TWI837629B - Multispectral image assessment and analysis method for gait disorders and static-pressure hydrotherapy exercise device - Google Patents

Abstract

The invention discloses an evaluation method for gait disorders including Parkinson's disease freezing gait and a corresponding static-pressure hydrotherapy-pool. Using a multi-spectral thermal imager to observe and record multi-spectral images including the dynamic and static trajectories of the patient's COP on the black walkway of on-land and under the water, these images including far/near infrared and visible light of gait time/space parameters are used as a reference for physical-therapists and attending physicians to analyze and interpret; continue to cooperate with patients or the elderly provide a personalized static-pressure hydrotherapy pool for exercise and rehabilitation plan corresponding to the relationship, which increases the evaluation and analysis benefits and reduces the medical-economy of the patients. Enable patients to have better health and quality of life.

Description

Multispectral imaging assessment and analysis of gait disorders and hydrostatic exercise device

Disclosure Information:

This invention application (hereinafter referred to as this case) discloses the technical features disclosed in the Republic of China invention patent No. I757022 [System and method for analyzing gait footprints based on α-type multispectral imaging] (hereinafter referred to as No. I757022) of the same inventor, including a new case for the assessment, analysis and training of people with gait disorders after multiple experiments and combination with relevant hydrotherapy pools after the improvement of the walking path.

The present invention relates to a hydrotherapy system, and more particularly to a multispectral imaging evaluation method for people with gait disorders and a corresponding hydrotherapy exercise device.

Common gait disorders cause great problems to the patients' quality of life. The mortality rate of elderly people with gait disorders is higher than that of normal elderly people. The mortality rate of people with other diseases and abnormal gait is doubled. It is obvious that gait disorders and other diseases have additive harmful effects. The main causes of gait disorders in clinical practice are: sensory deficits, myelopathy, such as Parkinson's disease (PD), hereinafter referred to as Parkinson's disease.

The analysis of gait parameters by experts under traditional clinical conditions may sometimes lack relevant accuracy, thus having a negative impact on the diagnosis of pathology. This case can monitor the process "on the road" and "underwater" and conduct comparative evaluations, and use multispectral images to objectively evaluate different gait parameters, thereby improving the evaluation efficiency and providing experts with a large amount of reliable correlation information about the patient's (patient's) gait. This reduces the tolerance for errors caused by subjective technology.

The clinical assessment results of general gait disorders can determine the severity of gait disorders. For the convenience of explanation, this case roughly divides them into three types: low, moderate, and high. Low-grade disorders may be caused by joint, muscle, or sensory disorders, and patients may experience sensory movement disorders; moderate-grade disorders may be caused by abnormalities in the motor nervous system, including Parkinson's disease (disorder) and high-grade gait disorders, which are particularly emphasized in this case. They may come from the brain or psychological level.

A typical Parkinson's disease patient usually walks very slowly, with small steps but high frequency, and the body involuntarily moves forward or backward. Other symptoms include: mask-like face, reduced blinking, hunched back, drooling, etc. If treatment is delayed, in the late stage, depression and dementia will occur, so the patient often shows a rapid gait. This obviously irregular and problematic gait often affects the patient's functional independence and quality of life.

Parkinson's disease is a chronic neurodegenerative disease that seriously endangers the health of middle-aged and elderly people. Currently, the treatment of Parkinson's disease is still mainly based on "control" of symptoms. The diagnosis of Parkinson's disease relies on medical history and neurological examination. Currently, there is no test method that can effectively confirm Parkinson's disease. At present, there is no method that can completely cure Parkinson's disease, but there are some drugs, surgeries and cross-domain integrated treatments that can "relieve" symptoms.

The three major principles of gait disorder assessment in general medicine are: (1) Consideration should be given to gait disorders caused by pain and fear of falling, such as whether there is freezing of gait (FOG); (2) Consideration should be given to lower limb instability factors, including the strength of the leg muscles. Patients may experience dragging of the feet, slow walking speed, short stride, stiffness, reduced step height, and hesitant walking. Symptoms will improve after assistance. (3) Consideration should be given to observing the stride length of the same foot, the step width of the other foot, the symmetry of the two feet, and the range of variation of the step width or plantar shape.

Regarding the three principles of gait disorder assessment mentioned above, first of all, in terms of gait disorders caused by patients’ great fear due to pain and fear of falling, this case proposes a corresponding “static hydrotherapy” exercise device, because the buoyancy of water in water can reduce the fear of falling, and even if the patient does stumble, the risk of injury is very small;

In terms of considering the instability of the limbs and the range of variation in gait or plantar posture, the inventor's previous Republic of China invention patent No. I 666935 [System and method for analyzing gait footprints based on σ-type multispectral imaging] proposes a safe, normal, economical and efficient assessment and analysis and a corresponding hydrostatic water therapy method.

Freezing of gait (FOG) is a condition in which about 50% of Parkinson's disease patients stop walking in the later stages. This usually occurs when turning, passing through narrow roads, multi-tasking, or approaching a target. This is a sudden restriction in a certain part of the movement process.

According to the Parkinson's Foundation, nearly one million Americans suffer from the disease. Globally, about 60,000 new cases are diagnosed in the United States each year. In addition to confirmed cases, thousands of Americans suffer from Parkinson's without knowing it. Among them, according to the foundation, some Parkinson's patients choose to improve the quality of life and overall health to control symptoms. To this end, patients turn to a "water therapy" method.

Today, hydrotherapy remains a widely recognized treatment for many conditions and can be used to help patients with cardiovascular disease, minor injuries, and serious illnesses such as Parkinson's disease. Even generally healthy patients and high-endurance athletes turn to this form of treatment to improve endurance and repair various injuries.

A rehabilitation center in Omaha, Nebraska, USA, has an Aquatic Therapy Program to encourage Parkinson's patients to participate.

This type of hydrotherapy refers to any exercise or therapy performed in a controlled and monitored water environment, usually a swimming pool, for example, water sports in a heated swimming pool. It can be used to improve health or overall condition. Hydrotherapy involves a physical therapist using physical therapy programs in a swimming pool or water environment.

According to the buoyancy of water, it can offset about 80-90% of body weight, so a person weighing 100Kg will move as if he weighs only 10-20Kg. Therefore, the help of buoyancy allows greater movement. Parkinson's patients can practice walking with a more normal or exaggerated gait and gradually move to a wider range of movements. At the same time, the resistance and turbulent forces challenge balance and coordination. His movements will be more labor-saving and easier than doing the same movements in a land environment.

We can now use photography and walking analysis systems, even plantar pressure tests and dynamic temperature thermal images, to further conduct quantitative footprint analysis including time and space parameters to determine the gait function and walking quality of Parkinson's patients.

For example, the [Gait Analysis Method and System] of the Republic of China Invention Patent No. I657800 discloses that it includes multiple acceleration sensors. This method includes: for each time point and each acceleration sensor, calculating the root and square according to the acceleration value sensed by the acceleration sensor on the sensing axis; calculating the mutual correlation coefficient according to the root and square of the first acceleration sensor and the second acceleration sensor; calculating the first autocorrelation coefficient of the root and square of the first acceleration sensor; calculating the second autocorrelation coefficient of the root and square of the second acceleration sensor; and calculating the first gait index according to the mutual correlation coefficient, the first autocorrelation coefficient and the second autocorrelation coefficient.

For example, the Republic of China's invention patent No. I637738 [Walking Assist Wearable Device and Walking Assist Method] discloses: a walking assist wearable device for providing a user with feedback information about the road conditions ahead, the device comprising: a wearable garment for wearing; a plurality of distance sensors disposed at a plurality of positions of the wearable garment; a processor coupled to the distance sensors to utilize the distance sensors to The distance sensing information provided by the sensor from different heights, horizontal angles, vertical angles and directions is compared with at least one stored information to obtain environmental information; a storage module is coupled to the processor to provide the stored information; a wireless module is coupled to the processor to provide a wireless connection to at least one monitoring end; and a feedback module is coupled to the processor to provide feedback information based on the environmental information.

For example, the Republic of China's invention patent No. I581829, "Intelligent Suspension System with Gait Analysis Function", discloses: an invention that can be applied to general sports equipment or rehabilitation equipment to assist users in rehabilitation training. The invention is to install a weight sensor and a displacement sensor on the sports equipment in a position area that can detect and present the weight change and gait change of the user. The transmission mechanism of the sports equipment is connected to a device that can restrain the user. The vehicle allows the user to be supported on the sports device through an intelligent suspension system. The weight sensor can detect the load-bearing capacity of the user's lower limbs and adjust the support force appropriately. The displacement sensor can detect and analyze the user's gait in real time and provide feedback in real time, allowing the user to know the gait status of exercise or rehabilitation through visual feedback, and then make appropriate gait adjustments. The feedback signal can also be used for the operation control of the rehabilitation device.

For example, the [Thermochromic Gait Analysis System] of the Republic of China's Invention Patent No. I578961 discloses: a base station can be used by the subject to step on and walk, and a color-changing area can be generated corresponding to the temperature of each foot part that is stepped on. The image capture device can capture the image of the color-changing area. The gait analysis device can receive and analyze the shape and color changes of the image of each color-changing area, and establish a stepping pattern data for the foot corresponding to each color-changing area. By analyzing the color change caused by stepping on the base, more accurate foot stepping information can be obtained, which can greatly improve the accuracy of the established walking gait data. It is an innovative and more accurate gait analysis system design, which is characterized in that the base 3 has a flat plate 31 and a thermochromic film 32 fixed to the top of the flat plate 31 and capable of temperature-sensitive color change. In this embodiment, the flat plate 31 is transparent, and the color change of the thermochromic film 32 can be viewed from bottom to top.

Others include the Republic of China Patent No. I579530, "Mobile device step counting system and gait analysis method thereof", the Republic of China Patent No. I549033, "Touch sensing gait analysis system", the Republic of China Patent No. I517875, "Gait analysis device and running sports equipment using the same", etc.

In addition, as of the time of writing this invention, according to the Patent Information Retrieval System of the Republic of China and its related global patent retrieval system, the keywords include Parkinson's disease (Parkinson's disease or Parkinson), aquatic exercise therapy (aquatic exercise therapy or hydrotherapy).

Among them, hydrotherapy intervention and assessment of changes in movement balance must be involved. All articles that meet the conditions were searched, as well as "multispectral thermal imaging and Parkinson's and frozen gait", but no search results were found.

The present invention is concerned with the overall assessment and analysis of gait and the corresponding training methods. The main problems are (1) the popular wearable sensors among patients, such as the assessment and analysis of the "whole body gait analysis system" currently released by the Industrial Technology Research Institute of Taiwan. For the elderly or people with gait disorders, wearing multiple sensors on the whole body is a big challenge. (2) The "hydrotherapy" training program for people with gait disorders is purely a training tool for the elderly or people with gait disorders. For example, the famous HydroWorx treatment pool in the United States cannot achieve the purpose of assessment and analysis.

