Note: Descriptions are shown in the official language in which they were submitted.
DEVICE, SYSTEM, AND METHOD FOR PROMOTING PATIENT COMPLIANCE
WITH A PRESCRIBED LOWER EXTREMITY PARTIAL WEIGHT-BEARING
REHABILITATION PROGRAM
TECHNICAL FIELD
[0001] The present disclosure relates to device, system, and method for
promoting
patient compliance with a prescribed lower extremity partial weight-bearing
rehabilitation program.
BACKGROUND
[0002] A lower extremity injury, such as trauma to or surgery upon a toe,
foot, ankle,
calf, knee, thigh, or hip, may require rehabilitation to promote proper
healing.
Rehabilitation typically involves walking with the assistance of a walking aid
that bears
at least part of the weight of the user, such as a crutch, a pair of crutches,
a cane, a
pair of canes, or a walker.
[0003] Rehabilitation is typically performed according to a rehabilitation
program
prescribed by a doctor or other medical professional. The rehabilitation
program may
span multiple weeks and may have one or more phases. During each phase, a
different partial weight-bearing (load) target may be prescribed for the
injured lower
extremity. The target load may be expressed as a fraction of a peak load
normally
placed upon the lower extremity while walking, which is 100% of the person's
weight.
[0004] A medical professional may customize the parameters of a rehabilitation
program, such as its duration, number of phases, and the target load for each
phase.
The parameters may be specific to the type of lower extremity injury that has
been
suffered.
[0005] In one example, a rehabilitation program for a patient with a heel
fracture
may have only one phase spanning four weeks, specifying a target load of 30%
of the
patient's weight on the injured leg throughout the four-week period.
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[0006] In another example, a rehabilitation program for a patient who has
recently
undergone hip replacement surgery may have three phases spanning seven weeks,
as follows:
[0007] Phase 1: three weeks of 0% load on the injured hip; then
[0008] Phase 2: two weeks of a 30% load on the injured hip; then
[0009] Phase 3: two weeks of a progressively increasing load on the injured
hip,
starting at 30% load and increasing steadily to 70%.
[0010] Historically, patients have had difficulty complying with the target
loads of
lower extremity rehabilitation programs. The reason is that commonly used
rehabilitation techniques do not provide patients with suitable tools for
accurately
judging a degree of load being placed upon a lower extremity as the patient
walks.
[0011] For example, a common approach for training a patient to apply a
partial
weighting target to an injured lower extremity involves the use of a scale,
e.g., a
common bathroom scale. The patient may be asked to step onto the scale using
the
injured leg while suspending the other leg and partially supporting himself or
herself on
a pair of crutches whose tips are on the floor. The patient may then be asked
to lean
more heavily or less heavily on the crutches until a target load on the
injured leg is
achieved. The target weight reading on the scale will depend on the patient's
weight.
For example, for a patient weighing 200 lbs. to achieve 40% weighting on the
injured
leg, the scale should read 80 pounds.
[0012] Such training may be repeated several times to encourage the patient to
remember what the target percentage weighting on the injured leg feels like.
The
patient may then be asked to simply do his or her best to replicate that same
feeling
during day-to-day use of the crutches, to comply with the target load during
rehabilitation.
[0013] Yet, limitations in human perception can undermine attempts by even the
most well-intentioned patients to comply with weight-bearing targets by feel.
For
example, sensation in an injured lower extremity may change over time for
various
reasons. One reason may be that perceived pain levels drop as the injury
heals.
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Another reason may be that sensation in the injured extremity may change over
the
course of a day, e.g., as a patient becomes fatigued. Such changes in
sensation may
alter the patient's perception of the amount of weight being applied to the
injured lower
extremity. This altered perception may cause the patient to unknowingly apply
an
improper load, be it too low or too high, on the injured lower extremity.
Improper
loading may disadvantageously prolong recovery times or may risk re-injuring
the
lower extremity.
[0014] Patient compliance with partial weight-bearing targets may be even more
difficult to achieve when a rehabilitation program specifies a target load
that changes
over time, such as in the hip replacement example above. Just when a patient
has
become accustomed to the feel of one target load, he or she may be asked to
comply
with a new, different target load with which the patient may not be readily
familiar in
terms of feel.
[0015] Even if a device were available that could dynamically measure a weight
applied to an injured lower extremity in relation to a target weight, such a
device would
be impractical if periodic reprogramming were required to accommodate a
changing
weight-bearing target load over the course of a rehabilitation program.
SUMMARY
[0016] In one aspect, there is provided an electronic device for promoting
proper
use of a walking aid during patient rehabilitation from a lower extremity
injury, the
device comprising: a body having a receptacle configured to receive a tip of a
leg of
the walking aid; a substantially cylindrical housing configured to cooperate
with the
body to define an enclosed annular space; at least one load sensor anchored to
the
body, the at least one load sensor being configured to measure a load on the
walking
aid; a memory that, during device operation, stores rehabilitation program
data
defining: at least one time interval of a rehabilitation period; and for each
of the at least
one time interval, a target load for the walking aid during the time interval;
a processor,
communicatively coupled to the memory and to the at least one load sensor,
operable
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to: identify a currently operative time interval of the at least one time
interval of the
rehabilitation period; receive, from the at least one load sensor, data
indicative of a
dynamic load on the walking aid during a patient step; determine, based upon
the
received data, a peak load upon the walking aid during the patient step; and
provide a
user notification indicating that the peak load upon the walking aid during
the patient
step is non-compliant with the target load for the walking aid for the
currently operative
time interval, wherein the memory and the processor are housed within the
enclosed
annular space; a retaining mechanism for retaining the tip of the leg of the
walking aid
within the receptacle; a base configured for limited axial movement relative
to the
body; and a foot at a lower end of the base, wherein the at least one load
sensor is
disposed between the base and the body and is configured to bear a load placed
upon
the walking aid during use of the walking aid.
[0017] In another aspect, there is provided a system for promoting proper use
of a
walking aid during patient rehabilitation from a lower extremity injury, the
system
comprising: an electronic device associated with the walking aid, the
electronic device
comprising: a body having a receptacle configured to receive a tip of a leg of
the
walking aid; a substantially cylindrical housing configured to cooperate with
the body to
define an enclosed annular space; at least one load sensor anchored to the
body, the
at least one load sensor being configured to measure a load on the walking
aid; a
processor housed within the enclosed annular space, the processor
communicatively
coupled to the at least one load sensor; a retaining mechanism for retaining
the tip of
the leg of the walking aid within the receptacle; a base configured for
limited axial
movement relative to the body; and a foot at a lower end of the base, wherein
the at
least one load sensor is disposed between the base and the body and is
configured to
bear a load placed upon the walking aid during use of the walking aid; a
computing
device comprising a processor and memory storing instructions that, when
executed,
cause the computing device to: receive rehabilitation program parameter data
originating from a medical professional, the rehabilitation program parameter
data
including, for each of a plurality of time intervals spanning a rehabilitation
period, a
target relative load for an injured lower extremity during the time interval,
the target
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relative load being relative to a patient body weight; receive an indication
of the patient
body weight; based on the rehabilitation program parameter data and the
patient body
weight, calculate, for each of the plurality of time intervals spanning the
rehabilitation
period, a target absolute load for the walking aid during the time interval;
and output
rehabilitation program data comprising a schedule for use by the electronic
device
associated with the walking aid, the schedule specifying: the plurality of
time intervals
spanning the rehabilitation period; and for each of the plurality of time
intervals
spanning the rehabilitation period, a target absolute load for the walking aid
during the
time interval, wherein the processor of the electronic device is operable to
automatically adjust, according to the schedule, a currently operative target
absolute
load on the walking aid by, periodically during the rehabilitation period:
based on a
current date, identifying one of the time intervals of the schedule as
currently
operative; using the at least one load sensor, determining a peak load on the
walking
aid during a patient step taken during the currently operative time interval;
and
providing a user notification indicating that the peak load upon the walking
aid during
the patient step is non-compliant with the target absolute load on the walking
aid
during the currently operative time interval.
[0018] In yet another aspect, there is provided a method of promoting proper
use of
a walking aid during patient rehabilitation from a lower extremity injury, the
method
comprising: receiving rehabilitation program parameter data originating from a
medical
professional, the rehabilitation program parameter data including, for each of
a
plurality of time intervals spanning a rehabilitation period, a target
relative load on an
injured lower extremity during the time interval, the target relative load
being relative to
a patient body weight; receiving an indication of the patient body weight;
based on the
rehabilitation program parameter data and the patient body weight,
calculating, for
each of the plurality of time intervals spanning the rehabilitation period, a
target
absolute load on the walking aid during the time interval; and generating
rehabilitation
program data comprising a schedule specifying: the plurality of time intervals
spanning
the rehabilitation period; and for each of the plurality of time intervals
spanning the
rehabilitation period, a target absolute load on the walking aid during the
time interval,
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and at an electronic device associated with the walking aid, the electronic
device
having at least one load sensor operable to measure a dynamic load on the
walking
aid, automatically adjusting, according to the schedule, a currently operative
target
absolute load on the walking aid by, periodically during the rehabilitation
period: based
on a current date, identifying one of the time intervals of the schedule as
currently
operative; using the at least one load sensor, determining a peak load on the
walking
aid during a patient step taken during the currently operative time interval;
and
providing a user notification indicating that the peak load upon the walking
aid during
the patient step is non-compliant with the target absolute load on the walking
aid
during the currently operative time interval.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] In the figures which illustrate example embodiments,
[0020] FIG. 1 is a schematic diagram of an example system for promoting proper
use of a during lower extremity rehabilitation;
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Date Recue/Date Received 2023-12-29
[0021] FIG. 2 is a schematic diagram depicting the gait of a patient having an
injured left leg walking with the assistance a pair of crutches;
[0022] FIG. 3 is a perspective view of one of the smart crutch tip electronic
devices
of FIG. 1;
[0023] FIG. 4 is an elevation view of the smart crutch tip electronic device
of FIG. 3;
[0024] FIG. 5 is a primarily cross-sectional view of the smart crutch tip
electronic
device of FIG. 4 taken along line 5-5;
[0025] FIG. 6 is an exploded view of the smart crutch tip electronic device of
FIG. 4;
[0026] FIG. 7 is a simplified schematic cross-section of a lower portion of
the smart
crutch tip electronic device of FIG. 4;
[0027] FIG. 8 depicts a graphical user interface (GUI) displayed by a mobile
patient
software application at a patient mobile device of FIG. 1;
[0028] FIG. 9 depicts a GUI displayed by a mobile doctor software application
at a
doctor mobile device of FIG. 1;
[0029] FIG. 10 depicts a data structure used at a primary smart crutch tip
electronic
device of FIG. 1;
[0030] FIG. 11 is a perspective view of the smart crutch tip devices of FIG. 1
installed onto crutches and ready for use;
[0031] FIG. 12 is a flowchart of operation of the primary smart crutch tip of
FIG. 1 for
monitoring compliance with a currently operative target load;
[0032] FIG. 13 is a flowchart providing detail regarding one of the operations
of FIG.
