WO2002018019A1

WO2002018019A1 - Rehabilitation device

Info

Publication number: WO2002018019A1
Application number: PCT/GB2001/003896
Authority: WO
Inventors: Neill Malcolm Pounder; Julian Anthony Webb; Nicholas William Granville
Original assignee: Smith & Nephew Plc
Priority date: 2000-08-31
Filing date: 2001-08-31
Publication date: 2002-03-07
Also published as: AU2001286039A1; GB0021327D0

Abstract

The invention relates to exercise devices used for rehabilitation, physiotherapy and general exercise. The exercise device comprises sensors that are able to detect the use of body parts of the user to monitor performance and/or compliance of the exercise.

Description

REHABILITATION DEVICE

The invention relates to exercise devices used for the rehabilitation of patients following traumatic joint injury but also for sports physiotherapy and general exercise. The device may also be suitable for care of patients following wound injury, especially when patient compliance is required. More specifically, the invention relates to an intelligent device that allows a selection of exercise programmes to be monitored.

It is well known that muscle, bones and joints should be exercised to maintain strength. It is also known that fractures exposed to permissible weight bearing stress often heal more predictably and more rapidly than fractures, which are not stressed at all. This is also believed to be true for connective tissue, such as ligaments and certain cartilage. Similarly the exercising of injured limbs has beneficial effects on the healing of the joint or muscle injury.

Currently the neuromuscular stage of rehabilitation is only addressed by one -to -one physiotherapy treatment, which can be costly and is time consuming. Current treatment systems and devices are concerned with enhancing proprioception via skin receptors or by training balance alone in the therapist's clinic, this could include the wobble board and KAT system.

Previously proprioception was thought of as just balance. However surprisingly the devices of this invention show that the position and angle of the user's limbs, and/or the kinesthesia of the user's limbs may allow the therapist a better understanding of condition of the limbs of the user. With regard to proprioceptive/neuromuscular rehabilitation this may allow the therapist a better understanding of the progression of a patient's rehabilitation, whether the patient, is progressing at the desired rate and whether the exercise programme is suitable to the patient, or if it is not, to change the exercise programme. Similarly this can offer benefits to the therapist working with sports men and women.

Previous physiotherapy equipment and treatment systems needed close supervision by the therapist to ensure that the exercises were being carried out correctly and indeed to ensure that the user was doing the exercises. The therapist, for the prior art rehabilitation systems had to be present when the user was being assessed. Usually the person using the physiotherapy equipment or treatment system, whether a patient or sports person would have to travel to the therapist at a clinic to use the equipment and to perform the exercises. Due to the time wasted between seeing one patient or client and the next this current system has the disadvantage of being a very ineffective use of the therapist's time.

It was previously thought that the current system, of the patient or client always travelling to the therapist for their rehabilitation treatment could not be improved upon as the treatment system required large, sometimes heavy, expensive equipment which was not easily transportable and that the therapist would have to be present to monitor the exercise programme.

It is an object of the present invention to address some of these before mentioned problems.

It is an object of the present invention to provide a device, which indicates the position and/or movement of a user's limb, limbs or body part.

It is an object of the present invention to provide a proprioceptive and/or neuromuscular device that will monitor and record the user's performance. Also according to the present invention there is provided an exercise device comprising at least one position and/or motion sensor that indicate the position and/or motion of a body part of the user of the exercise device.

Preferably the, or all, position and/or motion sensor(s) are in communication with a processor for processing data generated from the position and/or motion sensor.

According to the present invention there is provided an exercise device comprising; at least one position and/or motion sensor that senses the position and/or motion of a body part of the user of the exercise device; and a control means in communication with the position and/or motion sensor for receiving outputs from the position and/or motion sensor, the control means further including a programmed processor for processing outputs from the position and/or motion sensor.

