JP2003126272A - Percutaneous neuromuscle stimulation instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a percutaneous neuromuscle stimulation instrument capable of accurately percutaneously electrically stimulating the peripheral motorial nerves, contracting human skeletal muscles. SOLUTION: In a computer-controlled electric stimulator percutaneously electrically stimulating the peripheral motor nerves through surface electrodes pasted to the surface of the skin of a user, and contracting the skeletal muscles, an output waveform that gradually increases the strength of stimulation by amplitude modulation at a minimum stimulation frequency and increases the stimulation frequency while retaining a fixed value when a prescribed stimulation strength is reached at the start of motor nerve stimulation, and gradually decreases the strength of stimulation by amplitude and frequency modulation when prescribed time of the prescribed stimulation strength is reached at the start of motor nerve stimulation is obtained.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a percutaneous nerve for percutaneously electrically stimulating peripheral motor nerves and contracting human skeletal muscles via a surface electrode attached on the skin surface of a user. The present invention relates to a muscle stimulator.

[0002]

2. Description of the Related Art Conventionally, as a technique in such a field,
FES (Functional Electrical Stimulation: Functional El
There has been a so-called electrical stimulation) in which a simple low-frequency pulse is applied to the affected area of the user.

[0003]

However, the above-mentioned conventional FES merely applies a low-frequency pulse to the affected part of the user, and percutaneously electrically stimulates the peripheral motor nerves. No special effect could be expected to contract skeletal muscle.

In view of the above situation, the present invention provides a percutaneous neuromuscular stimulator capable of appropriately percutaneously electrically stimulating peripheral motor nerves to contract human skeletal muscle. To aim.

[0005]

In order to achieve the above-mentioned object, the present invention provides [1] a surface electrode attached on the skin surface of a user,
In a computer-controlled electrical stimulator that electrically stimulates peripheral motor nerves percutaneously and contracts human skeletal muscle,
At the start of motor nerve stimulation, the stimulus intensity by amplitude modulation is gradually increased at the lowest stimulus frequency, the stimulus frequency is increased while maintaining a constant value when the predetermined stimulus intensity is reached, and when the predetermined time of the predetermined stimulus intensity is reached, the motor nerve is It is characterized by obtaining an output waveform that gradually reduces the stimulation intensity by amplitude / frequency modulation when the stimulation is stopped.

[2] In the percutaneous neuromuscular stimulator according to the above [1], the stimulating frequency is such that the rising of the stimulating wave train starts from repetitive stimulation in a low frequency region around 20 Hz and up to 80 Hz. It is characterized by modulating up to.

[3] In a computer-controlled electric stimulator that electrically stimulates peripheral motor nerves percutaneously through surface electrodes pasted on the skin surface of a user to contract human skeletal muscle, At the start of nerve stimulation, the stimulation intensity by amplitude modulation is gradually increased at the lowest stimulation frequency,
It is characterized in that frequency reduction modulation is also used in combination, and when a predetermined stimulus intensity is reached, the stimulus frequency is raised while maintaining a constant value to obtain an output waveform that continues for a predetermined time.

[4] In a computer-controlled electrical stimulator for percutaneously electrically stimulating peripheral motor nerves and contracting human skeletal muscles via a surface electrode attached on the skin surface of a user, a pulse is applied. Width 0.2msec ~ 0.5mse
c, a fundamental frequency is a bipolar rectangular wave of 1 Hz to 100 Hz, and a sine wave or triangular burst wave of 1 kHz to several tens of kHz as a group waveform is 0.2
From msec to 0.5msec, repeat cycle is 1s
It is characterized in that the output waveform is obtained by selecting in 10 msec from ec.

[5] In the percutaneous neuromuscular stimulator according to the above [1], [2] or [4], the stimulus intensity of each stimulus channel is freely set on the time axis or on the memory address of the computer controller. It is characterized by being able to do it.

[0010]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described in detail below.

In the transcutaneous electrical stimulation, since the electrical stimulation is applied to the motor nerve via the skin surface, discomfort and pain of the skin at the stimulation site are likely to occur.

Therefore, in the percutaneous neuromuscular stimulator of the present invention, the fact that the higher the stimulation frequency is, the smaller the skin resistance is, so that the sine wave and the triangular wave in the medium frequency range from 1 kHz to 10 kHz are kept constant. Burst (group waveform), and this is repeated frequency 1Hz ~ 100Hz (hereinafter,
It is a device that outputs at a basic stimulus frequency).

