Remote medical treatment assistance system

Abstract

The present invention provides a rehabilitation program for an orthopedic patient through a remote medical treatment system using a smart device.　A recovery evaluation score for a patient is calculated by inputting, from a smart device of the patient, answers to a plurality of questions in a medical questionnaire in which a health-related QOL evaluation scale is used. Alternatively, a calculated recovery evaluation score is inputted to a PC of a medical institution. A rehabilitation index for quantitatively evaluating a recovery state of the patient on a numerical scale on the basis of the calculated or inputted recovery evaluation score is determined, and a rehabilitation program of a grade suitable for the recovery state of the patient is selected on the basis of the determined rehabilitation index. The selected rehabilitation program is stored in a storage of the PC of the medical institution together with an identification number of the patient, the rehabilitation program stored in the PC is invoked and displayed on a screen as a video by inputting the identification number of the patient, and the patient performs instructed rehabilitation exercise in accordance with the rehabilitation program displayed as the video.

Description

Remote medical support system

[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.

[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 of health. Rehabilitation is carried out with the aim 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 care support system that allows a doctor or physical therapist to quantitatively evaluate the state of a patient's motor function using a questionnaire, prescribe a rehabilitation program selected based on the results of that quantitative evaluation, update the assessment of the patient's health condition at any given time as the patient carries out the independent exercises prescribed in the prescribed rehabilitation program, and update the rehabilitation program prescribed for the patient based on the updated assessment (WO2023 / 219056 Patent No. 7344622).

[0006] Patent number 7344622 (WO2023 / 219056)

[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 medical institutions. If patients correctly recognize their own condition and correctly understand the meaning of each question on the medical questionnaire, the system can be configured so that the patient can calculate the evaluation score by inputting their own answers to each question on the medical questionnaire without the need for a doctor or physical therapist, thereby significantly reducing the burden on medical institutions.

[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 move independently, the system comprising a smart device and a PC (personal computer) wirelessly connected to the smart device via an Internet line, the PC being installed in a medical institution and set so as to be accessible by the patient's doctor or physical therapist, and having application software for the remote medical care support system installed thereon, and comprising: means for accepting input of a patient's identification number, profile, and type of disease treated; means for transmitting and receiving data to and from the smart device; a storage device; and a CPU, the smart device being installed with application software for the remote medical care support system, and comprising: means for logging into the remote medical care support system by inputting a patient's identification number registered in the PC; means for accepting input of answers to a plurality of questions in a questionnaire using a health-related QOL assessment scale; means for transmitting and receiving data to and from the PC; and means for displaying the rehabilitation program received from the PC on an output screen, the storage device of the PC storing, in video format, a plurality of rehabilitation programs corresponding to post-surgery for a predetermined type of disease, Each rehabilitation program is composed of a plurality of exercise programs, and each rehabilitation program has a plurality of grades according to the magnitude of the load placed on the body by performing the exercise program instructed by the rehabilitation program, and a patient rehabilitation index appropriate for the load placed on the body by performing the exercise program of that grade is registered for each grade of each rehabilitation program, and the system calculates a recovery evaluation score for the patient based on the patient's answers to a plurality of questions in the questionnaire, determines a rehabilitation index that evaluates the recovery state of the patient on a numerical scale based on the calculated recovery evaluation score, and calculates the rehabilitation index based on the type of disease treated for the patient and the rehabilitation index.The inventors have arrived at the invention of a remote medical support system for supporting the selection and implementation of a rehabilitation program for an orthopedic patient who is able to move independently, by selecting a rehabilitation program and its grade to be prescribed for the patient from among multiple rehabilitation programs stored in the storage device of a PC and displaying it on the output screen of the smart device.

[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 further comprises means for accepting input of the patient's recovery assessment score calculated based on answers to a plurality of questions in a questionnaire using a health-related quality of life assessment scale, and is configured to be able to determine the patient's rehabilitation index based on either the input recovery assessment score or the input recovery assessment score.

