BACKGROUND
1. Technical Field
[0001] The present disclosure generally relates to the field of stimulating tissue growth
and healing, and more particularly to an apparatus for monitoring and controlling
the transmissibility of mechanical vibration energy during dynamic motion therapy.
More specifically, the present disclosure relates to a dynamic motion therapy apparatus
having a treatment feedback indicator for providing treatment feedback relating to
a patient undergoing treatment of damaged tissues, bone fractures, osteopenia, osteoporosis,
or other tissue conditions, as well as postural instability, using dynamic motion
therapy and mechanical impedance methods. In particular, the treatment feedback indicates
the percentage of mechanical vibration energy transmitting through the patient during
treatment.
2. Background of the Related Art
[0002] When damaged, tissues in a human body such as connective tissues, ligaments, bones,
etc. all require time to heal. Some tissues, such as a bone fracture in a human body,
require relatively longer periods of time to heal. Typically, a fractured bone must
be set and then the bone can be stabilized within a cast, splint or similar type of
apparatus. This type of treatment allows the natural healing process to begin. However,
the healing process for a bone fracture in the human body may take several weeks and
may vary depending upon the location of the bone fracture, the age of the patient,
the overall general health of the patient, and other factors that are patient-dependent.
Depending upon the location of the fracture, the area of the bone fracture or even
the patient may have to be immobilized to encourage complete healing of the bone fracture.
Immobilization of the patient and/or bone fracture may decrease the number of physical
activities the patient is able to perform, which may have other adverse health consequences.
Osteopenia, which is a loss of bone mass, can arise from a decrease in muscle activity,
which may occur as the result of a bone fracture, bed rest, fracture immobilization,
joint reconstruction, arthritis, and the like. However, this effect can be slowed,
stopped, and even reversed by reproducing some of the effects of muscle use on the
bone. This typically involves some application or simulation of the effects of mechanical
stress on the bone.
[0003] Promoting bone growth is also important in treating bone fractures, and in the successful
implantation of medical prostheses, such as those commonly known as "artificial" hips,
knees, vertebral discs, and the like, where it is desired to promote bony ingrowth
into the surface of the prosthesis to stabilize and secure it. Numerous different
techniques have been developed to reduce the loss of bone mass. For example, it has
been proposed to treat bone fractures by application of electrical voltage or current
signals (e.g.,
U.S. Patent Nos. 4,105,017;
4,266,532;
4,266,533, or
4,315,503). It has also been proposed to apply magnetic fields to stimulate healing of bone
fractures (e.g.,
U.S. Patent No. 3,890,953). Application of ultrasound to promoting tissue growth has also been disclosed (e.g.,
U.S. Patent No. 4,530,360).
[0004] While many suggested techniques for applying or simulating mechanical loads on bone
to promote growth involve the use of low frequency, high magnitude loads to the bone,
this has been found to be unnecessary, and possibly also detrimental to bone maintenance.
For instance, high impact loading, which is sometimes suggested to achieve a desired
high peak strain, can result in fracture, defeating the purpose of the treatment.
[0005] A further treatment technique is disclosed in
patent document US 4 570 927 where stimulating vibration is provided to bones of immobilized limbs to reverse
osteoporosis. The limbs are vibrated while they are moved by pedals of a cycle like
apparatus. Thereby an accelerometer may be mounted to the leg for measuring the vibration
amplitude to provide a feedback signal for controlling a vibrator.
[0006] It is also known in the art that low level, high frequency stress can be applied
to bone, and that this will result in advantageous promotion of bone growth. One technique
for achieving this type of stress is disclosed, e.g., in
U.S. Patent Nos. 5,103,806;
5,191,880;
5,273,028;
5,376,065;
5,997,490; and
6,234,975.
US 5273028 disclosing an apparatus according to the preamble of claim 1. In this technique (referred
to as dynamic motion therapy), the patient is supported by an oscillating platform
apparatus that can be actuated to oscillate vertically, so that resonant vibrations
caused by the oscillation of the platform, together with acceleration brought about
by the body weight of the patient, provides stress levels in a frequency range sufficient
to prevent or reduce bone loss and enhance new bone formation. The peak-to-peak vertical
displacement of the platform oscillation may be as little as 2 µm.
[0007] However, these systems and associated methods often depend on an arrangement whereby
the operator or user must measure the weight of the patient and make adjustments to
the frequency of oscillation to achieve the desired therapeutic effect.
U.S. Patent No. 6,843,776 discloses an oscillating platform apparatus that automatically measures the weight
of the patient and adjusts characteristics of the oscillation force as a function
of the measured weight, to therapeutically treat damaged tissues, bone fractures,
osteopenia, osteoporosis, or other tissue conditions.
[0008] Another example is provided by the patent document
US 2004/0092848 A1 in which the weight of the patient may be determined automatically by means of a
capacitor assembly.
[0009] Characteristics of the oscillating force may be adjusted to treat damaged tissues
and bone fractures.
