ADVICE TO A SUBJECT

FIELD OF THE INVENTION

The invention relates to a system, mobile device, processing device, method and computer program for providing a health advice to a subject. BACKGROUND OF THE INVENTION

GB 2 454 705 A discloses a wearable personal activity monitor and computer based coaching system for assisting in exercise. The wearable personal activity monitor has an accelerometer to sense extent of movement of a user and a wireless communication module to receive data from physiological data gathering devices (e.g. weighing scales, body composition analysis monitor, blood pressure monitor). Data may also be received from exercise equipment. The monitor, which may be worn on the wrist or ankle, stores movement data and physiological data over a period of time and can transmit the data over the internet to a computer based coaching system on a server. The coaching system interacts with the user, via web pages. The user can input data relating to physical or mental condition, and plan a schedule of activities and lifestyle. The system provides suggestions, hints, tips and recommendations as to forms of exercise and lifestyle. Links to other users of the system are provided. The system displays a commitment meter.

A wearable device assembly according to US 2013/0106603 Al has a housing supporting a controller, display and indicator system thereon. The controller has at least one sensor wherein activity of a user wearing the device is detected. The controller selectively illuminates the indicator system to indicate a level of activity of the user.

Chronic obstructive pulmonary disease (COPD) refers broadly to a group of conditions that cause irreversible respiratory impairment by increasing obstruction to airflow through the bronchi of the lungs.

COPD typically has two components which may be present to varying degrees: chronic obstructive bronchitis where the airways become reduced in volume, showing increased airway resistance making it more difficult to move air out of the lung (see Fig. 1 A). The other component is pulmonary emphysema, where the small air sacs are ruptured causing air to be retained in the lungs and limit the available space during inhalation (see Fig. IB). Individuals who predominantly have emphysema experience symptoms that differ in detail from those who predominantly have chronic bronchitis; however, both disorders contribute to shortness of breath during exercise and to general disability.

Chronic obstructive pulmonary disease is progressive and irreversible. It is an under-diagnosed, life -threatening lung disease that interferes with normal breathing. The primary cause of COPD is tobacco smoke. Other risk factors for COPD are indoor and outdoor air pollution, occupational dusts and chemicals.

The most common symptoms of subjects with COPD are breathlessness, abnormal sputum with respect to volume and color and chronic coughing. Daily activities, such as walking up a stair or a hill can become very difficult due to breathlessness as the condition gradually worsens. Furthermore cough and getting rid of secretions that build up in the lungs is an issue for subjects with COPD. COPD subjects can be very prone to lung infections and pneumonia, which can cause a downward spiral of repeated lung infections and a further decline of lung function.

Acute exacerbations of COPD subjects have a negative impact on their health related quality of life, pulmonary function and survival of subjects with COPD.

COPD is predicted to become the third leading cause of death and disease worldwide by 2020, mainly due to its growing prevalence in developing and low income countries. This has to be seen in context with the fact that COPD subjects are one of the most expensive to manage, largely driven by hospitalization. A small proportion of COPD subjects who are experiencing acute exacerbations, accounts for over 50 to 70 % of the healthcare costs as a result of emergency visits and hospitalizations. Reduction of healthcare costs, by more effective disease management is therefore of high importance.

To improve the quality of COPD subject's lives and reduce healthcare costs, there is a need to support COPD subjects from the hospital to the home.

Compared with age-matched control subjects, studies have shown that clinically stable COPD subjects are significantly physically less active and are limited in their physical activity due to their condition. This baseline low level of physical activity decreases even further following a hospitalization for a COPD exacerbation. Furthermore, it has been shown that subjects with higher self-reported physical activity are less likely to be re- hospitalized due to COPD exacerbation.

Pulmonary rehabilitation (PR) programs are used to support COPD to be physical active after hospital discharge. These rehabilitation programs are effective. However, it has been found that after subjects have completed PR and return home, they do not sustain their physical activity level. Instead their physical activity typically declines to the low levels they had before re-admission. With these low levels of physical activity at home after PR, COPD patients are at risk of being re-admitted.

US2007219059A1 discloses a method and system for continuous monitoring, real-time analysis, and automated and personalized training of exercise. The system embodies a multi-sensor data acquisition system to measure body sounds, body signs, vital signs, motions, and machine settings continuously and automatically. The system is able to capture the body sounds and other vital signs, analyze them, and report and display summarized results. The signal processing functions utilize a unique signal separation and noise removal methodology by which authentic signals can be extracted from interfered signals and in noisy environments, even when signals and noises have similar frequency components or are statistically dependent. The method and system will facilitate continuous monitoring, real-time analysis, and computerized evaluation of level of effort, and physical stress during physical activity or exercise. In addition, based on body sound data, or in combination with other monitored physiological signals, and knowledge of the individual and exercise being performed, the system will evaluate the person's physical performance and then act as an automated coach to guide exercise intensity and duration thereby optimizing and individualizing the training process. The method and system is especially targeted, but not limited to, cardiopulmonary monitoring for athletes for improving the efficiency and safety of exercise, rehabilitation programs for out-of-shape individuals, and routine exercise of the general population.

Although there are considerations to keep COPD subjects physical active at home, there are no physical activity coaching services available that are tailored and that coach COPD subjects effectively at home to prevent them from falling back into low levels of physical activity. Rather, known coaching applications typically only look at physiological or vital signs like heart rate, breathing, or the user's body sounds to measure physical effort, physical stress and fatigue. Data is subsequently used to tailor a personalized coaching program (or rather a training schedule) that is linked to explicit exercise on exercise equipment. In addition, real time monitoring occurs that could help tune the intensity, duration of the ongoing activity. Known applications are thus intended for athletes, sports, or people being out of shape. Put differently, activity monitoring devices (and coaching applications therefore) are not specifically tailored for users such as subjects suffering from COPD who exhibit a much lower overall activity and capability.

It further has to be noted that activity monitors can be worn on different parts of the body depending on the type of device and configuration. For example, some activity monitors are wrist worn, whereas some are to be placed close to the hip region. As a consequence, some activities are better detected than others depending on the wearing position.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide an improved system for providing a health advice to a subject, an improved mobile device for receiving a health advice to a subject, an improved processing device for providing a health advice to a subject, an improved method for providing a health advice to a subject, an improved computer program for providing a health advice to a subject.

In an aspect of the invention, there is provided a system for providing a health advice to a subject as defined in claim 1.

It is noted that the term "assign" is to be understood in the broadest sense of simply linking the first activity tag to the first time period. This may be done automatically, in response to user input, etc.

