Patent Description:
Health care providers often use the National Institute of Health Stroke Scale (NIHSS) to assess stroke symptoms, see https://www. gov/Disorders/All-Disorders/Stroke-Information-Page and also https://www. gov/documents/NIH_Stroke_Scale_508C. pdf for a chart used to conduct the NIH stroke scale. The scale is typically performed several times per day while a stroke patient is hospitalized. Although the scale is designed to objectively quantify stroke symptoms, at least some of the individual components that make up the scale are subjective such that the results can differ between clinicians. Additionally, the tasks that are needed to complete the stroke scale require a clinician's direct involvement and are time consuming.

<CIT> discloses methods and systems for the monitoring and assessment of clinical function through sensors and interactive patient responses (in particular, for patients with stroke).

In general terms, the present disclosure relates to automated stroke assessment. In one possible configuration, a system and method for automated stroke assessment provide a technical effect by mitigating clinician intervention and subjectivity. Various aspects are described in this disclosure, which include, but are not limited to, the following aspects.

<FIG> schematically illustrates a healthcare facility <NUM> that includes a stroke scale system <NUM>. The stroke scale system <NUM> can determine a stroke scale score for a patient P located in the healthcare facility <NUM>. Advantageously, the stroke scale score can be determined through an automated method that mitigates human error and subjectivity. Illustrative examples of the healthcare facility <NUM> may include, without limitation, a hospital, a medical clinic, a long-term-care facility, a nursing home, a skilled nursing facility, a surgical center, a physician's office, and may include the patient P's home.

The stroke scale system <NUM> communicates with the patient P such as by instructing the patient P to perform one or more tasks. Additionally, the stroke scale system <NUM> can provide various stimuli to induce a response from the patient P. Advantageously, the stroke scale system <NUM> can provide the instructions and stimuli to the patient P without requiring any intervention from a clinician or staff member of the healthcare facility <NUM>.

The stroke scale system <NUM> records the patient P's performance of the instructions and the patient P's responses to the stimuli, and uses the recorded performance and responses to objectively assess and score various stroke symptoms. Thereafter, the stroke symptom scores are used to determine a stroke scale score for the patient P. Illustrative examples of the stroke symptoms assessed by the stroke scale system <NUM> include, without limitation, the patient P's level of consciousness, vision including gaze and visual field, facial palsy, motor control of arms and legs, limb ataxia, sense of touch, comprehension, speech, and attention.

In certain examples, the stroke scale system <NUM> determines a stroke scale score for the patient P by combining the stroke symptom scores, and utilizes a network <NUM> to transfer the stroke scale score to a server <NUM> that is remotely located with respect to the Patient P and stroke scale system <NUM>. In alternative examples, the stroke scale system <NUM> does not determine the individual stroke symptom scores or the stroke scale score, and instead transfers to the server <NUM> data collected from the patient P's performance of the instructions and responses to stimuli, and the server <NUM> determines the stroke symptom scores, and combines the stroke symptom scores to determine the stroke scale score for the patient P.

The network <NUM> can include any type of wired or wireless connections or any combinations thereof. Examples of wireless connections include digital cellular network connections such as <NUM>. In some examples, wireless connections can be accomplished using, without limitation, Bluetooth, Wi-Fi, RFID, NFC, ZigBee, and the like.

In certain examples, the server <NUM> includes an electronic medical record system <NUM> (alternatively termed electronic health record, EMR/EHR). Advantageously, the server <NUM> can automatically store the stroke scale score of the patient P in an electronic medical record <NUM> or electronic health record of the patient P located in the EMR system <NUM> without requiring any input or intervention from a clinician. Advantageously, this can further reduce human errors that may result from manually updating the electronic medical record of the patient P.

<FIG> schematically illustrates the stroke scale system <NUM>. The stroke scale system <NUM> includes a patient support apparatus <NUM>, a display unit <NUM>, an audio unit <NUM>, motion detectors <NUM>, a communications module <NUM>, and a controller <NUM>.

The controller <NUM> is operatively coupled to each of the patient support apparatus <NUM>, display unit <NUM>, audio unit <NUM>, motion detectors <NUM>, and communications module <NUM>. The controller <NUM> is configured to control and coordinate the operation of each of these components to perform an automated method to determine the stroke scale score of the patient P. The controller <NUM> is a computing device. In certain examples, the controller <NUM> includes a timer <NUM> that can be used to automatically initiate a method for determining a stroke scale score when a clinician in the healthcare facility <NUM> is not available to initiate the method.

The communications module <NUM> is connected with the network <NUM> such that is able to transfer the stroke scale score and/or the recorded performance of the instructions and responses to the stimuli to another device or system, such as the server <NUM>.

<FIG> illustrates an example the patient support apparatus <NUM>. While <FIG> depicts the patient support apparatus <NUM> as a hospital bed, alternative examples are possible where the patient support apparatus <NUM> may be a chair, a recliner, surgical table, or any other type of support apparatus. Thus, the description provided herein is not limited to hospital beds.

The patient support apparatus <NUM> extends longitudinally from a head end H to a foot end F and laterally from a left side L to a right side R, where left and right are taken from the perspective of a supine occupant of the patient support apparatus <NUM>. The patient support apparatus <NUM> includes a frame <NUM> that has a base frame <NUM> and an elevatable frame <NUM> that is supported on the base frame <NUM> by supports <NUM>. The elevatable frame <NUM> is vertically moveable relative to the base frame <NUM>. The frame <NUM> includes wheels <NUM> extending from the base frame <NUM> to the floor to facilitate the portability of the bed around the healthcare facility <NUM>.

The elevatable frame <NUM> includes a sub-frame <NUM> and a deck <NUM> that supports a mattress <NUM>. The mattress <NUM> is flexible such that it conforms to the profile of the deck <NUM> as the orientation of the deck <NUM> is adjusted between horizontal and vertical orientations.

The patient support apparatus <NUM> includes a left siderail assembly having at least one left siderail mounted on the left side of the frame and a right siderail assembly having at least one right siderail mounted on the right side of the frame. In the example of <FIG>, the left siderail assembly includes an upper left siderail 90A and a lower left siderail 90B, and the right siderail assembly includes an upper right siderail 90C and a lower right siderail 90D.

In certain examples, the upper siderails 90A, 90C are connected to an upper body section of the deck <NUM> and rotate with the upper body section as that section rotates, while the lower siderails 90B, 90D are connected to a portion of the elevatable frame <NUM> that does not rotate with respect to the sub-frame <NUM>. Accordingly, the lower siderails 90B, 90D are always at a fixed orientation relative to sub-frame <NUM> as shown in <FIG>.

Each siderail 90A-90D is positionable at a deployed position at which its upper edge is higher than the top of the mattress <NUM> and at a stowed position at which its upper edge is lower than the top of the mattress <NUM>. When the deployed position, the siderail prevents the patient P from exiting the patient support apparatus <NUM>. When in the stowed position, the siderail allows the patient P to enter and exit the patient support apparatus <NUM>. In some examples, the siderails 90A-90D are also positionable at intermediate positions that are not as high as the deployed position nor as low as the stowed position. In the example illustrated in <FIG>, all four siderails 90A-90D are in the deployed position.