In response to the above shortcomings, this case proposes a solution to the above shortcomings and proposes (1) an evaluation and analysis method for the elderly or people with gait disorders that "does not require multiple sensors to be worn on the whole body" and (2) for the elderly or people with gait disorders, it is not only a training tool but also a method of evaluation and analysis.

The above solution to (1) and (2) is to use a multi-spectral image evaluation and analysis method and a corresponding hydrotherapy system.

The technical solution to the problem has the following significant effects on the above existing technologies: (1) It can reduce the economic burden and daily life pressure of people with gait disorders, and (2) It can reduce the "fear of falling and the trouble caused by the assessment test" of people with gait disorders and the advantages of "immediate exercise after assessment and immediate assessment after exercise".

First, in order to facilitate the explanation of the overall basic principles and mechanism of this case [Multispectral imaging assessment and analysis method for gait disorders and its hydrostatic exercise device], please refer to Figures 1, 1A, 1B and 1C for more understanding.

Please refer to Figure 1 for a schematic diagram of the liftable black trail platform; Figure 1A for a schematic diagram of the evaluation and analysis principle on the road surface; Figure 1B for a schematic diagram of the evaluation and analysis principle under water; and Figure 1C for a schematic diagram of the VC temperature change plate.

In the diagrams of Figure 1 to Figure 1C, in order to clearly emphasize the position of patient 50 on the black trail 20, patient 50 is marked with a red line for easier understanding.

As shown in Figure 1, the liftable black walkway platform 100 includes a liftable support 10, a black walkway 20, a monitoring box 30, a wide-bottomed handrail 40, and a subject (patient) 50 standing on the black walkway 20.

Among them, the black walkway 20 on which "one" patient 50 can stand is only about 1.5 meters long in the embodiment, which can provide the patient 50 with a maximum step distance of 2 to 3 steps, so as to be conveniently placed in the "personal" hydrotherapy pool body.

The main focus of this design is the change of "footprint", which replaces the common change of "gait" of having patient 50 walk on a longer test trail, and conducts an assessment and analysis of gait disorders in patient 50 and an exercise plan of hydrostatic pressure therapy.

As shown in Figure 1, the "lifting" action of the liftable support 10 is to enable the black trail 20 to rise to the road surface or descend to the bottom of the water, so as to facilitate the "evaluation and training" function in different states of "road surface or bottom of the water".

Why is there a distinction between "road surface or underwater"?

Because the buoyancy in water can help Patient 50 allow for greater movement, Patient 50 can practice walking with a more normal or exaggerated gait and gradually move to a wider range of motion. At the same time, the buoyancy challenges balance and coordination, and Patient 50's movements will be less laborious and easier than doing the same movements in a land environment. Obviously, footprints "on the road or underwater" will have different variation characteristics.

Among them, "rising or falling" can be provided by hydraulic pressure, air pressure or electric method driven by a motor.

As shown in Figure 1, more than two liftable pillars 10 are installed at the corners around the black walkway 20 to support/balance and drive the lifting action of the black walkway 20. The liftable pillar 10 structure can mainly include a sleeve column 11 and a telescopic column 12.

When the liftable support 10 rises, the telescopic column 12 "slowly shortens" and enters the sleeve column 11; when the liftable support 10 descends, the telescopic column 12 "slowly extends" and extends from the sleeve column 11, as shown in Figure 1A and Figure 1B.

The liftable support 10 further includes a waterproof transmission line (as indicated by 303 in the second figure below) wrapped around it, which is used to transmit the multispectral image of the patient's gait 50 captured by the multispectral thermal imager 301 to a display (not shown in the figure) through the transmission line for monitoring, analysis and video storage by the physical therapist or attending physician.

A wide-bottomed handrail 40 for a patient 50 to support is provided at the upper end of the black walkway 20; and a waterproof monitoring box 30 is provided at the lower end of the black walkway 20. A multi-spectral thermal imager (as shown in FIG. 2A) 301 is provided in the monitoring box 30, which can penetrate the black walkway 20 and capture the gait image of the patient 50.

The reason why the black trail 20 "must" be black is mainly to "prevent the patient 50 from standing on the black trail 20 and peeking into the monitoring box 30 and "not concentrating on the test"!

As mentioned above, the black walkway 20 can not only avoid distraction of the patient 50, but also be used to "distinguish" the transparent walkway board adopted by the previous technology, so that the camera installed under the transparent walkway board can take pictures of people walking on the "transparent" walkway board (to facilitate the camera to take pictures with visible light).

As shown in Figure 1, the wide-bottomed handrails 40 provided for the patient 50 to support the body and the left and right hands are respectively arranged on the two sides of the black walkway 20. The left and right wide-bottomed handrails 40 are "unequal in width". For example, the distance D2 presented at the upper end is smaller than the distance D1 presented at the lower end, so as to prevent the patient 50 from accidentally kicking the lower end of the wide-bottomed handrail 40 with his lower limbs when he is about to enter the black walkway 20.

As shown in Figure 1, if a wide-bottomed handrail 40 is used for safer activities on the black trail 20, a "weight-reducing sling" can be used to "suspend" part of the patient's 50 body, thereby reducing the "weight" of the patient's lower limbs when walking and improving walking ability.

Such a "hanging" method, for example, connects the hanging wire to a dedicated track on the ceiling.

Therefore, both the wide-bottomed handrail and the weight-reducing sling can be equally referred to as the protective unit of the present embodiment.

As shown in Figure 1, if the patient 50 standing on the black walkway 20 is not "protected" by the protective unit, the patient 50 can also use a "walker" to support and maintain balance or stability while walking, and then directly stand on the black walkway 20 and then remove the "walker", providing convenience for the patient 50.

As shown in the diagrams of Figure 1A and Figure 1B, the "dashed rectangle" symbol frame is a liftable black walkway platform 100, which is used to indicate that the black walkway 20 is above the ground plane 201 (which can be understood as upstairs) and; the black walkway 20 is below the ground plane 201 (which can be understood as downstairs, corresponding to the meaning of upstairs) in the personal hydrotherapy pool 60.

As shown in Figure 1A, this is the principle and mechanism of the road surface assessment and analysis. It is to place the liftable black trail platform 100 on the road surface 201 "upstairs" during normal times, so that the patients 50 who enter can directly "enter and take their place" in the black trail 20 to wait for the test.

As shown in Figure 1A, if the liftable black walkway platform 100 is located on the real "upstairs" in daily life, then the patient 50 may first take the "elevator" upstairs, and then walk to the black walkway 20 by himself or with the help of a walker.

As shown in Figure 1A, a hydrotherapy pool 60 is set up in the "downstairs". The black walkway 20 can stay on the ground plane 201 (upper floor) or drop to the water (warm water) 61 of the hydrotherapy pool 60 below the ground plane 201 (lower floor) by the lifting action of the liftable support 10.

As shown in Figure 1A, the black trail 20 stays on the upper floor, so that the patient 50 on the black trail 20 can receive the evaluation and analysis mode, which is defined as the road surface evaluation and analysis method 200 in this case.

As shown in Figure 1A, the hydrotherapy pool 60 includes pool water 61, a pool body 62, a window 621 and a water source device 63, which will be described in detail in Figure 3.

As shown in Figure 1B, the black walkway platform 20 is lowered into the water 61 of the hydrotherapy pool 60 by the lifting action of the liftable support 10, so that at least the lower body of the patient 50 below the appropriate part of the body is soaked in the water 61.

The so-called "appropriate part of the body" is mainly based on the patient's height 50, or the requirements under the test conditions (such as the physical therapist's advice to patients with cardiovascular disease), as shown in the hydrotherapy pool 60 in Figure 3.

As shown in Figure 1B, the black trail 20 stays in the pool water 61, so that the lower body of the patient 50 is immersed in the pool water 61 to receive the evaluation and analysis model, which is defined as the underwater evaluation and analysis method 300 in this case.

Among them, the underwater assessment analysis method 300 shown in FIG. 1B can also be defined as a type of hydrotherapy system.

That is to say: a hydrotherapy system includes a device including a liftable black walkway platform 100 and a hydrotherapy pool 60.

As shown in Figures 1, 1A, and 1B, the multispectral imager 301 can capture multispectral images inside or outside the hydrotherapy pool 60 by using the lifting function of the liftable black walkway platform 100.

The multispectral gait images of the patient 50 on the road and underwater are taken for evaluation and analysis. The multispectral gait images can be displayed on a monitor (not shown in the figure). The physical therapist or his attending physician can provide on-site guidance and observation or use the video recording to conduct a "comparison analysis" of the multispectral gait images on the road and underwater for reference.

This "comparison analysis" evaluation includes: further comparison analysis of multispectral gait images of normal people and patients of different (mild/medium/heavy) levels on the road and underwater.

Regarding the multispectral gait images of the patient 50 on the road and underwater, in addition to evaluating the near-infrared and visible light images of the patient's 50 lower limbs, how can the multispectral thermal imager 301 further evaluate the far-infrared thermal images of the patient's 50 lower limbs (including gait/footprints) because it is impossible for the multispectral thermal imager 301 to penetrate the "black trail 20 and pool water 61" to take images?

As shown in Figure 1C, when the multispectral thermal imager 301 is aimed at the patient 50 standing next to the wide-bottomed handrail 40, a VC (Vapor Chamber) temperature changing plate 80 is placed at an appropriate distance to the side of the patient 50.

The VC temperature changing plate 80 used in this embodiment is formed by improving a common VC temperature balancing plate.

This VC temperature changing plate 80 is a kind of thing that can be placed at any small point on the entire metal plate surface. As long as this "small point" receives "cold" or "hot" temperature, it can diffuse to the entire metal plate surface in an instant (about 3 seconds later). For example, if a copper metal plate with the same thickness of about 2mm is used, it will take more than a few minutes to diffuse to the entire copper metal plate!

As shown in Figure 1C, the VC temperature changing plate 80 of this embodiment has a point cold source called a semiconductor cooling plate TEC attached to the first surface of the VC temperature changing plate 80 to instantly generate a cold temperature of about 0°C. The second surface of the VC temperature changing plate 80 faces the lower limbs of the patient 50, so that the multi-spectral thermal imager 301 can capture the thermal image of the side of the lower limbs of the patient 50.

In short, the purpose of this VC temperature changing plate 80 is to generate different temperatures as the "background" temperature when the multispectral thermal imager 301 is aimed at the lower limbs of the patient 50 to capture thermal images, so that the "lower limb temperature of the patient 50" and the "background" temperature can generate an obvious "appropriate temperature difference" that can be easily identified by the thermal imager.

