App for assisting alleviation of symptoms of movement disorders

Abstract

An assistive application 10 for controlling a wearable device 12 to operate as an assistive device for alleviating symptoms of a movement disorder, stress and / or anxiety. The device has a computer pro

Description

The present invention relates to an app, and associated methods, for configuring a wearable device to operate as an assistive device for alleviating symptoms of movement disorders. The present invention has particular, but not exclusive, relevance to a smartwatch app that is configured to allow a user to operate the smartwatch to vibrate with an appropriate vibratory pattern for alleviating symptoms (e.g., involuntary movements such as tics, tremors, dyskinesias and / or the like) associated with disorders such as Parkinson’s disease, Tourette syndrome, Tics, Tremor, and / or the like. Movement disorders are neurological conditions that adversely affect the ability of an individual to control their movement. There are many different types of movement disorders, and many different types of symptoms associated with them. Whilst movement disorders are often associated with involuntary movements such as tics, tremors, spasms, jerking, shaking, etc., they can also affect the ability of the affected individual to make and control voluntary movements including, for example, the ability to control the muscles and organs required for coherent speech. The most common movement disorders include Parkinson’s Disease (PD) which, it is estimated, is suffered by over 10 million people globally, including approximately 1 million people in the US, and 153,000 people in the UK, living with the disease. Parkinson’s disease is a progressive neurodegenerative disorder characterized by bradykinesia (slow movement), resting tremors, muscle rigidity, and postural instability. Other common movement disorders include, for example: Essential Tremor (ET) which causes involuntary, rhythmic shaking, typically in the hands, head, or voice; Dystonia, that causes involuntary muscle contractions that lead to abnormal postures or repetitive movements; Tourette Syndrome involving motor and vocal tics, such as blinking, head jerking, or involuntary sounds; and the like. There are a number of different treatments available to help manage the symptoms of movement disorders depending on the specific condition, severity, and underlying cause. Medication the primary technique used to treat the underlying condition and in so doing reduce the associated involuntary movements and / or lack of voluntary movement control. For example, dopaminergic drugs (e.g., Levodopa, dopamine agonists) may be used for Parkinson’s disease to help replenish dopamine levels that have been reduced by the loss of dopamine-producing neurons, in the region of the brain (substantia nigra (SN)) that is crucial for motor control, that is associated with Parkinson’s. Moreover, anticholinergics (e.g., Trihexyphenidyl) are sometimes used to help reduce tremors and rigidity in Parkinson’s disease and dystonia. In other cases, beta-blockers (e.g., Propranolol) can help control essential tremor, and botulinum toxin (Botox) injections may be used in the context of dystonia, tics, and some tremors to reduce muscle contractions. Nevertheless, the use of medication has a number of limitations. In the case of Parkinson’s disease, for example, Levodopa can lose effectiveness as the disease progresses due to ongoing dopamine neuron degeneration. As a result, patients need higher doses to alleviate symptoms, increasing the risk of side effects (e.g., nausea, dizziness, hallucinations, and / or confusion). Similarly, the beneficial effects of medication typically reduce over time as the medication ‘wears-off’ leading to the return of symptoms before the next dose. Long-term use of medication such as Levodopa can also, in itself, lead to the development of involuntary uncontrolled, jerky movements. Moreover, the effects of using medication can be unpredictable with associated swings between mobility and immobility in a relatively short space of time. Because of these limitations, treatment for movement disorders such as Parkinson’s disease often involves a combination of medication, lifestyle modifications, and advanced therapies. Deep brain stimulation (DBS) is one such therapeutic technique that may be used to help regulate abnormal movement-related signals and thus alleviate the symptoms of movement disorders such as Parkinson’s disease, essential tremor, and dystonia. However, DBS involves surgical implantation of electrodes into the brain and is thus invasive, carries surgical risks such as brain bleeds and infection, and can require further ‘revision’ circuitry to deal with hardware issues such as lead displacement, battery failure, or system malfunctions. It has also been found that whilst DBS can be effective for some symptoms (e.g., tremors, rigidity, and dyskinesias) it is less effective for freezing of gait, balance issues, and cognitive symptoms. In some cases, it can also lead to a worsening of speech and swallowing issues. DBS also requires regular adjustment and maintenance such as frequent reprogramming of stimulation settings, and ongoing battery management and / or replacement. DBS is also costly, not always covered by medical insurance, and so is not accessible to all patients. Wearable technology is increasingly being used to monitor, manage, and assist individuals with movement disorders like Parkinson’s disease, essential tremor, dystonia, and others. These devices help track symptoms, improve mobility, and provide feedback for treatment adjustments. Existing wearable technology includes symptom monitoring wearables that include a number of motion sensors for tracking tremors, bradykinesia, dyskinesias, and gait changes. However, these wearables are relatively complex and, in general, cannot always detect subtle symptoms accurately. The data produced also tends to be complex, requiring expert interpretation leading to limited real-time feedback for patients. Existing wearable technology also includes assistive wearables designed to counteract involuntary movements, such as tremors, and / or improve motor function. One such assistive wearable, for example, comprises a glove like wearable device that fits over the hand, wrist, and forearm. The device utilises gyroscopic stabilisation that helps stabilise the hand and thus reduce hand tremors. Whilst this device is effective at providing hand stabilisation, however, it is relatively bulky and does not help to alleviate involuntary movements elsewhere in the body. Moreover, because of the underlying gyroscopic technology, the device is expensive, which thus excludes a large proportion of potential users from being able to obtain one. Other assistive wearables comprise watch like wearable devices that are designed to provide vibratory haptic feedback to the wearer. Such feedback has been found to be effective in temporarily reducing, or even eliminating, involuntary movements in some individuals that suffer from movement disorders. One wearable assistive device, for example, has several small vibration sources arranged, when the device is worn, around the wrist of a user. Each vibration source is arranged to provide vibratory haptic feedback to the wearer with at a different respective vibration pattern. Another similar device