WO2011070322A1

WO2011070322A1 - An interactive rehabilitation computer peripheral system

Info

Publication number: WO2011070322A1
Application number: PCT/GB2010/002245
Authority: WO
Inventors: Martin Levesley; Bipin Bhakta
Original assignee: The University Of Leeds
Priority date: 2009-12-08
Filing date: 2010-12-08
Publication date: 2011-06-16

Abstract

An interactive rehabilitation computer peripheral system and method comprising computer communication means, at least one operating controller, operable to control an object, sensing means associated with one or more of the at least one operating controllers and operable to sense the position of the respective controller, and actuating means associated with one or more of the at least one operating controllers and operable to apply a force to, and/or detect a force from, the operating controller relative to at least one of the position of the object, the sensed position of the respective controller and the ability of the user.

Description

AN INTERACTIVE REHABILITATION COMPUTER PERIPHERAL SYSTEM

Field of the Invention The present invention relates to apparatus for rehabilitation of people who have disabilities and those who have impaired function, such as, for example, muscular disorders and musculoskeletal conditions including, but not restricted to, cerebral palsy, stroke, developmental coordination disorder (DCD), muscular dystrophy, and also people who have prosthetics.

In particular, the present invention relates to a computer based system that can be used in a variety of environments (home, school, hospital, community centres) for providing single user and collaborative exercise. Background to the Invention

Cerebral palsy is the commonest cause of severe physical disability in childhood. Similarly stroke is the commonest cause of severe disability in adults. Despite occupational therapy and physiotherapy resources within healthcare, community and schools, the delivery of sufficiently intense treatment for upper limb impairment is limited, reducing the person's (adult or child) chances of achieving full potential.

In 2003, a UK government Green Paper entitled "Every Child Matters" committed government to greater integration with help with the social care and education to improve provision and early intervention for children with disabilities. Furthermore, a paper entitled "Removing Barriers to Achievement" presented a vision for education of children with disabilities, highlighting the need for children to have opportunities to learn, play and develop alongside each other within their local communities (e.g. schools), pointing out that if they are supported within peer groups, children will be better able to develop social skills, thereby enabling them to participate in society. A key aspect of play is engagement in collective activity with peers, which is essential in skill acquisition and in gaining independence. However, varying levels of disability can be a barrier to engagement in collective activity.

Each year more than 110,000 people in England will have a stroke, which costs the National Health Service (NHS) over £2.8 billion. Up to 85% of these people experience varying degrees of arm weakness at onset. The present invention addresses the lack of upper limb exercise therapy for patients with arm weakness as a result of injury to the nervous system. The amount of exercise therapy determines the speed and completeness of patients' recovery. This is important because upper limb function contributes to independence and self esteem.

According to the present invention there is provided an interactive rehabilitation computer peripheral system comprising computer communication means, at least one operating controller, operable to control an object, sensing means associated with one or more of the at least one operating controllers and operable to sense the position of the respective controller, and actuating means associated with one or more of the at least one operating controllers and operable to apply a force to, and/or detect a force from, the operating controller relative to at least one of the position of the object, the sensed position of the respective controller and the ability of the user.

The actuating means is advantageously operable to apply at least one of a resistive or assistive force to the operating controller. The sensing means and the actuating means are advantageously operable in combination to at least substantially mitigate a disability of a user relative to a defined standard.

The defined standard may be at least one of a predetermined standard or a real- time standard of another user.

The operating controller may be a hand held device. The computer peripheral system may comprise a pair of hand held devices which are operable simultaneously.

The operating controller is advantageously detachably attachable. This provides for different shapes and characteristics of operating controller to be used with the system depending on the rehabilitation requirements of the user.

The, or each, operating controller is advantageously in the form of a regular household object on which rehabilitation is required. The regular household object may be, for example, a cup, kettle, a piece of cutlery or the like or a part thereof used for holding or gripping.

