Note: Descriptions are shown in the official language in which they were submitted.
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METHOD AND APPARATUS FOR MONITORING PATIENT
COMPLIANCE DURING DYNAMIC MOTION THERAPY
PRIORITY
The present application claims priority to a U.S. Patent Application filed on
July 14, 2006 titled "Method and Apparatus for Monitoring Patient Compliance
During
Dynamic Motion Therapy. This U.S. Patent Application is a Continuation-In-Part
patent
application of a U.S. Patent Application filed on March 6, 2006 titled
"Supplemental Support
Structures Adapted to Receive a Non-invasive Dynamic Motion Therapy Device"
and
assigned U.S. Patent Application Serial No. 11/369,611; the contents of which
are hereby
incorporated by reference. U.S. Patent Application Serial No. 11/369,611
claims priority
from a U.S. Provisional Application filed on March 7, 2005 and assigned U.S.
Provisional
Application No. 60/659,159; the contents of which are hereby incorporated by
reference.
The U.S. Patent Application filed on July 14, 2006 is also a Continuation-In-
Part patent application of a U.S. Patent Application filed on March 24, 2006
titled "Apparatus
and Method for Monitoring and Controlling the Transmissibility of Mechanical
Vibration
Energy During Dynamic Motion Therapy" and assigned U.S. Patent Application
Serial No.
11/388,286; the contents of which are hereby incorporated by reference. U.S.
Patent
Application Serial No. 11/388,286 claims priority from a U.S. Provisional
Application filed
on March 24, 2005 and assigned U.S. Provisional Application No. 60/665,013;
the contents
of which are hereby incorporated by reference.
The U.S. Patent Application filed on July 14, 2006 further claims the benefit
of and priority to U.S. Provisional Application filed on July 27, 2005 titled
"Method and
Apparatus for Monitoring Patient Compliance During Dynamic Motion Therapy" and
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assigned U.S. Provisional Application Serial No. 60/702,815; the contents of
which are
hereby incorporated by reference. Additionally, the U.S. Patent Application
filed on July 14,
2006 claims the benefit of and priority to U.S. Provisional Application filed
on July 27, 2005
titled "Dynamic Motion Therapy Apparatus Having a Treatment Feedback
Indicator" and
assigned U.S. Provisional Application Serial No. 60/702,735; the contents of
which are
hereby incorporated by reference.
CROSS-REFERENCE TO RELATED PATENTS
The present application is related to U.S. Patent Nos. 6,843,776 and 6,884,
227, the contents of which are hereby incorporated by reference.
BACKGROUND
1. Technical Field
The present disclosure generally relates to the field of stimulating tissue
growth and healing, and more particularly, the present disclosure describes
dynamic motion
therapy apparatus having remote monitoring station for remotely monitoring
data related to
therapeutic treatment of tissue in a body during dynamic motion therapy. More
specifically,
the present disclosure relates to a method and apparatus for remotely
monitoring data related
to therapeutic treatment of damaged tissues, bone fractures, osteopenia,
osteoporosis, or other
tissue conditions, as well as postural instability, using dynamic motion
therapy and
mechanical impedance methods.
2. Background of the Related Art
When damaged, tissues in a human body such as connective tissues,
ligaments, bones, etc. all require time to heal. Some tissues, such as a bone
fracture in a
human body, require relatively longer periods of time to heal. Typically, a
fractured bone
must be set and then the bone can be stabilized within a cast, splint or
similar type of
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apparatus. This type of treatment allows the natural healing process to begin.
However, the
healing process for a bone fracture in the human body may take several weeks
and may vary
depending upon the location of the bone fracture, the age of the patient, the
overall general
health of the patient, and other factors that are patient-dependent. Depending
upon the
location of the fracture, the area of the bone fracture or even the patient
may have to be
immobilized to encourage complete healing of the bone fracture. Immobilization
of the
patient and/or bone fracture may decrease the number of physical activities
the patient is able
to perform, which may have other adverse health consequences. Osteopenia,
which is a loss
of bone mass, can arise from a decrease in muscle activity, which may occur as
the result of a
bone fracture, bed rest, fracture immobilization, joint reconstruction,
arthritis, and the like.
However, this effect can be slowed, stopped, and even reversed by reproducing
some of the
effects of muscle use on the bone. This typically involves some application or
simulation of
the effects of mechanical stress on the bone.