provides haptic feedback that cycles through several different vibration patterns automatically. Yet another wrist worn wearable device is configured to both sense the tremors of a wearer, and to provide vibratory stimulation to the wearer that is adapted based on sensor feedback to provide a personalised therapeutic experience along with feedback via an associated app. All of these devices are, however, relatively complex including, for example, various combinations of: multiple vibration actuators, control circuitry, sensor circuitry, communication circuitry etc. This relative complexity increases the power consumption of the device, thus shortening battery lifetime for a given battery size, or increasing the battery size for a given battery lifetime. Available devices can also be difficult, for someone who is experiencing involuntary movements such as tremors, to use. The available wrist worn devices are also relatively expensive (from several hundred to several thousand dollars), making them unavailable to a large proportion of potential users. Moreover, the vibration patterns used in current devices can begin to cause discomfort I irritation to users after prolonged use. The present invention aims to provide one or more apps, and associated methods, for configuring a wearable device to operate as an assistive device for alleviating symptoms of movement disorders that overcomes, or at least partially ameliorates, one or more of the above issues. In one example described in more detail below there is provided an assistive application, stored on a computer-readable storage medium, for controlling a wearable device to operate as an assistive device for alleviating the symptoms of a movement disorder, stress and / or anxiety, the wearable device having a computer processor, a user interface, and a source of vibration for vibrating the wearable device against skin of a user when the wearable device is being worn by that user, the assistive application comprising instructions which, when executed by the wearable device, cause the wearable device: to receive a first user input, via the user interface, for initiating vibration of the wearable device; and on receipt of the first user input to the user interface, to initiate the vibration of the wearable device, wherein the vibration is switched on and off periodically at a specific periodic frequency specifically configured for alleviating the symptoms of the movement disorder, stress and / or anxiety. The specific periodic frequency may, for example, be 1.35Hz within a 10% tolerance. The specific periodic frequency may, nevertheless, be reconfigurable to a different periodic frequency, and the assistive application may further comprise instructions which, when executed by the wearable device, cause the wearable device to receive instructions, for reconfiguring the specific periodic frequency, from a companion application on a companion device. The specific periodic frequency may be specifically configured for alleviating the symptoms of movement disorders. The instructions which, when executed by the wearable device, cause the wearable device to initiate the vibration of the wearable device, may be configured to initiate the vibration at a specific intensity that is specifically configured to result in the vibration passing into a user’s subconscious after a period of use. The specific intensity may be reconfigurable to a different intensity, and the assistive application may further comprise instructions which, when executed by the wearable device, cause the wearable device to receive instructions, for reconfiguring the specific intensity, from a companion application on a companion device. The user interface may comprise a touchscreen display, and the instructions which, when executed by the wearable device, cause the wearable device to receive the first user input, may configured to cause the wearable device to display on the touchscreen display a first button for receiving the first user input, and the first user input may be received when the user touches the first button. The assistive application may further comprise instructions which, when executed by the wearable device, cause the wearable device, on receipt of the first user input, to display on the touchscreen display a second button for receiving second user input for stopping vibration of the wearable device. The instructions which, when executed by the wearable device, cause the wearable device to display on the touchscreen display the second button, may be configured to cause the wearable device to display the second button in place of the first button. The instructions which, when executed by the wearable device, cause the wearable device to display on the touchscreen display the second button, may be configured to cause the wearable device to receive the second user input for stopping vibration of the wearable device, when the user touches the second button. The assistive application may further comprise instructions which, when executed by the wearable device, cause the wearable device, on receipt of the second user input, to stop the vibration of the wearable device. The instructions which, when executed by the wearable device, cause the wearable device to display on the touchscreen display the second button, may be configured to cause the wearable device to display the second button in place ofthe first button. The assistive application may further comprise instructions which, when executed by the wearable device, cause the wearable device, on receipt of the second user input, to redisplay on the touchscreen display the first button for receiving first user input for initiating vibration of the wearable device. The instructions which, when executed by the wearable device, cause the wearable device to redisplay on the touchscreen display the first button, may be configured to cause the wearable device to redisplay the first button in place of the second button. The assistive application may further comprise instructions which, when executed by the wearable device, cause the wearable device to disable at least one energy saving function that could otherwise cause the wearable device to pause or stop operation of the assistive application. The instructions which, when executed by the wearable device, cause the wearable device to disable at least one energy saving function may be configured to allow the wearable device to continue to employ at least one further energy saving function that turns a display of the wearable device off whilst operation of the assistive application continues. In one example described in more detail below there is provided a wearable device having installed thereon an assistive application as summarised above. In one example described in more detail below there is provided a companion application to the assistive application summarised above, the companion application being stored on a computer-readable storage medium, and configured for controlling a companion device to the wearable device, the companion device having a further computer processor and a further user interface, the companion application comprising instructions which, when executed by the companion device, cause the companion device: to receive a third user input, via the further user interface, for reconfiguring the vibration of the wearable device; and on receipt of the third user input, to