The patient support apparatus <NUM> includes a headboard <NUM> and a footboard <NUM>. In certain examples, the footboard <NUM> is removable from the foot end F of the frame <NUM> in order to accommodate occupant egress from the foot end F. For example, in certain examples, the patient support apparatus <NUM> can be adjusted so that its profile mimics that of a chair. When the patient support apparatus <NUM> is in a chair-like profile, the footboard <NUM> can be removed to facilitate egress and ingress at the foot end F of the patient support apparatus <NUM>.

The patient support apparatus <NUM> can further include a user interface <NUM> for operation by a clinician. The user interface <NUM> includes a display <NUM> for displaying information, and user input devices <NUM> such as buttons, switches, or a keyboard. In the example illustrated in <FIG>, the user interface <NUM> is positioned on the footboard <NUM>.

<FIG> schematically illustrates the patient support apparatus <NUM>. Referring now to <FIG>, the patient support apparatus <NUM> includes one or more pressure sensors <NUM> provided on a portion of the patient support apparatus <NUM> that can be grasped by the patient P. In examples where the patient support apparatus <NUM> is a hospital bed, such as in the example depicted in <FIG>, the pressure sensors <NUM> are provided on at least one siderail <NUM> of the bed. In alternative examples, for example when the patient support apparatus <NUM> is a chair, the pressure sensors <NUM> are provided on an armrest of the chair.

In alternative examples, the pressure sensors <NUM> can be provided on a device that is separate from the patient support apparatus <NUM>, and that is accessible by the patient P such that the patient P can grasp the device while being supported on the patient support apparatus <NUM>. The device may or may not attach to the patient support apparatus <NUM>. In such alternative examples, the device can communicate with the communications module <NUM> to transfer data detected by the pressure sensors <NUM>.

As will be described in more detail, a level of consciousness (LOC) physical exam <NUM> (see <FIG>) is performed as part of a method for determining the stroke scale score of the patient P, and includes instructions for the patient P to grasp a portion of the patient support apparatus <NUM> such as a siderail of a hospital bed or an armrest of a chair, or alternatively the instructions may instruct the patient P to grasp a device separate from the patient support apparatus <NUM> which may or may not be attached to the patient support apparatus <NUM>. The pressure sensors <NUM> are used by the stroke scale system <NUM> to detect the patient P's response to the instructions by measuring an applied pressure. Advantageously, the pressure sensors <NUM> can objectively measure the strength of the pressure applied by the patient P to remove subjectivity from the stroke scale score determination.

The patient support apparatus <NUM> further includes one or more probes <NUM> that provide a sensory stimulus that can be felt by the patient P such as by gently poking or prodding the patent P without causing harm to the patient P. The probes <NUM> are embedded in a siderail of the patient support apparatus <NUM> adjacent to the pressure sensors <NUM>.

As will be described in more detail, a sensory stimulus exam <NUM> (see <FIG>) is performed as part of a method for determining the stroke scale score of the patient P. The sensory stimulus exam <NUM> uses the probes <NUM> to provide sensory stimuli to the patient P, and the stroke scale system <NUM> detects and/or measures the patient P's response to the stimuli.

<FIG> schematically illustrates an example of a siderail <NUM> of the patient support apparatus <NUM> that can be used to implement aspects of the present disclosure. As described above, the patient support apparatus <NUM> can include at least one pressure sensor <NUM> on a portion of the siderail <NUM> that can be grasped by the patient P such that the pressure sensor <NUM> can detect when the patient P grasps the siderail <NUM> and can measure the pressure applied by the patient P to the siderail <NUM> in response to a command that requests the patient P to grasp the siderail <NUM>.

As further shown in <FIG>, one or more probes 132a-132c are embedded in the siderail <NUM> adjacent to the location of the pressure sensor <NUM>. The probes 132a-132c are stored inside respective cavities 134a-134c in the siderail <NUM>, and are controlled by the controller <NUM> to project outwardly to provide sensory stimuli during the sensory stimulus exam <NUM>. After completion of the sensory stimulus exam <NUM>, the controller <NUM> instructs the probes 132a-132c to return inside their respective cavities 134a-134c so that they do not disturb the patient P.

As shown in <FIG>, multiple probes 132a-132c can be used by the stroke scale system <NUM> to provide different types of sensory stimuli. For example, probe 132a, which is depicted as having a blunt distal end, can be used to provide a mild sensory stimulus, while probe 132c has a pointed distal end that can be used to provide a moderate sensory stimulus, and a probe 132b includes another pointed distal end that can be used to provide a stronger sensory stimulus. While multiple probes are shown in the example of the siderail <NUM> shown in <FIG>, in alternative examples, the siderail <NUM> may include only one probe, may include two probes, or may include more than three probes. Thus, <FIG> is provided by way of illustration only.

The arrangement depicted in <FIG> can be used on multiple siderails <NUM> of the patient support apparatus <NUM> such as in the left siderail assembly that includes the upper left siderail 90A and the lower left siderail 90B, and the right siderail assembly includes the upper right siderail 90C and the lower right siderail 90D. Advantageously, the sensory stimuli from the probes 132a-132c can be provided to both the left and right sides of the patient P's body. Additionally, the pressure sensors <NUM> can be used to determine whether the patient P is able to grasp a siderail on the left siderail assembly or on the right siderail assembly.

<FIG> schematically illustrates the display unit <NUM>. The display unit <NUM> displays various objects for viewing by the patient P during the automated method. Additionally, in scenarios where the patient P is deaf or has hearing impairment, text and visual instructions can be presented on the display unit <NUM> instead of audio instructions.

In certain examples, the display unit <NUM> is both an input and output device such as a touchscreen that has both a visual display <NUM> and a touch input <NUM>. In such examples, the display unit <NUM> can be fixed to the patient support apparatus <NUM> such that the visual display <NUM> can be both viewed and touched by the patient P to enter one or more responses during the method for determining the stroke scale score. As an illustrative example, the display unit <NUM> can be attached to a siderail <NUM> of the patient support apparatus <NUM>.

In some examples, the display unit <NUM> is only an output device such that it includes the visual display <NUM>, but not the touch input <NUM>. In such examples, the display unit <NUM> does not need to be in close proximity with the patient P because there is no need for the patient P to touch and interact with the display unit <NUM>. Thus, the display unit <NUM> can be fixed to the footboard <NUM> of the patient support apparatus <NUM> so that it can be easily viewed by the patient P when sitting upright on the patient support apparatus <NUM>. Also, in such examples, the display unit <NUM> does not need to be fixed to the patient support apparatus <NUM> such that the display unit <NUM> can be mounted on a portable stand that can be positioned adjacent to or in front of the patient support apparatus <NUM>, or can be mounted to a wall adjacent to or in front of the patient support apparatus <NUM> for viewing by the patient P while on the support apparatus.

<FIG> schematically illustrates the audio unit <NUM> as including one or more speakers <NUM> and a microphone <NUM>. The speakers <NUM> are used by the stroke scale system <NUM> to provide audible instructions to the patient P during the method for determining the stroke scale score. For example, the audible instructions can include asking the patient P the month and his or her age, to open and close their eyes, grip, and release a hand, follow with their eyes the movement of an object displayed on the display unit <NUM>, and so on. Additionally, the speakers <NUM> can be used to announce the start of the method for determining the stroke scale score. In scenarios where the patient P is deaf, instead of using the audio unit <NUM> to present audible instructions, the stroke scale system <NUM> can display text and visual instructions on the display unit <NUM>.

