Remote medical support system

Abstract

We provide rehabilitation programs for orthopedic patients through a remote medical consultation system using smart devices. A patient's recovery assessment score is calculated by inputting answers to multiple questions in a questionnaire using a health-related QOL assessment scale from the patient's smart device. Alternatively, the calculated recovery assessment score is input into a medical institution's PC. A rehabilitation index that quantitatively evaluates the patient's recovery state on a numerical scale is determined based on the calculated or input recovery assessment score, and a rehabilitation program of a grade appropriate for the patient's recovery state is selected based on the determined rehabilitation index. The selected rehabilitation program is saved in the storage device of the medical institution's PC together with the patient's identification number. The rehabilitation program saved on the PC is called up by inputting the patient's identification number and displayed as an animation on the screen, and the patient performs the instructed rehabilitation exercises according to the rehabilitation program displayed as an animation.

Description

[Technical Field]

[0001] The present invention relates to a remote medical support system for supporting the selection and implementation of a rehabilitation program for orthopedic patients who are able to move independently. [Background technology]

[0002] Orthopedic patients with musculoskeletal diseases and disorders have reduced mobility even after treatment is complete, so they require a certain period of rehabilitation to return to their pre-illness state. Rehabilitation is performed with the goal of restoring the patient's motor function after treatment is complete.

[0003] Rehabilitation guidance for orthopedic patients who are able to move independently is provided by a doctor who examines the patient and provides exercise guidance tailored to the patient's condition as determined by the examination. Rehabilitation usually takes several months or more, depending on the type and severity of the disease being treated, and because the patient's motor function fluctuates during the recovery process, patients must visit medical institutions regularly during the rehabilitation period to receive checkups, monitor their condition at any given time, and update their rehabilitation program to accommodate that condition. As a result, patients are forced to make regular visits to hospitals for checkups over an extended period of time, resulting in hospitals constantly being overwhelmed with outpatients.

[0004] Recently, telemedicine systems using computer network systems have been proposed. By delivering video to patients via a computer network, patients can easily and effectively receive exercise instruction without having to visit a hospital. In telemedicine systems, a medical questionnaire can be used for the examination. The patient is asked to answer multiple questions written on the questionnaire, and the patient's health condition is evaluated based on the patient's answers to the questions.

[0005] The inventors of the present invention have proposed a remote medical support system in which a doctor or physical therapist can quantitatively assess the state of a patient's motor function using a questionnaire, prescribe a rehabilitation program selected based on the results of that quantitative assessment, update the assessment of the patient's health condition at any given time as the patient performs the independent exercises prescribed in the prescribed rehabilitation program, and update the rehabilitation program prescribed to the patient based on the updated assessment (WO2023 / 219056 Patent No. 7344622). [Prior art documents] [Patent documents]

[0006] [Patent Document 1] Patent number 7344622 (WO2023 / 219056) Summary of the Invention [Problem to be solved by the invention]

[0007] WO2023 / 219056 connects a dedicated wearable electronic device to a medical institution's system server. However, with the widespread use of smart devices such as smartphones and tablets, using commercially available smart devices is more cost-effective and efficient. Furthermore, the system in WO2023 / 219056 inputs an evaluation score calculated based on responses to a medical questionnaire into the system server, which places a significant burden on the medical institution. If the patient correctly recognizes their condition and correctly understands the meaning of each question on the medical questionnaire, the system can be configured so that the patient can calculate the evaluation score by entering the answers to each question on the medical questionnaire themselves, without the need for a doctor or physical therapist. This significantly reduces the burden on the medical institution. [Means for solving the problem]

[0008] Under the circumstances described above, the inventors of the present invention have conducted intensive research to solve the above problems, and have come up with a remote medical care support system for supporting the selection and implementation of a rehabilitation program for orthopedic patients who are able to exercise independently, which includes: The system includes a smart device and a PC (personal computer) wirelessly connected to the smart device via an Internet line, the PC is installed in a medical institution and set to be accessible by the patient's doctor or physical therapist, and has application software of the remote medical care support system installed thereon; Accepts input of patient identification number, profile, type of disease treated and means for transmitting and receiving data to and from the smart device; It has a storage device and a CPU, The smart device has application software of the remote medical care support system installed thereon, The remote diagnosis is performed by inputting the patient's identification number registered in the PC. A means for logging in to the medical support system; Enter answers to multiple questions in a questionnaire using a health-related QOL assessment scale The means of acceptance, means for transmitting and receiving data to and from the PC; a means for displaying the rehabilitation program received from the PC on an output screen; It is equipped with The storage device of the PC stores a plurality of rehabilitation programs corresponding to post-operative treatments for a predetermined type of disease in the form of video, Each rehabilitation program consists of multiple exercise programs. Each of the rehabilitation programs is an exercise program that the rehabilitation program prescribes. Multiple exercises depending on the amount of stress placed on the body by running the It has a grade Each grade of the rehabilitation program has an exercise program for that grade. The rehabilitation index of the patient is appropriate for the load on the body by performing the exercise. is registered, The system comprises: The patient's answers to the plurality of questions in the questionnaire are used to Calculate a recovery assessment score; The recovery status of the patient is numerically calculated based on the calculated recovery assessment score. Determine the rehabilitation index to be evaluated on the scale, Based on the type of disease treated by the patient and the rehabilitation index, The patient is selected from among a plurality of rehabilitation programs stored in the PC storage device. Prescribe a rehabilitation program and select its grade. Display on the device output screen, The inventors have arrived at an invention of a remote medical care support system for supporting the selection and implementation of a rehabilitation program for orthopedic patients who are able to move independently.

[0009] Preferably, the grade of the rehabilitation program selected based on the rehabilitation index is stored in the PC's memory device together with the patient's identification number, and by inputting the patient's identification number registered in the PC from the smart device, the grade of the rehabilitation program stored in the PC's memory device is called up and displayed as a video on the display screen of the smart device.

[0010] Preferably, the smart device has installed thereon, in addition to the application software of the remote medical support system, application software for health management, and is configured to update the grade of the rehabilitation program selected based on the rehabilitation index based on the patient's exercise bio-information measured using the application software for health management.

