WO2017221389A1

WO2017221389A1 - Electrotherapy device for domestic use

Info

Publication number: WO2017221389A1
Application number: PCT/JP2016/068736
Authority: WO
Inventors: 正悦袴田
Original assignee: 正悦袴田
Priority date: 2016-06-23
Filing date: 2016-06-23
Publication date: 2017-12-28
Also published as: JP6100985B1; JPWO2017221389A1

Abstract

The purpose of the invention is to provide an inexpensive electrotherapy device for domestic use that is effective even for patients having an organic disorder in the central nervous system. Provided is a electrotherapy device for domestic use with which it is possible to comprehensively improve various conditions, including cerebrovascular disorders, by inputting medical information to a smartphone, controlling the output signal by a microprocessor, installing electrodes on the peripheral nerves of the hand, peripheral nerves of the foot, sacral foramina, and cervical spine, and applying voltage.

Description

Home electrotherapy device

The present invention relates to a home electrotherapy device that is also preferably used as a sleep induction device.

Conventionally, an electrotherapy device is known in which electrodes are connected to various parts of a living body, and current is passed from the electrodes (see, for example, Patent Documents 1 to 4). Examples of such an electrotherapy device include a low-frequency treatment device and a high-frequency treatment device according to the frequency of the current used. In a general electrotherapy device, it is known that a strong electrical stimulation is locally applied to a nerve with a special waveform to secrete β-endorphin from the central nerve. β-endorphin is an endogenous opioid neuropeptide found in neurons of both the central and peripheral nervous system. When β-endorphin is secreted in the nervous system, it acts as an agonist at the opioid receptor, and morphine It produces an analgesic effect that is said to be 6.5 times that of. As described above, in the treatment using an electrotherapy device such as a low-frequency treatment device or a high-frequency treatment device, the generation of β-endorphin is promoted by local electrical stimulation given to the nerve, resulting in an analgesic effect. It has been known.

However, treatment using a conventional electrotherapy device has little effect on patients who have an organic disorder in the central nervous system including the brain. Examples of such patients having an organic disorder in the central nerve (particularly the brain) include patients suffering from cerebrovascular disorders such as cerebral hemorrhage and cerebral infarction. Cerebrovascular disorders are classified into cerebral hemorrhage and cerebral infarction, cerebral hemorrhage is classified into intracerebral hemorrhage and subarachnoid hemorrhage, and cerebral infarction is classified into cerebral thrombosis and cerebral embolism. Cerebrovascular disorders account for 10.3% of the Japanese cause of death and are said to be the third most common cause of death among Japanese. The number of patients in Japan is as high as 1.18 million. Risk factors for cerebrovascular disorders include arteriosclerosis, hypertension, dyslipidemia, diabetes, and smoking. Among these, diabetes, which has a tendency to damage blood vessels, is said to be a reserve group of cerebrovascular disorders and heart diseases. According to the World Health Organization (WHO), the number of adults with diabetes is high. It has been reported that it has reached 422 million people by 2014, especially in China, India, the United States, Brazil, and Indonesia, and as the number of diabetics increases, cerebrovascular disorders There is also a strong concern that the number of people with heart disease will increase dramatically.

Patients with cerebrovascular disorders often have motor disabilities as a sequelae, so it is often difficult to work, and labor income tends to decrease significantly. For these patients with physical disabilities, the state needs to guarantee their lives through the public insurance system and the disability pension system. However, the current situation is that it is difficult to maintain the public insurance system and the public pension system. In the future, if the number of people with cerebrovascular disorders increases significantly, it is assumed that financial resources for public insurance and public pensions will be compressed. There is a need to develop a treatment method that can be easily carried out at a low cost, which is not an economic burden for patients.

By the way, with the explosive increase in the number of mobile phone holders, portable communication terminals have become one of the main necessities in daily life. Here, along with the explosive increase in the distribution volume of portable communication terminals, the functions of portable communication terminals themselves have become more sophisticated and multifunctional. Now, competition for functional development of portable communication terminals is intensifying. Among such portable communication terminals, smartphones have been widely distributed in the world in recent years. In addition to telephone functions and e-mail functions, Internet browsing, music playback, video playback, information generation / recording, still images / videos It is a highly functional and multifunctional terminal that can perform various functions such as shooting, schedule management, and home appliance operation.

JP2015-231511 JP2013-202194A JP2012-040102 JP 2010-220754

Here, as described above, conventionally known electrotherapy devices have almost no effect on patients who have an organic disorder in the central nervous system. For this reason, there is a need for the development of an electrotherapy device that is effective even for patients with organic disorders in the central nervous system. In particular, a home electrotherapy device that can be easily used at home is developed. However, for patients with organic disorders in the central nervous system, the income is low, so that it is easily accessible to such low income patients. The electrotherapy device needed to be inexpensive. Therefore, the present invention has been made in view of the above problems, and an object thereof is to provide an inexpensive home electrotherapy device that is effective even for a patient having an organic disorder in the central nerve. And

The inventors of the present invention have conducted intensive research in view of the above problems. As a result, it was found that smartphones widely distributed as portable communication terminals can be used for home electrotherapy devices. In this home electrotherapeutic device, medical information is input to the smartphone, the output signal is controlled by the microprocessor, and electrodes are placed on the peripheral nerve of the hand, the peripheral nerve of the foot, the sacral foramen, and the cervical vertebrae. As a result, it was found that various diseases including cerebrovascular disorders can be comprehensively improved, and the present invention has been completed.

Specifically, the present invention provides the following.