Promoting bone growth is also important in treating bone fractures, and in the
successful implantation of medical prostheses, such as those commonly known as
"artificial"
hips, knees, vertebral discs, and the like, where it is desired to promote
bony ingrowth into
the surface of the prosthesis to stabilize and secure it. Numerous different
techniques have
been developed to reduce the loss of bone mass. For example, it has been
proposed to treat
bone fractures by application of electrical voltage or current signals (e.g.,
U.S. Patent Nos.
4,105,017; 4,266,532; 4,266,533, or 4,315,503). It has also been proposed to
apply magnetic
fields to stimulate healing of bone fractures (e.g., U.S. Patent No.
3,890,953). Application of
ultrasound to promoting tissue growth has also been disclosed (e.g., U.S.
Patent No.
4,530,360).
While many suggested techniques for applying or simulating mechanical loads
on bone to promote growth involve the use of low frequency, high magnitude
loads to the
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bone, this has been found to be unnecessary, and possibly also detrimental to
bone
maintenance. For instance, high impact loading, which is sometimes suggested
to achieve a
desired high peak strain, can result in fracture, defeating the purpose of the
treatment.
It is also known in the art that low level, high frequency stress can be
applied
to bone, and that this will result in advantageous promotion of bone growth.
One technique
for achieving this type of stress is disclosed, e.g., in U.S. Patent Nos.
5,103,806; 5,191,880;
5,273,028; 5,376,065; 5,997,490; and 6,234,975, the entire contents of each of
which are
incorporated herein by reference. In this technique (referred to as dynamic
motion therapy),
the patient is supported by an oscillating platform apparatus that can be
actuated to oscillate
vertically, so that resonant vibrations caused by the oscillation of the
platform, together with
acceleration brought about by the body weight of the patient, provides stress
levels in a
frequency range sufficient to prevent or reduce bone loss and enhance new bone
formation.
The peak-to-peak vertical displacement of the platform oscillation may be as
little as 2[tm.
However, these systems and associated methods often depend on an
arrangement whereby the operator or user must measure the weight of the
patient and make
adjustments to the frequency of oscillation to achieve the desired therapeutic
effect. U.S.
Patent No. 6,843,776 discloses an oscillating platform apparatus that
automatically measures
the weight of the patient and adjusts characteristics of the oscillation force
as a function of the
measured weight, to therapeutically treat damaged tissues, bone fractures,
osteopenia,
osteoporosis, or other tissue conditions.
It is also known in the art that the application of low level, high frequency
stress is effective in treating postural instability. A method of using
resonant vibrations
caused by the oscillation of a vibration table or unstable vibrating platform
for treating
postural instability is described in U.S. Patent No. 6,607,497 B2; the entire
contents of which
are incorporated herein by reference. The method includes the steps of (a)
providing a non-
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invasive dynamic therapy apparatus having a vibration table with a non-rigidly
supported
platform; (b) permitting the patient to rest on the non-rigidly supported
platform for a
predetermined period of time; and (c) repeating the steps (a) and (b) over a
predetermined
treatment duration. Step (b) includes the steps of (bl) measuring a
vibrational response of the
patient's musculoskeletal system using a vibration measurement device; (b2)
performing a
frequency decomposition of the vibrational response to quantify the
vibrational response into
specific vibrational spectra; and (b3) analyzing the vibrational spectra to
evaluate at least
postural stability.
The method described in U.S. Patent No. 6,607,497 B2 entails the patient
standing on the vibration table or the unstable vibrating platform. The
patient is then exposed
to a vibrational stimulus by the unstable vibrating platform. The unstable
vibrating platform
causes a vibrational perturbation of the patient's neuro-sensory control
system. The
vibrational perturbation causes signals to be generated within at least one of
the patient's
muscles to create a measurable response from the musculoskeletal system. These
steps are
repeated over a predetermined treatment duration for approximately ten minutes
a day in an
effort to improve the postural stability of the patient.
The patient undergoing vibrational treatment for treating postural instability
and/or the promotion of bone growth, as described above, may experience a
level of
discomfort due to whole-body vibration acceleration. The level of discomfort
caused by
vibration acceleration depends on the vibration frequency, the vibration
direction, the point of
contact with the body, and the duration of the vibration exposure. It is
desirable to monitor at
least one mechanical response of the body during vibrational treatment in an
effort to control
the at least one mechanical response to influence comfort level, as well as to
determine
patient- and treatment-related characteristics. Two mechanical responses of
the body that are
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often used to describe the manner in which vibration causes the body to move
are
transmissibility and mechanical impedance.