provide instructions to the wearable device for reconfiguring the vibration of the wearable device in accordance with the third user input. The third user input may be for reconfiguring the specific periodic frequency to a different specific periodic frequency, and the instructions which, when executed by the companion device, cause the companion device to provide instructions to the wearable device for reconfiguring the vibration, may be configured to cause the companion device to provide instructions to the wearable device for reconfiguring the specific periodic frequency to the different specific periodic frequency. The third user input may be for reconfiguring an intensity of the vibration to a different intensity, and the instructions which, when executed by the companion device, cause the companion device to provide instructions to the wearable device for reconfiguring the vibration, may be configured to cause the companion device to provide instructions to the wearable device for reconfiguring the intensity of the vibration to the different intensity. The companion application may further comprise instructions which, when executed by the companion device, cause the companion device: to provide means for receiving user feedback, via the further user interface, for indicating a quality of experience arising from using the assistive application; and to provide data corresponding to the user feedback to a central entity for accumulation of performance data from multiple assistive applications on multiple wearable devices. In one example described in more detail below there is provided a companion device having installed thereon a companion application as summarised above. An example of complementary assistive and companion apps incorporating the innovative concepts to which this disclosure relates, variations of that device, and associated methodologies will now be described, by way of example only, with reference to the accompanying drawings in which: Figure 1 illustrates schematically, installation and operation of an assistive app for configuring a wearable device to operate as an assistive device for alleviating symptoms of movement disorders; Figure 2 is a simplified illustration of configuration and operation of example user interfaces that may be implemented for an assistive app of the type shown in Figure 1; Figure 3 is a simplified sequence diagram illustrating the main steps that may be involved in operating an assistive app of the type shown in Figure 1; and Figure 4 is a simplified block schematic illustrating the main components of a device such as a wearable device on which an assistive app of the type shown in Figure 1 may be installed, or a companion device on which a companion app may be installed. Overview Figure 1 illustrates schematically, installation and operation of an assistive application (‘app’) 10 for configuring a wearable device 12 (in this example a smartwatch) to operate as an assistive device for alleviating symptoms of movement disorders. As those skilled in the art will be appreciate, whilst the assistive app 10 is described primarily in terms of alleviating symptoms of movement disorders the haptic vibratory sensation provided by the wearable device 12 under the control of the assistive app 10 can also provide benefits to sufferers of anxiety and / or stress, for example, by providing stimuli for helping to control breathing or the like. As seen in Figure 1, the assistive app 10, and (optionally) a companion app 14 for the assistive app are installable on the wearable device 12 (in this example a smartwatch) and on a companion device 16 (in this example a smartphone) respectively. It will be appreciated that whilst the wearable device 12 and companion device 16 are described as being a smartwatch and smartphone respectively (because such devices are commonplace and generally user friendly) the wearable device 12 and companion device 16 could be in the form of any suitable device. For example, the wearable device 12 could be any wearable device that is capable of providing a vibratory haptic sensation to the wearer, and to which an app can be installed, such as wearable fitness trackers, health monitors, smart glasses, smart jewellery (such as rings, bracelets, or the like), and / or smart clothing. Similarly, if a companion app 14 is provided, the companion device 16 on which it is installed may be any device that is capable of forming a wireless or wired communicative connection with the wearable device 12 for the purposes of assisting the configuration, management, and / or installation of the assistive app on the wearable device 12. For example, the companion device 16 could be any suitable computing device such as a general purpose computer, tablet computer, personal digital assistant, or the like. The assistive app 10 is obtainable from an app provider 20, for example in the form of a download over the internet, or as an installable file stored on a memory device such as a universal serial bus (USB) drive / stick, a secure digital (SD) card, or the like. It will be appreciated that the assistive app 10 may be installable directly onto the wearable device 12 from the app provider 20 I memory device without requiring the assistance of another device (such as the companion device 16 or another computing device). Nevertheless, that the assistive app 10 may be installable indirectly onto the wearable device 12 from (or at least with the assistance of) another device (such as the companion device 16 or another computing device or the like). Similarly, the companion app 14 (if used) is obtainable from the (or possibly a different) app provider 20, for example in the form of a download over the internet, or as an installable file stored on a memory device such as a universal serial bus (USB) drive / stick, a secure digital (SD) card, or the like. It will be appreciated that the comp / anion app 14 may be installable directly onto the companion device 16 from the app provider 201 memory device without requiring the assistance of another device. Nevertheless, that the companion app 14 may be installable indirectly onto the companion device 16 from another device (such as another computing device or the like). The wearable device 12 comprises a vibration source (not shown) for providing harmonic vibration V, for example in the form of a small form factor direct current (DC) motor that is configured to generate harmonic vibration by means of an eccentric rotating mass (ERM), or a linear resonant actuators (LRAs). Beneficially, as described in more detail later, the assistive app 10, is configured for controlling, when installed and activated on the wearable device 12, the vibration source to provide vibration V with a specific (default) on-off frequency (and duty cycle and / or intensity) - i.e., the frequency at which the vibration is switched on and off (and the proportion of the time the vibration is on) - that has been deliberately optimised to be effective in alleviating the symptoms of as broad a range of different movement disorders as possible. Generally, it has been found that a 50% duty cycle (i.e., with equal length ‘ON’ and ‘OFF periods is effective. However, it is possible that the optimum duty cycle might vary depending on the user and / or condition being treated (for example where the period that the vibration is on is shorter than the period that