JP2007044160A - Rehabilitation training apparatus for finger exercise - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a rehabilitation training apparatus for finger exercise which is achieved by the application of an observation that plastic changes in a brain can be induced by an experiment using an animal. <P>SOLUTION: The rehabilitation training apparatus for finger exercise keeps a board hollowed and an object with a very small dimension housed in the hollow so that a user works hard to hold the object with the very small dimension in the hollow, thereby accomplishing a training for finger exercise. Moreover, the rehabilitation training apparatus for finger exercise keeps a plurality of hollows arranged with differences in the opening area and depth of the hollows, and the board shaped like a disc and supported by its body part so as to be freely rotatable about the center axis while the plurality of hollows with their opening areas and depths made different is arranged about the center axis of the board. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a rehabilitation training apparatus for finger movement, and more particularly to a training apparatus configured to perform rehabilitation training in stages.

Conventionally, there are several rehabilitation devices aiming at finger function recovery. These can be broadly classified into devices that passively extend or bend fingers (for example, see Patent Documents 1, 2, and 3) and devices that apply finger muscle strength (for example, see Patent Document 4).
JP-A-2005-80872 JP 2004-298573 A JP 2002-95771 A JP 2001-346855 A

  The number of patients suffering from sequelae such as stroke exceeds 1.5 million. In particular, it is difficult to recover the function of finger movements, and it is not uncommon for people to give up using the hand on the disabled side. Currently, the devices described in Patent Documents 1 to 4 above are proposed as rehabilitation devices for restoring the function of the fingers, but all of them have poor scientific basis and quantitatively evaluate the progress of training. There were many problems, such as being unable to.

In order to aim for functional recovery of finger movement, it is necessary to reconstruct a neural circuit for finger movement by making maximum use of the plasticity (flexibility) of the remaining area of the brain.
The present invention is a rehabilitation training apparatus for finger movement applying knowledge known to induce plastic changes in the brain through animal experiments,
(1) Rehabilitation training is performed in stages by preparing multiple indentations with different levels of difficulty.
(2) Assessing the functional recovery of finger movements by quantifying daily task results,
(3) By installing a camera on the board with the indentation, the finger movement is photographed at a close range, the movement of the finger photographed by the camera is analyzed, and it is used as an index of function recovery.
An object of the present invention is to provide a rehabilitation training apparatus for finger movement that can be performed.

In order to achieve the above object, the rehabilitation training apparatus for finger movement according to the present invention is provided with a recess in a board, storing a small-sized object that can be stored in the recess, and grasping the object in the recess with a finger. It is characterized by performing finger movement training.
The rehabilitation training apparatus for finger movement according to the present invention is characterized in that a plurality of depressions are provided, and the opening area and depth of each depression are made different.
The rehabilitation training apparatus for finger movement according to the present invention has a board shape and supports the board by a main body so as to be rotatable about the central axis, and has a plurality of openings having different opening areas and depths. The indentation is arranged around the central axis of the board.
The rehabilitation training apparatus for finger movement according to the present invention is characterized in that a camera is installed in a body portion supporting a board toward a recess at a training position.
Moreover, the rehabilitation training apparatus for finger movement of the present invention is characterized by providing an analysis means for analyzing the movement of a finger taken by a camera.

The present invention has the following excellent effects.
(1) This device is a rehabilitation training device based on scientific knowledge, and since the difficulty of the task can be adjusted freely by changing the opening area and depth of the dent, from the early stage to the late stage of recovery Consistent training is possible.
(2) The progress of functional recovery can be grasped by the success rate of the task of taking out a small-sized object in each recess. This is an index that is easy for the patient to understand.
(3) By installing a small camera on the device and analyzing the captured images of finger movements, it is possible to analyze changes in finger movements in detail and quantitatively determine the degree of progress or function of training. Can be evaluated.
(4) By using this device, it is difficult for the finger to move independently, so the recovery of the finger can be performed independently from the previous period of recovery where only compensatory grasping using the movement of the entire palm is possible. It is possible to perform consistent rehabilitation training up to the later stage.
(5) It has been clarified by animal experiments that brain function is restored by rehabilitation training using this device. Because of scientific support, patients can be trained with peace of mind.

