The present invention relates to a measuring system and measuring device. The present invention also relates to a watch into which the measuring device is integrated. The present invention relates particularly to a measuring system and measuring device which are suitable for the analysis of tremors in Parkinson's patients.

Parkinson's disease is a progressive, degenerative neurological movement disorder. About 6.3 million people suffer from this disease worldwide. Although Parkinson's disease usually only manifests itself over the age of 65, 15% of patients already develop this disorder before the age of 50.

As Parkinson' s disease progresses the debilitating effect of the disease increases and daily activities such as bathing or dressing and undressing become increasingly more difficult or even impossible. Many of the symptoms and discomforts associated with Parkinson' s disease relate to the motor functions, muscle and movement control.

The four primary symptoms of Parkinson's disease are tremors, rigidity, bradykinesia and postural instability. A tremor comprises of involuntary rhythmical trembling or shaking of the limbs, the head or the whole body. The best-known symptom of Parkinson's disease is the occurrence of tremor in a finger which gradually extends over the whole arm. The tremor can occur in only a part or a side of the body, particularly at the first stages of the disorder.

Rigidity relates to stiffness or inflexibility of limbs or joints. The muscle stiffness occurring in Parkinson's often begins in the legs and the neck. A majority of patients have problems with muscle stiffness. The muscles are tightly contracted and, in addition to stiffness, sometimes also cause pain.

Bradykinesia or akinesia refer to slowness of movement or complete loss of movement. Bradykinesia is one of the classic symptoms of Parkinson's disease. Someone with Parkinson's disease will often eventually develop a forward-flexed posture and a slow, shuffling gait. People may also encounter problems initiating and continuing a movement. After a period of years akinesia can occur: the patient "freezes" during his/her movements.

Postural instability relates to problems with balance and coordination. People with postural instability often stand in a stooped posture with a bowed head and drooping shoulders. They often develop a forward or backward leaning posture, whereby they fall easily and sustain injury. People with a backward-flexed posture often have the tendency to involuntarily walk backwards.

Parkinson's disease is caused by degeneration of a specific part of the brain, the substantia nigra ("black substance" or black nuclei). With the death of brain cells in the substantia nigra the supply of dopamine to the brain declines.

Dopamine is necessary to enable communication between brain cells which regulate control of movement. Reduction in the dopamine level results in the symptoms of Parkinson' s disease occurring. According to the American National Parkinson foundation 80% of the dopamine-producing cells have often died off before the first motor symptoms of Parkinson's disease become manifest.

The course of Parkinson's disease is often progressive and debilitating. Parkinson's patients often encounter problems in performing normal activities such as standing up from a chair or walking through a room. As the disease progresses, people sometimes become wheelchair- bound or bedridden.

Medicines can be prescribed to suppress the tremors. These medicines can have side- effects. It is therefore important to customize the dosage of the medicines as well as possible to the patient. Reliance is often placed here on the perception of the patient. This perception is however subjective because it may depend on factors such as the mood or fatigue of the patient.

Recent research has indicated that physical exertion can have a tremor-reducing effect. It has thus been found that many patients experience relatively few or no tremors during or immediately after physical exertion.

The present invention has for its object to provide a system which can be used to objectively determine the influence of Parkinson's on the life of a patient and to optimize the use of medicines.

The invention provides for this purpose a measuring system comprising a timer for generating time information, a heart rate meter for measuring a heart rate of a person and a measuring device wearable on the body of the person and comprising one or more sensors for measuring movement information relating to the body or a body part of the person. It is preferred here to attach the measuring device to a body part wherein tremors occur most often or most severely. Examples of such body parts are arms, hands or wrists.

The timer can for instance comprise a clock which generates a time signal, such as the time in a fixed format, such as hours-minutes-seconds, optionally supplemented with the date. It is however also possible for the timer to generate only a clock signal, such as a clock pulse signal with a known frequency.

