TECHNICAL FIELD
[0001] The present invention belongs to the field of medical devices, namely devices intended
for users with reduced mobility who require a support backing for walking and respective
operating method. Concretely, the present invention is related to a gait support device,
robotic cane type, also intended for preventing falls in real time.
BACKGROUND
[0002] Among the most difficult health problems with which the elderly struggle are the
falls and unstable balance control. They are a significant cause of immobility and
early entry into homes for the elderly, as well as an increase factor in death and
morbidity rates. Currently the World Health Organization (WHO) refers to a fall as
"an occurrence which results in the fact that a person inadvertently lands on the
ground, the pavement or other lower level". Before a fall, there occurs an event which
is more frequent and potentially predicts the risk of a fall: the near-fall. A near-fall
is considered "a loss of balance which would result in a fall in case enough recovery
mechanisms were not activated". The problem with falls in the elderly population is
a combination of a high incidence with a high susceptibility to injuries due to a
high frequency of clinical disorders (for example, osteoporosis, neurological diseases)
and age-related physiological alterations (for example, slower protection reflexes)
which cause even a relatively small fall to be particularly dangerous.
[0003] About 28-42% of the elderly (>65 years) fall at least once a year. According to the
WHO, the falls are the second main cause of death by unintentional injuries, following
the injuries caused by road traffic, representing an average of 684 000 fatal falls
and an estimated number of 37,3 million non-fatal falls, requiring medical care, every
year. In the United States, almost three quarters of all deaths related to falls occur
in the 13% of the population that is over 65 years old, which largely indicates, a
geriatric syndrome.
[0004] The General Health Directorate indicates that the physiological falls predicted (78%
of the causes), just by fall risk assessment, can be avoided by means of fall risk
assessment with validated schedule, planning and specific interventions.
[0005] Approximately 40% of this age group, who live at home, will fall at least once a
year and about 1 in every 40 will be hospitalized. Only about half the individuals
hospitalized following a fall will be alive a year later. The instability and the
recurring non-fatal falls are frequent warning signs for admission in homes for the
elderly. According to the European Mortality Database, in 2019 Germany recorded 16.657
deaths, being the member of the European Union with the highest number of deaths by
accidental falls. In the same database, the last results for Portugal correspond to
2018, when there were recorded 815 deaths. The non-fatal falls resulting in motor
injuries lessen the Quality of Life (Acronym in English Quality of Life - QoL). People
who fall develop a fear of falling with consequent depression and autonomy restriction
of social and physical activity. This further contributes to the deconditioning, weakness
and abnormal gait, and, in the long term, can effectively increase the risk of falls.
Additionally, the recovery from injuries caused by falls is frequently delayed in
the elderly.
[0006] The expenses associated with the injuries caused by falls are significant from the
financial point of view. It is predicted that the social and health costs reach 4%
of the European expenses with health care, expected to duplicate in 2050 to 50 billion
Euros in the European Union. In the United States of America alone, in 2000 there
were spent 19 billion dollars with direct medical costs for injuries related to falls.
In 2015, this value increased to over 31 billion dollars in Medicare only, and there
are foreseen costs of 43,8 billion dollars in 2020. Several studies have also shown
the average cost of the health system by injury caused by a fall. In the Republic
of Finland and in Australia, these costs are of 3611 dollars and 1049 respectively.
In Portugal, the value can rise to about 3000 Euros if the injury is severe. The pressure
over the national health system has intensified with the increase in population aging
which, unfortunately, tends to worsen. According to the United Nations, in 2085 the
elderly population will be triple the current one.
[0007] The socio-economic impact of the injuries enhances the crucial importance of implementing
strategies which mitigate or eliminate the risk of fall. According to data from Canada,
a reduction of 20% in the incidence of falls can result in net savings of more than
120 million dollars per year. To alleviate this social and economic burden, the existing
systems are mainly centered on fall detection, with little emphasis on fall forecast.
Detecting the impact is the basis of the fall detection systems, which notify the
user and the health caregiver of the occurrence of a fall to expedite and improve
the medical services rendered. Since these systems cannot avoid the falls, the scientific
literature also explores the fall prediction systems, which are conceived to warn
users before a fall, avoiding the emotional and physical effects of a fall. They must
be able to recognize all the situations and potential conditions for a fall and offer
a scheme to avoid them. The fall prediction systems or the Falls Risk Assessment Tool
(FRA) can also be divided into two different categories: i) prediction of future falls
- which can estimate the risk of fall by means of some clinical evaluation tests.
These examples frequently use questionnaires or functional evaluations of posture,
gait, cognition and other risk variables. These clinical evaluations are subjective
and qualitative, there being habitually used threshold assessment scores to categorize
between who falls and who does not fall. To evaluate the balance and strength of the
lower members, these tests are typically the Timed Up and Go Test (TUG), the Berg
Balance Scale (BBS), the sit to stand and the one leg stand; and ii) real-time fall
prediction system - recognizes abnormal gait patterns to calculate the probability
of occurrence of a fall in real time, continuously evaluating the risk of fall using
data from sensors while the user is carrying out his Activities of Daily Living (ADL)
(for example, walking, climbing stairs, sitting down, getting up, catching objects).
Upon detecting anomalous situations, the user can be notified in good time, or an
external aid can be used, such as a walker or a robot, as a fall prevention technique.
The robotic walking aid devices provide safety and stability, rendering assistance
in many phases of ADLs, according to the mobility level of the user, which results
in better QoL and autonomy for the elderly.
[0008] The falls occur occasionally and assume many different forms. On average, those residing
in homes for the elderly suffer 2.6 falls per person and per year. The low frequency
thereof, combined with the difficulty in instrumenting a subject and the unexpected
character thereof, lead to lack of data which can be used in several algorithms for
detection and fall forecast systems. On the other hand, there are several types of
falls which can occur, as well as a number of reasons which lead to a fall. Thus,
forecasting falls is a challenge.
[0009] Thus, the implementation and use of walking aid devices is assumed as an essential
tool for providing safety and stability. This area has been highly explored, bearing
in mind that these devices try to help in different phases of the ADLs of the patients
(for example, getting up, sitting down, providing balance while standing or moving,
going up and down stairs), providing a higher QoL and autonomy to the elderly.
