MEDICAL DEVICE FOR A PERSON'S JOINT AND METHOD FOR OPERATING A MEDICAL DEVICE

Description

[0001] The invention relates to a medical aid for a joint of a person, wherein the aid has at least two parts to be applied to the joint, movable relative to each other through the joint, and at least one detection device for detecting a relative movement of the parts, as defined in independent claim 1.

[0002] Medical aids for various joints have already been proposed in numerous forms in the prior art and include, for example, bandages, orthoses, belt systems, stockings, and other garments, particularly those with a compressive effect. For the purposes of this description, "medical" is also to be understood in the sense of sports applications characterized by intended positive effects on anatomy, health, and / or performance, based on medical considerations. Medical aids of this type for joints therefore also include, for example, sports bandages and the like. Furthermore, for the purposes of this description, the spine is also to be understood as a joint or a group of joints to which medical aids can be applied.

[0003] The medical device can also exist independently of such treatment devices, which can be formed by or comprise the aforementioned components. For example, it can be explicitly designed to capture joint movement as a relative movement of the components, thus constituting, in particular, an add-on or accessory for a treatment device such as an orthosis, a bandage, a stocking, or the like. In the case of medical treatment devices or, more specifically, treatment units, the two components can be formed by separate parts, which, for example, are rigid and connected to each other by joints. However, it is also possible for the components to be formed as sub-sections of a single flexible object, such as a stocking.

[0004] Individuals who use medical devices, particularly those intended for therapeutic treatment and / or joint protection, tend to adopt or perform protective postures or movements that can lead to adverse effects during treatment with the device. For example, if the device includes an orthosis that restricts the range of motion of a joint, such as a knee, the individual will typically not use the full range of motion permitted by the orthosis, but rather a significantly smaller range, which may also be considerably less than the range of motion desired by a therapist. This can be detected by a sensor on the device that records the relative movement of its components.

[0005] For example, WO 2016 / 176544 A1 discloses a sensor and feedback platform for use in orthotic and prosthetic devices. Parameters measured by sensors, which can describe movement, are supplied to data processing and / or data display units for evaluation and / or the execution of actions. Specifically, it is proposed to use an inductive sensor as the sensor mechanism, which interacts with conductive material in a band or strip to generate sensor data indicating the position of the inductive sensor relative to the band / strip.

[0006] Unfortunately, such a platform only allows for retrospective determination that the used range of motion did not correspond to a desired or even maximum permissible range, in order to then inform the person using the orthosis or prosthesis. This limits the potential for improvements in utilizing the range of motion, as there is no intuitively understandable connection between the evaluation and the previously performed movements. However, the use of compensatory postures or movements leads to deficits in muscle strength and / or motor function when wearing a medical device, which is undesirable.

[0007] US 2002 / 0146672 A1 concerns a method and system for individually practicing one or more parameters of hand movement in a virtual reality environment, which also provides performance-based interaction with the user to improve user motivation. Specifically, a sensor glove can be used to measure the positions of the patient's fingers and wrist flexion. Measured data is forwarded for evaluation, in particular to a virtual reality simulation module. For example, virtual simulation exercises for ranges of motion should be possible to improve finger flexion and extension. Target ranges for the exercises can be predefined, with the new target range always being defined according to the preceding performance.

[0008] WO 2014 / 176353 A1 concerns a portable rehabilitation monitoring device that can be used by patients and medical personnel to monitor progress and compliance in home-based rehabilitation programs. This device is worn by the patient during exercises and includes suitable sensors, such as a goniometer, to monitor the range of motion. The device may also include a feedback component.

[0009] US Patent 5,429,140 A concerns a rehabilitation system that uses a force feedback system, such as a force feedback glove, to simulate virtual deformable objects. Prior to rehabilitation, a measurement is taken on a real object to determine the patient's basic ability. This allows rehabilitation control signals to be generated for the virtual objects, so that, for example, when using a glove, the user experiences the sensation of holding a real object. Recorded diagnostic information is collected, and rehabilitation information is used to update patient data.

[0010] US 2010 / 0116277 A1 concerns a switchable joint restriction system in which motion sensor signals are compared with predetermined situations and joint restrictions are switched when certain predefined situations occur.

[0011] US 2016 / 0213924 A1 discloses patient therapy systems and procedures that utilize stimulation. A pair of stimulation electrodes is coupled to a device, which in turn can be coupled to a patient to trigger wired or wireless stimulation. A sensor is coupled to a controller, and the sensor can also capture range-of-motion (ROM) data to provide active feedback on the current range of motion. This can encourage the user to use muscles during a recovery period.

[0012] The invention is therefore based on the objective of providing an improved way to avoid protective postures, in particular without having to forgo any protective function that may be present in a treatment device.

[0013] This problem is solved according to the invention by a medical device according to claim 1. Advantageous embodiments are set out in the dependent claims.

[0014] According to the invention, a medical device of the type mentioned at the outset therefore has an evaluation unit which comprises: an investigation unit for determining the actual range of motion of the joint used when wearing the assistive device from data collected by the recording device, a comparison unit for comparing the used range of motion with a desired range of motion, and a support unit for determining a support instruction to guide the person to make the greatest possible use of the desired range of motion, depending on the comparison result, wherein the medical aid further comprises an output device for issuing the support instruction to the person, wherein the evaluation device is designed to control the output device for issuing at least one support instruction during an assessed movement.

[0015] The support unit is available for selection here. at least one output parameter, at least one of the at least one support indicator, wherein the output parameter is an intensity of a sound and / or a light signal and / or a volume of a sound, depending on a utilization measure of the desired movement range and / or approximation measure to a limit of the desired movement range determined from the comparison result.

[0016] Within the scope of the present invention, it is understood that, as mentioned at the outset, medically oriented sports aids are also to be considered medical aids. The aid can also be designed for the spine as a group of joints, so that, in other words, it is a medical aid for a joint or the spine. Other joints in which such a medical aid can be used include, for example, knee joints and / or elbow joints. The range of motion must also be parameterized in relation to the respective joint. In the case of a uniaxial joint, such as a knee, the range of motion can be defined by angles between which the movement takes place or is intended to take place. For example, a desired range of motion can be defined by a target angle in at least one direction of movement, such as flexion and / or extension in the case of a knee.