  The best mode for carrying out the rehabilitation training apparatus for finger movement according to the present invention will be described below with reference to the drawings based on the embodiments.

FIG. 1 is a perspective view showing an appearance of a rehabilitation training apparatus for finger movement.
A disk-shaped board 5 is supported on a main body 3 including a base 1 and a support frame 2 standing from the base 1 so as to be rotatable around a central axis 4.
The disk-shaped board 5 is provided with recesses (hereinafter also referred to as “wells”) 6 having different opening areas and depths. Although FIG. 1 shows a plurality of cylindrical recesses having different diameters and depths, the shape of each recess is not limited to a cylindrical shape, but a mortar shape in which the lower portion of the cylindrical portion is conical, and the cross section is elliptical. Various shapes such as an elliptic cylindrical shape, a rectangular parallelepiped shape, and a convex shape in which a lower portion of the rectangular parallelepiped bulges downward can be adopted. The number of wells 6 is not limited to seven, and is set as appropriate according to the content of training.
The disk-shaped board 5 can be removed from the main body 3 by removing the clasp 16 and a well 6 suitable for the patient's condition and finger length can be easily provided by using a work drill. Can do. The disk-shaped board 5 is released from being fixed and can be freely rotated by pulling the knob 7 while being supported by the main body 3. When the knob 7 is released, the movement of the board 5 in the rotational direction is fixed when any of the wells 6 reaches the training position indicated by 11.

The patient performs rehabilitation training using a finger by performing a task of taking out an object 8 of a small size (a size that can be grasped by the whole palm at the maximum) stored in the well 6 at the training position 11 in advance. is there. As the small-sized object 8, a small spherical, red bean shape, complex shape, cylindrical shape, or crushed stone shape that can be accommodated in a well 6 such as a pachinko ball made of metal, ceramics, or synthetic resin is used. In some cases, by using food as the object 8, it is considered that the patient's motivation for rehabilitation can be reduced. In FIG. 1, a small spherical object 8 is shown as the small-sized object 8.
In the process of recovering the function of a finger, there is often a change from grasping using the entire palm to grasping a thumb with the thumb and index finger opposed (hereinafter, sometimes referred to as “precision grasping”). Therefore, it is desirable that the largest one of the size of the well 6 can grasp a small sphere with the entire palm, and the smallest one of the size of the well 6 needs to be grasped using a precise grasp. desirable. Furthermore, by setting up a well 6 having an intermediate size and performing training using small wells in stages, it is possible to aim at recovery of precise grasp.

  A small camera 9 is installed in the apparatus in order to photograph the movement of the finger while performing the task from a close range. By integrating the apparatus and the camera 9, the distance between the finger at the training position 11 and the camera is always constant during the task. As a result, since the finger is always photographed from the same position even when the photographing dates and times are different, it is possible to compare in detail the change in finger movement when the function is restored. The projector 9 is provided with a projector 10, which can illuminate a shooting area that tends to be dark as a shadow of a hand, and a clearer image can be obtained. By making the circular board 5, the camera 9, and the projector 10 into a single unit and reducing the size of the entire apparatus, it is possible to carry the apparatus, and for example, training can be performed easily while riding on a wheelchair or on a bed. Since the patient can perform training using the right hand and training using the left hand, a camera mounting portion is provided on the opposite side 12 of the apparatus so that the camera position can be switched.

  If necessary, two more cameras can be used to capture images from different angles, and three-dimensional reconstruction of images can capture more detailed changes in finger movement. FIG. 2 shows a schematic diagram when two cameras 9 and 9 are installed in the apparatus. The two cameras 9 and 9 are both focused on the training position 11. Each of the cameras 9 and 9 is connected to an image recording device 13 so that necessary moving images can be recorded and image analysis can be performed.

