WO2021094288A1

WO2021094288A1 - Device positioning and orienting in user activity monitoring systems

Info

Publication number: WO2021094288A1
Application number: PCT/EP2020/081590
Authority: WO
Inventors: Johannes DAGEVOS VAN RIJ; Allan Kenneth Frazer Grugeon HUNT
Original assignee: T.J.Smith And Nephew,Limited
Priority date: 2019-11-14
Filing date: 2020-11-10
Publication date: 2021-05-20
Also published as: GB201916545D0

Abstract

A system is disclosed for positioning or orienting an electronic device that monitors activities of a user. The system can include a housing, an indicator, a sensor, a memory device, and a processor. The housing can attach to the user, and the indicator can be supported by the housing. The sensor can monitor a movement of the housing and generate motion data responsive to the movement. The processor can determine, from the motion data, a change in position or orientation of the housing relative to a package device, as well as activate, responsive to the change in position or orientation, the indicator to identify a direction in which to move the housing or an orientation in which to rotate the housing for attachment to the user.

Description

DEVICE POSITIONING AND ORIENTING IN USER ACTIVITY MONITORING

SYSTEMS

CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims priority to U.K. Provisional Application No. 1916545.5 filed on November 14, 2019; the disclosures of which are hereby incorporated by reference in its entirety.

TECHNICAL FIELD

[0002] Embodiments of the present disclosure relate to apparatuses, systems, and methods for managing wounds with user activity monitoring devices.

BACKGROUND

[0003] Pressure ulcers, which may also be known as pressure sores, bedsores, or decubitus ulcers, are injuries to skin and underlying tissue resulting from prolonged pressure on the skin, soft tissue, muscle, or bone above capillary filling pressure (approximately 32 mmHg).

[0004] One type of pressure ulcer that develops on a foot is known as a diabetic foot ulcer (DFU), which tends to occur with a higher frequency and intensity in the diabetic population. Management and treatment of diabetic foot ulcers requires offloading the diabetic foot ulcers by using cushioned footwear, such as a support boot, cast, shoe, or the like. While offloading can be effective, it has been found that non-compliance with or non-use of the offloading devices can play a large role in the delayed healing of the diabetic foot ulcers.

[0005] Prior art approaches and systems provide little or no information regarding an individual’s compliance with the offloading devices. Gaining insight into the individual’s compliance can be important for the prevention and healing of pressure ulcers. However, because of these limitations, the prevention and healing of pressure ulcers using prior art approaches and systems may be delayed or, worse yet, worsened leading to prolonged discomfort, hospitalization, or even surgery.

SUMMARY [0006] A system is disclosed for positioning or orienting an electronic device that monitors activities of a user. The system can include a housing, an indicator, a sensor, a memory device, and a processor. The housing can to attach to a user. The indicator can be supported by the housing. The sensor can be supported by the housing and monitor a movement of the housing and generate motion data responsive to the movement. The memory device can store the motion data. The processor can be supported by the housing. The processor can determine, from the motion data, a change in position or orientation of the housing with respect to a package device, and responsive to the change in position or orientation, activate the indicator to identify how to move the housing for attachment to the user.

[0007] The system of the preceding paragraph can include one or more of the following features: The sensor can include one or more of an accelerometer, a gyroscope, a magnetometer, or an optical sensor that is configured to generate the motion data. The change in position or orientation can include the change in position and orientation. The indicator can include a display, a plurality of lights, or a speaker. The processor can determine how to move the housing from a comparison of the change in position or orientation to a set change in position or orientation for attaching the housing to the user. The processor can determine the change in position or orientation from a first time when the housing is positioned proximate to the package device to a second time when the housing is not positioned proximate to the package device. The package device can include an identification on its surface of where the housing is to be positioned with respect to the package device at the first time. The package device can include a beacon configured to transmit a signal, the sensor being configured to detect the signal, and the processor can determine a distance between the sensor and the beacon from the signal and determine the change in position or orientation from the distance. The processor can determine the distance from a detected strength of the signal. The beacon can initiate wireless communications responsive to the electronic device being placed proximate to the package device. The processor can determine the change in position or orientation from a comparison of the motion data to sensor data generated by the package device. The package device can store the housing. The processor can identify the first time from the motion data. The processor can activate the indicator to identify how to move the housing for attachment to a limb of the user. The limb can be a leg or an arm. The housing can be attached to a wound dressing. The processor can determine a location at which the housing is attached to the user from a height or a weight of the user. The housing can enclose the sensor, the memory device, or the processor.

[0008] A method of making or operating the system of the preceding two paragraphs is disclosed.

BRIEF DESCRIPTION OF THE DRAWINGS

[0009] Embodiments of the present disclosure will now be described hereinafter, by way of example only, with reference to the accompanying drawings in which:

[0010] Figure 1 illustrates an example user activity monitoring system that includes an activity monitoring device and an offloading monitoring device;

[0011] Figure 2 illustrates example components of the activity monitoring device of Figure 1 and a package device;

[0012] Figure 3 illustrates an example computing environment that includes the activity monitoring device and the offloading monitoring device of Figure 1;

[0013] Figure 4A illustrates an example implementation of the package device of Figure 2;

[0014] Figure 4B illustrates the activity monitoring device of Figure 1 while positioned on the package device of Figure 4A;

[0015] Figure 4C illustrates the activity monitoring device of Figure 1 after being attached to a user;

[0016] Figure 5 illustrates a placement guidance process performable with the activity monitoring device of Figure 1; and

[0017] Figure 6 illustrates an example computer system usable to construct one or more of the devices or systems within the computing environment of Figure 3. DET AILED DESCRIPTION

Introduction to User Activity Monitoring

[0018] Activities of a user may be desirably monitored by an activity monitoring device for a variety of reasons, including wound prevention and monitoring. In one example, the activities of a user can be monitored when the user may be prone to or already have a wound, such as a pressure ulcer. Information gathered by the activity monitoring device about the activities of the user can be helpful for assisting with prevention or treatment of the pressure ulcer. In addition, information gathered by the activity monitoring device about the activities can be useful for checking compliance with a treatment regimen.