In other words: assuming that T1 is the generated "background" temperature and T2 is the measured temperature of the patient's lower limbs, where △T is the "appropriate temperature difference", the mathematical formula is: T1-T2=△T. The larger the value of this △T, the easier it is to identify.

Among them, because T2 is usually a constant and T1 is a variable, it is not difficult to find the "appropriate temperature difference" as long as a controller (not shown in the figure) is provided to control and generate appropriate power to the VC temperature changing board 80.

This "appropriate temperature difference" allows the multispectral thermal imager 301 to obtain a clearer far-infrared "thermal image 801" of "patient 50's lower limbs". This thermal image 801 can identify the abnormalities of patient 50's lower limbs before and after the assessment test!

The question is: How to identify the thermal image of "patient 50's lower limbs"?

When evaluating gait, the lower limbs of patient 50 should be visible at least below the knee joint, so as to more accurately observe and evaluate the far-infrared thermal image of the overall gait, that is, to observe the correlation between the changes in the shape and size of the calf and the step length and frequency during the gait activity.

However, when the patient 50 is in the pool water 61 as shown in Figure 1B, as shown in Figure 1C, how can the thermal image of the "lower limbs of the patient 50" be identified?

It is very difficult. As shown in Figure 1B, it is very difficult to identify the thermal image of "patient 50's lower limbs"!

From the principle of most thermal imagers, we know that thermal imagers capture the "temperature (infrared radiation)" radiated from the surface of an object. Therefore, we can measure the temperature of this "gait/footprint of patient 50". As shown in Figures 1A and 1B, the temperature measured by the multispectral thermal imager 301 is not the real temperature of this "gait/footprint of patient 50" because the real temperature of this "gait/footprint of patient 50" is lost to a certain extent when it is transmitted through the medium of the black trail 20 and is "absorbed" by the black trail 20.

So, how does the multispectral thermal imager 301 shown in Figures 1A and 1B obtain a clearer far-infrared "thermal image" of "Patient 50's gait/footprint"?

There are two methods: (1) reduce the "thickness" of the black trail 20 to reduce the "heat" "absorbed" by the black trail 20; and (2) use a higher-resolution multispectral thermal imager 301.

It is not important whether the "thermal image" mentioned in one or more embodiments of the present case is the "real" temperature of the patient 50's gait footprint or lower limbs.

The important thing is: these "thermal images" are only for physical therapists to evaluate the "difference reference" produced when "comparing" the "assessment and analysis results" and "results before and after hydrotherapy exercise" of patients 50, and do not involve the actual temperature data values.

The human body surface is a complex isotherm diagram with a wide temperature range that changes with changes in internal and external factors. In this case, a multispectral thermal imager 301 was used to evaluate the temperature of the lower limbs or gait footprints of patient 50. The use of thermal imaging technology can be used to analyze the biothermodynamic processes occurring in the human body; because temperature changes are usually the first sign of pathological processes in body tissues, and are obvious before functional or structural changes occur.

Therefore, thermal images generated by the multispectral thermal imager 301 for evaluating patients 50 for gait disorders and for detecting potential pathological thermal changes may have important diagnostic value in medicine, health sciences, rehabilitation, physical therapy and sports.

At least, the biggest advantage of thermal imagers is that they are a non-invasive, non-contact technology that can be safely used as a research instrument for evaluation and analysis. Other embodiments of this case suggest using a thermal imager with a higher resolution grade for observation in research.

Thermal imager performance is also affected by the instantaneous field of view (IFOV) (i.e. the angle subtended by a single pixel of the detector), however, due to equipment errors, variations between different cameras are expected even with similar spatial resolution or IFOV.

Therefore, these "thermal images" in this embodiment are only for reference to evaluate the differences generated when analyzing the "comparison".

However, among the various grades of thermal imagers on the market, no multispectral thermal imager like the multispectral thermal imager 301 in this case can simultaneously capture multispectral images of the far infrared FIR, near infrared NIR and visible light VIS of the patient 50 with gait disorders.

Because the dual lenses of the multispectral thermal imager 301 and general thermal imagers include: a first lens and a second lens.

The first lens has the same function as the first lens disclosed in common thermal imagers, which is responsible for capturing the far infrared FIR band in the range of "8~14μm". The second lens of the multispectral thermal imager 301 is responsible for capturing the visible light VIS band in the range of "0.4~0.8μm" and the near infrared NIR band in the range of "0.8~1.0μm". However, the image sensor in the second lens of common thermal imagers limits the capture of images in the near infrared band in the range of "0.8~1.0μm".

Among them, the near infrared captured by the second lens of the multispectral thermal imager 301 usually requires a "near infrared auxiliary light source" to illuminate the target and then reflect back to the image sensor in the second lens of the multispectral thermal imager 301, so that an enhanced near infrared image can be sensed.

Among them, it was found in other embodiments that: even without the "near-infrared auxiliary light source" projecting near-infrared, the second lens can sometimes capture a clear near-infrared image of the target object! Why?

The reason may be that there is natural near-infrared radiation in the indoor environment during the day, but it is impossible for natural near-infrared radiation to occur at night like during the day!

After the above evaluation and analysis of patient 50, the next step is to carry out a subsequent "related and corresponding" exercise plan for the same patient 50 based on the results of the above evaluation and analysis.

"Related and corresponding" here means that the exercise steps or methods of hydrotherapy are planned or arranged by the physical therapist or attending physician of the patient 50 based on the evaluation and analysis of the patient 50 "on the road and under the water" and are "tailor-made" for the patient 50.

The training plan here means that the underwater assessment and analysis method 300 can be used as both an assessment and analysis method and a training plan.

One embodiment of this case includes capturing frozen gait FOG images of Parkinson's patients, and then processing them with different transparency alpha (σ) images to form a multispectral thermal image for evaluating frozen gait FOG. It can further allow physical therapists to provide a device and guidance for "exercise programs in a hydrotherapy environment" to Parkinson's patients or elderly people.

Among them, the method of evaluating frozen gait FOG multispectral thermal image with different transparency alpha (σ) images is similar to the method disclosed in No. I757022. The difference is only in the visible light part. This case adds a window image, which will not be described in detail here.

The evaluation analysis includes multispectral images of Parkinson's patients freezing their gait "on the road" and "underwater", including the time and space parameters involved in the freezing gait.

Among them, the time parameters of gait include: the speed of moving distance along the direction of travel, the time from the first contact of one foot to the first contact of the opposite foot and the time from the first contact of one foot to the second contact of the same foot, the swing period of the observed foot leaving the ground during the gait cycle, etc.

Among them, the spatial parameters of gait include: the distance between the two heels in the direction of travel when the heel touches the ground to the other (or the same) heel touching the ground when walking, etc.

Another embodiment of the present case includes the patient 50 walking on the black trail 20 "on the road" and "under the water", and additional "external" stimulation is used to urge the patient 50 to "more" focus on the gait during the practice.

This stimulation may increase the control of the patient's gait through the coordination area of the cerebellum. It is used to observe whether the coordination of gait movements with this "external stimulation" is effective in the long term? Can increasing the opportunity for limb activity also prevent falls?

In the above evaluation and analysis of patient 50 on the black trail 20 "on the road" and "underwater", is the effect of patient 50 before and after taking the medication (levodopa) related to the results of the "underwater" exercise?

Another implementation example of "tailor-made" treatment for patient 50 in this case includes setting reasonable "underwater" black trail 20 exercise goals for patient 50, and regularly tracking the achievement rate of patient 50. Patient 50 can return to the hospital for regular follow-up visits to evaluate the patient's "underwater" exercise process or "on the road", and infer when, where and under what circumstances he is most likely to fall in daily life, and give patient 50 appropriate exercise to increase his independent living function.

It is important to note that having reliable information about gait characteristics at a specific time, such as monitoring and evaluating "on the road" and "under the water" over time, will help patients50 diagnose the disease and its complications at an early stage and help find the best training method.

From a clinical perspective: the analysis of human gait disorders includes the study of gait footprint characteristics of people with multiple sclerosis, muscular atrophy or Parkinson's disease, myelopathy, brain tumors and trauma, muscle spasms, Alzheimer's disease, heart disease or physiological aging. The description of the embodiment of the present invention uses Parkinson's disease PD and frozen gait FOG (PD+FOG) as the "representative" of gait disorder evaluation and analysis, but it does not exclude the evaluation and analysis of gait footprint characteristics of other diseases.

From the perspective of non-clinical environment gait training: The research of the embodiments of the present invention includes a balance training and exercise program designed for Parkinson's disease patients, including adjuvant therapy of hydrotherapy environment exercise and training to improve balance, effectively prevent falls, and improve cognitive function. It is more economical (saving money) and cost-effective than traditional assessment and treatment alone, thereby maximizing the quality of life of Parkinson's disease patients.

Because, discrete clinical assessments during consultations in clinical (long-term care, hospital) and non-clinical settings (nursing homes, independent living, etc.) often make it difficult or impossible to detect changes in daily gait, although changes in cognition, mobility, or health status can lead to changes in gait parameters until serious problems occur.

Because, in daily life or during a short visit, it is not easy to detect the "gradual" changes in gait parameters. Obviously, in this case, multispectral image monitoring (including video recording) and evaluation on the "road" and "underwater" can relatively "easily or instantly" detect the "gradual" changes in gait parameters.

For the above multispectral images, in a further in-depth evaluation and analysis, a method called "σ multispectral image" can be used for classification and interpretation. The "σ" here means "alpha blending", which means that the multiple images captured by the multispectral thermal imager 301 are blended by a transparency method to form a superimposed multispectral image that is easier for observation and research personnel to classify and interpret. This case defines it as "σ multispectral image".

One or more embodiments of this case clearly adopt "multi-spectral imaging" as a method of evaluation, analysis and tracking training, mainly to distinguish from the previous technical solution of using multiple sensors to expose patients and the previous technical solution of using visible light images on a transparent walkway to expose patients.

Because the "wearable" technology solution that uses multiple sensors on patients is a big challenge for elderly patients!

Also, because it is easy to distract patients 50 on the transparent walkway and lose accuracy.

Obviously, the above-mentioned evaluation and analysis and hydrostatic exercise method, from the road evaluation and analysis method 200 and the underwater evaluation and analysis method 300, can achieve the evaluation and analysis including thermal imaging, visible light and near-infrared gait footprint image information of gait disorder patients before and after taking medicine, which can indeed achieve early diagnosis of patients 50 and help find the best exercise method and effect.

