EP2675522A2 - Dispositif et procédé pour réduire les douleurs - Google Patents
Dispositif et procédé pour réduire les douleursInfo
- Publication number
- EP2675522A2 EP2675522A2 EP12714940.9A EP12714940A EP2675522A2 EP 2675522 A2 EP2675522 A2 EP 2675522A2 EP 12714940 A EP12714940 A EP 12714940A EP 2675522 A2 EP2675522 A2 EP 2675522A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- electrode assembly
- electrode
- electrodes
- anodes
- pain
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
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Classifications
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/132—Tourniquets
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- A61B5/150106—Means for reducing pain or discomfort applied before puncturing; desensitising the skin at the location where body is to be pierced
- A61B5/150137—Means for reducing pain or discomfort applied before puncturing; desensitising the skin at the location where body is to be pierced by vibration
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
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- A61N1/0404—Electrodes for external use
- A61N1/0408—Use-related aspects
- A61N1/0456—Specially adapted for transcutaneous electrical nerve stimulation [TENS]
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- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
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- A61H2230/00—Measuring physical parameters of the user
- A61H2230/65—Impedance, e.g. skin conductivity; capacitance, e.g. galvanic skin response [GSR]
- A61H2230/655—Impedance, e.g. skin conductivity; capacitance, e.g. galvanic skin response [GSR] used as a control parameter for the apparatus
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- A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive
- A61H23/0254—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with rotary motor
- A61H23/0263—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with rotary motor using rotating unbalanced masses
Definitions
- the device according to the invention comprises a stowage means which is adapted to be attached to the body part and which can reduce the flow of liquid when it is attached to the human or animal body part.
- the invention can be implemented particularly easily with the interference tubes known from practice, which interact with at least two electrodes and a current source connected to the electrodes in order to implement the invention.
- the stowage agent is primarily intended to reduce the venous blood flow.
- the accumulation means according to the invention should be suitable for being attached to the body part.
- the stowage means should be attached to the body part in such a way that it does not have to be held by the operator, ie, it can hold it independently on the body part.
- the electrodes are connected via electrical conductors to a control unit, by means of which the electrodes can be controlled.
- electrical conductors can be used for this purpose, which are connected to the electrodes via plug-in contacts, for example, as is known in the prior art.
- plug-in contacts for example, as is known in the prior art.
- control of the electrodes known from the prior art embodiments for TENS devices can be used, such as those known from US 5,350,414.
- the invention proposes an electrode arrangement, in particular for use in the abovementioned device.
- the two aforementioned electrodes in the storage means may be part of the electrode assembly.
- One surface of the electrodes is designed to rest on the skin, and several anodes are provided. In this way, a simply constructed and flexibly controllable electrode arrangement can be created. Due to the flexible controllability of the electrode arrangement, the possibility of a wide range of applications for pain reduction and / or pain suppression is given.
- the electrode assemblies described herein may be used in the storage means adapted to be attached to the body part and which may reduce the flow of liquid when attached to the body part.
- the plurality of anodes may be configured as concentric anode rings around a central cathode. By this arrangement, a flexible loading of the anodes is possible. It is envisaged that at least one anode ring is driven, wherein also optionally two or more rings can be controlled.
- a plurality of anodes and a plurality of cathodes may be provided for a planar configuration of the electrode arrangement.
- the anodes and cathodes may be arranged in the form of an electrode array.
- the anodes and cathodes can be arranged in a line, which leads to a simple geometry of the arrangement of the anodes and cathodes and at the same time provides a simple way of connecting the anodes or cathodes.
- a linear arrangement is to be understood as an arrangement in a row; similar configured electrodes are strung with their centers as on a chain.
- a line-shaped arrangement also includes a wavy or zigzag-shaped arrangement.
- the anodes and cathodes may be arranged alternately transversely to the line-shaped configuration of the arrangement transversely to the line.
- a geometrically defined grid can be created with predeterminable properties with regard to the emission of the electric field into the skin. It can be provided that in the alternating arrangement transverse to the line-shaped formation of cathodes and anodes can be arranged directly opposite each other, almost grid-shaped. It can also be provided that linearly arranged cathodes and anodes are offset relative to one another, so that a cathode is located opposite a gap between two anodes. An offset arrangement may reduce unintentional short circuits and improve pain reduction and / or pain suppression.
- It may be a 40mm x 40mm matrix provided with 17 rows and 17 columns, with an alternating sequence of anode and cathode in the rows.