(1) A first aspect of the present invention is installed on a cervical spine, a microprocessor, a power supply control unit, an overvoltage protection unit, a smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit. An electrode, a part of the palm through which the median nerve passes, and a hand supporter capable of fixing the electrode to a part of the back of the hand through which the radial and ulnar nerves pass; a part of the back of the foot through which the radial and tibial nerves pass; and A foot supporter capable of fixing an electrode to the inner surface of the shin through which the femoral nerve passes; a plurality of electrodes disposed on the hand supporter and the foot supporter; and a cable capable of connecting the electrode and the microprocessor. A home electrotherapy device, in which the smartphone is configured to output current patterns, current output intensity, energization time, energization start / The home electrotherapy device can add 0V to the cervical spine, and can add 5V or 6V, or -5V or -6V to the peripheral nerve of the hand. Yes, 5V or 6V or -5V or -6V can be added to the peripheral nerve of the foot, the peripheral nerve of the hand is the median nerve, radial nerve, ulnar nerve, and the peripheral nerve of the foot is radial nerve, tibial nerve , And femoral nerves, which can be energized to the sacral foramen, transmit the stimulation to the central nerve of the cerebrum to the peripheral nerve of the hand and the peripheral nerve of the foot, respectively, via the positive signal and the motor area of the cerebrum A negative signal that transmits a stimulus to the peripheral nerve can be added, and there are 32 types of additional patterns of the positive signal and the negative signal added by the home electrotherapeutic device. Among the above 32 types, there are 2 types of additional patterns with 5 positive signals and 1 negative signal, 2 types of additional patterns with 1 positive signal and 5 negative signals, 4 positive signals and 4 negative signals 9 additional patterns, 9 additional patterns with 2 positive signals and 4 negative signals, 10 additional patterns with 3 positive signals and 3 negative signals, and the home electrotherapy device , Right radial nerve, left radial nerve, right median nerve, left median nerve, right ulnar nerve, left ulnar nerve, right radial nerve, left radial nerve, right tibial nerve, left tibial nerve An electric therapy device for home use characterized in that electricity can be passed through each peripheral nerve and between the sacral fora and cervical vertebra in order of the right femoral nerve and the left femoral nerve.

(2) A second aspect of the present invention includes a microprocessor, a power supply control unit, an overvoltage protection unit, a smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit, and left and right ear canals. The electrode to be installed, the part of the palm through which the median nerve passes, the hand supporter that can fix the electrode to the part of the back of the hand through which the radial and ulnar nerves pass, and the part of the instep of the foot through which the radial and tibial nerves pass A foot supporter capable of fixing an electrode to the inner surface of the shin through which the femoral nerve passes, a plurality of electrodes disposed on the hand supporter and the foot supporter, and a cable capable of connecting the electrode and the microprocessor; A home electrotherapy device having a current output pattern, a current output intensity, an energization time, a Start / end timing, energization state, energization history can be controlled, and the home electrotherapy device can apply 0V to the external auditory canal and add 5V or 6V or -5V or -6V to the peripheral nerve of the hand 5V or 6V or -5V or -6V can be added to the peripheral nerve of the foot, the peripheral nerve of the hand is the median nerve, the radial nerve, the ulna nerve, and the peripheral nerve of the foot is the radial nerve, The tibial and femoral nerves are capable of energizing the sacral foramen and transmit the stimulation to the central nerve of the cerebrum to the peripheral nerves of the hand and the peripheral nerve of the foot. It is possible to add a minus signal that transmits stimulation to the peripheral nerve via the plus signal to the peripheral nerve and sacral foramen of the hand from the addition pattern of 6 plus signals at intervals of 2 to 8 ms. The number of times It is possible to add a plus signal and a minus signal while changing to an additional pattern that gradually increases the number of minus signals while gradually reducing it, and from the additional pattern of 6 minus signals to the peripheral nerve of the foot, 2 ms to 8 ms It is possible to add a plus signal and a minus signal while changing to an additional pattern that gradually increases the number of plus signals while gradually reducing the number of minus signals at an interval of milliseconds. Radial nerve, right radial nerve, left radial nerve, left radial nerve, right median nerve, right femoral nerve, left median nerve, left femoral nerve, right ulnar nerve, right tibial nerve, left The home electrotherapy device is characterized in that it can be energized between the peripheral nerve and the sacral foramen and cervical vertebra in the order of the ulnar nerve of the left and the left tibial nerve.

(3) According to a third aspect of the present invention, a microprocessor, a power supply control unit, an overvoltage protection unit, a smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit, and a median nerve pass A hand supporter capable of fixing an electrode to a part of the palm to be touched and a part of the back of the hand through which the radial nerve and the ulnar nerve pass, a part of the back of the foot through which the radial nerve and the tibial nerve pass, and a shin through which the femoral nerve passes A home electrotherapy device comprising a foot supporter capable of fixing an electrode on an inner surface, a plurality of electrodes disposed on a hand supporter and a foot supporter, and a cable capable of connecting the electrode and the microprocessor. The smart phone has a current output pattern, current output intensity, energization time, energization start / end timing, energization The home electrotherapy device can add 5V or 6V or -5V or -6V to the peripheral nerve of the hand, and 5V or 6V or -5V to the peripheral nerve of the foot. -6V can be added, the peripheral nerve of the hand is the median nerve, radial nerve, ulnar nerve, the peripheral nerve of the foot is the radial nerve, the tibial nerve, and the femoral nerve, and the sacral foramen can be energized The peripheral nerve of the hand and the peripheral nerve of the foot can each be added with a positive signal that conveys stimulation to the central posterior cerebral gyrus, and a negative signal that conveys stimulation to the peripheral nerve via the cerebral motor cortex There are 32 types of additional patterns of positive signal and negative signal added by the home electrotherapy device, each additional pattern is composed of 6 energization stimuli, and among the 32 types, 5 times of positive signal Two additional patterns for one negative signal, two additional patterns for one positive signal and five negative signals, nine additional patterns for four positive signals and two negative signals, two positive signals and negative There are 9 additional patterns for 4 signals, 10 additional patterns for 3 positive signals and 3 negative signals, and the home electrotherapeutic device has a right radial nerve, a left radial nerve, and a right median. Nerve, left median nerve, right ulnar nerve, left ulnar nerve, right radial nerve, left radial nerve, right tibial nerve, left tibial nerve, right femoral nerve, left femoral nerve This is an electric treatment device for home use characterized in that it can be energized between the peripheral nerve and between the sacral foramen and the cervical vertebra.