The purpose of this case is to detect and intervene early to help high-risk groups reduce the risk of falls, to remove high-risk elderly people and those who need care from the risk of subsequent tragic life that may be caused by falls, to reduce the physical, mental and economic pressure of long-term care for caregivers, and more importantly, to allow patients with Parkinson's disease, Alzheimer's disease, other serious diseases and the elderly to have better health and quality of life.

Another purpose of this case is to provide a hydrotherapy device that can produce evaluation and exercise dual benefits, which can be easily distinguished from traditional common hydrotherapy (pool) devices that only provide exercise functions for rehabilitation exercises.

Another purpose of this case is to provide a method for assessing and exercising gait disorders, wherein the assessment method includes an on-road assessment analysis method 200 and an underwater assessment analysis method 300; and the exercise method includes an audiovisual stimulation hydrotherapy method.

Another purpose of this case is to provide a method for assessment, analysis and tracking of exercise, replacing the "wearable" technology solution that uses multiple sensors on patients, reducing the huge challenges for elderly patients!

10: Liftable support pillars

100: Elevating black trail platform

11: Sleeve column

12: Telescopic column

20: Black Trail

20d

200: Pavement evaluation analysis method

201: Road surface

22: Testing area

23: Scale table

30: Monitoring box

300: Underwater evaluation and analysis method

301: Multispectral Thermal Imager

302: Near infrared auxiliary light source

303: Transmission line

304: Reflector

40: Wide-bottomed handrails

41: Tilt-type wide-bottom handrail

42: N-shaped wide bottom handrail

50: Patients

60: Hydrotherapy pool

61: Pool water

62: Pool body

621:Window

63: Water source equipment

70: Soft obstacles

80:VC temperature changing board

801: Thermal imaging

Figure 1 is a schematic diagram of the liftable black trail platform

Figure 1A is a schematic diagram of the evaluation and analysis principle on the road surface

Figure 1B is a schematic diagram of the underwater assessment and analysis principle

Figure 1C is a schematic diagram of the VC temperature changing plate

Figure 2 is a schematic diagram of the black trail.

Figure 2A is a schematic diagram of the black trail.

Figure 2B is a schematic diagram of a wide-bottomed handrail

Figure 2C is a schematic diagram of footprint photography

Figure 2D is the second schematic diagram of footprint photography

Figure 3 is a schematic diagram of a hydrotherapy pool.

Figure 3A is a schematic diagram of the glass pool body

Figure 4 is a schematic diagram of near-infrared image characteristics

Figure 4A is a schematic diagram of the multispectral thermal imager color palette

Figure 5 is a schematic diagram of thermal imaging of the lower limbs

Figure 5A is a schematic diagram of normal gait footprints

Figure 5B is a schematic diagram of the thermal image of gait footprints

Figure 5C is the second schematic diagram of gait footprint thermal image

Figure 6 is a schematic diagram of frozen gait 1

Figure 6A is the second schematic diagram of frozen gait

Figure 6B is a schematic diagram of PD’s COP

Figure 7 is a schematic diagram of the vertical line of the human body's center of gravity.

Figure 7A is the second schematic diagram of the vertical line of the human body's center of gravity

Figure 7B is the third schematic diagram of the vertical line of the human body's center of gravity

Figure 7C is a schematic diagram of the vertical line of the human body's center of gravity

Figure 8 is a diagram of guided exercise 1

Figure 8A is the second diagram for guiding exercise

Figure 8B is the third diagram for guiding exercise

Figure 9 is a schematic diagram of the leg-lifting exercise.

Figure 9A is the second schematic diagram of the leg-lifting exercise

Figure 10 is a schematic diagram of multi-spectral thermal imaging

Figure 10A is a schematic diagram of multi-spectral near-infrared imaging 2

Figure 11 is a diagram showing standing on the black trail

Figure 11A is a schematic diagram of the footprint pattern

Figure 11B is a diagram showing standing stability

Figure 11C is a schematic diagram of the footprint image area

Figure 11D is a schematic diagram of footprint parameters

In order to achieve the basic principle and mechanism of this case [Multispectral imaging evaluation and analysis method of gait disorders and hydrostatic exercise device], the main method is to "raise" the liftable black walkway platform 100 above the indoor road surface 201 and "lower" the liftable walkway platform 100 to a hydrostatic pool 60 below the indoor road surface 201, which are used for evaluation and analysis and hydrostatic exercise plan respectively.

Embodiment 1: Forming a VC temperature changing plate 80

As shown in Figure 1C, the VC temperature changing plate 80 in this embodiment is an improvement on the mature VC temperature averaging plate that has been available at home and abroad, that is, a semi-conductive cooling sheet TEC and a heat insulation unit are attached to the first surface of the VC temperature averaging plate.

Insulation units (such as insulation cloth or insulation coating, etc.) are pasted around the point cold source of the semiconductor cooling plate TEC. In other words, insulation units are pasted around the semiconductor cooling plate TEC to prevent the "heat" generated by the semiconductor cooling plate TEC from being wasted on the first side of the VC temperature changing plate 80. The "heat" generated by the semiconductor cooling plate TEC should be reflected on the second side to produce a more appropriate temperature difference between the lower limbs of the patient 50.

In this way, the improvement of the general VC temperature balancing plate is called VC temperature changing plate 80.

Embodiment 2: Forming a liftable walkway platform 100:

Please refer to Figure 2 for the schematic diagram of the black trail 1; Figure 2A for the schematic diagram of the black trail 2; Figure 2B for the schematic diagram of the wide-bottomed handrail; Figure 2C for the schematic diagram of the footprint photography 1 and Figure 2D for the schematic diagram of the footprint photography 2.

As shown in Figure 2 and Figure 2A, the black trail 20 (opaque) can be said to be a further explanation of Figure 1.

As shown in Figure 2, the black walkway 20 of the present embodiment is made of black plastic (or black glass) material, or it can be formed of a composite matrix material, such as a black-sprayed aluminum alloy and black plastic (or black glass) bonded together.

Why is the Black Trail 20 material black?

Because, when the patient 50 with gait disorder moves on the black trail 20, if the material of the black trail 20 is transparent, the patient 50 may be "inattentive" and curious to see what is "under" the black trail 20? This will affect the evaluation and analysis of gait!

However, if the material of the black trail 20 is black and opaque! Then, how can the multispectral thermal imager 301 under the black trail 20 capture the gait image of the patient 50 on the black trail 20 as a method for evaluation, tracking and analysis?

There are many methods for forming black plastic: for example, the same inventor has "revealed" the method of making the opaque material of the black "walkway" in the Chinese Patent No. I423676 [Monitoring use of coated substrate imaging], the Chinese Patent No. I328593 [Making method and application of infrared-transparent black plastic] and the above-mentioned Patent No. I666935 [Micro thermal imager for enhanced near-infrared image capture], etc.; this black walkway can penetrate most of the near-infrared and a small part of the visible light, and its principle mechanism will not be described in detail here.

In other embodiments of the present invention, a simple method for forming black plastic is to mix a black masterbatch called carbon black into a transparent plastic (such as PMMA or PC).

Sometimes, in order to "reduce" the weight of the black trail 20! The material of this black trail 20 can be a composite material of aluminum alloy and black plastic.

Among them, aluminum alloy is lighter than black plastic material of the same volume, and black acrylic is lighter than black glass.

In a preferred embodiment of the present case, black plastic is used, which is easier to process (punch and assemble). For example, as shown in Figure 1, it is easy to process and install the liftable support 10 and the wide-bottomed handrail 40 on the black walkway 20.

As shown in Figure 2, a test area 22 is set in the center of the front of the black trail 20, and the gait range of all patients 50 being tested is "recommended to be restricted" within this test area 22.

How come patient 50 is "recommended to be restricted" to this testing area 22?

It can be (1) directly observed by a physical therapist or patient 50 on a liquid crystal display installed above the black walkway 20; or (2) the test area 22 is set a little higher than the surface of the black walkway 20 (e.g. 2~5mm) to allow the patient 50 to experience it himself.

Because, a monitoring box 30 is installed at the bottom of the test area 22; the camera (such as a multi-spectral thermal imager 301) in the monitoring box 30 is aimed at the test area 22 to capture the gait pattern of the patient 50 standing on the test area 22.

As shown in Figure 2A, a scale 23 is drawn on the back of the black trail 20, which "corresponds" to the outer periphery of the test area 22 (indicated by the dotted line). The purpose of this scale 23 is to serve as a reference length for the gait of the patient 50 on the test area 22. This test area 22 and this scale 23 are white lines printed on both sides of the black trail 20 with "opaque white paint".

As shown in Figures 2 and 2A, this "opaque white paint" cannot penetrate visible light and near-infrared light, so the multispectral thermal imager 301 can "penetrate" the black trail 20 and capture the images of the "white lines" on the test area 22 and the scale 23, as well as the near-infrared and visible light gait images of the patient 50.

As shown in Figure 2B, different forms of the wide-bottomed handrail 40 shown in Figure 1 are further described, such as the inclined shape 41 or N-shaped shape 42 in Figure 2B, whose main function is to prevent "the lower limbs and feet of the patient 50 from hitting the lower end of the wide-bottomed handrail 40 when entering the black trail 20", as shown in Figure 1, D1 (distance 1)> D2 (distance 2).

In Figure 2C, the monitoring box 30 is located at a suitable position in the center below the black walkway 20. A multi-spectral thermal imager 301 is installed inside the monitoring box 30.

When the camera lens of the multispectral thermal imager 301 is aimed at the gait of the patient 50 in the test area 22 above the black walkway 20, in order to obtain a more complete image, the range of the image captured by the camera lens of the multispectral thermal imager 301 must cover the test area 22.

Among them, when the camera lens of the multispectral thermal imager 301 is aimed at the gait of the patient 50 in the test area 22 above the black trail 20, in order to further obtain a clearer image, a "near-infrared auxiliary light source" 302 for "filling light" may be needed.

The near-infrared auxiliary light source 302 is mainly IR-LDEs (infrared light emitting diodes) with a wavelength of 940nm, which is used to allow the multispectral thermal imager 301 to further obtain clearer near-infrared images of gait. The reason for using 940nm IR-LDEs is that 940nm IR-LEDs will not emit red visible light dots (Red dots) when in motion, which is called "red dots" in the industry. Otherwise, when the "red dots" are displayed above the black trail 20, the patient 50 will see the bright dots of the "red dots" and become "inattentive"!

The definition of "940nm" mentioned above means "does not include near-infrared visible or recognizable to the human eye", which means that the common 850nm IR-LDEs are excluded!