In preferred embodiments, the exercise device of the present invention will have a memory to store data generated from the position and/or motion sensor, in order to download the data generated at a later time. However the exercise device of the present invention may also have a data transmitter that automatically transmits the data (generated) as it is generated. Whether the data generated, by the sensor is downloaded as it is generated or at a later time, this information may be transmitted to the user or the therapist. If the data generated is stored by the exercise device of the present invention or by a separate memory database to which the exercise device has sent the data, then the therapist, or user, can examine the data at a later, perhaps more convenient, time than when the actual exercise was performed. Optionally the exercise device of the present invention may have a message conveyor, in order to instruct the user to perform a predetermined exercise programme. In simple embodiments of the present invention the instructions to the user may be written on a sheet of paper given to the user by the therapist. In more sophisticated embodiments of the present invention the instructions may be displayed on a separate monitor.

The message conveyor however may simply be attached to the exercise device or be an integral part thereof.

It is envisaged that the present invention can be small enough to be easily transportable and therefore the exercise routine need not necessarily be performed at the therapist's clinic. The term therapist is used broadly to mean anyone overseeing the exercise programme or the rehabilitation of the user and this would include, but not be limited to, physiotherapists and occupational therapists.

Even if the device is used in the therapist's clinic there are many advantages for using the present invention over the prior art devices. The therapist would be able to deal with users of the device more quickly than in the past and may have a reliable means of comparison to how the user is performing the exercises and how the improvement is progressing.

There is an increasing demand for numerical records of patients' rehabilitation to be available for the following purposes.

To make therapists accountable for their actions, for instance, for performance reviews or litigation cases.

For feedback to the surgeon/physician, for example for justification for or against further intervention. For feedback for reimburser, for example to fulfil requirements by insurance companies requiring proof that patients are complying with treatment.

For greater understanding of therapy and clinical research i.e. optimisation, of treatments and presentation of results.

For standardisation of treatment and common practices.

For overcoming prejudiced views in the art, by therapists, relating to rehabilitation.

Likewise, as this form of the device may have means to convey instructions for the exercise programme to the user and has means to monitor and record the user's performance, it is again not necessary to use the device in the therapist's clinic only.

Not being restricted to performing the exercises at the therapist's clinic has many benefits to both the user and the therapist.

The user can save considerable time, by not having to visit the therapist as often and can more easily fit the required exercise programme into his or her daily routine. Being able to do the required exercises in private may also be a favourable consideration to some users and thus the user's compliance for doing the exercises may in fact increase when not in the presence of the therapist. This may be especially true when the device is for rehabilitation of elderly patients.

The therapist also saves considerable time as data from the device can be collated some time after the exercises have been done and can be sent to the therapists for analysing or can be down loaded to a αata collecting station at a mutually convenient time. The therapists will however still be able to closely monitor the user's compliance of carrying out the exercise and to determine if the exercises are having the desired effect. The therapist can alter the predetermined exercise programme of the device in order to ensure that the user does have an exercise programme suitable to their particular needs.

As individuals will perform the same exercise programme in very different ways with differing degrees of abilities, especially regarding speed, force and accuracy, it is hard for the therapist to compare the progress of one user with another. For example a young sports person may well be able to perform a programme of exercises faster than an elderly person that has been on the same programme of exercises for a longer period of time than the sports person. Consequently for the therapist to measure the progress of the user it is not only how well the user performs the exercise on the particular occasion but also how much of an improvement there is in performing the exercises from before. The present invention provides an easy means to store and analyse the user's current and past exercise data to aid the therapist to monitor the progress of the user and therefore to be able to change the exercise programme accordingly. There is therefore an opportunity for the user to have a speedier recovery, saving time and money for the user and the therapist.

We hereby define the term position and/or motion sensor to mean any device that can detect or compare its position, angle or motion and/or its rate of change of position, angle or motion. Further, the term, position and/or motion sensor may mean any device used to calculate or infer the position, angle or motion of a target point of a user, or an apparatus used by a user.

