the segments 61 and the arcs 62.
Before operation, the COP 63 is initially zeroed, or reset, to align the axes 66 and the segments 61 over the COP 63. However, the axes 66 may also be zeroed after a subset of the predetermined motions during the motional therapy. The therapist 40 may zero the axes 66 and segments 61, for example, via the therapist remote interface 41 while monitoring the subject's attempt to perform a set of predetermined motions. The motional training system 10 allows the subject 15 to sequentially move from one region to another according to the set of predetermined motions, e.g. from a sitting position to a standing position and so on. Zeroing allows to each region, i.e., a subset of the predetermined motions. Otherwise, the thresholds would only apply to the set of predetermined motions as a whole.
The predetermined motions corresponding to a functional activity may require the subject 15, and thus the COP 77, to move from one area to another. Accordingly, in some embodiments, vibrotactile cueing may be employed to guide the subject 15 to the specific target area 71. In particular, using the motional training system 10, the subject 15 is encouraged via vibrotactile cueing to move his COP 77 until it reaches the target zone area 71. Vibrotactile cueing may initially activate the actuator 51 that corresponds to the segment facing the target 71. The activation of that actuator 51 causes the subject to turn toward the target area 71. Movement to the target area 71 may require the COP 77 to traverse an intermediate zone 78. Vibrotactile pulses may be modulated to indicate the range to the target area 71. For example, the vibrotactile feedback with a frequency of 250 Hz and duration of 300 ms may be pulsed initially at 0.1 Hz, pulsed at 1 Hz in the intermediate zone 78, and then pulsed at 5 Hz when the target area 71 is reached. Alternatively, vibrotactile pulses may be modulated to indicate the rate at which the COP 77 is approaching the target area 71. For example, the vibrotactile feedback with a frequency of 250 Hz and duration of 300 ms may be pulsed initially at 0.1 Hz, pulsed at between 1 Hz and 5 Hz based on the rate of COP 77 movement during movement in the intermediate zone 78, and then pulsed at 5 Hz when the target area 71 is reached.
Directional or navigation feedback may also be provided to the subject 15 using adjacent actuators 51. For example, if the COP 77 shown in the view 70 moves off target, i.e., out of the intermediate segment 78, into the adjacent segment 73 defined between segments 72 and 74, the corresponding actuator 51 associated with the segment 73 may be pulsed at a low frequency 15 Hz amplitude modulation to indicate that the subject is off target. Alternatively, directional feedback can be provided by activating the actuator 51 that corresponds to the segment 76, which is the segment on the opposite side of the intermediate segment 78. In this case, the vibrotactile cueing is provided as a “tether” and signals the subject 15 to move in the direction of the vibrotactile stimulation. As shown in the view 70, the representation 64 of the subject 15 positioned in the segment 73 would be drawn back to the segment 78 as the representation 64 moves toward the segment 76 in response to the activation of the actuator 51 corresponding to segment 76.
Further vibrotactile feedback can be communicated to the subject 15 to indicate to the subject is that the target area 71 has been reached. This vibrotactile feedback, for example, may include pulsing two front actuators 51 alternately, and then pulsing one back actuator 51. The subject 15 may learn the various messages associated with the vibrotactile feedback before the start of the motional training.
Once the target 71 has been reached, the therapist 40 may also elect to move the axes 79 and 76 to the new location 71 and revert to the view 60 as shown in
Embodiments of the present invention may be employed to treat stroke subjects with Pusher Syndrome. These subjects suffer from disturbed body orientation that drives both conscious perception of body orientation and abnormal muscle activation patterns or synergies. For example, subjects with Pusher Syndrome may perceive that their bodies are oriented in an upright position when in fact their bodies may be leaning by as much as 20 degrees towards the side of the brain lesion. When sitting or standing, the nonparetic extremities push lateral balance to the hemiparetic side. The phenomenon is present in approximately 79% of all acute strokes that resolves to 10% by 6 months (early intervention may eliminate Pusher Syndrome altogether), and is present in both left and right sided CVA. Subjects with Pusher Syndrome may have a normal perception of visual vertical, but they may be unable to perceive that their body posture may be leaning severely. Observations suggest that Pusher Syndrome affects the neurological pathway that is integral to sensing orientation of gravity and controlling upright body posture.
Treatment of subjects with Pusher Syndrome can be achieved by employing the vibrotactile feedback mechanism 16 to provide the subject a reference for body-orientation. If the subject shows a tendency to lean to a particular side, the length of the segment arc 62 corresponding to the opposite side is adjusted to be closer to the COP 63. The vibrotactile feedback mechanism 16 is set to activate the corresponding actuator 51 if the COP 63 moves over a particular segment arc 62. For example, if a subject leans to the right, segment 166 on the left side as shown in
Referring now to
The definitions of the functional tasks and sub-tasks, together with subject data, and user defined parameters are stored in a system database 252 and may be accessed 279 for the selection of a functional task 274. The system also permits multiple tasks 275 to be concatenated to create more complex functional task sequences. Once the task 274 and task combination have been selected, the functional activities are commenced 276. Depending on the activity the therapist may adjust various parameters for task or sub-task performance based on a visual assessment of the subject. For example, the therapist may change a threshold to encourage a subject to lean in a reach task. In other embodiments, the functional activity may be programmed to automatically adapt based on the context and performance of the subject in a particular set of tasks. Activities may be repeated 277 until completion 278. The performance of the subject during the functional activities may be stored for later evaluation and assessment in database 252.