12 in the case where the walking aid comprises two crutches;
[0033] FIG. 14 is a flowchart providing detail regarding another one of the
operations of FIG. 12 in the case where the walking aid comprises two
crutches;
[0034] FIG. 15A is a line graph depicting the dynamic load on a first crutch
of the
pair of crutches shown in FIG. 1 during a patient step;
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[0035] FIG. 15B is a line graph depicting the dynamic load on a second crutch
of the
pair of crutches shown in FIG. 1 during the same patient step;
[0036] FIG. 16 is a line graph depicting the dynamic load on the pair of
crutches
shown in FIG. 1 collectively during the patient step;
[0037] FIG. 17 depicts another GUI displayed by the mobile patient software
application at the patient mobile device of FIG. 1;
[0038] FIG. 18 depicts a GUI displayed by a web-based doctor software
application
at the doctor mobile device of FIG. 1;
[0039] FIG. 19 is an elevation view of an alternative embodiment of the smart
crutch
tip electronic device that is integrally formed with a crutch;
[0040] FIG. 20 is a cross-section of the smart crutch tip electronic device of
FIG. 19
taken along line 20-20;
[0041] FIG. 21 is an exploded view of the smart crutch tip device of FIG. 19;
[0042] FIG. 22 is a schematic diagram of an alternative embodiment system for
promoting proper use of a during lower extremity rehabilitation;
[0043] FIG. 23 is a front elevation view of one of the smart crutch tip
electronic
devices of FIG. 22;
[0044] FIG. 24 is a side elevation view of the smart crutch tip electronic
device of
FIG. 23;
[0045] FIG. 25 is an exploded view of the smart crutch tip electronic device
of FIG.
23; and
[0046] FIG. 26 shows a user interface for configuring the smart crutch tip
electronic
device of FIG. 23.
DETAILED DESCRIPTION
[0047] In this document, the term "exemplary" should be understood to mean "an
example of" and not necessarily to mean that the example is preferable or
optimal in
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some way. Terms such as "upper", "lower", and "above" may be used to describe
some embodiments in this description but should not be understood to
necessarily
connote an orientation of the embodiments during manufacture or use.
[0048] FIG. 1 is a schematic diagram of an exemplary system 100 for promoting
proper use of a walking aid 110 by a patient 112 during lower extremity
rehabilitation.
In this example, the walking aid 110 is a pair of crutches 110R, 110L
(generically or
collectively crutch(es) 110), and the lower extremity is an injured left leg.
Alternative
embodiments of the system may be used with other types of walking aids and for
other
types of lower extremity injuries.
[0049] The depicted example system 100 has various components, including: two
smart crutch tip devices 120L and 120R (generically or collectively smart
crutch tip
device(s) 120), which have been installed onto crutches 110L and 110R
(generically or
collectively crutch(es) 110) respectively in a manner that will be described;
a mobile
device 130, used by the patient 112, executing a mobile patient software
application
("app") 132; a mobile device 140, used by a doctor 116, executing a mobile
doctor app
142; a computer 150, also used by the doctor 116, executing a web-based doctor
app
152; and a cloud-based server 160 executing a backend server application 162.
[0050] Each of the smart crutch tips 120 is an electronic device that is
attachable to
a respective one of crutches 110 to dynamically measure the load placed on the
crutch
110 as it is being used by the patient 112. The smart crutch tips 120R, 120L
are
designed to intercommunicate wirelessly in order to amalgamate dynamic load
information from the two crutches at one of the smart crutch tips 120R,
referred to as
the "primary" smart crutch tip. This is done to permit a collective (total)
load on the pair
of crutches 110 to be computed in real time for each step taken using the
crutches, as
will be described below.
[0051] In overview, the smart crutch tips 120 are designed to promote patient
compliance with a lower extremity rehabilitation program that has been
prepared
specifically for the patient 112 by the doctor 116. The smart crutch tips 120
do this by
receiving and utilizing patient-specific rehabilitation program data 144 based
on
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rehabilitation program parameters originating from the doctor 116. The data
144
specifies a duration of the rehabilitation program (the "rehabilitation
period") during
which the patient should use the crutches 110, e.g., expressed as a number of
days,
and specifies (indirectly) a weight-bearing target on the injured lower
extremity for
each day of the rehabilitation program.
[0052] Upon receipt of the rehabilitation program data 144, the smart crutch
tips 120
configure themselves to monitor for patient compliance with the daily weight-
bearing
target as the crutches are used. More specifically, the smart crutch tips 120
use the
current date and time to determine which day of the rehabilitation program is
currently
operative. The smart crutch tips 120 then indirectly determine the weight
being placed
on the injured lower extremity during each step by measuring how much of the
patient's weight is being carried by the crutches 110. That load is compared
to the
target load for the crutches for the current day.
[0053] Based on the results of the comparison, feedback is provided to the
patient
112, in real time, in the form of one or more configurable user notifications,
e.g., visual
indicators, auditory indicators, or voice indicators. The user notification(s)
indicate(s)
whether the weight placed on the injured lower extremity is too high or too
low.
Absence of a user notification may indicate compliance with the target load,
which may
include being within a range of tolerance of the target. Usage data may also
be
continuously or periodically wirelessly communicated to the patient mobile
device 130
and relayed to the cloud-based server 160 for near real-time access by the
doctor 116
in monitoring for patient compliance with the rehabilitation program from a
remote
location.
[0054] By way of the foregoing mechanisms, the smart crutch tips 120 are
operable
to automatically adjust the weight-bearing targets for the injured lower
extremity (i.e., a
currently operative target load on the walking aid) over time in accordance
with the
rehabilitation program schedule originally prescribed by the doctor 116 for
the patient
112. Moreover, the smart crutch tips 120 can automatically adapt themselves to
monitor for compliance with dynamically changeable weight bearing targets
during the
rehabilitation period.
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[0055] It should be appreciated that the smart crutch tips 120 do not directly
measure the amount of weight placed on the injured lower extremity. Rather,
the smart
crutch tips 120 compute a peak weight on the pair of crutches 110 at a point
in the
patient's gait at which the patient's weight will simultaneously be on the
crutches and
on the injured lower extremity. The smart crutch tips 120 operate on the
presumption
that, at that moment of the patient's gait, whatever portion of the patient's
weight is not
on the crutches will be on the injured lower extremity. This is perhaps best
understood
with reference to FIG. 2.
[0056] FIG. 2 schematically depicts the gait of a patient having an injured
left lower
extremity (e.g., left leg) and an uninjured right leg, walking with the
assistance a pair of
crutches. Time is representing on the horizontal axis. Three steps of the
patient's gait
are depicted in FIG. 2.
[0057] In a first step (step 1) taken between time tO and time t1, the patient
places
100% of his or her weight on the uninjured right leg RL. During step 1,
neither the tips
of the crutches nor the injured leg is on the ground. Rather, the crutch tips
are being
swung forwardly in anticipation of step 2, and the injured leg is suspended.
[0058] In a second step (step 2) taken between time t1 and t2, the patient
plants two
crutch tips on the ground at points CT1 and CT2 respectively. At approximately
the
same time as the crutch tips are planted, the patient steps lightly on the
injured left leg
LL while using the crutches to steady himself or herself. At this time, the
uninjured leg
RL is swinging forwardly in anticipation of step 3, i.e., is not on the
ground. As a result,
part of the patient's weight will be on the injured leg, and the remainder of
the patient's
weight will be on the crutches at this time. It is at this moment that the
weight on the
injured leg can be deduced (indirectly measured) by measuring the weight on
the pair
of crutches and subtracting it from the patient's body weight. This is the
principle by
which the smart crutch tips 120 operate to indirectly measure the weight
placed on the
injured leg.
[0059] The third patient step (step 3), taken between time t2 and t3, is a
repetition of
step 1. The cycle is thereafter repeated with step 4 (not depicted) being a
repetition of
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step 2, and so on. As will be appreciated, the measuring of the body weight on
the
crutches is only performed during alternate steps¨in this example, step 2,
step 4, and
so forth.
[0060] An example embodiment of a smart crutch tip 120 is illustrated in FIGS.
3, 4,
5, and 6 in perspective view, elevation view, cross-sectional view (taken
along line 5-5
of FIG. 4), and exploded view, respectively. FIG. 7 is a schematic diagram
depicting a
simplified representation of a lower portion of the smart crutch tip 120 in
cross-section
when attached to a crutch leg.
[0061] As illustrated in FIGS. 3-6, the smart crutch tip 120 has a housing 202
that
houses and protects structural and electronic components of the smart crutch
tip 120.
In the depicted embodiment, the housing has two halves to facilitate device
assembly.
The first half is an upper housing portion 204, which is substantially
cylindrical in the
present embodiment. The second half is a lower housing portion 206, which is
generally funnel-shaped in the present embodiment. The housing 202 may have
different shapes and/or different components in alternative embodiments.
[0062] The structural components of the smart crutch tip 120 include a body
208,
only partly visible in FIGS. 3 and 4. The body 208 may be considered as the
primary
structural component or frame of the smart crutch tip 120. It may be made from
a rigid,
strong, lightweight material, such as aluminum or suitable plastic for
example.
[0063] As perhaps best seen in FIGS. 5 and 6, the body 208 defines receptacle
210
for receiving the tip of a leg of a walking aid, such as a crutch tip (i.e.,
the tip of a leg of
the crutch), from above. A nut 212 and a resilient split ring 214 at the open
end of the
receptacle collectively serve as a retaining mechanism (or clamp or attachment
means) for retaining the tip of the leg of the walking aid within the
receptacle 210, i.e.,
for attaching the smart crutch tip 120 to the walking aid without tools, as
will be
described.
[0064] Referring to FIGS. 5 and 6, the body 208 of the present embodiment has
a
generally spool-like shape, with upper and lower annular flanges 216, 218
depending
radially from either end of a central barrel portion 220. In the present
embodiment, the
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Date recue / Date received 2021-11-09
barrel portion 220 is generally cylindrical, and the receptacle 210, which is
also
cylindrical in this embodiment, is coaxial with the barrel 220. The two
flanges 216, 218
cooperate with the barrel 220 and the housing 202 to define an enclosed
annular
space 222 for safely housing electronic components, such as processor 252
(see, e.g.,
FIG. 5).
[0065] The body 208 includes an annular skirt 224 depending axially from a
periphery of the lower annular flange 218, away from the barrel portion 220.