[0010] With the technological evolution, there has been a progression to robotic assistance
means, so as to provide more safety, improve interaction with the user, allow controlled
handling, and even enable incorporating systems which provide fall detection and prevention
mechanisms. Among the robotic mobility assistance means there are highlighted the
robotic wheelchair, the robotic mobile walker, the robotic exoskeleton and the cane-type
robot. The use of support devices is associated to the user's limitations, which means
that each walking aid device is designed for the corresponding health levels and mobility
conditions of each person.
[0011] Among these devices, there is highlighted the cane-type robot, which is a device
that is not commercialized yet, able to detect and prevent falls. The cane-type robots,
in comparison with other means of assistance, are highlighted due to: 1- the low cost
thereof, which makes them the most accessible product in the market; 2- low weight,
facilitating the use and working thereof; 3- reduced dimensions, which allows the
use thereof in external and uncontrolled environments. With the purpose of aiding
with walking, the cane-type robot offers less body weight support, when compared with
the walker, not placing as much support on the upper members. Thus, it promotes greater
corporal activity and more extensive and complete muscle use of the lower member.
By having this moderate support, the user will have a better recovery, more independence
and more practical use while walking.
[0012] Although all the cane-type robots in question share the same purpose of assisting
with gait, they present very different solutions and mechanical characteristics from
each other. Each cane-type robot presents different weight and dimensions and several
types of components. They can also present several handling modes, which allows the
device to be controlled by one hand, two hands or even with no contact. In addition,
there exist different configurations and models of cane-type robots, which can vary
between 1 to 5 degrees of freedom, as well as contain a mobile structure composed
of 1 to 4 wheels.
[0013] Among these types of structures for cane-type robots there exist certain solutions,
as is the case of patent document
CN 110575371 A and
US20130041507A1, which have only 1 or 2 points of contact with the ground. Thus, there exists the
possibility of these types of devices, due to the inherent characteristics of the
designs thereof: 1- providing few degrees of freedom to the system, limiting the user's
movement; 2- not being able to stand alone without the assistance of in-wheel motors,
which enhances the lack of stability in case of engine failure; 3- not being sufficiently
robust to provide the necessary support to support the body weight of the user transferred
to the device in case of a fall.
[0014] Another important point in conceiving a cane-type robot arises from the decision
to use or not external devices by the user, namely wearable sensors. These external
sensors try to collect some behavior data of the user which can be necessary to detect
and prevent the occurrence of a fall. In this sense, patent document
CN112137847 comprises an accelerometer for detecting falls, sending a signal to the emergency
contact of the user, when the latter falls. However, a camera films the fall process
and while this happens the airbag which the user has coupled to his waist is activated,
avoiding more serious consequences which can result from the fall. Additionally, there
also exist devices wherein the wearable sensors appear in watches, as in the case
of patent document
KR 20160144193 A, and in shoes, as in patent document
CN104382307A, having the same purpose of acquiring postural information of the user for fall prevention
and detection.
[0015] The inconvenience of devices such as these which use wearable sensors is that there
exists something additional which the user has to use for working to occur in the
desired manner. This extra accessory can lead to a lower adoption and greater resistance
to using the device, thus resulting in abandonment of same.
[0016] As regards the fall detection methods, some are based on wearable sensors, as previously
mentioned, and others depend on sensors embedded in the device which can be complemented
with wearable sensors, with the same purpose of acquiring data which allows assessing
the walking status of the user and consequently distinguishing between a normal walking
state and an abnormal walking state on the part of the user and thus detect a possible
fall.
[0017] After detecting the fall, there immediately enters the fall prevention which activates
actuation mechanisms so as to enable the user to recover balance, granting a type
of support which in its turn would not be possible by means of traditional mobility
assistance devices. Patent document
JP 2015217155 A,
CN 107015564 A and
CN107693314A, are devices which have similar fall detection and prevention systems. The devices
include a Laser Range Finder (LRF) for detecting the position of the legs of the user,
which jointly with a 6-axis force-torque sensor, enables activating a pre-fall state
in case the mass center of the user is outside the area of the support polygon, indicating
that the user is about to fall. The fall prevention mechanism acts so the robotic
device moves in the same direction as the fall, placing itself in front of the user
so as to provide greater support and thus support a higher body weight percentage
of the user. Although the components incorporated within these devices that are responsible
for the fall detection method, namely the LRF and the 6-axis force-torque sensor,
allow offering important information about the gait, the posture and the stability
of the user, they present elevated costs (higher than 1000€) which can be a barrier
in the production of a cane-type robot which is accessible to most users.
[0018] These facts are described to illustrate the technical problem solved by the embodiments
of the present document.
GENERAL DESCRIPTION
[0019] The present disclosure is related to a walking aid device, also known as robotic
pyramid, capable for applying movement control and real-time fall detection algorithms.
The purpose of this apparatus is assisting elderly users in walking, allowing a quantitative
and continuous assessment of the gait and the risk of fall of the user and promoting
greater support in abnormal gait conditions through the movement thereof in space
to a position believed to be more advantageous for the recovery of balance of the
subject. The result expected from this support is the real time fall prevention after
detection of abnormalities in the gait, thus promoting greater independence and better
quality of life to the target population. These contributions are possible by means
of monitoring the spatiotemporal parameters of the device and the user. In addition
to the strategy for fall prevention, the system will be able to provide clues/sensory
data by means of a real time biofeedback system, directly connected to the sensor
unit, with the purpose of using these stimuli to increase the awareness of the users
relative to their motor function. In orderfor the fall prevention to work as expected,
the system must be able to adjust to the specific gait patterns of the user, detecting
abnormalities.
[0020] At this time, the systems proposed in literature require the use of wearable sensors
by the subject, so as to gather vital information for the correct working of the methods
currently suggested. However, it is important to emphasize that it is desired that
the device be comfortable, discrete and easy to use, something which is compromised
by the use of wearable sensors. Bearing this in mind, there exists as objective for
this solution the exclusion of wearable sensors, so as to ensure greater adoption
on the part of the target population.
