Field of the Invention

The present invention relates to rehabilitation apparatus. More specifically the present invention relates to apparatus for controlled rehabilitation of a person who has suffered traumatic injury more specifically a stroke.

Background of the Invention

A stroke, previously known medically as a Cerebro vascular accident (CVA), is the rapidly developing loss of brain fimction(s) due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (arterial embolism) or a hemorrhage (leakage of blood). As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body.

In the United States more than 700,000 people suffer a stroke each year, and approximately two-thirds of these individuals survive and require rehabilitation. The goals of rehabilitation are to help survivors become as independent as possible and to attain the best possible quality of life. Even though rehabilitation does not "cure” stroke in that it does not reverse brain damage, rehabilitation can substantially help people achieve the best possible long-term outcome.

Paralysis is one of the most common disabilities resulting from stroke. The paralysis is usually on the side of the body opposite the side of the brain damaged by the stroke, and may affect the face, arm, leg, or the entire side of the body. This one-sided paralysis is called hemiplegia (one-sided weakness is called hemiparesis). Stroke patients with hemiparesis or hemiplegia may have difficulty with everyday activities such as walking or grasping objects. After a stroke, the damaged lobe loses the ability to control its limbs (the crossover limbs) while the neighboring lobe may remain unharmed and fully in control of its limbs. It has been clinically proven that one lobe can be trained to control not only the crossover limbs but the limbs on the same side as well. This fact is the driving force behind physical therapy treatments for stroke victims. Dysfunction of a limb and inability to move and perform functional activities of every day live, which calls for physical therapy, can be caused by at least two types of injuries; neurological injuries and physical injuries. Neurological injuries can include trauma brain injuries (TBI) due to external mechanical force on the brain and non- traumatic brain injuries due to internal deficiencies which damage the brain, e.g. stroke. Physical injuries are injuries caused by external force directly on one of the limbs.

To enable a person who suffered from a stroke or any other injury that causes dysfunction of a limb, to restore, as much as possible, normal functioning of the disabled limb, many hours of physical therapy are necessary. For best results physical therapy should start as soon as possible after injury; in the case of stroke, preferably within 24 to 48 hours. However, because of lack of rehabilitation centers, shortage of physical therapists and experts the average patient begins therapy after the critical period and, after starting physical therapy, the patient receives only infrequent sessions. US 9,820,908 discloses a method and apparatus for rehabilitation and training of an injured limb by using the corresponding functional healthy limb to control the motion of the injured limb. A sensor system on the healthy and active limb, a processing unit, and a power supply are provided in the apparatus to provide signals that activate a powered mechanism configured for moving individual bones on the injured passive limb.

During various stages of stroke recovery, the patient develops some synergy patterns and is able to perform minimal voluntary movements. As the powered mechanism forces a bone on the injured limb to move in exactly the same way that the corresponding bone on the healthy limb moved, a physical therapist assisting the patient during the stroke recovery is unable to determine the range of motion that the patient has developed.

It is an object of the present invention to provide an apparatus for assisting a physical therapist to diagnose the present range of motion of an injured limb of a neurologically injured patient.

It is an additional object of the present invention to provide an apparatus that will help the patient to improve his or her range of motion of the injured limb until being able to perform functional activities in a similar fashion as performed prior to being injured.

It is yet an additional object of the present invention to reduce the cost of rehabilitation by enabling a patient to train himself and reduce the hours of work with a physical therapist.

Other objects and advantages of the invention will become apparent as the description proceeds.

Summary of the Invention

Controlled rehabilitation apparatus comprises a first set of sensors mounted on a functional healthy limb for measuring motion of the functional healthy limb during performance of a desired motion; a powered mechanism comprising one or more actuators configured to reproduce the desired motion with respect to an injured limb which is contralateral to the healthy limb; a detection device mounted on the injured limb which comprises a second set of sensors for measuring present independent motion achievable by the injured limb; and a controller configured to receive a first signal from each of the first set of sensors and a second signal from each of the second set of sensors, to analyze said first and second signals, and to generate a third reproducing initiating signal which is transmitted to each of said actuators, so that, when each of said actuators generates a predetermined controlled force that is transmitted to a corresponding region of the injured limb to induce movement, a combined actuator- assisted movement and independent motion of the injured limb will reproduce the desired motion made by the contralateral healthy limb.

