Mobile physical telemedicine

Abstract

A mobile physical telemedicine system includes a processing system and at least one robotic manipulator communicatively coupled to the processing system and configured to support and manipulate a body part of a subject. In some embodiments, the system includes a motion capture system communicatively coupled to the processing system and configured to capture a motion of the subject. In some embodiments, the system includes an adjustable therapy bench. In some embodiments, the system includes a base supporting the at least one robotic manipulator, the motion capture system, and the adjustable therapy bench. In some embodiments, the at least one robotic manipulator is configured to be controlled remotely by a clinical provider. In some embodiments, the at least one robotic manipulator is configured to be operated in an autonomous mode.

Description

MOBILE PHYSICAL TELEMEDICINECROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 514,652 filed on July 20, 2023, and entitled “Mobile Physical Telemedicine”, which is hereby incorporated by reference herein in its entirety.BACKGROUND

[0002] The world’s population, especially in developed countries such as the United States, is undergoing a continuous aging process leading to a change in the age distribution: from pyramidal (more young than old individuals) to flat (similar numbers of young and old individuals). According to the United Nations, the number of persons aged 60 or older will reach 3.1 billion by 2100. While on one hand, this is a positive sign in terms of expected life span, on the other hand, aged individuals are more prone to develop physical, neurological, or cognitive disorders such as obesity, diabetes, cardiovascular disorders (e.g. stroke), Alzheimer’s disease, and Parkinson’s disease.

[0003] Most of these diseases and disorders are often non-lethal but may be highly impairing and lead to the patient requiring care. These care recipients typically need a combination of physical training and every-day care in order to recover from, reduce, or compensate for their impairment level. For example, post-stroke survivors in rehabilitation hospitals often need repeated meetings with a clinician to recover as many motor capabilities as possible. The duration and frequency of meetings varies greatly across facilities and with financial resources. In the US, Medicare usually covers up to 100 days in skilled nursing facilities and reimburses up to 60 days of at-home therapy.

[0004] For these reasons, the burden on the health-care system is expected to grow accordingly. However, since the young adult population is not expected to increase as significantly as the aged population, this will lead to a critical shortage of professionals. Especially for physiatrists and physical / occupational therapists, the increasing workload will pose a challenge. Without appropriate growth of the number of clinicians, an increase in demand will cause an increase in the cost of care and / or assistance. Moreover, it will reduce the access to care for people with limited financial or environmental resources. It is the intention of the systems and methods disclosed herein to make post-stroke rehabilitationavailable to populations in rural or inner-city parts, who presently have limited access (independent of cost) or cannot afford these services.SUMMARY

[0005] Disclosed herein are structures and techniques to provide low-cost care delivered directly at locations accessible to care recipients, while reducing and optimizing the workload of professionals involved in healthcare and rehabilitation. A mobile physical telemedicine system disclosed herein is configured to perform various physical activities required to interact with a subject, such as a care recipient, during rehabilitation or physical training. The disclosure further describes mobile units, each of which could be any vehicle with sufficient carry ing space (e.g., an ambulance, a small bus, or truck) containing a mobile physical telemedicine system.

[0006] In accordance with an embodiment of the present disclosure, a mobile physical telemedicine system includes a processing system and at least one robotic manipulator communicatively coupled to the processing system and configured to support and manipulate a body part of a subject. The system further includes a motion capture system communicatively coupled to the processing system and configured to capture a motion of the subject. The system also includes an adjustable therapy bench and a base supporting the at least one robotic manipulator, the motion capture system, and the adjustable therapy bench.

[0007] Alternatively, or in addition, the at least one robotic manipulator may be configured to be controlled remotely by a clinical provider. The at least one robotic manipulator may be configured to be operated in an autonomous mode. The at least one robotic manipulator may be configured to support and manipulate a limb of the subject.

[0008] Alternatively, or in addition, the system may include at least two robotic manipulators. The at least two robotic manipulators may be configured to be controlled by a clinical provider.

[0009] Also alternatively, or in addition, the system may include a first robotic manipulator and a second robotic manipulator. The first robotic manipulator may be configured to be controlled by a clinical provider, and the second robotic manipulator may be configured to operate in an autonomous mode.

[0010] Alternatively, or in addition, the at least one robotic manipulator may include at least one of a force sensor, a torque sensor, and a current sensor. The at least one robotic manipulator may be configured to be controlled by impedance or admittance control.

[0011] Alternatively, or in addition, the system may further include a microphone and may be configured to transmit audio data received from the microphone to a computing device of a clinical provider. The system may further include a camera and may be configured to transmit data related to communication from the subject and movement of the subj ect during the support and manipulation received from the camera to a computing device of a clinical provider.

[0012] Alternatively, or in addition, the mobile physical telemedicine system is disposed in a vehicle and the base is movable and configured to load the mobile physical telemedicine system in and out of the vehicle.

[0013] In accordance with another embodiment of the present disclosure, a computer- implemented method for providing mobile physical telemedicine to a subject during a telemedicine session uses a mobile physical telemedicine system. The mobile physical telemedicine system includes a processing system, at least one robotic manipulator configured to support and manipulate a body part of the subject. The method includes detecting, by the processing system, an initiation of the telemedicine session by a remote computing device (e.g., a computing device utilized by a remote clinical provider). The method includes receiving, by the processing system, a selection of an operating mode for the at least one robotic manipulator from the remote computing device. The method also includes operating, by the processing system, the at least one robotic manipulator in accordance with the operating mode to perform at least one physical activity with the subject, the physical activity related to rehabilitation or physical training. The method further includes receiving, by the processing system, a command to end the telemedicine session from the remote computing device. The method also includes terminating, by the processing system, movement of the at least one robotic manipulator.

[0014] Alternatively, or in addition, the operating mode may be an autonomous mode and / or a teleoperation mode. The mobile physical telemedicine system may include first and second robotic manipulators. The operating mode for the first robotic manipulator may be a teleoperation mode, and the operating mode for the second robotic manipulator may be an autonomous mode.

[0015] Alternatively, or in addition, the at least one robotic manipulator may be configured to support and manipulate a limb of the subject. The processing system may be coupled to a network and the processing system may receive the selection of an operating mode over the network. The processing system may receive a plurality of commands to control the at least one robotic manipulator over the network.

[0016] Alternatively, or in addition, the mobile physical telemedicine system may further include a motion capture system configured to capture a motion of the subject. The method may further include analyzing, by the processing system, the captured motion.

