Persuasive Motivation for Orthopedic Treatment

This application is a continuation of U.S. patent application Ser. No. 18/520,137 filed Nov. 27, 2023, titled “Persuasive Motivation for Orthopedic Treatment,” which is a continuation of U.S. patent application Ser. No. 17/075,508 filed Oct. 20, 2020, titled “Persuasive Motivation for Orthopedic Treatment,” now U.S. Pat. No. 11,826,613, which claims priority to and the benefit of U.S. Provisional Application Patent Ser. No. 62/923,829 filed Oct. 21, 2019, titled “Persuasive Motivation for Orthopedic Treatment,” the entire disclosures of which are hereby incorporated by reference for all purposes.

Patients may use treatment apparatuses for any suitable purpose, such as rehabilitation of a body part, pre-habilitation of a body part, strengthening a body part, exercising a body part, and the like.

A method is disclosed. The method includes, while the patient uses the treatment apparatus, controlling, based on a treatment plan for a patient, a treatment apparatus. The method includes receiving, by a processing device, data from an electronic device, wherein the data comprises one of a position of a body part of the patient or a force exerted by the body part. The method includes storing, via the processing device, the data for the patient in a computer-readable medium. The method includes causing, via a processing device, presentation of a user interface on a patient interface. The user interface comprises an adjustment confirmation control, and the adjustment confirmation control is configured to solicit a response regarding the patient's comfort level with the one of the position of the body part or the force exerted by the body part.

A computer-implemented system for physical rehabilitation is provided. The computer-implemented system comprises a clinician interface including a patient profile display configured to present data regarding performance, by a patient, of a regimen for a body part, the body part comprising at least one of a joint, a bone, or a muscle group. The computer-implemented system also comprises a sensor configured to measure one of a position of the body part or a force exerted by the body part. The computer-implemented system also comprises a patient interface including an output device and an input device for communicating information regarding the performance of the regimen, respectively to and from the patient. The patient interface is configured to present instructions and status information to the patient regarding the performance of the regimen. The patient interface is configured to present an adjustment confirmation control configured to solicit a response regarding the patient's comfort or discomfort with the one of the position of the body part or the force exerted by the body part.

A system for remote treatment is also provided. The system for remote treatment comprises: a clinician interface configured to present controls for modifying a treatment plan comprising a regimen for treatment of a body part of a patient, with the body part comprising at least one of a joint, a bone, or a muscle group. The system also comprises a treatment apparatus for performing the regimen upon the body part, the treatment apparatus is configured to be manipulated by the patient. The system also comprises a patient interface including an output device and an input device for communicating information regarding the performance of the regimen, respectively to and from the patient. The patient interface and the treatment apparatus are each configured to enable operation from a patient location geographically separate from a location of the clinician interface. The patient interface is configured to present an adjustment confirmation control configured to solicit a response regarding the patient's comfort level with one of a position of the body part or a force exerted by the body part.

A patient user interface generated by a computer is also provided. The patient user interface comprises a session period action screen configured to present real-time status of a measurement regarding a patient's use of a treatment apparatus for performing a regimen for a body part, the body part comprising at least one of a joint, a bone, or a muscle group. The patient user interface also comprises an adjustment confirmation control configured to solicit a response regarding the patient's comfort level with one of a position of the body part or a force exerted by the body part. The measurement regarding the patient's use of the treatment apparatus includes the one of the position of the body part or the force exerted by the body part.

Various terms are used to refer to particular system components. Different companies may refer to a component by different names—this document does not intend to distinguish between components that differ in name but not function. In the following discussion and in the claims, the terms “including” and “comprising” are used in an open-ended fashion, and thus should be interpreted to mean “including, but not limited to . . . ” Also, the term “couple” or “couples” is intended to mean either an indirect or direct connection. Thus, if a first device couples to a second device, that connection may be through a direct connection or through an indirect connection via other devices and connections.

The terminology used herein is for the purpose of describing particular example embodiments only, and is not intended to be limiting. As used herein, the singular forms “a,” “an,” and “the” may be intended to include the plural forms as well, unless the context clearly indicates otherwise. The method steps, processes, and operations described herein are not to be construed as necessarily requiring their performance in the particular order discussed or illustrated, unless specifically identified as an order of performance. It is also to be understood that additional or alternative steps may be employed.

