Surgery – Diagnostic testing – Measuring anatomical characteristic or force applied to or...
Reexamination Certificate
1999-08-13
2001-07-31
O'Connor, Cary (Department: 3736)
Surgery
Diagnostic testing
Measuring anatomical characteristic or force applied to or...
C600S552000, C600S595000
Reexamination Certificate
active
06267733
ABSTRACT:
BACKGROUND OF THE INVENTION
The present invention relates to improving somatosensory perception and motor control deficits. More particularly, the present invention relates to computer-implemented methods and apparatus for improving somatosensory perception and motor control in an individual via somatosensory training that incorporates proprioceptive, tactile and/or kinesthetic sensory input.
Motor control problems range from shaking in the hands and fingers to more severe issues such as debilitating pain related to a motor control deficit. Often, the motor control problems may include weakness, fatigue, motor control inaccuracy, loss of coordination, loss of voluntary movement, abnormal synhcracies of movement, involuntary dystonic movements, e.g., when a hand touches an object, and involuntary motor movement such as co-contraction of flexors and extensors when the hand touches a target surface. For some individuals, these abnormalities may compromise a person's ability to attend work, school or even handle personal care or common household tasks.
Motor control and somatosensory deficits in individuals find their genesis in a variety of different causes. Typical causes include injury, birthing, inflammation, cardiopulmonary malfunction, impingement, chronic pain, disease, aging, degeneration, atrophy and gradual “occupational” type injury. The deficits related to an injury may be associated with trauma, stroke, anoxia, aneurysm, embolism, invasive surgery, etc. The deficits may also be related to any peripheral or central nervous system deficit. Examples of diseases capable of inducing motor control and/or somatosensory deficits include meningitis, infections, allergy, diabetes, neuromuscular disorders, and cancer. Alternatively, some motor control and somatosensory problems may not be not caused by an acute injury or disease, but may be associated with a gradual degradation of the somatosensory or motor control system over time. Examples of progressive degradation of the somatosensory and/or motor control systems over time include work-induced focal dystonia, myaesthonia gravis, amyotrophic sclerosis, torticollis, Alzheimer's disease, cerebral palsy, multiple sclerosis and movement disorders such as Parkinson's disease, ataxia, Huntington's chorea, and other progressive neurological illnesses. In some cases, the cause of the motor control impairment may be unaccountable.
In particular, focal hand dystonia is the involuntary co-contraction of flexors and extensors in the hands when performing a target task. In other words, there is a loss of reflex inhibition leading to uncontrolled contraction of the flexors pulling the hand closed and the extensors pulling the digits open. As a result, the individual typically loses fine motor control of the hand and can no longer perform tasks that require fine motor coordination.
A common origin of focal dystonia is as a component of a repetitive use. Repetitive strain injuries may be the result of attended rapid movements repeated over a relatively long period of time. Generally, these potentially harmful rapid movements occur at a frequency at or below about 100 milliseconds. Typical symptoms of focal hand dystonia include pain, swelling, inflammation and muscle spasm, loss of motor control, and involuntary movements of the affected hand. Rest and anti-inflammatories can decrease the symptoms but continued repetition can lead to painful fatigue and awkward movements.
Individuals who frequently suffer from these motor control deficits include those who are highly skilled and required to repeatedly execute rapid motoric tasks. Conditions such as stress and high attention may also contribute to the development of the condition. For example, musicians and typists, or other skilled manual workers who are required to repeatedly execute rapid alternating movements (e.g., to produce trills and keyboard strokes or to perform a particular assembly line task) are particularly prone to motor control degradation of this nature. Potentially harmful rapid movements may also include rapid simultaneous movement of adjacent portions of a limb which can otherwise be controlled independently, e.g., when multiple digits of one hand are opened and closed rapidly.
Unlike traumatic injury patients, most repetitive strain injury subjects experience a slow onset of symptoms such as painful inflammatory problems of the capsule, ligaments, tendons and fascia. Subsequently, if the potentially harmful repetitive movements are continued, the degradation of motor control ultimately develops, primarily in the area responsible for the movement. Eventually, the dysfunction may spread to other parts of the body and other tasks, and the patient may then report a feeling of awkwardness, fatigue, or impaired timing or force.
In the past, evaluation and treatment of deficient motor skills typically required face-to-face treatment in a clinical setting with a health care professional. Unfortunately, the convenience or ability of the person to travel to the treatment site limits the treatment frequency and may compromise treatment efficacy. This limitation may be further exacerbated if the motor control deficit compromises the ability of the individual to travel to the treatment site. More importantly, treatment consistency and quality with conventional manual testing has been limited due to the reliance on estimated and non-quantitative judgements by the health care professional regarding treatment efficacy.
Historically, regardless of whether the deficit is accompanied by a loss of motor or sensory ability, the manual training may typically include strengthening, flexibility, splinting, conditioning and neuromuscular retraining techniques, and has produced limited success. This is partly because the conventional treatments tend to be directed at the symptoms but do not attempt to identify nor address the source of the problem. As a result, despite rest and conventional treatment, the motor control problems, and any accompanying issues such as inflammation, often return as soon as the subjects attempt to resume the repetitive movements.
In view of the foregoing, there are desired improved apparatus and methods for treating motor control deficits accompanied by sensory degradation.
SUMMARY OF THE INVENTION
The present invention describes computer-implemented methods and apparatus for treating somatosensory perception and motor control deficits. The somatosensory perception and motor control deficits may have their genesis in a wide variety of issues including injury, disease, and a gradual degeneration over time due to repetitive strain, for example. Typically, the motor control deficits are related to somatosensory feedback problems. By administering a computer-implemented training regime directed to improve somatosensory perception and motor control, abnormal motor control deficits may be substantially improved. The computer-implemented training regime includes somatosensory and motor control exercises which may be flexibly administered. The training regime may be directed to progressively improving one or more somatosensory perception abilities and/or motor control deficits.
The invention also encompasses several computer-implemented systems for training one or more somatosensory perception and motor control deficits. The systems generally consist of a computer and a testing apparatus. The computer typically has a processor, a storage means for storing unprocessed training information, processed training information and instructions for manipulating training information. Three testing apparatus are described which implement somatosensory perception and motor control exercises based on proprioceptive, kinesthetic and tactile perception. The testing apparatus may allow for user input, provide output to the user, and require for a wide range of sensory feedback and motor control ability from the person.
The invention relates in accordance with one embodiment to a somatosensory and motor control training device for improving one of a somatosensory perception
Byl Nancy
Calhoun Barbara M.
Jenkins William M.
Merzenich Michael Mathias
Nagarajan Srikantan
Beyer Weaver & Thomas LLP
Marmor II Charles
O'Connor Cary
Scientific Learning Corporation
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