The transmissibility shows the fraction of the vibration which is transmitted
from, say, the vibration table or oscillating platform apparatus to the head
of the patient. The
transmissibility of the body is highly dependent on vibration frequency,
vibration axis and
body posture. Vertical vibration on the non-invasive dynamic therapy device
causes
vibration in several axes at the head; for vertical head motion, the
transmissibility tends to be
greatest in the approximate range of 3 to 10 Hz.
The mechanical impedance of the body shows the force that is required to
make the body move at each frequency. Although the impedance depends on body
mass, the
vertical impedance of the human body usually shows a resonance at about 5 Hz.
The
mechanical impedance of the body, including this resonance, has a large effect
on the manner
in which vibration is transmitted through seats.
SUIVIMARY
It is an aspect of the present disclosure to provide a method and apparatus
for
monitoring data related to therapeutic treatment of tissue in a body of a
patient. It is also an
aspect of the present disclosure to provide a method and apparatus for
communication with a
central monitoring station via a network, such as, for example, the internet
and transmitting
patient compliant data to a remote monitoring station for monitoring. Patient
compliant data
(directed to whether the patient is complying to treatment protocols) and
other patient and
treatment related data are preferably stored in a dynamic therapy system for
evaluation at a
later time or for transmission via the network using a communications
circuitry to the central
monitoring station for observation. The transmission can also occur in real
time during
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dynamic motion therapy for enabling a medical professional or other observer
to transmit
data via the network to the patient during the therapy session.
The present disclosure describes dynamic motion therapy apparatus having a
remote monitoring station for monitoring patient compliance during therapeutic
treatment of
tissue during dynamic motion therapy. In particular, the present disclosure
provides a
method and system for remotely monitoring data related to therapeutic
treatment of tissue in a
body during dynamic motion therapy. The dynamic motion therapy apparatus
generally
includes a platform configured to support a body of the patient, an oscillator
operably
connected to the platform and configured to impart an oscillating force at a
predetermined
frequency on the platform; and a processing device in operable communication
with the
platform and configured for processing data related to the therapeutic
treatment. The system
further includes a communication device in operative communication with the
processing
device and a display for displaying treatment and other information to the
patient.
The communication device is adapted for transmitting the processed data to a
remote monitoring station via at least one network. The communication device
is adapted for
transmitting data to a remote station, such as for example, a doctor's office.
The data
transmitted is indicative of at least one treatment parameter such as, for
example, a
vibrational response of the patient's musculoskeletal system, the amplitude of
the frequency
of the oscillating force, oscillation frequency, a calculated weight, and the
time interval of the
treatment.
The communication device may be, for example, a cellular phone having a
port connector capable of connecting to the communication device for receiving
the data via
the port connector-communication interface connection and for transmitting
said data to the
remote monitoring station via a CDA cellular communications network according
to the
CDMA communications protocol. The communication device may also be, for
example, a
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PDA having a port connector capable of connecting to the communication device
for
receiving the data via the port connector-communication interface and for
transmitting the
received data to a PSTN, form where it is transmitted through the Internet
according to the
Internet protocol, and then to another PSTN connected to the central computer
station.
The communication device may also operate in accordance with a
communication protocol, as is well known in the art, preferably, a TCP/IP
protocol.
Moreover, the communication device may transmit data via a communication
medium, such
as, for example, copper wire, phone line connection, internet connection,
optical fibre, radio-
link, laser, radio or infrared light.
The present disclosure further provides a method for effectively monitoring
data related to therapeutic treatment of tissue in a body of a patient. The
method includes the
step of supporting the body on a platform; oscillating the platform at an
oscillation frequency
to impart an oscillating force on the body to treat the tissue in the body;
and obtaining data by
at least one processing device or digital signal processor. The data obtained
is related to at
least one treatment parameter during oscillating of the body. The method
further includes
transmitting the data to a remote monitoring station for monitoring thereof.
The method
further includes transmitting a control signal from the remote station to the
at least one
processing device for remotely controlling a value of the at least one
treatment parameter.
The at least one treatment parameter may be a calculated weight, a vibrational
response of a
musculoskeletal system of the patient, amplitude of the frequency of the
oscillating force, and
a time interval of the duration of the treatment. The frequency of oscillation
or oscillating
frequency is not changed during treatment.
During dynamic motion therapy, the digital signal processor determines and
monitors the weight of the patient. The dynamic (apparent) weight of the
patient is
continuously in real-time or periodically measured and stored within the
digital signal
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processor to determine the posture of the patient and accordingly, the
transmissibility of the
mechanical vibration energy through the patient or oscillating platform system-
seat/support
structure-patient interface, since the posture of the patient and dynamic
stiffiiess of the
seat/support structure affects the transmissibility of the mechanical
vibration energy through
the patient.
