JP2002263149A - Device for joint bending and stretching exercise - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a device for joint bending and stretching exercise with which the health of the central nervous system and the peripheral nervous system (proprioception system) is improved simultaneously with the bending and stretching exercise of a joint by connecting the intention of a patient himself/herself and the bending, stretching and turning motions of the joint. SOLUTION: This device for joint bending and stretching exercise for performing the bending and stretching exercise of the joint by attaching arms 2 and 3 provided so as to be bent by a driving means 22 to the joint of the knee 12 is provided with: a recognized angle input means for inputting the bend angle of the arms 2 and 3 sensuously recognized by the patient, an angle measurement means for measuring the bend angle of the arms 2 and 3 when input is performed from the recognized angle input means, a judgment means for comparing the recognized angle inputted from the recognized angle input means with the measured angle measured with the angle measurement means and judging whether the recognized angle approximates the measured angle, a judged result reporting means for reporting the judged result of the judgment means to the patient, and a switching means 45 for selectively switching to the state of connecting the arms 2 and 3 to the driving means 22 and passively performing the bending and stretching exercise and the state of disconnecting the arms 2 and 3 from the driving means and actively performing the bending and stretching exercise.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a joint bending and stretching exercise device suitable for use in rehabilitation of a patient, for example, after surgery on a joint or the like.

[0002]

2. Description of the Related Art Conventionally, rehabilitation of a patient's joint is performed after surgery such as osteoarthritis of the knee or osteoarthritis of the knee. This rehabilitation is performed to maintain or improve the range of motion of the joint. A joint bending and stretching exercise device is used. This joint bending and stretching movement device passively performs a bending and stretching movement of a joint by attaching an arm provided to bend by a driving means such as a motor to the joint.

[0003]

However, in the above-mentioned conventional articulating and stretching apparatus, the articulating and extending movement of the joint is continuously performed by passive force, and the articulation of the joint is not necessarily related to the intention of the patient. Although it is possible to simply perform mechanical contraction training of specific muscles and maintain and improve the range of motion of joints, the arm attached to the joint is directly connected to the motor with a ball screw with a large reduction ratio, etc.
Furthermore, when the motor is stopped, the motor is held by the off-brake, so that it is not possible to perform active muscle contraction training, joint flexion / extension training, or kinesthetic retraining training at the will of the patient.

The present invention has been made in view of the above-mentioned problems of the conventional articulating and bending exercise apparatus, and combines the intention of the patient with the articulation and rotation of the joint to simultaneously exercise the articulation of the central nervous system and peripheral nerves. An object of the present invention is to provide a joint flexion / extension exercise device that can improve the soundness of the system (proprietary sense system).

[0005]

In order to achieve the above-mentioned object, a joint bending and stretching apparatus according to the present invention performs a bending and stretching movement of a joint by attaching an arm provided to bend by a driving means to the joint. In a joint bending and stretching exercise device, a recognition angle input means for inputting a bending angle of an arm sensuously recognized by a patient, and an angle measurement for measuring a bending angle of the arm when an input is performed by the recognition angle input means. Means, comparing the recognition angle input by the recognition angle input means with the measurement angle measured by the angle measuring means, and determining whether or not the recognition angle is close to the measurement angle. And a state in which the arm is connected to the driving means to perform the bending and stretching movement passively, and the arm is separated from the driving means to actively perform the bending and stretching movement. Characterized by comprising a switching means for selectively switching on the power sale state.

[0006] In this joint flexion / extension exercise device, the bending angle of the joint, which is sensed through the arm, is determined by comparing it with the actual angle. Of the sensory nervous system and peripheral nervous system based on the action of the central nervous system. Further, by providing switching means for selectively switching between a state in which the arm is connected to the driving means and the bending and extension movement is passively performed and a state in which the arm is separated from the driving means and the bending and extension movement is actively performed, the passive state is provided. In addition to dynamic muscle contraction training and joint maintenance range improvement training, active muscle contraction training and joint flexion / extension training are performed by the patient's own intention. Training can be implemented effectively in a short period of time.

In this case, it is possible to provide a load device that applies a load to the arm while actively bending and stretching.