[0017] According to yet another embodiment of the present disclosure, a non-transitory computer-readable medium has software encoded thereon. The software, when executed by a processing system coupled to a mobile physical telemedicine system including at least one robotic manipulator configured to support and manipulate a body part of the subject, is operable to detect an initiation of the telemedicine session by a remote computing device. The software is operable to receive a selection of an operating mode for the at least one robotic manipulator from the remote computing device. The software is operable to operate the at least one robotic manipulator in accordance with the operating mode to perform at least one physical activity with the subject, the physical activity related to rehabilitation or physical training. The software is operable to receive a command to end the telemedicine session from the remote computing device. The software is operable to terminate movement of the at least one robotic manipulator.DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

[0018] The manner and process of making and using the disclosed embodiments may be appreciated by reference to the figures of the accompanying drawings. It should be appreciated that the components and structures illustrated in the figures are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the concepts described herein. Like reference numerals designate corresponding parts throughout the different views. Furthermore, embodiments are illustrated by way of example and not limitation in the figures, in which:

[0019] Fig. 1A shows a block diagram of a mobile physical telemedicine system according to an embodiment of the present disclosure;

[0020] Fig. IB shows an illustration of a mobile physical telemedicine system according to an embodiment of the present disclosure;

[0021] Fig. 2A shows an illustration of a mobile physical telemedicine system loaded on a vehicle according to an embodiment of the present disclosure;

[0022] Fig. 2B shows an illustration of a mobile physical telemedicine system unloaded from a vehicle according to an embodiment of the present disclosure;

[0023] Fig. 3 illustrates tele-operation mode for mobile physical telemedicine, according to an embodiment of the present disclosure;

[0024] Fig. 4A is a flow diagram showing an illustrative process for providing mobile physical telemedicine, according to an embodiment of the present disclosure;

[0025] Fig. 4B is a flow diagram showing an illustrative computer-implemented method for providing mobile physical telemedicine, according to an embodiment of the present disclosure; and

[0026] Fig. 5 shows another illustration of a mobile physical telemedicine system, according to an embodiment of the present disclosure.DETAILED DESCRIPTION

[0027] Throughout this disclosure and the claims, the term “care recipient” or “subject” refers to the individual who receives medical treatment. The term “clinical provider” refers to a medical professional that remotely provides and supervises the treatment. The term “caregiver” refers to an individual who may assist the care recipient before, during or after the treatment (e g. a spouse, adult child, etc.).

[0028] Fig. 1 A shows a block diagram of a mobile physical telemedicine system 100 in accordance with an embodiment of the present disclosure. System 100 includes a processing system 130. The processing system 130 includes at least one processor coupled to at least one memory and is communicatively coupled to one or more robotic manipulators 102 and a motion capture system 160. The processing system 130 may also be communicatively coupled to at least one microphone 162 and at least one camera 164. The processing system 130 may be coupled to these components in any way known to the skilled person. The connection may be wired or wireless. The processing system 130 may further be coupled to additional devices. Illustratively, the processing system 130 may be communicatively coupled to a speaker and / or a display. It is also expressly contemplated that the motioncapture system 160 may use or be integrated into the at least one camera 164 of the mobile physical telemedicine system 100. In other embodiments, motion capture system 160 may include one or more cameras that are separate from the at least one camera 164 of the mobile physical telemedicine system.

[0029] The processing system 130 may be configured to control the at least one robotic manipulator 102. Exemplarily, the processing system 130 may transmit commands to the robotic manipulator 102 that cause the robotic manipulator to move or to exert force as described in detail below. The processing system 130 may further receive sensory data from the robotic manipulator 102. The processing system 130 may also receive data from the motion capture system 160, the microphone 162, and the camera 164. The processing system 130 may be configured to process the received data as described in detail below.

[0030] The processing system 130 may also be communicatively coupled to a network 132. The network 132 may be the internet, or it may be any other public or private network, or it may be a combination of more than one network. The processing system 130 may be configured to transmit and receive data to / from the network 132. For example, the processing system 130 may be configured to exchange data with a remote computing device 170 of a clinical provider, a technician, or any other entity involved in the treatment, as described in detail below. The remote computing device 170 may be communicatively coupled to network 132. To this end, the processing system 130 may process the data received from network 132, and it may process data received from sensory inputs before transmitting the processed data over network 132. In some embodiments, the processing system 130 may receive data from network 132, for example control data received from a remote computing device 170 of a clinical provider, process the data, and then transmit commands to the at least one robotic manipulator 102 that correspond to the received data. In another example, the processing system 130 may receive audio and video data from microphone 162 and camera 164, process the data, and then transmit the processed data over network 132 to a remote computing device 170 of a clinical provider. The processing system 130 may also receive data from the motion capture system 160, process the data, and then transmit the processed data over network 132 to the remote computing device 170 of the clinical provider. In general, the processing system 130 may transmit and receive over the network 132 any suitable data as known to the skilled person.

[0031] Fig. IB shows an illustration of a mobile physical telemedicine system 100 for delivering physical rehabilitation / training to a care recipient 150. System 100 includes oneor more robotic manipulators 102 configured or controlled to contact, support, and manipulate parts, such as limbs, of the subject’s body. The illustrative system 100 further includes a motion capture system, such as motion capture system 160 shown in Fig. 1A, that includes one or more cameras mounted on stands 110 and 112 along with one or more motion capture processors described further below. The system 100 may further include a physical therapy bench 140 (sometimes referred to as a medical examination bed) to support the care recipient 150 during rehabilitation / training. The various system components 102, 110, 1 12, 140 are supported on base 180. System 100 also includes aprocessing system 130 (not shown in Fig. IB but shown in Fig. 1A) communicatively coupled to the at least one robotic manipulator 102 and the motion capture system as described above.

[0032] The at least one robotic manipulator 102 may be configured to reproduce the movement of a clinical provider while guaranteeing complete physical safety as defined in international standards and regulations known to the skilled person. The robotic manipulator 102 may be a kinematically redundant robot, i.e. a robotic manipulator that possesses more degrees of freedom than needed to execute its tasks. The robotic manipulator 102 may be a serial manipulator with a series of links connected by joints, enabling rotation and movement with varying degrees of freedom in each joint.

[0033] Accordingly, the robotic manipulator 102 may simulate arm motions through the maneuvering of its various degrees of freedom, i.e. its joints. A distinctive feature of human motor control is the ability to routinely manipulate an environment with body parts other than hands and fingers. For example, humans may use a forearm, elbow, shoulder, hip and so forth to nudge or push objects. Moreover, humans commonly use multiple body-parts simultaneously. For example, humans may push a door open with an elbow' or a shoulder while simultaneously carrying an object in one or both hands. As a way to mimic this motor control, each degree of freedom (i.e. joint) enables a specific motion of the robotic kinematic chain. The degree of freedom is often referred to by a number that increases from the mounting plate of the robotic manipulator to the end-effector. The robotic manipulator may, for instance, include degrees of freedom increasing from 1 to 7. The first two joints 1+2 emulate human shoulder mechanics, the second two joints 3+4 emulate human elbow and upper-arm mechanics, and the remaining joints 5+6+7 emulate human wrist mechanics (e.g., shoulder = joint 1+2, elbows = joint 3+4, wrist = joint 5+6+7). Alternatively, other configurations of the degrees of freedom are possible. For instance, multiple degrees of freedom (for instance, linear degrees of freedom may be combined and / or rotary degrees offreedom may be combined) may be combined in order to maximize the kinematic chain workspace and manipulability.

