HRP960175A2

HRP960175A2 - Apparatus for a bio-reflexive connection by combined parametres

Info

Publication number: HRP960175A2
Application number: HR960175A
Authority: HR
Inventors: Slobodan Radumilo
Original assignee: Slobodan Radumilo
Priority date: 1996-04-16
Filing date: 1996-04-16
Publication date: 1997-12-31

Description

Predmet izuma Subject of the invention

Ovaj izum se odnosi na medicinske uređaje za trening bio-povratnom vezom. This invention relates to biofeedback training medical devices.

Stanje tehnike State of the art

Sustavi za bio-povratnu vezu dobro su poznati u struci za upotrebu prilikom detekcije razine stresa osoba i za adekvatnu stimulaciju koja utječe i mijenja protok obrazaca moždanih valova. Sustav za bio-povratnu vezu prati i obrađuje bioelektrične signale generirane u specifičnim topološkim regijama živčanog sustava te proizvodi osjetilne stimuluse ako sustav detektira prisutnost ili odsutnost neke karakteristike u obrascu valnog oblika signala. Ove karakteristike mogu korelirati sa nekim željenim stanjem živčanog sustava. Osjetilni stimulus proizveden sustavom za bio-povratnu vezu, tipično slušni ili vidni stimulus ili njihova kombinacija, primjenjuje se na osobi da bi ga osjetila u svrhu postizanja željenog stanja živčanog sustava. Odgovarajući na stimulus, osoba može biti trenirana da kontrolira obrazac valnog oblika praćenog bioelektričnog signala i tako kontrolira svoj živčani sustav. Takav sustav je ilustriran u patentu SAD br. 3,727,616 (Ross). Bio-feedback systems are well known in the art for use in detecting a person's stress level and for providing adequate stimulation that affects and alters the flow of brain wave patterns. The biofeedback system monitors and processes bioelectrical signals generated in specific topological regions of the nervous system and produces sensory stimuli if the system detects the presence or absence of some characteristic in the signal waveform pattern. These characteristics may correlate with some desired state of the nervous system. A sensory stimulus produced by a bio-feedback system, typically an auditory or visual stimulus or a combination thereof, is applied to a person to sense it in order to achieve a desired state of the nervous system. By responding to a stimulus, a person can be trained to control the waveform pattern of the monitored bioelectrical signal and thus control their nervous system. Such a system is illustrated in US Pat. No. 3,727,616 (Ross).

Uređaj i metoda prikazani u patentu SAD br. 4,553,534 (Stiegler) je posebno konstruiran šljem kojim se osobi koja ga nosi predaje programirana kombinacija svjetala, boja, riječi i glazbe. Patent SAD br. 4,315,502 (Gorges) ilustrira drugi tip uređaja za stimulaciju funkcije mozga koji se ne pouzdaje na unutarnji osobni stimulus. Uređaj stimulira i koordinira funkciju svih moždanih valova pomoću kombiniranog izvora pulzirajućeg svijetla u maski koja pokriva oči te u kojoj su izvori svijetla blizu desnog i lijevog oka osobe te pomoću slušalica koje zvuče u desno i u lijevo uho osobe. Patenti SAD br. 3,826,250 (Adams) i br. 4,640,266 (Levy) prikazuju sustave koji imaju zatvorenu komoru u kojoj osoba sjedi dok sustav daje različite stimulanse zvučnicima ili vidnim prikazima. The device and method shown in US Pat. No. 4,553,534 (Stiegler) is a specially constructed helmet that transmits a programmed combination of lights, colors, words and music to the wearer. US Patent No. 4,315,502 (Gorges) illustrates another type of brain function stimulation device that does not rely on an internal personal stimulus. The device stimulates and coordinates the function of all brain waves using a combined source of pulsating light in a mask that covers the eyes and in which the light sources are near the right and left eyes of the person and by means of headphones that sound into the right and left ear of the person. US Patent No. 3,826,250 (Adams) and no. 4,640,266 (Levy) disclose systems having a closed chamber in which a person sits while the system provides various stimuli through speakers or visual displays.

Elektromiografske (EMG) aktivnosti i mjerenja se izvode transkutanim mjerenjima preko kože tj. na koži ili površini kože, upotrebom elektroda spojenih na elektronički sustav i elektroničke sklopove te povratom bolesniku ili osobi u obliku vidnih i/ili slušnih signala za vanjsku percepciju. Transkutana elektromiografska neuromuskularna povratna veza je dokazano važno i osnovno sredstvo za postizanje i oporavak voljne kontrole mišićne akcije i koordinaciju u mnogim područjima medicine i terapije. EMG povratna veza također služi za dodatnu kvantitativnu evaluaciju efikasnosti terapije specifičnih mišića i mišićnih grupa u smislu brzine i stupnja napredovanja u terapiji. Electromyographic (EMG) activities and measurements are performed by transcutaneous measurements across the skin, i.e. on the skin or skin surface, using electrodes connected to an electronic system and electronic circuits and returning to the patient or person in the form of visual and/or auditory signals for external perception. Transcutaneous electromyographic neuromuscular feedback has been proven to be an important and essential tool for achieving and recovering voluntary control of muscle action and coordination in many areas of medicine and therapy. The EMG feedback also serves for additional quantitative evaluation of the effectiveness of the therapy of specific muscles and muscle groups in terms of speed and degree of progress in the therapy.