[0010] It is also known in the art that the application of low level, high frequency stress
is effective in treating postural instability. A method of using resonant vibrations
caused by the oscillation of a vibration table or unstable vibrating platform for
treating postural instability is described in
U.S. Patent No. 6,607,497 B2. The method includes the steps of (a) providing a non-invasive dynamic therapy apparatus
having a vibration table with a non-rigidly supported platform; (b) permitting the
patient to rest on the non-rigidly supported platform for a predetermined period of
time; and (c) repeating the steps (a) and (b) over a predetermined treatment duration.
Step (b) includes the steps of (b1) measuring a vibrational response of the patient's
musculoskeletal system using a vibration measurement device; (b2) performing a frequency
decomposition of the vibrational response to quantify the vibrational response into
specific vibrational spectra; and (b3) analyzing the vibrational spectra to evaluate
at least postural stability.
[0011] The method described in
U.S. Patent No. 6,607,497 B2 entails the patient standing on the vibration table or the unstable vibrating platform.
The patient is then exposed to a vibrational stimulus by the unstable vibrating platform.
The unstable vibrating platform causes a vibrational perturbation of the patient's
neuro-sensory control system. The vibrational perturbation causes signals to be generated
within at least one of the patient's muscles to create a measurable response from
the musculoskeletal system. These steps are repeated over a predetermined treatment
duration for approximately ten minutes a day in an effort to improve the postural
stability of the patient.
[0012] The patient undergoing vibrational treatment for treating postural instability and/or
the promotion of bone growth, as described above, may experience a level of discomfort
due to whole-body vibration acceleration. The level of discomfort caused by vibration
acceleration depends on the vibration frequency, the vibration direction, the point
of contact with the body, and the duration of the vibration exposure. It is desirable
to monitor at least one mechanical response of the body during vibrational treatment
in an effort to control the at least one mechanical response to influence comfort
level, as well as to determine patient- and treatment-related characteristics. Two
mechanical responses of the body that are often used to describe the manner in which
vibration causes the body to move are transmissibility and mechanical impedance.
[0013] The transmissibility shows the fraction of the vibration which is transmitted from,
say, the vibration table or oscillating platform apparatus to the head of the patient.
The transmissibility of the body is highly dependent on vibration frequency, vibration
axis and body posture. Vertical vibration on the non-invasive dynamic therapy apparatus
causes vibration in several axes at the head; for vertical head motion, the transmissibility
tends to be greatest in the approximate range of 3 to 10 Hz.
[0014] The mechanical impedance of the body shows the force that is required to make the
body move at each frequency. Although the impedance depends on body mass, the vertical
impedance of the human body usually shows a resonance at about 5 Hz. The mechanical
impedance of the body, including this resonance, has a large effect on the manner
in which vibration is transmitted through seats.
[0015] As in many other treatment activities, patients undergoing therapeutic treatment
of tissue will be more focused and committed when engaged and able to actively view
treatment information. Thus, it is desirable to provide a dynamic motion therapy apparatus
for providing treatment feedback relating to the transmissibility of the mechanical
vibration energy through the patient during dynamic motion therapy.
SUMMARY
[0016] The present invention provides an apparatus according to claim 1.
[0017] The dynamic motion therapy apparatus has a treatment feedback indicator for providing
treatment feedback relating to a patient undergoing therapeutic treatment of tissue,
namely for indicating the transmissibility of mechanical vibration energy through
the patient's body during dynamic motion therapy.
[0018] The dynamic motion therapy apparatus includes at least one processing device or digital
signal processor for determining and monitoring the weight of the patient's body resting
on an oscillating platform. The dynamic (apparent) weight of the patient is continuously
in real-time or periodically measured and stored within the digital signal processor
to determine the posture of the patient and accordingly, the transmissibility of the
mechanical vibration energy through the patient's body as described herein. The posture
of the patient and dynamic stiffness of the seat/support structure affects the transmissibility
of the mechanical vibration energy through the patient.
[0019] The at least one processing device continuously determines a deviation value (how
much the patient's apparent weight deviates from the calculated weight (apparent weight
minus calculated weight equals the deviation value)) for determining the transmissibility
of mechanical vibration energy through the patient's body. The transmissibility of
mechanical vibration energy is inversely proportional to the deviation value. The
greater the deviation value, the smaller the transmissibility of mechanical vibration
energy. Conversely, the smaller the deviation value, the greater the transmissibility
of mechanical vibration energy.
[0020] If the calculated weight during dynamic motion therapy differs significantly (i.e.,
more than a predetermined threshold) from the stored apparent weight, the digital
signal processor determines that the patient's posture changed and the amount of mechanical
vibration energy transmitting through the patient increased or decreased depending
on whether the deviation value got smaller from the previous calculation (mechanical
vibration energy increased) or got larger from the previous calculation (mechanical
vibration energy decreased).
[0021] The treatment feedback indicator of the dynamic motion therapy apparatus of the present
disclosure generates and displays via a graphical format the amount (e.g., percentage
or otherwise) of mechanical vibration energy transmitting through the patient's body.
