Method for diagnosis and/or training of proprioceptor feedback capabilities in a muscle and joint system of a human patient

A method for testing proprioceptor feedback mechanisms in a muscle and joint system of a patient using a controllable resistance exercise system which applies resistance to movement of a part of the patient's body in response to a resistance control signal comprising the steps of:

• defining a patient performance goal over a range of motion as a function of a selected exercise parameter;
• defining a perturbation function over a portion of the range of motion;
• deriving the resistance control signal from the function of the selected exercise parameter;
• applying resistance to movement of a part of the body of the patient in accordance with the patient performance goal;
• and
• modifying the resistance control signal sufficiently to at least momentarily cause the movement of the patient's body part to deviate unexpectedly from the performance goal within the range of motion.

In a method for measuring proprioceptor feedback capabilities in a muscle and joint system of a human patient using a controllable resistance exercise system having a resistance value determined by a resistance control signal, the steps of:

• defining a patient performance goal as a real time function of preselected exercise parameters;
• defining a perturbation function for controllable resistance over an exercise motion;
• modifying the resistance control signal by the perturbation function value during the exercise motion for unexpectedly altering the resistance value;
• attempting, by the patient, to match the patient performance goal despite the alteration of the resistance value;
• displaying said defined performance goal during the patient exercise motion;
• tracking and displaying actual patient performance relative to said performance goal during the patient exercise motion;
• and
• measuring as an error value the difference between actual patient performance and said patient performance goal during the exercise motion.

In a method for measuring proprioceptor feedback capabilities in a muscle and joint system of a human patient using a controllable resistance exercise system having a patient attachment device mounted for movement through space, a resistive component coupled to said patient attachment device to resist the movement of said patient attachment device with a resistance value determined by a resistance control signal, and having means for tracking position of said attachment, and means for tracking force applied to said attachment, the steps of:

• profiling the parameters of actual patient exercise movements by collecting data on position of said attachment device as a function of time, force on said attachment device as a function of position, and the value of said resistance control signal as a function of position;
• producing patient exercise profile curves from said collected data and storing representations of said profile curves;
• deriving from said stored curve representations a patient goal performance function selected as one of position as a function of time and torque as a function of position;
• defining a perturbation function for said stored curve representation for said resistance control signal value as a function of time;
• applying during a subsequent patient exercise motion a resistance control signal value as a function of actual position derived from said patient exercise profile curves modified by the current value of said perturbation function for unexpectedly altering the resistance value;
• attempting, by the patient, to match the goal despite the altered resistance value;
• displaying said defined performance goal during said subsequent patient exercise motion;
• tracking and displaying actual patient performance relative to said performance goal during said subsequent patient exercise motion;
• and
• measuring as an error value the difference between actual patient performance and said patient performance goal during the subsequent exercise motion.

In a method for measuring proprioceptor feedback capabilities of a muscle and joint system of a human patient using an exercise system having a patient attachment device and means for controlling parameters of an exercise movement in response to a control signal derived from one or more measured exercise parameters, the steps of:

• defining a patient performance goal as a real time function of preselected exercise parameters;
• defining a perturbation signal function for said control signal;
• modifying said control signal by said perturbation function value to produce an unexpected perturbation signal during a patient exercise motion;
• attempting, by the patient, to match the performance goal despite said modified control signal;
• displaying said defined performance goal during said patient exercise motion;
• tracking and displaying actual patient performance relative to said performance goal during said patient exercise motion;
• and
• measuring as an error value the difference between actual patient performance and said patient performance goal during said patient exercise motion.

In a method for measuring proprioceptor feedback capabilities of a muscle and joint system of a human patient using a controllable resistance exercise system having a hydraulic actuator with complementary hydraulic fluid chambers and a shaft, a lever arm coupled to said actuator shaft and a flow control valve coupled to said actuator for controlling the degree of resistance applied to said lever arm by said actuator in response to a valve position command signal, means for measuring the lever position and means for measuring the torque applied to said shift, the steps of:

• collecting and storing patient exercise profile data during a series of actual patient exercises on the system for both flexion and extension exercise movements, including collecting and storing data sets comprising lever position as a function of time from the last turnaround of the lever, torque as a function of lever position, and valve position command signal as a function of lever position;
• determining from said stored lever position data a maximum and minimum lever position for said profiled patient exercise;
• calculating curve fit polynomial factors for said stored data sets;
• receiving and storing input goal type, perturbation type, and perturbation scale factor selections;
• constructing and storing for each of flexion and extension exercise movements a set of data tables comprising valve setting command values as a function of lever position, exercise goal values based on input goal type, and perturbation values based on input perturbation type and scale factor;
• receiving and storing values of current lever position and torque;
• determining an active data set from current lever position and torque values;
• selecting a perturbation value from said data table of perturbation values based on a time factor;
• selecting an unperturbed valve setting command from said data table based on current lever position;
• determining a perturbed valve setting command by combining said unperturbed valve setting command with said perturbation value;
• communicating said perturbed valve setting command to said flow control valve to set the current value of exercise resistance to an unexpected perturbation value of said exercise resistance;
• determining the current goal parameter value in said goal data set;
• displaying said current goal parameter value and the associated current exercise value;
• and
• determining and storing a current error value based on the difference between said current goal parameter value and said associated current exercise value.