In one aspect, the predetermined controlled force generated by each of the actuators in response to a corresponding reproducing initiating signal received from the controller is of a smaller magnitude than the magnitude of a maximum controlled force generated by each of the actuators to reproduce the desired motion made by the contralateral healthy limb during absence of any independent motion of the injured limb.

In one aspect, the controller is operable to set a current limit for the reproducing initiating signal that is equal to a product of a fraction of the measured motion achievable by the injured limb relative to the measured desired motion of the healthy limb, and of a current value needed by each of the one or more actuators to generate the maximum controlled force.

In one aspect, the apparatus further comprises one or more transmission elements in kinematic connection with both one or more of the actuators and a corresponding bone of the injured limb, for transmitting the controlled force produced by the one or more actuators in kinematic connection therewith to the corresponding bone of the injured limb.

In one aspect, the first set of sensors are configured to measure relative motion of two appendages of the functional healthy limb during performance of the desired motion.

In one aspect, the detection device is configured with a tubular wall provided with at least one sensor of the second set of sensors and with fixating means for fixation to the injured limb.

In one aspect, a diameter of the tubular wall is slightly greater than that of the injured limb, to permit angular displacement of the injured limb within the interior of detection device relative to a longitudinal axis of the tubular wall. In one aspect, the second set of sensors includes a plurality of contact sensors in data communication with the controller that are interspersed throughout an inner face of the tubular wall, a relative location of each of the contact sensors that are contacted by the injured limb during performance of a test motion being indicative of the present independent motion achievable by the injured limb.

In one aspect, the second set of sensors includes one or more inertial sensors in data communication with the controller for tracking movement of the injured limb.

In one aspect, the second set of sensors includes a transmitter configured to transmit radio waves to a transceiver of the controller, in order to track a real-time position of a corresponding region of the injured limb during performance of a test motion.

In one aspect, the detection device is additionally configured with a closed end to which the fixating means is applied.

In one aspect, the tubular wall is discontinuous, in order to facilitate positioning around an appendage of the injured limb, and of sufficient structural strength to withstand a patient-initiated test motion. Two adjacent edges of the discontinuous wall are positionable in abutting relation with each and fastenable together.

In one aspect, the apparatus further comprises a power supply adapted to supply power to the first and set sets of sensors, the one or more actuators, and the controller.

In one aspect, each sensor of the first set of sensors is in data communication with the controller and is mounted on an anchor element that is secured to a corresponding region of the healthy limb.

In one aspect, each sensor of the first set of sensors is selected from the groups consisting of analog sensors, digital sensors, and a combination of analog and digital sensors. In one aspect, each sensor of the first set of sensors is selected from the group consisting of accelerometer sensors, strain gauges, bend sensors, fiber optic sensors, and Hall Effect sensors.

In one aspect, each of the one or more transmission elements is connected to a corresponding actuator and to a corresponding bone of the healthy limb by means of a cable or a rod.

In one aspect, at least one of the first, second and third signals is transmitted over a wired communication link.

In one aspect, at least one of the first, second and third signals is transmitted over a wireless communication link.

In one aspect, at least one of the sensors of the first and second sets or at least one of the actuators of the powered mechanism has a unique IP address.

In one aspect, the powered mechanism comprises a feedback sensor system which is adapted to provide real time information to the controller, in order to adjust a magnitude of the controlled force.