[0034] Robotic manipulators that deploy these various degrees of freedom can assume different architectures. Said architectures can be categorized in two ways: first, by analyzing the contrast between rigid and soft robots; and second, by analyzing the geometric configuration of the robotic links.

[0035] A first categorization of robotic architectures differentiates between rigid and soft robots. As is known to the skilled person, rigid robots are characterized by a combination of rigid bodies (or links) interconnected by joints that constrain the motion of successive links to specific degrees of freedom. Some examples of these joints are: (i) rotational joints (e.g., hinges) that provide a rotative motion between successive links; (ii) prismatic joints that provide a pure translation, i.e. linear motion, between successive links; and (iii) spherical joints providing free rotation, but not translation between successive links.

[0036] Alternatively, soft robots are designed to include some degree of deformability'. Such deformability can be achieved by combining structural rigid elements with compliant elements. For example, a compliant element may include one or more springs, elastic bands, inflatable surfaces or deformable polymers. Soft robots have seen a recent growth due to the economical availability of modem manufacturing technologies (e.g., additive manufacturing such as 3D printing). Due to the compliant nature of these robots, soft robot actuation systems may be configured to move without the use of rigid materials such as the links described above, or the metal frame that is common in rigid robots. For example, for actuation that involves bending, a stress difference must be created across the robotic component, such that the component has a tendency to bend towards a certain shape to relieve this stress. A stress difference may be created, for example, through use of one or more of an electric field or electrostatic force, a thermal difference, and a pressure difference.

[0037] A second categorization of robotic architectures can be achieved through an analysis of the geometrical configuration of the robotic links. Specifically, the geometric configuration of the robotic links may result in an open- or closed-kinematic-chain robot. These two categories are not mutually exclusive, which means that a robotic manipulator could include a combination of open and closed kinematic chains. As is known to the skilled person, in an open kinematic chain, the various links of the robot are connected in seriesleaving the final link unconstrained. Alternatively, in a closed kinematic-chain robot, the last link of the chain is constrained to a specific element, surface, or motion.

[0038] The robotic manipulators 102 may include or be coupled to one or more sensors to measure and monitor the subject’s motion and the cognitive and physical interaction between the robotic manipulators 102 and the care recipient. Force and / or torque sensors may be embedded in and / or coupled to the robotic manipulators 102 and / or the mobile physical telemedicine system 100. It is noted that any other suitable kind of sensor known to the skilled person may be used in addition to or instead of the force and / or torque sensors. These sensors may be configured to sense force exerted on / by the care recipient. For example, force and torque sensors may measure a force exerted by a robotic manipulator on a limb of the subject during manipulation of that limb to ensure that the subject is not harmed by the robotic manipulator.

[0039] The processing system 130 may also be coupled to one or more microphones and / or cameras to measure and monitor the subject’s motion and the cognitive and physical interaction between the robotic manipulators 102 and the care recipient. Microphones may be configured to transmit and / or exchange audio data between the care recipient and the clinical provider. For example, microphones may enable the clinical provider to listen to audio transmitted from the site of the mobile physical telemedicine system 100 to ensure that the subject is feeling well and is not harmed or distressed by the manipulation. Microphones in combination with speakers or other audio output devices may also enable the clinician to talk to the care recipient.

[0040] Cameras may be used for relaying communication and monitoring movement from the care recipient or from the robotic manipulator 102. The sensors, microphones, and / or cameras may be used before the rehabilitation / training for set up and / or may be used during the rehabilitation / training to facilitate cognitive and physical support and manipulation.

[0041] The sensors are configured to determine interaction forces on different locations of the robotic manipulators 102. Various techniques, and combinations thereof, may be used to determine interaction forces, as known to the skilled person. For example, interaction forces may be determined based on torque sensors in each axis of the robotic manipulator. In other embodiments, current sensors may be used to determine an interaction force, as known to the skilled person. In other embodiments, sensor skin placed on a robotic structure may be used to determine an interaction force. Sensor skin includes one or more dedicatedsensors used to measure the distribution of contact forces, for instance one or more capacitive sensors.

[0042] The interaction forces are processed and analyzed with regard to the corresponding robotic manipulator 102. Various algorithms may be used to analyze the resulting data, as is known to the skilled person. In particular a force-overlay based on impedance superposition may be used. Illustrative analysis and robot control techniques that may be used within mobile physical telemedicine system 100 are described, for example, in (1) U.S. Pat. No. 10,335,946 entitled “Compositional Impedance Programming for Robots” and issued on July 2, 2019, and (2) U.S. Pat. No. 11,691,281 entitled “Robot Control at Singular Configurations” and issued on July 4, 2023, both of which patents are hereby incorporated by reference herein in their entirety.

[0043] In case of an unintended contact with the subject, the robotic manipulator 102 may go into a compliant mode to eliminate any clamping hazard for the care recipient. In compliant mode, the robotic manipulator 102 will move to a position that ensures a safe interaction between the care recipient 150 and the robotic manipulator 102. While in compliant mode, the robotic manipulator 102 can be pushed away by the care recipient 150. thereby eliminating clamping hazards. Compliant mode may include minimizing the energy the robotic manipulators 102 exchanges with the environment. In order to minimize the energy exchanged with the subject in the case of unintended interaction, a low energy threshold may be used. In other words, the energy applied by the robotic manipulator 102 is lowered to such a level in which the robotic manipulator 102 is passively moved instead of applying force against the care recipient 150.

[0044] When operating manipulators with physical human-robot interaction, challenges arise in terms of collisions and clamping between humans and robots. These challenges pose control engineering difficulties, especially during robot-based rehabilitation where the robot guides the care recipient and the risk of injury from clamping must be eliminated.

[0045] As described in detail in U.S. Patent No. 10,335,946 referenced above, an impedance controller may be associated with virtual potential energy, stored in virtual springs, that pulls the robotic manipulator towards a desired location. This virtual potential energy is then converted into kinetic energy, which corresponds to the motion of the robotic manipulator. Consequently, an impedance controller allows for the regulation of energy, thereby controlling the exchanged energy between the robot and the care recipient. An impedance controller may impose a spring-mass -damper behavior on the roboticmanipulator by maintaining a dynamic relationship between force and position, velocity and acceleration. Compositional impedance programming may be used to facilitate human-robot compatibility.

