Patent Application
20240359057
The present invention generally relates to exercise equipment and, in particular, to methods, systems, and computer program products for remotely managing physical therapy and rehabilitation.
Existing technology-enabled exercise applications are not well suited to patients receiving physical therapy or rehabilitation. In particular, conventional methods of treatment do not provide an ability to view therapeutic activities completed outside of the clinical environment, such as in the home of the patient. Physical therapists must therefore often make subjective judgements based solely on their professional experience and education. Because out-of-office therapeutic activities constitute about 70% of a typical treatment plan, the lack of the tools to effectively transfer treatment plans from the clinic to the home environment can be an impediment to maintaining compliance. This lack of compliance may, in addition to reducing the effectiveness of the treatment, impede the confidence building between patient and caregiver necessary to achieve consistent outcomes.
Applications used for performing therapeutic exercises outside of a clinical setting are often difficult to use, and the accompanying hardware is often bulky and expensive. In many cases, the applications also require multiple sensors or markers to be placed on different parts of the body. Typical equipment setups include one or more cameras that must be positioned around the workout area. While the patient is exercising, the cameras capture sequences of images of the patient performing the exercise. The system then attempts to determine the patient's movement based on the positions of the optical markers in the images using inverse kinematics.
The complexity inherent in these types of exercise systems often leads to incorrect utilization and inconsistent patient experiences. Using cameras to assess body movement patterns also has several disadvantages. Camera-based systems are typically expensive, and have significant logistical requirements. The need to avoid changes in perceived position due to parallax may contribute to these logistical requirements. The logistical requirements may include the need for a large area in which the cameras can be set up and preferably left undisturbed. The need to attach optical markers to specific parts of the patient's body can further complicate matters, leading to inconsistent measurements between sessions, increased errors, and reduced user compliance. These and other disadvantages of conventional exercise monitoring systems can lead to low adoption rates and utilization.
As a result of the above deficiencies in remote exercise applications and equipment, it has been estimated that when patients undergoing physical therapy are prescribed exercises which are to be performed at home, only 35% of the patients fully adhere to their exercise plan, and 70% drop out after their third visit.
Thus, there is a need for improved systems, methods, and computer program products for facilitating and monitoring exercise sessions in a home environment.
The present invention overcomes the foregoing and other shortcomings and drawbacks heretofore known in systems, methods, and computer program products for remotely managing exercise regimes. While the present invention will be discussed in connection with certain embodiments, it will be understood that the present invention is not limited to the specific embodiments described herein.
In an embodiment of the present invention, an apparatus is provided. The apparatus includes a human-device interface, a motion sensor operatively coupled to the human-device interface, and a controller. The controller is configured to receive first motion data from the motion sensor and transmit the first motion data to a first computing device. The first computing device displays a first graphical element that depicts a first movement of the human-device interface based on the first motion data.
In an aspect of the present invention, the apparatus may further include a source of resistance.
In another aspect of the present invention, the apparatus may further include a force sensor configured to detect an amount of force being generated by the source of resistance.
In another aspect of the present invention, the human-device interface may include a grip having one or more transducers.
In another aspect of the present invention, the one or more transducers may include at least one of a pressure sensor and a haptic device.
In another aspect of the present invention, the apparatus may further include a network database, and the controller may be configured to transmit the first motion data to the network database.
In another aspect of the present invention, the apparatus may further include a second computing device configured to retrieve the first motion data from the network database and display a second graphical element that depicts the first movement of the human-device interface based on the first motion data.
In another aspect of the present invention, the first computing device may be a patient device, and the second computing device may be a therapist device.
In another aspect of the present invention, the first computing device may be configured to determine a target motion based on the first motion data, receive second motion data indicative of a second movement, determine a current motion based on the second motion data, and compare the current motion to the target motion. In response to the current motion matching the target motion, the first computing device may display a second graphical element indicating an exercise is being performed properly. In response to the current motion not matching the target motion, the first computing device may provide feedback indicating the exercise is not being performed properly.
In another aspect of the present invention, the first computing device may be configured to determine the target motion by receiving a first signal from a therapist device, in response to receiving the first signal, begin recording the first motion data, receiving a second signal from the therapist device, in response to receiving the second signal, stop recording the first motion data, and in response to receiving a third signal from the therapist device, saving the recorded data as calibration data.
In another aspect of the present invention, the first graphical element may depict an animated figure performing the exercise, and a movement of the animated figure may be based on the target motion, the current motion, or both the target motion and the current motion.
In another aspect of the present invention, the first computing device may be further configured to compare the current motion to the target motion. If the current motion does not match the target motion, the first computing device may cause at least a portion of the animated figure to provide feedback indicating that the exercise is being performed improperly, and display a third graphical element that provides feedback indicating how to correct the current motion to match the target motion.
In another aspect of the present invention, the human-device interface may include the grip having the haptic device, and the first computing device may be further configured to, if the current motion does not match the target motion, cause the haptic device to provide feedback indicating that the exercise is being performed improperly.
In another aspect of the present invention, the first computing device may be further configured to, if the current motion does not match the target motion, emit an auditory warning.
In another embodiment of the present invention, a method is provided. The method includes receiving, at the first computing device, the first motion data from the motion sensor operably coupled to the human-device interface, the first motion data indicative of the first movement, and displaying, on the first computing device, the first graphical element that depicts the first movement of the human-device interface based on the first motion data.
In an aspect of the present invention, the method may further include transmitting the first motion data to the network database.
In another aspect of the present invention, the method may further include retrieving, at the second computing device, the first motion data from the network database, and displaying, on the second computing device, the second graphical element that depicts the first movement of the human-device interface based on the first motion data.
In another aspect of the present invention, the method may further include determining the target motion based on the first motion data, receiving the second motion data from the motion sensor indicative of the second movement, determining the current motion based on the second motion data, and comparing the current motion to the target motion. In response to the current motion matching the target motion, the method may display the second graphical element indicating the exercise is being performed properly. In response to the current motion not matching the target motion, the method may provide feedback indicating the exercise is not being performed properly.
In another aspect of the present invention, the method may determine the target motion based on the first motion data by receiving the first signal from the therapist device, in response to receiving the first signal, begin recording the first motion data, receiving the second signal from the therapist device, in response to receiving the second signal, stop recording the first motion data, and in response to receiving the third signal from the therapist device, saving the recorded data as calibration data.