it is off (or vice versa). Specifically, the assistive app 10 is configured to switch the vibration V on and off at a frequency of 1.35Hz (within reasonable tolerances of, for example, 10%), which corresponds to 81 beats per minute (or 73 to 89 beats per minute when the 10% tolerance is applied). This frequency has been found to be particularly effective at alleviating the symptoms of various movement disorders in as large a proportion of different wearers as possible. Whilst the specific reasons for this efficacy are not certain, it is believed that the proximity of this optimised frequency to the centre of the typical range of heart rates for a human (typically 60 to 100 beats per minute) may be a factor. In effect, controlling the vibration V in this way creates a tapping sensation as the assistive device 10 switches periodically between vibrating and not vibrating. Whilst understanding of the precise mechanisms behind the haptic vibratory sensation’s effectiveness is currently limited, it appears that the various conditions it benefits generally involve dysfunction of the basal ganglia - a brain region responsible for subconscious, automatic sensorimotor control. Whilst earlier studies of similar phenomenon suggested that users may benefit by consciously focusing on the vibration signals, in a process known as "cueing", the inventors believe that such a conscious focus may simply trigger goal-directed behaviour, which influences the basal ganglia indirectly through alternate neural pathways. In contrast, for example, the assistive app 10 has been found to be more effective, in alleviating the symptoms of movement disorders, when the user is able to entirely ignore, at a conscious level, the vibration V that the assistive app 10 controls the wearable device 12 to provide. It is believed this allows the somatosensory stimulation to act directly on the subconscious processes governed by the basal ganglia. In effect, the assistive app 10 is controlling the wearable device 12 to function as a ‘pacemaker for the brain’; supporting the regulation of neural activity via rhythmic sensory input to the basal ganglia. By allowing conscious attention to be diverted away from the vibratory stimulus, the effect remains within the subconscious sensorimotor system rather than being rerouted by conscious attention. Initial data supports this theory, though in cases of anxiety or heightened stress, consciously engaging with the vibrations may still offer therapeutic benefits. Additionally, anecdotal evidence suggests a possible entrainment effect - with some evidence of sustained improvement even when the assistive device is no longer in use after several weeks. This may point to longer-term changes in brain activity, potentially driven by subtle, unconscious neural re-patterning that bypasses the kind of conscious scrutiny that might otherwise inhibit such change. In its simplest form, the assistive app 10 may be configured to control the wearable device 12 to provide the default optimised on-off frequency of, for example, 1.35Hz (±10%) as a single on-off frequency without, for example, providing a mechanism for selecting, or automatically switching, between different on-off frequencies and / or patterns of on-off duty cycle switching. Such a configuration allows the complexity of the assistive app 10, and hence the associated user interface provided on the wearable device, to be minimised. This is particularly beneficial in the context of a wearable device 12, such as a smartwatch or the like, with a relatively small screen via which a user interface can be provided because a more complex user interface requiring, for example, several buttons, menus, sub-menus, specific figure movements, and / or the like and be extremely difficult-if not impossible -for someone exhibiting symptoms of a movement disorder. Beneficially therefore, as described in more detail later, the assistive app 10 is configured to provide a simple user interface, for activating and deactivating the haptic vibratory sensation, at the default on-off frequency, that is accessible to users who experience the difficulties with fine motor control / dyskinesia that is typical of people with a movement disorder. This is particularly advantageous, for example, where a user’s movement disorder affects their ability to control the movement of their hands and arms and thus make operation of the wearable device 12 more difficult, especially in the case where the wearable device 12 is, itself, worn on part of the user’s body that the user’s movement disorder makes it difficult to control. Moreover, configuring the assistive app 10 for operation using a single button to activate and deactivate the assistive device 10 (e.g., without providing any other additional mechanism for receiving user input for controlling operation of the device), also helps to keep the cost and complexity of the assistive device 10 to a minimum whilst allowing for simple operation that ensures that the assistive device 10 can be operated relatively easily even by an individual affected by a movement disorder, such as Parkinson’s disease, that can make it difficult to operate more complex small devices with several small, multifunctional, buttons or the like. It will be appreciated that many conventional wearable devices 12 such as smartwatches or the like employ aggressive energy saving functions including, for example, aggressive management of installed apps (e.g., pausing / closing them) to reduce drain on battery life. Beneficially, as described in more detail later, the assistive app 10 is configured to disable any power saving function that would pause or close the assistive app 10 and stop the vibrations. This may be achieved in different ways for wearable devices 12 that operate using different operating systems. For some operating systems (e.g., Android ©based operating systems), for example, a so-called ‘wake-lock’ can be employed to stop the operating system closing the assistive app 10. Nevertheless, to minimise the battery drain while the assistive app 10 is active ( / .e., causing the wearable device to vibrate at the default on-off frequency), the assistive app 10 is configured to allow the wearable device 12 to engage a screen lock or the like, to allow the screen to go blank, in accordance with default, or user configured settings, of the wearable device 12. Typically, a wearable device 12 such as a standard smartwatch, will be configured to naturally disengage the screen lock, when a user looks at the screen, based on feedback from sensors (e.g., one or more accelerometers) of the wearable device 12, thus avoiding the need for a user having to manually disengage the screen lock. For a wearable device 12 that does not have such an auto-unlock function, however, the assistive app 10 may be configured to automatically disengage the screen lock when a user looks at a screen of the wearable device 12 (subject to appropriate user consent if needed). It will be appreciated that avoiding or minimising occasions in which the haptic vibratory sensation provided by the assistive app 10 comes to an apparent ‘random’ stop due to operating system ‘housekeeping’ helps to ensure that the user has a relatively high QoE while using the assistive app 10, by avoiding what would otherwise be a negative user experience. Effectively disabling the ability of the wearable device to