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WO2025088137A1 - Procédé et système de formation en mouvements d'un mouvement - Google Patents

Procédé et système de formation en mouvements d'un mouvement Download PDF

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Publication number
WO2025088137A1
WO2025088137A1 PCT/EP2024/080255 EP2024080255W WO2025088137A1 WO 2025088137 A1 WO2025088137 A1 WO 2025088137A1 EP 2024080255 W EP2024080255 W EP 2024080255W WO 2025088137 A1 WO2025088137 A1 WO 2025088137A1
Authority
WO
WIPO (PCT)
Prior art keywords
movement
body part
patient
representation
reality
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/EP2024/080255
Other languages
German (de)
English (en)
Inventor
Andreas Bohland
Roland Auberger
Christian DAUR
Kai-Hendrik BUSSIEK-CILLIEN
Gordon Siewert
Michael Joch
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ottobock SE and Co KGaA
Original Assignee
Ottobock SE and Co KGaA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ottobock SE and Co KGaA filed Critical Ottobock SE and Co KGaA
Publication of WO2025088137A1 publication Critical patent/WO2025088137A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/68—Operating or control means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F3/00—Input arrangements for transferring data to be processed into a form capable of being handled by the computer; Output arrangements for transferring data from processing unit to output unit, e.g. interface arrangements
    • G06F3/01—Input arrangements or combined input and output arrangements for interaction between user and computer
    • G06F3/011—Arrangements for interaction with the human body, e.g. for user immersion in virtual reality
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • A61F2002/7615—Measuring means
    • A61F2002/763—Measuring means for measuring spatial position, e.g. global positioning system [GPS]