[0017] The medical device can be a standalone device, but preferably it is at least associated with, or includes, a treatment system, particularly one comprised of or encompassing its components. Treatment systems can include, for example, bandages, orthoses, garments (especially compression garments), belt systems, and / or splint systems. In particular, it is conceivable that the device is, so to speak, associated with at least one treatment system as an accessory, a point which will be discussed in more detail below.

[0018] A fundamental idea of ​​the present invention is therefore to track the current movement of the joint using the detection device and to compare it, as close to real-time as possible, with a desired range of motion, for example, predefined by an adjustment device, in order to issue a support signal if necessary, guiding the person to utilize the desired range of motion to the greatest extent possible. In other words, the medical aid proposed according to the invention not only informs the person that, for example, unintentional protective postures are present, but also guides them towards a desired, and in particular, specifically predefined, range of motion, thus providing a kind of proactive approach.

[0019] In particular, if support notes are not to be issued in every instance, the support unit may include at least one notification criterion that evaluates the comparison result and, if this criterion is met, issues a support note. Different support notes may be assigned to different notification criteria, and / or different support notes may be determined, particularly through further evaluation of the comparison result, when a specific notification criterion is met.

[0020] Specifically, the indicator criterion can compare at least one measure of use with a threshold value, for example, to what extent the desired range of motion is utilized and / or for what proportion of movement cycles of the joint it has been sufficiently utilized, for which a further threshold value may be provided if necessary.

[0021] In other words, the support unit, by evaluating the comparison results, provides the individual with information when the level of use is too low, guiding them towards better utilizing their movement possibilities and achieving the desired range of motion. Preferably, information describing the specific nature of the usage deficiency can be derived from the comparison results and considered when configuring the support message, particularly the timing of the message. For example, in the case of a knee, the usage deficiency might be identified as insufficient flexion due to a significant deviation from the target flexion angle that defines the desired range of motion.By configuring the support prompt based on the type of functional impairment, the system effectively communicates to the individual where there is potential for improvement. A preferred design also considers the current movement state when configuring the support prompt, particularly for timing the prompt and / or guiding the individual to adapt their movement state to better utilize the desired range of motion.

[0022] In summary, the support instruction based on the comparison result is generally designed and timed in such a way as to convey information leading to better utilization of the desired range of motion, especially intuitively and in the movement situation itself.

[0023] The desired range of motion, which is preferably predefined or adjustable via an adjustment device, ultimately corresponds to a goal towards which the person, for example a patient or athlete, is guided or led by appropriately designed support instructions. In particular, it is thus possible to guide a patient from a currently used range of motion corresponding to protective postures or movements to a therapeutically beneficial, currently desired range of motion, which can be individually specified by the therapist.

[0024] As already explained, while a medical device may only be associated with a treatment device, it preferably incorporates the treatment device itself, thus ultimately adding further functionality to it. Specifically, the device, particularly as a treatment device and / or realizing its components, may include at least one stocking-like enclosing section that can be pulled over the joint and / or wrapped around the joint like a bandage and / or designed as a garment and / or as a belt system, and / or at least one joint guidance element, in particular at least two articulated, rigid joint guidance elements. A treatment device formed in this way may therefore be, in particular, a bandage, an orthosis, a stocking, a back brace for the spine, a garment, and / or a belt system.

[0025] It should be noted at this point that when assigning a medical device to a treatment facility, this does not have to be permanent or fixed, but it is quite conceivable, for example, to use the medical aid, which is particularly detachable and can be connected to a treatment facility, over an entire therapy or the like, for example first with an orthosis as a treatment facility, then with a bandage as a treatment facility, followed by a stocking as a treatment facility and finally with a belt or similar as a treatment facility.

[0026] Specifically, the detection device may include at least one sensor that is integrated into at least one component or attached, either detachably or permanently, to at least one component and / or a body part that moves with a component. It should be noted again here that the components that move relative to each other do not necessarily have to be two separate components of the assistive device or treatment device; it is also conceivable to use a flexible component, in which case the components are formed by sections of the component. Such flexible components could include, for example, the aforementioned stocking, compression bandage elements, flexible splints, straps, and / or the like. Particularly when the components are implemented as part of a surrounding section, it may be advantageous to integrate sensors or...The sensor components of the detection device can be integrated directly into the corresponding component, for example, the surrounding section, or specific means for releasable attachment to the respective component, specifically to the individual components, can be provided. For releasable attachment, hook-and-loop fasteners, snap fasteners, and similar devices can be used, for example. This is particularly advantageous when the components, or more specifically the treatment device and the way they are applied, already define suitable positions for the sensors of the detection device, so that ultimately, the fasteners can be used to attach the sensors to defined positions on the respective components.

[0027] In a further specific embodiment, the detection device can be configured to measure a distance between two sensors and / or sensor components and / or a joint angle and / or at least one dynamic parameter of the joint movement, in particular an angular velocity and / or an angular acceleration. For example, in the case of a uniaxial joint, the movement of the joint and thus of its components relative to each other occurs as a pivoting motion about this joint axis. Two sensors or two sensor components of a single sensor can measure the distance between the sensors or sensor components and thereby infer a joint angle or, over time, dynamic parameters. Of course, its use with joints with multiple joint axes is also conceivable, for example, with ball joints and the like.With regard to the application of the medical aid to a spine, more complex movement ranges can also be defined, in particular those that depict the movement of several individual vertebral joints together.

[0028] Advantageously, at least one sensor may employ a measuring principle utilizing magnetism and / or induction. Such sensors, as described, for example, in the aforementioned WO 2016 / 176544 A1, are particularly suitable for measuring the movement of the components relative to each other with sufficient accuracy; however, other sensor principles are also conceivable, such as capacitive distance sensors and the like.

[0029] It is advantageous to locate at least some of the components of the medical device, particularly the evaluation unit, remotely from the joint, and thus externally from a treatment device. Parts of the detection unit can also be located remotely from the joint or a treatment device. While it is generally conceivable to implement wired communication between such spatially separated components of the medical device, the present invention prefers to use wireless communication, particularly radio communication, to minimize interference with the user. For example, proprietary or standardized wireless communication methods can be used, such as Bluetooth or similar technologies.Such wireless communication can take place, for example, between the evaluation unit and the acquisition unit and / or subcomponents thereof.

[0030] Within the scope of the present invention, it is of course also possible to arrange the entire medical device, in particular the detection device, the evaluation device, and the output device, on the joint itself, especially on or as part of a treatment device. Compact designs are particularly possible in this regard, which then preferably include haptic and / or acoustic output devices.