Such position and/or motion sensors are known in the art and include variable capacitance sensors, rotatory potentiometers, accelerometers, and angle sensors e.g. gyroscope and potentiometers. Accelerometers are well known in the car industry for triggering car airbags. Accelerometers on the market that may be used with the present invention include accelerometers sold under the Trade Name IC sensors and those marketed by Analog Device Inc., for example the ADXL202 accelerometer. These are two-axis ± 2g micromachined sensors.

Typical gyroscopes suitable for use with the present invention are MG 100 supplied from Gyration Inc. This is a dual-axis gyroscope, originally designed for integration into pointers and remote controls, and computers and home entertainments systems.

The position and/or motion sensor can be attached to the exercise device by any suitable means. This could be simply by having a stick-on patch with the sensor or alternatively the sensor could be held on the user by a bandage or dressing. Likewise a strap with suitable hook and loop fastenings, for instance like those sold under the trade name of Velcro (Trade Mark), could be used to hold the position and/or motion sensor in place.

The communication means by which the data from the position and/or motion sensor is conveyed to the control unit, in embodiments where there is a control unit, can be by any means suitable for such a purpose. Preferably the communication means will be by radio signalling or the like, so that the user is not hindered physically when doing the exercises. The communication means however can be by wire to the control unit provided that the exercises could be performed within the limited range of the wire.

The control unit can be attached to the exercise device or to the user, for instance to a belt held around the user's waist, to allow freedom of movement of the device when the user is performing the exercises. This may. be an important feature when the means of communicating the data from the position and/or motion sensor to the control unit is by wire. This type of embodiment of the present invention may be especially important when the user is jogging and the control unit must be able to move with the user.

Alternatively the control unit and position and/or motion sensor could be contained together within one unit provided the one unit could be small enough and sufficiently light in weight to be attached to the exercise device or be an integral part thereof.

The abovementioned sensors, of the present invention, can be attached to, or be an integral part of, various objects to form the exercise device of the present invention.

Examples include, but are not limited to, wobble boards, canes, rods, continuous passive motion (CPM) machines or other currently known exercise machines e.g. bikes, pulleys, cables and weights.

Exercise machines typically exercise one particular muscle group at a time. The ability to accurately assess functional exercises, (exercises that exercise a number of muscle groups) is normally limited. An example of an exercise machine that allows functional exercise may consist of a pulley, cables with handles and weights. One particular disadvantage, that is typical of most exercise machines, is the lack of quantitative data and patient/therapist feedback. An accelerometer/gyroscope sensing unit can be incorporated into for instance a handle of the device or have sensors attached to the main cables. The accelerometers/gyroscopes can recognise the motions being requested and determine if the patient is following those motions. Feedback to the patient can be given in a wide variety of forms (as previously listed out). Memory means may record the patterns of particular exercises and the sensors can detect if those motions are being carried out. If part of the device rotates, another option is to incorporate simple potentiometric angle sensor to determine this rotation. (Resistance against this rotation can be achieved if desired). Incorporation of force sensing means allows other exercise types to be carried out. The sensing unit does not necessarily have to be included within the handle of the device, but can be attached to other moving parts of the device.

The exercise devices of the present invention will also include Aids of Daily Living (ADLs) such that a user's ability to perform activities for daily living can be assessed.

Any device that allows or incorporates motion during exercise or rehabilitation can benefit from an accelerometer/gyroscope sensing unit. This type of rehab/exercise can occur following a wide range of conditions - examples of which are: palsies, stroke, contractures, etc.

This would be particularly useful for users that had suffered from a stroke.

Following conditions such as stroke, a patient will go through a lengthy retraining process prior to being discharged from the hospital. The majority of the patients are elderly and have lost some functionality and fine control to undertake activities of daily living. During the retraining process, often a room is set up similar to a patient's own home (e.g. kitchen) and the patient will be taught how to do basic actions (e.g. make a cup of tea, cook an egg, etc).