Definitions

  • the invention relates to a method for movement training of a movement of at least one body part of a patient equipped with an orthopaedic device.
  • the invention also relates to a system for this purpose.
  • orthopedic devices include, in particular, orthoses, prostheses, exoskeletons, and possibly also wheelchairs.
  • Orthoses are products that support, assist, protect, and/or restrict the freedom of movement of a patient's body part, such as a joint, in order to prevent excessive strain.
  • Prostheses do not replace, or no longer replace, the patient's existing body parts.
  • Exoskeletons are, in particular, mechanical support structures designed to support, assist, and/or protect the patient's main musculoskeletal system.
  • a patient is defined as any user of the orthopedic device. This is therefore the provider of the orthopedic device.
  • Every orthotic device is placed on a specific part of the patient's body. It doesn't necessarily have to come into contact with the patient's skin. Orthoses and exoskeletons, for example, are often worn over clothing, so that the clothing, such as trousers, is between the orthotic device and the patient's skin. Nevertheless, for example, a knee orthosis is attached to the patient's knee or leg.
  • a prosthesis always has an interface element connected to an amputation stump or other body part, which is attached to the respective body part.
  • a leg prosthesis for example, uses a prosthetic socket that represents the interface between the prosthesis and the amputation stump. In this case, the amputation stump would be the patient's body part.
  • a liner is typically used between the skin surface of the patient's amputation stump and the prosthetic socket to reduce shear forces acting on the skin.
  • a prosthetic socket for an amputation stump is typically made of a rigid (hardly deformable) material, such as fiber-reinforced plastic, and forms an important part of the interface between the amputation stump and the prosthesis attached to the socket.
  • Such prosthetic sockets have long been used, particularly for leg prostheses that are to be attached to an amputation stump, such as a femoral stump.
  • Prosthetic sockets for leg amputees are subject to particular stresses in daily use.
  • the patient's entire weight rests on the prosthetic socket, and thus particularly on the amputation stump, which is housed in the prosthetic socket. It is therefore of utmost importance to adapt the prosthetic socket as optimally as possible to the patient's individual circumstances and needs, especially to the shape and geometry of the affected body part.
  • the patient is assisted by a technically trained user, such as an orthotist.
  • an orthotist With their knowledge and experience, the orthotist can make the necessary adjustments to ensure the orthopedic device fits optimally and provides a gentle movement pattern.
  • DE 10 2018 128 514 B4 discloses a method for performing a static prosthesis assembly, wherein several components are arranged next to one another. The actual position and actual orientation of the arranged components relative to one another are determined based on recorded positions and orientations of markings and compared with corresponding target values.
  • CN 10958157 B discloses a method for a treadmill in which footprints are superimposed onto the user's reality.
  • US 2021354023 discloses a device and a method in which targets for the position of joints are displayed to the user during movement by means of augmented reality.
  • a method for training the movement of at least one body part of a patient equipped with an orthopaedic device comprising the following steps: - generating a digital graphic representation of the movement of the body part equipped with the orthopaedic device as a function of a target movement that the body part is to perform with the equipped orthopaedic device, by means of an electronic processing unit,
  • a method for movement training of a movement that is to be performed by a patient equipped with an orthopedic device is proposed.
  • an orthopedic device can be, for example, a prosthesis, an orthosis, or even a wheelchair.
  • the movement training is carried out in particular with the body part to which the orthopedic device is arranged. This can also include the entire upper or lower extremity and, if necessary, the entire body.
  • Such movement training of a movement serves to ensure that the patient becomes accustomed to the orthopedic device and performs optimal movements in order to achieve the best possible care and increase comfort.
  • Such movement training also serves to ensure that the patient performs movements with the orthopedic device that provide optimal support and do not have a negative effect on other parts of the body or body elements that are not equipped with the orthopedic device.
  • the digital graphical movement representation shows the target movement in the form of a movement sequence, with the orthopedic device and, if applicable, the treated body part being part of the graphical movement representation.
  • the orthopedic device and, if applicable, the treated body part are preferably generated in the form of an outline representation or a semi-transparent body representation.
  • the device and body part can be represented in a highly abstract form with a low level of detail. However, a very detailed representation of the device and the body part is also conceivable, provided the corresponding information has been provided to the computing unit in advance.
  • a body part movement of the patient's body part equipped with the orthopedic device is now recorded. This can be done, for example, using a camera or other optical sensors.
  • the recording device thus records the movement of the orthopedic device performed by the patient, making it possible to determine how the orthopedic device and the body part fitted with it move in space and where they are located (absolutely in space or relative to a reference, such as the recording device or the body).
  • the generated movement representation is now overlaid as a reality extension into the reality perceived by the patient in his or her direction of vision, in such a way that the position of the overlay of the graphic movement representation depends on the recorded body part movement.