By adjusting the posture of the patient and/or dynamic stiffness of the seat (or other
support structure) resting on the oscillating platform, the calculated weight is made
to approximate the apparent weight which directly influences the transmissibility
of the mechanical vibration energy through the patient's body or support structure,
as well as dynamic loading, for maximizing the treatment effects caused by dynamic
motion therapy. The change in the amount of mechanical vibration energy transmitting
through the patient's body can be visually observed via the graphical format. The
graphical format may include a series of bars which are highlighted or other graphical
icons which indicate the amount of mechanical vibration energy transmitting through
the patient.
[0022] The treatment feedback indicator may include auditory feedback where a prerecorded
voice or a number of beeps indicates the amount of mechanical vibration energy transmitting
through the patient's body. The treatment feedback indicator may also include a tactile
feedback where a tangible signal is transmitted and felt by the patient through a
support structure or otherwise.
[0023] The apparatus of the present disclosure includes communication circuitry adapted
for transmitting patient and treatment related data to a central, remote monitoring
station via at least one network, such as the Internet, as described in
U.S. Provisional Application Serial No. 60/702,815. The remote monitoring station is adapted for generating and transmitting a signal
to the at least one processing device for controlling at least one treatment parameter,
such as, for example, the oscillation frequency of the oscillating platform.
[0024] It is further disclosed a method for providing treatment feedback relating to a patient
undergoing therapeutic treatment of tissue. The method includes the step of supporting
a patient's body on a platform; oscillating the platform at an oscillation frequency
to impart an oscillating force on the body and to transmit mechanical vibration energy
through the body for therapeutically treating the tissue in the body; calculating
a weight value relating to the body during oscillation of the body; comparing an apparent
weight of the body to the calculated weight value for determining a deviation value
indicative of the amount the calculated weight value deviates from the apparent weight;
and correlating the deviation value to a transmissibility value indicative of the
amount of mechanical vibration energy transmitting through the patient's body.
[0025] The method further includes indicating the amount of mechanical vibration energy
transmitting through the patient's body via the treatment feedback indicator. The
method further includes monitoring the deviation value and generating and transmitting
a signal indicative of the deviation value to a remote monitoring station. The method
further includes transmitting a control signal from the remote monitoring station
to the dynamic motion therapy device for remotely controlling at least one operating
parameter of the dynamic motion therapy device.
BRIEF DESCRIPTION OF THE DRAWINGS
[0026] The foregoing features of the present disclosure will become more readily apparent
and will be better understood by referring to the following detailed description of
preferred embodiments, which are described hereinbelow with reference to the drawings
wherein:
FIG. 1 is a perspective view illustrating a non-invasive dynamic motion therapy apparatus
having a display unit for displaying treatment feedback in accordance with the present
disclosure.
FIG. 2 is a perspective view of an of an ergonomic support structure having an ergonomic
hand support structure, a monitor provided on a column having a monitor for displaying
treatment feedback and a platform for supporting the non-invasive dynamic motion therapy
apparatus in accordance with the present disclosure;
FIG. 3 is a flow chart illustrating a method in accordance with the present disclosure;
FIG. 4 is schematic block diagram of the non-invasive dynamic motion therapy apparatus
in accordance with the present disclosure;
FIGS. 5A-5D are schematics of a display screen illustrating graphical formats indicating
the transmissibility of mechanical vibration energy through a patient.in accordance
with the present disclosure; and
FIG. 6 is a top view of an alternative display screen illustrating a graphical format
indicating the transmissibility of mechanical vibration energy through a patient in
accordance with the present disclosure.
DETAILED DESCRIPTION
[0027] The dynamic motion therapy apparatus and method in accordance with various embodiments
of the disclosure provide a treatment feedback indicator capable of providing treatment
feedback information relating to a patient undergoing treatment of damaged tissue,
bone fractures, osteopenia, osteoporosis, or other tissue conditions, as well as postural
instability, using dynamic motion therapy and mechanical impedance methods. Dynamic
motion therapy apparatus has an oscillating platform for positioning the patient thereon
for providing low displacement, high frequency mechanical loading of bone tissue.
[0028] The dynamic motion therapy apparatus includes circuitry and related components including
a treatment feedback indicator for providing treatment feedback relating to the transmissibility
of mechanical vibration energy during therapeutic treatment of tissue. The treatment
feedback indicator may provide visual, tactile, and auditory feedback, or a combination
thereof. Apparatus further includes communication circuitry in operative communication
with at least one processing device or digital signal processor for transmitting and
receiving data from and to a central, remote monitoring station, as described in
U.S. Provisional Application Serial No. 60/702,815.
