Abstract:
Systems and methods are provided for a rehabilitative and ambulation accessory for a walker. The system provides visual and auditory cues to improve the movement pattern or walking ability of an individual with gait problems caused by physiological or neurological issues, injury, or surgical wounds. The invention may also be used as an exercise training device. The invention includes two balls which illuminate in an alternating fashion to provide a visual target for each leg. The user then reaches for the illuminated ball with his foot. When sensors inside the balls are triggered, the system returns visual and auditory feedback, such as a bright light and a pleasing tone indicating a successful step.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application is a continuation-in-part of co-pending U.S. patent application Ser. No. 13/341,622, filed Dec. 30, 2011, which is incorporated herein by reference and should be considered a part of this specification. 
    
    
     BACKGROUND 
     1. Field 
     The invention relates to improving the movement pattern or walking ability of an individual with gait problems caused by physiological or neurological issues, injury, or surgical wounds. The invention may be used for rehabilitative, training, and/or exercise purposes. 
     2. Background 
     Individuals with neurological conditions such as Parkinson&#39;s Disease, Huntington&#39;s Chorea, Multiple Sclerosis, traumatic brain injuries (TBI), stroke, etc., often present problems with gait or walking. Studies have shown that visual cues can help improve the individual&#39;s gait and initiate movement. (Movement Disorders: Volume 17, Issue 6, pages 1148-1160, November/December 2002. The power of cueing to circumvent dopamine deficits: A review of physical therapy treatment of gait disturbances in Parkinson&#39;s disease. Tamar C. Rubinstein MSc, Nir Giladi MD, Jeffrey M. Hausdorff PhD). There are commercially available products such as the STEPOVER WAND® which is a device commonly used for individuals with gait related issues, but nothing is available as a walker accessory which provides visual cues and visual/auditory feedback. Often individuals with the above neurological conditions have one side of their body which is more compromised than the other. Thus, the ability to provide stimuli or cues to a specific leg is valuable. 
     SUMMARY 
     In certain embodiments, a system for improving movement in a user comprises a flexible front cross bar configured for removable attachment to a walker, a first ball configured to attach to the front cross bar, and a second ball configured to attach to the front cross bar. The first ball includes electronic circuitry, a first light, and a first sensor, and the first ball is configured to provide a first visual cue. The second ball includes electronic circuitry, a second light, and a second sensor, and the second ball is configured to provide a second visual cue. The first visual cue and the second visual cue instruct the user to move legs in a particular order so as to improve walking gait of the user. In one embodiment, the first visual cue comprises the first light turning on, and the second visual cue comprises the second light turning on. 
     In some embodiments, the first sensor associated with the first ball is a magnetic sensor and the second sensor associated with the second ball is a magnetic sensor. In some embodiments, a system for improving movement in a user further comprises one or more magnets configured to removably attach to the user&#39;s ankle. 
     In certain embodiments, the first ball is configured to provide a first visual feedback when the first sensor is triggered, and the second ball is configured to provide a second visual feedback when the second sensor is triggered. In some embodiments, the first visual feedback comprises the first light glowing brighter, followed by the first light turning off, and the second visual feedback comprises the second light glowing brighter, followed by the second light turning off. In some embodiments, the system further comprises a speaker electronically coupled to the first and second balls. The speaker is configured to provide auditory feedback when the first or second sensor is triggered. 
     In some embodiments, a system for improving movement in a user further comprises a controller in electronic communication with the first ball and the second ball. The controller is configured to control operation of the first visual cue and the second visual cue. In some embodiments, the system further comprises a speaker in electronic communication with the controller. The speaker is configured to provide auditory feedback when the first or second sensor is triggered. The controller is configured to control operation of the auditory feedback. In some embodiments, the first ball is configured to provide a first visual feedback when the first sensor is triggered, and the second ball is configured to provide a second visual feedback when the second sensor is triggered. The controller is configured to control operation of the first visual feedback and the second visual feedback. 
     In one embodiment, the controller includes one or more independent triggers. In one embodiment, the controller is configured to track times at which the first sensor is triggered and times at which the second sensor is triggered. In one embodiment, the controller is configured to control the frequency of the first visual cue and the frequency of the second visual cue. 
