Title:
Therapy system
Kind Code:
A1


Abstract:
A therapy system providing exercise, massage, and medication. The system includes a portable, wearable exercise device with provisions for resistance during range of motion exercises. The system also offers metrics, diagnostics, remote monitoring, massage therapy, and controlled delivery of medication. The therapy system automatically provides information that is useful for determining recommendations for enhancing therapy.



Inventors:
Brassil, Thomas William (San Diego, CA, US)
Brassil, John Michael (Northbrook, IL, US)
Application Number:
11/639998
Publication Date:
04/19/2007
Filing Date:
12/16/2006
Primary Class:
Other Classes:
482/49
International Classes:
A63B23/16; A63B23/14
View Patent Images:
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Primary Examiner:
DONNELLY, JEROME W
Attorney, Agent or Firm:
Thomas Brassil (San Diego, CA, US)
Claims:
What is claimed is:

1. An therapy system comprising: a product worn by a person, said product including a compressible substance affixed thereto, said compressible substance being located proximate to a joint of said person, said compressible substance providing resistance against flexion of said joint, during the active flexion movements of said person, wherein said compressible substance may be squeezed between bones brought together during the flexion of said joint, wherein massaging the body tissues between said compressible substance and the converging bones; and stretchable fabric, said fabric having elastic properties, wherein said fabric is attached to the product, and extending outwardly therefrom, and spanning to the compressible substance, and coupled thereto, said fabric providing resistance against extension of said joint, during the active extension movements of said person, wherein said fabric, when stretched between bones brought farther apart during the extension of said joint, may urge said product to press against said person, wherein massaging the body tissues under the pressure; and attachment means, whereby said compressible substance and said fabric may be affixed to said product.

2. The system of claim 1 further comprising means for monitoring said therapy.

3. The system of claim 1 further comprising means for controlling said therapy.

4. The system of claim 1 wherein said product further comprises means for regulating pressure, wherein a therapeutic gas, fluid, gel, or ingredient may enter, exit, be retained, be extracted, be flow-regulated, or be flow-restricted.

5. The system of claim 1 wherein said product contains one or more therapeutic ingredients, such as a medication, supplement, gene, transdermal or transcellular carrier agent.

6. The system of claim 5 further comprising means for monitoring said therapy.

7. The system of claim 5 further comprising means for controlling the delivery of said therapy.

8. A therapy system comprising: an exercise device worn on an extremity of a person comprising: a resilient compressible substance positioned in close proximity to a joint of said extremity, said compressible substance providing resistance against flexion of said joint, wherein said compressible substance is squeezed between the extremity portions that converge during the active flexion movements of said person; and at least one base fabric portion for engaging one or more portions of said extremity; and one or more elastic fabric portions, said elastic fabric coupled to said compressible substance and extending outwardly therefrom, and spanning to one or more of said base fabric portions, and attached thereto, said elastic fabric providing resistance against the extension of said joint, during the active extension movements of said person; and attachment means, whereby the base fabric may be affixed to the elastic fabric.

9. The system of claim 8 further comprising a circuitry module linked thereto, said circuitry module including means for providing a signal proportional to a performance parameter.

10. The system of claim 8 further comprising display means, for displaying performance information, whereby facilitating the communication of performance information to a person monitoring the performance.

11. The system of claim 8 further comprising means for communicating with a processing system, whereby said processing system may determine performance information.

12. The system of claim 11 further comprising networking means, wherein said performance information adapted to being communicated, processed, stored, or displayed over a network.

13. The device of claim 8 further comprising a gas, fluid, gel, or therapeutic ingredient contained therein.

14. The system of claim 13 further comprising pressure regulating means connected thereto.

15. The system of claim 13 further comprising means for monitoring said therapy.

16. The system of claim 15 further comprising means for controlling said therapy.

17. The device of claim 15 further comprising means for storing therapy information.

18. The device of claim 15 further comprising means for communicating therapy information.

19. A monitoring system for monitoring one or more therapy systems, said monitoring system comprising: means for collecting therapy information from said therapy system; and means for determining performance information from said therapy system information, wherein a provider determines a customized recommendation based on said performance information.

20. The monitoring system of claim 20 wherein said customized recommendation further comprises a therapy product recommendation.

21. The monitoring system of claim 20 wherein said customized recommendation further comprises a customized incentive recommendation.

Description:

This is a Continuation-in-Part of U.S. patent application Ser. No. 10/212,485, entitled HAND REHABILITATION GLOVE, of Brassil, et al., filed Aug. 8, 2002 (which is currently pending and will be abandoned), which is a Divisional of U.S. patent application Ser. No. 09/475,793, entitled HAND REHABILITATION GLOVE, of Brassil, et al., filed Dec. 30, 1999, (which issued as U.S. Pat. No. 6,454,681) which is a Continuation-in-Part of U.S. patent application Ser. No. 09/197,035, entitled HAND REHABILITATION GLOVE, of Brassil, filed Nov. 29, 1998, which claims priority from U.S. Provisional Application 60/070,380, entitled HAND REHABILITATION GLOVE, of Brassil, filed Jan. 5, 1998, all of which are incorporated, in their entireties, herein by reference.

BACKGROUND OF THE INVENTION

The present invention relates to therapy systems. As the baby boomers age, healthcare providers and financing providers, such as Medicare and private insurers, will be stressed by high demand, relative to supply. Insurance is well known in the art, with managed care strategies that include insurers in medical decisions, but healthcare costs have grown to 16% of GDP, with projections for 20% by 2015. Nationalized solutions result in rationing, waiting lines, and overcrowding. Supply-centered solutions would offer more doctors, nurses, and clinics, but a massive expansion could impact the quality of care, disrupt established providers, and discourage investors. Taxes can be raised to cover spending, but estimates show Medicare's total unfunded liability to be over $70 trillion. There is an unmet need for systems that will help the Medicare trustees grow and preserve the fund. Post-process audits and investigations for misbehaving members, are well known in the art. But, there is an unmet need for feedback early in the process to help the trustees find members of the Medicare system who promote safety and savings; to calculate and offer them early incentives. This system automatically generates feedback useful for determining early incentives.

Arthritis is the nation's leading cause of disability, with estimates showing that one in five adults in the nation are affected by arthritis. The limited supply of providers helping arthritis patients will be stressed by increasing demand as the baby boomers age. This system offers savings, balanced neuromuscular development, massage, controlled delivery of medication, and feedback, from the comfort of the patient's home.

SUMMARY

Disclosed is an exercise and therapy system. It provides resistance exercise, massage, and medication. It provides means for monitoring, delivering, and controlling therapy. It generates therapy information that is useful for patients and providers.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects, features and advantages of the present invention will be more apparent from the following more particular description, along with the following drawings wherein:

FIG. 1 is a view of an exercise and therapy device in accordance with one embodiment of the present invention;

FIG. 2 is a view of an embodiment delivering medication;

FIG. 3 is a view of an embodiment delivering pressurized medication;

FIG. 4 is a view of an embodiment with an encapsulant or pocket;

FIG. 5 is a view of an embodiment with an array of electrodes;

FIG. 6 is a view of an embodiment which includes monitoring means;

FIG. 7A is a view of another embodiment of the device of FIG. 6 including multiple chambers within the compressible substance;

FIG. 7B is a view of another embodiment of the device of FIG. 7A wherein the multiple chambers of the compressible substance are separated by walls;

FIG. 8 is a view of the embodiment of the device of FIG. 7A and including a displacement transducer module of the embodiment of FIG. 6;

FIGS. 9A and 9B are views of the device of FIG. 6 illustrating the displacement transducer module and line configurations;

FIG. 10 is a block diagram of one embodiment of the therapy system.

FIG. 11 is a functional block diagram of an embodiment of a therapy system.

FIG. 12 a view of an embodiment of the compressor/pressure transducer module.

FIG. 13 is a flow chart illustrating the steps for generating information for facilitating therapy.

FIG. 14 is a view an embodiment of means for monitoring the therapy.

FIG. 15 is a view of an embodiment of a display for monitoring the therapy.

FIG. 16 is a view of an embodiment of a display for monitoring the therapy.