- the matrix size or the size of the extent of the electrode arrangement can be chosen as large or small as desired. For example, fabrics with an electrode configuration of 10cm x 10cm may significantly exceed.
- the anodes and / or the cathodes have a hemispherical surface for abutment on the skin, which in addition to a positive feeling for the skin also improves the emission of the field into the skin.
- a positive feeling for the skin also improves the emission of the field into the skin.
- cathode shapes can be varied between pointed, blunt, rounded and angular.
- the support structure can be made flexible in the direction of its surface normal.
- the electrode assembly "snuggles" as it were to the desired contour.
- the anodes and / cathodes have an adjustable or variable distance from each other. It can be provided, for example, that the electrode arrangement is designed as a displaceable grid electrode for adjusting the distances when reducing and enlarging the carrier structure surface.
- the electrode arrangement has a control unit, with which the anodes can be acted upon together with cathodes with electrical pulses.
- the control unit may be attached remotely; It can be a transmission of energy or control pulses through a wireless standard done (Bluetooth, Zigbee, etc.).
- the anodes can be separately acted upon with one or more cathodes of the control unit with elektrn pulses, which increases the flexibility and parametrization of the electrode assembly and the achievable with their pulse introduction possibilities.
- the anodes can be impulsively acted upon by a current of 1 to 15 mA, which can be regulated by the control unit.
- the pulse duration can be 100ps to 500ps.
- a pulse repetition frequency a value between 0.1 Hz to 10 Hz can be selected.
- the regulation of the current for applying the electrodes to a constant value takes into account the pulse width. As a result, a certain energy can be applied.
- the control unit may be configured as an application specific integrated circuit (ASIC) or programmable microprocessor or controller. Depending on the setting, the control unit can be charged with the electrodes. If the control unit is designed as a measuring and control unit, a control for the parameters of the application of the electrodes can be carried out in dependence on a measured or detected signal, for example the skin resistance.
- the electrode arrangement can be arranged or placed by a holding means on the animal or human.
- the holding means may be, for example, a plaster, an antistatic coated material or a bandage.
- the holding means may be configured as a holding device, in which the electrode arrangement is designed as a separable unit which has an electrical connection for connecting the electrode arrangement to a control unit located on the holding device.
- the electrode arrangement is part of the holding means, but a control unit and / or a voltage supply are not part of the holding means.
- a control unit and / or a voltage supply are not part of the holding means.
- the possibility can be created that the electrode assembly, which comes into contact with the skin according to the application, can be easily exchanged after a certain useful life.
- the possibility can be created to clean the holding device without the electrode assembly.
- the control unit and the power supply can be protected in a housing, which can be produced for example by an injection molding technique.
- the electrode assembly is, as it were, an arrangement of limited or specific useful life, which may be dependent on the number of applications on the skin and / or on the number of possible cleaning cycles of the electrode assembly.
- An electrical connection in the sense of the invention can be understood to mean any releasable connection which allows a fast and secure connection between the electrode arrangement and the control unit, preferably without a mechanical tool. Included in the term connection should be snap connections, plug connections, Velcro connections, connections by sliding and screw connections.
- the holding device and the electrode arrangement may be designed such that the holding device with the electrode arrangement when worn on the human or animal body does not constitute a movement restriction and / or restriction with regard to accessibility to the body.
- the holding device for positioning the electrode arrangement on the human or animal body may preferably have a thickness of less than 10 cm, more preferably a thickness of less than 5 cm and most preferably a thickness of less than 3 cm.
- an electrode arrangement is used for stimulating nerve fibers of a human or animal is used to suppress or reduce a chronic or acute pain, wherein the electrode assembly is brought into abutment on the skin of the human or animal and a plurality of anodes are provided in the electrode assembly.
- An embodiment of the invention is a device for inducing a permanent attenuation of the signal transmission at the synapses of nerve cells (long-term depression) on the human or animal body by means of electromechanical pain suppression (EMSS). This can reduce acute or chronic pain, as well as itching.
- EMS electromechanical pain suppression
- the mechanism can also be used as an electromechanical local anesthetic in minor surgery or wound pain.
- the nociceptive system has two types of pain fibers: ⁇ and C nerve fibers.
- the ⁇ fibers are relatively thick (about 3-5 ⁇ m) and due to the sheath by a so-called.
- Myelin sheath fast conductive (5 - 50m / s) fiber types.
- the C-fibers are thin (about 1 ⁇ m) and not myelinated. They show conduction velocities of less than 1m / s.
- ⁇ fibers terminate at the spinal cord level in the layers I and V of the posterior horn, where they form synapses with projection neurons.
