WO2020170001A1

WO2020170001A1 - Device and method for patient exercising in aquatic conditions

Info

Publication number: WO2020170001A1
Application number: PCT/IB2019/000236
Authority: WO
Inventors: Alizée AMIENS; Frédéric BARBOT; Beatriz ALVES MARTINS; Charlotte ADAMO; Margot ASCOET
Original assignee: INSERM (Institut National de la Santé et de la Recherche Médicale); Universite De Versailles-Saint-Quentin-En-Yvelines
Priority date: 2019-02-22
Filing date: 2019-02-22
Publication date: 2020-08-27

Abstract

A device (10) comprises a housing (2) forming an enclosed area and being configured to be filled with fluid up to an adjustable level; a sensory carpet (1)provided with a plurality of force sensors; a processing unit and a first interface (5) coupled to the processing unit. The force sensors are able to record and transmit plantar pressure data of a user moving on the carpet to the processing unit. A plurality of cameras (41, 42, 43, 44) provided on parts of the housing is able to record and transmit lower limb movement data of said user to the processing unit. The processing unit is able, based on the received plantar pressure data and lower limb movement data, to transmit a first signal relative to a type of movement to perform on the carpet to the first interface. A training method of a user uses such a device (10).

Description

Device and method for patient exercising in aquatic conditions

FIELD OF THE INVENTION

The present invention relates to devices and methods for patient exercising in aquatic condition, and more particularly for patients endeavouring to recover a normal stance and balance after having undergone a disorder.

BACKGROUND OF THE DISCLOSURE

Rehabilitation is a public health issue that addresses the problem of loss of autonomy. Following a rehabilitation program involves the practice of movements with consistency and perseverance by people suffering from motor difficulties, in order to achieve a continuous and gradual improvement of their motor skills. Such an effort makes it harder for the patients to keep up and stay focused during the exercise. Preserving the patients’ motivation and interest is then a challenge for the physiotherapist supervising their progress.

Practice of rehabilitation in an aquatic environment has many advantages, whether for the treatment of acute traumas, musculoskeletal disorders, neurological problems, orthopaedic or rheumatological problems, cardiopulmonary problems or by keeping fit in the face of chronic diseases. Thanks to the clinical adaptability of such a technique, the practitioner can program therapies adapted to a population of patients with diverse pathologies.

From a physiological point of view, immersion in an aquatic environment has many biological effects. Immersion up to the belly button brings the perceived weight down to 50% of the actual weight of the patient. Combination with the hydrostatic pressure allows an elevation of the centre of gravity as well as an easing of the maintenance of static and dynamic equilibrium. The temperature of water provides a physiological effect as the heat helps to relax muscles through dilation of blood vessels. These effects make the patient feel lighter, freer and therefore reassured, and help to provide a positive psychological effect.

Association of the hydrostatic pressure with the viscosity of the medium creates exteroceptive sensory stimuli. In fact, immersion of the body in water causes a better perception of the position of the patient’s limbs. Resistance to displacement enhances both exteroceptive and proprioceptive information, thus allowing a better awareness of the overall body pattern during movement. Moreover, the hydrostatic pressure, by intensive stimulation of the baresthetic receptors, acts as an analgesic for the joints. Such an effect is known under the“gate control system” theory, and seems to improve the functional abilities of the patient thanks to the reduction of suffering.

At the musculoskeletal level, the use of water properties allows a better rehabilitation through several effects, among which are: musculoligamentary circulation by the increase of oxygen supply and the improvement of metabolic waste disposal; decrease in potential edema; modular muscle toning; reduction of joint constraints by a work in discharge; relaxation and analgesic effect of immersion, especially on chronic pain; sensory stimulation, for example in the case of a significant postural deficit; stimulation of afferent fibres in subjects whose sensitivity is impaired; proprioception and better perception of the body diagram; improved motor coordination and balance thanks to the inertia of water, in the case of central nervous system dysfunction.

The fields of application of immersion in water are very wide and may be suitable for a large part of the population: athletes, paediatrics, patients affected with disorders mentioned above, geriatrics and obese persons.

Existing technologies suggest therapy pools and underwater treadmills, and combine large boxes equipped with a treadmill on the ground or specific water resistance jets. These technologies being directed to recovery of stability and even support on both legs, their applications are diverse: sport performance purposes, weight challenge, recovery from injuries, re-education after neurological disorders, strokes, orthopedic pathologies including fractures, malformations such as varus valgus, but also and especially re-education after prosthesis placement. However, only a small proportion of this kind of products is registered as medical devices, and most of them do not record clinical parameters. The association of such devices with connected gaming has not been seen on the market so far.

SUMMARY OF THE DISCLOSURE

According to one aspect of the present invention, it is disclosed a device comprising: a housing forming an enclosed area, the housing being configured to be filled with fluid up to an adjustable level;

a sensory carpet extending substantially horizontally within the housing;

a processing unit and a first interface coupled to the processing unit;

a plurality of force sensors provided in the carpet and able to record and transmit plantar pressure data of a user moving on the carpet to the processing unit;

a plurality of cameras provided on parts of the housing and able to record and transmit lower limb movement data of the user moving on the carpet to the processing unit; the processing unit being able, based on the received plantar pressure data and lower limb movement data, to:

transmit a first signal, relative to a type of movement to be performed by the user on the carpet, to the first interface,

the first interface comprising a display screen to display information depending on said first signal.