disable I pause the assistive app 10 whilst it is engaged in providing the haptic vibratory sensation, whilst still allowing the screen to switch off, balances the need for reducing battery drain with the needs of a user that is experiencing symptoms of a movement disorder. Operating at a single optimised ‘default’ on-off frequency without switching between different on-off frequencies and / or using patterns of on-off switching can help to allow a user to divert their conscious focus to other activities, and to reduce / prevent discomfort / irritation that might otherwise be experienced by a userafter prolonged use. This is because the consistent nature of the vibration V, and the relatively low on-off frequency used (that is close to that of a normal heartbeat), results in the vibration V rapidly passing into a user’s sub-conscious as they continue with their normal activities. Nevertheless, where a companion app 14 is also provided, the companion app 14 may comprise an assistive app manager 22, or the like, that is configured to allow user configuration and / or automated optimisation of: the on-off frequency of the vibration V provided by the wearable device 12 under the control of the assistive app 10; and / or the intensity of the vibration. For example, the assistive app manager 22 may be configured to allow a user of the assistive app 10 to select an on-off frequency and / or intensity, for the vibration V, from a set of selectable candidate on-off frequencies and / or intensities. For example, the assistive app manager 22 may allow selection from a set of candidate on-off frequencies that respectively includes one or more condition-specific optimised on-off frequencies that have been found to be particularly effective for each of a number of different movement disorders. Additionally, or alternatively, the assistive app manager 22 may be configured to allow a user of the assistive app 10 to indicate a specific on-off frequency from a range of possible on-off frequencies and / or to fine-tune the on-off frequency to suit their own personal needs. Similarly, the assistive app manager 22 may additionally, or alternatively, be configured to allow a user of the assistive app 10 to seiect / indicate a specific intensity to fine-tune the intensity to suit their own personal needs. It will be appreciated, for example, that whilst a default frequency of 1,35hz has been found to be the most universally effective on-off frequency in that it has been observed to provide the greatest benefits across the widest range of conditions and individuals, a different on-off frequency may be prove to be more effective for a specific condition (e.g., tremor) and / or for certain individuals. Accordingly, providing a companion app 14 that can be used to configure the assistive app 10 to perform in accordance with these different requirements, by varying the frequency of the vibration Vina relatively simple way, provides a number of advantages. Similarly, it will be appreciated that, in the context of alleviating the symptoms of movement disorders, whilst it may be desirable for a user to be able to ignore the vibrations V, different users will have different capabilities for allowing the vibrations V to pass into their subconscious. Conversely, in the context of providing relief from anxiety or stress, a user may find it more effective if that user remains conscious of the haptic vibratory sensation throughout the time the assistive app 10 is active. Accordingly, providing a companion app 14 that can be used to configure the assistive app 10 to perform in accordance with these different (conflicting) goals, by varying the intensity of the vibration Vin a relatively simple way, provides a number of advantages. It will be appreciated that, by providing such functionality via a companion app 14, on a companion device 16 (such as a smartphone or tablet), there is more flexibility to have a user interface that provides the additional functionality, whilst remaining relatively accessible, for someone with a movement disorder. For example, where the companion device 16 has a touch screen interface, the larger screen that is typically provided with such a device allows for a greater number of larger buttons, menus, submenus, and / or the like to be provided that are, nevertheless, still reasonably accessible by someone exhibiting symptoms of a movement disorder, thus enabling relatively easy navigation and control of the assistive app 10, via the companion app 14. Moreover, as the wearable device 12 and companion device 16 are separate devices, the assistive app 10 on the wearable device 12 can be operating to provide the vibration V, and hence alleviate a user’s symptoms, while the user is using the companion app 22 to reconfigure the assistive app 10, and hence the on-off frequency and / or intensity of the vibration V provided via the wearable device 12. Beneficially, where a companion app 14 having an assistive app manager 22 is provided, the assistive app manager 22 may, additionally (or alternatively), be configured to accumulate feedback from the assistive app 10 relating to the way in which the assistive app 10 is used, data relating to the way the user configures the assistive app 10, and / or qualitative feedback from the user (e.g., indicating a quality of experience (QoE) of the user). The accumulated data may, for example, be used to track the effectiveness of a given reconfiguration of the assistive app 10. For example, a given setting (intensity and / or frequency) may be recorded by the assistive app manager 22 and the user prompted to provide a QoE evaluation - e.g., of the efficacy of the frequency. The accumulated data can thus be analysed and used locally to provide an indication of a recommended on-off frequency (and / or intensity) for a given user and / or condition. Moreover, the assistive app manager 22 may be configured to provide the feedback from the assistive app 10 (and / or user of the assistive app 10) to a (remotely located) assistive app knowledge pool 24 (subject to appropriate anonymisation and / or user permissions) - e.g., located in the ‘cloud’. Such feedback data may be accumulated in the assistive app knowledge pool 24, in conjunction with similar feedback data from other assistive apps 10 on other wearable devices belonging to other users (and / or from their users). The accumulated data from multiple users may thus be analysed and used to provide feedback to the assistive app manager 22 of the companion app 14 to configure a recommended ‘tuned’ on-off frequency (and / or intensity) for a specific condition (e.g., reported via a given companion app 14), or to provide a respective recommended ‘tuned’ on-off frequency (and / or intensity) for each of a plurality of different conditions that a user of the companion app 14 may manually select from, and / or the assistive app manager 22 may automatically select from (e.g., based on information entered by the user indicating their condition). It will be appreciated that, to facilitate this, the assistive app knowledge pool 24 may employ machine learning, based on the accumulated user / app feedback, to continuously improve the efficacy of the assistive app through direct analysis and feedback. Moreover, the accumulated user / app feedback may be used to inform further development and / or refinement of the assistive app 10 and / or