Brief Description of the Drawings

In the drawings:

Fig. 1 is a schematic illustration of controlled rehabilitation apparatus, according to one embodiment;

Fig. 2 is a schematic illustration of controlled rehabilitation apparatus, according to another embodiment;

Fig. 3 is a schematic illustration in side view of a limb-mounted detection device which is usable in conjunction with the apparatus of Fig. 1; Fig. 4 is a perspective view from the top of another detection device which is usable in conjunction with the apparatus of Fig. 1, shown when separated from a limb;

Fig. 5 is an embodiment of a method for reproducing motion made by a corresponding contralateral healthy limb; - Fig. 6 is another embodiment of a method for reproducing motion made by a corresponding contralateral healthy limb; and

Fig. 7 is a block diagram which shows the main features of a control circuit for use by a controller of the apparatus of Fig. 1. Detailed Description of the Invention

The present invention is a method and apparatus used for rehabilitation and training of an injured limb of a neurologically injured patient by using the corresponding functional healthy limb to supplement the motion of the injured limb. The apparatus comprises a separate sensor system for each of the healthy and injured limbs, a powered mechanism for moving individual bones on the injured limb, a processing unit, and a power supply.

While the sensor system associated with the healthy limb measures relative motion at a joint between two bones, or relative motion at a plurality of joints, the sensor system associated with the injured limb which is contralateral to the healthy limb measures absolute motion of a bone. By suitably processing data detected by the sensor system associated with the injured limb, a present range of motion achievable by the injured limb is able to be determined. The sensor system associated with the injured limb is generally provided as a detection device that is loosely mounted on the injured limb and that permits free movement of the injured limb.

As the patient moves the healthy limb, the movement of each of the bones is measured by the sensors, transmitted to and processed by the processor, which then transmits a signal to the powered mechanism that activates the corresponding actuators on the injured limb forcing the specific bone to move in exactly the same way that the bone on the healthy limb moved. The fact that the patient sees the repeated motion of his healthy and injured limb, i.e. by allowing the patient to create repeated movements with his healthy limb and to observe the (independently made or mechanically assisted) movements performed with his injured limb, creates a bio-feedback cycle which, in the case of neurological injury, can retrain the brain and the neurological system to allow them eventually to regain control of the injured limb.

The term limb used in the present invention refers to any one of the jointed appendages of a human or animal, such as an arm, foot, hand and leg, used for locomotion or grasping. The invention can be applied to any of the jointed appendages mentioned above. In order to illustrate the invention, the specific case of retraining a human hand that has been paralyzed as a result of a stroke or any other kind of injury will be described herein. On the basis of the following description the skilled man of the art will know how to adapt the invention mutatis mutandis for use with a different type of limb.

Fig. 1 schematically controlled rehabilitation apparatus, generally indicated by numeral 30, according to one embodiment. Apparatus 30 comprises a plurality of sensors 2, which may be digital or analogical sensors, mounted on a healthy functional limb 5, shown to represent an index finger having a distal phalange 3 and an intermediate phalange 4, to track the movement of individual bones of the fingers of a hand. Each sensor 2 is mounted on an anchor element 8 that is secured to a corresponding bone on healthy limb 5. Anchor elements 8 may be attached directly to the finger at each side of a joint, e.g. in the form of rings as illustrated.

When the hand is used, for example to grasp or release an object, adjacent bones in each finger move with respect to one another. The movement of a bone, hereinafter referred to as the "object bone", in relation to one or more other bones, each of which hereinafter referred to as a "reference bone", is detected by the sensors 2. The object bone and the reference bone are connected by a joint that permits relative movement of one with respect to the other. Each sensor 2 transmits a signal H, whether a wireless signal or a wired signal, indicative of a measurement made with respect to a corresponding bone of a healthy limb 5 to controller 18, which is powered by power supply 20. Controller 18 receives and analyzes all time-dependent signals H from the sensors mounted on healthy limb 5 during performance of a specific motion, such as bending the distal phalange towards the palm or away from the palm, and is able to initiate reproduction of the specific motion through definition of relative motion associated with each phalange of limb 5 following analysis of the received signals H.

