초록 ▼

The invention provides a method and apparatus to enable a user to perform upper extremity exercises. The apparatus includes an arm with one end connected to a base to securely support the arm while locating the other end adjacent to the user, proximate the user's upper extremities. The arm is formed

The invention provides a method and apparatus to enable a user to perform upper extremity exercises. The apparatus includes an arm with one end connected to a base to securely support the arm while locating the other end adjacent to the user, proximate the user's upper extremities. The arm is formed with a plurality of joints at or between its ends, each joint having one or more rotational degrees of freedom while providing resistance to rotational movement in the one or more degrees of freedom, such that the free end of the arm can be moved in three dimensional space, and such that the arm is self-supporting. A manipulandum assembly including a plurality of manipulanda is attached to the free end of the arm, each manipulandum being positioned within hand grasping range of the user, and each manipulandum being or representing an object encountered in an upper extremity activity of the user's daily life. Sensors on the arm, joints or manipulanda sense movement or force, and relay signals to a processing device in order to sample, display, store and process the signals into kinematic or kinetic variables. These variables may be processed to control software programs such as computer games and to allow quantification of performance for outcome evaluation of therapy regimes.

대표청구항 ▼

What is claimed is: 1. An apparatus to enable a user to perform upper extremity exercises, the apparatus comprising: an arm having a fixed end and a free end, the fixed end being connected to a base for securely supporting the arm and to locate the free end adjacent to the user, proximate to the us