In another embodiment of the present invention, a computer program product is provided. The computer program product includes a non-transitory computer-readable storage medium, and program code stored on the non-transitory computer-readable storage medium. When executed by one or more processors, the program code causes the one or more processors to receive the first motion data from the motion sensor operably coupled to the human-device interface, the first motion data indicative of the first movement, and display the first graphical element that depicts the first movement of the human-device interface based on the first motion data.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various embodiments of the present invention and, together with the general description of the present invention given above, and the detailed description of the embodiments given below, serve to explain the embodiments of the present invention.
It should be understood that the appended drawings are not necessarily to scale, and may present a somewhat simplified representation of various features illustrative of the basic principles of the present invention. The specific design features of the sequence of operations disclosed herein, including, for example, specific dimensions, orientations, locations, and shapes of various illustrated components, may be determined in part by the particular intended application and use environment. Certain features of the illustrated embodiments may have been enlarged or distorted relative to others to facilitate visualization and a clear understanding.
Embodiments of the present invention provide a simple and portable system for management of exercise regimens prescribed to patients that are to be carried out in a home environment. Feedback mechanisms may help patients correct their motion during exercise. Asynchronous virtual care may be enabled by allowing patients to complete exercise routines correctly without the need for real-time feedback from a therapist. The system thus addresses an unmet need for personalized care provided in a home environment that is guided by a therapist, that produces higher compliance rates and more consistent outcomes than known methods, and which provides the therapist with objective information with which to assess the treatment plan.
The system includes one or more exercise devices in communication with one or more applications that may be loaded into one or more of a patient device and a therapist device. Data collected from the exercise devices is used to define and monitor patient exercise sessions. Embodiments of the present invention thereby provide a simple, portable, inexpensive, and easy to use solution that extends the in-clinic experience into the home environment of the patient.
Sensors embedded in each exercise device collect data indicative of movement of the exercise device. This motion data is transmitted to an application resident in the patient device, which may be a smartphone or other portable computing device. The motion data is processed by the patient application to determine and evaluate the form and movement of the patient while they are exercising with the exercise device. This processing of motion data may use simulation and visualization techniques in conjunction with objective progress measurements. The patient application may provide a more accurate comparison between current motion and target motion than is typically achieved using inverse kinematics.
This improved accuracy enables both real-time and post-session feedback mechanisms that can help the patient correct their motions, provides objective measures of progress over the course of the therapy, and thereby enables the patient to achieve a greater benefit from the exercise. By embedding motion sensors and supporting circuitry in the exercise device, and transmitting data to the patient device, embodiments of the present invention minimize the burdens imposed by the setup process and logistical needs, and reduce the potential for errors. Advantageously, by facilitating setup and use, embodiments of the present invention may improve adoption, portability, and equipment costs as compared to known systems.
Data received by the patient device may be forwarded to a network database, where it can be accessed by a therapist application. The therapist application may use the data to generate graphical images that facilitate visualization of the patient's movement. Based on this visualization, the therapist can make informed decisions throughout the rehabilitation process without having to see the patient in a clinical environment. This ability to make decisions asynchronously may result in higher quality and quantity of care for each patient's rehabilitation treatment plan.
The system captures kinematic body motions of patients performing exercises, and provides feedback to patients and therapists regarding the performance of the exercises without the need for bulky sensors or cameras. The system thereby extends physical therapy and other treatments involving the performance of exercises by a patient beyond the clinical setting. Data collected by motion sensors embedded in the exercise device may be collectively referred to herein as “motion data”. Motion data may include, but is not limited to, data indicative of linear or angular acceleration, velocity, position, orientation, and force. Motion data generated by the exercise device may be received by a patient device (e.g., a smartphone) and forwarded to a network database. The motion data can then be used to generate visual aids that enable therapists to analyze patient movements and progress while outside the clinical environment, and make informed decisions regarding treatment throughout a rehabilitation process. The motion data may also be used to provide visual feedback to the patient while they are exercising, thereby helping the patient maintain form and perform the exercise properly. The system may thereby improve the quality and quantity of care received by the patient outside a clinical environment.
In the clinical environment, the system may be used by the physical therapist to assess the patient, create a treatment plan, and calibrate exercises specific to the patient's physical build and recovery status. In the home environment, the system may be used by the patient to follow guided instructions on their phone or other suitable computing device to complete the prescribed treatment routine. The physical therapist may then evaluate the results and personalize the patient's treatment plan based on motion data relating to the patient's exercise sessions collected by the system.
By way of example,
The patient 12 may use the exercise device 14 to perform an exercise, e.g., by repeating a movement while holding the exercise device 14. The exercise device 14 may include a human-device interface, such as a handle, grip, strap, attachment device, or other suitable element through which the patient physically interacts with the exercise device 14. The exercise device 14 may be operatively coupled to an anchor point 26 or another exercise device 14 (not shown) by an elastic member 28 (e.g., a resistance band) to provide a source of resistance to the exercise device 14. Exemplary anchor points may include the patient's foot (shown), a door anchor, or any other suitable anchor point. In an alternative embodiment of the present invention, the source of resistance may be provided by the mass of the exercise device 14. To this end, the exercise device 14 may be internally weighted or configured to receive weights. Thus, the exercise device 14 may also be used for exercises where the exercise device 14 is untethered, e.g., for exercises that rely on resistance provided by working against the force of gravity, movement through a fluid (e.g., swimming), or any other type of resistance. Exercise devices 14 may also use elastic members in a compressive manner, such as for exercises that require squeezing, gripping, crunches, or other movements by the patient.
The patient and therapist devices 16, 18 (which may be referred to collectively as a user device) may include smart phones, tablet computers, or any other suitable computing devices. The patient device 16 may communicate with the exercise device 14 using a suitable wireless protocol, such as Bluetooth® or a protocol based on IEEE 802.11, i.e., “Wi-Fi”. One or more of the patient device 16 and therapist device 18 may receive data from the exercise device 14 relating to one or more of a status or motion of the exercise device 14. The patient and therapist devices 16, 18 may also transmit data to the exercise device 14, such as control messages, software updates, or any other suitable data. The patient and therapist devices 16, 18 may be configured to display information to the patient 12 or therapist that provides feedback relating to the exercise being performed with the exercise device 14. In a home exercise environment, the patient device 16 may be used with a suitable holder so that the display of the patient device 16 is visible to the patient 12 while the patient 12 is performing the exercise.
