Image analysis – Applications – Motion or velocity measuring
Reexamination Certificate
2002-11-18
2004-11-09
Mehta, Bhavesh M. (Department: 2625)
Image analysis
Applications
Motion or velocity measuring
C382S174000, C600S301000
Reexamination Certificate
active
06816603
ABSTRACT:
TECHNICAL FIELD
The present invention relates to techniques for monitoring the medical condition of a subject or subject/patient most especially neuromuscular motor activity, and, to a method and apparatus for monitoring a subject or subject/patient at a remote site from a central station by means of interactive visual, audio and data transmission communications. While the invention is also suitable for use in any situation where any subject or subject/patient is to be monitored at a site remote from a central station, an important application is the monitoring and caring for the elderly (both well and ill persons) in the home environment. Thus, the present invention can also be said to relate to the field of geriatric care. Further, the techniques disclosed may also be utilized in a hospital or clinic setting inasmuch as they constitute diagnostic techniques useful for any person and at any local or remote location. Additionally the techniques and methods have application to other disciplines including, but not limited to, psychological diagnosis and monitoring, and interrogation monitoring and analysis. Finally, the invention enables conduct of physiological analysis utilizing a single video camera and without markers.
BACKGROUND OF THE INVENTION
Ambulatory Care in General
Most of the resources for modern medicine have been invested in the development of highly sophisticated hospital facilities. Therefore, institutional patient care has become prohibitively expensive, in many cases overused and for a substantial number of patients potentially harmful. The tendency to substitute costly institutional patient care with effective and cost containing extra-institutional, ambulatory medical facilities is gaining rapid momentum. These attempts however are still confined to the delivery of care in outpatient clinics to which the patient has to come to obtain medical care, or home nurse visits which are short, scarce, and insufficient. The combination of growing sophistication in ambulatory monitoring technology together with the explosive development of telecommunication provides the ideal substrate to enable the development of highly sophisticated, reliable and affordable, remotely controlled, remote monitoring capabilities which can monitor, analyze and assess many physiological parameters in any potential subject and in any possible location. Such a system is specially suited to provide a sophisticated platform or home care facilities for a wide spectrum of subject/patient.
The described invention is a neuromuscular and motor activity remote monitoring system for any person in need of remote assessment of physiological, psychological, and other parameters. From the subject/patient care aspect one of the important applications of this system is monitoring and care of the elderly geriatric population. This is due to the complexity of the holistic approach to geriatric care, which will be elaborated below.
Geriatric Ambulatory Home Monitoring
Modern society with its improvement in living conditions and advanced health care has brought about a marked prolongation of life expectancy. This change has resulted in a dramatic and progressive increase in the geriatric population. A large percentage of the geriatric population needs continuous general, as well as medical, supervision and care. For example, supervision of daily activities such as dressing, personal hygiene, eating and safety as well as supervision of their health status is necessary. Furthermore, the relief of loneliness and anxiety is a major, yet unsolved, problem to be addressed. These and other facets of the management of the ever increasing geriatric population have yet to be successfully addressed and solved.
The creation of retirement facilities and old age homes, as well as other geriatric facilities, provide only a partial solution to the problems facing the geriatric population. The geriatric population, a constantly increasing fraction of society, has become increasingly dependent upon the delivery of home health and general care, which has its own set of challenges and drawbacks.
The notion of ambulatory (home environment) subject/patient care is gaining increased popularity and importance. This shift in subject/patient care from the “sheltered” institutional milieu to the subject/patient's home, work place, or recreational environment is due primarily to a radical change in concepts. That is, specialists in geriatric care now tend to keep the aged in their own natural environment for as long as possible.
Except for scarce model organizations, home care is still carried out either by the subject/patient's family or by nonprofessional help, or, in the usual circumstance, by professional, highly trained personnel at very significant expense. The monitoring equipment at home care facilities is usually minimal or nonexistent, and the subject/patient has to be transported to the doctor's office or other diagnostic facility to allow proper evaluation and treatment.
Subject/patient follow-up is presently done by means of home visits of nurses which are of sporadic nature, time consuming and generally very expensive. A visiting nurse can perform about 5-6 home visits per day. The visits have to be short and can usually not be carried out on a daily basis. Moreover, a visiting nurse program provides no facilities for continuous monitoring of the subject/patient and thus no sophisticated care, except in fortuitous circumstances, in times of emergency. The remainder of day after the visiting nurse has left is often a period of isolation and loneliness for the subject/patient. The existing home care nursing facilities divert skilled nurses, a scarce commodity, from the hospital environment and uses them in a highly inefficient manner due to the wide dispersion of the subject/patients and the lack of sophisticated diagnostic facilities in the subject/patient's home. Clearly, the practice of visiting nurses leaves much to be desired.
These considerations apply to the general population as well, as the spiraling cost of hospital care has lead to a dramatic increase in the use of outpatient care as a treatment modality.
Falls and Injuries in the Aged
Additional facts support development of an improved home health care system especially for a geriatric population. In particular, falls are a major health problem among the elderly, causing injury, disability and death. One third (some studies suggest half) of those over the age of 65 suffer at least one fall each year. The rate of falling increases to 40% among those who exceed the age of 80. According to the National Safety Council, falls accounted for one-third of the death total for the elderly. Those who survive falls may have restricted activity, soft-tissue injuries, or fractures. It is estimated that up to 5% of falls by elderly persons result in fractures. A similar percent result in soft-tissue injury requiring hospitalization or immobilization for an extended period. It is estimated that hip fractures resulting from falls cost approximately $2 billion in the United States during 1980. Falls are mentioned as a contributing factor to admissions to nursing homes.
The factors leading to falls can be divided into two main groups: environmental factors and medical factors. In spite of the difficulty in the surveillance of subject/patient condition before a fall, almost all researchers share the conclusion that environmental hazards are decreasingly important in causing falls as age increases. A clear correlation between clinical or medical problems and the incident of falls by the elderly has been established. Many of these medical problems of the elderly or infirm can be detected by simple clinical observation. For example gait and balance abnormality may indicate difficulty with neurologic and musculoskeletal functions that may contribute to physical instability. Changes in gait can be identified by the following: slow speed, short step length, narrow stride width, wide range of stepping frequency, a large variability of step length, and increasing variab
David Daniel
David Zipora
Garber Semion
Margolis Avmir
Mikhlin Mark
Banner & Witcoff , Ltd.
Choobin Barry
Commwell, Inc.
Mehta Bhavesh M.
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