JP2006204832A - Patient simulating robot for rehabilitation education and rehabilitation education method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a patient simulating robot for rehabilitation education suitable for training and education of rehabilitation, by indicating a response similar to a patient of an actual living body. <P>SOLUTION: A standard therapeutic mode of the rehabilitation corresponding to a case of a disease is inputted into a computer in advance, and a change in a load received by predetermined training to a joint constitute by joining of turnable two members is measured, and is evaluated by comparing with the standard therapeutic mode. Thus, training of the rehabilitation is repeatedly performed, and a high-degree rehabilitation technology can be learnt in a short period. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

The present invention relates to a rehabilitation education patient simulation robot and a rehabilitation education method suitable for training of a physical therapist involved in the recovery of the functions of the elderly, an injured person, and a sick person.

In order to improve the quality of life of a person who has a physical disability due to injury or illness, it is necessary to construct a medical system that can receive appropriate rehabilitation. This is a particularly important issue for Japan, which is facing a super-aging society. The number of physical therapists who play an important role in this system is extremely small, 1/7 of the population in Europe and the United States.

In recent years, rehabilitation vocational schools and universities have been established in various places in response to such social demands. Although these educational institutions place emphasis on practical training for acquiring therapeutic techniques, there are very few opportunities for practical training for patients with disabilities. The most common practice is for students to practice as one patient, and this is meaningful by knowing the patient's position, but it is actually a disability. Experience with the patient is not possible. In addition, there are sometimes yugoes that have actual patients cooperate with practical training, but there is no opportunity for each student to perform practical training, and the symptoms that can be experienced are limited.

The rehabilitation of human resources for people with disabilities and illness due to injury and illness as soon as possible to return to society and improve the quality of life will be an important issue for our country. It ’s an urgent issue.

On the other hand, in recent years, various robots have been actively developed, and it has already been announced that sensors can be installed in the joint part to reach the movable critical range of the joint part and the magnitude of the force applied to the joint part can be measured. However, it is determined only that the force applied to the joint reaches a certain value (movable critical range). However, in actual human beings, even if the joint is bent to the same state, it bends suddenly. However, it is almost ignored that there is a difference in the feeling of bending and the burden on the joint.

In general, rehabilitation of joints of the lower limbs and upper limbs gives a moderate stimulus to the muscles that are atrophied, and gradually expands the range that can be bent and extended, thereby expanding the movable range to the range that could not be done so far In the educational patient simulation robots provided so far, first of all, the evaluation method is not limited to recognizing the critical state of how long it can be stretched or bent. Is too far from the state you want to acquire in actual rehabilitation training. Second, the response of the simulated joint is too uniform, and the feeling of this person is too far from the response of the human body. In reality, it is unsatisfactory as a patient-simulating robot for proper training, and there has been a demand for the emergence of a patient-simulating robot for education that solves these problems and is suitable for training.
Patent Publication 2004-309389 Patent Publication 2004-309916 Patent Publication 2004-309917

In view of this situation, it is controlled and managed by a computer, and by switching programs, various dysfunction symptoms can be simulated, and the process of changing the joint state (acceleration of change) is evaluated, By developing a robot (human body model) that can be used as an exercise platform for rehabilitation after being evaluated according to how people feel, and that can respond to trainees' movements similar to human joints. Therefore, the present invention has been completed, considering that it can be improved even a little and contribute to the early and high quality training of human resources involved in rehabilitation.

The main feature of the present invention is that it is possible to measure the change in load that is applied to a joint that is formed by joining two rotatable members to a computer in which a standard rehabilitation mode according to the case is input in advance by predetermined training. It is connected so that evaluation is possible in comparison with the standard treatment mode.

Second, it is configured by joining two rotatable members to a computer in which a standard rehabilitation mode according to the case is input in advance, and the rotational resistance of the joint portion changes corresponding to the case. This is because the change of the load received by the predetermined training can be measured and the joint configured so as to be able to be evaluated in comparison with the standard treatment mode.