Corresponding reference characters indicate corresponding components throughout the several views of the drawings.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The following description of the presently contemplated best mode of practicing the invention is not to be read in a limiting sense, but is made merely for the purpose of describing the general principles of the invention.

Referring now in detail to the drawings, in which like numerals indicate corresponding parts throughout the several views, FIG. 1 illustrates a therapy device embodied preferably as a glove 1. Included are a compressible substance 3, a proximate (to the compressible substance) portion 4, finger portions 5, a distal (to the compressible substance) portion 6, and elastic members 2. Each elastic member 2 spans or extends from glove 1 to the compressible substance 3. The compressible substance 3 provides resistance during flexion, and the elastic members 2 provide resistance during extension. Each elastic member 2 is coupled to the compressible substance 3 and then spans to, and attaches to, the glove 1. In another embodiment, the elastic members may be attached to the proximate portion 4, through “slits” 13 formed in the compressible substance 3 which the elastic members 2 pass through and then span to and attach to the distal portion 6. Such slits 13 run through the compressible substance 3. In FIG. 1, the dashed line 14 represents an elastic member 2 extended through the compressible substance 3 and attached to the proximate portion 4 directly. Note that only one of the slits 13 is shown, although multiple elastic members 2 could extend through slits in the compressible substance 3. The elastic members 2 may be attached along an edge 8 of the glove 1, between the proximate portion 4 and the distal portion 6. Additionally, the subject matter described herein is related to Canadien Patent Application Serial No. 2,282,072, entitled HAND REHABILITATION GLOVE, of Brassil, filed Sep. 10, 1999, which is incorporated herein by reference. It is to be appreciated that a skilled artist could easily alter or modify a preferred embodiment without departing from the spirit of the invention.

Referring next to FIG. 2, a medication delivery device, preferably a disposable glove, is shown with a cutaway window view. The medication delivery device 202 includes an inner surface 210 and an outer surface 208. The interior surface 210 of the medication delivery device 202 is coated with medication 212. The system provides a massaging effect that will enhance medication 212 absorption into the skin. During extension, the elastic members 2, pull the medication delivery device 202 closer to the wearer's skin, whereby massaging the medication 212 pressed between the medication delivery device 202, and the wearer's skin. During flexion, the compressible substance 3, pushes the medication delivery device 202 closer to the wearer's skin, whereby massaging the medication 212 pressed between the medication delivery device 202, and the wearer's skin. Medications or supplements with transdermal or transcellular carriers may be used to synergistically enhance therapy. Examples of such medications or supplements are glucosomine and chrondroitin sulfate, which have been found to be helpful in treating osteoarthritis, and are described in pages 29-52 of “The Arthritis Cure” by Theodosakis, Adderly and Fox, 1997, which is incorporated herein by reference. Research studies have shown that glucosomine and chrondroitin are safe and effective, but only a limited percentage is delivered to the target site when ingested orally. These medications 212 may also include carriers or penetration enhancing agents, such as those shown in U.S. Pat. No. 4,362,737, issued Dec. 7, 1982 to Schafer, and U.S. Pat. No. 4,405,616 issued Sep. 20, 1983 to Rajadhyaksha, both of which are incorporated herein by reference. Thus, the system provides exercise, massage, and controlled delivery of medication 212 to the target site, which can be controlled for example, by the number of extension and flexion repetitions. Since the system delivers medication directly to the target site, the patient doesn't need to purchase as much medication as would be required for an oral medication to reach the same concentration at the target site. The system can help patients and providers avoid the safety risks of uncontrollable oral medications, which travel through the digestive system, mix with foods, drinks, and other medications; filter into the circulatory system, and affect many other off-target sites throughout the body. The safety hazards to off-target body sites are well known in the art, and are often admitted to within or on the medication package, so the foreknown safety risks and resulting costs (including the costs of legal service providers) must be calculated by malpractice, business, and health financing provider underwriters, if the financing provider entity is going to attract and retain investors, which leads to a multiplier effect increasing the cost of care. If uncontrollable oral medication must be used, the system may still be able to help draw medication to the target site, because resistance exercise, tissue massage, and leeching (see FIG. 5) can enhance circulation at the target site. The system also offers advantages in the way that medication 212 is dispensed. For examnple, medication dispensed as a bottle of 100 uncontrollable pills, allows many more unsafe permutations than a single disposable device 202, coated with site-specific medication 212. Medication 214 may also be formed within the body of the medication delivery device 202, especially if the medication delivery device 202 is formed with a sponge-like material. The inner surface 210 and body of the medication delivery device 202 could be formed with a sponge-like material, while the outer surface 214 could be formed with a less porous material. Advantageously, the medication delivery device 202 operating under repetitious compression from the compressible substance 3 and tension from the elastic members 2, dispenses and delivers medication 214, to the target site.

Referring next to FIG. 3, a medication delivery device, preferably a glove, is shown with a cutaway window view. The medication delivery device 302 includes an inner surface 310 and an outer surface 308. In one embodiment, the inner surface 310 may contain a medication 312. In another embodiment, a canister 314 provides medication under pressure, through a connecting tube 316. The canister 314 may be pressurized, or may be connected to a compressor/pressure transducer module (see FIG. 12). These techniques and equipment for accomplishing the techniques are described, for example, in U.S. Pat. No. 5,688,233, issued Nov. 18, 1997 to Hofmann, et al. entitled “ELECTROINCORPORATION ENHANCED TRANSDERMAL DELIVERY OF MOLECULES”; which is incorporated herein by reference. Advantageously, the system delivers pressurized medication directly to the target site. For example, the known safety risks of ear or lung damage from a whole-body hyperbaric oxygen chamber could be avoided by pumping concentrated oxygen directly to the target site. By reversing the pressure, a leeching effect can be useful for removing waste, enhancing circulation, or reducing swelling. The vacuumed effluent can be retained in a canister 314, and analyzed by researchers. Such research and equipment for conducting the research are commercially available from Finnegan Corporation of San Jose, Calif. which provides mass spectrometer technology capable of identifying the exact molecular or particulate breakdown of the contents of the canister 314. So, one group of patients could ingest an oral medication, and another group could use the medication delivery device 302 to deliver a similar medication directly to the target site. After a predetermined time period, a fresh disposable device 302, operating in vacuum mode, provides effluent from the target site which can be retained in a canister 314, providing researchers with evidence useful for comparing concentration levels of medications or other markers at the target site. Such feedback can be useful for advising patients and providers who need to compare the safety, cost, control, and effectiveness of medications and their delivery systems. Such information is especially useful for financing providers, as input into automated risk scoring and underwriting systems, for determining early incentives.

Referring next to FIG. 4, a sectional view of a glove embodiment 402 is shown. This embodiment provides an encapsulant 404 or pocket, within which the compressible substance 3 is positioned. Additionally, the encapsulant 404 could have a cover flap 406 that folds or seals over the compressible substance 3. The compressible substance 3 under pressure from flexion exercise, may force the cover flap 406 to become separated or unsealed from the glove 402, thus dispensing and delivering medication 408 under pressure emanating from the deflating compressible substance 3.

Referring next to FIG. 5, an exploded view of a glove embodiment 502 with an array of electrodes 506 is shown. Electrodes 506 for providing a low level pulsed electric field, are coupled to the interior surface 504 of the glove 502. The pulsed electric field delivers materials, such as medication 508 and supplements, through the skin; to the target site. The electrodes 506 are connected to the signal generator 515 (see FIG. 10) by a cable 512. A fluid medium carrying molecules or medication may be supplied from the fluid medium source 514, which is coupled to the glove 502 by a tube 510 which may include a pump (see FIGS. 10 and 12). Such techniques are known in the art and are referred to as “electroporation” or “electroincorporation”. These techniques and equipment for accomplishing the techniques are described in U.S. Pat. No. 5,688,233, issued Nov. 18, 1997 to Hofmann, et al. entitled “ELECTROINCORPORATION ENHANCED TRANSDERMAL DELIVERY OF MOLECULES”; which is incorporated herein by reference. The pneumatics/fluidics, sensors, and controller modules provide monitoring and control of the pressure and electrical pulses (explained below). Thus, the system provides means for delivering medication, including means for monitoring and controlling its delivery. Operating in reverse or vacuum mode, the system provides means for controlling the reduction of swelling or removing medication, with electroporation and transdermal or transcellular carrier means.

