the rehabilitation method based on the device herein referred to as sword allows a high intensity straining due to its outpatient use , it is intended for the repetition of specific tasks , and is the only one able to provide biofeedback in terms of the characterization of the movement carried out and in terms of the quality and quantity thereof . yet compared with the complex high technology robotic devices , the method and system herein referred to as sword requires less manpower to operation and may be more easily spread by patients in need thereof , thus maximizing potential health gains . the rehabilitation paradigm underlying the object of the invention , the method and system herein referred to as sword , is based on extracorporeal application of proprioceptive stimuli , either intermittently or continuously , of various kinds ( vibration , thermal , pressure ) onto the main joints of the affected side , on the one hand , and on the correct quantification and qualification of any type of movement performed in an outpatient setting during and after the stimulus . the integration and communication between the stimulation system and quantification system allow a dynamic configuration of the two components . one may also export continuous monitoring data on the movement in order to assist the therapy decision in rehabilitation medicine . the system may be described according to several levels of complexity . at a macrostructural level , it consists of segmental modules . each of these modules is composed of units , each having a primary function . finally , each unit is composed of several blocks which articulate according to the function performed by the respective unit . the system herein referred to as sword is usually composed of several interconnected modules . each module is responsible for the proprioceptive stimulation and characterization of the movement carried out by a body segment . the number of modules to be used in each individual depends on the body segments intended to stimulate and from which quantitative and qualitative information on the movement performed on an outpatient basis is intended for collection . communication among modules is bi - directional . all modules communicate with each other and share information regarding the stimulation mode in use and movement performed . thus , each module knows the current and past status of the other modules , thus allowing a dynamic configuration of the proprioceptive stimuli to be used . this communication methodology allows the proprioceptive stimulus to be applied only onto the body limb responsible for the erroneous execution of the motor task . biofeedback transmitted could thus be directed only to a part instead of the generality of bodily elements , notifying the user in detail on the location of the error . additionally , such communication is essential in order to update the biomechanical model at each time instant , since there is a direct dependency relationship between the several body elements . each of the individual modules ( e . g . 1 , 2 , 3 , 4 , 17 , 18 , 19 ) is dedicated to stimulate a particular segment of the human body and to collect kinetic information from the same segment , as shown in fig1 . this information is communicated among modules , as illustrated in fig1 for the upper limb . in each module such communication is established by the unit for global control , communication and synchronization among modules ( 6 ). the main module ( 1 ) is the one closest to the center of body gravity and integrates the information collected by all modules of said limb , and controls the stimulation mode at each distal module and sets whether stimulation should occur simultaneously , randomly or according to predetermined and programmed patterns . as for the internal operation of each module , the system typically consists of three components overlapping and connected as shown in fig2 : a continuous movement quantification and monitoring unit ( 5 ); a unit for global control , communication and synchronization among modules ( 6 ); and a stimulation or intervention unit ( 7 ). the internal components of each unit , the operation mode thereof and how they interconnect are described below and in connection to fig3 . as far as the communication among modules is concerned , it may occur with or without wires , depending on the wearable solution chosen . in the case of wireless communication and synchronization among modules , this is done by low energy elements in order to maximize the device &# 39 ; s autonomy . thus , for the upper limb ( fig4 ), for example , the modules may be described as follows : module for movement control , proprioceptive stimulation and quantification on the shoulder girdle ( 1 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the shoulder . this module has control priority over the modules surrounding it , denoted by 2 and 3 . in terms of communication , module 1 is responsible for synchronizing the proprioceptive operating modes of 2 and 3 . module for movement control , proprioceptive stimulation and quantification on the arm region ( 2 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the arm . its proprioceptive operating mode is synchronized by means of the interface with module 1 . module for movement control , proprioceptive stimulation and quantification on the forearm region ( 3 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the forearm . its proprioceptive operating mode is synchronized by means of the interface with module 1 . module for movement control , proprioceptive stimulation and quantification on the hand region ( not shown in fig4 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the hand . its proprioceptive operating mode is synchronized by means of the interface with module 1 . for the lower limb ( fig5 ), for example , the modules may be described as follows : module for movement control , proprioceptive stimulation and quantification on the thigh region ( 17 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the thigh . depending on the selected localization typology , it may be the main controlling element , or it may have its proprioceptive operating mode synchronized by means of the interface with another module . module for movement control , proprioceptive stimulation and quantification on the leg and knee region ( 18 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the leg . its proprioceptive operating mode is synchronized by means of the interface with the remainder modules ( e . g . 