  As a training sequence, first, the largest well 6 is used for training for about 1 hour a day, and if the fixed number of small-sized objects, for example, 1000 objects can be grasped per day, the next day is the next size. Go to well 6 and do the same training. In FIGS. 1 and 2, reference numeral 14 is a pilot hole indicating a position for installing a spare well 15 (one-dot chain line), and training has been stagnant due to a sudden decrease in the size of the well 6 formed in advance. In some cases, a medium-sized well 15 is further provided, and training is performed alternately on a plurality of wells to promote the progress of functional recovery. In addition, the degree of recovery can be quantitatively shown by performing test tasks about 10 times daily in each well 6. In order to form the spare well 15 at the position of the lower hole 14, the board 5 may be removed and the spare well 15 may be formed using the lower hole 14. The spare well 15 can be formed in advance in the same manner as the other wells 6. In that case, the total number of wells is eight.

  FIG. 3 shows the result of an experiment for confirming the effect of this apparatus using a model animal. As a model animal, a Japanese monkey having a finger movement characteristic close to that of a human was used. The upper part shows the changes in the task results performed using this device. The task results in the largest well are shown by a solid line, and the changes in the task results in the smallest well are shown by a broken line. The horizontal axis shows the number of days after damage (Days after revision), and the vertical axis shows how many times each test was performed 10 times a day for each well. Indicates the success rate of the task. When artificial brain injury was created in the motor cortex of the Japanese monkey, motor paralysis of the upper limbs occurred, and the task could not be performed for the first approximately 10 days after injury. This corresponds to a state in which a part responsible for exercise is damaged due to brain infarction or the like in the case of a human being. From the 10th day after the injury, the task score gradually increased while repeating the rise and fall, and the task score improved to the same extent as the pretraining at 45 days after the injury. The lower row shows a series of photographs of finger movements taken before and after injury taken by this device. The captured video was processed and the lines connecting the joints of the fingers were superimposed on the photo. Before damage (Before region), grasping by so-called precise grasping, in which a thumb and forefinger were opposed to pick up a small-sized object, was observed. On the 21st day after injury, there was a temporary increase in task performance. At this time, the thumb was bent along with the bending of the index finger. I knew the object. On the 45th day after the injury, each finger can move independently, and the grasp of the tip of the thumb and index finger can be seen again.

  In FIG. 4, the grasping method when grasping a small-sized object is classified according to the relationship between the small-sized object and the thumb. As shown in the upper and middle figures, the grasping method is as follows: 1. Grasp the index finger tip and thumb beyond the IP joint. 2. grasping of the tip of the index finger and the thumb on the IP joint; 3. grasping the tip of the index finger and the inner side of the noble bone of the thumb; 4. Grasp between index finger tip and thumb IP joint and MP joint; The index finger tip and thumb grasp on the MP joint were classified into five. The lower part shows the change over time of the ratio of the five types of grasping methods on each experimental day. Before the damage, 100% was the number one grasping method, and grasped with the tip of the thumb. On the 21st day after injury, grasp near the MP joint of the thumb (second joint counted from the fingertip, 4.5. In FIG. 4), and on the 31st day, the thumb IP joint (one counted from the fingertip) It turned out that it was grasped in the vicinity of the joint of the eye, 2.3.) In FIG. On the 45th day after the injury, 100% were grasped using the tip of the thumb as before the injury.

  FIG. 5 shows the time change of the angle between the thumb and the index finger in one grasp. The horizontal axis represents time (milliseconds), and the vertical axis represents the angle between the thumb and index finger. Before the injury, the angle between the thumb and the index finger was stably within 90 degrees, whereas on the 21st or 31st day after the injury, the angle between the thumb and the index finger increased with time. The angle at the time of grasping the object was about 160 degrees or 220 degrees. Although the angle change on the 45th day after the damage is not exactly the same as before the damage, the angle at the time of grasping the small ball is within 90 degrees, and it can be said that the angle approached before the damage.

  FIG. 6 schematically shows the results of a behavioral experiment using a model animal that has undergone rehabilitation training using this apparatus. This device showed a recovery of the precise grasp of the monkey that created the experimental brain injury. In the process of recovery, a compensatory grasp was seen near the thumb joint, and then a precise grasp using the tip of the thumb became possible.