The server 20 may host one or more server applications, such as a web server, database management server, etc., that enable the patient device 16 and therapist device 18 to store data to and receive data from the database 22. The patient device 16 and therapist device 18 may communicate with the server 20 through the network 24. The network 24 may include one or more local access networks, wide area networks, cellular networks, the Internet, etc., that enable the patient device 16, therapist device 18, and server 20 to exchange data.
The housing 34 may comprise an upper portion 58 and a lower portion 60 that, when assembled, define a cavity which houses a sensor module 62, an induction coil 63, and a power source 64, e.g., a battery. Each end 42 of housing 34 may include an indentation 66 configured to receive a respective tab 50 of loop 32. Each indentation 66 may include a threaded hole 68 configured to threadedly engage a respective fastener 56. When tightened, the fastener 56 may urge the tab 50 into contact with the indentation 66, thereby operatively coupling the housing 34 to the loop 32. The housing 34 may also include one or more openings 70 that provide access to a charging/communication port (e.g., a Universal Serial Bus (USB) port) configured to receive a connectorized cable 72. End caps 74 may be removably coupled to the loop 32 by insertion into the rings 40 to conceal the ends 42 of housing 34. One or more of the end caps 74 may be configured to pivot upward to reveal the charging/communication port and a pressure sensitive device 76 (e.g., a button) that allows the patient to interact with the sensor module 62. Patent interactions using the pressure sensitive device 76 may include turning the sensor module 62 on and off, pairing the handle 30 with the patient or therapist device 16, 18, or any other suitable interaction. The grip 36 may be configured to receive the housing 34 prior to insertion of the ends 42 of housing 34 into the rings 40 of loop 32, and may be configured to rotate about a longitudinal axis of the housing 34.
The grip 36 may have a round or elliptical cross-sectional shape specific to human factors and ergonomics standards for patients spanning a 5% female to 95% male size model. The grip 36 may have an inner diameter of about one inch and a thickness of between 0.15 to 0.25 inches. In an embodiment of the present invention, the grip 36 may include one or more transducers, such as pressure sensors (not shown) or haptic devices. The pressure sensors may enable one or more of the exercise device 14 and the patient device 16 to determine whether the exercise device 14 is being held in the right or left hand of the patient 12, e.g., by identifying thumb placement. The haptic devices may be used to provide haptic feedback to the patient 12, e.g., to indicate to the patient that their form needs correction. Haptic devices may include one or more of a vibration motor, linear resonant actuator, eccentric rotating mass actuator, piezoelectric actuator, or any other suitable actuator that provides the user with instant feedback. This feedback may provide an indication when the user is in a correct position (e.g., at the start of an exercise), and may also be used to let the user know when they have reached the end of an exercise repetition or a target displacement. Auditory feedback may also be used during exercise sessions, either alone or in conjunction with the haptic feedback, to let the user know whether they are tracking at the correct velocity.
An internal force sensor 75 may be operatively coupled between the housing 34 and one of the rings 40 of loop 32 (e.g., by an end cap 74) so that the force sensor 75 is deformed in response to displacement of the housing 34 relative to the rings 40. The force sensor 75 may include a stress sensor 77, e.g., a flex sensor, stress gauge, force sensing resistor, or other type of sensor that provides a signal indicative of a stress acting on the sensor. One type of stress sensor 77 has a flexible insulating substrate that supports a conductive pattern. The electrical resistance of the conductive pattern changes in response to deformation of the stress sensor 77 so that the electrical resistance of the stress sensor 77 depends on the displacement distance di. The magnitude of the force 73 may then be determined based on this electrical resistance.
In the depicted embodiment, one actuator 35 is oriented in a vertical direction (i.e., so that the vibrations emitted by the actuator 35 are generally aligned with the force 73 being applied to the grip during an exercise) and another actuator 35 is oriented in a horizontal direction (i.e., so that the vibrations emitted by the actuator 35 are generally aligned with the axis of the grip 36). Each actuator 35 may comprise a vibration motor, linear resonant actuator, eccentric rotating mass actuator, piezoelectric actuator, or other suitable actuator, and may be coupled to a circuit board 65 of sensor module 62 by one or more conductors 45. To accommodate the actuators 35, the lower portion 60 of housing 34 may include one or more retainers 61 each configured to receive a respective actuator 35.
The force sensor may include one or more stress sensors 77 (e.g., two stress sensors 77) that generate a signal indicative of an amount of force 73 the handle 30 is being subjected to. To this end, and as shown in the depicted embodiment, stress sensors 77 may be embedded or otherwise located in a portion of the arcuate band 38 between of the rings 40 and the boss 44 of loop 32. The position of the stress sensor 77 may be selected based on an expected or measured amount of flexing of the arcuate band 38 to maximize one or more of the sensitivity and output linearity of the stress sensor 77. For example, one stress sensor 77 may be located in an area subject to flexing at relatively low levels of force 73 to provide high sensitivity, and another stress sensor 77 may be located in an area subject to flexing at relatively high levels of force 73 to provide a large force measurement range. To accommodate integration of the force sensor, the loop 32 may include a channel 39 that connects one or more cavities 41 (e.g., upper and lower cavities 41) to the inner surface 54 of ring 40. The upper and lower cavities 41 may be vertically separated by a portion of the arcuate band 38, and each cavity 41 may be configured to receive a stress sensor 77. The channel 39 may be configured to receive one or more conductors 47 that operatively couple the stress sensors 77 to a circuit board 65 of sensor module 62. In this embodiment, the two stress sensors 77 may be located opposite each other, and spaced from each other by the thickness of at least a portion of the arcuate band 38. The stress sensors 77 may be configured to enable positive (i.e., tensile) and negative (i.e., compression) forces 73 to be distinguished from each other.
The motion sensor 80 may include one or more sensors configured to detect the position, movement, or orientation of the handle 30. Exemplary sensors that may be used to quantify kinematics of the handle 30 may include, but are not limited to, time of flight, infrared, or ultrasonic sensors (e.g., to determine position and orientation relative to the surrounding environment), ultra-wideband (UWB) sensors, accelerometers, gyroscopes, magnetometers, or any other type of sensor that can be used to determine the acceleration, velocity, position, or orientation of the handle 30. Accelerometers may be used to measure acceleration along one or more orthogonal axes, e.g., x, y, and z-axes of a cartesian coordinate system. The detected acceleration may be used to determine changes in position and velocity of the exercise device 14. The detected acceleration may also be used determine the direction of gravitational pull in order to detect orientation or tilt. One or more gyroscopes may be used to measure angular movement about the orthogonal axes. Magnetometers may be used to sense magnetic force, such as the magnetic field of the Earth, and can thus be used to orient the exercise device 14 to magnetic north. The data output by the accelerometers, gyroscopes, and magnetometers may be used to determine the position and orientation of the exercise device 14 with respect to Earth or any other suitable frame of reference, such as the patient 12 or another exercise device 14.