In the present invention, as described above, a load that is received by a predetermined training on a joint formed by joining two rotatable members to a computer in which a standard rehabilitation mode according to a case is input in advance. The change is measurable, and it is connected so that it can be evaluated in comparison with the standard treatment mode. A robot using this device does not evaluate only the magnitude of the critical point applied to the joint as a numerical value. The process to reach the critical point can be measured and compared with the standard mode, and if the trainee bends or extends the joint to the critical range with any force applied. There is a great advantage of being able to learn whether training can be done without causing physical pain or burden to the patient.

In this case, an actuator such as a motor is connected to the joint part, and the movement is detected in response to the rotation or torsional passive of the joint part, and controlled by a computer so as to respond to the changing movement every moment. For example, by imitating the movement resistance that resembles a human joint passively so that the resistance during exercise increases for fast movement and decreases during slow movement, You can achieve a natural feeling like training. That is, in a human joint, when a bending / extending load is applied, a force is generated so as to naturally resist in response to how the load is applied. Rather, the joint has a movement that changes momentarily with respect to the external force. Furthermore, there is a difference between healthy and disabled patients for the same treatment, but even in the same case, for example, symptoms that the knee is difficult to bend, depending on the degree of rehabilitation In response to this procedure, there is a difference in the response of the muscle, and in order to change this difference as the resistance of the joint in advance corresponding to the standard procedure mode, the corresponding mode of the joint is input to the computer in advance. It is intended to realize a response feeling closer to a living patient by expressing it as a change in response resistance of the joint.

In addition, by moving the standard mode to the recovery mode by stacking predetermined training, the training process added to the joint is stored, and the preset healing process is learned by the trainee. Therefore, appropriate training according to the skill acquisition stage of the trainee can be performed. In this case, the recovery mode can be changed according to the training accumulation interval. For example, it is possible to set a difference such that the degree of recovery is lower in the case of stacking several days after the daily training stacking.

Of course, by setting and selecting a plurality of standard treatment modes according to cases, it is possible to perform training for trainees in a wide range of cases from mild to severe.

In addition, if the computer records the performance of each individual trainee and recalls the record so that re-recording is possible, each trainee is not trained uniformly. There is an advantage that appropriate training can be accumulated according to the proficiency level of each technique, and flexibility can be dealt with according to individual characteristics.

If you react to the degree of excessive pressurization, for example, if you are a live patient when you use too much force, you can say "It hurts!" Representation of mimicry and mimicry that shows a good attitude, rehabilitation training closer to human treatment can be performed.

If the measurement of the load change includes both the rotation direction and the twist direction of the joint, rehabilitation training can be performed with a feeling close to that of an actual joint.

As described above, the rehabilitation education method using the robot of the present invention is not limited to simply using the robot as a substitute for human beings, but performs rehabilitation education by feeling the same level of reaction as an actual patient. It is possible to conduct a higher-level curriculum faster and to allow trainees to learn advanced treatment methods at an early stage.

In the human body model, as shown in FIG. 1, the head 1 is the neck 2, the upper arm 3 is the shoulder 5, the lower arm 4 is the upper arm 3, the hand 6 is the lower arm 4, the upper leg 7 is the pelvis 9, and the lower leg 8. Is joined to the upper leg 7 and the foot 10 is joined to the lower leg 8 so as to be able to rotate and twist at joints 11 respectively. An example of the joint 11 is shown in FIG. These skeleton portions may be left as they are, but preferably, the muscular member 12 such as foamed rubber or urethane foam has a human body feel and texture. The present invention can be applied to any of these parts.

As shown in FIG. 2, the joint 11 may be connected to the first part 12 and the second part 13 by joints 14 and 15, preferably universal joints so as to be rotatable in either direction. A simple joint that can be rotated may be used. A sensor 16 is provided in the vicinity of the joints 14 and 15 to detect changes, magnitudes, and degrees of change of rotation and torsion, so that the magnitude of the load applied to the joints 14 and 15 and the state of change can be recognized. Yes. The recognition of the critical point can be variously changed by adjusting the sensitivity and position of the sensor 16.