A powered mechanism 10 configured to reproduce the specific motion in conjunction with the injured limb 7 includes one or more actuators 13 in data communication with controller 18, which are adapted to operate in accordance with a reproducing initiating signal R received from controller 18. One or more transmission elements 19 in kinematic connection with both an actuator and a bone of the injured limb 7 transmit the controlled force F produced by an actuator to a corresponding bone of the injured limb 7, so that the combined actuator-assisted movement of all propelled bones will reproduce the specific motion made by the corresponding contralateral healthy limb 5.

One or more sensors 11 mounted at a specific region of injured limb 13 measures absolute motion of a corresponding bone, and transmits a signal S to controller 18 which is representative of the measured absolute motion. Controller 18 analyzes the received signal S and determines the present range of motion achievable by the injured limb 13. In response to determining the achievable range of motion, controller 18 determines the magnitude and direction of the supplementing forces that have to be generated by each actuator 13, so that, together with the determined range of motion achievable by the injured limb 13, the specific motion may be reproduced by the injured limb 13. Fig. 2 illustrates an exemplary analog system for reproducing a specific motion of the healthy limb when the injured limb is fully incapacitated and therefore there is no need for any absolute motion detecting sensors. In this embodiment, the sensors mounted on the healthy limb are potentiometers 16, which are connected by cables 14a and 140a to corresponding anchor elements 8 that are secured on each finger bone of healthy hand 25. Anchor elements 8 can be attached directly to the finger in the form of a ring, as shown, or can be configured in other ways. It will be appreciated that any other number of sensors and cables may be employed, depending on the anatomy of the limb or on the specific motion that is desired to be reproduced.

A set of flexible cables 140a, 14a is used for each joint of the fingers to measure the relative movement of the object bone relative to the reference bone when the joint is bent. The set of cables comprises an internal cable 140a that passes through the hollow center of an external cable 14a. The external cable, which is essentially a flexible tube, is attached at one of its ends to an anchor element 8 on reference bone 6 and at its other end to a fixed location on the arm of the patient. The internal cable 140a is attached at one of its ends to anchor element 8 on the object bone 3, passes through the hollow center of external cable 14a and is connected at its other end to lever 21. Bending of the joint between object bone 3 and reference bone 6 causes the inner cable 140a to pull on lever 21, which rotates about pivot 9, pulling on linkage 28 and changing the output of potentiometer 16. Not seen in the figure is a spring located on pivot 19. The spring pulls back on the end of the lever to which the inner cable is attached so that, when the joint on the finger is straightened, the tension in the inner cable is maintained and linkage 28 is pushed in the opposite direction changing the output of potentiometer 16. The output of potentiometer 16 is transmitted to controller 18.

In this way, the movements of the object bone 3 in relation to the reference bone 6 are transferred to the related sensor by pull of the cable. As long as the bones move together, the distance between the anchor elements 8 on the object bone 3 and reference bone 6 stays constant, the potentiometer is not moved and the system d react. That is, the wrist is free to move as long as the external and internal cables move together.

The sensors can be either digital or analog, e.g. accelerometer sensors, strain gauges, bend sensors, fiber optic sensors, or Hall Effect sensors. In the case in which digital sensors are used, the sensors are located on the bones at the locations of anchor elements 8. The output signals from each sensor or potentiometer can be transmitted by either a wired or wireless communication link 24 to processor based controller 18. In embodiments of the invention wireless transmitters having a unique IP address are associated with some or all of the sensors and communication link 24 is a wireless network that uses, for example, Wi-Fi or Bluetooth technology.

In controller 18, the output of each of the sensors 16 is analyzed and then signals are transmitted to powered mechanism 10 on the injured limb 27. The transmitted signals are instructions related to the duration and magnitude of the force that should be applied by the components of the powered mechanism 10 to each specific bone on the injured limb 27 in order to cause that bone to move in exactly the same way that the corresponding bone on the functional limb 25 moved. One example of an actuator that can be used in the powered mechanism 10 is a miniature electric motor 22 that is fixedly attached to the arm of the patient and mechanically linked to cables or rods that are connected to anchor elements 12 on the finger bones. Another example is a pneumatic or hydraulic pump and a driving jig connected to the bones in a similar manner. The actuators receive the electric power to activate them from power supply 20 by means of a network of wires 26.