     In certain embodiments, the vertical position of the front cross bar is adjustable. In some embodiments, the anterior-posterior position of the front cross bar is adjustable. In some embodiments, the first and second balls are configured to move along the front cross bar. 
     In certain embodiments, a system for improving movement in a user comprises a flexible front cross bar configured for removable attachment to a walker, a first ball configured to attach to the front cross bar, and a second ball configured to attach to the front cross bar. The first ball is configured to provide a first visual cue and the second ball is configured to provide a second visual cue. The first visual cue and the second visual cue instruct the user to move legs in a particular order so as to improve walking gait of the user. 
     In some embodiments, the first visual cue comprises a first predetermined color and the second visual cue comprises a second predetermined color. In some embodiments, the first visual cue is provided by a first light associated with the first ball, and the second visual cue is provided by a second light associated with the second ball. In certain embodiments, the system further comprises a controller in electronic communication with the first ball and the second ball. The controller is configured to control operation of the first visual cue and the second visual cue. 
     In some embodiments, the system further comprises a first wrist ball configured to removably attach to the user&#39;s first wrist, and a second wrist ball configured to removably attach to the user&#39;s second wrist. In some embodiments, the first wrist ball is configured to provide a visual cue, and the second wrist ball is configured to provide a visual cue. The visual cues instruct the user to move arms in a particular order so as to improve reciprocal movement of the user. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a schematic back perspective view of a user utilizing the invention and moving his left foot. 
         FIG. 2  is a schematic back perspective view of a user utilizing the invention and moving his right foot. 
         FIG. 3  is a schematic top perspective view of an embodiment of the invention with a front cross bar attached to the right and left legs of a walker and two balls attached to the front cross bar. 
         FIG. 4  is a schematic top view of an embodiment of side cross bars which are adjustable in length and have Velcro strips at both ends for attachment to a walker. 
         FIG. 5  is a schematic side view of the side cross bar. 
         FIG. 6  is a schematic back perspective of an embodiment of the invention with two side cross bars that are adjustable nylon straps. 
         FIG. 7  is a schematic front view of two balls attached to a front cross bar by clips. 
         FIG. 8  is a schematic front view of two balls moved closer to each other on the front cross bar. 
         FIG. 9  is a schematic front and top view of an ankle strap with an integrated magnet. 
         FIG. 10  is a schematic side view of the ankle strap attached to a user&#39;s ankle. 
         FIG. 11  is a schematic back perspective view of an embodiment of the invention with a controller. 
         FIG. 12  is a schematic block diagram illustrating an embodiment of a processing system inside the controller. 
         FIG. 13  is a schematic top view of an embodiment of a design of a controller. 
         FIG. 14  is a schematic side view of the controller. 
         FIG. 15  is a schematic bottom view of the controller. 
         FIG. 16  is a front view of a wrist ball attached to a user&#39;s wrist. 
         FIG. 17  is an embodiment of the invention with two differently colored wrist balls and two differently colored balls attached to a walker. 
         FIG. 18  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise. 
         FIG. 19  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise. 
         FIG. 20  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise. 
         FIG. 21  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise. 
         FIG. 22  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with lateral steps. 
         FIG. 23  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with lateral steps. 
         FIG. 24  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with lateral steps. 
         FIG. 25  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with lateral steps. 
         FIG. 26  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
         FIG. 27  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
         FIG. 28  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
         FIG. 29  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
         FIG. 30  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
         FIG. 31  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
         FIG. 32  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
         FIG. 33  is a schematic front view of an embodiment of the invention with a user practicing a reciprocal movement exercise with marching steps. 