What is claimed is: 1. An apparatus to enable a user to perform upper extremity exercises, the apparatus comprising: an arm having a fixed end and a free end, the fixed end being connected to a base for securely supporting the arm and to locate the free end adjacent to the user, proximate to the user's upper extremities; a plurality of joints formed in the arm at or between its fixed and free ends, each joint having one or more rotational degrees of freedom while providing resistance to rotational movement in the one or more degrees of freedom, such that the free end of the arm can be moved in three dimensional space, and such that the arm is self-supporting; and a manipulandum assembly comprising a plurality of hand function manipulanda attached to the free end of the arm in a manner such that each manipulandum can be moved by the user through the one or more rotational degrees of freedom provided by the plurality of joints, each manipulandum being positioned within hand grasping range of the user, each manipulandum being configured to represent a different object encountered in an upper extremity activity, and the plurality of hand function manipulanda includes two or more of a vertically split cylinder manipulandum, a doorknob manipulandum, a key-grip manipulandum, a horizontal handles manipulandum, a peg manipulandum and a coin manipulandum. 2. The apparatus as set forth in claim 1, wherein the plurality of manipulanda is fixed or tethered to the free end of the arm such that the manipulanda so connected remain accessible to the user without dropping or becoming lost. 3. The apparatus as set forth in claim 2, wherein one or more of the manipulanda are attached to the free end of the arm such that an additional rotational degree of freedom is provided to the manipulanda so attached. 4. The apparatus as set forth in claim 3, wherein one or more of the manipulanda are mounted on a rotatable shaft connected at the free end of the arm such that the additional rotational degree of freedom is provided along the long axis of the shaft. 5. The apparatus as set forth in claim 4, wherein the plurality of joints provides passive resistance against rotational movement, such that the arm and the manipulandum assembly adopt an equilibrium rest position when not in use. 6. The apparatus of claim 5, wherein the arm is positioned above a floor, and wherein the arm is formed in two interconnected segments with a first segment extending generally upwardly from the base and a second segment extending generally forwardly toward the user to position the free end proximate the user's upper extremities, the first segment having the fixed end connected to the base through a first joint providing a rotational degree of freedom in a horizontal axis generally parallel to the floor, and a rotational degree of freedom in a vertical axis, the first and second segments being interconnected through a second joint providing a rotational degree of freedom in a horizontal axis, and the free end of the second segment being attached to the plurality of manipulanda through a third joint providing a rotational degree of freedom in a horizontal axis. 7. The apparatus of claim 6, wherein the first, second and third joints are spring-loaded joints with a spring in the joint or ball and socket joints. 8. The apparatus of claim 7, wherein the plurality of manipulanda includes two or more of a vertically split cylinder manipulandum, a doorknob manipulandum and a key-grip manipulandum. 9. The apparatus of claim 8, wherein, the apparatus further comprises a platform connected for movement with the third joint such that the platform is generally horizontal in the equilibrium rest position, and the rotatable shaft is connected to be generally perpendicular to the platform in the equilibrium rest position, and wherein, if present: the vertically split cylinder manipulandum comprises two cylinder halves which are spring biased apart and which are mounted on the rotatable shaft such that the user may squeeze, rotate on the rotatable shaft, or move the cylinder in the rotational degrees of freedom of the arm; the doorknob manipulandum comprises a rotatable doorknob attached to the platform such that the user may rotate the doorknob relative to the platform, and may move the doorknob in the rotational degrees of freedom of the arm; the key-grip manipulandum comprises a key way formed in the doorknob and a key tab fixed or tethered in the key way such that the user may rotate the key tab in the doorknob, pull the key tab in the key way, or move the doorknob in the rotational degrees of freedom of the arm; the horizontal handles manipulandum comprises one or more handle mounted for rotation on an axle connected to the rotatable shaft in a manner such that the handles are generally horizontal in the equilibrium rest position, such that the user may rotate the handles on the axle, move the handles in a twisting motion along the long axis of the rotatable shaft, and move the handles in the rotational degrees of freedom of the arm; the peg manipulandum comprises a peg which is spring biased in a housing connected to the platform such that the user may pull the peg against the spring and move the peg in the rotational degrees of freedom of the arm; and the coin manipulandum comprises a coin tethered to the platform such that the user may pick up the coin from the platform. 10. The apparatus of claim 9, further comprising one or more sensors located in one or more positions selected from the first, second and third joints, the first and second segments, and one or more of the manipulanda, the sensors being operative to detect movement or force and to generate an electrical signal representative of movement or force. 11. The apparatus of claim 10, further comprising locking means for locking one or more of the first joint, the second joint, the third joint, the rotatable shaft and the handle axle. 12. The apparatus of claim 6, further comprising one or more sensors located in one or more positions selected from the first, second and third joints, the first and second segments, and one or more of the manipulanda, the sensors being operative to detect movement or force and to generate an electrical signal representative of movement or force. 13. The apparatus of claim 12, further comprising a processing device for processing the electrical signal representative of movement or force, and means for transmitting the electrical signal to the processing device. 14. The apparatus of claim 13, wherein the one or more sensors are selected from potentiometers, gyroscopes, accelerometers, linear variable displacement transducers, optical encoders, strain gauges, electrical contacts, and photo-electric sensors. 15. The apparatus of claim 14, further comprising an electrical stimulator for activating nerves and muscles of the user to assist in manipulating the plurality of manipulanda. 16. The apparatus of claim 14, wherein the first and second segments are formed of a rigid material. 17. The apparatus of claim 14, wherein the processing device processes the electrical signal to generate feedback. 18. The apparatus of claim 17, wherein the processing device generates feedback in the form of an interactive computer game. 19. The apparatus of claim 14, wherein the processing device processes the electrical signal to generate performance ratings to evaluate a treatment or an exercise schedule. 20. The apparatus of claim 14, further comprising a telecommunications link between a computer located at the user's site and a remote computer under the control of a therapist. 21. The apparatus of claim 14, wherein the processing device includes software to prompt the user to manipulate the plurality of manipulanda through a series of movements from a standardized performance test. 22. The apparatus of claim 14, further comprising a horizontal support adjacent to the user, and one or more stationary manipulanda on the horizontal support within the reach of the user. 23. The apparatus of claim 22, wherein the stationary manipulanda includes a pegboard defining one or more holes and at least one peg tethered from a gantry positioned on the pegboard. 