The terms first, second, third, etc. may be used herein to describe various elements, components, regions, layers and/or sections; however, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms may be only used to distinguish one element, component, region, layer, or section from another region, layer, or section. Terms such as “first,” “second,” and other numerical terms, when used herein, do not imply a sequence or order unless clearly indicated by the context. Thus, a first element, component, region, layer, or section discussed below could be termed a second element, component, region, layer, or section without departing from the teachings of the example embodiments. The phrase “at least one of,” when used with a list of items, means that different combinations of one or more of the listed items may be used, and only one item in the list may be needed. For example, “at least one of: A, B, and C” includes any of the following combinations: A, B, C, A and B, A and C, B and C, and A and B and C. In another example, the phrase “one or more” when used with a list of items means there may be one item or any suitable number of items exceeding one.

Spatially relative terms, such as “inner,” “outer,” “beneath,” “below,” “lower,” “above,” “upper,” “top,” “bottom,” and the like, may be used herein. These spatially relative terms can be used for ease of description to describe one element's or feature's relationship to another element(s) or feature(s) as illustrated in the figures. The spatially relative terms may also be intended to encompass different orientations of the device in use, or operation, in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be oriented “above” the other elements or features. Thus, the example term “below” can encompass both an orientation of above and below. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptions used herein interpreted accordingly.

The following discussion is directed to various embodiments of the disclosure. Although one or more of these embodiments may be preferred, the embodiments disclosed should not be interpreted, or otherwise used, as limiting the scope of the disclosure, including the claims. In addition, one skilled in the art will understand that the following description has broad application, and the discussion of any embodiment is meant only to be exemplary of that embodiment, and not intended to intimate that the scope of the disclosure, including the claims, is limited to that embodiment.

shows a block diagram of a computer-implemented system, hereinafter called “the system” for managing a treatment plan. The treatment plan includes one or more treatment protocols, and each treatment protocol includes one or more sessions. Each session comprises several session periods, with each session period including a particular activity for treating the body part of the patient. For example, a treatment plan for post-operative rehabilitation after a knee surgery may include an initial treatment protocol with twice daily stretching sessions for the first 3 days after surgery and a more intensive treatment protocol with active exercise sessions performed 4 times per day starting 4 days after surgery.

The systemincludes a clinician interfacefor a clinician, such as a doctor, a nurse, a physical therapist, or a technician, to use to review and to configure various aspects of a treatment plan for use in treating a patient. The clinician interfaceincludes a clinician input deviceand a clinician display, which may be collectively called a clinician user interface,. The clinician input devicemay include one or more of a keyboard, a mouse, a trackpad, or a touch screen, for example. Alternatively or additionally, the clinician input devicemay include one or more microphones and voice-based functionalities, with hardware and/or software configured to interpret spoken instructions by the clinician by using the one or more microphones. The clinician input devicemay include functionality provided by or similar to existing voice-based assistants such as Siri by Apple, Alexa by Amazon, Google Assistant, or Bixby by Samsung. The clinician input devicemay include other hardware and/or software components. The clinician input devicemay include one or more general purpose devices and/or special-purpose devices.

The clinician displaymay take one or more different forms including, for example, a computer monitor or display screen on a tablet, smartphone, or a smart watch. The clinician displaymay include other hardware and/or software components such as a projector, virtual reality capability, or augmented reality capability etc. The clinician displaymay incorporate various different visual, audio, or other presentation technologies. For example, the clinician displaymay include a non-visual display, such as an audio signal, which may include spoken language and/or other sounds such as tones, chimes, and/or melodies which may signal different conditions and/or directions. The clinician displaymay comprise one or more different display screens presenting various data and/or interfaces or controls for use by the clinician. The clinician displaymay include graphics, which may be presented by a web-based interface and/or by a computer program or application (App.).

The systemalso includes a serverconfigured to store and to provide data related to managing the treatment plan. The servermay include one or more computers and may take the form of a distributed and/or virtualized computer or computers. In some embodiments, the servermay generate aspects of the clinician displayfor presentation by the clinician interface. For example, the servermay include a web server configured to generate the display screens for presentation upon the clinician display. In some embodiments, the clinician displaymay be configured to present a virtualized desktop that is hosted by the server. The serveralso includes a first communication interfaceconfigured to communicate with the clinician interfacevia a first network. In some embodiments, the first networkmay include a local area network (LAN), such as an Ethernet network. In some embodiments, the first networkmay include the Internet, and communications between the serverand the clinician interfacemay be secured via encryption, such as, for example, by using a virtual private network (VPN). In some embodiments, the first networkmay include wired and/or wireless network connections such as Wi-Fi, Bluetooth, ZigBee, Near-Field Communications (NFC), cellular data network, etc. The serverincludes a first processorand a first machine-readable storage memory, which may be called a “memory” for short, holding first instructionsfor performing the various actions of the serverfor execution by the first processor. The serveris configured to store data regarding the treatment plan. For example, the memoryincludes a system data storeconfigured to hold system data, such as data pertaining to treatment plans for treating one or more patients. The serveris also configured to store data regarding performance by a patient in following a treatment plan. For example, the memoryincludes a patient data storeconfigured to hold patient data, such as data pertaining to the one or more patients, including data representing each patient's performance within the treatment plan.