The aforementioned near-infrared with "940nm" as the center wavelength is also defined as "940±20nm" near-infrared in this case, because the "±20nm" is the reference error range of IR-LEDs manufacturers' products, and its characteristic is that the near-infrared is "completely invisible to the human eye"! Among them, other common near-infrared particle products with 960nm and 980nm as the center wavelengths produced on the market should also be equally regarded as the "940nm as the center wavelength" family.

As shown in Figure 2C, the junction of the monitoring box 30 and the black trail 20 must have a "waterproof" function to prevent the pool water 61 from seeping into the monitoring box 30.

As shown in Figure 2C, the transmission line 303 for transmitting the video signal (video) required by the multi-spectral thermal imager 301 in the monitoring box 30 is led out from the outside of the monitoring box 30 through the black walkway 20. After the transmission line 303 is led out, it is transmitted to a display at an appropriate position indoors (not shown in the figure) through the liftable support 10 for viewing the gait image of the patient 50.

The transmission line 303 can pass through the inside of the telescopic column 12 of the liftable support 10 and then be led out through a hole dug at the top of the telescopic column 12 (close to the sleeve column 11). This is because, even if the outer edge of the transmission line 303 is waterproof or has safety specifications, at least, when the transmission line 303 is led out from the top of the telescopic column 12, it will not touch the pool water (warm water) 61.

This transmission line 303 transmits the multi-spectral image of the gait of the patient 50 standing on the black walkway 20, so that the physical therapist of the patient 50 or others can watch or record it for archiving.

As shown in Figure 2C, the image can also be stored in the SD card in the multispectral thermal imager 301 and taken out and placed after leaving the hydrotherapy pool 60, thus eliminating the need to install the transmission line 303.

As shown in Figure 2C, the power source required by the near-infrared auxiliary light source 302 can be a rechargeable battery (not shown in the figure).

As shown in Figure 2C, because the multispectral thermal imager 301 and light source 302 in the monitoring box 30 need to be repaired sometimes, it is necessary to remove the monitoring box 30 from the black walkway 20. The screw device used between the monitoring box 30 and the black walkway 20 must be equipped with a "gasket" for waterproofing (not shown in the figure).

When the range of the image captured by the multispectral thermal imager 301 camera lens cannot cover the test area 22 due to its insufficient "depth of field" as shown in Figure 2C, the "focal length" of the image captured by the multispectral thermal imager 301 camera lens can be extended, as shown in Figure 2D, and reflected by a reflector 304 into the test area 22, or;

Directly put an appropriate magnifying glass on the multispectral thermal imager 301 camera lens to enlarge the image to cover the test area 22.

Embodiment 3: Forming a hydrotherapy pool 60:

Please refer to Figure 3 for a schematic diagram of a hydrotherapy pool and Figure 3A for a schematic diagram of the glass pool body.

As shown in Figure 3, the hydrotherapy pool 60 includes: pool (warm) water 61, a pool body 62 and water source equipment 63.

The "hydrostatic pressure" of the hydrotherapy pool 60 refers to the hydrostatic pressure: it is the pressure exerted by the warm water 61 in a static state in the pool body 62. Assuming that the body force exerted on the warm water 61 is only gravity, the hydrostatic pressure at any point in the warm water 61 area is isotropic, that is, the pressure at the same point is the same in all directions.

Specifically, in the hydrotherapy pool 60, except for the "convection" of the warm water 61 caused by the activities of the patient 50 in the warm water 61 area, there is no "interference" from external forces (such as no one around), so as to avoid indirectly "interfering" with the quality of the multispectral image captured by the multispectral thermal imager 301.

For example, for some patients 50 with cardiovascular diseases, their physical therapists may recommend that the height of the warm water 61 be lower than the "chest" of the patient 50 to reduce the water pressure of the warm water 61. This can be done by controlling the height of the elevating support 10 to adjust the height of the warm water 61.

Obviously, this hydrotherapy pool 60 means a "personal pool" for the 50 patients, which is different from a swimming pool shared by many people, but it does not rule out the possibility of setting up multiple "personal pools" "side by side" in a large rehabilitation room.

Among them, warm water 61 refers to water that is suitable for human body temperature, such as about 30~37℃, which can be adjusted in temperature. However, if the exercise is allowed, it is not ruled out that warm water with a temperature control can be used instead, because warm water can provide a soothing and warm temperature for patients 50 to relax their muscles, which helps to relieve stiffness and pain.

Since the water is usually kept warm in a hydrotherapy pool 60, it is important to keep the air warm as well as comfortable and prevent shivering in the PD patient 50. Even patients 50 with more advanced PD Parkinson's disease can enjoy some benefits of immersion in a hydrotherapy pool 60.

This is also the reason why the liftable black walkway platform 100 shown in Figure 1B must be able to be controlled to sink within an "arbitrary" depth range in the pool body 62, in order to meet the needs of patients 50 of different heights or with different other diseases.

Obviously, the main structure of the "walkway 131" exposed by the liftable black walkway platform 100 and No. I757022 [System and method for analyzing gait footprints based on α-type multispectral images] is obviously different from the technical field and functional features of the liftable black walkway platform 100 structure of this case.

The material of the pool body 62 can be reasonably designed, such as general building materials (cement soil tiles, fiberglass or tempered glass, etc.). However, one or more transparent "windows" 621 can be reserved around the pool body 62 to clearly see the activities of the patient 50 in the warm water 61, so that physical therapists, attending physicians, family visitors, etc. can watch or set up external cameras to record the hydrotherapy process.

As shown in Figure 3A, in order to retain one or more "windows" on the pool body 62, in other embodiments of the present invention, the pool body 62 is made of reinforced thick transparent glass (such as 9mm thick) in any shape (square or round), mainly to match the liftable black walkway platform 100, thus forming one or more "windows" 621.

Among them, the recorded images of the hydrotherapy process of patient 50 taken by "window" 621 are defined as "window images" here, which can be compared with the multispectral images taken by the multispectral thermal imager 301 as shown in Figure 2B, so as to obtain further evaluation and analysis and the effectiveness of the hydrotherapy exercise results.

Among them, the water source equipment 63 includes the circulation, replacement, cleaning, disinfection and sterilization of warm water 61, supply and temperature control of hot and cold water, etc.

Example 4: Basic gait image recognition.

In order to further understand the multispectral images of the basic gait captured by the multispectral thermal imager 301 in this embodiment, in particular, as shown in Figure 2B, the multispectral thermal imager 301 captures far infrared, near infrared and visible light images of various gait patterns of the patient 50 moving on the black trail 20.

Among them, the thermal images in the gait state are shown in Figure 1C and Figure 4A.

Among them, the near infrared in the gait pattern is shown in Figure 4 and Figures 8~9A.

Among them, the visible light images in the gait state are such as visual and window images such as Figure 3.

It is worth noting that in one or more embodiments of the present invention, the evaluation and analysis is largely focused on the analysis of near-infrared images, but it is not limited to near-infrared images as the only analysis method of the present invention.

Please refer to Figure 4 for a schematic diagram of near-infrared image characteristics and Figure 4A for a schematic diagram of the multispectral thermal imager color palette.

As shown in Figure 4, it shows "two" images of the "same" apple, the left one is a visible light image and the right one is a near-infrared image. Both photos were taken shortly after the apple was purchased.

Clearly, signs of surface damage can be seen very clearly in the NIR image, while no signs of damage are seen in the visible light image, which shows the characteristics of near-infrared (NIR) images.

As shown in Figure 4, near infrared has unique advantages. In addition to its ability to penetrate deep tissues of the soles of the feet, it also has a much greater contrast between what it is viewing and its surroundings than visible light. If there is no good contrast, then no matter how bright the sunlight is, you will not be able to see clearly (as shown in the visible light image on the left).

However, darker objects will make some images difficult to see against a dark background, which is called poor contrast. The lack of visible light will naturally reduce the image contrast, which is also the reason for the near-infrared auxiliary light source 302 as shown in Figure 2B.

The thermal image of the multispectral thermal imager 301 is "independent" of the presence or absence of visible light, so they can be compared and evaluated with each other.

As shown in Figure 4A, the multispectral thermal imager 301, like ordinary thermal imagers, has a built-in function called "palette". This palette can process the images captured (photographed) by the multispectral thermal imager 301 through image software, thus generating images with different color toning "false" color display indexes.

As shown in Figure 4A, the different color palettes are the "Gray Palette", which is particularly good at resolving smaller geometric details, but not so good at showing small temperature differences; the "Iron Palette" is very intuitive and easy to understand for those without thermal imaging experience; the "Rainbow Palette" is more vivid and switches between light and dark colors, which produces greater contrast, but may produce noisy images for elements with different surfaces or many temperatures.

In fact, because completely different color palettes have different interpretation purposes, physical therapists can distinguish some subtle differences.

Conventionally, the "black and white palette" shown above assigns "black" to the coldest temperature in the thermal image, "white" to the hottest temperature in the thermal image, and gradually forms gray shades in between.

Please refer to Figure 5 for the schematic diagram of thermal image of lower limbs; Figure 5A for the schematic diagram of normal gait footprint; Figure 5B for the schematic diagram of gait footprint thermal image 1 and Figure 5C for the schematic diagram of gait footprint thermal image 2.

As shown in Figure 5, it is an example of capturing the thermal image of the lower limbs of patient 50 in front of the VC temperature changing plate 80 as described in Figure 1C. It is for reference only. The light blue background in the figure shows that the background temperature is significantly lower than that of the lower limbs; the "pseudo-color temperature bar 51" on the right side of the figure shows the mark of the thermal image of the temperature distribution of the lower limbs. The black rectangular frame of the lower limbs shown in the figure may be the area of interest for professional doctors to study.

As shown in Figure 5A, it is the pattern of normal human gait footprints. In the figure, LL is the left foot stride length, RL is the right foot stride length, and SL is the stride length. Generally speaking, LL=RL is normal.

As shown in Figure 5B, this is an example of a thermal image of footprints on the black trail 20. This is a thermal image that can only be clearly captured by a high-resolution thermal imager of about 320*240 or above.

It is worth noting that the gait footprints in Figure 5B are a "thermal image" of the gait footprints left by patient 50 on the black trail 20. This "thermal image" may disappear in about 1 to 5 seconds due to the "convection" of the surrounding air!

As shown in Figure 5C, it is a thermal image of a footprint of another color palette on the black trail 20. The "pseudo-color temperature bar 51" on the edge of the image shows the temperature distribution of this thermal image of the footprint.

It is worth noting that: from the thermal images shown in Figures 5, 5B, and 5C, clear thermal images can be captured even in a completely dark environment (such as a sudden power outage), which is a characteristic of the gait pattern. .

Please refer to Figure 6 for the schematic diagram of frozen gait 1; Figure 6A for the schematic diagram of frozen gait 2 and Figure 6B for the schematic diagram of PD COP.

