A wearable device, a method, and a system for providing a swallowing exercise and for providing feedback during a swallowing exercise

Abstract

A wearable surface electromyography apparatus for providing feedback during a swallowing exercise includes an electrode arranged to be in contact with the epidermis of a patient for collecting surface electrical signals relating to a muscle contraction, a processor coupled with the electrode for processing the collected surface electrical signals, and a wireless communicator coupled with a processor and operable to transmit the signals to a remote computing device. A method includes receiving, from at least one sensor, a signal representing a muscle contraction performed during a swallowing exercise, and plotting, on a display, together with a displayed symbol, a graphical representation of the received signal, such that it is visible on the display whether a characteristic component of the swallowing contraction signal corresponds with the target exercise component.

Description

[0001] A wearable device, a method, and a system for providing a swallowing exercise and for providing feedback during a swallowing exercise

[0002] Field of the Invention

[0003] The present invention relates to a wearable surface electromyography (sEMG) apparatus. The invention also relates to a method, in combination with a wearable sEMG apparatus, for monitoring and providing feedback during a swallowing exercise. The invention also relates to a method and system for providing a swallowing exercise and for providing feedback during a swallowing exercise.

[0004] Background to the Invention

[0005] Swallowing impairment - termed dysphagia - is a wide-spread medical condition that affects up to 1 in 5 people over the age of 50 years old. It is also seen in children and young adults. Dysphagia can be caused by conditions that affect the nervous system, such as a stroke, head injury, or dementia, by structural damage to the head and neck or a disability or developmental condition. Due to the unique way that swallowing is controlled by the brain, rehabilitation can be highly effective. However, to be effective habilitation / rehabilitation should be undertaken frequently at regular intervals.

[0006] Rehabilitation is usually undertaken in a clinic in the presence of a clinician or technician. Due to availability, clinics sessions are often scheduled less frequently than is ideal for effective rehabilitation. Moreover, many of the conditions that cause dysphagia are also associated with increased age and reduced mobility. Many dysphagic patients struggle with mobility and may have difficulty accessing rehabilitation as frequently as is needed for change.

[0007] Rehabilitation exercises can be set for patients to conduct outside of a clinic such as in a home, residential or other non-clinic environment. However, due to the abstract nature of rehabilitation exercises, it can be hard for a patient to understand whether the exercise is being undertaken correctly or in accordance with the correct nature of the task. Rehabilitation exercises are also often not completed, altered from the intended use, or skipped altogether which can reduce the overall effectiveness of rehabilitation.

[0008] Summary of the Invention

[0009] It is at least one object of the present invention to provide a wearable surface electromyography (sEMG) apparatus.

[0010] It is a second object of the present invention to provide a method, in combination with a wearable sEMG apparatus, for monitoring and providing feedback during a swallowing exercise.

[0011] It is a third object of the present invention to provide a method for providing a swallowing exercise and for providing feedback during a swallowing exercise.

[0012] It is a fourth object of the present invention to provide a system for providing a swallowing exercise and for providing feedback during a swallowing exercise.

[0013] It is a fifth object of the present invention to provide a system for providing an out of clinic dysphagia rehabilitation exercise.

[0014] It is a sixth object of the present invention to provide a device, a method and / or a system for dysphagia rehabilitation exercises which overcomes or ameliorates some of the disadvantages of present dysphagia rehabilitation.

[0015] According to one example of the present invention there is provided a wearable surface electromyography (sEMG) apparatus for providing feedback during a swallowing exercise, the device including: an electrode arranged, in use, to be in contact with the epidermis of a patient for collecting surface electrical signals relating to a muscle contraction performed during a swallowing exercise, a processor coupled with the electrode for processing the collected surface electrical signals, and a wireless communicator coupled with the processor and operable to transmit the processed signals to a remote computing device.

[0016] In some examples the electrode and processor are mounted together on a PCB so as to minimise the electrical signal path between the electrode and the processor.

[0017] In some examples processing includes converting the collected signal into a digital signal and wirelessly transmitting the digital signal to the remote computing device.

[0018] In some examples converting the collected signal includes determining a plurality of amplitude components and time components of the signal.

[0019] In some examples processing collected surface electrical signals includes determining a valid surface electromyograph signal relating to a swallowing contraction.

[0020] In some examples processing includes both hardware and software processing of collected surface electrical signals.

[0021] In some examples the sEMG apparatus further includes a housing adapted to be worn against skin in the head or neck region of a user of the device.

[0022] In some examples the sEMG apparatus further includes a battery, and wherein the processor, wireless communicator and battery are contained together in the housing.

[0023] In some examples the electrode includes a pair of electrodes, the pair of electrodes, when connected with an external power source, transfer energy for charging the battery.

[0024] According to a second example of the present invention there is provided a method of providing feedback during a swallowing exercise, the method including: plotting, on a display of an exercise zone, a symbol to indicate a target having a target amplitude component, receiving, from at least one sensor associated with a person, a signal representing a muscle contraction performed during a swallowing exercise, the signal including a plurality of data points each representing one of a plurality of amplitude components, plotting, on the display, together with the displayed symbol, a graphical representation of the received signal, such that it is visible on the display whether a characteristic one of the plurality of amplitude components of the swallowing contraction signal corresponds with the target amplitude component.

[0025] In some examples the symbol to indicate a target includes a target amplitude component and a target time component, the received signal representing a muscle contraction includes a plurality of data points each representing one of a plurality of amplitude components and time components of the signal, plotting on the display includes plotting a graphical representation of the received signal together with the symbol such that it is visible on the display whether a characteristic one of the plurality of amplitude components and / or time components of the swallowing contraction signal corresponds with the target amplitude component and / or a target time component.

[0026] According to a third example of the present invention there is provided a method of providing a swallowing exercise, the method including: plotting, on a display of an exercise zone, a symbol to indicate a target having a target amplitude component, receiving, from at least one sensor associated with a patient, a signal representing a muscle contraction performed during a swallowing exercise, the signal including a plurality of data points each representing one of a plurality of amplitude components, comparing a characteristic amplitude component of the signal with the target amplitude component, and based on the comparing choosing a second target, and plotting on the display a second symbol to indicate the second target. In some examples the symbol to indicate a target includes a target amplitude component and a target time component, the received signal representing a muscle contraction includes a plurality of data points each representing one of a plurality of amplitude components and time components of the signal, and comparing a characteristic time component of the signal with the target time component, and based on the comparing choosing a second target, and plotting on the display a second symbol to indicate the second target.

[0027] In some examples comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component, and in response to determining an insufficient matching weighting the amplitude component of the second target.

[0028] In some examples comparing includes determining whether a second match exists between the characteristic time component and the target time component, and in response to determining an insufficient matching weighting the time component of the second target.

[0029] In some examples the target time component includes a target time component range and the target amplitude component includes a target amplitude component range, and comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component range, and in response to determining an insufficient matching increasing the target amplitude component range of the second target, or in response to determining a sufficient matching decreasing the target amplitude component range of the second target.

[0030] In some examples comparing includes determining whether a second match exists between the characteristic time component and the target time component range, and in response to determining an insufficient matching increasing the target time component range of the second target, or in response to determining a sufficient matching decreasing the target time component range of the second target. According to a fourth example of the present invention there is provided a system for providing feedback during a swallowing exercise, the system including a: a wearable surface electromyography (sEMG) apparatus arranged, in use, to be in contact with the surface of skin for collecting surface electrical signals, a processor for processing collected surface electrical signals, and a wireless communicator coupled with the processor and operable to transmit the processed signals to a remote computing device, and a computer implemented method of providing feedback during a swallowing exercise, the method including: plotting, on a display of an exercise zone, a symbol to indicate a target having an amplitude component and a time component, receiving, from at least one sensor associated with a person, a signal representing a swallowing contraction of the person, the signal including a plurality of data points each representing one of a plurality of amplitude components and time components of the signal, plotting, on the display, together with the displayed symbol, a graphical representation of the received signal, such that it is visible on the display whether a characteristic one of the plurality of amplitude components and / or time components of the swallowing contraction signal corresponds with the target amplitude component and target time component.