Referring now to
As schematically illustrated in
The system controller 402 may be any processing device, such as a conventional desktop computer, capable of executing programmed instructions provided on media such as computer-readable memory. The controller 402 may be coupled via a USB connection 416 to the moveable device controller 404 or any other suitable connection. In the illustrated embodiment, the moveable device 408 is depicted in
In the embodiment illustrated in
The operation of the system 400 is illustrated with reference to
As noted above, the force plate 404 (or plates 11a, 11b) employed in the system 400 of this embodiment provides a means for measuring body sway in terms of displacement of the COP of a subject 15 standing on the force plate 404. This feature of the invention herein is employed to control the movement of the car 418 in each of a number of directions, i.e. forward, rearward, side-to-side and combinations thereof. Preferably, when the subject 15 stands in an upright or neutral position, the system controller 402 is operative to cause the moveable device controller 404 to transmit a “stop” signal to the car 418 so that it remains in a fixed position. In response to motion of the subject 15 in a forward direction, i.e. in the orientation of the subject 15 as depicted in
Viewing the car 418 in the same direction as would the subject 15 standing on the force plate 404, as illustrated in
Additionally, if permitted by the software in the moveable drive controller 404, the car 418 may be made to move in directions that combine forward motion, rearward motion, a right-hand turn and/or a left-hand turn shown in
It is contemplated that the therapist may begin rehabilitative activities employing the system 400 of this invention by instructing the subject 15 to perform simple forward and rearward movements of the car 418 and/or right-hand and left-hand turns. As the subject 15 progresses in his or her therapy, and if space permits, the therapist may choose to create a “course” on which the car 418 must be “steered” by the subject 15. Any number of different variations or how the subject 15 may be tasked with moving the car 418 may be employed by the therapist to add variety, interest and a measure of enjoyment to the rehabilitation process using the system 400 of this invention.
While the system 400 may be operated without a vibrotactile actuator mechanism 16, it is believed that particularly for subjects 15 who are relatively early on in the rehabilitation process it is advisable to equip them with a vibrotactile belt 55 having a number of vibrotactile actuators 51. In the same manner described in connection with a discussion of
While the invention has been described with reference to a preferred embodiment, it should be understood by those skilled in the art that various changes may be made and equivalents substituted for elements thereof without departing from the scope of the invention. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof.
For example, the connections between components of the apparatus illustrated in
Therefore, it is intended that the invention not be limited to the particular embodiment disclosed as the best mode contemplated for carrying out this invention, but that the invention will include all embodiments falling within the scope of the appended claims.
Claims
1. A method of providing motional training to a subject, comprising:
- (a) providing a force plate having at least one sensor;
- (b) providing a controller coupled to the force plate, the controller being operative to receive input signals from the at least one sensor and to transmit control signals to a moveable device;
- (c) positioning a subject having a center of pressure on the force plate;
- (d) shifting the center of pressure of the subject on the force plate in one or more of forward, rearward and side-to-side directions, and combinations thereof;
- (e) receiving input signals produced by the at least one sensor in response to step (d); and
- (f) transmitting a control signal in response to step (e) which causes the moveable device to move in the same direction as the shift of the subject's center of pressure.
2. The method of claim 1 in which step (b) includes providing a controller operative to the transmit control signals to a radio-controlled vehicle.
3. The method of claim 1 in which step (d) includes beginning with the center of pressure of the subject at a neutral position relative to one or more of the forward, rearward or side-to-side directions, and combinations thereof.
4. The method of claim 3 in which step (f) includes transmitting a control signal to the moveable device when the subject's center of pressure shifts to the neutral position which causes the moveable device to stop.
5. A method of providing motional training to a subject comprising:
- (a) providing a force plate having at least one sensor;
- (b) providing a controller coupled to the force plate, the controller being operative to receive input signals from the at least one sensor and to transmit control signals to a moveable device;
- (c) positioning a subject having a center of pressure on the force plate;
- (d) shifting the center of pressure of the subject on the force plate in one or more of forward, rearward and side-to-side directions, and combinations thereof;
- (e) defining parameters within which step (d) may be performed;
- (f) receiving input signals produced by the at least one sensor in response to step (d);
- (g) transmitting a control signal in response to step (f) which causes the moveable device to move in the same direction as the shift of the subject's center of pressure; and
- (h) providing vibrotactile stimulation to the subject in the event of a variance between the input signals and the parameters, the vibrotactile stimulation being applied at one or more locations on the subject to induce one or more movements on the part of the subject in order to counteract the variance.
6. The method of claim 5 in which step (h) comprises providing a number of vibrotactile actuators each coupled at a different location on the subject.