If the calculated weight during dynamic motion therapy differs or deviates
significantly (i.e., more than a predetermined threshold) from the apparent
weight, the digital
signal processor determines that the patient's posture changed thereby
decreasing or
increasing the transmissibility of the mechanical vibration energy depending
on whether the
calculated weight decreased (transmissibility decreased) or increased
(transmissibility
increased). If the calculated weight decreased, it can be assumed that the
patient has deviated
from or is not compliant with the dynamic motion therapy treatment protocol.
It is one object
of the invention to provide a system for generating and transmitting a message
instructing the
patient to comply with the dynamic motion therapy treatment, e.g. change
posture.
Accordingly, by adjusting the posture and/or dynamic stiffness of the seat (or
other support
structure) resting on the oscillating platform system to bring the calculated
weight to
approximate the apparent weight, the transmissibility of the mechanical
vibration energy
through the patient or oscillating platform apparatus-seat/support structure-
patient interface
can be influenced, as well as dynamic loading, for maximizing the treatment
effects caused
by dynamic motion therapy.
The step of transmitting data includes transmitting data via a communications
medium, such as, for example, copper wire, phone line connection, internet
connection,
optical fibre, radio-link, laser, radio or infrared light.
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BRIEF DESCRIPTION OF THE DRAWINGS
The foregoing features of the present disclosure will become more readily
apparent and will be better understood by referring to the following detailed
description of
preferred embodiments, which are described hereinbelow with reference to the
drawings
wherein:
FIG. 1 is a perspective view illustrating a non-invasive dynamic motion
therapy apparatus having a display unit for displaying treatment feedback, in
accordance with
the present disclosure.
FIG. 2 is a perspective view of an of an ergonomic support structure having an
ergonomic hand support structure, a monitor provided on a column having a
monitor for
displaying treatment information feedback and a platform for supporting the
non-invasive
dynamic motion therapy device in accordance with the present disclosure;
FIG. 3 is a flow chart illustrating a method in accordance with the present
disclosure; and
FIG. 4 is schematic block diagram of the non-invasive dynamic motion
therapy apparatus in accordance with the present disclosure.
DETAILED DESCRIPTION
The dynamic motion therapy apparatus and method in accordance with various
embodiments of the disclosure provide a method and system for monitoring
patent
compliance when undergoing treatment of damaged tissue, bone fractures,
osteopenia,
osteoporosis, or other tissue conditions, as well as postural instability,
using dynamic motion
therapy and mechanical impedance methods. Dynamic motion therapy apparatus has
an
oscillating platform for positioning the patient thereon for providing low
displacement, high
frequency mechanical loading of bone tissue.
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The dynamic motion therapy apparatus includes communication circuitry in
operative communication with at least one processing device or digital signal
processor for
transmitting and receiving data from and to a central, remote monitoring
station. The data
transmitted can include patient monitoring data to determine, at the central
monitoring
station, whether the patient is complying with a treatment regimen; and data
to determine
whether the patient is properly positioned on the dynamic motion therapy
device to obtain
optimum treatment effects. The apparatus further includes circuitry and
related components
including a treatment feedback indicator for providing treatment feedback
relating to the
transmissibility of mechanical vibration energy during therapeutic treatment
of tissue, as
described in U.S. Provisional Application Serial No. 60/702,815.
Referring initially to FIG. 1, there is illustrated a perspective view of a
non-
invasive dynamic motion therapy apparatus in accordance with the present
disclosure. The
apparatus having a treatment feedback indicator is designated generally by
reference numeral
100. Apparatus 100 includes a vibration table 102 having a non-rigidly
supported platform
104. At least one processing device or digital signal processor 402 (see FIG.
4), is in
operative communication with platform 104 for processing data related to the
therapeutic
treatment. Apparatus 100 further includes a treatment feedback indicator 106
having a
display 108 operably connected to the processing device 402 for providing
transmissibility
information and/or for displaying other information to the patient. Apparatus
100 further
includes foot rests I 10 for resting the apparatus 100 on a flat surface.
The non-rigidly supported platform 104 rests on motorized spring mechanisms
(not shown) which cause the platform 104 to move when they are turned on.
Alternatively,
the non-rigidly supported platform 104 may rest on a plurality of springs or
coils which cause
the non-rigidly supported platform 104 to move once a patient stands thereon.
Further, the
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non-rigidly supported platform 104 can include various compliant modalities
other than
springs (e.g., rubber, elastomers, foams, etc.).