The, or each, operating controller advantageously comprises sensor means operable to monitor at least one of the orientation, velocity, position and acceleration of the operating controller.

The, or each, operating controller comprises sensor means operable to monitor at least one of the gripping force and dexterity applied to the operating controller. The operating controller may alternatively be adapted to enable assisted rotation of the upper limb of a user in the form of pronation and supination of the user's arm.

The interactive rehabilitation computer peripheral system may additionally comprise a chassis upon which one or more operating controllers are mountable.

Also according to the present invention there is provided a computer system comprising an interactive rehabilitation computer peripheral system as described above.

The computer system advantageously further comprises assessment means operable to evaluate a user's performance based on one or more predetermined parameters. The predetermined parameters may comprise at least one of position velocity and acceleration of the operating controller and force applied to the operating controller.

The object is advantageously a virtual object provided by a computer programme and is displayed on a visual display unit.

Accordingly, the present invention enables the user of the system to engage in functionally relevant exercises either individually with the system or while participating in an enjoyable social interaction with his/her peers whether the other participants have any form of impairment or not.

The movement performance of each participant can be assessed and the levels of assistance provided through the actuators adjusted according to the participant's personal profile. The interactive activities on the screen are also adjusted to level the playing field in collaborative mode.

Also according to the present invention there is provided a method of facilitating rehabilitation comprising: retrieving an electronically stored predetermined activity, running the retrieved activity on a computer and thereby displaying a virtual object on a computer visual display unit, controlling movement of the virtual object using an operating controller, sensing the user characteristics applied to the operating controller, communicating the sensed user

characteristics to the computer, comparing the communicated user

characteristics relative to a defined standard, calculating a feedback signal in response to the comparison, communicating the feedback signal from the computer to the operating controller, wherein the feedback signal comprises at least one of a resistive force and an assistive force to compensate for the characteristics of the disability of the user.

Sensing the user characteristics advantageously comprises determining at least one of period of time taken to complete the activity, the number of attempts taken to successfully complete a task, the accuracy achieved, the position of the controller, the velocity of the controller, the acceleration of the controller, the orientation of the controller, the gripping force applied to the controller and the consistency.

The defined standard advantageously comprises at least one of a predetermined standard relative to the users disability or a real-time standard of another user.

Also according to the present invention there is provided a computer program product comprising programme code instructions recorded on a medium readable by a computer, comprising computer readable programmatic means for performing the method above-mentioned method when the programme is running on a computer.

The present invention will now be described, by way of example only, with reference to the accompanying drawings, in which:

Figure 1 is a schematic drawing of an interactive rehabilitation computer peripheral system according to the present invention; Figure 2 is a drawing of an operating controller for use with the interactive rehabilitation computer peripheral system of Figure 1;

Figure 3 is a schematic drawing of computer system according to the present invention, incorporating the interactive rehabilitation computer peripheral system of Figure 1 ; and

Figure 4 is a drawing showing a preferred embodiment of an interactive rehabilitation computer peripheral system according to the present invention. The system, in accordance with the present invention, is primarily for use in rehabilitation and training of people with upper limb impairment, including, but not restricted to, cerebral palsy, stroke, developmental coordination disorder (DCD), muscular dystrophy, and people with prosthetics. For example, Hemiplegic disability affects one side of the body; the system of the present invention exercises the impaired arm and allows use of the other arm in bi-manual activities by means of a second hand held operating controllers containing one or a variety of input switches.

Referring to Figure 1 of the accompanying drawings, an interactive rehabilitation computer peripheral system 10 and computer system 12 comprises an operating controller 14 connected to a personal computer (PC) 16 and allows interaction between the user and computer software loaded on the computer 16. Referring also to Figure 2, the operating controller 14 comprises haptic interface equipment having an end point handle 18 linked by articulated arms 20 and 22 through a chassis housing 24 to a chassis (shown in Figure 4). The chassis allows one or more computer peripheral systems to move within a set workspace relative to the participant and is set to maximise motion. The workspace can be adjusted if needed both physically or through software, or if the participant improves the working area through using the system.