[0031] Preferably, the assistive device may include an adjustment mechanism for setting the desired range of motion of the joint that the person is to use while wearing the device. While it is generally preferred within the scope of the present invention to allow manual adjustment of the desired range of motion, for example by a therapist or another user, or possibly even the person themselves, in many embodiments it may also be advantageous, preferably additionally or alternatively, to allow automatic adjustment of a desired range of motion by the adjustment mechanism. For this purpose, for example, a therapy progress, possibly determined by the detection device itself, and / or a predefined therapy plan may be used.

[0032] In one embodiment of the invention, the adjustment device can comprise an electronic and / or mechanical adjustment means, particularly a handheld mobile device, which may be separate from a treatment device formed by the components. This means that the adjustment device can be configured in a variety of ways within the scope of the invention. In particular, if a corresponding adjustment means of the adjustment device is provided near a joint, especially on a treatment device, the adjustment process can also include a mechanical component, for example, by moving the at least one joint or at least the adjustment device into a position that limits the desired range of motion, which can then be stored accordingly.It is particularly advantageous, especially for the manual and / or automatic adjustment of the desired range of motion, to provide electronic adjustment mechanisms, which can be implemented, at least in part, via a handheld mobile device. This handheld mobile device, such as a mobile phone, can, for example, have a user interface through which desired ranges of motion and / or criteria for their automatic determination can be entered. For this purpose, a corresponding computer program, i.e., an application (app), can be provided for a smartphone and / or tablet used as a handheld mobile device.

[0033] Particularly with regard to such a design, a particularly preferred embodiment of the present invention provides that the mobile device additionally comprises a computing unit designed as at least part of the evaluation unit, on which an application is provided that configures the mobile device as a setting means and as part of the evaluation unit. In an exemplary embodiment, it can therefore be provided that the handheld mobile device communicates, preferably wirelessly, with the detection unit and evaluates the detection data of the detection unit by means of the computing unit, in particular to compare the used range of motion with a desired range of motion and to determine whether a support message should be issued and / or how the support message must be parameterized in order to guide the person to make the most extensive possible use of the desired range of motion.In this context, an output device of the handheld mobile device can also serve as an output unit, for example, a speaker for the acoustic output of a support instruction and / or a display, particularly a touchscreen, for the visual output of a support instruction. In this way, the features and / or computing power of the handheld mobile device are optimally utilized, allowing only a few components of the medical device to be located on the joint itself. For example, it is advantageous if only the detection device and, if applicable, the treatment device need to be positioned on the joint itself.

[0034] Another embodiment, which may be used in addition to a handheld mobile device as an adjustment means, provides that the adjustment device, in particular comprising at least one adjustment knob that uses a current joint position as a limit, for example, maximum or minimum, of the desired range of motion, is implemented on or as part of the treatment device and / or is designed to evaluate data from the acquisition device to determine a current joint position as a limit, for example, maximum or minimum, of the desired range of motion. In a specific further development, it is therefore conceivable that, for example, the treatment device has an adjustment knob, such as a "Set" button, to use current joint positions to define the desired range of motion.In this context, data from the recording device can be used to identify the current joint position, although other configurations are of course conceivable. It should be noted that a control element corresponding to a "Set" button (adjustment button) can, of course, also be implemented on the user interface of a handheld mobile device. In both configurations, i.e., both at the treatment device and...If at least one component of the device has a dedicated adjustment button and / or an adjustment button implemented via a user interface of the mobile device, a "Reset" button can be provided in addition to such a "Set" button. This "Reset" button can be used, for example, when repositioning the medical device, specifically at least its components, on the patient, to reset all settings and / or, for example, to display basic positions for calibrating the detection device.

[0035] It should be noted at this point, particularly with regard to manual adjustment via the settings device, that further settings can of course also be made via the settings device with appropriate training, especially the setting of support parameters related to the support prompt. For example, in addition to specifying a desired range of motion, it is also possible to define portions of the desired range of motion in which support should actually be provided (see also the prompt criterion discussed above), at which (also relative) times support should be provided, what the general intensity of the support prompt should be, and so on.Furthermore, it may be provided that at least one additional area parameter assigned to the desired range of motion can be set via the setting device, in particular a time parameter describing the period over which the comparison is to be evaluated and / or a type of movement for which the desired range of motion is to be applied.

[0036] As already mentioned, the adjustment device need not be (exclusively) suitable for manually adjusting the desired range of motion, but can also implement at least partially automatic determination of the desired range of motion. Thus, a preferred embodiment of the present invention provides that the adjustment device is designed to at least partially automatically determine the desired range of motion by evaluating person-specific predefined data and / or historical data, captured by the detection device, describing the joint movement of the person over a past period. Person-specific predefined data can, for example, describe the state of health and / or the progress of therapy and / or a desired type and / or speed of treatment.In particular, the target data can also include a treatment plan in which different desired ranges of motion are assigned to different time periods. These time periods do not need to be fixed, as the progress of the therapy can be tracked, for example, by evaluating data recorded by the monitoring device. For instance, if the descriptive historical data recorded by the monitoring device indicates that the previously intended range of motion is being used sufficiently in a past time period, the treatment can proceed to a new time period with an expanded desired range of motion.In other words, the desired range of motion to be used can be automatically adjusted depending on the person's behavior and / or their progress in therapy.

[0037] In preferred embodiments of the present invention, the support unit can also be configured to use the current state of movement described by data acquired by the sensing device and / or the immediately preceding movement history of the joint when determining the support instructions to be issued. In other words, and in some cases more specifically, the support unit can take into account a phase of movement, in particular an approach of the movement state to an extreme position, and / or a movement history of the joint to determine the support instruction and / or the output time of the support instruction. For support instructions intended to lead to better utilization of the desired range of motion, the time of output or the current state of movement at the time of output is considered relatively important.For example, when considering knee movement, it is advantageous to encourage the person to extend the leg further when it is already in the extension process. Similarly, a different, distinguishable form of support during flexion can be particularly useful and easily understood by the person if the support cue occurs as the flexion process slows down towards the corresponding turning point.

[0038] Therefore, within the scope of the present invention, it is particularly advantageous to use the acquisition data to evaluate the current state of movement and / or the immediately preceding movement history of the joint in order to determine or predict when a turning point and / or stopping point of the movement is reached. Ultimately, it can be generally stated that support is provided that is tailored to the current state of movement, in particular a current phase of movement, and thus intuitively understandable to the person. In the case of a knee and / or another single-axis joint, the angular velocity can also be considered, and the support signal can be determined depending on the angular velocity. As already explained, shortly before turning, i.e., the turning point, the movement slows down, which is an indication that the turning point is approaching.Only then can, for example, support instructions for continuing the swing be given. Other movement phases, such as those of the knee joint, can of course also be identified and taken into account as part of the support, for example, a swing phase and / or a push-off phase.