The microphone <NUM> is used by the stroke scale system <NUM> to record audible responses from the patient P to the instructions and stimuli that are provided by the stroke scale system <NUM>. For example, the microphone <NUM> can be used to record the patient P's responses to a level of consciousness inquiry that asks the patient P to state the month and his or her age.

Additionally, the audio unit <NUM> can provide the audio instructions and information depending on the preferred language of the patient P, and the microphone <NUM> can record the responses from the patient P in their preferred language. Thus, the stroke scale system <NUM> is multilingual. In certain examples, the preferred language of the patient P is identified from the electronic medical record <NUM> of the patient P stored in the EMR system <NUM> (see <FIG>).

In certain examples, the display unit <NUM> and audio unit <NUM> are packaged together in a single device such as a monitor, tablet computer, and the like. Alternatively, the display unit <NUM> and audio unit <NUM> can be contained in separate devices.

<FIG> schematically illustrates the motion detectors <NUM> of the stroke scale system <NUM>. The motion detectors <NUM> detect movements of the patient P in response to the instructions and stimuli that are provided for determining the stroke scale score. The motion detectors <NUM> are used by the stroke scale system <NUM> to objectively identify compliance or non-compliance with the instructions and stimuli such that the motion detectors <NUM> mitigate clinician subjectivity. Additionally, the motion detectors <NUM> provide improved refinement and precision in quantifying the patient P's compliance or non-compliance with the instructions and stimuli.

In the example depicted in <FIG>, the motion detectors <NUM> include an eye tracker <NUM> for measuring the eye movement of the patient P during the automated method. For example, the eye tracker <NUM> can measure the point of gaze of the patient P when the patient P is instructed to follow a moving target displayed on the display unit <NUM>. The eye tracker <NUM> is used by the stroke scale system <NUM> to record the eye movement and gaze of the patient P.

The eye tracker <NUM> can include a camera that captures images of the patient P's eyes from which eye position and movement are extracted. In certain examples, the eye tracker <NUM> uses infra-red eye tracking such as by detecting infra-red light reflection from the patient P's eyes using the camera or some other optical sensor. The detected infra-red light reflection is analyzed to extract the patient P's eye position and movement.

The motion detectors <NUM> can further include a body tracker <NUM> that detects the position and movement of the patient P's limbs. For example, the method for determining the stroke scale score can include instructing the patient P to cover one eye with their hand, and the body tracker <NUM> can be used by the stroke scale system <NUM> to confirm whether the correct eye has been covered. Additionally, the body tracker <NUM> can detect facial expressions of the patient P in response to the instructions or stimuli provided during the method.

As described above, the method for determining the stroke scale score of the patient P can include instructions for the patient P to grab a portion of the patient support apparatus <NUM> such as a siderail of a hospital bed or an armrest of a chair. In certain examples, the body tracker <NUM> can be used by the stroke scale system <NUM> to detect whether the patient P grabbed a portion of the patient support apparatus <NUM> such that the body tracker <NUM> can be used to determine compliance with the instructions instead of the pressure sensors <NUM>.

In certain examples, the body tracker <NUM> uses radar technology to detect the position and movement of the patient P's limbs. In such examples, the body tracker <NUM> transmits electromagnetic wave signals that the patient P's limbs reflect. By capturing the reflected signal, the body tracker <NUM> can determine the position and movement of the limbs of the patient P. In some examples, the body tracker <NUM> uses millimeter waves (also referred to as mmWaves) which is a special class of radar technology that uses short-wavelength electromagnetic waves. In alternative examples, other technologies can be used by the body tracker <NUM> to track the position and movement of the patient P's limbs such as a camera that captures images from which limb position and movement are extracted.

In certain examples, the body tracker <NUM> is mounted to the patient support apparatus <NUM> such as by attachment to a siderail <NUM> or the footboard <NUM> of the apparatus. In other examples, the body tracker <NUM> is fixed to a ceiling above the patient support apparatus <NUM> or to a wall that is adjacent to or in front of the patient support apparatus <NUM>. In some examples, the body tracker <NUM> is mounted to a portable stand that can be positioned adjacent to or in front of the patient support apparatus <NUM>.

In certain examples, the functions of both eye tracker <NUM> and body tracker <NUM> are performed by a single device. As an illustrative example, a radar system such as one that uses mmWaves can be used to capture both the eye and limb movement of the patient P. As a further illustrative example, a camera that is used to detect eye position and movement can also be used to detect the position and movement of the patient P's limbs.

<FIG> schematically illustrates a method <NUM> for determining a stroke scale score for the patient P. The method <NUM> includes an operation <NUM> of initiating a test performed by the stroke scale system <NUM>. The initialization can be done by a clinician such as a nurse in the healthcare facility <NUM>. As an illustrative example, a nurse can enter an input to initiate the test at a workstation that is remotely located with respect to the patient P and the stroke scale system <NUM>. Advantageously, the nurse does not need to be physically present in the patient P's room to initiate the test. Alternatively, the initialization at operation <NUM> can be done automatically by using the timer <NUM> of the stroke scale system <NUM> (see <FIG>). This can be advantageous especially when it is desirable to perform the stroke scale examinations multiple times per day, and the clinicians in the healthcare facility <NUM> are not available to perform the initialization.

Next, the method <NUM> includes an operation <NUM> of announcing the beginning of the test to the patient P. This is helpful to ensure that the patient P is aware that the test is beginning especially when a clinician is not present in the patient P's room. Operation <NUM> can include providing an audio output from the audio unit <NUM> to inform the patient P that the test is beginning, and to listen and follow the instructions of the test. Alternatively, or in addition to providing the audio output, operation <NUM> can include displaying a message on the display unit <NUM> to inform the patient P that the test is beginning, which can be especially helpful when the patient P has a hearing impairment or is deaf.

Next, the method <NUM> includes an operation <NUM> of determining the readiness of the patient P to perform the test. In certain examples, a motion detector <NUM>, such as the body tracker <NUM>, is used to detect the location and position of the patient P such that it can be determined whether the patient P is positioned in the patient support apparatus <NUM>. In certain examples, operation <NUM> can further include detecting whether the patient P has any amputated limbs or is currently intubated. When it is detected that the patient P is not positioned in the patient support apparatus <NUM>, it is determined that the patient P is not ready to perform the test.

In some instances, operation <NUM> can include providing an audio output or visual message that requests the patient P to affirmatively confirm whether they are ready to perform the test. Thereafter, the patient P can provide an audible answer (e.g., "Yes" or 'No") that is detected by the microphone <NUM>, or the patient P can enter an answer through the display unit <NUM> in examples where the display unit <NUM> is a touchscreen accessible by the patient P.

When the patient P enters an answer that they are not ready to start the test (i.e., "No" at operation <NUM>), the method <NUM> returns to operation <NUM> to re-initiate the test after a predetermined amount of time has passed.

When the patient P enters an answer that they are ready to start the test (i.e., "Yes" at operation <NUM>), the method <NUM> proceeds to perform a series of stroke scale examinations at operation <NUM>. The stroke scale examinations performed at operation <NUM> will be described in more detail below with references to <FIG>.

After completion of the stroke scale examinations, the method <NUM> proceeds to operation <NUM> to determine the scores from the stroke scale examinations. In some examples, the score from each stroke scale examination is determined and recorded before proceeding to the next stroke scale examination such that operations <NUM> and <NUM> occur simultaneously. Alternatively, the responses from the patient P are recorded during completion of each stroke scale examination, and after completion of all stroke scale examinations, the responses are processed and analyzed such that operation <NUM> occurs after completion of operation <NUM>. Furthermore, as described above, in some examples, the stroke scale system <NUM> determines the score from each stroke scale examination, or alternatively, the server <NUM> can determine the score from each stroke scale examination based on the recorded responses.