17 and 19 ), depending on the selected localization typology . module for movement control , proprioceptive stimulation and quantification on the ankle region ( not shown in fig5 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the ankle . its proprioceptive operating mode is synchronized by means of the interface with the remainder modules , depending on the selected localization typology . module for movement control , proprioceptive stimulation and quantification on the foot region ( not shown in fig5 ). in terms of movement characterization , this module is responsible for characterizing the movement performed by the foot . its proprioceptive operating mode is synchronized by means of the interface with the remainder modules , depending on the selected localization typology . in certain situations additional modules located on the head , chest or abdomen regions may be required ( fig6 ) and they work in an integrated manner with the other modules , allowing the collection of global information on body movement , particularly the detection of falls and also allowing integrated patterns of stimulation of the upper limb , lower limb and torso . its components , as well as the operating mode , are the same as for the remainder modules . according to needs , the system may operate only on the upper limb , only on the lower limb , only on the torso , only on the head or with all possible segmental components or combinations thereof . depending on the needs for collecting kinetic or stimulation information , there may be a saving of modules at each segment . in this situation , the position of the proprioceptive stimulation elements ( 16 ) is maintained , but the total number of modules per system may be reduced . each continuous movement quantification and monitoring unit ( 5 ) includes gyroscopes ( 8 ), accelerometers ( 9 ) magnetometer ( 10 ), sensor fusion block ( 11 ) and a movement characterization block ( 12 ) and is responsible for all kinetic data collection from the respective segment and processing thereof , for the purposes of transferring them to the unit for global control communication and synchronization among modules ( 6 ). each unit for global control , communication and synchronization among modules ( 6 ) contains a general control block ( 13 ) and a communication and synchronization block ( 14 ). the stimulation or intervention unit ( 7 ) includes a proprioceptive control and stimulus definition block ( 15 ) and proprioceptive stimulation elements ( 16 ), the latter being placed on the site , or sites , of the human body intended to stimulate . as described in fig1 and 2 , the articulation among the various constituent units of each module follows the following model : the movement quantification and characterization unit ( 5 ), by means of the interface with the global control unit ( 6 ) allows defining the type of stimulus intended to be applied by the proprioceptive intervention unit ( 7 ), depending on segment and body position and whether the movement performed has been the default movement or not . detailed description of the elements and blocks composing the units in each module elements 8 , 9 , 0 . 10 are collecting structures of kinetic information ( quantitative and qualitative information ), which project their data into the sensor fusion block ( 11 ). movement qualification is defined as characterizing the displacement of the limb in space in terms of translation and rotation . this qualification is obtained by merging the measurements from the magnetometers ( 10 ), accelerometers ( 9 ) and gyroscopes ( 8 ) incorporated in the device using stochastic estimators for such purpose . the movement is subsequently compared with the movement trained by the patient in a clinical setting at block 13 . the parameterization of the trained movement is obtained through the device herein referred to as sword , in combination with traditional rehabilitation therapy . this information is stored in block 13 . the sensor fusion block ( 11 ) represents the mathematical algorithm , which based on three independent measurements ( acceleration , angular rotation and magnetic field ) calculates translation and rotation in space of the module and body segment to which it is associated . this block 11 receives unidirectional information from elements 8 , 9 and and projects it into block 12 . the mathematical algorithm underlying the sensor fusion block is based on the estimate of a rotation matrix ( 23 ) between two reference axis , which relate to the earth &# 39 ; s reference axis system and to the rotating module &# 39 ; s axis system ( fig7 ). therefore , the estimated rotation for the module will always be in reference to the earth &# 39 ; s axis system . the rotation matrix ( 23 ) which converts the earth &# 39 ; s axis system into the module &# 39 ; s axis system ( and vice - versa ) is obtained by discrete integration in time of gyroscope ( 8 ) measurements concerning angular rotation . if measurements from the gyroscope ( 8 ) were noise - free , this mathematical operation would be sufficient to estimate the rotation of the module in three - dimensional space . however , as this does not happen , it is necessary to estimate the noise present in gyroscope measurements so there is a consequent compensation thereof . after this compensation , gyroscope measurements are obtained error - free , and obviously the rotation matrix ( 23 ) resulting from the discrete integration in time of gyroscope ( 8 ) measurements shall also be error - free . the estimate of the error in the measurements from the gyroscope results from a geometrical comparison drawn between the earth &# 39 ; s axis system and reference vectors obtained from the magnetometer ( 12 ) and accelerometer ( 9 ). the noise in measurements of angular rotation is also present in the earth &# 39 ; s axis system , since this is obtained by multiplying the rotation matrix ( 23 ) by the module &# 39 ; s axis system . although measurements from both blocks also contain noise , this will always be independent