In an embodiment of the present invention, the motion sensor 80 may include a six degree-of-freedom motion detector that provides the controller 78 with data indicative of linear motion along, and angular rotation about, three orthogonal axes. This type of motion sensor is sometimes referred to as an Inertial Measurement Unit (IMU). Methods for determining position and orientation using inertial sensors are disclosed by U.S. Pub. No. 2018/0056128 to Bharath Narasimha Rao et al., and U.S. Pat. No. 9,273,967 to Yimei Ding et al., the disclosures of which are incorporated by reference herein in their entireties.
In scenarios in which two or more exercise devices 14 are used, accelerometer, gyroscope, or magnetometer sensors in one exercise device 14 may provide orientation and displacement in space relative to an IMU in another of the exercise devices 14. Orientation and displacement may, in turn, be used to determine rotation and translation of the exercise device 14 relative to the Earth frame. Accelerometers and gyroscopes may be used to measure relatively fast movements (e.g., exercise repetitions), and induction coil/magnetometer sensors may be used to measure slow movements, determine absolute starting position, and determine distances between multiple exercise devices 14.
IMUs may suffer from drift and have poor signal to noise ratio when dealing with low acceleration movements, such as under quasi-static conditions. To mitigate these issues, embodiments of the present invention may leverage IMUs in combination with other sensors for static measurements. Sensors which may be used to improve static measurements may include time of flight sensors, ultrasonic sensors, UWB sensors, or other wireless location tracking technologies, such as Bluetooth Low Energy (BLE). An induction coil in conjunction with a magnetometer may also be used to measure both distance and orientation. Use of these sensors may allow the exercise device 14 to determine its starting position and orientation in cases where quasi-static or static exercises are used as part of a prescribed exercise regime.
The force sensor 48, 75, 82 may include a stress sensor in the form of a strain gauge or other device that provides a signal to the controller 78 indicative of an amount of force that is being exerted by the source of resistance (e.g., the elastic member 28) on the exercise device 14. In an embodiment of the present invention, the force sensor 48, 75, 82 may comprise a force sensing resistor (e.g., a polymer thick film (PTF) device) that exhibits a change in resistance (e.g., a decrease in resistance) in response to an increase in force applied to its surface. The force sensing resistor or other stress sensor may be positioned between the housing 34 and loop 32, between the housing 34 and grip 36, between the exercise device and elastic member 28, or in any other location through which force is transmitted from the patient 12 to the source of resistance during use of the exercise device 14.
The force sensor 48, 75, 82 may enable the system to directly and accurately measure the force exerted by the patient during each repetition regardless of the position of the exercise device 14. The force sensor 48, 75, 82 may also facilitate self-calibration, resulting in more accurate measurements, and provide a mechanism for assessing the condition of the elastic member 28. For example, if the measured force for a given position of the exercise device 14 differs from an expected value for the elastic member 28, the patient device 16 may indicate that the elastic member 28 should be replaced (e.g., is worn out) or that an elastic member 28 having an incorrect resistance level is being used for the exercise in question. The measured force may be considered as correct or as matching the expected force for the prescribed exercise and source of resistance if the measured force is within a predetermined threshold of the expected force. In contrast, the measured force may be considered as incorrect or as not matching the expected force for the prescribed exercise and source of resistance if the measured force is not within the predetermined threshold of the expected force. The predetermined threshold may be defined, for example, as a predetermined percentage of the expected force (e.g., measured force is within +/−10% of the expected force) or as an absolute value (e.g., measured force is within +/−2 lbs. of the expected force).
The communication module 84 may include a wireless transceiver that enables the controller 78 to communicate with external devices (e.g., the patient device 16) using a suitable wireless communication protocol, e.g., a Near Field Communication (NFC) protocol, a Bluetooth or Bluetooth Low Energy (BLE) protocol, and/or Wi-Fi. The communication module 84 may thereby enable the controller 78 to transmit data to, and receive data from, the patient device 16. In cases where more than one exercise device 14 is being used for an exercise (e.g., two exercise devices 14 connected by the elastic member 28), the exercise devices 14 may communicate with the patient device 16 through a single data stream.
The user interface 86 may include one or more input devices (e.g., pressure sensitive device 76) that enable the patient to control or otherwise communicate with the exercise device 14, and one or more output devices (e.g., light emitting diodes) that provide information to the patient 12 (e.g., a power-on indication). For example, in response to the application of pressure to a pressure sensitive device, the exercise device 14 may power up, begin a calibration sequence, establish a communication link with the patient device 16 (e.g., Bluetooth pairing), or any other suitable response. In an alternative embodiment of the present invention, the user interface 86 may include the motion sensor 80, in which case the exercise device 14 may be configured to respond to detection of certain specific types of motion, e.g., shaking or swiping.
The connector port 88 may provide a physical connection for use in charging the power source 64 or uploading and downloading data to and from the controller 78. To this end, the connector port 88 may include one or both of a data and a power connection, such as a USB port. The connector port 88 may also include an inductive or capacitive coupling device configured to enable wireless charging of the power source 64.
During an in-person physical therapy session, the exercise device 14 and therapist device 18 may be in operable communication so that the therapist device 18 receives motion data from the exercise device 14. While the patient is performing an exercise, the therapist may start and stop a process that records the output of each exercise device 14 for use in generating calibration data. The therapist may thereby selectively capture motion data indicative of proper performance of the exercise by the patient. The motion data captured may be used to generate metrics that quantify form, pace, range of motion, and exertion by the patient while performing the exercise. This calibration data may then be used to determine whether the patient is performing the exercise correctly during exercise sessions performed at home, as well as to quantify changes in the patient's range of motion and other physical characteristics over time. Advantageously, calibrating the exercise to the patient in the above manner may allow for improved design and monitoring of rehabilitation regimens, and thus greater personalization according to how far the patient has progressed in their treatment.
In block 96, the process 90 may detect repetitions of a prescribed movement. To detect a repletion, the process 90 may determine an orientation of the one or more exercise devices 14 being used. If there is more than one exercise device 14 being used, the process 90 may also determine one or more distances between the exercise devices 14. Orientation of the exercise device 14 may be determined by measuring the gravity vector, and the distance between exercise devices 14 may be determined using time-of-flight measurements, for example. In response to one or more of the orientation(s) and distance(s) between the one or more exercise devices 14 matching a baseline value associated with an exercise, the process 90 may determine that the user is at the start of a repetition of the exercise.