Thanks to these dispositions, there is provided a convenient and efficient device for contributing to patient balance and stance recovery.

By‘user’ herein, it should be understood a patient or a training individual seeking to increase their balance or athletic performance by exercising.

In various embodiments of the invention, one may possibly have recourse in addition to one and/or other of the following arrangements:

the first interface further comprises communication means with the user, configured to generate information depending on said first signal;

the device comprises a second interface coupled to processing unit, the processing unit being able, based on the received plantar pressure data and lower limb movement data, to transmit a second signal representative of the motion of the user on the carpet to the second interface;

the processing unit is able, based on the received plantar pressure data and lower limb movement data, to transmit a third signal representative of the motion of the user on the carpet to the first interface, the first interface being configured to provide the user with feedback information about his or her motion on the carpet based on said third signal;

the carpet is provided with a plurality of vibrating devices, the processing unit being able, based on the received plantar pressure data and lower limb movement data, to transmit a fourth signal to the plurality of vibrating devices, the fourth signal being configured to activate at least a subset of the plurality of vibrating devices;

the housing comprises a base frame, a front panel, two transparent side panels and a back panel;

a door is arranged on the back panel, a watertight sealing arrangement being provided on the door in the closed door position; the cameras of the plurality of cameras are waterproof;

each side panel is provided with a camera, each camera having a field-of-view oriented toward a center area of the housing and being arranged below a fluid minimum level;

at least three cameras of the plurality of cameras are arranged below the fluid minimum level, and at least one camera is arranged in the vicinity of the first interface, for tele-surveillance purposes, the first interface being arranged on the front panel in substantially upright position;

the housing extends along a longitudinal direction, and the device comprises at least one guard bar extending along the longitudinal direction of the housing, said guard bar being adjustable in height and provided on one of the parts of the housing;

the housing extends along a longitudinal direction and a transversal direction, and the force sensors are disposed in arrays along the longitudinal and transversal directions; the sensory carpet is provided with data communication means between the sensory carpet and the processing unit, said data communication means comprising wireless means configured to transfer data between force sensors and the processing unit, the sensory carpet being powered by a battery;

the device comprises an inclination system for tilting the carpet with regard to the base frame.

The sensory carpet is therefore a proprioceptive platform which allows the user to perform advanced and various balance exercises, in particular when becoming unstable by tilting, and provides information about the support of the user through plantar pressure data to improve the monitoring of said balance exercises. Such properties are essential for the user to regain full confidence in their leg supports.

According to another aspect of the present invention, it is disclosed a training method of a user using a device as described above, the method comprising the following steps:

record and transmission, by the plurality of force sensors, of plantar pressure data of the user moving on the carpet, to a processing unit;

record and transmission, by a plurality of cameras provided on parts of the housing, of lower limb movement data of the user moving on the carpet, to the processing unit; transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a first signal relative to a type of movement to perform on the carpet, to the first interface.

The use of lower limb water rehabilitation is improved by providing a device combining the use of sensors for direct biofeedback and serious game aspects to increase patient motivation. The equipment facilitates real-time monitoring of the user’s rehabilitation and learning. In addition, the device allows the physiotherapist, through information management and processing software, to program personalized movement sequences based on each patient's pathology and monitor their progress throughout the rehabilitation session as well as the entire program. At each stage, the needs of professionals and patients have to be taken into account to ensure the success of rehabilitation processes.

the training method further comprises the following step: transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a second signal representative of the motion of the user on the carpet, to a second interface; the training method further comprises the following step: transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a third signal representative of the motion of the user on the carpet to the first interface, the first interface being configured to provide the user with feedback information about his or her motion on the carpet based on said third signal;

the training method further comprises the following step: transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a fourth signal to a plurality of vibrating devices, the fourth signal being configured to activate at least a subset of the plurality of vibrating devices.

The provided device and training method are directed to training a patient, also referred to as a user of the disclosed device, in order to relearn to take support on their legs, to regain confidence in their balance and coordination. This device and training method serve to test the weight transfer, test the recovery of support evenly on each foot or leg, test the body balance, test the coordination of the legs and the user’s learning of suggested trajectories, and prepare for a faster and easier prospective walking reeducation.

BRIEF DESCRIPTION OF THE DRAWINGS

Other features and advantages of the invention appear from the following detailed description of one of its embodiments, given by way of non-limiting example, and with reference to the accompanying drawings, in which:

- Figure 1 illustrates a general layout of a device according to the invention,

- Figure 2 is a diagrammatic side elevational view of the device of Figure 1 with a user exercising therein,

- Figure 3 is a diagrammatic top view of the device of Figure 1 with a patient exercising therein,

- Figure 4 shows an exemplary block diagram of the device,

- Figure 5 illustrates a diagrammatic sectional view of the sensory carpet,

- Figure 6 illustrates an exemplary set of steps involved in the disclosed method,

- Figures 7A, 7B and 7C illustrate inclination of the carpet through an inclination system,

- Figure 8 illustrates an exemplary sensory carpet,

- Figure 9 illustrates a plantar pressure mapping.