(4) According to a fourth aspect of the present invention, a microprocessor, a power supply control unit, an overvoltage protection unit, a smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit, and a median nerve pass. A hand supporter capable of fixing an electrode to a part of the palm to be touched and a part of the back of the hand through which the radial nerve and the ulnar nerve pass, a part of the back of the foot through which the radial nerve and the tibial nerve pass, and a shin through which the femoral nerve passes A home electrotherapy device comprising a foot supporter capable of fixing an electrode on an inner surface, a plurality of electrodes disposed on a hand supporter and a foot supporter, and a cable capable of connecting the electrode and the microprocessor. The smart phone has a current output pattern, current output intensity, energization time, energization start / end timing, energization The home electrotherapy device can add 5V or 6V or -5V or -6V to the peripheral nerve of the hand, and 5V or 6V or -5V to the peripheral nerve of the foot. -6V can be added, the peripheral nerve of the hand is the median nerve, radial nerve, ulnar nerve, the peripheral nerve of the foot is the radial nerve, the tibial nerve, and the femoral nerve, and the sacral foramen can be energized The peripheral nerve of the hand and the peripheral nerve of the foot can each be added with a positive signal that conveys stimulation to the central posterior cerebral gyrus, and a negative signal that conveys stimulation to the peripheral nerve via the cerebral motor cortex The addition of 6 positive signals to the peripheral nerves and sacral foramen of the hand, gradually increasing the number of negative signals while gradually decreasing the number of positive signals at intervals of 2 to 8 milliseconds. pattern It is possible to add a plus signal and a minus signal while changing it, and gradually reduce the number of minus signals at intervals of 2 to 8 milliseconds from the addition pattern of 6 minus signals to the peripheral nerve of the foot. It is possible to add a plus signal and a minus signal while changing to an additional pattern that gradually increases the number of plus signals, and the home electrotherapy device includes the right radial nerve, the right radial nerve, the left radial nerve, the left Each peripheral nerve in this order: radial nerve, right median nerve, right femoral nerve, left median nerve, left femoral nerve, right ulnar nerve, right tibial nerve, left ulnar nerve, left tibial nerve This is a home-use electrotherapy device that can be energized between the sacral fora and the cervical spine.

(5) A fifth aspect of the present invention is the home electric treatment device according to any one of (1) to (4) used as a sleep induction device, wherein the home electric treatment device is a radial nerve. Can be energized at 7 Hz, the peroneal nerve can be energized at 7 Hz, the sacral canal can be energized at 4 Hz, the median nerve can be energized at 6 Hz, the femoral nerve can be energized at 6 Hz, and the ulnar nerve This is a home-use electrotherapy device that can be energized at 5 Hz and can be energized at 5 Hz to the tibial nerve.

(6) A sixth aspect of the present invention is the home electrotherapy device according to any one of (1) to (4) used as a sleep induction device, wherein the home electrotherapy device is a radial nerve. Can be energized at 7 Hz, the peroneal nerve can be energized at 7 Hz, the sacral canal can be energized at 4 Hz, the median nerve can be energized at 6 Hz, the femoral nerve can be energized at 6 Hz, and the ulnar nerve Can be energized at 5 Hz, the tibial nerve can be energized at 5 Hz, and the smartphone can notify the energization start time 3 hours before the inputted scheduled sleep time, and energization is started simultaneously with the notification. It is a home electrotherapy device.

In the present invention, a smartphone is used as a home electrotherapy device. Smartphones have the same functions as computers, but with the increase in the number of mobile phone holders, they are widely distributed worldwide, are easily available, and are inexpensive. For this reason, by using a smart phone as a home electrotherapy device, highly effective treatment using the electrotherapy device can be easily performed at home.

Furthermore, a patient suffering from cerebrovascular disorder in which flexion contracture is caused in the upper limb and extension contracture is caused in the lower limb using the home electrotherapy device according to a preferred embodiment of the present invention. When electrification is performed, the extensor muscles of the lower limbs are improved by electrification for only 15 minutes, and the lower limbs can be flexed arbitrarily. Since the upper limb is required to have a high degree of movement, although there is a tendency for the therapeutic effect to be insufficient for the flexor muscle of the upper limb at the initial stage of treatment, according to the treatment using the home electrotherapy device of the present invention, Only 15 minutes of energization effectively improved the flexion contracture of the upper limbs.

In addition, the home electrotherapy device of the present invention is used for patients suffering from Parkinson's disease, which is a progressive disease showing extrapyramidal symptoms due to a lack of dopamine in the brain and a relative increase in acetylcholine. In this case, 15-minute energization improves muscle stiffness, posture maintenance reflex disorder, and walking distance also improves. However, 40% of patients suffering from Parkinson's disease have been reported to have dementia, but if the walking distance is improved by the electrotherapeutic device of the present invention, the disadvantage of hesitation over long distances arises. There is also.

The electrotherapy device of the present invention improves the basic condition of brain function, but the effect gradually disappears in units of 24 hours. However, since it is possible to voluntarily extend the upper limbs and voluntarily flex the lower limbs, using the electrotherapy device of the present invention provides a high therapeutic effect for patients suffering from cerebrovascular disorders and the like. At the same time, it brings great hope for the cure of the disease.

It is drawing which shows the schematic block diagram of the home electrotherapy device of this invention. It is drawing which shows typically arrangement | positioning of the electrode in the home electrotherapy device of this invention. Shows the most effective site in the area of the median nerve. The hand supporter which can fix the electrode arrange | positioned to a median nerve is shown. It shows the most effective site in the area of radial nerve and ulnar nerve. The hand supporter which can fix the electrode arrange | positioned to a radial nerve and an ulnar nerve is shown. Shows the most effective site in the area of the tibial nerve. Shows the most effective site in the area of the radial nerve. Shows the most effective site in the femoral nerve region. The foot supporter which can fix the electrode arrange | positioned to a tibial nerve, a peroneal nerve, and a femoral nerve is shown. The electrode fixing position in the sacrum is shown. The relationship between the iliac bone and the sacrum and the blood transition are shown. The application pattern of the electrical stimulation to the peripheral nerve of a hand and the peripheral nerve of a leg | foot in the 1st aspect of this invention is shown. The application pattern of the electrical stimulation to the peripheral nerve of the hand in the 2nd aspect of this invention is shown. The application pattern of the electrical stimulation to the peripheral nerve of the leg | foot in the 2nd aspect of this invention is shown. It is a reference example of the electricity supply pattern in the 2nd aspect of this invention.

<Home electrotherapy device>
Hereinafter, the home electrotherapy device 100 of the present invention will be described in detail with reference to the drawings. In addition, the form for implementing the home electric treatment device 100 of the present invention shown below shows an example of the home electric treatment device 100 of the present invention, and the present invention is not limited to the embodiment shown below. It is not limited.