[0031] According to a fifth example of the present invention there is provided a system for providing a swallowing exercise, the system including a: a wearable surface electromyography (sEMG) apparatus as herein described, the apparatus arranged, in use, to be in contact with the surface of skin for collecting surface electrical signals, and a computer implemented method including: plotting, on a display of an exercise zone, a symbol to indicate a target having a target amplitude component and / or a target time component, receiving, from the sEMG apparatus associated with a patient, a signal representing a swallowing contraction of the patient, the signal including a plurality of data points each representing one of a plurality of amplitude components and / or time components of the signal, comparing a characteristic amplitude component and / or time component of the signal with the target amplitude component and / or a target time component, and based on the comparing choosing a second target, and plotting on the display a second symbol to indicate the second target.

[0032] In some examples comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component, and in response to determining an insufficient matching weighting the amplitude component of the second target.

[0033] In some examples comparing includes determining whether a second match exists between the characteristic time component and the target time component, and in response to determining an insufficient matching weighting the time component of the second target.

[0034] In some examples the target time component includes a target time component range and the target amplitude component includes a target amplitude component range, and comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component range, and in response to determining an insufficient matching increasing the target amplitude component range of the second target, or in response to determining a sufficient matching decreasing the target amplitude component range of the second target.

[0035] In some examples comparing includes determining whether a second match exists between the characteristic time component and the target time component range, and in response to determining an insufficient matching increasing the target time component range of the second target, or in response to determining a sufficient matching decreasing the target time component range of the second target.

[0036] Further aspects of the invention, which should be considered in all its novel aspects, will become apparent to those skilled in the art upon reading of the following description which provides at least one example of a practical application of the invention. Brief Summary of the Drawings

[0037] One or more examples of the invention will be described below by way of example only, and without intending to be limiting, with reference to the following drawings, in which:

[0038] Figure 1 shows a front perspective illustration of a wearable surface electromyography (sEMG) apparatus for measuring muscle activity (muscle contractions) in a patient,

[0039] Figure 2 shows a bottom view of the sEMG,

[0040] Figure 3 shows a side section view through A-A

[0041] Figure 4 shows a schematic illustration of the sEMG,

[0042] Figure 5 shows a schematic side illustration of a second example sEMG apparatus,

[0043] Figure 6 shows a charging cradle 500 for an sEMG,

[0044] Figure 7 shows a schematic illustration of an sEMG apparatus connected with a patient,

[0045] Figure 8 shows a schematic illustration of a remote computing device according to the invention,

[0046] Figure 9 shows a schematic illustration of a wide area network including individual elements of the invention,

[0047] Figure 10 shows a schematic illustration of a method according to the invention,

[0048] Figure 11 shows a schematic illustration of a first example feedback graphical representation of the invention,

[0049] Figure 12 shows a schematic illustration of an example of a duration of a training for a patient,

[0050] Figure 13 shows a schematic illustration of an example target based exercise for a patient, and

[0051] Figure 14 shows a schematic illustration of an example strength-based exercise for a patient. Description of the preferred examples

[0052] Examples of the invention provide a device, and / or a method and / or a system for monitoring and providing feedback during a swallowing exercise of a patient undergoing habilitation or rehabilitation of swallowing skills as a result of conditions such as Dysphagia. Habilitation might be necessary to develop, attain, improve, or retain swallowing skills in individuals with disabilities or developmental conditions, for example. Rehabilitation might be necessary where an individual needs to regain skills, abilities, or knowledge that may have been lost or compromised because of illness, injury, or acquiring a disability. In the description and claims the terms habilitation or rehabilitation may be used interchangeably to mean develop, attain, improve, retain, or regain swallowing skills for whatever reason.

[0053] Some examples of the invention provide a device, and / or a method, and / or a system for providing a swallowing exercise and for providing feedback during a swallowing exercise. Examples of the invention may be used in a clinic environment or, advantageously, in a non-clinic environment. Some examples of the invention provide a device, and / or a method, and / or a system for providing a home-based swallowing exercise and for providing feedback during a home-based swallowing exercise. Home- or residential-based swallowing exercises can be undertaken more frequently than might be possible than with clinic-based exercises due to appointment availability. More frequently performed swallowing exercises might in some patients result in faster rehabilitation results. Some examples of the invention, advantageously, provide feedback on performance of a swallowing exercise which might otherwise only be available in clinic-based exercises. Examples of the invention increase exercise task challenge or provide greater feedback based on the needs of the patient.

[0054] Some examples of the invention provide time-based swallowing exercises. Some examples of the invention provide amplitude base swallowing exercises. Some examples of the invention provide both time-based and amplitude-based swallowing exercises. Time-based and amplitudebased exercises require a patient to control both the timing and force (strength) of the muscle contractions of a swallowing effort. This is a skill type exercise that helps patients improve control over the timing and force of muscle contractions during swallowing. Amplitude-based exercises require a patient to control only the force (or strength) of muscle contractions during a swallowing effort. This a strength type exercises that help patients improve the force of muscle contractions during swallowing. A combination of time-based and amplitude-based swallowing exercises might in some patients result in faster and more effective habilitation and / or rehabilitation results. Some examples of the invention can dynamically adapt a target timing and / or target strength of a swallowing exercise based on patient performance of the swallowing exercises. Some examples of the invention can dynamically adapt a difficulty of a swallowing exercise based on patient performance of the swallowing exercises. In some examples adapting a difficulty of a swallowing exercise includes adapting a range of a target timing and / or a range of a target strength of a swallowing exercise. In some examples if a patient misses a target the exercise is made easier by reducing the target effort or increasing the target size. In some examples the invention can dynamically adapt a difficulty of a swallowing exercise based on a performance threshold (plus or minus T). If the patient misses the target by less than the threshold (+ / -T) then the exercise target is not adapted. If the patient misses the target by greater than the threshold T then the exercise target is adapted (increased or decreased as the case may be) by a predetermined % value.

[0055] Some examples of the invention include a wearable surface electromyography (sEMG) apparatus 100 which is arranged to be worn under the chin of a patient undergoing habilitation / rehabilitation treatment. The sEMG apparatus 100 / 1001 has an electrode or pair of electrodes 102 that, in use, are in contact with the epidermis or outermost layer of skin. In some examples the apparatus is fitted under the chin of the patient. In other examples the apparatus may be adapted to be worn in the head and neck region of a patient. In some examples the sEMG apparatus has three electrodes 102, including a ground or reference electrode. The electrodes collect electrical signals relating to the contraction of muscles used in a swallowing action (in some examples a swallowing contraction or muscle contraction). The wearable sEMG apparatus 100 / 1001 has an onboard processor 103 and is wirelessly connected with a computing device 200. In some examples the collected electrical signals are processed either in hardware or software and transmitted to the remote computing device 200. In some examples the hardware 107 is a microcontroller unit running software. In other examples the hardware may include a field-programable gate array (FPGA) for processing electrical signals. In some examples the collected electrical signals are part processed in the sEMG and part processed in the remote computing device. In some examples hardware processing might be preferred in the sEMG for speed, accuracy and / or power reasons. The remote computing device has greater power capacity and so a more powerful processor for fast software processing of signals. In some examples of the invention data communication between the sEMG apparatus 100 / 1001 and remote computing device 200 is via a Bluetooth connection, and in some examples Bluetooth Low Energy. Sample data may be exchanged between the sEMG apparatus 100 / 1001 and remote computing device 200 at a rate of at least lOx (ten-times) per second. In some examples the rate is up to 90 samples per second. In some examples the sEMG apparatus 100 / 1001 samples electrical signals relating to the contraction of muscles used in a swallowing action at a rate of greater than 10 data points per second. In some examples the sEMG apparatus 100 / 1001 samples electrical signals relating to the contraction of muscles at a rate of over 1000 data points per second. The sEMG apparatus 100 / 1001 buffers collected data points and transfers multiple data points, or a signal representing multiple data points, in each data exchanged between the sEMG apparatus 100 / 1001 and remote computing device 200.