In block 97, the process may perform a zero velocity update. Zero velocity updates may be performed each time the process 90 determines the exercise device 14 is in a zero velocity condition. A zero velocity condition may be determined, for example, based on the magnitude of total acceleration (e.g., when total acceleration aTOTAL=1 G), a moving acceleration variance, magnetometer measurements, the magnitude of gyro signals, or any other suitable method. The process 90 may detect the start and the end of a zero velocity condition by comparing collected data with one or more predetermined thresholds.
While in the zero velocity condition, the process 90 may presume any nonzero output of the motion sensor 80 is an error signal, and zero out those velocity measurements. The process 90 may also remove any gyro sensor drift in each of one or more channels. Zero velocity conditions may occur when the user ceases movement, such prior to the start of an exercise session, after stopping the exercise session, or momentarily during an exercise session when the exercise device reverses direction. To avoid discontinuities in the measurement function, any errors detected during a zero velocity condition may be propagated backward to a previous zero velocity condition to provide smooth measurement data.
The start of a repetition may be indicated by a rate of change in the output of motion sensor 80 increasing above a threshold level. In response to detecting the start of a repetition, the process 90 may determine and store kinematic movement (e.g., orientation and translation) of the exercise device 14. A Kalman filter may be used to determine the orientation of the exercise device 14 and the orientation of the gravity vector. The gravity vector may be removed from the acceleration data to isolate acceleration due to movement of the exercise device 14. The acceleration due to movement may then be filtered and integrated with respect to time to determine the velocity of the exercise device 14.
In block 98, the process 90 may integrate the velocity of the exercise device 14 with respect to time to determine its displacement. This displacement may be used to determine the position of the exercise device 14, which, in combination with orientation, may be used to determine translation and rotation of the user.
In block 99, the process 90 may integrate displacement with respect to time to determine the absement of the exercise device 14. Absement is a measure of sustained displacement of an object from an initial position, and may be a parameter of the exercise in cases where the user has been instructed to move the exercise device 14 at a certain rate, or hold a certain position for a certain amount of time.
During home exercise sessions, data generated by the sensor module 62 may be transmitted from the exercise device 14 to the patient device 16, either in raw form or after being processed by the controller 78. This data may be used to provide real-time feedback to the patient 12 while they are performing the exercise, e.g., by comparing current motion data to the calibration data. Data collected during home exercise sessions may also be transmitted from patient device 16 to the server 20 for storage in the database 22. The database 22 may also store data that defines a library of exercise movements for use in designing exercise sessions.
Data stored in the database 22 may be used to generate output that can be viewed by physical therapists to monitor patient progress between in-person visits. The ability to monitor progress of patients between in-person sessions may allow therapists to identify unexpected problems or progress early on, and adjust treatment regimens midcourse if indicated. The increased level of engagement between the patient and the therapist provided by embodiments of the present invention may essentially extend the therapist into the patient's home. This may both reduce the need for frequent in-person visits and result in improved compliance with prescribed exercise regimes and patient care.
Embodiments of the present invention may include a patient application resident on the patient device 16. The patient application may provide the patient with a prescribed treatment and exercise regimen, instructions for the correct approach and technique for each exercise based on their personalized in-clinic experience, real-time feedback to help correct technique where necessary, metrics to help the patient understand their progress relative to their goals, and a personalized exercise and session-specific notifications to assist the patient over the course of their treatment.
To this end, the patient application may cause the patient device 16 to display graphical elements depicting movement of the patient (e.g., an animated figure), as well as other graphical elements that demonstrate the pace, range of motion, form, and exertion of the patient in real-time as the patient is performing an exercise. To provide realistic movement, animated figures may be generated, for example, by a human body movement simulator based on the motion data. The graphical elements may demonstrate how to perform the exercise by comparing the current motion data to calibration data generated during an in-clinic therapy session. In addition to displaying graphical elements, the exercise device 14 may also emit auditory beeps (e.g., by the handle 30) that provide the patient with feedback on whether they are performing the exercise correctly. By providing immediate feedback and guidance, the patient application may improve compliance with the exercise regimen and the accuracy with which the patient performs the prescribed exercises.
Referring now to
In response to the application confirming the patient's login information, the patient device 16 may display an instruction screen, such as the exemplary instruction screen 110 depicted by
Referring now to
In response to the patient 12 activating the control element 124, the application may cause the patient device 16 to display pre-session set-up screen, such as the exemplary kit explanation screen 130 depicted in
As the tutorial continues (e.g., in response to the patient 12 proceeding to additional screens), the application may cause the patient device 16 to display an instruction screen, such as the exemplary instruction screen 140 depicted by
Instruction screens may be sequenced to step the patient 12 through a setup process. For example, as depicted by
The exercise instruction screen 180 may include a graphical element 182 that depicts how the exercise in question is to be performed, a data display field 184 with written instructions for performing the exercise, and a control element 186 for starting the exercise session. Information provided by the exercise instruction screen 180 may include directions regarding how to set up for the exercise, such as proper body positioning, equipment placement, and resistance level. The information may also include a position calibration step, such as bringing the exercise devices 14 into contact with each other or the patient device 16, so that a starting position of each exercise device 14 is established at the beginning of the exercise session.
Referring now to
The range-of-motion graphical element 192 may include one set of animated handle icons 196 that indicate a current position of the exercise devices 14, another set of animated handle icons 198 that indicate a target position of the exercise devices, and a scale 200 which indicates the relative positions of the handle icons 196, 198 within the range of motion of the exercise. The target position of the exercise device 14 may be based on the patient-specific calibration data described above, and may depict movement in accordance with what was recorded by the therapist during a previous in-person session. Thus, the target positions of the exercise device 14 displayed by the application may reflect a form, pace, range of motion, and exertion level for the exercise session which is personalized to the patient 12. A vertical line in the center of the range-of-motion graphical element 192 may indicate a starting position, and the left/right vertical lines may indicate a calibrated range of motion for the exercise set. A line connecting the animated handle icons 196 may have a color indicating the type of elastic member 28 to be used for the exercise session. For ease of use, the color displayed by the patient application may match the color of an elastic member 28 provided in the exercise device kit.