DETAILLED DESCRIPTION OF THE DISCLOSURE

In the figures, the same references denote identical or similar elements. It should be noted that, for clarity purposes, some element(s) may not be represented at scale.

Figure 1 shows an exemplary device designated by reference numeral 10. The device 10 comprises a housing 2 extending in a longitudinal direction (X).

The housing 2 forms an enclosed area and is impervious. Watertightness rating allows water to be filled at least up to 1 m high without leak ; watertightness rating can be at least IP68. In this illustrated embodiment, the housing 2 is a fluid container, preferably a water container, adapted to be filled with a fluid, preferably water, up to an adjustable level. The level up to which the fluid container is filled varies between a minimum level designated by reference LI in figure 2, and a maximum level designated by reference L2 in figure 2. Fluid levels are measured in the vertical direction Z. A purge valve, designated by reference 54 in figure 4, is provided to empty the fluid container from fluid.

The housing 2 comprises a base frame 20 extending in a horizontal plane (XY), a front panel 21 and a back panel 24 each extending in a vertical plane (YZ), and two side panels (22,23) each extending in a vertical plane (XZ). In a preferred embodiment, the side panels are manufactured in a transparent material. The side panels face each other in the transversal direction (Y). The front and back panels face each other in the longitudinal direction (X). As illustrated in figure 1, a door 6 is provided on the back panel with a door handle 64. The door 6 is configured to be in an open door position designated by reference 6’ in figure 1 to let the user in or out of the internal space of the housing, and a closed door position where it extends in the same vertical plane (YZ) as the back panel 24. The door 6 is provided with a watertight sealing arrangement in the closed door position. For allowing the user to enter or exit the internal space of the housing, the housing is preferably devoid of fluid prior to door opening.

The housing 2 is provided with at least one guard bar (61, 62). Said guard bar (61, 62) is provided on a part of the housing and preferably extends along the longitudinal direction (X) of the housing. Said guard bar (61, 62) is preferably adjustable in height, so that the guard height varies between a minimum height HI and a maximum height H2 referenced in figure 2. The housing 2 may also be provided with a crash bar or a harness to support a polytraumatic user.

In the embodiment of figure 1, the housing 2 is provided with two guard bars 61 and 62, each of them being located along a side panel of the housing. Each guard bar 61, respectively 62, extends between two bar ends (61a, 61b), respectively (62a, 62b). The front panel, respectively back panel, is provided with a first front vertical slot, respectively a first back vertical slot, to which the bar end 61a, respectively the bar end 61b, is connected, and with a second front vertical slot, respectively a second back vertical slot, to which the bar end 62a, respectively the bar end 62b, is connected. The vertical slots extend between the height HI and the height H2.

The device 10 further comprises a sensory carpet 1 provided on the base frame 20. The sensory carpet extends in a horizontal plane (XY), and comprises a plurality of force sensors 16. In a preferred embodiment, the plurality of force sensors is arranged in arrays, preferably in longitudinal and/or transversal arrays. In a preferred embodiment, and in the interest of safety, the force sensors 16 are isolated by rubber, silicone, plastics or any other similar material to prevent fluid from reaching them. In an exemplary embodiment, the sensory carpet 1 comprises a plurality of sensor mounting elements, each force sensor 16 being mounted in a sensor mounting element as illustrated in figure 4.

Figure 5 illustrates a diagrammatic sectional view of the sensory carpet 1. The sensory carpet 1 comprises a first carpet layer 11 and a second carpet layer 12. The first and second carpet layers extend in the same plane and are superimposed to form the carpet 1. The first and second carpet layers (11, 12) can be made from a rigid or flexible material. The first and second carpet layers (11, 12) are at least sealed on their borders to form a watertight enclosure and provide the carpet with waterproof property. Force sensors 16 are provided in the carpet 1 and are sandwiched between the first carpet portion 11 and the second carpet portion 12 as illustrated on figure 5.

The force sensors 16 may be pressure transducers of different types. The force sensors 16 are preferably chosen from the following list: strain gage transducers, variable capacitance type transducers, piezoelectric transducers. The sensors can be of the resistive or capacitive type. In a preferred embodiment, the sensory carpet is a baropodometry platform comprising force plates. Such a sensory carpet allows assessment of the balance of the user and quantification of the position and movement of the center of gravity of the user’s body.

The top side of the carpet is provided with pictograms, preferably step pictograms as an indication, for a user moving on the carpet, of positions to step on. A first pair of step pictograms is provided at the center of the carpet. A second, respectively third, pair of step pictograms may be provided in front of the first pair, respectively behind the first pair, the first, second and third pairs being arranged along the same longitudinal direction (X). An exemplary embodiment of the second pair of step pictograms is designated by reference 14a in figure 3. A fourth pair of step pictograms may be provided on the same transversal direction (Y) as the first pair, each step pictogram of the fourth pair being at a side of the first pair.