FIG. 1 is a schematic configuration diagram of a home electrotherapy device 100 according to the present invention. The home electrotherapy device 100 of the present invention includes a microprocessor 50, a power supply control unit 20, an overvoltage protection unit 30, a smartphone 40, an electrode 80 placed on the cervical spine, a hand supporter 801, and a foot supporter 802. And a plurality of electrodes 80 arranged on the hand supporter 801 and the foot supporter 802, and a cable 70 capable of connecting the electrode 80 and the microprocessor 50.

[smartphone]
The smartphone 40 has the same function as a general computer. When the owner of the smartphone 40 applies the smartphone 40 to the home electrotherapy device 100, the high-performance home electrotherapy device 100 can be used at low cost. Patients suffering from cerebrovascular disorders require long-term rehabilitation with a greatly reduced income, and the economic burden of rehabilitation is very large. However, in the home electrotherapy device 100 of the present invention, since the smartphone 40 is used as a member that plays a central role in the home electrotherapy device 100, the high-performance home electrotherapy device 100 is inexpensive. It can be used at a cost.

In the home electrotherapy device 100 of the present invention, the smartphone 40 is bidirectionally connected to the microprocessor 50, the power supply control unit 20, and the overvoltage protection unit 30 by a cable 70. And the smart phone 40 hold | maintains medical information, Based on this medical information, the microprocessor 50, the power supply control unit 20, and the overvoltage protection unit 30 are controlled, and an exact and safe electric treatment is implement | achieved. More specifically, the smartphone 40 stores, as medical information, a current output pattern, current output intensity, energization time, energization start / end timing, energization state, energization history, and controls this, The processor 50, the power supply control unit 20, and the overvoltage protection unit 30 are controlled to realize electrotherapy. By storing medical information in the smartphone 40 in advance and controlling the medical information, even in the case of a patient with poor medical knowledge, highly effective electrotherapy can be performed with high reproducibility.

[Microprocessor]
The microprocessor 50 has a function of individually controlling the voltage, current, frequency, and the like of the output signal under the control of the smartphone 40 based on medical information. The microprocessor 50 is connected to the signal output unit 60 by a cable 70, and the signal output unit 60 receives electricity from the ports 1 to 15 to energize each nerve under the control of the microprocessor 50. Stimulus can be output. The microprocessor 50 individually controls the voltage, current, frequency, etc. of the output signal, so that the electric therapy by the home electrotherapy device 100 of the present invention can be performed with high safety and accuracy and medical knowledge. Even in poor patients, a high therapeutic effect can be achieved. The specific configuration of the microprocessor 50 is not particularly limited, but preferably includes, for example, a central processing unit (CPU), a memory that is a storage device, and a storage medium that is a storage device. It is preferable to further have a control means for controlling the microprocessor 50 itself. The microprocessor 50 is bi-directionally connected to the smartphone 40 via a cable 70, and is also bi-directionally connected to the power supply control unit 20 and the overvoltage protection unit 30 described later via the cable 70.

[Power control unit]
The home electrotherapy device 100 of the present invention has a power supply control unit 20. The power supply control unit 20 is bi-directionally connected to the smartphone 40, the overvoltage protection unit 30, and the microprocessor 50 through a cable 70, and is controlled by the microprocessor 50 and the microprocessor 50 under the control of the smartphone 40. The current supplied to the signal output unit 60 and its voltage are controlled. Since the home electrotherapy device 100 has the power supply control unit 20, the current and voltage supplied to the microprocessor 50 and the signal output unit 60 are controlled, so that the electrotherapy is highly safe and highly accurate. Can be enforced.

[Overvoltage protection unit]
The home electrotherapy device 100 of the present invention has an overvoltage protection unit 30. The overvoltage protection unit 30 is bidirectionally connected to the smartphone 40, the power supply control unit 20, and the microprocessor 50 via a cable 70, and is controlled by the microprocessor 50 and the microprocessor 50 under the control of the smartphone 40. The signal output unit 60 has a function of preventing electrical stimulation with a voltage higher than a specified voltage from being output. For example, the overvoltage protection unit 30 has means for monitoring the electrical stimulus to be output by the microprocessor 50 and the voltage of the electrical stimulus output by the signal output unit 60, and the voltage of the output electrical stimulus has a specified voltage. When exceeding, it is preferable that the means for stopping the output of the electrical stimulation can be executed via the smartphone 40 and the power supply control unit 20 as necessary.

[electrode]
FIG. 2 is a drawing schematically showing the arrangement of the electrodes 80 in the home electrotherapy device 100 of the present invention. As described above, the signal output unit 60 is provided with the ports 1 to 15, and the plurality of electrodes 80 connected to each port are arranged. The electrode 80 can apply electrical stimulation to the median nerve, the radial nerve, and the ulnar nerve of the left and right hands, and the radial nerve, tibial nerve, and femoral nerve of the left and right feet. In addition, in the home electrotherapeutic device 100 of the present invention, an electrode 80 installed on the cervical spine as necessary (in FIG. 2, assuming electrodes for left and right external auditory canals, assuming a person with a brain disease) 80), and electrodes 80 placed on the left and right sacral nerves (sacral foramen). Details of each nerve will be described later.

Among the positions where these electrodes 80 are installed, the auricular branch of the vagus nerve which is parasympathetic is distributed in the ear canal. The vagus nerve consists of motor nerves of the sympathetic nervous system of the internal organs and organs up to the right 2/3 of the pharynx, trachea, bronchi, esophagus, heart, stomach, abdomen, liver, gallbladder, pancreas, small intestine, colon, and sensory nerves. Dominated. In addition, the recurrent nerve, which is a branch of the vagus nerve, is the palatal levator ani muscle, tubulopharyngeal muscle, stylopharyngeal muscle, palatine lingual muscle, palatopharyngeal muscle, nasopharyngeal constrictor muscle, oropharyngeal constrictor muscle, hypopharyngeal constrictor muscle Dominated. Since the vagus nerve plays a central role in the conversation function, by installing an electrode 80 in the ear canal and applying electrical stimulation to the vagus nerve, aphasia that tends to occur due to cerebrovascular disorders Can also provide effective improvements.

These electrodes 80 are connected to the microprocessor 50 through the cable 70 and, if necessary, through the signal output unit 60, and are arranged at the passage positions of the peripheral nerves.

[Peripheral nerves of limbs]
According to teamLabBody, a medical app developed under the supervision of Osaka University Motor Organ Biomaterials and Prof. Kazuomi Enomoto (Orthopedic Surgeon), Osaka University has the following description.