In the embodiment shown in Fig. 2, the small electric motor 22 is activated by instructions received from controller 18. On the injured hand 27, as opposed to the healthy hand 25, for each joint the powered mechanism 10 comprises two sets of flexible cables 150a, 15a one on the top of the joint to cause the straightening of the joint and another similar set (not shown for clarity) on the bottom to cause bending of the joint. Each set of cables comprises an internal cable 150a that passes through the hollow center of an external cable 15a. The external cable, which is essentially a flexible tube, is attached at one end to an anchor element 12 on the reference bone and at the other end to a location on the arm above the wrist. The internal cable 150a is attached at one end to an anchor element 12 on the reference bone, passes through the hollow center of external cable 15) and is connected to one end of lever 21. Anchor elements 12 can be attached directly to the finger, e.g. in the form of rings as shown. The motor 22 is coupled to a screw 23 which, depending on the direction the screw is rotated by the motor, causes the end of lever 2G to which it is attached to be pushed forward or pulled backwards. As the end of lever 2G connected to the screw 23 moves, the lever 2T rotates around pivot 19' pulling on the ends of cables 150a causing the object bone to move relative to the reference bone causing the joint between them to bend or be straightened depending on if the top or bottom internal cable is pulled.

According to one embodiment of the invention a feedback sensor system is provided on the injured hand 27. The feedback sensor system is identical to the sensor assembly on the healthy hand 25. In the embodiment shown in Fig. 2, the cables and anchor elements of the powered mechanism 10 that are used to move the injured fingers are also utilized for the feedback sensor system. The end of lever 21' of the powered mechanism to which the cables 150a on the top and bottom of a finger are connected is also connected by linkage 25' to potentiometer 16'. As lever 21 moves, linkage 28' is pushed or pulled changing the output signal of potentiometer 16'. The output of potentiometer 16' is transmitted to controller 18.

The feedback sensor system on the injured limb provides real time information to controller 18, which uses this information to adjust the magnitude of the force of the actuators on the injured limb 27. This feedback is important in order to match the motion of the bones on the injured limb 27 exactly with that of the corresponding bone on the healthy limb 25 and prevent the application of excessive force to the bone which could further injure the hand.

It will be appreciated that any other kinematic system is also in the scope of the invention.

Fig. 3 schematically illustrates a limb-mounted absolute motion detection device 35, according to one embodiment. In order to permit, on one hand, free movement of a jointed appendage of the injured limb and, on the other hand, detection of its absolute motion, detection device 35 may be configured to be loosely mounted on a jointed appendage, shown to be for example distal phalange 3 of an index finger.

Detection device 35 is shown to be cylindrical and configured similarly as a thimble, with a continuous tubular wall 37 and a closed end 39, but it will be appreciated that the detection device may be configured in other ways as well. The diameter of tubular wall 37 may be slightly greater than that of distal phalange 3, to permit angular displacement of distal phalange 3 within the interior of detection device 35. Closed end 39 is fixated to the fingertip by fixating means 42, for example by adhesive means, to limit the axial movement of detection device 35. The length of tubular wall 37 may be equal to the total length of distal phalange 3 and intermediate phalange 4, allowing the tubular wall to be contacted by intermediate phalange 4 and being rendered substantially stationary relative to distal phalange 3. One or more sensors 32 in data communication with the controller are provided with tubular wall 37 in order to track the movement of distal phalange 3 during a patient-initiated test motion.