Nedavna istraživanja pokazuju da EMG povratna veza povoljno utječe na usmjerenu vježbu u smislu povećanja mišićne mase vježbanog dijela tijela gdje EMG povratna veza u svezi sa vježbanjem daje značajnu dobit mišićne mase od one dobivene samo vježbom. Kao primjer, bolesnici sa imobiliziranim frakturama ekstremiteta tijela pate od smanjenog protoka krvi kroz sputani ud, što često zahtjeva dugotrajnu i ponekad bolnu rehabilitaciju nakon uklanjanja sadrenog odljeva. Takvi bolesnici su kandidati za izometričko vježbanje potpomognuto EMG povratnom vezom, tako što su EMG elektrode ugrađene u sadreni odljev i namještene superficijalno na treniranom mišiću. Patent SAD br. 5,277,197 prikazuje sustav za vježbanje koji zahtjeva od korisnika stereotipnu vježbu te koji snima intenzitet vježbanja. Sustav za treniranje sadrži elektromiografski senzorski dio koji proizvodi ispravljeni i usrednjeni signal koji predstavlja signal sile mišica, gdje senzorski dio ima najmanje jednu elektrodu namještenu blizu grupe mišića čija se sila mišica prati. Sustav također sadrži kontrolni dio koji ima sat za mjerenje vremenskih intervala i dio koji daje znak korisniku da je započeo period vježbanja predodređen satom u trajanju vremenskog intervala memoriranog u kontrolnom dijelu, pri čemu korisnik na znak kontrahira i relaksira preodređenu mišićnu grupu dok se sila vježbanog mišića detektira elektromiografskim senzorom. Recent research shows that EMG feedback has a beneficial effect on targeted exercise in terms of increasing the muscle mass of the exercised body part, where EMG feedback in connection with exercise gives a significant gain in muscle mass over that obtained by exercise alone. As an example, patients with immobilized fractures of the extremities of the body suffer from reduced blood flow through the restrained limb, which often requires long-term and sometimes painful rehabilitation after removal of the cemented cast. Such patients are candidates for isometric exercise supported by EMG feedback, as EMG electrodes are embedded in a plaster cast and placed superficially on the trained muscle. US Patent No. 5,277,197 shows an exercise system that requires the user to perform a stereotyped exercise and that records the intensity of the exercise. The training system includes an electromyographic sensor portion that produces a rectified and averaged signal representing a muscle force signal, wherein the sensor portion has at least one electrode positioned near the group of muscles whose muscle force is being monitored. The system also contains a control part that has a clock for measuring time intervals and a part that signals to the user that the exercise period predetermined by the clock has begun for the duration of the time interval memorized in the control part, whereby the user contracts and relaxes the predetermined muscle group on the signal while the force of the exercised muscle detected by an electromyographic sensor.

Patent SAD br. 3,905,355 (Brudney) prikazuje opremu za obradu detektirane EMG aktivnosti tako sa se prikaže osobi na psihofiziološki značajan način u svrhu tretmana poremećaja voljnih pokreta. US Patent No. 3,905,355 (Brudney) shows equipment for processing detected EMG activity so that it is presented to a person in a psychophysiologically meaningful way for the purpose of treating voluntary movement disorders.

Patent SAD br. 3,641,993 (Gaarder) prikazuje više općenitu shemu za povratnu vezu EMG aktivnosti za pretvaranje amplitude obrađenog signala u logaritamski oblik da bi se spriječila potreba za stalnim podešavanjem raznih pojačanja što prekida terapeutski proces te zbunjuje kliničara koji može samo približno znati značenje raznih podešavanja pojačanja. US Patent No. 3,641,993 (Gaarder) shows a more general scheme for EMG activity feedback to convert the amplitude of the processed signal into a logarithmic form to prevent the need for constant adjustment of various gains which interrupts the therapeutic process and confuses the clinician who can only approximate the meaning of the various gain adjustments.