No particular devices, apart of ADLs, are used during these activities. The retraining process requires constant supervision during this time. In the past it has been difficult to make a judgement as to whether a patient is fully competent. The present invention enables sensing technology to be attached to, or incorporated into, a range of devices (e.g. cooker, kettle, tap, etc) in order to monitor patient performance. This data is fed into a computer to monitor performance and provide feedback to the patient and therapist. Such a device can be used to highlight particular patient difficulties (e.g. turning a tap) so specific ADLs can be recommended.

The device of the present invention can be used by itself or with other exercise aids. Other exercise aids could be a mat that has markings on it to indicate positions on the mat that the user may be requested to move to or to move a particular body part or limb to.

Preferably it is envisaged that . the user will have an exercise programme that requires that the user to move either a hand or foot, or any other suitable part of the body, to a desired position on the mat. These programmes may specify whether it is the left or right, hand or foot or other body part that is to be moved. For exercises requiring the user to move his foot or feet, to desired positions on the mat, the mat may preferably be positioned on the floor. Likewise for exercises designed to exercise mainly the lower body of the user the mat may preferably be positioned on the floor. Where the exercises require the user to move their hand, the mat may suitably be placed on a table or on a wall or other vertical surface to allow easy positioning of the user's hand on the mat. Likewise for exercises designed mainly for the upper body of the user the mat may be suitably placed on a table or held vertically. Suitable means of attaching the mat to a wall or vertical surface could be used to position the mat. The mat need not be restricted to substantially flat surfaces for it is envisaged that the mat could be used on uneven surfaces in order to test a user's balance and/ or movement on an uneven surface. Typically the mat could be used on stairs or on a wobble board. This is especially important for rehabilitation exercises where a patient may feel quite stable when on surfaces that are substantially even but not when on stairs or when on surfaces that are uneven. Suitable attachment means to attach the mat securely to the stairs would be preferably used in conjunction with the mat in order to ensure safe usage of the mat by the user.

Likewise the mat may also be used on soft surfaces. For example the mat may be used on an exercise bouncer.

The mat may be of any size or shape however it is envisaged that a mat of approximately 1m to 2m by 1m to 2m would be preferable to allow for easy transportation of the device. It is envisaged that a smaller mat could be used for upper body exercises, for instance 1m by 1m, and a larger mat, for instance 2m by 2m, for exercises directed at lower body exercises. Typically the mat may be 1m by 2m for exercises directed solely for the upper body, and typically 1.5m by 2.5m for exercises directed solely for the lower body. The particular mat need not be limited for any particular programme of exercise and it is envisaged that the one mat could be used for exercises directed at both the upper and lower body of the user. When not being used, the mat in some embodiments of the present invention may be easily rolled or folded to facilitate storage.

The mat can be made of any suitable material.

Preferably the mat will have markings to act as specific targets for the user to make contact with the mat when directed to do so for the particular exercise programme. This could be simply a series of labelled or indexed grids on the mat. The grids on the mat could be of different sizes and therefore suitable for a wider range of exercise programmes. Typically when different size grids are used on the one mat the grids will be colour coded in order to allow easy visual differentiation between the grids. Typically the grid spacing will enable desired targets to be large enough for the user's hand or foot to be placed substantially over the target area.

Other markings could simply be shapes, numbers, letters or pictures on the surface of the mat. The markings could be permanent or an overlay.

Typically the grid spacing will enable desired target areas to be large enough for the user's hand or foot, or other body part, to be placed substantially over the target area.

The mat may even contain lights on the surface of the mat in embodiments of the present invention where the lights themselves are the targets for which the user should place their hand or foot, or other body part, on to when that particular light lights up. The lights would suitably be protected from the physical contact of the user putting pressure on the surface of the mat. It would also be preferable with this embodiment of the present invention if the lights could be contained within the substantially flat surface of the mat or cover target so that the surface is still substantially flat. Having the surface substantially flat is important where the user is walking on the mat and may be tripped by the lights if the lights projected from the surface.