Next, the method <NUM> proceeds to operation <NUM> to calculate an extinction/inattention score which indicates whether the patient P exhibits a lack of awareness on one side of their body and/or a loss of exploratory search and other actions normally directed toward that side of their body. Data that identifies extinction/inattention is obtained by the stroke scale system <NUM> during performance of the stroke scale examinations at operation <NUM> such that this data can be used by the stroke scale system <NUM> to calculate the extinction/inattention score at operation <NUM>. For example, the data collected from the motion detectors <NUM> and the microphone <NUM> of the audio unit <NUM> can identify whether the patient P exhibited visual, tactile, auditory, spatial, or personal extinction or inattention. Advantageously, the stroke scale system <NUM> mitigates and/or eliminates clinician subjectivity that is often present when scoring extinction or inattention.

An extinction/inattention score of <NUM> indicates that there was no abnormality. An extinction/inattention score of <NUM> is assigned when the data from operation <NUM> indicates that patient P exhibited visual, tactile, auditory, spatial, or personal extinction or inattention to bilateral simultaneous stimulation of at least one sensory modality. An extinction/inattention score of <NUM> is assigned when the data from operation <NUM> indicates that the patient P exhibited extinction or inattention to more than one modality, was orientated to only one side of their body during operation <NUM> such that they exhibited extinction to bilateral simultaneous stimulation, or exhibited hemi-inattention such that the patient P did not recognize their own hand.

Next, the method <NUM> proceeds to operation <NUM> to calculate a level of consciousness (LOC) score for the patient P. Level of consciousness is often not determinable by a few responses to verbal prompts. Thus, the stroke scale system calculates the LOC score based on how well the patient P participated in the other parts of the method <NUM> (e.g., Was the patient P responsive? Did the patient P follow instructions to the best of their ability and attempt each of the tests? Or did the patient P ignore prompts and not attempt the tests?). For example, data that can identify the patient P's level of consciousness is obtained by the stroke scale system <NUM> during performance of the stroke scale examinations at operation <NUM> such that this data can be used by the stroke scale system <NUM> to calculate the LOC score at operation <NUM>. For example, the data collected from the motion detectors <NUM> and the microphone <NUM> of the audio unit <NUM> can identify whether the patient P was able to follow most of the instructions during operation <NUM>. Advantageously, the stroke scale system <NUM> mitigates and/or eliminates clinician subjectivity from the calculation of the LOC score.

A LOC score of <NUM> indicates that the patient P was alert and keenly responsive, such as when the patient P attempts to perform all of the tests. A LOC score of <NUM> indicates that the patient P was aroused and alert, such as when the patient P attempts more than half of the tests. A LOC score of <NUM> indicates that the patient P was not alert, such as when the patient P attempts fewer than half of the tests. A LOC score of <NUM> indicates that the patient P was unresponsive, such as when the patient did not attempt any of the tests.

Next, method <NUM> proceeds to operation <NUM> to determine the stroke scale score by combining the stroke scale examination scores (determined at operation <NUM>), the inattention score (determined at operation <NUM>), and the LOC score (determined at operation <NUM>). In certain examples, the stroke scale score determined at operation <NUM> ranges from <NUM> to <NUM> where a score of <NUM> indicates no stroke, and a score in the range of <NUM>-<NUM> indicates a severe stroke.

In certain examples, when the determined stroke scale score is indicative of a stroke, an alarm is generated to request immediate attention from a caregiver. Example alarms include sounding an alarm at a nurses' station, sounding a local alarm on the patient support apparatus <NUM>, and/or sending an alert message directly to one or more caregivers.

The method <NUM> further includes an operation <NUM> of automatically storing the stroke scale score in the EMR <NUM> of the patient P. Advantageous, operation <NUM> can be done without any input or intervention from a clinician to reduce human errors that may result from manually updating the EMR <NUM> of the patient P. Operation <NUM> is completed by using the network <NUM> to provide a communications link between the stroke scale system <NUM> and the server <NUM>, and by the server <NUM> having access to the EMR system <NUM>.

In some examples, after completion of operation <NUM>, the method includes an operation <NUM> of resetting the timer <NUM> to repeat the test after a predetermined period of time has passed. For example, a reminder can be sent to a clinician to repeat the initialization of the test (operation <NUM>) after the predetermined period of time has passed. Alternatively, the timer <NUM> can instruct the controller <NUM> to automatically repeat the initialization of the test without requiring any input from a clinician after the predetermined period of time has passed.

<FIG> schematically illustrates the stroke scale examinations that are performed at operation <NUM> in the method <NUM> for determining the stroke scale score for the patient P. The stroke scale examinations include a level of consciousness (LOC) inquiry exam <NUM>, a level of consciousness (LOC) physical exam <NUM>, a gaze tracking exam <NUM>, a visual field exam <NUM>, a facial palsy exam <NUM>, an arm physical exam <NUM>, a leg physical exam <NUM>, a limb ataxia exam <NUM>, a sensory stimulus exam <NUM>, a comprehension exam <NUM>, and a dysarthria exam <NUM>. In some examples, the stroke scale examinations <NUM>-<NUM> are performed sequentially in the order depicted in <FIG>. In alternative examples, the stroke scale examinations <NUM>-<NUM> are performed in a different order than the one depicted in <FIG>.

<FIG> schematically illustrates details of the LOC inquiry exam <NUM>. As shown in <FIG>, the LOC inquiry exam <NUM> includes an operation <NUM> of asking the patient P one or more questions. In some examples, the questions are provided to the patient P by an audio output from the speakers <NUM> of the audio unit <NUM>. Alternatively, or in addition to providing an audio output, the stroke scale system <NUM> may also provide the questions to the patient P by displaying a visual message or text on the visual display <NUM> of the display unit.

The questions may include asking the patient P the month and his or her age. While the foregoing questions are provided as illustrative examples, it is contemplated that are variety of questions may be asked to the patient P during the LOC inquiry exam.

Next, the LOC inquiry exam <NUM> includes an operation <NUM> of receiving the responses from the patient P. In some examples, the responses are audible responses that are recorded by the microphone <NUM> of the audio unit <NUM>. Alternatively, or in addition to recording an audible response, the stroke scale system <NUM> may also allow the patient P to type or otherwise enter the answers to the questions using the touch input <NUM> of the display unit <NUM> in examples where the display unit <NUM> is a touchscreen that is accessible by the patient P.

The LOC inquiry exam <NUM> includes an operation <NUM> of processing and recording the responses from the patient P. As described above, the responses from the patient P are used by the stroke scale system <NUM> or server <NUM> to calculate the LOC score at operation <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., after operation <NUM> in the method <NUM>). When calculating the LOC score, the recorded responses from the patient P must be correct such that there is no partial credit for the patient P being almost correct.

<FIG> schematically illustrates details of the LOC physical exam <NUM>. As shown in <FIG>, the LOC physical exam <NUM> includes an operation <NUM> of providing a first command to the patient P. In some examples, the first command requests the patient P to open and close their eyes. The stroke scale system <NUM> provides the first command by an audio output from the audio unit <NUM>, or by a message or text displayed on the display unit <NUM>, or both.