[0056] The remote computing device 200 might be a desktop computer, personal computer, or tablet type device. In some examples the remote computing device 200 is a personal tablet type device of the patient. The patent downloads an application (APP) from an internet-based software distribution server compatible with their personal tablet type device. Running of the downloaded application on the personal tablet type device facilitates the personal tablet type device being used a remote computing device 200 according to some examples of the invention. In some examples the invention provides visual feedback to the patient during a swallowing exercise. Visual feedback is provided on a display screen of the remote computing device 200. In some examples the invention also provides audible feedback to the patient. Audible feedback is provided via a speaker of the remote computing device 200 to indicate a successful or unsuccessful swallowing effort. In some examples the invention also provides tactile feedback to the patient. Tactile feedback is provided via a vibration function of the remote computing device 200 to indicate a successful or unsuccessful swallowing effort. In some examples the invention includes a method of providing a swallowing exercise to the patient via the remote computing device 200. In some examples the method is in the form of a computer programme operating on the remote computing device 200 and causing the device to be paired with the sEMG apparatus 100 / 1001, and to graphically display representations of a target exercise (in some examples a training target or swallowing target) to be performed by the patient, and in response to the patient performing a swallowing exercise receiving collected electrical signals of a muscle contraction relating to the swallowing exercise from the sEMG apparatus, and displaying a representation of the collected electrical signals on the remote computing device 200 together with the target exercise. Displaying a representation of the collected electrical signals on the remote computing device 200 together with the target exercise allows the patient to obtain immediate visual feedback on performance of the swallowing exercise. In some examples the method is able to assess performance of a swallowing exercise and to adjust future target exercises in order to adapt future swallowing exercises to the patient's swallowing performance. In some examples the displaying a representation of the collected electrical signals on the remote computing device 200 occurs in real-time as the collect occurs at, say, at least lOx or up to 90x per second. A patient can track their swallow contraction in real-time. In some examples the displaying a representation of the collected electrical signals on the remote computing device 200 together with the target exercise occurs only after the swallow contraction has occurred. The patient cannot visualise their swallow contraction in real-time on the display device. This is a delayed feedback or 'ghost-training' that in some examples may help improve timing and / or strength swallowing skill of the patient by teaching a patient to rely on their intrinsic skills, that is to say, it forces a patient to use their own intrinsic representation of the swallow.

[0057] In some examples assessing performance of a swallowing exercise includes comparing a portion of the signal representing a muscle contraction relating to a swallowing exercise with the target swallowing exercise. If the portion of the signal corresponds with a portion of the target swallowing exercise the patient has successfully completed the exercise. If the portion of the signal does not correspond with a portion of the target swallowing exercise the patient has unsuccessfully completed the exercise. In some examples the portion of the signal representing a muscle contraction is the peak value of the signal representing the peak of the swallowing muscle contraction. The portion of the target is any portion of the target, be it a line target, a square target, or any other shaped target. If the peak value of the signal touches (or corresponds) with any portion of the target then the patient has 'hit the target'. If the peak value of the signal does not touch (or correspond) with any portion of the target then the patient has 'missed the target'. In some examples a patient's swallowing performance is based on a difference between the portion of the signal and the target swallowing exercise. The smaller the difference the better the performance. The larger the difference the worse the performance. In some aspect of the invention the comparing is a hit / miss sensitivity which is used to inform future exercise target choices. In some examples the hit / miss sensitivity is a hit / miss threshold (say T). If the peak value of the signal hits or misses the target by less than the hit / miss threshold T then the exercise target is not adapted. If the peak value of the signal hits or misses the target by greater than the threshold T then the exercise target is adapted (increased or decreased as the case may be) by a predetermined % value. In some examples the threshold T and the predetermined % value are predetermined by a clinician.

[0058] In some examples a target exercise includes a target amplitude component 242, and the method adapts the amplitude component of future swallowing exercises to the patient's swallowing performance. In some examples a target exercise includes both a time component and an amplitude component. In some examples the method adapts the time component of subsequent swallowing exercises, and adapts the amplitude component of the subsequent swallowing exercises to the patient's swallowing performance. In some examples the patient's swallowing performance is based on the hit / miss threshold T.

[0059] In some examples a target exercise includes both a time component range (TR) and an amplitude component range (AR). In some examples the target time component changes as the target moves along a time axis 234 between subsequent targets or exercise efforts (for example moves left to right in figure 11). The time range component (TR) is the size of the target on the time (horizontal) axis 234 and can be adapted based on the hit miss sensitivity threshold. A target exercise with a small time-component range and a small amplitude-component range is a small size target 240. A target exercise with a larger time component range and a larger amplitude component range is a larger size target 240. In some examples a difficulty of a target exercise relates to a size of the target. A larger target is a less difficult target making it less difficult for a patient to successfully complete the exercise. A smaller target is a more difficult target making it more difficult for a patient to successfully complete the exercise. In some examples if the patient has successfully completed a target exercise the method reduces the time component range and amplitude component range of future target exercises. In some examples if the patient has unsuccessfully completed a target exercise the method increases the time component range and amplitude component range of future target exercises. In some example success in completing a target exercise is based on a hit miss sensitivity threshold T.

[0060] In some examples if the patient has successfully completed a target exercise two or more times (in some examples three or more times) the method changes the time component range and amplitude component range of a future target exercise. The method preferable decreases the time component range and amplitude component range of a future target exercise, but in some examples may increase the time and amplitude component ranges. In some examples if the patient has unsuccessfully completed a target exercise two or more times (in some examples three or more times) the method changes the time component range and amplitude component range of a future target exercise. The method preferably increases the time component range and amplitude component range of a future target exercise, but in some examples may decrease the time and amplitude component ranges. In some examples a clinician may set a maximum and / or a minimum boundary for the time component range and / or amplitude component range.

[0061] In some examples a portion of a signal representing a muscle contraction that is compared with a target swallowing exercise is a portion of the signal that includes a maximum amplitude component. In some examples a portion of a signal representing a muscle contraction that is compared with a target swallowing exercise is a portion of the signal that includes a time component corresponding to a maximum amplitude component.

[0062] In some examples the remote computing device 200 is able to communicate over the Internet with a remote server 322. The remote server 322 stores patient information in a database 324 and details of target exercises to be performed by the patient as well as a schedule of exercise sessions and the length of exercise sessions. In some examples the remote computing device 200 is able to upload results from the performance of exercises by the patient for storage in the server 322. In some examples a clinician or other medical practitioner is able to access data stored on the server 322 either in real time or at a later date to assess performance of the exercises by the patient and to adjust the exercise regime or target exercises for future exercise sessions.