from that observed in measurements from the gyroscope ( 8 ). in order to estimate the error in the measurements relating to angular rotation associated with ( 22 ), the later is compared with the gravitational vector obtained by the accelerometer block ( 9 ). comparison is performed by the external product , which will provide the magnitude and direction of the error in the measurements of angular rotation . similarly , in order to estimate the error in the angular rotation measurements relating to ( 20 ) and ( 21 ) of the earth &# 39 ; s axis system , the later is compared with the magnetic field vector obtained by the magnetometer block . the comparison is also made using the external product between both vectors . in order to complete the compensation process , both error components obtained are applied to a proportional - integral type controller from which error - free measures of angular rotation shall result and which may be used in time discrete integration of the rotation matrix ( 23 ). depending on the rating required to represent the three - dimensional rotation of the module in space , the rotation matrix may be transformed into euler angles or quaternions . this error compensation process has the advantage of being efficient in terms of processing time required , which can be implemented in a microcontroller operating in real time . another advantage lies in its proficiency in estimating the error in the measurements of the gyroscope . the movement characterization block ( 12 ) represents the mathematical algorithm combining rotation and translation measurements from the sensor fusion block ( 11 ) with the biomechanical system representative of the user . this block displays vectors as output which mathematically describe the movement performed . this block 12 receives unidirectional information from block 11 relative to translation and rotation in space of the segment intended to be characterized in terms of movement . block 12 sends and receives information to and from block 13 . the mathematical algorithm transforms , by means of the rotation and translation operations , each vectorial element of the biomechanical system . the transforming element represents the rotation of a reference axis in three - dimensional space and may be present as quaternions , rotation matrices , or euler angles . the transformed element may be any position of interest in the biomechanical system defined within three - dimensional space . block 13 ( fig3 ) is the general control block responsible for the aggregation and analysis of information received by the three blocks 12 , 14 and 15 . block 13 sends and receives information to and from blocks 12 , 14 and 15 . information at each module is of two types : internal to the module , when coming from blocks 12 and 15 ; and external to the module ( from other modules ) when coming from block 14 which is responsible for the communication and synchronization among modules . information received at block 13 is on the characterization of the movement from other body segments to be rehabilitated . the information sent to block 13 refers to the characterization of movement of the segment relative to the module . the internal logic is established through the use of a microcontroller which is the main component of the general control block ( 13 ) of the unit for global control , communication and synchronization among modules ( 6 ). the movement carried out , characterized by the dynamics on points of interest defined and calculated at the movement characterization block ( 12 ) is compared with metrics from a motor performance perceived as being normal . information regarding a deviation in the quality of the movement performed is converted into a proprioceptive stimulus , specified according to the body element which caused an abnormally performed movement . block 13 sends the dynamics definition of the applicable proprioceptive stimulus to block 15 . block 15 performs the interface between block 13 and proprioceptive stimulation elements ( 16 ). the proprioceptive control and stimulus definition block ( 15 ) adjusts the modulated signal from the general control block ( 13 ) so as to obtain an efficient transduction for the proprioceptive stimulation elements ( 16 ). in the case of stimulation being based on vibration , the signal from the microcontroller shall be adapted in terms of current so as to be properly replicated in topology by vibration motors . detailed description of communication modes among modules and with the exterior as far as the communication with modules is concerned , it may occur with or without wires , depending on the wearable solution chosen . in case of wireless communication / synchronization among modules , this is done by low energy elements in order to maximize the device &# 39 ; s autonomy . main modules are to be understood as , for example , the module placed on the shoulder , in the case of the upper limb , and the module placed on the thigh in case of lower limb . the remainder modules communicate with each other via an internal communication network . all modules are provided with a transmitter and receiver . main modules are provided with information storage systems . the extra - module communication takes place among the main modules and the analysis software of the physicist responsible for the treatment plan . this communication is bi - directional and allows obtaining data concerning outpatient use from the device handled by the user . it also allows configuring module network in terms of movement characterization and stimuli definition according to the treatment plan specified by the physicist . the internal communication network exchanges information concerning rotation and translation of each sensory element in three - dimensional space , in order to allow for a mapping of various body segments in a complete biomechanical model , able to represent movement dynamics , to take place in the movement characterization block ( 12 ) of each module . the exchange of information among modules also includes the definition of proprioceptive stimuli being applied in each module . this component allows a rhythmical proprioceptive stimulation , since each module knows the sequence and timing of each proprioceptive stimuli in each module . the device also allows its rapid configuration through communication between the main module and a personal computer , using for this purpose a software specifically developed . in terms of device configuration , it is possible to set the stimulation mode from continuous to intermittent and , should the latter be selected , it is possible to configure the intervention range . another possibility is configuring the amplitude of the stimulus , should these be vibration - based , and should they occur synchronously or asynchronously across all modules . this software also displays movements performed by the patient after stimuli and the assessment thereof compared with movements made in clinical setting . dynamic configuration of module network on the upper limb is made e . g . by the main module placed on the shoulder . dynamic configuration of module network on the lower limb is made e . g . by the main module placed on the thigh . main modules are responsible for the aggregation of information from the network which , combined with the previous definition of therapy , allows a better adjustment of proprioceptive stimulus to the relevant situation . the previous definition of therapy is performed by the software available to the physicist performing synchronization with the network by means of both main modules . in a preferred embodiment , each module includes a portable power supply that will allow using the device for several hours or more . total autonomy shall depend on the configuration of the device in terms of intervention mode . batteries may be included in the same housing of modules and are preferably rechargeable via usb connection to a computer or to a power outlet ( through the use of a specific adapter ). devices for stimuli application ( e . g ., vibration , tactile , thermal , painful stimuli , among others ). in case of vibration stimulus , it may be carried out by means of vibrating motors controlled in terms of stimulus amplitude and frequency by means of the voltage applied across its terminals . setting the stimulation is performed by combining three variables : vibration frequency , vibration amplitude and interval between stimuli . if the operating mode is specified as continuous , the definition of the stimuli will depend only on two variables : vibration frequency and vibration amplitude . positioning of proprioceptive intervention elements will depend on the configuration selected and on the limb intended to rehabilitate : upper or lower limb . should vibratory stimuli be used , one possibility is to place a vibration motor at each bone eminence in a position close to the main joints of the upper limb ( shoulder , elbow , wrist , carpus and hand ) and lower limb ( hip , knee , ankle , tarsus and foot ). the use of this device right from an early stage after a stroke , and with no time restriction , may result in major benefits for neurorehabilitation and , by democratizing access to this technology , a social impact and objective gains in healthcare shall be possible . this contribute is enhanced by other features such as lower cost of production and operation when compared to other technologies , energy autonomy and the possibility of outpatient use , handled by family members and in the future being embedded in garments . taking the rehabilitation process of patients with neurological deficits after a stroke into consideration , the application of this technology enables a new generation of processes herein identified : 1 ) traditional rehabilitation plans may now be enhanced through outpatient use of the device herein referred to as sword 2 ) all outpatient activity may now be monitored , both in real time and pre - recorded modes , using for such purpose , for example , bluetooth technology in its low power consumption version . 3 ) new algorithms for clinical decision may be created based on monitoring data provided by the system and method herein referred to as sword 4 ) rehabilitation plans may be designed and tested which progressively include more outpatient activities without loss of therapeutic intensity the application of the system and method herein referred to as sword allows a radical change . for the first time , new devices may come to life with the following characteristics : vibratory stimulation instruments for applying vibratory and proprioceptive stimuli in all joints of the upper and lower limb integrated activity of all stimulators allowing programming activation sequences stimuli adjusted automatically according to movement quantity and / or quality detected in the body part under rehabilitation global and segmental movement quantifier qualitative characterization of movement patterns performed in all limb segments when in use integration of movement proprioceptive stimulation , quantification and qualification instruments integrated into a user - friendly garment in individuals with hemiplegia due to central nervous system damage directly programmable remotely programmable onsite use registration online use registration clinical analysis tools for the movement to assist decision making in rehabilitation plan rechargeable long - term batteries (& gt ; 24 h ) the present invention shall thus allow outpatient use combining the possibility of vibratory stimulation and continuous characterization of movement performed by a deficient body segment , as well as the provision of information collected to the patient and responsible physicists through specific software .
system and method for movement proprioceptive stimulation , monitoring and characterization comprising : a component for proprioceptive action and another for movement characterization . both components are coupled so that they can be used in outpatient treatment on the upper and lower limbs of the body side showing motor deficit . this device can be applied in healthcare , particularly in neurorehabilitation , in basic or clinical science activities , in products aimed at recreational market segments and in sports and motor performance improvement for competition purposes . the system comprises a main module for movement control , proprioceptive stimulation and quantification , modules for movement control , proprioceptive stimulation and quantification and proprioceptive stimulation elements .