The skirt
224 defines a hollow space 226 with an open end (see, e.g., FIG. 5). The
hollow space
226 accommodates a load sensor 230, whose edges are anchored to the body 208
at
skirt 224.
[0066] In the present embodiment, the load sensor 230 is an aggregation of
three
load sensor elements 232 held together with fastener 234 (e.g., a screw). The
reason
for aggregating multiple sensors 232 may be to aggregate a load-sensing
capacity of
multiple ones of the load sensor elements. Alternative embodiments may employ
other
load sensor arrangements, e.g., a single load sensor whose load-sensing
capacity is
sufficient for the purposes described herein.
[0067] A screw in the base of the receptacle 210 serves as an adjustable stop
236
to guard against possible load sensor damage that may result from excessive
flexing
of load sensor 230. The position of stop 236 may be adjusted by turning the
screw to
increase or decrease the size of a gap 237 above the load sensor 230 within
which
flexing can occur (see FIG. 6).
[0068] The funnel-shaped lower housing portion 206 has a tubular neck 207. The
tubular neck slidably receives a base 240 having a rubber foot 241 at its
lower end.
The base 240, which is a cylindrical post in the present embodiment, is
configured for
limited axial movement (translation) with respect to the body 208 of the smart
crutch
tip 120 (vertically in FIG. 6).
[0069] A base stop 244 limits downward movement of the base 240 relative to
the
body 208 of the smart crutch tip 120. In the present embodiment, the base stop
244 is
a cuboid rigid element that is attached to the base 240 using a bolt 239. More
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specifically, the base stop 244 is received within a notch 245 at the upper
end 242 of
the base 240, and a bolt 239 is passed through a central bore 243 of the base
stop
244 and threaded into a vertical bore at the base of the notch 245. In the
illustrated
embodiment, the base stop 244 has a horizontal extent wider than that of the
base
240, with the overhanging ends serving to limit downward movement of base 240
relative to body 208. The base stop 244 and bolt 239 may each be considered as
an
extension of the base 240 in this embodiment. Other forms of base stop could
be used
in alternative embodiments.
[0070] The load sensor 230 is disposed between the body 208 and the bolt 239
(and thus base 240, of which bolt 239 may be considered as a part). As such,
the load
sensor 230 is in the load path of the smart crutch tip 120. Specifically, in
this
embodiment, load passes between head of fastener 234 and the abutting head of
bolt
239.
[0071] FIG. 7 is a schematic diagram illustrating a simplified model of a
portion of
the smart crutch tip 120. FIG. 7 may facilitate comprehension of the way in
which
smart crutch tip 120 can be used to measure a load upon a crutch 110, or other
walking aid. For simplicity, FIG. 7 omits certain components of the smart
crutch tip
120, such as the housing 202. Moreover, the components that are depicted are
in
simplified schematic form. For example, the base 240 and base stop 244 are
depicted
collectively as a single combined base element 240, again for simplicity.
[0072] Referring to FIG. 7, the tip (of the leg) of crutch 110 is received
within the
receptacle 210 and is retained therein by the nut 212 and the split ring 214
(not
shown). When a patient applies weight W to the crutch 110, a downward force
proportional to the applied weight W is transferred to the body 208 of the
smart crutch
tip 120. This downward force causes the body 208 to translate downwardly
relative to
the base 240 in respect of which the body 208 is axially translatable. The
edges of
load sensor 230, which are anchored to the body 208 within the hollow space
226,
move with the body 208. A central area of the load sensor 230 transfers the
downward
force to an upper end of the base 240. However, the base 240 is prevented from
moving downwardly by the ground G upon which the foot 241 sits. A resultant
upward
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force F from the ground G is relayed by the base 240 (in this example, through
bolt
239 see FIG. 6) and bears upon the central area of the load sensor 230 (in
this
example, upon fastener 234), causing the load sensor 230 to flex. The flexing
causes
the load sensor 230 to output a signal (data) indicative of the amount of
weight W that
is being borne by the crutch 110.
[0073] Referring again to FIGS. 5 and 6, the smart crutch tip 120 further
includes a
printed circuit board 250 with a processor 252 communicatively coupled to each
of a
memory 254 and a short-range wireless transceiver 256 (e.g., BluetoothIm
transceiver). The processor, memory, and transceiver may for example comprise
a
BluetoothTM 5 module or BluetoothTM BLE module, which may be a single
integrated
circuit component. The electronic components are powered by batteries 258 held
by a
battery holder 260, which also supports the printed circuit board 250 in this
embodiment.
[0074] The memory 254 includes processor-executable instructions, e.g.,
firmware,
that govern operation of the smart crutch tip 120 as described herein. The
instructions
may for example be loaded during manufacture of the smart crutch tip 120 and
may be
subsequently updated, e.g., via flashing.
[0075] The smart crutch tip 120 also includes an auditory notification element
262
(e.g., a buzzer), a visual notification element 264 (e.g., an LED protected by
a
transparent cover 266), and a speaker for providing voice notifications (not
expressly
depicted). These elements are for providing user feedback regarding target
compliance directly from the smart crutch tip device itself. The mobile
patient app 132
may also be configured to provide similar user notifications when in wireless
communication range (e.g., BluetoothTM LE range) of the smart crutch tip 120.
If the
body 208 is made from an electrically conductive material (e.g., aluminum),
then a
sheet of insulation 268 may be wrapped around the surface of barrel 220 to
electrically
isolate the printed circuit board 250, and other electrical components, from
the body
208. Insulation 268 may be unnecessary when the body 208 is made from an
electrically non-conductive material.
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Date re9ue / Date received 2021-11-09
[0076] Referring again to FIG. 1, the crutches 110 may be one of a variety of
types
of crutches, such as axillary (underarm) crutches, elbow (lofstrand or
Canadian)
crutches, gutter (forearm support) crutches, or otherwise. Each crutch has a
leg whose
length may be adjustable to accommodate patients of different heights.
[0077] The mobile devices 130 and 140 (FIG. 1) may for example be smartphones
carried by the patient 112 and the doctor 116 respectively, each having a
touchscreen
display for example. The computer 150 may for example be a laptop computer,
desktop computer, or tablet used by the doctor 116.
[0078] The mobile doctor app 142 (FIG. 1) provides a mechanism for the doctor
116
to customize, prescribe, and optionally update lower extremity rehabilitation
programs
for one or more patients from the convenience of his mobile device 140. The
mobile
doctor app 142 also permits the doctor 116 to monitor the progress of a
patient to
whom a rehabilitation program has been prescribed. Monitoring can be performed
in
real time while the crutches 110 are being used. As will be described,
monitoring is
facilitated by graphical user interfaces (GUIs) by which the mobile doctor app
142 may
efficiently display data regarding patient compliance with a prescribed
rehabilitation
program. The doctor web app 152 provides functionality like that of the mobile
doctor
app 142 but is web-based and thus platform-agnostic.
[0079] The mobile patient app 132 (FIG. 1) provides a mechanism for the
patient
112 to receive a rehabilitation program designed by doctor 116 and to
configure the
smart crutch tips 120 to implement that rehabilitation program in the manner
described
herein. The mobile patient app 132 also receives usage data from the smart
crutch tips
120, in real-time, indicating whether the crutches 110 are being used in
accordance
with the rehabilitation program. The patient 112 can efficiently display usage
data in
various ways using GUIs in the mobile patient app 132, as will be described.
The
usage data is also communicated back to the doctor 116 by way of the backend
server
application 162 for display within the mobile doctor app 142 and/or web-based
doctor
app 152, described above.
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Date recue / Date received 2021-11-09
[0080] Operation of the system 100 will be described in the context of an
example
usage scenario. In this scenario, the patient 112 is a male who has suffered a
lower
extremity injury and has undergone surgery as a result. It presumed that the
patient
112 has been referred to the doctor 116 for post-surgical rehabilitation. For
example,
the referral may be made verbally or in writing by a surgeon who performed the
surgery. By way of the referral, the doctor 116 may be provided with unique
patient
contact information, such as a mobile telephone number or email address, and
informed of the nature of the patient's lower extremity injury.
[0081] To prepare a rehabilitation program for the patient 112, the doctor 116
may
invoke the mobile doctor app 142 on his mobile device 140. The app 142 may
have
been downloaded to the doctor's mobile device 140 from an app store, such as
Google TM Play or the Apple TM App Store for example. The doctor may have
completed
a registration procedure upon initial app invocation, e.g., specifying
information that
may include the doctor's name, location, professional specialization,
experience,
workplace, and telephone number.
[0082] If the patient 112 is a new patient, the doctor 116 may initially use
the app
142 to create a new patient record. A patient record, which may be referred to
as a
"patient card", may be considered as a digital representation of a patient
file
maintained in the context of a lower extremity rehabilitation. The mobile
doctor app
142 may permit the user to create multiple patient records to permit the user
to
oversee the rehabilitation of multiple patients in parallel.
[0083] Creation of a new patient card may entail three steps.
[0084] In a first step, the app 142 may prompts the doctor 116 to enter unique
patient contact information for patient 112, such as a mobile telephone number
or an
email address.
[0085] In a second step, the app 142 may prompt the doctor 116 to specify the
type
of lower extremity injury that has been suffered. For example, the app 142 may
display
GUI that includes a radio button (or other user input mechanism) with two
mutually
exclusive options: a "surgery" option and a "therapy" option. For the present
scenario,
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Date recue / Date received 2021-11-09
the surgery option may be chosen to indicate that the patient 112 has
undergone
surgery. The therapy option may be chosen in scenarios in which a lower
extremity
injury has been suffered but no surgery has been performed.
[0086] The GUI may further prompt the doctor to enter specifics regarding the
injury,
e.g., via several pull-down lists (or other user input mechanism). One pull-
down list
may be used to identify the lower extremity that has been injured, which in
this
example is the left hip joint. Another pull-down list, which may appear only
in the case
where the surgery option was chosen, may specify the type of surgery that was
performed (e.g., metal osteosynthesis in this example). A further pull-down
list may be
used to precisely identify the injury that was initially suffered (e.g., a
fracture of the
femoral neck in this example).
[0087] In a third step, the doctor app 142 may prompt the doctor 116 to
specify
and/or customize the parameters of a rehabilitation program. To that end, the
mobile
doctor app 142 may display a GUI 300 as shown in FIG. 8. In the depicted
embodiment, the GUI 300 permits the rehabilitation program to be specified in
terms of
one, and possibly multiple, rehabilitation phases. For each phase, the doctor
116 is
prompted to specify the following parameters: the type of loading that should
be
performed on the injured lower extremity during that phase (zero load,
constant load,
or steadily increasing load); the duration of the phase; and the percentage of
body
weight to apply to the injured lower extremity during that phase. Each phase
that is
specified by the user is represented as a numbered entry in GUI 300. In
alternative
embodiments, other GUI formats could be used.