companion app 14 that can be implemented in new, updated, versions of the assistive app 10. It will be appreciated that the assistive app manager 22 (where provided) may also (or alternatively) provide assistance in the initial downloading / installation of the assistive app to the wearable device 12. Beneficially, where a companion app 14 having an assistive app manager 22 is provided, the assistive app manager 22 may, additionally (or alternatively), be configured to implement one or more mechanisms or techniques for handling scenarios in which the user of the wearable device 12 is not in the vicinity of the companion device 14. In such a scenario for example, when the assistive app 10 on the wearable device 12 is unable to connect (e.g., via a Bluetooth, WiFi, or other connection) to the companion app 14 on the companion device 16, then the assistive app 10 may be configured to maintain, or revert to, the last known setting / configuration provided via the companion app 14 by default. Accordingly, the assistive app 10 can continue to function even when the wearable device 12 is not within communication range of the companion device 16. Nevertheless, even when out of communication range with the wearable device 12, the assistive app manager 22 of the companion app 14 may still be configured to allow simple variation of the configuration (e.g., on-off frequency I pattern, intensity and / or other control information) at the companion device 16. When the companion device 16 enters the communication range of, and connects to, the wearable device 12, the companion app 14 can pass on the revised settings / configuration to the assistive app 10 for the purposes of reconfiguring the assistive app 10. The configuration and operation of the assistive app 10 will now be described, by way of example only, with reference to Figures 2 to 4. Assistive App User Interface As mentioned above, the assistive app 10 is configured to provide a simple user interface, for activating and deactivating the haptic vibratory sensation, at the default on-off frequency. A possible implementation of the user interface will now be described, by way of example only, with reference to Figure 2 which is a simplified illustration of configuration and operation of example user interfaces that may be implemented for an assistive app 10 of the type shown in Figure 1. In Figure 2, two different types of wearable device 12-1, 12-2 (12) are shown (both smartwatches of different shapes in the illustrative example). Each wearable device 12 has a respective assistive app 10 (not illustrated) installed on it having a corresponding user interface 200-1, 200-2 (200). Each user interface 200 is respectively configured for the display, on a touch screen of the corresponding wearable device 12, of a corresponding start button 210-1, 210-2 (210) or a corresponding stop button 212-1, 212-2 (212) depending on the current state of the assistive app 10. The assistive app 10 is configured, when the assistive app 10 is in a first ‘open but inactive’ state (S1) in which the assistive app 10 is open and operating, but the vibration V is deactivated, to display the start button 210 on the user interface 200 but not the stop button 212. The assistive app 10 is also configured, when the assistive app 10 is in a second ‘open and active’ state (S2) in which the assistive app 10 is open and operating, and the vibration V is activated, to display the stop button 212 on the user interface 200 but not the start button 212. Moreover, the assistive app 10 is configured, when in the first state S1 and the displayed start button 210 is touched by a user, to transition (back) to the second state S2 - by starting the vibrations V at the default / configured on-off frequency and changing from displaying the start button 210 to displaying the stop button 212. Similarly, the assistive app 10 is configured, when in the second state S2 and the displayed stop button 212 is touched by a user, to transition (back) to the first state S1 - by stopping the vibrations V at the default / configured on-off frequency and changing from displaying the stop button 212 to displaying the start button 210. Since only a single button is displayed at a given time, as seen in Figure 2, the start button 210 and stop button 212 can be configured to take up a relatively large proportion of the screen ‘real-estate’ of the wearable device making the button more visible to users, easier to operate even for those struggling with fine motor control / dyskinesia, and the user interface simplerand more intuitive forthose who may be less able. It will be appreciated that whilst the start and stop buttons 210, 212 shown in Figure 2 fora given type of wearable device 12 are of the same size and shape this need not be the case as long as they are visible and of sufficiently large size for a user to operate with relative ease. Similarly, whilst there are technical benefits (e.g., in terms of simplicity and ease of operation) in having the start and stop buttons 210, 212 at essentially the same location on the screen of the wearable device 12, even if this were not the case the display of a single simple button which changes based on the state of the assistive app 10 still provides the benefit that the need to display two smaller buttons is avoided. It will also be appreciated that complete closure of the assistive app 10 may be triggerable by means of the companion device 16 (if any) and / or by another mechanism via the wearable device - e.g., by touching the stop button 212 (and / or possibly start button 210) for a prolonged period, and / or by a standard mechanism for a wearable device 12 of that type (e.g., swiping of the app display I button 210, 212 in a given direction). Assistive App Operation Exemplary operation of the assistive app will now be described, by way of example only, with reference to Figure 3 which is a simplified sequence diagram illustrating the main steps that may be involved in operating the assistive app 10. In the example of Figure 3, it is assumed that the assistive app 10 has previously been installed on the wearable device 12 by a user 50 (for example with the assistance of a companion app 14 installed on a companion device 16). As seen in Fig. 3, at S300, when the user 50 initially interacts with the wearable device12 to open the assistive app 10, the wearable device 12 instructs, at S302, the assistive app S302 to launches. The assistive app 10 then instructs, at S304, the wearable device to display the start button (e.g., the start button 210 as shown in Figure 2) and, if needed, to disable any sleep mode and / or any similar energy saving function that might otherwise close the assistive app 10 (or to pause it) and thus stop the assistive app 10 from functioning (e.g., after a period of perceived inactivity). For example, a so-called ‘wake-lock’, or the like, may be employed to stop the operating system closing the assistive app 10. It will be appreciated that whilst the step at S304 is shown as a single step for simplicity, instruction of the display of the start button, and the disabling of the energy saving functionality, may take place at different times in any appropriate sequence. Accordingly, at S306 the wearable device disables any sleep mode and / or any similar energy saving function that might otherwise close or pause the assistive app 10 and displays the start