7. The method of claim 6 in which step (e) comprises defining the parameters by determining the maximum extent of shifting of the subject's center of pressure which is permitted in each of the forward, rearward and side-to-side directions, and combinations thereof.
8. The method of claim 7 in which each of the vibrotactile actuators is associated with the maximum extent of shifting of the subject's center of pressure in at least one of the forward, rearward and side-to-side directions, and combinations thereof.
9. The method of claim 8 in which step (h) comprises providing vibrotactile stimulation from each of the vibrotactile sensors that are associated with one or more of the forward, rearward and side-to-side directions, and combinations thereof, wherein the maximum extent of shifting of the subject's center of pressure is exceeded.
10. Apparatus for providing motional training to a subject, comprising:
- a force plate having at least one sensor, said at least one sensor being operative to produce input signals in response to shifting of the center of pressure of a subject positioned on said first plate in one or more of forward, rearward and side-to-side directions, and combinations thereof;
- a radio-controlled moveable device having a receiver;
- a controller coupled to said at least one sensor of said force plate, said controller being operative in response to receipt of said input signals to transmit control signals to said receiver thereby causing said moveable device to move in the same direction as the shift of the subject's center of pressure.
11. The apparatus of claim 10 in which said at least one sensor comprises a load cell mounted at each corner of said force plate.
12. The apparatus of claim 10 in which said radio-controlled moveable device is a radio-controlled vehicle.
13. The apparatus of claim 10 further including a number of vibrotactile actuators coupled to said controller, each of said vibrotactile actuators being adapted to be positioned at different locations on a subject.
14. The apparatus of claim 13 in which said input signals produced by said at least one sensor correspond to the direction in which the center of pressure of the subject is shifted.
15. The apparatus of claim 14 in which the location at which each of said vibrotactile actuators is positioned on the subject corresponds to one of said forward, rearward or side-to-side directions, or to combinations thereof.
16. The apparatus of claim 15 in which said controller is operative to compare said input signals to a predetermined maximum extent of shifting of a subject's center of pressure in any one or more of the forward, rearward and side-to-side directions and combinations thereof, said controller producing one or more activation signals in the event of a variance between any of said input signals and said predetermined maximum extent of shifting of a subject's center of pressure.
17. The apparatus of claim 16 in which said controller is operative to transmit an activation signal to each of said vibrotactile actuators which is positioned on the subject at a location corresponding to the direction in which shifting of the subject's center of pressure exceeds said predetermined maximum extent, each of said vibrotactile actuators when activated being effective to provide vibrotactile stimulation to a discrete location on the subject to induce one or more movements on the part of the subject in order to counteract said variance.
18. Apparatus for providing motional training to a subject, comprising:
- a force plate having at least one sensor, said at least one sensor being operative to produce input signals in response to shifting of the center of pressure of a subject positioned on said first plate in one or more of forward, rearward and side-to-side directions and combinations thereof;
- a radio-controlled moveable device having a receiver;
- a controller coupled to said at least one sensor of said force plate, said controller being operative in response to receipt of said input signals to transmit control signals to said receiver causing said moveable device to move in the same direction as the shift of the subject's center of pressure;
- a number of vibrotactile actuators coupled to said controller, each of said vibrotactile actuators begin positioned on the subject at a location corresponding to one of said forward, rearward or side-to-side directions, or to combinations thereof;
- said controller being effective to process said input signals to determine if there is a variance between the shifting of the subject's center of pressure and predetermined parameters within which said shifting is permitted to take place, said controller being operative to activate one or more of said vibrotactile actuators in the event of a variance to induce the subject to shift his or her center of pressure in order to correct said variance.
19. The apparatus of claim 18 in which said input signals produced by said at least one sensor correspond to the direction in which the center of pressure of the subject is shifted.
20. The apparatus of claim 19 in which the location at which each of said vibrotactile actuators is positioned on the subject corresponds to one of said forward, rearward or side-to-side directions, or to combinations thereof.
21. The apparatus of claim 20 in which said controller is operative to compare said input signals to a predetermined maximum extent of shifting of a subject's center of pressure in any one or more of the forward, rearward and side-to-side directions and combinations thereof, said controller producing one or more activation signals in the event of a variance between any of said input signals and said predetermined maximum extent of shifting of a subject's center of pressure.
22. The apparatus of claim 21 in which said controller is operative to transmit an activation signal to each of said vibrotactile actuator which is positioned on the subject at a location corresponding to the direction in which shifting of the subjects center of pressure exceeds said predetermined maximum extent, each of said vibrotactile actuators when activated being effective to provide vibrotactile stimulation to a discrete location on the subject to induce one or more movements on the part of the subject in order to counteract said variance.
Type: Application
Filed: Dec 6, 2011
Publication Date: Apr 19, 2012
Applicant: BALANCESENSE LLC (Maitland, FL)
Inventors: Karen L. Atkins (Celebration, FL), Jonathan D. Birck (Portland, OR)
Application Number: 13/311,924
International Classification: A63B 26/00 (20060101);