Patent SAD br. 4,241,739 prikazuje spirometrijski uređaj za poboljšanje postoperacijskog oporavka. Uređaj sadrži mjerač protoka, sredstvo za obradu te sredstvo za prikaz koje daje vidni prikaz volumena zraka za vrijeme inhalacije. Ovaj uređaj ima ograničenu korisnost jer uzima u račun nekoliko ograničenih parametara za određivanje programa respiratorne vježbe koji bolesnik mora pratiti. Parametri uključuju minimalni protok koji se mora postignuti, minimalni totalni volumen koji se mora udahnuti, vrijeme zadržavanja daha te broj koliko puta bolesnik mora udahnuti predodređeni minimalni volumen. Povratna veza bolesniku sastoji se od prikaznih prozora koji sadrže niz svijetlo-emitirajućih dioda koje prikazuju alfanumeričke znakove. Na primjer, brzina protoka zraka koji udahne bolesnik se integrira da bi se odredio volumen. Ako je volumen udahnutog zraka veći od vrijednosti koju je podesio terapeut, prikazni panel pokaže riječ "dobar". Ovakav uređaj ima nedostatak ograničene povratne veze bolesniku. Također, povratna veza nije interaktivna. Vrijednosti željenih parametara kao što su minimalna brzina protoka, minimalni ukupni udahnuti volumen, ili broj inhalacija moraju biti predodređene od strane terapeuta i programirane u različite memorijske registre. Odgovori bolesnika se tada uspoređuju sa predodređenim vrijednostima. U principu, ovaj uređaj nije neki napredak u odnosu na konvencionalni mehanički spirometar koji ima povratnu vezu takvu što udaljenost objekta raste u kalibriranoj cijevi. US Patent No. 4,241,739 discloses a spirometric device for improving postoperative recovery. The device contains a flow meter, processing means and a display means that gives a visual representation of the volume of air during inhalation. This device has limited utility because it takes into account several limited parameters to determine the respiratory exercise program that the patient must follow. The parameters include the minimum flow that must be achieved, the minimum total volume that must be inhaled, the breath holding time, and the number of times the patient must inhale the predetermined minimum volume. The feedback to the patient consists of display windows that contain a series of light-emitting diodes that display alphanumeric characters. For example, the flow rate of the air inhaled by the patient is integrated to determine the volume. If the volume of inhaled air is greater than the value set by the therapist, the display panel shows the word "good". This type of device has the disadvantage of limited feedback to the patient. Also, the backlink is not interactive. Values of desired parameters such as minimum flow rate, minimum total inhaled volume, or number of inhalations must be predetermined by the therapist and programmed into various memory registers. The patient's responses are then compared to predetermined values. In principle, this device is not an improvement over the conventional mechanical spirometer that has feedback such that the distance of the object increases in the calibrated tube.

Tipični uređaj za treniranje, kako je opisan u patentu SAD br. 3,991,304, uključuje respiratornu bio-povratnu vezu i sustav za ocjenu sposobnosti. Odnos prema treningu i ocjeni sposobnosti je u repetitivnim obrascima disanja. Svrha ovog sustava je da poveća efikasnost obrasca disanja kojim diše bolesnik da bi se povećalo napajanje kisikom i eliminacija ugljičnog dioksida u plućima. Repetitivni obrasci disanja su karakterizirani međusobno zavisnim parametrima: frekvencija disanja, tidalni volumen te odnos inspiratornog prema ekspiratornom vremenu. Sustav ima standardni vidni prikaz za trening bolesnika na kojem je nacrtan volumen udahnutog ili izdahnutog zraka na vertikalnoj osi u odnosu na vrijeme predstavljeno na horizontalnoj osi, pri čemu je frekvencija disanja podesiva od 0 do 40 ciklusa u minuti. A typical training device, as described in US Pat. No. 3,991,304, includes a respiratory bio-feedback and capability assessment system. The relationship to training and ability assessment is in repetitive breathing patterns. The purpose of this system is to increase the efficiency of the patient's breathing pattern in order to increase the supply of oxygen and the elimination of carbon dioxide in the lungs. Repetitive breathing patterns are characterized by interdependent parameters: breathing frequency, tidal volume and the ratio of inspiratory to expiratory time. The system has a standard visual display for patient training where the volume of inhaled or exhaled air is drawn on the vertical axis in relation to time represented on the horizontal axis, with the breathing frequency adjustable from 0 to 40 cycles per minute.

Izum iz patenta SAD br. 5,343,871 prikazuje metodu i aparat za upravljanje bio-povratnom vezom sa ljudskom osobom u kojima se mjerenja elektrofizioloških veličina koriste za kontrolu prezentacije osobi serija prije spremljenih audio-vizualnih sekvenci različitog nivoa jasnoće mogućih u uređaju za video spremanje sa direktnim pristupom. Sekvence su prave scene koje služe za izazivanje željenog psihološkog stanja. Kako osoba napreduje u promjeni svoga psihološkog stanja, jasnoća prezentirane slike i tona se poboljšava kao znak uspjeha. Upotrebom ovog izuma osoba razvija odnos prema scenama i može kontrolirati svoje psihološke parametre čak i kada je udaljena od aparata pamćenjem audio-vizualnih sekvenci upotrebljenih u terapiji. Izum patenta SAD br. 5,304,112 prikazuje sustav za redukciju stresa koji detektira razinu stresa osobe i prikazuje obrazac svijetla koji odražava odnos između razine stresa osobe i ciljne razine. Sustav, u isto vrijeme, daje relaksirajuće vizualne, zvučne, osjetilne, efekte okoline te druge efekte da bi pomogao osobi u smanjenju razine stresa na ciljni nivo. U jednoj izvedbi se intenzitet, tip i trajanje relaksirajućih efekata kontrolira računalnim programom u svezi sa mjerenom razinom stresa. Prikaz za razinu stresa obrascem svijetla upotrebljava laser čiji se otklon u jednoj osi kontrolira signalom razine stresa, a u drugoj osi ciljnim signalom koji predstavlja ciljnu razinu stresa. Dobiveni obrazac je složeniji kada dva signala nisu ista i postaje manje složeni geometrijski lik kako se razina stresa osobe približava cilju. The invention from US patent no. 5,343,871 discloses a method and apparatus for biofeedback control with a human subject in which measurements of electrophysiological quantities are used to control the presentation to the subject of a series of pre-stored audio-visual sequences of varying clarity levels possible in a direct access video storage device. Sequences are real scenes that serve to induce the desired psychological state. As a person progresses in changing their psychological state, the clarity of the presented image and tone improves as a sign of success. By using this invention, the person develops a relationship with the scenes and can control his psychological parameters even when he is away from the device by memorizing the audio-visual sequences used in the therapy. The invention of US patent no. 5,304,112 shows a stress reduction system that detects a person's stress level and displays a light pattern that reflects the relationship between the person's stress level and a target level. The system, at the same time, provides relaxing visual, sound, sensory, environmental and other effects to help a person reduce their stress level to a target level. In one embodiment, the intensity, type and duration of the relaxing effects are controlled by a computer program in relation to the measured stress level. The light pattern stress level display uses a laser whose deflection in one axis is controlled by the stress level signal, and in the other axis by the target signal representing the target stress level. The resulting pattern is more complex when the two signals are not the same and becomes a less complex geometric figure as the person's stress level approaches the target.