Regarding the median nerve of the hand, “The anterior interosseous nerve of the median nerve dominates the deep flexor flexor, the long flexor flexor, and the rectangular prorotator. The palm branches dominate the skin of the palm side 2/3 of the palm. The half-branch dominates the thumb ball, short thumb abductor, short thumb flexor, thumb allele, and first and second worm-like muscles. Regarding the ulnar nerve of the hand, “The ulnar nerve branch dominates the ulnar carpal flexor and deep finger flexor. The deep branch governs the little ball muscle, little finger allele, little finger abductor, thumb adductor, third and fourth worm-like muscles, dorsal interosseous muscle, and palmar interosseous muscle. The sensory nerves of the superficial branch, dorsal branch, and palm branch are distributed in the palm and palm skin corresponding to the inner skin of the fifth and fourth fingers. Regarding the radial nerve of the hand: “The radial nerve branch dominates the triceps, elbow, arm radius, and long flexor extensor muscles. Fukae dominates the short flexor and extensor muscles. The posterior interosseous nerve dominates the finger extensor, pinky extensor, ulnar carpal extensor, long thumb abductor, long / short thumb extensor, and index extensor.

Regarding the tibial nerve of the foot: “The muscle branch that occurs in the lower leg of the tibial nerve controls the gastrocnemius, soleus, popliteal, long flexor, long mother flexor, and posterior tibial muscles. The medial plantar nerve dominates the toe abductor muscle, the short torso flexor muscle, the first worm-like muscle, and the inner 3 to 5th skin of the plantar skin. The lateral plantar nerve controls the small ankle abductor, plantar square, interosseous, second to fourth worm-like muscles, tibial adductor, and short minor flexor. The skin at the bottom of the foot conveys the perception of the outer first to fifth heels ”. Regarding the radial nerve of the foot, “The lateral sural nerve of the total radial nerve dominates the skin outside the upper leg. The superficial peroneal nerve controls the long and short peroneal muscles. The medial / intermediate foot dorsal nerve controls most of the skin on the back of the foot. The deep peroneal nerve controls the anterior tibialis, long mother extensor, long extensor, and third gastrocnemius. The lateral branch of the deep peroneal nerve controls the short extensor and short mother extensor muscles. The inner branch of the deep peroneal nerve is distributed in the skin between the mother and the second heel ”. Regarding the femoral nerve of the foot, “The branch of the femoral nerve dominates the psoas muscle and iliac muscle. The anterior thigh skin branch is distributed on the skin on the inner side 2/3 of the front surface of the thigh and the skin on the front surface of the knee. The anterior muscle branch dominates the pubic and sewing muscles. The saphenous nerve is distributed on the skin inside the foot. The posterior limbs dominate the quadriceps (stratus thigh, lateral vastus, intermediate vastus, medial vastus).

As seen in these descriptions, the median nerve, radial nerve, and ulnar nerve of the hand, as well as the radial, tibial, and femoral nerves of the foot govern the various muscles that govern the movement of the hands and feet. Therefore, even when electrification is applied to a patient with cerebrovascular disorder who has flexion contracture in the upper limbs and extension contracture in the lower limbs, voluntary movement of the hands and feet is possible with only 15 minutes of energization. .

Based on the above, FIG. 3 shows the most effective part of the hand in the region of the median nerve, and FIG. 4 shows a hand supporter 801 that can fix the electrode 80 placed on the median nerve. FIG. 5 shows the most effective site in the radial nerve and ulnar nerve regions, and FIG. 6 shows a hand supporter 801 capable of fixing the electrode 80 arranged on the radial nerve and ulnar nerve. 7 shows the most effective site in the tibial nerve region, FIG. 8 shows the most effective site in the radial nerve region, and FIG. 9 shows the most effective region in the femoral nerve region. The typical site is shown. FIG. 10 shows a foot supporter 802 to which an electrode 80 placed on the tibial nerve, radial nerve, and femoral nerve can be fixed.

[Hand supporters, foot supporters]
As shown in FIGS. 4, 6, and 10, the home electrotherapy device 100 of the present invention includes a hand supporter 801 and a foot supporter 802 as essential members. Here, the supporter 801 of the hand can fix the electrode 80 to the part of the palm through which the median nerve passes, and the part of the back of the hand through which the radial nerve and the ulnar nerve pass, and the foot supporter 802 includes the radial nerve and The electrode 80 can be fixed to the part of the instep of the foot through which the tibial nerve passes and the inner surface of the shin through which the femoral nerve passes. Therefore, it is preferable that the hand supporter 801 can cover at least the palm, the back of the hand, and the wrist, and the foot supporter 802 can cover at least the sole, the back of the foot, the ankle, and the shin. Preferably there is. As shown in FIGS. 4, 6, and 10, the hand supporter 801 and the foot supporter 802 are respectively in the median nerve, radial nerve, and ulnar nerve, and radial nerve, tibial nerve, and femoral nerve, respectively. It is preferable that the electrode 80 can be fixed to a site where electrical stimulation is most effective.

In the home electrotherapy device 100 of the present invention, the hand supporter 801 and the foot supporter 802 are adopted, and the electrode 80 can be fixed to the most effective site in the palm, the back of the hand, the back of the foot, and the shin. Therefore, even a patient suffering from a cerebrovascular disorder who does not have medical knowledge or a caregiver thereof can place the electrode 80 at an effective site with good reproducibility. Thereby, the electrotherapy using the home electrotherapy device 100 of the present invention can be performed with high accuracy.

[Sacral nerve (sacral foramen)]
FIG. 11 shows the fixing position of the electrode 80 in the sacrum. If necessary, the electrode 80 is fixed to this portion using an electrode fixing tape, and electrotherapy is performed. A good therapeutic effect can be exerted on the sacral parasympathetic nervous system while providing a good effect. FIG. 12 shows the relationship between the iliac bone and the sacrum and the blood transition. A large amount of hematopoietic stem cells are present in the bone marrow of the iliac bone where the sacrum is located, white blood cells (neutrophils, eosinophils, basophils, lymphocytes, monocytes, macrophages), red blood cells, platelets, Produces mast cells and dendritic cells. The sacral parasympathetic nervous system controls the right third of the large intestine, the kidneys and bladder, the genitals, and the vulva.