Freezing of gait (FOG), a common symptom of Parkinson's disease (PD) patients 50, is mainly manifested as "sudden" interruption of walking and severe movement difficulties as shown in Figure 6. Patient 50 suddenly feels as if his feet are "stuck" to the ground and cannot walk forward. In addition, as shown in Figure 6A, it manifests when "turning" at the beginning and approaching the destination, as well as in narrow or obstructed spaces. For PD patients 50 with FOG (PD+FOG), the risk of falling will increase and the quality of life will also decline.

The clinical features of patient 50 with (PD+FOG) are as follows: (1) During an attack, the feet or toes cannot leave the ground; (2) During an attack, both legs tremble alternately at a frequency of about 5 Hz; (3) Before an attack, there is often a shortening of the stride and an increase in the walking speed; (4) During an attack, the attack can be relieved by external "stimulation"; (5) The attack is asymmetric, that is, it mainly affects one side of the lower limb or when turning to one side, thus seriously affecting the quality of life of patient 50.

The mechanism by which PD patients 50 develop FOG symptoms has not yet been clearly understood by the global medical community. Preliminary research results from some international medical literature indicate that the pathogenesis of FOG may be caused by dysfunction of multiple brain regions.

Therefore, this embodiment does not involve medical research on the pathology of the FOG symptoms produced by patient 50, and the case is not sufficient to provide sufficient medical resources and equipment. In several embodiments, it is only based on general common sense to provide physical therapists with a preliminary evaluation and analysis of multi-spectral images for patient 50, and then to find the corresponding hydrotherapy exercise plan, which is provided to physical therapists or related personnel for reference, with the purpose of improving the daily quality of patient 50.

As shown in Figure 6, it is a gait of FOG patient 50. In each step, there is a short distance FOG-D between the left and right feet. As shown in the figure, when the left foot "exaggerates" a step, the right foot cannot "step out" the left foot like a normal person, and the right foot "always follows" the left foot a distance FOG-D behind. It is also like a propulsive gait or "shuffling gait" phenomenon.

Will this "shuffling step" phenomenon be affected by external force (or resistance) in the hydrotherapy pool 60? Finding a method of "exercise or treatment" is also one of the purposes of the present invention.

As shown in Figure 6B, the gait of FOG patient 50 is "head down and body leaning forward" (such as COP1), which forces the right foot of patient 50 to "exaggerate" one step to "seek" to maintain the balance of his body (such as COP2).

The physical therapist of this embodiment can obtain multiple variations of data by visually evaluating the movement of the patient's body displacement center COP (Center of pressure, COP) in three multispectral footprint images, and then find a better guidance exercise method.

Now, the reasoning method of this embodiment to explore the "connection relationship" between the plantar pressure center (body displacement center) or gait balance and multispectral images is explained.

Gait footprint is a very interesting and complex joint. Our ankle joint requires a high degree of stability and mobility at the same time. This sounds very conflicting and also makes the evaluation and analysis process relatively complicated. It is necessary to consider the overall biomechanics of the lower limbs, rather than just looking at the "footprint" area.

However, let us "focus" on a local area of this "footprint" for now, which will make it easier to understand.

COP can be used to assess the balance ability (body control ability) of patients 50. Literature points out that the center of pressure can reflect the position of the body's center of gravity when maintaining a static posture, so it can be used to represent the sway of the body's center of gravity, the COP movement trajectory, the maximum front/back, left/right offset, and the COP area are all indicators for assessing balance ability.

In other embodiments, the patient 50 may be asked to "open his eyes" or "close his eyes" to find out more COP trajectory image data of the patient 50 and how to enhance the patient's 50 balance ability and predict the patient's 50 probability of falling in the future based on the COP trajectory image data.

Please refer to Figure 7 for the schematic diagram 1 of the vertical line of the human body's center of gravity; Figure 7A for the schematic diagram 2 of the vertical line of the human body's center of gravity; Figure 7B for the schematic diagram 3 of the vertical line of the human body's center of gravity and Figure 7C for the schematic diagram 4 of the vertical line of the human body's center of gravity.

As shown in Figure 7, when patient 50 stands, the area enclosed by both feet (in the circular dotted frame) is called the base of support (BOS) of patient 50. There is a COG point (vertical line of the center of gravity of the human body) in the center of this area. If you pass through this COG point, you can maintain balance. However, if it is a single foot (its center of support COG has moved), draw a red straight line upward from this COG. If it passes through the COP, you can maintain balance. Otherwise, you are likely to fall.

As shown in Figure 7A, when patient 50 walks, the vertical line of the center of gravity of the human body (dashed line) can be seen from the center line of the head (solid line) to produce a small displacement slightly to the left and slightly to the right.

As shown in Figure 7B, when patient 50 walks on the black trail 20, in the dashed boxes of Figures (a) to (e) in the following row, you can see that the black block represents the vertical line of the center of gravity of patient 50 moving toward the white block. For example, in Figure (a), the center of gravity is on the left foot at the beginning, and in Figure (b), it slowly moves toward the right foot. From the left foot in Figure (b), the black block becomes smaller, indicating that the vertical line of the center of gravity of the human body is moving toward the white block... until (e) completes a cycle and repeats.

If a straight line is drawn upward from the support point of one foot, and it passes through the COG, then the person will not fall.

Generally, the three processes that patient 50 must pay attention to are (1) the center of gravity COG that supports the body weight, (2) the support point of single-leg support, and (3) the swinging leg must be within the support base BOS of patient 50 when taking a step, even on the road or underwater. It is particularly important to observe the differences in the footprints in these three processes and perform cross-comparison.

Therefore, from the "movement" of the vertical line of the human body's center of gravity to the white area in the following rows (a) to (e) as described in Figure 7B, it can be inferred that by obtaining the multispectral images of the black part in the following rows (a) to (e), especially from the near-infrared images with high contrast (such as Figures 4, 10A, 11B, and 11D), the difference in the movement of this near-infrared image can be evaluated, analyzed, and inferred from the balance ability of this patient 50.

As shown in Figure 7C, referring to Figure 7A and Figure 7B, the correlation between the image captured by this embodiment and the COP displacement trajectory is roughly divided into three stages A, B and C for evaluation and analysis.

For example, from the displacements of (1) to (2) in Figure 7A and (a) to (c) in Figure 7B, the Y-axis A area in Figure 7C shows an example of the corresponding COP movement trajectory.

From the above example of the COP movement trajectory, we can evaluate and analyze whether the patient 50's body is "shaking" or not.

However, the degree of such "swaying" will produce different center of gravity shifts on the ground and underwater due to gravity. In other words, through repeated evaluation and analysis, it is possible to determine the degree of "benefit" of patient 50 before and after hydrotherapy exercise in the hydrotherapy system by using the shifts produced on the ground and underwater.

Among them, the "swaying" speed refers to the distance that the COP moves per unit time, which is related to the ability to control posture. It can be used to evaluate the changes in strategies to maintain the patient's stable posture and the changes in the patient's body muscle contraction and extension.

The evaluation of the patient 50's standing posture balance within the support base BOS range as shown in Figure 7 can be divided into static and dynamic balance. Static balance means that the patient 50 maintains a fixed action without movement or rotation; while dynamic balance means that the patient 50 maintains a certain trajectory or moves on the rotation axis in the test area 22 without any external force interference.

The total length and area of the COP movement trajectory, the range of the front and back and left and right directions of both feet, and other parameters are inferred to evaluate the balance ability of the test patient 50. The position of the body's center of gravity reaction is evaluated by the "footprint" multispectral image, which can be used to represent the sway of the body's center of gravity, the COP movement trajectory, the maximum front/back, left/right offset, and the COP area, which are all indicators for evaluating balance ability (body control ability).

Please refer to Figure 8 for the schematic diagram 1 of the guided exercise; Figure 8A for the schematic diagram 2 of the guided exercise and Figure 8B for the schematic diagram 3 of the guided exercise.

Figures 8, 8A, and 8B are some examples of corresponding guidance for patients to practice basic gait after evaluation and analysis by physical therapists.

Among them, for patients with mild/moderate symptoms 50, in addition to more basic walking exercises, they can further perform slightly more difficult exercises in the road assessment analysis method 200 and underwater assessment analysis method 300.

As shown in Figure 8, the initial stage is to walk a small step forward with both feet close to the ground in a straight line, then relax both feet and walk a big step forward, and then advance to add a soft obstacle 70 between the two feet in the big step every other day, and then "step" over it. For the moderate patient 50 on the road, this may require the assistance of others, otherwise, the patient 50 may be "afraid of falling" and affect his mood for exercise. However, when underwater, the patient 50 may feel relieved to exercise because he "feels that he is not likely to fall."

As shown in Figure 8A, keep your feet close to the ground and take small steps forward in a straight line to train a more difficult sense of balance.

As shown in Figure 8B, after patient 50 stands firmly with both feet, he first moves his right foot sideways one step to the right and then retracts it. Then, he moves his left foot sideways one step to the left and then retracts it... Repeat the action several times.

Please refer to Figure 9 for the schematic diagram of the leg-lifting exercise 1 and Figure 9A for the schematic diagram of the leg-lifting exercise 2.

For example, Figures 9 and 9A are examples of leg lifting or single-leg exercise, where 1 represents leg lifting or single-leg exercise (as in the gray man's action diagram) and 2 represents return to the starting position, as well as standing (1) with the toes (black) touching the ground and the heels (gray) lifted for single-leg (2) and double-leg (3) exercises, repeating the action several times.

In addition, the physical therapist can also perform assessment and training on the patient 50 in the road assessment analysis method 200 and the underwater assessment analysis method 300 as shown in Figures 8 to 9A according to Figures 7 to 7B above, and further refer to the imaging information data of the patient 50, and then study and improve as appropriate.

Please refer to Figure 10 for a multi-spectral thermal image diagram 1 and Figure 10A for a multi-spectral near-infrared image diagram 2.

As shown in Figure 10, it is a multispectral "thermal" image of a gait. Medical research often focuses on the step-by-step analysis of temperature in gait thermal images, because the temperature of gait disorders involves different variations before and after exercise. For example, inflammation of injured tissues after falls will show obvious thermal image differences.

It is worth reminding you that when the "thermal" image in Figure 10 is displayed on the black trail 20, the multispectral thermal imager 301 must take images (take photos or videos) immediately. Otherwise, the "thermal" images remaining on the black trail 20 may disappear in a short time (e.g. 1 to 5 seconds) because the "heat" of these "thermal" images is "convection-generated" by the air near the black trail 20 and disappears!