FIG. 6 illustrates an embodiment providing means for monitoring therapy. Shown is a monitored therapy system device 600, embodied as a glove 602, with a proximate portion 604, finger portions 606, distal portion 608, fingernail portion 610, wrist portion 612, a compressible substance 614 that has a chamber 616 located within the compressible substance 614, a displacement transducer module 618, a compressor/pressure transducer module 620, a thermal transducer 622, lines 624, line guides 626, anchor 628, fill tube 630, output means 632, and a computer interface 634. This embodiment offers transducers to determine estimates of performance, such as force exerted on the compressible substance 614 (using the compressor/pressure transducer module 620), range of motion (using the displacement transducer module 618), heat generated (using the thermal transducer 622), number of repetitions, or velocity. It features a transducer module 618, with lines 624 extending therefrom. The lines are guided through line guides 626 and are anchored at the anchor 628, which is located distally at the fingernail portion 610. Force is monitored by a compressor/pressure transducer module 620 affixed at the inside wrist portion 612. The fill tube 630 extends from the compressor/pressure transducer module 620 and into the compressible substance 614 to the chamber 616 within the compressible substance 614. In other embodiments, modules may be swapped out or relocated. For example, the fill tube may be coupled directly to the glove 602 (see FIGS. 3 and 5). The elastic members (not shown) are also present. Furthermore, the displacement transducer module 618 and the compressor/pressure transducer module 620 link to a computer. This embodiment illustrates an output means 632 connected to a computer interface 634 as means for linking to a computer or controller, as part of a monitored therapy system.

In operation, the monitored therapy system, quantifies motion, force, work done, as well as the number and speed of repetitions performed. In this embodiment, the compressible substance 614 has a chamber 616 inside which is used to for measuring pressure resulting from the force as applied onto the compressible substance 614. The chamber 616 is filled with air, a gas, a fluid or a gel through the fill tube 630 that extends from the compressor/pressure transducer module 620 into the compressible substance 614. The compressor/pressure transducer module 620 is typically controlled by a separate controller. Thus, when pressure is applied to the compressible substance 614, a portion of the content within the chamber 616 is forced out through the fill tube 630 into the compressor/pressure transducer module 620. The pressure transducer portion of the compressor/transducer module 620 translates this push of gas, fluid, or gel into a signal proportional to or representing the pressure or force applied against the compressible substance 614. This signal is output using output means 632. Valves may be used at the entry of the fill tube 630 into the chamber 616 to help establish the required pressure level within the chamber 616.

The compressor portion of the compressor/pressure transducer module 620 is a pneumatic or fluidic component, which uses a compressor or pump. This compressor is a miniature mechanical compressor, such as those commercially available from Gast located in Benton Harbor, Mich. or Medo USA of Hanover Park, Ill. or Sensidyne of Clearwater, Fla., and are used to inflate the compressible substance to a therapeutic pressure. The compressor may be a part of the compressor/pressure transducer module 620 as shown or may be a separate unit that is worn on the body of the patient (e.g. on the patient's belt) or placed nearby the patient and attached to the compressible substance 614 via a tube. The timing and rate at which the compressor inflates or pressurizes the chamber 616 within the compressible substance 614 maybe set by a separate controller. Alternatively, a squeezable ball, such as used in blood pressure cuffs, may be used to for inflation, or a miniature tank of compressed gas. Furthermore, valves may be used in addition to the compressor. For example, micro solenoid valves like those used in inkjet printers or pinch valves like those used in pneumatic systems can be used to control the air or fluid flowing in and out of the chamber 616 of the compressible substance 614. Such valves could be open or shut, or pulsed, working in concert with the compressor or pump to control the pressure in the chamber 616 (or chambers) and the rate at which they are inflated or filled. These valves are readily available, such as commercially available from Lee Company of Westbrook, Conn. or SMC, located in Indianapolis, Ind.

The pressure transducer portion of the compressor/pressure transducer module 620 is a transducer that produces a signal proportional to the pressure applied to its port, which is proportional to or represents the pressure or force applied by the patient. Typically, the port of the pressure transducer is positioned at the end of the fill tube 630 within the compressor/pressure transducer module 620 so that the gas or fluid that is forced from the chamber 616 of the compressible substance 614. In response to the pressure against the port of the pressure transducer, the pressure transducer outputs a signal that is proportional to or represents the pressure inside the chamber 616. Such pressure transducers are well known in the art and are commercially available from Honeywell located in Minnesota. In this embodiment, the compressor/pressure transducer module 620 uses output means 632 that is linked to the computer interface 634, which in turn may be linked to a controller of a therapy system. Medication (not shown) may be contained in various locations throughout the system.

The displacement transducer module 618 provides the means for measuring motion or the distance traveled during extension and flexion. One embodiment of a displacement transducer module 618 is a rotary encoder system. Within the displacement transducer module 618, a shaft of the rotary encoder is coupled to a spool or roller carrying the line 624. Ideally, the spool or roller is spring loaded so that the line 624 is pulled tight from the anchor 628 to the spool of the displacement transducer module 618. The distal end of the lines 624 are attached to an anchor 628. The lines 624 pass through respective line guides 626. Alternatively, the lines 624 may pass through a flexible protective tubing so as to protect the lines during use.

In use, during flexion, the lines 624 are drawn from the spool causing the rotary encoder to transmit electrical pulses whose number is in proportion to the flexing and movement. The stiffness of the line 624 returning through the line guides 626, or a light-force spring return mechanism in the spool or roller would return the line 624 back onto the spool or across the roller during extension, providing extension and flexion displacement data. Thus, the rotary encoder can determine the magnitude of the movement, so that a complete range of movement while opening and closing the hand may be modeled. The displacement transducer module 618 will output a signal over output means 632 to the computer interface 634 that is proportional to or represents the displacement.

Alternative means for monitoring displacement include the use of strain gauge transducers. These sensors produce an electrical signal in proportion to motion. They work on a variety principles: piezo electric, electro mechanical (like a condenser microphone), accelerometer, goniometer, and variable resistance strain gauge. These transducers, and their detector circuits, are readily available in scientific materials catalogs like Cole Parmer, located in Vernon Hills, Ill. Other examples of monitoring means and wearing means, are shown in U.S. Pat. No. 5,280,265 issued Jan. 18, 1994 to Kramer, et al., entitled “STRAIN SENSING GONIOMETERS, SYSTEMS AND RECOGNITION ALGORITHMS”; in U.S. Pat. No. 4,414,537, issued Nov. 8, 1983 to Grimes entitled “DIGITAL DATA ENTRY GLOVE INTERFACE DEVICE”; and in U.S. Pat. No. 4,542,291, issued Sep. 17, 1995 to Zimmerman entitled “OPTICAL FLEX SENSOR”, all of which are incorporated herein by reference. The preferred means for monitoring motion are not meant to be limiting, as those skilled in the art can modify a preferred embodiment without departing from the scope or spirit of the invention.

Additionally, a thermal transducer 622 is positioned within the monitored therapy system device 600. The thermal sensor, measures the temperature change during exercise, providing a calorimetric estimate of work. This feedback can be used as simple and expensive way to measure the progress, and enhance a patient's therapy.

Thus, monitoring means can provide outputs that represent force, temperature, and motion during exercise. These output signals may also be used to determine the number and speed of repetitions. Additionally, the system includes means for linking to a computer system that may be used to display and store the measurements and/or control the pressure within the chamber 616 of the compressible substance 614. A therapy provider can monitor the results of therapy sessions, and use the performance feedback to make recommendations for enhancing the therapy.

Referring next to FIG. 7A, another glove embodiment is shown including multiple chambers within the compressible substance. Shown are a monitored therapy system device 700 a proximate portion 702, wrist portion 708, finger portions 704 and distal portion 706, the compressor/pressure transducer module 710, the compressible substance 712 including chambers 714 and fill tubes 716 extending through a main fill tube 718. Also shown are the elastic members 720. This embodiment provides a chamber within the compressible substance 712 that is divided into separate chambers 714. Similarly, instead of one fill tube, there is a separate fill tube 716 for each of the chambers 714. Each fill tube 716 extends through the compressible substance 712 into the compressor/pressure transducer module 710 via a main fill tube 718. Furthermore, the compressor/pressure transducer module 710 actually contains separate pressure transducers one for each chamber 714. The patient or therapist may adjust the pressure within each of the respective chambers 714. By adjusting the pressure, the delivery of medication (not shown), and extraction of waste, can be controlled.