[0011] Preferably, a wearable sensor device is connected to the smart device wirelessly or wired, and the grade of the rehabilitation program selected based on the rehabilitation index is updated based on the patient's exercise bio-information measured using the wearable sensor device.

[0012] Preferably, for each grade of each rehabilitation program, exercise bio-information (exercise target values) that is expected to be measured from a patient who performs the exercise prescribed by the program of that grade is registered, and the exercise target values are set corresponding to the profile of the patient who performs the exercise program, and the exercise bio-information measured and collected from a patient who performs the rehabilitation program of the selected grade can be compared with the exercise target values determined based on the patient's profile to determine whether to change the rehabilitation program of the selected grade.

[0013] Preferably, the predetermined types of diseases include musculoskeletal diseases including lower back pain (post-surgery for lumbar degenerative disease), scoliosis, post-knee joint surgery, post-hip joint surgery, and chronic lower back pain.

[0014] Preferably, the PC is configured to measure the health-related quality of life (HQOL) by calculating answers to a plurality of questions in a questionnaire using a health-related QOL assessment scale. The present invention further comprises a means for receiving an input of the recovery assessment score of the patient calculated based on the above, and is configured to be able to determine the rehabilitation index of the patient based on either the input recovery assessment score or the input recovery assessment score.

[0015] The inventors of the present invention further provide a remote medical care support system for supporting the selection and implementation of a rehabilitation program for an orthopedic patient who is able to move independently, comprising: The system includes a smart device and a PC (personal computer) wirelessly connected to the smart device via an Internet line, the PC is installed in a medical institution and set to be accessible by the patient's doctor or physical therapist, and has application software of the remote medical care support system installed thereon; Accepts input of patient identification number, profile, type of disease treated and Based on responses to multiple questions in a questionnaire using a health-related quality of life assessment scale a means for receiving an input of the recovery assessment score of the patient calculated by the above method; means for transmitting and receiving data to and from the smart device; It has a storage device and a CPU, The smart device has application software of the remote medical care support system installed thereon, The remote diagnosis is performed by inputting the patient's identification number registered in the PC. A means for logging in to the medical support system; means for transmitting and receiving data to and from the PC; A method for displaying the rehabilitation program received from the PC on an output screen as a video It is equipped with a stage, The storage device of the PC stores a plurality of rehabilitation programs corresponding to post-operative treatments for a predetermined type of disease in the form of video, Each rehabilitation program consists of multiple exercise programs. Each of the rehabilitation programs is an exercise program prescribed by the rehabilitation program. Multiple exercises depending on the amount of stress placed on the body by running the ram It has a grade Each grade of the rehabilitation program has an exercise program for that grade. The rehabilitation index of the patient is appropriate for the load on the body by performing the exercise. is registered, The system comprises: The recovery status of the patient is calculated based on the recovery assessment score entered into the PC. determining a rehabilitation index to be evaluated on a value scale; Based on the type of disease treated by the patient and the rehabilitation index, The patient is selected from among a plurality of rehabilitation programs stored in the PC storage device. Prescribe a rehabilitation program and select its grade in the PC memory storing the patient's identification number in the device; inputting the patient's registered identification number into the smart device; The rehabilitation program stored in the storage device of the PC is called by It was called out, A video is output and displayed on the display screen of the smart device. The inventors have arrived at an invention of a remote medical care support system for supporting the selection and implementation of a rehabilitation program for orthopedic patients who are able to move independently.

[0016] Preferably, the PC further comprises a means for accepting the identification number of the medical institution that prescribes the rehabilitation program along with the patient's identification number, and is configured so that the patient can log in to the remote medical support system by inputting the patient's identification number and the medical institution's identification number registered in the PC from the smart device.

[0017] Preferably, the smart device is set with a password for the patient to log in to the remote medical support system, and the patient is set up so that he or she can log in to the remote medical support system by inputting the password along with his or her own identification number into the smart device.

[0018] Preferably, the smart device has installed thereon, in addition to the application software of the remote medical support system, application software for health management, and is configured to update the grade of the rehabilitation program selected based on the rehabilitation index based on the patient's exercise bio-information measured using the application software for health management.

[0019] Preferably, a wearable sensor device is connected to the smart device wirelessly or wired, and the grade of the rehabilitation program selected based on the rehabilitation index is updated based on the patient's exercise bio-information measured using the wearable sensor device.

[0020] Preferably, for each grade of each rehabilitation program, exercise bio-information (exercise target values) that is expected to be measured from a patient who performs the exercise prescribed by the program of that grade is registered, and the exercise target values are set corresponding to the profile of the patient who performs the exercise program, and the exercise bio-information measured and collected from a patient who performs the rehabilitation program of the selected grade can be compared with the exercise target values determined based on the patient's profile to determine whether to change the rehabilitation program of the selected grade. [Effects of the Invention]

[0021] In one preferred embodiment of the system of the present invention, the system is configured so that a recovery assessment score is calculated and a rehabilitation index is determined by the patient inputting answers to multiple questions on a questionnaire using their own smart device, thereby eliminating the need for medical institutions to calculate and input a patient's recovery assessment score based on the patient's answers to the questions on the questionnaire, significantly reducing the burden on medical institutions.

[0022] One preferred embodiment of the system of the present invention allows patients to input answers to multiple questions on a medical questionnaire into a smart device without visiting a medical institution, making it possible to check the patient's recovery status at any time as it changes as rehabilitation progresses.

[0023] One preferred embodiment of the system of the present invention allows the application software of the remote medical support system to be installed on a commercially available mobile phone or tablet, making it extremely convenient for users and inexpensive, and therefore highly commercially viable.

[0024] One preferred embodiment of the system of the present invention is capable of selecting a rehabilitation program / grade to be prescribed to a patient based on a recovery assessment score / rehabilitation index calculated and determined according to the patient's profile (gender, age, height, weight, etc.), making it possible to provide a rehabilitation program tailored to the characteristics of each individual patient using a remote medical support system.

[0025] One preferred embodiment of the system of the present invention registers the patient's identification number (patient ID) along with the identification number (hospital ID) of the medical institution that prescribes the rehabilitation program to the patient, so that multiple medical institutions can access and use the database of the remote medical support system of the present invention, making it highly commercially practical.