In one arrangement, a plurality of contact sensors may be interspersed throughout a region of the inner face of tubular wall 37 that is able to be contacted by distal phalange 3, the relative location of each being indicative of the current motor skills of the patient. Since only the fingertip is fixated to closed end 39 of detection device 35, the test motion will result in the pivotal displacement P of distal phalange 3 relative to the longitudinal axis 44 of the tubular detection device 35. The range of absolute motion that the patient is capable of achieving with distal phalange 3 is dependent upon his or her level of recovery. Thus a different set of contact sensors will be triggered at a different level of recovery, and will consequently transmit the corresponding data to the controller.

In another arrangement, one or more inertial sensors such as accelerometers or gyroscopes may be used. In this arrangement, detection device 35 may be firmly fit on distal phalange 3 to resist any angular displacement therebetween.

Alternatively, a transmitter may transmit radio waves to a transceiver of the controller, in order to track the real-time position of a corresponding region of distal phalange 3 during the course of the test motion.

The controller accordingly receives the signals from each sensor 32 and analyzes them to determine, based on predetermined instructions, the real-time absolute range of motion that is able to be performed by distal phalange 3.

The detection device may be adapted to any other bodily appendage for tracking absolute range of motion, even if it is not a distal appendage.

Fig. 4 illustrates a detection device 45 whose tubular wall 43 is discontinuous, in order to be wrapped around an appendage, so that the two adjacent edges 46 and 47 of discontinuous wall 43 will be positioned in abutting relation with each and fastened together with fasteners 48, such as Velcro strips, so as to be sufficiently structurally strength to withstand the patient-initiated test motion. Detection device 45 also has a discontinuous end 41which forms an annular shape when its two pieces are positioned in abutting relation with each other and tightened, such as by means of a strap 49 and corresponding buckle 51, in order to be fixated to the appendage. When the two edges 46 and 47 are fastened together, a tubular wall 43 is produced that may have a significantly greater diameter than that of the appendage to which detection device 45 is fastened. When a patient performs a test motion, the appendage, even one that is not a distal appendage such as the thigh or an intermediate phalange, may be pivotally displaced at the region of fixation relative to the longitudinal axis of the tubular detection device 45, to facilitate determination of the range of absolute motion that the patient is capable of achieving by means of an array of sensors provided at a region of the inner face of tubular wall 43 which is at a distance from strap 49 and buckle 51. The length of tubular wall 43 is generally longer than that of the appendage and contact4d by an adjacent appendage so that the tubular wall will be rendered substantially stationary relative to the appendage.

Figs. 5 and 6 illustrate two embodiments, respectively, of a method carried out by the controller for determining which reproducing initiating signal should be transmitted to an actuator configured to output a controlled force to a corresponding bone of the injured limb, so that the combined actuator-assisted movement of all propelled bones will reproduce the specific motion made by the corresponding contralateral healthy limb. The following method illustrates the production of actuator-assisted movement for a single appendage, and the actuator-assisted movement can be similarly produced for a limb having a plurality of appendages mutatis mutandis.

In the embodiment of Fig. 5, the healthy limb and the injured limb simultaneously attempt to perform a desired motion.

When the healthy limb performs a desired motion in step 52, the controller determines, in response to analysis of the signals generated by the sensors mounted on the healthy limb, the corresponding range of motion and of applied force achieved by the healthy limb in step 59. The controller also registers during performance of attempted independent motion by the injured limb in step 61 intended to duplicate the motion performed by the contralateral healthy limb, in response to analysis of the signals generated by the sensors mounted on the injured limb, the range of motion and of applied force achieved by the injured limb in step 63. Based on the two inputs from the healthy limb mounted sensors and the injured limb mounted sensors, respectively, the controller outputs one or more reproducing initiating signals in step 75 in accordance with stored instructions, the number of reproducing initiating signals depending on the number of actuators provided with the powered mechanism. The stored instructions preferably include at least data related to a calculated fraction of the current injured limb motion relative to the motion of the contralateral healthy limb. Each outputted reproducing initiating signal is transmitted to a corresponding actuator in step 79, in order to be activated and to generate a predetermined controlled force that assists to reproduce the motion performed by the healthy limb by combined actuator-assisted movement and independent motion of the injured limb. In the embodiment of Fig. 6, the healthy limb and the injured limb attempt to perform a desired motion at different times.