The measuring device according to the invention further comprises a filter unit for filtering the movement information in order to form tremor information and physical activity information. The movement information comprises for instance data relating to the position, speed, acceleration, optionally in direction-dependent manner, of the body or body part on or to which the measuring device is attached. This information is filtered such that a distinction can be made between tremor information and physical activity information. The tremor information here comprises for instance an indication of the severity of the tremors. The physical activity information can comprise information representative of the activity of the body of the person/patient. Examples of this information are the number of steps per unit time which a person makes, cycling speed, an estimated amount of calories burned off per unit time or a speed or acceleration of the body or the respective body part. It is noted here that the physical activity information can also comprise information relating to activities of the body determined by external factors. An example hereof is the acceleration or braking of a car in which the person/patient is sitting. The braking or acceleration of the car will be visible here in the physical activity information, though not or less so in the measured heart rate. The heart rate of the person/patient will on the other hand rise when an exciting film is being watched, while the physical activity information will show no or hardly any increase in activity.

The system according to the invention also comprises a processing unit for correlating the measured heart rate, the tremor information and the physical activity information with or by means of the time information. Through this correlation a link is established between the tremor information, heart rate and physical activity information obtained at a moment in time.

The correlation can be performed in the following and other ways. As first option time information is linked to each of the measured heart rate, the obtained tremor information and physical activity information. This time information is preferably identical so that it is apparent what the heart rate, tremor information and physical activity information were at a given moment in time, optionally supplemented with date information. The time information can however also differ. It is thus possible that a measured heart rate corresponds to a time 23:00:45, while the measurements of the physical activity information which as seen in time are closest to this heart rate measurement are correlated with a time of 23:00:50.

Mentioned as a second option is that the timer generates a synchronization signal, such as a clock signal, which prompts the heart rate meter and the one or more sensors in the measuring device to perform a measurement. The time information is used here as means of correlating the heart rate measurement, the tremor information and physical activity information with each other.

The present invention does not preclude other options or means for correlating the physical activity information, heart rate and tremor information. Embodiments can be envisaged here which do not require a timer.

The processing unit is further configured to construct a data set on the basis of the heart rate, tremor information and physical activity information correlated with or by means of the time information. The system further comprises a central storage unit for storing the data set. The central storage unit can be embodied here as a remotely accessible memory, such as a server connected to Internet. The central storage unit is preferably configured so that authorized third parties can view the data stored in the central storage unit as well as the person/patient. A doctor for instance can thus view the data and draw up or modify a plan of treatment.

Applicant has found that the combination of correlated heart rate, tremor information and physical activity information results in a particularly suitable data set which can be used, for instance by a doctor, to optimize the use of medicines. The data set preferably comprises an indication of the time corresponding to the tremor information and/or physical activity information. It is however also possible for the data set to comprise a series of values or indications of the tremor information and/or physical activity, wherein the point in time associated with a determined value corresponds to the point in time of a previous value plus a predetermined time interval. It is thus possible for the measured heart rate and the obtained tremor information and physical activity information to be periodically stored in accordance with a predetermined time interval.

The measuring system can further comprise a user data input unit which is configured for input of user data, for instance by the person, wherein the processing unit is further configured to correlate the entered user data with the time and wherein the processing unit is also configured to construct the data set on the basis of the user data correlated with the time information. The user data can here comprise at least one from the group consisting of data concerning use of medicines, user indication concerning tremor perception and description of physical exertion. The input unit can be employed by the patient/person during for instance a period of severe tremors. The opposite can however also happen, wherein the patient/person indicates by means of the input unit that no or few tremors are occurring.

An output unit can also be provided, such as a buzzer or vibration unit. Such a unit can for instance be used to alert the person/patient that it is time to take medication.

The invention does not preclude other data not correlated with or by means of the time information being added to the data stored in the central storage unit. Examples of such data are information relating to gender, age and the medicines used and dosage thereof.

The user data can comprise subjective information concerning the perception of the tremors. By incorporating these in the data set a correlation can later be made between the objective data, formed by the heart rate, tremor information and physical activity information, and the subjective data entered by the patient/person. The patient/person can learn from this correlation or create awareness about how the perception of discomfort relates to the objective data.

It is preferably determined beforehand what the user data describe and how the entered data correlate with for instance tremor information. If the user data comprise for instance whether a pushbutton provided for the purpose is pressed in or not, it is preferred that the person/patient and the doctor both understand what is meant by the pushbutton being pressed in or not.

The filter unit can comprise a band filter for filtering a frequency band out of the measured movement information. The band filter is preferably configured here to perform a Fast Fourier Transform (FFT) operation on the measured movement information, preferably based on a frequency band between 2 Hz and 12 Hz, more preferably between 5 Hz and 9 Hz, and most preferably between 6 Hz and 8 Hz. The FFT can for instance be performed on a series of obtained values, for instance measurements carried out every 10 ms for a period of 10 s. A spectral analysis can be performed on these measurements, wherein the tremor information is determined with reference to the spectral components in the frequency range between preferably 6 Hz and 8 Hz.