In an embodiment, the tagging of activities may be done on a web browser. For instance, the user may be provided with a visual representation (such as, e.g., a graph) of physical activity. Next to this visual representation, there may be a canvas with activity icons that subjects can e.g. pick up with their mouse, and drag and drop on the spot of the day in the graph that they performed that activity.

In an embodiment, the tagging of activities may be done via a touch screen interface. In that case, a corresponding type of interaction of picking up an icon with the finger and dragging it on to the graph may be conceivable.

In an embodiment, the categorization unit comprises a user interface that is configured to enable an interaction between the subject and the system, wherein said categorization unit is configured to assign said first activity tag based on a signal received via said user interface.

In an embodiment, the system further comprises an activity level determination unit, wherein said activity level determination unit is configured to determine a third activity level corresponding to the first time period based on said first and second activity levels.

In an embodiment, the system may be operated on a computer with an internet connection, on a tablet or via an app operated on a mobile phone. In an embodiment, the system comprises user interface information of several topics for the subject. In an embodiment, a day-by-day overview on the performed physical activities is provided to the subject. In an embodiment, a tagging system is provided to enable linking the activities with daily actions such as, e.g., walking, running, household activities like vacuum cleaning, ironing, cleaning, tidying up, cooking, etc. physio exercises such as breathing exercise, swimming, home bicycling, treadmill, cross trainer, jogging, walking, nordic walking, strength exercise, flexibility exercise, daily activities like shopping, showering, eating, dressing, walking the stairs, etc. free time activities like activities outside, singing, playing instrument, activities inside, going outside with friends, etc.. In an embodiment, the system provides an indication if the subject has carried out a strength or a flexibility exercise. This may be done, e.g., by marking (e.g., tagging) the specific exercise through the subject, but can also be achieved e.g. by identifying the specific exercise through measurements with specific sensors.

In an embodiment, a tagging system is provided to enable subject linking the activities with daily actions as well as with emotions such as "fun", "breathless", "exhausted" etc.

In an embodiment, the system further comprises for the subjects means to perform activity planning, e.g., by means of a planning page, where the subject can plan in advance physical activities. In an embodiment, the system enables a subject to mark (e.g., tag) in the day-by-day overview whether or not the activities planned for a specific day have also been carried out.

In an embodiment, the system is collecting on a day-to-day basis (e.g., by means of questionnaires included in the system) information on the subject's status such as symptoms, status, mood, etc.

In an embodiment, the system may comprise a specific page for the subject where the subject gets a weekly overview on the status of his activities e.g. related to endurance, strength and flexibility. This status may be compared with goals, which have been set so as to indicate to the subject, whether or not he has achieved his goals for the week in the several areas, e.g., endurance, strength, flexibility, etc. In an embodiment the system further comprises a specific overview for the subject what he/she has achieved on physical activity on the specific day related to the set goal and how much activity at the day the patient still has to do to achieve the goals. The system may further request feedback whether the subject thinks that today could be a day that the goal will be achieved. In case the activity goals have already been achieved, the system may congratulate the subject.

In an embodiment, the system further comprises a specific coaching page for the subject, where based on the measured data over a period of time as well as the collected subject information data and the goals set along specific coaching rules, an active coaching is offered to the subject.

In an embodiment, the coaching rules cover e.g. the physical activity of the subjects related to endurance, strength, flexibility, etc. In an embodiment, the data are collected e.g. from week to week and are used to indicate to the subject, in which area the subject is on target, below target or above target. In an embodiment, the current status of the respective type of physical activity on target, below target or above target may be shown on a specific site to the subject in graphical information.

In an embodiment, from these data active coaching may be communicated to the subject along a side. In an embodiment, the coaching may give the subject an overview, in which physical activity he or she did well, e.g., on target or above target, and encourages the subject to continue to do so. In an embodiment, the system may inform the subject about a trend, e.g., over the past several (e.g., three) weeks. When the subject performs above target for a specific time period, e.g., over several weeks, the subject may be encouraged to take a step further. In an embodiment, the system may give the subject the opportunity to send a message to a (human or virtual) coach to increase the target for the next week.

In an embodiment, if the subject performs under target for some time period, e.g., over one week, the system may indicate to the subject that, before that time period (e.g., the weeks before) he/ she could achieve his/ her targets. In an embodiment, the system may encourage the subject to try better in the following week

In an embodiment, if the subject is below target for an extended time period such as, e.g. several weeks, the system may offer the subject the possibility to send a message to the (virtual or human) coach to lower the target.

In an embodiment, the system may further comprise a specific page (such as, e.g., a website) for the coach, which can be a physician, a physiotherapist, a nurse or a family member. It is also conceivable that the coach is not a human person, but e.g., an artificial intelligence unit configured to assess the subject's health data. In an embodiment, the page may display to the coach the activities achieved by the subject concerning, e.g. endurance, flexibility, strength, etc. and compare the achieved goals with the goals which had been set previously. For example, a simple color coding may indicate to the coach if the subject is on target, above target or below target. In an embodiment, the page may further enable the coach to set the goals for the subject in agreement with the subject. In an embodiment, setting the goals is performed when, for example, the subject is enrolled or when the subject asks to adapt the goals during the training.

Conventional systems are typically content with adapting the monitoring to the level for COPD subjects. By means of the categorization unit however, the present invention provides subjects with a possibility to indicate, which activities they did at a given day and how much this contributed to their activity per day. The categorization unit enables the subject to identify at least one activity tag from a plurality of activity tags. The at least one activity tag is subsequently assigned to the first time period. In an example, the subject may be presented (e.g., by means of a screen, which may be a touch screen) with a number of possible activities (such as, e.g., walking, running, etc.), where the subject may then select one of these activities (e.g., by maneuvering the respective sensitive area on a screen, but also other methods e.g. touching the respective touch sensitive area on a touch screen can be used).

The selection of a given activity corresponds to identifying an activity tag from a plurality of activity tags. It shall be understood that the subject is free to perform the activity tagging at a later stage. In other words, the subject may, e.g., in the evening of a given day, recall his or her daily activities and assign these activities (i.e., identify respective activity tags) to certain time periods. As an example, on a given day, a subject may have been walking from 9 am until 10 am, running from 10 am until 11 am, and sleeping from 1 lam until 1pm. For instance, in a consultation with the subject's physician from 3pm until 4pm, the subject may then identify an activity tag "walking" for the time period from 9am until 10am, an activity tag "running" for the time period from 10am until 1 lam, and an activity tag "sleeping" for the time period from 1 lam until 1pm. It shall be understood however, that activity tagging is not limited to respective consultation sessions with the subject's physician. Rather, the subject may choose to tag an activity at any time before, during and after a respective time period. That is, a subject may plan to go walking on the next morning from 8am until 9am. The subject accordingly identifies an activity tag "walking" with the time period from 8am until 9am of the next day. It may of course happen that the subject does not actually go walking during said time period (e.g., because the subject was not feeling well). In such a case, the subject may also correct a previously defined activity tag to specify, which activity was actually performed or whether no activity at all was performed during the time period in question.