[0029] Referring initially to FIG. 1, there is illustrated a perspective view of a non-invasive
dynamic motion therapy apparatus in accordance with the present disclosure. The apparatus
for providing treatment feedback relating to a patient undergoing therapeutic treatment
of tissue is designated generally by reference numeral 100. Apparatus 100 includes
a vibration table 102 having a non-rigidly supported platform 104. At least one processing
device or digital processor 402 (see FIG. 4), in operative communication with platform
104 for processing data related to the therapeutic treatment. Apparatus 100 further
includes a treatment feedback indicator 106 operably connected to the processing device
402 for providing transmissibility information. The treatment feedback indicator 106
or display unit 106 displays visual feedback of transmissibility information of mechanical
vibration energy and other information to the patient. Apparatus 100 further includes
foot rests 110 for resting the apparatus 100 on a flat surface.
[0030] The non-rigidly supported platform 104 rests on motorized spring mechanisms (not
shown) which cause the platform 104 to move when they are turned on. Alternatively,
the non-rigidly supported platform 104 may rest on a plurality of springs or coils
which cause the non-rigidly supported platform 104 to move once a patient stands thereon.
Further, the non-rigidly supported platform 104 can include various compliant modalities
other than springs (e.g., rubber, elastomers, foams, etc.).
[0032] It is envisioned that apparatus 100 may include a communication device in operable
communication with the processing device 402 and adapted for transmitting data to
a remote monitoring station via at least one network. The communication device is,
for example, a cellular phone having a port connector capable of connecting to the
communication device for receiving the data via the port connector-communication interface
connection and for transmitting said data to the remote monitoring station via a CDA
cellular communications network according to the CDMA communications protocol. The
communication device may also be, for example, a PDA having a port connector capable
of connecting to the communication device for receiving the data via the port connector-communication
interface and for transmitting the received data to a PSTN, form where it is transmitted
through the Internet according to the Internet protocol, and then to another PSTN
connected to the central computer station. The communication device may also operate
in accordance with a communication protocol, as is well known in the art, preferably,
a TCP/IP protocol. Moreover, the communication device may transmit data via a communication
medium, such as, for example, copper wire, phone line connection, internet connection,
optical fibre, radio-link, laser, radio or infrared light.
[0033] With reference to FIG. 2, apparatus 100 in accordance with the present disclosure
is received by a supplemental support structure. In a preferred embodiment of a supplemental
support structure, an ergonomic support structure is provided and is designated generally
by reference numeral 200. The ergonomic support structure 200 includes an ergonomic
hand support structure 202 and a platform 204 for supporting apparatus 100. Apparatus
100 is preferably removable from platform 204.
[0034] Ergonomic hand support structure 202 includes a curved structure 206 having inner
and outer curved walls 208a, 208b and two curved ends 210a, 210b connecting the two
walls 208a, 208b. During vibrational treatment by the non-invasive dynamic motion
therapy apparatus 100, the patient grasps the long curved end 210a or lightly touches
the inner curved wall 208a.
[0035] A patient suffering from a severe case of postural instability or other condition
which prevents the patient from standing on the non-rigidly supported platform 100
can be seated on a removable seat 212 and be treated with dynamic motion therapy apparatus
100. Seat 212 is adapted for placement on two opposing surfaces (not shown) defined
by the inner curved wall 208a.
[0036] Ergonomic support structure 200 further includes an RFID reader 214 for reading an
RFID tag provided on the patient for identifying the patient. The RFID reader 214
further includes a display 216 for displaying patient identification data and other
data, including video. The RFID reader 214 also includes a processor (not shown) storing
patient-related data, such as patient identification data, and treatment data, such
as, for example, the dates and duration times of the last five vibrational treatment
sessions. The patient-related data for each particular patient is accessed and portions
thereof displayed by the display 216 after the patient's corresponding RFID tag is
read by the RFID reader 214.
[0037] With continued reference to FIG. 2, ergonomic support structure 200 further includes
a vertical column 218 having a monitor 220. Monitor 220 displays transmissibility
information in similar graphical formats as those shown for example by FIGS. 5A-6.
Monitor 220 may also be adapted for displaying patient identification data and other
data, such as patient treatment data, including video. Preferably, the monitor 220
is inlaid within the vertical column 218 for enabling the patient to place a book,
laptop, etc. on the vertical column 218 without contacting the monitor 220. The vertical
column 218 is preferably height adjustable to accommodate patients of differing heights.
Monitor 220 is preferably touch-sensitive for controlling the operation of the non-invasive
dynamic motion therapy apparatus 100 and performing other functions, such as accessing
the Internet, accessing data stored within a memory, etc., by touching the screen
of the monitor 220. Another monitor 222 is provided on the outer wall 208b. The outer
wall 208b is further provided with a light source 224 above the monitor 222 and control
buttons 226.
[0038] Ergonomic support structure 200 is provided with circuitry and related components
for connecting to a network, such as the Internet, wirelessly and/or non-wirelessly
and at least one processor for transmitting and receiving data via the network as
known in the art. The data transmitted may include patient monitoring data to determine
at a central monitoring station if the patient is complying with a treatment regimen
and data to determine whether the patient is properly positioned on the dynamic motion
therapy apparatus to obtain optimum treatment effects. The data can include video
and/or sensor data obtained by a video camera and/or at least one sensor mounted to
the support structures and transmitted via the network to the central monitoring station.