Niti jedan od opisanih sustava za bio - povratnu vezu nije pogodan za trening male djece. Nije jednostavno malome djetetu povezati slike i događaje na prikazu sa treniranim parametrom. Prikaz za malu djecu mora biti jednostavan i djeci zanimljiv te lako shvatljiv. None of the described systems for bio-feedback is suitable for training small children. It is not easy for a small child to associate the images and events on the display with the trained parameter. The presentation for small children must be simple and interesting for children and easy to understand.

Fekalna inkontinencija je u pedijatriji dobro proučena bolest koja može imati različite uzroke. Do nje dolazi zbog nekontrolirane relaksacije, odnosno nemogućnosti kontrakcije mišića sfinktera anusa. Razne dijagnostičke metode opisane su u struci u svrhu evaluacije anorektalne funkcije (T.G.Parks et al.: The Usefulness of Test in Anorectal Disease, World J. Surg. 16, 804-810,1992.). Svakako je bio-povratna veza povoljna metoda za vježbanje sfinktera i za uspješno liječenje inkontinencije. No, ova tehnika ima nekoliko neriješenih problema: Fecal incontinence is a well-studied disease in pediatrics that can have different causes. It occurs due to uncontrolled relaxation, i.e. inability to contract the muscles of the anus sphincter. Various diagnostic methods are described in the profession for the purpose of evaluating anorectal function (T.G. Parks et al.: The Usefulness of Test in Anorectal Disease, World J. Surg. 16, 804-810, 1992). Certainly, bio-feedback is a favorable method for exercising the sphincter and for successfully treating incontinence. However, this technique has several unsolved problems:

- na mjerenje rektalnog tlaka balonom jako utječe kontrakcija trbušnih mišića i posljedično povećanje tlaka u abdomenu; - the measurement of rectal pressure with a balloon is strongly influenced by the contraction of the abdominal muscles and the consequent increase in pressure in the abdomen;

- postojanje miografskog signala ne mora značiti da električnu aktivnost mišića prati mehanička aktivnost mišića tj. kontrakcija; - the existence of a myographic signal does not necessarily mean that the electrical activity of the muscle is accompanied by the mechanical activity of the muscle, i.e. contraction;

- različiti senzori za mjerenje sila kontrakcije mišića su osjetljivi na manipulaciju i proizvode signal u slučaju gibanja tijela bolesnika ili slučajnog pomicanja sonde pretvornika. - various sensors for measuring muscle contraction forces are sensitive to manipulation and produce a signal in case of patient body movement or accidental movement of the transducer probe.

Iz fiziologije je poznato da mehanička kontrakcija mišića koja proizvodi silu, slijedi električnu depolarizaciju mišića koja proizvodi miografski signal. Dakle, da bi se izbjegla lažno pozitivna detekcija kontrakcije, pouzdano i točno mjerenje kontrakcije mišića se može izvoditi samo istovremenim mjerenjem miografskog signala i sile mišića. It is known from physiology that mechanical muscle contraction that produces force is followed by electrical muscle depolarization that produces a myographic signal. So, to avoid false positive detection of contraction, reliable and accurate measurement of muscle contraction can only be performed by simultaneous measurement of myographic signal and muscle force.

Opis izuma Description of the invention

SLIKA 1 prikazuje rasvjetni ilustrirani prikaz. FIGURE 1 shows a lighting illustration.

SLIKA 2 prikazuje pneumatski stativ sa prikazom balonima. FIGURE 2 shows a pneumatic tripod with display balloons.

SLIKA 3 prikazuje cjevasti hidrofon. FIGURE 3 shows a tubular hydrophone.

SLIKA 4 prikazuje hidrofon .i prstenaste elektrode montirane na valjkasto tijelo. FIGURE 4 shows a hydrophone and ring electrodes mounted on a cylindrical body.

SLIKA 5 prikazuje pojednostavljenu blok shemu uređaja. FIGURE 5 shows a simplified block diagram of the device.

SLIKA 6 prikazuje signale sa elektroda i pretvornika. FIGURE 6 shows the signals from the electrodes and the transducer.