[Applying pattern of electrical stimulation]
Neural activity and electrical stimulation are closely related. When a nerve is excited, an action potential is generated. This action potential is a transient change in membrane potential that occurs in a cell membrane in response to a stimulus. In the state where the action potential is generated, the cell membrane potential rapidly rises from −70 mV to 40 mV, and soon thereafter, the cell membrane potential returns to −70 mV. For this reason, the nerve can be artificially excited by applying electrical stimulation to the nerve. It is a great stimulus that causes an axon of the cranial nerve to expand and form a network of neurons. The action potential of the damaged part in the central nervous system can be harmful.

In the first aspect of the present invention, the home electrotherapy device 100 can add 5V or 6V or -5V or -6V to the peripheral nerve of the hand while allowing 0V to be applied to the cervical spine as needed. Yes, 5V or 6V or -5V or -6V can be applied to the peripheral nerve of the foot, the sacral foramen can be energized, and the peripheral nerve of the hand and the peripheral nerve of the foot, respectively, It is possible to add a positive signal that transmits a stimulus and a negative signal that transmits a stimulus to the peripheral nerve via the motor area of the cerebrum. Here, the center rear part is a part that receives somatosensory input from each part of the body. It is known that a positive potential may be applied to the peripheral nerve to transmit the stimulus from the peripheral nerve to the central posterior circle. In the present invention, a signal to which this positive potential is added is referred to as a positive signal. Regarding the motor area of the cerebrum, the primary motor area exercises in cooperation with supplementary motor areas. By applying a negative potential to the peripheral nerve, a signal of the central nerve can be drawn out to the peripheral nerve, and thus, stimulation can be transmitted to the peripheral nerve. In the present invention, the signal to which this negative potential is added is called a negative signal.

It should be noted that the addition of 0V electrical stimulation to the cervical spine is optional, and the electrical stimulation need not be applied to the cervical spine. FIG. 13 shows the application pattern of electrical stimulation to the peripheral nerve of the hand and the peripheral nerve of the foot in the first aspect of the present invention. In this aspect, there are 32 types of additional patterns of positive signals and negative signals added by the home electrotherapy device 100 included in the applied pattern, and each additional pattern is composed of six energization stimuli, 32 Of the types, there are 2 types of additional patterns with 5 positive signals and 1 negative signal, 2 types of additional patterns with 1 positive signal and 5 negative signals, and 9 additional patterns with 4 positive signals and 2 negative signals There are nine types of additional patterns with two plus signals and four negative signals, and ten additional patterns with three positive signals and three negative signals. The home electrotherapy device 100 includes a right radial nerve, a left radial nerve, a right median nerve, a left median nerve, a right ulnar nerve, a left ulnar nerve, a right radial nerve, a left radial nerve, and a right Electricity can be applied to each peripheral nerve and between the sacral fora and cervical vertebrae in the order of the tibial nerve, the left tibial nerve, the right femoral nerve, and the left femoral nerve.

In the second aspect of the present invention, the home electrotherapy device 100 can add 5V or 6V or -5V or -6V to the peripheral nerve of the hand while allowing 0V to the external auditory canal as necessary. Yes, 5V or 6V or -5V or -6V can be applied to the peripheral nerve of the foot, the sacral foramen can be energized, and the peripheral nerve of the hand and the peripheral nerve of the foot, respectively, It is possible to add a positive signal that transmits a stimulus and a negative signal that transmits a stimulus to the peripheral nerve via the motor area of the cerebrum. Note that the addition of 0 V electrical stimulation to the ear canal is optional, and the electrical stimulation need not be applied to the ear canal. FIG. 14 shows an application pattern of electrical stimulation to the peripheral nerve of the hand and FIG. 15 shows an application pattern of electrical stimulation to the peripheral nerve of the foot in the second embodiment of the present invention.

Specifically, there are 64 types of positive signal and negative signal additional patterns added by the home electrotherapy device 100 for the peripheral nerves of the hands and feet, and each additional pattern is composed of six energization stimuli. The As shown in FIG. 14, among 64 types related to the peripheral nerve of the hand, one additional pattern of 6 positive signals and 0 negative signal, 6 additional patterns of 5 positive signals and 1 negative signal, 14 additional patterns with 4 positive signals and 2 negative signals, 21 additional patterns with 3 positive signals and 3 negative signals, 15 additional patterns with 2 positive signals and 4 negative signals, plus signals There are six types of additional patterns of one and five negative signals, and one type of additional patterns of zero and six negative signals. Further, as shown in FIG. 15, among 64 types related to the peripheral nerve of the foot, one additional pattern of 0 plus signal and 6 minus signal is added, and 6 additional patterns of 1 plus signal and 5 minus signal are added. 15 types of additional patterns with 2 positive signals and 4 negative signals, 21 additional patterns with 3 positive signals and 3 negative signals, 14 additional patterns with 4 positive signals and 2 negative signals, There are 6 types of additional patterns with 5 positive signals and 1 negative signal, and 1 type of additional patterns with 6 positive signals and 0 negative signal.

In this embodiment, the home electrotherapy device 100 according to the present invention gradually increases the number of positive signals at intervals of 2 to 8 milliseconds from the additional pattern of 6 positive signals to the peripheral nerve and sacral foramen of the hand. It is possible to add a plus signal and a minus signal while changing to an additional pattern that gradually increases the number of negative signals while reducing the number of negative signals to the peripheral nerve of the foot. It is possible to add a plus signal and a minus signal while changing to an additional pattern in which the number of plus signals is gradually increased while the number of minus signals is gradually decreased at intervals of 8 milliseconds from the second. The home electrotherapy device 100 includes a right radial nerve, a right radial nerve, a left radial nerve, a left radial nerve, a right median nerve, a right femoral nerve, a left median nerve, a left femoral nerve, and a right Electricity can be applied to each peripheral nerve and between the sacral fora and cervical vertebrae in the order of the ulnar nerve, right tibial nerve, left ulnar nerve, and left tibial nerve (see also FIG. 16).

<Home electrotherapy device used as sleep induction device>
The home electrotherapy device 100 of the present invention is also used as a sleep induction device. Modern youth continue to receive many stimuli through vision and hearing, and they have a lot of daily exercise. As adults become active in society, work stress will increase rapidly, and even elderly people will become increasingly unhappy and anxious about the environment. With the sudden increase in daily stress, the sympathetic excitement time has increased rapidly in modern people, and even a healthy person needs a way to get good quality and ideal sleep. Yes. By using the home electrotherapy device 100 of the present invention as a sleep inducing device, sympathetic nerve excitement is suppressed and parasympathetic excitement is promoted, resulting in high quality and ideal sleep.