The present invention thereby may also be adapted to physical activity tasks a

COPD subject is doing and can do.

In an embodiment, one may consider looking not only at activity data, but also at more experiential subjective surveys in order to provide asynchronous advice of a completely different nature. Specifically, the present invention is suitable to be used in the context of activities of daily living and other low effort activities around the home. The present invention thus aims to increasing motivation for physical activity (in other words: getting subjects to do something) rather than to providing real-time fine tuning (in other words: increasing the user workout's intensity, duration, or variety while carrying out the workout).

The present invention is thus suitable to using interaction and user interface strategies to achieve getting subjects to be active at all. The goal is thus focused on habit formation and health behavior change, rather than on performance enhancement and behavior shaping.

In an embodiment, the user interface comprises one of a keyboard, a mouse, a touchscreen, a kinetic user interface, and/or a voice recognition unit, wherein said

categorization unit is configured to identify the selected at least one activity tag based on a signal received via said user interface. By providing a user interface in accordance with the above-described manner, the subject is given the opportunity to perform an activity selection, i.e., identify an activity tag, e.g., by simply pushing a button assigned to a special type of activity. Tagging an activity is thus made very easy for the subject.

In an embodiment, the user interface is configured to provide only said plurality of activity tags to said subject. By providing only said plurality of activity tags to said subject, activity tagging is again made simple for the subject. The subject does not need to understand a complicated and elaborated user interface, but the subject only needs to pick one activity from a list of activities which may be, e.g., displayed to the user on a screen. The embodiment is thus particularly suited for subjects not having much experience with computers and/or sophisticated user interfaces.

In an embodiment, a subject may consider monitoring himself or herself throughout the day. In other words, the measurement takes place outside a supervised or structured facility, such as e.g., a hospital or the like. In an embodiment, the monitoring may be easily achieved at home. In an embodiment, the physical activity monitors to be used may be low power so that they can run for an extended period of time, such as, e.g., several days or weeks without any charging. In an embodiment, the subject may, e.g., upload activity data from the physical activity monitor on to the system via e.g. computer with internet connection. At the same time the battery of the sensor can be charged to enable operation during the next days and weeks.

In an embodiment, the system further comprises a display unit that is configured to provide a graphical display of the subject's activity and inactivity during said first time period. By providing a graphical display of the subject's activity and inactivity during said first time period, the subject may be given an immediate feedback on its activity or activities. Further, a subject may not remember the precise times at which he or she performed a given activity. For instance, in the afternoon, a subject may have forgotten whether he or she went running from 8am until 9am or from 9am until 10am. By means of the graphical display of the subject's activity however, the subject is able to quickly identify the correct time period.

In an embodiment, the system is configured to modify an activity schedule based on an input provided via the categorization unit. In an embodiment, the system is configured to receive the activity schedule. The activity schedule may be received, e.g., via a user interface offering a user the option to build his/her own schedule. In an embodiment, the system is configured to provide the activity schedule. Providing the activity schedule may include, e.g., generating the schedule. Generating the schedule may be performed

automatically based on, e.g., previous input, user preferences, and/or user permission or request. By means of the above embodiment, the subject is given the opportunity to adapt the activity schedule to the activities actually performed. For instance, an activity schedule may foresee a daily walk between 8am and 9am. A subject may however not have been able to go walking, or may only have been able to go walking in the afternoon. The activity schedule may thus be modified such that the subject may, e.g., change the time period associated with walking on the day in question, or cancel the planned activity "walking" altogether. A subject's modification behavior may be analyzed as well. For instance, a subject may frequently shift his or her activity "walking" to the afternoon. That may be because walking in the afternoon simply fits better with the subject's general schedule. In some instances however, one may also deduce further information from this behavior (e.g., subject is too tired in the morning, etc.). In an embodiment, activities which are carried out on time as well as activities which are cancelled may be monitored in the system and give the system information on a subject's preferences and abilities. Additionally and/or alternatively, emotion tags may be employed for building a user profile or personal preferences activities database. In an embodiment, this information can be used in an active coaching system, to propose to the subject specific activities which he / she likes or specific time slots in the day which are suited for carrying out the activity.

In an embodiment, personalized goals refer to at least one of endurance, strength, and/or flexibility. In another embodiment, personalized goals refer to at least one of staying independent, travelling, and/or staying socially active, staying mobile etc. For instance, the system may be configured indicate to the user on an activity level which activity is particularly suited to maintaining a certain goal. Namely, staying independent may include activities that are related to personal care (e.g., bathing, dressing), a certain level of mobility (e.g., being able to displace within the home), and ability to do or organize household tasks like cooking and cleaning. Certain activity plans can be created for a long term goal. Thus, in an example application to prevent getting isolated (i.e., a long term goal to stay socially active), in agreement with a clinician or family member a goal is set to meet weekly with any one of the COPD self supporting group advised by the clinician, the bowling team, or any other team meeting the subject enjoys. The subject may be given the opportunity to plan this goal on a weekly basis by means of a planning tool of the coaching system and to indicate by means of tagging when this activity has been done. The system may be further configured to provide recognition to the subject when the goal is achieved. The system may further be configured to encourage the subject to achieve the goal next week e.g. when it was not possible for the subject to take part in a particular social event.

In an embodiment, targets are set by a professional in cooperation with the subject.

In an embodiment, during extended use of the system, targets may be adjusted to optimally suit the subject, while maintaining a minimum required level of the target.

In an embodiment, the categorization unit is configured to allow the subject to select the at least one activity tag during a second time period, wherein said second time period is different from said first time period. By enabling the subject to postpone the activity tagging to a later stage, the present embodiment allows for an asynchronous feedback from the user. That way, a subject is not required to tag an activity during or right after the activity is performed. Rather, a subject may, e.g., in the evening, recall his or her activities of the day and assign respective tags to corresponding time periods.

In an embodiment, the at least one activity threshold is personalized to the subject. By personalizing the at least one activity threshold to the subject, the present embodiment allows for an individual adjustment to the subject's health level. For instance, a subject may get exhausted even when performing low-level activities such as, e.g., walking slowly or taking few stairs. In that case, the at least one activity threshold may e.g. be set lower in order to account for the fact that the "absolute" activity difference between e.g., sleeping and walking for the subject in question is small. Nonetheless, it may be desirable to distinguish walking from sleeping, because the fact that the subject actually does try to be active (even if the subject is only walking slowly) is already an achievement for the subject.