As a result, even if the stimulus intensity is low, the stimulus reaches deep motor nerves, and transcutaneous stimulus with less pain and discomfort becomes possible.

In a normal living body, motor nerves are sequentially excited from thin nerve fibers to thick nerve fibers, and accordingly, muscles are also contracted sequentially from thin muscle fibers to thick muscle fibers (gradual increase phenomenon).

On the other hand, in skeletal muscle contraction control by amplitude-modulation or pulse-width-modulation electrical stimulation, as the stimulation strength is increased, the nerve fibers with a larger diameter excite from the smaller nerve fibers, and the muscles are thereby changed from the thicker muscle fibers to the thinner muscle. An inverse recruitment phenomenon occurs in which fibers contract.

For this reason, even a slight change in the electrical stimulation intensity causes a sharp muscle contraction, and there is a problem in the controllability of the muscle contraction, and the subject often complains of discomfort or pain during muscle contraction. To be However, when the stimulation intensity is kept constant and the electrical stimulation is performed by the frequency modulation method, the relationship between the stimulation intensity and the contraction force becomes linear, and a gentle muscle contraction is obtained as the stimulation frequency increases.

Therefore, in the present invention, as method 1, the stimulation intensity of the lowest frequency is gradually increased at the start of stimulation, and after the necessary muscle contraction is obtained, the stimulation frequency is gradually increased until it reaches a constant frequency with a constant stimulation intensity. Adopted the method.

As the method 2, the first rising of the stimulus gradually increases the amplitude while gradually decreasing from the high frequency to the low frequency, and when the stimulus amplitude reaches a constant value, the stimulus frequency is increased again. It is effective in improving non-linearity.

With these methods, not only skin pain and discomfort but also pain associated with muscle contraction can be suppressed as much as possible, and smooth and comfortable muscle contraction can be obtained. Recovery of motor function by stimulation can be efficiently obtained.

The joint movement of a living body is caused by contraction of a plurality of muscles in a temporally and spatially controlled pattern,
The safety of the locomotive itself,
It is a mechanism to maintain reliability. Therefore, to stimulate a plurality of motor nerves / muscle systems, it is necessary to create a stimulation pattern similar to that of the biological mechanism or with sufficient consideration thereof. Therefore, in the present invention, the stimulation pattern can be freely adjusted.

Specific examples will be described below.

FIG. 1 is a schematic view of a percutaneous neuromuscular stimulator according to the present invention.

In this figure, 1 is a user, 2 is a neuromuscular part of the user 1, 11 is a percutaneous neuromuscular stimulator for applying a pulse to the neuromuscular part 2, and this percutaneous nerve The muscle stimulator 11 includes a power source 12, a function generator 13,
A pulse mode switch (first mode selector 14A, second mode selector 14B, third mode selector 14C) 14 is provided.

The function generator 13 is a signal generator capable of selecting a number of different waveforms and has a function of changing the frequency over a wide range. Further, it is one of the non-linear arithmetic units of an analog computer, and can generate a voltage that satisfies a given functional relationship with respect to time or an input voltage.

FIG. 2 is a diagram showing a first output waveform (amplitude modulation-constant amplitude / frequency modulation-amplitude / frequency modulation stimulation waveform) from the percutaneous neuromuscular stimulator according to the first embodiment of the present invention. Is.

As shown in this figure, the first output waveform of this embodiment is such that the stimulus intensity by amplitude modulation is gradually increased at the lowest stimulus frequency at the start of motor nerve stimulation (step S1), and the predetermined stimulus intensity is obtained. When it reaches, the stimulus frequency is increased while maintaining a constant value (step S2), and when it reaches a predetermined time of a predetermined stimulus intensity, the stimulus intensity is gradually decreased by amplitude / frequency modulation when the motor nerve stimulation is stopped (cool down). (Step S3). For example, the output waveform is selected by operating the first mode selector 14A in FIG.

In detail, the frequency modulation starts from the repetitive stimulus in the low frequency region around 20 Hz at the rising edge of the stimulus wave train and is modulated up to the repetitive stimulus up to 80 Hz. The stimulation amplitude is gradually increased at the lowest stimulation frequency at the start of stimulation.

With such an output waveform, muscle contraction can be obtained while suppressing pain and discomfort as much as possible.