The systemalso includes a patient interfaceconfigured to communicate information to a patient and to receive feedback from the patient. Specifically, the patient interfaceincludes an input deviceand an output device, which may be collectively called a patient user interface,. The input devicemay include one or more devices, such as a keyboard, a mouse, a touch screen input, a gesture sensor, and/or a microphone and processor configured for voice recognition. The output devicemay take one or more different forms including, for example, a computer monitor or display screen on a tablet, smartphone, or a smart watch. The output devicemay include other hardware and/or software components such as a projector, virtual reality capability, augmented reality capability, etc. The output devicemay incorporate various different visual, audio, or other presentation technologies. For example, the output devicemay include a non-visual display, such as an audio signal, which may include spoken language and/or other sounds such as tones, chimes, and/or melodies, which may signal different conditions and/or directions. The output devicemay comprise one or more different display screens presenting various data and/or interfaces or controls for use by the patient. The output devicemay include graphics, which may be presented by a web-based interface and/or by a computer program or application (App.).

As shown in, the patient interfaceincludes a second communication interface, which may also be called a remote communication interface configured to communicate with the serverand/or the clinician interfacevia a second network. In some embodiments, the second networkmay include a local area network (LAN), such as an Ethernet network. In some embodiments, the second networkmay include the Internet, and communications between the patient interfaceand the serverand/or the clinician interfacemay be secured via encryption, such as, for example, by using a virtual private network (VPN). In some embodiments, the second networkmay include wired and/or wireless network connections such as Wi-Fi, Bluetooth, ZigBee, Near-Field Communications (NFC), cellular data network, etc. In some embodiments, the second networkmay be the same as and/or operationally coupled to the first network.

The patient interfaceincludes a second processorand a second machine-readable storage memoryholding second instructionsfor execution by the second processorfor performing various actions of patient interface. The second machine-readable storage memoryalso includes a local data storeconfigured to hold data, such as data pertaining to a treatment plan and/or patient data, such as data representing a patient's performance within a treatment plan. The patient interfacealso includes a local communication interfaceconfigured to communicate with various devices for use by the patient in the vicinity of the patient interface. The local communication interfacemay include wired and/or wireless communications. In some embodiments, the local communication interfacemay include a local wireless network such as Wi-Fi, Bluetooth, ZigBee, Near-Field Communications (NFC), cellular data network, etc.

The systemalso includes a treatment apparatusconfigured to be manipulated by the patient and/or to manipulate a body part of the patient for performing activities according to the treatment plan. In some embodiments, the treatment apparatusmay take the form of an exercise and rehabilitation apparatus configured to perform and/or to aid in the performance of a rehabilitation regimen, which may be an orthopedic rehabilitation regimen, and the treatment includes rehabilitation of a body part of the patient, such as a joint or a bone or a muscle group. More specifically, the regimen may be a physical rehabilitation regimen for improving strength and/or range of motion of the body part. The body part may include, for example, a spine, a hand, a foot, a knee, or a shoulder. The body part may include a part of a joint, a bone, or a muscle group, such as one or more vertebrae or a ligament. As shown in, the treatment apparatusincludes a controller, which may include one or more processors, computer memory, and/or other components. The treatment apparatusalso includes a fourth communication interfaceconfigured to communicate with the patient interfacevia the local communication interface. The treatment apparatusalso includes one or more internal sensorsand an actuator, such as a motor. The actuatormay be used, for example, for moving the patient's body part and/or for resisting forces by the patient.

The internal sensorsmay measure one or more operating characteristics of the treatment apparatussuch as, for example, a force a position, a speed, and/or a velocity. In some embodiments, the internal sensorsmay include a position sensor configured to measure at least one of a linear motion or an angular motion of a body part of the patient. For example, an internal sensorin the form of a position sensor may measure a distance that the patient is able to move a part of the treatment apparatus, where such distance may correspond to a range of motion that the patient's body part is able to achieve. In some embodiments, the internal sensorsmay include a force sensor configured to measure a force applied by the patient. For example, an internal sensorin the form of a force sensor may measure a force or weight the patient is able to apply, using a particular body part, to the treatment apparatus.

The systemshown inalso includes an ambulation sensor, which communicates with the servervia the local communication interfaceof the patient interface. The ambulation sensormay track and store a number of steps taken by the patient. In some embodiments, the ambulation sensormay take the form of a wristband, wristwatch, or smart watch. In some embodiments, the ambulation sensormay be integrated within a phone, such as a smartphone.