Firstly, the healthy limb performs a desired motion in step 52, and then the controller receives all time-dependent signals in step 54 that are generated by the sensors mounted on the healthy limb during performance of the desired motion. The controller analyzes the received signals in step 56, and defines the maximum controlled force in step 58 that should be applied by each actuator simultaneously so that the desired motion could be reproduced when the injured limb does not make any voluntary motion, when taking into account the configuration of each transmission element. A calibrating step is then performed whereby the current needed by each actuator to generate the maximum controlled force is detected in step 62.

Afterwards, the injured limb performs the test motion in step 64, and the controller receives all time-dependent signals from each sensor mounted on the limb-fixated detection device in step 66. The controller analyzes the signals received from the injured limb in step 68, and determines the range of absolute motion that is achievable by the injured limb in step 70. A calculation is made in step 72 to present the determined range as a fraction of the range of the contralateral healthy limb that performed the desired motion, and the current limit of the reproducing initiating signal is set in step 74 as a product of the calculated fraction of the injured limb motion to healthy limb motion, and the current needed by each actuator to generate the maximum controlled force. The calculated reproducing initiating signal is transmitted to the driver of each actuator in step 76 to generate a controlled force in step 78 that is transmitted to the injured limb while the injured limb recreates the test motion, so that the combined actuator-assisted movement of the injured limb will reproduce the desired motion made by the corresponding contralateral healthy limb in step 80.

Fig. 7 is a general block diagram presenting an embodiment of a control circuit for use by controller 18. The analog/digital conversion elements connected to the sensor arrays are not necessary when digital sensors are used. The controller may be a dedicated unit attached to or separated from the rest of the apparatus or it can be a general purpose computer, PC, or hand held device. In addition to the processor itself, this module comprises other components including: one or more input/output bus bars to facilitate electrical connection with the components of the apparatus; transmitting and receiving means for wireless and/or wired communication with the sensors; one or more memory units to record the activities and results of the sessions and historical data that show the progress of the patient; input devices, e.g. keyboard, touch pad, or touch screen, to input information about the patient or details of the session and instructions to the apparatus, for example limiting the maximum amount of force that can be applied by the actuators on the injured limb; and output devices, e.g. a display screen or audible signals to allow the progress and results of the session to be monitored. In addition, regardless of the type of processing unit employed, the processor is loaded with dedicated software adapted to receive the signals from the sensors and convert them into instructions to the actuators and also to control the overall operation of the apparatus.

The power supply 20 can supply either direct current, e.g. from rechargeable batteries, or low voltage alternating current to the sensor system on the healthy limb or on the injured limb, the powered mechanism on the injured limb, and controller 18 by means of electric wires as required.

The apparatus of the invention enables a patient to train himself and to reduce the hours of work with a physical therapist. For self-training sessions without the presence of a physical therapist, a patient receives, together with the apparatus of the invention, a training program with specific instructions of the kind and number of movements to be done with the healthy hand. Movements of the healthy hand will cause, according to the invention, movements in the injured limb, which will help regain use of the injured limb. Basically the healthy limb is used to replace the physical therapist in the training of the injured limb. According to an embodiment of the invention the apparatus comprises, as mention above, means to allow the progress and results of the session to be monitored, further enabling the absence of a therapist. The invention described is an apparatus and a method for performing self physiotherapy and providing biofeedback for training a neurologically damaged joint using its healthy mirror counterpart in the body. The invention enables better rehabilitation and promotes new neurological paths by providing biofeedback of the injured joint movements according to the brains commands. As well, the invention allows lower cost of physiotherapy by enabling the patient to train himself.

Although embodiments of the invention have been described by way of illustration, it will be understood that the invention may be carried out with many variations, modifications, and adaptations, without exceeding the scope of the claims.