Next, the LOC physical exam <NUM> includes an operation <NUM> of determining whether a response to the first command is detected from the patient P. In examples where the first command requests the patient P to open and close their eyes, the response is detected by using a motion detector <NUM> such as the eye tracker <NUM> to detect eye movement. The eye tracker <NUM> can include a camera that acquires images of the patient P's eyes from which eyelid movement can be detected. Alternatively, a body tracker <NUM> that uses radar technology can be used to detect eyelid movement to determine whether the patient P opened and closed their eyes.

Next, the LOC physical exam <NUM> includes an operation <NUM> of providing a second command to the patient P. In some examples, the second command requests the patient P to grasp a siderail <NUM> of the patient support apparatus <NUM>, or a separate device that may be attached or may not be attached to the patient support apparatus <NUM>. The stroke scale system <NUM> provides the second command by an audio output, or displayed message or text, or both.

Next, the LOC physical exam <NUM> includes an operation <NUM> of determining whether a response to the second command is detected from the patient P. In examples where the second command requests the patient P to grab a siderail <NUM> of the patient support apparatus <NUM>, the response to the second command is detected by using the one or more pressure sensors <NUM> provided on the siderail <NUM>, or on a separate device that may be attached or may not be attached to the patient support apparatus <NUM>. Alternatively, a body tracker <NUM> that uses radar technology can be used to detect whether the patient P grabbed the correct siderail <NUM> of the patient support apparatus <NUM>, or the correct separate device.

The LOC physical exam <NUM> includes an operation <NUM> of processing and recording the responses from the patient P. In some examples, the stroke scale system <NUM> calculates a score at operation <NUM> based on the recorded responses to the first and second commands. Alternatively, the score can be calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM>.

Credit for calculating the LOC command score is given when an unequivocal attempt is made by the patient P to perform a command, but the patient P is not able to complete the command due to weakness. A score of <NUM> is given when the patient P completes both commands correctly, a score of <NUM> is given when the patient P completes only one command correctly, and a score of <NUM> is given when the patient P is not able to complete either command correctly.

<FIG> schematically illustrates details of the gaze tracking exam <NUM>. As shown in <FIG>, the gaze tracking exam <NUM> includes an operation <NUM> of instructing the patient P to follow a moving target with their eyes. The stroke scale system <NUM> can provide the instruction to the patient P by an audio output, or displayed text, or both. Thereafter, the gaze tracking exam <NUM> includes an operation <NUM> of displaying the moving target on the display unit <NUM>.

Next, the gaze tracking exam <NUM> includes an operation <NUM> of tracking the eye movement of the patient P while the moving target is displayed on the display unit <NUM>. The stroke scale system tracks the patient P's eye movement by using the eye tracker <NUM>. As discussed above, the eye tracker <NUM> can include a camera that acquires images of the patient P's eyes from which eye position and movement are extracted.

Thereafter, the gaze tracking exam <NUM> includes an operation <NUM> of processing and recording the patient P's eye movement. In some examples, the stroke scale system <NUM> calculates a gaze score at operation <NUM> based on the recorded eye movement. Alternatively, the gaze score can be calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., at operation <NUM>).

A gaze score of <NUM> is assigned when the recorded eye movement does not exhibit any abnormality. A gaze score of <NUM> is assigned when partial gaze palsy is detected from the recorded eye movement, and a gaze score of <NUM> is assigned when total gaze palsy is detected.

<FIG> schematically illustrates details of the visual field exam <NUM>. As shown in <FIG>, the visual field exam <NUM> includes an operation <NUM> of instructing the patient P to cover their left or right eye with their hand. The stroke scale system <NUM> can provide the instruction to the patient P by an audio output, or displayed text, or both.

The visual field exam <NUM> includes an operation <NUM> of confirming whether the patient P has covered the correct eye with their hand. The stroke scale system <NUM> can use a motion detector <NUM> to detect whether the patient P has covered the correct eye. For example, the body tracker <NUM> can be used to detect that the patient P has not covered any eye, or has covered an incorrect eye such as when the instruction requests the patient P to cover their left eye, and instead, the patient P incorrectly covers their right eye.

In certain examples, when the motion detector <NUM> detects that the patient P has not covered an eye, or has covered an incorrect eye, the stroke scale system <NUM> can repeat the instruction, and/or alert the patient P about the error so that the patient P can correct it to obtain compliance with the instruction. The stroke scale system <NUM> can repeat the instruction to the patient P by an audio output, or displayed text, or both.

The visual field exam <NUM> includes an operation <NUM> of displaying objects on the display unit <NUM> and instructing the patient P to count and audibly state the number of objects displayed on the display unit <NUM> while the left or right eye of the patient P remains covered. The stroke scale system <NUM> provides the instructions to the patient P by audio output, or displayed text, or both. The stroke scale system <NUM> determines whether the eye of the patient P remains covered by using a motion detector <NUM> such as the body tracker <NUM>.

Next, the visual field exam <NUM> includes an operation <NUM> of processing and storing the patient P's responses. For example, the stroke scale system <NUM> can use the microphone <NUM> to record the patient P's audible answer to counting the number of objects displayed on the display unit <NUM> while the patient P's hand remains covering one eye. A score of <NUM> is assigned when there is no visual loss due the patient P's eye being covered, a score of <NUM> is assigned when there is partial hemianopia (i.e., blindness in one half of the visual field of the eye), a score of <NUM> is assigned when there is complete hemianopia in one eye, and a score of <NUM> is assigned when there is bilateral hemianopia (i.e., hemianopia is present in both eyes).

The visual field exam <NUM> determines at operation <NUM> whether both eyes of the patient P have been examined. When it is determined that both eyes have not been examined (i.e., "No" at operation <NUM>), the visual field exam <NUM> repeats operations <NUM>-<NUM> for the opposite eye of the patient P. When it is determined that both eyes have been tested (i.e., "Yes" at operation <NUM>), the stroke scale system <NUM> proceeds to the next stroke scale examination at operation <NUM> such as, for example, the facial palsy exam <NUM>.

<FIG> schematically illustrates details of the facial palsy exam <NUM>. As shown in <FIG>, the facial palsy exam <NUM> includes an operation <NUM> of instructing the patient P to make a facial expression. The stroke scale system <NUM> provides the instruction to make a facial expression by an audio output, or displayed message, or both. In some examples, an image or pantomime is displayed on the display unit <NUM> to encourage the patient P to make a facial expression. Examples of facial expressions may include, without limitation, requesting the patient P to show their teeth, or raise their eyebrows, or close their eyes.

Next, the facial palsy exam <NUM> includes an operation <NUM> of detecting the facial expression. The stroke scale system <NUM> uses a motion detector <NUM> such as the body tracker <NUM> that uses radar or captured image technology to detect the facial expression.

Next, the facial palsy exam <NUM> includes an operation <NUM> of processing and storing the patient P's facial expressions. For example, images of the facial expressions are captured using a camera, and are stored by the stroke scale system <NUM>. The stroke scale system <NUM> calculates a facial palsy score at operation <NUM> based on the captured facial expressions. The facial palsy score can be calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., at operation <NUM>).