The device comprises a processing unit designated by reference 3 as shown in figure 4. The plurality of force sensors 16 is coupled to the processing unit 3 and is configured to record and transmit plantar pressure data of a user, designated by reference U in figure 2 and moving on the carpet 1, to the processing unit 3.

In the embodiment of figures 1 to 3, the device 10 comprises a plurality of cameras (41, 42, 43, 44) provided on parts of the housing. Each side panel (22, 23) is provided with a camera (42, 43). The front panel is provided with two cameras (41, 44). The plurality of cameras is coupled to the processing unit 3 and able to record and transmit lower limb movement data of the user U moving on the carpet 1 to the processing unit 3. The data collected by the plurality of force sensors 16 and the plurality of cameras (41, 42, 43, 44) and transmitted to the processing unit 3 is an aggregate of low level and/or preprocessed data. The device 10 comprises a first interface 5 coupled to the processing unit 3. The first interface 5 is provided on the front panel 21 and comprises a display screen. In a preferred embodiment, the first interface 5 comprises a touch screen. The first interface 5 is configured to receive a first signal from the processing unit and display information based on said first signal. One of the two cameras (41, 44) is arranged in the vicinity of the first interface 5.

In another embodiment, the first interface further comprises communication means with the user, configured to generate information depending on said received first signal from the processing unit. Generated information might be visual as well as acoustic, for example through a loudspeaker 8 as illustrated on figure 4. The first interface might also be coupled to an augmented reality device such an augmented reality headset for the user U.

The first interface is arranged at a higher height H3 than the highest level attainable by the fluid in the fluid container, which corresponds to the maximum level L2 up to which the fluid container can be filled.

Figure 2 is a diagrammatic side elevational view of the device 10 of Figure 1 with the user U exercising therein. As explained above, an exercise allowed by the device 10 is one where the user U steps on different positions of the sensory carpet 1 with varying plantar pressures, with the fluid container being filled with a fluid up to a certain level. Optimal rehabilitation therapy results are reached when the user U exercises with their lower limbs being immersed in the fluid up to a height between their knee and their belly button. A goal of such an exercise is for the user to regain confidence in their body balance and leg support.

The fluid minimum level LI, when the filling of the fluid container is completed, is comprised between about 29 cm and about 57 cm, so that the fluid always reaches at least the knee when the device is in use by the user U. The fluid maximum level L2, when the filling of the fluid container is completed, is comprised between about 55 cm and about 106 cm. Advantageously, the value of the fluid level depends on the height of the user and especially the height of the user’s belly button, as optimal results are reached when the user exercises while being immerged in the fluid up to their belly button. The fluid container may be filled with a fluid volume comprised between 1000 liters to 2000 liters, depending of the dimensions of the fluid container and the size of the user.

The height H3 of the first interface is engineered so that it faces the user U when he or she is moving on the carpet 1. The height H3 is comprised between about 98 cm and 188 cm. By height H3 of the first interface, it is meant height of the gravity center of the first interface. In a preferred embodiment, the height of the first interface is adjustable, preferably between about 98 cm and 188 cm. the first interface can be either integral with the front panel, or mounted thereon for example through an arm extending above the top of the front panel, especially if the height of the first interface is higher than the height of the front panel.

The height of the fluid container is engineered to take into account the various sizes of potential users who shouldn’t feel boxed in. To this end, the height of the fluid container is comprised between 1.55 cm and 1.60 cm.

Figure 3 is a diagrammatic top view of the device of Figure 1 with the user exercising therein. The width of the fluid container is designated by reference DY1 in figure 3, and is measured along the transversal direction (Y). Said width DY1 is comprised between about 60 cm and 208 cm, preferably between about 70 cm and 173 cm. In an exemplary embodiment, said width DY1 is of about 1.20 m, for which an appropriate carpet width may be of about 1 m.

The length of the fluid container is designated by reference DX1 in figure 3, and is measured along the transversal direction (X). Said length DX1 is comprised between about 1 m and 2 m, and preferably of about 1.60 m which may correspond, for example, to a carpet length of about 1.30 m, a distance between the carpet and the front panel of about 10 cm and a distance between the back panel and the carpet of about 20 cm, said distances being measured along the longitudinal direction X. The carpet can occupy all the base frame surface. In alternate embodiment, the carpet can occupy a smaller surface compared to the base frame surface.

Cameras 41, 42 and 43 are configured to run in immersion in fluid; therefore, they are arranged at a height lower than the minimum level LI of fluid. In that purpose, the cameras 41, 42 and 43 are waterproof. In the illustrated embodiment of figure 3, the camera 41 is arranged in a median position in the transversal direction (Y), and the cameras 42 and 43 are arranged in a median position in the longitudinal direction (X). Such an arrangement of the cameras allows optimal space coverage by the cameras’ fields of view, which is particularly important to capture the user’s lower limbs movements during exercise and in immersion in fluid.

Figure 4 shows an exemplary block diagram of the device 10, and illustrates data exchanges in the device 10. In a preferred embodiment, the processing unit 3 is a serious game controller. The processing unit 3 is configured to receive data from at least the force sensors 16 of the sensory carpet 1. Wireless communication means 31, such as Wi-Fi or Bluetooth emitters-receivers, between the sensory carpet and the processing unit are provided, so that data exchange between the sensory carpet and the processing unit can be performed safely, especially when the sensory carpet is immerged in fluid.