Referring next to FIG. 7B, is a view of another embodiment wherein multiple chambers of the compressible substance are separated by walls 715. This embodiment includes walls 715 that separate the chambers 714 within the compressible substance 712. As can be seen, walls 715 are molded in between the individual chambers 714 of the compressible substance 712. Such walls 715 are slightly more rigid than the remaining material of the compressible substance 712 so that pressure applied to one chamber 714 will not in effect apply pressure to an adjacent chamber. Therefore, the majority of the pressure will be channeled such that the fluids within the individual chambers 714 will be forced out of the chamber 714 into the fill tubes 716, and not expand sideways into adjacent chambers. The walls 715 should not be so rigid that they do not allow the compressible substance to adequately be compressed or squeezed. These walls 715 may be molded as described above while the compressible substance 712 is being formed. Alternatively, the walls 715 could be made to be rigid; thus, these rigid walls would almost completely eliminate pressure from an adjacent chamber from having an effect on a given chamber's pressure reading. As another alternative, the walls themselves may be the elastic members 720 that extend through slits in the compressible substance 712. These slits and elastic members are described with reference to FIG. 1. Thus, the elastic members 720 would extend through the compressible substance 712 and attach to the proximate portion of the glove, while at the same time forming walls between chambers 714 of the compressible substance 712.

Referring next to FIG. 8, is a monitored therapy system device including a displacement transducer module. Shown is a monitored therapy system device 800 embodied as a glove having a back portion 802, a proximate portion, distal portion 804, fingernail area 806, and wrist area 808. Also shown are the compressible substance 810 including multiple chambers 812, and fill tubes 814 within a main fill tube 816, the compressor/pressure transducer module 820, displacement transducer module 822, lines 824, line guides 826, anchor 828, and the elastic members 830. The individual chambers 812 within the compressible substance are better illustrated including their positioning within the compressible substance in FIG. 8. The fluid within each chamber 812 is forced through a respective fill tube 814 to a respective pressure transducer within the compressor/pressure transducer module 820 via the main fill tube 816. It is also noted that the compressor may not be within the compressor/pressure transducer module 820, but may be located elsewhere on the body of the patient or located proximate to the patient. Also, the entire compressor pressure transducer module 820 could be located separately and attached by the fill tube 816. Thus, the compressor is coupled to the fill tubes 814 through the pressure transducer. For example, the compressor and the pressure transducer are both coupled to the fill tubes, but a valve or similar functioning device can cut off the compressor from the fill tube when desired. Furthermore, there are multiple pressure transducers as a part of the compressor/pressure transducer module 820. Medication (not shown) may be positioned in various locations within the system. Medication could be contained and pressurized in one chamber 812, while waste or effluent could be vacuumed into and captured in another chamber.

Referring next to FIGS. 9A and 9B, two different embodiments are shown for the displacement transducer modules and the structures used to measure the displacement. Shown is a monitored therapy system device 900 embodied as a glove including the back portion 902, finger portion 904, fingernail portion 906, lines 908, line guides 910, anchors 912, and displacement transducer modules 914, 914′ and 915 are output means 916. As shown and also as described above, the lines 908 are a low stretch, monofilament or wound thread that extends from the displacement transducer module 914 to the anchor 912 at the distal portion 906. The lines 908 are threaded or fed through line guides 910 that have holes therein or a channel formed at the exterior surface (alternatively, the line guides 910 may be flexible hollow tubes). The lines 908 are wound onto a spring loaded spool or a spring tensioned roller such that the lines 908 are held relatively tightly from the anchor 912 at the distal end of the displacement measuring system and the displacement transducer. The displacement transducer module 914 shown in FIG. 9A contains multiple displacement transducers and a single output 916 which includes a computer interface (not shown). The displacement transducer module shown in FIG. 9B is broken into two separate modules, first displacement transducer module 914′ and second displacement transducer module 915. Again, output means 916 is shown, which is linked to a computer interface.

Referring next to FIG. 10, is a block diagram of the monitored therapy system 1000. This embodiment of the monitored therapy system 1000 includes the therapy device 1010, patient 1020, sensing/communicating/controlling equipment (“SCCE”) 1030, service provider 1040, product provider 1050, financing provider 1060, and communications provider 1070. The financing provider 1060 includes Medicare 1062 but other embodiments could include various financing providers 1060 such as banks, lenders, or insurance entities such as health, malpractice, business, medicaid, disability, workers compensation, long term care, etc., which are well known in the art. The financing provider 1060 provides capital for the purchase of products or services that a member, usually a patient 1020, service provider 1040, or product provider 1050, cannot afford to, chooses no to, or is otherwise unable to, afford outright. Occasionally, financing providers 1060 such as malpractice or business insurance firms, provide capital to settle disputes between members. The financing provider 1060 has the functions of attracting members, protecting and growing their fund, determining and minimizing waste, safety risks, and health risks (which will deplete the fund), and providing capital. The sensing/communicating/controlling equipment (“SCCE”) 1030 include a control panel 1037, feedback controller 1036, and transducers 1031. The control panel 1037 includes a keyboard 1038 and display 1039. The transducers include motion 1032, force 1033, sound 1034, and temperature 1035. The therapy device 1010 includes an encapsulant 1011, compressible substance 1012, pneumatics/fluidics 1014, elastic members 1016, medication 1017, electrodes 1018, and preferably, a glove 1019. The service provider 1040 includes diagnostics 1041, therapy 1042, and advice 1043. Advice providers 1043 includes training 1044, research 1045, and advertising 1046. The product provider 1050 includes pharmaceutical 1052 and equipment 1054. The communications provider 1070 includes well known means for computing and communicating throughout the system, allowing data processing and storage to occur at various points. The monitored therapy system 1000 automatically provides information that is useful for determining members' needs, helping providers meet members' needs in a targeted manner. For example, the advertising provider 1046 can provide targeted ads (not shown) promoting product providers 1050, or service providers 1040 to specific patients 1020 (or other provider members) based on automatically generated target-specific information, such as a diagnosis code, thereby avoiding the cost of expensive off-target broadcast ads. Lower advertising costs can generate a multiplier effect; decreasing prices throughout the system 1000; not just for the patients 1020, but also for providers. Advertising expenditure information is readily available from SEC filing, prospectus, annual report, and investor relations documents. Thus, the system 1000, offers patients 1020 and financing providers 1060 such as Medicare 1062, information that is useful for limiting spending on unsafe or unrelated items, for example for passthroughs that aren't healthcare, such as broadcast advertising. Furthermore, targeted advice 1043, such as needs based training 1044, related research 1045, and personalized advertising 1046, based on information provided by the system 1000, is a reasonable way to spend Medicare 1062 funds on passthroughs, if that advice 1043 meets specific healthcare needs. The system 1000 includes incentives (not shown) that financing providers 1060 can award to service providers 1040, product providers 1050, and patients 1020 who, for example, promote safety, or minimize unnecessary passthrough spending.

The patient 1020 interacts with a therapy device 1010, that provides flexion resistance exercise, extension resistance, exercise, massage, medication, and medication delivery control. The electrodes 1018 receive signals from the SCCE 1030 that control the transdermal delivery of medication 1017. The pneumatics/fluidics module 1014 may also receive signals from the SCCE 1030 that control pressure to inflate or deflate the compressible substance 1012, or deliver or remove medication 1017. In operation, the monitored therapy system 1000 provides means for measuring the motion, force and work done by the patient. Furthermore, it provides a means for controlling, the pressure resistance of the compressible substance 1012, and the delivery of medication 1017 automatically, so that therapy parameters can be set, monitored, and maintained automatically by the patient's 1020 or therapy provider's 1042 interaction with the SCCE 1030.