The systemshown inalso includes a goniometer, which communicates with the servervia the local communication interfaceof the patient interface. The goniometermeasures a position of the patient's body part. More specifically, the goniometermeasures an angle of the body part, particularly where the body part is a joint. For example, the goniometermay measure the angle of flex of a patient's knee or elbow or shoulder.

The systemshown inalso includes a pressure sensor, which communicates with the servervia the local communication interfaceof the patient interface. The pressure sensormeasures an amount of pressure or weight applied by a body part of the patient. For example, pressure sensormay measure an amount of force applied by a patient's foot when pedaling a stationary bike.

The systemalso includes a wearable deviceconfigured to be worn or carried on the patient's person. The wearable devicemay take one of several different forms such as, for example, a smart watch, a wristband, a pendant, or a smartphone. The wearable devicemay include a means of attachment, such as a pin, a belt clip, a strap, or a lanyard, to facilitate the device's being worn or carried by the patient. In some embodiments, and as shown in, the wearable deviceincludes the ambulation sensor. The wearable devicemay include one or more other sensors, such as a heartrate sensor, a blood pressure sensor, or a pulse oximeter. The ambulation sensoror another one of the sensors in the wearable devicemay be configured to monitor one or more factors that indicate an activity level of the patient. The patient's activity level could be used to determine a quantity and/or quality of exercise performed by the patient. The patient's activity level could also be used to determine a quantity and/or quality of the patient's sleep.

The wearable deviceincludes a wearable input deviceand a wearable display, which may be collectively called a wearable user interface,. The wearable input devicemay include one or more devices, such as a keyboard, a mouse, a touch screen input, a gesture sensor, and/or a microphone and processor configured for voice recognition. The wearable displaymay take one or more different forms including, for example, a display screen, and/or one or more lights or other indicators. The wearable displaymay incorporate various different visual, audio, or other presentation technologies. For example, the wearable displaymay include a non-visual display, such as a haptic or tactile device and/or an audio signal, which may include spoken language and/or other sounds such as tones, chimes, and/or melodies, and the non-visual display may signal different conditions and/or directions. The wearable displaymay comprise one or more different display screens configured to present various data and/or interfaces or controls for use by the patient. The wearable displaymay include graphics, which may be presented by a web-based interface and/or by a computer program or application (App.). The wearable user interface,may be configured to present different types of information to the patient. For example, the wearable user interface,may be configured to present a reminder when it is time for the patient to perform a rehabilitation session. The wearable user interface,may allow the patient to track daily goals or to receive messages from a clinician, etc. This function of the wearable devicemay be especially useful when the patient is away from the patient interface.

The systemshown inalso includes a supervisory interfacewhich may be similar or identical to the clinician interface. In some embodiments, the supervisory interfacemay have enhanced functionality beyond what is provided on the clinician interface. The supervisory interfacemay be configured for use by a person having responsibility for the treatment plan, such as an orthopedic surgeon.

The systemshown inalso includes a reporting interfacewhich may be similar or identical to the clinician interface. In some embodiments, the reporting interfacemay have less functionality from what is provided on the clinician interface. For example, the reporting interfacemay not have the ability to modify a treatment plan. Such a reporting interfacemay be used, for example, by a biller to determine the use of the systemfor billing purposes. In another example, the reporting interfacemay not have the ability to display patient identifiable information, presenting only pseudonymized data and/or anonymized data for certain data fields concerning a data subject and/or for certain data fields concerning a quasi-identifier of the data subject. Such a reporting interfacemay be used, for example, by a researcher to determine various effects of a treatment plan on different patients.

In some embodiments, the patient interfaceand the treatment apparatusare each configured to operate from a patient location geographically separate from a location of the clinician interface. For example, the patient interfaceand the treatment apparatusmay be used as part of an in-home rehabilitation system, which may be monitored remotely by using the clinician interfaceat a centralized location, such as a clinic or hospital. In some embodiments, either or both of the patient interfaceand/or the treatment apparatusare configured to communicate with a remote computer, such as the server, to receive the treatment plan and to report back to the remote computer with data regarding performance by the patient in following the treatment plan.

show an embodiment of a treatment apparatus. More specifically,shows a treatment apparatusin the form of a stationary cycling machine, which may be called a stationary bike, for short. The stationary cycling machineincludes a set of pedalseach attached to a pedal armfor rotation about an axle. In some embodiments, and as shown in, the pedalsare movable on the pedal armsin order to adjust a range of motion used by the patient in pedaling. For example, the pedals being located inwardly toward the axlecorresponds to a smaller range of motion than when the pedals are located outwardly away from the axle. A pressure sensoris attached to or embedded within one of the pedalsfor measuring an amount of force applied by the patient on the pedal. The pressure sensormay communicate wirelessly to the treatment apparatusand/or to the patient interface.