In a preferred embodiment, the processing unit 3 is also configured to receive data from the plurality of cameras (41, 42, 43, 44), through communication means which can be wireless or not. For example, wireless communication means can be provided between the processing unit 3 and a part of the plurality of cameras (41, 42, 43, 44) which is arranged at a height lower than the minimum level LI of fluid, to run in immersion in fluid when the device 10 is on operation, or at a height between the minimum level LI and the maximum level L2 of the fluid, to occasionally run in immersion in fluid, depending of the level of the fluid in the fluid container when the device 10 is on operation.

In the illustrated embodiment of figure 4, a pair of microphones (81, 82) is arranged in the device 10 to collect and transfer acoustic data from the housing 2 to the processing unit 3. In a possible embodiment, the device 10 comprises at least one microphone to collect and transfer acoustic data from the housing 2 to the processing unit 3. In another embodiment, at least one microphone 82 is arranged to run underwater, i.e. in immersion in fluid, and is waterproof to serve that purpose.

The processing unit 3 processes different data types received from the multiple sources. More specifically, the processing unit 3 is configured to emit the first signal depending on at least the received plantar pressure data of the user U moving on the carpet 1. In a preferred embodiment, the processing unit 3 is configured to emit the first signal depending on at least the received plantar pressure data and lower limb movement data of the user U moving on the carpet 1. The first signal is transmitted at least to the first interface 5 which is configured to display information based on said first signal, the first signal being relative to a type of movement to perform on the carpet 1. Said displayed information on the first interface is therefore representative of a type of movement to perform on the carpet 1. This configuration is particularly useful for the processing unit to be a serious game controller.

In that purpose, the processing unit comprises at least a memory and a processor, a serious game software being stored in the memory and executed on the processor. The serious game software comprises program instructions adapted to process the different types of data received by the processing unit, and to transmit the first signal based on said received data and relative to a type of movement to perform by the user U on the carpet 1. In a preferred embodiment, the first signal is frequently adjusted to the data received by the processing unit 3, advantageously in time sequences lower than 3 seconds. The first signal is preferably adjusted to the received data every second. In another embodiment, the first signal is continuously adjusted to the received data.

In a particular embodiment, the first interface displays information to indicate to the user U where, how and when to perform a movement on the carpet 1. The data received by the processing unit may also be processed to provide a feedback on the movements performed by the user U on the carpet 1, as part of a third signal. Therefore, the third signal transmitted to the first interface is representative of such feedback information, so that the first interface displays information indicating to the user if the movement he or she is performing is right or wrong and, preferably and thanks to the first signal, how to correct or improve it. The sensory carpet 1 allows to collect useful information of the pedobarography and stabilometry of the user, in order to know the pressure exerted on the plantar level by his or her feet on the carpet, and if he or she places his or her foot correctly on the pictograms. One example of pedobarography output is given at figure 9 where each color (grey level) gives an image of the local pressure under the user’s feet.

Said displayed information on the first interface, based on first signal, can comprise instructions addressed to the user U to encourage him or her to place the right, respectively left, foot forward, on the right, respectively on the left, or take a step back, and more particularly on a specific step pictogram. In addition, when the third signal is transmitted by the processing unit, the first interface may display information representative of the plantar pressure exerted on the carpet by the user, for example visual information of step pictograms being more or less colored in one or various shades depending on the plantar pressure data collected by the force sensors 16.

Feedback on the way the user places his or her foot on the step pictograms can also be provided as haptic information, preferably perceivable on the user’s feet. To this end, the carpet may be provided with a plurality of vibrating devices (not shown) adapted to receive a fourth signal from the processing unit, the fourth signal being based on the movement of the user on the carpet. Vibrating devices of the plurality of vibrating devices may be activated independently of each other. More specifically, if the user doesn’t place his or her foot according to what is instructed by the serious game controller, for example if the foot is placed on the wrong step pictogram or outside of any step pictogram, or is placed on the right pictogram but doesn’t cover at least a certain percentage of its surface, or is placed on the right pictogram but doesn’t exert a certain amount of plantar pressure, the fourth signal comprises a command signal configured to activate a subset of the plurality of vibrating devices depending on the movement performed by the user on the carpet. For example, if the foot is placed on the wrong step pictogram or outside of any step pictogram, a subset of the plurality of vibrating devices located under said wrong step pictogram, or under the current position of the foot that is placed outside of any step pictogram, is activated by the command signal to indicate to the user that it is not the step pictogram he or she is instructed to step on, or that the foot is placed outside of any step pictogram. In another example, if the foot is only partially placed on the right pictogram, i.e. it doesn’t cover at least a certain percentage of its surface, a subset of the plurality of vibrating devices located under the foot portion that is being placed outside of said right step pictogram is activated by the command signal to indicate to the user that the foot is not placed correctly on the right step pictogram he or she is instructed to step on. When activated, vibrating devices may vibrate with different intensities and/or frequencies, to transmit different haptic messages according to the user’s motion.