[0026] In one preferred embodiment of the system of the present invention, the rehabilitation program is displayed as video with audio on the display screen of the patient's smart device, allowing the patient to easily and effectively receive rehabilitation exercise instructions from their own smart device.

[0027] One preferred embodiment of the system of the present invention uses a commercially available smartwatch as the wearable sensor device, which is extremely convenient for users and inexpensive, making it commercially viable.

[0028] In one preferred embodiment of the system of the present invention, instead of the patient inputting answers to each question on the questionnaire using a smart device, a doctor or physical therapist can calculate a recovery evaluation score based on the questionnaire and input it into a PC at the medical institution.This makes it highly practical as it can accommodate cases where the patient does not want to input answers to the questions on the questionnaire using a smart device or where it is difficult for the patient to input answers. [Brief explanation of the drawings]

[0029] [Figure 1] Figure 1 shows a conceptual diagram of a network of a system according to one embodiment of the present invention. A smart device 21 of patient 1, a smart device 22 of patient 2, and a smart device 23 of patient 3 are each connected to a PC 10 at a medical institution. A wearable sensor device 33 is connected to the smart device 23 of patient 3. [Figure 2] FIG. 2 shows the configuration of a PC used in a system according to one embodiment of the present invention. [Figure 3] FIG. 3 shows a configuration in which a wearable sensor device is connected to a smart device used in a system according to one embodiment of the present invention. [Figure 4] FIG. 4 shows an example of a display screen of a smart device used in a system according to one embodiment of the present invention. [Figure 5] 5(A) and (B) show the configuration of a wearable sensor device (smart watch) used in connection with a smart device according to one embodiment of the present invention. [Figure 6] FIG. 6 shows an example of the SF-36 questionnaire used in the remote medical care support system according to one embodiment of the present invention. [Figure 7] FIG. 7 shows an example of an RDQ questionnaire used in a remote medical care support system according to one embodiment of the present invention. [Figure 8] FIG. 8 shows an example of a medical questionnaire used in a remote medical care support system according to one embodiment of the present invention. [Figure 9] FIG. 9 shows an example of an input screen for answers to a plurality of questions in a medical questionnaire used in a remote medical consultation support system according to one embodiment of the present invention. [Figure 10] FIG. 10 shows the relationship between the recovery evaluation score, rehabilitation index, and rehabilitation program (for patients with lower back pain) used in the remote medical care support system according to one embodiment of the present invention. [Figure 11] Figure 11 shows the profile, target heart rate, and calorie expenditure (for a patient with lower back pain) of a patient who completed one rehabilitation unit (15 minutes of exercise) in a remote medical care support system according to one embodiment of the present invention. Figure 11(A) shows an example for a male patient, and Figure 11(B) shows an example for a female patient. [Figure 12] FIG. 12 shows the relationship between the selection and update of a rehabilitation program (for a patient with lower back pain) in one embodiment of the remote medical care support system of the present invention. [Figure 13] FIG. 13 shows the relationship between the type of patient's disease, the prescribed rehabilitation exercise program, and the rehabilitation index in one embodiment of the remote medical care support system of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0030] definition

[0031] <Smart devices> In one preferred embodiment of the system of the present invention, the "smart device" includes a commercially available smartphone (mobile phone) or tablet, which is used by installing the application software of the remote medical support system of the present invention. The smart device is wirelessly connected to a PC at a medical institution via an Internet line (see Figure 1). In one preferred embodiment of the system of the present invention, the smart device has an input unit that allows a patient to log in to the system by entering an identification number (ID) and enter answers to multiple questions on a medical questionnaire, and an output screen that displays a video of the rehabilitation program sent from the medical institution.

[0032] <PC(パーソナルコンピュータ)> In one preferred embodiment of the system of the present invention, a "personal computer (PC)" refers to a device that is connected to a smart device via an internet line and has the function of installing and running the remote medical care support system of the present invention (see Figure 2). The PC is used by installing the application software of the remote medical care support system of the present invention. The PC's memory stores multiple rehabilitation programs (grades) prescribed for patients and related data, as well as programs for running the system of the present invention. The PC is equipped with a CPU (central control unit), a communication unit that sends and receives data to and from the smart device, and an input unit (see Figure 2). The input unit stores the patient's identification number (ID), profile, and information on the disease being treated. In another preferred embodiment of the present invention, the PC is provided with a means for accepting input of a recovery assessment score calculated based on answers to a plurality of questions in a questionnaire.

[0033] <Rehabilitation Program> In one preferred embodiment of the system of the present invention, a "rehabilitation program" refers to an exercise instruction program prescribed for the purpose of restoring the motor function of a patient whose treatment for a disease has been completed, and is configured to instruct the patient on multiple types of exercises using videos. The rehabilitation program has multiple grades, and a rehabilitation program of a grade selected according to the patient's profile (age, sex, weight, height, etc.) and the state of recovery of motor function is prescribed. In one preferred embodiment of the system of the present invention, the rehabilitation program consists of 15-minute units.

[0034] <Wearable sensor device> In one preferred embodiment of the system of the present invention, the "wearable sensor device" refers to a device that is connected to a smart device wirelessly or via a wired connection and has the function of measuring the patient's exercise biometric information as they perform the exercises prescribed in the rehabilitation program and transmitting the information to the smart device (see Figures 5(A) and (B)). Commercially available smartwatches (Apple Watch, HUAWEI WATCH, etc.) can be used as the wearable sensor device.

[0035] <Remote medical care support system> In one preferred embodiment of the system of the present invention, the "remote medical care support system" refers to a system that can remotely support the selection, implementation, or updating of a rehabilitation program and its grade according to the recovery state of a patient's motor function, and includes a PC installed in a medical institution and a smart device connected to the PC via an internet line. In one preferred embodiment of the present invention, by connecting a wearable sensor device to the smart device, it is possible to measure the patient's exercise biometric information, such as heart rate.

[0036] <Health management application software> In one preferred embodiment of the system of the present invention, "health management application software" refers to application software that is installed on a smart device and used to measure or monitor a patient's exercise biometric information. Health management application software includes home electrocardiogram programs and home heart rate monitor programs. Commercially available health management application software includes Google Fit (registered trademark) and Apple Health (registered trademark).