The data received can include Internet content and treatment-related data transmitted
from the central monitoring station. The data received can include visual and/or audio
content for viewing via the monitor 220 and/or listening via earphones connected to
audio circuitry embedded within the support structures.
[0039] With reference to FIG. 3, there is shown a flow chart illustrating an exemplary method
for providing therapeutic treatment of tissue in accordance with the present disclosure.
During treatment, a treatment feedback indicator, such as display unit 106 (see FIG.
1), provides treatment feedback as described herein. The method includes the step
of supporting the body on a platform 104. Step 300 includes oscillating platform 104
at an oscillation frequency to impart an oscillating force on the body to treat the
tissue in the body. Step 302 includes the step of obtaining data via processing device
402. The data is related to at least one treatment parameter during oscillation of
the body. The treatment parameter includes, for example, the weight of the patient,
the oscillation frequency of platform 104; an amplitude of the oscillating force;
and a time interval duration of the treatment. Obtaining data relating to a vibrational
response of a musculoskeletal system of the patient is also envisioned.
[0040] In one aspect of the present disclosure, the processing device 402 is adapted for
monitoring a deviation value indicative of the amount of a calculated weight value
deviates from an apparent weight. Predetermined data based on experimental data/knowledge
is pre-stored in the at least one processing device. The predetermined data includes
a look up table illustrating an inverse relationship between the deviation value and
the transmissibility of mechanical vibration energy. That is, the transmissibility
of mechanical vibration energy is inversely proportional to the deviation value. More
in particular, the greater the deviation value, the smaller the transmissibility of
mechanical vibration energy. Conversely, the smaller the deviation value, the greater
the transmissibility of mechanical vibration energy. Table 1 illustrates a list of
exemplary deviation values (percentages) and their corresponding transmissibility
value (percentages) indicating the amount of mechanical vibration energy transmitted
through the patient.
Table 1.
| DEVIATION VALUE (%) |
TRANSMISSIBILITY OF MECHANICAL VIBRATION ENERGY (%) |
| 0 |
100 |
| 25 |
75 |
| 50 |
50 |
| 75 |
25 |
| 100 |
0 |
[0041] Following the step of obtaining the data via processing device 402 (Step 302), the
system will verify whether the predetermined treatment duration has elapsed. If the
treatment duration has elapsed, then the step of oscillating platform 104 is discontinued
(Step 306) and data corresponding to treatment duration is transmitted to the remote
monitoring station (Step 308). If the treatment duration has not elapsed, then data
relating to treatment parameters are transmitted to the remote monitoring station
(Step 310). In Step 312, the remote monitoring station receives the data relating
to the treatment parameters, i.e., weight of the patient, the oscillation frequency
of platform 104, an amplitude of the oscillating force, and a time interval duration
of the treatment. The remote monitoring station determines whether data relating to
weight is indicative of compliance to a treatment protocol (Step 314).
[0042] Since the posture of the patient and dynamic stiffness of the seat/support structure
affects the weight of the patient and thus the transmissibility of the mechanical
vibration energy through the patient, the processing device 402 determines and monitors
the weight of the patient. The weight of the patient is continuously, in real time
or periodically, compared to an original stored weight to determine a deviation value
(Apparent Weight minus Calculated Weight), i.e., weight data, (Step 314). If the weight
data indicates that the calculated weight is equal to zero (Step 320) (that is, the
deviation value is substantially equal to the apparent weight), it is determined that
the patient has stepped off the platform 104. A message is transmitted to the patient
at Step 322 instructing the patient to resume the treatment until the predetermined
treatment time has elapsed. The process then proceeds to Step 302.
[0043] If weight data indicates that the calculated weight is not equal to zero, i.e. the
platform is still supporting the patient, and the deviation value is positive and
greater than a predetermined threshold, it is determined that the patient's posture
is incorrect and a message is generated and transmitted to the display unit 106 instructing
patient to change or correct posture (Step 324). The process then proceeds to Step
302. If the calculated weight does not differ significantly from the original stored
weight as determined by the processing device 402, i.e., deviation value is substantially
zero, (patient is complying to treatment protocol), then at Step 316 it is determined
whether the treatment parameters are satisfactory based on the weight of the patient.
If yes, the process then proceeds to Step 302. If no, then at Step 318, at least one
treatment parameter, e.g., amplitude of the oscillating force, is adjusted and the
process proceeds to Step 302.
[0044] The frequency of oscillation or oscillating frequency is not changed during treatment.
The apparatus 100 during the initial tune-up performs a self-evaluation (calibration)
and does a frequency sweep between 32 and 37 Hz to find the maximum acceleration for
the particular user. After the initial tune-up, the apparatus 100 maintains the chosen
oscillating frequency for the rest of the treatment duration.