[0088] In the example GUI 300 depicted in FIG. 8, the doctor 116 has specified
a
six-week rehabilitation program having three phases. A first numbered entry
302
displayed in GUI 300 represents a first, "non load" (i.e., 0% loading) phase,
whose
duration has been set to two weeks. A second numbered entry 304 represents a
second, constant load phase, also having a duration of two weeks, during which
30%
body weight should be applied to the injured lower extremity. A third numbered
entry
306 represents a third, increasing load phase, also having a duration of two
weeks,
during which the body weight applied to the injured lower extremity should
increase
- 17 -
Date recue / Date received 2021-11-09
progressively from 30% to 70%. In GUI 300, the numerical order of the entries,
i.e.,
their relative ordinal positions, specifies the chronological order in which
the phases
should be performed during the rehabilitation program.
[0089] In the example GUI 300 of FIG. 8, the "+" (plus) icon 308 and "-"
(minus) icon
310 depicted in each entry are user input mechanisms whose selection either
increases or decreases, respectively, a duration (here, in weeks) of the phase
that is
represented by the entry in association with which the icons are displayed. A
phase
may be eliminated by setting its duration to zero weeks. Moreover, the doctor
116 may
use the "edit" icons 312 to change the percentage of loading, e.g., in
increments of
10%, for the phase represented by the entry in which the icons are displayed.
Notably,
the degree of loading is expressed in relative terms, e.g., as a percentage
(fraction) of
total body weight, rather than in absolute units such as pounds, since the
doctor 116
may not have any indication of the patient's weight at this stage.
[0090] Once the rehabilitation program has been customized as the doctor
116
sees fit, selection of the "send the program to the patient" button 336 (or
similar GUI
construct) may cause two steps to be performed.
Firstly, data 143 indicative of the specified rehabilitation program
parameters may be
communicated to the backend server application 162 along with a unique patient
identifier, e.g., the unique patient contact information (see FIG. 1). The
backend server
application 162 may create a patient database record (not expressly depicted)
containing this rehabilitation program parameter data 143, indexable by the
unique
patient identifier. This step may occur transparently from the perspective of
the doctor
112. The data 143 in this example includes, for each of a plurality of time
intervals
(here, days) spanning a rehabilitation period (here, six weeks), a target
relative load on
an injured lower extremity during the time interval (here, expressed as a
percentage)
relative to a patient body weight.
[0091] Secondly, the earlier-specified patient contact information may be used
to
send a communication to the patient 112, e.g., via SMS (text message) or
email, to
advise that a rehabilitation program has been prepared for that patient. The
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Date recue / Date received 2021-11-09
communication may include a URL (link) whose selection by patient 112 may
trigger a
download of the mobile patient app 132 to the mobile device 130.
[0092] Upon being installed and invoked at the mobile device 130, the mobile
patient app 132 may prompt the patient 112 to complete patient registration by
entering data including name, gender, date of birth, and weight information.
It will be
appreciated that entry of an indication of patient body weight is required to
permit the
mobile patient app 132 to convert the relative (percentage) lower extremity
target
loads specified by doctor 116 within the rehabilitation program parameter data
143 to
absolute target loads (e.g., in pounds or kilograms) that the smart crutch
tips 120 will
be capable of measuring, as will be described.
[0093] At the completion of patient registration, the mobile patient app 132
may
communicate the collected patient information to the backend server
application 162.
The backend server application 162 may add that information to the patient
database
record maintained at the cloud-based server 160.
[0094] Based on the presence of rehabilitation program parameter data 143 in
the
patient database record, the mobile patient app 132 may notify the patient 112
that a
rehabilitation program has been prepared by the doctor 116. Upon receiving
approval
from the patient 112, the rehabilitation program parameter data may 143 be
communicated to the mobile device 130 for use by the mobile patient app 132.
[0095] At this stage, the patient 112 may acquire the pair of smart crutch
tips 120,
e.g., from the doctor 116 or another source. The crutches 110 may already in
the
possession of the patient 112 or may be newly acquired along with the smart
crutch
tips 120.
[0096] One of the smart crutch tips 120R may then be installed onto the tip of
a leg
of the right crutch 110R, and the other smart crutch tip 120L may be installed
onto the
tip of a leg of the second crutch 110L. Installation (attachment) may entail
removing a
rubber foot from each crutch leg, inserting the tip of the crutch leg through
the nut 212
and into the receptacle 210 of the respective smart crutch tip 120, and
tightening of the
nut 212 to attach the body 208 the smart crutch tip 120 to the crutch 110. The
smart
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Date re9ue / Date received 2021-11-09
crutch tips 120R, 120L may be considered to be associated with the crutches
110R,
110L, respectively, onto which they have been, or will be, installed. Each of
the smart
crutch tips 120 may then be activated using a power button (not expressly
depicted).
[0097] At this stage, the mobile patient app 132 may display a GUI 350 as
shown in
FIG. 9. This GUI 350 may be considered as a main GUI screen of the mobile
patient
app 132 by which the patient 112 can monitor daily progress through the
rehabilitation
program. As illustrated, the main GUI 350 includes a progress bar 352 showing
how
much of the lower extremity rehabilitation program has been completed. In this
embodiment, a textual indicator "Day 0/42" indicates that the patient 112 has
not yet
commenced the six-week (42-day) rehabilitation program. A recent usage history
display area 354 may accordingly be blank as shown in FIG. 9.
[0098] To establish a wireless connection between the mobile device 130 and
the
smart crutch tips 120 by which data may be exchanged, the user may be prompted
to
select a "Connect" button 356 or similar GUI construct. In the present
embodiment,
selection of this button may trigger a BlueToothTm LE pairing process between
the
mobile device 130 and one of the smart crutch tips 120R that has been
predesignated
as the "primary" smart crutch tip that will be responsible for communication
with the
mobile device 130 on behalf of the pair of smart crutch tips 120R, 120L. For
example,
upon selection of the "connect" button 356, the mobile device 130 may scan for
any
BlueToothTm LE advertising packets being wirelessly broadcast by any nearby
smart
crutch tip devices. In so doing, the mobile device 130 will detect the
proximity of
primary smart crutch tip 120R and may identify that device as being proximate.
Upon
user confirmation that connection should proceed, the two devices may exchange
security keys and establish a data communication channel.
[0099] In the present embodiment, the mobile device 130 does not communicate
directly with the other, secondary smart crutch tip 120L. The reason is that
the primary
smart crutch tip 120R is solely responsible for communicating with the mobile
device
130 on behalf of the pair of smart crutch tips 120 in this embodiment. The
secondary
smart crutch tip 120L will communicate information about the dynamic load upon
associated left crutch 110L, wirelessly in real time, to the primary smart
crutch tip
- 20 -
Date re9ue / Date received 2021-11-09
120R. In turn, the primary smart crutch tip 120R will use the information from
the
secondary smart crutch tip 120L, together with locally measured dynamic load
information upon associated right crutch 110R, to calculate the collective
load on the
pair of crutches 110 in real time, as will be described. It is the collective
load
information that will be communicated to the mobile device 130.
[00100] The primary smart crutch tip 12OR of the present embodiment is
operable to
automatically establish a wireless connection with the secondary smart crutch
tip
120L, e.g., soon after the devices 120R, 120L are powered up. This may be done
via a
short-range wireless communication mechanism such as BluetoothTM. In one
embodiment, a unique Media Access Control (MAC) address of the secondary smart
crutch tip 120L may be preprogrammed into the firmware of the primary smart
crutch
tip 120R, e.g., during manufacture, to facilitate such automatic establishment
of the
wireless connection, transparently from the perspective of the user.
[00101] After some predetermined number of steps has been taken (e.g., five
steps),
the rehabilitation program may be considered to have commenced. The current
date at
the mobile device when this occurs may be deemed as the first day of the
rehabilitation period.
[00102] The mobile patient app 132 may use the rehabilitation program
parameter
data 143 originating from the doctor 116 and the patient body weight
information
specified locally by the patient 112 to generate and output rehabilitation
program data
144 for configuring the smart crutch tips 120. The rehabilitation program data
144
specifies patient-specific absolute target loads for the pair of crutches 110
for each day
of the rehabilitation program. In effect, the rehabilitation program data 144
defines a
schedule for use by the smart crutch tip 120, which specifies a target
(absolute) load
for the walking aid for each day of the rehabilitation period. A calendar date
may be
computed and stored with each of the daily target loads (of which there are 42
in the
present embodiment), to indicate when each target load will be operative.
Creation of
the array may be triggered by the patient 112 in the mobile patient app 132.
Alternative
embodiments could employ other data structures besides an array (e.g., a
linked list of
records).
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Date recue / Date received 2021-11-09
[00103] It will be appreciated that expressing the targets as absolute weight
targets
for the crutches, rather than as absolute weight targets for the injured lower
extremity,
facilitates use of the smart crutch tips 120 to monitor rehabilitation program
compliance by patient 112 in real time. The reason is that the smart crutch
tips 120
directly measure the load on the crutches rather than directly measuring a
load on the
injured lower extremity.
[00104] In the present embodiment, the rehabilitation program data 144 is
expressed
as an array of N elements, where N is a positive integer indicating a number
of time
intervals into which the rehabilitation period has been divided. In the
present
embodiment, each of the N elements represents a single day of the
rehabilitation
program and contains a value indicating a target load for the pair of crutches
for that
day, in absolute units (e.g., pounds or kilograms). The rationale for using a
single day
as the time interval is that patients may expect that their use of the walking
aid over
the course of a single day should be consistent, i.e., should target the same
load
throughout the day. It is possible that the rehabilitation program data 144 in
alternative
embodiments could specify target loads for time intervals that are shorter
than or
longer than one day. In general, the term "time interval" as used herein
refers to a
finite period of time, be it one day or otherwise.
[00105] FIG. 10 depicts example rehabilitation program data 144 that may be
generated by the mobile patient app 132 from the example rehabilitation
program
parameters specified in FIG. 8. The loads in FIG. 10 assume a patient-
specified weight
of 200 pounds. As illustrated, the data 144 comprises an array of 42 elements.
Each
element is identified in FIG. 10 by a reference numeral that is the ordinal
day number
of the 42-day (six week) rehabilitation program preceded by "144-". For
example, array
element 144-3 contains the target load for the pair of crutches 110 for the
third day of
the rehabilitation program. The associated calendar date of January 20, 2021
for that
day (expressed in format MM/DD/YY in FIG. 10) may also be stored in the array
element 144-3.