Slika 1 prikazuje rasvjetni ilustrirani prikaz koji se sastoji od stativa (10) na kojem je kućište (11). Na prednjoj strani kućišta nalazi se niz slika čije su ilustracije prozirne tako da se straga mogu osvijetliti te da propuštaju svjetlo. U kućištu se nalaze rasvjetne žarulje, po jedna iza svake ilustracije. Normalno, ilustracija nije jasno vidljiva, a kada je ilustracija osvijetljena, tada postaje jasno vidljiva. Postoje pregrade između žarulja koje sprječavaju osvjetljavanje susjednih ilustracija. Sasvim lijeva slika (12) koja sadrži prvu ilustraciju, osvjetljava se u slučaju minimalne kontrakcije mjerenog mišića. Ostale slike se osvjetljavaju redom kako sila kontrakcije raste, da bi se kod maksimalne snage kontrakcije osvijetlila i posljednja, sasvim desna slika rasvjetnog prikaza (13). Dakle, određenom broju upaljenih žarulja, pripisuje se određeni iznos sile kontrakcije. Prikazan je prikaz sa deset slika, odnosno deset žarulja, što znači i deset stupnjeva snage kontrakcije mišića. Rasvjeta određenog broja slika traje toliko koliko traje kontrakcija mišića određenom silom. Ako dođe do parcijalne relaksacije mišića, dakle promjene iznosa sile kontrakcije, ugasiti će se određeni broj žarulja. Dakle, prilikom treninga, kod kojeg se izvode ritmička ponavljanja kontrakcije i relaksacije, žarulje se redom pale s lijeve strane na desnu, a gase se redom sa desne strane na lijevu u ritmu ponavljanja kontrakcija. Figure 1 shows a lighting illustration consisting of a stand (10) on which the housing (11) is placed. On the front of the case there is a series of pictures, the illustrations of which are transparent so that they can be illuminated from behind and allow light to pass through. There are light bulbs in the case, one behind each illustration. Normally, the illustration is not clearly visible, and when the illustration is illuminated, then it becomes clearly visible. There are partitions between the bulbs that prevent adjacent illustrations from being illuminated. The very left image (12), which contains the first illustration, lights up in case of minimal contraction of the measured muscle. The other images are illuminated in order as the force of contraction increases, so that at the maximum force of contraction, the last, far right image of the lighting display will also be illuminated (13). So, a certain amount of contraction force is attributed to a certain number of light bulbs. A display with ten images, or ten light bulbs, is shown, which means ten levels of muscle contraction strength. Illumination of a certain number of images lasts as long as muscle contraction with a certain force lasts. If there is a partial relaxation of the muscles, i.e. a change in the amount of contraction force, a certain number of light bulbs will go out. So, during training, in which rhythmic repetitions of contraction and relaxation are performed, the light bulbs turn on from left to right, and turn off from right to left in the rhythm of repeated contractions.

Psihološki, malo dijete određenu snagu kontrakcije mišića povezuje uz pojavu osvjetljavanja određenog broja ilustracija, a pogotovo uz osvjetljavanje posljednje ilustracije u nizu osvijetljenih na desnoj strani. Dijete tako može vizualno predočiti napredak u treningu koji je povezan uz mogućnost osvjetljavanja sve većeg broja ilustracija. Ilustracije moraju biti zanimljive i razumljive djetetu određenog uzrasta. To mogu biti likovi ili prizori iz bajki, animiranih filmova i sl. Psychologically, a small child associates a certain force of muscle contraction with the appearance of the illumination of a certain number of illustrations, and especially with the illumination of the last illustration in a series of illuminated ones on the right side. The child can thus visually represent the progress in training, which is connected with the possibility of illuminating an increasing number of illustrations. The illustrations must be interesting and understandable to a child of a certain age. These can be characters or scenes from fairy tales, animated films, etc.

Moguća je izvedba u kojoj je uvijek upaljena rasvjeta samo jedne ilustracije te je stoga osvijetljena uvijek samo jedna ilustracija. Tada se ilustracije osvjetljavaju s lijeva na desno, ali se osvjetljavanjem iduće ilustracije u nizu gasi osvjetljenje posljednje ilustracije. U tom slučaju dijete povezuje snagu kontrakcije sa određenom ilustracijom, a ne određenim brojem osvijetljenih ilustracija. It is possible to perform in which the lighting of only one illustration is always on, and therefore only one illustration is always illuminated. Then the illustrations are illuminated from left to right, but when the next illustration in the sequence is illuminated, the illumination of the last illustration is turned off. In this case, the child associates the strength of the contraction with a specific illustration, and not with a specific number of illuminated illustrations.