In the present invention, the computer 17 is linked to the joint 11 as described above. As shown in FIG. 3, measurement data from the sensor 16 mounted on the joint 11 is transmitted to the computer 17, analyzed, and compared with the standard treatment mode preset in the computer 17 in advance. It can be displayed or printed on the paper 20 by the printer 19.

The computer is preset with a standard pattern and an allowable range for the process of applying the treatment, and the actual input process of the practitioner is measured to determine whether it is within the allowable range. If the pattern is known too quickly and the timing to apply the force is late, it will be cleared without being cleared. If it is slightly disengaged, the operation is started again. If the disengagement is too large, the apparatus is stopped.

And if necessary, you can make it react to the display device as appropriate. For example, the color may change according to the state, or “appropriate (or feels good)” or “too much effort” (It hurts) "," Your power is not applied (It is not working) "or a voice may be displayed.

Furthermore, the computer can be provided with a learning function as necessary. FIG. 6 shows an example. First, the computer is started and a target pattern is selected. If it is a knee, it can be set freely, such as being able to choose from 5 levels. Next, the name of the practitioner is input, and if it is continued from the previous data, it is called, and if it is the first time, training is started from the initial setting state.

Then, training is started and a force is applied to the joint 11 to rotate it. The joint 11 can employ a universal joint that can freely rotate around any of the X, Y, and Z axes. In this case, a sensor 16 that senses rotation about each axis is provided. FIG. 2 shows a simple example in which only the rotation around one axis is sensed. The first part 12 and the second part 13 are rotatably connected by joints 14 and 15, and one of them is interlocked with the rotation. Thus, the rotating motor is arranged as the sensor 16, and the state where force is applied can be measured using the amount of power generated according to the turning process as a parameter. Here, it is possible to measure the degree of change in the rotation of the joint regardless of the presence or absence of resistance in the joint portion, that is, in the case of either passive or automatic control.

If the treatment pattern is included in the allowable range of the standard pattern, one process is finished and the process proceeds to the next step. Here, if it deviates slightly from the standard pattern, it will be redone again, and if it deviates significantly, it will stop immediately. These processes are registered in the computer and are completed.

When a registered practitioner performs training for the second and subsequent times, he / she will continue training from the state after learning as described above, and he / she accumulates training by completing a preset process. Can be terminated.

When the automatic turning function is added to the joint 11, there are some that can automatically bend and stretch in a range corresponding to the set obstacle degree. In this case, if the learning program is further provided, the practitioner can connect the joint 11. As the operation of applying resistance is repeated, the function recovery state based on learning can be expressed such that the extension force of the knee or the like increases or the range in which bending and extension is possible is expanded.

(Single mode training)
The simplest training is training in which the first part 12 and the second part 13 are bent and stretched by a predetermined angle. In this case, the allowable range surrounded by the standard mode A curve, the upper limit B curve, and the lower limit C curve is preset in the computer 17 in advance. When the computer 17 is started and the first part 12 and the second part 13 are bent and stretched, the intensity and speed of the change are measured by the sensor 16 and data is transmitted to the computer 17. The data measured in accordance with the trainee's bending / stretching operation is checked for the presence or absence of deviation from the above-mentioned allowable range. Even in the case of acceptance, rank evaluation can be performed according to the degree close to the standard treatment mode, and in the case of failure, rank evaluation can be performed according to the degree of deviation from the allowable range. And if you pass several times, you can proceed to the next step. Here, if it falls outside the permissible range, it can be said that “It hurts!”, Or after that, the joint part is braked and cannot move. In this case, it is restored by a reset operation.

(Multi-mode training)
The standard mode preset in the computer 17 and the permissible range thereof are made to correspond to a plurality of training target cases, and can be applied to a plurality of rehabilitation trainings by selecting the mode. Of course, the number of sets according to the present invention can be prepared corresponding to each case.

(Grant learning function)
The training result of each time is stored in the computer 17, and when the predetermined number of passes is reached by the accumulation, the training for the case is evaluated as being completed.