In this embodiment, both the patient 1020 and the therapy provider 1042 are operators of the SCCE 1030. In other embodiments, it may be advantageous for a training provider 1044, equipment provider 1054, or pharmaceutical provider 1052 to interact directly or remotely with the SCCE 1030 to help novice users. Both the patient 1020 and the therapy provider 1042 can set the therapy parameters such as resistance pressure, or range of motion goals, and will review the therapy outcomes such as joint movement, pressure or force applied, or work done. Over time, the therapy provider 1042 will adjust the therapy parameters to reflect the best plan of treatment. The therapy provider 1042 may interact remotely through the SCCE 1030 to control the therapy device 1010, or by making recommendations to the patient 1020 regarding adjustments.

A computer (not shown) could be physically integrated with the SCCE 1030, located in its vicinity, or connected via a network link. It provides a way for the therapy provider 1042 to adjust parameters and review treatment, locally and remotely. It stores and organizes therapy parameters and outcomes in a database for archival and ready access. It also converts outcomes data into a graphical charts displayable on a computer terminal and printable on paper that ease the interpretation of the outcomes data and help the providers make better recommendations. The SCCE 1030 might be a standalone unit, located near the patient 1020, or it might be a miniature battery operated controller that is integrated, for example as an attachment to the therapy device 1010. The SCCE 1030 receives and generates signals to and from various sources throughout the system 1000, and contains the algorithms necessary to translate the signals from the various transducers 1031 into the respective estimations of actual displacement, temperature and force or pressure applied. Such algorithms for translating these conventional signals supplied by conventional transducers are well known in the art; thus, no further explanation is required. The SCCE 1030 is also able to determine the number of repetitions and speed of repetitions, for example, by comparing the direction of the displacement signals received and when the signals “change direction” (indicating a change from extension to flexion, for example) to a timer or clock. The SCCE 1030 also sends control signals to the compressor to set the resistance. The SCCE 1030 translates the signals from the transducers 1031, and maintains communications between the therapy device 1010, and its users. It could contain a custom computer, such as a microcomputer or personal digital assistant, or a common personal computer running commercially available software, such as National Instruments' Labview. The control panel 1037 consists of knobs, buttons and displays 1039 that allow the user to set therapy parameters and review therapy outcomes. These knobs, buttons and displays are electronically connected to the SCCE's 1030 embedded computer. The control panel 1037 may be configured so that the patient 1020 or therapy provider 1042 can: set the initial and final pressure resistance level of the compressible substance 1012; set a repetitions counter or therapy timer; set limits and alarms for excess pressure or other abnormal conditions; set control parameters such as PID (proportional, integral, derivative) constants; store parameters for future use; and control the power for the SCCE 1030. Additionally, the control panel 1037 may provide a display 1039 indicating real time indications of pressure, displacement, and work, as well as graphical displays of such measurements. Additionally, the therapy settings may be shown. Such displays may be displayed on a corresponding computer or on a screen or display 1039 of the SCCE 1030 itself depending on the embodiment. The knobs, buttons and displays comprising the control panel 1037 are commercially available from many sources as discrete components or integrated into control panel assemblies. Displays are widely available in the following forms: LED alphanumeric displays, LCD alphanumeric and graphic displays, electro luminescent and plasma displays, and cathode ray tubes.

The SCCE 1030 allows the pressure resistance to be adjusted automatically in dynamic response to predetermined pressure profiles and sequences, existing pressure in the chamber/s of the compressible substance 1012, motion, and the work being done. The feedback control 1036 is a function performed by the SCCE's embedded computer. It receives the real-time pressure, displacement, and work measurements, then uses readily available algorithms, such as PID (proportional, integral, derivative) control to send the proper signals to adjust the valve settings and the compressor (within the pneumatics/fluidics module 1014), to maintain the pressure resistance within the chamber/s of the therapy device 1010 according to the therapy provider's 1042 or patient's 1020 settings. The feedback controller 1036 contains therapy data storage circuits, parameter storage circuits, and a real time clock that permit it to operate autonomously.

The SCCE 1030 communicates with the therapy device 1010. It outputs signals to the pneumatic/fluidic module 1014, to control the amount of pressure that the chambers are inflated to, and to the electrodes 1018, to control the delivery of medication 1017. These output signals might be pulsed waveforms intended to switch the compressor and valves on and off, or to induce electroporation, or they may be analog voltage signals intended to set the compressor speed. The SCCE 1030 also receives signals from the transducers 1031, e.g. pressure transducer, displacement transducers and thermal transducer. These received signals might be pulsed waveforms, or analog voltage levels as output from the respective types of transducers 1031.

Additionally, the SCCE 1030 may perform communications via the communications provider 1070, typically with a therapy provider 1042. Thus, the therapy provider 1042 may be located at another location than the patient 1020. Advantageously, the patient 1020 may operate the monitored therapy system 1000 at home and be simultaneously monitored by the therapy provider 1042. Thus, a service provider 1040 can send signals to the SCCE 1030 via the communications provider 1070 to control or set the parameters of the patient's 1020 session in accordance with a therapy plan, or in response to the measurements. Advantageously, the providers can see the results of the session and provide diagnostics, advice, or make therapeutic changes to further enhance the therapy, from a remote location. Furthermore, a provider computer (in addition to or instead of the SCCE 1030) may also be capable of translating the signals output from the transducers into the appropriate measurements of displacement, work, pressure or force, and the number and speed of repetitions. Advantageously, the monitored therapy system provides a system that other members, such as advice providers 1043 or financing providers 1060 could connect to and interact with. Thus, a financing provider 1060 can monitor, or verify that therapy session data was stored (and can be later retrieved), to facilitate the immediate transfer of funds to the service provider's 1040 account (not shown). Monitoring and storage and systems are well known and commercially available from Nice Systems, Motorola, Diebold, or Logitech. Storage, search, and retrieval systems for complex databases are commercially available from Teradata or TRW. Knowing that the therapy session has been electronically stored, a financing provider 1060 can recommend immediate incentives (not shown) such as discounts to encourage members who reduce facility and transportation costs by participating in remotely monitored therapy. Such stored session information is also useful as unambiguous evidence that can help reduce costs for legal services, and help amicably settle disputes.

The SCCE 1030 will comprise many different circuits including: pulse width modulation circuits that will generate a pulsatile waveform to control medication delivery and pressure, digital to analog circuits to create a variable voltage level to adjust the compressor speed; driver circuits to convert the outputs from the pulse width modulator and the digital to analog circuit into the proper voltage and current to supply the valves and the compressor; transceiver circuits to convert the pulsed waveform from the displacement transducers into a computer readable form; analog to digital circuits to convert the signals from the displacement transducers, temperature sensors, and pressure transducers into computer readable form; and also data communication circuits such as a modem, Ethernet transceiver, USB transceiver, infrared or RF transceivers, or a simple serial interface to allow connection to the computer (e.g. the therapist's computer if it is located nearby). These circuits are commercially available as add-on-boards for personal computers through companies like National Instruments located in Austin, Tex. They are also readily constructed from available components from electronics components made by manufacturers like Texas Instruments (located in Dallas, Tex.) and National Semiconductor (located in Santa Clara, Calif.), available through distributors and catalog sources like DigiKey and Newark Electronics. The circuits themselves are well-understood and are described in readily available reference books.

The pneumatics/fluidics module 1014 receives signals from the SCCE 1030, either generated by the therapy provider 1042 or the patient 1020, to regulate the air or fluids going into and out of the compressible substance 1012. Thus, the SCCE 1030 sends the appropriate signals to make sure the pressure within the compressible substance is as desired. Again, as described above, the pneumatics/fluidics module may comprise an electronically controlled compressor (or pump) and/or valves. The compressible substance 1012 is also as described above and includes a flexible enclosure containing one or more chambers within the compressible substance 1012. The compressor and/or valves (of the pneumatics/fluidics module 1036) would be connected to the fill tubes leading to each chamber, to establish air or fluid pressure in each chamber and to regulate the flow in and out of each chamber. The transducers 1031, provide the measurements in the form of signals so that determinations of motion, force while squeezing the compressible substance, a calorimetric estimate of the work done can be obtained by the SCCE 1030, along with the number and speed of repetitions.