[0019] The activity monitoring device or another electronic device in communication with the activity monitoring device may determine or record a location or orientation of the activity monitoring device over time, such as with respect to an initial time or position. The location or orientation of the activity monitoring device can be used to activate an indicator to assist in attaching the activity monitoring device at a desired location to the user. Moreover, because one activity monitoring device may be used in place of another activity monitoring device, the location or orientation of one activity monitoring device can be used to assist with consistent placement and attachment of different activity monitoring devices to the user. The consistent placement and attachment of multiple activity monitoring devices can help to obtain consistent, accurate readings from the multiple activity monitoring devices.

[0020] Some aspects disclosed herein relate to wound monitoring or therapy for a human or animal body. Therefore, any reference to a wound herein can refer to a wound on a human or animal body, and any reference to a body herein can refer to a human or animal body. The disclosed technology may relate to preventing or minimizing damage to physiological tissue or living tissue, or to the treatment of damaged tissue (for example, a wound as described herein).

[0021] As used herein the expression “wound” may include an injury to living tissue that may be caused by a cut, blow, or other impact, typically one in which the skin is cut or broken. A wound may be a chronic or acute injury. Acute wounds occur as a result of surgery or trauma. They move through the stages of healing within a predicted timeframe. Chronic wounds typically begin as acute wounds. The acute wound can become a chronic wound when it does not follow the healing stages resulting in a lengthened recovery. It is believed that the transition from acute to chronic wound can be due to a patient being immuno-compromised.

[0022] Chronic wounds may include for example: venous ulcers (such as those that occur in the legs), which account for the majority of chronic wounds and mostly affect the elderly, diabetic ulcers (for example, foot or ankle ulcers), peripheral arterial disease, pressure ulcers, or epidermolysis bullosa (EB).

[0023] Examples of other wounds include, but are not limited to, abdominal wounds or other large or incisional wounds, either as a result of surgery, trauma, sterniotomies, fasciotomies, or other conditions, dehisced wounds, acute wounds, chronic wounds, subacute and dehisced wounds, traumatic wounds, flaps and skin grafts, lacerations, abrasions, contusions, bums, diabetic ulcers, pressure ulcers, stoma, surgical wounds, trauma and venous ulcers or the like.

[0024] Wounds may include a deep tissue injury. Deep tissue injury is a term proposed by the National Pressure Ulcer Advisory Panel (NPUAP) to describe a unique form of pressure ulcers. These ulcers have been described by clinicians for many years with terms such as purple pressure ulcers, ulcers that are likely to deteriorate and bruises on bony prominences.

[0025] Wound may also include tissue at risk of becoming a wound as discussed herein. For example, tissue at risk may include tissue over a bony protuberance (at risk of deep tissue injury/insult) or pre-surgical tissue (for example, knee tissue) that may have the potential to be cut (for example, for joint replacement/surgical alteration/reconstruction).

[0026] Some aspects relate to methods of monitoring or treating a wound with the technology disclosed herein in conjunction with one or more of the following: advanced footwear, turning a patient, offloading (such as, offloading diabetic foot ulcers), treatment of infection, systemix, antimicrobial, antibiotics, surgery, removal of tissue, affecting blood flow, physiotherapy, exercise, bathing, nutrition, hydration, nerve stimulation, ultrasound, electrostimulation, oxygen therapy, microwave therapy, active agents ozone, antibiotics, antimicrobials, or the like. [0027] Alternatively or additionally, a wound may be treated using topical negative pressure or traditional advanced wound care, which is not aided by the using of applied negative pressure (may also be referred to as non-negative pressure therapy).

[0028] Although the present disclosure may refer to pressure ulcers, foot ulcers, or the like, the systems and methods disclosed herein can be used for monitoring or treating any type of skin injury or wound, such as a venous leg ulcer.

User Activity Monitoring System

[0029] Figure 1 illustrates a user activity monitoring system 100 including an activity monitoring device 120 attached to a body part 110. The activity monitoring device 120 can be attached to the body part 110 using a strap, adhesive, or other coupling mechanism and may be worn on or supported by the body.

[0030] The body part 110 can be a limb of a user, such as a leg that includes a knee 112 and a foot 114. As illustrated, the activity monitoring device 120 can be supported by the body part 110 at a position between the knee 112 and the foot 114, such as proximate to the knee 112. In other aspects, the activity monitoring device 120 can be supported by another part of the body part 110, such as above the knee 112 or elsewhere. The activity monitoring device 120 can monitor and record activities (for instance, walking, jumping, sitting, laying down, running, squatting, or standing) of the body part 110, such as from a position, movement, or orientation of the activity monitoring device 120 or one or more other sensors of the activity monitoring device 120. The activity monitoring device 120 can, for example, be used for loading monitoring of loading of the foot 114. In certain implementations, multiple body parts can be monitored by the activity monitoring device 120, and different sensors can be used for monitoring different body parts. Individual sensors of or in communication with the activity monitoring device 120 may be referred to as user motion sensors, or simply as user sensors.

[0031] The body part 110 is shown wearing and being partly covered by an offloading device 130, such as a removable cast. The offloading device 130 can support the body part 110 and reduce a pressure on the foot 114 when the user may be standing or engaging in other activities. The offloading device 130 can distribute an applied force to the body part 110 away from an injury when the offloading device is worn. An offloading monitoring device 132 can be attached to the offloading device 130. The offloading monitoring device 132 can be the same as or similar to the activity monitoring device 120 and monitor and record activities of the offloading device 130. The offloading monitoring device 132 can be supported by the offloading device 130 using a strap, adhesive, or other coupling mechanism. The offloading monitoring device 132 can be attached to an inner surface or outer surface of the offloading device 130. Although not shown in Figure 1, the offloading monitoring device 132 may be attached to an offloading device that is not worn by the user (for example, a cane or a walker). Moreover, the activity monitoring device 120 can be worn regardless of whether the offloading device 130 may be worn. Individual sensors of or in communication with the offloading monitoring device 132 may be referred to as offloading device motion sensors, or simply as offloading device sensors.

[0032] The user activity monitoring system 100 can additionally or alternatively include one or more of the activity monitoring device 120 or the offloading monitoring device 132 at other positions, such as at a position supported by the offloading device 130 or another part of the body part 110 or elsewhere. The one or more additional or alternative of the activity monitoring device 120 or the offloading monitoring device 132 can be the same as or similar to the activity monitoring device 120 may monitor and record activities of the offloading device 130, the another part of the body part 110, or the body.