[00106] It will be appreciated that elements 144-1 to 144-14 of FIG. 10
correspond to
phase 1 of the rehabilitation program (entry 302 of FIG. 8), elements 144-15
to 144-28
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Date recue / Date received 2021-11-09
of FIG. 10 correspond to phase 2 of the rehabilitation program (entry 304 of
FIG. 8),
and elements 144-29 to 144-42 of FIG. 10 correspond to phase 3 of the
rehabilitation
program (entry 306 of FIG. 8). From the perspective of the smart crutch tip
120,
however, there may be no awareness of the existence of any phase(s). The
reason is
that the smart crutch tip 120 does not require phase information to be able to
provide
immediate user feedback regarding target load compliance via visual, auditory,
or
voice notifications. In contrast, the mobile patient app 132 does maintain
phase
information, so that more sophisticated usage analytics may be provided to the
patient
132 on request.
[00107] To compute the crutch target loads expressed in pounds for each of the
42
elements of array 144, the mobile patient app 132 may first compute the lower
extremity target load in pounds for each day. This may be done by multiplying
the
target percentage load on the lower extremity, as specified by the doctor 116
for the
relevant day, by the patient weight of 200 pounds. The resultant values may
then be
subtracted from the patient weight to calculate daily crutch target loads,
i.e., to
calculate, for each of the plurality of time intervals spanning the
rehabilitation period, a
target absolute load on the walking aid during the time interval. In this
example, the
target loads are expressed in pounds, e.g., for consistency with the unit of
measure of
the load sensor 230 (which is assumed to be pounds the present example).
[00108] It will be appreciated that the progressively decreasing target load
values in
array elements 144-29 to 144-42 correspond to the progressively increasing
phase 3
lower extremity target load of 30%-70% of body weight. The target load values
in the
array may be computed as follows. First, the change in absolute weight on the
lower
extremity during this phase may be calculated: (70%-30%)* 200 lbs. = 80 lbs.
Then
that change in absolute weight may be broken into fixed daily increments for
the
number of days in the phase (e.g., increments of 6.15 lbs. in this example).
Then the
crutch target load for each day of the phase may be set to the previous day's
target
load less that amount. In the present embodiment, target loads in array 144
are
rounded to the nearest pound, although such rounding is not absolutely
required.
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Date recue / Date received 2021-11-09
[00109] Once the mobile patient app 132 has generated the rehabilitation
program
data 144 (array in this example), the data 44 is wirelessly transmitted to the
primary
smart crutch tip 120R. As earlier noted, one smart crutch tip 120R is
predesignated as
the primary and the other smart crutch tip 120L is predesignated as the
secondary.
The primary smart crutch tip 120R is responsible not only for measuring the
dynamic
load on its own respective crutch 110R for each detected step but also for
combining
that dynamic load data with the dynamic load data received wirelessly from the
other,
secondary crutch to compute a peak load for the pair of crutches 110. The
secondary
smart crutch tip 120L is only responsible for measuring the dynamic load on
its
respective crutch 110L for each patient step and for wirelessly communicating
that
information to the primary. The secondary smart crutch tip 120L does not
directly
communicate with the mobile device 130 in this embodiment. In this
arrangement, the
rehabilitation program data 144 is stored only at the primary smart crutch tip
120R.
The smart crutch tips 120R, 120L that are designated as primary and secondary
may
be on either crutch and on either side of the patient's body.
[00110] At this stage, the crutches 110 are ready for use by the patient 112,
e.g., as
shown in the perspective view of FIG. 11.
[00111] Operation of the smart crutch tips 120 for monitoring compliance with
a
weight-bearing target of a lower extremity rehabilitation program is depicted
in FIGS.
12-16. FIG. 12 is a flowchart of operation 400 of the primary smart crutch tip
120R for
monitoring compliance with a currently operative target load during the
rehabilitation
program. Operation 400 may be triggered whenever motion is detected at the
smart
crutch tip 120R, e.g., using an accelerometer (not expressly depicted). FIGS.
13 and
14 are flowcharts providing detail regarding certain operations of FIG. 12 in
the case
where the walking aid comprises two crutches. The operations in FIGS. 12, 13,
and 14
may be effected largely or entirely in software, which may be stored in memory
254
and executed by processor 252. The software may for example be firmware. FIG.
15
illustrates the dynamic load data measured by each of smart crutch tip 120R
and
smart crutch tip 120L during an example patient step. FIG. 16 illustrates the
total
dynamic load on the pair of crutches 110 during the same patient step.
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Date recue / Date received 2021-11-09
[00112] For the purpose of FIG. 12, it is presumed that the primary smart
crutch tip
120R has already received, and has stored in its memory 254 (see FIG. 6), the
array
of rehabilitation program data 144 depicted in FIG. 10. It will be recalled
that this data
144 corresponds to the six-week rehabilitation program customized by the
doctor 116
using the GUI 300 of FIG. 8. The rehabilitation program is presumed to have
been
commenced on January 18, 2021. It is also presumed that the clocks of the
processors 252 on the two smart crutch tips 120R, 120L have been synchronized.
This
may for example occur at the time that the wireless connection between the
smart
crutch tips 120R, 120L is first established.
[00113] In operation 402 (FIG. 12), a currently operative time interval of the
at least
one time interval of the rehabilitation period is identified. In the present
embodiment,
identification of the currently operative time interval is based on the
current date. More
specifically, the processor 252 of the primary smart crutch tip 120R
determines the
current date. This may for example be done in software via a suitable
operating
system API call. Alternatively, the current date may be transmitted by the
mobile
device 130 to the primary smart crutch tip 120R at the time that a wireless
connection
is established between the two devices.
[00114] In this example, it is presumed that current date that is determined
in
operation 402 is February 2, 2021. Using this information as a lookup into the
array
144 of FIG. 10, the primary smart crutch tip 120R identifies the 16th day of
the 42-day
rehabilitation period, represented by array element 144-16, as the current
day¨or,
more generally, as the currently operative time interval¨of the rehabilitation
period. In
other words, it is presumed that patient 112 has already been using the smart
crutch
tips 120 for 15 days. The processor 252 may then read the value contained in
that
array element, i.e., 140 pounds, and may update a "current target load"
variable to
indicate the target for the current day.
[00115] In operation 404 (FIG. 12), data is received from one or more load
sensors
indicative of a dynamic load on the walking aid during a patient step. For the
present
scenario, in which the walking aid comprises multiple units (two crutches
110),
operation 404 may entail the steps shown in FIG. 13.
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Date recue / Date received 2021-11-09
[00116] Referring to FIG. 13, in step 410, the primary smart crutch tip 120R
receives
data from load sensor 230 indicative of a dynamic load on the first crutch
11OR during
a patient step. A step may be considered to have occurred when processor 252
of the
primary smart crutch tip 120R detects the following pattern output by the load
sensor
230: zero load followed by a positive load followed by zero load. For this
example, it is
assumed that the dynamic load is as depicted in FIG. 15A.
[00117] FIG. 15A is a line graph depicting the dynamic load measured by the
load
sensor 230 of the primary smart crutch tip 120 during the three patient steps
shown in
FIG. 2. Load is represented by the vertical axis, and time is represented by
the
horizontal axis. For step 410, it is presumed that the processor 252 receives
data
corresponding to the dynamic load between time t1 and time t2 of FIG. 15A. The
data
may be sampled at a predetermined frequency to generate a digital
representation of
the line graph of FIG. 15A. The digital representation may be recorded with
timestamp
information indicating when the samples were taken. As shown in FIG. 15A at
440, the
maximum load measured on the first crutch 11OR during step 2 is 62 pounds.
[00118] In step 412 of FIG. 13, the primary smart crutch tip 120R receives
wireless
signals carrying data indicative of a dynamic load on the second crutch 110L
during
the same patient step. The secondary smart crutch tip 120L may use the same
approach as the first crutch to determine when a patient step has been taken
and to
sample the load on the second crutch 110L during the step. The dynamic load on
the
second crutch is presumed to be as shown in FIG. 15B, with a maximum load of
80
pounds shown at 442. The samples capturing the dynamic load on the second
crutch
may be transmitted via BluetoothTM LE to the primary smart crutch tip 120R
along with
associated timestamp information indicating when the samples were taken.
[00119] It will be appreciated that the maximum load on the second crutch
during the
step, i.e., 80 pounds, is greater than the maximum load on the first crutch
during that
step, i.e., 62 pounds. Such discrepancies in load between crutches may arise,
e.g.,
when the patient 112 leans more heavily on one crutch than on the other while
taking
a step.
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Date recue / Date received 2021-11-09
[00120] Referring again to FIG. 12, in operation 406, the smart crutch tip
120R
determines, based upon the received data, a peak load upon the pair of
crutches 110
collectively during the patient step. For the present scenario, in which the
walking aid
comprises two crutches 110, operation 406 may entail the steps depicted in
FIG. 14.
[00121] In step 420 (FIG. 14), first crutch dynamic load data is time-aligned
with the
second crutch dynamic load data. This step may entail using timestamp
information to
identify pairs of load samples that were taken substantially simultaneously at
the smart
crutch tips 120R, 120L, respectively.
[00122] In step 422 (FIG. 14), a representation of the dynamic load on the
pair of
crutches collectively during the patient step is generated. This step may
entail
summing the time-aligned samples from the two smart crutch tips 120R, 120L to
generate a representation of total load on both crutches 110R, 110L. In the
present
example, this may result in a digital representation of the line 450 shown in
FIG. 16.
[00123] FIG. 16 is a line graph whose axes are analogous to those of FIGS. 15A
and
15B. Dashed lines 452 and 454 represent dynamic load data for crutch 1 and
crutch 2,
respectively, as depicted in FIGS. 15A and 15B, respectively. Line 450
represents a
summation of lines 452 and 454, which may be the result of step 422 of FIG.
14. It will
be appreciated that the time-aligning is performed so that the summing will
accurately
reflect the total load on the crutches 110 at the relevant times.
[00124] In step 424 (FIG. 14), the maximum load of the representation (sum)
generated in step 422 is determined. Referring to FIG. 16, the maximum load
456 for
the step taken between time t1 and time t2 is determined to be 142 pounds.
This load
may be considered as the peak load on the pair of crutches 110R, 110L during
the
patient step.
[00125] Referring again to FIG. 12, in operation 408, a user notification is
provided
indicating whether the peak load upon the walking aid during the patient step,
as
determined in operation 406, is non-compliant with the target load for the
currently
operative time interval, i.e., day 16 of the six-week rehabilitation program.
In the
present embodiment, the patient 112 is considered to have complied with the
target
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Date re9ue / Date received 2021-11-09
load if the peak load is within a range that is centered on the current target
load and
whose limits are 10% greater than and 10% less than the target load.
[00126] In the present example, the target load for the current date of Feb.
2, 2021, is
140 pounds (see element 144-16 of FIG. 10), so the range of weights that are
considered compliant is 126 lbs. to 154 lbs. Because the peak load of 142 lbs.
determined in operation 406 is within that range, no user notification is
provided.