[0015] The inventors of the present invention have further developed 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, the system comprising a smart device and a PC (personal computer) wirelessly connected to the smart device via an Internet line, the PC being installed in a medical institution and set so as to be accessible by the patient's doctor or physical therapist, and having application software for the remote medical care support system installed thereon, and comprising: means for receiving input of a patient's identification number, profile, and type of disease treated; means for receiving input of the patient's recovery evaluation score calculated based on answers to a plurality of questions in a questionnaire using a health-related QOL assessment scale; means for transmitting and receiving data to and from the smart device; a storage device; and a CPU, the smart device having application software for the remote medical care support system installed thereon, and comprising: means for logging into the remote medical care support system by inputting a patient's identification number registered in the PC; means for transmitting and receiving data to and from the PC; and means for displaying the rehabilitation program received from the PC as video on an output screen, the storage device of the PC storing a plurality of rehabilitation programs corresponding to post-surgery of a predetermined type of disease as video, Each rehabilitation program is composed of a plurality of exercise programs, and each rehabilitation program has a plurality of grades according to the magnitude of the load placed on the body by executing the exercise program instructed by the rehabilitation program, and a rehabilitation index for the patient appropriate to the load placed on the body by executing the exercise program of that grade is registered for each grade of each rehabilitation program, and the system determines a rehabilitation index that evaluates the recovery state of the patient on a numerical scale based on the recovery evaluation score input to the PC, and selects a rehabilitation program for the patient from among a plurality of rehabilitation programs stored in a storage device of the PC based on the type of disease treated by the patient and the rehabilitation index.The present inventors have arrived at the invention of a remote medical care support system for supporting the selection and implementation of a rehabilitation program for an orthopedic patient who is capable of independent movement, which system selects a rehabilitation program and its grade to be prescribed for the patient and stores it in the memory device of the PC together with the patient's identification number, and by inputting the patient's registered identification number into the smart device, the rehabilitation program stored in the memory device of the PC is called up and displayed as a video on the display screen of the smart device.

[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.

[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] In one preferred embodiment of the system of the present invention, the patient's identification number (patient ID) is registered 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.

[0029] FIG. 1 shows a conceptual diagram of a network for a system according to one embodiment of the present invention. Patient 1's smart device 21, patient 2's smart device 22, and patient 3's smart device 23 are each connected to a medical institution's PC 10. A wearable sensor device 33 is connected to patient 3's smart device 23. FIG. 2 shows the configuration of a PC used in the system according to one embodiment of the present invention. FIG. 3 shows a configuration in which a wearable sensor device is connected to a smart device used in the system according to one embodiment of the present invention. FIG. 4 shows an example of a display screen for a smart device used in the system according to one embodiment of the present invention. FIGS. 5(A) and 5(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. FIG. 6 shows an example of an SF-36 questionnaire used in a remote medical consultation support system according to one embodiment of the present invention. FIG. 7 shows an example of an RDQ questionnaire used in a remote medical consultation support system according to one embodiment of the present invention. FIG. 8 shows an example of a questionnaire used in a remote medical consultation support system according to one embodiment of the present invention. FIG. 9 shows an example of an input screen for answers to multiple questions in a questionnaire used in a remote medical consultation support system according to one embodiment of the present invention. Figure 10 shows the relationship between the recovery assessment score, rehabilitation index, and rehabilitation program (for a patient with lower back pain) used in one embodiment of the remote medical care support system of the present invention. Figure 11 shows the profile, target heart rate, and calorie expenditure (for a patient with lower back pain) of a patient who has completed one rehabilitation unit (15 minutes of exercise) in one embodiment of the remote medical care support system 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 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 shows the relationship between the type of patient's illness, the prescribed rehabilitation exercise program, and the rehabilitation index in one embodiment of the remote medical care support system of the present invention.