[0037] <Independent exercise> In the present invention, "independent exercise" refers to exercise that a patient can perform by themselves under the guidance of a doctor or physical therapist, and includes exercise to strengthen muscle strength, exercise to strengthen muscle endurance, exercise to strengthen cardiopulmonary capacity (exercise to strengthen whole body endurance), exercise to improve flexibility, exercise to improve dexterity, exercise to improve coordination, and exercise to improve running ability. Walking exercise corresponds to exercise to strengthen muscle strength, exercise to strengthen muscle endurance, and exercise to strengthen cardiopulmonary capacity, and exercise to stand up from a chair corresponds to exercise to strengthen muscle strength and exercise to strengthen muscle endurance.

[0038] <Health-related QOL assessment scale> In one preferred embodiment of the system of the present invention, "health-related QOL" refers to the quality of life of individuals affected by a disease or treatment. "Health-related QOL assessment scale" refers to a scale used to objectively assess health-related QOL, and includes disease-nonspecific scales (e.g., SF-36) and disease-specific scales (e.g., RDQ). In a preferred embodiment of the present invention, questions on the medical questionnaire are categorized according to the health-related QOL assessment scale. The questions that have been created are used to calculate a recovery assessment score for the patient based on the total score assigned to the answers to the questions.

[0039] In one preferred embodiment of the system of the present invention, a health-related QOL scale is prepared. The questionnaire items consisted of questions based on non-specific measures (e.g., SF-36) that were not related to the specific diseases the patient had, and questions based on disease-specific measures related to the specific diseases the patient had. In a preferred embodiment of the present invention, the questionnaire used combines questions based on disease-nonspecific scales and questions based on disease-specific scales, and questions based on health-related QOL assessment scales are used to assess the patient's motor function. It is used to evaluate the degree of recovery of function.

[0040] In one preferred embodiment of the present invention, the SF-36, RDQ, and JOABPEQ are used as health-related QOL scales. The SF-36 is a disease-nonspecific scale used to quantitatively evaluate health-related QOL (HRQOL: Health Related Quality of Life). The RDQ (Roland Morris Disability Questionnaire) is a scale that allows patients to quantitatively evaluate the impairment of daily life caused by lower back pain. The JOABPEQ (Japanese Orthopaedic Association Lower Back Pain Questionnaire) is a scale that allows patients to quantitatively evaluate the impairment of daily life caused by lower back pain. This scale is used to calculate the severity scores for five categories: spinal dysfunction, walking dysfunction, social life disability, and psychological disability. The patient's condition is quantitatively assessed by the sum of the scores assigned to each question. The quantitative assessment of the patient's health condition based on these scales is internationally recognized and highly reliable.

[0041] <Recovery assessment score> In a preferred embodiment of the system of the present invention, the "recovery assessment score" refers to the sum of scores assigned to each patient's answers to multiple questions in the questionnaire used in the present invention, and the patient's motor function recovery status is evaluated based on the sum of the scores. In the present invention, the recovery assessment score is used as the basis for calculating a rehabilitation index. In a preferred embodiment of the present invention, the questionnaire includes non-disease-specific questions and / or disease-specific questions, and the patient's motor function recovery status is evaluated in the form of a quantitative score based on the patient's answers to these questions. By including questions regarding the patient's profile in the questionnaire, the recovery assessment score can be calculated as a value that takes into account the patient's gender, age, height, weight, etc. In this case, the patient's profile is taken into consideration both when initially selecting a rehabilitation program grade and when updating the selected rehabilitation program grade based on the patient's motor biometric information.

[0042] <Disease-nonspecific score> In one preferred embodiment of the system of the present invention, the "disease-nonspecific score" is a score based on multiple questions on a health-related quality of life assessment scale, regardless of the specific disease that the patient has. The score is calculated as the sum of the scores given to the answers to the questions. It is the most widely used self-reported health questionnaire and is used to measure specific illnesses and symptoms. The study was designed to measure a comprehensive concept of health, rather than a specific health condition, through eight areas. (See Figure 6.)

[0043] <Disease-specific score> In one preferred embodiment of the system of the present invention, the "disease-specific score" is a score calculated in relation to a specific disease that a patient has, and is a score calculated based on multiple disease-specific QOL scales. The score is calculated as the sum of the scores given to the answers to the questions above. The RDQ (Roland Morris Disability Questionnaire) is a questionnaire in which patients themselves assess the disability in their daily lives caused by their lower back pain. These are questions for quantitative evaluation (see Figure 7), and are based on the JOABPEQ (Japanese Orthopaedic Association Low Back Pain Response Examination). The questionnaire is a set of questions used to calculate the severity scores of five categories: pain-related disability, lumbar dysfunction, walking dysfunction, social life disability, and psychological disability.

[0044] <Rehabilitation Index> In one preferred embodiment of the system of the present invention, the "rehabilitation index" refers to a value that evaluates the recovery state of a patient's motor function on a numerical scale based on the recovery assessment score. In a preferred embodiment of the present invention, the rehabilitation index is registered together with the exercise target value for each grade of the rehabilitation program stored in the storage device of the PC. In one preferred embodiment of the system of the present invention, when the SF-36 is used as the questionnaire, the evaluation score according to the SF questionnaire is divided into 10 stages from 1 to 100, with 1 to 10 being the rehabilitation index, 11 to 20 is rehabilitation index 2, 21 to 30 is rehabilitation index 3, 31 to 40 is rehabilitation index 4, 41 to 50 is rehabilitation index 5, 51 to 60 is rehabilitation index 6, 61 to 70 is rehabilitation index 7, 71 to 80 is rehabilitation index 8, 81 to 90 is rehabilitation index 9, and 91 to 100 is rehabilitation index 10 (see Figures 10 and 13). For example, if a patient is interviewed using the SF-36, If the total score obtained is 43, the patient's rehabilitation index will be 5. If a disease-nonspecific score (SF-36) and a disease-specific score (RMDQ) are used in the interview, if the average value obtained by adding up the SF-36 evaluation score and the RMDQ evaluation score and dividing it by 2 is 25, the patient's rehabilitation index will be 3 (see Figure 12).