- most C-fibers are interconnected with interneurons in layer II. In the layers III and IV of the rear horn end the axons of the contact and temperature sensors.
- the two populations of pain fibers produce a delay in pain sensation: the first pain, perceived in fractions of a second, is passed through the ⁇ fibers and is often stabbing or burning. Seconds later, C-fiber-mediated pain occurs, which is described as boring or dull.
- TENS Transcutaneous Electrical Nerve Stimulation
- electromedical stimulation current therapy with low frequency rectangular pulses, i. two to four Hz, or high frequency, i. 80 to 100Hz, apply.
- the TENS is used primarily for the treatment of pain and muscle stimulation.
- Via electrodes electrical impulses are transmitted to the surface of a human body or animal body. Usually, the placement of the electrodes takes place near the painful areas.
- LTP longterm potentiation
- the neurobiological pain mechanism of sensitization of central pain neurons in the dorsal horn of the spinal cord is to be regulated by electric stimulation as "counter irritation” (LTD)
- LTD is a spinal (localized in the spinal cord) learning mechanism that leads to a regulation of pain sensitivity down, ie that a previously increased sensitivity to pain, for example in the context of a gonarthrosis, again reduced This results in improved mobility, everyday workload and thus improved quality of life.
- a preferred embodiment for pain reduction or pain suppression is an electrode assembly which is vibrated via a vibration device, whereby the transmission of periodic, medium to high frequency and low amplitude vibrations is made possible on the skin surface Electrode the skin surface is mechanically stretched so that optimum vibration is achieved. This can irritate various nerve fibers (for example A ⁇ fibers), which in turn can interrupt ⁇ and C fibers in their pain propagation (modified gate control hypothesis).
- various nerve fibers for example A ⁇ fibers
- the electrode arrangement is vibrated, whereby predominantly marrow-containing mechanoafference (A ⁇ fibers) are excited.
- the term "contact with the surface” means that the electrode arrangement essentially rests on the skin of the human or the animal, but it can also be provided, in particular in the case of a wound, that the electrode arrangement for wound care is in contact with the wound, ie injured skin.
- Substantia gelatinosa in the dorsal horn of the spinal cord acts as a "gate" for in-depth nociceptive information, and A ⁇ fibers can have an inhibitory effect on the im ⁇ and C fibers in the posterior horn, modulating the substantia gelatinosa This activates the inhibitory interneurons, activating the excitatory interneurons at the substantia gelantinosa in a normal pain stimulus, and various switching mechanisms eventually produce the typical pain.
- the current necessary for the stimulation of a myelinated nerve by skin electrodes preferably has a monophasic rectangular pulse in a duration of about 0.05 to 3 ms, which can be varied.
- the pulse width is also decisive for the fiber spectrum that is excited. The shorter the pulse, the higher the amplitude must be and vice versa. In order to excite the large caliber fibers needed for pain relief, it is preferred to use a sufficient, mostly fixed pulse width, usually about 0.2 to 0.3 ms, to provide the prerequisite that the amplitude can be reduced.
- the pulse shape used is preferably a rectangular pulse.
- the pulse shape has a sinusoidal course.
- the electrode arrangement is preferably an electrode array.
- the term "electrode array” is understood to mean an arrangement of electrodes which is configured in terms of area. Several electrodes are provided in an area between about one and several square millimeters. For example, areas between 1cm x 1cm to 10cm x 10cm are possible. A square area is preferred, but rectangular areas are also covered according to the invention. It is particularly preferred that the planar arrangement of the electrodes is flexible with respect to the surface of the electrodes which comes into contact with the surface of the human or animal body, whereby the electrode assembly can be applied to the surface of a human or animal body without loss of contact.
- the arrangement of the electrodes in the electrode array is such that anodes and cathodes are arranged in a line alternately adjacent to each other in the electrode array.
- the other line of the electrode array are similar electrodes, ie anodes or cathodes, arranged side by side.
- the distance between a cathode and an adjacent anode in the range of 1, 5mm to 3.5mm, more preferably, there is a distance of 2.5mm between directly adjacent anode and cathode.
- the contact surfaces can be chosen as short as possible, so that a pulse application can be applied under the secretion film of the skin. This results in an effective stimulation of the nerve fibers running in the cutis and subcutis. Muscle stimulation is virtually eliminated due to the short current flows between the anodes and the adjacent cathodes.
- the electrodes can be configured as so-called ball grids.