As shown in Figure 10A, it is a multi-spectral image of gait processed by a color palette (such as Figure 4A). In the implementation of the on-road assessment analysis method 200 and the underwater assessment analysis method 300 for the patient 50 in multiple embodiments of this case, most of them are for professional doctors and physical therapists to jointly conduct assessment and analysis on this "relatively" complicated color palette image.

Embodiment 5: Evaluation and analysis system.

This embodiment uses multispectral imaging to evaluate and analyze the risk of abnormal gait, including: (1) evaluation mode; (2) evaluation method; (3) evaluation object; (4) evaluation items and images; (5) audio-visual guidance method; and (6) physical therapist coaching method.

(1). Evaluation mode: including two methods: the on-surface evaluation and analysis method 200 and the underwater evaluation and analysis method 300. (1-1). As shown in Figure 1A, the on-surface evaluation and analysis method 200 is a method in which the black walkway 20 stays on the upstairs road surface, and the patient 50 standing on the black walkway 20 is evaluated; (1-2). As shown in Figure 1B, the underwater evaluation and analysis method 300 is a method in which the black walkway 20 is lowered into the pool water 61, and the appropriate part of the lower body of the patient 50 is immersed in the pool water 61 to evaluate the patient 50's activities.

(2) Evaluation method: (2-1) You can try to let patient 50 "open his eyes" or "close his eyes", and then analyze it several times with (1) evaluation mode, so as to find out more deviation data about the COP movement trajectory image of patient 50; (2-2) By using the image data of the COP movement trajectory, find out how to enhance patient 50's balance ability and predict the probability of patient 50 falling in the future.

(3). The evaluation subjects include: (3-1). Severe patients 50 or those who have difficulty walking on their own and need assistance and (3-2). Mild/moderate patients 50 or those who can walk on their own without assistance and (3-3) normal controls.

(4). Assessment items and images include: (4-1). Patient 50's foot contact area with the ground and the "thermal image" distribution of the lower limbs and (4-2). Patient 50's footprint outline size, gait speed, stride (distance), step frequency and human body pressure center (COP) and other "visible light" and "near infrared" imaging gait footprint information.

(5). The audio-visual guidance method includes: (5A). Visual group and (5B). Auditory group.

The purpose of the audio-visual guidance method is to find out: (5-1). Does patient 50 have a significant effect in gait training with the addition of external "cues"? (5-2). The inclusion condition includes patient 50 as the

In order to promote the gait assessment and analysis and training effect of patient 50, it should be emphasized during implementation that patient 50 needs to be given high-repetition exercises under the effect of "taking medicine", and the exercises should be regular and consistent, and should not vary too much. In addition, simple and clear audio-visual guidance should be given to help patient 50 perform the movements.

At the same time, under the audio-visual guidance method, it is also recommended that patients 50 "stride" as long as possible, and the exercise content is adjusted according to the patient's level 50 to help patients build self-confidence.

(5A1). The audio-visual team lets the patient 50 watch a screen display (or TV), which shows whether the patient 50 is in the black trail 20 test area 22. If the patient 50 has followed the correct instructions, a "●" mark will be given. Otherwise, a "×" mark and instructions to "move forward or backward or to the right or left a little bit" will be displayed.

(5B1). Hearing group: After the patient 50 hears a sound such as "dong", he walks forward "one step". If he hears the next "dong" sound, he walks forward "one step". Each "dong" sound (N) can be set between 0.5 and 2 seconds. Assuming there are X different segments (such as N=0.5, 1...2), these X different segments can be set according to the patient's body shape, age or gender.

(6.)Physical therapist coaching method.

(6-1). Because sometimes it is necessary to evaluate many times, so the patient can be allowed to rest appropriately in between to avoid gait changes due to excessive fatigue or pain.

(6-2). If patient 50's feet suddenly freeze or cramp during exercise, and the feet seem to be stuck to the bottom of the pool, you should teach patient 50 to try to "stretch out the toes", so that the feet may regain mobility. Otherwise, stop the movement! Pause trying to exert force, and take 2-3 deep breaths to let patient 50 relax and calm down.

(6-2-1). If a physical therapist encounters a patient with an emergency situation at the on-site instruction, and it is difficult to handle the patient in time, the patient must be transferred to a professional emergency room.

(6-3). Patient 50 should note that the hydrostatic pressure in water is proportional to the water depth. For example, the higher the water level, the greater the cardiac load on patient 50.

(6-3-1). The water depth can be adjusted according to the patient's comfort level. You can also go deeper and deeper or keep the same depth. This exercise is shown in Figures 7-8A. It usually takes about 10-15 minutes.

(6-4). Follow the music rhythm of the audio-visual guidance method (5). At the same time, move your body's center of gravity, sway gently left and right or forward and backward in a rhythmic manner, and prepare to take the first step;

(6-4-1). Prepare to take a big step. Move the COP to one foot and take a big step with the other free foot. Take a big step to the rhythm of the music in the audio-visual guidance method (5) and take the first step after releasing the frozen gait FOG.

The above effects depend on the individual patient 50 and the background in which the method needs to be applied. From a physiological point of view, this is also a self-regulatory function of the patient 50.

The parameters of space (foot lift) and distance involved in the multispectral image of gait footprints evaluated and analyzed above are just a reference for "the time percentage of 50 patients relative to the entire gait cycle".

(6-5). Literature data show that patients 50 often spontaneously create new gaits to overcome their walking difficulties in order to maintain COP mobility and independence. At this time, physical therapists should teach patients 50 to accept different health education so that patients 50 can understand and find methods that are more suitable for their unique situations.

Of course, it is also possible to combine audio-visual guidance (5) or riding a bicycle with a projection-type static treadmill specially designed for patient 50, so that patient 50 can establish a new balance method for his body.

Please refer to Figure 11 for a schematic diagram of standing on a black trail; Figure 11A for a schematic diagram of footprint pattern 1; Figure 11B for a schematic diagram of footprint pattern 2; Figure 11C for a schematic diagram of gait parameters 1 and Figure 11D for a schematic diagram of gait parameters 2.

As shown in Figure 11, it is an example of patient 50 standing on the black trail 20 to evaluate and analyze the footprints. In fact, standing on the black trail 20 for evaluation and analysis will not be difficult for patient 50 in terms of physical activities and daily life functions, at least compared to wearing many wearable sensors on the body, which is a big challenge for the elderly or patients with moderate/severe PD 50!

Moreover, the multispectral image data of gait footprints provided on the black trail 20 is reliable for analyzing the vertical line of the human body's center of gravity to predict the probability of future falls, especially pointing out that the analysis results of left-right displacement and front-back standing footprints are significantly related to a series of falls.

As shown in Figure 11A, it is a partial near-infrared illustration of various footprint patterns. Some of these footprint patterns may be affected by the balance of the human body's center of gravity or due to disease, resulting in so many or more different patterns.

As shown in Figure 11B, the stability of patient 50 when standing (as shown in Figure 7) (whether he will fall) is directly proportional to the BOS range and inversely proportional to the COG level. Therefore, it is important to observe the footprints of patient 50 on the same patient 50.

As shown in Figure 11C, these footprints were observed from 50 different patients with and without walkers. In this embodiment, the stability of the footprints was observed by dividing the footprint images into three "area" regions, A, B, and C, and then using the percentage of B/(A+B+C) as the index center of the observation.

Of course, the changes in the "areas" of the three areas A, B and C mentioned above are only provided to physical therapists for preliminary assessment and analysis. In clinical practice, artificial intelligence AI calculations are still used to serve as assessment and analysis for attending physicians and to further propose corresponding exercise plans.

As shown in Figure 11D, the main parameters of a single foot footprint include the foot deviation angle Lφ (the angle between the foot centerline and the “walking line” on the same side), the palm length W1 and the palm width W2. The changes in the angle of the foot deviation angle Lφ and the changes in the area or peripheral contours of the palm length W1, palm width W2, etc. of the single foot footprint will have obvious “contrast images” in the near-infrared image, which can easily identify whether the single foot footprint has “swelling” or “atrophy” abnormalities for patients 50 and physical therapists.

Of course, is there any "swelling or atrophy" in the footprint? It is only provided to the physical therapist for preliminary evaluation and analysis. In clinical practice, artificial intelligence AI calculations are still used to serve as evaluation and analysis for the attending physicians and to further propose corresponding exercise plans.

Generally speaking, the COP in a static posture can reflect the position of the body's center of gravity, so it can be used to represent the sway of the body's center of gravity. The COP movement trajectory and COP area are all indicators for evaluating balance ability (body control ability). The shorter the COP movement trajectory and the smaller the COP area, the better the balance ability.

Regarding the movement of the COP trajectory, we can find a comparison between the parallel and forward and backward standing positions as shown in Figure 8A. When standing forward and backward, there will be a larger displacement in the left and right direction. When standing parallel, there will be a larger displacement in the front and back direction. Due to the different standing methods, there is a narrower base BOS space when standing forward and backward, so there will be a larger displacement in the left and right direction.

In the different conditions of opening and closing eyes, it can be found that almost all parameters are greater in the closed eyes state than in the open eyes state. Under the same action, the change of parameters after closing eyes does not increase with age and presents irregular changes. The change in different directions under different standing postures will also be affected. When standing parallel, the displacement in the front and back direction will increase, but there is no difference in the left and right direction. When standing forward and backward, the displacement in the left and right direction will increase, but there is no difference in the front and back direction.

From the above results, we can find that the difficulty of standing forward and backward is higher than that of standing parallel, and the difficulty of standing with eyes closed is higher than that of standing with eyes open.

Normal people don’t actually “think” about how to walk during their daily walks. They can even chat while handling other things with their hands, and can adjust their gait and body posture at any time according to various situations. However, PD patient 50 is not so smooth. Therefore, it is necessary to further evaluate and analyze the gait disorders of normal people and patient 50.

Since PD patient 50 often shows a flexed posture, causing the center of gravity to move forward, in order to maintain balance, patient 50 will walk forward quickly with small steps and "cannot" stop or turn at will, showing a panic gait, which can be easily identified from the multispectral images of gait assessment analysis.

Due to the numerous clinical and non-clinical literature reports on various footprint patterns, the evaluation and analysis process is relatively complicated. Even in clinical medicine, the overall biomechanics and anatomy of the lower limbs need to be considered. Therefore, it is not possible to simply evaluate and analyze the footprint gait alone.

In order to find out that "image difference" and "center of gravity displacement" have a certain degree of correlation, our team was able to find out through the self-report of a PD patient 50:

(1) As shown in Figure 7B, in the image analysis of mild/moderate patients 50 after taking stable medication, the "displacement of the center of gravity" is more difficult underwater than on the road; and (2) For mild patients 50, it is more difficult to close their eyes than to open them.