In an embodiment, the health advice comprises at least one of an activity suggestion and/or a motivation message. By means of providing an activity suggestion, the subject may be led to e.g. go running rather than walking. By means of providing a motivation message, a subject may be led to perform an activity at all or to refrain from terminating an activity too early.

In an embodiment, the activity tag corresponds to a type of activity. Types of activity may include, e.g., walking, running, relaxing (e.g., yoga), swimming, household activities (e.g., cleaning the dishes). By tagging a type of activity, the subject may associate said activity with a given time period. For instance, the subject may indicate that he or she went running from 9am until 10am.

In an embodiment, said advice providing unit provides a tailored health advice in order to enhance the subject's coping skills and self-efficacy, in order to increase the subject's planning skills, and in order to make the subject feel good about oneself. In an embodiment, e.g., in order to enhance the subject's planning skills, the system may remind the subject when he/she is logging in, to plan the days in a week very detailed, using the tagging system so that the subject has well distributed activities over the day. If there are no activities planned, the system may remind the subject to plan them. The system may further assess whether, at the time an activity was planned in the week, an activity actually took place and may congratulate the subject to a successful planning and execution. The history of past successes and the feedback of which types of activities were executed in the past may enhance a subject's self-efficacy. In addition, incorporating tools and additional features in the planning can lead to enhanced self-efficacy in for example the following two ways. First, subjects may be asked to rate confidence, difficulty and importance of planned tasks provides the system with additional information on the likelihood of activity performance. Doing this in a self- learning system, allows the system to reason and provide the subject with

information that will enhance their self-efficacy. For example: drawing on previously difficult tasks that were accomplished, or accomplished activities that were rated as difficult, allows the system to provide the subject with unique information on achievement despite hardship - a strategy that is known to increase self-efficacy. Second, providing subjects with challenges (activities that were difficult but rewarding), and having subjects explicitly accepting the challenge, leads to feeling of increased self-efficacy.

Finally, coping could be addressed by action planning, barrier planning and relapse planning. When planning an activity with high difficulty and low confidence, subjects may volunteer information on things that may go wrong or may prevent them from

accomplishing the activity (barriers), e.g., "If it starts raining a bit, I'm not likely to go for my planned walk". Subjects are encouraged to not only offer barriers, but also how they personally could overcome ("I will keep a sturdy umbrella ready") or prevent the barrier from occurring ("I will look at the weather forecast, and only plan outdoor walks on days with little chance for rain"). This increases the likelihood of overcoming barriers. Relapse planning could involve patients to commit to the same activity with a lesser intensity or a shorter duration tomorrow if they fail. Or they may offer alternatives to the activity.

In an embodiment, said advice providing unit is further configured to provide practical tips and education. In an example, practical tips and education may be provided e.g., in written form or through other media. To that extent, the system may comprise information about the disease COPD, information about the disease progression and information about the disease symptoms, information about smoking and the disease as education material, which may be made available to the subject on a page when clicking on a button

"tips/information" or the like. In an example, the system may further provide information on how physical activity in subjects with CODP is related to exacerbation and potential hospitalization. In a further example, the system may provide information on indoor or outdoor activities that the subject should perform, depending on the weather conditions. In an embodiment, the general information is always provided, but other information may be provided depending on the user profile, progress or other event. For example, information may be provided on "pulmonary artery pressure and rehospitalization" when the subject's pulmonary artery pressure is steadily decreasing. Additionally and/or alternatively, the system may provide information on "smoking cessation" if a subject smokes and is considering to quit. In an embodiment, said advice providing unit is configured to tailor said health advice to one or more reasons provided by the subject for being less active than anticipated. As an example, subjects may state that they were feeling tired on a particular day, which kept them from achieving their goals. In an example, when the subject does not achieve the weekly activity target, the system may encourage the subject to try again during the next week. When the system recognizes that the subject has not reached the activity targets for an extended period of time (such as, e.g., several week, e.g., three weeks), the subject may be asked why. Different options in the system may be foreseen as a response: "no time", "nobody could join", "do not like", "do not feel like it", "home environment", "tired/no energy", "breathless", other. Depending on the reason the subject indicates, the system checked by the clinician, nurse, family member, etc. can for example lower the target for the subject for the coming week (for example in case the subject indicated to be tired, ill, etc.). Further, in case the subject answered "do not like", the system checked by the clinician, nurse, family member, etc. can for example recommend to the subject to try another activity in the coming week, which he/she might like more.

In an embodiment, if the subject performs under target for some time period, e.g., over one week, the system may indicate to the subject that, before that time period (e.g., the weeks before) he could achieve his targets. In an embodiment, the system may encourage the subject to try better in the following week. In order to achieve the subject's target in the following week, the subject may e.g. select on a specific link where tips are given how to achieve this.

In an embodiment, if the subject is below target for a given time period (e.g. several weeks) and if the subject further indicates that the goal is too hard, the system may offer the subject the possibility to send a message to the coach to lower the target.

In an embodiment, the system may comprise questionnaires (e.g., on a regular basis, such as, e.g., daily) on e.g. the subject's status, mood, symptoms, etc. If the subject indicates low symptoms such as, e.g., low coughing, low sputum production, and that he is energized at that day or week, the system may propose to the subject to increase the physical activity on that day or during that week.

In an embodiment, the system comprises a mobile device and a processing device; wherein the mobile device comprises said first activity sensor unit and said categorization unit and wherein said processing device comprises said activity evaluation unit and said advice providing unit; wherein said mobile device and said processing device are configured to communicate via a wireless network connection. By distributing the system over a mobile device and a processing device in the above-described manner, the present embodiment enables activity tagging e.g. by means of a mobile phone application, wherein the mobile phone application includes software that emulates the categorization unit. In an embodiment, the system may enable the subject to have continuous information on his daily activity as well as his weekly activities related to the goals set.

In a further aspect of the invention, there is provided a method for providing a health advice to a subject as defined in claim 11.

In a further aspect of the invention, there is provided a computer program for providing a health advice to a subject, the computer program comprising program code means for causing the system for providing a health advice to a subject to carry out the steps of the method for providing a health advice to a subject, when the computer program is run on a computer controlling the system for providing a health advice to a subject.