[0030] definition

[0031] <Smart Device> 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 care 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 in a medical questionnaire, and an output screen that displays a video of the rehabilitation program sent from the medical institution.

[0032] <PC (Personal Computer)> In one preferred embodiment of the system of the present invention, a "personal computer (PC)" refers to a device connected to a smart device via an internet line and equipped with the functionality to install and run the remote medical care support system of the present invention (see Figure 2). The PC is used by installing application software for 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 operating the system of the present invention. The PC is equipped with a CPU (central control unit), a communication unit for transmitting and receiving data to and from the smart device, and an input unit (see Figure 2). The input unit is used to input patient data such as the patient's identification number (ID), profile, and type of disease treated. In another preferred embodiment of the present invention, the PC is equipped with a means for accepting input of a recovery assessment score calculated based on answers to multiple 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 video. 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, each rehabilitation program unit consists of 15 minutes.

[0034] <Wearable Sensor Device> In one preferred embodiment of the system of the present invention, a "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 bio-information as they perform the exercises prescribed in the rehabilitation program and transmitting the information to the smart device (see FIGS. 5(A) and 5(B)). A commercially available smart watch (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 in accordance with 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 bio-information, such as heart rate.

[0036] <Health Management Application Software> In a 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 muscle strength building exercise, muscle endurance building exercise, cardiopulmonary capacity building exercise (whole body endurance building exercise), flexibility building exercise, dexterity improvement exercise, coordination improvement exercise, and running ability improvement exercise. Walking exercise corresponds to muscle strength building exercise, muscle endurance building exercise, and cardiopulmonary capacity building exercise, and chair standing exercise corresponds to muscle strength building exercise and muscle endurance building exercise.

[0038] <Health-Related QOL Assessment Scale> In one preferred embodiment of the system of the present invention, "health-related QOL" refers to a concept that quantifies the impact of a disease or treatment on a patient's subjective sense of health (mental health, vitality, pain, etc.) and their daily work, housework, and social activities. A "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 created in accordance with the health-related QOL assessment scale are used as questions in the questionnaire, and the patient's recovery assessment score is calculated based on the sum of the scores assigned to the answers to those questions.

[0039] In one preferred embodiment of the system of the present invention, the question items of the questionnaire prepared according to a health-related QOL scale include questions prepared according to a disease-nonspecific scale (e.g., SF-36) that is not related to the specific disease of the patient, and questions prepared according to a disease-specific scale (e.g., RDQ, JOABPEQ) that is related to the specific disease of the patient. In the questionnaire used in one preferred embodiment of the present invention, questions based on a disease-nonspecific scale and questions based on a disease-specific scale are combined, and question items prepared based on a health-related QOL assessment scale are used to evaluate the degree of recovery of the patient's motor function.

[0040] In one preferred embodiment of the present invention, the SF-36, RDQ, and JOABPEQ are used as health-related quality of life (HRQOL) scales. The SF-36 is a disease-nonspecific scale used to quantitatively assess health-related quality of life (HRQOL). The RDQ (Roland Morris Disability Questionnaire) is a scale in which patients themselves quantitatively assess the impairments in daily life caused by low back pain. The JOABPEQ (Japanese Orthopaedic Association Low Back Pain Questionnaire) is a scale used to calculate five severity scores: pain-related disability, lumbar dysfunction, walking dysfunction, social life disability, and psychological disability. These scales consist of numerous questions, and the patient's condition is quantitatively evaluated based on the answers to the questions by the sum of the scores assigned to each question. Quantitative assessment of a patient's health status 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 calculated as the sum of scores assigned to answers to multiple questions based on a health-related quality of life assessment scale, regardless of the specific disease the patient has. The SF-36 is the most widely used self-report health status questionnaire in the world, and is designed to measure a comprehensive health concept in eight domains, rather than health conditions specific to a specific disease or symptom (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 suffered by the patient, and is calculated as the sum of scores assigned to answers to multiple questions based on a disease-specific QOL scale. The RDQ (Roland Morris Disability Questionnaire) is a questionnaire that allows patients to quantitatively evaluate the impairment of daily life caused by low back pain (see Figure 7), and the JOABPEQ (Japanese Orthopaedic Association Low Back Pain Questionnaire) is a questionnaire used to calculate five severity scores: pain-related disability, lumbar dysfunction, walking dysfunction, social life disability, and psychological disability.