A common exercise programme presently used by therapists to monitor rehabilitation of a patient, which may be performed by a user with the present invention is the step up step down exercise.

This exercise can be used to address ankle, knee and even hip mobility and strength of the patient. Additional sensors may also be attached to the user at various positions on the leg, e.g. front and/or back, to detect sideways and vertical accelerations, and sideways and vertical rotations. With some embodiments of the present invention, when the exercise is done correctly, the device will be able to show this. And when the exercise is done incorrectly again the device will be able to detect this by the presence or absence of movement. Preferably both accelerometers and gyroscopes would be used with an embodiment of this invention to perform this type of exercise. For some exercises, using only accelerometers or gyroscopes can work.

When the sensor is attached to the user, suitably the position and/or motion sensor will be incorporated into a sleeve in which the sleeve can be easily attached to the exercise device at the desired position. The sleeve may be any size or shape suitable to be attached to the user. The sleeve may be made of any suitable material that would enable it to be safely attached to the user. The sleeve may be rigid like a conventional brace or may be of soft material. Preferably the sleeve will be substantially of soft material. When the sleeve is of substantially soft material, any soft material may be used to construct the sleeve for instance, textile fabrics. Suitably the sleeve will be small, soft and light in weight.

A particularly suitable exercise for performing with the present invention is the simple active/passive range of motion exercises. For these, during rehabilitation, the patient is asked to move their joint through certain angles. Either passively (moved by the therapist or a machine) or actively using the muscles. The range of motion should increase during rehabilitation.

Typically the control means will be able to collect and store the data from the position and/or motion sensor or any other sensors being used with the invention, in order to be able to later download the collected data. The downloading of the collected data, may be done by the therapist either at the clinic, or elsewhere, or the data could be downloaded by the user and sent to the therapist for analysing. It is possible, using suitable means that the collected data could be sent to the therapist by telephone, e.g. e-mail, or radio. It is even possible that the collected data could be sent to a collecting station near to the therapist or at the clinic to enable the therapist to analyse the data when required.

The predetermined exercise programme of the device may be preprogrammed into the device by the therapist. There is no limitation to what exercise programmes could be programmed into the device, in order for the user to carry out the exercise programme. The therapist would preferably choose an exercise programme that would be challenging to the user but still within their capabilities.

The instructions or commands of what movement the user is required to do can be conveyed to the user by any suitable means. The means to convey instructions or commands to the user need not necessarily be attached to the control unit, or the device of the present invention, as the means to convey instructions or commands to the user as the means to convey instructions or commands to the user may be in wireless communication with it. This may be by instructions on a TV or LCD screen that the user can look at whilst performing the exercise programme. The display on the screen may be by any suitable means but would typically be written instructions or a graphic display of what the instructions are. The instructions may also be conveyed to the user by other visual means for example when lights are used within the mat to move to the light, which is switched on or off as the case may be. Additionally the device may incorporate a light projecting means on to a mat where the user must move to where the light projection falls onto the mat. The instructions however could be by simple audio means, i.e. audiotape, or digitised voice. In the simplest of embodiments of the present invention the instructions to the user in order to perform the exercise programme may be written on a sheet of paper. Once the device has indicated to the user to start the exercises, for instance, this may be to show that the control means is ready to monitor and record the exercises, the user may perform the exercises as written on the sheet of paper.

This embodiment of the present invention may be easily adapted that the device may have pressure sensors positioned to monitor the pressure for hand, shoulder, arm exercises or the like. For instance, the amount of pressure by a user's hand against the exercise device may be monitored when performing a predetermined exercise.

Devices of the present may be of various weights but preferably the device will be of a weight that can easily be portable.

For small devices having few sensors the total weight of the device may be less than 200g. Suitably a portable device with few sensors would weigh less than 100g.