In the context of the invention, there may be provided a processing device for providing goals to a subject via a clinician, physiotherapist, nurse, family member, etc., wherein the processing device comprises: an input unit that is configured to receive at least one activity goal for the subject and at least one activity level of the subject during a first time period; an activity evaluation unit that is configured to compare the at least one activity level to said at least one activity goal, wherein the activity evaluation unit is configured to provide an activity evaluation signal for said first time period based on the result of the comparison of the activity level to the activity goal; a coaching providing unit that is configured to provide a coaching advice to the subject based on the activity evaluation signal and on said at least one activity goal. In an embodiment, the coaching advice may comprise at least one of a compliment and/or encouragement if the subject is on target or above target. In an embodiment, the coaching advice may comprise advice to maintain the subject's activity level as well as encouragement of the subject to ask for an increase of the activity goal for the next time period. In an embodiment, the increased activity goal may be set by the coach. The coaching advice may further comprise motivational messages for motivating the subject to be active, e.g., when he or she is below target. In an embodiment, the coaching advice may further comprise advice on how to increase the subject's activity level. In an embodiment, the coaching advice may also offer the subject the possibility to ask for a lowering of the activity goal, e.g., when the subject fails to meet the target over an extended time period, e.g., several days or weeks. In an embodiment, the processing device is configured to communicate via a wireless network connection. In an example, when the activity level of the subject during a first time period is below the activity goal for the subject, the activity evaluation signal may indicate that the subject is below target, and/or that the subject is below target by a respective target difference, and/or that the subject has been below target for a given time period. In such a case, the advice providing unit may recommend lowering the activity goal, e.g., by an amount equal to or larger than the respective target difference.

In an example, when the activity level of the subject during a first time period is above the activity goal for the subject, the activity evaluation signal may indicate that the subject is above target, and/or that the subject is above target by a respective target difference, and/or that the subject has been above target for a given time period. In such a case, the advice providing unit may recommend raising the activity goal, e.g., by an amount equal to or larger than the respective target difference.

In a further aspect of the invention the advice providing unit is configured to provide a health advice to the subject based on the activity evaluation signal and on a health target for said subject.

Herein, a "health target" may refer to a given amount of activity for the subject. Additionally and/or alternatively, a health target may specify the types of activities to be performed by the subject. Still additionally and/or alternatively, the health target may refer to data provided by means of a health questionnaire, aiming to e.g. increase the subject's mood. In an embodiment, a health target corresponds to an activity goal. Still additionally and/or alternatively, a "life goal" (such as, e.g., staying independent) may be considered a health target.

In an embodiment, the system further comprises a user interface that is configured to enable an interaction between the subject and the system, wherein said user interface is configured to receive health questionnaire data from said subject, said health questionnaire data comprising information on at least one of the subject's symptoms or the subject's mood.

In an embodiment, the system further comprises a user interface that is configured to enable an interaction between a caregiver of said subject and the system, wherein said user interface is configured to receive a new health target for said subject;

wherein said advice providing unit is configured to provide said health advice to the subject further based on said new health target. In an embodiment, the system further comprises a goal adaptation unit that is configured to automatically adapt said health target for said subject based on an evaluation of how well said health target has been achieved by said subject.

In an embodiment, said advice providing unit is configured to provide said health advice to the subject further based on said health questionnaire data.

In an embodiment, the system further comprises at least one health sensor unit, said health sensor unit selected from the group comprising a heart rate sensor, a respiration rate sensor, and a glucose level sensor.

In an embodiment, the system further comprises a categorization unit configured to assign at least one first activity tag from a plurality of activity tags to said first time period, wherein an activity tag from said plurality of activity tags corresponds to said first type of activity; wherein the categorization unit comprises a user interface that is configured to enable an interaction between the subject and the system, wherein said categorization unit is configured to assign said first activity tag based on a signal received via said user interface.

In an embodiment, the system further comprises a categorization unit configured to assign at least one first activity tag from a plurality of activity tags to said first time period, wherein an activity tag from said plurality of activity tags corresponds to said first type of activity; wherein the system further comprises a second activity sensor unit that is configured to be attached to a health equipment device, wherein said second activity sensor unit is configured to provide at least one second activity level during the first time period, wherein said first type of activity involves said subject employing said health equipment device; wherein the categorization unit is configured to automatically assign said first activity tag based on a signal received from said second activity sensor unit.

In an embodiment, the system further comprises a categorization unit configured to assign at least one first activity tag from a plurality of activity tags to said first time period, wherein an activity tag from said plurality of activity tags corresponds to said first type of activity; wherein the system further comprises a second activity sensor unit that is configured to be attached to said subject, wherein said second activity sensor unit is configured to provide at least one second activity level during the first time period, wherein the categorization unit is configured to automatically assign said first activity tag based on a signal received from said second activity sensor unit; and wherein said first and second activity sensor units are configured to be attached to said subject at different locations. In an embodiment, the system further comprises an activity level

determination unit, wherein said activity level determination unit is configured to determine a third activity level corresponding to the first time period based on said first and second activity levels.

In an embodiment, the system further comprises a categorization unit configured to assign at least one first activity tag from a plurality of activity tags to said first time period, wherein an activity tag from said plurality of activity tags corresponds to said first type of activity; wherein the system is configured to modify an activity schedule based on an input provided via the categorization unit. In an embodiment, the system is configured to receive the activity schedule. The activity schedule may be received, e.g., via a user interface offering a user the option to build his/her own schedule. In an embodiment, the system is configured to provide the activity schedule. Providing the activity schedule may include, e.g., generating the schedule. Generating the schedule may be performed

automatically based on, e.g., previous input, user preferences, and/or user permission or request.

In an embodiment, the system comprises a mobile device and a processing device; wherein the mobile device comprises said first activity sensor unit and wherein said processing device comprises said activity evaluation unit and said advice providing unit; wherein said mobile device and said processing device are configured to communicate via a wireless network connection.

It shall be understood that the system for providing a health advice to a subject of claim 1, the method for providing a health advice to a subject of claim 11, and the computer program for providing a health advice to a subject of claim 12 have similar and/or identical preferred embodiments, in particular, as defined in the dependent claims.

It shall be understood that a preferred embodiment of the present invention can also be any combination of the dependent claims or above embodiments with the respective independent claim.

These and other aspects of the invention will be apparent from and elucidated with reference to the embodiments described hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

In the following drawings:

Fig. 1 A shows an example case of chronic obstructive bronchitis; Fig. IB shows an example case of pulmonary emphysema; Fig. 2 shows schematically and exemplary an embodiment of a system for providing a health advice to a subject;

Fig. 3 shows schematically and exemplary an embodiment of a graphical representation;

Fig. 4 shows schematically and exemplary an embodiment of a user interface;

Fig. 5 shows schematically and exemplary an embodiment of a weekly schedule for a subject;

Fig. 6 shows schematically and exemplary an embodiment of an active coaching service;

Fig. 7 shows schematically and exemplary an embodiment of a method for providing a health advice to a subject;

Fig. 8 shows schematically and exemplary an embodiment of a graphical representation;

Fig. 9 shows schematically and exemplary an embodiment of a graphical representation providing an overview on activities over four weeks and the relation of three types of activities to the chosen activity goals; and

Fig. 10 shows example energy expenditure data along which may be measured by an activity monitor during a day in rehab. DETAILED DESCRIPTION OF EMBODIMENTS

In an embodiment, a physical activity monitoring device is connected to a COPD coaching service, where the subject's physical activity may be displayed on a daily basis and made available to the subject as well as to the subject's caregiver. The subject gets feedback based on his or her daily activities as well as weekly and monthly activities. A system in accordance with the embodiment enables the subject the plan his or her daily activities. More specifically, the system enables subjects in an interactive way to get feedback on their activity.

