Rehabilitation systems and methods

This application claims the benefit of U.S. Provisional Patent Application No. 60/964,861 filed Aug. 15, 2007, the entirety of which is hereby incorporated by reference into this application.

1. Field of the Invention

The present invention is a device, system and method for providing rehabilitation to several types of patients in a rehabilitation hospital or outpatient clinic. The approach integrates an actuated tilting rehabilitation table, video tracking of the patient\'s arm and opposite shoulder, a low-friction forearm support with grasping force sensing, remote data transmission and additional weighing means, one or more large displays, a computer and a plurality of video games.

2. Description of Related Art

A training system for arm rehabilitation is described in Yu-Luen Chen et al, “Aid Training System for Upper Extremity Rehabilitation,” 2001 Proceedings of the EMBS International Conference, Istanbul, Turkey. Patients exercise on a special table that incorporates reed relays and a hand support (“arm skate”) with small underside wheels. The movement of the arm in the arm skate on the supporting table is detected by the interaction of the magnet incorporated in the arm skate with the relays integrated in the table. A computer presents a variety of patterns on its monitor, which the patient needs to replicate to improve arm coordination, with performance data stored by the computer in a clinical database. The table is horizontal and does not use virtual reality simulations.

Another training system that uses a forearm support on a table for rehabilitation purposes is described by some of the inventors of the present specification in Kutuva et al., “The Rutgers Arm: An Upper-Extremity Rehabilitation System in Virtual Reality,” Proceedings of the Fourth International Workshop on Virtual Rehabilitation (IWVR\'05), pp. 94-103, Catalina Island, Calif., September 2005. The table has a low-friction surface and a forearm support has a low-friction underside (made of TEFLON®studs). The tracking of the forearm movement is done by a magnetic tracker (Fastrack, Polhemus Inc.), with a sensor mounted on the forearm support, and an emitter mounted on the table away from the patient. Patients exercise sitting at the table and looking at a computer monitor, while playing a plurality of virtual reality games. The games are designed to improve motor coordination, as well as dynamic arm response. The table does not tilt.

Several tilting tables exist commercially and are used in rehabilitation. They are meant for people who have low blood pressure and who get dizzy when they stand up. Tilting tables are also used for the rehabilitation of patients who have to lie down for a long period of time. The person lies face up on a padded table with a footboard and is held in place with a safety belt. The table is tilted so that the angle is very slowly increased until the person is nearly upright. By slowly increasing the angle, the patients blood vessels regain the ability to constrict.

A study describes development of a sensorized tilt table which measures and displays the knee bent angle and pressure for each foot during exercise in real time, as described in Kimet et al. “An Intelligent Tilt Table for Paralytic Patients,” 3^rd Kuala Lumpur International Conference on Biomedical Engineering, Kuala Lumpur, Malaysia, 2006. It is expected that the patient\'s exercising effect can increase by monitoring these two values during exercise. Tilt tables are known for providing tilting manually or using an electrical motor, such as in a Rehab Electric Tilt Table manufactured by Cardon Rehab.

An automated stepping training developed with the tilting table is described in Colombo et al. “Novel Stepping Mechanism: Design Principles and Clinical Application,” Rehabilitation Robotics, ICORR 2005. Unlike the previous tilting tables it exercises the feet in stepping. No virtual reality simulation is incorporated and tilting is done manually, rather than determined by a simulation.

All of the above tilting-table based systems are for rehabilitation of the legs. The tilting tables described above do not incorporate virtual reality simulations and do not store/upload clinical data automatically. They have a single degree of freedom (the tilting angle).

Systems for rehabilitating the arms are known, and are based on force feedback joysticks (such as those manufactured by Logitech or Microsoft), or various types of planar or 3D robots. Examples of planar robots are the MIT Manus or those described in Colombo et al., “Upper Limb Rehabilitation and Evaluation of Stroke Patients Using Robot-Aided Techniques”, Rehabilitation Robotics, 515-518 (2005). Other examples of 3D robots are the Reo robot manufactured by Motorika, N.J., or the Haptic Master manufactured by FCS, Holland.

Other upper limb rehabilitation systems have been described. U.S. Pat. No. 7,204,814 describes an orthotic system that performs predefined or user-controlled limb movements, collects data regarding the limb movement, performs data analysis and displays the data results, modifies operational parameters based on the data to optimize the rehabilitative process performed by the system. A force sensor data, torque data and angular velocity data can be collected using an external actuating device.

U.S. Patent Application Publication No. 2007/0060445 describes a method and apparatus for upper limb rehabilitation training of coordinated arm/forearm, forearm/forearm, and grasping movements comprising a non-robotic, passive support, an arm/forearm sensor, gripping device and sensor. A computer processes measurements of movements to control a graphical representation of the arm/forearm and grasping movements in interaction with a virtual environment.

It is desirable to provide a device, system and method for rehabilitation of an upper limb in which an activated tilting table provides a plurality of degrees of freedom and grasping force is sensing integrated into a video tracking system.

The present invention integrates an actuated tilting rehabilitation table, video tracking of the patient arm and shoulder, a low-friction forearm support with grasping force sensing, remote data transmission and additional weighing means, one or more large displays, a computer and a plurality of simulation exercises, such as video games. The patient can be monitored by a local or remote clinician. Online storage of data obtained by the rehabilitation tilting table can be provided. Additionally, the table surface can be constructed as a graphics display making a separate display unnecessary.

In one embodiment, a patients arm rests on a forearm support that has infrared LEDs. The patient wears similar LEDs on the opposite shoulder, and an infrared video camera is used to track the patients arm movement on the table. The table tilts in order to increase exercise difficulty due to gravity loading on the patients arm. In one embodiment, the present the invention includes an actuated tilting table which tilts in four degrees of freedom. A large display, facing the patient presents a sequence of rehabilitation games with which the patient interacts by moving the arm resting on the low-friction support, on the table surface.

The invention will be more fully described by reference to the following drawings.