[0045] With reference to FIG. 4, there is shown a schematic block diagram of the dynamic
motion therapy apparatus 100 in accordance with the disclosure. Schematic block diagram
includes at least one processing device or digital processor as described in
U.S. Patent Application Serial No. 11/388,286. The dynamic motion therapy apparatus 100 includes the platform 104 and two accelerometers
A1, A2 for transmitting information to processing device 402. Processing device 402
is preferably a digital signal processor 402 as shown by FIG. 4 having circuitry and
programmable instructions stored within a memory and capable of being executed by
the digital signal processor 402 for operating the dynamic motion therapy apparatus
100. The digital signal processor 402 includes two incoming data paths 404, 406 having
identical components for processing data received from the two accelerometers A1,
A2 and one outgoing data path 408 for relaying control or feedback signals to the
oscillating actuator 112 for causing vibration of the platform 104 via drive lever
114.
[0046] Digital signal processor 402 includes a memory storing a set of programmable instructions
capable of being executed by the digital signal processor 402 for operating the components
of the two incoming data paths 404, 406 and one outgoing data path 408 for performing
the functions described above in accordance with the disclosure, as well as other
functions. The set of programmable instructions can also be stored on a computer-readable
medium, such as a CD-ROM, diskette,.and other magnetic media, and downloaded to the
digital signal processor 402.
[0047] Each incoming data path includes four major components for processing the incoming
data from the two accelerometers A1, A2. The four major components are in order from
left to right in FIG. 4 an analog-to-digital (A/D) converter 410, a bandpass filter
412, a rectifier 414, a moving average filter 416, and a fault tolerance decision
block 418.
[0048] Preferably, the bandpass filter 412 in each incoming data path is a 4
th order elliptic bandpass filter which finds the "sweet spot" for each particular patient
(this causes the processor to shift the resonance of the dynamic therapy system 100
based on the patient's mass or weight by transmitting a signal to the oscillating
actuator 112 to change the frequency of the oscillating force). The digital signal
processor 402 processes the polynomial coefficients of the 4
th order elliptic bandpass filters by implementing "power of two" coefficients. The
processor 402 is programmed to do this instead of performing polynomial multiplication
for each coefficient in the polynomial which would require a significantly longer
processing time. The processor 402 in accordance with the present disclosure reduces
processing time by approximating the polynomial coefficients using the "power of two."
For example, if the coefficient is 3.93215, the processor 402 can perform a quick
approximation of the coefficient by approximating the coefficient as follows: 4- 1/16
+ 3/128 -1/512. It is contemplated that the same method can be used to process the
coefficients of the other filters of the processor 402.
[0049] The output from the moving average filter 416 of incoming data path 404 is provided
to the fault tolerance decision block 418 for determining fault tolerance level and
an adder/subtractor block 420 for deciding whether to increase or decrease the gain
to maintain the average vibration intensity to a preset value. The output of block
420 is an error signal which determines whether to increase or decrease the vibration
level of the oscillating actuator 112.
[0050] The output from the adder/subtractor block 420 is the acceleration of the patient
and the output from A/D converter 410 of incoming data path 406 is provided to a low-pass
filter 422 which outputs a weight/presence signal. The weight/presence signal is used
to sense the presence of the patient and to calculate the weight of the patient continuously
or periodically using conventional weight/angle equations during dynamic motion therapy.
[0051] By determining the weight of the patient during treatment and comparing the weight
to the original stored weight as described above, the processor 402 is able to determine
whether the patient is compliant with the treatment protocols (e.g., whether patient
is resting, standing, etc. on platform 104) and the posture of the patient for determining
the transmissibility of the mechanical vibration energy through the patient. The patient
can then influence the transmissibility, if necessary (i.e., if the calculated weight
indicates poor transmissibility), by shifting or changing his posture accordingly.
[0052] The acceleration value of the patient and the output from the fault tolerance decision
block 418 are inputs at separate times (since the processor 402 of the dynamic motion
therapy apparatus 100 is designed as a real time interrupt driven software system
as described below) during operation of the dynamic therapy apparatus 100 to the outgoing
data path 408.
[0053] The outgoing data path 408 includes four major components for processing control
and feedback signals transmitted from the processor 402 to the oscillating actuator
112. The four major components are in order from right to left in FIG. 4 a digital
gain adjustment module 424 for performing automatic gain control as described above,
a variable amplitude signal generation module 426 for increasing or decreasing the
sinusoidal signal driving the oscillating actuator 112, a low-pass filter 428 for
filtering the control and feedback signals and a power amplifier 430 for amplifying
the control and feedback signals.
[0054] The apparatus 100 includes a treatment feedback indicator 500, 500' which in a preferred
embodiment includes display unit 106 for displaying treatment related information
(amount of mechanical vibration energy transmitted through the patient) and other
information, such as diagnostic information, to the patient, medical professional
or other individual. The treatment related information can include the original calculated
weight of the patient and the calculated weight of the patient during treatment, the
acceleration of the patient, automatic gain control information, level or degree of
compliance to the treatment protocols, a transmissibility value indicating or approximating
the amount of mechanical vibration energy being transmitted through the patient or
support structure-patient during treatment, etc.