In an alternative embodiment, apparatus 100 includes a platform housed
within a housing and having first and second accelerometer, as described in
U.S. Patent
Application Serial No. 11/388,286.
It is envisioned that apparatus 100 may include a communication device in
operable communication with the processing device 402 and adapted for
transmitting data to
a remote monitoring station via at least one network. The communication device
is, for
example, a cellular phone having a port connector capable of connecting to the
communication device for receiving the data via the port connector-
communication interface
connection and for transmitting said data to the remote monitoring station via
a CDA cellular
communications network according to the CDMA communications protocol. The
communication device may also be, for example, a PDA having a port connector
capable of
connecting to the communication device for receiving the data via the port
connector-
communication interface and for transmitting the received data to a PSTN, form
where it is
transmitted through the Internet according to the Internet protocol, and then
to another PSTN
connected to the central computer station. The communication device may also
operate in
accordance with a communication protocol, as is well known in the art,
preferably, a TCP/IP
protocol. Moreover, the communication device may transmit data via a
communication
medium, such as, for example, copper wire, phone line connection, internet
connection,
optical fibre, radio-link, laser, radio or infrared light.
With reference to FIG. 2, apparatus 100 in accordance with the present
disclosure is received by a supplemental support structure. In a preferred
embodiment of a
supplemental support structure, an ergonomic support structure is provided and
is designated
generally by reference numeral 200. The ergonomic support structure 200
includes an
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ergonomic hand support structure 202 and a platform 204 for supporting
apparatus 100.
Apparatus 100 is preferably removable from platform 204.
Ergonomic hand support structure 202 includes a curved structure 206 having
inner and outer curved walls 208a, 208b and two curved ends 210a, 210b
connecting the two
walls 208a, 208b. During vibrational treatment by the non-invasive dynamic
motion therapy
apparatus 100, the patient grasps the long curved end 210a or lightly touches
the inner curved
wall 208a.
A patient suffering from a severe case of postural instability or other
condition
which prevents the patient from standing on the non-rigidly supported platform
100 can be
seated on a removable seat 212 and be treated with dynamic motion therapy
device 100. Seat
212 is adapted for placement on two opposing surfaces (not shown) defined by
the inner
curved wal1208a.
Ergonomic support structure 200 further includes an RFID reader 214 for
reading an RFID tag provided on the patient for identifying the patient. The
RFID reader 214
further includes a display 216 for displaying patient identification data and
other data,
including video. The RFID reader 214 also includes a processor (not shown)
storing patient-
related data, such as patient identification data, and treatment data, such
as, for example, the
dates and duration times of the last five vibrational treatment sessions. The
patient-related
data for each particular patient is accessed and portions thereof displayed by
the display 216
after the patient's corresponding RFID tag is read by the RFID reader 214.
With continued reference to FIG. 2, ergonomic support structure 200 further
includes a vertical column 218 having a monitor 220 for displaying patient
identification data
and other data, such as patient treatment data, including video. Preferably,
the monitor 220 is
inlaid within the vertical column 218 for enabling the patient to place a
book, laptop, etc. on
the vertical column 218 without contacting the monitor 220. The vertical
column 218 is
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preferably height adjustable to accommodate patients of differing heights.
Monitor 220 is
preferably touch-sensitive for controlling the operation of the non-invasive
dynamic motion
therapy device 100 and performing other functions, such as accessing the
Internet, accessing
data stored within a memory, etc., by touching the screen of the monitor 220.
Another
monitor 222 is provided on the outer wa11208b. The outer wall 208b is further
provided with
a light source 224 above the monitor 222 and control buttons 226.
Ergonomic support structure 200 is provided with circuitry and related
components for connecting to a network, such as the Internet, wirelessly
and/or non-
wirelessly and at least one processor for transmitting and receiving data via
the network as
known in the art. The data transmitted can include patient monitoring data to
determine at a
central monitoring station if the patient is complying with a treatment
regimen and data to
determine whether the patient is properly positioned on the dynamic motion
therapy
apparatus to obtain optimum treatment effects. The data can include video
and/or sensor data
obtained by a video camera and/or at least one sensor mounted to the support
structures and
transmitted via the network to the central monitoring station. The data
received can include
Internet content and treatment-related data transmitted from the central
monitoring station.
The data received can include visual and/or audio content for viewing via the
monitor 220
and/or listening via earphones connected to audio circuitry embedded within
the support
structures.