The action screen 190 may initially provide the patient 12 with information indicating a starting position for the exercise session. Arrow icons 202 proximate to the animated figure may then provide the patient 12 with an indication of which direction the exercise devices 14 should be moved. The action screen 190 may thereby provide the patient 12 with real-time indications of how the exercise is to be performed, as well as feedback on how closely their movements are tracking the target positions and a count of the number of repetitions performed. While the exercise session is in progress, the application may store data that establishes a record of the exercise session, e.g., time, date, location, user, and motion data. This data may be stored locally in the patient device 16, uploaded to the database 22, or both stored locally and in the database 22.
Referring now to
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In some cases, the patient device 16 may be unable to connect to one or more of the exercise devices 14. In this case, the application may cause the patient device 16 to display a trouble shooting screen, such as the exemplary trouble shooting screen 340 depicted by
The therapist application may facilitate goal setting and goal tracking. Goal metrics may include pain levels, function, range of motion, and strength. Goals may be set by the therapist based on outcome and progress predictions, which in turn may be based on trends. To create an exercise session, the therapist may login to the therapist application (e.g., through the therapist device 18), and select a patient from a list of patients representing patients in the database 22. The therapist may then activate a “build treatment” feature, and proceed to select one or more exercises from a library of exercises. The therapist may then define a number of sets of the exercise in the exercise session, a number of repetitions of the exercise in each set, and the resistance band level needed to complete the exercise. To calibrate the exercises, the therapist may first demonstrate the exercise to the patient 12. The therapist may then have the patient 12 perform the exercise using one or more exercise devices 14 (depending on the type of exercise) while the system records the motion data received from the exercise device 14. When the therapist is satisfied with the patient's movement, they may activate a calibration feature to identify the data being collected as “calibration data”. The therapist may repeat the calibration procedure with each type of exercise prescribed to the patient 12. The calibration data may then be stored in the database 22.
Auditory beeps may be emitted by the exercise device 14 (e.g., by the handle 30) to provide confirmation that the aspects of the baseline exercise have been recorded. These beeps may help the physical therapist know that they are setting the baseline correctly. To facilitate recording and performing the exercise, the exercise may be broken down into a plurality of components, e.g., repetition start, repetition extension, hold, and repetition contraction.
The patient information window 354 may include one or more data display and entry fields 362-364, an add note tab 365, and an edit patient tab 366. The data display fields 362, 363 may display text and graphical data, such as the patient's name, contact information, and a graphical element 367 indicating areas of the patient's anatomy which are being treated. The data entry field 364 may allow the therapist to enter notes regarding interactions with the patient 12, the results of the patient's exercise sessions, or data for creating a new patient file.
The patient report window 356 may include a plurality of control elements 368-371 for selecting a patient performance metric, such as a “Pace” button, a “Range of Motion” button, a “Form” button, and an “Exertion” button. The patient report window 356 may also include an exercise window 374 that displays a list of exercises that can be or have been prescribed to the patient 12, and a “view report” tab 376. Activation of view report tab 376 may cause the therapist device 18 to display a patient report screen for the selected metric.
The patient treatment window 358 may include a data entry field 378 for entering search terms, an exercise session design window 380, a plurality of control elements 382-387 for selecting an exercise, and a modify treatment tab 388. The exercise session design window 380 may include a band strength selection window 390, a repetition control element 391, a set control element 392, and a range adjustment control element 393. The therapist may design an exercise session by first selecting the type of exercise using the exercise control elements 382-387. The therapist may then set the number of repetitions and number of sets for the exercise session using the repetition and set control elements 391, 392. Once the therapist is satisfied with the exercise session, the session can be saved to the patient's file by activating a save control element 394.
The patient treatment window 358 may also include a graphical element 395 (e.g., an animated figure) that shows the patient's range of motion and pace during a therapy session. The pose of the animated figure may be based on data received by the therapist device 18 from the exercise devices 14 during the therapy session. The therapist may use the range of motion measured for the patient 12 during the therapy session to help design one or more exercise sessions to be performed by the patient 12 outside the office. For example, the therapist may record the patient's movement, and use the recorded movement as a basis for designing an exercise session. To this end, the recorded movement may be used as is or modified by the therapist to provide the calibration data.
The timeframe selection window 404 may include a plurality of timeframe selection control elements 424-426, such as a “View by Session” button, a “Since Last Calibration” button, and a “From Beginning” button. The metrics selection window 406 may include a plurality of metric selection control elements 430-433, such as a “Pace” button, a “Range of Motion” button, a “Form” button, and an “Exertion” button.
In response to activation of a combination of exercise, timeframe, and metric control elements, the therapist application may select relevant portions of the data downloaded from the database 22 (or launch a query to the database 22 to retrieve the relevant data) to populate the results display window 408. The results display window 408 may include a plurality of graphical elements 438, 440 that display data in a form which is easily readable. For example, each of the graphical elements 438, 440 may include a bar graph that illustrates results for each exercise session for each of a plurality of time periods. By providing the therapist with detailed metrics describing the patient's experience and progress over time, the patient report screen 400 may provide the therapist with insights from condition-specific assessments completed by the patient 12 periodically through their treatment. These insights may include whether the patient 12 is adhering to the prescribed treatment, is using the correct technique, and how well the patient's recovery is progressing.
Activating a different control element in one or more of the patient treatment, timeframe, or metrics selection windows 402, 404, 406 may cause the host computer to update the results display window. For example, as depicted by
Advantageously, the therapist application may facilitate remote treatment of patients by supporting virtual visits between the patient and therapist, or a doctor who has access to data from the therapist application. The graphical views provided by the therapist application show the patient's progress with respect to treatment criteria, such as pace, range of motion, form, and exertion, in a manner analogous to witnessing actual performance of the prescribed exercises. This may enable therapists or doctors to accurately determine patient progress and design new exercise sessions or modify existing treatment plans in accordance therewith without the patient having to be physically present. New or modified exercise sessions and treatment plans can then be stored in the database and downloaded into the patient device 16 without the patient having to physically visit the therapist or doctor.