[0008] Thus, it is possible to perform flexion training while applying a load at the time of flexion and extension, and the effect of retraining training on joint muscles and sensory functions is further improved, and the transition to future walking training can be performed in a short time. it can.

The recognition angle input means may include a switch operated when the patient recognizes the bending angle of the arm as a predetermined angle.

[0010] This makes it possible to easily input the bending angle that the patient has intuitively recognized.

Further, an angle notifying means for notifying the patient of the predetermined angle by voice or display can be provided.

[0012] Thus, the patient can be informed of the predetermined angle easily during training.

Further, the judgment result notifying means can notify the judgment result by voice or display.

[0014] This makes it possible to inform the patient of the judgment result easily during the training.

[0015] Statistical processing means for statistically processing the judgment result of the judging means can be provided.

Thus, the training results can be statistically evaluated.

Further, storage means for storing the result of the statistical processing by the statistical processing means can be provided.

Thus, the training results can be stored and evaluated over time.

[0019]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of a joint bending and stretching exercise device according to an embodiment of the present invention.

FIG. 1 to FIG. 5 show an embodiment of a joint bending and stretching exercise device according to the present invention. As shown in FIG. 1, this joint bending and stretching exercise device is configured such that a shaft 22
Arms 2 and 3 provided to bend at the border
For example, by attaching to the joint of the knee 12, the knee joint can bend and stretch. The arms 2 and 3 are folded by a ball screw 43 driven by the motor 22 and a slider (nut) 25 screwed to the drive shaft 24 of the ball screw and a link mechanism 44 interposed between the arms 2 and 3. Drive to expand and tune.

In this joint bending and stretching exercise device, a bending angle of the arms 2 and 3 and a bending angle of the arms 2 and 3 operated when the patient sensuously recognizes the bending angle are inputted. Angle input means, angle measuring means for measuring a bending angle of the arms 2 and 3 when the input is made by the recognition angle input means, and recognition angle and angle measurement means input by the recognition angle input means. A determination unit that compares the measurement angle with the measurement angle to determine whether the recognition angle is close to the measurement angle, and a determination result notification unit that notifies a determination result of the determination unit to a patient are provided in the control device 42 of the control panel 20. Have been.

As shown in FIG. 1, the joint bending and stretching apparatus includes a state in which the arms 2 and 3 are connected to driving means to perform a bending and stretching movement passively, and Switching means 45 for selectively switching to a state in which the patient actively performs bending and stretching movements, and a load device 27 for applying a load to the arms 2 and 3 while actively performing bending and stretching movements;
Are provided. In this embodiment, the switching unit 45 is
The drive lever 46 of the link mechanism 44 is configured to be selectively connected to the slider 25 of the ball screw 43 and the fixed portion 28 of the load device 27, and a lever receiving portion 48 to which the drive lever 46 is pivotally connected is provided. A pin holding lid 47 pivotally attached to the lever receiving portion 48, and a pin holding lid 47 that penetrates the lever receiving portion 48 and is provided with the slider 25 or the load device 27.
And a pin 49 that engages with the fixing portion 28. The load device 27 is composed of a tension balancer or the like incorporating a coil spring, and the strength of the load can be changed according to the degree of recovery of the patient by adjusting the strength of the spring, such as winding the axis of the coil spring.

On the other hand, as shown in FIG. 3, the control panel 20 has an angle notifying means for notifying the patient of a predetermined angle by voice and an electric sign, and a real-time display by the sound and electric sign. And a judgment result notifying means for notifying the judgment result. As shown in FIG. 3 (a), the angle notifying means and the judgment result notifying means display the flexion / extension angle in a plurality of graphic diagrams by pictorial drawing of the foot, and designate the graphic diagrams by the lamps 39 provided on both sides. Thus, the predetermined angle and the determination result are respectively shown. In addition, as shown in FIG. 3 (b), these displays can selectively display a graphic diagram based on a pictorial diagram of a foot by an illumination window according to the bending / stretching angle. These indications are displayed on display panel 2
0 can be displayed on the indicator 40.

Further, the control device 42 is provided with statistical processing means for statistically processing the determination result of the determination means, and storage means for storing the statistical processing result of the statistical processing means. Furthermore, the recognition angle input means, patients arm 2,
3 is provided with a push button switch 13 that is operated when the bending angle is recognized as a predetermined angle.