[0046] One way of controlling the exchanged energy between the robotic manipulator and the subject is by establishing an energy limit, referred to as "energy budget," for the overall energy of the robot. This energy budget includes the potential energy in the virtual springs and the current kinetic energy of the robotic manipulator. In situations where the overall energy of the robotic manipulator exceeds the limit, such as during clamping scenarios, a scaling function is used to reduce the virtual potential energy stored in the springs (e.g., by scaling down the stiffness of the springs). Since, in the impedance controller described in U.S. Patent No. 10,335,946, the virtual springs may correspond to damped mechanical springs between the actual and desired positions of the robot joints, reducing the virtual energy stored in the springs reduces the energy exerted by the robotic manipulator. This ensures that the robot remains compliant and can always be manipulated by the care recipient, effectively eliminating the risks associated with clamping. Additionally, if the care recipient pushes the robotic manipulator in an undesired direction and the resulting kinetic energy exceeds the energy budget, another scaling function increases the potential energy of additional virtual springs to counteract the manipulator's motion, thereby reducing its kinetic energy effect on the overall energy of the robot. An example, for the use of energy budgets and corresponding methods to control the exchanged energy between the robotic manipulator and the subject is described in detail in the scholarly article J. Lachner, F. Allmendingen E. Hobert, N. Hogan, and S. Stramigioli, “Energy budgets for coordinate invariant robot control in physical human-robot interaction,"’ International Journal of Robotics Research, vol. 40. no. 8-9, pp. 968-985, Aug. 2021, doi: 10.1177 / 02783649211011639 / , which is incorporated herein by reference in its entirety.

[0047] The motion capture system 160 is configured to capture movement of the care recipient 150 and / or robotic manipulators 102 over time in three dimensions (3D). Conventional motion capture systems as known to a person of ordinary skill in the art may be used. The motion capture system 160 captures movement of care recipient 150 with particular emphasis on the limb motion (for example, emphasizing on arms, torso and head for upper limb rehabilitation, and emphasizing on legs, waist and torso for lower limb rehabilitation). The motion capture system 160 may use an optical system (e g. an optical system that uses passive markers, active markers, time modulated active markers, etc.) or anon-optical system (e.g. an inertial system, a mechanical motion system, a magnetic system, etc.) to capture movement. In the case of a system that uses markers, the markers may be attached to one or more particular, known locations on the care recipient 150. In the example shown, a motion capture system may include one or more cameras mounted on vertical stands 110 and 112 positioned along sides of the adjustable therapy bench 140. In the case of a system that uses an optical sy stem, machine learning algorithms may be used. Said machine learning algorithms may reconstruct the motions of the human body without the need of markers, reducing the often time-consuming operation of applying markers which might impede natural human motion. Exemplary machine learning systems that do not require markers are publicly available from DeepMotion (San Mateo, CA) and Radical Motion by Radical Solutions (Wilmington. DE). Other examples of machine learning systems that do not require markers are publicly available as open-source software, such as OpenPose, available at github.com / CMU-Perceptual-Computing-Lab / openpose, and MediaPipe, available at github.com / google-ai-edge / mediapipe.

[0048] The cameras of motion capture system 160 may be the same cameras 164 of the mobile physical telemedicine system 100. In other embodiments, motion capture system 160 may include cameras that are separate from the cameras 164 of the mobile physical telemedicine system. The motion capture system’s cameras may obtain image / video data that is processed by one or more processors to generate data (“motion capture data'’) encoding 3D movements of the care recipient 150. The motion capture processors may be part of the processing system 130, they may be integrated into vertical stands 110, 1 12 or otherwise located within the mobile physical telemedicine system 100. In some embodiments, the processors of processing system 130 and the processors of motion capture system 160 are the same. It is also noted that, while vertical stands 110 and 112 are shown here to include parts of the motion capture system 160, in some embodiments the motion capture system 160, and by extension the mobile physical telemedicine system 100, may not include any vertical stands. In such embodiments, the cameras for the motion capture system 160 may be attached to other components of the mobile physical telemedicine system 100.

[0049] The motion capture system 160 in combination with the processing system 130 may be used to transmit motion capture data, for example over network 132, to a remote server accessible by a clinical provider. In some cases, “raw” image / video data may be transmitted to a remote system which generates motion capture data therefrom. Thecollected data (the motion capture data, “raw"’ image / video data, and any additional data captured from the cameras, microphones, etc.) may also be transferred through the network, enabling the clinical provider access during the treatment. The collected data may be accessed through an online portal or database on a computer or through a mobile device, such as remote computing device 170. The microphones enable the care recipient and / or technician to speak with the clinical provider. Loudspeakers and displays may be used to guarantee bidirectional vocal and visual communication between the two sites.

[0050] The data is transmitted efficiently to the clinical provider, in quasi real-time. By exploiting high-speed internet communication, delays between the care recipient and the clinical provider can be minimized. Any latency under 200 ms is acceptable; latency of 100 to 120 ms is possible with certain robotic manipulators, such as two inMotion 2.0 manipulators (Interactive Motion Technologies, Inc., Watertown, MA). This enables the clinical provider and care recipient to efficiently and effectively interact. Additionally, cameras provide the clinical provider with a complete view of the care recipient, further enabling effective interactions. The clinical provider may wear augmented or virtual reality goggles that reconstruct the care recipient’s environment. Meanwhile the care recipient interacts with the clinical provider by means of microphones and loudspeakers as well as a screen from which they may see the clinical provider. In case of communication loss, the system is configured to remain safe by switching to a recover mode. In recover mode, the system may stop of all movement of the robotic manipulators, enter a compliant mode, move the robotic manipulators away from the subject, etc.

[0051] The adjustable therapy bench 140 may be used to support the care recipient 150 during rehabilitation / training. The adjustable therapy bench 140 may have dimensions sufficient to support the full body of the care recipient 150 (e.g.. in a seated or lying position) or a portion thereof. The adjustable therapy bench 140 may be adjusted to recline or to lie fully flat. The adjustable therapy bench 140 may be supported on wheels, rollers, etc. such that it can be easily moved or repositioned. In alternative embodiments, the adjustable therapy bench 140 may be fixedly attached to a top surface of the base 180 using one or more fasteners such as those described below.

[0052] The base 180 may support the technician, care recipient 150, and various system components such as robotic manipulators 102, vertical stands 110 and 112, and adjustable therapy bench 140 during and before rehabilitation / training. The base 180 may also support other components such as one or more of processing system 130, motion capture system 160,microphones 162, and cameras 164. As shown, the base 180 may have general planar shape including a top surface onto which the various system components may be attached or otherwise supported. Base 180 can be formed, at least in part, of a plastic, metal, or wood material. Base 180 may have dimensions (e.g., thickness) and construction (e.g., rigidity, etc.) sufficient to support the weight of the various system components, the care recipient, and the technician. In some embodiments, base 180 may be provided in multiple sections (e.g., multiple planar sections) configured to slide apart / together. enabling the base 180 to become larger / smaller. The various system components may be fixedly attached to the top surface of base 180 using one or more fasteners such as screws, bolts, adhesives, straps, clamps, or other types of connectors. In some embodiments, the base 180 may be movable and may have wheels or rollers fixedly attached to the surface.

[0053] While the processing system 130, motion capture system 160, robotic manipulators 102, and other components of the mobile physical telemedicine system 100 are described as separate components herein, it is expressly contemplated that they may integrated to various extents and forms that are suitable and known to the skilled person. For example, the motion capture system 160 may be a part of the processing system 130. In other embodiments, parts or all the processing system 130 may be integrated into one or more of the robotic manipulators 102. In yet other embodiments, parts or all of the processing system 130 and the motion capture system 160 may be integrated in one or more of vertical stands 110. 112.