24. A method for providing an exercising therapy for a user's upper extremity, the method comprising the steps of: providing the apparatus of claim 1; and causing the user to manipulate the plurality of manipulanda with the user's hand to simulate movements representative of activities of the user's daily life. 25. The method of claim 24, wherein manipulating includes one or more of grasping, squeezing, releasing, pinching, lifting, lowering, moving from side to side, twisting and rotating. 26. The method of claim 24, further comprising: providing one or more movement or force detecting sensors positioned in one or more locations selected from the arm, the plurality of joints or one or more of the manipulanda; detecting with the one or more sensors, movement or force of any of the arm, the joints or the manipulanda; generating an electrical signal from the detected movement or force; and transmitting the electrical signal to a processing device to monitor the user's progress. 27. The method as set forth in claim 26, wherein the plurality of manipulanda is fixed or tethered to the free end of the arm such that the manipulanda so connected remain accessible to the user without dropping or becoming lost. 28. The method as set forth in claim 27, wherein one or more of the manipulanda are attached to the free end of the arm such that an additional rotational degree of freedom is provided to the manipulanda so attached. 29. The method as set forth in claim 28, wherein one or more of the manipulanda are mounted on a rotatable shaft connected at the free end of the arm such that the additional rotational degree of freedom is provided along the long axis of the shaft. 30. The method as set forth in claim 29, wherein the plurality of joints provides passive resistance against rotational movement, such that the arm and the manipulandum assembly adopt an equilibrium rest position when not in use. 31. The method of claim 30, wherein the arm is positioned above a floor, and wherein the arm is formed in two interconnected segments with a first segment extending generally upwardly from the base and a second segment extending generally forwardly toward the user to position the free end proximate the user's upper extremities, the first segment having the fixed end connected to the base through a first joint providing a rotational degree of freedom in a horizontal axis generally parallel to the floor, and a rotational degree of freedom in a vertical axis, the first and second segments being interconnected through a second joint providing a rotational degree of freedom in a horizontal axis, and the free end of the second segment being attached to the plurality of manipulanda through a third joint providing a rotational degree of freedom in a horizontal axis. 32. The method of claim 31, wherein the first, second and third joints are spring-loaded joints with a spring in the joint or ball and socket joints. 33. The method of claim 32, wherein at least one manipulanda is a vertically split cylinder manipulandum. 34. The method of claim 33, wherein, the apparatus further comprises a platform connected for movement with the third joint such that the platform is generally horizontal in the equilibrium rest position, and the rotatable shaft is connected to be generally perpendicular to the platform in the equilibrium rest position, and wherein, if present: the vertically split cylinder manipulandum comprises two cylinder halves which are spring biased apart and which are mounted on the rotatable shaft such that the user may squeeze, rotate on the rotatable shaft, or move the cylinder in the rotational degrees of freedom of the arm; the doorknob manipulandum comprises a rotatable doorknob attached to the platform such that the user may rotate the doorknob relative to the platform, and may move the doorknob in the rotational degrees of freedom of the arm; the key-grip manipulandum comprises a key way formed in the doorknob and a key tab fixed or tethered in the key way such that the user may rotate the key tab in the doorknob, pull the key tab in the key way, or move the doorknob in the rotational degrees of freedom of the arm; the horizontal handles manipulandum comprises one or more handle mounted for rotation on an axle connected to the rotatable shaft in a manner such that the handles are generally horizontal in the equilibrium rest position, such that the user may rotate the handles on the axle, move the handles in a twisting motion along the long axis of the rotatable shaft, and move the handles in the rotational degrees of freedom of the arm; the peg manipulandum comprises a peg which is spring biased in a housing connected to the platform such that the user may pull the peg against the spring and move the peg in the rotational degrees of freedom of the arm; and the coin manipulandum comprises a coin tethered to the platform such that the user may pick up the coin from the platform. 35. The method of claim 34, further comprising one or more sensors located in one or more positions selected from the first, second and third joints, the first and second segments, and one or more of the manipulanda, the sensors being operative to detect movement or force and to generate an electrical signal representative of movement or force. 36. The method of claim 35, further comprising locking means for locking one or more of the first joint, the second joint, the third joint, the rotatable shaft and the handle axle. 37. The method of claim 31, further comprising one or more sensors located in one or more positions selected from the first, second and third joints, the first and second segments, and one or more of the manipulanda, the sensors being operative to detect movement or force and to generate an electrical signal representative of movement or force. 38. The method of claim 37, further comprising a processing device for processing the electrical signal representative of movement or force, and means for transmitting the electrical signal to the processing device. 39. The method of claim 38, wherein the one or more sensors are selected from potentiometers, gyroscopes, accelerometers, linear variable displacement transducers, optical encoders, strain gauges, electrical contacts, and photo-electric sensors. 40. The method of claim 39, further comprising an electrical stimulator for activating nerves and muscles of the user to assist in manipulating the plurality of manipulanda. 41. The method of claim 39, wherein the first and second segments are formed of a rigid material. 42. The method of claim 41, wherein the electrical signal is processed to generate feedback. 43. The method of claim 41, wherein the electrical signal is processed to generate feedback in the form of an interactive computer game. 44. The method of claim 41, wherein the electrical signal is processed to generate performance ratings to evaluate a treatment or an exercise schedule. 45. The method of claim 41, further providing a telecommunications link between a computer located at the user's site and a remote computer under the control of a therapist. 46. The method of claim 41, further comprising prompting the user to manipulate the plurality of manipulanda through a series of movements from a standardized performance test. 47. The method of claim 41, further comprising: providing a horizontal support adjacent to the user; and providing one or more stationary manipulanda on the horizontal support within the reach of the user. 48. The method of claim 47, wherein the stationary manipulanda includes a pegboard defining one or more holes and at least one peg tethered from a gantry positioned on the pegboard, and wherein the user is caused to move the peg into the one or more holes. 49. The method of claim 39, wherein the first and second segments are telescopic, elastic or rotational segments.