The handles 18 may be interchangeable thereby allowing a variety of functions, for example, a second handle can be incorporated to provide bimanual rehabilitation and exercise.

In alternative embodiments the user's dexterity can be assessed and developed by using one or more roller balls or push buttons as operating controllers. The computer peripheral system 10 also has actuators 26 which apply a resistive or assistive force to movement of the handle 18. Sensors 28 within the haptic interface device handle 18 and chassis allow tracking of the handle position and sense the force being applied to the handle. In this way a control loop is created which can be changed in real time to make the handle 18 move to different positions in the workspace.

The computer peripheral system also has a signal controller 30 for controlling the signals from the sensors 28 and to and from the actuators 26 and for communicating with the computer 16 to provide force feedback to guide the position of the handle 18. The system of sensors 28 is used to track the position of the handle and any other inputs via the controller 30 to the computer 16, such as the force being applied to the handle 18.

The controller 30 communicates with the computer 16 using a dedicated data acquisition device. The workspace and configurations of the handle 18, and hence the inputs of the sensors 28, are adjustable and dependent on the user's requirements and impairment and are programmable within the computer software.

The requirements of the computer peripheral system are dependent on the degree and nature of the user's impairment. Initial settings can be evaluated by physiotherapists locally or remotely using the system via a communication link. The configuration stage and maximum force can also be set using software loaded on the computer 16.

The computer 16 may be connected to a computer server 32 as part of a Local Area Network (LAN) or Client-Server network or connected to other remote servers via the internet.

Referring to Figure 3, in an alternative embodiment the computer system 12 comprises a plurality of computers 16¹ to 16ⁿ. Each computer 16¹ to 16ⁿ can receive and transmit signals from one or more controllers 30¹ to 30ⁿ. For example, as shown in Figure 3, computer 16¹ receives and transmits signals to both controllers 30¹ and 30², whereas computer 16" receives and transmits signals only from controller 30ⁿ. This type of set-up can be utilised for multi-user participation in that a plurality of operating controllers 10¹ to 10ⁿ may be connected - i.e. one to each signal controller 30 to 30ⁿ, respectively.

Each computer 16¹ to 16ⁿ may be stand alone or connected to a network 34 for accessing a remote server 32. Referring to Figure 4, one or more interactive rehabilitation computer peripheral systems 10¹ to 10ⁿ may be mounted on a chassis 36. In the example shown the chassis 36 provides for four user workstations at which a user can sit to participate. The chassis 36 also provides for mounting a visual display unit 38¹ to 38ⁿ for use with each user workstation.

In use, predetermined rehabilitation and/or exercise activities are stored on the computer 16 or the server 32. Alternatively, predetermined limb function assessment tasks or activities are stored on the computer 16 or server 32. A health professional selects an appropriate task or activity and runs it on the computer 16. The task or activity typically comprises controlling movement of a virtual object displayed on a computer screen. However, it will be appreciated that the present invention is equally applicable to a remote object such as a robotic or motorised object.

The system provides for a operating controller lock which ensures the operating controller is locked in a predetermined position until the user's arm and/or hand is correctly position thereon and no resistive or assistive force is provided until the user is correctly holding the handle 18. Once properly positioned the user controls the movement of the object in accordance with predetermined instructions or, alternatively, attempts to follow the movement of the object which is programmed to move in a predetermined manner in order to translate predetermined movements or exercises to the user's controlling limb or limbs. The user controls the object using the handle 18.

In an alternative embodiment the handle may be detachably attachable and may be in the form of different household objects, such as, for example, a cup, kettle etc., or parts thereof, for example, the handle, for the purpose of rehabilitation and training to use such objects.