[0054] Figs. 2A and 2B illustrate mobile physical telemedicine system 220 loaded and unloaded, respectively, on / from a vehicle 210 for delivering physical rehabilitation / training to a care recipient. The system 220 may be similar to or substantially the same as the mobile physical telemedicine system 100 described above with reference to Figs. 1A and IB. The system 220 may further be dimensioned to fit inside the vehicle 210.

[0055] The vehicle 210 may be a passenger vehicle (e.g., a van or truck). The vehicle 210 may be operated by a technician and driven to a dedicated location (e.g., a residential home, office building, recreational facility, or community center). The mobile physical telemedicine system 220 may be dimensioned and configured to fit inside of an entrance way, for example of the residential home of the care recipient. Once at the residential location, the system 220 may be loaded out of the vehicle 210. After treatment of the subject, the system 220 may be loaded back into the vehicle 210.

[0037] A technician (or driver) may drive the vehicle 210 and prepare the mobile physical telemedicine system 220. including the robotic manipulators and communication system, for rehabilitation / treatment. The technician may also activate and maintain the mobile physical telemedicine system 220. The technician does not perform the therapy but may ensure that the care recipient is correctly positioned relative to the manipulators before the therapy session is initiated. The technician also prepares the system and the care recipient for treatment, e.g., starting the system, positioning the care recipient, etc. The ability to move the mobile physical telemedicine system 220 to the care recipient is especially important for under-serv ed communities, such as rural communities or inner-city urban communities.

[0038] To load the system 220 in and out of the vehicle 210, any means known to the skilled person, such as ramps, a pallet jack, or an electrical lift may be used. A base 280, similar to or substantially the same as base 180 described with reference to Fig. 1A, may be used to assist in loading and unloading. In some embodiments, the base 280 with the system 220 may be configured to remain in the vehicle 210 during treatment. In those cases, the base 280 may not be movable and may not include wheels or rollers. Alternatively, in other embodiments, the system 220 may be set up outside of the vehicle 210 at the designated location and the base 280 may be movable and may therefore include wheels or rollers. When loaded in the vehicle 210, the base may be secured to the vehicle to prevent movement. For example, rollers / wheels attached to the base may be locked. The wheels or rollers attached to the base 280 may be used to move the system 220 in and out of the vehicle 210. The wheels or rollers may be used to enable movement once off the vehicle 210, enabling the technician to move the system 220 to the dedicated location. Alternatively, electric motors may be used to automatically move the base 280.

[0039] Fig. 3 illustrates a mobile physical telemedicine system being operated in teleoperation mode 300, according to some embodiments. In tele-operation mode, the robotic manipulator is controlled by the clinical provider. The mobile physical telemedicine system, which may be similar to or substantially the same as mobile physical telemedicine systems 100 and 220 shown and described above with reference to Figs. 1A, IB, 2A. and 2B, includes one or more robotic manipulators 330, 340 for stimulating a care recipient 320. The robotic manipulators 330 and 340 may be similar to or substantially the same as robotic manipulator 102 described above. A clinical provider 310 located at a remote location from the care recipient 320 may use their arms 312, 314 (or other body parts) to exert forces onone or more input devices 350, which in turn causes robotic manipulators 330, 340 to exert effectively the same forces on an arm 322 (or other body part) of the care recipient 320. Additional input modalities are possible through the one or more input devices 350. In other words, the input devices 350 serve as a proxy for the remote care recipient’s arm 322, and robotic manipulators 330, 340 serve as proxies for the remote clinical provider’s arms 312, 314. The input devices 350 may be any suitable input device known to the skilled person, such as one or more robotic manipulators, haptic interfaces, space mouses, etc. In some embodiments, the one or more input devices 350 may also include a motion tracking system similar to the motion capture system described above. In that case, the motion capture system may track the motion of one or both of the clinical provider’s arms (or other body parts). The tracked motion may then be used to cause movement of the robotic manipulators 330, 340.

[0039] During tele-operation mode 300, data may be collected from various sensors, cameras, microphones, etc. as previously described, and the collected data may be transferred between a processing system located with or otherwise accessible by clinical provider 310 and another processing system located with / accessible by care recipient 320. An example of such a processing system is shown and described in the context of Figs. 1 A and 5. Robotic manipulators 330, 340 may be part of a mobile physical telemedicine system and may be similar to or the same as the robotic manipulators 102 described above with reference to Figs. 1 A and IB. In some embodiments, the one or more input devices 350 may be part of a different mobile physical telemedicine system, or they may be located in a physical therapist’s office or other non-mobile setting.

[0040] In the embodiment of Fig. 3, manipulators 330, 340 and one or more input devices 350 may be used to establish physical contact and interaction between the arm 322 or other body part of the care recipient 320 and the arms 312, 314 of the clinical provider 310. On one side, the arms 312, 314 of the clinical provider 310 interact with one or more input devices 350, which simulates the care recipient’s impaired arm 322 modeling the treatment and directing the manipulators 330, 340 located with the care recipient 320. On the other side, the first robotic manipulator 330 and the second robotic manipulator 340 exert forces on the care recipient 320, which simulate the motion of the arms 312, 314 of the clinical provider 310.

[0041] Manipulators 330, 340 and input devices 350 may be connected via network communication (e.g., over the internet) to implement bidirectional force-reflecting tele-operation. Each of the manipulators 330, 340 and input devices 350 may sense the forces exerted by the others and display them to the respective care recipient 320 and clinical provider 310. The care recipient 320 may feel the touch of the clinical provider 310; the clinical provider 310 may feel the resistance of the care recipient’s upper or lower limbs to applied forces. The one or more processing systems relay the resistance through haptics or alerts notifying the clinical provider of the applied force. This is especially useful to assess spasticity and abnormal muscle tone. In addition, the manipulators 330. 340 at the care recipient’s location may perform as an autonomous agent to provide therapy to the care recipient, as instructed by the clinical provider.

[0042] This autonomous mode may be based on instructions given to the processing system by the clinical provider. The clinical provider, through suitable software, may design a therapy plan for the care recipient that the robotic manipulators then execute at a later time. The processing system may execute the plan as designed by the clinical provider, or the processing system may adapt the plan in any suitable manner, for example to adjust for the physical abilities of the care recipient, as described below. In other embodiments, the autonomous mode may be based on movements recorded by the processing system during a previous therapy session. Illustratively, the processing system may record or otherwise save the inputs received from the clinical provider through the one or more input devices 350. The processing system may then, at a later time, use these saved inputs to cause motion of the robotic manipulators 330, 340. The processing system may use the inputs as saved, or it may adapt the saved inputs in any suitable manner, for example to adjust for the physical abilities of the care recipient.

[0043] In alternative embodiments, there may be multiple robotic manipulators at each location. The clinical provider may interact physically with the care recipient at more than one location on the body, requiring more than one robotic manipulator. Similarly, the care recipient may require physical support at several locations on the body, requiring multiple robotic manipulators.