The patient 1020 wears the therapy device 1010 and interacts with the compressible substance 1012 and elastic members 1016. The system may include medication 1017 and electrodes 1018 on the interior surface of the glove 1019. The electrodes 1018 are linked to the SCCE 1030 to monitor and control the transdermal delivery of the medication 1017. Precise estimates of drug absorption can be transmitted and displayed for the patient 1020 on the display 1039, or for a provider. If analysis of variables such as duration, number of repetitions, medication concentration, electrode activity, temperature or other measurements indicate an anomaly, then alarms can be displayed and the therapy parameters appropriately adjusted. A skilled artist could easily alter this embodiment by swapping or positioning sensors, or transducer modules, in various locations without departing from the spirit of the invention.

Referring next to FIG. 11, a functional block diagram is shown of therapy system 1100 that uses a glove embodiment, as described above with reference to FIGS. 6 through 9B. The therapy system 1100 includes the therapist/patient 1102, computer 1104, computer link 1106, controller 1108, glove 1110, and the hand 1112. The controller 1108 includes a control panel 1114, feedback controller 1116, and input/output 1118 (also referred to as IO 1118). The glove 1110 includes a pneumatics/fluidics module 1120, the compressible substance 1122, and transducers 1124. The therapist/patient block 1102 is coupled to the computer 1104 and control panel 1114 of the controller 1108. The control panel 1108 is coupled to the feedback controller 1116 of the controller 1108 which is coupled to the input/output 1118 (IO) of the controller 1108. The computer 1104 is coupled to the IO 1118 of the controller 1108 via the computer link 1106. Furthermore, the IO 1118 of the controller 1108 is coupled to the pneumatics/fluidics module 1120 of the glove 1110, which is coupled to the compressible substance 1122 of the glove. The transducers 1124 are coupled back to the IO 1118 of the controller 1108. The hand 1112 of the patient interacts with compressible substance 1122 and the transducers 1124 of the glove 1110.

In operation, the hand therapy system works 1100 with the glove 1110 to provide a means for measuring the motion, force and work done by the patient 1110. Furthermore, it provides a means for controlling the pressure resistance of the compressible substance 1122 of the glove 1110 automatically, so that therapy parameters can be set and maintained automatically by the patient's or therapist's interaction with the controller 1108.

The therapist/patient block 1102 represents both the patient and the therapist. As shown in this embodiment, both the patient and the therapist have access to the measurements obtained using the glove 1110 in addition to being the operators of the hand therapy system 1100. Both the patient and the therapist can set the therapy parameters such as resistance pressure (of the compressible substance 1122), and will review the therapy outcomes such as joint movement, pressure or force applied, and work done. Over time, the therapist will adjust the therapy parameters to reflect the best plan of treatment. The therapist may interact with the hand therapy system 1100 directly through the computer 1104 or remotely over a computer network via the computer link 1106, such as the Internet link. The computer 1104 is either physically integrated with the controller 1108 in a monolithic enclosure, located in the vicinity of the controller 1108, or connected to the controller 1108 via a computer network (e.g. the internet) through the computer link 1106 (e.g. an internet link). It provides a readily accessible way for the therapist to adjust parameters and review treatment, locally and remotely. The computer 1104 stores and organizes therapy parameters and outcomes in a database for archival and ready access. It also converts outcomes data into a graphical charts displayable on a computer terminal and printable on paper that ease the interpretation of the outcomes data and help the therapist make better decisions.

The controller 1108 is the electronic brain of the hand therapy system 1100. It might be a standalone unit, located near the patient, or it might be a miniature battery operated controller that is integrated onto the glove (e.g. as an attachment to the compressor/pressure transducer module or the displacement transducer module). The controller 1108 receives signals from the transducers 1124 of the glove representing finger displacement (from the displacement transducers), force applied (from the pressure transducers) and work (measured as a calorimetric estimate from the thermal transducer) and contains the algorithms necessary to translate the signals from the various transducers into the respective estimations of the finger displacement, temperature and force or pressure applied. The controller also sends control signals to the compressor (within the pneumatic/fluidics module 1120) of the glove to set the glove's resistance (e.g. the compressor and valve settings). The controller 1108 contains an embedded computer that manages the activities of the controller, translates the signals from the transducers, and maintains communications between the controller 1108, the glove 1110, and its users. It could be a custom computer, or be a common personal computer running commercially available software, such as National Instruments' Labview.

The controller 1108 is comprised of the subsystems of the feedback controller 1116, control panel 1114 and the IO 1118. The control panel 1114 consists of knobs, buttons and displays that allow the user to set therapy parameters and review therapy outcomes.

Theses knobs, buttons and displays are electronically connected to the controller's 1108 embedded computer. The control panel 1114 may be configured so that the user can: set the initial and final pressure resistance level of the compressible substance 1122 within the glove; set a repetitions counter or therapy timer; set limits and alarms for excess pressure or other abnormal conditions; set control parameters for the feedback controller 1116, such as PID (proportional, integral, derivative) constants; store parameters for future use; and control the power to the controller 1108.

Additionally, the control panel 1114 may provide a display indicating real time indications of pressure, displacement, and work in aggregate or on a finger by finger basis, as well as graphical displays of such measurements. Additionally, the glove settings may be shown. Such displays may be displayed on a corresponding computer or on a screen or display of the controller itself depending on the embodiment.

The feedback controller 1116 allows the pressure resistance of the compressible substance 1122 to be adjusted automatically in dynamic response to predetermined pressure profiles and sequences, existing pressure in the chamber/s of the compressible substance 1122, finger motion, and the work being done. The feedback controller 1116 is a function performed by the controller's embedded computer. It receives the real-time pressure, displacement, and work measurements, then uses readily available algorithms, such as PID (proportional, integral, derivative) control to send the proper signals to adjust the valve settings and the compressor (within the pneumatics/fluidics module 1120), to maintain the pressure resistance within the chamber/s of the glove 1110 according to the user's settings. The feedback controller 1116 contains therapy data storage circuits, parameter storage circuits, and a real time clock that permit it to operate autonomously.

The IO 1118 allows the controller 1108 to communicate with the glove 1110 and the computer 1104. The IO 1118 outputs signals to the pneumatic/fluidic module 1120, which contains the compressor and the valves, to control the amount of pressure that the chambers are inflated or filled up to in order to provide the appropriate resistance when the patient squeezes the compressible substance 1122. These output signals might be pulsed waveforms intended to switch the compressor and valves on and off, or they may be analog voltage signals intended to set the compressor speed. The IO 1118 also receives signals from the transducers 1124, e.g. pressure transducer, displacement transducers and thermal transducer. These received signals might be pulsed waveforms, or analog voltage levels as output from the respective types of transducers 1124.

Additionally, the IO 1118 may perform data communications with the computer 1104 via the computer link 1106. The computer 1104 is typically the therapist's computer, which may be physically attached to the controller 1108 through serial interfaces or may be linked via a computer link 1106 to the controller. The computer 1104 may be part of a local area network or wide area network or other computer network. Thus, the therapist may be located at another location than the patient. Advantageously, the patient may operate the hand therapy system 1100 at home and be simultaneously monitored by the therapist online with the controller 1108. Thus, the therapist can send signals from the therapists computer 1104 to the controller 1108 via the computer link 1106 (such as an internet link) to control or set the parameters of the patient's session in response to the measurements of the glove 1110. Advantageously, the therapist can see the results of the session (i.e. the estimations of finger displacement, work, force or pressure, and the number and speed of repetitions) and recommend desired changes to further facilitate improve in a patient's condition without having to be physically present at the session. Furthermore, the computer 1104 (in addition to or instead of the controller 1108) may also be capable of translating the signals output from the transducers into the appropriate measurements of displacement, work, pressure or force, and the number and speed of repetitions.

The IO 1118 will comprise many different circuits including: pulse width modulation circuits that will generate a pulsatile waveform to control the compressor and valves of the pneumatics/fluidics module 1120; digital to analog circuits to create a variable voltage level to adjust the compressor speed; driver circuits to convert the outputs from the pulse width modulator and the digital to analog circuit into the proper voltage and current to supply the valves and the compressor; transceiver circuits to convert the pulsed waveform from the displacement transducers into a computer readable form; analog to digital circuits to convert the signals from the displacement transducers, temperature sensors, and pressure transducers into computer readable form; and also data communication circuits such as a modem, Ethernet transceiver, USB transceiver, infrared or RF transceivers, or a simple serial interface to allow connection to the computer (e.g. the therapist's computer if it is located near the IO 1118).