A facial palsy score of <NUM> is assigned when no abnormalities are detected such as when the facial expression is symmetrical on both sides of the patient P's face. A facial palsy score of <NUM> is assigned when minor paralysis is detected (e.g., an asymmetrical smile), a facial palsy score of <NUM> is assigned when partial paralysis is detected on one side of the patient P's face, and a facial palsy score of <NUM> is assigned when complete paralysis is detected on one or both sides of patient P's face such as when there is no facial movement in the upper and lower portions of the face.

<FIG> schematically illustrates details of the arm physical exam <NUM>. As shown in <FIG>, the arm physical exam <NUM> includes an operation <NUM> of instructing the patient P to move their left or right arm into a position, and to maintain the position for a predetermine period of time. For example, the stroke scale system <NUM> can instruct the patient P to extend their left or right arm (with the palms facing downward) <NUM> degrees when the patient P is sitting upright, or to extend their left or right arm <NUM> degrees when the patient P is supine on the patient support apparatus <NUM>, and to maintain the position for <NUM> seconds.

The stroke scale system <NUM> provides the instructions by an audio output, or displayed message, or both. As an illustrative example, the stroke scale system <NUM> can generate an audio output from the audio unit <NUM> to instruct the patient P to move their left or right arm into the correct position, and can display an image of the correct position on the display unit <NUM> for visual reference. Additionally, the stroke scale system <NUM> can display a countdown clock on the display unit <NUM> to inform the patient P how much longer the patient P is required to maintain the position. Alternatively, or in addition to the countdown clock displayed on the display unit <NUM>, the audio unit <NUM> can audibly countdown the time remaining.

Next, the arm physical exam <NUM> includes an operation <NUM> of detecting whether the patient P is able to move their arm to the correct position, and thereafter keep the arm in the correct position for a predetermined period of time (e.g., <NUM> seconds). The stroke scale system <NUM> uses a motion detector <NUM>, such as the body tracker <NUM> that uses radar or captured image technology, to detect the position and movement of the patient P's arm.

Next, the arm physical exam <NUM> includes an operation <NUM> of processing and storing the position and movement of the patient P's arm. For example, images of the patient P's arm (e.g., captured by a camera) or data identifying the position and movement of the arm (e.g., determined by a radar system) are processed stored by the stroke scale system <NUM>. In some examples, the stroke scale system <NUM> calculates an arm physical exam score at operation <NUM>. Alternatively, the arm physical exam score can be calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM>.

An arm physical exam score of <NUM> is assigned when no drift is detected such as when the arm holds at <NUM> or <NUM> degrees for the full <NUM> seconds. An arm physical exam score of <NUM> is assigned when minor drift is detected such as when the arm holds at <NUM> or <NUM> degrees, but drifts down before the full <NUM> seconds without hitting the bed or other support. An arm physical exam score of <NUM> is assigned when it is detected that the arm cannot get to or maintain the <NUM> or <NUM> degree angle, drifts down to the bed or other support, but has some effort against gravity. An arm physical exam score of <NUM> is assigned when the arm immediately falls and there is no effort against gravity. An arm physical exam score of <NUM> is assigned when no arm movement is detected.

The arm physical exam <NUM> includes an operation <NUM> of determining whether both arms of the patient P have been examined. When it is determined that both arms have not been examined (i.e., "No" at operation <NUM>), the arm physical exam <NUM> repeats operations <NUM>-<NUM> for the opposite arm. When it is determined that both arms have been tested (i.e., "Yes" at operation <NUM>), the stroke scale system <NUM> proceeds to the next stroke scale examination at operation <NUM>. As an example, the next stroke scale examination is the leg physical exam <NUM>.

<FIG> schematically illustrates details of a leg physical exam <NUM>. As shown in <FIG>, the leg physical exam <NUM> includes an operation <NUM> of instructing the patient P to move their left or right leg into a position for a predetermined period of time. For example, the patient P can be instructed to lift their left or right leg <NUM> degrees while they are supine on the patient support apparatus <NUM>, and to maintain the position for <NUM> seconds.

The stroke scale system <NUM> provides the instructions by an audio output, or displayed message, or both. As an illustrative example, the stroke scale system <NUM> generates an audio output from the audio unit <NUM> to instruct the patient P to move their left or right leg into the correct position, and an image of the correct position can be displayed on the display unit <NUM> for visual reference. Additionally, the stroke scale system <NUM> can display a countdown clock on the display unit <NUM> to inform the patient P for how much longer they are required to maintain the position. Alternatively, or in addition to the countdown clock displayed on the display unit <NUM>, the audio unit <NUM> can audibly countdown the time remaining.

Next, the leg physical exam <NUM> includes an operation <NUM> of detecting whether the patient P is able to move their leg to the correct position, and thereafter keep the leg in the correct position for a predetermined period of time (e.g., <NUM> seconds). The stroke scale system <NUM> uses a motion detector <NUM>, such as the body tracker <NUM> that uses radar or captured image technology, to detect the position and movement of the patient P's leg.

Next, the leg physical exam <NUM> includes an operation <NUM> of processing and storing the position and movement of the patient P's leg. For example, images of the patient P's leg (e.g., captured by a camera) or data identifying the position and movement of the leg (e.g., determined by a radar system) are processed stored by the stroke scale system <NUM>. In some examples, the stroke scale system <NUM> calculates a leg physical exam score at operation <NUM>. Alternatively, the leg physical exam score can be calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., at operation <NUM>).

A leg physical exam score of <NUM> is assigned when no drift is detected such as when the leg holds at <NUM> degrees for the full <NUM> seconds. A leg physical exam score of <NUM> is assigned when minor drift is detected such as when the leg falls before the full <NUM> seconds, but does not hit the bed. A leg physical exam score of <NUM> is assigned when it is detected that the leg falls to the bed before the <NUM> seconds, but exhibits some effort against gravity. A leg physical exam score of <NUM> is assigned when the leg immediately falls to the bed and there is no effort against gravity. A leg physical exam score of <NUM> is assigned when no leg movement is detected.

The leg physical exam <NUM> includes an operation <NUM> of determining whether both legs of the patient P have been examined. When it is determined that both legs have not been examined (i.e., "No" at operation <NUM>), the leg physical exam <NUM> repeats operations <NUM>-<NUM> for the opposite leg. When it is determined that both legs have been tested (i.e., "Yes" at operation <NUM>), the stroke scale system <NUM> proceeds to the next stroke scale examination at operation <NUM>. As an example, the next stroke scale examination is the limb ataxia exam <NUM>.

<FIG> schematically illustrates details of the limb ataxia exam <NUM>. Limb ataxia is the inability to make smooth, coordinated movements of an arm or a leg, such as when a patient tries to touch their nose with their index finger or when the patient tries to run their right or left heel straight down the opposite shin. The limb ataxia exam <NUM> includes an operation <NUM> of instructing the patient P to perform a first ataxia task. In certain examples, the first ataxia task is a finger-nose-finger test that requires the patient P to extend the index finger of their right or left hand, touch their nose with the same index finger, and then touch the index finger of the opposite hand with the same index finger.

The stroke scale system <NUM> provides the instructions by an audio output, or displayed message, or both. As an illustrative example, the stroke scale system can generate an audio output from the audio unit <NUM> to instruct the patient P to extend the index finger of their right or left hand, touch their nose with the same index finger, and then touch the index finger of the opposite hand with the same index finger. A video of the first ataxia task can be displayed on the display unit <NUM> for visual reference.