Moreover, if the performed movement is evaluated as being right or wrong according to the data received by the processing unit 3, the first interface displays information representative of corrective instructions encouraging the user U to improve his or her posture, for example by placing a foot more or less on the right, the left, forward or backward, preferably with regard to the current position of said foot. The data collected by the cameras is therefore useful to determine if a foot is correctly placed on the corresponding pictogram and if said foot covers properly said pictogram. In a preferred embodiment, lower limb movement data is coupled to plantar pressure data to determine if the foot is placed correctly and/or how it should be moved by the user from a current position to be placed correctly. Correctness of a foot placement on the carpet is evaluated from the manner the foot covers a pictogram and how much plantar pressure is applied by said foot. Accuracy of such evaluation is related to the spacing between the force sensors 16, which can be equal to or lower than 10 cm, preferably 9.5 cm. In an advantageous embodiment, the spacing between the force sensors 16 under pictograms is smaller than the spacing between the force sensors 16 in the rest of the carpet. In this respect, the spacing between the force sensors 16 under pictograms is preferably comprised between 1 mm and 10 mm, preferably between 1 mm and 5 mm, which allows higher accuracy of the plantar pressure data sent to the processing unit 3. For cost reasons, the force sensors 16 under pictograms can be chosen of a higher measuring accuracy and capacity than the force sensors 16 in the rest of the carpet 1. Haptic information transmitted to the user by the plurality of vibrating devices completes said corrective instructions displayed on the first interface. Corrective instructions may also be addressed to the user through a loudspeaker 8 generating prerecorded instructions or retransmitting oral instructions from a third party such as medical personnel.

In an advantageous embodiment, the processing unit 3 processes at least one of the plantar pressure data and lower limbs movement data to generate a second signal based on said data and transmit it to a second interface 52, the second interface being part of a remote surveillance system. Transmission of said second signal to the second interface 52 can be performed through wireless communication means such as Wi-fi, Bluetooth or 3G/4G emitters-receivers, and an antenna (collectively denoted 53) can be provided in this respect, as illustrated in figure 4. The second signal is representative of the motion of the user on the carpet. The remote surveillance system is preferably intended for a third party such as medical personnel, and the second interface may comprise a screen for displaying data relative to the movements performed by the user on the carpet. An example of such user movements data display is a pressure mapping of the user steps on the carpet, as illustrated on figure 9.

The purge valve 54 is coupled to the processing unit 3 and is configured to receive an emergency signal from the processing unit 3 to empty the fluid container, said emergency signal being a command signal depending on data received by the processing unit 3 from the plurality of cameras (41, 42, 43, 44) and the plurality of force sensors 16. More particularly, the processing unit 3 is configured to analyze such data to detect for example if the user has fallen or if their head is under water and, accordingly, activate the purge valve through said emergency signal. As a safety measure, the purge valve can be coupled with a fluid pump to accelerate the fluid container emptying. We note that pipes for filling and emptying the housing are not shown at the figures.

In a preferred embodiment, the goal of the serious game integrated into the device 10 would be to make the user U virtually travel the world. A world map is displayed on the first interface screen, in front of the user. At the beginning of the serious game, it can be assumed that the player is in France or in one town in particular. The goal is to travel all around the world, to visit countries and towns and to discover different cultures and famous locations. Challenge is brought by the way of transport and the new countries and places to unlock. The curiosity of the user is maintained by the cultural aspects of local customs and history for example.

The serious game is designed to be adapted to rehabilitation needs. The user’s movements in the water and his plantar pressure on the carpet are used to determine where and how an avatar, representative of the user, moves on the serious game map. For example, the serious game can be designed so that the user imagines himself, through information displayed on the first interface, as virtually moving along pathways having various features such as lengths, steepness, presence of obstacles and more generally any relevant feature representative of a difficulty to move along said pathway. In an advantageous embodiment, at least a parameter of said pathways is adjusted depending on the data received by the processing unit. For example, if the user performs well during a period of time, the pathways get harder to move along.

In order to properly achieve this goal of the serious game, the inclination of the sensory carpet is adjustable. In this embodiment, an inclination system is coupled to the sensory carpet, and is configured to adjust the inclination of the carpet. In a preferred embodiment, the inclination system receives a fourth signal from the processing unit 3. The fourth signal comprises control commands of the carpet inclination. The fourth signal is generated according to the data received by the processing unit. For example, if the performance of the user is evaluated by the serious game software as being satisfying, the processing unit 3 commands the inclination system through the fourth signal to incline the sensory carpet by a certain tilt angle and along a certain direction. Said tilt angle and direction are determined depending on said received data. For example, the tilt angle increases on a direction if the user has been placing correctly his or her foot on a pictogram located in said direction. Inversely, the tilt angle decreases on a direction if the user hasn’t been placing correctly his or her foot on a pictogram located in said direction. Such an adjustment of the carpet tilt angle to the performance of the user allows adjustment of the exercise difficulty to the performance of the user.