button (e.g., the start button 210 as shown in Figure 2). Again, it will be appreciated that the display of the start button and the disabling of the energy saving functionality may take place at different times in any appropriate sequence. When the user 50 subsequently touches the start button at S308, the assistive app 10 instructs, at S304, the wearable device to display the stop button (e.g., the stop button 212 as shown in Figure 2), and to commence vibration with the default / configured on-off frequency / duty cycle. It will be appreciated that whilst the step at S310 is shown as a single step for simplicity, instruction of the display of the stop button, and the initiation of vibration may take place at different times in any appropriate sequence. Accordingly, at S312 the wearable device displays the stop button (e.g., the stop button 212 as shown in Figure 2) and initiates the vibration at the default / configured on-off frequency / duty cycle. Again, it will be appreciated that the display of the stop button and the initiation of vibration may take place at different times in any appropriate sequence. When the user 50 subsequently touches the stop button at S314, the assistive app 10 instructs, at S316, the wearable device to display the start button again (e.g., the start button 210 as shown in Figure 2), and to cease vibration. It will be appreciated that whilst the step at S316 is shown as a single step for simplicity, instruction of the (re)display of the start button, and the ceasing of vibration may take place at different times in any appropriate sequence. Accordingly, at S318 the wearable device displays the start button (e.g., the start button 210 as shown in Figure 2) and ceases the vibration. Again, it will be appreciated that the display of the start button and the ceasing of vibration may take place at different times in any appropriate sequence. Steps S308 through S318 may thus be repeated as needed by the user 50 until the assistive app 10 is closed. Wearable Device Figure 4 is a simplified block schematic illustrating the main components of a device such as the wearable device 12 on which the assistive app 10 may be installed, or companion device 16 on which the companion app 14 may be installed. As shown, the wearable / companion device 12 / 16 is a communication device having a transceiver circuit 410 that is operable to transmit signals to and to receive signals from other communication devices, via one or more antenna 412, including, for example, the other of the wearable / companion device 12 / 16, and possibly an access node (such as a cellular base station) of a cellular communication system. The wearable / companion device 12 / 16 has a controller 420 for controlling the operation of the wearable / companion device 12 / 16. The controller 420 is associated with a memory 430 and is coupled to the transceiver circuit 410. The wearable / companion device 12 / 16 also has a user interface 440 (a touch screen display in this example) for allowing control by, and interaction with, a user. Although not necessarily required for its operation, the wearable / companion device 12 / 16 might, of course, have all the usual additional functionality of a conventional communication device of that type (e.g., in the case of a smartwatch, a microphone, speaker, messaging, voice and data communication, other communication functionalities, and / or the like) and may be provided by any one or any combination of hardware, software, and firmware, as appropriate. Software may be pre-installed in the memory 430 and / or may be downloaded via a communication system or from a removable data storage device (RMD), for example. The controller 420 is configured to control overall operation of the wearable device 12 by, in this example, program instructions or software instructions stored within the memory 430. As shown, these software instructions include, among other things, an operating system 432, a communication control module 434, and an energy saving module 436. The memory 430 also includes an app storage area 438 in which apps such as the assistive / companion app 10 / 12 and any other apps 450 may be stored. The communication control module 434 is operable to control the communication between the wearable / companion device 12 / 16 and other communication devices such as the other of the wearable / companion device 12 / 16, and possibly an access node (such as a cellular base station) of a cellular communication system. The communication control module 434 is configured, in particular, to control the communication of the wearable / companion device 12 / 16, where applicable, in accordance with any of the methods described above. The energy saving module 436 is configured to apply energy saving functions such as the pausing and / or closing of apps that a user has not interacted with for a time and the switching off of the screen when not being used. Summary It can be seen, therefore, that the assistive app described above beneficially provides a low-cost effective way to convert an existing wearable device with a vibratory capability into an assistive device for alleviating the symptoms of movement disorders, stress, and / or anxiety. Moreover, where a companion app is provided the assistive app and companion app may be used together to help build a knowledge pool, based on (anonymised) data from multiple users, which can be subject to appropriate cloud-based data analysis for improving the efficacy of the assistive app, can be used as a source of training data to facilitate federated asynchronous machine learning and the formation of federated asynchronous databases that act in synergy to provide a complete platform that is continually improved based on the experience of multiple users. As those skilled in the art will appreciate, whilst a detailed example has been described above, a number of modifications and alternatives can be made to the above example whilst still benefiting from the innovative concepts embodied therein. In the above description the wearable device and the companion device are described for ease of understanding as having a number of discrete functional components or modules. Whilst these modules may be provided in this way for certain applications, for example where an existing system has been modified to implement the disclosed enhancements, in other applications, for example in systems designed with the inventive features in mind from the outset, these modules may be built into the overall operating system or code and so these modules may not be discernible as discrete entities. Each controller may comprise any suitable form of processing circuitry including (but not limited to), for example: one or more hardware implemented computer processors; microprocessors; central processing units (CPUs); arithmetic logic units (ALUs); input / output (IO) circuits; internal memories I caches (program and / or data); processing registers; communication buses (e.g. control, data and / or address buses); direct memory access (DMA) functions; hardware or software implemented counters, pointers and / or timers; and / or the like. Various other modifications will be apparent to those skilled in the art and will not be described in further detail here. Various other modifications will be apparent to those skilled in the art and will not be described in further detail here.