With reference to FIG. 3, there is a flow chart illustrating an exemplary
method for providing therapeutic treatment of tissue in accordance with the
present
disclosure. The method includes the step of supporting the body on a platform
104. Step 300
includes oscillating platform 104 at an oscillation frequency to impart an
oscillating force on
the body to treat the tissue in the body. Step 302 includes the step of
obtaining data via
processing device 402. The data is related to at least one treatment parameter
during
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oscillation of the body. The treatment parameter includes, for example, the
weight of the
patient, the oscillation frequency of platform 104; an amplitude of the
frequency of the
oscillating force generated by the oscillating frequency; and a time interval
duration of the
treatment. Obtaining data relating to a vibrational response of a
musculoskeletal system of
the patient is also envisioned.
Table 1 illustrates a list of exemplary data corresponding to a treatment
duration of 10 minutes and their corresponding transmissibility value
indicating the average
weight and average amplitude.
Time Interval (minutes) Average Weight (Ibs) Average Amplitude (mm)
1 155 1.5
2
3
4
5
6
7
8
9
Table 1.
10 Following the step of obtaining the data via processing unit 400 (Step
302),
the system will verify whether the predetermined treatment duration has
elapsed. If the
treatment duration has elapsed, then the step of oscillating platform 104 is
discontinued (Step
306) and data corresponding to treatment duration is transmitted to the remote
monitoring
station (Step 308). If the treatment time has not elapsed then data relating
to treatment
parameters are transmitted to the remote monitoring station (Step 310). In
Step 312, the
remote monitoring station receives the data relating to the treatment
parameters, i.e. weight of
the patient, the oscillation frequency of platform 104, an amplitude of the
oscillating force,
and a time interval duration of the treatment, as illustrated in Table 1. The
remote monitoring
station determines whether data relating to weight is indicative of compliance
to a treatment
protocol (Step 314).
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Since the posture of the patient and dynamic stiffness of the seat/support
structure affects the weight of the patient and thus the transmissibility of
the mechanical
vibration energy through the patient, the processing device 402 determines and
monitors the
weight of the patient. The weight of the patient is continuously, in real time
or periodically,
compared to an apparent weight to determine a deviation value (Apparent Weight
minus
Calculated Weight), i.e., weight data, (Step 314). If the weight data
indicates that the
calculated weight is equal to zero (Step 320) (that is, the deviation value is
substantially equal
to the apparent weight), it is determined that the patient has stepped off the
platform 104. A
message is transmitted to the patient at Step 322 instructing the patient to
resume the
treatment until the predetermined treatment time has elapsed. The process then
proceeds to
Step 302.
If weight data indicates that the calculated weight is not equal to zero, i.e.
the
platform is still supporting the patient, and the deviation value is positive
and greater than a
predetermined threshold, it is determined that the patient's posture is
incorrect and a message
is generated and transmitted to the display unit 106 instructing patient to
change or correct
posture (Step 324). The process then proceeds to Step 302. If the calculated
weight does not
differ significantly from the apparent weight as determined by the processing
device 402, i.e.,
deviation value is substantially zero, (patient is complying to treatment
protocol), then at Step
316 it is determined whether the treatment parameters are satisfactory based
on the weight of
the patient. If yes, the process then proceeds to Step 302. If no, then at
Step 318, at least one
treatment parameter, e.g., amplitude of the oscillating force, is adjusted and
the process
proceeds to Step 302. The frequency of oscillation or oscillating frequency is
not changed
during treatment. The apparatus 100 during the initial tune-up performs a self-
evaluation
(calibration) and does a frequency sweep between 32 and 37 Hz to fmd the
maximum
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acceleration for the particular user. After the initial tune-up, the apparatus
100 maintains the
chosen oscillating frequency for the rest of the treatment duration.
With reference to FIG. 4, there is shown a schematic block diagram of the
dynamic motion therapy apparatus 100 in accordance with the disclosure.
Schematic block
diagram includes at least one processing device or digital signal processor as
described in
U.S. Patent Application Serial No. 11/388,286 filed on March 24, 2006; the
entire contents of
which are hereby incorporated by reference. The dynamic motion therapy
apparatus 100
includes platform 104 and two accelerometers Al, A2 for transmitting
information to the
processing device 402. Processing device 402 is preferably a digital signal
processor 402 as
shown by FIG. 4 having circuitry and programmable instructions stored within a
memory and
capable of being executed by the digital signal processor 402 for operating
the dynamic
motion therapy apparatus 100. The digital signal processor 402 includes two
incoming data
paths 404, 406 having identical components for processing data received from
the two
accelerometers Al, A2 and one outgoing data path 408 for relaying control or
feedback
signals to the oscillating actuator 112 for causing vibration of the platform
104 via drive lever
114.