[0044] <Rehabilitation Index> In a 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 along with exercise goals for each grade of the rehabilitation program stored in a PC storage device. In a preferred embodiment of the system of the present invention, when the SF-36 is used as the questionnaire, the evaluation score from the SF questionnaire is divided into ten levels, with 1 to 10 being rehabilitation index 1, 11 to 20 being rehabilitation index 2, 21 to 30 being rehabilitation index 3, 31 to 40 being rehabilitation index 4, 41 to 50 being rehabilitation index 5, 51 to 60 being rehabilitation index 6, 61 to 70 being rehabilitation index 7, 71 to 80 being rehabilitation index 8, 81 to 90 being rehabilitation index 9, and 91 to 100 being rehabilitation index 10 (see Figures 10 and 13). For example, if a patient's total score after the SF-36 questionnaire is 43, the patient's rehabilitation index is 5. When using a disease-nonspecific score (SF-36) and a disease-specific score (RMDQ) in the interview, if the average value obtained by adding 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, diseases such as lower back pain are caused by 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. However, lower back pain may be caused by factors other than lower back disease, and therefore, it is necessary to evaluate these factors using a non-disease-specific scale. In this invention, an orthopedic patient's disease is interviewed using both questionnaire items based on a disease-specific scale and a non-disease-specific scale, a rehabilitation index is calculated based on the results of both 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 Biological Information> In a preferred embodiment of the system of the present invention, "exercise biological information" refers to data measured and collected from a patient performing the exercises prescribed in a rehabilitation program. In one embodiment of the present invention, the exercise biological information is measured and collected from the patient's body using a smart device and / or a wearable sensor device on which health management application software is installed. The exercise biological 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 Target Value> In a 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 a 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 physician 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 each patient's profile (age, gender, weight, height), so 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 Calories Burned> In a preferred embodiment of the system of the present invention, the "target calories burned" 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 calories burned. 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 consumed (calories burned) by a patient performing prescribed exercise varies depending on the weight, etc. of each individual patient, in the present invention, the target calories burned 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 calories burned, 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 value" refers to a unit of exercise intensity that indicates how many times the energy consumed by a particular exercise, assuming a resting oxygen intake of 3.5 ml / kg is 1. For example, sitting while watching television or riding in a car is 1.9 METs, sitting while talking, eating, or doing 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 muscle 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 calories burned while performing the exercises in a prescribed rehabilitation program by registering the METs values ​​of the exercises in 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 high, and decreases when the load is low. Since the load imposed on a patient when 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 gender, age, height, weight, etc. of the patient. 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] 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 a 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] FIG. 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 of 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 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 the smart device 22 in addition to the 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 the smart device 22. Based on the calculated recovery assessment score / rehabilitation index, a rehabilitation program grade appropriate for the patient 2 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 22 and displayed as a video on the output screen of the smart device 22, and exercise instructions are prescribed for the patient 2. The health management application software 1 is installed on the smart device 22, and the health management application software 1 is used to measure the patient 2's exercise biometric information (e.g., number of steps, walking distance) after the patient 2 performs rehabilitation exercises. Based on the measured values, the grade of the prescribed rehabilitation program is updated.

[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 also 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 uses the wearable sensor device 33 to measure the patient 3's exercise biometric information (e.g., heart rate, etc.) 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 instruction.