Next, the limb ataxia exam <NUM> includes an operation <NUM> of recording and processing the patient P's performance of the first ataxia task. In certain examples, the stroke scale system <NUM> uses a body tracker <NUM> that uses radar technology to objectively measure the patient P's performance of the first ataxia task. Alternatively, or in addition to using radar technology, a video of the patient P's performance of the first ataxia task can be recorded.

Next, the limb ataxia exam <NUM> includes an operation <NUM> of determining whether the first ataxia task has been performed for both sides of the patient P's body. When it is determined that both sides have not been examined (i.e., "No" at operation <NUM>), the limb ataxia exam <NUM> repeats operations <NUM> and <NUM> for the opposite side of the patient's body. When the first ataxia task is the finger-nose-finger test, the limb ataxia exam <NUM> instructs the patient P to use the index finger of the opposite hand to perform the finger-nose-finger test.

When it is determined that both sides have been tested (i.e., "Yes" at operation <NUM>), the stroke scale system <NUM> proceeds to operation <NUM> which includes instructing the patient P to perform a second ataxia task. In certain examples, the second ataxia task is a heel-shin test that requires the patient P to run their right or left heel straight down the shin of the opposite leg. While the first ataxia task is described as the finger-nose-finger test and the second ataxia task is described as the heel-shin test, it is possible for the order of the ataxia tasks to be reversed such that in certain examples, the first ataxia task is the heel-shin test and the second ataxia task is the finger-nose-finger test.

The limb ataxia exam <NUM> includes an operation <NUM> of recording and processing the patient P's performance of the second ataxia task. In certain examples, the stroke scale system <NUM> uses a body tracker <NUM> that uses radar technology to objectively measure the patient P's performance of the second ataxia task. Alternatively, or in addition to using radar technology, a video of the patient P's performance of the second ataxia task can be recorded.

Next, the limb ataxia exam <NUM> includes an operation <NUM> of determining whether the second ataxia task has been performed for both sides of the patient P's body. When it is determined that both sides have not been examined (i.e., "No" at operation <NUM>), the limb ataxia exam <NUM> repeats operations <NUM> and <NUM> for the opposite side of the patient's body. For example, in examples where the second ataxia task is the heel-shin test, the limb ataxia exam <NUM> instructs the patient P to use the heel of the opposite foot to perform the heel-shin test. When it is determined that both sides have been tested (i.e., "Yes" at operation <NUM>), the stroke scale system <NUM> proceeds to the next stroke scale examination at operation <NUM>. As an illustrative example, the next stroke scale examination is the sensory stimulus exam <NUM>.

In some examples, the stroke scale system <NUM> calculates a limb ataxia score before proceeding to operation <NUM> and performing the next stroke scale examination. Alternatively, the limb ataxia score can be calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., at operation <NUM>).

A limb ataxia score of <NUM> is given when no ataxia is detected. A limb ataxia score of <NUM> is given when ataxia is detected in one limb. A limb ataxia score of <NUM> is given when ataxia is detected in both limbs. A limb ataxia score is not given for an amputated limb.

<FIG> schematically illustrates details of the sensory stimulus exam <NUM>. At operation <NUM>, the sensory stimulus exam <NUM> includes announcing the start of the sensory stimulus exam so that the patient P is prepared and is not startled by the stimuli that are provided during the exam. The stroke scale system <NUM> can announce the start of the sensory stimulus exam by an audio output, or displayed text, or both.

Next, the sensory stimulus exam <NUM> includes an operation <NUM> of projecting a probe to provide a sensory stimulus that can be felt by the patient P such as by gently poking or prodding the patent P without harming the patient P. As described above, one or more probes <NUM> are embedded in a portion of the patient support apparatus <NUM> such as in a siderail of a hospital bed or an armrest of a chair. In certain examples, the probes <NUM> are stored inside cavities of a siderail <NUM>, and are controlled by the controller <NUM> to project outwardly to provide the sensory stimulus during the sensory stimulus exam <NUM>. In alternative examples, the probes <NUM> can be embedded in a device that is separate from the patient support apparatus <NUM>, and that may or may not attach to the patient support apparatus <NUM>.

The sensory stimulus exam <NUM> includes an operation <NUM> of detecting a response from the patient P to the sensory stimulus. For example, a motion detector <NUM>, such as the body tracker <NUM> that uses radar or captured image technology, is used by the stroke scale system <NUM> to detect a facial expression such as a grimace that is generated by the patient P in response to the sensory stimulus. Alternatively, or in addition to using the body tracker <NUM>, the stroke scale system <NUM> can provide an audio output or visual message that requests the patient P to confirm whether they felt the sensory stimulus. Thereafter, the patient P can provide an audible answer detectible by the microphone <NUM>, or the patient P can enter an answer through the display unit <NUM> in examples where the display unit <NUM> is a touchscreen.

Next, the sensory stimulus exam <NUM> includes an operation <NUM> of processing and storing the patient P's response to the sensory stimulus. In some examples, operations <NUM> and <NUM> are repeated for multiple probes that each provide a different type or intensity of stimulus. For example, operations <NUM> and <NUM> can be performed for each of the probes 132a-132c depicted in <FIG> such that the sensory stimulus exam <NUM> provides different types of sensory stimuli, and records the patient P's responses to each type of stimuli. Additionally, operations <NUM> and <NUM> can be repeated for stimuli that are provided to different portions of the patient P's body such as the arms, legs, torso, and the like, and for different sides of the patient P's body such as the right side and the left side of the body.

In some examples, the stroke scale system <NUM> calculates a sensory score at operation <NUM> based on the detection of patient P's responses to the sensory stimuli. Alternatively, the sensory score is calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., at operation <NUM>).

A sensory score of <NUM> is assigned when no sensory loss is detected. A sensory score of <NUM> is assigned when there is moderate sensory loss such as when the patient P feels the sensory stimuli, but the feeling is less sharp or is duller than what should ordinarily be felt by normal patients. A sensory score of <NUM> is assigned when the patient P cannot sense being touched at all.

<FIG> schematically illustrates details of the comprehension exam <NUM>. The comprehension exam <NUM> is performed to detect aphasia which is a disorder that affects a person's ability to express and understand written and spoken language. Aphasia can occur suddenly after a stroke or head injury, or develop slowly from a growing brain tumor.

At operation <NUM>, the comprehension exam <NUM> includes instructing the patient P to view the display unit <NUM>. The stroke scale system <NUM> can provide the instructions at operation <NUM> by an audio output, or displayed text, or both.

Next, the comprehension exam <NUM> includes an operation <NUM> of displaying an image or video on the display unit <NUM>. As an illustrative example, <FIG> shows an image 21a, a naming sheet 21b, and a list of sentences 21c that can be displayed on the display unit <NUM> during operation <NUM> of the comprehension exam <NUM>.

Thereafter, the comprehension exam <NUM> includes an operation <NUM> of instructing the patient P to describe the images and videos displayed on the display unit <NUM>. For example, operation <NUM> can include asking the patient P to verbally describe what is happening in the image 21a, to name items in the naming sheet 21b, and/or to read from the list of sentences 21c displayed on the display unit <NUM>. When the patient P is blind, operations <NUM> and <NUM> can include generating audio outputs, and instructing the patient P to repeat the audio outputs.

Next, the comprehension exam <NUM> includes an operation <NUM> of processing and storing the response from the patient P. For example, the responses from the patient P can be recorded using the microphone <NUM> of the audio unit <NUM>. When the patient P is intubated, the patient P can be asked to enter their responses using the touch input <NUM> of the display unit <NUM>.