When more sensors are used this may increase the weight of the device used and therefore when a number of sensors are used the total weight of the device may be approximately, for instance, 2kg. Suitably the weight will be less than 1.5kg when a low weight device is required.

It may however be required that the device is of a substantial weight and therefore the device of the present invention may be any suitable weight which enables the user to perform the exercise programme.

According to the present invention there is also provided a method of manufacturing an exercise device comprising the steps of combining an exercise device having one or more position and/or motion sensors, which indicate the position and/or motion of a body part of the user, with processor for processing data generated from one or more of the position and/or motion sensors.

The invention further provides a method of manufacturing an exercise device comprising the step of connecting, an exercise device comprising; a position and/or motion sensor which senses the position and/or motion of a body part of the user. and a control means in communication with the position and/or motion sensor for receiving outputs from the position and/or motion sensor, the control means further including programmed processor for processing outputs from the position and/or motion sensor and memory for retaining the processed data outputs from the position sensing means, the control means further having means to instruct a user to perform a predetermined exercise programme.

The invention will now be further described by way of example only with reference to the drawings which are:-

Fig. 1a and 1b show a device according to a first embodiment of the invention.

Fig. 2 shows a mat for use with an embodiment of the present invention.

Fig. 3 shows a Capacitance One Dimensional Angle sensor suitable for use with the present invention, the sensor having a position of low capacitance.

Fig. 4 shows a Capacitance sensor of Fig. 3, the sensor having a position of high capacitance. Fig. 5 shows a circuit diagram typical of an electrical circuit for use with the Capacitance sensor shown in Fig. 3.

Fig. 6 shows inductive Angle Sensors for use with the present invention.

Fig. 7 is a view of a user's leg with two positioned gyroscopes, positioned ready for a knee bend exercise programme.

Fig. 8 is a view of a user performing an embodiment of an active range of motion exercises.

Fig. 9 shows one embodiment of a sensor and attachment means of the present invention.

Fig. 1a and 1 b show a first embodiment of the invention in which a gyroscope (11) and accelerometer (12) are incorporated into the handle (13) of a pulley type exercise machine (14). A user would grip the pulley handle

(13) and pull the handle (13) in various directions according to the instructions of an exercise programme.

The gyroscope (11) and accelerometer (12) are in wireless communication with a central data collecting control unit (not-shown).

Attached to the control unit is a small television screen whereby instructions from the control unit are conveyed to the user, to perform an exercise programme. The exercise programme is predetermined by a therapist. After performing the exercise programme the user downloads the data via radio from the control unit to a central data-collecting unit at the therapist's clinic for analysing. The therapist can also change the exercise programme by radio, without the need for seeing the user. Fig 2 depicts a mat (21) suitable for use with an embodiment of the present invention. The mat (21) has a target grid on its upper surface.

Figures 3 and 4 show and example of a capacitance One Dimensional

Angle Sensor suitable for use with the present invention. The angle sensor is based on the capacitance of a pair of parallel plates. The area of the plates overlapping is directly proportional to the capacitance. As the angle changes, the overlap of the plates change, as seen in Fig. 3 and Fig. 4, resulting in a change in capacitance.

The sensor may be attached to a hinged device and therefore would be capable of detecting angles in one plane (i.e. elbow type motion). The sensor can be produced for a low cost and using a simple circuit, for instance as shown in figure 5. In order to remove the need for every sensor requiring calibration, incorporation of an absolute angle marker (e.g. at 0°, 45° or 90°) is necessary, such as an L.E.D. and/or a photocell. The capacitance varies non-linearly with angle, hence the output voltage requires linearising by use of a look-up table, curve fit or spline. For instance a notched disk and a L.E.D. may be used that when aligned indicates a predetermined angle.