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

[0061] 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 FIG. 3 (corresponding to smart device 23 in FIG. 1) is connected to the wearable sensor device (corresponding to wearable sensor device 33 in FIG. 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, which 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] Figure 6 shows a sample of the SF-36 questionnaire used in one embodiment of the present invention, and Figure 7 shows a sample of the RDQ questionnaire used in one embodiment of the present invention. Figure 8 shows a sample of the questionnaire items used in one embodiment of the present invention. The first question in the questionnaire contains questions related to the patient's profile (gender, age, height, weight).

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

[0066] Example 1 (1) Rehabilitation Program Selection: A 65-year-old male visited a clinic with lower back pain. At the time of his outpatient visit, he measured 170 cm tall and weighed 85 kg. His SF-36 PCS score was 48, and his RDQ score was 38. The sum of these scores divided by 2 resulted in an evaluation score of 43, and based on the interview results, he was assessed as having a rehabilitation index of 5. As a result, a rehabilitation program (15 minutes per unit) was selected, including Nordic walking, lower back stretching, lower back stretching, muscle strength and balance exercises, core muscle strengthening exercises, back stretching, calf exercises, and balance improvement exercises (see Figure 10). (2) Rehabilitation Program Update: The selected rehabilitation program was displayed as a video on the output screen of a smart device, and the patient was instructed on the rehabilitation program exercises. Heart rate and calorie expenditure were measured at the end of the exercise. Based on the patient's height (normal) and weight (overweight), a target heart rate of 150 / min and a target calorie expenditure of 148 kcal were set for the rehabilitation program (see Figures 11 and 12). At the end of the rehabilitation exercise, the patient's heart rate was 160 beats per minute and the calorie expenditure was 160 kcal. Since the measured heart rate of 160 beats per minute and the 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 for the grade of the prescribed rehabilitation program, it was decided to maintain the rehabilitation program at grade 5 (see Figure 12).

[0067] Example 2: Rehabilitation Program Selection. A 60-year-old woman visited a clinic with lower back pain. At the time of her outpatient visit, she measured 150 cm tall and weighed 60 kg. Her SF-36 PCS score was 26, and her RDQ score was 24. The sum of these scores divided by 2 resulted in an evaluation score of 25, and her rehabilitation index was determined to be 3 based on the interview results. A rehabilitation program (15 minutes per unit) was selected, including Nordic walking, back stretching, core muscle strengthening exercises, back stretching exercises, lower limb muscle strengthening exercises, calf exercises, and balance improvement exercises (see Figure 10). (2) Rehabilitation Program Update. The patient was instructed on the rehabilitation program by displaying the selected rehabilitation program as a video on the smart device display screen, and her heart rate and calorie expenditure were measured at the end of the exercise. Based on the patient's height (normal) and weight (overweight), the target heart rate and calorie expenditure for the selected rehabilitation program were set to 155 beats per minute and 148 kcal, respectively (see Figures 11 and 12). At the end of the rehabilitation exercise, the patient's heart rate was 165 beats per minute and the calorie expenditure was 110 kcal. Because the heart rate (165 beats per minute) was within ±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), it was determined that the patient had sufficient capacity for the prescribed program, and the patient was promoted to a program with a rehabilitation index of 4, the next higher grade (see Figure 12).