[0021] Additionally, the device comprises a navigating strategy so as to allow detection
of possible obstacles to the movement thereof and, consequently, that of the user,
signaling and stopping the movement to avoid a collision. In this way, and allied
to the fall prevention system, as the device autonomously detects relevant events
and activates a corresponding response, there is not such a high cognitive load for
the user, that is, an extremely attentive attitude is not required when walking. In
short, this device can be easily included in the user's daily life, not constituting
a cognitive burden or requiring the use of additional equipment for the correct working
thereof, ensuring greater support to the user in fall situations which could result
in negative consequences.
[0022] Currently, the market lacks a robotic solution for daily assessment, fall risk forecast
and fall prevention, in home and/or institutional context. At the same time, the current
fall assistance solutions require the use of wearable devices to complement the prevention
action and usually lack artificial intelligence.
[0023] The device, or robotic pyramid, is distinguished by the continuous monitoring ability
and mobility assessment (number of steps, speed, distance covered) in a customized
manner (to the user and motor activity). This continuous customized assessment contributes
to a more effective and timely clinical and/or ergonomic diagnosis, in detriment of
the subjective assessment currently employed, and for predicting a more realist fall
risk indicator in face of the daily activity of the users.
[0024] Additionally, the device or robotic pyramid is distinguished by assisting the user,
by means of tactile vibration, only when necessary, in detriment of continuously warning
the user whenever the fixed balance thresholds are exceeded. In this way, it reduces
cognitive effort, favoring the extended daily use thereof and ensuring the preventive
potential thereof over the current solutions. Real time assistance also innovates
by means of the quick repositioning of the cane (the cane shaft with the grip) which,
when strategically activated, guide the user in the best configuration for correcting
the balance. The combination of these assessment and assistance functionalities in
a robot is distinctive on its own. Additionally, the device or robotic pyramid innovates
by introducing a digital counselor which: a) provides a daily report on motor performance
and postural evolution, for subsequent analysis by clinicians or caregivers; b) suggests
motor learning exercises adapted to the evaluation and evolution of every individual.
[0025] Thus, they allow new daily assistance activities for the users, constituting competitive
advantages of the device or robotic pyramid.
[0026] In an embodiment, the manufacturer will follow a sustainable perspective, complying
with the European ecology norms (Ecolabel). The eco-friendly cane will have a modern
and lasting design, with good quality materials, guaranteeing comfort and safety to
the user.
[0027] The device is adjustable, adapting to the needs of different users.
[0028] The use of the device or robotic pyramid will have a social impact for the different
users. The device or robotic pyramid will provide older adults with a 50% reduction
in fall episodes, fall prevention and increase of physical activity in 20%, with consequent
cardiovascular benefits and physical and mental well-being. These aspects can equally
impact the elderly population, promoting active and healthy aging. The indirect results
of a more active elderly population include reduction of dependence on third parties
and social isolation.
[0029] Daily assistance will increase the physical ability of the users (individuals with
high risk of falling and/or fear of falling) in 20%, reducing the social isolation
and stimulating proactivity. Indirectly, the device or robotic pyramid will promote
reduction of absenteeism and early retirement and increase physical activity by 10%.
[0030] Some of the advantages of the device are:
free of the need for using wearable sensors by the user;
with three points of contact with the ground for greater mobility and stability of
the system;
intuitive and easy to use;
able to bridge the users' needs;
accessible cost;
able to detect and prevent falls.
[0031] Briefly, the present invention allows:
Following a non-pharmacological approach, which has shown to be in the forefront in
helping with treatment of motor symptoms in question;
Does not require cognitive effort on the part of the users, which can compromise their
multitasking, nor their freedom of movement. Designed to be light and ergonomic, the
robotic pyramid aims at being used daily for long periods;
Being adaptable to each person's gait: inclusion of a gait monitoring system and respective
processing units for analysis of the adaptable gait;
Being universal and adjustable to the different users: achieved by means of the handle
height adjustment; universal supply of vibrotactile stimulation at one of the sensitive
anatomic areas, the hands;
Having a development centered on the user by means of continuous validation with the
final user and validated by clinicians;
Being a reliable system; continuous validation;
Being compact: inclusion of the electronic components both for monitoring and analysis
of the gait, as for tactile stimulation in the same device, which does not become
unpleasant for the users;
Allowing segmentation and analysis of the gait carried out by means of a laser and
force sensors;
Allowing a complete analysis over the movement and contextual activity of the user,
enabling an actuation strategy more adapted to them;
Being a system based on the concept of intelligent aid: upon using gait information
of the user, the device is able to discern the desired direction for rendering the
necessary balance support. This intelligent approach allows the device to automatically
adjust and provide customized, efficient and adaptive assistance, accompanying the
user's movement in a precise manner;
Including the implementation of graphic applications interconnected to the database
and systems for keeping data gathered by the device, allowing the clinicians and investigators
to monitor, accompany and study the use of the robotic pyramid by the users;
Including the implementation of graphic interfaces which allow the investigators,
clinicians and users to access the device via wireless.
[0032] With these characteristics it is intended to help patients in hospitals, physiotherapy
clinics, and even domestic users to overcome the adversities associated with the mobility
limitations on the part of the lower members.
[0033] A first functionality refers to the quantitative and continuous assessment of the
gait, in home and/or institutional context, so as to allow an effective forecast of
the risk of fall by means of sensors and artificial intelligence algorithms. The monitoring
of the spatiotemporal parameters of the device and of the user, as well as the characteristics
that are common in scientific literature for studying the falls, will be essential.
[0034] Another functionality is the ability of the device to prevent falls in real time
and detect falls of the user, thus contributing to an objective and reliable evaluation
of the physical activity and quality of life of the user. The device supplies real
time assistance to prevent falls, moving in space so as to provide a more effective
support and maintain the protection of the mass center within the support base established
by the user's legs and the device.
[0035] Another functionality of the device or robotic pyramid consists of providing real
time vibratory sensory, visual and auditive clues, according to the information obtained
with the sensory unit installed in the device. These clues increase user awareness
relative to their motor function (
biofeedback)
, thus contributing to a more customized assistance.
[0036] The device or robotic pyramid responds to the need for daily assistance solutions
which can reduce the prevalence of falls by 10%. The device or robotic pyramid acts
as a key element in early detection and daily prevention of falls. It allows obtaining
a more precise fall risk forecast (precision>85%) than the current traditional forecast
scales.