In the drawings, 1 is a bending and stretching device, 4 is a foot plate, 5, 6, and 7 are foot fixtures, 10 is a patient's foot, 11 is a patient's hand, 14 is a guide, 21 is a bed, 23 Indicates potentiometers, respectively.

Next, the operation of the joint bending and stretching movement device of the present embodiment will be described by taking as an example a case where the bending and stretching movement is performed passively.
Patients requiring joint flexion exercises lie on the bed 21 so that the knee 12 is above the axis 26. Then, the shin side is fixed to the arm 2 with the fixing tool 5 so that the foot 10 does not come off the bending and stretching device 1, the thigh side is fixed to the arm 3 with the fixing tool 6, and the instep of the foot is fixed with the fixing tool 7. Fix to foot plate 4. It is preferable to use a hook-and-loop fastener or the like so that the fixtures 5 to 7 can be easily attached and detached.

The motor 22 is connected to a link mechanism 44 of the arms 2 and 3 via a drive shaft 24 of a ball screw and a slider 25. When the slider 25 is moved to the left as shown in FIG. The leg is extended, and when moved to the right, the leg is bent. Therefore, by repeating these operations, the knee 12 of the patient's foot 10
It is possible to continuously perform the bending and stretching exercise of the muscle.
Further, these exercises can be performed by changing the adduction and abduction angle of the foot plate.

On the other hand, the operation of the joint bending and stretching exercise apparatus of the present embodiment will be described by taking as an example a case where the bending and stretching movement is actively performed.

During the passive movement by the motor 22, the drive lever 46 of the link mechanism 44 is fixed to the slider 25 of the ball screw 43 by a pin 49 as shown in FIG. 1, but during active operation, the pin 49 is pulled out. hand,
The drive lever 46 can be fixed to the load device 27 by inserting the drive lever 46 into the fixing portion 28 of the load device 27 indicated by a dashed line. Thus, the load device 2 of the drive lever 46 is
7 can be easily fixed and released to and from the slider 25 by replacing the pin 49 at the base point of the drive lever 46 and pressing and fixing the pin 49 with the pin pressing lid 47. . In this case, the strength of the load of the load device 27 can be changed according to the degree of recovery. However, the drive lever 46 can be used without load by simply removing the drive lever 46 from the slider 25 and not connecting to the load device 27. it can.

As described above, in the joint bending and stretching movement device of the present embodiment, the arms 2 and 3 are connected to the driving means to perform the bending and stretching movement passively, and the arms 2 and 3 are separated from the driving means to perform the bending and stretching movement. Switching means 45 for selectively switching to a state of performing active muscle contraction, passive muscle contraction training and exercise for maintaining and improving the range of motion of joints, as well as active muscle contraction by the patient's own will. Exercise and joint flexion / extension training are performed, and thereby, it is possible to effectively perform practical training such as walking in the future in a short period of time. Also,
By providing the load device 27 that applies a load to the arm in a state where the bending and extension movements are actively performed, the bending training can be performed while applying a load at the time of bending and extension, and the effect of the retraining training of the joint muscles and sensory functions is further improved. Improve and make the transition to future walking training in a short time.

Next, with reference to FIG. 2, a control method of the joint bending and stretching movement device of the present embodiment will be described. Here, in the figure, 31 is a main power switch, 32 is a start / stop switch, 33 is a floppy driver, 34 is a speed switching knob, 35 is an extension angle setting knob, 36 is a bending angle setting knob, 37 is a timer setting knob, 38 Denotes an emergency stop switch, 39 denotes a lamp, 40 denotes a display, 41 denotes a speaker, and 42 denotes a control device. These members constitute a control panel 20, and this control panel 20 is connected to the motor 22 and the push button switch 13 by wiring.

The start / stop switch 32 functions as a start switch for operation when pressed once, and functions as a stop switch when pressed again. The floppy driver 33 reads and writes the operation specifications unique to the patient, the judgment result of the judging means, or the statistical processing result of the statistical processing means on a floppy disk. Speed switching knob 34
Is a knob for changing the rotation speed of the motor 22, and an extension angle setting knob 35 is a knob for setting the maximum value of the bending angle θ formed by the arms 2 and 3. The bending angle setting knob 36 is a knob for setting the minimum value of the angle θ formed by the arms 2 and 3, and the timer setting knob 37 is a time from when the start / stop switch 32 is pressed to when it is automatically stopped. Is a knob for setting.