  • this means that the digital movement representation is displayed synchronously with the recorded body part movement. This allows the patient to detect a deviation between their own body part movement and the displayed movement representation of the target movement, which can be compensated or balanced by adjusting their own body part movement. This encourages the patient to approach the target movement and thus achieve an optimal movement sequence with the orthopedic device.
  • the digital motion representation is not only displayed synchronously with the recorded body part movement, but is also accurately integrated into the patient's perceived reality, so that the image of the orthopedic device and, if applicable, the body part contained in the digital motion representation are perceived at exactly the spatial positions in the patient's perceived reality where the orthopedic device and the body part should be located according to the target movement.
  • the reality augmentation device typically has sensors that detect the patient's gaze direction, for example, using inertial sensors and/or gaze sensors.
  • the body part is a body part of the lower extremity.
  • the orthopedic device is an orthosis to stabilize the lower extremities, whereby gait training is carried out as movement training using the present procedure.
  • the orthopaedic device is a prosthesis that is used to replace the stump of an amputated body part.
  • the orthopedic device involves a wheelchair, which also indirectly supports the lower extremities for movement.
  • the body parts to be recorded for a movement can then also refer to the upper extremities.
  • the graphical movement representation includes at least part of a gait cycle.
  • a configuration of the orthopaedic device is obtained and provided to the electronic computing unit, wherein the target movement is generated or selected by the electronic computing unit depending on the provided configuration.
  • Individual movement sequences can be trained with the orthopedic device. Different movement modes that are technically supported by the orthopedic device can also be trained.
  • the graphical movement representation is then generated depending on the target movement, also taking into account the specifics of the selected movement mode of the orthopedic device. In other words, during movement training, the orthopedic device is placed in an initial movement mode, and this movement mode is communicated to the electronic processing unit, so that the graphical movement representation is created taking the selected movement mode into account.
  • the target movement is generated or selected by the electronic computing unit depending on a type of movement set on the orthopaedic device.
  • Such a movement type could be walking or running, for example.
  • Another movement type could be climbing stairs.
  • the target movement is the correct movement sequence and/or the placement of the foot on the step.
  • Another movement type could be walking up or down a ramp.
  • the movement of the knee angle through the two body segments of the upper and lower leg can be displayed.
  • Other movement sequences could be sitting down and/or standing up with the help of orthopedic devices.
  • Movement sequences of the upper extremities are also conceivable.
  • the orientation of the arm for different grips can be displayed as a predetermined movement sequence in order to achieve the best possible grip security or minimal compensatory movement with the shoulder and/or upper body.
  • the graphical movement representation is displayed synchronously with the detected body part movement as a function of the latter.
  • the synchronous display of the graphic movement representation not only includes the temporal synchronicity, i.e. the movement sequence of the graphic movement representation is displayed synchronously with the movement sequence of the patient's movement, as already described above, but also the spatial synchronicity, i.e. the movement sequence of the graphic movement representation is displayed in the reality perceived by the patient in such a way that the graphic movement representation overlays the actual movement of the patient, whereby deviations in the actual movement sequence from the target movement become visible.
  • status and/or movement-related data of the orthopaedic technical supply are recorded during the display of the graphical movement representation and are included in the perceived reality can be displayed through the reality enhancement device.
  • Such status and/or movement-related data of the orthopedic device can include, for example, joint angles or forces acting on the orthopedic device.
  • the detected movement sequence is provided to an image recognition device and that movement information of the detected movement sequence is detected by the image recognition device and blended into the perceived reality by the reality extension device.
  • Such movement information could, for example, be the joint angle at which the body part with the orthopedic device or the orthopedic device itself is moved in the joint.
  • movement of the knee joint will still be possible, which can be recorded as movement information.
  • the user when walking down a ramp, the user is shown the knee angle curve to be achieved / optimal / generated as well as the current knee angle in order to build confidence in the system and to learn or practice the movement and to adapt to the target value of the maximum flexion angle.
  • the necessary conditions for triggering certain functions e.g. climbing stairs, sitting down or standing up
  • the current sensor data of the orthopedic device is displayed in addition to the movement sequence to be achieved.
  • the sensor data can be given as absolute values (e.g. force in Newtons), as relative values (e.g. force as a percentage of body weight) and/or relative or as a difference to the target value (e.g. % of the required EMG signal for a grip or 3° knee angle difference).
  • the detected movement sequence is provided to the electronic computing unit and that a deviation between the detected movement sequence and the target movement is detected and a graphic representation of this detected deviation is displayed in the perceived reality by the reality extension device.