[0037] In an embodiment, making the motor activity report available, by means of mobile
application, will make the individual self-aware of their motor condition, motivating
the alteration of motor behaviors. Additionally, these reports can act as support
for a diagnosis and more effective and immediate follow up (precision>85%, updated
every 5 minutes) and, consequently, allow the interested parties (caregivers and clinicians)
to timely outline prevention solutions.
[0038] In a preventive perspective, the use of vibrating mechanisms for warning the person
as to the postural correction will lessen by 50% the time in risk conditions. Daily
awareness will allow the user to develop a muscle memory and alter, in an autonomous
and healthy way, the manner in which he carries out his daily activities. As a complement
to the prevention of falls, the digital caregiver will suggest training and/or muscle
reinforcement exercises directed to each user, promoting a 20% increase in physical
activity.
[0039] Preferably, the users of the device can be older adults with mobility level 3 on
the
Holden scale (functional ambulation classification), that is, people who need support during
mobility. However, any user can use said device.
[0040] The present disclosure is related to a device with omnidirectional movement to support
a user's gait, comprising:
a controller;
a shaft with a grip for support by the user; and
a base which comprises:
an upper plate and a lower plate for supporting electronic components including said
controller,
at least three wheels to support the base, and
at least three electric actuators for acting on said wheels;
wherein the controller is configured for controlling the actuators for acting on said
wheels for correction of the user's gait;
wherein the actuators are distributed between the upper plate and the lower plate;
wherein the grip comprises a plurality of vibrotactile motors for providing feedback
to the user;
wherein the shaft is connected to the upper plate of the base by a connection element.
[0041] In an embodiment, the connection element comprises a plate and at least three fixing
elements.
[0042] In an embodiment, the device comprises a plurality of movement sensors arranged on
the base for detecting movement of the device, preferably of the omnidirectional wheels.
Preferably, the force sensors will detect the user's intention, as the laser can also
detect. Based on the force sensors and the laser, it is possible to monitor the user's
gait. That is, the device with the IMU has a reference of their movement in space,
being able to monitor the user's gait.
[0043] In an embodiment, the movement sensors comprise an inertial measurement unit positioned
on the base.
[0044] In an embodiment, the connection element comprises a plate and at least three fixing
elements.
[0045] In an embodiment, the device comprises a plurality of force sensors arranged on the
grip to detect forces exerted on the grip. Optionally, the grip can comprise physiological
monitoring sensors such as, for example for detecting heartbeat, temperature and galvanic
skin response.
[0046] In an embodiment the device comprises one or more, in particular three or more, force
sensors arranged on the grip to detect forces exerted on the grip.
[0047] In an embodiment, the force sensor or sensors are arranged on the shaft for detecting
directional forces exerted on the shaft by the user in a direction perpendicular to
the shaft, for detecting the direction in which the user intends to move.
[0048] In an embodiment, the device comprises one or more, in particular four or more, force
sensors arranged on the shaft to detect forces exerted on the shaft.
[0049] In an embodiment, the force sensor or sensors are a plurality of force sensitive
resistors.
[0050] In an embodiment, the force sensors (FSRs) on the shaft are 4 and detect in 2 axes
x, y (or anteroposterior and mediolateral) which measure lateral forces on the 2 axes.
In an embodiment, the third force axis is measured on the grip by 3 FSR force sensors
and measure the force only vertically and from top to bottom.
[0051] In an embodiment, the device comprises a laser distance measurer arranged on a surface
of the upper plate, for measuring the distance between the device between the user's
legs and an obstacle or obstacles. One of the advantages of the device comprising
the laser distance measurer is that it is also able to detect the distance between
the legs, between the legs and the device and also between the legs and one or more
obstacles. The device can also measure the distance to the obstacles within a radius
less than 360 degrees.
[0052] In an embodiment, the device comprises a light source, preferably a photodiode.
[0053] In an embodiment, the device comprises at least one photoresistor for brightness
detection and activation of the photodiode when the value of the signal obtained is
less than a pre-defined value.
[0054] In an embodiment, the photoresistor is arranged on the shaft. Preferably, it is arranged
on a lower part of the shaft, more distant from the grip and closer to the base.
[0055] In an embodiment, each of the wheels is an omnidirectional wheel.
[0056] In an embodiment, the actuators are electric actuators, preferably motors.
[0057] The present disclosure is further related to an operating method for a device with
omnidirectional movement for support to a user's gait, wherein the device comprises:
a controller;
a shaft with a grip for support of the user, wherein the shaft is connected to the
upper plate of the base by a connection element and wherein the grip comprises a plurality
of vibrotactile motors for providing feedback to the user;
a base which comprises:
an upper plate and a lower plate for supporting electronic components,
at least three wheels to support the base, and
at least three electric actuators for acting on said wheels;
wherein the method comprises the controller executing the following steps:
acquiring, from each sensor of the plurality of sensors, a signal received from the
grip and the shaft;
determining from the acquired signals the user's movement;
controlling the actuators for acting on the wheels for correcting the user's gait.
[0058] In an embodiment, the controller is configured for detecting a vertical force, in
particular a force exerted by the user on the grip in a direction parallel to the
shaft, by means of one or more, particularly three or more, force sensors arranged
on the grip for detecting forces exerted on the grip.
[0059] In an embodiment, the controller is configured for detecting directional forces exerted
on the shaft by the user in a direction perpendicular to the shaft, by means of one
or more, in particular four or more, force sensors, for detecting the forces exerted
on the shaft.
[0060] In an embodiment, the device comprises 5 units responsible for ensuring the necessary
functions for the correct working of the system and due processing of data. These
units are the following: sensory unit, control unit, memory unit, actuation unit and
power unit.
[0061] In an embodiment, so as to apply the algorithms and strategies outlined for the system,
it is first necessary to gather the data to be used. Obtaining these data is guaranteed
by the sensory unit of the device. The implemented sensors focus on detecting the
movement of the device and the surrounding environment, so as to allow the best possible
knowledge about the factors external to the device for correctly controlling the same.