Further, the emergency stop switch 38 is a button for urgently stopping the articulation flexion / extension device by pressing it. The lamp 39a is for instructing the patient at a predetermined bending angle. Is turned on when the push button switch 13 is pressed. The display unit 40 displays the determination result and the statistical processing result, and the speaker 41 outputs a number to be described later by voice, and outputs an operation evaluation result to be described later by voice. The control unit 42 controls the operation of the entire joint bending and stretching exercise device, and also has a function of storing, reading, and writing necessary information. Control panel 2
A personal computer can be used instead of 0, in which case the functions of the switches and knobs can be replaced by keyboard operations.

Next, a description will be given of the operation evaluation of the joint bending and stretching exercise device of this embodiment. FIG. 4 shows a predetermined bending angle θ of the arm and an angle range that is an approximate value of the bending angle θ.
It is shown as a bending angle diagram of the foot, and it is assumed that θ = 15 ± 1
No. 1 in the range of 5 °, No. 2 in the range of θ = 30 ± 15 °, θ
No. 3 in the range of = 45 ± 15 °, No. 4 in the range of θ = 60 ± 15 °, No. 5 in the range of θ = 75 ± 15 °, θ = 90 ± 1
The range of 5 ° is defined as No. 6, the range of θ = 105 ± 15 ° is defined as No. 7, and the like.

When the operation starts, the above-mentioned number is output from the speaker 41 by voice or electric notice in accordance with an appropriate rule, and the patient is notified of a predetermined angle. Appropriate rules include, for example, the order of numbers such as 1 to 7, or the designation of random numbers such as 2, 4, 5, 1, 3, 7, and 7, or the same. Numbers are repeated. At this time, the angle range of the arms 2 and 3 is limited to the angle range set in advance by the extension angle setting knob 35 and the bending angle setting knob 36.

The patient who undergoes the flexion and extension movements of the joint has the display 4
While listening to the number 0 or a graphic output or a voice output number from the speaker 41 and recognizing the amount of flexion or elongation of the own joint, the push button switch 13 at hand is considered to have reached the angle range of the voice output number. push. Thus, the arms 2, 3 that the patient has sensuously recognized by the joints
Is input to the control unit 42. Control unit 42
Means that the value of the bending angle θ of the arms 2 and 3 is constantly monitored, for example, by the number of pulses of an encoder mounted on the motor 22, and the angle when the push button switch 13 is pressed is the number output by voice. It is determined whether or not it is within the angle range. If the angle at which the push button switch 13 is pressed falls within the angle range of the predetermined angle, a signal such as “ping-pong” is given as a signal of success. As a signal, for example,
A sound “bubbles” is generated from each of the speakers 41.

Thus, the patient naturally focuses his or her central nervous system and peripheral nervous system on the determination of the angle of the knee joint in an attempt to increase the number of successes as much as possible. Forget about being a motor training, it is possible to conduct training to increase the number of successes, that is, re-education training of the kinesthetic sensation of the sensory nervous system and peripheral nervous system based on the bending and extension of the knee joint and the action of the central nervous system Become. As a result, at the same time as muscle contraction training and training in maintaining and improving the range of motion of joints, training on contraction of muscles and flexion and extension of joints by the patient himself, that is, retraining training on the sensory nervous system and peripheral nervous system, This makes it possible to carry out effective training such as walking in the future effectively and in a short period of time.

The above operation is shown as a flowchart in FIG. In this flowchart, only the essential points of the operation are described, and details are partially omitted.

[0039]

According to the articulation flexion / extension device of the present invention, the bending angle of the joint perceptually recognized through the arm is determined by comparing it with the actual angle. And the peripheral nervous system to focus on determining the angle of the joint, which enables retraining of the sensory nervous system and the kinesthetic sensation of the peripheral nervous system based on the flexion and extension of the joint and the action of the central nervous system . Further, by providing switching means for selectively switching between a state in which the arm is connected to the driving means and the bending and extension movement is passively performed and a state in which the arm is separated from the driving means and the bending and extension movement is actively performed, the passive state is provided. In addition to dynamic muscle contraction training and joint maintenance range improvement training, active muscle contraction training and joint flexion / extension training are performed by the patient's own intention. Training can be implemented effectively in a short period of time.