Obviously, it can be inferred that this "difference in images" is related to the "displacement of the center of gravity" to a certain extent, that is, the movement correlation of the "COP trajectory" corresponding to patient 50 can be found.

In short, the assessment analysis and hydrotherapy exercise device proposed in this case only hopes to "help" each patient 50 find the model and method that best suits him or her.

As mentioned above, the method of capturing the footprint gait image assessment and analysis will be accompanied by a corresponding computer APP software program when applying for a new case in the future to "automatically" assist in analyzing more parameters, such as important data analysis including the strength of the sole of the foot, the duration of the standing stop phase, and the duration of the mental tension phase, etc.

As mentioned above, the method of capturing the footprint gait image assessment and analysis, combined with the intelligent telemedicine system for frequent and automatic risk assessment and analysis by AI when applying for a new case, may be feasible and cost-effective.

In summary, the technical features of the hardware (including the trail) disclosed in this case and No. I757022 are different in terms of technical fields and functions.

(1). Definition and explanation of terms:

(1A). Multispectral definition: The multispectral here includes three types: Far Infrared (FIR) with a wavelength range of 8~14um, Near Infrared (NIR) with a wavelength range of 0.8~1.0um, and Visible light (VIR) with a wavelength range of 0.4~0.8um.

However, the three types of multispectral images involved in this case refer to those captured by the multispectral thermal imager 301, including the thermal image of the lower limbs of the patient 50 in Figure 1C (also known as far-infrared image), the near-infrared image of the footprints of the patient 50 in Figures 1A, 1B, 7B, 8, 8A, and 8B, and the visible light image (or visual image) of the whole body of the patient 50 in Figure 1 and the image of the window 621 of the patient 50 under water in Figure 3 are also defined within the scope of the visible light image.

Among them, the footprints of patient 50 on the black trail 20 were evaluated and analyzed mainly with the clearest and high-contrast near-infrared images and assisted by thermal images/visible light images.

(1B). Application of this case to multispectral imaging:

Among them, the difference in near-infrared images of patient 50 is also related to the trajectory of patient 50 to a certain extent. In other words, by analyzing the displacement trajectory of patient 50's center of gravity and the difference in multispectral images, it is possible to find out the correlation between the probability of patient 50 falling and the abnormality of the lower limb tissue.

(2). Technical solution

(2-1). Compared with the evaluation and analysis of gait footprints of patients 50 in foreign countries, which are only performed on the road surface, this case provides the use of interactive comparison of two types of multispectral images on the road surface (floor) of the black trail 20 and underwater, for example: first from the road surface, then from underwater, and then from the road surface again, and so on. Repeated interactive comparison.

Among them, after repeated cross-comparison, according to the cross-comparison images, the best fixed-type training method is then found and the subsequent training plan is carried out.

(2-2). Evaluation and analysis on the road (floor) alone is not enough and cannot be used as a reliable predictor of falls in patients 50 or the elderly. By distinguishing the variability of stride length and standing time of patients 50 related to underwater, the correlation between patients who fall 50 and patients who do not fall 50 can be better distinguished.

(2-3). Combining audio-visual guidance with the patient’s own body sensation, the patient is guided to do relevant hydrostatic exercises to improve gait disorders.

(2-4). The evaluation and analysis of 50 patient gait footprints in this case may help to better understand the gait of the footprints and distinguish between pathological gait changes and compensatory gait changes caused by the use of the corresponding exercise program.

(2-5). Although this case cannot provide a method to "cure" gait disorders, patient 50 who has tried many treatments without success may not have high expectations for this case. However, what is described in this case can improve patient 50's quality of life and help control symptoms. In particular, physical therapists can use this case to motivate patient 50 to try exercises and sports that patient 50 believes are "impossible for them."

(2-6). In other embodiments of this case, since the assessment and analysis of gait disorders in this case only provides a preliminary assessment for patient 50, and is not a further medical research, the case is not sufficient to provide sufficient resources and equipment. In the embodiments, based on general basic common sense, a preliminary assessment of patient 50 is provided to the physical therapist for reference, so as to find a corresponding exercise plan and improve the quality of daily life of patient 50.

(3). Technical features

(3-1). This case involves a hydrotherapy system suitable for people with gait disorders, comprising a liftable black walkway platform 100 and a hydrotherapy pool 62.

(3-2). A multispectral thermal imager 301 is installed at the lower end of the liftable black walkway platform 100 to capture the multispectral image of the gait of the gait-impaired person (patient 50) inside or outside the hydrotherapy pool 62, which is not available in current domestic and foreign hydrotherapy (water environment); and the gait footprints described in other previous technologies or literature are only evaluated and analyzed on the road surface.

For example: This case uses multispectral imaging to replace the current evaluation and analysis methods (such as those published by Taiwan Industrial Technology Research Institute) that mostly use wearable sensors on the road surface.

At present, most domestic and foreign hydrotherapy pools (such as HydroWork in the United States) only have the function of exercise, but this case not only has the function of exercise but also has the function of evaluation and analysis.

For example, in the hydrotherapy pool of HydroWork in the United States, patient 50 can "practice walking with a cup in hand or practice putting on a shirt", but in the hydrotherapy pool 62, in addition to "practice walking with a cup in hand or practice putting on a shirt", in the hydrotherapy pool 62, the patient 50 can also evaluate and analyze the variation of the patient's footprints during the practice to infer whether his standing posture is correct? Whether he needs to practice adjusting his COP, etc.

Among them, in this hydrotherapy system, it is possible to capture multispectral images of the gait of the patient 50 (a person with gait disorder) "inside" or "outside" the hydrotherapy pool 62, so as to facilitate the physical therapist's evaluation and analysis and propose a corresponding exercise plan.

(3-3). In this hydrotherapy system, a VC temperature-changing plate 80 is used to enable the multispectral thermal imager 301 in the system to capture a "clearer" thermal image of the lower limbs of the patient 50 standing on the liftable black walkway platform 100.

(3-4).Only one patient 50 can stand on the black walkway 20 in this hydrotherapy system, so that when the patient 50 is in the hydrotherapy pool 62, the hydrotherapy mode of the patient 50 being tested in the warm water 61 "next to him" can be avoided.

(3-5). In this hydrotherapy system, the multispectral image of the patient 50 captured by the multispectral thermal imager 301 can be sent for observation or recording.

(3-6). On the black walkway 20 in this hydrotherapy system, because a near-infrared auxiliary light source with a wavelength of 940nm LEDs is used, the patient 50 standing on the black walkway 20 will not be distracted during the test.

(3-7). On the black walkway 20 in this hydrotherapy system, a protective unit including a wide-bottomed handrail, a weight-reducing sling and a walker can be placed to make the patient 50 feel at ease and not afraid.

(3-8). This case involves a gait disorder assessment and training method, which is applicable to people with gait disorders, wherein the assessment method includes multispectral images captured in the on-road assessment and analysis method 200 and the underwater assessment and analysis method 300;

(3-9). The training method includes the training plans shown in Figures 7B, 8, 8A, and 8B, thereby finding the COP movement trajectory image data of patient 50, and further adopting the corresponding intravenous pressure therapy training method.

The multispectral images captured by this gait disorder assessment and training method can achieve early diagnosis of 50% of patients and help find the best training process.

This gait disorder assessment and training method includes, as shown in Figures 7B, 8, 8A, and 8B, an assessment and training method for the deviation of the gait disorder of patient 50 and the gait time/space parameters of a normal person.

Patentability discussion:

In order to find out that "image difference" and "fall probability" have a certain degree of correlation, as shown in the above-mentioned embodiment diagram and explanation, "image difference" and "fall probability" both involve COP, and COP involves the center of gravity COG of the human body, and COG affects the area and outer contour of the footprint.

Obviously, the probability of 50 patients falling can be predicted by the image differences of 50 patient footprints.

This case is the result of many explorations and experiments by the inventor team to try various possible reasonable combinations. The final improvement has exceeded the use of previous technical components. It is beyond the expectations of common thermal imager users, Case No. I 666935 and Case No. I 425292, etc., and is not something that can be easily achieved by people with general knowledge in this technical field!

201: Road surface

60: Hydrotherapy pool

61: Pool water

62: Pool body

621:Window

63: Water source device

Claims (13)

A hydrotherapy system for people with gait disorders includes: a liftable black walkway platform, which includes liftable pillars, a black walkway, a multispectral thermal imager, and a protective unit; and a hydrotherapy pool, which includes a pool body, a water source device, and a window. The hydrotherapy system uses the liftable black walkway platform and the hydrotherapy pool to capture multispectral images of the footprints of the person with gait disorders inside and outside the hydrotherapy pool, thereby achieving the dual functions of assessment and corresponding exercise. According to the hydrostatic water therapy system described in item 1 of the patent application, the liftable black walkway platform further includes a VC temperature changing plate and its controller. According to the hydrotherapy system described in item 1 of the patent application, the front and back sides of the black trail are divided into a test area and a scale. According to the hydrotherapy system described in item 1 of the patent application, the water source device includes water circulation, replacement and cleaning, disinfection and sterilization, and supply and temperature control of hot and cold water. According to the hydrotherapy system described in item 1 of the patent application, the multispectral thermal imager includes a near-infrared auxiliary light source of LEDs with a wavelength of 940nm. According to the hydrotherapy system described in item 1 of the patent application, the protective unit includes a wide-bottomed handrail or a weight-reducing sling or a walker. An assessment and analysis system is applicable to the footprints of people with gait disorders, which includes assessment mode, assessment method, assessment object, assessment items and images, audio-visual guidance method and physical therapist coaching method to assess the position of the body's center of gravity reaction, as an assessment and analysis and training plan for taking corresponding hydrotherapy pools. By means of the assessment and analysis system, the person with gait disorders can achieve the indicators of the footprint COP area and movement trajectory to assess the balance ability and help find the best training plan process. According to an evaluation and analysis system described in Item 7 of the patent application, the image includes three types of footprint images: far infrared with a wavelength range of 8 to 14 um, near infrared with a wavelength range of 0.8 to 1.0 um, and visible light with a wavelength range of 0.4 to 0.8 um. According to an evaluation and analysis system described in Item 7 of the patent application, the position of the body's center of gravity reaction further includes a connection line between the body's COP and COG. According to an evaluation and analysis system described in Item 7 of the patent application, the evaluation and analysis system further comprises a hydrotherapy pool. According to an evaluation and analysis system described in item 10 of the patent application, the hydrotherapy pool further includes warm water, a pool body, water source equipment and a window. According to an evaluation and analysis system described in Item 11 of the patent application, the body of the pool is made of reinforced thick transparent glass. According to an evaluation and analysis system described in Item 8 of the patent application, the visible light includes a window image of the pool body.