(Response to symptom relief)
Normally, when rehabilitation is performed, the movable range of the damaged part is expanded corresponding to the stacking. Correspondingly, if the computer 17 has one symptom in advance, for example, the knee does not bend, the knee can be bent only 130 degrees initially, but it can be bent to 180 degrees later by repeated rehabilitation. Assuming the process of being able to sit upright, the computer 17 can be preliminarily trained in advance to receive a predetermined training, and if it passes, it is possible to preset a state in which the flexion / extension angle of the knee sequentially increases. By doing so, it is possible to perform advanced training corresponding to the recovery of the knee flexion / extension function by accumulating appropriate training.

(Response to multiple trainees)
Next, a plurality of trainees are individually registered in the computer 17 so that individual training results can be recorded. Even if there is a variation in the symptom and progress of the target training, Corresponding to a large number of trainees in the set.

(Example of lower limb rehabilitation training robot)
4 and 5 show an example of a model in which the lower body is connected to the buttocks, and shows a lower limb rehabilitation training robot having both a hip joint and a knee joint. A pelvic part 21 is attached to one end of the base 40, and the thigh 23 is connected to the thigh 23 via the hip joint 22 so that the thigh 23 can rotate freely within a range of about 15 degrees in the rear direction and about 125 degrees in the front direction. The distal end of the portion 23 is connected to the distal end of the crus 25 via the knee joint 24 so as to be rotatable in a range of 130 degrees in the backward direction from the stretched state. An ankle portion 27 is rotatably connected to the crus portion 25 via a heel joint portion 26. These outer portions are covered with a skin outer skin portion 28 made of a material such as flexible urethane foam.

Although the base 40 is placed on a desk or the like, the weight 29 can be increased or decreased as necessary to adjust the stability. Further, in the illustrated example, motors M1 and M2 are disposed on both sides of the hip joint portion 22, and the motor M1 is directly connected to the hip joint portion 22 to directly drive the thigh 23, and the motor M2 is connected to the knee joint 24 via the belt 36. Is connected to drive the crus 25. Further, a force sensor 30 is disposed in the vicinity of the knee joint portion 24 so as to be able to detect torque when bending and stretching, and to detect changes in rotation and torsion (acceleration, strength) of the knee joint portion 24. The critical point of the bending angle of the knee joint portion 24 can be adjusted by changing the installation angle of the knee joint stopper 30 by operating the knee joint stopper adjusting screw 35.

In the figure, reference numeral 32 denotes a lower limb fixing knob, 33 denotes a lower limb rotation locating pin, and 34 denotes a hip joint stopper adjusting screw. The critical point of the bending angle of the hip joint section 22 can be changed by the hip joint stopper adjusting screw 34. Further, by removing the lower limb rotation locating pin 33 and loosening the lower limb fixing knob 32, the pelvis portion 21 can be rotated in a vertical plane with respect to the base 40, and the installation angle of the pelvis portion 21 and the portion connected thereto is necessary. It can be arbitrarily adjusted according to.

(Details of lower limb joints)
Details of the lower limb joint of the lower limb rehabilitation training robot will be described below. An example of a lower limb simulation robot capable of simulating various symptoms for use in the practice of a therapeutic technique for the knee joint, which is the most typical and important of physical therapy, will be described. A link mechanism that drives a hip joint and a knee joint with a DD (Direct Drive) motor is incorporated into a model formed of a foamed resin and a flexible resin simulating the lower limbs of a human body. A 6-axis force sensor is built in the lower leg. The motor and sensor are connected to the computer via a drive circuit and an IO interface. The computer feeds back the sensor signal to perform impedance control and simulates the viscoelastic characteristics of the joint. Various symptoms can be selected by the user interface on the computer, and the procedure is recorded and evaluated.

(Details of knee joint)
In order to simplify the description, the upper and lower thighs are defined as first and second parts 12 and 13 by a uniaxial joint (hinge joint), respectively. If a drive motor is connected to the joint 11, it is possible to perform automatic bending / extension (from a normal sitting position to a complete extension, etc.). Appearance / outer surface should be similar in appearance and feel to human knees. Here, the motor M connected to the joint 11 is controlled by the computer 17, and when the joint 11 undergoes rehabilitation training and is bent and stretched, a change in the movement is detected by the sensor 16, and the computer 17 is preliminarily determined according to the case. The rotation position of the joint 11, the rotation acceleration, and the like are detected and responded by the program preset in the above.