[0055] The digital signal processor 402 of the dynamic motion therapy apparatus 100 is designed
as a real time interrupt driven software system (the apparatus 100 does not have a
main loop). A timer interrupt occurs every 1/fs milliseconds. That is, for example,
if the apparatus 100 is tuned at 34 Hz, a timer interrupt occurs every 1/34 seconds.
A different function occurs during each timer interrupt, such as replenishing or updating
the display unit 106, transmitting the control or feedback signals to the oscillating
actuator 112, and generating a transmitting a sine wave to the oscillating actuator
112 for automatic gain control (the sine wave is preferably generated and transmitted
approximately 500 times per second). It is contemplated that higher priority interrupts
are performed first. If there is not interrupt to be performed, the processor 402
goes into an idle mode until there is an interrupt to perform.
[0056] The digital signal processor 402 generates the (sinusoidal) signal to the oscillating
actuator 112 and processes the acceleration signal received from accelerometer A1
using at least one digital bandpass filter 412 with a variable sampling rate during
calibration (tuning) of the dynamic motion therapy apparatus 100. In the dynamic motion
therapy apparatus 100, the sampling rate and thus the vibration frequency is between
0 and 250 Hz, with the at least one digital bandpass filter 412 adaptively tuned to
the current operating frequency. The variable sampling rate is possible due to the
interrupt driven software system of the software control loop as described above.
[0057] The dynamic therapy apparatus 100 further includes communication circuitry 434 for
downloading/uploading data, including software updates, to the processor 402 and for
communicating with a central monitoring station via a network, such as the Internet,
including receiving Internet content. The communication circuitry 434 can include
RS232, USB, parallel and serial ports and associated circuitry, as well as network
connection software and circuitry, such as a modem, DSL connection circuitry, etc.
Preferably, the process of downloading/uploading data, including software updates,
is configured as an interrupt for being performed during a timer interrupt by the
dynamic therapy apparatus 100. As shown by FIG. 4, communication circuitry 434 is
connected to the central, remote monitoring station 10 via the Internet 12.
[0058] The data transmitted from the dynamic motion therapy apparatus 100 to the remote
monitoring station can include video and/or sensor data obtained by a video camera
and/or at least one sensor mounted to the support structure or the dynamic motion
therapy apparatus 100 and transmitted via the network to the central, remote monitoring
station.
[0059] Patient compliant data (directed to whether the patient is complying to treatment
protocols) and other patient- and treatment-related data are preferably stored in
the dynamic therapy apparatus 100 for evaluation at a later time or for transmission
via the network using the communications circuitry 434 to the central monitoring station
for observation. The transmission can also occur in real time during dynamic motion
therapy for enabling a medical professional or other observer to transmit data via
the network to the patient during the therapy session. The transmitted data can be
displayed to the patient on the display unit 106 and/or audibly played via a speaker.
The display unit 106 includes a graphic display 108 for providing visual feedback
of the amount of mechanical vibration energy transmitted to the patient, wherein the
graphic display 108 includes a graphical format, such as, for example, an icon or
graph as illustrated in FIGs. 5A-5D.
[0060] FIGs. 5A-5D illustrate display unit 106 having a graphical format 501 indicating
the transmissibility of mechanical vibration energy through the patient. Icon 502
illustrates an image of a body for graphically illustrating the transmissibility of
mechanical vibration energy. For example, when the deviation of the apparent stored
weight to the calculated weight is on or about zero, the transmissibility of mechanical
vibration energy is 100%, and, as illustrated in FIG. 5A, the icon 502 is highlighted
up to the 100% level of bar display 506. Another icon 504 also is highlighted to indicate
100% transmission of the mechanical vibration energy generated by the dynamic motion
therapy apparatus 100. As the patient's posture changes from a correct posture to
an substantially incorrect posture, the amount of mechanical vibration energy transmitted
through the patient changes and is accordingly displayed in sequence by FIGs. 5B to
5D.
[0061] With reference to FIG. 6, an alternative embodiment of the graphical format is illustrated
and designated by reference numeral 602. The graphical format 602 has a series of
bars 603 where one is highlighted at any given time to indicate the amount of mechanical
vibration energy being transmitted through the patient at that time. In FIG. 6, the
middle bar is highlighted indicating 50% transmission of the mechanical vibration
energy. If the leftmost bar is not highlighted, the graphical format 602 automatically
displays a message 604 instructing the patient to correct posture. The message can
also be relayed by the remote monitoring station as described above. The same message
can also be displayed by graphical format 501.
[0062] Using the dynamic therapy apparatus 100 and mechanical impedance methods as known
in the art, one can predict the transmissibility of the mechanical vibration energy
through the patient being supported by a support structure, such as a kneeling chair-type
support structure, wheel chair, seat, exercise device, etc., using the dynamic stiffness
of the support structure and the apparent mass of the body measured at appropriate
vibration magnitudes. The materials, structure, orientation, etc. of the support structure
can then be selected and re-designed for maximizing the transmissibility of the mechanical
vibration energy through the oscillating platform apparatus-support structure-patient
interface in order to maximize the transmissibility of the mechanical vibration energy
through the patient. The support structure can in effect be custom designed for each
patient for maximizing the transmissibility of the mechanical vibration energy through
the patient.