[00127] Had the peak load from operation 406 been greater than 154 lbs.,
meaning
that too much weight was on the crutches 110 and not enough weight was on the
injured lower extremity, the primary smart crutch tip 120R may have provided a
visual,
auditory, or voice notification to urge the patient 112 to put more weight on
the injured
lower extremity. Conversely, if the peak load from operation 406 had been less
than
126 lbs., meaning that not enough weight was on the crutches 110 and too much
weight was on the injured lower extremity, the primary smart crutch tip 120R
may have
provided a visual, auditory, or voice notification to urge the patient 112 to
put less
weight on the injured lower extremity.
[00128] At the conclusion of operation 408 of FIG. 12, the primary smart
crutch tip
120R may store usage data pertaining to the patient step for subsequent
analysis. The
stored data may include the time at which the step was taken and the peak load
on the
crutches during the step. In some embodiments, the maximum load on each of the
two
crutches during the step, as show in FIG. 15A at 440 and FIG. 15B at 442, may
also
be stored. A step counter for the current day (or, more generally, time
interval) may
also be incremented.
[00129] Operations 404, 406, and 408 may thereafter be repeated for each step
taken by the patient using the crutches 110. In the result, the primary smart
crutch tip
120R may accumulate usage data for multiple steps taken at various times
during the
patient's rehabilitation program. This usage data is periodically wirelessly
transmitted
back to the mobile patient app 132, e.g., via BluetoothTM LE, when
connectivity with
the mobile device 130 is available. In one embodiment, the usage data is sent
in real
time immediately after each step is taken.
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[00130] The mobile patient app 132 may be used to display various types of
analytics
of the patient's usage of the crutches 110 during the rehabilitation program.
For
example, referring to FIG. 17, the main GUI 350 of the mobile patient app 132
may
display recent usage data in display area 354. In the GUI 350, individual
steps are
represented as bars in a bar graph whose vertical axis indicates load on the
injured
lower extremity (expressed in relative terms, e.g., percent) and horizontal
axis
represents time. The currently operative target load for the injured lower
extremity
(30% in this example) may be displayed in a textual banner 360 and as a
horizontal
line 362 in the bar graph. The range of weights that are considered compliant
(in this
example, from 20% to 40% of body weight) may be indicated, e.g., by
highlighting the
range using a differently colored graph background 364.
[00131] In GUI 300, the bars of the bar graph may be color-coded. Steps with
insufficient load on the injured lower extremity may be denoted by a white bar
366;
steps with an excessive load on the injured lower extremity may be denoted by
a red
bar 368; and steps that were compliant with the operative recommended target
load
may be denoted by a green bar 370. Such color coding, or other types of visual
indicators, may provide valuable, at-a-glance user feedback as to whether the
crutches 110 are being properly used. A step count indicator 372 may provide a
tally of
steps taken during the current day and may provide a progress indicator
showing
progress towards a daily goal, which the doctor may prescribe through the
mobile
doctor app 142.
[00132] The mobile patient app 132 also relays the recent usage data that it
continuously or periodically receives from the primary smart crutch tip 120R
to the
cloud-based backend software application 162 for storage in connection with
the
database record for patient 112. The stored usage data information is
accessible by
the mobile doctor app 142 and/or web-based doctor app 152.
[00133] The doctor 116 may use the doctor app 142 or 152 to remotely monitor,
in
real time or near-real time, the patient's usage of the crutches 110 during
the
rehabilitation program. Various types of analytics may be viewable. For
example, FIG.
18 illustrates an example GUI 500 of the web-based doctor app 152. This GUI
500 can
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Date recue / Date received 2021-11-09
be used to display historical usage data of the patient 112. A similar GUI 500
could be
generated and displayed at the mobile patient app 132.
[00134] The example GUI 500 includes a composite bar graph 502 in which the
vertical axis represents step count and the horizontal axis identifies the day
(or, more
generally, a chosen time interval) of the rehabilitation period. Each bar
represents
steps taken using the crutches 110 in a single day. The height of the bar
represents
total steps taken during the relevant day. The component bar portions making
up each
bar collectively indicate the proportion of the steps taken during that day in
which the
load on the injured lower extremity was too high, too low, or in the
recommended
range.
[00135] For example, bar 504 represents steps taken on February 2, 2021. The
height of the bar 504 indicates that 350 steps were taken using the crutches
110 on
that day. A first bar portion 506 shows that, for 20 of those steps, the load
on the
injured lower extremity was excessive. A second bar portion 508 shows that,
for 300 of
those steps, the load on the injured lower extremity was in the recommended
range,
i.e., compliant with the target load. A third bar portion 510 shows that, for
30 of those
steps, the load on the injured lower extremity was insufficient.
[00136] A pie chart icon 512, or similar GUI construct, may be used to present
an at-
a-glance graphical indicator of the proportion of excessively loaded,
insufficiently
loaded, or compliant steps taken by the patient 112 during a chosen duration
of the
rehabilitation period (e.g., day, week, month, or total rehabilitation
period). Another
icon 514 may be used to present an at-a-glance graphical indicator of a
proportion of
weight being loaded onto the left crutch 11 OL versus the right crutch 110R,
on
average, for a chosen duration. The GUI may further display the total time
spent
walking using the crutches 110 for the currently displayed interval, such as a
week.
[00137] The doctor can also make changes to the weight-bearing rehabilitation
program if necessary. Any such changes are communicated to the patient app and
are
relayed to the smart crutch tip devices. This may result in an update to the
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Date recue / Date received 2021-11-09
rehabilitation program data 144 array elements corresponding to the current
day and
any days remaining in the rehabilitation period.
[00138] As will be appreciated, the described system 100 provides a flexible
and
convenient mechanism for a patient 112 and a doctor 116 to monitor for patient
compliance with a prescribed lower extremity rehabilitation program, even when
the
target load dynamically changes. After being configured once at the outset of
a
rehabilitation period, the smart crutch tips 120 can change the target load
autonomously and automatically during the rehabilitation period, in accordance
with
the rehabilitation program. The smart crutch tips 120 can also monitor for
compliance
with the dynamically changing target load throughout the rehabilitation
program. The
likelihood of patient compliance with the rehabilitation program may be
improved in
comparison to conventional techniques.
[00139] As described above, the smart crutch tip 120 has attachment means (nut
212
and resilient split ring 214) for selectively attaching the smart crutch tip
120 to various
types of walking aids. The ability to attach the device 120 to different
walking aids may
be considered advantageous because the same device can be used for
rehabilitation
from different types of lower extremity injuries.
[00140] Nevertheless, the attachment means may contribute to device
complexity,
weight, and production cost. Moreover, attachment of the smart crutch tip 120
to a
walking aid may increase the height of the walking aid by perhaps 8 to 12
centimeters
in some embodiments, which may make the walking aid too tall for a patient to
use
properly. For this reason, it may be necessary to reduce the height of the
walking aid
by a complementary amount, e.g., by collapsing a telescoping leg portion of
the
walking aid, when the smart crutch tip 120 is attached. Some patients may
consider
attaching the smart crutch tip 120 and adjusting the walking aid height to be
tedious.
Moreover, some patients may consider the added weight and/or girth of the
smart
crutch tip 120 device(s) to feel awkward, at least initially, as compared with
using the
walking aid by itself.
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Date recue / Date received 2021-11-09
[00141] For such patients, a different embodiment of electronic device, which
is
similar to smart crutch tip 120 in terms of functionality but lighter and
integrally formed
with, or embedded within, the walking aid, may be preferred. One such example
embedded smart crutch tip device is depicted in FIGS. 19, 20, and 21.
[00142] FIG. 19 is an elevation view of an axillary crutch 610 (a form of
walking aid)
having a smart crutch tip 620 integrally formed therewith. The smart crutch
tip 620 is
an electronic device whose functionality is like that of smart crutch tip 120.
The form
factor of the crutch 610 depicted in FIG. 19 is such that, from outward
appearances,
the presence of an embedded smart crutch tip 620 is not immediately apparent.
This is
not strictly required but may facilitate patient acceptance of smart crutch
tip
technology.
[00143] The electronics of smart crutch tip 620 are arranged to fit within the
body or
structure of the walking aid. In the depicted embodiment, the smart crutch tip
620 is
designed to fit within a tubular leg portion 611 of the crutch 610. The crutch
leg 611
(or, more generally, walking aid body) acts as the housing for the smart
crutch tip 620,
reducing or eliminating the need for a dedicated housing, such as housing 202
of
smart crutch tip 120 (see, e.g., FIG. 5). This may help to reduce a weight
and/or
bulkiness of the smart cane tip 620.
[00144] FIG. 20 is a cross-section of the embedded smart crutch tip 620 taken
along
line 20-20 of FIG. 19. FIG. 21 is an exploded view of the smart crutch tip 120
with
some components (e.g., fasteners) omitted and other components (e.g.,
circuitry)
depicted schematically for clarity.
[00145] Referring to FIGS. 20 and 21, it should be appreciated that many
components of the smart cane tip 620 are analogous to counterpart components
in
smart crutch tip 120 of FIGS. 5 and 6. These components include the processor
752,
memory 754, and short-range wireless transceiver 756 (e.g., BluetoothTM
transceiver),
which may be analogous to processor 252, memory 254, and transceiver 256
described above, and may all form part of a Bluetoothrm 5 module or
Bluetoothrm BLE
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Date re9ue / Date received 2021-11-09
module. The auditory notification element 762 is also analogous to auditory
notification
element 262, shown above.
[00146] In the present embodiment, the above-referenced electronic components
are
mounted to a surface of a printed circuit board 750 having an elongate shape
designed to fit inside the hollow crutch leg 611. A battery 758 for powering
the smart
crutch tip 120 electronics may have a semi-cylindrical shape (see, e.g., FIG.
21) to
maximize utilization of space between the opposite side of the printed circuit
board
750 and the wall of crutch leg 611.
[00147] The example smart crutch tip 620 has a generally tubular body 708,
fixed
with respect to the crutch leg 611, that acts as a primary structural element
for the
device. The body 708 of this embodiment is differently shaped from body 208
described above. In particular, the body 708 has a shallow top receptacle 709
with an
open top and a deeper bottom receptacle 726 with an open bottom. The top
receptacle
709 supports the printed circuit board 750 and battery 758. The deepest
(uppermost in
FIGS. 20 and 21) portion of the bottom receptacle 726 accommodates a load
sensor
730.
[00148] A tubular flanged collar 727 fits snugly within the bottom receptacle
726,
below the load sensor 730. The collar 727 has a cylindrical central opening
that is
sized to slidably receive a crutch tip base 740. The base 740, which is a
cylindrical
post in the present embodiment, is configured for limited axial movement
(translation)
with respect to the collar 727 and body 708 of the smart crutch tip 120
(vertically in
FIGS. 20 and 21). The base 740 has a rubber foot 741 at its lower end.