- the board is preferably flexible and, together with the ball shape of the electrodes, makes it possible to achieve a particularly good skin contact.
- the balls function on the one hand as anodes and cathodes as well as the transmission of the vibration.
- a unit for changing the temperature of the ball grids or the electrode surfaces in contact with the human or animal surface is present. With the electrodes or the ball grid then heat and / or cold pulses could be applied.
- the ball grids can be designed as measuring heads of a measuring and control unit with which a skin resistance can be detected. By an automatic variation of the pulse strength, an optimal effect can thus be achieved.
- the electrode arrangement has at least one concentric electrode, which has a, preferably narrow, central cathode and surrounding the cathode larger, preferably designed annular, anode comprises. It can also be provided that the cathode is split into many small centrally arranged cathodes. It is also important here that the distance between the two electrodes to one another is not greater than 3.5 mm, in particular preferably less than 2.5 mm. It can also be provided that the anode is formed centrally and surrounds the cathode, the anode.
- the electrodes can be made flexible or solid.
- the anode and the cathode are configured annular, wherein the cathode has a diameter in the range of a few millimeters, preferably the diameter is 1 mm.
- the anode preferably has an inner diameter of about 8mm and an outer diameter of about 24mm.
- stimulation at a frequency of 0.1 to 20 Hz is possible via the electrode arrangement. This will optimize the effect of LTD.
- the device has a measuring and control unit, which allows detection of the current skin resistance or the impedance in the pacing pauses.
- the pulse emitted by the electrode arrangement can be adjusted on the basis of the detected current skin resistance or the impedance.
- the measuring and control unit thus detects the current skin resistance or the impedance and uses the detected value as a control variable for controlling the electrode arrangement. It can thus determine the secretion status of the skin and used as a control variable.
- the conductor tracks of the electrode arrangements or the electrode arrangement are designed to be flexible or have gel electrodes and / or textile electrodes.
- a gel matrix comprises the electrode arrangement which is either elastic itself or consists of elastically connected individual parts or components in which all the conductor paths are partially or completely constructed by a conductive medium (liquid, electrolyte, metallic conductor). This will construct the electrode like a gel pad or a blister pack.
- the compressible filling allows a particularly good contact with the skin.
- This can be configured, for example, by a spring mechanism, by means of which the contacts, the so-called pins, seated on a spring or spring arrangement can be pressed into a matrix.
- the electrode arrangement can also be placed on curved surfaces of a human or animal body.
- the electrode assembly is provided with a coating of a pharmacological substance class, whereby in addition to the stimulation, an additional effect, for example, for wound healing, can be achieved.
- the coating takes place in such a way that the electrodes of the electrode arrangement coming into contact with the human or animal surface are coated on the end side.
- the classes of substances may be, for example, local anesthetics, cortisone-containing substances, etc.
- the power supply of the device may be by energy harvesting.
- a device for generating energy can be provided, which is connected to the electrode arrangement.
- the primary goal in energy harvesting related to the present application is to energize the pulse generating unit to apply voltage to the electrode assembly and to effectively energize the vibrator to vibrate the electrode assembly.
- the energy required to operate the device can be obtained at least partially, for example, by exploiting the temperature difference between the skin and the environment. It is also possible that the kinetic energy is utilized, the z. B. is generated by a movement of the user.
- orthoses or support units is required for the utilization of the kinetic energy an implementation of the device in bandages, orthoses or support units is required.
- the kinetic energy for example, mechanically - similar to the winding mechanism of automatic watches - done.
- Charging can be wireless via induction.
- the device comprises an accumulator or a rechargeable battery which is charged via energy harvesting.
- the rechargeable battery may be connected to the pulse generator unit and the power supply vibration unit.
- the circuit for applying the electrode arrangement is firmly welded.
- a padding - for example in the form of a gel pad - is provided which buffers or reduces the effects of force on the circuit.
- the invention further provides a method for reducing chronic pain, acute pain such as itching, incision and / or sore pain on a human or animal body with an electrode assembly.
- a superficial stimulation of the cutis and subcutis is carried out by the electrode arrangement.
- the electrode assembly is vibrated when performing the superficial stimulation.
- the sweat secretion is preferably determined in order to control the pulses emitted by the electrode arrangement via the pulse generation unit by means of a measuring and control unit.
- energy is gained to pressurize the electrode assembly.
- the energy is obtained in such a way that a conversion unit provided adjacent to the electrode arrangement is provided, which converts mechanical or thermal energy into electrical energy.
- the electrical energy can be temporarily stored in an accumulator or a rechargeable battery.