FIG. 3 is a diagram showing a second output waveform (amplitude / frequency modulation-constant width / frequency modulation stimulation waveform) from the percutaneous neuromuscular stimulation apparatus according to the second embodiment of the present invention.

As shown in the figure, the second output waveform of this embodiment is such that the stimulus intensity is gradually increased by amplitude modulation at a stimulating frequency higher than the lowest frequency and the frequency decreasing modulation is used at the rising edge of the motor nerve stimulation. Let (Step S
1) When reaching a predetermined stimulus intensity, the stimulus frequency is increased while maintaining a constant value, and continued for a predetermined time (step S2).

Here, while the amplitude at the start of stimulation is increased to a constant value, it is gradually decreased from a high frequency to a low frequency. By using these methods, it is possible to reduce the discomfort and pain associated with the stimulation and to adjust the muscle contraction force in a more linear and smooth manner.

FIG. 4 is a diagram showing partial output waveforms according to the present invention.

The sine wave or triangular wave in the medium frequency range may be used as the group waveform for each of the waves of the above-described first and second embodiments to further suppress the discomfort and pain of the skin.

FIG. 5 is a diagram showing a third output waveform (half-wave rectification stimulation waveform: alternating stimulation) from the percutaneous neuromuscular stimulation apparatus according to the third embodiment of the present invention.

As shown in this figure, by applying a half-wave rectification type stimulation waveform to the nerve muscle site of the user, discomfort and pain of the skin can be suppressed.

FIG. 6 is a diagram showing a fourth output waveform (bipolar rectangular wave: fundamental wave) from the percutaneous neuromuscular stimulator according to the fourth embodiment of the present invention.

This bipolar rectangular wave has, for example, a pulse width of 0.2 msec to 0.5 msec and a fundamental frequency of 1 Hz.
Up to 100 Hz. Group waveform from 1 kHz to several tens
Burst waves of sine waves or triangular waves up to kHz are selected for 0.2 msec to 0.5 msec, and their repetition period is selected from 1 sec to 10 msec to be used as a stimulating wave.

By applying this bipolar rectangular wave to the neuromuscular region of the user, the discomfort and pain of the skin can be suppressed.

FIG. 7 is a block diagram of a computer-controlled electrostimulator according to the present invention, and FIG. 8 is a block diagram of its main memory.

In these figures, 21 is the main memory, 2
2 is a program counter, 23 is a first register, 24 is a second register, 31 is a fixed part of the main memory, 32 is a variable part of the main memory, 1a is a command part, 1b is an operand part,
1c is a pattern file part, a to g are addresses, and STP
Is a set stack pointer instruction, JSP is a variable pattern read command, and RSP is a return command.

As a computer-controlled electrostimulator (pattern signal generator), as shown in FIG. 7, a main memory 21, a program counter 22 and a first register 2 are provided.
3, the second register 24 is provided, and the main memory 21 is provided with the fixed part 31 and the variable part 32 as shown in FIG.

Therefore, the fixed section 31 and the variable section 32 of the main memory 21 are individually stored, the fixed section 31 is read out according to a predetermined program to output a predetermined pattern, and the variable is set at a desired address position of the fixed section 31. The pattern read command JSP is stored and the variable pattern read command J is stored.
Every time SP is read, the variable pattern of the address stored in the first register 23 is read. In this way, a pattern signal is generated by combining the fixed portion 31 and the variable portion 32 [for example, JP-A-55-31949].

The stimulation intensity of each stimulation channel can be freely set on the time axis or on the memory address of the computer-controlled electric stimulator, and joint motion control can be performed for a purpose or with high safety.

When stimulating a plurality of muscles, the stimulation data of each stimulation channel can be freely changed on both the stimulation time axis and the stimulation intensity axis. It shall be possible to freely control the joint movements of.

As a result, it can be used as a functional electrical stimulator for reconstructing the motion of the paralyzed limb and trunk, and also as a therapeutic electrical stimulator for recovering the motor function by electrical stimulation training.

When this percutaneous neuromuscular stimulator is used as a functional electrical stimulator, a control command or a negative feedback signal is input, and when it is used as a therapeutic electrical stimulator, a negative feedback signal is input. The input unit shall be provided in this percutaneous neuromuscular stimulator.

The present invention is not limited to the above embodiments, and various modifications can be made based on the spirit of the present invention, and these modifications are not excluded from the scope of the present invention.

[0048]

As described in detail above, according to the present invention, the following effects can be achieved.