     
    
    
     DETAILED DESCRIPTION 
     The present invention is directed to a system for improving movement in a user. The movement includes the user moving his foot to improve gait performance, such as minimum stride length, cadence, gait symmetry, and stepping speed. Referring to  FIGS. 1-2 , an exemplary embodiment of a system includes a walker, roller, or any similar assistive walking device with a frame extending upward from the walking surface to support a user while on foot, e.g., while walking, running, or standing. As used herein, “walker” shall refer to any or all of the above. In one embodiment, the system includes side cross bars  110  attached to the front legs  120   a,b  and back legs  130  of a walker, a front cross bar  140  attached to the side cross bars  110 , and a pair of balls  150  attached to the front cross bar  140 . In another embodiment, shown in  FIG. 3 , the front cross bar  140  attaches to the left  120   a  and right legs  120   b  of a walker  100 . In one embodiment, the balls  150  are spherical in shape. The balls may also be shaped ellipsoid, cylindrical, or any other suitable shape. As used herein, “ball” or “balls” shall include any or all of these shapes. Returning to  FIGS. 1-2 , a visual cue from a ball prompts the user to move his foot toward the ball. In one embodiment, the visual cues comprise different colored balls. In this embodiment, the color of the left ball  150   a  prompts the user to move his left foot toward that ball  150   a , and the color of the right ball  150   b  prompts the user to move his right foot toward that ball  150   b.    
     The front cross bar  140  is flexible so as not to injure or cause discomfort to the user when the user nears or hits a ball  150 . For example, in one embodiment, the front cross bar  140  is made of elastic medical grade tubing. In an exemplary embodiment, the front cross bars  140  attach to the side cross bars  110  using hooks  160 . The front cross bar  140  may also attach to the side cross bars  110  using straps, clamps, clips, rings, clasps, fasteners, or any other suitable attachment mechanism. In one embodiment, the front cross bar  140  is movable along the side cross bars  110 . Thus, the anterior-posterior position of the front cross bar  140  is adjustable so that the front cross bar  140  and balls  150  can be positioned closer to or farther away from the user. In this manner, the system accommodates for different stride lengths. The system can also be used to train a user to take longer strides as part of a gait rehabilitation program. 
     Referring to  FIG. 3 , in one embodiment, the front cross bar  140  may be moved vertically along the legs  120  of a walker and set at different heights, thus accommodating users of different heights. The front cross bar  140  and balls  150  may be selectively placed at different heights also to encourage the user to make the proper walking motion (e.g., use a natural walking slide). For example, the front cross bar  140  and balls  150  may be placed at a proper height to discourage small “shuffling” steps exhibited by users with Parkinson&#39;s Disease. 
     Exemplary embodiments of the side cross bars are illustrated in  FIGS. 4-6 . In one embodiment, the side cross bars are adjustable in length to fit on walkers of different sizes and shapes. For example, in one embodiment, the side cross bars are telescopic  FIGS. 4-5 . In one embodiment, Velcro straps  410  are included on the ends of the side cross bars for attachment to the legs of a walker. The side cross bars may attach to the legs of a walker using clamps, clips, hooks, rings, clasps, fasteners, or any other suitable attachment mechanism. Referring to  FIG. 6 , the side cross bars may be adjustable nylon straps  610 . In one embodiment, the side cross bars may be moved vertically along the legs of a walker and set at different heights. Thus, the front cross bar  140  and the balls  150  may be positioned at different heights by attaching them to side cross bars that are movable vertically along the legs of the walker. 
     Referring to  FIGS. 7-8 , in one embodiment, the balls  150  include a clip  710  for attachment to the front cross bar  140 . The balls  150  may also attach to the front cross  140  bar using any suitable mechanism, such as straps, rings, fasteners, or clasps. In one embodiment, the balls  150  are movable along the front cross bar  140  as illustrated in  FIGS. 7-8 . In another embodiment, the front cross bar  140  may be strung through holes  310  in the balls  150 , as shown in  FIG. 3 . The balls in this embodiment  FIG. 3  may also be movable along the front cross bar. Thus, the distance between the balls  150  may be adjusted, accommodating users of different hip widths. 
     Returning to  FIGS. 1-2 , in an exemplary embodiment of the invention, the balls light up  150   a ,  150   b  as a visual cue to help initiate movement (e.g., as part of a therapeutic exercise). In one embodiment, the user receives visual and/or auditory feedback when the user correctly executes a movement. For example, referring to  FIG. 1 , when the user&#39;s ankle comes within a predetermined distance to a ball  150   a , a sensor inside the ball  150   a  is triggered, the ball  150   a  glows brighter and a speaker sounds a chime, then the light inside the ball turns off. In one embodiment, after the light turns off, the opposite ball  150   b  lights up, as illustrated in  FIG. 2 . The illuminated ball  150   b  prompts the user to move his other foot toward that ball  150   b.    