[0039] It can be provided that the support unit for determining the support indication by evaluating the comparison result over a predetermined and / or predefinable period, in particular defined by a time parameter entered via the adjustment device, and especially as a number of movement cycles of the joint. Within the scope of the present invention, it is therefore possible to consider a period that may be user-adjustable in order to evaluate the utilization of the desired range of motion over this period and, based on this evaluation, to decide which type of support is most appropriate.For example, an analysis can be conducted over several cycles to determine, for instance, the average utilization rate of the desired range of motion and / or recurring "usage errors" or deficiencies, thus providing a sound basis for support recommendations. In particular, it can be advantageous to consider a rolling timeframe, thereby keeping the assessment results continuously up-to-date. This allows for a robust, well-founded determination of the required support and a correspondingly reliable design of support recommendations, without compromising their timeliness.

[0040] Within the scope of the present invention, the evaluation unit is designed to control the output unit for displaying at least one support message during an assessed movement. Output after the assessed movement is also possible. The output of the support message after an assessed movement is particularly advantageous immediately following the movement itself. The assessment can relate to the aforementioned period, in which case it is particularly expedient to implement the aforementioned "sliding period" in order to be able to react continuously to past changes, especially progress.While the person uses the joint, they receive relatively immediate feedback on the utilization of the desired range of motion and, in particular, directly actionable information on how to better utilize that range of motion in the form of support prompts. In the example of knee movement, for instance, an assessment can be made over several movement cycles, such as one to four, while walking. Then, during the ongoing movement, the corresponding result is displayed, especially at appropriate times within a movement cycle.For example, if the assessment reveals that the desired range of motion is used significantly less effectively during extension than during flexion, timely support cues can be provided when approaching full knee extension, guiding the person towards further extension. Conversely, when approaching maximum flexion, the support cues can be of lower intensity, indicating that while there is still room for improvement, the deviation is smaller. This intuitively conveys to the person that while there is still room for improvement in flexion, the primary problem lies in extension, which the person can then focus on, for example, at times highlighted by the support cue.

[0041] However, even if the assessment doesn't necessarily take place over a period of time, such targeted support can still occur. For example, during a flexion movement, the extent of the flexion can be predicted, perhaps based on a decrease in angular velocity. The system can then check how close this predicted angle is to the limit of the desired range of motion, and thus proactively provide support cues that guide the person toward further flexion if there is a significant difference from the limit of the desired range of motion. This approach therefore leads to movement-phase-specific support, which is more dedicated but potentially less robust and subject to greater fluctuations than an assessment over several joint movement cycles.

[0042] The output device can include a haptic and / or acoustic and / or visual output means. However, other output options are also conceivable, such as an olfactory output means or the like. Preferred designs utilize the output of the support message as a visual and / or acoustic, configurable output signal and / or also as a haptic signal, which will be discussed in more detail below.

[0043] The invention provides that the support unit for selection The support unit is configured to select at least one output parameter, at least one of the support cues, wherein the output parameter is the intensity of a sound and / or a light signal and / or the volume of a sound, depending on a utilization measure of the desired movement range and / or approximation measure to a boundary of the desired movement range determined from the comparison result. It may be provided that the support unit is configured to select at least one further output parameter, in particular the frequency of repetition of a sound and / or a light signal, of the at least one of the support cues depending on the utilization measure and / or approximation measure. The support cue may, in particular, be a pulsating or...A periodic signal is generally emitted, whereby, for example, the period and / or intensity can be adjusted depending on the comparison result. In the case of an acoustic signal, for example, similar to a parking warning system or the like, the repetition frequency of a tone can be increased as the boundary of the desired movement area is approached more closely, and / or reaching the boundary is acknowledged with a continuous tone. A reverse configuration (reducing the repetition frequency as the boundary of the desired movement area is approached more closely) is also conceivable within the scope of the present invention if this appears more intuitive to a certain group of people. Additionally or alternatively, the intensity, for example, the volume, can also increase the less effectively the desired movement area is utilized.Another specific embodiment of the present invention may also provide, for example, several individual light sources in the form of a scale as optical output means, for example, near the joint, in particular on at least one of the components and / or a treatment device. The better the desired range of motion is utilized, the more light sources of the scale can be illuminated, for example. In this context, it is also conceivable to progressively switch on or off output means at the joint that provide the support signal by means of vibration.

[0044] A particularly advantageous embodiment, which can be used in addition to an optical and / or acoustic output of the support instruction, provides that the medical device further comprises, especially as part of the output device, at least one stimulation device for at least one muscle of the person associated with the joint, which can be controlled by the evaluation device depending on the comparison result, and / or at least one electrical and / or mechanical drive means designed to change the relative position of the components, which can be controlled by the evaluation device depending on the comparison result. Such a stimulation device can, for example, comprise a vibrating cushion, which can be integrated, in particular, into a treatment device.Such a vibration cushion is positioned to specifically stimulate relevant muscle groups whose activation in the current movement state leads to improved utilization of the desired range of motion. For example, if the approach to an extreme position of a movement cycle slows down significantly too early, stimulation of muscles by the stimulation device can specifically achieve or encourage a continuation of the movement, thus generating a highly targeted haptic support cue.

[0045] However, it is also conceivable to use a specific electric and / or mechanical drive mechanism. This allows for the provision of clear haptic feedback, for example, to encourage the user to continue a movement phase beyond the original plan. This can be achieved by slightly increasing the angular velocity through the operation of the drive mechanism and the corresponding influence on the relative position of the components. The increase should be kept within limits, ensuring that a sufficiently large movement is not "forced," but rather primarily serves as a guide. For instance, the effect of such haptic feedback can be reduced to a maximum of 1 to 3° during a pivoting movement. Furthermore, it is also possible to use a purely mechanical drive mechanism to provide haptic feedback.For example, the release of a spring that supports a specific direction of movement can be considered; that is, the drive mechanism can have a spring that mechanically supports a particular direction of movement. The support unit can, for example, release and / or lock the spring to issue the support signal.