[0044] Fig. 4A illustrates a process 400 for providing mobile physical telemedicine. The process 400 may be used in conjunction with a mobile physical telemedicine system, such as any of the systems described above with reference to Figs. 1 A, IB, 2A, 2B, and 3.

[0045] At step 402, a vehicle in which a physical telemedicine system is transported may be parked in a dedicated area, such as a residential home, office building, recreational facility, community center, etc. where a care recipient is located.

[0046] At step 404, the vehicle and / or various components of the physical telemedicine system may be prepared for treatment / rehabilitation of the care recipient. This may include opening a vehicle door, unloading the physical telemedicine system from the vehicle, adjusting the position / orientation of one or more system components, guiding the care recipient onto a therapy bench, providing instructions to a caregiver, etc.

[0047] At step 406, the treatment / rehabilitation is initiated. This may include reaching out to a clinical provider to set up the treatment / rehabilitation, interacting with the components of the physical telemedicine system to begin the treatment / rehabilitation, etc. The session may be initiated by the clinical provider, the technician, or any other entity involved in the treatment /

[0048] In steps 408 and / or 410. the mobile physical telemedicine system performs treatment / rehabilitation on the care recipient through one or both of a manual or teaching mode (step 408) and an autonomous mode (step 410). In step 408, the mobile physical telemedicine system performs treatment / rehabilitation on the care recipient in a manual or teaching mode. Teaching mode is a variant of the manual or teleoperation mode described above. The teleoperation mode may allow the clinical provider to assess the care recipient and try some activities that the care recipient may tolerate. Subsequently, the clinical provider may identify a particular exercise and teach it to the mobile physical telemedicine system for use in autonomous mode. In the teaching mode, the clinical provider performs a particular motion (or motions), such as scapular plane elevation, by moving one or more input devices at the clinical provider’s location, which then move the care recipient's limbs using the robot manipulators of the mobile physical telemedicine system. The teaching action is then recorded as a template for this particular session, which may be executed later in autonomous mode.

[0049] In teleoperation mode, one or more manipulators, which are a part of the mobile physical telemedicine system, are remotely controlled by the clinical provider. The clinical provider may be equipped with virtual, or augmented-reality goggles, a haptic display and through high-speed internet communication may direct the manipulators with negligible delay. The mobile physical telemedicine system may be equipped with digital assets to visualize the clinical provider as a digital avatar, e g. a screen, virtual, augmented or extended reality goggles, a projector, a 3D screen, etc.

[0050] In step 410, the mobile physical telemedicine system performs treatment / rehabilitation of the care recipient in autonomous mode. In autonomous mode, therobotic manipulators interact physically with the care recipient to perform the treatment / rehabilitation as previously specified by the clinical provider while in teleoperation mode. In some embodiments, while in autonomous mode, the processing system and / or robotic manipulators adapt the instructions given by the clinical provider to keep the care recipient challenged. The processing system and / or robotic manipulators may, for example, sense the amount of interaction of force and keep it at the same level, so to maintain a constant challenge level for the care recipient. Alternatively, if sensor readings show an increase in the fatigue level of the subject (slower movements, with more frequent pauses), then the processing system and / or robotic manipulators can adapt the rehabilitative exercise to match the care recipient's level of fatigue and avoid exercise failure. Said adaptation is a form of performance-based progressive therapy and is a key feature of interactive robot-aided therapy for post-stroke recovery. This is especially beneficial since the manipulator adapts to the care recipient’s need and the therapy does not depend on continuous intervention by the clinical provider. The clinical provider may configure all aspects of the system, including the camera angles, voice quality, manipulator actions, etc. The clinical provider may supervise all health-related aspects of the care recipient’s treatment. The technician may perform tasks such as setting up the system and verifying the correct operation of the system before and during therapy.

[0051] Impedance control, as described above, is an approach to the control of dynamic interaction between a mechanism and its environment. Impedance control regulates the relationship between force and motion of the mechanism, such as a robotic manipulator. Impedance control may facilitate a safe interaction between the robot and the care recipient. Data collected from sensors may be used to assist in directing the robot. Safe physical interaction between the robot and the care recipient is provided by a combination of robot design, actuator performance, and control architecture. Illustrative robot control techniques that may be used within process 400 or system 100 are described in U.S. Pat. No. 5,466,213 entitled “Interactive Robot Therapist” and issued on November 14, 1995, which is hereby incorporated by reference herein in its entirety.

[0052] To illustrate the general concepts, structures, and techniques sought to be protected herein, an example of autonomous mode is now provided. The session starts in teleoperation mode, wherein the clinical provider virtually meets with the care recipient to assess their health condition and specify the desired activity for the robotic manipulators. Then, the manipulators perform the treatment / rehabilitation with the care recipient for theremaining time of the session in the autonomous mode. While operating with the care recipient, the manipulators perform mobilization and training of the care recipient while simultaneously recording the exercises performed as well as the care recipient’s health status. Data may be collected (the motion capture data, "raw " image / video data, and any additional data captured from the cameras, microphones, force sensors, etc.) and may also be transferred through the network, enabling the clinical provider to access the data during the treatment / rehabilitation. The clinical provider is free to disconnect and re-connect to the manipulators at any time during the treatment / rehabilitation and to adapt the manipulators’ behavior based on collected data and feedback from the technician or from the care recipient. An exemplary therapy session may last for one hour.

[0053] At step 412, the mobile physical telemedicine system may end the treatment / rehabilitation based on a request by the technician, clinical provider, or care recipient, or based on other suitable factors, such as expired session time. At the end of the treatment / rehabilitation, collected data may be compiled as a report and sent to the clinical provider to facilitate monitoring, assessment, and progress of the care recipient's recovery’. The report may contain information about the care recipient’s performance during treatment / rehabilitation. For example, the report may include the number of completed exercises, the level of fatigue, the amount of consumed energy’, any specific motor pattern adopted by the care recipient to complete the rehabilitative tasks. The report may also contain robot-related data, i.e., positions, time stamps, interaction forces, etc.

[0054] At step 414, the care recipient is supported as they exit the treatment / rehabilitation session. This may include exiting the physical telemedicine system, exiting the vehicle, etc.

[0055] Fig. 4B shows a computer-implemented method 450 for providing mobile physical telemedicine to a subject during a telemedicine session, using a mobile physical telemedicine system. The mobile physical telemedicine system may be similar to or substantially the same as the mobile physical telemedicine systems described above with reference to Figs. 1A, IB, 2A, 2B, and 3. The mobile physical telemedicine system may include a processing system and at least one robotic manipulator configured to support and manipulate a body part of the subject.

[0056] In step 452, the processing system detects an initiation of the telemedicine session by a remote computing device. Similar to what is described above with reference to step 406 of Fig. 4A. initiation of the session may include an indication given by the clinicalprovider on his or her remote computing device that the provider is now ready to work with the care recipient. Illustratively, the processing system may receive an initiation signal over the network. In other cases, the processing system may detect an initiation of the session by a login of the clinical provider on the remote computing device, by a signal provided by the technician on the remote computing device, or by any other suitable means.