[0062] In an embodiment, for detecting the orientation, tilt and acceleration of the apparatus,
which can next be extrapolated to obtain the speed thereof, the sensory unit presents
an inertial component, constituted by an Inertial Measurement Unit (IMU). Contrary
to the other analysis systems, the IMU allows obtaining a complete analysis of the
desired structure without requiring a long post-processing of the data, allowing an
effective analysis and in real time. In the case in question, the IMU used, combining
the degrees of freedom of the accelerometer, gyroscope and magnetometer, allows a
detection capacity of 9 degrees of freedom. This last sensor is calibrated already
considering the material which constitutes the gait support device for their measurements
not to be affected. The information obtained by this component serves as support for
a more objective clinical diagnosis based on evidence, allowing to provide clinicians
with a quantitative evaluation of the motor symptoms and continuously monitor the
evolution of the assistance process. The determination of the orientation and speed
of the system are essential for allowing determining situations wherein the robotic
pyramid is not in the expected position, such as in cases wherein it has fallen.
[0063] Additionally, the sensor unit presents the implementation of a force unit, by means
of the use of Force Sensitive Resistors (FSRs), able to perform measurements of force
applied on the device. This force unit presents two systems: an axial detection system
and one of vertical detection. In the case of the axial one, this presents, in an
embodiment, 4 FSRs arranged in an equidistant manner around the shaft of the device,
which allow gauging in which direction the user wishes to move, so that the low level
control unit can thus exert control over the device for the latter to move according
to the detected movement intention. The vertical detection system presents, in an
embodiment, 3 FSRs placed on the grip or handle of the device, allowing estimating
the force which the user applies over the device. These values allow estimating when
the user supports himself on the structure and determining the normal gait pattern
thereof and, consequently, estimate in which situations the latter is affected. Fall
risk situations are most likely when the user does not exert or exerts little force
on the device and, therefore, this system becomes essential in the fall detection
strategy to be implemented. The preferred choice for implementing FSRs for this function
is due to there being components with high sensitivity, thus allowing efficiently
measuring the minimal deformation values which it is expected to obtain from using
the pyramid, being at the same time robust, flexible and with low cost.
[0064] The present description further presents the ability of the user to move correctly
in an environment full of possible obstacles to the movement of the user and the device,
whereby there must also be included the cases wherein, although the obstacle does
not affect the user, it can cause embarrassment in the path of the device. For this,
it is necessary for the sensory unit to present a component that is able to analyze
distances around the system, being responsible for detecting the object and tracking
the distance between the obstacle and the device or robotic pyramid. With this purpose,
the use of the LRFs is outlined. This type of sensor is characterized by the emission
of laser beams which, when colliding with a possible obstacle, will return to the
LRF. The device will use the time lapsed between the emission and reception of the
reflected beam to determine the distance at which the obstacle is found. The use of
LRFs is due to the efficiency and detection speed thereof, to the ease of use and
to not presenting the questions of invasion of privacy associated with other sensors.
[0065] An environment limitation which can lead to an increase in the likelihood of falls
and mobility problems is the lack of visibility present in environments with low light,
since this reduces the reaction ability of the user to possible obstacles or other
conditions. Thus, in an embodiment, the device further presents the implementation
of a photoresistor able to analyze the brightness of the environment surrounding the
device and, in accordance with the measured values, activate the corresponding component
of the actuation system for lighting up the space around the user. This allows reducing
the risk of fall in these situations, being a less complex manner of acting to prevent
falls.
[0066] The control unit of the device or robotic pyramid is responsible for a great part
of the working of the device, receiving information from the sensory unit, processing
this information according to the algorithms and strategies defined and sending commands
to the actuation unit to enable carrying out the necessary actions. Due to the various
abilities included in the device, the control unit is divided into two components:
a low level component and a high level one. The low level is responsible for the basic
processing of the information received by the sensors for carrying out more elemental
functions of the device, such as, for example, the detection of the user's intention
of moving or the biofeedback vibrotactile system. Additionally, the functions thereof
also include passing information from the sensory unit to the high level component
of the control unit, so that these can be used for other algorithms. Additionally,
it is in direct communication with the actuation unit, so as to transmit commands
resulting from the low level processing or which are received by the high level component.
In an embodiment, the low level unit comprises a microcontroller able to carry out
said processing at a satisfactory speed for applying the implemented strategies in
real time, but which also presents high versatility and efficiency of communication,
so as to allow connecting to the various components of the actuation unit, sensory
unit and to the high level processing unit. In an embodiment, the high level unit
will use information from the sensors for implementing the algorithms with greater
complexity than those previously mentioned, being responsible for detecting and preventing
falls and for the navigation based on detecting obstacles.
[0067] In an embodiment, due to the greater computer power necessary for carrying out these
tasks, this processing component is ensured by the use of a compact and discrete microcomputer
implemented in the device or robotic pyramid. Since it is a more complex system than
a microcontroller, the microcomputer further presents other functions which could
not be carried out by the low level unit, including storage of information relative
to the data collected by the sensors and which can subsequently be analyzed to study
the behavior of the device and the user. Due to this ability of the high level unit
which, together with the cloud used for storage of data, the microcomputer works as
the memory unit of the system. In the same manner, another function comprised by the
high level unit is the communication and synchronization with other technological
systems not built into the device, being the manner of connection established based
on protocols without networks, wireless, such as Wi-Fi or Bluetooth.
[0068] In an embodiment, the actuation unit comprises components able to interact with the
user and with the surrounding space, due to their action based on the commands sent
by the processing unit. Additionally, the action thereof depends directly on the components
of the sensory unit, whereby the behavior thereof is a response to the stimuli detected
by the device.
[0069] In an embodiment, taking as reference the use of the photoresistor for detecting
the brightness of the system, this sends information to the low level processing system.
In case it is determined that the value read is below a pre-defined reference value,
there is activated a light source, for example, a photodiode or Light-Emitting Diode
(LED) which allows brightening the surrounding environment to ensure the safety of
the user. This device is installed next to the photoresistor, so that the measurement
of brightness considers the effect of the LED.
[0070] As previously mentioned, the walking aid and fall prevention device implements the
use of a biofeedback system for signaling the user in situations of possible danger.
Due to the fact that this method implements the use of vibrotactile motors, these
should preferably be located in a position of contact with the user, being implemented
on the grip or handle of the device.