Here, in general, an electroencephalogram has a potential of 20 μV to 70 μV, and a δ wave that appears in high quality and deep sleep has a potential of 70 μV. Parasympathetic nerves predominate during deep sleep, and are said to be repairing cells, tissues, organs and organs. In general, sleep repeats REM sleep (REM; Rapid Eye Movement) and non-REM sleep. In REM sleep, the skeletal muscles relax and the body is in a resting state, but the brain is active and in an awake state, and the electroencephalogram is predominantly a θ wave of 4 Hz to 7 Hz. Non-REM sleep is divided from 1 stage to 4 stages, and a waveform called δ wave of 1 Hz to 4 Hz appears.

Accordingly, in consideration of such characteristics of brain waves during sleep, when the home electrotherapy device 100 is used as a sleep induction device, the home electrotherapy device 100 can energize the radial nerve at 7 Hz, The radial nerve can be energized at 7 Hz, the sacral canal can be energized at 4 Hz, the median nerve can be energized at 6 Hz, the femoral nerve can be energized at 6 Hz, and the ulnar nerve can be energized at 5 Hz. It is preferable that the tibial nerve can be energized at 5 Hz. And the smart phone 40 which is one of the big features in the home electrotherapy device 100 of the present invention is capable of setting the scheduled sleep time and the energization start time. For example, the inputted sleep scheduled time is 3 hours. The energization start time is notified before, and energization is started simultaneously with the notification. The energization start time does not necessarily have to be 3 hours before the scheduled sleep time and may be a time of 2 hours or more and 4 hours or less. Is preferred.

In the present invention, a good quality sleep is achieved by energizing between the peripheral nerve of the hand and the peripheral nerve of the foot and the cervical vertebra (the external auditory canal for patients with brain disease) and from the sacrum controlled by the parasympathetic nerve to the cervical vertebra (the external auditory canal). We also propose a sleep-inducing program that creates the preconditions to bring about

DESCRIPTION OF SYMBOLS 100 Home electrotherapy device 20 Power supply control unit 30 Overvoltage protection unit 40 Smartphone 50 Microprocessor 60 Signal output unit 70 Cable 80 Electrode 801 Hand supporter 802 Foot supporter