[0046] It should be noted at this point that the support instructions, which are issued during the movement of the joint, are in any case preferably designed in such a way that the movement sequence is not interrupted and / or disturbed, but is at most supported.

[0047] A particularly advantageous embodiment of the present invention provides that the evaluation unit includes a classification unit which, based on the acquisition data of the acquisition unit, classifies the current movement into a movement type class, with the support message being issued only if a movement type class corresponding to the assigned movement type is present. For example, historical data, in particular of the last movement cycles, can be evaluated to identify the movement type, for example with regard to a knee or the spine as a joint or joints, whether one is currently driving a motor vehicle, climbing stairs, walking along a level path, and the like.In particular, the support information can be limited to specific movement type classes, but it is also possible, of course, to differentiate between movement type classes in such a way that, for example, different movement type classes are assigned different desired movement ranges and / or different methods for determining the support information and / or different support information. For example, it can be provided that when at least one desired movement range assigned to a movement type is selected using the setting device, the evaluation device, in particular the classification unit, is configured to use the desired movement range for comparison only if a movement type class corresponding to the assigned movement type is present.In particular, when differentiating between different movement types, it is possible to adapt support instructions specifically to certain movement types, in order to work optimally towards achieving the therapy result, especially during a therapy phase.

[0048] A further development of the present invention provides that the medical device includes a limiting device for restricting the joint's range of motion to a permissible range. Such limiting devices, which are frequently used, for example, in orthoses as medical devices or treatment devices, thus make it possible not only to define a desired range of motion but also to establish a maximum permissible range of motion. In this context, it is particularly advantageous if the adjustment device for adopting the permissible range of motion set by means of the limiting device is designed as the desired range of motion. Therefore, a particularly simple definition of the desired range of motion as the permissible range of motion can be achieved when the latter is to be utilized to its maximum extent.

[0049] For the medical device, a method for operating the medical device of the type according to the invention for a joint of a person, comprising at least two parts to be applied to the joint, movable relative to each other through the joint, and at least one detection device for detecting a relative movement of the parts, is conceivable, wherein the method comprises the following steps: Determining the actual range of motion of the joint used when wearing the treatment device from data collected by the device, comparing the used range of motion with a desired range of motion, determining a support instruction to guide the person to make the greatest possible use of the desired range of motion depending on the comparison result, and issuing the support instruction to the person during an assessed movement.

[0050] Here, the support unit selects at least one output parameter, at least one of the at least one support indicator, wherein the output parameter is an intensity of a sound and / or a light signal and / or a volume of a sound, depending on a utilization measure of the desired movement range and / or approximation measure to a limit of the desired movement range determined from the comparison result.

[0051] All statements regarding the medical aid according to the invention can be applied analogously to the conceivable method, so that the advantages already mentioned can also be obtained with this method.

[0052] In particular, the procedure may also provide that the desired range of motion that the person is to use when wearing the aid is set on an adjustment device, especially based on user input.

[0053] Further advantages and details of the present invention will become apparent from the exemplary embodiments described below and from the drawing. The drawings show: Fig. 1 a sketch to illustrate the problem and solution approach underlying the invention, Fig. 2 a schematic diagram of components of a medical device according to the invention, Fig. 3 an orthosis as an embodiment of a medical device according to the invention, Fig. 4 the application of a medical device according to the invention in a bandage, Fig. 5 a handheld mobile device, Fig. 6 the application of the present invention in a back orthosis, Fig. 7 a flowchart of a first embodiment of a method for operating a medical device, Fig. 8 a flowchart of a second embodiment of a method for operating a medical device, and Fig. 9 a dependence of a signal's repetition frequency on the degree of use.

[0054] Fig. 1 The underlying idea of ​​the present invention is explained using the example of different ranges of motion (ROM) of a person's joint 1, indicated by the central point, for example, a knee joint. The maximum range of motion 2 of the joint 1, indicated by dashed lines, is limited by a limiting device of a treatment device used, in particular an orthosis, resulting in a permissible range of motion 4 bounded by lines 3. Due to protective postures and movements during the therapy phase, patients, or generally persons using the aforementioned treatment device, only utilize a small portion of the permissible range of motion 4, shown here as the range of motion 5 actually used when wearing the treatment device.

[0055] Furthermore, there also exists a therapeutically useful, desired range of motion 6, which can be described by the boundaries 7. The basic idea of ​​the present invention is to design a medical aid, which can be associated with or comprise the aforementioned treatment facility, in such a way that the patient is guided, by means of support cues symbolized by arrows 8, from the currently used range of motion 5 to the use of larger portions of the desired range of motion 6.

[0056] Fig. 2 Figure 1 shows a schematic diagram of such a medical device 9 according to the invention for a joint 1, here for example a knee joint or other single-axis joint, of a person 10 (indicated only). It is evident that parts 11 are provided on the body of the person 10, adjacent to the joint 1, which are moved relative to each other by the movement of the joint 1, indicated by the arrow. A detection device 13 (indicated only here), which may, for example, comprise two sensors 14 or parts of a sensor 14 configured to measure the relative position and / or relative orientation between them, measures the actual movement of the joint 1. Its detection data can be transmitted to an evaluation device 16 via a communication link 15 (indicated only here).The evaluation unit 16 initially comprises a determination unit 17, which uses the acquisition data from the acquisition unit 13 to determine the actual range of motion 5 of joint 1 used when wearing the medical aid 9, in the case of a single-axis joint, as shown here, in particular by tracking the joint angle and determining the maximum angles. It should be noted at this point that the acquisition unit 13 also describes dynamic parameters in its acquisition data, in this example an angular velocity.

[0057] A comparison unit 18 of the evaluation device 16 compares the actually used range of motion 5 with the desired range of motion 6. For example, the corresponding joint angles describing the used range of motion 5, in particular the maximum joint angles, can be compared with the maximum and minimum joint angles describing the limits 7. Ultimately, this yields at least one measure of utilization that indicates the extent to which the desired range of motion 6 is actually used, particularly with regard to each individual limit 7.

[0058] Finally, the evaluation unit 16 also includes a support unit 19, which determines a support instruction based on the comparison result. The support instruction is determined in such a way as to guide or direct the person 10 to utilize the desired range of motion 6 to the greatest extent possible, which will be explained in more detail below with regard to specific implementation examples.