[0063] The wearable surface electromyograph apparatus

[0064] Figures 1 to 3 and 4 illustrate one example of a wearable surface electromyograph (sEMG) apparatus 100 for measuring muscle contractions in a patient 300 experiencing a disorder such as dysphasia. Figures 5 and 4 illustrate a second example of a wearable surface electromyograph (sEMG) apparatus 1001 for measuring muscle contractions in a patient 300 experiencing a disorder such as dysphasia. The sEMG apparatus 100 / 1001 has an electrode or pair of electrodes 102 that, in use, collect electrical signals relating to the contraction of muscles used in a swallowing action of a patient. In some examples the sEMG apparatus has three electrodes, including a reference electrode. In some examples the wearable sEMG apparatus 100 / 1001 consists of a semi-circular puck-shaped device 100 that, in use, is attachable under the chin 302 of a patient 300 such that electrodes 102 of the apparatus 100 are in communication with the patient's skin such that the electrodes 102 can collect electrical signals generated by oropharyngeal muscles during a swallowing action. In some examples the electrodes 102 of the sEMG apparatus 100 / 1001 can collect electrical signals generated by suprahyoid muscles. In some examples the electrodes 102 of the sEMG apparatus 100 / 1001 can collect electrical signals generated by thyrohyoid muscles. In some examples the electrodes 102 of the sEMG apparatus 100 / 1001 can collect electrical signals generated by sternohyoid muscles. In some examples the electrodes 102 of the sEMG apparatus 100 / 1001 can collect electrical signals generated by retrohyoid muscles. In some examples the sEMG apparatus 100 / 1001 is a single channel device arranged to collect electrical signals from a single group of muscles. In other examples the sEMG apparatus 100 / 1001 is a multichannel device arranged to collect electrical signals from multiple muscles or muscle groups.

[0065] In some examples the sEMG apparatus 100 / 1001 is a self-contained wireless sEMG apparatus 100 / 1001 with an onboard processor 103, processor readable storage 122, an energy source 105 and a wireless communications module 124 wearable by a user. Physical external wires or connections extending from the device may introduce interference or noise into detected signals, and so in some examples the device does not have any physical external wires or connections extending from the device 100. In some examples the sEMG apparatus 100 / 1001 is fixed in place under the chin 302 of a patient 300 (as illustrated in Figure 4) such that sensing electrodes of the device are in direct contact with the patient's skin. In some examples the sEMG apparatus 100 / 1001 is fixed in place using replaceable medical grade adhesive patches (represented by broken line 310). In other examples the sEMG apparatus 100 / 1001 may be held in place using straps and / or a headgear worn by a patient 300 to support and hold the sEMG apparatus 100 / 1001 in place under the chin 302 of the patient 300.

[0066] In some examples the shape of the sEMG apparatus 100 / 1001 in plain view is generally semicircular. In some examples (as illustrated in Figure 2) the apparatus 100 has a semi-circular forward wall 114 facing, in situ, towards the chin 302 of the patient, and a generally concave or recessed rearward wall 116 facing, in situ, towards the neck 304 of the patient 300. A first, in situ, skin facing surface 118 of the sEMG apparatus 100 / 1001 is generally planer for locating an adhesive patch 310. In some examples a second opposite surface 119 of the sEMG apparatus 100 / 1001 has a large handle 110 / 1101 type protrusion for easy gripping of the sEMG apparatus 100 / 1001 for positioning and or removal. The concave or recessed rearward wall 116 provides a means to access an edge of a replaceable adhesive patch 310 for removal and replacement of the patch 310, if necessary, between uses.

[0067] In some examples the device includes a printed circuit board (PCB) 104 supporting three biocompatible medical grade silver or gold coated sensing electrodes 102. Also mounted on the PCB 104 in close proximity to the electrodes 102 is a processor 103. The processor 103 is connected with the electrodes 102 for receiving collected electrical signals from the electrodes 102. In some examples an electrical path distance between the electrodes 102 and the processor 103 is minimised so as to reduced noise or interference induced into electrical signals collected by the electrodes 102 and received by the processor 103. In some examples the PCB 104 also supports a battery 105 for powering the sEMG apparatus 100 / 1001 and a wireless communicator 124 or communication module 124 for wirelessly transmitting electrode signal data to a remote computing device 200. In some examples collected electrical signals received by the processor 103 are processed and digitised to form signal data for wirelessly transmitting to a remote computing device 200. In other examples collected electrical signals are digitised without processing for transmitting to a remote computing device 200.

[0068] In some examples - depicted in figures 1, 2 and 3 - the body of the sEMG apparatus 100 is formed by a first body half 112 and a second body half 113 joined about an equator 115 to define an internal cavity 117 for accommodating the PCB 104, processor 103, battery 105 and communication module 124. In some examples, edges of the first and second body halves 112 / 113 joining at the equator 115 are provided with cooperating connection features to facilitate the body halves being removably 'clipped' together. In other examples the two body halves may be joined with adhesives or removable fasteners. Apertures are provided in one of the body halves to facilitate external contact of the sensing electrodes 102 with the skin of a patient. The first and second body halves 112 / 113 can be made or formed by injection moulding, 3D printing or the like. In some examples the first and second body halves 112 / 113 are made by Selective Laser Sintering (SLS) or Stereolithography (SLA) 3D Printing. In some examples the first and second body halves 112 / 113 can be made or formed from a thermoplastic, or castable plastic or resign material such as, but not limited to, Nylon, Polycarbonate, Polybutylene Terephthalate Acrylonitrile Butadiene Styrene as required by the manufacturing or forming process. The body 112 / 113 has provides an intrinsic and medically safe sEMG apparatus 100.

[0069] In some examples a tab 110 is formed to extend beyond the opposite outer surface 119 of the housing 112 / 113 to form a handle 110. In some examples Dysphagia can be caused by a condition that affects the nervous system of a patient, such as a stroke, head injury, or dementia. In such examples other muscle function of a patient 300 may also be affected, such as muscles the control grip and movement of the hands and fingers. In some examples the handle 110 is a large hand-grippable tab extends from housing 112 / 113 to define an area that is grippable between the thumb and side of the index finger by a less dextrous hand or by someone with impaired motor skills. In other examples- depicted in figure 5 for example - the body 1121 of the sEMG apparatus 1001 is formed by over-moulding the PCB 104, processor 103, battery 105 and communication module 124 with a plastic material as aforementioned. In addition to defining the external structure of the wearable sEMG apparatus 1001, over-moulding 1121 encapsulates the PCB 104, processor 103, battery 105 and communication module 124 to protect those features and to provide an intrinsic and medically safe sEMG apparatus 1001. In some examples the battery 105 has a battery cap 106 formed around the battery 105 and allowing a space 108 between the battery 105 and an inner surface of the battery cap 106. The encapsulating over-mould forms over the battery cap 106 allowing an airspace 108 around the battery 105 for contraction and expansion of the battery 105 during charging and discharging. In some examples the battery cap 106 is made of aluminium or a rigid material and is affixed with the PCB 104 to provide a space 108 between the over-mould 1121 and battery 105. In some examples surfaces of the electrodes 102 are provided at or near the skin contact surface 118 of the sEMG apparatus 1001 for sensing surface electrical signals of the patient 300.

[0070] In some examples the battery cap 106 has a tab 110 arranged to extend beyond the opposite outer surface 119 of the encapsulating over-mould 1121 to form a handle 1101. The handle 1101 is a large hand-grippable tab extending from the over-mould 1121 to define an area that is grippable between the thumb and side of the index finger by a less dextrous hand or by someone with impaired motor skills.