The one or more sensors can comprise one or more sensors from the group consisting of gyroscope, acceleration sensor, magnetometer, GPS sensor and air pressure sensor. This latter sensor can be utilized to detect a fall of the person/patient, optionally in combination with the other sensor(s). The output from these sensor(s) often comprises one or more numerical values representative of movement in a specific direction. The values can relate here to position, speed, acceleration, rotation speed or rotational acceleration. The filter unit can be configured to distil from these numerical values information which can be incorporated in the data set. It is however also possible for this operation to be performed by the sensor itself or by a processing unit arranged specifically for this purpose.

The system can be further provided with a transmitting device for transmitting the data set to the central storage unit. Before being transmitted the data can, if desired or necessary, be stored temporarily in a local memory.

In an embodiment the timer and heart rate data are integrated into the measuring device wearable on the body of the person. Other embodiments are however also possible. Mentioned by way of example is the combination of a smart phone and the measuring device wearable on the body of the person. Here the smart phone can comprise a heart rate meter and the smart phone can be configured to obtain data from the measuring device wearable on the body of the person in order to itself thus perform the filtering function and construct the data set. The smart phone can then send the data set to the central storage unit.

In a further embodiment the filter unit, the processing unit and the transmitting device are integrated into the measuring device wearable on the body of the person. The system can comprise a gateway here for establishing an Internet connection between the gateway and the central storage unit, wherein the transmitting device is configured to transmit the data set via the gateway to the central storage unit. The transmitting device can then be configured to transmit the data set when the measuring device wearable on the body of the person is located in a communication range with the gateway. The gateway can for instance be located in a house of the patient. During the day the patient will generally not be at home. In that case the measuring device will gather and store data in a local memory. Once in the vicinity of the gateway the measuring device can establish contact, preferably automatically, with the gateway and send the locally stored data to the central storage unit via the gateway. Not precluded here is the gateway having a buffer for storing the received data. This can be advantageous when the central storage unit is temporarily not accessible.

The measuring device wearable on the body of the person can comprise a battery unit for providing power to at least one of the timer, the heart rate meter, the filter unit and the processing unit. The gateway can also comprise a charging unit for charging the battery unit, preferably by means of wireless charging. The measuring device and gateway can thus be embodied to support the Qi standard.

The transmitting device and the gateway can be configured to communicate with each other on the basis of a wireless connection, such as a Wi-Fi connection or a Bluetooth connection.

In a particularly preferred embodiment the measuring device wearable on the body of the person is integrated into a watch. The advantage of a watch is that it is worn on a body part where both the heart rate and the tremors are readily measurable. The heart rate meter can thus be configured to determine the heart rate optically. A light source such as an LED here emits a light signal which is modulated by the flowing blood. The heart rate can be determined by the reflected light being received by means of a light sensor. Such heart rate meters are known in the prior art.

A further advantage of a watch is that the timer of the measuring device can be coupled thereto. In the case of a digital watch the watch is already provided with a timer, since this provides the time recording for the watch. This timer can also be used to generate time information as described above.

The watch can comprise a watch face, wherein the input unit comprises an at least partially transparent touch interface which is mounted above the watch face. The watch hereby has the appearance of a regular analog watch, whereby any stigmatizing effect associated with a medical device is avoided.

In the case of a digital watch comprising a display for showing the time the input unit can comprise an at least partially transparent touch interface which is coupled to the display. An example hereof is a touch-sensitive screen. It is preferably also the case here that the watch has the appearance of a normal watch.

According to a second aspect, the present invention provides a measuring device comprising the measuring device wearable on the body of the person as defined above.

According to a third aspect, the present invention provides a watch comprising the measuring device wearable on the body of the person as defined above.

The present invention will be discussed in more detail hereinbelow with reference to the accompanying figures, wherein:

Figure 1 shows an embodiment of a measuring system according to the present invention;

Figure 2 shows an example of a data set which can be generated by the system of figure 1 ; Figure 3 shows a measuring device into which components of the system of figure 1 are integrated; and

Figure 4 shows an embodiment of a watch according to the present invention which can be coupled to a gateway.