shows a person (a patient) using the treatment apparatus of, and showing sensors and various data parameters connected to a patient interface. The example patient interfaceis a tablet computer or smartphone, or a phablet, such as an iPad, an iPhone, an Android device, or a Surface tablet, which is held manually by the patient. In some other embodiments, the patient interfacemay be embedded within or attached to the treatment apparatus.shows the patient wearing the ambulation sensoron his wrist, with a note showing “STEPS TODAY 1355”, indicating that the ambulation sensorhas recorded and transmitted that step count to the patient interface.also shows the patient wearing the goniometeron his right knee, with a note showing “KNEE ANGLE 72°”, indicating that the goniometeris measuring and transmitting that knee angle to the patient interface.also shows a right side of one of the pedalswith a pressure sensorshowing “FORCE 12.5 lbs.,” indicating that the right pedal pressure sensoris measuring and transmitting that force measurement to the patient interface.also shows a left side of one of the pedalswith a pressure sensorshowing “FORCE 27 lbs.”, indicating that the left pedal pressure sensoris measuring and transmitting that force measurement to the patient interface.also shows other patient data, such as an indicator of “SESSION TIME 0:04:13”, indicating that the patient has been using the treatment apparatusfor 4 minutes and 13 seconds. This session time may be determined by the patient interfacebased on information received from the treatment apparatus.also shows an indicator showing “PAIN LEVEL 3”. Such a pain level may be obtained from the patent in response to a solicitation, such as a question, presented upon the patient interface.

is an example embodiment of an overview displayof the clinician interface. Specifically, the overview displaypresents summary information regarding each of a plurality of different patients. In some embodiments, and as shown on, the summary information includes an indicator showing a procedure performed upon each of the patients, temporal progress of the patient within the treatment plan (post-op day), an indicator of a last-reported pain level, range-of-motion (ROM) numbers, and an indicator showing if there are any alerts requiring special attention.

show an example embodiment of a patient profile displayof the clinician interface. The example patient profile displayincludes a patient summarywith the patient's name, date of birth (DOB), age, a description of a procedure performed or to be performed on the patient, e.g., “Knee surgery”, and a picture of the patient, if available. The example patient profile displayalso includes a treatment progress summary, showing one or more indicators of progress within a treatment regimen or plan. The example treatment progress summaryshown onincludes textual progress summaries, “DAY 18”, “3 days remaining”, “12/63 DAILY SESSIONS COMPLETED”, as well as graphical progress summaries in the form of horizontal bar graphs, which may also be called progress bars.

The example patient profile displaypresents information regarding a treatment history of the patient. For example, the example patient profile displayincludes a plurality of different treatment graphsshowing the effect of various treatment parameters over time. The treatment graphsshown in the example patient profile displayofinclude extension (angle), flexion (angle), pain (0-10 scale), ambulation (steps/day), and total revolutions (i.e., revolutions performed on the stationary cycling machine). The patient profile displayshown onalso includes a pictorial history, showing one or more images of the surgical site for reference by a clinician or other healthcare professional in reviewing post-operative progress. The images in the pictorial historymay be taken by the patient and/or by a clinician or other healthcare professional. For example, the first picture may be taken by a member of the surgical staff, and subsequent pictures may be taken by the patient and/or the rehabilitation clinician. The example patient profile displayshown onalso includes a protocol summary displayshowing a summary overview of a treatment protocol to be performed by the patient. The example protocol summary displayincludes a protocol headingwith a protocol name, e.g. “Acute Protocol.” The protocol headingalso includes overview information regarding how and when the protocol is to be performed, e.g. “Days 1-14, 3 sessions daily.” The protocol summary displayalso includes several protocol session icons, each indicating details of an activity to be performed within a protocol session, e.g., “Passive”, “Active”, or “Resistance”, together with other information regarding the protocol session, such as a direction (forward/reverse), and an amount of time that each protocol session is prescribed to be performed.

shows an example embodiment of a protocol management displayof a clinician interfacefor editing a treatment protocol. Specifically, the protocol management displayincludes a protocol name controlfor renaming the treatment protocol. The protocol management displayalso includes a protocol timing controlfor adjusting various timing settings of the treatment protocol, such as a duration for the treatment protocolwithin the treatment plan, and a number of sessions to be performed per day. The example protocol timing controlshown onincludes drop-down menus for changing the various timing settings, but other controls could be used such as, for example, numeric entry fields or increase/decrease buttons. The protocol management displayalso includes a protocol session controlfor customizing the session periods. Specifically, the protocol session controlincludes a graphical representation of a session, with protocol session icons, which may be similar or identical to the protocol session iconsof the protocol summary display. Each session period may have an associated type, such as passive, resistance, assisted, or active. Each session period may also have several parameters associated therewith.