[0045] In many cases, the causes of diseases such as lower back pain involve not only disease-specific factors with clear causes but also non-disease-specific factors with unclear causes. When selecting a rehabilitation program for lower back pain, the RDQ is an evaluation criterion related to the patient's lower back disease, but lower back pain can also be caused by factors other than lower back disease. In the present invention, an orthopedic patient's disease is interviewed using both a questionnaire based on a disease-specific scale and a questionnaire based on a disease-nonspecific scale, a rehabilitation index is calculated based on the results of the interviews using both the questionnaire items, and a rehabilitation program for the patient who has been treated for a specific disease is selected based on the rehabilitation index thus calculated.

[0046] In one preferred embodiment of the system of the present invention, in addition to the interview score using SF-36, RMDQ, JOABPEQ, etc., a doctor or physical therapist can calculate a recovery assessment score taking into account other characteristics or profiles of the patient that are not evaluated in such interviews, and ultimately determine the rehabilitation index.

[0047] <Exercise bio-information> In a preferred embodiment of the system of the present invention, "exercise bio-information" refers to data measured and collected from a patient performing exercises prescribed in a rehabilitation program. In one embodiment of the present invention, the exercise bio-information is measured and collected from the patient's body using a smart device and / or a wearable sensor device with health management application software installed. The exercise bio-information may include measurements linked to the magnitude of exercise load, and may include all or part of data on calories burned, heart rate, walking distance, walking speed, and number of steps.

[0048] <Exercise goal value> In one preferred embodiment of the system of the present invention, the "exercise target value" refers to the target value of exercise bio-information expected to be measured from the patient's body after performing the exercises prescribed in the rehabilitation program, and is registered in the PC's storage device in correspondence with the rehabilitation index for each grade of the rehabilitation program. The exercise target value is set for each measurement item according to the patient's profile. In one preferred embodiment of the system of the present invention, the exercise target value is determined based on the rehabilitation index of the patient performing the rehabilitation program and the patient's profile input from the input unit, and the exercise target value thus determined is compared with the exercise bio-information measured and collected from the patient's body.

[0049] In one preferred embodiment of the present invention, the exercise biometric information measured from a patient for a specific measurement item is determined to be within a ±10% range of the exercise target value. In this case, the percentage range above and below the exercise target value is determined by a clinical doctor or physical therapist at a medical institution. The exercise target values (target heart rate, target calories burned, target walking distance, target number of steps, target walking speed) are not the same for all patients performing the same exercise, and even when performing the same exercise, they vary depending on the individual patient's profile (age, gender, weight, height). Therefore, they are set according to the patient's profile. In one preferred embodiment of the present invention, the correspondence between the rehabilitation program, patient profile, and exercise target value is stored in a PC storage device and is used to calculate the exercise target value for each patient performing the rehabilitation program. Figure 11 shows an example of the correspondence between a patient's profile, target heart rate, and target calories burned in a rehabilitation program for a patient with lower back pain.

[0050] <Target calorie consumption> In a preferred embodiment of the system of the present invention, the "target calorie expenditure" is one of the exercise target values and refers to the calories a patient is expected to burn by performing the exercise prescribed in the rehabilitation program. In a preferred embodiment of the present invention, it is determined whether the patient's measured calorie expenditure is within a range of 10% above or below the value registered as the target calorie expenditure. The amount of energy consumed in a single exercise session is determined by the patient's physique (weight), exercise intensity, and exercise duration. Since the amount of energy (calories consumed) a patient consumes by performing the prescribed exercise varies depending on the weight, etc. of each individual patient, in the present invention, the target calorie expenditure is set according to the patient's profile. In a preferred embodiment of the present invention, if the measured calorie expenditure measured and collected by the patient's smart device while performing the exercise prescribed in the prescribed rehabilitation program is above or below a predetermined range above or below the target calorie expenditure, the exercise is determined to be too high / low load for the patient.

[0051] <Exercise intensity, METs value> In a preferred embodiment of the system of the present invention, "exercise intensity" refers to the load or difficulty exerted when a patient performs the exercise prescribed in the rehabilitation program. "METs" refers to a unit of exercise intensity, expressed as the number of times the energy consumed by a particular exercise, where 3.5 ml / kg of oxygen intake at rest is taken as 1. For example, sitting down to watch television or riding in a car is 1.9 METs, sitting down to talk, eat, or do desk work is 1.5 METs, and walking around the house is 2.0 METs. In a preferred embodiment of the system of the present invention, the exercises in the rehabilitation program include Nordic walking (4.3 METs), back stretching of the lower limbs (2.3 METs), exercises for strength and balance (2.3 METs), exercises for strengthening the lower limb muscles (4.3 METs), calf exercises (4.0 METs), exercises for improving balance (2.3 METs), exercises for strengthening the core muscles (4.0 METs), and physical strength training (4.1 METs). One preferred embodiment of the system of the present invention allows a patient to calculate the calorie expenditures associated with performing the exercises in a prescribed rehabilitation program by registering the METs value of the exercise for each rehabilitation program stored in a PC.

[0052] <Target heart rate> In a preferred embodiment of the system of the present invention, the "target heart rate" is one of the exercise target values and refers to the heart rate that a patient is expected to exhibit when performing the exercise prescribed in a rehabilitation program. Generally, a patient's heart rate increases when the load imposed by the exercise is heavy, and decreases when the load is light. Since the load imposed on a patient by performing the prescribed exercise varies depending on the gender, age, height, weight, etc. of each patient, the target heart rate in the present invention is set according to the patient's gender, age, height, weight, etc. In a preferred embodiment of the present invention, if the heart rate measurements collected from a patient performing the walking exercise prescribed in a prescribed rehabilitation program exceed the target heart rate, the exercise is determined to be too demanding for the patient.

[0053] <Target walking distance> In a preferred embodiment of the system of the present invention, the "target walking distance" is one of the exercise target values and refers to the distance a patient is expected to walk within a predetermined time period after performing the walking exercise prescribed in the rehabilitation program. In the present invention, if the measured walking distance of a patient performing the walking exercise prescribed in the prescribed rehabilitation program falls below the target walking distance, the exercise is determined to be too strenuous for the patient.