[00149] As perhaps best seen in FIG. 20, the smart crutch tip 620 includes a
base
stop 744 that limits downward movement of the base 740 relative to the body
708 of
the smart crutch tip 620. As with the base stop 244 of the earlier-described
embodiment, the base stop 744 of the present embodiment is a cuboid rigid
element
held within a notch 745 at the upper end of the base 740 by a bolt 739. Other
forms of
base stop could be used in alternative embodiments.
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Date recue / Date received 2021-11-09
[00150] The load sensor 730 is disposed between the body 708 and the bolt 739
(and thus base 740, of which bolt 739 may be considered as a part). As such,
the load
sensor 730 is in the load path of the smart crutch tip 620.
[00151] Configuration and operation of the smart crutch tip 620 may be
performed as
described above for smart crutch tip 120 and as shown in FIGS. 8-14, 15A, 15B,
and
16-18, with certain exceptions. Once such exception is that the patient 112
need not
attach any device(s) to his or her walking aid, since the smart crutch tip 620
is already
integral therewith. Another exception is that user notifications directly from
the smart
crutch tip 620 may be limited to auditory user notifications rather than
visual ones,
because the illustrated embodiment lacks a visual user notification indicator
(although
one could be provided in alternative embedded crutch tip embodiments).
Otherwise,
operation of the mobile patient app 132, the mobile doctor app 142, and the
web-
based doctor app 152 may be the same as the operation of these apps that was
described above for removable smart crutch tips 120.
[00152] As with smart crutch tips 120R and 120L, in cases when a pair of smart
crutch tips 620R, 620L are used as a pair, one of the smart crutch tips 620R
is
predesignated as the primary device, and the other smart crutch tip 620L is
predesignated as the secondary device. Intercommunication between the primary
and
secondary smart crutch tips 620R and 620L may occur as described above for
devices
120R and 120L. Each smart crutch tip 620R, 620L may be considered to be
associated with the crutches 110R, 110L, respectively, with which they are
integrally
formed.
[00153] FIG. 22 illustrates an example alternative system 800 for encouraging
proper
use of a walking aid (e.g., a pair of crutches 110) during lower extremity
injury
rehabilitation. Like system 100, described above, system 800 includes a pair
of smart
crutch tips 820R, 820L (generically or collectively smart crutch tip(s) 820).
Each of the
smart crutch tips 820 is an electronic device that is similar in many respects
to smart
crutch tip 120. For example, each smart crutch tip 820 is attachable to a
respective
one of crutches 110 to dynamically measure the load placed on the crutch 110
as it is
being used. Moreover, the smart crutch tips 820R, 820L are designed to
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Date recue / Date received 2021-11-09
intercommunicate wirelessly to amalgamate dynamic load information from the
two
crutches 110, as described above in connection with FIG. 14 for crutch tips
120R,
120L.
[00154] Yet, each smart crutch tip 820 differs from the smart crutch tip 120
in certain
respects. A key difference is that the smart crutch tip 820 incorporates a
display
component and user input mechanism (UIM) not present in smart crutch tip 120.
The
display and UIM are usable by the patient 112, as will be described, to
manually
program the device consistently with a rehabilitation program from a doctor
116.
Another difference is that, for simplicity, smart crutch tip 820 does not
store, or relay to
any other device, historical usage data showing how the walking aid has been
used
during the current rehabilitation period (e.g., as graphically represented in
GUI 500 of
FIG. 18 for example). Rather, smart crutch tip 820 is limited to providing
immediate
feedback to the patient 112, in real time, in the form of one or more user
notifications,
e.g., visual indicators, auditory indicators, or voice indicators. These user
notifications
may be similar to those provided by smart crutch tip 120, e.g., notifying the
patient 112
whenever the weight applied to the walking aid is excessive or insufficient.
[00155] These differences between smart crutch tip 820 and smart crutch tip
120
permit the system 800 to be greatly simplified in comparison to system 100 of
FIG. 1.
For example, the example system 800 omits the following components of system
100
(see FIG. 1): the mobile patient app 132 executed at a patient mobile device
130; the
mobile doctor app 142 and/or web-based doctor app 152 being executed at a
doctor
mobile device 140 and computer 150, respectively; and backend server
application
162 executed at the cloud-based server 160. The cost of implementing and
maintaining the system 800 may accordingly be reduced compared to system 100.
[00156] System 800 may be considered particularly suitable for patient
rehabilitation
in certain patient and/or doctor scenarios, e.g.: when the doctor 116 lacks
access to,
or is unwilling to use, the mobile doctor app 142 or web-based doctor app 152;
when
the patient 112 lacks a suitable mobile device for executing the mobile
patient app
132; when the patient 112 is in a remote location with no internet
connectivity, which
may prevent the patient-specific rehabilitation program parameter data 143
originating
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Date recue / Date received 2021-11-09
from doctor app 142 or 152 from being transmitted to a mobile patient app 132
and
being converted to patient-specific rehabilitation program data 144 and
wirelessly
transmitted to smart crutch tip 120; when the patient 112 prefers to have
manual
control over rehabilitation program parameters; or a combination of these
factors.
[00157] A possible trade-off of using system 800 rather than system 100 may be
a
greater responsibility upon the patient 122 for correctly setting his or her
own
rehabilitation program parameter settings, including target load and time
interval
(duration), as described below. In view of this responsibility, system 800 may
be best
suited for more straightforward rehabilitation programs, e.g., ones with
constant target
load settings over extended periods of time, than for complicated
rehabilitation
programs with frequently changing target loads upon the walking aid.
[00158] FIGS. 23 and 24 are front and side elevation views, respectively, of
an
example embodiment of a smart crutch tip electronic device 820 of system 800.
FIG.
25 is an exploded view of the smart crutch tip 820 in which some components
are
depicted schematically or are omitted for clarity.
[00159] Like smart crutch tip 120, described above, the example smart crutch
tip 820
has a housing 902 comprised of an upper housing portion 904 and a lower
housing
portion 906, to facilitate device assembly. The housing 902 may have different
shapes
and/or different components in alternative embodiments.
[00160] The smart crutch tip 820 has a receptacle 910 that is sized and shaped
for
receiving the tip of a leg of a walking aid, such as a crutch tip, from above.
A nut 912
and a resilient split ring 914 (see FIG. 25) at the open end of the receptacle
comprise
attachment means for selectively attaching the smart crutch tip 820 to the
walking aid,
as described above.
[00161] The housing portion 904 attaches to a flat body element 908. The two
components collectively define a cavity in which the receptacle 910 is formed
and
electronics are housed. The housed electronics include a processor 952, memory
954,
and short-range wireless transceiver 956, all communicatively coupled with one
another and mounted to a printed circuit board 950. The processor, memory, and
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Date re9ue / Date received 2021-11-09
transceiver may for example comprise a BluetoothTM 5 module or BluetoothTM BLE
module, which may be a single integrated circuit. The memory 954 includes
processor-
executable instructions, e.g., firmware, that govern operation of the smart
crutch tip
820 as described herein. The instructions may for example be loaded during
manufacture of the smart crutch tip 820 and may be subsequently updated, e.g.,
via
flashing. A battery 958 powers the electronics of smart crutch tip 820 and is
rechargeable via a charging port 959.
[00162] An auditory notification element 962 (e.g., a buzzer) and a visual
notification
element 964 (e.g., an LED) are also mounted to the printed circuit board 950
and are
controllable by the processor 252. A transparent cover 966 protects the visual
notification element 964.
[00163] As alluded to above, the smart crutch tip 820 further includes a
display 970
and user input mechanism 972. The display may for example by a liquid-crystal
display (LCD) screen. In the present embodiment, the UIM 972 comprises four
physical buttons 972R, 972L, 972T, and 972B. The display 970 and UIM 972 may
be
mounted to the upper housing portion 904, e.g., by surface mounting or in
corresponding openings that are sized and shaped to receive these components,
and
are communicatively coupled to processor 952.
[00164] The lower housing portion 906 has a central opening 907 that slidably
receives a cylindrical post or base 940 with a rubber foot 941 at its lower
end. A base
stop 944, similar to base stops 244 and 744 described above, limits downward
axial
translation of the base 940 relative to the body 908 and housing 902 of the
smart
crutch tip 820. The base stop 944 fits within a notch 945 at the upper end of
base 940
and is attached to base 940, e.g., using a bolt 939.
[00165] A load sensor 930 is disposed between the body portion 908 and the
bolt
939 (and thus base 740, of which bolt 739 may be considered as a part). As
such, the
load sensor 930 is in the load path of the smart crutch tip 820.
[00166] The smart crutch tips 820R and 820L may be predesignated as primary
and
secondary, respectively, as described above for smart crutch tips 120R and
120L.
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Date recue / Date received 2021-11-09
When the primary smart crutch tip 820R is activated, it may automatically
establish a
wireless connection with the secondary smart crutch tip 820L. This may be done
via a
short-range wireless communication mechanism such as BluetoothTM using a
preprogrammed MAC address, as described above.
[00167] Unlike smart crutch tips 120R and 620R, described above, the primary
smart
crutch tip 820R of the present embodiment is not operable to wirelessly
receive
patient-specific rehabilitation program data 144 originating from the doctor
116
defining one or more time intervals with target load specified for each time
interval
(e.g., as depicted in FIG. 10). Rather, smart crutch tip 820R is manually
programmable
by a user, such as patient 112, to specify rehabilitation program parameters
for only a
single time interval at a time. The rehabilitation program parameters 143 may
be
specified by a doctor 166, during an in-person visit or over the phone for
example (see
FIG. 22). The parameters 143 may include multiple time intervals with
different targets
loads for different intervals.
[00168] To effect manual programming (configuration) of the smart crutch tip
820,
firmware stored in memory 954, when executed by processor 952, may cause the
display 970 to present three textual fields, as shown in FIG. 26, representing
user-
configurable rehabilitation program parameters for a single time interval of a
the
rehabilitation program. In this example, the first field 980 is for specifying
the body
weight of the patient, e.g., in pounds. The second field 982 is for specifying
the target
load on the injured lower extremity relative to the body weight, e.g., as a
percentage
value from 0% to 95%. The third field 984 is for specifying a duration of a
single time
interval, e.g., in weeks.
[00169] In one embodiment, a user may be able to configure the values in these
fields as follows. User selection of the right button 972R or left button
972L,
respectively, of the UIM 972 (see Fig. 25) may cause a cursor (e.g., reverse
video
highlighting) to tab forward or backward through the fields 980, 982, and 984.