(A) Human peripheral skeletal muscles can be contracted by electrical stimulation of the peripheral motor nerves accurately and percutaneously.

(B) It is possible to obtain muscle contraction while suppressing pain and discomfort as much as possible.

(C) The discomfort and pain associated with the stimulation can be reduced, and more linear and smooth muscle contraction force can be adjusted.

[Brief description of drawings]

FIG. 1 is a schematic diagram of a percutaneous neuromuscular stimulator according to the present invention.

FIG. 2 is a diagram showing a first output waveform (amplitude modulation-constant amplitude / frequency modulation-amplitude / frequency modulation stimulation waveform) from the percutaneous neuromuscular stimulator according to the first embodiment of the present invention. .

FIG. 3 shows a second output waveform (amplitude / frequency modulation-constant width / width) from the percutaneous neuromuscular stimulator according to the second embodiment of the present invention.
It is a figure which shows a frequency modulation type stimulus waveform.

FIG. 4 is a diagram showing a partial output waveform according to the present invention.

FIG. 5 is a diagram showing a third output waveform (half-wave rectification type stimulation waveform) from the percutaneous neuromuscular stimulation device according to the third embodiment of the present invention.

FIG. 6 is a diagram showing a fourth output waveform (bipolar rectangular wave: fundamental wave) from the percutaneous neuromuscular stimulator showing the fourth embodiment of the present invention.

FIG. 7 is a configuration diagram of a computer-controlled electrical stimulation device according to the present invention.

FIG. 8 is a configuration diagram of a main memory of the computer-controlled electrical stimulator according to the present invention.

[Explanation of symbols]

1 user 2 user's neuromuscular region 11 Percutaneous neuromuscular stimulator 12 power supplies 13 Function generator 14 Pulse mode switch 14A First mode selector 14B Second mode selector 14C 3rd mode selector 21 main memory 22 Program counter 23 First Register 24 Second register 31 Fixed part of main memory 32 Variable part of main memory 1a Command section 1b Operand part 1c pattern file section ag address STP set stack pointer instruction JSP variable pattern read command RSP return command

Claims (5)

[Claims] 1. A computer-controlled electrical stimulator for percutaneously electrically stimulating a peripheral motor nerve to contract human skeletal muscle via a surface electrode attached on the skin surface of a user. At the start of stimulation, the stimulation intensity by amplitude modulation is gradually increased at the lowest stimulation frequency, the stimulation frequency is raised while maintaining a constant value when the predetermined stimulation intensity is reached, and when the predetermined time of the predetermined stimulation intensity is reached, motor nerve stimulation A percutaneous neuromuscular stimulator that obtains an output waveform that gradually reduces the stimulus intensity by amplitude / frequency modulation at the time of a fall. 2. The percutaneous neuromuscular stimulator according to claim 1, wherein the stimulating frequency is such that the rising edge of the stimulating wave train is:
A percutaneous neuromuscular stimulator which is characterized by starting from repetitive stimulation in a low frequency region around 20 Hz and modulating up to repetitive stimulation up to 80 Hz. 3. A computer-controlled electrical stimulator for percutaneously electrically stimulating a peripheral motor nerve to contract human skeletal muscle through a surface electrode attached on the skin surface of a user. When the stimulus rises, the stimulus intensity is gradually increased by amplitude modulation at the lowest stimulus frequency, and frequency reduction modulation is used together.When the stimulus intensity reaches a predetermined value, the stimulus frequency is increased while maintaining a constant value, and the output waveform is continued for a predetermined time. A percutaneous neuromuscular stimulator which is obtained. 4. A computer-controlled electrical stimulator for percutaneously electrically stimulating peripheral motor nerves and contracting human skeletal muscles via a surface electrode attached on the skin surface of a user. 0.2 msec to 0.5 msec, a fundamental frequency is a bipolar rectangular wave of 1 Hz to 100 Hz, and a burst wave of a sine wave or a triangular wave of 1 kHz to several tens kHz as a group waveform is 0.2 msec to 0.
Repeating cycle of 1m to 10m for 5msec
A percutaneous neuromuscular stimulator which is selected in sec to obtain an output waveform. 5. The percutaneous neuromuscular stimulator according to claim 1, 2, 3 or 4, wherein the stimulus intensity of each stimulus channel can be freely set on a time axis or on a memory address of a computer controller. Percutaneous neuromuscular stimulator.