     In one embodiment, the system includes a speaker and the balls  150  include electronic circuitry, a light, and a sensor. The speaker is electronically coupled to the balls  150  so that the speaker is able to emit sound when a sensor inside a ball is triggered, for example by a user&#39;s ankle coming hear it. The light may be a light emitting diode, incandescent light, fluorescent light, halogen light, neon light, or any other suitable light. In one embodiment, the sensor is a vibration sensor, which is triggered when the sensor detects vibration. For example, vibration can be caused by the user&#39;s ankle coming into physical contact with the ball. In another embodiment, the sensor is a magnetic sensor, which is triggered when a magnet nears the sensor. Referring to  FIGS. 9-10 , in one embodiment, the system includes a magnet  910  attached to the user&#39;s ankle  920 . In this embodiment, the magnet  910  may be integrated on an ankle strap  930  worn by the user. In another embodiment, a magnet is removably attached to the user&#39;s sneaker at the location of his ankle. When the user&#39;s ankle  920  nears the magnetic sensor, the sensor is triggered. The balls also include electronic circuitry necessary to achieve the functions just described and above with respect to  FIGS. 1-2 . Such electronic circuitry is well known in the art. 
     Referring to  FIG. 11 , one embodiment of the invention includes a controller  111  electronically coupled to the balls  150 . For example, they may be electronically coupled through a wire  112 , cable, or wirelessly through Bluetooth, WiFi, or Rf. In one embodiment, the two balls  150  are connected via a flexible electronic communication wire  1130 . Thus, as  FIGS. 7-8  illustrate, the flexible electronic communication wire  1130  allows for adjustment of the distance between the balls  150  on the front cross bar  140 . The distance between the balls  150  can be adjustable between a range of desired widths, which can be determined by the hip width of a user according to one embodiment of the invention. For example, the maximum spacing between the balls  150  can be ten inches according to one embodiment of the invention, and the spacing can be decreased to seven inches or shorter. In one embodiment, a speaker is integrated with the controller  111 . In another embodiment, a speaker is physically separate from the controller and in electronic communication with the controller  111  and the pair of balls  150 . In one embodiment, the speaker is removably attached to any part of the walker. In one embodiment, the controller  111  includes a headphone jack. 
       FIG. 12  is a block diagram illustrating one embodiment of the invention with a processing system  1210  (e.g., computer processor) inside the controller  1110 . In this embodiment, the system  1210  includes a bus  1220  or other communication mechanism for communicating information. The system  1210  also includes a processor  1230  and memory  1240  coupled to the bus  1220 . The processor  1230  processes information and executes instructions. The memory  1240  stores information and instructions to be executed by the processor  1230 . In one embodiment, the processing system  1210  sends commands to a first ball  1250 , a second ball  1260 , and/or speaker  1270 . For example, the system  1210  may instruct the first ball  1250  to light up, as a visual cue prompting the user to move his foot toward that ball  1250 . The system  1210  also receives and analyzes information from the balls  1250 ,  1260  and speaker  1270 . For example, the system  1210  may determine whether a sensor inside the first ball  1250  has triggered, indicating that a user correctly executed a movement. If the system  1210  determines that the sensor has been triggered, the system  1210  may output instructions to first ball  1250 , second ball  1260 , and the speaker  1270  so that they emit feedback. In one embodiment, the feedback comprises the first ball  1250  glowing brighter, the speaker  1270  sounding a chime, then the light inside the first ball  1250  turning off. Subsequently, the second ball  1260  lights up. 