[0033] Figure 2 illustrates an attachment monitoring system 200 that includes the activity monitoring device 120 and a package device 220. The activity monitoring device 120 can include a housing 201, a controller 202, a memory device 204, a user interface 206, a power source 208, one or more sensors 210, and a communication interface 212 that are configured to communicate, such as electrically, with one another. The power source 208 can provide power to one or more components of the activity monitoring device 120.

[0034] One or more of the components of the activity monitoring device 120 can be contained in or supported by the housing 201. The housing 201 can be composed of a top portion and a bottom portion that are sealed together, and the top portion or the bottom portion can be hard or soft. The housing 201 can be flexible and have a mechanical structure and design features that provide for a shouldered key way alignment of components within the housing 201. The housing 201 can support a circuit board on its inside and on which one or more components of the activity monitoring device 120 may be positioned. The housing can be attached to or integrated with a dressing, such as a wound dressing.

[0035] The housing 201 can be made by stereolithography (SLA) or polyjet from photopolymer 3D printing material or by 3D printing from an engineering resin with a shorehardness of 80A. The housing 201 can include an elastomer, a thermoplastic elastomer, or be constructed by injection molding. The molded parts of the housing 201 can be made from liquid silicone rubber in white. An adhesive (for example, one for attaching plastics and elastomeric materials) can be used to glue the top and bottom portions of the housing 201 together, and a wide range of other adhesives (for example, cyanoacrylates, silicones, epoxies, hydrogels, hydrocolloids, sealant systems) or other techniques (for example use of double sided adhesive tapes, ultrasonic welding, staking) can be used.

[0036] The controller 202 can control operations of one or more other components (for instance, the memory device 204, the user interface 206, the power source 208, the one or more sensors 210, or the communication interface 212) of the activity monitoring device 120 according at least to instructions stored in the memory device 204. The controller 202 can, for instance, control monitoring of loading of the body part 110 with a weight of the body or positioning of the body part 110 and record data indicative of loading of the body part 110 or positioning of the body part 110 to the memory device 204.

[0037] The user interface 206 can include one or more output elements, such as visual feedback devices (for example, light emitting diodes), haptic feedback devices, or audio devices (for example, speakers), that provide user outputs to a user. The one or more output elements can convey status information to the user like whether the activity monitoring device 120 is successfully functioning, has successfully configured communication with another device, or how the activity monitoring device 120 is positioned or oriented or how to reposition or reorient the activity monitoring device 120. The user interface 206 can include one or more input elements, such as buttons, switches, dials, touch pads, microphones, or touch screens, for receiving user inputs for configuring the activity monitoring device 120. The user interface 206 can permit input of a height and weight of the user. In some aspects, the user interface 206 may have no more than one user input element, such as a button, for receiving user inputs to activate and deactivate the activity monitoring device 120 or performing one or more other functions.

[0038] The one or more sensors 210 can be used to detect and monitor a motion of the activity monitoring device 120 or other characteristics of or around the activity monitoring device 120. The one or more sensors 210 can be used to detect and monitor activities of the user of the activity monitoring device 120 that include, for instance, a loading or positioning of the body part 110, as well as to detect and monitor the location of the activity monitoring device 120 on or with respect to the user or the package device 220. The one or more sensors 210 can include one or more accelerometers, gyroscopes, magnetometers, impedance sensors, thermistors, pressure sensors, or optical sensors, among other types of sensors. The one or more sensors 210 can be positioned by the housing 201 proximate to the body part 110 or may be remote from the body part 110 yet usable to monitor characteristics of the body part 110. The controller 202 can, for instance, use analogue lenticular print detection to assist with detection and monitoring.

[0039] The controller 202 and the one or more sensors 210 can be used to determine multiple features indicative of movement by or positioning of the activity monitoring device 120 over a data window. For example, the controller 202 can use an accelerometer (which senses x-axis, y-axis, and z-axis acceleration) and a magnetometer (which senses x-axis, y-axis, and z-axis magnetic field variation) of the one or more sensors 210 to determine one or more or all of the data features listed in Table 1, including for individual data windows, such as over time periods of 1, 2, 5, 10, 20, or 30 seconds. The data features determined from accelerometer data can include “Ace” in their names, and the data features determined from magnetometer data can include “Mag” in their names.

Table 1

[0040] The data features in Table 1 can, for example, be calculated according to equations provided in Table 2.

Table 2

[0041] The controller 202 and the one or more sensors 210 can, for example, operate under or calculate data features according to one or more of the data collection or processing settings listed in Table 3.

Table 3

[0042] The settings listed in Table 3 can advantageously, in certain aspects, permit the activity monitoring device 120 to operate for at least 7 days, which may mean that the memory device 204 and the power source 208 can continue to operate without failing (such as due to memory overflow or insufficient power) for at least 7 days. The activity monitoring device 120 can be designed or constructed, in some aspects, to not last much longer than 7 days. For example, the activity monitoring device 120 can operate such that the memory device 204 overflows after 10, 12, 14, 16, 18, 20, 22, or 24 days. As another example, the activity monitoring device 120 can operate such that the power source can be expected to fail after 10, 12, 14, 16, 18, 20, 22, or 24 days. In some implementations, the activity monitoring device 120 can be designed or constructed to operate for less or more than 7 days, such as for 5 days, 10 days, 12 days, or the like.

[0043] The data features listed in Table 1 can desirably, in some aspects, be processed by the controller 202 despite the controller 202 having processing limitations, such as a limited data sorting ability. Because the activity monitoring device 120 may be portable and designed to have a compact size or form, the controller 202 may be selected to have a compact size or form that may as a result have fewer processing features or computational abilities than some other controllers. Moreover, the data features listed in Table 1 may have been selected from among additional data features because the data features listed in Table 1 may be together usable for accurately (for instance, with around 90% or 95% confidence) detecting a high acceleration experienced by the activity monitoring device 120, classifying an activity engaged in by a user wearing the activity monitoring device 120, or detecting an offloading device usage by the user wearing the activity monitoring device 120. Fewer than all of the data features listed in Table 1 (or alternative features) may be used, in some instances, if a lower detection accuracy may be acceptable.