Figure 1 shows an embodiment of a measuring system according to the present invention. Figure 2 further shows an example of a data set which can be generated by the system of figure 1.

The measuring system of figure 1 comprises a timer 1 for generating time information. This time information has the format xx.yy.zzzz, aa:bb:cc with xx being the day, yy the month, zz the year, aa the hours, bb the minutes and cc the seconds. It will be apparent to the skilled person that other formats, such as a Unix timestamp, are not precluded.

Timer 1 can be embodied as a clock which generates clock pulses. In such a case the time information can comprise an identification of a clock pulse, such as the clock pulse number.

Because the clock pulses are produced at fixed intervals, the clock pulse provides number implicit time information. When a reference is agreed on, for instance clock pulse number 1 corresponds to 01.01.2015, 00:00:00, a corresponding date and time can then be extracted from the clock pulse number.

The measuring system further comprises a heart rate meter 2 for measuring a heart rate of a person. Such heart rate meters are known in the prior art and do not therefore require further explanation.

The measuring system also comprises a measuring device 3 wearable on the body of the person and comprising one or more sensors for measuring movement information relating to the body or a body part of the person. Movement information provides information about movements of the body. This relates to information about movements which are initiated by the person, unconsciously or consciously, and movements caused by external factors, for instance because the person is in a moving vehicle. The movement information usually comprises numerical data which represent at least one of position, speed or acceleration, optionally related to one or more directions. It is noted here that the one or more sensors can for instance comprise an acceleration sensor, or even a gyroscope, magnetometer, GPS sensor or air pressure sensor.

When timer 1 generates clock pulses, it is not necessary for the clock pulse number or other time information to be stored in the data set. The clock pulses can for instance be used to trigger the heart rate measurement or the measurements of movement information. In this latter case timer 1 directly controls measuring device 3 and heart rate meter 2. This latter option is indicated by the broken lines in figure 1.

Filter unit 4 is used to filter the movement information for the purpose of forming tremor information and physical activity information. Tremors can generally be characterized in that they have a vibration frequency around a specific frequency such as 7 Hz. The information about tremors must be separated from other information about the movement of the body, this information being related for instance to preferably conscious physical activity such as cycling or walking.

Filter unit 4 is configured to filter the movement information received from measuring device 3 in order to thus form tremor information as well as physical activity information. In addition to a separation in the frequency range, this can likewise comprise one or more operations such as normalizing of the tremor information and/or the physical activity information. Such a normalization is shown in figure 2. The tremor information is thus normalized to a scale between 1 and 10, and the physical activity information is normalized to a scale between 1 and 100. It is noted here that higher or lower resolutions are possible for displaying the information. The normalization can also be carried out in processing unit 5 instead of in filter unit 4.

Processing unit 5 is configured to correlate the measured heart rate, the tremor information and the physical activity information with or by means of the time information. This unit ensures that the measurements from heart rate meter 2 and measuring device 3 are linked to or by means of the time information so that it will for instance be apparent when the person had a given heart rate.

A data set is also constructed by processing unit 5 on the basis of the heart rate, tremor information and physical activity information correlated with or by means of the time information. Such a data set is shown in figure 2. In addition to the above stated date, this data set also comprises a perception, which can be entered by the person and which is a subjective assessment of the severity of the tremors. It will be apparent from figure 2 that this information can also be normalized, for instance to a scale between 1 and 5. The data set can also comprise data about the use of medicines which corresponds to the time information. Shown in figure 2 is when the person took medicines during this time period. The invention does not preclude the addition of further user data which may or may not be normalized. The user data can moreover be incorporated in a different format in the data set.

Figure 1 shows that the data set constructed by processing unit 5 is sent via a computer network, such as the Internet 7, to a central storage unit 8. The invention does not preclude central storage unit 8 being installed locally, optionally being integrated into measuring device 3. Central storage unit 8 makes it possible for a doctor for instance to gain access by means of a terminal 9 to central storage unit 8 and to get from the data set(s) stored thereon an impression of the course of the Parkinson's or other illness, and to modify the treatment plan, such as the medicine dosage or the type of medicine, accordingly. The treatment plan can here also comprise physical exercises which a person can perform in order to reduce the tremors.