In an embodiment, the system comprises an active coaching part, where target setting can be done e.g. by the general practitioner or by the physiotherapist in order to optimize e.g. endurance, strength, and/or flexibility. In an embodiment, an activity sensor unit, such as, e.g., a physical activity monitor, is monitoring the subject with respect to being stable, physical active or less active. The system may further comprise components to provide individual coaching to the subject. Based thereon, the subject receives personalized activity suggestions (based on preference, maximum impact, therapist suggestions), proposals for increasing or lowering the target as well as personalized motivation messages (such as, e.g., encouragements, compliments, feedback). The example system is explained in more detail in the following.

Fig. 2 shows schematically and exemplary an embodiment of a coaching system 200, that is a system for providing a health advice to a subject. System 200 comprises a mobile device 210, which in turn comprises physical activity monitoring device 211 in order to monitor a COPD subject's daily activity. Mobile device 210 comprising physical activity monitoring device 211 may be, e.g., carried in the subject's pocket, or around the subject's neck. Likewise, mobile device 210 may correspond to a device worn on the subject's wrist. Mobile device 210 may further comprise a display unit 213. Display unit 213 is configured to graphically display the subject's activity during a given time period. It shall be understood however that display unit 213 may also be provided external to mobile device 210, e.g., by means of a computer, a mobile phone, or a tablet. By means of a categorization unit 212, which in the present example may comprise a user interface involving keys, the subject is enabled to select at least one activity tag 212a by pushing one of the keys. It shall be understood however that categorization unit 212 may be part of display unit 213 and also be provided external to mobile device 210, e.g., by means of a computer, a mobile phone, or a tablet. Activity sensor unit 211 provides at least one activity level 21 la of the subject during a time period. In the embodiment, activity level 211a and activity tag 212a are transmitted to processing device 220. Transmission may be performed, e.g., via a wireless network or by coupling mobile device 210 and processing device 220 with a network cable. Processing device 220 comprises an activity evaluation unit 221. Activity evaluation unit 221 compares activity level 21 la to at least one activity threshold in order to decide how active the subject is. Based on the comparison, activity evaluation unit 221 may generate an activity evaluation signal 221a. Activity evaluation signal 221a is then provided to advice providing unit 222. Based on the activity evaluation signal 221a and on the received activity tag 212a, advice providing unit 222 provides a health advice 222a to the subject. In an embodiment, health advice 222a may be communicated to the subject via display unit 213.

In an embodiment, the data collected on a daily basis are uploaded via a computer with internet connection to a COPD service, which may be a database application running on e.g., processing device 220. It shall be understood however that the data may also be uploaded via another type of data connection. For instance, data could be provided to a smartphone via a Bluetooth connection, and subsequently by transferred via the internet to a COPD service. In an embodiment, both the subject and the caregiver may access the database.

Fig. 3 shows schematically and exemplary an embodiment of a graphical representation 300 providing an overview of the subject's daily activities as well as of their distribution over the week to the subject and caregiver. The COPD service may also enable the subject and caregiver to create an overview over the day or the month. In graphical representation 300, the respective amount of a subject's daily activity on a given day (such as, e.g., Monday Mo, Tuesday Tu, Wednesday We, Thursday Th, Friday Fr, Saturday Sa, or Sunday Su) is translated into the size of the respective pie chart piece for a given day. In the example shown, Wednesday We is shown as the most active day of the week.

Consequently, a subject's awareness on how physically active he or she was on a given day is raised. Namely, a subject (or the caregiver) may wonder on which days he or she performed with high physical activity and at which days he or she was less active. Coaching system 200 raises the subject's awareness to his or her physical activity at home in comparison to the physical activity at rehab and motivates by providing feedback to continue to be physically active.

In an embodiment, coaching system 200 enables the subject to interactively work with the coaching system. By means of categorization unit 212, system 200 enables the subject along a specific service to correlate the daily physical activity with the activities he or she performed. Fig. 4 shows schematically and exemplary an embodiment of a user interface 400 offering the subject to select (i.e., to "tag") an activity from a list of activities. In the example shown, the list of activities includes activities 410 related to the gym, activities 420 related to the household, activities 430 related to leisure, and activities 440 related to sports. Small icons represent specific activities such as, e.g., pilates 411, gardening 421, or fishing 431. The subject may tag one or more activities for the time periods relating to night 400a, morning 400b, afternoon 400c, and evening 400d. In the example shown in Fig. 4, the subject has tagged a pilates session 411 during the morning, gardening 421 during the early afternoon, and fishing 431 in the afternoon.

System 200 provides the subjects with feedback which physical activities they performed and which of them related to a high physical activity count, which to a medium or a low activity count. The present embodiment thus increases the subject's awareness to physical activity and how it is related with the subject's daily activities.

In an embodiment, coaching system 200 enables the subjects to interactively work with the coaching system and plan those physical activities for a given day, which the subject prefers, likes and considers most effective. Fig. 5 shows schematically and exemplary an embodiment of a weekly schedule 500 for a subject. For each day (such as, e.g., Monday Mo, Tuesday Tu, Wednesday We, Thursday Th, Friday Fr, Saturday Sa, or Sunday Su), activities may be planned for the time periods relating to night 500a, morning 500b, afternoon 500c, and evening 500d. As in Fig. 4, small icons represent specific activities. The present embodiment achieves not only the subject's awareness of his or her physical activity and how they are related with the daily activities, but also motivates a subject to actively plan those activities, which he or she prefers to do. The present embodiment thus coaches subjects to be physically active.

In an embodiment, coaching system 200 is combined with an active coaching service that may be, e.g., web-based. Fig. 6 shows schematically and exemplary an embodiment of an active coaching service 600 which is configured to provide one or more coaching actions from a list of coaching actions 640.