Referring now to
The patient 12 may successfully perform the movement by reaching a peak parameter value that falls within the parameter target window 554, and holding the parameter value within the parameter target window 554 for a predetermined hold time target tT. In response to the patient successfully performing the movement (e.g., tH≥tT), the exercise device 14 may emit a positive reinforcement haptic signal 548. The haptic signal 548 may indicate to the patient 12 that they have maintained the desired extension position of the exercise for the predetermined hold time, and can start the movement back to the starting position. The exercise device 14 may then emit another positive reinforcement haptic signal 548 when the patient 12 has returned to the starting position, thereby indicating to the patient 12 that they can begin the next movement of the exercise. Although not depicted in
In plot 562, the patient 12 reaches a peak parameter value 566 at time t0 and maintains the parameter value within the parameter target window 554 until time t1. In this embodiment, the parameter target window 554 may be defined based on the peak parameter value 566, e.g., by defining a range 556 that has upper and lower thresholds above and below the peak parameter value 566, respectively. The hold time target tT may define an absolute hold time target tT0 relative to t0. The hold time target window 558 may then be defined as a time range 568 (e.g., +/−15 percent) centered on the absolute hold time target tT0. In the depicted example, the hold time tH=t1−t0 is less than the hold time target tT. Because the patient is unable to maintain the parameter value within the parameter target window 554 until reaching the absolute hold time target tT0=t0+tT, the movement has not been successfully completed. Accordingly, the exercise device 14 may either not emit a haptic signal 548, or emit a movement correction haptic signal (not shown).
In plot 563, the patient 12 reaches a peak parameter value 566 and maintains the parameter value within the parameter target window 554 until tH=tT. The parameter target window 554 may be defined based on the peak parameter value 566 as described above. The hold time target tT may define an absolute hold time target (not shown), and the hold time target window 558 may be defined as described above. In the depicted example, the hold time t is equal to the hold time target tT, and the movement has been successfully completed. Accordingly, the exercise device 14 may emit a positive reinforcement haptic signal 548 in response to the parameter value requirements being met.
In plot 564, the patient 12 reaches a peak parameter value 566 and maintains the parameter value within the parameter target window 554 until tH>tT. The parameter target window 554 and hold time target window 558 may be defined as described above for plots 562 and 563. Because the hold time ty is greater than the hold time target tT, the movement has been successfully completed. Accordingly, the exercise device 14 may emit a positive reinforcement haptic signal 548 in response to the parameter value requirements being met.
The parameter speed S may be used alone or in combination with the various parameter targets and windows described above to define the parameter value requirements for an exercise. These parameters may be set to predetermined values by the therapist, or determined based on parameter values generated by the patient during an exercise session.
The exercise device 14 may use one or more algorithms to evaluate different types of movement. Types of movement may include linear with resistance (e.g., using a resistance band 502), linear without resistance (e.g., in air without a resistance band 502), linear without resistance on surface (e.g., sliding the exercise device 14 across a table), rotational with resistance, and rotational without resistance.
For linear movements without resistance on a surface, the exercise device 14 may monitor vibrations associated with sliding the device across the surface. The vibrations may be detected using the accelerometer 83, and used to determine the direction of movement and distance moved. The direction of movement may be determined, for example, by determining the directional vector of vibration, i.e., the vector axis along which the vibration is oriented. If the direction determined from the vibrations indicates the patient is moving in the wrong direction, the exercise device 14 may provide feedback to the patient instructing the patient on how to perform the movement correctly. The accelerometers may also be used to detect the movement distance to make sure that the user is going the same distance as recorded for the baseline exercise. Movement detection based on vibration may work on multiple surfaces, such as a tabletop with or without a tablecloth between the exercise device 14 and the table. For rotational exercises, the exercise device 14 may track movement along the x, y, and z-axes of the accelerometer to determine whether the patient is moving in the correct direction.
In another embodiment of the present invention, when the handle 30 is dragged on top of a surface 580 (e.g., a tabletop—see
Embodiments of the above described system may be configured so that specific hold time targets tT may be dictated on a per exercise and a per patient basis. Time targets tT may be used for stretches, strengthening exercises, and isometric exercises. Different exercise paces (e.g., speed and repetition rates) may be defined for concentric and eccentric movements, or for any other type of movement. Embodiments of the present invention may use quaternion information to determine starting positions, e.g., the starting position of a handle 30. Information received from one or more stress sensors 77 may be used to determine if the user is using a resistance band 502 with the appropriate tension for the starting position of the exercise, e.g., based on a ratio of force versus distance. The sensor module 504 may depict movement along each axis to determine if the detected motion is good motion or bad motion. Performance of exercises may be evaluated based on one or more of the position, orientation, velocity, acceleration, displacement, absement, etc., of the exercise device 14.
Data collected on patients 12 may be used to train artificial intelligence systems so that these systems can identify patterns regarding types of exercises and issues treated. These patterns may be used to identify treatments that are likely to be successful based on the condition being treated, for example. Data generated by embodiments of the present invention may also be used to generate progression analysis, best practices, and trend setting. This use of data may be on a treatment level (e.g., progression over a multi-week treatment protocol), on an exercise level (e.g., how well are exercises performing at treating certain medical conditions), and from a demographic perspective (how are certain demographics and ages progressing compared to others). Data collected from patients at home may be used to generate reports to support patients' medical necessity charts. These charts may facilitate the patients' ability to access in-clinic visits.
Referring now to
The processor 602 may include one or more devices selected from microprocessors, micro-controllers, digital signal processors, microcomputers, central processing units, field programmable gate arrays, programmable logic devices, state machines, logic circuits, analog circuits, digital circuits, or any other devices that manipulate signals (analog or digital) based on operational instructions stored in memory 604. Memory 604 may include a single memory device or a plurality of memory devices including, but not limited to, read-only memory (ROM), random access memory (RAM), volatile memory, non-volatile memory, static random access memory (SRAM), dynamic random access memory (DRAM), flash memory, cache memory, or data storage devices such as a hard drive, optical drive, tape drive, volatile or non-volatile solid state device, or any other device capable of storing data.
The processor 602 may operate under the control of an operating system 614 that resides in memory 604. The operating system 614 may manage computer resources so that computer program code embodied as one or more computer software applications, such as an application 616 residing in memory 604, may have instructions executed by the processor 602. In an alternative embodiment, the processor 602 may execute the application 616 directly, in which case the operating system 614 may be omitted. One or more data structures 618 may also reside in memory 604, and may be used by the processor 602, operating system 614, or application 616 to store or manipulate data.
The I/O interface 606 may provide a machine interface that operatively couples the processor 602 to other devices and systems, such as the external resource 610 or the network 612. The application 616 may thereby work cooperatively with the external resource 610 or network 612 by communicating via the I/O interface 606 to provide the various features, functions, applications, processes, or modules comprising embodiments of the present invention. The application 616 may also have program code that is executed by one or more external resources 610, or otherwise rely on functions or signals provided by other system or network components external to the computer 600. Indeed, given the nearly endless hardware and software configurations possible, persons having ordinary skill in the art will understand that embodiments of the present invention may include applications that are located externally to the computer 600, distributed among multiple computers or other external resources 610, or provided by computing resources (hardware and software) that are provided as a service over the network 612, such as a cloud computing service.