The protocol session controlallows the clinician to adjust the number, the order, and the types of the session periods within a given session of the treatment protocol. Each session period has a type that corresponds to a category of activity to be performed upon a body part during that session period. For example, the session periods may be one of a passive period, an assisted period, an active period, or a resistance period. Each passive period is associated with a particular activity that includes moving a body part by an external force; each assisted period is associated with a particular activity that includes moving the body part by the patient with assistance of the external force; each active period is associated with a particular activity that includes the patient moving the body part without assistance of the external force; and each resistance period is associated with a particular activity that includes the patient actively moving the body part against a resistance force. For example, where the treatment apparatusincludes a stationary cycling machine, a passive period may include an actuator, such as a motor, that rotates the pedalswith the patient's feet and legs attached thereto and without any action or force being applied by the patient. An assisted period may include the patient applying force to rotate the pedalswith some additional help or assistance from the actuator. An active period may include the patient applying force to rotate the pedalswithout any assistance from any outside force. A resistance period may include the patient exerting some force to rotate the pedalsin opposition to a resistance force applied by the actuator. In some embodiments, the actuatormay produce the external forces for each of the different categories of the session periods. The external forces may have different attributes, such as directions, intensities, or rates of changes, for each of the different categories of the session periods. Each session may include any number of session periods in any combination.

In some embodiments, the protocol session iconsmay be modified using a drag-and-drop interface. Additional protocol sessions may be added to the protocol session using a session period control. Additionally, parameters for any or all of the session periods may be adjusted using various session parameter controls. For example, a duration and direction of each session period may be adjusted using the session parameter controlslocated below an associated one of the protocol session icons. Various other parameters, such as resistance, target speed range (RPM), pedal radius limits, etc. may be adjusted using other session parameter controls. In some embodiments, the number and the type of session parameter controlsmay change depending on the type of session period selected. For example, selecting a protocol session iconfor an active type of session period may cause the target speed range (RPM) session parameter controlto be visible and adjustable, but the target speed range (RPM) session parameter controlmay not be visible and/or adjustable in response to selecting a protocol session iconfor a passive type session.

In some embodiments, the systemmay impose limits on values that can be set using the session parameter controls. For example, the treatment planmay include a maximum session time. In some embodiments, to satisfy a rule of the systemor a rule within the treatment plan, one or more of the values of the parameters may be automatically changed by the system. For example, the treatment planmay require a resistance type of session period after an active type of session period, wherein the former is at least 25% as long as the active type of session to allow the patient to cool down after active exercise. The systemmay automatically create the resistance type session period in response to the clinician creating an active type session period. The systemmay also automatically adjust the time of the resistance type session period to satisfy the requirement of it lasting at least 25% as long as the active type of session.

In some embodiments, the treatment planmay include maximum values for certain parameters until an associated condition is satisfied. For example, the pedal radius limit may be limited to 40 mm until an associated condition is satisfied. Associated conditions may include, for example, approval by an authorized person, such as an orthopedic surgeon; the elapsing of a particular time, such as 5 days after a surgical procedure; or successful completion of a post-operation checkup. Similarly, the treatment planmay place limits on the types of session periods that may be performed until an associated condition is satisfied. The treatment planmay be limited to only passive or assisted session periods (and not active periods or resistance periods until an associated condition is satisfied. Different associated conditions may be associated with each of the different parameters and/or with limits on the types of session periods available.

shows an example embodiment of positioning confirmation screenof the patient interface. This screenis the beginning of a guided walk-through for the patient to use the treatment apparatus. Specifically, this screenincludes written instructions to guide the patient in placing their feet in the pedalsof a stationary cycling machine. In some embodiments, this screenmay include graphics, such as pictures or animations to help the patient perform particular actions for using the treatment apparatus. Screenincludes a position confirmation selectorfor the patient to indicate that they are in position to use the treatment apparatus. Screenalso includes a trouble buttonfor the patient to indicate that they are having trouble getting in position to use the treatment apparatus.