  • Such a display device worn in front of the patient's eyes can be an augmented reality device (AR device) with which information can be projected into the patient's perceived reality by projecting or displaying corresponding images on the transparent surface worn in front of the eyes.
  • AR device augmented reality device
  • an additional display device is installed in the patient's environment in order to provide training-relevant information to be able to display on projection surfaces in the patient's environment, such as walls, tables and/or floors.
  • the system comprises an electronic computing unit, a detection device, and a reality augmentation device for carrying out the method.
  • Figure 1 shows a schematic representation of the system for carrying out the method according to the invention
  • FIG. 1 schematic representation of a movement training in
  • Figure 5 schematic representation of a movement training when grasping objects using a smartphone.
  • Figure 1 shows a system 10 comprising a reality augmentation device 11, a detection device 12, and an electronic computing unit 13.
  • the reality augmentation device 11 is designed such that it can be worn on the head 21 of a patient 20, so that something can be visually overlaid into the reality perceived by the patient in his or her line of sight.
  • the patient 20 is provided with a leg prosthesis 30 and performs a movement sequence in order to train the movement with the leg prosthesis 30.
  • the electronic processing unit 13 further generates a digital graphic movement sequence of the body part equipped with the orthopedic device, including the orthopedic device, based on a target movement that the patient 20 is to perform with their leg prosthesis 30.
  • This graphic representation, which is created by the electronic processing unit 13, includes, in particular, a target movement sequence of the patient 20 with their leg prosthesis 30.
  • the actual movement sequence of the patient 20 with his leg prosthesis 30 is recorded by the recording device 12 and transmitted to the electronic processing unit 13.
  • the actual movement sequence of the patient 20 is recorded on the electronic processing unit 13 using image recognition. recorded and synchronized with the digital graphic motion representation of the target movement.
  • the electronic processing unit 13 is communicatively connected to the reality augmentation device 11, for example via WLAN, and now sends the synchronized digital movement representation to the reality augmentation device 11 so that the latter can overlay the synchronized movement representation into the reality perceived by the patient 20 in his line of sight.
  • Figure 2 shows a schematic representation of an embodiment of a movement training session in which the patient 20 is to climb a flight of stairs.
  • the patient 20 is equipped with a leg prosthesis 30.
  • a second person only schematically indicated, holds the external recording device 12, with which the movement of the patient 20 is recorded during the execution of his movement training.
  • the external recording device 12 then continuously sends the recorded movement to the reality augmentation device 11, which is designed in the form of a tablet.
  • the electronic processing unit required for synchronization (designated in Figure 1.1.2013) is located in the reality augmentation device 11.
  • the tablet uses the electronic processing unit to generate a graphical movement representation 40, 41 of the movement while climbing stairs.
  • a movement representation 40 of the leg prosthesis and a movement representation 41 in the form of footprints are generated and overlaid into the reality perceived by the patient 20.
  • the overlay is provided by the display of the reality enhancement device 11, which the patient 20 holds in their hands while performing the movement.
  • the movement representations 40, 41, which are generated and synchronized with the recorded movement, are schematically indicated on the stairs in Figure 2.
  • Figure 3 shows an embodiment in which the reality augmentation device 11 is designed in the form of glasses.
  • the glasses also have the detection device 12, so that the patient 20 can both detect his own movement and the generated graphical movement representation 40, 41.
  • the electronic processing unit can be embedded in the glasses or carried as an external device.
  • Figure 4 shows a representation of how the patient perceives their reality with the reality augmentation device 11 when performing the movement sequence from Figure 3.
  • the graphic movement representation 40, 41 is superimposed onto the perceived reality so that the patient can see how the movement sequence should actually be performed.
  • the position of the prosthesis is shown as a first movement representation 40 and, in addition, footprints 41 are shown as a second movement representation.
  • the footprints 41 serve to show the patient where each foot should touch the ground.
  • the represented position of the prosthesis also shows the patient how the prosthesis should best be used for climbing stairs.
  • Figure 4 also shows the representation of further status and/or movement-related data 42, which are also displayed as a reality extension into the perceived reality of the patient by the reality extension device 11.
  • Figure 5 shows an embodiment in which the reality augmentation device 11, the detection device 12 and the electronic computing unit 13 are accommodated in a common device in the form of a smartphone 14.
  • an object 50 is to be grasped by a hand prosthesis 31 as an orthopedic device.
  • the smartphone 14 which the patient aligns with the other hand toward the object 50, the movement of the hand prosthesis 31 is recorded and corresponding graphical movement representations are generated, which are then superimposed on the display as an extension of reality.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Theoretical Computer Science (AREA)
  • General Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Vascular Medicine (AREA)
  • Epidemiology (AREA)
  • Biophysics (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Primary Health Care (AREA)
  • Human Computer Interaction (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Medical Informatics (AREA)
  • Processing Or Creating Images (AREA)