[0054] <Target walking speed> In one preferred embodiment of the system of the present invention, the "target walking speed" is one of the exercise target values, and refers to the walking speed that a patient who performs the walking exercise prescribed in a rehabilitation program is expected to walk within a predetermined time. In the present invention, if the measured walking speed of a patient who performs the walking exercise prescribed in a prescribed rehabilitation program is lower / higher than a predetermined range from the target walking speed, the exercise is determined to be too high / low load for the patient. Preferred Embodiments of the Invention

[0055] Figure 1 shows the network configuration of a system according to one embodiment of the present invention. A doctor's PC (personal computer) 10 is connected via an internet line to smart devices 21 (smart device 1), 22 (smart device 2), and 23 (smart device 3) carried by patients 1, 2, and 3, respectively. Application software for the remote medical care support system of the present invention is installed on each of smart devices 21, 22, and 23. Health management application software 1 is installed on smart device 22. Health management application software 2 is installed on smart device 23, and a wearable sensor device 33 is connected to smart device 23.

[0056] 1, application software for the remote medical care support system of the present invention is installed in the smart device 21, and the patient 1 (smart device 1) inputs answers to a plurality of questions in a medical questionnaire through the smart device 21. Based on the recovery assessment score / rehabilitation index calculated thereby, a rehabilitation program grade with an appropriate load for the patient 1 is selected from a plurality of rehabilitation programs registered in the storage device of the PC 10. The selected rehabilitation program is transmitted from the PC 10 to the smart device 21 and displayed as a video on the output screen of the smart device 21, and exercise instruction is prescribed for the patient 1.

[0057] 1, health management application software 1 is installed on smart device 22 in addition to application software of the remote medical care support system of the present invention. Patient 2 (smart device 2) inputs answers to multiple questions on a questionnaire via smart device 22, and a rehabilitation program grade with an appropriate load for patient 2 is selected from multiple rehabilitation programs registered in the storage device of PC 10 based on the recovery assessment score / rehabilitation index calculated thereby. The selected rehabilitation program is transmitted from PC 10 to smart device 22 and displayed as a video on the output screen of smart device 22, and exercise instructions are prescribed for patient 2. Health management application software 1 is installed on smart device 22, and health management application software 1 is used to measure exercise bio-information (e.g., number of steps, walking distance) of patient 2 who has performed rehabilitation exercise, and an update of the grade of the prescribed rehabilitation program is determined based on the measured values.

[0058] Referring further to FIG. 1 , the smart device 23 is installed with application software for the remote medical care support system of the present invention and health management application software 2, and is further connected to a wearable sensor device 33. The patient 3 (smart device 3) inputs answers to multiple questions on a questionnaire via the smart device 23. Based on the calculated recovery assessment score / rehabilitation index, a rehabilitation program grade appropriate for the patient 3 is selected from multiple rehabilitation programs registered in the storage device of the PC 10. The selected rehabilitation program is transmitted from the PC 10 to the smart device 23 and displayed as a moving image on the output screen of the smart device 23. The patient 3 then performs the displayed exercise program. The smart device 23 measures the patient 3's exercise biometric information (e.g., heart rate, etc.) using the wearable sensor device 33 and compares the measured values with the exercise target values registered for the prescribed rehabilitation program grade to determine whether to update the grade of the prescribed rehabilitation program. The updated grade of the rehabilitation program is then displayed on the output screen of the smart device 23 for subsequent rehabilitation exercise guidance.

[0059] 1, the doctor or physical therapist in charge can input a recovery evaluation score calculated based on answers to multiple questions in a medical questionnaire into an input unit of a PC 10 installed in a medical institution. In this case, the rehabilitation indexes of Patients 1, 2, and 3 are determined based on the recovery evaluation scores input into the PC 10 by the doctor or physical therapist, and the rehabilitation programs and their grades to be prescribed for Patients 1, 2, and 3 are determined based on the rehabilitation indexes thus determined.

[0060] FIG. 2 shows the configuration of a PC (personal computer) used in the present invention. The device processes the data received from the client device through the communication unit and outputs the results to the display unit.

[0061] Figure 3 shows the configuration of a smart device and a wearable sensor device used in one embodiment of the present invention. The smart device includes an input unit that can be used to input answers to questions on a medical questionnaire, an exercise biometric information measurement and collection unit that measures and collects the patient's exercise biometric information, and a communication unit that transmits the measured exercise biometric information of the patient to a PC. The smart device shown in Figure 3 (corresponding to smart device 23 in Figure 1) is connected to the wearable sensor device (corresponding to wearable sensor device 33 in Figure 1) wirelessly or via a wired connection.

[0062] 4 shows an example of an output screen of a smart device used in an embodiment of the present invention. The output screen displays rehabilitation exercises (including videos) to be instructed to the patient, as well as the patient's exercise biometric information.

[0063] 5(A) and (B) show the configuration of a wearable sensor device (smart watch) used in one preferred embodiment of the present invention. This example is configured to measure the patient's heart rate while the belt is wrapped around the patient's arm.

[0064] FIG. 6 shows a sample SF-36 questionnaire used in one embodiment of the present invention, and FIG. A sample RDQ questionnaire for use in one embodiment of the present invention is shown in FIG. A sample questionnaire used in one embodiment is shown below: The first question in the questionnaire is related to the patient's profile (gender, age, height, weight). [Example]

[0065] Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

[0066] Example 1 (1) Choosing a rehabilitation program A 65-year-old man visited the clinic with lower back pain. At the time of his outpatient visit, he was 170 cm tall and weighed 85 kg. His SF-36 score was PCS 48, his RDQ score was 38, and his total score divided by 2 was 43. Based on the interview results, the rehabilitation index was determined to be 5. As a result, a rehabilitation program (15 minutes per unit) was selected that included Nordic walking, lower back stretching, back stretching, lower back stretching, exercises for improving muscle strength and balance, exercises for strengthening core muscles, back stretching, calf exercises, and exercises for improving balance (see Figure 10). (2) Updating the rehabilitation program The selected rehabilitation program was displayed as a video on the output screen of the smart device, and the patient was instructed on the rehabilitation program exercises, and the heart rate and calorie consumption at the end of the exercise were measured. Based on the height (normal) and weight (overweight) of the male patient who underwent the rehabilitation program, the target heart rate was set at 150 / min and the target calorie consumption at 148 kcal (see Figures 11 and 12). At the end of the rehabilitation exercise, the patient's heart rate was 160 / min and the calorie consumption was 160 kcal. The patient's measured heart rate of 160 / min and calorie expenditure of 160 kcal were both within a ±10% range of the target heart rate (150 / min) and target calorie expenditure (148 kcal) set in the prescribed rehabilitation program grade, so it was decided to maintain the rehabilitation program grade at 5 (see Figure 12).