Figures 7 A and 7B illustrate possible inclinations of the sensory carpet 1 which has a rectangular shape in the illustrated embodiment. In the embodiment illustrated on figure 7A, the carpet is inclined by a tilt angle a along the longitudinal direction X, i.e. in the plan (XZ), with regard to the base frame 20. In the embodiment illustrated on figure 7B, the carpet is inclined by a tilt angle b along the transversal direction Y, i.e. in the plan (YZ), with regard to the base frame 20. The carpet 1 can be inclined in one or more directions, simultaneously or sequentially, to allow more sophisticated arrangements of the carpet 1.

Figures 7A to 7C also illustrate an exemplary embodiment of an inclination system comprising twelve actuators configured to vertically displace portions of the carpet. Said actuators are numbered from 91 to 102 on the figure 7C. Vertical displacement of said actuators may be comprised between 0.5 cm and 10 cm, which leads to an external housing height preferably comprised between 1.65 cm and 1.70 cm in this embodiment, the external housing height corresponding to the height of the panels. When the actuators are displaced to their maximum extent of 10 cm, the internal housing height is comprised between 1.55 m and 1.60 m, the internal height being measured between the vertically displaced carpet and the top of the panels. Said actuators may be mechanically, electrically or hydraulically controlled. However, given the weight of the carpet and the user standing thereon and the fact that the housing is destined to be filled with fluid, it is preferable to use hydraulic actuators. In an advantageous embodiment, the vibrating devices are associated to the actuators (91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102). In that respect, said actuators may be configured to receive the fourth signal as well from the processing unit, and consequently provide haptic information to the user’s feet in the form of vibrations. In another embodiment, the vibrating devices are independent from said actuators.

With such an inclination system, inclining the carpet with a tilt angle a along the longitudinal direction X is realized by activating the actuators (92, 95, 98, 101), whereas inclining the carpet with a tilt angle b along the transversal direction Y is realized by activating the actuators (91, 92, 93). Actuators can be activated independently of each other. Inclination along a diagonal direction is also made possible by such an inclination system, for example by activating only the actuator 93 if the user is standing on the portion of the carpet above the actuator 95. Actuators are advantageously arranged under the carpet consistently with the step pictograms arrangement on the carpet, said step pictograms arrangement being representative of the movements the user may be performing on the carpet. The inclination system can be provided with any other number of actuators.

In the interest of safety, the actuators can be isolated by rubber, silicone, plastics or any other similar material. The actuators can be configured to vertically displace portions of the carpet with an adjustable height, to allow different inclination angles with regard to the base frame 20. As part of the serious game, an increase of a tilt angle can be accompanied by displaying an image of a steep pathway or an obstacle on the first interface screen.

In another embodiment of the carpet, as illustrated in figure 8, the carpet has a round shape and six pairs of step pictograms are provided thereon and collectively designated by reference 14. Four pairs are drawn on the carpet similarly to the first, second, third and fourth pairs of step pictograms illustrated in figure 3. A fifth pair of step pictograms is provided along a diagonal direction forming a 45° angle with the longitudinal direction X, each step pictogram of the fifth pair being at a side of the first pair along said diagonal direction. A sixth pair of step pictograms is provided along a diagonal direction forming a -45° angle with the longitudinal direction X, each step pictogram of the sixth pair being at a side of the first pair along said diagonal direction.

Figure 6 illustrates an exemplary set of steps involved in the disclosed method. The illustrated set of steps is involved in an exercise sequence performed by the user U on the device 10. A training session may comprise at least one exercise sequence. The exercise sequence starts with prompting the user to perform a movement on the carpet, through instructions and/or incentives. Instructions may be given by medical personnel, directly or through a remote surveillance system, or provided automatically as part of an exercising program generated by the processing unit 3, preferably according to settings configured by medical personnel. Incentives may take the form of a serious game where the user is represented by an avatar traveling the world as a simulation of the actual movements of the user on the carpet of the device 10.

Instructions and/or incentives may comprise an indication of a type of movement to perform. An example of a type of movement to perform may be to place the right or left foot on a pictogram of the second pair of step pictograms. The user gets acquainted with said indication and performs the indicated movement.

As the indicated movement is being performed, plantar pressure data is collected by the plurality of force sensors 16 and transmitted to the processing unit which may comprise a serious game controller. Arrangement density of the plurality of force sensors 16 and technical features thereof determine footsteps detection accuracy. Lower limb movement data is collected by the plurality of cameras and transmitted to the processing unit.

Plantar pressure data and lower limb movement data are analyzed and synthetized by the processing unit to determine the user’s movements on the carpet and draw a behavioral pattern. Said data analysis may be performed according to input settings which can be either measured or input parameters such as height, weight, age and gender of the user, or any other relevant parameter for the exercise.

Upon analysis and synthesis of said data, comments and/or instructions are provided for the user. In a preferred embodiment, comments and/or instructions are provided for the user and a feedback about the performed movement is provided to a third party such as a member of the medical personnel. Comments and/or instructions may be provided for the user in different forms, and more particularly in the form of visual information displayed on the screen of the first interface, acoustic information emitted by the loudspeaker, haptic information emitted by a subset of plurality of vibrating devices. The provided comments and/or instructions may be either corrective of a previously performed movement, or indicative of the next movement to perform. Said comments and/or instructions may be completed by personalized comments and/or instructions provided by the member of the medical personnel, on the basis of said feedback.