  FIG. 7 shows an individual (training individual) who has been trained using the present apparatus and an individual who has not been trained using the present apparatus after creating the same degree of damage to the motor cortex in the brains of two Japanese monkeys. This shows the change in task performance of (untrained individuals). As in FIG. 3, the task results in the maximum size well are indicated by solid lines, and the change in the task results in the minimum size wells are indicated by broken lines. The horizontal axis indicates the number of days after damage (Days after version), and the vertical axis indicates the success rate of the task. Non-trained individuals showed little improvement in task performance in small wells.

  FIG. 8 schematically shows the difference in finger movement between the training individual and the non-training individual. The trained individuals showed independent finger movements on the 45th day after injury, whereas the non-trained individuals did not see independent finger movements, and precise grasping was impossible. From this result, it is considered that rehabilitation training using this device may promote recovery of independent finger movement.

  FIG. 9 is a diagram in which genetic changes in the brain were examined in the function-recovered individuals trained by this apparatus. In the functionally restored individuals, the expression of the gene GAP · 43 was increased, particularly in the brain region called the premotor cortex, compared to the normal individuals. This molecule is known to increase in expression with changes in the neural circuit of the brain, and as a result of training with this device, reconfiguration of the neural circuit compensates for the function of the lost brain region. Suggests that this is happening in the brain. None of the rehabilitation devices that have been proposed so far are known to induce reconfiguration of neural circuits in the brain. Although it is undeniable that neural network reconfiguration may occur during training with other devices, using scientifically-supported tasks, such as those using this device, will reinforce patient rehabilitation in a long and difficult rehabilitation life. It helps to improve.

It is a perspective view which shows the external appearance of the rehabilitation training apparatus for finger movement which concerns on embodiment of this invention. It is a perspective view which shows the external appearance at the time of installing two cameras in the rehabilitation training apparatus for finger movement which concerns on embodiment of this invention. The result of the experiment which confirmed the effect of the rehabilitation training apparatus for finger movement which concerns on embodiment of this invention using a model animal is shown. The grasping method when grasping a small-sized object is classified according to the relationship between the small-sized object and the thumb. This is a result of examining the time change of the angle between the thumb and the index finger in one grasp. The result of the behavior experiment by the model animal which performed rehabilitation training using the device concerning an embodiment of the invention is shown typically. An individual (training individual) who performed training using the device according to the embodiment of the present invention after creating the same degree of damage to the motor cortex in the brains of two Japanese monkeys and the embodiment of the present invention It shows the change in task performance of an individual who did not train using the device (non-training individual). It shows schematically the difference in finger movement between a training individual and a non-training individual. It is the figure which investigated the gene change in a brain in the function recovery individual | organism | solid which performed the training with the apparatus which concerns on embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Base 2 Support frame 3 Main-body part 4 Center axis 5 Board 6 Recess (well)
7 Knob 8 Small object 9 Camera 10 Projector 11 Training position 13 Image recording device 14 Spare well pilot hole 15 Spare well 16 Clasp

Claims (5)

  For finger movement, characterized in that a depression is provided on the board, an object of a small size that can be stored in the depression is accommodated, and finger movement training is performed by grasping the object in the depression with a finger. Rehabilitation training device.   The rehabilitation training apparatus for finger movement according to claim 1, wherein a plurality of depressions are provided, and the opening area and depth of each depression are made different.   The board has a disk shape and is supported by the main body so as to be rotatable about the central axis, and a plurality of depressions having different opening areas and depths are arranged around the central axis of the board. The rehabilitation training device for finger movement according to claim 1 or 2.   The rehabilitation training apparatus for finger movement according to any one of claims 1 to 3, wherein a camera is installed on a main body supporting the board toward a hollow at a training position. 5. The rehabilitation training apparatus for finger movement according to claim 4, further comprising analysis means for analyzing movement of a finger photographed by a camera.