Claims

1. An assistive application, stored on a computer-readable storage medium, for controlling a wearable device to operate as an assistive device for alleviating the symptoms of a movement disorder, stress and / or anxiety, the wearable device having a computer processor, a user interface, and a source of vibration for vibrating the wearable device against skin of a user when the wearable device is being worn by that user, the assistive application comprising instructions which, when executed by the wearable device, cause the wearable device:to receive a first user input, via the user interface, for initiating vibration of the wearable device; andon receipt of the first user input to the user interface, to initiate the vibration of the wearable device, wherein the vibration is switched on and off periodically at a specific periodic frequency specifically configured for alleviating the symptoms of the movement disorder, stress, and / or anxiety.

2. The assistive application of claim 1, wherein the specific periodic frequency is 1,35Hz within a 10% tolerance.

3. The assistive application of claim 1 or 2, wherein the specific periodic frequency is reconfigurable to a different periodic frequency, and wherein the assistive application further comprises instructions which, when executed by the wearable device, cause the wearable device to receive instructions, for reconfiguring the specific periodic frequency, from a companion application on a companion device.

4. The assistive application of any preceding claim, wherein the specific periodic frequency is specifically configured for alleviating the symptoms of movement disorders.

5. The assistive application of any preceding claim, wherein the instructions which, when executed by the wearable device, cause the wearable device to initiate the vibration of the wearable device, are configured to initiate the vibration at a specificintensity that is specifically configured to result in the vibration passing into a user’s subconscious after a period of use.

6. The assistive application of claim 5, wherein the specific intensity is reconfigurable to a different intensity, and wherein the assistive application further comprises instructions which, when executed by the wearable device, cause the wearable device to receive instructions, for reconfiguring the specific intensity, from a companion application on a companion device.

7. The assistive application of any preceding claim, wherein the user interface comprises a touchscreen display, wherein the instructions which, when executed by the wearable device, cause the wearable device to receive the first user input, are configured to cause the wearable device to display on the touchscreen display a first button for receiving the first user input, and wherein the first user input is received when the user touches the first button.

8. The assistive application of claim 7, wherein the assistive application further comprises instructions which, when executed by the wearable device, cause the wearable device, on receipt of the first user input, to display on the touchscreen display a second button for receiving second user input for stopping vibration of the wearable device.

9. The assistive application of claim 8, wherein the instructions which, when executed by the wearable device, cause the wearable device to display on the touchscreen display the second button, are configured to cause the wearable device to display the second button in place of the first button.

10. The assistive application of claim 8 or 9, wherein the instructions which, when executed by the wearable device, cause the wearable device to display on the touchscreen display the second button, are configured to cause the wearable device to receive the second user input for stopping vibration of the wearable device, when the user touches the second button.

11. The assistive application of claim 8, 9, or 10, wherein the assistive application further comprises instructions which, when executed by the wearable device, causethe wearable device, on receipt of the second user input, to stop the vibration of the wearable device.

12. The assistive application of any of claims 8 to 11, wherein the instructions which, when executed by the wearable device, cause the wearable device to display on the touchscreen display the second button, are configured to cause the wearable device to display the second button in place of the first button.

13. The assistive application of any of claims 8 to 12, wherein the assistive application further comprises instructions which, when executed by the wearable device, cause the wearable device, on receipt of the second user input, to redisplay on the touchscreen display the first button for receiving first user input for initiating vibration of the wearable device.

14. The assistive application of claim 13, wherein the instructions which, when executed by the wearable device, cause the wearable device to redisplay on the touchscreen display the first button, are configured to cause the wearable device to redisplay the first button in place of the second button.

15. The assistive application of any preceding claim, wherein the assistive application further comprises instructions which, when executed by the wearable device, cause the wearable device to disable at least one energy saving function that could otherwise cause the wearable device to pause or stop operation of the assistive application.

16. The assistive application of claim 15, wherein the instructions which, when executed by the wearable device, cause the wearable device to disable at least one energy saving function are configured to allow the wearable device to continue to employ at least one further energy saving function that turns a display of the wearable device off whilst operation of the assistive application continues.

17. A wearable device having installed thereon an assistive application according to any previous claim.

18. A companion application to the assistive application of any of claims 1 to 16, the companion application being stored on a computer-readable storage medium, and configured for controlling a companion device to the wearable device, the companion device having a further computer processor and a further user interface, the companion application comprising instructions which, when executed by the companion device, cause the companion device:to receive a third user input, via the further user interface, for reconfiguring the vibration of the wearable device; andon receipt of the third user input, to provide instructions to the wearable device for reconfiguring the vibration of the wearable device in accordance with the third user input.

19. A companion application as claimed in claim 18, wherein the third user input is for reconfiguring the specific periodic frequency to a different specific periodic frequency, and the instructions which, when executed by the companion device, cause the companion device to provide instructions to the wearable device for reconfiguring the vibration, are configured to cause the companion device to provide instructions to the wearable device for reconfiguring the specific periodic frequency to the different specific periodic frequency.

20. A companion application as claimed in claim 18, or 19, wherein the third user input is for reconfiguring an intensity of the vibration to a different intensity, and the instructions which, when executed by the companion device, cause the companion device to provide instructions to the wearable device for reconfiguring the vibration, are configured to cause the companion device to provide instructions to the wearable device for reconfiguring the intensity of the vibration to the different intensity.

21. A companion application as claimed in claim 18, 19, or 20, further comprising instructions which, when executed by the companion device, cause the companion device: to provide means for receiving user feedback, via the further user interface, for indicating a quality of experience arising from using the assistive application; and to provide data corresponding to the user feedback to a central entity for accumulation of performance data from multiple assistive applications on multiple wearable devices.

22. A companion device having installed thereon a companion application according to any of claims 18 to 21.A

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