Claims

A microprocessor;
A power control unit;
An overvoltage protection unit;
A smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit;
Electrodes placed on the cervical spine,
A hand supporter capable of fixing electrodes to the palm part through which the median nerve passes and the back part of the hand through which the radial and ulnar nerves pass;
A foot supporter capable of fixing an electrode to a portion of the instep of the foot through which the radial nerve and the tibial nerve pass, and an inner surface of the shin through which the femoral nerve passes;
A plurality of electrodes disposed on the supporter of the hand and the supporter of the foot;
A home electrotherapy device having a cable connectable to the electrode and the microprocessor,
The smartphone can control the current output pattern, current output intensity, energization time, energization start / end timing, energization state, energization history,
The home electrotherapy device is
0V can be added to the cervical spine,
5V or 6V or -5V or -6V can be added to the peripheral nerve of the hand,
5V or 6V or -5V or -6V can be added to the peripheral nerve of the foot,
The peripheral nerve of the hand is the median nerve, radial nerve, ulnar nerve,
The peripheral nerves of the foot are the radial, tibial, and femoral nerves;
The sacral foramen can be energized,
Each of the peripheral nerves of the hand and the peripheral nerves of the foot,
A positive signal that conveys stimulation to the central part of the cerebrum,
It is possible to add a negative signal that conveys stimulation to the peripheral nerve via the motor area of the cerebrum,
There are 32 additional patterns of plus signal and minus signal added by the home electrotherapy device,
Each additional pattern consists of six energization stimuli,
Of the 32 types,
There are 2 types of additional patterns with 5 plus signals and 1 minus signal.
There are two types of additional patterns, one plus signal and five minus signals.
9 additional patterns with 4 positive signals and 2 negative signals
9 additional patterns with 2 plus signals and 4 minus signals
There are 10 additional patterns of 3 plus and 3 minus signals,
The home electrotherapy device includes a right radial nerve, a left radial nerve, a right median nerve, a left median nerve, a right ulnar nerve, a left ulnar nerve, a right radial nerve, a left radial nerve, a right A home-use electrotherapy device characterized by being capable of energizing each peripheral nerve and between the sacral fora and cervical vertebrae in the order of the tibial nerve, the left tibial nerve, the right femoral nerve, and the left femoral nerve.
A microprocessor;
A power control unit;
An overvoltage protection unit;
A smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit;
Electrodes installed in the left and right ear canals,
A hand supporter capable of fixing electrodes to the palm part through which the median nerve passes and the back part of the hand through which the radial and ulnar nerves pass;
A foot supporter capable of fixing an electrode to a portion of the instep of the foot through which the radial nerve and the tibial nerve pass, and an inner surface of the shin through which the femoral nerve passes;
A plurality of electrodes disposed on the supporter of the hand and the supporter of the foot;
A home electrotherapy device having a cable connectable to the electrode and the microprocessor,
The smartphone can control the current output pattern, current output intensity, energization time, energization start / end timing, energization state, energization history,
The home electrotherapy device is
0V can be added to the ear canal,
5V or 6V or -5V or -6V can be added to the peripheral nerve of the hand,
5V or 6V or -5V or -6V can be added to the peripheral nerve of the foot,
The peripheral nerve of the hand is the median nerve, radial nerve, ulnar nerve,
The peripheral nerves of the foot are the radial, tibial, and femoral nerves;
The sacral foramen can be energized,
Each of the peripheral nerves of the hand and the peripheral nerves of the foot,
A positive signal that conveys stimulation to the central part of the cerebrum,
It is possible to add a negative signal that conveys stimulation to the peripheral nerve via the motor area of the cerebrum,
From the additional pattern of 6 positive signals to the peripheral nerve of the hand and the sacral foramen, it is changed to the additional pattern of gradually increasing the number of negative signals while gradually decreasing the number of positive signals at intervals of 2 to 8 milliseconds. While adding, plus signal and minus signal can be added,
While changing the additional pattern of 6 negative signals from the additional pattern of 6 negative signals to the peripheral nerve of the foot, gradually changing the number of positive signals while gradually decreasing the number of negative signals at intervals of 2 to 8 milliseconds, Plus signal and minus signal can be added,
The home electrotherapy device includes a right radial nerve, a right radial nerve, a left radial nerve, a left radial nerve, a right median nerve, a right femoral nerve, a left median nerve, a left femoral nerve, a right An electric treatment device for home use characterized in that electricity can be applied to each peripheral nerve and between the sacral fora and cervical vertebrae in the order of ulnar nerve, right tibial nerve, left ulnar nerve, and left tibial nerve.
A microprocessor;
A power control unit;
An overvoltage protection unit;
A smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit;
A hand supporter capable of fixing electrodes to the palm part through which the median nerve passes and the back part of the hand through which the radial and ulnar nerves pass;
A foot supporter capable of fixing an electrode to a portion of the instep of the foot through which the radial nerve and the tibial nerve pass, and an inner surface of the shin through which the femoral nerve passes;
A plurality of electrodes disposed on the supporter of the hand and the supporter of the foot;
A home electrotherapy device having a cable connectable to the electrode and the microprocessor,
The smartphone can control the current output pattern, current output intensity, energization time, energization start / end timing, energization state, energization history,
The home electrotherapy device is
5V or 6V or -5V or -6V can be added to the peripheral nerve of the hand,
5V or 6V or -5V or -6V can be added to the peripheral nerve of the foot,
The peripheral nerve of the hand is the median nerve, radial nerve, ulnar nerve,
The peripheral nerves of the foot are the radial, tibial, and femoral nerves;
The sacral foramen can be energized,
Each of the peripheral nerves of the hand and the peripheral nerves of the foot,
A positive signal that conveys stimulation to the central part of the cerebrum,
It is possible to add a negative signal that conveys stimulation to the peripheral nerve via the motor area of the cerebrum,
There are 32 additional patterns of plus signal and minus signal added by the home electrotherapy device,
Each additional pattern consists of six energization stimuli,
Of the 32 types,
There are 2 types of additional patterns with 5 plus signals and 1 minus signal.
There are two types of additional patterns, one plus signal and five minus signals.
9 additional patterns with 4 positive signals and 2 negative signals
9 additional patterns with 2 plus signals and 4 minus signals
There are 10 additional patterns of 3 plus and 3 minus signals,
The home electrotherapy device includes a right radial nerve, a left radial nerve, a right median nerve, a left median nerve, a right ulnar nerve, a left ulnar nerve, a right radial nerve, a left radial nerve, a right A home-use electrotherapy device characterized by being capable of energizing each peripheral nerve and between the sacral fora and cervical vertebrae in the order of the tibial nerve, the left tibial nerve, the right femoral nerve, and the left femoral nerve.
A microprocessor;
A power control unit;
An overvoltage protection unit;
A smartphone that controls the microprocessor, the power supply control unit, and the overvoltage protection unit;
A hand supporter capable of fixing electrodes to the palm part through which the median nerve passes and the back part of the hand through which the radial and ulnar nerves pass;
A foot supporter capable of fixing an electrode to a portion of the instep of the foot through which the radial nerve and the tibial nerve pass, and an inner surface of the shin through which the femoral nerve passes;
A plurality of electrodes disposed on the supporter of the hand and the supporter of the foot;
A home electrotherapy device having a cable connectable to the electrode and the microprocessor,
The smartphone can control the current output pattern, current output intensity, energization time, energization start / end timing, energization state, energization history,
The home electrotherapy device is
5V or 6V or -5V or -6V can be added to the peripheral nerve of the hand,
5V or 6V or -5V or -6V can be added to the peripheral nerve of the foot,
The peripheral nerve of the hand is the median nerve, radial nerve, ulnar nerve,
The peripheral nerves of the foot are the radial, tibial, and femoral nerves;
The sacral foramen can be energized,
Each of the peripheral nerves of the hand and the peripheral nerves of the foot,
A positive signal that conveys stimulation to the central part of the cerebrum,
It is possible to add a negative signal that conveys stimulation to the peripheral nerve via the motor area of the cerebrum,
From the additional pattern of 6 positive signals to the peripheral nerve of the hand and the sacral foramen, it is changed to the additional pattern of gradually increasing the number of negative signals while gradually decreasing the number of positive signals at intervals of 2 to 8 milliseconds. While adding, plus signal and minus signal can be added,
While changing the additional pattern of 6 negative signals from the additional pattern of 6 negative signals to the peripheral nerve of the foot, gradually changing the number of positive signals while gradually decreasing the number of negative signals at intervals of 2 to 8 milliseconds, Plus signal and minus signal can be added,
The home electrotherapy device includes a right radial nerve, a right radial nerve, a left radial nerve, a left radial nerve, a right median nerve, a right femoral nerve, a left median nerve, a left femoral nerve, a right An electric treatment device for home use characterized in that electricity can be applied to each peripheral nerve and between the sacral fora and cervical vertebrae in the order of ulnar nerve, right tibial nerve, left ulnar nerve, and left tibial nerve.
The home electrotherapy device according to any one of claims 1 to 4, which is used as a sleep induction device,
The home electrotherapy device is
The radial nerve can be energized at 7 Hz,
The radial nerve can be energized at 7 Hz,
The sacral hole can be energized at 4Hz,
The median nerve can be energized at 6 Hz,
The femoral nerve can be energized at 6 Hz,
The ulnar nerve can be energized at 5 Hz,
The home electrotherapy device according to any one of claims 1 to 4, wherein the tibial nerve can be energized at 5Hz.
The home electrotherapy device according to any one of claims 1 to 4, which is used as a sleep induction device,
The home electrotherapy device is
The radial nerve can be energized at 7 Hz,
The radial nerve can be energized at 7 Hz,
The sacral hole can be energized at 4Hz,
The median nerve can be energized at 6 Hz,
The femoral nerve can be energized at 6 Hz,
The ulnar nerve can be energized at 5 Hz,
The tibial nerve can be energized at 5 Hz,
The home electrotherapy device in which the smartphone can notify the energization start time 3 hours before the inputted sleep scheduled time and starts energization simultaneously with the notification.