As the user controls the handle 18, sensors 28 sense the characteristics being applied to the handle 18 by the user. Characteristics which are sensed include, but are not limited to, position, gripping force, velocity, acceleration and user tremor. These user characteristics are communicated to the signal controller 30 which in turn communicates then to the computer software stored on the computer 16. The computer software compares the communicated user characteristics with a defined standard which may be a predetermined standard relative to the impairment of the user or a real-time standard of another user who has previously participated or who is simultaneously participating. Having undertaken the comparison, the computer software generates a feedback through the signal controller 30 and the actuators 26 to provide a real-time resistive or assistive force to the handle 18.

The resistive and assistive feedback forces can be used to at least substantially mitigate any disadvantage a user may have due to his/her impairment relative to the standard task when participating alone or relative to another user.

Data in relation to the control accuracy and required assistive and resistive forces can be collected and stored and further programmes of activities can be developed therefrom to enhance the rehabilitation and training for the benefit of the user.

The computer software includes a base engine for underlying functions and a set of activity based tasks for the participant to be engaged with, in the form of actions or games. Preferred and advantageous features of the software include:

Data acquisition and interface device inputs - Inputs are important for moving elements of the activity relative to the handle position. Data acquisition is sufficiently accurate to control the position of the handle in a safe way;

Multimedia, including graphics and sound - Libraries within the software produce images on the computer screen using available graphics cards, and produce sound through the PC sound card. Local Area Networking and Client/Server Networking may be used to transmit data between two or more computers, allowing multi-user activities on a local network or through the internet.

Statistical data tracking - Storing measurements of the position, velocity, acceleration force applied etc and other important data that can be used in the evaluation of the user's performance. Interactive software - This enables interactive activities which engage participants in using the system. Collaboration with multiple players is also enabled.

The software can run in single user mode on a computer or in multi-player mode. Multi-player activity can be collaborative or competitive - The haptic force feedback provided by the software on the operating controller allows all players to take part in an activity on a more even playing field with varying amount of assistance to each player, depending on physical ability. The central server 32 can be a separate computer on a network or the internet, or the system can be set up on a single local computer but acts as the server and client. The server part in the system holds a data base, storing participant information, including:

1. Logins. The number of times a user logs in and when.

2. Time playing. Time per session and overall.

3. Number of attempts. How many times tasks are completed before moving to another level or scenario.

4. Accuracy. How accurately can a position in the handle be used when on task speed. How fast can the handle be moved, this being cross-linked to the accuracy of the movement.

5. Improvement. How has each participant improved using the system over a period of time. Clinical results are stored in clinical sessions for professionals to track improvement of function and effectiveness of the system.

Testing modes can build up a model of each participant for optimum assisted settings. This mode can also be used by to analyse current levels of ability.

The performance of tasks or activities can be carried out in individual mode or against the computer. The system allows groups of players to join in on an activity and play with or against each other, each with their own level of assistance. Each player has different assistance setting, depending on their arm functionality. Able-bodied participants may have no assistance, possibly even resistance, and someone with high impairment in the arm would have high assistance. Through this differential assistance, each participant can take part on a level playing field.

Group tasks and activities can be differentiated into two sections: collaborative and competitive. In collaboration, each member joins together to complete an activity or task or achieve a goal. In competition, each participant is working against each other to complete a goal and beat the other players.

The system, including the software, provides for the promotion of functional movement. The themes of each activity can vary depending on the interests of the participant. Users can choose from a number of designs based on user feedback and ideas. Within a task, there are options for levelling up or improving, thereby allowing the character of the user to develop. This is used as a motivation tool for the participants.

Professionals (e.g. physiotherapists etc) can set up limits for each participant manually. Through the system they can observe their progress and, using the statistical software, analyse movement. Physiotherapists can also join in with a task or activity. Teachers, parents and carers can also log in and participate within the multi-player activities. This can also be used as a motivational tool to encourage engagement.