As can be seen from the circuit diagram (figure 5), U1a is used to produce a free-running oscillator. The output from this circuit triggers U1 b, which is configured as a monostable mulitvibrator. The pulse period of this monostable is determined by the capacitance connected across terminals CN1 and CN2, which in this instance is a rotary vane capacitor whose capacitance is dependent on angular position. The output from IC 1b is a pulse train of fixed frequency with a mark/space ratio, which varies according to the position of the variable capacitor. The DC component of the pulse train will vary with the mark/space of the pulse train. IC U2b is configured as a filter, which extracts the DC component from the pulse train. The DC component is level shifted and buffered by IC U2a and presented at connector CN4 for processing as required.

Inductive 3D angle sensors (Fig. 6) may also be used with the present invention in order to detect the angle of motion of a body limb of a user. These sensors may be suitable for sensing the angle of joints capable of moving in more than one dimension (i.e. shoulder, hip, ankle, wrist).

The device may be wireless and may be based on mutual inductance

(as used to transmit heart rate data in sports heart monitor products). The sensor consists of a coil driven at a given frequency. The detector is a set of three coils, with iron cores, set orthogonally to each other (Fig. 6). As the sensor moves through the field, voltages are induced in the three coils, which can be detected and interpreted in response to the sensor position. When the coils are parallel the coupling is at a maximum and at a minimum when the coils are orthogonal. The coupling is dependent on the angle between the coils' axes, but also the distance between the coils.

An exercise programme suitable for use with the present invention is the Knee Bend Exercise (Fig. 7). This exercise programme involves measuring the angle of the patient's limbs and is particularly suitable for movement in one plane. This exercise programme can work equally well for the elbow and other joints where the movement required is in one plane. Suitably therefore the One-dimensional Angle sensors such as the Capacitance Angle Sensor shown in Fig. 3 may be used.

Similarly when more complex joints are being monitored more sensors could be used. In addition to using an exercise device of the present invention, additional sensors may be attached to the user. Two additional sensors attached to the user e.g. gyroscopes are used, the first sensor (71) positioned above the knee and the second sensor (72) positioned below the knee. A larger number of sensors could be used, however for simplicity two is adequate.

The angle between the two parts of the limb, e.g. leg, is calculated from the orientation of the sensors.

Figures 8a, 8b and 8c show an embodiment of an active range motion exercise that can be performed with the present invention. Sensors in an exercise device of the present invention may be positioned on or in a tap or pulley (not shown) to monitor the user's arm so that the vertical motion of the arm (Fig. 8a), the horizontal motion of the arm (Fig. 8b) or the rotation of the arm (Fig. 8c) may be monitored. By using the present invention to monitor this type of exercise enables accurate results to be collected quickly and efficiently. Using the present invention to monitor this type of exercise enables complex movement of the arm to be performed whilst still accurate results can be collected which may be analysed to give useful data that can indicate how well the user can perform the exercises.

For this exercise the sensors of the present invention may be, suitably positioned on a rod or cone by means of a bracelet, as shown in Fig. 9. These are typically made of an elongated plastic material coiled to form an expanding bracelet shape (91) having one or more sensors (92) and optionally having a detachable cover (93). This bracelet may be positioned anywhere on the rod or cone, the coiled mechanism acting to hold the bracelet without causing discomfort to the user and also not restricting movement by the user. The bracelet may be suitable for use on other limbs of the body, for instance on the leg. The bracelets may be attached by any suitable means. A possible means to attach the bracelet around a cone is by VELCRO (Trade Mark) material.

The bracelets of Fig. 9 may have a hard wire connection to a data processor for processing the data generated, however preferably the data generated would be conveyed to the processor by radio. This has the advantage that the user has good freedom of movement.

Examples of the manufacture and use of the invention are described below:-

Example 1 Wobble board/platform

An exercise device of the present invention comprising of a wobble board incorporating accelerometers is used.

A wobble board disturbs balance, but equally a patient could stand on a platform and their ability to stand stably can be measured. The accelerometers monitor the tilt and the acceleration and can therefore determine the level of user (patient) stability. Additionally, if a sprung loaded platform is used, the accelerometer can detect when a user (patient) stands on the device and hence this acts a compliance monitor. The signal from the accelerometer can be detected, indicating the presence or absence of movement. User (patient) stability can be monitored through accelerometers either by double integrating or to monitoring the acceleration signals.