Further, by providing a load device for applying a load to the arm while actively performing the bending and stretching movement, it is possible to perform bending training while applying a load at the time of bending and stretching, and to conduct retraining training for joint muscles and sensory functions. The effect is further improved, and the transition to future walking training can be performed in a short time.

Further, the recognition angle input means is provided with a switch which is operated when the patient recognizes the bending angle of the arm as a predetermined angle, so that the bending angle which the patient sensuously recognizes can be easily obtained. Can be entered.

Further, by providing the angle notifying means for notifying the patient of the predetermined angle by voice or display, the predetermined angle can be easily notified to the patient even during training.

Further, the judgment result notifying means notifies the judgment result by voice or display, so that during the training,
The judgment result can be easily notified to the patient.

By providing statistical processing means for statistically processing the results of the determination by the determining means, the training results can be statistically evaluated.

Further, by providing storage means for storing the results of the statistical processing by the statistical processing means, the training results can be stored and evaluated over time.

[Brief description of the drawings]

FIG. 1 shows an embodiment of a joint bending and stretching exercise device of the present invention,
(A) is a side view, (b) is a plan view omitting an upper part,
(C) is a sectional view in the direction perpendicular to the axis.

FIG. 2 is a front view showing a control panel of the joint bending and stretching exercise device of the embodiment.

FIG. 3 is a diagram illustrating an example of a screen of a display device.

FIG. 4 is an explanatory diagram showing a predetermined bending angle of an arm and an angle range that is an approximate value of the bending angle in association with a number.

FIG. 5 is a flowchart showing an operation of the control device of the embodiment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Bending and stretching apparatus 2 Arm 3 Arm 4 Foot plate 5, 6, 7 Fixture 10 Patient's foot 11 Patient's hand 12 Patient's knee 13 Push button switch 14 Guide 20 Control board 21 Bed 22 Motor 23 Potentiometer 24 Drive shaft (ball screw shaft) 25 slider 26 axis 27 load device 28 fixing part 31 main power switch 32 start / stop switch 33 floppy driver 34 speed switching knob 35 extension angle setting knob 36 bending angle setting knob 37 timer setting knob 38 emergency stop switch 39 lamp 40 indicator 41 Speaker 42 Control device 43 Ball screw 44 Link mechanism 45 Switching means 46 Drive lever 47 Pin holding cover 48 Lever receiving part 49 Pin

Claims (7)

[Claims] An arm provided to bend by a driving means is attached to a joint, so that a bending angle of the arm which is perceived by a patient in a joint bending and stretching movement device for performing a bending and stretching movement of the joint is input. Recognition angle input means for
The angle measuring means for measuring the bending angle of the arm when the input is made by the recognition angle input means, and the recognition angle inputted by the recognition angle input means is compared with the measurement angle measured by the angle measurement means to perform the recognition. A determination unit for determining whether the angle is close to the measurement angle, and a determination result notification unit for notifying a determination result of the determination unit to a patient, and the arm is connected to a driving unit to passively perform bending and extension movement. A joint bending and stretching exercise device comprising switching means for selectively switching between a state in which the arm is separated from the driving means and a state in which the bending and stretching movement is actively performed. 2. The joint bending and stretching exercise device according to claim 1, further comprising a load device for applying a load to the arm while actively performing the bending and stretching motion. 3. The joint according to claim 1, wherein the recognition angle input means includes a switch operated when the patient recognizes the bending angle of the arm as a predetermined angle. Bending and stretching exercise device. 4. The joint bending and stretching exercise device according to claim 1, further comprising angle notification means for notifying a patient of a predetermined angle by voice or display. 5. The method according to claim 1, wherein the judgment result notifying means notifies the judgment result by voice or display.
5. The joint bending and stretching exercise device according to 3 or 4. 6. The apparatus according to claim 1, further comprising a statistical processing means for statistically processing a result of the determination by the determining means.
6. The joint bending and stretching exercise device according to 4 or 5. 7. The apparatus according to claim 6, further comprising storage means for storing a result of the statistical processing by the statistical processing means.