In some examples, the stroke scale system <NUM> calculates a comprehension score at operation <NUM> based on the recorded responses from the patient P. Alternatively, the comprehension score is calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., at operation <NUM>).

A comprehension score of <NUM> is assigned when no aphasia is detected by the stroke scale system <NUM>. A comprehension score of <NUM> is assigned when moderate aphasia is detected such as when the patient P exhibits some loss of comprehension without significant limitation such that the image 21a, items in the naming sheet 21b, and/or to the list of sentences 21c can be identified from the patient P's responses. A comprehension score of <NUM> is assigned when severe aphasia is detected such as when all communication is through fragmentary expression, and the image 21a, items in the naming sheet 21b, and/or to the list of sentences 21c cannot be identified from the patient P's responses. A comprehension score of <NUM> is assigned when global aphasia is detected such that no comprehension is identified from the patient P's recorded responses.

<FIG> schematically illustrates details of a dysarthria exam <NUM>. The dysarthria exam <NUM> is performed to detect dysarthria which is a motor speech disorder in which the muscles that are used to produce speech are damaged, paralyzed, or weakened. The person with dysarthria cannot control his or her tongue, larynx, vocal cords, and surrounding muscles, which makes it difficult for the person to form and pronounce words. Weakness in the muscles used for speech can cause the patient P to have slowed or slurred speech.

The dysarthria exam <NUM> includes operation <NUM> of instructing the patient P to view the display unit <NUM>. The stroke scale system <NUM> can provide the instructions at operation <NUM> by generating an audio output, or displayed text, or both.

Next, the dysarthria exam <NUM> includes an operation <NUM> of displaying words on the display unit <NUM>. As an illustrative example, <FIG> shows words <NUM> that can be displayed on the display unit <NUM> during operation <NUM> of the dysarthria exam <NUM>.

Thereafter, the dysarthria exam <NUM> includes an operation <NUM> of instructing the patient P to verbally read the words <NUM> displayed on the display unit <NUM>. When the patient P is blind, operations <NUM> and <NUM> can include generating audio outputs, and instructing the patient P to verbally repeat the audio outputs such that the speech of the patient P can be obtained.

Next, the dysarthria exam <NUM> includes an operation <NUM> of processing and storing the response from the patient P. For example, the responses from the patient P can be recorded using the microphone <NUM> of the audio unit <NUM>. In some examples, the stroke scale system <NUM> calculates a dysarthria score at operation <NUM> based on the recorded responses from the patient P. Alternatively, the dysarthria score is calculated by the stroke scale system <NUM> or server <NUM> after completion of the stroke scale examinations <NUM>-<NUM> (i.e., at operation <NUM>).

A dysarthria score of <NUM> is assigned when no dysarthria is detected such that the patient P's speech is normal. A dysarthria score of <NUM> is assigned when moderate dysarthria is detected such as when the patient P slurs at least some of the words <NUM>, and can be understood with some difficulty. A dysarthria score of <NUM> is assigned when severe dysarthria is detected such as when the patient P's speech is so slurred it is unintelligible.

<FIG> illustrates an exemplary architecture of a computing device <NUM> which can be used to implement aspects of the present disclosure, such as the functions of the stroke scale system <NUM> described above. The computing device <NUM> includes a processing unit <NUM>, a system memory <NUM>, and a system bus <NUM> that couples the system memory <NUM> to the processing unit <NUM>. The processing unit <NUM> is an example of a processing device such as a central processing unit (CPU). The system memory <NUM> includes a random-access memory ("RAM") <NUM> and a read-only memory ("ROM") <NUM>. A basic input/output logic containing the basic routines that help to transfer information between elements within the computing device <NUM>, such as during startup, is stored in the ROM <NUM>.

The computing device <NUM> can also include a mass storage device <NUM> that is able to store software instructions and data. The mass storage device <NUM> is connected to the processing unit <NUM> through the system bus <NUM>. The mass storage device <NUM> and its associated computer-readable data storage media provide non-volatile, non-transitory storage for the computing device <NUM>.

Although the description of computer-readable data storage media contained herein refers to a mass storage device, it should be appreciated by those skilled in the art that computer-readable data storage media can be any available non-transitory, physical device or article of manufacture from which the device can read data and/or instructions. The mass storage device <NUM> is an example of a computer-readable storage device.

Computer-readable data storage media include volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer-readable software instructions, data structures, program modules or other data. Example types of computer-readable data storage media include, but are not limited to, RAM, ROM, EPROM, EEPROM, flash memory or other solid-state memory technology, or any other medium which can be used to store information.

The computing device <NUM> may operate in a networked environment using logical connections to remote network devices through the network <NUM>, such as a local network, the Internet, or another type of network. The device connects to the network <NUM> through a network interface unit <NUM> connected to the system bus <NUM>. The network interface unit <NUM> may also connect to other types of networks and remote computing systems.

The computing device <NUM> can also include an input/output controller <NUM> for receiving and processing input from a number of input devices. Similarly, the input/output controller <NUM> may provide output to a number of output devices.

The mass storage device <NUM> and the RAM <NUM> can store software instructions and data. The software instructions can include an operating system <NUM> suitable for controlling the operation of the device. The mass storage device <NUM> and/or the RAM <NUM> also store software instructions <NUM>, that when executed by the processing unit <NUM>, cause the device to provide the functionality of the stroke scale system <NUM> discussed in this document. For example, the mass storage device <NUM> and/or the RAM <NUM> can store software instructions that, when executed by the processing unit <NUM>, cause the stroke scale system <NUM> to perform the method <NUM> for determining a stroke scale score for the patient P.

Claim 1:
A stroke scale system (<NUM>), comprising:
a patient support apparatus (<NUM>) having one or more pressure sensors (<NUM>) that can be grasped by a patient while the patient is supported on the patient support apparatus (<NUM>);
one or more motion detectors (<NUM>) that detect movements of the patient;
a display unit (<NUM>) positioned relative to the patient support apparatus (<NUM>) to be viewable by the patient while the patient is supported on the patient support apparatus (<NUM>);
an audio unit (<NUM>) having one or more speakers (<NUM>) and a microphone (<NUM>); and
a controller (<NUM>) having at least one processor, and a memory storing instructions which, when executed by the at least one processor, cause the system to:
perform a series of stroke scale examinations by using the display unit (<NUM>) or the audio unit (<NUM>) to provide instructions to the patient, and using the one or more motion detectors (<NUM>) and microphone (<NUM>) to determine compliance with the instructions, wherein at least one stroke scale examination instructs the patient to grasp a portion of the patient support apparatus (<NUM>), and the pressure sensors (<NUM>) determine compliance with the instructions by measuring an applied pressure to the portion of the patient support apparatus (<NUM>); and
characterized in that
the portion of the patient support apparatus (<NUM>) further includes one or more probes (<NUM>) stored inside respective cavities in a siderail (<NUM>) of the patient support apparatus (<NUM>) adjacent to the one or more pressure sensors (<NUM>),
and wherein another stroke scale examination includes:
projecting the one or more probes (<NUM>) outwardly from the siderail to provide a sensory stimulus,
detecting the patient's response to the sensory stimulus,
returning the one or more probes to inside their respective cavities so that they do not disturb the patient, and
calculate a stroke scale score by combining scores determined from the series of stroke scale examinations.