[0071] In some examples the handle 110 / 1101 is provided with an attachment means for a lanyard which can be looped around the neck 304 of a patient 300. In some examples the attachment point can be an aperture (hole) 111 near an edge of the tab 110. In other examples the attachment point can be an eyelet or loop provided on the tab 110 / 1101. The lanyard provides a convenient way of ensuring that if the sEMG apparatus 100 / 1001 is dropped during positioning or removal process it is retained around the neck 304 of the patient without falling to the floor where it may become damaged and or be difficult for a patient with impaired motor skills or limited movement to retrieve. In some examples the sEMG apparatus 1OO / 1OO1 is powered by a rechargeable battery 105. In some examples the battery 105 is a rechargeable battery of lithium-ion technology. In some examples the battery 105 is a Lithium-ion polymer battery (LiPo) 105 mounted in the housing and connected with the printed circuit board 104. In some examples the battery 105 is charged via a wireless charger. In other examples the battery 105 can be charged via the main electrodes 102. In other examples the apparatus has secondary charging electrodes 109. When the electrodes 102 / 109 are connected with an energy source the processor 103, or electrodes 102, can transfer energy to the battery 105 for charging the battery 105. In some examples the sEMG apparatus 100 / 1001 is provided with a charging cradle 500 for receiving the sEMG apparatus 100 / 1001 when not in use. In some examples the cradle 500 receiving space 510 is provided with a pair of electrode contacts 520 that make electrical contact with the charging electrodes 109 when the sEMG apparatus 100 / 1001 is received within the cradle 500. In other examples the cradle 500 receiving space is provided with a pair of electrode contacts that make electrical contact with the sensing electrodes 102 to charge the battery via the sensing electrodes 102. In yet other examples a wireless charging interface is provided in the charging cradle 500 for wirelessly charging the battery. In some examples a battery charging circuit is provided in the cradle 500. The battery charging circuit can be connected with an external energy source such as a USB-A or USB-C type power source, or a mains electricity power source. The battery charger is connected with the battery 105 via the contacts 520 and electrodes 102 / 109, as provided, when the sEMG apparatus 100 / 1001 is received within the cradle 500. One advantage of having the battery charging circuit in the cradle 500 is to minimise complexity on the sEMG apparatus 100 / 1001 PCB 104 and allow for the focus of circuit layout on the PCB 104 to be towards minimising interference in the electrical signals collected by the electrodes 102 and received by processor 103. In some examples a battery charging circuit may be located within the sEMG apparatus 100 / 1001. In some examples the battery charging circuit may be located on the PCB 104 within the sEMG apparatus 100 / 1001.

[0072] In some examples it is envisaged that the remote computing device 200 will, in use, be in close proximity to the patient 300 wearing the sEMG apparatus 100 / 1001. In some examples the wireless communicator or transmitter 124 includes a short-range wireless transmitter. A number of different wireless technologies (wireless communication protocols) have been developed for short distance wireless communication. In some examples an appropriate wireless technology is chosen for fast throughput of data while at the same time minimising energy usage. In some examples the wireless communication protocol of the wireless transmitter 124 is Bluetooth. In some examples the wireless communication protocol is Bluetooth Low Energy (BLE). In some examples the wireless communication protocol is a radio frequency transmission technology. In some examples the wireless communication protocol is a Wi-Fi technology.

[0073] In some examples pairing of the wireless transmitter (wireless communicator) 124 of the sEMG apparatus 100 / 1001 with the remote computing device 200 is initiated by the remote computing device 200. In some examples the sEMG apparatus 100 / 1001 includes on its outer case 112 / 1121 or outer surface 119 a scannable indication for initiating pairing with the remote computing device 200. In some examples the scannable indication is a Quick Response (QR) code. In some examples the sEMG apparatus 100 / 1001 includes an LED indicator 128 to indicate to the user through the use of lights and or light sequences the power status and / or the wireless communication status of the sEMG apparatus 100 / 1001. In some examples the sEMG apparatus 100 / 1001 may include a button that can be manipulated by a user in order to initiate a pairing mode and / or for powering on and off the sEMG apparatus 100 / 1001.

[0074] In some examples the sEMG apparatus 100 / 1001 includes an auto on / off function. In other examples the sEMG apparatus 100 / 1001 includes a low power function. In yet other examples the sEMG apparatus 100 / 1001 includes a standby function. In some examples the auto on / off function or the low power function or the standby function are initiated an accelerometer or tilt switch which detects when the apparatus 100 / 1001 is inverted under the chin of the patient. In other examples the auto on / off function or the low power function or the standby function are initiated by an internal timer. In yet other examples the auto on / off function or the low power function or the standby function are initiated by the remote computing device. In some examples the auto on / off function or the low power function or the standby function are initiated by a status of the electrodes 102. When the electrodes 102 are not connected or contacted with the skin of a patient 300 or an energy source for charging the batteries an electrical charge is established resulting in a potential difference of 0.7 (zero-point-seven) volts on the electrodes 102. When the electrodes 102 are brought into electrical contact with skin of a patient 300 the electrical charge is discharged causing the potential difference on the electrodes 102 to fall to zero. Likewise, when the electrodes 102 are connected to an energy source for charging the battery 105 the potential difference between the electrodes 102 changes. The processor 103 monitors the potential difference across the electrodes 102 and based on the status of the potential difference initiates an auto on / off mode or initiates a low power mode or initiates a standby mode or initiates a battery charge mode. In some examples the processor 103 monitors the potential difference across the electrodes 102. When the potential difference across the electrodes 102 is approximately 0.7 volts (in some examples between, say, 0.4 volts and 1.4 volts) the processor 103 powers down or powers off or puts into standby all functions of the sEMG apparatus 100 / 1001 except a function of monitoring the potential difference across the electrodes 102. This conserves power of the sEMG apparatus 100 / 1001 when it is not worn by a patient 300 or positioned in a charging cradle 500.

[0075] In some examples the processor 103 monitors the potential difference on the electrodes 102 and based on the potential difference powers on appropriate functions of the sEMG apparatus 100 / 1001. In some examples when the processor 103 detects that the electrodes 102 are connected with an external energy source of, say, a charging cradle 500 the processor 103 powers on a charging mode of the battery 105. In some examples when the processor 103 detects that the electrodes 102 are in contact with the skin of a patient 300 the processor 103 powers on the sensing and transmitting functions of the sEMG apparatus 100 / 1001. In some examples charging is initiated when dedicated charging pins 109 are contacted by a charging power source from the cradle 500.

[0076] In some examples a low power mode of the sEMG apparatus 100 / 1001 may include changing the polling and / or sampling rate of the wireless communicator 124 and electrodes 102 when the device is not in position with a patient 300.

[0077] In some examples communication between the sEMG apparatus 100 / 1001 and the remote computing device 200 is a one-way communication with the processor 103 sending received electrical signal data to the remote computing device 200 whenever the data is received. In some examples the communication between the sEMG apparatus 100 / 1001 and the remote computing device 200 is a two-way communication where the remote computing device 200 can send instructions or commands to the sEMG apparatus 100 / 1001. In some examples the sEMG apparatus 100 / 1001 includes a haptic feedback device 126 which allows a patient 300 to receive tactile feedback information through the sense of touch. In some examples the haptic feedback device 126 can be initiated to provide a feedback signal to a patient 300 on a command from the remote computing device 200. In some examples the feedback signal is a vibration or buzzing that can be felt by the patient 300 wearing the sEMG apparatus 100 / 1001.