Druga moguća izvedba prikaza iznosa sile mišića ilustrirana je na slici 2. Na stativu (20) nalazi se kućište (21) koje sadrži niz balona i pneumatski sustav za punjenje balona zrakom. Sasvim lijevi balon (22), napuhne se u slučaju minimalne kontrakcije mjerenog mišića. Ostali baloni se napuhnu redom kako sila kontrakcije raste, da bi se kod maksimalne kontrakcije napuhnuo i posljednji, sasvim desni balon (23). Dakle, određenom broju napuhnutih balona, pripisuje se određeni iznos sile kontrakcije. Prikazan je prikaz sa deset balona, što znači i deset stupnjeva snage kontrakcije mišića. Određeni broj balona je napuhnut toliko dugo, koliko traje kontrakcija mišića određenom silom. Ako dođe do parcijalne relaksacije mišića, dakle promjene iznosa sile kontrakcije, ispuhati će se određeni broj balona. Dakle, prilikom treninga, kod kojeg se izvode ritmička ponavljanja kontrakcije i relaksacije, baloni se redom napuhavaju u nizu s lijeve strane na desnu, a ispuhavaju se redom s desne strane na lijevu u ritmu ponavljanja kontrakcija. Another possible embodiment of the display of the amount of muscle force is illustrated in Figure 2. On the stand (20) there is a housing (21) that contains a series of balloons and a pneumatic system for filling the balloons with air. The very left balloon (22) is inflated in case of minimal contraction of the measured muscle. The other balloons are inflated in order as the force of the contraction increases, so that at the maximum contraction, the last, very right balloon will be inflated (23). So, a certain amount of contraction force is attributed to a certain number of inflated balloons. A display with ten balloons is shown, which means ten degrees of strength of muscle contraction. A certain number of balloons are inflated for as long as the muscle contraction with a certain force lasts. If there is a partial relaxation of the muscles, i.e. a change in the amount of contraction force, a certain number of balloons will be deflated. So, during training, in which rhythmic repetitions of contraction and relaxation are performed, the balloons are inflated in sequence from left to right, and deflated from right to left in the rhythm of repeated contractions.

Psihološki, malo dijete određenu snagu kontrakcije mišića povezuje uz pojavu određenog broja napuhnutih balona u nizu, a pogotovo uz napuhavanje posljednjeg balona u nizu na desnoj strani. Dijete tako može vizualno predočiti napredak u treningu koji je povezan uz mogućnost napuhavanja sve većeg broja balona. Pneumatski sustav (nije prikazan) sastoji se od niza elektro-pneumatskih ventila tako da je svaki balon montiran na izlaz jednog ventila. Dakle, u ilustriranom primjeru, u kućištu se nalazi deset ventila spojenih na razvodnik te na izvor komprimiranog zraka (nije prikazan) niskoga tlaka potrebnog da se balon napuhne a da ne pukne. Ilustrirani primjer koristi niz balona različite veličine (ili različitih oblika odnosno boje) tako da je krajnji lijevi balon (22) najmanji, a veličina balona raste s lijeve na desnu stranu tako da je krajnji desni balon (23) najveći. U tom slučaju dijete može snagu kontrakcije mišića povezati i sa veličinom balona. Za takvu izvedbu moguća je i takva modifikacija da uvijek samo jedan balon bude napuhnut tj. da redom napuhavanje balona uzrokuje ispuhavanje prethodnog balona. Psychologically, a small child associates a certain force of muscle contraction with the appearance of a certain number of inflated balloons in a row, and especially with the inflation of the last balloon in the row on the right side. The child can thus visually represent the progress in training, which is connected with the possibility of blowing up an increasing number of balloons. The pneumatic system (not shown) consists of a series of electro-pneumatic valves so that each balloon is mounted on the outlet of one valve. So, in the illustrated example, there are ten valves in the housing connected to the distributor and to a source of compressed air (not shown) of low pressure necessary to inflate the balloon without bursting. The illustrated example uses a series of balloons of different sizes (or different shapes or colors) so that the leftmost balloon (22) is the smallest, and the size of the balloons increases from left to right so that the rightmost balloon (23) is the largest. In this case, the child can relate the force of muscle contraction to the size of the balloon. For such a performance, such a modification is also possible that only one balloon is always inflated, i.e. that in turn, the inflation of the balloon causes the previous balloon to deflate.

Za vrijeme treninga, uvijek se dogodi da se pretvornik slučajno pomakne ili direktnim doticanjem ili dodirivanjem njegovog kabela. Tako se signal pretvornika proizvede unatoč tome što nije bilo kontrakcije mišića. To može jako zbuniti malo dijete i ugroziti uspjeh vježbanja. Nadalje, bolestan mišić proizvodi intenzivni elektromiografski signal, ali ne i dovoljnu silu kontrakcije. Zato treba uključiti neki algoritam unakrsnog ispitivanja između signala EMG-a i signala pretvornika. During training, it always happens that the transducer is accidentally moved either by touching it directly or touching its cable. Thus, the transducer signal is produced despite the absence of muscle contraction. This can be very confusing for a small child and jeopardize the success of the exercise. Furthermore, the diseased muscle produces an intense electromyographic signal, but not sufficient force of contraction. Therefore, some cross-checking algorithm between the EMG signal and the transducer signal should be included.