[0044] The controller 202 can store without loss or with loss of precision (such as losslessly or lossy) the determinations of the data features in the memory device 204. A lossless storage approach can advantageously, in certain aspects, ensure that the data feature determinations are continuously monitored and recorded once the activity monitoring device 120 begins monitoring and recording and throughout use of the activity monitoring device 120. The controller 202 may or may not store raw sensor data, such as x-axis accelerometer data or z-axis magnetometer data, to the memory device 204. The controller 202 may not, in some aspects, store the raw sensor data to the memory device 204 at least to limit a utilization of the memory device 204 and permit the memory device 204 to be selected to have a lower memory capacity than may be otherwise used.

[0045] The communication interface 212 can be used to communicate with the package device 220 or other devices, such as via radio waves. The communication can be performed according to a communication protocol, such as an iBeacon™ protocol or a Bluetooth™ protocol like Bluetooth™ Low Energy. The communication interface 212 can, for example, communicate and pair with other devices and transmit device usage or sensor data (such as [i] sens or- derived data including the determined values of one or more of the data features listed in Table 1 over data windows, [ii] monitored loading, positioning, or orienting, [iii] alarms, or [iv] changes to a monitoring or therapy program performed by the activity monitoring device 120) to the other devices. The communication interface 212 can be used to receive data, including commands or position or orientation data, from the other devices. The communication interface 212 can permit communication with (for example, transfer of data to or processing commands from) another device once a communication channel has been configured for communication with the another device (for example, by device pairing). The communication interface 212 may, in some aspects or when using certain communication channels, be unable to communicate farther than 10 meters, 30 meters, or 100 meters away from the communication interface 212.

[0046] The one or more sensors 210 can be used to assist the user in placing the activity monitoring device 120 or a replacement device (which can be another activity monitoring device similar to or the same as the activity monitoring device 120) at a particular location on the user. For example, the controller 202 can process one or more signals from the one or more sensors 210 and present placement instructions with the user interface 206 to assist the user in placing different devices in the same location or different locations on the user. As another example, the controller 202 can detect irregularities, errors, or issues in collected motion data and process one or more signals from the one or more sensors 210 to determine that the irregularities, errors, or issues in the collected motion data may or are likely due to an issue with a device placement or orientation.

[0047] The package device 220 can include one or more similar components as the activity monitoring device 120. The package device 220 can include a housing 250, a controller 222, a memory device 224, a user interface 226, a power source 228, one or more sensors 230, and a communication interface 232 that are configured to communicate, such as electrically, with one another. One or more of the components of the package device 220 can be contained in or supported by the housing 250. The housing 250 can support, enclose, contain, or house the housing 201 for storage of the housing 201, such as for transportation of the housing 201 or storage of the housing 201 prior to use of the activity monitoring device 120. The package device 220 may be reusable, such as either by the activity monitoring device 120 multiple times or by the activity monitoring device 120 and one or more other devices, rather than a one-time use disposable item.

[0048] The controller 222 can control operations of one or more other components (for instance, the memory device 224, the user interface 226, the power source 228, the one or more sensors 230, or the communication interface 232) of package device 220 according at least to instructions stored in the memory device 204.

[0049] The user interface 226 can include one or more output elements, such as visual feedback devices (for example, light emitting diodes), haptic feedback devices, or audio devices (for example, speakers), that provide user outputs to a user. The one or more output elements can convey status information to the user like whether the package device 220 is successfully functioning, has successfully configured communication with another device, or whether the activity monitoring device 120 is positioned correctly with respect to the user or the housing 250. The user interface 226 can include one or more input elements, such as buttons, switches, dials, touch pads, microphones, or touch screens, for receiving user inputs for configuring the package device 220.

[0050] The communication interface 232 can be used to communicate with the activity monitoring device 120 and other devices in similar ways as the communication interface 212 of the activity monitoring device 120 (for example, Bluetooth™ protocol like Bluetooth™ Low Energy). The communication interface 232 can, for instance, communicate with other devices, such as the activity monitoring device 120, and be used to determine a position of the package device 220 with relative to the activity monitoring device 120. The communication interface 232 may, in some aspects or using certain communication mediums, be unable to communicate farther than 10 meters, 30 meters, or 100 meters away from the communication interface 232. The communication interface 232 can be or include one or more beacons.

[0051] The one or more sensors 230 can be used to detect and monitor a motion of the package device 220 or other characteristics of or around the package device 220, such as a motion of the activity monitoring device 120. The one or more sensors 230 can include one or more accelerometers, gyroscopes, magnetometers, impedance sensors, thermistors, pressure sensors, or optical sensors, among other types of sensors. The controller 222 can determine a relative distance or orientation of the activity monitoring device 120 in relation to the package device 220 with at least the one or more sensors 230 or the communication interface 232. The controller 222 can, for instance, use analogue lenticular print detection to assist with detection and monitoring.

[0052] The one or more sensors 230 can be used to assist the user in placing the activity monitoring device 120 or a replacement device (which can be another activity monitoring device similar to or the same as the activity monitoring device 120) at a particular location on the user. For example, the controller 222 can process one or more signals from the one or more sensors 230 and present placement instructions with the user interface 226 to assist the user in placing different devices in the same location or different locations on the user. As another example, the controller 222 can detect irregularities, errors, or issues in collected motion data and process one or more signals from the one or more sensors 230 to determine that the irregularities, errors, or issues in the collected motion data may or are likely due to an issue with a device placement or orientation.

[0053] Figure 3 illustrates a computing environment 300 that includes the activity monitoring device 120 and the offloading monitoring device 132. The computing environment 300 shows the activity monitoring device 120 and the offloading monitoring device 132 in communication with a user operation device 310 and a clinician operation device 320, as well as the user operation device 310 and the clinician operation device 320 in communication with a device management system 340 via a network 330.

[0054] The user operation device 310 can be operated by a user, such as a wearer, of the activity monitoring device 120 and the offloading monitoring device 132. The user operation device 310 can permit the user to use the user operation device 310 to collect, process, review, or transmit the data gathered by the activity monitoring device 120 and the offloading monitoring device 132. On the other hand, the clinician operation device 320 can be operated by a clinician for the user, such as an individual who supervises, assists, or cares for the user that uses the activity monitoring device 120 and the offloading monitoring device 132. The clinician operation device 320 can permit the clinician to use the clinician operation device 320 to collect, process, review, or transmit the data gathered by the activity monitoring device 120 and the offloading monitoring device 132.