[0078] In use the sEMG apparatus 100 / 1001 is located under the chin 302 of a patient 300, with electrodes 102 on contact with the skin, so that it can collect electrical signals from a muscle contraction related to swallowing. The sEMG apparatus 100 / 1001 is adapted to collect electrical signals representing the swallowing contraction of the patient 300 via the electrodes 102 and to receive the collected signals at the processor 103. The processor 103 digitises the received signals and transmits them to the remote computing device 200 via the wireless communicator 124. In some examples the processor 103 firstly processes the collected electrical signals. In some examples the processing is done via hardware, such as an FPGA 107, arranged on the printed circuit board 104. In some examples the hardware includes a low pass filter. In some examples the hardware includes a high pass filter. In some examples the hardware includes a band pass filter. In some examples the processor 103 also processes the received signals in software. In some examples processing the signals includes filtering the signals in hardware and / or software. In some examples processing the signals includes identifying signals relating to a swallowing contraction of the patient 300. In some examples processing the signals includes identifying a time component and an amplitude component of the signal. In some examples processing the signals includes digitising the signals. In some examples digitising the signals includes sampling the received signal and identifying a collection of data points representing the received signal. In some examples the collection of data points each include only an amplitude component. In some examples the collection of data points each include an amplitude component and a time component. In some examples transmitting the signal to the remote computing device 200 includes transmitting the collection of data points to the remote computing device 200. In some examples transmitting the signal to the remote computing device 200 includes transmitting the collection of data points to the remote computing device 200 at a rate of lOx (ten-times) per second. In some examples the sEMG apparatus 100 / 1001 samples electrical signals relating to the contraction of muscles used in a swallowing action at a rate of greater than 10 data points per second. The sEMG apparatus 100 / 1001 buffers collected data points and transfers multiple data points, or a signal representing multiple data points, in each data exchanged between the sEMG apparatus 100 / 1001 and remote computing device 200.

[0079] The Remote computing device

[0080] The remote computing device 200 includes a computer such as a personal computer or, in some examples, a hand-held type portable computing device such as a tablet or smartphone like device. In some examples the remote computing device 200 is a tablet type computing device such as a device similar to, but not exclusively, a Samsung Tab, Lenovo Tab, Apple iPad, Microsoft Surface, or Dell Detachable type device.

[0081] In some examples the remote computing device 200 includes a case or housing 202 supporting hardware features such as but not exclusively, a processor 210, a computer readable medium 214 in the form of one or more of volatile and non-volatile memory units, a wireless communication module 212, a user input interface 216 and a user output interface 230. In some examples the input user interface is a mouse and keyboard. In some examples the user output interface is a screen 230. In some examples the user input interface and the user output interface may be a touch screen. In some examples the user input interface may include a touch screen and one or more separate buttons for providing user inputs to the remote computing device 200. In some examples the video screen 230 may be included on the housing 202 supporting other hardware features. In some examples the video screen 230 may be included in a separate dedicated case or housing.

[0082] In some examples the remote computing device 200 may also include one or more cameras 224. In some examples at least one camera is arranged to capture an image of a user of the device 200 such as a patient 300 wearing a wireless sEMG apparatus 100 / 1001 as described above. In some examples the remote computing device 200 includes a microphone 222 able to record sounds and a speaker 220 able to play sounds. In some examples the wireless communication module 212 includes a short-range wireless receiver and transmitter. In some examples the wireless communication protocol of the wireless communication module 212 is Bluetooth. In some examples the wireless communication protocol is Bluetooth Low Energy (BLE). In some examples the wireless communication protocol is ZigBee. In some examples the wireless communication protocol is a radio frequency transmission technology. In some examples the wireless communication protocol is an infrared wireless communication protocol. In some examples the wireless communication protocol is a Wi-Fi technology.

[0083] In some examples machine readable operating instructions are downloaded to the memory 214 in the form of an application (APP) from an internet-based software distribution server compatible with their personal tablet type device. Running of the downloaded application on the personal tablet type device facilitates the personal tablet type device being used a remote computing device 200 according to some examples of the invention.

[0084] In some examples the memory 214 includes machine readable operating instructions that when executed by the processing device 210 are configured to cause the remote computing device 200 to perform various functions such as receive, via the wireless communication module 212, a signal representing collected electrical signals relating to a swallowing contraction of a patient and graphically displaying on the screen 230 a representation of the collected signals.

[0085] In some examples the memory 212 includes machine readable operating instructions that when executed by the processor 210 cause a portion 232 of a training duration to be graphically represented on the computing device screen 230, and cause a symbol 240 representing a training target to be displayed on the screen 230, and upon receiving a signal representing collected electrical signals relating to a swallowing contraction of a patient cause a representation 248 of the collected signals to be graphically displayed on the screen 230. In some examples the portion 232 of the training duration graphically represented includes a time period (axis) 234 and amplitude range 236. The symbol 240 representing the training target includes a time component and an amplitude component that fall within the time period 234 and amplitude range 236 that are displayed within the graphically represented training duration 232 on the screen 230. In some examples the signal representing collected electrical signals relating to a swallowing contraction include a swallowing time component and a swallowing amplitude component. The swallowing time component and a swallowing amplitude component are graphically represented on the screen 230 together with the symbol 240 representing the training target such that a patient can see a graphical representation of the time of the swallowing effort in relation to the time component of the training target 240 and an amplitude (or strength) of the swallowing effort in relation to the amplitude component of the training target 240. In some examples displaying on the screen a signal 248 representing collected electrical signals relating to a swallowing contraction includes displaying on the screen a plurality of data points 250 relating to the collected electrical signal, where each datapoint 250 includes a swallowing time component and a swallowing amplitude component. In some examples a line is drawn between the plurality of data points 250 representing the collected electrical signal.

[0086] The sEMG apparatus 100 / 1001 collecting electrical signals relating to a swallowing contraction of a patient is sensitive to electrical signals relating to other activities of the patient such as talking or twitching or moving during the swallowing activity. In some examples the sEMG apparatus 100 / 1001 processes the collected signals, as previously described, prior to transmitting the signals to the remote computing device 200. In some examples further processing of collected electrical signals can be undertaken in the remote computing device 200. In some examples the remote computing device 200 includes a touch screen 230 and the machine-readable operating instructions when executed by the processor 210 enable the remote computing device 200 to detect when a patient touches one or more data points 250 displayed on the screen 230 representing a portion of the collected electrical signals from the swallowing contraction. In this way the patient is able to help the remote computing device 200 correctly identify a signal relating to a swallowing contraction. In some examples data relating to this touching feedback identifying the correct electrical signals representing a swallowing contraction is collected and stored. In some examples the collected and stored identification of the correct electrical signal representing a swallowing contraction is included in training data for an artificial intelligence (Al) algorithm used to identify electrical signals representing muscle contractions during swallowing from amongst a collection of signals representing other actions of a patient. In some examples the system uses a calibration step to estimate or determine a patients present swallowing ability. In some examples this system normalises this present swallowing ability on a percentage, or similar, scale. Target exercise and ranges are determined from the normalised scale. In some examples a patient is instructed or attempts to or more normal swallows during a calibration step. In some examples the number of calibration swallows is 5. The system then determines an average swallow strength or effort over the attempted number of swallows during the calibration step. In some examples a median value is determined. In some examples the average swallow strength or effort is normalised to a central or median value of the normalised range. In some examples the average swallow strength or effort is normalised to 50 on the normalised scale or range.

[0087] In some examples touching feedback is used in calibrating the system to identify a patient's normal (or baseline) swallowing strength. In some examples a calibration stage includes requiring the patient to undertake a series of normal swallows and between each swallow identify the swallow peak 249 by attaching the swallow peak on a touch sensitive display screen. This exercise can be repeated a plurality of times, for example up to five times, while the system learns to identify a swallow of the patient. In some examples the sEMG device may include a sound detector which may be coupled to the remote computing device such that the calibration includes matching a sound with collected data points to improved accuracy in detecting swallows from within muscle contractions related to non-swallow events. On some examples the sound is the sound of opening of the eustachian tubes - which run from the middle ears to the back of the nose and throat. Usually, the eustachian tubes stay closed. But when a person yawns, chews or swallows the eustachian tubes open. When the eustachian tubes open the cause a popping sounds that can be detected by a microphone positioned, for example, in the ear of a patient. The microphone placement could be facilitated, for example, in the manner of an in-ear headphone. Feedback from the microphone detecting the sound of the eustachian tubes opening can be used alone, or in combination with a patient touching feedback described above for identifying a swallowing peak. In some examples the sound of the eustachian tubes opening is aligned with a patient touching feedback to identify a swallowing peak. In some examples the microphone detecting the sound of the eustachian tubes opening can be used as an aid during calibration steps. In other examples the microphone detecting the sound of the eustachian tubes opening can be used to show a successful swallow during a swallowing exercise.