The glove 1110 comprises the pneumatics/fluidics module 1120, the compressible substance 1122, and the transducers 1124. The pneumatics/fluidics module 1120 contains the compressor and appropriate valves of the compressor/pressure transducer module described earlier. The pneumatics/fluidics module 1120 receives signals from the controller 1108, either generated by the therapist or the patient, to regulate the air or fluids going into and out of the compressible substance 1122. Thus, the controller 1108 sends the appropriate signals to make sure the pressure within the compressible substance is as desired. Again, as described above, the pneumatics/fluidics module may comprise an electronically controlled compressor (or pump) and/or valves.

The compressible substance 1122 is also as described above and includes a flexible enclosure containing one or more chambers within the compressible substance 1122. The multi-chamber compressible substance as shown in FIGS. 7A through 8 would permit resistance pressure regulation on a finger-by-finger basis, whereas a single chamber, such as shown in FIG. 6, would be a simpler way to regulate the pressure resistance of all the fingers together. The compressor and/or valves (of the pneumatics/fluidics module 1120) would be connected to the fill tubes leading to each chamber, to establish air or fluid pressure in each chamber and to regulate the flow in and out of each chamber.

The transducers 1124, as described above as the pressure transducer, the displacement transducer, and the thermal transducer, provide the measurements in the form of signals back to the controller 1108 so that determinations of finger motion, force exerted by each finger or the hand total while squeezing the compressible substance, a calorimetric estimate of the work done can be obtained by the controller 1108, and the number and speed of repetitions.

The patient's hand 1112 fits within the glove 1110 and interacts with the compressible substance 1122. The glove 1110 is designed to snugly fit the patient's hand 1112 and contains the transducers 1124 required to obtain the measurements. Additionally, the glove may be embodied as described above, including the addition of medication on the interior surface of the glove 1110. The glove 1110 will fit properly to the patient's hand 1112 and will provide resistance to motion that is therapeutically appropriate. Furthermore, the glove 1110 will position and anchor the transducers 1124 and compressible substance 1122 so that the measurements are sufficiently accurate and precise.

Referring next to FIG. 12, a view is shown of the details of the compressor/pressure transducer module described above. Shown are a glove 1200, compressible substance 1202, first tube 1204, and the compressor/pressure transducer module 1206. The compressor/pressure transducer module 1206 includes a first tee 1208, second tee 1210, vent solenoid 1212 (also referred to as the vent valve), pump solenoid 1214 (also referred to as the pump or compressor valve), pressure transducer 1216, compressor 1218, filters 1220 and 1221, tubes 1222, 1224, 1226, 1228, 1230, 1232, and 1234, wires 1236, 1238, 1240 and 1242, the interface port 1244, and the interface means 1246. The first tube 1204 enters the compressor/transducer module 1206 and is coupled to the first tee 1208. The vent solenoid 1212 is coupled to the first tee 1208 via tube 1222 and is also coupled to filter 1220 via tube 1224. Tube 1226 couples the first tee 1208 to the second tee 1210. The second tee is coupled to the pressure transducer 1216 via tube 1228 and the pump solenoid 1214 via tube 1230. The pump solenoid 1214 is coupled to the compressor 1218 via tube 1232. The compressor 1218 is coupled to the filter 1221 via tube 1234. Wire 1236 is coupled from the vent solenoid 1212 to the interface port 1244, wire 1238 is coupled from the pressure transducer 1216 to the interface port 1244, wire 1240 is coupled from the pump solenoid to the interface port 1244, and wire 1242 is coupled from the compressor 1218 to the interface port 1244. The interface means 1246 links to the interface port 1244 and is the input to a computer system, e.g. the SCCE of FIG. 10.

In practice, the compressor/transducer module 1206 pumps materials, such as gas, air, fluids, or gels into the chamber or chambers (not shown) of the compressible substance 1202 and provides the means for measuring the force exerted by the fingers (i.e. fingers and thumb) of the patient's hand upon squeezing the compressible substance 1202. The embodiment shown in FIG. 12 inflates the chamber/s of the compressible substance, 1202 with air or another similar gas.

In order to inflate the chamber/s within the compressible substance 1202, the compressor 1218 pulls air through the filter 1221 via tube 1234 and forces the air out through tube 1232. The compressor, which is a miniature mechanical compressor as described above with reference to FIG. 6, e.g. rotary vane pump, is controlled or activated by control signals sent through wire 1242. Furthermore, the compressor 1218 may be reversible, such that it may assist in the deflation of the compressible substance 1202. The pump solenoid 1214 acts as a valve and controls the flow of air into the rest of the system. Typically, the pump solenoid 1214 (controlled by signal sent via wire 1240) works in concert with the compressor 1218, such that when the compressor is “pumping” to inflate the chambers within the compressible substance 1202, the pump solenoid 1214 is open to allow the compressor 1218 to force the air therethrough. Alternatively, pinch valves may be used instead of the solenoids as described above with reference to FIG. 6. The air is pumped through tube 1230 and through the second tee 1210 into tube 1226 and the first tee 1208. The air continues through the first tee 1208 and into the first tube 1204 which is fed into the chambers of the compressible substance 1202 in order to inflate the chambers to a desired pressure level.

Air is also pumped into tube 1222 from the first tee 1208 to the vent solenoid 1212, which acts as a valve; however, during the “pumping” of the compressor 1218, the vent solenoid 1212 is closed such that the air will not be allowed to flow through the vent solenoid 1212. The vent solenoid 1212 is controlled via signals sent through wire 1236.

Furthermore, air is forced against the port of the pressure transducer 1216 through tube 1228 of the second tee. The pressure transducer 1216 of the compressor/pressure transducer module 1206 is a transducer that produces a signal, such as a voltage proportional to the pressure applied to its port. The pressure transducer 1216 is used during inflation to determine when the desired pressure (e.g. desired psi) within the compressible substance 1202 has been reached. Wire 1238 of the pressure transducer 1216 transmits the voltage signals proportional to the pressure within tube 1228 to the controlling computer (to translate the signals into estimation of pressure) through the interface port 1244 and the interface means 1246. Such information is used to control the switching on and off of the compressor 1218. The compressor 1218 is well known in the art as described with reference to FIG. 6.

Once the pressure within the chambers of the compressible substance 1202 is at the desired level, i.e. the pressure at the pressure transducer 1216 is at the desired level, the pump solenoid 1210 is closed and the patient squeezes the compressible substance 1202, which forces air back into the first tube 1204 and causes more pressure to be placed upon the pressure transducer 1216. Thus, the pressure transducer 1216 sends voltage signals which are proportional to the additional pressure within the system, which can be translated, by the controller of FIG. 10 for example, into the pressure or force exerted by the digits of the hand (e.g. by taking the difference between the initial pressure and the additional pressure), either collectively, or individually, depending on the embodiment. There is typically a direct proportionality between the force or pressure applied by the fingers and the measurements of the pressure transducer; however, this proportionality may be altered by different configurations and different material selection.

Additionally, the vent solenoid 1212 may be employed to vent the system; thus, allowing rapid deflation of the compressible substance 1202 upon completion of the therapy. In this case, the vent solenoid 1212 is opened, while the pump solenoid 1214 is closed. Thus, the air contained within the compressible substance 1202 and the system will be pushed out through tube 1222, through the vent solenoid 1212, through tube 1224, and out of the compressor/transducer module 1206 through filter 1220.

The compressor/pressure transducer module 1206 may be as shown, i.e. as a separate unit not physically located on the body of the glove. Thus, the compressor/pressure transducer module 1206 may be worn on the body of the patient (e.g. on the patient's belt) or placed nearby the patient and attached to the compressible substance 1202 via the first tube 1204. Alternatively, the compressor/pressure transducer module 1206 may be integrated onto the body of the glove, as described above with reference to FIG. 6. The components of such a module are well known in the art; thus, no further explanation is required. Furthermore, the compressor/pressure transducer module 1206 may be easily modified to pump fluids or other gases into the compressible substance 1202 by attaching gas canisters or fluid reservoirs at the locations of the filters 1220 and 1221, for example (see FIG. 3).