[0055] The user operation device 310 and the clinician operating device 320 may each be a computing device such as a smart phone, a tablet computer, or a desktop computer. In some aspects, the user operation device 310 and the clinician operating device 320 can receive, send, present, and access data gathered by the activity monitoring device 120 and the offloading monitoring device 132 or data determined therefrom, but may not process the data gathered by the activity monitoring device 120 and the offloading monitoring device 132 to analyze the characteristics of the data (such as to identify from the data when the user used an offloading device or calculate a duration of activity engaged in by the user).

[0056] The user operation device 310 can include a user application 312, a communication interface 314 (which can, for instance, include any one or more of the features of the communication interface 212), and a user interface 316 (which can, for instance, include any one or more of the features of the user interface 206). The user application 312 can be a program that is executed by a processor of the user operation device 310. The user application 312 can enable the user operation device 310 to communicate via the communication interface 314 with the activity monitoring device 120, the offloading monitoring device 132, and the device management system 340. The user application 312 may receive, collect, process, review, or transmit (i) data gathered or determined by the activity monitoring device 120 and the offloading monitoring device 132, such as determined feature data, motion data, alarms, monitored loading or positioning, or changes to a monitoring or therapy program, (ii) data collected or determined by the user application 312, such as user observations, goal information, or identifications of activities engaged in by a user, or (iii) data collected or determined by the device management system 340, such as a duration of time that the user was active, a portion of time that the user used an offloading device, or an amount of time at which an injury of the user may be at risk due to activity by the user or nonuse of the offloading device. The user application 312 can moreover present to the user one or more graphical user interfaces with the user interface 316, such as on a display or a touchscreen of the user interface 316.

[0057] The user application 312 can be used to gather information from the user to assist with understanding what type of activity was engaged in by the user when the foot of the user may have experienced a loading force which risked adversely impacting an existing ulcer on the foot or risked causing a new ulcer on the foot. The user application 312 can receive from the device management system 340 a time that the motion data from the activity monitoring device 120 indicates a foot of the user experienced a loading force which risked adversely impacting an existing ulcer on the foot or risked causing a new ulcer on the foot, and the user application 312 can determine a geographic location of the user operation device 310 (such as from a global positioning system (GPS) receiver of the user operation device 310 or a communication received by the user operation device 310 via the network 330) that may be indicative of a geographic location of the activity monitoring device 120 at the time. The user application 312 may output the time and the geographic location of the user operation device 310 along with a request that the user identify the type of activity engaged in by the user at the time and the geographic location. The type of activity can, for example, include a type of transportation, a type of exercise, a type of leisure, a type of hobby, or a type of work. The request may list a set of types of activities commonly engaged in by the user to assist in selecting the type of activity engaged in by the user.

[0058] The user application 312 can include features and interfaces that seek to increase the amount or frequency of user engagement with the user application 312. The user application 312 may request contextual information (such as an identification of an activity engaged in by the user while wearing the activity monitoring device 120 or an indication by the user of how the user is feeling) to assist with tracking or understanding why the foot of the user may have experienced a loading force which risked adversely impacting an existing ulcer on the foot or risked causing a new ulcer on the foot.

[0059] The clinician operation device 320 can include a clinician application 322, a communication interface 324 (which can, for instance, include any one or more of the features of the communication interface 212), and a user interface 326 (which can, for instance, include any one or more of the features of the user interface 206). The clinician application 322 can be a program that is executed by a processor of the clinician operation device 320. The clinician application 322 can enable the clinician operation device 320 to communicate via the communication interface 324 with the activity monitoring device 120, the offloading monitoring device 132, and the device management system 340. The clinician application 322 may receive, collect, process, review, or transmit (i) data gathered or determined by the activity monitoring device 120 and the offloading monitoring device 132, such as determined feature data, motion data, alarms, monitored loading or positioning, or changes to a monitoring or therapy program, (ii) data collected or determined by the user application 312, such as user observations, goal information, or identifications of activities engaged in by a user, or (iii) data collected or determined by the device management system 340, such as a duration of time that the user was active, a portion of time that the user used an offloading device, or an amount of time at which an injury of the user may be at risk due to activity by the user or nonuse of the offloading device. The clinician application 322 can present to the clinician one or more graphical user interfaces with the user interface 326, such as on a display or a touchscreen of the user interface 326.

[0060] In some aspects, the clinician operation device 320 may not directly communicate with the activity monitoring device 120 or the offloading monitoring device 132. Instead, the clinician operation device 320 may receive any data collected by or associated with the activity monitoring device 120 and offloading monitoring device 132 from the device management system 340. Such a design may desirably limit the number of devices (other than the user operation device 310) that may receive data directly from the activity monitoring device 120 and the offloading monitoring device 132 and thereby enhance the security of and limit access to the data. [0061] The device management system 340 can be a computing device, such as a server, and include a communication management system 342, a data processing system 344, and a data storage 346 that may be in communication with one another. The device management system 340 may, for instance, be constructed partly or entirely of a server infrastructure or a cloud architecture, such as using a cloud infrastructure provided by Amazon Web Services™ (AWS), Microsoft™ Azure™, Google Cloud Platform™ (GCP), or Oracle™ Cloud Infrastructure (OCI). The server infrastructure and the cloud infrastructure can be compliant with the requirements of HIPAA (Health Insurance Portability and Accountability Act of 1996) and provide data privacy and security protections in view of the potentially sensitive nature of the data collected, processed, or determined by the device management system 340.

[0062] The communication management system 342 may permit the device management system 340 to communicate over the network 330 with the user operation device 310 and the clinician operation device 320. The communication management system 342 can include an application programming interface (API), such as a cloud API, to facilitate its communications.

[0063] The data processing system 344 can collect, process, present, store (such as in the data storage 346), or transmit the data gathered or determined by the activity monitoring device 120 and the offloading monitoring device 132 (such as determined feature data, motion data, alarms, monitored loading or positioning, or changes to a monitoring or therapy program) and the data collected or determined by the user application 312 (such as user observations, goal information, or identifications of activities engaged in by a user). For example, the data processing system 344 can process the data gathered by the activity monitoring device 120 and the offloading monitoring device 132 to determine an activity likely engaged in by the user during various periods of time over which the data was gathered, as well as whether the user likely wore an offloading device during various periods of time over which the data was gathered. The determined likely activity or use of the offloading device may be shared by the device management system 340 with the user operation device 310 or the clinician operation device 320. As another example, the data processing system 344 can process the data gathered by the activity monitoring device 120 and the offloading monitoring device 132 to identify events of interest, such as events that may indicate excessive pressure being placed on the body part 110, and may share the events of interest with the user operation device 310 or the clinician operation device 320.