shows an example embodiment of a positioning help screenof the patient interface. This help screenmay be shown in response to the user selecting the trouble buttonon the positioning confirmation screen. The help screenmay automatically be displayed if the patient fails to select the position confirmation selectorwithin a predetermined period of time. In some embodiments, an intermediate screen such as a popup asking if the patient needs more time may be displayed before the help screenis shown. The help screenincludes assistance instructionsfor the patient to obtain assistance for using the treatment apparatus. In some embodiments, the assistance instructionsmay include a phone number. The assistance instructionsmay also include other items, such as a link to a video conference with someone able to help the patient, and/or a link to a video or animated walk-through with detailed instructions for performing a particular action to use the treatment apparatus. The particular action may include, for example, placing the feet in the pedals. The help screenmay also include an exit buttonthat the patient can use to stop the treatment session in case they are unable to resolve their issue with using the treatment apparatus. Use of the exit buttonmay generate an alert to the clinician. The help screenalso includes a proceed buttonthat the patient can use to indicate that they have resolved their issue and are able to proceed with the treatment session.

shows an example embodiment of an adjustment introduction screenof the patient interface. The adjustment introduction screenincludes text and/or graphics indicating various adjustments to be performed by the treatment apparatus. In the example shown, the adjustments include the treatment apparatusthat is a stationary cycling machinethat automatically moves the pedalsoutwardly to a predetermined position for the session period.

In some embodiments, the patient interfacepresents an adjustment confirmation control configured to solicit a response regarding the patient's comfort level with the position of the body part or the force exerted by the body part. The comfort level may be indicated by a binary selection (e.g., comfortable or not comfortable). In some embodiments, the comfort level may be an analog value that may be indicated numerically or with an analog input control, such as a slider or a rotary knob. In some embodiments, the comfort level may be indicated by one of several different comfort level values, such as an integer number from 1 to 5. In some embodiments, the comfort level may be indicated using controls for the patient to maintain a setting or for the patient to change the setting. More specifically, the adjustment confirmation control for the patient to change the setting may provide for the patient to change the setting in either of two or more directions. For example, the controls may allow the patient to maintain the value of a setting, to increase the value of the setting, or to decrease the value of the setting.

In some embodiments, the patient interfaceand/or a server may generate and/or present the adjustment confirmation control using one or more machine learning models. The one or more machine learning models may be trained using training data including inputs that are mapped to outputs, such that the machine learning models identify patterns in the data to generate a certain output. The training data may include input data of types and/or arrangements of graphical user interface elements to present that are associated with a higher likelihood of a patient providing feedback. The training data may include input data of values of comfort levels to present that are associated with a higher likelihood of a patient providing feedback. The training data may include input data of values of positions of body parts to present that are associated with a higher likelihood of a patient providing feedback.

The adjustment confirmation control may take the form of an adjustment confirmation screen, as shown, for example, in. The adjustment confirmation control may take other forms, such as a popup window or a portion of a larger display screen. The patient interfacemay present the adjustment confirmation control on a graphical user interface, such as a display screen or an overlay or virtual control within a virtual reality (VR) or augmented reality (AR) display. Additionally or alternatively, the adjustment confirmation control may include one or more physical control devices, such as buttons, knobs, sliders, etc. In some embodiments, the adjustment confirmation control may be used in conjunction with an automatic adjustment, such as an actuatorwithin the treatment apparatus. For example, as shown in the FIGS., an actuatormay change the radius of one of the pedals, thus changing the position of the patient's knees. The adjustment confirmation control may then solicit a response regarding the patient's comfort or discomfort with the adjusted position. In another example, the patient interfacemay prompt the patient to apply a target pressure, such as 50 lbs. The adjustment confirmation control may then solicit a response regarding the patient's comfort or discomfort in applying the target pressure.

The phrase “ICON” refers to ‘increase control’, the phrase “DCON” refers to ‘decrease control’, and the phrase “SCON” refers to ‘stay control’, unless explicitly stated otherwise, are intended to be understood as noun phrases meaning controls that serve the functions of increasing, decreasing, or maintaining corresponding values.

The adjustment confirmation screenincludes text and/or graphics requesting the patient to confirm their satisfaction with the position of the treatment apparatusduring and/or after the automatic adjustments are made. The adjustment confirmation screenincludes an increase control that the patient may select to indicate a desire to increase the value of a corresponding parameter. The corresponding parameter may be a position of the treatment apparatussuch as the radius of the pedalon the pedal arm. The corresponding parameter may be a setting for a force or a speed of an exercise performed as part of the regimen. For example, the corresponding parameter may be a target pressure or a target RPM speed in a given session period. The increase control may take the form of an increase button, such as the button shown on. The increase control may take other forms, such as a knob or slider control, which may be a physical device or part of a graphical user interface. The adjustment confirmation screenalso includes a stay control that the patient may select to indicate a desire to maintain the value of the corresponding parameter. The stay control may take the form of a stay button, such as the button shown on. The stay control may take other forms, such as a knob or slider control, which may be a physical device or part of a graphical user interface. The adjustment confirmation screenalso includes a decrease control that the patient may select to indicate a desire to decrease the value of the corresponding parameter. The decrease control may take the form of a decrease buttonsuch as the button shown on. The decrease control may take other forms, such as a knob or slider control, which may be a physical device or part of a graphical user interface. For example, if the patient experiences pain or discomfort with the initial position, he or she may change the position using the decrease buttonuntil the pain or discomfort is alleviated.