Slika 3 prikazuje cjevasti piezoelektrični pretvornik (30), na pr. hidrofon spomenute tvrtke AMP. Jednokanalni uređaji, kao sustav za bio - povratnu vezu, opisan na slikama 1 i 2, koriste samo jedan pretvornik. Takav pretvornik (30) je čvršće konstrukcije geometrijskog oblika šupljeg valjka debljine stjenke od oko 1 mm, koji sadrži vanjsku (31) i unutarnju (32) metaliziranu elektrodu. Figure 3 shows a tubular piezoelectric transducer (30), e.g. hydrophone of the mentioned company AMP. Single-channel devices, such as the bio-feedback system described in Figures 1 and 2, use only one transducer. Such a converter (30) is a more rigid construction of a geometric shape of a hollow cylinder with a wall thickness of about 1 mm, which contains an external (31) and an internal (32) metallized electrode.

Slika 4 prikazuje pretvornik na tijelu od plastike ili nekog drugog materijala valjkastog oblika koje može biti i drugog oblika zavisno o primjeni. Piezo pretvornik (41) montira se na tijelo (44) na potrebnu udaljenost od vrha pretvornika zavisno o anatomskoj poziciji promatranog mišića. Piezo pretvornik koristi se u funkciji pretvorbe mehaničke energije u električni naboj. Amplituda i frekvencija signala odgovara amplitudi i frekvenciji mehaničke deformacije piezoelektričnog materijala, odnosno mišićne kontrakcije. Deformacija uzrokovana mišićnom kontrakcijom uzrokuje promjene površinskog naboja tako da se javlja napon na elektrodama pretvornika. Kada je primijenjena sila suprotnoga smjera, tada je izlazni napon suprotnoga polariteta. Sila izazvana kontrakcijom i relaksacijom mišića rezultira izlaznim naponom koji je pozitivan prilikom kontrakcije a negativan prilikom relaksacije. Distalno od pretvornika nalazi se jedna prstenasta elektroda (42), a proksimalno od pretvornika nalazi se druga prstenasta elektroda (43) za registraciju elektromiografskog signala. Takav raspored omogućuje bilježenje EMG-a i sile istoga mišića. Figure 4 shows a transducer on a body made of plastic or some other material with a cylindrical shape, which can be of another shape depending on the application. The piezo transducer (41) is mounted on the body (44) at the required distance from the tip of the transducer depending on the anatomical position of the observed muscle. The piezo transducer is used in the function of converting mechanical energy into an electrical charge. The amplitude and frequency of the signal corresponds to the amplitude and frequency of the mechanical deformation of the piezoelectric material, i.e. muscle contraction. The deformation caused by muscle contraction causes surface charge changes so that a voltage appears on the electrodes of the transducer. When a force of opposite direction is applied, then the output voltage is of opposite polarity. The force caused by muscle contraction and relaxation results in an output voltage that is positive during contraction and negative during relaxation. One ring electrode (42) is located distal to the transducer, and another ring electrode (43) is located proximal to the transducer for recording the electromyographic signal. Such an arrangement makes it possible to record EMG and force of the same muscle.

Blok shema uređaja za bio - povratnu vezu prikazana je na slici 5. Signal elektroda (42; 43) dovodi se na ulaz EMG pojačala (51). Signal pretvornika (41) se vodi na piezo pojačalo (52). Piezo pojačalo (51) realizirano je kao nabojsko pojačalo. Pojačani EMG signal se vodi na sklop za obradu signala (53), a pojačani signal pretvornika se vodi na drugi sklop za obradu signala (54). Oba sklopa za obradu signala spojena su na mikroprocesorski izvedeno računalo (55) koje sadrži odgovarajuću programsku podršku za opisanu funkciju prikaza (56), kakav je ilustriran na slici 1. Slika 6 prikazuje dva parametra koji se kombiniraju u svrhu pravilne funkcije uređaja za bio-povratnu vezu: elektromiogram (EMG) i signal piezo-pretvornika. Valni oblici su prikazani u vremenskoj korelaciji kako se javljaju na pojedinom mišiću. Prilikom kontrakcije mišića, prvo se javlja EMG signal, a zatim se stvara sila kontrakcije što rezultira pozitivnim signalom pretvornika. Relaksacija mišića uzrokuje nestanak EMG signala te negativni signal pretvornika. The block diagram of the bio-feedback device is shown in Figure 5. The signal from the electrodes (42; 43) is fed to the input of the EMG amplifier (51). The signal from the transducer (41) is fed to the piezo amplifier (52). The piezo amplifier (51) is implemented as a charge amplifier. The amplified EMG signal is fed to the signal processing circuit (53), and the amplified transducer signal is fed to another signal processing circuit (54). Both signal processing circuits are connected to a microprocessor-based computer (55) that contains appropriate software support for the described display function (56), as illustrated in Figure 1. Figure 6 shows two parameters that are combined for the purpose of proper function of the device for bio- feedback: electromyogram (EMG) and piezo-transducer signal. The waveforms are shown in time correlation as they occur on a single muscle. During muscle contraction, first the EMG signal occurs, and then the contraction force is generated, resulting in a positive signal from the transducer. Muscle relaxation causes the disappearance of the EMG signal and the negative signal of the transducer.