Digital signal processor 402 includes a memory storing a set of programmable
instructions capable of being executed by the digital signal processor 402 for
operating the
components of the two incoming data paths 404, 406 and one outgoing data path
408 for
performing the functions described above in accordance with the disclosure, as
well as other
functions. The set of programmable instructions can also be stored on a
computer-readable
medium, such as a CD-ROM, diskette, and other magnetic media, and downloaded
to the
digital signal processor 402.
Each incoming data path includes four major components for processing the
incoming data from the two accelerometers Al, A2. The four major components
are in order
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from left to right in FIG. 4 an analog-to-digital (A/D) converter 410, a
bandpass filter 412, a
rectifier 414, a moving average filter 416, and a fault tolerance decision
block 418.
Preferably, the bandpass filter 412 in each incoming data path is a 4I' order
elliptic bandpass filter which finds the "sweet spot" for each particular
patient (this causes the
processor to shift the resonance of the dynamic therapy system 400 based on
the patient's
mass or weight by transmitting a signal to the oscillating actuator 112 to
change the
frequency of the oscillating force). The digital signal processor 402
processes the polynomial
coefficients of the 4th order elliptic bandpass filters by implementing "power
of two"
coefficients. The processor 402 is programmed to do this instead of performing
polynomial
multiplication for each coefficient in the polynomial which would require a
significantly
longer processing time. The processor 402 in accordance with the present
disclosure reduces
processing time by approximating the polynomial coefficients using the "power
of two." For
example, if the coefficient is 3.93215, the processor 402 can perform a quick
approximation
of the coefficient by approximating the coefficient as follows: 4- 1/16 +
3/128 -1/512. It is
contemplated that the same method can be used to process the coefficients of
the other filters
of the processor 402.
The output from the moving average filter 416 of incoming data path 404 is
provided to the fault tolerance decision block 418 for determining fault
tolerance level and an
adder/subtracter block 420 for deciding whether to increase or decrease the
gain to maintain
the average vibration intensity to a preset value. The output of block 420 is
an error signal
which determines whether to increase or decrease the vibration level of the
oscillating
actuator 112.
The output from the adder/subtractor block 420 is the acceleration of the
patient and the output from A/D converter 410 of incoming data path 406 is
provided to a
low-pass filter 422 which outputs a weight/presence signal. The
weight/presence signal is
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used to sense the presence of the patient and to calculate the weight of the
patient
continuously or periodically using conventional weight/angle equations during
dynamic
motion therapy.
By determining the weight of the patient during treatment and comparing the
weight to the apparent weight as described above, the processor 402 is able to
determine
whether the patient is compliant with the treatment protocols (e.g., whether
patient is resting,
standing, etc. on platform 104) and the posture of the patient for determining
the
transmissibility of the mechanical vibration energy through the patient. The
patient can then
influence the transmissibility, if necessary (i.e., if the calculated weight
indicates poor
transmissibility), by shifting or changing his posture accordingly.
The acceleration value of the patient and the output from the fault tolerance
decision block 418 are inputs at separate times (since the processor 402 of
the dynamic
motion therapy system 400 is designed as a real time interrupt driven software
system as
described below) during operation of the dynamic therapy system 400 to the
outgoing data
path 408.
The outgoing data path 408 includes four major components for processing
control and feedback signals transmitted from the processor 402 to the
oscillating actuator
112. The four major components are in order from right to left in FIG. 4 a
digital gain
adjustment module 424 for performing automatic gain control as described
above, a variable
amplitude signal generation module 426 for increasing or decreasing the
sinusoidal signal
driving the oscillating actuator 112, a low-pass filter 428 for filtering the
control and
feedback signals and a power amplifier 430 for amplifying the control and
feedback signals.
Apparatus 100 includes a treatment feedback indicator 500, 500' which in a
preferred embodiment includes display unit 106 for displaying treatment
related information
(amount of mechanical vibration energy transmitted through the patient) and
other
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information, such as diagnostic information, to the patient, medical
professional or other
individual. The treatment-related information can include the original
calculated weight of
the patient and the calculated weight of the patient during treatment, the
acceleration of the
patient, automatic gain control information, level or degree of compliance to
the treatment
protocols, a transmissibility value indicating or approximating the amount of
mechanical
vibration energy being transmitted through the patient or support structure-
patient during
treatment etc.