[0067] Example 2 Choosing a Rehabilitation Program A 60-year-old woman visited the clinic due to lower back pain. At the time of outpatient visit, she was 150 cm tall and weighed 60 kg. Her SF-36 score was PCS 26, and her RDQ score was 24. The sum of these scores divided by 2 gave an evaluation score of 2. 5, and the rehabilitation index was determined to be 3 based on the interview results. As a result, a rehabilitation program (15 minutes per unit) was selected, which included Nordic walking, stretching the back of the legs, exercises to strengthen the core muscles, back stretching, exercises to strengthen the lower limb muscles, calf exercises, and exercises to improve balance (see Figure 10). (2) Updating the rehabilitation program The patient was instructed on the exercises of the selected rehabilitation program by displaying the video on the display screen of the smart device, and the heart rate and calorie consumption at the end of the exercise were measured. Based on the height (normal) and weight (overweight) of the female patient who underwent the rehabilitation program, the target heart rate for the selected rehabilitation program was set at 155 / min and the target calorie consumption at 148 kcal (see Figures 11 and 12). Heart rate at the end of the patient's rehabilitation exercise: 165 / min The calorie expenditure was 110 kcal. The heart rate (165 beats per minute) was within the range of ±10% of the target heart rate (160 beats per minute), and the calorie expenditure (110 kcal) was below the lower limit of ±10% of the target calorie expenditure (148 kcal). Therefore, the prescribed program was effective for the patient. Judging that there was room for improvement, it was decided to move to a program with a rehabilitation index of one level higher (see Figure 12).

[0068] Example 3 (1) Choosing a rehabilitation program A 45-year-old man visited the clinic due to lower back pain. At the time of his outpatient visit, he was 160 cm tall and weighed 75 kg. His SF-36 score was 60 on the PCS scale and 62 on the RDQ scale. The sum of these scores divided by 2 gave an evaluation score of 61, and based on the interview results, his rehabilitation index was determined to be 7. As a result, a program was selected that included Nordic walking, lower back stretches, back stretches, exercises for muscle strength and balance, back strengthening, exercises for strengthening lower limbs, calf exercises, and exercises for improving balance (see Figure 10). (2) Updating the rehabilitation program The selected rehabilitation program was displayed as a video on the display screen of the smart device, and the patient was instructed on the rehabilitation program exercises, and the heart rate and calorie consumption at the end of the exercise were measured. Based on the height (normal) and weight (overweight) of the male patient who underwent the rehabilitation program, the target heart rate for the selected rehabilitation program was set at 140 / min and the target calorie consumption at 132 kcal (see Figures 11 and 12). The patient's heart rate at the end of the rehabilitation exercise was 150 The patient's measured heart rate of 150 beats per minute was within a ±10% range of the target heart rate, but the calorie expenditure of 150 kcal exceeded the upper limit of the ±10% range of the target calorie expenditure of 132 kcal, so the program was downgraded by one grade and changed to a program with a rehabilitation index of 6 (see Figure 12).

[0069] Example 4 (1) Choosing a rehabilitation program A 60-year-old woman visited the clinic with osteoarthritis of the knee. At the time of her outpatient visit, she was 156 cm tall and weighed 52 kg. Her SF-36 score was PCS 43 and WOMAC score 46. The sum of these scores divided by 2 gave an evaluation score of 44.5. Based on the interview results, her rehabilitation index was determined to be 5. As a result, she was scheduled to undergo rehabilitation three times a week. A program that involves sitting down and standing up from a chair 30 times (10 times x 3 sets) for 10 minutes each. was selected. (2) Updating the rehabilitation program The patient was instructed on the exercises of the selected rehabilitation program by displaying the video on the display screen of the smart device, and the heart rate and calorie consumption at the end of the exercise were measured. Based on the height (normal) and weight (overweight) of the female patient who underwent the rehabilitation program, the target heart rate was set at 155 / min and the target calorie consumption was set at 148 kcal. At the end of the rehabilitation exercise, the patient's heart rate was 160 / min and the calorie consumption was 120 kcal. Because the calorie expenditure was below the ±10% range of the target value set in the rehabilitation program, it was determined that the prescribed program was within the patient's comfort zone, and the rehabilitation program grade was increased by one.

[0070] Although the embodiments of the present invention have been described above with reference to the drawings, the present invention is not limited to these embodiments and can be modified and implemented in various embodiments within the scope of the present invention. [Explanation of symbols]

[0071] 10 PCs (personal computers) 21 Smart Device 1 22 Smart Devices 2 23 Smart Devices 3 33 Wearable Sensor Devices

Claims

1. A telemedicine support system for assisting in the selection and implementation of rehabilitation programs for orthopedic patients who are able to perform independent movements, The system includes a smart device and a PC (personal computer) wirelessly connected to the smart device via an internet connection. The aforementioned PC is installed in a medical institution and configured to be accessible to the patient's attending physician or physical therapist, and has the application software for the telemedicine support system installed on it. A means for receiving input of the patient's identification number, profile, and type of disease treated, Means for sending and receiving data with the aforementioned smart device, It is equipped with a memory device and a CPU, The smart device has the application software for the telemedicine support system installed. By entering the patient identification number registered on the PC, the telemedicine support The means of logging into the support system, Inputting answers to multiple questions on a questionnaire using a health-related quality of life assessment scale. The means of acceptance, A means for sending and receiving data with the aforementioned PC, Means for displaying the rehabilitation program received from the PC on an output screen, It is equipped with, The storage device of the aforementioned PC stores multiple rehabilitation programs corresponding to the postoperative period for a predetermined type of disease. Each rehabilitation program consists of multiple exercise programs. Each of the aforementioned rehabilitation programs follows the exercise program instructed by the rehabilitation program. It has multiple grades depending on the level of physical strain placed on the body when performed. Each grade of the aforementioned rehabilitation program has an exercise program for that grade. By performing the exercise, a patient's rehabilitation index appropriate to the physical load is registered. Occasionally, The aforementioned application software is Based on the patient's answers to the multiple questions on the aforementioned medical questionnaire, the patient's Calculate the reassessment score, Based on the calculated recovery evaluation score, the patient's recovery status is numerically scaled. Determine the rehabilitation index to be evaluated using the log. Based on the type of disease treated by the patient and the rehabilitation index, the PC From among multiple rehabilitation programs stored in a memory device, one is prescribed to the patient. Select the rehabilitation program and its grade and display it on the output screen of the smart device. It is configured to display, A telemedicine support system for assisting in the selection and implementation of rehabilitation programs for orthopedic patients who are capable of independent movement.