[0063] The described embodiments of the present disclosure are intended to be illustrative
rather than restrictive. Various modifications and variations can be made without
departing from the scope of the following claims.
1. Vorrichtung (100) zur therapeutischen Behandlung von Gewebe in einem Körper eines
Patienten, die Folgendes umfasst:
eine Plattform (104) zum Unterstützen eines Körpers eines Patienten;
einen Oszillator (112), der mit der Plattform betriebsfähig verbunden ist und dazu
eingerichtet ist, zu oszillieren und eine Oszillationskraft mit einer vorbestimmten
Frequenz an die Plattform (104) zu übermitteln, um mechanische Vibrationsenergie durch
den Körper des Patienten zu übertragen; gekennzeichnet durch
zumindest eine Verarbeitungsvorrichtung (402), die mit dem Oszillator (112) in Betriebsverbindung
steht und für ein Verarbeiten von therapeutischen Behandlungsdaten eingerichtet ist,
wobei das Verarbeiten ein Ausführen eines Satzes von programmierbaren Anweisungen
zur Bestimmung der Durchlässigkeit von mechanischer Vibrationsenergie durch den Körper des Patienten umfasst, und wobei das Verarbeiten ein Steuern des Oszillators
(112) mit Hilfe zumindest eines Steuersignals umfasst, wobei die Vorrichtung weiterhin
ein Anzeigemittel (106) umfasst, das in Betriebsverbindung mit der zumindest einen
Verarbeitungsvorrichtung (402) steht, um die Durchlässigkeit von mechanischer Vibrationsenergie
durch den Körper des Patienten anzuzeigen.
2. Vorrichtung nach Anspruch 1, bei der die zumindest eine Verarbeitungsvorrichtung (402)
dazu eingerichtet ist, einen Abweichungswert zu überwachen, der ein Maß für die Abweichung
eines berechneten Gewichtswerts von einem ursprünglich gespeicherten tatsächlichen
Gewicht des Patienten ist, wobei der berechnete Gewichtswert auf Basis einer Information
berechnet wird, die von der Plattform (104) empfangen wurde.
3. Vorrichtung nach Anspruch 1, bei der das Anzeigemittel (106) ein auditives, ein taktiles
oder ein visuelles Anzeigemittel ist.
4. Vorrichtung nach Anspruch 3, bei der das visuelle Anzeigemittel (106) ein Display
umfasst, um die Menge der durch den Körper des Patienten übertragenen mechanischen
Vibrationsenergie über ein grafisches Format anzuzeigen.
5. Vorrichtung nach Anspruch 1, die weiterhin einen Verbindungsschaltkreis (434) umfasst,
der in Betriebsverbindung mit der zumindest einen Verarbeitungsvorrichtung (402) steht,
um Daten an eine entfernte Überwachungsstation (10) zu übersenden, wobei die Daten
die Menge der durch den Körper des Patienten übertragenen mechanischen Vibrationsenergie
beinhalten.
6. Vorrichtung nach Anspruch 5, bei der die entfernte Überwachungsstation (10) ein Signal
erzeugt und es an die zumindest eine Verarbeitungsvorrichtung (402) sendet, um den
Oszillator (112) fernzusteuern.
7. Vorrichtung nach Anspruch 1, bei der die zumindest eine Verarbeitungsvorrichtung (402)
bestimmt, ob eine vorbestimmte Behandlungszeit verstrichen ist, und die Oszillation
des Oszillators (112) stoppt, wenn die vorbestimmte Behandlungszeit verstrichen ist.
8. Vorrichtung nach Anspruch 2, bei der die zumindest eine Verarbeitungsvorrichtung (402)
bestimmt, ob der Abweichungswert größer als eine vorbestimmte Schwelle ist, und eine
Nachricht erzeugt und sendet, die den Patienten anweist, seine Haltung zu korrigieren,
wenn der Abweichungswert größer als die vorbestimmte Schwelle ist.
9. Vorrichtung nach Anspruch 2, bei der die zumindest eine Verarbeitungsvorrichtung (402)
bestimmt, ob der Abweichungswert mit dem ursprünglich gespeicherten tatsächlichen
Gewicht im Wesentlichen übereinstimmt, sie weiterhin bestimmt, ob eine vorbestimmte
Behandlungszeit verstrichen ist, und sie eine Nachricht erzeugt und sendet, die den
Patienten anweist, sich auf die Plattform zu begeben, wenn der Abweichungswert dem
ursprünglich gespeicherten tatsächlichen Gewicht zumindest im Wesentlichen entspricht
und die vorbestimmte Behandlungszeit nicht verstrichen ist.