- stimulation is triggered over a period of time greater than one minute at a frequency of 0.1 to 20 Hz.
- Fig. 1 a schematic representation of the attachment of the inventive
- Figure 2 a possible embodiment of the invention Staufittels, including a possible arrangement of the stimulation current electrodes, 3 shows a welters possible embodiment of the invention,
- FIG. 4 shows a possible arrangement of stimulation current electrodes and control unit, which is connected to the electrodes attached to the stowage means
- FIG. 5A a stowage means which has sections which can be connected by a closure, by the closing of which an electrical line provided in the stowage means can be closed between an electrode and the current source, FIG.
- Fig. 5B the stowing means according to Figure 5 (A) after attachment to the upper arm
- FIG. 6 shows a further embodiment of the device according to the invention in a schematic representation.
- FIG. 7 shows a schematic representation of a further embodiment of a
- FIG. 7 after attachment to the upper arm
- FIGS. 9 shows a schematic representation of an electrode arrangement according to the invention, which can preferably be used in a device according to one of FIGS. 1 to 8,
- FIG. 11a shows a schematic plan view of an electrode arrangement of the device according to FIG. 10, FIG.
- FIG. 11b the electrode arrangement of FIG. 11a in a schematic perspective view, FIG.
- Fig. 13 mechanical pain threshold at 1 Hz
- Fig. 14 mechanical pain threshold at 3 Hz
- Fig. 15 mechanical pain threshold at 4 Hz
- Fig. 16 pressure pain threshold (PPT);
- Fig. 17 a hedgehog electrode
- Fig. 19 test areas
- Fig. 20 Course of the pain threshold in BASELINE (day 1, 2), SHAM (day 3, 4) and EMSS (day 5, 6);
- Fig. 23 PPT results Test area 3 (lateral).
- FIG. 1 shows a schematic representation of the attachment of the device according to the invention to an arm 1 in the one also shown in FIG.
- FIG. 1 Cross-sectional view through the upper arm 1 in the plane of attachment of the stuffer means the stowage means 2 is shown in the form of a compression tube in its attachment to the upper arm 1. It can be seen that the upper arm 1 has a bone 3 and a jammed vessel 4, a vein.
- FIG. 2 The illustrated in Fig. 2 embodiment of the invention belonging to the stuffer 2 shows that the stowage means 2 connectable by a closure portions 5, 6.
- the sections 5, 6 provided in the storage means 2 not shown electrical line between an electrode not shown in detail and a power source, not shown, closed.
- the attachment of this embodiment of the device according to the invention to the upper arm 1 can be recognized.
- the plus sign and the minus sign in the sections of the closure to be connected show that an electrical line can be closed by connecting the sections.
- FIG. 3 shows a further embodiment of the device according to the invention.
- the storage means 2 is provided as a continuous sleeve with a recess for the puncture site 7 (intervention site).
- the electrical stimulation can be activated by means of a button. This type of bandage can also be used for minor surgery and pain relief in the joint.
- FIG. 4 shows a possible structure of the dam 2 to be used.
- the stowage means has two electrodes 8, 9.
- the electrodes 8, 9 are fixed in non-illustrated small pockets in the existing of flexible material buffer tube 2.
- the electrodes used have a minimum size of 40 x 40 mm and are coated with a conductive medium (self-adhesive).
- the device according to the invention has a control device (TENS device) which is connected to the electrodes 8, 9 via electrical conductors 10, 11.
- the control unit is built as small as possible and can be particularly preferably mounted in the buffer tube or on the buffer tube 2, for example in one of the sections of a closure. Such an arrangement is shown in FIG. 5A.
- the TENS control unit 12 is arranged in a position of the baffle tube 2.
- the electrodes 8, 9 are formed in a second layer of the buffer tube 2. If such a configured tourniquet tube 2 is placed around the upper arm, as shown in Figure 5B, the electrodes come into contact with the upper arm.
- the electrode 8 is arranged on the storage means 2, but the electrode 9 is formed separately from the storage means 2, namely on a plaster 13.
- the electrode 9 is connected via a line 14 with a control unit, not shown, which is formed on the storage means 2.
- FIG. 7 shows a further embodiment of the device according to the invention.
- the storage means 2 is formed as a band-shaped, elastic element.
- the band-shaped elastic element kinks in a blow to the upper arm and superimposed on the upper arm.
- Such devices are designed according to the type of device shown in US 5,738,398. In this way, a tourniquet can be attached particularly well to different sizes of upper arm.