In some embodiments, one or more of the increase, the decrease, and/or the stay control(s) may be provided by one or more of the sensors,,. For example, the patient interfacemay prompt the patient to move a body part until they start to feel discomfort, the systemmay use one or more of the sensors,,to measure the range of motion that the body part moved, and that range of motion may be used for performing the rehabilitation regimen. In another example, one or more of the sensors,,, such as a pressure sensorand/or a goniometer, may measure a physical response by the patient, such as a flinch that indicates pain. A target value of the parameter may be set based upon the value of the parameter where the patient indicated pain or discomfort. That target value of the parameter may then be used for performing the rehabilitation regimen. The target value of the parameter may be set based upon a value of the parameter where the patient indicated pain or discomfort. The target parameter value may be set to X % of P, where X is a predetermined percentage, and P is the value of the parameter where the patient indicated pain or discomfort. For example, if a patient indicated pain at a pedal radius of 6.0 cm, and X is 90%, the target parameter value for the pedal position may be set to 5.4 cm, or 90% of 6.0 cm. Alternatively, the target parameter value may be set using an offset value that is added or subtracted from the value of the parameter where the patient indicated pain or discomfort. For example, if a patient indicated pain at pedal radius of 8.0 cm, and the offset value is −1.2 cm, then the target parameter value for the pedal radius may be set to 6.8 cm. Values of other parameters, such as target pressure or target speed, may be similarly adjusted.

In some embodiments, the systemmay be configured to persuasively motivate the patient to use one or more settings for the position of the body part and/or the force exerted by the body part. For example, the patient interfacemay show a target value or a target range for the position of the body part and/or the force exerted by the body part. In another example, the patient interfacemay periodically encourage the patient to increase a setting for the position of the body part and/or the force exerted by the body part, particularly where that setting is below a target value or a target range. The systemmay gradually increase a setting for the position of the body part and/or the force exerted by the body part while the patient is using the body part to perform the rehabilitation regimen. In some embodiments, the adjustment confirmation control may be presented to the patient only after the setting for the position of the body part and/or the force exerted by the body part has been actively used in performing the rehabilitation regimen for some period of time. In some embodiments, the adjustment confirmation control may not be presented to the patient, even after the setting for the position of the body part and/or the force exerted by the body part is adjusted.

In some embodiments, the patient interfacemay present the adjustment confirmation control before the patient performs the rehabilitation regimen. Such a pre-performance adjustment allows the patient to use a confirmed or adjusted position and/or force setting while performing the rehabilitation regimen. Additionally or alternatively, the patient interfacemay present the adjustment confirmation control during and/or after the rehabilitation regimen. For example, the adjustment confirmation screenmay be presented to the patient during a session or between sessions of the rehabilitation regimen. In some embodiments, the adjustment confirmation control may be presented in response to a triggering event. The triggering event may include, for example, the patient reporting pain in excess of a given value, or an inability to complete one or more activities within the treatment plan, or a sudden decrease in walking performed by the patient. Additionally or alternatively, the adjustment confirmation screenmay be presented to the patient after the patient has completed a session of the rehabilitation regimen. Such a post-session confirmation may be used to determine the patient's comfort, which may be a proxy for satisfaction with the session of the rehabilitation regimen. The post-session confirmation may be used to determine one or more settings for use in subsequent sessions. For example, an indication of “stay” or “increase” may cause a target value for position and/or pressure of the body part to be increased in subsequent sessions of the rehabilitation regimen.

shows an example embodiment of a session period action screenof the patient interface. This screenis displayed while a given session period is in progress. It includes one or more indicators showing real-time status of measurements regarding the patient's use of the treatment apparatusto perform the rehabilitation regimen upon patient's body part. The measurements displayed may include, for example, a position of, and/or a force exerted by, the patient's body part. The example session period action screenofincludes pressure indicatorsshowing an amount of pressure or force applied by each foot. The pressure indicatorsshow the pressures of the patient's feet upon the pedalsas measured by the pressure sensors. The pressure indicatorsare shown as bar graphs, but other types of displays may be used, such as rotary gauges and/or numeric indicators. The pressure indicatorsmay also include a target pressure indicatorrepresenting a target setting such as a target pressure value. The target setting may be determined by the clinician using an associated session parameter controlon the protocol management display, as shown, for example, on. The target setting may be set or adjusted via the adjustment confirmation control, by the patient.