For example, if the motor M is controlled and driven in the forward direction with respect to the rotation of the joint 11, the rotation is light, and if it is controlled and driven in the reverse direction, the resistance increases and the rotation becomes heavy. This linkage between the detection of the position, acceleration, etc. and the control of the motor M obtains a feeling very similar to a human body by controlling the motor M at a high speed, for example, about 1000 times per second. It should be noted that the change in resistance when the joint is passive can be achieved similarly by using a DD motor as well as a control system using a fluid resistance such as a torque converter.

(General description of the motor control system)
In order to simulate the characteristics of a human joint, for example, in the case of a motor that can accept a torque command, a command represented by the following expression is sent every time based on the measured value of the joint angle.
(Formula 1)

(Formula 2)

(Formula 3)

Further, the control of the motor is variable in strength and pattern (multiple levels of strength setting such as 0-5 can be switched on the manual strength test). In addition, regardless of whether motor control is applied to the joint 11, the joint 11 can bend and stretch (the operator practices bending and stretching). The quality of the treatment is evaluated by sensing the increase or decrease in resistance and comparing it with a model pattern preset in a computer connected in advance (evaluation based on the amount of deviation from the standard model pattern). Further, when a twisting / drawing force exceeding a preset size or strength is applied, a warning sound can be emitted from the speaker, or an abnormality can be notified by heat generation, discoloration, display image, etc. of the joint portion.

That is, the joint 11 is provided with a sensor 16 that can detect rotation and twist and detect the magnitude and speed of the change. This sensor 16 has a reaction of amplification of bending force with respect to gradually increasing resistance. For example, when the practitioner bends the knee quickly, the resistance increases, and when the operator slowly bends, the resistance decreases. By sensing this change in resistance value, the degree of force application is determined as the degree of change (acceleration) in the rotational speed of the joint 11. Further, the degree of bending of the joint 11, that is, the degree of change may be detected by a stopper, or the stopper function may be provided by detecting the rotation angle. The limit (critical point) of the rotation angle in this case can be arbitrarily changed and set, and can be changed according to the progress of a predetermined process by the learning function.

(Usage method 1 above: In the case of rehabilitation training when the knee cannot be bent)
In the case of rehabilitation education corresponding to a case where it is difficult to sit straight due to pain in the knee, a range of 180 degrees backward from the state where the lower leg 25 is extended to the tip of the thigh 23 via the knee joint 24. In this process, the bending angle is increased in the process of bending after the angle of 130 degrees is exceeded. For example, assume that the bendable angle is expanded from 130 degrees to 180 degrees by 10 treatments.

FIG. 9 shows a state at the beginning of training, and the lower leg 25 can be bent only 130 degrees later with respect to the thigh 23. That is, the initial critical point is set to 130 degrees. Here, training is started along the flow as shown in FIG. 8, and when the trainee's training is within an allowable range, the critical point is improved by one and the lower leg 25 is bent to 135 degrees. It is set so that it is memorized and completed. If the trainee's training deviates from the allowable range, the critical point is not changed, and is memorized at the same level as the previous time.

FIG. 10 shows the middle state of the above training, and the critical point has been improved to 155 degrees. In FIG. 11, the critical point has reached 180 degrees in the final state, and it has recovered to a state where it can be substantially seated. Rehabilitation training in the state of being.

In the above example, the lower limb is taken as an example, but other parts such as the shoulder, upper limb, neck, and waist can be applied by inputting a program having a pattern corresponding to each case as needed. It is.

For example, when the present invention is used for practical training of a knee joint treatment technique, the knee can be actively bent and stretched, and the bending and stretching force that resists external force can be changed variously. Practice muscular strength tests (rehabilitation training, education). That is, it can bend and stretch passively according to external force (by bending and stretching by the operator), the resistance force at that time can be varied, and a change in resistance force (viscosity resistance) according to speed can be simulated. The force exerted by the practitioner is measured and a warning is issued if improper twisting or pulling force is applied. Simulate the patient's response to treatment. For example, a reaction that the extension force increases as the practitioner repeats the operation of applying resistance to knee extension can be realized in a simulated manner.