In step 610, the clinician or caregiver sets targets for, e.g., endurance, strength, flexibility, or activity in general. In step 621, activity sensor unit 210 monitors the subject with respect to whether the subject is stable, physical active or becoming less active. System 200 may provide feedback on a daily basis (step 622), on a weekly basis (step 623), or on a monthly basis (step 624), where the feedback may be adjusted based on the selected time period. For instance, daily feedback (step 622) may include user statistics, mood, attitude, and/or the subject's symptoms/condition (step 632). Weekly feedback (step 623) may include information on whether the subject is below (step 634), on (step 633) or above (step 635) target. Monthly feedback (step 624) may involve assessing the achievement of personal goals (step 636) and suggesting activities (step 649).

Based on the embodiments described above, a subject's preferences may be analyzed by monitoring (step 621) the subject's feedback, tagging, planning, and/or surveys (step 631), where surveys may relate, e.g., to psychological or social aspects, to context, preferences, symptoms, target achievement, or to reasons for not achieving a target.

Specifically, the embodiment may comprise daily questionnaires on symptoms, mood, etc. Thereby, the subject's personal situation is analyzed. Upon combining all available information (e.g., from tagging, from questionnaires), system 200 may provide personalized activity suggestions.

For subjects on target (step 633), advice providing unit 222 may provide compliments and encouragements (step 641). Also, a potential target raise may be proposed. For those subjects below target (step 634), based on the situation of the subject, advice providing unit 222 may propose to try harder (step 642). If a subject exhibits symptoms of deterioration which might result in an exacerbation, advice providing unit 222 may propose to pause the program (step 643) or to lower the target (step 644). Further, advice providing unit 222 may suggest activities to the subject (step 645).

For those subjects who are above target (step 635), advice providing unit 222 may provide a compliment and encouraging feedback (step 646), e.g. with a proposal to raise the target (step 647) or to add a new target (step 648).

It shall be understood that the active coaching scheme proposed above is not limited to coaching on a weekly basis. Namely, coaching on a daily basis or monthly basis is just as well conceivable as coaching for individually selected time periods.

Fig. 7 shows schematically and exemplary an embodiment of a method 700 for providing a health advice to a subject. In a step 710, the method comprises providing at least one activity level of the subject during a first time period. In a step 720, the method comprises comparing the at least one activity level to at least one activity threshold. In a step 730, the method comprises providing an activity evaluation signal for said first time period based on the result of the comparison of the activity level to at least one activity threshold, wherein said subject performs a first type of activity during said first time period. In a step 740, the method comprises assigning at least one activity tag from a plurality of activity tags to said first time period, wherein an activity tag from said plurality of activity tags corresponds to said first type of activity. In a step 750, the method comprises providing a health advice to the subject based on the activity evaluation signal and on said at least one activity tag.

Fig. 8 shows schematically and exemplary an embodiment of a graphical representation 800 giving an overview on three different activities over one week and the relation of the activities to the goals set, e.g., by the coach. For each day (such as, e.g.,

Monday Mo, Tuesday Tu, Wednesday We, Thursday Th, Friday Fr, Saturday Sa, or Sunday Su), three activities are color-coded in the pie-chart representation of Fig. 8. The innermost ring corresponds to a first type of activity; the intermediate ring corresponds to a second type of activity. The outermost ring corresponds to a third type of activity. For each day, the ring section corresponding to each activity may be color-coded to indicate whether or not the subject achieved the target on that day. For instance, light colors may indicate that the target has not been achieved. Dark colors may indicate that the target has been achieved. In the example shown in Fig. 8, the subject met respective targets for all three types of activity on Wednesday We and on Thursday Th. On the contrary, the subject met none of the targets for the three types of activity on Saturday Sa and on Sunday Su.

Fig. 9 shows schematically and exemplary an embodiment of a graphical representation 900 providing an overview on activities over four weeks (week 911, week 912, week 913, and week 914) and the relation of three types of activities 910, 920, 930 to the chosen activity goals 910a, 920a, 930a. In an embodiment, the system may congratulate the subject for being above the endurance target and encourages the subject to stay in the strength and flexibility targets, which the subject showed in the period of time to have once achieved. Specifically, the subject may receive messages that compliment him or her on achieving the endurance target 910a for several weeks in a row. The subject may also receive messages that he or she did not make the strength target 920a and flexibility target 930a, but that he or she was able to meet these targets in the week before. The subject is accordingly encouraged to be more active on strength and flexibility, e.g., like the week before.

In an example, the subject may send a request to increase or lower the target to the coach. The request may be sent based on, e.g., a weekly overview and on messages he / she received. Thereby, the subject is enabled to request adaptations of the goals set by the clinician, physiotherapist, nurse, family member, etc. if the subject was above target and wants to increase the target or if the subject was below target (e.g., several times) and wants to reduce the target.

A further embodiment refers to extending coaching with measured activities such as, e.g., usage of training equipment and assistive devices. As outlined herein below, by means of said embodiment, improved data accuracy is achieved.

Subjects undergoing pulmonary rehab typically follow a specific schedule of activities that fall into the moderate- and vigorous-intensity physical activity categories. Subjects may continuously wear an activity monitor throughout the period. The activity monitor generates data on a frequent basis, e.g., minute by minute. The data may e.g.

correspond to the energy expenditure, measured, e.g., in activity counts, kCalories, or METs.

Fig. 10 shows example energy expenditure data 1000 along a y axis 1010 (e.g. measured in METs) which may be measured by an activity monitor during a day in rehab, where the x-axis 1020 corresponds to the respective time of day. Regions 1031, 1032, 1033, 1041, 1042, 1050, 1060, 1070 indicated by dashed lines correspond to time periods, where certain activities are performed. For instance, during time periods 1031, 1032, 1033, the subject had a meal (e.g., breakfast, lunch, or dinner). During time period 1041 and 1042, the subject was performing a treadmill exercise. During time period 1050, the subject was performing strength exercises. During time periods 1060, the subject was walking outdoor. During time period 1070, the subject had an education period.

For the example illustrated by the data in Fig. 10, the subject's activity monitor was configured to be worn on the hip. As can be seen from Fig. 10, not all activities performed were detected by the activity monitor. For example, no significant change in activity can be seen for time period 1050 in which the subject performed strength exercises. The reason for this seeming lack of activity is based on the actual locomotion/displacement of the body such that the accelerometers in the device detect motion. During walking for example, it does not matter whether the device is worn on the hip of neck or pocket. The sensors will measure the displacement, and the intensity. However, with strength exercises, the subject is stationary and the device does not detect any kind of motion. Also, in this example, no significant change in activity can be seen during time periods 1041, 1042 when the subject was on the treadmill. In principle, a treadmill exercise should be detected, since the subject's body is in motion. A subject may however walk very slowly on the treadmill so that three-dimensional sensors only measure very small movement in one direction

(horizontal) and barely any other movement in the vertical or other direction. On the other hand, in the example illustrated in Fig. 10, outdoor walking (time period 1060) may be well distinguished by the data generated by the activity monitor.