The exercise sequence ends and may be followed by another exercise sequence. At the end of each exercise sequence, the collected data and the analysis and synthesis results may be stored in a database 7 and associated to a user’s profile and history. The user’s profile may be based on said input settings as well as on the settings configured by medical personnel. Storage of such data and results is useful to monitor the progress of the user, and may serve as a basis for a deep learning process, in order to make the exercise sequences more adapted to the user’s needs.

Claims

1. A device (10) comprising :

- a housing (2) forming an enclosed area, the housing being configured to be filled with fluid up to an adjustable level;

- a sensory carpet (1) extending substantially horizontally within the housing;

- a processing unit (3) and a first interface (5) coupled to the processing unit;

- a plurality of force sensors (16) provided in the carpet (1) and able to record and transmit plantar pressure data of a user (U) moving on the carpet to the processing unit;

- a plurality of cameras provided on parts of the housing and able to record and transmit lower limb movement data of the user (U) moving on the carpet to the processing unit

- the processing unit being able, based on the received plantar pressure data and lower limb movement data, to:

- transmit a first signal, relative to a type of movement to be performed by the user on the carpet, to the first interface,

the first interface comprising a display screen (5) to display information depending on said first signal.

2. A device (10) according to claim 1, wherein the first interface further comprises communication means with the user, configured to generate information depending on said first signal.

3. A device (10) according to any of the preceding claims, comprising a second interface (52) coupled to processing unit, the processing unit being able, based on the received plantar pressure data and lower limb movement data, to transmit a second signal representative of the motion of the user on the carpet to the second interface.

4. A device (10) according to any of the preceding claims, wherein the processing unit is able, based on the received plantar pressure data and lower limb movement data, to transmit a third signal representative of the motion of the user on the carpet to the first interface, the first interface being configured to provide the user with feedback information about his or her motion on the carpet based on said third signal.

5. A device (10) according to any of the preceding claims, wherein the carpet (1) is provided with a plurality of vibrating devices, the processing unit being able, based on the received plantar pressure data and lower limb movement data, to transmit a fourth signal to the plurality of vibrating devices, the fourth signal being configured to activate at least a subset of the plurality of vibrating devices;

6. A device (10) according to any of the preceding claims, wherein the housing comprises a base frame (20), a front panel (21), two transparent side panels (22, 23) and a back panel (24).

7. A device (10) according to any of the preceding claims, wherein a door (6) is arranged on the back panel, a watertight sealing arrangement being provided on the door in the closed door position.

8. A device (10) according to any of the preceding claims, wherein the cameras of the plurality of cameras are waterproof;

9. A device (10) according to any of the preceding claims, wherein each side panel (22, 23) is provided with a camera (42, 43), each camera (42, 43) having a field-of-view oriented toward a center area of the housing and being arranged below a fluid minimum level (LI).

10. A device (10) according to any of the preceding claims, wherein at least three cameras (41, 42, 43) of the plurality of cameras are arranged below the fluid minimum level (LI), and at least one camera (44) is arranged in the vicinity of the first interface, for tele-surveillance purposes, the first interface being arranged on the front panel in substantially upright position.

11. A device (10) according to any of the preceding claims, wherein the housing extends along a longitudinal direction (X), and wherein the device (10) comprises at least one guard bar (61, 62) extending along the longitudinal direction (X) of the housing, said guard bar being adjustable in height and provided on one of the parts of the housing.

12. A device (10) according to any of the preceding claims, wherein the housing extends along a longitudinal direction (X) and a transversal direction (Y), and wherein the force sensors (16) are disposed in arrays along the longitudinal and transversal directions (X, Y).

13. A device (10) according to any of the preceding claims, the sensory carpet being provided with data communication means between the sensory carpet and the processing unit, said data communication means comprising wireless means (31) configured to transfer data between force sensors (16) and the processing unit (3), the sensory carpet being powered by a battery.

14. A device (10) according to any of the preceding claims, comprising an inclination system for tilting the carpet with regard to the base frame (20).

15. A training method of a user (U) using a device (10) according to any of the preceding claims, the method comprising the following steps:

record and transmission, by the plurality of force sensors, of plantar pressure data of the user (U) moving on the carpet (1), to a processing unit (3);

record and transmission, by a plurality of cameras provided on parts of the housing (2), of lower limb movement data of the user (U) moving on the carpet, to the processing unit; transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a first signal relative to a type of movement to be performed by the user on the carpet, to the first interface (5).

16. A training method according to the preceding claim, comprising the following step: transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a second signal representative of the motion of the user on the carpet, to a second interface.

17. A training method according to any of the preceding claims, comprising the following step:

transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a third signal representative of the motion of the user on the carpet to the first interface, the first interface being configured to provide the user with feedback information about his or her motion on the carpet based on said third signal.

18. A training method further comprising the following step:

transmission by the processing unit, based on the received plantar pressure data and lower limb movement data, of a fourth signal to a plurality of vibrating devices, the fourth signal being configured to activate at least a subset of the plurality of vibrating devices.