The digital signal processor 402 of the dynamic motion therapy apparatus 100
is designed as a real time interrupt driven software system (the apparatus 100
does not have a
main loop). A timer interrupt occurs every 1/fs milliseconds. That is, for
example, if the
apparatus 100 is tuned at 34 Hz, a timer interrupt occurs every 1/34 seconds.
A different
function occurs during each timer interrupt, such as replenishing or updating
the display unit
432, transmitting the control or feedback signals to the oscillating actuator
112, and
generating a transmitting a sine wave to the oscillating actuator 112 for
automatic gain
control (the sine wave is preferably generated and transmitted approximately
500 times per
second). It is contemplated that higher priority interrupts are performed
first. If there is not
interrupt to be performed, the processor 402 goes into an idle mode until
there is an interrupt
to perform.
The digital signal processor 402 generates the (sinusoidal) signal to the
oscillating actuator 112 and processes the acceleration signal received from
accelerometer A1
using at least one digital bandpass filter 412 with a variable sampling rate
during calibration
(tuning) of the dynamic motion therapy apparatus 100. In the dynamic motion
therapy
apparatus 100, the sampling rate and thus the vibration frequency is between 0
and 250 Hz,
with the at least one digital bandpass filter 412 adaptively tuned to the
current operating
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frequency. The variable sampling rate is possible due to the interrupt driven
software system
of the software control loop as described above.
The dynamic therapy apparatus 100 further includes communication
circuitry/device 434 for downloading/uploading data, including software
updates, to the
processor 402 and for communicating with a central monitoring station via a
network, such as
the Internet, including receiving Internet content. The communication
circuitry 434 can
include RS232, USB, parallel and serial ports and associated circuitry, as
well as network
connection software and circuitry, such as a modem, DSL connection circuitry,
etc.
Preferably, the process of downloading/uploading data, including software
updates, is
configured as an interrupt for being performed during a timer interrupt by the
dynamic
therapy apparatus 100. As shown in FIG. 4, communication circuitry 434 is
connected to the
central, remote monitoring station 10 via the internet 12.
The data transmitted from the dynamic motion therapy apparatus 100 to the
remote monitoring station can include video and/or sensor data obtained by a
video camera
and/or at least one sensor mounted to the support structure or the dynamic
motion therapy
apparatus 100 and transmitted via the network to the central, remote
monitoring station.
Patient compliant data (directed to whether the patient is complying to
treatment protocols) and other patient- and treatment-related data are
preferably stored in the
dynamic therapy apparatus 100 for evaluation at a later time or for
transmission via the
network using the communications circuitry 434 to the central monitoring
station for
observation. The transmission can also occur in real time during dynamic
motion therapy for
enabling a medical professional or other observer to transmit data via the
network to the
patient during the therapy session. The transmitted data can be displayed to
the patient on the
display unit 432 and/or audibly played via a speaker. The display unit 106
includes a graphic
display 108 for providing visual feedback of the amount of mechanical
vibration energy
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transmitted to the patient, wherein the graphical display 108 includes a
graphical format, such
as, for example, an icon or graph.
The transmitted data can include a message for the patient to change his
posture for maximizing mechanical impedance and the transmissibility of the
mechanical
vibration energy through the patient. Another transmitted message can be for
the patient to
manually change one or more operating parameters of the dynamic therapy
apparatus 100.
The data transmitted from the dynamic therapy apparatus 100 can include
video and/or sensor data obtained by a video camera and/or at least one sensor
mounted to the
support structure or the dynamic therapy apparatus 100 and transmitted via the
network to the
central monitoring station.
Using the dynamic therapy apparatus 100 and mechanical impedance methods
as known in the art, one can predict the transmissibility of the mechanical
vibration energy
through the patient being supported by a support structure, such as a kneeling
chair-type
support structure, wheel chair, seat, exercise device, etc., using the dynamic
stiffness of the
support structure and the apparent mass of the body measured at appropriate
vibration
magnitudes. The materials, structure, orientation, etc. of the support
structure can then be
selected and re-designed for maximizing the transtnissibility of the
mechanical vibration
energy through the oscillating platform system-support structure-patient
interface in order to
maximize the transmissibility of the mechanical vibration energy through the
patient. The
support structure can in effect be custom designed for each patient for
maximizing the
transmissibility of the mechanical vibration energy through the patient.
The described embodiments of the present disclosure are intended to be
illustrative rather than restrictive, and are not intended to represent every
embodiment of the
present disclosure. Various modifications and variations can be made without
departing from
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the spirit or scope of the disclosure as set forth in the following claims
both literally and in
equivalents recognized in law.
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