- FIG. 8 illustrates the stuffer tube shown in FIG. 7 after attachment to the upper arm. By lateral pressure and the baffle tube 2, the baffle tube can be further compressed and so the storage capacity can be varied.
- FIG. 9 schematically shows an electrode arrangement according to the invention, which can preferably be used in a device according to one of FIGS. 1 to 8.
- an electrode assembly having electrodes 30 having a plurality of anodes and at least one cathode which may be in contact with the skin of a human or an animal.
- the electrodes 30 are arranged on or in a support structure 31, which is preferably designed allergen-free.
- the support structure 31 may also comprise silicone knobs or silicone-coated knobs.
- the support structure 31 is in mechanical connection with a mechanical applicator, which is designed in the form of a vibration motor 32.
- the vibration motor 32 is used as a vibration generator to apply vibration to the skin via the electrodes 30 and / or the nubs on the support structure 31. By the support structure 31 and with her mechanically connected further elements, the vibration can be transferred to a large area.
- a flexible outer layer 33 is provided at the rear of the vibration motor 32.
- the electrodes 30, the support structure 31, the vibration motor 32 and the outer layer 33 form a unit 37 which can be handled as a whole.
- a voltage source or energy supply 34 is provided, which can be electrically connected to the electrodes 30 and the vibration motor 32 in the form of a plug connection.
- the electrode arrangement or the electrodes 30 and / or the vibration motor 32 can be controlled via a designed as a measuring and control electronics control unit 35.
- the control unit 35 can apply pulses to the electrodes 30 of the electrode arrangement.
- the unit 37 can be inserted into a holding device 38, which is shown schematically with dashed lines, and - in the embodiment in FIGS. 1 to 8 designed as a storage means.
- the control unit 35 and the power supply 34 may be part of the holding device 38.
- the power supply 34 can be detachably connected to the holding device 38 in order to be able to replace the power supply 34 in the event of a defect, for example.
- the holding device 38 may have an (active) bandage or an (active) bandage-like configuration.
- a device according to the invention is shown schematically.
- the device is intended for use on the surface of a human body and for this purpose has an electrode arrangement 15 which can come into contact with the surface of the human body.
- the surface of the electrode assembly 15 includes ends of electrodes.
- a pulse generating unit 16 is operatively connected to the electrode assembly.
- the electrode assembly 15 can be supplied with voltage or current.
- the device has a vibration device 17 for vibrating the electrode arrangement 15.
- the vibration device 17 may be physically formed in the electrode assembly 15 or physically connected thereto.
- a means 18 for providing energy which is connected to the pulse generating unit 16 and the vibration device 17.
- the means 18 for providing energy which may be configured as a rechargeable battery, supplies the pulse generating unit 16 and the vibration device 17 with current or voltage.
- the device also has a measuring and control unit 19 with which the current skin resistance or the impedance can be determined, for example, at the electrode arrangement 15.
- the value detected by the measuring and control unit 19 can be used as a control variable, which the measuring and control unit 19 influences on the pulse generating unit 16 connected to it such that the duration of the pulses and / or depending on the size of the detected measured value the distances between the pulses are regulated or changed.
- the measuring and control unit is connected to the power supply or power supply to the means 18 for providing energy.
- FIG. 10 Also shown in FIG. 10 is a device 20 for converting thermal and / or mechanical energy into electrical energy as part of the device in an embodiment that can be used to supply the means 18 for providing energy with electrical energy.
- the dashed line between the means 18 for providing energy and the conversion device 20 is indicated that the connection can also be wireless, that is, in this case inductively.
- FIG. 11a schematically shows a plan view of the electrode arrangement 15 of the device according to FIG. 10 in a first exemplary embodiment.
- the view is such that the surface of the human or animal body that reaches the surface of the electrode assembly 15 is viewed.
- the electrode assembly 15 includes spherical electrode ends on a circuit board 24, which are configured as anodes 21 and cathodes 22.
- the board 24 is flexible.
- the arrangement of the cathodes 22 and anodes 21 is flat in the form of an electrode array in which anodes 21 and cathodes 22 alternate in a direct line in a line. In a line which extends at 90 ° to the first line similar electrodes are arranged side by side, which are electrically conductively connected to each other.
- an anode connection 25 and a cathode connection 26 are present on an extension of the circuit board 24 outside the surface of the electrode arrangement.
- the anode and cathode rows i. the lines, in which similar electrodes are arranged side by side, which are electrically connected to each other, are present in an odd number, in order to ensure a uniform current distribution.