Figure 3 shows a measuring device 100 into which components of the system of figure 1 are integrated. Similar or identical components are designated here with the same reference numerals. Supplementary to figure 1, measuring device 100 comprises a processing unit 5 comprising a correlation unit 51 and a data construction unit 52. Correlation unit 51 is configured here to correlate the measured heart rate, the tremor information and the physical activity information with or by means of the time information, and data construction unit 52 is configured to construct a data set on the basis of the heart rate, tremor information and physical activity information correlated with or by means of the time information. Measuring device 100 also comprises an input unit 120 comprising a user interface unit 121 which provides a user interface with which a person can enter user data. This user interface can be shown on a display 130 which can also be embodied externally of measuring device 100.

The user interface preferably comprises a touch interface. Display 130 can be equipped for this purpose with a touch-sensitive panel coupled to user interface unit 121.

Input unit 120 further comprises a unit 122 which is configured to receive user data by means of mechanical elements such as buttons or keys. The data from input unit 120 is fed to processing unit 5 where the other data are correlated if desired with or by means of the time information. It is noted here that the functionality of input unit 120 can be at least partially integrated into processing unit 5.

Measuring device 100 comprises a battery 140 for providing electric power to the different components of measuring device 100. Measuring device 100 also comprises a local memory 150 for storing data sets. For the purpose of communicating the data stored in local memory 150 measuring device 100 comprises a transmitting unit 160. Transmitting unit 160 is preferably configured here for wireless communication with an external device such as a gateway. Already known wireless communication protocols can be utilized here, such as Wi-Fi or Bluetooth.

Figure 4 shows an embodiment of measuring device 100 of figure 3 which is embodied as a watch. This watch has a watch case 101 in which measuring device 100 is received, as well as a watch-strap 102.

The watch can be placed on a surface of a gateway 200. Gateway 200 is provided for this purpose with support elements 210 which facilitate placing of watch case 101. A recess can be provided here so that watch-strap 102 need not be removed. Measuring device 100 and gateway 200 are further configured for wireless charging of battery 140 by gateway 200, for instance in accordance with the Qi standard. Gateway 200 can be provided here with a battery level indicator 220.

Gateway 200 preferably communicates wirelessly with transmitting unit 160. This latter can be embodied as a transmitting/receiving unit so that measuring device 100 not only sends data but can also receive data or commands, for instance for the purpose of adjusting measuring device 100.

Gateway 200 is preferably connected to the Internet so that measuring device 100 can send the locally stored data to a central storage unit such as shown in figure 1. Gateway 200 can for this purpose comprise a setting in which an address of the central storage unit is shown. This address can be programmed following manufacture of gateway 200 so that the user does not need to install it. Measuring device 100 can be further configured to communicate with gateway 200 in the sense that the user does not need to adjust any settings. If Bluetooth is used as communication protocol between gateway 200 and measuring device 100, gateway 200 and/or measuring device 100 can be provided with operating means, such as a button, in order to place the respective device in the pairing mode, and/or operating means for confirming a Bluetooth connection between gateway 200 and measuring device 100.

In an exemplary application a person wears the watch shown in figure 4. Gateway 200 is installed here in the home of the person. Because of the local memory in the watch it is possible for the required measurements to be performed during the day even if the user is not in the communication range of gateway 200. However, when the person comes home and is in the communication range of gateway 200, the watch will send the data to the central storage unit via gateway 200. The transmitted data can then be deleted from the local memory if necessary or desired. The person can also recharge the watch by placing it on top of gateway 200.

The present invention therefore provides a highly advantageous system for obtaining objective data relating to the medical condition. It moreover enables a doctor to draw up or change a treatment plan in targeted manner.

It will be apparent to the skilled person that the present invention is not limited to the above described embodiments, but that the scope of protection is defined solely by the appended claims and the equivalents thereof.

An example hereof is that the tremor information can additionally or alternatively give an indication of the tremor which corresponds to the qualification by means of a Meerwaldt chart. Patient episodes are recorded here. This qualification can take place automatically by means of said one or more sensors for measuring movement information relating to the body or a body part of the person. By way of example measurements from a multi-axis motion sensor, such as a 9-axis motion sensor, can be used to qualify the condition of the user. A good condition can be identified here, and a poor condition characterized by stiffness and slowness, as well as episodes of dyskinesia. A user can additionally input this qualification him/herself as a form of user indication concerning tremor perception.