[0057] In step 454, the processing system receives a selection of an operating mode for the at least one robotic manipulator from the remote computing device. As described above, the operating mode may include one or both of a teleoperation mode and an autonomous mode. If there is more than one robotic manipulator, the processing system may receive a selection of an operating mode for each manipulator, or it may receive a selection of an operating mode for all manipulators. The processing system may receive selections of different operating modes for different robotic manipulators. For example, the processing system may receive a selection of a teleoperation mode for a first manipulator and a selection of an autonomous mode for a second manipulator. The processing system may receive the selection of an operating mode over the network.

[0058] In step 456, the processing system operates the at least one robotic manipulator in accordance with the operating mode to perform at least one physical activity with the subject, the physical activity related to rehabilitation or physical training. Depending on the operating mode, the processing system may operate the robotic manipulator in different ways. Illustratively, in autonomous mode the processing system may operate the robotic manipulator in accordance with instructions stored in a memory of the processing system. The processing system may also receive instructions from a computing device of the clinical provider over the network to operate the robotic manipulator in autonomous mode. In teleoperation, the processing system may receive a plurality of commands from a computing device of the clinical provider over the network to operate the robotic manipulator. The commands may, for example, indicate various positions and orientations for the robotic limbs to assume, or forces to exert on the care recipient. Operating the at least one robotic manipulator may also include transferring data over the network back to the computing device of the clinical provider, such as sensor data from the robotic manipulator, motion capture date, microphone and camera data, etc.

[0059] In step 458, the processing system receives a command to end the telemedicine session from the remote computing device. Similar to what is described above with reference to step 412 of Fig. 4A, the clinical provider may transmit a command to end thetelemedicine session from his or her remote computing device over the network to the processing system. Similarly, the technician may transmit a command to end the telemedicine session from a remote computing device. Even if the care recipient or technician requests to end the session, the clinical provider may review and approve the request as needed.

[0060] In step 460. the processing system terminates movement of the at least one robotic manipulator in response to the command to end the telemedicine session. Terminating movement may include moving the robotic manipulator to a safe position before ending the session. For example, the processing system may cause movement of the robotic manipulator away from the care recipient so that he / she is able to safely exit the treatment area.

[0061] To illustrate the general concepts, structures, and techniques sought to be protected herein, an example of mobile physical telemedicine is now provided. John Smith, the care recipient, looks forward to his next session to treat the partial paralysis he has suffered since his recent stroke. His clinical provider, who specializes in his condition, is located thousands of miles away, but John only needs to travel to his local small-town community center to meet the "Express RoboDoc”, a mobile physical telemedicine system located in a vehicle parked at the community center. Once set up by the technician, John chats with his clinical provider who is connected over the internet and can be seen as a digital avatar in the vehicle.

[0062] The clinical provider checks on his progress and decides what this session will emphasize. Guided by the clinical provider, a robotic manipulator moves John’s arm to demonstrate the action he is to work on during this session. Then his clinical provider signs off and John repeatedly attempts this action. In the meantime, the clinical provider has time to tele-visit another patient or focus on John’s health condition and plan his next treatment. John initiates the exercise as well as he can while the manipulator takes care of guiding and assisting him. The manipulator assists only enough to keep him from being discouraged and, as John improves, the manipulator assists less. The system also monitors and collects data on John’s performance. Towards the end of the session, the clinical provider logs in again to check on John’s condition. The clinical provider then terminates the therapy session and collects the results of the therapy from the system before proceeding to the next care recipient scheduled at this location. When all care recipients at this location have been treated, thetechnician moves the vehicle to the next location to repeat the process with another group of patients.

[0063] Fig. 5 shows an example of a mobile physical telemedicine system 500 including robotic manipulators 510, 520 supported on a platform 540 and connected to a processing system 530, according to an embodiment of the present disclosure. It should be appreciated that Fig. 5 is not intended to show all aspects or components of a mobile physical telemedicine system. For example, a mobile physical telemedicine system can include a therapy bench, various components / sensors of a motion capture system, a base, etc. as described above.

[0064] Robotic manipulators 510, 520 may be connected to processing system 530 via wired and / or wireless communication means. As shown, processing system 530 may be external to the robotic manipulators 510, 520. In other embodiments, processing system 530 may be integrated into robotic manipulators 510 and 520. The robotic manipulators 510, 520 may be spaced apart such that they can freely move while being able to act in concert to manipulate a body part of a care recipient. The robotic manipulators 510. 520 may be bolted or otherwise fastened to the platform 540. The platform 540 may be made from a metal or other rigid material. The processing system 530 may be connected to both robotic manipulator 510, 520 and may power, transfer data to / from, and control the robotic manipulators 510, 520.

[0065] The mobile physical telemedicine system described herein reduces and optimizes the workload of clinical providers. Through the system, clinical providers will be able to use their time more efficiently by requiring only a small fraction of the typical visit duration for each patient.

[0066] Thus, the mobile physical telemedicine system described herein improves the capacity of the health-care system. This directly translates to an increased ability to offer health-care services, which may cause a reduction in the cost of rehabilitation / training. Therefore, access to treatment is improved for care recipients with limited financial or environmental resources, such as post-stroke survivors living in rural areas or inner-city urban areas with limited access to care facilities.

[0067] As used herein, the terms '‘processor’’ and '‘controller” are used to describe electronic circuitry that performs a function, an operation, or a sequence of operations. The function, operation, or sequence of operations can be hard coded into the electronic circuit or soft coded by way of instructions held in a memory’ device. The function, operation, orsequence of operations can be performed using digital values or using analog signals. In some embodiments, the processor or controller can be embodied in an application specific integrated circuit (ASIC), which can be an analog ASIC or a digital ASIC, in a microprocessor with associated program memory, in a digital signal processor (DSP), and / or in a discrete electronic circuit, which can be analog or digital. A processor or controller can include internal processors or modules that perform portions of the function, operation, or sequence of operations. Similarly, a module can include internal processors or internal modules that perform portions of the function, operation, or sequence of operations of the module. A single processor or other unit may fulfill the functions of several means recited in the claims.

[0068] Although reference is made herein to particular materials, it is appreciated that other materials having similar functional and / or structural properties may be substituted where appropriate, and that a person having ordinary' skill in the art would understand how to select such materials and incorporate them into embodiments of the concepts, techniques, and structures set forth herein without deviating from the scope of those teachings.

[0069] Various embodiments of the concepts, systems, devices, structures and techniques sought to be protected are described herein with reference to the related draw ings. Alternative embodiments can be devised without departing from the scope of the concepts, systems, devices, structures and techniques described herein. It is noted that various connections and positional relationships (e.g.. over, below, adjacent, etc.) are set forth betw een elements in the following description and in the drawings. These connections and / or positional relationships, unless specified otherwise, can be direct or indirect, and the described concepts, systems, devices, structures and techniques are not intended to be limiting in this respect. Accordingly, a coupling of entities can refer to either a direct or an indirect coupling, and a positional relationship between entities can be a direct or indirect positional relationship.