[0088] In some examples the average swallow strength or effort of a patient determined from a calibration step is normalised to 50-percent on a normalised scale or range. To establishing or setting target exercises for a patient the normalised scale is divided in to swallowing effort ranges. In some examples a normal swallowing effort range is from 40- to 60-percent. In some examples the normal swallowing effort range is from 30- to 70-percent. In some examples a soft swallowing effort range is below 30-percent. In some examples the soft swallowing effort range is below 20-percent. In some examples a hard swallowing effort range is above 70-percent. In some examples the hard swallowing effort range is between 70- to 100-percent. In some examples the remote computing device 200 provides visual feedback to the patient to indicate a relationship between the swallowing contraction and the swallowing target. In some examples the remote computing device 200 provides a first audible, and / or tactile, feedback signal when a swallowing contraction corresponds with the swallowing target. In some examples the remote computing device 200 provides a second, different, audible, and / or tactile, feedback when the swallow contraction does not correspond with the swallowing target. In some examples the remote computing device 200 can communicate in two directions with the sEMG apparatus 100 / 1001. In these examples the remote computing device 200 may instruct the sEMG apparatus 100 / 1001 to provide a haptic or tactile feedback to the patient that is detectable by the patient's sense of touch. In some examples a first tactile feedback is provided by the sEMG apparatus 100 / 1001 if the swallowing contraction corresponds to the swallowing target. In some examples a second, different, tactile feedback is provided by the sEMG apparatus 100 / 1001 if the swallowing contraction does not correspond to the swallowing target.

[0089] In some examples the memory 212 includes machine readable operating instructions that when executed by the processor 210 cause the processor 210 to compare a swallowing contraction with a swallowing target and to determine a difference between the swallowing contraction and the swallowing target. In some examples if the difference exceeds a threshold the processor 210 is caused to choose a second swallowing target having a second amplitude component and a second time component that is within a threshold of the swallowing contraction. In some examples a (second) symbol 240' representing the second swallowing target is caused to be graphically represented on the screen 230 to provide the patient with a second swallowing exercise. In some examples machine readable operating instructions cause the processor 210 to choose and display on the screen 230 a plurality of swallowing targets 240. In some examples each swallowing target 240 is selected randomly and has a different time component and a different amplitude component. In some examples each swallowing target 240 is selected randomly from within the time period 234 and amplitude range 236 of the graphically represented portion 232 of the training duration. In some examples the processor 210 is caused to select one or more of the plurality of swallowing targets 240 based on a comparison of a swallowing contraction with respect to a previous swallowing target. In some examples the machine-readable operating instructions cause the processor 103 to identify a normal swallowing behaviour of the patient based on a number of previous muscle contractions during swallowing and to choose the plurality of swallowing targets based on the identified normal swallowing behaviour of the patient. In some examples the processor 210 is caused to identify a swallowing characteristic of the patient as a normal swallowing characteristic, or a hard swallowing characteristic or a soft swallowing characteristic based on an amplitude component of an identified normal swallowing behaviour of the patient and to choose the plurality of swallowing targets based on the identified normal, soft, or hard swallowing characteristic.

[0090] In some examples the memory 212 includes machine readable operating instructions that when executed by the processor 210 cause the processor 210 to select an amplitude range 236 for the training duration 232 based on an identified swallowing characteristic of the patient. In some examples normalised scale is also used to determine an amplitude range 236 for the training duration displayed by the based on the identified normal swallowing characteristic effort of the patient. In some examples amplitude range 236 has a maximum value of 140, where the normal swallowing characteristic effort of the patient is normalised to 50-percent. A range of 100 + 40- percent provides the patient an improvement zone. In some examples the processor 210 is caused to choose a time period between subsequent ones of the plurality of swallowing targets 240 based on an identified swallowing characteristic of the patient. In some examples the processor 210 is caused to periodically identify a new swallowing characteristic of the patient and in response to a new swallowing characteristic of the patient to adjust the amplitude range 236 of the training duration. In some examples the processor 210 is caused to periodically identify a new swallowing characteristic of the patient and in response to a new swallowing characteristic of the patient to adjust the time period between subsequent ones of the plurality of swallowing targets 240.

[0091] In some examples the memory 212 includes machine readable operating instructions that when executed by the processor 210 operate a front camera of the remote computing device 200 to display a real-time image the face of the patient. In some examples the processor 210 is caused to, using feature recognition, superimpose a silhouette, or the like, of the sEMG apparatus 100 / 1001 on the chin area 230 of the patient real-time image. The patient can be guided by the silhouette to correctly locate the sEMG apparatus 100 / 1001. The method enables or facilitates the corrected placement of the sEMG apparatus 100 / 1001.

[0092] Referring to Figure 10, in some examples the memory 212 includes machine readable operating instructions that when executed by the processor 210 cause the processor 210 to, generally, perform steps of:

[0093] 400: accessing a remote server to obtain exercise data relating to a patient

[0094] 402: pairing with a sEMG apparatus for receiving signals representing a muscle contraction relating to a swallowing activity

[0095] 404: graphically display on a screen a symbol representing a target swallowing exercise to be performed by the patient

[0096] 406: receive from the sEMG apparatus a signal representing a muscle contraction relating to the target swallowing exercise, and displaying on the screen a representation of the received signal together with the symbol 408: uploading to the remote server the signal representing the muscle contraction relating to the target swallowing exercise

[0097] 410: comparing a portion of the signal representing a muscle contraction relating to the target swallowing exercise with the target swallowing exercise and choosing a new target swallowing exercise based on the comparing

[0098] 412: uploading the new target exercise to the remote server repeating steps 404 to 408 using the new target exercise.

[0099] In some examples the memory 212 includes machine readable operating instructions that when executed by the processor 210 cause the processor 210 to retrieve data from a remote server 322 and to upload data to a storage medium 324 of the remote server 322. In some examples the data retrieved from the remote server 322 includes training programme data for the patient. In some examples the data uploaded to the remote server 322 includes a representation of a swallowing contraction and / or training results data for the patient. In some examples a clinician or technician using a second remote computing device 1200 can access the remote server 244 to set or adjust the data relating to the training programme. In some examples data relating to a training programme includes a time and duration of a training exercise. In some examples the data includes a frequency of a training exercise. In some examples the data includes a weighting on an amplitude component of a training target 240. In some examples the data includes a weighting on a time component of a training target 240. In some examples the data includes a weighting on a time component and an amplitude component of a training target 240. In some examples the remote computing device 200 uploads the training results data in real time so that a clinician or technician using a second remote computing device 1200 can review the results data in real time. In some examples the results data is stored in the remote server 322 storage 324 and can be reviewed by the clinician or technician at a later time. In some examples the remote server 322 and storage database 324 are so called cloud server / storage accessible via a wide area network (WAN) 320. In some examples the WAN 230 is the, so called, Internet.

[0100] In some examples machine readable operating instructions that cause the processor 210 to perform methods of the invention can be provided on a remote server 322 and made downloadable to a computing device to configure the computing device to operate as a remote computing device 200 or second remote computing device 1200 of the present invention.