[0059] It is not necessary to issue a support message at every time or in every situation, as the support unit can include at least one indicator criterion that evaluates the comparison result and, if this criterion is met, issues a support message, possibly after appropriate parameterization. Furthermore, it can be generally stated that, with regard to guiding person 10 towards greater use of the desired range of motion 6, it is advisable to consider the current movement status and at least the past movement history when designing the support message, particularly during its specific parameterization, so that the support message contains an intuitively understandable instruction for person 10 on how to achieve greater use of the desired range of motion 6.

[0060] The support information determined by support unit 19 can be output via a corresponding output device 20. This device can, for example, have appropriate output means for the visual and / or acoustic and / or haptic output of the support information, which will be discussed in more detail in the specific example.

[0061] In preferred embodiments, the medical device 9 according to the invention further comprises an input device 21 with at least one input means by which the desired range of motion 6 can be set manually and / or automatically, with user input being preferred. In particular, an input means can also be in mechanical form on the parts 11 or of a treatment device 22, which are located in Fig. 2 as also indicated, and which may also be part of medical aid 9, may be intended as a mechanical input device, for example in the case of the regarding Fig. 1 The previously mentioned limiting device allows for the mechanical definition of a desired range of motion 6. With regard to automatic definition, a therapist, acting as the user, can, for example, define a dynamic or fixed therapy plan for person 10, which, for instance, expands the desired range of motion 6 in successive periods to reflect different stages of therapy progress.The therapy progress can follow a defined temporal sequence, but it is preferable to track the therapy progress using the recording data, since in particular the aforementioned usage measure, which determines the comparison unit 18, provides an excellent indication, as it shows to what extent a desired range of motion 6 is already being used, so that this can be taken into consideration if necessary in order to progress to the next therapy stage and thus to an expanded desired range of motion 6.

[0062] Such a therapy plan may also involve the use of different treatment devices 22, for example, an orthosis, then a bandage, and finally a belt system or the like. Since the components and / or the at least one sensor can preferably be detachably attached to the treatment device 22, to which the components 11 may also belong, for example via hook-and-loop fasteners, which may also apply to other components of the medical device 9, the medical device 9 can therefore, in certain configurations, also be used with different treatment devices 22.

[0063] It should be noted at this point that the components 11 may, but do not necessarily, belong to the treatment device 22. For example, in the case of an orthosis (treatment device 22), the components 11 could be rigid joint guide elements that are articulated. However, it is also possible that the components 11 are formed by sections of a flexible component of the treatment device 22 or the medical aid 9, for example, compression material in the case of a bandage.

[0064] Furthermore, it generally applies that the evaluation unit 16, the output unit 20, and the setting unit 21 can be implemented at least partially on the treatment unit 22, i.e., close to the joint, and / or at least partially external to the treatment unit 22, in particular away from the joint 1, in which case the communication link 15 is preferably a wireless communication link. Specific configurations will be explained in more detail below.

[0065] As described, sensor 14 preferably measures the relative position and orientation to the other sensor 14 or, in particular, to the passive sensor component on the other part 11. Magnetic and / or inductive measuring principles can be used, for example, by providing magnetic material on one part and a corresponding magnetic field sensor on the other part 11. Other conceivable embodiments include providing conductive material on one part 11 and induction sensors on the other part 11.

[0066] Fig. 3 Figure 1 shows a first, concrete embodiment of a medical device 9a according to the invention, comprising an orthosis 23 as a treatment device 22. Only the components of the medical device 9a provided at the joint 1, in this case a knee joint, are shown. The orthosis has two rigid joint guide elements 25 coupled via a joint 24, which can be held on the thigh and lower leg of the person 10 by means of straps 26. The sensors 14, or sensor components of the sensor 14, are arranged on the straps 26 that are inner with respect to the knee joint, but can also be provided on the joint guide elements 25. The sensor elements 14, which form the detection device 13, can, for example, be integrated into the straps 26.

[0067] Fig. 3 Figure 20 also shows various possible configurations of output means for the output device 20. One example is a scale-like output means 27, preferably comprising haptic output elements, which is less preferably optical. The output elements of this scale-like output means can be activated sequentially, for example, as the desired range of motion 6 is approached fully, in order to indicate this to the person 10. Figure 20 also shows a further preferred acoustic output means. Fig. 3 The orthosis 23 also includes a loudspeaker 28, located on one of the rigid joint guide elements 25, through which tones, and optionally speech outputs, can be emitted as support information. A preferred design features repeated tones whose repetition frequency and / or volume and / or pitch can be varied depending on how well the desired range of motion 6 is actually used by the person 10.

[0068] A particularly intuitive and feasible design has proven to be based on the parking warning system of a motor vehicle, in which, for example, a higher repetition frequency indicates a closer approach to the limits 7 of the desired movement range 6. The pitch of the tone can, for example, convey the limit 7, i.e., in the direction of flexion or extension, to the person 10. It is already advisable to make the output dependent on the current movement phase or state, for example, to issue support instructions related to flexion when approaching the turning point of the movement in extension, and similarly for flexion.

[0069] Other preferred, optional haptic output methods are shown Fig. 3 in the form of a vibration cushion 29 provided on the thigh, via which relevant muscle groups can be stimulated, for example as a haptic indication to maintain a direction of movement for longer, and an electrical drive means 30 on the joint connection 24, which within a certain range, preferably only in an indicative manner, can further force the movement in one direction, for example when it slows down, in order to give a hint to person 10 that there is still more desired range of motion.

[0070] Fig. 3 Figure 31 further indicates a limiting device 31 on the joint connection 24, via which a permissible range of motion 4 can be set. As already explained, the limiting device 31 can also be understood as a mechanical adjusting means for the adjusting device 21, which in this case can be supplemented by an adjusting knob 32, for example, a SET knob. For example, a desired range of motion 6 can first be set via the limiting device 31 by using the SET knob 32, after which it is still possible to further extend the permissible range of motion 4 compared to the desired range of motion 6 by subsequently adjusting the limiting device 31. A further RESET knob 33 may also be provided. It can be used, for example, when the orthosis 23 is newly fitted.

[0071] Fig. 4 Figure 1 shows the use of a medical device 9b with a bandage 34 as a treatment device 22, whereby the bandage 34 does not necessarily have to be part of the medical device 9b. For the sake of clarity, only the at least one sensor 14 and sensor-side components of a fastening device 35, here a hook-and-loop fastener, which form the parts 11, are shown. By means of the fastening device 35, the at least one sensor 14 and the parts 11 can thus be detachably attached to the bandage 34, in particular at predetermined positions, whereby the other components of the medical device 9b (evaluation device 16, output device 20 and input device 21) are not shown as they are provided externally to the joint.