[0068] Example 3 (1) Rehabilitation Program Selection: A 45-year-old male visited a clinic with lower back pain. At the time of his outpatient visit, he measured 160 cm tall and weighed 75 kg. His SF-36 PCS score was 60 and his RDQ score was 62. The sum of these scores divided by 2 resulted in an evaluation score of 61, and based on the interview results, he was assessed as having a rehabilitation index of 7. As a result, a program was selected that included Nordic walking, lower back stretching, back leg stretching, muscle strength and balance exercises, back strengthening, lower limb strengthening exercises, calf exercises, and balance improvement exercises (see Figure 10). (2) Rehabilitation Program Update: The selected rehabilitation program was displayed as a video on the smart device display screen, and the patient was instructed on the rehabilitation program exercises. Heart rate and calorie expenditure were measured at the end of each exercise. Based on the patient's height (normal) and weight (overweight), the target heart rate and calorie expenditure for the selected rehabilitation program were set to 140 beats per minute and 132 kcal, respectively (see Figures 11 and 12). At the end of the rehabilitation exercise, the patient's heart rate was 150 / min and the calories burned were 150 kcal. The measured heart rate of 150 / min was within a range of ±10% of the target heart rate, but the calories burned of 150 kcal exceeded the upper limit of the ±10% range of the target calorie burn of 132 kcal. Therefore, the program was downgraded by one level to a program with a rehabilitation index of 6 (see Figure 12).

[0069] Example 4 (1) Rehabilitation Program Selection: A 60-year-old woman visited a clinic with knee osteoarthritis. At the time of her outpatient visit, her height was 156 cm and her weight was 52 kg. Her SF-36 score was 43, her PCS score was 43, and her WOMAC score was 46. The sum of these scores divided by 2 resulted in an evaluation score of 44.5. Based on the interview results, her rehabilitation index was determined to be 5. As a result, a program was selected in which the patient performed chair stand-up exercises 3 times a week for 10 minutes each, 30 times (10 times x 3 sets). (2) Rehabilitation Program Update: The selected rehabilitation program was displayed as a video on the smart device display screen, and the patient was instructed on the rehabilitation program exercises. Her heart rate and calorie expenditure at the end of the exercise were measured. Based on the patient's height (normal) and weight (overweight), the target heart rate was set at 155 / min and the target calorie expenditure at 148 kcal. At the end of the rehabilitation exercises, the patient's heart rate was 160 / min and the calorie expenditure was 120 kcal. Because the patient's calorie expenditure fell below the range of ±10% 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 was upgraded by one grade.

[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.

[0071] 10 PC (personal computer) 21 Smart device 1 22 Smart device 2 23 Smart device 3 33 Wearable sensor device

Claims

1. 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, the system comprising a smart device and a PC (personal computer) wirelessly connected to the smart device via an Internet line, the PC being installed at a medical institution and set up so that the patient's doctor or physical therapist can access it, and having application software for the remote medical care support system installed thereon, comprising: means for accepting input of a patient's identification number, profile, and type of disease being treated; means for transmitting and receiving data to and from the smart device; a storage device; and a CPU, the smart device being installed with the application software for the remote medical care support system, and having means for logging into the remote medical care support system by inputting a patient's identification number registered in the PC; means for accepting input of answers to a plurality of questions in a questionnaire using a health-related QOL assessment scale; means for transmitting and receiving data to and from the PC; and means for displaying the rehabilitation program received from the PC on an output screen, the storage device of the PC storing a plurality of rehabilitation programs corresponding to post-surgery for a predetermined type of disease, each rehabilitation program consisting of a plurality of exercise programs, Each of the rehabilitation programs has a plurality of grades according to the magnitude of the load placed on the body by executing the exercise program instructed by the rehabilitation program, and a patient rehabilitation index appropriate for the load placed on the body by executing the exercise program of that grade is registered for each grade of each rehabilitation program, and the system calculates a recovery evaluation score for the patient based on the patient's answers to a plurality of questions in the questionnaire, determines a rehabilitation index that evaluates the recovery state of the patient on a numerical scale based on the calculated recovery evaluation score, and selects a rehabilitation program from among the plurality of rehabilitation programs stored in the storage device of the PC based on the type of disease treated for the patient and the rehabilitation index.and selecting a rehabilitation program and its grade to be prescribed for the patient from the smart device and displaying it on an output screen of the smart device.

2. The remote medical care support system of claim 1, wherein the grade of the rehabilitation program selected based on the rehabilitation index is stored in the memory device of the PC 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 memory device of the PC is called up and displayed as a video on the output screen of the smart device.