The HMI 608 may be operatively coupled to the processor 602 of computer 600 to allow a patient to interact directly with the computer 600. The HMI 608 may include video or alphanumeric displays, a touch screen, a speaker, and any other suitable audio and visual indicators capable of providing data to the patient. The HMI 608 may also include input devices and controls such as an alphanumeric keyboard, a pointing device, keypads, pushbuttons, control knobs, microphones, etc., capable of accepting commands or input from the patient and transmitting the entered input to the processor 602.
A database 620 may reside in memory 604, and may be used to collect and organize data used by the various systems and modules described herein. The database 620 may include data and supporting data structures that store and organize the data. In particular, the database 620 may be arranged with any database organization or structure including, but not limited to, a relational database, a hierarchical database, a network database, or combinations thereof. A database management system in the form of a computer software application executing as instructions on the processor 602 may be used to access the information or data stored in records of the database 620 in response to a query, which may be dynamically determined and executed by the operating system 614, other applications 616, or one or more modules.
In general, the routines executed to implement the embodiments of the present invention, whether implemented as part of an operating system or a specific application, component, program, object, module or sequence of instructions, or a subset thereof, may be referred to herein as “computer program code,” or simply “program code.” Program code typically comprises computer-readable instructions that are resident at various times in various memory and storage devices in a computer and that, when read and executed by one or more processors in a computer, cause that computer to perform the operations necessary to execute operations or elements embodying the various aspects of the embodiments of the present invention. Computer-readable program instructions for carrying out operations of the embodiments of the present invention may be, for example, assembly language, source code, or object code written in any combination of one or more programming languages.
Various program code described herein may be identified based upon the application within which it is implemented in specific embodiments of the present invention. However, it should be appreciated that any particular program nomenclature which follows is used merely for convenience, and thus the present invention should not be limited to use solely in any specific application identified or implied by such nomenclature. Furthermore, given the generally endless number of manners in which computer programs may be organized into routines, procedures, methods, modules, objects, and the like, as well as the various manners in which program functionality may be allocated among various software layers that are resident within a typical computer (e.g., operating systems, libraries, API's, applications, applets, etc.), it should be appreciated that the embodiments of the present invention are not limited to the specific organization and allocation of program functionality described herein.
The program code embodied in any of the applications/modules described herein is capable of being individually or collectively distributed as a computer program product in a variety of different forms. In particular, the program code may be distributed using a computer-readable storage medium having computer-readable program instructions thereon for causing a processor to carry out aspects of the embodiments of the present invention.
Computer-readable storage media, which is inherently non-transitory, may include volatile and non-volatile, and removable and non-removable tangible media implemented in any method or technology for storage of data, such as computer-readable instructions, data structures, program modules, or other data. Computer-readable storage media may further include RAM, ROM, erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), flash memory or other solid state memory technology, portable compact disc read-only memory (CD-ROM), or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to store data and which can be read by a computer. A computer-readable storage medium should not be construed as transitory signals per se (e.g., radio waves or other propagating electromagnetic waves, electromagnetic waves propagating through a transmission media such as a waveguide, or electrical signals transmitted through a wire). Computer-readable program instructions may be downloaded to a computer, another type of programmable data processing apparatus, or another device from a computer-readable storage medium or to an external computer or external storage device via a network.
Computer-readable program instructions stored in a computer-readable medium may be used to direct a computer, other types of programmable data processing apparatuses, or other devices to function in a particular manner, such that the instructions stored in the computer-readable medium produce an article of manufacture including instructions that implement the functions, acts, or operations specified in the flowcharts, sequence diagrams, or block diagrams. The computer program instructions may be provided to one or more processors of a general purpose computer, a special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the one or more processors, cause a series of computations to be performed to implement the functions, acts, or operations specified in the text of the specification, flowcharts, sequence diagrams, or block diagrams.
The flowcharts and block diagrams depicted in the figures illustrate the architecture, functionality, or operation of possible implementations of systems, methods, or computer program products according to various embodiments of the present invention. In this regard, each block in the flowchart or block diagrams may represent a module, segment, or portion of instructions, which comprises one or more executable instructions for implementing the specified logical function or functions.
In certain alternative embodiments, the functions, acts, or operations specified in the flowcharts, sequence diagrams, or block diagrams may be re-ordered, processed serially, or processed concurrently consistent with embodiments of the present invention. Moreover, any of the flowcharts, sequence diagrams, or block diagrams may include more or fewer blocks than those illustrated consistent with embodiments of the present invention. It should also be understood that each block of the block diagrams or flowcharts, or any combination of blocks in the block diagrams or flowcharts, may be implemented by a special purpose hardware-based system configured to perform the specified functions or acts, or carried out by a combination of special purpose hardware and computer instructions.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the embodiments of the present invention. As used herein, the singular forms “a”, “an” and “the” are intended to include both the singular and plural forms, and the terms “and” and “or” are each intended to include both alternative and conjunctive combinations, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” or “comprising,” when used in this specification, specify the presence of stated features, integers, actions, steps, operations, elements, or components, but do not preclude the presence or addition of one or more other features, integers, actions, steps, operations, elements, components, or groups thereof. Furthermore, to the extent that the terms “includes”, “having”, “has”, “with”, “comprised of”, or variants thereof are used in either the detailed description or the claims, such terms are intended to be inclusive in a manner similar to the term “comprising”.
While all the present invention has been illustrated by a description of various embodiments, and while these embodiments have been described in considerable detail, it is not the intention of the Applicant to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. The present invention in its broader aspects is therefore not limited to the specific details, representative apparatus and method, and illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the spirit or scope of the Applicant's general inventive concept.
The present application is a Continuation-In-Part of co-pending U.S. application Ser. No. 18/042,358, filed Feb. 21, 2023, which is a submission under 35 U.S.C. § 371 of International Application No. PCT/US2021/047713, filed Aug. 26, 2021, which claims the filing benefit of U.S. Provisional Application Ser. No. 63/071,762, filed Aug. 28, 2020, the disclosures of which are incorporated by reference in their entireties.
| Number | Date | Country | |
|---|---|---|---|
| 63071762 | Aug 2020 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 18042358 | Feb 2023 | US |
| Child | 18767215 | US |