Claims

1. Device for bio-feedback with combined parameters, characterized by the fact that it contains: - piezoelectric transducer for measuring muscle contraction force (30/31/32; 41) and electrodes (42; 43) for electromyography in the immediate vicinity of said transducer so that said transducer and said electrodes measure contraction force and electrical signal of the same muscle; - display (11/21; 56) of the force of muscle contraction; - control means (51 to 55) in connection with the measurement of said force, which in turn activates the elements of said display so that the number of activated display elements is proportional to the said measured muscle force, but in such a way that, in connection with said electromyography, it allows activation of said display elements only if it is present signal on the mentioned electrodes for electromyography;

2. The device for bio-feedback from the first patent claim, indicated by the fact that in it the display of the size of the muscle contraction is performed as an illuminated illustrated display (11; 56) with images of characters recognizable to small children, the lighting of which draws the attention of the child.

3. Device for bio-feedback from the second patent claim, characterized in that in it the control means (51 to 55) turn on the lighting of the mentioned display (56) so that the number of illuminated mentioned images is proportional to the mentioned measured muscle force.

4. Device for bio-feedback from the first patent claim, characterized by the fact that it displays the size of the muscle contraction performed as a stand with balloons and a pneumatic device (21) for inflating the balloon, which said inflation attracts the child's attention.

5. Device for bio-feedback from patent claim 4, characterized in that in it the control means (51 to 55) sequentially activates the pneumatic device of the said stand so that the number of inflated said balloons is proportional to the said measured muscle force.

6. The device for bio-feedback from any one of claims 1 to 5, characterized in that said piezoelectric transducer (30/31/32; 41) of a geometric shape of a foil or tube is mounted on a solid body (44) of a geometric shape the roller so that it can be easily placed in the anus in such a way that the sphincter muscle covers the aforementioned transducer.

7. The device for bio-feedback from any one of claims 1 to 6, characterized in that said electrodes for electromyography (42; 43) are geometrically ring-shaped mounted on a solid body (44) geometrically shaped like a roller so that it can be easy to put in the anus in such a way that the sphincter muscle covers the mentioned electrodes in such a way that the electrodes can register the electrical signal of depolarization of the mentioned muscle whose contraction force is measured by the mentioned transducer.

8. Device for bio-feedback from patent claim 6, characterized by the fact that the said sphincter muscle with its contraction acts on the said transducer (41) so that it produces an electrical signal in the said transducer, the amplitude of the said signal being greater the greater the force of the said contraction and vice versa.

9. Device for bio-feedback from patent claim 7, characterized by the fact that the mentioned sphincter muscle acts on the mentioned electrodes (42; 43) by its contraction so that it produces an electrical signal registered by the mentioned electrodes, with the amplitude of the mentioned signal being greater the greater the force mentioned contractions are greater and vice versa.

10. Device for bio-feedback from patent claim 6, characterized in that said sphincter muscle with its contraction acts on said transducer (41) so that it produces an electrical signal in said transducer, wherein the amplitude of said signal is greater the faster the contraction speed is and vice versa.

11. Bio-feedback device from any one of claims 1 to 10, characterized in that said control means processes said electromyography electrode signal in such a way that it activates the elements of said display only if the electromyography electrode signal is registered.

12. Device for bio-feedback from patent claim 11, characterized in that said control means simultaneously processes said transducer signal and said electromyography electrode signal in such a way that it compares the amplitudes and amplitude changes of said signals.

13. Device for bio-feedback from patent claim 12, characterized in that said control means processes the signals of said transducer and said electrodes in such a way as to prevent the activation of the elements of said display in the event that the increase in the amplitude of the transducer signal did not occur in connection with the increase in amplitude electrode signal.

14. Device for bio-feedback from any of patent claims 1 to 13, characterized in that said control means processes said signal of the transducer in such a way that it turns on the bulbs that illuminate from behind said images of said display (11), so that the number of lit bulbs corresponds to discrete intervals of the amplitude of the mentioned signal.

15. Device for bio-feedback from patent claim 14, characterized by the fact that the number of illuminated mentioned images corresponds to the strength of the muscle contraction, so during a contraction of minimum strength, one of the mentioned images (12) is illuminated, and when the contraction is intensified, the other images are illuminated in turn, so that the maximum force contraction causes the illumination of the last image (13), and when the muscles relax, the illumination of the image turns off in turn, thus enabling the child to consciously control the strength of the contraction by looking at the change in the number of illuminated images.

16. The device for bio-feedback from any of claims 1 to 13, characterized in that said control means processes said transducer signal in such a way that it inflates balloons in order, so that the number of inflated balloons corresponds to discrete intervals of the amplitude of said signal .

17. Device for bio-feedback from patent claim 16, characterized by the fact that the number of inflated mentioned balloons corresponds to the strength of the muscle contraction, so during a contraction of minimum strength, one of the mentioned balloons (22) is inflated, and when the contraction is intensified, the other balloons are inflated in turn, so that the maximum force contraction causes the last balloon to be inflated (23), and during muscle relaxation, the balloons are deflated in turn, thus enabling the child to consciously control the strength of the contraction by looking at the change in the number of inflated balloons.

18. The bio-feedback device of any one of claims 1 to 17, characterized in that it has a plurality of piezoelectric transducers for measuring muscle force mounted on said solid body so that said piezoelectric transducers, if said body is introduced into the anus, measurements are the force of contractions of the external sphincter, internal sphincter and rectum, respectively.