[0071] In an embodiment, the device comprises a type of tactile mechanism as it is more
discrete than other types such as auditive or visual, allied to the fact that it is
intuitive and easy to distinguish the different stimuli created. These actuators work
together with the sensors used for gait detection, so as to activate the signaling
in situations where the gait is affected and can lead to danger for the user.
[0072] Finally, the last actuators to consider are the 3 DC motors installed in the device
which, jointly with the omnidirectional wheels installed grant freedom of movement
to the apparatus so that this can move according to the user's needs. These actuators
are located on the base of the device, and depend on commands received by the axial
force sensory units, which are responsible for studying the user's intention of moving
and which will subsequently allow the low level processing unit to send information
to the motors for displacing the structure according to this intention, and the obstacle
detection unit, whereby the LRF information is used by the high level processing for
determining possible obstacles to mobility and which will allow using the motors to
avoid collision.
[0073] Lastly, it is necessary to refer to the power unit of the system, responsible for
providing power to the device (or robotic pyramid) and to the remaining units of which
it is composed. In an embodiment, this role is performed by a battery, able to power
the system. Considering that most of the components are not able to operate with this
level of power the structure presents voltage regulators, which maintain the voltage
which is passed to the components at the suitable voltage level which they need, so
as to avoid damage to same. In an embodiment, the system further presents an emergency
button which turns off the connection between the power and the rest of the system,
so as to make available a safety option for when the robotic pyramid is not in use.
[0074] After the force sensors allow detecting the forces which are being applied to the
structure, it is necessary to process the data received to determine in which direction
the user wishes to move and next use this information to exert control over the motors.
As referred, this processing is carried out by the low level processing unit, being
based on the admission control model.
[0075] In an embodiment, the control model implemented takes into consideration the gait
of the user and the forces which the latter applies on the device, which means that
the full force system is used to determine what behavior to adopt. After the signals
received are processed, there is performed the control of the motors by means of the
application of forward kinematics. Initially, it is considered that the user is standing
by the device, with his feet aligned with same. When the apparatus detects the walking
intention of the user, it will move in this direction to the next phases. Considering
that one of the user's legs is injured, there exist two phases: the support phase
of the healthy leg, wherein the injured leg moves and that of support to the injured
leg, when the healthy leg moves. In both situations, it is necessary that the device
remains stationary, so as to support mobility in the best manner. Although the behavior
of the device in both phases is similar, the phase of support of the injured leg is
the most important one, since in this phase the injured leg will serve as a support
point. Being more fragile, this is the phase wherein the support of the device is
more necessary, so as to provide the necessary stability. For this reason, the vertical
detection system is essential for determining when the user is supporting their weight
on the structure.
[0076] After determining the current gait pattern of the user and knowing the direction
in which the user wishes to move, it is necessary to transfer these interaction forces
for moving the device (or robotic pyramid) by applying forward kinematics, which will
be based on the use of kinematics equations to determine the rotation speed to be
applied on each motor to provoke the motion of the device in the desired direction.
To allow the correct application of this type of algorithms the mass center of the
system was considered as the reference center to apply, which in turn makes it possible
to estimate the rotation speed that each motor must take to cause the desired movement
for the system. Defining the reference as being that which is represented in
Figure 4, whereby the positive direction of the ordinate axis (axis y) will correspond to the
front direction of the movement, and the positive direction of the abscissa axis (axis
x) will be the direction corresponding to the device moving to the right. Considering
that α, β and γ are the angles which each motor makes relative to the abscissa axis
of the reference, then the angles for the movement direction of each wheel, represented
by
Θ1,
Θ2 and
Θ3, can be calculated in the following manner:

[0077] Having this in mind, the force of the movement in the axis of x (
Fx), axis of the y (
Fy) and in the vertical direction (
Fw), can be given by the following expressions:

[0078] These expressions can next be used to build the following matrix, whereby F represents
the components of each wheel for movement and M the contribution of each motor. This
matrix represents the distance that the device must move in each distance according
to the rotation speed applied to each motor. Using this expression, it is then possible
to determine which rotation speed each motor must present for the device to move in
the intended direction.

BRIEF DESCRIPTION OF THE FIGURES
[0079] For an easier understanding, figures are herein attached which represent preferred
embodiments that do not intend to limit the object of the present description.
Figure 1: Schematic representation of an embodiment of the device or robotic pyramid with all
the structural components thereof and for data acquisition.
Figure 2: Schematic representation of an embodiment of the dimension measurements of the device.
Figure 3: Schematic representation of an embodiment of the main structure of the device, wherein
between the upper base 1 and the lower base 2 there are located the omnidirectional wheels 3 and the direct current motors 6. The connection between the shaft 7 and the upper plate of the base of the device is made by means of three supports
4 and a plate 5 wherein these are welded. The axial force system is found in shaft 7.
Figure 4: Schematic representation of an exploded view of an embodiment of the components which
are located on the lower part of the walking aid device namely, the LRF 8, the battery 9, the STM32 plate and the IMU 10, the controller 12 and the voltage regulators 11, 13.
Figure 5(a): Representation of an embodiment of the base of the device, with the Cartesian reference
located in the mass center of the pyramid (of the device).
Figure 5(b): Representation of the forces involved in the movement of the device.
Figure 6: Representation of the haptic detection system on the handle of the device, wherein
there are demonstrated three force detection phases: (a) no contact with null detection;
(b) slight contact with small disturbances in detection; (c) support phase, where
the forces detected are maximum.
Figure 7: Representation of several embodiments of grip/handle of the device, which comprises
FSRs, adapted from the original handle for precise acquisition of vertical forces.
Figure 8: Representation of a working diagram of the closed loop solution implemented for the
device.
DETAILED DESCRIPTION
[0080] Falls are the second largest cause of death by injury in the elderly population and
result in high costs for the national health system.
[0081] The present disclosure is related to an intelligent robot for preventing falls. The
device or robotic pyramid is an intelligent cane-type robot consisting of an autonomous
and multifunctional accompaniment device for the user and which allows a quantitative
and continuous evaluation of the gait. It can be used in domicile and/or institutional
context with the purpose of allowing an effective forecast of the risk of fall by
means of sensors and artificial intelligence algorithms.
[0082] The present disclosure is related to a device with omnidirectional movement for gait
support. It refers particularly to the device and respective operating method, preferably
a robotic pyramid.