[0064] The network 330 can be a computer network, such as or may include a cellular communications network. Although the network 330 is shown as one connected network, the network 330 can be subdivided into one or more separate networks which may not directly communicate with one another. For example, the device management system 340 can communicate with the user operation device 310 via a separate and different network from the network that the device management system 340 uses to communication with the clinician operation device 320.

[0065] Although certain data processing in the computing environment 300 may be described as being performed by the activity monitoring device 120, the offloading monitoring device 132, the user operation device 310, the clinician operation device 320, or the data processing system 344, the certain data processing can be shifted to a different device or system in the computing environment 300. For example, the user operation device 310 may be described as not processing the data provided by the activity monitoring device 120 and the offloading monitoring device 132 and can instead rely on the data processing system 344 to analyze the data; however, the user operation device 310 can additionally or alternatively analyze the data using similar or different approaches or algorithms to the data processing system 344.

[0066] Figure 4A illustrates a package device 480, which can be an example implementation of the package device 220. The package device 480 can include a container that has pads 482 that fold out of the container. Markings on the pads 482, such as the footprints shown in Figure 4A, can indicate to a user where to stand on the package device 480. The markings on the pads 482 can help ensure that the user stands in a particular location on or with respect to the package device 480 when another device, such as the activity monitoring device 120, is moved or oriented with respect to the package device 480. The container may include markings 484, 486 on the center portion of the container, such as the Xs shown in Figure 4A, between the pads 482 to indicate where to position or how to orient the another device, such as the activity monitoring device 120, on or with respect to the package device 480. The markings 484, 486 can help to ensure that the another device is positioned or orientated at a particular location on or with respect to the package device 480 prior to the another device being moved or oriented with respect to the package device 480. The markings 484, 486 can help to ensure that the user may be able to repeatedly position the another device at the same location or different locations on the user by providing a consistent, known starting position or orientation of the another device with respect to the package device 480 prior to movement or reorienting of the another device.

[0067] Figure 4B illustrates the activity monitoring device 120 positioned on the package device 480 prior to attachment to a user 410. When the activity monitoring device 120 is on the package device 480, the activity monitoring device 120 or the package device 480 can determine and record the position or orientation of the activity monitoring device 120, which can be relative to the package device 480. The user 410 may then move the activity monitoring device 120 from the package device 480 to position the activity monitoring device 120 on the user 410. Once the activity monitoring device 120 is moved from the package device 480 or the activity monitoring device 120 is placed on the user 410, the activity monitoring device 120 or the package device 480 can determine and record (for example, one time, repeatedly, or periodically) a change in the position or orientation of the activity monitoring device relative to the package device 480. The activity monitoring device 120 or the package device 480 can determine from the change in the position or orientation of the activity monitoring device 120 over time, such as from a first time illustrated by Figure 4B to a second time illustrated by Figure 4C, where or how the activity monitoring device 120 may have been moved and where or how the activity monitoring device 120 may have been placed on the user 410 (such as on a leg of the user 410 below a knee as illustrated in Figure 4C).

[0068] Figure 5 illustrates a placement guidance process 500 for assisting in manual placement of a device, such as the activity monitoring device 120 on a user. For convenience, the placement guidance process 500 is described as being performed primarily by the activity monitoring device 120, but the placement guidance process 500 may instead be implemented in other components or systems described herein (such as by the package device 220, alone or in combination with the activity monitoring device 120), or by other computing systems not shown. The placement guidance process 500 can advantageously, in certain aspects, facilitate accurate, precise, or consistent placement of an electronic device, such as the activity monitoring device 120, on the user.

[0069] At block 510, the placement guidance process 500 can determine a change in position or orientation of the activity monitoring device 120 with respect to the package device 220. The activity monitoring device 120 may have been initially placed at a certain location, such as a known location, with respect to the package device 220, and the activity monitoring device 120 may then have been moved, such as toward a user for positioning on the user. The controller 202 can use one or more signals (such as a signal indicative of a location or motion by the activity monitoring device 120 or the package device 220) output by the one or more sensors 210 or the one or more sensors 230 (such as an accelerometer, a gyroscope, a magnetometer, or an optical sensor) to determine the change in position or orientation from a first time to a second time. The controller 202 can, for example, determine the change in position or orientation from a comparison of the one or more signals output by the one or more sensors 210 to the one or more signals output by the one or more sensors 230. The controller 202 may moreover identify the first time from the one or more signals (such as from detecting when the activity monitoring device 120 is removed from the package device 220) or activation of the controller 202. The communication interface 212 and the communication interface 232 can communicate position or orientation information or measurements between the activity monitoring device 120 and the package device 220, such as to enhance the accuracy or precision of the determination.

[0070] In some aspects, the package device 220 may broadcast with one or more beacons one or more beacon signals usable by the one or more sensors 210 of the activity monitoring device 120 to monitor and determine the change in position or orientation of the activity monitoring device 120 with respect to the package device 220 (such as via ranging or triangulation). For example, the controller 202 can monitor changes in detected signal strength of the one or more beacon signals to detect corresponding changes in distance from the one or more beacons to the one or more sensors 210 to thereby determine the change in position or orientation. The one or more beacons can initiate wireless communications responsive to the activity monitoring device 120 being placed proximate to the package device 220, such as in contact with one within a threshold distance.

[0071] At block 520, the placement guidance process 500 can activate an indicator responsive to the change in position or orientation of the activity monitoring device 120. For example, the controller 202 can activate, according to the change in position or orientation, an indicator of the user interface 206 to identify how to move (such as, a direction in which to move or an orientation in which to rotate) the housing 201 for attachment to a limb of the user. Additionally or alternatively, the controller 202 can activate, according to the change in position or orientation, an indicator of the user interface 206 to identify when a relative distance or a relative orientation between the activity monitoring device 120 and the package device 220 matches a set relative distance or a set relative orientation. The set relative distance or the set relative orientation can be the same as or based on (for instance, may differ by a determined amount) the relative distance or the relative orientation of a previous attachment of the activity monitoring device 120 or another device to the user. The indicator may thus guide a positioning or orienting of the housing 201 for or by the user.