Furthermore, for a compressible substance 1202 including more than one chamber, e.g. one chamber for each finger, there are five separate pressure transducers 1216 within five separate compressor/pressure transducer modules 1206. Thus, there is one compressor/pressure transducer module 1206 for each respective chamber of the compressible substance 1202. Alternatively, there may be one compressor/pressure transducer module, including 5 pressure transducers all sharing the same compressor and/or sharing common vent solenoids.

Referring next to FIG. 13 is a flowchart showing the steps for providing information useful to offer targeted incentives. The system provides diagnostic information (step 1302); which is useful for generating therapy plan information (step 1304); which is useful for gaining patient approval information (step 1306); all of which information is useful for obtaining financing provider approval and incentive information (steps 1308, 1310). The product and advice providers access the therapy plan information (step 1312) which is useful for advertising, promoting, proposing, or bidding (step 1314). Advertising provides product knowledge and substantial revenue. This step provides targeted information to members based on estimates of their needs. This competitive bidding process is useful for providing savings. The patient and provider accept offers (step 1316) and this information is useful for transferring funds (step 1318) from the financing provider to the product and service providers. The funds transfer information is useful for prompting the delivery of products and services (step 1320). The therapy session (step 1322) information is useful for monitoring and controlling the therapy (step 1324). This information is stored (also step 1324) and is useful for updating diagnostics (step 1302).

Referring back to step 1310, when the financing provider offers incentives: there is an unmet need for incentives for protecting funds managed by healthcare financing providers, such as Medicare. For example, Medicare funds might be readily available for limosine or air travel for non-emergency therapy sessions, without any incentive to save by choosing remotely monitored home therapy. Other questionable factors that providers employ include items such as broadcast advertising, or legal expenses for unsafe pills. For example, recent broadcast television ads promote motorized scooters that can be financed by Medicare; with company sales reps ready to assist with Medicare processing. Thus, questionable items, such as broadcast advertising and sales commissions, are passed through to the Medicare members in higher scooter prices. Restated with reference to FIG. 10, financing providers 1060, such as Medicare 1062, are paying for factors employed by product providers 1050, such as equipment providers 1054, who employ broadcast advertising 1046, and Medicare processing advice 1044, which increases the prices Medicare 1062 and patients 1020 pay for equipment. Thus, Medicare trustees need improved processing systems, and incentives to encourage members to protect the fund. In the above example, an equipment provider could simply access the system (step 1312) to target patients with diagnostic data that indicate potential need for their equipment, and use the system to send advertising information (step 1314) directly to those patients. Instead of paying Medicare processing commissions, the patient can simply use the system to efficiently update or fill in the appropriate Medicare data fields online. If targeted advertising and automatic processing reduce costs, then Medicare can offer incentives to patients and providers who choose (step 1316) methods that effect those savings. Thus performance can be tracked and rewarded based on individual transactions, or perhaps by tiered or certification programs, whereby providers can be rewarded. Incentive systems are known in the art, such as U.S. Pat. No. 6,434,534, issued Aug. 13, 2002 to Walker, et al. entitled “METHOD AND SYSTEM FOR PROCESSING CUSTOMIZED REWARD OFFERS”, and U.S. Pat. No. 5,689,100 issued Nov. 18, 1997 to Carrithers, et al. entitled “DEBIT CARD SYSTEM AND METHOD FOR IMPLEMENTING INCENTIVE AWARD PROGRAM” (both of which are incorporated herein by reference). The U.S. Pat. No. 5,689,100 patent is assigned to Maritz, Inc. of Fenton, Mo. whose methods and systems for managing incentive programs are commercially available, so Medicare would not need to manage the incentive program directly. Furthermore, Medicare members may lobby for macroincentives, such as tax exemptions; research grants; tiered levels of antitrust exemptions; investment trusts; securities; interstate licensing; targeted advertising lists; or access to foreign membership. Thus, providers who implement systems that protect (or grow) the Medicare fund can be rewarded with strategic incentives. Most conventional theories would object to early incentives, such as using diagnostic information from a therapy system to generate targeted advertising. It is obvious that this is a violation of privacy laws. Thus, conventional theory would reject proposals to use a therapy system to provide targeted advertising that generates a profit, or at least reduces broadcast advertising passthrough cost. But, U.S. Pat. No. 6,285,983 issued Sep. 4, 2001 to Jenkins entitled “MARKETING SYSTEMS AND METHODS THAT PRESERVE CONSUMER PRIVACY” (which is incorporated herein by reference) teaches a targeted advertising system that can protect privacy through a third party repository. And U.S. Pat. No. 6,334,110 issued Dec. 25, 2001 to Walter, et al. entitled “SYSTEM AND METHOD FOR ANALYZING CUSTOMER TRANSACTIONS AND INTERACTIONS” (which is incorporated herein by reference) teaches how to extract targeted information from the therapy system in a timely manner, so incentives or rewards can be offered early in the process.

Referring to FIG. 14 is a view an embodiment of means for monitoring the therapy system. The screen display 1400 receives and displays information from the controller 1402. The controller 1402 receives information from the patient. In this instance, the patient positions a member incentive card 1404 so as to be readable by the controller 1402. Information from the card is transmitted, received, and displayed for members of the system who can help meet the patient's needs, such as (referring back to FIG. 10) the financing provider 1060, service provider 1040, or product provider 1050. In this embodiment, the incentive card 1404, provides markings that verify that the patient is a member of a remote monitoring plan. Thus the identification, authorization, pricing, therapy session, and payment processes are remote and automatic, so the therapy session can commence in a timely manner. If problems arise, the stored session records can be retrieved, and reviewed; providing evidence useful for legal expense savings. U.S. Pat. No. 6,442,532 issued Aug. 27, 2002 to Kawan entitled “WIRELESS TRANSACTION AND INFORMATION SYSTEM”, U.S. Pat. No. 7,040,533 issued May 9, 2006 to Ramachandran entitled “CASH WITHDRAWAL FROM ATM VIA VIEDOPHONE”, and U.S. Pat. No. 6,385,595 issued May 7, 2002 to Kolling et al. (all of which are incorporated herein by reference) teach related methods and systems.

Referring next to FIG. 15 is a screen display view of remote therapy in operation. A side window 1502 displays therapy related information; in this view the therapist is speaking to the patient. Content topics or menus 1504 provide means for choosing therapy related information. Buttons let the patient start as new session 1506; save a session 1508; send a stored session as an email attachment 1510; review a previous session 1512; or review therapy progress 1514. The main window 1516 displays content such as a therapy session in progress. U.S. Pat. No. 6,813,372 issued Nov. 2, 2004 to Standridge et al, entitled “MOTION AND AUDIO DETECTION BASED WEBCAMMING AND BANDWIDTH CONTROL” (which is incorporated herein by reference) teaches a system for transmitting and receiving signals to generate such a display under low bandwidth or low memory conditions. U.S. Pat. No. 6,173,317 issued Jan. 9, 2001 to Chadda, et al. entitled “STREAMING AND DISPLAYING A VIDEO STREAM WITH SYNCHRONIZED ANNOTATIONS OVER A COMPUTER NETWORK” (which is incorporated herein by reference) teaches a system for providing such a display under higher bandwidth and higher memory conditions. Alternatively, the main window 1516 could display training or research information; and previously stored therapy sessions could be used for research studies, or licensed as content for such training sessions.

FIG. 16 is another embodiment of a screen display of a remote therapy session in operation. A side window 1602 displays performance metrics. The internet address 1604 shows a link whereby the patient, therapist, and other providers can obtain access to help meet the patient's needs, depending on levels of permission. The main window title bar 1606 displays information about the patient and the therapy session, along with information about the incentive level. The main window 1608, displays a therapy session in progress, preferably, in real time. U.S. Pat. No. 7,130,618 issued Oct. 31, 2006 to Hirotugu, entitled “METHODS, APPARATUS, AND SYSTEM FOR TRANSMITTING MOVING IMAGE DATA” (which is incorporated herein by reference) teaches modern means for monitoring therapy. Information from the therapy is transmitted, received, and displayed for members of the system who can then make customized recommendations, based on the collected therapy information, to help meet that patient's specific needs.

While the invention herein disclosed has been described by means of specific embodiments and applications thereof, numerous modifications and variations could be made thereto by those skilled in the art without departing from the scope of the invention set forth in the claims.