[0072] In this regard, it shows Fig. 5 One possible embodiment in which a handheld mobile device 36, here a smartphone 37 or tablet, is used at least partially as an evaluation device 16, output device 20, and setting device 21. For this purpose, the mobile device 36 has a computing device 38, in particular comprising at least one processor, on which an application 39 (app), i.e., a computer program, is provided that implements the corresponding parts or components of a medical device 9, 9a, 9b.

[0073] For example, a touchscreen 40 can be used as an input device for the input unit 21 via the application 39 to input desired movement ranges 6 or predefined data to be used for their automatic determination. Furthermore, the display of the touchscreen 40, just like a loudspeaker 41, can also be used as an output device for the output unit 20. The computing unit 38 can at least partially implement the determination unit 17, the comparison unit 18, and / or the support unit 19.

[0074] Fig. 6 Figure 9c shows the use of a medical device 9c in a treatment device 22 designed as a back orthosis 42. The back orthosis 42, which is assigned to the spine as a joint or joint group, has a back splint 43 that is held in place by a strap system 44. In this case, a large number of sensors 14 are arranged along the back splint 43, which acts as a joint guide element, in order to measure the movement of the spine as precisely as possible. Ranges of motion 4, 5, and 6 can be described, for example, by local movement limitations or the like.

[0075] Again, for the sake of clarity, further components of the medical device 9c are not shown; the back orthosis 42 may, but does not have to, be part of the medical device 9c as a treatment device 22.

[0076] It should be noted at this point that the belt system 44, the bandage 34, and the straps 26 ultimately form enclosing sections which, if the treatment device 22 belongs to the corresponding medical aid 9, 9a, 9b, 9c, can serve at least partially as components. Furthermore, it should be pointed out that, similar to the bandage 34, a stocking or other article of clothing can also be used as a treatment device 22 or as part of the medical aid 9, 9a, 9b, 9c.

[0077] Returning to Fig. 2 Furthermore, the evaluation unit 16 can also include a classification unit 45, which, based on the data acquired by the acquisition unit 13, can classify the current movement into a movement type class. In particular, it may be provided that support instructions are only issued for at least one specific movement type, that different support instructions or different desired movement ranges 6 are defined for different movement type classes, and so on. For example, it may be desirable to provide different desired movement ranges 6 or different support instructions for a knee joint than for joint 1 when climbing stairs and when walking normally on a level surface.

[0078] The data collected, especially over a defined past period, can clearly indicate which movement type class is currently being used.

[0079] With reference to the Figuren 7 und 8 Exemplary embodiments of a procedure that can be carried out using the described medical devices 9, 9a, 9b, 9c will now be explained in more detail.

[0080] In the exemplary embodiment according to Fig. 7 In step S1, the data is recorded using the recording device 13.

[0081] In step S2, the detection unit 17 of the evaluation unit 16 is used to determine the actual range of motion 5 of joint 1 used when wearing the treatment device from the acquisition data, whereby further analyses of the acquisition data are also carried out. In the case of the exemplary embodiment of the Fig. 7 This is because not only the current state of movement is considered, but also the immediately preceding movement history and / or dynamic parameters, such as angular velocity in the case of a single- or multi-axis joint. In this case, a knee will be examined more closely during a cyclic movement. This movement typically consists of sequences of extension and flexion, with these two processes alternating at inflection points that represent the limits of the actually used range of motion. As the state of movement approaches an inflection point, this manifests itself, for example, in a reduction of angular velocity. This makes it possible to determine, even before reaching the inflection point, that one is approaching this point, and in particular which inflection point, and also to predict how far the current movement process is likely to proceed, specifically, to what joint angle.

[0082] Based on the information gathered in step S2, step S3 checks whether a relevant movement phase or state is present. This can be considered an initial indicator criterion, as it ultimately verifies whether an intuitively perceptible, and therefore meaningful, support indicator is possible in the current movement state or phase. If not, the process returns to step S1; otherwise, it proceeds to step S4. In step S4, the comparison unit 18 of the evaluation unit 16 checks how closely the predicted turning point approaches the corresponding boundary 7 of the desired range of motion 6 in the specific example. In the example of the knee as a single-axis joint, for instance, an angular distance between the boundary 7 and the predicted turning point can be determined.Of course, more complex analyses / measures of use are conceivable in other implementation examples.

[0083] In step S5, a further indicator criterion can be used to check whether the deviation from limit 7 determined in step S4 actually requires a support indicator. If this is not necessary, for example, because limit 7 is reached (or even exceeded) anyway, the process returns to step S1. It should be noted, however, that it is also conceivable to issue a confirmatory support indicator even when the movement range 6 is fully or almost fully utilized.

[0084] In step S6, the support note is then determined depending on the comparison result of step S4, in order to be output in step S7.

[0085] In step S6, the support cue is parameterized based on the information gathered from the data collection and, in particular, the comparison result. For example, the intensity of a support cue that intuitively encourages further movement towards the limit 7 can increase as the angular distance from the limit 7 increases. If, for instance, a stimulation device such as the vibration cushion 29 and / or a drive device 30 is used, stronger stimulation / support cues can be provided if the person 10 is to be advised to continue a current movement, such as extension or flexion, for a longer period. The same applies to acoustic and / or visual support cues; however, it may also be appropriate to intuitively convey an approach towards the limit 7 through higher intensity.

[0086] Fig. 8 shows a second one, alternatively or also in combination with Fig. 7 usable embodiment of the method.

[0087] There, too, in step S1, the movement is measured by recording data. In step S2, however, the investigation unit considers several movement cycles. This means that past recording data describing the movement history in the period immediately preceding the present time is also used, resulting in a more robust description of the currently used movement range 5. For example, weighted averages can be calculated for extreme positions, and so on. Continuous updates are performed with all new recording data, meaning a moving average is considered to enable a rapid response to changes, especially improvements or deteriorations, with regard to the desired movement range 6.

[0088] In step S4', the comparison takes place in the comparison unit 18, since in this embodiment continuous information, as guidance or direction of the person, is desired anyway through support instructions.

[0089] Nevertheless, in step S5', which is optional, a review of the indicator criteria can be carried out to determine whether a support indicator is even necessary. Particularly when the ultimate goal is to provide continuous guidance to person 10 towards improved utilization of the desired movement range 6, it may be desirable to discontinue issuing support indicators once sufficient utilization has been achieved.