Claims

1. An interactive rehabilitation computer peripheral system comprising computer communication means, at least one operating controller, operable to control an object, sensing means associated with one or more of the at least one operating controllers and operable to sense the position of the respective controller, and actuating means associated with one or more of the at least one operating controllers and operable to apply a force to, and/or detect a force from, the operating controller relative to at least one of the position of the object, the sensed position of the respective controller and the ability of the user.

2. An interactive rehabilitation computer peripheral system as claimed in claim 1 , wherein the actuating means is operable to apply at least one of a resistive or assistive force to the operating controller.

3. An interactive rehabilitation computer peripheral system as claimed in claim 1 or 2, wherein the sensing means and the actuating means are operable in combination to at least substantially mitigate a disability of a user relative to a defined standard.

4. An interactive rehabilitation computer peripheral system as claimed in claim 3, wherein the defined standard is at least one of a predetermined standard or a real-time standard of another user.

5. An interactive rehabilitation computer peripheral system as claimed in any of the preceding claims, wherein the, or each, operating controller is a hand held device.

6. An interactive rehabilitation computer peripheral system as claimed in claim 5, comprising a pair of hand held devices which are operable simultaneously.

7. An interactive rehabilitation computer peripheral system as claimed in any of the preceding claims wherein the operating controller is detachably attachable.

8. An interactive rehabilitation computer peripheral system as claimed in any of the preceding claims wherein the operating controller is in the form of a regular household object on which rehabilitation is required.

9. An interactive rehabilitation computer peripheral system as claimed in any preceding claim wherein the operating controller comprises sensor means operable to monitor at least one of the orientation, velocity, position and acceleration of the operating controller.

10. An interactive rehabilitation computer peripheral system as claimed in any preceding claim wherein the operating controller comprises sensor means operable to monitor at least one of the gripping force and dexterity applied to the operating controller.

11. An interactive rehabilitation computer peripheral system as claimed in any of the preceding claims wherein the operating controller is adapted to enable assisted rotation of the upper limb of a user in the form of pronation and supination of the user's arm.

12. An interactive rehabilitation computer peripheral system as claimed in any of the preceding claims comprising a chassis upon which one or more operating controllers are mountable.

13. A computer system comprising an interactive rehabilitation computer peripheral system as claimed in any of the above-mentioned claims.

14. A computer system as claimed in claim 13, further comprising assessment means operable to evaluate a user's performance based on one or more predetermined parameters.

15. A computer system as claimed in claim 14 wherein the predetermined parameters comprise at least one of position, velocity, acceleration and force of the operating controller.

16. A computer system wherein the object is a virtual object provided by a computer programme and is displayed on a visual display unit connected to the computer.

17. A method of facilitating rehabilitation comprising:

retrieving an electronically stored predetermined activity,

running the retrieved activity on a computer and thereby displaying a virtual object on a computer visual display unit,

controlling movement of the virtual object using an operating controller, sensing the user characteristics applied to the operating controller, communicating the sensed user characteristics to the computer,

comparing the communicated user characteristics relative to a defined standard, calculating a feedback signal in response to the comparison,

communicating the feedback signal from the computer to the operating controller, wherein the feedback signal comprises at least one of a resistive force and an assistive force to compensate for the characteristics of the disability of the user.

18. A method as claimed in claim 17, wherein sensing the user characteristics comprises determining at least one of period of time taken to complete the activity, number of attempts taken to successfully complete a task, the accuracy achieved, position of the controller, the velocity of the controller, the acceleration of the controller, the orientation of the controller, the gripping force applied to the controller and consistency.

A method as claimed in claim 17 or 18, wherein the defined standard comprises at least one of a predetermined standard relative to the users disability or a realtime standard of another user.

A computer program product comprising programme code instructions recorded on a medium readable by a computer, comprising computer readable programmatic means for performing the method of claims 17 to 19 when the programme is running on a computer.