Abstract

L'invention concerne un procédé de formation en mouvements d'un mouvement d'au moins une partie corporelle d'un patient, ladite partie corporelle étant équipée d'un dispositif orthopédique, ledit procédé comprenant les étapes suivantes consistant : - à générer, au moyen d'une unité de calcul électronique, une représentation de mouvement graphique numérique de la partie corporelle équipée du dispositif orthopédique en fonction d'un mouvement cible que la partie corporelle est censée effectuer avec le dispositif orthopédique fourni, - à détecter, au moyen d'un appareil de détection, un mouvement de partie corporelle de la partie corporelle du patient équipée du dispositif orthopédique, et - à superposer, avec un dispositif de réalité augmentée, la représentation de mouvement graphique numérique générée comme réalité augmentée sur la réalité du patient perçue dans la direction de vision du patient de telle sorte que la superposition de la représentation de mouvement graphique est positionnée en fonction du mouvement de partie corporelle détecté.
PCT/EP2024/080255 2023-10-26 2024-10-25 Procédé et système de formation en mouvements d'un mouvement Pending WO2025088137A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102023129572.1A DE102023129572A1 (de) 2023-10-26 2023-10-26 Verfahren und System zum Bewegungstraining einer Bewegung
DE102023129572.1 2023-10-26

Publications (1)

Publication Number Publication Date
WO2025088137A1 true WO2025088137A1 (fr) 2025-05-01

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DE (1) DE102023129572A1 (fr)
WO (1) WO2025088137A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102012009507A1 (de) 2012-05-14 2013-11-14 Otto Bock Healthcare Gmbh Vorrichtung und Verfahren zur Bestimmung von Fehlstellungen im Aufbau von Prothesen
EP2153370B1 (fr) 2007-05-03 2017-02-15 Motek B.V. Procédé et système pour un alignement dynamique interactif en temps réel de prothèses
US20190030394A1 (en) * 2015-12-29 2019-01-31 Vr Physio Ltd A therapy and physical training device
CN109581570A (zh) 2018-11-23 2019-04-05 京东方科技集团股份有限公司 金属线栅及其制造方法、显示面板、显示装置
DE102018128514B4 (de) 2018-11-14 2021-01-14 Ottobock Se & Co. Kgaa Verfahren und Vorrichtung zum Durchführen eines Prothesenaufbaus
US20210354023A1 (en) 2020-05-13 2021-11-18 Sin Emerging Technologies, Llc Systems and methods for augmented reality-based interactive physical therapy or training
WO2023102599A1 (fr) * 2021-12-06 2023-06-15 Virtetic Pty Ltd Procédés et systèmes de rééducation d'utilisateurs de prothèse

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2153370B1 (fr) 2007-05-03 2017-02-15 Motek B.V. Procédé et système pour un alignement dynamique interactif en temps réel de prothèses
DE102012009507A1 (de) 2012-05-14 2013-11-14 Otto Bock Healthcare Gmbh Vorrichtung und Verfahren zur Bestimmung von Fehlstellungen im Aufbau von Prothesen
US20190030394A1 (en) * 2015-12-29 2019-01-31 Vr Physio Ltd A therapy and physical training device
DE102018128514B4 (de) 2018-11-14 2021-01-14 Ottobock Se & Co. Kgaa Verfahren und Vorrichtung zum Durchführen eines Prothesenaufbaus
CN109581570A (zh) 2018-11-23 2019-04-05 京东方科技集团股份有限公司 金属线栅及其制造方法、显示面板、显示装置
US20210354023A1 (en) 2020-05-13 2021-11-18 Sin Emerging Technologies, Llc Systems and methods for augmented reality-based interactive physical therapy or training
WO2023102599A1 (fr) * 2021-12-06 2023-06-15 Virtetic Pty Ltd Procédés et systèmes de rééducation d'utilisateurs de prothèse

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