     In one embodiment, the processing system  1210  tracks and analyzes the user&#39;s movement history. For example, the processing system  1210  may track the times at which the first and second sensors are triggered, and determine the pace of the user&#39;s gait. In one embodiment, this data is communicated to an electronic device, such as a smart phone  1280 , through an output port on the controller. In one embodiment, this data is communicated wirelessly to a computer or other electronic device  1290 , which in one embodiment can store said data in a memory. The data may be sent via Rf, Bluetooth, WiFi, or any other suitable mechanism for transferring data wirelessly. In one embodiment, this data is displayed on a screen on the controller  111 . In one embodiment, this data is spoken out loud through the speaker  336 . Such data can be used to evaluate a user&#39;s gait history to measure progress in improving gait, as well as allow a therapist to make adjustments to therapeutic exercises for the user. 
     An exemplary embodiment of a design of the controller  1110  is illustrated in  FIGS. 13-15 . The controller  1110  may be powered by a battery  1510 , rechargeable battery, photovoltaic power, or any other suitable power source, which can power all electronics in the controller  1110 . In one embodiment, the controller  1110  includes Velcro straps  1140  for attachment to the walker. Thus, the controller  1110  can be attached to walkers of different sizes and shapes. The controller  1110  may also be attached to the walker using straps, hooks, clips, clamps, or any other suitable mechanism. In one embodiment, as shown in  FIG. 11 , the controller  1110  is attached to the walker at a location that is easily accessible to the user. 
     The controller  1110  includes a user interface for controlling visual and auditory settings. The settings may be controlled through knobs, dials, buttons, switches, touch screens, combinations thereof, or any other suitable mechanism. The user may utilize the visual and auditory settings in any combination. 
       FIGS. 1-2  illustrate the operation of the system when the light settings on the controller  1110  are set at “On L,”  1310  or “On R”  1320 . If the light settings are set “On L,”  1310 , the left ball  150   a  will light up first. If a sensor inside the left ball  150   a  is triggered, for example by a user&#39;s ankle  920  coming near it, the ball  150   a  will glow brighter, then turn off. Subsequently, the right ball  150   b  lights up. If a sensor inside the right ball  150   b  is triggered, the right ball  150   b  glows brighter, then turns off. After, the left ball  150   a  turns on. Thereafter, the sequence continues. If the settings are set at “On R,”  1320  the system performs in the same way, except that the right ball  150   b  lights up first. In one embodiment, only one ball illuminates at a time, thus allowing for individual visual cueing for each leg so that there is a specific prompt for each step. 
     The visual cues may comprise a variety of light characteristics such as color and intensity. The visual cues may also comprise a variety of patterns. In one embodiment, the visual cue is a green glow that flutters and shimmers. The visual feedback may also comprise a variety of light characteristics and patterns. For example, if a user correctly executes a movement, the light in the ball may turn off, change color, change intensity, or exhibit a pattern comprising any combination of the light turning on and off, changing colors, and/or changing intensities. In one embodiment, the user may control the visual cues and feedback through the controller  1110 . In one embodiment, the user may choose to keep both balls  150  lit. In this embodiment, both balls  150  will stay lit even if a sensor inside either ball is triggered. 
     Returning to  FIGS. 13-15 , if the sound  1340  is turned on, the system will return auditory feedback, such as a pleasing and rewarding chime, when a sensor is triggered inside a ball. The auditory feedback can be a tone, a series of tones, a chime, a melody, a synthesized voice, or any other suitable sound. The user may control the type of auditory feedback  1340  through the controller  1110 . The user may utilize the sound and light features in any combination. In one embodiment, both balls stay lit and only the sound triggers when the user&#39;s foot nears the ball. In this embodiment, the system does not return visual feedback. 
     Referring to the “Exercise Mode,”  1350  the user may set the pace of the cues. In Exercise Mode  1350 , a sound cue may also prompt the user to initiate a movement. The sound cue coincides in time with any visual cue. In one embodiment, the user may set a metronome pace for the visual and auditory cueing of the balls. In one embodiment, the user may increase or decrease the frequency of the visual cues and sound cues. The user may also choose to practice Exercise Mode  1350  for only one leg by utilizing the “Single Side Repeat”  1360  feature on the controller  1110 . In Single Side Repeat  1360 , the cues repeat in one ball while the other ball remains off. Single Side Repeat  1360  allows for repetitive mobilization of a single leg. In Exercise Mode, the system does not output visual or auditory feedback. During Exercise Mode, the user attempts to match the visual and auditory cues with his strides. The Exercise Mode can be used to train the user&#39;s cadence and stepping speed. In one embodiment, the controller processing system  1210  may determine the successful triggering percentage during an Exercise Mode session. The processing system  1210  may then communicate this data to an electronic device such as a cell phone, computer, a screen on the controller, or a speaker. 