Example 2 Upper Body Cane Exercises An exercise device of the present invention comprising of a cane with a sensing (accelerometer) unit attached by means of Velcro. The user was asked to perform an exercise programme using the exercise device.

A typical shoulder exercise involves holding the device (cane) horizontally and lifting it up at arms length. This exercise is for increasing range of motion. A typical 'cheat' is to lean backwards rather than extends the shoulder motion. A standalone sensing unit can be attached to the device (cane) and to the patient. This unit also included a data transfer means. This can monitor the height to which the device (cane) is raised, and whether the back is being flexed. User performance was monitored.

Example 3

An exercise device of the present invention comprising a Continuous

Pressure Motion (CPM) machine incorporating gyroscopes.

A CPM machine drives a patient's limb passively through a given range of motion. The sensing unit of the present invention can be used to monitor joint angle, but also speed of motion if accelerometers are used. By incorporating rate of change of angle, joint stiffness can be detected since the limb will get slower as the limit of motion is reached.

The feedback to the device of the areas of motion which has joint stiffness, enables the CPM machine to set on appropriate speed and range of motion for the therapy. Having an appropriate or optimal speed and range of motion of the CPM machine can offer quicker rehabilitation.

Example 4 Tap The present invention is in the form of kitchen sink taps with two potentiometers incorporating into the tap. The potentiometers are able to detect angle and angular rate. (The sink does not necessarily have to be plumbed into water, as the important data is the ability to turn the tap). The user was instructed to turn on the taps and their performance was monitored. Data from the movement of the taps is collected and analysed.

Example 5

The present invention is an embodiment of an oven temperature control dial with a rotary potentiometer. The rotary potentiometer can detect turning of the oven temperature control dial. The user was instructed to turn the oven temperature control dial and their performance was monitored by collecting and analysing data from the oven temperature control dial.

Example 6

An embodiment of the present invention in the form of an oven door incorporating a switch which can sense when the oven door is open or closed. Performance of an exercise by the user which opens or closes the oven door can be monitored and the user's performance of the exercise was monitored by collecting and analysing data from the sensor in the oven door.

Example 7

An embodiment of the present invention, in the form of a kettle incorporating a gyroscope which can sense movement of the kettle is used.

In activities of moving the kettle for example, in filling, the kettle or making tea, the user's performance is monitored by collecting and analysing the data generated from the sensors. Example 8

An exercise device of the present invention comprising a pulley device, similar to the one showing in Figs. 1a and 1b, is used to detect and monitor a user's movement.

An accelerometer inside the handle of the pulley detects the movement of a user's hand when the user pulls the pulley by the target hand.

The user was asked to perform an exercise programme consisting of moving the hand held pulley with varying resistance applied to the pulley.

Movement by the user's hand was detected and monitored by the device, when the user moved the handle of the pulley. This data was later downloaded to a computer at a therapist's office in order to analyse the data.

Claims

1. An exercise device comprising; at least one position and/or motion sensor that senses the position and/or motion of a body part of a user of the exercise device; and a control means in communication with the position and/or motion sensor for receiving outputs from the position and/or motion sensor; the control means further including a programmed processor for processing outputs from the position and/or motion sensor.

2. An exercise device as claimed in claim 1 in which comprises a data memory.

3. An exercise device as claimed in claim 1 or 2 in which comprises a data transmitter.

4. An exercise device as claimed in claim 1 in which the position and/or motion sensor is a rotatory potentiometers.

5. An exercise device as claimed in claim 1 in which the position and/or motion sensor is an accelerometer.

6. An exercise device as claimed in claim 1 in which the position and/or motion sensor is a gyroscope.

7. An exercise device as claimed in claim 1 in which the exercise device comprises a bike.