- the number of anode and cathode rows is thus 2n + 1, where n is a natural number.
- the number of anode rows is n and the number of cathode rows is n + 1 or vice versa. If the rows of anodes and cathodes are not odd, then the last row of electrodes would have to have twice the voltage, otherwise the current between the last row and the penultimate row of electrodes would only be about half that.
- FIG. 11 b schematically illustrates the electrode arrangement 15 according to FIG. 11 a in a perspective view.
- the ends of the anodes 21 and the cathodes 22 of the electrode assembly are in the form of balls.
- a vibration motor 27 which contacts the circuit board 24 with the anodes 21 and the cathodes 22.
- the contacting of the vibration motor 27 with the circuit board 24 may be such that the longitudinal ends of the vibration motor 27 are each connected to the circuit board 24.
- FIG. 12 shows an alternative embodiment of the electrode arrangement 15 of the device according to FIG. 10.
- An annular narrow central cathode 22 is formed within an also circularly configured anode 21.
- the end surfaces of the anode 21 and the cathode 22 may come into contact with the surface of the human body.
- a receptacle 23 for the cathode 22 is arranged, which is mechanically connected to the vibration device 17 for vibration of the electrode assembly 15.
- the annular configured anode 21 has an inner Diameter of 8mm and an outer diameter of 24mm.
- the narrow central cathode 22 has a diameter of 1 mm.
- FIGS. 9 to 12 can be combined. Parameter settings for applying the electrodes - for example, pulse duration, frequency, amplitude, etc. - described with respect to an embodiment may also be used for embodiments for which they are not explicitly mentioned. Furthermore, it is possible, according to the invention, to use the electrode arrangement by means of various holding means, i. preferably by means of a (wound) plaster, an antistatic coated material (the antistatic coated material may also be designed as a dirt-repellent coating), a bandage or a band-shaped textile, etc., to be placed on the skin. The electrode arrangement may also be part of the holding device.
- the embodiments of FIGS. 9 to 12 may preferably be used in an embodiment shown in FIGS. 1 to 8.
- An electrode arrangement according to the invention may preferably have a planar arrangement of electrodes, an electrode arranged concentrically around a centrally arranged electrode or a combination. All electrode arrangements may preferably have a mass of less than 500 g, more preferably less than 100 g, particularly preferably less than 20 g.
- the electrode arrangement can be designed for contact with the skin. It can also be provided that the electrode arrangement has electrodes which penetrate or perforate the skin.
- the planar arrangement of electrodes, the electrode arranged concentrically around a centrally arranged electrode, or a combination thereof, can be designed so that the distance between an anode and a cathode adjacent to the anode is less than 3 cm, values also specified above being possible.
- Electrodes of all the aforementioned electrode arrangements can be formed on a printed circuit board that has a flexible design.
- the electrodes of the planar electrode assembly, the concentric electrode assembly and hybrid forms thereof may have a hemispherical surface for abutment with the skin. All of the aforementioned electrode arrangements can be arranged on a carrier structure.
- the electrodes formed on a circuit board, which can be designed as ball grids, can be introduced into or arranged on a carrier structure.
- the elevation of the electrodes from the support structure may be larger than the weld film on the skin.
- the support structure may comprise an electrically non-conductive material, by means of which the electrodes are insulated from the support structure.
- the support structure of planar electrode arrangement, concentric electrode assembly or combination of the two electrode assemblies may comprise a skin-facing material that is absorbent.
- the support structure may comprise layered materials.
- the support structure can be configured flexibly for all electrode arrangements.
- the spacing of the electrodes of all electrode arrangements can be adjustable.
- the electrode arrangements can be acted on by a control unit with electrical pulses.
- the control unit may be formed on the support structure or body remote.
- the electrodes of all the electrode arrangements can be acted upon in pulses, with preferably a controllable current of 1 to 15 mA being used.
- As a pulse duration a duration of 100 ps to 500 ⁇ can be used for all electrode arrangements.
- a pulse repetition frequency of 0.1 Hz to 10 Hz can be used.
- a first stimulation burst stimulation
- an accumulator or a battery can be used which provides a voltage of 9V.
- a programmable microprocessor can be provided as a control unit.
- a holding means can be provided.
- the holding means may be designed as a textile, bandage, antistatic coated material, etc.
- the control unit for the electrode assemblies fixed or detachable, be formed.
- the electrode arrangement can be permanently or detachably connected to the holding means or integrated in the holding means. All electrode arrangements can be used in particular for the reduction of the wound pain.
