Remote psychological evaluation

Abstract

Instrumented orthoses with more sophisticated structures provide for coordinated support and rehabilitation of complex joints and multiple injured joints. Improved instrumented orthoses can include hinges that can rotate in multiple different planes. Particularly preferred embodiments include a shoulder brace with a hand hold and a lower extremities brace. Preferably, a control unit monitors the output of transducers used to instrument the brace. A patient can be prompted by the control unit for the performance of a variety of different monitored exercises.

1 . An ambulatory medical device comprising a display, an input device, a microprocessor, memory, a download channel with an output portal and software wherein the software executes on the microprocessor to present questions on the psychological state of the patient with answers being input through the input device for storage for subsequent downloading from the output portal.  
   
   
       2 . The ambulatory medical device of  claim 1  wherein the display comprises an LCD display.  
   
   
       3 . The ambulatory medical device of  claim 1  wherein the input device comprises a keypad.  
   
   
       4 . The ambulatory medical device of  claim 1  wherein the microprocessor has a deep sleep mode.  
   
   
       5 . The ambulatory medical device of  claim 1  wherein the microprocessor has analog to digital multiplexing capability.  
   
   
       6 . The ambulatory medical device of  claim 1  wherein the memory is non-volatile memory.  
   
   
       7 . The ambulatory medical device of  claim 1  wherein the output comprises an RS-232 port.  
   
   
       8 . The ambulatory medical device of  claim 1  wherein the output comprises an internal modem.  
   
   
       9 . The ambulatory medical device of  claim 1  wherein the output comprises a radio transmitter.  
   
   
       10 . The ambulatory medical device of  claim 1  wherein the questions relate to pain levels.  
   
   
       11 . The ambulatory medical device of  claim 1  wherein the questions relate to the formation of a pain diagram.  
   
   
       12 . The ambulatory medical device of  claim 1  wherein the questions relate to depression.  
   
   
       13 . The ambulatory medical device of  claim 12  wherein a statistical analysis is performed on the depression questions to obtain an objective quantitative measure of depression.  
   
   
       14 . The ambulatory medical device of  claim 1  wherein the device is further connected to an orthosis.  
   
   
       15 . The ambulatory medical device of  claim 1  wherein the device is further connected to a pulse rate sensor, galvanic skin response or a blood pressure sensor.  
   
   
       16 . A method for remote evaluation of the psychological state of a patient, the method comprises posing questions to a patient using an ambulatory device comprising a display, an input device, a microprocessor, memory, an output portal and software wherein the software executes on the microprocessor to present questions on the psychological state of the patient with answers being input through the input device for storage for subsequent downloading from the output portal.  
   
   
       17 . The method of  claim 16  wherein the questions relate to pain levels.  
   
   
       18 . The method of  claim 16  wherein the questions relate to the formation of a pain diagram.  
   
   
       19 . The method of  claim 16  wherein the questions relate to depression.  
   
   
       20 . The method of  claim 19  wherein a statistical analysis is performed on the depression questions to obtain an objective quantitative measure of depression.  
   
   
       21 . The method of  claim 16  wherein the psychological evaluation is coupled with a physiological evaluation.  
   
   
       22 . The method of  claim 21  wherein the physiological evaluation comprises evaluation of the performance of target exercises.  
   
   
       23 . The method of  claim 21  wherein the physiological evaluation comprises pulse measurements.  
   
   
       24 . The method of  claim 21  wherein the physiological evaluation comprises blood pressure measurements.  
   
   
       25 . The method of  claim 21  wherein the physiological evaluation comprises galvanic skin response measurements.  
   
   
       26 . The method of  claim 16  further comprising modifying a treatment program in response to the psychological evaluation.  
   
   
       27 . The method of  claim 16  wherein the downloading of important information is performed in a timely way.  
   
   
       28 . The method of  claim 16  further comprising characterizing the patient's answers prior to review by a health care professional.  
   
   
       29 . The method of  claim 28  wherein the characterization is performed on the ambulatory medical device.  
   
   
       30 . The method of  claim 28  wherein the characterization is performed on a central processor.  
   
   
       31 . The method of  claim 16  wherein detection of specific responses from the patient prompts an instruction to the patient to immediately contact a treatment professional.  
   
   
       32 . A method of evaluating a patient's mental condition comprising: 
 collecting answers to a set of questions regarding the patient's mental condition using a remote controller programmed to pose the questions and receive the answers; and    evaluation of the answers by a health care professional.    
   
   
       33 . The method of  claim 32  further comprising performing initial analysis of the answers using a computer processor.  
   
   
       34 . The method of  claim 32  wherein the remote controller is operably connected to transducers associated with an orthosis.  
   
   
       35 . The method of  claim 34  wherein the transducers are selected from the group consisting of strain gauges, position sensors, and combinations thereof.  
   
   
       36 . The method of  claim 34  wherein the orthosis comprises a hinge that can rotate in several different planes and a position sensor operably connected to the hinge such that motion can be measured with respect to different rotational motions around the joint, the controller being operably connected to the position sensor to receive signals related to the position of the hinge.  
   
   
       37 . The method of  claim 34  wherein the orthosis comprises a plurality of hinges such that motions about separate hinges correspond to motions about different joints.  
   
   
       38 . The method of  claim 32  wherein the controller further processes a signal related to a physiological condition in the patient correlated with stress.  
   
   
       39 . The method of  claim 38  wherein the physiological condition is pulse rate.  
   
   
       40 . The method of  claim 38  wherein the physiological condition is the galvanic skin response.