In an embodiment involving non-electrical equipment such as weights, an accelerometer may be incorporated to the device (e.g., for instance the training equipment, such as, e.g., the weights) to give an indication of the usage of the device. This can be applied to all equipment recommended to the all forms of physical activity can be detected for a comprehensive analysis. The accelerometer may also be linked back to the server to determine the intensity and duration of the task performed. To that extent, an activity monitor may be Bluetooth enabled, so that data can be transmitted wirelessly over short distances. Another option refers to connecting the activity monitor to the server by USB. In the embodiment, the accelerometer should be able to be placed and removed easily from device to device. For example the accelerometer can be mounted on a surface by means of a magnet or by means of a reusable adhesive. Typically, activity data will differ depending on the activity performed even though the energy expenditure for two given activities might be on a similar level. Therefore, an RFID tag may be placed on the training equipment in order to be acknowledged by the accelerometer (or by a mobile device worn by the user) so that the best mode of data calibration is found. In fact, for some activities, it may be more reliable to use only the activity data from the training equipment. For others, using the data from the worn accelerometer might be preferable. For still others, combining both data sets might yield the most accurate results. By recording activity data from devices (such as, e.g., training equipment), it is possible to categorize types of activity, e.g. activity data from weights correspond to 'strength' exercises. Other types of activity could be flexibility and endurance.

In a further embodiment, in pulmonary rehab, subjects (e.g., COPD patients) perform a variety of activities which require the use of gym equipment such as treadmill and strength exercises. Subjects are expected to continue these activities post-rehab. A coaching service for subjects (e.g., for COPD patients) would include monitoring the subject's physical activity post-rehab. Such a coaching service could be one of the embodiments described herein above. Activity monitors can be used to monitor physical activity however they are not always suitable for detecting activity when using this type of equipment. In the embodiment, it is proposed to monitor all electrical gym equipment for intensity and duration, and this will be linked to the coaching server in combination with the activity monitor. Data transmission may be performed e.g. via network cables or wirelessly by using e.g. a Bluetooth device. This allows for a more accurate recording of the overall total energy expenditure especially during these activities which are not well identified by the activity monitor.

In a further embodiment , for patients that have an assistive device or equipment, a separate satellite activity monitor could be considered that is substantially fixed to the assistive device or equipment, for example a walking frame. Whenever the walking frame is used it sends usage data to the coaching servers. In an embodiment, this data feed may be joined with the data feed from the accelerometer to provide better estimations of calorie expenditure and, in general, of the activity level of the subject. In an example, yes/no markers (e.g., "cane used" or "cane not used") may be sufficient. Then, the body worn device data may be used and properly adjusted in expenditure by means of appropriate algorithms.

In a further embodiment, the activity monitor comprises of an accelerometer and a heart rate monitor that can be used in combination with the previous embodiments described.

A system may be configured to accurately monitor a subject's physical activity to include moderate to high intensity activities that are not always detected by a worn activity monitor. An accurate measurement of physical activity, energy expenditure, and type of activity is preferred for any coaching service that will monitor physical activity and provide feedback. Specifically, an accelerometer may be mounted onto a surface (e.g., by means of a reusable adhesive or a magnet) and placed on equipment (either temporarily or more permanently) that is recommended e.g. for a COPD patient in order to maintain and promote physical activity. The accelerometer monitors usage of the equipment and may be used in combination with a second activity monitor worn by the subject so as to compute an accurate estimation of the subject's energy expenditure to include for significant activities which otherwise would not have been detected by a regular wrist or waist worn activity monitor. Both devices will be linked to a coaching server which will monitor and track the patient's energy expenditure. In an example, gym equipment allows the user to input data and subsequently computes the energy expenditure based on additional usage of the equipment, like speed and duration. In another example, an accelerometer may be mounted on weights. Arm movement will not be detected by an activity monitor located at the waist, so data on the usage of weights will provide a more accurate account of the subject's energy expenditure. In another example, the accelerometer is calibrated to the equipment. In another example, the accelerometer may freely move between equipment without calibration.

Gym equipment recommended for a given subject (such as, e.g., a COPD patient) may be linked to a coaching server. Data (e.g. including duration, intensity and energy expenditure by the equipment) may then be transmitted to the coaching server.

Transmission to the coaching server may be carried out wirelessly. The coaching server may be used to coach a COPD patient to maintain and improve physical activity. In an example, the accelerometer data is transmitted to the server where it is then processed (that is, in this example, not in the activity monitor itself). Thus, other than in the case of a treadmill, rowing machines and elliptical machines, most other equipment requires the subject to be stationary. One approach comprises to, first, use data from equipment usage and caloric expenditure to replace the data received from body-worn device, to, second, use equipment accelerometer data (e.g., in combination with RFID activity recognition) and to replace that portion of body-worn data, and to, third, for assistive devices, use yes/no markers to adjust the body- worn device data.

When coaching subjects on improving physical activity, they may be coached in different areas. For example, subjects may have targets for endurance activities, activities focusing on improving flexibility, and/or targeting strength. As well as accelerometer data, through receiving additional data on the type of devices they are using, additional insights may be obtained on the type of physical activity the subjects are doing. This can be used to tune the feedback and targets as more information is available on what the subject is doing. The system, devices and method according to the present invention are suited for CODP subjects but could also be adapted for other subjects e.g. HF subjects, diabetes subjects, etc. The system, devices and method according to the present invention are not limited to physical activity sensing but can also comprise other sensing technologies relating to, e.g., heart rate, respiration rate, blood pressure, glucose level, etc.

Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention, from a study of the drawings, the disclosure, and the appended claims.

In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "a" or "an" does not exclude a plurality.

A single unit or device may fulfill the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage.

A computer program may be stored/distributed on a suitable medium, such as an optical storage medium or a solid-state medium, supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems. The term "computer program" may also refer to embedded software.

Any reference signs in the claims should not be construed as limiting the scope.

The present invention relates to a system, mobile device, processing device, method and computer program for providing a health advice to a subject. An activity sensor determines a subject's activity level during a first time period. An activity evaluation unit compares the at least one activity level to at least one activity threshold. A categorization unit enables the subject to assign an activity to said first time period. An advice providing unit provides a health advice to the subject based on the activity evaluation unit's comparison and on the assigned activity. The system is not limited to activity sensing but can also comprise other sensors of other vital parameters such as, e.g., heart rate, respiration rate, blood pressure, glucose level, etc.