- All electrode arrangements can be set in vibration by means of a vibration motor.
- the electrode assembly may be mechanically connected to a vibration motor.
- a vibratory unit allows for low frequency stimulation, but also stimulates other nerve fibers (A ⁇ fibers) which enhance the already mentioned mechanism of action.
- Low-frequency stimulation causes weak activation of NMDA synapses and only leads to a slight increase in the calcium concentration intracellularly. This causes a long-term depression (LTD) via a corresponding cell mechanism.
- LTD long-term depression
- mGluR-LTD metabotropic glutamate receptor-dependent LTD
- NMDAR-LTD the so-called NMDA receptor is activated by a simultaneous transmitter release at the synapse and electrical excitation, so that calcium can flow into the cell.
- calcium also activates a number of other enzymes in LTD that regulate signal transduction at the synapse.
- Metabotropic glutamate receptors are activated, which, as so-called G proteins, trigger the release of calcium from intracellular stores via additional signaling molecules.
- Both LTD types can occur at the same synapses, but use separate mechanisms. Applicants were able to determine that the pain memory can be influenced by a long-term stimulation, for example with the aid of a bandage. The mechanisms mentioned above can lead to a reduction or normalization of pain conditions.
- the control unit can supply the vibration motor with power or voltage.
- the control unit can be designed for all electrode arrangements as a measuring and control unit, with which preferably the sweat secretion can be determined.
- the electrodes of the electrode arrangements can comprise gel electrodes or textile electrodes. At least one of the electrodes of the electrode arrangements can be provided with a coating of a pharmacology substance class. For each of the aforementioned electrode arrangements, energy can be obtained for applying the electrode arrangements.
- the local stimulation takes place with electrode arrangements according to the invention (see above) on the forearm, which are connected to a stimulation current generator.
- Testarreal right or left forearm with electrode arrangement according to the invention circular electrode with frequency 1 Hz / 5 min stimulation duration or hedgehog electrode with frequency 4 Hz / 15 min stimulation time; Intensity up to 2.5mA.
- the stimulation is randomized either as a verum or placebo with an ineffective stimulation pattern over 5 min (concentric electrode) and 15 min (hedgehog electrode). Structure of the electrodes:
- FIG. 13 to 15 illustrate the results.
- Pressure pain threshold (PPT) PPT
- the study shows that an electrode arrangement according to the invention has a significant influence on the mechanical pain threshold and the pressure pain threshold.
- a hand-held algometer (Somedic AB, Sweden) was used.
- the sample tip (1 cm 2 ) was tested at three predetermined skin points of the peripatellar region (see Figure 19).
- the pressure was applied at 30 kPa / s until the subject reported the pressure as painful.
- test series with 5 subjects showed with a stimulation duration of 5min a further increased pain threshold compared to the first test series.
- the additional vibration thus led to a further reduction in pain and pain suppression.
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- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Pain & Pain Management (AREA)
- Heart & Thoracic Surgery (AREA)
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Abstract
L'invention concerne un dispositif et un procédé pour réduire les douleurs au niveau d'une partie du corps chez l'homme ou l'animal, au moyen d'au moins deux électrodes faisant partie d'un système d'électrodes.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102011011610.9A DE102011011610B4 (de) | 2011-02-17 | 2011-02-17 | Vorrichtung zur Reduktion von Schmerzen |
DE201110120068 DE102011120068A1 (de) | 2011-12-05 | 2011-12-05 | Vorrichtung und Verfahren zum lindern akuter oder chronischer Schmerzzustände |
PCT/EP2012/000706 WO2012110248A2 (fr) | 2011-02-17 | 2012-02-17 | Dispositif et procédé pour réduire les douleurs |
Publications (1)
Publication Number | Publication Date |
---|---|
EP2675522A2 true EP2675522A2 (fr) | 2013-12-25 |
Family
ID=45976253
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP12714940.9A Withdrawn EP2675522A2 (fr) | 2011-02-17 | 2012-02-17 | Dispositif et procédé pour réduire les douleurs |
Country Status (3)
Country | Link |
---|---|
US (1) | US20150257970A1 (fr) |
EP (1) | EP2675522A2 (fr) |
WO (1) | WO2012110248A2 (fr) |
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Also Published As
Publication number | Publication date |
---|---|
WO2012110248A2 (fr) | 2012-08-23 |
US20150257970A1 (en) | 2015-09-17 |
WO2012110248A3 (fr) | 2013-01-24 |
WO2012110248A8 (fr) | 2012-12-06 |
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