[0083] The present disclosure is related to a device with omnidirectional movement to support
a user's gait, comprising:
a controller;
a shaft with a grip for support by the user; and
a base which comprises:
an upper plate and a lower plate for supporting electronic components including said
controller,
at least three wheels to support the base, and
at least three electric actuators for acting on said wheels;
wherein the controller is configured for controlling the actuators for acting on said
wheels for correction of the user's gait;
wherein the actuators are distributed between the upper plate and the lower plate;
wherein the grip comprises a plurality of vibrotactile motors for providing feedback
to the user; wherein the shaft is connected to the upper plate of the base by a connection
element.
[0084] In an embodiment, the present disclosure is related to a gait support device for
a user, which comprises: a shaft
7 which allows support for the user; a connection element
5 which transmits the forces between the device and the user; three fixing elements
4 which provide structure to the device; at least two base plates
1,2 for electronic components; at least three electric actuators
6 which allow correction of the gait; at least one omnidirectional wheel
3 for each actuator used, which allow creating an omnidirectional base, essential for
corrections/actuation in limited spaces, allowing aid and movement of the user according
to their needs.
[0085] In an embodiment, the base is stable and self-supporting in the vertical position,
waiving the need for external or additional components. Thus, when the device is at
rest, it does not tend to unbalance, since it maintains the mass center contained
within its own support base.
[0086] In an embodiment, the device is adjustable, enabling the complete customization of
the physical form thereof to meet the needs of different users. This level of customization
aims at providing a maximum adaptation to the user, thus promoting higher efficacy
and ergonomics of the device. Preferably, the shaft of the device is height adjustable.
This allows the user, by means of clear orientations, to adjust the height of the
shaft so as to use the device correctly, thus avoiding negative consequences associated
with inadequate height, such as incorrect posture.
[0087] In an embodiment, the system for continuous evaluation and detection of the gait
and fall risk in real time is carried out by means of the use of algorithms for movement
control.
[0088] In an embodiment, the monitoring of spatiotemporal parameters of the device and the
user is carried out so as to provide a broad and continuous analysis. This approach
aims at evaluating and recording the relevant variables along space and time, thus
offering a complete vision of the interactions between the robotic device and the
user which are extremely important for helping the control and decision algorithms
towards an efficient fall prevention.
[0089] In an embodiment, the increase of the motor function of the user is obtained by means
of a biofeedback system in real time, based on vibrotactile units.
[0090] In an embodiment, the device allows automatic and autonomous adjustment to the user's
gait pattern, using sensors to dynamically adapt the configuration thereof and optimize
the moving experience in a customized and efficient manner.
[0091] In an embodiment, the device allows reducing the cognitive load during the use of
the device by means of the implementation of a navigation system, which allows detecting
possible obstacles to their movement, signaling and stopping the movement of the device/user,
avoiding potential collisions, based on the use of LRFs.
[0092] In an embodiment, the environment lighting unit comprises an environmental light
detection system which allows adjusting the intensity in real time, according to the
context in which the user is located.
[0093] In an embodiment, the device comprises actuation on the
Internet of Medical Things (IoMT) mode.
[0094] In an embodiment, the device comprises systems able for the implementation of wireless
protocols.
[0095] In an embodiment, algorithms and systems previously indicated, powered by a sensory
unit which allows detecting the orientation, tilt, acceleration and speed by means
of the use of an IMU; detecting forces applied to the device by means of the use of
FSRs, being possible to detect the user's movement intention and create the gait pattern
of the user.
[0096] Said controller can be a microcontroller, a computer, or any type of data processor,
namely, an electronic data processor. In an embodiment, the algorithms and systems
previously indicated are supported by a low level control unit, supported by a microcontroller.
In an embodiment, the algorithms and systems previously indicated are supported by
a high level control unit, supported by a microcomputer.
[0097] In an embodiment, the algorithms and systems previously indicated are supported by
a local storage unit.
[0098] In an embodiment, the algorithms and systems previously indicated are supported by
a local storage unit in a cloud.
[0099] In an embodiment, the algorithms and systems previously indicated are supported by
an energy power unit further composed by voltage limiters which ensure safety to the
different components which act simultaneously.
[0100] In an embodiment, the implementation of the safety system allows cutting off the
power between the power unit and the remaining systems by activating a button.
[0101] In an embodiment, the protection of the systems and components previously mentioned
is ensured by means of a coating or shroud which isolates these surrounding environment
elements, thus ensuring the preservation and integrity of same.
[0102] In an embodiment, the coating or shroud is made of metal.
[0103] In an embodiment the coating or shroud is made of steel or aluminum or carbon fibers.
[0104] In an embodiment, the components integrated in the device are totally independent
from external hardware for the correct working of the algorithms and systems previously
indicated, allowing greater freedom and universality of use on the part of the user.
[0105] In an embodiment the device uses IoMT systems [Internet of Medical Things] and wireless
protocols, provided with omnidirectional wheels for optimizing the position and providing
an adjustable support base in real time, stimulating balance. It uses an IMU and FSRs
for precisely detecting the orientation, tilt, acceleration and the forces applied
on the device, enabling the identification of the user's intention of moving and creating
customized gait patterns. Operating with low and high level control units, and supported
by local and cloud storage, the device stands out by prioritizing the detection and
prevention of falls through the real time analysis of the data captured.
[0106] Figure 1 represents an embodiment of the device.
[0107] Figure 2 represents an embodiment of the device, wherein the height of same is of 1061 cm
and the base width is 388 cm. The height and width can be variable, according to whom
they are destined.
[0108] Figure 3 represents an embodiment of the device, being represented the upper plate of the
base
1 and the lower plate of the base
2 wherein there are located the omnidirectional wheels
3 and the direct current motors
6. The connection between the shaft
7 and the upper plate of the device is made by means of three fixing elements or supports
4 and a sheet plate
5 where they are welded. The axial force system is found in shaft
7.
[0109] In an embodiment, the shaft
7 is adjustable, namely adjustable in height, for a better support on the part of the
user.
[0110] In an embodiment,
Figure 5(a) shows the base of the device, with the Cartesian reference located in the mass center
of the pyramid, namely the mass center of the device. This figure shows the numbering
of the motors (1 to 3) and the respective angles α, β and γ which each motor makes
relative to the abscissa axis of the reference.