[0072] The indicator can include a display, multiple lights (such as LEDs), or a speaker. The indicator can denote not to move or rotate the housing 201 or to move or rotate the housing 201 downwards (which can be a direction in which gravity points), upwards (which can be a direction opposite which gravity points), forwards (which can be a direction in which the user faces), rearwards (which can be a direction opposite the direction which the user faces), inwards (which can be a direction which points towards a center of the user), outwards (which can be a direction which points away from the center of the user), or some direction or orientation between one or more of the directions or orientations. The indicator may provide feedback to denote when a relative distance or a relative orientation of the activity monitoring device 120 with respect to the package device 220 may be the same as a previous application or positioned within a threshold distance or orientation of a desired position or orientation.

[0073] The controller 202 can determine how to move the housing 201 from a comparison of the change in position or orientation to a set change in position or orientation for attaching the housing 201 to the user. The set change in position or orientation may, for instance, have been (i) received from the package device 220 or another device which may have received the set change in position or orientation from another activity monitoring device that was previously attached to the user or (ii) determined from the one or more signals output by the one or more sensors 210 when the housing 201 was previously attached to the user.

[0074] The controller 202 or the controller 222 can use the change in position or orientation to determine where the activity monitoring device 120 may be positioned on the user. For example, the controller 202 or the controller 222 can use the change in position or orientation to determine whether the housing 201 is positioned (i) above or below a waist or another body part of the user, (ii) on a leg, an arm, or an abdomen of the user, (iii) on a left side or a right-side of the user, or (iv) on an upper or a lower part of a limb of the user. Moreover, the controller 202 or the controller 222 can use a height, a weight, or other information indicative of physical characteristics of the user to determine where the activity monitoring device 120 may be positioned on the user. The controller 202 or the controller 222 can output a determined location where the activity monitoring device 120 may be positioned for user presentation, such as on the user interface 206 or the user interface 226.

[0075] The controller 202 can output the change in position or orientation or a determined location where the activity monitoring device 120 may be positioned to another device, such as the package device 220 or another activity monitoring device. The another device may use or communication the change in position or orientation or the determined location to assist with placement of the another device or a different device directly or indirectly in communication with the another device.

[0076] The activity monitoring device 120 or the package device 220 may be automatically activated (for instance, by turning on or waking up the controller 202 or the controller 222) when placed at the certain location with respect to one another, such as responsive to one or more signals output by the one or more sensors 210 or the one or more sensors 230. Computer System Components

[0077] Figure 6 illustrates a computer system 600 usable to construct one or more of the devices (for instance, the user operation device 310 or the clinician operation device 320), systems (for instance, the device management system 340), servers, or the like within the computing environment 300 ofFigure 3.

[0078] As shown in Figure 6, the computer system 600 can include (i) a processor(s) (CPUs) 610, (ii) an input/output device(s) 620 configured to allow users to input and output information and interact with the computer system 600 as well as transfer and receive data or capture data with one or more sensors like an image sensor, (iii) a read only memory device(s) (ROMs) 630 or equivalents to provide nonvolatile storage of data or programs, (iv) a display(s) 650 such as a computer monitor or other display device, (v) a network connection(s) 640 and a network interface(s) 642 configured to allow the computer system 600 to connect to other systems, servers, or portable devices, as well as a memory space(s) 660 and a database(s) 690. The database(s) 690 may be further divided or distributed as sub-database(s) 690A-690N, with the sub-database(s) storing feature or function specific information associated with a particular feature or function. The various components shown in Figure 6 may be incorporated in a computer(s) 670. It is noted that the various components shown in Figure 6, including the database(s) 690, are typically included as part of the computer(s) 670, however, they may be external to the computer(s) 670 in some aspects. For example, the database(s) 690 may be external to the computer(s) 670 and may be part of a separate database computer system or networked database system. In some instances, the computer system 600 may be a computing device like a desktop computer, mobile phone, or a server.

[0079] The memory space(s) 660 may include DRAM, SRAM, FLASH, hard disk drives, or other memory storage devices, such as a media drive(s) 680, configured to store an operating system(s) 662, an application program(s) 664, and data 668, and the memory space(s) 660 may be shared with, distributed with or overlap with the memory storage capacity of the database(s) 690. In some aspects, the memory space(s) 660 may include the database(s) 690 or in some aspects the database(s) 690 may include the data 668 as shown in the memory space(s) 660. The data stored in the memory space(s) 660 or the database(s) 690 may include information, such as motion data, pairing program information, data processing routines, or other types of data described herein.

Other Variations and Terminology

[0080] Although examples disclosed herein for features may be presented in the context of activity monitoring for foot ulcer management or prevention, the features disclosed can be applied to other technologies, such as technologies where a device may be removed from a packaging and desirably placed in a particular location or orientation or where a location or orientation of placement may be automatically determined. Such technologies may include dressing technologies, including a wound dressing where the wound dressing may be removed from a packaging and desirably placed at a particular location or orientation on an individual or the location or orientation of placement of the wound dressing on the individual may be automatically determined.

[0081] Many other variations than those described herein will be apparent from this disclosure. For example, depending on the embodiment, certain acts, events, or functions of any of the algorithms described herein can be performed in a different sequence, can be added, merged, or left out altogether (e.g., not all described acts or events are necessary for the practice of the algorithms). Moreover, in certain embodiments, acts or events can be performed concurrently, e.g., through multi-threaded processing, interrupt processing, or multiple processors or processor cores or on other parallel architectures, rather than sequentially. In addition, different tasks or processes can be performed by different machines or computing systems that can function together.

[0082] One or more user inputs described in this disclosure may be received using one or more different mechanisms. For example, user interface controls may be selected by a user using one or more input options, such as a mouse, touch screen input, or keyboard input, among other user interface input options. The user interface controls selected by the user can include one or more of buttons, dropdown boxes, select boxes, text boxes, check boxes, slider controls, or other user interface controls.