[0101] Reference to any prior art in this specification is not, and should not be taken as, an acknowledgement or any form of suggestion that that prior art forms part of the common general knowledge in the field of endeavour in any country in the world. The invention may also be said broadly to consist in the parts, elements, characteristics, and features referred to or indicated in the specification of the application, individually or collectively, in any or all combinations of two or more of said parts, elements, characteristics or features.

[0102] Aspects of the present invention have been described by way of example only and it should be appreciated that modifications and additions may be made thereto without departing from the scope thereof as defined herein.

[0103] Where in the foregoing description reference has been made to integers or components having known equivalents thereof, those integers are herein incorporated as if individually set forth.

[0104] It should be noted that various changes and modifications to the presently preferred examples described herein will be apparent to those skilled in the art. Such changes and modifications may be made without departing from the spirit and scope of the invention and without diminishing its attendant advantages. It is therefore intended that such changes and modifications be included within the present invention.

Claims

CLAIMS:

1. A wearable surface electromyography (sEMG) system for providing feedback during a swallowing exercise, the system including: a wearable surface electromyography device including an electrode arranged, in use, to be in contact with the epidermis of a patient for collecting surface electrical signals relating to a muscle contraction performed during a swallowing exercise, a processor coupled with the electrode and a wireless communicator coupled with the processor, the processor adapted to process the collected surface electrical signals, and the wireless communicator operable to transmit the processed signals to a remote computing device.

2. The wearable surface electromyography system of claim 1 wherein the electrode and processor are mounted together on a PCB so as to minimise the electrical signal path between the electrode and the processor.

3. The wearable surface electromyography system of claim 1 or 2 wherein the wearable surface electromyography includes a housing adapted to be worn against skin in the head or neck region of a user of the device.

4. The wearable surface electromyography system of claims 1, 2 or 3 further including a pair of charge electrodes, the charge electrodes, when connected with an external power source, transfer energy for charging the battery.

5. The wearable surface electromyography system of any preceding claim wherein processing the collected electrical signals includes converting the collected signal into a digital signal and wirelessly transmitting the digital signal to the remote computing device.

6. The wearable surface electromyography system of any preceding claim wherein converting the collected signal includes determining a plurality of amplitude components and time components of the signal.

7. The wearable surface electromyography system of any preceding claim wherein processing collected surface electrical signals includes determining a valid surface electromyograph signal relating to a swallowing contraction.

8. The wearable surface electromyography system of any preceding claim wherein processing includes both hardware and software processing of collected surface electrical signals.

9. The wearable surface electromyography system of any preceding claim wherein the sEMG apparatus further including a battery, and wherein the processor, wireless communicator and battery are contained within the housing.

10. A method of providing feedback during a swallowing exercise, the method including: plotting, on a display of an exercise zone, a symbol to indicate a target having a target amplitude component, receiving, from at least one sensor associated with a person, a signal representing a muscle contraction performed during a swallowing exercise, the signal including a plurality of data points each representing one of a plurality of amplitude components, plotting, on the display, together with the displayed symbol, a graphical representation of the received signal, such that it is visible on the display whether a characteristic one of the plurality of amplitude components of the swallowing contraction signal corresponds with the target amplitude component.

11. The method of claim 10 wherein the symbol to indicate a target includes a target amplitude component and a target time component, the received signal representing a muscle contraction includes a plurality of data points each representing one of a plurality of amplitude components and time components of the signal, plotting on the display includes plotting a graphical representation of the received signal together with the symbol such that it is visible on the display whether a characteristic one of theplurality of amplitude components and / or time components of the swallowing contraction signal corresponds with the target amplitude component and / or a target time component.

12. A method of providing a swallowing exercise, the method including: plotting, on a display of an exercise zone, a symbol to indicate a target having a target amplitude component, receiving, from at least one sensor associated with a patient, a signal representing a muscle contraction performed during a swallowing exercise, the signal including a plurality of data points each representing one of a plurality of amplitude components, comparing a characteristic amplitude component of the signal with the target amplitude component, and based on the comparing choosing a second target, and plotting on the display a second symbol to indicate the second target.

13. The method of claim 12 wherein the symbol to indicate a target includes a target amplitude component and a target time component, the received signal representing a muscle contraction includes a plurality of data points each representing one of a plurality of amplitude components and time components of the signal, and comparing a characteristic time component of the signal with the target time component, and based on the comparing choosing a second target, and plotting on the display a second symbol to indicate the second target.

14. The method of claim 12 or 13 wherein comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component, and in response to determining an insufficient matching weighting the amplitude component of the second target.

15. The method of claim 12, 13 or 14 wherein comparing includes determining whether a second match exists between the characteristic time component and the target time component, and in response to determining an insufficient matching weighting the time component of the second target.

16. The method of any one of claims 12 to 15 wherein the target time component includes a target time component range and the target amplitude component includes a target amplitude component range, and comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component range, and in response to determining an insufficient matching increasing the target amplitude component range of the second target, or in response to determining a sufficient matching decreasing the target amplitude component range of the second target.

17. The method of any one of claims 12 to 16 comparing includes determining whether a second match exists between the characteristic time component and the target time component range, and in response to determining an insufficient matching increasing the target time component range of the second target, or in response to determining a sufficient matching decreasing the target time component range of the second target.

18. A system for providing feedback during a swallowing exercise, the system including a: a wearable surface electromyography (sEMG) apparatus arranged, in use, to be in contact with the surface of skin for collecting surface electrical signals, a processor for processing collected surface electrical signals, and a wireless communicator coupled with the processor and operable to transmit the processed signals to a remote computing device, and a computer implemented method of providing feedback during a swallowing exercise, the method including: plotting, on a display of an exercise zone, a symbol to indicate a target having an amplitude component and a time component, receiving, from at least one sensor associated with a person, a signal representing a swallowing contraction of the person, the signal including a plurality of data points each representing one of a plurality of amplitude components and time components of the signal, plotting, on the display, together with the displayed symbol, a graphical representation of the received signal, such that it is visible on the display whether a characteristic one of theplurality of amplitude components and / or time components of the swallowing contraction signal corresponds with the target amplitude component and target time component.

19. A system for providing a swallowing exercise, the system including a: a wearable surface electromyography (sEMG) apparatus as herein described, the apparatus arranged, in use, to be in contact with the surface of skin for collecting surface electrical signals, and a computer implemented method including: plotting, on a display of an exercise zone, a symbol to indicate a target having a target amplitude component and / or a target time component, receiving, from the sEMG apparatus associated with a patient, a signal representing a swallowing contraction of the patient, the signal including a plurality of data points each representing one of a plurality of amplitude components and / or time components of the signal, comparing a characteristic amplitude component and / or time component of the signal with the target amplitude component and / or a target time component, and based on the comparing choosing a second target, and plotting on the display a second symbol to indicate the second target.

20. The system of claim 19 wherein comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component, and in response to determining an insufficient matching weighting the amplitude component of the second target.

21. The system of claim 19 or 20 wherein comparing includes determining whether a second match exists between the characteristic time component and the target time component, and in response to determining an insufficient matching weighting the time component of the second target.

22. The system of claim 19, 20 or 21 wherein the target time component includes a target time component range and the target amplitude component includes a target amplitudecomponent range, and comparing includes determining whether a first match exists between the characteristic amplitude component and the target amplitude component range, and in response to determining an insufficient matching increasing the target amplitude component range of the second target, or in response to determining a sufficient matching decreasing the target amplitude component range of the second target.

23. The system of any one of claims 19 to 22 wherein comparing includes determining whether a second match exists between the characteristic time component and the target time component range, and in response to determining an insufficient matching increasing the target time component range of the second target, or in response to determining a sufficient matching decreasing the target time component range of the second target.

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