[0111] In its turn,
Figure 5(b) represents a simulation of forces (F1 to F4) which can be interpreted by the kinematic
equations for performing the movement of the wheels (1 to 3), allowing the device
to move in the most varied directions and rotate over itself.
[0112] Figure 6 refers to the results of an embodiment of the haptic detection system on the handle
of the device, wherein there are demonstrated three phases of the force detection:
a) no contact with null detection;
b) slight contact with small disturbances in detection;
c) support phase, where the forces detected are maximum. It is verified in the graphic
that the system provides a precise and sensitive tactile response, reflecting the
force variations during the different detection phases.
[0113] Figure 7 represents a plurality of grip/handle variations of the device whereby in
a) the handle comprises three force sensitive resistors (FSR), in
b) the sensors are coated with three 3D printed parts for better targeting of the force,
in
c) the handle is coated with a 3D printed part to isolate the sensors and in
d) there is observed a section view of the handle with the elements described in a),
b) and c). These representations are adapted for the precise acquisition of vertical
forces.
[0114] Figure 8: Representation of an operating diagram of the closed loop solution implemented for
the device.
[0115] Next, there will be described the working method of the device for gait support.
[0116] In a preferred embodiment, initially, after the user acquires the device and adjusts
the handle considering the dominance (that is, preferred hand of the user for operating
the device), as well as the handle height, the device is turned on and, next, there
are performed the following steps:
- 1. The user must remain stable and in an upright position next to the device for 5
seconds, for the calibration routine of the data for acceleration of the device to
be carried out, as well as the laser data.
- 2. During the calibration routine, there are collected values from the accelerometer
of the device, for calculating an average, and distance values measured by the laser,
for an initial interpretation of the position of the user relative to the robotic
pyramid. The calculated average value allows determining a stable and initial acceleration
value for each use of the device.
- 3. The calculated acceleration value is used in the calibration of the acceleration
data acquired after this phase.
- 4. After the calibration routine takes place, the user can carry out his tasks freely
and the device continues with the analysis of the gait, the intention of moving and
the detection of the gait phases, following the next calibration phases.
- 5. Whenever the user leans on the device, that is, whenever there is detected a determined
vertical force, the device will remain motionless to provide support to the user.
- 6. When the user desires to move, a force is applied in the direction of the movement
of the handle of the device. The detection of the application and direction of these
forces results in the movement of the device in the desired direction.
- 7. When there occurs an unbalance, detected by the sensory unit, the control unit
of the device activates the motors of the omnidirectional wheels to position the device
so as to provide the adequate support to the user, prioritizing their safety and comfort.
- 8. The data of the different components of the sensory unit which are acquired during
the use are saved in the memory unit.
[0117] After the device has been used it is possible to access the control unit, namely
the high level, with the purpose of obtaining the data saved in the sensory unit.
The control unit is able to send data via online to a cloud. Next, these data are
analyzed, by means of an interface, which allows analysis of the collected data and
estimated metrics.
[0118] Optionally, another actuation mode includes a closed loop vibrotactile stimuli delivery
strategy, contemplating the following steps:
- 1. After positioning himself next to the device, the user is able to select the vibration
frequence and which vibratory units to activate, through a phone app or other mobile
device, which communicates with the device through Bluetooth.
- 2. During the calibration routine, there are collected acceleration values of the
device, for calculating an average, and distance values measured by the laser, for
an initial interpretation of the position of the user relative to the walking aid
device. The calculated average value allows determining the stable and initial acceleration
value for each use of the device.
- 3. The calculated acceleration value is used in the calibration of the acceleration
data acquired after this phase.
- 4. After the calibration routine takes place, the user can carry out his tasks freely
and the device continues with the analysis of the gait, the detection of the intention
of moving and the detection of the gait phases, following the next calibration phases.
- 5. Whenever the user presents a gait considered abnormal, the handle will present
vibration in an attempt to correct a behavior considered as a fall risk.
- 6. If obstacles are detected in the path of the walking aid device, there will be
generated a vibratory response in the handle so as to warn the user.
- 7. In case the user has their hand on the handle of the walking aid device, but has
not moved for a long while, a vibratory stimulus is performed with the purpose of
stimulating the movement of the user.
- 8. The data of the different components of the sensory unit associated with the handle
and the shaft of the device are acquired during use, being subsequently saved in the
memory unit.
[0119] In an embodiment, it is also possible to follow the following steps to access the
device by means of one of the two graphic interfaces developed (for example Android
and C# Visual Studio):
- 1. Subsequently to the due adjustment of the handle, considering both the dominance
of the user as the height of the same, and the device being turned on, there is performed
the pairing between the device and the graphic interface (for example, cellphone or
computer) by means of Bluetooth, which is integrated in the robotic pyramid.
- 2. Selection of the parameters which it is intended to analyze, by means of the respective
graphic interface buttons. There can be selected the frequency of vibration (according
to the range which is perceived by the human being), the vibration time interval and
the vibratory pattern.
[0120] This utilization mode allows analyzing which vibration frequency a certain user can
perceive in their hand. It is further possible to determine the minimum interval which
each user requires to fully perceive the vibrotactile stimuli in the stimulated zone
in question. There is added, once more, that the data of the gait are being collected,
by means of the laser acquisition and the force sensors. In the same manner, this
fact allows accessing the data acquired in the high level control unit or in a computer,
where there can be carried out the calculation of the gait parameters.
[0121] Finally, it is further possible for the device to operate only as a gait monitoring
system, where the gait data are acquired, saved in the memory unit and, next, in a
computer, duly analyzed and parametrized. All the data can be kept in a database with
reference to each user.
[0122] Whenever used in this document, the term "comprises" or "comprising" is meant to
indicate the presence of features, elements, integers, steps and components mentioned,
but does not preclude the presence or addition of one or more other features, elements,
integers, steps and components, or groups thereof. The present invention is of course
in no way restricted to the embodiments described in this document and a person with
average skills in the art may foresee many possibilities of modifying the same and
of substituting technical features for equivalent ones, depending on the requirements
of each situation, as defined in the appended claims. The following claims define
additional embodiments of the present description.