[0070] The follow ing definitions and abbreviations are to be used for the interpretation of the claims and the specification. As used herein, the terms "comprises." "comprising, "includes." "including," "has." "having," "contains" or "containing," or any other variation thereof, are intended to cover a non-ex elusive inclusion. For example, a composition, a mixture, process, method, article, or apparatus that comprises a list of elements is not necessarily limited to only those elements but can include other elements not expressly listed or inherent to such composition, mixture, process, method, article, or apparatus.

[0071] The term "one or more" is understood to include any integer number greater than or equal to one, i.e. one, two, three, four. etc. The terms "a plurality" are understood to include any integer number greater than or equal to two, i.e. two, three, four, five, etc.

[0072] References in the specification to "one embodiment, "an embodiment," "an example embodiment," etc., indicate that the embodiment described can include a particular feature, structure, or characteristic, but every embodiment can include the particular feature, structure, or characteristic. Moreover, such phrases are not necessarily referring to the same embodiment. Further, when a particular feature, structure, or characteristic is described in connection with an embodiment, it is submitted that it is within the knowledge of one skilled in the art to affect such feature, structure, or characteristic in connection with other embodiments whether or not explicitly described.

[0073] For purposes of the description hereinafter, the terms "upper," "lower," "right," "left," "vertical," "horizontal," "top," "bottom," and derivatives thereof shall relate to the described structures and methods, as oriented in the drawing figures.

[0074] Use of ordinal terms such as “first,” “second,” “third,” etc., in the claims to modify a claim element does not by itself connote any priority, precedence, or order of one claim element over another or the temporal order in which acts of a method are performed, but are used merely as labels to distinguish one claim element having a certain name from another element having a same name (but for use of the ordinal term) to distinguish the claim elements.

[0075] It is to be understood that the disclosed subject matter is not limited in its application to the details of construction and to the arrangements of the components set forth in the following description or illustrated in the drawings. The disclosed subject matter is capable of other embodiments and of being practiced and carried out in various ways. Also, it is to be understood that the phraseology and terminology employed herein are for the purpose of description and should not be regarded as limiting. As such, those skilled in the art will appreciate that the conception, upon which this disclosure is based, may readily be utilized as a basis for the designing of other structures, methods, and systems for carrying out the several purposes of the disclosed subject matter. Therefore, the claims should be regarded as including such equivalent constructions insofar as they do not depart from the spirit and scope of the disclosed subject matter.

[0076] Although the disclosed subject matter has been described and illustrated in the foregoing exemplary embodiments, it is understood that the present disclosure has beenmade only by way of example, and that numerous changes in the details of implementation of the disclosed subject matter may be made without departing from the spirit and scope of the disclosed subject matter.

[0077] All publications and references cited herein are expressly incorporated herein by reference in their entirety.

Claims

Claims1. A mobile physical telemedicine system, comprising: a processing system; at least one robotic manipulator communicatively coupled to the processing system and configured to support and manipulate a body part of a subject; a motion capture system communicatively coupled to the processing system and configured to capture a motion of the subject; an adjustable therapy bench; and a base supporting the at least one robotic manipulator, the motion capture system, and the adjustable therapy bench.

2. The mobile physical telemedicine system of claim 1, wherein the at least one robotic manipulator is configured to be controlled remotely by a clinical provider.

3. The mobile physical telemedicine system of claim 1. wherein the at least one robotic manipulator is configured to be operated in an autonomous mode.

4. The mobile physical telemedicine system of claim 1, comprising at least two robotic manipulators, wherein the at least two robotic manipulators are configured to be controlled by a clinical provider.

5. The mobile physical telemedicine system of claim 1, comprising a first robotic manipulator and a second robotic manipulator, wherein the first robotic manipulator is configured to be controlled by a clinical provider and the second robotic manipulator is configured to operate in an autonomous mode.

6. The mobile physical telemedicine system of claim 1, wherein the at least one robotic manipulator further comprises at least one of a force sensor, a torque sensor, and a current sensor.

7. The mobile physical telemedicine system of claim 1, wherein the at least one robotic manipulator is configured to be controlled by impedance control.

8. The mobile physical telemedicine system of claim 1, further comprising a microphone and configured to transmit audio data received from the microphone to a computing device of a clinical provider.

9. The mobile physical telemedicine system of claim 1, further comprising a camera and configured to transmit data related to communication from the subject and movement of the subject received from the camera to a computing device of a clinical provider.

10. The mobile physical telemedicine system of claim 1, wherein the mobile physical telemedicine system is disposed in a vehicle and wherein the base is movable and configured to load the mobile physical telemedicine system in and out of the vehicle.

11. The mobile physical telemedicine system of claim 1, wherein the at least one robotic manipulator is configured to support and manipulate a limb of the subject.

12. A computer-implemented method for providing mobile physical telemedicine to a subject during a telemedicine session, using a mobile physical telemedicine system, the mobile physical telemedicine system including a processing system, at least one robotic manipulator configured to support and manipulate a body part of the subject, the method comprising: detecting, by the processing system, an initiation of the telemedicine session by a remote computing device: receiving, by the processing system, a selection of an operating mode for the at least one robotic manipulator from the remote computing device; operating, by the processing system, the at least one robotic manipulator in accordance with the operating mode to perform at least one physical activity with the subject, the physical activity related to rehabilitation or physical training. receiving, by the processing system, a command to end the telemedicine session from the remote computing device; and terminating, by the processing system, movement of the at least one robotic manipulator.

13. The method of claim 12, wherein the operating mode is an autonomous mode.

14. The method of claim 12, wherein the operating mode is a teleoperation mode.

15. The method of claim 12, wherein the mobile physical telemedicine system includes first and second robotic manipulators and wherein the operating mode for the first robotic manipulator is a teleoperation mode and the operating mode for the second robotic manipulator is an autonomous mode.

16. The method of claim 12, wherein the at least one robotic manipulator is configured to support and manipulate a limb of the subject.

17. The method of claim 12, wherein the processing system is coupled to a network and wherein the processing system receives the selection of an operating mode over the network.

18. The method of claim 14, wherein the processing system is coupled to a network and wherein the processing system receives a plurality of commands to control the at least one robotic manipulator over the network.

19. The method of claim 12, wherein the mobile physical telemedicine system further includes a motion capture system configured to capture a motion of the subject and wherein the method further comprises analyzing, by the processing system, the captured motion.

20. A non-transitory computer-readable medium having software encoded thereon, the software, when executed by a processing system coupled to a mobile physical telemedicine system including at least one robotic manipulator configured to support and manipulate a body part of a subject, operable to: detect an initiation of a telemedicine session by a remote computing device; receive a selection of an operating mode for the at least one robotic manipulator from the remote computing device;operate the at least one robotic manipulator in accordance with the operating mode to perform at least one physical activity with the subject, the physical activity related to rehabilitation or physical training. receive a command to end the telemedicine session from the remote computing device; and terminate movement of the at least one robotic manipulator.

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