2. The remote medical care support system according to claim 1, wherein the grade of the rehabilitation program selected based on the rehabilitation index is stored in the storage device of the PC along with the patient's identification number, and by entering the patient's identification number registered in the PC from the smart device, the grade of the rehabilitation program stored in the storage device of the PC is retrieved and displayed as a video on the output screen of the smart device.

3. The telemedicine support system according to claim 1 or 2, wherein the smart device has health management application software installed in addition to the application software for the telemedicine support system, and is configured to update the grade of the rehabilitation program selected based on the rehabilitation index based on the patient's exercise biometric information measured using the health management application software.

4. The telemedicine support system according to claim 1 or 2, wherein a wearable sensor device is wirelessly or wiredly connected to the smart device, and the system is configured to update the grade of the rehabilitation program selected based on the rehabilitation index based on the patient's exercise biometric information measured using the wearable sensor device.

5. Each grade of the aforementioned rehabilitation program has registered exercise biometric information (exercise target values) that are expected to be measured from patients who perform the exercises instructed by the program of that grade, and these exercise target values ​​are set according to the profile of the patient performing the exercise program. The telemedicine support system according to claim 3 or 4, wherein the system can determine whether to change the selected grade of rehabilitation program by comparing the exercise biometric information measured and collected from a patient who has performed the selected grade of rehabilitation program with the exercise target value determined based on the patient's profile.

6. The telemedicine support system according to claim 1 or 2, wherein the aforementioned predetermined types of diseases include musculoskeletal disorders such as low back pain (post-operative for lumbar degenerative disease), scoliosis, post-knee joint surgery, post-hip joint surgery, and chronic low back pain.

7. The telemedicine support system according to claim 1 or 2, wherein the PC further comprises means for receiving input of the patient's recovery evaluation score calculated based on answers to multiple questions in a questionnaire using a health-related QOL evaluation scale, and can determine the patient's rehabilitation index based on either the calculated recovery evaluation score or the input recovery evaluation score.

8. A telemedicine support system for assisting in the selection and implementation of rehabilitation programs for orthopedic patients who are able to perform independent movements, The system includes a smart device and a PC (personal computer) wirelessly connected to the smart device via an internet connection. The aforementioned PC is installed in a medical institution and configured to be accessible to the patient's attending physician or physical therapist, and has the application software for the telemedicine support system installed on it. A device that accepts input of the patient's identification number, profile, and the type of disease treated. Steps and, Based on responses to multiple questions on a questionnaire using a health-related quality of life assessment scale. A means for receiving input of the calculated recovery assessment score of the patient, Means for sending and receiving data with the aforementioned smart device, It is equipped with a memory device and a CPU, The smart device has the application software for the telemedicine support system installed. By entering the patient identification number registered on the PC, the telemedicine support The means of logging into the support system, A means for sending and receiving data with the aforementioned PC, Means for displaying the rehabilitation program received from the PC on an output screen, It is equipped with, The storage device of the aforementioned PC stores multiple rehabilitation programs in video format that correspond to the postoperative period for a predetermined type of disease. Each rehabilitation program consists of multiple exercise programs. Each of the aforementioned rehabilitation programs executes the exercise program instructed by the rehabilitation program. By doing so, it has multiple grades corresponding to the amount of stress placed on the body. Each grade of the aforementioned rehabilitation program will execute the exercise program corresponding to that grade. By doing so, a rehabilitation index for patients appropriate to the physical load is registered. The aforementioned application software is Based on the patient's recovery assessment score, the patient's recovery status is expressed on a numerical scale. Determine the rehabilitation index to be evaluated, Based on the type of disease treated by the patient and the rehabilitation index, the PC From among multiple rehabilitation programs stored in the memory device, the rehabilitation program prescribed to the patient The patient selects a rehabilitation program and its grade, and stores it in the PC's storage device. Save it with a different number, By entering the patient's registered identification number into the smart device, The rehabilitation program stored in the storage device of the PC is called up, It is configured to be displayed on the output screen of a smart device. A telemedicine support system for assisting in the selection and implementation of rehabilitation programs for orthopedic patients who are capable of independent movement.

9. The telemedicine support system according to claim 8, wherein the PC further includes means for receiving the identification number of a medical institution that prescribes a rehabilitation program along with the patient's identification number, and is configured so that the user can log in to the telemedicine support system by entering the patient's identification number and the medical institution's identification number registered on the PC from the smart device.

10. The telemedicine support system according to claim 8 or 9, wherein the smart device is configured to have a password set for the patient to log in to the telemedicine support system, and the patient is configured to be able to log in to the telemedicine support system by entering the password along with their identification number from the smart device.

11. The telemedicine support system according to claim 8 or 9, wherein the smart device has health management application software installed in addition to the application software for the telemedicine support system, and is configured to update the grade of the rehabilitation program selected based on the rehabilitation index based on the patient's exercise biometric information measured using the health management application software.

12. The telemedicine support system according to claim 8 or 9, wherein a wearable sensor device is wirelessly or wiredly connected to the smart device, and the system is configured to update the grade of the rehabilitation program selected based on the rehabilitation index based on the patient's exercise biometric information measured using the wearable sensor device.

13. Each grade of the aforementioned rehabilitation program has registered exercise biometric information (exercise target values) that are expected to be measured from patients who perform the exercises instructed by the program of that grade, and these exercise target values ​​are set according to the profile of the patient performing the exercise program. The telemedicine support system according to claim 11 or 12, wherein the system can determine whether to change the rehabilitation program of the selected grade by comparing the exercise biometric information measured and collected from a patient who has performed the selected grade rehabilitation program with the exercise target value determined based on the patient's profile.

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