     In one embodiment, the controller  1110  includes independent triggers  1370 . When the independent triggers  1370  are activated, the corresponding ball lights up. Thus, the user can control which ball illuminates to provide a visual cue and aid the initiation of movement. For example, if the user experiences freezing or hesitation, the user can activate the appropriate trigger to illuminate the ball to provide a visual cue. In one embodiment, the controller includes indicator lights  1380 , which light on and off as the corresponding balls light on and off. 
     Referring to  FIGS. 16-17 , one embodiment of the invention includes a pair of different colored wrist balls  1610  removably attached to the user&#39;s wrists. For example, a wrist ball may be attached to an elastic band  1620  that the user wears around his wrist. The wrist ball may also be attached to the user&#39;s wrist using straps, strings, bracelets, or any other suitable mechanism. 
     Referring to  FIG. 17 , the colors of the balls  1710  attached to the front cross bar  140  of the walker match the colors of the wrist balls  1610 . For example, in one embodiment, one wrist ball is red  1610   a  and the other wrist ball is blue  1610   b . In this embodiment, one of the balls attached to the walker is red  1710   a  and the other ball is blue  1710   b.    
     The user wears on one wrist the colored ball that corresponds with the user&#39;s opposite foot. For example, if the left ball  1710   b  attached to the walker is blue, the right wrist is where the user wears the blue wrist ball  1610   b . The colored balls serve as visual cues, indicating to the user which arm should be moved with which foot. The user should practice movements corresponding with the same colored balls. For example, the user may practice movements corresponding with the blue colored balls. In this example, the user moves his left foot while at the same time moving his right arm. The user moves his left foot because the blue ball on the walker is toward the left. Thus, the user moves his left foot toward the blue ball. In addition, the blue wrist ball is on the user&#39;s right wrist. Thus, the user moves his right arm. In this manner, the system can be used train reciprocal movement. In one embodiment, the invention includes a booklet or DVD with instructions on training exercises. 
     An exemplary method of exercising is illustrated in  FIGS. 18-21 . The user moves his left foot toward the left ball  1710   b  on the walker, while extending his right arm outward  1810 . Then the user returns to standing position  FIG. 19 . Next, the user moves his right foot toward the right ball  1710   a  on the walker, and extends his left arm outward  2010 . Next, the user returns to standing position  FIG. 21 . The user then continues practicing these movements. 
     Referring to  FIGS. 22-25 , the user makes a lateral step with his left leg  2210 , while extending his right arm laterally  2220 . Then, the user returns to standing position  FIG. 23 . Next, the user makes a lateral step with his right leg  2410 , while extending his left arm laterally  2420 . Next, the user returns to standing position  FIG. 25 . The user then continues practicing these movements. 
     The user may combine any number of different exercises. For example, the user may combine a “marching pattern” with the exercise illustrated in  FIGS. 18-21 . Referring to  FIGS. 26-33 , the user bends his left foot upward  2610  while bending his right arm upward  2620 . The user then returns to standing position  FIG. 27 . Next, the user moves his left foot toward the left ball on the walker  2810 , while extending his right arm outward  2820 . The user then returns to standing position  FIG. 29 . Next, the user repeats the same exercise but using the opposite limbs of his body, as illustrated in  FIGS. 30-33 . The user then continues practicing these movements illustrated in  FIGS. 26-33 . 
     Although this invention has been disclosed in the context of certain preferred embodiments and examples, it will be understood by those skilled in the art that the present invention extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses of the invention and obvious modifications and equivalents thereof. Thus, it is intended that the scope of the present invention herein disclosed should not be limited by the particular disclosed embodiments described above.