[0083] The various illustrative logical blocks, modules, and algorithm steps described in connection with the embodiments disclosed herein can be implemented as electronic hardware, computer software, or combinations of both. To clearly illustrate this interchangeability of hardware and software, various illustrative components, blocks, modules, and steps have been described above generally in terms of their functionality. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the overall system. The described functionality can be implemented in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the disclosure.

[0084] The various illustrative logical blocks and modules described in connection with the embodiments disclosed herein can be implemented or performed by a machine, a microprocessor, a state machine, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A hardware processor can include electrical circuitry or digital logic circuitry configured to process computer-executable instructions. In another aspect, a processor includes an FPGA or other programmable device that performs logic operations without processing computer-executable instructions. A processor can also be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration. A computing environment can include any type of computer system, including, but not limited to, a computer system based on a microprocessor, a mainframe computer, a digital signal processor, a portable computing device, a device controller, or a computational engine within an appliance, to name a few.

[0085] The steps of a method, process, or algorithm described in connection with the embodiments disclosed herein can be embodied directly in hardware, in a software module stored in one or more memory devices and executed by one or more processors, or in a combination of the two. A software module can reside in RAM memory, flash memory, ROM memory, EPROM memory, EEPROM memory, registers, hard disk, a removable disk, a CD- ROM, or any other form of non-transitory computer-readable storage medium, media, or physical computer storage known in the art. An example storage medium can be coupled to the processor such that the processor can read information from, and write information to, the storage medium. In the alternative, the storage medium can be integral to the processor. The storage medium can be volatile or nonvolatile. The processor and the storage medium can reside in an ASIC.

[0086] Conditional language used herein, such as, among others, “can,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain aspects include, while other aspects do not include, certain features, elements or states. Thus, such conditional language is not generally intended to imply that features, elements or states are in any way required for one or more aspects or that one or more aspects necessarily include logic for deciding, with or without author input or prompting, whether these features, elements or states are included or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Further, the term “each,” as used herein, in addition to having its ordinary meaning, can mean any subset of a set of elements to which the term “each” is applied.

[0087] Conjunctive language such as the phrase “at least one of X, Y, and Z,” unless specifically stated otherwise, is otherwise understood with the context as used in general to convey that an item, term, etc. may be either X, Y, or Z. Thus, such conjunctive language is not generally intended to imply that certain embodiments require the presence of at least one of X, at least one of Y, and at least one ofZ.

[0088] Language of degree used herein, such as the terms “approximately,” “about,” “generally,” and “substantially” as used herein represent a value, amount, or characteristic close to the stated value, amount, or characteristic that still performs a desired function or achieves a desired result. For example, the terms “approximately”, “about”, “generally,” and “substantially” may refer to an amount that is within less than 10% of, within less than 5% of, within less than 1% of, within less than 0.1% of, and within less than 0.01% of the stated amount. As another example, in certain embodiments, the terms “generally parallel” and “substantially parallel” refer to a value, amount, or characteristic that departs from exactly parallel by less than or equal to 15 degrees, 10 degrees, 5 degrees, 3 degrees, 1 degree, or 0.1 degree.

[0089] While the above detailed description has shown, described, and pointed out novel features as applied to various embodiments, it will be understood that various omissions, substitutions, and changes in the form and details of the devices or algorithms illustrated can be made without departing from the spirit of the disclosure. As will be recognized, certain embodiments described herein can be embodied within a form that does not provide all of the features and benefits set forth herein, as some features can be used or practiced separately from others.

Claims

WHAT IS CLAIMED IS:

1. A system for positioning or orienting an electronic device that monitors activities of a user, the system comprising: a housing configured to attach to a user; an indicator supported by the housing; a sensor supported by the housing and configured to monitor a movement of the housing and generate motion data responsive to the movement; a memory device configured to store the motion data; and a processor supported by the housing and configured to: determine, from the motion data, a change in position or orientation of the housing with respect to a package device, and responsive to the change in position or orientation, activate the indicator to identify how to move the housing for attachment to the user.

2. The system of claim 1, wherein the sensor comprises one or more of an accelerometer, a gyroscope, a magnetometer, or an optical sensor that is configured to generate the motion data.

3. The system of claim 1 or 2, wherein the change in position or orientation comprises the change in position and orientation.

4. The system of claim 1 or one or more other preceding claims, wherein the indicator comprises a display, a plurality of lights, or a speaker.

5. The system of claim 1 or one or more other preceding claims, wherein the processor is configured to determine how to move the housing from a comparison of the change in position or orientation to a set change in position or orientation for attaching the housing to the user.

6. The system of claim 1 or one or more other preceding claims, wherein the processor is configured to determine the change in position or orientation from a first time when the housing is positioned proximate to the package device to a second time when the housing is not positioned proximate to the package device.

7. The system of claim 6, in combination with the package device, the package device comprising an identification on its surface of where the housing is to be positioned with respect to the package device at the first time.

8. The system of claim 6 or 7, in combination with the package device, the package device including a beacon configured to transmit a signal, the sensor being configured to detect the signal, the processor being configured to determine a distance between the sensor and the beacon from the signal and determine the change in position or orientation from the distance.

9. The system of claim 8, wherein the processor is configured to determine the distance from a detected strength of the signal.

10. The system of claim 8 or 9, wherein the beacon is configured to initiate wireless communications responsive to the electronic device being placed proximate to the package device.

11. The system of one or more of claims 6 to 10, wherein the processor is configured to determine the change in position or orientation from a comparison of the motion data to sensor data generated by the package device.

12. The system of one or more of claims 6 to 11, in combination with the package device, the package device being configured to store the housing.

13. The system of one or more of claims 6 to 12, wherein the processor is configured to identify the first time from the motion data.

14. The system of claim 1 or one or more other preceding claims, wherein the processor is configured to activate the indicator to identify how to move the housing for attachment to a limb of the user.

15. The system of claim 14, wherein the limb is a leg or an arm.

16. The system of claim 1 or one or more other preceding claims, wherein the housing is attached to a wound dressing.

17. The system of claim 1 or one or more other preceding claims, wherein the processor is configured to determine a location at which the housing is attached to the user from a height or a weight of the user.

18. The system of claim 1 or one or more other preceding claims, wherein the housing is configured to enclose the sensor, the memory device, or the processor.

19. A method of making or operating the system of one or more preceding claims.

20. An apparatus, system, method, or non-transitory computer readable medium as disclosed or illustrated herein.