3. A remote medical care support system as described in claim 1 or 2, wherein the smart device has installed thereon, in addition to the application software of the remote medical care 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.

4. A remote medical support system as described in claim 1 or 2, wherein a wearable sensor device is connected to the smart device wirelessly or via a wired connection, 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.

5. A remote medical support system as described in claim 3 or 4, wherein each grade of each rehabilitation program is registered with 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, the exercise target values ​​being set corresponding to the profile of the patient performing 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.

6. The remote medical support system of claim 1 or 2, wherein the predetermined types of diseases include lower back pain (post-surgery for lumbar degenerative disease), scoliosis, post-knee joint surgery, post-hip joint surgery, and musculoskeletal diseases including chronic lower back pain.

7. A remote medical care support system as described in claim 1 or 2, wherein the PC further comprises means for accepting input of the patient's recovery assessment score calculated based on answers to multiple questions in a questionnaire using a health-related QOL assessment scale, and is capable of determining the patient's rehabilitation index based on either the calculated recovery assessment score or the input recovery assessment score.

8. 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, the system comprising a smart device and a PC (personal computer) wirelessly connected to the smart device via an Internet line, the PC being installed in a medical institution and set so as to be accessible by the patient's doctor or physical therapist, and having application software for the remote medical care support system installed thereon, and comprising: means for accepting input of a patient's identification number, profile, and type of disease treated; means for accepting input of the patient's recovery assessment score calculated based on answers to multiple questions in a questionnaire using a health-related QOL assessment scale; means for transmitting and receiving data to and from the smart device; a storage device; and a CPU, the smart device being installed with the application software for the remote medical care support system, and comprising: means for logging into the remote medical care support system by inputting a patient's identification number registered in the PC; means for transmitting and receiving data to and from the PC; and means for displaying the rehabilitation program received from the PC on an output screen, the storage device of the PC storing multiple rehabilitation programs in video format corresponding to post-surgery for a predetermined type of disease, each rehabilitation program consisting of multiple exercise programs. Each rehabilitation program has a plurality of grades according to the magnitude of the load on the body when the exercise program instructed by the rehabilitation program is executed, and a patient rehabilitation index appropriate for the load on the body when the exercise program of that grade is executed is registered for each grade of each rehabilitation program, and the system determines a rehabilitation index that evaluates the recovery state of the patient on a numerical scale based on the patient's recovery evaluation score input to the PC, and selects a rehabilitation program from among the plurality of rehabilitation programs stored in the storage device of the PC based on the type of disease treated by the patient and the rehabilitation index.a rehabilitation program and its grade to be prescribed for the patient from the smart device and saves it in the storage device of the PC together with the patient's identification number; and by inputting the patient's registered identification number into the smart device, the rehabilitation program saved in the storage device of the PC is called up and displayed on the output screen of the smart device.

9. A remote medical care support system as described in claim 8, wherein the PC further comprises a means for accepting an identification number of a medical institution that prescribes a rehabilitation program together with a patient's identification number, and is configured so that the patient can log in to the remote medical care support system by inputting the patient's identification number and the medical institution's identification number registered in the PC from the smart device.

10. A remote medical care support system as described in claim 8 or 9, wherein the smart device is set with a password for the patient to log in to the remote medical care support system, and the patient is configured to be able to log in to the remote medical care support system by inputting the password along with their own identification number from the smart device.

11. A remote medical consultation support system as described in claim 8 or 9, wherein the smart device has installed thereon, in addition to the application software of the remote medical consultation 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.

12. A remote medical support system as described in claim 8 or 9, wherein a wearable sensor device is connected to the smart device wirelessly or via a wired connection, 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.

13. A remote medical support system as described in claim 11 or 12, wherein each grade of each rehabilitation program is registered with 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, the exercise target values ​​being set corresponding to the profile of the patient performing 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.

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