[0090] In step S6', analogous to step S6 in Fig. 7 The support message is determined and output in step S7. In this embodiment, it is preferred to use a tone sequence whose repetition frequency depends on the degree of use, in particular the approach to the limits 7.

[0091] Such an exemplary dependence of a tone's repetition frequency f on the utilization rate N shows Fig. 9 The value 46 indicates essentially complete utilization of the desired movement range 6. Initially, a low repetition frequency is evident, which increases significantly with increasing utilization in range 47, thus intuitively conveying this approach to the limits 7, similar to a "parking warning system". From the value 46, range 48, a continuous tone can be emitted and / or the support message can be deactivated due to reaching the maximum possible utilization of the desired movement range 6.

[0092] Finally, it should be noted that this is not only the case in the exemplary embodiments according to Fig. 7 und Fig. 8 It is not only provided that the support instructions are intuitively assigned to the movement during the movement itself, but also, in principle, in all embodiments of the invention, that they are output immediately after the assessment, in a manner that is readily assignable to the movement. This improves the assignment, particularly when reacting to specific movement phases or predictions, and thus also the guidance and support effect for improved utilization of the desired range of motion 6. Furthermore, it should be noted in general that the support instructions preferably do not disturb or interrupt the movement itself, thus intuitively integrating into the movement sequences and leading the user to improved utilization of the desired range of motion 6.

Claims

1. Medical aid (9, 9a, 9b, 9c) for a joint (1) of a person (10), the medical aid having at least two parts (11) which can be positioned on the joint (1), and are movable in relation to one another by the joint (1), and having at least one detection device (13) for detecting a relative movement of the parts (11), characterized by an evaluation device (16) having: - a determination unit (17), by means of which a movement range (5) of the joint (1) that is actually in use when the aid (9, 9a, 9b, 9c) is being worn is determined from detection data from the detection device (13), - a comparison unit (18), by means of which the movement range (5) used is compared with a desired movement range (6), and - an assistance unit (19), by means of which an item of assistance information which causes the person (10) to make as extensive use as possible of the desired movement range (6) is determined in dependence on the comparison result, wherein the medical aid (9, 9a, 9b, 9c) also has an output device (20) for outputting the item of assistance information to the person (10), wherein the evaluation device (16) is designed to activate the output device (20) for outputting the at least one item of assistance information during an assessed movement, characterized in that the assistance unit (19) is designed for selecting • at least one output parameter of at least one of the at least one item of assistance information, wherein the output parameter is an intensity of a sound and / or of a light signal and / or a volume of a sound, • in dependence on an extent of use of the desired movement range (6), the extent of use being determined from the comparison result, and / or an extent of approach to a limit (7) of the desired movement range (6).

2. Medical aid (9, 9a, 9b, 9c) according to Claim 1, characterized in that the aid (9, 9a, 9b, 9c) has at least one stocking-like enclosure section to be pulled over the joint (1) and / or to be wrapped in a bandage-like manner around the joint (1) and / or in the form of an item of clothing and / or in the form of a strap system (44), and / or has at least one joint-guiding element (25), in particular at least two rigid joint-guiding elements (25) coupled in an articulated manner.

3. Medical aid (9, 9a, 9b, 9c) according to Claim 1 or 2, characterized in that the detection device (13) comprises at least one sensor (14), which is integrated in at least one part (11) or is fastened, or can be fastened, detachably or non-detachably on at least one part (11) and / or a body region moving with a part (11), and / or is designed for measuring a distance between two sensors (14) and / or sensor parts and / or for measuring a joint angle and / or at least one dynamic variable of the joint movement, in particular an angular velocity and / or an angular acceleration, and / or the at least one sensor (14) has a measuring principle which uses magnetism and / or induction.

4. Medical aid (9, 9a, 9b, 9c) according to one of the preceding claims, characterized in that the aid (9, 9a, 9b, 9c) has a setting device (21) for setting the desired movement range (6) of the joint (1) that the person (10) is to use when wearing the aid (9, 9a, 9b, 9c).

5. Medical aid (9, 9a, 9b, 9c) according to Claim 4, characterized in that the setting device (21) comprises an electronic and / or mechanical setting means, in particular a hand-held mobile device (36), which exists in particular independently of a treatment device (22) formed by the parts (11).

6. Medical aid (9, 9a, 9b, 9c) according to Claim 5, characterized in that the mobile device (36) additionally has a computing device (38), which is formed as at least part of the evaluation device (16) and on which there is an application (39), which makes the mobile device (36) a setting means and part of the evaluation device (16).

7. Medical aid (9, 9a, 9b, 9c) according to one of Claims 4 to 6, characterized in that the setting device (21) is designed for at least partly automatically determining the desired movement range (6) by evaluation of person-specific default data and / or historical data detected by the detection device (13) and describing the movement of the joint (1) of the person (10) in a previous period of time.

8. Medical aid (9, 9a, 9b, 9c) according to one of the preceding claims, characterized in that a movement phase, in particular an approach of the state of movement to an extreme position, and / or a movement history of the joint (1) is / are taken into account by the assistance unit (19) for determining the item of assistance information and / or an output time of the item of assistance information.

9. Medical aid (9, 9a, 9b, 9c) according to one of the preceding claims, characterized in that the assistance unit (19) is designed for selecting at least one further output parameter, in particular the frequency of repetition of the sound and / or of the light signal, of the at least one of the at least one item of assistance information in dependence on the extent of use and / or extent of approach.

10. Medical aid (9, 9a, 9b, 9c) according to one of the preceding claims, characterized in that it also has, in particular as part of the output device (20), at least one stimulation device, which can be activated by the evaluation device (16) in dependence on the comparison result and is intended for at least one muscle, associated with the joint (1), of the person (10), and / or at least one electrical and / or mechanical drive means (30), which is designed for changing the relative position of the parts (11) and can be activated by the evaluation device (16) in dependence on the comparison result.

11. Medical aid (9, 9a, 9b, 9c) according to one of the preceding claims, characterized in that the evaluation device (16) has a classification unit (45), which classifies the current movement into a class of movement types on the basis of the detection data from the detection device (13), wherein the item of assistance information is output only in the presence of a class of movement types which corresponds to the associated movement type.

12. Medical aid (9, 9a, 9b, 9c) according to one of the preceding claims, characterized in that it has a limiting device (31) for limiting a movement range (2) of the joint (1) to an admissible movement range (4).