In this way, for example, instead of the students being trained in training courses at a physical therapist training school, instead of just practicing the treatment of the practitioner, the device of the present invention is merely used to detect the movable allowable range. In addition, since it is possible to sense and evaluate changes in the force applied to reach the set allowable range, there is a great advantage that training can be performed with a feeling very similar to an actual human being. In addition, since it is a robot rather than a human being, it can be repeatedly trained until it is accepted, so it can be expected to improve the training efficiency.

In addition, it is possible to change the state of the joint according to the operation training by giving the learning function to the program incorporated in the computer, and experience that the function of the patient is changed (improved) by the accumulation of the operation training. It is possible to perform training at a level that could not have been experienced until now. And since these can be experienced as much as necessary when needed, the advantage that many trainees can acquire advanced skills in a short time is great.

In order to improve such a situation, the present inventors have conducted various studies, and as a result, have developed a patient simulation robot for education of the present invention that serves as a practice base for rehabilitation instead of humans. This robot is controlled and managed by a computer, and can simulate various malfunction symptoms by switching programs. In addition, a positive (satisfactory) or negative (warning) response simulating a human according to the treatment technique based on various sensor signals is shown. It also enables quantitative evaluation (scoring) of the procedure.

Furthermore, if evaluation is obtained quantitatively on the spot, it is easy to draw out student motivation. In addition, you can experience treatments for patients with various symptoms in a simulated manner before putting yourself in the actual medical field. Therefore, by introducing the present invention, it can be expected that a highly capable physical therapist can be sent to society.

The schematic conceptual diagram of one Example of this invention. The schematic conceptual diagram of a joint part same as the above. The schematic of the whole system same as the above. The top view of a lower limbs rehabilitation training robot same as the above. The side view which served as operation | movement description same as the above. The flowchart which shows an example of the process of the apparatus using the same as the above. Schematic which shows an example of evaluation of a treatment same as the above. The flowchart in case a symptom eases by training same as the above. Schematic which shows the initial state of an example of evaluation in case a symptom eases by training same as the above. Schematic which shows the state of the middle period of an example of evaluation in case a symptom eases by training same as the above. Schematic which shows the final state of an example of evaluation in case a symptom eases by training same as the above.

Explanation of symbols

11 Joint 12 First member
13 Second member 16 Sensor 17 Computer M Motor

Claims (8)

It is possible to measure changes in the load that is applied to a joint that is composed of a joint of two rotatable members in a computer in which a standard rehabilitation mode according to the case has been input in advance by predetermined training. A patient simulation robot for rehabilitation education characterized by being connected so that evaluation is possible in comparison with the mode. A joint that is configured by joining two rotatable members to a computer in which a standard rehabilitation mode according to the case is input in advance, and the rotational resistance of the joint portion is configured to be variable according to the case. A patient simulation robot for rehabilitation education, wherein a change in a load received by predetermined training can be measured and can be evaluated in comparison with the standard treatment mode. The patient simulation robot for rehabilitation education according to claim 1 or 2, wherein the standard treatment mode can be shifted to the recovery mode by stacking predetermined training. The patient simulation robot for rehabilitation education according to any one of claims 1 to 3, wherein a plurality of standard treatment modes can be selected and selected according to a case. The rehabilitation according to any one of claims 1 to 4, wherein the computer records each operation training result for each operation trainee, calls the record to start the operation training, and can re-record and re-record. Patient simulation robot for education. The patient simulation robot for rehabilitation education according to claim 1, wherein the robot reacts according to the degree of excessive pressurization. 7. The patient simulation robot for rehabilitation education according to claim 1, wherein the measurement of the load change includes both the rotation direction and the twist direction of the joint. The standard treatment mode of the load change applied by rehabilitation training is input to the computer in advance for the joint constituted by joining two rotatable members, and the change of the load received by the joint is measured by the trainee's rehabilitation training. A rehabilitation education method characterized in that the evaluation is performed in comparison with the standard treatment mode.