When
the cursor highlights a particular field 980, 982, or 984, user selection of
the top button
972T or bottom button 972B, respectively, may cause the value of that field to
increase
or decrease by some predetermined increment (e.g., in field 980, by 5-pound
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Date recue / Date received 2021-11-09
increments). When the values in fields 980, 982, and 984 are set as desired,
the
cursor may be tabbed to either of the "OK" user input construct 986 or
"Cancel" user
input construct 988, e.g., using buttons 972R or 972L. Then, selection of one
of the top
button 972T or bottom button 972B may cause any changes made to the values in
any
of fields 980, 982, and 984 to be accepted or rejected.
[00170] When the values in the fields 980, 982, and 984 are accepted, the
processor
952 may automatically compute the target absolute load on the walking aid for
the
specified time interval based on the patient weight specified in FIG. 980 and
the target
relative load on the injured lower extremity specified in FIG. 982. For
example, if the
patient weight specified in field 980 is 200 pounds and the target relative
load on the
injured lower extremity specified in field 982 is 40%, then the target
absolute load on
the walking aid may be computed by calculating the absolute load on the
injured lower
extremity and subtracting that absolute load from the body weight, as follows:
200
pounds ¨(200 pounds * 40%) = 120 pounds.
[00171] After some predetermined number of steps has been taken with the
walking
aid 110 (e.g., five steps), the time interval of the rehabilitation program,
as specified in
FIG. 984 of FIG. 26, may be considered to have commenced. The processor 952
may
initiate a countdown timer that has been set to the time interval duration.
[00172] Operation 400 of the primary smart crutch tip 820R for monitoring
compliance with the currently operative target load, as computed from the
values of
fields 980 and 982 (see above), is depicted in FIG. 12. Operation 400 may be
triggered whenever motion is detected at the smart crutch tip 820R, e.g.,
using an
accelerometer (not expressly depicted).
[00173] In operation 402, a currently operative time interval of the at least
one time
interval of the rehabilitation period is identified. In the present
embodiment, the
currently operative time interval is the one whose duration was specified in
field 984 of
FIG. 26. Operation 402 may entail verifying that the time interval remains
unexpired,
e.g., by confirming that the countdown timer has not yet expired.
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Date recue / Date received 2021-11-09
[00174] In operation 404 (FIG. 12), data is received from one or more load
sensors
indicative of a dynamic load on the walking aid during a patient step. For the
present
scenario, in which the walking aid comprises multiple units (two crutches
110),
operation 404 may entail the steps shown in FIG. 13, as described above.
[00175] In operation 406 (FIG. 12), the primary smart crutch tip 820R
determines,
based upon the received data, a peak load upon the pair of crutches 110
collectively
during the patient step. For the present scenario, in which the walking aid
comprises
two crutches 110, operation 406 may entail the steps depicted in FIG. 14,
described
above.
[00176] In operation 408 (FIG. 12), a user notification is provided indicating
whether
the peak load upon the walking aid during the patient step, as determined in
operation
406, is non-compliant with the target load for the currently operative time
interval. In
the present embodiment, the patient 112 is considered to have complied with
the
target load if the peak load is within a range that is centered on the current
target load
and whose limits are a predetermined percentage (e.g., 10%) greater than and
less
than the target load. The primary smart crutch tip 820R may for example
provide a
visual, auditory, or voice notification to urge the patient 112 to put more
weight or less
weight on the injured lower extremity when the target load on the walking aid
is found
to be excessive or insufficient, respectively.
[00177] Operations 404, 406, and 408 may thereafter be repeated for each step
taken by the patient using the crutches 110. In the present embodiment, the
primary
smart crutch tip 820R does not store usage data for multiple steps taken at
various
times during the time interval, nor is in this information periodically
communicated to
any mobile patient app at a patient mobile device.
[00178] When the time interval expires (e.g., upon expiry of the countdown
timer),
then the processor 952 may trigger an audible or visual user notification
indicative of
that. The processor 952 may, alternatively or in conjunction, cause a prompt
to be
displayed on display 970 for entry of further user input via the user input
mechanism
972. The prompt may seek user input of a new target relative load on the
injured lower
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extremity and a new time interval of the rehabilitation period during which
the new
target load on the walking aid is to be operative, e.g., via fields 982 and
984 described
above. Once these new parameters have been entered and accepted, the processor
952 may automatically recompute the target absolute load on the walking aid
for the
specified time interval based on the earlier-specified patient weight and the
newly
specified target relative load. Thereafter, operation 400 may be repeated with
the new
target absolute load and for the newly specified time interval. This may be
repeated as
many times as necessary for a given rehabilitation period.
[00179] It will be appreciated that, although the electronic devices 120, 620,
and 820
are referred to above as a smart "crutch tips", the devices are not
necessarily used
only with crutches. They could alternatively be installed onto, or be
integrally formed
with, other types of walking aids, such as canes.
[00180] All references to a "doctor" in this document should be interpreted as
being
inclusive of any other medical professional who may be qualified to prescribed
and
monitor patient progress through a lower extremity rehabilitation program,
such as a
physical therapist for example. Similarly, all references to a "patient" in
this document
should be interpreted as inclusive of any users of a walking aid as described
herein,
regardless of whether the users are formally under the care of a medical
professional
at the time of use.
[00181] It will be appreciated that each memory 254, 754, and 954 described
herein
constitutes a form of non-transitory, machine-readable medium, other forms of
which
may include magnetic or optical storage media.
[00182] Various alternative embodiments are possible.
[00183] As noted above, it is possible to use a smart crutch tip device 120,
620, or
820 to monitor for patient compliance with a rehabilitation program when the
walking
aid comprises only one unit, such as a single crutch, rather than a pair. In
this case,
there would be no secondary smart crutch tip. In the case of smart crutch tip
120 or
820, the sole device would be installed onto the leg of the sole walking aid
unit, as
described above, or in the case of smart crutch tip 620 would be integrally
formed
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therewith. The sole devices 120, 620, and 820 would not receive wireless
signals from
any secondary smart crutch tip. In the case of devices 120 and 620, wireless
communication with the patient mobile device 130 would still occur.
[00184] In such a single-device scenario, operation 400 of the primary (and
sole)
smart crutch tip 120, 620, or 820 would still be as described above in FIG.
12, with the
following exceptions. Operations 404 and 406 would not be performed according
to
the steps outlined in FIGS. 13 and 14 respectively. Rather, operation 404 of
FIG. 12
may entail only step 410 of FIG. 13, with step 412 being unnecessary.
Moreover,
referring to FIG. 14, performing operations 420 and 422 would be unnecessary,
and
step 424 would entail determing the peak load based solely on the dynamic load
as
measured by the primary smart crutch tip 120R, 620R, or 820R during the
patient step.
[00185] The above-described embodiments use a short-range wireless
communication technology, such as BluetoothTM, for transmitting dynamic load
information from the secondary smart crutch tip 120L, 620L, or 820L to the
primary
smart crutch tip 120R, 620R, or 820R, respectively, in real time. A short-
range wireless
communication technology (be it Bluetooth TM or some other technology) may be
used
because the expected distance between the paired primary and secondary smart
crutch tips during use is expected to be well within the short-range
communication limit
of about 10 meters.
[00186] The above-described embodiments further use a short-range wireless
communication technology, such as BluetoothTM, for communicating the
collective
dynamic load on the pair of crutches 110 from the primary smart crutch tip
120R or
620R to the mobile device 130 in real time. It is possible that the distance
between the
mobile device 130 and the primary smart crutch tip 120R or 620R could exceed a
maximum range, e.g., if the mobile device 130 were left in another room from
the
smart crutch tips. In that case, wireless communication between the primary
smart
crutch tip 120R or 620R and the mobile device 130 may be interrupted. Until
communication can be reestablished, the primary smart crutch tip 120R or 620R
may
buffer, e.g., in flash memory, collective load information for each step taken
from the
time at which communication was interrupted. It is for this reason (at least
in part) that
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Date recue / Date received 2021-11-09
a capacity of memory at the primary smart crutch tip 120R or 620R may be
larger than
memory capacity at the secondary smart crutch tip 120L or 620L, respectively.
[00187] It is possible that a longer-range wireless communication technology
(e.g., a
medium or long-range technology) could be used for communication between the
primary smart crutch tip 120R or 620R and the mobile device 130 or possibly
even for
communication between the secondary smart crutch tip 120L, 620L, or 820L and
the
primary smart crutch tip 120R, 620R, or 820R, respectively. Longer range
wireless
communication technology may reduce a risk of any loss of communication
between
the devices, e.g., if real time user notification of load upon crutches 110 is
crucial for
some reason. A tradeoff may be higher cost of manufacture for smart crutch
tips
employing such longer-range communication technologies.
[00188] Whatever wireless communication technology is used between these
devices
(be it short-range or otherwise) should avoid excessive lag. Lag may be
considered
excessive, e.g., if it prevents any requisite user notification regarding load
on the
crutches 110 for the most recent step from being provided at the primary smart
crutch
tip 120R before a subsequent step is taken. References to "real time" user
notification
in this document may include near real-time ("near time") user notification,
although
any lag in user notification should not be so excessive as to cause confusion
over
which patient step has triggered the user notification.
[00189] In the foregoing description, when a pair of smart crutch tips 120,
620, or 820
is used together, one of the devices is designated as primary device and the
other is
designated as the secondary device. For clarity, it is not required for the
primary
device to always be used on the right side of the body of the patient and the
secondary
device on the left side of the body. The positions of primary smart crutch tip
and
secondary smart crutch tip relative to the body of the patient could be
reversed.
Moreover, the position of the primary smart crutch tip relative to the injured
lower
extremity is immaterial.
[00190] In the description of system 100 above, the mobile patient app 132 at
the
patient mobile device 130 is operable to receive rehabilitation program
parameter data
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originating from doctor 116, the rehabilitation program parameter data
including, for
each of a plurality of time intervals spanning a rehabilitation period, a
target relative
load for an injured lower extremity during the time interval relative to
patient body
weight. The mobile patient app 132 also receives an indication of the patient
body
weight, e.g., directly from the patient 112 using the mobile patient app 132.
This
information is used to generate rehabilitation program data 144 comprising a
schedule
for use by the electronic device associated with the walking aid. The schedule
specifies the plurality of time intervals (e.g., days) spanning the
rehabilitation period
and, for each of the time intervals, a target absolute load for the walking
aid during the
time interval. This rehabilitation program data 144 is output to the smart
crutch tip 120,
which uses it it to automatically adjust a currently operative target absolute
load on the
walking aid over time according to the schedule.
[00191] It will be appreciated that the operations described in the preceding
paragraph need not necessarily be performed at the patient mobile device 130
in all
embodiments. For example, in some embodiments, these operations could be
performed at another computing device, such as the cloud-based server 160, the
mobile doctor app 142, or the mobile doctor app 152.
[00192] Other modifications may be made within the scope of the following
claims.
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